Conduct Problems As a Pathway From Childhood Adversity to Community Violence Exposure: The Protective Roles of Caregiver Knowledge and Involvement.

Exposure to community violence (ECV) poses a prevalent threat to the health and development of adolescents. Research indicates those who have more Adverse Childhood Experiences (ACEs) are at higher risk for ECV, which further exacerbates risk of negative mental and physical health impacts. Additionally, those with more ACEs are more likely to exhibit conduct problems, which has also been linked to risk for ECV. Despite the prevalence and impact of ECV, there is limited longitudinal research on the risk factors that precede this exposure as well as family-level factors that may prevent it. The current study examined conduct problems as a potential mediator between ACEs and future indirect (i.e. witnessing) ECV in adolescents. Additionally, this study included caregiver factors, such as caregiver knowledge about their adolescent, caregiver involvement, and caregiver-adolescent relationship quality as potential protective moderators. Participants included (N = 1137) caregiver-adolescent dyads identified as at-risk for child maltreatment prior to child's age four for inclusion in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Conduct problems at age 14 mediated the relationship between ACEs from ages 0-12 and indirect ECV at age 16 (standardized indirect effect = .03, p = .005). Caregiver knowledge moderated the indirect relationship (b = -.40, p = .030), and caregiver involvement moderated the direct relationship between ACEs and indirect ECV (b = -.03, p = .033). Findings expand our knowledge about the longitudinal pathways that increase risk of violence exposure over the course of adolescent development, as well as the protective benefits caregivers can offer to disrupt these pathways and reduce risk of future traumatization. Implications are discussed for interventions that aim to address and prevent trauma and adverse outcomes among youth exposed to child maltreatment, household dysfunction, and community violence.

Everyday Conflict in Families at Risk for Violence Exposure: Examining Unique, Bidirectional Associations with Children's Anxious- and Withdrawn-Depressed Symptoms.

Exposure to family conflict during childhood increases risk for the development of anxiety and mood problems, though the potential for bidirectionality in this association remains unknown. It is also unclear whether nonviolent family conflict is related to children's anxious- and withdrawn-depressive symptoms within high-risk family contexts, independent of more severe events such as children's exposure to violent victimization. Participants included 1,281 children and their caregivers identified as being at high risk for family violence, interviewed prospectively at ages 6, 8, and 10 about family conflict, children's anxious- and withdrawn-depressive behaviors, and children's victimization experiences. After controlling for cumulative victimization prior to and between each time point, significant cross-lagged, bidirectional associations were identified between family conflict and children's anxious- and withdrawn-depressive symptoms across ages 6 and 8, but not across ages 8 and 10. Invariance testing revealed no differences in model fit between boys and girls and minimal differences depending on whether families were reported for maltreatment prior to recruitment. Findings are partially supportive of a conceptualization of the family-child relationship that is reciprocal, while highlighting the role of daily negative familial interactions, over and above experiences of victimization, in predicting anxious- and withdrawn-depressed symptoms in early and middle childhood.

Bidirectional associations between family conflict and child behavior problems in families at risk for maltreatment.

BACKGROUND: Children's exposure to family conflict is associated with the development of behavior problems. However, it remains unclear whether this association (1) functions bidirectionally and (2) exists independent of more severe forms of violent victimization. OBJECTIVE: The present study aimed to examine bidirectional and transactional associations between family conflict and children's behavioral problems, controlling for time-varying violent victimization experiences. Invariance testing examined whether these models differed by gender and by maltreatment status prior to initial recruitment. PARTICIPANTS AND SETTING: Participants were caregiver-child dyads identified prospectively as being at risk for maltreatment and family violence exposure prior to age four (N = 1281; 51.4 % female; 74.6 % persons of color). METHODS: Caregivers were interviewed prospectively about family conflict, children's aggressive and delinquent behavior, and children's victimization experiences at child ages 6, 8, and 10. RESULTS: After controlling for prior victimization, significant cross-lagged bidirectional associations were identified between family conflict and child behavior problems. Indirect effects from age 6 to age 10 externalizing problems through age 8 family conflict were not supported. Several bidirectional paths were stronger among boys than girls. Results revealed little evidence for moderation by prerecruitment maltreatment status. CONCLUSIONS: Findings support a conceptualization of the family-child relationship that is reciprocal in nature and highlight the importance of non-violent, everyday negative family processes. Interventions aiming to improve child behavior problems by targeting severely dysfunctional family processes should also address non-violent, lower-level patterns of negative family interactions, such as everyday instances of blame, criticism, nonacceptance, and favoritism.

