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Tian T, Fang J, Liu D, Qin Y, Zhu H, Li J, Li Y, Zhu W. Long-term effects of childhood single-parent family structure on brain connectivity and psychological well-being. Brain Imaging Behav 2024:10.1007/s11682-024-00887-6. [PMID: 38809332 DOI: 10.1007/s11682-024-00887-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 05/30/2024]
Abstract
The high and increasing proportion of single-parent families is considered a risk factor associated with various childhood trauma experiences. Consequently, concerns have been raised regarding the potential long-term effects of the childhood single-parent family structure. In this study, we employed advanced magnetic resonance imaging technology, including morphometric similarity mapping, functional connectivity density, and network-based analysis, to investigate brain connectivity and behavioral differences among young adults who were raised in single-parent families. Our study also aimed to explore the relationship between these differences and childhood trauma experiences. The results showed that individuals who grew up in single-parent families exhibited higher levels of anxiety, depression, and harm-avoidant personality. The multimodal MRI analysis further showed differences in regional and network-based connectivity properties in the single-parent family group, including increased functional connectivity density in the left inferior parietal lobule, enhanced cortical structural connectivity between the left isthmus cingulate cortex and peri-calcarine cortex, and an increase in temporal functional connectivity. Moreover, elevated levels of anxiety and depression, along with heightened functional connectivity density in the left inferior parietal lobule and increased temporal functional connectivity, were found to be correlated with a greater number of childhood trauma experiences. Through analyzing multiple data patterns, our study provides objective neuropsychobiological evidence for the enduring impact of childhood single-parent family structure on psychiatric vulnerability in adulthood.
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Affiliation(s)
- Tian Tian
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China
| | - Jicheng Fang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China
| | - Dong Liu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China
| | - Yuanyuan Qin
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China
| | - Hongquan Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China
| | - Jia Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China
| | - Yuanhao Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China.
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China.
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Frewen P, Vincent A, Olff M. Childhood trauma histories in men and women assessed by the childhood attachment and relational trauma screen (CARTS) and the global psychotrauma screen (GPS): Results from the global collaboration on traumatic stress (GC-TS). CHILD ABUSE & NEGLECT 2024; 149:106610. [PMID: 38184904 DOI: 10.1016/j.chiabu.2023.106610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 12/01/2023] [Accepted: 12/17/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Whether there are biological sex differences in rates of childhood trauma exposure perpetrated by female versus male biological parents remains largely unknown. Moreover, the relative risk posed by various vulnerability factors for transdiagnostic mental health outcomes among females vs. males in adulthood has received insufficient attention. OBJECTIVE To compare biological sex differences in the long-term impact of childhood abuse and neglect on transdiagnostic mental health outcomes, especially comparing the outcomes of childhood maltreatment perpetrated by biological mothers vs. fathers. PARTICIPANTS AND SETTING 3129 participants (2784 female [89 %]) were recruited online, the majority (82 %) of whom endorsed having a childhood trauma history and a high number of mental health problems. METHODS Online surveys were administered. Specifically, the Childhood Attachment and Relational Trauma Screen (CARTS) was completed as a relationally-contextualized screening measure of both positive and traumatic-neglectful experiences during childhood, comparing severity of perpetration by male vs. female biological parents. Further, the Global Psychotrauma Screen (GPS) was completed to assess the relative risk of five vulnerability factors, including childhood abuse and neglect, for long-term transdiagnostic mental health outcomes. Statistical analyses elucidate group differences between males and females primarily by way of t-tests and associated effect sizes (Cohen's d). RESULTS Biological sex differences were shown for childhood maltreatment perpetration by male vs. female biological parents, wherein responses to CARTS showed that females reported that their biological mothers exhibited less positivity (d = 0.21), less attachment security (d = 0.22), more negative feelings toward them (d = 0.28), were more emotionally abusive (d = 0.17), and held more negative relational beliefs about them (d = 0.24). Comparably, males reported that their biological fathers were more physically abusive (d = 0.15) and that they held more negative relational beliefs toward their fathers (d = 0.25). Risk factors including having a history of childhood trauma and neglect were associated with transdiagnostic mental health problems among both females (d = 0.57) and males (d = 0.46), with other risk factors evidencing similar results. CONCLUSIONS Childhood trauma and neglect is a risk factor for transdiagnostic mental health outcomes among both females and males, although the two biological sexes may exhibit different levels of risk of being maltreated by female and male biological parents. Specifically, females reported having more emotionally abusive biological mothers, while males reported having more physically abusive biological fathers.
