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Attention-deficit/hyperactivity disorder (ADHD) and posttraumatic stress disorder (PTSD) are highly comorbid among children and adolescents with a history of maltreatment and trauma. This comorbidity is linked to increased symptom severity and poor academic and social outcomes. Such negative outcomes are shown to have further negative outcomes during the college years. However, research has yet to directly examine the associations between ADHD, trauma exposure, and PTSD among college students. To address this gap, the current study examined the relations between childhood ADHD symptoms, lifetime trauma exposure, and current PTSD symptoms among a racially and ethnically diverse group of college students (N = 454). Analyses controlled for symptoms of depression and anxiety and examined demographic differences. Findings indicated that college students with a childhood history of elevated ADHD symptoms reported significantly higher numbers of trauma exposure and PTSD symptoms. Findings also indicated that trauma-related arousal symptoms and more general depressive symptoms were the strongest mediators in the association between ADHD symptoms and trauma exposure. These results have implications for child and adolescent clinical interventions, as well as for college counseling and accessibility services related to psychological well-being and academic accommodations.

Objective: We examined whether perceptions of being bullied during middle and high school were associated with depressive, anxiety, and posttraumatic stress disorder (PTSD) symptoms during college. We also examined whether perceived social support (PSS) mediated the association between bullying and symptoms, and explored whether parental, peer, or other sources of support was most beneficial. Participants: Undergraduates (N = 270) from an urban commuter college in the Northeast participated during Spring 2013 or Fall 2015. Methods: Psychometrically sound self-report measures were used to assess symptoms and perceptions of bullying and social support. Results: As hypothesized, bullying was associated with more symptoms, and PSS significantly mediated the associations between bullying and symptoms of PTSD and depression. Conclusion: The college years provide another opportunity to address the effects of middle and high school bullying. Receiving current support for past bullying is beneficial but is not enough, college counseling services are needed to reduce symptoms.

Alternative models of traumatic stress and broader psychopathology have been proposed to address issues of heterogeneity, comorbidity, clinical utility, and equitable representation. However, systematic and practical methods and guidelines to organize and apply these models remain scarce. The Middle‐Out Approach is a novel, integrative, contextually informed framework for organizing and applying existing empirical methods to evaluate current and alternative traumatic stress reactions. Rather than beginning to identify traumatic stress reactions from the top‐down (i.e., disorder‐first approach) or bottom‐up (i.e., symptom‐first approach), constructs are evaluated from the middle out (i.e., presentation‐first approach), unconstrained by higher‐order disorders or lower‐order diagnostic symptoms. This approach provides innovation over previous methods at multiple levels, including the conceptualization of traumatic stress reactions as well as the type of assessments and data sources used and how they are used in statistical analyses. Conceptualizations prioritize the identification of middle‐order phenotypes, representing person‐centered clinical presentations, which are informed by the integration of multidimensional, transdiagnostic, and multimodal (e.g., psychosocial, physiological) assessments and/or data sources. Integrated data are then analyzed concurrently using person‐centered statistical models to identify precise, discrete, and representative health outcomes within broader heterogeneous samples. Subsequent variable‐centered analyses are then used to identify culturally sensitive and contextually informed correlates of phenotypes, their clinical utility, and the differential composition within and between broader traumatic stress reactions. Examples from the moral injury literature are used to illustrate practical applications that may increase clinical utility and the accurate representation of health outcomes for diverse individuals and communities. [ABSTRACT FROM AUTHOR]

Objective: To determine if and how cardiometabolic conditions (MetC) may be associated with posttraumatic stress disorder (PTSD) symptoms over time when controlling for the influence of potentially confounding variables. Method: Parallel process latent growth modeling was applied to self-reported longitudinal data collected from 35,788 World Trade Center 9/11 survivors to determine how the development and course of PTSD symptoms and MetC influence each other when controlling for age, sex, race/ethnicity, preexisting traumas, physical health problems, general psychological distress, smoking, and alcohol use. Results: A unidirectional relationship was found in which the intercept of PTSD symptoms predicted the slope of MetC. Hyperarousal (β = .172) and emotional numbing (β =.171) PTSD symptoms demonstrated the strongest association with MetC changes over and above the effects of control variables and potential confounders. Post hoc analyses indicated that utilization of PTSD-related psychotherapy was associated with decreased early presentations of MetC following trauma, which may have vital implications for the integrated treatment of trauma-exposed individuals. Conclusions: Findings have strong theoretical and clinical implications for conceptualizing traumatic stress reactions as systemic processes and utilizing integrated treatment practices following psychological trauma. [ABSTRACT FROM AUTHOR]

