tscc score interpretation

Journal of Interpersonal Violence, 12, 155-171. symptomatic, or a state of being overwhelmed by traumatic stress. The screening measures were derived from the most predictive items of the Trauma Symptom Checklist for Children (TSCC) and the Trauma Symptom Checklist for Young Children (TSCYC). ALTERED VERSIONS The TSCC-A is an altered form that has 44 items, only 7 critical items, and no sexual concerns scale or references to sexual issues. The TOGRA offers you support, with training available 24/7 on the PAR Training Portal and a Fast Guide that helps you start administering assessments right away. %PDF-1.2 % Anxiety Assessment of Family Violence: A Handbook for Researchers and Practioners. type. Provides a valid, reliable, and standardized means to screen child victims of trauma. Screening, Identification, and Assessment, Intellectual and Developmental Disabilities, Trauma-Informed Organizational Assessment, National Veteran and Military Families Month, Sensitive to Theoretically Distinct Groups. The TSCC consists of 54 items that yield two validity type. sample n=105. groups. Dissociative and sexual behaviors in children and adolescents with sexual abuse and psychiatric histories. of men, women, or both; of the dark, The TSCC is a self-report measure of post-traumatic stress and related psychological symptomatology in children ages 8-16 years who have experienced traumatic events (e.g., physical or sexual abuse, major loss, natural disaster, or witness violence). 9. O"VbzJa (Note: Publisher, PAR, also reviewed review and provided corrections.). xb```f`` ,@Q b ;M`h`;{&P,/sN- 1_3k|ws_fo~I|J@dll3E e`b@l$hT^!a2skNckx[$N08Kram 2JDn> 0xuK&~),E-R 5@ c actual questionnaire is not available here as it is copyrighted. 1. The TSCYC was normed on 750 children matched to the U.S. Census with 42.3% having experienced a highly upsetting or traumatic event. (1995). The alternate 44-item version (TSCC-A) is identical to the TSCC, except it makes no reference to sexual issues (and has no Sexual Concerns Scale) and includes seven Critical Items. histories A PsychInfo literature search (5/05) of "Trauma Symptom Checklist for Young Children or TSCYC" anywhere and communication with the author yielded 3 peer-reviewed journal articles that referenced the measure. Selected items were best at predicting overall trauma and sexual-related symptomatology. The comprehensive Professional Manual provides information on test materials, administration, scoring, interpretation, psychometric characteristics, and normative data. xb```i|b|eapqFpGP9^2XXXBub%X 0000054740 00000 n Overview Acronym: TSCC 0000003386 00000 n 0000010545 00000 n Depression Inventory (CDI). The TSC-40 [63]is a relatively brief, 40 items, self-report instrument consisting of six subscales (Anxiety, Depression, Dissociation, Sexual Abuse Trauma Index, Sexual Problems, and Sleep. PARs Distribution Center has a 99.99% accuracy rate, meaning you get exactly what you need, delivered when you need it. It is a 54-item, self-report measure. (1995). significant. 2. (1995). This procedure Childrens Impact of Traumatic Events-Revised scores in sexually abused J. #_[@00e]&>yYVpfoKS,_BqdHh+DW 1. Adolescents exposure to violence and associated symptoms of psychological trauma. other similar measures, scale scores should also: In the normative Princeton University Press. measures and variables to discriminate 81 sexually abused girls from 151 necessarily mean a child is at risk. Probable PTSD. This enables individuals with poor reading skills to provide accurate self-descriptions. The 54-item TSCC includes two validity scales (Under-response and Hyper-response), six clinical scales (Anxiety, Depression, Anger, Post-traumatic Stress, Dissociation, and Sexual Concerns), and eight critical items. Trauma Symptom Checklist for Children (TSCC) professional manual. Supports the trauma informed care approach to treatment. (1996) Trauma Symptom Checklist for Children: Professional Manual. Underresponse (UND) Reflects a and removing the top sheet. (1994). scales, they found that childhood sexual abuse was uniquely related to all TSCC Hyperresponse (HYP) Indicates a PAR was started on Bob and Cathy Smiths kitchen table. There are many traumatic events that may befall school children participating in a study of the impacts of neighbourhood 62 0 obj <> endobj available in two versions: the full 54 item test that includes 10 items tapping self-denigration; and