Scholars@Duke
Angela Marie Tunno

Angela Marie Tunno

Assistant Professor in Psychiatry and Behavioral Sciences
Psychiatry, Child & Family Mental Health & Community Psychiatry
angela.tunno@duke.edu
Duke North Pavilion (Office NP6021), DUMC 102505, Durham, NC 27710
Duke North Pavilion (Office NP6021), DUMC 102505, Durham, NC 27710

Selected Publications

Polyvictimization and Psychosocial Outcomes Among Trauma-Exposed, Clinic-Referred Youth Involved in the Juvenile Justice System.

Journal Article Child Maltreat · November 2022 Polyvictimization is a robust predictor of emotional and behavioral problems and is linked to involvement in juvenile justice and other public sector systems. This study extends prior research by employing person-centered methods for identifying polyvictim ... Full text Open Access Link to item Cite

What about trauma? Accounting for trauma exposure and symptoms in the risk of suicide among adolescents who have been adopted.

Journal Article Child Abuse Negl · August 2022 BACKGROUND: Research suggests that individuals who have been adopted are at increased risk for suicidal behaviors, but this research does not account for the role of trauma. OBJECTIVES: The study provided rates of trauma exposure among individuals who were ... Full text Link to item Cite

Tailoring Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for Youth with Intellectual and Developmental Disabilities: A Survey of Nationally Certified TF- CBT Therapists

Journal Article Evidence-Based Practice in Child and Adolescent Mental Health · January 1, 2022 In the United States, approximately one in six youth has an intellectual or other developmental disability (DD). Historically, there have been barriers to providing these youths with trauma treatment, although they are at elevated risk for exposure to trau ... Full text Cite

Feasibility of an Integrated Treatment Approach for Youth with Depression, Suicide Attempts, and Substance Use Problems.

Journal Article Evid Based Pract Child Adolesc Ment Health · 2021 Depression, suicidal behaviors and substance use problems frequently co-occur, and treatment for youth with these co-occurring problems is often fragmented and challenging. An integrated cognitive-behavioral treatment approach that builds upon a relapse pr ... Full text Link to item Cite

A Trauma-Informed Approach to Youth Suicide Prevention and Intervention

Journal Article Evidence-Based Practice in Child and Adolescent Mental Health · January 1, 2021 Suicide, suicidal behaviors, and self-harm are major public health problems among youth and can often co-occur with traumatic stress experiences and related symptoms. Given this interrelation, it is important that suicide prevention and intervention practi ... Full text Cite

"Lock and Protect": Development of a Digital Decision Aid to Support Lethal Means Counseling in Parents of Suicidal Youth.

Journal Article Front Psychiatry · 2021 Objective: Reducing access to lethal methods is an effective suicide prevention strategy that is often neglected in routine care. Digital interventions have shown promise for addressing such gaps in care; and decision aids have proven useful for supporting ... Full text Link to item Cite

The Intersection of Trauma and Substance Use in Adolescent Populations

Chapter · January 1, 2021 In the current chapter, the authors discuss the intersection of trauma and substance use difficulties among youth. The current statistics, signs, and symptoms of trauma exposure and substance use in adolescent populations are presented, followed by a discu ... Full text Cite

Trauma-informed measurement-based care for children: Implementation in diverse treatment settings.

Journal Article Psychol Serv · August 2020 Ongoing and comprehensive assessment is a critical part of the implementation of evidence-based care; yet, most providers fail to routinely incorporate measurement into their clinical practice. Few studies have focused on the complex application of routine ... Full text Link to item Cite

Military Life Stressors, Family Communication and Satisfaction: Associations with Children's Psychosocial Outcomes.

Journal Article J Child Adolesc Trauma · March 2020 Families experience multiple stressors as a result of military service. The purpose of this study was to examine facets of military life and family factors that may impact child psychosocial and mental health functioning. Using baseline data from the Mille ... Full text Link to item Cite

Suicide, Self-Harm, & Traumatic Stress Exposure: A Trauma-Informed Approach to the Evaluation and Management of Suicide Risk.

Journal Article Evid Based Pract Child Adolesc Ment Health · 2020 In accordance with Taylor & Francis policy and their ethical obligation as researchers, the authors of this paper report the following disclosures. Dr. Asarnow receives grant, research, or other support from the National Institute of Mental Health, the Sub ... Full text Link to item Cite

Promoting trauma-informed parenting of children in out-of-home care: An effectiveness study of the resource parent curriculum.

