Characteristics of the Children's Revised Impact of Event Scale in a Clinically Referred Dutch Sample

Early identification of posttraumatic stress disorder (PTSD) in children is important to offer them appropriate and timely treatment. The Children's Revised Impact of Event Scale (CRIES) is a brief self‐report measure designed to screen children for PTSD. Research regarding the diagnostic validity of the CRIES is still insufficient, has been restricted to specific populations, and sample sizes have often been small. This study evaluated the reliability and validity of the 8‐item (CRIES‐8) and 13‐item (CRIES‐13) versions of the CRIES in a large clinically referred sample. The measure was completed by 395 Dutch children (7–18 years) who had experienced a wide variety of traumatic events. PTSD was assessed using the Anxiety Disorders Interview Schedule for DSM‐IV: Child and Parent version. A cutoff score of 17 on the CRIES‐8 and 30 on the CRIES‐13 emerged as the best balance between sensitivity and specificity, and correctly classified 78%–81% of all children. The CRIES‐13 outperformed the CRIES‐8, in that the overall efficiency of the CRIES‐13 was slightly superior (.81 and .78, respectively). The CRIES appears to be a reliable and valid measure, which gives clinicians a brief and user‐friendly instrument to identify children who may have PTSD and offer them appropriate and timely treatment.     

The Utility of the Children's Revised Impact of Event Scale in Screening for Concurrent PTSD Following Admission to Intensive Care

Although there is some information available regarding the utility of the Children's Revised Impact of Event Scale (CRIES) in screening for posttraumatic stress disorder (PTSD), data are scarce and limited to studies sampling children predominantly injured in road traffic accidents. This study investigated the utility of 2 versions, the CRIES‐8 and CRIES‐13, in identifying those children meeting criteria for PTSD following admission to a pediatric intensive care unit (PICU). The Children's PTSD Inventory (CPTSDI), a diagnostic interview, and the CRIES‐13 were administered to 55 children, aged 6–16 years, 6 months following admission to the PICU. Of the 55, 14 (25%) met criteria on the CPTSDI. Cutoff scores of 14.5 on the CRIES‐8 and 22.5 on the CRIES‐13 maximized sensitivity and specificity and correctly classified 78%–86% of children. Both cutoff scores were lower than those reported in other samples. The CRIES‐13 appeared to offer greater utility than the CRIES‐8, also in contrast to previous findings. Methodological or sampling differences may account for the discrepancy with prior studies. The proposed cutoffs are recommended specifically for use with PICU patients and replication and further validation of the CRIES with other samples is warranted.     

The Children's Revised Impact of Event Scale: Dimensionality and Measurement Invariance in a Sample of Children and Adolescents Exposed to Wildfires

Natural disasters are potentially traumatic events due to their disruptive nature and high impact on social and physical environments, particularly for children and adolescents. The present study aimed to examine the psychometric properties of the Children's Revised Impact of Event Scale (CRIES‐13) in a sample of Portuguese children and adolescents exposed to a specific type of natural disaster (i.e., wildfire). The sample was recruited at six school units of the Central region of Portugal following wildfires in the summer of 2017 and included children and adolescents without a clinical diagnosis of a psychopathological condition associated with exposure to the traumatic event (i.e., nonclinical sample, n = 486) and those with a clinical diagnosis of a trauma‐ and/or stress‐related disorder (i.e., posttraumatic stress disorder [PTSD], adjustment disorder, separation anxiety disorder, or grief; clinical sample, n = 54). Confirmatory factor analyses indicated that a two‐factor model (i.e., Intrusion/Arousal and Avoidance) provided a better fit than a three‐factor model (i.e., Intrusion, Arousal, and Avoidance) and was found to be invariant across gender and age groups. The CRIES‐13 showed good reliability for all subscales, with Cronbach's αs > .79. Higher CRIES‐13 scores were associated with poorer health and well‐being and more internalizing and externalizing problems. The clinical sample presented with significantly higher CRIES‐13 scores than the nonclinical sample, η_p² = .13. These results contribute to the cross‐cultural validation of the CRIES‐13 and support its use as a reliable and valid measure for assessing posttraumatic symptoms in children and adolescents.     

