The National Child Traumatic Stress Network
01 Sep 2017-The Brown University Child and Adolescent Behavior Letter (John Wiley & Sons, Ltd)-Vol. 33, Iss: 9, pp 8-8
TL;DR: This position statement contains the NCTSN consensus regarding the clinical competencies that must, at minimum, be present before a provider can be trained to effectively deliver an NCTSN-endorsed trauma-informed intervention.
Abstract: The dissemination of standardized, effective, trauma-informed clinical interventions is a central means by which the NCTSN seeks to advance the standard of care for traumatized children and to increase the nation’s capacity to meet the needs of these children. The safe and effective implementation of these interventions requires proficiency in several basic areas of clinical competency. This position statement contains the NCTSN consensus regarding the clinical competencies that must, at minimum, be present before a provider can be trained to effectively deliver an NCTSN-endorsed trauma-informed intervention.
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TL;DR: Childhood adversity and traumatic toxic stress is reviewed, epidemiologic data on the prevalence of ACEs and their physical and mental health impacts are presented, and intervention modalities for prevention are discussed.
Abstract: Adverse childhood experiences (ACEs) are related to short- and long-term negative physical and mental health consequences among children and adults. Studies of the last three decades on ACEs and traumatic stress have emphasized their impact and the importance of preventing and addressing trauma across all service systems utilizing universal systemic approaches. Current developments on the implementation of trauma informed care (TIC) in a variety of service systems call for the surveillance of trauma, resiliency, functional capacity, and health impact of ACEs. Despite such efforts in adult medical care, early identification of childhood trauma in children still remains a significant public health need. This article reviews childhood adversity and traumatic toxic stress, presents epidemiologic data on the prevalence of ACEs and their physical and mental health impacts, and discusses intervention modalities for prevention.
301 citations
TL;DR: An increase in children's psychological and behavioral symptoms, increased screen-time, reduced physical activity, and more sleep hours/night is revealed, and hierarchical multiple regressions revealed that having an outdoor exit in the house contributed to lower levels of psychological and Behavioral symptomatology.
Abstract: The coronavirus disease (COVID-19) pandemic forced the home confinement of the majority of population around the world, including a significant number of children and adolescents, for several weeks in 2020. Negative psychological effects have been identified in adults, but research about the impact of this type of social distancing measure on children and adolescents is scarce. The present study aimed to describe and compare the immediate psychological and behavioral symptoms associated with COVID-19 quarantine in children and adolescents from three southern European countries with different levels of restrictions (Italy, Spain, and Portugal). Parents of 1,480 children and adolescents (52.8% boys) between 3 and 18 years old (M = 9.15, SD = 4.27) participated in the study. An online survey using snowball sampling techniques was conducted during 15 days between March and April 2020, representing the early phase of the quarantine associated with COVID-19 outbreak. Parents answered questionnaires about sociodemographic data, housing conditions, immediate psychological responses during quarantine (e.g., anxiety, mood, sleep, and behavioral alterations), patterns of use of screens, daily physical activity, and sleep hours before and during the quarantine. The results revealed an increase in children's psychological and behavioral symptoms, increased screen-time, reduced physical activity, and more sleep hours/night. Italian children presented less psychological and behavioral symptoms compared with Portuguese and Spanish children. In general, hierarchical multiple regressions revealed that having an outdoor exit in the house (e.g., garden, terrace) contributed to lower levels of psychological and behavioral symptomatology. Future studies are needed to identify family and individual variables that can better predict children and adolescents' well-being during and after quarantine. Recommendations for families and implications for practice are discussed.
137 citations
TL;DR: A comprehensive review of the current emerging literature on trauma and adverse life events in the CHR population is provided, addressing etiological questions that cannot be answered in studies of fully psychotic or non-clinical populations.
Abstract: The experience of childhood trauma and stressful life events is associated with subsequent development of a variety of mental health conditions, including psychotic illness. Recent research identifying adolescents and young adults at clinical high-risk (CHR) for psychosis allows for prospective evaluation of the impact of trauma and adverse life events on psychosis onset and other outcomes, addressing etiological questions that cannot be answered in studies of fully psychotic or nonclinical populations. This article provides a comprehensive review of the current emerging literature on trauma and adverse life events in the CHR population. Up to 80% of CHR youth endorse a lifetime history of childhood traumatic events and victimization (e.g. bullying). Several studies have shown that the experience of childhood trauma predicts psychosis onset among CHR individuals, while the literature on the influence of recent stressful life events (e.g. death of a loved one) remains inconclusive. Multiple models have been proposed to explain the link between trauma and psychosis, including the stress-vulnerability and stress-sensitivity hypotheses, with emphases on both cognitive processes and neurobiological mechanisms (e.g. the hypothalamic-pituitary-adrenal axis). Despite the preponderance of CHR individuals who endorse either childhood trauma or stressful life events, no clinical trials have been conducted evaluating interventions for trauma in CHR youth to date. Furthermore, the current process of formal identification and assessment of trauma, stressful life events and their impact on CHR youth is inconsistent in research and clinical practice. Recommendations for improving trauma assessment, treatment, and future research directions in the CHR field are provided.
136 citations
TL;DR: Using elementary school personnel reports of child ACE exposure minimized family burden and potential intrusion while producing prevalence estimates consistent with those of caregiver report from the National Survey of Children’s Health.
Abstract: We explored the feasibility of using school personnel as reporters to examine the relationship between the level of adverse childhood experiences (ACEs) exposure in a nonclinical sample of public elementary schoolchildren and academic risk. We selected a random sample of 2,101 children from kindergarten through 6th grade classroom rosters at 10 elementary schools. Students were 50% male, 78% White, and 55% free and reduced meal program participants. School personnel reported their factual knowledge of 10 ACEs and academic risk in a database controlled by the schools. Data were de-identified prior to analysis. A high prevalence of ACEs exposure was reported (44%), with 13% of students experiencing 3 or more ACEs. Binary logistic regression analyses revealed a dose-response effect between the number of ACEs and risk of poor school attendance, behavioral issues, and failure to meet grade-level standards in mathematics, reading, or writing. Using elementary school personnel reports of child ACE exposure minimized family burden and potential intrusion while producing prevalence estimates consistent with those of caregiver report from the National Survey of Children's Health. Results suggest that understanding and responding to a child's ACE profile might be an important strategy for improving the academic trajectory of at-risk children. (PsycINFO Database Record
126 citations
TL;DR: Child and adolescent mental health services can contribute greatly to emergency preparedness, resilience and response and, ultimately, mitigate harmful effects on the most vulnerable members of society.
Abstract: The mental health of children and young people can be disproportionally affected and easily overlooked in the context of emergencies and disasters. Child and adolescent mental health services can contribute greatly to emergency preparedness, resilience and response and, ultimately, mitigate harmful effects on the most vulnerable members of society.
116 citations