***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE : The current study evaluates a treatment intervention developed with the goal of reducing symptoms of posttraumatic stress , depression , and anxiety in parents of premature infants . METHODS : A total of 105 mothers of preterm infants ( 25–34 weeks ’ gestational age ; > 600 g ) were r and omized to receive a 6-session intervention developed to target parental trauma as well as facilitate infant redefinition ( n = 62 ) or to an active comparison group ( n = 43 ) . Mothers in the intervention group received a combination of trauma-focused treatments , including psychoeducation , cognitive restructuring , progressive muscle relaxation , and development of their trauma narrative . The intervention also incorporated material targeting infant redefinition , defined as the process of changing the mother ’s negative perceptions of her infant and the parenting experience . RESULTS : Mothers in the intervention group reported a greater reduction in both trauma symptoms ( Cohen ’s d = 0.41 , P = .023 ) and depression ( Cohen ’s d = 0.59 , P < .001 ) compared with the comparison group . Patients under both conditions improved significantly in terms of anxiety , with no differences between groups . Results of the moderator analysis showed that mothers with higher ratings of baseline NICU stress benefited more from the intervention compared with mothers who had lower ratings ( P = .036 ) . CONCLUSIONS : This short , highly manualized intervention for mothers of preterm infants statistically significantly reduced symptoms of trauma and depression . The intervention is feasible , can be delivered with fidelity , and has high ratings of maternal satisfaction . Given that improvements in mothers ’ distress may lead to improved infant outcomes , this intervention has the potential for a high public health impact BACKGROUND Little is known about long-term psychological outcomes after major trauma in adolescents , a leading cause of death and preventable morbidity in this age group . A prospect i ve epidemiologic study was conducted to examine quality of life ( QoL ) and posttraumatic stress disorder ( PTSD ) outcomes in injured adolescents . The specific objectives of the present report are to describe long-term PTSD and to identify risk factors for long-term PTSD and the impact of PTSD on QoL. METHODS Between April 26 , 1999 , and November 13 , 2002 , 401 eligible trauma patients aged 12 to 19 years triaged to five participating trauma center hospitals in a regionalized trauma system were enrolled in the study . The admission criteria for patients were as follows : age 12 to 19 years and injury diagnoses excluding severe traumatic brain injury or spinal cord injury . PTSD was diagnosed with the Impact of Events Scale-Revised ; scores of 24 + were used to diagnose PTSD . QoL after trauma was measured using the Quality of Well-Being scale , a sensitive and well-vali date d functional index ( range : 0 = death to 1.000 = optimum functioning ) . Patient outcomes were assessed at discharge and at 3 , 6 , 12 , 18 , and 24 months after discharge . RESULTS The rate of long-term PTSD was 27 % , with high rates over the follow-up period . Risk factors for long-term PTSD were perceived threat to life ( odds ratio [ OR ] , 2.2 ; p < 0.001 . ) ; death of a family member at the scene ( OR , 4.7 ; p < 0.001 ) ; no control over injury event ( OR , 1.7 ; p < 0.05 ) , and violence-related injury ( OR , 2.2 ; p < 0.05 ) . PTSD in adolescents was significantly and strongly associated with female gender , older age , low socioeconomic status , drug and alcohol abuse , and other adolescent behavioral problems . Long-term PTSD was also associated with marked and significant QoL deficits throughout the 24-month follow-up interval . CONCLUSION High rates of long-term PTSD persist after major trauma in adolescents . Injury events such as perceived threat to life and control over the event are strongly associated with PTSD risk . Prolonged PTSD severely impacts QoL outcomes . Early identification and treatment of risk factors for long-term PTSD will be important to improve outcomes in injured adolescents Background Road traffic accidents ( RTAs ) are the leading health threat to children in Europe , result ing in 355 000 injuries annually . Because children can suffer significant and long-term mental health problems following RTAs , there is considerable interest in the development of early psychological interventions . To date , the research in this field is scarce , and currently no evidence -based recommendations can be made . Methods To evaluate the effectiveness of a single-session early psychological intervention , 99 children age 7 - 16 were r and omly assigned to an intervention or control group . The manualised intervention was provided to the child and