PTSD symptoms of mothers following occurrence of a disaster affecting their children

This study investigated the PTSD symptoms of 37 mothers whose adolescent children had been directly involved in a disaster, the Jupiter sinking in 1988. This group included mothers whose children were (a) not diagnosed with Posttraumatic Stress Disorder and (b) were diagnosed with Posttraumatic Stress Disorder. The measure used was the Posttraumatic Stress Disorder Symptom Scale. Women whose children were involved in the disaster presented PTSD symptoms. 35% (n = 13) were diagnosed with PTSD 3 mo. after the disaster, and 89% (n = 3) of them were diagnosed with PTSD 6 yr. afterward. This effect was greater in the subgroup whose children had developed traumatic stress disorder following the disaster.     

The development of posttraumatic stress disorder following four different types of traumatization

The Children's Posttraumatic Stress Disorder Inventory (CPTSDI) was used to identify 230 childhood posttraumatic stress disorder (PTSD) cases. Of these cases, 58 had been traumatized through direct experience, 128 through observation, 13 through verbal mediation, and 31 by combinations thereof. The 230 children and 35 controls completed the Revised Children's Manifest Anxiety Scale (RCMAS) and the Children's Depression Inventory (CDI). In addition, their conduct was rated on the Connor's Teacher Rating Scale (CTRS) criteria. Each of the PTSD groups had significantly greater RCMAS, CDI, and CTRS scores than the non-clinical controls, but there were no differences between the four types of PTSD cases.     

Adapted character styles of Vietnam veterans with Posttraumatic Stress Disorder

A total of 189 male Vietnam veterans who were admitted to a specialized inpatient treatment program were evaluated using the Millon Clinical Multiphasic Personality Inventory to assess character styles. The veterans were assessed for Posttraumatic Stress Disorder by using a subscale of the Minnesota Multiphasic Personality Inventory (MMPI) and 72% of the patients were classified as having Posttraumatic Stress Disorder. The character styles of passive-aggressive, schizoid, avoidant, and borderline were significantly associated with these patients. The most common 2-point profile was passive-aggressive and avoidant (8-2 or 2-8) and was significantly related to the diagnosis. While drug and alcohol abuse were common problem areas for the entire sample, the profile of patients with Posttraumatic Stress was different from those of substance abusers. These results indicate that treating Vietnam veterans with this disorder requires adopting strategies which include a character style focus as well as a symptom focus.     

Screening for trauma in children and adolescents: the validity of the Traumatic Stress Disorder Scale of the screen for child anxiety related emotional disorders

Examined the validity of the Traumatic Stress Disorder scale of the Screen for Child Anxiety Related Emotional Disorders (SCARED), a recently developed self-report questionnaire measuring Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) defined anxiety disorders symptoms in children. A large sample of normal schoolchildren (N = 996) ages 7 to 19 years completed the SCARED. Children who scored high on the SCARED Traumatic Stress Disorder scale (i.e., trauma group; n = 43) and children who scored low on this scale (i.e., control group; n = 43) were then interviewed about their most aversive life event. In addition, children completed self-report questionnaires of traumatic experiences and posttraumatic stress disorder (PTSD) symptomatology. Results showed that children in the trauma group more frequently reported life events that independent judges considered to be 'potentially traumatic' than did control children. Furthermore, children in the trauma group reported having experienced more traumatic incidents and had higher scores on PTSD-related questionnaires compared with control children. Moreover, trauma group children more frequently fulfilled DSM-IV criteria for PTSD than did control children. The results of this study support the validity of the Traumatic Stress Disorder scale of the SCARED.     

