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Trauma Resilience Scale for Children: Validation of protective factors associated with positive adaptation following violence

Dissertation
Author: Machelle D. Madsen Thompson
Abstract:
The Trauma Resilience Scale for Children (TRS-C) was created to be a developmentally appropriate, psychometrically valid, reliable and unbiased measure of the major protective factors associated with children's resilience following violence. Extending pilot work with adults, this scale assesses children's perceived presence of ten protective factors following child maltreatment including: physical abuse, sexual abuse, witnessing or experiencing intimate partner violence, and/or witnessing or experiencing a serious threat or injury to life. Empirical and theoretical literature guided subscale and item formulation. Mixed methods design was used for content validation and item refinement with adult trauma experts (n=9) and children in the foster care system (n=9). Refined items were subsequently tested on a larger sample within school and clinical settings (n=208) for scale reliability, validity, factor structure, and differences across demographic characteristics. The scale demonstrated psychometric properties that support its use with children in varied circumstances. The limitations and implications of the scale are discussed, including application within clinical and research settings.

v TABLE OF CONTENTS

List of Tables.. …………………………………………………………………………. . …

Abstract ... ………………………………………………………………………………….

CHAPTER

ONE : Introduction and Dissertation Overvi ew …………… … ……………..........

I. Statement

of Problem ……………...……………………………..… . …… ………

A. Violence Prevalence ………………….…………………………..………

B. Relevance to Social Work ……………….………………………..………

C.

Statement of Need ……………………………….………………………..

D . Study Goal ………………………………...… …………………..…… . …

II . Overview of Dissertation Elements …………….………………………..…… . …

C HAPTER

TWO : Conceptual Literature Review…………..

... ………………… ... ……...…

I. Violence Literature Summary. …………………………...………………..………

A. Impact of Violence on Children ………………...………………..…… …

B. Risk Factors ……………………………………….……………..………

C. Violence Symptom Measurement

with Children.. .………………..….…..

D.

Defining Violence and Inclusion Criteria

.........................….……..………

II. Related Theories and Models ……………………………………………..…… …

A.

Stress and Coping ………………………...……………………..………

B.

Empowerment …………………………………………………..….……

C.

Strengths - Based Perspective ……………….……………………………

D.

Ecological Model ……………………………………………..…………

E.

Conclusion……………………………………………………………….

III. Resilience ……………………………………………………………..…………

A.

Historical and Conceptual Overview …………………………..…………

B. Definitional Disagreement ………………………………….……………

C. Resilience Definitions ………………………………………………… . …

IV. Measures Similar to the TRS - C ……………………………………….…………

A.

General Resilience ……………………………………………..…….….

B.

Resili ence Following Violence …………………………….……………

C.

Children’s Resilience ……………………………………………………

V. Protective Factors …………………………………………………..…….… .. .…

A . Protective Factors Associated wit h Resilience Following Violence … … ...

B. Protective Factors

Utilized in this Study… ……………………………….

a. Self Value ………………………………………...……….. . .… … .

b. Self Regulation ………………………………………………… …

c. Optimism/ Motivating Power

. . ....………………………….…… …

d. Creative Problem Solving ………………………………….…... ....

e. Supportive Belief Structure ………………………………….… ….

f. Health y Caregiv er/Family Support ………………… ……………..

g. Supportive Pe er Relationships ………………… …. …………… …

h. Supported Academic Functioning …….……………………..… …

ix

x

1 1 1 4 5 6 6

8 9 9 12 14 18 20 20 27 31 34 39 39 39 43 45 46 46 48 49 52 52 52 53 54 55 56 56 57 59 6 1

vi

i. Activity Involvement/ Active Diversion

…………… … …….… . ….

j. Community Safety/Support ………………… ……………. …… . …

k. Infused Co ntent ………………..………………….. ……… …....…

C . Implications for Measurement ... ………………………………………… .

CHAPTER THREE : Me thods…………… . ………………………………….…….. . …… ... ..

I. Research Design ................................................................................... . .........................

