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Nass BYS, Dibbets P, Markus CR. Mediating effect of coping dispositions on the association between trauma and gastrointestinal symptoms. Stress Health 2024; 40:e3380. [PMID: 38324223 DOI: 10.1002/smi.3380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 01/11/2024] [Accepted: 01/26/2024] [Indexed: 02/08/2024]
Abstract
Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are two gastrointestinal (GI) conditions known to be exacerbated by traumatic life experiences. One way in which these experiences might influence individuals' susceptibility to GI pathology, is by reducing their ability to deal with adversities effectively and predisposing them to passive coping styles that leave them vulnerable to the somatic effects of trauma. To validate this hypothesis, the present cross-sectional study assessed the mediating effect of coping dispositions on the association between trauma and GI disease activity in an adult sample of 189 bowel patients (94 IBD, 95 IBS) and 92 controls. Results confirmed that GI patients exhibit significantly more cumulative trauma, pervasive feelings of uncontrollability and passive coping strategies than controls. Moreover, the use of passive coping styles was positively associated with the accumulation of trauma and the expression of GI symptoms. Using hierarchical regression and mediation analyses, we found support for the sequential model postulating passive coping styles as (partial) mediators of trauma-induced (GI) disease manifestations. Specifically, out of all coping styles associated with cumulative trauma, behavioural disengagement most powerfully mediated the effect of trauma on GI symptom severity, accounting for 12% (IBD) to 14% (IBS) of its total effect. A somewhat smaller mediating role was observed for social support coping, the reduced reliance on which explained 7% (IBS) to 10% (IBD) of trauma's total effect. Finally, neuroticism acted as a channel through which past traumatization affected subjects' proneness to behavioural disengagement and, consequently, their GI disease activity.
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Affiliation(s)
- Boukje Y S Nass
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Dr. Rath Health Foundation, Heerlen, The Netherlands
| | - Pauline Dibbets
- Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - C Rob Markus
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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2
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Vaillancourt-Morel MP, Bussières ÈL, Nolin MC, Daspe MÈ. Partner Effects of Childhood Maltreatment: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1150-1167. [PMID: 37209135 PMCID: PMC10913306 DOI: 10.1177/15248380231173427] [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: 05/22/2023]
Abstract
Although several studies have shown that childhood maltreatment (CM) is associated with a host of negative consequences including romantic relationship difficulties for victims in adulthood, most overlooked the potential effects on the romantic partner. This systematic review and meta-analysis aims to comprehensively synthesize the literature on the association between a person's CM and their partner's individual and couple outcomes. We searched PubMed, PsycNET, Medline, CINAHL, and Eric using search strings related to CM and partner. We identified 3,238 articles after removal of duplicates; 28 studies met the inclusion criteria and relied on independent sample. The studies reported associations between a person's CM and a wide breadth of partner's negative couple outcomes (e.g., communication, sexuality) as well as intra-individual psychological difficulties (e.g., psychological distress, emotion, and stress reactivity). Meta-analytic results showed significant, but trivial to small associations between a person's CM and their partner's lower relationship satisfaction (r = -.09, 95% CI [-.14, -.04]), higher intimate partner violence (r = .08, [.05, .12]), and higher psychological distress (r = .11, [.06, .16]). These associations were similar for women and men and did not differ as a function of sample's mean age, proportion of cultural diversity, and publication year. These findings suggest that a person's CM is related to their partner's outcomes including to the partner's intra-individual outcomes. Prevention and intervention strategies should acknowledge that a person's CM may also affect their romantic partner, considering the couple as a reciprocal system, and offer victims' romantic partners specific services.
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Cheung CTY, Cheng CMH, Lee VWP, Lam SKK, He KL, Ling HWH, Lee K, Ross CA, Fung HW. COULD FAMILY WELL-BEING MODERATE THE RELATIONSHIP BETWEEN ADVERSE CHILDHOOD EXPERIENCES AND SOMATOFORM DISSOCIATION? A PRELIMINARY INVESTIGATION. J Trauma Dissociation 2024; 25:153-167. [PMID: 37424207 DOI: 10.1080/15299732.2023.2233095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 06/05/2023] [Indexed: 07/11/2023]
Abstract
The impacts of adverse childhood experiences (ACEs) have been well documented. One possible consequence of ACEs is dissociation, which is a major feature of post-traumatic psychopathology and is also associated with considerable impairment and health care costs. Although ACEs are known to be associated with both psychoform and somatoform dissociation, much less is known about the mechanisms behind this relationship. Little is known about whether social and interpersonal factors such as family environments would moderate the relationship between ACEs and somatoform dissociation. This paper discusses the importance of having a positive and healthy family environment in trauma recovery. We then report the findings of a preliminary study in which we examined whether the association between ACEs and somatoform dissociation would be moderated by family well-being in a convenience sample of Hong Kong adults (N = 359). The number of ACEs was positively associated with somatoform dissociative symptoms, but this association was moderated by the level of family well-being. The number of ACEs was associated with somatoform dissociation only when the family well-being scores were low. These moderating effects were medium. The findings point to the potential importance of using family education and intervention programs to prevent and treat trauma-related dissociative symptoms, but further investigation is needed.
