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Using Multivariate Statistics

Attachment--and loss.

25. Multiple Imputation for Nonresponse in Surveys. By D. B. Rubin. ISBN 0 471 08705 X. Wiley, Chichester, 1987. 258 pp. £30.25.

Multiple Imputation for Nonresponse in Surveys

A review of 45 studies clearly demonstrated that sexually abused children had more symptoms than nonabused children, with abuse accounting for 15-45% of the variance. Fears, posttraumatic stress disorder, behavior problems, sexualized behaviors, and poor self-esteem occurred most frequently among a long list of symptoms noted, but no one symptom characterized a majority of sexually abused children. Some symptoms were specific to certain ages, and approximately one third of victims had no symptoms. Penetration, the duration and frequency of the abuse, force, the relationship of the perpetrator to the child, and maternal support affected the degree of symptomatology. About two thirds of the victimized children showed recovery during the first 12-18 months. The findings suggest the absence of any specific syndrome in children who have been sexually abused and no single traumatizing process. Language: en

/pdf/impact-of-sexual-abuse-on-children-a-review-and-synthesis-of-zxbfk1bzuz.pdf

Impact of sexual abuse on children: A review and synthesis of recent empirical studies

This report builds on a highly valued predecessor, the 1994 Institute of Medicine (IOM) report entitled Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. That report provided the basis for understanding prevention science, elucidating its then-existing research base, and contemplating where it should go in the future. This report documents that an increasing number of mental, emotional, and behavioral problems in young people are in fact preventable. The proverbial ounce of prevention will indeed be worth a pound of cure: effectively applying the evidence-based prevention interventions at hand could potentially save billions of dollars in associated costs by avoiding or tempering these disorders in many individuals. Furthermore, devoting significantly greater resources to research on even more effective prevention and promotion efforts, and then reliably implementing the findings of such research, could substantially diminish the human and economic toll.

Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities

Objective To examine the differential efficacy of trauma-focused cognitive-behavioral therapy (TF-CBT) and child-centered therapy for treating posttraumatic stress disorder (PTSD) and related emotional and behavioral problems in children who have suffered sexual abuse. Method Two hundred twenty-nine 8- to 14-year-old children and their primary caretakers were randomly assigned to the above alternative treatments. These children had significant symptoms of PTSD, with 89% meeting full DSM-IV PTSD diagnostic criteria. More than 90% of these children had experienced traumatic events in addition to sexual abuse. Results A series analyses of covariance indicated that children assigned to TF-CBT, compared to those assigned to child-centered therapy, demonstrated significantly more improvement with regard to PTSD, depression, behavior problems, shame, and abuse-related attributions. Similarly, parents assigned to TF-CBT showed greater improvement with respect to their own self-reported levels of depression, abuse-specific distress, support of the child, and effective parenting practices. Conclusions This study adds to the growing evidence supporting the efficacy of TF-CBT with children suffering PTSD as a result of sexual abuse and suggests the efficacy of this treatment for children who have experienced multiple traumas.

/pdf/a-multisite-randomized-controlled-trial-for-children-with-1xmb36y3jv.pdf

A Multisite, Randomized Controlled Trial for Children With Sexual Abuse-Related PTSD Symptoms

Part I: Trauma-focused Cognitive-Behavioral Therapy. The Impact of Trauma and Grief on Children and Families. Assessment Strategies for Traumatized Children. The TF-CBT Model: How it Works. The Role of the TF-CBT Therapist. Part II: Trauma-focused Components. Introduction to the TF-CBT Components. Trauma-focused Component 1: Psychoeducation. Trauma-focused Component 2: Parenting Skills. Trauma-focused Component 3: Relaxation. Trauma-focused Component 4: Affective Expression and Modulation. Trauma-focused Component 5: Cognitive Coping and Processing I: The Cognitive Triangle. Trauma-focused Component 6: Trauma Narrative. Trauma-focused Component 7: Cognitive Coping and Processing II: Processing the Traumatic Experience. Trauma-focused Component 8: In Vivo Mastery of Trauma Reminders. Trauma-focused Component 9: Conjoint Child-Parent Sessions. Trauma-focused Component 10: Enhancing Future Safety and Development. Part III: Grief-focused Components. Introduction to the Grief-focused Components. Grief-focused Component 1: Grief Psychoeducation. Grief-focused Component 2: Grieving the Loss and Resolving Ambivalent Feelings About the Deceased: "What I Miss and What I Don't Miss." Grief-focused Component 3: Preserving Positive Memories of the Deceased. Grief-focused Component 4: Redefining the Relationship with the Deceased and Committing to Present Relationships. Grief-focused Component 5: Conjoint Child-parent Sessions, Treatment Review, and Closure. Appendix 1: Handouts. Appendix 2: Resources. Appendix 3: Additional Training.

http://www.dlfiles24.com/pdf46/157347049-treating_trauma_and_traumatic_grief_in_children_and_adolescents_anthony_mannarino.pdf

Treating Trauma and Traumatic Grief in Children and Adolescents

Treating trauma and traumatic grief in children and adolescents, 2nd ed.

Objective Treatment outcome for sexually abused preschool-age children and their parents was assessed, comparing the effectiveness of a cognitive-behavioral intervention to nondirective supportive treatment. Method Sixty-seven sexually abused preschool children and their parents were randomly assigned to either (1) cognitive-behavioral therapy adapted for sexually abused preschool children (CBT-SAP) or (2) nondirective supportive therapy (NST). Treatment consisted of 12 individual sessions for both the child and parent, monitored for integrity with the therapeutic model through intensive training and supervision, use of treatment manuals, and rating of audio taped sessions. Parents completed the Child Behavior Checklist, the Child Sexual Behavior Inventory, and the Weekly Behavior Report to measure a variety of emotional and behavioral symptoms. Results Within-group comparison of pretreatment and posttreatment outcome measures demonstrated that while the NST group did not change significantly with regard to symptomatology, the CBT-SAP group had highly significant symptomatic improvement on most outcome measures. Repeated-measures analyses of variance demonstrated group × time interactions on some variables as well. Clinical findings also supported the effectiveness of the CBT-SAP intervention over NST. Conclusions Findings provide strong preliminary evidence for the effectiveness of a specific cognitive-behavioral treatment model for sexually abused preschool children and their parents.

Anthony P. Mannarino

Papers

A Multisite, Randomized Controlled Trial for Children With Sexual Abuse-Related PTSD Symptoms

Treating Trauma and Traumatic Grief in Children and Adolescents

Treating trauma and traumatic grief in children and adolescents, 2nd ed.

A treatment outcome study for sexually abused preschool children: initial findings

Treating sexually abused children: 1 year follow-up of a randomized controlled trial.