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

Cytoplasmic localization of calcium/calmodulin-dependent protein kinase I-α depends on a nuclear export signal in its regulatory domain

AbstractCalcium/calmodulin-dependent protein kinase I-α (CaMKI-α) is a ubiquitous cytosolic enzyme that phosphorylates a number of nuclear proteins in vitro and has been implicated in transcriptional regulation. We report that cytoplasmic localization of CaMKI-α depends on CRM1-mediated nuclear export mediated through a Rev-like nuclear export signal in the CaMKI-α regulatory domain. Interaction of CaMKI-α with a CRM1 complex in vitro is enhanced by incubation with calcium/calmodulin. Translocation of CaMKI-α into the nucleus involves a conserved sequence located within the catalytic core. Mutation of this sequence partially blocks nuclear entry of an export-impaired mutant of CaMKI-α

New York Residents' Awareness of Invasive Species

Click on the PDF for an Executive Summary and the full report. Visit the HDRU website for a complete listing of HDRU publications at: http://hdru.dnr.cornell.edu

Horizontal rotation signals detected by "G-Pisa" ring laser for the Mw=9.0, March 2011, Japan earthquake

We report the observation of the ground rotation induced by the Mw=9.0, 11th of March 2011, Japan earthquake. The rotation measurements have been conducted with a ring laser gyroscope operating in a vertical plane, thus detecting rotations around the horizontal axis. Comparison of ground rotations with vertical accelerations from a co-located force-balance accelerometer shows excellent ring laser coupling at periods longer than 100s. Under the plane wave assumption, we derive a theoretical relationship between horizontal rotation and vertical acceleration for Rayleigh waves. Due to the oblique mounting of the gyroscope with respect to the wave direction-of-arrival, apparent velocities derived from the acceleration / rotation rate ratio are expected to be always larger than, or equal to the true wave propagation velocity. This hypothesis is confirmed through comparison with fundamental-mode, Rayleigh wave phase velocities predicted for a standard Earth model.Comment: Accepted for publication in Journal of Seismolog

Preparation for Full Time Employment: A Capstone Experience for Students in Leadership Programs

This practice paper describes the development and implementation of a senior capstone course for communication and leadership development for undergraduate students. The resulting course is a unique combination of experiential skill development and career preparation. The success of this course provides students with an important and meaningful culmination of their undergraduate experiences