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Smith AB, Cooley DT, Mesman GR, John SG, Wilburn EH, Vanderzee KL, Pemberton JR. Behavior Management in Young Children Exposed to Trauma: A Case Study of Three Evidence-Based Treatments. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:839-852. [PMID: 38045836 PMCID: PMC10689672 DOI: 10.1007/s40653-023-00573-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 12/05/2023]
Abstract
Young children are particularly vulnerable to traumatic events and the development of posttraumatic stress symptoms, including comorbid disruptive behaviors. Fortunately, several evidence-based interventions have been shown to be effective at decreasing both posttraumatic stress symptoms and disruptive behaviors in young children. This paper provides an overview of three such interventions-Child-Parent Psychotherapy (CPP), Parent-Child Interaction Therapy (PCIT), and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). An illustrative case study is used to compare how each intervention addresses disruptive behaviors, with a focus on theoretical underpinnings, model similarities, and model differences. The models each have empirical evidence for the treatment of disruptive behavior in young children, and therefore, may be appropriate for treating children with a history of trauma exposure and comorbid disruptive behaviors. Child, caregiver, and environmental factors are essential to consider when identifying an evidence-based intervention for this population.
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Affiliation(s)
- Allison B. Smith
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Daryl T. Cooley
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Glenn R. Mesman
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Sufna G. John
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Elissa H. Wilburn
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Karin L. Vanderzee
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
| | - Joy R. Pemberton
- Department of Psychiatry, University of Arkansas for Medical Sciences, 1210 Wolfe Street, Little Rock, AR 72202 USA
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Kongshøj ILL, Bohn A, Berntsen D. To mention or not to mention? The inclusion of self-reported most traumatic and most positive memories in the life story. Memory 2021; 30:133-146. [PMID: 34713774 DOI: 10.1080/09658211.2021.1995876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Many theories on Posttraumatic Stress Disorder (PTSD) make assumptions on the relationship between PTSD and centrality of traumas to the life story and identity. Although the Centrality of Event Scale (CES) is a popular measure of centrality of personally experienced events to the life story, no studies have examined whether self-rated "central" events are mentioned, when individuals recount their lives. It is also unknown if mentioning specific event types in the life story is related to psychological health or life story coherence. We asked 386 adults to write their life stories, nominate their most traumatic and positive events, rate these events on the CES, and complete measures of PTSD and depression. Two-thirds of the sample mentioned at least one event, with the positive event being mentioned twice as often as the trauma. Mentioned events were more central than non-mentioned events. Participants who mentioned their trauma scored higher on symptoms of PTSD and depression than participants who only mentioned their positive event, but did not write less coherent life stories. Further, death- and illness-related traumas were mentioned more often than accidents and disasters. Findings are discussed in relation to theories on trauma memory in PTSD.
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Affiliation(s)
- Inge Lise Lundsgaard Kongshøj
- Center on Autobiographical Memory Research (CON AMORE), Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Annette Bohn
- Center on Autobiographical Memory Research (CON AMORE), Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Dorthe Berntsen
- Center on Autobiographical Memory Research (CON AMORE), Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
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Hoeboer C, de Roos C, van Son GE, Spinhoven P, Elzinga B. The effect of parental emotional abuse on the severity and treatment of PTSD symptoms in children and adolescents. CHILD ABUSE & NEGLECT 2021; 111:104775. [PMID: 33158585 DOI: 10.1016/j.chiabu.2020.104775] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 08/07/2020] [Accepted: 10/08/2020] [Indexed: 05/23/2023]
Abstract
BACKGROUND Maltreatment by a primary caregiver is an important risk factor for the development of PTSD symptoms. Whereas meta-analyses indicate that parental emotional abuse is one of the most common forms of maltreatment, the impact of emotional abuse on PTSD symptoms and treatment effectiveness is still unclear, especially in children. OBJECTIVE We aimed to investigate the impact of parental emotional abuse on PTSD symptom severity and effectiveness of trauma treatment in children and adolescents. METHOD In an outpatient sample (N = 287, mean age = 15.5 years), emotional abuse, index traumatic event, and PTSD symptoms were assessed at baseline. Thereafter, patients received evidence-based treatment for trauma-related symptoms embedded in a broader (systemic) treatment package. In a subsample (n = 130, mean age = 15.3 years) PTSD symptoms were assessed again 6 and 12 months after baseline. RESULTS Emotional abuse (rather than any other type of maltreatment) was associated with more severe PTSD symptoms in all symptom clusters. This was independent of whether emotional abuse was reported as index traumatic event or not. Moreover, PTSD symptoms were significantly reduced 6 months after the start of trauma-focused treatment, and emotional abuse was associated with more severe PTSD symptoms over the course of treatment. CONCLUSIONS These findings underline the detrimental nature of emotional maltreatment in the context of PTSD symptomatology and treatment effectiveness. This calls for routine assessment of parental emotional abuse in the diagnostic phase, even when this is not the reason of referral.
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Affiliation(s)
- Chris Hoeboer
- Leiden University, Institute of Psychology, Section Clinical Psychology, Leiden, the Netherlands; Parnassiagroep, PsyQ The Hague, the Netherlands.
| | - Carlijn de Roos
- Amsterdam University Medical Centre, Department of Child and Adolescent Psychiatry, Amsterdam, the Netherlands.
| | | | - Philip Spinhoven
- Leiden University, Institute of Psychology, Section Clinical Psychology, Leiden, the Netherlands; Leiden University Medical Center, Department of Psychiatry, the Netherlands.
| | - Bernet Elzinga
- Leiden University, Institute of Psychology, Section Clinical Psychology, Leiden, the Netherlands.
