{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T03:35:52Z","timestamp":1774928152746,"version":"3.50.1"},"reference-count":60,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:00:00Z","timestamp":1683590400000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,4,12]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Post-traumatic stress disorder (PTSD) symptoms in youth are influenced by parental anxiety and stress. When parents have high levels of stress or have developed PTSD themselves, children tend to show more anxiety symptoms. Parental stress can affect the severity of children\u2019s PTSD and lower the success of recovery. However, the influence of parental stress on the effectiveness of trauma-focused therapies (eye movement desensitisation and reprocessing and cognitive behavioural therapy) has not yet been investigated to our knowledge. Hence, we will measure parental stress (using both validated scales and vocal acoustic markers) and investigate how it influences children\u2019s PTSD recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method and analysis<\/jats:title>\n                    <jats:p>Sixty children between the ages of 7 and 15 years who experienced type 1 trauma will be recruited at the Nice Pediatric Psychotrauma Center in France. We plan to measure stress using two different approaches. We will ask parents to answer validated scales of stress and mood in general. Stress will also be measured using vocal acoustic markers. Parents will be recorded while narrating their child\u2019s trauma and during the narrative of a positive and neutral recall of events. Child participants will have to complete anxiety, PTSD and depression scales before the beginning of the trauma-focused therapy and after 3\u2009months of treatment.<\/jats:p>\n                    <jats:p>Linear mixed effects models and differential statistics, such as significance testing corrected for multiple testing, will be used to determine the validity of speech features for the proposed hypotheses. Repeated measures analysis of variance will be performed on the clinical scales scores according to parental stress. Correlations will be performed between clinical scales of parents and children according to time of assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study was approved by the Committee for the Protection of Individuals of the University of Nice Sophia Antipolis (CERNI) on 21 February 2022, under the number CER2022-015.<\/jats:p>\n                    <jats:p>All participants will be informed that this is an observational study and their consent taken prior to the experiment. Participants will be informed that they can withdraw from the study at any time and that it would not affect the care provided.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>CER AVIS n\u00b0 2022-015.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-068026","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T11:36:30Z","timestamp":1683718590000},"page":"e068026","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Study protocol: how does parental stress measured by clinical scales and voice acoustic stress markers predict children\u2019s response to PTSD trauma-focused therapies?"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4089-1675","authenticated-orcid":false,"given":"Radia","family":"Zeghari","sequence":"first","affiliation":[{"name":"Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, H\u00f4pitaux P\u00e9diatriques Universitaires Lenval, Nice, France"},{"name":"Cobtek (Cognition-Behaviour-Technology), Universit\u00e9 C\u00f4te d'Azur, Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgane","family":"Gindt","sequence":"additional","affiliation":[{"name":"Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, H\u00f4pitaux P\u00e9diatriques Universitaires Lenval, Nice, France"},{"name":"Cobtek (Cognition-Behaviour-Technology), Universit\u00e9 C\u00f4te d'Azur, Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9960-9657","authenticated-orcid":false,"given":"Alexandra","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Cobtek (Cognition-Behaviour-Technology), Universit\u00e9 C\u00f4te d'Azur, Nice, France"},{"name":"ki:elements GmbH, Saarbrucken, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ophelie","family":"Nachon","sequence":"additional","affiliation":[{"name":"Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, H\u00f4pitaux P\u00e9diatriques Universitaires Lenval, Nice, France"},{"name":"Cobtek (Cognition-Behaviour-Technology), Universit\u00e9 C\u00f4te d'Azur, Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hali","family":"Lindsay","sequence":"additional","affiliation":[{"name":"Cognitive Assistants, Deutsches Forschungszentrum fur Kunstliche Intelligenz GmbH Standort Saarbrucken, Saarbrucken, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Robert","sequence":"additional","affiliation":[{"name":"Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, H\u00f4pitaux P\u00e9diatriques Universitaires Lenval, Nice, France"},{"name":"Cobtek (Cognition-Behaviour-Technology), Universit\u00e9 