cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.21829421.v1
title: How to quantify exposure to traumatic stress? Reliability and predictive validity of measures for cumulative trauma exposure in a post-conflict population

description: While studies with survivors of single traumatic experiences highlight individual response variation following trauma, research from conflict regions shows that almost everyone develops posttraumatic stress disorder (PTSD) if trauma exposure reaches extreme levels. Therefore, evaluating the effects of cumulative trauma exposure is of utmost importance in studies investigating risk factors for PTSD. Yet, little research has been devoted to evaluate how this important environmental risk factor can be best quantified. We investigated the retest reliability and predictive validity of different trauma measures in a sample of 227 Ugandan rebel war survivors. Trauma exposure was modeled as the number of traumatic event types experienced or as a score considering traumatic event frequencies. In addition, we investigated whether age at trauma exposure can be reliably measured and improves PTSD risk prediction. All trauma measures showed good reliability. While prediction of lifetime PTSD was most accurate from the number of different traumatic event types experienced, inclusion of event frequencies slightly improved the prediction of current PTSD. As assessing the number of traumatic events experienced is the least stressful and time-consuming assessment and leads to the best prediction of lifetime PTSD, we recommend this measure for research on PTSD etiology.
DOI: 10.6084/m9.figshare.21829427
title: Psychophysiological characteristics of pediatric posttraumatic stress disorder during script-driven traumatic imagery

description: Psychophysiological alterations such as elevated baseline levels and hyperresponsivity in cardiac, electrodermal, and facial muscle activity have been observed in adults with posttraumatic stress disorder (PTSD). There are only few, inconclusive studies investigating psychophysiological responses in children and adolescents with PTSD. This cross-sectional study sought to examine if autonomic variables, facial electromyography (EMG), and self-reported anxiety at baseline, while listening to neutral and idiosyncratic trauma scripts, differ between minors with a trauma history and PTSD, and a traumatized control (TC) group without PTSD. A better understanding of psychophysiological reactions in trauma-exposed children and adolescents could improve differential assessment and treatment decisions. PTSD was assessed using the Clinician Administered PTSD Scale for Children and Adolescents in 6- to 17-year-old trauma-exposed children, resulting in a group with PTSD according to DSM-IV (<i>n=</i>16) and a TC group without PTSD (<i>n=</i>18). Facial EMG, (para-)sympathetic measures (heart rate, electrodermal activity, respiratory sinus arrhythmia), and self-reported anxiety were measured during 5-min baseline, 3-min neutral script, and 3-min idiosyncratic trauma script. Baseline, reactivity (trauma minus baseline), and script contrast (trauma minus neutral) were analyzed by multivariate analyses of variance. Children and adolescents with PTSD reported more anxiety compared to TC for baseline, reactivity, and script contrast (<i>ps&lt;</i>0.021, <i>ds</i>&gt;0.59), and showed elevated corrugator supercilii muscle activity for script contrast (<i>p&lt;</i>0.05, <i>d=</i>0.79). No group differences emerged for sympathetic or parasympathetic measures. Children and adolescents with PTSD experienced elevated anxiety at baseline and elevated anxiety and facial corrugator muscle response to an idiosyncratic trauma narrative. Autonomic hyperreactivity, typical for adult PTSD samples, did not figure prominently.
DOI: 10.6084/m9.figshare.21829427.v1
title: Psychophysiological characteristics of pediatric posttraumatic stress disorder during script-driven traumatic imagery

