Disturbances in self-organisation and trauma exposure in children and young people

Melamed, Daniela (2021) Disturbances in self-organisation and trauma exposure in children and young people. Doctoral thesis, University of East Anglia.

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Abstract

Background: Over two-thirds of children worldwide experience trauma (Copeland et al., 2007) with some developing subsequent mental health difficulties following exposure (Alisic et al., 2014; Kessler et al., 2005). Complex Post-Traumatic Stress Disorder (PTSD), a new diagnosis, has been added to the International Classification of Diseases (ICD-11; WHO, 2018) following trauma exposure. It includes three additional symptom criteria: affect dysregulation, negative self-concept, and interpersonal difficulties, known as disturbances in self-organisation (DSO). The thesis portfolio aims to explore DSO in children and adolescents.
Method: A meta-analysis was conducted to understand the relationship between trauma and maltreatment and negative self-concept in children and adolescents. An empirical study sought to explore the psychometric properties of a new measure of DSO and its related correlates using a cross-sectional questionnaire design.
Results: Ninety-five studies were included in the meta-analysis. A small relationship was found between trauma exposure and negative self-concept. Moderator analyses found that type of trauma, multiple trauma exposure, and country’s lower socioeconomic status had a larger effect. The empirical paper included 278 adolescents and found good internal consistency and adequate factor structure for the new measure of DSO. DSO was significantly correlated with mood difficulties, lower well-being, and trauma exposure. Regression analysis found that increased DSO symptoms and mood difficulties uniquely contributed to lower well-being.
Conclusions: This thesis portfolio provides valuable understanding and background about disturbances in self-organisation, as defined by the ICD-11, in young people. Clinical and theoretical implications bring into question the meaning of DSO as a unique construct, theorising whether DSO may be linked to other outcomes not exclusive to Complex PTSD. Strengths and limitations for both papers are discussed with further implications for clinical practice and directions for future research identified.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Jackie Webb
Date Deposited:	19 Nov 2021 11:51
Last Modified:	19 Nov 2021 11:51
URI:	https://ueaeprints.uea.ac.uk/id/eprint/82234
DOI:

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