Abstract
The study of change mechanisms in psychotherapy needs to be integrated with the causality of behavior, which leads to the concept of causal psychotherapy. Causal psychotherapy is posited as a useful adjunct to standard, evidence based psychotherapies for child and youth victims of abuse and trauma. The article illustrates six processes that could be involved in causal psychotherapy in this context, from the distal to the proximal. They include the distal mechanism of activation-inhibition coordination. The most proximal one relates to executive function. The intermediate levels include ones related to co-regulation (e.g., self control), analysis-synthesis, objectivity-subjectivity, and psychological reserve, which is a new concept in the domain of psychological change mechanisms. Each of the variables can vary from high to low, with the low end being more problematic. Psychotherapy can aim to bring the patient toward adaptive levels. The literature review focuses on psychotherapeutic change mechanisms, and standard psychotherapies for child/youth abuse/trauma, especially trauma-focused cognitive behavior therapy (TF-CBT). Then, it considers causal aspects of child/youth abuse and trauma, including PTSD. The discussion relates causal therapy to the question of unifying psychology and psychotherapy under the rubric of causality as a core integrative mechanism.
Similar content being viewed by others
References
Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 profile. University of Vermont, Department of Psychiatry.
Alpert, E., Hayes, A. M., Yasinski, C., Webb, C., & Deblinger, E. (2021). Processes of change in trauma-focused cognitive behavioral therapy for youths: An approach informed by emotional processing theory. Clinical Psychological Science, 9(2), 270–283. https://doi.org/10.1177/2167702620957315
American Psychiatric Association. (2000). DSM-IV-TR: Diagnostic and statistical manual of mental disorders (text revision (4th ed.). Author.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition: DSM-5 (5th ed.). Author.
An, Y., Hu, C. P., Zhao, J., Chen, Y., & Wu, X. (2021). Changes in the network structure of post-traumatic stress disorder symptoms among earthquake exposed adolescents in China: A 2-Year longitudinal study. Child Psychiatry & Human Development, 52(1), 104–113. https://doi.org/10.1007/s10578-020-00995-6
Atilola, O., Stevanovic, D., Moreira, P., Dodig-Ćurković, K., Franic, T., Djoric, A., Davidovic, N., Avicenna, M., Noor I. M., Monteiro, A. L., Ribas, A., Stupar, D., Deljkovic, A., Nussbaum, L., Thabet, A., Ubalde, D., Petrov, P., Vostanis, P., Knez, R. (2021). External locus-of-control partially mediates the association between cumulative trauma exposure and posttraumatic stress symptoms among adolescents from diverse background. Anxiety, Stress, & Coping, 1–19. https://doi.org/10.1080/10615806.2021.1891224
Aunger, R. (2020). Toward a model of situations and their context. Review of General Psychology, 24(3), 268–283. https://doi.org/10.1177/1089268020931767
Boisjoli, C., Hébert, M., Gauthier-Duchesne, A., & Caron, P. O. (2019). A mediational model linking perceptions of security, alexithymia and behavior problems of sexually abused children. Child Abuse & Neglect, 92, 66–76. https://doi.org/10.1016/j.chiabu.2019.03.017
Borelli, J. L., Cohen, C., Pettit, C., Normandin, L., Target, M., Fonagy, P., & Ensink, K. (2019). Maternal and child sexual abuse history: An intergenerational exploration of children’s adjustment and maternal trauma-reflective functioning. Frontiers in Psychology, 10, 1062. https://doi.org/10.3389/fpsyg.2019.01062
Borsboom, D. (2008). Psychometric perspectives on diagnostic systems. Journal of Clinical Psychology, 64(9), 1089–1108. https://doi.org/10.1002/jclp.20503
Boyd, J. E., O’Connor, C., Protopopescu, A., Jetly, R., Lanius, R. A., & McKinnon, M. C. (2020). The contributions of emotion regulation difficulties and dissociative symptoms to functional impairment among civilian inpatients with posttraumatic stress symptoms. Psychological Trauma: Theory, Research, Practice, and Policy, 12(7), 739–749. https://doi.org/10.1037/tra0000576
