Stress Symptoms In Children Research Articles

Somatic and Posttraumatic Stress Symptoms in Children and Adolescents in France

Somatic symptoms are a major concern among the pediatric population because of frequency and burden. The association between adverse childhood experiences and somatic symptoms in adults is well established but less is known concerning somatic symptoms in young people. To explore the frequency and intensity of somatic symptoms in children and adolescents exposed to traumatic events. This cross-sectional study was conducted from January 1 to December 31, 2021, at the Nice Pediatric Psychotrauma Referral Center in Nice, France. Participants included pediatric outpatients, aged 7 to 17 years, who were referred to the center. Statistical analysis was performed in January 2022. All participants experienced at least 1 traumatic event during life. Somatic and posttraumatic stress symptoms were assessed using the Patient Health Questionnaire-13 (PHQ-13) and Child PTSD Checklist (CPC). Posttraumatic stress disorder (PTSD) and non-PTSD groups were defined based on CPC symptoms severity score. In the hypothesized association between somatic symptoms and posttraumatic stress symptoms (PTSS), PTSD and non-PTSD groups were compared, correlations between PTSS and severity of CPC were analyzed, and a regression model was performed. There were 363 participants included (mean [SD] age, 13.58 [0.25] years; 174 [47.9%] female, 189 [52.1%] male). Compared with the non-PTSD group, the PTSD group presented with a higher mean (SD) number of somatic symptoms (7.0 [2.5] vs 4.0 [2.5] symptoms; t360 = 11.7; P < .001), and higher mean (SD) intensity (10.4 [4.6] vs 4.8 [3.7] points; t360 = 12.6; P < .001). Most of the explored somatic symptoms positively correlated with the intensity of PTSS and their functional alterations (eg, PTSS intensity correlated with stomach pain symptoms [r = .30; P < .001]; and with headaches symptoms [r = .44; P < .001]). In the regression model, the combination of migraines, palpitation, nausea, tiredness, and sleep disorders explained 6.5% of the variance in the PTSD group. (F1,341 = 22.651; P < .001). In this cross-sectional study, somatic symptoms were positively correlated with PTSS both in frequency and intensity among youths. These results suggest that the systematic screening for somatic symptoms in youths with traumatic exposure should be a routine evaluation procedure.

What Predicts COVID-Specific Symptoms of Stress in Children and Adolescents, Virus Threats or Social Distancing?

The COVID-19 crisis may have deleterious effects on children's and adolescents' mental health. However, there have been no published studies in which the COVID-related stress symptoms were investigated in a French ordinary pediatric population. The main objective of this study was to examine virus threats and social distancing measures to determine which were more disturbing for children and adolescents, and which were better predictors of post traumatic stress symptoms (PTSS). 1639 parents of children aged between 1 and 18 participated in an online survey. Parents completed questionnaires regarding their children's and adolescents' mental health while in the first French confinement. The data showed that most children and adolescents had PTSS, such as irritability and tantrums, intrusive thoughts or memories, difficulties in falling asleep, aggression, trouble concentrating, and negative emotions. Multiple linear models supported that both virus threats and social distancing- related disturbances were predictors of PTSS scores, with social distancing being a stronger predictor of PTSS scores than virus threats. Additional analyses across age groups revealed that social distancing measures predicted two times more PTSS than virus threat measures in toddlers, while virus threat measures were a stronger predictor of PTSS in adolescents. This is the first study that has investigated stress symptoms in a French pediatric population during the first French confinement episode because of the COVID-19 crisis.

It’s all in the hair: Association between changes in hair cortisol concentrations in reaction to the COVID-19 pandemic and post-traumatic stress symptoms in children over time

