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Zolopa C, Leon M, Rasmussen A. A Systematic Review of Response Styles Among Latinx Populations. Assessment 2024; 31:947-962. [PMID: 37667523 DOI: 10.1177/10731911231194969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Culture influences responses to psychological measurements in ways unrelated to target constructs, thus biasing test scores and potentially contributing to under- and over-diagnosis of mental health problems in populations for which measures have not yet been normed. We conducted a systematic review of publications addressing response style among Latinx population groups in North and South America. In a final corpus of 24 studies, Latinx/Latin American populations were generally found to exhibit higher levels of extreme response style (n = 17), acquiescent response style (n = 10), and socially desirable responding (n = 5). The few publications (n = 3) that investigated midpoint responding reported no differences. Seven publications (29%) attempted to adjust scores to mitigate response style bias, using both scale design and statistical techniques. Findings suggest that researchers and clinicians should directly assess culturally patterned response style as a construct, rather than inferring style indirectly using other measures. For clinicians, knowledge of response style represents another facet of case conceptualization.
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Zvolensky MJ, Shepherd JM, Clausen BK, Robison J, Cano MÁ, de Dios M, Correa-Fernández V. Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke. J Behav Med 2024:10.1007/s10865-024-00480-8. [PMID: 38409553 DOI: 10.1007/s10865-024-00480-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/09/2024] [Indexed: 02/28/2024]
Abstract
There has been little scientific effort to evaluate the associations between cigarette smoking and cessation-related constructs and exposure to traumatic events, posttraumatic stress, and Posttraumatic Stress Disorder (PTSD) symptoms among Hispanic persons who smoke in the United States (US). Such trauma-related factors may pose unique difficulties for Hispanic persons who smoke and possess a desire to quit. As such, the present investigation sought to fill this gap in the literature and examine posttraumatic stress and probable PTSD in terms of their relations with several clinically significant smoking constructs among trauma-exposed Hispanic persons who smoke from the United States. Participants included 228 Spanish-speaking Hispanic persons who endorsed prior traumatic event exposure and smoked combustible cigarettes daily (58.3% female, Mage= 32.1 years, SD = 9.65). Results indicated that posttraumatic stress symptoms were related to increased cigarette dependence, perceived barriers for smoking cessation, and more severe problems when trying to quit with effect sizes ranging from small to moderate in adjusted models. Additionally, Hispanic persons who smoke with probable PTSD compared to those without probable PTSD showcased a statistically effect for perceived barriers for cessation (p < .008) and a severity of problems when trying to quit (p < .001). No effect was evident for cigarette dependence after alpha correction. Overall, the present study offers novel empirical evidence related to the role of posttraumatic stress symptoms and PTSD among Hispanic persons who smoke in the US. Such findings highlight the need to expand this line of research to better understand the role of posttraumatic stress and PTSD among Hispanic persons who smoke which can inform smoking cessation treatments for Hispanic persons who smoke experiencing trauma-related symptomology.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA.
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- HEALTH Institute, University of Houston, Houston, TX, USA.
| | - Justin M Shepherd
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Bryce K Clausen
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Jillian Robison
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Miguel Ángel Cano
- Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center, Dallas, USA
| | - Marcel de Dios
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
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3
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Nillni YI, Horenstein A, McClendon J, Duke CC, Sawdy M, Galovski TE. The impact of perceived everyday discrimination and income on racial and ethnic disparities in PTSD, depression, and anxiety among veterans. PLoS One 2023; 18:e0291965. [PMID: 37751447 PMCID: PMC10521990 DOI: 10.1371/journal.pone.0291965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
OBJECTIVES Black and Hispanic/Latinx individuals experience a greater burden of mental health symptoms as compared to White individuals in the general population. Examination of ethnoracial disparities and mechanisms explaining these disparities among veterans is still in its nascence. The current study examined perceived everyday discrimination and income as parallel mediators of the association between race/ethnicity and PTSD, depression, and general anxiety symptoms in a sample of White, Black, and Hispanic/Latinx veterans stratified by gender. METHODS A random sample of 3,060 veterans living across the U.S. (oversampled for veterans living in high crime communities) completed a mail-based survey. Veterans completed self-report measures of perceived discrimination via the Everyday Discrimination Scale, PTSD symptoms via the Posttraumatic Stress Disorder Checklist-5, depressive symptoms via the Patient Health Questionnaire, and anxiety symptoms via the Generalized Anxiety Disorder Questionnaire. RESULTS Models comparing Black vs. White veterans found that the significant effect of race on PTSD, depression, and anxiety symptoms was mediated by both perceived discrimination and income for both male and female veterans. Results were less consistent in models comparing Hispanic/Latinx vs. White veterans. Income, but not perceived discrimination, mediated the relationship between ethnicity/race and depression and anxiety symptoms, but only among women. CONCLUSIONS Results suggest that discrimination and socioeconomic status are important mechanisms through which marginalized social status negatively impacts mental health.
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Affiliation(s)
- Yael I. Nillni
- National Center for PTSD, Women’s Health Sciences Division at VA Boston Healthcare System, Boston, MA, United States of America
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States of America
| | | | - Juliette McClendon
- National Center for PTSD, Women’s Health Sciences Division at VA Boston Healthcare System, Boston, MA, United States of America
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States of America
| | | | - Molly Sawdy
- Suffolk University, Boston, MA, United States of America
| | - Tara E. Galovski
- National Center for PTSD, Women’s Health Sciences Division at VA Boston Healthcare System, Boston, MA, United States of America
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States of America
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Diestel AJ, Price M, Hidalgo JE, Contractor AA, Grasso DJ. Linkages Between Childhood Maltreatment, Intimate Partner Violence, and Posttraumatic Stress Disorder Symptoms in Pregnant Hispanic Women: A Network Analysis. CHILD MALTREATMENT 2023; 28:243-253. [PMID: 35465753 DOI: 10.1177/10775595221092948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pregnant Hispanic women are at increased risk for posttraumatic stress disorder (PTSD) in part due to greater risk of childhood maltreatment, intimate partner violence (IPV), and pregnancy-related vulnerabilities. However, PTSD, is a highly heterogenous diagnosis with numerous presentations. Individual PTSD symptoms may be differentially associated with specific types of maltreatment, IPV. Determining how IPV exposure across the lifespan is associated with specific symptoms of PTSD in pregnant Hispanic women is necessary to develop group-relevant models of this disorder and targeted interventions. The present study examined a network model of PTSD symptoms, childhood maltreatment, and adulthood IPV in a sample of pregnant Hispanic women (N = 198). Childhood emotional abuse and adulthood psychological distress had the highest bridge centrality. These types of exposures were most strongly associated with social isolation. Childhood emotional abuse was associated with more individual PTSD symptoms than any IPV type. These findings suggest that associations between PTSD symptoms and different types of IPV exposure vary. In addition, robust associations between childhood emotional abuse and PTSD symptoms suggest that this domain may be particularly important for the clinical assessment and intervention for pregnant women.
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Affiliation(s)
- Annabel J Diestel
- Department of Psychological Science, Center for Research on Emotion, Stress, and Technology, 2092University of Vermont, Burlington, VT, USA
| | - Matthew Price
- Department of Psychological Science, Center for Research on Emotion, Stress, and Technology, 2092University of Vermont, Burlington, VT, USA
| | - Johanna E Hidalgo
- Department of Psychological Science, Center for Research on Emotion, Stress, and Technology, 2092University of Vermont, Burlington, VT, USA
| | - Ateka A Contractor
- Department of Psychology, 3404University of North Texas, Denton, TX, USA
| | - Damion J Grasso
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
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Yasuhara K, Morreale K, Talley D, Cooper DT, Hoy-Watkins M, Coker KL. Psychiatric disorders among employment requiring firearms. BEHAVIORAL SCIENCES & THE LAW 2023; 41:19-29. [PMID: 35445436 DOI: 10.1002/bsl.2570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/14/2022] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
Individuals who carry guns as a requirement of employment frequently experience hazards that can be stress inducing, violent, traumatizing, or cause personal injury. This study used data from the Collaborative Psychiatric Epidemiological Surveys (CPES; n = 20,013), to examine mental health diagnoses of individuals that ever worked at a job requiring a firearm. Consistent with existing literature, the findings indicated that those who worked in professions requiring a firearm showed similar risk of mental health diagnoses as law enforcement officers which includes symptoms of trauma, mood disorders, and alcohol use. Further, race/ethnic differences emerged in patterns of mental health diagnoses, suggesting sociocultural differences influence diagnoses. These findings indicate the necessity for further investigation of the understudied area of mental health of those within employment positions that require firearms.
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Affiliation(s)
- Kento Yasuhara
- Department of Psychology, University of New Haven, West Haven, Connecticut, USA
| | - Kristina Morreale
- Department of Psychology, University of New Haven, West Haven, Connecticut, USA
| | - Dijonee Talley
- Department of Criminal Justice, Temple University, Philadelphia, Pennsylvania, USA
| | - Danielle T Cooper
- Department of Criminal Justice, University of New Haven, West Haven, Connecticut, USA
| | | | - Kendell L Coker
- Department of Psychology & Allied Health, University of New Haven, West Haven, Connecticut, USA
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Mayorga NA, Shepherd JM, Garey L, Viana AG, Zvolensky MJ. Heart-Focused Anxiety Among Trauma-Exposed Latinx Young Adults: Relations to General Depression, Suicidality, Anxious Arousal, and Social Anxiety. J Racial Ethn Health Disparities 2022; 9:1135-1144. [PMID: 33977507 PMCID: PMC10027393 DOI: 10.1007/s40615-021-01054-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/12/2021] [Accepted: 05/03/2021] [Indexed: 11/27/2022]
Abstract
Rates of traumatic event exposure, posttraumatic stress (PTS), and co-occurring mental health symptoms and disorders are conditionally higher among Latinx individuals compared to other racial/ethnic populations. Importantly, Latinx persons are a heterogeneous population, and certain subgroups endorse higher rates of negative mental health outcomes than others, including Latinx young adults born in the USA. Yet, there is little understanding of individual difference factors among trauma-exposed US born Latinx young adults that may be involved in mental health burden among this group. The present investigation sought to evaluate the potential explanatory relevance of heart-focused anxiety as an individual difference factor regarding some of the most common co-occurring mental health problems among trauma-exposed populations. Specifically, we tested whether heart-focused anxiety was related to increased co-occurring anxious arousal symptoms, depression, social anxiety, and suicidality among 169 (84% female, Mage=23.15 years, SD=6.07) trauma-exposed Latinx young adults. Results indicated that heart-focused anxiety was a statistically significant predictor of general depression (ΔR2 = .02, F(1, 161) = 4.25, p = .041), suicidality (ΔR2 = .10, F(1, 161) = 21.49, p < .001), anxious arousal (ΔR2 = .11, F(1, 161) = 27.31, p < .001), and social anxiety (ΔR2 = .03, F(1, 161) = 7.93, p = .005). Overall, this work offers empirical evidence that individual differences in heart-focused anxiety are related to more severe co-occurring anxiety and depressive symptomatology among a particularly at risk Latinx segment of the Latinx population (non-immigrant Latinx young adults s with previous trauma history).
