Early childhood trauma exposure and neurocognitive and emotional processes: Associations in young children in a partial hospital program.

Early childhood trauma has been linked to neurocognitive and emotional processing deficits in older children, yet much less is known about these associations in young children. Early childhood is an important developmental period in which to examine relations between trauma and executive functioning/emotion reactivity, given that these capacities are rapidly developing and are potential transdiagnostic factors implicated in the development of psychopathology. This cross-sectional study examined associations between cumulative trauma, interpersonal trauma, and components of executive functioning, episodic memory, and emotion reactivity, conceptualized using the RDoC framework and assessed with observational and performance-based measures, in a sample of 90 children (ages 4-7) admitted to a partial hospital program. Children who had experienced two or more categories of trauma had lower scores in episodic memory, global cognition, and inhibitory control as measured in a relational (but not computerized) task, when compared to children with less or no trauma. Interpersonal trauma was similarly associated with global cognition and relational inhibitory control. Family contextual factors did not moderate associations. Findings support examining inhibitory control in both relationally significant and decontextualized paradigms in early childhood, and underscore the importance of investigating multiple neurocognitive and emotional processes simultaneously to identify potential targets for early intervention.

Recognizing Suicidal Risk in Very Young Children.

Suicidal thought and behavior (STB) in preschool and kindergarten-age children is an alarming event. Until recently, these young children's experiences have been under recognized, in part due to an under appreciation for their awareness of the finality of death. Although rare, serious suicide attempts and death by suicide among preschool and kindergarten-age children are well documented. There is limited research on the risk factors that contribute to STB in very young children. We present de-identified case descriptions of very young children seen for psychiatric treatment at a day hospital program who presented with self-injurious behavior and suicidal ideation (SI). The patients described have common risk factors, including exposure to trauma, family conflict and family history of suicidal behavior. It is critical that children presenting with STB be assessed and offered services to mitigate these risks.