Utility of the impact of event scale in screening for posttraumatic stress disorder

This study assesses the optimal cut-off point for the Impact of Event Scale and compares its screening properties with those of the Self-rating Inventory for Posttraumatic Stress Disorder among war-related trauma victims. 74 patients with war-related trauma were administered the Impact of Event Scale and the Self-rating Inventory for Posttraumatic Stress Disorder, followed 1 wk. later by the Clinician-administered PTSD Scale. Receiver operating characteristic analysis indicated for the Impact of Event Scale a sensitivity of .77 and a specificity of .51 at a cut-off value of 36. For the Self-rating Inventory for Posttraumatic Stress Disorder a sensitivity of .86 and a specificity of .69 were found at a cut-off value of 52. The authors conclude that careful use of the Impact of Event Scale as a screening measure for Posttraumatic Stress Disorder is warranted.     

Psychotraumatology: A two-factor formulation of posttraumatic stress

Other than the “sudden death” phenomenon, posttraumatic stress represents the most severe and incapacitating form of human stress (Everly, 1989). Posttraumatic stress is directly associated with three DSM-III-R, Axis I disorders: Posttraumatic Stress Disorder (PTSD), Multiple Personality Disorder, and Brief Reactive Psychosis (APA, 1987). It is similarly associated with the Axis II personality disorder Borderline Personality Disorder (Herman and van der Kolk, 1987). Posttraumatic stress may be indirectly related to various forms of mood disorders, substance abuse syndromes, and phobic disorders. Regarding the prevalence of posttraumatic stress, Helzer et al. (1987) found the lifetime prevalence of PTSD at around 1% in the general population. Breslau et al. (1991) found the prevalence of PTSD to be 9% in a cohort of young adults in an urban setting. They further found a prevalence of 24% in young adults who had been exposed to traumatic events. Norman and Getek (1988) have estimated that nearly one-half of all patients admitted to urban trauma centers are likely to suffer from PTSD in addition to their physical traumatization, while another 31% may suffer from a milder variant of posttraumatic stress. These data argue compellingly for the potential severity of the threat that posttraumatic stress poses to society. Yet, no one clear-cut therapy for posttraumatic stress has emerged, nor has a generally agreed-upon phenomenology emerged upon which to base such a therapy. The purpose of this paper is to present a comprehensive formulation of posttraumatic stress based upon an integration of biological and psychological evidence.     

Comparison of characteristics of Vietnam veterans with and without posttraumatic stress disorder

Characteristics of 107 Vietnam veterans with and without Posttraumatic Stress Disorder (PTSD), who had been exposed to varying levels of combat, were compared. Severity of psychopathology as assessed on the Eysenck Personality Questionnaire, locus of control orientation as measured by the Nowicki-Strickland Internal-External Control Scale, and ability to have provided structure and meaning to the Vietnam experience were examined. Compared to veterans with Posttraumatic Stress Disorder, those without the disorder had lower Neuroticism and Psychoticism scores, were more internal in their locus of control orientation, and were more likely to have shown ability to provide structure to the Vietnam experience. The additional finding that veterans with high combat experience but without PTSD evidenced less neuroticism than low combat veterans without PTSD provides evidence that those who did not develop the disorder despite high exposure to combat stress are individuals with exceptional emotional strength and resilience.     

Gaining Control Over Traumatic Experiences: The Role of Guilt in Posttraumatic Stress Disorder

The present study explores the relationship between guilt, sense of control, and posttraumatic stress disorder. Seventy-eight participants who had experienced a traumatic event completed the following self-report measures online: the Posttraumatic Stress Diagnostic Scale, the Guilt Cognitions subscale of the Trauma-Related Guilt Inventory, the Posttraumatic Cognitions Inventory, and Sense of Control During the Trauma. Results revealed that “behavioral self-blame” that refers to functioning during the trauma, positively correlated with posttraumatic stress symptoms. However, when Sense of Control During the Trauma was introduced into the analysis, this correlation appeared only for participants who had experienced lack of control during the traumatic event. Among the participants who had experienced a sense of control, no such link was found. Results suggest that guilt may be produced to avoid feelings of helplessness following the trauma, because guilt conveys a sense of control.     

