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Détail de l'auteur
Auteur C. DIXON |
Documents disponibles écrits par cet auteur (2)
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A core role for cognitive processes in the acute onset and maintenance of post-traumatic stress in children and adolescents / R. MEISER-STEDMAN in Journal of Child Psychology and Psychiatry, 60-8 (August 2019)
[article]
Titre : A core role for cognitive processes in the acute onset and maintenance of post-traumatic stress in children and adolescents Type de document : Texte imprimé et/ou numérique Auteurs : R. MEISER-STEDMAN, Auteur ; A. MCKINNON, Auteur ; C. DIXON, Auteur ; A. BOYLE, Auteur ; P. SMITH, Auteur ; Tim DALGLEISH, Auteur Article en page(s) : p.875-884 Langues : Anglais (eng) Mots-clés : Post-traumatic stress disorder cognitive development early intervention longitudinal studies Index. décimale : PER Périodiques Résumé : BACKGROUND: Post-traumatic stress disorder (PTSD) is a common reaction to trauma in children and adolescents. While a significant minority of trauma-exposed youth go on to have persistent PTSD, many youths who initially have a severe traumatic stress response undergo natural recovery. The present study investigated the role of cognitive processes in shaping the early reactions of child and adolescents to traumatic stressors, and the transition to persistent clinically significant post-traumatic stress symptoms (PTSS). METHODS: A prospective longitudinal study of youth aged 8-17 years who had attended a hospital emergency department following single trauma was undertaken, with assessments performed at 2-4 weeks (N = 226) and 2 months (N = 208) post-trauma. Acute stress disorder and PTSD were assessed using a structured interview, while PTSS, depression severity and peritraumatic and post-traumatic cognitive processes were assessed using self-report questionnaires. On the basis of their PTSS scores at each assessment, participants were categorised as being on a resilient, recovery or persistent trajectory. RESULTS: PTSS decreased between the two assessments. Cognitive processes at the 2- to 4-week assessment accounted for the most variance in PTSS at both the initial and follow-up assessment. The onset of post-traumatic stress was associated particularly with peritraumatic subjective threat, data-driven processing and pain. Its maintenance was associated with greater peritraumatic dissociation and panic, and post-traumatic persistent dissociation, trauma memory quality, rumination and negative appraisals. Efforts to deliberately process the trauma were more common in youth who experienced the onset of clinically significant PTSS. Regression modelling indicated that the predictive effect of baseline negative appraisals remained when also accounting for baseline PTSS and depression. CONCLUSIONS: Cognitive processes play an important role in the onset and maintenance of PTSS in children and adolescents exposed to trauma. Trauma-related appraisals play a particular role when considering whether youth make the transition from clinically significant acute PTSS to persistent PTSS. En ligne : http://dx.doi.org/10.1111/jcpp.13054 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=404
in Journal of Child Psychology and Psychiatry > 60-8 (August 2019) . - p.875-884[article] A core role for cognitive processes in the acute onset and maintenance of post-traumatic stress in children and adolescents [Texte imprimé et/ou numérique] / R. MEISER-STEDMAN, Auteur ; A. MCKINNON, Auteur ; C. DIXON, Auteur ; A. BOYLE, Auteur ; P. SMITH, Auteur ; Tim DALGLEISH, Auteur . - p.875-884.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 60-8 (August 2019) . - p.875-884
Mots-clés : Post-traumatic stress disorder cognitive development early intervention longitudinal studies Index. décimale : PER Périodiques Résumé : BACKGROUND: Post-traumatic stress disorder (PTSD) is a common reaction to trauma in children and adolescents. While a significant minority of trauma-exposed youth go on to have persistent PTSD, many youths who initially have a severe traumatic stress response undergo natural recovery. The present study investigated the role of cognitive processes in shaping the early reactions of child and adolescents to traumatic stressors, and the transition to persistent clinically significant post-traumatic stress symptoms (PTSS). METHODS: A prospective longitudinal study of youth aged 8-17 years who had attended a hospital emergency department following single trauma was undertaken, with assessments performed at 2-4 weeks (N = 226) and 2 months (N = 208) post-trauma. Acute stress disorder and PTSD were assessed using a structured interview, while PTSS, depression severity and peritraumatic and post-traumatic cognitive processes were assessed using self-report questionnaires. On the basis of their PTSS scores at each assessment, participants were categorised as being on a resilient, recovery or persistent trajectory. RESULTS: PTSS decreased between the two assessments. Cognitive processes at the 2- to 4-week assessment accounted for the most variance in PTSS at both the initial and follow-up assessment. The onset of post-traumatic stress was associated particularly with peritraumatic subjective threat, data-driven processing and pain. Its maintenance was associated with greater peritraumatic dissociation and panic, and post-traumatic persistent dissociation, trauma memory quality, rumination and negative