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Espinoza CN, Goering M, Mrug S. Disclosure of Exposure to Violence in Urban Adolescents. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1161-1189. [PMID: 37799041 DOI: 10.1177/08862605231202979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Research has documented high rates of exposure to violence in urban African American adolescents together with their negative effects on psychosocial adjustment. Coping with violence exposure may be facilitated by disclosure of these experiences to others, but little is known about the extent to which youth disclose their various experiences with violence. This study examined the prevalence of disclosure of violence experienced as a witness or victim in different contexts or locations to parents, friends, siblings, teachers, counselors, and relatives. Urban African American adolescents from Southeastern U.S. were interviewed at three time points (N = 81; average ages 13.3, 16.1, and 17.8). Across the three time points, 90% to 91% witnessed violence and 64% to 81% were victimized in the last year. Of these youth, 40% to 53% disclosed experiences of witnessing violence and 29% to 52% disclosed experiences of victimization. The results showed that disclosure of violence most often involved parents and friends, with fewer youth disclosing to teachers and counselors. Disclosure of violence victimization increased from early to late adolescence. Experiences of dating violence victimization were less likely to be disclosed by adolescents, especially among males. These findings support the need for more research on adolescents' disclosure of violence exposure and its links to adjustment, with implications for interventions aimed at improving coping in youth exposed to violence.
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2
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Henriksen M, Skrove M, Hoftun GB, Sund ER, Lydersen S, Kalvin CB, Sukhodolsky DG. Exposure to traumatic events poses greater risk for irritability in girls than in boys. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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3
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Ruchkin V, Isaksson J, Schwab-Stone M, Stickley A. Prevalence and early risk factors for bulimia nervosa symptoms in inner-city youth: gender and ethnicity perspectives. J Eat Disord 2021; 9:136. [PMID: 34674763 PMCID: PMC8529812 DOI: 10.1186/s40337-021-00479-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Research on risk factors associated with bulimia nervosa symptoms (BN) in ethnic minorities has been limited. This study adds to the existing literature by providing the ethnicity- and gender-specific prevalence of BN in US inner-city youth and by exploring the longitudinal associations between a clinical level of BN and early risk factors assessed one year previously. METHODS The study was conducted on a representative sample of predominantly ethnic minority youth (N = 2794; 54.1% female; age 11-16 years old (M(SD) = 12.77(1.29)); 60.0% African-American, 26.1% Hispanic American, 13.9% White). Self-reported information was obtained on BN and early risk factors (e.g., depressive and anxiety symptoms, posttraumatic stress, somatic complaints). Multivariate analysis of covariance was used to examine the longitudinal associations. RESULTS The 3-month BN prevalence was higher in girls (5.1%) than in boys (2.3%) (ratio 2.22:1). Significant differences in BN rates were found between White and African American students (higher in Whites), whereas Hispanic-Americans did not differ significantly from either group. Individuals with BN had significantly higher levels of early risk factors one year prior. CONCLUSIONS Timely recognition of BN and associated early risk factors is important for early prevention and intervention strategies.
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Affiliation(s)
- Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85, Uppsala, Sweden. .,Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA. .,Säter Forensic Psychiatric Clinic, 783 27, Säter, Sweden.
| | - Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, 751 85, Uppsala, Sweden.,Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Mary Schwab-Stone
- Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.,Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
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4
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Allen L, Ashford PA, Beeson E, Byford S, Chow J, Dalgleish T, Danese A, Finn J, Goodall B, Grainger L, Hammond M, Humphrey A, Mahoney-Davies G, Morant N, Shepstone L, Sims E, Smith P, Stallard P, Swanepoel A, Trickey D, Trigg K, Wilson J, Meiser-Stedman R. DECRYPT trial: study protocol for a phase II randomised controlled trial of cognitive therapy for post-traumatic stress disorder (PTSD) in youth exposed to multiple traumatic stressors. BMJ Open 2021; 11:e047600. [PMID: 34210731 PMCID: PMC8252885 DOI: 10.1136/bmjopen-2020-047600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a distressing and disabling condition that affects significant numbers of children and adolescents. Youth exposed to multiple traumas (eg, abuse, domestic violence) are at particular risk of developing PTSD. Cognitive therapy for PTSD (CT-PTSD), derived from adult work, is a theoretically informed, disorder-specific form of trauma-focused cognitive-behavioural therapy. While efficacious for child and adolescent single-event trauma samples, its effectiveness in routine settings with more complex, multiple trauma-exposed youth has not been established. The Delivery of Cognitive Therapy for Young People after Trauma randomised controlled trial (RCT) examines the effectiveness of CT-PTSD for treating PTSD following multiple trauma exposure in children and young people in comparison with treatment as usual (TAU). METHODS/DESIGN This protocol describes a two-arm, patient-level, single blind, superiority RCT comparing CT-PTSD (n=60) with TAU (n=60) in children and young people aged 8-17 years with a diagnosis of PTSD following multiple trauma exposure. The primary outcome is PTSD severity assessed using the Children's Revised Impact of Event Scale (8-item version) at post-treatment (ie, approximately 5 months post-randomisation). Secondary outcomes include structured interview assessment for PTSD, complex PTSD symptoms, depression and anxiety, overall functioning and parent-rated mental health. Mid-treatment and 11-month and 29-month post-randomisation assessments will also be completed. Process-outcome evaluation will consider which mechanisms underpin or moderate recovery. Qualitative interviews with the young people, their families and their therapists will be undertaken. Cost-effectiveness of CT-PTSD relative to TAU will be also be assessed. ETHICS AND DISSEMINATION This trial protocol has been approved by a UK Health Research Authority Research Ethics Committee (East of England-Cambridge South, 16/EE/0233). Findings will be disseminated broadly via peer-reviewed empirical journal articles, conference presentations and clinical workshops. TRIAL REGISTRATION ISRCTN12077707. Registered 24 October 2016 (http://www.isrctn.com/ISRCTN12077707). Trial recruitment commenced on 1 February 2017. It is anticipated that recruitment will continue until June 2021, with 11-month assessments being concluded in May 2022.
