Given the public health crisis of Adverse Childhood Experiences (ACEs) in childhood and adolescence, and the potential lifelong repercussions, this study sought to identify significant predictors of a high self-rating for having experienced ACEs in childhood/adolescence with Hispanic/Latinx adults (n=292) with 55.8% female and 81.5% U.S. born with a mean age of 33 years. Some 52.5% presented moderately high to extremely high levels of race-related stress due to being Hispanic/Latinx; 63.6% experienced moderate to very severe toxic stress in childhood/adolescence and, 66.1% in the past year; 82.6% reported depression, 87% anxiety, and 86.2% trauma during childhood/adolescence; and, 83.1% reported depression, 89.7% anxiety, and 81.1% trauma for the past year. The study introduced the Knowledge of Adverse Childhood Experiences Survey (KACES-20) finding a moderate level of knowledge with deficits regarding how ACEs in childhood/adolescence can place individuals at risk later in life for type 2 diabetes, cancer, and high blood pressure. An ACEs video was included in the study with over 90% recommending the KACES-20 and ACEs video to others; and, together these brief online e-health interventions were associated with significant increases in knowledge of ACEs and self-efficacy for the ability to recognize ACEs in children/adolescents. After taking the KACES-20 and watching the ACEsvideo, 94.6% revealed experiencing ACEs during childhood/adolescence. Having more severe experiences of ACEs was significantly predicted by male gender, higher race-related stress due to being Hispanic/Latinx, higher toxic stress in childhood/adolescence, higher mental distress in childhood/adolescence and the past year, and a higher KACES-20 score. Findings highlight the value of the KACES-20 and ACEs video as brief online e-health interventions, and the important contribution of a new methodology for investigating experiences of ACEs in childhood/adolescence without causing discomfort or re-traumatization. These findings have particular value as contributions to the literature, while focusing on the neglected Hispanic/Latinx population, especially at this historic time of a pandemic and post-pandemic era when ACEs have risen; and, there is an urgent need for tools for prevention and intervention. This study has provided evidence for using the KACES-20 and ACEs video, as well as the study measures for prevention and future research.

Dissertation (PhD)--University of Stellenbosch, 2005. / Bibliography. Also available via the Internet.

