Parent and child agreement for acute stress disorder, post-traumatic stress disorder and other psychopathology in a prospective study of children and adolescents exposed to single-event trauma

Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined by structured interview in a prospective study of assault and motor vehicle accident (MVA) child survivors, assessed at 2-4 weeks and 6 months post-trauma. Children were significantly more likely to meet criteria for ASD, as well as other ASD and PTSD symptom clusters, based on their own report than on their parent's report. Parent-child agreement for ASD was poor (Cohen's κ = -.04), but fair for PTSD (Cohen's κ = .21). Agreement ranged widely for other emotional disorders (Cohen's κ = -.07-.64), with generalised anxiety disorder found to have superior parent-child agreement (when assessed by phi coefficients) relative to ASD and PTSD. The findings support the need to directly interview children and adolescents, particularly for the early screening of posttraumatic stress, and suggest that other anxiety disorders may have a clearer presentation post-trauma

A pilot study on peritraumatic dissociation and coping styles as risk factors for posttraumatic stress, anxiety and depression in parents after their child's unexpected admission to a Pediatric Intensive Care Unit

Aim: To study the prevalence of posttraumatic stress disorder (PTSD), anxiety and depression in parents three months after pediatric intensive care treatment of their child and examine if peritraumatic dissocation and coping styles are related to these mental health problems. Methods: This is a prospective cohort study and included parents of children unexpectedly admitted to the Pediatric Intensive Care Unit (PICU) from January 2006 to March 2007. At three months follow-up parents completed PTSD (n = 115), anxiety and depression (n = 128) questionnaires. Immediately after discharge, parents completed peritraumatic dissocation and coping questionnaires. Linear regression models with generalized estimating equations examined risk factors for mental health problems. Results: Over 10% of the parents were likely to meet criteria for PTSD and almost one quarter for subclinical PTSD. Respectively 15% to 23% of the parents reported clinically significant levels of depression and anxiety. Peritraumatic dissocation was most strongly associated with PTSD, anxiety as well as depression. Avoidance coping was primarily associated with PTSD. Conclusion: A significant number of parents have mental health problems three months after unexpected PICU treatment of their child. Improving detection and raise awareness of mental health problems is important to minimize the negative effect of these problems on parents' well-being. © 2009 Bronner et al; licensee BioMed Central Ltd

Anxiety Levels in Children with Autism Spectrum Disorder:A Meta-Analysis

The aim of the current study was to meta-analytically examine whether anxiety levels in children with autism spectrum disorders (ASD) are elevated. A total of 83 articles were selected from a systematic literature search and were included in the meta-analyses. Results demonstrated that children with ASD had higher anxiety levels compared to typically developing children, and this difference increased with IQ. Youth with ASD also tended to have higher anxiety levels compared to clinically referred children, and this difference increased with age. Children with ASD had higher anxiety levels compared to youth with externalizing or developmental problems, but not when compared to youth with internalizing problems. The study findings highlight the importance of more research in order to fully understand the nature and development of anxiety in children with ASD. More specifically, the results suggest that especially high-functioning adolescents with ASD may be at risk for developing anxiety disorders. Therefore, it seems important to carefully follow and monitor children with ASD transcending to adolescenc

Estresse pós-traumático da criança sobrevivente de câncer e sua percepção acerca da experiência parental Post-Traumatic stress disorder of the child survivor of cancer and their perception about parental experience

