Journal of Child & Adolescent Trauma最新文献

Characteristics of individuals with disruptive behavior disorders often include elevated externalizing behaviors such as impulsivity, defiance of authority and antagonism of social norms. Evidence shows that adolescents diagnosed with these types of disorders are particularly challenging to treat; however, therapies incorporating horses have shown some success. We examined the impact of an equine-assisted intervention compared to a non-manualized cognitive behavioral therapy in youth between 12- and 18-years old living in a residential childcare facility. Upon admittance, youth were administered three assessments: the Youth Self-Report, Adolescent Psychopathology Scale, and Basic Empathy Scale. Youth scoring in the clinical range for at least one externalizing subscale of the Youth Self-Report were assigned to equine-assisted intervention (EQI; N = 23) or non-manualized cognitive behavioral therapy (NM-CBT; N = 20) groups. Each group received a total of 7 h of treatment per week (three 2-hr group sessions and one 1-hr individual session) for 24 weeks. After 24 weeks of treatment, the same three assessments were administered a second time. There were no significant differences between the NM-CBT and EQI groups in the amount of change between assessments. A significant time effect was found for total externalizing behaviors in the Adolescent Psychopathology Scale and Youth Self-Report such that these measures were within the normal range after 24 weeks of treatment for participants in both groups.

Trauma-informed education is an internationally and widely adopted approach to support traumatized students in their needs in schools. In this two-year longitudinal pre-posttest design study, the outcomes of a school-wide trauma-informed approach during a baseline year and first year of implementation in two regular primary and six special primary and secondary schools were examined with six measurement waves. We examined students' perception of school class climate, more specifically class atmosphere, quality of student relationships, quality of teacher-student alliance and order in the classroom. In addition, we examined posttraumatic stress symptoms, internalizing, externalizing, attention and total behavioral problems, executive functioning, and resilience. Results of the piecewise latent growth curve models showed more positive scores for atmosphere in the classroom and resilience at the end of the first implementation year compared to the end of the baseline year. In addition, there was an increase in youth-reported classroom atmosphere during the implementation year. After the first year of implementing the trauma-informed educational approach initial modest positive outcomes begin to emerge.

Little is known about somatic complaints in school-aged child victims of sexual abuse and the associated risk factors. Given that somatic symptoms can lead to functional impairment and decreased health-related quality of life, identifying associated factors in the child's environment is essential. This study aimed to identify personal, family, and environmental factors associated with somatic complaints among child victims of sexual abuse. The sample included 654 children (68.8% girls; M = 8.96 years, SD = 1.88) seeking services after disclosure of child sexual abuse. Hierarchical linear regression models were used to investigate the associations between personal, family, and environmental factors, and somatic symptoms. Sex differences in the associations between risk factors and the level of somatic symptoms were systematically tested. Most children (58%) had at least one somatic symptom (M girls = 1.37, SD = 1.44 and M boys = 1.04, SD = 1.38). After controlling for sex and age, stress related to sexual abuse disclosure (β = 0.16, 95% CI [0.08, 0.23]), parental distress (β = 0.18, 95% CI [0.10, 0.26]), the number of stressful life events experienced (β = 0.12, 95% CI [0.05, 0.20]) and neighborhood social deprivation (β = 0.21, 95% CI [0.01, 0.42]) were independently associated with greater level of somatic complaints. Stress related to sexual abuse disclosure, parental distress, the number of stressful life events, and neighborhood social deprivation were associated with higher levels of somatic complaints in this population.

Supplementary information: The online version contains supplementary material available at 10.1007/s40653-024-00665-y.

Emergency service personnel experience high levels of psychological distress, with increasing evidence of associations with shame and trauma. Additionally, adolescence is a critical time in social and cognitive development, in which shame plays an important role. In Australia, adolescent volunteer surf lifesavers (SLS) are particularly vulnerable due to exposure to potentially traumatic experiences (PTEs) such as rescues and resuscitation of human lives. The aim of this study was to investigate the association between direct or indirect PTEs, and the relationship PTSS and shame may have in adolescent surf lifesavers. This cross-sectional study surveyed patrolling adolescent SLS, aged 13-17 years, recruited via internal communications and social media groups. Complete responses from patrolling adolescents (n = 118; 59% female; mean age 15.4 years) were used to determine exposure to PTEs across global, direct, and within SLS trauma domains. Associations between demographics, PTEs, post-traumatic stress symptoms (PTSS), with shame as a moderator were assessed for each trauma domain. PTEs and PTSS were positively associated across trauma domains. Shame was identified as a significant predictor of PTSS and as an important moderator of PTSS for experiences within SLSA, but not global or direct trauma. By exploring links between PTEs, PTSS, and shame, these findings contribute to the development of strategies and interventions for adolescents during stressful times. Responsiveness to adolescents via feedback and genuine, reassuring relationships that acknowledge the complexity of coping with stressful situations, may be potentially effective approaches to support coping with experiences of shame following PTE's in adolescent surf lifesavers.

