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Biomedical subjects

William Yule

Publications and source records attributed to William Yule.

17 recordsLinked to original sources
PubMed2007

Parent and child agreement for acute stress disorder, post-traumatic stress disorder and other psychopathology in a prospective study of children and adolescents exposed to single-event trauma.

Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined by structured interview in a prospective study of assault and motor vehicle accident (MVA) child survivors, assessed at 2-4 weeks and 6 months post-trauma. Children were significantly more likely to meet criteria for ASD, as well as other ASD and PTSD symptom clusters, based on their own report than on their parent's report. Parent-child agreement for ASD was poor (Cohen's kappa = -.04), but fair for PTSD (Cohen's kappa = .21). Agreement ranged widely for other emotional disorders (Cohen's kappa = -.07-.64), with generalised anxiety disorder found to have superior parent-child agreement (when assessed by phi coefficients) relative to ASD and PTSD. The findings support the need to directly interview children and adolescents, particularly for the early screening of posttraumatic stress, and suggest that other anxiety disorders may have a clearer presentation post-trauma.

Accidents, Traffic↗
PubMed2006

Post-traumatic stress reactions of children and adolescents exposed to the Athens 1999 earthquake.

This study was undertaken 6-7 months after the 1999 Athens earthquake with the aim of exploring the differences in post-traumatic stress disorder (PTSD), anxiety and depression symptoms between a group of children exposed to earthquake with a group of children not exposed to it, but with both groups potentially exposed to the same levels of post-earthquake adversities. The study included 2037 children, aged 9-17 years, who were assessed with self-completed questionnaires. The directly exposed group (N=1752) had significantly higher anxiety and PTSD scores than the indirectly exposed group (N=284), but no significant group differences were found in depression scores. Girls in both groups reported significantly more PTSD, anxiety and depressive symptoms than boys. Younger children reported significantly more PTSD and anxiety symptoms than the older ones. No significant interactions were found between direct exposure to earthquake, age group and gender. The severity of PTSD symptoms was most strongly predicted by greater perceived threat during the earthquake, whereas depression was most strongly predicted by the level of post-earthquake adversity. The severity of anxiety symptoms was most strongly predicted by female gender. These findings are discussed in relation to the need for screening and intervention following earthquake events.

Adolescent↗
PubMed2006

Theory, training and timing: psychosocial interventions in complex emergencies.

The Asian tsunami of December 2004 galvanised mental health and emergency agencies in a way that no other recent disaster has done. The loss of life and forced migration focused national and international agencies on the need to provide appropriate psychosocial care from the very beginning. The prior academic arguments surrounding early intervention paled into insignificance against the urgent need to reduce distress and prevent chronic mental health problems. This chapter notes that there was a major, planned and early intervention following the earthquake in Bam, exactly one year earlier. The lessons from that are only now beginning to filter through and help shape better responses to disasters. It is argued that too many non-governmental organizations (NGOs) and even IGOs are following theoretical positions that have little empirical justification. There is an urgent need for training for mental health and NGO personnel alike to deliver evidence-based psychological first aid. There is no justification for mental health responses to be delayed until weeks after a disaster happens.

Asia↗
PubMed2006

A randomised controlled trial to determine the effectiveness of an early psychological intervention with children involved in road traffic accidents.

OBJECTIVE: To determine whether an early intervention using a psychological debriefing format is effective in preventing psychological distress in child road traffic accident survivors. DESIGN: Randomised controlled trial. SETTING: Accident and Emergency Department, Royal United Hospital, Bath. SUBJECTS: 158 children aged 7-18. Follow-up assessment completed eight months post accident with 132 (70/82 of the experimental group and 62/76 in the control group). MAIN OUTCOME MEASURES: Self-completed measures of psychological distress; fulfilment of diagnostic criteria for post-traumatic stress disorder. RESULTS: Children in both groups demonstrated considerable improvements at follow-up. The early intervention did not result in any additional significant gains. CONCLUSIONS: Although children in this study made significant improvements it is unclear whether these are better or worse than natural recovery rates. The specific intervention did not result in additional gains although the structured assessment provided for both groups may have been helpful in reducing subsequent pathology.

Accidents, Traffic↗
PubMed2006

Practitioner review: assessment and treatment of refugee children and adolescents who have experienced war-related trauma.

