Trauma exposure, post-traumatic stress disorder and safety-seeking behaviours in children and adolescents

Alberici, Alice (2017) Trauma exposure, post-traumatic stress disorder and safety-seeking behaviours in children and adolescents. Doctoral thesis, University of East Anglia.

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Background: a significant portion of young people exposed to traumatic events (TEs) such as road traffic accidents or violence, develop post-traumatic stress disorder (PTSD). Most research focuses on trauma-exposed populations such as child victims of natural disasters. There has also been a trend to look at cognitive aspects of models of PTSD rather than behavioural. Although safety-seeking behaviours have been highlighted in PTSD models as an important mechanism in PTSD, no current child measure of safety-seeking behaviours exists.
Aims: the first aim was to provide a synthesis of population-based school-related studies and calculate pooled prevalence rates for TEs and PTSD. A further aim was to develop and explore the psychometric properties of a novel Child Safety Behaviour Scale (CSBS) in both school pupils and existing data from a sample of trauma-exposed young persons with or without a clinical diagnosis of PTSD.
Method: a systematic review conducted between 1980 and 2016 produced 687 studies, 14 of which met the inclusion criteria. In the empirical study a battery of questionnaires was administered to 391 school pupils (aged 12-15 years). This was combined with existing data of 68 (8-17 years) children who completed the CSBS previously.
Results: rates of cross-cultural TE exposure were 50.0% and 7.8% for PTSD. All studies were high quality but mostly US-based. The CSBS demonstrated good psychometric properties and a weak, possible two-factor structure. Safety-seeking behaviours, negative appraisals, number of trauma types, cognitive avoidance and rumination were significant predictors of post-traumatic stress symptoms.
Conclusions: the high rates of TE and PTSD observed in this review calls for more cross-cultural research within population-based school samples and necessitates the integration of mental health and education services. Further, the CSBS may be a useful tool both for clinical monitoring and within research to further examine the role of safety-seeking behaviours in PTSD.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Stacey Armes
Date Deposited: 22 Mar 2018 15:23
Last Modified: 22 Mar 2018 15:23


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