description: Psychophysiological alterations such as elevated baseline levels and hyperresponsivity in cardiac, electrodermal, and facial muscle activity have been observed in adults with posttraumatic stress disorder (PTSD). There are only few, inconclusive studies investigating psychophysiological responses in children and adolescents with PTSD. This cross-sectional study sought to examine if autonomic variables, facial electromyography (EMG), and self-reported anxiety at baseline, while listening to neutral and idiosyncratic trauma scripts, differ between minors with a trauma history and PTSD, and a traumatized control (TC) group without PTSD. A better understanding of psychophysiological reactions in trauma-exposed children and adolescents could improve differential assessment and treatment decisions. PTSD was assessed using the Clinician Administered PTSD Scale for Children and Adolescents in 6- to 17-year-old trauma-exposed children, resulting in a group with PTSD according to DSM-IV (<i>n=</i>16) and a TC group without PTSD (<i>n=</i>18). Facial EMG, (para-)sympathetic measures (heart rate, electrodermal activity, respiratory sinus arrhythmia), and self-reported anxiety were measured during 5-min baseline, 3-min neutral script, and 3-min idiosyncratic trauma script. Baseline, reactivity (trauma minus baseline), and script contrast (trauma minus neutral) were analyzed by multivariate analyses of variance. Children and adolescents with PTSD reported more anxiety compared to TC for baseline, reactivity, and script contrast (<i>ps&lt;</i>0.021, <i>ds</i>&gt;0.59), and showed elevated corrugator supercilii muscle activity for script contrast (<i>p&lt;</i>0.05, <i>d=</i>0.79). No group differences emerged for sympathetic or parasympathetic measures. Children and adolescents with PTSD experienced elevated anxiety at baseline and elevated anxiety and facial corrugator muscle response to an idiosyncratic trauma narrative. Autonomic hyperreactivity, typical for adult PTSD samples, did not figure prominently.
DOI: 10.6084/m9.figshare.21829430
title: The Dutch version of the Child Posttraumatic Cognitions Inventory: validation in a clinical sample and a school sample

description: With the inclusion of trauma-related cognitions in the DSM-5 criteria for posttraumatic stress disorder (PTSD), the assessment of these cognitions has become essential. Therefore, valid tools for the assessment of these cognitions are warranted. The current study aimed at validating the Dutch version of the Child Posttraumatic Cognitions Inventory (CPTCI). We included children aged 8–19 years in our study and assessed the factor structure, reliability and validity of the CPTCI in a clinical sample (<i>n</i>=184) and a school sample (<i>n</i>=318). Our results supported the two-factor structure of the CPTCI and showed good internal consistency for the total scale and the two subscales. We found significant positive correlations between the CPTCI and measures of PTSD, depression, and anxiety disorder. The CPTCI correlated negatively with a measure of quality of life. Furthermore, we found significantly higher scores in the clinical sample than in the school sample. For children who received treatment, we found that a decrease in CPTCI scores was accompanied by a decrease in posttraumatic stress symptoms and comorbid problems indicating that the CPTCI is able to detect treatment effects. Overall, our results suggest that the Dutch CPTCI is a reliable and valid instrument.
DOI: 10.6084/m9.figshare.21829430.v1
title: The Dutch version of the Child Posttraumatic Cognitions Inventory: validation in a clinical sample and a school sample

description: With the inclusion of trauma-related cognitions in the DSM-5 criteria for posttraumatic stress disorder (PTSD), the assessment of these cognitions has become essential. Therefore, valid tools for the assessment of these cognitions are warranted. The current study aimed at validating the Dutch version of the Child Posttraumatic Cognitions Inventory (CPTCI). We included children aged 8–19 years in our study and assessed the factor structure, reliability and validity of the CPTCI in a clinical sample (<i>n</i>=184) and a school sample (<i>n</i>=318). Our results supported the two-factor structure of the CPTCI and showed good internal consistency for the total scale and the two subscales. We found significant positive correlations between the CPTCI and measures of PTSD, depression, and anxiety disorder. The CPTCI correlated negatively with a measure of quality of life. Furthermore, we found significantly higher scores in the clinical sample than in the school sample. For children who received treatment, we found that a decrease in CPTCI scores was accompanied by a decrease in posttraumatic stress symptoms and comorbid problems indicating that the CPTCI is able to detect treatment effects. Overall, our results suggest that the Dutch CPTCI is a reliable and valid instrument.
DOI: 10.6084/m9.figshare.21829433
title: Guilt is associated with acute stress symptoms in children after road traffic accidents