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Affiliation(s)
- Paul Frewen
- Department of Psychiatry, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada; Department of Psychology, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada.
| | - Andrew Vincent
- Department of Psychology, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada
| | - Miranda Olff
- Amsterdam University Medical Centers, University of Amsterdam, ARQ National Psychotrauma Center, The Netherlands, 1012 WX Amsterdam, Netherlands
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Craig F, Servidio R, Calomino ML, Candreva F, Nardi L, Palermo A, Polito A, Spina MF, Tenuta F, Costabile A. Adverse Childhood Experiences and Mental Health among Students Seeking Psychological Counseling Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105906. [PMID: 37239632 DOI: 10.3390/ijerph20105906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023]
Abstract
Recent years have seen a marked rise in the number of students accessing University Psychological Counseling (UPC) services, and their concerns have been increasingly severe. This study aimed to examine the impact of cumulative adverse childhood experiences (ACEs) on mental health in students who had approached counseling services (N = 121) and students who had no experience with counseling services (N = 255). Participants completed an anonymous online self-report questionnaire measuring exposure to adverse childhood experiences (ACE-Q), psychological distress (General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9), personality traits (PID-5), and coping strategies. We found that students who approached UPC services scored higher on cumulative ACEs than the non-counseling group. While ACE-Q score was a direct positive predictor of PHQ-9 (p < 0.001), it did not predict GAD-7. Moreover, the results supported the existence of a mediation effect of avoidance coping, detachment, and psychoticism on the indirect effects of ACE-Q score on PHQ-9 or GAD-7. These results underlined the importance of screening for ACEs in a UPC setting because it can help identify students at higher risk for developing mental and physical health problems and provide them with early interventions and support.
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Affiliation(s)
- Francesco Craig
- Department of Cultures, Education and Society (DICES), University of Calabria, 87036 Cosenza, Italy
| | - Rocco Servidio
- Department of Cultures, Education and Society (DICES), University of Calabria, 87036 Cosenza, Italy
| | | | - Francesca Candreva
- Psychological Counseling Services, University of Calabria, 87036 Cosenza, Italy
| | - Lucia Nardi
- Psychological Counseling Services, University of Calabria, 87036 Cosenza, Italy
| | - Adriana Palermo
- Psychological Counseling Services, University of Calabria, 87036 Cosenza, Italy
| | - Alberto Polito
- Psychological Counseling Services, University of Calabria, 87036 Cosenza, Italy
| | | | - Flaviana Tenuta
- Department of Cultures, Education and Society (DICES), University of Calabria, 87036 Cosenza, Italy
| | - Angela Costabile
- Department of Cultures, Education and Society (DICES), University of Calabria, 87036 Cosenza, Italy
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Katz C, Tener D. "It burns her more than it burns for me": The sibling subsystem in the context of child physical abuse as portrayed by children during forensic interviews. CHILD ABUSE & NEGLECT 2021; 120:105251. [PMID: 34392024 DOI: 10.1016/j.chiabu.2021.105251] [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: 11/30/2020] [Revised: 06/20/2021] [Accepted: 07/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The sibling subsystem is a central and potentially protective factor for children. Nevertheless, in the context of child abuse, it remains surprisingly understudied. OBJECTIVE The current study was designed to examine how children referred to a forensic interview following suspected physical abuse experienced and perceived the sibling subsystem. PARTICIPANTS AND SETTING The sample included 60 forensic interviews with children, aged 4 to 14. Each child had at least one sibling and referred to this sibling in the context of the abuse they experienced. METHODS Thematic analysis was carried out on the narratives provided by the children. Several steps were taken to ensure the trustworthiness of the study, with four criteria: credibility, transferability, dependability, and confirmability. RESULTS The main theme identified was physical abuse as a familial routine. This abusive routine was sometimes perceived as normal and sometimes traumatic, with descriptions of fear and physical pain. The children addressed the various figures in this abusive routine. When these horrific daily experiences were elaborated on, the children often captured the sibling subsystem as a source of security, comfort and protection. Moreover, the children's language often communicated the siblings' bond, referring to "we" and "us." Within a few narratives, a split between the siblings was identified, which appeared to be a strategy of self-protection by going against their siblings. CONCLUSION The current findings join the recent accumulating evidence with respect to the centrality of the sibling subsystem in the experiences and consequences of child abuse. It is imperative to advance practitioners' knowledge and interventions to better adapt to the central role of the sibling subsystem in the context of child abuse.
