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Pampanel DV, Gewirtz-Meydan A, Tarshish N. Childhood sexual abuse and technology-facilitated sexual violence on dating apps: The moderating role of motivations for use. CHILD ABUSE & NEGLECT 2024; 155:106958. [PMID: 39126880 DOI: 10.1016/j.chiabu.2024.106958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/18/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND The study aimed to investigate the potential link between a history of childhood sexual abuse (CSA) and the experience of technology-facilitated sexual violence on dating apps (TFSV), considering distinct motivations for app usage among CSA survivors. OBJECTIVE To explore the association between CSA and TFSV on dating apps, while also examining the potential moderating role of motivations for app usage and differences based on sexual orientation. PARTICIPANTS AND SETTING The study utilized an online survey among 534 dating app users in Israel. METHODS Participants completed an online survey assessing history of CSA, experiences of TFSV on dating apps, and motivations for app usage. RESULTS The study found that individuals with a history of CSA experienced more TFSV on dating apps. Survivors of CSA showed lower motivation for love and higher motivation for self-worth validation, ease of communication, and thrill of excitement. Differences between heterosexual and LGBTQ+ participants were observed, with LGBTQ+ individuals reporting higher levels of CSA prevalence and TFSV on dating apps. Motivations for app usage and sexual orientation were found to moderate the association between CSA history and TFSV on dating apps. Among LGBTQ+ participants, those who experienced CSA had a higher likelihood of encountering TFSV on dating apps, regardless of their motivations. Heterosexual individuals with a history of CSA were more prone to TFSV on dating apps if they had a strong motivation for love. CONCLUSIONS This study shed light on unique vulnerabilities among individuals with a history of CSA, including increased susceptibility to TFSV on dating apps.
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Affiliation(s)
- Denise Volman Pampanel
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
| | - Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel. agewirtz-@univ.haifa.ac.il
| | - Noam Tarshish
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
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2
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Wagner B, Emmerich OLM, van Noort BM. Internet-Based Prevention of Re-Victimization for Youth with Care Experience (EMPOWER-YOUTH): Results of a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1159. [PMID: 39338042 PMCID: PMC11431617 DOI: 10.3390/ijerph21091159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 08/25/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024]
Abstract
Traumatic experiences and maltreatment are highly prevalent among adolescents in foster or institutional care and have severe long-term effects on mental health. Childhood maltreatment increases the risk of revictimization. This study aimed to evaluate the efficacy of the internet-based prevention program EMPOWER YOUTH in reducing victimization experiences among youth with care experience. A total of 163 youth, that is, adolescents in foster or institutional care, adopted adolescents, or young care leavers aged 14 to 21 years (Mage = 17.68 years; SD = 2.11) were randomized to the six-module guided program or a wait-list control group. The primary endpoint was the decrease in victimization experiences at an 18-week follow-up. Secondary endpoints included risk perception, aggressive tendencies, empathy, prosocial behavior, depressiveness, post-traumatic stress symptoms, and loneliness. About half of the youth exhibited increased psychopathology. No significant interaction between time-point and group was found for victimization measures, though both groups saw a significant reduction over time (p = 0.012, ηp2 = 0.06; p = 0.017, ηp2 = 0.06). The intervention group showed a significant increase in perception of thrill-seeking and rebellious risks (p = 0.036, ηp2 = 0.04; p = 0.026, ηp2 = 0.05). While EMPOWER YOUTH effectively increased risk perception of thrill-seeking and rebellious behaviors, it should be considered an add-on to more intensive interventions for common mental health disorders in this vulnerable group, rather than a stand-alone online program.
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Affiliation(s)
- Birgit Wagner
- Department of Psychology, MSB Medical School Berlin, 14197 Berlin, Germany; (O.L.M.E.); (B.M.v.N.)
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3
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Leri J, Cisler JM, Dodd CG, Clark SL, Taylor L, Theodorou A, Belford A, Liberzon I, Rathouz PJ, Newport DJ, Devargas C, Wagner K, Nemeroff CB. The role of recurrent trauma on post-traumatic stress disorder symptoms and substance use among trauma exposed youth. Psychiatry Res 2024; 338:115980. [PMID: 38833935 DOI: 10.1016/j.psychres.2024.115980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/17/2024] [Accepted: 05/25/2024] [Indexed: 06/06/2024]
Abstract
Comorbidity between post-traumatic stress disorder (PTSD) and substance use disorder may be explained by a prospective trauma risk conferred by both conditions. The current study modeled concurrent and prospective associations of trauma, PTSD symptoms, and substance use (SU) behavior among trauma exposed youth (ages 8-20). Clinical interviews assessed trauma exposure, PTSD symptom severity, and SU behavior at baseline and at six- and 12-month follow up study visits (N = 2,069). Structural equation models assessed the associations of trauma, PTSD symptoms, and SU behavior. Lifetime trauma was associated with more severe PTSD symptoms and SU behaviors, whereas trauma exposure during the study was only associated with PTSD symptoms. PTSD symptom severity was prospectively associated with trauma exposure. PTSD symptom severity and SU behavior at follow-up study visits were prospectively associated. These results highlight the dynamic interplay between trauma, PTSD symptoms, and SU behavior during youth, a developmental period during which complex psychiatric presentations can have longstanding consequences for health.
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Affiliation(s)
- John Leri
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States.
| | - Josh M Cisler
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States
| | - Cody G Dodd
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, United States
| | - Shaunna L Clark
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, United States
| | - Leslie Taylor
- Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, United States
| | - Arrian Theodorou
- The University of North Texas Health Science Center, United States
| | - Anissa Belford
- Department of Psychiatry and Behavioral Sciences, The University of Texas at San Antonio, United States
| | - Israel Liberzon
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, United States
| | - Paul J Rathouz
- Department of Population Health, The University of Texas at Austin Dell Medical School, United States
| | - D Jeffrey Newport
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States; Department of Women's Health, The University of Texas at Austin Dell Medical School, United States
| | - Cecilia Devargas
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, United States
| | - Karen Wagner
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, United States
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States
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4
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Kong J, Moorman SM, Qin Y. Lifetime Abuse Victimization and Prospective Health Outcomes in Older Adults. J Appl Gerontol 2024; 43:990-996. [PMID: 38350889 PMCID: PMC11166519 DOI: 10.1177/07334648231225377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
Objectives: The current study examined the associations between lifetime abuse victimization and prospective health outcomes in late adulthood. Methods: Data from 4907 older adults (mean age = 80) from the Wisconsin Longitudinal Study were analyzed. Multivariate analyses examined the associations of lifetime abuse victimization with depression, physical health status, and memory. Results: Greater exposure to lifetime abuse was associated with a significantly higher risk of depression (OR = 1.13, CI: [1.08, 1.19], p < .001) and a greater number of limitations in physical functioning (b = .08, SE = .02, p < .001), but not with memory performance (b = .01, SE = .14, p > .05). Discussion: Our results support the interrelations of interpersonal violence across the life course and the lasting health effects of exposure to lifetime abuse. Findings highlight the need for a life course-based, trauma-informed approach in prevention and intervention programs for older adults.
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Affiliation(s)
- Jooyoung Kong
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, WI, USA
| | - Sara M. Moorman
- Department of Sociology, Boston College, Chestnut Hill, MA, USA
| | - Yue Qin
- Department of Sociology, University of Wisconsin-Madison, Madison, WI, USA
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5
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Monti E, D’Andrea W, Carroll LM, Norton K, Miron N, Resto O, Toscano K, Williams J, Harris D, Irene L, Maass A. Can perpetrators discern survivors from voice? Eur J Psychotraumatol 2024; 15:2358681. [PMID: 38837122 PMCID: PMC11188952 DOI: 10.1080/20008066.2024.2358681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/14/2024] [Indexed: 06/06/2024] Open
Abstract
Background: Research has shown that potential perpetrators and individuals high in psychopathic traits tend to body language cues to target a potential new victim. However, whether targeting occurs also by tending to vocal cues has not been examined. Thus, the role of voice in interpersonal violence merits investigation.Objective: In two studies, we examined whether perpetrators could differentiate female speakers with and without sexual and physical assault histories (presented as rating the degree of 'vulnerability' to victimization).Methods: Two samples of male listeners (sample one N = 105, sample two, N = 109) participated. Each sample rated 18 voices (9 survivors and 9 controls). Listener sample one heard spontaneous speech, and listener sample two heard the second sentence of a standardized passage. Listeners' self-reported psychopathic traits and history of previous perpetration were measured.Results: Across both samples, history of perpetration (but not psychopathy) predicted accuracy in distinguishing survivors of assault.Conclusions: These findings highlight the potential role of voice in prevention and intervention. Gaining a further understanding of what voice cues are associated with accuracy in discerning survivors can also help us understand whether or not specialized voice training could have a role in self-defense practices.