Adverse childhood experiences (ACEs) increase risk for mental and physical health disorders in adulthood, particularly in individuals from sexual and ethnic minority groups. The effects of ACEs on health may be mediated by the immune system. The exact mechanisms by which an environmental exposure, such as childhood adversity, can affect the immune system are still unknown. The primary aim of this study was to determine whether early adversity is associated with significant changes in the expression of a predefined set of immune-related genes, known as the conserved transcriptional response to adversity (CTRA), in a diverse group (African American and Latino) of sexual minority men (SMM) (n = 259). Participants included HIV positive and negative males, with a median age of 31 years (range = 19-46 years), from the mSTUDY. Expression data from 53 CTRA genes were obtained at baseline and 12-month follow-up. Childhood adversity was measured with the 10-item ACEs questionnaire. Wilcoxon rank sum and chi-squared tests were used to assess differences in sociodemographic variables, HIV status, smoking, weekly alcohol use, and methamphetamine use between exposed (cumulative ACEs ≥ 1) and unexposed groups (cumulative ACEs = 0). As we had transcriptional data from two timepoints, linear mixed models were used to determine associations between ACEs (cumulative score, dichotomous measure (exposed/unexposed), childhood maltreatment, household dysfunction, abuse and neglect subscales) and CTRA gene expression. Exploratory subgroup analysis was conducted in younger (≤ median age) and older (> median age) participant groups. There were no statistically significant differences in sociodemographic variables and substance use between the exposed and unexposed groups. There were no significant associations between any of the ACEs variables and CTRA gene, suggesting that early adversity does not influence immune-related gene expression in a group of ethnically diverse SMM. Further studies are needed to assess the biological effects of ACEs in adulthood.

Supplementary information: The online version contains supplementary material available at 10.1007/s40653-024-00661-2.

This study sought to identify gaps in the current literature base by exploring the perspectives of General Practitioners (GPs) in Northern Ireland in relation to the significance, relevance, and feasibility of conducting a comprehensive inquiry into Adverse Childhood Experiences (ACEs) with patients. Semi-structured, in-depth interviews were conducted with 10 qualified GPs using Zoom Videoconferencing technology. Interviews were audio recorded and transcribed verbatim. Qualitative data was analysed using Theoretical Thematic Analysis (Braun & Clarke Qualitative Research in Psychology 3(2):77-101, 2006). Analysis revealed nine key superordinate themes. These themes encompassed various aspects such as the role of a GP, trauma-informed training, the advantages and barriers associated with conducting an ACE assessment, and the impact of childhood adversity on subsequent physical and mental health. This study provides valuable primary care professional insights that contribute to the existing evidence base. It highlights the importance of recognising, discussing, and screening for ACEs in primary care settings. Furthermore, this study explores a range of practical adjustments that could support the implementation of routine ACE enquiry within the primary healthcare system in Northern Ireland.

Researchers have explored the direct association between self-esteem and depression as well as the factors that mediate it. The parallel mediating roles of life satisfaction and anxiety symptoms in the aforementioned direct link are, however, poorly understood, particularly in the Vietnamese context. This study investigated whether life satisfaction and anxiety symptoms mediate the association between self-esteem and depression symptoms among late adolescents in Vietnam. Using a cross-sectional survey, Vietnamese late adolescents (N = 408, 83.6% female; M_age = 19.95 years) completed questionnaires related to anxiety symptoms, depressive symptoms, life satisfaction, and self-esteem. The results indicated that in the parallel mediation model, both direct and indirect effects were significant (β = -0.080, p < 0.05, and β = -0.391, p < 0.01). The association between self-esteem and depression symptoms was mediated by life satisfaction and anxiety symptoms. These findings suggest that to reduce the adverse impact of self-esteem on depression symptoms, effective measures should prioritize reducing anxiety symptoms and increasing life satisfaction among late adolescents.

