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There is an urgent imperative to scale up access to effective, family‐focused mental health services for trauma‐exposed infants, toddlers, and preschoolers, who represent the most vulnerable and most underserved sector of the clinical child population. This article describes the process of scaling child–parent psychotherapy, an evidence‐based treatment currently used in 39 U.S. states and six countries, as an example of the promise and challenge of large‐scale implementation of relationship‐based treatments [ABSTRACT FROM AUTHOR]

Copyright of Infant Mental Health Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article explores the role of primary care in addressing health disparities caused by trauma, particularly among marginalized and low-income populations. It emphasizes that trauma, especially when experienced without supportive relationships, can lead to physical and mental health issues. The article argues that primary care can serve as a protective factor by establishing safe and nurturing relationships with patients, addressing trauma's causes and consequences, and promoting positive growth. It highlights the importance of primary care in improving health outcomes and equity, while acknowledging the need for increased funding and resources to fully implement this approach. The text also suggests replacing punitive policies with more compassionate and equitable approaches and promoting social and civic engagement. It references existing models, such as the Ryan White HIV/AIDS Program and the Veterans Health Administration, that demonstrate the effectiveness of primary care as a protective factor. [Extracted from the article]

Trauma exposure is strongly linked to maternal posttraumatic stress disorder (PTSD) and depressive symptoms during the perinatal period; however, childhood trauma exposure is often assessed without accounting for adult exposure. This study tested the unique impacts of childhood and adulthood trauma exposure on PTSD and depressive symptoms among pregnant women (N = 107, 82.9% Latina) enrolled in a nonrandomized intervention study. Regression analyses at baseline showed positive associations between trauma exposure and PTSD symptoms irrespective of trauma timing, childhood: B = 1.62, t(91) = 2.11, p =.038; adulthood: B = 2.92, t(91) = 3.04, p =.003. However only adulthood trauma exposure, B = 1.28, t(94) = 2.94, p =.004, was positively associated with depressive symptoms. Mixed‐effects analyses of variance revealed interaction effects of time and adulthood trauma exposure, indicating that women with high degrees of adulthood trauma exposure had higher baseline levels of PTSD, F(1, 76.4) = 6.45, p =.013, and depressive symptoms, F(1, 87.2) = 4.88, p =.030, but showed a more precipitous decrease posttreatment than women with lower levels of adulthood trauma exposure. These findings support the clinical relevance of assessing both childhood and adulthood trauma exposure during the perinatal period given their impacts on baseline symptoms and psychotherapy response. [ABSTRACT FROM AUTHOR]

Adverse Childhood Experiences (ACEs) are very common and presently implicated in 9 out of 10 leading causes of death in the United States. Despite this fact, our mechanistic understanding of how ACEs impact health is limited. Moreover, interventions for reducing stress presently use a one-size-fits-all approach that involves no treatment tailoring or precision. To address these issues, we developed a combined cross-sectional study and randomized controlled trial, called the California Stress, Trauma, and Resilience Study (CalSTARS), to (a) characterize how ACEs influence multisystem biological functioning in adults with all levels of ACE burden and current perceived stress, using multiomics and other complementary approaches, and (b) test the efficacy of our new California Precision Intervention for Stress and Resilience (PRECISE) in adults with elevated perceived stress levels who have experienced the full range of ACEs. The primary trial outcome is perceived stress, and the secondary outcomes span a variety of psychological, emotional, biological, and behavioral variables, as assessed using self-report measures, wearable technologies, and extensive biospecimens (i.e. DNA, saliva, blood, urine, & stool) that will be subjected to genomic, transcriptomic, proteomic, metabolomic, lipidomic, immunomic, and metagenomic/microbiome analysis. In this protocol paper, we describe the scientific gaps motivating this study as well as the sample, study design, procedures, measures, and planned analyses. Ultimately, our goal is to leverage the power of cutting-edge tools from psychology, multiomics, precision medicine, and translational bioinformatics to identify social, molecular, and immunological processes that can be targeted to reduce stress-related disease risk and enhance biopsychosocial resilience in individuals and communities worldwide. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is often considered an adult problem despite profound consequences for the children who are exposed toviolent relational patterns. About a third of children and adolescents report past exposure to parental IPV, and a majority were first exposed as infants. Exposure to IPV during pregnancy through the first 5 years of a child's life has consequences ranging from adverse birth outcomes to diagnosable emotional problems and lasting physiological dysregulation. This article reviews risks and consequences of IPV in pregnancy and early childhood and discusses a relational psychotherapeutic treatment approach (Child–Parent Psychotherapy) applied to both developmental stages to mitigate the adverse consequences of family violence on parents and their children. Research evidence for the effectiveness of Child–Parent Psychotherapy (CPP) among IPV‐exposed families is reviewed as are specific treatment components which seek to restore relational safety following familial violence. Additionally, clinical considerations unique to families with histories of or ongoing exposure to IPV are discussed. Finally, recommendations are presented to improve the integration between medical and early childhood behavioral health systems for families at highest risk for chronic IPV. Key points for the family court community: Infants and children exposed to IPV are at elevated risk for later socioemotional difficulties, physiological dysregulation and child welfare involvement.IPV threatens relational safety; dyadic, relationship‐based psychotherapies are well suited to repair ruptures in family relationships caused by violence restore psychological health.Child Parent Psychotherapy and its perinatal application are interventions that can improve to child and parental psychopathology, parenting beliefs and attachment security. [ABSTRACT FROM AUTHOR]

