A multilevel developmental psychopathology model of childbirth and the perinatal transition.

Despite recent applications of a developmental psychopathology perspective to the perinatal period, these conceptualizations have largely ignored the role that childbirth plays in the perinatal transition. Thus, we present a conceptual model of childbirth as a bridge between prenatal and postnatal health. We argue that biopsychosocial factors during pregnancy influence postnatal health trajectories both directly and indirectly through childbirth experiences, and we focus our review on those indirect effects. In order to frame our model within a developmental psychopathology lens, we first describe "typical" biopsychosocial aspects of pregnancy and childbirth. Then, we explore ways in which these processes may deviate from the norm to result in adverse or traumatic childbirth experiences. We briefly describe early postnatal health trajectories that may follow from these birth experiences, including those which are adaptive despite traumatic childbirth, and we conclude with implications for research and clinical practice. We intend for our model to illuminate the importance of including childbirth in multilevel perinatal research. This advancement is critical for reducing perinatal health disparities and promoting health and well-being among birthing parents and their children.

Early Emergence of Rumination has no Association with Performance on a Non-affective Inhibitory Control Task.

Rumination is a vulnerability for depression and potentially linked to inhibitory control weaknesses. We aimed to replicate the association observed in adults between inhibitory control and rumination in adolescents, and to examine putative moderating roles of childhood maltreatment and perceived family cohesion in an adolescent sample at risk for depression due to familial/personal history. Ninety adolescents aged 11-17 (M = 14.6, SD = 1.8) completed self-report scales of rumination, maltreatment, and family cohesion, and performed a task assessing inhibitory control. Hierarchical regression models showed no significant relation between inhibitory control and moderator variables on rumination. However, adolescents who reported higher levels of maltreatment and who perceived lower family cohesion tended to indicate higher levels of rumination (BChilhood Maltreatment = 27.52, 95% CIs [5.63, 49.41], BFamily Cohesion = -0.40, 95% CIs [-0.65, -0.15]). These findings demonstrate an alternative understanding of factors that increase depression onset risk and recurrence in adolescents.

Youth Dually-Involved in the Child Welfare and Juvenile Justice Systems: Varying Definitions and Their Associations with Trauma Exposure, Posttraumatic Stress, & Offending.

Recently, scholars have placed increasing effort on better understanding the unique needs of youth involved in both the child welfare and juvenile justice systems. This study drew from the Developmental Cascade of Multisystem Involvement Framework to examine group differences in trauma exposure, posttraumatic stress symptoms, and offending among youth solely involved in the juvenile justice system and youth with varying degrees of dual-system involvement, including crossover youth (i.e., youth with a history of maltreatment and offending regardless of system involvement), dual-contact youth (i.e., youth who had a history of a substantiated CW maltreatment petition prior to their involvement in the current study), and dually-involved youth (i.e., youth under the care and custody of the state's child welfare system at the time of study participation). Four-hundred adolescents (25% girls, Mage = 15.97) who were recruited from a detention center and completed self-report measures assessing trauma exposure, posttraumatic stress, and offending. Juvenile justice and child welfare records also were collected. Results indicated that, compared to youth solely involved in the juvenile justice system, crossover youth reported significantly more exposure to traumatic events, more severe posttraumatic stress symptoms, and more self-reported offending. In contrast, results indicated few differences between dual-contact youth and youth solely involved in the juvenile justice system; these groups only differed in age and in recidivism charges. There also were few differences between dually-involved youth and youth solely involved in the juvenile justice system; these groups only differed in age and exposure to non-Criterion A traumatic events. The current results suggest that categorizing youth as crossover youth based on their own self-reported history of child maltreatment exposure resulted in more observed differences between dual-system youth and youth solely involved in juvenile justice. The present results have valuable implications for how we operationalize youth's system involvement and highlight the importance of examining child maltreatment as a point of prevention and intervention efforts for these youth.

Vocally-Encoded Emotional Arousal as a Marker of Callous-Unemotional Traits in a Sample of Justice-Involved Adolescents.

