Child traumatic stress is a pervasive problem that affects the well-being and healthy development of children from all races, ethnicities, and cultures. Major factors known to affect trauma symptoms include type of trauma, level or severity of trauma exposure, and age and gender of children. Utilizing Bronfenbrenner’s ecological model, this study measured the additional influence of children’s race, ethnicity, and cultural factors on symptoms after trauma. A dataset of children in treatment after experiencing trauma (0-21 years, N = 10,115) from The National Child Traumatic Stress Network (NCTSN), a federally funded initiative that collected longitudinal data across 56 research and treatment centers in the US, was examined, looking at clinical symptoms at baseline and at three month (or first recorded) follow-up. Predictors for symptoms included number of trauma types, age, gender, race, ethnicity (Latino/non-Latino), and three cultural markers, born outside the United States, English as the primary language not spoken at home, and refugee/immigrant status. Results (hierarchical regressions, logistic regressions) confirmed that age, gender, and number of trauma types predict the scores and clinical level of eight validated outcomes (e.g., CBCL externalizing, internalizing; PTSD measures) as well as the total numbers of functional problems and clinical problems. Results also demonstrated that race, ethnicity, and culture affect symptoms but to a very small extent (i.e., these accounted for little variance) and in varying directions. For example, Black/African American children had lower internalizing scores compared to White/Caucasian children, while being Latino was associated with lower externalizing and higher internalizing scores than non-Latinos. Children with differing cultures sometimes scored better, sometimes worse, than their counterparts. For example, children who spoke English at home and were born in the United States had more functional problems, though fewer clinical problems. At three month (or first recorded) follow up, results demonstrated all children’s scores improving. No differences at three month (or first recorded follow up) were found between our predictors in clinical rates except for children with more types of trauma who continued to show a greater likelihood of falling into the clinical range for externalizing and internalizing. Discussion focuses on the possible protective effects of cultural factors and the importance of an ecological model in understanding trauma symptoms in diverse populations.

No description available.

Adoption-focused psychoeducation is deemed essential in maintaining the permanency of traumatized children within a new family unit. However, adoptive parents of traumatized children struggle to find training to address their unique concerns. Guided by the lens of psychodynamic theory, the purpose of this study was to investigate the challenges faced by adoptive families of traumatized children. Special focus was placed on the social and emotional relationships of the adoptive parents of traumatized children, to identify the realistic expectations towards attachment from the families' perspectives. Fifteen families were randomly selected to participate in this study from a group of 30 parents who adopted traumatized children in Arizona. A phenomenological approach was utilized to gather information from face-to-face and telephone interviews. The data analysis utilized the horizontalization approach which highlighted significant statements that were classified into codes. Thematic categories were drawn and summarized. Textual descriptions evolved from the thematic groups acknowledging their experiences and how these lived experiences guided their decision to adopt a traumatized child. Verification techniques, data mining, journaling, clustering, brainstorming, and peer reviews were used to ensure the quality of data. Emergent themes emphasized the need for adoption-focused training specific to traumatized children. Further research on this phenomenon should determine the significance of specialized psychoeducational training versus general foster care training, before and after adoption. Positive social change may result in tailoring existing training programs to meet the needs of families who adopt traumatized children.

Varje år traumatiseras 200 000 barn och trauma anses vara den vanligaste orsaken till att barn söker sjukvård i Sverige. Sjuksköterskor inom akutsjukvården träffar dessa barn i sitt arbete, men de procedurer och rutiner som finns för omhändertagande av vuxna anses inte direkt vara applicerbara på barn. Syftet med denna studie var att belysa hur specialistsjuksköterskor upplever omhändertagandet av traumatiserade barn. En kvalitativ studie med individuella intervjuer (n=9) genomfördes och analyserades med hjälp av innehållsanalys. Analysen resulterade i fyra kategorier: upplevelsen av kunskapsbrist, upplevelsen av svårigheter i samband med omhändertagandet, upplevelsen av behovet av god omvårdnadskunskap och upplevelsen av skillnader i gällande rutiner. I resultatet framkom att alla intervjuade specialistsjuksköterskor upplever kunskapsbrist och har ett stort behov av att öka sina kunskaper om barn och barntrauma. Det skulle öka deras upplevelse av trygghet i yrkesrollen som specialistsjuksköterskor avsevärt. / The most common reason for children to be seek in-hospital care in Sweden is trauma and every year more than 200000 children is traumatized. Nurses meet these children in their work but the procedures used to care for traumatized adults are not transferable to children. The aim of this study was to illuminate how special educated nurses experience the caring for traumatized children. A qualitative design with one-to-one interviews (n=9) was used to collect data. Content analysis was used to analyze the data. The analysis ended up in four categories; the experience of lacking knowledge, the experience of difficulties in the care, the experience of the need of good nursing skills and the experience of differences in the routines in use. The findings show that all the interviewed nurses experience a need to increase their knowledge concerning the care for traumatized children. Increased skills and knowledge in this matter would raise their feelings of being secure in their professional role.