A. Introduction……………………………………………………………….

a. Domains……………………………………………………………

b. Infused Content…………………………………………………….

II. Research

Q uestions & Hypotheses ........................... ……………………………....

I I I. Safety Precautions …………………………… ...…...……..….………… … …….

I V . Phase One: Initial Instrument Design

and Development ... …….…..…...………...

A . Adult

Expert Panel .............. ..……………………………….………. .…...

a. Sample………………………………………………………… . ….

b. Methods………………………………………………………… .. ..

B. Children’s Focus Groups …………………………………… . ……… . .….

a. Sample………………………………………………………… . ….

b. Methods……………………………………………………………

C. Study Transition Methods…………………………………………………

V. Phase Two: Full Validation Sample Methods ...........................................................

A. Sample .......................... ..................................................................................

a. Inclusion Criteria…………………………………………………..

b. Sample Sites……………………………………………………….

c. Sample Size A dequacy… ………………………………………….

B. Testing Process ...............................................................................................

a. Children……………………………………………………………

b. Parent/Caretakers……………………… …………………………..

C. Resilience

Narrative Analysis .........................................................................

D. Data Management ...........................................................................................

a. Clerical Error Checks………………………………………………

b. Missing Data……………………………………………………….

E. Psychometric Analyse s....................................................................................

a. Assumption s……………………………………………………….

b. Redundancy………………………………………………………..

c. Reliability Analysis………………………………………………..

d. Factor Analysis…………………………………………………….

e. Standard

Error of Measurement……………………………………

f. Item Changes……………………………………………………….

g. Convergent and Discriminant Construct Validation………………..

h. Differences Between Groups………………………………………

i. Scoring and Descriptive Summary…………………………………

6 2

63 63 63

65 65 65 66 66 67 70 72 72 73 73 74 74 75 76 76 76 76 77 79 81 81 82 83 84 84 84 87 87 88 88 89 92 92 92 94 95

vii

C HAPTER

FOUR : Results ........................................................................ ...................................

I. Phase One: Inital Instrument Desig n and Development Group ........ ..........................

A. Adult Expert Panel............................................................................................

B. Children’s Focus Groups....... ...........................................................................

a. Resilience Narratives............................................................................

b. Ratings..................................................................................................

C. Item Removal and Rewording.........................................................................

D. Consequences as a Source of Validity.............................................................

E. Preliminary Conclusions...................................................................................

II. P hase Two: Full Validation Sample Analyses ............................................................

A. Resilience Narrative Results ..........................................................................

B. Demographics ............. ....................................................................................

C. Missing Data ....................................................................................................

D. Assumptions ................................... .................................................................

E. Redundancy .....................................................................................................

F. Reliability ....................................................... ..................................................

G. Confirmatory Factor Analyses .......................................................................

H. Item Decisions ............................................................................... .................

I. External Convergent Validity Evidence .........................................................

J. Internal Convergent and Discriminant Evidence ............................................

K. External Discriminant Validity .... ..................................................................

L. Group Differences ...........................................................................................

M. Descriptive / Scoring Summary ........................................ ............................

CHAPTER

FIVE : Conclusion

..................................................................................................... .

I. Conceptualization.................................................................. ..........................................

II. Psychometric Properties................................................................................................

A. Phase I . ............................................................................................................

a. Strengths................................................................................................

b. Limitations... ..........................................................................................

B. Phase II ............................................................................................... . ............

a. St rengths.................................................................................................

b. Limitations.............................................................................................

II. C hildren as Research Participants ................................................................... . ...........

II. Implications........................................................................................................ . ..........

A.

Theory ... ........................................................................................... . .. . ..........

B.

Practice ............................................................................................ . .... . .........

C.

Research ........................ ................................................................. . ...... . ........

96 96 96 96 96 96 97 101 102 102 102 103 104 105 105 106 108 113 114 117 119 121 124

128 128 129 129 129 130 130 130 132 134 135 135 135 136

viii

APPENDICES ...................................................................................................................... I. Appendix A:

Initial Proposed Items with Reading Level ...................................

