William Yule's research while affiliated with King's College London and other places

Publications (221)

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Introduction: Post-traumatic stress disorder (PTSD) is a disabling psychiatric condition that affects a significant minority of young people exposed to traumatic events. Effective face-to-face psychological treatments for PTSD exist. However, most young people with PTSD do not receive evidence-based treatment. Remotely delivered digital interventi...
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Over the last 20 years, our knowledge and understanding of the epidemiology of trauma exposure and associated mental health problems in children and adolescents, of risks for developing and maintaining posttraumatic stress disorder (PTSD), and of effective treatments for PTSD have increased considerably for this population. This book article discus...
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Background: The latest version of the International Classification of Diseases (ICD-11) proposes a posttraumatic stress disorder (PTSD) diagnosis reduced to its core symptoms within the symptom clusters re-experiencing, avoidance and hyperarousal. Since children and adolescents often show a variety of internalizing and externalizing symptoms in th...
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The number of children affected by natural disasters each year is alarmingly high and can be expected to rise as climate change continues. The mental consequences have been documented not only in the rates of post-traumatic stress symptoms and post-traumatic stress disorder, but also for depression and other mental health problems. To contribute to...
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Aim: To investigate whether the mental health of unaccompanied asylum-seeking children (UASC) was negatively affected by having their ages disputed and being detained. Method: Participants within this cross-sectional study were 35 UASC, aged between 13 and 17 when they were detained. Some years later, a team of child mental health professionals...
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Background: Although direct exposure to war-related trauma negatively impacts children's psychological well-being, little is known about this impact within the context of parental military deployment to a combat zone and 'indirect' experience of the effects of armed conflict. This study investigates the impact of father's military deployment to Af...
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The current study is the first to implement and evaluate a group-based trauma-specific program for adolescents in a secure accommodation facility in Scotland. A randomized control and qualitative pilot study compared an intervention group (n = 10), who received Teaching Recovery Techniques, to a waitlist control group (n = 7). Measures included sub...
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This treatment is based on a developmentally sensitive adaptation of Ehlers and Clark’s (2000) model of PTSD, empirical evidence and our own clinical experience. Central to this model is the experience of a sense of current threat despite the fact the traumatic event happened in the past and which arises from two sources:
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Objective: Age-appropriate criteria for posttraumatic stress disorder (PTSD) in young children have been established. The present study investigated the long-term course of such PTSD and its predictors in young children. Methods: Young children (aged 2-10 years) and parents/caregivers who had attended emergency departments after motor vehicle co...
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Table S1. Confirmatory Factor Analytic studies examining the structure of Acute Stress Disorder symptoms in adults. Table S2. Performance of different symptom requirements per 3‐ and 5‐factor models to predict concurrent ratings of impairment (N = 594).
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Background: Although there is some evidence of the posttraumatic stress disorder (PTSD) construct’s cross cultural validity, trauma-related disorders may vary across cultures, and the same may be true for treatments that address such conditions. Experienced therapists tailor psychotherapy to each patient’s particular situation, to the nature of the...
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Background. The revision of Acute Stress Disorder (ASD) in the DSM-5 (DSM-5, 2013) proposes a cluster-free model of ASD symptoms in both adults and youth. Published evaluations of competing models of ASD clustering in youth have rarely been examined. Methods We used Confirmatory Factor Analysis (combined with multi-group invariance tests) to explo...
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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. Specificall...
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Background: Many young people are exposed to traumatic events and a significant minority of these individuals will go on to experience posttraumatic stress disorder (PTSD). Valid and reliable measurement tools for assessing PTSD are essential and can aid screening, clinical diagnosis, treatment planning and outcome monitoring. Methods: This arti...
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Objective: Following child trauma, parents are at risk of developing PTSD, either due to their direct involvement or from hearing of their child’s involvement. Despite the potential impact of a parent’s development of PTSD on both the parent and child, little is known about what may place a parent at increased risk. Method: PTSD symptoms were ass...
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Depression in adolescents is a common and impairing problem. Effective psychological therapies for depression are not accessed by most adolescents. Computerised therapy offers huge potential for improving access to treatment. To test the efficacy of Stressbusters, a Computerised-CBT (C-CBT) programme for depression in young people. Multi-site, scho...
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Objective: Certain thought control strategies for managing the intrusive symptoms of posttraumatic stress disorder (PTSD) are thought to play a key role in its onset and maintenance. Whereas measures exist for the empirical assessment of such thought control strategies in adults, relatively few studies have explored how children and adolescents ma...
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This study investigated the effect of bereavement (father death due to war in Afghanistan) on autobiographical memory specificity in Afghan adolescents living in Iran. Participants consisted of bereaved (n=70) and non-bereaved (n=33) Afghan adolescents. The measures included Farsi versions of the Autobiographical Memory Test, Mood and Feeling Quest...
