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Wong NE, Hagan MJ, Holley SR. Childhood Maltreatment and Suicidal Thoughts and Behaviors in Young Adults. CRISIS 2024; 45:26-32. [PMID: 37337753 DOI: 10.1027/0227-5910/a000909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Background: Childhood maltreatment strongly predicts suicidality in young adulthood, which is increasingly common among Latina/o and Asian Americans. However, greater attention to modifiable explanatory factors is needed, particularly in ethnically minoritized populations. Aims: The current study evaluated whether the association between childhood maltreatment and suicidality may be accounted for by emotion regulation difficulties among a sample of young adults attending a large, minority-serving state university. Methods: Young adults (n = 853 participants; Mage = 22.43 years; 76.2% female) completed validated measures of suicidality, childhood maltreatment, depression, and emotion regulation difficulties. A multiple indirect effect analysis was conducted in a structural equation modeling framework. Results: Greater childhood maltreatment was associated with significantly greater emotion regulation difficulties across all six types and greater endorsement of overall suicidality. An indirect effect was found for limited access to regulation strategies only. Unexpectedly, lack of emotional awareness was associated with lower levels of ideation/attempts or threats of engaging in suicidal behavior. Limitations: The study was cross-sectional, precluding conclusions regarding causality. Conclusions: The findings suggest that, for individuals who have experienced childhood maltreatment, it is particularly important to address deficits in access to emotion regulation strategies to reduce the risk of suicidal ideation and behavior.
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Affiliation(s)
- Natalie E Wong
- Department of Psychology, San Francisco State University, CA, USA
| | - Melissa J Hagan
- Department of Psychology, San Francisco State University, CA, USA
| | - Sarah R Holley
- Department of Psychology, San Francisco State University, CA, USA
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2
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Measuring post-traumatic stress disorder and complex post-traumatic stress disorder using the International Trauma Questionnaire: results from a Hungarian clinical and non-clinical sample. Eur J Psychotraumatol 2023; 14:2152929. [PMID: 37052096 PMCID: PMC9793941 DOI: 10.1080/20008066.2022.2152929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: The 11th revision of the International Classification of Diseases (ICD-11) simplified the description of post-traumatic stress disorder (PTSD) and also introduced a new trauma-related diagnosis called complex post-traumatic stress disorder (CPTSD). CPTSD is linked to earlier, prolonged interpersonal trauma, and is characterized by a broader range of symptoms, in addition to the core PTSD symptoms. The International Trauma Questionnaire (ITQ) has been developed to assess the new diagnostic criteria.Objectives: The primary aim of our study was to test the factor structure of the ITQ in a clinical and a non-clinical Hungarian sample. We also examined whether the degree of traumatization or the type of trauma experienced was associated with meeting the criteria for PTSD or CPTSD, or with the severity of PTSD or disturbances in self-organization (DSO) symptoms, in both samples.Method: A trauma-exposed heterogeneous clinical sample (N = 176) and a non-clinical sample (N = 229) filled out the ITQ and a modified version of the Life Events Checklist (LEC-5). The factor structure of the ITQ was tested by examining the model fit of seven competing confirmatory factor analysis models.Results: A two-factor second-order model with a second-order PTSD factor (measured by three first-order factors) and a DSO factor (measured directly by six symptoms) had the best fit to the data in both samples if an error correlation was allowed between negative self-concept items. Those in the clinical group who reported more interpersonal and childhood trauma experienced more PTSD and DSO symptoms. Also, there were significant, positive, and weak associations between the total number of different traumas and PTSD and DSO factor scores in both samples.Conclusion: ITQ was found to be a reliable tool to differentiate between PTSD and CPTSD, two related but distinct constructs in a clinical and a non-clinical trauma-exposed sample in Hungary.
