Structured Trauma-Related Experiences and Symptoms Screener for Adults (STRESS-A): Validation in a child welfare sample of mothers and fathers with active domestic violence.

OBJECTIVE: Posttraumatic stress disorder (PTSD) is associated with impaired parenting, child mental health problems, and family dysfunction. Public service agencies, such as child welfare, may serve as critical points of entry to services for families impacted by caregiver PTSD; however, assessment of trauma and PTSD among caregivers is not always systematically incorporated into service planning. The Structured Trauma-Related Experiences and Symptoms Screener for Adults (STRESS-A) was developed to address barriers to screening and assessment by providing an easy-to-administer tool for use by clinically and nonclinically trained professionals. The current study evaluated the reliability and validity of the STRESS-A among fathers and mothers (N = 1245) referred by child protective services (CPS) to receive an intervention to reduce domestic violence. METHODS: Caregivers enrolled in the intervention completed the STRESS-A, along with measures of co-occurring mental health concerns. RESULTS: The STRESS-A demonstrated satisfactory internal reliability across the full sample and within maternal and paternal subsamples. Construct validity was supported by well-fitting models of the DSM-5 symptom structure. Convergent validity was supported by strong correlations with scores on measures of commonly occurring comorbid symptoms (e.g., depression, anxiety). Measurement invariance testing revealed that PTSD symptom factor loadings may not be equivalent between mothers and fathers when using the DSM-5 four-factor, DSM-IV three-factor, or one-factor models. CONCLUSION: The study supports the STRESS-A as a reliable and valid tool for measuring PTSD symptoms in caregivers with current domestic violence and CPS involvement. Findings indicate further research investigating symptom structure differences between mothers and fathers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Quantifying Severity of Maltreatment, Adversity, and Trauma From Child Protective Services Case Record Files.

Children referred to child protective services (CPS) for allegations of abuse or neglect often have diverse experiences of maltreatment, adversity, and trauma. Severity of these experiences is associated with greater mental health impairment and increased risk of revictimization and other adversities. Although aspects of these experiences are often captured during CPS investigations and stored in case records as narrative documents, much of this information is underutilized in estimating risk and service planning. The current study extracted case record information from a randomly selected sample of 100 families, with 150 children referred to CPS during a 12-month period. The Yale-Vermont Adversity in Childhood Scale (Y-VACS) was applied to extracted information for quantifying severity of various forms of childhood maltreatment, adversity, and trauma. Study aims were to examine (a) the scope and severity of maltreatment, adversity, and trauma types and their associations; (b) linkages between severity and CPS allegation types and outcomes; and (c) the utility of severity in predicting new allegations of abuse or neglect within 12 months of referral. Results indicated feasibility in quantifying severity of maltreatment and other adversities from case record information and revealed associations between adversity severity and CPS allegation types and outcomes. Severity of psychological intimate partner violence and neglect were predictive of new allegations of abuse or neglect within 12 months of referral. Findings support moving beyond an incident-based CPS strategy to one that better incorporates case record information to assess risk.

Prevalence of Cyberbullying in Patients Presenting to the Pediatric Emergency Department.

OBJECTIVES: Mental health (MH) complaints are increasingly responsible for visits to pediatric emergency departments (PEDs). Bullying is associated with MH problems. Most adolescents use social media and many experience problems with cyberbullying (CB). This study determines prevalence of CB in MH and non-MH adolescents in a PED, describes technology use in these groups, and measures influence of CB on presentation to the PED and on thoughts/acts of self-harm. METHODS: A prospective survey was administered to a convenience sample of 149 patients aged 11 to 17 years in a PED. Data were analyzed using descriptive and comparative statistical methods. RESULTS: Cyberbullying was significantly more common in MH than in the non-MH patients (17% vs 3%, P = 0.007). More MH patients reported that bullying led to the current PED visit than that in the non-MH group (25% vs 10%, P = 0.02), and they were significantly more likely to report that CB led to self-harm (22% vs 4%, P = 0.003). Mental health participants who spent more than 3 hours on the Internet report higher levels of bullying than non-MH patients (38% vs 6%, P < 0.001). CONCLUSIONS: Prevalence of bullying in MH patients presenting to a PED is significantly greater than controls, and CB caused more MH patients to have acts or thoughts of self-harm. Bullying is a risk factor for self-harm and suicide in patients with MH problems. Future studies should evaluate CB as part of suicide screening tools for emergency MH patients.

Using Child Protective Services Case Record Data to Quantify Family-Level Severity of Adversity Types, Poly-victimization, and Poly-deprivation.