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Affiliation(s)
- Nubia A Mayorga
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Justin M Shepherd
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Andres G Viana
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA.
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- HEALTH Institute, University of Houston, Houston, TX, USA.
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7
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Gao T, Mei S, Li M, Arcy CD, Meng X. Roles of Psychological Distress and Social Support in the Relationship Between Childhood Maltreatment and Perceived Needs for Mental Health Care. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP14089-NP14116. [PMID: 33858262 DOI: 10.1177/08862605211006368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Childhood maltreatment is a major public health issue worldwide. It increases a range of health-risk behaviors, psychological and physical problems, which are associated with an increased need for mental health services in adulthood. Identification of mediating factors in the relationship between maltreatment and seeking mental health care may help attenuate the negative consequences of childhood maltreatment and promote more appropriate treatment. This study aims to examine whether the relationship between childhood maltreatment and perceived need for mental health care is mediated by psychological distress and/or moderated by social support. Data from the Canadian Community Health Survey-Mental Health 2012 are analyzed. A total of 8,993 participants, who had complete information on childhood maltreatment and diagnoses of mental disorders or psychological distress, are included in this study. Structural equation modeling and the PROCESS macro were used to identify relationships among childhood maltreatment, perceived needs for mental health care, and psychological distress. Hierarchical linear regression was then used to verify the moderated mediation model. We found that psychological distress partially mediated the effect of childhood maltreatment on perceived needs for mental health care in adulthood. Social support played an important role in terms of moderating the relationship between maltreatment and perceived needs for care. For those with a history of childhood maltreatment, those who perceived a low level of social support were more likely to have higher levels of psychological distress and perceived need for mental health care. This is the first study to identify the separate and combined roles of psychological distress and social support in the relationship between childhood maltreatment and perceived need for mental health care. Selective prevention strategies should focus on social support to improve mental health services among people with a history of childhood maltreatment.
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Affiliation(s)
- Tingting Gao
- Jilin University, Changchun, China
- McGill University, Montreal, Canada
- Douglas Mental Health University Institute, Montreal, Canada
- Shandong University, Jinan, China
| | | | - Muzi Li
- McGill University, Montreal, Canada
- Douglas Mental Health University Institute, Montreal, Canada
| | | | - Xiangfei Meng
- McGill University, Montreal, Canada
- Douglas Mental Health University Institute, Montreal, Canada
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8
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Zvolensky MJ, Rogers AH, Mayorga NA, Shepherd JM, Bakhshaie J, Garza M, Viana AG, Ochoa-Perez M, Lemaire C, Ruiz A, Peraza N. Perceived Discrimination, Experiential Avoidance, and Mental Health among Hispanic Adults in Primary Care. Transcult Psychiatry 2022; 59:337-348. [PMID: 35018872 DOI: 10.1177/13634615211038159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Hispanic population is the largest minority group in the United States and frequently experiences racial discrimination and mental health difficulties. Prior work suggests that perceived racial discrimination is a significant risk factor for poorer mental health among Hispanic in the United States. However, little work has investigated how perceived racial discrimination relates to anxiety and depression among Hispanic adults. Thus, the current study evaluated the explanatory role of experiential avoidance in the relation between perceived racial discrimination and anxiety/depressive symptoms and disorders among Hispanic adults in primary care. Participants included 202 Spanish-speaking adults (Mage = 38.99, SD = 12.43, 86.1% female) attending a community-based Federally Qualified Health Center. Results were consistent with the hypothesis that perceived racial discrimination had a significant indirect effect on depression, social anxiety, and anxious arousal symptoms as well as the number of mood and anxiety disorders through experiential avoidance. These findings suggest future work should continue to explore experiential avoidance in the association between perceived racial discrimination and other psychiatric and medical problems among the Hispanic population.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, 14743University of Houston, Houston, TX, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,HEALTH Institute, 14743University of Houston, Houston, TX, USA
| | - Andrew H Rogers
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | - Nubia A Mayorga
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | - Justin M Shepherd
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | - Jafar Bakhshaie
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | | | - Andres G Viana
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | | | | | - Ana Ruiz
- Department of Psychology, 14743University of Houston, Houston, TX, USA
| | - Natalia Peraza
- Department of Psychology, 14743University of Houston, Houston, TX, USA
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Kanamori M, Shrader CH, George SS, Adkins T, Bartholomew TS, Sanchez M, de la Rosa M. Influences of immigration stress and occupational exploitation on Latina seasonal workers' substance use networks: a qualitative study. J Ethn Subst Abuse 2022; 21:457-475. [PMID: 32609076 PMCID: PMC7775321 DOI: 10.1080/15332640.2020.1778591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
US female Latina seasonal farm workers (LSW) are a medically underserved community experiencing severe health disparities. We explored the relationship between alcohol and prescription medication, and LSW social networks using a qualitative approach. In 2015, this study used convenience sampling to recruit 28 LSWs in South Florida for three focus group discussions in Spanish. Focus groups were translated to English for analysis, which employed a general inductive approach. Themes included prescription medication distribution within networks, spirituality/religion practice with friends and family, and alcohol use with friends. Substance abuse prevention and treatment interventions should account for the unique needs of LSW.
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Affiliation(s)
- Mariano Kanamori
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Cho-Hee Shrader
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sara St. George
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Taylor Adkins
- Pediatrics Infectious Disease, Emory University, Atlanta, GA, USA
| | - Tyler S. Bartholomew
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mariana Sanchez
- Robert Stempel College of Social Work and Public Health, Florida International University, Miami, FL, USA
| | - Mario de la Rosa
- Robert Stempel College of Social Work and Public Health, Florida International University, Miami, FL, USA
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10
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Ceja A, Yalch MM, Maguen S. Posttraumatic stress disorder symptom expression in racially and ethnically diverse women veterans. Psychiatry Res 2022; 309:114426. [PMID: 35124547 DOI: 10.1016/j.psychres.2022.114426] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Abstract
The number of racial/ethnic and women minorities entering the military continues to grow and more research is needed to properly assess, conceptualize, and treat posttraumatic stress disorder (PTSD) in diverse women. Recently, typological approaches have been useful in revealing distinct PTSD symptom presentations; however, existing research has not examined racial/ethnic differences among women veterans. We examined PTSD symptom expression and whether it differed by race/ethnicity in a sample of 407 women veterans that were recruited as part of a larger study on veterans' health. We conducted a series of model-based cluster analyses by race/ethnicity. Most racial/ethnic groups had between two- and four-group typologies that differed primarily in symptom severity. Latina veterans were found to have a unique eight-group PTSD typology differing not only in overall symptom severity but also in elevations of avoidance and hyperarousal symptoms. Racial and ethnic minority trauma survivors may present with a variety of posttraumatic symptom expressions. Better understanding these varying PTSD typologies will allow us to provide more tailored assessment and treatment for diverse women veterans with PTSD.
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Affiliation(s)
- Alejandra Ceja
- San Francisco VA Health Care System, 4150 Clement Street (116-P), San Francisco, CA 94121, United States; University of California - San Francisco, San Francisco, CA, United States.
| | - Matthew M Yalch
- San Francisco VA Health Care System, 4150 Clement Street (116-P), San Francisco, CA 94121, United States; Palo Alto University, Palo Alto, CA, United States
| | - Shira Maguen
- San Francisco VA Health Care System, 4150 Clement Street (116-P), San Francisco, CA 94121, United States; University of California - San Francisco, San Francisco, CA, United States
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11
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Garcia NM, Colombo Eiff A, Lopez-Esteban A, Zoellner L. Cultural Considerations for Treating PTSD in Latinx Sexual Assault Survivors With Prolonged Exposure. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Borelli JL, Russo LN, Arreola J, Cervantes BR, Hecht HK, Leal F, Montiel G, Paredes P, Guerra N. Más Fuertes Juntos: Attachment relationship quality, but not demographic risk, predicts psychopathology in Latinx mother-youth dyads. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:2086-2105. [PMID: 33635588 DOI: 10.1002/jcop.22535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/20/2021] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
Latinx families are increasing in the population in the United States and have documented mental health concerns. Much remains to be understood about mental health predictors within this population. The present study aimed to help fill this gap and offer an in-depth assessment of psychopathology within a large (N = 330) sample of Latinx mothers and youth by exploring associations between sociodemographic risk, attachment relationship quality, and mental health. Demographic risk was not associated with youth or maternal psychopathology, but attachment relationship quality was associated with all indices of psychopathology in youth and mothers. The interaction between demographic risk and psychopathology only added to the prediction of maternal depression, revealing a pattern wherein maternal closeness was associated with lower depression at low and mean but not high levels of demographic risk. We discuss these findings in terms of the importance of supporting parent-child relationships in this population.
