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Newton TL, Cerrillos AM, Phares AM. Dissociative Symptoms in Women with Histories of Intimate Partner Victimization: A Focus on Coercive Control. J Trauma Dissociation 2024; 25:485-499. [PMID: 38615343 PMCID: PMC11192617 DOI: 10.1080/15299732.2024.2341228] [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: 07/08/2023] [Accepted: 03/22/2024] [Indexed: 04/16/2024]
Abstract
Identifying and contrasting different patterns of intimate partner violence (IPV) (e.g. situational couple violence, coercive controlling violence) is useful for understanding IPV and its connections with health. Applying this approach to dissociation may be fruitful, given theoretical perspectives that predict a specific connection between coercive controlling violence and dissociative symptoms. To address this, community women with divorce histories (N = 188) completed measures to identify patterns of IPV victimization in prior relationships (no direct violence, situational couple violence, coercive controlling violence), and to quantify recent dissociative symptoms and number of depressed days, for comparison. Contrary to predictions, the predicted odds of recent dissociative symptoms did not differ between women who experienced situational couple violence versus coercive controlling violence. However, the latter group had greater odds of recent dissociative symptoms, but not depressed days, compared to women with no histories of direct violence. Further, a continuous measure of coercive control was uniquely associated with increased odds of dissociative symptoms. This study provides preliminary empirical support for a connection between coercive controlling violence and dissociative symptoms, compared to women without histories of direct violence. This deserves further attention given the strong theoretical rationale for this link, and the importance of dissociation for mental health.
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Affiliation(s)
- Tamara L Newton
- Department of Psychological and Brain Sciences, University of Louisville, Kentucky, USA
| | - Alexis M Cerrillos
- Department of Psychological and Brain Sciences, University of Louisville, Kentucky, USA
| | - Ashley M Phares
- Department of Psychological and Brain Sciences, University of Louisville, Kentucky, USA
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2
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Wolf MR, Prabhu S. Through the Eyes of a Child: Witnessing Childhood Trauma Is as Impactful as Experiencing Trauma for Polyvictimized Survivors of Child Sexual Abuse. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP5663-NP5677. [PMID: 30362857 DOI: 10.1177/0886260518807913] [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
In this retrospective study of 244 adult survivors of child sexual abuse (CSA), their experiences of childhood polyvictimization were analyzed as to their cumulative effect on trauma symptoms, education, and income levels. The data were gathered by anonymously sampling adult survivors of CSA from websites that were specific to this population (such as online peer support groups). Their experiences of victimization were examined as to Cumulative Polyvictimization, Witnessing Traumas (such as witnessing intimate partner violence), and Experiencing Traumas (such as child physical abuse). The majority of the sample (87%) experienced polyvictimization in childhood (in combination with CSA), with the largest part of the sample (83%) experiencing emotional abuse by someone close to them, and the smallest part of the sample (22%) experiencing child physical abuse by someone with whom they were not close. The results of the linear regressions showed that both experiencing and witnessing trauma were significantly associated with trauma symptoms for CSA survivors. These results suggest that both types of victimization (experiencing and witnessing) need to be treated as direct traumas, and a more holistic approach toward survivors of CSA is needed toward assessment and treatment.
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Hardner K, Wolf MR, Rinfrette ES. Examining the relationship between higher educational attainment, trauma symptoms, and internalizing behaviors in child sexual abuse survivors. CHILD ABUSE & NEGLECT 2018; 86:375-383. [PMID: 29074261 DOI: 10.1016/j.chiabu.2017.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 09/05/2017] [Accepted: 10/14/2017] [Indexed: 06/07/2023]
Abstract
The trauma symptoms of child sexual abuse (CSA) survivors don't end with the abuse, or even with the advent of adulthood. Instead, these symptoms can persist into all the realms of a survivor's life, including education, which sets the foundation for career advancement. This retrospective study of adult survivors of childhood sexual abuse (n=260) examined the relationships between trauma symptoms, dissociation, dissociative amnesia, anxiety, depression, sleep problems and higher education attainment. The purpose of this study was to determine if these factors are associated with higher education completion for childhood sexual abuse (CSA) survivors. Linear regressions and ANOVAs suggest that many of these variables are significantly associated with survivors' educational trajectory, and multiple linear regressions show that trauma symptoms (as measured by the Trauma Symptom Checklist-40), caregivers' education levels, and age at onset of abuse are significant predictors of decreased education levels. This information can provide insight into additional risk and protective factors for CSA survivors in order to enhance acute and long-term management of trauma symptoms to increase levels ofattainment of higher education.
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Affiliation(s)
- Kimberly Hardner
- Edinboro University of Pennsylvania, Hendricks Hall G-43, 235 Scotland Rd., Edinboro, PA 16444, United States.
| | - Molly R Wolf
- Edinboro University of Pennsylvania, Hendricks Hall G-43, 235 Scotland Rd., Edinboro, PA 16444, United States
| | - Elaine S Rinfrette
- Edinboro University of Pennsylvania, Hendricks Hall G-43, 235 Scotland Rd., Edinboro, PA 16444, United States
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Rizeq J, Flora DB, McCann D. Construct Validation of the Trauma Symptom Checklist–40 Total and Subscale Scores. Assessment 2018; 27:1016-1028. [DOI: 10.1177/1073191118791042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The Trauma Symptom Checklist–40 (TSC-40) is commonly used in clinical research to index history of childhood maltreatment and assess complex trauma symptomatology in adults. Yet the dimensional structure of this measure has not been examined. We examined the factor structure of the TSC-40 in a sample of 706 undergraduate students, measurement invariance of the TSC-40 across groups with or without a history of abuse-related and multiple trauma, and the association between the TSC-40 and other trauma indices. A higher order model of complex trauma symptomatology was optimal. The higher order model also demonstrated strong measurement invariance across participants with or without abuse-related and multiple trauma histories. The current findings support the dimensional structure of the TSC-40, as well as extending and revising its subscale composition. This study provided support for using the TSC-40 to measure trauma symptoms across groups exposed to different and multiple types of trauma and provided further evidence for the construct of complex trauma symptomatology.