This study examined differences between young women who are survivors of sexual violence and young women who are survivors of other traumas in terms of posttraumatic growth (PTG) and possible PTG predictors: personal factors (shame and self-blame) and social factors (social support and social reactions to the traumatic event). Additionally, the study explored the possible association between these factors and PTG among the two groups. The sample comprised 285 female trauma survivors, aged 18–30, of whom 128 were sexual violence survivors. Lower PTG was found among sexual violence survivors, while shame, self-blame, and receiving negative reactions were higher among this group than the other group. Among both groups, higher levels of PTG were associated with low levels of shame and high levels of positive reactions, but only in those who experienced sexual violence was PTG associated with high levels of self-blame. Implications for research and practice are discussed.

The primary aim of this study was to investigate the experiences of Dutch children whose parents joined the SS or NSB (a political party that collaborated with Nazi Germany) during World War II, linked to their childhood, adulthood or both. As a secondary aim, it explored the recommendations of these –now elderly- children of NSB and SS members for the (re)integration of minor returnees from the caliphate, who also grew up in a war situation with radicalized parents and have to deal with considerable prejudice and different norms and values upon their (re)integration into Dutch society. The first three research questions are related to the primary aim of this study and focus on 1) the participants' experiences throughout childhood and adulthood, 2) the implications of these experiences for their well-being throughout childhood and adulthood, and 3) their coping responses in response to these experiences throughout childhood and adulthood. The fourth research question is related to the secondary aim of this study and concerns 4) participants' recommendations for the succesful (re)integration of current minor returnees. Semi-structured interviews were conducted with 17 Dutch -now elderly- children of NSB or SS members during World War II. Interview questions were based on recurring topics in the literature, a codebook was generated, and the verbatim transcribed interviews were scored using Atlas.ti 8. Frequently reported codes are described and discussed in relation to each other. Participants reported social exclusion, being separated from their parents, and family secrecy as frequent experiences, which had severe implications for their identity development, self-esteem, and family relationships. Their coping responses included reappraisal, active (e.g., searching information) and avoidant (e.g., merel socially desirable) coping behaviour. Participants’ main recommendations for minor returnees from the caliphate included transparency within families about the past, a focus on social (re)integration, and respecting minor returnees’ loyalty to their parents. The participants' childhood experiences had serious effects on their well-being, starting in childhood and often lasting well into adulthood. Many participants sought professional support throughout their lives, but eventually found recognition only after sharing their experiences in a self-help group for Dutch children of NSB and SS members. We conclude that the insights gained from participants’experiences and their recommendations for the (re)integration of minor returnees are valuable, especially since there is still little research available on the development and experiences of minor returnees.

Background

Youth mental health is an important global healthcare topic and early interventions that are timely and evidence-based to support young people can increase quality of life and lower deaths by suicide. Research exploring young people’s mental health experiences and how they manage can further understanding into help-seeking processes.

Objective

This study aimed to explore young people’s experiences of living with and managing mental health problems and how this impacts professional help-seeking.

Methods

Eighteen young people were recruited, aged 16–25 years, with experiences of help-seeking to services for mental health problems (N = 18). Data were analysed using Constructivist Grounded Theory methods (Charmaz, Constructing grounded theory, 2014).

Findings

The findings were presented across three sub-categories: (1) “Early experiences”; (2) “Conceptualising mental health” and (3) “Managing mental health”. Findings expand understanding on the resource pressures that young people experience whilst managing persistent mental distress emanating from early experiences of trauma, life stressors, and developmental tasks. Findings also report lived experiences of pain, loneliness and stigma, and how individual conceptualisations of mental health are informed. The preference for self-reliance can be rooted in developmental needs or learned behaviours and how this impacts self-management and help seeking is discussed.

Conclusion

Through an enhanced understanding about how young people experience mental distress, developmental pressure points, marginalisation and stigma, mental health providers can prioritise individualised approaches to healthcare that can both respect a young person’s individual conceptualizations and positively leverage self-management strategies, which can contribute positively to young people’s development, quality of life, and healthcare outcomes.