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Violence exposure, posttraumatic stress, and affect variability among African American Youth: A time sampling approach. Dev Psychopathol 2020; 33:1085-1096. [PMID: 32478650 DOI: 10.1017/s095457942000036x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The current study examines the immediate and short-term impact of daily exposure to community violence on same-day and next-day levels of posttraumatic stress symptomatology and various affective states (i.e., dysphoria, hostility, and anxiety), in a sample of 268 African American adolescents living in urban, low-income, high-violence neighborhoods (Mage = 11.65; 59% female). In addition, the moderating role of affective state variability on this relationship was examined. This study utilized experience sampling method and a daily sampling approach, which contributes a more robust investigation of the short-term effects of violence exposure in youth. Hierarchical linear modeling revealed that community violence exposure was positively associated with same-day and next-day symptoms of posttraumatic stress. Violence exposure also exhibited an immediate effect on dysphoria, anxiety, and hostility levels. Youth variability in dysphoria exacerbated the effect of violence exposure on concurrent or next-day posttraumatic stress, dysphoria, and hostility. Moreover, variability in anxiety and hostility exacerbated the experience of next-day hostility. The clinical implications relating to these findings, such as the importance of implementing screening for posttraumatic stress following exposure, the incorporation of preventative treatments among those at risk of exposure, and the targeting of emotion regulation in treatments with adolescents, are discussed.
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5
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Karadag M, Gokcen C, Sarp AS. EMDR therapy in children and adolescents who have post-traumatic stress disorder: a six-week follow-up study. Int J Psychiatry Clin Pract 2020; 24:77-82. [PMID: 31663396 DOI: 10.1080/13651501.2019.1682171] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objectives: The purpose of this study is to explore whether eye movement desensitisation and reprocessing (EMDR) is an effective therapy and to investigate whether EMDR affects anxiety levels for children and adolescents.Methods: We conducted this study with 30 clients. The clients completed self-administered questionnaires Child Post-Traumatic Stress Reaction Index Scale and The State-Trait Anxiety Inventory. The questionnaires were conducted before the therapy and 6 weeks after the completion of the therapy.Results: Nineteen clients (63%) had only one traumatic event, but 11 clients (37%) had more than one traumatic event. While the mean score on the PTSD symptom scale was 60 (±8.7), this rate decreased to 24 (±10.1), whereas the mean STAI-T scale was 59 (±8.9) before treatment and 41 (±11.5) after treatment. We found a statistically significant difference between symptom scores as quantified by both questionnaires before and after EMDR therapy (p < .05).Conclusions: As a result, we have shown that EMDR is an effective method for children and adolescents with PTSD in terms of both post-traumatic and anxiety symptom levels; however, we recommend a larger sample size with a control group to further establish the effectiveness of EMDR therapy in children.KEY POINTSPTSD is a common disorder in children and adolescents.Additional psychiatric disorders such as anxiety and depression are common in children and adolescents with PTSD.In PTSD cases applying for psychiatric treatment, trauma associated with sexual abuse is more pronounced and complex.EMDR is an effective therapy in children and adolescents as well as in adults.There is a statistically significant decrease at anxiety and PTSD symptom scores as quantified by questionnaires in patients with PTSD after EMDR therapy.
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Affiliation(s)
- Mehmet Karadag
- Child and Adolescent Psychiatry Department, Gaziantep University Medical School, Gaziantep, Turkey
| | - Cem Gokcen
- Department of Child and Adolescent Psychiatry, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Ayse Sevde Sarp
- Department of Child and Adolescent Psychiatry, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
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Vaeroy H, Schneider F, Fetissov SO. Neurobiology of Aggressive Behavior-Role of Autoantibodies Reactive With Stress-Related Peptide Hormones. Front Psychiatry 2019; 10:872. [PMID: 31866881 PMCID: PMC6904880 DOI: 10.3389/fpsyt.2019.00872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 11/05/2019] [Indexed: 12/31/2022] Open
Abstract
Adrenocorticotropic hormone together with arginine vasopressin and oxytocin, the neuropeptides regulating the stress response and the hypothalamic-pituitary-adrenal axis activity, are known to modulate aggressive behavior. The functional role of the adrenocorticotropic hormone immunoglobulin G autoantibodies in peptidergic signaling and motivated behavior, including aggression, has been shown in experimental and in vitro models. This review summarizes some experimental data implicating autoantibodies reactive with stress-related peptides in aggressive behavior.
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Affiliation(s)
- Henning Vaeroy
- Department of Psychiatric Research, Akershus University Hospital, Nordbyhagen, Norway
| | - Frida Schneider
- Department of Psychiatric Research, Akershus University Hospital, Nordbyhagen, Norway
| | - Sergueï O Fetissov
- Inserm UMR1239, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, University of Rouen Normandy, Rouen, France
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7
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Whitt-Woosley A, Sprang G, Royse DG. Identifying the trauma recovery needs of maltreated children: An examination of child welfare workers' effectiveness in screening for traumatic stress. CHILD ABUSE & NEGLECT 2018; 81:296-307. [PMID: 29778039 DOI: 10.1016/j.chiabu.2018.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 04/30/2018] [Accepted: 05/08/2018] [Indexed: 06/08/2023]
Abstract
Children in the child welfare system comprise a group characterized by exposure to trauma via experiences of maltreatment, under circumstances presenting multiple risk factors for traumatic stress. High rates of posttraumatic stress have been observed in this population. However, there is currently no standard for the universal screening of children in child welfare for trauma exposure and traumatic stress. This study examined the trauma experiences of a sample of maltreated children and whether their child welfare workers were effective screeners of traumatic stress symptoms. Descriptive and correlational analyses were conducted regarding a sample of children (N = 131) with trauma screenings completed by their child welfare workers and clinical measures of traumatic stress symptoms. Four hierarchical regression models were also examined to determine whether workers' screening information regarding child age, trauma exposure history and symptoms of traumatic stress were predictive of outcomes on clinical measures. The analyses revealed complex trauma exposure histories and high rates of traumatic stress symptoms among this generally younger sample of maltreated children. Additionally, the models supported workers' efficacy in screening for symptoms of total posttraumatic stress and specific trauma symptoms of intrusion and avoidance. Workers were less effective in screening for the symptoms of arousal. These findings support the importance of identifying the trauma recovery needs of maltreated children and the utility of child protection workers in assisting with the trauma screening process. Implications are provided for related practice, policy and training efforts in child welfare.
