Cognitive therapy as an early treatment for post-traumatic stress disorder in children and adolescents: a randomized controlled trial addressing preliminary efficacy and mechanisms of action / Richard MEISER-STEDMAN in Journal of Child Psychology and Psychiatry, 58-5 (May 2017)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 58-5 (May 2017) . - p.623-633 Titre : Cognitive therapy as an early treatment for post-traumatic stress disorder in children and adolescents: a randomized controlled trial addressing preliminary efficacy and mechanisms of action Type de document : Texte imprimé et/ou numérique Auteurs : Richard MEISER-STEDMAN, Auteur ; Patrick SMITH, Auteur ; Anna MCKINNON, Auteur ; Clare DIXON, Auteur ; David TRICKEY, Auteur ; Anke EHLERS, Auteur ; David M. CLARK, Auteur ; Adrian BOYLE, Auteur ; Peter WATSON, Auteur ; Ian GOODYER, Auteur ; Tim DALGLEISH, Auteur Article en page(s) : p.623-633 Langues : Anglais (eng) Mots-clés : Post-traumatic stress disorder  cognitive therapy Index. décimale : PER Périodiques Résumé : Background Few efficacious early treatments for post-traumatic stress disorder (PTSD) in children and adolescents exist. Previous trials have intervened within the first month post-trauma and focused on secondary prevention of later post-traumatic stress; however, considerable natural recovery may still occur up to 6-months post-trauma. No trials have addressed the early treatment of established PTSD (i.e. 2- to 6-months post-trauma). Methods Twenty-nine youth (8–17 years) with PTSD (according to age-appropriate DSM-IV or ICD-10 diagnostic criteria) after a single-event trauma in the previous 2–6 months were randomly allocated to Cognitive Therapy for PTSD (CT-PTSD; n = 14) or waiting list (WL; n = 15) for 10 weeks. Results Significantly more participants were free of PTSD after CT-PTSD (71%) than WL (27%) at posttreatment (intent-to-treat, 95% CI for difference .04–.71). CT-PTSD yielded greater improvement on child-report questionnaire measures of PTSD, depression and anxiety; clinician-rated functioning; and parent-reported outcomes. Recovery after CT-PTSD was maintained at 6- and 12-month posttreatment. Beneficial effects of CT-PTSD were mediated through changes in appraisals and safety-seeking behaviours, as predicted by cognitive models of PTSD. CT-PTSD was considered acceptable on the basis of low dropout and high treatment credibility and therapist alliance ratings. Conclusions This trial provides preliminary support for the efficacy and acceptability of CT-PTSD as an early treatment for PTSD in youth. Moreover, the trial did not support the extension of ‘watchful waiting’ into the 2- to 6-month post-trauma window, as significant improvements in the WL arm (particularly in terms of functioning and depression) were not observed. Replication in larger samples is needed, but attention to recruitment issues will be required. En ligne : http://dx.doi.org/10.1111/jcpp.12673 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=306 [article] Cognitive therapy as an early treatment for post-traumatic stress disorder in children and adolescents: a randomized controlled trial addressing preliminary efficacy and mechanisms of action [Texte imprimé et/ou numérique] / Richard MEISER-STEDMAN, Auteur ; Patrick SMITH, Auteur ; Anna MCKINNON, Auteur ; Clare DIXON, Auteur ; David TRICKEY, Auteur ; Anke EHLERS, Auteur ; David M. CLARK, Auteur ; Adrian BOYLE, Auteur ; Peter WATSON, Auteur ; Ian GOODYER, Auteur ; Tim DALGLEISH, Auteur . - p.623-633. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 58-5 (May 2017) . - p.623-633 Mots-clés : Post-traumatic stress disorder  cognitive therapy Index. décimale : PER Périodiques Résumé : Background Few efficacious early treatments for post-traumatic stress disorder (PTSD) in children and adolescents exist. Previous trials have intervened within the first month post-trauma and focused on secondary prevention of later post-traumatic stress; however, considerable natural recovery may still occur up to 6-months post-trauma. No trials have addressed the early treatment of established PTSD (i.e. 2- to 6-months post-trauma). Methods Twenty-nine youth (8–17 years) with PTSD (according to age-appropriate DSM-IV or ICD-10 diagnostic criteria) after a single-event trauma in the previous 2–6 months were randomly allocated to Cognitive Therapy for PTSD (CT-PTSD; n = 14) or waiting list (WL; n = 15) for 10 weeks. Results Significantly more participants were free of PTSD after CT-PTSD (71%) than WL (27%) at posttreatment (intent-to-treat, 95% CI for difference .04–.71). CT-PTSD yielded greater improvement on child-report questionnaire measures of PTSD, depression and anxiety; clinician-rated functioning; and parent-reported outcomes. Recovery after CT-PTSD was maintained at 6- and 12-month posttreatment. Beneficial effects of CT-PTSD were mediated through changes in appraisals and safety-seeking behaviours, as predicted by cognitive models of PTSD. CT-PTSD was considered acceptable on the basis of low dropout and high treatment credibility and therapist alliance ratings. Conclusions This trial provides preliminary support for the efficacy and acceptability of CT-PTSD as an early treatment for PTSD in youth. Moreover, the trial did not support the extension of ‘watchful waiting’ into the 2- to 6-month post-trauma window, as significant improvements in the WL arm (particularly in terms of functioning and depression) were not observed. Replication in larger samples is needed, but attention to recruitment issues will be required. En ligne : http://dx.doi.org/10.1111/jcpp.12673 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=306