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Affiliation(s)
- Elisa Monti
- Voice and Trauma Research and Connection Group, Inc., New York, NY, USA
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Wendy D’Andrea
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | | | - Katherine Norton
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Noga Miron
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Olivia Resto
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Kayla Toscano
- Voice and Trauma Research and Connection Group, Inc., New York, NY, USA
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - John Williams
- Department of Biostatistics, Columbia University, New York, NY, USA
| | | | | | - Anne Maass
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, UAE
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6
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Mirabile M, Gnatt I, Sharp JL, Mackelprang JL. Shame and Emotion Dysregulation as Pathways to Posttraumatic Stress Symptoms Among Women With a History of Interpersonal Trauma. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1853-1876. [PMID: 37942893 PMCID: PMC10913341 DOI: 10.1177/08862605231211924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Women who have survived interpersonal trauma are at elevated risk of developing posttraumatic stress disorder (PTSD), and potentially modifiable factors that may be targeted in treatment warrant further investigation. This study examined a pathway from interpersonal trauma to PTSD symptoms via emotion dysregulation and shame in a large non-clinical sample of women. The sample comprised 380 women, aged 18 to 59 years (M = 31.70, standard deviation = 10.06), all of whom had a history of interpersonal trauma. Participants completed the Experience of Shame Scale, the Difficulties in Emotion Regulation Scale-Short Form, and the Life Events Checklist for DSM-5. A serial and parallel process model with interpersonal trauma as a predictor of PTSD symptoms, emotional dysregulation and facets of shame as intermediary variables, was analyzed using Statistical Package for Social Sciences Statistics PROCESS Model 81with bias-corrected bootstrap tests of indirect effects. Non-interpersonal trauma was included as a covariate. Interpersonal trauma, emotion dysregulation, and characterological and bodily shame were significantly and directly associated with PTSD symptoms, together explaining 59% of the variation in PTSD symptoms. While emotion dysregulation was associated with behavioral shame, interpersonal trauma was not associated with behavioral shame, nor was behavioral shame associated with PTSD symptoms. Tests of indirect effects supported a pathway from interpersonal trauma to PTSD symptoms via emotion dysregulation and characterological and bodily shame. These findings suggest interventions that are particularly effective at reducing emotion dysregulation and characterological and bodily shame, such as compassion and acceptance-based approaches, may complement evidence-based PTSD interventions when working with women who have survived interpersonal trauma.
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Affiliation(s)
| | - Inge Gnatt
- Swinburne University of Technology, Melbourne, VIC, Australia
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7
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Ceroni TL, Holmes SC, Alshabani N, Silver KE, Johnson DM. The Role of Race, Social Support, Empowerment, and Posttraumatic Cognitions in Survivors of Intimate Partner Violence Symptoms of Posttraumatic Stress Disorder. Violence Against Women 2023:10778012231214773. [PMID: 38128921 PMCID: PMC11190036 DOI: 10.1177/10778012231214773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Black women experience more frequent and severe intimate partner violence (IPV), but there are mixed findings on their posttraumatic stress disorder (PTSD) symptom severity. This may be explained by cultural-salient factors which are associated with fewer posttraumatic cognitions. We hypothesized an indirect effect of race on PTSD symptoms via social support, empowerment, and posttraumatic cognitions, serially. Path analysis revealed Black women reported increased social support, which was associated with higher levels of empowerment, which was associated with lower levels of posttraumatic cognitions. Decreased posttraumatic cognitions were associated with less severe PTSD symptoms. Results increase understanding of culturally-salient factors that may impact PTSD symptoms in Black women.
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Affiliation(s)
- Taylor L. Ceroni
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, LA, USA
- South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans, LA, USA
| | - Samantha C. Holmes
- College of Staten Island, City University of New York, Staten Island, NY, USA
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8
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Navalón P, Ghosn F, Ferrín M, Almansa B, Moreno-Giménez A, Campos-Berga L, Sahuquillo-Leal R, Diago V, Vento M, García-Blanco A. Temperamental and psychomotor predictors of ADHD symptoms in children born after a threatened preterm labour: a 6-year follow-up study. Eur Child Adolesc Psychiatry 2023; 32:2291-2301. [PMID: 36056973 PMCID: PMC10576661 DOI: 10.1007/s00787-022-02073-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/19/2022] [Indexed: 11/29/2022]
Abstract
Children born after threatened preterm labour (TPL), regardless of whether it ends in preterm birth, may represent an undescribed "ADHD cluster". The aim of this cohort study is to identify early temperament and psychomotor manifestations and risk factors of TPL children who present ADHD symptoms. One hundred and seventeen mother-child pairs were followed from TPL diagnosis until the child's 6 years of life. TPL children were divided according to the prematurity status into three groups: full-term TPL (n = 26), late-preterm TPL (n = 53), and very-preterm TPL (n = 38). A non-TPL group (n = 50) served as control. Temperament and psychomotor development at age 6 months and ADHD symptoms at age 6 years were assessed. Perinatal and psychosocial factors were also recorded. All TPL groups showed higher severity of ADHD symptoms compared with non-TPL children (difference in means + 4.19 for the full-term group, + 3.64 for the late-preterm group, and + 4.99 for the very-preterm group, all ps < 0.021). Concretely, very-preterm and late-preterm TPL children showed higher restless/impulsive behaviours, whereas full-term TPL children showed higher emotional lability behaviours. Higher surgency/extraversion and delayed fine motor skills at age 6 months predicted ADHD symptoms at 6 years in TPL children. Male sex, maternal state anxiety symptoms at TPL diagnosis, low parental education, and past maternal experience of traumatic events predicted higher ADHD symptoms in TPL children. Therefore, TPL children may have a higher risk for developing ADHD symptoms, presenting a phenotype that depends on the prematurity status. Moreover, the specific combination of early manifestations and risk factors suggests that TPL children may conform an undescribed group at-risk of ADHD symptoms.
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Affiliation(s)
- Pablo Navalón
- Neonatal Research Group, La Fe Health Research Institute, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell, 106, 46026, Valencia, Spain
- Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Farah Ghosn
- Neonatal Research Group, La Fe Health Research Institute, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell, 106, 46026, Valencia, Spain
- Department of Personality, Evaluation, and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Maite Ferrín
- Haringey Children and Adolescent Mental Health Service, National Health Service, London, UK
- ReCognition Health, London, UK
| | - Belén Almansa
- Neonatal Research Group, La Fe Health Research Institute, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell, 106, 46026, Valencia, Spain
- Department of Personality, Evaluation, and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Alba Moreno-Giménez
- Neonatal Research Group, La Fe Health Research Institute, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell, 106, 46026, Valencia, Spain
- Department of Personality, Evaluation, and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Laura Campos-Berga
- Neonatal Research Group, La Fe Health Research Institute, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell, 106, 46026, Valencia, Spain
- Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Rosa Sahuquillo-Leal
- Department of Personality, Evaluation, and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Vicente Diago
- Division of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Máximo Vento
- Neonatal Research Group, La Fe Health Research Institute, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell, 106, 46026, Valencia, Spain
- Division of Neonatology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Ana García-Blanco
- Neonatal Research Group, La Fe Health Research Institute, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell, 106, 46026, Valencia, Spain.
- Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.
- Department of Personality, Evaluation, and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain.
