Disengaged parenting: Structural equation modeling with child abuse, insecure attachment, and adult symptomatology

Trying to Fit a Square Peg in a Round Hole? Testing the Robustness of Maltreatment Measurement Models for Youth

Research on maltreatment exposure often demonstrates mixed findings and a potential explanation for this may be the measurement of maltreatment. One approach for addressing measurement concerns, which also accounts for maltreatment's multidimensional nature, is the use of a measurement or latent model. However, there is minimal evidence on the generalizability of this approach across populations of youth. This study examined measurement invariance of a one-factor maltreatment model across two samples of youth exposed to maltreatment using case file data from the SPARK and LONGSCAN datasets (N = 1286). Results showed that only partial metric invariance could be established for the one-factor model between SPARK and LONGSCAN subsamples, and neglect and emotional abuse indicators tended to show low factor loadings. Findings highlight the need to consider how potential differences in documentation and maltreatment rates influence model performance and the need for research on which maltreatment characteristics may best capture youths' experiences.

Sibling support exchange in late adulthood moderates the long-term impact of childhood neglect on psychological outcomes

Objectives: Sibling relationships are often the longest-lasting and serve as a source of support and comfort for many older adults. The current study examined the moderating effect of sibling support exchange in the association between childhood maltreatment and mental health outcomes.Method: Using data from the Wisconsin Longitudinal Study (WLS), we analyzed a sample of older adults whose selected sibling was alive across the three data collections (baseline N = 4,041). Longitudinal multilevel regression models were estimated.Results: Key results showed that a history of neglect was associated with decreased psychological well-being, and all three forms of childhood maltreatment were related to increased depressive symptoms. We also found that sibling support exchange mitigated the negative mental health effects of childhood neglect.Conclusion: Our findings suggest that siblings may be uniquely positioned to support older adults who grew up in a neglectful family environment. Older adults may be encouraged to promote resilience by strengthening their sibling relationships.

Risk factors for traumatic bonding and associations with PTSD symptoms: A moderated mediation

BACKGROUND

Traumatic bonding, defined as attachment to a perpetrator of intimate partner violence (IPV), offers one explanation as to why many people with abusive romantic partners do not break off these relationships. But what individual-level risk factors make some victims of IPV more likely than others to develop traumatic bonding toward their partners? What is the nature of the potential association between traumatic bonding and PTSD symptoms?

PARTICIPANTS

A path model tested the potential roles of childhood maltreatment and attachment insecurity as risk factors for traumatic bonding, as well as the potential association between traumatic bonding and PTSD symptoms, in a high-risk sample of 354 participants in current abusive relationships.

RESULTS

As hypothesized, childhood maltreatment and attachment insecurity significantly predicted traumatic bonding over and above the effects of age, gender, and romantic love. In addition, attachment insecurity moderated the association between childhood maltreatment and traumatic bonding, such that at higher levels of attachment insecurity, the association between childhood maltreatment and traumatic bonding was stronger than at mean or lower levels of attachment insecurity. Traumatic bonding was positively associated with PTSD symptoms.

CONCLUSIONS

Overall, the results support the role of childhood maltreatment as a risk factor for both traumatic bonding and PTSD symptoms and highlight the importance of attachment insecurity in these associations. This was the first study to examine a complex model of risk factors for traumatic bonding. Theoretical and clinical implications are discussed.

Profiles of parents' emotion socialization within a multinational sample of parents

Introduction

Seminal emotion socialization theories classify parents according to two patterns of parent emotion socialization processes: 'emotion coaching' (i.e., parents validate and teach children about emotions) versus 'emotion dismissing' parenting (i.e., parents minimize and dismiss their children's emotions). However, empirical evidence supporting this binary distinction of parents remains limited. Our objective was to investigate whether parents can be differentiated by distinct patterns in their (1) beliefs about children's emotions, (2) emotion regulation, and (3) emotion-related parenting practices.

