In the News

By Erin Holaday Ziegler

LEXINGTON, Ky. (Aug. ##, 2011) — The effects of trauma on a child's life and well-being are internationally recognized, but the differences in trauma outcomes for boys and girls are less well-known.

Ginny Sprang, the Buckhorn Professor of Child Welfare and Children’s Mental Health at the University of Kentucky and Director of the Center on Trauma and Children, presented her latest gender-based trauma research at the European Conference on Traumatic Stress Studies in Vienna, Austria on June 3.

"In terms of epidemiological research, work in Europe is parallel to that of the U.S.," said Sprang. "Europeans take a broad perspective on child trauma and tend to be innovative in their approach to the assessment and treatment of traumatic stress."

Sprang and her colleagues Carlton Craig and Michele Staton- Tindall measured and compared the trauma scores of girls and boys at baseline, at three and six months into treatment, finding that girls had higher rates of post-traumatic stress disorder (PTSD) when they arrived into treatment than boys do.

After 3 months, both boys and girls were improving significantly, but the girls were still suffering more. After 6 months, gender differences remained, but the gap between PTSD scores in girls and boys narrowed.

"The majority of treatment gains were realized in that first three months," Sprang said.

One of the reasons for the gender differential during the first three months of treatment may have been related to the different types of trauma that girls are exposed to, according to Sprang.

"Girls more likely to be exposed to sexual trauma and more likely to endure more physical punishment than their male counterparts; boys are more likely to be exposed to non-sexual assaults, accidents, injuries and witnessing violence than girls." Sprang said.

While Sprang's research breaks new ground in understanding the role that gender plays in trauma treatment, many questions remain.  "We see some similarities in how adults and children respond to trauma exposure” said Sprang. "But we really have a lot to learn in terms of how children at different developmental stages experience and report symptoms, and how they will respond to different treatments at various points in time. Some of the tools that are commonly used to measure traumatic stress symptoms in younger children are not developmentally sensitive enough, and we see problems with underreporting of symptoms in children who have been traditionally considered old enough to self-report."

Even within the field of child psychotherapy, studies have demonstrated consistent patterns of recovery in children suffering from conduct disorders and depression. "But the way children respond to trauma treatments seems to differ from response patterns noted in the general child psychotherapy literature," said Sprang.

The nature of the trauma exposure is often an important determining factor in how children will respond to treatment.  For example, children adversely affected by interpersonal trauma in their family might have continued exposure to their perpetrator, unless the court terminates the parent’s rights. "These kids can't always protect themselves," said Sprang. "A child may be forced into visitation with the perpetrator, so they are being re-exposed and retriggered on a regular basis, which complicates the treatment."

The next step for Sprang and her team is to find out exactly why girls are taking longer to recover in treatment than boys "One of the issues we're interested in is how the characteristics of the therapist or the intervention may impact the way that boys and girls receiving trauma treatment"  Sprang said.

Most of the available child traumatic stress treatments are not gender-specific. "At the Center, our role is to adapt interventions to be sensitive to gender, culture, trauma type and/or real world application," said Sprang. “Making these adaptations, and ensuring the essential elements of the intervention stay intact is an example of the translational work we do at the Center, and one of the biggest challenges to the field of child trauma treatment and research".

Conference proceedings from Sprang’s presentation at the European Conference on Traumatic Stress in Austria will be published in a supplement to the European Journal of Psychotraumatology.

As reality television has shown us in recent years, life with all its twists and turns is in essence a "real world" laboratory. Triumphs and tragedies cause various positive and negative reactions that ripple through family circles, as well as communities. When life is simple, the impact people have on each other can be a blessing. But when Therapist with a mother and child tragedy and suffering strike, it is not uncommon for some to take anger out on the most innocent and weak among us – children.

The challenges of doing research and science-informed clinical work with children and their families are daunting. Scientific inquiry is often thwarted by the complex problems and conditions that children and families face. In fact, according to the National Research Council’s Institute of Medicine, scientists and professionals have barely begun to use our growing research capabilities to help children and families negotiate the changing demands and possibilities of life in the 21st century.

Faculty members at the University of Kentucky Center for the Study on the Violence Against Children (CSVAC) are responding to this challenge by following a scientific agenda that is translational and multidisciplinary in focus. By calling upon researchers from many different backgrounds, the Center is developing treatments that can truly help children where they live and go to school. Due to CSVAC’s focus on utilizing and applying the latest advancements in brain development and innovative social science research, CSVAC has become an invaluable resource to the scientific and clinical community.

