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King SE, Smith HP. Reexploring Female Pathways to Incarceration: Assessing the Role of Mental Illness. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2024; 68:1438-1461. [PMID: 36624988 DOI: 10.1177/0306624x221144297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The pathways framework represents an emerging body of work that emphasizes gendered-based influences on crime and incarceration. To date, studies on female pathways often minimize or exclude the role of mental illness. The current study employs Life Course Theory and the use of Life History Calendar to examine the pathways of a sample of 15 female prison inmates diagnosed with serious and persistent mental health conditions. Findings indicate that mental illness carried criminogenic risk throughout the life course, with crucial transitions of risk leading these women toward long term incarceration. Self-reported pathways included repeated victimization, substance use, psychological trauma, delinquency, and/or crime. This study suggests that the pathway framework would benefit from the increased recognition of the role of mental illness on female criminality. Trauma-informed policy implications are provided and discussed.
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Pollack MS, Lloyd BP, Doyle LE, Santini MA, Crowell GE. Are Function-Based Interventions for Students with Emotional/Behavioral Disorders Trauma Informed? A Systematic Review. Behav Anal Pract 2024; 17:709-726. [PMID: 39391191 PMCID: PMC11461383 DOI: 10.1007/s40617-023-00893-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 10/12/2024] Open
Abstract
Students with emotional/behavioral disorders (EBD) commonly engage in both externalizing and internalizing behaviors-a behavioral profile that has been connected to childhood trauma. Although the efficacy of function-based interventions for students with EBD has been documented, the extent to which these interventions align with principles of trauma-informed care (TIC) is unknown. We conducted a systematic review of function-based intervention studies for students with EBD to evaluate whether and how these interventions incorporated critical elements of TIC. We identified 56 articles that met the eligibility criteria and used an iterative process to identify intervention practices consistent with each of six pillars of TIC, then evaluated the extent to which interventions in the study sample incorporated these practices. Despite identifying 45 function-based intervention practices aligned with pillars of TIC, we found most of these practices were absent in most interventions. We identified teaching skills, building healthy relationships, and including family, culture, and community as three pillars of TIC that warrant more attention when developing function-based interventions for students with EBD. For pillars of TIC that lack a strong empirical foundation in behavior analysis, we point to related literatures and disciplines with potential to inform next steps in behavior analytic research and practice.
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Affiliation(s)
- Marney S. Pollack
- Department of Special Education, Peabody College at Vanderbilt University, Box 228 Peabody College, 230 Appleton Place, Nashville, TN 37203 USA
| | - Blair P. Lloyd
- Department of Special Education, Peabody College at Vanderbilt University, Box 228 Peabody College, 230 Appleton Place, Nashville, TN 37203 USA
| | - Lilian E. Doyle
- Department of Special Education, Peabody College at Vanderbilt University, Box 228 Peabody College, 230 Appleton Place, Nashville, TN 37203 USA
| | - Matthew A. Santini
- Department of Special Education, Peabody College at Vanderbilt University, Box 228 Peabody College, 230 Appleton Place, Nashville, TN 37203 USA
| | - Gabrielle E. Crowell
- Department of Special Education, Peabody College at Vanderbilt University, Box 228 Peabody College, 230 Appleton Place, Nashville, TN 37203 USA
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Arslanlı SE, Duru HA, Bakır E, Pulat P. Exploring the disaster experiences and psychosocial support needs of children affected by the Kahramanmaras earthquake in Turkey through drawing narratives. J Pediatr Nurs 2024; 78:e260-e269. [PMID: 39025712 DOI: 10.1016/j.pedn.2024.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 07/13/2024] [Accepted: 07/13/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND On February 6, 2023, a catastrophic earthquake struck the Kahramanmaras region in Turkey. Among the most vulnerable demographic groups in the wake of such disasters are children. To provide effective psychosocial support to these young individuals, it is crucial to gain a comprehensive understanding of their specific needs resulting from the earthquake experience. OBJECTIVES This study aimed to determine the disaster experiences and psychosocial support needs of children between the ages of 7 and 12 who were affected by the Kahramanmaraş earthquake in Turkey with drawings. METHODS This research used a descriptive qualitative design, employing purposive and snowball sampling approaches to select 32 children aged 7-12 for the study. Thematic analysis approach was used to analyze the data, revealing six distinct themes as expressed through the drawings of school-aged children. The reporting in this study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). RESULTS These six themes are associating precipitation with earthquakes, security and relocation, emotional chaos, expressing the earthquake symbolically, death and physical damage and longing for normalcy. CONCLUSIONS This study highlights the importance of acknowledging and attending to children's requirements through psychosocial interventions tailored to their age. IMPLICATION TO PRACTICE It underscores the complex nature of the psychosocial needs of children impacted by earthquakes and promotes collaborative efforts among healthcare professionals and nurses to provide more effective support to these children during challenging circumstances.