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Affiliation(s)
- Cherry T Y Cheung
- School of Professional Education and Executive Development, The Hong Kong Polytechnic University, Hong Kong
| | | | - Vincent Wan Ping Lee
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kyle Langjie He
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Po Fok Lam, Hong Kong
| | - Kunhua Lee
- Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu, Taiwan
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas, USA
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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McCollum DC, Teeters JB, Moskal KR, Woodward MJ. Does Social Support Moderate the Association between Adverse Childhood Experiences and Substance-Related Problems? Subst Use Misuse 2023; 59:269-277. [PMID: 37853713 DOI: 10.1080/10826084.2023.2269570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Background: More than half of individuals in the United States have had adverse childhood experiences (ACEs), which can result in physical and mental distress. ACEs has been linked with greater likelihood of harmful alcohol and drug use. Research has found that protective factors, such as social support, may potentially buffer against harmful substance use engagement among those who have experienced ACEs. The purpose of this study was to examine associations between perceived social support, ACEs, and alcohol and cannabis-related problems. Moreover, this study aimed to examine if specific domains of perceived social support (family, friends, and significant other) moderated the relationship between ACEs and alcohol and cannabis-related problems. Method: Validated measures of ACEs, perceived social support, and alcohol and cannabis problems were collected in a sample of 401 emerging adults via Prolific Academic (an online data collection platform). Results: Overall perceived social support and domains such as perceived family and friend social support moderated the relationship between ACEs and alcohol-related problems but not ACEs and cannabis-related problems. The association between ACEs and alcohol-related problems was strongest at low levels of perceived family and friend social support. Perceived social support was not associated with cannabis-related problems. Conclusions: Lack of social support is a potential risk factor for alcohol-related problems among emerging adults. Bolstering perceived social support from family and friends among those who have experienced ACEs may be beneficial in intervention and treatment efforts aiming to reduce harmful substance use in this population.
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Affiliation(s)
- Diamonde C McCollum
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Jenni B Teeters
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Katie R Moskal
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Matthew J Woodward
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
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Epstein R, Bock SD, Drew MJ, Scandalis Z. Infantilization across the life span: A large-scale internet study suggests that emotional abuse is especially damaging. MOTIVATION AND EMOTION 2022. [DOI: 10.1007/s11031-022-09989-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractWhen competent adults are treated like children, negative outcomes sometimes follow. We used a concurrent study design to conduct an internet-based study to determine how infantilization varies by demographic category and which types of infantilization might be most harmful. The test, which measured 15 types of infantilization, was taken by 32,118 people (mean age 27.6) from 153 countries (most from the United States). Test scores were correlated with self-reported happiness, depression, anger, sense of control, and personal and professional success, and regression analyses consistently showed that of the 15 types of infantilization we measured, emotional abuse was by far the best predictor of adverse outcomes. Infantilization was highest during the teen years and decreased gradually throughout adulthood. Effects were found for gender, education, and sexual orientation, with vulnerable groups more subject to infantilization. Our data, collected between 2011 and 2020, appear to parallel recent increases in authoritarianism and intolerance, with total infantilization scores increasing by 30.1% over this period.
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Hemingway A, Sullivan K. Reducing the incidence of domestic violence: An observational study of an equine-assisted intervention. FAMILY PROCESS 2022; 61:549-570. [PMID: 35355260 PMCID: PMC9310829 DOI: 10.1111/famp.12768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 06/14/2023]
Abstract
This paper is presenting results from an observational study which has measured the impact of an equine-assisted education (EAE) intervention on the future occurrence of domestic violence within the family over 1 year following completion of the intervention as part of the troubled families program. The data analyzed were collected by the local authority troubled family's team from the different agencies involved including crime, health, and social care data. The data were analyzed and compared across four groups, those families on the troubled families program who had a key worker with a member or members who had attended and completed the equine-assisted intervention (n = 268); those families who were on the troubled families program but no support had been offered (n = 10,569), those families who were on the program and were being supported by a key worker only (n = 2119), and those families on the program who were being supported by a key worker and had received further support, not from the equine-assisted intervention (N = 1119). Significant reductions in domestic violence and child in need status were found for those families who had a member or members attend and complete the equine-assisted intervention under study. Those families referred to the equine-assisted intervention also had significantly more complex needs than those in the other groups. Referrals to this intervention are normally for those families for whom talk-based interventions such as parenting, or education-based interventions are not working.