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Affiliation(s)
| | - Ginny Sprang
- University of Kentucky, College of Medicine- Department of Psychiatry, United States
| | - David G Royse
- University of Kentucky, College of Social Work, United States
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8
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Barboza GE, Dominguez S, Pinder J. Trajectories of post-traumatic stress and externalizing psychopathology among maltreated foster care youth: A parallel process latent growth curve model. CHILD ABUSE & NEGLECT 2017; 72:370-382. [PMID: 28917187 DOI: 10.1016/j.chiabu.2017.09.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 09/05/2017] [Accepted: 09/07/2017] [Indexed: 06/07/2023]
Abstract
Few longitudinal studies have analyzed how violence exposure (e.g. child maltreatment, witnessing community violence) influence both externalizing and Post-Traumatic Stress (PTS) symptoms among children in foster care. Data from three waves of the National Survey of Child and Adolescent Well-Being (1999-2007) (NSCAW; National Data Archive on Child Abuse and Neglect, 2002) were analyzed to investigate the change trajectories of both externalizing and PTS symptomatology among children with a substantiated report of child maltreatment by Child Protective Services (CPS) between October 1999 and December 2000. This study uses data collected at three time points: baseline and approximately 18 (Wave 3) and 36 (Wave 4) months post-baseline. The Child Behavior Checklist (CBCL) scale measured externalizing symptoms and the Post Traumatic Stress Disorder section of a version of the Trauma Symptom Checklist for Children (TSCC) provided the measure of current trauma-related symptoms or distress. Analyses were conducted using a parallel process growth curve model with a sample of n=280 maltreated youth between the ages of 8 and 15 following home removal. Findings revealed that initial levels of externalizing and PTS symptomatology were both significantly and positively related and co-develop over time. Externalizing symptom severity remained in the borderline range during the first two years in out-of-home care. Both direct and indirect forms of interpersonal violence exposure were associated with initial level of externalizing symptom and PTS symptom severity, respectively. Taken together, our results suggest an underlying process that links early violence exposure to the co-development and cumulative impact of PTS on externalizing behavior above and beyond experiences of maltreatment. We conclude by discussing the key points of intervention that result from a more nuanced understanding of the longitudinal relationship between PTS and externalizing symptoms and the effect of complex trauma on growth in these symptoms over time.
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Affiliation(s)
- Gia Elise Barboza
- Northeastern University, College of Social Science and Humanities, 212 Renaissance Park, Boston, MA 02115, United States.
| | - Silvia Dominguez
- Northeastern University, College of Social Science and Humanities, 212 Renaissance Park, Boston, MA 02115, United States.
| | - Jyda Pinder
- Northeastern University, College of Social Science and Humanities, 212 Renaissance Park, Boston, MA 02115, United States.
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9
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Graham RA, Osofsky JD, Osofsky HJ, Hansel TC. School based post disaster mental health services: decreased trauma symptoms in youth with multiple traumas. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/1754730x.2017.1311798] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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10
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School-Related Outcomes of Traumatic Event Exposure and Traumatic Stress Symptoms in Students: A Systematic Review of Research from 1990 to 2015. SCHOOL MENTAL HEALTH 2016. [DOI: 10.1007/s12310-016-9175-2] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Verlinden E, van Laar YL, van Meijel EPM, Opmeer BC, Beer R, de Roos C, Bicanic IAE, Lamers-Winkelman F, Olff M, Boer F, Lindauer RJL. A parental tool to screen for posttraumatic stress in children: first psychometric results. J Trauma Stress 2014; 27:492-5. [PMID: 25069420 DOI: 10.1002/jts.21929] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The Children's Revised Impact of Event Scale (CRIES-13) is a brief self-report measure designed to screen children for posttraumatic stress disorder (PTSD). This study investigates the psychometric properties of a Dutch version of the CRIES-13-parent version and evaluates its correlation with the child version. A sample of 59 trauma-exposed children (8 years-18 years) and their parents completed an assessment including the CRIES-13 (child/parent version) along with the Anxiety Disorders Interview Schedule for DSM-IV: Parent version. Results demonstrated good internal consistency (α = .87) with acceptable values for the 3 subscales. A strong correlation (r = .73) with another measure of PTSD and lower correlations with a behavioral measure (r = .15 to .38) were found, confirming the convergent/divergent validity. A cutoff score ≥ 31 emerged as the best balance between sensitivity and specificity, and correctly classified 83.6% of all children as having a diagnosis of PTSD. This study provides support for the reliability and validity of the CRIES-13-parent version as a screening measure for posttraumatic stress in children.
