Network News
Study Finds Exposure to Interpersonal Violence May Affect Treatments for Behavior Disorders
Feb 23, 2015Disruptive behavior disorders (DBD) are some of the most prevalent psychiatric conditions among children and adolescents. Examples of DBDs are conduct disorder, attention deficit disorder, and oppositional defiant disorder. There are a number of established interventions for children with DBD and their families. However, despite positive short-term outcomes, scientists are uncertain about the long-term benefits of interventions. According to previous research, approximately half of children with DBD continued to have or regained symptoms three to five years after they received treatment. Chad Shenk, Assistant Professor of Human Development and Family Studies, wanted to learn more about the factors that accounted for variations in a child’s response to treatment. Why did some children display less problematic behaviors, while others continued to act out? Children with DBD often have a history involving one or more interpersonal violence (IPV) experiences. IPV includes exposures to sexual and physical assault, domestic violence, and violence outside of the home. Researchers know that IPV increases the risk for DBD symptoms, neuroendocrine disruption, and callous-unemotional (CU) traits, which include severe emotional conditions like an extreme lack of empathy or an indifference to rules or laws. Children with CU traits typically have the most severe conduct problems. Dr. Shenk was curious if these IPV experiences were affecting treatment results. “For decades researchers have studied the effectiveness of behavioral interventions and clinical trials that treat DBD,” Dr. Shenk said. “We wanted to see if the differences in outcomes depended on whether the child had been exposed to IPV or not.” Dr. Shenk and his colleagues recruited 66 boys between the ages of 6 and 11, all of whom had received treatment for DBD symptoms. Using a 15-item questionnaire, the research team identified which of the participants had a history of IPV. Fifty-four percent of the participating boys had at least one IPV experience. The research team conducted six treatment evaluations over a three-year period to examine the long-term effects of the treatment. In the evaluations, CU traits, DBD symptoms, and cortisol levels were monitored. Individuals who are exposed to a traumatic event typically have high levels of cortisol, measured using saliva samples. The team predicted that for those boys with an IPV history, treatment would not be as successful over the long term. “We found that the boys who had experienced at least one incident of IPV did far worse in their response to initial treatment,” Dr. Shenk said. “For boys who were not exposed to IPV, treatment successfully reduced symptoms to a significantly greater magnitude when compared to those boys with an IPV history.” The research found that in addition to a lack of emotional symptoms from boys with IPV histories, interventions had little effect on cortisol trajectories for these boys as well, indicating no change in stress levels. These results provide a basis to screen for IPV before conducting interventions for DBDs. There are many evidence-based interventions that treat DBD. These programs aim to reduce emotional and behavioral problems among children by incorporating trauma-informed treatment components into DBD interventions “Once clinicians find out that a child has an IPV history, it’s pretty clear—based on this research—that you need to do something more than the traditional treatment for DBD,” Dr. Shenk said. Future steps include adding these trauma-focused components to interventions that treat DBD. The team will work on implementing the IPV screen into diagnostic practice and monitor its success in improving established interventions.
Researchers Investigate Long-Term Effects of Early Abuse
Jan 15, 2015From Penn State News Penn State researchers want to know if victims of child sexual abuse age faster than their counterparts. Though the physiological effects of early life trauma receive considerable attention, many of these victims are not followed up on, and long-term outcomes are not always studied. Jennie Noll, Professor of Human Development and Family Studies, wants to change that. Dr. Noll is principal investigator of the National Institutes of Health (NIH) Female Growth and Development Study (FGDS), a longitudinal study of the long-term sequelae of sexual abuse that began in 1987. At the time, the mean age of the girls in the sample was 10. In September, Dr. Noll was awarded additional funding from the National Institute of Child Health and Human Development to continue to track the cohort and conduct assessments when the women in the sample will be aged 38 to 40. Researchers specializing in aging in the College of Health and Human Development have joined the study, which aims to examine the long-term effects of child maltreatment and premature cognitive aging in later life. Combining expertise Dr. Noll is a professor in the Department of Human Development and Family Studies (HDFS) and director of research and education at the Child Maltreatment Solutions Network. “For most of the past 17 years I have had the distinct good fortune to work directly with Frank Putnam (University of North Carolina School of Medicine) and Penelope Trickett (University School of Southern California School of Social Work) on their ground-breaking study, and I have been a PI for the past 10 years,” Noll said. Both Putnam and Trickett remain involved in the research. Dr. Noll, whose graduate training is in aging, joined Penn State about a year ago, at which time she began working with Martin Sliwinski and David Almeida at the Center for Healthy Aging. “Recently, we received an NIH Research Project Grant to continue to assess this cohort, and their offspring, for the seventh and eighth waves, which will constitute the 27 and 30 year follow-ups of the initial assessment. The three main aims of the grant will be the assessment of physical health outcomes, intergenerational transmission of the effects of sexual abuse, and the identification of mechanisms of resilience,” Dr. Noll said. Asking more questions Of the 200 women in the study, half have been sexually abused. The other half, a matched control group, are of the same ages and races as their counterparts who have been abused, and also come from