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Stickley A, Isaksson J, Koposov R, Schwab-Stone M, Sumiyoshi T, Ruchkin V. Loneliness and posttraumatic stress in U.S. adolescents: A longitudinal study. J Affect Disord 2024:S0165-0327(24)00931-5. [PMID: 38852860 DOI: 10.1016/j.jad.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Loneliness and posttraumatic stress (PTS) are common in adolescence. However, there has been little longitudinal research on their association. To address this deficit, this study examined the longitudinal association between these phenomena in a sample of U.S. school students while also exploring if gender was important in this context. METHODS Data were analysed from 2807 adolescents (52.1 % female; age at baseline 11-16 years (M = 12.79)) who were followed over a one-year period. Information was obtained on loneliness in year 1 using a single-item question, while PTS was assessed with the self-report Child Post-Traumatic Stress - Reaction Index (CPTS-RI). A full path analysis was performed to assess the across time associations. RESULTS Almost one-third of the students reported some degree of loneliness while most students had 'mild' PTS. In the path analysis, when controlling for baseline PTS and other covariates, loneliness in year 1 was significantly associated with PTS in year 2 (β = 0.06, 95%CI: 0.02, 0.09). Similarly, PTS in year 1 was significantly associated with loneliness in year 2 (β = 0.19, 95%CI: 0.15, 0.23). An interaction analysis further showed that loneliness was higher in girls with PTS than in their male counterparts. LIMITATIONS The use of a single-item measure to assess loneliness that used the word 'lonely' may have resulted in underreporting. CONCLUSION Loneliness and PTS are bidirectionally associated in adolescence. Efforts to reduce loneliness in adolescence may help in combatting PTS, while clinicians should intervene to address loneliness if detected in adolescents with PTS.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
| | - Johan Isaksson
- Child and Adolescent Psychiatry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Center of Neurodevelopmental Disorders, Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Roman Koposov
- Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Sechenov First Moscow State Medical University, Moscow, Russia
| | - Mary Schwab-Stone
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan; Japan Health Research Promotion Bureau, Toyama, Shinnjiku-ku, Tokyo, Japan
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Regional forensic psychiatric clinic Sala, Sala, Sweden
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Dincel M, Karayagmurlu A. An Investigation of Dissociative Symptoms and Related Factors in Autistic Adolescents. J Autism Dev Disord 2024:10.1007/s10803-024-06374-7. [PMID: 38743151 DOI: 10.1007/s10803-024-06374-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2024] [Indexed: 05/16/2024]
Abstract
Despite exposure to trauma and adverse life events being frequently reported in Autism Spectrum Disorder (ASD), few studies have examined the relationship between these factors and dissociative symptoms in the autistic population. The aim of the study is to investigate symptoms of dissociation in autistic adolescents, and to explore factors that could be associated with dissociative symptoms in ASD. This cross-sectional study involved 59 autistic adolescents between 12 and 18 years old, with the mean age of 14.3 ± 1.8. Dissociation, autism characteristics, childhood traumas, peer bullying, and Post-Traumatic Stress Disorder (PTSD) symptoms were assessed using the Adolescent Dissociative Experiences Scale (ADES), the Childhood Autism Rating Scale (CARS), the Childhood Trauma Questionnaire (CTQ), the Nine-Item Child-Adolescent Bullying Screen (CABS-9), and the Child Posttraumatic Stress Reaction Index (CPTS-RI), respectively. Results from the ADES revealed that 12.5% of the participants scored above the threshold for dissociative disorders. In the linear regression model constructed to evaluate factors associated with dissociative symptoms, an increase in dissociative symptoms was statistically significantly associated with an increase in the total CTQ score (p = 0.002) and age (p = 0.006). The findings of the study indicate that dissociative symptoms may occur in autistic adolescents. It is suggested that dissociative symptoms observed in autistic adolescents may particularly be associated with childhood traumas and increasing age. Further research into dissociative symptoms in ASD is warranted, requiring larger sample sizes, specialized measurement scales, and structured interviews.
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Affiliation(s)
- Melodi Dincel
- Department of Child and Adolescent Psychiatry, Midyat State Hospital, Midyat, Mardin, Turkey.
| | - Ali Karayagmurlu
- Department of Child and Adolescent Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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Çobanoğlu Osmanlı C. Child Exhibits Throat-Squeezing Behavior for 5 Years Following Trauma. Psychiatry 2024:1-5. [PMID: 38739375 DOI: 10.1080/00332747.2024.2346941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
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May AK, Smeeth D, McEwen F, Karam E, Rieder MJ, Elzagallaai AA, van Uum S, Lionetti F, Pluess M. The role of environmental sensitivity in the mental health of Syrian refugee children: a multi-level analysis. Mol Psychiatry 2024:10.1038/s41380-024-02573-x. [PMID: 38702371 DOI: 10.1038/s41380-024-02573-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024]
Abstract
Individuals with high environmental sensitivity have nervous systems that are disproportionately receptive to both the protective and imperilling aspects of the environment, suggesting their mental health is strongly context-dependent. However, there have been few consolidated attempts to examine putative markers of sensitivity, across different levels of analysis, within a single cohort of individuals with high-priority mental health needs. Here, we examine psychological (self-report), physiological (hair hormones) and genetic (polygenic scores) markers of sensitivity in a large cohort of 1591 Syrian refugee children across two waves of data. Child-caregiver dyads were recruited from informal tented settlements in Lebanon, and completed a battery of psychological instruments at baseline and follow-up (12 months apart). Univariate and multivariate Bayesian linear mixed models were used to examine a) the interrelationships between markers of sensitivity and b) the ability of sensitivity markers to predict anxiety, depression, post-traumatic stress disorder, and externalising behaviour. Self-reported sensitivity (using the Highly Sensitive Child Scale) significantly predicted a higher burden of all forms of mental illness across both waves, however, there were no significant cross-lagged pathways. Physiological and genetic markers were not stably predictive of self-reported sensitivity, and failed to similarly predict mental health outcomes. The measurement of environmental sensitivity may have significant implications for identifying and treating mental illness, especially amongst vulnerable populations, but clinical utility is currently limited to self-report assessment.
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Affiliation(s)
- Andrew K May
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Demelza Smeeth
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Fiona McEwen
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Department of War Studies, King's College London, London, UK
| | - Elie Karam
- Department of Psychiatry and Clinical Psychology, Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Michael J Rieder
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Abdelbaset A Elzagallaai
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Stan van Uum
- Division of Endocrinology and Metabolism, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Francesca Lionetti
- Department of Neuroscience, Imaging and Clinical Science, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Michael Pluess
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK.
- Department of Psychological Sciences, School of Psychology, University of Surrey, Guildford, UK.
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Düken ME, Yayan EH. Psychosocial conditions of children after liver transplant: Post-traumatic stress, depression, and anxiety. J Pediatr Nurs 2024; 75:e75-e80. [PMID: 38216348 DOI: 10.1016/j.pedn.2023.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 12/29/2023] [Accepted: 12/29/2023] [Indexed: 01/14/2024]
Abstract
AIM This study aimed to determine psychosocial conditions, post-traumatic stress, depression, and anxiety of children who underwent a liver transplant. METHOD This is a relational descriptive study, which was conducted between March 2019 and December 2020 in the Inonu University Liver Transplantation Institute Pediatric Liver Transplant Clinic. The "Child Information Form," "Child Post-Traumatic Stress Reaction Index," "State-Trait Anxiety Inventory for Children-Trait Form," and "Children's Depression Inventory" were used to collect data. The study was conducted with 71 children who had a previous liver transplant. RESULTS Of the participating children, 56.3% were girls, 63.4% continued their primary school education after the transplant, 32.5% were diagnosed with cirrhosis, 39.4% received the transplant in 2017, 32.4% received it from the mother, and 25.4% received it from a cadaveric donor. Although it had been at least 3 years since the transplant, 47.9% exhibited moderate and 43.7% severe post-traumatic stress responses. There was a significant negative relationship between the age of children with a liver transplant and trait anxiety and post-traumatic stress responses (path coefficients β = -0.268, p = 0.002; β = -0.166, p = 0.023, respectively). There was a significant positive relationship between anxiety and post-traumatic stress responses of the children after the transplant and there was a statistically significant relationship between the path coefficients (β = 0.750; p < 0.001). CONCLUSION Children who underwent a liver transplant had post-traumatic stress disorder, depression, and trait anxiety.
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Affiliation(s)
- Mehmet Emin Düken
- Harran University, Health Sciences of Faculty -Department of Child Health and Diseases Nursing, Şanlıurfa 63000, Turkey; Inönü University, Faculty of Nursing- Department of Child Health and Diseases Nursing, Malatya 44280, Turkey.
| | - Emriye Hilal Yayan
- Inönü University, Faculty of Nursing- Department of Child Health and Diseases Nursing, Malatya 44280, Turkey.
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Düken ME, Kaplan V, Almazan J. The association between posttraumatic stress disorder and mental health of adolescents who exposed to the worst disaster of the century: Extensive data from southeast Turkey. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12449. [PMID: 38403993 DOI: 10.1111/jcap.12449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/14/2023] [Accepted: 12/20/2023] [Indexed: 02/27/2024]
Abstract
PROBLEMS This study was conducted to examine the association between posttraumatic stress disorder and mental health status of adolescents exposed to the worst disaster of the century. METHODS This study was descriptive, cross-sectional, and correlational. This research was conducted between March 31 and July 1, 2023. The study was conducted with earthquake survivors who migrated from Kahramanmaraş, the epicenter of the earthquake, and Adıyaman and Hatay, the other two cities where it was most effective, to Şanlıurfa. The study was conducted with a total of 947 adolescents. "Personal Information Form," "Child Posttraumatic Stress Reaction Index," and "Symptom Distress Check List- (SCL-90)" were used to collect data. Linear regression method was used in the analysis of the research. Path analysis was performed using PATH analysis. FINDINGS The mean age of the adolescents participating in the study was 16.69 ± 1.41 years. It was found that the Global Severity Index (GSI) of the adolescents was at the pathological level with a mean of 2.36 ± 0.68. Posttraumatic stress reactions of the adolescents who experienced the earthquake was found to explain 97.2% of their mental symptoms (anxiety, depression, somatization, anger-hostility, obsession-compulsion, interpersonal sensitivity, phobic anxiety, paranoid ideation, psychotic symptoms, other problems, and GSI) (p < 0.001). It was found that the age of the adolescents, total number of losses in the earthquake, the time they stayed under the rubble, the time they waited for siblings to be pulled from under the rubble and the state of having loss due to the earthquake explained 74.4% of the posttraumatic stress reactions (p < 0.001). CONCLUSIONS As a conclusion, it was found that the adolescents who experienced the earthquake experienced severe posttraumatic stress symptoms. It was also found that adolescents who experienced high levels of trauma symptoms showed pathological mental symptoms. After the earthquake, adolescents should be evaluated periodically in terms of posttraumatic stress symptoms. In the evaluations to be made, it is important to determine how adolescents are affected especially mentally. In this context, interventions should be implemented for the identified mental symptoms (anxiety, depression, somatization, etc.).
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Affiliation(s)
- Mehmet Emin Düken
- Department of Child Health and Diseases Nursing, Health Sciences of Faculty, Harran University, Şanlıurfa, Turkey
| | - Veysel Kaplan
- Department of Psychiatric Nursing, Health Sciences of Faculty, Harran University, Şanlıurfa, Turkey
| | - Joseph Almazan
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
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Isaksson M, Isaksson J, Schwab-Stone M, Ruchkin V. Longitudinal associations between community violence exposure, posttraumatic stress symptoms, and eating disorder symptoms. J Eat Disord 2024; 12:6. [PMID: 38212849 PMCID: PMC10785541 DOI: 10.1186/s40337-024-00965-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Eating disorder (ED) symptoms have been associated with different types of traumatic events, such as exposure to sexual and physical violence, and emotional abuse. However, the relation between ED symptoms and community violence exposure (CVE) is underexplored, despite the latter's adverse effects on many aspects of adolescent functioning. The primary aim of this study was to evaluate the relation between CVE and ED symptoms in adolescents, while also investigating the potential mediating and moderating roles of posttraumatic stress (PTS) symptoms, gender, and ethnicity. METHODS Data were collected longitudinally over two consecutive years in the city of New Haven, CT, in the United States. Participants were 2612 adolescent students from the public school system (1397 girls and 1215 boys) with an average age of 12.8 years (SD = 1.29). The students were comprised of several different ethnic groups, including Caucasians, African Americans and Hispanic Americans. Associations between CVE (no exposure, witnessing, and victimization) and PTS symptoms at year one, and ED symptoms (thoughts and compensatory behaviors) at year two, were assessed with self-rating instruments. Moderation and mediation analyses were conducted using a variant of linear regression (Hayes PROCESS macro). RESULTS ED symptoms at year two were significantly associated with both witnessing and being a victim of community violence at year one, with most or all of the relations being explained by PTS symptoms. Overall, neither gender nor ethnicity had a meaningful moderating effect in the observed relations. CONCLUSIONS The findings support the notion that assessing and addressing PTS symptoms might be beneficial when treating individuals with ED symptoms who have experienced community violence, irrespective of gender or ethnicity.
