One in Six Children and Adolescents in South Ethiopia Had Childhood trauma

doi:10.21203/rs.3.rs-3452942/v1

Download PDF

Research Article

One in Six Children and Adolescents in South Ethiopia Had Childhood trauma

https://doi.org/10.21203/rs.3.rs-3452942/v1

This work is licensed under a CC BY 4.0 License

Version 1

posted

You are reading this latest preprint version

Background: Trauma in childhood is a serious experience that can affect the physical, psychological, and social development of the child and adolescent and has immense long-term effects on the child, and society. However, the condition is overlooked by parents, teachers, medical professionals, mental health practitioners, and researchers. Hence this study aimed to assess childhood trauma and its associated factors among children and Adolescents aged 5–14 years old at Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, in 2022.

Method: From 22 September to 22 November, 2022, a hospital-based cross-sectional study was conducted, at Wolaita Sodo University Comprehensive Specialized Hospital. About 423 study participants were selected using a systematic random sampling technique. Data was collected using a structured interviewer administered questionnaire. Childhood trauma was screening using the Child trauma screening questionnaire. The data was analyzed using descriptive and logistic regression analysis methods. The strength as well as presence of association was presented using odds ratio and 95% CI with a corresponding p-value < 0.05.

Result: The magnitude of childhood trauma among children and Adolescents aged 5–14 was17.5%. Large family size (AOR = 1.8; 95% CI: 1.07, 3.13), educational level of parents (AOR = 4.4; 95% CI: 2.18, 9.00), and children and adolescent emotional problems (AOR = 1.9; 95% CI: 1.09, 3.20) were significantly associated with childhood trauma

Conclusion and Recommendation: Approximately one in six children and adolescents had experienced childhood trauma. Large family size, educational level of parents, and emotional problems of children and adolescents were factors associated with childhood trauma. Therefore, a holistic preventive approach and early detection and management are important to halt the short and long-term impact of childhood trauma.

Childhood trauma

Children

Adolescents

Wolaita sodo

South Ethiopia

Childhood trauma happens when a child experiences or witnesses an extreme incident or events that endanger or harm his or her mental and physical well-being. Childhood trauma occurs when a child goes through a traumatic event or series of events that endangers or harms their emotional and physical well-being. Extremely bad events like war, terrorism, or natural disasters may be included, as well as more common stressful situations including actual or threatened death, significant injury, physical or sexual assault, domestic or community violence, neglect, and medical emergencies (1–3).

There are various ways in which children can react to distressing circumstances. They might return to previous stages of development, exhibiting behaviors similar to those of younger children, such as trouble falling asleep, nightmares, and anxiety about future violent encounters. In trying to protect themselves from any further traumas, they could also retreat to earlier ways of communicating with their parents through increased issues with their diet, self-care, and academics (4, 5). The majority of children experience various types of trauma as they grow up, and these traumas can have negative effects on adult functioning, particularly physical and psychological health (6).

Childhood trauma-related pathology is linked to serious social impairments, cognitive deficits, poor academic performance, and an increased risk for emotion-related disorders over the course of a person's lifetime, highlighting the significance of early detection and appropriate intervention to reduce post-traumatic stress pathology (7). Childhood trauma exposure raises the chance of developing several types of psychopathology, including typical emotional and behavioral issues in children and adolescents (8–10). A child's capacity to cope with and respond to stress may be exceeded by enduring trauma in the absence of supports, which would increase stress levels and affect the child's physical, social, and emotional development (11).

A child who has encountered a traumatic incident or series of events early in life may face behavioral problems that could eventually hinder the development of healthy interpersonal connections in the future (12).

Before reaching adulthood, more than half of all kids suffer a traumatic event (13, 14). Within a year, more than 60% of kids experienced at least one sort of childhood trauma, more than 10% stated they had experienced five or more trauma exposures (15). Among them around 10–30% of children go on to acquire posttraumatic stress disorder (PTSD) after childhood trauma (16).

