The association between social support and posttraumatic stress symptoms among survivors of betrayal trauma: a meta-analysis

Associations of caregiver-adolescent conflict and caregiver emotional support with adolescent trauma symptoms and adjustment after sexual abuse

BACKGROUND

Emotional support from a caregiver is believed to be important for reducing the likelihood of adolescent trauma symptoms and adjustment problems after sexual abuse. Conflict with a caregiver, another relational dynamic, is very common during adolescence, but little is known about how it might operate in tandem with emotional support to influence adolescent trauma symptoms and adjustment after sexual abuse.

OBJECTIVE

To better understand how caregiver emotional support and caregiver-adolescent conflict jointly contribute to adolescent trauma symptoms and adjustment after sexual abuse.

PARTICIPANTS AND SETTING

Participants were 477 adolescents (Mage = 13.59, SD = 1.77) and a non-offending caregiver presenting at a children's advocacy center.

METHODS

Adolescents completed measures of caregiver-adolescent conflict, caregiver emotional support, and their own trauma symptoms and adjustment. Caregivers completed a measure of adolescent adjustment.

RESULTS

Caregiver-adolescent conflict and caregiver emotional support each correlated in the expected direction with adolescent trauma symptoms and adjustment (conflict correlations ranged from 0.27 to 0.38, all p values ≤.001; support correlations ranged from -0.15 to -0.21, all p values ≤.01). Regression analyses, which simultaneously considered conflict and support, indicated that conflict related to adolescent trauma symptoms and each of the measures of adolescent adjustment, whereas caregiver emotional support contributed to caregiver reports of adolescent adjustment. Caregiver-adolescent conflict did not moderate any of the relations between caregiver emotional support and adolescent trauma symptoms or adjustment.

CONCLUSIONS

In the aftermath of sexual abuse, caregiver-adolescent conflict contributes to adolescent trauma symptoms and adjustment.

Childhood experiences and dissociation among high school students in China: Theoretical reexamination and clinical implications

BACKGROUND

Dissociation remains a controversial topic in terms of its prevalence, cross-cultural validity, and relationship with childhood trauma and adversities.

AIMS

This study investigated the prevalence of dissociative symptoms and probable dissociative disorders among Chinese high school students and tested the trauma model of dissociation.

METHODS

A total of N = 1,720 high school students completed standardized measures of positive and adverse childhood experiences (PCEs and ACEs), dissociation, depression, and anxiety.

RESULTS

The prevalence rates of dissociative symptoms and (probable) DSM-5 dissociative disorders (DDs) were 11.2% and 6.9%, respectively. Dissociation was a reliable construct (ICC = .682 to .752, p < .001) and was moderately correlated with general psychopathology (r = .424 with depressive symptoms, r = .423 with anxiety symptoms). Participants with a probable DD reported more ACEs, fewer PCEs, and more mental health symptoms than those without a probable DD. ACEs were significantly associated with dissociative symptoms (β = .107, p < .001) even after controlling for age, depressive, and anxiety symptoms. PCEs moderated the relationship between ACEs and dissociative symptoms.

CONCLUSIONS

This is the first report of the prevalence of dissociative symptoms and probable DSM-5 DDs among nonclinical children. We provide cross-cultural evidence that dissociation is a reliable and valid clinical phenomenon associated with psychopathology in children across cultures. The findings partly support the trauma model of dissociation. This study contributes to the limited literature on dissociation in children. It also offers empirical data to facilitate the ongoing controversy about (childhood) trauma and dissociation. Our findings imply that dissociation is cross-culturally associated with childhood adversities, but trauma is not the only, sufficient cause. Theoretical and clinical implications are discussed.

Associations between constructs related to social relationships and mental health conditions and symptoms: an umbrella review

BACKGROUND

Loneliness and social isolation are increasingly recognised as prevalent among people with mental health problems, and as potential targets for interventions to improve quality of life and outcomes, as well as for preventive strategies. Understanding the relationship between quality and quantity of social relationships and a range of mental health conditions is a helpful step towards development of such interventions.

