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The purpose of this study is to explore the impact of persistence within STEM learning environments as a function of cumulative stress and latent trauma. The biopsychosocial impact of prolonged stressors due to hostile environments and academic demands has deleterious health effects on historically underrepresented students who enter STEM disciplines. The Trauma Symptoms Checklist for Children, clinical histories, and psychophysiomeasurement tools were used to measure the effects of cumulative stress and latent trauma as historically underrepresented students persisted through high school STEM discipline classes. Elevated responses on the inventory and history were triangulated through measures of biological markers for cumulative stress and developed into a profile combination of traits to identify those students likely to show symptomology consistent with the negative effects of cumulative stress and latent trauma. Examination of these outcomes using a latent class profile analysis model suggested the presence of cumulative stress resulting from program participation was significant.

Most out-of-home placed children have experienced early adversities, including maltreatment and neglect. A challenge for caregivers is to adequately interpret their foster child’s internal mental states and behavior. We examined caregivers’ mind-mindedness in out-of-home care, and the association among caregivers’ mind-mindedness (and its positive, neutral, and negative valence), recognition of the child’s trauma symptoms, and behavior problems. Participants (N = 138) were foster parents, family-home parents, and residential care workers. Caregivers’ mind-mindedness was assessed with the describe-your-child measure. Caregivers’ recognition of the child’s trauma symptoms, their child’s emotional symptoms, conduct problems, prosocial behavior, and quality of the caregiver-child relationship were assessed using caregivers’ reports. Foster parents produced more mental-state descriptors than did residential care workers. General mind-mindedness, as well as neutral and positive mind-mindedness, related negatively to conduct problems. Besides, positive mind-mindedness was associated with prosocial behavior and neutral mind-mindedness with a better quality of the caregiver-child relationship and fewer child conduct problems. Negative mind-mindedness related positively to the caregiver’s recognition of the child’s trauma symptoms, and indirectly, to emotional symptoms. In conclusion, mind-mindedness seems to be an essential characteristic of out-of-home caregivers, connected to the understanding of their child’s behavior problems and trauma symptoms, as well as to the relationship with the child. The findings suggest a possible use of mind-mindedness in out-of-home care evaluation and intervention.

Police officers are frequently exposed to traumatic events and therefore are at elevated risk of developing post-traumatic stress disorder (PTSD) and other mental health conditions. While evidence-based treatments for PTSD such as prolonged exposure therapy demonstrate effectiveness, residual symptoms and relapse remain problematic outcomes. Improvements in outcomes may be enhanced by modifying psychotherapy processes based upon recent neuroscientific findings. The present study explored incorporating memory reconsolidation principles into evidence-based exposure therapy for PTSD to create memory reconsolidation therapy (MRT). MRT incorporates memory recall followed by a wait period to make memories liable for modification. Using a case series design, three police officers diagnosed with PTSD participated in a maximum of twelve 90-min sessions of MRT and recorded weekly self-report measures of trauma symptoms and psychological distress. Results indicated participants experienced significantly reduced psychological distress with gains maintained over a 3-month follow-up. A significant reliable reduction in trauma symptoms by post-therapy was identified in two of the three cases with the third narrowly missing the clinically significant cut-off. These significant changes were maintained over the 3-month follow-up in one participant, while the maintenance of these improvements in trauma symptoms approached significance in the other two participants. These findings provide preliminary evidence to justify larger future studies to test the efficacy of MRT with police officers experiencing PTSD.

Trauma is prevalent among children and adolescents, with youth of color generally reporting greater exposure compared to White youth. One factor that may account for this difference is racial stress, which can manifest into trauma symptoms. Although racial stress and trauma (RST) significantly impacts youth of color, most of the research to date has focused on adult populations. In addition, little attention has been given to the impact of the ecological context in how youth encounter and cope with RST. As such, we propose the Developmental and Ecological Model of Youth Racial Trauma (DEMYth-RT), a conceptual model of how racial stressors manifest to influence the trauma symptomatology of children and adolescents of color. Within developmental periods, we explore how individual, family, and community processes influence youth’s symptoms and coping. We also discuss challenges to identifying racial trauma in young populations according to clinician limitations and the post-traumatic stress disorder framework within the diagnostic and statistical manual of mental disorders—fifth edition (DSM-5). The article concludes with implications on applying DEMYth-RT in clinical and research settings to address RST for youth of color.