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Affiliation(s)
- Sevilay Ergün Arslanlı
- Department of Midwifery, Çankırı Karatekin University, Faculty of Health Science, Çankırı, Turkey.
| | - Hilal Altundal Duru
- Department of Public Health Nursing, Çankırı Karatekin University, Faculty of Health Science, Çankırı, Turkey.
| | - Ebru Bakır
- Department of Child Health and Diseases Nursing, İzmir Katip Çelebi University, Faculty of Health Science, İzmir, Turkey
| | - Pervin Pulat
- Department of Art Teaching, Mersin University, Faculty of Education, Mersin, Turkey
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4
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Even D, Cohen GH, Wang R, Galea S. The cumulative contribution of direct and indirect traumas to the production of PTSD. PLoS One 2024; 19:e0307593. [PMID: 39141638 PMCID: PMC11324107 DOI: 10.1371/journal.pone.0307593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/08/2024] [Indexed: 08/16/2024] Open
Abstract
OBJECTIVE Posttraumatic Stress Disorder (PTSD) affects millions of people worldwide. While the relationship between direct exposure to traumatic events and PTSD is well-established, the influence of indirect trauma exposure on PTSD remains unclear. It is similarly unclear what role cumulative exposure to direct and indirect traumas play in the risk of PTSD. METHODS The study uses data from the Houston Trauma and Recovery Study, conducted on 2020-2021, and involved a random sampling of 1,167 individuals residing in Houston during Hurricane Harvey in 2017. Participants were asked about their experiences related to both Hurricane Harvey and the subsequent COVID-19 pandemic. Exposures were categorized as direct or indirect traumas, in line with the criteria delineated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Cumulative exposures were also calculated. RESULTS Among participants, 12.6% were experiencing current PTSD. There were significant associations between both direct [OR = 3.18, 95% CI 1.85, 5.46] and indirect [OR = 1.91, 95% CI 1.05, 3.46] traumas related to Harvey, as well as direct [OR = 2.13, 95% CI 1.20, 3.77] and indirect [OR = 1.69, 95% CI 0.93, 3.09] traumas due to COVID and the risk of PTSD in fully adjusted models. Further, significant associations were found between the cumulative exposure to traumas from both Hurricane Harvey and COVID-19 and the risk of PTSD, considering both direct [OR = 2.53, 95% CI 1.36, 4.70] and indirect exposures [OR = 2.79, 95% CI 1.47, 5.28]. CONCLUSIONS Our study offers support for connections between exposure to both direct and indirect traumas stemming from large-scale disasters and PTSD. Moreover, we show that cumulative exposures to multiple large-scale events increase the risk of PTSD. This highlights the importance of the consideration of a range of exposures as risks for PTSD, particularly in a time of compounding disasters and broad population exposures to these events.