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Affiliation(s)
- Eva Verlinden
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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12
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Escitalopram or novel herbal mixture treatments during or following exposure to stress reduce anxiety-like behavior through corticosterone and BDNF modifications. PLoS One 2014; 9:e91455. [PMID: 24690945 PMCID: PMC3972209 DOI: 10.1371/journal.pone.0091455] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Accepted: 02/11/2014] [Indexed: 01/15/2023] Open
Abstract
Anxiety disorders are a major public health concern worldwide. Studies indicate that repeated exposure to adverse experiences early in life can lead to anxiety disorders in adulthood. Current treatments for anxiety disorders are characterized by a low success rate and are associated with a wide variety of side effects. The aim of the present study was to evaluate the anxiolytic effects of a novel herbal treatment, in comparison to treatment with the selective serotonin reuptake inhibitor escitalopram. We recently demonstrated the anxiolytic effects of these treatments in BALB mice previously exposed to one week of stress. In the present study, ICR mice were exposed to post natal maternal separation and to 4 weeks of unpredictable chronic mild stress in adolescence, and treated during or following exposure to stress with the novel herbal treatment or with escitalopram. Anxiety-like behavior was evaluated in the elevated plus maze. Blood corticosterone levels were evaluated using radioimmunoassay. Brain derived neurotrophic factor levels in the hippocampus were evaluated using enzyme-linked immunosorbent assay. We found that (1) exposure to stress in childhood and adolescence increased anxiety-like behavior in adulthood; (2) the herbal treatment reduced anxiety-like behavior, both when treated during or following exposure to stress; (3) blood corticosterone levels were reduced following treatment with the herbal treatment or escitalopram, when treated during or following exposure to stress; (4) brain derived neurotrophic factor levels in the hippocampus of mice treated with the herbal treatment or escitalopram were increased, when treated either during or following exposure to stress. This study expands our previous findings and further points to the proposed herbal compound's potential to be highly efficacious in treating anxiety disorders in humans.
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13
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Choi JY, Oh KJ. Cumulative childhood trauma and psychological maladjustment of sexually abused children in Korea: mediating effects of emotion regulation. CHILD ABUSE & NEGLECT 2014; 38:296-303. [PMID: 24210271 DOI: 10.1016/j.chiabu.2013.09.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 09/10/2013] [Accepted: 09/21/2013] [Indexed: 06/02/2023]
Abstract
The purpose of the present study was to identify the mediating effects of emotion regulation on the association between cumulative childhood trauma and behavior problems in sexually abused children in Korea, using structural equation modeling (SEM). Data were collected on 171 children (ages 6-13 years) referred to a public counseling center for sexual abuse in Seoul, Korea. Cumulative childhood traumas were defined on the basis of number of traumas (physical abuse, witnessing domestic violence, neglect, traumatic separation from parent, and sexual abuse) and the severity and duration of traumas. Children were evaluated by their parents on emotion regulation using the Emotion Regulation Checklist and internalizing and externalizing behavior problems using the Korean-Child Behavior Checklist. SEM analyses confirmed the complete mediation model, in which emotion dysregulation fully mediates the relationship between cumulative childhood traumas and internalizing/externalizing behavior problems. These findings indicate that emotion regulation is an important mechanism that can explain the negative effects of cumulative childhood traumas and that there is a need to focus on emotion regulation in sexually abused children exposed to cumulative trauma.
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Affiliation(s)
- Ji Young Choi
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, 1342 Dongilro, Nowon-gu, Seoul, Republic of Korea
| | - Kyung Ja Oh
- Department of Psychology, Yonsei University, Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea
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14
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Perreira KM, Ornelas I. Painful Passages: Traumatic Experiences and Post-Traumatic Stress among Immigrant Latino Adolescents and their Primary Caregivers. INTERNATIONAL MIGRATION REVIEW 2013; 47:10.1111/imre.12050. [PMID: 24385676 PMCID: PMC3875301 DOI: 10.1111/imre.12050] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Using data from a stratified random sample of 281 foreign-born adolescents and their parents, this study provides data on migration-related trauma exposures and examines how the migration process influences the risk of experiencing trauma and developing Post-Traumatic Stress Disorder (PTSD). We find that 29% of foreign-born adolescents and 34% of foreign-born parents experienced trauma during the migration process. Among those that experienced trauma, 9% of adolescents and 21% of their parents were at risk for PTSD. Pre-migration poverty combined with clandestine entry into the US increased the risk of trauma and the subsequent development of PTSD symptoms. Post-migration experiences of discrimination and neighborhood disorder further exacerbated this risk, while social support and familism mitigated it. Our results emphasize the importance of understanding how factors prior to, during, and after migration combine to influence the health of immigrants.
