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Children With Higher Intelligence Appear To Be At Reduced Risk Of Post-Traumatic Stress Disorder
Article Date: 09 Nov 2006 - 22:00 PST
Children who are more intelligent at age 6 may be less likely to experience trauma by age 17 and if they do, may be less likely to develop post-traumatic stress disorder (PTSD), according to a report in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals. In contrast, children who have anxiety disorders and conduct problems at age 6 appear more likely to develop PTSD following exposure to traumatic events.
PTSD is a psychological condition that occurs following exposure to a traumatic event, such as warfare, crime, a natural disaster or a life-threatening illness. Symptoms include sleep problems, depression, flashbacks and anxiety. However, not every individual exposed to such an event will develop PTSD, according to background information in the article. Researchers currently believe that certain factors--such as gender, race and socioeconomic background--predispose individuals to experiencing trauma and also increase their risk of developing PTSD following exposure to trauma. These factors may be more important than the type or severity of the trauma experienced in determining who will develop PTSD.
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Naomi Breslau, Ph.D., and colleagues at Michigan State University, East Lansing, studied 713 children (336 boys and 377 girls) born between 1983 and 1985 at two Michigan hospitals, one located in a disadvantaged urban community and one in a middle-class suburban community. At age 6, the children were given intelligence tests. Their teachers rated their behavior at school, and parents reported any symptoms of anxiety disorders, which include phobias (irrational fears), separation anxiety and generalized anxiety disorder. At age 17, the participants completed an interview designed to measure the number and type of traumatic events they had experienced in their lives and also how deeply those events affected them, including whether they had ever experienced symptoms of PTSD.
By age 17, 541 (75.9 percent) of the participants had experienced a traumatic event and 45 (6.3 percent, 8.3 percent of those experiencing trauma) met criteria for PTSD. Those who had an IQ of greater than 115 at age 6 were less likely to be exposed to any type of trauma, especially violent assaults, and were less likely to develop PTSD by age 17 when they did experience a traumatic event. Those whose teachers reported that they had more conduct problems than normal at age 6 had a higher risk of being exposed to violent crime, such as rape, mugging or beating, by age 17. Those children, and also those with anxiety disorders at age 6, were about twice as likely as those who did not have conduct problems or anxiety disorders to develop PTSD by age 17 if they were exposed to a traumatic event.
Sociodemographic factors also influenced the children's risk for exposure to traumatic events and for PTSD. "We observed in these data the sex-related pattern reported in previous studies, with males more likely to be exposed to trauma, and females more likely to experience PTSD following exposure," the authors write. "As in previous studies, the cumulative incidence of exposure to traumatic events was higher in inner-city (urban) youth than in suburban youth."
Individuals with high IQ were less prone to PTSD even if they had other factors, such as anxiety disorders and an urban background, stacked against them. "The ways in which high IQ might protect from the PTSD effects of traumatic exposure are unclear," the authors conclude. "The findings underscore the importance of investigating cognitive processes in a person's responses to challenging and potentially traumatic experiences and the involvement of general intelligence in shaping them."
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(Arch Gen Psychiatry. 2006;63:1238-1245. Available pre-embargo to the media at www.jamamedia.org.)
This study was supported by grants from the National Institutes of Health, Bethesda, Md. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Contact: Tom Oswald
JAMA and Archives Journals
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Study explores link between depression, anxiety and asthma in Puerto Rican children
Parents of Puerto Rican children are more likely than parents in other ethnic groups to report asthma among their children, and researchers wonder if the relationship between asthma symptoms and psychological problems may explain why.
The connections between asthma and psychological symptoms are complex, and it is difficult to disentangle what's really causing the various symptoms suffered by Puerto Rican children in this study, said Alexander Ortega, the study's lead author and associate professor of public health at Ohio State University.
His study found that children whose parents reported they had asthma were more likely than others to have a depressive disorder. Those children whose parents reported they had actual asthma attacks were more likely to have not just depressive disorders, but also anxiety disorders, such as separation anxiety.
However, Ortega said the reasons behind these associations are not yet clear.
"There's a lot of confusion as to what the symptoms of asthma really are, and it is easy to confuse some psychiatric symptoms with symptoms of asthma," Ortega said. "There's no standard way to diagnose the disease. A well-meaning parent may suggest to a pediatrician that her child has asthma, which could help lead to a misdiagnosis."
Ortega pointed out that asthma, panic attack and separation anxiety have similar symptoms, including shortness of breath, chest tightness and physical anxiety. This sometimes makes it difficult to determine which disorder a child may have, based on symptomatology alone.
The study appears in a recent issue of the journal Psychosomatics.
The researchers interviewed nearly 1,900 Puerto Rican children, ages 4 to 17, and their parents. The children lived in cities and rural regions in Puerto Rico.
For reasons that aren't quite clear, Puerto Rican children have significantly higher asthma rates than do children of any other ethnic group, including Mexican-American and other Hispanic children. Experts say the incident rate of asthma among Puerto Rican children is as high as 30 percent, compared to an average of 5 to 16 percent among other ethnic groups.
"One reason for such astoundingly high asthma rates is that Puerto Rican children and their families may have different perceptions of the symptom severity," Ortega said. "Or they might experience those symptoms differently."
There may also be cross-cultural differences in how Puerto Ricans interpret the terminology and symptoms associated with asthma.
By studying this population, the researchers hoped to tease out a clearer relationship between asthma, anxiety and depression.
Of the 1,900 children in the study, parents of about 600 children said their child had asthma, while parents of 400 of these children reported that their child had had an asthma attack.
"Again, it's difficult to diagnose asthma in the first place, so a parent may assume that her child's breathing difficulties are due to asthma when something else entirely could be going on," Ortega said.
Parents answered questions related to their child's asthma and if the child had ever shown signs of anxiety or depression. Children and their parents were asked to describe feelings related to anxiety and depression.
According to parent reports, children who had had an asthma attack had higher rates of depressive and anxiety disorders than did asthmatic children who had never had an attack and children who didn't have asthma.
Specifically, children who had had an attack were more likely to suffer from major depression along with symptoms of depression, including irritability, loss of interest in activity, weight gain or loss and fatigue. These children were also more likely to experience separation anxiety disorder and generalized anxiety disorder, or feelings of restlessness.
"It's possible that having an asthma attack, or the threat of having an attack, makes a child nervous about being away from his or her parents," Ortega said.
"The mechanisms behind asthma and mental illness are multiple and complex," Ortega said. "Children may fear the exacerbation of asthma symptoms, causing them to be anxious and fear separation from a parent. They may also feel distressed from internalizing the chronic burden of asthma.
"There's some evidence suggesting that psychiatric disorders in youth are related to the onset and persistence of asthma, so we need to think about creative ways for intervening."
Ortega conducted the study with researchers from Brown University, the University of Puerto Rico and Columbia University.
This study received support from the National Institutes of Mental Health.
Contact: Alexander Ortega, (614) 293-8547; aortega@sph.osu.edu
Written by Holly Wagner, (614) 292-8310; Wagner.235@osu.edu
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