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Affiliation(s)
- Martina Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, S-751 85, Uppsala, Sweden
| | - Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, S-751 85, Uppsala, Sweden
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Mary Schwab-Stone
- Child Study Center, Yale University School of Medicine, New Haven, USA
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, S-751 85, Uppsala, Sweden.
- Child Study Center, Yale University School of Medicine, New Haven, USA.
- Sala Forensic Psychiatric Clinic, Sala, Sweden.
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A systematic literature review of the relationship between parenting responses and child post-traumatic stress symptoms. Eur J Psychotraumatol 2023; 14:2156053. [PMID: 37052099 PMCID: PMC9788707 DOI: 10.1080/20008066.2022.2156053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Parents are a key source of support for children exposed to single-incident/acute traumas and can thereby play a potentially significant role in children's post-trauma psychological adjustment. However, the evidence base examining parental responses to child trauma and child posttraumatic stress symptoms (PTSS) has yielded mixed findings.Objective: We conducted a systematic review examining domains of parental responding in relation to child PTSS outcomes.Method: Studies were included if they (1) assessed children (6-19 years) exposed to a potentially traumatic event, (2) assessed parental responses to a child's trauma, and (3) quantitatively assessed the relationship between parental responses and child PTSS outcomes. A systematic search of three databases (APAPsycNet, PTSDpubs, and Web of Science) yielded 27 manuscripts.Results: Parental overprotection, trauma communication, avoidance of trauma discussion and of trauma reminders, and distraction were consistently related to child PTSS. There was more limited evidence of a role for trauma-related appraisals, harsh parenting, and positive parenting in influencing child outcomes. Significant limitations to the evidence base were identified, including limited longitudinal evidence, single informant bias and small effect sizes.Conclusion: We conclude that key domains of parental responses could be potential intervention targets, but further research must validate the relationship between these parental responses and child PTSS outcomes.
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Smeeth D, May AK, Karam EG, Rieder MJ, Elzagallaai AA, van Uum S, Pluess M. Risk and resilience in Syrian refugee children: A multisystem analysis. Dev Psychopathol 2023; 35:2275-2287. [PMID: 37933522 DOI: 10.1017/s0954579423000433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Refugee children are often exposed to substantial trauma, placing them at increased risk for mental illness. However, this risk can be mitigated by a capacity for resilience, conferred from multiple ecological systems (e.g., family, community), including at an individual biological level. We examined the ability of hair cortisol concentrations and polygenic scores for mental health to predict risk and resilience in a sample of Syrian refugee children (n = 1359). Children were categorized as either at-risk or resilient depending on clinical thresholds for posttraumatic stress disorder, depression, and externalizing behavior problems. Logistic regression was used to examine main and interacting effects while controlling for covariates. Elevated hair cortisol concentrations were significantly associated with reduced resilience (odds ratio (OR)=0.58, 95%CI [0.40, 0.83]) while controlling for levels of war exposure. Polygenic scores for depression, self-harm, and neuroticism were not found to have any significant main effects. However, a significant interaction emerged between hair cortisol and polygenic scores for depression (OR=0.04, 95%CI [0.003 0.47]), suggesting that children predisposed to depression were more at risk for mental health problems when hair cortisol concentrations were high. Our results suggest that biomarkers (separately and in combination) might support early identification of refugee children at risk for mental health problems.
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Affiliation(s)
- Demelza Smeeth
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Andrew K May
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Elie G Karam
- Department of Psychiatry and Clinical Psychology, St Georges Hospital University Medical Center, Beirut, Lebanon
| | - Michael J Rieder
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Abdelbaset A Elzagallaai
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Stan van Uum
- Division of Endocrinology and Metabolism, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Michael Pluess
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Department of Psychological Sciences, School of Psychology, University of Surrey, Guildford, UK
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Ruchkin V, Stickley A, Koposov R, Sukhodolsky DG, Isaksson J. Depressive symptoms and anger and aggression in Russian adolescents. Child Adolesc Psychiatry Ment Health 2023; 17:130. [PMID: 37974287 PMCID: PMC10652468 DOI: 10.1186/s13034-023-00677-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
Research among adolescents exploring the association between depressive symptoms and aggression has produced inconsistent findings. This study investigated the prevalence of clinically significant (current major depressive episode) and subthreshold depressive symptoms in a general population sample of adolescents from Northern Russia and explored their association with aggression and anger, while controlling for comorbid mental health problems. The sample consisted of 2600 participants, aged 13-17 years (59.5% female; 95.7% ethnic Russian). Symptoms of a current major depressive episode, types of anger and aggression (anger rumination, trait anger, physical, verbal and social aggression) and comorbid problems (posttraumatic stress, alcohol use, anxiety, and hyperactivity/impulsivity) were assessed by means of self-reports. The prevalence of a clinically significant depressive episode in the past month was 3.5%, while for subthreshold depression it was 21.6%. All anger and aggression variables, as well as comorbid problems increased together with increasing levels of depression. The association between overt aggressive behavior and depression was primarily explained by comorbid mental health problems, whereas anger rumination and social aggression had more direct associations with depression, independent of comorbidity. Among adolescents with depression, boys reported higher levels of social and verbal aggression and of anger rumination than girls. The results of this study suggest that interventions aiming to reduce aggressive behavior in adolescents should consider depression and its comorbid conditions.
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Affiliation(s)
- Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, S-751 85, Sweden.
- Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA.
| | - Andrew Stickley
- Department for Preventive Intervetion for Psychiatric Disorders, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, Northern Norway, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Epidemiology and Modern Technologies of Vaccination, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Denis G Sukhodolsky
- Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA
| | - Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, S-751 85, Sweden
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Allwood MA, Robinson JN, Kim H. Youth Exposure to Gun, Knife, and Physical Assaults: Assessing PTSD Symptoms Across Types of Assaults, Race, Ethnicity, Sex, and Context. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11545-11568. [PMID: 37409648 DOI: 10.1177/08862605231185300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
This study examined posttraumatic stress disorder (PTSD) symptoms in relation to physical assaults and weapons-related victimization, as well as the moderating roles of demographic characteristics and the context of victimization. The sample consisted of 910 racially and ethnically diverse adolescents and young adults from an urban commuter college in the Northeast U.S. Findings include significant sex differences and racial differences in reported victimization and symptoms. Men reported significantly more physical assaults, gun victimizations, and knife victimizations than women. Black participants reported significantly more gun victimization than all other groups, and Black, White, and Asian participants reported significantly more physical assault experiences than Latinx participants. Individuals victimized by physical assault or by gun victimization were more than twice as likely to report clinically significant PTSD symptoms than individuals without such experiences, even after adjusting for demographic differences. In addition, for gun victimization in the community, a two-way interaction (gun victimization by race) and a three-way interaction (gun victimization by race by sex) were significantly associated with clinically significant PTSD symptoms. Gun victimization in the community, which disproportionately impacts Black men, was the only context in which PTSD symptoms were highest for men compared to women. The overall finding of lower PTSD symptoms among men suggests that clinical practice must include an intentional focus on violence victimization, including the use of weapons, as well as the various ways that distress might manifest among men. In addition to symptoms of PTSD, other symptoms of distress, including substance use, anger, and retaliatory aggression, should be considered. Public policy and public health must also direct attention to the use of weapons in violence victimization and the proliferation of weapons violence.
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Affiliation(s)
| | - Janelle N Robinson
- John Jay College, City University of New York, USA
- The University of the West Indies, Mona Campus, Jamaica
| | - Hyun Kim
- John Jay College, City University of New York, USA
- University of South Alabama, Mobile, USA
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Bailin A, Cho E, Sternberg A, Evans SC, Hollinsaid NL, Bearman SK, Weisz JR. Principle-Guided Psychotherapy for Children and Adolescents (FIRST): study protocol for a randomized controlled effectiveness trial in outpatient clinics. Trials 2023; 24:682. [PMID: 37864269 PMCID: PMC10589969 DOI: 10.1186/s13063-023-07717-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/07/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Hundreds of youth psychotherapy randomized trials have generated scores of helpful empirically supported treatments (ESTs). However, the standardized structure of many ESTs and their focus on a single disorder or homogeneous cluster of problems may not be ideal for clinically referred youths who have comorbidity and whose treatment needs may shift from week to week. This concern has prompted development of flexible transdiagnostic, modular youth psychotherapies. One of these, designed for efficient training and implementation, is FIRST-a transdiagnostic intervention built on five empirically supported principles of change (i.e., feeling calm, increasing motivation, repairing thoughts, solving problems, and trying the opposite) and targeting common internalizing and externalizing youth mental health disorders and problems. FIRST has shown promise in improving youth mental health in three open trials. Now, in a more rigorous test, we seek to (1) conduct a randomized controlled trial comparing FIRST to usual care in real-world clinical practice settings; (2) examine a promising candidate mediator of change-regulation of negative emotions; and (3) explore variables that may influence clinicians' treatment implementation. METHODS This is an assessor-naïve randomized controlled effectiveness trial in youth outpatient community clinics in New England and Texas. Using double randomization, clinic-employed clinicians and treatment-referred youths (7-15 years old) are independently randomly allocated (1:1) to FIRST or usual care. We aim to recruit 212 youth participants, all referred through normal community pathways, with elevated symptoms of anxiety, depression, conduct problems, or post-traumatic stress. This study will test the effectiveness of FIRST compared to usual care on mental health outcomes, examine whether those outcomes are mediated by regulation of negative emotions, and explore clinician factors that may be associated with FIRST implementation and outcomes. Session recordings are coded to assess treatment fidelity. DISCUSSION This study will evaluate the effectiveness of FIRST in youth community mental health settings, relative to the care usually provided in those settings. If FIRST is found to be effective, it could offer an efficient and practical method to increase use of empirically supported treatment principles in real-world practice contexts. TRIAL REGISTRATION NIH Clinical Trials Registry, NCT04725721. Registered 27 January 2021, https://clinicaltrials.gov/ct2/show/study/NCT04725721.