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Affiliation(s)
| | | | - Jose Arreola
- University of California, Irvine, California, USA
| | | | | | | | | | | | - Nancy Guerra
- University of California, Irvine, California, USA
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13
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Wang Y, Chung MC, Fang S. Post-Traumatic Distress and Burnout Among Chinese School Teachers: The Mediating Role of Forgiveness. Front Psychol 2021; 12:642926. [PMID: 34393882 PMCID: PMC8362850 DOI: 10.3389/fpsyg.2021.642926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose Teachers’ mental health is concerning due to high stress at work. Its association with job-related stressors has been well-documented. Little is known; however, about how traumatic life events and trauma reactions might contribute to their psychological distress. This paper is to explore whether Post-traumatic Stress Disorder (PTSD) following past traumatic event would predict burnout and psychiatric co-morbidity among Chinese k-12 school teachers and whether this prediction would be mediated by forgiveness after controlling for work-related factors. Methods Two hundred and seventy-nine Chinese teachers (F = 223, M = 56) from primary and secondary schools completed demographic information, Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5), Heartland Forgiveness Scale (HFS), General Health Questionnaire-28 (GHQ-28), Maslach Burnout Inventory-Educator’s Survey (MBI-ES), and a series of measures assessing work-related factors. Results Structured equation modeling (SEM) showed that after controlling for work-related factors, PTSD following past trauma was positively associated with burnout and general psychological problems but negatively associated with levels of forgiveness. Forgiveness carried the impact of PTSD onto burnout rather than general psychological distress. Conclusion To conclude, regardless of the level of stress experienced from working in school, primary and secondary teachers with PTSD from past trauma found it more difficult forgiving which in turn could affect their levels of burnout.
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Affiliation(s)
- Yabing Wang
- School of English Education, Guangdong University of Foreign Studies, Guangzhou, China
| | - Man Cheung Chung
- Faculty of Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Siqi Fang
- Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong, China
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14
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Botero-Rodríguez F, Hernandez MC, Uribe-Restrepo JM, Cabariqe C, Fung C, Priebe S, Gómez-Restrepo C. Experiences and outcomes of group volunteer befriending with patients with severe mental illness: an exploratory mixed-methods study in Colombia. BMC Psychiatry 2021; 21:239. [PMID: 33957896 PMCID: PMC8103575 DOI: 10.1186/s12888-021-03232-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Improving care for patients with severe mental illness in Latin America requires effective strategies that are low-cost. One such strategy is a volunteering scheme, referred to as befriending, which seeks to support the social integration of patients. Despite positive reports in other world regions, this intervention has not been studied in Latin America. Whilst befriending programmes commonly form patient-volunteer dyads, group arrangements may be an alternative with some benefits. Here, we aim to explore the feasibility, experiences and outcomes of a group volunteer befriending intervention for patients with severe mental illness in Colombia. METHODS In this exploratory non-controlled study, 10 groups of five individuals were formed, each consisting of three individuals with schizophrenia or bipolar disorder and two volunteers from the community in Bogotá, Colombia. Each group was encouraged to participate together in social activities within their community over a 6-month period. Patients' quality of life, objective social outcomes, symptom levels and internalised stigma were assessed before and after the intervention. Patients' and volunteers' experiences were explored in semi-structured interviews which were analysed using inductive content analysis. RESULTS Outcomes were available for 23 patients. Whilst their objective social situation had significantly improved at the end of the intervention, other outcomes did not show statistically significant differences. The interviews with participants revealed positive experiences which fell into five categories: 1) stigma reduction; 2) personal growth; 3) formation of relationships; 4) continuity and sustainability of befriending; 5) acceptability and feasibility of befriending. CONCLUSIONS A volunteer befriending programme in small groups of two volunteers and three patients is feasible and associated with positive experiences of participants. Such programmes may also improve the objective social situation of patients. This low-cost intervention may be useful for patients with severe mental illnesses in Latin America. TRIAL REGISTRATION ISRCTN72241383 (Date of Registration: 04/03/2019, retrospectively registered).
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Affiliation(s)
- Felipe Botero-Rodríguez
- grid.41312.350000 0001 1033 6040Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - María Camila Hernandez
- grid.41312.350000 0001 1033 6040Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - José Miguel Uribe-Restrepo
- grid.41312.350000 0001 1033 6040Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Camilo Cabariqe
- grid.41312.350000 0001 1033 6040Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Catherine Fung
- grid.4464.20000 0001 2161 2573Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary, University of London, London, UK
| | - Stefan Priebe
- grid.4464.20000 0001 2161 2573Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary, University of London, London, UK
| | - Carlos Gómez-Restrepo
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia. .,Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia. .,Hospital Universitario San Ignacio, Bogotá, Colombia.
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15
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Kirkinis K, Pieterse AL, Martin C, Agiliga A, Brownell A. Racism, racial discrimination, and trauma: a systematic review of the social science literature. ETHNICITY & HEALTH 2021; 26:392-412. [PMID: 30165756 DOI: 10.1080/13557858.2018.1514453] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 08/16/2018] [Indexed: 06/08/2023]
Abstract
Objective: The aim of this paper is to provide a systematic review of studies that examine relationships between racial discrimination and trauma in order to further understand the relationship between racial oppression and psychological functioning.Design: In this review, we describe the characteristics of 28 studies, identified by a comprehensive search strategy, including measurements of racial discrimination and trauma, as well as the nature of the reported associations.Results: Half of studies included in this review were published in the last 6 years. The majority of studies used cross-sectional designs and were conducted in the United States with adults ≥18 years old. African American, White, Latinx, and Asian populations were most frequently included in these studies. Of the 44 associations examined in these studies, 70% of the trauma symptomology outcomes were statistically significantly associated with racial discrimination. Significant positive associations ranged in strength, with the strongest relationships between racial discrimination and trauma occurring in studies examining veteran populations and moderate relationships among these variables in non-veteran, student populations.Conclusions: Our findings reveal that current research on race-based trauma seems to be limited by a lack of measures that capture the stress/intensity associated with race-related events, an inability to account for vicarious/collective/intergenerational experiences of trauma, and failure to control for non-race-based trauma.
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Affiliation(s)
- Katherine Kirkinis
- The University at Albany - State University of New York, Albany, NY, USA
| | - Alex L Pieterse
- The University at Albany - State University of New York, Albany, NY, USA
| | - Christina Martin
- The University at Albany - State University of New York, Albany, NY, USA
| | - Alex Agiliga
- The University at Albany - State University of New York, Albany, NY, USA
| | - Amanda Brownell
- The University at Albany - State University of New York, Albany, NY, USA
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Chopko BA, Palmieri PA, Adams RE. Trauma-Related Sleep Problems and Associated Health Outcomes in Police Officers: A Path Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP2725-NP2748. [PMID: 29642766 DOI: 10.1177/0886260518767912] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Police officers are frequently exposed to two different types of potentially traumatic events: one dealing with physical threats to self and the other involving the witnessing of harm to others. These different types of traumatic experiences are thought to produce various posttraumatic reactions. Furthermore, sleep problems are also reported as a hallmark of posttraumatic stress disorder. There is evidence, however, that sleep problems may mediate the relationship between posttraumatic stress disorder symptoms and health outcomes, especially physical health and depression. Previous research has shown this to be the case among officers from large urban agencies. The purpose of the present study was to test a model involving a pathway from trauma type and posttraumatic stress disorder symptoms to physical health and depression that is mediated by sleep quality in officers (N = 193) using data from small- to mid-size police agencies. Results revealed that sleep problems served as a mediator between posttraumatic stress disorder hyperarousal and avoidance symptoms and health outcomes, that the trauma types are related to different posttraumatic stress disorder symptoms, and that complicated relationships exist between the study variables. In addition, the results indicated that approximately 25% of our sample displayed probable partial posttraumatic stress disorder or probable full posttraumatic stress disorder, causing substantial functional impairment. Suggestions for improving officer health and performance in the field are provided. Specifically, it appears that interventions designed to address posttraumatic stress disorder hyperarousal symptoms related to personal life threat and the posttraumatic stress disorder avoidance symptoms related to the witnessing of human suffering may maximize officer sleep quality and ultimately overall wellness. In particular, mindfulness-based interventions are well suited for addressing these symptom clusters.
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17
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Intergenerational trauma in Latinxs: A scoping review. Soc Sci Med 2021; 270:113662. [DOI: 10.1016/j.socscimed.2020.113662] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/30/2020] [Accepted: 12/24/2020] [Indexed: 12/13/2022]
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18
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Kimmell J, Mendenhall E, Jacobs EA. Deconstructing PTSD: Trauma and emotion among Mexican immigrant women. Transcult Psychiatry 2021; 58:110-125. [PMID: 32046617 DOI: 10.1177/1363461520903120] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The symptomatology for Post-Traumatic Stress Disorder (PTSD) narrowly focuses on particular diagnostic frames and a single triggering event. Such narrow definitions of trauma and recovery have been heavily critiqued by anthropologists and cultural psychiatrists for overlooking cultural complexity as well as the effects of multiple and overlapping events that may cause someone to become "traumatized" and thereby affect recovery. This article investigates how subjective reporting of traumatic experience in life history narratives relates to depressive and PTSD symptomatology, cultural idioms, and repeated traumatic experiences among low-income Mexican immigrant women in Chicago. We interviewed 121 Mexican immigrant women and collected life history narratives and psychiatric scales for depression and PTSD. Most women spoke of the detrimental effects of repeated traumatic experiences, reported depressive (49%) and PTSD (38%) symptoms, and described these experiences through cultural idioms. These data complicate the PTSD diagnosis as a discrete entity that occurs in relation to a single acute event. Most importantly, these findings reveal the importance of cumulative trauma and cultural idioms for the recognition of suffering and the limitation of diagnostic categories for identifying the needs of those who experience multiple social and psychological stressors.