A study shows that child and adolescent mental health problems, including hyperactive, emotional, and conduct problems, are factors linked to childhood trauma in older children and adolescents. Furthermore, low income, a lower parental educational level, and parenting practices are factors related to childhood trauma (7, 17–19).

Studying the magnitude and associated factors of childhood trauma has critical input to the physical and mental wellbeing of children and adolescents. However, despite this widespread problem, there is a lack of adequate information about childhood trauma, in Ethiopia. So, this study is particularly focused on assessing childhood trauma and its associated factors in children and adolescents aged 5–14 years old attending the pediatric outpatient Clinic at Wolaita Sodo University Comprehensive Specialized Hospital in Wolaita Sodo, South Ethiopia.

Study area and period

From September 22 to November 22, 2022, a study was carried out at Wolaita Sodo University Comprehensive Specialized Hospital (WSUCSH). The hospital lies in the village of Wolaita Sodo, which is 329 kilometers south of the capital city of Addis Ababa. A total of 450–500 patients each day receive various medical treatments from the hospital, which serves over 3 million people in its catchment areas. These patients include outpatients, emergency patients, and inpatients. Pediatric outpatient, pediatric emergency (admission and outpatient unit), neonatal intensive care unit, pediatric surgical admission ward, pediatric medical admission ward, and stabilization center unit are the four main divisions of the pediatrics department.

Study design

A hospital based cross-sectional study design was conducted.

Population

We have included all children and adolescents aged 5–14 who visited WSUCSH pediatric outpatient department services during the data collection period. Children and adolescents who were critically ill to the extent of being unable to communicate during the data collection period were excluded.

Sampling technique and procedure

A single population proportion formula was used to calculate the necessary sample size for this investigation under the following assumptions: As there is a scarcity of published research that demonstrates the scope and contributing variables of childhood trauma in Ethiopia, the prevalence of childhood trauma is estimated at 50% with a 95% confidence interval, a 5% margin of error, and a 10% non-response rate. The ultimate sample size was 423 as a result. The study participants were chosen using a systematic random sampling method. The average number of children who attended the pediatric outpatient department within the three months before the study was determined from the client registration data in order to choose the necessary sample. On the basis of this, a 2350 patient flow rate was predicted for the duration of the study. The sampling interval (k) was then calculated by dividing the predicted number of patients who would visit the unit throughout the study period (N) by the chosen sample size (n) of respondents, and it was found to be 5. The first subject from interval 1-K was chosen by the lottery method, and then each of the remaining K intervals of the sample was chosen until the necessary sample size was reached.

Data collection Instrument

Child trauma Screening Questionnaire (CTSQ)

Childhood trauma in this study was defined as any stressful event for children and adolescents with a CTSQ score of ≥ 5. The CTSQ was used to evaluate childhood trauma. The total score ranged from 0 to 10, and an ideal cutoff score of ≥ 5 was used to assess whether children and adolescents had suffered childhood trauma. The responses to each question were coded as either yes (scoring 1) or no (scoring 0) (20, 21). The scale's internal consistency, according to Cronbach's alpha within the context of the current study, was 0.76. A structured questionnaire to evaluate socio-demographic characteristics was linked to the inquiries.

Strengths and Difficulties Questionnaire Parent Report (SDQ-PR)

The child’s difficult behavioral problems were measured by the strengths and difficulties questionnaire parent report (SDQ-PR). It has 25 items subdivided into five subscales, which measure hyperactivity, emotional symptoms, conduct problem symptoms, interpersonal relationships, and pro-social behavior. Without a pro-social behavioral subscale, a 25-item, 3-point Likert scale with a total score of 0–40 always scores 'Somewhat true' as 1, while the scoring of 'Not True' and 'Certainly True' changes depending on the item. Without the pro-social behavioral subscale, the SDQ-PR's overall optimal cutoff point of ≥ 17 can detect behavioral problems with a sensitivity of 70.96% and a specificity of 69.15%. The optimal cutoff scores for the subscales are ≥ 7 for hyperactive-inattentive problems, ≥ 4 for conduct, and ≥ 5 for emotional problems (22). In the current study setting, its internal consistency (Cronbach’s alpha) for the scale was 0.79.

