{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T06:50:55Z","timestamp":1776840655461,"version":"3.51.2"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH119114"],"award-info":[{"award-number":["R01MH119114"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["P50HD112027"],"award-info":[{"award-number":["P50HD112027"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000058","name":"Substance Abuse and Mental Health Services Administration","doi-asserted-by":"publisher","award":["U79SM080049"],"award-info":[{"award-number":["U79SM080049"]}],"id":[{"id":"10.13039\/100000058","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Health Serv."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This article features the application of Causal Data Science (CDS) methods to determine the mechanism for Posttraumatic Stress (PTS) in young, maltreated children, in order to advance knowledge for prevention. Advances in prevention require research that identifies causal factors, but the scientific literature that would inform the identification of causes are almost exclusively based on the application of correlational methods to observational data. Causal inferences from such research will frequently be in error. We conducted the present study to explore the application of CDS methods as an alternative\u2014or a supplement\u2014to experimental methods, which can rarely be applied in human research on causal factors for PTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A data processing pipeline that integrates state-of-the-art CDS algorithms was applied to an existing observational, longitudinal data set collected by the Consortium for Longitudinal Studies in Child Abuse and Neglect (LONGSCAN). This data set contains a sample of 1,354 children who were identified in infancy to early childhood as being maltreated or at risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A causal network model of 251 variables (nodes) and 818 bivariate relations (edges) was discovered, revealing four direct causes (Emotional Maltreatment at age 0\u20134, Physical Assault at age 8, Feeling of Safety at age 8, and Witnessing Violence at age 8) and two direct effects (Negative Self-Image and Severe Assault from a Non-Caregiver at age 8) of PTS at age 8, within a network containing a broad diversity of causal pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These results indicate that CDS methods show promise for research on the complex etiology of PTS in young, maltreated children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frhs.2026.1784459","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:51:58Z","timestamp":1776837118000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Posttraumatic stress in young children at risk for maltreatment: a causal data science analysis"],"prefix":"10.3389","volume":"6","author":[{"given":"Glenn N.","family":"Saxe","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, New York University School of Medicine","place":["New York, NY, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah J.","family":"Morales","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, New York University School of Medicine","place":["New York, NY, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sisi","family":"Ma","sequence":"additional","affiliation":[{"name":"Institute for Health Informatics, University of Minnesota","place":["Minneapolis, MN, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Urgurbil","sequence":"additional","affiliation":[{"name":"Institute for Health Informatics, University of Minnesota","place":["Minneapolis, MN, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantin","family":"Aliferis","sequence":"additional","affiliation":[{"name":"Institute for Health Informatics, University of Minnesota","place":["Minneapolis, MN, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"B1","year":"2016"},{"key":"B2","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1016\/S0145-2134(98)00062-3","article-title":"Prevalence of post-traumatic stress disorder and other psychiatric diagnoses in three groups of abused children (sexual, physical, and both)","volume":"22","author":"Ackerman","year":"1998","journal-title":"Child Abuse Negl"},{"key":"B3","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/0145-2134(94)90093-0","article-title":"Maternal and child posttraumatic stress disorder in cases of child maltreatment","volume":"18","author":"Famularo","year":"1994","journal-title":"Child Abuse Negl"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1176\/ajp.156.8.1223","article-title":"Posttraumatic stress disorder in abused and neglected children grown up","volume":"156","author":"Widom","year":"1999","journal-title":"Am J Psychiatry"},{"key":"B5","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1192\/bjp.bp.113.131227","article-title":"Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis","volume":"204","author":"Alisic","year":"2014","journal-title":"Br J Psychiatry"},{"key":"B6","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.amepre.2009.06.021","article-title":"Adverse childhood experiences and the risk of premature mortality","volume":"37","author":"Brown","year":"2009","journal-title":"Am J Prev Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1001\/archpedi.156.8.824","article-title":"A 12-year prospective study of the long-term effects of early child physical maltreatment on psychological, behavioral, and academic problems in adolescence","volume":"156","author":"Lansford","year":"2002","journal-title":"Arch Pediatr Adolesc Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1016\/s0006-3223(99)00262-0","article-title":"A developmental psychopathology model of childhood traumatic stress and intersection with anxiety disorders","volume":"46","author":"Pynoos","year":"1999","journal-title":"Biol