Search Results (17)

This study aims to illustrate the impact of accumulated traumatic experiences in adolescence and to evaluate the potential of brief focal psychotherapy (BFP) as a treatment approach for complex trauma. We present the case of a 14-year-old boy who experienced vicarious gender-based violence, child abuse, early maternal separation without alternative secure attachment figures, and forced sudden migration. The patient exhibited symptoms consistent with post-traumatic stress disorder (PTSD) and complex trauma. The culturally sensitive intervention, delivered at a public child and adolescent mental health center, consisted of twenty weekly individual sessions of 45 min each, complemented by three 45 min psychoeducation sessions with the caregiver. The assessment was conducted using a multitrait and multi-informant approach, systematically gathering information across multiple domains of functioning (emotional–behavioral, physical, cognitive, self-perception, and relational) and from different sources (the adolescent, his mother, and the clinician) through clinical interviews, projective techniques, and parental feedback. The primary therapeutic focus was the establishment of a secure therapeutic alliance to facilitate emotional exploration and trauma processing. Following treatment, the patient demonstrated significant improvements in emotional regulation, family relationships, and school performance, as measured by both self-report and parental observations. This case highlights the potential of BFP in addressing complex trauma in adolescents, particularly during a developmental stage marked by increased vulnerability to the effects of chronic trauma exposure. The findings suggest that BFP can effectively reduce both acute symptomatology and broader psychosocial consequences associated with prolonged and cumulative trauma. Further research, particularly controlled studies and longitudinal follow-ups, is needed to refine and optimize the use of BFP by mental health professionals working with adolescents affected by complex trauma. Full article

War refugees are more likely to present psychological disorders, such as PTSD. Memory impairments often hinder their ability to recall and integrate traumatic events. This study investigated the memory capacity of 133 Syrian refugee children and adolescents in Lebanon and examined the moderating role of resilience in the relationship between exposure to negative events, post-traumatic stress reactions, and traumatic events recollection. Participants completed the Childhood War Trauma Questionnaire (CWTQ), Post-Traumatic Symptom Reactions Checklist for Children (PTSR-C), and Child and Youth Resilience Measure-28 (CYRM-28). They also performed a timeline exercise, part of Narrative Exposure Therapy, in which they organized and described their positive and negative life memories. Results showed that memories of traumatic events were lower than potentially traumatic events that participants had witnessed. This difference increased as post-traumatic stress increased. Moreover, potentially traumatic events experienced predicted post-traumatic stress reactions, and these predicted negative memories recalled. Participants’ resilience moderated the association between post-traumatic reactions and remembered traumatic memories showing that only for children and adolescents with higher resilience post-traumatic symptoms predicted trauma-related memories. The results highlight meaning making and sharing capacities of natural relational contexts (family, peers, etc.) as potential key processes to be promoted to overcome and process traumatic events. Full article

Background/Objectives: Sleep and cognitive alterations are common symptoms associated with child Post-traumatic stress disorder (PTSD) and depression (DEP). This study aims to investigate the relationship between sleep disturbances and cognitive alterations in PTSD and DEP. Methods: Using a quantitative, cross-sectional exploratory design, we examined 130 students (106 girls and 24 boys) aged 11 to 16 years (mean age = 12.9, SD = 1.35) from 6th to 8th grade. Twenty-eight participants met the criteria for PTSD, 15 met the criteria for DEP, 43 met the criteria for both PTSD+/DEP+, and 44 served as the control group. Comparative analyses were conducted using the MANOVA and multiple one-way ANOVA tests. Results: The MANOVA test indicated an interaction between cognitive and sleep alterations. Post hoc analysis revealed that sleep patterns were significantly altered among the groups with PTSD, DEP, and PTSD+/DEP+ (F(3, 126) = 16.98, p = 0.001). In contrast, cognitive alterations were most pronounced in PTSD and PTSD+/DEP+ (F(3, 126) = 63.97, p < 0.001). Conclusions: These findings emphasize the impact of PTSD and DEP on cognition and sleep. Potential clinical implications suggest the need for interventions targeting sleep and cognitive alterations. This study underscores the complex relationship among traumatic experiences, depression, and cognitive/sleep alterations. Full article

