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Egan SJ, Munro C, Pauley-Gadd SB, O'Brien A, Callaghan T, Payne N, Raghav S, Myers B, Hall C, Wilson H, Eisma MC, Boelen PA, Smith KV, Wild J, Duffy M, Trickey D, Bills E, Breen LJ. A protocol for a pilot randomised controlled trial of unguided internet cognitive behaviour therapy for grief in adolescents. Internet Interv 2024; 38:100771. [PMID: 39291171 PMCID: PMC11405812 DOI: 10.1016/j.invent.2024.100771] [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: 03/26/2024] [Revised: 08/05/2024] [Accepted: 09/03/2024] [Indexed: 09/19/2024] Open
Abstract
Grief is highly prevalent in adolescents, however, there have been no studies investigating internet delivered cognitive behaviour therapy for grief in adolescents (ICBT-G-A). In this paper, the co-design of an unguided ICBT-G-A intervention is described, and a protocol outlined for a pilot randomised controlled trial of the intervention. Participants will be randomised to the intervention (delivered via eight modules over a four-week period) or a four-week waitlist control. Intervention participants will complete a follow-up assessment at one-month post-intervention (eight weeks from the pre-intervention assessment). The intervention outcomes assessed at pre-intervention, post-intervention and follow-up include wellbeing and symptoms of anxiety, depression, post-traumatic stress, and prolonged grief. User feedback on experiences and acceptability of the intervention will be sought and feasibility assessed via programmatic data on recruitment and attrition.
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Affiliation(s)
- Sarah J Egan
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Caitlin Munro
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Sian B Pauley-Gadd
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Amy O'Brien
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Thomas Callaghan
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Nicholas Payne
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | | | - Bronwyn Myers
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research council, Tygerberg, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape town, South Africa
| | | | - Hayden Wilson
- Child and Adolescent Mental Health Service, Western Australia Country Health Service, Perth, Australia
| | - Maarten C Eisma
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
| | - Paul A Boelen
- Department of Clinical Psychology, Utrecht University, the Netherlands
- ARQ National Psychotrauma Centre, Amsterdam, the Netherlands
| | - Kirsten V Smith
- Department of Experimental Psychology, University of Oxford, United Kingdom
| | - Jennifer Wild
- Department of Experimental Psychology, University of Oxford, United Kingdom
- Phoenix Australia, Department of Psychiatry, University of Melbourne, Australia
| | | | | | - Elizabeth Bills
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Lauren J Breen
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
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Tang M, Chui PL, Chong MC, Liu X. Post-traumatic stress disorder in children after discharge from the pediatric intensive care unit: a scoping review. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02505-8. [PMID: 38916767 DOI: 10.1007/s00787-024-02505-8] [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: 02/20/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024]
Abstract
As the prevalence of post-traumatic stress disorder (PTSD) among children discharged from pediatric intensive care unit (PICU) continues to rise, corresponding research efforts have also increased. This scoping review aimed to review the PTSD prevalence, influencing factors, and tools used for PTSD measurements in children discharged from the PICU. This review employed the five-stage framework proposed by Arksey and O'Malley. The data sources included PubMed, Web of Science, Ovid, ScienceDirect, Springer, Scopus, CNKI, and WANFANG. Studies in English or Chinese published up to September 2023 were eligible for inclusion. The search yielded a total of 3536 results, with 31 articles meeting the inclusion criteria. The included studies reported that the prevalence of PTSD ranged from a minimum of 13% to a maximum of 84.6%. Risk factors for PTSD included medical interventions, child-related factors, and family environment. A total of 17 assessment tools for PTSD in PICU patients were reported. Given the significance of PTSD in this pediatric population, further attention, research, and intervention are warranted to help alleviate the burden of PTSD.
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Affiliation(s)
- Maoting Tang
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Kuala Lumpur, 50603, Malaysia
- Department of Pediatric Intensive Care Unit Nursing, West China Second University Hospital, West China School of Nursing, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Ping Lei Chui
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Kuala Lumpur, 50603, Malaysia.
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Kuala Lumpur, 50603, Malaysia
| | - Xianliang Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong, China
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Strauven S, Dennison MJ, O'Donnell ML, Cowlishaw S, Gibson K, Pedder DJ, Baur J, Nursey J, Cobham VE. A pilot study of a brief and scalable psychosocial intervention for children and adolescents following disasters. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024. [PMID: 38868927 DOI: 10.1111/bjc.12484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 05/09/2024] [Accepted: 05/20/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVES Following disaster exposure, a significant proportion of children/adolescents will develop levels of post-traumatic stress symptoms (PTSS) that do not meet diagnostic threshold for PTSD, but which cause ongoing distress. This paper describes the development and pilot testing of a brief, scalable, psychosocial intervention. SOLAR-Kids/Teens has been designed to be delivered by non-mental health professionals ('coaches') to children/adolescents experiencing moderate levels of PTSS following disasters. METHODS An international collaboration of experts developed The Skills fOr Life Adjustment and Resilience (SOLAR) for Kids and Teens programs. The programs were piloted-using a pre-post mixed methods design-with 10 children and adolescents (8-18 years), with the aims of examining the feasibility of the program's delivery model as well as the program's potential usefulness. RESULTS The pilot data indicated that after 1 day of training and with ongoing supervision, the SOLAR program was safe and feasible for coaches to deliver to children/adolescents experiencing PTSS. Coaches reported increased knowledge (p = .001), confidence (p = .001) and skills (p = .006). The programs were acceptable to coaches, children/adolescents and parents. Parents and children/adolescents reported reductions in trauma and anxiety symptoms from pre- to post-treatment, with moderate to large effect sizes. CONCLUSIONS The preliminary findings demonstrate that the SOLAR-Kids/Teens program is feasible, acceptable and safe to be delivered by trained non-mental health professionals to children and adolescents experiencing PTSS and anxiety following disaster exposure. Randomized controlled trials are required to evaluate the efficacy of the SOLAR-Kids/Teens programs.
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Affiliation(s)
- Sarah Strauven
- Phoenix Australia Centre for Posttraumatic Mental Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Carlton, Victoria, Australia
| | - Meg J Dennison
- Phoenix Australia Centre for Posttraumatic Mental Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Carlton, Victoria, Australia
| | - Meaghan L O'Donnell
- Phoenix Australia Centre for Posttraumatic Mental Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Carlton, Victoria, Australia
| | - Sean Cowlishaw
- Phoenix Australia Centre for Posttraumatic Mental Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Carlton, Victoria, Australia
| | - Kari Gibson
- Phoenix Australia Centre for Posttraumatic Mental Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Carlton, Victoria, Australia
| | - David J Pedder
- Phoenix Australia Centre for Posttraumatic Mental Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Carlton, Victoria, Australia
| | - Jenelle Baur
- Phoenix Australia Centre for Posttraumatic Mental Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Carlton, Victoria, Australia
| | - Jane Nursey
- Phoenix Australia Centre for Posttraumatic Mental Health, The University of Melbourne, Carlton, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Carlton, Victoria, Australia
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Children's Health Queensland Child and Youth Mental Health Service (CHQ CYMHS), Brisbane, Queensland, Australia
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Bleile ACE, Koppenol-Gonzalez GV, Orech B, Verreault K, Jordans MJD. Evaluating a Movement-Based Mental Health Promotion Intervention for Refugee Children in Uganda: A Quasi-Experimental Study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-16. [PMID: 38564186 DOI: 10.1080/15374416.2024.2330073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Mental health promotion interventions are widely implemented in humanitarian settings and low- and middle-income contexts (LMICs), yet evidence on effectiveness is scarce and mixed. This study evaluated the movement-based mental health promotion intervention "TeamUp" in Bidibidi refugee settlement, in Northern Uganda. METHOD A quasi-experimental study including four schools (two per arm) assessed the outcomes of 10- to 15-year-old South Sudanese and Ugandan children (n = 549). Randomly allocated, they either participated in up to 11 TeamUp sessions (n = 265) provided by trained facilitators; or belonged to a control group, which continued care as usual (n = 284). Primary outcomes measured psychosocial wellbeing, friendships and attitude to school; secondary outcomes included traumatic distress, depressive symptoms, quality of life, physical health, bullying, interoceptive awareness, and irritability. Data were collected at baseline and endline. RESULTS Children joining TeamUp, showed significantly more improvements on primary outcomes: emotional and psychosocial wellbeing (Mdiff = -1.49, SE = 0.6, p = .01), satisfaction with and attitude toward school (-0.57, SE = 0.2, p = .004); and secondary outcomes: traumatic stress (2.64, SE = 0.8, p < .001), health-related quality of life (-1.56, SE = 0.4, p = .001), physical health (-0.78, SE = 0.3, p = .014) and the TeamUp mechanisms of action scale (-3.34, SE = 0.9, p < .001), specifically the subscales social connectedness (-0.74, SE = 0.3, p = .007) and sense of agency (-0.91, SE = 0.3, p = .005), compared to the control group. No significant differences were found on bullying, interoceptive awareness, irritability and depressive symptoms. CONCLUSION The results are promising for TeamUp as a mental health promotion intervention for children affected by armed-conflict, displacement and on-going adversity. Further research will need to assess the intervention's effectiveness.
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Affiliation(s)
- Alexandra C E Bleile
- Research and Development Department, War Child
- Amsterdam Institute of Social Science Research, University of Amsterdam
| | | | - Bruce Orech
- Research and Development Department, War Child
| | | | - Mark J D Jordans
- Research and Development Department, War Child
- Amsterdam Institute of Social Science Research, University of Amsterdam
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Koumoula A, Marchionatti LE, Caye A, Karagiorga VE, Balikou P, Lontou K, Arkoulaki V, Simioni A, Serdari A, Kotsis K, Basta M, Kapsimali E, Mitropoulou A, Klavdianou N, Zeleni D, Mitroulaki S, Botzaki A, Gerostergios G, Samiotakis G, Moschos G, Giannopoulou I, Papanikolaou K, Aggeli K, Scarmeas N, Koulouvaris P, Emanuele J, Schuster K, Karyotaki E, Kalikow L, Pronoiti K, Gosmann NP, Schafer JL, Merikangas KR, Szatmari P, Cuijpers P, Georgiades K, Milham MP, Corcoran M, Burke S, Koplewicz H, Salum GA. The science of child and adolescent mental health in Greece: a nationwide systematic review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02213-9. [PMID: 37179505 DOI: 10.1007/s00787-023-02213-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/11/2023] [Indexed: 05/15/2023]
Abstract
Evidence-based information is essential for effective mental health care, yet the extent and accessibility of the scientific literature are critical barriers for professionals and policymakers. To map the necessities and make validated resources accessible, we undertook a systematic review of scientific evidence on child and adolescent mental health in Greece encompassing three research topics: prevalence estimates, assessment instruments, and interventions. We searched Pubmed, Web of Science, PsycINFO, Google Scholar, and IATPOTEK from inception to December 16th, 2021. We included studies assessing the prevalence of conditions, reporting data on assessment tools, and experimental interventions. For each area, manuals informed data extraction and the methodological quality were ascertained using validated tools. This review was registered in protocols.io [68583]. We included 104 studies reporting 533 prevalence estimates, 223 studies informing data on 261 assessment instruments, and 34 intervention studies. We report the prevalence of conditions according to regions within the country. A repository of locally validated instruments and their psychometrics was compiled. An overview of interventions provided data on their effectiveness. The outcomes are made available in an interactive resource online [ https://rpubs.com/camhi/sysrev_table ]. Scientific evidence on child and adolescent mental health in Greece has now been cataloged and appraised. This timely and accessible compendium of up-to-date evidence offers valuable resources for clinical practice and policymaking in Greece and may encourage similar assessments in other countries.