The Dissociative Symptoms Scale (DSS) was developed to assess moderately severe types of dissociation (depersonalization, derealization, gaps in awareness and memory, and dissociative reexperiencing) that would be relevant to a range of clinical populations, including those experiencing trauma-related dissociation. The current study used data from 10 ethnically and racially diverse clinical and community samples (N = 3,879) to develop a brief version of the DSS (DSS-B). Item information curves were examined to identify items with the most precision in measuring above average levels of the latent trait within each subscale. Analyses revealed that the DSS-B preserved the factor structure and content domains of the full scale, and its scores had strong reliability and validity that were comparable to those of scores on the full measure. DSS-B scores showed high levels of measurement invariance across ethnoracial groups. Results indicate that DSS-B scores are reliable and valid in the populations studied. [ABSTRACT FROM AUTHOR]

Childhood maltreatment is associated with disruptions in narrative coherence about close relationships. The current pilot study introduced a brief new measure of narrative coherence about romantic partners, and tested whether post-traumatic stress disorder (PTSD) symptoms mediated the link between childhood maltreatment and narrative coherence about romantic partners during pregnancy. Participants were 101 low-income, ethnically diverse pregnant women (62% living below the poverty line; 37% Latina, 22% Black, 20% White, 22% other), with high rates of childhood maltreatment. They completed the Five-Minute Speech Sample about their romantic partner (i.e., the baby's father) during pregnancy, which independent pairs of raters coded for prenatal narrative coherence and prenatal expressed emotion (including negative and warm affect) about partners. Participants also completed standardized self-report instruments assessing childhood maltreatment, romantic partner support, and prenatal PTSD and depression symptoms. Narrative coherence about partners from the Five-Minute Speech Sample showed convergent validity with romantic partner support and expressed emotion about partners. PTSD symptoms (but not depression symptoms) mediated the link between childhood maltreatment and prenatal narrative coherence about partners. The Five-Minute Speech Sample offers a brief and valid strategy to assess NC about romantic partners. PTSD symptoms and narrative coherence about partners are both potential intervention targets to promote healthy psychological and relational functioning during pregnancy. [ABSTRACT FROM AUTHOR]

In this article, the authors reflect on the 5 years since the publication of DC:0-5™: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0--5; ZERO TO THREE, 2016). They describe the context in which the Task Force was created, some of the initial shaping decisions that were made, and the process used to create the revised nosology. The authors highlight the major changes in DC:0--5 and conclude by assessing the value of DC:0--5 based on a priori criteria that we established prior to publication. [ABSTRACT FROM AUTHOR]

