The nature of trauma memories in acute stress disorder in children and adolescents

Claire Helen Salmond · Richard Meiser‐Stedman · Edward Glucksman · Tim Dalgleish · Patrick A. Smith

76 citations0/0 files storedJournal of Child Psychology and Psychiatry

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Posttraumatic Stress Disorder Research Child Abuse and Trauma Memory Processes and Influences

Abstract

BACKGROUND: There is increasing theoretical, clinical and research evidence for the role of trauma memory in the aetiology of acute pathological stress responses in adults. However, research into the phenomenology of trauma memories in young people is currently scarce. METHODS: This study compared the nature of trauma narratives to narratives of unpleasant non-traumatic events in young people (aged 8-17) who sought emergency medical attention following an assault or road traffic accident. Data were collected within 2-4 weeks of the index event. Symptom severity was assessed by child self-report and face-to-face diagnostic interviews. Comparisons of narrative indices were made between those children with acute stress disorder (ASD) and those without ASD. RESULTS: Among participants (n = 50), those with ASD (38%) had significantly elevated levels of disorganisation in their trauma narrative, compared both to trauma-exposed controls and to their unpleasant comparative narrative. This effect was not accounted for by age. Regardless of ASD diagnostic status, trauma narratives had significantly higher sensory content and significantly lower positive emotion content compared to the unpleasant comparative narrative. These effects were not significant when age was included as a covariate. Acute symptom severity was significantly predicted by the level of disorganisation in the trauma narrative and the child's cognitive appraisals of the event. CONCLUSIONS: These data provide the first empirical evidence that disorganisation is not only directly linked to symptom severity, but also specific to the trauma memory. In addition, it provides support for the adaptation of adult cognitive models to acute pathological stress reactions in children and adolescents.

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References

1983The Hospital Anxiety and Depression Scale 1997The Strengths and Difficulties Questionnaire: A Research Note 2000A cognitive model of posttraumatic stress disorder 1996A dual representation theory of posttraumatic stress disorder.2003Psychological theories of posttraumatic stress disorder 2001The Child PTSD Symptom Scale: A Preliminary Examination of its Psychometric Properties 2003Posttraumatic stress disorder following assault: The role of cognitive processing, trauma memory, and appraisals.1995Change in rape narratives during exposure therapy for posttraumatic stress disorder

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2015Talking (or Not Talking) about the Past: The Influence of Parent–Child Conversation about Negative Experiences on Children's Memories 2016Coherence, disorganization, and fragmentation in traumatic memory reconsidered: A response to Rubin et al. (2016).2013Research Methods in Child Disaster Studies: A Review of Studies Generated by the September 11, 2001, Terrorist Attacks; the 2004 Indian Ocean Tsunami; and Hurricane Katrina

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