Method

Participants were parents of children aged 4-10 years from the Child and Parent Emotion Study (N = 869) (https://bmjopen.bmj.com/content/10/10/e038124). Parents completed self-reported measures of emotion socialization processes via an online survey, which took 20-30 min to complete. Data included in the current study were collected May-August 2019. We conducted a latent profile analysis of parents' emotion socialization (13 indicators). To assess reliability of the profiles, we examined stability of the profiles across (1) parents of children in early versus middle childhood, and (2) fathers versus mothers, via measurement invariance testing. Further, to assess for construct validity of the profiles, we examined concurrent associations between six criterion constructs and parents' emotion socialization profiles.

Results

A three-profile model emerged characterizing parents by: (1) emotion coaching; (2) emotion dismissing; (3) emotion disengaged. There was strong support for construct validity and reliability.

Discussion

Our study provides empirical support for distinct differentiated classifications of emotion coaching and emotion dismissing parenting, aligned with emotion socialization theories. We further extend on extant theory and suggest a third 'emotion disengaged' classification, describing parents with moderate levels of emotion dismissing parenting and low levels of emotion coaching parenting. It should be noted that the profiles were derived with self-report data, therefore, data may have been biased by contextual factors. Furthermore, the study sample consisted of Western families from affluent backgrounds. The field should focus efforts on conducting person-centered studies with more diverse samples in future.

Three-level containment model of hospitalized adolescents with borderline pathology: a holistic therapeutic perspective

Borderline personality disorders account for 50% of adolescent hospitalization cases in psychiatry. The severity and psychopathological complexity of these symptoms indicate the need for inclusive models of understanding. Adopting a holistic approach allows for the consideration of not only the patient's environment, but also their position within that environment and their life history. In this article, a model based on the concept of therapeutic containment at three levels is presented. Global containment refers to the mindset and organization of the institution that provides care, which is itself a part of society at a specific time. Local containment focuses on understanding and therapeutic interventions within the immediate social environment of the individual. Lastly, individual containment encompasses the development of independent processes during the course of care. These three levels are integrated in the hospital treatment of borderline personality disorders, forming a trans-theoretical approach.

The importance of organic screening, regarding a clinical case

INTRODUCTION

Before cataloguing a morbid process as a "mental disorder", it is essential to bear in mind the importance of early diagnosis of causes of non-psychiatric origin for a possible clinical presentation. For this reason, we will try to reflect this fact, which it seems necessary to remember even though it is well known, since it can be overlooked in emergency situations in the hospital setting, with the consequences derived from an incomplete diagnosis and with the potential life-threatening risk for the patient.

CASE PRESENTATION

A 13-year-old female adolescent, who presented an acute clinical picture suggestive of dissociative disorder. She required hospital admission for diagnostic-therapeutic clarification, and neuroimaging findings led to an initial diagnosis of a neoplastic lesion in the brain stem and, finally, as ischaemic lesion of vasculitic origin in said location.

DISCUSSION

A differential diagnosis was proposed through the different psychic and non-psychic aetiologies of the clinical picture, but the intervention of the hospital's paediatric service was necessary for orientation and definitive affiliation, given the suspicion of non-psychiatric illness after a torpid evolution in spite of psychotherapeutic and psychopharmacological interventions.

CONCLUSIONS

Through the presentation and review of a clinical case that happened in our hospital, we must insist on an adequate comprehensive approach to the patient, especially with the child-adolescent population, when faced with an acute clinical presentation and without previous studies at a relevant physical level.

Development of a Differential Assessment Guide to Improve Engagement with Youths & Families Living with Chronic Trauma