Objectives: This study examined maternal pregnancy wantedness and perceptions of paternal wantedness, and their associations with maternal perinatal mental health symptoms and relationship dynamics. Methods: Low-income, ethnically-diverse pregnant women (N = 101, Mage = 29.10 years, SDage = 6.56, rangeage = 18–44; 37% Latina, 22% African-American, 20% White, 21% biracial/multiracial/other) completed semi-structured interviews of pregnancy wantedness coded by trained raters, and standardized instruments of depression and PTSD symptoms during pregnancy and at 3–4-months postpartum. Results: While maternal pregnancy wantedness (rated from 0-Predominately Ambivalent, 1-Mixed, and 2-Predominately Positive) showed no significant associations, a couple-level scale that combined maternal wantedness and her perceptions of paternal wantedness (Equally Positive Wantedness, Mom Wants More, Dad Wants More and Equally Ambivalent) showed several significant associations. Compared to women in the Equally Positive group, women in the Mom Wants More group had significantly higher prenatal and postnatal depression symptoms, prenatal PTSD symptoms, and prenatal and postnatal relationship conflict; and lower prenatal and postnatal relationship support. Women in the Mom Wants More group also had significantly higher prenatal and postnatal depression symptoms and prenatal conflict; and lower prenatal support than women in the Dad Wants More group. Conclusions for Practice: Women who perceive themselves as wanting the pregnancy more than their baby's father are at higher risk for mental health and relationship problems than women who perceive themselves and their partners as equally ambivalent. Providers should ask women about their perceptions of partners' pregnancy wantedness to inform delivery of targeted mental health and relationship-based intervention during pregnancy. [ABSTRACT FROM AUTHOR]

Romantic partner support from the father-to-be is associated with women's mental health during pregnancy. However, most studies of partner support rely upon women's responses to self-report questionnaires, which may be biased and should be corroborated by efficient, coder-rated measures of partner support. This study tested whether the Five-Minute Speech Sample (FMSS), adapted to assess expressed emotion about romantic partners, can provide information about partner support during pregnancy that is less prone to bias than self-report. Participants were 101 low-income, ethnically diverse pregnant women who completed self-report questions on partner support quality and the FMSS. Self-reported and coder-rated (FMSS) partner support were highly correlated and were each significantly associated with self-reported depressive and post-traumatic stress disorder (PTSD) symptoms, perceived stress, and partner victimization during pregnancy. Self-reported and coder-rated support corresponded in approximately 75% of cases; however, nearly 25% of women self-reported high support but received low FMSS support ratings. These women reported elevated PTSD symptoms, perceived stress, and victimization during pregnancy. While self-reported partner support may be valid for many respondents, the FMSS is less susceptible to reporting biases and may better identify women facing heightened psychopathology and stress during pregnancy, who would benefit from supportive intervention. [ABSTRACT FROM AUTHOR]

The Adverse Childhood Experiences (ACEs) scale and the Childhood Trauma Questionnaire (CTQ) are among the most widely used instruments for assessing childhood maltreatment, yet the convergent validity and concordance of their maltreatment subscales has only been examined in one previous non-U.S. study. This study represents the first replication and extension study to address the strengths and weaknesses of relying on the five-item ACEs maltreatment scale versus the 28-item CTQ. Participants were 77 low-income, ethnically-diverse women (M = 29.19, SD = 6.55, range = 18–44 years; 34% Latina, 24% White, 22% African-American, 20% biracial/multiracial/other; 18% Spanish-speaking) who completed the ACEs scale during pregnancy and the CTQ at three months post-partum. We hypothesized that total childhood maltreatment scores and maltreatment subtypes would be significantly associated, indicating concordance across instruments. We also conducted sensitivity and specificity analyses to determine the extent to which ACEs maltreatment subtypes correctly predicted corresponding CTQ subtypes and performed exploratory analyses on minimization/denial (MD) and inconsistent responding across instruments. Results supported generally good convergent validity of total childhood maltreatment and most subtype scores across instruments. Sexual abuse had the highest sensitivity and specificity, while physical neglect was most prone to underreporting on the ACEs scale. A small subset of women were characterized by high MD, reflecting tendencies to minimize their maltreatment histories across both instruments and also report significantly lower contemporaneous depression and PTSD symptoms than women with low MD. This study informs strengths and tradeoffs of two well-known instruments for assessing retrospectively-reported childhood maltreatment in low-income, vulnerable populations. [ABSTRACT FROM AUTHOR]

