Development and validation of an intervention for childhood trauma and exposure to violence in Vhembe District, South Africa.

Most strategies are implemented; however, South Africa needs to evaluate and develop trauma interventions. The study aims to develop, test and validate childhood trauma exposure intervention in the Vhembe district, Limpopo province. Donabedian's structure-process-outcome model will guide the study. The study will employ multiphase mixed methods with five phases. Phase 1 will be a thorough systematic evaluation of literature on childhood trauma and exposure to violence interventions to describe existing interventions. Phase 2, stage 1: Will explore the experiences of children exposed to trauma and violence regarding their experiences of the treatment they received, using semi-structured qualitative interviews. Non-probability purposeful sampling techniques will be used to select participants. The Thoyondou Victim Empowerment's database will select participants. The researchers will conduct semi-structured and unstructured interviews with youngsters exposed to violence and trauma. Stage 2 will be a qualitative study of trauma centre managers and personnel sampled from the contact record. IPA will analyze data. Phase 3 will conceptualize Phase 1 and the empirical phase into Donabedian's SPO framework for Phase 4. Phase 4 develops the intervention using Phase 3's conceptual framework and tests and validates it.

Complex Trauma Exposure and Placement Stability among Systems-Impacted Black and Latinx Youth: The Mediating Role of Multisystemic Strengths.

The purpose of this study is to investigate the mediating role of multisystemic strengths in the association between complex trauma (CT) exposure and placement stability among racialized youth using the Child and Adolescent Needs and Strength (CANS) assessment. Participants were 4022 Black and Latinx youth in the child welfare system in a midwestern state. Negative binomial regressions revealed a significant indirect effect of CT exposure on placement stability through interpersonal strengths (p < .01), coping skills (p < .001), optimism (p < .01), and talents/interests (p < .05). At the familial level, there was a significant indirect effect of CT exposure on placement stability through family strengths and relationship permanence (p < .001). At the community level, educational system supports, and community resources indirectly impacted the relationship between CT exposure and placement stability (p < .01). These findings suggest that early interventions aimed at identifying and developing multisystemic strengths in Black and Latinx youth in the child welfare system can help maximize placement stability.

The role of childhood cumulative trauma in the risk of lifetime PTSD: An epidemiological study.

Cumulative trauma is usually devastating and can lead to severe psychological consequences, including posttraumatic stress disorder (PTSD). Exposure to various types of traumas, particularly during childhood, can be even more deleterious than the sheer number of events experienced. This epidemiological study is the first to investigate the impact of discrete childhood traumatic exposure on the risk of developing lifetime PTSD in a representative sample of the general population of the two biggest Brazilian cities. Participants were aged between 15 and 75 years old, living in São Paulo and Rio de Janeiro, Brazil, who had experienced traumatic events (N = 3,231). The PTSD diagnosis was assessed using the DSM-IV criteria through the version 2.1 of Composite International Diagnostic Interview. To operationalize childhood cumulative trauma, we considered the sum of 15 different childhood trauma categories that occurred before PTSD onset. The final multivariate logistic regression model indicated a strong relationship between the number of discrete types of childhood traumas and the likelihood of the lifetime PTSD development. The lifetime PTSD risk increased 28 % with each different type of childhood trauma when adjusted by confounds. Our study strengthens the evidence associating childhood cumulative trauma to increased lifetime PTSD risk.

Pediatric Traumatic Injuries Due to Agrarian Hay-Hole Falls.

Hay-holes are a design feature in many traditionally built barns that serve as a portal through which stored hay is passed to the lower level where animals are fed. Unfortunately, children sometimes fall through the hay-hole to the concrete or packed earth below. Available data on the frequency and types of hay-hole injuries is limited. The purpose of this study was to better characterize the resultant injuries and identify prognostic factors that predict outcomes from them. We performed a retrospective review of 53 children admitted to the Penn State Hershey Children's Hospital at the Penn State Hershey Medical Center with injuries due to a fall through a hay-hole over 15 years. Compared to urban trauma, hay-hole falls more frequently involve younger children and craniofacial injuries. Although they may result in significant injuries, they are rarely fatal. Greater fall height is associated with longer length of stay (LOS) but not with a greater frequency of intubation, intracranial hemorrhage, or skull fracture. A re-examination of barn design may help to reduce the frequency of this injury type.

