Background Best practice in the assessment of child trauma symptoms involves collecting reports from multiple informants, including both children and caregivers. However, previous research has shown that caregiver and child reports of child trauma symptoms often differ. Objective This study examined whether child- and caregiver-level protective factors were associated with the degree of concordance between caregiver and child reports of trauma symptoms among children receiving mental health services following exposure to child maltreatment. Participants and Setting Seventy-one children aged 8 to 17 and their caregivers were recruited from the [anonymized] Child and Youth Advocacy Centre in [anonymized] to participate in this study. Methods A retrospective file review was conducted to obtain demographic information and the child’s exposure to adverse childhood experiences (ACEs). Children and their caregiver also completed questionnaires to assess trauma symptoms, as well as personal and caregiver protective factors. Findings Results indicated moderate concordance between caregiver and child reports of trauma symptoms (ICC = .59, p < .001). Child age, child gender, and ACEs were not significantly associated with concordance. Children’s perceptions of caregiver warmth and support was associated with lower discordance (β = –.38, p = .005). Conclusion These findings suggest that caregiver protective factors, such as the quality of the caregiver-child relationship, may influence the extent to which caregivers and children agree in their reports of trauma symptoms. They underscore the importance of considering relationship factors when interpreting discrepancies between informants and support the inclusion of caregivers in trauma-focused interventions aimed at strengthening caregiver-child relationships.

BACKGROUND:Key inquiries into Problematic Sexual Behavior (PSB) in children include identifying risk factors, descriptive characteristics, and evaluating treatment outcomes of PSB populations. Cognitive Behavioral Therapy for PSB (PSB-CBT) is an evidence-informed and developmentally appropriate intervention. However, further research is needed to assess PSB-CBT in community clinics. OBJECTIVE:To provide a descriptive overview of population characteristics and to explore treatment outcomes of a PSB-CBT intervention program offered at a Child and Youth Advocacy Centre (CYAC). PARTICIPANTS AND SETTING:Participants included 61 children and their families who attended a PSB-CBT treatment group in person at a CYAC between 2015 and 2019 (83.6 % male; Mage = 8.9 years). METHODS:A retrospective case file review was conducted. Descriptive characteristics were extracted from case files and summarized. Dependent comparison analyses were conducted to examine pre-post differences in caregiver-reported sexual behaviors, parenting stress, clinical symptoms, and self-reported trauma symptoms. RESULTS:Children who engaged in a PSB-CBT intervention and their families displayed varied sociodemographic, adversity, symptom, and sexual behavior characteristics. Pre- to post-intervention decreases were observed in sexual behaviors t(29) = 4.40, p < .001 and parenting stress t(27) = 2.16, p = .012. Decreases in clinical and trauma symptoms were generally not observed. CONCLUSIONS:Descriptive characteristics of children with PSB reflect a heterogeneous sample, aligned with a developmentally informed understanding of PSBs in children. Results support findings that PSB-CBT within CYACs is a developmentally appropriate treatment to reduce sexual behavior problems and parenting stress. Providing best-practice treatments to children with PSB and their families would be supported by further empirical research examining PSB-CBT.

Childhood trauma refers to deeply distressing or profoundly overwhelming experiences, such as abuse or violence, that are associated with long-term health and mental health challenges. In the absence of psychological interventions and support, children exposed to trauma are at risk of post-traumatic stress disorder and other mental health difficulties. Most children and families face long waitlists for trauma treatment, despite evidence suggesting that addressing child trauma symptoms early is beneficial for their recovery. While families wait to receive treatment, there is a window of opportunity where resources could be provided to reduce the development of trauma symptoms and help families cope with the acute impacts of trauma exposure. To meet this need, clinicians and researchers partnered to launch Caregiver Online PsychoEducation (COPE; www.copewithtrauma.org) to provide caregivers with easily accessible, evidence-based information on how to understand and support their child's child trauma symptoms. From the perspective of clinicians and researchers, this paper describes the rationale and development of COPE, provides a brief overview of its contents, reviews plans for evaluation and implementation, and discusses its potential reach.

