A Community Study on the Relationship of Posttraumatic Cognitions to Internalizing and Externalizing Psychopathology in Taiwanese Children and Adolescents

Abstract

A growing number of studies indicate that posttraumatic cognitions play a crucial role in the development and maintenance of posttraumatic stress disorder (PTSD). However, the effects of posttraumatic cognitions on general psychopathology beyond PTSD remain unclear. The current study aimed to validate the Chinese version of the Child Posttraumatic Cognitions Inventory (CPTCI-C) and to investigate the relationship between posttraumatic cognitions and psychopathology. A community sample of 285 school-aged children and adolescents (aged 9-17, 160 [56.1 %] female) reported their trauma-related cognitions on the CPTCI-C and completed measures of symptoms of PTSD, depression, and generalized anxiety. Parents reported their children's internalizing and externalizing problems. We validated a revised version of the CPTCI-C based on the results of confirmatory factor analyses. The resulting evidence suggests that this revised CPTCI-C possesses good internal consistency, fair 6-week temporal stability, and good concurrent validity. In addition to significant correlations between posttraumatic cognitions and internalizing and externalizing psychopathology, after controlling for age, gender, and trauma types, both the revised CPTCI-C subscale scores conveyed unique contributions to psychological distress while only the maladaptive appraisals of the trauma remained weakly associated with externalizing problems. Structural equation modeling analysis showed that maladaptive appraisals of the trauma had a direct longitudinal impact on chronic PTSD severity. No mediation effect of posttraumatic cognitions on the relationship between acute and chronic PTSD activity was observed. The implications of our findings are discussed for the specificity of posttraumatic cognitions to posttraumatic internalizing psychopathology and cognitive interventions that target negative trauma-related cognitions.

Dysfunctional maltreatment-related cognitions in children and adolescents

“…The moderate correlations between dysfunctional cognitions and externalizing symptoms in our study were slightly stronger than in studies which had assessed proxy-reported externalizing symptoms [14, 16]. Again, discrepancies between self-reports and proxy-reports might be one reason for the slightly different results.…”

“…In contrast, studies comparing dysfunctional cognitions with parent-reported internalizing problems found smaller correlations [14, 16]. Discrepancies between self-reports and proxy-reports are in line with the literature [49].…”

Longitudinal Associations Between Dysfunctional Maltreatment‐Related Cognitions and Psychopathology in Children and Adolescents

“…The significant cross-sectional correlations at each assessment, in line with our second hypothesis, confirmed previous findings on the association between dysfunctional posttraumatic cognitions and PTSS (see Mitchell, Brennan, Curran, Hanna, & Dyer, 2017) as well as their association with internalizing and externalizing problems (Leeson & Nixon, 2011;Liu & Chen, 2015). They are also in line with the findings reported in a nationally representative German sample in which youth affected by violence showed both internalizing and externalizing mental health problems, and they also exhibited significantly higher rates of cumulative mental health problems (Schlack & Petermann, 2013).…”

The manifestation of post-traumatic stress in children and young persons aged 7-14 years and implications for PTSD diagnosis

“…Several studies have demonstrated that post-traumatic cognitions are predictive of the severity and chronicity of PTSD symptoms (Hitchcock, 2015;Liu & Chen, 2015;Ma et al, 2011;Palosaari et al, 2013;Ponnamperuma & Nicolson, 2016), and may play an influential role in the maintenance of PTSD. In a longitudinal study with war-exposed Palestinian children aged 10-12 years, Palosaari et al (2013) found that high levels of post-traumatic cognitions at 3 months post exposure to trauma significantly predicted a worsening of PTSD symptoms 5 and 11 months post-trauma.…”