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9
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Fereidooni F, Daniels JK, D Krause-Utz A, Hagenaars MA, Smeets T, Heins J, Dorahy MJ, Emmerik AAPV, de Jong PJ, Hoekstra S, Warrens MJ, Lommen MJJ. Childhood maltreatment and adulthood victimization: An evidence-based model. J Psychiatr Res 2023; 167:46-62. [PMID: 37832203 DOI: 10.1016/j.jpsychires.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/12/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023]
Abstract
There is ample evidence showing that childhood maltreatment increases two to three fold the risk of victimization in adulthood. Various risk factors, including posttraumatic stress disorder (PTSD) symptoms, dissociation, self-blame, and alcohol abuse are related to revictimization. Although previous research examined associations between risk factors for revictimization, the evidence is limited and the proposed models mostly include a handful of risk factors. Therefore, it is critical to investigate a more comprehensive model explaining the link between childhood maltreatment and adulthood (re)victimization. Accordingly, this study tested a data-driven theoretical path model consisting of 33 variables (and their associations) that could potentially enhance understanding of factors explaining revictimization. Cross-sectional data derived from a multi-wave study were used for this investigation. Participants (N = 2156, age mean = 19.94, SD = 2.89) were first-year female psychology students in the Netherlands and New Zealand, who responded to a battery of questionnaires and performed two computer tasks. The path model created by structural equation modelling using modification indices showed that peritraumatic dissociation, PTSD symptoms, trauma load, loneliness, and drug use were important mediators. Attachment styles, maladaptive schemas, meaning in life, and sex motives connected childhood maltreatment to adulthood victimization via other factors (i.e., PTSD symptoms, risky sex behavior, loneliness, emotion dysregulation, and sex motives). The model indicated that childhood maltreatment was associated with cognitive patterns (e.g., anxious attachment style), which in turn were associated with emotional factors (e.g., emotion dysregulation), and then with behavioral factors (e.g., risky sex behavior) resulting in revictimization. The findings of the study should be interpreted in the light of the limitations. In particular, the cross-sectional design of the study hinders us from ascertaining that the mediators preceded the outcome variable.
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Affiliation(s)
- Fatemeh Fereidooni
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
| | - Judith K Daniels
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands.
| | - Anne D Krause-Utz
- Department of Clinical Psychology, Leiden University, the Netherlands
| | | | - Tom Smeets
- Department of Medical and Clinical Psychology, Tilburg University, the Netherlands
| | - Jenna Heins
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Martin J Dorahy
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | | | - Peter J de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
| | - Steven Hoekstra
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
| | - Matthijs J Warrens
- Department of Educational Sciences, University of Groningen, the Netherlands
| | - Miriam J J Lommen
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
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10
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Corbett E, Theobald J, Billett P, Hooker L, Edmonds L, Fisher C. Revictimisation of Women in Non-Urban Areas: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:2379-2394. [PMID: 35549602 DOI: 10.1177/15248380221094317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Literature widely acknowledges that women who experience Child Sex Abuse (CSA) have a higher risk of experiencing sexual revictimisation later in life, yet less is known about experiences of revictimisation in non-urban areas. The aim of this review is to examine what is known internationally regarding revictimisation of non-urban women, and to provide future research, practice and policy recommendations. A total of 2414 articles were identified through a comprehensive search across five broad health sciences and humanities databases; 11 articles met inclusion criteria and were included in this review. This review found a general lack of qualitative revictimisation studies, and limited research focusing on non-urban women. While existing studies included non-urban research samples, few articles (n = 3) explored how non-urban location contextualises revictimisation experiences. Most peer-reviewed articles identified within this paper (n = 7) examined intimate partner violence (IPV) revictimisation, highlighting a significant lack of research on sexual revictimisation within non-urban settings. Findings from the review indicate that experiences of violence in childhood and adulthood are frequent among non-urban women, and that experiencing child abuse is associated with a heightened likelihood of poor mental health and IPV in adulthood. The review also found that non-urban women faced significant structural disadvantage including low levels of employment and income, limited-service sector resources, unsafe family environments and exposure to community violence. Additional qualitative research is needed to better understand the experiences and needs of non-urban revictimised women, particularly within an Australian context.
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Affiliation(s)
- Emily Corbett
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Jacqui Theobald
- Department of Community and Allied Health, Social Work and Social Policy, La Trobe University School of Rural Health, Bendigo, VIC, Australia
| | - Paulina Billett
- Department of Social Inquiry, School of Humanities and Social Sciences, La Trobe University, Flora Hill, VIC, Australia
| | - Leesa Hooker
- School Department of Rural Nursing and Midwifery, La Trobe Rural Health, Bendigo, VIC, Australia
| | - Lee Edmonds
- Centre Against Sexual Assault Central Victoria, Bendigo, VIC, Australia
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11
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Walsh K, Gilmore AK, Jaffe AE, Frazier P, Ledray L, Acierno R, Ruggiero KJ, Kilpatrick DG, Resnick HS. A preliminary examination of sexual and physical victimization 6 months after recent rape. Arch Womens Ment Health 2023; 26:495-501. [PMID: 37286883 PMCID: PMC10913087 DOI: 10.1007/s00737-023-01335-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 06/01/2023] [Indexed: 06/09/2023]
Abstract
One in four US women will experience a completed or attempted rape in their lifetime, and more than 50% of survivors will experience two or more rapes. Rape and physical violence also co-occur. Multiple experiences of sexual and physical violence are associated with elevated mental and physical health problems. This secondary analysis examined the prevalence and correlates of experiencing sexual or physical violence within 6 months of a sexual assault medical forensic exam (SAMFE). Between May 2009 and December 2013, 233 female rape survivors aged 15 and older were enrolled in a randomized controlled trial during a SAMFE in the emergency department (ED). Demographics, rape characteristics, distress at the ED, and pre-rape history of sexual or physical victimization were assessed. New sexual and physical victimization was assessed 6 months after the SAMFE via telephone interview. Six months after the exam, 21.7% reported a new sexual or physical victimization. Predictors of revictimization during follow-up included sexual or physical victimization prior to the index rape, making less than $10,000 annually, remembering the rape well, life threat during the rape, and higher distress at the ED. In adjusted models, only pre-rape victimization and making less than $10,000 annually were associated with revictimization. Factors assessed at the ED can inform subsequent victimization risk. More research is needed to prevent revictimization among recent rape victims. Policies to provide financial support to recent rape victims and/or targeted prevention for those with pre-rape victimization at the SAMFE could reduce revictimization risk. TRIAL REGISTRATION: NCT01430624.
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Affiliation(s)
- Kate Walsh
- Departments of Psychology and Gender & Women's Studies, University of Wisconsin-Madison, Madison, WI, USA.
| | - Amanda K Gilmore
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
- National Center for Sexual Violence Prevention, Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Anna E Jaffe
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Patricia Frazier
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Linda Ledray
- SANE SART Resource Service, Minneapolis, MN, USA
| | - Ron Acierno
- Department of Psychiatry, University of Texas Health Science Center, Houston, TX, USA
| | - Kenneth J Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Dean G Kilpatrick
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Heidi S Resnick
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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12
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Kasparek SW, Rosen ML, Lurie LA, Cikara M, Sambrook K, Cvencek D, Meltzoff AN, McLaughlin KA. Differentiating Between Us & Them: Reduced In-Group Bias as a Novel Mechanism Linking Childhood Violence Exposure with Internalizing Psychopathology. Res Child Adolesc Psychopathol 2023; 51:961-975. [PMID: 36862283 PMCID: PMC9979122 DOI: 10.1007/s10802-023-01035-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 03/03/2023]
Abstract
Strong in-group bonds, facilitated by implicit favoritism for in-group members (i.e., in-group bias), promote mental health across development. Yet, we know little about how the development of in-group bias is shaped by early-life experiences. Childhood violence exposure is known to alter social information processing biases. Violence exposure may also influence social categorization processes, including in-group biases, in ways that influence risk for psychopathology. We examined associations of childhood violence exposure with psychopathology and behavioral and neural indices of implicit and explicit bias for novel groups in children followed longitudinally across three time points from age 5 to 10 years old (n = 101 at baseline; n = 58 at wave 3). To instantiate in-group and out-group affiliations, youths underwent a minimal group assignment induction procedure, in which they were randomly assigned to one of two groups. Youth were told that members of their assigned group shared common interests (in-group) and members of the other group did not (out-group). In pre-registered analyses, violence exposure was associated with lower implicit in-group bias, which in turn was associated prospectively with higher internalizing symptoms and mediated the longitudinal association between violence exposure and internalizing symptoms. During an fMRI task examining neural responses while classifying in-group and out-group members, violence-exposed children did not exhibit the negative functional coupling between vmPFC and amygdala to in-group vs. out-group members that was observed in children without violence exposure. Reduced implicit in-group bias may represent a novel mechanism linking violence exposure with the development of internalizing symptoms.
