Journal of Child & Adolescent Trauma最新文献

Catatonia is a psychomotor syndrome that can present secondary to mood and psychotic disorders, other medical conditions, antipsychotic use, and alcohol withdrawal (Rasmussen et al., World Journal of Psychiatry, 6:391-398, 2016). In addition, acute and chronic trauma are increasingly recognized as a substrate for catatonia (Dhossche et al., Acta Psychiatrica Scandinavica, 125:25-32, 2012). Catatonia is a clinical diagnosis that relies on standardized examination of the patient. The Pediatric Catatonia Rating Scale (PCRS) was modified from the Bush Francis Catatonia Rating Scale and validated in children and adolescents (Benarous et al., Schizophrenia Research, 176:378-386, 2016). Changes included the addition of urinary incontinence, schizophasia and acrocyanosis; and withdrawal was separated into refusal to eat or drink and social withdrawal (Benarous et al., Schizophrenia Research, 176:378-386, 2016). In both pediatric and adult patients, catatonia must be differentiated from other movement disorder emergencies such as serotonin syndrome and neuroleptic malignant syndrome, which can also present with altered mental status and autonomic dysfunction (Rajan et al., Seminars in Neurology, 39:125-136, 2019). In pediatric patients, catatonia may be the genuine diagnosis in cases of Resignation Syndrome and Pervasive Refusal Syndrome (Sallin et al., Frontiers in Behavioral Neuroscience, 10(7), 2016; Ngo and Hodes, Clinical Child Psychology and Psychiatry, 25:227-241, 2019). The literature on pediatric catatonia is scarce but nevertheless expanding. Herein, we contribute to the literature by reporting four complex cases of pediatric catatonia that appear to have been triggered by a traumatic event and further reviewing the role of acute and chronic trauma in the presentation of pediatric catatonia.

Childhood, often associated with various forms of harassment, requires a tool to assess children's ability to recognize abuse. This study was conducted with the aim of localizing and evaluating the psychometrics of the Good/Bad Touch Questionnaire (GBT) in preschool children. This study conducted as a cross-sectional design, utilizing the multi-stage sampling method to select 82 preschool children from Ardabil city in the year 2023. Data collection was conducted using the GBT questionnaire. Initially, the questionnaire underwent translation, and for each question, individual calculations were made for the Content Validity Index (CVI) and Content Validity Ratio (CVR). The reliability of the questionnaire was assessed through internal and external consistency methods, in addition to the retest method, employing the Kuder-Richardson index (KR-21). The study participants had an average age of 5.74 ± 0.42 years. The CVR index exceeded the minimum acceptable level, as per Lawshe Table (0.42). The overall CVI index reached 0.901, surpassing the minimum acceptable value (0.79), indicating the appropriateness of the questions' content. Moreover, the entire questionnaire demonstrated reliability (r = 0.256, P = 0.151), and the Cod Richardson 21 coefficient at the study's onset and conclusion were 0.726 and 0.844, respectively. The results of the present study indicate that the GBT questionnaire, meeting the minimum acceptable value of CVR and yielding favorable results in the CVI index, is a valid and reliable tool for assessing children's ability to recognize inappropriate touches. The confirmation of both quantitative and qualitative content validity, along with form validity and questionnaire reliability, strengthens the robustness of the tool in its intended purpose.

Supplementary information: The online version contains supplementary material available at 10.1007/s40653-025-00689-y.

Early exposure to chronic maltreatment and other biopsychosocial adversities accounts for high prevalence of developmental impairments among children residing in foster care and other types of statutory out-of-home care (OOHC), including: complex, trait-like mental health difficulties; intellectual disability (ID); and speech and language difficulties (SLD). However, little is known about the characteristics and prevalence of co-occurring mental health difficulties and developmental disabilities among this population - which we refer to as inter-developmental impairment. The present article reports findings from epidemiological surveys of pre-adolescent school-aged children (N = 347) and adolescents (N = 230) residing in foster and kinship care in New South Wales, Australia. Mental health was measured from caregiver-reported Child Behavior Checklist and Assessment Checklist for Children / Assessment Checklist for Adolescents scores; and ID and SLD were reported in a caregiver questionnaire. The proportions of children and adolescents with caregiver-reported ID were 22.5% (78/347) and 30.0% (69/230) respectively, while the proportions with SLD were 21.6% (75/347) and 15.7% (36/230) respectively. While mental health case rates were high among the aggregate child (67%) and adolescent (60%) samples, those with ID and/or SLD were considerably more likely to have clinical-level mental health difficulties compared to those without ID or SLD, with odds ratios ranging from 1.9 to 6.5. The prevalence of inter-developmental impairment (defined as having ID and/or SLD, as well as mental health caseness) among the child and adolescent samples was 23.9% and 28.7% respectively. Children and adolescents with inter-developmental impairment on average had with more complex symptomatology than did mental health cases without reported developmental difficulties. The article discusses mechanisms accounting for inter-developmental impairment among formerly maltreated children residing in foster care, and implications for clinical services.