Posttraumatic stress and depression symptom classes in parents of trauma-exposed children: a transdiagnostic perspective using pooled individual participant data.

Background: In the aftermath of child trauma, post-traumatic stress (PTS) and depression symptoms often co-occur among trauma exposed children and their parents. Studies have used latent class analysis (LCA) to examine PTS and depression symptoms and identify homogeneous subgroups among trauma exposed children. However, little is known about subgroups or classes of PTS and depression reactions of parents of traumatised children.Objectives: (1) Determine PTS and depression symptom classes at 2-9 months post-trauma, and (2) to examine sociodemographic covariates among parents of trauma exposed children.Methods: Using harmonised individual participant data (n = 702) from eight studies (Australia, UK, US) included in the Prospective studies of Acute Child Trauma and Recovery Data Archive (PACT/R), we modelled these phenomena at the symptom level using LCA.Results: Our LCA yielded three solutions: 'high internalizing symptom' class (11%); 'low PTS-high depression' class (17%); and 'low internalizing symptom' class (72%). Parents of children in the 'low PTS-high depression' class were more likely to have children of older age and be part of an ethnic minority, compared to the 'low internalizing symptoms' class. Mothers were more likely to be in the 'high internalizing symptom' class compared to the 'low internalizing symptoms' class.Conclusions: These findings reveal a qualitative structure and relationship between depression and PTS symptoms that highlights the importance of assessing and targeting a broad range of internalising symptoms in post-trauma psychological treatment.

Using harmonised individual participant data from eight studies included in the Prospective studies of Acute Child Trauma and Recovery (PACT/R) Data Archive we identified three distinct classes of parental internalising reactions using Latent Class Analysis.Mothers, family ethnic minority status, and children of older age were associated with distinct classes of problematic symptoms.The findings from the present study highlight the need for assessing and targeting a broad range of internalising symptoms after trauma, and that mothers, parents of older children and families with ethnic minority status might be at risk for elevated symptoms.

Childhood Trauma and Exposure to Violence Interventions: The Need for Effective and Feasible Evidence-Based Interventions.

Several crimes in South Africa cause physical, economic, and mental problems. Xenophobic attacks, mob justice, and other violent conduct directly traumatise children. Service delivery riots and physical and sexual abuse are examples. This evaluation evaluates childhood trauma and exposure to violence interventions. The review describes the therapeutic methods for traumatised children exposed to violence, the healthcare professionals administering them, and the strategies used to tailor the interventions. The researcher systematically searched PsycINFO, Google Scholar, PubMed, Science Direct, and EBSCOhost. Literature from 2011 to 31 July 2023 was searched, and 19 papers were chosen for further review after the systematic search. The authors conducted an eligibility evaluation according to PRISMA guidelines. A thorough review of article texts identified 19 papers that met eligibility standards. Only nineteen studies have validated trauma and violence therapies for children. An effective multi-phased intervention that is feasible and adaptable to varied socioeconomic backgrounds is needed. Further studies on the mental health benefits of brief trauma intervention treatment are needed.

Use of technology in evidence-based programs for child maltreatment and its impact on parent and child outcomes.

Introduction: Technology has been used in evidence-based child maltreatment (CM) programs for over a decade. Although advancements have been made, the extent of the application of technology in these programs, and its influence on parental and child outcomes, remains unclear within the context of changes that emerged because of the COVID-19 pandemic. This scoping review provides a contextualized overview and summary of the use of technology in evidence-based parenting and child programs serving families impacted by child maltreatment and the effects of technology-enhanced programs on target outcomes. Materials and methods: Using Arksey and O'Malley's methodological framework, we searched seven databases to identify peer-reviewed and grey literature published in English from 2000 to 2023 on evidence-based programs, according to the California Evidence-Based Clearinghouse (CEBC), that included technological supports for two populations: at-risk parents for child maltreatment prevention, and children and youth 0-18 years exposed to child maltreatment. All study designs were included. Results: Eight evidence-based parenting programs and one evidence-based child trauma program were identified as using technology across a total of 25 peer-reviewed articles and 2 peer-reviewed abstracts meeting inclusion criteria (n = 19 on parent-level programs; n = 8 on child-level programs). Four studies were published in the context of COVID-19. Two main uses of technology emerged: (1) remote programmatic delivery (i.e., delivering all or part of the program virtually using technology) and (2) programmatic enhancement (i.e., augmenting program content with technology). Improvements across parenting and child mental health and behavioral outcomes were generally observed. Discussion: Technology use in evidence-based child maltreatment programs is not new; however, the small sample since the start of the COVID-19 pandemic in this review that met inclusion criteria highlight the dearth of research published on the topic. Findings also suggest the need for the inclusion of implementation outcomes related to adoption and engagement, which could inform equitable dissemination and implementation of these programs. Additional considerations for research and practice are discussed.

