Posttraumatic cognitions and posttraumatic stress symptoms among war-affected children: A cross-lagged analysis.

Palosaari, Esa; Punamäki, Raija‐Leena; Diab, Marwan; Qouta, Samir

doi:10.1037/a0033875

Cited by 35 publications

(40 citation statements)

References 33 publications

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“…These results are consistent with previous literature regarding the application of the cognitive model of PTSD (e.g., Ehlers & Clark, 2000) to children and adolescents (Meiser-Stedman, Palosaari et al, 2013).…”

Section: Discussionsupporting

confidence: 93%

“…A number of studies have found that this model can also be applied for children, postulating that cognitive processing of traumatic events mediates the development and maintenance of posttraumatic symptoms and PTSD (Ehlers, Mayou, & Bryant, 2003;Leeson & Nixon, 2011;Palosaari, Punamäki, Diab, & Qouta, 2013;. In school-age children and adolescents, maladaptive cognitions are causally implicated in the unfolding and maintenance of the posttraumatic response over time .…”

Section: Psychometric Properties Of the Child Posttraumatic Cognitionmentioning

confidence: 95%

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

Lobo

Brunnet

Ecker

et al. 2015

Journal of Aggression, Maltreatment & Trauma

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Section: Discussionsupporting

confidence: 93%

Section: Psychometric Properties Of the Child Posttraumatic Cognitionmentioning

confidence: 95%

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

Lobo

Brunnet

Ecker

et al. 2015

Journal of Aggression, Maltreatment & Trauma

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“…Posttraumatic stress symptoms were modelled as a latent variable. Based on earlier analyses with this data (Palosaari, Punamäki, Diab, & Qouta, 2013), a four-factor structure similar to that identified among combat veterans (Simms, Watson, & Doebbeling, 2002) was selected for this purpose. Parcel indicators were constructed corresponding to intrusion (average of four items on the CRIES), avoidance (four items), dysphoria/negative affectivity (three items) and hyperarousal (two items) symptoms.…”

Section: Methodsmentioning

confidence: 99%

Peritraumatic dissociation predicts posttraumatic stress disorder symptoms via dysfunctional trauma-related memory among war-affected children

Peltonen

Kangaslampi

Saranpää³

et al. 2017

European Journal of Psychotraumatology

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Background: Among adults there is strong evidence about peritraumatic dissociation (PD) predicting posttraumatic stress disorder (PTSD), yet evidence among children is very limited. It has been suggested that disturbances in memory functioning might explain the association between PD and PTSD, but this has not yet been empirically tested. Objective: We aimed to test the hypotheses that greater PD would be associated with more posttraumatic stress disorder (PTSD) symptoms, and that some of this association would be mediated by disorganized and non-verbal memories about the traumatic event. Method: The sample included 197 Palestinian children (10–12-years) living in the Gaza Strip, participating in the aftermath of the 2008/9 war. Self-report questionnaires were used to measure PD (Peritraumatic Dissociative Experiences Questionnaire) three months post-war, as well as trauma-related memory (Trauma Memory Quality Questionnaire) and PTSD symptoms (Children’s Revised Impact of Event Scale) six months later. Exposure to war trauma was assessed by a checklist. Structural equation modelling was used to examine direct and indirect paths from PD to posttraumatic PTSS, controlling for number of traumatic war events. Results: Structural equation modelling results showed that greater self-reported PD predicted higher levels of PTSS nine months post-war, and that a significant part, but not all, of this relationship was mediated via the quality of trauma-related memories. Conclusions: This study provided empirical evidence that, among war-affected children, greater PD during traumatic events is linked with higher levels of PTSD symptoms several months later, even when accounting for their personal exposure to war trauma. Further, the study supported the idea that the detrimental effects of dissociation during a traumatic event may be due to dysfunctional memories characterized by disorganization and lack of access to verbal and coherence. Further tests of these hypotheses with larger samples and more points of measurement are called for.

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“…Similar to findings on adult fear generalization, anxious youth exhibit impaired extinction learning and response inhibition to safety cues (e.g., Waters, Henry, & Neumann, 2009), suggesting that overgeneralization might have relevance to PTSD in youth. In a sample of war-exposed Palestinian children, Palosaari and colleagues (Palosaari, Punamäki, Diab, & Qouta, 2013) reported that changes in overgeneralization from 3 to 5 months after trauma exposure predicted subsequent changes in PTSD symptoms 5 to 11 months later, whereas changes in PTSD symptoms did not predict changes in cognitions. Overgeneral negative appraisals (child PTCI) have also been shown to predict PTSD symptoms one month (Salmon, Sinclair, & Bryant, 2007) and six months post-trauma in a non-treatment seeking sample (ages 7-13; Bryant, Salmon, Sinclair, & Davidson, 2007).…”

Section: Overgeneralization In Posttraumatic Stress Disordermentioning

confidence: 99%

Overgeneralized Beliefs, Accommodation, and Treatment Outcome in Youth Receiving Trauma-Focused Cognitive Behavioral Therapy for Childhood Trauma

et al. 2015

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Inhibition of fear generalization with new learning is an important process in treatments for anxiety disorders. Generalization of maladaptive cognitions related to traumatic experiences (overgeneralized beliefs) have been demonstrated to be associated with posttraumatic stress disorder (PTSD) in adult populations, whereas more balanced, accommodated beliefs are associated with symptom improvement. It is not yet clear whether: 1) overgeneralization and accommodation are associated with PTSD treatment outcome in youth, or 2) whether accommodated beliefs can interact with or inhibit cognitive overgeneralization, as has been demonstrated in research on behavior-based fear generalization. The current study examined the relationships between overgeneralized and accommodated beliefs, child age, and symptom reduction in a sample of 81 youth (age 7-17 years), who received Trauma-Focused Cognitive Behavioral Therapy. Overgeneralized and accommodated beliefs expressed during the exposure phase of treatment were coded in audio-recorded therapy sessions. Overgeneralization predicted (a) higher internalizing symptom scores at post-treatment, particularly for younger children, and less improvement over treatment, and (b) higher externalizing scores at 1 year follow-up and steeper symptom increases over this period. In contrast, accommodation was associated with (a) lower post-treatment internalizing symptoms and greater improvement over treatment, and (b) lower externalizing scores at 1 year follow-up, particularly for younger children. High levels of accommodation moderated the relationship between overgeneralization and worse symptom outcomes, except when predicting the slope of internalizing scores over treatment, and age did not moderate these effects. There were no significant predictors of child-reported PTSD-specific symptoms, although PTSD symptoms did decrease significantly over the course of treatment and maintain one year after treatment.

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Posttraumatic cognitions and posttraumatic stress symptoms among war-affected children: A cross-lagged analysis.

Cited by 35 publications

References 33 publications

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

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

Peritraumatic dissociation predicts posttraumatic stress disorder symptoms via dysfunctional trauma-related memory among war-affected children

Overgeneralized Beliefs, Accommodation, and Treatment Outcome in Youth Receiving Trauma-Focused Cognitive Behavioral Therapy for Childhood Trauma

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