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The role of environmental sensitivity in post-traumatic stress symptoms in Lebanese children and adolescents

Published online by Cambridge University Press:  22 January 2024

Elie G. Karam Open the ORCID record for Elie G. Karam [Opens in a new window] ,
John Fayyad ,
Yuanyuan Huang ,
Dahlia Saab ,
Josleen Al Barathie Open the ORCID record for Josleen Al Barathie [Opens in a new window]  and
Michael Pluess Open the ORCID record for Michael Pluess [Opens in a new window]
Elie G. Karam*
Affiliation:
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
John Fayyad
Affiliation:
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon Department of Psychiatry and Clinical Psychology, University of Balamand Faculty of Medicine, Beirut, Lebanon Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
Yuanyuan Huang
Affiliation:
Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, Mile End Road, London, UK
Dahlia Saab
Affiliation:
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
Josleen Al Barathie
Affiliation:
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
Michael Pluess
Affiliation:
Department of Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, Mile End Road, London, UK
*
Corresponding author: Elie G. Karam; Email: [email protected]
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Abstract

Children differ substantially in their sensitivity to the quality of their environment. Some are more sensitive and more likely to develop Post-Traumatic Stress Disorder (PTSD) in response to Childhood Adversities (CAs), but might also benefit more from Positive Home Experiences (PHE). The aim of this study is to investigate the role of Environmental Sensitivity (ES), CAs and PHEs in PTSD development in children and adolescents. Data was collected from N = 2,569 children/adolescents. PTSD symptoms, CAs, PHEs and ES were assessed with self-report measures. We found that higher ES and CAs emerged as risk factors for PTSD development whereas higher levels of PHEs protected against PTSD. ES moderated the effects of CAs (β = 1.08, p < .001) on PTSD symptoms in the total sample. This moderating effect was more pronounced in girls, suggesting that highly sensitive girls with high childhood adversities were more likely to have higher PTSD symptoms than girls with low levels of sensitivity (β = 1.09, p < .001). In conclusion, Environmental Sensitivity played an important role as a risk factor for PTSD and as a moderating factor that accentuated the main effects of childhood adversities, particularly in girls.

Keywords

childhood adversitiesenvironmental sensitivitypositive home experiencesPTSDtrauma
Type
Regular Article
Information
Development and Psychopathology , Volume 37 , Issue 1 , February 2025 , pp. 251 - 258
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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Footnotes

†

Deceased.