Adverse childhood experiences (ACEs) have already been associated, in some studies, with various diverse psychosocial abnormalities in later life. However, it is still unclear whether ACEs reported by biological parents differ from ACE scores in community samples. Background/Objectives: The aim of this study was to investigate the extent to which parents of a patient sample differ from a community sample in terms of reporting childhood experiences. In addition, the connection between parental negative traumatic experiences and their children’s reporting of these experiences should be examined in more detail. Methods: In total, 256 child psychiatric patients (73.8% female and 26.2% male) aged 4–18 years (mean [M] = 13.26 years, standard deviation [SD] = 2.73) were retrospectively examined for post-traumatic stress symptoms (using the CATS questionnaire). In addition, 391 caregivers, 316 of whom were biological parents, completed the ACE questionnaire on adverse childhood experiences. The frequencies of ACEs of the parents, the traumatic experiences of the patients and their cumulative occurrence were evaluated descriptively. Results: A total of 139 (73%) mothers reported at least one negative experience in childhood. In contrast, 65 fathers (52%) reported at least one negative experience in childhood. Mothers most frequently mentioned separation from a parent (38.7%), while fathers cited emotional abuse as the most frequent negative experience. These ACE scores were significantly higher than those reported from community samples. Post-traumatic stress disorder was diagnosed in 75 (29.3%) of the 256 patients. A total of 44.6% of children of mothers and 53.8% of children of fathers reporting at least one ACE showed a CATS score above the cut-off. Conclusions: Parents of child psychiatric patients show higher scores of adverse childhood experiences than a community sample with the same population background. Further empirical studies in parents of child psychiatric patients and a larger sample seem mandatory in the face of these results. Full article

Child sexual abuse (CSA), the most common type of maltreatment, is any action of a sexual nature by one or more adults towards a minor without the minor’s consent. This abuse represents one of the most damaging forms of trauma, has a severe impact on mental health and psychopathology, and can lead to several disorders, including post-traumatic stress disorder (PTSD). PTSD is characterized as a disorder that encompasses physical symptoms resulting from traumatic experiences that are experienced or witnessed by the victim. This systematic review aims to understand the impact of sexual abuse on post-traumatic stress disorder in children and adolescents. Studies focusing on the relationship between these two variables were obtained through multiple databases. Of the 940 documents collected, 24 were retained for further analysis and the objectives, methodologies, results, and main conclusions were registered. One of the main conclusions was that the earlier the abuse starts and the more severe and long-lasting it is, the symptomatology of PTSD will be aggravated and remain in the long term. Full article

Emotional dysregulation (ED) has recently been conceptualized as a transnosographic entity in major mental disorders, and increasing evidence has suggested association between ED and post-traumatic stress symptoms (PTSS), though the nature of this association is unclear. The aim of the present review was to examine the possible interplay between ED and trauma exposure in the literature, as well as a possible role for the comorbidity of PTSD or PTSS in adolescents and young adults. In particular, we explored whether ED may represent a risk factor for PTSD or, conversely, a consequence of traumatic exposure. This systematic review was conducted according to PRISMA 2020 guidelines in three databases (PubMed, Scopus, and Embase). The 34 studies included showed a wide heterogeneity in terms of the populations selected and outcomes examined. Most studies used the Difficulties in Emotion Regulation Scale (DERS) and examined the relationship between ED, trauma, and psychopathological manifestations after the occurrence of trauma, with a focus on child abuse. Although current data in the literature are heterogeneous and inconclusive, this research highlights the role of ED as a mechanism that may mediate vulnerability to PTSD, but also as a predictor of severity and maintenance of typical, atypical, or associated PTSD symptoms, suggesting prevention programs for PTSD and other mental disorders should support the development of emotion regulation strategies. Full article

Background: Since the World Health Organization (WHO) declared the COVID-19 pandemic in March 2020, many measures have been taken to prevent the spread of the virus. Consequently, many minors have been confined to their homes and have had to subsequently adapt to countless protocol changes. These factors appear to have contributed to post-traumatic stress disorder (PTSD) in many children. Materials and Methods: The authors searched Medline through PubMed and other databases for studies published from 1 December 2019 to 31 December 2021 on the prevalence of PTSD in schoolchildren. The authors used a random-effects model to calculate the pooled prevalence of PTSD. Results: A total of six studies were included in this review. Our results show a pooled prevalence of PTSD of 14% in children and adolescents. Subgroup analyses identify a significantly higher prevalence of PTSD for studies conducted in China and a higher prevalence in boys. The prevalence of PTSD appeared independent of child age or the methodological rigor of the study. Conclusions: Our results suggest that a large number of children may be suffering from PTSD (post-traumatic stress disorder). Public health measures are thus needed to improve children’s mental health during and after the pandemic, so that the suffering is mitigated to prevent long-lasting effects. Full article

