Cumulative trauma and symptom complexity in children: A path analysis

Hodges, Monica; Godbout, Natacha; Briere, John; Lanktree, Cheryl; Gilbert, Alicia; Kletzka, Nicole Taylor

doi:10.1016/j.chiabu.2013.04.001

Cited by 147 publications

(98 citation statements)

References 35 publications

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“…Chronicity of maltreatment experiences also appears to matter for explaining the variance in outcomes for youth (Hodges et al, 2013), and it is unclear what information is lost about dosage of maltreatment experiences (such as chronicity of abuse) if only the presence of one or two types of maltreatment are assessed. A child may have had one sexual abuse exposure, but years of neglect; whereas another child may have had one experience of sexual abuse but no neglect history.…”

Section: Discussionmentioning

confidence: 99%

The blind men and the elephant: Identification of a latent maltreatment construct for youth in foster care

Gabrielli

Jackson

Tunno

et al. 2017

Child Abuse & Neglect

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Child maltreatment is a major public health concern due to its impact on developmental trajectories and consequences across mental and physical health outcomes. Operationalization of child maltreatment has been complicated, as research has used simple dichotomous counts to identification of latent class profiles. This study examines a latent measurement model assessed within foster youth inclusive of indicators of maltreatment chronicity and severity across four maltreatment types: physical, sexual, and psychological abuse, and neglect. Participants were 500 foster youth with a mean age of 12.99 years (SD = 2.95 years). Youth completed survey questions through a confidential audio computer-assisted self-interview program. A two-factor model with latent constructs of chronicity and severity of maltreatment revealed excellent fit across fit indices; however, the latent constructs were correlated .972. A one-factor model also demonstrated excellent model fit to the data (χ2 (16, n = 500) =28.087, p =.031, RMSEA (0.012 – 0.062) =.039, TLI =.990, CFI =.994, SRMR =.025) with a nonsignificant chi-square difference test comparing the one- and two-factor models. Invariance tests across age, gender, and placement type also were conducted with recommendations provided. Results suggest a single-factor latent model of maltreatment severity and chronicity can be attained. Thus, the maltreatment experiences reported by foster youth, though varied and complex, were captured in a model that may prove useful in later predictions of outcome behaviors. Appropriate identification of both the chronicity and severity of maltreatment inclusive of the range of maltreatment types remains a high priority for future research.

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Section: Discussionmentioning

confidence: 99%

The blind men and the elephant: Identification of a latent maltreatment construct for youth in foster care

Gabrielli

Jackson

Tunno

et al. 2017

Child Abuse & Neglect

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“…Polyvictimized children presented the worst outcomes in terms of delinquency and trauma symptom scores (Turner et al, 2015). Number of trauma types experienced was also associated with self-reported and caregiverreported symptom complexity (i.e., clinical elevations in a variety of symptom clusters) in a clinical sample of school-aged children (Hodges et al, 2013). Finally, a study of sexually abused children found that cumulative childhood trauma was positively associated with emotional dysregulation and internalized and externalized behavior problems (Choi and Oh, 2014).…”

Section: Cumulative Childhood Traumamentioning

confidence: 99%

Cumulative childhood trauma, emotion regulation, dissociation, and behavior problems in school-aged sexual abuse victims

Hébert

Langevin

Oussaïd

2018

Journal of Affective Disorders

104

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Background-Child sexual abuse is associated with a plethora of devastating repercussions. A significant number of sexually abused children are likely to experience other forms of maltreatment that can seriously affect their emotion regulation abilities and impede on their development. The aim of the study was to test emotion regulation and dissociation as mediators in the association between cumulative childhood trauma and internalized and externalized behavior problems in child victims of sexual abuse.Methods-Participants were 309 sexually abused children (203 girls and 106 boys; Mean age = 9.07) and their non-offending parent. Medical and clinical files were coded for cumulative childhood trauma. At initial evaluation (T1), parents completed measures assessing children's emotion regulation abilities and dissociation. At Time 2 (T2), parents completed a measure assessing children's behavior problems. Mediation analyses were conducted with emotion regulation and dissociation as sequential mediators using Mplus software.Results-Findings revealed that cumulative childhood trauma affects both internalized and externalized behavior problems through three mediation paths: emotion regulation alone, dissociation alone, and through a path combining emotion regulation and dissociation.Limitations-Both emotion regulation and dissociation were assessed at T1 and thus the temporal sequencing of mediators remains to be ascertained through a longitudinal design. All measures were completed by the parents.Conclusions-Clinicians should routinely screen for other childhood trauma in vulnerable clienteles. In order to tackle behavior problems, clinical interventions for sexually abused youth need to address emotion regulation competencies and dissociation.

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“…1,2 As described in this article, complex trauma exposure not only increases the likelihood of posttraumatic stress in response to a given event but it also can result in several simultaneously presenting but phenomenologically discrete psychological difficulties, described in the empirical literature as symptom complexity. [3][4][5] Research on the effects of complex trauma has had significant impacts on empirical and clinical models of posttraumatic distress and disorder. Most importantly, it reinforces the notion of multidimensional symptoms arising from multiple traumatic events and challenges traditional assumptions regarding the single-event cause of posttraumatic stress disorder (PTSD).…”

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confidence: 99%