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Affiliation(s)
- Krista M Perreira
- Department of Public Policy, University of North Carolina, Chapel Hill
| | - India Ornelas
- Department of Health Services, University of Washington, Seattle
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15
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Verlinden E, Schippers M, Van Meijel EPM, Beer R, Opmeer BC, Olff M, Boer F, Lindauer RJL. What makes a life event traumatic for a child? The predictive values of DSM-Criteria A1 and A2. Eur J Psychotraumatol 2013; 4:20436. [PMID: 23977424 PMCID: PMC3750195 DOI: 10.3402/ejpt.v4i0.20436] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 06/14/2013] [Accepted: 07/26/2013] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The Diagnostic and Statistical Manual of Mental Disorders (DSM)-Criteria A1 and A2 for posttraumatic stress disorder (PTSD) have been discussed extensively, with several studies in adults or adolescents supporting the removal of Criterion A2. However, solid research in children is missing. OBJECTIVE This study evaluated the DSM-Criteria A1 and A2 in predicting posttraumatic stress in children. METHOD A sample of 588 Dutch school children, aged 8-18 years, completed a self-report questionnaire to determine if they met Criteria A1 and/or A2. Their posttraumatic stress response was assessed using the Children's Revised Impact of Event Scale. RESULTS The contribution of Criterion A2 to the prediction of posttraumatic stress in children is of greater importance than the contribution of Criterion A1. Children who met Criterion A2 reported significantly higher levels of posttraumatic stress and were nine times more likely to develop probable PTSD than children who did not meet Criterion A2. When Criterion A1 was met, a child was only two times more likely to develop probable PTSD as compared with those where Criterion A1 was not met. Furthermore, the low sensitivity of Criterion A1 suggests that children may regularly develop severe posttraumatic stress in the absence of Criterion A1. The remarkably high negative predictive value of Criterion A2 indicates that if a child does not have a subjective reaction during an event that it is unlikely that he or she will develop PTSD. CONCLUSIONS In contrast to most adult studies, the findings of this study emphasize the significant contribution of Criterion A2 to the prediction of posttraumatic stress in children and raise fundamental questions about the value of the current Criterion A1.
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Affiliation(s)
- Eva Verlinden
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Mirjam Schippers
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Els P. M. Van Meijel
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Renée Beer
- De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Brent C. Opmeer
- Clinical Research Unit, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Frits Boer
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Ramón J. L. Lindauer
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
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Zeni CP, Coelho RPS, Ferreira AAM, Machado PDO, Tramontina S, Grassi-Oliveira R. Tradução e adaptação semântica para versão em português do Stressful Life Events Schedule (SLES). PSICO-USF 2013. [DOI: 10.1590/s1413-82712013000200006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O Stressful Life Events Schedule (SLES) é um instrumento que visa investigar a presença e o impacto de eventos de vida estressantes (EVE) ocorridos nos últimos 12 meses. O objetivo deste trabalho é traduzir e adaptar por equivalência semântica os itens da escala para a língua portuguesa. Seis etapas foram realizadas: (1) Tradução; (2) Retrotradução; (3) Revisão técnica e adaptação semântica; (4) Avaliação e validação do conteúdo e do significado geral considerando o contexto da população; (5) Realização de uma medida de confiabilidade em relação ao construto dependência/independência dos EVE; e (6) Produção da versão final do instrumento. O tempo verbal se manteve na maioria dos itens da escala. Algumas alterações foram necessárias como um acréscimo da variação de alguns termos. A versão adaptada demonstrou ser de fácil aplicação, não tendo sido avaliada como extensa e contemplando um número considerável de EVE.
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Jarero I, Roque-López S, Gomez J. The Provision of an EMDR-Based Multicomponent Trauma Treatment With Child Victims of Severe Interpersonal Trauma. JOURNAL OF EMDR PRACTICE AND RESEARCH 2013. [DOI: 10.1891/1933-3196.7.1.17] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study evaluated a multicomponent phase–based trauma treatment approach for 34 children who were victims of severe interpersonal trauma (e.g., rape, sexual abuse, physical and emotional violence, neglect, abandonment). The children attended a week-long residential psychological recovery camp, which provided resource building experiences, the Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP), and one-on-one EMDR intervention for the resolution of traumatic memories. The individual EMDR sessions were provided for 26 children who still had some distress about their targeted memory following the EMDR-IGTP. Results showed significant improvement for all the participants on the Child’s Reaction to Traumatic Events Scale (CRTES) and the Short PTSD Rating Interview (SPRINT), with treatment results maintained at follow-up. More research is needed to assess the EMDR-IGTP and the one-on-one EMDR intervention effects as part of a multimodal approach with children who have suffered severe interpersonal trauma.
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Milan S, Zona K, Acker J, Turcios-Cotto V. Prospective Risk Factors for Adolescent PTSD: Sources of Differential Exposure and Differential Vulnerability. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 41:339-53. [DOI: 10.1007/s10802-012-9677-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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19
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Wechsler-Zimring A, Kearney CA. Posttraumatic stress and related symptoms among neglected and physically and sexually maltreated adolescents. J Trauma Stress 2011; 24:601-4. [PMID: 21887714 DOI: 10.1002/jts.20683] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Posttraumatic stress disorder (PTSD) is common among maltreated youth, but few investigations compare neglect with other maltreatment types. This study examined 84 adolescents who experienced neglect only, physical and/or sexual maltreatment only, or neglect with physical and/or sexual maltreatment. Symptoms of PTSD, dissociation, and depression were measured. Adolescents who experienced physical and/or sexual maltreatment, whether neglected or not, reported significantly greater symptomatology than adolescents who experienced neglect only (η2 = .094). This difference applied to PTSD symptoms, dissociative amnesia, depersonalization and derealization, negative mood, and anhedonia. Adolescents exposed to neglect only displayed substantial psychopathology but less than that of other groups. The findings may reflect emerging cascade models of the etiology of symptoms of PTSD following extensive maltreatment history.