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Affiliation(s)
- Leila Allen
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Polly-Anna Ashford
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ella Beeson
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK
| | - Sarah Byford
- King's Health Economics, King's College London, London, UK
| | - Jessica Chow
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Tim Dalgleish
- MRC Cognition and Brain Sciences Unit, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Andrea Danese
- Department of Child and Adolescent Psychiatry, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Jack Finn
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ben Goodall
- North East London NHS Foundation Trust, Rainham, UK
| | - Lauren Grainger
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Matthew Hammond
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ayla Humphrey
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | | | - Nicola Morant
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Lee Shepstone
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Erika Sims
- Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Patrick Smith
- Department of Psychology, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | | | - Annie Swanepoel
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK
| | - David Trickey
- Specialist Trauma and Maltreatment Service, Anna Freud National Centre for Children and Families, London, UK
| | - Katie Trigg
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jon Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
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5
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Isaksson J, Sukhodolsky DG, Koposov R, Stickley A, Ruchkin V. The Role of Gender in the Associations Among Posttraumatic Stress Symptoms, Anger, and Aggression in Russian Adolescents. J Trauma Stress 2020; 33:552-563. [PMID: 32384585 DOI: 10.1002/jts.22502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/01/2019] [Accepted: 11/05/2019] [Indexed: 11/10/2022]
Abstract
Symptoms of posttraumatic stress disorder (PTSD) have been linked to anger and aggressive behavior in adult and veteran populations. However, research on the associations among anger, aggression, and PTSD in adolescents is lacking, particularly regarding differences between the sexes. To address this research gap, we used self-report data from Russian adolescents (N = 2,810; age range: 13-17 years) to perform a full path analysis examining the associations between PTSD symptoms and the emotional (anger traits) and cognitive (rumination) components of anger as well as physical/verbal and social aggression, after adjusting for depressive symptoms. We also examined the interaction effects between PTSD symptoms and sex on anger and aggression. The results indicated that girls scored higher on measures of anger and PTSD symptoms, ds = 0.20-0.32, whereas boys scored higher on measures of physical and verbal aggression, d = 0.54. Clinical levels of PTSD symptoms were associated with anger rumination, β = .16, and trait anger, β = .06, and an interaction effect for PTSD symptoms and sex was found for aggression, whereby boys with clinical levels of PTSD symptoms reported more physical/verbal and social aggression, βs = .05 and .20, respectively. Our findings suggest that PTSD symptoms may have an important impact on anger, anger rumination, and aggression during adolescence. In particular, boys seem to have an increased risk for aggressive behavior in the presence of PTSD symptoms. The present results highlight the importance of taking anger and aggression into account when evaluating PTSD.
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Affiliation(s)
- Johan Isaksson
- Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden.,Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit, Centre for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden
| | - Denis G Sukhodolsky
- Child Study Centre, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, The Arctic University of Norway, Tromsö, Norway
| | - Andrew Stickley
- Stockholm Centre for Health and Social Change (SCOHOST), Sodertorn University, Huddinge, Sweden.,Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Vladislav Ruchkin
- Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden.,Child Study Centre, Yale University School of Medicine, New Haven, Connecticut, USA.,Säter Psychiatric Clinic, Säter, Sweden
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6
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Parker J, Olson S, Bunde J. The Impact of Trauma-Based Training on Educators. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:217-227. [PMID: 32549933 PMCID: PMC7289915 DOI: 10.1007/s40653-019-00261-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
An extensive literature establishing the prevalence of Adverse Childhood Experiences (ACEs) and their destructive impact over the lifespan has motivated recent efforts to fundamentally alter the educational milieu. One such initiative, entitled "Compassionate Schools," involves the training of educators in trauma-informed and trauma-sensitive practices, in the hopes of creating scholastic environments more conducive to widespread resilience. Despite encouraging initial reports, few studies have empirically evaluated the impact of Compassionate Schools training on attendees. The current investigation reports the results of two studies. In Study 1, participants completed a questionnaire 6 months after their Compassionate Schools trainings, including items relevant to mindset and behavior change. In Study 2, participants completed the Attitudes Relevant to Trauma Informed Care (ARTIC) scale before and after a Compassionate Schools training. The majority of participants in Study 1 reported enduring changes in mindset and behavior as a result of their trainings, and described those changes in terms consistent with the Compassionate Schools model. ARTIC responses in Study 2 suggested marked trauma-informed attitudinal improvements between pre- and post-training assessments. These data, although preliminary, are consistent with the Compassionate Schools paradigm, and empirically support its promise as a ACEs-informed intervention for educators.
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Affiliation(s)
- Jennifer Parker
- Child Protection Training Center, University of South Carolina Upstate, 160 E. St. John Street, Spartanburg, SC 29306 USA
| | - Stacey Olson
- Child Protection Training Center, University of South Carolina Upstate, 160 E. St. John Street, Spartanburg, SC 29306 USA
| | - James Bunde
- Psychology Department, University of South Carolina Upstate, Spartanburg, SC USA
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7
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Rudd BN, Last BS, Gregor C, Jackson K, Berkowitz S, Zinny A, Kratz HE, Cliggitt L, Adams DR, Walsh LM, Beidas RS. Benchmarking Treatment Effectiveness of Community-Delivered Trauma-Focused Cognitive Behavioral Therapy. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:438-450. [PMID: 31429951 PMCID: PMC7136484 DOI: 10.1002/ajcp.12370] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
It is critical for urban youth with post-traumatic stress disorder (PTSD) living in poverty to have access to evidence-based interventions for their traumatic stress. However, there is limited research on the effectiveness of these interventions when provided in urban, community settings. The objectives of the current study are to (a) evaluate the effectiveness of trauma-focused cognitive behavioral therapy delivered from 2013 to 2016 in 15 behavioral health agencies on youth (N = 114) PTSD as well as general mental health symptoms and functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. Effectiveness data are from the Philadelphia County Community Behavioral Health System, a system that has invested significantly in the training and ongoing support of clinicians providing high-quality trauma services to youth since 2012. From baseline to last assessment, youth PTSD symptom severity (d = 0.34), PTSD functional impairment (d = 0.38), and overall mental health problem severity (d = 0.29) improved. The effect sizes of improvements were smaller than effect sizes observed in efficacy and effectiveness studies. This study is the first benchmarking study of TF-CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF-CBT to urban community settings that serve youth in poverty.