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Affiliation(s)
- Dan Even
- Moshe Prywes Center for Medical Education, Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel
- School of Public Health, Boston University, Boston, Massachusetts, United States of America
| | - Gregory H. Cohen
- School of Public Health, Boston University, Boston, Massachusetts, United States of America
| | - Ruochen Wang
- School of Public Health, Boston University, Boston, Massachusetts, United States of America
| | - Sandro Galea
- School of Public Health, Boston University, Boston, Massachusetts, United States of America
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5
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The relationship between multiple traumatic events and the severity of posttraumatic stress disorder symptoms – evidence for a cognitive link. Eur J Psychotraumatol 2023; 14:2165025. [PMID: 37052097 PMCID: PMC9879173 DOI: 10.1080/20008066.2023.2165025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: Previous research has shown that multiple traumatic experiences cumulatively increase the risk for the development of severe symptoms of posttraumatic stress disorder (PTSD). Yet, little is known about the specific psychological mechanism through which this increased risk comes about.Objective: In the present study, we examined a possible cognitive link between multiple traumatic events and PTSD symptom severity through dysfunctional cognitions and expectations.Methods: A sample of patients with a diagnosed PTSD (N = 70; MAge = 42.06; 82% female) and high symptom burden (IES-R M = 79.24) was examined. On average, patients had experienced 5.31 different traumatic events. In a structural equation model, we tested the hypothesis that the relationship between multiple traumatic experiences and PTSD symptom severity is mediated through dysfunctional general cognitions and dysfunctional situation-specific expectations. General trauma-related cognitions were assessed with the Posttraumatic Cognition Inventory (PTCI) and trauma-related situational expectations were assessed with the Posttraumatic Expectations Scale (PTES).Results: The direct effect of the number of traumatic events on PTSD symptom severity was non-significant. Instead, as hypothesised, there was evidence for a significant indirect effect via dysfunctional general cognitions and situation-specific expectations.Conclusions: The current results further specify the cognitive model of PTSD by indicating that the relationship between the number of traumatic events and PTSD symptom severity is mediated through dysfunctional cognitions and expectations. These findings emphasise the importance of focused cognitive treatment approaches that seek to modify dysfunctional cognitions and expectations in people with multiple traumatic experiences.
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Sonsteng-Person M, Jaggers JW, Loomis AM. Academic Achievement After Violence Exposure: The Indirect Effects of School Attachment and Motivation to Succeed. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:717-729. [PMID: 37593062 PMCID: PMC10427593 DOI: 10.1007/s40653-023-00546-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 08/19/2023]
Abstract
Disparities in educational outcomes for students living in communities burdened with high rates of violence are striking as they are at an increased risk for misbehavior, low GPA, poor school attendance, and decreased standardized test scores. However, limited research identifies the role that schools play in exacerbating exposure to violence to inform changes that aid in mitigating violence exposure. As such, this study utilizes the Pathways to Desistance Study to explore the mediating roles of school attachment and motivation to succeed on students' academic outcomes after exposure to community violence. Using a serial mediation model, findings indicate that school attachment and motivation to succeed mediate the relationship between exposure to violence and grades. Implications for adapting school programs and policies as well as providing teacher training to increase school attachment and motivation are discussed.
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Affiliation(s)
- Melanie Sonsteng-Person
- College of Education , University of Florida, 1414 Norman Hall, PO Box 117050, Gainesville, FL 32611 USA
| | - Jeremiah W. Jaggers
- College of Social Work, University of Utah, 395 South 1500 East #111, Salt Lake City, UT 84112 USA
| | - Alysse M. Loomis
- College of Social Work, University of Utah, 395 South 1500 East #111, Salt Lake City, UT 84112 USA
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7
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Lohmiller K, Gruber H, Harpin S, Belansky ES, James KA, Pfeiffer JP, Leiferman J. The S.I.T.E. Framework: A Novel Approach for Sustainably Integrating Trauma-Informed Approaches in Schools. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:1011-1027. [PMID: 36439671 PMCID: PMC9684395 DOI: 10.1007/s40653-022-00461-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 06/16/2023]
Abstract
Students who present as dysregulated due to the impacts of trauma and toxic stress can challenge educators and find themselves improperly or insufficiently supported, punitively consequenced and unable to equitably access education. Trauma-informed approaches based on an understanding of brain development and function have been put forth as best practice for supporting students with trauma histories. The novel Sustainably Integrated Trauma-Informed Education Framework (S.I.T.E. Framework) facilitates systemic integration of trauma-informed approaches across a school and was developed through a community-informed process to address implementation challenges traditionally linked to trauma-informed initiatives. The S.I.T.E Framework promotes the science-based content of the Neurosequential Model in Education (NME) and was piloted during the 2017-18 school year at a metropolitan elementary school in Colorado. Mixed analytic methods identified four components, 1) establish and facilitate school-based Core Team, 2) deliver school-wide professional development training, 3) provide on-site staff support and consultation and 4) conduct a comprehensive evaluation as critical to the successful implementation of the framework. Pilot testing of the S.I.T.E. Framework's innovative, multicomponent structure illustrates the potential for sustainable, whole-school integration of brain-based, trauma-informed approaches that are supportive of both educators and students regardless of their trauma history.
