In a sample of 59 children and adolescents (7–14 years) exposed to interpersonal trauma, Carrion et al. In the adolescent group (12–14 years), the odds for functional impairment was increased in adolescents exhibiting diminished interest in activities, irritability, concentration problems, or sleep problems. In the pre-adolescent group (7–11 years), the odds for functional impairment were increased in children exhibiting psychological cue reactivity, physiological cue reactivity, avoidance of thoughts/feelings, irritability, concentration problems, or hypervigilance. Vibhakar investigated the relationship between distinct PTSD symptoms and overall functional impairment in a sample of non-mental health treatment referred pre-adolescents and adolescents following an accident or unintentional injury. To date, only two studies of children and adolescents explored the associations between PTSD symptoms and functional impairment. This might help tailor therapy according to the needs of patients from the start, and as a result, could help to prevent children and adolescents from following a negative developmental trajectory. Therefore, knowing the functionally most impairing PTSD symptoms in trauma-exposed children and adolescents would inform clinicians about the complex interplay between PTSS and symptom-related impairment in daily function. Furthermore, there is evidence that not all symptoms resolve at the end of treatment and that symptom-related functional impairment may follow a chronic trajectory. Whether certain symptoms might be more impairing than other is highly relevant from both a theoretical and a clinical perspective because patients exhibit large differences in symptom presentation. Yet, thorough investigations in children and adolescents are missing. Given the highly differential nature of symptoms within the diagnostic criteria however, it is highly unlikely that all symptoms have an equal impairing impact. Research endeavors, albeit only in adult samples, have shown a strong link between PTSD symptomatology and functional impairment(s). PTSD often has an impact on children’s and adolescents’ social or educational spheres, compromising the ability to perform and take part in important and desired daily aspects of life. PTSD is a highly heterogeneous disorder comprising internalizing and externalizing symptoms divided into clusters of intrusion, avoidance, negative cognition and mood, and hyperarousal. Nearly 16% of children and adolescents develop post-traumatic stress disorder (PTSD) following trauma exposure. Population-based and clinical-based studies indicate that a vast number of children and adolescents are exposed to one or several potentially traumatic events (PTEs). ConclusionĪs negative beliefs, emotional numbing symptoms, concentration problems and irritability may be especially related to functional impairment in traumatized children and adolescents, monitoring and targeting these symptoms throughout therapy might be of particular importance to restore functioning as early as possible and to facilitate overall recovery. Further, the hyperarousal symptom irritability showed a unique high association with functional impairment in the US sample. Negative beliefs, detachment from others, inability to experience positive emotions, and diminished interest in activities within the symptom cluster negative alterations in cognitions and mood, and the hyperarousal symptom concentration problems accounted for the largest proportions of unique variance explained in functional impairment in both samples. Utilizing relative importance analyses, unique shared variance of each DSM-5 PTSS with functional impairment were estimated in clinical samples of 3400 Norwegian ( M age = 14.18, SD age = 2.49, range age = 7–17) and 747 US ( M age = 10.76, SD age = 3.10, range age = 7–17) children and adolescents from naturalistic settings. Identifying PTSS that have the most impact on functional impairment can broaden our understanding of post-trauma reactions and guide the selection of treatment components and techniques required to help patients to restore functioning following trauma exposure. This study aims to provide a better understanding of the individual impact of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) post-traumatic stress symptoms (PTSS) on functional impairment in trauma-exposed children and adolescents.
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