After exposure to a stressful/traumatic event, some individuals will develop post-traumatic stress symptoms (PTSS). In adults, low cortisol levels appear to be a risk factor for the development of PTSS. Indeed, both lower pre-trauma cortisol levels and low cortisol levels in the aftermath of a traumatic event have been associated with greater PTSS. In contrast, studies conducted in children showed that elevated cortisol levels shortly after trauma exposure are associated with more severe post-traumatic stress symptomatology. The few studies that have examined how pre-trauma cortisol levels predict PTSS in children have found no effect. Given that a pandemic can induce PTSS in certain individuals, we investigated whether cortisol secretion prior to and in the early stages of the COVID-19 pandemic in Quebec (Canada) predicted PTSS in children. In June 2020, we collected a hair sample from 71 children (8–15 y/o, M = 11.65; 54.93% girls) without a history of psychopathology or exposure to previous traumatic events. Hair samples allowed us to derive cumulative measures of cortisol levels for the months prior to (from mid-December 2019 to mid-March 2020) and at the beginning of the pandemic (from mid-March 2020 to mid-June 2020). PTSS were assessed every 3 months between June 2020 (T1) and March 2021 (T4). The results showed that a greater increase in hair cortisol at the beginning of the pandemic predicted less PTSS at T1, with an increase in these symptoms over time. This study highlights the utility of using hair cortisol during future chronic stressful events to better understand its association with the evolution of distress.

The Incidence of Posttraumatic Stress Symptoms in Children.

To determine the incidence of posttraumatic stress disorder (PTSD) symptoms and risk factors for their development in children and adolescents undergoing orthopaedic surgery for trauma. Prospective cohort study. Level-1 trauma center. Children (8 to 18), undergoing surgery for orthopaedic trauma. Upper and lower extremity surgery for orthopaedic trauma. PTSD symptoms at postoperative follow-up as determined by the Child PTSD Symptom Scale (CPSS). A total of 176 children with an average age at surgery of 13 years (8 to 18.8 years) participated in the study. Twenty-six subjects had high levels of PTSD symptoms (15%; 95% CI = 10.0 to 21.1%). Univariable and multivariable analyses determined that female sex (OR 2.63, 95% CI = 1.06 to 6.67, P = 0.04), older age at surgery (OR 1.25, 95% CI = 1.04 to 1.51, P = 0.02), and undergoing a previous surgery (OR 2.86, 95% CI = 1.06 to 7.73, P = 0.04) were all associated with increased PTSD risk. Children and adolescents experience a high level of PTSD symptoms (15%) after surgery for orthopaedic trauma. Clinicians should be aware of PTSD symptoms in children and adolescents after surgery for orthopaedic injuries and use comprehensive screening to facilitate timely intervention and treatment. II.

Smaller Hippocampal Volume Is Associated With Reduced Posttraumatic Stress Symptoms in Children With Cancer and Survivors Following a Brief Novel Martial Arts-Based Intervention.

Children with cancer and survivors frequently report posttraumatic stress symptoms (PTSS), which are associated with volumetric changes in stress-sensitive brain regions, including the hippocampus. We examined the impact of a novel, 4-week martial-arts-based meditative intervention on cancer-related PTSS in 18 pediatric patients and survivors and whether baseline hippocampal volumes correlate with PTSS severity and/or PTSS changes over time. Overall, PTSS did not significantly change from baseline to post-intervention. Smaller hippocampal volume was correlated with more severe re-experiencing PTSS at baseline, and greater reductions in PTSS post-intervention. Together, hippocampal volume may be a biomarker of PTSS severity and intervention response. Identifying hippocampal volume as a potential biomarker for PTSS severity and intervention response may allow for more informed psychosocial treatments.

It’s all in the hair: Changes in hair cortisol concentrations in reaction to the COVID-19 pandemic predicts post-traumatic stress symptoms in children

About 25 to 35% of victims of a traumatic event will develop post-traumatic stress disorder (PTSD). Low cortisol levels appear to be a risk factor for the development of PTSD. In adults, decreased diurnal and cumulative cortisol levels before or shortly after a traumatic event are associated with increased post-traumatic symptoms in the months thereafter. In contrast, results from the only two studies conducted in children showed that elevated diurnal cortisol levels shortly after exposure to a traumatic event are associated with more severe post-traumatic symptomatology. Given that a pandemic can induce post-traumatic stress symptoms, we investigated whether cumulative cortisol levels prior to and in the beginning stages of the COVID-19 pandemic in Quebec (Canada) predicted post-traumatic stress symptoms in children. We collected hair samples from 69 children (8-12 y/o) without history of psychopathology and exposure to a traumatic event. Cortisol levels were measured before (December 2019 - February 2020) and at the beginning of the pandemic (March 2020 - May 2020). Post-traumatic stress symptoms were assessed every 3 months between June 2020 (T1) and March 2021 (T4). The results showed that the percentage change in cumulative cortisol levels between the beginning of and prior to the pandemic predicted post-traumatic stress symptoms at T1. Specifically, a decrease in cortisol levels early in the pandemic was associated with increased post-traumatic stress symptoms. This study suggests that a decrease in cortisol in response to a stressful event may be a predisposing factor for PTSD in children.

