Дисертації з теми "Childhood traumatic experiences"

In directed forgetting research, participants are instructed to forget information recently learned, and asked instead to remember new information given later. When asked to recall both the to-be-remembered and the to-be-forgotten information, participants successfully exhibit directed forgetting by recalling more to-be-remembered material, than to-be-forgotten material. In the present study, two directed forgetting list method experiments were conducted on undergraduate students of psychology (n = 25; n = 78). The aim of the study was to see if retrieval inhibition between participants with or without traumatic childhood experiences differed, when presented with negative or positive words. All participants were screened for childhood trauma with the CTQ-SF. The participants in the second experiment were additionally screened for dissociation with the DES-II. While Experiment 1, possibly due to small sample size failed to attain a directed forgetting effect, Experiment 2 succeeded. The issue of childhood trauma did not influence the directed forgetting effect.

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Purpose We sought to evaluate the extent to which childhood physical and/or sexual abuse history is associated with post-traumatic stress disorder (PTSD) during early pregnancy and to explore the extent to which the childhood abuse-PTSD association is mediated through, or modified by, adult experiences of intimate partner violence (IPV). Methods In-person interviews collected information regarding history of childhood abuse and IPV from 2,928 women aged 18-49 years old prior to 16 weeks of gestation. PTSD was assessed using the PTSD Checklist-Civilian Version. Multivariate logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results Compared to women with no childhood abuse, the odds of PTSD were increased 4.31-fold for those who reported physical abuse only (95% CI, 2.18–8.49), 5.33-fold for sexual abuse only (95% CI, 2.38–11.98), and 8.03-fold for those who reported physical and sexual abuse (95% CI, 4.10–15.74). Mediation analysis showed 13% of the childhood abuse-PTSD association was mediated by IPV. Furthermore, high odds of PTSD were noted among women with histories of childhood abuse and IPV compared with women who were not exposed to either (OR = 20.20; 95% CI, 8.18–49.85). Conclusions Childhood abuse is associated with increased odds of PTSD during early pregnancy. The odds of PTSD were particularly elevated among women with a history of childhood abuse and IPV. Efforts should be made to prevent childhood abuse and mitigate its effects on women's mental health.
Revisión por pares

The present exploratory study examined adverse childhood experiences and religiosity in a sample of individuals from Southern Appalachia. Self-reports of childhood adversity and intrinsic religion were obtained from 167 individuals. Results showed that fifty-five percent had not experienced a childhood adversity while forty-three percent had experienced one to five episodes. Although a little under half the sample had one or more adverse experiences, there was no significant relationship between ACEs and intrinsic religion (r= -.037, p= .631). Sex and intrinsic religion were significantly related in that men endorsed the use of intrinsic religiosity more than women (t(165)= -2.28, p= .005).

Background An increasing body of research is suggesting that childhood trauma and adversity may be associated with various adverse mental health outcomes, including psychosis. Cognitive functioning is often compromised in psychosis, and research has shown that there may be a link between early trauma and cognitive impairment in people with psychosis. No systematic review of the literature of this link has been undertaken, and very few studies have examined samples of individuals at high clinical risk for psychosis, to assess whether the potential link between adversity and cognitive functioning exists, without the confounding factors of length of illness, antipsychotic medication and chronicity of symptoms. Method The systematic review of all relevant electronic databases investigates the research to date on the association between childhood adverse experiences and cognitive ability in psychosis, and the conclusions that can be drawn from the existing literature, taking into account relevant considerations regarding sample, methodology and statistical analysis. The subsequent empirical study utilizes a sample at clinical high risk of developing psychosis, and a healthy control group to investigate whether any putative association in specific domains of cognitive functioning, or global cognitive ability and childhood adversity exist in those at clinical high risk, compared to controls. Results The systematic review indicated that at present, the literature looking into childhood adversity and cognitive ability in relation to psychosis is heterogeneous, with some studies finding that this association only occurs in patients, whilst others suggest it only occurs in the control groups. Some studies found it to be specific to certain cognitive domains, whilst others suggest it was a more global impairment. Methodology, samples and analysis differed considerably across studies, and likely contribute to the heterogeneity of the literature. The empirical paper showed a significant interaction effect between group (high risk versus controls) in the high childhood adversity group, in relation to global cognitive ability. Interestingly, this was not related to psychotic symptom severity or distress. Conclusion Several limitations of the existing studies limit the conclusions that can be drawn from the existing evidence regarding the link between childhood adversity and cognitive ability, and future research in prodromal samples is essential. The empirical study showed that there is a link between childhood adversity and cognitive ability in those at clinical high risk of developing psychosis, before disorder onset, that is not present in controls. This suggests that this may form a vulnerability in those at high risk for psychosis, rather than a more general mechanism present in the typical population.