Development and Evaluation of the Thinking About Recovery Scale: Measure of Parent Posttraumatic Cognitions Following Children's Exposure to Trauma

Researchers have recently suggested that parent posttraumatic appraisals potentially contribute to the development of posttraumatic stress in both parents and children following children's exposure to trauma. However, a single‐instrument, multidimensional measure of parent posttraumatic cognitions as they relate to their child's recovery has yet to be operationalized. This study described the development and evaluation of a parent‐report questionnaire of parent posttraumatic cognitions, designed to be used after a child's exposure to trauma. We generated an initial pool of items in reference to existing theories and subjected this list to an iterative process of item writing and revision. Items were subjected to expert review to maximize construct validity. The 33‐item Thinking About Recovery Scale (TARS), which measures three domains (My child has been permanently damaged; The world is dangerous for my child; Parents should always promote avoidance) demonstrated good internal consistency (Cronbach's α = .74‐88) and convergent validity (r ² range = .08‐.40) when piloted in a sample of 116 parents of children who had been exposed to a serious accidental injury. The TARS augments the available literature by providing a brief measure of parent posttraumatic cognitions, an area which is currently understudied in childhood posttraumatic stress and could have broad clinical and research use.     

Association Between Parents’ PTSD Severity and Children's Psychological Distress: A Meta‐Analysis

The authors conducted a meta‐analysis of studies on the correlation between parents’ PTSD symptom severity and children's psychological status. An extensive search of the literature yielded 550 studies that were screened for inclusion criteria (i.e., parent assessed for PTSD, child assessed for distress or behavioral problems, associations between parent PTSD and child status examined). Sixty‐two studies were further reviewed, resulting in a final sample of 42 studies. Results yielded a moderate overall effect size r = .35. The authors compared effect sizes for studies where only the parent was exposed to a potentially traumatic event to studies where both parents and children were exposed. A series of moderators related to sample characteristics (sex of parent, type of traumatic event) and study methods (self‐report vs. diagnostic interview, type of child assessment administered) were also evaluated. The only significant moderator was type of trauma; the effect size was larger for studies with parent–child dyads who were both exposed to interpersonal trauma (r = .46) than for combat veterans and their children (r = .27) and civilian parent–child dyads who were both exposed to war (r = .25). Results support the importance of considering the family context of trauma survivors and highlight areas for future research.     

Acute stress disorder and posttraumatic stress disorder in parents of injured children

Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) were examined in 334 parents of children with traffic‐related injuries. In the first month after their child's injury, 12% of parents had ASD and another 25% had partial ASD. Among 251 parents assessed again approximately 6 months postinjury, 8% had PTSD and another 7% had partial PTSD. The ASD and PTSD severity were associated (r = .54), but ASD status was not a sensitive predictor of later PTSD. Independent predictors of ASD severity included prior trauma exposure, peritrauma exposure and perceptions of the child's pain and life threat, and child ASD severity. Independent predictors of PTSD severity included prior trauma exposure, parent ASD severity, and parent‐rated child physical health at follow‐up.     

Child posttraumatic stress symptoms in an acute injury sample: Patterns of associations among child report,parent report,and child heart rate parameters

Parent–child agreement on measures of child posttraumatic stress disorder (PTSD) is moderate at best, and understanding of this discrepancy is limited. To address this, we conducted an item-level investigation of parent–child symptom agreement to examine the potential influence of parental posttraumatic stress symptoms (PTSS) on parents’ reports of their child's PTSS. We also examined heart rate (HR) indices as possible independent indicators of child PTSD, examining patterns of association with parent versus child report. Parent–child dyads (N = 132, child age: 6–13 years, 91.7% White) were recruited after the child's hospital admission following an acute, single-incident traumatic event. At 1-month posttrauma, questionnaires assessing children's PTSS (self- and parental reports) and parental PTSS were administered. For a subset of participants (n = 70), children's HR recordings were obtained during a trauma narrative task and analyzed. Parent and child reports of child PTSS were weakly positively correlated, r = .25. Parental PTSS were found to be stronger positive predictors of parental reports of child PTSS than the children's own symptom reports, β = 0.60 vs. β = 0.14, and were associated with higher parent-reported child PTSS relative to child reports. Finally, children's self-reported PTSS were associated with HR indices, whereas parent reports were not, βs = −.33–.30 vs. βs = −.15–.01. Taken together, children's self-reported PTSS could be a more accurate reflection of their posttrauma physiological distress than parent reports. The potential influence of parental PTSS on their perceptions of their child's symptoms warrants further consideration.     