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Affiliation(s)
- Ann Hemingway
- Department of Medical Science & Public HealthBournemouth UniversityBournemouthUK
| | - Kezia Sullivan
- Department of Medical Science & Public HealthBournemouth UniversityBournemouthUK
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Moreno-Manso JM, García-Baamonde ME, de la Rosa Murillo M, Blázquez-Alonso M, Guerrero-Barona E, García-Gómez A. Differences in Executive Functions in Minors Suffering Physical Abuse and Neglect. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP2588-NP2604. [PMID: 32713236 DOI: 10.1177/0886260520944528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This research analyzes the executive functions in minors between 7 and 16 years of age who have suffered physical abuse and neglect, as well as minors in residential care centers with other measures of protection. Most studies focus on the neurobiological consequences of the abuse, and mainly at an early age. However, there are very few studies that analyze the executive functions of victims of child abuse, while also taking into account the type of abuse suffered. This study aims to identify whether the consequences of child abuse for the executive functions are different for those minors who have been victims of physical abuse and neglect, in comparison with minors with other protective measures. The participants were 44 minors who had suffered child abuse and 24 minors with other protective measures, distinct from abuse. Three neuropsychological tests were used: (a) the Five Digits Test (FDT), (b) the Behavioral Assessment of the Dysexecutive Syndrome in Children (BADS-C), and (c) the Wechsler Intelligence Scale for Children-V (WISC-V). The results showed difficulties in those minors who had been victim of physical abuse and neglect, in their cognitive flexibility capabilities, inhibitory control, the ability to take decisions, the ability to organize and plan their behavior, control of emotions, and attention control. It was the minors who were victims of physical neglect that showed the greatest difficulties in their executive functions. The results of the study will permit us to design an educational intervention in the residential care centers that can encourage advances in the affected areas through the setting up of different strategies to favor the stimulation, reinforcement, and rehabilitation of the executive functions.
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Sun L, Canevello A, Lewis KA, Li J, Crocker J. Childhood Emotional Maltreatment and Romantic Relationships: The Role of Compassionate Goals. Front Psychol 2021; 12:723126. [PMID: 34912264 PMCID: PMC8666543 DOI: 10.3389/fpsyg.2021.723126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022] Open
Abstract
Past research indicates that childhood emotional maltreatment (CEM) undermines the quality of adult romantic relationships by fostering negative characteristics in survivors. Two longitudinal studies investigated the hypothesis that decreased compassionate goals toward partners over time explain the association between CEM and declining relationship quality. In Study 1, CEM predicted decreased compassionate goals over time, which in turn predicted decreased relationship quality in individuals in romantic relationships. Study 2 replicated this effect in romantically involved couples and showed that partners' high compassionate goals attenuated the decline in compassionate goals associated with reported CEM. These results point to the importance of examining how CEM may affect positive relationship processes and the protective roles of partners' compassionate goals.
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Affiliation(s)
- Lining Sun
- Department of Psychology, National University of Singapore, Singapore, Singapore
- Department of Psychology, The Ohio State University, Columbus, OH, United States
| | - Amy Canevello
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States
| | - Kathrine A. Lewis
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Jiqiang Li
- Department of Psychology, The Ohio State University, Columbus, OH, United States
| | - Jennifer Crocker
- Department of Psychology, The Ohio State University, Columbus, OH, United States
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9
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Krinner LM, Warren-Findlow J, Bowling J, Issel LM, Reeve CL. The dimensionality of adverse childhood experiences: A scoping review of ACE dimensions measurement. CHILD ABUSE & NEGLECT 2021; 121:105270. [PMID: 34419902 DOI: 10.1016/j.chiabu.2021.105270] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/21/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Despite extensive research, the concept of adverse childhood experiences (ACEs) is not fully developed and there is low agreement on how the concept should be defined and measured. The purpose of this study was to 1) identify different conceptual dimensions associated with ACEs, such as timing or frequency; and 2) determine how these dimensions have been operationalized and analyzed to this point, in order to advance the conceptual understanding of ACEs. METHODS We conducted a scoping review of empirical journal articles on ACEs published after the original ACE-Study in 1998 to summarize the use of dimensions for the 10 conventional ACE domains. We used a PRISMA methodology to identify articles that assessed at least two of the 10 conventional ACE domains and at least two ACE dimensions. A standardized data extraction spreadsheet was used to record basic article information and specifics on ACE domains and dimensions. RESULTS Of 15,417 initial search results, 61 articles met all selection criteria. We identified four primary dimensions used for most ACE domains: frequency, timing, perception, and the role of the perpetrator. Additionally, we found several secondary and domain-specific dimensions, which relate to the intensity of the adverse event. DISCUSSION We identified the most commonly used ACE dimensions, but these lack standardized phrasing of items and response options. The inclusion of ACE dimensions may increase the accuracy of the association between ACEs and health outcomes and provide for more tailored treatment plans for people who have experienced ACEs. Future research should include a more comprehensive list of ACE domains and aim to develop a clearly articulated, standardized approach to assessing and analyzing ACE dimensions.
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Affiliation(s)
- Lisa M Krinner
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America.
| | - Jan Warren-Findlow
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America.
| | - Jessamyn Bowling
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America.
| | - L Michele Issel
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America.
| | - Charlie L Reeve
- Department of Psychological Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, United States of America.
