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Prevalence and predictive value of ICD-11 post-traumatic stress disorder and Complex PTSD diagnoses in children and adolescents exposed to a single-event trauma / Rachel ELLIOTT in Journal of Child Psychology and Psychiatry, 62-3 (March 2021)
[article]
Titre : Prevalence and predictive value of ICD-11 post-traumatic stress disorder and Complex PTSD diagnoses in children and adolescents exposed to a single-event trauma Type de document : Texte imprimé et/ou numérique Auteurs : Rachel ELLIOTT, Auteur ; Anna MCKINNON, Auteur ; Clare DIXON, Auteur ; Adrian BOYLE, Auteur ; Fionnuala MURPHY, Auteur ; Theresa DAHM, Auteur ; Emma TRAVERS-HILL, Auteur ; Cari-Lène MUL, Auteur ; Sarah-Jane ARCHIBALD, Auteur ; Patrick SMITH, Auteur ; Tim DALGLEISH, Auteur ; Richard MEISER-STEDMAN, Auteur ; Caitlin HITCHCOCK, Auteur Article en page(s) : p.270-276 Langues : Anglais (eng) Mots-clés : Complex PTSD International Classification of Diseases Post-traumatic stress disorder adolescent child trauma Index. décimale : PER Périodiques Résumé : BACKGROUND: The 11th edition of the International Classification of Diseases (ICD-11) made a number of significant changes to the diagnostic criteria for post-traumatic stress disorder (PTSD). We sought to determine the prevalence and 3-month predictive values of the new ICD-11 PTSD criteria relative to ICD-10 PTSD, in children and adolescents following a single traumatic event. ICD-11 also introduced a diagnosis of Complex PTSD (CPTSD), proposed to typically result from prolonged, chronic exposure to traumatic experiences, although the CPTSD diagnostic criteria do not require a repeated experience of trauma. We therefore explored whether children and adolescents demonstrate ICD-11 CPTSD features following exposure to a single-incident trauma. METHOD: Data were analysed from a prospective cohort study of youth aged 8-17 years who had attended an emergency department following a single trauma. Assessments of PTSD, CPTSD, depressive and anxiety symptoms were performed at two to four weeks (n = 226) and nine weeks (n = 208) post-trauma, allowing us to calculate and compare the prevalence and predictive value of ICD-10 and ICD-11 PTSD criteria, along with CPTSD. Predictive abilities of different diagnostic thresholds were undertaken using positive/negative predictive values, sensitivity/specificity statistics and logistic regressions. RESULTS: At Week 9, 15 participants (7%) were identified as experiencing ICD-11 PTSD, compared to 23 (11%) experiencing ICD-10 PTSD. There was no significant difference in comorbidity rates between ICD-10 and ICD-11 PTSD diagnoses. Ninety per cent of participants with ICD-11 PTSD also met criteria for at least one CPTSD feature. Five participants met full CPTSD criteria. CONCLUSIONS: Reduced prevalence of PTSD associated with the use of ICD-11 criteria is likely to reduce identification of PTSD relative to using ICD-10 criteria but not relative to DSM-4 and DSM-5 criteria. Diagnosis of CPTSD is likely to be infrequent following single-incident trauma. En ligne : http://dx.doi.org/10.1111/jcpp.13240 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=443
in Journal of Child Psychology and Psychiatry > 62-3 (March 2021) . - p.270-276[article] Prevalence and predictive value of ICD-11 post-traumatic stress disorder and Complex PTSD diagnoses in children and adolescents exposed to a single-event trauma [Texte imprimé et/ou numérique] / Rachel ELLIOTT, Auteur ; Anna MCKINNON, Auteur ; Clare DIXON, Auteur ; Adrian BOYLE, Auteur ; Fionnuala MURPHY, Auteur ; Theresa DAHM, Auteur ; Emma TRAVERS-HILL, Auteur ; Cari-Lène MUL, Auteur ; Sarah-Jane ARCHIBALD, Auteur ; Patrick SMITH, Auteur ; Tim DALGLEISH, Auteur ; Richard MEISER-STEDMAN, Auteur ; Caitlin HITCHCOCK, Auteur . - p.270-276.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 62-3 (March 2021) . - p.270-276
