Journal of Youth and Adolescence

, Volume 40, Issue 12, pp 1674–1690 | Cite as

Gender Differences in the Longitudinal Impact of Exposure to Violence on Mental Health in Urban Youth

Empirical Research

Abstract

There is evidence of gender differences in psychopathology during adolescence, but little research has investigated gender differences in trauma-related symptoms. Exposure to violence is a commonly experienced potentially traumatic event among urban adolescents, and the few studies examining gender differences in its mental health impact have produced inconsistent findings. The present study examines the moderating effects of gender on the longitudinal association between exposure to violence and a variety of mental health symptoms (externalizing, internalizing, PTSD, dissociation) in a racially diverse urban adolescent sample (N = 615; 50.6% female; Time 1 mean age = 14.15; Time 2 mean age = 16.70). For both genders, exposure to violence prospectively predicted increases in all types of symptoms. Although boys reported more exposure to violence on average, girls experiencing violence were more likely to experience dissociative (but not PTSD, internalizing, or externalizing) symptoms. The results suggest that adolescent girls exposed to potentially traumatic events may be especially vulnerable to experiencing certain trauma-related symptoms and imply gender-specific pathways to trauma-related psychopathology.

Keywords

Gender Violence PTSD Dissociation Internalizing Externalizing 

Notes

Acknowledgments

We gratefully acknowledge the Project on Human Development in Chicago Neighborhoods (PHDCN) data set used in this study that was made available to researchers, and express our appreciation to the PHDCN study investigators, personnel, and participants. The PHDCN was supported by the US Department of Justice’s National Institute of Justice (93-IJ-CX-K005) and the John D. and Catherine T. MacArthur Foundation.

