Using a clinical sample of 63 girls aged 5 - 16 years, the Psychoanalytic Rorschach Profile (PRP; Burke et al., 1988), a measure of drive, ego, and object relations functioning, was examined for differences between sexual abuse (SA) victims and distressed but nonabused (NA) peers. The hypothesis that the SA group would evidence more pathological, less developed levels of drive, ego, and object relations functioning than the NA group was not supported. Limitations of the use of archival data are discussed. The effects of controlling for the number of responses (R) in Rorschach research were examined by comparing entire protocols of a clinical sample of girls from 5 - 16 years of age to shortened versions which included only the first one (N = 89; R = 10) or two (N = 17; R = 20) responses to each blot. Of 12 PRP scales compared, differences between the R = 10 and entire protocols were found on 5 variables, but when R was increased to 20, only 2 differences remained. Support was given for the notion of uniform Rorschach administration in which 2 responses per card are solicited.

M.Cur.

Adverse childhood experiences (ACEs) influence student learning, behavior, and lifelong health and success. About one in four children have experienced at least one traumatic event (e.g., household dysfunction, neglect, and/or abuse) before the age of four, and that rate more than triples for children living in poverty. Trauma sensitive schools have been disseminated as a way to address this need, but there is little research on the topic. This study sought to improve understanding about adoption of trauma sensitive practices in a representative sample of the 77 elementary-level community schools in New York City and to identify facilitators and barriers to adoption of these practices. Thirty schools were randomly-selected, and interviews were conducted with 23 (76.7%) community school directors. Comprehensive Educational Plans were reviewed to supplement the interviews. The measurements and data analysis were informed by the Behavioral Health and Public Schools Framework (The Framework). Diffusion of Innovation Theory was used to classify facilitators and barriers. Data analysis comprised both deductive and inductive approaches. The findings indicated that community schools have adopted some practices aligned with the Framework, though services and resources are not delivered in strategic and coordinated ways. School cultures, priorities, and goals are not always well aligned with trauma sensitive practices. There is a wide range of experience among staff and agencies responsible for driving the adoption of trauma sensitive practices, and this is a barrier to adoption of coordinated school-wide approaches. Consequently, while community schools are a promising model, many social-emotional, mental health, and other needs of children and families persist. Schools are clearly an important social institution within society to foster upward social mobility and increase the chances for youth and children to develop in healthful fulfilling ways and contribute to the democratic society in which they live. But given the unequal and unfair distribution of access to educational resources, employment, housing, health care, income among other social resources, long-term efforts by communities as well as government policies, and investments are needed to ameliorate the traumatic experiences that continue to affect children and families and to prevent the intergenerational trauma that has occurred for centuries.

This study compared the Children’s Depression Inventory (CDI) scores of traumatized youth with or without PTSD to the scores of a nonclinical comparison group. Diagnostic interviews identified children with PTSD (28), traumatized PTSD negatives (64), and a nonclinical comparison group (41). In the absence of major comorbid disorders, the CDI scores of children and adolescents with PTSD significantly exceeded the CDI scores of traumatized PTSD negatives and controls on the CDI Total, Negative Mood, Ineffectiveness, and Anehdonia scales. The PTSD group also had significantly higher scores than the traumatized PTSD negatives on the Negative Self Esteem scale. Furthermore, as hypothesized, the CDI scores of the traumatized PTSD negatives and controls were not significantly different on any of the six subscales measured. On the other hand, there were three unexpected nonsignificant findings. First, the PTSD group mean CDI Interpersonal Problems score did not significantly differ from the traumatized PTSD negative group. Second, the PTSD group mean CDI Interpersonal Problems score also did not significantly differ from the control group. Finally, the PTSD group mean CDI Negative Self Esteem score did not significantly differ from the control group. Overall, PTSD was associated with increased depression across the majority of the CDI scales and trauma exposure without PTSD was not. Implications for research and practice are considered.

This study compared the Family Adaptability and Cohesion Evaluation Scales, Second Edition (FACES II) scores of traumatized youth diagnosed with posttraumatic stress disorder (PTSD) to the scores of trauma-exposed youth without PTSD and a non-traumatized comparison group. Child diagnostic interviews determined that all participants were free of additional major comorbid disorders. The FACES II scores of children and adolescents with PTSD were not significantly different from the FACES II scores of trauma-exposed youth without PTSD and the non-traumatized comparison group. FACES II scores were also not significantly different between the trauma-exposed youth without PTSD and the non-traumatized comparison group. Accordingly, PTSD and trauma-exposure without PTSD were not associated with variations in the perception of family functioning as measured by the FACES II. Implications for research and practice are considered.