Alabama Parenting Questionnaire APQ-9

Child parenting practices were evaluated by APQ-9. It has three items chosen for each of the factors: positive parenting, inconsistent discipline, and poor supervision. APQ-9 item 5-point Likert scale never (1), almost never (2), sometimes (3), often (4), and always (5). The mean score of 4.48 and above indicates positive parenting; the mean score of 2.73 to 4.48 indicates inconsistent discipline; and the mean score of 1 to 2.73 indicates poor supervision(23). In our setup, the internal consistency of Cronbach’s alpha for the scale was 0.87.

Data collection procedure

Data were gathered using a structured face-to-face interviewer-administered questionnaire from parents of children aged 5 to 8 and from children and adolescents aged 9 to 14 years. Six psychiatry-trained bachelor's degree holders who were under the supervision of two mental health specialists collected the data.

Data quality management

The questionnaire was originally written in English and then translated into Amharic and Wolaita by experts in all three languages, including mental health specialists, who subsequently rewrote the questionnaire in English to ensure consistency. For two days, supervisors and data collectors received training. 20 kilometers outside the study area, at the Humbbo Tebela primary hospital, 5% (n = 22) of the sample size had a pre-test to identify potential issues with the data collection methods and to modify the questionnaires. The supervisors and primary investigator regularly oversaw and assisted the data collectors. During the time of data collection, supervisors and primary investigators reviewed the data daily for accuracy and consistency.

Data processing, analysis and presentation

Data were entered into Epi Data Version 4.6 and analyzed using SPSS version 25 statistical software; descriptive statistics were used to explain the sample characteristics. Both Multicollinearity and Hosmer-Lemeshow goodness-of-fit were checked. The association between independent variables and the outcome variable was analyzed using logistic regression analysis. The multivariable logistic regression analysis included variables with a p-value of < 0.25 in the bivariate binary logistic regression analysis, and variables with a p-value of < 0.05 in the multivariate logistic regression analysis were deemed to have a significant association. The outcome and explanatory variables' strength of associations were assessed using the 95% CI OR and a p-value of < 0.05.

Socio demographic characteristics of respondents

In this study, 423 children and adolescents participated, and 417 completed the interview, with a response rate of 98.6%. Participants (n = 6, 1.4%) had a non-response rate. The mean age of participants was 8.3 years, with a standard deviation of (SD ± 2.31). The study subjects (n = 271, 65%) were boys. Most study participants (n 359, 86.1%) were living with their parents, and half of participants (n 214, 51.3%) live in a family size of less than four (Table 1).

Table 1

Socio-demographic related factors of children a and adolescents aged 5–14 year old at Wolaita sodo university comprehensive specialized hospital, Wolaita sodo, south Ethiopia 2022
Variables	Category	Number	Percentage (%)
Age	5–8 year	247	59.2
	9–11 year	113	27.1
	12–14 year	57	13.1
Sex of child	Male	271	65
Sex of child	Female	146	35
Residences	Urban	241	57.8
Residences	Rural	176	42.2
Living circumstance	With parents	359	86.1
Living circumstance	Others*	58	13.9
Parental education	Below high school	266	63
Parental education	High school and above	151	36.2
Family size	< 4	214	51.3
Family size	≥ 4	203	48.7
Parental occupation	Employed	262	62.8
Parental occupation	Unemployed	155	37.2
Income	Below poverty line	191	45.8
Income	Above poverty line	226	54.2

Psychosocial characteristics of respondents

From the study sample, nearly a third (n = 137, 32.9%) had emotional problems, and (n = 117, 28.1%) had behavioral problems. Among the mothers who participated (n = 110, 26.4%) had a history of substance use. Regarding parenting practices, positive parenting practices were (n = 42, 10.1%) of the sample, while inconsistent discipline and poor supervision were (n = 113, 27.1%) and (n = 262, 62.8%) of the sample, respectively (Table 2).