References

  1. Achenbach, T. (1991a). Manual for the Youth Self-Report and 1991 Profile. Burlington, VT: University of Vermont, Department of Psychiatry.Google Scholar
  2. Achenbach, T. M. (1991b). Manual for the child behavior checklist/4-18 and 1991 Profile. Burlington, VT: University of Vermont, Department of Psychiatry.Google Scholar
  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  4. Appleyard, K., Egeland, B., van Dulmen, M. H. M., & Sroufe, A. (2005). Why more is not better: The role of cumulative risk in child behavior outcomes. Journal of Child Psychology and Psychiatry, 46, 235–245.PubMedCrossRefGoogle Scholar
  5. Armstrong, J. G., Putnam, F. W., Carlson, E. B., Libero, D. Z., & Smith, S. R. (1997). Development and validation of a measure of adolescent dissociation: The Adolescent Dissociative Experiences Scale. Journal of Nervous and Mental Disease, 185, 491–494.PubMedCrossRefGoogle Scholar
  6. Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Disease, 164, 727–734.Google Scholar
  7. Breslau, N., Chilcoat, H. D., Kessler, R. C., Peterson, E. L., & Lucia, V. C. (1999). Vulnerability to assaultive violence: Further specification of the sex difference in posttraumatic stress disorder. Psychological Medicine, 29, 813–821.PubMedCrossRefGoogle Scholar
  8. Buka, S. L., Selner-O’Hagan, M. B., Kindlon, D. J., & Earls, F. J. (1997). The “my exposure to violence interviews:” Administration and scoring manual, version 3. Boston, MA: Harvard School of Public Health.Google Scholar
  9. Buka, S. L., Stichick, T. L., Birdthistly, I., & Earls, F. J. (2001). Youth exposure to violence: Prevalence, risks and consequences. American Journal of Orthopsychiatry, 71, 298–310.PubMedCrossRefGoogle Scholar
  10. Byrne, B. (2001). Structural equation modeling with AMOS: Basic concepts, applications and programming. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  11. Cooley-Quille, M., Boyd, R. C., Frantz, E., & Walsh, J. (2001). Emotional and behavioral impact of exposure to community violence in inner-city adolescents. Journal of Clinical Child Psychology, 30, 199–206.PubMedCrossRefGoogle Scholar
  12. Costello, E. J., Erkanli, A., Fairbank, J. A., & Angold, A. (2002). The prevalence of potentially traumatic events in childhood and adolescence. Journal of Traumatic Stress, 15, 99–112.PubMedCrossRefGoogle Scholar
  13. Cyranowski, J., Frank, E., Young, E., & Shear, K. (2000). Adolescent onset of the gender difference in lifetime rates of major depression: A theoretical model. Archives of General Psychiatry, 57, 21–27.PubMedCrossRefGoogle Scholar
  14. Dodge, K. A., & Somberg, D. R. (1987). Hostile attributional biases among aggressive boys are exacerbated under conditions of threats to the self. Child Development, 58, 213–224.PubMedCrossRefGoogle Scholar
  15. Elwood, L. S., Hahn, K. S., Olatunji, B. O., & Williams, N. L. (2009). Cognitive vulnerabilities to the development of PTSD: A review of four vulnerabilities and the proposal of an integrative vulnerability model. Clinical Psychology Review, 29, 87–100.PubMedCrossRefGoogle Scholar
  16. Farrell, A., & Bruce, S. (1997). Impact of exposure to community violence on violent behavior and emotional distress among urban adolescents. Journal of Clinical Child Psychology, 26, 2–14.PubMedCrossRefGoogle Scholar
  17. Farrington, A. F., Waller, G., Smerden, J., & Faupel, A. W. (2001). The Adolescent Dissociative Experiences Scale: Psychometric properties and differences in scores across age groups. Journal of Nervous and Mental Disease, 189, 722–727.PubMedCrossRefGoogle Scholar
  18. Fitzpatrick, K. M. (1993). Exposure to violence and presence of depression among low-income, African–American youth. Journal of Consulting and Clinical Psychology, 61, 528–531.PubMedCrossRefGoogle Scholar
  19. Fitzpatrick, K. M., & Boldizar, J. P. (1993). The prevalence and consequences of exposure to violence among African–American youth. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 424–430.PubMedCrossRefGoogle Scholar
  20. Folkman, S. (1984). Personal control and stress and coping processes: A theoretical analysis. Journal of Personality and Social Psychology, 46, 839–852.PubMedCrossRefGoogle Scholar
