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Background: Clinical presentations of child and adolescent psychopathology can vary systematically for boys and girls. While network analysis is increasingly being applied to explore psychopathology in adults, there is a dearth of network studies considering differences in symptoms for boys and girls, particularly in developmental trauma‐related symptomatology. Methods: This study involves rural children (n = 375, 39.47% girls) and adolescents (n = 291, 51.20% girls) involved with child protection services in Ontario, Canada. Caregivers completed the Assessment Checklist for Children or Adolescents within the first 6 months of care. Psychometric network analyses were conducted using subscales for boys and girls. Differences were examined via network comparison permutation tests, moderated network models, and independent t‐tests. Results: Attachment‐related interpersonal difficulties were the most central nodes in the child and adolescent networks for both boys and girls. Emotional dysregulation also had high strength centrality for adolescents. While network comparison tests found the overall network structures and global network strength to be invariant between boys and girls for children and adolescents, moderated network models and independent t‐tests revealed several differences with regards to the expression of specific symptoms. Among children, girls exhibited more indiscriminate and pseudomature interpersonal behaviors, whereas boys expressed significantly more non‐reciprocal interpersonal behaviors and self‐injury. Adolescent girls exhibited more behavioral dysregulation and suicide discourse in the moderated network model; t‐tests also indicated higher levels of emotional dysregulation, negative self‐image, and other items considered clinically important complex trauma symptoms (e.g., distrust of adults, confused belonging). Discussion: This study supports evidence of differences in the expression of complex trauma symptomatology for boys and girls. Additionally, girls exhibit more symptoms, in general. Consistent with the transdiagnostic conceptualization of the consequences of developmental trauma, findings demonstrate the primacy of attachment‐specific difficulties and emotion dysregulation. [ABSTRACT FROM AUTHOR]

Abstract Background Clinical presentations of child and adolescent psychopathology can vary systematically for boys and girls. While network analysis is increasingly being applied to explore psychopathology in adults, there is a dearth of network studies considering differences in symptoms for boys and girls, particularly in developmental trauma‐related symptomatology. Methods This study involves rural children (n = 375, 39.47% girls) and adolescents (n = 291, 51.20% girls) involved with child protection services in Ontario, Canada. Caregivers completed the Assessment Checklist for Children or Adolescents within the first 6 months of care. Psychometric network analyses were conducted using subscales for boys and girls. Differences were examined via network comparison permutation tests, moderated network models, and independent t‐tests. Results Attachment‐related interpersonal difficulties were the most central nodes in the child and adolescent networks for both boys and girls. Emotional dysregulation also had high strength centrality for adolescents. While network comparison tests found the overall network structures and global network strength to be invariant between boys and girls for children and adolescents, moderated network models and independent t‐tests revealed several differences with regards to the expression of specific symptoms. Among children, girls exhibited more indiscriminate and pseudomature interpersonal behaviors, whereas boys expressed significantly more non‐reciprocal interpersonal behaviors and self‐injury. Adolescent girls exhibited more behavioral dysregulation and suicide discourse in the moderated network model; t‐tests also indicated higher levels of emotional dysregulation, negative self‐image, and other items considered clinically important complex trauma symptoms (e.g., distrust of adults, confused belonging). Discussion This study supports evidence of differences in the expression of complex trauma symptomatology for boys and girls. Additionally, girls exhibit more symptoms, in general. Consistent with the transdiagnostic conceptualization of the consequences of developmental trauma, findings demonstrate the primacy of attachment‐specific difficulties and emotion dysregulation.

The number and type of traumatic experiences (especially childhood maltreatment) appear to increase the risk of developing complex trauma symptoms. There is initial evidence that patients with complex trauma benefit from phase-based therapeutic approaches. STAIR-NT (Skills Training in Affective and Interpersonal Regulation with Narrative Therapy) is a two-phase trauma therapy approach: emotion regulation and interpersonal skills are learned in the STAIR phase, and in the narrative therapy phase (NT) the exposure to trauma aims at recognizing and changing dysfunctional, trauma-associated assumptions. Experiences with STAIR-NT in the context of a current treatment study show that the two phases provide a clear structure and more security for the treatment. First clinical experiences with STAIR-NT as well as short case vignettes are presented and recommendations for the treatment of patients with complex trauma are given. Concrete practical recommendations are offered for the implementation and individualization on interventions, which among others relate to offender contact, motivational work, handling dissociative states, therapeutic methods (especially exposure), and therapy completion. The close connection between theory and practice facilitates the transfer of learning experiences into everyday life and promotes the strengthening of patients' self-efficacy and autonomy. [ABSTRACT FROM AUTHOR]

The Trauma Symptom Checklist–40 (TSC-40) is commonly used in clinical research to index history of childhood maltreatment and assess complex trauma symptomatology in adults. Yet the dimensional structure of this measure has not been examined. We examined the factor structure of the TSC-40 in a sample of 706 undergraduate students, measurement invariance of the TSC-40 across groups with or without a history of abuse-related and multiple trauma, and the association between the TSC-40 and other trauma indices. A higher order model of complex trauma symptomatology was optimal. The higher order model also demonstrated strong measurement invariance across participants with or without abuse-related and multiple trauma histories. The current findings support the dimensional structure of the TSC-40, as well as extending and revising its subscale composition. This study provided support for using the TSC-40 to measure trauma symptoms across groups exposed to different and multiple types of trauma and provided further evidence for the construct of complex trauma symptomatology. [ABSTRACT FROM AUTHOR]