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Affiliation(s)
- Jala Rizeq
- York University, Toronto, Ontario, Canada
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Fenerci RLB, DePrince AP. Intergenerational Transmission of Trauma: Maternal Trauma-Related Cognitions and Toddler Symptoms. CHILD MALTREATMENT 2018; 23:126-136. [PMID: 29092624 DOI: 10.1177/1077559517737376] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to elucidate possible cognitive mechanisms involved in the intergenerational transmission of trauma from maltreatment-survivor mothers to their toddler/preschool-aged children. This study investigated whether maternal trauma-related cognitions-posttrauma appraisals and disorganized memory for maltreatment-were associated with higher levels of toddler internalizing and externalizing symptoms and more dysfunction in the mother-child relationship. A community sample of mothers with histories of maltreatment and a child between the ages of 2 and 5 years was recruited for a study on maternal attachment, coping, and health ( N = 113). Path analysis results showed that posttrauma appraisals and disorganized memory were significantly related to toddler internalizing symptoms, even with maternal trauma symptoms included in the model. Maternal posttrauma appraisals and disorganized memory were also linked to more dysfunction in the mother-child relationship. These findings provide preliminary evidence in support of maternal trauma-related cognitions as potential mechanisms for the intergenerational transmission of trauma.
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Affiliation(s)
| | - Anne P DePrince
- 1 Department of Psychology, University of Denver, Denver, CO, USA
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Silver KE, Kumari M, Conklin D, Karakurt G. Trauma and Health Symptoms in a Community Sample: Examining the Influences of Gender and Daily Stress. THE AMERICAN JOURNAL OF FAMILY THERAPY 2018; 46:153-167. [PMID: 30872885 PMCID: PMC6411092 DOI: 10.1080/01926187.2018.1461031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Although there is a rich body of literature on trauma and health, limited research has investigated the variables of gender, trauma symptoms, physical health, mental health, and daily stress together in a community sample. Considering the deleterious effects of trauma on health, our overarching inquiry was whether trauma symptoms can predict overall mental and physical health with attention to gender and daily stress as potential moderators. Participants (n = 103; 50.5% women) completed self-report measures of trauma symptoms, mental health, physical health, and daily stress, along with demographic information. Trauma symptoms predicted 25.2% of the variance in general health symptoms. Gender significantly added to the variance accounted for, but daily stress was not significant in the model. Trauma symptoms predicted 37.1% of the variance in mental health symptoms. Daily stress significantly added to the model, but gender did not. Results are interpreted through the integration of family stress theory and feminist frameworks, adding to the literature by further illuminating the relationships between gender, daily stress, health symptoms, and trauma in a community sample.
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Affiliation(s)
- Kristin E. Silver
- Department of Psychology, The University of Akron, Akron,
OH, 44325, USA
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Johnson SM, Murphy MJ, Gidycz CA. Reliability and Validity of the Sexual Experiences Survey-Short Forms Victimization and Perpetration. VIOLENCE AND VICTIMS 2017; 32:78-92. [PMID: 28234199 DOI: 10.1891/0886-6708.vv-d-15-00110] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The Sexual Experiences Survey (SES), the most widely used measure of unwanted sexual experiences, was recently updated (Koss et al., 2007). The purpose of this study was to provide psychometric data on the updated Sexual Experiences Survey-Short Form Perpetration (SES-SFP) and the Sexual Experiences Survey-Short Form Victimization (SES-SFV). Men (n = 136) and women (n = 433) were randomly assigned to in-person or Internet formats of administration for 3 measurement points. Women completed victimization surveys and trauma measures. Men completed perpetration surveys and attitude/ personality measures. Results supported the validity and reliability of both the SES-SFV with women and the SES-SFP with men. Further research is needed regarding the use of the SES-SFV with men and the SES-SFP with women.
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Nidich S, Seng A, Compton B, O'connor T, Salerno JW, Nidich R. Transcendental Meditation and Reduced Trauma Symptoms in Female Inmates: A Randomized Controlled Study. Perm J 2017; 21:16-008. [PMID: 28333611 DOI: 10.7812/tpp/16-008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
CONTEXT Compared with the general population, trauma experiences are higher among incarcerated women. OBJECTIVE To evaluate the effects of Transcendental Meditation (TM) on trauma symptoms in female offenders. DESIGN Twenty-two inmates at the Coffee Creek Correctional Facility in Wilsonville, OR, with at least 4 months left of incarceration were enrolled in this randomized controlled pilot study. Subjects were randomly assigned to either the TM group (n = 11) or a wait-list control group (n = 11). MAIN OUTCOME MEASURES Subjects were measured at baseline and 4-month posttest using the Posttraumatic Stress Disorder Checklist-Civilian version (PCL-C; primary outcome) with intrusive thoughts, avoidance, and hyperarousal subscales (secondary outcomes). Twenty of the subjects (10 in each group) took part in their treatment assignment and completed posttesting. RESULTS Significant reductions were found on total trauma (p < 0.036), intrusive thoughts (p < 0.026), and hyperarousal (p < 0.043) on the PCL-C. Effect sizes ranged from 0.65 to 0.99 for all variables. Eighty-one percent of the TM subjects were compliant with their program. CONCLUSION The results of this study indicate feasibility of the TM program in a female prison population and suggest that TM may be an effective tool for decreasing trauma symptoms. Future large-scale research is warranted.
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Affiliation(s)
- Sanford Nidich
- Professor and Director of the Center for Social and Emotional Health at Maharishi University of Management in Fairfield, IA.
| | - Angela Seng
- Affiliated Research Associate at the Center for Social and Emotional Health at Maharishi University of Management in Fairfield, IA.
| | - Blaze Compton
- Affiliated Research Associate at the Center for Social and Emotional Health at Maharishi University of Management in Fairfield, IA.
| | - Tom O'connor
- Assistant Professor of Criminal Justice at Western Oregon University in Monmouth.
| | - John W Salerno
- Assistant Director of the Center for Natural Medicine and Prevention at Maharishi University of Management in Fairfield, IA.
| | - Randi Nidich
- Senior Researcher at the Center for Social and Emotional Health at Maharishi University of Management in Fairfield, IA.
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Jun M, Tracy EM, Min MO. Formal and Informal Concrete Support and Discharge Disposition among Women in Substance Abuse Treatment in the U.S. CHONGSIN POGON KWA SAHOE SAOP 2017; 45:144-169. [PMID: 29151801 PMCID: PMC5687517 DOI: 10.24301/mhsw.2017.03.45.1.144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The purpose of this study is to examine the relative contribution and the relationships between formal (treatment related members) • informal (family members) concrete support and discharge disposition. A total of 172 women interviewed upon intake in one of 3 counties funded substance abuse treatment programs in Cleveland, Ohio. Hierarchical logistic regression was performed to assess the impact of formal concrete support and informal concrete support on the likelihood of a discharge disposition of completed treatment. Formal concrete support showed a statistically significant contribution to discharge disposition, while informal concrete support did not. Findings of this study highlight the importance of formal concrete support. Future research should continue to expand our knowledge of how support from formal treatment services interacts with support from informal (family) networks.
