Resilience Variables and Posttraumatic Symptoms Among Maltreated Youth

Child maltreatment is associated with an array of social, behavioral, neurobiological, and developmental problems that can last for many years. A key outcome of child maltreatment includes posttraumatic stress symptoms such as reexperiencing, avoidance, and hyperarousal. Considerable research has focused on risk factors for posttraumatic symptoms in maltreated youth, but less so on possible protective factors such as resilience. This study examined several resilience variables (sense of mastery, sense of relatedness, emotional reactivity) in an ethnically diverse sample of maltreated adolescents with posttraumatic symptoms. Key aspects of resilience that predicted posttraumatic stress disorder (PTSD) symptoms included sense of mastery (for fewer symptoms) and emotional reactivity (for more symptoms). In particular, optimism, self-efficacy, and adaptability were inversely related to PTSD symptoms. In addition, emotional reactivity moderated a relationship between resilience resource scores and PTSD symptoms. The findings appeared to apply most to sexually maltreated youth. The results preliminarily demonstrate the importance of considering resilience-based variables during clinical processes for maltreated youth.     

An Examination of Posttraumatic Stress Symptoms among Maltreated Multiracial Youth

Symptoms of posttraumatic stress disorder (PTSD) are common among maltreated youth removed from their homes. These symptoms might be particularly evident in multiracial youth, although little research exists on this vulnerable population. A model whereby depression, dissociation, and posttraumatic cognition symptoms contributed to symptoms of PTSD met goodness-of-fit criteria in 160 maltreated multiracial adolescents. Enhanced model fit was found for females and for adolescents 11 to 13 years old. Analyses further revealed that the best predictors of PTSD symptoms were negative cognitions about the world and anhedonia. The findings are discussed within the context of existing theoretical models of PTSD. The results further highlight the importance of ethnically and racially sensitive approaches to assessment and treatment of youth with PTSD symptoms.     

A Multilevel Meta-analysis on Academic Achievement Among Maltreated Youth

Maltreatment can influence normative development and negatively impact emotional, behavioral, and social functioning in youth. As a result, it is not surprising that maltreated youth, as compared to non-maltreated youth, tend to underperform academically. Research on the academic performance of maltreated youth has increased over the last decade and several review papers have been published in this area. While the conclusions of these review articles have been that maltreated youth are at greater risk for academic deficits as compared to their non-maltreated peers, there are several conflicting findings within the literature that make it difficult to determine if or to what extent maltreated youth may demonstrate academic difficulty. Using a multilevel, structural equation model meta-analysis technique, the current study sought to provide a quantitative synthesis of the literature by examining the mean difference between maltreated and non-maltreated youth on measures of academic performance. Moreover, the current study also examined group differences between academic subject and maltreatment type. A total of 72 effect sizes were extracted from 32 studies that met inclusion criteria. Results demonstrated an overall negative, medium effect size, such that maltreated youth tended to perform slightly greater than half a standard deviation below non-maltreated youth on measures of academic performance. Moderation analyses suggest deficits may be greater on measures of general academic performance, as compared to language arts measures. No differences were observed for maltreatment type. These findings highlight the need for increased focus on academic difficulties among maltreated youth.     

Posttraumatic Stress Disorder in Maltreated Youth: A Review of Contemporary Research and Thought

Youths who have been maltreated often experience symptoms of posttraumatic stress disorder (PTSD), and this special population has received increased attention from researchers. Pathways toward maladaptive effects of maltreatment and PTSD are remarkably similar and reflect specific biological diatheses and psychological vulnerabilities that produce wide-ranging self-regulation deficits. Developmental models of effects of maltreatment and of PTSD are thus increasingly intertwined and have begun to inform specialized assessment and treatment strategies for this population. This review covers key aspects of posttraumatic stress disorder in maltreated youth, including epidemiology, symptomatology, outcome, and risk factors as well as assessment and treatment strategies and challenges for these youths.     

Posttraumatic Growth, Posttraumatic Stress Symptoms and Mental Health Among Coronary Heart Disease Survivors

The present study aimed to estimate posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among heart disease survivors and examine whether PTG moderates the association between PTSS and mental health. Data from 82 myocardial infarction and acute coronary artery bypass graft survivors (aged 46–82) was obtained at admission to a cardiac rehabilitation unit. Mental status was assessed by the PTSD Inventory, Posttraumatic Growth Inventory (PTGI), Mental Health Inventory and Health Related Quality of Life (HRQOL). 17.1 % of the participants suffered significantly from PTSS and most of the study sample (71.2 %) reported PTG. PTSS were positively associated with PTG and psychological distress and negatively with well-being and HRQOL. PTG moderated the association between PTSS and most mental health outcomes. We conclude that posttraumatic growth may attenuate the negative effect of posttraumatic stress symptoms on mental health.     