Copyright of Infant Mental Health Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

During pregnancy, low-income women are at high risk for depression and posttraumatic stress disorder (PTSD), but they are unlikely to receive mental health services. As a follow-up to Narayan et al. (2017), we provide a detailed picture of pregnant women's mental health service (MHS) need versus utilization. Results suggested that the majority of women with very elevated depression and PTSD symptoms received MHSs during pregnancy. However, few women with lowergrade depression received MHSs, despite meeting prenatal depression criteria recommended by the American Academy of Pediatrics. Pregnant women of color were also especially unlikely to receive MHSs. Inefficient transportation and lack of child care were primary issues interfering with service utilization. Detailed recommendations for how to improve MHS access are discussed. [ABSTRACT FROM AUTHOR]

Caregivers' ability to identify infant cues plays a crucial role in child development, enabling attuned and responsive caregiving that serves as the basis for secure attachment. At the same time, exposure to interpersonal violence (IPV) could alter mothers' interpretations of social stimuli and interfere with normative parent-child interactional processes. The current study examined four interrelated hypotheses. The first two hypotheses test whether IPV-exposed mothers show bias toward fear or anger in interpreting infants' facial expressions, and whether this bias is related to child symptoms. Our second set of hypotheses examines whether bias can be changed by Child-Parent Psychotherapy (CPP) and whether this change mediates treatment gains. 113 IPV-exposed mothers of 2 to 6 year old children completed the I FEEL picture task at baseline and again twelve months later. In the interim, 33 mothers were randomized into a treatment comparison group and the remainder received CPP. Analyses revealed that IPV-exposed mothers exhibit a perceptual bias toward fear, but not anger. Bias toward fear was linked to greater child internalizing symptoms while bias toward anger was linked to greater child externalizing symptoms. Participation in CPP resulted in decreased bias toward fearful faces. The treatment-related changes in mothers' perceptions of children's facial expression did not emerge as the mechanism by which CPP reduces children's symptoms. These results suggest that exposure to IPV alters mothers' ability to interpret infant facial expressions and that CPP is effective in reducing such biases. [ABSTRACT FROM AUTHOR]

The Guild et al. ([9]) study makes a significant addition to the literature documenting the long-term beneficial impact of Child-Parent Psychotherapy (CPP) on child and maternal outcomes in dyads at risk for or manifesting mental health problems. Together, these findings indicate that treatment effects for CPP are sustained years after the completion of treatment. In this study, the CPP intervention group showed significant decreases in maternal posttraumatic stress symptoms (specifically avoidance symptoms) and global psychiatric distress (Lieberman et al, [11]) that were sustained at 6-month follow-up (Lieberman et al., [12]). Lack of CPP-specific treatment effects might have been due to the outside treatment received by both groups, as well as to the relatively restricted range of depression scores. [Extracted from the article]