BACKGROUND:Among children under the age of 18, approximately 58 % report experiencing one or more adverse childhood experience (ACE). Exposure to ACEs is consequential for children's development and increases risk of poor physical and mental health outcomes across the lifespan. Resilience science suggests that protective factors within a child's social ecology can mitigate the impact of ACEs on outcomes. OBJECTIVE:The current study examines how personal and caregiver protective factors moderate the association between cumulative ACEs and child trauma symptoms in a sample of children receiving psychological services for maltreatment. METHODS:A retrospective file review of 71 participants aged 8 to 17 (M age = 12.6, SD = 2.5, 78.6 % girls) seen at a child and youth advocacy centre was conducted. Participants also completed questionnaires to assess trauma symptoms and protective factors. RESULTS:Analyses revealed that children's personal protective factors, such as perceived peer support, internal locus of control, and future orientation (r = -0.51, p < .001), as well as caregiver protective factors (r = -0.39, p = .010), were negatively correlated with their trauma symptoms. Furthermore, child personal protective factors were found to moderate the association between ACEs and trauma symptoms (β = -1.84, p = .036), suggesting that these factors mitigate the risk of cumulative ACEs. Caregiver protective factors did not moderate this association (β = -0.5, p = .700). CONCLUSIONS:This study highlights the importance of embedding intrapersonal and interpersonal skills training in trauma-based intervention programs and encourages further research into the impacts of protective factors at different phases of child development.

Background: Exposure to sexual content, such as online pornography or live sexual content, has been posited in the literature as a risk factor for problematic sexual behaviors (PSBs) in children and adolescents, and has been identified as an important avenue for research and intervention, particularly given the ubiquitous access to technology among children. Objective: To examine the association between live/violent and non-violent sexual content exposure and PSB among children and adolescents. Objectives also include informing future research on sexual content exposure as a risk factor for PSB, and providing clinical recommendations related to prevention and intervention. Participants and setting: Results are based on 16,200 participants (28.65 % female; Mage = 14.26; range = 4.74-17.92) and 27 studies conducted in North America, Europe, Asia, and Africa. Methods: A systematic review was conducted of available literature published up to September 2021. Abstract and full-text review were conducted to assess whether studies met inclusion criteria. Random-effects meta-analyses were conducted on included studies. Results: Significant associations were found between exposure to non-violent sexual content and likelihood of engaging in PSB (OR = 1.82; p < .001; 95 % CI: 1.50-2.21), and between exposure to violent/live sexual content and PSB (OR = 2.52; p < .001; 95 % CI: 1.75-3.61). Sex emerged as a moderator of the association between exposure to non-violent sexual content and PSB, such that the association was stronger in studies with a greater proportion of females. Conclusions: Results support the need for future research on risk factors and mechanisms implicated in PSB. Prevention and intervention programs for children with PSB and their families could benefit from incorporating education on sexual content exposure.

There is now a growing understanding that translational research must be co-created in collaboration with community partners and that solutions to real-world social problems require stepping outside the academic silo. Fewer than half of psychology programs in Canada, however, offer courses in community-based research or evaluation, leaving a gap in skill development amongst the next generation of scholars. In an effort to partially fill this learning gap, the current paper provides insights into lessons learned from the perspectives of researchers and community partners alike, who have been mutually engaging in community-based research over the last 25 years. Ultimately this paper seeks to provide a roadmap for conducting community-based research and illustrates why it should be a central component to research seeking to answer critical questions in psychological science. First, we provide a conceptual foundation of community-based research. Next, using three specific community-based research projects as examples, we share the challenges and benefits of conducting research in the community context. Finally, we highlight future directions for increasing the uptake of community-based research in Canada.

Children exposed to child sexual abuse (CSA) vary considerably with regards to their presenting concerns and treatment needs. One factor creating heterogeneity amongst children experiencing CSA is their history of experiencing other victimizations (i.e., poly-victimized or not). However, little is known about risk factors for poly-victimization as well as differences in protective factors among these two groups. Additionally, there is currently limited understanding of whether poly-victimization is associated with greater trauma symptoms in children exposed to CSA and being seen for trauma treatment. Using a clinical sample of 117 children who were sexually abused (64 CSA only and 53 poly-victimized) ranging from age 3–18 years, the current study examined demographic characteristics, abuse characteristics, trauma symptoms, and protective factors using casefile review methodology. After accounting for other risk factors, parental abuse history and protective factors were significantly associated with child poly-victimization status. Children exposed to poly-victimization were more likely to have financial concerns χ(1,115)2 = 4.16, p = 0.04, parents with abuse histories χ(1,117)2 = 8.93, p = 0.003, and parents with histories of mental health or substance use difficulties χ(1,117)2 = 4.02, p = 0.045. Although cumulative trauma symptoms scores were higher for children who were poly-victimized compared to CSA only, t(115) = −2.24, p = 0.03, multiple regression analyses showed that poly-victimization status was not significantly associated with child trauma symptoms after accounting for other demographic and abuse characteristics. Assessing and understanding the extent to which children exposed to CSA have experienced other forms of maltreatment is critical for identifying children who may be most at risk of poor outcomes.