Breuer, F., Greggersen, W., Kahl, K. G., Schweiger, U., & Westermair, A. L. (2020). Caught in a web of trauma: Network analysis of childhood adversity and adult mental ill-health. Child Abuse & Neglect, 107, 104534. https://doi.org/10.1016/j.chiabu.2020.104534
Brown, E. J., Cohen, J. A., & Mannarino, A. P. (2020). Trauma-focused cognitive-behavioral therapy: The role of caregivers. Journal of Affective Disorders, 277, 39–45. https://doi.org/10.1016/j.jad.2020.07.123
Carey, T. A., Griffiths, R., Dixon, J. E., & Hines, S. (2020). Identifying functional mechanisms in psychotherapy: A scoping systematic review. Frontiers in Psychiatry, 11, 291. https://doi.org/10.3389/fpsyt.2020.00291
Carvalho, J. N., Renner, A. M., Donat, J. C., de Moura, T. C., Fonseca, R. P., & Kristensen, C. H. (2020). Executive functions and clinical symptoms in children exposed to maltreatment. Applied Neuropsychology: Child, 9(1), 1–12. https://doi.org/10.1080/21622965.2018.1497989
Chard, K. M., Healy, E. T., & Martin, C. E. (2020). Cognitive processing therapy. In J. D. Ford &. C. A. Courtois (Eds.), Treating complex traumatic stress disorders: An evidence-based guide, 249–266 (2nd ed.,). London, United Kingdom: Routledge.
Chung, M. C., & Chen, Z. S. (2021). The interrelationship between child abuse, emotional processing difficulties, alexithymia and psychological symptoms among Chinese adolescents. Journal of Trauma & Dissociation, 22(1), 107–121. https://doi.org/10.1080/15299732.2020.1788689
Cloitre, M., Brewin, C. R., Kazlauskas, E., Lueger‐Schuster, B., Karatzias, T., Hyland, P., & Shevlin, M. (2021). Commentary: The need for research on PTSD in children and adolescents – a commentary on Elliot et al. (2020). Journal of Child Psychology and Psychiatry, 62(3), 277–279. https://doi.org/10.1111/jcpp.13361
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents. Guilford Press.
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2017). Treating trauma and traumatic grief in children and adolescents (2nd ed.). Guilford Press.
Cohodes, E. M., Chen, S. H., Lieberman, A. F., & Bush, N. R. (2020). Examination of the associations between young children’s trauma exposure, trauma-symptomatology, and executive function. Child Abuse & Neglect, 108, 104635. https://doi.org/10.1016/j.chiabu.2020.104635
Danzi, B. A., La Greca, A. M., Greif Green, J., & Comer, J. S. (2021). What’s in a name? Comparing alternative conceptualizations of posttraumatic stress disorder among preadolescent children following the Boston marathon bombing and manhunt. Anxiety, Stress, & Coping, 34(5), 545–558. https://doi.org/10.1080/10615806.2021.1894330
DePrince, A. P., Weinzierl, K. M., & Combs, M. D. (2009). Executive function performance and trauma exposure in a community sample of children. Child Abuse & Neglect, 33(6), 353–361. https://doi.org/10.1016/j.chiabu.2008.08.002
D’Errico, L., Call, M., Blanck, P., Vonderlin, E., Bents, H., & Mander, J. (2019). Associations between mindfulness and general change mechanisms in individual therapy: Secondary results of a randomised controlled trial. Counselling & Psychotherapy Research, 19(4), 419–430. https://doi.org/10.1002/capr.12233
Ensink, K., Borelli, J. L., Normandin, L., Target, M., & Fonagy, P. (2020). Childhood sexual abuse and attachment insecurity: Associations with child psychological difficulties. American Journal of Orthopsychiatry, 90(1), 115–124. https://doi.org/10.1037/ort0000407
Finsterer, J., & Soraru, G. (2016). Onset manifestations of spinal and bulbar muscular atrophy (Kennedy’s disease). Journal of Molecular Neuroscience, 58(3), 321–329. https://doi.org/10.1007/s12031-015-0663-x
Fitzgerald, M., London-Johnson, A., & Gallus, K. L. (2020). Intergenerational transmission of trauma and family systems theory: An empirical investigation. Journal of Family Therapy, 42(3), 406–424. https://doi.org/10.1111/1467-6427.12303
