The Effects of Trauma Type and Executive Dysfunction on Symptom Expression of Polyvictimized Youth in Residential Care.

Risk for traumatic sequelae is conveyed directly by risk factors (i.e., exposure to trauma), and via the disruption of developmental competencies. Exposure to caregiver trauma is an especially salient risk factor, as its early and pervasive nature is likely to undermine multiple facets of development, most notably the emergence of cognitive controls (i.e., executive function [EF]). Deficits in EF have been observed among youth exposed to multiple types of trauma and are associated with a range of functional impairments, posttraumatic stress symptoms (PTSS), and behavioral disorders; they represent a mechanism by which the negative impact of caregiver trauma is conveyed. This study included 672 youth in residential placement, and examined the associations between both caregiver and noncaregiver trauma, measured by the Trauma History Profile (THP); executive dysfunction, measured by the Behavioral Inventory of Executive Function (BRIEF); PTSS, measured by the UCLA Posttraumatic Stress Disorder (PTSD) Reaction Index (PTSD-RI); and externalizing and internalizing problems, measured by the Child Behavior Checklist (CBCL). A structural equation model demonstrated direct associations between caregiver trauma and PTSS, β = .15; noncaregiver trauma and externalizing problems, β = .14; gender and PTSS, β = .26, externalizing problems, β = .12, and internalizing problems, β = .26; and age and externalizing problems, β = -.11. We observed indirect effects via deficits in EF between caregiver trauma and PTSS, β = .04 and externalizing problems, β = .19. Results indicate for screening for executive dysfunction among trauma-impacted youth is needed, as it represents a critical therapeutic target.