This study examined posttraumatic stress disorder (PTSD) symptoms in relation to physical assaults and weapons-related victimization, as well as the moderating roles of demographic characteristics and the context of victimization. The sample consisted of 910 racially and ethnically diverse adolescents and young adults from an urban commuter college in the Northeast U.S. Findings include significant sex differences and racial differences in reported victimization and symptoms. Men reported significantly more physical assaults, gun victimizations, and knife victimizations than women. Black participants reported significantly more gun victimization than all other groups, and Black, White, and Asian participants reported significantly more physical assault experiences than Latinx participants. Individuals victimized by physical assault or by gun victimization were more than twice as likely to report clinically significant PTSD symptoms than individuals without such experiences, even after adjusting for demographic differences. In addition, for gun victimization in the community, a two-way interaction (gun victimization by race) and a three-way interaction (gun victimization by race by sex) were significantly associated with clinically significant PTSD symptoms. Gun victimization in the community, which disproportionately impacts Black men, was the only context in which PTSD symptoms were highest for men compared to women. The overall finding of lower PTSD symptoms among men suggests that clinical practice must include an intentional focus on violence victimization, including the use of weapons, as well as the various ways that distress might manifest among men. In addition to symptoms of PTSD, other symptoms of distress, including substance use, anger, and retaliatory aggression, should be considered. Public policy and public health must also direct attention to the use of weapons in violence victimization and the proliferation of weapons violence. [ABSTRACT FROM AUTHOR]

This study elaborated on associations between youth's trauma-related emotional numbing across multiple affective domains (e.g., fear, sadness, happiness, anger) and delinquent behaviors. The study also examined whether the effects of posttrauma emotional numbing varied by the occurrence of posttrauma arousal symptoms. Participants were 123 middle school boys and girls from working-class, urban communities. Emotional numbing, particularly diminished fear, was related to both home and community violence exposure. Numbing of fearful emotions was associated with all types of delinquent behaviors examined. In addition, numbing of sadness was associated with aggression. Interactions between numbing of fear and hyperarousal suggested a complex pattern of emotional processing following exposure to traumatic events in which numbing related to delinquent behavior only in the context of high posttrauma arousal. These patterns may coalesce to place youth at risk for early involvement in delinquent behaviors. (Contains 6 tables.)

Two studies examined shared and unique relations of social information processing (SIP) to youth's anxious and depressive symptoms. Whether SIP added unique variance over and above trait affect in predicting internalizing symptoms was also examined. In Study 1, 215 youth (ages 8-13) completed symptom measures of anxiety and depression and a vignette-based interview measure of SIP. Anxiety and depression were each related to a more negative information-processing style. Only depression was uniquely related to a less positive information processing style. In Study 2, 127 youth (ages 10-13) completed measures of anxiety, depression, SIP, and trait affect. SIP's relations to internalizing symptoms were replicated. Over and above negative affect, negative SIP predicted both anxiety and depression. Low positive SIP added variance over and above positive affect in predicting only depression. Finally, SIP functioning partially mediated the relations of affect to internalizing symptoms. (Contains 1 footnote, 2 tables and 1 figure.)

Two studies describe the development of a comprehensive, vignette-based measure of social information processing (SIP) particularly relevant for children with internalizing problems. Study 1 (N = 219 3rd-6th graders) describes the creation of the Children's Evaluation of Everyday Social Encounters Questionnaire (ChEESE-Q) and evidence for its reliability and validity, including internal structure and relation of SIP variables to depressive and anxious symptoms. Study 2 (N = 127 5th-6th graders) replicated the factor structure and validity evidence found in Study 1 and provided support for the reliability of alternate forms of the ChEESE-Q. Overall, results supported ChEESE-Q scores' moderate temporal stability and internal consistency in assessing SIP. Results also supported the presence of positive- and negative-valenced SIP patterns. Child internalizing symptoms were strongly related to a negative SIP style across both depression and anxiety, whereas only depressive symptoms were negatively associated with positive aspects of SIP. (Contains 3 tables, 1 figure and 1 footnote.)