II. Appendix B:

Human Participant Protections

Certifications. ...............................

III. Appendix C : Phase I Agency Approvals and Agr eements ...............................

IV. Appendix D: Phase I Content Validation Expert Test Packet

...........................

V. Appendix E: Phase I Informed Consents ..........................................................

VI. Appe ndix F: Children’s Focus Group Outline ..................................................

VII. Appendix G : Phase II Agency Approval Documents ...................................... VIII. Appendix H : Phase II Consent and Participant Contact Letters .....................

IX . Appendix I : Parent Demographic Form .............................................................

X. Appe ndix J : Research Changes from Prospectus to Dissertation........................

REFERENCES ... ............................................................................................................................

BIOGRAPHICAL SKETCH........................................................................................................

138 138 143 145 158 160 163 164 172 181 182

183

209

ix

LIST OF TABLES

Table

1:

Convergent Hypotheses of TRS - C

and Relevant

Measures

…… ... ….. ….

Table 2: Content Validation Expert and Children's Focus Group Ratings

……...…

Table 3 :

Qualitative Resilience Responses: In Order of Frequency ……………….

Table 4 :

Demographics of TRS - C General Validation Sample ……………………

Table 5:

Re liability Analysis ……………………………………………………….

Table 6: Multiple Groups Method Final Correlations ……………………………..

Table 7: Structural Equation Modeling Goodness of Fit

Indicators:

Initial and Respecified Models ………………………………...………...

Table 8:

Item Removal and Rewording Decisions ...……………………………….

Table 9: Convergent Validity Indicators: Global Scale Correlations ……………..

Table 10: Convergent Validity Indicators: Subscale Correlations …………………

Table 11: Internal Convergent Validity

Calculation s ………………………………

Table 12: Internal Discriminant Validity Calculations……………………………..

Table 13 Discriminant Validity: Test Administration ……………………………..

Table 1 4: Group Comparisons by TRS - C Subscales and Global Scale ……………

Table 1 5 : TRS - C Mean S co re Propert ies …………………………………………...

Table 1 6 : TRS - C Mean Score Percentiles for Global and Subscales ………………

6 8

97

102

104

106

109

112

113

115

116

118

119

120

122

125

126

x ABSTRACT

The Trauma Resilience Scale for Children (TRS - C) was creat ed to be a

developmentally appropriate, psychometrically valid, reliable and unbiased measure of the major protective factors associated with children’s resilience following violence. Extending pilot work with adults, this scale assesses children’s percei ved presence of ten protective factors following child maltreatment including: physical abuse, sexual abuse, witnessing or experiencing intimate partner violence , and/or

witnessing or experiencing a serious threat or injury to life. Empirical and theoreti cal literature guid ed subscale and item formulation. Mixed methods design was used for content validation and item refinement with adult trauma experts (n=9) and children in the foster care system (n= 9 ). Refined items were subsequently tested on a larger

sample

within school and clinical settings

(n =208) for scale reliability, validity,

factor structur e, and differences across demographic characteristics . The scale demonstrated psychometric properties that support its use with children in varied circumst ances.

The limitations and implications of the scale are discussed, including application within clinical and research setting s .

1

CHAPTER

ONE

I NTRODUCTION AND DISSERTATION OVERVIEW

Statement of Problem

Children, all human beings under age 18, need spe cial care, safeguards and assistance due to their developmental immaturity ,

according to the 1989 United Nations Convention on the Rights of the Child (CRC) Preamble. They have the right to protection from “all forms of violence” (CRC, article 19) includ ing maltreatment; injury; exploitation; sexual abuse; abduction; torture; any cruel, inhuman, and degrading treatment or punishment; and taking part in or being targeted by hostilities during armed conflict (CRC, 1989, Articles 19, 34, 35 & 37 - 39; Optional

Protocol, 2000). Even with 192 countries ratifying the CRC, children throughout the world continue to experience violent events through phenomena such as war, crime, human trafficking, exploitation, family violence and abuse ( Krug, Dahlberg, Mercy, Zwi & Lozano , 2002).

