European Child & Adolescent Psychiatry

, Volume 27, Issue 4, pp 527–544 | Cite as

Emotion regulation difficulties in traumatized youth: a meta-analysis and conceptual review

  • L. Villalta
  • P. Smith
  • N. Hickin
  • A. Stringaris
Original Contribution


This article provides a quantitative and conceptual review of emotion regulation difficulties in trauma-exposed young people, and informs future directions in the field. Despite long-standing interest in the influence of emotion regulation difficulties on different internalizing and externalizing psychiatric disorders in childhood, several questions remain unresolved with respect to children and adolescents with PTSD (post-traumatic stress disorder). Meta-analytic data from adult victims suggest that emotion regulation problems are associated with PTSD, but this has never been studied in children and young people. We therefore provide a conceptual review of features related to the phenomenology, assessment, severity and treatment of emotion regulation difficulties in trauma-exposed children and young people. We combine this with a meta-analysis of published literature. We searched studies in Medline, PsychINFO, and Embase databases based on pre-selected criteria. Eight hundred and eighty-six papers were identified and 41 were included. We found that children and adolescents with a diagnosis of PTSD reported more emotion regulation difficulties than those who did not develop PTSD, and that the overall association between the two symptom dimensions was moderately strong. We identify a number of research priorities: the development of instruments to assess emotion regulation difficulties in children, the design of studies that describe its prevalence in young epidemiological traumatized samples, its predictive role in the onset, severity and persistence of post-traumatic symptoms, and its relevance as a moderator, outcome or treatment target for young survivors.


Emotion regulation Anger Post-traumatic stress disorder Meta-analysis Review Childhood 



L. Villalta was financially supported by the Alicia Koplowitz Foundation while working on this manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Supplementary material 1 (DOCX 201 kb)
787_2018_1105_MOESM2_ESM.docx (64 kb)
Supplementary material 2 (DOCX 63 kb)


  1. 1.
    McLaughlin KA, Koenen KC, Hill ED, Petukhova M, Sampson NA, Zaslavsky AM, Kessler RC (2013) Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. J Am Acad Child Adolesc Psychiatry 52(8):815–830. PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Copeland WE, Keeler G, Angold A, Costello EJ (2007) Traumatic events and posttraumatic stress in childhood. Arch Gen Psychiatry 64(5):577–584. PubMedCrossRefGoogle Scholar
  3. 3.
    Stevens NR, Gerhart J, Goldsmith RE, Heath NM, Chesney SA, Hobfoll SE (2013) Emotion regulation difficulties, low social support, and interpersonal violence mediate the link between childhood abuse and posttraumatic stress symptoms. Behav Ther 44(1):152–161PubMedCrossRefGoogle Scholar
  4. 4.
    Badour CL, Feldner MT (2013) Trauma-related reactivity and regulation of emotion: associations with posttraumatic stress symptoms. J Behav Ther Exp Psychiatry 44(1):69–76. PubMedCrossRefGoogle Scholar
  5. 5.
    Tull MT, Barrett HM, McMillan ES, Roemer L (2007) A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behav Ther 38(3):303–313PubMedCrossRefGoogle Scholar
  6. 6.
    Lilly MM, London MJ, Bridgett DJ (2014) Using SEM to examine emotion regulation and revictimization in predicting PTSD symptoms among childhood abuse survivors. Psychol Trauma 6(6):644–651CrossRefGoogle Scholar
  7. 7.
    Stringaris A, Goodman R (2009) Mood lability and psychopathology in youth. Psychol Med 39(8):1237–1245. PubMedCrossRefGoogle Scholar
  8. 8.
    Wakschlag LS, Briggs-Gowan MJ, Carter AS, Hill C, Danis B, Keenan K, McCarthy KJ, Leventhal BL (2007) A developmental framework for distinguishing disruptive behavior from normative misbehavior in preschool children. J Child Psychol Psychiatry 48(10):976–987. PubMedCrossRefGoogle Scholar
  9. 9.