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Affiliation(s)
- Anastasia Koumoula
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Lauro Estivalete Marchionatti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Arthur Caye
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Vasiliki Eirini Karagiorga
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Panagiota Balikou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Katerina Lontou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Vicky Arkoulaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - André Simioni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Aspasia Serdari
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Child and Adolescent Psychiatry, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Kotsis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Basta
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Efi Kapsimali
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Andromachi Mitropoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Nikanthi Klavdianou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Domna Zeleni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Sotiria Mitroulaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Anna Botzaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Gerostergios
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Samiotakis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Moschos
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Ioanna Giannopoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- 2nd Department of Psychiatry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Papanikolaou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Child Psychiatry, Agia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Aggeli
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Nikolaos Scarmeas
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, USA
| | - Panagiotis Koulouvaris
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Jill Emanuele
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Kenneth Schuster
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Eirini Karyotaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Clinical Neuro and Developmental Psychology, Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Lily Kalikow
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Katerina Pronoiti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Natan Pereira Gosmann
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Julia Luiza Schafer
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, USA
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Pim Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Michael P Milham
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Mimi Corcoran
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Sarah Burke
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Harold Koplewicz
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Giovanni Abrahão Salum
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA.
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA.
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
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Boelen PA, Giannopoulou I, Papadatou D. Patterns and predictive value of acute prolonged grief and posttraumatic stress in youngsters confronted with traumatic loss: A latent class analysis. Psychiatry Res 2023; 319:114961. [PMID: 36446220 DOI: 10.1016/j.psychres.2022.114961] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/15/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022]
Abstract
Deaths of relatives and peers in potentially traumatizing circumstances may lead to symptoms of prolonged grief (PG, e.g.,yearning, preoccupation) and posttraumatic stress (PTS, e.g., re-experiencing, hypervigilance). There is limited knowledge about how symptoms of PG and PTS co-occur following such events. The current study aimed to identify patterns of DSM-5-TR defined PG symptomatology and PTS in a sample of 213 youngsters, involved in a school bus accident killing seven peers 2 months earlier. Using latent class analysis, three groups were identified evidencing moderate endorsement of most symptoms (Class 1), high endorsement of almost all but the avoidance symptoms (Class 2), and high endorsement of almost all symptoms (Class 3), respectively. Classes differed in terms of levels of grief, PTS, and depression, assessed concurrently, and-in a subgroup of n=137 participants-assessed at 16 month follow-up. E.g., Class 3 membership was associated with a greater likelihood of meeting criteria for DSM-5-TR defined prolonged grief disorder at follow-up. Gender (fewer females in Class 1) but not age and proximity to the accident were associated with class membership. Findings indicate that it is important to identify groups with elevated PG and PTS early after traumatic bereavement who may be en route to persistent mental health problems.
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Affiliation(s)
- Paul A Boelen
- Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, PO Box 80140, 3508 TC Utrecht, the Netherlands; ARQ National Psychotrauma Centre, Nienoord 5, NL-1112 XE Diemen, the Netherlands.
| | | | - Danai Papadatou
- National and Kapodistrian University of Athens, Athens, Greece
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Laksmita OD, Chung MH, Shieh YY, Chang PC. Psychometric Validation of the Indonesian Version of Children's Revised Impact of Event Scale 13. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17069. [PMID: 36554952 PMCID: PMC9778705 DOI: 10.3390/ijerph192417069] [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: 11/14/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
A psychometric evaluation of the Children's Revised Impact of Event Scale 13 (CRIES-13), which measures the posttraumatic stress disorder (PTSD) symptoms in children and adolescents caused by the coronavirus disease 2019 (COVID-19) pandemic, was conducted. We aimed to cross-culturally adapt and test the psychometric qualities of the CRIES-13 that was applied to Indonesian adolescents exposed to COVID-19 risk across gender groups. A cross-sectional study was conducted at a junior high school in Yogyakarta, Indonesia, in May 2022; 346 Indonesian adolescents aged 12 to 18 years completed the Indonesian version of the CRIES-13. The factorial validity results supported the scale's three-factor structure (intrusion, avoidance, and arousal), which satisfied all parameter index requirements and exhibited a favorable level of internal consistency reliability. Excellent results were obtained across genders for the four-level measurement of invariance (i.e., configural, metric, scalar, and full invariance), and they met the recommended criteria. Our Cronbach's alphas and composite reliability ratings were high (>0.7), indicating a strong correlation and reliability of the items for measuring each construct. We strongly support the use of the Indonesian CRIES-13, which was demonstrated to be valid and reliable for an adolescent population.
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Affiliation(s)
- Okki Dhona Laksmita
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Yann-Yann Shieh
- Office of Special Education and Rehabilitation Service, U.S. Department of Education, Washington, DC 20202-2800, USA
| | - Pi-Chen Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
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Topic: Perception of Recreancy as a Predictor of Stress Associated with Hydraulic Fracturing — the Case of England. TRENDS IN PSYCHOLOGY 2022. [DOI: 10.1007/s43076-022-00250-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Increased occurrence of PTSD symptoms in adolescents with major depressive disorder soon after the start of the COVID-19 outbreak in China: a cross-sectional survey. BMC Psychiatry 2021; 21:395. [PMID: 34372807 PMCID: PMC8352150 DOI: 10.1186/s12888-021-03400-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 07/29/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The Coronavirus Disease 2019 (COVID-19) pandemic continues to threaten the physical and mental health of people across the world. This study aimed to understand the psychological impact of this disease on adolescents with major depressive disorder (MDD) at 1 month after the start of the outbreak in China. METHODS Using the Children's Impact of Event Scale (CRIES-13) questionnaire, we investigated the occurrence of posttraumatic stress disorder (PTSD) in two groups of adolescents: MDD patients who were in continuous antidepressant therapy and healthy controls. Total scores and factor subscores were compared between the two groups and subgroups stratified by sex and school grade. Logistic regression was used to identify variables associated with high total CRIES-13 scores. RESULTS Compared to controls (n = 107), the MDD group (n = 90) had higher total CRIES-13 scores and a higher proportion with a total score ≥ 30. They also had a lower intrusion subscore and a higher arousal subscore. In the MDD group, males and females did not differ significantly in total CRIES-13 scores or factor subscores, but junior high school students had higher avoidance subscores than senior high school students. Logistic regression showed high total CRIES-13 scores to be associated with MDD and the experience of "flashbacks" or avoidance of traumatic memories associated with COVID-19. CONCLUSIONS It is crucial to understand the psychological impact of COVID-19 on adolescents with MDD in China, especially females and junior high school students. Long-term monitoring of adolescents with a history of mental illness is required to further understand these impacts. TRIAL REGISTRATION ChiCTR, ChiCTR2000033402 , Registered 31 May 2020.
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10
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Pereira J, Vagos P, Fonseca A, Moreira H, Canavarro MC, Rijo D. The Children's Revised Impact of Event Scale: Dimensionality and Measurement Invariance in a Sample of Children and Adolescents Exposed to Wildfires. J Trauma Stress 2021; 34:35-45. [PMID: 33245801 DOI: 10.1002/jts.22634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 01/10/2023]
Abstract
Natural disasters are potentially traumatic events due to their disruptive nature and high impact on social and physical environments, particularly for children and adolescents. The present study aimed to examine the psychometric properties of the Children's Revised Impact of Event Scale (CRIES-13) in a sample of Portuguese children and adolescents exposed to a specific type of natural disaster (i.e., wildfire). The sample was recruited at six school units of the Central region of Portugal following wildfires in the summer of 2017 and included children and adolescents without a clinical diagnosis of a psychopathological condition associated with exposure to the traumatic event (i.e., nonclinical sample, n = 486) and those with a clinical diagnosis of a trauma- and/or stress-related disorder (i.e., posttraumatic stress disorder [PTSD], adjustment disorder, separation anxiety disorder, or grief; clinical sample, n = 54). Confirmatory factor analyses indicated that a two-factor model (i.e., Intrusion/Arousal and Avoidance) provided a better fit than a three-factor model (i.e., Intrusion, Arousal, and Avoidance) and was found to be invariant across gender and age groups. The CRIES-13 showed good reliability for all subscales, with Cronbach's αs > .79. Higher CRIES-13 scores were associated with poorer health and well-being and more internalizing and externalizing problems. The clinical sample presented with significantly higher CRIES-13 scores than the nonclinical sample, ηp 2 = .13. These results contribute to the cross-cultural validation of the CRIES-13 and support its use as a reliable and valid measure for assessing posttraumatic symptoms in children and adolescents.
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Affiliation(s)
- Joana Pereira
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioural Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Paula Vagos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioural Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal.,Portucalense Institute for Human Development (INPP), Portucalense University, Porto, Portugal
| | - Ana Fonseca
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioural Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Helena Moreira
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioural Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Maria Cristina Canavarro
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioural Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Daniel Rijo
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioural Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
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11
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McKinnon A, Scheeringa MS, Meiser-Stedman R, Watson P, De Young A, Dalgleish T. The Dimensionality of Proposed DSM-5 PTSD Symptoms in Trauma-Exposed Young Children. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:1799-1809. [PMID: 31172404 PMCID: PMC6805819 DOI: 10.1007/s10802-019-00561-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
A subtype of the posttraumatic stress disorder diagnosis for children 6 years and younger (PTSD-6Y) was introduced in the Diagnostic and Statistical Manual, Fifth Edition (DSM-5). This study utilized confirmatory factor analytic techniques to evaluate the proposed DSM-5 PTSD-6Y factor structure and criterion and convergent validity against competing models. Data for N = 284 (3–6 years) trauma-exposed young children living in New Orleans were recruited following a range of traumas, including medical emergencies, exposure to Hurricane Katrina and repeated exposure to domestic violence. The model was compared to DSM-IV, a 4-factor ‘dysphoria’ model that groups symptoms also associated with anxiety and depression, and alternate 1- and 2- factor models. Convergent validity was established against the Child Behavior Checklist (CBCL). Criterion related validity was established by comparing each model to a categorical rating of impairment. The Dysphoria and PTSD-6Y models offered the better accounts of symptom structure, although neither satisfied minimum requirements for a good fitting model. These two models also only showed small levels of convergence with CBCL dimensions. The 1-factor model offered the most compelling balance of sensitivity and specificity, with the 2-factor model and the Dysphoria model following closely behind. These CFA results do not support the symptom clusters proposed within the DSM-5 for PTSD-6Y. Although a 4-factor Dysphoria model offers a better overall account of clustering patterns (relative to alternate models), alongside acceptable sensitivity and specificity for detecting clinical impairment, it also falls short of being an adequate model in this younger age group.