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Peraica T, Kovačić Petrović Z, Blažev M, Blažev D, Kozarić-Kovačić D. Sociodemographic Factors in Combat Compensation Seekers for Delayed-Onset PTSD. Mil Med 2021; 187:464-472. [PMID: 34226924 DOI: 10.1093/milmed/usab273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/07/2021] [Accepted: 06/24/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Sociodemographic factors can sometimes be more contributory in relation to war-related stress-induced disorder treatment and compensation-seeking than health-related factors. However, their impact is often overlooked. This study explores a relationship between sociodemographic factors and diagnoses of combat-related stress-induced disorders in combat compensation seekers for delayed-onset PTSD (DOPTSD). MATERIALS AND METHODS Between June 2002 and August 2004, at the Regional Centre for Psychotrauma Zagreb, University Hospital Dubrava, the expert team evaluated subjects to diagnose DOPTSD and other comorbid illnesses. The study included 831 war veterans who experienced combat stress during the 1991-1995 Croatian war. They were subjects of psychiatric treatments before applying for compensation. The researchers derived results from data collected during the expert evaluation for compensation seeking, which included a structured diagnostic procedure. The diagnostic procedure included structured clinical interviews that also provided sociodemographic (age, sex, education, employment, marital status, number of children, and place of residence) and other data (heredity, medical history of physical and mental disorders, history of social functioning, combat-related and post-traumatic experiences, symptoms, their duration, intensity, and treatment). After the interview, the Clinical Global Impression Scale, the Clinician-Administrated PTSD Scale, and the Mississippi Scale for Combat-Related PTSD were applied. Final diagnoses of a lifetime or current PTSD and stress-related disorders according to the ICD-10 were established after fulfilling psychiatric and psychometric criteria. Multiple logistic regression determined independent contributions of sociodemographic characteristics (e.g., age, gender, education, employment and marital status, and parental status), war (duty duration and physical disabilities from combat injuries), and post-war experiences (outpatient treatment duration and the number of hospitalizations) in predicting compensation eligibility. RESULTS Better-educated combat compensation seekers were 2.23 times more likely to have eligible psychiatric diagnoses. Furthermore, married veterans were 2.22 times more likely to have eligible diagnoses than single compensation seekers. Likewise, hospitalization status was a risk factor concerning post-war experiences for eligible psychiatric diagnoses. CONCLUSION Marriage and higher education are accounted for longer DOPTSD in the group of combat compensation seekers with diagnoses eligible for compensation as a protective factor. A higher number of hospitalizations was also predictive because of more severe PTSD symptomatology as a risk factor. Higher education, marriage, and the higher number of the hospitalizations contributing to war-related DOPTSD diagnoses eligible for compensation.
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Affiliation(s)
- Tina Peraica
- Department of Psychiatry, Referral Center for Stress-related Disorders of the Ministry of Health, University Hospital Dubrava, Zagreb 10000, Croatia.,University Department for Forensic Sciences, University of Split, Split 21000, Croatia
| | - Zrnka Kovačić Petrović
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia.,University Psychiatric Hospital Vrapče, Zagreb 10000, Croatia
| | - Mirta Blažev
- Ivo Pilar Institute of Social Sciences, Zagreb 10000, Croatia
| | - Divna Blažev
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb 10000, Croatia
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Moreno-Manso JM, García-Baamonde ME, Guerrero-Barona E, Godoy-Merino MJ, Guerrero-Molina M, Barbosa-Torres C. Externalizing and internalizing symptoms and coping strategies in young victims of abuse. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01996-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractThis research analyses the internalizing and externalizing symptoms and the coping strategies of young victims of abuse. These young people are in residential care under protective measures due to abuse. The participants were 61 youths (32 male and 29 female) between 12 and 17 years of age. Different works of research stress the need for an early identification of the psychopathological symptomatology that these adolescents may present in order to provide an adequate psycho-educational intervention. The relationship between the adolescents’ psychopathological symptomatology and the coping strategies and styles they use to resolve problems is studied. It is also analyzed whether internalizing and externalizing problems predict the style and coping strategies of adolescents. Two tests were used: 1. Child and Adolescent Evaluation System (SENA); 2. Adolescent Coping Scales (ACS). The results indicate that young victims of abuse have internalizing and externalizing symptoms. These adolescents are characterized by an unproductive coping style, as well as by the use of coping strategies that are not very functional and ineffective for resolving conflicts. The psychopathological symptomatology is related to and predicts an unproductive coping style, badly adapted to solving daily problems (worrying, blaming oneself, not coping, ignoring the problem, or keeping it to oneself). This research has allowed us to identify the presence of several areas of vulnerability in these young persons which could be playing an important role in their psychosocial maladjustment. The research suggests the design of intervention strategies, for both groups and individuals, aimed at mitigating and modifying the sources of the problems in victims of child abuse.