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Affiliation(s)
- Carmit Katz
- Bob Shapell School of Social Work, Tel-Aviv University, Israel.
| | - Dafna Tener
- Bob Shapell School of Social Work, Tel-Aviv University, Israel
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5
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Leuchter L, Frewen P, Lueger-Schuster B. Validation and cross-cultural comparisons of the German Childhood Attachment and Relational Trauma Screen (CARTS). Eur J Psychotraumatol 2021; 12:1918901. [PMID: 34104351 PMCID: PMC8168775 DOI: 10.1080/20008198.2021.1918901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Background: Child maltreatment is embedded in a complex system of familial, societal and cultural influences. However, the microsystemic framework in which child maltreatment occurs has not been sufficiently accounted for in previous measures of trauma history. In order to include this relational context, a novel survey method, the Childhood Attachment and Relational Trauma Screen (CARTS), was developed, focusing specifically on the familial environment and childhood attachment relationships. Prior validation studies of the English and Italian versions of the CARTS have tended to support its use. Objective: The current study aims at evaluating the psychometric properties of the German version of the CARTS as well as conducting cross-cultural comparison analyses. It is part of an international research project of the Global Collaboration on Traumatic Stress which was initiated by the International Society for Traumatic Stress Studies (ISTSS). Method: The sample consisted of n = 140 participants from the German general population aged 18 or older. Further trauma specific measures (GPS, BSI-18, CTQ-SF, ECR-R, PBI) were included for validation. Cross-cultural comparisons were conducted with a German subsample of students in reference to Italian- and English-speaking student samples. Results: Most CARTS subscales showed acceptable internal consistency. Statistically significant relationships were observed with other measures of childhood trauma exposure and parental bonding, as well as PTSD- and other distress-related outcomes. Comparing the German-speaking sample with Italian- and English-speaking samples indicated significant differences with regard to childhood attachment and child maltreatment. Conclusion: The present findings are consistent with previous results concerning the CARTS and advance the validation of this novel survey method within German-speaking samples. Further, the CARTS appears to be sensitive to cross-sample differences in childhood attachment and child maltreatment. Further psychometric evaluations of the CARTS in other languages and within further German-speaking samples are needed.
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Affiliation(s)
- Louisa Leuchter
- Department of Psychology, University of Vienna, Vienna, Austria
| | - Paul Frewen
- Departments of Psychiatry and Psychology, Western University, London, Canada
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6
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Emery RL, Yoon C, Mason SM, Neumark-Sztainer D. Childhood maltreatment and disordered eating attitudes and behaviors in adult men and women:Findings from project EAT. Appetite 2021; 163:105224. [PMID: 33766616 DOI: 10.1016/j.appet.2021.105224] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 12/26/2022]
Abstract
This study examined gender differences in the association between childhood maltreatment and disordered eating attitudes and behaviors in adulthood. Data were derived from 1647 adults (ages 27-33) participating in a population-based, longitudinal study (Project EAT-IV: Eating Among Teens and Young Adults, 1998-2016). Childhood maltreatment (sexual abuse, physical abuse, emotional abuse, emotional neglect) and disordered eating attitudes and behaviors (overeating, binge eating, extreme weight control behaviors, unhealthy weight control behaviors, chronic dieting, weight and shape concerns) were assessed. Relative risk regression models were used to examine whether childhood maltreatment was related to individual disordered eating attitudes and behaviors. Gender differences in these associations were explored. A history of any childhood maltreatment was associated with more than 60% greater risk for chronic dieting and overeating, with additional associations found for binge eating, weight and shape concerns, and unhealthy weight control behaviors. All types of abuse and neglect were associated with at least one type of disordered eating outcome. Examination of the point estimates indicated that emotional neglect was most consistently related to higher risk for disordered eating attitudes and behaviors. Although there were no statistically significant gender differences in the association between childhood maltreatment and disordered eating attitudes and behaviors, the patterning of these effects highlighted unique qualitative similarities and differences in these relationships between men and women. Taken together, these findings implicate childhood maltreatment, particularly emotional neglect, as a meaningful risk factor for problematic eating outcomes in both men and women during adulthood.
