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Lynch S, Weber S, Kaplan S, Craun E. Childhood and Adult Sexual Violence Exposures as Predictors of PTSD, Dissociation, and Substance Use in Women in Jail. JOURNAL OF CHILD SEXUAL ABUSE 2024; 33:424-440. [PMID: 37357921 DOI: 10.1080/10538712.2023.2226132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/29/2023] [Indexed: 06/27/2023]
Abstract
Women involved in the criminal legal system report high rates of interpersonal violence, particularly sexual violence, and mental health problems. Although existing research has linked experiences of interpersonal violence to multiple negative mental health outcomes, few researchers have examined concurrent psychopathology as an outcome of child and adult sexual violence in system-involved women. The purpose of this study was to examine child sexual abuse (CSA) and adult sexual violence, while controlling for other forms of interpersonal violence, as predictors of current symptoms of posttraumatic stress disorder (PSTD), substance use disorder (SUD), and dissociation in women in jail in the Mountain West. Randomly selected participants (N = 146) completed clinician-administered measures of trauma histories and mental health symptoms. The majority of the women (73%) reported experiences of CSA and about half reported experiences of adult sexual violence. Over half of the women reported symptoms consistent with current probable PTSD, about 20% reported dissociation symptoms in a clinical range, and over 70% met criteria for a SUD in the past year. The proposed model was tested with path analysis. CSA significantly predicted current symptoms of PTSD while adult sexual violence exposure predicted symptoms of SUD and dissociation. These results illustrate the high rates of sexual violence exposure as well as the complexity of mental health needs associated with these exposures in system-involved women. Findings highlight the need to comprehensively assess incarcerated women's trauma exposure and psychological distress to better meet the needs of this population.
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Affiliation(s)
| | | | - Stephanie Kaplan
- Idaho State University, Pocatello, ID, USA
- Idaho State University, Boston, Massachusetts, USA
| | - Elizabeth Craun
- Idaho State University, Pocatello, ID, USA
- Idaho State University, Murray, UT, USA
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2
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Sommer JL, Blaney C, Mota N, Bilevicius E, Beatie B, Kilborn K, Chang U, Sareen J, El-Gabalawy R. Dissociation as a Transdiagnostic Indicator of Self-Injurious Behavior and Suicide Attempts: A Focus on Posttraumatic Stress Disorder and Borderline Personality Disorder. J Trauma Stress 2021; 34:1149-1158. [PMID: 34426995 DOI: 10.1002/jts.22726] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 05/06/2021] [Accepted: 05/16/2021] [Indexed: 12/17/2022]
Abstract
Dissociative symptoms and suicidality are transdiagnostic features of posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD). The primary objective of this study was to examine associations between dissociation (i.e., depersonalization and derealization) and suicidality (i.e., self-harm and suicide attempts) among individuals with PTSD and BPD. We analyzed data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III; N = 36,309). The Alcohol Use Disorder and Associated Disabilities Interview Schedule for DSM-5 was used to assess lifetime PTSD and BPD. Estimated rates of self-harm among individuals who endorsed dissociation were 15.5%-26.2% for those with PTSD and 13.7%-23.5% for those with BPD, and estimates of suicide attempts among individuals who endorsed dissociation were 34.5%-38.1% for those with PTSD and 28.3%-33.1% for those with BPD. Multiple logistic regressions were conducted to examine the associations between dissociation (derealization, depersonalization, and both) and both self-harm and suicide attempts among respondents with PTSD and BPD. The results indicated that dissociation was associated with self-harm and suicide attempts, especially among individuals with BPD, aORs = 1.39-2.66; however, this association may be driven in part by a third variable, such as other symptoms of PTSD or BPD (e.g., mood disturbance, PTSD or BPD symptom severity). These results may inform risk assessments and targeted interventions for vulnerable individuals with PTSD, BPD, or both aimed at mitigating the risk of self-harm and suicide.