This investigation evaluated trauma-focused cognitive behavioral therapy (T-F CBT) with detained male adolescents with serious offending behaviors. One hundred and seventeen youth with trauma symptoms participated in an average of twelve T-F CBT individual sessions. Trauma symptoms were assessed prior to and following treatment using the Trauma Symptom Checklist for Children (TSCC) and a paired sample t-test was used to analyze changes from pre- to posttest. Trauma symptoms in five of the six scales (i.e., anger, depression, anxiety, posttraumatic stress, dissociation) were significantly reduced following treatment. T-F CBT may be effective in reducing general trauma symptoms among detained adolescents; assessing and treating trauma symptoms are recommended as standard protocol in the juvenile justice system; and T-F CBT may be effective without caregiver participation.

Training in trauma-informed early intervention programs is greatly needed for Part C early intervention providers (EIs). This study evaluated the feasibility, acceptability, and initial outcomes of Trauma-Informed Behavioral Parenting (TIBP; subsequently renamed Smart Start), an early intervention program designed to meet the social–emotional needs of toddlers enrolled in Part C services. This pilot study consisted of training and supervising 5 EIs to implement TIBP with 8 parent–child dyads as part of their Part C services. Preliminary changes in child behavior problems, trauma exposures, parenting stress, and parenting skills were evaluated quantitively. EIs completed treatment integrity measures. Focus groups provided data regarding the feasibility of implementation and caregiver attitudes about TIBP. Significant reductions in child trauma symptoms on both the YCPC-PTSD (S = 11.5, p = 0.0586, rMPRB = 0.64) and YCPC-FI (S = 11.5, p = 0.0586, rMPRB = 0.53) were indicated. No significant changes in externalizing behaviors were observed. Caregivers demonstrated improved use of positive verbal reinforcement and verbal reflections, and reported improvements on parent–child dysfunctional interactions on the PSI-SF (S = 16, p = 0.0117, rMPRB = 0.89). All focus group participants reported benefits from participating in TIBP. EIs demonstrated high adherence to treatment protocol and identified TIBP as a feasible program to implement within Part C services. This study showed promising results as a means to disseminate evidence-based practices into a community-level program to address the social–emotional needs of toddlers. The need for additional, large sample research was highlighted.

To date, few studies have examined stress responses during or shortly after potentially traumatic events in real-time. In this study, a prospective Virtual Reality analogue trauma paradigm was used to assess peri- and post-traumatic stress responses in healthy individuals (N = 80). Here we compared a range of peri-traumatic psychophysiological responses following analogue trauma to a control condition. Furthermore, we aimed to identify essential regulatory mechanisms in response to an analogue trauma and their effects on subsequent analogue trauma symptoms. Therefore, we examined the impact of subjective and physiological emotional responses, cognitive processing, cognitive regulation and appraisal as well as flexible emotion regulation on analogue trauma symptoms. Results of the hierarchical multiple regression analyses revealed that cognitive processing as well as cognitive regulation and appraisal predicted analogue trauma symptoms beyond psychophysiological responses, while flexible emotion regulation was uniquely predictive only directly afterwards. The findings provide evidence that flexible emotion regulation might be in particular protective directly after trauma exposure and highlight the general importance of peri- and post-traumatic cognitive factors in the development and maintenance of stress-associated psychopathology, thereby supporting cognitive models of PTSD.