It has been well documented that Adverse Childhood Experiences (ACEs) lead to unfavorable outcomes in later life, especially with regard to health and psychological outcomes. Recent research has demonstrated the impact of early childhood adversity on the onset of aggression and illegal behavior. However, often those with mental illness diagnoses with comorbid behavioral problems exhibit trajectories that include both arrest and hospitalization. While some are arrested for their criminal behavior, others are hospitalized. This begs the question: are those with mental illness and behavioral problems more likely to be arrested, or hospitalized, for their early behavioral problems? In the current study, it was hypothesized that arrest precedes hospitalization for the majority of these offenders, and that specific diagnoses of a mental illness are related to outcome. It was also hypothesized that early exposure to environmental adversity, as measured by the age of earliest ACE and total ACE score, would significantly predict whether offenders were arrested or hospitalized first. Other socio-ecological factors were also studied. The data for this study were gathered from a sample of 182 adult psychiatric inpatients in a secure forensic facility. Data were archival and retrospective in nature. All participants had been hospitalized following acts of violence or aggression, exhibiting a history of both behavioral problems as well as mental illness. A series of logistic and linear regressions were used to examine the relationship between reason for first admission to a psychiatric facility, diagnosis of a mental disorder, and early childhood adversity to clarify whether early problematic behaviors resulted in initial arrest or psychiatric hospitalization. Results indicate that subjects were much more likely to be hospitalized initially than arrested (33.5% arrested first, 66.5% hospitalized first). A diagnosis of impulse control disorder was significantly related to whether initial incident led to arrest or hospitalization (p=0.030), while the diagnosis of ADHD neared significance (p=0.056). No significant relationship was found between incidence of initial arrest or hospitalization and age that drug/alcohol abuse began. Other findings and implications for future research will be discussed.

Aims of the study This study investigated relationships between severity of Post Traumatic Stress Disorder, shame, anger and early childhood experiences (early maladaptive schemas and recalled patterns of parental bonding). Design of the study This is a non-experimental, cross-sectional study. Data was collected once, using a semistructured interview and self-report questionnaires. The Sample The sample was 50 individuals with a diagnosis of Post Traumatic Stress Disorder. On average the group had high levels of PTSD, depression symptoms and high levels of shame and anger. Main findings The study found that shame, anger and early maladaptive schemas (abandonment, social isolation, defectiveness/shame, incompetence and subjugation) were significantly associated with severity of PTSD. Shame was found to mediate the relationship between severity of PTSD and early maladaptive schemas and anger, respectively. Early maladaptive schemas mediated the relationship between low maternal care and shame. Finally this study found that shame emerges as the only independent predictor of the severity of PTSD when other variables (anger and early maladaptive schemas) are taken into account. This suggests that the relationships of anger and early maladaptive schemas to severity of PTSD are not independent of shame.Implication of findings These findings highlight the need to take into account the presence of emotions (such as shame and anger) and other psychological factors (such as early maladaptive schemas) when formulating clinical cases of PTSD and executing treatment plans. This is particularly important as many current treatment interventions are based on exposure therapy aimed at alleviating fear/anxiety based responses to trauma. Traditionally such treatments do not pay sufficient attention to shame and anger, which may worsen with exposure techniques and disrupt emotional processing of the traumatic event. Also the presence of early maladaptive Schemas may contribute to chronicity and maintenance of PTSD and may need to be addressed in any treatment plan.

