Project period: September 2018 – April 2019 

This community previously received Initiator Funding for the project: A biosocial approach to trauma research

GW4 community leads 

University of Bath: Sarah Halligan (PI)
University of Bristol: Abigail Fraser 
Cardiff University: Stan Zammit 
University of Exeter: Anke Karl 

Project overview 

Our goal is to leverage expertise from across GW4 in order to achieve a step change of our understanding of Post-Traumatic Stress Disorder in children and young people, with a particular focus on groups from low and middle income countries. 


Childhood trauma exposure is an extremely common contributor to mental health problems across the lifespan, conferring vulnerability to PTSD, depression, conduct problems, and associated poor physical health, educational and criminal justice outcomes. Nonetheless, progress towards understanding the psychobiological mechanisms underlying for risk trauma related psychopathology in CYP has been hampered by the limited availability of well-powered longitudinal studies. Such evidence relating to CYP in LMIC contexts is almost non-existent, despite the fact that they are particularly vulnerable to experiencing serious trauma. This omission is important, as the available evidence may not translate easily. For example, appraisals of the world as highly dangerous or the self as vulnerable have been identified as robust predictors of PTSD in CYP in studies of low risk populations, but may have a different meaning in contexts where actual levels of prevailing threat are high (i.e., the appraisal is accurate). Similarly, parental support that emphasises future threat is associated with persistent child distress in low risk samples, but may be normal and even adaptive in high risk environments. In terms of biological risk of PTSD, much of the evidence relates to biological stress response systems (e.g., the hypothalamic-pituitary-adrenal axis), yet it is hypothesised that these may show different baseline activity patterns in contexts where prevailing levels of stress is high. We have almost no evidence relating to the biological sequelae of trauma and PTSD in CYP (or indeed in adults) living in high adversity, international contexts. 

Project summary 

The community consolidated existing partnerships across the GW4, building significant research capacity both within and across groups, as well as expanding the community to include international collaborators. They used existing international cohort data to understand risk factors for and presentations of PTSD in LMIC youth, obtaining major MRC funding to continue this research. Pilot work was completed which established the capacity to identify and study CYP in the acute aftermath of trauma exposure in high adversity contexts in South Africa; this work led to a major MRC grant. The community continues to collaborate with multiple cross-institute PhD students, original research papers and planned grant applications. 

Community site (GW4 Portal)