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Affiliation(s)
- Rebecca L Emery
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55454, USA.
| | - Cynthia Yoon
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55454, USA
| | - Susan M Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55454, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55454, USA
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7
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Olff M, Bakker A, Frewen P, Aakvaag H, Ajdukovic D, Brewer D, Elmore Borbon DL, Cloitre M, Hyland P, Kassam-Adams N, Knefel M, Lanza JA, Lueger-Schuster B, Nickerson A, Oe M, Pfaltz MC, Salgado C, Seedat S, Wagner A, Schnyder U. Screening for consequences of trauma - an update on the global collaboration on traumatic stress. Eur J Psychotraumatol 2020; 11:1752504. [PMID: 32489523 PMCID: PMC7241533 DOI: 10.1080/20008198.2020.1752504] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
This letter provides an update on the activities of "The Global Collaboration on Traumatic Stress" (GC-TS) as first described by Schnyder et al. in 2017. It presents in further detail the projects of the first theme, in particular the development of and initial data on the Global Psychotrauma Screen (GPS), a brief instrument designed to screen for the wide range of potential outcomes of trauma. English language data and ongoing studies in several languages provide a first indication that the GPS is a feasible, reliable and valid tool, a tool that may be very useful in the current pandemic of the coronavirus disease 2019 (COVID-19). Further multi-language and cross-cultural validation is needed. Since the start of the GC-TS, new themes have been introduced to focus on in the coming years: a) Forcibly displaced persons, b) Global prevalence of stress and trauma related disorders, c) Socio-emotional development across cultures, and d) Collaborating to make traumatic stress research data "FAIR". The most recent theme added is that of Global crises, currently focusing on COVID-19-related projects.
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Affiliation(s)
- Miranda Olff
- Department of Psychiatry, Amsterdam Neuroscience & Public Health, Amsterdam UMC, Amsterdam, The Netherlands.,ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Anne Bakker
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Paul Frewen
- Department of Psychiatry, Western University, London, Canada
| | - Helene Aakvaag
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Douglas Brewer
- Ramsay Health Care, The Hollywood Clinic, Perth, Australia
| | - Diane L Elmore Borbon
- Policy Program, UCLA-Duke University National Center for Child Traumatic Stress, Washington, DC, USA
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, Stanford University, Menlo Park, CA, USA
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Nancy Kassam-Adams
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Center for Pediatric Traumatic Stress, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Juliana A Lanza
- Traumatic Stress Unit, Psychiatric Emergency Hospital, Buenos City, Argentina.,Human Factors, Emergency Medical Care System (SAME), Buenos Aires City, Argentina
| | | | | | - Misari Oe
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Monique C Pfaltz
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Carolina Salgado
- Department of Psychiatry, Medical School of Universidad Catolica Del Maule, Chile
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anne Wagner
- Department of Psychology, Ryerson University, Toronto, Canada and Remedy, Toronto, Canada
| | - Ulrich Schnyder
- Department of Psychiatry, Amsterdam Neuroscience & Public Health, Amsterdam UMC, Amsterdam, The Netherlands.,ARQ National Psychotrauma Centre, Diemen, The Netherlands.,Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Psychiatry, Western University, London, Canada.,Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia.,Ramsay Health Care, The Hollywood Clinic, Perth, Australia.,Policy Program, UCLA-Duke University National Center for Child Traumatic Stress, Washington, DC, USA.,National Center for PTSD Dissemination and Training Division, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, Stanford University, Menlo Park, CA, USA.,Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland.,Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Center for Pediatric Traumatic Stress, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,University of Vienna, Vienna, Austria.,Traumatic Stress Unit, Psychiatric Emergency Hospital, Buenos City, Argentina.,Human Factors, Emergency Medical Care System (SAME), Buenos Aires City, Argentina.,Faculty of Psychology, Clinical Psychology, University of Vienna, Vienna, Austria.,UNSW School of Psychology, UNSW Sydney, Australia.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.,Department of Psychiatry, Medical School of Universidad Catolica Del Maule, Chile.,Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Psychology, Ryerson University, Toronto, Canada and Remedy, Toronto, Canada.,Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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8
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Ford JD. Trauma Memory Processing in Posttraumatic Stress Disorder Psychotherapy: A Unifying Framework. J Trauma Stress 2018; 31:933-942. [PMID: 30444287 DOI: 10.1002/jts.22344] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 09/05/2018] [Accepted: 09/08/2018] [Indexed: 12/19/2022]
Abstract
Trauma memory processing (TMP) is an empirically supported approach to psychotherapy for posttraumatic stress disorder (PTSD). However, TMP is not a single, uniform intervention but instead a paradigm that can be operationalized through a variety of component procedures that have not been systematically elucidated and formally tested. Based on findings from phenomenological/structural and neuroimaging research, a central feature of PTSD is theorized to be the involuntary immersion in trauma memories with diminished awareness or negative appraisals of self and current context. Such intrusive reexperiencing-which is epitomized by, but not limited to, flashbacks-is postulated to underlie PTSD's avoidance, altered emotions and cognitions, dissociative, and hyperarousal/hypervigilance symptoms; it is thus a logical target for TMP. The varied approaches to TMP for PTSD are conceptualized as having the common goal of activation of the neural networks in the brain that underlie two key capacities disrupted by intrusive reexperiencing in PTSD: intentional self-referential retrieval of memories and suppression of memory retrieval. Therefore, TMP is postulated to involve two core functions (purposeful reflective remembering and memory awareness in situ) and three essential types (in vivo, imaginal, and cognitive reappraisal). Several implications of this framework for clinical practice and research on TMP for PTSD are discussed.