C\u00f4te d'Azur, Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6326-9096","authenticated-orcid":false,"given":"Arnaud","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, H\u00f4pitaux P\u00e9diatriques Universitaires Lenval, Nice, France"},{"name":"Cobtek (Cognition-Behaviour-Technology), Universit\u00e9 C\u00f4te d'Azur, Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence","family":"Askenazy","sequence":"additional","affiliation":[{"name":"Nice Pediatric Psychotrauma Center (NPPC), Child And Adolescent Psychiatry department, H\u00f4pitaux P\u00e9diatriques Universitaires Lenval, Nice, France"},{"name":"Cobtek (Cognition-Behaviour-Technology), Universit\u00e9 C\u00f4te d'Azur, Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,5,9]]},"reference":[{"key":"2025120600254342000_13.5.e068026.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2011.12.001"},{"key":"2025120600254342000_13.5.e068026.2","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association . Diagnostic and statistical manual of mental disorders. 5th ed. 2013.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"2025120600254342000_13.5.e068026.3","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.113.131227"},{"key":"2025120600254342000_13.5.e068026.4","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1177\/0706743718792194","article-title":"Prevalence of posttraumatic stress disorder among children and adolescents following road traffic accidents: a meta-analysis","volume":"63","author":"Dai","year":"2018","journal-title":"Can J Psychiatry"},{"key":"2025120600254342000_13.5.e068026.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2013.05.011"},{"key":"2025120600254342000_13.5.e068026.6","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00004"},{"key":"2025120600254342000_13.5.e068026.7","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1007\/s10578-020-01093-3","article-title":"Posttraumatic symptoms in 3\u20137 year old trauma-exposed children: links to impairment, other mental health symptoms, caregiver PTSD, and caregiver stress","volume":"52","author":"Cervin","year":"2021","journal-title":"Child Psychiatry Hum Dev"},{"key":"2025120600254342000_13.5.e068026.8","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1007\/s10578-019-00924-2","article-title":"Short and long-term parental posttraumatic stress after a child\u2019s accident: prevalence and associated factors","volume":"51","author":"van Meijel","year":"2020","journal-title":"Child Psychiatry Hum Dev"},{"key":"2025120600254342000_13.5.e068026.9","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1007\/s10567-021-00367-z","article-title":"Post-traumatic stress disorder in parents following their child\u2019s single-event trauma: a meta-analysis of prevalence rates and risk factor correlates","volume":"24","author":"Wilcoxon","year":"2021","journal-title":"Clin Child Fam Psychol Rev"},{"key":"2025120600254342000_13.5.e068026.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-015-0492-z","article-title":"Predicting posttraumatic stress disorder in children and parents following accidental child injury: evaluation of the screening tool for early predictors of posttraumatic stress disorder (STEPP)","volume":"15","author":"van Meijel","year":"2015","journal-title":"BMC Psychiatry"},{"key":"2025120600254342000_13.5.e068026.11","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1001\/jamapediatrics.2013.2741","article-title":"Posttraumatic stress following pediatric injury: update on diagnosis, risk factors, and intervention","volume":"167","author":"Kassam-Adams","year":"2013","journal-title":"JAMA Pediatr"},{"key":"2025120600254342000_13.5.e068026.12","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsv074"},{"key":"2025120600254342000_13.5.e068026.13","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsj054"},{"key":"2025120600254342000_13.5.e068026.14","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsp090"},{"key":"2025120600254342000_13.5.e068026.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2011.03.001"},{"key":"2025120600254342000_13.5.e068026.16","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jss091"},{"key":"2025120600254342000_13.5.e068026.17","doi-asserted-by":"crossref","DOI":"10.1007\/s11920-016-0691-4","article-title":"The role of parents, parenting and the family environment in children\u2019s post-disaster mental health","volume":"18","author":"Cobham","year":"2016","journal-title":"Curr Psychiatry Rep"},{"key":"2025120600254342000_13.5.e068026.18","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20424"},{"key":"2025120600254342000_13.5.e068026.19","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20667"},{"key":"2025120600254342000_13.5.e068026.20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2011.02520.x"},{"key":"2025120600254342000_13.5.e068026.21","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1080\/14616734.2016.1148748","article-title":"Parental PTSD, adverse parenting and child attachment in a refugee sample","volume":"18","author":"van Ee","year":"2016","journal-title":"Attach