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19
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Zalta AK, Tirone V, Orlowska D, Blais RK, Lofgreen A, Klassen B, Held P, Stevens NR, Adkins E, Dent AL. Examining moderators of the relationship between social support and self-reported PTSD symptoms: A meta-analysis. Psychol Bull 2021; 147:33-54. [PMID: 33271023 PMCID: PMC8101258 DOI: 10.1037/bul0000316] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Social support is one of the most robust predictors of posttraumatic stress disorder (PTSD). Yet, little is known about factors that moderate the relationship between social support and PTSD symptom severity. This meta-analysis estimated the overall effect size of the relationship between self-reported social support and PTSD severity and tested meaningful demographic, social support, and trauma characteristics that may moderate this association using both cross-sectional and longitudinal effect sizes. A comprehensive search identified 139 studies with 145 independent cross-sectional effect sizes representing 62,803 individuals and 37 studies with 38 independent longitudinal effect sizes representing 25,792 individuals. Study samples had to comprise trauma-exposed, nonclinical adult populations to be included in the analysis. Cross-sectional and longitudinal analyses revealed a near medium overall effect size (rcross = -.27; 95% CI [-.30, -.24]; rlong = -.25; 95% CI [-.28, -.21]) with a high degree of heterogeneity (cross-sectional I2 = 91.6, longitudinal I2 = 86.5). Both cross-sectional and longitudinal moderator analyses revealed that study samples exposed to natural disasters had a weaker effect size than samples exposed to other trauma types (e.g., combat, interpersonal violence), studies measuring negative social reactions had a larger effect size than studies assessing other types of social support, and veteran samples revealed larger effect sizes than civilian samples. Several other methodological and substantive moderators emerged that revealed a complex relationship between social support and PTSD severity. These findings have important clinical implications for the types of social support interventions that could mitigate PTSD severity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Alyson K. Zalta
- Department of Psychological Science, University of California, Irvine, Irvine, CA
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Vanessa Tirone
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Daria Orlowska
- University Libraries, Western Michigan University, Kalamazoo, MI
| | | | - Ashton Lofgreen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Brian Klassen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Philip Held
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Natalie R. Stevens
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Elizabeth Adkins
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Amy L. Dent
- Department of Psychological Science, University of California, Irvine, Irvine, CA
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Cancio R. Experiences With Machismo and Pain: Latino Veterans. Am J Mens Health 2020; 14:1557988320976304. [PMID: 33256534 PMCID: PMC7711234 DOI: 10.1177/1557988320976304] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 11/18/2022] Open
Abstract
Physical and emotional pain from combat-related injuries and experiences are serious problems among Latino veterans. This study fleshes out existing cultural constructs and concepts (e.g., machismo and familism) from the participants' point of view and may serve as an important step in unraveling the influence of Latino culture on pain, providing a deeper and more critical theorization between masculinity, race/ethnicity, and the military. Using 26 interviews from U.S.-born Latino veterans, this study analyzes the meanings and experiences of pain from combat, masculinity, and how culture affects expressions of pain. The following themes emerged: (a) Latino culture and ethnicity, (b) machismo and pain, (c) the transforming self, and (d) feeling disconnected and dealing with pain. Overall, respondents were governed by strict gender standards influenced by their ethnic identity and exacerbated by military masculinity. Findings suggest that the study of race/ethnicity acts as a fundamental framework from which to understand the experiences and behaviors of pain.
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Affiliation(s)
- Roberto Cancio
- Department of Sociology, Loyola
Marymount University, Los Angeles, CA, USA
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21
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Addressing Diversity in PTSD Treatment: Disparities in Treatment Engagement and Outcome Among Patients of Color. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s40501-020-00212-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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22
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Hartmann WE, Wendt DC, Burrage RL, Pomerville A, Gone JP. American Indian historical trauma: Anticolonial prescriptions for healing, resilience, and survivance. ACTA ACUST UNITED AC 2020; 74:6-19. [PMID: 30652896 DOI: 10.1037/amp0000326] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The American Indian historical trauma (HT) concept is an important precursor to racial trauma (RT) theory that reflects the distinct interests of sovereign Indigenous nations but shares much of the same promise and challenge. Here, that promise and challenge is explored by tracing HT's theoretical development in terms of its anticolonial ambitions and organizing ideas. Three predominant modes of engaging HT were distilled form the literature (HT as a clinical condition, life stressor, and critical discourse), each informing a research program pursuing a different anticolonial ambition (healing trauma, promoting resilience, practicing survivance) organized by distinct ideas about colonization, wellness, and Indigeneity. Through critical reflection on these different ambitions and dialogue of their organizing ideas, conflict between research programs can be mitigated and a more productive anticolonialism realized in psychology and related health fields. Key recommendations emphasized clarifying clinical concepts (e.g., clinical syndrome vs. idiom of distress), disentangling clinical narratives of individual pathology (e.g., trauma) from social narratives of population adversity (e.g., survivance stories), attending to features of settler-colonialism not easily captured by heath indices (e.g., structural violence), and encouraging alignment of anticolonial efforts with constructive critiques establishing conceptual bridges to disciplines that can help to advance psychological understandings of colonization and Indigenous wellness (e.g., postcolonial studies). This conceptual framework was applied to the RT literature to elaborate similar recommendations for advancing RT theory and the interests of ethnic/racial minority populations through engagement with psychology and related health fields. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Hoppen TH, Heinz-Fischer I, Morina N. If only… a systematic review and meta-analysis of social, temporal and counterfactual comparative thinking in PTSD. Eur J Psychotraumatol 2020; 11:1737453. [PMID: 32341763 PMCID: PMC7170331 DOI: 10.1080/20008198.2020.1737453] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 02/06/2020] [Accepted: 02/10/2020] [Indexed: 11/03/2022] Open
Abstract
Comparative thinking is ubiquitous in human cognition. Empirical evidence is accumulating that PTSD symptomatology is linked to various changes in social, temporal and counterfactual comparative thinking. However, no systematic review and meta-analysis in this line of research have been conducted to this date. We searched titles, abstracts and subject terms of electronic records in PsycInfo and Medline from inception to January 2019 with various search terms for social, temporal and counterfactual comparative thinking as well as PTSD. Journal articles were included if they reported a quantitative association between PTSD and social, temporal and/or counterfactual comparative thinking in trauma-exposed clinical or sub-clinical samples. A total of 36 publications were included in the qualitative synthesis. The number of publications on the association between PTSD and social and temporal comparative thinking was too scarce to warrant a meta-analytic review. A narrative review of available literature suggests that PTSD is associated with distortions in social and temporal comparative thinking. A meta-analysis of 24 independent samples (n = 4423) assessing the association between PTSD and the frequency of counterfactual comparative thinking yielded a medium to large positive association of r =.464 (p <.001, 95% CI =.404; .520). Higher study quality was associated with higher magnitude of association in a meta-regression. Most studies collected data cross-sectionally, precluding conclusions regarding causality. Overall, study quality was found to be moderate. More longitudinal and experimental research with validated comparative thinking measures in clinical samples is needed to acquire a more sophisticated understanding of the role of comparative cognitions in the aetiology and maintenance of PTSD. Comparative thinking might be a fruitful avenue for a better understanding of posttraumatic reactions and improving treatment.
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Affiliation(s)
- Thole H. Hoppen
- Institute of Psychology, University of Münster, Münster, Germany
| | | | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Münster, Germany
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24
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Slobodin O, Clempert N, Kula Y, Cohen O. Educating health professionals for cultural competence in emergency situations: A study protocol for a randomized controlled trial. J Adv Nurs 2019; 76:380-386. [DOI: 10.1111/jan.14245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 09/02/2019] [Accepted: 10/15/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Ortal Slobodin
- Department of Education Ben‐Gurion University of the Negev Beer‐Sheva Israel
| | - Neta Clempert
- Department of Middle East Studies Ben‐Gurion University of the Negev Beer‐Sheva Israel
| | - Yosef Kula
- Masters' program in Emergency Medicine School of Public Health Faculty of Health Sciences Ben‐Gurion University of the Negev Beer‐Sheva Israel
| | - Odeya Cohen
- Masters' program in Emergency Medicine School of Public Health Faculty of Health Sciences Ben‐Gurion University of the Negev Beer‐Sheva Israel
- Nursing Department Recanati School for Community Health Professions Ben‐Gurion University of the Negev Beer‐Sheva Israel
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25
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Nichter B, Norman S, Haller M, Pietrzak RH. Psychological burden of PTSD, depression, and their comorbidity in the U.S. veteran population: Suicidality, functioning, and service utilization. J Affect Disord 2019; 256:633-640. [PMID: 31299445 DOI: 10.1016/j.jad.2019.06.072] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/29/2019] [Accepted: 06/30/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Emerging evidence suggests that comorbid posttraumatic stress disorder (PTSD) and major depressive disorder (PTSD/MDD) may impose an even greater burden than either disorder alone. However, nearly all previous studies examining these associations have relied on treatment-seeking samples. This study examined the mental health burden associated with co-occurring PTSD/MDD compared to PTSD and MDD alone using a nationally representative sample of U.S. veterans. METHODS Data were analyzed from National Health and Resilience in Veterans Study, a nationally representative survey of U.S. veterans (n = 2,732). Analyses (a) estimated the current prevalence of PTSD only, MDD only, and comorbid PTSD/MDD; (b) compared demographic/military variables by PTSD/MDD status; and (c) examined associations between PTSD/MDD status and suicidality, functioning, psychiatric comorbidities, and service utilization. RESULTS The current prevalences of probable PTSD only, probable MDD only, and probable comorbid PTSD/MDD were 1.7%, 4.8%, and 3.4%. Compared to all other groups, the PTSD/MDD group was more likely to screen positive for current suicidal ideation, lifetime suicide attempts, probable generalized anxiety and social anxiety disorders, and ever utilize mental health services. They also scored lower on measures of mental health functioning (d = 1.49), cognitive functioning (d = 1.03), and quality of life (d = 0.84). Veterans with comorbid PTSD/MDD were more than twice as likely as those with PTSD only to have attempted suicide. LIMITATIONS The cross-sectional design of this study precludes causal inference. CONCLUSIONS Results provide a population-based characterization of the psychological burden of PTSD/MDD comorbidity in U.S. veterans. Findings further underscore the importance of screening, monitoring, and treatment of the comorbid manifestation of these disorders.