Poor maternal mental health, including depression and high stress levels, can negatively impact many domains of child development, particularly among low-income, ethnic minority families experiencing multiple stressors. Low-income minority mothers, particularly Hispanic mothers, are also at increased risk of experiencing exposure to community violence and other types of trauma. However, studies exploring the additional impact of maternal trauma symptoms on children’s functioning are rare. This study aims to address this gap by examining the impact of maternal trauma symptoms on young children’s functioning in a low-income, predominantly Hispanic sample through the mechanisms of maternal depressive symptoms, and mother’s experiences of parenting stress and strain. The sample consisted of 158 biological mothers (58% Hispanic, 13% African American, 5.7% White American) who were participating in community-based mental health treatment for their children (MAGE = 3.7, SD = 1.2). Mothers completed questionnaires providing information on their children’s behaviors and their own mental health and stress levels at intake. Path analysis indicated that there was a significant indirect effect of maternal trauma symptoms on children’s behavior problems through maternal depressive symptoms and maternal stress in the parent-child relationship (β = 0.09, p

There have been large, recent increases in the number of children and families migrating from Central America to the U.S. to escape regional cartel and gang violence. The rate of trauma exposure in recently immigrated youth from Central America is therefore alarmingly high and current trauma symptom measures have not been evaluated for use in this population. The broad goal of this study was to report on the psychometric properties of one such measure in two studies of recently immigrated youth. Data collected included self-report of recent immigrants from Central America attending public high school in the Southwestern U.S. and caregiver-report from a sample of Central American immigrants who arrived in the U.S. within the last 24 hours and reported on trauma symptoms in their children. Aims included providing descriptive data and examining inter-item correlations and factor structure. Results indicated trauma symptoms far exceeding published cutoff levels as well as adequate internal consistency and inter-item correlations. Findings of the current studies suggest a pressing need for the assessment of trauma symptoms among recently immigrated youth from Central America, in which the rates of exposure and symptoms were striking.

Child maltreatment can lead to a unique set of trauma stress among young children that can be challenging to measure. The purpose of this review was to review measures of maltreatment-related trauma outcomes (trauma-related symptoms and post-traumatic stress disorders) in very young children (ages 0–6) and to examine research trends in how and if child development is accounted for in this area of measurement. A systematic search strategy was used to identify articles in two databases, CINAHL and PsychInfo. Articles were eligible for inclusion in the review if they measured trauma symptoms in children ages 0–6, were quantitative research reports of studies conducted in North America, and were published in English. The search resulted in 74 articles meeting prespecified inclusion criteria. Results suggested that recognition of the ways maltreatment trauma affects child development and the importance of developmental sensitivity in assessing trauma symptoms has grown in recent years. However, many research studies did not use developmental frameworks and applied adult-oriented trauma symptom frameworks in measurement and treatment. Behavioral symptoms were the primary outcome of interest for this age group. There was also incongruity and lack of consensus about diagnostic tools for post-traumatic stress disorders in young children. Further research is needed to resolve theoretical and empirical controversies related to measurement and diagnosis of trauma symptomatology in young children.

Victimization has been associated with increased depression, anxiety, anger, and delinquency; yet, research on adolescent victimization has largely relied on variable-centered approaches to examine associations with singular outcomes. With secondary data from the Developmental Victimization Survey, we utilized latent profile analysis to identify subgroups of youth, ages 12–17, based on clusters of internalizing and externalizing behaviors. We also examined how the behavioral outcome clusters were associated with different forms of victimization. Four behavioral subscales were included within the latent profile analysis and a four-class model had the best fit. Youth in Class 3 (high depression, anxiety, anger, and delinquency) were significantly more likely to have experienced peer/sibling victimization and to have experienced indirect victimization than youth in Class 2 (high depression, anxiety, and anger). The study findings indicate that certain types of victimization have greater consequences on mental health and that the unique clustering of symptoms is at least partially accounted for by the types of victimization experienced.

The Calgary Counselling Centre offers therapy groups for both women whose partners abuse them, “You’re Not Alone” (YNA) and women who abuse partners, “Responsible Choices for Women” (RCW). The study examines 262 group members (157 RCW & 105 YNA), comparing their demographics and scores on measures of physical and non-physical partner abuse, and mental health symptoms. At pretest, women in YNA reported significantly more problematic depression, anxiety, general distress and trauma symptoms than women in the RCW program. Nevertheless, the factorial repeated measures analysis of variance on pretest/posttest data from 177 women found statistically significant improvements on all four outcomes measures for women in both groups, although women in the YNA survivor groups made the most improvements on depression, stress and general distress. Clinical implications are described.

