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Using clinical expertise and empirical data in constructing networks of trauma symptoms in refugee youth
European Journal of Psychotraumatology ( IF 5.783 ) Pub Date : 2021-06-09 , DOI: 10.1080/20008198.2021.1920200
Lea Schumacher 1, 2 , Julian Burger 3, 4 , Fionna Zoellner 1 , Areej Zindler 5 , Sacha Epskamp 4, 6 , Dana Barthel 1, 5
Affiliation  

ABSTRACT

Background: In recent years, many adolescents have fled their home countries due to war and human rights violations, consequently experiencing various traumatic events and putting them at risk of developing mental health problems. The symptomatology of refugee youth was shown to be multifaceted and often falling outside of traditional diagnoses.

Objective: The present study aimed to investigate the symptomatology of this patient group by assessing the network structure of a wide range of symptoms. Further, we assessed clinicians’ perceptions of symptoms relations in order to evaluate the clinical validity of the empirical network.

Methods: Empirical data on Post-Traumatic Stress Disorder (PTSD), depression and other trauma symptoms from N = 366 refugee youth were collected during the routine diagnostic process of an outpatient centre for refugee youth in Germany. Additionally, four clinicians of this outpatient centre were asked how they perceive symptom relations in their patients using a newly developed tool. Separate networks were constructed based on 1) empirical symptom data and 2) clinicians’ perceived symptom relations (PSR).

Results: Both the network based on empirical data and the network based on clinicians’ PSR showed that symptoms of PTSD and depression related most strongly within each respective cluster (connected mainly via sleeping problems), externalizing symptoms were somewhat related to PTSD symptoms and intrusions were central. Some differences were found within the clinicians’ PSR as well as between the PSR and the empirical network. Still, the general PSR-network structure showed a moderate to good fit to the empirical data.

Conclusion: Our results suggest that sleeping problems and intrusions play a central role in the symptomatology of refugee children, which has tentative implications for diagnostics and treatment. Further, externalizing symptoms might be an indicator for PTSD-symptoms. Finally, using clinicians’ PSR for network construction offered a promising possibility to gain information on symptom networks and their clinical validity.



中文翻译:

使用临床专业知识和经验数据构建难民青年创伤症状网络

摘要

背景: 近年来,许多青少年因战争和侵犯人权而逃离祖国,因此经历了各种创伤性事件,使他们面临出现心理健康问题的风险。难民青年的症状被证明是多方面的,而且往往不属于传统诊断的范畴。

目的:本研究旨在通过评估广泛症状的网络结构来调查该患者组的症状。此外,我们评估了临床医生对症状关系的看法,以评估经验网络的临床有效性。

方法:在德国难民青年门诊中心的常规诊断过程中,收集了N = 366 名难民青年关于创伤后应激障碍 (PTSD)、抑郁症和其他创伤症状的经验数据。此外,该门诊中心的四名临床医生被问及他们如何使用新开发的工具来看待患者的症状关系。基于 1) 经验症状数据和 2) 临床医生的感知症状关系 (PSR) 构建了单独的网络。

结果:基于经验数据的网络和基于临床医生 PSR 的网络均表明,PTSD 和抑郁症的症状在每个集群中的相关性最强(主要通过睡眠问题相关),外化症状与 PTSD 症状有一定的相关性入侵是中央。在临床医生的 PSR 以及 PSR 和经验网络之间发现了一些差异。尽管如此,一般的 PSR 网络结构显示出与经验数据的适度到良好的拟合。

结论:我们的结果表明,睡眠问题侵扰在难民儿童的症状学中起着核心作用,这对诊断和治疗具有初步意义。此外,外化症状可能是 PTSD 症状的指标。最后,使用临床医生的 PSR 进行网络构建为获取有关症状网络及其临床有效性的信息提供了有希望的可能性。

更新日期:2021-06-10
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