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Affiliation(s)
- Abby Bailin
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Suite 5.708, Austin, TX, 78712-1289, USA.
| | - Evelyn Cho
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02318, USA
| | - Ariel Sternberg
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02318, USA
| | - Spencer C Evans
- University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33146, USA
| | - Nathan L Hollinsaid
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02318, USA
| | - Sarah Kate Bearman
- Department of Educational Psychology, The University of Texas at Austin, 1912 Speedway, Suite 5.708, Austin, TX, 78712-1289, USA
| | - John R Weisz
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA, 02318, USA
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13
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Bailin A, Cho E, Sternberg A, Evans SC, Hollinsaid NL, Kate Bearman S, Weisz JR. Principle-Guided Psychotherapy for Children and Adolescents (FIRST): Study Protocol for a Randomized Controlled Effectiveness Trial in Outpatient Clinics. RESEARCH SQUARE 2023:rs.3.rs-3210987. [PMID: 37720052 PMCID: PMC10503852 DOI: 10.21203/rs.3.rs-3210987/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Background Hundreds of youth psychotherapy randomized trials have generated scores of helpful empirically supported treatments (ESTs). However, the standardized structure of many ESTs and their focus on a single disorder or homogeneous cluster of problems may not be ideal for clinically referred youths who have comorbidity and whose treatment needs may shift from week to week. This concern has prompted development of flexible transdiagnostic, modular youth psychotherapies. One of these, designed for efficient training and implementation, is FIRST-a transdiagnostic intervention built on five empirically supported principles of change (i.e., feeling calm, increasing motivation, repairing thoughts, solving problems, and trying the opposite) and targeting common internalizing and externalizing youth mental health disorders and problems. FIRST has shown promise in improving youth mental health in three open trials. Now, in a more rigorous test, we seek to (1) conduct a randomized controlled trial comparing FIRST to usual care in real-world clinical practice settings; (2) examine a promising candidate mediator of change-regulation of negative emotions; and (3) explore variables that may influence clinicians' treatment implementation. Methods This is an assessor-naïve randomized controlled effectiveness trial in youth outpatient community clinics in New England and Texas. Using double randomization, clinic-employed clinicians and treatment-referred youths (7-15 years old) are independently randomly allocated (1:1) to FIRST or usual care. We aim to recruit 212 youth participants, all referred through normal community pathways, with elevated symptoms of anxiety, depression, conduct problems, or post-traumatic stress. This study will test the effectiveness of FIRST compared to usual care on mental health outcomes, examine whether those outcomes are mediated by regulation of negative emotions, and explore clinician factors that may be associated with FIRST implementation and outcomes. Session recordings are coded to assess treatment fidelity. Discussion This study will evaluate the effectiveness of FIRST in youth community mental health settings, relative to the care usually provided in those settings. If FIRST is found to be effective, it could offer an efficient and practical method to increase use of empirically supported treatment principles in real-world practice contexts. Trial registration NIH Clinical Trials Registry, NCT04725721. Registered 27 January 2021, https://clinicaltrials.gov/ct2/show/study/NCT04725721.
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14
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Düken ME, Yayan EH, Zengin M, Sevgi T. The effects of the posttraumatic stress and general health status on paediatric burns and their sleep habits. Burns 2023; 49:1321-1327. [PMID: 36566094 DOI: 10.1016/j.burns.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 10/18/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Burns are serious injuries that can require hospitalization and have physical and emotional sequelae. Sleep disturbance can occur after trauma as evidenced by posttraumatic stress symptoms such as re-experiencing of a trauma with repetitive dreams, memories and flashbacks. This area has been minimally examined with pediatric burn survivors; therefore, the aim of this study was to investigate the effects of posttraumatic stress and general health on sleep habits of pediatric burn survivors from. METHOD This is a correlational descriptive study. Its sample included 7-18-year-old inpatients at the burn clinic of a university hospital from January to November 2019. This study used the Posttraumatic Stress Disorder Reaction Index, the General Health Questionnaire (12) and the Children's Sleep Habits Questionnaire for data collection. RESULTS Of the participants, 58.6% were male, 46.5% were primary school students, and 62.6% had no diseases other than their burns. 20.2% of the children had epilepsy, 14.2% had diabetes and 3% had pneumonia. Of the child burn victims, 45.5% were brought to the hospital because of contact with fire. All of them had first-degree burns, 59.6% had second-degree burns, and 80.8% had third-degree burns. After their burns, infections developed in 20.2% during trauma and in 43.4% during burn treatment. A structural equation model indicated that the child burn victims' general health perceptions did not significantly affect their sleep habits (p > 0.05). A significant correlation was found between the children's posttraumatic stress disorder and their sleep habits (p < 0.05). Posttraumatic stress disorder explained 7.2% of their sleep habits. A positive and significant correlation was found between the children's general health perceptions and posttraumatic stress disorder (r = 0.74, p < 0.05). CONCLUSION Burns of any kind can cause posttraumatic stress, sleep disorders and impairment of health status in children.
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Affiliation(s)
- Mehmet Emin Düken
- Health Sciences of Facult, Department of Child Health and Diseases Nursing, Harran University, Şanlıurfa 63000, Turkey.
| | - Emriye Hilal Yayan
- Faculty of Nursing, Department of Child Health and Diseases Nursing, Inönü University, Malatya 44280, Turkey.
| | - Mürşide Zengin
- School of Health, Department of Child Health Nursing, Adıyaman University, Adıyaman 02000, Turkey.
| | - Tekcan Sevgi
- Department of Child Health ve Disease of Nursing, Adana Yuregir State Hospital-Child Health and Diseases Service, Adana, Turkey.
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15
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Isaksson J, Isaksson M, Stickley A, Vermeiren R, Koposov R, Schwab-Stone M, Ruchkin V. Community Violence Exposure and Eating Disorder Symptoms among Belgian, Russian and US Adolescents: Cross-Country and Gender Perspectives. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01590-1. [PMID: 37606867 DOI: 10.1007/s10578-023-01590-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 08/23/2023]
Abstract
Community violence exposure (CVE) is one of the most common adverse childhood experiences worldwide. Despite this, its potential effect on disordered eating in adolescents from different cultures is underexplored. In the present cross-sectional study, self-reported data were collected from 9751 students (Mean age = 14.27) from Belgium, Russia and the US on CVE (witnessing violence and violence victimization), eating disorder (ED) symptoms (ED thoughts with associated compensatory behaviors), and comorbid symptoms of posttraumatic stress, depression and anxiety. Increased CVE (from no exposure to witnessing to victimization) was associated with more ED symptoms, and the associations remained significant after adjusting for comorbid conditions. The associations were similar for adolescents across the three countries. No gender differences were observed in the association between CVE and ED symptoms, even though girls in general reported more ED symptoms than boys. We conclude that CVE appears to be associated with ED symptoms in three culturally different samples of adolescents.
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Affiliation(s)
- Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Martina Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Robert Vermeiren
- Department of Child and Adolescent Psychiatry Curium, Leiden University Medical Center, Leiden, Netherlands
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsö, Norway
- Department of Epidemiology and Modern Technologies of Vaccination, Institute of Professional Education, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Mary Schwab-Stone
- Child Study Center, Yale University School of Medicine, New Haven, USA
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
- Child Study Center, Yale University School of Medicine, New Haven, USA.
- Sala Forensic Psychiatric Clinic, Sala, Sweden.
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16
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Ruchkin V, Isaksson J, Stickley A, Schwab-Stone M. Longitudinal Associations Between Community Violence Exposure and Mental Health Problems in Inner-City Youth: Ethnicity and Gender Perspectives. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:8619-8644. [PMID: 36915222 DOI: 10.1177/08862605231158754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
There is a lack of agreement on whether children and adolescents with different cultural/ethnic backgrounds react to trauma in a similar fashion. This study adds to the existing literature by providing ethnicity and gender perspectives on the longitudinal associations between the degree of community violence exposure (CVE) and mental health problems in U.S. inner-city youth. The study was conducted on a representative sample of predominantly ethnic minority youth (N = 2,794; 54.1% female; age 11-16 years old (M [SD] = 12.77 [1.29]); 60.0% African-American, 26.1% Hispanic American, 13.9% White). Self-reported information was obtained on CVE in year 1 and on mental health problems (depressive symptoms, posttraumatic stress, alcohol use, and conduct problems) in year 1 and year 2. Multivariate analyses of covariance (MANCOVA) were used to compare mental health problems in youth from the three ethnic groups in relation to the different degrees of CVE experienced one year prior, while controlling for their baseline mental health problem levels, age, and socio-economic status. Mental health problems in year 2 increased in a similar fashion in relation to the degree of severity of CVE in year 1 in all three ethnic groups. The interaction effects suggested a gender-specific response to CVE, where girls in the three ethnic groups reported higher levels of depression and posttraumatic stress in relation to the same degree of CVE, as compared to boys. Adolescents from different ethnic backgrounds respond similarly to differing degrees of CVE with an increase in mental health problems over time. In response to a similar degree of exposure, girls tend to experience greater levels of internalizing problems than boys. Timely recognition of traumatic exposure and associated mental health problems is important for early prevention and intervention strategies.
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Affiliation(s)
- Vladislav Ruchkin
- Uppsala University, Sweden
- Yale University School of Medicine, New Haven, CT, USA
- Sala Forensic Psychiatric Clinic, Sweden
| | | | - Andrew Stickley
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Södertörn University, Huddinge, Sweden
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17
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Klippenstein ADW, Piotrowski CC, Winkler J, West CH. Growth in the face of overwhelming pressure: A narrative review of
sibling donor experiences in pediatric hematopoietic stem cell
transplant. J Child Health Care 2023; 27:60-77. [PMID: 34570621 PMCID: PMC9932621 DOI: 10.1177/13674935211043680] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sibling donation in pediatric hematopoietic stem cell transplant (HSCT) can be emotionally distressing for children, but may simultaneously evoke positive emotions, and has the potential to facilitate personal growth. We conducted a narrative review of sibling donor experiences, which included an analysis of psychosocial distress and post-traumatic growth (PTG). We searched the following databases: MEDLINE, CINAHL, PsycInfo, and SCOPUS. Search concepts used to develop key terms included HSCT, siblings, children, and psychosocial outcomes. Specific inclusion criteria included a) research articles published in English in peer-reviewed journals until September 2020, and b) reported trauma symptoms and PTG characteristics of sibling donation experiences. Four themes were identified: fear and anxiety related to HLA testing, overwhelming pressure to donate, guilt and blame when the ill child died, as well as emotional and physical isolation following donation. Sibling responses also included evidence of PTG, articulated as a deepened appreciation for life, closer relationships with the ill child and other family members, increased personal strength, and spiritual growth. These results highlight a critical need for future research approaches that further empower sibling donor voices, such as those found in participatory, arts-based methodologies.
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Affiliation(s)
- Andrea D Winther Klippenstein
- College of Nursing,
University
of Manitoba, Winnipeg, MB, Canada,Andrea D Winther Klippenstein,
Interdisciplinary Doctoral Student, College of Nursing, Rady Faculty of Health
Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB R3T 2N2, Canada.
| | - Caroline C Piotrowski
- Department of Community Health
Sciences, University
of Manitoba, Winnipeg, MB, Canada
| | - Janice Winkler
- Elizabeth Dafoe Library,
University
of Manitoba, Winnipeg, MB, Canada
| | - Christina H West
- College of Nursing,
University
of Manitoba, Winnipeg, MB, Canada
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18
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Saunderson JM, Stickley A, Sturidsson K, Koposov R, Sukhodolsky DG, Ruchkin V. Posttraumatic Stress and Perceived Interpersonal Provocation in Adolescents. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3191-3214. [PMID: 35613735 PMCID: PMC9850389 DOI: 10.1177/08862605221104525] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To examine the impact of posttraumatic stress on the choice of responses to and attribution of intentionality in peer provocation in adolescent boys and girls. Methods: A sample of 2678 adolescents from Northern Russia, aged 13-17 years (59.3% female; 95.7% ethnic Russian) completed self-reports on posttraumatic stress and rated hypothetical peer provocation scenarios that teenagers can encounter in their daily lives. Results: Adolescents with clinically significant levels of posttraumatic stress symptoms (n=184 (6.8%)) reported a different pattern of reactions to peer provocation as compared to all other adolescents. Boys and girls with high levels of posttraumatic symptoms reported that they would be less likely to discuss conflict situations and more likely to react with physical aggression. Compared to their male counterparts, girls with high levels of posttraumatic stress symptoms were more likely to endorse hostile intentions, avoid provocations, and were less likely to endorse verbally aggressive responses. In provocation scenarios that involved physical aggression, girls with high levels of posttraumatic stress symptoms were less likely to endorse verbal aggressive responses and more likely to endorse physically aggressive responses than girls without clinically significant levels of posttraumatic symptoms. Girls with high levels of posttraumatic stress symptoms were also more likely to avoid socially aggressive situations than non-traumatized girls, whereas boys had an opposite pattern. Conclusions: High levels of posttraumatic stress symptoms may play a significant role in the endorsement of aggressive reactions in conflicts with peers and patterns of reactions may be gender-specific. A history of posttraumatic stress should be carefully evaluated in children and adolescents seeking treatment for aggressive behavior.
