Traumatic experiences are common among youths and can lead to posttraumatic stress disorder (PTSD). In order to identify traumatized children who need PTSD treatment, instruments that can accurately and efficiently evaluate pediatric PTSD are needed. One such measure is the Child PTSD Symptom Scale (CPSS), which has been found to be a reliable and valid measure of PTSD symptom severity in school-age children exposed to natural disasters (Foa, Johnson, Feeny & Treadwell, 2001). However, the psychometric properties of the CPSS are not known in youths who have experienced other types of trauma. The current study aims to fill this gap by examining the psychometric properties of the interview (CPSS-I) and self-report (CPSS-SR) administrations of the CPSS in a sample of 91 female youths with sexual abuse-related PTSD, a population that is targeted in many treatment studies. Scores on both the CPSS-I and CPSS-SR demonstrated good to excellent internal consistency. One week test-retest reliability assessed for CPSS-SR scores was excellent (r = .86); inter-rater reliability of CPSS-I scores was also excellent (r = .87). Symptom-based diagnostic agreement between the CPSS-SR and CPSS-I was excellent at 85.5%; scores on both the CPSS-SR and CPSS-I also demonstrated good convergent validity (74.5–76.5% agreement) with the PTSD module of The Schedule of Affective Disorders and Schizophrenia for School-Age Children–Revised for DSM-IV (K-SADS; Kaufman, Birmaher, Brent, & Rao, 1997). The strong psychometric properties of the CPSS render it a valuable instrument for PTSD screening as well as for assessing symptom severity.

No abstract

This study examined the relationship between the characteristics of childhood sexual abuse (CSA) and the severity of consequent posttraumatic stress disorder (PTSD), depression, suicidal ideation, and substance use in a sample of 83 female adolescents aged 13-18 years seeking treatment for PTSD. Nearly two-thirds of the sample (60.7%, n = 51) reported the perpetrator of the CSA was a relative. A large portion (40.5%, n = 34) of the sample reported being victimized once, while almost a quarter of the sample reported chronic victimization (23.8%, n = 20). PTSD and depression scores were in the clinical range, whereas reported levels of suicidal ideation and substance use were low. The frequency of victimizations was associated with suicidal ideation. Contrary to expectation, CSA characteristics including trauma type, perpetrator relationship, and duration of abuse were unrelated to PTSD severity, depressive symptoms, or substance abuse.

BackgroundGrowth cone navigation across the vertebrate midline is critical in the establishment of nervous system connectivity. While midline crossing is achieved through coordinated signaling of attractive and repulsive cues, this has never been demonstrated at the single cell level. Further, though growth cone responsiveness to guidance cues changes after crossing the midline, it is unclear whether midline crossing itself is required for subsequent guidance decisions in vivo. In the zebrafish, spinal commissures are initially formed by a pioneer neuron called CoPA (Commissural Primary Ascending). Unlike in other vertebrate models, CoPA navigates the midline alone, allowing for single-cell analysis of axon guidance mechanisms.ResultsWe provide evidence that CoPA expresses the known axon guidance receptors dcc, robo3 and robo2. Using loss of function mutants and gene knockdown, we show that the functions of these genes are evolutionarily conserved in teleosts and that they are used consecutively by CoPA neurons. We also reveal novel roles for robo2 and robo3 in maintaining commissure structure. When midline crossing is prevented in robo3 mutants and dcc gene knockdown, ipsilaterally projecting neurons respond to postcrossing guidance cues. Furthermore, DCC inhibits Robo2 function before midline crossing to allow a midline approach and crossing.ConclusionsOur results demonstrate that midline crossing is not required for subsequent guidance decisions by pioneer axons and that this is due, in part, to DCC inhibition of Robo2 function prior to midline crossing.

A sizable gap exists between the availability of evidence-based psychological treatments and the number of community therapists capable of delivering such treatments. Limited time, resources, and access to experts prompt the need for easily disseminable, lower cost options for therapist training and continued support beyond initial training. A pilot randomized trial tested scalable extended support models for therapists following initial training. Thirty-five postdegree professionals (43%) or graduate trainees (57%) from diverse disciplines viewed an initial web-based training in cognitive-behavioral therapy (CBT) for youth anxiety and then were randomly assigned to 10 weeks of expert streaming (ES; viewing weekly online supervision sessions of an expert providing consultation), peer consultation (PC; non-expert-led group discussions of CBT), or fact sheet self-study (FS; weekly review of instructional fact sheets). In initial expectations, trainees rated PC as more appropriate and useful to meet its goals than either ES or FS. At post, all support programs were rated as equally satisfactory and useful for therapists' work, and comparable in increasing self-reported use of CBT strategies (b = .19, p = .02). In contrast, negative linear trends were found on a knowledge quiz (b = -1.23, p = .01) and self-reported beliefs about knowledge (b = -1.50, p < .001) and skill (b = -1.15, p < .001). Attrition and poor attendance presented a moderate concern for PC, and ES was rated as having the lowest implementation potential. Preliminary findings encourage further development of low-cost, scalable options for continued support of evidence-based training.

Supported treatments are not broadly available, prompting the need for effective training of front-line providers. Observational methods for assessing training success are resource-and time-intensive, and brief self-reports of comprehension are prone to bias and poor correspondence with practice. The present study presents a preliminary psychometric evaluation of a novel alternative method to assessing trainee comprehension of and clinical reasoning in cognitive-behavioral therapy (CBT) for child anxiety disorders, the Assessment of Clinical decision-making in Evidence-based treatment for Child Anxiety and Related and Disorders (ACE CARD). The ACE CARD, developed in consultation with a panel of child anxiety experts, presents respondents with clinical vignettes describing prototypical anxious youth at various points of CBT treatment and has respondents select which of 4 response options is most consistent with the CBT model of child anxiety treatment. In a sample of novice trainees and experts in CBT for anxiety (N ϭ 54), results suggest the measure can discriminate across levels of clinical expertise. Experts performed significantly better than trainees (d ϭ .60, p Ͻ .001), although 3 of the vignettes were largely responsible for group differences. Future iterations of the ACE CARD are needed to remove items with poor discriminating properties and to add additional items with greater difficulty. With continued support, vignette-based assessment approaches may prove to have a meaningful role in dissemination efforts as brief, resource-efficient proxies of CBT competence.

No abstract

No abstract