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Affiliation(s)
- Brittany N Rudd
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Briana S Last
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Courtney Gregor
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Steven Berkowitz
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- School of Medicine, University of Colorado, Boulder, CO, USA
| | - Arturo Zinny
- Community Behavioral Health, Philadelphia, PA, USA
- Center for Nonviolence and Social Justice, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Hilary E Kratz
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Psychology, La Salle University, Philadelphia, PA, USA
| | | | - Danielle R Adams
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- School of Social Service Administration, University of Chicago, Chicago, IL, USA
| | - Lucia M Walsh
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Rinad S Beidas
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PSICE@LDI), University of Pennsylvania, Philadelphia, PA, USA
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8
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Stickley A, Koposov R, Koyanagi A, Inoue Y, Ruchkin V. ADHD and depressive symptoms in adolescents: the role of community violence exposure. Soc Psychiatry Psychiatr Epidemiol 2019; 54:683-691. [PMID: 30706080 DOI: 10.1007/s00127-019-01662-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 01/21/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Comorbid depression is common in adolescents with attention-deficit/hyperactivity disorder (ADHD). As yet, however, little is known about the factors associated with co-occurring depression in this population. To address this research gap, the current study examined the role of community violence exposure in the association between ADHD symptoms and depression. METHODS Data came from 505 Russian adolescents [mean age 14.37 (SD = 0.96)] who had teacher-reported information on ADHD symptoms that was collected in conjunction with the Social and Health Assessment (SAHA). Adolescent self-reports of witnessing and being a victim of community violence were also obtained while depressive symptoms were self-assessed with an adapted version of the Center for Epidemiologic Studies-Depression Scale (CES-D). Logistic regression analyses were performed to examine associations. RESULTS In univariable analyses, both witnessing and being a victim of violence were associated with significantly increased odds for depressive symptoms in adolescents with ADHD symptoms compared to non-ADHD adolescents who had not experienced community violence. However, in the multivariable analysis only being a victim of violence continued to be associated with significantly increased odds for depression [odds ratio (OR) 4.67, 95% confidence interval (CI) 1.33-16.35]. CONCLUSION Exposure to community violence may be associated with depression in adolescents with ADHD symptoms. Clinicians should enquire about exposure to community violence in adolescents with ADHD/ADHD symptoms. Early therapeutic interventions to address the effects of violence exposure in adolescents with ADHD may be beneficial for preventing depression in this group.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 1878553, Japan. .,Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, 141 89, Huddinge, Sweden.
| | - Roman Koposov
- Regional Center for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsö, Norway
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, 28029, Madrid, Spain
| | - Yosuke Inoue
- Carolina Population Center, The University of North Carolina at Chapel Hill, 123 West Franklin St, Chapel Hill, NC, 27516, USA
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Child Study Centre, Yale University Medical School, New Haven, CT, 06520, USA
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9
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Perceived neighborhood quality, family processes, and trajectories of child and adolescent externalizing behaviors in the United States. Soc Sci Med 2017; 192:152-161. [DOI: 10.1016/j.socscimed.2017.07.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 07/21/2017] [Accepted: 07/29/2017] [Indexed: 11/23/2022]
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10
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Cromer KD, Villodas MT. Post-traumatic stress as a pathway to psychopathology among adolescents at high-risk for victimization. CHILD ABUSE & NEGLECT 2017; 67:182-192. [PMID: 28279865 DOI: 10.1016/j.chiabu.2017.02.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 02/11/2017] [Accepted: 02/17/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Victimization by violence elevates adolescents' risk for developing internalizing and externalizing psychopathology. Recent findings suggest that disruptions in developmental processes associated with post-traumatic stress (PTS) reactions may partially account for the relationship between victimization and the subsequent development of psychopathology during adolescence. The present study tested the temporal sequencing of these associations using multi-informant measurements in a large, diverse sample of adolescents at high-risk for victimization. METHOD Data were collected from a multi-site consortium of prospective studies, the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Information about 833 youth's victimization experiences (i.e., direct, indirect, familial, and non-familial violence), PTS, and affective, anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms were gathered from youth and their caregivers during biannual face-to-face interviews when youth were between the ages of 4 and 14 years, and continuously from official child protective services records. RESULTS Structural equation modeling revealed that cumulative victimization contributed to elevations in youth and caregiver reported late childhood and early adolescent psychopathology. While PTS mediated the association between victimization and youth reported ADHD, ODD, CD, major depressive, and generalized anxiety symptoms during adolescence, it only mediated the association between victimization and caregiver reported affective symptoms. CONCLUSIONS PTS reactions following childhood victimization partially accounted for escalations in psychopathology during the transition to adolescence. These findings underscore the importance of integrating trauma-informed assessment and intervention approaches with at-risk adolescents. Researchers should determine whether trauma-focused interventions sufficiently ameliorate other psychopathology among victimized adolescents or if additional interventions components are necessary.
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Affiliation(s)
- Kelly D Cromer
- Florida International University, Center for Children and Families, Main Office DM 256, 11200 S.W. 8th Street, Miami, FL 33199, United States; Florida International University, United States.
| | - Miguel T Villodas
- Florida International University, Center for Children and Families, Main Office DM 256, 11200 S.W. 8th Street, Miami, FL 33199, United States; Florida International University, United States.
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11
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Lüdtke J, Boonmann C, Dölitzsch C, In-Albon T, Jenkel N, Kölch M, Fegert JM, Schmeck K, Schmid M. Komorbide Angststörungen bei Störungen des Sozialverhaltens. KINDHEIT UND ENTWICKLUNG 2017. [DOI: 10.1026/0942-5403/a000221] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Obwohl Angststörungen (AS) häufig komorbid mit einer Störung des Sozialverhaltens (SSV) auftreten, wurde diese Komorbidität in der Forschung weitgehend vernachlässigt. Komorbide AS wirken sich in Studien sowohl positiv als auch negativ auf den Verlauf einer SSV aus. Diese Studie zielt darauf ab, Heranwachsende mit einer SSV mit und ohne AS hinsichtlich psychischer Belastung, traumatischen Erlebnissen, psychopathischen Persönlichkeitstraits und Legalbewährung zu untersuchen. 207 Heranwachsende mit einer SSV (9 – 25 Jahre; 73.4 % männlich; SSV: N = 180, SSV und AS: N = 27), die zum Zeitpunkt der Untersuchung in Jugendhilfeeinrichtungen lebten, konnten eingeschlossen werden. Es wurden strukturierte klinische Interviews und eine psychometrische Testbatterie eingesetzt. Die Resultate zeigen, dass die Gruppe mit SSV und AS signifikant weniger externalisierende und mehr internalisierende Symptome sowie traumatische Erlebnisse aufweisen. Bezüglich psychopathischer Persönlichkeitsmerkmale und Verurteilungen (>50 % in beiden Gruppen) ergaben sich keine signifikanten Gruppenunterschiede. Die Ergebnisse legen nahe, dass die Ausprägung der SSV für die Kriminalitätsentwicklung bedeutsamer und die spezifische Komorbidität von AS aber doch ätiologisch und symptomatisch von großem Interesse ist. Diese sollte deshalb mit Längsschnittstudien und Therapieprozessanalysen intensiver beforscht werden.