Ethnic Identity,Family Cohesion,and Symptoms of Post-traumatic Stress Disorder in Maltreated Youth

Post-traumatic stress disorder (PTSD) is prevalent among maltreated youth, but little empirical work exists regarding the role of ethnic identity and family cohesion as influential factors among different ethnic groups. This study included an ethnically diverse sample of adolescents affiliated with a state-administered residential facility for maltreated youth. Variables included ethnic identity and family cohesion, as well as symptoms of PTSD, depression, dissociation, and post-traumatic cognitions. The most prominent finding was that low family cohesion predicted greater PTSD symptoms, depression, dissociation, and post-traumatic cognitions. This finding was especially pronounced for multiracial youth. Results are discussed within the context of developmental pathways regarding ethnic identity development in multiracial youth.     

Behavioral Inhibition and Risk for Posttraumatic Stress Symptoms in Latino Children Exposed to Violence

Latino children in urban contexts marked by poverty are at high risk of being exposed to violence and developing posttraumatic stress disorder (PTSD). Nonetheless, there is great variability in individual responses to violence exposure. This study examines risk for developing re-experiencing, avoidance, and arousal symptoms of PTSD as a function of individual differences in behavioral inhibition and exposure to community violence. Participants were 148 Latino students (M age =11.43 years, SD?=?0.69; 55 % girls) living in an area marked by poverty and crime. Children completed self-report measures of behavioral inhibition and posttraumatic stress symptoms during a baseline assessment. During a follow-up interview 6 months later, children completed self-report measures of exposure to community violence since the baseline assessment and posttraumatic stress symptoms. Structural equation models revealed that behavioral inhibition at baseline was positively associated with PTSD avoidance and arousal symptoms at follow-up, after controlling for symptoms at baseline. Furthermore, behavioral inhibition moderated the association between violence exposure and symptoms such that violence was more strongly associated with the development of PTSD avoidance symptoms as behavioral inhibition increased. Results suggest that individual differences in behavioral inhibition contribute to risk for specific PTSD symptoms and are important for understanding variation in responses to trauma exposure. By examining diathesis-­stress models within a disorder, we may be better able to elucidate the etiology of a disorder and translate this improved understanding into personalized intervention approaches that maximize effectiveness.     

Identifying Youth at Risk for Treatment Failure in Outpatient Community Mental Health Services

We developed predicted change trajectories and a warning system designed to identify psychotherapy cases at risk for treatment failure as observed in archival Youth Outcome Questionnaire data (parent/guardian-report) from 363 children and adolescents (ages 4–17) served in an outpatient community mental health system. We used multilevel modeling procedures to develop models of predicted change based on demographic information. Controlling for the effects of age on intercept, no other variables were significant in the model. The warning system we created from half of the sample (n = 181) correctly identified 71% of treatment failures in the other half of the sample (n = 182), defined as cases whose symptoms were significantly higher at the end of treatment compared to symptoms at intake. As over half of youth cases in this usual care setting did not demonstrate reliable improvement in symptoms, these results further emphasize the value of patient-focused research in monitoring patient progress and prompting changes in the treatment approach if suitable progress is not observed.     

Patterns of Posttraumatic Stress Symptoms Among United States Air Force Combat Search and Rescue Personnel

U.S. Air Force (USAF) combat search and rescue (CSAR) aircrew and special duty rescue personnel are specially trained airmen with high levels of direct exposure to combat-related medical trauma. The purpose of this study was to explore the prevalence rate of CSAR military personnel meeting the Diagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM–5) posttraumatic stress disorder (PTSD) symptom criteria. USAF CSAR aircrew (n = 128) and rescue personnel (n = 300) across multiple units participated in the study by completing a demographics survey and the PTSD checklist based on DSM–5. Fourteen participants endorsed a pattern of symptoms of moderate to extreme level of severity meeting PTSD diagnostic criteria. Recommendations are provided for line and medical leadership to optimize health and performance among CSAR personnel.     

The Relationship Between Posttraumatic Stress Symptoms and Suicide Ideation Among Child Survivors Following the Wenchuan Earthquake

The association between posttraumatic stress disorder (PTSD) symptoms and suicide ideation was examined in a sample of 2,298 child survivors of the Wenchuan earthquake. Results indicated that intrusion, avoidance, hyperarousal symptom clusters, and PTSD total score were significantly associated with suicide ideation. Except for intrusion, other measures of PTSD remained as statistically significant correlates of suicide ideation even after controlling for age, gender, direct exposure, indirect exposure, and depression. Furthermore, results showed that PTSD symptoms had an indirect influence on suicide ideation that was mediated by depression. The findings suggest that avoidance and hyperarousal symptom clusters of PTSD may be two important indicators of suicide ideation among child survivors of the Wenchuan earthquake. Implications of the results for intervention and prevention of suicide behavior are discussed.     