Forte, G., Favieri, F., & Casagrande, M. (2019). Heart rate variability and cognitive function: A systematic review. Frontiers in Neuroscience, 13, 710. https://doi.org/10.3389/fnins.2019.00710
Gagne, J. R., Liew, J., & Nwadinobi, O. K. (2021). How does the broader construct of self-regulation relate to emotion regulation in young children? Developmental Review, 60, 100965. https://doi.org/10.1016/j.dr.2021.100965
Gahr, M., Nowak, D. A., Connemann, B. J., & Schönfeldt-Lecuona, C. (2013). Cerebral amyloidal angiopathy—A disease with implications for neurology and psychiatry. Brain Research, 1519, 19–30. https://doi.org/10.1016/j.brainres.2013.04.052
Gallagher, M. W., Long, L. J., Richardson, A., D’Souza, J., Boswell, J. F., Farchione, T. J., & Barlow, D. H. (2020). Examining hope as a transdiagnostic mechanism of change across anxiety disorders and CBT treatment protocols. Behavior Therapy, 51(1), 190–202. https://doi.org/10.1016/j.beth.2019.06.001
Gunnar, M., & Quevedo, K. (2007). The neurobiology of stress and development. Annual Review of Psychology, 58, 145–173. https://doi.org/10.1146/annurev.psych.58.110405.085605
Gunther, K. E., & Pérez-Edgar, K. (2021). Dopaminergic associations between behavioral inhibition, executive functioning, and anxiety in development. Developmental Review, 60, 100966. https://doi.org/10.1016/j.dr.2021.100966
Harmon-Jones, E., & Gable, P. A. (2018). On the role of asymmetric frontal cortical activity in approach and withdrawal motivation: An updated review of the evidence. Psychophysiology, 55(1), 1–23. https://doi.org/10.1111/psyp.12879
Heiss, S., Vaschillo, B., Vaschillo, E. G., Timko, C. A., & Hormes, J. M. (2021). Heart rate variability as a biobehavioral marker of diverse psychopathologies: A review and argument for an “ideal range.” Neuroscience & Biobehavioral Reviews, 121, 144–155. https://doi.org/10.1016/j.neubiorev.2020.12.004
Hidalgo, E. T., Orillac, C., Hersh, A., Harter, D. H., Rizzo, W. B., & Weiner, H. L. (2016). Intrathecal baclofen therapy for the treatment of spasticity in Sjögren-Larsson syndrome. Journal of Child Neurology, 32(1), 100–103. https://doi.org/10.1177/0883073816671440
Higginson, S., & Mansell, W. (2008). What is the mechanism of psychological change? A qualitative analysis of six individuals who experienced personal change and recovery. Psychology and Psychotherapy: Theory, Research and Practice, 81(3), 309–328. https://doi.org/10.1348/147608308X320125
Hoeboer, C., de Roos, C., van Son, G. E., Spinhoven, P., & Elzinga, B. (2021). The effect of parental emotional abuse on the severity and treatment of PTSD symptoms in children and adolescents. Child Abuse & Neglect, 111, 104775. https://doi.org/10.1016/j.chiabu.2020.104775
Holochwost, S., Wang, G., Kolacz, J., Mills-Koonce, W., Klika, J., & Jaffee, S. (2021). The neurophysiological embedding of child maltreatment. Development and Psychopathology, 33(3), 1107–1137. https://doi.org/10.1017/S0954579420000383
Jenness, J. L., Peverill, M., Miller, A. B., Heleniak, C., Robertson, M. M., Sambrook, K. A., Sheridan, M. A., & McLaughlin, K. A. (2021). Alterations in neural circuits underlying emotion regulation following child maltreatment: A mechanism underlying trauma-related psychopathology. Psychological Medicine, 51(11), 1880–1889. https://doi.org/10.1017/S0033291720000641
Jennissen, S., Connolly Gibbons, M. B., Crits-Christoph, P., Schauenburg, H., & Dinger, U. (2021). Insight as a mechanism of change in dynamic therapy for major depressive disorder. Journal of Counseling Psychology, 68(4), 435–445. https://doi.org/10.1037/cou0000554
Jensen, T. K., Holt, T., Ormhaug, S. M., Fjermestad, K. W., & Wezel- Larsen, T. (2018). Change in post-traumatic cognitions mediates treatment effects for traumatized youth – A randomized controlled trial. Journal of Counseling Psychology, 65(2), 166–177. https://doi.org/10.1037/cou0000258.
