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June 2010

Table 9. Child Psychological Assessment Rating Scales Trauma Ratings (based on case narratives)

  • 0

    No discernable trauma

1 One time traumatic event 2 Recurring trauma 3 Ongoing trauma in one area 4 Ongoing trauma in multiple areas 5 Profound trauma that remains unresolved

Psychopathology Ratings (using DSM-IV diagnoses)

  • 0

    No current psychopathology

1 Axis II only 2 Axis I – no psychotic symptoms or disorder 3 Asis I – psychotic symptoms or disorder 4 Axis I and Axis II or multiple Axis I disorders 5 Chronic, serious, treatment resistant mental illness and/or cognitive issues

Behavior Ratings (based on case narratives)

  • 0

    No current behavior problems

1 Behavior manageable with correction 2 Behavior an issue in one setting – no violence 3 Behavior an issue in multiple settings – no violence 4 Behavior an issue in multiple settings, with violence or serious criminality 5 Unmanageable in all but secure settings, with violence or serious criminality

It is important to acknowledge the interrelatedness of these dimensions, especially given our increasing knowledge of the impact of trauma on brain structure and function. These children and their clinical presentation represent the complex interplay of genetic endowment, intrauterine development, the birth process (presence and quality of medical care), early care and nutrition, bonding and attachment, exposure to trauma, behavioral models, the degree to which primary needs (sustenance, shelter, love) are met, and personality development. All of these factors interact with one another, and represent the incredible complexity of human development and behavior.

A critical component of this study was to create an objective summary measure of the mental health complexity of cold cases in Georgia. Table 10 presents the child psychological assessment rating measures created for the cold case study for the 196 children for whom complete data was available. Adding the three scales together results in a total possible score of 15. Cold cases scored an average of 10.2 on that scale. Table 10. Child Psychological Assessment Ratings of Cold Cases Rating Range Number of Children Average Rating 0-5 0-5 0-5 0-15 3.4 3.6 3.2 10.2 201 201 205 196 Trauma Psychopathology Behavior Total Score It is interesting to note the pattern of total ratings by case outcomes that has emerged already (outcomes measured in AFCARS as of


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