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12
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Dai H, Xu S, Han J, Li Z, Cao J, Hu T, Li H, Wei J, Dou X, Zhou F, Zheng J. Prevalence and factors associated with anxiety and depressive symptoms among patients hospitalized with hematological malignancies after chimeric antigen receptor T-cell (CAR-T) therapy: A cross-sectional study. J Affect Disord 2021; 286:33-39. [PMID: 33676261 DOI: 10.1016/j.jad.2021.02.041] [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] [Received: 11/07/2020] [Revised: 02/07/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND We conducted a survey to investigate the prevalence and factors associated with anxiety and depressive symptoms among patients hospitalized with hematological malignancies after chimeric antigen receptor T-cell (CAR-T) therapy. METHODS In total, 130 eligible patients completed the Self-Rating Anxiety Scale and Self-Rating Depression Scale at week 4 after CAR-T cell infusion. We collected sociodemographic information during the same period. We studied factors associated with anxiety and depressive symptoms using logistic regression analysis. RESULTS The prevalence of anxiety and depressive symptoms at week 4 after infusion were 13.8% and 40.0%, respectively. A cutoff value of 50 or above indicates significantly anxiety and depressive symptoms. Binary logistic regression analysis showed that high school education and above (OR = 0.22, 95% CI = 0.06-0.78) and middle age (OR = 0.16, 95% CI = 0.03-0.90) were associated with lower risk of anxiety symptoms, and increased odds of depressive symptoms was associated with old age (OR = 11.39, 95% CI = 2.50-51.88), non-manual occupations before illness (OR = 3.72, 95% CI = 1.20-11.58), and higher healthcare expenditure (OR = 3.93, 95% CI = 1.50-10.33), while lower risk of depressive symptoms was associated with rural household location (OR = 0.25, 95% CI = 0.08-0.76) and being cared for by spouse (OR = 0.12, 95% CI = 0.02-0.63). CONCLUSIONS Patients receiving CAR-T therapy with lower education background, old ages, urban household location, or who used to work as non-manual workers require more attention and psychological care. Support from a spouse and medical expense deductions from the government may help patients develop positive attitudes.
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Affiliation(s)
- Hongyuan Dai
- School of Nursing, Xuzhou Medical University, Jiangsu, China
| | - Shuya Xu
- School of Nursing, Xuzhou Medical University, Jiangsu, China; Intensive care unit, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jing Han
- School of Nursing, Xuzhou Medical University, Jiangsu, China
| | - Zhenyu Li
- Department of hematology, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jiang Cao
- Department of hematology, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Tingyu Hu
- Department of hematology, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Hongxia Li
- Department of hematology, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Jing Wei
- Department of hematology, the Affiliated Hospital of Xuzhou Medical University, Jiangsu, China
| | - Xue Dou
- School of Nursing, Xuzhou Medical University, Jiangsu, China
| | - Fang Zhou
- School of Nursing, Xuzhou Medical University, Jiangsu, China.
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Vaillancourt-Morel MP, Byers ES, Péloquin K, Bergeron S. A Dyadic Longitudinal Study of Child Maltreatment and Sexual Well-Being in Adult Couples: The Buffering Effect of a Satisfying Relationship. JOURNAL OF SEX RESEARCH 2021; 58:248-260. [PMID: 32703046 DOI: 10.1080/00224499.2020.1792396] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study examined the contribution of child maltreatment (CM) to trajectories of couples' sexual well-being, and whether relationship satisfaction moderates these associations. Using a sample of 269 mixed-sex couples followed over one year, dyadic latent growth curve models showed both actor and partner effects. In terms of actor effects, women's emotional neglect was associated with lower initial levels of sexual satisfaction, and most types of women's CM were related to a sharper decrease over time in sexual satisfaction. Men and women's emotional abuse and neglect, and women's sexual abuse, were associated with lower initial levels of sexual function. Men and women's emotional neglect and women's emotional abuse were related to higher initial levels of sexual distress. Women's sexual abuse was associated with a steeper increase in sexual distress. In terms of partner effects, women's emotional neglect was associated with lower initial levels of partner sexual satisfaction, and women's emotional abuse and neglect, with lower initial levels of partner sexual function. Greater relationship satisfaction buffered some of these negative effects. Given that sexual well-being requires a context in which the individual feels safe, all forms of CM may affect sexual well-being, although a satisfying relationship may buffer some of these effects.
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14
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Moreno-Manso JM, García-Baamonde ME, Guerrero-Barona E, Godoy-Merino MJ, Bueso-Izquierdo N, Guerrero-Molina M. Emotional, Behavioural and Executive Functioning Problems in Children in Residential Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3596. [PMID: 32443869 PMCID: PMC7277212 DOI: 10.3390/ijerph17103596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 11/16/2022]
Abstract
This research analyses the emotional and behavioural problems, as well as the problems in the executive functions, of children in residential care under protective measures, between 8 and 12 years of age. We analyse the relationship between the problems with their executive functions and their emotional and behavioural problems, as well as the predictive value of the executive functions for the said emotional and behavioural problems. The instruments used were as follows: five digits test (FDT), behavioural assessment of the dysexecutive syndrome in children (BADS-C) and the system of evaluation for children and adolescents (SENA). The results indicate that the children have difficulties in their executive functions, with such problems as in attention control and regulation, impulsiveness, mental rigidity, behavioural organisation and planning and resolving problems. They also have internalising and externalising problems, as well as difficulties in controlling their emotional reactions and understanding the emotions of others. It becomes evident that the difficulties in their executive functions are related to and predict their emotional and behavioural problems. The research demonstrates the need to intervene in the problems detected through the design of therapeutic programmes and interventions in the residential context.
