Trajectory of Post-traumatic Stress and Depression among Children and Adolescents Following Single-incident trauma

Abstract

Objective: PTSD-depression has high comorbidity and understanding their relationship is of clinical and theoretical importance. A comprehensive way to understand posttrauma psychopathology is through symptom trajectories. The study aimed to look at the developmental courses of PTSD and depression symptoms in the initial months posttrauma, and their interrelationship in children and adolescents by utilizing advanced group-based trajectory modeling (GBTM). Methods: Two-hundred-and-seventeen children and adolescents aged between eight and 17 exposed to single-event trauma were included in the study. Their PTSD and depression symptoms were measured at two weeks, two months and nine months, with further psychological variables measures at the two-week assessment. Results: The GBTM modeling yielded a three-group model for PTSD and a three-group model for depression. All participants’ PTSD symptoms reduced to non-clinical level by nine months: participants were observed to be resilient (42.4%) or to be able to recover within two months (35.6%), while 21.9% experienced high level PTSD symptoms but recovered in nine months time. The depression trajectories described a chronic non-recovery depression group (20.1%) and two mild symptom groups (45.9%, 34.0%). Further analysis showed high synchronicity between PTSS and depression groups but predictor analysis revealed disparate predictors. Perievent panic (CPP), appraisal (CPTCI), rumination and thought suppression at week two predicted slow recovery from PTSS, while pre-trauma wellbeing (CPAS), post-trauma anxiety (SCAS) and appraisal (CPTCI) predicted chronic depression. Conclusions: Posttrauma depression was more persisting than PTSD symptoms at nine months in the sampled population. Cognitive appraisal may be central to explaining PTSD-depression comorbidity.