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Affiliation(s)
| | - Andrew Stickley
- Department of Preventive
Intervention for Psychiatric Disorders, National Institute of Mental
Health, National Center of Neurology
and Psychiatry, Kodaira, Tokyo, Japan
- Stockholm Center for Health and
Social Change (SCOHOST), Södertörn
University, Huddinge, Sweden
| | - Knut Sturidsson
- Department of Clinical
Neuroscience, Division of Psychology, Karolinska Institute,
Stockholm, Sweden
| | - Roman Koposov
- Regional Centre for Child and Youth
Mental Health and Child Welfare, Faculty of Health Sciences,
UiT The Arctic
University of Norway, Tromsø, Norway
- Sechenov First Moscow State Medical
University, Moscow, Russia
| | | | - Vladislav Ruchkin
- Child Study Center,
Yale University
Medical School, New Haven, CT, USA
- Department of Child and Adolescent
Psychiatry, Division of Neuroscience, Uppsala University,
Uppsala, Sweden
- Säter Forensic Psychiatric
Clinic, Säter, Sweden
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19
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Taskesen B, Kardas O, Yılmaz K. Evaluation of depression, anxiety and posttraumatic stress response levels of children and adolescents treated with COVID-19. Eur J Pediatr 2023; 182:567-574. [PMID: 36383286 PMCID: PMC9666990 DOI: 10.1007/s00431-022-04713-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/20/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022]
Abstract
UNLABELLED We aimed to evaluate stress level reactions to depression, anxiety, and posttraumatic stress in paediatric patients' post-COVID-19 infection. A total of two hundred consecutive patients aged 8 to 18 years were prospectively enrolled in the study between March 2020 and June 2021. One hundred patients were diagnosed with a positive COVID-PCR test and had inpatient management. Another hundred patients had positive COVID-PCR results and completed their care and isolation for 14 days at home. We used the child posttraumatic stress reaction index (CPTS-RI), child depression inventory (CDI), and screen for child anxiety-related disorders (SCARED) to evaluate their post-COVID-19 infection mental health state. In the study population, the mean age was 13.4 years, and 50.5% were male. Sixty-seven patients were paediatric, and the rest were adolescents. Based on our scaling system, 10% of patients had depression. Forty-one percent of patients had at least one high subscale of SCARED. Forty-four percent of patients' CPTS-RI was above the normal limit, while 4% had a severe stress reaction level. In the female patient population, SCARED and CPTS-RI were significantly high (p = 0.01). There was no significant correlation between hospitalization duration and test scores. The CPTS-RI score was significantly higher in the outpatient group than in the other groups (p = 0.01). The inpatient group had significantly higher social phobia, while the outpatient group had significantly higher school phobia (p = 0.01 and p = 0.05, respectively). CONCLUSION The present study showed that COVID-19 infection is a significant risk factor for psychopathology in children and adolescents. WHAT IS KNOWN • COVID-19 causes multiple physical complications in the body along with significant harmful physiologic mental health effects. After being diagnosed with COVID-19, paediatric and adolescent patients have been engaging in social isolation. • Shutdowns, school closings, minimizing social interaction, and isolating behaviour are some of the measures used to control the pandemic. For kids to develop into healthy individuals, they need social interaction and a safe environment. WHAT IS NEW • The present study showed that COVID-19 infection is a significant risk factor for childhood and adolescent psychopathology. Based on our scaling system, 10% of patients had depression. Forty-four percent of patients' CPTS-RI was above the normal limit, while 4% had a severe stress reaction level. In the female patient population, SCARED and CPTS-RI were significantly high. • These patients need to be evaluated and monitored by paediatric and adolescent psychiatry clinics simultaneously with paediatric clinics.
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Affiliation(s)
- Bekir Taskesen
- Department of Paediatrics, Dicle University School of Medicine, Diyarbakir, 21200 Turkey
| | - Omer Kardas
- Department of Paediatric Mental Health and Disease, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Kamil Yılmaz
- Department of Paediatric Infectious Diseases, Dicle University School of Medicine, Diyarbakir, 21200, Turkey.
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20
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Peng M, Xiao T, Carter B, Chen P, Shearer J. Effectiveness and Cost-Effectiveness of Mental Health Interventions Delivered by Frontline Health Care Workers in Emergency Health Services: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15847. [PMID: 36497923 PMCID: PMC9736335 DOI: 10.3390/ijerph192315847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/03/2022] [Accepted: 11/15/2022] [Indexed: 06/17/2023]
Abstract
This systematic review is to evaluate the effectiveness and cost-effectiveness of mental health interventions delivered by frontline health care workers in disasters and public health emergencies. Six databases and trial registries were searched, and manual searches were conducted. Of the 221 studies identified, 21 were included. Meta-analyses assessed differences between the intervention and control in terms of PTSD outcomes. Eleven studies of 1802 participants were incorporated in the meta-analysis. Interventions delivered or prompted by specialist health care workers showed significant and large effects in improving PTSD-related symptoms with a SMD = 0.99 (95% CI: 0.42-1.57, p = 0.0007). Interventions delivered or prompted by frontline non-specialist health care workers showed significant but small effects in improving PTSD-related symptoms with SMD of 0.25 (95% CI: 0.11-0.39; p = 0.0007). The results showed that most mental health interventions delivered by frontline health care workers effectively supported affected people. Mental health interventions delivered by mental health care professionals are effective in reducing PTSD-related disorders in natural disasters. Future adequately powered RCTs are needed to evaluate the effectiveness of mental health interventions delivered by trained non-specialists. Economic modelling may be useful to estimate cost effectiveness in low- and middle-income countries given the difficulties of conducting studies in disaster and emergency settings.
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Affiliation(s)
- Min Peng
- King’s Health Economics, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Tao Xiao
- Department of Emergency Response and Preparedness, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Psychological Rescue Branch, China Association for Disaster and Emergency Rescue Medicine, Haidian District, Beijing 100080, China
| | - Ben Carter
- Department of Biostatistics and Health informatics, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Pan Chen
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410011, China
| | - James Shearer
- King’s Health Economics, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
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21
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Capurso M, De Stasio S, Ragni B. Universal crisis psychoeducational interventions in schools: A scoping review. SCHOOL PSYCHOLOGY INTERNATIONAL 2022. [DOI: 10.1177/01430343221104986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In times of crisis, schools are expected to help students deal with the situation and any help offered should consider the social and emotional problems arising from the critical event. Therefore, school-based activities enabling children to recognize the experience and work through it are essential to sustain their normal development and prevent academic and mental health problems. This paper provides an overview of the literature on universal school crisis interventions. We performed a scoping literature search in Scopus, ERIC, and Psych Info for articles published between January 2000 and May 2021 and identified 32 universal school-based crisis interventions based on three main crisis types (armed conflict, natural disaster, and Covid-19). Analysis of the methodologies and theoretical backgrounds generated six key psychoeducational factors commonly adopted. Comparing the different programmes in terms of topics, course content, duration, and methodology can help administrators and educators select the most appropriate crisis intervention for their school and situation. We also discuss the collaboration between mental health care specialists, school teams, and other important factors needed to implement these programmes and ensure their effectiveness under real-life conditions.
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Affiliation(s)
- Michele Capurso
- Department of Philosophy, Social & Human Sciences and Education, University of Perugia, Perugia, Italy
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22
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Ceballo R, Alers‐Rojas F, Mora AS, Cranford JA. Exposure to community violence: Toward a more expansive definition and approach to research. CHILD DEVELOPMENT PERSPECTIVES 2022. [DOI: 10.1111/cdep.12448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Rosario Ceballo
- Department of Psychology Georgetown University Washington District of Columbia USA
| | - Francheska Alers‐Rojas
- Department of Human Development and Family Sciences University of Texas at Austin Austin Texas USA
| | - Andrea S. Mora
- Department of Psychology University of Michigan Ann Arbor Michigan USA
| | - James A. Cranford
- Department of Emergency Medicine University of Michigan Ann Arbor Michigan USA
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23
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Woolgar FA, Wilcoxon L, Pathan N, Daubney E, White D, Meiser-Stedman R, Colville GA. Screening for Factors Influencing Parental Psychological Vulnerability During a Child's PICU Admission. Pediatr Crit Care Med 2022; 23:286-295. [PMID: 35081084 DOI: 10.1097/pcc.0000000000002905] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To identify the risks of developing post-traumatic stress disorder (PTSD) and/or depression in parents following their child's PICU admission using a brief screening instrument and to examine the associations with these risks. DESIGN A cross-sectional parental survey. SETTING A general 13-bed PICU at a large teaching hospital. SUBJECTS One hundred and seven parents of 75 children admitted to the PICU. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS All parents completed the 10-item Posttraumatic Adjustment Screen (PAS) before discharge. The PAS assesses risk factors known to be associated with poorer psychological outcome, including psychosocial variables pretrauma and peritrauma, and acute stress. Parents' scores on the PAS indicated that 64 (60%) were at risk of developing PTSD and 80 (75%) were at risk of developing depression following their child's admission. Univariate analyses suggested that psychosocial variables, such as preexisting stressors and a history of previous mental health problems, were more strongly associated with PAS risk scores for PTSD and depression than medical or sociodemographic factors. In logistic regression analyses, a history of previous mental health problems was significantly associated with risk of developing PTSD and depression (p < 0.001) explaining 28% and 43% of the variance in these outcomes. CONCLUSIONS This study suggests that a significant number of parents on PICU are potentially at risk of developing PTSD and/or depression postdischarge and that psychosocial factors, pretrauma and peritrauma, are stronger determinants of this risk, and of acute distress, than other variables. Identification of vulnerable parents during admission, using a measure such as the PAS, could facilitate the targeting of support and monitoring, acutely and postdischarge, at those who might be most likely to benefit.
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Affiliation(s)
- Francesca A Woolgar
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Lucy Wilcoxon
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Nazima Pathan
- Department of Paediatrics, Addenbrookes Hospital, Cambridge, United Kingdom
| | - Esther Daubney
- Department of Paediatrics, Addenbrookes Hospital, Cambridge, United Kingdom
| | - Deborah White
- Department of Paediatrics, Addenbrookes Hospital, Cambridge, United Kingdom
| | - Richard Meiser-Stedman
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Gillian A Colville
- Paediatric Psychology Service, St George's Hospital, London, United Kingdom
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24
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Woolgar F, Garfield H, Dalgleish T, Meiser-Stedman R. Systematic Review and Meta-analysis: Prevalence of Posttraumatic Stress Disorder in Trauma-Exposed Preschool-Aged Children. J Am Acad Child Adolesc Psychiatry 2022; 61:366-377. [PMID: 34242737 PMCID: PMC8885427 DOI: 10.1016/j.jaac.2021.05.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 05/13/2021] [Accepted: 06/29/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Trauma exposure is common in preschool-aged children. Understanding the psychological impact of such exposure and the prevalence of posttraumatic stress disorder (PTSD) in this population is important for provision of appropriate and timely intervention. This pre-registered (PROSPERO: CRD41019133984) systematic review and meta-analysis examined the prevalence of PTSD in trauma-exposed preschool-aged children. METHOD Literature searches were conducted of PubMed (Medline), PsycINFO and PILOTS, alongside reference lists of relevant reviews. Studies were selected if they comprised trauma-exposed samples with a mean age of less than 6.5 years, and PTSD was assessed using standardized interviews at least 1-month post trauma. Information on sample characteristics, trauma exposure, PTSD measurement, and diagnostic criteria were extracted. For studies that applied more than one PTSD diagnostic algorithm, the most age-appropriate criteria were used to estimate pooled prevalence estimate across studies. A random-effects model was used for meta-analysis. RESULTS Eighteen studies were included (N = 1941). The pooled PTSD prevalence was 21.5% (95% CI = 13.8%-30.4%) when using the most developmentally appropriate diagnostic algorithm that was available. When focusing on the subset of studies that reported both standard adult criteria and age-appropriate criteria (k = 12), a pooled estimate of 4.9% (95% CI = 2.5%-8.0%) was obtained for standard adult criteria (DSM-IV), and 19.9% (95% CI = 12.1%-29.0%) was obtained for age-appropriate criteria (PTSD-AA). Prevalence was 3-fold higher following interpersonal and repeated trauma exposure, compared to non-interpersonal or single-event trauma, respectively. Higher prevalence was found when age-appropriate diagnostic tools were used. There was significant heterogeneity across studies and a lack of studies conducted in low-income countries and applying age-appropriate diagnostic algorithms. CONCLUSION Preschool-aged children are vulnerable to developing PTSD following trauma exposure. Younger children show prevalence trends similar to those of older youths and adults following different types of trauma. Age-appropriate diagnostic criteria are essential to ensure that appropriate identification and early support are provided.
