Looking Beyond Posttraumatic Stress Disorder in Children: Posttraumatic Stress Reactions, Posttraumatic Growth, and Quality of Life in a General Population Sample
J Clin Psychiatry 2008;69(9):1455-1461
© Copyright 2017 Physicians Postgraduate Press, Inc.
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Objective: In order to broaden the view beyond posttraumatic
stress disorder (PTSD) in children, we examined to what extent posttraumatic
stress reactions, posttraumatic growth, and quality of life were related to
each other and to traumatic exposure in the general population.
Method: 1770 children of 36 randomly selected primary schools
(mean age = 10.24 years, 50% boys) reported in October/November 2006 on their
worst experience (traumatic exposure was considered present when the described
event fulfilled the A1 criterion for PTSD of the DSM-IV-TR) and filled out the
Children's Responses to Trauma Inventory, the Posttraumatic Growth Inventory
for Children, and the KIDSCREEN-27. Correlational and hierarchical linear
regression analyses were carried out in a multiple imputation format.
Results: Posttraumatic stress reactions were strongly related
to posttraumatic growth (r = 0.41, p < .01) and quality of life (r = -0.47, p <
.01). The latter 2 variables were weakly related; positively when controlling
for posttraumatic stress reactions (r = 0.09, p < .01), negatively when not (r
= -0.12, p < .01). Children who were exposed to trauma reported more
posttraumatic stress reactions (beta = .12, p < .01), more posttraumatic growth
(beta = .09, p < .01), and less quality of life (beta = -.08, p < .01) than
nonexposed children (effect sizes were small).
Conclusions: Negative and positive psychological sequelae of
trauma can coexist in children, and extend to broader areas of life than
specific symptoms only. Clinicians should look further than PTSD alone and pay
attention to the broad range of posttraumatic stress reactions that children
show, their experience of posttraumatic growth, and their quality of life.