Treating Multitraumatized,Socially Marginalized Children: Results of a Naturalistic Treatment Outcome Study

Although early-onset, repeated trauma is relatively common in socially marginalized populations and related to numerous negative outcomes, most empirically validated interventions are not especially well tailored to meet the complex and individualized needs of child and adolescent trauma survivors in such contexts. Integrative treatment of complex trauma (ITCT) was developed as a specialized treatment that is empirically informed, culturally sensitive, extendable beyond the short term, and customized to the specific social and psychological issues of each child. This article examines the potential effectiveness of ITCT in assisting 151 traumatized children living in an economically deprived environment. Results indicate significant reductions in anxiety, depression, posttraumatic stress, anger, dissociation, and sexual concerns as a function of time in treatment.     

Emotional Constriction and Risk for Posttraumatic Stress: The Roles of Trauma History and Gender

Research suggests there are qualitative differences in emotionality across gender, with men being more emotionally constrictive than women. Constrictive emotionality has consistently been linked to posttraumatic stress disorder (PTSD) and because men are generally more emotionally constrictive, one could infer they are at increased risk for PTSD. However, research demonstrates that twice as many women are diagnosed with PTSD than men. In an undergraduate sample, men reported significantly greater emotional constriction, but significantly less posttraumatic stress severity in comparison to women. The gender differences in emotional constriction disappeared in a subsample of students who endorsed experiencing an upsetting event. Emotional constriction mediated the relationship between trauma and posttraumatic stress severity, although it was a stronger mediator for women than men.     

Emotional Freedom Techniques

Abstract

Callahan (1985) developed a procedure of tapping on acupressure points for treating mental problems. Craig and Fowlie (1995) modified Callahan's procedure to a simplified version called Emotional Freedom Techniques (EFT). EFT is easy to teach and is effective with symptoms of PTSD. This article presents EFT as an adjunct to the Critical Incident Stress Reduction debriefing procedures. The use of EFT in debriefings results in shorter and more thorough sessions. It often reduces the emotional pain of the debriefing. This paper provides complete instructions and safeguards for using EFT when debriefing in disaster situations and with other applications. Included are references for further reading and training.     

Effects of Racial Discrimination,Childhood Trauma,and Trauma Symptoms on Juvenile Delinquency in African American Incarcerated Youth

To understand racial disproportionality in juvenile delinquency, we studied relationships between 2 possible contributors: effects of manifestations of a structural factor (racism) and psychological consequences of trauma. Informed by Carter’s (2007) theory of race-based trauma, we explored the role of experiences of racial discrimination, childhood trauma, and trauma symptoms in juvenile delinquency through self-reported experiences of incarcerated African American youth. We found that childhood trauma, trauma symptoms, and racial discrimination experiences all significantly contributed to juvenile delinquency, but participants who experienced greater racial discrimination had higher posttraumatic stress symptoms and elevated delinquency rates. Considering the well-documented effects of trauma symptoms on juvenile delinquency, race-based trauma experiences might help us understand one aspect of racial disproportionality in juvenile delinquency.     

Cognitive Behavioral Therapy for PTSD: The Role of Complex PTSD on Treatment Outcome

Posttraumatic stress disorder (PTSD) represents an often chronic and debilitating mental illness resulting from exposure to trauma. Although the most compelling evidence for the treatment of PTSD is cognitive behavioral therapy (CBT), many patients experience residual functional impairment, or relapse, suggesting that this approach does not work for all cases of PTSD. Repeated severe trauma, particularly during development, might increase the risk for a more intricate clinical profile, called complex PTSD (CPTSD), which might contribute to poorer treatment response. The following provides a comprehensive summary of the evidence examining whether CPTSD symptomatology is related to poorer treatment outcome of CBT, reviews the literature on the treatment of CPTSD, and offers insights into current issues and future directions of the construct.     

