Posttraumatic Overmodulation,Callous–Unemotional Traits,and Offending Among Justice-Involved Youth

A large body of research has demonstrated an association between childhood trauma exposure (TE) and adolescent delinquency. This association may be explained by callous–unemotional (CU) traits, which may stem from TE and are associated with persistent offending and recidivism. However, research on the mechanisms underlying TE and delinquency has lacked specificity regarding the posttraumatic symptoms that may drive this effect, particularly new models that distinguish between posttraumatic symptoms (PTS) of overmodulation versus undermodulation. This article sought to investigate the role of overmodulation in the association between TE and CU traits and their relations with persistent offending. Participants included 829 detained youth who completed self-report measures of TE, PTS, and CU traits. Official records of youth offenses were also obtained. Results of path analyses demonstrated that the association between interpersonal TE and persistent offending exhibited an indirect effect through overmodulation and CU traits. Efforts to address overmodulation among traumatized detained youth may represent a promising avenue of intervention for reducing recidivism.     

Individual, Social, and Behavioral Factors Associated with Co-Occurring Conduct Problems and Callous-Unemotional Traits

Conduct problems (CP) and callous-unemotional (CU) traits can have a long-lasting negative impact into adulthood. Importantly, among youth with CP, those high on CU traits engage in a more severe, aggressive, and persistent pattern of antisocial behavior. The current study investigates the co-occurrence between CP and CU traits among a large sample of Greek-Cypriot adolescents (N?=?1,674; 50.1 % girls). Five distinct groups were identified with Latent Profile Analysis: low risk (48.7 %), average risk (33.8 %), co-occurring high CP-high CU (5.4 %), high CP-low CU (5.2 %), and low CP-high CU (6.9 %). Although more boys were identified in the higher risk groups, boys and girls within each group were not differentiated on levels of CP or CU traits during early adolescence. Youth in the identified groups were compared on early (Mean age?=?12.12) and middle (Mean age?=?14.02) adolescence individual and contextual factors. Youth with high CP-high CU were at higher risk for behavioral (bullying and substance use), individual (inattention, impulsivity, narcissism), and contextual (low family-support) problems compared to youth in the high CP-low CU and low CP-high CU groups, providing evidence that the combination of CP and CU traits might constitute a pathological group. These findings demonstrate the usefulness of sub-typing CP based on CU traits for the forthcoming fifth edition of the Diagnostic and Statistical Manual. Additional novel findings suggested that adolescents scoring high on CP, irrespective of CU, were not differentiated on hyperactivity, victimization, and anxiety/depression, and adolescents scoring high on CU traits, with or without CP, reported similar low levels of self-esteem and peer and family social-support.     

Victimization and PTSD in a Faroese youth total-population sample

Petersen, T., Elklit, A. & Olesen, J. G. (2010). Victimization and PTSD in a Faroese youth total-population sample. Scandinavian Journal of Psychology, 51, 56–62.
The prevalence of twenty traumatic events and negative life events in relation to posttraumatic stress disorder (PTSD) was studied in a Faroese total-population sample of 687 eighth-grade students with a mean age of 14.2 years. Ninety-four percent of the females and 89% of the males were directly exposed to or had witnessed at least one traumatic event or a negative life event. The odds ratios for PTSD after direct and indirect exposure to specific events are described. The lifetime prevalence of PTSD was 20%, whereas another 14% reached a subclinical level of PTSD. After exposure, females had PTSD more than twice as often as males. Being exposed to multiple traumatic events, living with a single parent, and having experienced a traumatic event or a negative life event within the last year were all associated with PTSD and its subscales.     