the same neighborhoods and family constellations. Therefore, any differences in cognitive function would most likely be due to abuse, not socioeconomic status. Dr. Noll noticed a few years ago, because of her background in aging, that the women who had suffered abuse were displaying cognitive or reasoning problems. In a paper on receptive language for sexually abused females, published in the journal Pediatrics in 2010, she found that victims of abuse were scoring lower on reasoning and memory tests. “I thought that it’s too early for the women to be showing these symptoms,” she said. “In normal development we wouldn’t start seeing things until the late 60s.” That’s why she decided to bring in Drs. Sliwinski and Almeida. “I knew I was going to need their expertise,” she said. The new grant adds cognitive tests, including about two weeks of daily stress coping assessments, to the original protocol, which contains a variety of vocabulary and reasoning tests. Assessments added by Dr. Sliwinski explore more fine-grained cognitive systems, such as information processing and visual acuity. These additional tests will enable researchers to more accurately pinpoint defects so they can target interventions, Dr. Noll said. “This is so we can say something much more definitive about the processes that are being affected,” she said. Dr. Noll believes that cognitive processes are impacted by early stress; that childhood sexual abuse is essentially bad for brain development. Furthermore, chronic stress results in more permanent cognitive damage than short-term stress, she said. For the cognitive assessments, subjects address what their stressors are and how they are coping through questionnaires and brain games on electronic tablets. “We think (chronic stress) is the most damaging kind of stress,” Dr. Noll said. The grant is funded under what Dr. Noll calls the “reversibility pot,” money designated specifically for research aimed at reversing the effects of chronic conditions. “We want science to show what we can do in midlife to change this cycle,” she said. “Can we train people at midlife to cope better so cognitive processes are preserved longer?” Dr. Noll said there are no other studies of stress that examine these processes all across the lifespan. “This is a good opportunity to advance several fields all at once,” she said. Dr. Almeida, Professor of HDFS, said he and Dr. Noll bring complementary areas of expertise to the study. Dr. Almeida studies “normal” stress as it affects daily life, while Dr. Noll focuses on long-term stress related to trauma. Together they are evaluating how childhood trauma affects daily life. “What happens in childhood lays the foundation for your life,” said Dr. Sliwinski, Professor of HDFS and director of the Center for Healthy Aging. “What we brought to the table was different methods to measure stress.” The study is entitled “Daily Stress Coping & Premature Cognitive Aging in Child Abuse Victims at Midlife.” For more information about the Department of Human Development and Family Studies at Penn State visit hhd.psu.edu/hdfs. For more information about the Center for Healthy Aging visit healthyaging.psu.edu. For more information about the Child Maltreatment Solutions Network visit here.
New Book Promotes Evidence Based Therapies, Connects Clinicians with Researchers
Sep 4, 2014Brian Allen, Assistant Professor of Pediatrics at Penn State Hersey and Network Faculty Member, saw a need to bridge the gap between researchers and clinicians working with children who have experienced trauma. Along with co-editor Mindy Kronenberg, a Clinical Assistant Professor of Psychiatry at the Louisiana State University School of Medicine, Dr. Allen aims to close the gap with his book, “Treating Traumatized Children: A Casebook of Evidence Based Therapies,” which was released last month. “We identified a need for published case studies to show clinicians how to overcome barriers,” Dr. Allen said. “The purpose of the book is to focus on improving the research-to-practice translation.” Connecting work conducted by researchers to real-life clinical practice, according to Dr. Allen, does not always happen naturally or smoothly. To open the dialogue, he asked clinicians using evidence based therapies (EBTs) to write detailed accounts of their most challenging cases. The cases are chapters in “Treating Traumatized Children,” and chronicle cases from the beginning to the end of treatments. The participating clinicians brainstormed with the editors to identify cases that covered a range of challenges, including sexual and physical abuse, neglect, witnessing abuse, drug use, and maternal depression. “We wanted to stay away from the textbook cases and asked clinicians to give us a case that challenged their skills,” Dr. Allen said. “There is no perfect example of a case.” Part 1 of the book overviews the development of EBTs and their importance to the treatment of trauma-exposed children. The final three parts discuss specific types of EBTs: cognitive behavioral, child-parent psychotherapy, and parent-child interaction therapy. Drs. Allen and Kronenberg make the researcher-to-practitioner link by introducing expert commentary that reviews the cases at the end of each part. The reviews identify strengths and areas for improvement in the treatment, as well as other suggestions and observations. Dr. Allen said, “Both clinicians and researchers saw this book as a worthy cause. It was great to see them come together to bridge the gap.” In one review of the volume, Sandra Azar, Professor of Psychology at Penn State, noted that the book is: “an excellent overview of the major empirically based approaches for trauma work with children. I recommend this book highly for graduate courses and staff training at agencies. It is useful for introducing the approaches as a prelude to gaining more focused accredited training and/or as follow-up for case discussions." Dr. Allen joined Penn State’s Child Maltreatment Solutions Network in June as the sixth of at least 12 new co-funded faculty hires. In addition to his work with the Penn State Hershey Center for the Protection of Children, based at Penn State Hershey Children’s Hospital and its Harrisburg-based James M. and Margaret V. Stine Foundation TLC (Transforming the Lives of Children) Clinic, which is expected to open in October, Allen specializes in research and treatment of child abuse and trauma.