Callous-unemotional (CU) traits are associated with severe and persistent juvenile offending. CU traits are also associated with dampened emotional arousal, which suggests that fundamental frequency (f0), a measure of vocally-encoded emotional arousal, may serve as an accessible psychophysiological marker of CU traits in youth. This study investigated the associations between f0 range measured during an emotionally evocative task, CU traits, and emotion dysregulation in a mixed-gender sample of 168 justice-involved youth. For boys, after controlling for covariates, wider f0 range-indicating greater emotional arousal-was negatively associated with CU traits and positively associated with emotion dysregulation. For girls, no significant associations with f0 range emerged; however, CU traits were positively associated with emotion dysregulation. Findings suggest that f0 range may serve as a valid indicator of CU traits in JJ-involved boys, and that detained boys and girls with high CU traits are characterized by different profiles of emotion dysregulation.

Why Participate in Peer Review?

The scholarly publishing enterprise is currently undergoing a "crisis," likely exacerbated by the global pandemic, in which peer reviewers are increasingly less available to perform reviews at the same time the flow of submitted manuscripts has not subsided. This editorial considers possible reasons why scholars might decline to participate in the peer review process, including the lack of compensation for this time-consuming and effort-laden service activity; questions about the fairness, validity, and efficacy of peer review; a commonly experienced dearth of training in peer review skills; and the fact that a lack of diversity in the sciences, academia, and the professions is reflected in the makeup of scholarly publishing leadership such that peer review is not necessarily conducted by one's "peers." Potential considerations are also offered on the other side of the ledger. These include the benefits that accrue to our own scholarship and publishing acumen when we review the work of others; the value of peer review to the quality of our journals and the excellence of our field; the positive contributions that thoughtful and educative reviews can make to the work of our colleagues; recent initiatives designed to increase representativeness, reduce bias, and guard against conflicts of interest in the peer reviewing process; the availability of guides and tutorials to assist emerging scholars to develop the relevant skills and acumen; and the ways in which peer reviewing can set the stage for professional growth and entry into leadership positions in the field of scholarly publishing.

Introduction to the Special Issue on Posttraumatic Stress and Suicide.

This article introduces this special issue of the Journal of Traumatic Stress devoted to new research investigating the associations among trauma exposure, posttraumatic stress symptoms, and suicidal ideation and behavior. Given the high rates of suicide seen in the aftermath of trauma exposure around the globe, it is important that researchers and clinicians strive to better understand the underlying processes and mechanisms that account for this association and that potentially could be harnessed in intervention and prevention efforts. This opening article introduces the content and themes of the present collection of manuscripts gathered together in this special issue, which includes both conceptual and empirical pieces devoted to the study of suicidality in the context of trauma exposure and considers implications for future research and evidence-based interventions.

Fluid vulnerability theory as a framework for understanding the association between posttraumatic stress disorder and suicide: A narrative review.

Suicide is a persistent issue in the United States and across the globe. A large body of published research shows that posttraumatic stress disorder (PTSD) increases the risk of suicidal ideation, suicidal behaviors, and death by suicide. However, the existing literature examining why that association might pertain is widely dispersed across disciplines (e.g., psychology, nursing) and lacks an integrative theoretical framework, making it difficult to conceptualize the current state of science in this area. Therefore, the primary aims of this narrative review were to (a) provide a comprehensive and interdisciplinary critique of the current state of knowledge regarding mechanisms that underlie the association between PTSD and suicide and (b) organize that knowledge according to a specified theoretical framework. The framework guiding this review is "fluid vulnerability theory," a diathesis-stress model of suicide that emphasizes the dynamic nature of suicide risk across cognitive, emotional, behavioral, and physiological domains. A summary of the findings, including patterns that emerged, gaps that remain, and recommendations for the advancement of science and practice in this area are addressed in this narrative review.

Profiles of autonomic stress responsivity in a sample of justice-involved youth: Associations with childhood trauma exposure and emotional and behavioral functioning.

