Group interventions for mental health have proved very effective, but there is little consensus on their mechanism of action. In the present study, we posit that normative change is a plausible mechanism and provide a test of this in an eating disorder prevention group program. Participants were 112 women aged 15-25 years with body, shape or weight concerns who completed five questionnaires across the four session group-based intervention. Results indicated that participants experienced a significant reduction in thin-ideal internalization, body dissatisfaction and dieting intentions across the course of the program. These decrements were preceded by changes in group norms. Changes in both descriptive norms and injunctive norms in the first half of the program predicted improvement in thin-ideal internalization, body dissatisfaction and dieting intentions in the second half. Implications for theoretical models of attitude change are discussed, as well as implications for group interventions more generally.

Objectives: This study investigated trauma symptom trajectories of children 2–16 years old following admission to pediatric intensive care and identified factors that predicted a child’s trauma symptom trajectory. Design: Prospective longitudinal design. Setting: Two tertiary care PICUs in Brisbane, Qld, Australia. Patients: Children 2–16 years old admitted to PICU for longer than 8 hours. Measurements Main Results: Maternal reported child posttraumatic stress symptoms (n = 272) on the Trauma Symptom Checklist for Young Children were used to assess posttraumatic stress symptoms up to 12 months post admission. Semiparametric group-based trajectory analyses were completed to identify patterns over time. Age, gender, length of stay, premorbid functioning, maternal perceived threat to life, and maternal acute distress were assessed as potential risk factors. Three likely trajectory groups were identified. The majority of children were resilient (83.8%); however, a significant minority experienced chronic symptoms (12.9%) or elevated stress symptoms which resolved quickly (3.3%). After controlling for other variables, maternal report of premorbid internalizing behavior significantly predicted both chronic (odds ratio, 6.3) and recovery (odds ratio, 38.0) trajectories. Maternal acute distress significantly predicted child chronic symptom trajectories (odds ratio, 5.2). Conclusions: Children with elevated trauma symptoms postintensive care need timely and effective intervention. The majority of children with high levels of acute symptoms will continue to have chronic, ongoing posttraumatic stress symptoms. In addition, acute maternal distress and preexisting internalizing child behavior predict ongoing psychologic distress after discharge from the PICU. Screening in the acute period post-PICU admission may identify children likely to experience ongoing chronic posttraumatic distress symptoms and enable targeted treatment of children at risk. This is the first study to examine symptom trajectories in children following pediatric intensive care admission and includes a sample of very young children.

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