Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Arts

Program

Education

Supervisor

Rodger, Susan

Abstract

Children who experience developmental trauma often exhibit a constellation of symptoms across several psycho-social-bio domains. This study explored the symptom clusters that school-age children and adolescents who have experienced maltreatment exhibit and whether these children/adolescents can be differentiated from those without trauma histories. Using data from the Child and Youth Mental Health instrument, exploratory factor analyses of clinical items were completed for children/adolescents who have experienced maltreatment. Six factors for children (i.e., dysregulation in cognitive processes, dysregulation in self-concept, externalizing behaviours, violent or high-risk behaviours, indicators of withdrawal and depression, and hyperarousal and anxiety behaviours) and 5 factors for adolescents (i.e., externalizing behaviours, affect dysregulation, substance use, withdrawal and indicators of depression, and hyperarousal and dysregulation in cognitive processes) emerged. Discriminant function analyses using factors scores accurately differentiated children and adolescents who have experienced maltreatment from those who have not, 61.5% and 63.7% of the time respectively.

Summary for Lay Audience

Background. Children who experience prolonged interpersonal trauma, or complex trauma, often exhibit a myriad of symptoms across several psycho-social-bio domains and self-regulation difficulties. These include dysregulation in affect, physiology, behaviour, attention, and cognition, disturbances in self-concept, attachment difficulties, and post-traumatic spectrum symptoms. A separate diagnosis of Developmental Trauma Disorder (DTD) was proposed, but not included in the latest version of the Diagnostic Statistical Manual, to account for the diverse clinical presentations found among children who have experienced complex trauma. However, there are few studies that have examined the validity of the DTD construct, due to the novelty of the proposed diagnosis. Further research on how trauma reactions present in children across different ages is necessary to provide support for a developmental trauma diagnosis.

Objectives. This study explored the symptom clusters that school-age children (i.e., 4-11) and adolescents (i.e., 12-18) who have experienced maltreatment exhibits and whether these individuals can be differentiated from those without trauma histories based on clinical presentation.

Methods. Data from the interRAI Child and Youth Mental Health (ChYMH) instrument was obtained from mental health agencies across Ontario for an estimated 14 507 children and adolescents.

Results. Analyses were conducted to determine how items on the ChYMH grouped together to represent symptom clusters for children/adolescents who have experienced maltreatment. Six symptom groups for children (i.e., dysregulation in cognitive processes, dysregulation in self-concept, externalizing behaviours, violent or high-risk behaviours, indicators of withdrawal and depression, and hyperarousal and anxiety behaviours) and 5 symptom groups for adolescents (i.e., externalizing behaviours, affect dysregulation, substance use, withdrawal and indicators of depression, and hyperarousal and dysregulation in cognitive processes) emerged. Further analyses revealed that scores on these symptom groupings were able to accurately differentiate between children/adolescents who have experienced maltreatment compared those who have not.

Implications. This study contributes to the growing body of literature that examines the varied effects complex trauma has on children/adolescents and lends preliminary support for DTD. Understanding symptom presentations of children/adolescents who experience trauma at different stages of development will inform the establishment of developmentally appropriate interventions for children and youth accessing mental health services across Canada.

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