Table 2

Psychosocial related factors of children a and adolescents aged 5–14 year old at Wolaita sodo university comprehensive specialized hospital, Wolaita sodo, south Ethiopia 2022
Variables	Category	Number	Percentage (%)
Maternal substance use	Yes	110	26.4
Maternal substance use	No	307	73.6
Child behavioral problems	Yes	117	28.1
Child behavioral problems	No	300	71.9
Child emotional problems	Yes	137	32.9
Child emotional problems	No	280	67.1
Child conduct problems	Yes	89	21.3
Child conduct problems	No	328	78.7
Child hyperactive problems	Yes	73	17.5
Child hyperactive problems	No	344	82.5
Parenting practices of child	Positive	42	10.1
	Inconsistent discipline	113	27.1
	Poor supervision	262	62.8

Magnitude of child trauma

The magnitude of overall childhood trauma among children and adolescents age 5–14 was (n 73, 17.5%) with 95% CI [14, 21.5] (Fig. 1).

Factors associated with childhood trauma

Large family size (AOR = 1.8; 95% CI: 1.07, 3.13), educational level of parents (AOR = 4.4; 95% CI: 2.18, 9.00), and children and adolescent emotional problems (AOR = 1.9; 95% CI: 1.09, 3.20) were significantly associated with childhood trauma (Table 3)

Table 3

multivariable analysis of socio-demographic and Psychosocial related factors of children and adolescents aged 5–14 year old at Wolaita sodo university comprehensive specialized hospital, Wolaita sodo, south Ethiopia 2022
Variable	Category	Childhood trauma		COR (95% CI)	AOR (95% CI)	P-value
Variable	Category	Yes n (%)	No n (%)	COR (95% CI)	AOR (95% CI)	P-value
Family size	< 4	28	186	1	1	1
Family size	>= 4	45	158	1.89(1.23, 3.17)	1.8(1.07, 3.13)	0.026*
Educational level of parents	Below high school	63	203	4.37(2.17, 8.82)	4.4(2.18, 9.00)	< 0.001*
Educational level of parents	High school and above	10	141	1	1	1
Emotional problem	Yes	31	106	1.65(0.98, 2.78)	1.9(1.09, 3.20)	0.023*
Emotional problem	No	42	238	1		1
*Factors that have association at p-value < 0.05 on multivariable analysis, 1 = reference category

The purpose of this study was to evaluate the prevalence of childhood trauma and its contributing factors in children and adolescents. In this study, girls (23.8%) experienced more childhood trauma than boys (14%). The results of this study showed that childhood trauma becomes more prevalent with age. Childhood trauma prevalence among children aged 5–8 years (16.6%), 9–11 years (17.7%), and 12–14 years (21%). According to this study, big family size, parental education, and emotional issues were effective cause of childhood trauma.

In the current study, the total magnitude of childhood trauma was 17.5%, which is consistent with a similar study conducted in US, 18.6% (14), London 16% (24) and North Carolina 14.8% (25). However, the finding of this study was higher than studies conducted in Australia (9%) (26), in Romania 4.6% (19), In Switzerland 11.5% (3). The difference between the present study and the finding from Australia could be that the study conducted in Australia involved inpatient department service and utilized 135 samples of children and adolescents aged 7 to 16 years old. In addition to this, children and adolescents were excluded if they were in foster care or if they had experienced child abuse. But the current study was carried out among 417 samples of children and adolescents from the pediatric outpatient department who were aged 5 to 14 years old. A possible variation between this study and Romania might be that the current study investigated any kind of childhood trauma among children and adolescents, while Romanian studies investigated only physical abuse in childhood. Furthermore, the discrepancy between Switzerland and our findings may be that studies carried out in Switzerland investigated whether the diagnosis of cancer and type 1 diabetes mellitus in childhood resulted in childhood trauma among 209 samples of children and adolescents aged between 6.5 and 14.5 years, but our study focused on whether any kind of trauma exposure during childhood resulted in childhood trauma among 417 samples of children and adolescents aged 5 to 14 years old attending pediatric outpatient department service.