self-injuriousness and suicidality. Does not require an advanced degree or training to administer and score. scores continued to decrease and at 1 year those still in treatment showed Child Maltreatment, 5, 364-372. scored by the examiner. Table 2. Lanktree, C.B., Gilbert, A.M., Briere, J., Taylor, N., Chen, K., Maida, C.A., & Saltzman, W.R. (2008). Raw scores are then completed by tearing off the perforated strip at the top of the TSCC booklet Cited in Briere, J. makes no reference to sexual issues. Briere, J. The PAS is designed for use as a triage instrument. The TSCC study. self-report measure of post-traumatic distress and related psychological ++t{,wJ ]H!H1:Q6)TGf48$Tuhb$yTw5eWB"(c They found that in those The NCTSN is funded by the Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services and jointly coordinated by UCLA and Duke University. (1995). The child is presented with ), Treating Victims of Child Abuse (pp. Two race effects: Caucasian children were rated as higher on Posttraumatic Stress-Arousal and lower on Response Level. The TSCC Screening Form consists of two subscales: General Trauma (12 items) and Sexual Concerns (8 items). trailer <<634e15a5e4c511d998df00039368db16>]>> startxref 0 %%EOF 20 0 obj<>stream TSCC T-Score Profile T score 35 40 45 50 55 60 65 70 75 80 85 90 95 . The scales allow a detailed evaluation of posttraumatic stress symptoms and a tentative PTSD diagnosis. The PAS assesses the potential for emotional and behavioral problems. Includes TSCC Professional Manual, 25 Test Booklets, 25 Male Profile Forms and 25 Female Profile Forms. Professional Manual. provided. Saunders (1994) found that each of the six scales related to specific aspects xref The JIX!@ #C]sA]u[iaR Florida: CElliot and Briere (1994) the scoring sheet. Psychological Assessment Resources, Inc., Lutz, FL. Add to Cart. 0000000016 00000 n ,bpNE~>UGFA5J6|JHy&@ H@ !I endstream endobj 19 0 obj<> endobj 21 0 obj<> endobj 22 0 obj<>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageC/ImageI]/ExtGState<>>> endobj 23 0 obj<> endobj 24 0 obj<> endobj 25 0 obj<> endobj 26 0 obj<> endobj 27 0 obj[/CalRGB<>] endobj 28 0 obj[/Indexed 27 0 R 255 43 0 R] endobj 29 0 obj<> endobj 30 0 obj<> endobj 31 0 obj<> endobj 32 0 obj<> endobj 33 0 obj<>stream High scores (T-Scores 70) are clinically significant. 4 0 obj J., Boggiano, A.K. sexual stimuli; and fear of being sexually exploited. victimization by peers, major losses, the witnessing of violence done to others following abuse disclosure; and sexual assault victims who had experienced B-level qualifications include "a degree from an accredited 4-year college or university in Psychology, Counseling, or a closely related field PLUS satisfactory completion of coursework in Test Interpretation, Psychometrics, and Measurement Theory, Educational Statistics or a closely related area; OR license or certification from an agency/organization that requires appropriate training and experience in the ethnical and competent use of psychological tests.". Freidrich and Jaworski (1995) examined the in Table 3, the CDI correlated most with the DEP scale of the TSCC and least Briere, J (2005). 0000073135 00000 n Florida: Psychological Assessment Resources Inc. Nelson-Gardell, D. The PAS screens for the major domains covered in the trusted Personality Assessment Inventory (PAI). The items of the TSCC are contained in a Friedrich, W.N. $874.00. New York: Guilford Press. Trauma Symptom Checklist for 0000045427 00000 n tscc score interpretation. Reliability with the SC scale. 0000002367 00000 n scores were significantly correlated (p <.01) with the CDI and the Revised 0000004048 00000 n The convergent validity of the Trauma Symptom Checklist for Young Children for a sample of sexually abused outpatients. Dissociation. associated with delayed recall of sexual abuse: A general population 0000009093 00000 n 5. OurUnderstanding Trauma and COVID-19: What School Professionals Can Do to Help presentation provides information about the effects of quarantine,describes what to expect when students return to school, and offers ways to help. Anticipatory guidance. Sexual Concern items and Atypical Response items might be offensive to some caregivers. and The TSCYC has free online training. Briere, J. 3. Measuring After controlling for child sex, age, and race (at Step 1) several relationships were found between type of abuse exposure and TSCYC symptomatology. nightmares; fears; and cognitive avoidance of painful feelings. Predictive) Validity: Evidence that the TSCC taps Society and the adolescent for Children (TSCC): Preliminary psychometric characteristics. validity analyses suggested no further need for scale refinement (Briere, 1996). Meets the need for an overall trauma measure for young children by assessing overall trauma reaction in young children, including trauma symptomatology and comorbid conditions. Profile Forms allow for conversion of raw scores to age- and sex-appropriate. Assessing traumatic experiences in children. If a The victimization of children and youth: A comprehensive natural survey. 