Brandon G. Scott

The impact of adverse childhood experiences on an urban pediatric population.

OBJECTIVE The goal of this study was to investigate the adverse childhood experiences (ACEs) in youth in a low-income, urban community. STUDY DESIGN Data from a retrospective chart review of 701 subjects from the Bayview Child Health Center in San Francisco are presented. Medical chart documentation of ACEs as defined in previous studies were coded and each ACE criterion endorsed by a traumatic event received a score of 1 (range=0-9). This study reports on the prevalence of various ACE categories in this population, as well as the association between ACE score and two pediatric problems: learning/behavior problems and body mass index (BMI)≥85% (i.e., overweight or obese). RESULTS The majority of subjects (67.2%, N=471) had experienced 1 or more categories of adverse childhood experiences (ACE≥1) and 12.0% (N=84) had experienced 4 or more ACEs (ACE≥4). Increased ACE scores correlated with increased risk of learning/behavior problems and obesity. CONCLUSIONS There was a significant prevalence of endorsed ACE categories in this urban population. Exposure to 4 or greater ACE categories was associated with increased risk for learning/behavior problems, as well as obesity. PRACTICE IMPLICATIONS Results from this study demonstrate the need both for screening of ACEs among youth in urban areas and for developing effective primary prevention and intervention models.

Resting vagal tone and vagal response to stress: associations with anxiety, aggression, and perceived anxiety control among youths.

This study tested the associations of both resting vagal tone and vagal response to stress with anxiety control beliefs, anxiety, and aggression among 80 youths (aged 11-17 years). Measures included physiological assessments of emotion regulation along with youth self-report of anxiety control beliefs, anxiety, and aggression and caregiver reports of their childs anxiety and aggression. Resting vagal tone was positively related to anxiety control beliefs, but negatively associated with anxiety. Conversely, higher levels of anxiety and aggression were associated with increased vagal tone during a cognitive stress task. Findings suggest associations between physiological and self-report of emotion regulation (anxiety control beliefs) and that anxiety and aggression may have specific and nonspecific relations with physiological indices of emotion regulation.

A theoretical model of continuity in anxiety and links to academic achievement in disaster-exposed school children

This study tested a theoretical model of continuity in anxious emotion and its links to academic achievement in disaster-exposed youth. An urban school based sample of youths (n = 191; Grades 4-8) exposed to Hurricane Katrina were assessed at 24 months (Time 1) and then again at 30 months (Time 2) postdisaster. Academic achievement was assessed through end of the school year standardized test scores (~31 months after Katrina). The results suggest that the association of traumatic stress to academic achievement was indirect via linkages from earlier (Time 1) posttraumatic stress disorder symptoms that predicted later (Time 2) test anxiety. Time 2 test anxiety was then negatively associated with academic achievement. Age and gender invariance testing suggested strong consistency across gender and minor developmental variation in the age range examined. The model presented advances the developmental understanding of the expression of anxious emotion and its links to student achievement among disaster-exposed urban school children. The findings highlight the importance of identifying heterotypic continuity in anxiety and suggest potential applied and policy directions for disaster-exposed youth. Avenues for future theoretical refinement are also discussed.

Is TV Traumatic for All Youths? The Role of Preexisting Posttraumatic-Stress Symptoms in the Link Between Disaster Coverage and Stress

In youths, watching TV coverage of a disaster is associated with traumatic-stress symptoms. However, the role of predisaster symptoms in this link has not been addressed. In this study, urban-school youths who had experienced both Hurricanes Katrina and Gustav (N = 141; grades 4–8) were assessed 12 months and 6 months before Gustav and then 1 month after Gustav. The amount of TV viewing was associated with post-Gustav stress symptoms, controlling for pre-Gustav symptoms. However, pre-Gustav stress symptoms interacted with TV viewing in predicting post-Gustav symptoms such that for youths with higher preexisting symptoms, there was a stronger association between TV viewing and level of post-Gustav symptoms. The results advance the literature on the role of media coverage in stress reactions by showing that preexisting symptoms can be an important component of identifying which children are likely to be most negatively affected by TV coverage.

Aggressive Behavior and Its Associations With Posttraumatic Stress and Academic Achievement Following a Natural Disaster

Despite an abundance of evidence linking maltreatment and violence-related trauma exposure to externalizing problems in youth, there is surprisingly little evidence to support a direct link between disaster exposure and youth aggressive behavior. This study tested the theory that there is primarily an indirect association between disaster exposure and aggression via posttraumatic stress disorder (PTSD) symptoms. The current study also examined the association between aggression and academic achievement. A sample of 191 4th- to 8th-grade minority youth who experienced Hurricane Katrina were assessed for aggressive behavior using the Peer Conflict Scale (PCS), disaster exposure, PTSD symptoms, and academic achievement. Structural equation modeling of the set of associations was consistent with the theory suggesting that there is an indirect link between disaster exposure and aggression through PTSD symptoms. Aggression was negatively associated with academic achievement, and modeling indicated that the set of associations was age and gender invariant. Findings advance the theoretical understanding of the linkage between aggression and disaster exposure. Findings also support the utility of the PCS in disaster research and the link between PCS scores and academic achievement.

Memories of traumatic events in childhood fade after experiencing similar less stressful events: results from two natural experiments.