负性生活事件、社会支持和创伤后应激障碍症状：对汶川地震后青少年的追踪研究

创伤后应激障碍是灾难后常见的心理病理问题, 灾后继发负性生活事件和社会支持是影响创伤后应激障碍症状的重要因素。该研究采用追踪设计, 历时2年对汶川地震后都江堰地区1573名青少年进行3次测查, 考察震后继发负性生活事件、不同类型社会支持与创伤后应激障碍症状之间的相互作用关系。研究发现：不同类型的社会支持与震后继发负性生活事件、创伤后应激障碍症状存在不同的作用关系; 震后继发负性生活事件不仅直接影响个体的心理健康还对个体的社会支持系统有损害; 震后负性生活事件、主观支持与创伤后应激障碍症状存在联动效应, 即三者中任一方面的变化都可能引起其他方面的变化。     

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.     

Violence Exposure Mediates the Relation Between Callous-Unemotional Traits and Offending Patterns in Adolescents

The link between callous-unemotional (CU) traits in youth and delinquent, aggressive and violent behavior is well-replicated in the literature. However, the mediating effects of violence exposure on this relationship are unclear. The current study addresses this important gap in the literature with a sample of 88 detained, primarily ethnic minority adolescent boys (M age?=?15.57; SD?=?1.28). Results indicate that exposure to violence fully mediated the relationship between CU traits and violent delinquency, and this pattern of mediation was accounted for by exposure to witnessed violence, but not direct violent victimization. Secondly, exposure to violence, both direct and witnessed forms, also mediated the relationship between CU traits and drug delinquency. These findings suggest that (a) the well-established link between CU traits and violence may be attributed to high rates of witnessed violence among this subpopulation, and (b) specific types of violence exposure may be important for predicting the offending patterns of youth high on CU traits. Theoretical and practical implications are discussed.     

The Relationship Between Secondary Traumatic Stress and Personal Posttraumatic Growth: Personality Factors as Moderators

This present study examined the relationship between secondary traumatic stress, personality factors, and personal posttraumatic growth for persons indirectly exposed to traumatic life events. A sample of 162 nurses and physicians completed the self-report measures describing symptoms of secondary traumatic stress, personality factors and vicarious posttraumatic growth. The results indicated that secondary traumatic stress negatively correlated with vicarious posttraumatic growth. Moreover, this relation is moderated by personality factors. A low level of secondary traumatic stress symptoms is associated with a higher level of perceived posttraumatic growth for participants with a high level of openness, agreeability and conscientiousness. These findings emphasize the differences in perceiving posttraumatic growth in the context of secondary exposure to traumatic life events.     

The Impact of Benefit Finding and Leadership on Combat-Related PTSD Symptoms

Benefit finding and unit leadership have been identified as buffers against the negative effects of combat exposure on posttraumatic stress disorder (PTSD) symptoms. However, little is known about how these different buffers work together to protect military personnel from the negative effects of combat. We examined benefit finding and leadership as buffers of the combat–PTSD symptoms link in a sample of recently returned combat veterans (N?=?583). Results revealed that when higher levels of noncommissioned officer (NCO) leadership and benefit finding (BF) were reported, fewer PTSD symptoms were endorsed. Additionally, BF buffered the relationship between combat stress and PTSD symptoms, but only under conditions of supportive officer leadership. Implications of these findings for military settings are discussed.     

青少年创伤后应激障碍和创伤后成长对亲社会行为的影响:生命意义的中介作用

采用创伤暴露程度问卷、创伤后应激障碍症状核查表、创伤后成长问卷、生命意义感量表和亲社会行为问卷,在汶川地震8.5年后对地震极重灾区的1182名中学生进行调查,考察创伤后应激障碍（PTSD）和创伤后成长（PTG）对亲社会行为的影响,并检验存在意义感和寻求意义感在其中的中介作用。结果发现：PTSD可以直接负向预测亲社会行为,也可以通过降低存在意义感进而负向预测亲社会行为,还可以通过提高寻求意义感进而正向预测亲社会行为;PTG可以直接正向预测亲社会行为,也可以分别通过提高存在意义感和寻求意义感进而正向预测亲社会行为。     

The roles of trauma exposure,rejection sensitivity,and callous‐unemotional traits in the aggressive behavior of justice‐involved youth: A moderated mediation model