The finding of this study lower than study conducted in Pakistan 32.5% (27) and California 35% (28). This observed difference between the present study and Pakistan might be that the Pakistan study was conducted in a primary care clinic and data was collected by female-trained medical students, whereas the present study was conducted in a comprehensive specialized hospital and data was collected by trained bachelor's degree holders in psychiatry who were under the supervision of mental health specialists collected the data. Since there might be a skill gap between medical students and licensed mental health specialists and a bachelor’s science degree in psychiatry, this can result in an observed discrepancy in the magnitude of childhood trauma between our study and Pakistan. Childhood trauma in California studies is higher than the current study. This difference could be a study done in California to evaluate whether children and adolescents develop childhood trauma after being admitted to the pediatric intensive care unit and their families. This study investigated whether any kind of trauma exposure in childhood can result in childhood trauma among children and adolescents seeking treatment from pediatric outpatient department service.

In this study, large family size was approximately two times more likely to be associated with childhood trauma than small family size. This finding is similar to the study conducted in Island (29). A possible explanation for this association might be that in large family, family conflict were common, which can have an impact on physical and psychological trauma in pediatric populations (29). A typical issue in large families was criticism, a lack of cohesiveness, and a lack of communication, which was also, associated with worse pediatric health outcomes. A further finding showed that trauma symptoms in kids and teens were directly correlated with criticism from the large family (30, 31).

This study found that parental educational levels below high school were just over four times more likely to be associated with childhood trauma compared to high school and above. This finding is in line with similar study cared out in Columbia (32). Lower parental education levels have been found to be a risk factor for childhood trauma, (33), Because parents with lower educational levels have fewer cognitive resources, they are more ineffective parents and expose kids and teenagers to trauma (34). Studies have revealed that lower parental education levels are more prevalent in lower socioeconomic status (SES), which is connected to higher levels of perceived parental stress, a higher risk of tension buildup, and a higher probability that parents will abandon their parenting responsibilities, all of which are linked to various types of childhood trauma (35, 36). Additionally, it has been noted that mothers with poorer educational backgrounds tend to overstress their children by failing to appropriately meet their requirements, which puts them at risk for trauma (37).

Finally, this study observed a significant association between the emotional problems of children and adolescents and childhood trauma. In this study, children and adolescents who have emotional problems were nearly two times more likely to have had childhood trauma than those who had no emotional problems. This finding is in line with a study conducted in Brazil (18). A possible explanation for this association might be that childhood trauma has been linked to increased vulnerability to the detrimental effects of pediatrics on mental health and has been established as a key risk factor for developing emotional difficulties later in life (38).

A child's and adolescents, emotional and physical health are significantly impacted by childhood trauma, which increases the risk of dangerous behaviors and sickness. Childhood trauma can prevent someone from processing painful situations, which can have a long-lasting negative emotional effect (39, 40). Traumatic experiences that cause maladaptive responses to stress diminish a person's ability to understand and deal with stressful situations, which causes emotional difficulties in children and teenagers (41, 42). Anguish and suffering brought on by a traumatic event might result in a person having ongoing emotional problems (43–45). Beyond an individual's viewpoint, the occurrence and severity of childhood trauma can be determined by factors other than that person's perception, such as the environment they have been exposed to since they were children. Depending on the length of exposure and the severity of the traumatic experiences, this can lead to emotional problems (46, 47). After experiencing extreme trauma as a child, intolerable agony is unavoidable due to the effects on feelings and emotions. Additionally, the child will experience pain and suffering as a result of the trauma, which will lead to emotional problems (10, 46, 48).

Limitation of the study

This study utilized a small number of participants, which could undermine the generalizability of the findings in other study settings. In addition to this lack of scale validation in the study setting area and, finally, social desirability bias may have been introduced.

