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  1. Article ; Online: Validation of the Long-term Difficulties Questionnaire-Youth version as a measure of chronic stress in adolescents in Sri Lanka.

    Ponnamperuma, Thyagi

    WHO South-East Asia journal of public health

    2022  Volume 11, Issue 2, Page(s) 71–78

    Abstract: Introduction: As a validated stress questionnaire to assess ongoing adversities of adolescents in developing countries is not available, we developed a brief general checklist, the "Long-term Difficulties Questionnaire-Youth" version (LTD-Y) to measure ... ...

    Abstract Introduction: As a validated stress questionnaire to assess ongoing adversities of adolescents in developing countries is not available, we developed a brief general checklist, the "Long-term Difficulties Questionnaire-Youth" version (LTD-Y) to measure daily stressors of adolescents and examine the psychometric properties of the instrument.
    Methods: In 2008, 755 schoolchildren in Sri Lanka (54% girls), age 12-16 years, completed a self-reported questionnaire with four sections. (1) demographic information (2) daily stressors and social support (3) trauma exposures measures; different trauma exposures and tsunami impact, (4) current psychological problem measures; posttraumatic stress symptoms, emotional and behavioral problems, functional impact, happiness at home, and happiness at school. In July 2009, a subsample of 90 adolescents repeated these measures. Internal consistency factor structure, concurrent validity, construct validity, and temporal stability were assessed in the scale.
    Results: LTD-Y adequately identified the ongoing adversities of adolescents. The scale showed an excellent internal consistency with Cronbach's alpha = 0.79. The principal component analysis showed two-factor solutions which concern "external" and "internal" stressors. The concurrent validity was indicated by its positive association with all measures of current psychological problems. The discriminant ability of the adversity measure was evident in cumulative trauma exposure and all variables with current psychological problems. The stability of reporting was satisfactory.
    Conclusion: This school-based screening showed that the LTD-Y has sufficient validity, competency, and stability in measuring ongoing adversities of adolescents.
    MeSH term(s) Female ; Adolescent ; Humans ; Child ; Male ; Sri Lanka ; Social Support ; Surveys and Questionnaires
    Language English
    Publishing date 2022-12-28
    Publishing country India
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2676354-0
    ISSN 2304-5272 ; 2304-5272 ; 2224-3151
    ISSN (online) 2304-5272
    ISSN 2304-5272 ; 2224-3151
    DOI 10.4103/WHO-SEAJPH.WHO-SEAJPH_199_21
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Gender moderates diurnal cortisol in relation to trauma and PTSD symptoms: A study in Sri Lankan adolescents.

    Nicolson, Nancy A / Ponnamperuma, Thyagi

    Psychoneuroendocrinology

    2019  Volume 104, Page(s) 122–131

    Abstract: Trauma exposure and posttraumatic stress disorder (PTSD) have been linked to aspects of diurnal cortisol secretion in adolescents, but little is known about gender differences in these associations. A school-based sample of Sri Lankan adolescents aged 13- ...

    Abstract Trauma exposure and posttraumatic stress disorder (PTSD) have been linked to aspects of diurnal cortisol secretion in adolescents, but little is known about gender differences in these associations. A school-based sample of Sri Lankan adolescents aged 13-16 years took part in this study 4.5 years after the 2004 tsunami had impacted many of their lives to varying degrees. Saliva samples were obtained 4 times a day for 3 days in 84 participants, who also completed measures of lifetime trauma, current stressors, and posttraumatic stress symptoms (PTSS). We used multilevel regression to estimate effects of trauma exposure and symptoms on cortisol level, diurnal slope, and awakening response (CAR). Results indicated higher cortisol in girls and older adolescents. Although trauma, PTSS, and recent PTSD had non-significant main effects, these three variables interacted with gender, with higher cortisol in girls than in similarly traumatized or symptomatic boys. Co-occurrence of internalizing symptoms and PTSS was also associated with higher cortisol. The 28 adolescents with recent PTSD displayed flatter diurnal slopes, reflecting relatively low morning cortisol. Among the 56 trauma-exposed participants, negative trauma appraisals were associated with higher cortisol. Girls were more likely than boys to display elevated cortisol in relation to re-experiencing and hyperarousal symptoms. In contrast to significant findings for cortisol level and diurnal slope, the CAR showed no association with either trauma or PTSS, irrespective of gender. Findings, viewed in light of normative gender differences in HPA activity during adolescence, can contribute to understanding heightened female vulnerability to posttraumatic stress disorder.
    MeSH term(s) Adolescent ; Circadian Rhythm/physiology ; Female ; Humans ; Hydrocortisone/analysis ; Hydrocortisone/metabolism ; Hypothalamo-Hypophyseal System/metabolism ; Male ; Pituitary-Adrenal System/metabolism ; Saliva/chemistry ; Sex Factors ; Sri Lanka/epidemiology ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/metabolism ; Stress Disorders, Post-Traumatic/physiopathology ; Wounds and Injuries/metabolism ; Wounds and Injuries/psychology
    Chemical Substances Hydrocortisone (WI4X0X7BPJ)
    Language English
    Publishing date 2019-02-27
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 197636-9
    ISSN 1873-3360 ; 0306-4530
    ISSN (online) 1873-3360
    ISSN 0306-4530
    DOI 10.1016/j.psyneuen.2019.02.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1235: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: The Relative Impact of Traumatic Experiences and Daily Stressors on Mental Health Outcomes in Sri Lankan Adolescents.