An exploratory examination of the associations among racial and ethnic discrimination, racial climate, and trauma-related symptoms in a college student population

In this study, we examined the association among perceptions of racial and/or ethnic discrimination, racial climate, and trauma-related symptoms among 289 racially diverse college undergraduates. Study measures included the Perceived Stress Scale, the Perceived Ethnic Discrimination Questionnaire, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Racial Climate Scale. Results of a multivariate analysis of variance (MANOVA) indicated that Asian and Black students reported more frequent experiences of discrimination than did White students. Additionally, the MANOVA indicated that Black students perceived the campus racial climate as being more negative than did White and Asian students. A hierarchical regression analysis showed that when controlling for generic life stress, perceptions of discrimination contributed an additional 10% of variance in trauma-related symptoms for Black students, and racial climate contributed an additional 7% of variance in trauma symptoms for Asian students.     

Parenting stress and competence among mothers of young children with substance use disorders: The roles of trauma and reflective functioning

Posttraumatic stress symptoms are prominent in the lives of parents of young children with substance use disorders (SUD). Parenting experiences, particularly stress and competence, impact parenting behaviors and concomitant child growth and development. Factors that promote positive experiences of parenting, such as parental reflective functioning (PRF), and protect the mother and child from negative outcomes are crucial to understand to develop effective therapeutic interventions. The current US study analyzed baseline data from a parenting intervention evaluation to examine how length of substance misuse, PRF, and trauma symptoms were associated with parenting stress and parenting sense of competence among mothers in treatment for SUDs. Measures included the Addiction Severity Index, PTSD Symptom Scale-Self Report, Parental Reflective Functioning Questionnaire, Parenting Stress Index/Short Form, and Parenting Sense of Competence Scale. The sample included 54 predominantly White mothers with SUDs who had young children. Two multivariate regression analyses found that (1) lower parental reflective functioning and higher posttraumatic stress symptoms were associated with higher parenting stress, and (2) only higher posttraumatic stress symptoms were associated with lower levels of parenting sense of competence. Findings underscore the importance of addressing trauma symptoms and PRF when aiming to improve parenting experiences for women with an SUD.     

Rural Hispanic Adolescents at Risk for Depressive Symptoms

Levels of depression among rural Hispanic adolescents were assessed. Psychological factors affecting depression were examined. Included were family characteristics, measured by the Background Information Questionnaire; self-esteem, by the Piers-Harris Children's Self-Concept Scale; perceived stress level, by the Hispanic Children's Stress Inventory; acculturation, by the Cuellar Acculturation Index; and depression levels, by the Center for Epidemiological Studies-Depression Scale. Results revealed moderate to severe depression symptomatology among 33% of the subjects, and mild depression symptoms among 17%. Two family structure variables, birth order and number of brothers, were significantly related to depression. Gender was an important predictor of depression, as was self-esteem. Higher stress scores were related to higher levels of depression.     

Validation of the acculturative stress inventory for children

The psychometric properties of the Acculturative Stress Inventory for Children (ASIC) were examined with a sample of 139 Hispanic children. This self-report instrument was studied using the items of the Societal, Attitudinal, Familial, and Environmental Acculturative Stress Scale for Children (SAFE-C; Chavez, Moran, Reid, & Lopez, 1997), which had face validity for acculturative stress. The psychometric properties of the ASIC were examined by conducting an exploratory principal-axis factor analysis, which yielded a two-factor solution. The first factor includes 8 items assessing perceived discrimination and the 4 items of the second factor measure immigration-related experiences. Evidence of internal consistency and test-retest reliability for the 2 factors and the total scale were found to be adequate. In addition, sufficient estimates of convergent, discriminant, and predictive validity were obtained. Implications for future research of acculturative stress in children involving the ASIC are discussed.     

Do traumatic events influence the clinical expression of compulsive hoarding?