A limited number of studies have begun to investigate how the coordinated actions of distinct physiological systems may be related to the development of psychopathology. However, the form taken by these patterns of coordination as well as their antecedents and developmental implications remain to be clarified. The Adaptive Calibration Model (ACM) proposes four prototypical patterns of physiological stress responsivity and corresponding behavioral patterns, which are further tied to varying levels of childhood adversity. The current study is among the first to investigate whether patterns of sympathetic and parasympathetic stress responsivity predicted by the ACM generalize to a sample of justice-involved youth with disproportionately high rates of childhood trauma exposure. Psychophysiological and self-report data were collected from 822 justice-involved youth (182 girls) ages 12-19 years. Latent profile analyses yielded five profiles of physiological responsivity that largely corresponded to the patterns proposed by the ACM. Further, these profiles demonstrated predicted associations with self-reported emotionality and adjustment. Trauma exposure was associated with a lower likelihood of membership in one of the profiles showing blunted physiological responsivity. Our discussion highlights ways in which insights from the ACM may inform understanding about linkages between physiology and adjustment.

Associations Among Trauma Exposure, Posttraumatic Dissociation, Reckless/Self-Destructive Behavior, and Adolescent Offending.

Previous research has established that trauma exposure and subsequent posttraumatic stress symptoms confer risk for adolescent offending and involvement in the juvenile justice system. However, recent research and theory have called attention to the contributions of specific posttraumatic reactions, including posttraumatic dissociation (PD) and reckless or self-destructive behavior (RSDB), to offending behavior among adolescents. Therefore, this study investigated direct and indirect associations among trauma exposure, PD, RSDB, and offending in a sample of justice-involved adolescents. Participants were 301 adolescents (Mage = 16.03, SD = 1.24; 21% girls) recruited from a detention center in the Mountain West. The sample was racially and ethnic diverse, with 63% identifying as a racial or ethnic minority. Youth completed self-report measures of trauma exposure, PD, RSDB, and offending. As hypothesized, results of multiple mediation analysis demonstrated a significant indirect effect linking trauma exposure and offending through PD and RSDB. Results testing an alternative multiple mediation model were non-significant. These findings suggest that PD and RSDB may serve as key links accounting for the association between trauma exposure and offending behavior and reinforce the value of incorporating trauma-informed practices within juvenile justice systems.

Open Science Practices at the Journal of Traumatic Stress.

This editorial describes new initiatives designed to promote and maintain open science practices (OSP) at the Journal of Traumatic Stress, to be enacted beginning January 2020. Following a brief description of the rationale underlying the argument for conducting and reporting research in ways that maximize transparency and replicability, this article summarizes changes in Journal submission and publication procedures that are designed to foster and highlight such practices. These include requesting an Open Science Practices Statement from authors of all accepted manuscripts, which will be published as supplementary material for each article, and providing authors with the opportunity to earn OSP badges for preregistering studies, making data available to other researchers by posting on a third party archive, and making available research materials and codes used in the study.

Introduction to the Special Issue on Moral Injury: Conceptual Challenges, Methodological Issues, and Clinical Applications.

This article introduces a special issue of the Journal of Traumatic Stress devoted to new directions in the study of moral injury (MI), defined as transgressive harms and the outcomes of those experiences. Although a significant body of research has emerged devoted to the study of the MI construct, a number of conceptual and empirical challenges have arisen; these are summarized and discussed in the present article. In addition, this article proposes ways of overcoming these challenges in order to further research and clinical practice in the field. We then go on to introduce the content and themes of the present collection of articles in this special issue, all of which provide examples of some of the most innovative and forward-looking work on the topic and expand into new conceptual frameworks, new methods of investigation, and new populations and contexts.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Introducción al número especial sobre daño moral: desafíos conceptuales, problemas metodológicos y aplicaciones clínicas INTRODUCCION AL NÚMERO ESPECIAL DE DAÑO MORAL Este artículo introduce el número especial de la Revista de Estrés Traumático (Journal of Traumatic Stress en su nombre en inglés) dedicado a nuevas direcciones en el estudio del daño moral (DM), definido como daños transgresores y los resultados de esas experiencias. Aunque surgió un importante cuerpo de investigación dedicado al estudio del constructo de DM, surgieron varios desafíos conceptuales y empíricos; Estos se resumen y discuten en el presente artículo. Además, este artículo propone formas de superar estos desafíos con el fin de promover la investigación y la práctica clínica en este campo. A continuación, presentamos el contenido y los temas de la presente colección de artículos en este especial temático, todos los cuales proporcionan ejemplos de algunos de los trabajos más innovadores y prospectivos sobre el tema y se expanden a nuevos marcos conceptuales, nuevos métodos de investigación y nuevas poblaciones y contextos.