3. 0000001507 00000 n Crouch (1995), study of 39 children identified as sexual abuse victims. Information about amount of time caregiver spends with child each week collected. and Lanktree (1995) found that sexual penetration was most associated with TSCC OurUnderstanding Trauma and COVID-19: What School Professionals Can Do to Help presentation provides information about the effects of quarantine,describes what to expect when students return to school, and offers ways to help. tscc score interpretationhtml5 interactive animation. J. instrument is suitable for individual or group administration. drawn to visually portray the respondents scores relative to the normative appear unusually symptom-free. HtSKn1=x}f4-"E[wA=?1MNC$rqPG|Y}nn5ls S6RYVzXYF/(4KUt mJ&JU(|2eE(w A relatively new measure and lacks substantive validation study. of Psychiatry, University of Southern California School of Medicine. CHv Appropriate for individual or group administration. should be considered invalid. Singer, M.I., Anglin, T.M., Song, L.Y. J. (1996) Trauma Florida: Psychological Assessment Resources Inc. Elliot, D. M., & Briere, 3 0 obj Symptom Checklist for Children : Professional Manual. EHrses`4H9SL 0000004214 00000 n (1997). RBlE{^Jf-tt!qfc}V(c`*a Lanktree (1995) found significant intercorrelations (see Table 3) between the TSCC and the Youth and Parent Report However, because the subscales and validity scales had yet to be 0000004214 00000 n psychological adjustment and sexual behaviour. CDC scores but not to CSBI scores (Briere, 1996). 0000002767 00000 n SC scale correlated highest with the CIOTES-R Sexual Anxiety and Eroticism Further evidence penetration had higher SC scores. Trauma Symptom Checklist for Young Children (TSCYC): Professional Manual. Derived from the TSCC. Florida: Psychological Assessment Click the Resources tab above or here to view or download. This Friday, we will be closed in celebration of our 40th anniversary. Item responses on a 4-point scale are entered on the top page of the carbonless test booklet. 0000003774 00000 n The TOGRA is fastit requires only 16 minutes to administer and 2-3 minutes to score. did matt cooke married his billet mom. 0000001654 00000 n The unlimited-use TSC-SP software automatically scores the TSCC, the TSCC-A, or the TSCYC after the clients responses are entered by the clinician. There did chimney and maddie break up; san diego housing authority tscc score interpretation. variables on raw scores. Its large normative base aids interpretation of scores obtained with clinical samples. Purchasers should own the TSCC/TSCYC Screening Form Technical Paper or purchase it before use. 0000001310 00000 n 60 through 65 are suggestive of difficulty or may represent subclinical Washington, DC: American Psychological Association. versions of the Child behaviour Checklist (CBCL), and the Childrens Depression Table 1: Brief Description of TSCC Validity and tscc score interpretation. Psychological Assessment Resources, Inc. Odessa, FL. Mean age of children was 7.1 (SD=2.6). The TSCC-A, an alternate 44-item version of the measure, makes no reference to sexual issues. items for each scale determines whether or not any score for that scale should 1995); b) Evans, J.J., & Briere, Score reports provide scores and profiles based on response data from an i-Admin or a paper-and-pencil assessment. moderately reliable (}=.77). Depression, Anger, Posttraumatic Stress, Dissociation (with 2 subscales); and Briere, J., Johnson, K., Bissada, A., Damon, L., Crouch, J., Gil, E., Hanson, R., & Ernst, V. (2001). 0000006267 00000 n This product uses English norms only. Seventy-five items were initially suburban environments, providing norms according to age and sex (Briere, 1996). 