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Affiliation(s)
- Janine Lüdtke
- Universitäre Psychiatrische Kliniken Basel, Kinder- und Jugendpsychiatrische Klinik, Universität Basel
| | - Cyril Boonmann
- Universitäre Psychiatrische Kliniken Basel, Kinder- und Jugendpsychiatrische Klinik, Universität Basel
| | - Claudia Dölitzsch
- Universitätsklinikum Ulm, Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie
| | - Tina In-Albon
- Universität Koblenz-Landau, Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters
| | - Nils Jenkel
- Universitäre Psychiatrische Kliniken Basel, Kinder- und Jugendpsychiatrische Klinik, Universität Basel
| | - Michael Kölch
- Klinik für Kinder- und Jugendpsychiatrie/-psychotherapie der Ruppiner Kliniken Hochschulklinik Medizinischen Hochschule Brandenburg
| | - Jörg M. Fegert
- Universitätsklinikum Ulm, Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie
| | - Klaus Schmeck
- Universitäre Psychiatrische Kliniken Basel, Kinder- und Jugendpsychiatrische Klinik, Universität Basel
| | - Marc Schmid
- Universitäre Psychiatrische Kliniken Basel, Kinder- und Jugendpsychiatrische Klinik, Universität Basel
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12
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Posttraumatic Stress and Youth Violence Perpetration: a Population-Based Cross-Sectional Study. Eur Psychiatry 2016; 40:88-95. [DOI: 10.1016/j.eurpsy.2016.08.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/23/2016] [Accepted: 08/23/2016] [Indexed: 11/19/2022] Open
Abstract
AbstractBackgroundExposure to trauma was found to increase later violent behaviours in youth but the underlying psychopathological mechanisms are unclear. This study aimed to test whether posttraumatic stress disorder (PTSD) is related to violent behaviours and whether PTSD symptoms mediate the relationship between the number of trauma experiences and violent behaviours in adolescents.MethodThe present study is based on a nationally representative sample of 9th grade students with 3434 boys (mean age = 15.5 years) and 3194 girls (mean age = 15.5 years) in Switzerland. Lifetime exposure to traumatic events and current PTSD were assessed by the use of the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (UCLA-RI). Logistic regression was used to assess associations between PTSD and violent behaviours, and structural equation modelling (SEM) was used to examine the meditation effects of PTSD.ResultsPTSD (boys: OR = 7.9; girls: OR = 5.5) was strongly related to violent behaviours. PTSD symptoms partially mediated the association between trauma exposure and violent behaviours in boys but not in girls. PTSD symptoms of dysphoric arousal were positively related to violent behaviours in both genders. Anxious arousal symptoms were negatively related to violent behaviours in boys but not in girls.ConclusionsIn addition to trauma, posttraumatic stress is related to violent outcomes. However, specific symptom clusters of PTSD seem differently related to violent behaviours and they do not fully explain a trauma-violence link. Specific interventions to improve emotion regulation skills may be useful particularly in boys with elevated PTSD dysphoric arousal in order to break up the cycle of violence.
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Boonmann C, Grisso T, Guy LS, Colins OF, Mulder EA, Vahl P, Jansen LMC, Doreleijers TAH, Vermeiren RRJM. Childhood traumatic experiences and mental health problems in sexually offending and non-sexually offending juveniles. Child Adolesc Psychiatry Ment Health 2016; 10:45. [PMID: 27822305 PMCID: PMC5093963 DOI: 10.1186/s13034-016-0127-2] [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: 12/29/2015] [Accepted: 10/12/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To examine the relationship between a history of childhood abuse and mental health problems in juveniles who sexually offended (JSOs) over and above general offending behavior. METHODS A sample of 44 JSOs incarcerated in two juvenile detention centers in the Netherlands between May 2008 and March 2014 were examined for childhood abuse history (Childhood Trauma Questionnaire-Short Form) and mental health problems (Massachusetts Youth Screening Instrument-Version 2). Furthermore, the connection between childhood abuse and mental health problems in JSOs was compared to a sample of 44 propensity score matched juveniles who offended non-sexually (non-JSOs). RESULTS In JSOs, sexual abuse was related to anger problems, suicidal ideation, and thought disturbance. These associations were significantly stronger in JSOs than in non-JSOs. CONCLUSIONS Our results suggest that the relationship between childhood abuse and both internalizing and externalizing mental health problems is of more salience for understanding sexual offending than non-sexual offending, and should, therefore, be an important focus in the assessment and treatment of JSOs.
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Affiliation(s)
- Cyril Boonmann
- Department of Child and Adolescent Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical, P.O. Box 303, 1115 ZG Duivendrecht, Amsterdam, The Netherlands ,Department of Forensic Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, Basel, Switzerland
| | - Thomas Grisso
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA USA
| | - Laura S. Guy
- Department of Psychology, Simon Fraser University, Burnaby, BC Canada
| | - Olivier F. Colins
- Curium-LUMC, Leiden University Medical Center and Academic Workplace Forensic Care for Youth, Leiden, The Netherlands
| | - Eva A. Mulder
- Curium-LUMC, Leiden University Medical Center and Academic Workplace Forensic Care for Youth, Leiden, The Netherlands
| | - P. Vahl
- Curium-LUMC, Leiden University Medical Center and Academic Workplace Forensic Care for Youth, Leiden, The Netherlands
| | - Lucres M. C. Jansen
- Department of Child and Adolescent Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical, P.O. Box 303, 1115 ZG Duivendrecht, Amsterdam, The Netherlands
| | - Theo A. H. Doreleijers
- Department of Child and Adolescent Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical, P.O. Box 303, 1115 ZG Duivendrecht, Amsterdam, The Netherlands
| | - Robert R. J. M. Vermeiren
- Department of Child and Adolescent Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical, P.O. Box 303, 1115 ZG Duivendrecht, Amsterdam, The Netherlands ,Curium-LUMC, Leiden University Medical Center and Academic Workplace Forensic Care for Youth, Leiden, The Netherlands
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Yoon S, Steigerwald S, Holmes MR, Perzynski AT. Children's Exposure to Violence: The Underlying Effect of Posttraumatic Stress Symptoms on Behavior Problems. J Trauma Stress 2016; 29:72-9. [PMID: 26748761 DOI: 10.1002/jts.22063] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this study we investigated whether witnessing violence and violence victimization were associated with children's internalizing and externalizing behavior problems and examined the mediating role of posttraumatic stress (PTS) symptoms in these relationships. Secondary data analysis was conducted using 3 waves of data from the National Survey of Child and Adolescent Well-Being. Path analyses were conducted to test direct and indirect effects of violence exposure on behavior problems, using 2,064 children (ages 8-15 years) reported to Child Protective Services for maltreatment. Being a victim of violence in the home was directly associated with more internalizing (β = .06, p = .007) and externalizing behavior problems (β = .07, p = .002), whereas witnessing violence was not directly related to either internalizing (β = .04, p = .056) or externalizing behavior problems (β = .03, p = .130). PTS symptoms mediated the effects of witnessing violence and violence victimization on internalizing behavior problems (β = .02, p = .002). Our findings suggest that PTS symptoms may be a mechanism underlying the association between violence exposure and internalizing behavior problems (R(2) = .23), underscoring the potential importance of assessing PTS symptoms and providing targeted trauma-focused interventions for children exposed to violence at home.