Psychiatry"},{"key":"B9","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1016\/j.chiabu.2007.01.003","article-title":"Long-term physical and mental health consequences of childhood physical abuse: results from a large population-based sample of men and women","volume":"31","author":"Springer","year":"2007","journal-title":"Child Abuse Negl"},{"key":"B10","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1097\/00004583-200103000-00007","article-title":"Child maltreatment: risk of adjustment problems and dating violence in adolescence","volume":"40","author":"Wolfe","year":"2001","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"B11","first-page":"229","volume-title":"The Prevalence and Impact of Child Traumatic Stress","author":"Fairbank","year":"2007"},{"key":"B12","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1038\/nrn.2016.111","article-title":"The effects of childhood maltreatment on brain structure, function and connectivity","volume":"17","author":"Teicher","year":"2016","journal-title":"Nat Rev Neurosci"},{"key":"B13","doi-asserted-by":"publisher","first-page":"19119","DOI":"10.1073\/pnas.1310766110","article-title":"Childhood maltreatment is associated with altered fear circuitry and increased internalizing symptoms by late adolescence","volume":"110","author":"Herringa","year":"2013","journal-title":"Proc Natl Acad Sci USA"},{"key":"B14","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1111\/j.1469-7610.2010.02321.x","article-title":"The child and family traumatic stress intervention: secondary prevention for youth at risk of developing PTSD","volume":"52","author":"Berkowitz","year":"2010","journal-title":"J Child Psychol Psychiatry"},{"key":"B15","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1177\/0145445506295057","article-title":"A critical analysis of approaches to targeted PTSD prevention","volume":"31","author":"Feldner","year":"2007","journal-title":"Behav Modif"},{"key":"B16","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1002\/jts.20640","article-title":"A pilot randomized controlled trial assessing secondary prevention of traumatic stress integrated into pediatric trauma care","volume":"24","author":"Kassam-Adams","year":"2011","journal-title":"J Trauma Stress"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244x-10-92","article-title":"Protocol for a randomised controlled trial of risk screening and early intervention comparing child- and family-focused cognitive-behavioural therapy for PTSD in children following accidental injury","volume":"10","author":"Kenardy","year":"2010","journal-title":"BMC Psychiatry"},{"key":"B18","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1111\/j.1750-8606.2008.00069.x","article-title":"Treatment and prevention of posttraumatic stress reactions in children and adolescents exposed to disasters and terrorism: what is the evidence?","volume":"3","author":"La Greca","year":"2009","journal-title":"Child Dev Perspect"},{"key":"B19","doi-asserted-by":"publisher","first-page":"7858","DOI":"10.3402\/ejpt.v2i0.7858","article-title":"Characteristics and efficacy of early psychological interventions in children and adolescents after single trauma: a meta-analysis","volume":"2","author":"Kramer","year":"2011","journal-title":"Eur J Psychotraumatol"},{"key":"B20","volume-title":"Causality Models, Reasoning, and Inference","author":"Pearl","year":"2000"},{"key":"B21","volume-title":"Causation, Prediction, and Search","author":"Spirtes","year":"2000"},{"key":"B22","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.jaac.2018.09.442","article-title":"Editorial: In the causal labyrinth: finding the path from early trauma to neurodevelopment","volume":"58","author":"Saxe","year":"2019","journal-title":"J J Am Acad Child Adolesc Psychiatry"},{"key":"B23","first-page":"21","article-title":"HITON: a novel Markov blanket algorithm for optimal variable selection","volume":"2003","author":"Aliferis","year":"2003","journal-title":"AMIA Annu Symp Proc"},{"key":"B24","first-page":"171","article-title":"Local causal and Markov blanket induction for causal discovery and feature selection for classification part I: algorithms and empirical evaluation","volume":"11","author":"Aliferis","year":"2010","journal-title":"J Mach Learn Res"},{"key":"B25","first-page":"235","article-title":"Local causal and Markov blanket induction for causal discovery and feature selection for classification part II: analysis and extensions","volume":"11","author":"Aliferis","year":"2010","journal-title":"J Mach Learn Res"},{"key":"B26","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1007\/s10994-006-6889-7","article-title":"The max-min hill-climbing Bayesian network structure learning algorithm","volume":"65","author":"Tsamardinos","year":"2006","journal-title":"Mach Learn"},{"key":"B27","doi-asserted-by":"publisher","first-page":"3133","DOI":"10.1214\/09-aos685","article-title":"Estimating high-dimensional intervention effects from observational data","volume":"37","author":"Maathuis","year":"2009","journal-title":"The Annals of Statistics"},{"key":"B28","doi-asserted-by":"publisher","first-page":"22558","DOI":"10.1038\/srep22558","article-title":"An evaluation of active learning causal discovery methods for reverse-engineering local causal pathways of gene regulation","volume":"6","author":"Ma","year":"2016","journal-title":"Sci Rep"},{"key":"B29","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1126\/science.1105809","article-title":"Nolan GP.causal protein-signaling networks derived from multiparameter single-cell data","volume":"308","author":"Sachs","year":"2005","journal-title":"Science"},{"key":"B30","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/s41060-016-0032-z","article-title":"A million variables and more: the fast greedy equivalence search algorithm