Feeling anxious: a twin study of panic/somatic ratings, anxiety sensitivity and heartbeat perception in children / Thalia C. ELEY in Journal of Child Psychology and Psychiatry, 48-12 (December 2007)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 48-12 (December 2007) . - p.1184–1191 Titre : Feeling anxious: a twin study of panic/somatic ratings, anxiety sensitivity and heartbeat perception in children Type de document : Texte imprimé et/ou numérique Auteurs : Thalia C. ELEY, Auteur ; Alice M. GREGORY, Auteur ; David M. CLARK, Auteur ; Anke EHLERS, Auteur Année de publication : 2007 Article en page(s) : p.1184–1191 Langues : Anglais (eng) Mots-clés : Heartbeat-perception-(HBP) anxiety-sensitivity panic-attacks genetic twins Index. décimale : PER Périodiques Résumé : Background: Little is known about mechanisms of genetic influence on panic, particularly in childhood. Cognitive theories of panic disorder highlight threatening interpretations of physical sensations, and increased awareness of such sensations. Specifically, anxiety sensitivity (AS) and heartbeat perception (HBP) have been associated with panic in adults and children. We examined genetic and environmental influences on childhood AS, HBP, panic/somatic ratings, and their associations. Methods: Self-ratings of AS and DSM-based anxiety (including panic/somatic items) were obtained from 300 eight-year-old twin pairs (600 individuals), selected for mother-rated child anxiety at age 7. HBP was also assessed. Results: Panic/somatic ratings were significantly correlated with both AS (r = .55) and continuous HBP error scores (r = −.13). AS and HBP scores showed significantly greater correlations with panic/somatic ratings than with all other anxiety scales, except for HBP and school anxiety. Genetic influences on panic/somatic ratings were modest (15%), and moderate for both AS (37%), and HBP (30%). Non-shared environmental influences were substantial. The genetic correlations between panic/somatic ratings and both AS and HBP error scores were .98 (95% CI: .74–1.00) and −.46 (95% CI: −1.00–1.00) respectively. Conclusions: Self-ratings of panic and AS overlap genetically. Future research should consider whether AS mediates genetic risk for panic disorder. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2007.01838.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=309 [article] Feeling anxious: a twin study of panic/somatic ratings, anxiety sensitivity and heartbeat perception in children [Texte imprimé et/ou numérique] / Thalia C. ELEY, Auteur ; Alice M. GREGORY, Auteur ; David M. CLARK, Auteur ; Anke EHLERS, Auteur . - 2007 . - p.1184–1191. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 48-12 (December 2007) . - p.1184–1191 Mots-clés : Heartbeat-perception-(HBP) anxiety-sensitivity panic-attacks genetic twins Index. décimale : PER Périodiques Résumé : Background: Little is known about mechanisms of genetic influence on panic, particularly in childhood. Cognitive theories of panic disorder highlight threatening interpretations of physical sensations, and increased awareness of such sensations. Specifically, anxiety sensitivity (AS) and heartbeat perception (HBP) have been associated with panic in adults and children. We examined genetic and environmental influences on childhood AS, HBP, panic/somatic ratings, and their associations. Methods: Self-ratings of AS and DSM-based anxiety (including panic/somatic items) were obtained from 300 eight-year-old twin pairs (600 individuals), selected for mother-rated child anxiety at age 7. HBP was also assessed. Results: Panic/somatic ratings were significantly correlated with both AS (r = .55) and continuous HBP error scores (r = −.13). AS and HBP scores showed significantly greater correlations with panic/somatic ratings than with all other anxiety scales, except for HBP and school anxiety. Genetic influences on panic/somatic ratings were modest (15%), and moderate for both AS (37%), and HBP (30%). Non-shared environmental influences were substantial. The genetic correlations between panic/somatic ratings and both AS and HBP error scores were .98 (95% CI: .74–1.00) and −.46 (95% CI: −1.00–1.00) respectively. Conclusions: Self-ratings of panic and AS overlap genetically. Future research should consider whether AS mediates genetic risk for panic disorder. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2007.01838.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=309