The Child Trauma Screen: A Follow‐Up Validation

Although the prevalence of exposure to potentially traumatic events and associated outcomes among children is well documented, widespread trauma screening remains limited. This study provides additional data supporting the psychometrics of the Child Trauma Screen (CTS), a free, brief, empirically derived measure that was intended as a trauma screen for use across child‐serving systems. Participants were an ethnically diverse sample of 187 children aged 6–18 years recruited from an urban children's community mental health clinic. At intake, children and their caregivers completed the CTS and other standardized measures of posttraumatic stress disorder, externalizing behavior, anxiety, and depression. Results indicated that the CTS had strong properties on both child and caregiver reports, including internal consistency (Cronbach's α = .78 for both), convergent validity (r = .83 and r = .86), divergent validity (mean across measures and reporters, r = .31; range r = .01–.70), and criterion validity (sensitivity = 0.83 and 0.76; specificity = 0.95 and 0.79, correct classification 89.3% and 81.4%). Suggested cut points and recommendations for using the CTS as a trauma screen are provided. This study provides further empirical support for the use of the CTS as a brief trauma screening measure and provides recommendations for further research.     

An Update on the Clinical Utility of the Children's Post‐Traumatic Cognitions Inventory

The Children's Post‐Traumatic Cognitions Inventory (CPTCI) is a self‐report questionnaire that measures maladaptive cognitions in children and young people following exposure to trauma. In this study, the psychometric properties of the CPTCI were examined in further detail with the objective of furthering its utility as a clinical tool. Specifically, we investigated the CPTCI's discriminant validity, test‐retest reliability, and the potential for the development of a short form of the measure. Three samples (London, East Anglia, Australia) of children and young people exposed to trauma (N = 535; 7–17 years old) completed the CPTCI and a structured clinical interview to measure posttraumatic stress disorder (PTSD) symptoms between 1 and 6 months following trauma. Test‐retest reliability was investigated in a subsample of 203 cases. The results showed that a score in the range of 46 to 48 on the CPTCI was indicative of clinically significant appraisals as determined by the presence of PTSD. The measure also had moderate‐to‐high test‐retest reliability (r = .78) over a 2‐month period. The Children's Post‐Traumatic Cognitions Inventory‐Short Form (CPTCI‐S) had excellent internal consistency (α = .92), and moderate‐to‐high test‐retest reliability (r = .78). The examination of construct validity showed the model had an excellent fitting factor structure (Comparative Fit index = 0.95, Tucker‐Lewis index = 0.91, Root Mean Square Error of Approximation = .07). A score ranging from 16 to 18 was the best cutoff point on the CPTCI‐S, in that it was indicative of clinically significant appraisals as determined by the presence of PTSD. Based on these results, we concluded that the CPTCI is a useful tool to support the practice of clinicians and that the CPTCI‐S has excellent psychometric properties.     

Externalizing and Internalizing Subtypes of Posttraumatic Psychopathology and Anger Expression

Subtypes of posttraumatic psychopathology were replicated and extended in 254 female veterans with posttraumatic stress disorder (PTSD). Cluster analyses on Minnesota Multiphasic Personality Inventory‐2 and Personality Psychopathology Five scales (Harkness, McNulty, & Ben‐Porath, 1995 ) yielded internalizing and externalizing psychopathology dimensions, with a third low psychopathology group (simple PTSD). Externalizers were higher than the internalizers and the simple PTSD groups on the antisocial, substance, and aggression scales; internalizers were higher on depression and anxiety scales. Further validation included an independent measure of psychopathology to examine anger (Buss‐Durkee Hostility Inventory, [BDHI]; Buss & Durkee, 1957 ). Externalizers were higher on extreme behavioral anger scales (assault and verbal hostility); and externalizers and internalizers were higher than the simple PTSD subjects on other anger scales. Positive correlations between the BDHI scales and the PTSD symptom of “irritability and anger outbursts” were found across scales in the total sample (range: r = .19–.36), on the assault scale in externalizers (r = .59), and the verbal hostility scale in both internalizers (r = .30) and simple PTSD (r = .37) groups, suggesting the broad utility of the symptom in the diagnosis. The results demonstrate the generalizability of the internalizing/externalizing typology to the female veteran population and highlight clinically relevant distinctions in anger expression within PTSD.     

