Journal of Child & Adolescent Trauma最新文献

Increasing scientific evidence suggests that youth involvement in street gangs is positively associated with multiple trauma-related symptoms. These symptoms may be explained by high exposure to violence, both as perpetrators and victims. While studies have documented the associations between gang involvement and violence exposure, as well as traumatic outcomes, it is still unknown whether perpetrated violence and/or victimization explain the traumatic outcomes of gang involvement. Notably, girls in gangs are at a higher risk of certain types of victimization, such as sexual exploitation. In the current quantitative study, data from 107 girls from a larger longitudinal study on adolescent girls placed in residential care centers in Montreal, Canada, were analyzed. Recurrences of exposure to street gangs, perpetrated violence, and sexual exploitation victimization were self-reported over a period of four and a half years, from adolescence to emerging adulthood. Trauma-related symptoms were measured in emerging adulthood. Correlational analysis indicated that all key variables were positively associated. Mediation analyses were performed to clarify the respective contributions of perpetrated violence and sexual exploitation victimization to the traumatic sequelae of involvement in a gang. The results indicated a total mediation effect of sexual exploitation victimization on the associations between gang involvement and symptoms of self-disturbance and post-traumatic stress in emerging adulthood, as well as a total mediation effect of sexual exploitation victimization and perpetrated violence on symptoms of externalization. These results corroborate the deleterious effects of violence exposure among girls involved in street gangs, both as perpetrators of violence and victims of sexual exploitation.

Adverse childhood experiences (ACEs) are negative events during childhood or adolescence, including abuse and maltreatment. ACEs are associated with negative life outcomes, and the risk of such outcomes increases when polyvictimization (i.e., multiple types of ACEs) occurs. This study identified patterns in ACEs among girls in a residential treatment program (RTP) and examined how these patterns were associated with trauma symptoms, substance use, and delinquent behavior. Data were coded from psychological assessment records for girls ages 13 to 18 who entered the RTP between 2017 and 2021 (N = 256). Adolescents identified as 43.0% White, 20.9% Biracial/Multiethnic, 16.7% Black, 12.5% Hispanic/Latina, 4.2% Native American/Indigenous Peoples, and 2.7% Middle Eastern/North African descent. Participants reported an average of 5.08 adverse experiences (SD = 2.47). Four distinct classes were identified through latent class analysis: polyvictimization (endorsing all 10 ACEs), abuse and non-support (maltreatment and lack of parental support), household dysfunction (parental separation, incarceration, substance use), and low adversity (exposure to only parental separation). The polyvictimization class and the abuse and non-support class reported higher levels of trauma symptoms compared to the low adversity class. The polyvictimization class reported higher substance use compared to the low adversity class. The household dysfunction class reported higher substance use and higher delinquent behaviors compared to the low adversity class. These findings provide a deeper understanding of adolescent girls’ experiences of ACEs and mental health and behavioral concerns when entering residential treatment, which helps to inform prevention, intervention, and policy.

Background

People living with HIV experience traumatic incidents at higher rates than the general population; and research has documented significant association between trauma exposure and the development of mental disorders. Mental health problems have a a negative impact on anti-retroviral treatment adherence. All of these psychosocial concerns play a role in potentially increasing HIV transmission to sexual partners resulting in increased incidence rates. To inform interventions that improve quality of life, and decrease risky behaviors for adolescents and youth, it is critical to understand the extent to which childhood trauma, mental health problems, and poor adherence occur and coexist in this population of adolescents living with HIV. Thus, this study examined the associations between childhood trauma, mental health problems (depression, anxiety, and substance use) and adherence to ART among HIV infected youth in Botswana.

Methods

A cross-sectional quantitative survey was conducted among youth aged 15 and 24-years old living with HIV. The Childhood Trauma Questionnaire- Short Form; Depression, Anxiety, Stress Scale (DASS-21; Car Relax Alone Forget Friends Trouble” or CRAFFT 2.1 + N were used to collect data on exposure to childhood trauma, mental health symptoms and problematic substance use respectively. Adherence was assessed objectively with viral load and subjectively with Simplified Medication Adherence Questionnaire. Data analysis was conducted using Stata version 15. Bivariate logistical regression analysis testing for associations between mental health symptoms, substance use and adherence, and childhood trauma was conducted. Multivariate logistic regression was subsequently performed controlling for variables found to be significantly associated with childhood trauma.

Results

Of the 119 youth, 47% of the participants reported experiencing at least one type of childhood trauma, and physical neglect was the most frequently reported. Emotional abuse, emotional neglect, physical abuse, sexual abuse and physical neglect were significantly associated with non-adherence, OR 5.83; OR 3.10; OR 5.97, and OR 2.52, respectively.

Conclusion

Our findings revealed that exposure to all domains of childhood trauma except physical abuse were significantly associated with non-adherence. Sexual abuse and emotional neglect had the highest odds of predicting non-adherence. This highlights the need for trauma focused psychosocial interventions in managing youth living with HIV.