Child Traumatic Stress and COVID-19: The Impact of the Pandemic on a Clinical Sample of Children in Trauma Treatment.

Given the scope and duration of the COVID-19 pandemic, it is not surprising that research has documented negative effects to youth's mental health. Yet, there is negligible research on the impact of the pandemic among clinical samples of youth receiving treatment for pre-existing trauma exposure and symptoms. The current study investigates COVID-19 as an index trauma, and if prior traumatic stress scores mediate the relationship between pandemic-related exposure and subsequent traumatic stress. METHODS: This is a study of 130 youth ages 7-18 receiving trauma treatment at an academic medical center. The University of California Los Angeles Post-traumatic Stress Disorder-Reaction Index (UCLA-PTSD-RI) was completed by all youth during intake as part of routine data collection. From April, 2020 to March, 2022 the UCLA Brief COVID-19 Screen for Child/Adolescent PTSD was also administered to assess trauma exposures and symptoms specifically-related to the pandemic experience. Univariate and bivariate analyses were conducted on all variables of interest to describe response patterns cross-sectionally and longitudinally; a mediational analysis was used to determine if prior trauma symptoms mediate the relationship between COVID-19 exposure and response. Additionally, interviews were conducted with youth using a series of open-ended questions about their perceptions of safety, threat and coping related to the pandemic. RESULTS: A quarter of the sample reported COVID-19 related exposures that would meet Criterion A for PTSD. Participants whose UCLA-COVID scores that exceeded the clinical cutoff had lower scores on two items measuring social support. There was no evidence of full or partial mediation. Responses to interview questions revealed low levels of threat reactivity, perceptions of no to little impact, positive changes, varying opinions on social isolation, some evidence of inaccurate messaging and adaptive coping using strategies learned in treatment. IMPLICATIONS: The findings broaden our understanding of the impact of COVID-19 on vulnerable children and provide insight into how prior trauma history and the provision of evidence-based trauma treatment impact a youth's response to pandemic conditions.

Increased CT Use and No Change in Injury Severity among Child Motor Vehicle Victims: A National Trauma Database Study in Japan.

The number of fatalities associated with traffic accidents has been declining owing to improvements in vehicle safety performance and changes in the law. However, injuries in children can lead to social and economic losses. We examined 10-year changes in the characteristics of traffic trauma among pediatric motor vehicle passengers by analyzing data from the Japan Trauma Data Bank (JTDB). Among the 36,715 injured motor vehicle passengers under the age of 15 years who were registered in the JTDB from 2004 to 2019, we compared the groups injured during 2004-2007 (n = 94) and 2017-2019 (n = 203). Physiologically, the 2004-2007 group had a lower body temperature and Glasgow Coma Scale score as well as a higher mortality. Anatomical severity was higher in the 2004-2007 group for the head, face, and neck, according to the Abbreviated Injury Scale. In terms of treatment, only craniotomy as a primary surgery was significantly lower in the 2017-2019 group. The 2017-2019 group had significantly higher rates of receiving whole-body computed tomography (CT). Because the rate of performing CT has increased, with no changes in the injury severities of the trunk and extremities, limiting the number of CT examinations is suggested for pediatric motor vehicle passengers involved in road traffic collisions. The severity of trunk and extremity injuries has not improved in more than 10 years; further preventive measures for these injuries should be considered.

A thematic analysis of broker consultation in a TF-CBT community based learning collaborative.

Background: Consultation is an important implementation strategy to increase competence, knowledge, and fidelity to evidence-based practice in community settings. However, the literature has primarily focused on consultation for clinical providers, and less is known about consultation for "broker" professionals, or those who identify and refer children to mental health services. Given their critical role in connecting youth to evidence-based treatment, investigating broker knowledge and use of evidence-based screening and referral are needed. Objective: To address this gap, the current study examines the content of consultation provided to broker professionals.