Youths and parents/caregivers who have experienced multiple forms of severe interpersonal trauma may demonstrate severe and persistent symptoms of complex trauma including high-risk behaviors. Engagement, and sustaining engagement, of these youths and parents/caregivers in evidence-supported trauma treatment is a critical challenge, especially when youths or parents/caregivers have experienced chronic traumas that may be expected to continue into the foreseeable future. An extensive literature review was conducted leading to development of an assessment framework that could increase engagement of youths and parents/caregivers in trauma treatment based on research on chronic trauma, complex trauma, Developmental Trauma Disorder (DTD), and factors that promote engagement. A multi-dimensional assessment guide was developed to enable clinicians to differentiate types of chronic trauma based on a continuum of past, current and expected exposure over time and then to use this guide collaboratively with youths and parents/caregivers to develop priorities for treatment and service planning that matches their needs and strengths. The assessment guide incorporates exposure to intra-familial and community forms of interpersonal trauma, attachment disruptions, established symptoms of PTSD, Complex PTSD and DTD, as well as social-emotional development. The assessment and treatment planning guides proposed in this article expand applicability of evidence-supported trauma-informed therapy to youths and families who have not been engaged by programs offering treatments that are focused on past or single incident traumas or do not address disrupted attachments, multi-generational experiences of adversity, discrimination and community violence, life-threatening dangers or the impact of chronic trauma on youth, parent/caregiver and family development.

Childhood trauma and college student health: a review of the literature

The experience of childhood trauma is known to predict health-relevant outcomes across the lifespan. Previous reviews summarize existing knowledge of the implications of childhood trauma for health in young adults and adults more generally. The current theoretical review aims to integrate the existing literature on the relationship between childhood trauma and health-relevant outcomes specifically in college students, consolidating findings across specific health domains. Further, the following theoretical review highlights the need for more research in this area and discusses how college campuses may use the knowledge in this area of work to develop targeted interventions aimed at improving the health of college students who experienced trauma in childhood.

Adult Attachment as a Mediator of the Link Between Interpersonal Trauma and International Classification of Diseases (ICD)-11 Complex Posttraumatic Stress Disorder Symptoms Among College Men and Women

Previous research indicates that insecure attachment patterns are associated with interpersonal trauma and posttraumatic symptomatology, and that they mediate various trauma-related symptoms. However, no study to date has examined whether these patterns mediate the link between interpersonal trauma and the newly recognized diagnostic features of complex posttraumatic stress disorder (CPTSD), as published by the World Health Organization (2019) in the 11th version of the International Classification of Diseases (ICD-11). Mediators of CPTSD are important to identify because they can provide a deeper understanding of the condition's etiology. Moreover, if amenable to clinical intervention, they can be targeted to improve treatment effectiveness. The purpose of the present study was to formally test our hypothesis that two underlying dimensions of adult attachment insecurity (i.e., attachment anxiety and avoidance) would mediate the link between interpersonal trauma and ICD-11 CPTSD symptoms. Participants were a culturally diverse sample of 169 college men and women. They completed a modified version of the Life Events Checklist (LEC-5), the revised Experiences in Close Relationships (ECR-R) scale, and the International Trauma Questionnaire (ITQ). Results of path analysis partially supported our hypothesis, indicating that attachment anxiety, but not avoidance, partially mediated the link between interpersonal trauma and PTSD and DSO ("Disturbances in Self-Organization") features of CPTSD. Although longitudinal research is needed, findings suggest that attachment anxiety may contribute to the development and maintenance of CPTSD symptoms following interpersonal trauma. Clinical interventions that help individuals rework and integrate representations of attachment that involve a fear of not being able to access adequate care and protection, and a negative view of self may be particularly useful in ameliorating the symptoms of CPTSD.

Child Sexual Violence: Interpersonal Relationship and Self-Image Evaluated by Zulliger R-Optimized Application

Abstract This study aimed to verify the validity of Zulliger criteria in the evaluation of interpersonal relationships and self-image of children victims of sexual violence. Population: 42 children between 7 and 13 years old participated, divided into three groups: 19 Victims of sexual violence (G1); 10 Cancer patients (G2); 13 Control group (G3). Instruments: Zulliger in the Comprehensive System (ZSC) R-Optimized application; Personality Scale for Children (ETPC, EPQ-J); Social Skills Inventory for Children (SSRS); Intelligence Test (CPM-Raven). G1, when compared to other groups, showed more tendency to problematic or less adaptive understanding of interpersonal interactions [p < 0.05 in PHR, GHR and p (ZSC); Psychosis (ETPC, EPQ-J); EG and F2 (SSRS)], more self-critical and negative self-image [p < 0.05 in MOR (ZSC)] and increased traumatic content [p < 0.05 in Bl (ZSC)]. The ZSC demonstrated preliminary evidence of validity in the evaluation of Interpersonal Relationship and Self-image of victims of child sexual violence.