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Affiliation(s)
| | | | - Tim Dalgleish
- Cognition and Brain Sciences Unit, Medical Research Council, Cambridge, United Kingdom
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Koposov RA, Stickley A, Ruchkin V. Bulimia Symptoms in Russian Youth: Prevalence and Association With Internalizing Problems. Front Psychiatry 2022; 12:797388. [PMID: 35126206 PMCID: PMC8811208 DOI: 10.3389/fpsyt.2021.797388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/23/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND There has been limited research on bulimia symptoms in adolescents from the general population outside the United States. This study aimed to evaluate the prevalence of bulimia symptoms in Russian youth and explore the associations between a clinical level of self-reported probable bulimia nervosa (BN) and internalizing problems, binge drinking and functional impairment by gender. METHODS Data were collected from a representative sample of school students (N = 2,515, 59.5% female) from Northern Russia [age M (SD) = 14.89 ± 1.13 years]. Probable BN and internalizing psychopathology were assessed using self-report scales. Chi-square and independent sample t-tests were used to compare respondents' demographic characteristics and disordered eating behaviors. GLM multivariate analysis of covariance was used to assess the associations between probable BN, functional impairment and mental health problems (MHP) by gender. RESULTS Analyses showed that the 3-month prevalence of probable BN was higher in girls (3.9%) than in boys (1.2%). Probable BN was associated with depressive and anxiety symptoms, somatic anxiety, somatic complaints, binge drinking and functional impairment. Boys reported a higher level of problem scores in relation to probable BN. CONCLUSIONS Our findings suggest that bulimia symptoms are prevalent in Russian adolescents and are associated with MHP and functional impairment. Timely recognition of bulimia symptoms and associated MHP is important for early prevention and intervention strategies.
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Affiliation(s)
- Roman A. Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Stockholm Center for Health and Social Change, Södertörn University, Huddinge, Sweden
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden
- Child Study Center, Yale University Medical School, New Haven, CT, United States
- Säter Forensic Psychiatric Clinic, Säter, Sweden
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Qi X, Wang J, Liu J, Amporfro DA, Wang K, Liu H, Shah S, Wu Q, Hao Y. Factors associated with peritraumatic stress symptoms among the frontline healthcare workers during the outbreak of COVID-19 in China. BMJ Open 2022; 12:e047753. [PMID: 35017231 PMCID: PMC8753098 DOI: 10.1136/bmjopen-2020-047753] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES This study aimed to examine the prevalence of peritraumatic stress symptoms (PTSSs), perceived threat, social support and factors contributing to clinically significant PTSS among frontline COVID-19 healthcare workers (HCWs) in China. DESIGN AND SETTING An online survey through self-administered questionnaires was conducted from 18 February to 4 March 2020, during the outbreak of COVID-19. OUTCOMES MEASURES PTSS was assessed using the post-traumatic stress disorder (PTSD) self-rating scale. Demographic and socioeconomic characteristics, self-reported health, physical/psychological symptoms, perceived threat from frontline work and perceived social support were investigated. Multivariable line regression analysis distinguished factors associated with HCWs' PTSS scores. RESULTS A total of 676 (58.1%) HCWs have shown clinically significant high levels of PTSS. Only 441 (37.9%) self-reported good health. Most had physical symptom(s) (915 (78.7%)), psychological symptom(s) (906 (77.9%)), inability to vent emotions (284 (24.4%)), emotional exhaustion (666 (57.3%)) and 1037 (89.2%) needed professional respect. Moreover, social support received was less than expected, and the receipt of psychological services/help scored the lowest (3.11±1.73). Combined psychological and physical symptoms, difficulty in releasing tension and venting emotions timely, fear of infection, emotional exhaustion and depersonalisation are significantly associated with PTSS scores among frontline HCWs. Working ≥8 hours, having the senior professional title, self-reported health, enjoying perfect protection and control measures, economic subsidy and control policy on reducing discriminatory practices are negatively correlated with PTSS scores. CONCLUSIONS During the outbreak of COVID-19, frontline HCWs experienced clinically significant high levels of PTSS and heavy workload, and the emergency resulted in their inadequate psychosocial support. If this is left unchecked, HCWs have a higher risk of developing PTSD. Early detection, identification and person-directed, targeted multidisciplinary interventions should be undertaken to address various influencing factors. Comprehensive measures, including setting up emotional release channels, as well as providing psychological and social support intervention for HCWs globally, are highly recommended.
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Affiliation(s)
- Xinye Qi
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiahui Wang
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingjing Liu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Daniel Adjei Amporfro
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Kexin Wang
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Huan Liu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Saleh Shah
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qunhong Wu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanhua Hao
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
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Kelmanson IA. [Sleep disturbances and their associations with disorders in emotional sphere and behavior in children]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:93-98. [PMID: 34932293 DOI: 10.17116/jnevro202112111193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The paper addresses associations between sleep disorders and emotional and behavioral disturbances in children. These associations are considered in a view of commonly found co-occurrences of sleep problems, signs of anxiety and depression, oppositional-defiant behavior, and increased aggressiveness. The authors put forward a conception of reciprocal influences of these disturbances and provide information on potential physiological mechanisms responsible for associations between sleep problems and emotional and behavioral disturbances in children. Attention is drawn to hypothalamus-hypophysis-adrenal axis activation, serotonergic and aminergic systems imbalance, impaired melatonin and orexins production. Possibility of an existing pattern encompassing sleep problems, emotional and behavioral disturbances is discussed. Practical recommendations aimed at timely identification and treatment of the mentioned disorders are suggested.
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Affiliation(s)
- I A Kelmanson
- Almazov National Medical Research Centre, St. Petersburg, Russia.,Saint-Petersburg State Institute for Psychology and Social Work, St. Petersburg, Russia
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Clemans TA, White KL, Fuessel-Herrmann D, Bryan CJ, Resick PA. Acceptability, Feasibility, and Preliminary Effectiveness of Group Cognitive Processing Therapy with Female Adolescent Survivors of Commercial Sexual Exploitation in Cambodia. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2021; 14:571-583. [PMID: 34824667 PMCID: PMC8586407 DOI: 10.1007/s40653-021-00405-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
Research supports the efficacy of cognitive processing therapy (CPT) for reducing Posttraumatic Stress Disorder (PTSD) and comorbid conditions among survivors of sexual assault and other traumas. To date, there are no known studies using CPT with adolescents exposed to commercial sexual exploitation (CSE). The pilot study implemented a modified version of group CPT to determine the preliminary acceptability and feasibility of this intervention with adolescents who experienced CSE. Thirteen participants living in a residential treatment facility in Cambodia received 10 sessions of modified group CPT. Participants were adolescents ranging in age from 14 to 19. Measures of PTSD, depression symptom severity, and suicidal and non-suicidal ideation and behaviors were obtained at baseline, during the intervention, and 1-week and 3 months posttreatment. Group attendance rates and client satisfaction measures of the intervention were obtained. Client satisfaction with the group intervention was high (mean = 27, SD 2.61) and group attendance was good. There was a significant decline in PTSD symptom severity F(7,24) = 2.60, p = .037 and a significant decline in depression symptom severity over time F(7,12) = 9.67, p < .001. There were no occurrences of suicidal or non-suicidal behavior during the study or at follow-up with one participant reporting suicidal ideation after treatment began. The modified CPT intervention appeared to be feasible and received a high acceptability rating.
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Affiliation(s)
- Tracy A. Clemans
- The Center On Trauma and Children, University of Kentucky College of Medicine, 3470 Blazer Parkway, Suite 100, Lexington, KY 40509 USA
| | | | | | - Craig J. Bryan
- The Ohio State University College of Medicine, Columbus, USA
| | - Patricia A. Resick
- Department of Psychiatry and Behavioral Sciences, Duke Health, Durham, USA
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Le Roux IH, Cobham VE. Psychological Interventions for Children Experiencing PTSD After Exposure to a Natural Disaster: A Scoping Review. Clin Child Fam Psychol Rev 2021; 25:249-282. [PMID: 34779953 DOI: 10.1007/s10567-021-00373-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 11/25/2022]
Abstract
Exposure to a natural disaster can have a myriad of significant and adverse psychological consequences. Children have been identified as a particularly vulnerable population being uniquely susceptible to post-disaster psychological morbidity, including post-traumatic stress disorder (PTSD). Without effective intervention, the impact of natural disasters on children's developmental trajectory can be detrimental, however, research is yet to find evidence to definitively establish the comparative efficacy or unequivocal superiority of any specific psychological intervention. A scoping review was undertaken according to the Preferred Reporting Items extension for Scoping Reviews Guidelines (PRISMA-ScR), to evaluate the current research regarding psychological interventions for children (below 18 years of age) experiencing PTSD after exposure to natural disasters, a single incident trauma. Fifteen studies involving 1337 children were included in the review. Overall, psychological interventions, irrespective of type, were associated with statistically significant and sustained reductions in PTSD symptomatology across all symptom clusters. However, whilst evidence supported the general efficacy of psychological interventions in this population, the majority of studies were considered retrospective field research designed in response to the urgent need for clinical service in the aftermath of a natural disaster. Consequently, studies were largely limited by environmental and resource constraints and marked by methodological flaws resulting in diverse and highly heterogeneous data. As such, definitive conclusions regarding the treatment efficacy of specific psychological interventions, and furthermore their ameliorative contributions constituting the necessary mechanisms of change remains largely speculative. As natural disasters can have a catastrophic impact on human lives, establishing levels of evidence for the efficacy of different psychological interventions for children represents a global public health priority.
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Affiliation(s)
- Isabella H Le Roux
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia.
- Children's Health Queensland Child and Youth Mental Health Service (CHQ CYMHS), Brisbane, QLD, Australia.
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Ruchkin V, Isaksson J, Schwab-Stone M, Stickley A. Prevalence and early risk factors for bulimia nervosa symptoms in inner-city youth: gender and ethnicity perspectives. J Eat Disord 2021; 9:136. [PMID: 34674763 PMCID: PMC8529812 DOI: 10.1186/s40337-021-00479-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Research on risk factors associated with bulimia nervosa symptoms (BN) in ethnic minorities has been limited. This study adds to the existing literature by providing the ethnicity- and gender-specific prevalence of BN in US inner-city youth and by exploring the longitudinal associations between a clinical level of BN and early risk factors assessed one year previously. METHODS The study was conducted on a representative sample of predominantly ethnic minority youth (N = 2794; 54.1% female; age 11-16 years old (M(SD) = 12.77(1.29)); 60.0% African-American, 26.1% Hispanic American, 13.9% White). Self-reported information was obtained on BN and early risk factors (e.g., depressive and anxiety symptoms, posttraumatic stress, somatic complaints). Multivariate analysis of covariance was used to examine the longitudinal associations. RESULTS The 3-month BN prevalence was higher in girls (5.1%) than in boys (2.3%) (ratio 2.22:1). Significant differences in BN rates were found between White and African American students (higher in Whites), whereas Hispanic-Americans did not differ significantly from either group. Individuals with BN had significantly higher levels of early risk factors one year prior. CONCLUSIONS Timely recognition of BN and associated early risk factors is important for early prevention and intervention strategies.
