O Transtorno Traumático do Desenvolvimento (TTD) é um conceito teórico-clínico que ainda não consta dos guidelines psiquiátricos oficiais. O presente trabalho consiste na apresentação dos dados referentes às prevalências encontradas para os diferentes critérios diagnósticos do TTD, oriundos da aplicação de um instrumento elaborado em língua portuguesa originalmente para esse estudo. A amostra foi constituída por 102 crianças e adolescentes de 8 a 14 anos, provenientes de diferentes cenários de risco para maus-tratos, incluindo uma escola pública (n=51), um ambulatório de violência (n=30) e um albergue para vítimas de violência familiar (n=21). Os resultados preliminares sugerem ser possível corroborar a hipótese que sustenta o conceito do transtorno ao indicar que crianças que são expostas à violência, têm maiores probabilidades de apresentar os sintomas que caracterizam o TTD. / The Developmental Trauma Disorder (DTD) is a clinical-theoretical construct that is not yet included in the official psychiatric guidelines. This study consists of the presentation of data on the prevalence found for the different diagnostic criteria of DTD, derived from the application of an instrument originally prepared in Portuguese for this study. The sample consisted of 102 children and adolescents 8-14 years old, representing different risk scenarios for abuse, including a public school (51), an outpatient clinic for violence (30) and a shelter for victims of family violence (21). The preliminary results suggest that it is possible to corroborate the hypothesis that supports the concept relating to the disorder, which indicates that children who are exposed to violence are more likely to exhibit symptoms that characterize DTD.

O Transtorno Traumático do Desenvolvimento (TTD) é um conceito teórico-clínico que ainda não consta dos guidelines psiquiátricos oficiais. O presente trabalho consiste na apresentação dos dados referentes às prevalências encontradas para os diferentes critérios diagnósticos do TTD, oriundos da aplicação de um instrumento elaborado em língua portuguesa originalmente para esse estudo. A amostra foi constituída por 102 crianças e adolescentes de 8 a 14 anos, provenientes de diferentes cenários de risco para maus-tratos, incluindo uma escola pública (n=51), um ambulatório de violência (n=30) e um albergue para vítimas de violência familiar (n=21). Os resultados preliminares sugerem ser possível corroborar a hipótese que sustenta o conceito do transtorno ao indicar que crianças que são expostas à violência, têm maiores probabilidades de apresentar os sintomas que caracterizam o TTD. / The Developmental Trauma Disorder (DTD) is a clinical-theoretical construct that is not yet included in the official psychiatric guidelines. This study consists of the presentation of data on the prevalence found for the different diagnostic criteria of DTD, derived from the application of an instrument originally prepared in Portuguese for this study. The sample consisted of 102 children and adolescents 8-14 years old, representing different risk scenarios for abuse, including a public school (51), an outpatient clinic for violence (30) and a shelter for victims of family violence (21). The preliminary results suggest that it is possible to corroborate the hypothesis that supports the concept relating to the disorder, which indicates that children who are exposed to violence are more likely to exhibit symptoms that characterize DTD.

O Transtorno Traumático do Desenvolvimento (TTD) é um conceito teórico-clínico que ainda não consta dos guidelines psiquiátricos oficiais. O presente trabalho consiste na apresentação dos dados referentes às prevalências encontradas para os diferentes critérios diagnósticos do TTD, oriundos da aplicação de um instrumento elaborado em língua portuguesa originalmente para esse estudo. A amostra foi constituída por 102 crianças e adolescentes de 8 a 14 anos, provenientes de diferentes cenários de risco para maus-tratos, incluindo uma escola pública (n=51), um ambulatório de violência (n=30) e um albergue para vítimas de violência familiar (n=21). Os resultados preliminares sugerem ser possível corroborar a hipótese que sustenta o conceito do transtorno ao indicar que crianças que são expostas à violência, têm maiores probabilidades de apresentar os sintomas que caracterizam o TTD. / The Developmental Trauma Disorder (DTD) is a clinical-theoretical construct that is not yet included in the official psychiatric guidelines. This study consists of the presentation of data on the prevalence found for the different diagnostic criteria of DTD, derived from the application of an instrument originally prepared in Portuguese for this study. The sample consisted of 102 children and adolescents 8-14 years old, representing different risk scenarios for abuse, including a public school (51), an outpatient clinic for violence (30) and a shelter for victims of family violence (21). The preliminary results suggest that it is possible to corroborate the hypothesis that supports the concept relating to the disorder, which indicates that children who are exposed to violence are more likely to exhibit symptoms that characterize DTD.