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Affiliation(s)
- Brandon Nichter
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA.
| | - Sonya Norman
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA; National Center for PTSD, White River Junction, VT, USA
| | - Moira Haller
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Robert H Pietrzak
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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26
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An Exploration of Latina/o Respondent Scores on the Personality Assessment Inventory. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-017-9652-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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27
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Elkins J, Miller KM, Briggs HE, Kim I, Mowbray O, Orellana ER. Associations between Adverse Childhood Experiences, Major Depressive Episode and Chronic Physical Health in Adolescents: Moderation of Race/Ethnicity. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:444-456. [PMID: 31117927 DOI: 10.1080/19371918.2019.1617216] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Adverse childhood experiences (ACE) are associated with health problems in adolescence. However, the moderating role of race/ethnicity is not well understood. The current study examines direct and indirect effects of ACE on major depressive episodes and chronic health outcomes, and the moderating role of race/ethnicity among adolescents who participated in the National Comorbidity Survey-Adolescent Supplement. Results show an association between ACE and both health outcomes. Race/ethnicity was associated with differential outcomes and indicated moderation. Results underscore the importance of examining associations between ACE and adolescent well-being by race/ethnicity. The need for trauma-informed and culturally responsive services for adolescents is discussed.
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Affiliation(s)
- Jennifer Elkins
- a School of Social Work , University of Georgia , Athens , Georgia , USA
| | - Keva M Miller
- b School of Social Work , Portland State University , Portland , Oregon , USA
| | - Harold E Briggs
- a School of Social Work , University of Georgia , Athens , Georgia , USA
| | - Irang Kim
- c School of Social Work , University of Maryland , Baltimore , Maryland , USA
| | - Orion Mowbray
- a School of Social Work , University of Georgia , Athens , Georgia , USA
| | - E Roberto Orellana
- b School of Social Work , Portland State University , Portland , Oregon , USA
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28
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Ruglass LM, Yali AM. Do race/ethnicity and religious affiliation moderate treatment outcomes among individuals with co-occurring PTSD and substance use disorders? J Prev Interv Community 2019; 47:198-213. [PMID: 31081480 DOI: 10.1080/10852352.2019.1603674] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The effect of race/ethnicity and religious affiliation on treatment outcomes among 107 individuals with co-occurring substance use disorder (SUD) and full or subthreshold posttraumatic stress disorder (PTSD) was examined in a secondary analysis. Participants were randomly assigned to one of three treatment conditions: dual-disorder treatment of PTSD and SUD using prolonged exposure; single-disorder relapse prevention treatment for SUD; or an active monitoring control group. Results revealed no significant interaction between race/ethnicity and treatment on PTSD and substance use frequency. However, compared to Whites, African Americans had significantly lower levels of PTSD over the course of treatment. Religious affiliation moderated the impact of treatment on substance use frequency and was a significant predictor of PTSD scores during treatment. Results highlight the need to explore factors associated with social identity variables such as race and religion that may enhance or attenuate the mechanisms of treatments for PTSD and SUD.
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Affiliation(s)
- Lesia M Ruglass
- a Department of Psychology , The City College of New York , New York , USA
| | - Ann M Yali
- a Department of Psychology , The City College of New York , New York , USA
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Doric A, Stevanovic D, Stupar D, Vostanis P, Atilola O, Moreira P, Dodig-Curkovic K, Franic T, Davidovic V, Avicenna M, Noor M, Nussbaum L, Thabet A, Ubalde D, Petrov P, Deljkovic A, Antonio ML, Ribas A, Oliveira J, Knez R. UCLA PTSD reaction index for DSM-5 (PTSD-RI-5): a psychometric study of adolescents sampled from communities in eleven countries. Eur J Psychotraumatol 2019; 10:1605282. [PMID: 31105904 PMCID: PMC6507911 DOI: 10.1080/20008198.2019.1605282] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/22/2019] [Accepted: 03/28/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Children and adolescents are often exposed to traumatic events, which may lead to the development of posttraumatic stress disorder (PTSD). It is therefore important for clinicians to screen for potential symptoms that can be signs of PTSD onset. PTSD in youth is a worldwide problem, thus congruent screening tools in various languages are needed. Objective: The aim of this study was to test the general psychometric properties of the Traumatic Stress Disorder Reaction Index for children and adolescents (UCLA PTSD) Reaction Index for DSM-5 (PTSD-RI-5) in adolescents, a self-report instrument intended to screen for trauma exposure and assess PTSD symptoms. Method: Data was collected from 4201 adolescents in communities within eleven countries worldwide (i.e. Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, Palestine-Gaza, Philippines, Portugal, Romania, and Serbia). Internal consistency, discriminant validity, and a confirmatory factor analysis of a four-factor model representing the main DSM-5 symptoms of the PTSD-RI-5 were evaluated. Results: The PTSD-RI-5 total score for the entire sample shows very good reliability (α = .92) as well as across all countries included (α ranged from .90 to .94). The correlations between anxiety/depressive symptoms and the PTSD-RI-5 scores were below .70 indicating on good discriminant validity. The four-factor structure of the scale was confirmed for the total sample and data from six countries. The standardized regression weights for all items varied markedly across the countries. The lack of a common acceptable model across all countries prevented us from direct testing of cross-cultural measurement invariance. Conclusions: The four-factor structure of the PTSD-RI-5 likely represents the core PTSD symptoms as proposed by the DSM-5 criteria, but there could be items interpreted in a conceptually different manner by adolescents from different cultural/regional backgrounds and future cross-cultural evaluations need to consider this finding.
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Affiliation(s)
- Ana Doric
- Department of Psychology (Center for Applied Psychology), Faculty of Humanities and Social Sciences, University of Rijeka, Rijeka, Croatia
| | - Dejan Stevanovic
- Child Psychiatry, Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Dusko Stupar
- Child Psychiatry, Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Panos Vostanis
- School of Psychology, Leicester University, Leicester, UK
| | - Olayinka Atilola
- Department of Behavioural Medicine, Lagos State University College of Medicine Ikeja, Lagos, Nigeria
| | | | - Katarina Dodig-Curkovic
- Medical Faculty Osijek, Faculty for Dental Medicine and Health, University Health Center Osijek, Osijek, Croatia
| | - Tomislav Franic
- Child and Adolescent Psychiatry, School of Medicine, University of Split, Split, Croatia
| | - Vrljicak Davidovic
- Department of Psychiatry, Clinical Hospital Centre Split, Split, Croatia
| | - Mohamad Avicenna
- Faculty of Psychology, State Islamic University Syarif Hidayatullah, Jakarta, Indonesia
| | - Multazam Noor
- Psychiatry department, Dr Soeharto Heerdjan Mental Hospital Jakarta, Jakarta, Indonesia
| | - Laura Nussbaum
- Department of Child and Adolescent Psychiatry, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Abdelaziz Thabet
- School of Public Health, Al Quds University, Gaza Branch, Palestine
| | - Dino Ubalde
- Department of Psychology, St. Dominic College of Asia, City of Bacoor, Philippines
| | - Petar Petrov
- Department of Child and Adolescent Psychiatry, University Hospital St. Marina, Varna, Bulgaria
| | | | | | - Adriana Ribas
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Rajna Knez
- Department of Women´s and Children´s health, Skaraborgs Hospital, Skövde, Sweden.,Department of Psychiatry and Psychological Medicine, Medical School, University of Rijeka, Rijeka, Croatia.,University of Gothenburg, Sahlgrenska Academy, Institute of Neuroscience and Physiology, Göteborg, Sweden
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Koenig HG, Youssef NA, Oliver RJP, Ames D, Haynes K, Volk F, Teng EJ. Religious Involvement, Anxiety/Depression, and PTSD Symptoms in US Veterans and Active Duty Military. JOURNAL OF RELIGION AND HEALTH 2018; 57:2325-2342. [PMID: 30120690 DOI: 10.1007/s10943-018-0692-1] [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: 06/08/2023]
Abstract
Religious involvement is associated with mental health and well-being in non-military populations. This study examines the relationship between religiosity and PTSD symptoms, and the mediating effects of anxiety and depression in Veterans and Active Duty Military (V/ADM). This was a cross-sectional multi-site study involving 585 V/ADM recruited from across the USA. Inclusion criteria were having served in a combat theater and PTSD symptoms. Demographics, military characteristics, and social factors were assessed, along with measurement of religiosity, PTSD symptoms, depression, and anxiety. Bivariate and multivariate analyses examined the religiosity-PTSD relationship and the mediating effects of anxiety/depression on that relationship in the overall sample and stratified by race/ethnic group (White, Black, Hispanic). In bivariate analyses, the religiosity-PTSD relationship was not significant in the overall sample or in Whites. However, the relationship was significant in Blacks (r = - 0.16, p = 0.01) and in Hispanics (r = 0.30, p = 0.03), but in opposite directions. In the overall sample, religiosity was inversely related to anxiety (r = - 0.07, p = 0.07) and depression (r = - 0.21, p < 0.0001), especially in Blacks (r = - 0.21, p = 0.001, and r = - 0.34, p < 0.0001, respectively); however, in Hispanics, religiosity was positively related to anxiety (r = 0.32, p = 0.02) as it was to PTSD symptoms. When anxiety/depression was controlled for in multivariate analyses, the religiosity-PTSD relationship in the overall sample reversed from negative to positive, approaching statistical significance (B = 0.05, SE = 0.03, p = 0.079). In Blacks, the inverse association between religiosity and PTSD was explained by quality of relationships, whereas the positive relationship in Hispanics was explained by anxiety symptoms. In conclusion, religiosity was inversely related to PTSD symptoms in Blacks, positively related to PTSD in Hispanics, and unrelated to PTSD in the overall sample and in Whites. Anxiety/depression partially mediated the relationship in the overall sample and in Hispanics. Although longitudinal studies will be necessary to determine how these relationships come about, consideration should be given to spiritual/religious interventions that target anxiety/depression in V/ADM with PTSD.
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Affiliation(s)
- Harold G Koenig
- Duke University Medical Center, Box 3400, 2301 Erwin Rd, Durham, NC, 27710, USA.
