Dysfunctional posttraumatic cognitions, posttraumatic stress, and depression in children and adolescents exposed to trauma: A network analysis

Anke De Haan, Markus Landolt, Eiko Fried, Kristian Kleinke, Eva Alisic, Richard Bryant, Karen Salmon, Sue-Huei Chen, Shu-Tsen Liu, Tim Dalgleish, Anna McKinnon, Alice Alberici, Jade Claxton, Julia Diehle, Ramon Lindauer, Carlijn de Roos, Sarah Halligan, Rachel Hiller, Christian Haag Kristensen, Beatriz de Oliveira Meneguelo Lobo & 13 others Nicole Michaela Volkmann, Meghan Marsac, Lamia Barakat, Nancy Kassam-Adams, Reginald Nixon, Susan Hogan, Raika-Leena Punamaki, Esa Palosaari, Elizabeth Schilpzand, Rowena Conroy, Patrick Smith, William Yule, Richard Meiser-Stedman

Research output: Contribution to journalArticle

Abstract

Background: The latest version of the International Classification of Diseases (ICD-11) proposes a posttraumatic stress disorder (PTSD) diagnosis reduced to its core symptoms within the symptom clusters re-experiencing, avoidance, and hyperarousal. Since children and adolescents often show a variety of internalizing and externalizing symptoms in the aftermath of traumatic events, the question arises whether such a conceptualization of the PTSD diagnosis is supported in children and adolescents. Furthermore, although dysfunctional posttraumatic
cognitions (PTCs) appear to play an important role in the development and persistence of PTSD in children and adolescents, their function within diagnostic frameworks requires clarification.

Methods: We compiled a large international data set of 2313 children and adolescents aged 6 to 18 years exposed to trauma and calculated a network model including dysfunctional PTCs, PTSD core symptoms, and depression symptoms. Central items and relations between constructs were investigated.

Results: The PTSD re-experiencing symptoms strong or overwhelming emotions and strong physical sensations and the depression symptom difficulty concentrating emerged as most central. Items from the same construct were more strongly connected with each other than with items from the other constructs. Both dysfunctional PTCs and PTSD had a stronger connection
to depression than to each other.

Conclusions: Our findings provide support that a PTSD diagnosis reduced to its core symptoms could help to disentangle PTSD, depression, and dysfunctional PTCs. Investigating the role of depression longitudinally might give insight into the mechanisms and nature relating PTCs and PTSD.
Original languageEnglish
JournalJournal of Child Psychology and Psychiatry
Publication statusAccepted/In press - 6 Jun 2019

Cite this

Dysfunctional posttraumatic cognitions, posttraumatic stress, and depression in children and adolescents exposed to trauma: A network analysis. / De Haan, Anke; Landolt, Markus; Fried, Eiko; Kleinke, Kristian ; Alisic, Eva; Bryant, Richard; Salmon, Karen; Chen, Sue-Huei; Liu, Shu-Tsen; Dalgleish, Tim; McKinnon, Anna; Alberici, Alice; Claxton, Jade; Diehle, Julia; Lindauer, Ramon; de Roos, Carlijn; Halligan, Sarah; Hiller, Rachel; Kristensen, Christian Haag; Lobo, Beatriz de Oliveira Meneguelo ; Volkmann, Nicole Michaela; Marsac, Meghan; Barakat, Lamia; Kassam-Adams, Nancy; Nixon, Reginald; Hogan, Susan; Punamaki, Raika-Leena; Palosaari, Esa; Schilpzand, Elizabeth; Conroy, Rowena; Smith, Patrick; Yule, William; Meiser-Stedman, Richard.

In: Journal of Child Psychology and Psychiatry, 06.06.2019.