Nas últimas décadas, paralelamente ao aumento progressivo das taxas de cura em Oncologia Pediátrica, evidencia-se um interesse crescente pela sobrevivência ao câncer na infância. Esta investigação teve como objetivo analisar essa experiência de sobrevivência ao câncer na infância, enfatizando a percepção da criança acerca da experiência parental e avaliando o Transtorno de Estresse Pós-traumático infantil nesse contexto. Realizaram-se entrevistas semiestruturadas com a criança, complementadas pela aplicação do UCLA Posttraumatic Stress Disorder Reaction Index for DSM-IV - Child Version. Evidenciaram-se taxas moderadas de diagnóstico total e parcial de Transtorno de Estresse Pós-Traumático. Especificamente no que se refere aos sintomas de estresse pós-traumático, os escores encontrados foram baixos. Os resultados também sugeriram uma relação entre o modo como a experiência parental é percebida pela criança e o escore total de gravidade de Transtorno de Estresse Pós-traumático Infantil. Recomendam-se estudos com amostras mais extensas, visando disponibilizar instrumentos de avaliação para a área da saúde.<br>This investigation aimed to describe, analyze and comprehend the experience of survival after childhood cancer, emphasizing the child's perception of the parent's experience and the evaluation of the child Post-Traumatic Stress Disorder. So, semi-structured interviews were conducted with the participants, who also answered the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-IV - Child Version. The child's perception of the parental experience confirmed evidences pointed out by specialized literature. The total and partial diagnosis rates of Post-Traumatic Stress Disorder were moderate. Finally, it was possible to suggest a likely connection between the way the parental experience is perceived and the total severity score of the Post-Traumatic Stress Disorder in children. Further investigation, with more significant samples, is recommended in order to develop evaluation tools to be applied in other health situations

Post-traumatic stress and major depressive disorders in parent caregivers of children with a chronic disorder

Post-traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) are the most common psychiatric consequences among caregivers of pediatric patients affected by severe chronic illnesses. The aims of this study were to describe rates of PTSD and MDD in a sample of parents of epileptic children, and to examine the correlations between symptoms of post-traumatic stress and depression. Parents of children with epilepsy were enrolled and screened by means of the PTSD module of the Semi-Structured Clinical Interview for DSM-5 (SCID-5) and of the Hamilton Rating Scale for depression (HAM-D). They also completed the Trauma and Loss Spectrum Self-Report (TALS-SR), an international instrument to evaluate post-traumatic stress spectrum symptoms. Results revealed PTSD rates of 15.7% (19.5% mothers, 8,1% fathers; p =.043) and MDD rates of 7.5% (10.2% mothers,1.8% fathers; p =.064). A model of multiple linear regression indicated a significant B linear regression coefficient between being mothers (p =.012), witnessing tonic-clonic seizures (p =.015) and having higher TALS-SR total score (p &lt;.001) as predictors of HAM-D total score. Our findings highlight the relationship between PTSD and MDD, evidencing the need for further studies on pediatric caregivers aimed to develop specific intervention programs of healthcare prevention and assistance

Possible Contribution of PTSD to Altered Cortisol Activity in Young Adult Obese African-American Women

OBJECTIVE: African-Americans have been found to experience increased rates of post-traumatic stress disorder (PTSD), obesity, and flatter diurnal cortisol slopes compared to other demographic groups. Further exploration, however, is needed to understand how PTSD impacts diurnal cortisol activity in obese African-American women. The purpose of the current study is to examine the relationship between salivary cortisol levels and PTSD in a sample of obese young adult African-American women and to examine how depression and insomnia influence the relationship. METHODS: Thirty-four young adult African-American women (mean age=24.0 years; mean BMI=37.4 kg/m(2), 6/34 of the sample had a score of 40 or above on the PTSD Checklist (PCL) representing clinically significant PTSD) filled out questionnaires assessing PTSD, lifetime exposure to traumatic events, insomnia severity, and depression. A home-based assessment of salivary cortisol was provided upon awakening at 30 min and 1, 3, 6, and 12 h. RESULTS: There was a significant interaction between PTSD status and diurnal cortisol activity (p<0.04). There were trends for higher cortisol levels at awakening (p<0.051) and 30 min post-awakening (p<0.059) with PTSD. The significance of the interaction between PTSD and cortisol was attenuated by co-varying for depression and insomnia (p>0.05). CONCLUSION: PTSD, influenced by depression and insomnia symptoms, has an impact on diurnal cortisol activity in obese young adult African-American women