Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis

Background: Child sexual abuse (CSA) is a worldwide problem affecting children of all ages and socioeconomic backgrounds. A knowledge gap exists regarding the psychological outcomes for children, boys in particular, who are abused during their early lives.Objective: To provide a descriptive psychological profile of children who experienced sexual abuse as infants or toddlers from a male daycare worker and babysitter, and to assess the psychopathological impact on their parents.Method: Parents of children involved in the Amsterdam Sexual Abuse Case (41 parents; 44 children, age range 3–11 years, 30 boys, 14 girls) completed measures on post-traumatic stress disorder (PTSD), dissociation, sexual and non-sexual behaviour problems, and attachment insecurity in their children, as well as on parental psychological well-being, 3 years after disclosure. Sexual abuse characteristics were obtained from police records.Results: We found that 3% of confirmed child victims had PTSD, 30% sexual behaviour problems, 24% internalizing problems, 27% attachment insecurity, and 18% any psychiatric disorder (including PTSD); 39% were asymptomatic. In parents, we found feelings of guilt, shame, and anger about the abuse of their child; 19% showed PTSD symptoms and 3% showed avoidant and 8% anxious attachment problems in their intimate relationship. Parental symptomatology was related to child symptomatology, except for child sexual behaviour problems. One-quarter of confirmed child victims and 45% of parents had received psychological treatment.Conclusions: Three years after disclosure, extrafamilial CSA in very young children was associated with sexual and non-sexual behaviour problems and attachment insecurity, but rarely with PTSD or dissociation. For parents it was associated with PTSD symptoms and emotional reactions. Assessments and interventions should focus on the wide spectrum of problems that follow CSA, as well as on parental psychopathology and the parent–child relationship. Future follow-up assessments in our longitudinal study should provide insights into longer-term outcomes.

Section: Discussioncontrasting

confidence: 53%

Sexual abuse in very young children: a psychological assessment in the Amsterdam Sexual Abuse Case study

Duin

Verlinden

Vrolijk-Bosschaart

et al. 2018

“…Exposure to traumatic events is common in childhood and is associated with a range of adverse psychological outcomes, including post-traumatic stress disorder (PTSD) (Alisic et al, 2014; Hiller et al, 2016). One factor identified as a robust predictor of a child’s post-trauma psychological outcomes is their perceived social support (Kolaitis, 2017; Maercker & Hecker, 2016; Trickey, Siddaway, Meiser-Stedman, Serpell, & Field, 2012).…”

Section: Introductionmentioning

confidence: 99%

The Parent Trauma Response Questionnaire (PTRQ): development and preliminary validation

Williamson

Hiller

Meiser‐Stedman

et al. 2018

Background: Following a child’s experience of trauma, parental response is thought to play an important role in either facilitating or hindering their psychological adjustment. However, the ability to investigate the role of parenting responses in the post-trauma period has been hampered by a lack of valid and reliable measures. Objectives: The aim of this study was to design, and provide a preliminary validation of, the Parent Trauma Response Questionnaire (PTRQ), a self-report measure of parental appraisals and support for children’s coping, in the aftermath of child trauma. Methods: We administered an initial set of 78 items to 365 parents whose children, aged 2–19 years, had experienced a traumatic event. We conducted principal axis factoring and then assessed the validity of the reduced measure against a standardized general measure of parental overprotection and via the measure’s association with child post-trauma mental health. Results: Factor analysis generated three factors assessing parental maladaptive appraisals: (i) permanent change/damage, (ii) preoccupation with child’s vulnerability, and (iii) self-blame. In addition, five factors were identified that assess parental support for child coping: (i) behavioural avoidance, (ii) cognitive avoidance, (iii) overprotection, (iv) maintaining pre-trauma routines, and (v) approach coping. Good validity was evidenced against the measure of parental overprotection and child post-traumatic stress symptoms. Good test–retest reliability of the measure was also demonstrated. Conclusions: The PTRQ is a valid and reliable self-report assessment of parenting cognitions and coping in the aftermath of child trauma.

“…CMTs associated with maladaptive family function and interpersonal trauma are linked to the greatest risk of mental health disorders in adult life (Alisic et al, 2014; Green et al, 2010; Kessler et al, 2010). It is estimated that at least 80% of childhood maltreatment is perpetrated by parents or legal guardians, except for childhood sexual abuse, which is mostly perpetuated by other relatives or acquaintances (Gilbert et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Childhood maltreatment trauma: a comparison between patients in treatment for substance use disorders and patients in mental health treatment

Rasmussen¹,

Arefjord

Winje

et al. 2018

Background: While previous research has found strong associations between childhood maltreatment trauma and substance use disorders (SUDs), the role of possible moderating effects of gender and mediating effects of psychopathology and SUD is unclear.Objective: The objective of this study was to investigate differences in self-reported childhood maltreatment trauma, general psychological distress, and post-traumatic stress symptoms between 112 patients in treatment for substance use disorders (SUD group) and 112 matched controls with mild to moderate mental health disorders (comparison group).Methods: Childhood maltreatment trauma was measured by the Childhood Trauma Questionnaire – Short Form (CTQ-SF). General psychological distress was measured by the Symptom Checklist-90 – Revised (SCL-90-R), and post-traumatic stress symptoms were measured by the Impact of Event Scale – Revised (IES-R).Results: The SUD group reported more severe childhood maltreatment trauma than the comparison group. Females in the SUD group reported more severe and various forms of trauma compared to males. The SUD group reported higher mean scores on the SCL-90-R, but the proportions of people with caseness scores on the IES-R and the SCL-90-R were similar in the two samples. The SUD group reported more avoidance symptoms than the comparison group.Conclusion: This study adds further evidence to the repeatedly found strong associations between childhood maltreatment trauma and SUD, implying that the prevention of childhood maltreatment trauma may reduce the occurrence of SUD. Furthermore, patients with SUD should be screened for childhood maltreatment trauma, and the results should be applied in trauma-informed as well as trauma-focused interventions aimed to help this population. The association appears to be particularly strong for female substance users.