Children in the child welfare system experience high rates of exposure to potentially traumatic events, which are associated with significant impairments in safety, permanency, and well-being. However, child welfare systems have not routinely screened children for trauma, and little is known about such efforts. This paper describes five statewide and tribal projects to implement trauma screening for children in the child welfare system as part of broader, trauma informed care initiatives. Findings indicate that implementation strategies varied considerably but that screening generally resulted in identification of high rates of trauma exposure, trauma symptoms and service referrals. Further, screening was generally perceived favorably by child welfare workers and mental health professionals. However, wide variations were observed in the number of children screened, suggesting that more research is needed to identify optimal strategies. Lessons learned are described and recommendations made for implementing trauma screening in state or tribal child welfare systems.

This theoretical review aims to present the limited findings on traumatic stress and pain in children and adolescents, highlight recent discoveries regarding neurobiological processes, and suggest an alternative stress-health perspective in the future study and conceptualization of pediatric pain and traumatic stress based on results. Current literature highlights a positive correlation between pain and trauma symptoms in youth and suggests a complex relationship that may have mutually maintaining dynamics and intertwined physiological processes. Developmentally sensitive, longitudinal, process-oriented designs assessing neurobiological alterations and stress responses should be utilized in the examination of the trauma-pain relationship. Such investigations may provide a more unified explanation of the relationship between chronic pain and traumatic stress.

Meta-analyses of the treatment of posttraumatic stress disorder (PTSD) in childhood and adolescence are restricted to specific trauma, selected interventions, and methodologically rigorous studies. This large meta-analysis quantifies the effects of psychological treatments for PTSD symptoms in children and adolescents. An extensive literature search yielded a total of 13,040 articles; 135 studies with 150 treatment conditions (N = 9562 participants) met the inclusion criteria (psychological interventions with children and/or adolescents with PTSD symptoms that report quantitative measures of symptom change). The mean effect sizes (ESs) for PTSD symptoms ranged from large to small, depending on the control condition. Cognitive behavioral therapy (CBT) yielded the highest ESs. Age and caretaker involvement were identified as moderators. CBT, especially when conducted in individual treatment with the inclusion of parents, is a highly effective treatment for trauma symptoms. Psychological treatments need to be modified to address younger patients' specific needs.

Changes in sleep patterns among children following traumatic experiences may be indicative of post-traumatic psychiatric disorders and contribute to disease persistence. We evaluated long-term changes in the sleep habits of 1919 junior high school students who experienced the 2011 Japan earthquake and tsunami, and examined the associations among sleep patterns, trauma symptoms, and specific traumatic events. The Post-Traumatic Stress Symptoms for Children-15 items self-completion questionnaire was distributed to the children, and a questionnaire regarding three specific traumatic events (home damage, bereavement, and evacuation) was distributed to their teachers. Compared to the same survey conducted 8 months after the disaster, a 20-month postdisaster survey revealed significantly shorter mean sleep duration and a delay in sleep phase (p < 0.0001). On the 20-month survey, weekday sleep duration was shorter and sleep—wake pattern delayed in children who had experienced home damage compared to children with no such experience (p < 0.01). Children who had experienced bereavement also reported a shorter mean sleep duration on the 20-month survey compared to children reporting no bereavement experience (p < 0.05). Differences in sleep duration between weekdays and holidays at 20 months post-disaster suggested a sleep debt due to sleep disruption. There were no significant differences in Post-Traumatic Stress Symptoms for Children-15 items total scores between groups defined by the type of traumatic experience. Traumatic events (home damage, bereavement) associated with the 2011 Japan earthquake and tsunami have caused long-term sleep disruption in children from this region.

