The child and Adolescent Trauma Screen 2 (CATS-2) - validation of an instrument to measure DSM-5 and ICD-11 PTSD and complex PTSD in children and adolescents.

Background: The study examined the psychometric properties of the Child and Adolescent Trauma Screen 2 (CATS-2) as a measure of posttraumatic stress disorder (PTSD) according to DSM-5 and (Complex) PTSD following the ICD-11 criteria in children and adolescents (7-17 years). Methods: Psychometric properties were investigated in an international sample of traumatized children and adolescents (N = 283) and their caregivers (N = 255). We examined the internal consistency (α), convergent and discriminant validity, the factor structure of the CATS-2 total scores, latent classes of PTSD/Complex PTSD (CPTSD) discrimination, as well as the diagnostic utility using ROC-curves. Results: The DSM-5 total score (self: α = .89; caregiver: α = .91), the ICD-11 PTSD total score (self: α = .67; caregiver: α = .79) and the ICD-11 CPTSD total score (self: α = .83; caregiver: α = .87) have proven acceptable to excellent reliability. The latent structure of the 12-item ICD-11 PTSD/CPTSD construct was consistent with prior findings. Latent profile analyses revealed that ICD-11 CPTSD was empirically distinguishable from ICD-11 PTSD using the CATS-2. ROC-analysis using the CAPS-CA-5 as outcome revealed that CATS-2 DSM-5 PTSD scores of ≥21 (screening) to ≥25 (diagnostic) were optimally efficient for detecting probable DSM-5 PTSD diagnosis. For the ICD-11 PTSD scale scores of ≥7 (screening) to ≥9 (diagnostic) were optimally efficient for detecting probable DSM-5 PTSD diagnosis. Conclusions: The CATS-2 is a brief, reliable and valid measure of DSM-5 PTSD, ICD-11 PTSD and CPTSD symptomatology in traumatized children and adolescents, allowing crosswalk between diagnostic systems using one measure. HIGHLIGHTS: The CATS-2 screens for potentially traumatic events (PTEs) and PTSD symptoms.The CATS-2 captures DSM-5 and ICD-11 criteria for PTSD and CPTSD and enables clinicians and researchers to crosswalk between both diagnostic systems.International validation has proven good psychometric properties and presents cut-off scoresThe CATS-2 is a license-free instrument and is freely accessible.

Perceived social support and posttraumatic stress symptoms in children and youth in therapy: A parallel process latent growth curve model.

Many studies show that perceived social support protects against the development of posttraumatic stress symptoms (PTSS) in the aftermath of trauma, but less is known about support in relation to PTSS in trauma therapy. This study examined associations between perceived social support and PTSS in children and adolescents during trauma therapy. Parallel process latent growth curve modeling was used to examine trajectories of perceived social support and PTSS over five measurement waves in a sample of 156 patients, aged between 10 and 18 years (M age = 15.1, SD = 2.2, 79.5% girls), randomized to receive trauma-focused cognitive behavior therapy (TF-CBT) or therapy-as-usual (TAU). Across all participants there was an average decline in PTSS and increase of perceived social support from pre-therapy to 18 months after therapy. Most of the change occurred during therapy and was maintained after therapy. Higher levels of PTSS prior to therapy were associated with lower levels of perceived social support prior to therapy, and a decrease in PTSS was associated with increase in perceived social support. This co-development may have been directed by a third underlying factor or short-term temporal effects. Studies investigating within-person associations over shorter time intervals will benefit our understanding of possible temporal effects.

A decennial review of psychotraumatology: what did we learn and where are we going?

On 6 December 2019 we start the 10th year of the European Journal of Psychotraumatogy (EJPT), a full Open Access journal on psychotrauma. This editorial is part of a special issue/collection celebrating the 10 years anniversary of the journal where we will acknowledge some of our most impactful articles of the past decade (also discussed below and marked with * in the reference list). In this editorial the editors present a decennial review of the field addressing a range of topics that are core to both the journal and to psychotraumatology as a discipline. These include neurobiological developments (genomics, neuroimaging and neuroendocrine research), forms of trauma exposure and impact across the lifespan, mass trauma and early interventions, work-related trauma, trauma in refugee populations, and the potential consequences of trauma such as PTSD or Complex PTSD, but also resilience. We address innovations in psychological, medication (enhanced) and technology-assisted treatments, mediators and moderators like social support and finally how new research methods help us to gain insights in symptom structures or to better predict symptom development or treatment success. We aimed to answer three questions 1. Where did we stand in 2010? 2. What did we learn in the past 10 years? 3. What are our knowledge gaps? We conclude with a number of recommendations concerning top priorities for the future direction of the field of psychotraumatology and correspondingly the journal.