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Affiliation(s)
- Katie Lohmiller
- Department of Community & Behavioral Health, Colorado School of Public Health, Aurora, CO USA
| | | | - Scott Harpin
- College of Nursing, University of Colorado, Aurora, CO USA
| | - Elaine S. Belansky
- Center for Rural School Health & Education, Morgridge College of Education, University of Denver, Denver, CO USA
| | - Katherine A. James
- Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora, CO USA
| | | | - Jenn Leiferman
- Department of Community & Behavioral Health, Colorado School of Public Health, Aurora, CO USA
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8
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Musicaro RM, Langer DA. Applying shared decision-making to screening for trauma and adversity in youth. CHILD ABUSE & NEGLECT 2022; 131:105762. [PMID: 35777339 DOI: 10.1016/j.chiabu.2022.105762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/13/2022] [Accepted: 06/19/2022] [Indexed: 06/15/2023]
Abstract
Youth who have experienced adverse childhood experiences (ACEs) or trauma are at risk for negative outcomes that may be lessened by adversity screening and prevention efforts. However, experts and consumers do not universally embrace adversity screening efforts. Despite significant support for widespread adversity screening, and many guidelines on how to conduct such screening, successful implementation has lagged behind enthusiasm. This paper outlines the challenges of adversity screening and then proposes applying the shared decision-making (SDM) model to improve adversity screening by increasing youths' 1) engagement in adversity screening if doing so is appropriate for them, and 2) disclosure of honest information during screens. Using an SDM approach honors youth preferences and perspectives, which simultaneously accomplishes a third overarching goal: aligning adversity screening with the principles of trauma-informed care.
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Affiliation(s)
- Regina M Musicaro
- Yale School of Medicine, Child Study Center, 230 S. Frontage Rd., New Haven, CT, United States of America.
| | - David A Langer
- Suffolk University, Department of Psychology, 73 Tremont Street, Boston, MA 02108, United States of America
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9
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Dutta A, Peña F, Holcomb JM, Leiva L, Squicciarini AM, Canenguez KM, Bergmann P, Riobueno-Naylor A, Farley AM, Simonsohn A, Garfin DR, Silver RC, Benheim TS, Guzmán J, Jellinek MS, Murphy JM. Earthquake exposure, adverse childhood experiences, and psychosocial functioning in Chilean children: A longitudinal study. J Trauma Stress 2022; 35:1177-1188. [PMID: 35355336 PMCID: PMC9704030 DOI: 10.1002/jts.22826] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 02/06/2023]
Abstract
The impact of an 8.8 magnitude Chilean earthquake on elementary school students' psychosocial functioning was assessed along with exposure to adverse childhood experiences (ACEs). Skills for Life, a national school-based mental health program in Chile, routinely assesses first- and third-grade students' psychosocial functioning and classroom adaptation. Students (N = 19,627) were screened before (2009) and after (2011) the 2010 earthquake with parent- and teacher-report measures and with a parent-report of four ACEs (family psychopathology, child chronic illness, family social isolation, father absence). Earthquake exposure was categorized as mild, moderate, or severe for Chile's 15 regions. Multilevel models analyzed the unadjusted and adjusted impacts of earthquake exposure and ACEs on functioning while clustering for school- and district-level effects. In covariate-adjusted models, earthquake exposure and three ACEs were significantly associated with worsened psychosocial functioning; earthquake exposure and all four ACEs were significantly associated with worsened classroom adaptation. New family psychopathology, B = 1.90, p < .001; chronic illness, B = 2.25, p < .001; and severe earthquake impact, B = 1.29, p < .001, held the strongest negative effects on psychosocial well-being. Moderate, B = 3.04, p = .011, and severe earthquake exposure, B = 2.53, p = .047, and new family psychopathology, B = 1.99, p < .001, were associated with the worst classroom functioning 1-year postdisaster. Findings suggest that both exogenous and home-based stressors can have significant consequences for children's psychosocial functioning and classroom adaptation, and routine screening helps quantify how individual students are affected by chronic versus acute stressors.