Parental incarceration is often an adverse childhood experience that has been characterized as an enduring trauma that involves ongoing and repeated stressors. In this study we focus on the role of parental incarceration in predicting child trauma symptomology as well as key mediating family processes such as visitation and children’s caregiving arrangement. We utilize a comparison group design of single caregiver and child dyads (N = 45) among similarly disadvantaged single caregiver families to first determine mean differences in child trauma symptomology. Findings revealed that both child and caregiver reports of child trauma symptomology were significantly higher in single caregiver families impacted by parental incarceration and these levels were in the clinical range (parent reports) or approached the clinical range (child reports). We then tested a mediational model examining family processes linked to child trauma symptomology. Parental incarceration was associated with more serious visitation problems (than other contexts of visitation to a nonresident parent) and children being raised by someone other than a biological parent. Parental incarceration also significantly predicted parent and child reports of child trauma symptoms. The effect of parental incarceration on parent reports of child trauma symptomology was fully mediated by the quality of children’s visitation suggesting the importance of developing interventions aimed at alleviating child distress during visits in correctional settings.

High rates of child maltreatment demand attention, as exposure to child maltreatment substantially increases the risk of developing PTSD. Some evidence exists that the presence of coping skills may reduce the likelihood that victims of childhood maltreatment will develop PTSD (Agaibi & Wilson, Trauma Violence Abuse 6:195–216, 2005). This study examined whether avoidant and/or approach coping skills moderated the relationship between childhood trauma exposure and trauma symptoms among adolescent females with a history of complex trauma. Results suggest that the use of avoidant coping moderates the relationship between trauma exposure and trauma symptoms. More specifically, girls with higher levels of trauma exposure demonstrated lower levels of trauma symptoms if they reported using higher levels of avoidant coping. Clinical implications for these results are discussed.

This study examines the association between community violence exposure and trauma symptomatology among young children (6–16 years; N = 120). Further, the study explores whether children’s attributions of violence mediate the relationship between their exposure and their trauma symptoms. Youth completed the Kid-SAVE measure of exposure to violence, the CAPS measure of attributions/perceptions, and the Trauma Symptom Checklist for Children (TSCC). Multiple regression analyses supported the expectation that exposure to violence would produce more negative perceptions and were associated with higher TSCC symptom scores. Exposure to violence both directly and indirectly (through the negative attributions) led to higher symptom reports, and this effect was separate from the child’s report of having been a victim of aggression or violence. Implications of this study include targeting children’s attributions within treatment modalities for youth to reduce distress and post-traumatic stress symptomatology.

Mental health professionals working with trauma survivors often experience both psychological costs (e.g., compassion fatigue) and benefits (e.g., compassion satisfaction). In this study, trauma counsellors’ individual characteristics as well as workplace conditions were examined to determine their relative influence on compassion fatigue and compassion satisfaction. Lack of control over workplace, over-involvement with clients, and secondary exposure to clients with serious trauma symptoms were significantly related to compassion fatigue. Counsellors’ perceived control of the workplace, personal trauma history, and years of clinical experience were significantly related to compassion satisfaction.

Children in Kenya’s Kisumu District Primary Schools (N = 430) completed three measures of trauma. Respondents completed the My Worst Experience Scale (MWES; Hyman and Snook 2002) and its supplement, the School Alienation and Trauma Survey (SATS; Hyman and Snook 2002), sharing their worst experiences overall and specifically in schools. Participants also completed the Trauma and Attachment Belief Scale (TABS; Pearlman 2003), addressing their experiences of violence. The study examined children’s perceptions about themselves and others in the aftermath of violent experiences and the relationship between children’s trauma symptoms from experiencing violence and their social and academic functioning. Differences in the presence, frequency, and severity of symptoms emerged, with a large percentage attaining statistical and clinical significance. Research and practice implications are provided.

