(provided by candidate): There is mounting evidence that children growing up in low-income urban environments are exposed to severe, ongoing trauma and develop symptoms of complex traumatic stress at disproportionate rates. Repeated exposure creates a complex set of reactions that occur before, during, and after traumatic events and carries long-term developmental risks. Although exposure to and effects of chronic trauma in children from low-income, urban environments has been labeled a public health concern, there is little empirical support for available treatments. Modification of existing treatments or development of new treatments is necessary for improving the standard of care for this population. This application will prepare me to transition from clinician/administrator to interventions researcher with the goal of developing and testing treatments for this group of children. The proposed training and research agenda provide an opportunity to draw together and advance two areas that have strong theoretical foundations for strengthening child and family coping (trauma treatment and ritual/routine practice). Specific training goals involve acquiring new skills in biostatisties related to testing causal models, developing conceptual and methodological understanding of treatment development and testing, and gaining new tools for ensuring that the interventions developed are appropriate for the target population. Specific objectives of the research plan focus on development of a family skills-based intervention, but allow me to gain the knowledge and skills necessary to create a range of interventions (for families, schools, neighborhoods) and thus, accomplish my long-term goals. The research plan comprises two phases. The initial phase uses a cross sectional design to examine a theoretical model linking symptoms of chronic traumatic stress with a specified mechanism of change (constructive use of family rituals). Phase I includes a qualitative sub-study to further explore the ritual and routine practice of minority families dealing with the major stressors and traumas associated with urban poverty. Phase II is designed to produce a skill-building intervention, focused on the specified family ritual dimensions determined in Phase I, for families of children exhibiting symptoms of complex traumatic stress. This phase includes an open trials pilot to demonstrate feasibility of implementation. The proposed research provides preliminary data for an R34 application and lays the foundation for future R01applications.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZMH1-NRB-G (01))
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Boyce, Cheryl A
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University of Maryland Baltimore
Schools of Medicine
United States
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Kiser, Laurel J; Medoff, Deborah R; Black, Maureen M (2010) The Role of Family Processes in Childhood Traumatic Stress Reactions for Youths Living in Urban Poverty. Traumatology (Tallahass Fla) 26:33-42
Kiser, Laurel J; Donohue, April; Hodgkinson, Stacy et al. (2010) Strengthening family coping resources: the feasibility of a multifamily group intervention for families exposed to trauma. J Trauma Stress 23:802-6
Kiser, Laurel J; Medoff, Deborah; Black, Maureen M et al. (2010) Family Mealtime Q-Sort: A measure of mealtime practices. J Fam Psychol 24:92-6
Kiser, Laurel J; Baumgardner, Barbara; Dorado, Joyce (2010) Who Are We, But for the Stories We Tell: Family Stories and Healing. Psychol Trauma 2:243-249
Kiser, Laurel J; Nurse, Winona; Lucksted, Alicia et al. (2008) Understanding the Impact of Trauma on Family Life From the Viewpoint of Female Caregivers Living in Urban Poverty. Traumatology (Tallahass Fla) 14:77-90