The Effects of Maternal Disaster Exposure on Adolescent Mental Health 12 Years Later

Research on Child and Adolescent Psychopathology - Natural disasters adversely impact children’s mental health, with increased parent or child exposure and subsequent parental distress...     

Hardiness as a Moderator of Shame Associated with Childhood Sexual Abuse

An adult female sample of childhood sexual abuse survivors (n = 195) were surveyed to determine if hardiness was effective in moderating the negative effects of the perceived trauma and severity of the sexual abuse and internalized shame on relationship intimacy. The results indicated that perception of abuse, severity of abuse, and shame were significantly and negatively related to hardiness. Hardiness was found to have a significant moderating effect on the negative impact of internalized shame and severity of abuse on marital/relationship intimacy.     

Child and Adolescent Mental Health: Building a System of Care

According to recent studies, large numbers of children and adolescents with serious emotional or behavioral disorders receive either no mental health treatment or treatment inappropriate to their needs. In this article the authors examine the problem of unnecessary hospitalization and the inadequacy of community-based systems. They discuss the barriers that impede improved mental health service systems for children and their families and present the Child and Adolescent Service System Program (CASSP) “system of care” model as an alternative. Last, counseling and development's role in promoting and fostering positive changes in the mental health system serving children and adolescents is discussed.     

Access to Child and Adolescent Mental Health Services

Adequate access to child and adolescent mental health services for young people in high need populations is an important concern of service systems researchers and program evaluators. We present results of a statewide study of access to community mental health services for eight populations of special concern. The analysis relied exclusively on existing databases in conjunction with innovative statistical techniques to provide comprehensive measures of access to care. Our findings indicate that access to care varied substantially across special populations, although children and adolescents in each of our eight “special populations” had greater access to public mental health services than members of the general population of the state. The interpretation of the findings and directions for future research are discussed.     

Strategies for Enhancing Child and Adolescent Mental Health

The prevention of mental health disorders and development of competence and well-being are critical for enhanceing the long-term adjustment of children and adolescents. Approaches to mental health promotion are discussed in this article in terms of (a) preventing the onset of disorders: (b) strengthening competencies to enable children and adolescents to better handle life stressors; and (c) assisting children and adolescents in dealing with life transitions. Examples which illustrate the approaches are included.     

Childhood and Trauma

In this paper, I follow the evolution of the concept of trauma within psychoanalytic theory, and some of the effects of this evolution. Starting out from the point where Freud gives up the theory of trauma as the cause of neurosis in 1897, and the alleged reasons for such a change, I analyze the theoretical and clinical consequences of this change within psychoanalysis. I proceed to develop Ferenczi's ideas on trauma, their relevance to present-day psychoanalytic theorizing and practice, as well as for the understanding of the psychic processes in children, tracing the development of some of these ideas in contemporary psychoanalytic thinking.     

神经质人格调节青少年应激与抑郁症状的追踪研究

探讨神经质人格对青少年应激与抑郁症状的调节作用。采用自评的流调中心用抑郁量表、大五人格问卷-神经质分量表和青少年生活事件量表对618名在校高中生进行了首次测查,随后每隔3个月对被试的抑郁症状和生活事件进行追踪测查,追踪时间为期一年,结果发现:与低神经质青少年相比,随着生活事件应激水平的升高,高神经质青少年的抑郁躯体症状与心理症状增长速度更快。结论:神经质人格在青少年生活事件应激和抑郁症状的关系中起调节作用。     

Level of Health Threat as a Moderator of Social Comparison Preferences1

The effects of level of health threat and level of perceived control on social comparison preferences were examined. Participants were led to believe that they had a cholesterol level that was either in the borderline high-risk range or in the high-risk range. Half the participants were told cholesterol was controllable, whereas the others were told it was not. Participants then rated their interest in 4 types of social comparison information. The results indicated an overall preference for upward comparison to gather useful information. Level of threat interacted significantly with direction of comparison. Comparison preferences were not affected by the control manipulation. The implications of the findings for theories of social comparison as a coping strategy are discussed.     

Trauma Exposure and Health: A Review of Outcomes and Pathways

A growing body of literature has established robust relations between trauma and a variety of adverse physical health outcomes. In both retrospective and prospective research, adults with a history of self-reported or court-substantiated maltreatment report significantly more health concerns than those without maltreatment histories, in both clinical and community samples, whether health problems are self-reported or physician-diagnosed. Two pathways by which poor health outcomes are theorized to occur include the biological pathway, which largely implicates severe stress and subsequent dysregulations in central stress-response systems as the underlying cause of health problems, and the behavioral pathway, which suggests that health risk behaviors are largely responsible for the relations between trauma and health. This article reviews the research evaluating the relations between various types of trauma, particularly physical and sexual abuse in childhood, and three such health outcomes: pain, gastrointestinal disorders, and cardiovascular disease. Evidence to support the biological and behavioral pathways is also reviewed.     

