Journal of Child & Adolescent Trauma最新文献

Findings of high rates of complex trauma among justice-involved young people have engendered interest in developing trauma-informed youth justice systems. Although there have been several reviews of trauma-informed practice in youth justice settings, uncertainty remains about whether this approach can produce the outcomes expected of youth justice services. In this study we summarize findings from recent systematic reviews and meta-analyses to provide an overview of evidence relevant to implementing trauma-informed youth justice. We conducted an umbrella review of systematic reviews published between 2017 and 2023 that included group-based primary studies of trauma-informed interventions for justice-involved young people. Reviews were located via searches of PsycINFO, PubMedCentral, Embase, Criminal Justice Abstracts with Full Text, and ProQuest. Data extracted from each review included the number and type of primary studies reviewed, and outcomes related to trauma symptomatology, mental health and wellbeing, and justice system involvement. Nine systematic reviews met our inclusion criteria. Improvements in trauma symptoms, mental health and wellbeing, and justice system involvement were documented in each review. The strongest evidence related to the impact of trauma-focused interventions on posttraumatic stress disorder symptoms, but less evidence was available to demonstrate outcomes of organizational level and systemic components of trauma-informed practice. Each review highlighted the need to strengthen the methodological quality of primary studies. Trauma-informed practice should be seriously considered as part of any effort to implement evidence-based youth justice. This should extend beyond treatment of trauma symptomatology to incorporate a broader approach to trauma-informed practice that is organizationally embedded.

Youth in the legal system (YILS) report high rates of substance use (SU), complex family/social relationships, and chronic trauma. The current study tested the feasibility of a prevention intervention, Trust-based Relational Intervention® (TBRI®), that leverages family systems by strengthening connection and providing emotional and instrumental guidance and support. TBRI includes the primary TBRI Intervention, comprised of Caregiver Training, Youth Training, and joint youth-caregiver Nurture Groups, and TBRI Family Coaching. With a sample of eight youth-caregiver dyads, the study adopted a mixed-methods design with a multi-informant approach to fulfill two goals: (1) testing TBRI as a prevention intervention for opioid use (OU), other SU, and related issues, and (2) testing the feasibility and acceptability of the TBRI Intervention by virtual delivery. Session attendance and completion rates demonstrated feasibility of recruiting and retaining participants and intervention fidelity. Preliminary results were reported on intervention outcomes, including OU and other SU, illegal activities, and educational attainment. Pre- and post-intervention comparisons showed decreases in youth negative urgency, conduct problems, and hyperactivity. Caregiver and staff participants responded favorably to TBRI and its virtual delivery; youth were more capable of expressing their needs and acknowledged the importance of families in preventing problems after discharge from secure facilities. While acknowledging sufficiency of intervention content, caregivers expressed the desire for more sessions. Results demonstrate the feasibility and acceptability of a trauma-informed, attachment-based prevention intervention for youth and families in contact with the legal system. TBRI is a promising approach for preventing the initiation or escalation of OU among YILS.

Background

Young people in out-of-home care often have trauma histories that negatively impact their development and well-being. As a result, resource parents often face challenges meeting the needs of these youth, which can be addressed by ensuring access to effective trauma-informed training.

Objective

This qualitative study examined the impacts and helpfulness of a trauma-informed program (Resource Parent Curriculum (RPC)) designed for resource parents who care for a young person involved with child welfare.

Methods

Twenty resource parents from two child welfare agencies in Ontario, Canada participated in focus groups and interviews after completing the RPC program.

Results

Results of a thematic analysis indicated that, through use of relevant materials from the program, resource parents reported a better understanding of trauma reactions in their resource child. This improved understanding influenced their parenting approach when addressing their child’s behaviours through consideration of their underlying needs.

Conclusions

The findings can be used to support trauma-informed programming for resource parents within child welfare.