  21. Foster, J. D., Kuperminc, G. P., & Price, A. W. (2004). Gender differences in posttraumatic stress and related symptoms among inner-city minority youth exposed to community violence. Journal of Youth and Adolescence, 33, 59–70.CrossRefGoogle Scholar
  22. Fowler, P. J., Tompsett, C. J., Braciszewski, J. M., Jacques-Tiura, A. J., & Baltes, B. B. (2009). Community violence: A meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Development and Psychopathology, 21, 227–259.PubMedCrossRefGoogle Scholar
  23. Ge, X., Lorenz, F., Conger, R., & Elder, G. H. (1994). Trajectories of stressful life events and depressive symptoms during adolescence. Developmental Psychology, 30, 467–483.CrossRefGoogle Scholar
  24. Gershuny, B. S., & Thayer, J. F. (1999). Relations among psychological trauma, dissociative phenomena, and trauma-related distress: A review and integration. Clinical Psychology Review, 19, 631–657.PubMedCrossRefGoogle Scholar
  25. Gorman-Smith, D., Henry, D. B., & Tolan, P. H. (2004). Exposure to community violence and violence perpetration: The protective effects of family functioning. Journal of Clinical Child and Adolescent Psychology, 33, 439–449.PubMedCrossRefGoogle Scholar
  26. Gorman-Smith, D., & Tolan, P. (1998). The role of exposure to community violence and developmental problems among inner-city youth. Development and Psychopathology, 10, 101–116.PubMedCrossRefGoogle Scholar
  27. Griffin, M. G., Resnick, P. A., & Mechanic, M. B. (1997). Objective assessment of peritraumatic dissociation: Psychophysiological indicators. American Journal of Psychiatry, 154, 1081–1088.PubMedGoogle Scholar
  28. Guerra, N. G., Huesmann, L. R., & Spindler, A. (2003). Community exposure to violence, social cognition, and aggression among urban elementary school children. Child Development, 74, 1561–1577.PubMedCrossRefGoogle Scholar
  29. Hall, D. M., Cassidy, E. F., & Stevenson, H. C. (2008). Acting “tough” in a “tough” world: An examination of fear among urban African American adolescents. Journal of Black Psychology, 34, 381–398.CrossRefGoogle Scholar
  30. Hankin, B. L., & Abramson, L. (2001). Development of gender differences in depression: An elaborated cognitive vulnerability-transactional stress theory. Psychological Bulletin, 127, 773–796.PubMedCrossRefGoogle Scholar
  31. Hankin, B. L., Mermelstein, R., & Roesch, L. (2007). Sex differences in adolescent depression: Stress exposure and reactivity models. Child Development, 781, 279–295.CrossRefGoogle Scholar
  32. Hanson, R. F., Borntrager, C., Self-Brown, S., Kilpatrick, D. G., Saunders, B. E., Resnick, H. S., et al. (2008). Relations among gender, exposure to violence, and mental health: The National Survey of Adolescents. American Journal of Orthopsychiatry, 78, 313–321.PubMedCrossRefGoogle Scholar
  33. Harvey, A. G., & Bryant, R. A. (2000). Memory for acute stress disorder symptoms: A two-year prospective study. Journal of Nervous and Mental Disease, 188, 602–607.PubMedCrossRefGoogle Scholar
  34. Hollingshead, A. (1975). Four-factor index of social status. New Haven, CT: Yale University.Google Scholar
  35. Hornstein, H. L., & Putnam, F. W. (1992). Clinical phenomenology of child and adolescent dissociative disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 1077–1085.PubMedCrossRefGoogle Scholar
  36. Horowitz, K., Weine, S., & Jekel, J. (1995). PTSD symptoms in urban adolescent girls: Compounded community trauma. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 1353–1361.CrossRefGoogle Scholar
  37. Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the National Survey of Adolescents. Journal of Consulting and Clinical Psychology, 71, 692–700.PubMedCrossRefGoogle Scholar
  38. Kliewer, W., Lepore, S. J., Oskin, D., & Johnson, P. D. (1998). The role of social and cognitive processes in children’s adjustment to community violence. Journal of Consulting and Clinical Psychology, 66, 199–209.PubMedCrossRefGoogle Scholar
  39. Koopman, C., Carrion, V., Butler, L. D., Sudhakar, S., Palmer, L., & Steiner, H. (2004). Relationship of dissociation and childhood abuse and neglect with heart rate in delinquent adolescents. Journal of Traumatic Stress, 17, 47–54.PubMedCrossRefGoogle Scholar
