Child Trauma Exposure and Posttraumatic Stress Disorder: Identification in Community Mental Health Clinics

Chemtob, Claude M.; Gudiño, Omar G.; Luthra, Rohini; Yehuda, Rachel; Schmeidler, James; Auslander, Brian; Hirshbein, Hillel; Schoor, Alan; Greenberg, Revital; Newcorn, Jeffrey H.; Panzer, Paula G.; Schenk, Todd; Levine, Paul; Abramovitz, Robert

doi:10.1080/23794925.2016.1227949

Cited by 10 publications

(6 citation statements)

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“…This study's finding of comparable long-term treatment response regardless of trauma history has important implications for adolescents, their families, and their health care providers. As other studies have found comparable rates of trauma histories among help-seeking adolescents as the 53% in our sample (Chemtob et al, 2016;Lau & Weisz, 2003), considering trauma history when selecting and developing treatment may be a concern for about half the youth seeking mental health treatment. Choice of treatment, sense of autonomy, and feelings of normalcy are important for depressed adolescents and their families (Wisdom, Clarke, & Green, 2006).…”

Section: Discussionsupporting

confidence: 70%

The long-term effect of trauma history on adolescent depression treatment.

Waldron

Howard

Reinecke

2019

Psychological Trauma: Theory, Research, Practice, and Policy

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Background: Childhood trauma is associated with the development of depression during adolescence. Prior research suggests that traumatic experiences may result in differential acute treatment outcomes for depressed adolescents. However, the long-term effects of trauma on treatment response remain unclear. Method: Participants (N ϭ 318) with a primary diagnosis of major depressive disorder were randomly assigned to 1 of 3 treatment groups: cognitive-behavioral therapy (CBT), fluoxetine (FLX), or their combination (COMB). All participants received 36 weeks of active treatment followed by 1 year of open follow-up. We hypothesized that (a) adolescents without a trauma history would have greater symptom reduction over the course of treatment compared to those with a trauma history and (b) there would be an interaction between trauma history, treatment arm, and time such that adolescents without trauma histories in combination treatment would improve the most rapidly. Linear mixed effects modeling, factorial ANOVAs, and log-linear analyses were used to test these hypotheses. Results: The linear mixed effect model revealed a significant 3-way interaction of time, trauma, and treatment type. In the CBT and COMB groups, adolescents without trauma histories improved more rapidly than traumatized adolescents. In the single-time-point analyses, there were no significant differences between adolescents with trauma histories and those without trauma histories. Conclusions: Whereas all treatment groups experienced significant reductions in depression regardless of trauma history, adolescents without trauma histories receiving psychotherapy demonstrated more rapid improvements in depression symptom severity. Treatment response did not differ between traumatized and nontraumatized youth at long-term follow-up. Clinical Impact StatementThis study suggests that depressed adolescents with trauma histories may initially show a slower response to cognitive-behavioral therapy as compared with depressed adolescents without such histories. For long-term treatment of depression, however, adolescents with trauma histories may benefit from cognitive-behavioral therapy without a need for adjunctive medication.

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Section: Discussionsupporting

confidence: 70%

The long-term effect of trauma history on adolescent depression treatment.

Waldron

Howard

Reinecke

2019

Psychological Trauma: Theory, Research, Practice, and Policy

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“…Although a thorough assessment of childhood trauma and loss is indispensable to implementing trauma-informed evidence-based practice, including case conceptualization, treatment planning, identification of intervention foci, prioritizing targets of intervention, selection of intervention strategies, and monitoring of treatment effects (see Layne, Steinberg, & Steinberg, 2014), many clinicians do not systematically screen for trauma exposure as an integral part of routine clinical intake. For example, Chemtob et al (unpublished manuscript) 2012 examined trauma assessment practices among clinicians working with children and adolescents and reported that, despite being required to specifically ask about exposure to physical abuse, sexual abuse, and domestic violence at intake, community-based clinicians reported substantially lower rates of trauma exposure than research study clinicians who interviewed the same children. Similar patterns have also been found for clinicians working with adult populations (Young, Read, Barker-Collo, & Harrison, 2001).…”

Section: Discussionmentioning

confidence: 99%

Modeling constellations of trauma exposure in the National Child Traumatic Stress Network Core Data Set.

