Sex differences in the severity and natural recovery of child PTSD symptoms: a longitudinal analysis of children exposed to acute trauma

Background Higher levels of PTSD symptoms are present among trauma-exposed females v. males in adulthood; however, much less is known about the emergence of this sex difference during development. Methods In a multi-study sample of 7–18-year-olds (n = 3397), we examined the effect of sex and age on the severity of PTSD symptoms after a single incident trauma at 1 month (T1), and on symptom change after a natural recovery period of 3 (T2) and 6 months (T3). PTSD scores were harmonised across measurement types, and linear regressions were used to determine sex and age effects, adjusting for study level variance and trauma type. Results A sex × age interaction was observed at T1 (p < 0.001) demonstrating that older age was associated with greater PTSD symptom severity in females (β = 0.008, p = 0.047), but less severe symptoms in males (β = −0.011, p = 0.014). The same pattern was observed at T2 and T3, with sex differences beginning to emerge by age 12 years. PTSD symptoms decreased naturally by ~25% at T2 with little further improvement by T3. Further, females showed a greater reduction in symptoms at T3 than males, although the same effect was not observed at T2. Conclusions Sex differences in PTSD symptoms become apparent during adolescence, due to opposing changes in susceptibility occurring in females and males with age. Understanding the factors contributing to these findings is likely to provide wider insight into sex-specific psychological vulnerability to trauma-related psychopathology.

Post-traumatic Stress Disorder in Parents Following Their Child’s Single-Event Trauma: A Meta-Analysis of Prevalence Rates and Risk Factor Correlates

Evidence suggests parents of children who experience a trauma may develop Post-Traumatic Stress Disorder (PTSD), which can have significant consequences for their own and their child’s functioning. As such, identifying the rates and possible correlates for the development of PTSD in parents is of clinical and theoretical importance, and would enhance our understanding of how best to support families in the aftermath of trauma. This meta-analysis of 41 studies (n = 4370) estimated the rate of PTSD in parents following their child’s single-incident trauma to be 17.0% (95% CI 14.1–20.0%); when removing samples which were mixed, or not exclusively single-incident traumas the prevalence estimate dropped to 14.4% (95% CI 10.8–18.5%). Pooled effect sizes of 32 potential correlates for parents developing PTSD were also identified. Medium-to-large effects were found for factors relating to the parent’s post-traumatic cognition, psychological functioning and coping strategies alongside child PTSD. Small effects were found for pre-trauma factors, objective trauma-related variables and demographic factors for both parent and child. Results are consistent with cognitive models of PTSD, suggesting peri- and post-trauma factors are likely to play a substantial role in its development. These findings indicate the clinical need for screening parents most vulnerable to adverse post-traumatic reactions within the context of child trauma and tailoring interventions to include the family where necessary.

Symptoms of PTSD and Depression among Central American Immigrant Youth

The aim of this paper is to explore the mental health challenges that Central American immigrant youth face before and after arriving in the United States. This population is hard to reach, marginalized, and disproportionately exposed to trauma from a young age. This paper investigates the mental health stressors experienced by Central American immigrant youth and asylum seekers, including unaccompanied minors, surveyed in the U.S. in 2017. This mixed methods study uses qualitative data from interviews along with close-ended questions and the validated PHQ-8 Questionnaire and the Child PTSD Symptom Scale (CPSS). These new migrants face numerous challenges to mental health, increased psychopathological risk exacerbated by high levels of violence and low state-capacity in their countries of origin, restrictive immigration policies, the fear of deportation for themselves and their family members, and the pressure to integrate once in the U.S. We find that Central American youth have seen improvements in their self-reported mental health after migrating to the U.S., but remain at risk of further trauma exposure, depression, and PTSD. We find that they exhibit a disproportionate likelihood of having lived through traumatizing experiences that put them at higher risk for psychological distress and disorders that may create obstacles to integration. These can, in turn, create new stressors that exacerbate PTSD, depression, and anxiety. These conditions can be minimized through programs that aid immigrant integration and mental health.

Post-Traumatic Stress Disorder (PTSD) and Depression in Iranian Adolescents with and Without Hearing Loss (HL) in Previous and During the Outbreak of the COVID-19

Background: Due to the unavailability of information and resources about COVID-19 in people with Hearing Loss (HL), especially deaf people, the psychological problems, such as PTSD and depression are probably raised in people with hearing loss (HL) during the outbreak of COVID-19. This study was conducted to compare post-traumatic stress disorder (PTSD) and depression in Iranian adolescents with and without HL in previous and during the outbreak of COVID-19. Methods: The statistical sample was 112 adolescents half (56) of whom was with HL, while another half (56) was without HL. The two groups were also homogenized in terms of age, gender, and education. Data were gathered using the Child PTSD Symptom Scale for DSM-5 (CPSS-5) and Children's Depression Inventory Short version (CDI: S). The data obtained were analyzed using two-way MANOVA. Results: Results showed that 46.43% and 41.04% of with-HL adolescents during the outbreak of COVID-19, and 17.87% and 25.00% of them in previous the outbreak of COVID-19 had symptoms of PTSD and depression, respectively. Results indicated that the mean score difference between PTSD and depression during and in previous the outbreak of COVID-19 [(during)-(previous)] was higher in adolescents with HL than the control group. conclusion: We concluded that psychological and medical interventions must be beneficial to decrease symptoms of PTSD and depression in adolescents (especially in deaf and hard-of-hearing adolescents) during the outbreak of COVID-19.