Background: A 1998 seminal study catapulted adverse childhood experiences (ACEs) into the zeitgeist and shaped assessment of these experiences and long-term health consequences via The ACEs Study Questionnaire (ACE-SQ). However, the ACE-SQ's childhood sexual abuse (CSA) item requires the perpetrator have been 5-years or older than the survivor for endorsement. This may not adequately capture CSA and limit the questionnaire's ability to detect survivors. Objective: This study assessed whether CSA survivors were missed by this 5-year modifier, whether service access was restricted, and whether those missed were at elevated risk for adverse outcomes. Participants and setting: A sample of 974 women (M age = 30.46) completed an online survey. Methods: Histories of CSA were assessed using the original ACE-SQ and an alternative version without the 5-year modifier. Participants were grouped by endorsement (Modifier, No Modifier, No CSA) and compared across numerous physical and mental health outcomes using MANOVA, ANOVA, and logistic regression. Results: Numerous CSA survivors are presently missed by the 5-year modifier (n = 118 of N = 249). This group demonstrated the same elevated depression (t = 3.44, p = .002, d = 0.34), heightened somatic symptom burden (t = 3.34, p = .003, d = 0.35), and poorer subjective health (t = -2.86, p = .012, d = 0.27) as those captured by the modifier. Conclusions: Recommendations for research, practice, and policy include removing the 5-year modifier from CSA assessment, creating an empirically informed CSA definition, and eliminating or adjusting requisite cut-scores for accessing services.

Previous literature has shown that childhood trauma and adverse experiences are related to a wide range of negative outcomes that can span into adulthood (e.g., low self-worth, poor physical health, and increased likelihood of co-morbid psychological symptoms). However, a gap remains in the existing literature regarding early interventions that may target complicated outcomes (i.e., self-esteem and self-worth) while the survivor is still in childhood. This paper attempts to elucidate the impact that traumatic childhood experiences may have on self-worth, and the importance of implementing targeted intervention before the child reaches adulthood. Therefore, an extensive review was first conducted to gain further insight in regards to how specific variables, namely locus of control and health-related quality of life, may predict childhood development of self-worth. The present study then explored the influence of each factor on a child and adolescent community sample that experienced various types of trauma 61 children and adolescents who were survivors of varying types of trauma were recruited from a local mental health clinic (M=11.89; SD=2.49; 31 males, 30 females). Measures pertaining to locus of control, health-related quality of life, and self- worth were administered at their therapeutic baseline by a randomly assigned therapist. A measure of resiliency was also administered as a secondary exploratory analysis. Results highlighted pediatric quality of life and trauma type as meaningful predictors of self-worth outcomes. Additionally, resiliency as a construct with a significant correlational relationship with self-worth. All findings were interpreted for purposes of intervention, and treatment proposals were delineated.

No description available.

In the United States, there are advocacy groups that support sexual relationships between adults and children. These groups use justifications that make pedophile behaviors seem normal and appropriate. This thesis describes the physical, emotional, and psychological harms that result from child sexual abuse. The reader will understand how prominent child sexual abuse is and how it takes a lot of effort for abusers to take advantage of children. There are many psychological resources available to children and their families, but it does not make sexual abuse okay for society to ignore. The justifications used by pedophile advocates are irrational and should be fought against by society.

