Chris Hoeboer1, Carlijn de Roos2, Gabrielle E van Son3, Philip Spinhoven4, Bernet Elzinga5. 1. Leiden University, Institute of Psychology, Section Clinical Psychology, Leiden, the Netherlands; Parnassiagroep, PsyQ The Hague, the Netherlands. Electronic address: c.m.hoeboer@fsw.leidenuniv.nl. 2. Amsterdam University Medical Centre, Department of Child and Adolescent Psychiatry, Amsterdam, the Netherlands. Electronic address: c.deroos@debascule.com. 3. Rivierduinen, Department for Quality of Care, the Netherlands. Electronic address: g.vanson@rivierduinen.nl. 4. Leiden University, Institute of Psychology, Section Clinical Psychology, Leiden, the Netherlands; Leiden University Medical Center, Department of Psychiatry, the Netherlands. Electronic address: Spinhoven@fsw.leidenuniv.nl. 5. Leiden University, Institute of Psychology, Section Clinical Psychology, Leiden, the Netherlands. Electronic address: Elzinga@fsw.leidenuniv.nl.
Abstract
BACKGROUND: Maltreatment by a primary caregiver is an important risk factor for the development of PTSD symptoms. Whereas meta-analyses indicate that parental emotional abuse is one of the most common forms of maltreatment, the impact of emotional abuse on PTSD symptoms and treatment effectiveness is still unclear, especially in children. OBJECTIVE: We aimed to investigate the impact of parental emotional abuse on PTSD symptom severity and effectiveness of trauma treatment in children and adolescents. METHOD: In an outpatient sample (N = 287, mean age = 15.5 years), emotional abuse, index traumatic event, and PTSD symptoms were assessed at baseline. Thereafter, patients received evidence-based treatment for trauma-related symptoms embedded in a broader (systemic) treatment package. In a subsample (n = 130, mean age = 15.3 years) PTSD symptoms were assessed again 6 and 12 months after baseline. RESULTS: Emotional abuse (rather than any other type of maltreatment) was associated with more severe PTSD symptoms in all symptom clusters. This was independent of whether emotional abuse was reported as index traumatic event or not. Moreover, PTSD symptoms were significantly reduced 6 months after the start of trauma-focused treatment, and emotional abuse was associated with more severe PTSD symptoms over the course of treatment. CONCLUSIONS: These findings underline the detrimental nature of emotional maltreatment in the context of PTSD symptomatology and treatment effectiveness. This calls for routine assessment of parental emotional abuse in the diagnostic phase, even when this is not the reason of referral.
BACKGROUND: Maltreatment by a primary caregiver is an important risk factor for the development of PTSD symptoms. Whereas meta-analyses indicate that parental emotional abuse is one of the most common forms of maltreatment, the impact of emotional abuse on PTSD symptoms and treatment effectiveness is still unclear, especially in children. OBJECTIVE: We aimed to investigate the impact of parental emotional abuse on PTSD symptom severity and effectiveness of trauma treatment in children and adolescents. METHOD: In an outpatient sample (N = 287, mean age = 15.5 years), emotional abuse, index traumatic event, and PTSD symptoms were assessed at baseline. Thereafter, patients received evidence-based treatment for trauma-related symptoms embedded in a broader (systemic) treatment package. In a subsample (n = 130, mean age = 15.3 years) PTSD symptoms were assessed again 6 and 12 months after baseline. RESULTS:Emotional abuse (rather than any other type of maltreatment) was associated with more severe PTSD symptoms in all symptom clusters. This was independent of whether emotional abuse was reported as index traumatic event or not. Moreover, PTSD symptoms were significantly reduced 6 months after the start of trauma-focused treatment, and emotional abuse was associated with more severe PTSD symptoms over the course of treatment. CONCLUSIONS: These findings underline the detrimental nature of emotional maltreatment in the context of PTSD symptomatology and treatment effectiveness. This calls for routine assessment of parental emotional abuse in the diagnostic phase, even when this is not the reason of referral.
Authors: Shabatun J Islam; Jeong Hwan Kim; Emma Joseph; Matthew Topel; Peter Baltrus; Chang Liu; Yi-An Ko; Zakaria Almuwaqqat; Mahasin S Mujahid; Mario Sims; Mohamed Mubasher; Kiran Ejaz; Charles Searles; Sandra B Dunbar; Priscilla Pemu; Herman Taylor; J Douglas Bremner; Viola Vaccarino; Arshed A Quyyumi; Tené T Lewis Journal: Circ Cardiovasc Qual Outcomes Date: 2021-08-12