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Abstract
Exposure to war trauma has been independently associated with posttraumatic stress
(PTSD) and other emotional disorders in children and adults. The aim of this study
was to establish the relationship between ongoing war traumatic experiences, PTSD
and anxiety symptoms in children, accounting for their parents' equivalent mental
health responses.
The study was conducted in the Gaza Strip, in areas under ongoing shelling and other
acts of military violence. The sample included 100 families, with 200 parents and
197 children aged 9-18 years. Parents and children completed measures of experience
of traumatic events (Gaza Traumatic Checklist), PTSD (Children's Revised Impact of
Events Scale, PTSD Checklist for parents), and anxiety (Revised Children's Manifest
Anxiety Scale, and Taylor Manifest Anxiety Scale for parents).
Both children and parents reported a high number of experienced traumatic events,
and high rates of PTSD and anxiety scores above previously established cut-offs. Among
children, trauma exposure was significantly associated with total and subscales PTSD
scores, and with anxiety scores. In contrast, trauma exposure was significantly associated
with PTSD intrusion symptoms in parents. Both war trauma and parents' emotional responses
were significantly associated with children's PTSD and anxiety symptoms.
Exposure to war trauma impacts on both parents' and children's mental health, whose
emotional responses are inter-related. Both universal and targeted interventions should
preferably involve families. These could be provided by non-governmental organizations
in the first instance.
To describe the psychometric properties of the Strengths and Difficulties Questionnaire (SDQ), a brief measure of the prosocial behavior and psychopathology of 3-16-year-olds that can be completed by parents, teachers, or youths. A nationwide epidemiological sample of 10,438 British 5-15-year-olds obtained SDQs from 96% of parents, 70% of teachers, and 91% of 11-15-year-olds. Blind to the SDQ findings, all subjects were also assigned DSM-IVdiagnoses based on a clinical review of detailed interview measures. The predicted five-factor structure (emotional, conduct, hyperactivity-inattention, peer, prosocial) was confirmed. Internalizing and externalizing scales were relatively "uncontaminated" by one another. Reliability was generally satisfactory, whether judged by internal consistency (mean Cronbach a: .73), cross-informant correlation (mean: 0.34), or retest stability after 4 to 6 months (mean: 0.62). SDQ scores above the 90th percentile predicted a substantially raised probability of independently diagnosed psychiatric disorders (mean odds ratio: 15.7 for parent scales, 15.2 for teacher scales, 6.2 for youth scales). The reliability and validity of the SDQ make it a useful brief measure of the adjustment and psychopathology of children and adolescents.
Clinical, field, and experimental studies of response to potentially stressful life events give concordant findings: there is a general human tendency to undergo episodes of intrusive thinking and periods of avoidance. A scale of current subjective distress, related to a specific event, was based on a list of items composed of commonly reported experiences of intrusion and avoidance. Responses of 66 persons admitted to an outpatient clinic for the treatment of stress response syndromes indicated that the scale had a useful degree of significance and homogeneity. Empirical clusters supported the concept of subscores for intrusions and avoidance responses.
The psychometric properties of the PTSD Checklist (PCL), a new, brief, self-report instrument, were determined on a population of 40 motor vehicle accident victims and sexual assault victims using diagnoses and scores from the CAPS (Clinician Administered PTSD Scale) as the criteria. For the PCL as a whole, the correlation with the CAPS was 0.929 and diagnostic efficiency was 0.900 versus CAPS. Examination of the individual items showed wide ranging values of individual item correlations ranging from 0.386 to 0.788, and with diagnostic efficiencies of 0.700 or better for symptoms. We support the value of the PCL as a brief screening instrument for PTSD.
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