This replication study examined protective effects of positive childhood memories with caregivers ("angels in the nursery") against lifespan and intergenerational transmission of trauma. More positive, elaborated angel memories were hypothesized to buffer associations between mothers' childhood maltreatment and their adulthood posttraumatic stress disorder (PTSD) and depression symptoms, comorbid psychopathology, and children's trauma exposure. Participants were 185 mothers (M age = 30.67 years, SD = 6.44, range = 17–46 years, 54.6% Latina, 17.8% White, 10.3% African American, 17.3% other; 24% Spanish speaking) and children (M age = 42.51 months; SD = 15.95, range = 3–72 months; 51.4% male). Mothers completed the Angels in the Nursery Interview (Van Horn, Lieberman, & Harris, 2008), and assessments of childhood maltreatment, adulthood psychopathology, children's trauma exposure, and demographics. Angel memories significantly moderated associations between maltreatment and PTSD (but not depression) symptoms, comorbid psychopathology, and children's trauma exposure. For mothers with less positive, elaborated angel memories, higher levels of maltreatment predicted higher levels of psychopathology and children's trauma exposure. For mothers with more positive, elaborated memories, however, predictive associations were not significant, reflecting protective effects. Furthermore, protective effects against children's trauma exposure were significant only for female children, suggesting that angel memories may specifically buffer against intergenerational trauma from mothers to daughters. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) victimization during pregnancy is a major public health concern, yet little is known about how risk factors for IPV during pregnancy may depend on whether women have histories of victimization dating back to early childhood (ages 0-5 years). This study examined whether risk factors for physical IPV victimization during pregnancy (a pregnancy that was not planned and prenatal substance use) differed for women with versus without early childhood victimization. Participants were 236 ethnically diverse, low-income biological mothers (M = 30.94 years; 50.0% Latina, 16.9% Caucasian, 13.1% African American, and 16.9% multiracial) of children aged 0 to 6 years. Mothers were classified into four groups based on whether they had experienced early childhood victimization and physical IPV victimization during pregnancy with the target child. Multinomial logistic regressions, controlling for demographic characteristics, examined whether a pregnancy not planned and prenatal substance use predicted group membership. Compared to mothers with early victimization only, mothers with both early childhood victimization and physical IPV during pregnancy were more than 3 times as likely to report that their pregnancy with the target child was not planned. In follow-up analyses, mothers with early victimization and physical IPV during pregnancy also reported higher lifetime parity than mothers with physical IPV during pregnancy but no early victimization. Early childhood victimization may place women on a risk pathway to physical IPV during pregnancy, particularly if the pregnancy is not planned. Prevention and policy efforts should screen women for early childhood victimization to understand risks for physical IPV during pregnancy. [ABSTRACT FROM AUTHOR]

This article describes the impact on young children of sudden and extended separation from a primary attachment figure. It recommends clinical intervention when the child's development and family functioning are negatively affected by the severity of the child's symptoms, and it highlights key treatment modalities derived from Child--Parent Psychotherapy, including the importance of "speaking the unspeakable," defined as affirming reality by giving words to the separation and its sequelae and the importance of offering a safe space for the child's expression of sadness, anger, and fear in the supportive presence of the caregiver. Two clinical examples illustrate treatment while the separation is ongoing and after reunion takes place. [ABSTRACT FROM AUTHOR]

This paper outlines the theoretical antecedents that contextualize parental insightfulness and examines this concept’s value in assessing parental functioning and in monitoring treatment progress with parents and young children who experience mental health and relationship problems. As a concept, parental insightfulness provides a much-needed bridge linking important aspects of attachment theory with their psychoanalytic origins, including early contributions that conceptualize parenting as a developmental process that furthers the unfolding capacities of the adult self. The paper examines the compatibility between the dimensions of parental insightfulness and the criteria for a healthy adult sense of self. The empirical body of knowledge generated by the concept of parental insightfulness is briefly reviewed as the basis for using the concept as a valuable tool for the empirical exploration of intrapsychic, interpersonal, and clinical processes in parents and their children. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Traumatic Stress is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Infant Mental Health Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The prenatal period represents an opportunity to buffer the intergenerational transmission of adversity through integrated, comprehensive perinatal health services for women experiencing high levels of adversity and clinical symptoms. This article presents preliminary descriptive data, drawn from an ongoing clinical research study, on prenatal clinical symptomatology and service usage and needs in 101 pregnant women who have experienced lifetime adversity. The women gave birth at a university-affiliated county hospital that serves low-income, ethnically diverse, medically uninsured families. Results highlight the need for improved identification of unmet mental health service needs during pregnancy. The authors provide recommendations for strategies to more comprehensively understand how to support low-income pregnant women via tailored, trauma-informed services for maternal health and infant well-being. [ABSTRACT FROM AUTHOR]

This article describes the Attachment Vitamins program, a trauma-informed parent group intervention for families with young children. Attachment Vitamins is a relational psychoeducational intervention based on the principles of Child- Parent Psychotherapy (CPP). Its goal is to repair the impact of chronic stress and trauma through strengthening the child-parent relationship. The authors discuss the history, development, and implementation of the intervention, made possible through a collaborative research and development platform. Two vignettes are presented to highlight unique aspects of the program. Attachment Vitamins is a promising new intervention with the potential to improve outcomes for vulnerable young children and their families on a large scale. [ABSTRACT FROM AUTHOR]

