Traumatic events do not occur at random

Katie McLaughlinDr. Katie McLaughlin is a clinical psychologist and Assistant Professor in the Department of Psychology at the University of Washington.  She received her doctorate in Clinical Psychology and in Epidemiology and Public Health from Yale University in 2008.  Her research seeks to identify psychological and neurobiological mechanisms linking child trauma exposure to the onset of psychopathology in children and adolescents.

Today, Katie writes about what population-based data can tell us about trauma in U.S. children and adolescents.

The media is filled with stories about traumatized children and adolescents, such as the school shootings at Sandy Hook and Columbine. However, a range of more common traumatic events, such as accidents and caregiver maltreatment, receive less attention.  We sought to understand how common traumatic experiences are in the lives of U.S. youths by conducting a study examining trauma exposure and PTSD in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally-representative sample of 6,483 adolescents aged 13-17. This study is the largest population-based study examining trauma exposure and PTSD in U.S. youths, and the findings reveal trauma and PTSD are significant public health problems in this population.

Trauma Exposure is Pervasive among U.S. Youths

A majority of U.S. youths have experienced a traumatic event by the time they reach adolescence.  Sixty-two percent of teenagers have experienced at least one traumatic event in their lifetime, including interpersonal violence, serious injuries, natural disasters and death of a loved one, and 19 percent have experienced three or more such events.  The prevalence of trauma exposure among children and adolescents is nearly as high as the prevalence in adults based on similar population-based studies.

Traumatic Events do not Occur at Random Continue reading

New guidelines for the treatment of ASD and PTSD in children

Australian ASD PTSD GuidelinesDo not use psychological debriefing when a child has been exposed to a traumatic event such as assault or a major car crash.

And when you treat a child who has developed Posttraumatic Stress Disorder (PTSD) due to trauma, do not use pharmacotherapy either (that is, not as a first line treatment).

Rather, apply the principles of psychological first aid in the direct aftermath of trauma and use trauma-focused cognitive behavioral therapy to treat PTSD.

These recommendations come from the brand new, very extensive Australian Guidelines for the Treatment of ASD and PTSD. For the first time, the guidelines include separate sections on children and adolescents.

How are the guidelines developed?

The guidelines are mainly informed by a systematic review of the literature and a staged process of expert consensus. People affected by trauma, clinicians and the public have also had varying levels of input. Continue reading

Can we use Facebook to assess mental health needs after a disaster?

facebook disaster mental healthImagine: you have just received a request to assess the mental health needs of the survivors of a large-scale disaster. What are your major challenges: Logistics? Resources? Communication? Getting an overview of who is in the area, who has been assessed, and who still needs to be? And if needs are identified, getting the appropriate services in place?

Probably all of the above. In addition, it may be dangerous to enter the disaster area altogether, for example due to radiation risk.

Therefore, wouldn’t it help if you could conduct needs assessments via social networks like Facebook? If these give the same information as face-to-face interviews that you would conduct otherwise, it would be worthwhile as a low-cost-low-risk approach.

A research team from Israel set out to test whether a Facebook sample and a traditional face-to-face sample would show differences in mental health and disaster-related data after the 2011 Fukushima nuclear disaster. Continue reading

The role of siblings in children’s mental health

siblings mental healthWhen you were young(er), did you also engage in personality predictions with your peers based on order in the family? For example, that the oldest of three siblings would be the bossiest and the youngest the most spoiled? Almost everyone (90% of us) have one or more siblings. And we know they play an important role in our lives.

Scientists in the Netherlands have now combined international research examining siblings’ role in children’s mental health. This is an innovative step, since there is quite a lot of research on parenting but not so much on siblings. Moreover, the authors state that the sibling relationship is “one of the most neglected relationships in psychological research and practice.” Also in the child traumatic stress area, I think siblings are still overlooked. Continue reading

PTSD in the DSM-5

DSM5 DSMIVWhat is going to change in the criteria for a PTSD diagnosis in the 5th edition of the psychiatry ‘bible’, the Diagnostic and Statistical Manual of Mental Disorders?

The DSM-5 is to be published in May this year but some information on the changes starts to trickle through…

Below are the most important changes, drawn from a handout of the American Psychiatric Association:

1. PTSD will no longer be classified as an anxiety disorder. It will fall under the new ‘Trauma- and Stress-or-Related Disorders’. Continue reading