Overcoming the civil wars: the role of attachment styles between the impact of war and psychological symptoms and post-traumatic growth among Libyan citizens.

Background: Civil wars in Libya have impacted the mental health of the general population. The ways in which individuals cope with traumatic events are influenced by several psychological variables.Objectives: The present study aimed to investigate how post-traumatic stress symptoms (PTSS) are associated with psychological symptoms and post-traumatic growth (PTG), and to evaluate the role of avoidant and anxious attachment dimensions as mediators in these associations, among Libyan citizens.Method: Three-hundred participants (147 females; age 31.0 ± 8.4 years) completed the Impact of Event Scale - Revised, Experiences in Close Relationships, Patient Health Questionnaire, and Post-traumatic Growth Inventory - Short Form.Results: The structural equation model revealed that insecure attachment dimensions mediated the association between PTSS and psychological symptoms and PTG. PTSS were positively associated with psychological symptoms, PTG, and both insecure attachment dimensions. Insecure attachment dimensions were positively associated with psychological symptoms and negatively with PTG.Conclusion: The present findings contribute to growing empirical research on the roles of insecure attachment dimensions in the association between the impact of war, psychological symptoms, and PTG.

Insecure attachment dimensions mediated the association between the impact of war and psychological symptoms, as well as posttraumatic growth, among Libyan citizens.Higher psychological symptoms were negatively correlated with posttraumatic growth.Psychological interventions should consider insecure attachment dimensions, when evaluating the consequences of prolonged and repeated wars.

Types of community violence exposure and clinical outcomes: Evidence of differing associations among emerging adults.

OBJECTIVE: Community violence (CV) is an important public health concern. The literature has largely focused on CV exposure among higher-risk, urban youth, while the impact of CV on emerging adults in university settings remains poorly understood, even though this developmental period is associated with heightened risk. Much of the extant research has utilized a cumulative approach to study CV, thus, little is known about how different dimensions of CV (i.e., direct, witnessed, learned about) may be uniquely related to functioning. METHOD: The goals of this study were to: (a) examine the associations between cumulative CV and both adverse (i.e., posttraumatic stress symptoms [PTSS], anger, emotion dysregulation) and adaptive (i.e., resilience) clinical outcomes and (b) investigate the distinct ties between the three CV dimensions and these constructs. This study included 547 emerging adults from two universities that are located in two U.S. cities with high crime rates (Mage = 20.31, SD = 2.08, range = 18-28; 80.8% female; 57.8% white). RESULTS: Cumulative CV was related to higher levels of PTSS as well as resilience. For the specific CV dimensions, direct CV was positively linked with PTSS, anger, and emotion dysregulation, whereas witnessed CV inversely corresponded with emotion dysregulation and resilience. Learning about CV was unrelated to clinical outcomes. CONCLUSIONS: Students in high crime areas are at heightened risk for CV, which may contribute to both psychological difficulties and resilience. Findings signal the need to better understand how to foster resilience among emerging adults exposed to violence in their communities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Revictimization Risk Factors Following Childhood Maltreatment: A Literature Review.

Revictimization research, to date, has primarily focused on sexual revictimization (i.e., child sexual abuse and adult sexual assault), which has resulted in a lack of understanding of trauma revictimization more generally. Specifically, it is unclear what factors are placing individuals with a history of child maltreatment (i.e., sexual abuse, physical abuse, and witnessing intimate partner violence [IPV]) at greater risk for subsequent adult victimization (i.e., sexual assault and IPV). Existing theoretical and empirical work on revictimization suggest that multiple risk factors are likely present within this framework (e.g., posttraumatic stress symptoms [PTSS], emotion dysregulation, and risk-taking behaviors). Prior research has suggested that PTSS are often linked with these other risk factors, and it is possible that the development of PTSS following child maltreatment may be related to the development or maintenance of additional factors that increase the likelihood of revictimization. The purpose of this review was to synthesize findings regarding risk factors that place maltreated individuals at greater risk for adult revictimization. Approximately 228 studies were identified following a thorough search of the peer-reviewed literature using multiple databases (PsycINFO, PILOTS, and Google Scholar). Each study was critically analyzed for relevance. The included studies were used in our review of prevalence, specific risk factors that have been identified, and unanswered questions in this literature. PTSS were noted to be particularly important in the revictimization framework, and thus, a novel model of revictimization was also proposed where PTSS are illustrated as being associated with the development and maintenance of other factors within the revictimization framework.