BACKGROUND: Increasingly clinicians are being asked to assess and treat young refugees, who have experienced traumatic events due to war and organised violence. However, evidence-based guidance remains scarce. METHOD: Published studies on the mental health difficulties of refugee children and adolescents, associated risk and protective factors, as well as effective interventions, particularly those designed to reduce war-related post-traumatic stress disorder (PTSD) symptoms, were identified and reviewed. The findings are summarised. RESULTS: Young refugees are frequently subjected to multiple traumatic events and severe losses, as well as ongoing stressors within the host country. Although young refugees are often resilient, many experience mental health difficulties, including PTSD, depression, anxiety and grief. An awareness of relevant risk and protective factors is important. A phased model of intervention is often useful and the need for a holistic approach crucial. Promising treatments for alleviating symptoms of war-related PTSD include cognitive behavioural treatment (CBT), testimonial psychotherapy, narrative exposure therapy (NET) and eye movement desensitisation and reprocessing (EMDR). Knowledge of the particular needs of unaccompanied asylum-seeking children (UASC), working with interpreters, cross-cultural differences, medico-legal report writing and the importance of clinician self-care is also necessary. CONCLUSION: More research is required in order to expand our limited knowledge base.

Adolescent↗
PubMed2006

Cognitive-behavioural group intervention for PTSD symptoms in children following the Athens 1999 earthquake: a pilot study.

This study examined the effects of a short-term group cognitive-behavioural intervention in children who were experiencing PTSD symptoms following the Athens 1999 earthquake. Twenty children, aged 8-12 years, referred for treatment to a local child mental health team were assigned, depending on timing of referral to two groups-- Group 1 (N = 10), which started treatment 2 months after the earthquake and Group 2 (N = 10), which started treatment at 4 months postearthquake. A statistically significant reduction in overall PTSD (Posttraumatic Stress Disorder) symptoms across the three PTSD symptom clusters - intrusion, avoidance, and arousal--as well as in depressive symptoms was reported immediately after the intervention. The treatment also produced a statistically significant improvement in children's psychosocial functioning. Further significant improvement was reported in children at an 18-month follow-up. Treatment gains were maintained at a 4-year follow-up. Despite several limitations to this study, short-term group CBT (cognitive-behavioural therapy) was found to be a useful treatment approach, which can be offered in clinical settings, particularly if resources are limited.

Catchment Area, Health↗
PubMed2006

Conduct problems in adolescence: three domains of inhibition and effect of gender.

Behavioral and neuropsychological evidence has often shown that children with conduct disorder drawn from clinical populations show problems with impulsivity and are impaired in motor tasks of inhibitory control. We explored the relation between conduct problems and inhibitory deficits in a community sample. Three domains of inhibition were explored in 54 adolescents with conduct problems compared to 53 age, IQ, sex, school, and ethnicity matched controls in 2 geographical areas. Motor response inhibition was assessed using the Stop task, verbal inhibition using the Hayling Sentence Completion test, and cognitive interference inhibition using the Stroop task. Adolescents with conduct problems showed deficits in executive and inhibitory processes of the motor response inhibition task, but were unimpaired in cognitive or verbal inhibitory control. No sex differences were observed and impairments were independent of IQ or geographical location. Findings suggest that motor deficits, rather than higher cognitive forms of inhibitory control, are a specific deficit in children with conduct problems, that girls are as affected as boys, and that motor impulsiveness is a dimensional trait associated with conduct problems, as it is also observed in the community.

Adolescent↗
PubMed2005

The role of the family in child and adolescent posttraumatic stress following attendance at an emergency department.

OBJECTIVE: To evaluate the role of family factors in posttraumatic stress symptomatology (PTSS) in children and adolescents who have attended an emergency department following assaults or motor vehicle accident. METHODS: Children and their parents completed self-report questionnaires and semistructured interviews relating to their psychopathology and cognitive styles at 2-4 weeks and 6 months after trauma. RESULTS: Parental depression was correlated with child PTSS at each assessment point. Less consistent findings were observed for family functioning. Parental endorsement of worry was a correlate of child PTSS at each assessment and a mediator between parental depression and child PTSS. CONCLUSIONS: A role for family factors, in particular parental depression and parental endorsement of worry, in the development of child PTSS is supported. Weaknesses of the study are discussed, and suggestions for future research are given.

Accidents, Traffic↗
PubMed2005

Acute stress disorder and posttraumatic stress disorder in children and adolescents involved in assaults or motor vehicle accidents.

