Stress Disorder In Adolescents Research Articles

Depression and posttraumatic stress disorder in adolescents with nonsuicidal self-injury: comparisons of the psychological correlates and suicidal presentations across diagnostic subgroups.

Nonsuicidal self-injury (NSSI) combined with suicide ideation increases the risk of suicidal behaviors. Depression and posttraumatic stress disorder (PTSD) are comorbidities of NSSI compounding this relationship. The present study compared diagnostic subgroups of NSSI based on current depression and PTSD on psychological correlates (i.e., vulnerabilities and impairment) and suicidal presentations (i.e., suicidal cognitions and behaviors) in a psychiatric sample of adolescents. Eighty-seven adolescents meeting DSM-5 criteria for NSSI and 104 age-range-matched nonclinical controls (NC) participated. Participants completed self-report measures on psychological vulnerabilities and impairment (e.g., emotion regulation difficulties, negative cognitions). Adolescents with NSSI also completed clinical interviews on psychiatric diagnoses and a recent self-injurious behavior (SIB). Scores on the psychological correlates of NSSI were compared between adolescents with NSSI and NC, and across three diagnostic subgroups of NSSI (A: NSSI+/depression-/PTSD-, n = 14; B: NSSI+/depression+/PTSD-, n = 57; C: NSSI+/depression+/PTSD+, n = 14). Differences between NSSI diagnostic subgroups were tested on the motives for SIB and accompanying suicidal presentations (e.g., desire, intent, motive, lethality). Common comorbidities of NSSI included depression, panic disorder, generalized anxiety disorder, and PTSD. The NSSI subgroup classification was significantly associated with panic disorder, which was controlled for in the subsequent group comparisons. Overall, adolescents who engage in NSSI with vs. without depression reported more psychological vulnerabilities and impairment and a greater degree of suicidal thoughts/desire in SIB (i.e., groups B, C >A), which remained significant after controlling for panic disorder. An increased odds of the suicidal motive for SIB was found in adolescents with all three conditions (i.e., group C: NSSI+/depression+/PTSD+) compared to those with NSSI but neither depression nor PTSD (i.e., group A: NSSI+/depression-/PTSD-); however, this was not significant after controlling for panic disorder. Psychological underpinnings of adolescent NSSI in clinical contexts may be largely associated with concurrent depression. Suicidal motives in adolescents who engage in NSSI in the presence of depression and PTSD may be confounded by the co-occurrence of panic disorder. This study warrants the importance of attending to the comorbid depression with NSSI in adolescents as it is related to an increase in suicidal desire accompanying SIB.

Predictors of Post-Traumatic Stress Disorder in Adolescents: Loneliness and Self-Compassion

Predictors of Post-Traumatic Stress Disorder in Adolescents: Loneliness and Self-Compassion

Post-traumatic stress disorder in adolescents during the COVID-19 pandemic: a cross-sectional Tunisian study

ObjectivesEvaluate the prevalence of post-traumatic stress disorder (PTSD) on Tunisian adolescents enrolled in secondary schools during the COVID-19 pandemic and to identify associated factors.MethodsWe conducted a cross-sectional, descriptive, and analytic study on a sample of Tunisian adolescents. Participants were randomly selected from two schools in the region of Hamma (southern of Tunisia). This survey took place during the period extending from 5 March to 26 May 2021. Students were asked to complete a pre-established information sheet which contains questions about socio-demographic features, medical history, knowledge about the pandemic of COVID-19, and personal or family history of being infected with this virus. The Child PTSD Symptom Scale (CPSS) was used to screen for PTSD among students.ResultsThe sample was composed of 326 students (92 boys and 234 girls; mean age 16.65 years). The prevalence of PTSD was 37.4% according to the CPSS. Adolescents had more PTSD symptoms when they lived in a conflictual family atmosphere (AOR = 3.1 [1.4–6.9]). Moreover, adolescents who were infected by the virus, or whose relatives were contaminated or dead because of the COVID-19 infection, were more likely to develop PTSD symptoms. We stated that students who estimated that their knowledge about the COVID-19 pandemic were insufficient had a significant higher risk for PTSD (AOR = 2.5 [1.4–4.6]).ConclusionStudents seemed to have high frequency of PTSD symptoms during the COVID-19 pandemic. The identification of risk and protective factors are interesting to guide screening and prevention actions.Key points• Adolescents were vulnerable to psychological distress during COVID-19 pandemic, they were more exposed to develop post-traumatic stress disorder.• A total of 37.4% was the prevalence of PTSD among Tunisian adolescents. Sufficient information about the pandemic was protective. Conflictual family atmosphere constitutes a risk factor.• Family and social efforts should be directed toward supporting teenagers to cope with the pandemics’ mental health burden.