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The psychometric properties of the Child PTSD Symptom Scale (CPSS) were examined in 2 samples. Sample 1 (N = 185, ages 6-17 years) consisted of children recruited from hospitals after accidental injury, assault, and road traffic trauma, and assessed 6 months posttrauma. Sample 2 (N = 68, ages 6-17 years) comprised treatment-seeking children who had...
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The Children and War Foundation was established after the authors’ experiences following the civil war in former Yugoslavia in the mid-1990s. Many organizations tried to mitigate the effects of the war on children but few interventions were based on evidence and fewer were properly evaluated. The Foundation was established in Norway with the aim of...
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The objective of this study was to investigate the efficacy of memory specificity training (MEST) on autobiographical memory recall and depression. Afghan adolescents with depression were randomly assigned to a MEST group or to a control group. At baseline, both groups completed Persian versions of the Autobiographical Memory Test (AMT) and the Moo...
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Children react to severe and acute stress in ways that are very similar to adults. Until people started to interview children directly, this was not obvious and initially it had been thought that children rarely developed post traumatic stress disorder. Now it is recognised that even pre-school children manifest symptoms of PTSD and slightly differ...
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We review recent evidence regarding risk factors for childhood posttraumatic stress disorder (PTSD) and treatment outcome studies from 2010 to 2012 including dissemination studies, early intervention studies and studies involving preschool children. Recent large-scale epidemiological surveys confirm that PTSD occurs in a minority of children and yo...
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Effective evidence-based intervention for traumatic bereavement is one of the current major research issues in the field of Post Traumatic Stress Disorder (PTSD) in children and adolescents. The "Writing for Recovery" group intervention is a new treatment approach developed by the Children and War Foundation for traumatized and bereaved children an...
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Research in adults suggests that intrusive memories are not just found in individuals with post-traumatic stress disorder (PTSD), yet there is little evidence concerning the phenomenology of intrusive memories in children and adolescents. The present study investigated the frequency of intrusive memories following a recent negative event in an adol...
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Introduction The concept of post-traumatic stress disorder (PTSD) as “a normal reaction to an abnormal event” is appealing in its simplicity, but does not do justice to the complexity of children's responses to traumatic events. Recent epidemiological investigations have confirmed that far from being “abnormal, ” exposure to trauma in childhood and...
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The Children and War Foundation was established after the authors' experiences following the civil war in former Yugoslavia in the mid-1990s. Many organizations tried to mitigate the effects of the war on children but few interventions were based on evidence and fewer were properly evaluated. The Foundation was established in Norway with the aim of...
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Losing a sibling or even a parent can have a rather profound effect on a child. However, there are some deaths that can easily induce trauma in a child, specifically sudden and unexpected deaths. Two examples of such deaths are accidental deaths and murders, particularly where the child witnesses the accident or the murder. This chapter discusses w...
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Eye movement desensitization and reprocessing (EMDR) was used with 11 children who developed posttraumatic stress disorder (PTSD) after road traffic accidents. All improved such that none met criteria for PTSD on standardized assessments after an average of only 2.4 sessions. Significant improvements in PTSD, anxiety, and depression were found both...
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A recent meta-analysis by Benish, Imel, and Wampold (2008, Clinical Psychology Review, 28, 746-758) concluded that all bona fide treatments are equally effective in posttraumatic stress disorder (PTSD). In contrast, seven other meta-analyses or systematic reviews concluded that there is good evidence that trauma-focused psychological treatments (tr...
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A prospective longitudinal follow-up study (n = 59) of child and adolescent survivors of physical assaults and motor vehicle accidents assessed whether cognitive processes predicted posttraumatic stress symptomatology (PTSS) at 6 months posttrauma in this age group. In particular, the study assessed whether maladaptive posttraumatic appraisals medi...
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This paper provides an overview of post-traumatic stress disorder (PTSD) in children and adolescents. Manifestations of reactions to stress are briefly noted, and incidence and prevalence of PTSD in this population reviewed. An up-to-date overview of treatment is then given, followed by comments on some key issues and on research questions for the...
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Children and adolescents can develop traumatic stress reactions following exposure to particularly threatening events. These reactions approximate to adult-like Post Traumatic Stress Disorder, although there appear to be important differences in presentation at younger ages. This paper summarizes what is currently known of the risk and protective f...
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Negative trauma-related cognitions have been found to be a significant factor in the maintenance of post-traumatic stress disorder (PTSD) in adults. Initial studies of such appraisals in trauma-exposed children and adolescents suggest that this is an important line of research in youth, yet empirically validated measures for use with younger popula...