Mapping Individual, Relational, and Contextual Factors onto Posttraumatic Stress Symptoms and Resilience.

Posttraumatic stress symptoms (PTSS) and resilience are two well-established outcomes following trauma exposure, but little work has examined the unique associations between these outcomes and factors across the social ecology. This theoretically grounded study assessed how individual, relational, and contextual social ecological factors relate to PTSS and resilience. Participants included 606 college students (18-25 years, Mage = 20.79, SD = 1.86; 82.51% Female; 56.60% White, 29.37% Black or African American, 5.78% Asian, 8.25% Other races) with exposure to at least one traumatic event. Two hierarchical linear regression models examined associations between individual (i.e., emotion dysregulation, anger severity), relational (i.e., family support, friend support), and contextual (i.e., community cohesion, community disorder) factors, and PTSS and resilience. At the individual level, higher emotion dysregulation was associated with higher PTSS and lower resilience; anger severity was not related to either outcome. At the relational level, more friend support was negatively associated with PTSS. Friend and family support were positively related to resilience. At the contextual level, community cohesion was positively associated with resilience, but not PTSS, and community disorder was unrelated to both outcomes. Findings demonstrate unique factors across the social ecology that differentially relate to PTSS and resilience. Variables at all three ecological levels were associated with resilience, whereas only individual and relational variables were related to PTSS. Replication with longitudinal data could inform treatments for trauma-exposed individuals that may mitigate PTSS and bolster resilience.

Attrition from pediatric trauma-focused cognitive behavioral therapy: A meta-analysis.

Trauma-focused cognitive behavioral therapy (TF-CBT) is one of the leading interventions for trauma-exposed children and adolescents and is associated with significant improvements in a variety of trauma-related symptoms. Nonetheless, attrition from TF-CBT is quite common, and children who do not receive the full intervention may continue to suffer from trauma-related symptoms. Rates of premature termination have varied across studies, and to date, no meta-analyses have been conducted regarding dropout from TF-CBT. The objective of the present study was to conduct a meta-analysis of the rates of attrition from TF-CBT, as well as review factors related to premature termination from this intervention. A total of 22 studies were available for inclusion in this meta-analysis. The prevalence of attrition was 33.9% (95% CI [26.2%, 42.5%]) from 2,059 children receiving TF-CBT. Clinician-rated attrition was 38.5%, and 17.5% did not receive an adequate dose of TF-CBT (e.g., 12+ sessions). Further, the study type was related to differing rates of dropout, with randomized controlled trials having a much lower attrition rate. Regarding risk factors for premature termination, the emerging literature suggests that a child's age, racial-ethnic minority status, and symptom levels may evince some ties to attrition. Caregiver, family, therapist, and treatment factors remain underexplored in relation to premature termination; however, preliminary work suggests that lack of caregiver attendance and difficulty in the child-therapist relationship may be related to attrition. A substantial number of children prematurely terminate from TF-CBT, underscoring the need to better prevent dropout.

The Role of Dimensions of Emotion Dysregulation Following Exposure to Maltreatment and Adult Victimization.