Development and Validation of the Moral Injury Scales for Youth.

This paper describes the development and preliminary psychometric properties of the Moral Injury Scales for Youth (MISY). Although to date, the construct of moral injury has been focused on studies of samples of adult military personnel, the MISY was developed to extend the study of moral injury to interpersonal relationship stressors and transgressions among emerging adults, adolescents, and children. Participants in a validation study included 473 undergraduate students (78.6% female, age range: 18-25 years) recruited from a psychology participant pool at a large university in the Western United States as well as a second sample of 185 students recruited from the same pool, to assess reliability. Results of exploratory factor analysis and confirmatory factor analysis (CFA) indicated that the MISY demonstrated a five-factor latent structure with good internal consistencies. Correlational analyses indicated that the MISY subscales demonstrated good convergent validity, divergent validity, and test-retest reliability. The findings suggest that the MISY is a psychometrically reliable and valid measure of moral injury in emerging adults, with utility for examining moral injury in nonmilitary youth populations.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Desarrollo y validación de la escala de daños morales para jóvenes ESCALA DE DAÑO MORAL PARA JÓVENES Este artículo describe el desarrollo y las propiedades psicométricas preliminares de la escala de daño moral para jóvenes (MIY en sus siglas en inglés). A pesar que a la fecha el concepto de daño moral se ha centrado en estudios de muestras de personal militar adulto, el MIY se desarrolló para ampliar el estudio del daño moral a factores de estrés interpersonales y transgresiones entre adultos emergentes, adolescentes y niños. Los participantes para el estudio de validación incluyeron a 473 estudiantes de pregrado (78.6% mujeres, rango de edad: 18 a 25 años) reclutados de un grupo de participantes de psicología en una universidad grande en el oeste de los Estados Unidos, así como una segunda muestra de 185 estudiantes reclutados del mismo grupo, para evaluar la fiabilidad. Los resultados del análisis factorial exploratorio y el análisis factorial confirmatorio (AFC) indicaron que el MIY demostró una estructura de cinco factores latentes con buena consistencia interna. Los análisis correlacionales indicaron que las subescalas de MIY demostraron una buena validez convergente, validez divergente y confiabilidad de test- retest. Los hallazgos sugieren que el MIY es una medida psicométricamente confiable y válida de daño moral en adultos emergentes, con utilidad para examinar daño moral en poblaciones no militares de jóvenes.

Investigating the Association Between Posttraumatic Risky Behavior and Offending in Adolescents Involved in the Juvenile Justice System.

Risky behavior is common among traumatized youth and is associated with juvenile offending. This study examined predictors of posttraumatic risky behavior, the unique contribution of posttraumatic risky behavior in predicting offending, and tested whether a distinct class of youth was characterized by high levels of posttraumatic risky behavior. Participants were 400 adolescents (25% girls) between the ages of 12 and 19 years old (M = 15.97, SD = 1.25) who were involved in the Utah juvenile justice system. Approximately 54% of the sample identified as an ethnic minority. Youth completed self-report measures of trauma exposure, posttraumatic risky behavior, posttraumatic stress symptom severity, and offending. Formal legal records of offending were also collected. The results indicated that female sex was significantly related to posttraumatic risky behavior, though age was not significantly associated with posttraumatic risky behavior. Age and ethnicity were associated with both self-reported and formal offending, and male sex was associated with formal offending. Posttraumatic risky behavior was not related to formal offending, but was related to self-reported offending in some of the tested models. Latent class analysis identified 92 youth characterized by high levels of posttraumatic risky behavior; these youth also evidenced the highest rates of trauma exposure, posttraumatic stress symptom severity, and self-reported offending. There were no ethnic, age, or sex differences between youth in the high and low posttraumatic risky behavior groups. These results add to the extant literature documenting the associations among exposure to trauma, posttraumatic stress, and juvenile offending.