Studies of the association between traumatic experiences and psychopathology in early childhood have primarily focused on specific types of events (e.g., sexual abuse) or aggregated different types of events without differentiating among them. We extend this body of work by investigating patterns of traumatic event exposure in a high-risk, ethnically diverse sample of children ages 3-6 (N = 211; 51 % female) and relating these different patterns to parents' reports of child externalizing, internalizing, and post-traumatic stress symptomatology. Using latent class analysis, which divides a heterogeneous population into homogenous subpopulations, we identified three patterns of traumatic events based on parents' responses to an interview-based assessment of trauma exposure in young children: (1) severe exposure, characterized by a combination of family violence and victimization; (2) witnessing family violence without victimization; and (3) moderate exposure, characterized by an absence of family violence but a moderate probability of other events. The severe exposure class exhibited elevated internalizing and post-traumatic stress symptoms relative to the witness to violence and moderate exposure classes, controlling for average number of traumatic events. Results highlight the need for differentiation between profiles of traumatic life event exposure and the potential for person-centered methods to complement the cumulative risk perspective. [ABSTRACT FROM AUTHOR]

Childhood experiences of interpersonal trauma often leave a legacy of painful emotions and memories that can be especially destructive when adults transition to parenthood. In this article, the authors present a promising treatment approach, Perinatal Child-Parental Psychotherapy (P-CPP), adapted from evidence-based Child-Parent Psychotherapy (CPP) for trauma-exposed parents and young children. Like CPP, P-CPP addresses traumatic experiences and improves mother-child emotional attunement, but it brings this work to the prenatal period. A clinical case illustrates the core modalities of P-CPP and emphasizes how uncovering, making meaning of, and healing from childhood trauma has enduring benefits on prenatal and postnatal maternal and child well-being. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Traumatic Stress is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Traumatic Stress is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Including fathers is the next frontier for infant mental health. In this article, the authors describe the inclusion of fathers as equal partners in Child-Parent Psychotherapy (CPP), an evidence-based treatment for young children experiencing or at risk for mental health problems following exposure to violence and other adversities. The authors present two vignettes in which the father's participation in treatment was pivotal to successful outcomes for the child, and they illustrate some of the considerations, complexities, concerns, and rewards of engaging and working with fathers. They discuss the benefit of using a "triadic lens" (McHale, 2011) for formulation and treatment planning with all families involved with CPP. [ABSTRACT FROM AUTHOR]

This pilot study examined the potential impact of a perinatal adaptation to Child-Parent Psychotherapy (CPP), an evidence-based treatment for traumatized mother-child dyads, on maternal functioning 6 months post-partum among women with history of complex trauma and current intimate partner abuse. Pregnant women ( n = 64) enrolled during the third trimester of their pregnancy (Mean gestational age = 27.48 weeks, range of 12 to 42) and participated in weekly perinatal CPP sessions until their infant was 6 months old. Women completed measures of trauma history, depression, posttraumatic stress symptoms (PTSS), and child-rearing attitudes at pre- and post-treatment. Results showed decreases in depression and PTSS from pre- to post-treatment assessments, as well as an increase in positive child-rearing attitudes. As hypothesized, women with low maternal-fetal attachment demonstrated the greatest improvement in depression, PTSS, and child-rearing attitudes compared to women with high maternal-fetal attachment. The current study provides promising results indicating that a perinatal adaptation of CPP may lead to improved maternal mental health and parenting attitudes at a time of increased vulnerability in a high-risk population. [ABSTRACT FROM AUTHOR]

This discussion elaborates on Dr. Slade’s paper about the centrality of fear in the etiology of emotional problems and discusses the transmission from parent to child of unaddressed sources of parental fear. [ABSTRACT FROM AUTHOR]

Children's exposure to violence is a national crisis. The high prevalence of exposure to violence in infancy and early childhood has implications for lifelong health and development because early experiences are most influential in shaping the structure and functioning of the brain, the quality of attachments and other relationships, and the child's readiness to explore and learn. The authors highlight the urgency of creating effective approaches to identification and treatment as well as public policy initiatives that protect both children and society. [ABSTRACT FROM AUTHOR]