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Hicks TA, Bustamante D, Bountress KE, Adkins AE, Svikis DS, Gillespie NA, Dick DM, Amstadter AB. Is pre-college interpersonal trauma associated with cannabis use? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2645-2652. [PMID: 34586040 PMCID: PMC8960473 DOI: 10.1080/07448481.2021.1980399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/22/2021] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To examine the prevalence and correlates of lifetime cannabis use (i.e., experimental [use 1-5 times] and non-experimental [use ≥ 6 times]) in relation to interpersonal trauma (IPT) above and beyond relevant covariates. PARTICIPANTS A large (n = 9,889) representative sample of college students at an urban university in the southeastern part of the United States. METHODS Participants were 4 cohorts of first-year college students who completed measures of demographics, cannabis, alcohol, nicotine, and IPT. Associations were estimated using multinomial logistic regressions. RESULTS The prevalence of lifetime cannabis use was 28.1% and 17.4% for non-experimental and experimental cannabis use, respectively. IPT was significantly associated with experimental and non-experimental cannabis use above and beyond effects of sex, race, cohort, alcohol, and nicotine. CONCLUSIONS Results show that cannabis use is prevalent among college students and is associated with IPT above and beyond associations with sex, race, and other substance use.
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Affiliation(s)
- Terrell A Hicks
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Daniel Bustamante
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kaitlin E Bountress
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Amy E Adkins
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Dace S Svikis
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Danielle M Dick
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
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Bjørndal LD, Kendler KS, Reichborn-Kjennerud T, Ystrom E. Stressful life events increase the risk of major depressive episodes: A population-based twin study. Psychol Med 2023; 53:5194-5202. [PMID: 35920242 PMCID: PMC10476058 DOI: 10.1017/s0033291722002227] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Previous studies have found that stressful life events (SLEs) are associated with an increased risk of adult depression. However, many studies are observational in nature and limited by methodological issues, such as potential confounding by genetic factors. Genetically informative research, such as the co-twin control design, can strengthen causal inference in observational studies. Discrete-time survival analysis has several benefits and multilevel survival analysis can incorporate frailty terms (random effects) to estimate the components of the biometric model. In the current study, we investigated associations between SLEs and depression risk in a population-based twin sample (N = 2299). METHODS A co-twin control design was used to investigate the influence of the occurrence of SLEs on depression risk. The co-twin control design involves comparing patterns of associations in the full sample and within dizygotic (DZ) and monozygotic twins (MZ). Associations were modelled using discrete-time survival analysis with biometric frailty terms. Data from two time points were used in the analyses. Mean age at Wave 1 was 28 years and mean age at Wave 2 was 38 years. RESULTS SLE occurrence was associated with increased depression risk. Co-twin control analyses indicated that this association was at least in part due to the causal influence of SLE exposure on depression risk for event occurrence across all SLEs and for violent SLEs. A minor proportion of the total genetic risk of depression reflected genetic effects related to SLEs. CONCLUSIONS The results support previous research in implicating SLEs as important risk factors with probable causal influence on depression risk.
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Affiliation(s)
- Ludvig D. Bjørndal
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Kenneth S. Kendler
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eivind Ystrom
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- School of Pharmacy, University of Oslo, Oslo, Norway
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McGuire A, Huffhines L, Jackson Y. The trajectory of PTSD among youth in foster care: A survival analysis examining maltreatment experiences prior to entry into care. CHILD ABUSE & NEGLECT 2021; 115:105026. [PMID: 33721660 PMCID: PMC8052914 DOI: 10.1016/j.chiabu.2021.105026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 12/24/2020] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Youth in foster care are more likely than non-foster care youth to experience posttraumatic stress disorder (PTSD). While research has identified maltreatment as a risk factor for PTSD, this research remains limited because it tends to only (a) examine a single type or dimension of maltreatment and ignore the polyvictimization and heterogeneity in exposure, and (b) study this relation across a short period time or retrospectively at the end of care. OBJECTIVE The current study used survival analysis to simultaneously examine the influence of maltreatment characteristics on the risk of receiving a PTSD diagnosis at any time in care following entry into care. PARTICIPANTS/SETTING 291 youth (Mean age at entry = 9.71; 53 % female; 49 % Black) in foster care and their primary caregivers from a large, Midwestern county. METHODS Information on PTSD diagnosis was extracted from Medicaid records, and information on maltreatment and time in care was extracted from case files. Survival analysis was then used to determine the association between maltreatment and risk of PTSD diagnosis. RESULTS When examined independently, each dimension (frequency, severity) of the four maltreatment types was significantly associated with PTSD diagnosis risk (all hazard ratio's [HR] > 1.00), except sexual abuse frequency. In the comprehensive model with all dimensions examined simultaneously, only neglect frequency for youth entering care in adolescence (HR: 1.13[1.03-1.23]), and neglect severity (HR: 1.27[1.05-1.52]) and emotional abuse frequency (HR: 1.24[1.00-1.53]) for youth entering care pre-adolescence, were associated with PTSD diagnosis risk. Additionally, age of entry into care was associated with PTSD diagnosis risk (HR: 2.34[1.88-2.92]), as adolescents tended to spend fewer days in care before receiving a diagnosis. CONCLUSIONS Results suggest that researchers who study PTSD in youth in foster care should consider the entirety of youth's maltreatment exposure and the context of care to more accurately determine what aspects of youth's history contributes to receiving a PTSD diagnosis.