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Affiliation(s)
- Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85, Uppsala, Sweden. .,Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA. .,Säter Forensic Psychiatric Clinic, 783 27, Säter, Sweden.
| | - Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85, Uppsala, Sweden.,Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Mary Schwab-Stone
- Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.,Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
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Oddo ER, Maldonado L, Hink AB, Simpson AN, Andrews AL. Increase in Mental Health Diagnoses Among Youth With Nonfatal Firearm Injuries. Acad Pediatr 2021; 21:1203-1208. [PMID: 34119719 DOI: 10.1016/j.acap.2021.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/28/2021] [Accepted: 06/03/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Firearm injury is a leading cause of mortality for US youth. For every youth who dies from a firearm injury, at least 4 more survive. Little is known about the mental health consequences of non-fatal firearm injury in youth. Our objective was to quantify new mental health diagnoses after nonfatal firearm injury. METHODS MarketScan Medicaid and commercial data were used to identify youth age 0 to 17 years with an initial encounter for a nonfatal firearm injury in 2016 to 2017. The International Classification of Diseases, Tenth Revision codes determined the presence of mental health conditions in the 12 months preinjury, during the index encounter, and in the 12 months postinjury. Logistic regression analysis was performed to determine factors associated with new mental health diagnoses during the 12 months postinjury. RESULTS About 2178 patients (1769 Medicaid, 409 commercial) were identified for inclusion. 844 (38.8%) patients had a mental health diagnosis identified during the 12-month preinjury period. During the index encounter, 184 (8.5%) patients had a newly diagnosed mental health disorder. In the 12 months postinjury, 559 (25.7%) patients had a newly diagnosed mental health disorder. The most common new diagnosis categories were trauma disorders, substance abuse, and disruptive disorders. Medicaid insurance and a prior complex chronic condition were predictors of new mental health diagnosis. CONCLUSION Over a quarter of youth with nonfatal firearm injury were diagnosed with a new mental health condition in the 12 months after their injury. Health care providers should be vigilant about mental health screening and ensuring access to mental health care services in this population.
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Affiliation(s)
- Elizabeth R Oddo
- Department of Pediatrics, College of Medicine, Medical University of South Carolina (ER Oddo), Charleston, SC.
| | - Lizmarie Maldonado
- Department of Healthcare Leadership and Management, College of Health Professions, Medical University of South Carolina (L Maldonado), Charleston, SC
| | - Ashley B Hink
- Department of Surgery, College of Medicine, Medical University of South Carolina (AB Hink), Charleston, SC
| | - Annie N Simpson
- Department of Healthcare Leadership and Management, College of Health Professions, Medical University of South Carolina (AN Simpson), Charleston, SC
| | - Annie L Andrews
- Department of Pediatrics, College of Medicine, Medical University of South Carolina (AL Andrews), Charleston, SC
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Risky sexual behaviour among Russian adolescents: association with internalizing and externalizing symptoms. Child Adolesc Psychiatry Ment Health 2021; 15:40. [PMID: 34372880 PMCID: PMC8353740 DOI: 10.1186/s13034-021-00393-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 08/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Risky sexual behaviour (RSB) is regarded as a major health problem during adolescence. Russia has one of the highest rates of teenage pregnancy, abortion and newly diagnosed HIV infections in the world, but research on RSB in Russian youth has been limited. To address this deficit, this study examined the role of several factors, including internalizing and externalizing symptoms, in RSB among Russian adolescents. METHODS Self-reported data were collected from 2573 Russian adolescents aged 13-17 years old (59.4 % girls; Mean age = 14.89) regarding RSB (unprotected sex, early pregnancy, multiple sexual partners and substance use during sexual encounters). Information was also obtained on externalizing (conduct problems and delinquent behaviour) and internalizing (depression, anxiety and posttraumatic stress) symptoms, as well as interpersonal risk and protective factors (affiliation with delinquent peers, parental involvement and teacher support). Hierarchical multiple binary logistic regression analysis was used to examine the associations between these variables and RSB. RESULTS Boys reported engaging in more RSB than girls. Externalizing symptoms and affiliation with delinquent peers were most strongly associated with RSB, whereas symptoms of anxiety were negatively associated with RSB. There was an interaction effect for sex and affiliation with delinquent peers on RSB with boys reporting RSB when having more delinquent peers. Neither parental involvement nor teacher support were protective against RSB. CONCLUSIONS Early detection of and interventions for RSB and associated externalizing symptoms may be important for adolescent physical and mental wellbeing. Affiliation with delinquent peers should, especially among boys, be regarded as a risk marker for RSB.
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Haj-Yahia MM, Greenbaum CW, Lahoud-Shoufany L. Palestinian Adolescents' Prolonged Exposure to Political Violence, Self- Esteem, and Post-Traumatic Stress Symptoms. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:4137-4164. [PMID: 30027784 DOI: 10.1177/0886260518789144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The goal of this study was to understand the relation between adolescents' long-term exposure to political violence (EPV) and post-traumatic stress symptoms (PTSS). We examined the relations among EPV, PTSS, and self-esteem to determine whether self-esteem could buffer the effects of EPV on PTSS. A systematic cluster random sample of 2,934 Palestinian adolescent boys and girls in the West Bank area of the Palestinian Authority and in East Jerusalem participated in a study using a self-administered questionnaire. Multiple regression analysis showed that the more Palestinian youth were exposed to political violence during the last year and during previous years, the more they exhibited PTSS and its three manifestations, that is, avoidance, intrusion, and arousal. In addition, EPV showed effects on PTSS after controlling for sociodemographic variables and self-esteem. Girls and residents of the West Bank reported more PTSS than boys and residents of East Jerusalem, respectively. Higher levels of EPV correlated with lower levels of self-esteem, and children with relatively low self-esteem were likely to report more PTSS than children with high self-esteem. Hence, the correlations between participants' EPV and some of the PTSS were found to be partially dependent on the levels of their self-esteem, indicating moderating and mediating effects for self-esteem on the relation between degree of EPV and PTSS. The limitations of the study and implications for future research are discussed.
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Friedman MJ. Neurobiological Sensitization Models of Posttraumatic Stress Disorder: Their Possible Relevance to Multiple Chemical Sensitivity Syndrome. Toxicol Ind Health 2021. [DOI: 10.1177/074823379401000515] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Neurological sensitization has been proposed as a model for post-traumatic stress disorder (PTSD) (Lipper et al., 1986; van der Kolk, 1987; Friedman, 1988; Post et al., 1988, 1994; Charney et al., 1993). Laboratory paradigms in which repeated exposure to a discrete stimulus is associated with progressive intensification of a neurophysiologic, behavioral, or pharmacologic response has many parallels with the sequence of events that precipitates PTSD. Investigators with other clinical interests have also been attracted to sensitization models. Specifically, Bell and associates (1992) have proposed that olfactory-limbic kindling is a very good model for understanding the etiology of multiple chemical sensitivity (MCS) syndrome. A number of articles in this volume have addressed the goodness-of -fit between this model and MCS. My major assignment is to review laboratory data and clinical observations pertinent to sensitization models of PTSD. I will show that although there are intriguing parallels between the two phenomena, one must have great respect for the complexity and polymorphism of both sensitization and PTSD before grasping for simplistic theoretical conclusions. Secondly, I will address the following question; if both PTSD and MCS can be understood as sensitization phenomena, are PTSD patients at greater risk to develop MCS and vice versa? This article is divided into four sections: a) a description of three distinct sensitization phenomena; b) a description of the symptoms of PTSD; c) a review of the applicability of sensitization models to the clinical phenomenology of PTSD; and d) a review of the hypothesis that PTSD patients might be more vulnerable to MCS.
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Affiliation(s)
- Matthew J. Friedman
- National Center for PTSD, VAM, and ROC White River Junction, Vermont and Departments
of Psychiatry and Pharmacology Dartmouth Medical School Hanover, New Hampshire
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Giannakopoulos G, Kolaitis G. Sleep problems in children and adolescents following traumatic life events. World J Psychiatry 2021; 11:27-34. [PMID: 33643859 PMCID: PMC7896245 DOI: 10.5498/wjp.v11.i2.27] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 02/06/2023] Open
Abstract
Rates of childhood trauma exposure are extremely high, with approximately 70% of children and adolescents experiencing at least one traumatic event. Among the most common non-specific consequences of stress and trauma are disruptions of sleep. Sleep problems, such as shorter sleep duration, difficulty falling asleep, frequent awakenings, nightmares, sleepless nights, and early-morning wakefulness appear to have a higher prevalence among children and adolescents following traumatic events. This review will illustrate the role of sleep problems in traumatized children and adolescents, and emphasize the need to consider a wide range of etiological mechanisms for these symptoms. However, the relationship of trauma exposure to sleep problems among children and adolescents needs further investigation in future research. Moreover, in view of the adverse consequences of long-term disrupted sleep on mental health outcomes following trauma, the need to effectively address sleep disturbances in traumatized children and adolescents is crucial.
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Affiliation(s)
- George Giannakopoulos
- Department of Child Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece
| | - Gerasimos Kolaitis
- Department of Child Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece
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Karadag M, Topal Z, Ezer RN, Gokcen C. Use of EMDR-Derived Self-Help Intervention in Children in the Period of COVID-19: A Randomized-Controlled Study. JOURNAL OF EMDR PRACTICE AND RESEARCH 2021. [DOI: 10.1891/emdr-d-20-00054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Self-help treatments are an important intervention tool, with high accessibility and ease of application. To our knowledge, no research has previously been conducted on any self-help intervention derived from eye movement desensitization and reprocessing (EMDR) therapy. In this study, we evaluated the mental health status of children not directly affected by the pandemic and investigated the effects of using an EMDR-derived self-help intervention in children as a low-intensity treatment. The mental health status of 178 children was evaluated online via the State-Trait Anxiety Inventory for Children (STAIC) and Childhood Posttraumatic Stress Reaction Index (CPTS-RI). Then, children were randomly assigned to intervention and waitlist. A booklet containing EMDR-derived techniques was sent via the school online portal and the intervention was conducted. Posttests were administered 4 weeks later. The attrition rate was 45.5%, with 97 children completing the trial (intervention: 52; waitlist: 45). At baseline, 76.4% of children showed posttraumatic stress symptoms (PTSS) above threshold. Results showed a statistically significant decrease in the posttest PTSS scores for the intervention group compared to waitlist. The intervention group had significant pre–post improvement on all but one subscale, while the waitlist group showed a significant increase in state anxiety on the STAIC. In conclusion, posttraumatic stress was found to be high in children during the COVID-19 outbreak period, and EMDR-derived self-help intervention appeared to be an effective psychosocial intervention tool.
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Cimolai V, Schmitz J, Sood AB. Effects of Mass Shootings on the Mental Health of Children and Adolescents. Curr Psychiatry Rep 2021; 23:12. [PMID: 33570688 DOI: 10.1007/s11920-021-01222-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW To examine mass shootings in youth including mass shooting trends, risk and protective factors for emotional sequelae, mental health, prevention of mass shootings, and the assessment and treatment of survivors. RECENT FINDINGS Many youth are exposed to gun violence, with a smaller subset exposed to mass shootings. While youth have varying responses to mass shootings, possibly due to risk and protective factors as well as level of exposure, the mental health outcomes are significant and include posttraumatic stress, suicide, depression, substance abuse, and anxiety. Efforts at developing effective prevention and treatment programs are still underway but generally take a tiered public health approach. Mass shootings have significant mental health outcomes for youth survivors, particularly those with direct exposure or risk factors. Continued efforts are needed to better understand the effects of mass shootings and how to prevent them from occurring as well as how to best address the needs of survivors.
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Affiliation(s)
- Valentina Cimolai
- Virginia Treatment Center for Children, Virginia Commonwealth University, 1308 Sherwood Avenue, Richmond, VA, 23220, USA
| | - Jacob Schmitz
- Virginia Treatment Center for Children, Virginia Commonwealth University, 1308 Sherwood Avenue, Richmond, VA, 23220, USA
| | - Aradhana Bela Sood
- Virginia Treatment Center for Children, Virginia Commonwealth University, 1308 Sherwood Avenue, Richmond, VA, 23220, USA.