Mots-clés : Complex PTSD International Classification of Diseases Post-traumatic stress disorder adolescent child trauma Index. décimale : PER Périodiques Résumé : BACKGROUND: The 11th edition of the International Classification of Diseases (ICD-11) made a number of significant changes to the diagnostic criteria for post-traumatic stress disorder (PTSD). We sought to determine the prevalence and 3-month predictive values of the new ICD-11 PTSD criteria relative to ICD-10 PTSD, in children and adolescents following a single traumatic event. ICD-11 also introduced a diagnosis of Complex PTSD (CPTSD), proposed to typically result from prolonged, chronic exposure to traumatic experiences, although the CPTSD diagnostic criteria do not require a repeated experience of trauma. We therefore explored whether children and adolescents demonstrate ICD-11 CPTSD features following exposure to a single-incident trauma. METHOD: Data were analysed from a prospective cohort study of youth aged 8-17 years who had attended an emergency department following a single trauma. Assessments of PTSD, CPTSD, depressive and anxiety symptoms were performed at two to four weeks (n = 226) and nine weeks (n = 208) post-trauma, allowing us to calculate and compare the prevalence and predictive value of ICD-10 and ICD-11 PTSD criteria, along with CPTSD. Predictive abilities of different diagnostic thresholds were undertaken using positive/negative predictive values, sensitivity/specificity statistics and logistic regressions. RESULTS: At Week 9, 15 participants (7%) were identified as experiencing ICD-11 PTSD, compared to 23 (11%) experiencing ICD-10 PTSD. There was no significant difference in comorbidity rates between ICD-10 and ICD-11 PTSD diagnoses. Ninety per cent of participants with ICD-11 PTSD also met criteria for at least one CPTSD feature. Five participants met full CPTSD criteria. CONCLUSIONS: Reduced prevalence of PTSD associated with the use of ICD-11 criteria is likely to reduce identification of PTSD relative to using ICD-10 criteria but not relative to DSM-4 and DSM-5 criteria. Diagnosis of CPTSD is likely to be infrequent following single-incident trauma. En ligne : http://dx.doi.org/10.1111/jcpp.13240 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=443 Intensive prolonged exposure treatment for adolescent complex posttraumatic stress disorder: a single-trial design / Lotte HENDRIKS in Journal of Child Psychology and Psychiatry, 58-11 (November 2017)
[article]
Titre : Intensive prolonged exposure treatment for adolescent complex posttraumatic stress disorder: a single-trial design Type de document : Texte imprimé et/ou numérique Auteurs : Lotte HENDRIKS, Auteur ; Rianne A. DE KLEINE, Auteur ; Mieke HEYVAERT, Auteur ; Eni S. BECKER, Auteur ; Gert-Jan HENDRIKS, Auteur ; Agnes VAN MINNEN, Auteur Article en page(s) : p.1229-1238 Langues : Anglais (eng) Mots-clés : Complex PTSD treatment outcome adolescents prolonged exposure intensive treatment Index. décimale : PER Périodiques Résumé : Background The current study evaluated the effectiveness and safety of intensive prolonged exposure (PE) targeting adolescent patients with complex posttraumatic stress disorder (PTSD) and comorbid disorders following multiple interpersonal trauma. Methods Ten adolescents meeting full diagnostic criteria for PTSD were recruited from a specialized outpatient mental health clinic and offered a standardized intensive PE. The intensive PE consisted of three daily 90-min exposure sessions delivered on five consecutive weekdays, followed by 3 weekly 90-min booster sessions. In a single-trial design, the participants were randomly allocated to one of five baseline lengths (4–8 weeks) before starting the intensive PE. Before, during, and after intensive PE completion, self-reported PTSD symptom severity was assessed weekly as a primary outcome (a total of 21 measurements). Furthermore, clinician-administered PTSD diagnostic status and symptom severity (primary outcome), as well as self-reported comorbid symptoms (secondary outcomes), were assessed at four single time points (baseline-to-6-month follow-up). Results Time-series analyses showed that self-reported PTSD symptom severity significantly declined following treatment (p = .002). Pre-postgroup analyses demonstrated significant reductions of clinician-administered PTSD symptom severity and self-reported comorbidity that persisted during the 3- and 6-month follow-ups (all ps < .05), where 80% of adolescents had reached diagnostic remission of PTSD. There was neither treatment dropout nor any adverse events. Conclusions The results of this first proof of concept trial suggest that intensive PE can be effective and safe in an adolescent population with complex PTSD, although the gains achieved need to be confirmed in a randomized controlled trial. En ligne : http://dx.doi.org/10.1111/jcpp.12756 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=326