Research output: Contribution to journalArticle

De Haan, A, Landolt, M, Fried, E, Kleinke, K, Alisic, E, Bryant, R, Salmon, K, Chen, S-H, Liu, S-T, Dalgleish, T, McKinnon, A, Alberici, A, Claxton, J, Diehle, J, Lindauer, R, de Roos, C, Halligan, S, Hiller, R, Kristensen, CH, Lobo, BDOM, Volkmann, NM, Marsac, M, Barakat, L, Kassam-Adams, N, Nixon, R, Hogan, S, Punamaki, R-L, Palosaari, E, Schilpzand, E, Conroy, R, Smith, P, Yule, W & Meiser-Stedman, R 2019, 'Dysfunctional posttraumatic cognitions, posttraumatic stress, and depression in children and adolescents exposed to trauma: A network analysis', Journal of Child Psychology and Psychiatry.
De Haan, Anke ; Landolt, Markus ; Fried, Eiko ; Kleinke, Kristian ; Alisic, Eva ; Bryant, Richard ; Salmon, Karen ; Chen, Sue-Huei ; Liu, Shu-Tsen ; Dalgleish, Tim ; McKinnon, Anna ; Alberici, Alice ; Claxton, Jade ; Diehle, Julia ; Lindauer, Ramon ; de Roos, Carlijn ; Halligan, Sarah ; Hiller, Rachel ; Kristensen, Christian Haag ; Lobo, Beatriz de Oliveira Meneguelo ; Volkmann, Nicole Michaela ; Marsac, Meghan ; Barakat, Lamia ; Kassam-Adams, Nancy ; Nixon, Reginald ; Hogan, Susan ; Punamaki, Raika-Leena ; Palosaari, Esa ; Schilpzand, Elizabeth ; Conroy, Rowena ; Smith, Patrick ; Yule, William ; Meiser-Stedman, Richard. / Dysfunctional posttraumatic cognitions, posttraumatic stress, and depression in children and adolescents exposed to trauma: A network analysis. In: Journal of Child Psychology and Psychiatry. 2019.
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title = "Dysfunctional posttraumatic cognitions, posttraumatic stress, and depression in children and adolescents exposed to trauma: A network analysis",
abstract = "Background: The latest version of the International Classification of Diseases (ICD-11) proposes a posttraumatic stress disorder (PTSD) diagnosis reduced to its core symptoms within the symptom clusters re-experiencing, avoidance, and hyperarousal. Since children and adolescents often show a variety of internalizing and externalizing symptoms in the aftermath of traumatic events, the question arises whether such a conceptualization of the PTSD diagnosis is supported in children and adolescents. Furthermore, although dysfunctional posttraumatic cognitions (PTCs) appear to play an important role in the development and persistence of PTSD in children and adolescents, their function within diagnostic frameworks requires clarification.Methods: We compiled a large international data set of 2313 children and adolescents aged 6 to 18 years exposed to trauma and calculated a network model including dysfunctional PTCs, PTSD core symptoms, and depression symptoms. Central items and relations between constructs were investigated.Results: The PTSD re-experiencing symptoms strong or overwhelming emotions and strong physical sensations and the depression symptom difficulty concentrating emerged as most central. Items from the same construct were more strongly connected with each other than with items from the other constructs. Both dysfunctional PTCs and PTSD had a stronger connection to depression than to each other.Conclusions: Our findings provide support that a PTSD diagnosis reduced to its core symptoms could help to disentangle PTSD, depression, and dysfunctional PTCs. Investigating the role of depression longitudinally might give insight into the mechanisms and nature relating PTCs and PTSD.",
author = "{De Haan}, Anke and Markus Landolt and Eiko Fried and Kristian Kleinke and Eva Alisic and Richard Bryant and Karen Salmon and Sue-Huei Chen and Shu-Tsen Liu and Tim Dalgleish and Anna McKinnon and Alice Alberici and Jade Claxton and Julia Diehle and Ramon Lindauer and {de Roos}, Carlijn and Sarah Halligan and Rachel Hiller and Kristensen, {Christian Haag} and Lobo, {Beatriz de Oliveira Meneguelo} and Volkmann, {Nicole Michaela} and Meghan Marsac and Lamia Barakat and Nancy Kassam-Adams and Reginald Nixon and Susan Hogan and Raika-Leena Punamaki and Esa Palosaari and Elizabeth Schilpzand and Rowena Conroy and Patrick Smith and William Yule and Richard Meiser-Stedman",
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TY - JOUR

T1 - Dysfunctional posttraumatic cognitions, posttraumatic stress, and depression in children and adolescents exposed to trauma: A network analysis

