Parents May Not Recognize Kids’ PTSD

New research finds that young children may experience post-traumatic stress disorder (PTSD) for years without it being recognized by their parents.

In a new U.K. study, University of East Anglia (UEA) researchers investigated how children under 10 can experience PTSD weeks, months, and years after a traumatic event.

They discovered that children’s suffering is often under-recognized by parents despite being shaped to a large extent by the parents’ own stress in response to the child’s trauma.

“When people talk about PTSD they often think about soldiers returning from war zones. But children who experience traumatic events such as car accidents, assaults, and natural disasters are also at risk of developing post-traumatic stress disorder,” said researcher Dr. Richard Meiser-Stedman.

“Symptoms can include traumatic memories and nightmares, avoiding reminders of the trauma, and feeling like the world is very unsafe.

“We wanted to find out about how prevalent PTSD is in children three years after a trauma, and learn if parents recognize that their child is affected.

“We were also interested in whether early signs of stress soon after a trauma could predict PTSD further down the line. And whether factors such as trauma severity, intellect, and parental mental health can predict whether a child will go on to experience more chronic PTSD.”

The research team followed more than 100 children aged between two and 10 who had been involved in a road accident such as being involved in a car crash, being hit as a pedestrian, or knocked off their bike.

All had been taken to the hospital with varying injuries, including bruising, fracture, or losing consciousness. The children were assessed for PTSD between two and four weeks after the incident, then again at six months, and finally after three years.

The team assessed the children using standard criteria for diagnosing PTSD in young children. Those over the age of seven were interviewed, as well as all parents or caregivers.

Intellectual ability, parental mental health, and demographic variables were taken into account.

Researchers discovered the following key findings:

• Children showing signs of stress soon after a trauma will not necessarily go on to suffer PTSD after three years;
• Some children may develop PTSD that persists for years following a trauma, but this is only likely to happen in a minority of cases. Most will “bounce back” naturally in time;
• Most parents of children still experiencing difficulties after three years did not recognize their child’s PTSD. Relying on parent reports of PTSD may therefore be inadequate for identifying chronic patterns in young children;
• Trauma severity was linked with incidence of PTSD up to six months after an accident, but not three years after;
• A child’s intelligence and age were not linked with incidence of PTSD;
• Children were more likely to suffer PTSD after a trauma if their parents also suffered PTSD, both soon after the event, and even three years afterwards. But even these parents may not spot their child’s suffering.

Meiser-Stedman said, “This study reveals some really interesting links between how children and their parents respond to a trauma.

“We found that children may experience PTSD for years without it being recognized by their parents. We also found a strong link between parents suffering PTSD and their children suffering as well — even years after the traumatic event.

“This could be because parental stress early on is worsened by their children’s symptoms, or because the child’s responses are shaped by their parents’ initial reactions, or a bit of both, leading to an amplification of symptoms for both parties.

“Interestingly, even in these cases, the parents were still unlikely to acknowledge their children’s suffering.

“This study strengthens the case for considering parental mental health, and providing support for both children and their parents in the aftermath of a trauma to reduce the long-term effects for both,” he added.

Source: University of East Anglia

Automated Detection of Early Autism May Improve Outcomes

Presently, there is no medical test to diagnose autism spectrum disorder. The disorder is usually diagnosed around 36 months based on behavior although sometimes the diagnosis occurs later in life, often in relation to learning, social, or emotional difficulties.

New research suggests genetic detection of this brain disorder could mean more timely interventions that improve life for the patient and their families.

Investigators suggest that in the near future, machine learning might be used to analyze genetic data that points to an ASD diagnosis before symptoms become obvious.

A new study describing this approach is published in the International Journal of Data Mining and Bioinformatics.

Fuad Alkoot of PAAET in Kuwait, and Abdullah Alqallaf, Ph.D., of Kuwait University, Kuwait, said that unlike other conditions, such as cancer, little attention has focused on the possibility of early genetic detection of autism.

In the study, investigators report that they have developed a four-stage computerized neural network system for testing simplified genetic data.

The system traces between 150 and 500 features present on different chromosomes and known to be associated with ASD when certain genetic patterns are present.