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Affiliation(s)
- Austen McGuire
- Clinical Child Psychology Program, University of Kansas, Dole Human Development Building, 1000 Sunnyside Avenue, Lawrence, KS, 66045, USA.
| | - Lindsay Huffhines
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02906, USA; Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, Providence, RI, USA
| | - Yo Jackson
- Department of Psychology, The Pennsylvania State University, University Park, PA, 16802, USA
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Traditional rural values and posttraumatic stress among rural and urban undergraduates. PLoS One 2020; 15:e0237578. [PMID: 32797104 PMCID: PMC7428187 DOI: 10.1371/journal.pone.0237578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 07/29/2020] [Indexed: 11/19/2022] Open
Abstract
Although rurality is often treated as an aspect of diversity, researchers disagree regarding whether the traditional rural values of self-reliance, distrust of outsiders, religiosity, centrality of family, and fatalism continue to differentiate rural versus urban undergraduates. The present study examined 1) whether differences in these values exist between rural and urban college students in the United States and 2) whether these rural values might mediate the association between geographic remoteness and posttraumatic stress symptom (PTSS) severity. College undergraduates in the United States who reported experiencing traumatic and/or stressful events (N = 213) completed measures of these constructs through an online survey. T-test results indicated that rural respondents had significantly higher levels of PTSS severity and distrust of outsiders and significantly lower levels of religiosity when compared with urban participants. After controlling for gender, distrust of outsiders and religiosity also emerged as significant mediators of the relationship between geographic remoteness and PTSS severity. Thus, despite research that highlights differences based on geographic location, similarities and differences exist for rural and urban undergraduates in the United States with regard to traditionally rural values. For rural undergraduate clients presenting with trauma symptoms, our results suggest that building trust and religious and/or spiritual self-care may be particularly critical.
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Friedmann F, Santangelo P, Ebner-Priemer U, Hill H, Neubauer AB, Rausch S, Steil R, Müller-Engelmann M, Kleindienst N, Bohus M, Fydrich T, Priebe K. Life within a limited radius: Investigating activity space in women with a history of child abuse using global positioning system tracking. PLoS One 2020; 15:e0232666. [PMID: 32392213 PMCID: PMC7213734 DOI: 10.1371/journal.pone.0232666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/20/2020] [Indexed: 02/07/2023] Open
Abstract
Early experiences of childhood sexual or physical abuse are often associated with functional impairments, reduced well-being and interpersonal problems in adulthood. Prior studies have addressed whether the traumatic experience itself or adult psychopathology is linked to these limitations. To approach this question, individuals with posttraumatic stress disorder (PTSD) and healthy individuals with and without a history of child abuse were investigated. We used global positioning system (GPS) tracking to study temporal and spatial limitations in the participants’ real-life activity space over the course of one week. The sample consisted of 228 female participants: 150 women with PTSD and emotional instability with a history of child abuse, 35 mentally healthy women with a history of child abuse (healthy trauma controls, HTC) and 43 mentally healthy women without any traumatic experiences in their past (healthy controls, HC). Both traumatized groups—i.e. the PTSD and the HTC group—had smaller movement radii than the HC group on the weekends, but neither spent significantly less time away from home than HC. Some differences between PTSD and HC in movement radius seem to be related to correlates of PTSD psychopathology, like depression and physical health. Yet group differences between HTC and HC in movement radius remained even when contextual and individual health variables were included in the model, indicating specific effects of traumatic experiences on activity space. Experiences of child abuse could limit activity space later in life, regardless of whether PTSD develops.