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Affiliation(s)
- MinKyoung Jun
- Research Fellow, Gyeonggido Family and Women's Research Institute, Republic of Korea
| | - Elizabeth M Tracy
- Grace Longwell Coyle Professor, Case Western Reserve University, USA
| | - Meeyoung O Min
- Research Associate Professor, Case Western Reserve University, USA
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Nidich S, O'connor T, Rutledge T, Duncan J, Compton B, Seng A, Nidich R. Reduced Trauma Symptoms and Perceived Stress in Male Prison Inmates through the Transcendental Meditation Program: A Randomized Controlled Trial. Perm J 2016; 20:16-007. [PMID: 27723444 DOI: 10.7812/tpp/16-007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
CONTEXT Trauma events are four times more prevalent in inmates than in the general public and are associated with increased recidivism and other mental and physical health issues. OBJECTIVE To evaluate the effects of Transcendental Meditation (TM) on trauma symptoms in male inmates. DESIGN One hundred eighty-one inmates with a moderate- to high-risk criminal profile were randomly assigned to either the TM program or to a usual care control group. MAIN OUTCOME MEASURES The Trauma Symptom Checklist and the Perceived Stress Scale were administered at baseline and four-month posttest. RESULTS Significant reductions in total trauma symptoms, anxiety, depression, dissociation, and sleep disturbance subscales, and perceived stress in the TM group were found compared with controls (all p values < 0.001). The high-trauma subgroup analysis further showed a higher magnitude of effects in the TM group compared with controls on all outcomes, with Cohen effect sizes ranging from 0.67 to 0.89. CONCLUSION Results are consistent with those of prior studies of the TM program in other populations and its effects on trauma symptoms and perceived stress.
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Affiliation(s)
- Sanford Nidich
- Professor and the Director of the Center for Social and Emotional Health at Maharishi University of Management in Fairfield, IA.
| | - Tom O'connor
- Assistant Professor of Criminal Justice at Western Oregon University in Monmouth.
| | - Thomas Rutledge
- Staff Psychologist at Veterans Administration San Diego Healthcare System in La Jolla, CA.
| | - Jeff Duncan
- Research Analyst for the Oregon Department of Corrections in Salem.
| | - Blaze Compton
- Affiliated Research Associate at the Center for Social and Emotional Health at Maharishi University of Management in Fairfield, IA.
| | - Angela Seng
- Affiliated Research Associate at the Center for Social and Emotional Health at Maharishi University of Management in Fairfield, IA.
| | - Randi Nidich
- Senior Researcher at the Center for Social and Emotional Health at Maharishi University of Management in Fairfield, IA.
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McKnight PE, Monfort SS, Kashdan TB, Blalock DV, Calton JM. Anxiety symptoms and functional impairment: A systematic review of the correlation between the two measures. Clin Psychol Rev 2016; 45:115-30. [DOI: 10.1016/j.cpr.2015.10.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 10/23/2015] [Accepted: 10/29/2015] [Indexed: 01/01/2023]
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Tracy EM, Min MO, Park H, Jun M, Brown S, Francis MW. Personal Network Structure and Substance Use in Women by 12 Months Post Treatment Intake. J Subst Abuse Treat 2015; 62:55-61. [PMID: 26712040 DOI: 10.1016/j.jsat.2015.11.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 10/31/2015] [Accepted: 11/11/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Women with substance use disorders enter treatment with limited personal network resources and reduced recovery support. This study examined the impact of personal networks on substance use by 12 months post treatment intake. METHODS Data were collected from 284 women who received substance abuse treatment. At 6 month follow up, composition, support availability and structure of personal networks were examined. Substance use was measured by women's report of any use of alcohol or drugs. Hierarchical multivariate logistic regression was conducted to examine the contribution of personal network characteristics on substance use by 12 months post treatment intake. RESULTS Higher numbers of substance using alters (network members) and more densely connected networks at 6 month follow-up were associated with an increased likelihood of substance use by 12 months post treatment intake. A greater number of isolates in women's networks was associated with decreased odds of substance use. Women who did not use substances by 12 months post treatment intake had more non-users among their isolates at 6 months compared to those who used substances. No association was found between support availability and likelihood of substance use. CONCLUSIONS Both network composition and structure could be relevant foci for network interventions e.g. helping women change network composition by reducing substance users as well as increasing network connections. Isolates who are not substance users may be a particular strength to help women cultivate within their network to promote sustained sobriety post treatment.
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Affiliation(s)
- Elizabeth M Tracy
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, Ohio, 44106-7164.
| | - Meeyoung O Min
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, Ohio, 44106-7164
| | - Hyunyong Park
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, Ohio, 44106-7164
| | - MinKyoung Jun
- Gyeonggido Family and Women's Research Institute, Gyeonggi-do, Suwon, Republic of Korea
| | - Suzanne Brown
- Wayne State University, School of Social Work, Detroit, Michigan
| | - Meredith W Francis
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, Ohio, 44106-7164
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Kaiser D, Grundmann J, Schulze C, Stubenvoll M, Kosar M, Junker M, Najavits LM, Schäfer I. A Pilot Study of Seeking Safety in a Sample of German Women Outpatients with Substance Dependence and Posttraumatic Stress Disorder. J Psychoactive Drugs 2015; 47:401-8. [PMID: 26514284 DOI: 10.1080/02791072.2015.1090644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Seeking Safety is an integrated coping skills therapy for substance use disorder (SUD) and posttraumatic stress disorder (PTSD). Our aim was to examine the effects of Seeking Safety in a sample of female German outpatients with current SUD and PTSD. A total of 53 women were offered 12 weekly sessions of Seeking Safety, conducted in group modality. Women (N=33) who attended at least six sessions were considered minimum-dose completers and were in the analysis. We measured PTSD and substance use symptoms using the Posttraumatic Diagnostic Scale (PDS) and the Addiction Severity Index (ASI-Lite) at end-of-treatment and three-month follow-up. Additional measures were the Brief Symptom Checklist (BSI) and the Inventory of Interpersonal Problems (IIP-25). Our sample reported chronic SUD, multiple prior detoxifications, and serious childhood trauma. We found medium to large effect sizes for improvements in PTSD symptoms, general psychopathology, and interpersonal problems at end-of-treatment, all of which were sustained at follow-up. Alcohol use improved significantly only at follow-up. This study suggests that the model was associated with positive effects, at least in a subgroup of women attending a minimum of sessions. Limitations include the lack of a control condition as well as an intention-to-treat analysis.
