Phenomenology and psychological assessment of complex posttraumatic states
ABSTRACT The authors offer a framework for the assessment of psychological responses associated with exposure to early onset, multiple, or extended traumatic stressors. Six prominent and overlapping symptoms clusters are described: altered self-capacities, cognitive symptoms, mood disturbance, overdeveloped avoidance responses, somatoform distress, and posttraumatic stress. A strategy for the structured, psychometrically valid assessment of these outcomes is introduced, and specific recommendations for use of various generic and trauma-specific child and adult measures are provided. Implications of trauma assessment for treatment planning are discussed.
SourceAvailable from: Shelly Sadek McCoy
Article: Core competencies
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ABSTRACT: The complex symptom profiles of young children with histories of trauma exposure underscore the importance of matching individual child characteristics and symptom needs with existing evidence-based treatment protocols. Children (N = 134) between the ages of 2–12 and their caregivers were administered the Child Behavioral Checklist, Trauma Symptom Checklist for Young Children, and the Trauma Symptom Checklist for Children-Alternate Version at baseline and end of treatment. ANCOVA analyses examined the relationships between the number of different types of trauma exposures, child gender, placement status, child age, type of treatment received, and end of treatment symptom scores. Child age at the start of treatment was found to influence externalizing and total problem scores at the end of treatment when baseline scale scores were held constant. Older children were found to have significantly higher levels of externalizing and total problem scores at the end of treatment compared to younger children in the sample. Significant improvements were found between baseline and termination outcome scores regardless of treatment type, however, results suggest that differences in severity of symptoms may vary by treatment type. Study findings suggest that latency age children and their caregivers may have differing trauma-related treatment needs compared to younger children and may benefit from an adjusted focus in treatment. The matching of individual child characteristics and need can help maximize emotional and behavioral outcomes and the addition of a cognitive-based treatment modality may be indicated for some children.Journal of Child and Family Studies 12/2014; DOI:10.1007/s10826-014-0079-1 · 1.42 Impact Factor
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ABSTRACT: There is considerable research implicating posttraumatic stress disorder (PTSD) as a common reaction to intimate-partner violence (IPV; Golding, 1999). PTSD is categorized as a single disorder; however, there is significant heterogeneity in its symptom-presentation patterns (Dickstein, Suvak, Litz, & Adler, 2010). Researchers have posited underlying personality characteristics as potentiating different expressions of PTSD (Miller, Greif, & Smith, 2003). Specifically, a model with 3 personality subtypes (i.e., externalizing, internalizing, and simple) has been proposed to explain PTSD symptom-pattern heterogeneity (Miller, 2003; Miller & Resick, 2007). The current study tested the PTSD personality-subtype model in a sample of 129 women exposed to a range of IPV experiences. Temperament patterns of women reporting clinically significant PTSD symptoms replicated the 3 personality-subtype patterns found in previous investigations (i.e., an externalizing subtype group characterized by high negative emotionality and low disinhibition, an internalizing subtype group characterized by high negative emotionality and low positive emotionality, and a simple subtype group characterized by midrange scores across the temperament variables; Miller et al., 2003; Miller, Kaloupek, Dillon, & Keane, 2004; Miller & Resick, 2007). Differences between personality-subtype groups and women without clinically significant PTSD symptoms were found (p < .05), with women reporting personality patterns consistent with the internalizing and externalizing subtype groups exhibiting higher comorbid personality pathology and psychological difficulties. Implications are discussed for personality as a risk or resiliency factor in PTSD and as contributing to explaining PTSD symptom heterogeneity. (PsycINFO Database Record (c) 2015 APA, all rights reserved).Psychological Trauma Theory Research Practice and Policy 01/2014; 7(2). DOI:10.1037/tra0000003 · 0.89 Impact Factor