El 6 de diciembre de 2019 comenzamos el décimo año de la European Journal of Psychotraumatogy (EJPT), una revista de acceso abierto completa sobre psicotrauma. Esta editorial es parte de un número especial que celebra el décimo aniversario de la revista y reconoce algunos de nuestros artículos más impactantes de la última década. En esta editorial, los editores presentan una revisión decenal del campo que aborda una gama de temas que son fundamentales tanto para la revista como para la psicotraumatología como disciplina. Estos incluyen desarrollos neurobiológicos (genómica, neuroimagen e investigación neuroendocrina), formas de exposición a traumas e impacto a lo largo de la vida, traumas masivos e intervenciones tempranas, traumas relacionados con el trabajo, traumas en poblaciones de refugiados y las posibles consecuencias de traumas como el trastorno de estrés postraumático (TEPT) o TEPT complejo, pero también resiliencia. Abordamos las innovaciones en tratamientos psicológicos, medicamentos (mejorados) y asistidos por tecnología, mediadores y moderadores como el apoyo social y, finalmente, cómo los nuevos métodos de investigación nos ayudan a obtener información sobre las estructuras de los síntomas o predecir mejor el desarrollo de los síntomas o el éxito del tratamiento. Nuestro objetivo fue responder tres preguntas 1. ¿Dónde nos encontrábamos en 2010? 2. ¿Qué aprendimos en los últimos 10 años? y 3. ¿Cuáles son nuestras brechas de conocimiento? Concluimos con una serie de recomendaciones sobre las principales prioridades para la dirección futura del campo de la psicotraumatología y, en consecuencia, la revista.

Loss of Trust May Never Heal. Institutional Trust in Disaster Victims in a Long-Term Perspective: Associations With Social Support and Mental Health.

Natural disasters, technological disasters, and terrorist attacks have an extensive aftermath, often involving society's institutions such as the legal system and the police. Victims' perceptions of institutional trustworthiness may impact their potential for healing. This cross-sectional study investigates institutional trust, health, and social support in victims of a disaster that occurred in 1990. We conducted face-to-face interviews with 184 survivors and bereaved, with a 60% response rate 26 years after the disaster. Levels of trust in the police and in the justice system were compared with general population data. We assessed the relationships between institutional trust and current psychological distress, social support, and life satisfaction. The levels of trust in the police and in the justice system were notably lower in survivors and bereaved than in the general population. Among the victims, low institutional trust was associated with more mental health problems, poorer social support, more barriers to seeking social support, and a lower life satisfaction. Lost trust in the aftermath of a disaster may perhaps never be restored and the lack of trust may act to strengthen or maintain health problems. An exclusively individualistic approach to trauma and disaster may miss out on the opportunities for promoting health and well-being that lies within the larger societal structures. Decision-makers should take this information into account, and acknowledge the potential long-term consequences of institutional performance in the aftermath of a disaster.

Gender Differences in Posttraumatic Stress Symptoms after a Terrorist Attack: A Network Approach.

Background: Posttraumatic stress symptoms are more prevalent in women than in men. To improve our understanding of gender differences in PTSD, detailed knowledge about the underlying symptom networks and gender specific symptom profiles is needed. Objective: We aimed to describe the gender differences in levels of individual posttraumatic stress symptoms after a terrorist attack, as well as identify possible gender differences in associations between posttraumatic stress symptoms. Method: This study used survey data from ministerial employees directly (n = 190) and indirectly (n = 1,615) exposed to the 2011 Oslo bombing. Data was collected approximately 10 months after the event. In order to investigate gender differences in levels of symptoms, we used bootstrapped means and standard deviations. Network analyses were conducted to identify gender differences in the associations between posttraumatic stress symptoms. Results: Women reported higher levels of all symptoms, and the strongest effect sizes were found for symptoms of re-experiencing, and anxious and dysphoric arousal. Among individuals with considerable levels of posttraumatic stress symptoms, women reported higher levels of physiological cue activity and exaggerated startle response. No significant gender differences in the networks of posttraumatic stress were found. Conclusions: The present results find no indication that the gender difference in prevalence of PTSD can be explained by differences in associations between symptoms. In order to determine if this finding can be applied to other participants and circumstances, future studies should seek to replicate this study in both community and clinical samples.

Basic psychological need satisfaction in leisure activities and adolescents' life satisfaction.

Participation in leisure activities is an important arena for the positive psychological development of adolescents. The present study set out to examine the relationship between adolescents' satisfaction of the psychological needs for competence, relatedness, and autonomy in their participation in leisure activities and their perceived life satisfaction. The aim was to identify the extent to which satisfaction of the three needs explained the relationship between participation in leisure activities and life satisfaction. These proposed mechanisms were based on previous empirical work and the theoretical frameworks of self-determination theory, and were tested in a nationally representative sample of Norwegian adolescents (N = 3,273) aged 15 and 16 years (51.8 % boys). The structural equation analysis showed that competence and relatedness satisfaction fully mediated the association between participation in activities and life satisfaction. Autonomy satisfaction had a direct positive effect on life satisfaction but did not show any mediation effect. The positive processes of psychological need satisfaction, and especially the need for competence and relatedness, experienced in the leisure activity domain thus seem to be beneficial for adolescents' well-being. These findings add to previous research investigating the positive impact of need satisfaction in other important domains in the lives of children and adolescents.