- Durham Veterans Affairs Health Care System, Durham, NC, USA.
- Ningxia Medical University, 692 Shengli St, Xingqing Qu, Yinchuan Shi, 750000, Ningxia Huizuzizhiqu, China.
- King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
| | - Nagy A Youssef
- Medical College of Georgia, Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center Augusta, Augusta, GA, USA
| | | | - Donna Ames
- Duke University Medical Center, Box 3400, 2301 Erwin Rd, Durham, NC, 27710, USA
- VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA, 90073, USA
- University of California - Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Kerry Haynes
- South Texas Veterans Healthcare System, San Antonio, TX, USA
| | - Fred Volk
- Department of Counselor Education and Family Studies, School of Behavioral Sciences, Liberty University, Lynchburg, VA, USA
| | - Ellen J Teng
- Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA
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Williams DR. Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2018; 59:466-485. [PMID: 30484715 PMCID: PMC6532404 DOI: 10.1177/0022146518814251] [Citation(s) in RCA: 404] [Impact Index Per Article: 67.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This article provides an overview of research on race-related stressors that can affect the mental health of socially disadvantaged racial and ethnic populations. It begins by reviewing the research on self-reported discrimination and mental health. Although discrimination is the most studied aspect of racism, racism can also affect mental health through structural/institutional mechanisms and racism that is deeply embedded in the larger culture. Key priorities for research include more systematic attention to stress proliferation processes due to institutional racism, the assessment of stressful experiences linked to natural or manmade environmental crises, documenting and understanding the health effects of hostility against immigrants and people of color, cataloguing and quantifying protective resources, and enhancing our understanding of the complex association between physical and mental health.
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Affiliation(s)
- David R Williams
- 1 Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- 2 Department of African and African American Studies and of Sociology, Harvard University, Cambridge, MA, USA
- 3 Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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Sripada RK, Hoff R, Pfeiffer PN, Ganoczy D, Blow FC, Bohnert KM. Latent classes of PTSD symptoms in veterans undergoing residential PTSD treatment. Psychol Serv 2018; 17:84-92. [PMID: 30284867 DOI: 10.1037/ser0000284] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Although most veterans in the Department of Veterans Affairs (VA) health system are treated for posttraumatic stress disorder (PTSD) in the outpatient setting, the VA has approximately 40 residential PTSD treatment facilities across the country for those requiring more intensive care. The symptom profiles of these veterans are poorly understood. Thus, the current study was designed to characterize classes of PTSD symptoms in a national sample of veterans undergoing residential treatment. We analyzed latent classes of PTSD symptoms among 2,452 veterans entering VA PTSD residential treatment in fiscal year 2013. The model with the best fit was a 4-class model comprising a low symptom class, moderate symptom class with high reexperiencing symptoms, a moderate symptom class with high emotional numbing, and a high symptom class. Compared to classes identified in outpatient samples, these classes were similar in type but greater in severity. Classes differed by age, race/ethnicity, trauma type, co-occurring medical conditions, co-occurring psychiatric conditions, and social functioning. Compared to the moderate class with high emotional numbing, those in the moderate class with high reexperiencing symptoms were more likely to be non-White, have greater pain severity, greater sleep problems, and were less likely to be depressed. Our findings suggest that veterans in residential treatment who have more severe PTSD symptoms also experience other medical and psychosocial stressors. A better understanding of symptom profiles may help to create more individualized treatment planning and thus potentially improve care for these veterans. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Rani Hoff
- Veteran Affairs Northeast Program Evaluation Center
| | | | - Dara Ganoczy
- Veterans Affairs Center for Clinical Management Research
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Ahlin EM, Douds AS. Many Shades of Green: Assessing Awareness of Differences in Mental Health Care Needs Among Subpopulations of Military Veterans. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:3168-3184. [PMID: 28770637 DOI: 10.1177/0306624x17723626] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The current study sought to examine access to services by various veteran subgroups: racial/ethnic minorities, females, rural populations, and LGBTQ (Lesbian, Gay, Bisexual, Transgender, and Queer). Generally, the Veteran Service Officers (VSOs) interviewed for this study did not feel that these subgroups were well served by the program and treatment options presently available, and that other groups such as males and urban veterans received better access to necessary psychosocial and medical care. This research extends studies that explore overall connection to services by further demonstrating barriers to receipt of services by specific subgroups of veterans, particularly those at risk for involvement in the criminal justice system.
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Sauceda JA, Wiebe JS, Chan K, Kutner BA, Simoni JM. Acculturation, family cohesion, and mental health among Latinos living with HIV on the U.S.-Mexico border. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2018; 24:453-458. [PMID: 29389148 PMCID: PMC6023757 DOI: 10.1037/cdp0000166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The objective of the study was to investigate whether acculturation to U.S. culture is associated with greater posttraumatic stress disorder (PTSD) symptomatology through diminished family cohesion among Latinos living with HIV on the U.S.-Mexico border. METHOD Baseline survey data were analyzed from a sample of Latinos seeking HIV care from a publicly funded HIV clinic in El Paso, Texas. We used a regression-based bootstrapping approach to test our mediation hypothesis. RESULTS A total of 248 Latinos living with HIV completed the survey, with 96.4% being of Mexican descent, 19.4% female (gender self-identification), and 63.7% nonheterosexual (sexual orientation self-identification). Family cohesion mediated the relationship between U.S. acculturation and PTSD symptom scores (a1 ⁎ b1 = .03, 95% confidence interval [.01-.06]), an effect independent of acculturation to Latino culture. CONCLUSIONS Acculturation to U.S. culture may negatively impact mental health through weakening family bonds in this vulnerable population. (PsycINFO Database Record
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Affiliation(s)
- John A Sauceda
- Center for AIDS Prevention Studies, University of California, San Francisco
| | - John S Wiebe
- Department of Psychology, University of Texas at El Paso
| | - Kiana Chan
- San Francisco Department of Public Health
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Pérez-Pedrogo C, Martínez-Taboas A, González RA, Caraballo JN, Albizu-García CE. Sex differences in traumatic events and psychiatric morbidity associated to probable posttraumatic stress disorder among Latino prisoners. Psychiatry Res 2018; 265:208-214. [PMID: 29738944 PMCID: PMC6016368 DOI: 10.1016/j.psychres.2018.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 03/01/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
Latinos comprised 17.1% of the U.S. population and 33.1% of US prisoners, yet they are underrepresented in the psychopathology literature. Despite higher rates of trauma among incarcerated individuals than in the general population, most of the previous research in this area focused primarily on women samples, and very few studies examined sex differences in PTSD and traumatic experiences. In addition, there is a need for research assessing traumatic experiences and probable PTSD in men and women Latino inmates to inform culturally competent care and sex sensitive care for this vulnerable and underserved population. Our study examined whether men and women Latino inmates with probable Posttraumatic Stress Disorder (PTSD), based on the cut off 40 or more symptoms on the Davidson Trauma Scale (DTS), differed significantly by the number of event types experienced, the type of potentially traumatizing event, and in co-occurring psychiatric conditions. A multi-stage sample design was used to select a probabilistic sample of 1,331 inmates from 26 penal institutions in PR of which 1179 participated in the study. Bivariate associations were calculated for each type of traumatic event and probable PTSD. Mean number of types of potentially traumatizing event experienced was comparable for both sexes (F = 3.83, M = 3.74) yet sex differences were found in the nature of the event. Women with probable PTSD had higher rates of experiencing rape and sexual abuse. Men had higher rates of experiencing combat in war, a life-threatening accident, of witnessing violence, and being threatened with a weapon. Men with significant ADHD symptoms in childhood and with Generalized Anxiety Disorder (GAD) during adulthood were almost 5 and 7 times as likely to score above threshold on the DTS whereas women were >3 times as likely in the presence of ADHD symptoms in childhood or depression during adulthood. This study underscores the need to improve understanding of the clinical manifestations of trauma and co-occurring psychiatric conditions for appropriate sex sensitive interventions targeting Latinos living in prisons.
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Affiliation(s)
- Coralee Pérez-Pedrogo
- University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico; Carlos Albizu University, San Juan Campus, San Juan, Puerto Rico.