Effect of Audio-Visual-Based Art and Music Therapy in Reducing Adolescents Post Traumatic Stress Disorder

PurposePost-traumatic stress disorder (PTSD) is a severe anxiety disorder that can develop due to exposure to any event that may result in psychological trauma. This study compared the effect of interactive audio-visual-based art and music therapy in reducing post-traumatic stress disorder in adolescents who survived abduction in Nigeria. MethodsA quasiexperiment was carried out in two selected secondary schools in Northern Nigeria. The study sample comprised 470 students randomly divided into a control group of 235 and an experiment group of 235. The treatment group was further divided into art 118 and music 117 therapy groups, respectively. ResultsResults suggest that interactive audio-visual art therapy and music therapy is an effective intervention strategy for reducing the PTSD of school adolescents that have experienced kidnapping in Nigeria. However, art therapy is more effective in reducing PTSD than music therapy. DiscussionWe recommend the introduction of audio-visual-based music and art therapy to reduce the PTSD of adolescents that survived kidnapping in Nigeria. More focus should be made on art therapy, which is more effective in curtailing adolescents PTSD.

Resilience as Mediator in Relation to Parental Attachment and Posttraumatic Stress Disorder in Adolescents Following the Yancheng Tornado.

Resilience and secure parental attachment have been proven as important factors to alleviate the posttraumatic stress disorder (PTSD). However, the effects of the two factors on PTSD and the mechanisms of its effect at different time points in the aftermath of trauma are still unclear. This study explores the relationship among parental attachment, resilience, and development of PTSD symptoms in adolescents from a longitudinal perspective following the Yancheng Tornado. Using cluster sampling method, a total of 351 Chinese adolescents, survivors of a severe tornado, were tested on their PTSD, parental attachment and resilience at 12-months and 18-months after experiencing the natural disaster. The results showed that our proposed model fit the data well: χ2/df = 3.197, CFI = 0.967, TLI = 0.950, RMSEA = 0.079. It revealed that the resilience at 18-months partially mediated the relationship between parental attachment at 12-months and PTSD at 18-months. Research results showed that parental attachment and resilience are key resources for coping with trauma.

Use of Prazosin for Post-traumatic Stress Disorder in Adolescents is Associated with Longer Inpatient Psychiatric Hospitalization

Objectives: Prazosin has been shown to be effective in reducing PTSD-related nightmares in adolescents in outpatient studies with modest sample sizes. There are no data on the effects of prazosin on length of inpatient psychiatric hospitalization. Given prazosin’s adverse effects, we hypothesize that prazosin initiation during inpatient psychiatric hospitalization is associated with prolonged length of stay.
 Patients and Methods: Retrospective chart review identified 255 psychiatric admissions of adolescents with PTSD from 2012-2017 at an academic medical center. The treatment group comprised 101 admissions during which prazosin was initiated. Given a lack of rating scales, number of concurrent diagnoses and discharge medications were used to approximate overall illness severity.
 Results: There were no statistical differences between the treatment and non-treatment (control) groups with respect to age, gender, number of diagnoses or discharge medications. The mean dose of prazosin was 1.5±0.7 mg nightly with mean duration of 7.6±6.1 days. Length of hospital stay was significantly longer for the prazosin group compared with controls (11.1±6.6 vs 9.5±5.8 days, p=0.04). There was no difference in rates of orthostatic hypotension between groups. Adverse reactions were observed in 41% of individuals taking prazosin with a discontinuation rate of 14% due to intolerable side effects, lack of efficacy or request to reduce polypharmacy.
 Conclusions: Treatment with prazosin during inpatient psychiatric hospitalization may be associated with increased length of stay for adolescents with PTSD. Further studies are needed to validate these results.