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Affiliation(s)
| | | | | | - Holger Hill
- Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Andreas B. Neubauer
- DIPF | Leibniz Institute for Research and Information in Education, Frankfurt, Germany
| | - Sophie Rausch
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Heidelberg University, Heidelberg, Germany
| | | | | | - Nikolaus Kleindienst
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Heidelberg University, Heidelberg, Germany
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Heidelberg University, Heidelberg, Germany
- McLean Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | - Kathlen Priebe
- Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité –Universitätsmedizin Berlin, Berlin, Germany
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8
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Boykin DM, Teng EJ. A proposal for augmenting the measurement of index events in PTSD assessment using event centrality .. ANXIETY STRESS AND COPING 2019; 32:559-567. [PMID: 31272207 DOI: 10.1080/10615806.2019.1638682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND: Standard practice in assessing and diagnosing posttraumatic stress disorder (PTSD) entails identifying a single "worst" index event as the basis for symptom inquiry. Determining a single event can be challenging for clinicians and clients when multiple traumas are considered equally distressing. Additionally, it can be difficult to distinguish potential index events based on distress given the cumulative effect of repeated trauma exposure. This calls for the development of approaches that build on existing selection methods (e.g., worst event method). OBJECTIVE/CONCLUSIONS: In this article, we propose an innovative approach for identifying and measuring index events that utilizes the construct of event centrality to expand the parameters by which index events are selected. Event centrality assesses the degree to which traumatic events are perceived as integral to one's personal identity and worldviews. Given its role in the etiology and maintenance of PTSD symptoms, this construct also approximates the emotional impact of trauma. Incorporating validated measures of event centrality into PTSD assessments would provide an objective strategy for identifying index events in a way that may increase the reliability of diagnosis. Our proposed strategy may also have a positive impact on the therapeutic process and treatment outcomes.
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Affiliation(s)
- Derrecka M Boykin
- a Michael E. DeBakey Veterans Affairs Medical Center , Houston , TX , USA.,b Department of Psychology, Northern Illinois University , DeKalb , IL , USA
| | - Ellen J Teng
- a Michael E. DeBakey Veterans Affairs Medical Center , Houston , TX , USA.,c Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine , Houston , TX , USA.,d South Central Mental Illness Research, Education, and Clinical Center , Houston , TX , USA.,e Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (CIN13-413) , Houston , USA
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9
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Owens GP, Held P, Hamrick L, Keller E. The indirect effects of emotion regulation on the association between attachment style, depression, and meaning made among undergraduates who experienced stressful events. MOTIVATION AND EMOTION 2018. [DOI: 10.1007/s11031-018-9688-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Jordan JR, McGann V. Clinical work with suicide loss survivors: Implications of the U.S. postvention guidelines. DEATH STUDIES 2017; 41:659-672. [PMID: 28557576 DOI: 10.1080/07481187.2017.1335553] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The loss of a loved one to suicide can present difficult challenges for suicide loss survivors (people bereaved by suicide) as well as for clinicians who would seek to help them. Building on the recommendations in the new document Responding to Grief, Trauma, and Distress after a Suicide: U.S. National Guidelines, this article provides an overview of clinical work with suicide loss survivors. It includes discussions of the common themes of suicide bereavement, the psychological tasks for integration of a suicide loss, and the options for providing grief therapy after a suicide. The article will be of value to caregivers who work with suicide loss survivors in counseling or therapeutic context.