Systematic Review and Meta-analysis: Group-Based Interventions for Treating Posttraumatic Stress Symptoms in Children and Adolescents

Trauma exposure in childhood is common and can lead to a range of negative mental health outcomes, including posttraumatic stress disorder (PTSD). In many settings, resources to address this distress are scarce. Group-based interventions require minimal resources and training, can be delivered by non-mental health specialists, and target larger numbers of children and adolescents. This meta-analysis sought to establish whether such an approach is an effective method for targeting PTSD symptoms and to identify potential moderators of effectiveness. PubMed, PsycNET, and PTSDPubs were searched for randomized controlled trials that used a group-based PTSD intervention with children and adolescents aged 6 to 18 years. Data were extracted for PTSD symptoms and depression symptoms. A random-effects meta-analysis was conducted to obtain between-group pooled effect size estimates. This study was registered on PROSPERO (CRD42020187214). The initial search identified 9,650 studies, of which 42 were eligible for inclusion (N= 5,998). Children randomized to a group-based intervention had significantly lower PTSD symptoms after treatment compared with a control group, with a medium pooled effect (g=-0.55, 95% CI [-0.76,-0.35]). Group interventions were superior when compared with either active or passive controls, at follow-up, and for depression symptoms. There was a large amount of heterogeneity, but no evidence that this was explained by whether the intervention was delivered in a low- and middle-income or high-income country, included caregivers, or was universal or targeted. Group PTSD interventions, particularly cognitive-behavioral therapy-based interventions, are effective at targeting posttrauma distress in children and adolescents. There was evidence of effectiveness when delivered in highly complex and resource-scarce settings and to a range of trauma-exposed groups, including groups exposed to war/conflict, natural disasters, and abuse.

Symptoms of Stress Amongst Children and Adolescents During the COVID-19 Outbreak in Shiraz, Iran: A Cross-sectional Study

Background: Because of the high daily mortality and quarantine procedures, coronavirus disease 2019 (COVID-19) can cause several psychological problems, especially in younger people. Objectives: Since most studies have mainly focused on physical problems of COVID-19 and they have neglected children in their analysis, this study aimed to evaluate the frequency and severity of stress symptoms and associated factors amongst children and adolescents aged 4 - 18 years during the COVID-19 outbreak. Methods: Using a convenience sampling technique, this descriptive-analytic cross-sectional study was conducted in Shiraz, Iran, from March 2020 to June 2020. To collect data, the link of the online Children's Self-Reported Stress Symptoms Questionnaire was sent to eligible participants via SMS and WhatsApp. The data were analyzed using SPSS software version 21. Results: According to our results, 270, 77, and 16 cases had low, moderate, and severe stress, respectively. Age group, living with both parents, and birth rank had a significant relationship with the degree of stress. Furthermore, more than 50% of participants reported cognitive-emotional symptoms more than physical ones. There was a significant relationship between the age group and physical symptoms, the duration of quarantine with bad temper and sadness, and between no clear thoughts with mother’s workplace and father’s job. Conclusions: Generally, almost 25% of participants reported moderate-to-severe stress. The most common symptoms of stress in children and adolescents were worrying, anger, and weakness. Furthermore, older children, those being the first child, and children living with both parents were more exposed to stress. Therefore, these items should be included in the healthcare team's training.