    De Jongh A, Resick PA, Zoellner LA, van Minnen A, Lee CW, Monson CM, Foa EB, Wheeler K, Broeke ET, Feeny N, Rauch SA, Chard KM, Mueser KT, Sloan DM, van der Gaag M, Rothbaum BO, Neuner F, de Roos C, Hehenkamp LM, Rosner R, Bicanic IA (2016) Critical analysis of the current treatment guidelines for complex PTSD in adults. Depress Anxiety 33(5):359–369. PubMedCrossRefGoogle Scholar
  10. 10.
    Mikita N, Stringaris A (2013) Mood dysregulation. Eur Child Adolesc Psychiatry 22(Suppl 1):S11–S16. PubMedCrossRefGoogle Scholar
  11. 11.
    Vidal-Ribas P, Brotman MA, Valdivieso I, Leibenluft E, Stringaris A (2016) The status of irritability in psychiatry: a conceptual and quantitative review. J Am Acad Child Adolesc Psychiatry 55(7):556–570. PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Marwaha S, He Z, Broome M, Singh SP, Scott J, Eyden J, Wolke D (2014) How is affective instability defined and measured? A systematic review. Psychol Med 44(9):1793–1808. PubMedCrossRefGoogle Scholar
  13. 13.
    Kochanska G, Coy KC, Murray KT (2001) The development of self-regulation in the first four years of life. Child Dev 72(4):1091–1111PubMedCrossRefGoogle Scholar
  14. 14.
    Spear LP (2009) Heightened stress responsivity and emotional reactivity during pubertal maturation: implications for psychopathology. Dev Psychopathol 21(1):87–97. PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Shaw P, Stringaris A, Nigg J, Leibenluft E (2014) Emotion dysregulation in attention deficit hyperactivity disorder. Am J Psychiatry 171(3):276–293. PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Stringaris A, Taylor E (2015) Disruptive mood. Oxford University Press, OxfordCrossRefGoogle Scholar
  17. 17.
    Smith GE (1918) Shell Shock and its lessons. Longmans, Green & co., HarlowGoogle Scholar
  18. 18.
    Friedman MJ (2013) Finalizing PTSD in DSM-5: getting here from there and where to go next. J Trauma Stress 26(5):548–556. PubMedCrossRefGoogle Scholar
  19. 19.
    Maercker A, Brewin CR, Bryant RA, Cloitre M, Reed GM, van Ommeren M, Humayun A, Jones LM, Kagee A, Llosa AE, Rousseau C, Somasundaram DJ, Souza R, Suzuki Y, Weissbecker I, Wessely SC, First MB, Saxena S (2013) Proposals for mental disorders specifically associated with stress in the international classification of diseases-11. Lancet 381(9878):1683–1685. PubMedCrossRefGoogle Scholar
  20. 20.
    Dalgleish T, Power MJ (2004) Emotion-specific and emotion-non-specific components of posttraumatic stress disorder (PTSD): implications for a taxonomy of related psychopathology. Behav Res Ther 42(9):1069–1088. PubMedCrossRefGoogle Scholar
  21. 21.
    Hyland P, Shevlin M, Brewin CR, Cloitre M, Downes AJ, Jumbe S, Karatzias T, Bisson JI, Roberts NP (2017) Validation of post-traumatic stress disorder (PTSD) and complex PTSD using the international trauma questionnaire. Acta Psychiatr Scand. Google Scholar
  22. 22.
    Van der Kolk BA, Perry J, Herman JL (1991) Childhood origins of self-destructive behavior. Am J Psychiatry 148(12):1665–1671PubMedCrossRefGoogle Scholar
  23. 23.
