Predictors of Clinical Outcomes in Sexually Abused Adolescents

The Relationship Between Negative Self-Concept, Trauma, and Maltreatment in Children and Adolescents: A Meta-Analysis

Experiencing trauma in childhood is a global public health issue linked to worse physical and mental health outcomes, including Post-Traumatic Stress Disorder (PTSD). Self-concept is a transdiagnostic concept linked to various psychopathologies and understanding its unique relationship to trauma is important. This meta-analysis aimed to understand the size of the effect between trauma and maltreatment and self-concept in children and adolescents. The current meta-analysis searched PubMed, PILOTS, PsycINFO, and Web of Science databases. Inclusion criteria involved studies with defined trauma exposure, valid measures of self-concept, and participants' mean age under 18 years old. One-hundred-and-thirty-four studies were included in the meta-analysis (N = 255,334). A random-effects meta-analysis was performed. A small negative relationship was observed between trauma exposure and self-concept (r = - 0.20, 95% CI - 0.22, - 0.18). This relationship was significantly moderated by some variables (type and nature of trauma exposure) but not others (participant gender, type of self-concept measure, quality of studies, country economic status). A small relationship between trauma exposure and negative self-concept in children and adolescents was detected, with repeated trauma exposure and type of trauma exposure moderating this relationship. This provides important directions for clinical practice around providing support for those exposed or most vulnerable to experiencing trauma.

Perceived stress among Hispanic young adults: Impact of the coping with work and family stress program

Objective: To examine the effect of an evidence-based curriculum on stress perceptions across time. Participants: Hispanic college students from a Hispanic-serving institution in a U.S. southern border city. Methods: A permuted block design with repeated measures was used. Participants were randomly assigned to treatment and control groups. The treatment group received the Coping with Work and Family Stress (CWFS) evidence-based curriculum while the control group did not receive any programming. Data were collected from both the groups at baseline, exit, and at 3-month follow-up. Results: Stress reduction was observed among program participants however an unintended negative consequence of the intervention was found among those who experience intimate partner violence. Conclusion: The CWFS evidence-based intervention may be appropriate to use in reducing general types of stress but perhaps not stress resulting from intimate partner violence.

Prevalence and predictors of ICD-11 posttraumatic stress disorder and complex PTSD in young people

OBJECTIVE

The prevalence, construct validity, risk factors and psychopathological correlates associated with ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as measured by the International Trauma Questionnaire for Children and Adolescents (ITQ-CA) were assessed in a sample of young people from Northern Ireland.

METHOD

Participants were trauma-exposed 11-19-year-olds (N = 507) who participated in the Northern Ireland Youth Wellbeing Prevalence Survey (YWS-NI, 2020). Factor mixture modelling (FMM) was used to test the latent structure of the ITQ-CA. Risk-factors and psychopathological correlates associated with latent class membership, and ICD-11diagnostic status, were also investigated.

RESULTS

More participants met the ITQ-CA criteria for CPTSD (3.4%, n = 44) than PTSD (1.5%, n = 19). A second-order FMM comprising a 'partial-PTSD class', a 'CPTSD class', a 'DSO class' and a 'low symptom endorsement class' was the best-fitting model. Younger age and cumulative trauma were risk factors for all trauma classes. Female gender and two or more violent traumas were significant predictors of the 'PTSD' and 'CPTSD' classes, while single sexual trauma was a significant predictor of the 'DSO' and 'CPTSD' classes. Two or more sexual traumas was a unique predictor of 'CPTSD class', while two or more vicarious traumas was a unique predictor of 'DSO class'. The 'CPTSD' class displayed the most notable comorbidity.

CONCLUSIONS

Findings indicate that CPTSD may be more prevalent than PTSD in children and young people. Support for the ICD-11 conceptualisation of CPTSD as representing a unique diagnostic construct was supported using FMM, with findings indicating trauma symptom class-specific risk profiles.

Past is present: Pathways between childhood sexual abuse and relationship satisfaction

Research on childhood sexual abuse (CSA) has consistently demonstrated the damaging effects of these experiences, not only on survivors' development, but also on the nature and quality of their adult relationships, particularly romantic ones. Yet, research to date has not demonstrated a strong direct effect of CSA on relationship satisfaction. This study examined the pathways from CSA to relationship satisfaction via sexual shame and romantic partner attachment. Data collected through surveys from 732 adults were analyzed using a serial mediation model. As expected, the direct association between CSA and relationship satisfaction was statistically significant but rather weak. Results demonstrated that sexual shame, combined with either romantic partner attachment avoidance or romantic partner attachment anxiety, reduces relationship satisfaction. Specifically, three possible pathways mediated by sexual shame were identified. Implications of the findings are discussed and recommendations for clinical interventions with CSA survivors that address sexual shame and romantic partner attachment are provided.

Get secure soon: attachment in abused adolescents and young adults before and after trauma-focused cognitive processing therapy

Severe posttraumatic stress symptoms (PTSS) are connected to a variety of health-related and interpersonal problems, among them are the insecure attachment orientations. However, psychotherapy seems to improve not only PTSS but also attachment insecurities. In a large multicenter, randomized clinical trial, the attachment characteristics and PTSS of 85 adolescents and young adults (aged 14-21 years) with clinically relevant abuse-related PTSS were assessed at study entry, at the end of treatment, and 3 months after the end of treatment. Participants were randomized either to a developmentally adapted cognitive processing therapy (D-CPT) or to a wait-list with treatment advice (WL/TA). The purpose of the study was to analyze the association between PTSS and attachment at study entry as well as changes in attachment during the trial. We found that attachment-related avoidance (AR avoidance) was positively associated with PTSS from both self-reports and clinician ratings, whereas attachment-related anxiety (AR anxiety) was only related to self-reported PTSS (Pearson correlation coefficients between 0.37 and 0.46). Changes in AR anxiety occurred in both conditions at some point during the study (baseline to 3-month follow-up effect size was d = 0.60 for D-CPT and d = 0.44 for WL/TA) whereas for AR avoidance, only participants in D-CPT improved significantly (baseline to 3-month follow-up effect size was d = 0.75). The results indicate that PTSS and attachment are connected. Positive changes in attachment insecurities brought about by trauma-focused psychotherapy seem possible.Trial registration: German Clinical Trials Register (DRKS); Germanctr.de; identifier: DRKS00004787; date of registration: 18 March 2013.

The Role of Psychosocial Stress on a Family-Based Treatment for Adolescents with Problematic Behaviors

The stressful life events experienced by adolescents with problematic behaviors, should be considered for implementing effective interventions. This study aimed to examine the adjustment of adolescents with problematic behaviors, and to assess the effectiveness of a family-based treatment, namely Scene-Based Psychodramatic Family Therapy (SB-PFT), according to different stress profiles. Ten SB-PFT sessions, over 17 trials were implemented. Stressful life events and adolescent adjustment were evaluated at pretest and posttest, for the SB-PFT participants (n = 104 adolescents) and a control group (n = 106). The adolescents were categorized into three profiles depending on the nature of the stressors: family stress profile, individual and family stress profile, and low stress profile. The individual and family stress group showed worse adjustment. Effectiveness analyses revealed improvements in SB-PFT participants' emotional intelligence, but not in anger and hostility. Furthermore, adolescents with low and family-related stress profiles showed enhancements in parent attachment. In conclusion, interventions involving adolescents with problematic behaviors must be tailored to the stressful life events experienced. Specific treatments should be used alongside SB-PFT, when adolescents are met with individual-related stress. Nevertheless, SB-PFT seemed to promote emotional intelligence and parent attachment, particularly in adolescents with problematic behaviors that experienced only family stressors.