Research has demonstrated an association between childhood trauma exposure and adolescent aggression. This association may be explained by rejection sensitivity, defined as anger, or anxiety in the anticipation of rejection, which can be a consequence of trauma exposure. Callous‐unemotional (CU) traits also are associated with trauma exposure and aggressive behavior; however, research has not yet investigated the interactive roles that rejection sensitivity and CU traits play in the relation between trauma exposure and aggression. Therefore, this study sought to investigate the role of rejection sensitivity in the association between trauma exposure and aggression, and whether this indirect effect was moderated by CU traits. Participants included 380 detained youth (98 girls, 282 boys) who completed self‐report measures of trauma exposure, angry, and anxious rejection sensitivity, CU traits, and aggression. Results of moderated mediation demonstrated that the relation between trauma exposure and aggression exhibited an indirect effect through angry rejection sensitivity, but only at moderate or high levels of CU traits. This pattern was not found for anxious rejection sensitivity. Results suggest that interventions aimed to decrease aggressive behavior in traumatized adolescents may benefit from considering how youth respond to rejection, as well as whether youth endorse CU traits, as this may help to limit further involvement in the juvenile justice system after release.

     

Adverse Life Events, Coping and Internalizing and Externalizing Behaviors in Urban African American Youth

African American youth residing in low income urban neighborhoods are at increased risk of experiencing negative life events in multiple domains, increasing their risk for internalizing and externalizing behaviors. However, little is known about youth’s differential responses to life event stress, or protective processes and coping strategies for urban African American youth exposed to adverse life events. Thus, the present study examined whether variability in predominantly low income, urban African American youth’s responses to life event stress are accounted for by the type of life event experienced or the type of coping strategies used. Participants were a community sample of 353 urban African American youth (52.8 % girls; age range 8–12 years) who participated in the Multiple Opportunities to Reach Excellence (MORE) Project. Youth reported about their experiences with adverse life events, coping strategies, and internalizing and externalizing symptoms. Results indicated that violent life events were uniquely associated with externalizing behavior, while discrimination and economic stress were uniquely associated with internalizing behavior. The utility of coping strategies varied by gender, such that avoiding problems was protective for girls who experienced violent life events, but not for boys. For boys, exposure to violence was significantly positively associated with externalizing symptoms regardless of the amount of avoiding problems coping used. Findings suggest that interventions to develop coping strategies may need to be gender-specific as well as tailored for the types of stressors common for low income urban youth.     

Identity Distress Among Youth Exposed to Natural Disasters: Associations with Level of Exposure,Posttraumatic Stress,and Internalizing Problems

Identity distress involves intense or prolonged upset or worry about personal identity issues including long-term goals, career choice, friendships, sexual orientation and behavior, religion, values and beliefs, and group loyalties. Research suggests that trauma exposure and subsequent posttraumatic stress disorder (PTSD) symptoms may negatively affect identity development and psychological adjustment. However, little is known about their specific associations with identity distress and internalizing problems among disaster-exposed adolescents. This study aimed to examine these associations in a sample of 325 adolescents (60% female; 89% African American) who experienced a major natural disaster and its aftermath. The results indicated that identity distress was positively associated with age, hurricane exposure, PTSD symptoms, and internalizing problems. Linear regression analyses also showed that identity distress was uniquely associated with internalizing symptoms and that there was an indirect effect of hurricane exposure on identity distress via PTSD symptoms. PTSD symptoms moderated the link between identity distress and internalizing symptoms, with a significant positive slope found for youth with more PTSD symptoms. Findings were generally consistent with previous work and predictions, and they add to the extant knowledge about identity distress by providing data on the linkages among disaster exposure, posttraumatic stress, and internalizing problems in adolescents.     

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.     

