Victimization and PTSD-like states in an Icelandic youth probability sample

<p>Abstract</p> <p>Background</p> <p>Although adolescence in many cases is a period of rebellion and experimentation with new behaviors and roles, the exposure of adolescents to life-threatening and violent events has rarely been investigated in national probability studies using a broad range of events.</p> <p>Methods</p> <p>In an Icelandic national representative sample of 206 9th-grade students (mean = 14.5 years), the prevalence of 20 potentially traumatic events and negative life events was reported, along with the psychological impact of these events.</p> <p>Results</p> <p>Seventy-four percent of the girls and 79 percent of the boys were exposed to at least one event. The most common events were the death of a family member, threat of violence, and traffic accidents. The estimated lifetime prevalence of posttraumatic stress disorder-like states (PTSD; DSM-IV, APA, 1994 <abbrgrp><abbr bid="B1">1</abbr></abbrgrp>) was 16 percent, whereas another 12 percent reached a sub-clinical level of PTSD-like states (missing the full diagnosis with one symptom). Following exposure, girls suffered from PTSD-like states almost twice as often as boys. Gender, mothers' education, and single-parenthood were associated with specific events. The odds ratios and 95% CI for PTSD-like states given a specific event are reported. Being exposed to multiple potentially traumatic events was associated with an increase in PTSD-like states.</p> <p>Conclusion</p> <p>The findings indicate substantial mental health problems in adolescents that are associated with various types of potentially traumatic exposure.</p

Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

Background: There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD) is distinct from Borderline Personality Disorder (BPD) when the latter is comorbid with PTSD. Objective: To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD. Method: A latent class analysis (LCA) was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD. Results: The LCA revealed four distinct classes of individuals: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness. Conclusions: Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning

Objective and Subjective Factors as Predictors of Post-Traumatic Stress Symptoms in Parents of Children with Cancer – A Longitudinal Study

BACKGROUND: Parents of children with cancer report post-traumatic stress symptoms (PTSS) years after the child's successful treatment is completed. The aim of the present study was to analyze a number of objective and subjective childhood cancer-related factors as predictors of parental PTSS. METHODS: Data were collected from 224 parents during and after their child's cancer treatment. Data sources include self-report questionnaires and medical records. RESULTS: In a multivariate hierarchical model death of the child, parent's perception of child psychological distress and total symptom burden predicted higher levels of PTSS. In addition, immigrants and unemployed parents reported higher levels of PTSS. The following factors did not predict PTSS: parent gender, family income, previous trauma, child's prognosis, treatment intensity, non-fatal relapse, and parent's satisfaction with the child's care. CONCLUSIONS: Although medical complications can be temporarily stressful, a parent's perception of the child's distress is a more powerful predictor of parental PTSS. The vulnerability of unemployed parents and immigrants should be acknowledged. In addition, findings highlight that the death of a child is as traumatic as could be expected

Emotional functioning of parents of children with cancer: The first five years of continuous remission after the end of treatment

Objectives: The aim of this study is to investigate parental emotional functioning during the first five years of continuous remission after the end of their child's treatment and to identify predictors of parental emotional functioning. Methods: Psychological distress and situation-specific emotional reactions were assessed in 122 mothers and 109 fathers from 130 families. Longitudinal mixed model analyses were performed to investigate to what extent generic and disease-related coping, family functioning and social support were predictive of parental emotional functioning over time. Results: Initial elevated levels of distress, disease-related feelings of uncertainty and helplessness returned to normal levels during the first two years after the end of treatment. Being more optimistic about the further course of the child's disease (predictive control) was correlated with lower psychological distress and less negative disease-related feelings, while more passive reaction patterns were correlated with higher psychological distress and more negative disease-related feelings. Conclusions: Although in general the parents of children with successfully treated cancer showed adequate emotional resilience, support for these parents should not stop when treatment ends. Parents in need of help can be identified on the basis of their coping abilities

Family violence, war, and natural disasters: A study of the effect of extreme stress on children's mental health in Sri Lanka

