The posttraumatic stress disorder diagnosis in preschool- and elementary school-age children exposed to motor vehicle accidents

Objective: Increasingly, children are being diagnosed with psychiatric disorders, including preschool-age children. These diagnoses in young children raise questions pertaining to 1) how diagnostic algorithms for individual disorders should be modified for young age groups, 2) how psychopathology is best detected at an early stage, and 3) how to make use of multiple informants. The authors examined these issues in a prospective longitudinal assessment of preschool- and elementary school-age children who were exposed to a traumatic event. Method: Participants were 114 children (age range: 2-10 years) who had experienced a motor vehicle accident. Parents and older children (age range: 7-10 years) completed structured interviews 2-4 weeks (initial assessment) and 6 months (6-month follow-up) after the traumatic event. A recently proposed alternative symptom algorithm for diagnosing posttraumatic stress disorder (PTSD) was utilized and compared with the standard DSM-IV algorithms for diagnosing PTSD and acute stress disorder. Results: At the 2- to 4-week assessment, 11.5% of the children met conditions for a diagnosis of PTSD based on the alternative algorithm criteria per parent report, and 13.9% met criteria for this diagnosis at the 6-month follow-up. These percentages were much higher than those for DSM-IV diagnoses of acute stress disorder and PTSD. Among 7- to 10-year-old subjects, the use of combined parent- and child-reported symptoms to derive a diagnosis resulted in an increased number of children in this age group who were identified with psychiatric illness relative to the use of parent report alone. Agreement between parent and child on symptoms for 1) a diagnosis of PTSD based on the alternative algorithm criteria and 2) diagnoses of DSM-IV acute stress disorder and PTSD in this age group was poor. Among 2- to 6-year-old subjects, the alternative algorithm PTSD diagnosis per parent report was a more sensitive predictor of later onset psychopathology relative to a diagnosis of DSM-IV acute stress disorder or PTSD per parent report. However, among 7- to 10-year-old subjects, a combined symptom report (from both parent and child) was optimal in predicting posttraumatic psychopathology. Conclusions: These findings support the use of the proposed alternative algorithm for assessing PTSD in young children and suggest that the diagnosis of PTSD based on the alternative algorithm criteria is stable from the acute phase onward. When both parent- and child-reported symptoms are utilized for the assessment of PTSD among 7- to 10-year-old children, the alternative algorithm and DSM-IV criteria have broad comparable validity. However, in the absence of child-reported symptoms, the alternative algorithm criteria per parent report appears to be an optimal diagnostic measure of PTSD among children in this age group, relative to the standard DSM-IV algorithm for diagnosing the disorder

Maladaptive Cognitive Appraisals Mediate the Evolution of Posttraumatic Stress Reactions:A 6-Month Follow-Up of Child and Adolescent Assault and Motor Vehicle Accident Survivors

A prospective longitudinal follow-up study (n = 59) of child and adolescent survivors of physical assaults and motor vehicle accidents assessed whether cognitive processes predicted posttraumatic stress symptomatology (PTSS) at 6 months posttrauma in this age group. In particular, the study assessed whether maladaptive posttraumatic appraisals mediated the relationship between initial and later posttraumatic stress. Self-report measures of PTSS, maladaptive appraisals, and other cognitive processes, as well as structured interviews assessing for acute stress disorder and posttraumatic stress disorder (PTSD), were completed at 2-4 weeks and 6 months posttrauma. PTSS and PTSD at 6 months were associated with maladaptive appraisals and other cognitive processes but not demographic or objective trauma severity variables. Only maladaptive appraisals were found to associate with PTSS/PTSD after partialing out initial symptoms/diagnosis and to mediate between initial and later PTSS. It was argued that, on this basis, maladaptive appraisals are involved in the development and maintenance of PTSS over time, whereas other cognitive processes (e.g., subjective threat, memory processes) may have an effect only in the acute phase. The implications of this study for the treatment of PTSS in youths are discussed