Pynoos¹,

Steinberg²,

Layne³

et al. 2014

Psychological Trauma: Theory, Research, Practice, and Policy

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This article describes the features and utility of the Trauma History Profile (THP) component of the National Child Traumatic Stress Network (NCTSN) Core Data Set (CDS). The THP, which is derived from the Trauma History section of the University of California PTSD Reaction Index for DSM–IV, is a comprehensive tool to assist providers in identifying and characterizing a broad spectrum of 20 types of trauma experienced by children and adolescents. Additional questions assess the age during which each trauma type occurred and capture salient details about each experience. The THP allows for modeling of constellations of trauma history in ways conducive to risk stratification and triage, case conceptualization, treatment planning, and research. This article provides a conceptual background for the companion papers that are included in this special section. Selected illustrative findings from the NCTSN CDS (N = 14,088) are presented, including frequencies and mean duration of exposure to specific trauma types; distributions of age of onset by trauma type; frequencies of specific trauma exposure details relating to domestic violence; and a principal component analysis of clusters of co-occurring trauma types during childhood and adolescence. The article concludes with a discussion of implications of the THP for research and practice.

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“…PTSD can occur after the experience or witnessing of one or more Traumatic Events (TE) during childhood or adulthood [ 3 , 4 ]. Traumatic events can include physical, sexual or emotional abuse during childhood [ 5 , 6 ]. In adulthood these events include the experience or witnessing, of violent personal assault such as physical or sexual violence perpetrated by a partner, terrorism, serious illness or death of a loved one [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with PTSD among female urban slum dwellers in Ibadan, Nigeria: a cross-sectional study

Sekoni

Christofides

2021

BMC Public Health

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Background Little is known about the prevalence of and factors associated with PTSD among adult females in Nigeria, particularly those who live in slums. PTSD is a mental health condition that develops among some individuals who experience or witness a traumatic event. Several other factors could place individuals at heightened risk of PTSD including stress and comorbid mental disorders. Therefore, this study aimed to examine the prevalence and factors associated with PTSD among female urban slum dwellers in Ibadan, Nigeria. Methods We conducted a cross sectional survey using multistage sampling of 550 women aged 18 and above from selected slums. Interviewer administered questionnaires were used to elicit information on experience of childhood trauma, recent stressors, intimate partner violence, other mental disorders, sociodemographic characteristics and PTSD. PTSD was measured using the Harvard Trauma Questionnaire (HTQ) which is based on DSM IV. A multivariable linear regression model was built to test associations between PTSD and independent variables. Results The prevalence for PTSD was found to be 4.18% and the mean PTSD score was 5.80 ± 7.11. Sexual abuse in childhood, past year intimate partner violence and anxiety were significantly associated with higher PTSD scores. PTSD was not significantly associated with a history of recent stressors. Education, employment and marital status were not associated with PTSD however, age and wealth index showed marginal association with PTSD. Conclusion The prevalence of PTSD among women living in Ibadan slums was relatively low. Both child sexual abuse and intimate partner violence can be prevented. We also recommend longitudinal studies to better understand risk and protective factors.

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Child Trauma Exposure and Posttraumatic Stress Disorder: Identification in Community Mental Health Clinics

Cited by 10 publications

References 50 publications

The long-term effect of trauma history on adolescent depression treatment.

The long-term effect of trauma history on adolescent depression treatment.

Modeling constellations of trauma exposure in the National Child Traumatic Stress Network Core Data Set.

Prevalence and factors associated with PTSD among female urban slum dwellers in Ibadan, Nigeria: a cross-sectional study

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