The team points out that symptoms in ASD increase as the child gets older and so earlier diagnosis can offer the opportunity of treatment that might ameliorate some problems associated with the condition.

At present, diagnosis relies only on expert assessment by a medical specialist. However, ambiguous symptoms in the early stages may well preclude a definitive diagnosis.

In contrast, the inclusion of genetic characteristics strongly correlated with ASD in the diagnostic process might offer a stronger diagnosis or help rule out autism in a given case.

This approach could also have implications for a better understanding of how ASD arises, particularly as current theory suggests a mixture of genetic and environmental factors are involved.

“The implementation of such a system will lead to early intervention and enable us to detect if a subject has the potential to develop autism using the subjects’ gene data, even before any behavioral symptoms start to appear,” the team reported.

Source: AlphaGalileo

Age May Best Youth When Learning New Thinking Skills

A new study has found that older adolescents and adults can learn certain thinking skills, including non-verbal reasoning, more effectively than younger people.

Published in Psychological Science, the study also highlights the fact that non-verbal reasoning skills can be readily trained and do not represent an innate, fixed ability.

“Although adults and older adolescents benefitted most from training in non-verbal reasoning, the average test score for adolescents aged 11-13 improved from 60 percent to 70 percent following three weeks of 10-minute online training sessions,” said Professor Sarah-Jayne Blakemore of the University College London Institute of Cognitive Neuroscience.

“This calls into question the claim that entry tests for selective schools that include non-verbal reasoning ‘assess the true potential of every child.’”

The research involved 558 students between the ages of 11 and 18 and 105 adults, who were initially tested in various skills and then completed up to 20 days of online training in a particular skill before taking the tests again. They were then tested six months later to see whether the effect of training lasted.

The non-verbal reasoning test involved looking at a three by three grid of shapes with the final square left blank. Participants had to choose the correct shape to complete the pattern, with the shapes varying by color, size, shape, and position.

In another test, called “numerosity discrimination,” participants were shown two groups of different colored dots in quick succession and had to judge which group had the most dots.

“We find that these cognitive skills, which are related to mathematics performance, show greater training effects in late adolescence than earlier in adolescence,” said co-lead author Dr. Lisa Knoll. “These findings highlight the relevance of this late developmental stage for education and challenge the assumption that earlier is always better for learning.

“We find that fundamental cognitive skills related to mathematics can be significantly trained in late adolescence.”

At the testing stages, volunteers were tested on various tasks, not just the ones they had trained in, to see if the training effects transferred to other skills. No transfer effects were observed, suggesting that the effect of training was specific to each task.

“Some brain training apps claim to improve your IQ by getting you to practice a specific task, such as the non-verbal reasoning task we used in our experiment,” noted co-lead author Delia Fuhrmann. “However, there is no evidence that this leads to an improvement in overall cognitive ability.

“All we can say for sure is that training to spot patterns in a three by three grid of abstract shapes improves your ability to spot patterns in a three by three grid of abstract shapes. While this ability is commonly tested in IQ tests, it might not be appropriate to make judgements about other forms of intelligence based on the outcomes of such tests.”

Source: University College London

Music Therapy Can Impact Self-Esteem, Depression in Kids

Music therapy has been found to significantly lower depression and improve self-esteem in children and __teens ages 8 to 16 with behavioral and emotional problems, according to a new study by researchers at Bournemouth University and Queen’s University Belfast in the U.K.

The study, conducted in partnership with Every Day Harmony (the brand name for Northern Ireland Music Therapy Trust), also found that young people 13 and over who received music therapy experienced improvement in communication and interaction skills, compared to those who received typical care alone.

“Music therapy has often been used with children and young people with particular mental health needs, but this is the first time its effectiveness has been shown by a definitive randomized controlled trial in a clinical setting,” said Ciara Reilly, chief executive of Every Day Harmony.

“The findings are dramatic and underscore the need for music therapy to be made available as a mainstream treatment option. For a long time we have relied on anecdotal evidence and small-scale research findings about how well music therapy works. Now we have robust clinical evidence to show its beneficial effects.”

Music therapy is delivered by a certified therapist who has at least 1,200 hours of clinical training in music, psychology and medicine.