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Affiliation(s)
- Dorina Kaiser
- a Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany; and Center for Interdisciplinary Addiction Research (CIAR) , University of Hamburg , Hamburg , Germany
| | - Johanna Grundmann
- b Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Claudia Schulze
- a Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany; and Center for Interdisciplinary Addiction Research (CIAR) , University of Hamburg , Hamburg , Germany
| | - Martina Stubenvoll
- b Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Marita Kosar
- c DieBoje, Center for Addiction Counselling and Treatment , Hamburg , Germany
| | - Marita Junker
- c DieBoje, Center for Addiction Counselling and Treatment , Hamburg , Germany
| | - Lisa M Najavits
- d Director, Treatment Innovations, Newton Centre, MA; Lecturer, Department of Psychiatry, Harvard Medical School, Boston , Boston , MA
| | - Ingo Schäfer
- a Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany; and Center for Interdisciplinary Addiction Research (CIAR) , University of Hamburg , Hamburg , Germany
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Lutnick A, Harris J, Lorvick J, Cheng H, Wenger LD, Bourgois P, Kral AH. Examining the associations between sex trade involvement, rape, and symptomatology of sexual abuse trauma. JOURNAL OF INTERPERSONAL VIOLENCE 2015; 30:1847-63. [PMID: 25210029 PMCID: PMC4363006 DOI: 10.1177/0886260514549051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The high prevalence of rape and sexual trauma symptomatology among women involved in street-based sex trades is well-established. Because prior research has lacked appropriate, non-sex trade involved comparison groups, it is unknown whether differences exist among similarly situated women who do and do not trade sex. This article explores experiences of childhood and adult rape and symptomatology of sexual abuse trauma among a community-based sample of 322 women who use methamphetamine in San Francisco, California, 61% of whom were involved in the sex trade. Study participants were recruited via respondent-driven sampling and eligible if they were cisgender women, aged 18 or older, current methamphetamine users, and sexually active with at least one cisgender man in the past 6 months. The dependent variable was sexual abuse trauma symptomatology, as measured by the Sexual Abuse Trauma Index (SATI) subscale of the Trauma Symptom Checklist-40 (TSC-40), and the explanatory variable was sex trade involvement. Potential covariates were age, current homelessness, methamphetamine dependence, and experiences of childhood and adult rape. Sixty-one percent of participants had a SATI subscale score suggestive of sexual abuse trauma. The overall prevalence of rape in childhood and adulthood was 52% and 73%, respectively. In bivariate analysis, sex trade involvement and all of the potential covariates except for homelessness and age were associated with a SATI score suggestive of sexual abuse trauma. In multivariate models controlling for significant covariates, there was no longer a statistically significant association between sex trade involvement or childhood rape and an elevated SATI score. Elevated levels of psychological dependence on methamphetamine and experiences of rape as an adult were still associated with a high SATI score. These findings highlight that urban poor women, regardless of sex trade involvement, suffer high levels of rape and related trauma symptomatology.
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Cook SL, Swartout KM, Goodnight BL, Hipp TN, Bellis A. Impact of violence research on participants over time: Helpful, harmful, or neither? PSYCHOLOGY OF VIOLENCE 2015; 5:314-324. [PMID: 26191460 PMCID: PMC4503327 DOI: 10.1037/a0038442] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the impact of answering survey questions about experiences of stressful, stigmatizing, potentially traumatic and sexually violating events on well being, defined as reactions to research, anxiety, and positive and negative affect over two weeks. METHOD With an ethnically diverse sample of 559 higher education students, we employed a mixed experimental design (with between and within-subjects components) to evaluate changes in positive and negative affect, anxiety, traumatic stress symptoms, and reactions to research. We used multilevel regression models and planned contrasts to determine which, if any, specific characteristics of the survey questions caused changes in well being by comparing the effects of answering a randomly assigned set of survey questions about stressful, stigmatizing, potentially traumatic, or sexually violating life events across a two-week period. RESULTS Controlling for baseline post-traumatic stress symptoms and levels of the outcome, we identified few statistically significant effects between conditions or across time. Significant effects included a small decrease in positive affect immediately after responding to questions about sexually violating events, which diminished at two weeks; these same participants perceived fewer drawbacks to research participation. Participants who responded to questions about stressful life events reported greater perceptions of benefits. CONCLUSIONS Our data support the safety of survey research on sexual assault or other stressful, stigmatizing, or potentially traumatic events.
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Kim H, Tracy E, Brown S, Jun M, Park H, Min M, McCarty C. Personal networks of women in residential and outpatient substance abuse treatment. ADDICTION RESEARCH & THEORY 2015; 23:404-412. [PMID: 27011762 PMCID: PMC4800998 DOI: 10.3109/16066359.2015.1021339] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study compared compositional, social support, and structural characteristics of personal networks among women in residential (RT) and intensive outpatient (IOP) substance abuse treatment. The study sample included 377 women from inner-city substance use disorder treatment facilities. Respondents were asked about 25 personal network members known within the past 6 months, characteristics of each (relationship, substance use, types of support), and relationships between each network member. Differences between RT women and IOP women in personal network characteristics were identified using Chi-square and t-tests. Compared to IOP women, RT women had more substance users in their networks, more network members with whom they had used substances and fewer network members who provided social support. These findings suggest that women in residential treatment have specific network characteristics, not experienced by women in IOP, which may make them more vulnerable to relapse; they may therefore require interventions that target these specific network characteristics in order to reduce their vulnerability to relapse.
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Affiliation(s)
- HyunSoo Kim
- Department of Social Welfare, Dongguk University, Gyeongju-si, Republic of Korea
| | - Elizabeth Tracy
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Suzanne Brown
- School of Social Work, Wayne State University, Detroit, MI, USA
| | - MinKyoung Jun
- Gyeonggido Family & Women’s Research Institute, Gyeonggido, Suwon, Republic of Korea
| | - Hyunyong Park
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Meeyoung Min
- The Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Chris McCarty
- Survey Research Center, University of Florida, Gainsville, FL, USA
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Daglas R, Conus P, Cotton SM, Macneil CA, Hasty MK, Kader L, Berk M, Hallam KT. The impact of past direct-personal traumatic events on 12-month outcome in first episode psychotic mania: trauma and early psychotic mania. Aust N Z J Psychiatry 2014; 48:1017-24. [PMID: 25122448 DOI: 10.1177/0004867414545672] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Past traumatic events have been associated with poorer clinical outcomes in people with bipolar disorder. However, the impact of these events in the early stages of the illness remains unclear. The aim of this study was to investigate whether prior traumatic events were related to poorer outcomes 12 months following a first episode of psychotic mania. METHODS Traumatic events were retrospectively evaluated from patient files in a sample of 65 participants who had experienced first episode psychotic mania. Participants were aged between 15 and 28 years and were treated at a specialised early psychosis service. Clinical outcomes were measured by a variety of symptomatic and functioning scales at the 12-month time-point. RESULTS Direct-personal traumatic experiences prior to the onset of psychotic mania were reported by 48% of the sample. Participants with past direct-personal trauma had significantly higher symptoms of mania (p=0.02), depression (p=0.03) and psychopathology (p=0.01) 12 months following their first episode compared to participants without past direct-personal trauma, with medium to large effects observed. After adjusting for baseline scores, differences in global functioning (as measured by the Global Assessment of Functioning scale) were non-significant (p=0.05); however, participants with past direct-personal trauma had significantly poorer social and occupational functioning (p=0.04) at the 12-month assessment with medium effect. CONCLUSIONS Past direct-personal trauma may predict poorer symptomatic and functional outcomes after first episode psychotic mania. Limitations include that the findings represent individuals treated at a specialist early intervention centre for youth and the retrospective assessment of traumatic events may have been underestimated.