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"Stressbusters" is an interactive computer software programme based on a clinically effective face-to-face CBT protocol for young people with depression. It was designed for teenagers with mild to moderate depression, and comprises eight 45-minute sessions. Twenty-three young people (aged 12-16; mean age 14.87 years) with symptoms of depression wer...
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Developmental reading problems show strong persistence across the school years; less is known about poor readers' later progress in literacy skills. Poor (n = 42) and normally developing readers (n = 86) tested in adolescence (ages 14/15 years) in the Isle of Wight epidemiological studies were re-contacted at mid-life (ages 44/45 years). Participan...
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Concept of Post-Traumatic Stress DisorderManifestations of Stress Reactions in Children and AdolescentsDevelopmental AspectsIncidence and PrevalenceProspective Longitudinal StudiesRisk, Protective and Maintaining FactorsPhysiological ReactionsEvidence-based InterventionConclusions and RecommendationsReferences
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Increasingly, children are being diagnosed with psychiatric disorders, including preschool-age children. These diagnoses in young children raise questions pertaining to 1) how diagnostic algorithms for individual disorders should be modified for young age groups, 2) how psychopathology is best detected at an early stage, and 3) how to make use of m...
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Adult research suggests that the dissociation criterion of acute stress disorder has limited validity in predicting post-traumatic stress disorder (PTSD). We addressed this issue in child and adolescent survivors (n=367) of road accidents. Dissociation accounted for no significant unique variance in later PTSD, over and above other acute stress dis...
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To evaluate the efficacy of individual trauma-focused cognitive-behavioral therapy (CBT) for treating posttraumatic stress disorder (PTSD) in children and young people. Following a 4-week symptom-monitoring baseline period, 24 children and young people (8-18 years old) who met full DSM-IV PTSD diagnostic criteria after experiencing single-incident...
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Acute stress disorder (ASD) is a good predictor of posttraumatic stress disorder in adult populations, although the emphasis on dissociation symptoms within the diagnosis has been questioned. Recent studies suggest that ASD may also have application to children and adolescents. The present study examined properties of ASD within youth. A large (N =...
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It has been suggested that post-traumatic stress is related to the nature of an individual's trauma memories. While this hypothesis has received support in adults, few studies have examined this in children and adolescents. This article describes the development and validation of a measure of the nature of children's trauma memories, the Trauma Mem...
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Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined...
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To date, no studies have investigated factors associated with acute stress disorder (ASD) in children and adolescents. Relationships between ASD and a number of demographic, trauma, cognitive, and trauma memory variables were therefore investigated in a sample (N=93) of children and adolescents involved in assaults and motor vehicle accidents. Seve...
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Increasingly clinicians are being asked to assess and treat young refugees, who have experienced traumatic events due to war and organised violence. However, evidence-based guidance remains scarce. Published studies on the mental health difficulties of refugee children and adolescents, associated risk and protective factors, as well as effective in...
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FOREWORD Williams Syndrome (WS) is a rare condition, occurring in approximately 1 in 20,000 live births. As a result, most professionals will not have encountered a child with WS before, and they will understandably know little, if anything, about the characteristics and difficulties associated with the condition. The purpose of this booklet is to...
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Evidence-Based Psychotherapies in Child and Adolescent Mental Health Practice. Edited by William Yule & Orlee Udwin. ACAMH Occasional Papers No.27. London: Assocation for Child and Adolescent Mental Health ISBN: 978-1-899176-18-7. Pp. vi +72 Publication date: July 2007 The 2006 Jack Tizard Memorial Lecture coincided with the 50th Anniversary of th...
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This study examined the effects of a short-term group cognitive-behavioural intervention in children who were experiencing PTSD symptoms following the Athens 1999 earthquake. Twenty children, aged 8-12 years, referred for treatment to a local child mental health team were assigned, depending on timing of referral to two groups-- Group 1 (N = 10), w...
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The Asian tsunami of December 2004 galvanised mental health and emergency agencies in a way that no other recent disaster has done. The loss of life and forced migration focused national and international agencies on the need to provide appropriate psychosocial care from the very beginning. The prior academic arguments surrounding early interventio...
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To evaluate the role of family factors in posttraumatic stress symptomatology (PTSS) in children and adolescents who have attended an emergency department following assaults or motor vehicle accident. Children and their parents completed self-report questionnaires and semistructured interviews relating to their psychopathology and cognitive styles...
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This study was undertaken 6-7 months after the 1999 Athens earthquake with the aim of exploring the differences in post-traumatic stress disorder (PTSD), anxiety and depression symptoms between a group of children exposed to earthquake with a group of children not exposed to it, but with both groups potentially exposed to the same levels of post-ea...
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This paper describes the factor structure of the newly developed 13-item version of the Impact of Event Scale (CRIES), which was administered along with the Children’s Post-Traumatic Stress Reaction Index (CPTS-RI) to 2037 children and adolescents, aged 9–17 years, from the Municipality of Peristeri, as a part of a survey concerning children’s stre...