Attachment insecurity partially mediates the relationship between childhood trauma and depression severity in bipolar disorder

BACKGROUND

Childhood trauma is associated with greater depression severity among individuals with bipolar disorder. However, the mechanisms that explain the link between childhood trauma and depression severity in bipolar disorder remain poorly understood. The mediational role of attachment insecurity in childhood and adulthood was assessed in the current study.

METHODS

Participants with bipolar disorder (N = 143) completed measures of childhood trauma (Childhood Trauma Questionnaire), attachment insecurity (Experiences in Close Relationships Scale) and depression severity (Hamilton Depression Rating Scale) as part of the Prechter Longitudinal Study of Bipolar Disorder. A sequential mediation model was tested using path analysis: the direct and indirect effects of childhood trauma on depression severity with attachment insecurity (attachment anxiety and avoidance) in childhood (mother and father) and adulthood (partner) as mediators were estimated.

RESULTS

The final path model demonstrated an excellent fit to the data (comparative fit index = 0.996; root mean square error of approximation = 0.021 [90% confidence interval = 0.000-0.073]). Supporting the hypothesised sequential mediation model, maternal attachment anxiety in childhood and romantic attachment avoidance in adulthood partially mediated the relationship between childhood trauma and depression severity; this effect accounted for 12% of the total effect of childhood trauma on depression severity.

CONCLUSION

Attachment insecurity in childhood and adulthood form part of the complex mechanism informing why people with bipolar disorder who have a history of childhood trauma experience greater depression severity. Addressing attachment insecurity represents a valuable psychotherapeutic treatment target for bipolar disorder.

Adversity, attachment and emotion recognition in BPD adolescents: the distinct roles of disengaged and controlling environment

Background

Literature data about emotion perception in patients with borderline personality disorders (BPD) revealed some discrepancies between some patients that are vigilant and accurate to detect their emotional environment and others that are impaired at identifying emotions of others. Even if some links between childhood adversity and facial affect recognition have been established, there is a need to understand the heterogeneous psychobiological mechanisms underlying this association. The aim is to distinguish in a BPD sample, the links between facial emotion recognition (FER) and adversity types (maltreatment and parental bonding), by evaluating two dimensions of disengaged and controlling environment.

Method

The study includes BPD adolescents (n = 45) and healthy controls (HC, n = 44): two scores of disengaged environment (parental low care; emotional and physical neglect) and controlling environment (high level of parenting control; emotional, physical and sexual abuse) were established and correlated to FER, as well as to attachment dimensions. Multiple linear regression analyzes were conducted to evaluate the effect of disengaged and controlling dimensions, on FER scores of sensitivity and accuracy, including anxious and avoidant attachment as covariables.

Results

Analyzes revealed that a disengaged environment was positively correlated to sensitivity in BPD patients, and the correlation was negative in the HC group. Controlling environment was negatively associated to accuracy of emotion in BPD. Avoidant and anxious attachment did not influence these associations.

Conclusions

These results suggest that distinct adverse experiences account for the heterogeneity observed in emotion regulation in BPD patients.

"I Didn't Really Have Anybody to Turn To": Barriers to Social Support and the Experiences of Male Perpetrators of Intimate Partner Violence

Social support is crucial for adapting to stress and trauma, processing adverse emotions, developing better mental health, and garnering relationship success. Yet, social support may not always be accessible to those who need it the most. Through participant observation and in-depth interviews, this study examined how men who have perpetrated intimate partner violence (IPV) perceived the availability and adequacy of social ties, as well as how they discursively constructed social support during times of childhood adversity. Results indicated a prevalence of trauma in attachment relationships, a lack of perceived social support, and persistent messages that discouraged help seeking and engendered masculine norms (e.g., self-reliance, aggression, rejection of femininity, restrictive emotionality) and communication styles. The current study illustrates how the effects of adverse childhood experiences may be exacerbated by the absence of positive social ties and adherence to masculine gender norms governing communication. Thus, the protective benefit (or the "buffering effect") of social support appears to be inaccessible for this specific population. Findings suggest so-called "batterer intervention program" groups could provide measures to increase perpetrators' sense of social support during the intervention process and work to deconstruct additional masculine gender beliefs (i.e., in addition to power and control) to alleviate some of social and psychological effects of early childhood adversity.