The Odense Child Trauma Screening (OCTS) is Danish story stem screening tool applicable for assessment of preschoolers and young children in risk of being traumatized. Having shown initial evidence of validation, Danish norms are needed to strengthen the clinical assessment with the OCTS by serving as a baseline comparison for assessment of potentially traumatized children. We tested 169 children from the Danish general population aged 4–8 with the OCTS and investigated sex and age differences in play-based behavior and narrative representations. Caregivers reported electronically on child demographic information, psychosocial functioning, and history of trauma exposure using The Strengths and Difficulties Questionnaire (SDQ) and The Diagnostic Infant and Preschool Assessment (DIPA) trauma list. Across the 145 scores of the OCTS coding scheme, significant sex and age differences were only found in five and sixteen scores respectively. In the five codes where significant sex differences were observed, boys’ normative scores were higher. No significant sex differences were found in the partial story scores or the OCTS total score. Three significant age differences in partial story and OCTS total scores emerged with 4-year-olds scoring higher than 6–8-year-olds. We further found 13 significant age differences in code scores with higher scores among the youngest of the two groups in question suggesting that scores tend to decrease along older age. Few significant sex and age differences were found in children’s OCTS play-based behavior and narrative representations. Indicative of few sex and age biases of the OCTS coding scheme and stories, results suggest that the OCTS can be applied across the intended target group of children aged 4 to 8 years. As higher scores were found in the younger age groups, clinicians should be attentive to age in certain codes of the OCTS coding scheme in their assessment of children in clinical practice. The preliminary normative scores must be interpreted and clinically applied with caution due to our non-representative sample and lack of analyses on factors potentially influencing children’s responses to the OCTS (e.g., developmental, contextual, cultural factors).

Although trauma exposure is common among youth in the United States, it is not evenly distributed. In fact, Latinx youth have higher rates of trauma exposure than their non-Latinx White counterparts with approximately 78% of Latinx youth experiencing one traumatic event by the time they are 18 years old. Despite this, the impact of trauma exposure on Latinx youth’s mental health needs is not well-established. This is largely because Latinx youth are vastly underrepresented in many of the large-scale, epidemiological studies on childhood trauma exposure. To address this gap in the literature, this study applied PRISMA protocol guidelines to systematically review the methodologies, participant characteristics, and findings from 22 studies examining the relation between Latinx youths’ trauma exposure and their mental health needs. Results revealed that while trauma exposure is common among Latinx youth, its association to Latinx youth’s mental health needs is not well understood. Indeed, while some studies found a positive association between Latinx youth’s trauma exposure and their mental health risk, other studies found no such relation. An examination of the included studies’ methodologies and participant characteristics revealed several limitations in the existing research that are likely contributing to these inconsistencies. Concrete recommendations for how future research can address these limitations are put forth. Taken together, the results of this study underscore the urgent need to understand the role that trauma exposure plays in contributing to and/or maintaining mental health disparities among Latinx youth.

A history of maltreatment can increase risk for dating violence (DV) and risky sexual behaviour (RSB) among adolescents. Secure parent-child attachment may reduce this risk, yet few studies have examined this as a protective factor. This study differentiated developmentally appropriate, exploratory sexual behaviours from RSB and examined whether maltreatment experiences and parent-child attachment in adolescence predicted DV and RSB reported five years later in a high-risk sample. Participants were 179 adolescents (46% girls; M_age = 15.34, range = 12–18 years) at risk for aggressive and antisocial behaviour. Adolescents reported their maltreatment histories and attachment to their parents at Time 1; five years later, at Time 2, they reported their experiences with DV perpetration and victimization and engagement in RSB. Both bivariate correlations and structural analyses demonstrated that maltreatment was associated with DV perpetration and victimization but not RSB, and attachment avoidance was associated with fewer RSB but not DV. Attachment anxiety was associated with physical DV perpetration and greater condom use, but only at the correlational level; attachment anxiety was not associated with DV or RSB in the structural model. There were no significant interaction effects. Findings highlight the importance of considering key developmental factors such as maltreatment and parent-child attachment in understanding adolescent risk for DV and RSB, and may inform future research that accounts for contextual factors such as motivation for violence perpetration and contraceptive use with multiple and/or casual sex partners.