The roles of trauma exposure, rejection sensitivity, and callous-unemotional traits in the aggressive behavior of justice-involved youth: A moderated mediation model.

Research has demonstrated an association between childhood trauma exposure and adolescent aggression. This association may be explained by rejection sensitivity, defined as anger, or anxiety in the anticipation of rejection, which can be a consequence of trauma exposure. Callous-unemotional (CU) traits also are associated with trauma exposure and aggressive behavior; however, research has not yet investigated the interactive roles that rejection sensitivity and CU traits play in the relation between trauma exposure and aggression. Therefore, this study sought to investigate the role of rejection sensitivity in the association between trauma exposure and aggression, and whether this indirect effect was moderated by CU traits. Participants included 380 detained youth (98 girls, 282 boys) who completed self-report measures of trauma exposure, angry, and anxious rejection sensitivity, CU traits, and aggression. Results of moderated mediation demonstrated that the relation between trauma exposure and aggression exhibited an indirect effect through angry rejection sensitivity, but only at moderate or high levels of CU traits. This pattern was not found for anxious rejection sensitivity. Results suggest that interventions aimed to decrease aggressive behavior in traumatized adolescents may benefit from considering how youth respond to rejection, as well as whether youth endorse CU traits, as this may help to limit further involvement in the juvenile justice system after release.

Testing gender-differentiated models of the mechanisms linking polyvictimization and youth offending: Numbing and callousness versus dissociation and borderline traits.

The increasing prevalence of girls in the juvenile justice system suggests the importance of examining whether models of adolescent offending are differentiated by gender. Polyvictimization has emerged as a robust predictor of youth justice involvement, especially for girls, and research exploring mechanisms underlying the link between polyvictimization and offending suggests further gender differences in that callous-unemotional (CU) traits have been implicated in samples of boys whereas borderline personality (BP) traits have been implicated amongst girls. However, a limitation of these studies is that most have included all-male or all-female samples, thus not allowing for comparisons across gender. Further, few studies have used a trauma-informed lens to investigate posttraumatic symptoms, particularly dissociation and emotional numbing, that might account for these associations. To address this gap, this study investigated associations among polyvictimization, dissociation, numbing, CU, BP, and offending in a sample of 782 youth (579 boys and 203 girls) recruited from a detention center. As hypothesized, for both genders, polyvictimization was related to BP through the indirect effect of dissociation and to CU through the indirect effect of emotional numbing. Further, for both genders, path models indicated indirect effects on the association between polyvictimization and offending through dissociation and BP. These results suggest the value of using a trauma-informed approach to understanding youth justice involvement and continuing to fine-tune models of gender differences in traumatized girls' and boys' offending.

PTSD and dissociation symptoms as mediators of the relationship between polyvictimization and psychosocial and behavioral problems among justice-involved adolescents.

Polyvictimization (PV) has been shown to be associated with psychosocial and behavioral impairment in community and high risk populations, including youth involved in juvenile justice. However, the mechanisms accounting for these adverse outcomes have not been empirically delineated. Symptoms of posttraumatic stress disorder (PTSD) and dissociation are documented sequelae of PV and are associated with a wide range of behavioral/emotional problems. This study used a cross-sectional research design and bootstrapped multiple mediation analyses with self-report measures completed by a large sample of justice-involved youth (N = 809, ages 12-19 years old, 27% female, 46.5% youth of color) to test the hypothesis that PTSD and dissociation symptoms mediate the relationship between PV and problems with anger, depression/anxiety, alcohol/drug use, and somatic complaints after controlling for the effects of exposure to violence and adversities related to juvenile justice involvement. As hypothesized, PTSD symptoms mediated the relationship of PV with all outcomes except alcohol/drug use problems (which had an unmediated direct association with PV). Partially supporting study hypotheses, dissociation symptoms mediated the relationship between PV and internalizing problems (i.e., depression anxiety; suicide ideation). Implications are discussed for prospective research demarcating the mechanisms linking PV and adverse outcomes in juvenile justice and other high risk populations.