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Affiliation(s)
- Rothanthi Daglas
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Philippe Conus
- Treatment and Early Intervention in Psychosis Program (TIPP), Département de Psychiatrie CHUV, Université de Lausanne, Clinique de Cery, Prilly, Switzerland
| | - Sue M Cotton
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | | | | | - Linda Kader
- Orygen Youth Health Clinical Program, Parkville, Australia
| | - Michael Berk
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia Barwon Health and the Geelong Clinic, Swanston Centre, Geelong, Australia
| | - Karen T Hallam
- Department of Psychology, Victoria University, Melbourne, Australia
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Min MO, Tracy EM, Park H. Impact of trauma symptomatology on personal networks among substance using women. Drug Alcohol Depend 2014; 142:277-82. [PMID: 25042762 PMCID: PMC4127087 DOI: 10.1016/j.drugalcdep.2014.06.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Interpersonal trauma poses challenges and complications to the development and maintenance of personal networks of substance using women. Few studies have examined its effects on personal network support availability and quality of relationships, limiting our understanding of the social context in which substance using women with a history of trauma are embedded. METHODS Women with substance use disorders (SUD) who received treatment at three county-funded, women-only intensive treatment programs (N=375) were interviewed at intake and at follow ups 1, 6, and 12 months later. A network software program, EgoNet, elicited 25 network members per respondent, social support availability, and the quality of network relationship at each assessment. Trauma symptomatology was assessed with Trauma Symptom Checklist-40 at intake. RESULTS Findings from longitudinal mixed model analyses indicated that higher levels of trauma symptomatology were associated with both a negative, critical quality and less closeness in network relationships over the 12 month study period. However, trauma symptoms were not related to the number of network members reported as providing emotional, concrete, or sobriety support. Effects of trauma symptoms on the support availability in the network and the quality of network relationships were consistent over the follow-up period. CONCLUSIONS Findings highlight the potential role of trauma symptoms in determining the quality of relationships within personal networks among women with SUD, suggesting the need for routine mapping of network relationships throughout treatment.
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Affiliation(s)
- Meeyoung O Min
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, OH 44106, United States.
| | - Elizabeth M Tracy
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, OH 44106, United States
| | - Hyunyong Park
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 11235 Bellflower Road, Cleveland, OH 44106, United States
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Understanding the perceived treatment needs of patients with psychogenic nonepileptic seizures. Epilepsy Behav 2014; 31:295-303. [PMID: 24239434 DOI: 10.1016/j.yebeh.2013.10.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 10/15/2013] [Accepted: 10/17/2013] [Indexed: 11/22/2022]
Abstract
Psychological therapy is generally considered the treatment of choice for psychogenic nonepileptic seizures (PNES), but there is a paucity of research on patients' attitudes towards psychological referral. We conducted semistructured interviews with twelve patients with PNES awaiting psychological treatment in order to understand their perceived treatment needs. Data were analyzed inductively according to the principles of thematic analysis. The results indicated that our patients had clear ideas about their treatment needs and a desire to recover by 'returning to normality'. Many participants felt 'caught in limbo' following their PNES diagnosis, however, because of uncertainties about their condition and a lack of support from professionals. This linked with participants feeling unsure whether psychological treatment would meet their needs; there was also apprehension for some participants about the potential negative consequences of therapy. The clinical implications of these findings are discussed, and recommendations for future research are made.
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Min MO, Tracy EM, Kim H, Park H, Jun M, Brown S, McCarty C, Laudet A. Changes in personal networks of women in residential and outpatient substance abuse treatment. J Subst Abuse Treat 2013; 45:325-34. [PMID: 23755971 DOI: 10.1016/j.jsat.2013.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 04/14/2013] [Accepted: 04/24/2013] [Indexed: 10/26/2022]
Abstract
Changes in personal network composition, support and structure over 12 months were examined in 377 women from residential (n=119) and intensive outpatient substance abuse treatment (n=258) through face-to-face interviews utilizing computer based data collection. Personal networks of women who entered residential treatment had more substance users, more people with whom they had used alcohol and/or drugs, and fewer people from treatment programs or self- help groups than personal networks of women who entered intensive outpatient treatment. By 12 months post treatment intake, network composition improved for women in residential treatment; however, concrete support was still lower and substance users are still more prevalent in their networks. Network composition of women in outpatient treatment remained largely the same over time. Both groups increased cohesiveness within the network over 12 months. Targeting interventions that support positive changes in personal networks may heighten positive long term outcomes for women entering treatment.
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Affiliation(s)
- Meeyoung O Min
- Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106-7164, USA.
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Abstract
A number of studies have found experiential avoidance to mediate the relationship between sexual assault and adverse long-term effects. One treatment approach that has been developed for the treatment of experiential avoidance is Acceptance and Commitment Therapy (ACT). A small body of research has demonstrated preliminary efficacy for the use of ACT with trauma survivors suffering from posttraumatic stress disorder (PTSD). However, no treatment studies to date have evaluated ACT as a treatment model with survivors of adult sexual assault. In this case study, ACT was applied to an 18-year-old survivor of adult sexual assault suffering from PTSD symptoms. The results indicated that ACT was effective in reducing experiential avoidance, thought suppression, trauma symptomatology, and increasing valued action and quality of life. The findings of this study suggest that the use of grounding techniques, visual metaphors, and experiential mindfulness exercises in ACT may be particularly helpful for survivors of adult sexual assault.