This dissertation consists of two studies designed to broaden our understanding of the impact of complex trauma on symptom profiles and outcomes of children in the child welfare system through the lenses of gender, development, and placement permanency. Data for both were obtained using the Child and Adolescent Strengths and Needs Comprehensive Assessment tool (CANS; Lyons, Gawron, & Kisiel, 2005) for youth ages 6 -17 years involved in the child welfare system. In Study 1, I examined symptom profiles of 3,446 youth to determine the ability of gender, age, ethnicity, trauma type, and other adversity variables to predict the following CANS domains: posttraumatic stress symptoms (PTSS), emotional/ behavioral needs, risk behaviors, life domain functioning, and child strengths. Findings supported the hypothesis that males and females would exhibit a similar number and severity of PTSS subsequent to exposure to maltreatment, including complex trauma. Unique gender-specific developmental profiles of trauma exposure and symptomatology emerged. I concluded that the complex and dynamic interactions among gender, age, trauma experience, and psychosocial functioning are more complicated than can be elucidated in main effect or two-way interactions. It is therefore recommended that trauma researchers disaggregate analyses by gender in trauma research because the dynamics of trauma are different for males and females. In Study 2, I employed survival analyses to examine the ability of child characteristics, complex trauma exposure, and placement-related variables to predict placement disruption in a sample of 4,822 youth at high-risk for placement disruption. Older age, female gender, higher levels of externalizing behavior, and more prior placements increased risk for placement disruption, whereas longer time in care and type of out-of-home placement decreased risk for placement disruption in the sample. It is recommended that placement stability be directly targeted for those at higher risk through provision of intensive support to youth and their foster caregivers. Caseworkers should receive training about those subgroups most at-risk for placement disruption. Externalizing behavior and attachment, but not PTSS, mediated the relation between complex trauma and placement disruption. Intervention for youth with a history of complex trauma should focus on both attachment and externalizing behaviors.

To assess a wide range of stressors and traumas, we developed a trauma and stressors exposure checklist for adults to capture a wide variety of potential trauma exposure. This study details the extensive development and validation process of the Comprehensive Trauma and Stressors Checklist (CTSC). Study 1 consisted of item pool generation, review of existing trauma measures, content analysis, and expert review and input. Study 2 analyzed reliability and validity of the updated checklist. Participants were recruited from college and community samples (N = 200) and completed the CTSC along with five additional measures. The CTSC demonstrated high internal consistency (α =.96). Good temporal stability was established with a subset of participants (n = 28) who completed the survey twice for test-retest reliability (r = 0.86, p < .001). Significant correlations between scores on the CTSC and the Stressful Life Events Screening Questionnaire, Life Events Checklist for the DSM-5, Intersectional Discrimination Index, and Spiritual Abuse Questionnaire are evidence of strong convergent validity. Finally, the lack of significant correlations between CTSC scores and theoretically unrelated constructs supported the discriminant validity of the CTSC. This study provides preliminary evidence that the CTSC is a reliable and valid measure of exposure to traumas and stressors. Future studies with the CTSC will examine measurement invariance, exploratory and confirmatory factor analysis, and reading level.