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Affiliation(s)
- Juan Manuel Moreno-Manso
- Department of Psychology, University of Extremadura, 06006 Badajoz, Spain; (M.E.G.-B.); (E.G.-B.); (N.B.-I.); (M.G.-M.)
| | - María Elena García-Baamonde
- Department of Psychology, University of Extremadura, 06006 Badajoz, Spain; (M.E.G.-B.); (E.G.-B.); (N.B.-I.); (M.G.-M.)
| | - Eloísa Guerrero-Barona
- Department of Psychology, University of Extremadura, 06006 Badajoz, Spain; (M.E.G.-B.); (E.G.-B.); (N.B.-I.); (M.G.-M.)
| | | | - Natalia Bueso-Izquierdo
- Department of Psychology, University of Extremadura, 06006 Badajoz, Spain; (M.E.G.-B.); (E.G.-B.); (N.B.-I.); (M.G.-M.)
| | - Mónica Guerrero-Molina
- Department of Psychology, University of Extremadura, 06006 Badajoz, Spain; (M.E.G.-B.); (E.G.-B.); (N.B.-I.); (M.G.-M.)
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Vaillancourt-Morel MP, Bergeron S, Blais M, Hébert M. Longitudinal Associations Between Childhood Sexual Abuse, Silencing the Self, and Sexual Self-Efficacy in Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:2125-2135. [PMID: 31300978 DOI: 10.1007/s10508-019-01494-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 06/10/2023]
Abstract
Sexual self-efficacy-the belief in one's ability to engage in desired and to refuse unwanted, sexual activities and behaviors-is an important feature in promoting adolescent sexual health and well-being. One factor that may affect the development of sexual self-efficacy is child sexual abuse. However, little is known about the processes underlying the relation between child sexual abuse and sexual self-efficacy. Using longitudinal data from a sample of 739 adolescent girls and boys aged between 14 and 18 years, we examined the mediational role of two "silencing the self" attitudes and behaviors in romantic relationships-self-silencing, i.e., inhibiting fulfilling one's own needs, and divided self, i.e., presenting an outer compliant self-in the associations between child sexual abuse severity and two dimensions of sexual self-efficacy: the ability to set clear sexual limits and the ability to use sexual protection. Results of path analysis showed that child sexual abuse severity was associated with more self-silencing and more divided self. In turn, self-silencing was associated with lower protection use self-efficacy, whereas divided self was associated with lower limit-setting and protection use self-efficacy. Thus, self-silencing strategies in romantic relationships mediated the associations between child sexual abuse severity and lower sexual self-efficacy. The overall findings may inform the development of prevention/intervention programs that target the enhancement of an integrated sense of self in intimate relationships to promote assertive strategies in sexual situations.
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Affiliation(s)
- Marie-Pier Vaillancourt-Morel
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.
| | - Sophie Bergeron
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - Martin Blais
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Martine Hébert
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
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Caravaca-Sánchez F, Fearn NE, Vidovic KR, Vaughn MG. Female Prisoners in Spain: Adverse Childhood Experiences, Negative Emotional States, and Social Support. HEALTH & SOCIAL WORK 2019; 44:157-166. [PMID: 31353392 DOI: 10.1093/hsw/hlz013] [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] [Received: 11/11/2018] [Revised: 02/07/2019] [Accepted: 02/26/2019] [Indexed: 06/10/2023]
Abstract
A growing body of literature on correctional populations from the past two decades indicates that a significant proportion of prison inmates report experiencing adverse childhood experiences (ACEs) during childhood. Extant literature also suggests that women suffer disproportionate victimization at all life stages. The current study examines the prevalence and magnitude of the associations between ACEs, social support, and negative emotional states (that is, anxiety, depression, and stress) among a sample of incarcerated women-a small but growing correctional population. Data were obtained from a survey of women incarcerated in two prisons in Spain (N = 174); survey questions elicited information on these women's emotional, physical, and sexual victimization during childhood in addition to their self-reported levels of social support and mental health. A series of analyses indicated that female inmates who reported ACEs similarly reported lower levels of social support and higher levels of depression, anxiety, and stress as compared with nonvictimized women inmates. The findings reported here underscore the importance of attaining a fuller understanding of female inmates' histories of ACEs so that we can more accurately identify and, ideally, provide necessary services to those women at highest risk of mental health-related problems during incarceration.
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Affiliation(s)
- Francisco Caravaca-Sánchez
- Department of Social Work and Social Services, Pablo de Olavide University, Ctra. de Utrera, 1, Sevilla, Sevilla 41013, Spain
| | - Noelle E Fearn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University
| | - Kristina R Vidovic
- School of Social Work, College for Public Health and Social Justice, Saint Louis University
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, and Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
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de Montigny Gauthier L, Vaillancourt-Morel MP, Rellini A, Godbout N, Charbonneau-Lefebvre V, Desjardins F, Bergeron S. The risk of Telling: A Dyadic Perspective on Romantic Partners' Responses to Child Sexual Abuse Disclosure and Their Associations with Sexual and Relationship Satisfaction. JOURNAL OF MARITAL AND FAMILY THERAPY 2019; 45:480-493. [PMID: 30006975 DOI: 10.1111/jmft.12345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Among 70 community couples who reported childhood sexual abuse (CSA) and disclosure to their partner, this study examined associations between survivors' perception of partner responses to their disclosure, and both partners' sexual and relationship satisfaction. Participants completed self-report questionnaires online. Results of path analyses within an actor-partner interdependence model indicated that survivors' perceived partner responses of emotional support to disclosure were associated with their own and their partners' higher sexual satisfaction. Survivors' perceived responses of being stigmatized/treated differently by the partner were associated with their own and their partners' poorer relationship satisfaction. Findings suggest that survivor-perceived partner responses to the disclosure of CSA can have a positive and a negative impact on the sexual and relationship satisfaction of both partners.