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Affiliation(s)
- Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
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9
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Spinazzola J, van der Kolk B, Ford JD. When Nowhere Is Safe: Interpersonal Trauma and Attachment Adversity as Antecedents of Posttraumatic Stress Disorder and Developmental Trauma Disorder. J Trauma Stress 2018; 31:631-642. [PMID: 30338544 PMCID: PMC6221128 DOI: 10.1002/jts.22320] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 05/17/2018] [Accepted: 05/18/2018] [Indexed: 02/06/2023]
Abstract
Developmental trauma disorder (DTD) has been proposed as clinical framework for the sequelae of complex trauma exposure in children. In this study, we investigated whether DTD is associated with different traumatic antecedents than posttraumatic stress disorder (PTSD). In a multisite sample of 236 children referred from pediatric or mental health treatment, DTD was assessed using the DTD Structured Interview. Trauma history was assessed using the Traumatic Events Screening Instrument (TESI). On an unadjusted basis, both DTD, odds ratios (ORs) = 2.0-3.8, 95% CI [1.17, 7.19]; and PTSD, ORs = 1.8-3.0, 95% CI [1.04, 6.27], were associated with past physical assault and/or abuse, family violence, emotional abuse, neglect, and impaired caregivers; and DTD was associated community violence, OR = 2.7, 95% CI [1.35, 5.43]. On a multivariate basis after controlling for the effects of PTSD, DTD was associated with family and community violence and impaired caregivers, ORs = 2.0-2.5, 95% CI [1.09, 5.97], whereas PTSD was only associated with physical assault and/or abuse after controlling for the effects of DTD, OR = 2.4, 95% CI [1.07, 4.99]. Exposure to both interpersonal trauma and attachment adversity was associated with the highest DTD symptom count, controlling for the PTSD symptom count. Although childhood PTSD and DTD share several traumatic antecedents, DTD may be uniquely associated with pervasive exposure to violent environments and impaired caregiving. Therefore, DTD warrants further investigation as a framework for the assessment and treatment of children with histories of interpersonal victimization and attachment adversity.
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Affiliation(s)
| | - Bessel van der Kolk
- The Trauma CenterBrooklineMassachusetts,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
| | - Julian D. Ford
- Department of PsychiatryUniversity of Connecticut School of MedicineFarmingtonConnecticutUSA
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10
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Abstract
The present editorial introduces selected research for a special issue covering the 15th Annual Meeting of the European Society for Traumatic Stress Studies (ESTSS) 2017, 'Child Maltreatment across the Lifespan'. Unfortunately, childhood maltreatment is highly prevalent around the world. Exposure to child maltreatment is associated with a considerable risk of developing a wide range of psychopathologies. Thus, preventing child maltreatment and offering early treatment to victims is an important and promising area in reducing the risk of psychopathology. The 10 articles included in the special issue focus on different important areas related to the topic of child maltreatment. These include a biological and systemic understanding of maltreatment, a globalization perspective, and contributions on diagnosis and treatment, with implications for clinical practice. Furthermore, the special issue includes an update on ICD-11 and implications associated with the implementation of ICD-11. Future research recommendations are provided to underline the enduring need to promote and undertake research into all aspects of child maltreatment.
