The ripple effect of trauma: Evaluating vulnerability, post-traumatic stress symptoms, and aggression within a child and adolescent population.

BACKGROUND: The deleterious effects of experiencing adverse childhood experiences (ACEs), especially those associated with child abuse and neglect (CM-ACEs), is well documented. Two common behavioral and emotional concerns observed in children following CM-ACEs is post-traumatic stress and aggression. While support for cognitive models explaining both of these outcomes exists, little is known about any shared cognitive vulnerabilities that may explain the presence of both. OBJECTIVE: The purpose of the current study was to evaluate a cognitive model of vulnerability/safety as a shared underlying mechanism for the development of post-traumatic stress symptoms (PTSS) and aggression following the occurrence of CM-ACEs in children. METHODS: Male youth between the ages of 6 and 14 attending school within a residential setting participated in a school-based performance improvement program. As a part of the program, data were collected on the child's history of abuse, PTSS, aggression, and feelings of safety and vulnerability. RESULTS: The results of the SEM suggested that there was a significant serial indirect effect of vulnerability and PTSS on the relation between CM-ACEs and reactive aggression. This was not true for proactive aggression. DISCUSSION: The current results suggest that that there may be a shared schema-based model in which feelings of vulnerability and cognitive models promoting the world as an unsafe place may contribute to the maintenance and development of both PTSS and reactive aggression among children who have experienced abuse/neglect.

Exploring the Nexus of Adverse Childhood Experiences and Aggression in Children and Adolescents: A Scoping Review.

A strong relation between adverse childhood experiences (ACE) and aggression has been established in adult populations, with less research examining this relation earlier in development. The purpose of this study was to complete a scoping review of the current evidence available on the relation between ACE and aggression and subtypes of aggression within a child and adolescent population. Inclusion criteria for the review included publications in English between 1998 and 2023, use of a child/adolescent population, and peer-review and quantitative publications. Databases searched included PubMed, APA PsycINFO, Scopus, and EBSCO, and search terms included words related to ACE and aggression. Initial selection was based on title and abstract, with 32 papers meeting eligibility criteria for inclusion. Two authors extracted the relevant characteristics of the studies independently and conferred on any disagreements. The overall findings from the scoping review suggest that there is a strong link between aggression and ACE; however, this link may not be as strong for specific subtypes of aggression. Additionally, characteristics of ACE may play role in understanding this relation, but little research is available within a child and adolescent population. A few studies have attempted to examine potential mediators and moderators of this relation; however, none have been replicated within a child and adolescent population. The findings from this review support the need for additional research in this area and identify significant gaps in the literature that need to be addressed within a child and adolescent population.

Pathways to Suicidal Behavior in Children and Adolescents: Examination of Child Maltreatment and Post-Traumatic Symptoms.

Suicide in youth exacts significant personal and community costs. Thus, it is important to understand predisposing risk factors. Experiencing adverse childhood experiences (ACEs), such as child maltreatment (CM-ACE), and the presence of post-traumatic stress disorder has been identified as a risk factor of suicidal behaviors among adults. Theoretical models of suicide suggest that the presence of painful experiences such as CM-ACEs increase the risk of suicidal behaviors. The relation between child maltreatment, post-traumatic stress symptom clusters (PTSS) and suicidal behaviors has not been explicitly examined among youth. The present study examined the relations between CM-ACEs, PTSS clusters, and suicidal behaviors in a clinical population of children. Children, male, ages 6 to 14, enrolled in a residential treatment program completed self-report measures to evaluate variables of interest. Path analyses revealed statistically significant direct effects of CM-ACEs and PTSS clusters on suicidal behaviors. Significant total indirect effects and marginally significant individual indirect effects of intrusion and avoidance symptoms were observed for the relation between CM-ACEs and suicidal behavior. Findings suggest that symptoms associated with specific PTSS clusters might help explain the relation between CM-ACEs and suicidal behavior, and therefore, present important implications for clinical practice and future research.

Pathways from child maltreatment to proactive and reactive aggression: The role of posttraumatic stress symptom clusters.

OBJECTIVE: Childhood aggression is related to a myriad of negative concurrent and long-term outcomes. To mitigate the risks associated with childhood aggression, it is important to understand risk factors that might predispose 1 to aggressive behaviors. One risk factor commonly associated with aggression is the experience of child maltreatment. A common outcome associated with child maltreatment is the development of posttraumatic stress symptoms (PTSS). Several prevailing theoretical models of both posttraumatic stress and aggression indicate that these constructs have similar underlying cognitive, behavioral, and emotional mechanisms. Therefore, the present study examined the relations between and among child maltreatment, PTSS clusters, and proactive and reactive aggression in children. METHOD: Children between the ages of 6 and 14 who were enrolled in a residential treatment program completed self-report measures to evaluate variables of interest. These variables were included as multiple outcomes in a path analysis model in which individual PTSS clusters were examined as potential multiple mediators of the relations between child maltreatment and proactive and reactive aggression. RESULTS: Direct effects of child maltreatment and PTSS clusters on aggression were observed. Significant indirect effects of the intrusion PTSS cluster on the relation between child maltreatment and reactive aggression was found. CONCLUSIONS: Findings suggest that symptoms associated with these specific PTSS clusters might help explain the relation between child maltreatment and reactive aggression and therefore present important implications for clinical practice and future research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Comorbid Internalizing and Externalizing Symptoms Among Children with ADHD: The Influence of Parental Distress, Parenting Practices, and Child Routines.