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Tracy EM, Laudet AB, Min MO, Kim H, Brown S, Jun MK, Singer L. Prospective patterns and correlates of quality of life among women in substance abuse treatment. Drug Alcohol Depend 2012; 124:242-9. [PMID: 22333265 PMCID: PMC3366154 DOI: 10.1016/j.drugalcdep.2012.01.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 01/17/2012] [Accepted: 01/20/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Quality of life (QOL) is increasingly recognized as central to the broad construct of recovery in substance abuse services. QOL measures can supplement more objective symptom measures, identify specific service needs and document changes in functioning that are associated with substance use patterns. To date however, QOL remains an under investigated area in the addictions field, especially in the United States. METHODS This study examines patterns and predictors of QOL at 1 and 6 months post treatment intake among 240 women enrolled in substance abuse treatment in Cleveland, Ohio. The World Health Organization Quality of Life (WHOQOL-BREF) measure was used to assess physical, psychological, social and environmental domains. Hierarchical multiple regressions were conducted to identify correlates of QOL at 6 months post treatment intake. RESULTS All QOL domains across the follow up time points improved significantly. However, QOL scores across domains remained below those of healthy population norms. Trauma symptoms significantly predicted Physical and Psychological QOL. Among treatment process variables, alcohol use was the sole significant factor associated with QOL and only for Environmental QOL. Recovery support and friends support for abstinence were consistently associated with QOL across all four domains. IMPLICATIONS This study suggests the usefulness of the WHOQOL measure as an indicator of functioning in substance abusing populations. Findings underline the importance of helping women deal with trauma symptoms and develop support for recovery. Further research is needed on the longitudinal relationship between QOL and substance use patterns.
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Affiliation(s)
- Elizabeth M Tracy
- Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-7164, USA.
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Gray CMK, Montgomery MJ. Links between alcohol and other drug problems and maltreatment among adolescent girls: perceived discrimination, ethnic identity, and ethnic orientation as moderators. CHILD ABUSE & NEGLECT 2012; 36:449-60. [PMID: 22608406 PMCID: PMC3372674 DOI: 10.1016/j.chiabu.2012.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Revised: 03/13/2012] [Accepted: 03/20/2012] [Indexed: 05/04/2023]
Abstract
OBJECTIVES This study examined the links between maltreatment, posttraumatic stress symptoms, ethnicity-specific factors (i.e., perceived discrimination, ethnic identity, and ethnic orientation), and alcohol and/or other drug (AOD) problems among adolescent girls. METHODS These relations were examined using archived data from a community sample of 168 Black and Hispanic adolescent girls who participated in a school-based substance use intervention. RESULTS The results revealed that maltreatment was linked to AOD problems, but only through its relation with posttraumatic stress symptoms; maltreatment was positively related to posttraumatic stress symptoms, which were positively related to AOD problems. Both perceived discrimination and ethnic orientation were significant moderators. Specifically, greater perceived discrimination was associated with an increased effect of maltreatment on posttraumatic stress symptoms. Ethnic orientation demonstrated protective properties in the relation between maltreatment and AOD problem severity, such that the effect of maltreatment on AOD problem severity was less for girls with average to high ethnic orientation compared to girls with low ethnic orientation. CONCLUSIONS The findings of this study underscore the importance of developing interventions for Black and Hispanic girls that target maltreatment and AOD use concurrently and address ethnicity-specific factors.
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Affiliation(s)
- Calonie M K Gray
- Florida International University, Community-Based Research Group, Miami, FL 33132, USA
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Conybeare D, Behar E, Solomon A, Newman MG, Borkovec TD. The PTSD Checklist-Civilian Version: reliability, validity, and factor structure in a nonclinical sample. J Clin Psychol 2012; 68:699-713. [PMID: 22517497 DOI: 10.1002/jclp.21845] [Citation(s) in RCA: 189] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES We examined the reliability, validity, and factor structure of the posttraumatic stress diorder (PTSD) Checklist-Civilian Version (PCL-C; Blanchard, Jones-Alexander, Buckley, & Forneris, 1996) among unselected undergraduate students. PARTICIPANTS Participants were 471 undergraduate students at a large university in the Eastern United States and were not preselected based on trauma history or symptom severity. RESULTS The PCL-C demonstrated good internal consistency and retest reliability. Compared with alternative measures of PTSD, the PCL-C showed favorable patterns of convergent and discriminant validity. In contrast to previous research using samples with known trauma exposure, we found support for both 1-factor and 2-factor models of PTSD symptoms. CONCLUSIONS Overall, the PCL-C appears to be a valid and reliable measure of PTSD symptoms, even among nonclinical samples, and is superior to some alternative measures of PTSD. The factor structure among nonclinical samples may not reflect each of the PTSD symptom "clusters" (i.e., reexperiencing, avoidance/numbing, and hyperarousal).
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Affiliation(s)
- Daniel Conybeare
- Department of Psychology, University of Illinois at Chicago, IL 60607, USA.
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Searcy V, Lipps A. The Effectiveness of Seeking Safety on Reducing PTSD Symptoms in Clients Receiving Substance Dependence Treatment. ALCOHOLISM TREATMENT QUARTERLY 2012. [DOI: 10.1080/07347324.2012.663304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Vicki Searcy
- a School of Social Work, Abilene Christian University , Abilene , Texas , USA
| | - Alan Lipps
- a School of Social Work, Abilene Christian University , Abilene , Texas , USA
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REINERT DUANEF, BLOOMINGDALE JOHNR. Spiritual Maturity and Mental Health: Implications for Counseling. COUNSELING AND VALUES 2011. [DOI: 10.1002/j.2161-007x.1999.tb00144.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Zlotnick C, Johnson J, Najavits LM. Randomized controlled pilot study of cognitive-behavioral therapy in a sample of incarcerated women with substance use disorder and PTSD. Behav Ther 2009; 40:325-36. [PMID: 19892078 PMCID: PMC3031094 DOI: 10.1016/j.beth.2008.09.004] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2007] [Revised: 08/11/2008] [Accepted: 09/14/2008] [Indexed: 10/21/2022]
Abstract
This randomized controlled pilot study compared a cognitive-behavioral therapy (Seeking Safety; SS) plus treatment-as-usual (TAU) to TAU-alone in 49 incarcerated women with substance use disorder (SUD) and posttraumatic stress disorder (PTSD; full or subthreshold). Seeking Safety consisted of a voluntary group treatment during incarceration and individual treatment after prison release. TAU was required in the prison and comprised 180 to 240 hours of individual and group treatment over 6 to 8 weeks. Assessments occurred at intake, 12 weeks after intake, and 3 and 6 months after release from prison. There were no significant differences between conditions on all key domains (PTSD, SUD, psychopathology, and legal problems); but both conditions showed significant improvements from intake to later time points on all of these outcomes across time. Secondary analyses at follow-up found trends for SS participants improving on clinician-rated PTSD symptoms and TAU participants worsening on self-reported PTSD symptoms. Also, SS demonstrated continued improvement on psychopathology at 3 and 6 months, whereas TAU did not. However, alcohol use improved more for TAU during follow-up. Satisfaction with SS was high, and a greater number of SS sessions was associated with greater improvement on PTSD and drug use. Six months after release from prison, 53% of the women in both conditions reported a remission in PTSD. Study limitations include lack of assessment of SS outcomes at end of group treatment; lack of blind assessment; omission of the SS case management component; and possible contamination between the two conditions. The complex needs of this population are discussed.