  40. Krenichyn, K., Saegert, S., & Evans, G. W. (2001). Parents as moderators of psychological and physiological correlates of inner-city children’s exposure to violence. Applied Developmental Psychology, 22, 581–602.CrossRefGoogle Scholar
  41. Leadbeater, B., Blatt, S., & Quinlan, D. (1995). Gender-linked vulnerabilities to depressive symptoms, stress, and problem behaviors in adolescents. Journal of Research on Adolescence, 5, 1–29.CrossRefGoogle Scholar
  42. Low, G., Jones, D., MacLeod, A., Power, M., & Dugan, C. (2000). Childhood trauma, dissociation, and self-harming behaviour. British Journal of Medical Psychology, 73, 269–278.PubMedCrossRefGoogle Scholar
  43. Lynch, M. (2003). Consequences of children’s exposure to community violence. Clinical Child and Family Psychology Review, 6, 265–274.PubMedCrossRefGoogle Scholar
  44. Lynch, M., & Cicchetti, D. (1998). An ecological-transactional analysis of children and contexts: The longitudinal interplay among child maltreatment, community violence, and children’s symptomology. Development and Psychopathology, 10, 739–759.PubMedCrossRefGoogle Scholar
  45. Mak, A. S., Blewitt, K., & Heaven, P. C. L. (2004). Gender and personality influences in adolescent threat and challenge appraisals and depressive symptoms. Personality and Individual Differences, 36, 1483–1496.CrossRefGoogle Scholar
  46. Margolin, G., & Gordis, E. B. (2000). The effects of family and community violence on children. Annual Review of Psychology, 51, 445–479.PubMedCrossRefGoogle Scholar
  47. Marmar, C. R., Weiss, D. S., Metzler, T. J., & Delucchi, K. (1996). Characteristics of emergency services personnel related to peritraumatic dissociation during critical incident exposure. American Journal of Psychiatry, 153, 94–102.PubMedGoogle Scholar
  48. Martinez-Taboas, A., Canino, G., Wang, M. Q., Garcia, P., & Bravo, M. (2006). Prevalence and victimization correlates of pathological dissociation in a community sample of youth. Journal of Traumatic Stress, 19, 439–448.PubMedCrossRefGoogle Scholar
  49. Martinez-Taboas, A., Shrout, P. E., Canino, G., Chavez, L. M., & Ramirez, R. (2004). The psychometric properties of a shortened version of the Spanish Adolescent Dissociative Experiences Scale. Journal of Trauma and Dissociation, 5, 33–54.CrossRefGoogle Scholar
  50. Moses, A. (1999). Exposure to violence, depression, and hostility in a sample of inner city high school youth. Journal of Adolescence, 22, 21–32.PubMedCrossRefGoogle Scholar
  51. Mrug, S., Loosier, P. S., & Windle, M. (2008). Violence exposure across multiple contexts: Individual and joint effects on adjustment. American Journal of Orthopsychiatry, 78, 70–84.PubMedCrossRefGoogle Scholar
  52. Ng-Mak, D. S., Salzinger, S., Feldman, R., & Stueve, A. (2002). Normalization of violence among inner-city youth: A formulation for research. American Journal of Orthopsychiatry, 72, 92–101.PubMedCrossRefGoogle Scholar
  53. Nolen-Hoeksema, S., & Girgus, J. (1994). The emergence of gender differences in depression during adolescence. Psychological Bulletin, 115, 424–443.PubMedCrossRefGoogle Scholar
  54. Olff, M., Langeland, W., Draijer, N., & Gersons, B. P. R. (2007). Gender differences in posttraumatic stress disorder. Psychological Bulletin, 133, 183–204.PubMedCrossRefGoogle Scholar
  55. Perry, B. D. (2001). The neurodevelopmental impact of violence in childhood. In D. Schetky & E. P. Benedek (Eds.), Textbook of child and adolescent forensic psychiatry (pp. 221–238). Washington, DC: American Psychiatric Press.Google Scholar
  56. Perry, B. D., & Pollard, R. (1998). Homeostasis, stress, trauma, and adaptation: A neurodevelopmental view of childhood trauma. Child and Adolescent Psychiatric Clinics of North America, 7, 33–51.PubMedGoogle Scholar
  57. Perry, B. D., Pollard, R. A., Blakley, T. L., Baker, W. L., & Vigilante, D. (1995). Childhood trauma, the neurobiology of adaptation and “use dependent” development of the brain: How “states” become “traits”. Infant Mental Health, 16, 271–291.CrossRefGoogle Scholar
  58. Ptacek, J. T., Smith, R. E., & Zanas, J. (1992). Gender, appraisal, and coping: A longitudinal analysis. Journal of Personality, 60, 747–770.CrossRefGoogle Scholar
  59. Putnam, F. W. (1997). Dissociation in children and adolescents: A developmental perspective. New York: Guilford Press.Google Scholar