description: Although previous research has consistently found considerable rates of acute stress disorder (ASD) in children with accidental injuries, knowledge about determinants of ASD remains incomplete. Guilt is a common reaction among children after a traumatic event and has been shown to contribute to posttraumatic stress disorder. However, its relationship to ASD has never been examined. This study assessed the prevalence of ASD in children and adolescents following road traffic accidents (RTAs). Moreover, the association between peritraumatic guilt and ASD was investigated relying on current cognitive theories of posttraumatic stress and controlling for female sex, age, socioeconomic status (SES), injury severity, inpatient treatment, pretrauma psychopathology, and maternal posttraumatic stress symptoms (PTSS). One hundred and one children and adolescents (aged 7–16 years) were assessed by means of a clinical interview approximately 10 days after an RTA. Mothers were assessed by questionnaires. Three participants (3.0%) met diagnostic criteria for full ASD according to DSM-IV, and 17 (16.8%) for subsyndromal ASD. In a multivariate regression model, guilt was found to be a significant predictor of ASD severity. Female sex, outpatient treatment, and maternal PTSS also predicted ASD severity. Child age, SES, injury severity, and pretraumatic child psychopathology were not related to ASD severity. Future research should examine the association between peritraumatic guilt and acute stress symptoms in more detail. Moreover, guilt appraisals in the acute phase after an accident might be a relevant target for clinical attention.
DOI: 10.6084/m9.figshare.21829433.v1
title: Guilt is associated with acute stress symptoms in children after road traffic accidents

description: Although previous research has consistently found considerable rates of acute stress disorder (ASD) in children with accidental injuries, knowledge about determinants of ASD remains incomplete. Guilt is a common reaction among children after a traumatic event and has been shown to contribute to posttraumatic stress disorder. However, its relationship to ASD has never been examined. This study assessed the prevalence of ASD in children and adolescents following road traffic accidents (RTAs). Moreover, the association between peritraumatic guilt and ASD was investigated relying on current cognitive theories of posttraumatic stress and controlling for female sex, age, socioeconomic status (SES), injury severity, inpatient treatment, pretrauma psychopathology, and maternal posttraumatic stress symptoms (PTSS). One hundred and one children and adolescents (aged 7–16 years) were assessed by means of a clinical interview approximately 10 days after an RTA. Mothers were assessed by questionnaires. Three participants (3.0%) met diagnostic criteria for full ASD according to DSM-IV, and 17 (16.8%) for subsyndromal ASD. In a multivariate regression model, guilt was found to be a significant predictor of ASD severity. Female sex, outpatient treatment, and maternal PTSS also predicted ASD severity. Child age, SES, injury severity, and pretraumatic child psychopathology were not related to ASD severity. Future research should examine the association between peritraumatic guilt and acute stress symptoms in more detail. Moreover, guilt appraisals in the acute phase after an accident might be a relevant target for clinical attention.
DOI: 10.6084/m9.figshare.21829436
title: Accounting for sex differences in PTSD: A multi-variable mediation model

description: Approximately twice as many females as males are diagnosed with posttraumatic stress disorder (PTSD). However, little is known about why females report more PTSD symptoms than males. Prior studies have generally focused on few potential mediators at a time and have often used methods that were not ideally suited to test for mediation effects. Prior research has identified a number of individual risk factors that may contribute to sex differences in PTSD severity, although these cannot fully account for the increased symptom levels in females when examined individually. The present study is the first to systematically test the hypothesis that a combination of pre-, peri-, and posttraumatic risk factors more prevalent in females can account for sex differences in PTSD severity. The study was a quasi-prospective questionnaire survey assessing PTSD and related variables in 73.3% of all Danish bank employees exposed to bank robbery during the period from April 2010 to April 2011. Participants filled out questionnaires 1 week (T<sub>1</sub>, N=450) and 6 months after the robbery (T<sub>2</sub>, N=368; 61.1% females). Mediation was examined using an analysis designed specifically to test a multiple mediator model. Females reported more PTSD symptoms than males and higher levels of neuroticism, depression, physical anxiety sensitivity, peritraumatic fear, horror, and helplessness (the A<sub>2</sub> criterion), tonic immobility, panic, dissociation, negative posttraumatic cognitions about self and the world, and feeling let down. These variables were included in the model as potential mediators. The combination of risk factors significantly mediated the association between sex and PTSD severity, accounting for 83% of the association. The findings suggest that females report more PTSD symptoms because they experience higher levels of associated risk factors. The results are relevant to other trauma populations and to other trauma-related psychiatric disorders more prevalent in females, such as depression and anxiety.
DOI: 10.6084/m9.figshare.21829436.v1
title: Accounting for sex differences in PTSD: A multi-variable mediation model