| | | | - Rafael A González
- East London NHS Foundation Trust, Child and Adolescent Mental Health Service (CAMHS), London, UK; Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College, London, UK
| | - José N Caraballo
- University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
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Thackeray R, Magnusson BM, Bennion E, Nielsen NN, Bailey RJ. Attitudes of U.S. Hispanic and non-Hispanic women toward congenital CMV prevention behaviors: a cross sectional study. BMC Pregnancy Childbirth 2018; 18:181. [PMID: 29793438 PMCID: PMC5968502 DOI: 10.1186/s12884-018-1807-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/30/2018] [Indexed: 11/24/2022] Open
Abstract
Background Congenital cytomegalovirus (CMV) infection is the most common intrauterine infection. The only way to protect against congenital CMV infection is to practice CMV prevention behaviors. CMV seroprevalence rates are high in Hispanic women. It is unknown whether communication strategies should differ by ethnicity. The purpose of this study was to understand differences between U.S. Hispanic and non-Hispanic women’s attitudes toward CMV prevention behaviors and examine the relationship between perceived subjective norms and these attitudes. Methods This was a cross-sectional study using an online panel. Participants were U.S. women of childbearing age. The dependent variable was attitude toward practicing CMV prevention behaviors, specifically avoiding sharing cups, food, and utensils with a child and not kissing a child on the lips. Results Among 818 women (50% Hispanic), 16.8% of Hispanic women and 9.7% of non-Hispanic women (p = 0.002) reported familiarity with CMV. Attitudes toward CMV prevention through avoiding sharing behaviors (MHispanic = 5.55 vs. Mnon-Hispanic = 5.20; p = 0.002) and not kissing a child on the lips (MHispanic = 4.80 vs. Mnon-Hispanic = 4.21; p = 0.001) were positive for both ethnicities, but higher for Hispanic women. Hispanic women (M = 5.11) reported higher perceived behavioral control for avoiding kissing a child on the lips than non-Hispanic women (M = 4.63; p = 0.001). Hispanic women who were U.S. born or spoke English primarily more frequently kissed a child on the lips or engaged in sharing behaviors. Additionally, those who spoke Spanish mostly held more positive attitudes toward not kissing on the lips. Significant predictors for more positive attitudes toward CMV prevention behaviors were associated with perceived subjective norms, perceived behavioral control and pre-survey participation in risk behaviors. Conclusions Hispanic women have more positive attitudes toward CMV prevention behaviors than non-Hispanic women, however in regression models other factors are more important predictors of positive attitudes than ethnicity. In developing strategies to encourage women to practice CMV prevention behaviors, a focus on further understanding and increasing subjective norms and perceived control over those behaviors may be warranted. Electronic supplementary material The online version of this article (10.1186/s12884-018-1807-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Erica Bennion
- Department of Health Science, Brigham Young University, Provo, UT, USA
| | - Natalia N Nielsen
- Department of Health Science, Brigham Young University, Provo, UT, USA
| | - Ryan J Bailey
- Department of Epidemiology and Biostatistics, University of South Florida, Tampa, FL, USA
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Tiemensma J, Depaoli S, Winter SD, Felt JM, Rus HM, Arroyo AC. The performance of the IES-R for Latinos and non-Latinos: Assessing measurement invariance. PLoS One 2018; 13:e0195229. [PMID: 29614117 PMCID: PMC5882119 DOI: 10.1371/journal.pone.0195229] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 03/05/2018] [Indexed: 11/18/2022] Open
Abstract
Violent acts on university campuses are becoming more frequent. Enrollment rates of Latinos at universities is increasing. Research has indicated that youths are more susceptible to trauma, particularly Latinos. Thus, it is imperative to evaluate the validity of commonly used posttraumatic stress measures among Latino college students. The Impact of Event Scale-Revised (IES-R) is one of the most commonly used metrics of posttraumatic stress disorder symptomatology. However, it is largely unknown if the IES-R is measuring the same construct across different sub-samples (e.g. Latino versus non-Latino). The current study aimed to assess measurement invariance for the IES-R between Latino and non-Latino participants. A total of 545 participants completed the IES-R. One- and three-factor scoring solutions were compared using confirmatory factor analyses. Measurement invariance was then evaluated by estimating several multiple-group confirmatory factor analytic models. Four models with an increasing degree of invariance across groups were compared. A significant χ2 difference test was used to indicate a significant change in model fit between nested models within the measurement invariance testing process. The three-factor scoring solution could not be used for the measurement invariance process because the subscale correlations were too high for estimation (rs 0.92-1.00). Therefore, the one-factor model was used for the invariance testing process. Invariance was met for each level of invariance: configural, metric, scalar, and strict. All measurement invariance testing results indicated that the one-factor solution for the IES-R was equivalent for the Latino and non-Latino participants.
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Affiliation(s)
- Jitske Tiemensma
- Psychological Sciences, University of California, Merced, CA, United States of America
| | - Sarah Depaoli
- Psychological Sciences, University of California, Merced, CA, United States of America
- * E-mail:
| | - Sonja D. Winter
- Psychological Sciences, University of California, Merced, CA, United States of America
| | - John M. Felt
- Psychological Sciences, University of California, Merced, CA, United States of America
| | - Holly M. Rus
- Psychological Sciences, University of California, Merced, CA, United States of America
| | - Amber C. Arroyo
- Psychological Sciences, University of California, Merced, CA, United States of America
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Social, Occupational, and Spatial Exposures and Mental Health Disparities of Working-Class Latinas in the US. J Immigr Minor Health 2017; 18:589-599. [PMID: 26044667 DOI: 10.1007/s10903-015-0231-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Grounded in ecosocial theory, this paper discusses the mental health disparities of working-class Latinas from multiple perspectives. An overview of working-class Latinas' prevalent mental health disorders, barriers to care and suggestions for interventions and future studies are provided.
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Anderson C, Strickland S. The Influence of Acculturation on Traumatic Stress Following Childbirth Among Hispanic Adolescents. HISPANIC HEALTH CARE INTERNATIONAL 2017; 15:99-106. [PMID: 29164933 DOI: 10.1177/1540415317717410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Many studies have explored the role of acculturation on health outcomes; however, no studies to date have examined relationships between acculturation and the traumatic stress of childbirth among Hispanic adolescents. METHOD A convenience sample of 66 Hispanic adolescents 13 to 19 years of age completed the Acculturation Rating Scale for Mexican Americans-II (ARSMA-II), a demographic sheet, birth appraisal scale, and the Impact of Event Scale within 72 hours of birth. RESULTS Significant associations were found between the ARSMA-II subscales and acculturation proxy variables, excluding language; however, only the Mexican Orientation Subscale and generation proxy variable influenced the birth experience. The study findings showed that Hispanic adolescents reporting a more traumatic childbirth identified closer with the Mexican culture and reported fewer family generations residing in the United States. CONCLUSION As an overlooked area of research, our findings support the need for additional research related to the traumatic stress of birth among Hispanic adolescents. Using multiple acculturation measurements, including the ARSMA-II, with larger, more diverse samples of adolescents, equally balanced between all categories of acculturation and placement within the five-tier generation matrix, can provide some insightful information and directed health care.
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Affiliation(s)
- Cheryl Anderson
- 1 College of Nursing and Health Innovation, Arlington, TX, USA
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Goodman RD, Vesely CK, Letiecq B, Cleaveland CL. Trauma and Resilience Among Refugee and Undocumented Immigrant Women. JOURNAL OF COUNSELING AND DEVELOPMENT 2017. [DOI: 10.1002/jcad.12145] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Colleen K. Vesely
- Early Childhood Education and Human Development and Family Science Programs
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Arbona C, Fan W, Schwartz J, Pao C, Tran JK, Buser S. Measurement and Structural Invariance of Posttraumatic Stress Disorder Symptoms in Hispanic and Caucasian Firefighters: A Bias-Corrected Bootstrap Confidence Intervals Approach. Assessment 2017; 26:209-222. [DOI: 10.1177/1073191116685805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study compared across Hispanic and Caucasian firefighters the relative fit of the four-factor Emotional Numbing and Dysphoria posttraumatic stress disorder models to the more recently proposed Dysphoric Arousal five-factor model. As hypothesized, the Dysphoric Arousal five-factor model emerged as the best fitting model within each ethnic group and it also showed measurement invariance between groups (configural invariance). Results of multigroup confirmatory factor analyses and a bias-corrected bootstrap confidence intervals analytic approach indicated that the five factor model also demonstrated invariance in factor loadings (metric invariance) and item-level intercepts (scalar invariance) across the two ethnic groups. Results indicate that the Dysphoric Arousal five factor model captures similar psychological constructs across Caucasian and English-speaking Hispanic firefighters. Therefore, observed factor scores are comparable across ethnic groups and can be combined when examining predictors of posttraumatic stress disorder severity.
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Affiliation(s)
| | | | | | | | - Jana K. Tran
- Firefighter Support Network, Houston Fire Department, Houston, TX, USA
| | - Sam Buser
- Firefighter Support Network, Houston Fire Department, Houston, TX, USA
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Houllé WA, Silès J, Tarquinio P, Tarquinio C. Trauma et culture : influence des facteurs culturels dans la rencontre traumatique et perspectives psychothérapeutiques. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2017. [DOI: 10.1016/j.ejtd.2017.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gaviria SL, Alarcón RD, Espinola M, Restrepo D, Lotero J, Berbesi DY, Sierra GM, Chaskel R, Espinel Z, Shultz JM. Socio-demographic patterns of posttraumatic stress disorder in Medellin, Colombia and the context of lifetime trauma exposure. DISASTER HEALTH 2017; 3:139-150. [PMID: 28265488 DOI: 10.1080/21665044.2016.1263086] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 11/20/2016] [Indexed: 01/09/2023]
Abstract
Colombia, South America is currently transitioning to post-conflict status following 6 decades of armed conflict. The population has experienced extensive exposures to potentially traumatic events throughout the lifespan. Sources of trauma exposure include the prolonged armed insurgency, narco-trafficking violence, urban gang violence, violent actions of criminal bands, intra-familial violence, gender-based violence, and sex trafficking. Exposure to potentially traumatic events is related to a variety of psychiatric outcomes, in particular, posttraumatic stress disorder. Given this context of lifetime trauma exposure, socio-demographic patterns of posttraumatic stress disorder were explored in a sample of residents of Medellin, Colombia, the nation's second largest city and a nexus for multiple types of trauma exposure.