Emotional/behavioral concerns are common among children with ADHD. Familial factors (e.g., parental adjustment, parenting behaviors) are linked to the presence of comorbid internalizing/externalizing symptoms among children with ADHD. The purpose of the present study was to evaluate a model that includes multiple familial variables and their direct and indirect effects on child emotional and behavioral problems among children with ADHD. Participants included parents of children (6-12 years of age; M = 8.87, SD = 1.92) with a diagnosis of ADHD (N = 300). Participants completed measures of child emotional/behavioral concerns, parental distress, routines, and parenting behaviors. Path analyses revealed direct effects for parental distress, parent behavior and routines on child adjustment, after controlling for the other variables. A significant indirect relation between parental distress, routines, and externalizing behavior was observed. These findings highlight one specific path through which parental distress appears to influence specific behavioral concerns that are commonly observed in children with ADHD.

Sluggish Cognitive Tempo and Behavioral Difficulties in Children with ADHD: Associations with Internalizing and Externalizing Symptoms.

Sluggish cognitive tempo (SCT) appears to be distinct from attention-deficit/hyperactivity disorder (ADHD) and unique patterns of association between SCT and comorbid symptoms have been reported in the literature. The current study examined the relation between environmental supports and comorbid concerns among children with high SCT. Parents of children (ages 6-12) with a diagnosis of ADHD and clinically elevated SCT (N = 126) completed measures of emotional/behavioral functioning, child routines, and parental adjustment. Regression analyses revealed that after controlling for child age and parental adjustment, Household and Daily Living routines were associated with lower levels of externalizing symptoms while Discipline routines were associated with higher levels of these symptoms, accounting for nearly 20% of the variance in the equation. The findings suggest that for children with ADHD and high SCT routines may play an important role as an environmental support for externalizing symptoms.

Predicting Internalizing and Externalizing Symptoms in Children with ASD: Evaluation of a Contextual Model of Parental Factors.

Parental adjustment, parenting behaviors, and child routines have been linked to internalizing and externalizing child behavior. The purpose of the present study was to evaluate a comprehensive model examining relations among these variables in children with ASD and their parents. Based on Sameroff's Transactional Model of Development (Sameroff in: The transactional model of development: How children and contexts shape each other, American Psychological Association, Washington, DC, 2009), researchers hypothesized that these factors would collectively predict child behavior. Parents (n = 67) completed measures of parental adjustment, parenting behaviors, child routines, and child behavior using the Hopkins Symptom Checklist, Alabama Parenting Questionnaire, Child Routines Inventory, and Child Behavior Checklist, respectively. Results indicated that parental adjustment predicted harsh/disengaged parenting (B = 0.17, p < .01) and internalizing behavior (B = 0.32, p < .01). Harsh/disengaged parenting and warm/supportive parenting predicted externalizing behavior (B = 0.59, p < .01) and internalizing behavior (B = - 0.49 p < .01), respectively.

A Longitudinal Study of Hardiness as a Buffer for Posttraumatic Stress Symptoms in Mothers of Children with Cancer.

Mothers of children diagnosed with cancer have been found to be at a heightened risk for post-traumatic stress symptoms (PTSS). In an effort to identify a potential buffer, hardiness was examined as a protective factor for PTSS among mothers of children that were diagnosed with cancer in the past 2 weeks. Using a prospective design, mothers completed measures of PTSS and hardiness at the time of their child's cancer diagnosis and then again at 6- and 12-months post-diagnosis. Random effects regression analyses revealed that mothers who scored high on hardiness were less likely to experience PTSS after controlling for the effect of time. PTSS cluster-specific relations with hardiness were also examined, which revealed that mothers who scored high on hardiness experienced fewer avoidance/numbing symptoms at the time of their child's diagnosis of cancer and across 12 months; whereas mothers who scored low on hardiness tended to experience more avoidance/numbing symptoms at the time of their child's diagnosis. However, these symptoms declined gradually over the course of 12 months. The present findings support examining hardiness further as a buffer against specific PTSS clusters and exploring options for identifying and treating mothers of children with cancer that may be at risk for PTSS.

Independent evaluation of low-level laser therapy at 635 nm for non-invasive body contouring of the waist, hips, and thighs.

INTRODUCTION: The non-invasive body-contouring segment continues to exhibit uninhibited growth, a trend that has provoked the emergence of numerous body-contouring devices. One particular device, low-level laser therapy at 635 nm (LLLT-635), has exhibited promising clinical results. We performed an independent, physician-led trial to evaluate the utility of LLLT-635 nm for non-invasive body contouring of the waist, hips, and thighs. METHODS: Eighty-six participants were retrospectively assessed at an individual clinic in the United States. A multi-head laser device was administered every-other-day for 2 weeks. Each treatment consisted of 20 minutes of anterior and posterior treatment. Patients received concurrent treatment of the waist, hips, and bilateral thighs. Circumferential measurements were evaluated at baseline and one week following the 2-week treatment administration phase. RESULTS: Compared with baseline, a statistically significant 2.99 in. (7.59 cm) mean loss was observed at the post-procedure evaluation point (P < 0.0001). When analyzed individually, the waist, hips, and thighs each reported a statistically significant reduction of -1.12, -0.769, and -1.17, respectively. Furthermore, linear regression analysis revealed a weak linear dependence (r = 0.179) between the reported weight and circumference change. CONCLUSION: These data further validate the clinical efficacy and safety of LLLT at 635 nm.