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Affiliation(s)
- Anna McKinnon
- Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, New South Wales, 2109, Australia.
| | - Michael S Scheeringa
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1440 Canal St., MS 8448, New Orleans, 70112, USA
| | - Richard Meiser-Stedman
- Department of Clinical Psychology, Elizabeth Fry Building, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Peter Watson
- Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Rd, Cambridge, CB2 7EF, UK
| | - Alexandra De Young
- Centre for Children's Burns & Trauma Research, Centre for Children's Health Research, University of Queensland, Level 7, 62 Graham Street, South Brisbane, Queensland, 4101, Australia
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Rd, Cambridge, CB2 7EF, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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12
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Why Family Communication Matters: the Role of Co-rumination and Topic Avoidance in Understanding Post-Disaster Mental Health. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1511-1524. [PMID: 32827289 DOI: 10.1007/s10802-020-00688-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although families can be a source of support post-disaster, depending on how they communicate about their stress, their attempts at support can be helpful or harmful. This study explored the moderating role of topic avoidance and co-rumination on post-disaster mental health (MH) in a sample of 485 parent-child dyads following severe floods affecting Texas. Parents (69.0% female) and their oldest child between the ages of 10-19 years (M = 13.75 years, SD = 2.56) completed online surveys approximately one-year post-flooding. Participants reported their flood exposure, life stressors since the disaster, topic avoidance, co-rumination, and MH symptoms (posttraumatic stress symptoms [PTSS], depression, anxiety). Structural equation models tested a moderated-mediation model of whether communication processes moderated the associations of flood exposure and life stressors on MH. They did not moderate the association of flood exposure to PTSS, but did have a moderating role for depression and anxiety. At low levels of topic avoidance, there was no association between flood exposure and child anxiety or depression. However, at mean and high levels of topic avoidance, there was a significant, positive association between flood exposure and child anxiety and depression. Co-rumination impacted both parents and children. For parents, there was no association between flood exposure and depression or anxiety when co-rumination was low or mean-level. However, flood exposure increased risk for depression and anxiety at high levels of co-rumination. A similar pattern emerged for children. Results for life stressors were nuanced. Overall, this suggests that communication can influence post-disaster MH.
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13
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Aryee F, Szolucha A, Stretesky PB, Short D, Long MA, Ritchie LA, Gill DA. Shale Gas Development and Community Distress: Evidence from England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145069. [PMID: 32674396 PMCID: PMC7400381 DOI: 10.3390/ijerph17145069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 11/16/2022]
Abstract
This research examines psychosocial stress associated with shale gas development through the narratives of residents and the Revised Impact of Event Scale (IES-R). We carried out our research in three of England’s communities impacted by shale gas development. To gather data, we conducted qualitative interviews and engaged in participant observation in all three communities and conducted a quantitative survey of residents. From our qualitative interviews it was apparent that the residents we spoke with experienced significant levels of stress associated with shale gas development in each community. Importantly, residents reported that stress was not only a reaction to development, but a consequence of interacting with industry and decision makers. Our quantitative findings suggest that a significant portion of residents 14.1% living near the shale gas sites reported high levels of stress (i.e., scoring 24 or more points) even while the mean IES-R score of residents living around the site is relatively low (i.e., 9.6; 95% CI 7.5–11.7). We conclude that the experiences, of the three English communities, reported in the qualitative interviews and quantitative survey are consistent with the reports of stress in the United States for those residents who live in shale gas communities. We therefore suggest that psychosocial stress is an important negative externality, which needs to be taken seriously by local planning officers and local planning committees when considering exploration and development permits for shale gas.
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Affiliation(s)
- Feizel Aryee
- Department of Social Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK; (F.A.); (A.S.)
| | - Anna Szolucha
- Department of Social Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK; (F.A.); (A.S.)
| | - Paul B. Stretesky
- Healthy Living, Department of Social Sciences, Northumbria University, Newcastle upon Tyne NE1 8S, UK
- Correspondence:
| | - Damien Short
- Human Rights Consortium, School of Advanced Study, University of London, London WC1E 7HU, UK;
| | - Michael A. Long
- Department of Sociology, Oklahoma State University, Stillwater, OK 74078-4062, USA; (M.A.L.); (L.A.R.); (D.A.G.)
| | - Liesel A. Ritchie
- Department of Sociology, Oklahoma State University, Stillwater, OK 74078-4062, USA; (M.A.L.); (L.A.R.); (D.A.G.)
| | - Duane A. Gill
- Department of Sociology, Oklahoma State University, Stillwater, OK 74078-4062, USA; (M.A.L.); (L.A.R.); (D.A.G.)
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14
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Savatt JM, Wagner JK, Joffe S, Rahm AK, Williams MS, Bradbury AR, Davis FD, Hergenrather J, Hu Y, Kelly MA, Kirchner HL, Meyer MN, Mozersky J, O'Dell SM, Pervola J, Seeley A, Sturm AC, Buchanan AH. Pediatric reporting of genomic results study (PROGRESS): a mixed-methods, longitudinal, observational cohort study protocol to explore disclosure of actionable adult- and pediatric-onset genomic variants to minors and their parents. BMC Pediatr 2020; 20:222. [PMID: 32414353 PMCID: PMC7227212 DOI: 10.1186/s12887-020-02070-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/06/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Exome and genome sequencing are routinely used in clinical care and research. These technologies allow for the detection of pathogenic/likely pathogenic variants in clinically actionable genes. However, fueled in part by a lack of empirical evidence, controversy surrounds the provision of genetic results for adult-onset conditions to minors and their parents. We have designed a mixed-methods, longitudinal cohort study to collect empirical evidence to advance this debate. METHODS Pediatric participants in the Geisinger MyCode® Community Health Initiative with available exome sequence data will have their variant files assessed for pathogenic/likely pathogenic variants in 60 genes designated as actionable by MyCode. Eight of these genes are associated with adult-onset conditions (Hereditary Breast and Ovarian Cancer Syndrome (HBOC), Lynch syndrome, MUTYH-associated polyposis, HFE-Associated Hereditary Hemochromatosis), while the remaining genes have pediatric onset. Prior to clinical confirmation of results, pediatric MyCode participants and their parents/legal guardians will be categorized into three study groups: 1) those with an apparent pathogenic/likely pathogenic variant in a gene associated with adult-onset disease, 2) those with an apparent pathogenic/likely pathogenic variant in a gene associated with pediatric-onset disease or with risk reduction interventions that begin in childhood, and 3) those with no apparent genomic result who are sex- and age-matched to Groups 1 and 2. Validated and published quantitative measures, semi-structured interviews, and a review of electronic health record data conducted over a 12-month period following disclosure of results will allow for comparison of psychosocial and behavioral outcomes among parents of minors (ages 0-17) and adolescents (ages 11-17) in each group. DISCUSSION These data will provide guidance about the risks and benefits of informing minors and their family members about clinically actionable, adult-onset genetic conditions and, in turn, help to ensure these patients receive care that promotes physical and psychosocial health. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03832985. Registered 6 February 2019.
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Affiliation(s)
| | - Jennifer K Wagner
- Center for Translational Bioethics and Health Care Policy, Geisinger, Danville, PA, USA
| | - Steven Joffe
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | | | - Angela R Bradbury
- Department of Medicine, Division of Hematology-Oncology, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA
| | - F Daniel Davis
- Center for Translational Bioethics and Health Care Policy, Geisinger, Danville, PA, USA
| | - Julie Hergenrather
- Department of Psychiatry and Behavioral Health, Geisinger, Danville, PA, USA
| | - Yirui Hu
- Department of Population Health Sciences, Geisinger, Danville, PA, USA
| | | | - H Lester Kirchner
- Department of Population Health Sciences, Geisinger, Danville, PA, USA
| | - Michelle N Meyer
- Center for Translational Bioethics and Health Care Policy, Geisinger, Danville, PA, USA
| | - Jessica Mozersky
- Bioethics Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Sean M O'Dell
- Department of Psychiatry and Behavioral Health, Geisinger, Danville, PA, USA
- Department of Population Health Sciences, Geisinger, Danville, PA, USA
| | - Josie Pervola
- Genomic Medicine Institute, Geisinger, Danville, PA, USA
| | - Andrea Seeley
- Department of Pediatrics, Geisinger, Danville, PA, USA
| | - Amy C Sturm
- Genomic Medicine Institute, Geisinger, Danville, PA, USA
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15
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Xu J, Wang Y, Tang W. Risk Factors of Post-traumatic Stress and Depressive Disorders in Longmenshan Adolescents After the 2013 Lushan Earthquake. Community Ment Health J 2019; 55:497-506. [PMID: 29511996 DOI: 10.1007/s10597-018-0256-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 02/28/2018] [Indexed: 02/05/2023]
Abstract
This study examined the severity of post-traumatic stress and depressive disorders in Longmenshan adolescents after the 2013 Lushan earthquake, as well as relationships among earthquake-related exposure, post-earthquake negative factors, previous exposure to the 2008 Wenchuan earthquake, and level of earthquake impact (city). A cross-sectional survey was conducted among adolescents in Lushan (n = 1416), Baoxing (n = 1102) and Tianquan (n = 1265) at 3 years after the Lushan earthquake. Respondents were evaluated using the Earthquake Experience Scale, the Adolescent Self-rating Life Events Checklist (ASLEC), the Children's Revised Impact of Event Scale (CRIES-13), and the Depression Self-Rating Scale (KADS-6). High levels of post-traumatic stress and depression symptoms were found among adolescents in the most heavily affected cities, and these symptoms were more severe in respondents exposed to the 2008 earthquake. PTSD correlated most strongly with earthquake exposure, whereas depression correlated most strongly with psychosocial stressors following the event.