This study examined the possible mediational roles of posttraumatic stress disorder (PTSD) symptoms and acceptance of violence cognitions in the association between violence exposure and youth violent behaviors. This study also examined whether the strength of the relations between exposure and behavior varied across context of exposure and across sex. Participants were 123 early adolescents from the Midwest. Findings indicate a strong positive association between violence exposure at home and in the community. Regardless of context, violence exposure was significantly related to PTSD symptoms, acceptance of violence cognitions, and violent behaviors in youth. PTSD symptoms and acceptance of violence cognitions were both significant mediators in the exposure--behavior relationship but the associations differed for girls and boys and varied across context of exposure. (Contains 6 tables.)

The authors examined the mediating role of posttraumatic stress symptoms in the relationship between traumatic event exposure and attention problems in a sample of 791 Sarajevan children exposed to the Bosnian war. They hypothesized that because of similarities in the arousal symptoms of posttraumatic stress disorder (PTSD) and the hyperactive--inattentive symptoms of attention-deficit/hyperactivity disorder (ADHD), PTSD symptoms would mediate the relationship between trauma exposure and attention problems. The findings support the hypothesis. The findings also show evidence of a reporter effect, whereby the relationship between trauma symptoms and attention problems was strongest when both types of symptoms were reported by school officials. Given the potentially spurious relationship between trauma exposure and attention problems, careful consideration must be given to the diagnosis of traumatized youth who present with ADHD symptoms. In accordance with practice guidelines, a multi-informant, multi-measure approach in the assessment of attention problems is strongly recommended. (Contains 4 tables and 3 figures.)

This study examined one type of adolescent meaning making (i.e., the development of beliefs about violence) and its association with reported mental health symptoms in a sample of youth exposed to community violence. Eighty‐seven adolescents (age 11–18; 64.4% female) from a metropolitan city in the Northeast were recruited through Craigslist and recreation center postings and data collection occurred from 2009 to 2013. Participants completed self‐reported measures of community violence exposure, attitudes toward violence, and psychological symptoms of depression and posttraumatic stress disorder [PTSD]. Bivariate correlations, hierarchical linear regressions, and mediation analyses examined the associations between exposure, beliefs about violence, and mental health symptoms. Self‐reported pro‐violence attitudes were positively correlated with depression symptoms (r = 0.32, p < 0.01) and PTSD (r = 0.45, p < 0.01). Pro‐violence attitudes significantly mediated the relationship between community violence exposure and depression symptoms (95% confidence interval [CI] = 0.003–0.061) and PTSD symptoms (95% CI = 0.046–0.260). Preliminary findings suggest that meaning making through the development of pro‐violence attitudes may not protect against symptoms of PTSD and depression among youth. Findings can inform the integration of meaning making processes into community mental health interventions for youth. [ABSTRACT FROM AUTHOR]

Hate‐based violence is increasingly recognized as an urgent social justice and human rights issue that is pervasive across geographical and socioeconomic boundaries. There is a growing body of research that demonstrates the traumatic impact of hate‐based violence on the victim's mental and physical health. This review focuses on examining scientific knowledge and prevalence data on identity‐based hate and violence exposure. A framework for conceptualizing hate‐based violence as a traumatic event or series of traumatic events is offered as a means to understand research findings and intervention approaches. The importance of research, advocacy, and human rights training is highlighted in the efforts to address the traumatic impact of identity‐based hate and violence. [ABSTRACT FROM AUTHOR]