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Ruchkin V, Koposov R, Oreland L, af.Klinteberg B, Grigorenko EL. Dopamine-related receptors, substance dependence, behavioral problems and personality among juvenile delinquents. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.109849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lai BS, La Greca AM, Brincks A, Colgan CA, D’Amico MP, Lowe S, Kelley ML. Trajectories of Posttraumatic Stress in Youths After Natural Disasters. JAMA Netw Open 2021; 4:e2036682. [PMID: 33587133 PMCID: PMC7885036 DOI: 10.1001/jamanetworkopen.2020.36682] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Disaster exposure is associated with the development of posttraumatic stress (PTS) symptoms in youths. However, little is known about how to predict which youths will develop chronic PTS symptoms after disaster exposure. OBJECTIVE To evaluate PTS symptom trajectories among youths after 4 major US hurricanes and assess factors associated with those trajectories. DESIGN, SETTING, AND PARTICIPANTS This cohort study used integrative data analysis to combine data from 4 studies of youths' responses to natural disasters (hurricanes Andrew [1992], Charley [2004], Ike [2005], and Katrina [2008]) at time points ranging from 3 to 26 months after the disasters. Those studies recruited and surveyed youths aged 6 to 16 years at schools via convenience sampling of schools near the path of destruction for each hurricane. This study was conducted from August 2017 to August 2020, and pooled data were analyzed from February 2019 to October 2020. EXPOSURE Experience of a natural disaster during the ages of 6 to 16 years. MAIN OUTCOMES AND MEASURES Posttraumatic stress symptoms were assessed using the University of California, Los Angeles, Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI) and the UCLA PTSD-RI-Revised. Latent class growth analyses were used to evaluate the youths' PTS symptom trajectories and associated factors. RESULTS Among 1707 youths included in the study, the mean (SD) age was 9.61 (1.60) years, 922 (54%) were female, and 785 (46%) self-identified as White non-Hispanic. Four PTS symptom trajectories were identified: chronic (171 participants [10%]), recovery (393 [23%]), moderate-stable (563 [33%]), and low-decreasing (580 [34%]). Older youths were less likely to be in the chronic group; compared with the chronic group, each 1-year increase in age was associated with increased odds of being in the other groups (recovery: odds ratio [OR], 1.78 [95% CI, 1.29-2.48]; moderate-stable: OR, 1.94 [95% CI, 1.43-2.62]; and low-decreasing: OR, 2.71 [95% CI, 1.99-3.71]). Compared with males, females had higher odds of being in the chronic group than in any other group (recovery group: OR, 0.48 [95% CI, 0.26-0.91]; moderate-stable group: OR, 0.37 [95% CI, 0.21-0.64]; and low-decreasing group: OR, 0.25 [95% CI, 0.14-0.44]). CONCLUSIONS AND RELEVANCE In this cohort study, few youths reported chronic distress, and trajectories among most youths reflected recovery or low-decreasing PTS symptoms. Older age and identification as male were factors associated with decreased odds of a chronic trajectory. Youths with chronic or moderate-stable trajectories may benefit from intervention.
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Affiliation(s)
- Betty S. Lai
- Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education and Human Development, Boston College, Chestnut Hill, Massachusetts
| | | | - Ahnalee Brincks
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing
| | - Courtney A. Colgan
- Department of Counseling, Developmental, and Educational Psychology, Lynch School of Education and Human Development, Boston College, Chestnut Hill, Massachusetts
| | | | - Sarah Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut
| | - Mary Lou Kelley
- Department of Psychology, Louisiana State University, Baton Rouge
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Ungar M, Theron L, Murphy K, Jefferies P. Researching Multisystemic Resilience: A Sample Methodology. Front Psychol 2021; 11:607994. [PMID: 33510683 PMCID: PMC7835509 DOI: 10.3389/fpsyg.2020.607994] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/08/2020] [Indexed: 11/13/2022] Open
Abstract
In contexts of exposure to atypical stress or adversity, individual and collective resilience refers to the process of sustaining wellbeing by leveraging biological, psychological, social and environmental protective and promotive factors and processes (PPFPs). This multisystemic understanding of resilience is generating significant interest but has been difficult to operationalize in psychological research where studies tend to address only one or two systems at a time, often with a primary focus on individual coping strategies. We show how multiple systems implicated in human resilience can be researched in the same study using a longitudinal, six-phase transformative sequential mixed methods study of 14- to 24-year-olds and their elders in two communities dependent on oil and gas industries (Drayton Valley, Canada, and Secunda/eMbalenhle, South Africa). Data collection occurred over a 5-year period, and included: (1) community engagement and the identification of youth health and well-being priorities; (2) participatory youth-centric qualitative research using one-on-one semi-structured interviews and arts-based methods; (3) survey of 500 youth at three time points to assess psychosocial health indicators and outcomes; (4) collection of hair samples to assess stress biomarkers (cortisol and dehydroepiandrosterone-DHEA) over time; (5) youth-led ecological data collection and assessment of historical socio-economic development data; and (6) community resource mapping with community elders. Analyzing data from these multiple systems will allow us to understand the interrelationship and impact of PPFPs within and across systems. To date, we have undertaken thematic and narrative qualitative analyses, and descriptive analyses of the preliminary ecological and survey data. As we proceed, we will combine these and grounded theory approaches with innovative techniques such as latent transition analysis and network analysis, as well as modeling of economic conditions and spatial analysis of human geographies to understand patterns of PPFPs and their inter-relationships. By analyzing the complexity of data collected across systems (including cultural contexts) we are demonstrating the possibility of conducting multisystemic resilience research which expands the way psychological research accounts for positive development under stress in different contexts. This comprehensive examination of resilience may offer an example of how the study of resilience can inform socially and contextually relevant interventions and policies.
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Affiliation(s)
- Michael Ungar
- Faculty of Health, School of Social Work, Dalhousie University, Halifax, NS, Canada
| | - Linda Theron
- Department of Educational Psychology, Faculty of Education, University of Pretoria, Pretoria, South Africa
| | - Kathleen Murphy
- Faculty of Health, School of Social Work, Dalhousie University, Halifax, NS, Canada
| | - Philip Jefferies
- Faculty of Health, School of Social Work, Dalhousie University, Halifax, NS, Canada
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Larsen A, Lilja M, Sturidsson K, Blatny M, Hrdlicka M, Stickley A, Ruchkin V. Bulimia symptoms in Czech youth: prevalence and association with internalizing problems. Eat Weight Disord 2020; 25:1543-1552. [PMID: 31621001 PMCID: PMC7581576 DOI: 10.1007/s40519-019-00790-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 09/30/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Although clinical studies suggest that bulimia symptoms are common in youth, research on the prevalence of such symptoms and of their association with comorbid internalizing problems in the general population has been limited. This study aimed to evaluate the gender-specific prevalence of bulimia symptoms in Czech youth and explored the association between a clinical level of self-reported bulimia symptoms (CLBS) and internalizing problems by gender, controlling for age, socio-economic status and puberty status. METHOD The study was conducted on a representative national sample of Czech youth (N = 4430, 57.0% female) using self-report scales. Multivariate analysis of covariance (MANCOVA) was used to examine the associations. RESULTS The 3-month CLBS prevalence was higher in girls (11.4%) than in boys (3.8%) and in both genders a CLBS was associated with higher levels of comorbid internalizing problems. DISCUSSION Timely recognition of bulimia symptoms and associated risk factors is important for early prevention and intervention strategies. LEVEL OF EVIDENCE V, cross-sectional descriptive study (according to Oxford (UK) CEBM Levels of Evidence, 2011).
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Affiliation(s)
- Anna Larsen
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Marie Lilja
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Knut Sturidsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Säter Forensic Psychiatric Clinic, 783 27, Säter, Sweden
| | - Marek Blatny
- Department of Psychology, Faculty of Arts MU, Brno, Czech Republic
| | - Michal Hrdlicka
- Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
| | - Andrew Stickley
- Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85, Uppsala, Sweden. .,Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA. .,Säter Forensic Psychiatric Clinic, 783 27, Säter, Sweden.
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Psychological Well-Being Among Internally Displaced Adolescents and the Effect of Psychopathology on PTSD Scores Depends on Gender. Community Ment Health J 2020; 56:1489-1495. [PMID: 32124156 DOI: 10.1007/s10597-020-00594-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 02/24/2020] [Indexed: 10/24/2022]
Abstract
The purpose of this cross-sectional study was to investigate the post-traumatic symptoms and psychological well-being among internally displaced (ID) adolescents in the early phase of the conflict in the southeast part of Turkey and clarify the effect of psychopathology on PTSD scores depends on gender. With the help of the results of our study, we aimed to enhance our understanding of adolescent mental health. Our study was completed with 102 ID adolescents (42 boys, 60 girls). Our results showed that ID adolescents flee from conflict had significantly higher levels of mental disorders and PTSD. Girls show higher rates of PTSD symptoms than boys and there was no significant interactive effect of gender and emotional, behavioral and peer problems on PTSD. However, boys with ADHD seem to be more prone to develop PTSD than girls. We aimed to highlight the challenges facing adolescents forced to flee from conflict zones who were temporarily relocated. These results may help us to enlighten our understanding of ID adolescents and may suggest more studies to provide beneficial gender-specific intervention program.
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Isaksson J, Sukhodolsky DG, Koposov R, Stickley A, Ruchkin V. The Role of Gender in the Associations Among Posttraumatic Stress Symptoms, Anger, and Aggression in Russian Adolescents. J Trauma Stress 2020; 33:552-563. [PMID: 32384585 DOI: 10.1002/jts.22502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/01/2019] [Accepted: 11/05/2019] [Indexed: 11/10/2022]
Abstract
Symptoms of posttraumatic stress disorder (PTSD) have been linked to anger and aggressive behavior in adult and veteran populations. However, research on the associations among anger, aggression, and PTSD in adolescents is lacking, particularly regarding differences between the sexes. To address this research gap, we used self-report data from Russian adolescents (N = 2,810; age range: 13-17 years) to perform a full path analysis examining the associations between PTSD symptoms and the emotional (anger traits) and cognitive (rumination) components of anger as well as physical/verbal and social aggression, after adjusting for depressive symptoms. We also examined the interaction effects between PTSD symptoms and sex on anger and aggression. The results indicated that girls scored higher on measures of anger and PTSD symptoms, ds = 0.20-0.32, whereas boys scored higher on measures of physical and verbal aggression, d = 0.54. Clinical levels of PTSD symptoms were associated with anger rumination, β = .16, and trait anger, β = .06, and an interaction effect for PTSD symptoms and sex was found for aggression, whereby boys with clinical levels of PTSD symptoms reported more physical/verbal and social aggression, βs = .05 and .20, respectively. Our findings suggest that PTSD symptoms may have an important impact on anger, anger rumination, and aggression during adolescence. In particular, boys seem to have an increased risk for aggressive behavior in the presence of PTSD symptoms. The present results highlight the importance of taking anger and aggression into account when evaluating PTSD.
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Affiliation(s)
- Johan Isaksson
- Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden.,Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit, Centre for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden
| | - Denis G Sukhodolsky
- Child Study Centre, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, The Arctic University of Norway, Tromsö, Norway
| | - Andrew Stickley
- Stockholm Centre for Health and Social Change (SCOHOST), Sodertorn University, Huddinge, Sweden.,Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Vladislav Ruchkin
- Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden.,Child Study Centre, Yale University School of Medicine, New Haven, Connecticut, USA.,Säter Psychiatric Clinic, Säter, Sweden
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Charnsil C, Narkpongphun A, Chailangkarn K. Post-traumatic stress disorder and related factors in students whose school burned down: Cohort study. Asian J Psychiatr 2020; 51:102004. [PMID: 32222645 DOI: 10.1016/j.ajp.2020.102004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/29/2020] [Accepted: 03/16/2020] [Indexed: 11/15/2022]
Abstract
AIMS This research examines the prevalence of post-traumatic stress disorder (PTSD) and its related factors in students whose school burned down, one month and six months after the incident. METHODS A total of 56 students from grades one through six were invited to participate in this study with permission from their parents. Subjects were screened for PTSD by using UCLA PTSD Reaction Index (DSM-5 Version) during three periods: 1, 6, and 12 months after the incident. Children diagnosed with PTSD were interviewed by a child and adolescent psychiatrist to confirm their diagnosis and obtain related factors. Percentage and logistic regression were used for statistical evaluation. 5 out of the 56 students (8.9 %) had PTSD one month after the incident, 2 of them recovered after six months. 6 out of 56 students (10.7 %) had PTSD at six months and 2 of 40 (5%) had PTSD at one year after the incident. Students who lived in the school's dorms had significantly more PTSD than those who lived elsewhere, p < 0.01, RR = 5.16 (4.04-6.6). After one year, age was the only factor related to PTSD (p = 0.01, odds ratio = 0.452). CONCLUSION Post-traumatic stress disorder is a common disorder in children after a disaster. Although some can recover shortly after an incident, others develop symptoms one month after the incident. Age is a risk factor that can lead to the development of PTSD.
