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A Longitudinal Examination of the Relationship between Trauma-Related Cognitive Factors and Internalising and Externalising Psychopathology in Physically Injured Children.

ABSTRACT: Cognitive models of posttraumatic stress disorder (PTSD) highlight maladaptive posttrauma appraisals, trauma memory qualities, and coping strategies, such as rumination or thought suppression, as key processes that maintain PTSD symptoms. Anxiety, depression and externalising symptoms can also present in children in the aftermath of trauma, yet there has been little empirical investigation of the potential relevance of posttrauma cognitive processes for such difficulties. Here, we examined whether: a) acute maladaptive cognitive processes (specifically, maladaptive appraisals, memory qualities, and cognitive coping) were associated with symptoms of PTSD, internalising, and externalising at 1-month posttrauma (T1); and b) changes in these cognitive processes predicted symptom change at a follow-up assessment 6 months later (T2). We recruited 132 6-13 year old children and their parents from emergency departments following the child's experience of an acute trauma. Children self-reported on their maladaptive appraisals, trauma-memory and cognitive coping strategies, along with symptoms of PTSD, anxiety and depression. Parents also rated children's internalising and externalising symptoms. We found each cognitive process to be robustly associated with PTSD and non-PTSD internalising symptoms at T1, and change in each predicted change in symptoms to T2. Maladaptive appraisals and cognitive coping were unique predictors of children's posttrauma internalising. Effects were partially retained even controlling for co-occurring PTSD symptoms. There was less evidence that trauma-specific cognitive processes were associated with externalising symptoms. Findings suggest aspects of cognitive models of PTSD are applicable to broader posttrauma psychopathology, and have implications for how we understand and target children's posttrauma psychological adjustment.

SUBMITTER: Hiller RM

PROVIDER: S-EPMC6439173 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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A Longitudinal Examination of the Relationship between Trauma-Related Cognitive Factors and Internalising and Externalising Psychopathology in Physically Injured Children.

Hiller Rachel M RM Creswell Cathy C Meiser-Stedman Richard R Lobo Sarah S Cowdrey Felicity F Lyttle Mark D MD Ehlers Anke A Halligan Sarah L SL

Journal of abnormal child psychology 20190401 4

Cognitive models of posttraumatic stress disorder (PTSD) highlight maladaptive posttrauma appraisals, trauma memory qualities, and coping strategies, such as rumination or thought suppression, as key processes that maintain PTSD symptoms. Anxiety, depression and externalising symptoms can also present in children in the aftermath of trauma, yet there has been little empirical investigation of the potential relevance of posttrauma cognitive processes for such difficulties. Here, we examined wheth ...[more]

PMID: 30264278

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Project description:BackgroundInternalising and externalising problems commonly co-occur in childhood. Yet, few developmental models describing the structure of child psychopathology appropriately account for this comorbidity. We evaluate a model of childhood psychopathology that separates the unique and shared contribution of individual psychological symptoms into specific internalising, externalising and general psychopathology factors and assess how these general and specific factors predict long-term outcomes concerning criminal behaviour, academic achievement and affective symptoms in three independent cohorts.MethodsData were drawn from independent birth cohorts (Avon Longitudinal Study of Parents and Children (ALSPAC), N = 11,612; Generation R, N = 7,946; Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN), N = 408). Child psychopathology was assessed between 4 and 8 years using a range of diagnostic and questionnaire-based measures, and multiple informants. First, structural equation models were used to assess the fit of hypothesised models of shared and unique components of psychopathology in all cohorts. Once the model was chosen, linear/logistic regressions were used to investigate whether these factors were associated with important outcomes such as criminal behaviour, academic achievement and well-being from late adolescence/early adulthood.ResultsThe model that included specific factors for internalising/externalising and a general psychopathology factor capturing variance shared between symptoms regardless of their classification fits well for all of the cohorts. As hypothesised, general psychopathology factor scores were predictive of all outcomes of later functioning, while specific internalising factor scores predicted later internalising outcomes. Specific externalising factor scores, capturing variance not shared by any other psychological symptoms, were not predictive of later outcomes.ConclusionsEarly symptoms of psychopathology carry information that is syndrome-specific as well as indicative of general vulnerability and the informant reporting on the child. The 'general psychopathology factor' might be more relevant for long-term outcomes than specific symptoms. These findings emphasise the importance of considering the co-occurrence of common internalising and externalising problems in childhood when considering long-term impact.