Violence, “the exertion of physical force so as to injure or abuse” (Merriam - Webster, 2006), is a pervasive societal issue. Violence directly involving children ,

specifically including physical abuse, sexual abuse, domestic violence and

exposure to life - threatening situations continues to occur frequently in the United States and internationally. The CR C (1989) outlines the need for s tates

throughout the world

to take “all appropriate measures to promote physical and psychological recov ery” (Article 39) of children suffering from violence.

In many regions, s ocial work involvement is common during the recovery process following these violent experiences. The best practice methods are attained when social workers in research and practi ce settings have a clear understanding of those factors associated with both the symptoms and the recovery related to children’s violence exposure. For these workers, empirically - based tools aiding in the assessment of trauma and symptoms following violen ce are prevalent. However, comparable tools assessing aspects related to recovery and resilience are rare, especially those assessing the protective factors related to recovery from the children’s perspective.

Violence Prevalence

Worldwide, violence against children “exists in every State and cuts across boundaries of culture, class, education, income, ethnic origin and age” (Pinheiro, 2006, p.5). It occurs in settings ranging from the personal such as home and close friend or family dwellings to com munity locales such as school, work and justice systems. It occurs in forms considered somewhat socially

2

acceptable ,

such as moderate corporal punishment ,

to forms generally considered repulsive as seen in sexual slavery

and homicide. Violence involving

children can be found everywhere from the bully on America’s playgrounds to the child soldier on international battle fields. All ethnicities and both genders are affected, every day.

Corporal punishment is any use of violence to punish children and phys ically coerce their behavior. Although less effective and more destructive to the child’s well being than other forms of behavior management (Strauss, 2001; Gershoff, 2008), it remains common and moderately acceptable throughout much of the world. In 200 9, although several countries had laws minimizing corporal punishment in specified settings, only 25 countries prohibited corporal punishment of children across all settings including the home, school and the penal system (Global Initiative to End all Corp oral Punishment of Children).

Physical abuse and sexual abuse are pervasive issues both globally and in the United States. In the year 2007 alone, approximately 233,449 children of all major ethnic groups were determined by authorities to have expe rien ced physical abuse, sexual abuse, or multiple forms of maltreatment in the United States (Child Welfare Information Gateway, 2009). Worldwide, physical abuse prevalence

reports range

from a low 4.6% of children ,

as reported by parents in Romania and the U .S. ,

to a high 64% as reported by injured children in Ethiopia (Krug et al., 2002). These figures are difficult to obtain

and may be unreliable,

as reporting processes vary widely. Countries report from a low 1% to a high 45% of their children experience

sexual abuse (Krug et al., 2002). Although this wide range reflects international legal and definitional differences and possible underreporting in some areas, an estimated total of 150 million girls and 73 million boys have experienced “forced sexual i ntercourse or other forms of sexual violence involving physical contact” worldwide (Pinheiro, 2006, p.12). Although girls are more likely to be sexually abused, boys are more likely to be the victims of homicide and violence involving a weapon. It is est imated globally that 53,000 childhood deaths were the result of homicide in 2002 alone (Pinheiro, 2006). In the United States 10% of all FBI reported homicides in 2004 were children (Bureau of Justice Statistics, 2006).

Prevalence data on children who w itness violence or experience threats to life are more limited. No consistent national data are available, but researchers have conducted surveys. In a survey of over 4,000 randomly selected U.S. youth ages 12 to 17, Kilpatrick & Saunders (1997) found th at 43% of male and 35% of female adolescents experience d

witnessing firsthand someone either shot with a gun, knifed, sexually assaulted, mugged, robbed, or threatened with a weapon.

3

Jenkins and Bell (1994) report that almost two thirds of 203 sampled Ch icago inner city youth had witnessed a violent event ,

and 45% had seen someone killed. Domestic violence between parents consistently exposes children to violence. Between 3 and 10 million children may be exposed to domestic violence annually (Strauss, 1 992). Finkelhor, Ormrod, Turner & Hamby (2005) randomly selected 2030 children across the U.S. They found that in only one year, over 3% had witnessed domestic violence, 5% had been exposed to shooting, bombs and/or riots, and 13% had witnessed an assau lt with a weapon. Troublingly,

38 of these children reported having someone close to them murdered.