Posttraumatic Stress Symptoms and Disorders in Parents of Children and Adolescents With Chronic Physical Illnesses: A Meta‐Analysis

The present meta‐analysis analyzed whether parents of young people with pediatric chronic physical illnesses experience higher levels of posttraumatic stress symptoms (PTSS) and higher rates of posttraumatic stress disorder (PTSD) than other adults and searched for correlates of PTSS in these parents. Based on a systematic search in electronic databases, 184 studies were included in the meta‐analysis. On average, 18.9% of the parents fulfilled the criteria for PTSD, and PTSS were more common among parents of young people with pediatric chronic physical illnesses than in other adults, with Hedges' g showing a 0.85 increase in standard deviation units. Parental PTSS were most prevalent among parents of children with epilepsy, g = 1.25, and diabetes, g = 1.16, and were positively associated with being the mother, r = .19; illness severity, r = .18; treatment duration/intensity, r = .21; and PTSS of the child, r = .34. In contrast, longer illness duration, r = ?.19; longer time since active treatment, r = ?.10; and better social resources, rs = ?.17 to ?.07, were associated with lower parental PTSS. The findings indicate that parents who have faced traumatic events in the context of their child's chronic illnesses should be screened for PTSS and PTSD and receive psychological interventions when needed.     

A Meta‐Analysis of the Association Between Appraisals of Trauma and Posttraumatic Stress in Children and Adolescents

Cognitive models of posttraumatic stress disorder (PTSD) place an emphasis on the role of negative appraisals of traumatic events. It is suggested that the way in which the event is appraised determines the extent to which posttraumatic stress symptoms will be experienced. Therefore, a strong relationship between trauma appraisals and symptoms of PTSD might be expected. However, this relationship is not as firmly established in the child and adolescent literature. A systematic literature review of this relationship returned 467 publications, of which 11 met full eligibility criteria. A random effects meta‐analysis revealed a large effect size for the relationship between appraisals and PTSD symptoms in children and adolescents, r = .63, 95% CI [.58, .68], Z = 17.32, p < .001, with significant heterogeneity present. A sensitivity analysis suggested that this relationship was not contingent on 1 specific measure of appraisals. Results were consistent with the cognitive behavioral theory of PTSD, demonstrating that appraisals of trauma are strongly related to posttraumatic stress in children and adolescents. However, this relationship was not observed in a sample of 4‐ to 6‐year‐olds, indicating that further research is required to explicate cognitive processing of trauma in very young children.     

Parent and Child Trauma Symptoms During Child–Parent Psychotherapy: A Prospective Cohort Study of Dyadic Change

Five randomized controlled trials have shown that child–parent psychotherapy (CPP) improves trauma symptoms in children. Less is known about parent symptoms or moderators of symptom change. In a sample of 199 parent (81% biological mother; 54% Latina/o) and child (aged 2 to 6 years; 52% male; 49% Latina/o) dyads who participated in an open treatment study of CPP, this study investigated whether parent and child symptoms similarly decreased during treatment and whether improvement was moderated by parent, child, and treatment characteristics. Parents completed baseline and posttreatment interviews regarding exposure to traumatic events, posttraumatic stress symptomatology (PTSS), and other mental health indices. Latent difference score analysis showed that PTSS significantly decreased by more than 0.5 SD for parents and children. The PTSS improvement in parents was associated with reductions in child avoidance, r = .19, p = .040, and hyperarousal, r = .33, p < .001. Girls showed a greater reduction than boys in reexperiencing, β = −.13, p = .018, and hyperarousal, β = −.20, p = .001. Contrary to expectations, parent and child improvement in PTSS was greater for those with fewer parental lifetime stressors, β_range = .15 to .33, and for those who participated in fewer treatment sessions, β_range = .15 to .21. The extent of improvement in parent PTSS varied based on clinician expertise, β = −.20, p = .009. Significant reductions in parent and child PTSS were observed during community-based treatment, with CPP and symptom improvement varying according to child, parent, and treatment characteristics.     

