Prior research on trauma-exposed preschool children has found various levels of trauma-related stress symptoms depending on age, which might be explained by developmental factors.
This study uses network analysis to extend prior research and compare symptom presentation in younger and older preschoolers in the acute phase (first 4 weeks) following a potentially traumatic event.
Parent-reported trauma-related acute stress symptoms were assessed using the Pediatric Emotional Distress Scale - Early Screener via www.kidtrauma.com. First, the overall symptom severity and symptom levels were compared between younger (1-3 years) and older (4-6 years) preschoolers. Further, two Gaussian graphical models of stress symptoms in younger (n = 242; Mage = 2.3 years; SDage = 0.6 years) and older preschoolers (n = 299; Mage = 4.8 years; SDage = 0.7 years) were modelled and compared.
Overall symptom severity did not differ between the groups. Symptom levels for developmental regression and avoidance of talking about the event were higher in older preschoolers. The network structures of the younger and the older preschoolers were largely similar. Highly central symptoms in both networks were trauma-unrelated fear and anger. The connections between fear of reminders and clinginess and trauma-unrelated fear and clinginess were stronger in the older preschoolers\' network. The connections between worry and sadness and withdrawal; fear of reminders and creation of games, stories, and pictures; and whininess and clinginess were all stronger in the younger preschoolers\' network.
Trauma-related stress symptomatology of younger and older preschoolers may not differ greatly in the acute phase. Trauma-unrelated fear and anger seem to be central symptoms in both groups. However, examining symptom-level associations across age groups revealed differential connections that might arise from developmental differences. If replicated in longitudinal and within-subject studies, these findings could help tailor interventions for trauma-exposed preschoolers in the acute phase.
Antecedentes: Investigaciones previas sobre niños preescolares expuestos al trauma han encontrado varios niveles de síntomas de estrés relacionados al trauma dependiendo de la edad, los cuales pueden ser explicados por factores del desarrollo.Objetivo: Este estudio usa análisis en red para ampliar las investigaciones anteriores y comparar la presentación de síntomas en preescolares mayores y menores en la fase aguda (primeras 4 semanas).Método: Se evaluaron los síntomas de estrés agudo relacionados a trauma reportados por los padres a través de la escala de Sufrimiento Emocional Pediátrico – Early Screener www.kidtrauma.com. Primero, se comparó la severidad general de los síntomas y el nivel de los síntomas entre niños preescolares menores (1-3 años) y mayores (4-6 años). Luego, se modelaron y compararon dos modelos gráficos gaussianos de síntomas de estrés en preescolares menores (n = 242; Medad = 2.3 años; DEedad = 0.6 años) y mayores (n = 299; Medad = 4.8 años; DEedad = 0.7 años).Resultados: No hubo diferencias en la severidad general de los síntomas entre los grupos. Los niveles de síntomas para regresión del desarrollo y evasión de conversaciones sobre el tema, fueron más altos en los preescolares mayores. Las estructuras en red de los preescolares menores y mayores fueron mayormente similares. Los síntomas altamente centrales en ambas redes fueron el miedo y la ira no relacionados con el trauma. Las conexiones entre el miedo de recordatorios y apego excesivo fueron más fuertes en la red de los preescolares mayores. Las conexiones entre preocupación y tristeza y retraimiento; miedo de recordatorios y creación de juegos, historias y dibujos; y quejumbrosidad y apego excesivo, fueron todas más fuertes en la red de los preescolares menores.Conclusiones: Este estudio indica que la sintomatología de estrés relacionado a trauma en los preescolares menores y mayores no variaría de manera importante en la fase aguda. El miedo y la ira no relacionados al trauma parecen ser síntomas centrales en ambos grupos. Sin embargo, tras examinar asociaciones en los niveles de síntomas entre los grupos etarios, se revelaron conexiones diferenciales que podrían emerger a raíz de diferencias en el desarrollo. Si estos hallazgos se replicaran en estudios longitudinales y estudios controlados, podrían ayudar a adaptar las intervenciones para niños preescolares expuestos a trauma en la fase aguda.
背景: 先前对创伤暴露的学龄前儿童的研究发现, 不同的创伤相关应激症状水平取决于年龄, 可能由发育因素解释的。目的: 本研究使用网络分析来扩展先前的研究, 比较年幼和年长学龄前儿童急性期 (前 4 周) 的症状表现。方法: 使用儿科情绪困扰量表– 早期筛查 (www.kidtrauma.com) 评估父母报告的创伤相关急性应激症状。首先, 比较年幼 (1-3 岁) 和年长 (4-6 岁) 学龄前儿童的总体症状严重程度和症状水平。此外, 对年幼 (n = 242; Mage = 2.3 岁; SDage = 0.6 岁) 和年长 (n = 299; Mage = 4.8 岁; SDage = 0.7 岁) 的学龄前儿童应激症状的两个高斯图形模型进行了建模和比较。结果: 组间的总体症状严重程度没有差异。年长的学龄前儿童的发育倒退和回避谈论该事件症状水平更高。年幼和年长的学龄前儿童的网络结构基本相似。两个网络中的核心症状都是与创伤无关的恐惧和愤怒。在年长学龄前儿童的网络中, 对提示物的恐惧, 粘人以及与创伤无关的恐惧和粘人之间的关联更强。在年幼学龄前儿童的网络中, 担心, 悲伤和退缩之间, 对提示物的恐惧和创造游戏, 故事和图片之间, 抱怨和粘人之间的关联更强。结论: 本研究表明, 年幼和年长学龄前儿童的创伤相关应激症状在急性期可能没有很大不同。与创伤无关的恐惧和愤怒似乎是两人群的核心症状。然而, 对跨年龄人群症状水平关联的考查揭示了可能由发育差异引起的不同关联。如果能在纵向和被试内研究中重复, 这些发现可能有助于为急性期创伤暴露的学龄前儿童量身定制干预措施。.

Eighty percent of all patients suffering from major depressive disorder (MDD) relapse at least once in their lifetime. Thus, understanding the neurobiological underpinnings of the course of MDD is of utmost importance. A detrimental course of illness in MDD was most consistently associated with superior longitudinal fasciculus (SLF) fiber integrity. As similar associations were, however, found between SLF fiber integrity and acute symptomatology, this study attempts to disentangle associations attributed to current depression from long-term course of illness.
A total of 531 patients suffering from acute (N = 250) or remitted (N = 281) MDD from the FOR2107-cohort were analyzed in this cross-sectional study using tract-based spatial statistics for diffusion tensor imaging. First, the effects of disease state (acute v. remitted), current symptom severity (BDI-score) and course of illness (number of hospitalizations) on fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity were analyzed separately. Second, disease state and BDI-scores were analyzed in conjunction with the number of hospitalizations to disentangle their effects.
Disease state (pFWE < 0.042) and number of hospitalizations (pFWE< 0.032) were associated with decreased FA and increased MD and RD in the bilateral SLF. A trend was found for the BDI-score (pFWE > 0.067). When analyzed simultaneously only the effect of course of illness remained significant (pFWE < 0.040) mapping to the right SLF.
Decreased FA and increased MD and RD values in the SLF are associated with more hospitalizations when controlling for current psychopathology. SLF fiber integrity could reflect cumulative illness burden at a neurobiological level and should be targeted in future longitudinal analyses.