Children under the age of 18 who are known to forensic child and adolescent mental health services often present with complex psychosocial and behavioural needs that are elevated compared with those in the general youth population. The Forensic Child and Adolescent Mental Health Service for Northern Ireland (FCAMHSNI) was commissioned in 2014 to support these children. Despite almost a decade of implementation, the profile and characteristics in the service remain under-analysed, impeding service improvement and making international comparisons more difficult. The primary aim of the current study was to address the regional gaps in how the needs of those accessing FCAMHSNI are understood. A secondary aim was to capture comparable data. Data on 107 accepted referrals are included in the analyses. The majority of cases within this time period were male (81.1%, n = 86) and the majority of presenting behaviours were related to violence and aggression 62.3% (n = 48). However, some forms of violence, such as harmful sexual behaviour, was relatively low when compared with other jurisdictions. Specific demographic characteristics such as gender and religious background appeared to be significant risk factors for referral to the service. Almost all of the sample are known to have experienced at least one potentially traumatic event (95.2%) and in more than one-third of cases, service users presented with co-morbid issues (35.6%, n = 37). These observations are discussed. This study adds to the growing international literature around the needs of forensically involved youth and helps to inform future service development and provision.

Bullying victimisation affects an estimated 30% of individuals worldwide. While the prevalence and risk factors of bullying have been studied in India, comprehensive research on the phenomenon of bullying itself remains scarce. Our objective was to study the experiences, perceptions, and attitudes towards bullying among seventh to ninth-grade students. The study included all seventh to ninth graders (N = 205) from two schools in the Udupi district of South India. To collect information on bullying, we used the Bully Survey - Student Version with appropriate modifications for our context. The mean age of the participants was 13 (1.05) years, with 58% being females. Our findings showed that almost half of the students had bullying roles. Students attending private schools and residing in urban areas were more likely to be victims, bullies, and bully-victims. Seventh and eighth graders experienced higher rates of bullying, whereas ninth graders were more likely to engage in bully behaviours or be bully-victims. Verbal bullying, including name calling, playing jokes, and making fun of others, was more prevalent. No gender differences were observed in verbal or physical bullying. School teachers, staff, and parents were unaware of bullying incidents almost half of the time. Anti-bullying programs should consider these aspects of bullying to be effective.

This repeated-measures study examined the effects of a hybrid of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) with other therapeutic approaches at a community-based clinic in Perth Western Australia among a sample of children and young people overwhelmingly experiencing multiple forms of maltreatment and with complex family situations (i.e., family and domestic violence, parental mental health, parental substance abuse). Drawing on 1713 individual client records from between 2017 and 2020, the researchers identified 113 children and young people with viable pre-post treatment assessments including 78 on the TSCC, 36 on the TSCYC, and 12 on the CBCL. Significant improvements on most clinical scales were identified on the TSCC and TSCYC. Sub-analysis of the TSCC results found no differences across gender, age, care status, therapy funding source, and the presence of sexual abuse in the rate of improvement on trauma symptoms. Overall, the study highlights that integrating different therapy approaches for populations with multiple and complex trauma symptoms accessing community-based services can be useful for supporting the delivery of TF-CBT for difficult to treat populations.

Abstract

This study is an attempt to explore war-related trauma, its stressful effects, and the coping strategies of Saudi schoolchildren. The authors hypothesized that children exposed to war-related trauma will show higher levels of PTSD, and that those with higher levels of PTSD symptoms use more maladaptive coping strategies. The study describes the correlation between traumatic events and posttraumatic stress disorder (PTSD) as well as coping strategies. Five hundred twenty-seven intermediate and high school students, 12 to 18 years old, living in the conflict zone in southern Saudi Arabia completed three standardized self-reported scales: the War Zone Traumatic Events Checklist, the Child PTSD Symptom Scale, and the Children’s Coping Strategies Checklist. Each participating student was randomly chosen. Analysis was based on two groups: the high-PTSD symptoms group (182 children) and the low-PTSD symptoms group (345 children). The study was conducted between September 2020 and April 2022 while the war was ongoing as part of an ongoing larger study. Children exposed to war-related traumatic events exhibited greater prevalence rates for PTSD. The children reported high levels of PTSD symptoms and applied a variety of coping strategies to manage related stress. Participants rarely reported that psychological or educational interventions had been used to manage the war-related traumatic experiences and PTSD or to improve related coping styles. The results are discussed in the context of mental health services needed for children in the conflict zone. To bridge the gap between health care services and the needs of children with PTSD, and for better understanding and interventions, health professionals are invited to develop a biopsychosocial model that identifies the risks of PTSD related to exposure to war-related traumatic events in school-aged children and, hence, provide a multidisciplinary intervention program that educates, encourages, and supports teachers and parents in following medical recommendations and goals.