Clinical Child Psychologist Joins Child Maltreatment Solutions Network
Jul 10, 2014Dr. Brian Allen is looking forward to building Penn State Hershey Children’s Hospital’s TLC (Transforming the Lives of Children) Clinic from the ground up, relying on evidence-based practices as its foundation. Dr. Allen joined Penn State’s Child Maltreatment Solutions Network in June as the sixth of at least 12 new co-funded faculty hires. In addition to his work with the Harrisburg based TLC Clinic and the Penn State Hershey Center for the Protection of Children, Dr. Allen serves as an Assistant Professor of Pediatrics, specializing in researching child abuse and trauma. “I can’t think of any other university that has committed such significant resources to address child abuse and trauma,” he said. “It’s a very exciting opportunity to advance clinical practice and research in ways that are not possible anywhere else.” One of Dr. Allen’s primary areas of interest is the dissemination of evidence-based treatments. He said there can be many road blocks for clinicians who want to implement these treatments properly – or at all. Dr. Allen’s goals are to raise awareness of the importance of using treatments that have been carefully studied to document their effectiveness and to support clinicians in their efforts to implement them. “These programs and practices have been validated in clinical trials and yet we continue to investigate ways to enhance their effectiveness,” he said. “Some practitioners may not be aware of what’s available or may be reluctant to adopt new approaches.” Other areas of Dr. Allen’s research include the impact of trauma on children and their development into adolescence and adulthood. Research shows, for example, that trauma can have serious and long-term effects on children, including post-traumatic stress disorder and depression. Allen also studies children who experience sexual behavior problems. “12 percent of child sexual abuse is perpetrated by other children,” he said. “A lot of times, these children don’t receive proper treatment or the issue is not taken seriously. We have ways to effectively treat and reduce sexual behavior problems in children.” Many of these treatments and related research will occur at the TLC Clinic. Dr. Allen hopes the TLC’s services will reach children across the central Pennsylvania region. The Clinic is scheduled to open on October 1. He said his initials goals are to provide evidence-based treatment programs, find ways to treat children regardless of ability to pay, and serve as a setting for research that will advance knowledge of best practices for helping victims of child maltreatment and their families. Dr. Allen comes to Penn State from Primary Children’s Hospital in Salt Lake City where he served as a clinical psychologist in the Center for Safe and Healthy Families. He received his Psy.D. from Indiana University of Pennsylvania and completed a doctoral internship at the University of California, Davis, Children’s Hospital and a post-doctoral fellowship at the National Center for Child Traumatic Stress at the University of California at Los Angeles. Dr. Allen joins Dr. Lori Frasier, Professor of Pediatrics and Division Chief of Child Abuse Pediatrics; Dr. Kent Hymel, Child Abuse Pediatrician; Jennie Noll, Professor of Human Development and Family Studies and Director of Research and Education for the Network; Idan Shalev, Assistant professor of Biobehavioral Health; and Chad Shenk, Assistant Professor of Human Development and Family Studies who are all part of the Network’s cluster hire. Together and in collaboration with other faculty members at Penn State whose research focuses on children, youth and families, the Network faculty will work to produce new knowledge on the causes and consequences of child maltreatment and effective approaches to its prevention, detection and treatment. More information about the Child Maltreatment Solutions Network is available at http://protecthildren.psu.edu.