at least one parent around 10 days after the child 's involvement in an RTA . It included reconstruction of the accident using drawings and accident-related toys , and psychoeducation . All of the children were interviewed at 10 days , 2 months and 6 months after the accident . Parents filled in question naires . St and ardised instruments were used to assess acute stress disorder ( ASD ) , posttraumatic stress disorder ( PTSD ) , depressive symptoms and behavioural problems . Results The children of the two study groups showed no significant differences concerning posttraumatic symptoms and other outcome variables at 2 or at 6 months . Interestingly , analyses showed a significant intervention × age-group effect , indicating that for preadolescent children the intervention was effective in decreasing depressive symptoms and behavioural problems . Conclusions This study is the first to show a beneficial effect of a single-session early psychological intervention after RTA in preadolescent children . Therefore , an age-specific approach in an early stage after RTAs may be a promising way for further research . Younger children can benefit from the intervention evaluated here . However , these results have to be interpreted with caution , because of small subgroup sizes . Future studies are needed to examine specific approaches for children and adolescents . Also , the intervention evaluated here needs to be studied in other groups of traumatised children . Trial Registration Clinical Trial Registry : Clinical Trials.gov : NCT00296842 Posttraumatic stress disorder ( PTSD ) is a common and disabling anxiety disorder that may occur in the aftermath of exposure to potentially traumatic life events . PTSD is moderately heritable , but few specific molecular variants accounting for this heritability have been identified . Genes regulating the hypothalamic-pituitary-adrenal ( HPA ) axis , such as corticotrophin-releasing hormone type 1 receptor gene ( CRHR1 ) , have been implicated in traumatic-stress related phenotypes but have yet to be studied in relation to PTSD . The present study sought to examine the relation between 9 single nucleotide polymorphisms ( SNPs ) in the CRHR1 gene and posttraumatic stress symptoms in a prospect i ve study of pediatric injury patients ( n = 103 ) who were first assessed in the acute aftermath of their injury at the hospital . Results indicated that multiple SNPs were associated with acute symptoms at a univariate level , and after correction for multiple testing , rs12944712 was significantly related to acute PTSD symptoms . Longitudinal latent growth curve analyses suggest that rs12944712 is also related to both acute symptom level and trajectory of symptoms over time . The present study adds support for the role of CRHR1 in the stress response following potentially traumatic event exposure in youth . It should be noted that the sample size in this study was small , and therefore statistical power was low ; following , results from this study should be considered preliminary . Although results are not definitive , the findings from this study warrant future replication studies on how variation in this gene relates to response to traumatic event exposure in youth OBJECTIVE To examine post-traumatic stress symptoms ( PTSS ) and disorder ( PTSD ) among survivors of childhood cancer and comparison peers during the transition to emerging adulthood . METHOD From elementary and middle school , we prospect ively followed a cohort of 56 cancer survivors , 60 comparison peers , and their parents . Assessment s were completed after the youth 's 18th birthday using question naires and a semi-structured psychiatric interview . Healthcare providers rated treatment severity and late effects . RESULTS Survivors and comparison peers did not differ on rates of PTSS or PTSD , but comparison peers reported more dissociative experiences than survivors . Late effects were associated with a greater number of past PTSS . Of the 16 cancer survivors who reported a traumatic event , five ( 31 % ) were cancer-related . CONCLUSIONS Levels of PTSS were similar for survivors and comparison peers . Research with other potentially traumatic diseases or treatments ( e.g. , amputations , brain tumors ) is needed . The role of methodology and context ual factors in the assessment of PTSS/PTSD is discussed OBJECTIVE This study examines traumatic stress reactions in couples that were followed prospect ively for 18 months after a burn event to their child . METHOD The participants included 186 mothers and 159 fathers of 198 preschool children . Parents ' self-reported traumatic stress reactions were measured with the Impact of Event Scale ( IES ) . Predictors included parental emotions and the perceived life-threatening character of the child 's injury . RESULTS Rates for clinical ly