The Effects of Trauma Type and Executive Dysfunction on Symptom Expression of Polyvictimized Youth in Residential Care

Abstract

Risk for traumatic sequelae is conveyed directly by risk factors (i.e., exposure to trauma), and via the disruption of developmental competencies. Exposure to caregiver trauma is an especially salient risk factor, as its early and pervasive nature is likely to undermine multiple facets of development, most notably the emergence of cognitive controls (i.e., executive function [EF]). Deficits in EF have been observed among youth exposed to multiple types of trauma and are associated with a range of functional impairments, posttraumatic stress symptoms (PTSS), and behavioral disorders; they represent a mechanism by which the negative impact of caregiver trauma is conveyed. This study included 672 youth in residential placement, and examined the associations between both caregiver and noncaregiver trauma, measured by the Trauma History Profile (THP); executive dysfunction, measured by the Behavioral Inventory of Executive Function (BRIEF); PTSS, measured by the UCLA Posttraumatic Stress Disorder (PTSD) Reaction Index (PTSD-RI); and externalizing and internalizing problems, measured by the Child Behavior Checklist (CBCL). A structural equation model demonstrated direct associations between caregiver trauma and PTSS, β = .15; noncaregiver trauma and externalizing problems, β = .14; gender and PTSS, β = .26, externalizing problems, β = .12, and internalizing problems, β = .26; and age and externalizing problems, β = -.11. We observed indirect effects via deficits in EF between caregiver trauma and PTSS, β = .04 and externalizing problems, β = .19. Results indicate for screening for executive dysfunction among trauma-impacted youth is needed, as it represents a critical therapeutic target.

Catecholamines in Post-traumatic Stress Disorder: A Systematic Review and Meta-Analysis

“…It is difficult to explain this result, but it might suggest that differences in epinephrine concentrations were related to being exposed to trauma in general rather than manifestation of PTSD (Eiden, 2013). Findings of the current study suggest the need to consider trauma type as an important factor of PTSD (Hodgdon et al, 2018). In agreement with this suggestion, Guina, J et al found that combat trauma was associated with total PTSD severity, arousal and intrusions (especially physical symptoms) (Guina et al, 2018).…”

Developmental Trauma Disorder: A Legacy of Attachment Trauma in Victimized Children

“…Trauma history was assessed using a well‐validated and widely used semistructured interview measure but may be subject to retrospective bias (Widom, 2019 ) and may have false negatives when based only on either child and parent report but not both (Hungerford et al., 2010 ; Stover et al., 2010 ). Precise data on the age of onset, chronicity, and other trauma exposure variables associated with youth outcomes (Hodgdon, Liebman, et al., 2018 ; Hodgdon, Spinazzola, et al., 2018 ) could not be reported, and exposure may have been underreported by children due to their reluctance to disclose information in a caregiver's presence or to some caregivers’ lack of knowledge of events prior to caring for the child. Symptoms of PTSD were assessed based on the DSM‐IV criteria because the K‐SADS for DSM‐ 5 was not yet available.…”

A 3-year retrospective study of 866 children and adolescent outpatients followed in the Nice Pediatric Psychotrauma Center created after the 2016 mass terror attack

“…Externalizing behavior problems can lead to oppositional de ant disorder, conduct disorder and aggression; and internalizing behavior problems referred to somatic complaints, depression or anxiety [44]. In children, comorbid PTSD disorders are estimated at 75% [45] CBT can be performed with both children and adults, and has proven to be e cacious for a large spectrum of psychiatric disorders, especially for the treatment of anxiety disorders [50,51].…”