The impacts of violence for young children and their caregivers are multidimensional. The story of 2-year-old Tyronne, his mother, Josephine, and his father, James, illustrates the use of a relationship-focused treatment, child-parent psychotherapy (CPP), in addressing the traumatic consequences of exposure to violence. This family's story exemplifies the complexity of domestic violence by unraveling the source of intergenerational transmission of attachment patterns and unresolved psychological conflict that become internalized, impacting sense of self, safety, and emotional well-being. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Traumatic Stress is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Child-Parent Psychotherapy (CPP), an evidence-based dyadic therapeutic intervention for very young children exposed to trauma, is becoming the go-to therapeutic intervention for infant mental health practitioners. Although CPP has been shown to be effective for rebuilding the parent-child relationship, reducing trauma symptoms, and reducing depression in mothers, there are some challenges to training and disseminating the model. The authors present two training methods that have been anecdotally effective in training clinicians in the model. [ABSTRACT FROM AUTHOR]

The article discusses the impact of exposure to domestic violence on infants, toddlers, and preschoolers; the manifestations of post-traumatic stress disorder in the first years of life; and the parameters of Child-Parent Psychotherapy as a relationship-based treatment that aims at enhancing the parent's effectiveness as a protector as a means of restoring the child's momentum towards healthy development. Obstacles to the child's mental health and to the success of treatment are discussed, with particular attention to the adverse effects of parental psychopathology and of environmental stressors such as poverty, cultural marginalization, and lack of access to resources. It is argued that the infant mental health clinician working with traumatized children and their families needs to adopt a therapeutic approach that actively incorporates collaboration with other service systems, including pediatric care, childcare, law enforcement, child protective services, and the courts, in order to provide ecologically sound and culturally competent treatment. [ABSTRACT FROM AUTHOR]

The article discusses the effect of traumatic events on the development of infants and young children and the steps that physicians can take to help treat traumatic stress in children. A child's response to a traumatic event is influenced by the type of traumatic event, the availability of supports and the meaning that the child ascribes to the event. Symptoms of traumatic stress in children include re-experiencing the trauma, avoidance of reminders of the trauma and hyperarousal.

Each year, exposure to violent trauma takes its toll on the development of millions of children. When their trauma goes unaddressed, children are at greater risk for school failure; anxiety and depression and other post-traumatic disorders; alcohol and drug abuse, and, later in life, engaging in violence similar to that to which they were originally exposed. In spite of the serious psychiatric/developmental sequelae of violence exposure, the majority of severely and chronically traumatized children and youth are not found in mental health clinics. Instead, they typically are seen as the ‘trouble-children’ in schools or emerge in the child protective, law enforcement, substance abuse treatment, and criminal justice systems, where the root of their problems in exposure to violence and abuse is typically not identified or addressed. Usually, providers in all of these diverse service systems have not been sufficiently trained to know and identify the traumatic origins of the children's presenting difficulties and are not sufficiently equipped to assist with their remediation. This multiplicity of traumatic manifestations outside the mental health setting leads to the inescapable conclusion that we are dealing with a supra-clinical problem that can only be resolved by going beyond the child's individual clinical needs to enlist a range of coordinated services for the child and the family. This paper will focus on domestic violence as a paradigmatic source of violent traumatization and will (a) describe the impact and consequences of exposure to violence on children's immediate and long-term development; (b) examine the opportunities for, as well as the barriers to, bridging the clinical phenomena of children's violent trauma and the existing systems of care that might best meet their needs; and (c) critique current national policies that militate against a more rational and coherent approach to addressing these needs. [ABSTRACT FROM AUTHOR]

This article describes recent developments in theory and clinical practice with traumatized children in the birth to five age range. It revisits the treatment of an abused two-year-old girl and her mother from the perspective of the child's reappearance in the clinic twenty years later to ask about her past. The early treatment of the child and the mother is re-examined from the perspective of the advances in theory and practice about early childhood trauma in the intervening decades. These advances are contrasted with the persistent gap between the urgent needs of maltreated children and their families and the availability of services designed to support their mental health. [ABSTRACT FROM AUTHOR]