It has been well documented that Adverse Childhood Experiences (ACEs) lead to unfavorable outcomes in later life, especially with regard to health and psychological outcomes. Recent research has demonstrated the impact of early childhood adversity on the onset of aggression and illegal behavior. However, often those with mental illness diagnoses with comorbid behavioral problems exhibit trajectories that include both arrest and hospitalization. While some are arrested for their criminal behavior, others are hospitalized. This begs the question: are those with mental illness and behavioral problems more likely to be arrested, or hospitalized, for their early behavioral problems? In the current study, it was hypothesized that arrest precedes hospitalization for the majority of these offenders, and that specific diagnoses of a mental illness are related to outcome. It was also hypothesized that early exposure to environmental adversity, as measured by the age of earliest ACE and total ACE score, would impact whether offenders were arrested or hospitalized first. The data for this study were gathered from comprised sample of 182 adult psychiatric inpatients in a secure forensic facility. Data were archival and retrospective in nature. All participants had been hospitalized following acts of violence or aggression, exhibiting a history of both behavioral problems as well as mental illness. A series of logistic and linear regressions were used to examine the relationship between reason for first admission to a psychiatric facility, diagnosis of a mental disorder, and early childhood adversity to clarify whether early problematic behaviors resulted in initial arrest or psychiatric hospitalization. Results indicate that subjects were much more likely to be hospitalized initially than arrested (33.5% arrested first, 66.5% hospitalized first). A diagnosis of impulse control disorder was significantly related to whether initial incident led to arrest or hospitalization (p=0.030), while the diagnosis Page 54 2016 Appalachian Student Research Forum of ADHD neared significance (p=0.056). No significant relationship was found between incidence of initial arrest or hospitalization and age that drug/alcohol abuse began. Other findings and implications for future research will be discussed.

In this research, two studies were conducted in order to examine the psychological, social, somatic and educational effects of chronic traumatic experience on Palestinian children over the six years of the Al-Aqsa Intifada (2000-2006). Firstly, a quantitative study was conducted which aimed to explore the long-term effects of war and occupation on the Palestinian children in the Gaza Strip. The sample consisted of 1,137 children aged between ten and 18 years randomly selected from all parts of the Gaza Strip to participate in the study. The participants completed a Checklist of Traumatic Experiences (CTE), a Symptoms of Post Traumatic Stress Disorder Scale (SPTSDS), a Network of Psycho-Social Support (NPSS) and a Personality Assessment Questionnaire (PAQ). This study found that every child in Palestine is likely to have been exposed to at least three traumatic events. Importantly, this study also found that 41% of the participants suffered from Post-Traumatic Stress Disorders (PTSD). This indicates that there are potentially more than 300,000 children in the Gaza Strip in need of psychological, social,and medical services in the areas of rehabilitation and therapeutic treatment. The study revealed that the support of family, friends, relatives, teachers, and spiritual leaders can be of great help. In addition to this, positive traits of personality can reduce the effects of PTSD. Secondly, a qualitative study aimed to explore, in more depth, the moderating factors relating to Palestinian children who have been exposed to chronic traumatic experiences, particularly the children who show low levels of PTSD. The sample consisted of six children interviewed in Arabic by using a semi-structured interview. They were aged between 13-18 years. The participants were selected according to the amount of traumatic events and level of PTSD experienced by the children who took part in the first study. This study found that the moderating factors and levels of influence which protected them from developing PTSD are positive personality traits and ideological commitment, psychosocial support, entertainment and adaptation or acclimatization. This research concluded that having a normal childhood in Palestine is unlikely in the current circumstances and the future psychological well-being of Palestinian children is at risk of being compromised by on-going traumatic experiences.