The modular structure of posttraumatic stress disorder in adolescents

The modular structure of posttraumatic stress disorder in adolescents

Faktor Determinan Sosial Risiko Post Traumatic Stress Disorder (PTSD) Pasca Kejadian Bencana Tsunami Selat Sunda

<p>The Tsunami of the Sunda Strait in December 2018 resulted in many losses, fatalities, and infrastructure. The psychological impact that often occurs during a catastrophic event is Post Traumatic Stress Disorder (PTSD) and if a teenager experiences it will have an impact on life in the future. The purpose of this study was to analyse the social determinants associated with PTSD in post-Tsunami Banten. This research is a quantitative study with a cross-sectional study design with a sample size of 125. The sampling technique uses Proportional to Size (PPS) and Simple Random Sampling. Data analysis using Fisher's Exact test. Factors related to the risk of Post Traumatic Stress Disorder (PTSD) are family support (p-value 0,042<0,05) and peer support (p-value 0,021<0,05) significantly related to the risk of Post Traumatic Stress Disorder in adolescents in SMPN 2 Labuan. However, volunteer support and support of religious leaders do not have a significant relationship with the risk of Post Traumatic Stress Disorder (PTSD). Support of family and friends are risk factors PTSD in adolescents at SMPN 2 Labuan after the Sunda Strait tsunami disaster in December 2018. There needs to be socialization related to post-disaster mental health management to parents and peers.</p>

Journal Digest: Acyl Ghrelin and PTSD; MH Appointment and Follow-up Care; Neurons and Dissociation; Fatty Acid and Autism

Journal Digest: Acyl Ghrelin and PTSD; MH Appointment and Follow-up Care; Neurons and Dissociation; Fatty Acid and Autism

Association of Acyl-Ghrelin With Posttraumatic Stress Disorder in Adolescents Who Experienced Severe Trauma

Association of Acyl-Ghrelin With Posttraumatic Stress Disorder in Adolescents Who Experienced Severe Trauma

Health-Related Quality of Life and Costs of Posttraumatic Stress Disorder in Adolescents and Young Adults in Germany.

BackgroundPosttraumatic stress disorder (PTSD) is one of the psychopathological consequences of sexual and/or physical abuse. The economic burden is assumed to be high, whereas health-related quality of life and education is negatively affected. This study aims to determine health care costs, health-related quality of life, and educational interruption in adolescents and young adults with PTSD after sexual and/or physical abuse in Germany.MethodsThis analysis used data of 87 participants aged 14–21 years of a randomized controlled trial. Health care utilization, health-related quality of life (EQ-5D-5L), sick leave days, productivity, and delay or failure to achieve educational aims were assessed. Health care costs from a payer perspective were calculated using unit costs for the year 2014.ResultsMean health care costs for a six-month period were 5,243€ (SE 868€). In particular, costs of inpatient stays in psychiatric hospitals, general hospitals and rehabilitation as well as child welfare institutions were high. In addition, health-related quality of life was lower due to anxiety/depression, resulting in a mean EQ-5D index and EQ-VAS score of 0.70 and 61.0, respectively. Furthermore, participants reported on average 27 sick leave days, a productivity loss of 61%, and a delay in education attainment as well as having been unable to achieve educational aims.ConclusionPTSD in adolescents and young adults is associated with a high economic burden. Health-related quality of life was substantially reduced. Furthermore, delay and productivity losses in education were observed.Clinical Trial RegistrationGerman Clinical Trials Register identifier: DRKS00004787; date of registration: 18th March 2013; https://www.drks.de.