Pregnancy as an Opportunity for Trauma-Intervention Among Women Who Are Addicted to Substances

Victims of violence come from various backgrounds; however, the intersection of gender combined with poverty, belonging to a racial minority, [dis]ability, and youth, put women at greater risk for experiencing violence and trauma. Many of these features are also high-risk markers for women who experience addictions to substances. Considering the risk factors and prevalence of violence and addictions experienced by young women, it is important to consider the comorbidity of complex trauma and substance use disorder and their combined effects on women’s reproductive health. The experience of pregnancy, combined with the experience of past trauma and addictions, presents a complex and compelling situation in which women struggle to balance their intentions to maintain a healthy pregnancy, with the drive to use substances as a way to cope with unresolved past traumatic experiences. By reviewing the literature regarding addictions, pregnancy, and complex trauma, this article aims to demonstrate that pregnancy presents a unique opportunity for trauma intervention among addicted women, and to establish how a missed opportunity for trauma-focused intervention can contribute to intergenerational trauma, creating a cycle of harm for women and their children.     

Composite Trauma and Mental Health Diagnosis as Predictors of Lifetime Nonsuicidal Self-Injury History in an Adult Online Sample

Some research indicates that trauma history might be related to nonsuicidal self-injury (NSSI), but the exact nature of this relationship is unknown. Therefore, we created and tested a structural equation model for the relationships between composite trauma, NSSI, mental health diagnosis, and gender in a community sample of 296 U.S. adults recruited through Amazon Mechanical Turk. Composite trauma and mental health diagnosis were significantly predictive of an NSSI history. The pathway between NSSI and gender was not significant. It is important to consider multiple domains of trauma, in the form of composite lifetime trauma, as risk factors for NSSI.     

Evaluation of a Trauma-Informed School Intervention with Girls in a Residential Facility School: Student Perceptions of School Environment

In response to the high nationwide prevalence of psychological trauma among court-involved youth who have been exposed to abuse and neglect and the associated far-reaching adverse consequences, there are calls to develop a trauma-informed workforce across the various systems (child welfare, juvenile justice, mental health, and education) designed to serve this population. We describe a pilot test of a modified version of the Heart of Teaching and Learning (HTL) curriculum, an intervention designed to increase trauma-informed practices in education settings. This program was implemented in a public charter school that exclusively serves court-involved youth placed in residential treatment. The intervention was associated with decreases in trauma symptoms experienced by youth. Because student perceptions of teachers were high both before and after implementation of the curriculum, no statistically significant changes were observed. The article concludes with a discussion of the ways in which the curriculum can be used to help prepare a national education workforce capable of implementing trauma-informed evidence-based practices in school settings.     

Relationships among Dispositional Attributional Style,Trauma-Specific Attributions,and PTSD Symptoms

The learned helplessness model and its various revisions suggest that causal attributions influence responses to events. This study examined relationships among the 3-factor symptom clusters of posttraumatic stress disorder (PTSD) represented in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV; American Psychiatric Association, 1994) and the individual dimensions of dispositional attributional style and trauma-specific attributions (i.e., internal–external, stable–unstable, global–specific). Relationships among attributions and clusters of PTSD symptoms represented by the 4-factor dysphoria model were also examined. Trauma-specific attributions were most predictive of PTSD symptoms, with higher associations for avoidance and numbing symptoms compared to arousal symptoms in the three-factor model and higher associations for dysphoria symptoms compared to arousal and avoidance symptoms in the four-factor dysphoria model. Results suggest that cognitive vulnerabilities could underlie the comorbidity between PTSD and depression and might represent a high-impact target for treatment.     

Applications of Trauma Treatment for Schizophrenia

Because of the high rates of trauma and posttraumatic stress disorder in individuals with psychotic disorders, there has been increasing emphasis on incorporating trauma treatment into comprehensive care for schizophrenia. Yet, despite heightened awareness of the need, limited information has been provided specifying an effective approach tailored to this population. Significant advances in trauma treatment have been made in recent years that can provide a general framework for guiding such interventions for individuals with schizophrenia. This article provides a brief review of the relationship between trauma and schizophrenia and offers a heuristic view of applications of current trauma treatment to psychotherapy for schizophrenia.