in Journal of Child Psychology and Psychiatry > 58-11 (November 2017) . - p.1229-1238[article] Intensive prolonged exposure treatment for adolescent complex posttraumatic stress disorder: a single-trial design [Texte imprimé et/ou numérique] / Lotte HENDRIKS, Auteur ; Rianne A. DE KLEINE, Auteur ; Mieke HEYVAERT, Auteur ; Eni S. BECKER, Auteur ; Gert-Jan HENDRIKS, Auteur ; Agnes VAN MINNEN, Auteur . - p.1229-1238.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 58-11 (November 2017) . - p.1229-1238
Mots-clés : Complex PTSD treatment outcome adolescents prolonged exposure intensive treatment Index. décimale : PER Périodiques Résumé : Background The current study evaluated the effectiveness and safety of intensive prolonged exposure (PE) targeting adolescent patients with complex posttraumatic stress disorder (PTSD) and comorbid disorders following multiple interpersonal trauma. Methods Ten adolescents meeting full diagnostic criteria for PTSD were recruited from a specialized outpatient mental health clinic and offered a standardized intensive PE. The intensive PE consisted of three daily 90-min exposure sessions delivered on five consecutive weekdays, followed by 3 weekly 90-min booster sessions. In a single-trial design, the participants were randomly allocated to one of five baseline lengths (4–8 weeks) before starting the intensive PE. Before, during, and after intensive PE completion, self-reported PTSD symptom severity was assessed weekly as a primary outcome (a total of 21 measurements). Furthermore, clinician-administered PTSD diagnostic status and symptom severity (primary outcome), as well as self-reported comorbid symptoms (secondary outcomes), were assessed at four single time points (baseline-to-6-month follow-up). Results Time-series analyses showed that self-reported PTSD symptom severity significantly declined following treatment (p = .002). Pre-postgroup analyses demonstrated significant reductions of clinician-administered PTSD symptom severity and self-reported comorbidity that persisted during the 3- and 6-month follow-ups (all ps < .05), where 80% of adolescents had reached diagnostic remission of PTSD. There was neither treatment dropout nor any adverse events. Conclusions The results of this first proof of concept trial suggest that intensive PE can be effective and safe in an adolescent population with complex PTSD, although the gains achieved need to be confirmed in a randomized controlled trial. En ligne : http://dx.doi.org/10.1111/jcpp.12756 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=326 A longitudinal study of cognitive predictors of (complex) post-traumatic stress in young people in out-of-home care / Rachel M. HILLER in Journal of Child Psychology and Psychiatry, 62-1 (January 2021)
[article]
Titre : A longitudinal study of cognitive predictors of (complex) post-traumatic stress in young people in out-of-home care Type de document : Texte imprimé et/ou numérique Auteurs : Rachel M. HILLER, Auteur ; Richard MEISER-STEDMAN, Auteur ; Elizabeth ELLIOTT, Auteur ; Rosie BANTING, Auteur ; Sarah L. HALLIGAN, Auteur Article en page(s) : p.48-57 Langues : Anglais (eng) Mots-clés : Child maltreatment Ptsd complex PTSD complex trauma developmental trauma foster care looked-after children Index. décimale : PER Périodiques Résumé : BACKGROUND: Young people in out-of-home care are substantially more likely to meet criteria for PTSD than their peers, while their early maltreatment exposure may also place them at greater risk of developing the newly proposed complex PTSD. Yet, there remains limited empirical