Child maltreatment is related to a host of negative consequences, including difficulties with emotion regulation (ER), posttraumatic stress symptoms (PTSS), and greater risk for revictimization. Yet, the literature has largely focused on sexual revictimization, while relations between maltreatment and other adult victimization types (e.g., intimate partner violence [IPV]) are less clear. Further, associations between emotion dysregulation and both child and adult trauma exposure have been identified, but aspects of dysregulation (i.e., nonacceptance of emotional responses, difficulties engaging in goal-directed behavior, impulsivity, lack of emotional awareness, limited access to ER strategies, and lack of emotional clarity) have received less attention. This study aimed to: (1) investigate the associations between maltreatment and adult victimization and the six ER dimensions while accounting for PTSS, and (2) determine whether there are indirect effects between maltreatment and adult victimization through each ER component. Seven hundred and forty-four undergraduates from two universities participated in the study (Mage = 21.48, SD = 4.12; 80.9% women; 56.2% white). Maltreatment and PTSS were directly linked with adult victimization (B = 0.14, B = 0.01, respectively). PTSS was inversely associated with each ER aspect (Bs = 0.02-0.10). Unexpectedly, neither maltreatment nor adult victimization was related to the ER dimensions, and no indirect effects were observed between maltreatment and adult victimization through emotion dysregulation. These findings suggest that specific components of emotion dysregulation may not be tied to trauma exposure outside of PTSS. Further, it may be that the ER dimensions are not differentially related to increased risk for adult victimization.

Effectiveness of the expressive writing on the psychological distress and traumatic symptoms of the migrants: A prospective study multiarm randomized controlled trial.

OBJECTIVE: Migration is a phenomenon related to adverse impacts, including higher risk for psychological distress and trauma symptoms, highlighting the strong need for effective psychological treatments to help migrants. However, the use of expressive writing intervention (EW) has not been examined in this population. The aims of the study were to evaluate: (a) the effectiveness of a trauma-focused EW on psychological distress, trauma symptoms, alexithymia, and hope for the future in migrants, and (b) the role of alexithymia and hope for the future in the association with the EW and the psychological symptoms. METHOD: Twenty-eight migrants were enrolled in a multiarm double-blind randomized controlled trial (RCT) that included three groups: (a) trauma-focused EW, (b) neutral EW, and (c) control. Participants completed self-report measures at pretreatment, immediately after the intervention, and at 1 month follow-up. The study complied with the guidelines of Consolidate Standard of Reporting Trials (CONSORT) checklist and was retrospectively recorded on ClinicalTrials.gov. RESULTS: Trauma-focused EW was related to an immediate improvement in phobic anxiety and positive total symptoms and improvement in somatization, global severity index, and hope for the future at follow-up. Trauma symptoms and alexithymia did not show significant effects. Factorial regressions showed that the interaction group per time per hope for the future was a significant predictor on the phobic anxiety. DISCUSSION: EW may be an effective tool for reducing migrant's distress and may have long-term improvements in mental health. Moreover, the results suggest the potential influence of the hope for the future on anxiety in migrants. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Factors associated with caregiver help seeking behavior among at-risk children.

BACKGROUND: Few at-risk school-age children receive needed psychological help, and our understanding of predictors of service use in this population is limited. Many broader contextual factors have received little attention including caregiver's trauma history and social support, father involvement, family functioning, and neighborhood satisfaction. The links between types of and cumulative maltreatment have also been inconsistent, and prior work has not always accounted for children's symptoms. OBJECTIVE: The current study examined child, caregiver, family, neighborhood, and maltreatment factors in relation to past-year mental health service use among at-risk eight-year-old children. Cumulative and types of maltreatment were both investigated to help elucidate the role of these experiences. PARTICIPANTS/SETTING/METHOD: Eight hundred and forty-five eight-year-old at-risk children (48.3 % male; 59.5 % Black) from the Longitudinal Studies in Child Abuse and Neglect (LONGSCAN) were included. RESULTS: A small portion of children (12.4 %) received psychological help in the previous year. Children's externalizing symptoms, residing with a non-biological caregiver, cumulative maltreatment and sexual and emotional abuse were associated with seeking psychological services, whereas physical abuse, neglect, and domestic violence exposure were not. Other caregiver factors, and family and neighborhood factors were also unrelated. CONCLUSIONS: Non-biological caregivers as well as caregivers of children with higher levels of externalizing symptoms may be more inclined to seek out mental health services, along with greater, and specific, maltreatment experiences. These findings indicate that child factors may be key in understanding help seeking, however, it is important to further consider other broader contextual factors in future work.