Les personnes présentant un trouble de la personnalité antisociale avec ou sans sévérité psychopathique (TPA ± P) adoptent des comportements majoritairement agressifs et en dehors des normes et lois, intimident, trompent, mentent et sont particulièrement indifférent aux sentiments, besoins et à la souffrance d'autrui. Ces comportements sont en partie sous-tendus par des difficultés dans les processus émotionnels. Les capacités de reconnaissance, d'expression et de régulation des émotions sont, en effet, décrits comme assez faibles dans le TPA. Ces difficultés semblent émerger tôt dans le développement, notamment chez les adolescents présentant un trouble des conduites (TC). Toutefois, les descriptions de ces processus émotionnels sont peu généralisables au regard du manque de validité écologique des protocoles les mesurant. Depuis quelques années, des recherches basées sur du matériel à haute implication personnelle et émotionnelle se sont développées, comme l'utilisation de matériel autobiographique et plus précisément le rappel de souvenirs définissant le soi (SDM). Jusqu'alors, ce matériel a été peu utilisé auprès de personnes présentant un TPA ± P et d'autant moins dans un contexte institutionnel médico-légal. L'objectif de ce travail de thèse était de mieux comprendre le fonctionnement des processus émotionnels en jeu lors du rappel de SDM auprès de personnes présentant un TPA ± P et auprès d'adolescents présentant un TC. Ce travail a permis de mettre en évidence les particularités des caractéristiques autobiographiques de ces personnes. Pour atteindre cet objectif, nous avons mené quatre études expérimentales. Tout d'abord, nous avons identifié les caractéristiques des SDM à travers le rappel de souvenirs spécifiques multiples, non intégrés et relatifs à la thématique des évènements de vie menaçant. Nous avons mis en évidence que les variables expérientielles expliquent mieux la signature autobiographique des personnes adultes présentant un TPA ± P que les éléments de personnalité (étude 1). Par la suite, nous avons observé les capacités d'activation, d'expression et de régulation des émotions à partir de mesures comme les indicateurs neurovégétatifs et les expressions faciales. Les personnes présentant un TPA avec sévérité psychopathique détiennent de meilleures capacités de régulation émotionnelle que celles ne présentant pas de sévérité psychopathique, notamment en réponses à des stimuli moins activateurs (étude 2). De plus, nous avons observé que leur expression faciale de colère est prédite par la sévérité du style de vie impulsif (étude 3). Enfin, dans une approche exploratoire, nous avons identifié que la signature autobiographique des adolescents présentant un TC ressemble à celles des adultes présentant un TPA ± P mais leur production faciale émotionnelle semble moins cristallisée sur l'émotion de colère, étant donné l'importante présence de la tristesse (étude 4). Ces études ont permis de souligner l'importance d'adopter une compréhension des processus émotionnels en fonction des profils psychologiques et symptomatiques des personnes présentant un TPA ± P. De plus, ces résultats soutiennent la nécessité d'intervenir précocement dans la trajectoire développementale en proposant des prises en charge axées sur l'intégration des expériences traumatiques, les relations (pro)sociales et les compétences émotionnelles
People with antisocial personality disorder with or without psychopathic severity (ASPD ± P) adopt predominantly aggressive behaviors that are outside the norms and laws, intimidate, deceive, lie, and are particularly indifferent to the feelings, needs, and suffering of others. These behaviors are partly underpinned by difficulties in emotional processes. The abilities to recognize, express, and regulate emotions are, in fact, described as quite weak in ASPD. These difficulties seem to emerge early in development, particularly among adolescents with conduct disorder (CD). However, descriptions of these emotional processes are not very generalizable due to the lack of ecological validity of the protocols measuring them. In recent years, research based on material with high personal and emotional involvement has been developing, such as the use of autobiographical material and more specifically the recall of self-defining memories (SDM). Until now, this material has been little used with people with ASPD ± P and even less so in a forensic institutional context. The objective of this thesis was to better understand the functioning of emotional processes involved in the recall of SDMs among people with ASPD ± P and among adolescents with CD. This work highlighted the particularities of the autobiographical characteristics of these people. To achieve these insights, we conducted four experimental studies. First, we identified the characteristics of SDMs through the recall of multiple specific, non-integrated and related to life threatening events theme memories. We demonstrated that experiential variables better explain the autobiographical signature of adults with ASPD ± P than personality elements (study 1). Subsequently, we observed the capacities of activation, expression, and regulation of emotions using measures such as neurovegetative indicators and facial expressions. People with ASPD and with psychopathic severity have better emotional regulation abilities than those without psychopathic severity, particularly in response to less activating stimuli (study 2). Furthermore, we observed that their hyperexpression of anger is predicted by the severity of their impulsive lifestyle (study 3). In an exploratory approach, we identified that the autobiographical signature of adolescents with CD resembled that of adults with ASPD ± P, but their facial emotional production seemed less crystallized on the emotion of anger, given the significant presence of sadness (study 4). These studies highlighted the importance of adopting an understanding of emotional processes based on the psychological and symptomatic profiles of people with ASPD ± P. Moreover, these results underscore the importance of early intervention in the developmental trajectory by offering treatments focused on the integration of traumatic experiences, social relationships, and emotional skills