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Affiliation(s)
- Jiuping Xu
- Institute of Emergency Management and Reconstruction in Post-disaster, Sichuan University, Chengdu, 610064, People's Republic of China. .,Institute of Emergency Management and Reconstruction in Post-disaster, Sichuan University, No. 24, SouthSection 1, Yihuan Road, Chengdu, 610065, Sichuan, People's Republic of China.
| | - Yan Wang
- Institute of Emergency Management and Reconstruction in Post-disaster, Sichuan University, Chengdu, 610064, People's Republic of China
| | - Wanjie Tang
- Institute of Emergency Management and Reconstruction in Post-disaster, Sichuan University, Chengdu, 610064, People's Republic of China.,Centre for Educational and Health Psychology, Sichuan University, Chengdu, People's Republic of China.,Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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16
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Tozer L, Stedmon J, Dallos R. 'It is that bad but it isn't that bad': Exploring children's experiences of their mother's non-terminal cancer with a focus on attachment, resilience and trauma. Clin Child Psychol Psychiatry 2019; 24:53-68. [PMID: 30058837 DOI: 10.1177/1359104518781922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recent years have shown a welcome trend in the number of people surviving cancer. The impact of cancer survival has focused primarily on the patient perspective, and limited research has explored the effect of parental cancer on children. No research to date can be found which explores children's experiences of parental cancer from a narrative perspective yet the way in which people tell their story is associated with emotional wellbeing. Measures of attachment, resilience and trauma were completed by 10 children (six girls, four boys aged 10-18 years) all of whom have a mother with non-terminal cancer. Each child also completed a narrative interview where they spontaneously described their experiences. Interviews were analysed drawing on narrative and thematic approaches to ensure the structural and performative as well as content of the stories could be understood. Experiences were interpreted within the context of attachment, resilience and trauma. Clinically high levels of trauma were found within this group even for securely attached and resilient children. The narrative analysis corroborated this finding. Implications for services supporting families are discussed.
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Affiliation(s)
- Laura Tozer
- School of Psychology, University of Plymouth, UK
| | | | - Rudi Dallos
- School of Psychology, University of Plymouth, UK
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17
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Schwartz LA, Henry-Moss D, Egleston B, Patrick-Miller L, Markman E, Daly M, Tuchman L, Moore C, Rauch PK, Karpink K, Sands CB, Domchek SM, Bradbury A. Preventative Health and Risk Behaviors Among Adolescent Girls With and Without Family Histories of Breast Cancer. J Adolesc Health 2019; 64:116-123. [PMID: 30301677 PMCID: PMC7597848 DOI: 10.1016/j.jadohealth.2018.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 06/02/2018] [Accepted: 07/12/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE To compare health behaviors (smoking, alcohol use, fruit and vegetable intake, and exercise frequency) and breast self-exam (BSE) between girls with breast cancer family history (BCFH+) and without (BCFH-) and assess associates of behaviors across all girls. METHODS A total of 208 BCFH+ girls (11-19 years old), with first- or second-degree relatives with breast cancer or a mother with a BRCA1/2 mutation, and 112 BCFH- peers reported their health behaviors, beliefs, and psychosocial function. RESULTS Despite higher BCFH+ girls' greater perceived breast cancer risk, there were no differences between BCFH+ and BCFH- girls on diet, exercise, alcohol initiation, or BSE. BCFH+ girls were slightly more likely to report trying cigarettes (11% vs. 5%, p = .04). In multivariable models with all girls, categorical associations with behaviors included the following: developmental and demographic factors with smoking, alcohol, diet, and exercise; family breast cancer history and experience with smoking, alcohol, and diet; psychosocial factors with smoking; girls perceptions of cancer controllability and mother support for health behaviors with alcohol, diet, exercise, and BSE; and mother behaviors with diet. CONCLUSIONS Adolescent girls from BCFH+ families reported similar health behaviors to BCFH- peers, signaling that they are not translating their higher perceived risk into cancer control behaviors. Both uncontrollable (i.e., breast cancer experiences) and modifiable factors relate to health behaviors and warrant further investigation. Results indicate that interventions with teens and parents that target modifiable variables such as controllability perceptions, maternal modeling, and communication may relate to better health behaviors and reduced future breast cancer risk.
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Affiliation(s)
- Lisa A. Schwartz
- The Children’s Hospital of Philadelphia and the Perelman School of Medicine of the University of Pennsylvania, 3501 Civic Center Blvd, CTRB 10311, Philadelphia, PA19104;
| | - Dare Henry-Moss
- The Perelman School of Medicine of the University of Pennsylvania, 3400 Civic Center Blvd, PCAM 10, Philadelphia, PA 19104;
| | - Brian Egleston
- Fox Chase Cancer Center of Temple University Health, 333 Cottman Avenue, Philadelphia, PA 19111;
| | | | - Elisabeth Markman
- The Children’s Hospital of Philadelphia, 3501 Civic Center Blvd, CTRB 10311, Philadelphia, PA19104;
| | - Mary Daly
- Fox Chase Cancer Center of Temple University Health, 333 Cottman Avenue, Philadelphia, PA 19111;
| | - Lisa Tuchman
- Children’s National Medical Center, 111 Michigan Ave, NW, Washington, DC 20010;
| | - Cynthia Moore
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114;
| | - Paula K. Rauch
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114;
| | - Kelsey Karpink
- The Perelman School of Medicine of the University of Pennsylvania, 3400 Civic Center Blvd, PCAM 10, Philadelphia, PA;
| | - Colleen Burke Sands
- The Perelman School of Medicine of the University of Pennsylvania, 3400 Civic Center Blvd, PCAM 10, Philadelphia, PA;
| | - Susan M. Domchek
- The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, 3400 Civic Center Blvd, PCAM 3 SPE, Philadelphia, PA;
| | - Angela Bradbury
- The Perelman School of Medicine of the University of Pennsylvania, 3400 Civic Center Blvd, PCAM 10, Philadelphia, PA;
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18
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Magalhães SDS, Miranda DK, Paula JJD, Miranda DMD, Romano-Silva MA, Malloy-Diniz LF. Psychometric properties of a Brazilian Portuguese version of the Children's Revised Impact of Event Scale (CRIES-8). ACTA ACUST UNITED AC 2018. [DOI: 10.1590/0101-60830000000151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Jonas Jardim de Paula
- Federal University of Minas Gerais, Brazil; Faculty of Medical Sciences of Minas Gerais, Brazil
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19
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Hoytema van Konijnenburg EMM, van der Lee JH, Teeuw AH, Lindeboom R, Brilleslijper-Kater SN, Sieswerda-Hoogendoorn T, van Goudoever JB, Lindauer RJL. Psychosocial problems of children whose parents visit the emergency department due to intimate partner violence, substance abuse or a suicide attempt. Child Care Health Dev 2017; 43:369-384. [PMID: 27774638 DOI: 10.1111/cch.12419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/05/2016] [Accepted: 09/12/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND High levels of maltreatment are found in children who are identified because their parents visit the emergency department due to partner violence, substance abuse or suicide attempt. However, it is unknown if these children experience psychosocial problems. This study aims to assess their levels of post-traumatic stress, anxiety, depression, behavioural problems and health-related quality of life. METHODS A cross-sectional study was conducted in six hospitals. All consecutive families of which a parent visited the emergency department due to partner violence, substance abuse or suicide attempt between 1 July 2012 and 1 March 2014 with children aged 1.5-17 years were approached for participation. Parents and children aged 8 years and older filled out questionnaires measuring post-traumatic stress [13-item version of Children's Revised Impact of Event Scale (CRIES-13)], anxiety, depression (Revised Child Anxiety and Depression Scale), behavioural problems [Child Behavior Checklist (CBCL) and Youth Self-Report (YSR)] and health-related quality of life (PedsQL). Scores of participants were compared with reference data obtained in children in similar age ranges from representative Dutch community samples (CRIES-13, Revised Child Anxiety and Depression Scale, PedsQL and CBCL) and to a normed cutoff score (CRIES-13). RESULTS Of 195 eligible families, 89 (46%) participated in the study. Participating children did not score different from community children, both on child-reported and parent-reported instruments. Standardized mean differences of total sum scores were 0 (CRIES-13 and CBCL 1.5-5), 0.1 (YSR), 0.2 (CBCL 6-18) and -0.3 (PedsQL) and not statistically different from community children. Thirty-five percent of the participating children scored above the cutoff score on the CRIES-13, indicating post-traumatic stress disorder, but this difference was not statistically significant from community children (mean difference 8%; 95% CI -4-22%). CONCLUSIONS We found no differences in psychosocial problems between children whose parents visited the emergency department due to partner violence, substance abuse or suicide attempt and children from community samples. Because 35% of the children scored in the range of post-traumatic stress disorder, we advise healthcare providers to pay attention to post-traumatic stress symptoms.
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Affiliation(s)
- E M M Hoytema van Konijnenburg
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - J H van der Lee
- Pediatric Clinical Research Office, Woman-Child Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - A H Teeuw
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - R Lindeboom
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - S N Brilleslijper-Kater
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - T Sieswerda-Hoogendoorn
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - J B van Goudoever
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Department of Pediatrics, VU University Medical Center, VU University, Amsterdam, the Netherlands
| | - R J L Lindauer
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,The Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands.,Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Amsterdam, the Netherlands
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Bradbury AR, Patrick-Miller L, Schwartz LA, Egleston BL, Henry-Moss D, Domchek SM, Daly MB, Tuchman L, Moore C, Rauch PK, Shorter R, Karpink K, Sands CB. Psychosocial Adjustment and Perceived Risk Among Adolescent Girls From Families With BRCA1/2 or Breast Cancer History. J Clin Oncol 2016; 34:3409-16. [PMID: 27551110 DOI: 10.1200/jco.2015.66.3450] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
PURPOSE To evaluate the impact of breast cancer family history and maternal BRCA1/2 mutation on the psychosocial adjustment and perceived risk in girls age 11 to 19 years old. MATERIALS AND METHODS Girls age 11 to 19 years old with one or more relatives with breast cancer or a familial BRCA1/2 mutation (breast cancer family history [BCFH] positive, n = 208; n = 69 with BRCA1/2-positive mother), peers (BCFH negative, n = 112), and their mothers completed assessments of psychosocial adjustment, breast cancer-specific distress, and perceived risk of breast cancer. RESULTS General psychosocial adjustment did not differ significantly between BCFH-positive and BCFH-negative girls, either by self-report or mother report, except for higher self-esteem among BCFH-positive girls (P = .01). BCFH-positive girls had higher breast cancer-specific distress than BCFH-negative girls (P < .001), but girls from BRCA1/2-positive families did not differ from other BCFH-positive peers. BCFH-positive girls were more likely to report themselves at increased self-risk for breast cancer in adulthood than BCFH-negative peers (74% v 33%, respectively; P ≤ .001). Girls from BRCA1/2-positive families were more likely than other BCFH-positive and BCFH-negative peers to report themselves at increased risk (P < .001). In all groups, perceived risk of breast cancer was associated with older age. Higher breast cancer-specific distress among adolescent girls was associated with higher self-perceived risk of breast cancer and higher maternal breast cancer-specific distress. CONCLUSION Adolescent girls from BRCA1/2-positive and breast cancer families have higher self-esteem and do not have poorer psychosocial adjustment than peers. However, they do experience greater breast cancer-specific distress and perceived risk of breast cancer, particularly among older girls. Understanding the impact is important to optimize responses to growing up in families at familial and genetic risk for breast cancer, particularly given the debate over the genetic testing of children for cancer susceptibility in adulthood.