    Cook A, Spinazzola J, Ford J, Lanktree C, Blaustein M, Cloitre M, DeRosa R, Hubbard R, Kagan R, Liautaud J, Mallah K, Olafson E, van der Kolk B (2005) Complex trauma in children and adolescents. Psychiatr Ann 35(5):390–398CrossRefGoogle Scholar
  24. 24.
    Cloitre M, Garvert DW, Brewin CR, Bryant RA, Maercker A (2013) Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis. Eur J Psychotraumatol. Google Scholar
  25. 25.
    Perkonigg A, Hoefler M, Cloitre M, Wittchen H-U, Trautmann S, Maercker A (2016) Evidence for two different ICD-11 posttraumatic stress disorders in a community sample of adolescents and young adults. Eur Arch Psychiatry Clin Neurosci 266(4):317–328. PubMedCrossRefGoogle Scholar
  26. 26.
    Elklit A, Hyland P, Shevlin M (2014) Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples. Eur J Psychotraumatol. Google Scholar
  27. 27.
    Seligowski AV, Lee DJ, Bardeen JR, Orcutt HK (2015) Emotion regulation and posttraumatic stress symptoms: a meta-analysis. Cogn Behav Ther 44(2):87–102. PubMedCrossRefGoogle Scholar
  28. 28.
    Orth U, Wieland E (2006) Anger, hostility, and posttraumatic stress disorder in trauma-exposed adults: a meta-analysis. J Consult Clin Psychol 74(4):698–706. PubMedCrossRefGoogle Scholar
  29. 29.
    Olatunji BO, Ciesielski BG, Tolin DF (2010) Fear and loathing: a meta-analytic review of the specificity of anger in PTSD. Behav Ther 41(1):93–105. PubMedCrossRefGoogle Scholar
  30. 30.
    Novaco RW, Chemtob CM (2002) Anger and combat-related posttraumatic stress disorder. J Trauma Stress 15(2):123–132. PubMedCrossRefGoogle Scholar
  31. 31.
    Orth U, Cahill SP, Foa EB, Maercker A (2008) Anger and posttraumatic stress disorder symptoms in crime victims: a longitudinal analysis. J Consult Clin Psychol 76(2):208–218PubMedCrossRefGoogle Scholar
  32. 32.
    Cloitre M, Courtois CA, Charuvastra A, Carapezza R, Stolbach BC, Green BL (2011) Treatment of complex PTSD: results of the ISTSS expert clinician survey on best practices. J Trauma Stress 24(6):615–627. PubMedCrossRefGoogle Scholar
  33. 33.
    Ford JD, Kidd P (1998) Early childhood trauma and disorders of extreme stress as predictors of treatment outcome with chronic posttraumatic stress disorder. J Trauma Stress 11(4):743–761. PubMedCrossRefGoogle Scholar
  34. 34.
    Gillies D, Maiocchi L, Bhandari AP, Taylor F, Gray C, O’Brien L (2016) Psychological therapies for children and adolescents exposed to trauma. Cochrane Database Syst Rev 10:012371. Google Scholar
  35. 35.
    Gutermann J, Schreiber F, Matulis S, Schwartzkopff L, Deppe J, Steil R (2016) Psychological treatments for symptoms of posttraumatic stress disorder in children, adolescents, and young adults: a meta-analysis. Clin Child Fam Psychol Rev 19(2):77–93. PubMedCrossRefGoogle Scholar
  36. 36.
    Forman-Hoffman VL, Zolotor AJ, McKeeman JL, Blanco R, Knauer SR, Lloyd SW, Fraser JG, Viswanathan M (2013) Comparative effectiveness of interventions for children exposed to nonrelational traumatic events. Pediatrics 131(3):526–539. PubMedCrossRefGoogle Scholar
  37. 37.
    Taussig HN, Culhane SE (2010) Impact of a mentoring and skills group program on mental health outcomes for maltreated children in foster care. Arch Pediatr Adolesc Med 164(8):739–746. PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Cohen JA, Mannarino AP, Knudsen K (2005) Treating sexually abused children: 1 year follow-up of a randomized controlled trial. Child Abuse Negl 29(2):135–145. PubMedCrossRefGoogle Scholar
  39. 39.