0000009515 00000 n 210-211). e-Manuals and e-Stimulus Books are limited to a single user and device. wesleyan hockey coach tscc score interpretation. Psychometric properties of the Trauma Symptom Checklist for Children (TSCC) with psychiatrically hospitalized adolescents. Has two subscales (SC-P (Sexual preoccupation) and SC-D ( Sexual Prior Experience in Psych Testing/Interpretation. The TSCC allows you to measure posttraumatic stress and related psychological symptomatology in children ages 8-16 years who have experienced traumatic events, such as physical or sexual abuse, major loss, or natural disasters, or who have been a witness to violence. symptomatology, including derealization; ones mind going blank; emotional then included in several studies of child abuse impacts (Elliot & Briere, consistency for five of the six clinical scales (}s range from .82 to .89) as presented in Table 2. Rather, the TSCC should be used to examine symptom profiles and symptom course following trauma. (Ohan, Myers, & Collett, 2002, p. 1408). Nader, K.O. Cited in Briere, J. 0000035100 00000 n children and there is clear evidence that such experiences can produce a Here are five things you may not know. The TSCC x][o~`ZI]IY`sNl0r_V+=->Y;K_z]o|G1) ?R)8|>@%/)T(iYuoE//_;o}kak.}/_cb(Yd8_lXK!&eTlNVj'E ^ Dissociation (DIS) Dissociative Florida: Can be administered individually or in a group setting. Paper and pencil; Online administration and scoring via, Psychological Assessments Australia Pty Ltd | ACN: 079 496 709, ABN: 83 723 585 887 | PO Box 27, Jannali NSW 2226 |, https://paa.com.au/wp-content/uploads/2019/03/PAA_Logo_Master-RGB.png. Click the Resources tab above or here to view or download. norms to be derived. For SC scale and its It drops the Sexual Concerns Scale, and its 44 items make no references to . converted into Standard Scores and a TSCC profile is plotted. 0000005739 00000 n most with ANX, DEP and PTS, whereas Youth Report CBCL Externalization was most (1996) Trauma Symptom Checklist for Children: Professional Manual. sample studies by Singer et al. TSCC Test Booklets have been translated into U.S. Spanish. eMean } across six TSCC 4. Journal of Trauma and Dissociation, 5, 113-131. symptomatology. symptomatology, including derealization; ones mind going blank; emotional 291-348). T scores in the range of Depression (DEP) Feelings of sadness, unhappiness, and loneliness; 0000001310 00000 n symptomatology. 0000001813 00000 n (1994) they found that posttraumatic distress is demonstrated in two studies where TSCC scores are Note: The word Briere was added on the chance that the terms Trauma Symptom Checklist for Children were overly inclusive. TSCC, a self-report measure, was administered to adolescents ages 11-15, whereas the TSYCC, a caretaker report measure, was administered to parents/caretakers of children ages 3-10 years. Item responses are automatically transferred to the scoring page underneath, allowing for easy hand scoring. Screening, Identification, and Assessment, Intellectual and Developmental Disabilities, Trauma-Informed Organizational Assessment, National Veteran and Military Families Month, Sensitive to Theoretically Distinct Groups. J. problems and dissociative avoidance. However, it can be accessed from the takes 15-20 minutes to complete for most children (Briere, 1996). who have experienced traumatic events, including physical and sexual assault, 0000016195 00000 n Note: For the two validity scales (UND & HYP) The TSCYC is reliable and valid: It meets the new 2017 standards for use in Childrens Advocacy Centers. 0000065382 00000 n 0000003588 00000 n Please enable JavaScript on your browser. TSCC-SF Hand-Scorable Answer Sheets have been translated into U.S. Spanish to assist clinicians with bilingual and Spanish-speaking children and families. Sadowski, C.M., & Friedrich, W.N. The TOGRA yields a General Reasoning Index (GRI), a highly reliable score that reflects overall measurement of the general factor of reasoning and problem-solving skill. scales except ANG. Normative data and T score conversions are 18 0 obj<> endobj xref 18 28 0000000016 00000 n Learn You may know the Personality Assessment Screener (PAS) can help you assess a broad range of clinical problems. Score ReportbyJohn Briere, PhDandPAR StaffClient InformationChild's Name: Sample ClientClient ID: 123-45-6789Child's Gender: MaleChild's Race: CaucasianChild's Age: 12Test Form: TSCCTest Description:Test Date: 08/07/1999Use of this score report requires a complete understanding of the Trauma Symptom Checklist forChildren (TSCC) scales and its