Alaska Child Trauma Intervention Alaska Child Trauma Intervention Outcomes StudyOutcomes Study

Alaska Child Trauma Center at Alaska Child Trauma Center at Anchorage Community Mental Health Anchorage Community Mental Health

Services Services Done in collaboration with Duke Clinical Research Institute and the Done in collaboration with Duke Clinical Research Institute and the

University of Alaska Anchorage Center for Human DevelopmentUniversity of Alaska Anchorage Center for Human Development

Institutional Review Boards: University of Alaska AnchorageInstitutional Review Boards: University of Alaska AnchorageDuke UniversityDuke University

Principal Investigator: Joshua Arvidson, MSS., LCSWPrincipal Investigator: Joshua Arvidson, MSS., LCSW

Outcomes DataOutcomes Data

17.2 point drop in CBCL T-Scores 17.2 point drop in CBCL T-Scores from Baseline to Dischargefrom Baseline to Discharge

==At baseline 85At baseline 85thth percentile percentile At discharge 49At discharge 49thth percentile percentile

Statistically Significant with a 0.01 Statistically Significant with a 0.01 Confidence IntervalConfidence Interval

Number of Traumas X Total Co-morbid Number of Traumas X Total Co-morbid ConditionsConditions

NCTSN Core Data Set (N=8,120)NCTSN Core Data Set (N=8,120)

59.3%55.6%

47.1% 45.8%40.8%

33.8%

28.1%

18.4%

0%

15%

30%

45%

60%

Child Trauma History: Child Trauma History: Most Frequent Exposure Most Frequent Exposure

TypesTypes

61.5% 59.2% 57.9%53.1%

45.8%

0%

15%

30%

45%

60%

75%

Complex Posttraumatic Complex Posttraumatic Sequelae: Sequelae:

Most Frequent Difficulties Most Frequent Difficulties

Complex Traumatic Complex Traumatic ExposuresExposures

Aggregate data on 1,699 children Aggregate data on 1,699 children served across 25 sites within the served across 25 sites within the National Child Traumatic Stress National Child Traumatic Stress Network reveals that 78% of these Network reveals that 78% of these children have been exposed to children have been exposed to multiple and/or prolonged trauma.multiple and/or prolonged trauma.

Spinazzola, Ford, van der Kolk, et al. (2003)Spinazzola, Ford, van der Kolk, et al. (2003)

What is “Complex What is “Complex Trauma”?Trauma”?

Dual Definition:Dual Definition:

Exposure to multiple traumatic events, Exposure to multiple traumatic events, frequently within a caregiving system frequently within a caregiving system that is supposed to be the source of that is supposed to be the source of safety and stabilitysafety and stability

Impact of those events, across domains Impact of those events, across domains of development, on both immediate and of development, on both immediate and long-term outcomeslong-term outcomes

Mean Age of Onset: 5.0 (SD = 2.8)Mean Age of Onset: 5.0 (SD = 2.8) Median: 5.0Median: 5.0 Min, Max: 0, 13.0Min, Max: 0, 13.0

Child Trauma Exposure: Child Trauma Exposure: Age of Onset in NCTSNAge of Onset in NCTSN

Early ExposureEarly Exposure:: Over 1/3 of the sample is adolescent and yet 98% of clinicians surveyed report average age of onset under 11

Trauma Exposure, Adverse Trauma Exposure, Adverse Experiences, and Diverse Symptom Experiences, and Diverse Symptom

Profiles in a National Sample of Profiles in a National Sample of Traumatized Children Traumatized Children

Robert S. Pynoos, MD, John A. Fairbank, Robert S. Pynoos, MD, John A. Fairbank, PhD, PhD,

Ernestine C. Briggs-King, PhD, Alan Ernestine C. Briggs-King, PhD, Alan Steinberg, PhD, Christopher Layne, PhD, Steinberg, PhD, Christopher Layne, PhD,

Bradley Stolbach, PhD andBradley Stolbach, PhD and Sarah OstrowskiSarah Ostrowski

National Center for Child Traumatic StressNational Center for Child Traumatic Stress

Prevalence of Prevalence of Multiple TraumasMultiple Traumas

13.9

71.6

0

10

20

30

40

50

60

70

80

90

100P

erce

nt Single Trauma

Multiple Traumas

Met Full Criteria for Met Full Criteria for PTSDPTSD

73.5

24.5

0102030405060708090

100

NO

Yes

Percen

t