The study involved 251 children and young people who were all being treated for emotional, developmental or behavioral problems. The participants were divided into two groups: 128 underwent the usual care options, while 123 were assigned to music therapy in addition to usual care. The research took place between March 2011 and May 2014.

Specifically, children aged eight to 16 who received music therapy saw significant improvement in self-esteem as well as a significant reduction in depression compared with those who received treatment without music therapy. Young people aged 13 and older who received music therapy had improved communicative and interactive skills compared to those who received standard  care.

Music therapy also improved social functioning over time in all age groups.

“This study is hugely significant in terms of determining effective treatments for children and young people with behavioural problems and mental health needs,” said study leader Professor Sam Porter of the Department of Social Sciences and Social Work at Bournemouth University.

“The findings contained in our report should be considered by healthcare providers and commissioners when making decisions about the sort of care for young people that they wish to support.”

The research team will now look at the data to establish how cost-effective music therapy is in relation to other treatments.

“This is the largest study ever to be carried out looking at music therapy’s ability to help this very vulnerable group,” said co-researcher Dr. Valerie Holmes from the Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences at Queen’s University Belfast.

Source: Bournemouth University

Family Therapy Speeds Moms Recovery from Substance Abuse

In a first-of-its-kind study, researchers discovered that it is best to have the kids involved in their moms rehab for drug and alcohol use.

Specifically, Ohio State investigators found mothers recover faster if their children take part in their treatment sessions.

Research showed that women who were in family therapy — which included their eight to 16-year-old children — presented a quicker decline in alcohol, marijuana, and cocaine use over 18 months compared to mothers who were in individual therapy.

This is the first study to examine the effectiveness of family therapy for mothers who are substance users, said Natasha Slesnick, lead author of the study and professor of human sciences at the Ohio State University.

“Interpersonal stress, especially within the family, has been shown to be an important factor in drug and alcohol abuse,” Slesnick said. “So it makes sense that having mothers and children working together in therapy can help moms with substance use problems do better over time.

“Family therapy is not generally part of the treatment options for substance-using mothers, but this study suggests it should be.”

Slesnick conducted the study with Jing Zhang, a postdoctoral researcher at Ohio State. The study appears in the current issue of Psychology of Addictive Behaviors.

The study involved 183 mothers who were seeking outpatient treatment and met diagnostic criteria for having an alcohol or drug use disorder. All had at least one biological child aged eight to 16.

Some of the mothers were placed in a 12-session program called Ecologically Based Family Therapy. EBFT focuses on improving social interactions, emotional connectedness, and problem resolution skills among family members.

Other mothers were assigned to an individual therapy program called Women’s Health Education.

All participants were assessed at the beginning of the study and then three, six, 12, and 18 months later.

Substance use was assessed using structured interviews with the mothers in which the researchers calculated the percentage of mothers’ total days of alcohol, marijuana, cocaine, and opioids use in the past 90 days.

For the EBFT group, the mother and child participated in a 10-minute interaction task at the beginning of the study and six and 18 months later. The researchers watched the interaction and rated the mother and child relationship quality.

Results showed that all mothers showed reduced alcohol, marijuana, and cocaine use over time, but mothers in the family therapy saw their substance use decrease more quickly.

The exception involved opioids, such as heroin — mothers reported similar decreases in use after both the individual and family therapies.

“Different drugs affect family dynamics in different ways, and we need more research to determine why opioids respond differently to family therapy,” Slesnick said.

Family therapy is probably more helpful to moms battling most substance use issues than individual therapy because it deals with the family stresses that contribute to drug and alcohol use, she said.

Although the researchers hoped that assessing differences in the mother-child interaction before and after treatment would help them determine whether changes in these family dynamics were the key to the success of family therapy, the results did not confirm that link.

Slesnick said she still believes the link is there, but that there weren’t enough subjects in the study to prove it.

Preliminary data from upcoming studies by the researchers suggests that family therapy is not only good for the mothers — it helps their children’s mental health, as well.

“Children are usually not included in the treatment plans of their mothers, but they should be. They already have to deal with their moms’ substance use in many ways. Being part of the therapy can help both them and their mothers,” she said.