    Diehle J, Opmeer BC, Boer F, Mannarino AP, Lindauer RJ (2015) Trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing: what works in children with posttraumatic stress symptoms? A randomized controlled trial. Eur Child Adolesc Psychiatry 24(2):227–236. PubMedCrossRefGoogle Scholar
  40. 40.
    Kmet LM, Lee RC, Cook LS (2004). Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Accessed 3 Oct 2017
  41. 41.
    Lavi T, Solomon Z (2005) Palestinian youth of the intifada: PTSD and future orientation. J Am Acad Child Adolesc Psychiatry 44(11):1176–1183PubMedCrossRefGoogle Scholar
  42. 42.
    Ehlers A, Mayou RA, Bryant B (2003) Cognitive predictors of posttraumatic stress disorder in children: results of a prospective longitudinal study. Behav Res Ther 41(1):1–10PubMedCrossRefGoogle Scholar
  43. 43.
    Field A (2013) Discovering statistics using IBM SPSS statistics. Sage, Newcastle upon TyneGoogle Scholar
  44. 44.
    Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327(7414):557–560. PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Grissom RJ, Kim J (2005) Effect sizes for research: a broad practical approach. Lawrence Erlbaum Associates Publishers, New JerseyGoogle Scholar
  46. 46.
    Cooper H (2009) The handbook of research synthesis and meta-analysis, 2nd edn. The Russell Sage Foundation, New YorkGoogle Scholar
  47. 47.
    Laor N, Wolmer L, Kora M, Yucel D, Spirman S, Yazgan Y (2002) Posttraumatic, dissociative and grief symptoms in Turkish children exposed to the 1999 earthquakes. J Nerv Mental Dis 190(12):824–832CrossRefGoogle Scholar
  48. 48.
    Martinez W, Polo AJ, Zelic KJ (2014) Symptom variation on the trauma symptom checklist for children: a within-scale meta-analytic review. J Trauma Stress 27(6):655–663PubMedCrossRefGoogle Scholar
  49. 49.
    Pelaprat M (2010) Complex trauma among court-involved youth. Dissertation, Massachusetts School of Professional PsychologyGoogle Scholar
  50. 50.
    Stallard P, Velleman R, Langsford J, Baldwin S (2001) Coping and psychological distress in children involved in road traffic accidents. Br J Clin Psychol 40(2):197–208PubMedCrossRefGoogle Scholar
  51. 51.
    Plomin R, Haworth CM, Davis OS (2009) Common disorders are quantitative traits. Nat Rev Genet 10(12):872–878. PubMedCrossRefGoogle Scholar
  52. 52.
    Stringaris A (2015) Emotion regulation and emotional disorders: conceptual issues for clinicians and neuroscientists. In: Thapar A et al (eds) Rutter’s child and adolescent psychiatry, 6th edn. Wiley-Blackwell, New Jersey, pp 53–64Google Scholar
  53. 53.
    Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Sterne JA, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Lau J, Carpenter J, Rücker G, Harbord RM, Schmid CH, Tetzlaff J, Deeks JJ, Peters J, Macaskill P, Schwarzer G, Duval S, Altman DG, Moher D, Higgins JP (2011) Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 343:d4002PubMedCrossRefGoogle Scholar
  55. 55.
    Ovaert LB, Cashel ML, Sewell KW (2003) Structured group therapy for posttraumatic stress disorder in incarcerated male juveniles. Am J Orthopsychiatry 73(3):294–301PubMedCrossRefGoogle Scholar
  56. 56.
    Ovaert LB (1998) Posttraumatic stress disorder in adolescents with conduct disorder: pre- and post-treatment comparison of trauma types. Dissertation, University of North TexasGoogle Scholar
  57. 57.
