A new study explains why certain children and adolescents acquire mental health illnesses such as PTSD, anxiety, or depression following a traumatic event. While most children recover successfully from a traumatic event, a few suffer mental health conditions that might last for months, years, or even adulthood.
According to research conducted by the University of East Anglia, cognitive psychological characteristics such as how children recall the experience and how they view themselves thereafter are the strongest predictors of poor mental health outcomes following trauma.
Co-author Katie Lofthouse, of UEA’s Norwich Medical School, said: “Some children and adolescents who have experienced traumatic events like road traffic collisions or violence may develop post-traumatic stress disorder (PTSD), as well as other conditions such as anxiety and depression.
“However, we do not understand why children might develop one set of difficulties and not another. We found that cognitive psychological factors — like features of their memories for the trauma and how they see themselves after the trauma — were the most powerful predictors of all forms of poor mental health. Aspects of how severe the trauma was, or a child’s age or sex were much less important.”
These findings highlight risk factors for the development of mental health disorders following trauma exposure in youth. Negative thoughts about the traumatic event were a major predictor of all types of mental health problems studied.
Miss Lofthouse
The research team dealt with 260 children aged eight to seventeen who had visited a hospital emergency department following a single stressful occurrence. These included automobile accidents, assaults, dog attacks, and other medical situations.
These young people were assessed two and nine weeks after trauma using self-report questionnaires completed by the child, telephone interviews with parents, and hospital data, which were then used to develop four predictive models of risk factors for PTSD, Complex PTSD (CPTSD), depression, and Generalised Anxiety Disorder (GAD).
At nine weeks post-trauma, 64pc showed no signs of any disorder, 23.5pc met the criteria for PTSD, and 5.2pc for CPTSD. A total of 23.9pc and 10.7pc had developed clinically significant symptoms of depression and GAD, respectively.
When it came to predicting who would develop these mental health issues, a model based on how people think (a cognitive model) was the most accurate. A model that looked at social and psychological factors was weaker in predicting later mental health symptoms. Interestingly, a child’s personal perceptions of how severe the event was had a stronger impact on their mental health than objective, measurable facts about the severity of the event.
Miss Lofthouse added: “These findings highlight risk factors for the development of mental health disorders following trauma exposure in youth. Negative thoughts about the traumatic event were a major predictor of all types of mental health problems studied. This supports the use of treatments like trauma-focused cognitive behavioural therapy, which aims to address these negative thoughts. Our research also showed that poor memory of the trauma specifically predicted PTSD, suggesting that certain symptoms may help predict different mental health outcomes.”
Previous research from UEA found that children are more likely to suffer Post Traumatic Stress Disorder (PTSD) if they think their reaction to traumatic events is not ‘normal’. This latest research goes into further depth, looking at not just PTSD, but also other mental health outcomes such as complex PTSD, depression, and anxiety.
Complex PTSD involves all of the symptoms of PTSD, as well as some extra, more severe emotional and psychological effects. This can involve difficulties regulating intense emotions, feelings of deep shame, remorse, or worthlessness, difficulty trusting others, feelings of detachedness or isolation, or continuous interpersonal disputes. There have been few studies comparing how well different models predict mental health outcomes in persons who have been traumatized, and none of them have included young people.
With the recent introduction of Complex PTSD (CPTSD) as a diagnosis, the research team sought to determine whether it was possible to anticipate mental health issues in traumatized kids. The research team also assessed other life stressors and whether the child was in pain.
According to the researchers, the findings support the notion that how people think about their trauma plays a significant role in PTSD, but they also demonstrate that this model is not disorder-specific and applies to Complex PTSD, depression, and anxiety. Further studies could examine more closely at thoughts associated with specific diseases or general suffering following trauma.