Posttraumatic stress disorder (PTSD) is linked with self-harm and suicide, but few studies have examined these severe outcomes in relation to complex trauma. This study examined the associations between self-harm and suicide-related phenomena with ICD-11 complex PTSD (CPTSD) among treatment-seeking youths. A convenience sample of 109 adolescents with major depression (69.7% female; mean age = 15.24) were recruited from an outpatient psychiatric clinic. Participants completed measures for ICD-11 CPTSD, adverse childhood experiences (ACEs), self-harm behaviors, and past-year history of four suicide-related phenomena. Relationships between each self-harm and suicide-related variable with CPTSD were assessed at the symptom and diagnostic levels. Participants reported an average of three ACEs; 33.9% met diagnostic requirements for ICD-11 CPTSD. Past-year suicidal thought and attempt, but not self-harm, significantly associated with CPTSD status. At the symptom level, self-harm associated with CPTSD total symptom and all symptom clusters scores, with strongest associations found with symptoms of negative self-concept. CPTSD total symptom scores also associated strongly with past-year history of suicidal thought, plan, and attempt; the three core PTSD symptom clusters scores consistently and strongly linked with these suicide-related phenomena. For symptoms of complex trauma, relationship disturbances associated with having a suicide attempt, and negative self-concept associated with both having a plan and an attempt. Assessing and targeting ICD-11 CPTSD symptoms have potential to reduce self-harm and suicidality in young people experiencing mental distress, particularly for those with a trauma history and regardless of whether they meet criteria for a diagnosable trauma response.

The purpose of the current research study was to examine the relationship among Adverse Childhood Experiences (ACEs), racial discrimination, and internalizing problems (i.e., anxiety, depression) among Asian adolescents in the US. We used a subsample of Asian adolescents from the National Survey of Children's Health (NSCH) 2018–2019 (n = 1,110; age = 14.73 years; 47.8% male). Results of binary logistic regression analyses revealed most individual ACEs were not significantly associated with anxiety and depression, but ‘family mental illness’ had a strong association with the condition of depression (OR = 5.39, 95% CI [2.17, 13.40], p < .001). Racial discrimination was significantly associated with both anxiety (OR = 3.70, 95% CI [1.98, 6.89]) and depression (OR = 3.47., 95% CI [1.74, 6.91]), even after accounting for cumulative scores of other ACEs and sociodemographic covariates in the regression models. The findings demonstrate the unique role of racial discrimination in developing internalizing problems among Asian adolescents in the US. Implications for practitioners and future research are discussed.

Children growing up with alcohol-dependent parents have elevated risk for adverse childhood experiences (ACEs), but few studies have assessed the adverse effects of occasional or frequent exposure to parental intoxication episodes. This study examined whether such exposure was associated with increased risk of ACEs and negative psychological reactions (NPRs) in adolescence and young adulthood. The study relied on cross-sectional and longitudinal data from the Trøndelag Health Study in Norway and included 2,230 adolescents (ages 13–19 years) followed up 11 years later. Self-report questionnaires were used to collect information about exposure to parental intoxication, ACEs, and NPRs in adolescence and NPRs in young adulthood. Seeing parents drunk occasionally was associated with increased odds of six ACEs (odds ratios 1.42 [95% confidence interval 1.17–1.73] to 2.08 [1.44–3.01]) and increased odds of one NPR in adolescence (1.46, 1.12–1.91) compared with those who had never seen their parents intoxicated. Compared with those who had never seen parents intoxicated, seeing parents intoxicated frequently was associated with increased odds of all ACEs measured (1.80 [1.00–3.23] to 3.27 [1.92–5.56]), two NPRs in adolescence (1.60 [1.02–2.50] and 2.06 [1.30–3.27]), one NPR in adulthood (3.56, 1.83–6.94), and the perception of childhood as difficult/very difficult (2.99, 1.51–5.93). In conclusion, exposure to intoxicated parents was associated with increased risk of ACEs and NPRs during childhood, even at low frequency. Frequent exposure to parental intoxication was also associated with NPR in young adulthood.

To examine the associations between adverse childhood experiences (ACEs) and children’s obesogenic behaviors (meeting recommendations for sleep duration and screen time) in a representative sample of U.S. children and adolescents. This study assessed data from the 2019–2020 National Survey of Children’s Health. Separate multinomial logistic regressions examined the likelihood of failing to meet sleep and screen time recommendations given individual and cumulative ACE scores. 15,581 children (48% female, 32% non-White) experienced one ACE, representing 32% of the analyzed sample. Parents reported financial hardship as the most prevalent ACE (48%). After adjusting for child race/ethnicity, sex of the child, highest education in the household, and child age, we found that participants with four or more ACEs were (1) age-specific sleep recommendations compared with participants with zero ACEs (OR 1.96; 95%CI = 1.64–2.35), and (2) more likely to fall short of meeting screen use recommendations compared with participants with zero ACEs (OR 1.61; 95%CI = 1.26–2.07). U.S. children and adolescents who have experienced four or more ACEs are significantly more likely to fall short of sleep and screen time recommendations compared to their counterparts who experienced zero ACEs. Given the strong associations between ACEs and health outcomes in adulthood, screening for ACEs may better inform practitioners when attempting to improve youth health outcomes.