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Affiliation(s)
| | - Maya L Rosen
- Department of Psychology, Harvard University, Cambridge, MA, USA
- Program in Neuroscience, Smith College, Northampton, MA, USA
| | - Lucy A Lurie
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mina Cikara
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Kelly Sambrook
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Dario Cvencek
- Institute for Learning & Brain Sciences, University of Washington, Seattle, WA, USA
| | - Andrew N Meltzoff
- Institute for Learning & Brain Sciences, University of Washington, Seattle, WA, USA
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13
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Serpeloni F, Narrog JA, Pickler B, Avanci JQ, Assis SGD, Koebach A. Treating post-traumatic stress disorder in survivors of community and domestic violence using narrative exposure therapy: a case series in two public health centers in Rio de Janeiro/Brazil. CIENCIA & SAUDE COLETIVA 2023; 28:1619-1630. [PMID: 37255140 DOI: 10.1590/1413-81232023286.16532022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 11/15/2022] [Indexed: 06/01/2023] Open
Abstract
Prevalence of violence in Brazil is high, which contributes to an increasing number of trauma-related disorders, especially post-traumatic stress disorder (PTSD). This study aims to present a case series of PTSD patients treated with narrative exposure therapy (NET) in two public health centers in Rio de Janeiro (Brazil). Health professionals were trained in a two-week workshop to deliver NET. Exposure to violence and other potentially traumatic events, as well as PTSD were assessed by interviewers before treatment and six months later in follow-up interviews conducted by blind assessors. Multiple traumatic events, including different types of childhood and sexual abuse, intimate partner violence and community violence were reported. Five patients were exposed to community violence, and one to domestic violence, during or after NET treatment. Treatment delivery was integrated into the routine of health centers. Eight patients completed NET and presented a substantial reduction in PTSD severity at six-month follow-up. NET is a feasible and effective treatment for PTSD patients exposed to ongoing violence, and can be integrated into established public health services.
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Affiliation(s)
- Fernanda Serpeloni
- Departamento de Estudos sobre Violência e Saúde Jorge Careli, Fundação Oswaldo Cruz (Claves/Fiocruz). Av. Brasil 4.036, sala 700, Manguinhos. 21040-361 Rio de Janeiro RJ Brasil.
- ONG vivo international. Konstanz Alemanha
| | | | - Bianca Pickler
- Departamento de Estudos sobre Violência e Saúde Jorge Careli, Fundação Oswaldo Cruz (Claves/Fiocruz). Av. Brasil 4.036, sala 700, Manguinhos. 21040-361 Rio de Janeiro RJ Brasil.
| | - Joviana Quintes Avanci
- Departamento de Estudos sobre Violência e Saúde Jorge Careli, Fundação Oswaldo Cruz (Claves/Fiocruz). Av. Brasil 4.036, sala 700, Manguinhos. 21040-361 Rio de Janeiro RJ Brasil.
| | - Simone Gonçalves de Assis
- Departamento de Estudos sobre Violência e Saúde Jorge Careli, Fundação Oswaldo Cruz (Claves/Fiocruz). Av. Brasil 4.036, sala 700, Manguinhos. 21040-361 Rio de Janeiro RJ Brasil.
- Programa de Pós-Graduação em Neurologia, Universidade Federal do Estado do Rio de Janeiro. Rio de Janeiro RJ Brasil
| | - Anke Koebach
- ONG vivo international. Konstanz Alemanha
- Departamento de Psicologia, Universidade de Konstanz. Alemanha
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14
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Tannahill HS, Barrett TS, Zalta AK, Tehee M, Blais RK. Posttraumatic Cognitions Differ Between Men and Women after Military Sexual Assault Revictimization in Their Contribution to PTSD Symptoms. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:6038-6061. [PMID: 36210787 DOI: 10.1177/08862605221127211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Sexual revictimization is heightened among military service members and veterans and is associated with greater posttraumatic stress symptoms (PTSS) and severity. The heightened distress following revictimization may be due to posttraumatic cognitions (PTC), which include negative beliefs about the self and world, and self-blame. Moreover, it is unclear whether men and women experience different levels of PTC. The current study tested PTC (overall and subdomains) as a possible mediator between sexual revictimization and PTSS severity, and gender as a possible moderator of these associations. Revictimization was defined across time periods (military sexual assault [MSA] only vs. premilitary sexual trauma + MSA) and in military rape frequency (0, 1, 2+). Participants were 400 (n = 200 [50%] male) service members/veterans with a history of MSA and completed online, anonymous, self-report questionnaires. PTC mediated the association between revictimization and PTSS severity. A significant interaction of gender suggested that men reported high overall PTC and PTC about the self regardless of revictimization; by contrast, overall PTC and PTC about the self were lower for women in response to MSA only and increased with revictimization. Results also showed men were more sensitive to PTC about self-blame as it pertains to more severe PTSS compared to women. There were no unique gender interactions when assessing revictimization by rape frequency, although PTC (overall, all subdomains) significantly mediated the association between rape frequency and PTSS severity. PTC may be a beneficial target when treating PTSS in men, and may be especially heightened in women who have experienced revictimization.
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Affiliation(s)
| | | | | | | | - Rebecca K Blais
- Utah State University, Logan, UT, USA
- Arizona State University, Tempe, AZ, USA
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15
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Jaffe AE, Brockdorf AN, Messman TL, Gratz KL, DiLillo D. Is the Risk for Sexual Revictimization Cumulative? A Prospective Examination. Womens Health Issues 2023; 33:208-214. [PMID: 36581510 PMCID: PMC10023376 DOI: 10.1016/j.whi.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 11/13/2022] [Accepted: 11/22/2022] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Sexual abuse during childhood is associated with risk for sexual assault as an adult, known as revictimization. Although multiple experiences of sexual assault in adulthood are also common, it is unclear how risk trajectories might continue to evolve in emerging adulthood, defined as ages 18-25. Clarifying risk trajectories is important to inform the development of targeted risk reduction interventions. To fill this gap, we examined cumulative risk for sexual assault in emerging adult women following multiple experiences of childhood sexual abuse (CSA) and adulthood sexual assault (ASA). METHODS Women (n = 447; aged 18-25 years at enrollment) completed behaviorally specific assessments of unwanted sexual experiences at up to 9 time points across 3 years. Logistic regression was used to predict any sexual assault during the 3-year period as a function of victimization history at baseline. A multilevel logistic regression analysis among ASA survivors was then used to determine whether each successive ASA increased risk for further victimization. RESULTS Extending prior research, findings revealed that the risk for sexual assault during the 3-year study was greater for women reporting more prior experiences of CSA and ASA. Unexpectedly, each ASA increased the risk for a subsequent ASA to a lesser extent among women with more experiences of CSA. CONCLUSIONS Findings suggest that the risk for sexual revictimization can be cumulative, but that risk does not increase indefinitely. Future research should investigate the points at which survivors of multiple assaults may begin to experience a decreased risk for later assaults, as well as the factors associated with change in risk status (e.g., removal from violent environments or relationships, changes in institutional policies). Such research could inform intervention targets.
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Affiliation(s)
- Anna E Jaffe
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska.
| | | | | | - Kim L Gratz
- Department of Psychology, The University of Toledo, Toledo, Ohio
| | - David DiLillo
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska
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16
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Perry EW, Osborne MC, Kinnish K, Lee N, Self-Brown SR. The PTSD Symptom Presentation and the Effect of Polytrauma on PTSD Symptom Clusters Among Young People Who Have Experienced Commercial Sexual Exploitation and Trafficking. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:81-93. [PMID: 36776638 PMCID: PMC9908799 DOI: 10.1007/s40653-022-00474-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 06/18/2023]
Abstract
Purpose The purpose of this study was to describe the PTSD symptom presentation (including dissociative symptoms) of PTSD using the Diagnostic and Statistical Manual of Mental Disorders 5 th Edition diagnostic criteria and explore associations between the symptom severity for each of the four PTSD symptom clusters and polytrauma, defined as multiple exposures to different categories of potentially traumatic events. Methods This is a secondary analysis of cross-sectional program evaluation data among 95 young people (aged 11-19) at therapy initiation in a southeastern state in the U.S. We used descriptive statistics and multivariable linear regression to test study objectives. Results Eighty-one respondents (90.0%) experienced a potentially traumatic event in ≥ 2 trauma categories, in addition to experiencing CSE/T. Approximately two-thirds of respondents experienced clinically significant PTSD symptoms for each symptom cluster. Of the 31 young people who met full criteria for PTSD, 9 met criteria for the standard PTSD diagnosis, while 22 met criteria for the dissociative subtype of PTSD. On average, experiencing additional trauma categories was associated with substantively higher PTSD symptom cluster scores for each cluster. Conclusions These findings support the need for a comprehensive assessment of trauma symptoms that includes cluster-specific PTSD symptoms. They also underscore the need to assess the full breadth and chronicity of trauma experiences to guide treatment planning and delivery, targeting specific domains of trauma impact. These findings can also inform the tailoring and adaptation of evidence-based interventions and strategies to better meet the needs of young people who have experienced CSE/T.