Depressive Symptoms Among Delinquent Youth: Testing Models of Association with Stress and Support

The high prevalence of depression among incarcerated youth indicates a need to better understand factors that contribute to depression within this vulnerable subgroup. Previous research in general community samples has suggested that high levels of stress and low levels of parental support are associated with depression in young people, but it is unclear whether or how they might be associated with depression among incarcerated youth who are already vulnerable. Using a sample of 228 adolescents (aged 13–18 years) who were detained in the juvenile justice system, stress and support were modeled as independent main effects and as interactive risk factors in relation to depressive symptoms. More stressful life events and less caregiver support were each independently associated with depressive symptoms, but no evidence was found for the buffering hypothesis in this sample. Stressful life events were more strongly associated with depressive symptoms among boys compared to girls.     

Individual Quality of Life Among at Risk Indigenous Youth in Australia

This paper reports the findings from a pilot study in which the Schedule for Individual Quality of Life (SEIQoL-DW) was used to determine how 15 at-risk Indigenous Australian male youths aged between 14 and 19 conceptualised their quality of life. The youths, who were referred with problems associated with drug and alcohol misuse and criminal activity, were attending a diversionary program run by an Indigenous organisation in the Northern Territory, Australia. Quality of life was measured before and at the end of the nine-day programme in order to evaluate outcomes. Program staff found the SEIQoL-DW to be particularly useful in identifying culturally specific quality of life domains, allowing interventions to focus on improving the life areas that were of particular value to individuals as well as recognizing any deficits in their understanding the options available to them. While a control group was not used, mean SEIQoL-DW scores increased significantly over the course of the program.     

Externalizing Symptomatology Among Adoptive Youth: Prevalence and Preadoption Risk Factors

The extent of symptomatology related to attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) was examined in a statewide sample of adopted youth, aged 4–18 years (n = 808). The use of normed questionnaires in a nonclinical sample decreased biases associated with past research on adopted children. According to parental report, a striking number of the youth qualified as manifesting significant symptom levels of externalizing behavior problems: 21% met symptom cutoffs for ADHD (with or without ODD) and 20% met criteria for ODD (with or without ADHD), for a combined total of 29% of the sample. A number of parent-reported, preadoptive risk factors distinguished these groups from one another and from the nonexternalizing youth. The clearest associated factors included histories of preadoption abuse/neglect, later age of adoption, prenatal drug exposure, and placement in multiple foster homes prior to adoption. We discuss implications regarding both etiology and current controversies surrounding the disproportionate levels of behavioral difficulties in adopted youth.     

Longitudinal Linkages Between Posttraumatic Stress Disorder Symptoms and Violent Behaviors Among Chinese Adolescents Following the Wenchuan Earthquake

This study was conducted to examine the longitudinal relations between posttraumatic stress disorder (PTSD) symptoms and violent behaviors. In this study, 415 adolescent survivors of the Wenchuan earthquake in China (May 12, 2008) were assessed by using self-report questionnaires 1 year (T1), 1.5 years (T2), and 2 years (T3) after the earthquake. The findings suggested that from 1 to 1.5 years after the earthquake, only intrusive symptoms of PTSD were a risk factor for violent behaviors, whereas violent behaviors were a risk factor for all 3 PTSD symptom clusters. Furthermore, 1.5 to 2 years after the earthquake, avoidance symptoms of PTSD were a risk factor for violent behaviors and hyperarousal symptoms of PTSD had no significant relation with violent behaviors.     

Symptoms of Posttraumatic Stress Disorder and Social Support Among Children and Adolescents After the 2010 Haitian Earthquake

This study explored the prevalence of posttraumatic stress disorder (PTSD) symptoms related to social support received by the children and adolescents who survived the earthquake on January 12, 2010, in Haiti. A strategy of stratified sampling was used, and 540 children and teenagers were questioned. Questionnaires based on the PTSD Checklist, the Impact of Event Scale-Revised, and the Peritraumatic Distress Inventory, among others, were used and bivariate statistical analyses were carried out. The results showed high rates of complete and partial PTSD symptoms, with higher rates among females, and indicated the need for reinforcing social support as a resilience factor for youth.     

Relationships Between Trauma,Posttraumatic Stress Disorder Symptoms,Dissociative Symptoms,and Lifetime Heroin Use Among Individuals Who Abuse Substances in Residential Treatment

This study explored the relationships between trauma, posttraumatic stress disorder symptoms, dissociation, and lifetime heroin use among inpatient clients who abused substances. Results indicate important implications for practice and directions for future research.     

Associations Among Selective Attention, Memory Bias, Cognitive Errors and Symptoms of Anxiety in Youth

The purpose of this study was to examine the linkages among selective attention, memory bias, cognitive errors, and anxiety problems by testing a model of the interrelations among these cognitive variables and childhood anxiety disorder symptoms. A community sample of 81 youth (38 females and 43 males) aged 9-17 years and their parents completed measures of the child's anxiety disorder symptoms. Youth completed assessments measuring selective attention, memory bias, and cognitive errors. Results indicated that selective attention, memory bias, and cognitive errors were each correlated with childhood anxiety problems and provide support for a cognitive model of anxiety which posits that these three biases are associated with childhood anxiety problems. Only limited support for significant interrelations among selective attention, memory bias, and cognitive errors was found. Finally, results point towards an effective strategy for moving the assessment of selective attention to younger and community samples of youth.