Identifying the Challenges of Child Abuse Detection Among Emergency, Pediatrics, and Family Medicine Practitioners in Saudi Arabia.

BACKGROUND: Child abuse is a significant issue across many countries. Despite the situation's innate understanding, many children are not reported to authorities and continue to experience abuse, sometimes even death. Healthcare professionals must be alert for abuse in any child who appears with injuries that are out of the ordinary because it is easy for indicators of child abuse to go unnoticed in a busy emergency department. The current study aims to evaluate and detect the challenges in diagnosing and reporting cases of child abuse among healthcare practitioners in emergency, pediatrics, and family medicine. METHODS: A self-administered online disseminated questionnaire was used for data collection during the period from October 1 to December 30, 2022. A cross-sectional study was conducted on emergency, pediatrics, and family medicine healthcare practitioners working in hospitals in healthcare centers in Riyadh, Saudi Arabia. All data were collected, tabulated, and statistically analyzed using SPSS 23.0 for (IBM Corp., Armonk, NY) Windows. RESULTS: The study sample constituted 200 physicians working in the front lines of healthcare like emergency, pediatrics, and family medicine primary care services, 50.5% were males and 49.5% were females. 36.5% of participants were 31-39 years old. 42% were family medicine physicians, 36.5% were pediatricians, and 21.5% were emergency medicine. About 43% of participants attended an educational workshop on child abuse. Nineteen percent of participants are very familiar with the diagnosis of child abuse and 36% of participants reported one to three cases of child abuse in the emergency department in the last year, 5% reported four to six cases and 56.5% reported none. Forty-seven percent of participants reported diagnosing one to five cases of child abuse throughout their whole career, 13% reported 11-15 cases, 6.5% reported six to 10 cases and 28.5% reported none. Causes of underdiagnosis of child abuse by healthcare providers were reported as 63% inexperience, 59% inadequate time for physical examination, 59% lack of diagnosis protocol, 51% lack of confidence in communicating with parents, 36% physicians' cultural background, and 38% lack of confidence in the diagnosis. 93.5% of participants think that healthcare practices need further education for child abuse. CONCLUSION: In conclusion, physicians in Saudi Arabia who participated in the study had good knowledge to diagnose a case of child abuse. Inexperience, inadequate time for physical examination, lack of diagnosis protocol, lack of confidence in communicating with parents, and physicians' cultural background were the main identified challenges for diagnosing child abuse. Familiarity with cases of child abuse was significantly associated with physicians' age, specialty, and level of training.

A systematic literature review of the relationship between parenting responses and child post-traumatic stress symptoms.

Background: Parents are a key source of support for children exposed to single-incident/acute traumas and can thereby play a potentially significant role in children's post-trauma psychological adjustment. However, the evidence base examining parental responses to child trauma and child posttraumatic stress symptoms (PTSS) has yielded mixed findings.Objective: We conducted a systematic review examining domains of parental responding in relation to child PTSS outcomes.Method: Studies were included if they (1) assessed children (6-19 years) exposed to a potentially traumatic event, (2) assessed parental responses to a child's trauma, and (3) quantitatively assessed the relationship between parental responses and child PTSS outcomes. A systematic search of three databases (APAPsycNet, PTSDpubs, and Web of Science) yielded 27 manuscripts.Results: Parental overprotection, trauma communication, avoidance of trauma discussion and of trauma reminders, and distraction were consistently related to child PTSS. There was more limited evidence of a role for trauma-related appraisals, harsh parenting, and positive parenting in influencing child outcomes. Significant limitations to the evidence base were identified, including limited longitudinal evidence, single informant bias and small effect sizes.Conclusion: We conclude that key domains of parental responses could be potential intervention targets, but further research must validate the relationship between these parental responses and child PTSS outcomes.

Child post-traumatic stress symptoms following acute trauma are consistently related to post-trauma parental overprotection, avoidance of trauma discussion and of trauma reminders, and promotion of distraction from trauma-related thoughts and stimuli.The findings from this review provide a potential rationale for targeting these parental domains in clinical interventions addressing children's post-traumatic stress symptoms.Future research is needed to validate the longitudinal relationship between parental response domains following children's traumatic exposure and child post-traumatic stress symptoms.