  60. Putnam, F., & Trickett, R. (1993). Child sexual abuse: A model of chronic trauma. Psychiatry: Interpersonal and Biological Processes, 56, 82–95.Google Scholar
  61. Rice, K. G., Herman, M. A., & Petersen, A. C. (1993). Coping with challenge in adolescence: A conceptual model and psycho-educational intervention. Journal of Adolescence, 16, 235–251.PubMedCrossRefGoogle Scholar
  62. Richards, M. H., Larson, R., Miller, B. V., Luo, Z., Sims, B., Parrella, D. P., et al. (2004). Risky and protective contexts and exposure to violence in urban African American young adolescents. Journal of Clinical Child and Adolescent Psychology, 33, 138–148.PubMedCrossRefGoogle Scholar
  63. Rosenthal, B. S. (2000). Exposure to community violence in adolescence: Trauma symptoms. Adolescence, 35, 271–284.PubMedGoogle Scholar
  64. Rutter, M. (1979). Protective factors in children’s responses to stress and disadvantage. In M. W. Kent & J. E. Rolf (Eds.), Primary prevention of psychopathology, Vol. 3: Social competence in children (pp. 49–74). Hanover, NH: University of New England Press.Google Scholar
  65. Sameroff, A. J. (2000). Dialectical processes in developmental psychopathology. In A. Sameroff, M. Lewis, & S. Miller (Eds.), Handbook of developmental psychopathology (2nd ed., pp. 23–40). New York: Kluwer/Plenum.CrossRefGoogle Scholar
  66. Saul, A. L., Grant, K. E., & Carter, J. S. (2008). Post-traumatic reactions in adolescents: How well do the DSM-IV PTSD criteria fit the real life experience of trauma exposed youth?. Journal of Abnormal Child Psychology, 36, 915–925.PubMedCrossRefGoogle Scholar
  67. Schell, T. L., Marshall, G. N., & Jaycox, L. H. (2004). All symptoms are not created equal: The prominent role of hyperarousal in the natural course of posttraumatic psychological distress. Journal of Abnormal Psychology, 113, 189–197.PubMedCrossRefGoogle Scholar
  68. Schwab-Stone, M., Chen, C., Greenberger, E., Silver, D., Lichtman, J., & Voyce, C. (1999). No safe haven II: The effects of exposure to violence on urban youth. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 359–367.CrossRefGoogle Scholar
  69. Seedat, S., Stein, M. B., & Forde, D. R. (2003). Prevalence of dissociative experiences in a community sample: Relationship to gender, ethnicity, and substance use. Journal of Nervous and Mental Disorders, 191, 115–120.CrossRefGoogle Scholar
  70. Selner-O’Hagan, M., Buka, S., Kindlon, D., Raudenbush, S., & Earls, F. (1998). Urban youth exposure to violence. Journal of Child Psychology and Psychiatry and Allied Disciplines, 39, 215–224.CrossRefGoogle Scholar
  71. Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH Diagnostic Interview Schedule for Children, Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 28–38.PubMedCrossRefGoogle Scholar
  72. Silberg, J. L. (2000). Fifteen years of dissociation in maltreated children: Where do we go from here? Child Maltreatment, 5, 119–136.PubMedCrossRefGoogle Scholar
  73. Simeon, D., Guralnik, O., Gross, S., Stein, D. J., Schmeidler, J., & Hollander, E. (1998). The detection and measurement of depersonalization disorder. Journal of Nervous and Mental Disorders, 186, 536–542.CrossRefGoogle Scholar
  74. Simeon, D., Knutelska, M., Nelson, D., Guralnik, O., & Schmeidler, J. (2003). Examination of the pathological dissociation taxon in depersonalization disorder. The Journal of Nervous and Mental Disease, 191, 738–744.PubMedCrossRefGoogle Scholar
  75. Singer, M. I., Anglin, T. M., Song, L. Y., & Lunghofer, L. (1995). Adolescents’ exposure to violence and associated symptoms of psychological trauma. Journal of the American Medical Association, 273, 477–482.PubMedCrossRefGoogle Scholar
  76. Spiegel, D. (1991). Dissociation and trauma. In A. Tasman & S. M. Goldfinger (Eds.), American psychiatric press review of psychiatry (Vol. 10, pp. 262–266). Washington, DC: American Psychiatric Press.Google Scholar
  77. Spiegel, D. (1997). Dissociative disorders. In A. Tasman, J. Kay, & J. A. Lieberman (Eds.), Psychiatry (Vol. 2, pp. 1156–1172). Philadelphia: W. B. Saunders.Google Scholar
  78. Stein, B. D., Jaycox, L., Kataoka, S. H., Rhodes, H. H., & Vestal, K. D. (2003). Prevalence of child and adolescent exposure to community violence. Clinical Child and Family Psychology Review, 6, 247–264.PubMedCrossRefGoogle Scholar