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Briggs-Gowan MJ, Carter AS, Ford JD. Parsing the effects violence exposure in early childhood: modeling developmental pathways. J Pediatr Psychol 2011; 37:11-22. [PMID: 21903730 DOI: 10.1093/jpepsy/jsr063] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To prospectively examine pathways from early childhood violence exposure and trauma-related symptoms to school-age emotional health. METHODS A longitudinal, birth cohort (N = 437) was assessed with parent reports of lifetime violence exposure and trauma-related symptoms at 3 years of age and later, internalizing and externalizing symptoms, and social competence at school age. RESULTS Early family and neighborhood violence correlated significantly with early trauma-related symptoms and also significantly predicted school-age internalizing and externalizing symptoms and poorer competence, independent of sociodemographic risk and past-year violence exposure. Longitudinal pathways were significantly mediated by arousal and avoidance symptoms at 3 years of age, which increased risk for clinically significant emotional problems and lower competence at school age (adjusted odds ratios = 3.1-6.1, p < 0.01). CONCLUSIONS Trauma-related symptoms may mediate developmental pathways from early violence exposure to later emotional health. Interventions that prevent or reduce early trauma-related symptoms may ameliorate the long-term deleterious impact of violence exposure.
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Affiliation(s)
- Margaret J Briggs-Gowan
- Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030, USA.
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21
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Briggs-Gowan MJ, Ford JD, Fraleigh L, McCarthy K, Carter AS. Prevalence of exposure to potentially traumatic events in a healthy birth cohort of very young children in the northeastern United States. J Trauma Stress 2010; 23:725-33. [PMID: 21171133 PMCID: PMC5972451 DOI: 10.1002/jts.20593] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Prevalence estimates of very young children's exposure to potentially traumatic events (PTEs) are limited. The study objective was to estimate the lifetime prevalence and correlates of noninterpersonal PTEs and violence exposure in a representative healthy birth cohort (ages 1-3 years) from an urban-suburban region of the United States (37.8% minority, 20.2% poverty). Parents completed 2 surveys approximately 1-year apart. By 24-48 months of age, the prevalence of exposure was 26.3% (14.5% noninterpersonal, 13.8% violence). Exposure was common among children living in poverty (49.0% overall, 19.7% noninterpersonal, 33.7% violence). The most consistent factors associated with exposure were poverty, parental depressive symptoms, and single parenting. Findings underscore the potential for prevention and intervention in early childhood to advance public health and reduce morbidity.
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Affiliation(s)
| | - Julian D. Ford
- Department of Psychiatry, University of Connecticut Health Center, Farmington
| | - Lisa Fraleigh
- Department of Psychiatry, University of Connecticut Health Center, Farmington
| | - Kimberly McCarthy
- Department of Psychiatry, University of Connecticut Health Center, Farmington
| | - Alice S. Carter
- Department of Psychology, University of Massachusetts-Boston
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Hansel TC, Osofsky HJ, Osofsky JD, Costa RN, Kronenberg ME, Selby ML. Attention to process and clinical outcomes of implementing a rural school-based trauma treatment program. J Trauma Stress 2010; 23:708-15. [PMID: 21171131 DOI: 10.1002/jts.20595] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The Louisiana Rural Trauma Services Center was established to provide, improve, and enhance urgently needed assessment, treatment, crisis management, and consultation services for children and adolescents exposed to traumatic events in three rural southeastern Louisiana parishes. The purpose of this study is to describe the process of implementing the rural school-based trauma treatment program and to evaluate its effectiveness in 115 students. Through attention to process including the three-tiered approach of relationship building, trauma training, and trauma services, the school-based trauma treatment program proved effective in reducing trauma symptoms. This study is important to support the widespread implementation of school-based mental health services.
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Affiliation(s)
- Tonya Cross Hansel
- Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
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Huemer J, Erhart F, Steiner H. Posttraumatic stress disorder in children and adolescents: a review of psychopharmacological treatment. Child Psychiatry Hum Dev 2010; 41:624-40. [PMID: 20567898 DOI: 10.1007/s10578-010-0192-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED PTSD in children and adolescents differs from the adult disease. Therapeutic approaches involve both psychotherapy and psychopharmacotherapy. OBJECTIVES The current paper aims at reviewing studies on psychopharmacological treatment of childhood and adolescent PTSD. Additionally, developmental frameworks for PTSD diagnosis and research along with an experimental model of quenching and kindling in the context of stress exposure are presented. We conducted an extensive literature search of reviews on psychopharmacotherapy as well as studies on psychopharmacological treatment for PTSD among children and adolescents. We used the database PubMed and focused on the time period of the last 10 years up to January 2009. Pertinent earlier papers were also included.There are a limited number of studies specifically assessing the psychopharmacological treatment of PTSD in children and adolescents. The vast majority of them lack verification in RCTs. Only the use of imipramine, divalproex sodium and sertraline were already evaluated in RCTs. Future studies should take into account developmental approaches to the diagnosis and treatment of PTSD in children and adolescents. In this context, different underlying neurobiological patterns, which are reflected in distinct clinical symptomatology, require a precise investigation and a symptom-orientated psychopharmacological approach.