Catani C, Jacob N, Schauer E, Kohila M, Neuner F. Family violence, war, and natural disasters: a study of the effect of extreme stress on children's mental health in Sri Lanka. BMC Psychiatry. 2008;8(1): 33.BACKGROUND: The consequences of war violence and natural disasters on the mental health of children as well as on family dynamics remain poorly understood. Aim of the present investigation was to establish the prevalence and predictors of traumatic stress related to war, family violence and the recent Tsunami experience in children living in a region affected by a long-lasting violent conflict. In addition, the study looked at whether higher levels of war violence would be related to higher levels of violence within the family and whether this would result in higher rates of psychological problems in the affected children. METHODS: 296 Tamil school children in Sri Lanka's North-Eastern provinces were randomly selected for the survey. Diagnostic interviews were carried out by extensively trained local Master level counselors. PTSD symptoms were established by means of a validated Tamil version of the UCLA PTSD Index. Additionally, participants completed a detailed checklist of event types related to organized and family violence. RESULTS: 82.4% of the children had experienced at least one war-related event. 95.6% reported at least one aversive experience out of the family violence spectrum. The consequences are reflected in a 30.4% PTSD and a 19.6% Major Depression prevalence. Linear regression analyses showed that fathers' alcohol intake and previous exposure to war were significantly linked to the amount of maltreatment reported by the child. A clear dose-effect relationship between exposure to various stressful experiences and PTSD was found in the examined children. CONCLUSION: Data argue for a relationship between war violence and violent behavior inflicted on children in their families. Both of these factors, together with the experience of the recent Tsunami, resulted as significant predictors of PTSD in children, thus highlighting the detrimental effect that the experience of cumulative stress can have on children's mental health

Young People’s Experiences of Attending a Theater-in-Education Program on Child Sexual Exploitation

Child sexual exploitation and abuse (CSEA) has grave implications for the mental health and wellbeing of children and young people. It has been linked to a wide range of difficulties which may extend into adulthood. School-based prevention programs that aim to raise awareness (and thereby have the potential to prevent CSEA) are popular, however, have historically lacked robust and consistent evaluation. The purpose of the present study was therefore to explore young people’s experiences of attending a school-based theater-in-education program, and the impact this had on their awareness and understanding of CSEA. Four focus groups of between four to six participants each were conducted with young people from two co-educational State schools in the United Kingdom. The approach of Template Analysis was used to analyze the data, and revealed a number of themes related to the superordinate themes of “Information and Detail Delivered” and “Format and Timing.” The results suggest that participants gained new awareness and understanding of aspects related to CSEA, including other forms of (criminal) exploitation, as well as how to avoid harm and what to do “if bad things happen.” Participants further reported that the theater performance/live element of the program was particularly impactful, feeling that this was delivered to them at the right time, but suggesting that younger people would also benefit from the important messages. In addition, areas for improvement were identified in terms of the delivery of the program, and the issue of victim blaming. Findings are discussed with a view to practical implications and directions for future research

Codependence and conduct disorder: Feminine versus masculine coping responses to abusive parenting practices

This study supported the hypothesis that codependence reflects a stereotypically feminine coping strategy to environmental stressors, while conduct disorder represents an alternate coping response reflecting stereotypically masculine behaviors. High school students ( N = 218; 81% Anglo-American, 8% Asian-American, 5% Hispanic-American) completed measures of femininity/masculinity, codependence, conduct disorder, and unhealthy parenting practices. Multiple regression analyses revealed that codependence is related to parental abuse and femininity ( R = .50). A marginal relationship between codependence and parental alcoholism was mediated by parental abuse, calling into question the validity of the codependence construct. Conduct disorder was related to parental abuse, masculinity, parental alcoholism, and gender ( R = .62). The tendency to label stereotypically feminine coping strategies as pathological, while ignoring a more prevalent and destructive masculine coping strategy is discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45612/1/11199_2005_Article_BF01548255.pd