  79. Stein, M. B., Walker, J. R., & Forde, D. R. (2000). Gender differences in susceptibility to posttraumatic stress disorder. Behaviour Research and Therapy, 38, 619–628.PubMedCrossRefGoogle Scholar
  80. Taylor, S. E., Klein, L. C., Lewis, B. P., Gruenewald, T. L., Gurung, R. A., & Updegraff, J. A. (2000). Biobehavioral responses to stress in females: tend-and-befriend, not fight-or-flight. Psychological Review, 107, 411–429.PubMedCrossRefGoogle Scholar
  81. Terr, L. C. (1991). Childhood traumas: An outline and overview. American Journal of Psychiatry, 148, 10–20.PubMedGoogle Scholar
  82. Tolin, D. F., & Foa, E. B. (2006). Sex differences in posttraumatic stress disorder: Quantitative review of 25 years of research. Psychological Bulletin, 132, 959–992.PubMedCrossRefGoogle Scholar
  83. van der Hart, O., Nijenhuis, E., & Steele, K. (2005). Dissociation: An insufficiently recognized major feature of complex posttraumatic stress disorder. Journal of Traumatic Stress, 18, 413–424.PubMedCrossRefGoogle Scholar
  84. van der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18, 389–399.PubMedCrossRefGoogle Scholar
  85. van der Kolk, B. A., & van der Hart, O. (1989). Pierre Janet and the breakdown of adaptation in psychological trauma. American Journal of Psychiatry, 146, 1530–1540.PubMedGoogle Scholar
  86. van der Kolk, B. A., van der Hart, O., & Marmar, C. R. (1996). Dissociation and information processing in posttraumatic stress disorder. In B. A. van der Kolk, A. C. McFarlane, & L. Weisaeth (Eds.), Traumatic stress (pp. 303–330). New York: Guilford Press.Google Scholar
  87. van Ijzendoorn, M. H., & Schuengel, C. (1996). The measurement of dissociation in normal and clinical populations: Meta-analytic validation of the Dissociative Experiences Scale (DES). Clinical Psychology Review, 16, 365–382.CrossRefGoogle Scholar
  88. Waller, N. G., Putnam, F. W., & Carlson, E. B. (1996). Types of dissociation and dissociative types: A taxometric analysis of dissociative experiences. Psychological Methods, 1, 300–321.CrossRefGoogle Scholar
  89. Waller, N. G., & Ross, C. A. (1997). The prevalence and biometric structure of pathological dissociation in the general population: Taxometric and behavior genetic findings. Journal of Abnormal Psychology, 106, 499–510.PubMedCrossRefGoogle Scholar
  90. Wilson, J. P., Friedman, M. J., & Lindy, J. D. (Eds.). (2001). Treating psychological trauma and PTSD. New York: Guilford Press.Google Scholar
  91. Wilson, D., Kliewer, W., Teasley, N., Plybon, L., & Sica, D. (2002). Violence exposure, catecholamine excretion, and blood pressure non-dipping status in African–American male versus female adolescents. Psychosomatic Medicine, 64, 906–915.PubMedCrossRefGoogle Scholar
  92. Wilson, W. C., Rosenthal, B. S., & Battle, W. S. (2007). Effects of gender, ethnicity, and educational status on exposure to community violence and psychological distress in adolescence. Journal of Aggression, Maltreatment, and Trauma, 15, 93–111.CrossRefGoogle Scholar
  93. Wolfe, J., & Kimerling, R. (1997). Gender issues in the assessment of posttraumatic stress disorder. In J. P. Wilson, T. M. Keane, & S. D. Solomon (Eds.), Assessing psychological trauma and PTSD (pp. 192–238). New York: Guilford Press.Google Scholar
  94. Wolfradt, U., & Engelmann, S. (1999). Depersonalization, fantasies, and coping behavior in clinical context. Journal of Clinical Psychology, 55, 225–232.PubMedCrossRefGoogle Scholar
  95. Yehuda, R. (2002). Posttraumatic stress disorder. New England Journal of Medicine, 346, 108–114.PubMedCrossRefGoogle Scholar
  96. Zahn-Waxler, C., Shirtcliff, E. A., & Marceau, K. (2008). Disorders of childhood and adolescence: Gender and psychopathology. Annual Review of Clinical Psychology, 4, 275–303.PubMedCrossRefGoogle Scholar
  97. Zoroglu, S. S., Tuzun, U., Sar, V., Tutkun, H., Savas, H. A., Ozturk, M., et al. (2003). Suicide attempt and self-mutilation among Turkish high school students in relation with abuse, neglect and dissociation. Psychiatry and Clinical Neurosciences, 57, 119–126.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of ConnecticutStorrsUSA

Personalised recommendations