Child traumatic stress and unwanted intrusive thoughts

Sadly, about one of every four children will experience a traumatic event before the age of sixteen. The majority of these children develop posttraumatic stress reactions and a small proportion develops clinical syndromes such as posttraumatic stress disorder (PTSD). Amongst the most common posttraumatic stress reactions are intrusive re- experiencing symptoms, which include unwanted intrusive thoughts. Intrusive thoughts are symptomatic of many psychological disorders, but are also common in non-clinical individuals. Clinical studies have emphasized intrusive thoughts associated with negative affect. However, not all intrusive thoughts are negative or disruptive, and it is not normal for psychologically healthy individuals to only have positive or neutral thoughts. In fact, studies on the ratio between positive and negative thoughts emphasize balance between positive and negative cognitions, and suggest that deviations from this optimal balance maybe associated with psychopathology. By implication, there might also be an imbalance or funneling of intrusive thoughts, which is associated with PTSD or traumatic experiences per se. In a recent study with children affected by the Hurricane Katrina disaster a large sample of preschool and young elementary school-age children were surveyed about their unwanted intrusive thoughts (Sprung, in press). Surprisingly, there was no difference in the overall occurrence and frequency of intrusive thoughts between hurricane-exposed and a group of control children. However, a striking difference was found in the contents of children`s unwanted intrusive thoughts. A greater proportion of control children reported positive or neutral contents (e.g., thinking about a new toy or the last vacation), while the majority of hurricane- exposed children reported negative content (e.g. thoughts about a lost pet, an accident or damage through the hurricane). Whereas, in the control group there was a balance between positive and negative content, there was a funneling towards negative content in hurricane-exposed children. The main objective of the proposed research project is to further investigate this funneling effect, following other potentially traumatic experiences in childhood. For this, samples of children with experience of violence at home or school, as well as a sample of children who are especially likely to have traumatic experiences, namely children from families with a mental illness, will be compared with a group of control children. Children who show the funneling effect may be at increased risk of developing psychopathology, while children who show a balance between positive and negative contents may be more resilient. But why do some children fail to report having intrusive thoughts? That the prevalence of PTSD and PTSD symptoms has been reported to be lower in young children has been interpreted to suggest that young children are more resilient. However, children`s ability to report on their cognitive symptoms such as intrusive thoughts may also be influenced by their individual developmental level of cognitive functioning. Basic developmental research shows that preschool and young elementary school-age children are still learning about several fundamental aspects of thinking and its relationship to emotion. This suggests the hypothesis that some children may lack sufficient knowledge about thinking (e.g., about the partial uncontrollability of the mind) to report intrusive thoughts. In my study following Hurricane Katrina, children were also tested with a battery of tasks to assess their level of knowledge about thinking. It was found that children with more advanced knowledge about thinking were more likely to report intrusive thoughts, supporting the hypothesis that children`s knowledge about thinking underlies their ability to report on their cognitive symptoms. This finding will also be further examined in the proposed project, assessing children`s knowledge about thinking and their own intrusive thoughts in the sub- samples above (maltreatment, bullying, family with mental illness, and control). Moreover, children`s cognitive functioning can also be impaired following potentially traumatic experiences. They can have difficulties retrieving specific personal memories and this over-general memory effect has been linked to PTSD symptoms, especially intrusive thoughts. In the proposed project, this association between over-general memory and traumatic experiences will be examined in young children. By implication, there might also be a link between the over- general memory effect and the funneling of intrusive thoughts following traumatic experiences. This will also be investigated. Potentially traumatic experiences can also have a direct impact on young children`s knowledge about thinking, and this has been documented following experiences of violence at home and school, as well as for children from parents with mental illness. Thus, it will also be investigated whether knowledge about thinking is impaired in children from the above sub-samples compared to control group children.