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Di Napoli I, Procentese F, Carnevale S, Esposito C, Arcidiacono C. Ending Intimate Partner Violence (IPV) and Locating Men at Stake: An Ecological Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1652. [PMID: 31083608 PMCID: PMC6539536 DOI: 10.3390/ijerph16091652] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 11/17/2022]
Abstract
Interventions for ending intimate partner violence (IPV) have not usually provided integrated approaches. Legal and social policies have the duty to protect, assist and empower women and to bring offenders to justice. Men have mainly been considered in their role as perpetrators to be subjected to judicial measures, while child witnesses of violence have not been viewed as a direct target for services. Currently, there is a need for an integrated and holistic theoretical and operational model to understand IPV as gender-based violence and to intervene with the goal of ending the fragmentation of existing measures. The EU project ViDaCS-Violent Dads in Child Shoes-which worked towards the deconstruction and reconstruction of violence's effects on child witnesses, has given us the opportunity to collect the opinions of social workers and child witnesses regarding violence. Therefore, the article describes measures to deal with IPV, proposing functional connections among different services and specific preventative initiatives. Subsequently, this study will examine intimate partner violence and provide special consideration to interventions at the individual, relational, organizational and community levels. The final goal will be to present a short set of guidelines that take into account the four levels considered by operationalizing the aforementioned ecological principles.
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Affiliation(s)
- Immacolata Di Napoli
- Department of Humanities Università degli Studi di Napoli Federico II, Naples 80133, Italy.
| | - Fortuna Procentese
- Department of Humanities Università degli Studi di Napoli Federico II, Naples 80133, Italy.
| | - Stefania Carnevale
- Department of Humanities Università degli Studi di Napoli Federico II, Naples 80133, Italy.
| | - Ciro Esposito
- Department of Humanities Università degli Studi di Napoli Federico II, Naples 80133, Italy.
| | - Caterina Arcidiacono
- Department of Humanities Università degli Studi di Napoli Federico II, Naples 80133, Italy.
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Mishra AA, Christ SL, Schwab-Reese LM, Nair N. Post-traumatic stress symptom development as a function of changing witnessing in-home violence and changing peer relationship quality: Evaluating protective effects of peer relationship quality. CHILD ABUSE & NEGLECT 2018; 81:332-342. [PMID: 29793148 DOI: 10.1016/j.chiabu.2018.05.013] [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] [Received: 12/26/2017] [Revised: 05/05/2018] [Accepted: 05/13/2018] [Indexed: 06/08/2023]
Abstract
In the present study, witnessing in-home violence and peer relationship quality are evaluated as to their relative impact on Post Traumatic Stress (PTS) symptoms among children aged 8 to 17 investigated by child protective services (CPS) for maltreatment exposure. The sample included 2151 children from the National Survey of Child and Adolescent Well-Being II (NSCAW II). Linear growth models were estimated to assess associations between changes in PTS symptoms, witnessing in-home violence, and peer relationship quality over time. Greater frequency of witnessing in-home violence at baseline (i.e. wave 1) was associated with higher baseline PTS symptoms (β = 0.44). Increases in witnessing in-home violence frequency over time (average annual change across three years) had a strong association with increases in PTS symptoms over time (β = 0.88). Baseline peer relationship quality was associated with fewer PTS symptoms at baseline (β = -0.45). Increases in peer relationship quality over time were strongly associated with declines in PTS symptoms over time (β = -0.68). Peer relationship quality at baseline did not moderate baseline or over time associations between witnessing in-home violence and PTS symptoms. The average decline in PTS symptoms due to decreases in witnessing in-home violence and increases in peer relationship quality was 0.51 and 0.65 standard deviations respectively, over the three-year study period. Reducing chronic witnessing in-home violence and promoting the development of healthy social relationships with peers are critical for PTS symptom recovery.