OBJECTIVE:There is a dearth of Canadian-based literature on children referred to treatment services following maltreatment exposure. In order to inform assessment, intervention, and program development to improve outcomes, insight into the demographics and mental health needs of this population is required.METHODS:A retrospective file review of 176 children and youth who were referred for assessment and treatment at a mental health partner agency within a Canadian Child Advocacy Centre was conducted from January 2016 to June 2017. A standardized protocol was developed to extract data on family and child demographic characteristics, type of maltreatment, other adversity exposure, presenting concerns of the child, and mental health service utilization.RESULTS:The majority of children were female (66.5%), 4.5% were 0 to <5 years, 66.5% were 5 to <13 years, and 29.0% were 13 to <18 years of age. More than half of the children (53.4%) had multiple forms of maltreatment, with 67% exposed to sexual abuse. Exposure to other forms of adversity was also common, including domestic violence (53.4%) and parental mental health difficulties (52.3%). Most children had more than five presenting concerns at the time of referral, and most went on to receive intervention services. Sixty-nine percent of families had not previously received child mental health treatment, although 41.5% had prior child welfare involvement. Thirty percent of families ended treatment prematurely.CONCLUSIONS:The current study illustrates the complex profile and mental health needs of children referred for treatment following maltreatment exposure. Results may have implications for clinical care improvement that support maltreated children.

Background: Although the buffering effect of protective factors on children's outcomes following exposure to adverse childhood experiences has been well documented, research gaps remain as to whether this buffering effect differs based on the type of adversity experienced (i.e., maltreatment versus household dysfunction). Objective: To examine whether protective factors moderate the association between cumulative adversity, as well as adversity subtypes (i.e., maltreatment and household dysfunction) and child trauma-related distress in a clinical sample referred for treatment following exposure to adversity. Participants and setting: One-hundred and seventy-six children (aged 3-18) referred to a child abuse treatment clinic and who's files were opened between January 2016 and June 2017 were included. Methods: Data were collected, extracted, and coded from clinical files using a standardized data extraction protocol. Protective factors included: using individual coping strategies, peer support, individual social skills, caregiver physical caregiving, caregiver psychological caregiving, and educational involvement. Results: Cumulative childhood adversity (b = .16, p = .04) positively predicted child trauma-related distress. The link between exposure to cumulative adversity and child trauma-related distress varied as a function of protective factors: there was a positive association between adversity and child trauma-related distress for children who had low levels of protective factors, but not for those with high levels of protective factors (b = -0.56, p= < .001). Similar findings were observed when data was stratified by maltreatment and household dysfunction. Conclusions: Bolstering children's protective factors prior to, and during child abuse treatment, may reduce trauma-related distress following exposure to adversity.

The ongoing COVID-19 pandemic has led to unprecedented disruptions and stress in the lives of children and families internationally. Heightened family stress and turmoil can increase risk for, and exacerbate, child maltreatment. As a result, child maltreatment experts are concerned that there will be an influx of children requiring trauma assessment and treatment during and after COVID-19. As physical distancing measures have been implemented and will likely persist into 2021, organizations providing trauma treatment to children and their families have had to rapidly pivot to telemental health to maintain service delivery with clients. While the benefits of telemental health have been identified, including reduced barriers to access, increased cost effectiveness, and broad availability of services, there are unique limitations to its implementation within a child maltreatment population, such as challenges with attention and emotion regulation skills, difficulties identifying dissociative symptoms, and increased time with perpetrators of abuse due to shelter in place orders. These limitations are exacerbated for children and families who are most marginalized and facing the highest levels of social and economic barriers. Lack of access to reliable technology, lack of a private or confidential space for sessions, and reluctance to process trauma in the absence of a safe environment, are all barriers to conducting effective trauma treatment over telemental health. This article discusses both the benefits and barriers to telemental health in a child maltreatment population and offers considerations for child trauma service provision, program development, and policy during and post the COVID-19 pandemic.