The International Labour Office in 2005 (ILO) estimated that a total of 12.3 million peopl e are an approximate lower estimate

of forced labor throughout the world. Of these, approximately 40 - 50% or 5 - 6 million forced laborers are children. Forced labor is partially defined by the use of violence to keep the person working (ILO, 2005). Many forced laborers are beaten, sexually abused/exploited and ke pt in squalid conditions. Some are working as a result of human trafficking.

The U.S. Department of State (2005) estimated that 600,000 –

800,000 people are trafficked across international borders annually ,

and up to 50 percent of these are children. Th e large majority of transnational victims are forced into prostitution or other commercial sexual exploitation. Furthermore, as many as 1.2 million children may be affected when including trafficking within their own countries (ILO, 2005). Within the U.S., it is estimated that between 244,000 and 325,000 American children are at risk each year of becoming victims of commercial sexual exploitation when including child pornography and prostitution (Estes & Weiner, 2001). Approximately 98% of children forced

into sexual exploitation are girls (ILO, 2005) ,

b ut, 95% of the sexually exploited boys are procured by males, many of whom are married with children of their own (Estes & Weiner, 2001). Within forced labor, the gender distribution is more equal. Approx imately 44% of children forced into economic exploitation are boys (ILO, 2005).

These childhood violence prevalence statistics can be an underestimation of the actual problem. This can be a failure of the parents or children to disclose, lack of access to the victims of violence, or lack of inclusion in officially reported statistics. For example, U.S. child vic tims of crime are not always

reported as minors when compiling crime reports (Berliner & Elliot, 2002). Data show that a youth is more than twi ce as likely as an adult to be the victim of a violent crime (Finkelhor & Hashima, 2001). Although reporting processes and definitional differences may provide a range in the estimated number of children affected by violence, it remains clear that a

4

consid erable number are experiencing violence both within the United States

and on an international scale.

Violence towards children is a problem that is addressed from many viewpoints and varied disciplines. Social workers have a primary responsibility and fu nction in this field.

Relevance to Social Work

When children experience violent events, multiple adverse issues ranging from acute emotional difficulties to long term relational and health problems may occur (Acosta, Albus, Reynolds, Spriggs & Weist, 2001; Wolfe, Crooks, Lee, McIntyre - Smith & Jaffe, 2003). Social workers often become involved when families obtain services and/or come in to

contact with the legal system for violence - related issues.

Approximately 19.2% of general BSW graduates and 8% o f all National Association of Social Workers (NASW) members are employees in the child welfare field (Rogers, Smith, Ray & Hull, 1997; NASW, 2001). When 153,000 NASW member social workers were surveyed, 2.3 percent identified assisting victims of violenc e as their primary practice focus (Gibelman & Schervish, 1997). However, many more workers deal with children who have experienced violence. According to a random sample of over 4900 social workers licensed in 49 states and the District of Columbia, 13% stated that child welfare was their specialty (Center for Health Workforce Studies and NASW Center for Workforce Studies, 2006). According to Whitaker, Weismiller & Clark’s (2006) specialized report on this project relating to children and families, 78 % of all licensed social workers provided services to either children and/or adolescent clients in their practice. These workers state that 47% of these clients have child maltreatment issues as their presenting problem. A great majority, 95%, provided dir ect services to these youth , with 92% providing scree ning and assessment tasks . Beyond this, social workers are employed in areas such as family interventions, where the parents may have exhibit ed

violence toward each other , or criminal justice , where vio lence stems from non - familial sources as well. Clearly, a significant proportion of social workers are providing direct assessment services with maltreated children.

Furthermore, the social work profession has stated the value in understanding diversity and acting to prevent oppression and exploitation of vulnerable groups (National Association of Social Workers [NASW], 1999). In all settings, those social workers who served more children and adolescents also served larger proportions of children

from et hnic minority groups

(Whitaker et al., 2006). Certain international and inner city locales where many social workers are employed

5

have both high levels of violence , as discussed previously , as well as more diverse populations.