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Affiliation(s)
- Anamika Dutta
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Juliana M. Holcomb
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Psychology, Suffolk University, Boston, MA
| | - Loreto Leiva
- Department of Psychology, University of Chile, Santiago, Chile
| | | | - Katia M. Canenguez
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Alexa Riobueno-Naylor
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Chestnut Hill, Massachusetts, USA
| | - Alyssa M. Farley
- Center for Anxiety and Related Disorders, Boston University, Boston, Massachusetts, USA
| | - Ariela Simonsohn
- Department of School Health, Junta Nacional de Auxilio Escolar y Becas, Santiago, Chile
| | - Dana Rose Garfin
- Sue & Bill Gross School of Nursing and Program in Public Health, University of California, Irvine, Irvine, California, USA
| | - Roxane Cohen Silver
- Department of Psychological Science, Department of Medicine, Program in Public Health, University of California, Irvine, Irvine, California, USA
| | - Talia S. Benheim
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Javier Guzmán
- Department of School Health, Junta Nacional de Auxilio Escolar y Becas, Santiago, Chile
| | - Michael S. Jellinek
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - J. Michael Murphy
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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10
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Piper KN, Elder A, Renfro T, Iwan A, Ramirez M, Woods-Jaeger B. The Importance of Anti-Racism in Trauma-Informed Family Engagement. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2022; 49:125-138. [PMID: 34195916 PMCID: PMC9729020 DOI: 10.1007/s10488-021-01147-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 01/03/2023]
Abstract
Students of color are disproportionately affected by exposure to adverse childhood experiences (ACEs), racial trauma, and traumatic stress. Trauma-informed interventions in schools can promote healing among ACE-impacted students of color. These interventions require collaboration with family members to decide upon services and referrals; however, educators commonly face challenges with engaging families. The study purpose is to understand barriers and facilitators to engaging families in trauma-informed mental health interventions for ACE-impacted students of color. As part of a larger school-based trauma-informed trial (Link for Equity), 6 focus groups were conducted with parents/guardians of color and school staff (n = 39) across 3 Midwestern school districts. Participants were asked open-ended questions about trauma, discrimination, school supports, and family engagement. Transcripts were coded by two team members, and thematic analysis was used to identify barriers/facilitators to family involvement. Results indicated that families of ACE-impacted students of color commonly experienced racism including microaggressions and stereotypes from the school community, which deterred engagement and prevented trusting relationships between families and school staff. Parents highlighted feeling excluded from decisions related to their child's education and that their voices were not heard or understood. Participants discussed the need for schools to consider how family obstacles (such as mental health and trauma) may prevent families from engaging with staff, and they recommended structural changes, such as anti-racism trainings for educators. Findings highlight the need for anti-racist work that addresses interpersonal and structural racism in schools, in order to promote family engagement in trauma-informed mental health interventions.
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Affiliation(s)
- Kaitlin N. Piper
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Amy Elder
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tiffaney Renfro
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Allison Iwan
- University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Marizen Ramirez
- University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Briana Woods-Jaeger
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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11
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Asnaani A, Narine K, Suzuki N, Yeh R, Zang Y, Schwartz B, Mannarino A, Cohen J, Foa EB. An Innovative Mobile Game for Screening of Pediatric PTSD: a Study in Primary Care Settings. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2021; 14:357-366. [PMID: 34471454 PMCID: PMC8357874 DOI: 10.1007/s40653-020-00300-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Childhood is a developmental period associated with high risk of posttraumatic stress disorder (PTSD). Available validated pencil-and-paper diagnostic tools can be difficult for younger children to engage with given format and length. This study investigated psychometric properties of a briefer, more interactive game version of the Child PTSD Symptom Scale for DSM-5 (CPSS-5). Participants (n = 49) were children attending primary care appointments between 8 to 12 years of age who were exposed to a DSM-5 Criterion A trauma. Participants completed the 6-item screening version of the CPSS-5 delivered in mobile tablet game format (the CPSS-5 Screen Team Game) and a self-report version of the full CPSS-5 (CPSS-5-SR) before their medical appointments. The mobile game showed adequate internal consistency (α = 0.79), was significantly positively correlated to the total CPSS-5-SR (r = .74, p < .001, n = 49), and with the total of the six identical items of the CPSS-5-SR (r = .79, p < .001, n = 49), demonstrating good convergent validity. Receiver operating characteristic (ROC) analyses revealed a cut-off score of 9 on the screening game as indicative of probable PTSD. Implementation of this screening game into primary care settings could be a low-burden method to greatly increase the detection of pediatric PTSD for referral to appropriate integrated care interventions.