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Affiliation(s)
- Maj Hansen
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
- Arq Psychotrauma Expert Group, Diemen, The Netherlands
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11
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Schnyder U, Schäfer I, Aakvaag HF, Ajdukovic D, Bakker A, Bisson JI, Brewer D, Cloitre M, Dyb GA, Frewen P, Lanza J, Le Brocque R, Lueger-Schuster B, Mwiti GK, Oe M, Rosner R, Schellong J, Shigemura J, Wu K, Olff M. The global collaboration on traumatic stress. Eur J Psychotraumatol 2017; 8:1403257. [PMID: 29435201 PMCID: PMC5800488 DOI: 10.1080/20008198.2017.1403257] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 11/02/2017] [Indexed: 11/18/2022] Open
Abstract
Trauma is a global issue. The great majority of the global burden of disease arising from mental health conditions occurs in low- and middle-income countries (LMICs), among populations in political, economic, and/or cultural transition and those struck by forced migration. These mental health problems frequently arise as a result of traumatic events that adversely affect adults, children, and families, including war, mass violence, natural disasters, and accidents. In response to this, the International Society for Traumatic Stress Studies (ISTSS) launched the Global Initiative to have a stronger global impact on trauma-related issues. As part of this initiative, the Global Collaboration was established by representatives of eight professional organizations active in the field of traumatic stress. The group decided to focus on childhood abuse and neglect as its first collaboration. They collected guidelines worldwide, providing the basis for a synthesized core guide for prevention and treatment that can be customized for specific cultural contexts. The resulting 'Internet information on Childhood Abuse and Neglect' (iCAN) is a comprehensive guide for adults who have been affected by childhood abuse and neglect, as well as for the survivors' significant others. It is currently provided in eight languages, and is freely available at the homepage of ISTSS and other websites. A second achievement of the Global Collaboration is the validation of the Computerized Childhood Attachment and Relational Trauma Screen (CARTS), a self-report measure designed to measure occurrences of childhood maltreatment, and its translation into multiple languages, including Croatian, Dutch, French, Georgian, German, Italian, Japanese, Norwegian, Russian, and Spanish. A study is currently planned to collect normative responses to the questionnaire, and to conduct cross-cultural comparisons. The Global Collaboration's success may be seen as an encouraging step towards a truly global structure in the field of traumatic stress.
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Affiliation(s)
- Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Helene F. Aakvaag
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Anne Bakker
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Douglas Brewer
- Ramsay Health Care, The Hollywood Clinic, Perth, Australia
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Department of Psychiatry and Behavioral Sciences, Stanford University, Menlo Park, CA, USA
| | - Grete A. Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul Frewen
- Department of Psychiatry, Western University, London, Canada
| | - Juliana Lanza
- Argentine Society for Psychotrauma, Buenos Aires, Argentina
| | - Robyne Le Brocque
- School of Nursing, Midwifery, and Social Work, University of Queensland, Brisbane, Australia
| | | | - Gladys K. Mwiti
- Oasis Africa Centre for Transformational Psychology & Trauma, Nairobi, Kenya
| | - Misari Oe
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - Jun Shigemura
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Japan
| | - Kitty Wu
- Asian Society for Traumatic Stress Studies, Hong Kong, China
- Clinical Psychological Services, Kwai Chung Hospital, Hospital Authority, Hong Kong, China
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
- Arq Psychotrauma Expert Group, Diemen, The Netherlands
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12
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Punamäki RL, Qouta SR, Peltonen K. Family systems approach to attachment relations, war trauma, and mental health among Palestinian children and parents. Eur J Psychotraumatol 2017; 8:1439649. [PMID: 29844884 PMCID: PMC5965042 DOI: 10.1080/20008198.2018.1439649] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/31/2018] [Indexed: 11/25/2022] Open
Abstract
Background: Trauma affects the family unit as a whole; however, most existing research uses individual or, at most, dyadic approaches to analyse families with histories of trauma. Objective: This study aims to identify potentially distinct family types according to attachment, parenting, and sibling relations, to analyse how these family types differ with respect to war trauma, and to explore how children's mental health and cognitive processing differ across these family types. Method: Participants included Palestinian mothers and fathers (N = 325) and their children (one per family; 49.4% girls; 10-13 years old; mean ± SD age = 11.35 ± 0.57 years) after the Gaza War of 2008-2009. Both parents reported their exposure to war trauma, secure attachment availability, and parenting practices, as well as the target child's internalizing and externalizing symptoms [Strengths and Difficulties Questionnaire (SDQ)]. Children reported their symptoms of post-traumatic stress disorder (on the Children's Revised Impact Event Scale), depression (Birleson), and SDQ, as well as their post-traumatic cognitions (Children's Post Traumatic Cognitions Inventory). Results: A cluster analysis identified four family types. The largest type reflected secure attachment and optimal relationships (security and positive family relationships, 36.2%, n = 102), and the smallest exhibited insecurity and problematic relationships (insecurity and negative family relationships, 15.6%; n = 44). Further, families with discrepant experiences (23.0%; n = 65) and moderate security and neutral relationships (25.2%; n = 71) emerged. The insecurity and negative relationships family type showed higher levels of war trauma; internalizing, externalizing, and depressive symptoms among children; and dysfunctional post-traumatic cognitions than other family types. Conclusion: The family systems approach to mental health is warranted in war conditions, and therapeutic interventions for children should, thus, also involve parents and siblings. Knowledge of unique family attachment patterns is fruitful for tailoring therapeutic treatments and preventive interventions for war-affected children and families.
