FITT

 

FITT Model: Intergenerational Impact

  • Summary
  • Assessment Measures
  • Interventions
  • References

 

Summary

Although scant, the literature that addresses the impact of trauma on family of origin relationships in the context of urban poverty raises some important issues. In studies of violence-exposed urban adolescents the following findings are of interest: (1) parental psychopathology is a moderator in the relationship between community violence exposure, PTSD and distress; (2) parental PTSD is a potentiating factor for PTSD in their children; and (3) positive relationships with parents and high self reliance are protective factors. In the trauma literature, research has found that adults with histories of childhood abuse have problems with emotional regulation, social competence, and interpersonal relationships, leading to functional impairments in parenting patterns which affect outcomes in the next generation. In studies aimed at the transmission of risk or protection through parent child relationships in the context of poverty (urban and non) the following surfaced: a correlation between growing up in poverty and teen pregnancy which is associated with harsh parenting practices; cumulative maternal trauma is a predictor of child abuse potential and punitiveness; children of insecure caregivers with unresolved loss histories have increased behavior problems. In addition to the adult and child measures for PTSD and mood/behavior problems, studies have used the Adult Attachment Interview, the Parenting Stress Index, the Child Abuse Potential Inventory and the Lifetime Trauma Interview. The current literature offers little in the way of family intervention strategies geared to the urban poverty context. SURVIVE is a promising family based intervention for urban youth and parents with a focus on family and community violence. Engagement strategies that incorporate alliances with primary and extended family systems are essential to trauma interventions in urban poverty contexts. With the overrepresentation of ethnic groups in urban poverty populations, intervention strategies will be most effective if they build on cultural variations in family roles and functions.

 

 

Assessment Measures

Note: Intergeneration issues can be important to the response and adaptation to trauma, however, no instruments were endorsed in this section.

Name of Instrument Author(s) Domains Assessed Age Range  Source/Form (self report, lab, observation, other) # of items Time Cost Training Required Where to obtain  Psychometric Properties Other comments:  
Qualitative questions N/A Examples of possible qualitative questions include: "When you think back to your childhood, what sorts of traumatic events did your parent(s), grandparent(s), or primary caregiver(s) experience? Please explain each person's experience with a traumatic event" and "How did your parents(s), grandparent(s), or primary caregiver(s) respond, deal with or manage their feelings regarding the traumatic event?" N/A N/A N/A N/A N/A N/A N/A N/A  
Adult Attachment Interview George, Kaplan, & Main, 1985 Adult strategies for identifying, preventing, and protecting the self from perceived dangers, particularly those associated with intimate relationships  Adult Interview 20 60-90 Free access to measure, but approx. $1500 for training costs 2 weeks intensive training, followed by 18 months reliability checks Stony Brook Attachment Lab; Link: Click Here Strong evidence for reliability and validity  The AAI is primarily used in research. Requires a high level of training. After interview is completed, must transcribe full interview in order to score. 
Traumatic Stress Schedule (TSS) Norris, 1990 For use with general population and measures essential information about potentially traumatic events.  Excludes emotional abuse and neglect.  Adult Brief interview 12 questions for each of 10 types of trauma   5-30 minutes depending on person's history Free Familiarity w/administration, scoring guidelines, and interpretation Embedded within original reference (Norris, 1990). Also, can contact author directly: Fran.Norris@dartmouth.edu Strong evidence for reliability and validity  Score accounts for number and frequency of exposures. 
Working model of the child Zeanah, C.H. & Benoit, D., 1995 Assesses parents' perceptions of their infant's characteristics. Results in 1 of 3 classifications of representations: balanced, disengaged, distorted.  Parents of 0 to 48 month olds Structured Interview  22 1 hour  Free access to measure, but approx. $1500 for training costs 1 week intensive training, followed by additional reliability checks  Link to copy of measure: Click Here Strong evidence for reliability and validity  Extensive training required. Uses a formal coding system that results in 8 subscales. 

 

References

Bakermans-Kranenburg, M. J., & IJzendoom, M. H. (1993). A psychometric study of the Adult Attachment Interview: Reliability an discriminant validity. Developmental Psychology, 29, 870-879.

George, C., Kaplan, N., & Main, M. (1996). Adult Attachment Interview. Unpublished manuscript, University of California at Berkeley.

Norris, F. H. (1990). Screening for traumatic stress: A scale of use in the general population. Journal of Applied Social Psychology, 20, 1704-1718.

Norris, F. H. & Hamblen, J. L. (2004). Standardized self-report measures of civilian trauma and PTSD. In J.P. Wilson, T.M. Keane & T. Martin (Eds.), Assessing psychological trauma and PTSD (pp. 63-102). New York: Guilford Press.

Zeanah, C.H., & Benoit, D. (1995). Clinical adaptations of a parent perception interview in infant mental health. Child and Adolescent Psychiatric Clinics of North America, 4, 539-44.

 

Interventions

Treatment Name

Developer(s)

Essential Elements

URL for Additional Information

Clinician Assisted Videofeedback Exposure Session (CAVES)

Schechter, Myers, Brunelli, Coates, Zeanah, Davies, Grienenberger, Marshall, McCaw Trabka, & Liebowitz (2006)

Video session with mother and child to review interactions; used in conjunction with WMCI

http://www.ncbi.nlm.nih.gov/pmc/
articles/PMC2078524/

Supporting Urban Residents to be Violence-Free
in a Violent Environnent

(SURVIVE)

DeVoe, Dean, Traube & McKay (2005)

Family-based intervention for urban youth; 12 week program with family group format. Includes psychoeducation, safety planning, risk identification, and harm reduction

http://www.ncbi.nlm.nih.gov/pmc/
articles/PMC3045728/