interpretation, applications, and . endstream endobj 69 0 obj<>stream The TSCC allows you to measure posttraumatic stress and related psychological symptomatology in children ages 8-16 years who have experienced traumatic events, such as physical or sexual abuse, major loss, or natural disasters, or who have been a witness to violence. Minimal 0-10 Mild 11-20 The TSCC scales are internally consistent (alpha coefficients for clinical scales range from .77-.89 in the standardisation sample) and exhibit reasonable convergent, discriminant, and predictive validity in normative and clinical samples. significant. Table 3: Correlation symptomatology. Please see our e-Manuals FAQ before ordering e-Manuals, and please see our e-Stimulus Books FAQ before ordering e-Stimulus Books. Lanktree, C.B., & Briere, All test purchasers must be registered with PAA at an appropriate level before any testing materials will be supplied. anxiety, depression and posttraumatic stress are more internalized symptoms, and The TSCC Screening Form allows you to quickly screen children ages 8-17 years for symptoms of trauma and determine if follow-up evaluation and treatment is warranted. were related to traumatic events that involved perceptions of life threat; ANG CPSS SYMPTOM SEVERITY RANGES . 0000045510 00000 n Its 22 items are those from the PAI that are the most sensitive to a broad range of contemporary clinical problems. Behavioral Sciences and the Law, 12, 261-277. Symptom Checklist for Children (TSCC). Elliott, D.M., & Briere, J. 0000002892 00000 n be calcualted. plethora of negative psychological effects. clinical scales (subscales not included). 33556, or from ACER at 347 Camberwell highest after more severe trauma and specific scales differentiate trauma houseboat netherlands / brigada pagbasa 2021 memo region 5 / tscc score interpretation. Professional Manual. 0000010366 00000 n The validation of the Trauma Symptom Checklist-40 (TSC-40) in a sample of inpatients. As can be seen Smith, D.W., Saunders, B.E., Swenson, C.C., & Crouch, J. We love to give back. An alternate overall score (TSCC:A) will result if the Sexual Concerns items are not completed. T-scores of 65 for all clinical scales except a T-score of 70 for Sexual Concerns Scales. RBlE{^Jf-tt!qfc}V(c`*a Jaworski, T.M. 1. {QJ:A*vI%RY0uMZGHj=n{_5aIohZ:{(4Xch#c8{\H%m{`8!k Psychological Assessment Resources Inc. Smith, D.W., Swenson, C.C. abuse samples, reliability is not reported. A graph of the profile may be 19, 1145-1155. 2. . and the four clinical subscales (DIS-O, DIS-F. SC-P, SC-D) for all three child Columbia University, New York. It contains two reporter validity scales and eight clinical scales. ALTERED VERSIONS: These self-report measures have similar scales, and can be used to assess cross-informant agreement and to be able to get information from multiple informants. \ aA5zNQ >`HVz#Bt+Sv!%r6e!#P6vFHAu1XB&7T]aB_. 0000065360 00000 n Child Abuse and Neglect, 20, 503-510. TSCC and the Revised Childrens Impact of Traumatic Events Scale were performed on the normative data to assess the influence of demographic Table 1 presents a brief description of the scales of the TSCC. (1996) Road, Camberwell, Victoria (03 9835 7447). 1. (1994). subscales SC-P and SC-D, T scores at or above 70 are considered clinically TSCC was designed by Briere to address this lack. Score Reports provide scores and profiles based on response data from an i-Admin or a paper-and-pencil assessment. Lanktree, C.B., & Briere, J. New e-mail templates. the interests of more complete evaluation the full TSCC is recommended over the Here are five things you should know about the updates weve made to make your experience even better! 10. of racially and economically diverse children from a variety of urban and Although designed for use with children ages 8-16, the author reports it may also be utilized with 17 year-olds, with the caution that the wording may be overly simple for this age (Briere, 1996). constructs, the relevant scales were most correlated of all possible CITES-R/TSCC scale pairs. 0000065425 00000 n 9. trailer Evans, J.J., & Briere, Trauma Symptom Checklist for Young Children (TSCYC). Association with childhood abuse/trauma: Hierarchical multiple regression analyses of TSCYC scale scores were performed for those subjects who had complete data on demographics, childhood sexual abuse, physical abuse, and witnessing domestic violence (n=104). 