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Affiliation(s)
- Angela R Bradbury
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA.
| | - Linda Patrick-Miller
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
| | - Lisa A Schwartz
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
| | - Brian L Egleston
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
| | - Dare Henry-Moss
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
| | - Susan M Domchek
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
| | - Mary B Daly
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
| | - Lisa Tuchman
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
| | - Cynthia Moore
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
| | - Paula K Rauch
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
| | - Rebecca Shorter
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
| | - Kelsey Karpink
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
| | - Colleen Burke Sands
- Angela R. Bradbury, Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands, The Perelman School of Medicine of the University of Pennsylvania; Lisa A. Schwartz, The Children's Hospital of Philadelphia; Brian L. Egleston and Mary B. Daly, Fox Chase Cancer Center, Temple University Health System; Susan M. Domchek, The Basser Research Center for BRCA in the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA; Linda Patrick-Miller, The University of Chicago, Chicago, IL; Lisa Tuchman, Children's National Medical Center, Washington, DC; and Cynthia Moore and Paula K. Rauch, Massachusetts General Hospital, Boston, MA
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Leigh E, Yule W, Smith P. Measurement Issues: Measurement of posttraumatic stress disorder in children and young people - lessons from research and practice. Child Adolesc Ment Health 2016; 21:124-135. [PMID: 32680369 DOI: 10.1111/camh.12124] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Many young people are exposed to traumatic events and a significant minority of these individuals will go on to experience posttraumatic stress disorder (PTSD). Valid and reliable measurement tools for assessing PTSD are essential and can aid screening, clinical diagnosis, treatment planning and outcome monitoring. METHODS This article outlines the range of instruments available for these aspects of measurement, including assessment of PTSD in very young children, with a focus on those scales with good clinical utility and sound psychometric properties. FINDINGS This is a particularly challenging time for clinicians working with children and young people with PTSD: all instruments will need to be revised and updated in order to better reflect the recent revisions to the diagnostic criteria for PTSD with the publication of the DSM-5 and no doubt the anticipated ICD-11. Despite this, measurement tools can still play a vital role in assessing PTSD in children and young people.
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Affiliation(s)
- Eleanor Leigh
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK.,Anxiety & Traumatic Stress Clinic for Children and Young People, Michael Rutter Centre, Maudsley Hospital, South London & Maudsley NHS Foundation Trust, London, UK
| | - William Yule
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Patrick Smith
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK.,Anxiety & Traumatic Stress Clinic for Children and Young People, Michael Rutter Centre, Maudsley Hospital, South London & Maudsley NHS Foundation Trust, London, UK
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22
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Bradbury AR, Patrick-Miller L, Schwartz L, Egleston B, Sands CB, Chung WK, Glendon G, McDonald JA, Moore C, Rauch P, Tuchman L, Andrulis IL, Buys SS, Frost CJ, Keegan TH, Knight JA, Terry MB, John EM, Daly MB. Psychosocial Adjustment in School-age Girls With a Family History of Breast Cancer. Pediatrics 2015; 136:927-37. [PMID: 26482668 PMCID: PMC4972044 DOI: 10.1542/peds.2015-0498] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Understanding how young girls respond to growing up with breast cancer family histories is critical given expansion of genetic testing and breast cancer messaging. We examined the impact of breast cancer family history on psychosocial adjustment and health behaviors among >800 girls in the multicenter LEGACY Girls Study. METHODS Girls aged 6 to 13 years with a family history of breast cancer or familial BRCA1/2 mutation (BCFH+), peers without a family history (BCFH-), and their biological mothers completed assessments of psychosocial adjustment (maternal report for 6- to 13-year-olds, self-report for 10- to 13-year-olds), breast cancer-specific distress, perceived risk of breast cancer, and health behaviors (10- to 13-year-olds). RESULTS BCFH+ girls had better general psychosocial adjustment than BCFH- peers by maternal report. Psychosocial adjustment and health behaviors did not differ significantly by self-report among 10- to 13-year-old girls. BCFH+ girls reported higher breast cancer-specific distress (P = .001) and were more likely to report themselves at increased breast cancer risk than BCFH- peers (38.4% vs 13.7%, P < .001), although many girls were unsure of their risk. In multivariable analyses, higher daughter anxiety was associated with higher maternal anxiety and poorer family communication. Higher daughter breast cancer-specific distress was associated with higher maternal breast cancer-specific distress. CONCLUSIONS Although growing up in a family at risk for breast cancer does not negatively affect general psychosocial adjustment among preadolescent girls, those from breast cancer risk families experience greater breast cancer-specific distress. Interventions to address daughter and mother breast cancer concerns and responses to genetic or familial risk might improve psychosocial outcomes of teen daughters.
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Affiliation(s)
- Angela R. Bradbury
- Division of Hematology/Oncology, Department of Medicine, and,Department of Medical Ethics and Health Policy, The Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania;,Address correspondence to Angela R. Bradbury, MD, Perelman School of Medicine at the University of Pennsylvania, 3 West Perelman Center, 3400 Civic Center Blvd, Philadelphia, PA 19104. E-mail:
| | - Linda Patrick-Miller
- Division of Hematology-Oncology, Department of Medicine, and the Center for Clinical Cancer Genetics and Global Health, The University of Chicago, Chicago, Illinois
| | - Lisa Schwartz
- Department of Pediatrics, Division of Oncology, The Children’s Hospital of Philadelphia and Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | | | - Gord Glendon
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Jasmine A. McDonald
- Mailman School of Public Health, Columbia University Medical Center, New York, New York
| | - Cynthia Moore
- Department of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Paula Rauch
- Department of Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Lisa Tuchman
- Department of Adolescent Medicine, Children’s National Medical Center, Washington, District of Columbia
| | - Irene L. Andrulis
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada;,Departments of Molecular Genetics and Laboratory Medicine, and
| | - Saundra S. Buys
- Department of Medicine, Division of Oncology, The University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Caren J. Frost
- College of Social Work, The University of Utah, Salt Lake City, Utah
| | - Theresa H.M. Keegan
- Cancer Prevention Institute of California, Fremont, California; and,Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, and Stanford Cancer Institute, Stanford, California
| | - Julia A. Knight
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada;,Dalla Lana School of Public Health, The University of Toronto, Toronto, Canada
| | - Mary Beth Terry
- Herbert Irving Comprehensive Cancer Center, and,Mailman School of Public Health, Columbia University Medical Center, New York, New York
| | - Esther M. John
- Cancer Prevention Institute of California, Fremont, California; and,Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, and Stanford Cancer Institute, Stanford, California
| | - Mary B. Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania
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23
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Deeba F, Rapee RM. Prevalence of traumatic events and risk for psychological symptoms among community and at-risk children and adolescents from Bangladesh. Child Adolesc Ment Health 2015; 20:218-224. [PMID: 32680344 DOI: 10.1111/camh.12093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Children from developing countries are more vulnerable to traumatic experiences and more likely to suffer a range of psychological problems than children from developed countries. METHOD The current paper describes a survey of 1360 children and adolescents from Bangladesh who were selected either from the general community or through a range of social service organizations. Children completed a checklist of traumatic events and questionnaires to assess symptoms of PTSD, anxiety and depression. RESULTS Children from both samples reported high levels of exposure to traumatic events, both via direct experience and indirectly. Direct experiences with intentional, man-made events were more frequently reported by children from support services while trauma from natural disasters was more common among community children. Psychological symptoms were significantly higher within children from social support services. The strongest predictors of psychological symptoms were age, gender, sample source and exposure to man-made direct traumas. CONCLUSION The results point to the common occurrence of traumatic events and their emotional consequences among children and adolescents from Bangladesh and indicate the need to develop effective and accessible mental health services for Bangladeshi children and adolescents.
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Affiliation(s)
- Farah Deeba
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, C3A 721, Macquarie University, Sydney, New South Wales, 2109, Australia
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Meyer RML, Gold JI, Beas VN, Young CM, Kassam-Adams N. Psychometric evaluation of the child PTSD symptom scale in Spanish and English. Child Psychiatry Hum Dev 2015; 46:438-44. [PMID: 25129027 PMCID: PMC4663982 DOI: 10.1007/s10578-014-0482-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Given the consistent growth of the Latino population in the United States, there is a critical need for validated Spanish measures to assess posttraumatic stress disorder (PTSD) symptoms in children. The current study examines the psychometric properties of the Child PTSD Symptom Scale (CPSS). We examined 259 children (8-17 years) who had experienced a recent traumatic event. Study measures were completed in Spanish (n = 106; boys = 58, girls = 48) or in English (n = 153; boys = 96, girls = 57). In addition to internal consistency, confirmatory factor analyses were conducted by testing four models to examine construct validity: (1) PTS single-factor, (2) DSM-IV three-factor, (3) Numbing four-factor, and (4) Dysphoria four-factor models. Findings demonstrated good internal consistency for both the English and Spanish versions of the CPSS. The English version revealed superior fit to the data for several models of PTS symptoms structure compared to the Spanish version. The current study demonstrated construct validity for the English CPSS, but not for the Spanish CPSS. Future studies will examine additional alternative models as well as convergent and discriminant validity of the Spanish CPSS.