Social Functioning in Individuals Affected by Childhood Maltreatment: Establishing a Research Agenda to Inform Interventions.

Childhood maltreatment (CM) is linked to impairments in various domains of social functioning. Here, we argue that it is critical to identify factors that underlie impaired social functioning as well as processes that mediate the beneficial health effects of positive relationships in individuals exposed to CM. Key research recommendations are presented, focusing on: (1) identifying attachment-related alterations in specific inter- and intrapersonal processes (e.g., regulation of closeness and distance) that underlie problems in broader domains of social functioning (e.g., lack of perceived social support) in individuals affected by CM; (2) identifying internal (e.g., current emotional state) and external situational factors (e.g., cultural factors, presence of close others) that modulate alterations in specific social processes; and (3) identifying mechanisms that explain the positive health effects of intact social functioning. Methodological recommendations include: (1) assessing social processes through interactive and (close to) real-life assessments inside and outside the laboratory; (2) adopting an interdisciplinary, lifespan perspective to assess social processes, using multi-method assessments; (3) establishing global research collaborations to account for cultural influences on social processes and enable replications across laboratories and countries. The proposed line of research will contribute to globally develop and refine interventions that prevent CM and further positive relationships, which - likely through buffering the effects of chronic stress and corresponding allostatic load - foster resilience and improve mental and physical health, thereby reducing personal suffering and the societal and economic costs of CM and its consequences. Interventions targeting euthymia and psychological well-being are promising therapeutic concepts in this context.

Relational Factors Associated With Posttraumatic Stress Among Emerging Adults of Color Exposed to Community Violence.

The relationship between trauma exposure and posttraumatic stress symptoms (PTSS) is well-documented, but less is known about factors that contribute to the expression of PTSS following community violence exposure, particularly among emerging adults of color. Utilizing the Person-Environment Interaction model (Slaug et al., 2018), this study examined the role of relational factors, specifically ethnic identity, community cohesion, and social support, associated with PTSS following exposure to community violence. Participants included 243 emerging adult university students of color (Mage = 20.27, SD = 1.95, 83.5% female). Linear regression analyses indicated that less frequent trauma exposure and greater perceived social support were related to lower PTSS. A significant interaction was also found between social support and exposure to community violence, such that at low levels of social support, individuals with more community violence exposure had the highest levels of PTSS. Regression and moderation analyses indicated that ethnic identity and community cohesion were not significantly associated with PTSS in this sample. Findings highlight the importance of incorporating social support strategies in treatments for PTSS following community violence exposure.

Racism, Posttraumatic Stress Symptoms, and Racial Disparity in the U.S. COVID-19 Syndemic.

The COVID-19 syndemic, with a disproportionately higher adverse impact on communities of color (i.e., COVID-19 infection and death), will likely exacerbate the existing health disparities in trauma-related symptoms between people of color (POC) and White Americans. However, no studies have examined the racial disparity in posttraumatic stress symptoms (PTSS) during COVID-19. Grounded in ecological theory and racial trauma framework, we investigated racial disparity in PTSS and three possible mechanisms, 1) COVID stress, 2) direct racism, and 3) indirect racism, for these disparities using a large U.S. national sample. Results indicated that POC reported higher levels of PTSS than White Americans. The PTSS racial disparity was accounted more by direct and indirect racism than by the COVID-19-specific stressors, after controlling for age, gender, education, income, parent status, adverse childhood experiences (ACEs), and intimate partner violence (IPV). Additional fine-grained analyses for Hispanic/Latinx Americans, Black/African Americans, and Asian American and Pacific Islanders by and large corroborated the above findings. Our findings highlighted the deleterious impact of the ongoing racism pandemic on the POC community as a public health crisis in addition to the COVID-19 pandemic.Supplemental data for this article is available online at at http://doi:10.1080/08964289.2021.2006131.