Kangaslampi, S., & Peltonen, K. (2019). Mechanisms of change in psychological interventions for posttraumatic stress symptoms: A systematic review with recommendations. Current Psychology, 1–18. https://doi.org/10.1007/s12144-019-00478-5
Karatzias, T., Shevlin, M., Ford, J. D., Fyvie, C., Grandison, G., Hyland, P., & Cloitre, M. (2021). Childhood trauma, attachment orientation, and complex PTSD (CPTSD) symptoms in a clinical sample: Implications for treatment. Development and Psychopathology. https://doi.org/10.1017/s0954579420001509
Katrinli, S., Zheng, Y., Gautam, A., Hammamieh, R., Yang, R., Venkateswaran, S., Kilaru, V., Lori, A., Hinrichs, R., Powers, A., Gillespie, C. F., Wingo, A. P., Michopoulos, V., Jovanovic, T., Wolf, E. J., McGlinchey, R. E., Milberg, W. P., Miller, M. W., Kugathasan, S., Smith, A. K. (2021). PTSD is associated with increased DNA methylation across regions of HLA-DPB1 and SPATC1L. Brain, Behavior, and Immunity, 91, 429–436. https://doi.org/10.1016/j.bbi.2020.10.023
Kazdin, A. E. (2007). Mediators and mechanisms of change in psychotherapy research. Annual Review of Clinical Psychology, 3, 1–27. https://doi.org/10.1146/annurev.clinpsy.3.022806.091432
Koenig, J., Kemp, A. H., Beauchaine, T. P., Thayer, J. F., & Kaess, M. (2016). Depression and resting state heart rate variability in children and adolescents—A systematic review and meta-analysis. Clinical Psychology Review, 46, 136–150. https://doi.org/10.1016/j.cpr.2016.04.013
Koyanagi, M., Imai, S., Iwamitsu, Y., Matsumoto, M., Saigo, M., Moriya, A., Ogihara, T., Nakazato, Y., Yonezawa, A., Nakagawa, S., Nakagawa, T., & Matsubara, K. (2021). Cilostazol is an effective causal therapy for preventing paclitaxel-induced peripheral neuropathy by suppression of Schwann cell dedifferentiation. Neuropharmacology, 188, 108514. https://doi.org/10.1016/j.neuropharm.2021.108514
Landolt, M. A., & Kenardy, J. A. (2015). Evidence-based treatments for children and adolescents. In U. Schnyder & M. Cloitre (Eds.). Evidence based treatments for trauma-related psychological disorders, 363–380. Springer, Cham. https://doi.org/10.1007/978-3-319-07109-1_19
Laurent, H. K., Gilliam, K. S., Wright, D. B., & Fisher, P. A. (2015). Child anxiety symptoms related to longitudinal cortisol trajectories and acute stress responses: Evidence of developmental stress sensitization. Journal of Abnormal Psychology, 124(1), 68–79. https://doi.org/10.1037/abn0000009
Leitzke, B. T., Hilt, L. M., & Pollak, S. D. (2015). Maltreated youth display a blunted blood pressure response to an acute interpersonal stressor. Journal of Clinical Child and Adolescent Psychology, 44(2), 305–313. https://doi.org/10.1080/15374416.2013.848774
Lemmens, L. H. J. M., Müller, V. N. L. S., Arntz, A., & Huibers, M. J. H. (2016). Mechanisms of change in psychotherapy for depression: An empirical update and evaluation of research aimed at identifying psychological mediators. Clinical Psychology Review, 50, 95–107. https://doi.org/10.1016/j.cpr.2016.09.004
Lengua, L. J., Thompson, S. F., Moran, L. R., Zalewski, M., Ruberry, E. J., Klein, M. R., & Kiff, C. J. (2021). Pathways from early adversity to later adjustment: Tests of the additive and bidirectional effects of executive control and diurnal cortisol in early childhood – Corrigendum. Development and Psychopathology, 32, 545–558. https://doi.org/10.1017/s0954579421000110
Li, Y., Lv, Q., Li, B., Luo, D., Sun, X., & Xu, J. (2020). The role of trauma experiences, personality traits, and genotype in maintaining posttraumatic stress disorder symptoms among child survivors of the Wenchuan earthquake. BMC Psychiatry, 20, 439. https://doi.org/10.1186/s12888-020-02844-1