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Affiliation(s)
| | - Samir R Qouta
- Department of Education and Psychology, Islamic University Gaza, Gaza City, Palestine
| | - Kirsi Peltonen
- Faculty of Social Sciences Psychology, University of Tampere, Tampere, Finland
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13
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Simonelli A, Sacchi C, Cantoni L, Brown M, Frewen P. Italian translation and cross-cultural comparison with the Childhood Attachment and Relational Trauma Screen (CARTS). Eur J Psychotraumatol 2017; 8:1375839. [PMID: 29163857 PMCID: PMC5687796 DOI: 10.1080/20008198.2017.1375839] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/18/2017] [Indexed: 01/17/2023] Open
Abstract
Background: The Childhood Attachment and Relational Trauma Screen (CARTS) is a computer-administered survey designed to assess retrospectively the socio-ecological context in which instances of child abuse may have occurred. To date, studies supporting the validity of the CARTS have only been undertaken in English-speaking North American populations. Validation projects in other countries and cross-cultural comparisons are therefore warranted. Objective: Develop and preliminarily evaluate the psychometric properties of an Italian version of the CARTS on college students and compare such observations to data acquired from Canadian students. Method: Seventy-nine undergraduate students from the University of Padua (Italy) completed an Italian translation of the CARTS as well as measures of childhood experiences, mental health and attachment, responses to which were compared to those obtained in 288 Canadian students who completed the CARTS in English. Results: Internal consistency and convergent validity with the Childhood Trauma Questionnaire and Parental Bonding Instrument were found to be acceptable for the Italian translation. Within the Italian sample, correlation analyses suggested that CARTS Mother ratings referring to attachment and abuse were associated with romantic attachment, whereas CARTS Father ratings were significantly correlated to PTSD symptoms and other symptoms of psychopathology-distress. Significant differences between Italian and Canadian students across the relationship types for the CARTS abuse and attachment scales were found, indicating that Italian students rated their mothers and fathers as simultaneously less abusive, but also less as a source of secure attachment. Conclusions: The results of this preliminary study seem to suggest convergent validity of the Italian CARTS and the association between childhood attachment-related experiences and romantic attachment. Cultural variations were identified between Canadian and Italian students in both attachment and abuse scales. Future studies to investigate cross-cultural variations in the relational context of childhood abuse and in order to boost Italian CARTS psychometric features are warranted.
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Affiliation(s)
- A Simonelli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - C Sacchi
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - L Cantoni
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - M Brown
- Department of Psychology, Western University, London, Canada
| | - P Frewen
- Department of Psychology, Western University, London, Canada.,Department of Psychiatry, Western University, London, Canada.,Imaging Division, Lawson Health Research Institute, London, Canada
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14
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Malarbi S, Abu-Rayya H, Muscara F, Stargatt R. Neuropsychological functioning of childhood trauma and post-traumatic stress disorder: A meta-analysis. Neurosci Biobehav Rev 2017; 72:68-86. [DOI: 10.1016/j.neubiorev.2016.11.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 10/17/2016] [Accepted: 11/06/2016] [Indexed: 12/18/2022]
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15
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Keane CA, Magee CA, Kelly PJ. Is there Complex Trauma Experience typology for Australian's experiencing extreme social disadvantage and low housing stability? CHILD ABUSE & NEGLECT 2016; 61:43-54. [PMID: 27744217 DOI: 10.1016/j.chiabu.2016.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 09/30/2016] [Accepted: 10/04/2016] [Indexed: 06/06/2023]
Abstract
Traumatic childhood experiences predict many adverse outcomes in adulthood including Complex-PTSD. Understanding complex trauma within socially disadvantaged populations has important implications for policy development and intervention implementation. This paper examined the nature of complex trauma experienced by disadvantaged individuals using a latent class analysis (LCA) approach. Data were collected through the large-scale Journeys Home Study (N=1682), utilising a representative sample of individuals experiencing low housing stability. Data on adverse childhood experiences, adulthood interpersonal trauma and relevant covariates were collected through interviews at baseline (Wave 1). Latent class analysis (LCA) was conducted to identify distinct classes of childhood trauma history, which included physical assault, neglect, and sexual abuse. Multinomial logistic regression investigated childhood relevant factors associated with class membership such as biological relationship of primary carer at age 14 years and number of times in foster care. Of the total sample (N=1682), 99% reported traumatic adverse childhood experiences. The most common included witnessing of violence, threat/experience of physical abuse, and sexual assault. LCA identified six distinct childhood trauma history classes including high violence and multiple traumas. Significant covariate differences between classes included: gender, biological relationship of primary carer at age 14 years, and time in foster care. Identification of six distinct childhood trauma history profiles suggests there might be unique treatment implications for individuals living in extreme social disadvantage. Further research is required to examine the relationship between these classes of experience, consequent impact on adulthood engagement, and future transitions though homelessness.