The latent structure of Acute Stress Disorder symptoms in trauma-exposed children and adolescents / Anna MCKINNON in Journal of Child Psychology and Psychiatry, 57-11 (November 2016)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 57-11 (November 2016) . - p.1308-1316 Titre : The latent structure of Acute Stress Disorder symptoms in trauma-exposed children and adolescents Type de document : Texte imprimé et/ou numérique Auteurs : Anna MCKINNON, Auteur ; Richard MEISER-STEDMAN, Auteur ; Peter WATSON, Auteur ; Clare DIXON, Auteur ; Nancy KASSAM-ADAMS, Auteur ; Anke EHLERS, Auteur ; Flaura WINSTON, Auteur ; Patrick SMITH, Auteur ; William YULE, Auteur ; Tim DALGLEISH, Auteur Article en page(s) : p.1308-1316 Langues : Anglais (eng) Mots-clés : Acute Stress Disorder  DSM-5  factor analysis  children  post-traumatic stress disorder Index. décimale : PER Périodiques Résumé : Background The revision of Acute Stress Disorder (ASD) in the DSM-5 (DSM-5, 2013) proposes a cluster-free model of ASD symptoms in both adults and youth. Published evaluations of competing models of ASD clustering in youth have rarely been examined. Methods We used Confirmatory Factor Analysis (combined with multigroup invariance tests) to explore the latent structure of ASD symptoms in a trauma-exposed sample of children and young people (N = 594). The DSM-5 structure was compared with the previous DSM-IV conceptualization (4-factor), and two alternative models proposed in the literature (3-factor; 5-factor). Model fit was examined using goodness-of-fit indices. We also established DSM-5 ASD prevalence rates relative to DSM-IV ASD, and the ability of these models to classify children impaired by their symptoms. Results Based on both the Bayesian Information Criterion, the interfactor correlations and invariance testing, the 3-factor model best accounted for the profile of ASD symptoms. DSM-5 ASD led to slightly higher prevalence rates than DSM-IV ASD and performed similarly to DSM-IV with respect to categorising children impaired by their symptoms. Modifying the DSM-5 ASD algorithm to a 3+ or 4+ symptom requirement was the strongest predictor of impairment. Conclusions These findings suggest that a uni-factorial general-distress model is not the optimal model of capturing the latent structure of ASD symptom profiles in youth and that modifying the current DSM-5 9+ symptom algorithm could potentially lead to a more developmentally sensitive conceptualization. En ligne : http://dx.doi.org/10.1111/jcpp.12597 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=295 [article] The latent structure of Acute Stress Disorder symptoms in trauma-exposed children and adolescents [Texte imprimé et/ou numérique] / Anna MCKINNON, Auteur ; Richard MEISER-STEDMAN, Auteur ; Peter WATSON, Auteur ; Clare DIXON, Auteur ; Nancy KASSAM-ADAMS, Auteur ; Anke EHLERS, Auteur ; Flaura WINSTON, Auteur ; Patrick SMITH, Auteur ; William YULE, Auteur ; Tim DALGLEISH, Auteur . - p.1308-1316. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 57-11 (November 2016) . - p.1308-1316 Mots-clés : Acute Stress Disorder  DSM-5  factor analysis  children  post-traumatic stress disorder Index. décimale : PER Périodiques Résumé : Background The revision of Acute Stress Disorder (ASD) in the DSM-5 (DSM-5, 2013) proposes a cluster-free model of ASD symptoms in both adults and youth. Published evaluations of competing models of ASD clustering in youth have rarely been examined. Methods We used Confirmatory Factor Analysis (combined with multigroup invariance tests) to explore the latent structure of ASD symptoms in a trauma-exposed sample of children and young people (N = 594). The DSM-5 structure was compared with the previous DSM-IV conceptualization (4-factor), and two alternative models proposed in the literature (3-factor; 5-factor). Model fit was examined using goodness-of-fit indices. We also established DSM-5 ASD prevalence rates relative to DSM-IV ASD, and the ability of these models to classify children impaired by their symptoms. Results Based on both the Bayesian Information Criterion, the interfactor correlations and invariance testing, the 3-factor model best accounted for the profile of ASD symptoms. DSM-5 ASD led to slightly higher prevalence rates than DSM-IV ASD and performed similarly to DSM-IV with respect to categorising children impaired by their symptoms. Modifying the DSM-5 ASD algorithm to a 3+ or 4+ symptom requirement was the strongest predictor of impairment. Conclusions These findings suggest that a uni-factorial general-distress model is not the optimal model of capturing the latent structure of ASD symptom profiles in youth and that modifying the current DSM-5 9+ symptom algorithm could potentially lead to a more developmentally sensitive conceptualization. En ligne : http://dx.doi.org/10.1111/jcpp.12597 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=295

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