Children who have experienced trauma: An examination of the role of race, ethnicity, and cultural factors in presenting symptoms and at three months (or first recorded) follow up

CHILDREN WHO HAVE EXPERIENCED TRAUMA: AN EXAMINATION OF THE ROLE OF RACE, ETHNICITY, AND CULTURAL FACTORS IN PRESENTING SYMPTOMS AND AT THREE MONTH (OR FIRST RECORDED) FOLLOW UP By Stephanie Susanne Genser Wolf, M.S., J.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2013 Major Director: Barbara J. Myers, Ph.D. Associate Professor of Psychology, Director Developmental Psychology Child traumatic stress is a pervasive problem that affects the well-being and healthy development of children from all races, ethnicities, and cultures. Major factors known to affect trauma symptoms include type of trauma, level or severity of trauma exposure, and age and gender of children. Utilizing Bronfenbrenner’s ecological model, this study measured the additional influence of children’s race, ethnicity, and cultural factors on symptoms after trauma. A dataset of children in treatment after experiencing trauma (0-21 years, N = 10,115) from The National Child Traumatic Stress Network (NCTSN), a federally funded initiative that collected longitudinal data across 56 research and treatment centers in the US, was examined, looking at clinical symptoms at baseline and at three month (or first recorded) follow-up. Predictors for symptoms included number of trauma types, age, gender, race, ethnicity (Latino/non-Latino), and three cultural markers, born outside the United States, English as the primary language not spoken at home, and refugee/immigrant status. Results (hierarchical regressions, logistic regressions) confirmed that age, gender, and number of trauma types predict the scores and clinical level of eight validated outcomes (e.g., CBCL externalizing, internalizing; PTSD measures) as well as the total numbers of functional problems and clinical problems. Results also demonstrated that race, ethnicity, and culture affect symptoms but to a very small extent (i.e., these accounted for little variance) and in varying directions. For example, Black/African American children had lower internalizing scores compared to White/Caucasian children, while being Latino was associated with lower externalizing and higher internalizing scores than non-Latinos. Children with differing cultures sometimes scored better, sometimes worse, than their counterparts. For example, children who spoke English at home and were born in the United States had more functional problems, though fewer clinical problems. At three month (or first recorded) follow up, results demonstrated all children’s scores improving. No differences at three month (or first recorded follow up) were found between our predictors in clinical rates except for children with more types of trauma who continued to show a greater likelihood of falling into the clinical range for externalizing and internalizing. Discussion focuses on the possible protective effects of cultural factors and the importance of an ecological model in understanding trauma symptoms in diverse populations.