Types of childhood maltreatment, posttraumatic stress symptoms, and indices of fertility.

OBJECTIVE: Child maltreatment, including physical, sexual, and emotional abuse, witnessing intimate partner violence (IPV), and neglect, is related to decrements in physical health. Yet, it is not clear how maltreatment may impact indices of fertility and the specific forms of maltreatment may exhibit distinct associations with aspects of fertility. Because posttraumatic stress symptoms (PTSS) have corresponded with a longer length to conception, it is prudent to account for current level of trauma symptoms. The aim of the present study was to investigate whether the five types of maltreatment and PTSS were positively related to infertility, including length of time to conception, number of live births and miscarriages, and use of infertility treatments. METHOD: Two hundred seventy-five trauma-exposed females (Mage = 38.82, SD = 12.73) who had been, or had tried to become, pregnant participated in the study. RESULTS: Despite expectations, none of the maltreatment types, nor PTSS, was related to longer length to conception. Minorities reported longer length of time to conceive. PTSS was tied to fewer number of live births. A history of neglect corresponded with a greater number of miscarriages, as well as greater use of fertility treatments. CONCLUSIONS: Racial minorities may be at higher risk for longer conception length times. Although replication is needed, neglect and PTSS may be associated with fertility difficulties whereas other forms of child maltreatment (sexual, physical, and emotion abuse and witnessing IPV) may not evince ties to aspects of fertility. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Correlates of caregiver's help seeking behavior among young maltreated children.

BACKGROUND: Relatively few maltreated children receive mental health services, despite the importance of treatment in combating the deleterious impact of maltreatment. Characteristics of the child, caregiver, and family have been investigated in relation to caregiver's help seeking behavior for children's psychological difficulties; yet, these associations have been inconsistent, and are very understudied among younger maltreated children. Other aspects of the child's environment, such as father involvement, negative life events, and neighborhood risk and satisfaction have not been examined. It is also uncertain how cumulative maltreatment and the specific forms of maltreatment - sexual, physical, and emotional abuse, neglect, and domestic violence, are associated with mental health consultation. OBJECTIVE: The aim of the current study was to utilize an ecological model that included child, caregiver, family, neighborhood, and maltreatment factors to better understand caregiver's help seeking behavior. PARTICIPANTS/SETTING/METHOD: The study relied upon 448 six-year-old maltreated children (47.5% male; 48.7% Black) from the Longitudinal Studies in Child Abuse and Neglect (LONGSCAN) study. RESULTS: Several factors, including child's gender and externalizing symptoms, and caregiver educational attainment and depression and were associated with mental health consultation. Cumulative maltreatment, however, was unrelated. When the specific forms of maltreatment were included, none of the individual maltreatment types were tied to help seeking behavior. CONCLUSIONS: Child and caregiver factors, such as child's level of behavioral challenges as caregiver's level of education and depression, may contribute to decisions regarding seeking services for young, maltreated children. However, neither cumulative nor the forms of maltreatment may correspond with help seeking among young, maltreated children.

Caregiver-Child Symptom Concordance: Links to Premature Termination From Trauma-Focused Therapy.

Rates of attrition from child trauma-focused treatment are high, yet few predictors of premature termination are known. Caregiver-child symptom discrepancies are common in this population and have been related to treatment outcome. However, research has not examined whether caregiver-child symptom concordance is associated with attrition. The aim of the study was to determine whether pretreatment caregiver-child symptom agreement predicted premature termination from trauma-focused treatment. Two hundred and sixty-nine treatment-seeking children ages 8 to 12 (M = 9.97, SD = 1.49; 64.7% female, 51.3% Black) and their non-offending caregivers were included in the study. Two operational definitions of attrition are as follows: (a) clinician-rated dropout, and (b) whether the child received an adequate dose of treatment (i.e., 12 or more sessions), which were used to more thoroughly examine premature termination. Rates of attrition were high (68.1% clinician-rated premature termination, 37.4% received inadequate dose). Levels of symptom concordance between caregivers and children were low across symptom difficulties (intraclass correlations = .003-.16). Lower levels of discordance for posttraumatic stress symptoms (PTSS) were associated with an increased likelihood of receiving an adequate dose of treatment (odds ratio [OR] = 1.03). Nonetheless, unexpectedly, higher levels of caregiver-child discordance for anxiety symptoms at pretreatment predicted both clinician-rated treatment completion and adequate dose (ORs = .97, .96, respectively). However, caregiver's and children's perceptions of children's trauma-related difficulties may not converge, and thus, both reports are important to assess. Symptom disagreement regarding PTSS may help identify families at risk for attrition.