BACKGROUND: Child protective services (CPS) case records contain a vast amount of narrative information that is underutilized for estimating risk, conceptualizing family needs, and planning for services. OBJECTIVE: The current study applied a novel method for quantifying family-level severity of maltreatment and non-maltreatment-related adversity types to narrative information reflecting a family's full CPS history. PARTICIPANTS AND SETTING: Cases were randomly sampled (N = 100) from two regions of Connecticut that were referred over a specified 6-month period. METHODS: De-identified data were extracted through comprehensive chart review of electronic and paper case records. The Yale-Vermont Adversity in Childhood Scale (Y-VACS; Holbrook et al., 2015) was used to quantify adversity severity across a range of intrafamilial and extrafamilial experiences. RESULTS: Several family-level adversity severity ratings were associated with administrative data on allegations and investigative outcomes. Poly-victimization (ß = .47, p < .001) and poly-deprivation (ß = .25, p = .005) significantly predicted total allegation types and total substantiation types (ß = .30, p = .002; ß = .26, p = .008, respectively) across the case history. Poly-victimization significantly predicted the presence of a new allegation within 12 months of the index report, OR = 1.72, SE = .25, p = .027. CONCLUSIONS: Findings support the feasibility of a novel method that uses narrative case record information to quantify severity of maltreatment and non-maltreatment-related adversity types, as well as cumulative measures of threat- and deprivation-based adversities at the family level. Implications for utilizing case record data to inform CPS intervention are discussed.

Basic choking education to improve parental knowledge.

OBJECTIVE: To evaluate the effect of an educational intervention on parental knowledge of choking hazards and prevention. METHODS: A quasi experimental study was performed utilizing an internet based educational video intervention for parents with a child 6 months to 4 years old presenting to a Pediatric Otolaryngology clinic at a Level 1 pediatric hospital. Following the clinic visit, participants were sent a choking video (intervention) or general safety video (control) with a pretest and posttest knowledge survey (via email). An additional posttest knowledge survey was sent 30 days later as a surrogate measure for knowledge retained over time. Frequencies, chi square test, Independent t-test and McNemar's test were used for statistical analyses. RESULTS: 202 participants viewed the video and completed both the pretest and immediate posttest knowledge survey. Average change in total knowledge scores from the pretest to immediate posttest was statistically significant between the intervention (µâ€¯= 1.88, σ = 1.20) and control group (µâ€¯= 0.14, σ = 1.05); t (200) = -10.99, P < .001. This finding was consistent when assessing change from the pretest to 30 day posttest between the intervention (µâ€¯= 1.41, σ = 1.32) and control group (µâ€¯= 0.17, σ = 1.41); t (118) = -4.95, P < .001. A majority of the knowledge questions (5 of 7) showed a significant change in score from the pretest to immediate posttest (P = .001-.027). Additional analyses revealed accuracy on 4 of 7 knowledge questions significantly changed from the pretest to 30 day later posttest (P < .001- .002). CONCLUSION: The brief educational video overall improved parental knowledge of choking hazards and prevention immediately after the video and 30 days later. Importantly, improved parental knowledge may decrease rates of choking among children.

Establishing the Prevalence of Intimate Partner Violence Among Hair Salon Clients.

This study determined prevalence of intimate partner violence (IPV) victimization among female clients at three hair salons in Connecticut using an anonymous tablet based screening tool. While many may assume that women receive services at hair salons, victims of IPV are often isolated by their partners and unable to access help. Of the 203 clients who participated, 40 (20%) had experienced IPV in her lifetime. In identifying the prevalence of IPV within the salon setting, this study provides support for community-based programs and supports their legitimacy as an important locus for identifying women experiencing IPV and connecting them to resources.

Screening at hair salons: The feasibility of using community resources to screen for intimate partner violence.

BACKGROUND: Intimate partner violence (IPV) is a source of severe health consequences, and therefore, health care organizations have recommended routine IPV screening. Implementing health-related screenings outside of health care facilities is common public health practice, but to date, IPV screening in hair salons has not been reported. The objective of this study was to determine the prevalence of IPV among women at hair salons. We hypothesized that women would disclose IPV in this setting and that rates of abuse would reflect national averages. METHODS: We recruited a convenience sample of hair salons in Connecticut in 2014. Hair stylists were trained on how to recognize and refer IPV victims. Self-reported IPV of salon clients was measured by a tablet-based validated screening tool, the Patient Satisfaction and Safety Survey. RESULTS: Overall, reported past-year prevalence of physical abuse was 3.6%, past-year prevalence of sexual abuse was 2.7%, lifetime prevalence of emotional or physical abuse was 34.2%, and 5.3% of the sample reported that they had been hurt that day by their current or former partner. Past-year physical abuse was more common among women 30 years to 39 years old (9.1%), black (9%), and single women (7.5%). Past-year sexual abuse was more common among women 20 years to 29 years old (13.8%), other races (6.7%), and single women (5.4%). Lifetime abuse was more common among women 50 years to 59 years old (13.8%), black (36.1%), and divorced women (69.7%). Hurt-today abuse was more common among women younger than 20 years (12.5%), other races (13.3%), and women in common law relationships (25%). CONCLUSION: Women in our study reported IPV prevalence rates consistent with national data. Documentation of IPV prevalence in hair salons will provide much-needed support for novel interventions such as CUT IT OUT, a national program designed to train hair stylists on how to recognize and refer IPV victims.

Trends in Fatal Pediatric Injury.

We studied youth injury fatality rates in America, the Northeast region of the US, andinthe state of Connecticut for the years 1990 and 2013 to evaluate the incidence of injury. All areas of injury showed a decrease in mortality rates with the exception of deaths by suffocation and poisoning. Ihe age group most affected by suffocation is infants younger than one year. Adolescents between the ages of 15 and 19 years appear to be at increased risk for poisoning deaths. Injury surveillance provides important guidance for the implementation of community based programs to prevent injury.