There is a great need to better understand the impact of traumatic events very early in life on the course of children's future development. This report focuses on the intriguing case of a girl who witnessed the murder of her mother by her father at the age of 19 months and seemed to have no recollection of this incident until the age of 11, when she began to exhibit severe symptoms of posttraumatic stress disorder (PTSD) in response to a traumatic reminder. The case presentation serves as the basis for a discussion regarding pertinent issues involved in early childhood trauma. This case and accompanying discussion were originally presented at the 19th Annual Meeting of the International Society for Traumatic Stress Studies and were transcribed and revised for use in this article. Specific topics include early childhood memory and trauma, learning and the appraisal of danger, and PTSD and traumatic grief in early childhood. Clinical and public health implications are also discussed. This case illustrates the dramatic impact that "preverbal" traumatic memories can have on children's later functioning and speaks to the importance of assisting very young children in the immediate aftermath of traumatic events. [ABSTRACT FROM AUTHOR]

Fraiberg and her colleagues (1975) introduced the metaphor “ghosts in the nursery” to describe the ways in which parents, by reenacting with their small children scenes from the parents' own unremembered early relational experiences of helplessness and fear, transmit child maltreatment from one generation to the next. In this article we propose that angels in the nursery—care-receiving experiences characterized by intense shared affect between parent and child in which the child feels nearly perfectly understood, accepted, and loved—provide the child with a core sense of security and self-worth that can be drawn upon when the child becomes a parent to interrupt the cycle of maltreatment. We argue that uncovering angels as growth-promoting forces in the lives of traumatized parents is as vital to the work of psychotherapy as is the interpretation and exorcizing of ghosts. Using clinical case material, we demonstrate the ways in which early benevolent experiences with caregivers can protect against even overwhelming trauma, and examine the reemergence of these benevolent figures in consciousness as an instrument of therapeutic change. Finally, we examine implications of the concept of “angels in the nursery” for research and clinical intervention. [ABSTRACT FROM AUTHOR]

This article describes the interface between the fields of attachment and child trauma, their respective contributions to an understanding of infant mental health disturbances, and the clinical applications of an integration between attachment theory and trauma-informed treatment and research. The organizing theme is that a dual attachment and trauma lens must be used in the assessment and treatment of infants and toddlers with mental health and relationship problems. The quality of attachment is an important factor in children's capacity to process and resolve traumatic experiences. At the same time, traumatic events often have a damaging effect on the quality of existing attachments by introducing unmanageable stress in the infant–parent relationship. It is argued that trauma in the first years of life needs to be assessed and treated in the context of the child's primary attachments. Reciprocally, the etiology of attachment disturbances should include an assessment of possible exposure to trauma in the child and in the parents. Current conceptualizations of attachment and trauma are reviewed from this perspective, and a clinical illustration is presented to highlight how a traumatic stressor can trigger behaviors reminiscent of disorganized attachment. [ABSTRACT FROM AUTHOR]

Presents a study that examined the effects of the amount of father visitation on behavioral outcomes in preschool-aged children witnesses of domestic violence in the U.S. Review of literature on father visitation; Impact of the mother-child relationship on child behavior; Ethical implications of the results.

Focuses on the treatment of attachment disorder in infancy and early childhood based on reflections from clinical intervention with later-adopted foster care children. Lack of trust in the reliable availability and protectiveness of the attachment figure remaining a core problem for institutionalized children who are later adopted.

National experts discuss culturally competent domestic violence health care responses and children who witness domestic violence. Comments address culturally competent systems, research, and clinical responses in Native American, Latina immigrant, and lesbian, gay, bisexual, and transgender communities and effects on and responses to children who witness domestic violence. [ABSTRACT FROM AUTHOR]

The social dominance behavior of dyads of unacquainted, same-sex 3½- year-olds was observed in a familiar laboratory playroom under two conditions: A free play situation and a situation where candy was introduced. In each of the two conditions, a principal components analysis was used to explore two issues: the usefulness of the multivariate approach in devising a definition of dominance, and the cross-situational stability of the construct. In the free play session, the first principal component that emerged was consistent with a theoretical definition of dominance. This picture was disrupted by the introduction of candy in the second condition. However, a high correlation was found between the dominance hierarchies established in each situation. It was concluded that the multivariate analysis is a useful method for the study of dominance. The generalizability of social dominance across settings was discussed as a possible explanation for the high cross-situational stability. [ABSTRACT FROM AUTHOR]