Internationally, children o f marginalized status ,

including ethnic minorities and children experiencing disabilities ,

are at a higher risk of violence (Pinheiro, 2006).

Therefore, social workers must be aided in providing the best practice methods and assessment tools with respect

to children from these diverse backgrounds. The 2005 Social Work Congress , consisting of NASW, the Association of Baccalaureate Social Work Program Directors, the Council on Social Work Education (CSWE) and The National Association of Deans and Director s of Schools of Social Work, brought together over 400 leaders in social work. Of the top 12 imperatives they voted to guide the profession for the next decade, child welfare needs , including best practices related to empirical evidence , was the third hig hest priority (Clark et al., 2006).

It is evident that diverse children with violent experienc es are being assessed and serv ed by social workers across many settings. It is essential that these workers have the empirically based tools necessary to hel p serve these children in the best manner possible.

Statement of Need

Following violence experienced by their clients , social workers are engaged in helping and studying the whole person, both strengths and weaknesses. Empirically based resources exist th at are helpful when diagnosing and understanding symptoms related to violence. R esearchers have written a great deal of literature dedicated to understanding and defining problems and negative consequences associated with violent events. However, fewer r esearchers write about positive adaptation following violence. Empowering clients to build those protective factors associated with resilience , so that they can move beyond any resulting negative effects following violent events , is equally important in b oth clinical and research settings.

To help these children recover from the negative consequences of violence, clear evidence about how positive adaptation does or does not occur in children becomes essential. Currently, the resilience literature does not comprehensively address childhood violence with clearly defined concepts, organized models, and

ample

empirical research. To aid in focusing these issues, a strong psychometric scale measuring factors contributing to resilience following violence is essen tial. S everal symptom based measures exist.

Additional l y, the majority of scales related to children’s experiences with violence are answered primarily by the

adults in their lives. Yet, child and

parent reports can be useful when studied in combination (Litrownik, Newton, Hunter, English & Everson,

6

2003). No known resources are available for measuring the child’s perception of the presence protective factors associated with resilience following experiences of violence.

This hinders our research knowled ge and our ability to provide evidence - based services to these children. It is important, therefore, to listen to the children’s voices and build an assessment tool that is both relevant

to

and understandable by the children. Furthermore, because childre n from both genders and all ethnicities are affected by maltreatment, it is also essential to pay attention to distribution of gender and ethnicities, limiting any bias that items in the scale may present.

Study Goal

This dissertation is a starting place for addressing shortcomings related to maltreated children’s needs.

It is the goal of this study to create a psychometrically valid, reliable and unbiased measure of major protective factors which are strongly associated with children’s resilience followi ng violence.

Overview of Dissertation Elements

This document provides an overview of traumatic response, resilience, & protective factors associated with violent events in children’s lives. An empirical and conceptual literature review is offered for ea ch area.

In Chapter 1 , the dissertation purpose has been presented and the dissertation elements have been

outlined. The need for this project has been examined in relation to prevalence of violence related to children and the relevance to soc ial work. In Chapter 2 , a comprehensive review of the literature ensues. The negative effects of violence in children’s lives are examined incorporating measurement implications and relevance to the field. Theoretical concepts relating to violence processes and ou tcomes are defined and discussed in relation to relevance, distinguishing conceptual issues, and study inclusion and exclusion criteria. Resilience is overviewed from a historical and conceptual perspective highlighting issues relating to this study.

E xis ting measures concerning each conceptual viewpoint are critiqued for conceptual relevance and psychometric integrity. Protective factors as they relate to each concept are explored in the empirical literature ,

with a primary focus on resilience following violence. Clearly defined, focused and relevant factors included as subscale domains for the TRS - C are formulated: Self Value, Self Regulation, Optimism/Motivation, Creative Problem Solving, Supportive Belief Structure, Healthy Caregiver/Family Support, S upportive Peer Relations hips , Supported Academic Functioning, Activity Involvement/Active Diversion, Community Safety and Support.

