Dysfunctional Posttraumatic Cognitions in Children and Adolescents

Background: Dysfunctional trauma-related cognitions play an important role in the aftermath of a traumatic event. Children and adolescents, who think that the experienced trauma has a permanent and disturbing impact on their actual life and their future, feel threatened. Study results show that dysfunctional posttraumatic cognitions correlate highly with posttraumatic stress symptoms (PTSS), depression, and anxiety. In addition, children and adolescents with a posttraumatic stress disorder (PTSD) have significantly more dysfunctional trauma-related cognitions than those without PTSD. Especially for children and adolescents it is important to consider interacting developmental and environmental factors. A developmental approach, nevertheless, has not been investigated yet.

Aims: The aims of the proposed study are to achieve a better understanding of dysfunctional trauma-related cognitions considering child and environmental factors in a cross-sectional and a longitudinal design.

Method: The sample consists of two different subsamples: 1) A hospital sample consisting of children and adolescents (school age: 7-18 years), who experienced an accidental trauma (either acute traffic accident or burn injury) assessed at three times: in the acute phase (7-14 days), 3 months, and 6 months after the trauma occurred. 2) An already existing clinical sample of 159 children and adolescents (TreatChildTrauma study), who mostly experienced an interpersonal trauma such as sexual or physical abuse. The total sample will be used to investigate the impact of child and environmental factors including trauma type, trauma frequency, age, gender, risk status pre trauma (psychopathological status pre trauma and traumatic events pre trauma), psychopathological status post trauma, and parental trauma-related cognitions. In addition, the hospital sample will be used for assessing the naturalistic time course of dysfunctional trauma-related cognitions as well as the association between cognitions, PTSS, depression, and anxiety over time. Moreover, the association between parental dysfunctional trauma-related cognitions and altered parenting as well as their impact on the child's cognitions will be investigated.

Relevance: Dysfunctional trauma-related cognitions have an important impact on coping with a traumatic event in childhood and adolescence. Nevertheless, no study has investigated the interaction between several child and environmental factors so far. A gain of knowledge in this area is important to improve treatments of trauma-related disorders.

Inclusion criteria

• child age between 7.0 and 18.0
• outpatient or inpatient medical care at the University Children's Hospital Zurich because of an injury after a traffic accident or a burn accident
• at least one parent participating

Exclusion criteria

• a severe comorbid head injury (Glasgow Coma Scale < 9)
• any previous evidence of pervasive developmental disorder
• an insufficient command of the German language of the participant or of the parents