The importance of organic screening, regarding a clinical case

INTRODUCTION

Before cataloguing a morbid process as a "mental disorder", it is essential to bear in mind the importance of early diagnosis of causes of non-psychiatric origin for a possible clinical presentation. For this reason, we will try to reflect this fact, which it seems necessary to remember even though it is well known, since it can be overlooked in emergency situations in the hospital setting, with the consequences derived from an incomplete diagnosis and with the potential life-threatening risk for the patient.

CASE PRESENTATION

A 13-year-old female adolescent, who presented an acute clinical picture suggestive of dissociative disorder. She required hospital admission for diagnostic-therapeutic clarification, and neuroimaging findings led to an initial diagnosis of a neoplastic lesion in the brain stem and, finally, as ischaemic lesion of vasculitic origin in said location.

DISCUSSION

A differential diagnosis was proposed through the different psychic and nonpsychic aetiologies of the clinical picture, being the intervention of the hospital's paediatric service necessary for orientation and definitive affiliation, given the suspicion of non-psychiatric illness after a torpid evolution in spite of psychotherapeutic and psychopharmacological interventions.

CONCLUSIONS

Through the presentation and review of a clinical case that happened in our hospital, we must insist on an adequate comprehensive approach to the patient, especially with the child-adolescent population, when faced with an acute clinical presentation and without previous studies at a relevant physical level.

Child maltreatment and romantic relationships in adolescence and young adulthood: The mediating role of self-perception

BACKGROUND

Child maltreatment (CM) can disrupt the development of self, influencing the ability to form positive relationships, including romantic attachment. While mental health is a known mediator of maltreatment history and romantic relationships, less is known about the role of self-perception.

OBJECTIVE

The goal of this work is to understand the role self-perception plays in the association between CM history and romantic relationships during adolescence and young adulthood.

PARTICIPANTS

Longitudinal data from child welfare involved and comparison youth were gathered to examine whether self-perception mediated the association between CM history and the proportion of positive romantic relationships. Mean age at T1 was 11.03 years and 18.24 years at T4.

METHODS

Participants in the CM group were recruited from active Child Protective Services cases in a large west coast city. The comparison group was recruited using names from school lists of children residing in the same 10 zip codes. Assessments were conducted at an urban research university. After assent/consent were obtained, the adolescent was administered questionnaires. For the current analyses, only those who indicated they had ever had a romantic relationship were included (n = 306). Hypotheses were tested used path modeling in Mplus 7.0.

RESULTS

CM history was associated with lower self-perceptions in all domains. Only behavioral (β = 0.15, p= 0.02) and scholastic (β= -0.14, p= 0.04) self- perceptions predicted proportion of later positive romantic relationships. A significant mediation effect was found only for behavioral self- perceptions.

CONCLUSIONS

Interventions aimed at bolstering self- perceptions and engagement in positive behaviors could strengthen positive relationships for youth with CM and child welfare experiences.

Investigating the interplay between parenting dimensions and styles, and the association with adolescent outcomes

