Cheryl Lanktree

Complex Trauma in Children and Adolescents

The present paper highlights seven primary domains of impairment observed in children exposed to complex trauma. These phenomenologically based domains have been identified based on the extant child clinical and research literatures, the adult research on Disorders of Extreme Stress Not Otherwise Specified (Pelcovitz et al, 1997; van der Kolk, Pelcovitz, Roth, Mandel, McFarlane, & Herman, 1996; van der Kolk, Roth, et al., in press), and the combined expertise of the NCTSN Complex Trauma Taskforce.

Outcome of therapy for sexually abused children: A repeated measures study

The outcome of abuse-focused treatment was examined in a sample of 105 sexually abused children, 71 of whom completed 3 months of treatment or longer. Symptom change was measured with the Trauma Symptom Checklist for Children (TSCC; Briere, in press) and the Childrens Depression Inventory (CDI; Kovacs, 1983, 1992), administered at 3 month intervals. The CDI and all TSCC scales but Sexual Concerns decreased after 3 months of therapy, and of these, all but Dissociation continued to decline at one or more assessment periods thereafter. At 6 months, those remaining in therapy continued to decrease on the CDI and on the Anxiety, Depression, Post-traumatic Stress, and Sexual Concerns scales of the TSCC. At 9 months Anxiety and Post-traumatic Stress continued to decrease, and at 1 year those still in treatment showed decrements in Anxiety, Depression, and Post-traumatic Stress. These changes are hypothesized to be due to treatment per se, rather than merely as a result of the passage of time. In this regard, multiple regression analyses indicated that time from the end of abuse to either the beginning or the end of treatment was far less predictive of post-treatment TSCC or CDI scores than was number of months specifically spent in treatment.

Incidence and impact of sexual abuse in a child outpatient sample: The role of direct inquiry

From the child psychiatry outpatient department of a university medical center, 64 charts were reviewed in two phases: 29 were randomly selected from outpatient files, and 35 were examined after clinicians were asked to directly query sexual abuse. Although the reported sexual abuse rate for randomly selected charts was quite low (6.9%), reference to sexual abuse history in charts of children who were asked about molestation was 4.5 times more frequent (31.4%; 11.5% of all boys, 50% of all girls). Children with an identified sexual abuse history reported more psychological symptoms, had made more suicide attempts in the past, and were more likely than nonabused children to receive a diagnosis of major depression.

Cumulative trauma and symptom complexity in children: A path analysis

Multiple trauma exposures during childhood are associated with a range of psychological symptoms later in life. In this study, we examined whether the total number of different types of trauma experienced by children (cumulative trauma) is associated with the complexity of their subsequent symptomatology, where complexity is defined as the number of different symptom clusters simultaneously elevated into the clinical range. Childrens symptoms in six different trauma-related areas (e.g., depression, anger, posttraumatic stress) were reported both by child clients and their caretakers in a clinical sample of 318 children. Path analysis revealed that accumulated exposure to multiple different trauma types predicts symptom complexity as reported by both children and their caretakers.

Sex-role related effects of sex bias in language

Despite recent efforts to eliminate sexist language from journal and other publications, controversy persists over whether sexist language contributes to the perpetuation of sex bias. Seventy-two female and 57 male undergraduates were exposed to three levels of sexist noun and pronoun usage in a description of “Ethical Standards of Psychologists.” All subjects then rated the attractiveness of a career in psychology for males and females, and their own willingness to refer a male or female friend to a psychologist. In several instances, ratings of career attractiveness and willingness to refer were found to vary in sex-role stereotypic directions as a function of degree of exposure to sexist language. Recent demands for nonsexist language may be supportable on the basis of a genuine relationship between sexist language and the maintenance of sex-biased perceptions.

Treating Multitraumatized, Socially Marginalized Children: Results of a Naturalistic Treatment Outcome Study

Although early-onset, repeated trauma is relatively common in socially marginalized populations and related to numerous negative outcomes, most empirically validated interventions are not especially well tailored to meet the complex and individualized needs of child and adolescent trauma survivors in such contexts. Integrative treatment of complex trauma (ITCT) was developed as a specialized treatment that is empirically informed, culturally sensitive, extendable beyond the short term, and customized to the specific social and psychological issues of each child. This article examines the potential effectiveness of ITCT in assisting 151 traumatized children living in an economically deprived environment. Results indicate significant reductions in anxiety, depression, posttraumatic stress, anger, dissociation, and sexual concerns as a function of time in treatment.