References

Aron, E. N., & Aron, A. (1997). Sensory-processing sensitivity and its relation to introversion and emotionality. Journal of Personality and Social Psychology, 73(2), 345–368. https://doi.org/10.1037//0022-3514.73.2.345 CrossRefGoogle ScholarPubMed
Aron, E. N., Aron, A., & Jagiellowicz, J. (2012). Sensory processing sensitivity: A review in the light of the evolution of biological responsivity. Personality and Social Psychology Review, 16(3), 262–282. https://doi.org/10.1177/1088868311434213 CrossRefGoogle ScholarPubMed
Assary, E., Zavos, H. M. S., Krapohl, E., Keers, R., & Pluess, M. (2021). Genetic architecture of environmental sensitivity reflects multiple heritable components: A twin study with adolescents. Molecular Psychiatry, 26(9), 4896–4904. https://doi.org/10.1038/s41380-020-0783-8 CrossRefGoogle ScholarPubMed
Belsky, J., & Beaver, K. M. (2011). Cumulative-genetic plasticity, parenting and adolescent self-regulation. Journal of Child Psychology and Psychiatry, 52(5), 619–626. https://doi.org/10.1111/j.1469-7610.2010.02327.x CrossRefGoogle ScholarPubMed
Belsky, J., & Pluess, M. (2009). Beyond diathesis stress: Differential susceptibility to environmental influences. Psychological Bulletin, 135(6), 885–908. https://doi.org/10.1037/a0017376 CrossRefGoogle ScholarPubMed
Belsky, J., & Pluess, M. (2013). Beyond risk, resilience, and dysregulation: Phenotypic plasticity and human development. Development and Psychopathology, 25(4pt2), 1243–1261. https://doi.org/10.1017/S095457941300059X CrossRefGoogle ScholarPubMed
Cloitre, M., Stolbach, B. C., Herman, J. L., van der Kolk, B., Pynoos, R., Wang, J., & Petkova, E. (2009). A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity. Journal of Traumatic Stress, 22(5), 399–408. https://doi.org/10.1002/jts.20444 CrossRefGoogle ScholarPubMed
Copeland, W. E., Keeler, G., Angold, A., & Costello, E. J. (2007). Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry, 64(5), 577–584. https://doi.org/10.1001/archpsyc.64.5.577 CrossRefGoogle ScholarPubMed
Fayyad, J., Cordahi-Tabet, C., Yeretzian, J., Salamoun, M., Najm, C., & Karam, E. G. (2017). Resilience-promoting factors in war-exposed adolescents: An epidemiologic study. European Child & Adolescent Psychiatry, 26(2), 191–200. https://doi.org/10.1007/s00787-016-0871-0 CrossRefGoogle ScholarPubMed
Graham, J. W. (2009). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60(1), 549–576. https://doi.org/10.1146/annurev.psych.58.110405.085530 CrossRefGoogle ScholarPubMed
Gustafsson, P. E., Nilsson, D., & Svedin, C. G. (2009). Polytraumatization and psychological symptoms in children and adolescents. European Child & Adolescent Psychiatry, 18(5), 274–283. https://doi.org/10.1007/s00787-008-0728-2 CrossRefGoogle ScholarPubMed
Karam, E. G., Fayyad, J. A., Farhat, C., Itani, L., Mneimneh, Z. N., Karam, A. N., & Karam, G. E. (2016). War and the mental health of civilians: What did we learn so far from Lebanon?. In Christodoulou, G. (Eds.), Disasters: Mental health context and responses (pp. 125–150). Cambridge Scholars Publishing.Google Scholar
Karam, E. G., Fayyad, J. A., Farhat, C., Pluess, M., Haddad, Y. C., Tabet, C. C., Farah, L., & Kessler, R. C. (2019). Role of childhood adversities and environmental sensitivity in the development of post-traumatic stress disorder in war-exposed Syrian refugee children and adolescents. The British Journal of Psychiatry, 214(6), 354–360. https://doi.org/10.1192/bjp.2018.272 CrossRefGoogle ScholarPubMed
Kessler, R. C., Üstün, T. B. (2004). The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) composite international diagnostic interview (CIDI). International Journal of Methods in Psychiatric Research, 13(2), 93–121. https://doi.org/10.1002/mpr.168 CrossRefGoogle ScholarPubMed
Khamis, V. (2005). Post-traumatic stress disorder among school age Palestinian children. Child Abuse & Neglect, 29(1), 81–95. https://doi.org/10.1016/j.chiabu.2004.06.013 CrossRefGoogle ScholarPubMed
Lionetti, F., Aron, A., Aron, E. N., Burns, G. L., Jagiellowicz, J., & Pluess, M. (2018). Dandelions, tulips and orchids: Evidence for the existence of low-sensitive, medium-sensitive and high-sensitive individuals. Translational Psychiatry, 8(1), 24. https://doi.org/10.1038/s41398-017-0090-6 CrossRefGoogle ScholarPubMed