for learning high-dimensional graphical causal models, with an application to functional magnetic resonance images","volume":"3","author":"Ramsey","year":"2016","journal-title":"Int J Data Sci Anal"},{"key":"B31","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/1745-6150-6-25","article-title":"Causal graph-based analysis of genome-wide association data in rheumatoid arthritis","volume":"6","author":"Alekseyenko","year":"2011","journal-title":"Biol Direct"},{"key":"B32","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.jbi.2005.02.005","article-title":"Predicting dire outcomes of patients with community acquired pneumonia","volume":"38","author":"Cooper","year":"2005","journal-title":"J Biomed Inform"},{"key":"B33","doi-asserted-by":"publisher","first-page":"12724","DOI":"10.1038\/s41598-017-08582-x","article-title":"Predicting causal relationships from biological data: applying automated causal discovery on mass cytometry data of human immune cells","volume":"7","author":"Triantafillou","year":"2017","journal-title":"Sci Rep"},{"key":"B34","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1186\/s12888-017-1384-1","article-title":"Machine learning methods to predict child posttraumatic stress: a proof of concept study","volume":"17","author":"Saxe","year":"2017","journal-title":"BMC Psychiatry"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0151174","article-title":"A complex systems approach to causal discovery in psychiatry","volume":"11","author":"Saxe","year":"2016","journal-title":"PLoS One"},{"key":"B36","doi-asserted-by":"publisher","first-page":"e0","DOI":"10.1038\/tp.2017.38","article-title":"Utilization of machine learning for prediction of post-traumatic stress: a re-examination of cortisol in the prediction and pathways to non-remitting PTSD","volume":"7","author":"Galatzer-Levy","year":"2017","journal-title":"Transl Psychiatry"},{"key":"B37","first-page":"411","article-title":"Strong completeness and faithfulness in Bayesian networks","author":"Meek","year":"2005"},{"key":"B38","first-page":"499","article-title":"Algorithms for discovery of multiple Markov boundaries","volume":"14","author":"Statnikov","year":"2013","journal-title":"J Mach Learn Res"},{"key":"B39","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1176\/appi.ajp.161.2.195","article-title":"Psychobiological mechanisms of resilience and vulnerability: implications for successful adaptation to extreme stress","volume":"161","author":"Charney","year":"2004","journal-title":"Am J Psychiatry"},{"key":"B40","doi-asserted-by":"publisher","first-page":"2459","DOI":"10.1056\/nejmra1612499","article-title":"Post-traumatic stress disorder","volume":"376","author":"Shalev","year":"2017","journal-title":"N Engl J Med"},{"key":"B41","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1126\/science.1173299","article-title":"Scale-free networks: a decade and beyond","volume":"325","author":"Barab\u00e1si","year":"2009","journal-title":"Science"},{"key":"B42","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1038\/nrg2918","article-title":"Network medicine: a network-based approach to human disease","volume":"12","author":"Barab\u00e1si","year":"2011","journal-title":"Nat Rev Genet"},{"key":"B43","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/S1359-1789(96)00027-4","article-title":"LONGSCAN: a consortium for longitudinal studies of maltreatment and the life course of children","volume":"3","author":"Runyan","year":"1998","journal-title":"Aggress Violent Behav"},{"key":"B44","volume-title":"Trauma Symptom Checklist for Young Children (TSCYC): Professional Manual","author":"Briere","year":"2005"},{"key":"B45","first-page":"27","volume-title":"The Neurosequential Model of Therapeutics: Applying Principles of Neuroscience to Clinical Work with Traumatized and Maltreated Children in: Working with Traumatized Youth in Child Welfare (Nancy Boyd Webb, Ed.)","author":"Perry","year":"2006"},{"key":"B46","first-page":"2586","article-title":"Simulations evaluating resampling methods for causal discovery: ensemble performance and calibration","author":"Kummerfeld","year":"2019"},{"key":"B47","doi-asserted-by":"publisher","first-page":"4716","DOI":"10.1002\/sim.9535","article-title":"Multiple imputation and test-wise deletion for causal discovery with incomplete cohort data","volume":"41","author":"Witte","year":"2022","journal-title":"Stat Med"},{"key":"B48","volume-title":"MATLAB and Statistics Toolbox Release 2016a","author":"The Mathworks","year":"2016"},{"key":"B49","doi-asserted-by":"publisher","first-page":"2498","DOI":"10.1101\/gr.1239303","article-title":"Cytoscape: a software environment for integrated models of biomolecular interaction networks","volume":"13","author":"Shannon","year":"2003","journal-title":"Genome Res"},{"key":"B50","doi-asserted-by":"publisher","first-page":"58","DOI":"10.12688\/f1000research.9909.1","article-title":"The PathLinker app: connect the dots in protein interaction networks","volume":"6","author":"Gil","year":"2017","journal-title":"F1000Res"},{"key":"B51","first-page":"368","article-title":"A hybrid causal search algorithm for latent Variable models","volume":"52","author":"Ogarrio","year":"2016","journal-title":"JMLR Workshop Conf Proc"}],"container-title":["Frontiers in Health Services"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frhs.2026.1784459\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:52:07Z","timestamp":1776837127000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frhs.2026.1784459\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":51,"alternative-id":["10.3389\/frhs.2026.1784459"],"URL":"https:\/\/doi.org\/10.3389\/frhs.2026.1784459","relation":{},"ISSN":["2813-0146"],"issn-type":[{"value":"2813-0146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]},"article-number":"1784459"}}