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Affiliation(s)
- J Huemer
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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24
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Briggs-Gowan MJ, Carter AS, Clark R, Augustyn M, McCarthy KJ, Ford JD. Exposure to potentially traumatic events in early childhood: differential links to emergent psychopathology. J Child Psychol Psychiatry 2010; 51:1132-40. [PMID: 20840502 PMCID: PMC3106304 DOI: 10.1111/j.1469-7610.2010.02256.x] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine associations between exposure to potentially traumatic events (PTEs) and clinical patterns of symptoms and disorders in preschool children. METHOD Two hundred and thirteen referred and non-referred children, ages 24 to 48 months (MN = 34.9, SD = 6.7 months) were studied. Lifetime exposure to PTEs (family violence and non-interpersonal events) and recent stressful life events were assessed with the Preschool Age Psychiatric Assessment (PAPA) and Child Life Events Scale. Child psychiatric symptoms and disorders were assessed with parent-reports in the PAPA, a comprehensive, developmentally sensitive interview. Sociodemographic risk, parental anxiety and depressive symptoms (Center for Epidemiologic Studies Depression, Beck Anxiety Inventory), and child developmental level (Mullen Scales of Early Learning) also were assessed. RESULTS Violence exposure was broadly associated with psychiatric status in the areas of depression, separation anxiety, posttraumatic stress, and conduct problems, whereas potentially traumatic non-interpersonal exposure was associated with phobic anxiety. The majority of the associations between violence exposure and preschoolers' symptoms were significant even when other key factors, including economic disadvantage and parental mood and anxiety symptoms, were controlled statistically. However, parental depressive/anxious symptoms may have partially or fully mediated the relationships between violence exposure and depressive and conduct symptoms. CONCLUSIONS Evidence of robust associations between violence exposure and early childhood internalizing and externalizing disorders and symptoms highlights the need for longitudinal prospective research concerning neurodevelopmental mechanisms and pathways. Findings underscore the relevance of assessing trauma exposure, particularly interpersonal violence, to identify young children at risk.
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Affiliation(s)
| | - Alice S. Carter
- Department of Psychology, University of Massachusetts Boston, USA
| | - Roseanne Clark
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, USA
| | | | | | - Julian D. Ford
- Department of Psychiatry, University of Connecticut Health Center, USA
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25
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Mersky JP, Topitzes J. Comparing early adult outcomes of maltreated and non-maltreated children: A prospective longitudinal investigation. CHILDREN AND YOUTH SERVICES REVIEW 2010; 32:1086-1096. [PMID: 27667886 PMCID: PMC5034869 DOI: 10.1016/j.childyouth.2009.10.018] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Using prospective data from the Chicago Longitudinal Study, this investigation examined associations between child maltreatment and an array of outcomes in early adulthood. Findings from bivariate and multivariate analyses indicated that verified maltreatment victims fared significantly worse than participants without an indicated maltreatment report on indicators of educational and economic attainment, criminal offending, and behavioral and mental health. Results also revealed that, while many maltreated children appeared to function well on individual outcomes, a large majority did not achieve criteria for resilience when development was assessed across domains. For example, non-maltreated participants were more than twice as likely to attain five or more positive outcomes (38.2%) on an aggregate seven-item index as the maltreated group (15.7%). These findings suggest that child maltreatment is associated with extensive and enduring impacts, reinforcing the need to develop and implement effective maltreatment prevention and intervention strategies.
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Affiliation(s)
| | - James Topitzes
- University of Wisconsin-Milwaukee, School of Social Work
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26
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Kolko DJ, Hurlburt MS, Zhang J, Barth RP, Leslie LK, Burns BJ. Posttraumatic stress symptoms in children and adolescents referred for child welfare investigation. A national sample of in-home and out-of-home care. CHILD MALTREATMENT 2010; 15:48-63. [PMID: 19564628 DOI: 10.1177/1077559509337892] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This study examines the prevalence and correlates of heightened posttraumatic stress (PTS) symptoms in a nationally representative sample of 1,848 children and adolescents (ages 8-14) who were referred to child welfare for investigation of abuse or neglect based on the National Survey of Child and Adolescent Well-Being. The severity of current PTS symptoms was assessed using the PTS subscale of the Trauma Symptom Checklist for Children, a standardized child-report scale evaluating common symptoms associated with trauma. The overall prevalence of clinically significant PTS symptoms was 11.7% (overall mean T score = 49.5). The prevalence was higher for cases that were placed in out-of-home care (19.2%) than those maintained at home (10.7%). Multivariate hierarchical regression identified four contributors to heightened PTS symptoms: younger child age, abuse by a nonbiological parent, violence in the home, and child depression. The authors discuss the modest but still lower than expected prevalence of self-reported, clinically significant PTS symptoms and the variables associated with greater risk for heightened PTS symptoms found among cases referred to child welfare services.
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Affiliation(s)
- David J Kolko
- University of Pittsburgh School of Medicine and the Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA.
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27
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Posttraumatic Stress Disorder in Maltreated Youth: A Review of Contemporary Research and Thought. Clin Child Fam Psychol Rev 2009; 13:46-76. [DOI: 10.1007/s10567-009-0061-4] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Rodenburg R, Benjamin A, Meijer AM, Jongeneel R. Eye movement desensitization and reprocessing in an adolescent with epilepsy and mild intellectual disability. Epilepsy Behav 2009; 16:175-80. [PMID: 19664963 DOI: 10.1016/j.yebeh.2009.07.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Revised: 07/03/2009] [Accepted: 07/07/2009] [Indexed: 01/24/2023]
Abstract
Intellectual disability is a comorbid condition in epilepsy. People with epilepsy and intellectual disability are at high risk of developing behavioral problems. Among the many contributors to behavioral problems in people with epilepsy and intellectual disability are those of traumatic experiences. As such, behavioral problems can be seen as a reflection of these traumatic experiences. Among established trauma therapies, eye movement desensitization and reprocessing (EMDR) is an emerging treatment that is effective in adults and also seems to be effective in children. This article is a case report of EMDR in an adolescent with epilepsy and mild intellectual disability, in whom the EMDR children's protocol was used. The aim was to assess whether clinical trauma status significantly diminished to nonclinical status posttreatment. Change in trauma symptoms was evaluated with the Reliable Change Index (RCI). Results showed a significant decrease in trauma symptoms toward nonclinical status from pretreatment to posttreatment. EMDR consequences for epilepsy and intellectual disability are discussed.