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Affiliation(s)
- Susan Yoon
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Stacey Steigerwald
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Megan R Holmes
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Adam T Perzynski
- Center for Health Care Research and Policy, Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
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Post M, Hanten G, Li X, Schmidt AT, Avci G, Wilde EA, McCauley SR. Dimensions of trauma and specific symptoms of complex posttraumatic stress disorder in inner-city youth: a preliminary study. VIOLENCE AND VICTIMS 2014; 29:262-279. [PMID: 24834747 DOI: 10.1891/0886-6708.vv-d-12-00097r1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We examined relations of posttraumatic stress disorder (PTSD) symptoms with dimensions of trauma, including environment (Domestic vs. Community) and proximity (Indirect vs. Direct trauma) among inner-city youth. Participants (n = 65) reported traumatic events they had experienced on a version of the UCLA PTSD Reaction Index Trauma Exposure Screen, and reported PTSD symptoms with the PTSD Checklist--Civilian version (PCL-C). High rates of trauma and PTSD were found, consistent with other reports of inner-city youth. The 49% of youth surveyed met criteria for PTSD on the PCL-C symptom scale with a score cutoff of 35. Females reported elevated PTSD symptom scores and a higher incidence of Domestic trauma than did males but similar incidence of other trauma types. When males and females were combined, Domestic trauma significantly correlated with each of the PTSD symptom clusters of intrusions, numbing/avoidance, and hyperarousal. When participants with Community trauma were excluded from analyses to reduce confounding environmental influence, Domestic trauma marginally correlated with numbing/avoidance symptoms. Our findings suggest that Domestic trauma may result in more emotional numbing/avoidance symptoms than other types of trauma. Further analyses suggested that Community trauma may result in more intrusions and hyperarousal symptoms rather than emotional numbing. Environmental aspects of trauma, rather than the proximity of trauma, may have greater impact on presentation of PTSD. Future studies with larger samples are needed to confirm these findings.
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Leenarts LEW, Vermeiren RRJM, van de Ven PM, Lodewijks HPB, Doreleijers TAH, Lindauer RJL. Relationships between interpersonal trauma, symptoms of posttraumatic stress disorder, and other mental health problems in girls in compulsory residential care. J Trauma Stress 2013; 26:526-9. [PMID: 23900886 DOI: 10.1002/jts.21831] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This cross-sectional study examined the relationships (using structural equation modeling) between exposure to early-onset interpersonal trauma, symptoms of posttraumatic stress disorder (PTSD), symptoms of complex PTSD, and other mental health problems. The participants were 92 girls recruited from 3 residential treatment facilities. Exposure to early-onset interpersonal trauma was directly related to mental health problems and symptoms of PTSD mediated the relationship between exposure to early-onset interpersonal trauma and mental health problems. Symptoms of complex PTSD did not significantly mediate this relationship. These findings have direct implications for rehabilitation efforts in girls in compulsory residential care.
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Affiliation(s)
- Laura E W Leenarts
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
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Henrich CC, Shahar G. Effects of exposure to rocket attacks on adolescent distress and violence: a 4-year longitudinal study. J Am Acad Child Adolesc Psychiatry 2013; 52:619-27. [PMID: 23702451 DOI: 10.1016/j.jaac.2013.02.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 02/19/2013] [Accepted: 02/15/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The effects of Israeli adolescents' exposure to rocket attacks over time were examined, focusing on anxiety, depression, aggression, and violence commission. METHOD A sample of 362 adolescents from southern Israel was followed from 2008 through 2011 with four annual assessments. Measures included exposure to rocket attacks (gauging whether children were affected by rocket attacks, both directly and indirectly, through friends and family), anxiety (items from the State Anxiety Inventory), depression (the Center for Epidemiological Studies Child Depression Scale), aggression (the Orpinas Aggression Scale), and violence commission (from the Social and Health Assessment). RESULTS Concurrent and longitudinal findings differed. Wave 1 exposure to rockets attacks was associated with Wave 1 anxiety, depression, and aggression. Longitudinal results evinced only modest effects of exposure on anxiety and depression, no effects on aggression, but robust effects on violence commission. Exposure to terror attacks before the study predicted increased odds of violence commission at the fourth and final wave, controlling for violence commission at the first, second, and third wave. Exposure to rocket attacks in the second wave predicted increased odds of violence commission at the third wave. CONCLUSION This is the first longitudinal study attesting to the prospective longitudinal effect of exposure to terrorism on adolescent violence. Findings should serve as a red flag for health care practitioners working in civil areas afflicted by terrorism and political violence.