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Affiliation(s)
- Chawanun Charnsil
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Amphur Muang, Chiang Mai, 50200, Thailand.
| | - Assawin Narkpongphun
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Amphur Muang, Chiang Mai, 50200, Thailand
| | - Khanuengnit Chailangkarn
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Amphur Muang, Chiang Mai, 50200, Thailand
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Elsaesser C, Kennedy TM, Tredinnick L. The role of relationship proximity to witnessed community violence and youth outcomes. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:562-575. [PMID: 31691315 DOI: 10.1002/jcop.22275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/08/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
AIMS This study examines whether the relational proximity to the victim or perpetrator of witnessed community violence is associated with youth symptoms. METHODS Data come from the Longitudinal Studies of Child Abuse and Neglect, a national high-risk sample. The sample included 12-year-old youth (N = 720) who had witnessed violence in their lifetimes. Ordinary least squares (OLS) regressions tested whether relationship proximity differentiated youth functioning (social competency, withdrawal, anxiety/depression, delinquency, and aggression), and whether gender moderated these effects. RESULTS Witnessing violence toward a parent was associated with greater withdrawal, delinquency, and aggression symptoms. Witnessing violence perpetrated by a stranger was associated with lower social competency, higher anxiety/depression, and higher delinquency. Two perpetrator associations differed by gender. CONCLUSION Findings suggest important differences in outcomes based on relational proximity to victims and perpetrators. The particularly widespread associations between witnessing violence against a parent and youth functioning underscore the importance of targeting interventions toward youth with parent victims.
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Affiliation(s)
- Caitlin Elsaesser
- School of Social Work, University of Connecticut, Hartford, Connecticut
| | - Traci M Kennedy
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lorin Tredinnick
- School of Social Work, University of Connecticut, Hartford, Connecticut
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Karadag M, Gokcen C, Sarp AS. EMDR therapy in children and adolescents who have post-traumatic stress disorder: a six-week follow-up study. Int J Psychiatry Clin Pract 2020; 24:77-82. [PMID: 31663396 DOI: 10.1080/13651501.2019.1682171] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objectives: The purpose of this study is to explore whether eye movement desensitisation and reprocessing (EMDR) is an effective therapy and to investigate whether EMDR affects anxiety levels for children and adolescents.Methods: We conducted this study with 30 clients. The clients completed self-administered questionnaires Child Post-Traumatic Stress Reaction Index Scale and The State-Trait Anxiety Inventory. The questionnaires were conducted before the therapy and 6 weeks after the completion of the therapy.Results: Nineteen clients (63%) had only one traumatic event, but 11 clients (37%) had more than one traumatic event. While the mean score on the PTSD symptom scale was 60 (±8.7), this rate decreased to 24 (±10.1), whereas the mean STAI-T scale was 59 (±8.9) before treatment and 41 (±11.5) after treatment. We found a statistically significant difference between symptom scores as quantified by both questionnaires before and after EMDR therapy (p < .05).Conclusions: As a result, we have shown that EMDR is an effective method for children and adolescents with PTSD in terms of both post-traumatic and anxiety symptom levels; however, we recommend a larger sample size with a control group to further establish the effectiveness of EMDR therapy in children.KEY POINTSPTSD is a common disorder in children and adolescents.Additional psychiatric disorders such as anxiety and depression are common in children and adolescents with PTSD.In PTSD cases applying for psychiatric treatment, trauma associated with sexual abuse is more pronounced and complex.EMDR is an effective therapy in children and adolescents as well as in adults.There is a statistically significant decrease at anxiety and PTSD symptom scores as quantified by questionnaires in patients with PTSD after EMDR therapy.
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Affiliation(s)
- Mehmet Karadag
- Child and Adolescent Psychiatry Department, Gaziantep University Medical School, Gaziantep, Turkey
| | - Cem Gokcen
- Department of Child and Adolescent Psychiatry, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Ayse Sevde Sarp
- Department of Child and Adolescent Psychiatry, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
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Yayan EH, Düken ME, Özdemir AA, Çelebioğlu A. Mental Health Problems of Syrian Refugee Children: Post-Traumatic Stress, Depression and Anxiety. J Pediatr Nurs 2020; 51:e27-e32. [PMID: 31255362 DOI: 10.1016/j.pedn.2019.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 06/15/2019] [Accepted: 06/15/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE This study aims to examine the levels of post-traumatic stress, depression and anxiety in Syrian children who live in refugee camps. DESIGNS AND METHODS This descriptive and correlational study was conducted using the Child Post-Traumatic Stress Reaction Index (CPTS-RI), the State-Trait Anxiety Inventory for Children-Trait Form (STAIC-Trait Form) and the Children's Depression Inventory (CDI). The study sample included 1115 Syrian refugee children. RESULTS The mean age of refugee children was 10.53 ± 2.79 years. Of them, 52% were males and 38% had no diseases while 74% were smokers and smoked 8.39 ± 6.85 cigarettes per day. The children's mean score on CPTS-RI, STAIC-Trait Form and CDI was found to be 60.59 ± 14.50, 54.11 ± 14.55 and 47.57 ± 10.97, respectively. The regression analysis revealed that anxiety and depression had a statistically significant association with post-traumatic stress. CONCLUSIONS The study findings revealed that refugee children have physical and psychosocial health problems and experience a high level of post-traumatic stress, depression and anxiety. PRACTICE IMPLICATIONS In this context, the study recommends that nursing practices should be developed considering that children may have mental health problems due to war.
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Affiliation(s)
- Emriye Hilal Yayan
- Department of Child Health and Disease Nursing, Faculty of Nursing, Inönü University, 44280 Malatya, Turkey
| | - Mehmet Emin Düken
- Department of Child Health and Disease Nursing, Faculty of Nursing, Inönü University, 44280 Malatya, Turkey; Department of Child Health and Disease Nursing, Faculty of Health Siences-Harran University-Şanlıurfa-Turkey.
| | - Aynur Aytekin Özdemir
- Department of Child Health and Disease Nursing, Faculty of Health Sciences, Istanbul Medeniyet University, 34700 İstanbul, Turkey
| | - Ayda Çelebioğlu
- Department of Child Health and Disease Nursing, İçel Health School, Mersin University, 33343 Mersin, Turkey
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Ünay M, Önder A, Gizli Çoban Ö, Atalay A, Sürer Adanir A, Artan R, Özatalay E. Psychopathology, quality of life, and related factors in pediatric liver transplantation candidates and recipients. Pediatr Transplant 2020; 24:e13633. [PMID: 31840340 DOI: 10.1111/petr.13633] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/16/2019] [Accepted: 11/01/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Liver transplantation (LT) has been accepted as a standard treatment of pediatric liver diseases that can progress to end-stage liver disease or lead to acute liver failure. However, there is a lack of studies clarifying quality of life (QoL) and the characteristics and the prevalence of common psychiatric disorders in children before and/or after LT. Thus, this study aimed to investigate QoL and the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) in children and adolescents before and after LT and to compare them with healthy controls. METHODS The study included 30 children aged 5-18 years who were waiting for LT (pTx group) or had undergone LT (Tx group) as the study groups and 20 children for the control group. The PedsQL was used to evaluate QoL, and SCARED, CDI, and the CPTSD-RI were used to evaluate psychopathology. RESULTS The QoL scores were higher in the control group compared with the study groups in all or most of the dimensions, depending on the reporter. The mean scores of anxiety, depression, and PTSD of the control group were significantly lower than those of the Tx and pTx groups. A significant positive correlation was found between depression, anxiety, and PTSD scores, and a negative correlation was observed between depression, anxiety, and PTSD scores and QoL. CONCLUSION Waiting for LT and the transplantation process itself seem to be psychologically traumatic for children. Healthcare providers need to be trained to recognize the symptoms of the main psychiatric disorders.
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Affiliation(s)
- Mihriban Ünay
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Arif Önder
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Özge Gizli Çoban
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Atike Atalay
- Department of Pediatric Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Aslı Sürer Adanir
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Reha Artan
- Department of Pediatric Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Esin Özatalay
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
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Isaksson J, Sjöblom S, Schwab-Stone M, Stickley A, Ruchkin V. Risk Factors Associated with Alcohol Use in Early Adolescence among American Inner-City Youth: A Longitudinal Study. Subst Use Misuse 2020; 55:358-366. [PMID: 31686574 DOI: 10.1080/10826084.2019.1671867] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Early alcohol use is associated with an increased risk for later alcohol dependence, as well as social and mental health problems. In this study, we investigate the risk factors (internalizing and externalizing behaviors) associated with early alcohol consumption over a period of 1 year, and examine whether the association is sex-specific. Methods: U.S. inner-city adolescents (N = 1785, Mean age = 12.11) were assessed and reassessed in the sixth and seventh grades (Mean age = 13.10). Self-reported information was obtained on the lifetime level of alcohol consumption, internalizing (depression, anxiety and posttraumatic stress [PTS]), and externalizing behaviors (sensation seeking, conduct problems and affiliation with delinquent peers). Associations between the variables were examined using structural equation modeling (SEM). Results: In an adjusted SEM analysis drinking by the sixth grade was primarily associated with externalizing behaviors, whereas PTS was linked to lower levels of alcohol consumption. In addition, alcohol consumption and greater externalizing behaviors by the sixth grade predicted higher alcohol consumption by the seventh grade, whereas anxiety and African American ethnicity were associated with less alcohol consumption. No sex differences were found in the association between internalizing and externalizing behaviors and drinking. However, in the adjusted SEM analysis female sex predicted higher lifetime consumption by the seventh grade. Conclusion: Sensation seeking behavior, conduct problems and affiliation with delinquent peers should be regarded as risk factors and taken into consideration when planning prevention efforts in order to decrease alcohol use in early adolescence.
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Affiliation(s)
- Johan Isaksson
- Department of Child and Adolescent Psychiatry, Division of Neuroscience, Uppsala University, Uppsala, Sweden.,Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit, Centre for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Sjöblom
- Department of Child and Adolescent Psychiatry, Division of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Mary Schwab-Stone
- Child Study Center, Yale University Medical School, New Haven, Connecticut, USA
| | - Andrew Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.,Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Vladislav Ruchkin
- Department of Child and Adolescent Psychiatry, Division of Neuroscience, Uppsala University, Uppsala, Sweden.,Child Study Center, Yale University Medical School, New Haven, Connecticut, USA.,Säter Forensic Psychiatric Clinic, Säter, Sweden
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Isaksson J, Schwab-Stone M, Stickley A, Ruchkin V. Risk and Protective Factors for Problematic Drinking in Early Adolescence: A Systematic Approach. Child Psychiatry Hum Dev 2020; 51:231-238. [PMID: 31468271 PMCID: PMC7067730 DOI: 10.1007/s10578-019-00925-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alcohol use during early adolescence is associated with other risk behaviors as well as future health problems. Within the design of a larger prospective research program, a cohort of U.S. inner-city sixth-grade students (N = 1573, mean age = 12.10) were assessed and reassessed in the seventh-grade. Self-reported information was obtained on problems related to alcohol, fixed markers of risk (e.g. sex, age, SES), individual and interpersonal factors (e.g. internalizing and externalizing symptoms) and contextual factors (e.g. substance availability). Alcohol-related problems in seventh grade were foremost predicted by individual and interpersonal factors in the sixth grade including depressive symptoms, conduct problems, a decreased perception of wrongdoing, and affiliation with delinquent peers. In addition, alcohol use in the sixth grade and being of Hispanic or White ethnicity was also associated with subsequent alcohol-related problems. Interventions should be directed towards assessing and treating individual risk factors such as depression and externalizing symptoms.
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Affiliation(s)
- Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85 Uppsala, Sweden
| | - Mary Schwab-Stone
- Child Study Center, Yale University Medical School, New Haven, CT 06520 USA
| | - Andrew Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden ,Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85, Uppsala, Sweden. .,Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA. .,Säter Forensic Psychiatric Clinic, Säter, Sweden.
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