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Affiliation(s)
- Elizabeth W. Perry
- School of Public Health, Georgia State University, Atlanta, GA USA
- National SafeCare Training and Research Center, Georgia State University, Atlanta, GA USA
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA USA
| | - Melissa C. Osborne
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA USA
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA USA
| | - Kelly Kinnish
- School of Public Health, Georgia State University, Atlanta, GA USA
- National Center On Child Trafficking, Georgia State University, Atlanta, GA USA
| | - NaeHyung Lee
- School of Public Health, Georgia State University, Atlanta, GA USA
| | - Shannon R. Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA USA
- National SafeCare Training and Research Center, Georgia State University, Atlanta, GA USA
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA USA
- National Center On Child Trafficking, Georgia State University, Atlanta, GA USA
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17
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Mecholsky R, Garlock LR. Integrating Art Therapy With Feminism for Self-Advocacy Through Storycloth: Case Study. ART THERAPY 2023. [DOI: 10.1080/07421656.2022.2155140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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18
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Kilpatrick DG, Hahn CK. Understanding and Addressing Alcohol and Sexual Violence: We Have Made Progress but Still Have Miles to Go. NEBRASKA SYMPOSIUM ON MOTIVATION 2023. [DOI: 10.1007/978-3-031-24426-1_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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19
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Lehinger E, Bedard-Gilligan M, Holloway A, Kaysen D. Posttraumatic cognitions and sexual assault: Understanding the role of cognition type in posttraumatic stress symptoms and problematic alcohol use. J Trauma Stress 2022; 35:1672-1683. [PMID: 36000169 PMCID: PMC11198733 DOI: 10.1002/jts.22869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/21/2022] [Accepted: 05/24/2022] [Indexed: 12/24/2022]
Abstract
Identifying potential mechanisms underlying the association between posttraumatic stress symptoms (PTSS) and problematic alcohol use is an important target among college women who have experienced sexual assault. This study examined the role of posttraumatic cognitions in this association among college women (N = 530) who experienced either an alcohol-involved assault or non-alcohol-involved assault, using baseline assessment data from a larger study examining cognitive and emotional risk factors for problem drinking. Conditional path analysis was used to examine the indirect effects of posttraumatic cognitions on the association between PTSS and alcohol use consequences, with assault type as a moderator. The findings revealed a significant indirect path from PTSS to alcohol use consequences through posttraumatic cognitions, B = 0.21, SE = 0.04, p < .001, 95% CI [0.13, 0.29], β = .16, R2 = .32. Exploratory analyses revealed a significant conditional indirect effect through self-blame cognitions, R2 = .31, whereby the indirect effect of self-blame on the association between posttraumatic stress and alcohol consequences was present among participants who experienced alcohol-involved assault, B = 0.10, SE = 0.03, p < .001, 95% CI [0.06, 0.16], β = .07, but not among those who experienced a non-alcohol-involved assault, B = 0.03, SE = 0.03, p = 0.32, 95% CI [-0.02, 0.08], β = .02. Posttraumatic cognitions are a potential mechanism underlying the link between posttraumatic stress and alcohol consequences. Addressing posttraumatic cognitions, particularly those related to self-blame, may be an important target for interventions promoting healthy recovery following alcohol-involved assault.
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Affiliation(s)
- Elizabeth Lehinger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Michele Bedard-Gilligan
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Ash Holloway
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
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20
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Fung HW, Lam SKK, Chien WT, Hung SL, Ling HWH, Lee VWP, Wang EK. Interpersonal stress mediates the relationship between childhood trauma and depressive symptoms: Findings from two culturally different samples. Aust N Z J Psychiatry 2022:48674221138501. [PMID: 36440622 DOI: 10.1177/00048674221138501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Childhood trauma is associated with adulthood depressive symptoms, but very few studies explored potential social and interpersonal mediators behind this association. This study made the first attempt to test the potential mediating effects of interpersonal stress in the associations between childhood betrayal and non-betrayal trauma and depressive symptoms. METHOD We analyzed data in a sample of English-speaking adults from diverse backgrounds (from 19 different countries, mainly from Western countries) (N = 468). We then replicated and compared the results with those in another convenience sample of Chinese-speaking younger adults with different cultural backgrounds and mental health status (N = 205). RESULTS The results in both samples indicated that (1) childhood betrayal trauma had a stronger relationship with depressive symptoms than childhood non-betrayal trauma and that (2) interpersonal stress was a significant mediator in the relationship between childhood betrayal trauma and depressive symptoms, even when childhood non-betrayal trauma was included as a covariate. The indirect effect of childhood non-betrayal trauma on depressive symptoms through interpersonal stress was not consistent in two samples. CONCLUSIONS Our findings point to the importance of taking social and interpersonal contexts into account when investigating, preventing and managing depression in trauma-exposed populations. Early social interventions such as family interventions, interpersonal skills training and building social resources may have the potential to change the trajectory of the development of mental health problems in trauma survivors.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Suet Lin Hung
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Henry Wai-Hang Ling
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Edward Ks Wang
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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21
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Maharaj R, Tineo K, Flores-Ortega M, Cordova DA, Iskhakova A, Linn R, Nikulina V. The association between COVID-19-related stressors and mental health outcomes for survivors of past interpersonal and non-interpersonal trauma. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022; 6:100300. [PMID: 37520402 PMCID: PMC9547392 DOI: 10.1016/j.ejtd.2022.100300] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/18/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022]
Abstract
The mental health difficulties of trauma survivors during the COVID-19 pandemic have been under-reported. This study explored the moderating role of trauma history and trauma type (interpersonal and non-interpersonal) in the association between COVID-19-related stressors and depression, anxiety, and stress. A sample of n = 321 participants ages 19 to 71 (M = 36.63, SD = 10.36) was recruited from across the United States through MTurk. Participants reported the number of COVID-19-related stressors, trauma history and psychological symptoms. Hierarchical multiple regression analyses, controlling for age, race, ethnicity, gender, education, and income levels, were used to determine (a) whether COVID-19-related stressors are associated with adverse mental health outcomes; (b) whether trauma history and (c) trauma type moderated this association. Results revealed significant interactions; for those with a trauma history, exposure to COVID-19-related stressors was associated with higher levels of depression (β = .21, p < .05) and anxiety (β = .19, p < .05). For those with a history of interpersonal trauma specifically, COVID-19-related stressors were associated with depression (β = .16, p < .05) more so than for those without a trauma history. These findings highlight the vulnerability of trauma survivors to the unprecedented COVID-19-related stress.
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Affiliation(s)
- Reena Maharaj
- Department of Psychology, Queens College, City University of New York, United States
| | - Katherine Tineo
- Department of Psychology, Queens College, City University of New York, United States
| | - Marisol Flores-Ortega
- Department of Psychology, Queens College, City University of New York, United States
| | - Diego A Cordova
- Department of Psychology, Queens College, City University of New York, United States
| | - Alexandra Iskhakova
- Department of Psychology, Queens College, City University of New York, United States
| | - Rose Linn
- Department of Psychology, Queens College, City University of New York, United States
| | - Valentina Nikulina
- Department of Psychology, Queens College, City University of New York, United States
- The Graduate Center, City University of New York, United States
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22
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Heinrichs N, Brühl A. Preventing Revictimization Through a Web-Based Intervention for Primary Caregivers of Youth in Care (EMPOWERYOU): Protocol for a Randomized Factorial Trial. JMIR Res Protoc 2022; 11:e38183. [DOI: 10.2196/38183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/05/2022] [Accepted: 08/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Children in foster care are at a higher risk for relationship problems than their counterparts raised by their biological family because of higher exposure to or prevalence of neglect or maltreatment early in life. Consequently, these children may also show more challenging behavior in their foster families, which in turn increases the parental stress experience of foster caregivers. Furthermore, the children may engage in a vicious cycle of risky relationship behaviors and expectations that put them at a greater risk for revictimization.