Parents' Strategies in Dealing with Children's Stress Symptoms in Kindergarten during Online Learning

Online learning causes children's stress symptoms, specifically for the preschoolers during COVID-19. This makes parents seek a method in overcoming the difficulties that are faced by students while studying. Therefore, this study aims to examine the parents' strategy in dealing with children's stress symptoms during online learning. A total of 27 respondents were selected using a purposive sampling technique with the criteria of parents and children that are involved in e-learning during COVID-19 in the Batulayar group B kindergarten, Lombok, West Nusa Tenggara, Indonesia. Furthermore data were collected using a survey method. The results showed that most of the children experienced behavioral and cognitive stress symptoms. This critical condition is comprised of three categories including the low, moderate, and the high level that has 15%, 81%, and 4% of children respectively. Moreover, there are 67%, 22%, and 11% of parents prefer to give gifts or rewards, allow play and have recreation, as well as understand their children learning style to deal with stress symptoms while studying at home during COVID-19. Parents have to be more sensitive to their children's conditions to prevent boredom during online learning.

1.7 Screening Adolescents for Trauma and Traumatic Stress Symptoms at Annual Pediatric Wellness Visits: Implementation of a Standardized Screening Process

Routine screening for childhood trauma in the pediatric primary care setting is recommended to identify youth at risk for negative physical and mental health sequelae. We sought to improve adolescent trauma screening in our urban, hospital-based pediatric primary care clinic by implementing the use of the Pediatric Traumatic Stress Screening Tool (PTSST), a validated screening tool for trauma and traumatic stress symptoms in children and adolescents. A survey to assess current resident practices established the need for a standardized trauma screening process in our clinic, because none existed. A clinical workflow was implemented to screen adolescents aged 11 years and older for trauma and traumatic stress symptoms using the self-complete adolescent version of the PTSST during well visits. Additional interventions included: 1) provider educational sessions; 2) a provider decision-making algorithm; 3) standard language for documentation of screening; and 4) a list of patient resources. We reviewed adolescent well visits conducted during the first 6 weeks postimplementation (n = 103) to gather data on weekly rates of documented PTSST screening and screening results. We also reviewed visits during the 6 weeks pre-implementation (n = 120) to compare pre- and postimplementation rates of referrals to mental health services and reports to the Administration for Children's Services (ACS) for safety concerns. Residents documented trauma screening using the PTSST at 19.4% of visits postimplementation (weekly range: 7%-46%). Of those adolescents screened, 25% reported a prior trauma (n = 5) with 80% of these endorsing moderate or severe symptoms of traumatic stress. All youth screening positive for trauma were referred for mental health services (n = 4) or already engaged in care (n = 1). Rates of adolescent mental health referrals were similar pre- and postimplementation (18.3% vs 15.5%). Screening resulted in the only ACS report made pre- or postimplementation. Our initiative to standardize and increase trauma screening using the PTSST led to the detection of adolescents with prior traumatic experiences and facilitated the identification of youth in need of mental health services. Future interventions will aim to increase provider engagement and education on in-office interventions for traumatic stress symptoms.

Midazolam exposure in the paediatric intensive care unit predicts acute post-traumatic stress symptoms in children

BackgroundClinically significant post-traumatic stress symptoms (PTSS) have been reported in up to a quarter of paediatric intensive care unit (PICU) survivors. Ongoing PTSS negatively impacts children's psychological development and physical recovery. However, few data regarding associations between potentially modifiable PICU treatment factors, such as analgosedatives and invasive procedures, and children's PTSS have been reported. ObjectivesWe sought to investigate the medical treatment factors associated with children's PTSS after PICU discharge. MethodsA prospective longitudinal cohort study was conducted in two Australian tertiary referral PICUs. Children aged 2-16 y admitted to the PICU between June 2008 and January 2011 for >8 h and <28 d were eligible for participation. Biometric and clinical data were obtained from medical records. Parents reported their child's PTSS using the Trauma Symptom Checklist for Young Children at 1, 3, 6, and 12 months after discharge. Logistic regression was used to assess potential associations between medical treatment and PTSS. ResultsA total of 265 children and their parents participated in the study. In the 12-month period following PICU discharge, 24% of children exhibited clinically elevated PTSS. Median risk of death (Paediatric Index of Mortality 2 [PIM2]) score was significantly higher in the PTSS group (0.31 [IQR 0.14–1.09] v 0.67 [IQR 0.20–1.18]; p = 0.014). Intubation and PICU and hospital length of stay were also significantly associated with PTSS at 1 month, as were midazolam, propofol, and morphine. After controlling for gender, reason for admission, and PIM2 score, only midazolam was significantly and independently associated with PTSS and only at 1 month (adjusted odds ration (aOR) 3.63, 95% CI 1.18, 11.12, p = 0.024). No significant relationship was observed between the use of medications and PTSS after 1 month. ConclusionsElevated PTSS were evident in one quarter (24%) of children during the 12 months after PICU discharge. One month after discharge, elevated PTSS were most likely to occur in children who had received midazolam therapy.