Source: Ohio State University

CBT Can Lessen Kids’ Dental Anxiety

As many parents can attest, it is not uncommon for a child to experience significant anxiety when they go to the dentist. Sadly, the anxiety may influence pediatric dental care with the effects continuing through adulthood. New research suggests cognitive-behavioral therapy may provide a non-pharmaceutical solution to the conundrum.

In the study, U.K. researchers describe the development of a guided self-help cognitive behavioral therapy (CBT) resource for the management of children’s dental anxiety.

Investigators believe the pilot intervention provides evidence for the feasibility and acceptability of this approach with children aged between nine and 16 years.

CBT is an evidence-based treatment for dental anxiety; however, access to therapy is limited. This study employed a mixed methods design where within phase one, a qualitative “person-based” approach informed the development of the self-help CBT resource.

Guidelines for the development and evaluation of complex interventions were also used. Within phase two, children aged between nine and 16 years who had elevated self-reported dental anxiety and were attending a community dental service or dental hospital were invited to use the CBT resource.

Children completed questionnaires, which assessed their dental anxiety and health-related quality of life prior to and following their use of the resource. Recruitment and completion rates were also recorded.

Acceptability of the CBT resource was explored using interviews and focus groups with children, parents/caregivers and dental professionals. A total of 85 children were invited to participate in the feasibility study and trial the CBT resource.

The recruitment rate (proportion of children invited to take part in the study who agreed to participate) and completion rate (proportion of children who agreed to participate who completed the study) was 66 percent and 86 percent, respectively. A total of 48 patients completed the study.

At the conclusion of the study, the authors ascertained that there was a significant reduction in dental anxiety and an increase in health-related quality of life following the use of the guided self-help cognitive behavioral therapy resource.

The results of this study will inform the design of a definitive trial to examine the treatment and cost-effectiveness of the resource for the reduction of children’s dental anxiety.

The study appears in the OnlineFirst portion of JDR Clinical & Translational Research.

Source: International Association for Dental Research

Dads Get Kids’ Skills as Well as Moms

New research from Denmark finds that a father is able to evaluate a child’s cognitive and non-cognitive skills as well as a mother.

The discovery is important for parental rights cases, schools, or other places where in the past, a mother’s judgement of children was deemed superior.

Aarhus University researchers used the results from the so-called CHIPS-tests (Children’s Problem Solving) — which test the child’s linguistic and cognitive level and psychiatric diagnosis — and compared the results with the parents’ overall evaluation of the child’s academic and behavioral performance (the latter specified in a Strength and Difficulties Questionnaire).

The test results from 6,000 Danish families, adjusted for variables such as gender, the parents’ age, educational background, work situation, income, psychiatric diagnosis etc., show that dad is just as able to evaluate the child’s cognitive and non-cognitive skills as mom.

“This is important knowledge not least in e.g. divorce cases, where the majority of parental rights cases are decided in favor of the mother — among other things based on the parents’ testimonies on the well-being and skills of their children,” said Nabanita Datta Gupta, Ph.D., one of three researchers behind the study.

The research has been published in Review of Economics of the Household.

The study also shows that mothers who have mental issues often evaluate their children’s competences as being poorer than they actually are.

This could be a serious issue as a child may develop a lower self-esteem and a lack of confidence in their own abilities, say the researchers. Moreover, another study has previously shown that children of parents with mental illnesses are at a greater risk of attempting suicide.

“Many women who suffer from post-natal depression are never diagnosed, but their mental state still influences their life and also their ability to evaluate their children’s competences.

Generally, our results indicate that parents should be regarded equally in clinical and school-related contexts, where the doctor and the teacher might as well hear the father’s evaluation of e.g. symptoms and well-being as the mother’s. Especially in Denmark, where fathers are typically very actively involved in looking after the child,” Gupta said.

Gupta believes findings from the research can be widely applied.

“The results are valid, because the parent’s subjective evaluations are compared to the objective measurements of the CHIPS test and the psychiatric diagnoses. Naturally, a lot of other factors are also important, but our research is an important contribution to the collected understanding of the parents’ ability to evaluate their children’s behavior and competences,” she said.

Source: Aarhus University