Prospective Risk Factors for Adolescent PTSD: Sources of Differential Exposure and Differential Vulnerability

There are two types of risk factors for developing PTSD: factors that increase the likelihood of experiencing a potentially traumatizing event and factors that increase the likelihood of developing symptoms following such events. Using prospective data over a two-year period from a large, diverse sample of urban adolescents (n?=?1242, Mean age?=?13.5), the current study differentiates these two sources of risk for developing PTSD in response to violence exposure. Five domains of potential risk and protective factors were examined: community context (e.g., neighborhood poverty), family risk (e.g., family conflict), behavioral maladjustment (e.g., internalizing symptoms), cognitive vulnerabilities (e.g., low IQ), and interpersonal problems (e.g., low social support). Time 1 interpersonal violence history, externalizing behaviors, and association with deviant peers were the best predictors of subsequent violence, but did not further increase the likelihood of PTSD in response to violence. Race/ethnicity, thought disorder symptoms, and social problems were distinctly predictive of the development of PTSD following violence exposure. Among youth exposed to violence, Time 1 risk factors did not predict specific event features associated with elevated PTSD rates (e.g., parent as perpetrator), nor did interactions between Time 1 factors and event features add significantly to the prediction of PTSD diagnosis. Findings highlight areas for refinement in adolescent PTSD symptom measures and conceptualization, and provide direction for more targeted prevention and intervention efforts.     

Rumination and Impaired Cortisol Recovery Following a Social Stressor in Adolescent Depression

Response styles theory promotes rumination as a central cognitive construct driving negative mood and depression, and past research suggests that at least part of the mechanism driving rumination’s depressogenic effect is through inhibiting the individual’s ability to shift attentional focus away from negative environmental stimuli. In the current study, we hypothesized that high trait rumination would be associated with impaired recovery of the body’s biological response to psychological stress. In a community sample of depressed (n?=?31) and non-depressed (n?=?33) adolescents we assessed rumination and the more adaptive trait of distraction and problem-solving with the Children’s Response Styles Questionnaire (CRSQ; Abela 2000), and diagnostic status was confirmed using the Child and Adolescent Schedule of Affective Disorders and Schizophrenia (K-SADS; Kaufman et al. Journal of the American Academy of Child and Adolescent Psychiatry 36:980–988, 1997). Participants completed the Trier Social Stress Test (TSST; Kirschbaum et al. Neuropsychobiology 28:76–81, 1993), and the focus of our analyses was the change in salivary cortisol concentration between peak cortisol output (25 min post-stressor) and a sample taken during the “Recovery” period 65 minutes post-stressor. Consistent with the predictions of response style theory, among the depressed adolescents only, high trait rumination was associated with delayed post-stressor cortisol recovery, whereas high trait distraction and problem-solving was associated with more rapid recovery. In contrast, response styles were not associated with cortisol recovery in the non-depressed group. These findings implicate impaired post-stress cortisol recovery as a potential mechanism underlying the pathological effect of rumination on the development and maintenance of Major Depressive Disorder (MDD).     

A Longitudinal Assessment of the Associations Among Response Access, Attention Problems, and Aggression during Childhood

Children with ADHD symptoms often display social competence deficits, yet mechanisms for their social difficulties remain unclear. Using data from the normative sample of non-intervention respondents (N?=?387; 50 % male; 49 % non-European-American; age at initial assessment: M?=?6.5 years, SD?=?0.48) in the Fast Track project (Lochman and CPPRG Journal of Consulting and Clinical Psychology 63:549–59, 1995), the social-information processing ability of accessing responses for social situations was modeled across four time points from kindergarten to third grade. Teacher-rated aggression and ADHD symptoms were included as predictors of the intercept and slope. Low ADHD symptoms were associated with a decline in aggressive responses across childhood, whereas high ADHD symptoms were linked to an increase in aggressive responses that decelerated between second and third grade. Regarding competent responses, low ADHD symptoms predicted increases in competent responses, but this increase decelerated between second and third grade. High ADHD symptoms were also associated with a slight increase in competent responses into first grade, but competent responses decreased from first to third grade. Neither aggression nor the interaction of ADHD symptoms and aggression accounted for a significant amount of variance in aggressive or competent responses. Future research should identify if differences in response access associated with high and low ADHD symptoms link to difficulties making and keeping friendships.     

Pediatric traumatic brain injury: Language outcomes and their relationship to the arcuate fasciculus

Pediatric traumatic brain injury (TBI) may result in long-lasting language impairments alongside dysarthria, a motor-speech disorder. Whether this co-morbidity is due to the functional links between speech and language networks, or to widespread damage affecting both motor and language tracts, remains unknown.     

Inviting perspective transformation: Sexual history awareness for professional formation

How do we deal with our own sexuality as teachers and as learners in the classroom? As a seminary professor in a mainline Christian context, I find that discussing sexuality increases student discomfort levels by threatening to raise questions about the connections between morality, behavior, and bodies of those in the room – questions we have been culturally trained to avoid. In order to decrease discomfort, many instructors approach sexuality only as content‐based subject matter. Particularly for ministry students, this approach can be a disservice to their discernment process and preparation for future ministry contexts, especially for those in turmoil regarding sexuality‐related issues. By explicitly engaging how personal experience and cultural contexts shape our sexuality, pedagogical models can promote critical self‐reflection and seek perspective transformation, not values change, as a resource for professional sexual ethics training in ministry.     

Coaching Paraprofessionals to Promote Engagement and Social Interactions During Small Group Activities

Paraprofessionals need adequate training and supports to assist young children with autism spectrum disorders to engage in appropriate social interactions during small group activities with their peers. In this study, we used in situ coaching and brief post-session feedback to improve the use of environmental arrangement, prompting, and praise by three paraprofessionals working in inclusive classrooms. Results suggested the brief coaching intervention was effective for improving target behaviors. In addition, generalized use of behaviors and child outcomes were positive. In situ feedback is a promising practice for improving use of evidence-based practices by non-certified personnel in early childhood settings.     

A Psycho-Educational Intervention for People with a Family History of Depression: Pilot Results

We developed and pilot-tested the first online psycho-educational intervention that specifically targets people with a family history of depression (‘LINKS’). LINKS provides genetic risk information and evidence-rated information on preventive strategies for depression and incorporates a risk assessment tool and several videos using professional actors. LINKS was pilot-tested in the general practitioner (GP) setting. The patient sample included people with a family history of at least one first-degree relative (FDR) with major depressive disorder (MDD) or bipolar disorder (BD). Patients attending participating GP practices were invited to enroll in the study by letter from their GP. Patients who self-identified as having at least one first-degree relative (FDR) with MDD or BD were eligible. Patients completed questionnaires, pre-post viewing LINKS, with measures assessing satisfaction, relevance, emotional impact and perceived improvement of understanding. Six GP practices participated, and 24 patients completed both questionnaires. Of these, all reported that they were satisfied or very satisfied with LINKS, and 74 % reported that LINKS met their expectations, and 21 % that it exceeded their expectations. LINKS was judged highly acceptable by this sample of GP attendees, and results indicate that an assessment of its effectiveness in a larger controlled trial is warranted.