(PS6-35) Childhood Strengths and Needs as Mediators of the Pathway from Interpersonal Trauma to Posttraumatic Stress Symptoms Among Youth in Psychiatric Residential Treatment

Introduction: Interpersonal trauma (IPT) exposure is a well-established precursor to adverse psychological and socioemotional functioning, as well as severe psychiatric conditions such as posttraumatic stress disorder (PTSD; Overstreet et al., 2017). Outcomes subsequent to IPT in youth are often heterogenous (i.e., multifinality) given the multitude of factors that influence developmental processes (Cicchetti & Rogosch, 1996). Importantly, optimism and resilience are identified as promotive factors for healthy development among both traumatized and non-traumatized youth (Chen et al., 2021). Further, attachment difficulties are identified as a risk factor for youth development (Pham et al., 2021). How these factors influence the presence of posttraumatic stress symptoms (PTSS) following IPT in youth has yet to be determined.

 

Method: The current study explored individual child strengths and needs as mediators of the relationship between IPT and PTSS in a sample of 127 youth (55% Female; 67% White, 33% Black or Biracial) ages 6-17 (M = 11.8) enrolled in a Psychiatric Residential Treatment Facility (PRTF) in Northwestern Pennsylvania. Following routine clinical intake procedures, each child was administered the Child and Adolescent Needs and Strengths – Trauma Version (CANS – Trauma), as well as self-report measures of current trauma symptoms (TSCC or TSCYC). Two separate mediation models explored total child strengths and needs in the relationship between IPT and PTSS, with the inclusion of age and number of diagnoses as covariates. The mediation models were analyzed using Hayes’ PROCESS macro (model 4) for IBM SPSS Statistics (Version 28.0).

 

Results: Neither child strengths nor needs were observed as significant mediators in their respective models, despite significant total effects in both (i.e., path c’; IPT  PTSS). In an exploratory model with attachment difficulties as the mediator, mediation was not observed (indirect effect = -.42, SE = .19, 95% CI = [-.82, -.08]), but attachment difficulties demonstrated a suppression effect on IPT and PTSS in exploratory analyses, as path c’ increased in significance (p < .001) when accounting for the indirect effect (direct effect = 1.02, SE = .31, 95% CI = [.40, 1.64]). To understand whether child strengths and needs act as independent predictors of PTSS in conjunction with IPT, a linear hierarchical regression was conducted. The final model accounted for approximately 31.6% of the variance in PTSS (F [1,121] = 4.49, p = .04), wherein age at admission (b = -.52, p < .001), IPT (b = .17, p = .03), child strengths (b = -.19, p = .01), and child needs (b = .16, p = .04) were significant predictors.

 

Discussion: Results from the current study suggest that child strengths and needs do not account for the impact of IPT on PTSS to any degree. In fact, inclusion of attachment difficulties in the model even increases the predictive validity of IPT for PTSS. Instead, child strengths and needs appear to be orthogonal contributors to PTSS alongside IPT. Results align with prior research indicating the adverse effects of childhood IPT exposure (Overstreet et al., 2017) and attachment difficulties (Pham et al., 2012). Additionally, they reaffirm the protective role of childhood strengths (Masten, 2014).