Globally, individuals and communities that are marginalized based on their identities are at heightened risk for exposure to traumatic stress and socioeconomic hardship. Marginalization and disproportionate risk for many types of adversities correspond with disparities in physical health, mental health, and overall well‐being. Together, the 12 empirical studies, one systematic review, and commentary in this special issue of the Journal of Traumatic Stress highlight the impact of discrimination and disproportionate adversity among groups marginalized based on race, ethnicity, nativity, caste, gender identity, sexual orientation, economic status, and medical status. Although most studies in this issue focus on the United States, the articles that focus on disparities and risk factors in India, El Salvador, Uganda, and Burundi provides a multicontinent global perspective. The global perspective, including the impact of the global pandemic, invites further examination of how disproportionate exposure to traumatic stress and adversity are associated with inequitable burden and health disparities worldwide. This special issue further highlights the developmental and multigenerational burden of systemic marginalization by including studies of children, young adults, adults, and parent–child dyads. Pathways for change and intervention are illustrated through a liberatory consciousness perspective, with one study utilizing liberatory media skills (e.g., positive media images and messages) to mitigate the adverse effects of trauma exposure on at‐risk young adults of color. Worldwide, research on the effects of trauma, stress, and adversities must examine contextual factors (e.g., economic hardship), marginalization (e.g., discrimination, identity factors), and the differential impact on health among individuals and communities. [ABSTRACT FROM AUTHOR]

Longitudinal research has demonstrated that the prevalence of physical aggression among youth in the United States has been waning over the past decade; however, the prevalence of relational aggression has increased. Despite the increase in relational aggression, few studies have focused on the risk factors associated with relational aggression perpetration – particularly among college students. Understanding the risks and correlates of relational aggression perpetration among college students is of particular importance because perpetration of relational aggression is directly associated with peer rejection and social isolation and indirectly associated with a number of negative mental health outcomes. Based on established correlates of physical aggression, the current study examined violence exposure and psychological symptoms as potential correlates and risks of relational aggression perpetration. Results indicated that violence exposure and psychological symptoms were positively associated with relational aggression, but these findings were largely due to the intercorrelations between relational aggression and physical aggression. Findings also revealed ethnoracial differences in relational aggression, indicating that race and ethnicity are important covariates to consider in future studies of relational aggression and in relevant clinical practice. Identified correlates may have important implications for identifying college students at risk for relationally aggressive behaviors and in intervening in potentially negative psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Studies measuring Posttraumatic Stress Disorder (PTSD) symptoms from childhood into adulthood have been hampered by use of different measures across different developmental stages. Use of one measure across age groups would reduce measurement error and strengthen our understanding of the developmental progression of trauma. Thus, this study examined whether the UCLA PTSD Reaction-Index (PTSD-Index), which was developed for use with children and adolescents (aged 7 to 18), could be used with young adults. The utility of the measure was examined among three age groups of college students (17–18, 19–20, and 21–25). Sex differences and race/ethnicity differences were also examined. Findings indicate that the PTSD-Index is internally consistent and reliable when used with college students. Furthermore, the factor structure for the measure is similar for adolescents and for emerging adults. In sum, the PTSD-Index appears to be an appropriate screener for PTSD symptoms among young adults. The findings are relevant for both the DSM-IV and DSM-5 screening measures, and the findings have both research and clinical implications. The findings are particularly important for longitudinal studies that are challenged with addressing developmental progression of PTSD symptoms among participants, while also addressing changes in the PTSD nosology. [ABSTRACT FROM AUTHOR]

Scant research has examined how children of different races or ethnic backgrounds manifest consequences of neglect. We examined multiple domains of functioning (academic/intellectual, social/behavioral, and psychiatric), three theories (racial invariance, double jeopardy, and resilience), and potential confounding variables. Children with documented cases of neglect (ages 0–11) and matched controls without such histories were followed up and interviewed in adulthood (N = 1,039). The sample was 47.3% female, 62.4% White, 34.3% Black, and 3.4% Hispanic. Black and White neglected children showed negative consequences for IQ, reading ability, and occupational status compared to controls. Compared to same race and ethnic group controls, neglected White children showed extensive mental health consequences, Black children showed more anxiety and dysthymia, and Hispanic children showed increased risk for alcohol problems. Black and White neglected children differed in risk for violence compared to same race controls: Neglected Black children were arrested for violence two times more often than Black controls, whereas neglected White children were more likely than White controls to report engaging in violence. Findings provide some support for each theory (racial invariance, double jeopardy, and resilience). Understanding the factors that account for similarities and differences in consequences requires further investigation. Implications for research and policy are discussed. [ABSTRACT FROM PUBLISHER]