ADHD symptoms and callous‐unemotional traits as predictors of violent media use in adolescence

We investigated ADHD symptoms and CU traits as predictors of violent media use in adolescence, controlling for delinquency and ODD symptoms. The effects on of disinhibition and arousal to negative stimuli, core characteristics of ADHD symptoms and CU traits, and of gender were investigated. At age 15, 88 adolescents, 50 % boys reported on CU traits, ADHD symptoms and delinquency. Parents rated the adolescents’ CU traits, ADHD‐ and ODD symptoms. At age 16, adolescents reported on their media habits and performed tests of disinhibition and arousal to negative stimuli. Boys had higher levels of CU traits and violent media use and girls had higher levels of arousal to negative pictures. CU traits and inattention symptoms predicted violent media use, the latter association applying only to boys, with CU traits being the strongest predictor. Low arousal to threat pictures explained variance in violent media use, above CU traits. Attraction to violent media seems affected by problem behaviors, with CU traits coming forth as especially important.     

Personality factors and posttraumatic stress: associations in civilians one year after air attacks

There is an ongoing debate on which risk factors for developing posttraumatic stress symptoms are more important--personality traits reflecting vulnerability, previous stressful experiences or characteristics of the traumatic event. In this study, posttraumatic stress symptoms and their relationship with personality traits, previous stressful experiences and exposure to stressful events during air attacks in Yugoslavia were investigated. The Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983), Impact of Events Scale (IES; Horowitz, Wilner, & Alvarez, 1979), Life Stressor Checklist Revised (LSCL-R; Wolfe & Kimerling, 1997), and List of Stressors were administered to a homogeneous group of medical students 1 year after the attacks. In multiple regression analyses, compulsive and passive-aggressive personality traits and a higher level of exposure to stressors during air attacks independently predicted the degree of intrusion symptoms. Avoidance symptoms were predicted by avoidant personality traits and a higher exposure to stressors both previously in life and during the attacks. In the next step, we tested in analyses of variance whether personality traits, previous stressful experiences, and stressful events during attacks as independent variables interact in predicting intrusion and avoidance symptoms. For this, students were clustered into three groups depending on their predominant personality traits. In addition to direct predictive effects, there were significant interaction effects in predicting both intrusion and avoidance. The findings suggest that each of the tested factors, i.e., personality traits, previous stressful experiences, and exposure to traumatic events may have an independent and direct influence on developing posttraumatic stress. However, the effect of these factors cannot just be added up. Rather, the factors interact in their impact on posttraumatic stress symptoms. Bigger samples and longitudinal designs will be required to understand precisely how different personality traits influence response to stressful events.     

Exposure to Verbal Parental Aggression and Sexual Activity Among Low Income African American Youth

The study examined whether witnessing verbal parental aggression (VPA) was related to sexual activity among mostly low income African American youth, and whether psychological symptoms mediated this relationship. Five hundred and sixty-three African American high school adolescents (ages 13–19) completed self-administered questionnaires, which assessed demographics, psychological problems (e.g., depression, anxiety, aggression and posttraumatic stress disorder symptoms), witnessing VPA, and sexual activity. Participants who witnessed high versus no VPA were 2 times more likely to report sexual activity. This relationship was mediated by aggression for males and females, and posttraumatic stress disorder symptoms for females only. Youth service providers should be trained to understand the prevalence of co-occurring problems such as exposure to VPA, aggression, PTSD symptoms, and sexual activity, with the goal of more effectively supporting the healthy development of African American youth.     

Aggressive Male Juvenile Offenders with Callous-Unemotional Traits Show Aberrant Attentional Orienting to Distress Cues

