Melissa L. Whitson

Posttraumatic stress among young urban children exposed to family violence and other potentially traumatic events

This study examines the relationship between the number of types of traumatic events experienced by children 3 to 6 years old, parenting stress, and childrens posttraumatic stress (PTS). Parents and caregivers provided data for 154 urban children admitted into community-based mental health or developmental services. By parent and caregiver report, children experienced an average of 4.9 different types of potentially traumatic events. Nearly one quarter of the children evidenced clinically significant PTS. Posttraumatic stress was positively and significantly related to family violence and other family-related trauma exposure, nonfamily violence and trauma exposure, and parenting stress. Additionally, parenting stress partially mediated the relationship between family violence and trauma exposure and PTS. This study highlights the need for early violence and trauma exposure screening in help-seeking populations so that appropriate interventions are initiated.

Predictors of Parenting and Infant Outcomes for Impoverished Adolescent Parents

Adolescent mothers and their children are at risk for a myriad of negative outcomes. This study examined risk and protective factors and their impact on a sample (N = 172) of impoverished adolescent mothers. Multiple regression analyses revealed that depressed adolescent mothers report higher levels of parenting stress and that their children are more at risk for maltreatment and are developmentally behind other babies. In addition, adolescent mothers with restricted social support have babies who are at higher risk for maltreatment. Finally, mothers who were older during pregnancy were more likely to stay in school. Implications for program development are discussed.

An Examination of Exposure to Traumatic Events and Symptoms and Strengths for Children Served in a Behavioral Health System of Care

The present study examined how exposure to traumatic events affects children with severe emotional disturbance who are being served in a school-based system of care. Multilevel growth curve models were used to examine the relationships between a child’s history of traumatic events (physical abuse, sexual abuse, or domestic violence) and behavioral and emotional strengths, internalizing problem behaviors, and externalizing problem behaviors over 18 months. Results indicate that children receiving services (N = 134) exhibited increased emotional and behavioral strengths and decreased internalizing and externalizing problem behaviors from enrollment to 18-month follow-up. Children with a history of traumatic events improved more slowly than children without such a history on both strengths and internalizing problem behaviors, even after controlling for dosage of services received and other characteristics previously found to predict outcomes. Gender was also related to improvement in internalizing symptoms. Results highlight the continued need to assess the impact of exposure to traumatic events for children served in a system of care.

Parenting Stress as a Mediator of Exposure to Potentially Traumatic Events and Behavioral Health Outcomes in Children and Youth

The environment in which children grow and develop is vital to the trajectory of their development [1]. Risk and protective factors increase or decrease the likelihood of developmental disruptions and the onset of psychopathology [1,2]. Risk factors such as poverty, maternal depression maternal substance use, parenting stress and exposure to potentially traumatic events such as family and community violence have been shown to impact on development and place children at risk for the onset of psychopathology [3-10].

The Impact of Youth and Family Risk Factors on Service Recommendations and Delivery in a School-Based System of Care

The present study examines the impact of child and family risk factors on service access for youth and families in a school-based system of care. Regression analyses examined the relationships between risk factors and services recommended, services received, and dosage of services received. Logistic regression analyses examined the relationship between risk factors and whether or not youth received specific types of services within the system of care. Results revealed that youth with a personal or family history of substance use had more services recommended than youth without these risk factors, while youth with a family history of substance use received more services. Youth with a history of substance use received a significantly higher dosage of services overall. Finally, history of family mental illness was associated with receiving mental health and operational services (e.g., family advocacy, emergency funds). Implications and limitations are discussed.

The Relation of Exposure to Traumatic Events and Longitudinal Mental Health Outcomes for Children Enrolled in Systems of Care: Results from a National System of Care Evaluation

This study examined the relation between childrens history of exposure to potentially traumatic events (PTEs) and clinical and functional mental health trajectories over a 18-month period among a national sample of youth referred for services in childrens behavioral health systems of care (SOCs). Using data from the national evaluation of the Comprehensive Community Mental Health Services program for communities funded from 1997 to 2000, the study sample included 9556 children and their families. Latent growth modeling was used to assess the effect of history of exposure to PTEs on trajectories in a number of behavioral health outcomes during the 3-year period following referral to services, controlling for child demographic characteristics (gender, race, and age). Results revealed that, on average, children in SOCs exhibited significant improvements over time on all four outcome measures. Children with a history of exposure to PTEs had higher rates of internalizing and externalizing problem behaviors and functional impairments and fewer behavioral and emotional strengths at baseline, but experienced improvements in these outcomes at the same rates as children without exposure to a traumatic event. Finally, child race, gender, and age also were associated with differences in behavioral health trajectories among service recipients. Implications for SOCs, including approaches to make them more trauma-informed, are discussed.

Parenting stress as a mediator of trauma exposure and mental health outcomes in young children.

Exposure to potentially traumatic events (PTEs) significantly impacts outcomes for children in behavioral health systems of care (SOCs). The present study built on previous research that found parenting stress influences outcomes for children exposed to PTEs. The sample included 184 young children and their families who were enrolled in an early childhood SOC. Path analyses demonstrated that parenting stress mediated the relationship between the number of PTEs a child experienced and caregiver-reported internalizing/externalizing problem behaviors at baseline. Parenting stress also mediated PTEs and internalizing problem behaviors at 6 months. In response to the culmination of these studies, we discuss ways SOCs can support parents to help alleviate parenting stress.