A recent study published in the Journal of Psychological Medicine has identified key factors that explain how some children and adolescents develop mental health disorders such as post-traumatic stress disorder (PTSD), complex PTSD (CPTSD), depression, and anxiety after experiencing a traumatic event. The study emphasizes that cognitive psychological factors, particularly a child’s memory and perception of the trauma, are the strongest predictors of poor mental health outcomes. This research sheds light on how different mental health conditions can emerge in the aftermath of a single traumatic incident.
Involving 234 children aged 8 to 17 who had experienced traumatic events, the study assessed them at two- and nine-week post-trauma intervals through self-report questionnaires, parent interviews, and hospital data. This comprehensive approach allowed the researchers to develop four predictive models for PTSD, CPTSD, depression, and generalized anxiety disorder (GAD). The key factors predicting these mental health disorders are as follows:
- PTSD predictors: Panic and dissociation during trauma predicted PTSD, with cognitive factors explaining 55% of symptom variance.
- CPTSD predictors: Cognitive factors explained 59% of variance, with dissociation, maladaptive appraisals, and self-blame as significant predictors.
- Depression predictors: Female gender, prior trauma, social support, and maladaptive appraisals (56% variance explained) influenced depression.
- GAD predictors: Female gender, interpersonal trauma, appraisals, and dissociation were strong predictors, explaining 56% of variance.
Trauma-related cognitive factors, particularly appraisals and trauma memory qualities, were strongly associated with symptoms of PTSD, CPTSD, depression, and GAD. Among the predictive models, the cognitive model proved to be the most effective across all disorders, showing especially high predictive value for PTSD and CPTSD.
At the nine-week mark, 64% of the children did not meet the criteria for any mental health disorder. However, 23.5% were diagnosed with PTSD, 5.2% with CPTSD, 23.9% exhibited symptoms of clinical depression, and 10.7% developed symptoms of GAD. These findings underscore that while most children recover from trauma, a significant number may develop mental health issues in the following weeks.
The study revealed that a cognitive model, focused on how children think about and remember the traumatic event, was the most powerful predictor of PTSD, CPTSD, depression, and anxiety. Negative appraisals of the trauma such as viewing the event as extremely threatening or seeing themselves as permanently affected were linked to higher rates of mental health problems.
Conversely, models centered on psychosocial factors, like family dynamics and social support, were less effective in predicting mental health outcomes. Additionally, a child’s subjective view of the event’s severity, particularly the intensity with which they perceived the trauma, was more influential than objective indicators, such as physical injuries sustained. This highlights that a child’s mental processing of trauma plays a more crucial role in psychological recovery than the objective severity of the event.
The study findings support the use of trauma-focused cognitive-behavioral therapy (CBT) in treating young trauma survivors. CBT, which helps reframe negative trauma-related thoughts and beliefs, is crucial for preventing the development of PTSD, CPTSD, depression, and anxiety, according to the study. The study also highlighted differences between PTSD and CPTSD, noting that while both share core symptoms, CPTSD includes added emotional and psychological challenges, such as emotional regulation issues, deep shame, and relationship difficulties. Understanding how cognitive factors influence both PTSD and CPTSD can enhance trauma recovery interventions for children.
References
- Memarzia J, Lofthouse K, Dalgleish T, Boyle A, McKinnon A, Dixon C, et al. Predictive models of post-traumatic stress disorder, complex post-traumatic stress disorder, depression, and anxiety in children and adolescents following a single-event trauma. Psychological Medicine. 2024 Sep;54(12):3407–16.
- Torrico TJ, Mikes BA. Posttraumatic Stress Disorder in Children. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Oct 25]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK559140/