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Affiliation(s)
- Anu Asnaani
- Department of Psychology, University of Utah, 380 S. 1530 E BEH S 502, Salt Lake City, UT USA
| | - Kevin Narine
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA USA
| | - Noah Suzuki
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA USA
| | - Rebecca Yeh
- Clinical Psychology Department, La Salle University, Philadelphia, PA USA
| | - Yinyin Zang
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA USA
| | - Billie Schwartz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Anthony Mannarino
- Department of Psychiatry, Drexel University College of Medicine/Allegheny Health Network, Pittsburgh, PA USA
| | - Judith Cohen
- Department of Psychiatry, Drexel University College of Medicine/Allegheny Health Network, Pittsburgh, PA USA
| | - Edna B. Foa
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA USA
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12
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Sonsteng-Person M, Loomis AM. The Role of Trauma-Informed Training in Helping Los Angeles Teachers Manage the Effects of Student Exposure to Violence and Trauma. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2021; 14:189-199. [PMID: 33986905 PMCID: PMC8099941 DOI: 10.1007/s40653-021-00340-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
Exposure to trauma, such as community violence, has far-reaching effects on childrens' learning and behavior. While schools are a critical place to provide positive and safe spaces for students, teachers have self-reported a lack of knowledge on how to work effectively with traumatized students. In response to this, there has been an increase in teacher training on trauma-related topics. However, it is unclear how training impacts teachers' trauma knowledge and difficulty responding to traumatized students in the classroom. As such, this exploratory study used a survey (N = 94) with Los Angeles teachers to assess whether training on violence and trauma is related to trauma knowledge and reported difficulty responding to traumatized students. Regression analyses indicate that total training increased teachers' trauma knowledge, which was found to mediate teachers' difficulty responding to traumatized students. Findings from this study support the need for a focus on trauma-informed training within the education context.
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Affiliation(s)
- Melanie Sonsteng-Person
- University of California, 3250 Public Affairs Building, Box 951656, Los Angeles, CA 90095 USA
| | - Alysse M. Loomis
- College of Social Work, University of Utah, 395 South 1500 East #111, Salt Lake City, UT 84112 USA
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13
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Ormiston HE, Nygaard MA, Heck OC. The Role of School Psychologists in the Implementation of Trauma-Informed Multi-Tiered Systems of Support in Schools. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2020. [DOI: 10.1080/15377903.2020.1848955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Heather E. Ormiston
- Department of Counseling and Educational Psychology, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Malena A. Nygaard
- Department of Counseling and Educational Psychology, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Olivia C. Heck
- Department of Counseling and Educational Psychology, Indiana University Bloomington, Bloomington, Indiana, USA
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14
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Giovanelli A, Mondi CF, Reynolds AJ, Ou SR. Adverse childhood experiences: Mechanisms of risk and resilience in a longitudinal urban cohort. Dev Psychopathol 2020; 32:1418-1439. [PMID: 31663487 PMCID: PMC7190431 DOI: 10.1017/s095457941900138x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
There is an extensive literature describing the detrimental effects of adverse childhood experiences (ACE; e.g., abuse, neglect, and household dysfunction) on physical and mental health. However, few large-scale studies have explored these associations longitudinally in urban minority cohorts or assessed links to broader measures of well-being such as educational attainment, occupation, and crime. Although adversity and resilience have long been of interest in developmental psychology, protective and promotive factors have been understudied in the ACE literature. This paper investigates the psychosocial processes through which ACEs contribute to outcomes, in addition to exploring ways to promote resilience to ACEs in vulnerable populations. Follow-up data were analyzed for 87% of the original 1,539 participants in the Chicago Longitudinal Study (N = 1,341), a prospective investigation of the impact of an Early Childhood Education program and early experiences on life-course well-being. Findings suggest that ACEs impact well-being in low-socioeconomic status participants above and beyond the effects of demographic risk and poverty, and point to possible mechanisms of transmission of ACE effects. Results also identify key areas across the ecological system that may promote resilience to ACEs, and speak to the need to continue to support underserved communities in active ways.