Den psykiska ohälsan bland barn och ungdomar i Sverige har ökat under 2000-talet. Socialstyrelsen rekommenderar psykologisk behandling för de flesta psykiatriska tillstånd hos barn och unga samtidigt som utskrivning av läkemedel ökar. Förändrade strukturer och synsätt inom vården riskerar att viktig kunskap och kompetens går förlorad och att behandlingsutbudet inom vården minskar. Forskning kring hjärnan och barns utveckling kan bidra med värdefulla aspekter att ta hänsyn till i beslut kring det psykoterapeutiska arbetet och utbudet inom BUP. Studiens syfte var därför att belysa och undersöka hur modern neurovetenskap och mer specifikt teorin kring interpersonell neurobiologi kan användas i psykoterapi med barn, unga och familjer. Genom en litteraturstudie har tre centrala aspekter lyfts fram som viktiga när man försöker integrera denna kunskap med den kliniska tillämpningen: Hjärnutvecklande interventioner, Psykoedukation och Relationsfokus. Även om studiens avgränsning medför vissa svagheter, bedöms dock resultaten kunna vara intressanta för både kliniskt verksamma och andra individer och grupper i samhället. / The mental ill health among children and adolescents has increased in Sweden during the last two decades. The National Board of Health and Welfare recommends psychological treatment as a primary intervention for most of the psychiatric conditions seen in children and adolescents, at the same time as medical prescriptions continue to increase. Changes in organizational structure and perspectives within mental health care applies risk of losing important knowledge, experience and narrowing the range of treatment methods. Modern neuroscience has an opportunity to provide valuable aspects in decisions regarding the content and variety of treatment methods provided in child and adolescent psychiatry. The aim of this study was to illustrate and investigate how modern neuroscience and specifically the theory of interpersonal neurobiology can be applied in the clinical practice of psychotherapy with children, adolescents, and families. A literature review was carried out where three central themes emerged as important aspects of integrating this perspective in the clinical practice: Interventions for positive brain development, Focus on relationships and Psychoeducation. The selection of literature is relatively narrow and a limitation of the study, but the results could nonetheless be useful for both clinicians and other individuals and groups in the larger community.

Crime is as old as mankind. It started with an incident of theft inside Paradise and a murder outside. In order to understand the phenomenon of crime several theories were formulated over time. One fact should be recognized: All forms of trauma can be reduced to a single common factor: Control – or better said: a lack of control. A lack of personal control causes tension; tension leads to desperation; desperation leads to irresponsibility. Then the door to crime is unlocked. Fortunately all irresponsibilities doesn’t lead to crime. In order to understand the offender it is imperative to understand his background. The relationship between childhood trauma and crime cannot be denied. It is a fact that childhood traumas can lead to abnormal brain development in early childhood. For this reason special attention is paid to the processes involved in brain development, both in normal children and in maltreated ones. If not identified and intervened in time, it can lead to a situation where the cycle of frustration and desperation, and eventually crime, cannot be interrupted - not even by prisonization. Management of change (rehabilitation) must reckon with the influence of said traumas on the brain development of children. Efforts to rehabilitate the offender becomes senseless if applied for an hour once a week. Such efforts cannot repair the damage done by negative influences repeated thousands of times over many years. In the same vein it is fruitless to aim therapeutic interventions on the reason of man hoping to repair the emotional damage of his childhood. For this reason the Neurosequential Method of Therapeutics holds promise in the quest for the rehabilitation of the offender and in the fight against crime. / Penology / D. Litt. et Phil. (Penology)

Crime is as old as mankind. It started with an incident of theft inside Paradise and a murder outside. In order to understand the phenomenon of crime several theories were formulated over time. One fact should be recognized: All forms of trauma can be reduced to a single common factor: Control – or better said: a lack of control. A lack of personal control causes tension; tension leads to desperation; desperation leads to irresponsibility. Then the door to crime is unlocked. Fortunately all irresponsibilities doesn’t lead to crime. In order to understand the offender it is imperative to understand his background. The relationship between childhood trauma and crime cannot be denied. It is a fact that childhood traumas can lead to abnormal brain development in early childhood. For this reason special attention is paid to the processes involved in brain development, both in normal children and in maltreated ones. If not identified and intervened in time, it can lead to a situation where the cycle of frustration and desperation, and eventually crime, cannot be interrupted - not even by prisonization. Management of change (rehabilitation) must reckon with the influence of said traumas on the brain development of children. Efforts to rehabilitate the offender becomes senseless if applied for an hour once a week. Such efforts cannot repair the damage done by negative influences repeated thousands of times over many years. In the same vein it is fruitless to aim therapeutic interventions on the reason of man hoping to repair the emotional damage of his childhood. For this reason the Neurosequential Method of Therapeutics holds promise in the quest for the rehabilitation of the offender and in the fight against crime. / Penology / D. Litt. et Phil. (Penology)

Key words Forms of alternative care, institutional care, children's home, substitute family care, foster care, SOS Children's Village, a complex developmental trauma, abuse, deprivation, and child needs, parenting style. Summary This diploma work deals with the characterization of complex development trauma as the cause of placing children in foster care. The diploma work describes the foster care system in the Czech Republic and the specifics educational environment and educational process in the SOS Children's Villages. Includes a comparison of some factors and circumstances of educational conditions children's home and SOS Children's Village. Descriptive studies are concrete stories of children who passed the foster care system. 2

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