evidence for the mechanisms that might drive either PTSD or complex features in this group, and ongoing debate about the suitability of existing cognitive behavioural models and their related NICE-recommended treatments. In a prospective study of young people in out-of-home care, we sought to identify demographic and cognitive processes that may contribute to the maintenance of both PTSD symptom and complex features. METHODS: We assessed 120 10- to 18-year-olds in out-of-home care and their primary carer at two assessments: an initial assessment and 12-month follow-up. Participants completed questionnaires on trauma history, PTSD symptoms and complex features, while young people only also self-reported on trauma-related (a) maladaptive appraisals, (b) memory quality and (c) coping. Social workers reported on maltreatment severity. RESULTS: Young people's maltreatment severity was not a robust predictor of either PTSD symptoms or complex features. All three cognitive processes were moderately-to-strongly correlated with baseline and 12-month PTSD symptoms and complex features, with maladaptive appraisals the most robust unique driver of both, even when controlling for initial PTSD symptom severity. CONCLUSIONS: Existing cognitive models of PTSD are applicable in this more complex sample of young people. The model was also found to be applicable to the additional features of complex PTSD, with the same processes driving both outcomes at both time points. Clinical implications are discussed. En ligne : http://dx.doi.org/10.1111/jcpp.13232 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=435
in Journal of Child Psychology and Psychiatry > 62-1 (January 2021) . - p.48-57[article] A longitudinal study of cognitive predictors of (complex) post-traumatic stress in young people in out-of-home care [Texte imprimé et/ou numérique] / Rachel M. HILLER, Auteur ; Richard MEISER-STEDMAN, Auteur ; Elizabeth ELLIOTT, Auteur ; Rosie BANTING, Auteur ; Sarah L. HALLIGAN, Auteur . - p.48-57.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 62-1 (January 2021) . - p.48-57
Mots-clés : Child maltreatment Ptsd complex PTSD complex trauma developmental trauma foster care looked-after children Index. décimale : PER Périodiques Résumé : BACKGROUND: Young people in out-of-home care are substantially more likely to meet criteria for PTSD than their peers, while their early maltreatment exposure may also place them at greater risk of developing the newly proposed complex PTSD. Yet, there remains limited empirical evidence for the mechanisms that might drive either PTSD or complex features in this group, and ongoing debate about the suitability of existing cognitive behavioural models and their related NICE-recommended treatments. In a prospective study of young people in out-of-home care, we sought to identify demographic and cognitive processes that may contribute to the maintenance of both PTSD symptom and complex features. METHODS: We assessed 120 10- to 18-year-olds in out-of-home care and their primary carer at two assessments: an initial assessment and 12-month follow-up. Participants completed questionnaires on trauma history, PTSD symptoms and complex features, while young people only also self-reported on trauma-related (a) maladaptive appraisals, (b) memory quality and (c) coping. Social workers reported on maltreatment severity. RESULTS: Young people's maltreatment severity was not a robust predictor of either PTSD symptoms or complex features. All three cognitive processes were moderately-to-strongly correlated with baseline and 12-month PTSD symptoms and complex features, with maladaptive appraisals the most robust unique driver of both, even when controlling for initial PTSD symptom severity. CONCLUSIONS: Existing cognitive models of PTSD are applicable in this more complex sample of young people. The model was also found to be applicable to the additional features of complex PTSD, with the same processes driving both outcomes at both time points. Clinical implications are discussed. En ligne : http://dx.doi.org/10.1111/jcpp.13232 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=435