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Leenarts LEW, Diehle J, Doreleijers TAH, Jansma EP, Lindauer RJL. Evidence-based treatments for children with trauma-related psychopathology as a result of childhood maltreatment: a systematic review. Eur Child Adolesc Psychiatry 2013; 22:269-83. [PMID: 23266844 DOI: 10.1007/s00787-012-0367-5] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Accepted: 12/12/2012] [Indexed: 11/26/2022]
Abstract
This is a systematic review of evidence-based treatments for children exposed to childhood maltreatment. Because exposure to childhood maltreatment has been associated with a broad range of trauma-related psychopathology (e.g., PTSD, anxiety, suicidal ideation, substance abuse) and with aggressive and violent behavior, this review describes psychotherapeutic treatments which focus on former broad range of psychopathological outcomes. A total of 26 randomized controlled clinical trials and seven non-randomized controlled clinical trials published between 2000 and 2012 satisfied the inclusionary criteria and were included. These studies dealt with various kinds of samples, from sexually abused and maltreated children in child psychiatric outpatient clinics or in foster care to traumatized incarcerated boys. A total of 27 studies evaluated psychotherapeutic treatments which used trauma-focused cognitive, behavioral or cognitive-behavioral techniques; only two studies evaluated trauma-specific treatments for children and adolescents with comorbid aggressive or violent behavior; and four studies evaluated psychotherapeutic treatments that predominantly focused on other mental health problems than PTSD and used non-trauma focused cognitive, behavioral or cognitive-behavioral techniques. The results of this review suggest that trauma-focused cognitive-behavioral therapy (TF-CBT) is the best-supported treatment for children following childhood maltreatment. However, in line with increased interest in the diagnosis of complex PTSD and given the likely relationship between childhood maltreatment and aggressive and violent behavior, the authors suggest that clinical practice should address a phase-oriented approach. This review concludes with a discussion of future research directions and limitations.
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Affiliation(s)
- Laura E W Leenarts
- Department of Child and Adolescent Psychiatry, VU University Medical Center, De Bascule, Duivendrecht, P.O. Box 303, 1115 ZG, Amsterdam, The Netherlands.
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Saewyc EM, Chen W. TO WHAT EXTENT CAN ADOLESCENT SUICIDE ATTEMPTS BE ATTRIBUTED TO VIOLENCE EXPOSURE? A POPULATION-BASED STUDY FROM WESTERN CANADA. ACTA ACUST UNITED AC 2013; 32:79-94. [PMID: 26709332 DOI: 10.7870/cjcmh-2013-007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Suicide is the second leading cause of death among adolescents in Canada and globally. The purpose of our study was to calculate what proportion of adolescent suicide attempts could be prevented in the absence of verbal, physical and sexual violence. Using the province-wide 2008 British Columbia Adolescent Health Survey (N=29,315) we calculated population-attributable fractions for each type of violence, as well as exposure to any violence, separately by gender, among adolescents age 12-19. We found violence victimization is implicated in the majority of suicide attempts. Focusing on violence prevention may be an important strategy for reducing suicide among young people.
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Affiliation(s)
- Elizabeth M Saewyc
- University of British Columbia School of Nursing, Vancouver, British Columbia
| | - Weihong Chen
- University of British Columbia School of Nursing, Vancouver, British Columbia
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Curtis S, Pain R, Fuller S, Khatib Y, Rothon C, Stansfeld SA, Daya S. Neighbourhood risk factors for Common Mental Disorders among young people aged 10–20 years: A structured review of quantitative research. Health Place 2013; 20:81-90. [DOI: 10.1016/j.healthplace.2012.10.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 10/02/2012] [Accepted: 10/18/2012] [Indexed: 01/16/2023]
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Busby DR, Lambert SF, Ialongo NS. Psychological symptoms linking exposure to community violence and academic functioning in African American adolescents. J Youth Adolesc 2013; 42:250-62. [PMID: 23277294 DOI: 10.1007/s10964-012-9895-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
Abstract
African American adolescents are exposed disproportionately to community violence, increasing their risk for emotional and behavioral symptoms that can detract from learning and undermine academic outcomes. The present study examined whether aggressive behavior and depressive and anxious symptoms mediated the association between exposure to community violence and academic functioning, and if the indirect effects of community violence on academic functioning differed for boys and girls, in a community sample of urban African American adolescents (N = 491; 46.6 % female). Structural equation modeling was used to examine the indirect effect of exposure to community violence in grade 6 on grade 8 academic functioning. Results revealed that aggression in grade 7 mediated the association between grade 6 exposure to community violence and grade 8 academic functioning. There were no indirect effects through depressive and anxious symptoms, and gender did not moderate the indirect effect. Findings highlight the importance of targeting aggressive behavior for youth exposed to community violence to not only improve their behavioral adjustment but also their academic functioning. Implications for future research are discussed.
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Affiliation(s)
- Danielle R Busby
- Department of Psychology, The George Washington University, Washington, DC 20052, USA.
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Perkins SC, Cortina KS, Smith-Darden JP, Graham-Bermann SA. The mediating role of self-regulation between intrafamilial violence and mental health adjustment in incarcerated male adolescents. JOURNAL OF INTERPERSONAL VIOLENCE 2012; 27:1199-224. [PMID: 22080578 PMCID: PMC4129515 DOI: 10.1177/0886260511425240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This article investigates the relation between history of intrafamilial violence and self-regulatory capacity, cognitive processing, and mental health adjustment in incarcerated adolescents. Adolescents were incarcerated at the time of the study for various violent offenses, ranging from persistent delinquency to sexual assault (n = 115). A model is proposed that posits that self-regulation, cognitive ability, and cognitive processing are integral to the relation between intrafamilial violence and mental health function. The primary hypothesis of the study tests this mediation model. The relations between mental health, cognitive processing, self-regulation, and intrafamilial violence are also examined. The study was conducted during two sessions at a juvenile facility in the Midwest using survey measures, academic and intelligence testing, and cognitive tasks. Youth were between the ages of 13 and 20. Approximately 70% were previously diagnosed with a disability. Significant Pearson's correlations were found between seven out of eight mental health subscales of the Youth Self-Report (YSR) and intrafamilial violence history. Structural equation modeling was used to examine the role of cognitive processing in the association between intrafamilial violence and mental health function. Nonverbal or performance deficits, a significant difference between verbal skills and nonverbal skills, were related to intrafamilial violence. Self-regulation partially mediated the relation between intrafamilial violence and mental health function. Self-regulation ability may be compromised by intrafamilial violence and be a precursor to both internalizing and externalizing mental health problem in incarcerated youth. Educational, clinical, and research implications are discussed.