The developmental tasks and underlying neurobiological development associated with adolescence result in high rates of traumatization and posttraumatic stress disorder for this age group. Although the development of new measures is ongoing, assessing traumatized adolescents continues to present challenges. This article outlines some of the issues complicating an accurate assessment of trauma and posttraumatic stress disorder. Inaccuracies inherent in reporting traumatic exposure and associated sequelae are confounded by varying definitions of trauma, chronicity or multiplicity of exposure, and developmental factors unique to adolescence. Considerations in conducting thorough assessments are reviewed, with a focus on understanding the factors underlying the unintentional minimization and/or active concealment of traumatic events and trauma symptoms. Suggestions for enhancing assessment accuracy are offered, and treatment implications are discussed.

Parents and children together: Multifamily therapy for refugees with complex trauma symptoms

Psychological disorders associated with traumatic events, such as post-traumatic stress disorder (PTSD), may be prone to malingering due to the subjective nature of trauma symptomology. In general, symptoms tend to be inflated when an external reward (i.e., compensation) is associated with the claim. The present study was designed to test whether malingered claims of PTSD symptoms differed as a function of the type of trauma being malingered (accident, disaster, sexual assault) and the motivation for malingering (compensation, attention, revenge, no motivation). Participants were randomly assigned into conditions, given malingering instructions, and then asked to complete three measures of trauma symptoms (Impact of Event Scale—Revised; Post-Traumatic Stress Disorder Checklist; Trauma Symptom Inventory). Results indicated that participants in the sexual assault condition produced higher symptom reports on nearly all scales. Revenge and compensation motivations yielded elevated symptom scores. Further, individuals rated high in fantasy proneness and dissociation produced elevated scores on atypical responding and most clinical scales. More research is needed to examine the extent to which different motivations and trauma types influence symptom reporting.

This study examined MASTR/EMDR, a trauma-focused treatment for traumatized youth taken in charge by youth protective services. Participants were 40 adolescents who were exhibiting conduct problems and internalizing and externalizing behaviors and who had been exposed to maltreatment. Participants were randomly assigned to MASTR/EMDR treatment or to a routine care condition. Self-report questionnaires and semistructured interviews were administered to participants and one of their parents/caregivers at three points in time: pretreatment, post treatment (12 weeks), and follow-up (12 weeks). Repeated measures analyses of covariance showed that participants in the experimental group had significant improvements in their trauma symptoms and behavioral problems compared with the control group at the posttreatment evaluation. These effects were maintained at a 3-month follow-up. Results support the effectiveness of MASTR/EMDR.

False allegations of victimization typically are accompanied by malingered emotional symptomology to corroborate claims. This analog study was designed to compare truthful and fabricated symptom profiles on measures of post-traumatic stress (i.e., Revised Impact of Event Scale, Post-Traumatic Stress Disorder (PTSD) Checklist, Trauma Symptom Inventory) and levels of symptom consistency over time. Participants (undergraduate students) described their mental health symptoms for both traumas at time 1 (N = 291), time 2 (N = 252, 3 month), and time 3 (N = 181, 6 months). Results indicated that fabricated traumas were associated with inflated symptom profiles. Validity scales were not effective at discerning symptom veracity, although reports could be discriminated somewhat by atypical responding and clinical scales. PTSD symptoms in malingerers also were reported more consistently over time. This research offers applicable information for identifying feigned traumatic stress.

Although it is well documented that individuals who have experienced traumatic events smoke cigarettes at significantly higher rates than individuals without exposure to trauma, the longitudinal relationship between smoking and trauma-related symptoms remains unclear. The present study examined this issue among 288 female veterans receiving treatment for trauma-related disorders over a period of up to 3 years. Consistent with previous cross-sectional research, across time points more symptomatology was associated with higher rates of smoking. Longitudinally, decreases in symptoms of negative affect over time were associated with decreases in smoking.

Interpersonal violence impacts the lives of many women in society. However, despite the proliferation of research in this area, there is limited information about the frequency and impact of interpersonal trauma experiences in late life. This study investigated the relationship between a history of interpersonal trauma and subsequent adjustment difficulties, including psychological distress and physical health, in women over the age of 60. Findings demonstrate that interpersonal trauma has a significant impact on later-life functioning. Additionally, the presence of multiple traumatization experiences was a critical factor in determining which individuals manifested long-term trauma symptoms.