The Children’s Depression Inventory (CDI) is frequently used to screen for the symptoms of depression and suicidal thinking during psychological or neuropsychological evaluations. This includes assessment of children with neurological conditions who are at risk of experiencing suicidal thoughts due to general cognitive, psychiatric, and neurological deficits. The purpose of this study was to examine the prevalence and correlates of suicidal thinking and symptoms of depression in youth with neurological disorders, as measured by the CDI. We expected that reporting suicidal ideations would most often occur in children with epilepsy and individuals with low IQ, and positively correlate with impulsivity.

Summary Objective Cognitive rehabilitation ( CR ) is a well‐researched therapeutic option for a variety of neurocognitive problems. Recently, CR has been proposed as an option for patients who experience cognitive difficulties following epilepsy surgery ( ES ). However, there is inconsistency in reporting the efficacy of CR in this population. We appraise existing evidence regarding CR approaches in patients undergoing resective ES and review effectiveness of specific CR strategies. Methods A comprehensive literature search using MEDLINE , Embase , CINAHL , Psyc INFO , and EBM Reviews (including the Cochrane database) identified studies in English published before September 2014, without age restriction, related to CR in patients who underwent resective ES . We included studies focused on patients who underwent ES and who received at least one type of cognitive rehabilitation. Results Of 2,059 citations identified, four fulfilled eligibility criteria (n = 577), and all investigated the effectiveness of specific CR strategies in patients with either left or right temporal lobe resections. CR strategies used included internal compensatory strategies, external memory aids, psychoeducation, verbal and visual memory training, and exercises of attention and executive functions. None were randomized trials, and only one study involved standardized methods or described the procedures in detail. Evidence suggests that CR may contribute to improvements in aspects of verbal memory, with particular benefit of visual imagery techniques; CR aimed at verbal memory functions may be less effective for patients with hemispheric‐dominant resections, and figural memory may not be improved by CR . Furthermore, CR may improve functional and life outcomes, but its timing does not appear to influence its effectiveness. Significance We demonstrate that CR interventions are overwhelmingly under researched or underreported, and there is a need for a systematic evaluation of CR in this patient population. CR should be given greater attention after ES to determine its efficacy and role in the management of these patients.

OBJECTIVE:Childhood maltreatment is associated with subsequent parenting difficulties; however, most research has relied on self-reported parenting outcomes, and observational measures have revealed mixed findings. Furthermore, research has focused predominantly on histories of sexual and/or physical abuse. This study explored associations between a wide range of childhood maltreatment experiences and both observed and self-reported parenting outcomes.METHODS:Mothers of 4- to 6-year-old children at moderate social risk completed the History of Maltreatment and Trauma Form (HMTF), which assesses a range of maltreatment experiences and delineates specific characteristics such as chronicity and severity. Participants completed questionnaires assessing parenting stress and competence, and their emotional availability (sensitivity, intrusiveness, hostility) toward their children was coded from videorecorded interactions.RESULTS:Construct (factorial, convergent and discriminant) validity of the HMTF was demonstrated through factor analysis and a multi-trait, multi-method matrix comparing it to the Childhood Trauma Questionnaire. HMTF-assessed childhood maltreatment, specifically witnessing family violence, neglect and emotional maltreatment, were significantly associated with mothers' observed hostility toward their children, even after controlling for potentially traumatic adult experiences. In contrast, childhood sexual abuse history was associated with self-reported concerns regarding parenting competence, and this association held even after controlling for other forms of childhood maltreatment and potentially traumatic adult experiences. Self-reported parenting outcomes were unrelated to observed parenting behavior.CONCLUSIONS:Findings highlight the complexity of associations between child maltreatment and subsequent parenting outcomes. Although much previous research has focused on sexual and physical abuse, other more contextual forms of maltreatment may be similarly or more strongly associated with certain parenting outcomes. Furthermore, different forms of maltreatment may be associated with perceived versus observed parenting outcomes.