This study was undertaken 6–7 months after the 1999 Athens earthquake with the aim of exploring the differences in post-traumatic stress disorder (PTSD), anxiety and depression symptoms between a group of children exposed to earthquake with a group of children not exposed to it, but with both groups potentially exposed to the same levels of post-earthquake adversities. The study included 2037 children, aged 9–17 years, who were assessed with self-completed questionnaires. The directly exposed group (N = 1752) had significantly higher anxiety and PTSD scores than the indirectly exposed group (N = 284), but no significant group differences were found in depression scores. Girls in both groups reported significantly more PTSD, anxiety and depressive symptoms than boys. Younger children reported significantly more PTSD and anxiety symptoms than the older ones. No significant interactions were found between direct exposure to earthquake, age group and gender. The severity of PTSD symptoms was most strongly predicted by greater perceived threat during the earthquake, whereas depression was most strongly predicted by the level of post-earthquake adversity. The severity of anxiety symptoms was most strongly predicted by female gender. These findings are discussed in relation to the need for screening and intervention following earthquake events.

The Isle of Wight Studies began in 1964–65 with a series of epidemiological studies of educational, psychiatric and physical disorders in9- to 11-year-old children. These early studies were financed by the Department of Education and Science and the Foundation for Child Development (then the Association for the Aid of Crippled Children). The findings were fully reported in two books (Rutter, Tizard & Whitmore, 1970; Rutter, Graham & Yule, 1970) and only brief details are included here.

Background: “Stressbusters” is an interactive computer software programme based on a clinically effective face-to-face CBT protocol for young people with depression. It was designed for teenagers with mild to moderate depression, and comprises eight 45-minute sessions. Method: Twenty-three young people (aged 12–16; mean age 14.87 years) with symptoms of depression were recruited from CAMHS teams in Manchester and London, and received the Stressbusters treatment (range 1 – 8 sessions, mode 8 sessions). Results: On the K-SADS at initial assessment, 95% met diagnostic criteria for a depressive disorder, with a high group mean score of 35.48 (SD 9.84) on the MFQ. Post-treatment, 22% of young people met criteria for a depressive disorder, with the group mean score on the MFQ falling significantly below clinical cut-off to 20.32 (SD 11.75). These gains were maintained at 3-month follow-up. Significant improvements were also found in the adolescents' global functioning (CGAS), self-reported anxiety (RCMAS), depressive cognitions and attributions (ATQ and CTI-C), and in adolescent- and parent-reported emotional and behavioural difficulties (SDQ). Conclusions: Taken together, these results provide promising preliminary data for the clinical efficacy of Stressbusters as a valid form of CCBT for adolescents with depression.

Adult research suggests that the dissociation criterion of acute stress disorder has limited validity in predicting posttraumatic stress disorder (PTSD). We addressed this issue in child and adolescent survivors (n=367) of road accidents. Dissociation accounted for no significant unique variance in later PTSD, over and above other acute stress disorder criteria. Furthermore, thresholds of either three or more re-experiencing symptoms, or six or more re-experiencing/hyperarousal symptoms, were as effective at predicting PTSD as the full acute stress disorder diagnosis.

As part of a UNICEF-sponsored Psychosocial Programme in Bosnia, data were collected from a representative sample of 339 children aged 9–14 years, their mothers, and their teachers in order to investigate risk and moderating factors in children's psychological reactions to war. Self-report data from children revealed high levels of post-traumatic stress symptoms and grief reactions, but normal levels of depression and anxiety. Mothers' self-reports also indicated high levels of post-traumatic stress reactions, but normal levels of depression and anxiety. Child distress was related to both their level of exposure and to maternal reactions. Structural equation modeling was used to quantify the relationships between these risk factors and child distress, and to examine putative pathways to account for the association between child and maternal health. Children's adjustment was associated significantly with both exposure (ϕ = ·37) and maternal mental health (ϕ = ·37). Modeling also revealed a significant distorting effect of mother's own mental health on behavioural ratings of her child (ψ = ·59). Although evidence exists for an association between maternal mental health and mother rating errors, there is also a substantive association between maternal mental health and children's adjustment following war.