Liu, R., Calkins, S. D., & Bell, M. A. (2021). Frontal EEG asymmetry moderates the associations between negative temperament and behavioral problems during childhood. Development and Psychopathology, 33(3), 1016–1025. https://doi.org/10.1017/S0954579420000309
Lombera, A., Lee, A. H., Sharma-Patel, K., & Brown, E. J. (2021). Threat-specific maltreatment exposure: Comparison of measurement models and associations with internalizing, externalizing, and PTSD symptoms. Child Abuse & Neglect, 115, 105010. https://doi.org/10.1016/j.chiabu.2021.105010
Maasalo, K., Lindblom, J., Kiviruusu, O., Santalahti, P., & Aronen, E. (2021). Longitudinal associations between inhibitory control and externalizing and internalizing symptoms in school-aged children. Development and Psychopathology, 33(3), 843–855. https://doi.org/10.1017/S0954579420000176
Marshall, C., & Langevin, R. (2021). Ego control mediates the effect of maltreatment on child depression. Journal of Child & Adolescent Trauma, 1–12. https://doi.org/10.1007/s40653-021-00356-y
Marusak, H. A., Hehr, A., Bhogal, A., Peters, C., Iadipaolo, A., & Rabinak, C. A. (2021). Alterations in fear extinction neural circuitry and fear-related behavior linked to trauma exposure in children. Behavioural Brain Research, 398, 112958. https://doi.org/10.1016/j.bbr.2020.112958
Mason, L., Mansell, W., Linden, D. E. J., & Kumari, V. (2021). Editorial: Returning to mechanisms in psychological therapies: Understand the engine before steaming in. Frontiers in Psychiatry, 12, 694088. https://doi.org/10.3389/fpsyt.2021.694088
McGuire, A., Steele, R. G., & Singh, M. N. (2021). Systematic review on the application of trauma-focused cognitive behavioral therapy (TF-CBT) for preschool-aged children. Clinical Child and Family Psychology Review, 24(1), 20–37. https://doi.org/10.1007/s10567-020-00334-0
Meiser-Stedman, R., Smith, P., McKinnon, A., Dixon, C., Trickey, D., Ehlers, A., Clark, D. M., Boyle, A., Watson, P., Goodyer, I., & Dalgleish, T. (2017). Cognitive therapy as an early treatment for post-traumatic stress disorder in children and adolescents: A randomized controlled trial addressing preliminary efficacy and mechanisms of action. Journal of Child Psychology and Psychiatry, 58(5), 623–633. https://doi.org/10.1111/jcpp.12673
Motsan, S., Bar-Kalifa, E., Yirmiya, K., & Feldman, R. (2020). Physiological and social synchrony as markers of PTSD and resilience following chronic early trauma. Depression and Anxiety, 38(1), 89–99. https://doi.org/10.1002/da.23106
Negriff, S., Gordis, E. B., & Susman, E. J. (2021). Associations between HPA axis reactivity and PTSD and depressive symptoms: Importance of maltreatment type and puberty. Development and Psychopathology, 1–12. https://doi.org/10.1017/s095457942100050x
Paz, C., Montesano, A., Winter, D., & Feixas, G. (2019). Cognitive conflict resolution during psychotherapy: Its impact on depressive symptoms and psychological distress. Psychotherapy Research, 29(1), 45–57. https://doi.org/10.1080/10503307.2017.1405172
Peters, W., Rice, S., Cohen, J., Murray, L., Schley, C., Alvarez-Jimenez, M., & Bendall, S. (2021). Trauma-focused cognitive–behavioral therapy (TF-CBT) for interpersonal trauma in transitional-aged youth. Psychological Trauma: Theory, Research, Practice, and Policy, 13(3), 313–321. https://doi.org/10.1037/tra0001016
Prince, D. M., Epstein, M., Nurius, P. S., Gorman-Smith, D., & Henry, D. B. (2019). Reciprocal effects of positive future expectations, threats to safety, and risk behavior across adolescence. Journal of Clinical Child and Adolescent Psychology, 48(1), 54–67. https://doi.org/10.1080/15374416.2016.1197835
Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. Guilford Press.