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11
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Sandberg J, Gustafsson S, Holmqvist R. Interpersonally traumatised patients’ view of significant and corrective experiences in the psychotherapeutic relationship. EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING 2017. [DOI: 10.1080/13642537.2017.1313881] [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]
Affiliation(s)
- Jonatan Sandberg
- Faculty of Medicine and Health, University Health Care Research Center, University of Örebro, Örebro, Sweden
| | - Sanna Gustafsson
- Faculty of Medicine and Health, University Health Care Research Center, University of Örebro, Örebro, Sweden
| | - Rolf Holmqvist
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
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12
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Şar V. Parallel-Distinct Structures of Internal World and External Reality: Disavowing and Re-Claiming the Self-Identity in the Aftermath of Trauma-Generated Dissociation. Front Psychol 2017; 8:216. [PMID: 28261144 PMCID: PMC5313499 DOI: 10.3389/fpsyg.2017.00216] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 02/06/2017] [Indexed: 11/13/2022] Open
Abstract
The nature of consciousness and the autonomy of the individual's mind have been a focus of interest throughout the past century and inspired many theories and models. Revival of studies on psychological trauma and dissociation, which remained outside mainstream psychiatry, psychology, and psychoanalysis for the most part of the past century, has provided a new opportunity to revisit this intellectual and scientific endeavor. This paper attempts to integrate a series of empirical and theoretical studies on psychological consequences of developmental traumatization, which may yield further insight into factors which threaten the integrity of human consciousness. The paper proposes that an individual's experience of distorted reality and betrayal precipitates a cyclical dynamic between the individual and the external world by disrupting the developmental function of mutuality which is essential for maintenance of the integrity of the internal world while this inner world is in turn regulated vis-à-vis external reality. Dissociation -the common factor in all types of post-traumatic syndromes- is facilitated by violation of boundaries by relational omission and intrusion as represented by distinct effects and consequences of childhood neglect and abuse. Recent research conducted on clinical and non-clinical populations shows both bimodal (undermodulation and overmodulation) and bipolar (intrusion and avoidance) neurobiological and phenomenological characteristics of post-traumatic response. These seem to reflect "parallel-distinct structures" that control separate networks covering sensori-motor and cognitive-emotional systems. This understanding provides a conceptual framework to assist explanation of diverse post-traumatic mental trajectories which culminate in a common final pathway comprised of partly overlapping clinical syndromes such as complex PTSD, dissociative depression, dissociative identity disorder (DID), or "borderline" phenomena. Of crucial theoretical and clinical importance is that these maladaptive post-traumatic psychological formations are regarded as processes in their own right rather than as a personality disorder innate to the individual. Such mental division may perform in that internal detachment can serve to preserve the genuine aspects of the subject until such time as they can be reclaimed via psychotherapy. The paper attempts to integrate these ideas with reference to the previously proposed theory of the "Functional Dissociation of Self" (Şar and Öztürk, 2007).
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Affiliation(s)
- Vedat Şar
- Department of Psychiatry, Koc University School of Medicine (KUSOM)Istanbul, Turkey
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13
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Larsen SE, Pacella ML. Comparing the effect of DSM-congruent traumas vs. DSM-incongruent stressors on PTSD symptoms: A meta-analytic review. J Anxiety Disord 2016; 38:37-46. [PMID: 26803532 DOI: 10.1016/j.janxdis.2016.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 12/18/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
Abstract
Experts have long debated how to define the PTSD traumatic stressor criterion. Prior research demonstrates that PTSD symptoms (PTSS) sometimes stem from events that do not meet the DSM requirements for Criterion A (e.g., divorce, bereavement, illness). This meta-analysis of 22 studies examined whether PTSS differ for DSM-congruent criterion A1 traumatic events vs. DSM-incongruent events. The overall effect was significant, albeit small, suggesting that PTSS were greater for individuals who experienced a DSM-congruent event; heterogeneity analyses also indicated further exploration. Two significant moderators emerged: assessment of both A1 and A2 (vs. A1 alone) yielded a significant effect for higher PTSS following traumas vs. stressors. Likewise, self-report assessment of life threat (Criterion A1)-vs. rater or a priori assessment of A1-yielded a significant effect for higher PTSS following traumas. Our results indicate that higher levels of PTSS develop following traumas, and highlight important methodological moderators that may affect this relationship.
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Affiliation(s)
- Sadie E Larsen
- Clement J. Zablocki VA Medical Center, USA; Medical College of WI, USA.
| | - Maria L Pacella
- Center for AIDS Intervention Research, Medical College of WI, USA.