Research with clinically anxious adults has revealed that they estimate future negative events as far more likely to occur, relative to healthy controls. In addition, anxious adults estimate that such events are more likely to happen to themselves than to others. Previous research with anxious children and adolescents, in contrast, has revealed no increased probability estimates for negative events, relative to controls, and the events were rated as more likely to happen to others than to the self. The present study followed up these discrepant findings by investigating probability judgements concerning future negative events generated by children and adolescents who had actually experienced an extreme negative event and who met criteria for a diagnosis of Post-traumatic Stress Disorder ( PTSD). Control groups comprised a group of healthy participants, and a group of healthy participants whose parents had experienced a trauma and who met criteria for PTSD. The results revealed no overall differences between the clinical group and the controls. However, children and adolescents with PTSD estimated all negative events as significantly more likely to happen to others than to themselves, with this other-referent bias being strongest for events matched to their trauma. In contrast, the two control groups exhibited an other-referent bias for physically threatening events but not for socially threatening ones. Developmental analyses indicated that the strength of the relationship between anxiety and elevated judgements about future negative events declined with age in the control participants but that there was no significant relationship in the groups who had been exposed to trauma. The findings are discussed in the context of the literature on information processing biases and PTSD.

This paper examines risk factors for the development of Post Traumatic Stress Disorder (PTSD), and its severity and chronicity, in a group of 217 young adults who survived a shipping disaster in adolescence. The survivors were followed up 5 to 8 years after the disaster. Risk factors examined fell into three main categories: pre-disaster child and family vulnerability factors, including childhood psychopathology; objective and subjective disaster-related experiences; and post-disaster factors, including results from screening questionnaires administered 5 months post-disaster, coping mechanisms adopted subsequently, life events, and availability of social supports. Developing PTSD following the disaster was significantly associated with being female, with pre-disaster factors of learning and psychological difficulties in the child and violence in the home, with severity of exposure to the disaster, survivors' subjective appraisal of the experience, adjustment in the early post-disaster period, and life events and social supports subsequently. When all these factors were considered together, measures of the degree of exposure to the disaster and of subjective appraisal of life threat, and ratings of anxiety obtained 5 months post-disaster, best predicted whether survivors developed PTSD. For those survivors who developed PTSD, its duration and severity were best predicted not by objective and subjective disaster-related factors, but by pre-disaster vulnerability factors of social, physical, and psychological difficulties in childhood together with ratings of depression obtained 5 months post-disaster, and whether survivors received post-disaster support at school. The implications of these findings are considered for targeting assessment and intervention efforts at survivors most at risk of developing difficulties in adjustment following similar traumatic experiences.

Children are both the direct and indirect targets during wars. They are directly affected by violence aimed at them and their families; they are indirectly affected by the distress caused to their families; they may be internally displaced or find themselves crossing borders as asylum seekers. Their experiences during and immediately after war militate against their developing in a safe, secure, and predictable environment. Their human rights are compromised and their mental health put at risk.

Whether in the country at and after war, or in the country that offers refuge, children's mental health needs have to be properly assessed and met. In many cases, children may only require a sense of safety and support via their family and school. In other cases, they require more complicated psychosocial interventions that address the various stress reactions they manifest.

This paper addresses these issues against the context of a major community-based programme in Mostar in Bosnia during the recent civil war there. It argues that we have reasonably good screening measures to identify children at high risk of developing mental health problems. It presents an hierarchical model of support and intervention whereby psychosocial help is delivered primarily through schools with only a small proportion of more complex needs being met by specially trained mental health professionals. There is a strong need to evaluate various methods of delivering help and to develop new ways of reaching needy children in a nonstigmatising way.