description: Approximately twice as many females as males are diagnosed with posttraumatic stress disorder (PTSD). However, little is known about why females report more PTSD symptoms than males. Prior studies have generally focused on few potential mediators at a time and have often used methods that were not ideally suited to test for mediation effects. Prior research has identified a number of individual risk factors that may contribute to sex differences in PTSD severity, although these cannot fully account for the increased symptom levels in females when examined individually. The present study is the first to systematically test the hypothesis that a combination of pre-, peri-, and posttraumatic risk factors more prevalent in females can account for sex differences in PTSD severity. The study was a quasi-prospective questionnaire survey assessing PTSD and related variables in 73.3% of all Danish bank employees exposed to bank robbery during the period from April 2010 to April 2011. Participants filled out questionnaires 1 week (T<sub>1</sub>, N=450) and 6 months after the robbery (T<sub>2</sub>, N=368; 61.1% females). Mediation was examined using an analysis designed specifically to test a multiple mediator model. Females reported more PTSD symptoms than males and higher levels of neuroticism, depression, physical anxiety sensitivity, peritraumatic fear, horror, and helplessness (the A<sub>2</sub> criterion), tonic immobility, panic, dissociation, negative posttraumatic cognitions about self and the world, and feeling let down. These variables were included in the model as potential mediators. The combination of risk factors significantly mediated the association between sex and PTSD severity, accounting for 83% of the association. The findings suggest that females report more PTSD symptoms because they experience higher levels of associated risk factors. The results are relevant to other trauma populations and to other trauma-related psychiatric disorders more prevalent in females, such as depression and anxiety.
DOI: 10.6084/m9.figshare.21829442
title: Reliability, factor structure, and validity of the German version of the Trauma Symptom Checklist for Children in a sample of adolescents

description: The Trauma Symptom Checklist for Children (TSC-C) is the most widely used self-report scale to assess trauma-related symptoms in children and adolescents on six clinical scales. The purpose of the present study was to develop a German version of the TSC-C and to investigate its psychometric properties, such as factor structure, reliability, and validity, in a sample of German adolescents. A normative sample of <i>N</i>=583 and a clinical sample of <i>N</i>=41 adolescents with a history of physical or sexual abuse aged between 13 and 21 years participated in the study. The Confirmatory Factor Analysis on the six-factor model (<i>anger</i>, <i>anxiet</i>y, <i>depression</i>, <i>dissociation</i>, <i>posttraumatic stress</i>, and <i>sexual concerns</i> with the subdimensions <i>preoccupation</i> and <i>distress</i>) revealed acceptable to good fit statistics in the normative sample. One item had to be excluded from the German version of the TSC-C because the factor loading was too low. All clinical scales presented acceptable to good reliability, with Cronbach's α's ranging from .80 to .86 in the normative sample and from .72 to .87 in the clinical sample. Concurrent validity was also demonstrated by the high correlations between the TSC-C scales and instruments measuring similar psychopathology. TSC-C scores reliably differentiated between adolescents with trauma history and those without trauma history, indicating discriminative validity. In conclusion, the German version of the TSC-C is a reliable and valid instrument for assessing trauma-related symptoms on six different scales in adolescents aged between 13 and 21 years.
DOI: 10.6084/m9.figshare.21829442.v1
title: Reliability, factor structure, and validity of the German version of the Trauma Symptom Checklist for Children in a sample of adolescents