Research has indicated that a strictly dimensional or parental style approach does not capture the full complexity of parenting. To better understand this complexity, the current study combined these two approaches using a novel statistical technique, i.e., subspace K-means clustering. Four objectives were addressed. First, the study tried to identify meaningful groups of parents in longitudinal adolescent reports on parenting behaviour. Second, the dimensional structure of every cluster was inspected to uncover differences in parenting between and within clusters. Third, the parenting styles were compared on several adolescent characteristics. Fourth, to examine the impact of change in parenting style over time, we looked at the cluster membership over time. Longitudinal questionnaire data were collected at three annual waves, with 1,116 adolescents (mean age = 13.79 years) at wave 1. Based on five parenting dimensions (support and proactive, punitive, psychological and harsh control), subspace K-means clustering, analysed per wave separately, identified two clusters (authoritative and authoritarian parenting) in which parenting dimensions were interrelated differently. Authoritative parenting seemed to be beneficial for adolescent development (less externalising problem behaviour and higher self-concept). Longitudinal data revealed several parenting group trajectories which showed differential relations with adolescent outcomes. Change in membership from the authoritative cluster to the authoritarian cluster was associated with a decrease in self-concept and an increase in externalising problem behaviour, whereas changes from the authoritarian cluster to the authoritative cluster were associated with an increase in self-concept and a decrease in externalising problem behaviour.

A reasonably large review of operationalization in child maltreatment research: Assessment approaches and sources of information in youth samples

Child maltreatment research varies considerably in how maltreatment is measured. Although researchers have advocated for improvements in maltreatment assessment, a first step is a clear understanding of the status on how the field operationalizes maltreatment. The current paper sought to achieve this goal through reviewing research on child maltreatment over a recent 10-year span to identify trends in maltreatment assessment and operationalization. Information on maltreatment measurement was extracted from 338 articles across three major journals devoted to publishing research on child maltreatment. Among the various definitional dimensions of maltreatment, type was the most common way maltreatment was operationalized, followed by severity, frequency, and chronicity, a stable trend across the 10-year span of review. The results indicated that the majority of studies measured maltreatment as consisting of multiple types, although some studies focused on one type of maltreatment as the indicator of child maltreatment. Further, the most common assessment method was the administration of a questionnaire or the combination of two questionnaires with the second most common being summaries from case file review. Recommendations for future research are discussed.

Interpersonal violence: identification of associated features in a clinical sample

Violence is a burdensome problem in daily psychiatric practice, even though the diagnosisof a mental disorder is not sufficient to determine a violent behavior; therefore, other factors are involved. We predicted that the participants could be distributed in two groups (e.g. high versus low violence-maltreatment groups) because this grouping would better describe specific patterns of associations in a clinical sample. We aimed to investigate the relation between interpersonal violence and maltreating experiences in childhood. Affective states and personal functioning were also explored as meaningful outcomes. Consecutive patients (N = 101) admitted to a psychiatric unit were evaluated with the Risky Families Questionnaire, the Psychological Maltreatment Review, the Karolinska Interpersonal Violence Scale (KIVS), the Positive and Negative Affect Schedule and the Personal and Social Performance Scale. Single, with average education and unemployed individuals showed significantly higher KIVS scores. High levels of interpersonal violence (IV) in childhood correlated with a harsh family climate in early life. Moreover, IV correlated with perceived parental maltreatment and did not with parental support. The cluster analysis identified two clusters of patients. The first (n = 41) showed negative dysfunctional experiences; the second (n = 60) showed a more positive perception of parental support.The impairment of social functioning and emotions regulation are both involved in this complex relation. The study supports the hypothesis of a clustering of patients that needs tailored management of violence causes and consequences.

The Moderating Role of Attachment on the Association between Childhood Maltreatment and Adolescent Dating Violence

Approximately twenty percent of female and ten percent of male adolescents report violence in their dating relationships and there is a significant association between dating violence in adolescence and later perpetration of intimate partner violence (IPV) in adulthood. Identification of factors associated with dating violence can inform intervention and prevention efforts. This study was designed to examine the associations of early childhood maltreatment experience and involvement in adolescent dating violence. It also aimed to identify the moderating effect of insecure attachment styles on these associations. One hundred fifty adolescent who participated in a larger longitudinal study on prenatal drug exposure participated in this study. Participants completed self-report measures of childhood maltreatment at a standard follow-up visit between the ages of 15-19 years. Approximately 18 month later, they completed questionnaires on their attachment styles and level of dating violence perpetration and victimization. Hierarchical regression modeling revealed a significant main effect for childhood abuse but not insecure attachment on perpetration and victimization of dating violence. Avoidant attachment significantly moderated the relationship between childhood abuse exposure and dating violence: For adolescents who reported an avoidant attachment style, an increase in the level of experienced childhood maltreatment predicted significantly higher increases in victimization by dating violence, compared to those did not have avoidant attachment. Results suggest adolescents with child maltreatment history and avoidant attachment styles may be at higher risk for involvement in dating violence and support intervention efforts for fostering attachment relationship to attenuate the association between early exposures to maltreatment and involvement in dating violence later.