A Systematic Review of the Effect of Social Support on Post-Traumatic Stress Disorder in Post-Earthquake Adolescents

Introduction: Earthquakes can cause mental health disorders in adolescents, one of which is post-traumatic stress disorder (PTSD). The present study aimed to assess the effect of social support on post-traumatic stress disorder in adolescents after an earthquake.Methods: The study was a systematic review with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach. Articles were searched for using the Scopus, ScienceDirect, ProQuest, EBSCO and SAGE databases before classifying them into 3 categories: prevalence, risk factors, social support, and post-traumatic stress disorder. The inclusion criteria regarding the literature were documents that were original; where the source was from a journal; where the article was written in English and where the full text was available. The age of the subjects in the articles was determined to be in the range of 10-20 years old. The publication time limit was 2015 to 2020.Results: Adolescents who experienced an earthquake were found to demonstrate a high prevalence of post-traumatic stress disorder with the proportion in girls being higher than boys. Showing social support has a significant effect on PTSD after an earthquake. The earthquake-related factors that were the most strongly associated with probable PTSD were feeling scared of dying and exposure to an earthquake.Conclusion: Social support and the prevalence rates of PTSD should be observed in more detail. These results indicate that it is important to provide and strengthen the social support available to reduce the risk and severity of post-traumatic stress disorder after an earthquake among adolescents.

Prolonged exposure therapy and supportive counselling for posttraumatic stress disorder in adolescents in a community-based sample, including experiences of stakeholders: study protocol for a comparative randomized controlled trial using task-shifting

BackgroundThere is a dearth of empirical evidence on the effectiveness of pharmacological and non-pharmacological treatments for adolescents with posttraumatic stress disorder (PTSD) in developing countries. The primary aim of the study is to examine the effects of prolonged exposure therapy compared with supportive counseling for adolescents with PTSD delivered by nurses trained as counselors.Methods/designA single-blind randomized clinical trial comprising 90 adolescents with PTSD using a permuted block design will be utilized. Nurses previously naïve to prolonged exposure and supportive counselling will be trained to provide these treatments at the adolescents’ high schools. Data collection will last from March 2014 to December 2017 and annually thereafter, dependent on the availability of funding.Participants will receive seven to fourteen 60 min sessions of prolonged exposure treatment (n = 45) or supportive counselling (n = 45). All assessments will be conducted before treatment, at mid-treatment, immediately after treatment completion, at 3-, 6-, and 12-month follow-up, and annually thereafter. It is hypothesized that PE-A will be superior to SC in reducing PTSD symptoms at post-treatment as measured by the CPSS-I administered by an independent evaluator. It is further hypothesized that PE-A treatment gains will be maintained at 3-, 6- and 12-month follow-ups and annually thereafter.DiscussionWhile early indications are that PE-A is an effective treatment for PTSD in adolescents, this study will help determine the effectiveness of PE-A in a South African, community setting (school-based) when task-shifted to nurses, as compared to SC.Trial registrationPan African Clinical Trials Registry: PACTR201511001345372, retrospectively registered 11 November 2015.

Prolonged exposure therapy and supportive counselling for post-traumatic stress disorder in adolescents: task-shifting randomised controlled trial.

Empirical evidence on the effectiveness of evidence-based treatments for adolescents with post-traumatic stress disorder (PTSD) in low-resource settings is needed.AimsTo evaluate the comparative effectiveness of prolonged exposure and supportive counselling in adolescents with PTSD. Sixty-three adolescents (13-18 years) with PTSD were randomly assigned to receive either of the interventions comprising 7-14 sessions of treatment (trial registration in the Pan African Clinical Trials Registry: PACTR201511001345372). The primary outcome measure was PTSD symptom severity, as independently assessed on the Child PTSD Symptom Scale at pre-treatment, post-treatment, and at 3- and 6-month follow-up. Participants receiving prolonged exposure experienced greater improvement on the PTSD symptom severity scale than those receiving supportive counselling (between group differences at post-intervention, mean 12.49, 95% CI 6.82-18.17, P<0.001; d = 1.22). A similar effect size was maintained at 3-month (d = 0.85) and 6-month (d = 1.02) follow-up assessments. Adolescents with PTSD experienced greater benefit from prolonged exposure treatment when provided by non-specialist health workers (nurses) in a community setting.Declaration of interestNone.