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14
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Huth-Bocks AC, Krause K, Ahlfs-Dunn S, Gallagher E, Scott S. Relational trauma and posttraumatic stress symptoms among pregnant women. Psychodyn Psychiatry 2014; 41:277-301. [PMID: 23713621 DOI: 10.1521/pdps.2013.41.2.277] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Women experience remarkably high rates of relational trauma including childhood abuse and neglect and intimate partner violence (IPV) during adulthood, and the childbearing years are no exception. The meaning of past and current relational trauma perpetrated by primary caregivers and significant others may be unique during pregnancy, in particular, because pregnancy is a salient time when mothers' important relationships are reworked and reorganized to "make room" for the relationship with the baby. The present study examined associations between different forms of relational trauma and posttraumatic stress symptoms in 120 women during the last trimester of pregnancy. Women were between the ages of 18 and 42 years and came from diverse economic and ethnic backgrounds. Results indicated that severity of childhood maltreatment was significantly related to severity of IPV during pregnancy, and both types of trauma made unique, significant contributions to posttraumatic stress symptoms. Furthermore, emotional/psychological violence had the largest associations with posttraumatic stress symptoms compared to other forms of violence. Findings indicate that it is critically important for clinicians working with pregnant women to conduct a thorough assessment of current and past relational trauma, including emotional/psychological trauma, in order to improve the well-being of the mother, the infant, and the mother-infant relationship.
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Affiliation(s)
- Alissa C Huth-Bocks
- Department of Psychology, Eastern Michigan University, Ypsilanti 48197, USA.
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15
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Affiliation(s)
- Philip J Kinsler
- a Geisel School of Medicine at Dartmouth , Hanover , New Hampshire , USA
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16
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Ford JD, Grasso DJ, Hawke J, Chapman JF. Poly-victimization among juvenile justice-involved youths. CHILD ABUSE & NEGLECT 2013; 37:788-800. [PMID: 23428165 DOI: 10.1016/j.chiabu.2013.01.005] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 01/15/2013] [Accepted: 01/16/2013] [Indexed: 05/21/2023]
Abstract
OBJECTIVES This study replicates and extends the research literature on poly-victimization with a vulnerable and under-served population, juvenile justice-involved youths. METHODS N=1959, 10-16 year old youths (76% male; 74% youth of color) consecutively newly admitted to juvenile detention facilities completed psychometric measures of trauma history, posttraumatic stress, affect regulation, alcohol/drug use, suicide risk, and somatic complaints. RESULTS Using latent class analysis derived from 19 types of adversity, three unique classes best fit the data. A poly-victim class (49% female, 51% youth of color) accounted for 5% of the sample and reported a mean of 11.4 (SD=1.1) types. A relatively moderate adversity class (31% female, 70% youth of color) accounted for 36% of the sample and reported a mean of 8.9 (SD=0.3) types of adversity and 2.65 (SD=1.1) types of traumatic adversity. A low adversity class (59% of the sample; 17% female, 78% youth of color) reported a mean of 7.4 (SD=0.4) adversity types but only 0.3 (SD=0.45) types of traumatic adversity. The relatively moderate adversity class was comparable to poly-victims in endorsing extensive non-victimization traumatic adversity (e.g., accidental and loss trauma), but poly-victims were distinct from both moderate and low adversity class members in the likelihood of reporting all but one type of traumatic victimization, multiple types of traumatic victimization, and severe emotional and behavioral problems. Girls were at particularly high risk of poly-victimization, and African American and White youths also were at risk for poly-victimization. CONCLUSIONS Although youth involved in the juvenile justice system typically have experienced substantial victimization, a poly-victimized sub-group, especially (but not exclusively) girls, warrants particular scientific, clinical, and rehabilitative attention in order to address the most severe behavioral and mental health problems and risks faced by this vulnerable population.
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Affiliation(s)
- Julian D Ford
- University of Connecticut Health Center, Department of Psychiatry, United States
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Affiliation(s)
- Jennifer J Freyd
- a Department of Psychology , University of Oregon , Eugene , Oregon , USA
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