Family of Origin Coaching for Clinicians in a Child and Adolescent Mental Health Service

The role of the therapist as a person rather than only as a technician has become increasingly important in family therapy since the post-modern turn. Despite this there is a paucity of research exploring supervision models that focus on self-reflection, as opposed to clinical competence. This study documents the experience of a Family of Origin Coaching group, conducted with six clinicians and one supervisor working in a child and adolescent mental health service. A participatory action framework was used, with data analysed using grounded theory. A variety of benefits were reported, including personal development, an enhanced empathy towards clients and an ability to better cope with stressful team dynamics. Family of Origin coaching has the potential to yield benefits for clinicians as a compliment to traditional supervision. Issues of confidentiality and safety need to be addressed carefully, especially during times of organisational change or stress.     

Adolescent Religiosity as a Mediator of the Relationship Between Parental Religiosity and Adolescent Health Outcomes

Studies have demonstrated the positive impacts of both parent and adolescent religiosity on adolescent outcomes; however, the relationships among these variable have not been studied. Our study was conducted to assess whether adolescent religiosity mediates the relationship between parent religiosity and adolescent emotional and behavioral health outcomes. A sample of 491 late adolescents ages 18–22 completed surveys that assessed their parents’ religious practices, their own religious practices, deviant behaviors, and internalizing behaviors. Findings suggest that adolescent religiosity mediates the relationship between parents’ religiosity and adolescent health outcomes such as drug and alcohol use and depression.     

急性创伤青年患者的心理健康水平与小组干预

为了探讨急性创伤青年患者的心理健康水平及小组干预对策,采用三种国际通用量表（SCL-90、HAMA、HAMD）对160例急性创伤青年患者进行测评,在给予传统心理护理的同时,进行小组干预,然后比较患者干预前后心理健康水平;并以既往同种病例为对照,比较治疗效果。结果显示,86．25％的急性创伤青年患者存在有不同程度的心理障碍。通过小组干预后,患者心理健康水平明显提高;患者的临床疗效明显改善。因此小组干预可显著改善急性创伤青年患者的心理应激水平,提高临床疗效。     

Systemic Family Therapy Competences in Child and Adolescent Mental Health Care

This article is based on a doctoral research project aiming to identify a comprehensive and detailed outline of the systemic therapist competences in child and adolescent mental health care in Norway. Because of the growing demands to offer specialized services within child and adolescent mental health care, I intended the identified competences to target the psychosocial difficulties that are categorized as associated abnormal psychosocial situations (axis 5) in the multiaxial diagnostic system (WHO, Multiaxial classification of child and adolescent psychiatric disorders. The ICD-10 classification of mental and behavioural disorders in children and adolescents. Cambridge University Press, Cambridge, 1996). The project is based on twelve qualitative in-depth interviews with six experienced systemic family therapists, and fieldwork observations of the therapists (participants) in practice. The qualitative methodology is based on Grounded Theory and five overarching categories were identified through the analysis: (1): the importance of ethical and contextual awareness in systemic therapy; (2) the systemic therapist’s stance; (3) therapeutic processes; (4) therapeutic practices; and (5) session-specific features. Challenges, such as limiting the systemic approach to five overarching competences, are discussed alongside this strengths and limitations of the study. The detailed outline of systemic therapist competences is intended to offer a framework for delivering flexible, yet specialized systemic therapy in the context of child and adolescent mental health care. This research may therefore facilitate a “bridge-building process” between mental health’s biomedical focus and postmodern systemic ideas.     

Emotion Dysregulation as a Mechanism Linking Stress Exposure to Adolescent Aggressive Behavior

Exposure to stress is associated with a wide range of internalizing and externalizing problems in adolescents, including aggressive behavior. Extant research examining mechanisms underlying the associations between stress and youth aggression has consistently identified social information processing pathways that are disrupted by exposure to violence and increase risk of aggressive behavior. In the current study, we use longitudinal data to examine emotion dysregulation as a potential mechanism linking a broader range of stressful experiences to aggressive behavior in a diverse sample of early adolescents (N?=?1065). Specifically, we examined the longitudinal associations of peer victimization and stressful life events with emotion dysregulation and aggressive behavior. Structural equation modeling was used to create latent constructs of emotion dysregulation and aggression. Both stressful life events and peer victimization predicted subsequent increases in emotion dysregulation over a 4-month period. These increases in emotion dysregulation, in turn, were associated with increases in aggression over the subsequent 3?months. Longitudinal mediation models showed that emotion dysregulation mediated the relationship of both peer victimization (z?=?2.35, p?=?0.019) and stressful life events (z?=?2.32, p?=?0.020) with aggressive behavior. Increasing the use of adaptive emotion regulation strategies is an important target for interventions aimed at preventing the onset of adolescent aggressive behavior.     