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Affiliation(s)
- Alison Giovanelli
- Institute of Child Development, University of Minnesota, Twin Cities, MN, USA
- Department of Pediatrics, Adolescent and Young Adult Medicine, University of California, San Francisco, CA, USA
| | - Christina F. Mondi
- Institute of Child Development, University of Minnesota, Twin Cities, MN, USA
| | - Arthur J. Reynolds
- Institute of Child Development, University of Minnesota, Twin Cities, MN, USA
| | - Suh-Ruu Ou
- Institute of Child Development, University of Minnesota, Twin Cities, MN, USA
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15
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A Scoping Review of School-Based Efforts to Support Students Who Have Experienced Trauma. SCHOOL MENTAL HEALTH 2020. [DOI: 10.1007/s12310-020-09368-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AbstractThe current review sought to describe the published literature relative to addressing trauma in schools. Through a systematic review of peer-reviewed publications as well as gray literature, we identified a total of 91 publications that were coded for study rigor as well as a number of intervention characteristics. Publications included in the review mentioned a variety of intervention components, most notably an emphasis on counseling services, skill development, psychoeducation related to trauma, and parent engagement. We identified a relative lack of empirical evaluation of whole-school approaches and interventions intended to be delivered by non-clinical staff. We also found that less rigorous publications were more likely to highlight the needs of particularly vulnerable groups of youth and to emphasize cultural competence and community engagement in efforts to address trauma in schools. We call for more rigorous evaluation of practices and policies that take a whole-school approach and can be implemented by non-clinical staff. In particular, we highlight the need to evaluate professional development strategies that can help school staff acquire knowledge and skills that can translate into improved outcomes for students—especially students from historically marginalized groups. We also emphasize the importance of ensuring that high-quality research be made accessible to policymakers and school staff to ensure that clear, evidence-based guidance is available to avoid programs, practices, and policies that may inadvertently traumatize students or exacerbate symptoms among students who have already experienced trauma.
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Barnes AJ, Anthony BJ, Karatekin C, Lingras KA, Mercado R, Thompson LA. Identifying adverse childhood experiences in pediatrics to prevent chronic health conditions. Pediatr Res 2020; 87:362-370. [PMID: 31622974 PMCID: PMC6962546 DOI: 10.1038/s41390-019-0613-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 08/16/2019] [Accepted: 09/25/2019] [Indexed: 02/07/2023]
Abstract
Despite evidence that over 40% of youth in the United States have one or more adverse childhood experiences (ACEs), and that ACEs have cumulative, pernicious effects on lifelong health, few primary care clinicians routinely ask about ACEs. Lack of standardized and accurate clinical assessments for ACEs, combined with no point-of-care biomarkers of the "toxic stress" caused by ACEs, hampers prevention of the health consequences of ACEs. Thus, there is no consensus regarding how to identify, screen, and track ACEs, and whether early identification of toxic stress can prevent disease. In this review, we aim to clarify why, for whom, when, and how to identify ACEs in pediatric clinical care. To do so, we examine the evidence for such identification; describe the efficacy and accuracy of potential screening instruments; discuss current trends in, and potential barriers to, the identification of ACEs and the prevention of downstream effects; and recommend next steps for research, practice, and policy.