Abuso sexual infantil y su retorno en la adultez: reflexiones desde un caso clínico / Abús sexual infantil i el retorn a l’adultesa: reflexions des d’un cas clínic / Childhood sexual abuse and its return in adulthood: reflections from a clinical case

La clínica con adultosabusados sexualmente en la infancia es una línea de investigación muy abordada en estudios sobre el abusosexual infantil. El presente trabajo es un estudio descriptivo de caso único con el objetivo de analizar el materialclínico de una paciente de veinticinco años que sufrió abuso intrafamiliar en la infancia. Este material se extraede entrevistas de un proceso psicoterapéutico. En primer lugar, se realiza la descripción del caso clínico y lue-go se articula con análisis teórico psicoanalítico. Se profundiza en: desubjetivación, traumatismo, mecanismosdefensivos y desamparo, acomodación, síntomas, elaboración terapéutica y contexto patriarcal. Por último, sereflexiona sobre el ideal de familia como dadora incondicional de cuidado y se plantea al abuso sexual infantilcomo síntoma social, siendo una compleja problemática que requiere de abordajes interdisciplinarios.(AU)

The clinic with sexually abu-sed adults in childhood is a line of research that has been widely addressed in studies on child sexual abuse. Thepresent work is a descriptive single case study with the aim of analyzing the clinical material of a twenty-five yearold patient who suffered intrafamilial abuse in childhood. This material is extracted from interviews of a psychothe-rapeutic process. First, a description of the clinical case is made and then it is articulated with psychoanalytictheoretical analysis. It is deepened in: desubjectivation, traumatism, defensive mechanisms and helplessness, ac-commodation, symptoms, therapeutic elaboration and patriarchal context. Finally, we reflect on the ideal of thefamily as an unconditional giver of care and consider child sexual abuse as a social symptom, a complex problemthat requires interdisciplinary approaches.(AU)

La clínica amb adults abusats sexual-ment a la infància és una línia de recerca molt abordada en estudis sobre l'abús sexual infantil. Aquest treball ésun estudi descriptiu de cas únic amb l'objectiu d'analitzar el material clínic d'una pacient de vint-i-cinc anys queva patir abús intrafamiliar a la infància. Aquest material s’extreu d’entrevistes d’un procés psicoterapèutic. Enprimer lloc, es fa la descripció del cas clínic i després s’articula amb anàlisi teòrica psicoanalítica. S'aprofundeixen: desubjectivació, traumatisme, mecanismes defensius i desemparament, acomodació, símptomes, elaboracióterapèutica i context patriarcal. Finalment, es reflexiona sobre l’ideal de família com a donadora incondicionalde cura i es planteja l’abús sexual infantil com a símptoma social, cosa que és una problemàtica complexa querequereix abordatges interdisciplinaris.(AU)

Abnormal Brain Circuits Characterize Borderline Personality and Mediate the Relationship between Childhood Traumas and Symptoms: A mCCA+jICA and Random Forest Approach.

Borderline personality disorder (BPD) is a severe personality disorder whose neural bases are still unclear. Indeed, previous studies reported inconsistent findings concerning alterations in cortical and subcortical areas. In the present study, we applied for the first time a combination of an unsupervised machine learning approach known as multimodal canonical correlation analysis plus joint independent component analysis (mCCA+jICA), in combination with a supervised machine learning approach known as random forest, to possibly find covarying gray matter and white matter (GM-WM) circuits that separate BPD from controls and that are also predictive of this diagnosis. The first analysis was used to decompose the brain into independent circuits of covarying grey and white matter concentrations. The second method was used to develop a predictive model able to correctly classify new unobserved BPD cases based on one or more circuits derived from the first analysis. To this aim, we analyzed the structural images of patients with BPD and matched healthy controls (HCs). The results showed that two GM-WM covarying circuits, including basal ganglia, amygdala, and portions of the temporal lobes and of the orbitofrontal cortex, correctly classified BPD against HC. Notably, these circuits are affected by specific child traumatic experiences (emotional and physical neglect, and physical abuse) and predict symptoms severity in the interpersonal and impulsivity domains. These results support that BPD is characterized by anomalies in both GM and WM circuits related to early traumatic experiences and specific symptoms.