Modeling Patterns of Polyvictimization and Their Associations with Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in the Israeli Population

Although evidence is accumulating for the conceptual validity of the ICD‐11 proposal for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD), our understanding of the specificity of trauma‐related predictors is still evolving. Specifically, studies utilizing advanced statistical methods to model the association between trauma exposure and ICD‐11 proposals of traumatic stress and differences in profiles of trauma exposure are lacking. Additionally, time since trauma and a clear memory of the trauma are yet to be examined as predictors of PTSD and CPTSD. We analyzed trauma exposure as reported by a general population sample of Israeli adults (N = 834), using latent class analysis, and the resultant classes were used in regression models to predict PTSD and CPTSD operationalized both dimensionally and categorically. Four distinct groups were identified: child and adult interpersonal victimization, community victimization–male, community victimization–female, and adult victimization. These groups were differentially related to PTSD and CPTSD, with only child and adult interpersonal victimization consistently predicting CPTSD and disturbances in self‐organization. When modeled dimensionally, PTSD was associated with the child and adult interpersonal victimization and adult victimization groups, whereas only the child and adult interpersonal victimization group was predictive of PTSD when operationalized categorically. The roles of time since trauma and a clear memory of the trauma differed across PTSD and CPTSD. These findings support the use of trauma typologies for predicting PTSD and CPTSD and provide important insight into the distribution of trauma exposure in the Israeli population.     

Changes in Coping and Negative Cognitions as Mechanisms of Change in Online Treatment for Rape‐Related Posttraumatic Stress Disorder

Cognitive behavioral therapy (CBT)–based interventions, including those administered via telepsychology, represent efficacious posttraumatic stress disorder (PTSD) treatments. Despite demonstrated efficacy, limited research has examined mechanisms of change for CBT. We examined trauma‐related cognitions and coping as treatment mechanisms among 46 women who completed a randomized clinical trial of a CBT‐based, telepsychology‐delivered interactive program for rape survivors. The results indicated that both the interactive program, d = 1.5, and the active control condition, a psychoeducational website, d = 1.4, resulted in large reductions in posttest PTSD symptoms. Analysis of residual gain scores showed that reductions in the three types of assessed trauma‐related cognitions were strongly related to reductions in PTSD symptoms among women assigned to the interactive program, rs = .60–.79, but only weakly related to symptom reduction among those assigned to active control, rs = .06–.31. The results also suggest that increases in trauma‐related approach coping were weakly related to reductions in PTSD symptoms among participants in the interactive program, rs = ?.16 and ?.17, but, conversely, decreases in trauma‐related approach coping were weakly related to reductions in PTSD symptoms among those in the active control group, rs = .07 and .28. Reductions in avoidance coping were modestly related to reductions in PTSD symptoms among women in the interactive program, rs = .38 and .38, but unrelated to changes in PTSD symptoms among those assigned to the active control, rs = .03 and .05. Implications for future work examining mechanisms of change for PTSD treatments are discussed.     

Is maternal PTSD associated with greater exposure of very young children to violent media?

This study examined media viewing by mothers with violence‐related posttraumatic stress disorder (PTSD) and related media exposure of their preschool‐age children. Mothers (N = 67) recruited from community pediatric clinics participated in a protocol involving a media‐preference survey. Severity of maternal PTSD and dissociation were significantly associated with child exposure to violent media. Family poverty and maternal viewing behavior were also associated. Maternal viewing behavior mediated the effects specifically of maternal PTSD severity on child exposure. Clinicians should assess maternal and child media viewing practices in families with histories of violent trauma exposure and related psychopathology.     

Psychometric Properties of the Child PTSD Symptom Scale in Latino Children

The Child PTSD Symptom Scale (Foa, Johnson, Feeny, & Treadwell, 2001 ) is a self‐report measure of posttraumatic stress disorder symptoms (PTSD) in children and adolescents. Despite widespread use of this measure, no study to our knowledge has examined its psychometric properties in Latino children. This study examined the factor structure, internal consistency, and convergent validity of the measure utilizing a sample of 161 Latino students (M = 11.42 years, SD = 0.70) at high risk of exposure to community violence. Confirmatory factor analyses suggested that a 3‐factor model consistent with the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM‐IV‐TR; American Psychiatric Association, 2000 ) provided the best fit to the data. Internal consistency of the total scale and subscales was high when completed in English or Spanish. All Child PTSD Symptom Scale scores were positively correlated with violence exposure. As additional evidence of convergent validity, scores evidenced stronger correlations with internalizing symptoms than with externalizing symptoms. Results supported the use of the Child PTSD Symptom Scale as a measure of PTSD severity in Latino children, but additional research is needed to determine appropriate clinical cutoffs for Latino youths exposed to chronic levels of violence. Implications for clinical practice and future research are discussed.     