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Affiliation(s)
- Caron Zlotnick
- Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906, USA.
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Meade CS, McDonald LJ, Graff FS, Fitzmaurice GM, Griffin ML, Weiss RD. A prospective study examining the effects of gender and sexual/physical abuse on mood outcomes in patients with co-occurring bipolar I and substance use disorders. Bipolar Disord 2009; 11:425-33. [PMID: 19392857 PMCID: PMC2908240 DOI: 10.1111/j.1399-5618.2009.00682.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Prior research suggests possible gender differences in the longitudinal course of bipolar disorder. This study prospectively examined gender differences in mood outcomes and tested the effects of sexual/physical abuse and posttraumatic stress disorder (PTSD). METHODS Participants (49 men, 41 women) with co-occurring bipolar I and substance use disorders (92% alcohol, 42% drug) were enrolled in a group treatment trial. They were followed for eight months, with monthly assessments, yielding 32 weeks of data. Primary outcome measures were number of weeks in each mood state, recurrences of depression or mania, and polarity shifts from depression to mania or vice versa. Negative binomial regression was used to examine the effects of gender, lifetime abuse, and PTSD on these outcomes. RESULTS Participants met syndromal criteria for a mood episode on a mean of 27% of 32 weeks, with depression occurring most frequently. Compared to men, women reported significantly more weeks of mixed mania [relative rate (RR) = 8.53], fewer weeks of euthymia (RR = 0.58), more recurrences of mania (RR = 1.96), and more direct polarity shifts (RR = 1.49) (all p < 0.05). Women also reported significantly higher rates of lifetime sexual or physical abuse (68% versus 33%), which partially explained the relationships between gender and mixed mania and direct polarity shifts. CONCLUSIONS Participants experienced persistent mood symptoms over time. Women consistently reported poorer mood outcomes, and lifetime abuse may help explain observed gender differences in mood outcomes. Further research is necessary to better understand the treatment implications of these findings.
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Affiliation(s)
- Christina S Meade
- Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont, MA, USA.
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Kauer-Sant'Anna M, Tramontina J, Andreazza AC, Cereser K, da Costa S, Santin A, Yatham LN, Kapczinski F. Traumatic life events in bipolar disorder: impact on BDNF levels and psychopathology. Bipolar Disord 2007; 9 Suppl 1:128-35. [PMID: 17543031 DOI: 10.1111/j.1399-5618.2007.00478.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND There is evidence that vulnerability to depression and anxiety disorders is markedly increased by traumatic life events. While childhood abuse has been reported to be associated with poorer outcomes in bipolar disorder, little is known about the neurobiological basis underlying this association. The aim of this study was to ascertain whether bipolar patients who were exposed to a traumatic event or events (TE) have lower brain-derived neurotrophic factor (BDNF) levels and more severe psychopathology as indicated by increased comorbidity and other clinical features when compared to those who were not exposed to TE. METHODS One-hundred and sixty-three consecutively recruited bipolar outpatients were assessed by Structured Clinical Interview for DSM-IV (SCID) and standard protocol in order to evaluation psychopathology and clinical features. The reported TE was assessed using DSM-IV stem criteria for trauma (as defined by A1 and A2 criteria for trauma for post-traumatic stress disorder). Subjects were divided into 2 groups according to presence or absence of lifetime TE. The levels of BDNF, comorbidity and other clinical features were compared between groups. RESULTS After adjusting for confounders, results indicated that bipolar patients with a history of TE have alcohol abuse/dependence (p < 0.001), anxiety comorbidity, and lower levels of serum BDNF (p < 0.01) compared to those without a history of TE. There was no difference between the 2 groups in age of onset, presence of psychosis, other substance abuse and dependence, rapid cycling or suicide attempts. CONCLUSIONS Our findings suggest that TE are associated with significantly increased prevalence of alcohol and anxiety comorbidity as well as lower BDNF levels in bipolar patients. It is possible that a decrease in BDNF levels may account for increased comorbidity, but further prospective studies are required to confirm this.
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Affiliation(s)
- Marcia Kauer-Sant'Anna
- Post-Graduate Biochemistry Program, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Elklit A, Jones A. The association between anxiety and chronic pain after whiplash injury: gender-specific effects. Clin J Pain 2006; 22:487-90. [PMID: 16772804 DOI: 10.1097/01.ajp.0000208247.18251.bb] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE There is increasing evidence to suggest that anxiety is related more strongly to chronic pain experience in men relative to women. The aim of the present study was to examine for the first time gender-specific associations between anxiety and chronic pain experience in men and women exposed to whiplash trauma. METHOD One thousand seven hundred and nine people with whiplash (1349 women, 360 men) belonging to the Danish Society for Polio, Traffic, and Accident Victims completed a battery of questionnaires measuring demographic, psychologic, and pain-related factors (including frequency of painful episodes, level of pain interference, number of anatomic regions in which pain was felt, and the level of general disability). RESULTS Anxiety was found to be positively related to the level of general disability to a significantly stronger magnitude in men compared with women. A trend difference in correlation magnitude was also found between men and women when comparing anxiety with pain frequency, with the magnitude of correlation being higher in men. DISCUSSION The stronger association between anxiety and symptoms of whiplash trauma in men compared with women may be due to gender differences in the attribution of anxiety-related autonomic arousal as symptoms of whiplash injury. Alternatively, anxiety may differentially affect the willingness of men and women to report pain and other health indices. Anxiety is an important factor in understanding gender differences in whiplash-related symptoms such as chronic pain and disability, and requires further investigation.