What Mediates the Link Between Foster Parents' Sensitivity Towards Child Posttraumatic Stress Symptoms and Job Satisfaction? The Role of Compassion Fatigue and Foster Parent-Child Relationship.

Purpose: It is very likely that many children who enter the foster care system have experienced at least one traumatic event, and can develop symptoms of PTSS. Consequently, foster parents' level of sensitivity towards child symptoms of PTSS plays a significant role in child development, but the link between sensitivity and several professional characteristics is not well understood. The current study aims to explain the effect foster parents' sensitivity towards child trauma exert on their job satisfaction, via foster parents' compassion fatigue and the quality of their relationship with the children in care. This study is one of the few to investigate foster parents' sensitivity towards child trauma, and the direct and indirect effects on other variables. Methods: Structural equation modeling was used to test a mediating model on this sample (N = 165) after using an online survey to collect the cross-sectional data. Results: The model produced good fit (RMSEA = 0.087; CFI = 0.899). The direct effects between variables are significant. The relationship between foster parents' sensitivity towards trauma and their job satisfaction can be better understood with the contribution of compassion fatigue. Conclusion: Findings confirm the mediation effect of compassion fatigue and reveal more aspects of the sensitivity towards trauma concept. These results could be implemented by considering more accurate measurements for the caregiver's sensitivity towards child trauma. The importance of considering interventions for increasing foster parents' trauma knowledge and skills is highlighted.

Review of the Evidence for Neurofeedback Training for Children and Adolescents Who Have Experienced Traumatic Events.

Neurofeedback training is an established treatment for children with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder and is an increasingly accepted modality of treatment in the context of child trauma. This treatment is typically delivered as a complement to more traditional talk therapy such as trauma-focused-cognitive behavioral therapy (TF-CBT). This review examined the evidence for the effectiveness of this intervention for children with trauma through a systematic search of the literature. A targeted search across databases identified 10 eligible studies that focused on children/young people who had experienced traumatic events and/or demonstrated symptoms of trauma, and which conducted a repeated measures study at a minimum. While the included studies suggest some benefits from neurofeedback training, the available studies, including randomized trials, have to date been relatively small, involve dramatically different treatment length and intensity, and show inconsistent benefits relative to usual treatment conditions. To advance knowledge of this intervention further research is needed with a clear best practice protocol and with a clearer target group.

The relationship between fathers' heavy episodic drinking and fathering involvement in five Asia-Pacific countries: An individual participant data meta-analysis.

BACKGROUND: This study aims to increase understanding of the relationship between heavy episodic drinking (HED) and fathers' involvement in parenting in five countries. The potential moderating effect of fathers' experiences of childhood trauma is also studied, controlling for the possible confounding of the effect of HED by father's attitudes toward gender equality, father's age and father's education. METHOD: United Nations Multi-Country Study on Men and Violence (UNMCS) survey data from 4562 fathers aged 18-49 years from Cambodia, China, Indonesia and Papua New Guinea (PNG) and Sri Lanka were used to assess the relationship between fathering involvement (e.g., helping children with their homework) and self-reported HED of 6+ drinks in one occasion vs. non-HED and abstaining. Moderating effects of a 13-item fathers' childhood trauma (FCT) scale were tested and analyses were adjusted for gender-inequitable attitudes using the Gender-Equitable Men scale score. Bivariate and adjusted individual participant meta-analyses were used to determine effect estimates for each site and across all sites. RESULTS: Fathers' HED was associated with less positive parental involvement after adjusting for gender-equitable attitudes, FCT, age and education. No overall interaction between HED and FCT was identified. Gender equitable attitudes were associated with fathering involvement in some countries but not overall (p = 0.07). CONCLUSIONS: Heavy episodic drinking was associated with reduced positive fathering involvement. These findings suggest that interventions to increase fathers' involvement in parenting should include targeting reductions in fathers' HED. Structural barriers to fathers' involvement should be considered alongside HED in future studies of fathers' engagement with their children.

Outcomes of Parent-Child Interaction Therapy (PCIT) for families presenting with child maltreatment: A systematic review.