A pilot and feasibility randomised controlled study of Prolonged Exposure Treatment and supportive counselling for post-traumatic stress disorder in adolescents: a third world, task-shifting, community-based sample.

BackgroundThere is a dearth of empirical evidence on the effectiveness of pharmacological and nonpharmacological treatments for adolescents with post-traumatic stress disorder (PTSD) in developing country settings. The primary aim of this study was to demonstrate that Prolonged Exposure Treatment for Adolescents (PE-A) and supportive counselling (SC) are implementable by nurses in a South African context. A secondary aim was to perform a preliminary analysis of the effectiveness of registered nurses delivering either PE-A or SC treatment to adolescents with PTSD. It is hypothesised that PE-A will be superior to SC in terms of improvements in PTSD symptoms and depression.MethodA pilot, single-blind, randomised clinical trial of 11 adolescents with PTSD. Nurses previously naïve to Prolonged Exposure (PE) Treatment and SC provided these treatments at the adolescents’ high schools. Data collection lasted from March 2013 to October 2014. Participants received twelve 60–90-min sessions of PE (n = 6) or SC (n = 5). All outcomes were assessed before treatment, at mid-treatment, immediately after treatment completion and at 12-month follow-up. The primary outcome, PTSD symptom severity, was assessed with the Child PTSD Symptom Scale–Interview (CPSS-I) (range, 0–51; higher scores indicate greater severity). The secondary outcome, depression severity, was assessed with the Beck Depression Inventory (BDI) (range, 0–41; higher scores indicate greater severity).ResultsData were analysed as intention to treat. During treatment, participants in both the PE-A and SC treatment arms experienced significant improvement on the CPSS-I as well as on the BDI. There was a significant difference between the PE-A and SC groups in maintaining PTSD and depression at the 12-month post-treatment assessment, with the participants in the PE-A group maintaining their gains both on PTSD and depression measures.ConclusionThe treatment was adequately implemented by the nurses and well-tolerated by the participants. Preliminary results suggest that the delivery of either intervention led to a significant improvement in PTSD and depression symptoms immediately post treatment. The important difference was that improvement gains in PTSD and depression in the PE-A group were maintained at 12-month follow-up. The results of this pilot and feasibility study are discussed.Trial registrationPan African Clinical Trials Registry: PACTR201511001345372, registered on 11 November 2015.

Effectiveness of Cognitive Behavioral Therapy on the Reduction of Pathological Symptoms of Posttraumatic Stress Disorder in Adolescents

Effectiveness of Cognitive Behavioral Therapy on the Reduction of Pathological Symptoms of Posttraumatic Stress Disorder in Adolescents

Gender-Specific Predictors of Posttraumatic Stress Disorder in Adolescents: The Role of Problematic Substance Use and Interpersonal Relationships

Gender is an important risk factor for both posttraumatic stress disorder (PTSD) and substance use disorders (SUD) in adolescents; however, little is known about the influence of gender when considering their common co-occurrence. This study examined independent predictors of PTSD severity between genders in a Danish probability sample of 15- to 18-year-old males (n = 863) and females (n = 1,125). The results showed that drug abuse and avoidant attachment to best friends were significant predictors of PTSD severity in male adolescents, whereas alcohol abuse and the absence of posttraumatic social support from parents remained significant predictors for female adolescents. The results support the influence of gender-specific substance abuse patterns and dysfunctional interpersonal relationships on the PTSD severity of traumatized adolescents.

Post-traumatic stress disorder in adolescents in Lebanon as wars gained in ferocity: a systematic review.