Adult members of 79 Albanian families who had fled from Kosovo to Macedonia during the immediate postwar period (June–August 1999) were interviewed. In conjunction with therapeutic intervention, the Harvard Trauma Questionnaire (HTQ) and the General Health Questionnaire (GTQ) were administered. Trauma symptoms as measured by the HTQ and psychological distress as measured by the GHQ were highly correlated. The best predictor of psychological distress was severity of the trauma experienced. Refugees with high educational attainment had fewer trauma symptoms than those with lower educational attainment. Refugees who lived with host families in towns showed fewer trauma symptoms than those who lived in camps, but they were also more highly educated. The results of hierarchical multiple regression analyses suggested that educational attainment may mediate the effect of place of residence. Educational attainment may be an indicator of resourceful and effective coping strategies that ameliorate the effects of trauma.

Although posttraumatic stress theory has beenextensively developed in the psychological andmedical literature in the last decade,development of secondary traumatic stresstheory is still in its infancy. Thetraumatology literature reveals a focus on thetraumatized victims and, with few exceptions,excludes those who are secondarily traumatizedthrough their counselling work with survivorsof traumatic life events. Claims have recentlybeen made that counsellors working in the fieldof trauma are vulnerable and at risk fordeveloping trauma symptoms similar to thoseexperienced by traumatized clients. The authorreviews the recent research and literature onsecondary traumatic stress and addresses theimplications of these research findings tocounsellor educators and practitioners workingin the field of trauma.

Most often, for battered women, the decision to stay or leave is not made at a single point in time with finality, but instead unfolds over time, and represents the most fundamental and difficult decision women may face (Barnett & LaViolette, 1993). In order to increase our knowledge of the complex factors involved in stay–leave experiences for women in violent relationships, this study focused on explicating multiple variables relevant to battered women who were either in a violent relationship or who had left a violent relationship. Five relationship status groups were examined in order to better understand the potential differences in women's experiences at different points in time: women in violent relationships (1); women out of a violent relationship for up to 6 months (2); women out of a violent relationship from 6 months to 1 year (3); women out of a violent relationship 1 to 3 years (4); women out of a violent relationship 3 years or more. Two hundred women were recruited via advertisements and posters. Using cross-sectional analyses, the variables examined included trauma symptoms (Briere, 1989); coping (Folkman & Lazarus, 1985); self-efficacy for leaving a violent relationship (a measure developed for this study; Kennedy, 1996); and physical violence (Straus, 1979). Results indicated that dynamic psychological variables such as self-efficacy, trauma symptoms, and coping varied depending on whether women were in or out of the relationship and how long it had been since they had left the relationship. These findings support the importance of understanding and responding to process variables, relevant to battered women's experiences and the potential value in tailoring interventions that are relevant to each woman's needs at a given point in the decision-making process.

Though inner city adolescents are disproportionately affected by violence including homicide, they are underserved and understudied. This paper presents a framework for a community-based group treatment for inner city adolescent survivors of homicide victims. Strategic tasks for structuring the group include faculty and staff awareness, informed consent, adequate, consistent space, scheduling, group composition, and gender and cultural considerations. A ten week treatment model geared toward providing grief education, facilitating thoughts and feelings and reducing trauma symptoms is presented.

Medically ill children are often exposed to traumatizing situations within the medical setting. Approximately 25-30 % of medically ill children develop posttraumatic stress symptoms and 10-20 % of them meet criteria for posttraumatic stress disorder. Parents of medically ill children are at even higher risk for posttraumatic stress symptoms. Most children and parents will experience resolution of mild trauma symptoms without formal psychological or psychiatric treatment. Posttraumatic stress symptoms are associated with medical nonadherence, psychiatric co-morbidities, and poorer health status. Therefore, evidenced-based trauma-focused treatment is indicated for those who remain highly distressed or impaired. This paper reviews approaches to the assessment and management of pediatric iatrogenic medical trauma within a family-based framework.