Young children’s emotional stress reactions during the COVID-19 outbreak and their associations with parental emotion regulation and parental playfulness

ABSTRACT Children’s emotional adjustment during stressogenic events is highly dependent on their parents’ emotional state. The present study explored young children’s emotional adjustment during the COVID19 outbreak as it relates to their exposure to stress, and their parents’ emotion regulation and playfulness. A sample of 351 Israeli parents of children aged 2–7 years completed online questionnaires. The most frequent stress symptoms in children were nervousness, agitation, and aggression, separation fears and clinging. Parental difficulties in emotion regulation, and the level of exposure to stressogenic situations were both significantly associated with children’s stress reactions. Parental emotion regulation fully mediated the relationship between exposure to stress and children’s stress reactions. Parental playfulness was only inversely related to children’s stress reaction in fathers. These findings underscore the importance of parental emotion skills for children's emotional adjustment during stressful times.

Preserved executive functioning and low stress symptoms in children treated for acute lymphoblastic leukemia

Pediatric cancer treatment can negatively impact cognitive and psychosocial development, although it has been suggested that these adverse effects may be minimized when children have higher resilience and better executive functioning. We aimed to evaluate the impact of pediatric Acute Lymphoblastic Leukemia (ALL) treatment on executive function, resilience and stress in survivors and to investigate correlations between executive functioning and resilience and between executive functioning and stress. The neuropsychological assessment was performed in 32 ALL survivors aged 7–17 years and 28 age-, sex- and socioeconomic status matched controls. Executive functioning was assessed by inhibitory control, mental flexibility and working memory tasks. Children’s self-report scales were used to assess stress symptoms and resilience. Results revealed no executive function impairment nor stress symptom differences between ALL survivors and control group. In the ALL group, executive function and resilience were positively correlated, whereas executive function and stress were negatively correlated. We concluded that ALL treatment was not associated with impairment in executive functioning nor to increased stress symptoms in our sample. ALL survivors with better performance in mental flexibility and inhibition tasks reported fewer stress symptoms and more resilience, indicating a possible relationship between these variables.

Perceived social support and posttraumatic stress symptoms in children and youth in therapy: A parallel process latent growth curve model

Many studies show that perceived social support protects against the development of posttraumatic stress symptoms (PTSS) in the aftermath of trauma, but less is known about support in relation to PTSS in trauma therapy. This study examined associations between perceived social support and PTSS in children and adolescents during trauma therapy. Parallel process latent growth curve modeling was used to examine trajectories of perceived social support and PTSS over five measurement waves in a sample of 156 patients, aged between 10 and 18 years (M age = 15.1, SD = 2.2, 79.5% girls), randomized to receive trauma-focused cognitive behavior therapy (TF-CBT) or therapy-as-usual (TAU). Across all participants there was an average decline in PTSS and increase of perceived social support from pre-therapy to 18 months after therapy. Most of the change occurred during therapy and was maintained after therapy. Higher levels of PTSS prior to therapy were associated with lower levels of perceived social support prior to therapy, and a decrease in PTSS was associated with increase in perceived social support. This co-development may have been directed by a third underlying factor or short-term temporal effects. Studies investigating within-person associations over shorter time intervals will benefit our understanding of possible temporal effects.

Aggravating factors and assessment tools for Posttraumatic Stress Disorder in children after hospitalization.