Traumatic experiences have been posited as one potential catalyst for the abrupt onset of obsessive-compulsive symptoms including compulsive hoarding. To determine whether traumatic life events (TLEs) might influence the expression of compulsive hoarding in obsessive-compulsive disorder (OCD), interview responses to the Posttraumatic Stress Disorder module of the Structured Clinical Interview for DSM-IV (SCID) were examined in 180 individuals with OCD. Compared to individuals with OCD who did not meet criteria for hoarding, participants classified as hoarders (24% of the sample) were significantly more likely to have reported at least one TLE in their lifetime. Patients who met criteria for hoarding and who had also experienced TLEs had significantly greater hoarding symptom severity than those hoarders not exposed to trauma. This association was found to be robust. That is, the relationship between TLEs and hoarding symptom severity was not better accounted for by age, age of OCD onset, depressive symptoms, general OCD symptomatology, or mood and anxiety comorbidity. Closer examination revealed that the clutter factor of compulsive hoarding (and not difficulty discarding or acquisitioning) was most strongly associated with having experienced a traumatic event.     

Cognitive deficit or cognitive distortion in childhood depression

Three studies were conducted to evaluate cognitive disturbance and depression in children. In Study I, 47 sixth-grade children, including 17 who received a DSM-III diagnosis of depression, and their parents were independently interviewed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children, and they completed the Parent-Child Depression Inventory. Children completed the Children's Depression Inventory, the Matching Familiar Figures Test, and the My Standards Questionnaire. Results of Study 1 were consistent across raters and measures: Depression was associated with a negative style of processing self-evaluative information, while being unrelated to a processing deficit. A second study was initiated to replicate the results of Study 1 and to extend them to a wider age range of children. Thirty- eight third-, fourth-, fifth-, and sixth-grade children, half of whom were depressed and half of whom indicated a minimum of depressive symptomatology on the Children's Depression Inventory, completed the Matching Familiar Figures Test and the My Standards Questionnaire. Results were very similar to those found in Study 1. A third study was conducted to test whether the self-perceptions of depressed children were accurately negative or negatively distorted, as judged against their teachers' observations of them. Results supported the hypothesis that depressed children exhibit a distorted style of processing self-evaluative information. The implications of the results for theory and treatment were discussed.This research was funded by the Hogg Foundation for Mental Health, The University of Texas at Austin. The first two authors contributed equally to this investigation, and the order of their authorship was determined by the flip of a coin.     

Psychometric Properties of the Child Posttraumatic Cognitions Inventory in a Sample of Brazilian Children

Cognitive models of trauma propose that maladaptive cognitions in children and adolescents are causally implicated in the unfolding and maintenance of posttraumatic response. The objective of this study was to evaluate the psychometric properties of the Child Posttraumatic Cognitions Inventory (CPTCI). The sample included 131 children and adolescents. The psychometric properties of the CPTCI were examined, including reliability and convergent validity. The results showed high internal consistency for both CPTCI total scale (α = .90) and its subscales (CPTCI–PC α = .88 and CPTCI–SW α = .79) and a 2-component solution explaining 37.63% of the variance of CPTCI. Convergent validity evidence was obtained through correlations with the Trauma Symptom Checklist for Children and Children’s Depression Inventory. Findings suggest that CPTCI instruments are reliable and had adequate evidence of validity.     

Post-traumatic stress reactions following the March 11, 2004 terrorist attacks in a Madrid community sample: a cautionary note about the measurement of psychological trauma

Posttraumatic stress reactions related to the Madrid March 11, 2004, terrorist attacks were examined in a sample of Madrid residents (N = 503) 18-25 days after the attacks, using multiple diagnostic criteria and different cut-off scores. Based on the symptoms covered by the Posttraumatic Stress Disorder Checklist-Civilian (PCL-C; Weathers, Litz, Herman, Huska, and Keane, 1993), rates of probable posttraumatic stress disorder (PTSD) ranged from 3.4% to 13.3%. Taking into account additional criteria from the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 200; i.e., the impact of initial reaction and problems in daily functioning as a consequence of the traumatic event), only 1.9% of respondents reported probable PTSD. These results suggest that inferences about the impact of traumatic events on the general population are strongly influenced by the definition of traumatic response. Our findings also revealed that the magnitude of posttraumatic reactions is associated with several risk factors, including living close to the attacked locations, physical proximity to the attacks when they occurred, perception of one's life being at risk, intensity of initial emotional reactions, and being a daily user of the attacked train lines. The use of different cut-off scores did not affect the pattern of risk to develop traumatic stress. The implications of these results for public health policies related to terrorist attacks are discussed.     