Objective
To support foster caregivers in reducing the risk for revictimization, several intervention modules delivered via the internet were developed using a consumer-based approach (phase 1 of the multiphase optimization strategy). This project (phase 2 of the multiphase optimization strategy) aimed to develop a sustainable intervention by selecting promising intervention components based on their contribution to the outcome.
Methods
In a 24 factorial trial, a total of 317 foster caregivers with children aged 8 to 13 years are randomly assigned to 1 of 16 conditions. The primary outcome is the rate of revictimization from baseline to 3 months after intervention. Secondary outcomes include risk-taking and functional behaviors in relationships. All caregivers will receive access to all the intervention components after the follow-up assessment. The participants assigned to the condition with all component levels on are expected to show the best improvement in the primary and secondary outcomes.
Results
Recruitment and data collection for the factorial trial started in March 2022 and is ongoing. As of October 2022, we recruited 181 families. Although it is difficult to predict the exact study timeline owing to COVID-19 pandemic–related delays, results are expected in February 2024.
Conclusions
There is a need for easily accessible information related to raising children in foster care who have experienced early life adversities to interrupt the cycle of violence and enhance the developmental pathway of health and emotional stability. It might be useful, in addition to generally useful parenting information (eg, parental self-care or emotion regulation management), to specifically focus on the needs of these caregivers (eg, how to support the child to reduce dysfunctional relationship behaviors that may have developed because of early adverse experiences).
Trial Registration
ClinicalTrials.gov NCT05235659; https://clinicaltrials.gov/ct2/show/NCT05235659
International Registered Report Identifier (IRRID)
DERR1-10.2196/38183
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23
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Hetzel-Riggin MD, James S, Roby R, Buczek TJ. Gender, Myths, and Assumptions: Correlates of Risk Perception in Sexual Assault Scenarios. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP18085-NP18103. [PMID: 34330163 DOI: 10.1177/08862605211035867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sexual violence continues to plague college campuses even with the implementation of bystander intervention programs. Previous research has demonstrated that diminished situational risk recognition increases the risk for sexual assault victimization. However, there is a paucity of research comparing men's and women's risk perception in sexual assault scenarios, risk perception from a victim or perpetrator perspective, or the role of previous sexual violence history, rape myth acceptance, and world assumptions on sexual risk perception. The current study examined male and female college students' risk perception while reading a sexual assault scenario. Participants also completed measures of victim and perpetrator blame, rape myth acceptance, and beliefs in a just world. The results suggested that men's and women's risk perception is influenced by different rape myths and world assumptions. Specifically, women's risk perception and victim blame are associated with sexual communication myths and beliefs in the randomness of the world, while men's risk perception and victim blame are related to the acceptance of myths that women ask for sexual assault and that the world is a just, cruel place. The results call for the incorporation of additional training on how rape myths and world assumptions may impact risk recognition and intervention in sexual assault education. It will also be important to target different barriers to intervention for men and women.
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Affiliation(s)
| | | | - Ryan Roby
- Western Illinois University, Macomb, IL, USA
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24
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Scoglio AAJ, Molnar BE, Lincoln AK, Griffith J, Park C, Kraus SW. Sexual and physical revictimization in U.S. military veterans. J Trauma Stress 2022; 35:1129-1141. [PMID: 35233826 DOI: 10.1002/jts.22816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 12/15/2021] [Accepted: 01/23/2022] [Indexed: 11/08/2022]
Abstract
The present study examined revictimization, defined as sexual or physical assault in adulthood that followed a history of childhood maltreatment. We aimed to identify factors associated with revictimization over time in a group of U.S. military veterans deployed following the September 11, 2001, terrorist attacks (9/11). As revictimization is associated with multiple negative mental health outcomes in the literature, identifying risk and protective factors can aid in the prevention of revictimization and associated poor health outcomes among veterans. In this sample, the proportion of adult revictimization was 2.7% for men, 95% CI [2.0, 3.6] and 22.9% for women, 95% CI [20.5, 25.8]. Using multilevel logistic models, we found that women, β = 2.2, p < .001; Navy veterans, β = 1.5, p < .001; and participants who reported posttraumatic stress symptoms, β = 0.2, p = .028, were at significantly higher risk of revictimization across time compared to nonrevictimized counterparts. Social support while in the military was protective, β = -0.1, p < .001, against revictimization. In addition, childhood abuse experiences combined with characteristics such as female gender were related to an increased risk of revictimization during and following military service. The findings highlight opportunities for intervention and areas of strength within this population; social connection garnered during military service may serve as a protective factor against revictimization. Future research is needed to examine the role of social support in possibly lowering veterans' risk of revictimization over time, particularly for post-9/11 veterans struggling with transitioning from military to civilian life.
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Affiliation(s)
- Arielle A J Scoglio
- Institute for Health Equity and Social Justice Research, Northeastern University, Boston, Massachusetts, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Beth E Molnar
- Institute for Health Equity and Social Justice Research, Northeastern University, Boston, Massachusetts, USA.,Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Alisa K Lincoln
- Institute for Health Equity and Social Justice Research, Northeastern University, Boston, Massachusetts, USA.,Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | - John Griffith
- Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Crystal Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Shane W Kraus
- Department of Psychology, University of Nevada-Las Vegas, Las Vegas, Nevada, USA
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Perry EW, Osborne MC, Lee N, Kinnish K, Self-Brown SR. Posttraumatic Cognitions and Posttraumatic Stress Symptoms Among Young People Who Have Experienced Commercial Sexual Exploitation and Trafficking. Public Health Rep 2022; 137:91S-101S. [PMID: 35775917 DOI: 10.1177/00333549211041552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The impact of posttraumatic cognitions on the development and maintenance of posttraumatic stress symptoms (PTSS) is understudied among children and adolescents who have experienced commercial sexual exploitation/trafficking (CSE/T). The objectives of this study were to (1) explore posttraumatic cognitions among help-seeking young people aged 11-19 who have experienced CSE/T; (2) determine whether experiencing direct violence, witnessing violence, polyvictimization (ie, multiple exposures to different categories of potentially traumatic events), or demographic characteristics differentially affect whether these young people meet clinical criteria for posttraumatic cognitions using established cutoffs; and (3) explore associations between posttraumatic cognitions and PTSS among young people who have experienced CSE/T. METHODS This study is a secondary analysis of a baseline cross-sectional survey of 110 young people with substantiated CSE/T experiences who started trauma-focused cognitive behavioral therapy (mean [SD] age = 15.8 [1.5]) from August 1, 2013, through March 31, 2020, in a southeastern US state. We used descriptive statistics, adjusted modified Poisson regression, and adjusted linear regression to test study objectives. RESULTS Fifty-seven of 110 (51.8%) young people aged 11-19 met clinical criteria for posttraumatic cognitions. Increased age and a greater number of trauma categories experienced were significantly associated with meeting clinical criteria for posttraumatic cognitions. On average, higher posttraumatic cognition scores were associated with higher PTSS scores, controlling for demographic characteristics (β = 0.95; 95% CI, 0.64-1.26). CONCLUSIONS These findings underscore the importance of assessing comprehensive trauma history and PTSS of young people who have experienced CSE/T, with added usefulness of measuring cognitive appraisals to inform a therapeutic treatment plan. Measuring cognitive appraisals that may influence PTSS and therapeutic success can ensure an effective public health response for this population.