Thesis (MA)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Both human and animal studies indicate that early trauma can influence brain development and can lead to dysregulation and dysfunction. This includes cognitive deficits. The risk of childhood trauma (CHT) and resulting cognitive deficits are well established in Posttraumatic Stress Disorder (PTSD). This is not the case for Social Anxiety Disorder (SAD). The experience of CHT does not inevitably lead to later psychopathology, suggesting that resiliency factors may be at play. Indeed, research shows that resilience is protective against the development of PTSD although this has not been well studied in SAD, particularly in the context of childhood trauma and neurocognition. Methods: This exploratory study assessed for the possible contribution of CHT on cognitive functioning in adults with SAD. We assessed 44 individuals who formed part of a larger study on neurocognitive and neuroimaging correlates in a sample drawn from the Western Cape, South Africa. Using a neuropsychological test battery, memory, attention and executive functioning (EF) (underpinned by hippocampal, cingulate cortex and pre frontal-cortex function respectively) were assessed. CHT was assessed with the Childhood Trauma Questionnaire (CTQ). We compared neurocognitive and resilience (CD-RISC) variables across four groups (SAD with trauma, SAD without trauma, PTSD and healthy controls) using analysis of variance (ANOVA) statistics. Results: None of the groups differed significantly on cognitive variables, however, on average all outcomes were in the predicted direction. Separate analyses for the traumatised groups only showed a significant effect for EF and attention, suggesting an association between EF, attention and CHT. On a measure of resilience, healthy controls had significantly higher resilience scores than the other 3 groups. Unexpectedly, SAD and PTSD groups with CHT had higher resilience scores than the SAD group without CHT, suggesting that resilience moderates CHT. Lastly individuals with SAD and PTSD with CHT reported more emotional abuse and neglect than any other type of childhood trauma. Conclusion: This exploratory study is unique in its comparative assessment of the effects of CHT and resilience on discussed. / AFRIKAANSE OPSOMMING: Agtergrond: Beide mens- en dierestudies dui daarop dat vroeë trauma brein ontwikkeling kan beïnvloed en kan lei tot disfunksie. Dit sluit kognitiewe tekortkominge in. Die risiko van vroeë kinderjare trauma (KJT) en die gevolglike kognitiewe tekortkominge is goed gevestig in Posttraumatiese stresversteuring (PTSV). Dit is egter nie die geval in Sosiale angsversteuring (SAV) nie. Die ervaring van KJT lei nie noodwendig tot latere psigopatologie nie, wat daarop dui dat veerkragtigheidsfaktore 'n rol kan speel. Trouens, navorsing toon dat veerkragtigheid beskermend is teen die ontwikkeling van PTSV, maar dit is egter nie behoorlik nagevors in SAV nie - veral nie in die konteks van vroeë kinderjare en neurokognisie nie. Metodologie: Hierdie verkennende studie het die invloed van KJT op kognitiewe funksionering in 44 individue geëvalueer. Hierdie studie het deel gevorm van 'n groter studie oor neurokognitiewe- en neurobeeldingskorrelate in 'n steekproef wat gewerf is uit die Wes-Kaap, Suid-Afrika. ‘n Neurosielkundige toetsbattery was gebruik om geheue, aandag en uitvoerende funksionering (UF) (wat onderskeidelik deur die hippokampus, cingulate korteks en prefrontale korteks ondersteun word) te assesseer. KJT is beoordeel met die "Childhood Trauma Questionnaire" (CTQ). 'n Analise van variansie (ANOVA) was gebruik om die neurokognitiewe en veerkragtigheid (CD-RISC) veranderlikes oor vier groepe (SAV met trauma, SAV sonder trauma, PTSV en gesonde kontrole) te vergelyk. Resultate: Nie een van die groepe het beduidend verskil van mekaar op grond van kognitiewe veranderlikes nie, maar oor die algemeen was alle uitkomste in die voorspelde rigting. Afsonderlike analises op die getraumatiseerde groepe het 'n beduidende effek gehad vir UF en aandag, wat dui op 'n assosiasie tussen UF, aandag en KJT. Die gesonde kontrole het beduidende hoër veerkragtigheid tellings as die ander 3 groepe gehad. SAV en PTSV groepe met KJT het teen verwagtinge hoër veerkragtigheidstellings gehad as die SAV sonder KJT, wat daarop dui dat veerkragtigheid KJT modereer. Laastens, individue met SAV en PTSV met KJT het meer emosionele mishandeling en verwaarlosing gerapporteer as enige ander tipe kinderjare trauma. Bespreking: Hierdie verkennende studie is uniek in sy vergelykende evaluering van die invloed van KJT en veerkragtigheid op die neurokognisie in deelnemers met SAV en PTSV. Beperkings en aanbevelings vir toekomstige navorsing word bespreek.

Thesis (Ph. D.)--St. Mary's University, San Antonio, Texas, 2007. / "October 2007." Includes bibliographical references (leaves 74-85) and appendices.

Thesis (Ph. D.)--Georgia State University, 2007. / Title from file title page. Gregory J. Jurkovic, Gabriel P. Kuperminc, committee co-chairs; Lisa Armistead, Sarah Cook, committee members. Electronic text (117 p.) : digital, PDF file. Description based on contents viewed June 6, 2008. Includes bibliographical references (p. 72-83).

M.A. / Children are so often seen as unproductive, dependents that are vulnerable and not responsible for their own actions. Children are in fact individuals in the process of development that can learn to act in a responsible way and to manage their lives. Because children are in the process of development and change, it is a challenge for the therapist to meet the unique needs of the child. This study was developed as a response to a need under social workers for structure in the handling of children with adaptation problems. Social workers need more than just techniques that can be utilized with children in therapy. They also need guidelines on the best techniques to utilize in different phases of the process. This programme aimed at developing an integrated model for child therapy that can be utilized for children who have experienced trauma, who have difficulties adapting to new circumstances, who have behavioural problems or who are in need of personal skills. The Intervention Design and Development Model of Rothman and Thomas (1994) was utilized in the development of the new technological item. The different phases used in the development of the model for child therapy were the following: The problem analysis and planning phase, which included the planning of the study and the setting of goals for the study. The information gathering and synthesis phase, which included an investigation into the available sources for the development of new technology for child therapy. The first focus of the actions in this phase was to identify applicable sources that could be utilized to formulate a theoretical basis for the new technology. The theoretical basis served as a frame of reference to identify the most important aspects of a child that a therapy model should take into account. The next focus was to select existing interventions and technologies that could be used to formulate a practice model that would address the needed aspects of a child. The design phase, consisted of setting a preliminary product. The evaluation phase, which included the implementation of the pilot test and both the process and outcome evaluation. The aim of this phase was to test the programme and to see what can be done to improve on the results and to refine the final product. The implementation and dissemination phase which concluded the study by setting the final product ready for distribution. This product, a model for Functional child therapy, does not provide a recipe for child therapy, nor does it only help children to work through present traumas. The main focus of the model is to help children to become unique individuals within a world that is dominated and structured by adults. Children learn with this model not just to react on adult behaviour, but to become active, responsible role players in their own world.

