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Tabb LP, Rich JA, Waite D, Alberto C, Harris E, Gardner J, Gentile N, Corbin TJ. Examining Associations between Adverse Childhood Experiences and Posttraumatic Stress Disorder Symptoms among Young Survivors of Urban Violence. J Urban Health 2022; 99:669-679. [PMID: 35699886 PMCID: PMC9360210 DOI: 10.1007/s11524-022-00628-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2022] [Indexed: 01/31/2023]
Abstract
Our study examines the association between Adverse Childhood Experience (ACE) exposure and posttraumatic stress disorder (PTSD) symptoms among survivors of violence. In this cross-sectional study, an ACE questionnaire and PTSD Checklist for DSM-5 (PCL-5) were completed by 147 participants ≤ 3 months after presenting to a Philadelphia, PA emergency department between 2014 and 2019 with a violent injury. This study treated ACEs, both separate and cumulative, as exposures and PTSD symptom severity as the outcome. Most participants (63.3%) met criteria for provisional PTSD, 90% reported experiencing ≥ 1 ACE, and 39% reported experiencing ≥ 6 ACEs. Specific ACEs were associated with increasing PCL-5 scores and increased risk for provisional PTSD. Additionally, as participants' cumulative ACE scores increased, their PCL-5 scores worsened (b = 0.16; p < 0.05), and incremental ACE score increases predicted increased odds for a positive provisional PTSD screen. Results provide further evidence that ACEs exacerbate the development of PTSD in young survivors of violence. Future research should explore targeted interventions to treat PTSD among survivors of interpersonal violence.
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Affiliation(s)
- Loni Philip Tabb
- Department of Epidemiology & Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - John A Rich
- Center for Nonviolence & Social Justice, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Daria Waite
- Center for Nonviolence & Social Justice, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Cinthya Alberto
- Department of Health Management & Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Erica Harris
- Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA
| | - James Gardner
- Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC, USA
| | - Nina Gentile
- Department of Emergency Medicine, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Theodore J Corbin
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, 60612, USA.
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Conway A, Pilgrim D. The Policy Alignment of the British False Memory Society and the British Psychological Society. J Trauma Dissociation 2022; 23:165-176. [PMID: 35081008 DOI: 10.1080/15299732.2022.2028222] [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: 10/19/2022]
Abstract
This paper describes the alignment between the goals of the British False Memory Society (BFMS) and a group of sympathetic academics within the British Psychological Society (BPS). Since the 1990s, the policy formation process of the BPS has excluded critical colleagues concerned with child protection and the demonstration of the link between childhood adversity and adult mental health problems. Those involved in the nexus between the BPS and BFMS have focused singularly on the experimental evidence for false-positive outcomes and have systematically excluded a consideration of false negatives. We describe how this biased policy development emerged and was maintained. We discuss this skewed policy formation with reference to social network formation in professional life, as well as the wider context of child abuse in society.
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Affiliation(s)
- Ashley Conway
- CDS (Clinic for Dissociative Studies) & Private Practice, London, UK
| | - David Pilgrim
- Department of Psychology, University of Southampton, Southampton, UK
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Daignault IV, Hébert M, Cyr M, Pelletier M, McDuff P. Correlates and Predictors of Mothers' Adaptation and Trauma Symptoms Following the Unveiling of the Sexual Abuse of Their Child. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP5784-NP5808. [PMID: 30388043 DOI: 10.1177/0886260518808849] [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: 06/08/2023]
Abstract
Child sexual abuse (CSA) can severely affect the mental health of children and their parents. While correlates of recovery have been documented in children, factors exacerbating parents' adaptation to their child's unveiling of CSA deserves further attention. Parents' history of abuse has been inconsistently identified as a predictor of their distress in reaction to their child's abuse disclosure. This study proposes a mediation model that explores various processes underlying mother's psychological distress (posttraumatic stress disorder [PTSD], dissociation, and their comorbidity) following their children's unveiling of CSA. It investigates the influence of mother's own CSA, as well as of her exposure to additional forms of past and current victimization, on her reaction to the child's CSA disclosure, while considering coping mechanisms as mediators (avoidance, problem solving, search for social support, and feeling of guilt). Data were collected through self-report measures completed by 298 mothers of children who had recently disclosed CSA. Path analyses revealed that mother's exposure to interparental violence as a child acted as a primary predictor of dissociation and of its comorbidity with PTSD, while a history of CSA was directly and exclusively linked to dissociation. Being exposed to recent partner violence was indirectly related to trauma symptoms, with coping mechanisms acting as mediators. This study outlines the relationship between mother's psychological distress and her cumulative, past, and current exposure to various forms of victimization. Exposure to interparental violence as a child represents a particularly important factor for identifying mothers most in need of support, as it is a significant predictor of dissociation and of its comorbidity with PTSD.