Network Welcomes Dr. Kent Hymel
Apr 16, 2014Kent Hymel says that joining Penn State’s Child Maltreatment Solutions Network will enable him to fulfill professional goals that he cannot achieve anywhere else. The resources and collaborative opportunities with the University’s child maltreatment experts were too good to pass up. Hymel started at Penn State Hershey Children’s Hospital in March. He is a child abuse pediatrician and his research focuses on child physical abuse evaluation, with an emphasis on developing improved methods for screening for abusive head trauma. He expects that working with Penn State’s renowned faculty experts studying children, youth and families will help his research flourish. His research is aimed at improving the sensitivity and specificity of when and how evaluations for suspected child abuse occur — with particular emphasis on developing and implementing an algorithm regarding abusive head trauma that can be used by clinicians across the country. "There are data that show variability among physicians and other clinicians on whether to conduct a full-scale evaluation for suspected abuse,” Hymel said. “Evidence shows that professionals can be inconsistent in their judgments. This hurts children, their families and the professional community as well. We’re working to develop and validate an evidence-based measurement tool that combines relevant clinical findings to estimate the probability of abuse.” Physicians may struggle with a decision to launch — or forego — an evaluation for physical abuse, Hymel said. A screening tool can provide an objective basis for the decision to proceed with a full scale child abuse evaluation, and would promote consistent, evidence-based practice for addressing a complex problem. Having colleagues to work with will strengthen Hymel’s research. That is why establishing new collaborations is first on his to-do list. “I look forward to talking with others who come at the problem of child maltreatment from other disciplinary perspectives, with a different knowledge basis and methodological tools,” Hymel said. “That’s the real carrot. I believe Penn State and the network will provide these kinds of opportunities.” Hymel joins Jennie Noll, professor of human development and family studies, and director of research and education for the network; Chad Shenk, assistant professor of human development and family studies; Lori Frasier, professor of pediatrics and division chief of child abuse pediatrics; and Idan Shalev, assistant professor of biobehavioral health, as some of at least 12 network faculty hires. Brian Allen, a clinical child psychologist, is scheduled to join the network in June through an appointment at Penn State Hershey. For decades, Penn State has supported faculty members whose research spans a range of topics pertaining to child and family behavior, health and development. The network’s hires add expertise focused specifically on child maltreatment. Network faculty members are working to build cross-disciplinary collaborations and community-University relationships with the goal of translating research into sustainable, real-world practice. Hymel joins Penn State Hershey from Dartmouth-Hitchcock Medical Center in New Hampshire. He directed the medical center’s Child Advocacy and Protection Program. Prior to that, he was at the Inova Fairfax Hospital for Children in Virginia, where he served as medical director of its Forensic Assessment and Consultation Team. After completing his medical training, Hymel spent 20 years with the U.S. Air Force, serving at bases around the world. While serving in the Air Force, he trained as a child abuse pediatrician. Prior to retiring from active duty, Hymel served as the Air Force Medical Consultant in Child Abuse.
Conference on Child Protection and Well-Being Videos Available
Oct 18, 2013About 260 child advocates from around Pennsylvania gathered at The Penn Stater Conference Center Hotel on the University Park campus on September 25 to promote the expansion of multidisciplinary investigative teams and child advocacy centers. Penn State's Second Annual Conference on Child Protection and Well-Being aimed to provide information and share expertise in developing these teams and centers specifically in counties that do not have these resources. Read the full story on the conference on the Penn State News website. Opening Remarks Nicholas Jones Executive Vice President and Provost Penn State Honorable David Heckler District Attorney, Bucks County Chairman, Task Force on Child Protection Honorable Beverly D. Mackereth Secretary, PA Department of Public Welfare Mark R. Zimmer Chairman, PA Commission on Crime and Delinquency Keynote Speech Teresa Huizar Director, National Children's Alliance "Protecting Children - Building Multidisciplinary Investigative Teams and Child Advocacy Center Teams" MDIT Development Overview Penn State's Child Maltreatment Solutions Network CAC Development Model Set of Standards
Expert Panel Speaks on Preventing School Violence
May 7, 2013On April 1, Penn State's Social Science Research Institute, along with theChild Maltreatment Solutions Network; Outreach; World Campus; and several Centre County entities, sponsored a panel discussion that focused on the intricacies, responses, and effects of school violence. Two SSRI researchers, Drs. Karen Bierman and Brian Bumbarger, shared their expertise with a crowd of about 40 in the Outreach Building, and hundreds online. The evening's keynote speaker was John-Michael Keyes, who shared the story of his daughter, who lost her life in a Colorado school shooting in 2006. Rebecca Bywater, from Penn State's University Police & Public Safety, and Randy Rockey, the Centre County Director of Emergency Management, rounded out the evening's speakers. The line-up consisted of a diverse collection of specialties from several areas, and provided a complete look at school violence from many angles. For bios for each speaker, visit the event webpage on the Outreach site.
Professor named to governor's Council on Reform to aid vulnerable populations
Jul 26, 2025Jennie Noll, director of Penn State’s Child Maltreatment Solutions Network and professor of human development and family studies, is one of 25 individuals across the commonwealth to be appointed to Gov. Tom Wolf’s Council on Reform