This dissertation utilizes insights from economics and child development science to examine how trauma transmits across generations from mother to child. The first chapter consists of a literature review in which I survey the existing literature across multiple disciplines on maternal trauma and the early childhood home environment. Specifically, I investigate psychosocial pathways through which maternal trauma may affect maternal capacities and investment decisions, particularly through a mother’s behavioral responses to trauma, and its consequential effects on the early childhood home environment for children. I identify methodological challenges to estimating the effects of maternal trauma on the early childhood home environment, and discuss policy implications and possible avenues for future research. In my second chapter, I take an intergenerational perspective and review research across disciplines to demonstrate that childhood trauma should be conceptualized as an intergenerational phenomenon that plays a role in the dynamics of inequality. In doing so, I develop a conceptual framework for studying how a mother’s childhood trauma affects her future capacities as a mother and the early developmental outcomes of the next generation. To understand how traumatic environments affect early childhood development, scholars previously have concentrated on two processes: (1) how early adversity and potentially traumatic experiences affect the immediate cognitive and socio-emotional development of children, and (2) the extent to which caregivers, and mothers in particular, can buffer against the potentially detrimental effects of these early experiences. These frameworks acknowledge the importance of environmental influences on both processes, parenting practices and early childhood development. However, they largely ignore the intergenerational dynamics of traumatic experiences, and the consequences of the mother’s own previous traumas on the early childhood home environment she shapes for her children. I focus on the mother as the primary caregiver in the early years of a child’s development, and examine behavioral mechanisms, and specifically parenting, as a potential pathway for the intergenerational transmission of a mother’s childhood trauma. I conclude by discussing future avenues for research and implications for public policy. Finally, in my third chapter, I present empirical evidence on the intergenerational effects of childhood trauma using the specific case of a mother’s childhood exposure to armed conflict in Sub-Saharan Africa. A mother’s nurturing care is a critical input to early development, particularly for children at elevated risk of early adversity. Little is known, however, about how a mother’s own childhood adversity affects her ability to provide such nurturing care. In this chapter, I use geo-located data on armed conflicts in three countries in Sub-Saharan Africa combined with geo- located household level data on parenting practices and early childhood development to estimate the intergenerational effects of a mother’s childhood exposure to armed conflict on her parent- ing practices and the early developmental outcomes of her children. Difference-in-differences estimates use identifying variation in geographic differences in exposure to conflict across sub- national regions and temporal variation across maternal birth cohorts. I find that mothers exposed to conflict in their early childhood are more likely to use abusive disciplinary practices. They are also less likely to stimulate their children through educational activities, material investments, or sending their children to early childhood education centers. These mothers are also more likely to experience intimate partner violence, and engage in early marriage and early sex, which may be mechanisms by which a mother’s childhood exposure to conflict affects her future maternal capacities and investments, and the early developmental outcomes of her children. Together, these essays advance our conceptual understanding of the potential long run and intergenerational effects of childhood trauma, and provide causal evidence on aspects of its inter- generational consequences in a specific context in Sub-Saharan Africa.

Early life adversity (ELA) produces long lasting developmental changes to the postnatal brain, increasing predisposition to a number of physical and psychiatric disorders. The mechanisms through which ELA is able to create lasting detrimental changes to neuronal development remains unclear. This thesis tested the hypothesis that increases in fear generalization, a common symptom in psychiatric disorders, follows ELA exposure in age dependent and sexually dimorphic ways in alignment with the findings of clinical studies. The effects of ELA often impact fear circuitry and we confirmed, using electrophysiology and tissue imaging, that 5-HT circuitry from the median raphe nucleus (MRN), integral to fear response, was impaired following ELA. Using a transgenic mouse model that allows for modulation of serotonergic release, we showed that circumventing serotonergic pathways disrupted by ELA and increasing whole brain 5-HT release was enough to rescue hippocampal dependent fear responses and fear generalization. Involvement of the hippocampus in ELA effects, particularly the ventral dentate gyrus (vDG), in fear overgeneralization was confirmed as hyperactivity in thevDG following exposure to novel contexts was rescued by increased 5-HT release. In addition to ELA-induced hyperactivity of the vDG, known to potentiate stress susceptibility, I demonstrated that ELA resulted in an increase in passive coping strategies, HPA axis dysfunction and elevated stress hormone release. These effects were seen predominantly in adult females and rescued in those with increased 5-HT release. Together these data suggest that increased predisposition to psychiatric disorders following ELA exposure involves the disruption of fear circuitry regulated by 5-HT activity. Identifying the underlying circuits altered by ELA not only provides insight about disrupted postnatal brain development, but also increases our knowledge of the timeline, trajectory and factors affecting healthy postnatal brain development.