Trajectories of adolescent psychopathology among youth who were maltreated and placed in out-of-home care.

BACKGROUND: Although researchers have found an increased risk for psychopathology among maltreated adolescents placed in out-of-home care, different trajectories of psychopathology by out-of-home placements have not been previously studied. OBJECTIVE: The current study is built on previous investigation of youth in different long-term out-of-home placements and examined the trajectories of adolescent psychopathology by out-of-home placement classes. PARTICIPANTS AND SETTING: We leveraged data from the Southwestern site of the Longitudinal Studies of Child Abuse and Neglect. Participants included caregiver-youth dyads (N = 273), who had substantiated reports of child maltreatment (CM) prior to children's age four and were placed in out-of-home care. METHODS: Five out-of-home placement classes from ages 4 to 12 (i.e., stable adopted, stable reunified, stable kinship care, stable non-kin foster care, and unstable placement) were identified from previous study and participants were interviewed at youth ages 12, 14, and 16 to assess adolescent psychopathology. Latent Growth Curve Analysis was used to examine trajectories of psychopathology by placement classes. RESULTS: Adolescents in unstable placement and stable adopted classes had higher intercepts and more positive or less negative slopes for psychopathology compared to those in stable kinship care and stable reunified classes. CONCLUSIONS: Adolescents in unstable placement and stable adopted classes were at similarly elevated risk for psychopathology, whereas adolescents in stable kinship care and stable reunified classes were at lower risk for psychopathology. We discuss the clinical implication to preventing and intervening risks for psychopathology among maltreated youth in unstable and adopted placements.

A Systematic Review of the Validity, Reliability, and Clinical Utility of Developmental Trauma Disorder (DTD) Symptom Criteria.

Exposure to complex trauma is a prevalent and costly public health concern. Though not yet included in the formal diagnostic systems, developmental trauma disorder (DTD) was proposed to capture the consistent and predictable emotional, behavioral, and neurobiological sequelae observed in children exposed to complex trauma. This systematic review synthesizes and evaluates the existing empirical evidence for DTD as a reliable, valid, distinctive, and clinically useful construct. We identified 21 articles reporting on 17 non-overlapping samples that evaluated DTD symptom criteria using objective, empirical methods (e.g., factor analysis, associations with other diagnostic constructs, associations with trauma exposure type, clinician ratings of utility). Studies were largely supportive of the DTD construct and its clinical utility; however, it will be crucial for this work to be replicated in larger samples, by independent research groups, and with more rigorous methodological and analytic approaches before definitive conclusions can be drawn. Findings from this review, while preliminary, provide a promising empirical foundation for DTD and bring the field closer to improving diagnostic parsimony for children and adolescents affected by complex trauma.

Psychometric Analysis of the Dating Anxiety Scale for Adolescents in Samples of Polish and U.S. Young Adults: Examining the Factor Structure, Measurement Invariance, Item Functioning, and Convergent Validity.

This study explored whether the Dating Anxiety Scale for Adolescents (DAS-A), which was originally developed in the United States to assess dating anxiety in adolescents, is appropriate for use in samples of young adults from Poland and the United States. The factor structure, measurement invariance across country, gender and relationship status, degree of precision across latent levels of the DAS and the functioning of individual items, and convergent validity were examined in a sample of 309 Polish and 405 U.S. young adults. The confirmatory factor analysis (CFA) supported the original three-factor measurement model of the DAS. Invariance tests revealed factor loadings and item thresholds that differed across subgroups, supporting partial metric and partial scalar invariance. The MIRT analysis showed that all items adequately discriminated participants with low and high anxiety. Dating anxiety latent factor correlations with mental health and interpersonal competence were significant in the expected negative directions. The results call for careful interpretation of research involving the DAS in cultural, gender, and relationship status groups, particularly when the primary goal is to compare mean levels of dating anxiety. Further development of the scale is recommended before it can be used across country, gender, and relationship status groups.

Differences in late adolescent psychopathology among youth with histories of co-occurring abuse and neglect experiences.