This dissertation explores the work of specific female autobiographers or memoirists who have written about their endured emotional or physical wounds inflicted by trauma. Throughout history, women’s writings and experiences have been commonly devalued or excluded from those autobiographical texts within the traditional canon. Further, traumatized women have traditionally been regarded as pathologically divided victims who suffer holes in their psyches. Their stories about traumatized childhood and adolescence are thus treated as insignificant or dangerous and are easily silenced. As a result, life stories of traumatized women have been commonly considered as unfit texts for students to read in class (especially because of concerns about possibilities of (re)traumatizing readers), and thus are commonly omitted from the English curriculum. Considering that the literary world still is dominated by white male writers, this study examines not only traumatized women writers but also women writers who represent “difference” as well as have suffered trauma. This dissertation’s analyzed authors and texts include: Marguerite Duras’s The Lover, Rigoberta Menchú's I, Rigoberta Menchú: An Indian Woman in Guatemala, Susanna Kaysen’s Girl, Interrupted, Marjane Satrapi’s Persepolis, and Alison Bechdel’s Fun Home. These women writers variously demonstrate, through their embodied trauma writings, how easily a seemingly integrated/unitary self can be shattered, how unexpectedly the status quo can be destabilized by certain events in their life-writings, and how subversively the history of the female body can be rewritten. The life-writings by these women, who are non-heterosexual, non-white, and from the lower class, and/or who have lived with disabilities/illnesses, are far from that typical autobiographical writing that emphasizes tests of manhood, or beautifies the linear development of the masculine subject. In other words, they never emphasize their triumph over trauma, do not celebrate selfsufficiency or self-reliance, and are not interested in claiming any authority of their own personal experiences. Rather, they highlight the understanding of their own incompleteness, fragmentation, and self-contradiction, which serves to uncover the fictiveness or myths of self-control or self-mastery typically found in narratives by male and often white-only writers. In their life writings, the traumatized adolescent selves are continuously reshaped and discursively constructed, not as helpless victims of terrifying events, as is frequently assumed, but as those with rebellious, transgressive, and uncanny power, who can disturb patriarchal social norms or regulations in their life writing and come to terms with trauma in their own ways: Duras’s eroticizing trauma in The Lover, Menchú politicizing trauma in I, Rigoberta Menchú: An Indian Woman in Guatemala, Kaysen’s depathologizing trauma in Girl, Interrupted, Satrapi’s and Bechdel’s visualizing unrepresentable trauma in The Complete Persepolis and Fun Home. This study employs poststructural theories that “challenge the unity and coherence of the intact and fully conscious ‘self’ of Western autobiographical practices and the limits of its representations” (J. Miller, 49) to examine traumatized girlhood. In particular, based on feminist poststructural critiques of modernist, Enlightenment assumptions about autobiographical perspectives and voices, the following questions are examined in this dissertation: What words or images do this study’s examined authors utilize as a way to (re- )construct a self out of trauma? What understandings or insights do these authors achieve — or not achieve — while working to come terms with their traumas? In what ways might — or might not — these authors’ memoirs or life writings serve or disrupt a palliative/therapeutic role in what often is termed the healing process? What places, if any, might such autobiographical works focused on women’s experiences of trauma have in the English curriculum within the secondary classroom? And lastly, what and who constitutes the English literature canon, and what debates continue to characterize efforts to expand this canon to include voices of the marginalized?

This study compared the Family Adaptability and Cohesion Evaluation Scales, Second Edition (FACES II) scores of traumatized youth diagnosed with posttraumatic stress disorder (PTSD) to the scores of trauma-exposed youth without PTSD and a non-traumatized comparison group. Child diagnostic interviews determined that all participants were free of additional major comorbid disorders. The FACES II scores of children and adolescents with PTSD were not significantly different from the FACES II scores of trauma-exposed youth without PTSD and the non-traumatized comparison group. FACES II scores were also not significantly different between the trauma-exposed youth without PTSD and the non-traumatized comparison group. Accordingly, PTSD and trauma-exposure without PTSD were not associated with variations in the perception of family functioning as measured by the FACES II. Implications for research and practice are considered.