Experiencing early life adversity (ELA) increases the risk of anxiety disorders, such as generalized anxiety disorder and post-traumatic stress disorder, with disproportionally higher risk in women compared to men. Neurodevelopmental and behavioral outcomes following ELA are multifaceted and are influenced heavily by the type of adversity experienced and sex of the individual. A major contributor to emotional dysfunction and anxiety disorders resulting from ELA are changes in fear and threat circuitry. Children who experienced ELA have been reported to show an accelerated development of the amygdala, a region involved in processing threat, and greater cerebrospinal levels of corticotrophin releasing hormone (Crh), an orchestrator of neuroendocrine and behavioral responses to stress. Work in rodents have linked Crh signaling within the lateral central amygdala (CeAL) with processing and responding to threat, core features disrupted in anxiety-related disorders. Further, sex biases in risk and symptom presentation have been proposed to be related to sexual dimorphic signaling of Crh across the brain that differentially influence a variety of Crh-dependent behaviors. However, it remains unclear what properties of ELA portend differential neurobiological risk, what is the basis of sex-differences for negative outcomes, and how specific mechanistic changes give rise to certain endophenotypes. In this work, I use genetic, cellular, and behavioral approaches to explore the impact of ELA and sex on perinatal development in mice and the functional consequences of altered Crh neuron activity in the CeAL on threat responding in adulthood. In Chapter 1, I review how factors such as sex and type of ELA influence amygdala development and Crh. In Chapter 2, I assess the impact of two forms of ELA, maternal separation (MS) and limited bedding and nesting (LBN) on perinatal development and anxiety-like behavior. Both forms of ELA shifted the timing of somatic maturation and basal CORT levels and led to increased anxiety-like behaviors, but the degree of the impact depended on the sex and type of adversity experienced. In Chapter 3, I demonstrate that a distinguishing feature between types of ELA was the predictability of maternal care. The type of ELA also contributed to sex-differences in Crh related gene expression in the perinatal amygdala. Increased expression was primarily observed in males following MS and in females following LBN. In Chapter 4, I investigate the functional consequences of ELA in the form of LBN on the activity of CeALCrh+ neurons in vivo and their causal role in threat reactivity indexed by the startle response. LBN rearing led to sustained activity of CeALCrh+ in female mice but diminished in male mice. Persistent activity of this population was necessary for and predicted the magnitude of startle responding. In Chapter 5, I discuss important considerations when integrating new advancements in the study of ELA and the use of sex as a biological variable. Collectively, this work deepens our understanding of the neurobiological mechanisms impacted by sex and ELA and holds promise for future strategies that may consider the sex and specific experiences of the individual to target specific endophenotypes and address the underlying root causes of anxiety disorders.

Despite the growing recognition of the prevalence of domestic violence worldwide, there is an increasing number of women reporting abuse, and there are those who have died at the hands of their abusers. Many of these domestic violence situations involve children who grow up carrying the physical and/or emotional scars of abuse into adulthood, which also has negative implications for their social well-being. This study adopts a qualitative approach to analysing emerging themes relating to the experiences of eight adult participants (four men and four women) who have lived in domestically violent homes during their childhood. The study deals with definitions of abuse, the social, physical, emotional, cognitive, behavioural and psychological effects of abuse and identifies the social consequences of growing up in a violent home. With reference to the research interviews, it is the researcher’s finding that if there is violence in the home, children’s socialisation will be impaired. The results of the study support the hypothesis that the socialisation of adults and their ability to form healthy relationships are hindered by being exposed to domestic violence during childhood. In terms of the goals of intervention, the basic principle is that children need to be provided with a safe environment, appropriate discipline and a secure relationship with an attentive caregiver. The ultimate goal of intervention is to prevent further harm and promote recovery. Socio-educational goals include being taught to communicate and settle differences without the use of violence, to promote the development of well-adjusted social beings. / Educational Foundations / M. Ed. (Socio-Education)