School stress reported by children in grades 4, 5, and 6.

Stress in the school environment of 269 elementary school children attending Grades 4, 5, and 6 of a metropolitan school district were assessed using the School Stress Questionnaire. The effects of sex, ethnic background (minority vs nonminority), type of classroom placement (regular education versus special education), and family structure (traditional versus nontraditional or divorced) were investigated. Children from nontraditional or divorced families had significantly higher school stress than children from intact families. The possibility that these results are a reflection of society's negative attitudes toward children living in nontraditional families is raised.     

创伤暴露对青少年暴力行为和自杀意念的影响:创伤后应激障碍和抑郁的中介作用

采用创伤暴露问卷、基于DSM-5的创伤后应激障碍症状核查表、流调中心用抑郁量表和青少年行为问题调查表,在雅安地震3.5年后对地震极重灾区的703名中学生进行调查,考察创伤暴露对暴力行为和自杀意念的影响,并检验创伤后应激障碍和抑郁在其中的中介作用。结果发现：创伤暴露可以直接正向预测暴力行为和自杀意念,PTSD在创伤暴露对暴力行为和自杀意念的影响间起中介作用,抑郁仅在创伤暴露对自杀意念的影响间起中介作用,而在创伤暴露对暴力行为影响间的中介效应不显著。     

The generality of cognitive bias in acute stress disorder

Cognitive bias was investigated in acutely traumatised civilians with either acute stress disorder (ASD; n = 26) or no ASD (n = 24). Participants completed the Acute Stress Disorder Interview, the Beck Depression Inventory, the Beck Anxiety Inventory (BAI), the Impact of Event Scale (IES), and an Event Probability Questionnaire and an Event Cost Questionnaire that comprised items pertaining to (a) external harm, (b) somatic sensations and (c) social events. ASD participants exaggerated both the probability of negative external harm, somatic and social events occurring, and the adverse cost of those events more than non-ASD participants. Elevated probability and cost estimates were predicted by BAI and IES-Avoidance scores, respectively. These findings are discussed in the context of different patterns observed in other anxiety disorders, and interpreted in terms of network theories of posttraumatic stress.     

Motor vehicle accident trauma exposure: Personality profiles associated with posttraumatic diagnoses

Abstract

Personality profiles associated with diagnostically distinct posttraumatic responses were examined. Profiles were compared between three groups defined on the basis of posttraumatic diagnosis following motor vehicle accident (MVA) trauma exposure. The diagnostic groups were: Posttraumatic Stress Disorder (PTSD), Acute Stress Disorder (ASD) without progression to PTSD, and subclinical responses. Participants were male and female community volunteers aged 18 to 77 (N = 83) who had all been exposed to an MVA meeting the DSM-IV diagnostic criteria for a traumatic event. The Personality Assessment Inventory (Morey, 1991) was used to assess psychological variables in the framework of posttraumatic diagnostic groups. The PTSD group scored significantly higher than the ASD and subclinical groups on scales assessing somatic complaints, anxiety, anxiety related disorders, depression, non-psychotic symptoms of schizophrenia, and negative relationships. The profile of the ASD group was characterized by self report of greater interpersonal warmth and a trend for greater egocentricity than the PTSD group. There were no significant differences in the personality profiles of the ASD and subclinical groups. The role of personality factors in posttraumatic adjustment is discussed in the context of previous literature.