BACKGROUND: Childhood traumatic experiences, including physical and sexual abuse, antipathy, and neglect, are significantly associated with higher risk of developing both mental disorders and medical conditions. AIM: To elucidate the effects of childhood trauma on health, especially mental health, taking into account some literature-selected biological, psychological, and social correlates. METHODS: Investigations were conducted in three different sample groups: (1) a group of First Episode Psychosis (FEP) patients belonging to the “Genetics, Endophenotypes and Treatment: Understanding early Psychosis” (GET UP) Research Project; (2) a group of hepatitis C patients included in the "Chronic Inflammation and Depression” Research Project; and (3) a sample of healthy subjects. In these three samples, childhood traumatic experiences were evaluated by the Childhood Experience of Care and Abuse Questionnaire (CECA) questionnaire (Bifulco et al., 2005): physical punishments, sexual unwanted experiences, loss, separation, antipathy, and neglect were investigated. HPA axis functioning, cannabis use, and glucose metabolism were investigated as potentially involved biological correlates. HPA axis functioning was estimated by measuring salivary cortisol levels, as both diurnal cortisol levels and Cortisol Awakening Response (CAR). The Cannabis Experiences Questionnaire (CEQ) (Barkus et al., 2006) evaluated cannabis use. The concentrations of C-peptide, Ghrelin, GIP, GLP-1, Glucagon, Insulin, Leptin, PAI-1, Resistin and Visfatin were determined using Bio-PlexPro™ Human Diabetes Assays (Bio-Rad, CA, USA). Coping strategies, age, gender, education, socio-economic status, and recent severe stressful life events were taken into account as potentially involved psychosocial correlates. RESULTS: (1) Significant associations between severe sexual abuse and a diagnosis of affective psychosis and between childhood trauma, severe sexual abuse in particular, and lifetime cannabis use were found in FEP subjects. No gender difference was detected. Moreover, C-peptide and insulin levels were found increased in traumatized FEP subjects. Indeed, we found that C-peptide was higher in patients who experienced childhood trauma (with or without severe life events), while Insulin was higher in patients who reported childhood trauma (with no mention of severe recent stressful life events), in comparison to FEP subjects without traumatic events. (2) In subjects affected by Hepatitis C, childhood trauma, parental antipathy, and neglect were found significantly associated with higher levels of depressive and anxious symptomatology and with greater emotional distress. Exploring different types of trauma, we found that subjects with a history of physical punishments demonstrated significantly increased levels of depression, emotional distress, and fatigue in comparison with subjects not recalling this history. An even stronger association was found between sexual unwanted experiences and levels of depression, anxiety, and emotional distress. Healthy subjects (3) with a history of childhood trauma showed higher lifetime frequency of positive psychotic-like symptomatology, while maternal antipathy was significantly associated with lower lifetime frequency of negative symptoms and lower levels of distress in response to depressive symptoms. Lifetime cannabis use and salivary cortisol levels were explored as potentially mediating factors, but no mediational effect was found. Finally, higher insulin levels were significantly associated in healthy subjects with physical abuse and childhood trauma plus severe life events (SLEs); Body Mass Index (BMI), which was also significantly associated with higher insulin levels, completely mediated the association with physical abuse, while childhood trauma plus SLEs and BMI gave independent contributions to higher insulin levels. Higher PAI-1 levels were found in subjects reporting childhood trauma and SLEs. Finally, physical abuse, severe sexual abuse and childhood trauma plus SLEs were found significantly associated with higher C-peptide levels. BMI completely mediated the association between physical abuse and C-Peptide, while severe sexual abuse or childhood trauma plus SLEs and BMI independently contributed to C-Peptide levels. CONCLUSION: Our findings confirmed the detrimental consequences of childhood trauma, even at non-clinical level. On the other side, some of our results evoked a potential increased resilience in subjects with a history of childhood traumatic experiences.