Hum Dev"},{"key":"2025120600254342000_13.5.e068026.22","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1177\/0306624X211010290","article-title":"A meta-analysis of the effectiveness of EMDR and TF-CBT in reducing trauma symptoms and externalizing behavior problems in adolescents","volume":"66","author":"Hoogsteder","year":"2022","journal-title":"Int J Offender Ther Comp Criminol"},{"key":"2025120600254342000_13.5.e068026.23","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1007\/s40653-018-0212-1","article-title":"Comparing the effectiveness of EMDR and TF-CBT for children and adolescents: a meta-analysis","volume":"11","author":"Lewey","year":"2018","journal-title":"J Child Adolesc Trauma"},{"key":"2025120600254342000_13.5.e068026.24","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.jad.2022.04.111","article-title":"Cognitive behavioral therapy for children and adolescents with post-traumatic stress disorder: systematic review and meta-analysis","volume":"308","author":"Xian-Yu","year":"2022","journal-title":"J Affect Disord"},{"key":"2025120600254342000_13.5.e068026.25","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291706007963"},{"key":"2025120600254342000_13.5.e068026.26","unstructured":"Abidin R , Flens JR , Austin WG . The parenting stress index. Lawrence Erlbaum Associates Publishers, 2006."},{"key":"2025120600254342000_13.5.e068026.27","first-page":"125156","article-title":"Voice traces of anxiety: acoustic parameters affected by anxiety disorder","volume":"43","author":"\u00d6zseven","year":"2018","journal-title":"Arch Acoust"},{"key":"2025120600254342000_13.5.e068026.28","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.jvoice.2020.05.028","article-title":"Psychological stress and vocal symptoms among university professors in Israel: implications of the shift to online synchronous teaching during the covid-19 pandemic","volume":"36","author":"Besser","year":"2022","journal-title":"J Voice"},{"key":"2025120600254342000_13.5.e068026.29","first-page":"306","article-title":"Rela\u00e7\u00e3o entre os sintomas vocais E suas poss\u00edveis causas estudantes universit\u00e1rios","volume":"16","author":"Ferreira","year":"2012","journal-title":"Int Arch Otorhinolaryngol"},{"key":"2025120600254342000_13.5.e068026.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.specom.2015.03.004"},{"key":"2025120600254342000_13.5.e068026.31","doi-asserted-by":"crossref","first-page":"152","DOI":"10.2174\/1871527320666211213125847","article-title":"Speech as a biomarker for depression","volume":"22","author":"Koops","year":"2023","journal-title":"CNS Neurol Disord Drug Targets"},{"key":"2025120600254342000_13.5.e068026.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2012.03.015"},{"key":"2025120600254342000_13.5.e068026.33","doi-asserted-by":"crossref","DOI":"10.1192\/j.eurpsy.2021.2236","article-title":"Measuring neuropsychiatric symptoms in patients with early cognitive decline using speech analysis","volume":"64","author":"K\u00f6nig","year":"2021","journal-title":"Eur Psychiatry"},{"key":"2025120600254342000_13.5.e068026.34","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0165022","article-title":"How psychological stress affects emotional prosody","volume":"11","author":"Paulmann","year":"2016","journal-title":"PLoS ONE"},{"key":"2025120600254342000_13.5.e068026.35","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1146\/annurev-psych-122216-011854","article-title":"The emotion process: event appraisal and component differentiation","volume":"70","author":"Scherer","year":"2019","journal-title":"Annu Rev Psychol"},{"key":"2025120600254342000_13.5.e068026.36","doi-asserted-by":"crossref","first-page":"38","DOI":"10.5120\/21780-5056","article-title":"Vocal indicators of emotional stress","volume":"122","author":"Sondhi","year":"2015","journal-title":"IJCA"},{"key":"2025120600254342000_13.5.e068026.37","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1109\/89.905995","article-title":"Nonlinear feature based classification of speech under stress","volume":"9","author":"Zhou","year":"2001","journal-title":"IEEE Trans Speech Audio Process"},{"key":"2025120600254342000_13.5.e068026.38","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s13167-020-00229-8","article-title":"Voice perturbations under the stress overload in young individuals: phenotyping and suboptimal health as predictors for cascading pathologies","volume":"11","author":"Kunin","year":"2020","journal-title":"EPMA J"},{"key":"2025120600254342000_13.5.e068026.39","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.354"},{"key":"2025120600254342000_13.5.e068026.40","doi-asserted-by":"publisher","DOI":"10.1098\/rspb.2010.0567"},{"key":"2025120600254342000_13.5.e068026.41","doi-asserted-by":"publisher","DOI":"10.1016\/1043-2760(96)00036-7"},{"key":"2025120600254342000_13.5.e068026.42","doi-asserted-by":"publisher","DOI":"10.1016\/j.evolhumbehav.2011.05.004"},{"key":"2025120600254342000_13.5.e068026.43","doi-asserted-by":"crossref","unstructured":"Scherer S , Stratou G , Gratch J , et al . Investigating voice quality as a speaker-independent indicator of depression and PTSD. In: Interspeech. 