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Affiliation(s)
- Elizabeth W Perry
- 1373 School of Public Health, Georgia State University, Atlanta, GA, USA.,1373 Mark Chaffin Center for Healthy Development, Georgia State University, Atlanta, GA, USA.,1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Melissa C Osborne
- 1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA.,1373 Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA
| | - NaeHyung Lee
- 1373 School of Public Health, Georgia State University, Atlanta, GA, USA.,1373 Mark Chaffin Center for Healthy Development, Georgia State University, Atlanta, GA, USA.,1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | | | - Shannon R Self-Brown
- 1373 School of Public Health, Georgia State University, Atlanta, GA, USA.,1373 Mark Chaffin Center for Healthy Development, Georgia State University, Atlanta, GA, USA.,1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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Cerdá M, Hamilton AD, Tracy M, Branas C, Fink D, Keyes KM. Would restricting firearm purchases due to alcohol- and drug-related misdemeanor offenses reduce firearm homicide and suicide? An agent-based simulation. Inj Epidemiol 2022; 9:17. [PMID: 35681243 PMCID: PMC9185952 DOI: 10.1186/s40621-022-00381-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Substance-related interactions with the criminal justice system are a potential touchpoint to identify people at risk for firearm violence. We used an agent-based model to simulate the change in firearm violence after disqualifying people from owning a firearm given prior alcohol- and drug-related misdemeanors. METHODS We created a population of 800,000 agents reflecting a 15% sample of the adult New York City population. RESULTS Disqualification from purchasing firearms for 5 years after an alcohol-related misdemeanor conviction reduced population-level rates of firearm homicide by 1.0% [95% CI 0.4-1.6%] and suicide by 3.0% [95% CI 1.9-4.0%]. Disqualification based on a drug-related misdemeanor conviction reduced homicide by 1.6% [95% CI 1.1-2.2%] and suicide by 4.6% [95% CI 3.4-5.8%]. Reductions were generally 2 to 8 times larger for agents meeting the disqualification criteria. CONCLUSIONS Denying firearm access based on a history of drug and alcohol misdemeanors may reduce firearm violence among the high-risk group. Enactment of substance use-related firearms denial criteria needs to be balanced against concerns about introducing new sources of disenfranchisement among already vulnerable populations.
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Affiliation(s)
- Magdalena Cerdá
- Center for Opioid Epidemiology and Policy, Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine, New York, NY USA
- Department of Population Health, Grossman School of Medicine, NYU Langone Health, 180 Madison Avenue, Room 416, New York, NY 10016 USA
| | - Ava D. Hamilton
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
| | - Melissa Tracy
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Rensselaer, NY USA
| | - Charles Branas
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
| | - David Fink
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
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Kumar SA, Brockdorf AN, Jaffe AE, Church HR, Messman TL, DiLillo D. Mindful Awareness Promotes Resilience: Buffered Links Among Childhood Sexual Abuse Severity, Goal-Directed Emotion Dysregulation, and Psychopathology. Mindfulness (N Y) 2022; 13:993-1006. [PMID: 36185759 PMCID: PMC9518717 DOI: 10.1007/s12671-022-01854-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 10/18/2022]
Abstract
Objectives Childhood sexual abuse is linked to long-term consequences, including depression and anxiety in adulthood. Although considerable progress has been made to understand mechanisms that may account for this relation, such as emotion dysregulation, less attention has been given to protective factors that may mitigate it. One such protective factor might be mindful awareness. Those who act with awareness in daily living tend to engage in healthy emotion regulation skills when faced with stressors and experience less depression and anxiety. In the current study, we aimed to replicate the positive associations among childhood sexual abuse severity, emotion dysregulation, and psychopathology across time, and also identify a personal strength-in this case, mindful awareness-that might mitigate these effects. Methods Participants were 491 women recruited from the community who completed self-report assessments at three time points over a 32-month period. Results A series of moderated mediation models revealed childhood sexual abuse severity predicted later reports of depression and anxiety symptoms through greater emotion dysregulation in the form of difficulties engaging in goal-directed behaviors. As expected, mindful awareness weakened the relation between goal-directed emotion dysregulation and symptoms of depression and anxiety, such that greater levels of mindful awareness fully buffered these effects. Conclusions Through a better understanding of natural resiliency processes among survivors, we can ultimately encourage continued examination of what might be effective additions to existing treatments for the mental health consequences of trauma and adversity.
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Affiliation(s)
- Shaina A. Kumar
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE 68588
| | - Alexandra N. Brockdorf
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE 68588
| | - Anna E. Jaffe
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE 68588
| | - Haley R. Church
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE 68588
| | - Terri L. Messman
- Department of Psychology, Miami University, 90 North Patterson Avenue, Oxford, OH 45056
| | - David DiLillo
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE 68588
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Geoffrion S, Goncalves J, Robichaud I, Sader J, Giguère CÉ, Fortin M, Lamothe J, Bernard P, Guay S. Systematic Review and Meta-Analysis on Acute Stress Disorder: Rates Following Different Types of Traumatic Events. TRAUMA, VIOLENCE & ABUSE 2022; 23:213-223. [PMID: 32588756 DOI: 10.1177/1524838020933844] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Studies investigating rates of acute stress disorder following exposure to a traumatic event report widely varying results, even when examining the same types of traumatic events. The first purpose of this systematic review and meta-analysis was to describe rates of acute stress disorder following five different types of traumatic events. The second goal was to assess the methodological and trauma-related factors influencing these rates. Between May 2017 and October 2019, studies were identified by searching through the PsychINFO, PubMed/Medline, OVID, CINAHL, Scopus, and PILOTS databases. Records were included if (1) participants were 16 years old and over, (2) the assessment was completed within 30 days of the event, (3) a standardized assessment instrument was utilized, (4) the type of traumatic event was specified, and (5) the acute stress disorder rate was reported. The list of traumatic events used for the search strategy was based on the Diagnostic and Statistical Manual of Mental Disorders and was complemented by those listed in the Life Events Checklist and the National Comorbidity Survey Replication. Seventy-three samples from 70 studies totaling 20,065 participants met inclusion criteria. Results revealed that rates of acute stress disorder ranged from 14.1% for war-related trauma to 36.0% for interpersonal trauma. Interpersonal trauma was significantly more likely to lead to acute stress disorder than other types of events, except for disaster-related trauma. Differing assessment instruments, types of exposure and geographical locations, and the intentional nature of certain events contributed to heterogeneity in rates within each type of traumatic event.
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Affiliation(s)
- Steve Geoffrion
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
- School of Psychoeducation, University of Montreal, Quebec, Canada
- Research Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
| | - Jane Goncalves
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
- Research Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
| | - Isabelle Robichaud
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
- Research Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
| | - Josette Sader
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
- Research Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
| | | | - Maxime Fortin
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
- Research Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
| | - Josianne Lamothe
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
- Research Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
- School of Criminology, University of Montreal, Quebec, Canada
| | - Paquito Bernard
- Research Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
- Faculty of Science, Université du Québec à Montréal, Quebec, Canada
| | - Stéphane Guay
- Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
- Research Centre, Institut universitaire en santé mentale de Montréal, Quebec, Canada
- School of Criminology, University of Montreal, Quebec, Canada
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Hughesdon KA, Ford JD, Briggs EC, Seng JS, Miller AL, Stoddard SA. Interpersonal Trauma Exposure and Interpersonal Problems in Adolescent Posttraumatic Stress Disorder. J Trauma Stress 2021; 34:733-743. [PMID: 34021624 DOI: 10.1002/jts.22687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 02/24/2021] [Accepted: 03/22/2021] [Indexed: 11/12/2022]
Abstract
Traumatic experiences have been differentiated as interpersonal (i.e., the direct result of actions by other people) or noninterpersonal (i.e., other life-threatening events, such as severe accidents). Interpersonal trauma exposure generally has been shown to be associated with more severe posttraumatic stress disorder (PTSD) symptoms than noninterpersonal trauma exposure. Interpersonal problems also tend to be associated with trauma exposure and PTSD symptoms, but it is unclear whether a mediating association exists between trauma type, interpersonal problems, and PTSD symptoms. A clinical sample of 4,275 adolescents (age range: 12-18 years) from the National Child Traumatic Stress Network Core Data Set were classified as having experienced interpersonal trauma, noninterpersonal trauma, or both. Interpersonal problems were operationalized by social problem behaviors (e.g., immature and dependent behaviors) and aggressive behaviors on the Child Behavior Checklist. The results of path analyses showed that cumulative interpersonal trauma exposure was both directly and indirectly associated with PTSD symptoms via social problem behaviors but not aggressive behaviors, total effect β = .20, 95% CI [.17, .23]. In a second model, path analyses showed that cumulative interpersonal trauma exposure was associated directly and indirectly via PTSD symptoms with social problem behaviors, total effect β = .15, 95% CI [.11, .18], and aggressive behaviors, total effect β = .13, 95% CI [.09, .17]. These findings suggest that during adolescence, interpersonal problems play an important role in the association between interpersonal trauma exposure and PTSD symptoms.