This study revealed that 1 in 6 children and adolescents had childhood trauma. Large family size, educational levels of parents and emotional problems of children and adolescents were identified as significant factors associated with childhood trauma. Childhood trauma can halt development and result in physical, mental, and emotional impairments that last a lifetime. For this reason it is crucial for doctors to comprehend more accurate patient profiles and approaches for effective therapy modalities to help trauma survivors feel better. Therefore, holistic approaches, including preventive and therapeutic measures for children and adolescents with trauma, are needed to reduce the effect of the problem.

Acronyms and Abbreviations

APQ Alabama Parenting Questionnaire, CI Confidence Interval, CSTQ Child Trauma Screening Questionnaire, IRB Institutional Review Board, OR Odds Ratio, SDQ-PR Strength and Difficulty Questionnaire Parent Report, WSUCSH Wolaita Sodo University Comprehensive Specialized Hospital.

Acknowledgements

The authors would like to thank Jimma University for financial support and the study participants for providing study information.

Funding

This study was funded by Jimma University. Jimma University has no role in the design of the study, the collection, analysis, and interpretation of data, or the writing of the manuscript

Authors’ contributions

TB developed the proposal, involved in the data analysis, interpreted the data, and wrote the draft manuscript. All authors revised the proposal, checked the data analysis, revised the manuscript, and read and approved the final manuscript.

Ethical approval and consent to participate

Ethical approval for this study was obtained from the Institutional Review Board (IRB) of Jimma University Institute of Health (Ref.No.JUIH/IRB/63/22). Written informed consent was obtained from all parents of children and adolescents participating, and the children and adolescents verbally agreed to participate. Children and adolescents have childhood trauma after screen was linked to a health care service for further treatment.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding authors on reasonable request.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests

National Child Traumatic Stress Network. What is Child Traumatic Stress? 2003;1–2. Available from: https://www.nctsn.org/sites/default/files/resources/what_is_child_traumatic_stress.pdf.
Park SC, Park YC. Korea in the diagnostic and statistical manual of mental disorders, fifth edition. J Korean Med Sci. 2020;35(2).
Landolt MA, Vollrath M, Ribi K, Gnehm HE, Sennhauser FH. Incidence and associations of parental and child posttraumatic stress symptoms in pediatric patients. J Child Psychol Psychiatry Allied Discip. 2003;44(8):1199–207.
Prevention NC for MHP and YV. Childhood Trauma and Its Effect on Healthy Development. 2012;(July):1–9.
Samhsa. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. 2014;(July).
Finkelhor D. Early and long-term effects of child sexual abuse: An update. Prof Psychol Res Pract. 1990;21(5):325–30.
Wise AE, Delahanty DL. Parental factors associated with child post-traumatic stress following injury: A consideration of intervention targets. Front Psychol. 2017;8(AUG):1–10.
McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, Kessler RC. Childhood adversities and first onset of psychiatric disorders in a national sample of US adolescents. Arch Gen Psychiatry. 2012;69(11):1151–60.
Carliner H, Keyes KM, McLaughlin KA, Meyers JL, Dunn EC, Martins SS. Childhood Trauma and Illicit Drug Use in Adolescence: A Population-Based National Comorbidity Survey Replication–Adolescent Supplement Study. J Am Acad Child Adolesc Psychiatry [Internet]. 2016;55(8):701–8. http://dx.doi.org/10.1016/j.jaac.2016.05.010.
Copeland WE, Keeler G, Angold A, Costello EJ. Traumatic events and posttraumatic stress in childhood. Arch Gen Psychiatry. 2007;64(5):577–84.
Gerrity E, Folcarelli C. Child Traumatic Stress: What Every Policymaker Should Know. Nctsn. 2008;60.
Verma S, Centers ERT, Agrawal R. The Lasting Effects of Childhood Trauma. 2021;(March).
Costello EJ, Erkanli A, Fairbank JA, Angold A. The prevalence of potentially traumatic events in childhood and adolescence. J Trauma Stress. 2002;15(2):99–112.
McLaughlin KA, Koenen KC, Hill ED, Petukhova M, Sampson NA, Zaslavsky AM et al. Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. J Am Acad Child Adolesc Psychiatry [Internet]. 2013;52(8):815–830.e14. http://dx.doi.org/10.1016/j.jaac.2013.05.011.
Finkelhor D, Turner H, Ormrod R, Hamby SL. Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics. 2009;124(5):1411–23.
Alisic E, Zalta AK, Van Wesel F, Larsen SE, Hafstad GS, Hassanpour K, et al. Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: Meta-analysis. Br J Psychiatry. 2014;204(5):335–40.
Id RC, Id LDH. Associations of adverse childhood experiences with educational attainment and adolescent health and the role of family and socioeconomic factors: A prospective cohort study in the UK. 2020;1–21. http://dx.doi.org/10.1371/journal.pmed.1003031.
Alckmin-Carvalho F, Costa AB, El Rafihi-Ferreira R. The association between childhood trauma and psychiatric disorders in low-income and middle-income countries. The Lancet Psychiatry. 2022;9(12):932–4.
Child abuse and neglect by parents and other caregivers.
Charuvastra A, Goldfarb E. Implementation of a Screen and Treat Program for Child Posttraumatic Stress Disorder in a School Setting After a School Suicide. 2010;23(4):500–3.
Charuvastr A, Goldfarb E, Petkova E, Cloitre MD, Colleague. Thank you for your interest in the. Implement a Screen Treat Progr Child Posttraumatic Stress Disord a Sch Setting After a Sch Suicide J Trauma Stress. 2010;23(4).
Wimbarti S, Siregar J, Oktaviana M, Astriningsih R. Strengths and Difficulties Questionnaire Parent Report (SDQ-PR) as Screening Instrument of Children Mental Health in Indonesia. 2019;46:130–44.
Elgar FJ, Waschbusch DA, Dadds MR, Sigvaldason N. Development and Validation of a Short Form of the Alabama Parenting Questionnaire. 2007;243–59.
Gitleman L, Kleberger J. Practitioner Review: Post-traumatic Stress Disorder and its Treatment in Children and Adolescents. Pap Knowl Towar a Media Hist Doc. 2014;1–56.
Copeland WE, Shanahan L, Hinesley J, Chan RF, Aberg KA, Fairbank JA, et al. Association of Childhood Trauma Exposure with Adult Psychiatric Disorders and Functional Outcomes. JAMA Netw Open. 2018;1(7):1–11.
Kenardy JA, Spence SH, Macleod AC. Screening for posttraumatic stress disorder in children after accidental injury. Pediatrics. 2006;118(3):1002–9.
Sultan Ali N, Nawaz Ali F, Khan Khuwaja A, Nanji K. Magnitude and factors associated with child abuse in a mega city of developing country Pakistan. Iran J Pediatr. 2014;24(2):140–6.
Nelson LP, Gold JI. Posttraumatic stress disorder in children and their parents following admission to the pediatric intensive care unit: A review. Pediatr Crit Care Med. 2012;13(3):338–47.