Project description:AimsPrevious research has found links between cyberbullying victimisation and internalising and externalising problems among adolescents. However, little is known about the factors that might moderate these relationships. Thus, the present study examined the relationships between cyberbullying victimisation and psychological distress, suicidality, self-rated poor mental health and substance use among adolescents, and tested whether parent-child relationship and child's sex would moderate these relationships.MethodsSelf-report data on experiences of cyberbullying victimisation, self-rated poor mental health, psychological distress, suicidality and substance use were derived from the 2013 Ontario Student Drug Use and Health Survey, a province-wide school-based survey of students in grades 7 through 12 aged 11-20 years (N = 5478). Logistic regression models adjusted for age, sex, ethnicity, subjective socioeconomic status and involvement in physical fighting, bullying victimisation and perpetration at school.ResultsCyberbullying victimisation was associated with self-rated poor mental health (adjusted odds ratio (OR) 2.15; 95% confidence interval (CI) 1.64-2.81), psychological distress (OR 2.41; 95% CI 1.90-3.06), suicidal ideation (OR 2.38; 95% CI 1.83-3.08) and attempts (OR 2.07; 95% CI 1.27-3.38), smoking tobacco cigarette (OR 1.96; 95% CI 1.45-2.65), cannabis use (OR 1.82; 95% CI 1.32-2.51), and binge drinking (OR 1.44; 95% CI 1.03-2.02). The association between cyberbullying victimisation and psychological distress was modified by parent-child relationship and child's sex (three-way interaction term p < 0.05). The association between cyberbullying victimisation and psychological distress was much stronger among boys who have a negative relationship with their parents.ConclusionsFindings suggest that cyberbullying victimisation is strongly associated with psychological distress in most adolescents with the exception of males who get along well with their parents. Further research using a longitudinal design is necessary to disentangle the interrelationship among child's sex, parent-child relationship, cyberbullying victimisation and mental health outcomes among adolescents in order to improve ongoing mental health prevention efforts.

Project description:Background:The concurrence of sleep and socio-emotional development in children is well accepted. However, the predictive role of sleep problems in infancy and the development of emotional and behavioural problems later in childhood remain still unclear. Therefore, in this study we examined the associations between sleep problems in early childhood and internalising, externalising and dysregulation symptoms in toddlers. Methods:1679 families entered the study during pregnancy and 936 children participated at 24 months. Parent-reported sleep duration, sleep-onset latency, night wakings, proportion of daytime sleep and bedtime at 3, 8, 18 and 24 months were assessed with two sleep questionnaires. Externalising, internalising and dysregulation problems at 24 months were examined with the Brief Infant-Toddler Social and Emotional Assessment. Results:Short sleep duration at 3 and 8 months, more night wakings at 3, 8, 18 and 24 months and greater proportion of daytime sleep at 24 months were associated with internalising symptoms. Shorter sleep duration at 8, 18 and 24 months and longer sleep-onset latency and more night wakings at all time points, in addition to earlier bedtime at 8?months and greater proportion of daytime sleep at 24 months, were related to dysregulation. Finally, more night wakings at 3 and 24 months, and longer sleep-onset latency at 24 months were associated with externalising problems. Conclusion:Shorter sleep and poorer sleep quality in infancy were prospectively related to emotional and behavioural symptoms in toddlers, and these associations were strongest for internalising and dysregulation symptoms. This study contributes to the recent research on the role of early sleep problems in socio-emotional development, suggesting that shorter sleep duration, longer sleep-onset latency and higher waking frequency are related to internalising, externalising and dysregulation symptoms in toddlers, and thus it might be beneficial to provide early interventions for those infants reporting these sleep problems.

Dataset Information

A Longitudinal Examination of the Relationship between Trauma-Related Cognitive Factors and Internalising and Externalising Psychopathology in Physically Injured Children.

Publications

A Longitudinal Examination of the Relationship between Trauma-Related Cognitive Factors and Internalising and Externalising Psychopathology in Physically Injured Children.

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