Temporal Associations Among Chronic PTSD Symptoms in U.S. Combat Veterans

The present study examined fluctuation over time in symptoms of posttraumatic stress disorder (PTSD) among 34 combat veterans (28 with diagnosed PTSD, 6 with subclinical symptoms) assessed every 2 weeks for up to 2 years (range of assessments = 13–52). Temporal relationships were examined among four PTSD symptom clusters (reexperiencing, avoidance, emotional numbing, and hyperarousal) with particular attention to the influence of hyperarousal. Multilevel cross‐lagged random coefficients autoregression for intensive time series data analyses were used to model symptom fluctuation decades after combat experiences. As anticipated, hyperarousal predicted subsequent fluctuations in the 3 other PTSD symptom clusters (reexperiencing, avoidance, emotional numbing) at subsequent 2‐week intervals (rs = .45, .36, and .40, respectively). Additionally, emotional numbing influenced later reexperiencing and avoidance, and reexperiencing influenced later hyperarousal (rs = .44, .40, and .34, respectively). These findings underscore the important influence of hyperarousal. Furthermore, results indicate a bidirectional relationship between hyperarousal and reexperiencing as well as a possible chaining of symptoms (hyperarousal → emotional numbing → reexperiencing → hyperarousal) and establish potential internal, intrapersonal mechanisms for the maintenance of persistent PTSD symptoms. Results suggested that clinical interventions targeting hyperarousal and emotional numbing symptoms may hold promise for PTSD of long duration.     

The Cycle of Violence: Associations Between Exposure to Violence,Trauma‐Related Symptoms and Aggression—Findings from Congolese Refugees in Uganda

War‐related trauma exposure has been linked to aggression and enhanced levels of community and family violence, suggesting a cycle of violence. Reactive aggression—an aggressive reaction to a perceived threat—has been associated with posttraumatic stress disorder (PTSD). In contrast, appetitive aggression—a hedonic, intrinsically motivated form of aggression—seems to be negatively related to PTSD in offender and military populations. This study examined the associations between exposure to violence, trauma‐related symptoms and aggression in a civilian population. In semistructured interviews, 290 Congolese refugees were questioned about trauma exposure, PTSD symptoms, and aggression. War‐related trauma exposure correlated positively with exposure to family and community violence in the past month (r = .31, p < .001), and appetitive (r = .18, p = .002) and reactive aggression (r = .29, p < .001). The relationship between war‐related trauma exposure and reactive aggressive behavior was mediated by PTSD symptoms and appetitive aggression. In a multiple sequential regression analysis, trauma exposure (β = .43, p < .001) and reactive aggression (β = .36, p < .001) were positively associated with PTSD symptoms, whereas appetitive aggression was negatively associated (β = ?.13, p = .007) with PTSD symptoms. Our findings were congruent with the cycle of violence hypothesis and indicate a differential relation between distinct subtypes of aggression and PTSD.     

Long‐Term Symptoms and Posttraumatic Growth in Traumatised Adolescents: Findings From a Specialised Outpatient Clinic

Although traumatic experiences are associated with an increased risk of developing psychiatric disorders, little is known regarding the long‐term outcomes of traumatised adolescents. In the current study, 42 traumatised adolescents who had been referred to a specialised health service were reassessed 2 to 5 years after the traumatic event. The course of posttraumatic stress disorder (PTSD) and other psychiatric symptoms, the development of posttraumatic growth (PTG), and parental PTSD were analysed. The rate of PTSD (full and partial) declined from 59.5% to 11.9% between the first assessment and the follow‐up. On average, low levels of PTG were reported by the adolescents at follow‐up. Sexual abuse was associated with most severe PTSD symptoms at initial assessment (η² = .18) and the highest PTG (η² = .12). Adolescents with psychotherapeutic support showed the largest symptom reduction (η² = .15). Adolescent PTSD at follow‐up was shown to be correlated with both PTG (r = .34) and parental PTSD (r = .58). The results highlight the need for psychotherapeutic support for traumatised adolescents and their parents to prevent long‐term psychological impairment. The development of PTG should be considered in the aftermath of trauma and its relevance for posttraumatic recovery should be addressed in future studies.