Rothbart, M. K., Ahadi, S. A., Hersey, K. L., & Fisher, P. (2001). Investigations of temperament at three to seven years: The Children’s Behavior Questionnaire. Child Development, 72(5), 1394–1408. https://doi.org/10.1111/1467-8624.00355
Schramm, A. T., Pandya, K., Fairchild, A. J., Venta, A. C., deRoon-Cassini, T. A., & Sharp, C. (2020). Decreases in psychological inflexibility predict PTSD symptom improvement in inpatient adolescents. Journal of Contextual Behavioral Science, 17, 102–108. https://doi.org/10.1016/j.jcbs.2020.06.007
Shenk, C. E., O’Donnell, K. J., Pokhvisneva, I., Kobor, M. S., Meaney, M. J., Bensman, H. E., & Olson, A. E. (2021). Epigenetic age acceleration and risk for posttraumatic stress disorder following exposure to substantiated child maltreatment. Journal of Clinical Child & Adolescent Psychology, 1–11. https://doi.org/10.1080/15374416.2020.1864738
Stern, Y. (2012). Cognitive reserve in ageing and Alzheimer’s disease. The Lancet Neurology, 11(11), 1006–1012. https://doi.org/10.1016/S1474-4422(12)70191-6
Sturge-Apple, M. L., Davies, P. T., Cicchetti, D., & Manning, L. G. (2012). Interparental violence, maternal emotional unavailability and children’s cortisol functioning in family contexts. Developmental Psychology, 48(1), 237–249. https://doi.org/10.1037/a0025419
Sutin, A. R., Stephan, Y., & Terracciano, A. (2018). Psychological well-being and risk of dementia. International Journal of Geriatric Psychiatry, 33(5), 743–747. https://doi.org/10.1002/gps.4849
Thompson, K., Kramarchuk, M., Yagnatovsky, M., Kunichoff, D., Zacchilli, M., Campbell, K. A., Alaia, M., Jazrawi, L., & Strauss, E. (2020). Pain catastrophizing is associated with increased physical disability in patients with anterior knee pain. Journal of Orthopaedics, 21, 283–286. https://doi.org/10.1016/j.jor.2020.04.021
Toth, S. L., Sturge-Apple, M. L., Rogosch, F. A., & Cicchetti, D. (2015). Mechanisms of change: Testing how preventative interventions impact psychological and physiological stress functioning in mothers in neglectful families. Development and Psychopathology, 27(4pt2), 1661–1674. doi: https://doi.org/10.1017/S0954579415001017
Tsvieli, N., Lifshitz, C., & Diamond, G. M. (2021). Corrective attachment episodes in attachment-based family therapy: The power of enactment. Psychotherapy Research, 1–14. https://doi.org/10.1080/10503307.2021.1913295
Tsvieli, N., Nir-Gottlieb, O., Lifshitz, C., Diamond, G. S., Kobak, R., & Diamond, G. M. (2020). Therapist interventions associated with productive emotional processing in the context of attachment-based family therapy for depressed and suicidal adolescents. Family Process, 59(2), 428–444. https://doi.org/10.1111/famp.12445
Tyrer, R., & Masterson, C. (2019). Clients’ experience of change: An exploration of the influence of reformulation tools in cognitive analytic therapy. Clinical Psychology & Psychotherapy, 26(2), 167–174. https://doi.org/10.1002/cpp.2339
Villalta, L., Khadr, S., Chua, K. C., Kramer, T., Clarke, V., Viner, R. M., Stringaris, A., & Smith, P. (2020). Complex post-traumatic stress symptoms in female adolescents: The role of emotion dysregulation in impairment and trauma exposure after an acute sexual assault. European Journal of Psychotraumatology, 11(1), 1710400. https://doi.org/10.1080/20008198.2019.1710400