Numbing of Positive, Negative, and General Emotions: Associations With Trauma Exposure, Posttraumatic Stress, and Depressive Symptoms Among Justice-Involved Youth.

Increasing attention has been drawn to the symptom of emotional numbing in the phenomenology of posttraumatic stress disorder (PTSD), particularly regarding its implications for maladaptive outcomes in adolescence such as delinquent behavior. One change in the definition of emotional numbing according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) was the limitation to the numbing of positive emotions. Previous research with youth, however, has implicated general numbing or numbing of negative emotions in PTSD, whereas numbing of positive emotions may overlap with other disorders, particularly depression. Consequently, the goal of this study was to investigate whether numbing of positive emotions was associated with PTSD symptoms above and beyond numbing of negative emotions, general emotional numbing, or depressive symptoms among at-risk adolescents. In a sample of 221 detained youth (mean age = 15.98 years, SD = 1.25; 50.7% ethnic minority), results of hierarchical multiple regressions indicated that only general emotional numbing and numbing of anger accounted for significant variance in PTSD symptoms (total R(2) = .37). In contrast, numbing of sadness and positive emotions were statistical correlates of depressive symptoms (total R(2) = .24). Further tests using Hayes' Process macro showed that general numbing, 95% CI [.02, .45], and numbing of anger, 95% CI [.01, .42], demonstrated indirect effects on the association between trauma exposure and PTSD symptoms.

Introduction to the special issue: attachment-based treatments for adolescents.

During the past decade, new attachment-based treatments (ABTs) for adolescents have been developed and tested in both field and randomized control trials. The papers in this special issue represent important contributions to defining a more general model of ABTs for adolescents. Our discussion of these papers is organized by a series of challenges to developing and evaluating these treatments. We first consider how disturbances in the caregiver-adolescent attachment bond are implicated in adolescent psychopathology and family distress. We then describe different potential targets for attachment-based interventions for adolescents and their caregivers. Finally we review the different interventions and change mechanisms that have been used to increase security in the caregiver-adolescent bond. A general model of ABTs for adolescents can be useful in guiding future efforts to measure change in attachment constructs, evaluate the dynamic process of change in attachment bonds, and test the effectiveness of specific treatment elements in reducing adolescents' symptoms and increasing attachment security.

The roles of emotion dysregulation and dissociation in the association between sexual abuse and self-injury among juvenile justice-involved youth.

To date, scholars have established associations among nonsuicidal self-injury and sexual abuse, posttraumatic stress symptoms, and dissociation. However, leading theoretical models of the mechanisms underlying the association between trauma and negative outcomes suggest a more parsimonious explanation in that deficits in emotion regulation may underlie these various risk factors for self-injury. This study examined whether sexual abuse was differentially associated with nonsuicidal self-injury over and above other forms of traumatic experiences and whether the association between sexual abuse and self-injury was statistically mediated by emotion dysregulation and dissociation. Participants included 525 youth (392 boys, 133 girls) recruited from the U.S. juvenile justice system who completed measures of self-reported trauma exposure, posttraumatic stress symptoms, dissociation, and emotion dysregulation. Results of a hierarchical regression demonstrated that sexual abuse predicted posttraumatic stress symptoms and self-injury over and above other forms of traumatic experiences. Results of bootstrapped mediation analyses indicated that emotion dysregulation and dissociation in combination were implicated in self-injury among youth. The results suggest that youth in the juvenile justice system who experience sexual abuse may be at risk for higher rates of posttraumatic stress symptoms and that self-injury may be particularly salient for youth who experience sexual abuse. Furthermore, the results shed light on the role that dissociation and emotion dysregulation play in the relation between sexual abuse and self-injury, suggesting that a larger framework of self-regulation may have both empirical and clinical utility in helping to understand the underlying processes at play in these associations.