The role of the family in child and adolescent posttraumatic stress following attendance at an emergency department

Objective: To evaluate the role of family factors in posttraumatic stress symptomatology (PTSS) in children and adolescents who have attended an emergency department following assaults or motor vehicle accident. Methods: Children and their parents completed self-report questionnaires and semistructured interviews relating to their psychopathology and cognitive styles at 2-4 weeks and 6 months after trauma. Results: Parental depression was correlated with child PTSS at each assessment point. Less consistent findings were observed for family functioning. Parental endorsement of worry was a correlate of child PTSS at each assessment and a mediator between parental depression and child PTSS. Conclusions: A role for family factors, in particular parental depression and parental endorsement of worry, in the development of child PTSS is supported. Weaknesses of the study are discussed, and suggestions for future research are given

Direct measurement of diurnal polar motion by ring laser gyroscopes

We report the first direct measurements of the very small effect of forced diurnal polar motion, successfully observed on three of our large ring lasers, which now measure the instantaneous direction of Earth's rotation axis to a precision of 1 part in 10^8 when averaged over a time interval of several hours. Ring laser gyroscopes provide a new viable technique for directly and continuously measuring the position of the instantaneous rotation axis of the Earth and the amplitudes of the Oppolzer modes. In contrast, the space geodetic techniques (VLBI, SLR, GPS, etc.) contain no information about the position of the instantaneous axis of rotation of the Earth, but are sensitive to the complete transformation matrix between the Earth-fixed and inertial reference frame. Further improvements of gyroscopes will provide a powerful new tool for studying the Earth's interior.Comment: 5 pages, 4 figures, agu2001.cl

Hall state quantization in a rotating frame

We derive electromagnetomotive force fields for charged particles moving in a rotating Hall sample, satisfying a twofold U(1) gauge invariance principle. It is then argued that the phase coherence property of quantization of the line integral of total collective particle momentum into multiples of Planck's quantum of action is solely responsible for quantization in the Hall state. As a consequence, the height of the Hall quantization steps should remain invariant in a rapidly rotating Hall probe. Quantum Hall particle conductivities do not depend on charge and mass of the electron, and are quantized in units of the inverse of Planck's action quantum.Comment: 6 pages, accepted for publication in Europhysics Letter

Entanglement requirements for implementing bipartite unitary operations

We prove, using a new method based on map-state duality, lower bounds on entanglement resources needed to deterministically implement a bipartite unitary using separable (SEP) operations, which include LOCC (local operations and classical communication) as a particular case. It is known that the Schmidt rank of an entangled pure state resource cannot be less than the Schmidt rank of the unitary. We prove that if these ranks are equal the resource must be uniformly (maximally) entangled: equal nonzero Schmidt coefficients. Higher rank resources can have less entanglement: we have found numerical examples of Schmidt rank 2 unitaries which can be deterministically implemented, by either SEP or LOCC, using an entangled resource of two qutrits with less than one ebit of entanglement.Comment: 7 pages Revte

Assessment of wind speeds based on damage observations from the Angus (Ontario) Tornado of 17 June 2014

A tornado occurred in Angus, Ontario, during the late afternoon hours of 17 June 2014. The authors conducted a damage investigation on the morning following the storm. The damage indicators support the classification of the tornado as an EF-2 on the Enhanced Fujita Scale, including the observation of several complete roof failures of recently-constructed, wood-frame houses. Most of the damage to residential homes was contained along two streets, with the tornado appearing to have gone down the backyards between the two. In total, 101 houses were observed to have sustained some level of damage. The evidence suggests that the quality of construction likely affected the performance of failed roofs. A detailed fragility analysis was conducted to assess wind speeds associated with these failures of the roof-to-wall connections. An overturned and lofted box truck provided the opportunity to correlate this failure with adjacent, repetitive failures of roof sheathing, shingles, and garage doors. </jats:p

Milwaukee

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