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Affiliation(s)
- Roos Rodenburg
- Epilepsy Institute in The Netherlands Foundation, Heemstede, The Netherlands.
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Rodenburg R, Benjamin A, de Roos C, Meijer AM, Stams GJ. Efficacy of EMDR in children: a meta-analysis. Clin Psychol Rev 2009; 29:599-606. [PMID: 19616353 DOI: 10.1016/j.cpr.2009.06.008] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 06/17/2009] [Accepted: 06/17/2009] [Indexed: 11/28/2022]
Abstract
The efficacy of eye movement desensitization and reprocessing (EMDR) in children with post-traumatic stress symptoms was meta-analytically examined from the perspective of incremental efficacy. Overall post-treatment effect size for EMDR was medium and significant (d=.56). Results indicate efficacy of EMDR when effect sizes are based on comparisons between the EMDR and the non-established trauma treatment or the no-treatment control groups, and the incremental efficacy when effect sizes are based on comparisons between the EMDR and the established (CBT) trauma treatment. The discussion focuses on the future replication of EMDR findings and further research on post-traumatic stress in children.
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Affiliation(s)
- Roos Rodenburg
- Department of Educational Sciences, University of Amsterdam, The Netherlands.
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Faugli A, Emblem R, Bjørnland K, Diseth TH. Mental health in infants with esophageal atresia. Infant Ment Health J 2009. [PMID: 28636118 DOI: 10.1002/imhj.20202] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Chronic somatic illness in infancy may challenge the development of mental health and impinge the infant's capability to form close interpersonal relationships. Esophageal atresia (EA) is a congenital anomaly requiring neonatal surgery, medical aftertreatment, and extended hospitalization. The aim of the study was to assess mental health and to find prognostic factors for mental health among infants with EA. Thirty-nine infants treated consecutively during 2000 to 2003 and their mothers were included. Infant mental health was assessed by Diagnostic Classification: 0-3 (Zero to Three, 1994). Medical and environmental data were collected from medical records and semistructured interview with the mothers. Child development was assessed with the Bayley scales, second edition (N. Bayley, 1993). Maternal psychological distress, anxiety, and child temperament were assessed by self-report questionnaires: the General Health Questionnaire, 30-item version (D. Goldberg & P. Williams, 1988); the State Trait Anxiety Inventory (C.D. Spielberger, R. Gorsuch, & R. Lushene, 1970); and the Infant Behaviour Questionnaire (M.K. Rothbart, 1981). Thirty-one percent of the infants with EA showed mental health disorders by 1 year of age. Prognostic factors predicting mental health were posttraumatic symptoms reported by mother, more than one operation, mechanical ventilation beyond 1 day, and moderate/severe chronic family strain. Relational trauma, vulnerable attachment, and impaired self-development are highlighted as possible pathways for psychopathology. Children with EA are vulnerable to mental health disorders, and this study may help clinicians to identify children at risk.
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Affiliation(s)
- Anne Faugli
- Institute of Psychiatry, University of Oslo, Norway
| | - Ragnhild Emblem
- Department of Surgery, Rikshospitalet Medical Centre, University of Oslo, Norway
| | | | - Trond H Diseth
- Section of Child and Adolescent Psychiatry, Department of Paediatrics, Rikshospitalet Medical Centre, University of Oslo, Norway
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Henry J, Sloane M, Black-Pond C. Neurobiology and Neurodevelopmental Impact of Childhood Traumatic Stress and Prenatal Alcohol Exposure. Lang Speech Hear Serv Sch 2007; 38:99-108. [PMID: 17428956 DOI: 10.1044/0161-1461(2007/010)] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
Research reveals that prenatal alcohol exposure and child trauma (i.e., abuse, neglect, sexual abuse) can have deleterious effects on child development across multiple domains. This study analyzed the impact on childhood neurodevelopment of prenatal alcohol exposure and postnatal traumatic experience compared to postnatal traumatic experience alone. Although the harmful effects of both have been well documented individually, there is no research documenting the concurrent effects of prenatal alcohol exposure and postnatal trauma on a child’s developmental process.
Method
Transdisciplinary assessment of the children included the core disciplines of medicine, speech-language pathology, occupational therapy, social work, and psychology. Medical examination, standardized developmental and intelligence testing, projective tools, parent questionnaires, and psychosocial interviews provided information in the primary developmental areas.
Results
Findings indicated that children who had been exposed prenatally to alcohol along with postnatal traumatic experience had lower intelligence scores and more severe neurodevelopmental deficits in language, memory, visual processing, motor skills, and attention than did traumatized children without prenatal alcohol exposure, as well as greater oppositional/defiant behavior, inattention, hyperactivity, impulsivity, and social problems.
Clinical Implications
Successful teacher and speech-language pathologist interventions with traumatized children with prenatal alcohol exposure demand a paradigm shift that requires the development of new perspectives and ongoing training.
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Affiliation(s)
- Jim Henry
- Western Michigan University, 1000 Oakland Drive, 3 floor, Kalamazoo, MI 49008, USA.
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Osofsky JD, Osofsky HJ, Harris WW. Katrina's Children: Social Policy Considerations for Children in Disasters. ACTA ACUST UNITED AC 2007. [DOI: 10.1002/j.2379-3988.2007.tb00050.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Osofsky JD, Kronenberg M, Hammer JH, Lederman JC, Katz L, Adams S, Graham M, Hogan A. The development and evaluation of the intervention model for the Florida Infant Mental Health Pilot Program. Infant Ment Health J 2007. [DOI: 10.1002/imhj.20135] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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