Relationships Between Childhood Interpersonal Trauma, Religious Coping, Post-traumatic Stress Symptoms, and Resilience.

Positive and negative religious coping strategies have been linked to symptom trajectories following adult interpersonal trauma. However, the interactions between childhood interpersonal trauma, religious coping, and psychological outcomes are less clear. This study examined whether aspects of religious coping moderated the associations between cumulative childhood interpersonal trauma and mental health outcomes, such as post-traumatic stress symptoms (PTSS) and resilience. Participants included 525 undergraduates from two universities (Mage = 20.04, SD = 1.71; range = 18-24; 57.7% White; 82.1% female). In both the positive and negative religious coping models, cumulative childhood interpersonal trauma was related to PTSS (b = 6.66; b = 6.10, respectively). While positive religious coping was not associated with PTSS (b = .01), it was linked to resilience (b = .69). Negative religious coping was significantly related to PTSS (b = .75) but not resilience (b = -.20). No significant interactions were identified between aspects of religious coping and cumulative childhood interpersonal trauma. While religious coping was directly related to both positive and negative mental health outcomes, it may not be associated with the relationships between childhood interpersonal trauma exposure and clinical outcomes. Such findings offer valuable information on malleable factors that may contribute to adaptive and maladaptive functioning following childhood adversity.

Sexual Behavior Problems Among Sexually Abused Children: Associations With Co-Occurring Symptoms.

Sexual behavior problems (SBPs) and interpersonal SBPs (ISBPs) among sexually abused children often occur alongside a variety of other clinical difficulties, such as externalizing problems, attentional difficulties, social concerns, and posttraumatic stress symptoms (PTSS). Yet, as few studies have examined these links in a multivariate manner, it is unclear which symptoms are most strongly related to SBPs and ISBPs. Research regarding children's reports of their difficulties and SBPs and ISBPs is also very limited. The current study investigated the relations between both caregiver- and child-reported trauma-related symptoms and SBPs and ISBPs among 248 treatment-seeking sexually abused children (ages 6-12; M = 8.06, SD = 2.52; 64.5% female; 55.6% white). Children's caregiver-reported trauma-related sexual concerns and anger were associated with SBPs. For ISBPs, only caregiver-reported sexual concerns were related to ISBPs. Surprisingly, none of the child-reported symptoms were associated with either SBPs or ISBPs. Trauma-related sexual concerns and anger may be tied to SBPs, whereas other clinical difficulties may be less strongly implicated. Trauma-related sexual concerns may be most important in understanding interpersonally focused SBPs. Children's self-reported difficulties may be unrelated to caregiver-reported SBPs, or these results may be a function of a low degree of caregiver and child symptom concordance.

Trauma Exposure, Post-traumatic Stress Symptoms, and Indices of Parenting.