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Webermann AR, Brand BL, Kumar SA. Intimate Partner Violence Among Patients With Dissociative Disorders. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP1441-1462NP. [PMID: 29295027 DOI: 10.1177/0886260517746943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Childhood trauma is common among survivors and perpetrators of intimate partner violence (IPV). Although symptoms of posttraumatic stress disorder (PTSD) and dissociative disorders (DDs) are predictors of IPV victimization and perpetration, few studies explore IPV among those with DDs. The present study examined IPV and symptoms as predictors among participants in the Treatment of Patients With Dissociative Disorders (TOP DD) Network study, an educational intervention for individuals with DDs and their clinicians. Both clinicians and patients reported on patients' history of physical, emotional, and sexual IPV as both victims and perpetrators. Patients self-reported dissociative, posttraumatic (PTSD), and emotion dysregulation symptoms, as well as IPV-specific dissociative symptoms. According to patients and clinicians, patients were frequently victims of IPV, most commonly emotional IPV. Dissociative symptoms predicted IPV exposure, whereas dissociative and emotion dysregulation symptoms predicted IPV-specific dissociative symptoms.
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Fitton L, Yu R, Fazel S. Childhood Maltreatment and Violent Outcomes: A Systematic Review and Meta-Analysis of Prospective Studies. TRAUMA, VIOLENCE & ABUSE 2020; 21:754-768. [PMID: 30122119 DOI: 10.1177/1524838018795269] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The risk of violence following childhood maltreatment is uncertain. This meta-analytic review identified prospective studies that have examined this association. We systematically searched three electronic databases (PsycINFO, EMBASE, and MEDLINE) and completed a targeted search on Google Scholar. These were supplemented with scanning reference lists and correspondence with authors. We considered non-English-language and unpublished studies. Studies were included if childhood maltreatment was measured before age 18 years and occurred before violent outcomes. We identified 18 eligible studies with data on 39,271 participants. We conducted meta-analysis to calculate odds ratios (ORs) using random-effects models. Heterogeneity was explored through subgroup analyses and meta-regression. The overall OR of violent outcomes in childhood maltreatment was 1.8 (95% confidence interval [1.4, 2.3]) with substantial heterogeneity (I2 = 92%). Meta-regression suggested that risk of violence following childhood maltreatment was more elevated in samples with higher percentage of females, in higher quality investigations, in studies with case-linkage methods compared to that followed-up participants over time using a prospective cohort design, when general population or matched controls were used rather than selected population controls, and when violent outcomes were ascertained in older individuals. In conclusion, the risk of later violence perpetration was modestly increased in individuals with a history of childhood maltreatment. Preventative strategies and interventions for childhood maltreatment may have an important role in violence reduction. Methodological issues and recommendations for future research are discussed.