2013: 847\u201351.","DOI":"10.21437\/Interspeech.2013-240"},{"key":"2025120600254342000_13.5.e068026.44","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1109\/TAFFC.2015.2457417","article-title":"The Geneva minimalistic acoustic parameter set (gemaps) for voice research and affective computing","volume":"7","author":"Eyben","year":"2016","journal-title":"IEEE Trans Affective Comput"},{"key":"2025120600254342000_13.5.e068026.45","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2008\/06-0223)"},{"key":"2025120600254342000_13.5.e068026.46","doi-asserted-by":"crossref","unstructured":"Hansen JH , Patil S . Speech under stress: analysis, modeling and recognition. In: M\u00fcller C , ed. Speaker Classification I. Lecture Notes in Computer Science, Vol. 4343. Berlin: Springer, 2007: 108\u201337.","DOI":"10.1007\/978-3-540-74200-5_6"},{"key":"2025120600254342000_13.5.e068026.47","doi-asserted-by":"crossref","unstructured":"Godin KW , Hansen JHL . Analysis and perception of speech under physical task stress. In: Paper Prasanted at the ISCA Interspeech. Brisbane, 1674\u20131677.","DOI":"10.21437\/Interspeech.2008-365"},{"key":"2025120600254342000_13.5.e068026.48","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1002\/da.22890","article-title":"Speech-based markers for posttraumatic stress disorder in US veterans","volume":"36","author":"Marmar","year":"2019","journal-title":"Depress Anxiety"},{"key":"2025120600254342000_13.5.e068026.49","first-page":"211","article-title":"\u00c9tude psychometrique Du questionnaire de d\u00e9pression de Beck aupr\u00e8s d\u2019un \u00e9chantillon d\u2019\u00e9tudiants universitaires francophones","volume":"14","author":"Bourque","year":"1982","journal-title":"Canadian Journal of Behavioural Science \/ Revue Canadienne Des Sciences Du Comportement"},{"key":"2025120600254342000_13.5.e068026.50","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0161645","article-title":"Psychometric validation of the English and French versions of the posttraumatic stress disorder checklist for DSM-5 (PCL-5)","volume":"11","author":"Ashbaugh","year":"2016","journal-title":"PLoS One"},{"key":"2025120600254342000_13.5.e068026.51","doi-asserted-by":"crossref","unstructured":"Gibaud-Wallston J , Wandersman LP . Parenting sense of competence scale. Canadian Journal of Behavioural Science\/Revue Canadienne Des Sciences Du Comportement 1978. doi:https:\/\/doi.org\/10.1037\/t01311-000","DOI":"10.1037\/t01311-000"},{"key":"2025120600254342000_13.5.e068026.52","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(99)00130-8"},{"key":"2025120600254342000_13.5.e068026.53","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1024\/1421-0185\/a000158","article-title":"The French version of the revised child anxiety and depression scale (RCADS) in a nonclinical sample","volume":"74","author":"Bouvard","year":"2015","journal-title":"Swiss J Psychol"},{"key":"2025120600254342000_13.5.e068026.54","unstructured":"Scheeringa M . Child PTSD checklist\u2013parent version (CPC-P). New Orleans: Tulane University, 2014."},{"key":"2025120600254342000_13.5.e068026.55","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2021.678916","article-title":"Validation of the French version of the child posttraumatic stress checklist in French school-aged children","volume":"12","author":"Gindt","year":"2021","journal-title":"Front Psychiatry"},{"key":"2025120600254342000_13.5.e068026.56","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(96)00033-2"},{"key":"2025120600254342000_13.5.e068026.57","unstructured":"Beck A , Steer R , Brown GK , et al . Beck depression inventory. New York: Harcourt Brace Jovanovich, 1987."},{"key":"2025120600254342000_13.5.e068026.58","unstructured":"Spielberger CD , Gorsuch RL , Lushene R , et al . Manual for the state-trait anxiety scale. Consulting Psychologists 1983; ."},{"key":"2025120600254342000_13.5.e068026.59","doi-asserted-by":"crossref","unstructured":"Yao Y , Papakostas M , Burzo M , et al . MUSER: multimodal stress detection using emotion recognition as an auxiliary task. ArXiv 2021. doi:10.48550\/arXiv.2105.08146","DOI":"10.18653\/v1\/2021.naacl-main.216"},{"key":"2025120600254342000_13.5.e068026.60","doi-asserted-by":"crossref","first-page":"101119","DOI":"10.1016\/j.csl.2020.101119","article-title":"Emotion recognition in low-resource settings: an evaluation of automatic feature selection methods","volume":"65","author":"Haider","year":"2021","journal-title":"Comput Speech Lang"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-068026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T08:25:51Z","timestamp":1765009551000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-068026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":60,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5,9]]},"published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1136\/bmjopen-2022-068026"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-068026","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]}}}