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Affiliation(s)
- Jordana L Sommer
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Anesthesiology, Perioperative, and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Caitlin Blaney
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Anesthesiology, Perioperative, and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Elena Bilevicius
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Brooke Beatie
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kayla Kilborn
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Unice Chang
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jitender Sareen
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Anesthesiology, Perioperative, and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
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3
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Serrano-Ibáñez ER, Ruiz-Párraga GT, Gómez-Pérez L, Ramírez-Maestre C, Esteve R, López-Martínez AE. The Relationship Between Experiential Avoidance and Posttraumatic Stress Symptoms: A Moderated Mediation Model Involving Dissociation, Guilt, and Gender. J Trauma Dissociation 2021; 22:304-318. [PMID: 33455542 DOI: 10.1080/15299732.2020.1869647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Experiential avoidance, dissociation, and guilt have been shown to be associated with trauma exposure and to play an important role in explaining the development and maintenance of posttraumatic stress symptoms. However, there is a lack of studies that simultaneously address the relationship between these variables, which has never been studied within the framework of emotional processing theory. Furthermore, gender differences in traumatic victimization, posttraumatic stress symptoms, experiential avoidance, dissociation, and guilt have also been reported. Therefore, this study had a double aim: a) to assess the mediating roles of dissociation and guilt in the relationship between experiential avoidance and posttraumatic stress symptoms; and b) to investigate whether gender moderates any such relationship. The final sample comprised 683 undergraduate students (150 men and 533 women) with a history of exposure to traumatic events and with posttraumatic stress symptoms. Mediation and moderated mediation analyses were conducted. Dissociation and guilt independently mediated the association between experiential avoidance and posttraumatic stress symptoms: however, this mediation effect was not moderated by gender. The findings suggest that interventions aimed at controlling psychological variables linked to PTSD (i.e. experiential avoidance, dissociation, and guilt) may be of help to both men and women.
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Affiliation(s)
- Elena R Serrano-Ibáñez
- Departamento de Psicología, Universidad Isabel I (Burgos, Spain), Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - Gema T Ruiz-Párraga
- Universidad de Málaga (Spain). Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - Lidia Gómez-Pérez
- Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - Carmen Ramírez-Maestre
- Universidad de Málaga (Spain). Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - Rosa Esteve
- Universidad de Málaga (Spain). Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
| | - Alicia E López-Martínez
- Universidad de Málaga (Spain). Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Málaga, Spain
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Salem BE, Hudson AL, Yadav K, Lucas J, Toyama J, Chen S, Faucette M, Ekstrand ML, Nyamathi AM. Correlates of Posttraumatic Stress Symptoms among Formerly Incarcerated, Homeless Women. Issues Ment Health Nurs 2020; 41:713-722. [PMID: 32400227 PMCID: PMC8428553 DOI: 10.1080/01612840.2020.1720050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Posttraumatic stress symptoms are a pressing issue among women experiencing incarceration and homelessness. Baseline data were collected among formerly incarcerated homeless women (N = 130) who were on average 38.9 (SD = 11.36, range 19-64) years of age and recruited into a pilot randomized control trial (RCT) intervention program. A logistic regression was used to assess correlates of PTSD symptoms. The majority of the sample self-reported witnessing violence (85%) and had moderate PTSD symptoms (M = 1.61, SD = 1.62, range: 0-4). No past month drug use (p = 0.006), higher anger scores (p = 0.002), greater emotional support (p = 0.009), and psychological frailty (p = 0.02) were significantly associated with higher odds of PTSD symptoms. Moreover, women who experienced minor family conflicts had lower odds of PTSD symptoms relative to those that had family conflicts most of the time (p = 0.02). Similarly, controlling for all other variables, women who had a higher positive social interaction score also had lower odds of PTSD symptoms (p = 0.006). These findings are a call to action for academicians, service providers, and health practitioners to develop an intervention which integrates comprehensive PTSD screening, and discussion of ways to build coping skills, relationships with family and social networks, and utilizes a trauma-informed approach during reentry.
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Affiliation(s)
- Benissa E Salem
- School of Nursing, University of California, Los Angeles, California, USA
| | - Angela L Hudson
- School of Nursing, Azusa Pacific University, Azusa, California, USA
| | - Kartik Yadav
- School of Nursing, University of California, Irvine, California, USA
| | - Jaemilyn Lucas
- School of Nursing, San Bernardino and College of the Desert, California State University, San Bernardino, California, USA
| | - Joy Toyama
- School of Nursing, University of California, Los Angeles, California, USA
| | - Stephanie Chen
- Los Angeles County Department of Health Services, Los Angeles, California, USA
| | - Mark Faucette
- Housing for Health/Office of Diversion and Reentry, Los Angeles County Department of Health Services, Los Angeles, California, USA
| | - Maria L Ekstrand
- San Francisco School of Medicine, University of California, San Francisco, California, USA
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