Wagner, S. L., Cepeda, I., Krieger, D., Maggi, S., D’Angiulli, A., Weinberg, J., & Grunau, R. E. (2016). Higher cortisol is associated with poorer executive functioning in preschool children: The role of parenting stress, parent coping and quality of daycare. Child Neuropsychology, 22(7), 853–869. https://doi.org/10.1080/09297049.2015.1080232
Walker, H. E., Wamser-Nanney, R., & Howell, K. H. (2021). Child sexual abuse and adult sexual assault among emerging adults: Exploring the roles of posttraumatic stress symptoms, emotion regulation, and anger. Journal of Child Sexual Abuse, 30(4), 407–426. https://doi.org/10.1080/10538712.2021.1890295
Warmingham, J. M., Rogosch, F. A., & Cicchetti, D. (2020). Intergenerational maltreatment and child emotion dysregulation. Child Abuse & Neglect, 102, 104377. https://doi.org/10.1016/j.chiabu.2020.104377
Winn, L., & Cornelius, R. (2020). Self-objectification and cognitive performance: A systematic review of the literature. Frontiers in Psychology, 11, 20. https://doi.org/10.3389/fpsyg.2020.00020
World Health Organization. (2018). International classification of diseases for mortality and morbidity statistics (11th Revision). Retrieved from https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1136473465. Accessed date 31 May 2021.
Young, G. (2011). Development and causality: Neo-Piagetian perspectives. Springer Science + Business Media.
Young, G. (2015). Causality in psychiatry: A hybrid symptom network construct model. Frontiers in Psychiatry, 6, 164. https://doi.org/10.3389/fpsyt.2015.00164
Young, G. (2016). Unifying causality and psychology: Being, brain and behavior. Springer International Publishing.
Young, G. (2019a). Causality and development: Neo-Eriksonian perspectives. Springer International Publishing.
Young, G. (2019b). Personhood across disciplines: Applications to ethical theory and mental health ethics. Ethics, Medicine, and Public Health, 10, 93–101. https://doi.org/10.1016/jemep.2019.100407
Young, G. (2022). Causality and neo-stages in development: Toward unifying psychology. Springer International Publishing.
Zantvoord, J. B., Zhutovsky, P., Ensink, J. B., Op den Kelder, R., van Wingen, G. A., & Lindauer, R. J. (2021). Trauma-focused psychotherapy response in youth with posttraumatic stress disorder is associated with changes in insula volume. Journal of Psychiatric Research, 132, 207–214. https://doi.org/10.1016/j.jpsychires.2020.10.037
Zimmerman, A., Halligan, S., Skeen, S., Morgan, B., Fraser, A., Fearon, P., & Tomlinson, M. (2020). PTSD symptoms and cortisol stress reactivity in adolescence: Findings from a high adversity cohort in South Africa. Psychoneuroendocrinology, 121, 104846. https://doi.org/10.1016/j.psyneuen.2020.104846
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The author(s) declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Young, G. Psychotherapeutic Change Mechanisms and Causal Psychotherapy: Applications to Child Abuse and Trauma. Journ Child Adol Trauma 15, 911–923 (2022). https://doi.org/10.1007/s40653-022-00438-5
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40653-022-00438-5