OBJECTIVE: The authors investigated acute stress disorder and later posttraumatic stress disorder (PTSD) in children and adolescents who had been involved in assaults or motor vehicle accidents. METHOD: They interviewed 93 patients 10-16 years old who were seen in an emergency department for having been assaulted or involved in a motor vehicle accident within 4 weeks after the assault or accident to assess acute stress disorder. At 6 months, they reinterviewed 64 (68.8%) of the patients to assess PTSD. RESULTS: At initial interview, 18 (19.4%) of the 93 patients had acute stress disorder and 23 (24.7%) met all acute stress disorder criteria except dissociation. At 6 months, eight of the 64 patients (12.5%) had PTSD. Acute stress disorder and PTSD did not differ in prevalence between patients who had been assaulted and those who had been in accidents. Sensitivity and specificity statistics and regression modeling revealed that the diagnosis of acute stress disorder was a good predictor of later PTSD but that dissociation did not play a significant role. CONCLUSIONS: Acute stress disorder has merit as a predictor of later PTSD in children and adolescents, but dissociation has questionable utility.

Accidents, Traffic↗
PubMed2004

Memory for emotional stories in high and low depressed children.

Cognitive theories of depression emphasise a vicious circle linking depressed mood and biased recall towards negative information. In line with this, depressed adults show selectively enhanced recall for negative information. This recall bias is held to be mediated by increased accessibility of negative self-referent schemas formed as a result of adverse early experiences. Given this, surprisingly few studies have examined depression-related recall biases from a developmental perspective. Clinically depressed children have been found to show enhanced recall of negative adjectives, particularly when self-referent, but to date there is no evidence for similar recall biases in non-clinically depressed groups. The current study addressed this by investigating high and low non-clinically depressed children's (aged 5-11 years) recall of emotional stories. High depressed children showed enhanced recall of negative stories, relative to positive stories, compared to the low depressed group. This did not vary with age group. We conclude that, when child-oriented materials are used, depression-related biases in recall towards negative information are observable even in a non-clinical sample of children from 5 years of age.

Age Factors↗
PubMed2004

Long-term effects of psychological trauma on psychosocial functioning.

BACKGROUND: Most studies of the effects of trauma on mental health have generally not separately assessed psychosocial functioning, and in those that have key issues have received little attention, such as the relation between the time courses of the two kinds of outcome, and detailed assessment of social functioning in a range of domains. The present study made separate assessments with a view to testing four hypotheses. First, that the experience of trauma itself (independently of effects on mental health) has a negative effect on psychosocial functioning; second, that psychopathology following trauma is associated with poorer psychosocial functioning; third, that psychosocial functioning recovers when psychiatric conditions remit; fourth, that post-traumatic stress and depression have different associations with impairments of psycho-social functioning. METHOD: One hundred and fifteen young adults who had survived a shipping disaster (the sinking of the Jupiter in 1988) between 5 and 8 years previously, and 50 control participants were assessed for psychopathology, and for psychosocial functioning using the Adolescent to Adult Personality Functioning Assessment (ADAPFA). RESULTS: Results did not support the first hypothesis: survivors who, although experiencing a traumatic event, did not develop Post Traumatic Stress Disorder or other psychopathology warranting diagnosis, when compared with Controls who had no psychopathology since the time of the disaster, showed no significant differences on any ADAPFA domains or on total score. There was partial support for the second hypothesis: survivors with diagnosable disorder during the rating period showed poorer psychosocial functioning in total ADAPFA score and in the domains of Education/Work, Love Relationships, and Non-specific Social Contacts, though not in other domains. The third hypothesis was supported: recovered Survivors showed no psychosocial impairments compared with unaffected Controls. Results also supported the fourth hypothesis, showing differential effects of post traumatic stress and depression in relation to the extent and kind of psycho-social impairments. CONCLUSIONS: The results lend support to the general model that effects on psychosocial functioning following traumatic experience are mediated by psychopathology, though further research is needed to establish whether the present pattern of findings applies to other kinds of trauma.

Adolescent↗
PubMed2003

Patterns of processing bias for emotional information across clinical disorders: a comparison of attention, memory, and prospective cognition in children and adolescents with depression, generalized anxiety, and posttraumatic stress disorder.