description: The Trauma Symptom Checklist for Children (TSC-C) is the most widely used self-report scale to assess trauma-related symptoms in children and adolescents on six clinical scales. The purpose of the present study was to develop a German version of the TSC-C and to investigate its psychometric properties, such as factor structure, reliability, and validity, in a sample of German adolescents. A normative sample of <i>N</i>=583 and a clinical sample of <i>N</i>=41 adolescents with a history of physical or sexual abuse aged between 13 and 21 years participated in the study. The Confirmatory Factor Analysis on the six-factor model (<i>anger</i>, <i>anxiet</i>y, <i>depression</i>, <i>dissociation</i>, <i>posttraumatic stress</i>, and <i>sexual concerns</i> with the subdimensions <i>preoccupation</i> and <i>distress</i>) revealed acceptable to good fit statistics in the normative sample. One item had to be excluded from the German version of the TSC-C because the factor loading was too low. All clinical scales presented acceptable to good reliability, with Cronbach's α's ranging from .80 to .86 in the normative sample and from .72 to .87 in the clinical sample. Concurrent validity was also demonstrated by the high correlations between the TSC-C scales and instruments measuring similar psychopathology. TSC-C scores reliably differentiated between adolescents with trauma history and those without trauma history, indicating discriminative validity. In conclusion, the German version of the TSC-C is a reliable and valid instrument for assessing trauma-related symptoms on six different scales in adolescents aged between 13 and 21 years.
DOI: 10.6084/m9.figshare.21829445
title: Interventions for posttraumatic stress disorder in psychiatric practice across Europe: a trainees’ perspective

description: With an annual prevalence of 0.9–2.6%, posttraumatic stress disorder (PTSD) is very common in clinical practice across Europe. Despite the fact that evidence-based interventions have been developed, there is no evidence on their implementation in clinical practice and in national psychiatric training programmes. The Early Career Psychiatrists Committee of the European Psychiatric Association conducted a survey in 23 European countries to explore implementation of evidence-based interventions for PTSD and training options. The findings indicate that pharmacotherapy was available in the majority of the participating countries (<i>n</i>=19, 82.8%). However, psychological interventions were much less widespread. For example, psychoeducation was widely available in 52% of the countries (<i>n</i>=12), cognitive-behavioural therapy in 26.2% (<i>n</i>=6), and specific trauma-focused techniques were rarely available. Training on PTSD was part of the official training in 13 countries (56.5%), predominantly in the form of theoretical seminars. Overall, this survey indicates that the treatment for PTSD is largely focused on pharmacotherapy, with psychological evidence-based interventions poorly available, especially outside specialized centres. Poor implementation is linked to the lack of official training in evidence-based interventions for psychiatric trainees across Europe.
DOI: 10.6084/m9.figshare.21829445.v1
title: Interventions for posttraumatic stress disorder in psychiatric practice across Europe: a trainees’ perspective

description: With an annual prevalence of 0.9–2.6%, posttraumatic stress disorder (PTSD) is very common in clinical practice across Europe. Despite the fact that evidence-based interventions have been developed, there is no evidence on their implementation in clinical practice and in national psychiatric training programmes. The Early Career Psychiatrists Committee of the European Psychiatric Association conducted a survey in 23 European countries to explore implementation of evidence-based interventions for PTSD and training options. The findings indicate that pharmacotherapy was available in the majority of the participating countries (<i>n</i>=19, 82.8%). However, psychological interventions were much less widespread. For example, psychoeducation was widely available in 52% of the countries (<i>n</i>=12), cognitive-behavioural therapy in 26.2% (<i>n</i>=6), and specific trauma-focused techniques were rarely available. Training on PTSD was part of the official training in 13 countries (56.5%), predominantly in the form of theoretical seminars. Overall, this survey indicates that the treatment for PTSD is largely focused on pharmacotherapy, with psychological evidence-based interventions poorly available, especially outside specialized centres. Poor implementation is linked to the lack of official training in evidence-based interventions for psychiatric trainees across Europe.