    Ponnamperuma, Thyagi / Nicolson, Nancy A

    Journal of traumatic stress

    2018  Volume 31, Issue 4, Page(s) 487–498

    Abstract: Prior trauma, current stress, and poor social support contribute to youth mental health problems. As daily stressors often increase in the aftermath of traumatic events, trauma could plausibly impact psychopathology not only directly but also indirectly ... ...

    Abstract Prior trauma, current stress, and poor social support contribute to youth mental health problems. As daily stressors often increase in the aftermath of traumatic events, trauma could plausibly impact psychopathology not only directly but also indirectly via ongoing stress. In this study, we examined the relative roles of trauma and daily stressors in mental health outcomes in 753 Sri Lankan adolescents residing in areas impacted by the 2004 tsunami. In 2008, participants completed measures of trauma exposure, daily stressors, social support, posttraumatic stress symptoms (PTSS), emotional and behavioral problems (EBP), and functional impairment; a subsample (n = 89) repeated these assessments 16 months later. Regression models revealed positive associations between cumulative trauma and all three mental health measures. Significant variance in these associations could be explained indirectly, via daily stressors. For PTSS, the indirect effect accounted for 26.1% of the total effect of trauma, unstandardized coefficient ab = 0. 739, 95% CI [0.459, 1.122]. For EBP this percentage was 42.4%, ab = 0.287, 95% CI [0.189, 0. 404], and for functional impairment 70.0%, ab = 0.072, 95% CI [0.049, 0.121]. Indirect effects on impairment were strongest when perceived social support was low. Although we also present evidence that pathways between stressors and psychopathology may have been bidirectional, findings support the notion that adolescents' daily stressors are important transmitters of the impact of traumatic events and highlight the need for interventions focused not only on trauma processing but also on reducing current stress and improving social support.
    MeSH term(s) Adolescent ; Cross-Sectional Studies ; Disasters ; Female ; Humans ; Logistic Models ; Male ; Prospective Studies ; Social Support ; Sri Lanka/epidemiology ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/psychology ; Stress, Psychological/epidemiology ; Surveys and Questionnaires ; Tsunamis
    Language English
    Publishing date 2018-07-30
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 639478-4
    ISSN 1573-6598 ; 0894-9867
    ISSN (online) 1573-6598
    ISSN 0894-9867
    DOI 10.1002/jts.22311
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2386: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Posttraumatic stress and co-occurrence of mental health problems in Sri Lankan adolescents.

    Ponnamperuma, Thyagi / Sumathipala, Athula / Siribaddana, Sisira

    Asian journal of psychiatry

    2020  Volume 54, Page(s) 102444

    Abstract: A significant minority (5 %) of adolescents develop posttraumatic stress disorder (PTSD) after trauma exposure. These adolescents are likely to experience many other mental health problems and have related impaired functioning. This study examined the co- ...

    Abstract A significant minority (5 %) of adolescents develop posttraumatic stress disorder (PTSD) after trauma exposure. These adolescents are likely to experience many other mental health problems and have related impaired functioning. This study examined the co-occurrence of Emotional and Behavioral Problems (EBP) with PTSD symptoms and investigated the effect of PTSD symptoms on EBP-related impaired functioning. The initial sample (T1) comprised 729 Sri Lankan adolescents, age 12-16 years, living in an area impacted by the 2004 tsunami. In 2008, participants (T1) completed measures of trauma exposure, PTSD symptoms, EBP and related functional impairment. Sixteen months later a subsample of 90 adolescents (T2) underwent diagnostic interview for PTSD and co-occurrence of mental health morbidity. In the 58.2 % of the T1 sample reporting any trauma exposure, 23.7 % met criteria for full or partial PTSD. Among all participants, 13.4 % had borderline to abnormal levels of EBP. EBP was significantly higher among PTSD-positive participants compared to PTSD-negative and non-traumatized subgroups (p < 0.001). In the T2 sample, all four cases with diagnosed PTSD had coexisting psychological problems. Further, PTSD symptoms exacerbated the impact of EBP on functional impairment. Findings support the conclusion that researchers and practitioners should be alert to EBP among trauma-exposed adolescents, because such general psychological problems are common and, in combination with PTSD symptoms, are associated with even greater impairment. Moreover, identifying the presence of these trauma associated problems is of crucial clinical importance.
    MeSH term(s) Adolescent ; Child ; Humans ; Mental Health ; Problem Behavior ; Stress Disorders, Post-Traumatic/epidemiology ; Tsunamis
    Language English
    Publishing date 2020-10-16
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2456678-0
    ISSN 1876-2026 ; 1876-2018
    ISSN (online) 1876-2026
    ISSN 1876-2018
    DOI 10.1016/j.ajp.2020.102444
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Negative Trauma Appraisals and PTSD Symptoms in Sri Lankan Adolescents.