Journal Article Psychol Serv · February 2019 The Resource Parent Curriculum (RPC) is a workshop designed to promote trauma-informed parenting among foster, adoptive, and kinship caregivers (i.e., resource parents). The ultimate goal of RPC is to improve placement stability and promote healing from tr ... Full text Link to item Cite

A reasonably large review of operationalization in child maltreatment research: Assessment approaches and sources of information in youth samples.

Journal Article Child Abuse Negl · January 2019 Child maltreatment research varies considerably in how maltreatment is measured. Although researchers have advocated for improvements in maltreatment assessment, a first step is a clear understanding of the status on how the field operationalizes maltreatm ... Full text Link to item Cite

Treatment of adolescents who have co-occurring substance misuse and suicidal behaviours

Chapter · January 1, 2019 This chapter discusses the degree to which suicidal behaviour co-occurs with substance abuse for adolescents, and possible reasons for this interrelationship. An integrated relapse prevention (RP) approach may be advantageous for patients in underscoring t ... Full text Cite

Trauma Screening in Child Welfare: Lessons Learned from Five States

Journal Article Journal of Child and Adolescent Trauma · December 1, 2017 Children in the child welfare system experience high rates of exposure to potentially traumatic events, which are associated with significant impairments in safety, permanency, and well-being. However, child welfare systems have not routinely screened chil ... Full text Cite

The blind men and the elephant: Identification of a latent maltreatment construct for youth in foster care.

Journal Article Child Abuse Negl · May 2017 Child maltreatment is a major public health concern due to its impact on developmental trajectories and consequences across mental and physical health outcomes. Operationalization of child maltreatment has been complicated, as research has used simple dich ... Full text Link to item Cite

Case file coding of child maltreatment: Methods, challenges, and innovations in a longitudinal project of youth in foster care.

Journal Article Child Youth Serv Rev · August 2016 State social service agency case files are a common mechanism for obtaining information about a child's maltreatment history, yet these documents are often challenging for researchers to access, and then to process in a manner consistent with the requireme ... Full text Link to item Cite

"I Use Weed for My ADHD": A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD.

Journal Article PLoS One · 2016 BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a risk factor for problematic cannabis use. However, clinical and anecdotal evidence suggest an increasingly popular perception that cannabis is therapeutic for ADHD, including via online resou ... Full text Open Access Link to item Cite

Longitudinal Assessment of Self-Harm Statements of Youth in Foster Care: Rates, Reporters, and Related Factors.

Journal Article Child Psychiatry Hum Dev · December 2015 Self-harm in youth is a risk factor related to mental health and future morbidity, yet, relatively little is known about the rates and course of self-harm in youth residing in foster care. This study examined self-harm talk in foster youth based on caregiv ... Full text Link to item Cite

Therapeutic Day Treatment for Young Maltreated Children: A Systematic Literature Review

Journal Article Journal of Child and Adolescent Trauma · September 26, 2015 This review examines the literature on the effectiveness of therapeutic day treatment for young maltreated children (birth to 5-years old). Nine peer-reviewed articles reporting treatment outcomes were included. Two independent reviewers evaluated methodol ... Full text Cite

Peer Victimization, Depressive Symptoms, and Rule-Breaking Behavior in Adolescence: The Moderating Role of Peer Social Support

Journal Article Journal of Psychopathology and Behavioral Assessment · September 11, 2015 The current study examined whether peer social support, alone or in conjunction with peer delinquency, moderated the relations between overt and relational victimization, depressive symptoms, and rule-breaking behavior. Participants included 152 adolescent ... Full text Cite

Untangling the relative contribution of maltreatment severity and frequency to type of behavioral outcome in foster youth.

Journal Article Child Abuse Negl · July 2014 Within maltreatment research, type, frequency, and severity of abuse are often confounded and not always specifically documented. The result is samples that are often heterogeneous in regard to maltreatment experience, and the role of the different compone ... Full text Link to item Cite

Using Multiple Informants to Assess Child Maltreatment: Concordance Between Case File and Youth Self-Report.

Journal Article J Aggress Maltreat Trauma · January 1, 2014 To understand the psychosocial implications of child maltreatment, methods used to document prevalence must be clear. Yet, rates of maltreatment found in child self-report are generally inconsistent with data found in case files from state social service a ... Full text Link to item Cite

Strategies for Longitudinal Research with Youth in Foster Care: A Demonstration of Methods, Barriers, and Innovations.

Journal Article Child Youth Serv Rev · July 1, 2012 Longitudinal research on youth in foster care is important, but often challenging to accomplish. To assist the field, a thorough description of the development of the SPARK (Studying Pathways to Adjustment and Resilience in Kids) project, a longitudinal re ... Full text Link to item Cite