Posttraumatic stress disorder (PTSD) is a mental disorder caused by several distressing events that are related with psychotrauma. It is very frequent in childhood and untreated traumatic stress symptoms in children and adolescents often result in debilitating consequences on development with increased risks for a variety of physical and mental disorders. Ιt has been found that PTSD symptoms are reduced as soon as therapeutic interventions have been applied. The aim of the present review was to summarize the available literature regarding aggravating factors associated with the development of PTSD in children after hospitalization and assessment tools for a quick and reliable screening of children who are at risk for developing PTSD. A review of published papers was conducted until April 10, 2019 to identify articles that discuss the aggravating factors and the assessment tools for PTSD in children after hospitalization published in English, German or Greek language. Search was performed on PubMed with the following combination of key-words: "PTSD" and "children" and "hospitalization", using the filters ''human'' and "Publication date from 30/11/2007 to 09/04/2019" and choosing "all fields'' in PubMed Advanced Search Builder. Of the 115 articles reviewed, 16 relevant articles were included, 10 of them referred to the aggravating factors and the remaining 6 were related to the assessment tools. Significant aggravating factors associated with the development of PTSD were: traumatic injuries and illness/ medical-related hospital admission, previous health problems, Pediatric Intensive Care Unit (PICU) hospitalization, attendance at a hospital for child and adolescent psychiatry, female gender and psychotherapy and initial high Posttraumatic Stress Symptoms (PTSS) in parents. As for assessment tools, it was observed that the Child Trauma Screening Questionnaire (CTSQ)-Heart Rate (HR), the alternative PTSD algorithm (PTSD-AA), the Child Stress Disorders Checklist-Short Form (CSDC-SF), the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) model for PTSD symptom categories, the Posttraumatic Stress Disorder Semi-Structured Interview (PTSDSSI), the Preschool Children's Assessment of Stress Scale (PCASS) and the diagnostic interview for children and adolescents (DICA-P) led to the identification of children who were likely to develope or had already developed PTSD symptoms, in the study population wherein each was implemented. The greatest limitation - but also a significant finding - of this review is the scarceness of published studies on this topic. Overall, there is a variety of aggravating factors associated with the development of PTSD in children after hospitalization. Assessment tools should be able to identify immediately the children who are likely to or have already developed PTSD symptoms.

Profiles of Traumatic Stress Symptoms in Children Exposed to Intimate Partner Violence.

Childhood exposure to intimate partner violence (IPV) is associated with a host of problems, including the development of posttraumatic stress symptoms (PTSS). PTSS include a wide range of unique symptomatology and as a result, clinical presentations of PTSS can vary in both distribution and overall number of symptoms. Work in child and adolescent samples has largely focused on factors predicting the total number of symptoms (i.e., symptom severity), with less work focused on both patterns of symptom number and distribution. Furthermore, few studies have examined how functional impairment varies in relation to PTSS presentation. The goal of the current study is to (a) document patterns of PTSS severity and distribution in children with histories of witnessing IPV, (b) examine the factors that predict different PTSS presentations, and (c) investigate how PTSS presentation is associated with functional impairment. Data for this study were drawn from a sample of 236 children between the ages of 4 and 12 years and their mothers who had experienced recent IPV. Families reported high levels of IPV in the past year, and children reported moderate levels of PTSS. A latent profile analysis of PTSS revealed that three profiles were the best-fitting model for the data. The three profiles were differentiated between low, moderate, and high levels of PTSS, and membership in the profiles varied by children's age and trauma history. The results of this study give important information about the potential development of PTSS as well as clinically useful information about the relationship between children's PTSS and their functioning following exposure to IPV.

Examining the 8-Year Trajectory of Posttraumatic Stress Symptoms in Children Exposed to Intimate Partner Violence.