Despite substantial evidence to suggest that neurodivergent children are particularly vulnerable to experiencing interpersonal trauma, evidence-based therapeutic guidelines for this group of children are lacking and best practice parameters have yet to be established. This study aimed to synthesise and describe recommendations provided by two specialist clinical assessment services within a major metropolitan children's hospital in Melbourne, Australia, to families of children diagnosed with autism and/or an intellectual disability who have experienced interpersonal trauma. Twenty-six assessment reports written between 2021-2022 containing such recommendations were analysed. While less than half of the reports (43%) provided recommendations intended to directly support the child's experience of interpersonal trauma, the majority (88%) provided 'indirect' recommendations that addressed other treatment targets known to benefit neurotypical children, or neurodivergent children without a history of trauma. Overall, these results shed light on the limited evidence-based strategies clinicians can reliably draw upon when working with this vulnerable population and reinforce the importance of developing empirically supported trauma interventions that are appropriate for neurodivergent children.

Supplementary information: The online version contains supplementary material available at 10.1007/s40653-024-00684-9.

[This corrects the article DOI: 10.1007/s40653-024-00676-9.].

This study evaluated the effectiveness of a therapeutic intervention program Take Two; designed to address developmental trauma experienced by Child Protection clients in Victoria, Australia. Replicating a 2010 evaluation study of the program, we utilised a Time 1-Time 2 design to identify the impact of tailored Take Two treatments informed by the Neurosequential Model of Therapeutics' (NMT™). Change in the overall sample was measured by the Trauma Symptom Checklist for Children (TSCC; ages 8-16 years) and Trauma Symptom Checklist for Young Children (TSCYC; ages 3-12 years). In addition, a sub-cohort of children with severe adverse infant experiences was identified using a developmental history of adversity tool; Part A of the Neurosequential Network's Neurosequential Model of Therapeutics (NMT™) Metric. Treatment effects were also evaluated to determine the extent to which this potentially more vulnerable subgroup was improving. Significant improvement was found in the TSCC cohort (8-16 years) with effect sizes ranging from small to medium (d = 0.23-0.54) on TSCC sub-scales. The largest effects were found on Anxiety (0.54), which moved from sub-clinical to non-clinical. The TSCYC cohort (3-12 years) showed significant symptom reduction on all trauma scales with medium sized effects (d = 0.44-0.53), and the largest effect on Posttraumatic Stress-Total (0.53). In the sub-cohort experiencing moderate-to-severe adversity in infancy, effect sizes were small to medium (d = 0.15-0.59). Take Two interventions were associated with significantly reduced trauma symptoms even when children's adverse experiences in infancy were moderate to severe, highlighting the benefits of NMT™ guided systemic and individually tailored therapeutic interventions.

This study investigated the potential effectiveness, feasibility, acceptability, and putative mechanisms of change of Narrative Exposure Therapy (NET) delivered via videoconferencing with young people who witnessed domestic violence. A naturalistic, mixed-method, AB, interventional single case design was used. Five female adolescents aged 13-17 years were recruited from a Child and Adolescent Mental Health Service in the United Kingdom and attended 4-10 video-sessions of the child-friendly NET protocol. Participants completed questionnaires assessing posttraumatic stress symptoms (PTSS), general psychological distress, and trauma memory quality, wore a heart rate (HR) monitor assessing habituation, and were offered a Change Interview. At post-intervention, three participants showed reliable improvement in PTSS, but only one showed clinically significant change. One participant also demonstrated reliable improvement in general psychological distress. Effect size estimates ranged from moderate to very large and indicated change in the desired direction for all but one participant; estimated effects for general psychological distress were more modest. Three participants showed reductions in trauma memory quality, indicating increased integration. Within-session habituation was observed for all participants with available HR data; between-session habituation was also recorded for two of them. The lifeline was mentioned as a helpful aspect of NET, the video delivery was considered both a barrier and a facilitator to engagement, and positive or mixed changes were reported by two participants. Future research with more control and larger samples is needed to answer questions on generality of findings and impact of online delivery; future studies may also include longer follow-up periods and investigate other outcomes. Trial registration number NCT04866511 (ClinicalTrials.gov).