Significance for public healthPost traumatic stress disorder (PTSD) in adolescents has been implicated in developmental impairments, mental and scholastic problems, alcohol and drug abuse, and antisocial behavior in its victims among others. Absence of review studies regarding the prevalence of PTSD in adolescents in Lebanon, a country plagued by decades of civil strife and external occupation and invasion, is noted. Such information may reinforce the need to develop national public health policies to identify PTSD in children and adolescents, provide them with counseling and treatment, and formulate prevention strategies to protect vulnerable youth from devastations of war.For decades, Lebanon was war-torn by civil strife, and occupation and invasion by neighboring countries. In time, these wars have escalated in intensity from sniping, barricading streets and random shelling of residential quarters to the use of rockets, aerial bombing, and heavy artillery. Adverse mental health effects are noted in times of war with post traumatic stress disorder (PTSD) as a main outcome. The aim of this study was to carry out a systematic review of published studies documenting the prevalence of PTSD in the adolescent population of Lebanon, to investigate the increase in these rates with the escalation of war intensity, and to examine PTSD determinants. A search strategy was developed for online databases (PubMed and Google Scholar) between inception to the first week of January 2013. Search terms used were PTSD, adolescents and Lebanon. Eleven studies reporting PTSD in adolescents met the inclusion criteria for a total number of 5965 adolescents. Prevalence rates of PTSD ranged from 8.5% to 14.7% for the civil war, 3.7% for adolescents with sensory disabilities, 21.6% for the Grapes of Wrath War, and 15.4% to 35.0% for the 2006 July War. Some increase in PTSD rates in time is noted. Type of trauma such as bereavement, injury, house destruction, and economic problems, low self efficacy and scholastic impairment were related to PTSD. These findings may help in the development of public health policies for PTSD prevention and treatment for the protection of adolescents from war atrocities and their consequences.

Severe War Trauma and Post-Traumatic Stress Disorder in Adolescents with Sensory Impairments: A Cross-sectional Study.

A paucity of studies of the psychological status of adolescents with sensory impairments in political conflict areas is noted. This study was set up to examine the exposure of adolescents with sensory impairments (ASIs) to severe war trauma and development of post-traumatic stress disorder (PTSD) as compared to their able-bodied peers (ABPs). It also answers the question whether their impairments have made them more resilient in facing traumatic events. A cross-sectional study of all ASIs attending special schools in three administrative districts in Lebanon (n=166) as well as a group of 166 age and sex-matched ABPs from neighboring schools was conducted. The Post Traumatic Stress Reaction Checklist for children (PTSRC) was used to assess exposure to severe trauma, PTSD and their determinants. ASIs reported a lower exposure to severe traumatic events (24.1%) as compared to their ABPs (69.9%), and risk factors for their exposure were an older age group, a fatherless family, and severe visual impairment. Prevalence rates for PTSD were similar in the two study groups (17.5% and 16.4%). Younger ASIs were at a significantly higher risk of developing PTSD. Lower exposure to trauma among ASIs points to the more sheltered life that they lead. Given the same exposure as ABPs, similar rates of PTSD are noted among the two study groups. This may indicate that having a sensory impairment may protect from PTSD due to decreased exposure to severe trauma and not due to increased resilience of subjects.

Severe war trauma and post-traumatic stress disorder in adolescents with sensory impairments: a cross-sectional study

A paucity of studies of the psychological status of adolescents with sensory impairments in political conflict areas is noted. This study was set up to examine the exposure of adolescents with sensory impairments (ASIs) to severe war trauma and development of post-traumatic stress disorder (PTSD) as compared to their able-bodied peers (ABPs). It also answers the question whether their impairments have made them more resilient in facing traumatic events. A cross-sectional study of all ASIs attending special schools in three administrative districts in Lebanon (n=166) as well as a group of 166 age and sex-matched ABPs from neighboring schools was conducted. The Post Traumatic Stress Reaction Checklist for children (PTSRC) was used to assess exposure to severe trauma, PTSD and their determinants. ASIs reported a lower exposure to severe traumatic events (24.1%) as compared to their ABPs (69.9%), and risk factors for their exposure were an older age group, a fatherless family, and severe visual impairment. Prevalence rates for PTSD were similar in the two study groups (17.5% and 16.4%). Younger ASIs were at a significantly higher risk of developing PTSD. Lower exposure to trauma among ASIs points to the more sheltered life that they lead. Given the same exposure as ABPs, similar rates of PTSD are noted among the two study groups. This may indicate that having a sensory impairment may protect from PTSD due to decreased exposure to severe trauma and not due to increased resilience of subjects.