A Longitudinal Investigation of Children’s Trauma Memory Characteristics and Their Relationship with Posttraumatic Stress Disorder Symptoms

While trauma memory characteristics are considered a core predictor of adult PTSD, the literature on child PTSD is limited and inconsistent. We investigated whether children’s trauma memory characteristics predict their posttraumatic stress symptoms (PTSS) at 1 month and 6 months post-trauma. We recruited 126 6–13 year olds who experienced a single-incident trauma that led to attendance at an emergency department. We assessed trauma memory disorganisation and sensory-emotional qualities through both narrative recall and self-report questionnaire, and PTSS at 1-month post-trauma and at 6-month follow-up. We found that, after controlling for age, children’s self-reported trauma memory characteristics were positively associated with their concurrent PTSS, and longitudinally predicted symptoms 6-months later. However, observable trauma memory characteristics coded from children’s narratives were not related to PTSS at any time. This suggests that children’s perceptions of their trauma memories are a more reliable predictor of the development and maintenance of PTSS than the nature of their trauma narrative, which has important implications for clinical practice.

Trastorno por Estrés Postraumático en infancia y adolescencia: cuestiones sobre diagnóstico y evaluación

Posttraumatic stress disorder in childhood and adolescence: Issues on diagnosis and assessment Abstract: The aim of the study was to compare DSM-IV, DSM-5 and alternative criteria for PTSD, in three independent samples, with the purpose of analyzing their suitability. The sample consisted of 361 minors with ages between 8 and 18 years, (122 community sample, 86 minors that suffered chronic family violence and 153 minors exposed to intimate partner violence). From the entire sample, 52.9% (n = 191) were girls and 47.1% (n = 170) were boys. The CPPS (Child PTSD Symptom Scale) was administered. The results showed a better PTSD diagnostic valuation using alternative criteria for the different ages and sample groups. An exhaustive revision of current PTSD diagnostic criteria for childhood and adolescence stages seem necessary.Keywords: Evaluation; diagnosis; PTSD; childhood; adolescence. Resumen: El estudio tuvo por objetivo comparar criterios DSM-IV, DSM-5 y criterios alternativos de TEPT, en tres muestras independientes con la finalidad de analizar la idoneidad de estos. La muestra se configuró con 361 menores entre los 8 y 18 años (122 muestra comunitaria; 86 menores habían sufrido maltrato intrafamiliar crónico y 153 menores expuestos a violencia de género). De la totalidad de la muestra el 52.9% (n = 191) eran chicas y el 47.1% (n = 170) chicos. Se administró la escala CPSS (Child PTSD Symptom Scale). Los resultados evidenciaron una mejor valoración diagnóstica del TEPT utilizando los criterios alternativos en las diferentes edades y en los diferentes grupos muestrales. Parece necesario una revisión exhaustiva de los criterios diagnósticos TEPT actuales en la etapa de la infancia y la adolescencia. Palabras clave: Evaluación; diagnóstico; TEPT; infancia; adolescencia.

Posttraumatic Symptoms in 3–7 Year Old Trauma-Exposed Children: Links to Impairment, Other Mental Health Symptoms, Caregiver PTSD, and Caregiver Stress

Few studies have examined how PTSD symptoms in young children are associated with other mental health symptoms and mood and functioning in caregivers. This is an important gap in the literature as such knowledge may be important for assessment and treatment. This study used network analysis to identify how the major symptom domains of PTSD in young trauma-exposed children were related to impairment, internalizing and externalizing symptoms, caregiver PTSD, and caregiver stress. Caregivers of 75 trauma-exposed 3–7 year old children reported on their child’s symptoms and impairment and their own PTSD symptoms and caregiver stress. A strong association between the child PTSD domains of intrusions and avoidance emerged, which is in line with theoretical notions of how PTSD onsets and is maintained in adolescents and adults. Externalizing child symptoms were strongly linked to PTSD-related impairment and caregiver stress, highlighting the need to carefully assess and address such symptoms when working with young trauma-exposed children. Internalizing symptoms were uniquely associated with all three of the major childhood PTSD symptom domains with further implications for assessment and treatment.