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Affiliation(s)
- Lucy Fitton
- Oxford Institute of Clinical Psychology Training, University of Oxford, Oxford, United Kingdom
| | - Rongqin Yu
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Henderson DX, Walker L, Barnes RR, Lunsford A, Edwards C, Clark C. A Framework for Race-Related Trauma in the Public Education System and Implications on Health for Black Youth. THE JOURNAL OF SCHOOL HEALTH 2019; 89:926-933. [PMID: 31578726 DOI: 10.1111/josh.12832] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 12/02/2018] [Accepted: 12/14/2018] [Indexed: 05/18/2023]
Abstract
BACKGROUND A combination of increased suicide in the past decade, documented high rates of anxiety and depression, and the preponderance of other behavioral and emotional regulation challenges place black youth at risk for school suspension and involvement in the juvenile justice system. Pointing to deficits in black youth and their families negates how forces of racism, whether unconscious or conscious, can disrupt well-being. METHODS A framework for race-related trauma in the public education system illustrates the interplay between macro-level forces, such as institutional and symbolic racism, and micro level forces of racism such as racial discrimination and violence. Identifying causal links between these forces and adverse academic and health outcomes for black youth can inform interventions and strategies to reduce race-related trauma. RESULTS The framework for race-related trauma is a multi-level analysis of racism and recognizes school districts facing economic restraints and school personnel turnover may face significant challenges in designing intervening strategies. CONCLUSION The framework guides change effort towards improving school climate and culture through preparing school professionals to meet the diverse needs of youth, strengthening family and community collaboration, and tackling those policies and behaviors that exclude and disconnect black youth.
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Affiliation(s)
- Dawn X Henderson
- Center for Faculty Excellence, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599
| | - Larry Walker
- Department of Educational Leadership and Higher Education, University of Central Florida, Orlando, FL, 32816
| | - Rachelle R Barnes
- Department of Psychological Sciences, Winston-Salem State University, Winston-Salem, NC, 27110
| | - Alexis Lunsford
- Department of Psychology, North Carolina Central University, Durham, NC, 27707
| | - Christen Edwards
- Curry School of Education, University of Virginia, Charlottesville, VA, 22904
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Tschoeke S, Steinert T, Bichescu-Burian D. Causal connection between dissociation and ongoing interpersonal violence: A systematic review. Neurosci Biobehav Rev 2019; 107:424-437. [PMID: 31562923 DOI: 10.1016/j.neubiorev.2019.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/12/2019] [Accepted: 09/21/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To identify evidence for dissociation as a cause of ongoing interpersonal violence. METHOD A systematic review of the literature retrieved from ten databases. RESULTS Fifteen studies yielded from our search strategy have been included in the review; eleven of these were longitudinal and four were experimental. The evidence indicates that pathological dissociation may contribute towards enduring interpersonal violence. Thus, dissociation may account for instances of repeated victimisation. There are similar indications concerning offenders, but study designs in this area allow one to draw fewer causal conclusions. There is some evidence that dissociation decreases information processing from the limbic system, which may be one underlying neurofunctional mechanism of persistent violence. CONCLUSION There is growing evidence for dissociation as a cause of interpersonal violence. However, the available evidence is still limited, and our review rather reveals an important research gap. Future longitudinal and experimental studies aimed at clarifying the role of dissociation in the context of violence should take into account the theoretical and empirical complexity around the concept of dissociation.
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Affiliation(s)
- Stefan Tschoeke
- Center for Psychiatry Südwürttemberg, Ulm University, Ravensburg- Weissenau, Germany.
| | - Tilman Steinert
- Center for Psychiatry Südwürttemberg, Ulm University, Ravensburg- Weissenau, Germany.
| | - Dana Bichescu-Burian
- Center for Psychiatry Südwürttemberg, Ulm University, Ravensburg- Weissenau, Germany.
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Tschoeke S, Borbé R, Steinert T, Bichescu-Burian D. A Systematic Review of Dissociation in Female Sex Workers. J Trauma Dissociation 2019; 20:242-257. [PMID: 30689532 DOI: 10.1080/15299732.2019.1572044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We analyze the empirical evidence for the association between the occurrence of dissociation and acting as a female sex worker (FSW). The ten screened databases included original research papers looking at the association between various abusive relationships and dissociation. From the initial 5942 records, we screened 554 full-text articles from which eleven studies met the inclusion criteria. Dissociation was mainly described as a strategy to cope with work related experiences, persisting from an early age in cases affected by childhood sexual abuse (CSA). Only one study investigated the occurrence of dissociative disorders. The other studies showed that the FSW population frequently exhibits dissociative symptoms. Most study participants were street FSW characterized by high rates of revictimization, a history of childhood sexual abuse, and of trauma-related and substance use disorders. Due to the selectivity of the study samples, conclusions cannot be generalized. Our findings disclose an important research gap. Further research on mental health among FSW should cover all fields of the sex industry in order to understand the roots of sex work (SW) and its sequelae. This could help develop and implement targeted interventions.