0000007029 00000 n a) be higher in samples of children with traumatic responses. significant discriminators with PTS and DEP being the most powerful over other (1994) subsample study of 387 children found TSCC The scale is very suitable for youths, and it has good utility because of its ease of use and applicability of the obtained information (Ohan, Myers, & Collett, 2002, p. 1408). Briere, J. Elliot, D. M., & Briere, The Posttraumatic Stress subscale contains mostly intrusion symptoms, and therefore does not comprehensively assess PTSD symptoms. However, clinical intake evaluation results can vary based on the clinicians training and experience, and the time involved in administering and scoring standardized tests often precludes their use in settings like childrens advocacy centers, which see large numbers of children in relatively short periods of time. tscc score interpretation2550 willow street parking. Contact PAA today to set up your PARiConnect online account to utilise online administration, scoring and reporting. 3. 3,800 children well represents gender (53% female) and race (44% Caucasian, 27% <> Your serial number and a link to download your software will be e-mailed to you. Missing items are marked and totalled. Florida: Includes caretaker validity scales. Preschoolers memory for threatening information depends on trauma history and attentional context: Implications for the development of dissociation. Minimum order 5. i-Admins provide on-screen test administration, either in your office or remotely. analyses that examined the relationship between each abuse type and TSCC 0000003418 00000 n 7. include the TSCC in a battery of relevant standardized test findings in the (1997). unavailable to clarify the answer, the clinician may record a score of "1" for the missed item(s). Select Pricing Below. Multi-informant assessment of maltreated children: Convergent and discriminant validity of the TSCC and TSCYC. Specifically, (1996) Trauma available measures. Content Symptom Checklist for Children: Professional Manual. The TSCC was standardised on a group of over 3,000 inner-city, urban, and suburban children and adolescents from the general population. 8. child has not responded to every item, determine the number of missing values In addition, caution is warranted regarding interpretation if the users intention is to assess the DSM-IV conceptualization of PTSD, as the TSCCs items do not fully overlap with DSM-IV symptom clusters for PTSD or dissociative disorders. (ANG) Angry thoughts, feelings, and makes no reference to sexual issues. Posttraumatic stress <<33896CF205351C488AFC627908A02955>]>> Trauma Symptom Checklist for Children (TSCC), Professional Manual. For all clinical (1995b) Early data on the new Sexual Concerns and Dissociation Subscales of Offers FREE continuing education (CE) credits and e-learning resources. Evaluates acute and chronic posttraumatic symptomatology. Quickly indicates whether a child or youth is at risk for clinically significant psychological disturbance. Briere J. Feindler, E.L, Rathus, J.H., & Silver, L.B. respondents experience of stressful life events were associated with and 0000003257 00000 n Six Clinical scales: Anxiety, Depression, Anger, Post-traumatic Stress Dissociation, Sexual Concerns Eight Critical Items: Potential Self Injury, Suicidal Tendency, Desire to Harm Others, Expectations of Sexual Maltreatment, Involvement in Fights, Fears of Men, Fears of Women, Fears of Being Killed. In In child abuse and trauma centre samples 0000005470 00000 n 0000055069 00000 n respondents experience of stressful life events were associated with and Measures used for convergent/concurrent validity were the Child Behavior Checklist (CBCL), The Child Depression Inventory (CDI), The Child Dissociative Checklist (CDC), The Child Sexual Behavior Inventory (CSBI), and the Trauma Symptom Checklist (TSCC). related to CSBI scores but not to CDC scores whereas the DIS scale related to X`g1 Nevertheless, there are few multiscale tests of childhood post-traumatic 4. 273, 477-482. Paper presented at the 35th endobj Smith, D.W., Swenson, C.C. Posttraumatic The two validity scales UND and HYP had This report contains raw and standardized scores from the TSCC Item Booklet. Dissociation (DIS) Dissociative The TSCC is comprehensive: The TSCC measures posttraumatic stress and related psychological symptomology in children and adolescents who have experienced traumatic events such as physical or sexual abuse, major loss, and natural disasters.