Abusive experiences in childhood are common and can have effects on health and well-being that can last for many years, including altering the interpersonal behavior. There is also evidence showing that these early negative experiences may cause alteration in sensory modulation. This study aimed to understand if sensory over-responsivity (SOR) may play an important role in mediating the association between childhood abuse (Emotional Abuse, Emotional Neglect, Sexual Abuse, Physical Abuse, Physical Neglect) and Attachment-related Anxiety and Avoidance in adult romantic relationships. The sample consisted of 500 individuals aged 18-62 years (M= 28.83, SD = 7.82). Participants in this study completed an online survey, which contained the following instruments: Sensory Processing Scale Inventory (SPSI), Childhood Trauma Questionnaire (CTQ-SF), and Experiences in Close Relationships Questionnaire (ECR). The proposed mediation models have a higher mediation percentage for attachment-related anxiety rather than avoidance. All variables predicted the mediator, except sexual abuse that predicts the outcome but did not predict the overall model when the mediator was included.

This study aimed at exploring the impact of early traumatic experiences on bariatric patients with the intent to give "voice" to their experiences. The impact of morbid obesity and the lack of quality of life among those suffering from this form of chronic illness can be devastating. Meaningful support systems and bariatric surgery are therefore considered as forced behavioural interventions to remediate the impact of childhood trauma and subsequent development of morbid obesity among this group of bariatric patients. Through a process of social constructivism and dialogue between the researcher and the five participants, the co-construction according to themes was supported by a qualitative research approach and the case study method. For the analysis of the themes according to the participants' "voices", the thematic content analysis method was used to analyse the data and was finally linked to supportive literature. It is hoped that the results from this study will contribute to the development of a unique assessment and support programme to those who have to endure the burden of morbid obesity associated with early childhood trauma; and that the process prior to and post bariatric surgery will be an important contribution to finding quality of life and giving new meaning to patients after suffering through their bodies and traumatised minds.
Psychology
D.Litt. et. Phil (Psychology)