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Affiliation(s)
- Stefan Tschoeke
- a Center for Psychiatry Südwürttemberg , Ulm University , Ravensburg- Weissenau , Germany
| | - Raoul Borbé
- a Center for Psychiatry Südwürttemberg , Ulm University , Ravensburg- Weissenau , Germany
| | - Tilman Steinert
- a Center for Psychiatry Südwürttemberg , Ulm University , Ravensburg- Weissenau , Germany
| | - Dana Bichescu-Burian
- a Center for Psychiatry Südwürttemberg , Ulm University , Ravensburg- Weissenau , Germany
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Webermann AR, Murphy CM. Childhood Trauma and Dissociative Intimate Partner Violence. Violence Against Women 2018; 25:148-166. [DOI: 10.1177/1077801218766628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study assesses childhood abuse/neglect as a predictor of dissociative intimate partner violence (IPV) among 118 partner-abusive men. One third (36%) endorsed dissociative IPV, most commonly losing control (18%), surroundings seeming unreal (16%), feeling someone other than oneself is aggressing (16%), and seeing oneself from a distance aggressing (10%). Childhood physical abuse/neglect predicted IPV-specific derealization/depersonalization, aggressive self-states, and flashbacks to past violence. Childhood emotional abuse/neglect predicted derealization/depersonalization, blackouts, and flashbacks. Childhood sexual abuse uniquely predicted amnesia. Other potential traumas did not predict dissociative IPV, suggesting dissociative IPV is influenced by trauma-based emotion dysregulation wherein childhood abuse/neglect survivors disconnect from their abusive behavior.
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Gillikin C, Habib L, Evces M, Bradley B, Ressler KJ, Sanders J. Trauma exposure and PTSD symptoms associate with violence in inner city civilians. J Psychiatr Res 2016; 83:1-7. [PMID: 27518177 PMCID: PMC5107154 DOI: 10.1016/j.jpsychires.2016.07.027] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 05/12/2016] [Accepted: 07/29/2016] [Indexed: 01/10/2023]
Abstract
Understanding whether a history of psychological trauma is associated with perpetrating aggressive and violent behavior is of critical importance to public health. This relationship is especially important to study within urban areas where violence is prevalent. In this paper we examined whether a history of trauma or Post Traumatic Stress Disorder (PTSD) in inner city civilians was associated with violent behavior. Data were collected from over 1900 primary care patients at Grady Memorial Hospital in Atlanta, Georgia. Childhood trauma history was assessed with the Childhood Trauma Questionnaire (CTQ) and adult trauma history with the Traumatic Events Inventory (TEI). PTSD symptoms were measured with the PTSD Symptom Scale (PSS) and violent behaviors were measured with the Behavior Questionnaire (BQ). Using these measures we studied violent behavior in the inner city and its association with childhood or adult trauma history or PTSD. Trauma, PTSD and violence were all prevalent in this at-risk urban cohort. Perpetrating interpersonal violence was associated with a history childhood and adult trauma history, and with PTSD symptoms and diagnosis. An association between violent behavior and PTSD diagnosis was maintained after controlling for other pertinent variables such as demographics and presence of depression. Our findings point to a dysregulation of aggressive and violent behavior that may be a consequence of trauma and PTSD. These data indicate that more effective PTSD screening and treatment may help to reduce urban violence.
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Affiliation(s)
- Cynthia Gillikin
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 4000 Woodruff Memorial Bldg., Atlanta, GA 30322
| | - Leah Habib
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 4000 Woodruff Memorial Bldg., Atlanta, GA 30322
| | - Mark Evces
- Department of Psychiatry, New York University School of Medicine, 462 First Avenue, New York, NY 10016
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 4000 Woodruff Memorial Bldg., Atlanta, GA 30322
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 4000 Woodruff Memorial Bldg., Atlanta, GA 30322,Howard Hughes Medical Institute, Chevy Chase, Maryland 20815
| | - Jeff Sanders
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 4000 Woodruff Memorial Bldg., Atlanta, GA 30322, USA.
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