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Affiliation(s)
- Rika M. L. Meyer
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital Los Angeles, Los Angeles, California
| | - Jeffrey I. Gold
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital Los Angeles, Los Angeles, California,Departments of Anesthesiology and Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Virginia N. Beas
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital Los Angeles, Los Angeles, California
| | - Christina M. Young
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital Los Angeles, Los Angeles, California
| | - Nancy Kassam-Adams
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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25
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McCullough L, Risley-Curtiss C, Rorke J. Equine Facilitated Psychotherapy: A Pilot Study of Effect on Posttraumatic Stress Symptoms in Maltreated Youth. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/15289168.2015.1021658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Napper LE, Fisher DG, Jaffe A, Jones RT, Lamphear VS, Joseph L, Grimaldi EM. Psychometric Properties of the Child's Reaction to Traumatic Events Scale-Revised in English and Lugandan. JOURNAL OF CHILD AND FAMILY STUDIES 2015; 34:1285-1294. [PMID: 26085785 PMCID: PMC4465842 DOI: 10.1007/s10826-014-9936-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Brief and age-appropriate measures of trauma-related symptoms are useful for identifying children in need of clinical services. The current study examines the psychometric properties of the 23-item Child's Reaction to Traumatic Events Scale-Revised (CRTES-R). The CRTES-R includes subscales assessing hyperarousal, avoidance and intrusion. To date, no studies have examined the psychometric properties of this revised measure or cross-cultural differences in its factor structure. Two samples of (a) children (ages 6-21) who had experienced a hurricane in the USA or Grenada (N = 135), and (b) Ugandan children (ages 8-17) who had experienced a variety of traumatic events (N = 339) completed the CRTES-R in English or Lugandan. Confirmatory factor analysis supported an empirically adjusted model with three modified latent factors in both the English (χ2/df = 1.34, CFI = .90, RMSEA = .05) and Lugandan samples (χ2/df = 1.45, CFI = .93, RMSEA = .04). Although the analysis supported separate hyperarousal, avoidance and intrusion subscales, the items that loaded on each factor differed from the original CRTES-R subscales. The English version of the CRTES-R showed good concurrent validity with the Kauai Recovery Index measure of trauma symptoms. Those using the CRTES-R to assess children's experiences of the different symptom types should consider using the empirically-derived subscales described in this paper; however, those who wish to capture a broad spectrum of PTSD symptoms should consider using all the original CRTES-R items and calculating a total score.
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Affiliation(s)
- Lucy E Napper
- Department of Psychology, Loyola Marymount University, 1 LMU Dr. Ste. #4711, Los Angeles, CA 90045, USA
| | - Dennis G Fisher
- Center for Behavioral Research and Services, California State University, Long Beach, CA, USA
| | - Adi Jaffe
- Center for Behavioral Research and Services, California State University, Long Beach, CA, USA
| | - Russell T Jones
- Department of Psychology, Virginia Tech University, Blacksburg, VA, USA
| | | | - Lisa Joseph
- Department of Psychology, Sun Yat-Sen University, Guangzhou, China
| | - Elizabeth M Grimaldi
- Department of Psychology, Loyola Marymount University, 1 LMU Dr. Ste. #4711, Los Angeles, CA 90045, USA
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27
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Salifu Yendork J, Somhlaba NZ. Do Social Support, Self-efficacy and Resilience Influence the Experience of Stress in Ghanaian Orphans? An Exploratory Study. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/13575279.2014.985286] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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28
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Kliewer W, Lepore SJ. Exposure to violence, social cognitive processing, and sleep problems in urban adolescents. J Youth Adolesc 2015; 44:507-17. [PMID: 25218396 PMCID: PMC4294953 DOI: 10.1007/s10964-014-0184-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 08/30/2014] [Indexed: 12/17/2022]
Abstract
Exposure to violence is associated with elevated levels of sleep problems in adolescence, which contributes to poor mental and physical health and impaired academic performance. However, reasons underlying the associations between exposure to violence and sleep difficulty have not been examined. This study tested a social cognitive processing path model linking experiences of witnessing and directly experiencing community violence and sleep problems. Participants were 362 early adolescents (M age = 12.45 years, SD = 0.59; range 11-14 years; 48.9% male; 51% Latino/a; 34% black) from urban communities enrolled in a middle-school-based intervention study on the east coast of the United States that was designed to reduce the negative effects of exposure to violence. All youth in the current study reported witnessing or directly experiencing community violence. Adolescents completed four school-based assessments over an 18-month period, reporting on their exposure to community violence, sleep problems, intrusive thoughts about and social constraints in talking about violence, and life events. A path model that included both victimization and witnessing violence revealed that wave 1 witnessing violence, but not victimization, was associated with elevated social constraints in talking about violence at wave 2, which was associated with elevated intrusive thoughts at wave 3, which was associated with poor sleep quality at wave 4. Prior levels of all constructs were controlled in the analysis, in addition to life events, single parent household status, children's age and sex, intervention condition, and school. Youth exposed to violence may benefit from help in processing their experiences, thus reducing social constraints in talking about their experiences and associated intrusive thoughts. This is turn may improve sleep outcomes.
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Affiliation(s)
- Wendy Kliewer
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284-2018, USA,
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29
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Deeba F, Rapee RM, Prvan T. Psychometric properties of the Children's Revised Impact of Events Scale (CRIES) with Bangladeshi children and adolescents. PeerJ 2014; 2:e536. [PMID: 25237597 PMCID: PMC4157240 DOI: 10.7717/peerj.536] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 08/03/2014] [Indexed: 11/20/2022] Open
Abstract
Identification of possible cases suffering post-traumatic stress disorder (PTSD) is important, especially in developing countries where traumatic events are typically prevalent. The Children's Revised Impact of Events Scale is a reliable and valid measure that has two brief versions (13 items and 8 items) to assess reactions to traumatic events among young people. The current study evaluated the psychometric properties of both versions of the CRIES in a sample of 1,342 children and adolescents aged 9-17 years (M = 12.3 years, SD = 2.12) recruited from six districts of Bangladesh. A sub-group of 120 children from four schools was re-tested on the measures within 3.5 weeks. Confirmatory factor analysis supported factor structures similar to those found in other studies for both versions of the CRIES. Multiple group confirmatory factor analysis showed gender and age-group differences within the sample, supporting established age and gender differences in prevalence of PTSD symptoms. Analyses also indicated moderate to excellent internal consistency and test-retest reliability and clear discriminant and convergent validity. These data support use of both the CRIES-13 and CRIES-8 to provide quick and psychometrically sound assessment of symptoms of PTSD among children and adolescents from Bangla-speaking communities.
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Affiliation(s)
- Farah Deeba
- Centre for Emotional Health, Department of Psychology, Faculty of Human Sciences, Macquarie University, NSW, Australia
| | - Ronald M. Rapee
- Centre for Emotional Health, Department of Psychology, Faculty of Human Sciences, Macquarie University, NSW, Australia
| | - Tania Prvan
- Department of Statistics, Faculty of Science, Macquarie University, NSW, Australia
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Oh EA, Park EJ, Lee SH, Bae SM. Validation of the Korean Version of the Children's Revised Impact of Event Scale. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2014; 12:149-56. [PMID: 25191506 PMCID: PMC4153862 DOI: 10.9758/cpn.2014.12.2.149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 03/17/2014] [Accepted: 04/23/2014] [Indexed: 11/18/2022]
Abstract
Objective This study examined the psychometric properties of the Korean version of the Children's Revised Impact of Event Scale (CRIES) and its validity as a screening instrument for the post-traumatic stress disorder (PTSD). Methods The study population consisted of two samples. The clinical sample consisted of 60 child and adolescent patients from the Department of Neuropsychiatry, Ilsan Paik Hospital, Inje University College of Medicine. The normal sample consisted of 291 students from four schools (primary, middle, and high schools). We administered four self-report questionnaires (the CRIES, Child Reports of Post-traumatic Symptoms [CROPS], State-Trait Anxiety Inventory for Children [STAI-C], and Children's Depression Inventory [CDI]) to 351 children and adolescents after obtaining informed consent from all participants and their parents. Results The CRIES showed good reliability (Cronbach's α for the full scale and subscales ranged from 0.85 to 0.93). The total CRIES score was positively correlated with CROPS, STAI-C, and CDI. Confirmatory factor analysis indicated that a three-factor structure for the CRIES (intrusion, avoidance, and hyper-arousal) had a significantly better fit than a two-factor model (intrusion/hyper-arousal and avoidance). Receiver operating characteristic curve analysis indicated that a cutoff of 26 offered the optimum predictive point. That is, this cutoff maximized the balance between sensitivity (0.88) and specificity (0.85). Using this cutoff, the positive predictive value was 0.86, and the negative predictive value was 0.99. Conclusion These findings imply that the CRIES is a highly accurate diagnostic test in clinical settings.
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Affiliation(s)
- Eun A Oh
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Eun Jin Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sung-Man Bae
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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Lepore SJ, Kliewer W. Violence exposure, sleep disturbance, and poor academic performance in middle school. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2014; 41:1179-89. [PMID: 23315234 DOI: 10.1007/s10802-013-9709-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Violence has been linked to poor academic outcomes in youth, but there is little understanding of the mechanisms underlying this relation. This longitudinal survey study investigated whether sleep disturbance potentially mediates the associations between academic achievement and two forms of violence exposure--community violence and peer victimization-- in 498 seventh-grade youth. Structural equation models showed that community violence was associated with lower grade point average (GPA) directly and indirectly via sleep problems, whereas peer victimization was associated with lower GPA just indirectly via sleep problems. The structural models controlled for potential confounds, including depressive symptoms, intrusive thoughts and absenteeism. The findings suggest that failing grades and sleepiness in school may be signs that youth are exposed to violence. Interventions to improve sleep hygiene and reduce violence exposure may help to improve academic outcomes for youth.
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Affiliation(s)
- Stephen J Lepore
- Department of Public Health, Temple University, 1301 Cecil B. Moore Ave, 957 Ritter Annex, Philadelphia, PA, 19122, USA,
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Chen H, Chen Y, Au M, Feng L, Chen Q, Guo H, Li Y, Yang X. The presence of post-traumatic stress disorder symptoms in earthquake survivors one month after a mudslide in southwest China. Nurs Health Sci 2014; 16:39-45. [PMID: 24635896 DOI: 10.1111/nhs.12127] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Revised: 12/12/2013] [Accepted: 12/15/2013] [Indexed: 02/05/2023]
Affiliation(s)
- Hong Chen
- West China Hospital/West China School of Nursing; Sichuan University; Chengdu China
| | - Yanling Chen
- West China Hospital/West China School of Nursing; Sichuan University; Chengdu China
| | - Maylan Au
- The Hong Kong Polytechnic University; Hong Kong China
| | - Ling Feng
- West China Hospital/West China School of Nursing; Sichuan University; Chengdu China
| | - Qian Chen
- West China Hospital/West China School of Nursing; Sichuan University; Chengdu China
| | - Hongxia Guo
- West China Hospital/West China School of Nursing; Sichuan University; Chengdu China
| | - Yun Li
- West China Hospital/West China School of Nursing; Sichuan University; Chengdu China
| | - Xiaoling Yang
- West China Hospital/West China School of Nursing; Sichuan University; Chengdu China
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Psychosomatic conditions of the children and adolescents exposed to 5.12 Wenchuan earthquake. Int J Behav Med 2013; 21:730-5. [PMID: 24337952 DOI: 10.1007/s12529-013-9377-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND A devastating earthquake registering 8.0 on the Richter Scale struck Wenchuan County in Northwest Sichuan Province in China on May 12, 2008, claiming over 69,200 lives, seriously wounding more than 374,600 people, and rendering more than 18,400 people missing. The epicenter was close to Yingxiu Township in Wenchuan County. PURPOSE This study aimed to investigate the psychosomatic conditions of the children and adolescents exposed to the devastating earthquake and explore the risk factors for psychosomatic symptoms. METHOD A total of 1,828 participants aged 6 to 16 years, of whom 842 from the affected area and 986 from non-affected area, were administered a Psychosomatic Conditions Scale. RESULTS Each factor score, total somatic score, total psychological score, and total psychosomatic score of the experimental group were significantly higher than those of the control group (P < 0.001). Positive correlation was found between the psychological state and somatic symptoms in the experimental group(r = 0.157 ~ 0.489, P < 0.01). Respiratory system, cardiovascular system, nervous system, digestive system, urogenital system, emotion, behavior, and language, combined as a panel, were significantly differentiated between the two groups, accounting for 73.4% of the total difference. In the experimental group, the factor scores of anxiety, behavior, total psychological score, and total psychosomatic score of the girls were obviously higher than those of the boys (P < 0.01 ~ 0.05); most somatic factors and psychological factors, total somatic score, total psychological score, and total psychosomatic score of the elder adolescents were significantly higher than those of the younger children (P < 0.01 ~ 0.05). CONCLUSION The children and adolescents exposed to 5.12 earthquake greatly suffered from terrible psychosomatic conditions, among whom the elder girls had more severe symptoms, particularly in terms of anxiety and behavior.
