It is possible that an overgeneral bias for projections of the personal future may have already developed early in development in these individuals.
The average symptom duration was 11 years, which means that participants may have already developed a distinct set of beliefs about their condition, which may differ from patients who have had less experience of the illness.
As normal weight children may have already developed central obesity, health awareness efforts must include such children and advocate lifestyle changes, which may be easier to achieve in this group, before they develop overt obesity and its complications.
They may have already developed treatment resistant or intractable constipation defined as: 'constipation which does not respond to sustained optimum medical management' [ 2].
First, the duration of four weeks between the RTA and the intervention is probably too long, because PTSS may have already developed in some children.
Many individuals, particularly those diagnosed many years prior to participating in an intervention study, may have already developed strategies and acquired the relevant knowledge to manage their diabetes with minimal professional intervention.
A child may have already developed an A-TrP at the origin of the brachioradialis muscle at 4 years old, although the exact timing of the development of the A-TrP is unclear.
Of course, some early bloomers may already have developed into larvae or nymphs.
In parts of Britain, where house prices and mortgage issuances are now rising sharply, a credit boom may already be developing.
Other secondary preventive psychological interventions, such as brief Cognitive Behavioral Therapy (CBT), have yielded promising results [ 11, 12] but can be applied only several weeks after trauma, when trauma-exposed individuals may already have developed acute PTSD.