Morrow JA. Childhood trauma, family functioning and adult health: Protective factors as mediating variables. Diss Abstr Int Sect B Sci Eng [Internet]. 2002;4228. Available from: https://search.proquest.com/docview/619947476?accountid=14568%0Ahttp://rj9jj8rc3u.search.serialssolutions.com?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&rfr_id=info:sid/APA+PsycInfo®&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft.genre=dissertation.
IJsselmuiden CB, Faden RR. The New England Journal of Medicine Downloaded from nejm.org on January 31, 2011. For personal use only. No other uses without permission. Copyright © 1992 Massachusetts Medical Society. All rights reserved. 1992;326.
Abar C, Abar B, Turrisi R. Addictive Behaviors The impact of parental modeling and permissibility on alcohol use and experienced negative drinking consequences in college. Addict Behav [Internet]. 2009;34(6–7):542–7. http://dx.doi.org/10.1016/j.addbeh.2009.03.019.
Dubow EF, Boxer P, Huesmann LR. Long-term effects of parents’ education on children’s educational and occupational success: Mediation by family interactions, child aggression, and teenage aspirations. Merrill Palmer Q. 2009;55(3):224–49.
Reichman NE, Teitler J. Fragile Families: Sample and Design. 2001;23:303–26.
Neitzel C, Stright AD, Neitzel C. International Journal of Behavioral Development Parenting behaviours during child problem solving: The roles of child temperament, mother education and personality, and the problem-solving context Parenting behaviours during child problem solving : The. 2010;(January 2015):37–41.
Sieverson C. Characteristics associated to child sexual abuse in a specialized intervention program from Santiago, Chile Características asociadas al abuso sexual infantil en un programa de intervención especializada en Santiago de Chile Characteristics associated to. 2013;7(August).
Amorós-martí P, Byrne S, Mateos-inchaurrondo A, Vaquero-tió E. Psychosocial Intervention. Psychosoc Interv [Internet]. 2016; http://dx.doi.org/10.1016/j.psi.2016.02.002.
Studies I, Development F, Abuse S, Abuse S, Leuven KU, Kingdom U, INTERGENERATIONAL TRANSMISSION OF ATTACHMENT IN ABUSED AND NEGLECTED MOTHERS. : THE ROLE OF TRAUMA-SPECIFIC REFLECTIVE FUNCTIONING. 2015;36(2):200–12.
Ã CH, Newport DJ, Mletzko T, Miller AH, Nemeroff CB. The link between childhood trauma and depression: Insights from HPA axis studies in humans. 2008;(August).
Bock BB, Bastos CR, Ardais AP, Grellert M, Carvalho HW, De, Farias C et al. Temperament traits moderate the relationship between Childhood Trauma and Interleukin 1 profile in young adults. Psychoneuroendocrinology [Internet]. 2020;(March):104671. https://doi.org/10.1016/j.psyneuen.2020.104671.
Levy J, Goldstein A, Feldman R. The neural development of empathy is sensitive to caregiving and early trauma. Nat Commun [Internet]. (2019). http://dx.doi.org/10.1038/s41467-019-09927-y.
Programme E. Thinking Skill of Emotional Intelligence Education Programme. 2002.
Hansenne M. Clinical Perspectives in Emotional Intelligence. 2009.
Teicher MH, Samson JA. Annual Res Review: Enduring neurobiological Eff Child abuse Negl. 2016;3:241–66.
Chigiji H, Fry D, Mwadiwa TE, Elizalde A, Izumi N, Baago-rasmussen L et al. Risk factors and health consequences of physical and emotional violence against children in Zimbabwe: a nationally representative survey. 2018;1–12.
Hodgdon H, Suvak M, Zinoviev D, Liebman R. Network Analysis of Exposure to Trauma and Childhood. 2019;(July).
Terr LC. Tre a t i n g C h i l d h o o d Tr a u m a. Child Adolesc Psychiatry Clin NA [Internet]. 2013;22(1):51–66. http://dx.doi.org/10.1016/j.chc.2012.08.003.
Martin CG, Dishion TJ. Psychol Distress Late Adolescence. 2017;8(2):206–13.
Roberts ME, Ph D, Fuemmeler BF, Ph D, Mcclernon HMP. FJ, Association Between Trauma Exposure and Smoking in a Population- Based Sample of Young Adults. 2008;42:266–74.

No competing interests reported.

Download PDF

Version 1

posted

You are reading this latest preprint version

One in Six Children and Adolescents in South Ethiopia Had Childhood trauma

Status:

Version 1

Abstract

Figures

Introduction

Methods and materials

Study area and period

Study design

Population

Sampling technique and procedure

Data collection Instrument

Child trauma Screening Questionnaire (CTSQ)

Strengths and Difficulties Questionnaire Parent Report (SDQ-PR)

Alabama Parenting Questionnaire APQ-9

Data collection procedure

Data quality management

Data processing, analysis and presentation

Result

Socio demographic characteristics of respondents

Psychosocial characteristics of respondents

Magnitude of child trauma

Factors associated with childhood trauma

Discussion

Limitation of the study

Conclusion and Recommendation

Acronyms and Abbreviations

Declarations

References

Additional Declarations

Status:

Version 1