CSVAC is a translational research center that uses clinical practice, research and training on child and family trauma in an effort to address the detrimental effect of violence against children in the Commonwealth, as well as the nation. Their primary mission is to understand, treat, and eliminate violence against children.

Since 2000, UK's College of Social Work and Department of Psychiatry in the College of Medicine have provided the staff to implement CSVAC's innovative care and clinical practice to children and families in the state's most challenging child welfare cases. With every child and family entering the clinic, whether it is a biological or a foster/adoptive family, the staff works tirelessly to attain their goal of finding the best ways to reduce the effects of violence on children.

CSVAC was a recent recipient of one of 10 Community Treatment and Services Center grants from the Substance Abuse and Mental Health Services Administration. The grant, which is designed to promote and evaluate effective treatment systems in community and youth-oriented settings, provided the new center with $1.6 million over a four-year period to promote CSVAC's enhanced network systems for clinical, methodological, policy, financing and training issues. Likewise, the grant officially establishes CSVAC as a member of the National Child Traumatic Stress Network.

As a grant recipient, CSVAC used this federal funding to establish the Child and Adolescent Trauma Treatment and Training Institute, which provides clinical training and information on 'best practices' to child welfare programs throughout Kentucky to help children and their families recover from psychological trauma.

Story and image courtesy of UK Public Relations.

NCTSN Welcomes the Center for the Study on the Violence Against Children to Child Trauma Network

The University of Kentucky Center for the Study on the Violence Against Children (CSVAC) has won a competitive federal grant to join a national network of child trauma centers that provide services and support to children and families who are exposed to a wide range of traumatic experiences including physical and sexual abuse, domestic, school and community violence, natural disasters and terrorism, and life-threatening injury and illness.

With the four-year grant, CSVAC becomes a member of the National Child Traumatic Stress Network (NCTSN), whose mission is to improve the quality, effectiveness and availability of services for children and families who experience traumatic events.

With this new funding, CSVAC will establish the Child and Adolescent Trauma Treatment and Training Institute (CATTTI) which will provide treatment to child victims of trauma using three specific evidenced-based treatments (Parent Child Interaction Therapy, Trauma-Focused Cognitive Behavioral Therapy, and Abuse-Focused Cognitive Behavioral Therapy). Through a collaborative approach, CATTTI will also train partners in multiple regions across the state of Kentucky in providing these interventions to children in need using a “train the trainer” approach. Research will be conducted that will advance our understanding of the impact of trauma on the children in our state and the implementation of these services.

“We are honored that CSVAC was chosen as one of the select group of organizations to participate in this national endeavor," said Ginny Sprang, Ph.D., Principal Investigator for the project, Director of CSVAC, and nationally recognized expert in trauma. "This grant will provide us with opportunities to adapt and test best practice approaches to treating traumatic stress in children exposed to violence.”

“We are very excited about the opportunities this grant and involvement in the NCTSN will provide to enhancing the access of Kentucky’s children to effective trauma-related interventions,” said Heather Risk, Psy.D., Project Director of CATTTI.

The NCTSN grants are funded through the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Health and Human Services. Congress created the National Child Traumatic Stress Network in 2000 in response to the growing need of children exposed to trauma in the United States. Soon after its launch, the NCTSN mobilized to respond to the terrorist attacks of September 11, 2001. Since then, NCTSN members have responded to numerous traumatic events, including Hurricanes Katrina and Rita and the Virginia Tech shootings.

Combining knowledge of child development, expertise in child traumatic stress, and attention to cultural perspectives, the NCTSN supports the development and broad adoption of evidenced-based and trauma-informed treatments. The NCTSN is a collaboration of more than 70 academic, clinical and community service centers, including the UCLA Neuropsychiatric Institute and Duke University Medical Center, which co-direct the Network through the National Center for Child Traumatic Stress.

“With each new cohort of Network members, we expand the knowledge base of this relatively new field,” said Robert Pynoos, M.D., co-director of the National Center for Child Traumatic Stress for UCLA. “Children who experience trauma need all of us to work to improve care and increase access.”

NCTSN member centers help children and adolescents exposed to all forms of trauma. National surveys suggest that by their 16th birthday, 25 percent of American children are exposed to at least one significant traumatic experience.

“The local organizations that comprise the NCTSN are our strength,” noted John Fairbank, Ph.D., co-director of the National Center for Traumatic Stress for Duke University Medical Center. “We are very pleased to be moving forward together to the benefit of children and families across America.”