Youth involved in the criminal justice system exhibit elevated rates of sexual risk behavior (SRB), placing them at high risk for sexually transmitted infections (STIs) and other deleterious outcomes. High levels of youth-maternal connectedness have been shown to act as a protective factor for SRB in nationally representative studies and in studies with primarily White youth samples. However, there are mixed findings in the research literature on the association of maternal connectedness and SRB among African American and Latino youth, a population who are disproportionately over-represented in the criminal justice system. Additionally, no studies to date have examined the role of maternal connectedness in SRB among justice-involved youth. This dissertation used archived data to determine if maternal connectedness can buffer against the negative effects of adverse childhood experiences (ACEs) on SRB among justice-involved youth. A secondary aim was to explore the prevalence of ACEs among youth in the sample, including several new ACE items that focus on adversity occurring outside the home. Participants (N=263) were sentenced or detained adolescent males at a large correctional facility in New York City, aged 16-18 and predominantly African American and Latino. Data were collected from the baseline interview of an intervention study conducted from 2009-2010. Youth participated in an individually administered, computer-based survey covering a range of topics, such as sexual health history, family relationships, substance use, and exposure to adverse events. Consistent with the literature, our sample of detained youth reported a high degree of SRB and a significant number of adverse experiences. Logistic regression analysis found that total ACE scores do not predict risky sexual behavior, even when controlling for maternal connectedness, substance use, age, and number of days incarcerated/detained. However, every participant endorsed exposure to at least 2 ACEs and 92% endorsed exposure to 4 or more, suggesting that the restriction in range may have obfuscated a relationship between total ACE scores and sexual risk-taking. The new ACE items, including poverty, racial discrimination, and neighborhood violence were prevalent. Additionally, several of the individual ACE items, including physical abuse, emotional abuse, and racial discrimination were independently associated with sexual risk outcomes. Maternal connectedness was negatively correlated with one type of risky sexual behavior—frequency of substance use during sex. Maternal connectedness and total ACE scores were, as predicted, negatively correlated. These findings suggest that our sample of incarcerated youth have experienced such a profound degree of adversity and trauma that perhaps ACE scores alone cannot adequately predict their engagement in risky sex. The fact that so many of the adolescents in the study endorsed the new ACE items also provides strong support for dissemination of the revised ACE inventory. This study highlights the need for greater research on risk and protective factors influencing adolescent SRB, as well as psychosocial correlates of ACEs among at-risk youth. Furthermore, given the syndemic nature of SRB and high prevalence of STIs, HIV, and ACEs in urban communities of color, future research should consider a more comprehensive and integrative approach to preventing both childhood adversity and unwanted sexual risk outcomes. Directions for future research and clinical implications are discussed.

Thesis (Psy. D.)--Wheaton College, 2007. / Abstract. Includes bibliographical references (leaves 40-47).

An exploratory study covering phase 1 stages 1, 2 and 3 only was undertaken in this large hybrid research project to determine perceptions and understandings of the practitioners and the community about mental health problems of children and adolescents in Zambia because so far there is little known about this phenomenon. The aim of this exploratory study was to gain new insights into the phenomenon by undertaking a preliminary investigation to determine priorities for the future post doctoral research before a more structured study to develop the PHC innovative curriculum. The process first 'explored' social reality on the ground to better comprehend the perceptions and understandings of mental health problems of CA and the curricula model preferences as perceived by the practitioners and the community respectively. This was done to appreciate the "reality of practice" on the ground using the Systems, Ecological, and Biopsychosocial theories which underpinned the four field areas of the study which are: Mental Health, Curriculum Development, INSET and Action Research (AR). The total project is open-ended with three (3) phases and eight (8) stages, from the initial exploration of perceptions (phase 1), through reports to government and stakeholders, curriculum development and piloting with health educators (phase 2) and finally implementing the reconstructed curriculum and integration (phase 3) in such a way as to empower primary health workers to themselves do further research. This thesis, covering the initial explorations of perception, encompasses ONLY the first phase and three stages of this larger qualitative research project because of the Higher Education requirements and funding to try to complete in 4 years. This entails literature review of all 4 field areas because in order to orientate the first phase and three stages of such research and to see the implications of results, it is necessary to have a good grounding in all four. The research study process commenced with an orientation and introduction of the context and purpose of the study, followed by the search conferences and focus group meetings using Qualitative Research Design and Methodology. Search conferences, focus group discussions, hospital registers and clinic records were the three sources of data collection. Analysis of Qualitative and Quantitative Data used NVIVO and SPSS 13.0 Statistical Data Analysis Soft ware respectively. The study showed that mental health problems of Children and Adolescents perceived by the community and the practitioners were also referred and recorded in various hospital registers. The analysis of data from hospital records on referred cases further showed that there are serious psychotic mental health disorders in children and adolescents referred for further consultations to hospitals from the community, some of which are: acute psychotic states, with some associated with HIV/Aids. In addition to these psychotic states, epilepsy, drug and alcohol abuse, child defilement, rape cases, mental retardation and conversion disorders particularly in female children/adolescents appeared to be relatively significant mental health concerns and problems in the researched community sites. The conclusion of the study suggests that there were more environment related factors perceived to cause mental health challenges to children and adolescents. This finding further suggests that there are similarities of cases referred from the community with those seen in clinical practice areas. The significance of these findings in the reality of practice, implies that the preferred PRISMS curriculum model to be developed later as a post doctoral activity for 'INSET' of PHC practitioners in Zambia should have deliberate blending of curriculum content with more socio-environment related issues than the current traditional curricula models which are more clinical in structure, process and content. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2007.