Antisocial youth with callous-unemotional (CU) traits exhibit a pattern of severe and persistent conduct problems and deficits in emotional processing that parallels adults with psychopathy. Aberrant emotional attention, particularly among individuals high on aggression, constitutes one such deficit; however, its robustness across race/ethnicity requires further investigation given findings that the psychopathy construct manifests differently across race (Sullivan and Kosson 2006), and emotional attention is susceptible to the influence of adverse environmental factors such as violence exposure that is more common among ethnic minority youth (Kimonis et al. in Development and Psychopathology, 20, 569–589, 2008b). Also, the development of a comprehensive measure of CU traits, the Inventory of Callous-Unemotional Traits (ICU), has identified specific CU dimensions (Uncaring, Callous, Unemotional) that are yet to be investigated in relation to emotional attention deficits. Thus, the purpose of the present study was to examine whether aggressive boys high on total CU traits and specific ICU dimensions show deficits in attentional orienting to negative stimuli on a dot-probe task that are consistent across race/ethnicity. Results from a predominately Latino sample of incarcerated male adolescents (N = 156) showed that aggression moderated the association between CU traits and facilitation to distress stimuli. That is, aggressive boys high on CU traits or the Uncaring dimension showed deficient attentional orienting; a finding that was consistent across racial/ethnic minority groups. Results are consistent with prior research suggesting that the combination of high CU traits and aggression defines a unique subgroup of antisocial individuals that more closely fits with the construct of psychopathy than the presence of CU traits alone.     

Grandiose-Manipulative,Callous-Unemotional,and Daring-Impulsive: the Prediction of Psychopathic Traits in Adolescence and their Outcomes in Adulthood

There has been much debate about how to measure psychopathic traits in adolescence. One of the main issues is whether one should focus on callous-unemotional (CU) traits alone, or CU traits in combination with Grandiose-Manipulative (GM) and Daring-Impulsive (DI) traits. The current study first investigates the extent to which youth who are high on CU traits are also high on GM and DI traits. In addition, the study investigates if being high on both CU and GM, and high on both CU and DI, identify groups that are particularly characterized by past and future impairments. To investigate this, data from the Cambridge Study in Delinquent Development (CSDD) was analyzed. The CSDD is a prospective longitudinal study of 411 English boys spanning over 50 years. The information available at age 12–14 was coded on the Antisocial Process Screening Device (APSD). Childhood risk factors were measured at age 8–10 and later life outcomes were measured at age 32. The results indicate that being high on CU in combination with DI delineates a clinically interesting group who are characterized by high childhood risk and poorer adult life outcomes. The same applied to the high CU/high GM group, but to a lesser extent.     

震前生活事件、创伤程度对中学生震后心理应激状况的影响

采用青少年生活事件量表（ASLEC）、自编震后创伤程度调查表和PTSD自评量表对汶川地震区413名中学生进行问卷调查,探讨震前生活事件、创伤程度对震后心理应激反应的影响。结果表明：中学生PTSD症状有显著的性别差异,女生高于男生;震前生活事件、创伤程度的各维度与PTSD症状反应总分相关显著;学习压力、暴露和丧失程度均对再体验有显著的正向影响;学习压力、受惩罚、其他、暴露和丧失程度对逃避及麻木有显著影响;学习压力、其他、暴露和丧失程度对过度觉醒有显著的正向影响;震前生活事件对PTSD症状反应有重要的影响     

Posttraumatic Stress Related to Hyperglycemia: Prevalence in Adults with Type I Diabetes

Prevalence of hyperglycemia-related posttraumatic stress (PTS) was assessed in 239 adults with type 1 diabetes using the posttraumatic stress diagnostic scale (PDS; Foa, Posttraumatic stress diagnostic scale manual, National Computer Systems, Inc., Minneapolis, 1995) by an anonymous online survey. Additionally, this study aimed to identify variables related to hyperglycemia-related PTS. Over 30 % of participants reported symptoms consistent with PTSD related to hyperglycemia with standard PDS scoring, and 10 % with more conservative scoring. Hierarchical multiple regression analyses indicated that diabetes self-management behavior and perceived helplessness about hyperglycemia predicted PTSD with standard scoring. Perceived death threat, self-management behavior, helplessness about hyperglycemia, and severity of hypoglycemia in past month predicted PTSD using more conservative scoring. Perceived helplessness, hypoglycemia severity, perceived death-threat, HbA1c, and self-management behavior predicted PTS severity. When fear, helplessness, and perceived death-threat were combined to represent an overall cognitive appraisal factor, this variable was the strongest predictor of PTSD and PTS severity. Scores for PTSD symptom clusters appeared similar to data on hypoglycemia-related PTS.