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Affiliation(s)
- Aura A Mishra
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA; Public Health Graduate Program, Purdue University, West Lafayette, IN, USA.
| | - Sharon L Christ
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA; Department of Statistics, Purdue University, West Lafayette, IN, USA
| | - Laura M Schwab-Reese
- Department of Health & Kinesiology, Purdue University, West Lafayette, IN, USA; Public Health Graduate Program, Purdue University, West Lafayette, IN, USA
| | - Nayantara Nair
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA
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Nguyen TP, Karney BR, Bradbury TN. Childhood abuse and later marital outcomes: Do partner characteristics moderate the association? JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2017; 31:82-92. [PMID: 27064351 PMCID: PMC5064817 DOI: 10.1037/fam0000208] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Although people with a history of child abuse are known to be at elevated risk for later difficulties in relationships, there is debate over whether these effects are enduring and relatively immutable or are moderated by characteristics and behaviors of the partner. To reconcile these competing perspectives, we conducted a longitudinal study of 414 newlywed couples living in low-income neighborhoods, testing whether the association between abuse history and relationship satisfaction is dependent on the partners' aggression, depression, substance abuse, observed communication, and other demographic risk factors. Spouses who had been abused as children (25% of husbands, 31% of wives) reported more symptoms of depression and substance abuse and, among husbands, displayed more negative communication. Spouses with a history of child abuse were also less satisfied with their marriage, even as newlyweds; abused wives also declined in satisfaction over time compared to those without this history. However, interactions between abuse history and all of the proposed moderators were not significant, indicating that partner and relationship characteristics failed to strengthen or weaken the association between abuse history and relationship satisfaction. Childhood experiences of abuse appear to have lasting and broad effects on individual and relational outcomes, and these effects are neither heightened nor mitigated by the partner's characteristics or behaviors. (PsycINFO Database Record
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DiLillo D, Jaffe AE, Watkins LE, Peugh J, Kras A, Campbell C. The Occurrence and Traumatic Impact of Sexual Revictimization in Newlywed Couples. COUPLE & FAMILY PSYCHOLOGY 2016; 5:212-225. [PMID: 28392971 PMCID: PMC5383208 DOI: 10.1037/cfp0000067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The present study examines whether individuals with a history of child sexual abuse are at risk of sexual revictimization in marriage and, if so, whether these experiences are associated with increased trauma symptomatology. Two hundred heterosexual newlywed couples were recruited from marriage license records and completed self-report assessments of past sexual victimization and sexual coercion within the marital dyad. Actor-Partner Interdependence Models revealed that, compared to non-victims, women with a history of child sexual abuse (CSA) experienced more acts of sexual coercion by their husbands during the past year. Moreover, there was a significant interaction between CSA and sexual coercion such that, among women who experienced CSA, the relationship between marital revictimization and trauma symptoms was stronger. Findings suggest that, for women but not men, sexual revictimization may occur in the context of a new marriage, and these experiences are associated with increased trauma symptoms. These findings have implications for understanding female survivors' perceptions of risk, and are particularly concerning given the high degree of personal and legal commitment involved in marriage.
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Affiliation(s)
| | | | | | - James Peugh
- Cincinnati Children's Hospital Medical Center
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Treatment of Intimate Partner Violence Perpetration Among Male Veterans: An Example of a Comprehensive Approach. CONTEMPORARY FAMILY THERAPY 2015. [DOI: 10.1007/s10591-015-9353-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Averill LA, Eubanks Fleming CJ, Holens PL, Larsen SE. Research on PTSD prevalence in OEF/OIF Veterans: expanding investigation of demographic variables. Eur J Psychotraumatol 2015; 6:27322. [PMID: 25971312 PMCID: PMC4430556 DOI: 10.3402/ejpt.v6.27322] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 03/30/2015] [Accepted: 04/01/2015] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND A series of recent articles has reported on well-designed studies examining base rates of posttraumatic stress disorder (PTSD) screenings within the Operation Enduring Freedom (Afghanistan conflict)/Operation Iraqi Freedom (Iraq conflict) (OEF/OIF) military population. Although these studies have a number of strengths, this line of research points out several key areas in need of further examination. OBJECTIVE Many OEF/OIF Veterans do not use available Veterans Affairs (VA) services, especially mental health care. This highlights the need to understand the differences between those who use and do not use the VA, especially as research with pre-OEF/OIF Veterans suggests that these two groups differ in significant ways. The high rates of PTSD-related concerns in non-VA users also points to a need to understand whether-and where-Veterans are seeking care outside the VA and the accessibility of evidence-based, trauma-focused treatments in the community and private sectors. Careful examination of relationship status is also paramount as little research has examined relationship status or other relationship context issues. Social support, especially from a spouse, can buffer the development of PTSD; however, relationship discord has the potential to greatly exacerbate PTSD symptomatology. Furthermore, given the additional risk factors for sexual minority Veterans to be exposed to trauma, the 2011 repeal of the US Military "Don't Ask, Don't Tell" policy, and the emergence of the VA as likely the largest health care provider for sexual minority Veterans, it will be critically important to study the trauma and mental health experiences of this group. CONCLUSIONS Studies that examine prevalence rates of PTSD in the returning cohort contribute significantly to our understanding of the US OEF/OIF military population. Further study of PTSD in relation to demographic variables such as VA and non-VA use, relationship status, and sexual orientation will provide rich data that will enhance our ability to develop policy and practice to provide the best care to this population.
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Affiliation(s)
- Lynnette A Averill
- Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA;
| | - C J Eubanks Fleming
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Pamela L Holens
- Department of Clinical Health Psychology, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Operational Stress Injury Clinic, Deer Lodge Centre, Winnipeg, MB, Canada
| | - Sadie E Larsen
- Psychology Service, Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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