    Ponnamperuma, Thyagi / Nicolson, Nancy A

    Journal of abnormal child psychology

    2015  Volume 44, Issue 2, Page(s) 245–255

    Abstract: The cognitive model posits that negative appraisals play an important role in posttraumatic stress disorder, in children as well as in adults. This study examined correlates of negative appraisals in relation to trauma exposure and their relationship to ... ...

    Abstract The cognitive model posits that negative appraisals play an important role in posttraumatic stress disorder, in children as well as in adults. This study examined correlates of negative appraisals in relation to trauma exposure and their relationship to posttraumatic stress symptoms (PTSS) in 414 Sri Lankan adolescents, aged 12 to 16, living in areas impacted in varying degrees by the 2004 tsunami. In 2008, participants completed measures of negative appraisals, lifetime traumatic events, posttraumatic stress symptoms, internalizing symptoms, ongoing adversity, and social support. The majority (70 %) of the participants reported multiple traumatic events; 25 % met DSM-IV criteria for full or partial PTSD. Adolescents who had experienced more severe events, abusive events, greater cumulative trauma, or greater current adversity reported more negative appraisals. In regression analyses controlling for known risk factors such as female gender, cumulative trauma, ongoing adversity, and low social support, negative appraisals were the best predictor of PTSS, explaining 22 % of the variance. This relationship appeared specific to PTSS, as negative appraisals did not predict internalizing symptoms. Findings confirm the link between negative cognitions concerning traumatic events and persistent PTSS in adolescents, but longitudinal studies are needed to determine whether appraisals contribute to symptom maintenance over time.
    MeSH term(s) Adolescent ; Child ; Child Abuse/ethnology ; Child Abuse/psychology ; Disasters ; Female ; Humans ; Male ; Models, Psychological ; Psychological Trauma/ethnology ; Psychological Trauma/psychology ; Sri Lanka/ethnology ; Stress Disorders, Post-Traumatic/ethnology ; Stress Disorders, Post-Traumatic/psychology ; Tsunamis
    Language English
    Publishing date 2015-02-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 193136-2
    ISSN 1573-2835 ; 0091-0627
    ISSN (online) 1573-2835
    ISSN 0091-0627
    DOI 10.1007/s10802-015-9985-y
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1150: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article: The impact of the Tsunami on hospitalizations at the tertiary care hospital in the Southern Province of Sri Lanka.

    Ostbye, Truls / Ponnamperuma, Thyagi / Fernando, Nayana / Abeygunawardena, Vathsala / Wijayasiri, W A A / Chen, Jodi J / Woods, Christopher W

    American journal of disaster medicine

    2008  Volume 3, Issue 3, Page(s) 147–155

    Abstract: Objective: Sri Lanka's human, physical, social, and economic resources suffered a massive impact after the tsunami of December 26, 2004. To assist in preparing for future disasters, the authors sought to characterize the pattern of hospitalizations from ...

    Abstract Objective: Sri Lanka's human, physical, social, and economic resources suffered a massive impact after the tsunami of December 26, 2004. To assist in preparing for future disasters, the authors sought to characterize the pattern of hospitalizations from the main impact zone in the Southern Province.
    Design: Retrospective chart review.
    Setting: Patients admitted to Teaching Hospital, Karapitiya, the only tertiary care hospital in the Southern Province.
    Patients, participants: All hospital admissions on the day of and week following the tsunami, and a random sample (5 percent) of admissions from the month preceding, and the 3 months following the tsunami were coded according to the International Classification of Diseases, 10th Edition, analyzed, and geomapped.
    Intervention: N/A.
    Main outcome measure(s): The overall daily number of hospitalizations increased by 50 percent on the day of the tsunami and decreased in the following week.
    Results: Before the tsunami, injuries typically accounted for 20 percent of hospital admissions. However, injuries were markedly higher (89 percent of the total) on the day of the tsunami and remained elevated (35 percent) during the following week. After the initial peak in injuries (including near drownings), there was no increase in the frequency of infectious, cardiac, or psychiatric admissions.
    Conclusions: Injuries (including near drownings) were the most common cause of admissions immediately after the tsunami. The distribution of specific diagnoses differed from that seen after other natural disasters such as earthquakes and hurricanes. A central aspect of disaster relief operations and planning includes a thorough understanding of the postdisaster health effects and changes in disease patterns.
    MeSH term(s) Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Disasters ; Female ; Hospitalization/statistics & numerical data ; Hospitals, Teaching/statistics & numerical data ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Retrospective Studies ; Sri Lanka/epidemiology ; Tidal Waves ; Wounds and Injuries/epidemiology ; Young Adult
    Language English
    Publishing date 2008-05
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-149X
    ISSN 1932-149X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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