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To determine whether an early intervention using a psychological debriefing format is effective in preventing psychological distress in child road traffic accident survivors. Randomised controlled trial. Accident and Emergency Department, Royal United Hospital, Bath. 158 children aged 7-18. Follow-up assessment completed eight months post accident...
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Behavioral and neuropsychological evidence has often shown that children with conduct disorder drawn from clinical populations show problems with impulsivity and are impaired in motor tasks of inhibitory control. We explored the relation between conduct problems and inhibitory deficits in a community sample. Three domains of inhibition were explore...
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The authors investigated acute stress disorder and later posttraumatic stress disorder (PTSD) in children and adolescents who had been involved in assaults or motor vehicle accidents. They interviewed 93 patients 10-16 years old who were seen in an emergency department for having been assaulted or involved in a motor vehicle accident within 4 weeks...
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It has been claimed that Williams syndrome (WS) children have an unusual command of language reminiscent of "cocktail party speech." An analysis of the spoken language of 43 school-age WS children showed a subgroup (37% of the sample) who produced significantly more speech, more complex utterances, more social phrases and clichés, and more complex...
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This study evaluated the effectiveness of a school-based group intervention designed for children who have experienced trauma. Twenty-six children (aged 11-15 years) who were refugees or asylum-seekers from war-affected countries participated. The manual-based intervention consisted of cognitive-behavioural therapy (CBT) techniques and was implemen...
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Objective To evaluate the role of family factors in posttraumatic stress symptomatology (PTSS) in children and adolescents who have attended an emergency department following assaults or motor vehicle accident. Methods Children and their parents completed self-report questionnaires and semistructured interviews relating to their psychopathology an...
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Background: Most studies of the effects of trauma on mental health have generally not separately assessed psychosocial functioning, and in those that have key issues have received little attention, such as the relation between the time courses of the two kinds of outcome, and detailed assessment of social functioning in a range of domains. The pre...
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Cognitive theories of depression emphasise a vicious circle linking depressed mood and biased recall towards negative information. In line with this, depressed adults show selectively enhanced recall for negative information. This recall bias is held to be mediated by increased accessibility of negative self-referent schemas formed as a result of a...
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Research with clinically anxious adults has revealed that they estimate future negative events as far more likely to occur, relative to healthy controls. In addition, anxious adults estimate that such events are more likely to happen to themselves than to others. Previous research with anxious children and adolescents, in contrast, has revealed no...
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Previous studies have shown that children and adolescents exposed to traumatic experience in a disaster can suffer from high levels of post-traumatic stress. The present paper is the first a series reporting on the long-term follow-up of a group of young adults who as teenagers had survived a shipping disaster—the sinking of the “Jupiter” in Greek...
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This paper examines risk factors for the development of Post Traumatic Stress Disorder (PTSD), and its severity and chronicity, in a group of 217 young adults who survived a shipping disaster in adolescence. The survivors were followed up 5 to 8 years after the disaster. Risk factors examined fell into three main categories: pre-disaster child and...
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Research investigating attentional bias for emotional information using the modified Stroop task in younger anxious populations has produced equivocal results. The present data investigated the replicability in younger participants of the prototypical adult finding of Mathews and MacLeod (1985) with patients with Generalized Anxiety Disorder (GAD)....
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In 1999 the UK received 4346 refugees from Kosovo. To determine the prevalence of mental health problems in this group. A sample of 842 adults was surveyed. All were asked to complete self-report questionnaires (translated into Kosovan Albanian). A subset of 120 participants were later interviewed in Albanian using the Clinician Administered PTSD (...
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This study investigated theoretical claims that different emotional disorders are associated with different patterns of cognitive bias, both in terms of the cognitive processes involved and the stimulus content that is preferentially processed. These claims were tested by comparing clinically anxious (generalized anxiety disorder [GAD], posttraumat...
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A new 13-item version of the Impact of Event Scale (Horowitz, Wilner, & Alvarez, 1979) was adminstered to 2976 9–14 year old children from Bosnia as part of a large epidemiological screening survey. The IES-13 consists of four intrusion items, four avoidance items, and five new arousal items. Factor analyses showed the scale to have an identical un...
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UNICEF recently estimated that over 80% of the victims of today’s warfare are women and children. Civilian populations are deliberately targeted; “ethnic cleansing” and massacres are almost commonplace; populations are held hostage and under siege; even international economic sanctions are used as weapons in the struggles. The Northern Uganda Psych...
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This chapter discusses the effects of war and displacement on children. It examines some of the responses of refugee children to their losses and the traumatic events that have befallen them, and examines some of the ways that education, health, and social services can work with other community-based agencies to provide emotional support to refugee...