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Cerdá M, DiGangi J, Galea S, Koenen K. Epidemiologic research on interpersonal violence and common psychiatric disorders: where do we go from here? Depress Anxiety 2012; 29:359-85. [PMID: 22553006 PMCID: PMC3375609 DOI: 10.1002/da.21947] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Magdalena Cerdá
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York,Correspondence to: Magdalena Cerdá, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W168th St., New York, NY 10032.
| | - Julia DiGangi
- Department of Clinical Psychology, DePaul University, Chicago, Illinois
| | - Sandro Galea
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Karestan Koenen
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Perkins S, Graham-Bermann S. Violence Exposure and the Development of School-Related Functioning: Mental Health, Neurocognition, and Learning. AGGRESSION AND VIOLENT BEHAVIOR 2012; 17:89-98. [PMID: 22837647 PMCID: PMC3402358 DOI: 10.1016/j.avb.2011.10.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The relation between history of violence exposure and the development of academic and mental health problems is explored. Violence exposed children have an increased risk of developing school-related problems including: mental health problems, learning disabilities, language impairments, and other neurocognitive problems. These problems interact to create a complex web of deficits and disabilities where intervention access points are difficult to assess. Often mental health problems and academic problems develop in parallel. Timing of violence exposure and the developmental stage of the child during exposure complicate our understanding of the underlying mechanism. A model is presented that explores pathways linking violence exposure to aspects of school-related functioning, both academically and behaviorally. Early life stress, in the form of violence exposure, is related to neurocognitive deficits, including executive functioning and problems in self-regulation. Deficits in self-regulation at the level of behavior, and cognitive control and executive functioning, at the level of brain processing, are related to both academic and mental health problems, suggesting a possible psychological mechanism. Biological mechanisms are also included in the model to illustrate the contribution of the stress response, neuroendocrine system response, and neuroanatomical structural and functional impairments associated with violence exposure.
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Huculak S, McLennan JD, Bordin IAS. Exposure to violence in incarcerated youth from the city of São Paulo. BRAZILIAN JOURNAL OF PSYCHIATRY 2011; 33:275-82. [PMID: 21971781 DOI: 10.1590/s1516-44462011000300011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 09/27/2010] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aimed to determine the extent of exposure to community violence among delinquent Brazilian youth in the 12-month period prior to their incarceration and to identify factors associated with this exposure. METHOD With an oversampling of girls, a cross-section of youth under 18 years of age from juvenile detention units in the city of São Paulo, Brazil completed a structured interview. Key items related to exposure to violence (witnessed and experienced) were drawn from the Social and Health Assessment questionnaire to cover the 12-month period prior to incarceration. RESULTS Participants (n = 325, 89% boys) reported high rates of exposure to violence with largely similar levels for boys and girls. Being threatened with physical harm, being beaten or mugged and/or shot at were the most common forms of violence experienced. After controlling for demographic and family variables, the fact of having peers involved in risk behavior, easy access to guns and previous involvement with the justice system were associated with witnessed violence; whereas having slept on the street was the only variable associated with experienced violence. CONCLUSION This group of youth was exposed to high levels of violence and other adverse experiences. Future research should examine the effectiveness of strategies aimed at reducing the exposure to violence of high-risk youth.
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Affiliation(s)
- Susan Huculak
- Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Overstreet S, Mathews T. Challenges associated with exposure to chronic trauma:Using a public health framework to foster resilient outcomes among youth. PSYCHOLOGY IN THE SCHOOLS 2011. [DOI: 10.1002/pits.20584] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Landstedt E, Gillander Gådin K. Experiences of violence among adolescents: gender patterns in types, perpetrators and associated psychological distress. Int J Public Health 2011; 56:419-27. [DOI: 10.1007/s00038-011-0258-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 03/15/2011] [Accepted: 04/19/2011] [Indexed: 01/15/2023] Open
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Children's exposure to violence and distress symptoms: influence of caretakers' psychological functioning. Int J Behav Med 2010; 18:35-43. [PMID: 20405263 DOI: 10.1007/s12529-010-9090-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Accepted: 03/30/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Previous studies linking violence exposure to adverse child behavior have typically relied on parental report of child symptoms without accounting for the informant's mental well-being, despite evidence that parental mental health can influence children's mental health and the parent's report of distress symptoms. PURPOSE We assess the influence of maternal depression on the violence exposure and child distress association in a subset of the Maternal Infant Smoking Study of East Boston, a prospective birth cohort. METHODS Mothers reported on their children's violence exposure using the Survey of Children's Exposure to Community Violence (ETV) and completed the Checklist of Child Distress Symptoms (CCDS). The children also completed the ETV survey and the self-report version of the CCDS. Linear regression was used to assess the influence of violence exposure on distress symptoms adjusting for potential confounders, first using parent's report of exposure and outcome and a second time using the child's self-report. The mediating effect of maternal depression on the violence and distress association was also tested. RESULTS Among the 162 children ages 7 to 11, 51% were boys and 43% self-identified as Hispanic. When using child self-report, increased violence exposure was significantly associated with a broader range of distress symptoms (numbness, arousal, intrusion, avoidance subscales) compared to parent reported findings, which were only significantly related to the intrusion and avoidance subscales. Moreover, a significant mediation effect of maternal depression on the violence and distress association was noted only when mother's report of exposure and outcome was used. CONCLUSION Considering both parent and child self-report of violence is necessary to obtain a complete picture of violence exposure because parents and children may be offering different, although equally valid information. The influence of maternal depressive symptoms on preadolescent's distress symptoms may be attributed to reporting bias as opposed to more direct effects; thus, the parent's psychological functioning should be taken into consideration when relying on parental report of the child's psychological functioning.
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Mitchell SJ, Lewin A, Horn IB, Valentine D, Sanders-Phillips K, Joseph JG. How does violence exposure affect the psychological health and parenting of young African-American mothers? Soc Sci Med 2010; 70:526-33. [PMID: 19932932 PMCID: PMC2853478 DOI: 10.1016/j.socscimed.2009.10.048] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Indexed: 11/27/2022]
Abstract
Urban, minority, adolescent mothers are particularly vulnerable to violence exposure, which may increase their children's developmental risk through maternal depression and negative parenting. The current study tests a conceptual model of the effects of community and contextual violence exposure on the mental health and parenting of young, African-American mothers living in Washington, DC. A path analysis revealed significant direct effects of witnessed and experienced violence on mothers' depressive symptoms and general aggression. Experiences of discrimination were also associated with increased depressive symptoms. Moreover, there were significant indirect effects of mothers' violence exposure on disciplinary practices through depression and aggression. These findings highlight the range of violence young African-American mothers are exposed to and how these experiences affect their mental health, particularly depressive symptoms, and thus disciplinary practices.