The Relation Between Parental Mental Illness and Adolescent Mental Health: The Role of Family Factors

Children of parents with a mental illness are often found to be at high risk of developing psychological problems themselves. Little is known about the role of family factors in the relation between parental and adolescent mental health. The current study focused on parent–child interaction and family environment. This cross-sectional questionnaire study included 124 families with a mentally ill parent and 127 families without a mentally ill parent who at the time of the study had children aged 11–16 years old. Parents completed questionnaires about their mental health, parent–child interaction (i.e., parental monitoring and parental support), and family environment (i.e., cohesion, expressiveness, and conflict). Adolescents reported their internalizing and externalizing problems. Path analyses were used to examine the direct associations between parental mental illness and adolescent problems as well as the indirect relations via parent–child interaction and family environment. The results showed that interaction between parents with a mental illness and their child was significantly worse compared to parents without a mental illness. The family environment of parents with mental illness was also more negative. Mentally ill parents monitored their adolescents less, which in turn related to more externalizing problems of the adolescents. No factors mediated the relation between parental mental health and adolescent internalizing problems. Moreover, no direct effects of parental support, family cohesion, and family expressiveness with externalizing problems were found. These findings imply that parental monitoring should get a specific focus of attention in existing interventions designed to prevent adolescents with a mentally ill parent from developing problems.     

Testing Posttraumatic Stress as a Mediator of Childhood Trauma and Adult Intimate Partner Violence Victimization

This study examined whether potential posttraumatic stress disorder (PTSD) mediated the relationships between different forms of childhood trauma (sexual abuse, physical abuse, violence between caregivers) and intimate partner violence (IPV) victimization (psychological, physical, sexual). Participants were 1,150 female nurses and nursing personnel. Path analytic findings revealed potential PTSD partially mediated the relationships between childhood sexual abuse and psychological IPV and childhood sexual abuse and sexual IPV. Potential PTSD did not mediate the relationship between other types of childhood trauma and IPV. This study adds to the literature indicating PTSD as a risk factor for revictimization in the form of adult IPV among women. Screening for and treatment of PTSD among female child sexual abuse survivors could prevent future IPV victimization.     

The Relationship Between Childhood Trauma,Combat Exposure,and Posttraumatic Stress Disorder in Male Veterans

The current study investigated the effects of combat exposure, childhood trauma, and depression on posttraumatic stress disorder (PTSD) severity. Participants were 299 male veterans from the Korean War, World War II, Vietnam, and the first Gulf War who were being screened for admission to the PTSD unit. Participants were assessed with the Clinician-Administered PTSD Scale (CAPS), Combat Exposure Scale (CES), Hamilton Depression Rating Scale (HAMD), Childhood Trauma Questionnaire (CTQ), and Mississippi Scale for PTSD (MPTSD). Results of multiple regression analyses indicated that, as expected, combat exposure and depression were significant predictors of PTSD severity. When examined with combat exposure, childhood trauma has a complex relationship to PTSD severity. Examination of the interaction between the CES and CTQ suggests that when levels of combat are low and childhood trauma levels are high, the CTQ is related to higher levels of PTSD severity on the CAPS, regardless of depression. Treatment implications are discussed.     

Duty-Related Posttraumatic Stress Symptoms in 911 Telecommunicators: The Roles of Childhood Trauma Exposure and Emotion-Focused Coping

A history of childhood trauma exposure has been linked to the development of posttraumatic stress symptoms in adulthood following new exposure. Unhealthy coping behaviors that could develop or be utilized in response to early trauma could lend themselves to psychological issues in adulthood. Emotion-focused and problem-focused coping strategies in relation to stressful duty-related situations are examined as indirect pathways through which childhood trauma exposure could be associated with duty-related posttraumatic stress symptoms in 911 telecommunicators (N = 808). Multiple mediation models revealed that 3 of the 4 emotion-focused coping strategies, but not the problem-focused strategies, functioned as significant mediators in the association between childhood exposure and duty-related posttraumatic stress symptoms. Pairwise comparisons showed that self-controlling and escape-avoidance strategies were the strongest pathways of the indirect childhood trauma exposure–posttraumatic stress symptoms association. Implications of results regarding coping in response to new traumatic events in adulthood and potential research and intervention directions are discussed.