significant symptoms ( IES ≥ 26 ) decreased from 50 % within the first month to 18 % at 18 months postburn for mothers and from 27 % to 6 % for fathers . The decline in symptoms was not entirely linear . Mothers had higher scores than fathers , but the discrepancy in intrusion symptoms among couples diminished over the course of time . Early appraisal of life threat and emotions about the burn event were significant predictors . CONCLUSIONS Both mothers and fathers are seriously affected by a burn event of their young child . Despite a general decrease over time , a subgroup of parents is at risk for chronic symptoms . The results call for the integration of prolonged parent support in family centered pediatric burn aftercare programs OBJECTIVE The aim of this article was to evaluate the effectiveness of an information provision web-based early intervention via a r and omized controlled trial for children and their parents following pediatric unintentional injury . METHOD Participants were r and omly assigned to an  intervention ( n = 29 ) or a  control group ( n = 27 ) following baseline measurements . Further assessment was taken at 4 - 6 weeks and 6 months post-trauma event . RESULTS Analyses revealed that children within the intervention group reported improved anxiety , in comparison to a worsening of symptoms for children in the control group . Furthermore , children who had higher baseline trauma scores reported the intervention to be helpful . CONCLUSIONS The intervention showed promising results in its ability to aid child recovery Background Road traffic accidents ( RTA ) and burns are frequent events in children . Although many children recover spontaneously , a considerable number develop long-term psychological sequelae . Evidence on early psychological interventions to prevent such long-term problems is still scarce for school-age children and completely lacking for pre-school children . Objectives To evaluate the efficacy of an early two-session cognitive-behavioral intervention in 108 children ages 2–16 after RTAs and burns . Methods Children assessed at risk for the development of posttraumatic stress disorder ( PTSD ) were r and omly assigned to either a control group offered treatment as usual or an intervention group . Primary outcomes were PTSD , behavioral problems , and depression symptoms . Baseline and blinded 3- and 6-month follow-up assessment s were conducted . Results In pre-school children , no intervention effects were found . School-age children in the intervention group exhibited significantly fewer internalizing problems at 3-month follow-up relative to controls and a borderline significant time-by-group effect for PTSD intrusion symptoms was found ( p=0.06 ) . Conclusions This is the first study examining the efficacy of an indicated , early psychological intervention among both school-age and pre-school-age children . Because the intervention was ineffective for young children , no evidence -based practice can currently be suggested . Given that parents of pre-school children perceived the intervention as helpful , brief counseling of parents in terms of psychoeducation and training in coping skills still should be provided by clinicians , despite the current lack of evidence . To prevent trauma-related disorders in school-age children , the intervention might be used in a step-wise manner , where only children at risk for long-term psychological maladjustment are provided with psychological support OBJECTIVE The study objective is to evaluate the feasibility and efficacy of a web-based intervention for parents ( AfterTheInjury.org [ ATI ] ) in promoting emotional recovery following pediatric injury . METHODS 100 children with injuries requiring medical attention and their parents were r and omly assigned to the intervention or usual care . Efficacy outcomes included parent knowledge and child and parent posttraumatic stress symptoms ( PTSS ) . RESULTS All parents in the intervention group completed the intervention ( directed use of ATI ) in the hospital . 56 % reported using ATI online post-discharge , and 100 % of these parents found it helpful . Parent knowledge increased immediately post-intervention , but there was no significant intervention impact on parent knowledge or PTSS at a 6-week follow-up . Relationships between knowledge and PTSS were identified . CONCLUSIONS Brief web-based interventions introduced during child hospitalization are a feasible strategy to reach many parents following pediatric injury . Preventing psychological symptoms may require more than parental education alone OBJECTIVE To examine the role of cortisol in posttraumatic stress symptomatology among mothers of children 
    Output:
    
Results support and extend the model 's five assumptions , and suggest a sixth assumption related to health outcomes and PMTS .