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Affiliation(s)
- Ask Elklit
- Department of Psychology, University of Aarhus, Denmark
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Ginzburg K, Arnow B, Hart S, Gardner W, Koopman C, Classen CC, Giese-Davis J, Spiegel D. The abuse-related beliefs questionnaire for survivors of childhood sexual abuse. CHILD ABUSE & NEGLECT 2006; 30:929-43. [PMID: 16934330 DOI: 10.1016/j.chiabu.2006.01.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2004] [Revised: 12/28/2005] [Accepted: 01/29/2006] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To evaluate the psychometric properties of a new measure, the Abuse-Related Beliefs Questionnaire (ARBQ), designed to assess abuse-related beliefs among adult survivors of childhood sexual abuse (CSA). Study 1 examined the structure of the scale, and Study 2 evaluated its reliability and validity. METHOD One hundred and seventy female CSA survivors recruited into a group psychotherapy intervention study were administered the ARBQ in Study 1. A subsample of 45 women completed the ARBQ again 12 months later. In Study 2, 70 women from a health maintenance organization who identified themselves as survivors of CSA completed the ARBQ along with the Trauma Symptom Checklist-40 (TSC-40) and the Symptom Checklist 90R (SCL-90-R). RESULTS Three reliable ARBQ subscales emerged in Study 1: Guilt, Shame, and Resilience. Twelve-month test-retest reliability was high (r=.60-.64). The internal consistency of the subscales was further supported in Study 2, and validity was demonstrated by moderate to high correlations with the distress measures. CONCLUSIONS The results indicate that the ARBQ has good psychometric characteristics, supporting the feasibility of its use in measuring abuse-related beliefs in research on survivors of CSA. A next step for validation of the ARBQ would be to evaluate its sensitivity in measuring changes in studies of interventions for treating CSA survivors.
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Affiliation(s)
- Karni Ginzburg
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv 69978, Israel
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Ohan JL, Myers K, Collett BR. Ten-year review of rating scales. IV: scales assessing trauma and its effects. J Am Acad Child Adolesc Psychiatry 2002; 41:1401-22. [PMID: 12447027 DOI: 10.1097/00004583-200212000-00012] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This article summarizes scales assessing trauma and its effects on youths. METHOD We sampled trauma-related articles published over the past 25 years, with an emphasis on the past decade, selected scales with at least several publications, and reviewed their properties. Those with minimally adequate psychometric properties and continued literature citations or a special niche are presented. RESULTS Most of trauma-related scales are relatively new, reflecting the evolving interest in juvenile trauma. Therefore, they do not have the depth of psychometric examination nor the breadth of applications described for previously reviewed scales. However, they have been applied to various traumatic situations. These scales assess a range of trauma-related symptoms and behaviors, including posttraumatic stress disorder, symptoms related to posttraumatic stress disorder, and dissociation. Additionally, several scales assess the trauma itself. CONCLUSIONS Trauma-related scales show promise for research and clinical use in understanding youths' responses to trauma. However, their utility for treatment planning and for accountability in practice is generally not as clear. The potential user must clearly define the goals of measurement and use these scales within their limited roles. With these caveats, trauma-related scales may assist our work with traumatized youths.
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Banyard VL, Williams LM, Siegel JA. Re-traumatization among adult women sexually abused in childhood: exploratory analyses in a prospective study. JOURNAL OF CHILD SEXUAL ABUSE 2002; 11:19-48. [PMID: 16221645 DOI: 10.1300/j070v11n03_02] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The current exploratory study examined a variety of risk factors related to re-traumatization, defined broadly, in a prospective sample of women who were sexually abused in childhood. Eighty women, who were part of a larger longitudinal study of the effects of child sexual abuse, were interviewed at three points in time: in childhood and at two points in early adulthood. Risk factors were measured at the second interview and used to predict reported trauma exposure between interviews two and three. Given theoretical arguments for differences in risk factors based on ecological context, analyses were conducted separately for married and unmarried women. Situational and intrapersonal risk factors such as homelessness and depression were predictive of re-traumatization risk while reported social support satisfaction was a protective factor. Reports of trauma exposure between interviews two and three were related to mental health symptoms.
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Affiliation(s)
- Victoria L Banyard
- Department of Psychology, University of New Hampshire, Durham, NH 3824, USA.
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Rosenthal BS, Schreiner AC. Prevalence of psychological symptoms among undergraduate students in an ethnically diverse urban public college. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2000; 49:12-18. [PMID: 10967879 DOI: 10.1080/07448480009596277] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The levels of psychological symptoms (anger, anxiety, and depression) among 595 college students in an ethnically diverse urban public college were surveyed. The students reported a wide range of symptoms that were quite similar to those reported by a representative sample of adults in the United States in the 1990s. Among these Asian, Black/African American, Latino/Hispanic, White, and other ethnic minority students, women's levels of symptoms were higher than men's (although the differences were small). Older students reported lower levels of anger and depression (the differences were even smaller), and ethnic groups did not differ in manifestations of psychological symptoms. Some of these students, however, reported problematic levels of psychological symptoms that were similar to those reported by more traditional college and university students.
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Affiliation(s)
- B S Rosenthal
- York College, City University of New York, Jamaica, USA.
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Westbury E, Tutty LM. The efficacy of group treatment for survivors of childhood abuse. CHILD ABUSE & NEGLECT 1999; 23:31-44. [PMID: 10075191 DOI: 10.1016/s0145-2134(98)00109-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To assess the effectiveness of a new model of group treatment for sexual abuse survivors over individual therapy alone. METHOD In this quasi-experimental design, 32 women were in either group treatment (N = 22) or a wait-list comparison group (N = 10). They completed standardized measures on depression, self-esteem, and trauma symptomatology at pretest and after completing the 10 to 12 week group. All were in concurrent individual therapy. RESULTS On average, both groups of women decreased depression and trauma symptoms as well as increased self-esteem. However, the clients in the treatment group improved their depression and anxiety to a statistically significantly greater degree than clients in the wait-list comparison condition. Improvement approaching statistical significance was found in levels of self-esteem in the treatment as compared to the wait-list condition. CONCLUSION The group intervention was significantly more effective than individual treatment alone on depression and anxiety. The inclusion of the wait-list comparison group was critical in interpreting the improvement noted by all of the women in treatment.
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Affiliation(s)
- E Westbury
- Faculty of Social Work, University of Calgary, Alberta, Canada
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Pistorello J, Follette VM. Childhood sexual abuse and couples' relationships: female survivors' reports in therapy groups. JOURNAL OF MARITAL AND FAMILY THERAPY 1998; 24:473-85. [PMID: 9802006 DOI: 10.1111/j.1752-0606.1998.tb01101.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Therapy videotapes from five therapy groups for female child sexual abuse (CSA) survivors were analyzed for emerging themes of couples' difficulties reported by clients. Subsequently, the thematic categories were applied to sessions selected from an additional four groups and then correlated with CSA-specific variables. The two most frequent relationship themes were difficulties with emotional communication or intimacy, and polarized positions on control. Whereas these two themes were correlated with survivors' CSA characteristics, sexual difficulties were correlated with survivors' level of current traumatic symptomatology. Results are discussed in terms of implications for the treatment of CSA survivors and their partners.
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