Lionetti, F., Aron, E. N., Aron, A., Klein, D. N., & Pluess, M. (2019). Observer-rated environmental sensitivity moderates children’s response to parenting quality in early childhood. Developmental Psychology, 55(11), 2389–2402. https://doi.org/10.1037/dev0000795 CrossRefGoogle ScholarPubMed
Little, R. J. (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American statistical Association, 1198–1202.CrossRefGoogle Scholar
Miller, T., El‐Masri, M., Allodt, F., Qouta, S. (1999). II: Emotional and behavioural problems and trauma exposure of school‐age Palestinian children in Gaza: Some preliminary findings. Medicine, Conflict and Survival, 15(4), 368–393. https://doi.org/10.1080/13623699908409478 CrossRefGoogle Scholar
Monroe, S. M., & Simons, A. D. (1991). Diathesis-stress theories in the context of life stress research: Implications for the depressive disorders. Psychological Bulletin, 110(3), 406–425. https://doi.org/10.1037/0033-2909.110.3.406 CrossRefGoogle ScholarPubMed
Nader, K. O., Pynoos, R. S., Fairbanks, L. A., Al‐Ajeel, M., Al‐Asfour, A. (1993). A preliminary study of PTSD and grief among the children of Kuwait following the Gulf crisis. British Journal of Clinical Psychology, 32(4), 407–416. https://doi.org/10.1111/j.2044-8260.1993.tb01075.x CrossRefGoogle ScholarPubMed
Nocentini, A., Menesini, E., & Pluess, M. (2018). The personality trait of environmental sensitivity predicts children’s positive response to school-based antibullying intervention. Clinical Psychological Science, 6(6), 848–859. https://doi.org/10.1177/2167702618782194 CrossRefGoogle Scholar
Panter-Brick, C., Grimon, M. P., & Eggerman, M. (2014). Caregiver—child mental health: A prospective study in conflict and refugee settings. Journal of Child Psychology and Psychiatry, 55(4), 313–327. https://doi.org/10.1111/jcpp.12167 CrossRefGoogle ScholarPubMed
Pluess, M., Assary, E., Lionetti, F., Lester, K. J., Krapohl, E., Aron, E. N., & Aron, A. (2018). Environmental sensitivity in children: Development of the highly sensitive child scale and identification of sensitivity groups. Developmental Psychology, 54(1), 51–70. https://doi.org/10.1037/dev0000406 CrossRefGoogle ScholarPubMed
Pluess, M., & Boniwell, I. (2015). Sensory-processing sensitivity predicts treatment response to a school-based depression prevention program: Evidence of vantage sensitivity. Personality and Individual Differences, 82, 40–45. https://doi.org/10.1016/j.paid.2015.03.011 CrossRefGoogle Scholar
Punamäki, R.-L., Qouta, S., El-Sarraj, E. (2001). Resiliency factors predicting psychological adjustment after political violence among Palestinian children. International Journal of Behavioral Development, 25(3), 256–267.CrossRefGoogle Scholar
Runyan, D. K., Dunne, M. P., Zolotor, A. J., Madrid, B., Jain, D., Gerbaka, B., Menick, D. M., Andreva-Miller, I., Kasim, M. S., Choo, W. Y., Isaeva, O., Macfarlane, B., Ramirez, C., Volkova, E., & Youssef, R. M. (2009). The development and piloting of the ISPCAN child abuse screening tool—parent version (ICAST-P). Child Abuse & Neglect, 33(11), 826–832. https://doi.org/10.1016/j.chiabu.2009.09.006 CrossRefGoogle ScholarPubMed
Slagt, M., Dubas, J. S., van Aken, M. A. G., Ellis, B. J., & Deković, M. (2018). Sensory processing sensitivity as a marker of differential susceptibility to parenting. Developmental Psychology, 54(3), 543–558. https://doi.org/10.1037/dev0000431 CrossRefGoogle ScholarPubMed
Thabet, A. A., Ibraheem, A. N., Shivram, R., Winter, E. A., & Vostanis, P. (2009). Parenting support and PTSD in children of a war zone. International Journal of Social Psychiatry, 55(3), 226–237.CrossRefGoogle ScholarPubMed
Thabet, A. A. M., Abed, Y., Vostanis, P. (2004). Comorbidity of PTSD and depression among refugee children during war conflict. Journal of Child Psychology and Psychiatry, 45(3), 533–542. https://doi.org/10.1111/j.1469-7610.2004.00243.x CrossRefGoogle ScholarPubMed
Zuckerman, M. (1999). Vulnerability to psychopathology: A biosocial model. American Psychological Association.CrossRefGoogle Scholar
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