appraisals. Efforts to deliberately process the trauma were more common in youth who experienced the onset of clinically significant PTSS. Regression modelling indicated that the predictive effect of baseline negative appraisals remained when also accounting for baseline PTSS and depression. CONCLUSIONS: Cognitive processes play an important role in the onset and maintenance of PTSS in children and adolescents exposed to trauma. Trauma-related appraisals play a particular role when considering whether youth make the transition from clinically significant acute PTSS to persistent PTSS. En ligne : http://dx.doi.org/10.1111/jcpp.13054 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=404 Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: a trial based evaluation and model / J. SHEARER in Journal of Child Psychology and Psychiatry, 59-7 (July 2018)
[article]
Titre : Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: a trial based evaluation and model Type de document : Texte imprimé et/ou numérique Auteurs : J. SHEARER, Auteur ; N. PAPANIKOLAOU, Auteur ; R. MEISER-STEDMAN, Auteur ; A. MCKINNON, Auteur ; Tim DALGLEISH, Auteur ; P. SMITH, Auteur ; C. DIXON, Auteur ; Sarah BYFORD, Auteur Article en page(s) : p.773-780 Langues : Anglais (eng) Mots-clés : Economic evaluation cognitive therapy post-traumatic stress disorder Index. décimale : PER Périodiques Résumé : BACKGROUND: Untreated post-traumatic stress disorder (PTSD) in children and adolescents is associated with a considerable economic burden on the health system, families and society. Recent research has demonstrated the potential efficacy of cognitive therapy as an early intervention for PTSD in children and adolescents. Children who experienced a single traumatic event in the previous two to six months and were randomized to cognitive therapy for PTSD (CT-PTSD) were significantly more likely to be PTSD-free compared to those randomized to usual care represented by waitlist control. The current study evaluated the economic impact of improvements in the treatment of PTSD in children and adolescents. METHODS: A cost-effectiveness analysis was conducted from the national health service/personal social services perspective with outcomes expressed as quality-adjusted life years (QALYs). Patient level costs and outcomes were collected during the 11 week clinical trial and extrapolated to a three year time horizon using economic modelling methods. Uncertainty was estimated using probabilistic sensitivity analysis and assumptions were tested using one way sensitivity analysis. RESULTS: The incremental cost-effectiveness ratio at 3 years was pound2,205 per QALY with a 60%-69% probability of CT-PTSD being cost-effective compared to usual care at the UK pound20,000 to pound30,000 per QALY decision threshold. CONCLUSIONS: This study provides preliminary evidence for the cost-effectiveness of cognitive therapy in this treatment population. Larger pragmatic trials with longer follow-up are indicated. En ligne : http://dx.doi.org/10.1111/jcpp.12851 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=368
in Journal of Child Psychology and Psychiatry > 59-7 (July 2018) . - p.773-780[article] Cost-effectiveness of cognitive therapy as an early intervention for post-traumatic stress disorder in children and adolescents: a trial based evaluation and model [Texte imprimé et/ou numérique] / J. SHEARER, Auteur ; N. PAPANIKOLAOU, Auteur ; R. MEISER-STEDMAN, Auteur ; A. MCKINNON, Auteur ; Tim DALGLEISH, Auteur ; P. SMITH, Auteur ; C. DIXON, Auteur ; Sarah BYFORD, Auteur . - p.773-780.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 59-7 (July 2018) . - p.773-780
Mots-clés : Economic evaluation cognitive therapy post-traumatic stress disorder Index. décimale : PER Périodiques Résumé : BACKGROUND: Untreated post-traumatic stress disorder (PTSD) in children and adolescents is associated with a considerable economic burden on the health system, families and society. Recent research has demonstrated the potential efficacy of cognitive therapy as an early intervention for PTSD in children and adolescents. Children who experienced a single traumatic event in the previous two to six months and were randomized to cognitive therapy for PTSD (CT-PTSD) were significantly more likely to be PTSD-free compared to those randomized to usual care represented by waitlist control. The current study evaluated the economic impact of improvements in the treatment of PTSD in children and adolescents. METHODS: A cost-effectiveness analysis was conducted from the national health service/personal social services perspective with outcomes expressed as quality-adjusted life years (QALYs). Patient level costs and outcomes were collected during the 11 week clinical trial and extrapolated to a three year time horizon using economic modelling methods. Uncertainty was estimated using probabilistic sensitivity analysis and assumptions were tested using one way sensitivity analysis. RESULTS: The incremental cost-effectiveness ratio at 3 years was pound2,205 per QALY with a 60%-69% probability of CT-PTSD being cost-effective compared to usual care at the UK pound20,000 to pound30,000 per QALY decision threshold. CONCLUSIONS: This study provides preliminary evidence for the cost-effectiveness of cognitive therapy in this treatment population. Larger pragmatic trials with longer follow-up are indicated. En ligne : http://dx.doi.org/10.1111/jcpp.12851 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=368