Aims: Armed conflicts produce a wide series of distressing consequences, including death, all of which impact negatively on the lives of survivors. This paper focuses specifically on the mental health consequences of war on adults and child/adolescent refugees or those living in war zones through a review of all systematic reviews and/or meta-analyses published from 2005 up until the current time. Results: Fifteen systematic reviews and/or meta-analyses conducted in adult populations, and seven relating to children and adolescents, were selected for the purpose of this review. Prevalence rates of anxiety, depression and post-traumatic stress disorder (PTSD) were two- to three-fold higher amongst people exposed to armed conflict compared to those who had not been exposed, with women and children being the most vulnerable to the outcome of armed conflicts. A series of war-related, migratory and post-migratory stressors contribute to short- and long-term mental health issues in the internally displaced, asylum seekers and refugees. Conclusion: It should be a required social responsibility for all psychiatrists and psychiatric associations to commit to raising awareness amongst political decision-makers as to the mental health consequences caused by armed conflicts, as part of their duty of care for people experiencing the consequences of war. Full article

Background: The child psychiatry unit of the Cochin Hospital in Paris is specialized in a transcultural clinical approach and treatment of psychotraumatism. The clinical demands addressed to the service often combine several levels of vulnerability: recent migration, repeated and intentional traumas, isolation and breach in family bonds sometimes precarious living conditions. Mastering how to approach trauma content adapting to the person’s temporality while taking into account the individual, family and collective dimensions, is a key driver to the clinical intervention (of our approach). Objective and method: We describe a paradigmatic clinical situation articulating its multidimensional complexity: the case of Céline, a 16-year-old Mozambique teenager, unaccompanied minor (UM), who arrived in France three years ago with her 4-year-old child born out of rape. They are both cared for by Paris Child Welfare Bureau. The authors used the CARE guidelines for a rigorous approach to clinical case writing. Results and discussion: In the clinical discussion, we highlight the pertinence of transcultural abilities for the treatment of a complex PTSD (post-traumatic stress disorder). We describe the measures taken to adapt the clinical interview framework to the mother’s psychic temporality, while negotiating what can be said in attendance of the child. The idea of tranquility is primordial—whether she decides to tell or not tell the child. Removing the pressure to have to tell is an element of treatment. Conclusion: Working through a progressive narrative construction, the therapeutical process allowed for the restoration of multiple levels of continuity between times prior to the trauma and following it, as well as prior to migration and following it, to create a continuum from adolescence to adulthood. Restoring narrativity favors the process of becoming a mother and the one of negotiating this new identity. The therapeutic axes also focused on improving the well-being of the UM-mother and preventing the impacts of transgenerational trauma transmission to the child. For women with similar experiences, sharing their emotions and their stories with us makes their choice about telling their child legitimate and comfortable, regardless of the decision they make. Full article

Every year in Poland there are approximately 1200 new cases of malignant tumours in children and adolescents. Leukaemia, CNS tumours, and lymphomas are the most frequently diagnosed cancers. Coping with a child’s illness is challenging, which is why many parents suffer from anxiety, depression disorders, and even PTSD (post-traumatic stress disorder). The aim of this study is to assess the anxiety and depression levels of carers of children with cancer. Method: The study participants were 101 carers of children suffering from cancer. The study was conducted using standardized questionnaires: the Zung ccale, HADS scale, and Karnofsky scale, and three questionnaires designed by the author. Results: According to the results of the Karnofsky scale, carers’ anxiety and depression levels were negatively affected by their children’s poor performance. The younger age of children significantly correlated with the severity of depression in their parents. HADS and Zung scale anxiety levels were observed to have statistically significant effect on the severity of depressive disorders. Conclusions: Receiving a diagnosis of childhood cancer contributes to the incidence of depression and anxiety disorders among carers. Carers’ anxiety and depression levels were strongly associated with their child’s age and their child’s performance. Full article

Although the effect of the COVID-19 pandemic on children and adolescents’ mental health has been studied, there is still scarce evidence of the influence of nuclear family on the development of post-traumatic stress disorder (PTSD). This study aimed to determine the association between family dysfunction and PTSD in Peruvian high-school students during the COVID-19 pandemic. A cross-sectional study was conducted using a virtual survey administered to 562 high-school students in three schools in Chiclayo, Peru. The dependent variable was PTSD, which was measured with the Child PTSD Symptom Scale. Family dysfunction was the main independent variable, measured with the Family APGAR Questionnaire. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were estimated with generalized linear models. Most of the students were female (88.3%) and the average age was 14.4 years. We found that 21.4% showed severe family dysfunction and 60.3% had PTSD. Students with mild and moderate family dysfunction had 37% (PR: 1.37; 95% CI: 1.14–1.65) and 26% (PR: 1.26; 95% CI: 1.04–1.54) higher PTSD prevalence, respectively. In conclusion, family dysfunction may influence the development of PTSD in adolescents. This study suggests the importance to develop a healthy family environment to help adolescents face critical situations experienced during the pandemic. Full article