This study investigated theoretical claims that different emotional disorders are associated with different patterns of cognitive bias, both in terms of the cognitive processes involved and the stimulus content that is preferentially processed. These claims were tested by comparing clinically anxious (generalized anxiety disorder [GAD], posttraumatic stress disorder [PTSD]) and clinically depressed children and adolescents on a range of cognitive tasks measuring attention, memory, and prospective cognition, with both threat-related and depressogenic stimulus materials. The results did reveal some relative specificity of processing in that the anxious participants exhibited a greater selective attentional bias for threat relative to depressogenic material with no such difference being apparent in the depressed sample. However, this bias was only clear-cut on a dot-probe measure of attentional processing and not on a modified Stroop measure, and indeed threat-related bias on the 2 tasks was uncorrelated. On the prospective cognition task, anxious participants exhibited an other-referent bias in their risk estimations regarding future negative events that was absent in the depressed sample. No specificity effects were evident on the memory task. The results are discussed in terms of the strengths and weaknesses of carrying out direct comparisons across groups and tasks versus drawing conclusions from overall patterns across multiple studies.

Adolescent↗
PubMed2003

Selective processing of negative emotional information in children and adolescents with Generalized Anxiety Disorder.

OBJECTIVES: Research investigating attentional bias for emotional information using the modified Stroop task in younger anxious populations has produced equivocal results. The present data investigated the replicability in younger participants of the prototypical adult finding of Mathews and MacLeod (1985) with patients with Generalized Anxiety Disorder (GAD). METHOD: A sample of 19 child and adolescent patients with GAD and 19 controls completed the modified Stroop paradigm with threat, depression-related, positive and neutral words. RESULTS: The data revealed a selective Stroop interference effect for negative emotional information in the GAD patients, relative to the performance of the controls. CONCLUSIONS: The results provide evidence of a modified Stroop effect for negative emotional material in children and adolescents with GAD, suggesting that modified Stroop processing in younger generally anxious populations broadly mirrors the profile of results in adults.

Adolescent↗
PubMed2003

Mental health of Kosovan Albanian refugees in the UK.

BACKGROUND: In 1999 the UK received 4346 refugees from Kosovo. AIMS: To determine the prevalence of mental health problems in this group. METHOD: A sample of 842 adults was surveyed. All were asked to complete self-report questionnaires (translated into Kosovan Albanian). A subset of 120 participants were later interviewed in Albanian using the Clinician Administered PTSD (post-traumatic stress disorder) Scale and a depression interview. RESULTS: The study yielded estimates of prevalence of PTSD and depression. Self-report measures appear to overestimate the prevalence of these disorders. Just under half of the group surveyed had a diagnosis of PTSD and less than one-fifth had a major depressive disorder. CONCLUSIONS: These results may be taken as a sign of the resilience of many who survived this conflict but they also imply that there is still a substantial need for good health and social care in a significant proportion. Psychosocial interventions are likely to be an important part of the treatment programme.

Adult↗
PubMed2002

War exposure among children from Bosnia-Hercegovina: psychological adjustment in a community sample.

As part of a United Nations Children's Fund (UNICEF) psychosocial programme during the war in Bosnia-Hercegovina, data were collected from a community sample of 2,976 children aged between 9 and 14 years. Children completed standardized self-report measures of posttraumatic stress symptoms, depression, anxiety, and grief, as well as a report of the amount of their own exposure to war-related violence. Results showed that children reported high levels of posttraumatic stress symptoms and grief reactions. However, their self-reported levels of depression and anxiety were not raised. Levels of distress were related to children's amount and type of exposure. Girls reported more distress than boys, but there were few meaningful age effects within the age band studied. Results are discussed in the context of service development for children in war.

Adaptation, Psychological↗
PubMed2002

Depression and parasuicide in refugee and Slovenian adolescents.

The association between depression and traumatic experiences, stress, loss, and bereavement is well known. It was expected that Bosnian refugee adolescents who had fled from war zones to Slovenia would develop higher levels of depression than their Slovenian peers without war traumatic experiences. Two years after the beginning of the war in Bosnia, 265 8th-grade refugee students aged 14 to 15 years were assessed with the Children's Depression Inventory (CDI) and compared with a sample of 195 Slovenian students of the same age. The Bosnian refugees showed significantly lower rates of depressive symptomatology despite very high rates of posttraumatic stress symptoms. Slovenian adolescents showed significantly lower self-esteem and greater feelings of inadequacy in the academic field; they were more likely to have feelings of not being loved and more often expressed the wish to kill themselves. Refugees described more sadness, worried about the future and about physical pains, but they do not show lower school achievement or more behavioral problems. The results indicate that the association between traumatic experiences and depressive symptoms is not inevitable, and that other factors including culture and context influences must be taken into account.

Adolescent↗