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Palosaari E, Punamäki RL, Qouta S, Diab M. Intergenerational effects of war trauma among Palestinian families mediated via psychological maltreatment. CHILD ABUSE & NEGLECT 2013; 37:955-968. [PMID: 23768956 DOI: 10.1016/j.chiabu.2013.04.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 04/15/2013] [Accepted: 04/16/2013] [Indexed: 06/02/2023]
Abstract
We tested the hypothesis that intergenerational effects of parents' war trauma on offspring's attachment and mental health are mediated by psychological maltreatment. Two hundred and forty children and their parents were sampled from a war-prone area, Gaza, Palestine. The parents reported the number and type of traumatic experiences of war they had had during their lifetime before the child's birth and during a current war when the child was 10-12 years old. The children reported their war traumas, experiences of psychological maltreatment, attachment security, and symptoms of posttraumatic stress (PTSS), depression, and aggression. The direct and indirect intergenerational effects of war trauma were tested in structural equation models. The hypotheses were confirmed for father's past war exposure, and disconfirmed for mother's war exposure. The father's past war trauma had a negative association with attachment security and positive association with the child's mental health problems mediated by increased psychological maltreatment. In contrast, the mother's past war trauma had a negative association with the child's depression via decreased psychological maltreatment. The mother's current war trauma had a negative association with the child's depression and aggression via decreased psychological maltreatment. Among fathers, past war exposure should be considered as a risk factor for psychological maltreatment of children and the associated attachment insecurity and mental health problems. Among mothers, war exposure as such could be given less clinical attention than PTSS in the prevention of psychological maltreatment of children.
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Affiliation(s)
- Esa Palosaari
- University of Tampere, School of Social Sciences and Humanities, 33014 University of Tampere, Finland
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Tao T, Duan X, Shi J. Posttraumatic Stress Symptoms of Chinese Rural Children and Adolescents Surviving the 2008 Wenchuan Earthquake Assessed Using CRIES. JOURNAL OF LOSS & TRAUMA 2013. [DOI: 10.1080/15325024.2012.734201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Symptoms of post-traumatic stress disorder in bereaved children and adolescents: factor structure and correlates. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2013; 41:1097-108. [PMID: 23612882 DOI: 10.1007/s10802-013-9748-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study investigated the factor structure and correlates of posttraumatic stress-disorder (PTSD) symptoms among children and adolescents confronted with the death of a loved one. Three hundred thirty-two bereaved children and adolescents (aged 8-18; 56.9 % girls) who all received some form of psychosocial support after their loss, completed self-report measures of PTSD, together with measures tapping demographic and loss-related variables, depression, prolonged grief, and functional impairment. Parent-rated indices of impairment were also collected. We first evaluated the fit of six alternative models of the factor structure of PTSD symptoms, using confirmatory factor analyses. Outcomes showed that the 4-factor numbing model from King et al. (Psychological Assessment 10, 90-96, 1998), with distinct factors of reexperiencing, avoidance, emotional numbing, and hyperarousal fit the data best. Of all participants, 51.5 % met DSM-IV criteria for PTSD. PTSD-status and scores on the PTSD factors varied as a function of age and gender, but were unrelated to other demographic and loss-related variables. PTSD-status and scores on the PTSD factors were significantly associated symptom-levels of depression, prolonged grief, and functional impairment. Findings complement prior evidence that the DSM-IV model of the factor structure of PTSD symptoms may not represent the best conceptualization of these symptoms and highlight the importance of addressing PTSD symptoms in children and adolescents seeking help after bereavement.
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Validation of the Chinese version of the Children's Revised Impact of Event Scale (CRIES) among Chinese adolescents in the aftermath of the Sichuan Earthquake in 2008. Compr Psychiatry 2013; 54:83-90. [PMID: 22901598 DOI: 10.1016/j.comppsych.2012.06.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 06/04/2012] [Accepted: 06/11/2012] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study examined the psychometric properties of the 13-item Chinese version of the revised Impact of Event Scale for Children (CRIES) among 3160 high school students in Chengdu, China, 1 month after the Sichuan Earthquake in 2008. METHODS Participants self-administered a structured questionnaire in classroom settings. Posttraumatic stress symptoms (using the Chinese version of the CRIES) and other psychological variables, including depression, anxiety, thoughts of physical threat, and earthquake-related experiences, were measured. Confirmatory factor analysis and Spearman correlation analyses were conducted to confirm the factor structure and examine the validity of the CRIES. RESULTS As in previous Western studies, confirmatory factor analysis results indicated that the 3-factor structure of the CRIES (intrusion, avoidance, and hyperarousal) provided a significantly better fit than the single-factor model and the 2-factor model. The CRIES showed good reliability (Cronbach αs for the full scale and subscales ranged from .74 to .85). The CRIES total score was positively correlated with depression, anxiety, automatic thought of physical threat, earthquake-related worries, and postearthquake suicidal ideation. CONCLUSIONS The CRIES has shown to be reliable and valid in assessing Chinese adolescents' symptoms of potential posttraumatic stress disorder. Our findings also support the 3-factor measurement model of posttraumatic stress symptoms, which is comparable with their Western studies. Further validation studies on other forms of traumatic experience among Chinese adolescents are warranted.
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Blom M, Oberink R. The validity of the DSM-IV PTSD criteria in children and adolescents: a review. Clin Child Psychol Psychiatry 2012; 17:571-601. [PMID: 22287553 DOI: 10.1177/1359104511426408] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE DSM-V is on its way and doubts have been raised regarding the validity of pediatric PTSD. It is the goal of the current review to critically review the empirical literature on PTSD in youth. METHOD A search of PsycINFO, PubMed and reference lists was conducted. Empirical information considered relevant regarding the validity of the criteria was collected. RESULTS/CONCLUSIONS The validity of the symptom criteria and clusters varies, with the Avoidance/Numbing cluster outperforming the Re-experiencing-and Arousal cluster. Factor analytic findings suggest that Arousal criterion D4 should be placed within the Re-experiencing cluster, and that the Avoidance/Numbing cluster should be split up. Some non-DSM-IV PTSD symptoms, among which guilt, have considerable validity in trauma-exposed youth and their inclusion in DSM-V PTSD should be considered. As for preschool children, alternative criteria are recommended that are more developmentally sensitive.
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Affiliation(s)
- Marloes Blom
- University of Amsterdam, Department of Clinical Psychology, The Netherlands.
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Hair cortisol level as a biomarker for altered hypothalamic-pituitary-adrenal activity in female adolescents with posttraumatic stress disorder after the 2008 Wenchuan earthquake. Biol Psychiatry 2012; 72:65-9. [PMID: 22305287 DOI: 10.1016/j.biopsych.2011.12.020] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 12/23/2011] [Accepted: 12/23/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND The present study evaluated the accumulated changes in hair cortisol levels of patients with posttraumatic stress disorder (PTSD) attributed to the 2008 Wenchuan earthquake in China. METHODS Sixty-four female adolescents from two townships who experienced the earthquake were recruited 7 months after the disaster, including 32 subjects with PTSD (PTSD group) and 32 subjects without PTSD (non-PTSD group). Twenty matched adolescents were recruited from an area that was not affected significantly by the earthquake as the control group. Hair cortisol concentrations were measured by the electrochemiluminescence immunoassay in each 3-cm segment of hair sample from the scalp. RESULTS There was no significant difference at the baseline hair cortisol level in the three groups before the traumatic event (p > .6). Hair cortisol levels changed over time and differed among groups (p = .0042). The hair cortisol levels among the PTSD and non-PTSD subjects were elevated, suggesting increasing levels in response to stress. However, these two groups differed in their response. The non-PTSD subjects showed a significantly higher cortisol level than the PTSD group between month 2 and month 4 (p = .0137) and also between month 5 and month 7 (p = .0438) after the traumatic event. CONCLUSIONS This study revealed a blunted response curve to the disaster among PTSD subjects compared with subjects without PTSD. These findings suggest that hair cortisol level could be used to assess the integrated hypothalamic-pituitary-adrenal activity over a period of months after traumatic events and be used to serve as a biomarker in patients with PTSD.
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Meiser-Stedman R, Dalgleish T, Yule W, Smith P. Intrusive memories and depression following recent non-traumatic negative life events in adolescents. J Affect Disord 2012; 137:70-8. [PMID: 22244376 DOI: 10.1016/j.jad.2011.12.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 12/12/2011] [Accepted: 12/12/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Research in adults suggests that intrusive memories are not just found in individuals with post-traumatic stress disorder (PTSD), yet there is little evidence concerning the phenomenology of intrusive memories in children and adolescents. The present study investigated the frequency of intrusive memories following a recent negative event in an adolescent school sample, and considered the application of cognitive theory to understanding the maintenance of intrusive memories of recent negative events, and their role in maintaining depression. METHODS High school students (aged 11-18 years; n=231) completed questionnaires concerning affect experienced during a recent negative event, the frequency of subsequent intrusive memories, memory quality, thought suppression, post-traumatic stress and depressive symptoms. RESULTS Most participants had experienced at least one intrusive memory in the previous week, at similar rates for traumatic events and life events. In non-trauma exposed youth, peri-event affect and memory quality accounted for unique variance in a regression model of intrusive memory frequency, while peri-event affect, memory quality, and intrusive memory frequency accounted for unique variance in a regression model of depression. LIMITATIONS The study needs replication in younger children. Interview methods may be required to ensure that intrusive memories are being assessed and not intrusive thoughts or ruminations. CONCLUSIONS Intrusive memories are common reaction to negative events in adolescents, and may be involved in maintaining subsequent depressed mood. The nature of event memories may have a role in the maintenance of such psychopathology, and may be a target for psychological interventions in this age group.
