ORCID

http://orcid.org/0000-0001-5690-5341

Date of Award

2021

Document Type

Dissertation

Degree Name

Philosophy (Ph.D)

Department

Psychology

First Advisor

Elissa Brown

Second Advisor

William Chaplin

Third Advisor

Tamara Del Vecchio

Abstract

Youth with maltreatment and/or interpersonal trauma histories often demonstrate significant executive function difficulties, which may negatively affect self-regulation and represent a transdiagnostic risk factor for trauma-related psychopathology and impaired functioning across domains. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based treatment for posttraumatic stress disorder (PTSD) symptoms and other mental health sequelae among maltreated youth; however, the potential impact of impact of TF-CBT on youth executive function difficulties has not been examined despite emerging evidence that executive function may be related to PTSD symptom severity among trauma-exposed youth. The current study sought to evaluate caregiver-reported executive function as a treatment outcome of TF-CBT among youth with interpersonal trauma histories and examine the associations between executive function and PTSD symptom trajectories. Univariate latent growth models, allowing for interindividual heterogeneity in intercepts and slopes, were used to estimate linear trajectories of caregiver-reported executive function difficulties among youth ages 6 to 17 (N = 278). Results demonstrated reductions in global and specific executive function difficulties during treatment for both children and adolescents. Bivariate latent growth models, estimated separately for children and adolescents, were used to examine the associations between executive function and PTSD change. Among children ages 6 to 11, higher initial levels of PTSD symptoms were associated with higher initial levels of difficulties in Attentional Control, r = .36, SD = .15, 95% CI [.06, .65] and Behavioral Control, r = .35, SD = .17, 95% CI [-.87, .81]. Among adolescents ages 12 to 17, rates of decrease in overall executive function difficulties were positively associated with rates of PTSD symptom reduction, r = .59, SD = .21, 95% CI [.11, .90]. Findings highlight caregiver-observed improvements in youth executive function concerns during TF-CBT and suggest that rates of reduction in executive function difficulties and PTSD symptoms are interrelated among adolescents.

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