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Affiliation(s)
| | - Renato D Alarcón
- Universidad Peruana Cayetano Heredia, Lima, Peru; Mayo Clinic, Rochester, MN, USA
| | - Maria Espinola
- Department of Psychiatry and Behavioral Neuroscience, Clinical Psychiatry, University of Cincinnati College of Medicine , Cincinnati, OH, USA
| | - Diana Restrepo
- Department of Psychiatry, Universidad CES , Medellín, Colombia
| | - Juliana Lotero
- Department of Psychiatry, Universidad CES , Medellín, Colombia
| | - Dedsy Y Berbesi
- Department of Psychiatry, Universidad CES , Medellín, Colombia
| | | | - Roberto Chaskel
- Child and Adolescent Psychiatry, Fundación Santa Fe de Bogotá, Escuela Militar de Medicina, Escuela Militar Nueva Granada, Hospital Militar Central, Universidad El Bosque, Universidad de Los Andes , Bogotá, Colombia
| | - Zelde Espinel
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, and Jackson Memorial Hospital , Miami, FL, USA
| | - James M Shultz
- Center for Disaster & Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine , Miami, FL, USA
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Viana AG, Paulus DJ, Bakhshaie J, Garza M, Valdivieso J, Ochoa-Perez M, Lemaire C, Cardoso JB, Zvolensky MJ. Emotional nonacceptance within the context of traumatic event exposure: The explanatory role of anxiety sensitivity for traumatic stress symptoms and disability among Latinos in a primary care setting. Gen Hosp Psychiatry 2017; 44:30-37. [PMID: 28041573 DOI: 10.1016/j.genhosppsych.2016.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 10/20/2016] [Accepted: 10/24/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Research has found that Latinos (versus non-Latino Whites) evince higher rates of posttraumatic stress symptoms (PTS) and posttraumatic stress disorder (PTSD), yet little attention has been given to intra-individual, emotion-related processes to explicate the higher incidence of these symptoms among Latinos. METHOD Participants included 183 trauma-exposed adult Latinos (88.5% female; Mage=37.7, SD=10.7 and 93.4% reported Spanish as their first language) who attended a community-based primary healthcare clinic in Houston. It was hypothesized that anxiety sensitivity would explain the relation between emotional nonacceptance and traumatic stress symptoms, namely re-experiencing, avoidance, and arousal difficulties as well as overall disability. Additionally, it was expected that the observed effects would be evident above and beyond the variance accounted for by number of traumas reported, gender, age, marital status, educational status, years living in the U.S., and negative affectivity. RESULTS Consistent with our hypotheses, difficulties accepting negative emotions were associated with increased trauma-related re-experiencing, avoidance, and arousal difficulties. Additionally, anxiety sensitivity was an underlying mechanism in the association between emotional nonacceptance and all but one facet of traumatic stress symptoms (i.e., re-experiencing symptoms) and disability. Alternative models yielded no significant effects, providing greater confidence in the direction of the hypothesized effects. CONCLUSION Findings are discussed in the context of their significance for informing the development of specialized intervention strategies that target anxiety sensitivity for Latinos in primary care with elevated risk for PTS and PTSD by their heightened levels of emotional nonacceptance.
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Affiliation(s)
- Andres G Viana
- Department of Psychology, University of Houston, Houston, TX, United States.
| | - Daniel J Paulus
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Jafar Bakhshaie
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Monica Garza
- Legacy Community Health Services, Houston, TX, United States
| | | | | | - Chad Lemaire
- Legacy Community Health Services, Houston, TX, United States
| | | | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, TX, United States.
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Gómez JM, Smith CP, Gobin RL, Tang SS, Freyd JJ. Collusion, torture, and inequality: Understanding the actions of the American Psychological Association as institutional betrayal. J Trauma Dissociation 2016; 17:527-544. [PMID: 27427782 DOI: 10.1080/15299732.2016.1214436] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The Hoffman Report (Hoffman et al., 2015) documented devastating information about the American Psychological Association (APA) and the profession of psychology in the United States, prompting a public apology and a formal commitment by APA to correct its mistakes (APA, 2015). In the current article, we utilize betrayal trauma theory (Freyd, 1997), including betrayal blindness (e.g., Freyd, 1996; Tang, 2015) and institutional betrayal (Smith & Freyd, 2014b), to understand and learn from APA's behaviors. We further situate this discussion in the context of inequality, both within APA and in American society generally. We detail how the impact of APA's institutional betrayals extended beyond the organization, its members, and the psychology profession, highlighting the potential for disproportionate harm to minorities, including those who were tortured; Muslims, Middle Easterners, Afghans, and non-Americans who were not tortured; and other minority individuals (Gómez, 2015d). Acknowledging, understanding, and addressing its institutional betrayals offers APA the opportunity to take meaningful corrective and preventive measures. We propose several institutional reparations, including making concrete changes with transparency and conducting self-assessments to inform further needed changes (Freyd & Birrell, 2013). By engaging in institutional courage, APA has the potential to grow into an ethical governing body that fulfills its mission to "advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives" (APA, 2016).
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Affiliation(s)
- Jennifer M Gómez
- a Department of Psychology , University of Oregon , Eugene , Oregon , USA
| | - Carly P Smith
- b College of Medicine, Penn State , State College , Pennsylvania , USA
| | - Robyn L Gobin
- c Department of Kinesiology and Community Health , University of Illinois at Urbana-Champaign , Champaign , Illinois , USA
| | | | - Jennifer J Freyd
- a Department of Psychology , University of Oregon , Eugene , Oregon , USA
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Weiss NH, Johnson CD, Contractor A, Peasant C, Swan SC, Sullivan TP. Racial/ethnic differences moderate associations of coping strategies and posttraumatic stress disorder symptom clusters among women experiencing partner violence: a multigroup path analysis. ANXIETY STRESS AND COPING 2016; 30:347-363. [PMID: 27575609 DOI: 10.1080/10615806.2016.1228900] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Past research underscores the key role of coping strategies in the development, maintenance, and exacerbation of posttraumatic stress disorder (PTSD) symptoms. The goal of the current study was to extend existing literature by examining whether race/ethnicity moderates the relations among coping strategies (social support, problem-solving, avoidance) and PTSD symptom clusters (intrusion, avoidance, numbing, arousal). METHODS Participants were 369 community women (134 African Americans, 131 Latinas, 104 Whites) who reported bidirectional aggression with a current male partner. Multigroup path analysis was utilized to test the moderating role of race/ethnicity in a model linking coping strategies to PTSD symptom clusters. RESULTS The strength and direction of relations among coping strategies and PTSD symptom clusters varied as a function of race/ethnicity. Greater social support coping was related to more arousal symptoms for Latinas and Whites. Greater problem-solving coping was related to fewer arousal symptoms for Latinas. Greater avoidance coping was related to more symptoms across many of the PTSD clusters for African Americans, Latinas, and Whites, however, these relations were strongest for African Americans. CONCLUSION Results provide support for the moderating role of race/ethnicity in the relations among coping strategies and PTSD symptom clusters, and highlight potential targets for culturally informed PTSD treatments.
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Affiliation(s)
- Nicole H Weiss
- a Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA
| | - Clinesha D Johnson
- a Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA
| | | | - Courtney Peasant
- c Center for Interdisciplinary Research on AIDS , Yale University School of Public Health , New Haven , CT , USA
| | - Suzanne C Swan
- d Department of Psychology , University of South Carolina , Columbia , SC , USA
| | - Tami P Sullivan
- a Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA
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Association between Sexual Victimization History, Posttraumatic Stress Symptoms, and Women’s Decision Making in Risky Social Situations: the Moderating Effect of Ethnicity. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2016. [DOI: 10.1007/s10862-016-9557-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Arbona C, Schwartz JP. Posttraumatic Stress Disorder Symptom Clusters, Depression, Alcohol Abuse, and General Stress Among Hispanic Male Firefighters. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2016. [DOI: 10.1177/0739986316661328] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the association of the four posttraumatic stress disorder (PTSD) symptom clusters (re-experiencing, avoidance, dysphoria, and hyperarousal) included in the Dysphoria factor model to depression, substance abuse, and general stress among 551 male, Hispanic firefighters in a large metropolitan city in the United States. Approximately 11% of the participants demonstrated elevated PTSD compared with a 7% PTSD prevalence rate in the U.S. Hispanic population. Results of bivariate correlations and regression analyses indicated that, as expected, the dysphoria cluster captured a general distress dimension common to other affective disorders, whereas re-experiencing, avoidance, and hyperarousal symptoms demonstrated stronger specificity to depression than to substance abuse or general stress. Findings suggest that treatment approaches to PTSD with Hispanics should include interventions such as behavioral activation, which are designed to address non-specific distress.
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Hipolito-Delgado CP. Internalized Racism, Perceived Racism, and Ethnic Identity: Exploring Their Relationship in Latina/o Undergraduates. JOURNAL OF COLLEGE COUNSELING 2016. [DOI: 10.1002/jocc.12034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ramos Z, Fortuna LR, Porche MV, Wang Y, Shrout PE, Loder S, McPeck S, Noyola N, Toro M, Carmona R, Alegría M. Posttraumatic Stress Symptoms and their Relationship to Drug and Alcohol use in an International Sample of Latino Immigrants. J Immigr Minor Health 2016; 19:552-561. [PMID: 27150593 DOI: 10.1007/s10903-016-0426-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We identify the prevalence and correlates of posttraumatic stress (PTSD) symptoms and their relationship to alcohol and substance use disorders (AUD/SUD) among Latino immigrants in two countries. A screening battery assessing PTSD symptoms (PCL-C), alcohol use (AUDIT), drug abuse (DAST), and psychological measures was administered to 562 Latino immigrants recruited in clinics. We used logistical regression analyses to evaluate the relationship between PTSD symptoms and AUD/SUD. Prevalence of elevated PTSD symptoms was high (53.7 % in Boston, 47.9 % in Madrid and, 43.8 % in Barcelona). Screening positive for psychological measures was significantly correlated to screening positive on the PCL-C (p < 0.001). Significant gender differences in risk of AUD/SUD were moderated by PTSD symptoms. Presence of any PTSD symptoms predicted problems with benzodiazepine misuse. Given the high rates of co-morbidity between PTSD symptoms and AUD/SUD, we recommend early interventions for dual pathology for Latino immigrants with trauma history.
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Affiliation(s)
- Zorangelí Ramos
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50 Staniford St, 8th Floor, Boston, MA, 02114-2698, USA
| | - Lisa R Fortuna
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50 Staniford St, 8th Floor, Boston, MA, 02114-2698, USA.,Boston University Medical School, Boston Medical Center, Child and Adolescent Psychiatry, Boston, MA, USA
| | | | - Ye Wang
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50 Staniford St, 8th Floor, Boston, MA, 02114-2698, USA
| | - Patrick E Shrout
- Department of Psychology, New York University, New York, NY, USA
| | - Stephen Loder
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50 Staniford St, 8th Floor, Boston, MA, 02114-2698, USA
| | - Samantha McPeck
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50 Staniford St, 8th Floor, Boston, MA, 02114-2698, USA
| | - Nestor Noyola
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50 Staniford St, 8th Floor, Boston, MA, 02114-2698, USA
| | - Manuela Toro
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50 Staniford St, 8th Floor, Boston, MA, 02114-2698, USA
| | | | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50 Staniford St, 8th Floor, Boston, MA, 02114-2698, USA.
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