BACKGROUND: Knowledge about the impacts of child abuse and neglect (CAN) experiences on late adolescent psychopathology has been limited by a failure to consider the frequent co-occurrence of CAN types and potential unique impacts of specific combinations. OBJECTIVE: Using person-centered analyses, we aimed to identify unobserved groups of youth with similar patterns of lifetime CAN experiences before age 16 and differences in psychopathology symptom counts between groups two years later. PARTICIPANTS AND SETTING: Participants were 919 adolescent-caregiver dyads (56% female; 56% Black, 7% Latina/o, 13% mixed/other). METHODS: Prospective, multi-informant data, including child protective services records and caregiver and youth reports were collected, and youth completed a diagnostic interview at age 18. RESULTS: Latent Class Analyses classified adolescents into four distinct groups based on patterns of physical neglect, supervisory neglect, and physical, sexual, and psychological abuse: "Low-Risk" (37%), "Neglect" (19%), "Abuse" (11%), and "Multi-type CAN" (33%). The Multi-type CAN class had significantly more major depressive, generalized anxiety, and nicotine use symptoms than the Low-Risk class, and more post-traumatic stress, antisocial personality, and illicit substance use symptoms, than Low-Risk and Neglect classes. The Abuse class had significantly more generalized anxiety and attention deficit/hyperactivity symptoms than the Low-Risk class, and more major depressive, antisocial personality, and illicit substance use symptoms, than Low-Risk and Neglect classes. The Neglect class did not have elevated psychopathology symptoms. CONCLUSION: Findings highlight important differences in the associations between lifetime CAN experience patterns and psychopathology. Researchers should explore mechanisms underlying psychopathology that are impacted by different CAN experience patterns.

Reward-related neural correlates of early life stress in school-aged children.

OBJECTIVES: Early life stress likely contributes to dysfunction in neural reward processing systems. However, studies to date have focused almost exclusively on adolescents and adults, measured early life stress retrospectively, and have often failed to control for concurrent levels of stress. The current study examined the contribution of prospectively measured cumulative life stress in preschool-age children on reward-related neural activation and connectivity in school-age children. METHODS: Children (N = 46) and caregivers reported children's exposure to early life stress between birth and preschool age (mean = 4.8 years, SD = 0.80). At follow-up (mean age = 7.52 years, SD = .78), participants performed a child-friendly monetary incentive delay task during functional magnetic resonance imaging. RESULTS: Children with higher levels of cumulative early life stress, controlling for concurrent stressful life events, exhibited aberrant patterns of neural activation and connectivity in reward- and emotion-related regions (e.g., prefrontal cortex, temporal pole, culmen), depending on the presence of a potential reward and whether or not the target was hit or missed. CONCLUSIONS: Findings suggest that stress exposure during early childhood may impact neural reward processing systems earlier in development than has previously been demonstrated. Understanding how early life stress relates to alterations in reward processing could guide earlier, more mechanistic interventions.

Examining the Factor Structure and Measurement Invariance of the Trauma Symptom Checklist for Children in a Diverse Sample of Trauma-Exposed Adolescents.

The Trauma Symptom Checklist for Children (TSCC) is a widely used youth assessment of broad, transdiagnostic symptomatology following trauma. However, its factor structure has not been thoroughly tested in diverse samples. Youth (N = 738) exposed to interpersonal violence, including physical and sexual abuse, completed the TSCC. Confirmatory factor analysis was used to test one-, six-, and eight-factor models of the TSCC clinical scales, based on previous literature and the TSCC manual. We examined measurement invariance across boys and girls and Black and non-Black participants, as well as convergent and discriminant validity. An eight-factor structure, consisting of posttraumatic stress, anxiety, depression, anger, overt dissociation, fantasy dissociation, sexual preoccupation, and sexual distress, demonstrated the best fit, with two items removed. Invariance tests supported configural and metric (but not scalar) invariance. This research highlights the need for further testing before differences between gender and racial groups can be accurately compared.

Intergenerational Transmission of Abusive Parenting: Role of Prospective Maternal Distress and Family Violence.

Parents who were abused as children are at increased risk for perpetuating maladaptive parenting practices, yet the mechanisms underlying this relationship remain unclear. This study prospectively examined maternal distress (a latent variable consisting of depressive symptoms and daily stress) and family violence as potential mediators in the intergenerational transmission of abusive (i.e., psychologically aggressive and physically assaultive) parenting. Participants included (N = 768) mother-child dyads identified as being at-risk for family violence and maltreatment prior to children's age four. More maternal childhood abuse was associated with more distress and increased risk for family violence exposure in adulthood. However, only maternal distress mediated the association between mothers' history of abuse and their use of abusive parenting strategies. This study provides critical information about ecological mechanisms underlying the intergenerational transmission of abusive parenting and suggests the importance of targeting depression and stress management among mothers with abuse histories to curtail the cycle of violence.