The worldwide occurrence of potentially traumatic events (PTEs) in the life of children is highly frequent. We aimed to identify studies on early mental health interventions implemented within three months of the child/adolescent’s exposure to a PTE, with the aim of reducing acute post-traumatic symptoms, decreasing long term PTSD, and improving the child’s adjustment after a PTE exposure. The search was performed in PubMed and EMBASE databases resulting in twenty-seven articles meeting our inclusion criteria. Most non-pharmacological interventions evaluated had in common two complementary components: psychoeducation content for both children and parents normalizing early post-traumatic responses while identifying post-traumatic symptoms; and coping strategies to deal with post-traumatic symptoms. Most of these interventions studied yielded positive results on outcomes with a decrease in post-traumatic, anxiety, and depressive symptoms. However, negative results were noted when traumatic events were still ongoing (war, political violence) as well as when there was no or little parental involvement. This study informs areas for future PTSD prevention research and raises awareness of the importance of psychoeducation and coping skills building in both youth and their parents in the aftermath of a traumatic event, to strengthen family support and prevent the occurrence of enduring post-traumatic symptoms. Full article

Background: The worldwide population of child refugees is estimated to be over 10 million. Refugee children and adolescents are among the most vulnerable groups in the world, and the pandemic created new challenges for them. Objective: This study aimed to examine the PTSD and depression levels of Syrian refugee children and adolescents, the difficulties they experienced in access to food and education, and the changes in their family income, and evaluate the effects of these factors on symptom severities of depression and PTSD. Methods: We used data obtained from 631 Syrian refugee children between the ages of 7 and 15. Assessment measures for exposure to PTSD and depression included a socio-demographic form, stressors related to COVID-19, the Child and Adolescent Trauma Survey (CATS), and the patient-rated Children’s Depression Inventory (CDI). ANCOVA is conducted to evaluate the differences between the symptoms of PTSD and depression. The regression analysis was used to determine the relationship between the scales and the demographic data. Results: The study finds that 40.7% of the refugee children experienced at least one trauma, 24.9% met the criteria for PTSD, and 15.5% met the criteria for depression. The changes in income and food access are associated with PTSD and depression, while access to education is not associated with PTSD and depression. The adolescents aged between 12 and 15 show more depression and PTSD symptoms then the children aged between 7 and 11. Conclusions: The study revealed that the most risky group in refugee children and adolescents in terms of PTSD and depression were the adolescents aged between 12 and 15 and the children and adolescent whose family income was decreased and had limited access to food. Full article

Chronic pain is a highly prevalent and costly issue that often emerges during childhood or adolescence and persists into adulthood. Adverse childhood experiences (ACEs) increase risk for several adverse health conditions, including chronic pain. Recent evidence suggests that parental trauma (ACEs, post-traumatic stress disorder (PTSD) symptoms) confers risk of poor health outcomes in their children. Intergenerational relationships between parental trauma and child chronic pain may be mediated by epigenetic mechanisms. A clinical sample of youth with chronic pain and their parents completed psychometrically sound questionnaires assessing ACEs, PTSD symptoms, and chronic pain, and provided a saliva sample. These were used to investigate the intergenerational relationships between four epigenetic biomarkers (COMT, DRD2, GR, and SERT), trauma, and chronic pain. The results indicated that the significant biomarkers were dependent upon the gender of the child, wherein parental ACEs significantly correlated with changes in DRD2 expression in female children and altered COMT expression in the parents of male children. Additionally, the nature of the ACE (maltreatment vs. household dysfunction) was associated with the specific epigenetic changes. There may be different pathways through which parental ACEs confer risk for poor outcomes for males and females, highlighting the importance of child gender in future investigations. Full article

Being a victim of abuse in childhood can lead to the development of trauma-related psychopathology, which could affect the testimony of the child victim. Post-traumatic stress disorder (PTSD) is a factor that can increase both the levels of suggestibility and the production of memory errors, such as confabulations, which can be identified in distortions and fabrications. No studies have analyzed the relationship between suggestibility, fabrications, distortions, and PTSD on samples of children and adolescents suspected of being sexually abused. This study aims to verify in a sample of 221 sexually abused children and adolescents the effect of PTSD, measured by Trauma Symptoms Checklist for Children, in increasing the levels of immediate and delayed suggestibility and the production of fabrications and distortions in immediate and delayed memory tasks, obtained by Gudjonsson Suggestibility Scale 2, controlling age and non-verbal intelligence. Our results show that PTSD increases the levels of immediate and delayed suggestibility, but it has no effect on memory recall in immediate recall tasks. Moreover, PTSD leads to a greater number of distorted and fabricated information inserted in delayed memory. Forensic implications of PTSD consequences on memory tasks and suggestibility levels of sexually abused children are discussed. Full article