Rationale

Trauma from child abuse and neglect requires specialised assessment and intervention, especially for those experiencing complex trauma. Unfortunately, what constitutes complex trauma is contentious, alongside growing criticisms of diagnostic categories and labels. Recent literature critiques the symptom clusters and diagnostic categories/labels approach compared to focusing on the concrete impacts and functional nature of behavioural responses to trauma in context.

Aims

This research aimed to assess the conceptual maturity of complex trauma for children and young people who have experienced abuse and neglect by discussing the concept with Australian experts. The research aimed to conceptualise complex trauma through a dimensional lens and impacts-based approach. The overall aim was to increase understanding of the development and maintenance of complex trauma and its distinctiveness from other types of trauma.

Method

Group interviews were conducted, and reflexive thematic analysis was used to analyse the data. A member-checking survey helped review and improve the findings.

Results

Findings suggest a vast array of impacts from complex trauma, that diagnostic boxes may not be right for complex trauma, and that the potentially chaotic cycle of complex trauma perpetuates issues. Results from this pilot indicate that complex trauma may be an immature concept for expert clinicians and researchers alike.

Conclusions

Despite assessing complex trauma as an emerging or even immature concept, the discussion generates direction forward and suggests further research avenues. Associated ideas and emerging concepts begin a conceptual discussion of complex trauma.

Objective: Analyse the mediation role of emotional competences on behavior problems in adolescents exposed to Armed-Conflict Childhood Adversities (ACCA). Method: Families with adolescent children who studied in three schools in the municipality of Soacha, Colombia, were invited to participate in the study. One hundred and sixty-one participants were selected and pooled into three groups according to their Adverse Childhood Experiences (ACE) scores: lower-ACE (LACE), higher-ACE (HACE), and ACCA using the Adverse Childhood Experiences Questionnaire for Adolescents (ACE-QA). The Emotion Recognition Task, the Empathy for Pain Task, and the Child Behavior Checklist assessed teenagers’ emotional functioning. Results: Teenagers exposed to ACCA more frequently experienced childhood adversities such as domestic violence, child abuse, and parental neglect. Moreover, these adolescents were less accurate in discriminating angry faces, reported higher control perception after social stressors, were more rigorous in punishing those who intentionally harmed others, and showed more internalizing behavior problems. In the mediational model, we found that: the control perception after social stress mediated the reduction of depressive symptoms in adolescents with ACCA history. Additionally, inaccuracy in perceiving angry faces and harsh punishment toward behaviors that intentionally harm others mediated the presence of thinking problems, anxiety, and rule-breaking behaviors. Conclusions: Colombian adolescents who experienced ACCA showed specific changes in their emotional competences, which mediate the parental report of behavioral problems. These results indicate the need for more focused interventions aimed at improving the emotional competences and mental health of adolescent victims of armed conflicts.

Research examining the influence of physical and emotional sibling violence on siblings’ relationships across the lifespan is scant. This exploratory research examined whether affect, behavior, and cognitions associated with closest-aged sibling relationships in childhood as well as the occurrence of behaviors associated with physical and emotional sibling violence in childhood impacted adult sibling relationships in a sample of 156 adults. Using the Lifespan Sibling Relationship Scale (Riggio J Soc Pers Relat 17(6):707–728, 2000), associations were found between all aspects of childhood and adulthood sibling relationships. Frequency of sibling violence behaviors correlated with Child Affect and Adult Behavior. Differences were found between females and males on Child Affect, Adult Behavior, and Frequency of Sibling Violence Behaviors. Regression models examined whether childhood sibling relationship quality (Child Affect, Child Behavior, Child Cognitions), frequency of sibling violence behaviors in childhood, and gender predicted Adult Affect, Adult Behavior, Adult Cognitions. Child Affect and Child Cognitions predicted Adult Affect, Child Behavior and gender predicted Adult Behavior, and only Child Cognitions predicted Adult Cognition. Frequency of physical and emotional sibling violence in childhood did not predict Adult Affect, Adult Behavior, or Adult Cognitions individually. However, frequency of physical and emotional sibling violence in childhood was associated with a total adult sibling relationship score when controlling for a total childhood sibling relationship score. Findings suggest the need for future research to consider the complexity of closest-aged sibling relationships across the lifespan and how physical and emotional sibling violence factors into how individuals perceive their relationships with siblings.