    Bicanic I, de Roos C, van Wesel F, Sinnema G, van de Putte E (2014) Rape-related symptoms in adolescents: short- and long-term outcome after cognitive behavior group therapy. Eur J Psychotraumatol 5(1):22969CrossRefGoogle Scholar
  58. 58.
    Olafson E, Boat BW, Putnam KT, Thieken L, Marrow MT, Putnam FW (2016) Implementing trauma and grief component therapy for adolescents and think trauma for traumatized youth in secure juvenile justice settings. J Interpers Violence. PubMedGoogle Scholar
  59. 59.
    Dauber S, Lotsos K, Pulido ML (2015) Treatment of complex trauma on the front lines: a preliminary look at child outcomes in an agency sample. Child Adolesc Soc Work J 32(6):529–543CrossRefGoogle Scholar
  60. 60.
    Kagan R, Spinazzola J (2013) Real Life Heroes in residential treatment: implementation of an integrated model of trauma and resiliency-focused treatment for children and adolescents with complex PTSD. J Fam Violence 28(7):705–715CrossRefGoogle Scholar
  61. 61.
    Betancourt TS, McBain R, Newnham EA, Akinsulure-Smith AM, Brennan RT, Weisz JR, Hansen NB (2014) A behavioral intervention for war-affected youth in Sierra Leone: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry 53(12):1288–1297PubMedPubMedCentralCrossRefGoogle Scholar
  62. 62.
    March JS, Amaya-Jackson L, Murray MC, Schulte A (1998) Cognitive-behavioral psychotherapy for children and adolescents with posttraumatic stress disorder after a single-incident stressor. J Am Acad Child Adolesc Psychiatry 37(6):585–593PubMedCrossRefGoogle Scholar
  63. 63.
    Ford JD, Steinberg KL, Hawke J, Levine J, Zhang W (2012) Randomized trial comparison of emotion regulation and relational psychotherapies for PTSD with girls involved in delinquency. J Clin Child Adolesc Psychol 41(1):27–37PubMedCrossRefGoogle Scholar
  64. 64.
    Mitchell R, Brennan K, Curran D, Hanna D, Dyer KF (2017) A meta-analysis of the association between appraisals of trauma and posttraumatic stress in children and adolescents. J Trauma Stress 30(1):88–93. PubMedCrossRefGoogle Scholar
  65. 65.
    Leucht S, Hierl S, Kissling W, Dold M, Davis JM (2012) Putting the efficacy of psychiatric and general medicine medication into perspective: review of meta-analyses. Br J Psychiatry 200(2):97–106. PubMedCrossRefGoogle Scholar
  66. 66.
    Brewin CR, Cloitre M, Hyland P, Shevlin M, Maercker A, Bryant RA, Humayun A, Jones LM, Kagee A, Rousseau C, Somasundaram D, Suzuki Y, Wessely S, van Ommeren M, Reed GM (2017) A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD. Clin Psychol Rev 58:1–15. PubMedCrossRefGoogle Scholar
  67. 67.
    Sachser C, Keller F, Goldbeck L (2017) Complex PTSD as proposed for ICD-11: validation of a new disorder in children and adolescents and their response to trauma-focused cognitive behavioral therapy. J Child Psychol Psychiatry 58(2):160–168. PubMedCrossRefGoogle Scholar
  68. 68.
    Bardeen JR, Kumpula MJ, Orcutt HK (2013) Emotion regulation difficulties as a prospective predictor of posttraumatic stress symptoms following a mass shooting. J Anxiety Disord 27(2):188–196PubMedPubMedCentralCrossRefGoogle Scholar
  69. 69.
    Messman-Moore TL, Walsh KL, DiLillo D (2010) Emotion dysregulation and risky sexual behavior in revictimization. Child Abuse Negl 34(12):967–976. PubMedCrossRefGoogle Scholar
  70. 70.