AU - De Haan, Anke

AU - Landolt, Markus

AU - Fried, Eiko

AU - Kleinke, Kristian

AU - Alisic, Eva

AU - Bryant, Richard

AU - Salmon, Karen

AU - Chen, Sue-Huei

AU - Liu, Shu-Tsen

AU - Dalgleish, Tim

AU - McKinnon, Anna

AU - Alberici, Alice

AU - Claxton, Jade

AU - Diehle, Julia

AU - Lindauer, Ramon

AU - de Roos, Carlijn

AU - Halligan, Sarah

AU - Hiller, Rachel

AU - Kristensen, Christian Haag

AU - Lobo, Beatriz de Oliveira Meneguelo

AU - Volkmann, Nicole Michaela

AU - Marsac, Meghan

AU - Barakat, Lamia

AU - Kassam-Adams, Nancy

AU - Nixon, Reginald

AU - Hogan, Susan

AU - Punamaki, Raika-Leena

AU - Palosaari, Esa

AU - Schilpzand, Elizabeth

AU - Conroy, Rowena

AU - Smith, Patrick

AU - Yule, William

AU - Meiser-Stedman, Richard

PY - 2019/6/6

Y1 - 2019/6/6

N2 - Background: The latest version of the International Classification of Diseases (ICD-11) proposes a posttraumatic stress disorder (PTSD) diagnosis reduced to its core symptoms within the symptom clusters re-experiencing, avoidance, and hyperarousal. Since children and adolescents often show a variety of internalizing and externalizing symptoms in the aftermath of traumatic events, the question arises whether such a conceptualization of the PTSD diagnosis is supported in children and adolescents. Furthermore, although dysfunctional posttraumatic cognitions (PTCs) appear to play an important role in the development and persistence of PTSD in children and adolescents, their function within diagnostic frameworks requires clarification.Methods: We compiled a large international data set of 2313 children and adolescents aged 6 to 18 years exposed to trauma and calculated a network model including dysfunctional PTCs, PTSD core symptoms, and depression symptoms. Central items and relations between constructs were investigated.Results: The PTSD re-experiencing symptoms strong or overwhelming emotions and strong physical sensations and the depression symptom difficulty concentrating emerged as most central. Items from the same construct were more strongly connected with each other than with items from the other constructs. Both dysfunctional PTCs and PTSD had a stronger connection to depression than to each other.Conclusions: Our findings provide support that a PTSD diagnosis reduced to its core symptoms could help to disentangle PTSD, depression, and dysfunctional PTCs. Investigating the role of depression longitudinally might give insight into the mechanisms and nature relating PTCs and PTSD.

AB - Background: The latest version of the International Classification of Diseases (ICD-11) proposes a posttraumatic stress disorder (PTSD) diagnosis reduced to its core symptoms within the symptom clusters re-experiencing, avoidance, and hyperarousal. Since children and adolescents often show a variety of internalizing and externalizing symptoms in the aftermath of traumatic events, the question arises whether such a conceptualization of the PTSD diagnosis is supported in children and adolescents. Furthermore, although dysfunctional posttraumatic cognitions (PTCs) appear to play an important role in the development and persistence of PTSD in children and adolescents, their function within diagnostic frameworks requires clarification.Methods: We compiled a large international data set of 2313 children and adolescents aged 6 to 18 years exposed to trauma and calculated a network model including dysfunctional PTCs, PTSD core symptoms, and depression symptoms. Central items and relations between constructs were investigated.Results: The PTSD re-experiencing symptoms strong or overwhelming emotions and strong physical sensations and the depression symptom difficulty concentrating emerged as most central. Items from the same construct were more strongly connected with each other than with items from the other constructs. Both dysfunctional PTCs and PTSD had a stronger connection to depression than to each other.Conclusions: Our findings provide support that a PTSD diagnosis reduced to its core symptoms could help to disentangle PTSD, depression, and dysfunctional PTCs. Investigating the role of depression longitudinally might give insight into the mechanisms and nature relating PTCs and PTSD.

M3 - Article

JO - Journal of Child Psychology and Psychiatry

JF - Journal of Child Psychology and Psychiatry

SN - 0021-9630

ER -