7

Chapter 3

focuses on the specific research questions and methods used for answering these questions. Initially, the rese arch questions are delinea ted for each of two phases, including both qualitative a nd quantitative segments. Phase I

included an expert review panel and children’s focus groups which helped to refine and clarify items. Based on this input, item modificati ons were made . In Phase II,

the refined

item pool was given to a large sample o f children. Resulting data were

analyzed for global and subscale reliability, model integrity, factor structure,

and validity. The sample characteristics, data and statistica l methods of each phase are discussed.

In Chapter 4 , the results of the analyses are presented across both phases of research. Across the subscales and global TRS - C scales,

t he majority of results lend support to the reliability, validity,

the multidi mens ional structure, and lack of bias. However, t he convergent construct validation demonstrat ed mixed results. Finally, in Chapter 5 , the limitations, applications and implications of the findings are discussed.

8

CHAPTER TWO

CONCEPTUAL LITERATURE REVIEW

The following is an overview of the literature directly related to this project. This review first addresses the literature related to violence including: the impact that violence has been shown to have in the lives of children, the risk factors that inc rease the effects of violence in the child’s life, the implications for measurement, and the definitions of violence and trauma that serve as the basis of this study.

Relevant conceptual frameworks that are similar, but not utilized as the foundation of this dissertation , and those that support and guide this dissertation are subsequently discussed. The relevant frameworks include: stress and coping theory, the empowerment perspective, and strengths - based perspective. The frameworks integrated into the project are the ecological model, the trauma outcome model, and the resilience perspective from which protective factors have emerged. This discussion ends with definitions of resilience and related concepts as utilized specifically for this project.

The

measurement literature relevant to the Trauma Resilience Scale for Children is assessed and critiqued. This includes scales from related concepts as well as scales that measure similar domains . Scales that are utilized when validating the TRS - C are presented and discussed. Current scales’ limitations and the need for creating a new scale are discussed.

Finally, protective factors related to positive outcomes despite the child’s experiences of violence are defined and explored. Included are those empiric al works that specifically studied those factors that, when present, are associated with resilience and positive adaptation following violence. These factors: Self Value, Self Regulation, Optimism/Motivating Power, Creative Problem Solving, Supportive Bel ief Structure, Healthy Caregiver/Family Support, Supportive Peer Relations, Supported Academic Functioning, Activity Involvement/Active Diversion, and Community Safety and Support , are tied to the domains that lie at the foundation of the TRS - C. Implicati ons for measuring these factors are addressed , concluding with the research goal directing this project.

9

Violence Literature Summary

Impact of Violence on Children

Studies consistently show that violence has been associated with increased negative impac ts on children, beginning immediately and lasting, for some, over time. Although some differences are noted with the varying types of violence and between genders, it remains clear that across the research violence is associated with cert ain problems .

Gen erally, children experiencing maltreatment display several difficulties in comparison with their non - maltreated peers. In an empirical literature overview, Finkelhor & Hashima (2001) summarize that problems following violence include physical injuries and

Full document contains 220 pages
Abstract: The Trauma Resilience Scale for Children (TRS-C) was created to be a developmentally appropriate, psychometrically valid, reliable and unbiased measure of the major protective factors associated with children's resilience following violence. Extending pilot work with adults, this scale assesses children's perceived presence of ten protective factors following child maltreatment including: physical abuse, sexual abuse, witnessing or experiencing intimate partner violence, and/or witnessing or experiencing a serious threat or injury to life. Empirical and theoretical literature guided subscale and item formulation. Mixed methods design was used for content validation and item refinement with adult trauma experts (n=9) and children in the foster care system (n=9). Refined items were subsequently tested on a larger sample within school and clinical settings (n=208) for scale reliability, validity, factor structure, and differences across demographic characteristics. The scale demonstrated psychometric properties that support its use with children in varied circumstances. The limitations and implications of the scale are discussed, including application within clinical and research settings.