Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

The relationship between child maltreatment and exposure to traumatic events during later adolescence and young adulthood

Ask Elklit — 2016-12-16

Abstract Objective: The present study investigated the relationship between different types of childhood maltreatment (emotional abuse, sexual abuse, multiple abuse types, and no abuse) and the occurrence of later traumatic events during later adolescence and young adulthood. Method: Data were collected from a Danish national study conducted by The Danish National Centre for Social Research in 2008 and 2009. A sample of 4718 young adults who were 24 years old was randomly selected using the total birth cohort of children born in 1984. A structured interview was conducted during which participants were asked about a range of traumatic and abusive experiences. Results: A response rate of 63% was achieved for a total sample size of 2980. Chi-squared analyses revealed significant relationships between all child maltreatment groups and direct exposure to 10 of the 13 traumatic events; there were also significant relationships between all child maltreatment groups and indirect exposure to 12 of the 13 traumatic events. Conclusion: The results showed that childhood maltreatment was associated with increased risk of exposure to traumatic events, both directly and indirectly, during adolescence and young adulthood. The findings of this study suggest there is an increased risk of being exposed to both direct and indirect traumas during later adolescence and young adulthood after any form of child maltreatment.

Experiences of victimization among adolescents with Substance Abuse Disorders in Sweden

Mats Anderberg — 2016-12-16

Abstract Background: Adolescents who initiate treatment for substance abuse often have a history of victimization in the form of physical, psychological, or sexual abuse. These experiences can have serious adverse consequences that may affect their lives and social functioning. Objective: This article describes and analyzes victimization among adolescents who are in outpatient treatment for substance abuse disorders with respect to gender, social circumstances, alcohol and drug abuse, and mental health. Method: This cross-sectional study is based on structured interviews with 748 adolescents from seven outpatient clinics in Sweden. Chi-squared tests were performed to examine significant differences between gender and victimization (or lack of victimization). The study also included a quantitative content analysis of interview utterances. Results: The analysis showed that more than half of the adolescents had experienced violence or another type of abuse. There are also significant gender differences: two thirds of the girls and slightly less than half the boys had experienced abuse in some form, and the girls had more severe needs at treatment admission. Conclusion: This study established that experiences of victimization and exposure to violence are widespread among adolescents with substance abuse disorders in Sweden. This is an important issue that requires attention and action, with preventive and therapeutic interventions needed to provide support for both substance abuse disorders and psychiatric symptoms.

Children’s coping styles and trauma symptoms after an explosion disaster

Mette Elmose Andersen — 2016-12-16

Background: The negative impact of trauma on children and adolescents is well documented. However, few studies have investigated the relationship between coping and trauma and distress symptoms after man-made disasters, especially those not related to war. Objective: This study investigated the relationship between children’s coping styles and their self-reported levels of trauma and distress symptoms after an explosion disaster in a residential area. Method: Participants were recruited through the local public school that served the affected residential area. A total of 333 children and adolescents from grades 3 through 10 participated in the study 16 months after the explosion. All participants filled out questionnaires to assess their trauma and distress symptoms as well as their coping strategies. The adolescents answered additional questions about pre-, peri-, and post-traumatic factors and filled out questionnaires about their trauma and distress symptoms, including aspects of somatization and negative affectivity. Results: The following variables were associated with a higher degree of trauma symptoms for children in grades 6 through 10 and explained 39% to 48% of the unique variance in these symptoms: female gender; the experience of traumatic events pre-disaster; the destruction of property or danger to life occurring during the disaster; the experience of traumatic events post-disaster; and the use of self-blame, emotion regulation, wishful thinking, and cognitive restructuring. For the younger children, pre-, peri-, and post-disaster factors were not measured. However, female gender and the use of self-blame as a coping strategy explained 26% of the variance in trauma symptoms. Conclusions: This study generally supports the findings of the limited literature addressing coping skills after man-made disasters. However, contrary to previous findings in community samples after episodes of terrorism, adaptive coping strategies such as cognitive restructuring were found to influence the variance of trauma and distress symptoms.

Do the ADHD subtypes exist on a physiological continuum? A reply to Reiersen and Todorov (2013)

Keith Fluegge — 2016-12-16

No abstract for a letter.

Towards a New Generation of Quality Registries in Neurodevelopmental Disorders: The Example of NEUROPSYK

Anna Löfgren Wilteus — 2016-12-16

Swedish Healthcare Quality Registries are tools for the evaluation and improvement of clinical services and a basis for population-based research. There are presently 11 national quality registries focusing on psychiatric disorders, but none of them cover all ICD-10/DSM-5 defined neurodevelopmental disorders (NDD) across the lifetime and/or care providers. Furthermore, health care professionals have called for more user-friendly, time-saving, and clinically informative registers.

In order to fill this gap, the NEUROPSYK Quality Register was established in 2014 by the Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), formally and initially a clinical register of Child and Adolescent Psychiatry, Stockholm County Council.

The main objectives of NEUROPSYK are to improve assessment and intervention for individuals with NDD through (i) adequate follow-up of the implementation of existing regional and national guidelines for assessment and treatment of NDDs, (ii) providing clinical decision-making aids, and (iii) conducting large-scale clinical epidemiological research. The registry fully accounts for all current legal requirements concerning quality registries in Sweden (e.g., regulations in the Swedish Patient Data Act).

NEUROPSYK includes patients of all ages receiving a diagnosis under the NDD umbrella in DSM-5. This includes autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), intellectual disabilities, communication disorders, specific learning disorders and motor disorders. Medication and behavioral interventions are recorded and patient outcomes over time are measured with the economical and user-friendly Clinical Global Impression (CGI), Global Assessment of Functioning (GAF/C-GAS), and patient reported health related quality of life (EQ-5D/Disabkids).

NEUROPSYK minimizes administrative work for health care professionals through integration with digital structured patient record and increasing the likelihood for high coverage and data quality. In conclusion, NEUROPSYK combines several strengths making it an example for a new generation of quality and research registers in psychiatry and other areas of health care.

A conceptual framework for understanding characteristics of self-awareness associated with autism spectrum disorder

Mette Elmose Andersen — 2016-12-16

No abstract

Promising developments for the Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

Ole Jakob Storebø — 2016-12-16