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Affiliation(s)
| | - Julian D Ford
- Department of Psychology, University of Connecticut, Farmington, Connecticut, USA
| | | | - Julia S Seng
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Alison L Miller
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sarah A Stoddard
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
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Vance MC, Mash HBH, Ursano RJ, Zhao Z, Miller JT, Clarion MJD, West JC, Morganstein JC, Iqbal A, Sen S. Exposure to Workplace Trauma and Posttraumatic Stress Disorder Among Intern Physicians. JAMA Netw Open 2021; 4:e2112837. [PMID: 34100937 PMCID: PMC8188264 DOI: 10.1001/jamanetworkopen.2021.12837] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IMPORTANCE Physicians are exposed to traumatic events during their work, but the impact and outcomes of these exposures are understudied. OBJECTIVE To determine the prevalence and associations of work-related trauma exposure and posttraumatic stress disorder (PTSD) among a cohort of resident physicians in their internship year of training. DESIGN, SETTING, AND PARTICIPANTS This cohort study involved physicians entering internship at US residency programs nationwide in 2018. Participants completed a baseline survey 1 to 2 months before commencing internship, as well as follow-up surveys at 4 time points during internship. Statistical analysis was performed from April 2020 to January 2021. EXPOSURES Twelve months of internship. MAIN OUTCOMES AND MEASURES Prevalence of work-related trauma and prevalence of PTSD among those who experienced work-related trauma. Trauma exposure and PTSD symptoms were assessed using the Primary Care PTSD Screen for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (PC-PTSD-5). Risk factors assessed included depression, anxiety, early family environment, stressful life experiences, medical specialty, hours worked, and concern about medical errors. RESULTS Among 1134 interns who completed the PC-PTSD-5 at month 12 of internship, 665 (58.6%) were female and 695 (61.6%) were non-Hispanic White; the mean (SD) age was 27.52 (2.50) years. There were 640 interns (56.4%) who reported work-related trauma exposure; among these interns with trauma exposure, 123 (19.0%) screened positive for PTSD. Overall, 123 of 1134 training physicians (10.8%) screened positive for PTSD by the end of internship year, as compared with a 12-month PTSD prevalence rate of 3.6% in the general population. Multivariable logistic regression analyses, adjusting for demographic characteristics, indicated that risk factors associated with trauma exposure included non-Hispanic White race/ethnicity (odds ratio [OR], 1.51 [95% CI, 1.14-2.01]; P = .004), more hours worked (OR, 1.01 [95% CI, 1.00-1.03]; P = .03), early family environment (OR, 1.03 [95% CI, 1.01-1.05]; P < .001), and stressful life experiences at baseline (OR, 1.46 [95% CI, 1.06-2.01]; P = .02). Risk factors associated with PTSD were being unmarried (OR, 2.00 [95% CI, 1.07-3.73]; P = .03) and non-Hispanic White (OR, 1.77 [95% CI, 1.01-3.11]; P = .05), concern about medical errors (OR, 1.21 [95% CI, 1.00-1.46]; P = .05), stressful life experiences during internship (OR, 1.43 [95% CI, 1.14-1.81]; P = .002), depression at month 12 of internship (OR, 2.52 [95% CI = 1.36-4.65], P = .003), and anxiety at month 12 of internship (OR, 2.14, [95% CI, 1.13-4.04]; P = .02). CONCLUSIONS AND RELEVANCE This study found that work-related PTSD was 3 times more prevalent among intern physicians than the general population. These findings suggest that effective interventions to reduce trauma exposure and mitigate the effects of trauma are needed.
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Affiliation(s)
- Mary C. Vance
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, Maryland
| | - Holly B. Herberman Mash
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, Maryland
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, Maryland
| | - Zhuo Zhao
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor
| | - Jessica T. Miller
- F. Edward Herbert School of Medicine, Uniformed Services University, Bethesda, Maryland
| | | | - James C. West
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, Maryland
| | - Joshua C. Morganstein
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, Maryland
| | - Abeer Iqbal
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, Maryland
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland
| | - Srijan Sen
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor
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Abuse and suicide risk among college students in the United States: Findings from the 2019 Healthy Minds Study. J Affect Disord 2021; 282:554-560. [PMID: 33433385 DOI: 10.1016/j.jad.2020.12.140] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/11/2020] [Accepted: 12/24/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Suicide has increased among American youth, and remains a concern on college campuses where students have reported increasing levels of psychological distress, alcohol use, social isolation, and loneliness. Abuse is known to be a risk factor for suicide, but more research is needed to understand whether current specific types of abuse and their co-occurrence are related to current suicidal thoughts and behaviors among young adults in college. METHODS We analyzed data from the 2019 wave of the Healthy Minds Study, a cross-sectional, web-based survey administered to undergraduate and graduate students. Using multivariable logistic regression, we examined the associations between abuse and suicidal thoughts and behaviors, adjusting for sociodemographic and mental health covariates. RESULTS In the past 12 months, 12.56% of the sample reported suicidal ideation, 5.70% reported making a suicide plan, and 1.28% reported making a suicide attempt. Over a third of the sample reported at least one type of abuse over the past 12 months. Emotional, physical, and sexual abuse were all associated with greater odds of all suicide outcomes, adjusting for sociodemographic characteristics and mental health. Endorsing multiple types of abuses was associated with greater odds of suicide outcomes in a dose-response fashion. LIMITATIONS Data were cross-sectional and the response rate for this survey was 16%. CONCLUSIONS Universities can implement a multi-pronged approach that covers screening for types of abuse, initiating awareness campaigns around abuse and suicide, and training faculty and staff to make appropriate referrals. Student services must also be equipped to address students who perpetrate abuse.
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Majeed R, Lipinski AJ, Free BL, Lewin RK, Beck JG. The role of negative cognitions in co-occurring posttraumatic stress disorder and depression: Examination of interpersonal and noninterpersonal trauma survivors. J Clin Psychol 2020; 77:755-769. [PMID: 33037635 DOI: 10.1002/jclp.23056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/06/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine negative cognitions underlying both posttraumatic stress disorder (PTSD) and depression following trauma. METHOD A mixed-gender motor vehicle accident (N = 297, Mage = 43.49 years) sample and a female intimate partner violence (N = 242, Mage = 36.95 years) sample was cross-sectionally studied at research clinics of two universities. RESULTS When diagnostic groups (PTSD+/-, depression+/-) were studied, no significant interactions were noted for any of the three forms of negative cognitions (negative thoughts about the self, negative thoughts about the world, and self-blame) in either sample. When continuous ratings of PTSD and depression were studied, the results showed that negative thoughts about the self were linked to both PTSD and depression. CONCLUSION Findings suggest that it may be beneficial to target negative thoughts about the self when treating PTSD and depression together.
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Affiliation(s)
- Rimsha Majeed
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | | | - Bre'Anna L Free
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - Rivian K Lewin
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - J Gayle Beck
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
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Tirone V, Bagley JM, Blais R, Petrey K, Meade E, Sadler A. Military Sexual Trauma and Sexual Revictimization. Psychiatr Ann 2020. [DOI: 10.3928/00485713-20200911-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Brandt S, Rudden M. A psychoanalytic perspective on victims of domestic violence and coercive control. INTERNATIONAL JOURNAL OF APPLIED PSYCHOANALYTIC STUDIES 2020. [DOI: 10.1002/aps.1671] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Stephanie Brandt
- Assistant Clinical Professor in Psychiatry, Weill Cornell School of Medicine New York New York
- Supervising Child and Adolescent Analyst, New York Psychoanalytic Institute New York New York
| | - Marie Rudden
- Assistant Clinical Professor in Psychiatry, Weill Cornell School of Medicine New York New York
- Training and Supervising Analyst, Berkshire Psychoanalytic Institute Stockbridge Massachusetts
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Wojciechowski TW. The Impact of PTSD-Linked Strain Sensitivity on Violent Offending: Differences in Effects During Adolescence Versus Early Adulthood. VIOLENCE AND VICTIMS 2020; 35:176-194. [PMID: 32273376 DOI: 10.1891/vv-d-18-00094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Investigate the relevance of post-traumatic stress disorder (PTSD)-linked strain sensitivity associated with exposure to violence for predicting violence outcomes among juvenile offenders during adolescence and early adulthood. METHODS This study uses the Pathways to Desistance data and to test relevant relationships. Two series of negative binomial regression models were estimated to test hypotheses, one corresponding to each period of the life course. RESULTS Results indicated that witnessed violence interacted with PTSD status in adolescence, indicating that individuals afflicted with PTSD demonstrated heightened sensitivity to this strain, manifested in increased violent offending. CONCLUSIONS Results indicate that witnessed violence may act as a trigger during adolescence, resulting in juvenile offenders with PTSD responding with violence. This may have treatment implications for individuals suffering from PTSD.
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