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Affiliation(s)
- Richard Meiser-Stedman
- Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK.
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Papadatou D, Giannopoulou I, Bitsakou P, Bellali T, Talias MA, Tselepi K. Adolescents' reactions after a wildfire disaster in Greece. J Trauma Stress 2012; 25:57-63. [PMID: 22298431 DOI: 10.1002/jts.21656] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This cross-sectional study examined the factors associated with higher levels of posttraumatic stress disorder (PTSD) and depression symptoms in 1,468 adolescents, 6 months after a wildfire. The rate of probable PTSD was 29.4% and 20% for probable depression. Findings on predisaster, disaster-related, and postdisaster factors revealed that disaster-related factors-specifically objective and perceived threat to self and others-were associated with symptoms of PTSD but not depression. Predisaster life events, postdisaster losses, and escape-oriented coping strategies were associated with higher levels of both PTSD and depression symptoms, while control-oriented coping and perceived social support were differentially associated with symptoms of and depression. Findings have implications for the assessment and treatment of traumatized and depressed adolescents after a disaster.
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Risk factors of posttraumatic stress disorder among survivors after the 512 Wenchuan earthquake in China. PLoS One 2011; 6:e22371. [PMID: 21799838 PMCID: PMC3143136 DOI: 10.1371/journal.pone.0022371] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 06/22/2011] [Indexed: 12/02/2022] Open
Abstract
This study investigated the psychological reactions of survivors of the 512 Wenchuan earthquake in China and the risk factors associated with those reactions. The Impact of Event Scale-Revised (IES-R), Type D Scale-14 (DS14), a self-developed trauma experience questionniare, and a demographic questionnaire were administered to 956 earthquake survivors (389 males and 567 females) in Mianzhu, one of the cities most affected by the earthquake. The results showed that postraumatic stress disorder (PTSD) symptoms affected 84.8% of survivors one to two months after the earthquake. Significant risk factors associated with PTSD symptoms included: (1) being female; (2) older age; (3) higher exposure to traumatic events during the earthquake; and (4) negative affect in Type-D personality.
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Kieffer-Kristensen R, Teasdale TW, Bilenberg N. Post-traumatic stress symptoms and psychological functioning in children of parents with acquired brain injury. Brain Inj 2011; 25:752-60. [DOI: 10.3109/02699052.2011.579933] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Factor structure and psychometric properties of the Connor-Davidson Resilience Scale among Chinese adolescents. Compr Psychiatry 2011; 52:218-24. [PMID: 21295229 DOI: 10.1016/j.comppsych.2010.05.010] [Citation(s) in RCA: 169] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2009] [Revised: 05/11/2010] [Accepted: 05/31/2010] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Resilience refers to psychological characteristics that promote effective coping and positive adaptation in adversity. This study investigated the factor structure and psychometric properties of the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) among adolescents. METHODS A total of 2914 Chinese adolescents living in Chengdu, Sichuan, completed the CD-RISC 1 month after the 2008 Sichuan earthquake. They also self-administered the Multidimensional Scale of Perceived Social Support, the Children's Depression Inventory, and the Screen for Child Anxiety Related Emotional Disorders. With confirmatory factor analysis, various factor structures of the CD-RISC reported in previous studies (eg, the 5- and 3-factor models) were examined at the first-order level; and a single factor of resilience was investigated at the second-order level in this sample. The internal consistency and concurrent validity were investigated. Sex and age differences were also examined. RESULTS Confirmatory factor analysis results showed that the 5-factor model originally derived among US community adults was replicated in our sample, and these 5 factors also loaded on a higher-order "resilience" factor. The Cronbach α coefficient was 0.89. The resilience scores demonstrated expected positive correlation with social support (r = 0.44) and negative correlations with depression (r = -0.38) and anxiety (r = -0.25) (Ps < .001). Male participants reported higher resilience scores than female participants, and younger participants also reported higher resilience scores than older participants. CONCLUSIONS The Chinese version of the CD-RISC was demonstrated to be a reliable and valid measurement in assessing resilience among Chinese adolescents.
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ZHANG NING, ZHANG YUQING, WU KANKAN, ZHU ZHUOHONG, DYREGROV ATLE. Factor structure of the Children’s Revised Impact of Event Scale among children and adolescents who survived the 2008 Sichuan earthquake in China. Scand J Psychol 2011; 52:236-41. [DOI: 10.1111/j.1467-9450.2010.00867.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kassam-Adams N, Marsac ML, Cirilli C. Posttraumatic stress disorder symptom structure in injured children: functional impairment and depression symptoms in a confirmatory factor analysis. J Am Acad Child Adolesc Psychiatry 2010; 49:616-25, 625.e1-4. [PMID: 20494271 DOI: 10.1016/j.jaac.2010.02.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2009] [Revised: 01/21/2010] [Accepted: 03/02/2010] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine the factor structure of posttraumatic stress disorder (PTSD) symptoms in children and adolescents who have experienced an acute single-incident trauma, associations between PTSD symptom clusters and functional impairment, and the specificity of PTSD symptoms in relation to depression and general distress. METHOD Examined PTSD symptom structure in two samples of children (8 to 17 years of age) assessed an average of 6 months after unintentional injury: (1) a combined dataset of 479 children assessed with a PTSD symptom checklist, and (2) a sample of 204 children assessed via a standardized clinical interview. We evaluated the fit of six alternative models for the factor structure of PTSD symptoms, and the association of PTS symptom clusters with indicators of functional impairment. We then evaluated three models for the structure of PTSD and depression symptoms jointly, to examine specificity of PTSD versus general distress or mood symptoms. RESULTS In both samples, the DSM-IV 3-factor model fit the data reasonably well. Two alternative four-factor models fit the data very well: one that separates effortful avoidance from emotional numbing, and one that separates PTSD-specific symptoms from general emotional distress. Effortful avoidance and dysphoria symptoms were most consistently associated with impairment. The best-fitting model for PTSD and depression symptom clusters had three factors: PTSD-specific, depression-specific, and general dysphoria symptoms. CONCLUSIONS The DSM-IV model for PTSD symptom categories was a reasonable fit for these child data, but several alternative models fit equally well or better, and suggest potential improvements to the current diagnostic criteria for PTSD in children.
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Affiliation(s)
- Nancy Kassam-Adams
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, 3535 Market Street, Suite 1150, Philadelphia, PA 19104, USA.
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Meiser-Stedman R, Smith P, Bryant R, Salmon K, Yule W, Dalgleish T, Nixon RDV. Development and validation of the Child Post-Traumatic Cognitions Inventory (CPTCI). J Child Psychol Psychiatry 2009; 50:432-40. [PMID: 19338628 DOI: 10.1111/j.1469-7610.2008.01995.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Negative trauma-related cognitions have been found to be a significant factor in the maintenance of post-traumatic stress disorder (PTSD) in adults. Initial studies of such appraisals in trauma-exposed children and adolescents suggest that this is an important line of research in youth, yet empirically validated measures for use with younger populations are lacking. A measure of negative trauma-related cognitions for use with children and adolescents, the Child Post-Traumatic Cognitions Inventory (CPTCI), is presented. The measure was devised as an age-appropriate version of the adult Post-Traumatic Cognitions Inventory (Foa et al., 1999). METHODS The CPTCI was developed and validated within a large (n = 570) sample, comprising community and trauma-exposed samples of children and adolescents aged 6-18 years. RESULTS Principal components analysis suggested a two-component structure. These components were labelled 'permanent and disturbing change' and 'fragile person in a scary world', and were each found to possess good internal consistency, test-retest reliability, convergent validity, and discriminative validity. The reliability and validity of these sub-scales was present regardless of whether the measure was completed in the acute phase or several months after a trauma. Scores on these sub-scales did not vary with age. CONCLUSIONS The CPTCI is a reliable and valid measure that is not specific to the type of trauma exposure, and shows considerable promise as a research and clinical tool. The structure of this measure suggests that appraisals concerning the more abstract consequences of a trauma, as well as physical threat and vulnerability, are pertinent factors in trauma-exposed children and adolescents, even prepubescent children.
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Rasmussen A, Smith H, Keller AS. Factor structure of PTSD symptoms among West and Central African refugees. J Trauma Stress 2007; 20:271-80. [PMID: 17597123 DOI: 10.1002/jts.20208] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Although trauma is widespread in Africa, Africans are unrepresented in the literature on posttraumatic stress disorder (PTSD). The authors used confirmatory factor analysis of responses to the Harvard Trauma Questionnaire to model PTSD symptom structure in a sample of African refugees presenting at a U.S. torture treatment clinic. They tested four models that are proposed in the literature and one based on their clinical experience in which some symptoms of hyperarousal were integrated into intrusion. Their findings support a preference for a 4-factor aroused intrusion model. Discussion focuses on interpretation of models, the role of numbing and avoidance, and the limitations of Euro American symptoms in non-Euro American populations.
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Giannopoulou I, Dikaiakou A, Yule W. Cognitive-behavioural group intervention for PTSD symptoms in children following the Athens 1999 earthquake: a pilot study. Clin Child Psychol Psychiatry 2006; 11:543-53. [PMID: 17163223 DOI: 10.1177/1359104506067876] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the effects of a short-term group cognitive-behavioural intervention in children who were experiencing PTSD symptoms following the Athens 1999 earthquake. Twenty children, aged 8-12 years, referred for treatment to a local child mental health team were assigned, depending on timing of referral to two groups-- Group 1 (N = 10), which started treatment 2 months after the earthquake and Group 2 (N = 10), which started treatment at 4 months postearthquake. A statistically significant reduction in overall PTSD (Posttraumatic Stress Disorder) symptoms across the three PTSD symptom clusters - intrusion, avoidance, and arousal--as well as in depressive symptoms was reported immediately after the intervention. The treatment also produced a statistically significant improvement in children's psychosocial functioning. Further significant improvement was reported in children at an 18-month follow-up. Treatment gains were maintained at a 4-year follow-up. Despite several limitations to this study, short-term group CBT (cognitive-behavioural therapy) was found to be a useful treatment approach, which can be offered in clinical settings, particularly if resources are limited.
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Affiliation(s)
- Ioanna Giannopoulou
- NHS Community Mental Health Centre, Peristeri, Greece and Institute of Psychiatry, London, UK.
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