Sidsel Karsberg

Post-traumatic stress symptoms and childhood abuse categories in a national representative sample for a specific age group: associations to body mass index

Background: Studies of specific groups such as military veterans have found that posttraumatic stress disorder (PTSD) is linked to adverse health outcomes including unhealthy weight. The aim of this study was to examine the relationship between PTSD symptoms, experiences of childhood trauma and weight in a community sample. Methods: A stratified random probability survey was conducted in Denmark by the Danish National Centre for Social Research between 2008 and 2009 with 2,981 participants born in 1984, achieving a response rate of 67%. The participants were interviewed with a structured interview with questions pertaining PTSD symptomatology, exposure to childhood abuse, exposure to potentially traumatizing events, height, and weight. Underweight was defined by a body mass index (BMI) <18.5, overweight was defined by a BMI ≥25 and <30 and obesity was defined by a BMI ≥30. Results: PTSD symptomatology and childhood abuse were significantly associated with both underweight and overweight/obesity. Childhood emotional abuse was especially associated with underweight, whereas sexual abuse and overall abuse were particularly associated with overweight/obesity. Conclusion: These findings indicate that health care professionals may benefit from assessing PTSD and childhood abuse in the treatment of both overweight and underweight individuals.

Victimization and PTSD in a rural Kenyan youth sample

Within the last ten years, there has been a growing number of epidemiological studies, examining the effect of trauma exposure in children and adolescents. Although studies concerning Post-traumatic Stress Disorder (PTSD) have been conducted in a wide array of different cultural contexts [1], the knowledge on traumatization and development of PTSD is still limited [2]. Most studies conducted are clinical studies, which deal with subjects that have already been traumatized or affected by specific single events such as war [3], natural disasters [1], serious accidents [4] or physical/sexual abuse [5-7]. Though research indicates that adolescents are very vulnerable to the exposure of Potentially Traumatic Events (PTEs) [8], studies targeting non-clinical youth populations and the impact of their life experiences are very few. With the increasing ethnic diversity of populations worldwide, it is of particular interest to compare the prevalence of exposure and PTSD in children and adolescents of different ethnic backgrounds. When designing preventive interventions and treatment programs for youth suffering from PTSD it is crucial to understand the complex interaction of variables behind the disorder. Differences in prevalence of exposure, PTSD and demographic variables between ethnicities may reveal some important clues to the etiology of the disease. The present study replicated six previous non-clinical studies which were designed to provide epidemiological information about exposure to PTEs, and the prevalence of PTSD among adolescents (see Table 1). The six studies were conducted in different countries and were very similar in their research methods and samples. The studies have been conducted in four European countries: Denmark [9], Iceland, [10], Lithuania [11], and the Faroe Islands [2], as well as in two Asian countries: Israel [12], and India [13] of which the four first samples were nationally representative.

Impact of Traumatic Events on Posttraumatic Stress Disorder among Danish Survivors of Sexual Abuse in Childhood

Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute to the development and severity of posttraumatic stress disorder.

Victimisation and PTSD in a Greenlandic youth sample

Background. Despite a growing number of studies and reports indicating a very high and increasing prevalence of trauma exposure in Greenlandic adolescents, the knowledge on this subject is still very limited. The purpose of the present study was twofold: To estimate the lifetime prevalence of potentially traumatic events (PTEs) and post-traumatic stress disorder (PTSD) and to examine the relationship between PTEs, estimated PTSD, and sociodemographic variables. Methods. In a Greenlandic sample from 4 different schools in 2 different minor towns in Northern Greenland, 269 students, aged 12–18 (M=15.4; SD=1.84) were assessed for their level of exposure to 20 PTEs along with the psychological impact of these events. Results. Of the Greenlandic students, 86% had been directly exposed to at least 1 PTE and 74.3% had been indirectly exposed to at least 1 PTE. The mean number of directly experienced PTEs was 2.8 and the mean number of indirectly experienced PTEs was 3.9. The most frequent direct events recorded were death of someone close, near drowning, threat of assault/beating, humiliation or persecution by others and attempted suicide. The estimated lifetime prevalence of PTSD was 17.1%, whereas another 14.2% reached a subclinical level of PTSD (missing the full diagnosis by 1 symptom). Education level of the father, and being exposed to multiple direct and indirect PTEs were significantly associated with an increase in PTSD symptoms. Conclusion. The findings indicate substantial mental health problems in Greenlandic adolescents and that these are associated with various types of PTEs. Furthermore, the findings indicate that Greenlandic adolescents are more exposed to certain specific PTEs than adolescents in similar studies from other nations. The present study revealed that Greenlandic girls are particularly vulnerable towards experiencing PTEs. Indeed, in general, girls reported more experiences of direct and indirect PTEs. Furthermore, girls reported being more commonly exposed to specific types of PTEs compared to boys.

Validation of the PTSD screening cartoon test "Darryl" in a Danish clinical sample of children and adolescents.

The current study examined the reliability and validity of a Danish adaptation of “Darryl”, a cartoon‐based measure of DSM‐IV symptoms of post‐traumatic stress disorder (PTSD) in a sample of Danish children and adolescents. Exposure to potentially traumatizing events, PTSD symptoms and diagnostic status were assessed in 65 children between the ages of 7 and 17 years old. Participants were recruited from a crisis centre for battered women and a school for children with emotional and behavioural problems. The study revealed that Darryl has good internal consistency for the overall scale and adequate reliability for each DSM‐IV symptom cluster. Scores from Darryl were significantly correlated with the Clinician Administered PTSD Scale for Children and Adolescents (CAPS‐CA) scores and receiver operating characteristic (ROC) analysis showed that it could significantly predict the presence of a PTSD diagnosis according to the CAPS‐CA. In comparison to the CAPS‐CA, Darryl has comparable psychometric properties and assesses PTSD symptoms in a developmentally appropriate manner. Furthermore, Darryl is quick to administer and was easier for the children in this sample to comprehend than the more traditional measure of PTSD. Overall, Darryl is an effective instrument for screening children at risk of a PTSD diagnosis. The relatively high specificity suggests that screening positive for PTSD using Darryl merits further diagnostic assessment. Copyright

The Association Between Distinct Categories of Child Abuse Experiences and Dating Violence in Early Adolescence

Recent studies have shown significant associations between child maltreatment experiences and adolescent dating violence (ADV). However, few have investigated whether these associations differ by type of violence. The present study examined whether associations with four different ADV subgroups differed by the type of child maltreatment experienced. In total, 2934 7th grade students aged 12–15 (M = 13.5, SD = .5) filled out questionnaires at school. Logistic regression models which included eight potential confounding variables including gender, low SES, parenting styles as well as four forms of child abuse (i.e. emotional, physical, and sexual abuse, witnessing domestic violence), were performed to assess the impact of child maltreatment on the likelihood that the students would either be a victim or perpetrator of four distinct ADV subgroups (i.e. emotional only, physical, sexual only, multiple). Child sexual abuse was by far the strongest predictor of ADV, with odds ratios of 3.44 to 43.41. The remaining maltreatment types were associated with different types of ADV to varying degrees. The findings indicate a complex interaction between child maltreatment and ADV. To fully understand the complexity of the transmission of violence, further research on associations between subcategories of child maltreatment and ADV is suggested. More detailed knowledge on different child maltreatment experiences in relation to ADV would enable more specific targeting in future prevention programs aimed at reducing ADV.