    Dixon-Gordon KL, Tull MT, Gratz KL (2014) Self-injurious behaviors in posttraumatic stress disorder: an examination of potential moderators. J Affect Disord 166:359–367PubMedPubMedCentralCrossRefGoogle Scholar
  71. 71.
    Tull MT, Bardeen JR, DiLillo D, Messman-Moore T, Gratz KL (2015) A prospective investigation of emotion dysregulation as a moderator of the relation between posttraumatic stress symptoms and substance use severity. J Anxiety Disord 29:52–60PubMedCrossRefGoogle Scholar
  72. 72.
    Feiring C, Taska L, Lewis M (2002) Adjustment following sexual abuse discovery: the role of shame and attributional style. Dev Psychol 38(1):79–92PubMedCrossRefGoogle Scholar
  73. 73.
    Mouilso ER, Calhoun KS, Gidycz CA (2011) Effects of participation in a sexual assault risk reduction program on psychological distress following revictimization. J Interpers Violence 26(4):769–788. PubMedCrossRefGoogle Scholar
  74. 74.
    Sharma-Patel K, Brown EJ (2016) Emotion regulation and self blame as mediators and moderators of trauma-specific treatment. Psychol Violence 6(3):400–409CrossRefGoogle Scholar
  75. 75.
    Kaczkurkin AN, Asnaani A, Zhong J, Foa EB (2016) The moderating effect of state anger on treatment outcome in female adolescents with PTSD. J Trauma Stress 29(4):325–331. PubMedCrossRefGoogle Scholar
  76. 76.
    Bender PK, Pons F, Harris PL, Esbjorn BH, Reinholdt-Dunne ML (2015) Emotion understanding in clinically anxious children: a preliminary investigation. Front Psychol 6:1916. PubMedPubMedCentralCrossRefGoogle Scholar
  77. 77.
    Bennett DC, Modrowski CA, Kerig PK, Chaplo SD (2015) Investigating the dissociative subtype of posttraumatic stress disorder in a sample of traumatized detained youth. Psychol Trauma 7(5):465–472PubMedCrossRefGoogle Scholar
  78. 78.
    Espil FM, Viana AG, Dixon LJ (2016) Post-traumatic stress disorder and depressive symptoms among inpatient adolescents: the underlying role of emotion regulation. Resid Treat Child Youth 33(1):51–68CrossRefGoogle Scholar
  79. 79.
    Hodges M, Godbout N, Briere J, Lanktree C, Gilbert A, Kletzka NT (2013) Cumulative trauma and symptom complexity in children: a path analysis. Child Abuse Negl 37(11):891–898PubMedCrossRefGoogle Scholar
  80. 80.
    Kerig PK, Bennett DC, Chaplo SD, Modrowski CA, McGee AB (2016) Numbing of positive, negative, and general emotions: associations with trauma exposure, posttraumatic stress, and depressive symptoms among justice-involved youth. J Trauma Stress 29(2):111–119PubMedCrossRefGoogle Scholar
  81. 81.
    Kimonis ER, Ray JV, Branch JR, Cauffman E (2011) Anger mediates the relation between violence exposure and violence perpetration in incarcerated boys. Child Youth Care Forum 40(5):381–400CrossRefGoogle Scholar
  82. 82.
    Lanktree CB, Briere J, Godbout N, Hodges M, Chen K, Trimm L, Adams B, Maida CA, Freed W (2012) Treating multitraumatized, socially marginalized children: results of a naturalistic treatment outcome study. J Aggress Maltreat Trauma 21(8):813–828CrossRefGoogle Scholar
  83. 83.
    Ma EY, Li FW (2014) Developmental trauma and its correlates: a study of Chinese children with repeated familial physical and sexual abuse in Hong Kong. J Trauma Stress 27(4):454–460PubMedCrossRefGoogle Scholar
  84. 84.