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Affiliation(s)
- Carol A Keane
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia; Centre for Health Initiatives, University of Wollongong, Wollongong, NSW, Australia.
| | - Christopher A Magee
- Centre for Health Initiatives, University of Wollongong, Wollongong, NSW, Australia
| | - Peter J Kelly
- Centre for Health Initiatives, University of Wollongong, Wollongong, NSW, Australia
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16
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Carlos DM, Ferriani MDGC. Family violence against children and adolescents in context: How the territories of care are imbricated in the picture. Rev Lat Am Enfermagem 2016; 24:e2735. [PMID: 27508907 PMCID: PMC4990034 DOI: 10.1590/1518-8345.0593.2735] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 09/20/2015] [Indexed: 12/03/2022] Open
Abstract
Objective: to understand the context of care addressed to the families involved in family
violence against children and adolescents (IVCA), as produced in the context of
the Primary Health Care (PHC), from the vantage point of the practitioners of a
municipality in the State of Sao Paulo. Methods: qualitative research of the social-strategic type, based on the Complexity
Paradigm. The participants were 41 health practitioners in five health units of
the municipality under study, pertaining to the five districts of the
municipality. Data collection was done through 5 focus groups and 10
semi-structured interviews from April 24th 2013 to December 12th 2013. Data
analysis was oriented by the comprehension and contextualization mindset and based
on the dialogic, recursive and hologramatic principles. Results: two main issues regarding the care provided by the Health of the Family team were
identified: the context of this violence (the domestic space) and the power
relations that prevail in the territory where this violence surfaces. The
community health workers are the targets of specific attention because they
experience the live/work dialogic in this same area. Conclusion: paying attention to the territory, and considering the complexity of contexts and
dimensions is inherently linked to the design of care to families involved in IVCA
in the PHC environment.
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Affiliation(s)
- Diene Monique Carlos
- Post-doctoral fellow, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Maria das Graças Carvalho Ferriani
- PhD, Full Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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17
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Marsac ML, Kassam-Adams N. A novel adaptation of a parent-child observational assessment tool for appraisals and coping in children exposed to acute trauma. Eur J Psychotraumatol 2016; 7:31879. [PMID: 27652595 PMCID: PMC5031795 DOI: 10.3402/ejpt.v7.31879] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 07/08/2016] [Accepted: 07/08/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Millions of children worldwide are exposed to acute potentially traumatic events (PTEs) annually. Many children and their families experience significant emotional distress and/or functional impairment following PTEs. While current research has begun to highlight a role for early appraisals and coping in promoting or preventing full recovery from PTEs, the exact nature of the relationships among appraisals, coping, and traumatic stress reactions as well as how appraisals and coping behaviors are influenced by the child's environment (e.g., parents) remains unclear; assessment tools that reach beyond self-report are needed to improve this understanding. OBJECTIVE The objective of the current study is to describe the newly created Trauma Ambiguous Situations Tool (TAST; i.e., an observational child-parent interview and discussion task that allows assessment of appraisals, coping, and parent-child processes) and to report on initial feasibility and validation of TAST implemented with child-parent dyads in which children were exposed to a PTE. METHOD As part of a larger study on the role of biopsychosocial factors in posttraumatic stress reactions, children (aged 8-13) and parents (n=25 child-parent dyads) completed the TAST during the child's hospitalization for injury. RESULTS Children and parents engaged well with the TAST. The time to administer the TAST was feasible, even in a peri-trauma context. The TAST solicited a wide array of appraisals (threat and neutral) and coping solutions (proactive and avoidant). Forced-choice and open-ended appraisal assessments provided unique information. The parent-child discussion portion of the TAST allowed for direct observation of parent-child processes and demonstrated parental influence on children's appraisals and coping solutions. CONCLUSIONS The TAST is a promising new research tool, which may help to explicate how parents influence their child's developing appraisals and coping solutions following a PTE. More research should examine the relationships of appraisals, coping, and parent-child processes assessed by the TAST with traumatic stress outcomes.
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Affiliation(s)
- Meghan L Marsac
- The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.,Department of Pediatrics, Kentucky Children's Hospital, Lexington, KY, USA.,College of Medicine, University of Kentucky, Lexington, KY, USA;
| | - Nancy Kassam-Adams
- The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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