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The importance of the DSM-5 posttraumatic stress disorder symptoms of cognitions and mood in traumatized children and adolescents: two network approaches.
J Child Psychol Psychiatry 2019; 60(5):545-554JC

Abstract

BACKGROUND

The aim of this study is to provide a better understanding of the central symptoms of DSM-5 posttraumatic stress disorder (PTSD) in children and adolescents from the perspective of the child and its caregiver. Identifying core symptoms of PTSD can help clinicians to understand what may be relevant targets for treatment. PTSD may present itself differently in children and adolescents compared to adults, and no study so far has investigated the DSM-5 PTSD conceptualization using network analysis.

METHODS

The network structure of DSM-5 PTSD was investigated in a clinical sample of n = 475 self-reports of children and adolescents and n = 424 caregiver-reports using (a) regularized partial correlation models and (b) a Bayesian approach computing directed acyclic graphs (DAGs).

RESULTS

(a) The 20 DSM-5 PTSD symptoms were positively connected within the self-report and the caregiver-report sample. The most central symptoms were negative trauma-related cognitions and persistent negative emotional state for the self-report and negative trauma-related cognitions, intrusive thoughts or memories and exaggerated startle response for the caregiver-report. (b) Similarly, symptoms in the negative alterations in cognitions and mood cluster (NACM) have emerged as key drivers of other symptoms in traumatized children and adolescents.

CONCLUSIONS

As the symptoms in the DSM-5 NACM cluster were central in our regularized partial correlation networks and also appeared to be the driving forces in the DAGs, these might represent important symptoms within PTSD symptomatology and may offer key targets in PTSD treatment for children and adolescents.

Authors+Show Affiliations

Clinic for Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany.Harborview Center for Sexual Assault and Traumatic Stress, Seattle, WA, USA.Norwegian Center for Violence and Traumatic Stress Studies, Oslo. Mental & Physical Health, Norwegian Institute of Public Health, Oslo.Norwegian Center for Violence and Traumatic Stress Studies, Oslo. Department of Psychology, University of Oslo, Oslo, Norway.Harborview Center for Sexual Assault and Traumatic Stress, Seattle, WA, USA.Clinic for Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany. Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.Center on Child Abuse and Neglect, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.Institute for Psychology and Education, Ulm University, Ulm.Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany.Clinic for Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30648742

Citation

Bartels, Lasse, et al. "The Importance of the DSM-5 Posttraumatic Stress Disorder Symptoms of Cognitions and Mood in Traumatized Children and Adolescents: Two Network Approaches." Journal of Child Psychology and Psychiatry, and Allied Disciplines, vol. 60, no. 5, 2019, pp. 545-554.
Bartels L, Berliner L, Holt T, et al. The importance of the DSM-5 posttraumatic stress disorder symptoms of cognitions and mood in traumatized children and adolescents: two network approaches. J Child Psychol Psychiatry. 2019;60(5):545-554.
Bartels, L., Berliner, L., Holt, T., Jensen, T., Jungbluth, N., Plener, P., ... Sachser, C. (2019). The importance of the DSM-5 posttraumatic stress disorder symptoms of cognitions and mood in traumatized children and adolescents: two network approaches. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 60(5), pp. 545-554. doi:10.1111/jcpp.13009.
Bartels L, et al. The Importance of the DSM-5 Posttraumatic Stress Disorder Symptoms of Cognitions and Mood in Traumatized Children and Adolescents: Two Network Approaches. J Child Psychol Psychiatry. 2019;60(5):545-554. PubMed PMID: 30648742.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The importance of the DSM-5 posttraumatic stress disorder symptoms of cognitions and mood in traumatized children and adolescents: two network approaches. AU - Bartels,Lasse, AU - Berliner,Lucy, AU - Holt,Tonje, AU - Jensen,Tine, AU - Jungbluth,Nathaniel, AU - Plener,Paul, AU - Risch,Elizabeth, AU - Rojas,Roberto, AU - Rosner,Rita, AU - Sachser,Cedric, Y1 - 2019/01/16/ PY - 2018/10/24/accepted PY - 2019/1/17/pubmed PY - 2019/1/17/medline PY - 2019/1/17/entrez KW - DSM-5 KW - Posttraumatic stress symptoms KW - children and adolescents KW - network analysis SP - 545 EP - 554 JF - Journal of child psychology and psychiatry, and allied disciplines JO - J Child Psychol Psychiatry VL - 60 IS - 5 N2 - BACKGROUND: The aim of this study is to provide a better understanding of the central symptoms of DSM-5 posttraumatic stress disorder (PTSD) in children and adolescents from the perspective of the child and its caregiver. Identifying core symptoms of PTSD can help clinicians to understand what may be relevant targets for treatment. PTSD may present itself differently in children and adolescents compared to adults, and no study so far has investigated the DSM-5 PTSD conceptualization using network analysis. METHODS: The network structure of DSM-5 PTSD was investigated in a clinical sample of n = 475 self-reports of children and adolescents and n = 424 caregiver-reports using (a) regularized partial correlation models and (b) a Bayesian approach computing directed acyclic graphs (DAGs). RESULTS: (a) The 20 DSM-5 PTSD symptoms were positively connected within the self-report and the caregiver-report sample. The most central symptoms were negative trauma-related cognitions and persistent negative emotional state for the self-report and negative trauma-related cognitions, intrusive thoughts or memories and exaggerated startle response for the caregiver-report. (b) Similarly, symptoms in the negative alterations in cognitions and mood cluster (NACM) have emerged as key drivers of other symptoms in traumatized children and adolescents. CONCLUSIONS: As the symptoms in the DSM-5 NACM cluster were central in our regularized partial correlation networks and also appeared to be the driving forces in the DAGs, these might represent important symptoms within PTSD symptomatology and may offer key targets in PTSD treatment for children and adolescents. SN - 1469-7610 UR - https://www.unboundmedicine.com/medline/citation/30648742/The_importance_of_the_DSM_5_posttraumatic_stress_disorder_symptoms_of_cognitions_and_mood_in_traumatized_children_and_adolescents:_two_network_approaches_ L2 - https://doi.org/10.1111/jcpp.13009 DB - PRIME DP - Unbound Medicine ER -