Previous studies have reported that trauma exposure and post-traumatic stress symptoms (PTSS) may increase the risk for parenting difficulties, yet it is not clear whether trauma exposure and PTSS independently contribute to parenting-related indices or whether there is an indirect effect of trauma exposure on parenting-related outcomes through PTSS. Further, the associations between PTSS and parenting outcomes utilizing the most recent Diagnostic and Statistical Manual (DSM-5) post-traumatic stress disorder (PTSD) criteria are unknown. The aims of the current study were to determine: (a) whether trauma exposure and PTSS are related to parenting indices; (b) if trauma exposure is associated with parenting factors indirectly through PTSS; and (c) whether the DSM-5 PTSD symptom clusters are each linked with parenting outcomes. Participants were 225 trauma-exposed parents (Mage = 36.81; SD = 8.32) from a Midwestern University or Amazon's Mechanical Turk (MTurk). Cumulative trauma had an indirect effect on parental satisfaction, support, involvement, limit-setting, and autonomy via PTSS. The specific PTSD symptom clusters also demonstrated distinct ties to parenting outcomes. Higher levels of alterations in reactivity and arousal symptoms were associated with lower parental support and satisfaction, as expected. Avoidance symptoms were also inversely related to parental autonomy. However, a positive relationship was noted between intrusion symptoms and support, and changes in cognitions and mood were unrelated to parenting indices. PTSS may better explain decrements in aspects of parenting than trauma exposure. Certain types of PTSD symptoms, particularly trauma-related changes in reactivity and arousal, may be relevant in understanding and improving parenting outcomes among trauma-exposed parents.

Maternal support and caregiver-child symptom concordance among sexually abused children.

Caregivers and children often diverge in their reports of children's trauma-related symptoms, and this discordance has been linked with children's behavioral difficulties and poorer treatment outcomes. Knowledge regarding what factors may be related to discordance is limited, and maternal support in relation to trauma-related symptom agreement has yet to be investigated. The aim of the present study was to examine the associations between discordance and both maternal emotional support and blame/doubt in caregivers' and children's reports of trauma-related symptoms in sexually abused children. Participants were treatment-seeking, sexually abused children (N = 122) aged 8-12 years (M = 9.45 years, SD = 1.09; 70.5% female, 57.4% White) and their nonoffending caregivers. Low intraclass correlation coefficients (ICCs) indicated the presence of significant discordance across symptom types, with caregivers reporting higher levels of trauma-related difficulties, ICCs = -.21-.22. Older children were more likely to disclose higher levels of anger and sexual concerns than younger children, ßs = .18-.33. Children's gender, race, and relationship to their caregiver were not related to symptom discordance. Further, maternal emotional support and blame/doubt were not associated with caregiver-child concordance for any examined difficulties. Assessment of both caregivers' and children's perceptions of trauma-related symptoms is vital given the likelihood of discordance in child and caregiver reports of symptom levels. Although maternal emotional support and blame/doubt may not be linked to concordance with regard to trauma-related difficulties, child age should further be considered as a potentially important factor in understanding caregiver-child symptom concordance.

Massed cognitive processing therapy for posttraumatic stress disorder in women survivors of intimate partner violence.

OBJECTIVE: Survivors of intimate partner violence (IPV) report significant trauma histories, high rates of posttraumatic stress disorder (PTSD), head injuries and comorbid disorders, and multiple barriers to treatment that often preclude the regular attendance and engagement required in typical therapy protocols. The significant challenges faced by IPV survivors needing treatment may be ameliorated by condensing effective treatments for PTSD, such as cognitive processing therapy (CPT), in an accelerated delivery timeline. METHOD: Using a multiple subject, single case design of six matched pairs of 12 female IPV survivors, we preliminarily tested the relative effectiveness of individual massed CPT delivered over 5 days (mCPT) as compared with standard CPT (sCPT) delivery in women IPV survivors. Assessments included full psychiatric diagnostic interviews, clinical interviews assessing trauma history and head injury prior to treatment, symptom monitoring during treatment, and full repeat assessments at 1 month and 3 months following treatment. RESULTS: No treatment group effect was found for PTSD severity between mCPT and sCPT among intention-to-treat, F(1, 10) = .01, p = .93. Both mCPT and sCPT were associated with significant improvement in PTSD, F(2, 20) = 45.05, p < .001, ds = 1.32-2.38). CONCLUSION: Overall, findings indicate mCPT appears effective in reducing psychological symptoms for women IPV survivors and suggest that condensed treatment is both palatable and feasible. Accelerated treatment delivery in this population may provide a necessary lifeline for women with IPV-related PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).