Indiana University-Purdue University Indianapolis (IUPUI)
Epidemiologic studies suggest that depression is an independent risk factor for cardiovascular disease (CVD). Although several possible mediators of this association have been proposed, few studies have examined the role of moderators. Accordingly, I examined adverse childhood experiences (ACE) as a potential moderator of the depression-CVD association, given that individuals with a history of ACE show a greater inflammatory response to depression, and inflammation plays a role in the development of CVD. Data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analyzed. Participants were 29,282 adults (58% female, 42% non–white) aged 18–97 years, free of CVD diagnoses at baseline. Lifetime depressive disorder (LDD) was assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule–IV (AUDADIS–IV), and adverse childhood experiences (abuse, neglect, and household dysfunction), and CVD were assessed during separate interviews. The primary outcome was incident CVD (n = 1,255), defined as nonfatal arteriosclerosis, angina pectoris, myocardial infarction, and/or stroke reported during the Wave 2 interviews. All analyses were adjusted for demographic and traditional CVD risk factors. Logistic regression models revealed that both LDD (OR = 1.44, 95% CI: 1.28–1.62, p < .001) and any ACE (OR = 1.25, 95% CI: 1.16–1.35, p < .001) were independent predictors of incident CVD. Interactions between LDD x any ACE (p = .024), LDD x neglect (p = .003), and LDD x household dysfunction (p < .001), but not LDD x abuse (p = 0.16), were detected. Analyses stratified by the ACE variables revealed that LDD was a predictor of incident CVD among adults with a history of (1) any ACE (OR = 1.51, 95% CI: 1.32–1.73, p < .001), but not among those without a history (OR = 1.15, 95% CI: 0.87–1.50, p = .332); (2) neglect (OR = 1.59, 95% CI: 1.36–1.87, p < .001) and among those without a history (OR = 1.25, 95% CI: 1.07–1.62, p = .005); (3) household dysfunction (OR = 1.73, 95% CI: 1.46–2.04, p < .001), but not among those without a history (OR = 1.18, 95% CI: 0.96–1.43, p = .11). Overall, the present findings suggest that depression may be a stronger risk factor for CVD among adults with a history of ACE, especially neglect and household dysfunction, than among adults who did not have these experiences.

No
Existing research on the impact of growing up in care focuses upon either the care experience itself or the period of transition from care to independence. Our knowledge of outcomes largely ceases when former residents of the care system reach their early twenties. There are strong social justice reasons for extending research into the older adult lives of such young people. We know a great deal about the multiple disadvantages that such individuals face as children. But research is largely silent about their subsequent adult lives. While we must be cautious in drawing causal links to the childhood care experience as the time period since life in care extends, we know that early experiences can affect care-leavers across their life coursejust as childhood experience affects all adults in a variety of ways. In this review, we highlight evidence drawn from research in Australia, the United Kingdom, Canada, Ireland, and the United States, with particular attention paid to the first two of those countries. We use a wide range of sources and identify areas for further consideration, including access to personal records, mental health, education, and parenting. By doing so, we seek to open up this area for further research with the hope that such research will lead to an increasing recognition of care-leavers' needs and thus to improvements in social policy and service provision.

Masters Coursework - Masters of Clinical Psychology (MClinPsych)
Refugees experience multiple potentially traumatic events including conflict and human rights deprivations in their country of origin, perilous escape journeys, and isolation and discrimination in their new host country. The impact of these complex traumatic events on refugee children is a growing area of research. Therefore, this idiographic study explored the positive and negative interpretations of four adults reflecting on their experience of refugee status as children. Interpretative Phenomenological Analysis (IPA) guided data collection, through semi-structured interviews, and analysis. One theme: The violation and hope of refugee survival, overarched three subordinate themes: Violent detachment, Developing the refugee identity and Resourcefulness and reciprocity. One divergent theme emerged: Clashing cultural identities. These themes reflect the unique interpretations of former refugee children, abruptly forced to escape from oppression and persecution in their country of origin as children. As refugees, belonging nowhere, they became pawns in human opportunism without human rights protection. Survival was not guaranteed, producing a stark merging of acceptance of mortality and determined resourcefulness, even as children. Avoidant coping strategies were utilised as positive tools for surviving traumatic distress and constant threat. Additionally, avoidant coping became crucial in defining a life philosophy that was future oriented as adults. They rejected a ‘refugee victim’ identity, emphasising a legacy of resourcefulness, hope, gratitude and reciprocity. Posttraumatic growth from the horror of experiences as a refugee child was facilitated by a conscious commitment to future generations and an optimistic attitude towards the future. Implications for future research and clinical practice are discussed.