Predictors of psychological recommendations in child protection evaluation

Child protection matters from an important social and legal challenge, in which psychologists may be called upon to address a series of questions relevant for judicial decision-making. In an explorative manner, the current study investigates variables that influence psychological evaluators' recommendations in child protection cases. The data is based on a quantitative content review of 103 psychological evaluation reports, conducted at an institute of forensic psychology in Germany. Using bivariate and logistic regression analyses, the following predictors were analyzed in this study: Child-related factors, familial risk factors, and general custody criteria. The outcome measure was the evaluator's recommendation regarding long-term placement of the child and long-term custody arrangements. Evaluators were more likely to recommend permanent foster placement if the child showed insecure or disorganized attachment patterns, especially when combined with developmental delays, or if the child was temporarily in institutional or foster placement at the time of evaluation. The results support the conclusion that the most important factors for psychological expert recommendations refer to the "harm of the child" criterion in terms of developmental and psychological maladaptation.

Dimensions of maltreatment and academic outcomes for youth in foster care

Childhood maltreatment is often associated with youth's ability to successfully function in school. Youth with a history of maltreatment often receive lower grades and scores on tests of academic achievement, as well as demonstrate more negative behaviors in school, as compared to non-maltreated youth. However, there are many inconsistencies in previous studies examining the association between maltreatment and academic outcomes in youth. One potential reason for mixed findings within the literature could be a result of how maltreatment is measured and operationalized. The current study examined if the methods used to define and describe maltreatment contribute to the association between maltreatment and academic functioning in youth. Youth in foster care (N = 490, M_age = 13.13[3.09]) were recruited and information on their maltreatment history and academic functioning was obtained from official agencies, school records, and self-reported measures. Using a SEM framework when examining each dimension separately in the same model, results suggested that frequency maltreatment was more predictive of academic behavior, as compared to type and severity. No dimensions were associated with grades and significant findings were only observed for models using self-report data. However, when examined using a measurement model approach, maltreatment as a whole was associated with school behavior, which was found for both self-report and case file measurement models. The findings suggest a need for research on academic functioning to take a comprehensive approach when measuring and defining maltreatment as this may be a more robust and accurate predictor of academic functioning.

The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms

OBJECTIVE

The purpose of this study was to examine the co-occurrence of posttraumatic stress disorder (PTSD) and dissociation in a clinical sample of trauma-exposed adolescents by evaluating evidence for the depersonalization/derealization dissociative subtype of PTSD as defined by the DSM-5 and then examining a broader set of dissociation symptoms.

METHOD

A sample of treatment-seeking, trauma-exposed adolescents 12 to 16 years old (N = 3,081) from the National Child Traumatic Stress Network Core Data Set was used to meet the study objectives. Two models of PTSD/dissociation co-occurrence were estimated using latent class analysis, one with 2 dissociation symptoms and the other with 10 dissociation symptoms. After model selection, groups within each model were compared on demographics, trauma characteristics, and psychopathology.

RESULTS

Model A, the depersonalization/derealization model, had 5 classes: dissociative subtype/high PTSD; high PTSD; anxious arousal; dysphoric arousal; and a low symptom/reference class. Model B, the expanded dissociation model, identified an additional class characterized by dissociative amnesia and detached arousal.

CONCLUSION

These 2 models provide new information about the specific ways PTSD and dissociation co-occur and illuminate some differences between adult and adolescent trauma symptom expression. A dissociative subtype of PTSD can be distinguished from PTSD alone in adolescents, but assessing a wider range of dissociative symptoms is needed to fully characterize adolescent traumatic stress responses.