Millions of children witness intimate partner violence (IPV) each year, and the effects of these experiences are substantial. One of the more common sequelae of exposure to IPV is the development of posttraumatic stress symptoms (PTSS). Given the chronic nature of both IPV and PTSS, there is a need for prospective research on long-term mental health outcomes following IPV exposure in childhood. This study prospectively examines trajectories of PTSS over an 8-year period, beginning from the preschool period. This study also investigates factors that may be associated with these trajectories, including intervention participation, continued IPV exposure, and the caregiving environment. A total of 120 mother-child dyads participated in four study waves over an 8-year period, beginning when children were between the ages of 4 and 6. Mothers and children participated in an intervention between baseline and Time 2. At the onset of the study, all mothers reported experiencing IPV over the previous year. Findings demonstrate that, in general, children experienced worsening of their PTSS over the 8-year trajectory, and few factors were significantly associated with this trajectory. There were no associations between intervention participation, parenting behaviors, and long-term child PTSS outcomes; however, there were significant associations between amount of IPV exposure, mother's level of PTSS, and children's PTSS outcomes. These results underscore the need to better understand the impact of early-life exposure to IPV, as well as the need for interventions tailored to this developmental period. Furthermore, these findings highlight the long-term negative associations between chronic exposure to IPV and child well-being, as well as the significant connections between caregiver and child mental health.

The Greensboro Child Response Initiative: A Trauma-Informed, Mental Health–Law Enforcement Model for Children Exposed to Violence

ABSTRACTThis article evaluates a trauma-informed, mental health–law enforcement intervention model called the Greensboro Child Response Initiative (CRI). CRI is a community-coordinated response to mitigate the development of traumatic stress symptoms in children exposed to violence, with the goals of decreasing mental health symptoms and other negative outcomes. Results from a quasi-experimental study indicated that caregivers appreciate the quick follow-up and support by CRI advocates and police reported seeing CRI as a critical component of their responses to calls for service related to families and children. Police line-ups and training provided by CRI increased levels of empathy and awareness of child trauma. Monthly stakeholder meetings promoted an informed victim response and increased communication and networking opportunities among community providers and law enforcement. Results suggest that CRI is a promising community-based early intervention, and implications and suggestions are provided for replicability.

The Association Between Acute Pain and Posttraumatic Stress Symptoms in Children and Adolescents 3\xa0Months After Accidental Injury

Previous research suggests that acute pain is a risk factor for later posttraumatic stress symptoms (PTSS). In a prospective cohort study, we examined the association between acute pain from accidental injury and PTSS in children and adolescents, taking into account factors potentially related to pain or posttraumatic stress. Participants were 135 children and adolescents, 8–18 years old. We measured the worst experienced pain since the accident took place with a visual analogue scale. Three months after the accident, posttraumatic stress was assessed with a self-report measure. We found a positive association between acute pain and posttraumatic stress. The amount of pain was negatively associated with injury severity in girls and positively associated with the presence of an extremity fracture in boys. In children who reported severe pain, this pain was significantly associated with PTSS and may account for around 10% of the variance in the severity of PTSS. Although the experience of pain is subjective, our study indicates that severe pain is associated with the severity of later PTSS. Timely management of pain according to acute pain protocols in all phases and disciplines after accidental injury is therefore recommended.

Stress post-traumatique et liens d’attachement chez l’enfant atteint du cancer : revue de littérature

IntroductionMany studies show that the announcement of a chronic disease such as childhood cancer is often seen as a test for the child and his entourage. The child, unarmed meet this sudden threat of death, will have to face immediate changes, but later too, after the remission. The objective of this study is to see if there is development of post-traumatic stress disorder and post-traumatic stress symptoms in children suffering from cancer since the diagnosis is made, and whether modifications of the attachment links to relatives, especially the mother, will operate. MethodA systematic literature review was performed by crossing the following keywords: pediatric cancer; childhood cancer; post-traumatic stress disorder; PTSD; and their English equivalents. Only articles dealing with childhood cancer and affect the life of the child, published in French and English, have been preserved and analyzed. ResultsA total of 20 articles were selected. It shows that, to cancer, frequently, the children say post-traumatic stress disorder, and many of them develop post-traumatic stress related symptoms. In addition, links to attachments to other children and their families find themselves affected, particularly the one with the mother. DiscussionAn early care by health professionals on the psychological aspects engendered by childhood cancer could be interesting. The target would be to decrease the onset of some symptoms and negative consequences in the lives of children with cancer. ConclusionChildren with cancer are at greater risk for developing PTSD and/or post-traumatic symptoms than their healthy peers of the same age. The risk is greater in presence of certain factors (age, social support, representations and beliefs, etc), and this will have an impact on his later life and development.