    Marsee MA (2008) Reactive aggression and posttraumatic stress in adolescents affected by Hurricane Katrina. J Clin Child Adolesc Psychol 37(3):519–529PubMedCrossRefGoogle Scholar
  85. 85.
    Mazloom M, Yaghubi H, Mohammadkhani S (2016) Post-traumatic stress symptom, metacognition, emotional schema and emotion regulation: a structural equation model. Personal Individ Differ 88:94–98CrossRefGoogle Scholar
  86. 86.
    Ovaert LB (1998) Posttraumatic stress disorder in adolescents with conduct disorder: pre- and post-treatment comparison of trauma types. Dissertation, University of North TexasGoogle Scholar
  87. 87.
    Runyon MK, Deblinger E, Schroeder CM (2009) Pilot evaluation of outcomes of combined parent–child cognitive-behavioral group therapy for families at risk for child physical abuse. Cogn Behav Pract 16(1):101–118CrossRefGoogle Scholar
  88. 88.
    Sandler L, Sommerfeld E, Shoval G, Tsafrir S, Chemny A, Laor N, Zalsman G (2015) Effects of ethnicity on sub-clinical PTSD and depressive symptoms, following exposure to missile attacks in Israel—a pilot study. Int J Psychiatry Clin Pract 19(1):51–55PubMedCrossRefGoogle Scholar
  89. 89.
    Wechsler-Zimring A, Kearney CA, Kaur H, Day T (2012) Posttraumatic stress disorder and removal from home as a primary, secondary, or disclaimed trauma in maltreated adolescents. J Fam Violence 27(8):813–818CrossRefGoogle Scholar
  90. 90.
    Whalen DJ, Malkin ML, Freeman MJ, Young J, Gratz KL (2015) Brief report: borderline personality symptoms and perceived caregiver criticism in adolescents. J Adolesc 41:157–161PubMedPubMedCentralCrossRefGoogle Scholar
  91. 91.
    Zajac K, Ralston ME, Smith DW (2015) Maternal support following childhood sexual abuse: associations with children’s adjustment post-disclosure and at 9-month follow-up. Child Abuse Negl 44:66–75PubMedPubMedCentralCrossRefGoogle Scholar
  92. 92.
    Bennett DC, Kerig PK, Chaplo SD, McGee AB, Baucom BR (2014) Validation of the five-factor model of PTSD symptom structure among delinquent youth. Psychol Trauma 6(4):438–447CrossRefGoogle Scholar
  93. 93.
    Lanktree CB, Gilbert AM, Briere J, Taylor N, Chen K, Maida CA, Saltzman WR (2008) Multi-informant assessment of maltreated children: convergent and discriminant validity of the TSCC and TSCYC. Child Abuse Negl 32(6):621–625PubMedCrossRefGoogle Scholar
  94. 94.
    Pat-Horenczyk R, Kenan AM, Achituv M, Bachar E (2014) Protective factors based model for screening for posttraumatic distress in adolescents. Child Youth Care Forum 43(3):339–351CrossRefGoogle Scholar
  95. 95.
    Shenk CE, Putnam FW, Noll JG (2013) Predicting the accuracy of facial affect recognition: the interaction of child maltreatment and intellectual functioning. J Exp Child Psychol 114(2):229–242PubMedCrossRefGoogle Scholar
  96. 96.
    Valdez CE, Bailey BE, Santuzzi AM, Lilly MM (2014) Trajectories of depressive symptoms in foster youth transitioning into adulthood: the roles of emotion dysregulation and PTSD. Child Maltreat 19(3–4):209–218PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • L. Villalta
    • 1
  • P. Smith
    • 2
  • N. Hickin
    • 2
  • A. Stringaris
    • 3
  1. 1.Child and Adolescent Psychiatry DepartmentHospital Sant Joan de DeuBarcelonaSpain
  2. 2.Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
  3. 3.Mood Brain & Development Unit, Emotion and Development BranchNational Institute of Mental HealthBethesdaUSA

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