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Biros MH, Mann J, Hanson R, Cen YY. Unsuspected or unacknowledged depressive symptoms in young adult emergency department patients. Acad Emerg Med 2009; 16:288-94. [PMID: 19154563 DOI: 10.1111/j.1553-2712.2008.00344.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objective was to determine the frequency of unsuspected or unacknowledged depressive symptoms among young adult emergency department (ED) patients. METHODS The Beck Depression Inventory-II (BDI-II) and a demographic/lifestyle questionnaire were administered to a cross-section of medically stable, English-speaking young adult ED patients (aged 18-23 years) with nonpsychiatric chief complaints. The frequency of moderate to severe depressive symptoms was determined. Group results were analyzed with descriptive statistics; multivariate analysis assessed for patient characteristics associated with depressive symptoms. RESULTS A total of 2,898 patients were screened; 2,255 were eligible for enrollment, and 1,264 enrolled (56%; 64% female, 42% African American; mean age = 21 [+/-1.7] years). Twenty-nine percent had BDI-II scores consistent with moderate to severe depressive symptoms. Patient characteristics associated with depressive symptoms included knowledge of someone who had intentionally hurt him- or herself (odds ratio [OR] = 2) or died a violent nonaccidental death (OR = 1.4), low personal income (OR = 1.8), chronic health issues (OR = 1.7), cigarette smoking (OR = 1.6), and African American race (OR = 1.5). Those who attended school (OR = 0.5), engaged in frequent social activities (OR = 0.5), or drove a car (OR = 0.7) were less likely to have depressive symptoms. Patients lacked insight into their depressive symptoms. CONCLUSIONS There is a high prevalence of depressive symptoms in young adult ED patients. Young adults often do not recognize, or are reluctant to acknowledge, depressive symptoms. Specific patient characteristics may be useful in deciding which young adults should undergo ED screening for depression.
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Affiliation(s)
- Michelle H Biros
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USA.
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Jaycox LH, Langley AK, Stein BD, Wong M, Sharma P, Scott M, Schonlau M. Support for Students Exposed to Trauma: A Pilot Study. SCHOOL MENTAL HEALTH 2009; 1:49-60. [PMID: 20811511 DOI: 10.1007/s12310-009-9007-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
With high rates of trauma exposure among students, the need for intervention programs is clear. Delivery of such programs in the school setting eliminates key barriers to access, but there are few programs that demonstrate efficacy in this setting. Programs to date have been designed for delivery by clinicians, who are a scarce resource in many schools. This study describes preliminary feasibility and acceptability data from a pilot study of a new program, Support for Students Exposed to Trauma, adapted from the Cognitive Behavioral Intervention for Trauma in Schools (CBITS) program. Because of its "pilot" nature, all results from the study should be viewed as preliminary. Results show that the program can be implemented successfully by teachers and school counselors, with good satisfaction among students and parents. Pilot data show small reductions in symptoms among the students in the SSET program, suggesting that this program shows promise that warrants a full evaluation of effectiveness.
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Spilsbury JC. Sleep as a mediator in the pathway from violence-induced traumatic stress to poorer health and functioning: a review of the literature and proposed conceptual model. Behav Sleep Med 2009; 7:223-44. [PMID: 19787492 PMCID: PMC3576851 DOI: 10.1080/15402000903190207] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Millions of children are exposed to various forms of violence every year, resulting-for many of them-in psychological problems, decreased social functioning, and poorer overall quality of their relationships and lives. This article reviews the scientific literature investigating the role of sleep as a key mediator in the pathway between violence-induced traumatic stress and resulting negative health and behavioral outcomes. Based on evidence revealed by this review and general research on how exposure to violence influences child health and development, a conceptual model is proposed that posits sleep's role as an important mediator of health effects and that incorporates other factors believed to shape linkages between exposure to violence and health and behavioral outcomes in children. Recommendations are given for future research to test the proposed model.
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Affiliation(s)
- James C Spilsbury
- Center for Clinical Investigation, Case School of Medicine, Cleveland, OH 44106, USA.
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McDonald CC, Richmond TR. The relationship between community violence exposure and mental health symptoms in urban adolescents. J Psychiatr Ment Health Nurs 2008; 15:833-49. [PMID: 19012675 PMCID: PMC2821658 DOI: 10.1111/j.1365-2850.2008.01321.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Urban adolescents are exposed to a substantial amount of community violence which has the potential to influence psychological functioning. To examine the relationship between community violence exposure and mental health symptoms in urban adolescents, a literature review using MEDLINE, CINAHL, PubMed, PsycINFO, CSA Social Services and CSA Sociological Abstracts was conducted. Search terms included adolescent/adolescence, violence, urban, mental health, well-being, emotional distress, depression, anxiety, posttraumatic stress disorder and aggression. Twenty-six empirical research articles from 1997 to 2007 met inclusion criteria for review. Findings indicate an influence of community violence exposure on mental health symptoms, particularly posttraumatic stress and aggression. Mediators and moderators for community violence exposure and mental health symptoms help explain relationships. Limitations in the literature are the lack of consistency in measurement and analysis of community violence exposure, including assessment of proximity and time frame of exposure, and in analysis of victimization and witnessing of community violence. Knowledge about identification of urban adolescents exposed to chronic community violence and who experience mental health symptoms is critical to mental health nursing practice and research.
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Affiliation(s)
- C C McDonald
- Center for Health Disparities, University of Pennsylvania, School of Nursing, Philadelphia, PA, USA.
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Pailler ME, Kassam-Adams N, Datner EM, Fein JA. Depression, acute stress and behavioral risk factors in violently injured adolescents. Gen Hosp Psychiatry 2007; 29:357-63. [PMID: 17591513 DOI: 10.1016/j.genhosppsych.2007.04.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2006] [Revised: 04/06/2007] [Accepted: 04/09/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The objective of this study was to examine whether emergency department (ED) assessments of depressive and acute stress symptoms after an episode of interpersonal violence are associated with future risk behaviors, reinjury and posttraumatic stress disorder (PTSD) symptoms in adolescents. METHODS Three hundred ninety-four injured adolescents (age range, 12-17 years) were assessed for depressive symptoms, acute stress symptoms and self-reported risk behaviors either during or immediately after an ED visit (T1). One hundred fifty-eight adolescents completed the follow-up assessment between 6 and 18 months later (T2), during which they were assessed again for self-reported risk behaviors, PTSD symptoms and reinjury. RESULTS Depression ratings at T1 predicted risk behaviors at T2, controlling for risk behaviors at T1. Ratings of depression and acute stress at T1 predicted PTSD symptoms at T2 but did not significantly predict the self-reported incidence of violent reinjury at T2. CONCLUSIONS Assessment of depressive symptoms in adolescents who present to the ED after a violent event can help identify those in need of further and more formal assessments as well as, possibly, interventions to prevent future risk behaviors. Identification of depressive and acute stress symptoms can also help identify those violently injured youth who report subsequent PTSD symptoms.
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Affiliation(s)
- Megan E Pailler
- Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
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