This study aims to shed light on the influence of insecure attachment representations on the presence of emerging borderline personality features (EBPF) in school-age children, and the role of these features in manifestations of behavioral dysregulation. The sample is composed of 116 children aged 7 to 12 (M _age = 9.11; SD = 1.68; 47 girls) drawn from three groups: children under youth protective care (n = 35), consulting psychologists or child psychiatrists (n = 42), and the general population (n = 39). The EBPF were evaluated using the Borderline Personality Features Scale for Children. Attachment representations were assessed using the Child Attachment Interview. The Child Behavior Checklist for youth was used to verify the presence of behavioral dysregulation. Analyses of variance indicate that the three groups differ in the insecurity of attachment representations and the extent of behavioral dysregulation, with children under youth protective care showing the highest levels and children in the general population showing the lowest. Children under youth protective care have a higher EBPF score than the general population. Regression analyses confirmed that more insecure attachment representations predict an increase in EBPF, while the latter influence the increase in behavioral dysregulation. A partial mediating effect of EBPF was found in the relationship between attachment representations and behavioral dysregulation. To our knowledge, this is the first study to identify a mediation trajectory between attachment representations, EBPF, and behavioral dysregulation in a sample of school-age children. These results are discussed with regard to their implications for borderline-to-be functioning.

Teachers are dealing with the challenges of educating students who have been exposed to Adverse Childhood Experiences (ACEs) at an increasing rate (Brunzell et al., 2021; Mayor, 2021). Often their education has not prepared them for recognizing and mitigating the behaviors associated with ACE exposures. This article offers a review of current research regarding the role of the school counselor in supporting teachers. A case study provides insight into this support through a university partnership with a trauma-focused charter school. Suggestions are offered for teacher training and policy changes based on the author's experiences in working with a trauma-focused school. Specifically, there are many areas where school counselors can provide advocacy and support through efforts within their role in the areas of defining, managing, delivering, and assessing ASCA (2024). Partnering with a university can provide needed services for schools while simultaneously offering learning opportunities for students.

Substantial findings point to the risk of chronic pain following child maltreatment (CM). However, a coherent explanation for the mechanisms underlying pain following CM is lacking. Although peritraumatic pain may encompass a significant role in these processes, a systematic quantification of peritraumatic pain in CM has never been conducted. This study was conducted to provide an initial exploration of peritraumatic pain characteristics in CM, and its links with CM characteristics, pain expression, and later posttraumatic outcomes. Two samples of adult CM survivors (N = 160 and N = 120, respectively) filled out self-report questionnaires assessing peritraumatic pain characteristics, CM characteristics, peritraumatic dissociation, and complex posttraumatic-stress symptoms (cPTSD). Peritraumatic pain was reported by 42.2% (76 participants) and 57% (69 participants) in Samples 1 and 2, respectively. While pain was most prevalent in physical abuse (90%), it was also prevalent in sexual (63%) and emotional abuse (37.5%; X ² (3) = 14.65, p = .002). Peritraumatic pain was most prevalent when the perpetrator was a family member (X ² (3) = 14.65, p = .002), longer CM duration (p < .001), and in fight-or-flight peritraumatic responses (X ² (2) = 7.13, p = .028). Peritraumatic pain expression did not differ for CM type (p > .083), and most participants reported that the perpetrator ignored their pain (73.9%). Explicit and concealing expressions of pain were associated with later cPTSD symptoms (p < .047). The findings provide an initial understanding of peritraumatic pain characteristics and phenomenology, demonstrating that pain is a substantial constituent of CM experiences and potential posttraumatic outcomes.