Barndomstrauma är en av de identifierade folkhälsoutmaningar som samhället står inför. Dagens samhälle har öppnat upp för diskussion gällande den psykiska ohälsan, där ett självskadebeteende inkluderas. Denna studie syftar till att undersöka yrkesverksammas syn på relationen mellan barndomstrauma, speciellt sexuella övergrepp och uppkomsten av ett självskadebeteende genom semistrukturerade intervjuer. Resultatet indikerar att det finns ett samband mellan sexuella övergrepp och att senare utveckla någon form av självskadebeteende för att kunna hantera överväldigande känslor som kan uppstå efter att ha varit utsatt för sexuella övergrepp. Däremot är betoningen störst på barndomstrauma generellt och inte främst på sexuella övergrepp. I resultatet framkommer även att begreppet barndomstrauma är för brett för att det ska gå att garantera att samma definitioner används. Ett centralt fynd berör att de yrkesverksamma i denna studie inte definierar ett indirekt självskadebeteende som en form av självskadebeteende. Resultatet har visat motsägelsefulla meningar i form av att det indirekta självskadebeteendet inte anses vara en form av självskadebeteende samtidigt som intervjupersonerna beskriver att sin målgrupp ägnar sig åt beteenden och situationer som ingår i det indirekta självskadebeteendet. Därav finns ett tydligt behov att avgränsa begreppen ytterligare för att kunna bidra till en universell definition och en gemensam förståelse. / Child trauma is recognized as one of the prevailing public health challenges in society. Contemporary society has fostered an environment conducive to discussing mental health issues, encompassing self-harm. This study seeks to explore professionals' perspectives on the correlation between sexual abuse and self-harm through semi-structured interviews. The findings suggest a link between sexual abuse and the subsequent development of self-harm behaviors as a coping mechanism for dealing with overwhelming emotions following such abuse. However, it is evident that the terms "childhood trauma" and "self-harm" are perceived as overly broad, leading to variations in their definitions. A notable discovery is that the professionals in this study do not classify indirect self-harm as a form of self-harm. The results reveal conflicting meanings, as indirect self-harm is not officially recognized as such, despite interviewees describing behaviors within their target group that align with indirect self-harm. Therefore, there is a clear imperative to refine these concepts to foster a universal definition and shared understanding.

This study concentrates on the development, implementation and evaluation of a research based training program for intermediaries in South African courts in order to improve the intermediary’s knowledge and understanding of the role and duties of an intermediary. The motivation for this study had its origin in the fact that the adversarial nature of court proceedings is a major stumbling block for the child witness. The research problem, namely that there is no national research based training program for intermediaries in South Africa, was discussed. Intervention research was used as research methodology and a two phase research approach was undertaken. A quantitative survey research design was used during the phases. The research question formulated for the first phase was: What are the duties and role of an intermediary? 54 magistrates and 34 prosecutors who attended four workshops, completed a self-structured questionnaire. This data complemented the literature study and both were used to compile a training program for intermediaries. The quantitative approach was also used for phase two of the study. A quasi-experimental one-group pretest-posttest design was used. An assessment by means of a questionnaire was done before the training program started and was repeated again after the presentation of the training program to determine the effectiveness of the program The research hypotheses that was formulated was: If an intermediary is trained according to a research-based training program, the intermediary’s knowledge of her role in assisting the child before and during the trial in a South African court will be improved. A five-day training program was implemented. The hypothesis was confirmed after the data had been analyzed and compared to the literature. In chapter two the legal system of South Africa, in respect to the child, was discussed and in chapters three, four and five all aspects of child development were discussed with specific emphasis on the child witness that needs to testify in a separate courtroom. Cognitive development and language development in the context of the child witness were discussed. This information was used to develop a training program. In chapter six the development of a training program was discussed with specific attention being given to outcomes based education. In chapter seven all the data that was collected was quantified, analyzed and interpreted. The conclusion could be drawn that the respondents did show improvement of their skills and knowledge of an intermediary, his/her duties and theoretical knowledge. They also showed that their practical skills had improved by attending the training program. The conclusion could therefore be made that the intermediary training program was successfully implemented and complied with the requirements of an outcomes based training program. The findings obtained indicate that trainers of intermediaries throughout South Africa can successfully apply the developed training program. Conclusions and recommendations (chapter 8) of this study are put forward in accordance with the process that was followed in developing and implementing the training program for intermediaries who are to assist children when testifying in a court. / Thesis (DPhil (Social Work))--University of Pretoria, 2006. / Social Work / unrestricted