BACKGROUND: The developmental consequences of childhood trauma for young children are extensive and impact a diverse range of areas. Young children require treatments that consider their developmental stage and are inclusive of caregiver involvement. Parent-Child Interaction Therapy (PCIT), with its dyadic focus and developmental sensitivity, is uniquely positioned to offer therapeutic support to young children and their families. AIM: The current study aimed to conduct a systematic review of the current literature on PCIT and trauma and determine treatment outcomes for children and caregivers. METHOD: A systematic review of five electronic databases was undertaken. Studies that utilized PCIT to treat a population who had experienced trauma were included in the review regardless of study design. RESULTS: PCIT was used to treat a population who had experienced trauma in 40 studies. PCIT was an effective treatment in improving a variety of child and parent outcomes in this population including reduced parenting stress, child behavior problems, child trauma symptoms, parental mental health concerns, negative parenting strategies, and reducing potential risk of recidivism of abuse and neglect. These findings should be taken with caution given attrition rates and potential for bias in the study samples. DISCUSSION: Clinicians should consider PCIT as a potential treatment for children who have experienced trauma and their families. Future research should incorporate corroborative sources of information, assessment of caregiver and child trauma symptoms, examination of permanency outcomes, and consider standardization of PCIT modifications for child trauma to determine treatment in this population of children.

Childhood maltreatment increases the suicidal risk in Chinese schizophrenia patients.

Objectives: Childhood trauma might be a modifiable risk factor among adults with serious mental illness. However, the correlation of child trauma and suicide is unclear, which were cited most frequently as the biggest challenge to schizophrenia (SCZ) patients in China. We aim to study relationships between child trauma and suicide in SCZ patients of different disease stages. Methods: Ninety-one participants were included and divided into two groups, namely, first-episode group (n = 46), relapsed group (n = 45). The Positive and Negative Syndrome Scale was used to evaluate the severity of psychotic symptoms. The Beck's Suicide Intent Scale and The Nurses' Global Assessment of Suicide Risk were conducted by patient self-report to assess suicide symptom. The childhood trauma questionnaire was used to estimate severity of traumatic stress experienced during childhood. Results: Childhood trauma and different dimensions of suicide were significantly higher in the relapsed group than first-episode group (P < 0.01, respectively). BMI has a significant positive relationship with recent psychosocial stress (ß = 0.473, t = 3.521, P < 0.001) in first-episode group. As in relapsed group, BMI has a positive effect between severe mental illness and suicide ideation (ß = 0.672, t = 5.949, P < 0.001; ß = 0.909, t = 2.463, P < 0.001), Furthermore, emotional neglect presented positively related to the suicide risk and proneness to suicidal behavior (ß = 0.618, t = 5.518, P < 0.001; ß = 0.809, t = 5.356, P < 0.001). Conclusion: Relapsed group of patients had significantly more severe childhood trauma, recent psychosocial stress, suicidal risk and proneness to suicidal behavior. BMI and emotional neglect are unique predictors for different dimensions of suicide.

The child and family traumatic stress intervention: Factors associated with symptom reduction for children receiving treatment.

OBJECTIVE: We examine factors associated with changes in posttraumatic stress symptoms for children following completion of an early and brief, trauma-focused mental health treatment that engages children together with their caregivers, with the child as the identified patient. METHOD: The Child and Family Traumatic Stress Intervention (CFTSI), a brief (5-8 session) trauma-focused mental health treatment designed to reduce trauma symptoms in the aftermath of traumatic experiences in children aged 7 years and older. CFTSI has been widely disseminated in Child Advocacy Centers (CAC) and community treatment clinics nationally. We report on results of a naturalistic treatment study of CFTSI implementation without a comparison group that includes 1190 child caregiver dyads from 13 community-based clinical settings. RESULTS: Mixed modeling revealed a significant reduction in child reported posttraumatic stress scores from pre to post-CFTSI. Scores on the Child Posttraumatic Checklist (CPSS) declined an average of 8.74 points from pre to post-CFTSI (p < .0001). There were no statistically significant differences in CPSS score changes based on age, gender, ethnicity, race, number of prior trauma types the child had experienced, caregiver posttraumatic stress symptoms, child relationship to the perpetrator, nature of event or length of time to begin treatment. CONCLUSION: This study provides further evidence that CFTSI can reduce child posttraumatic stress symptoms when implemented by community-based providers.