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Affiliation(s)
- Andrew J Barnes
- Department of Pediatrics, University of Minnesota, St Paul, MN, USA.
| | - Bruno J Anthony
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Canan Karatekin
- Institute of Child Development, University of Minnesota, St Paul, MN, USA
| | - Katherine A Lingras
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, St Paul, MN, USA
| | - Rebeccah Mercado
- Departments of Pediatrics, Health Outcomes and Policy, University of Florida, Gainesville, FL, USA
| | - Lindsay Acheson Thompson
- Departments of Pediatrics, Health Outcomes and Policy, University of Florida, Gainesville, FL, USA
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Berger E. Multi-tiered Approaches to Trauma-Informed Care in Schools: A Systematic Review. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09326-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Abstract
This special issue aims to highlight the importance of exploring the empirical base for eye movement desensitization and reprocessing (EMDR) therapy with children and adolescents. Such an endeavor is set within a context where the American Psychological Association recommends trauma-focused cognitive behavioral therapy (TF-CBT) as the treatment of choice and the National Institute of Health and Care Excellence (NICE) recommends EMDR for children when TF-CBT fails to be effective. Studies in this special issue suggest otherwise and represent EMDR’s global reach over seven different countries. The studies address a range of conceptual gaps and evaluate differing EMDR protocols for individual and group delivery. Participants from preschool to adolescence experienced single event, cumulative violence, and trajectories of trauma and present with a range of trauma symptoms. Although studies with differing methodologies highlight the efficacy of EMDR with differing populations, recommendations are made for rigorous research designs in order to influence professional guidance organizations.
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Danaher BG, Seeley JR, Stormshak EA, Tyler MS, Caruthers AS, Moore KJ, Cardenas L. The Family Check-Up Online Program for Parents of Middle School Students: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e11106. [PMID: 30021712 PMCID: PMC6070726 DOI: 10.2196/11106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/23/2018] [Accepted: 06/24/2018] [Indexed: 01/08/2023] Open
Abstract
Background Research has established that skillful family management during adolescence protects youth from a variety of mental health and behavioral problems. Interventions associated with this research have focused on parenting skills as the mediator that links early risk factors with a profile of later behavioral risk, including problem behavior, substance use, and school failure. Fortunately, positive changes in family management skills have been linked to meaningful improvements in adolescent behavior, and these improvements have been significant across a variety of cultural groups. Objective We describe the background, research design, and intervention components of an electronic health version of the Family Check-Up program that is targeting middle school children and is being evaluated in a randomized controlled trial for its usability, feasibility, and efficacy. Methods We used an iterative formative research process to develop an electronic health version of the Family Check-Up program. In our ongoing randomized controlled trial, eligible families are randomly assigned to 1 of 3 conditions: Family Check-Up Online-only (n≈100), Family Check-Up Online + Coach (n≈100), and a waitlist control condition (middle school as usual; n≈100). We are conducting assessments at baseline, 3 months following randomization (posttest), and at follow-ups scheduled for 6 months and 12 months. Results This randomized controlled trial project was funded in 2015. Participant recruitment was completed in spring 2018 and enrollment is ongoing. Follow-up assessments will be completed in 2019. Conclusions The innovative Family Check-Up Online program has the potential to help address many of the barriers that more traditional school-based behavioral mental health implementation strategies have yet to solve, including staffing and resources to implement family-centered support within schools. Trial Registration ClinicalTrials.gov NCT03060291; https://clinicaltrials.gov/ct2/show/NCT03060291 (Archived by WebCite at http://www.webcitation.org/70f8keeN4) Trial Registration RR1-10.2196/11106
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Affiliation(s)
- Brian G Danaher
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - John R Seeley
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | | | - Milagra S Tyler
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Allison S Caruthers
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Kevin J Moore
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Lucia Cardenas
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
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Chafouleas SM, Koriakin TA, Roundfield KD, Overstreet S. Addressing Childhood Trauma in School Settings: A Framework for Evidence-Based Practice. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9256-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma. CHILDREN-BASEL 2017; 4:children4030016. [PMID: 28264496 PMCID: PMC5368427 DOI: 10.3390/children4030016] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 02/19/2017] [Accepted: 02/21/2017] [Indexed: 01/22/2023]
Abstract
Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes. Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood.
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Chafouleas SM, Johnson AH, Overstreet S, Santos NM. Toward a Blueprint for Trauma-Informed Service Delivery in Schools. SCHOOL MENTAL HEALTH 2015. [DOI: 10.1007/s12310-015-9166-8] [Citation(s) in RCA: 177] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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