Depression in Trauma-Exposed Children and Adolescents: An Exploration of Risk Factors and PTSD-Depression Comorbidity.

Claxton, Jade (2017) Depression in Trauma-Exposed Children and Adolescents: An Exploration of Risk Factors and PTSD-Depression Comorbidity. Doctoral thesis, University of East Anglia.

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Abstract

Background: Whilst traumatic exposure appears common and the majority remain resilient, some go on to develop depression and PTSD. Childhood and adolescence is a critical period for more deleterious and long-term impacts of trauma exposure; but crucially to date research has been limited. Post-traumatic depression and PTSD-depression comorbidity are particular facets of child and adolescent trauma responses that require increased focus. Aims: This portfolio presents two research elements: a synthesis of the literature aims to examine risk factors for post-traumatic depression in children and adolescents; an empirical study aims to investigate cognitive appraisals, cognitive avoidance and rumination as potential shared cognitive vulnerabilities in PTSD and depression. Methods: a systematic keyword search of the literature between 1980 and 2016 yielded 647 studies. Fifty-nine studies were identified for inclusion (N=45,688) and meta-analyses were conducted for 12 potential risk factors for post-traumatic depression. A community sample of 280 school-aged adolescents (12-15 years) reporting trauma exposure completed measures of PTSS, depression, trauma-related and depressogenic appraisals, cognitive avoidance and rumination. Findings: Pre-trauma and peri-trauma risk factors largely generated small effect sizes (r=.10 – r=.21) whereas post-trauma risk factors largely generated moderate to large effect sizes (r=.29 – r=.58). Comorbid PTSD was the most prominent risk factor. Negative cognitive appraisals, cognitive avoidance and rumination were found to be strong, equivalent correlates of PTSS and depression symptoms; endorsed by all probable diagnostic groups; and significant predictors in hierarchical regression models of PTSS and depression symptoms. Conclusions: post-trauma environment and responses appear important in determining post-traumatic depression in children in adolescents. Cognitive appraisals, cognitive avoidance and rumination are found to be shared cognitive vulnerabilities in PTSD and depression and may underlie comorbidity. Targets for assessment, monitoring and treatment are highlighted.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Jackie Webb
Date Deposited:	26 Apr 2018 11:28
Last Modified:	26 Apr 2018 11:28
URI:	https://ueaeprints.uea.ac.uk/id/eprint/66838
DOI:

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