The long-term stability of youth reports of traumatic events is largely unknown. Translational animal research suggests that there may be an alteration of memories for traumatic events via memory reconsolidation processes, whereas clinical research suggests memory alteration may occur through augmentation by negative emotions. In this report, 2 natural experiments test reconsolidation model and augmentation model predictions about the course of traumatic memories in youth. Data are from 2 prospective studies that assessed reports of an initial traumatic event (Hurricane Katrina) and tested recall both pre and post a similar event (Hurricane Gustav). In the 1st (Sample 1; n = 94, initial Grade 9 followed to 11), youth were assessed at 4 time points: Times 1-3 were 13, 20, and 26 months post-Katrina and then Time 4 was 5 months post-Hurricane Gustav. In the 2nd (Sample 2; n = 141, Grades 4 through 8), youth were assessed at 12 months pre-Gustav (Time 1; 24 months post-Katrina) and then again at 1 month (Time 2) and 8 months (Time 3) post-Gustav. Those with relatively high Gustav exposure showed more stability in their reports of Katrina exposure events, whereas in those with low Gustav exposure, reports of Katrina events decreased. Time spans between recall, age, gender, symptoms of posttraumatic stress disorder, or cognitive/learning ability did not explain changes in the reports. The study provides the 1st long-term data on the consistency of youth reports of disaster-related experiences and provides initial evidence for the ecological validity of memory reconsolidation theory applied to traumatic events in youth.

Patterns of actual and perceived control: are control profiles differentially related to internalizing and externalizing problems in youth?

Abstract This study provided an initial test of a theoretical model which emphasizes patterns of actual and perceived control. The model suggests that profiles of actual and perceived control are differentially related to emotional and behavioral problems. We examined whether anxiety and depression symptoms and aggressive behavior would differ among diverse patterns of actual (caregiver reported competencies) and perceived control (anxiety-related control beliefs) in youth (n=203). Results were consistent with the theoretical predictions in that reported levels of anxiety and depression symptoms and aggressive behavior varied depending upon youths control profiles. For example, youth with high actual and low perceived control exhibited relatively more anxiety/depression symptoms than aggressive behavior, while those youth with low actual and high perceived control exhibited relatively more aggressive behavior. Furthermore, youth with both high actual and perceived control reported and were reported by caregivers as having the least anxiety/depression symptoms and aggressive behavior, respectively. The findings provide empirical support for the model and suggest the importance of considering the role of actual and perceived control in emotional and behavioral problems. Implications for future tests of the model are also discussed.

Fitting Anxious Emotion-Focused Intervention into the Ecology of Schools: Results from a Test Anxiety Program Evaluation

Emotion-focused prevention and intervention efforts in schools have been promoted as a significant developmental and public health priority. This paper reports the results of a longitudinal study testing central premises of a school-based prevention model aimed at promoting positive emotional development through targeting test anxiety. Test anxiety interventions may be a practical strategy for conducting emotion-focused prevention and intervention efforts because of a natural fit within the ecology of the school setting. At-risk youth (n = 1,048) from urban public schools were screened and 325 with elevated test anxiety were offered the intervention in one of two waves (immediate intervention vs. waitlist). The intervention was associated with decreases in test anxiety, anxiety disorder, and depression symptoms. Critically, results suggest high participant satisfaction and growth curve analysis of follow-up assessments (end of the year, the next school year, and a subsequent school year) demonstrated positive developmental trajectories consistent with predictions (e.g., initial change in test anxiety predicted change in other symptoms). Findings provide evidence for the ecological validity of targeting test anxiety in school-based, emotion-focused prevention efforts.

Developmental variation in amygdala volumes among children with posttraumatic stress.

This article examined associations between indices of maturation (age and Tanner stage) and amygdala volumes in 24 youth (aged 7–14) with posttraumatic stress disorder symptoms and a matched control group. Fifteen of the youth with exposure to trauma were also re-evaluated one year later. A positive association between maturation and right amygdala volumes was observed in the trauma group but not in controls. Associations with maturation remained when controlling for a number of possible covariates and over time. Developmentally younger youth (Tanner stage 1 and 2) showed increases and older (Tanner stage 3 and 4) decreases in right amygdala volumes.

Natural Disasters and Existential Concerns A Test of Tillich’s Theory of Existential Anxiety

Existential anxiety is hypothesized to be a core human issue in a great deal of theoretical and philosophical writing. Fostering the empirical understanding of the expression of these concerns may be a valuable addition to the psychological literature on exposure to trauma. The purpose of this study was to test theoretical predictions about the association between different facets of existential anxiety and psychological symptoms (posttraumatic stress disorder symptoms, suicidal ideation) among individuals following a natural disaster. A sample of 386 Gulf Coast residents completed the Existential Anxiety Questionnaire, a posttraumatic stress disorder symptom checklist, and a measure of psychological symptoms that included an item on suicidal ideation in the months following Hurricane Katrina. The results suggested that existential concerns were prevalent in the sample and that the various facets of existential anxiety were differentially associated with psychological symptoms. These findings provide preliminary evidence for existential concerns as an important correlate of psychological distress following exposure to natural disasters and increment empirical understanding of the concept of existential anxiety.