PURPOSE

Our aim was to give an overview of associations between constructs related to social relationships (including loneliness and social isolation) and diagnosed mental conditions and mental health symptoms, as reported in systematic reviews of observational studies.

METHODS

For this umbrella review (systematic review of systematic reviews) we searched five databases (PsycINFO, MEDLINE, EMBASE, CINAHL, Web of Science) and relevant online resources (PROSPERO, Campbell Collaboration, Joanna Briggs Institute Evidence Synthesis Journal). We included systematic reviews of studies of associations between constructs related to social relationships and mental health diagnoses or psychiatric symptom severity, in clinical or general population samples. We also included reviews of general population studies investigating the relationship between loneliness and risk of onset of mental health problems.

RESULTS

We identified 53 relevant systematic reviews, including them in a narrative synthesis. We found evidence regarding associations between (i) loneliness, social isolation, social support, social network size and composition, and individual-level social capital and (ii) diagnoses of mental health conditions and severity of various mental health symptoms. Depression (including post-natal) and psychosis were most often reported on, with few systematic reviews on eating disorders or post-traumatic stress disorder (PTSD), and only four related to anxiety. Social support was the most commonly included social construct. Our findings were limited by low quality of reviews and their inclusion of mainly cross-sectional evidence.

CONCLUSION

Good quality evidence is needed on a wider range of social constructs, on conditions other than depression, and on longitudinal relationships between social constructs and mental health symptoms and conditions.

THE PAINS OF PARAMILITARISM: The Latent Criminogenic Effects of Exposure to Paramilitary Violence Among Young Men in a Post-Conflict Society

Purpose: Whilst most people who experience adversity recover, there is a cumulative body of evidence that illustrates that the effects can be long lasting, and can even become debilitating over time. Links have been made between traumatic distress, mental health disorders and disturbances in behavioural and emotional regulatory systems that may in context elevate the risk of offending. Despite the burgeoning evidence around the criminogenic effects of adversity, few studies have examined the traumatic effects of paramilitary related adversity in the context of post-conflict Northern Ireland. Methods: With reference to DSM-V PTSD diagnostic clusters, the aim of this study was to explore the latent impact of adversity and latent trauma among justice involved young men and identify potential criminogenic effects of exposure to paramilitary related adversity. Results and conclusions: This study found that across the sample, young men had self-reported to have experienced significant adversity, including violent victimisation. Exposure to paramilitary adversity often began during early adolescence. The participants described symptoms that were consistent with clinically diagnosable disorders such as Post-Traumatic Stress Disorder. Despite this, there appears to be a paucity of trauma screening and assessment, and few supports that victim could benefit from. In the absence of appropriate and evidence-based supports, many young men appear to find other (and more maladaptive) ways to cope. This exacerbates the risk of interfacing with the justice system and may even contribute towards a deterioration in wider psycho-social outcomes. Implications for practice are discussed.

Prevalence and Risk Factors of Post-Traumatic Stress Disorder in Survivors of a Cohort of Road Accident Victims in Benin: Results of a 12-Month Cross-Sectional Study

Purpose

Post-traumatic stress disorder (PTSD) is a frequent psychiatric complication in road accident survivors. However, it remains under-explored and is not taken into account in health policies in Benin. The purpose of this study was to determine the prevalence and risk factors of PTSD after a road traffic accident. This will help to improve its diagnosis and management in Benin hospitals.

Materials and Methods

An institution-based cross-sectional study was conducted from November 2020 to January 2021. Consenting victims of road traffic accidents from three hospitals across Benin, aged 18 years and above, living in the south of the country, were administered various questionnaires at 12-month follow-up. Data on PTSD were collected using a pre-tested, structured and standardized post-traumatic stress disorder questionnaire, the PTSD Checklist (specific version) (PCL-S). A logistic regression model was fitted to identify factors associated with PTSD. An adjusted odds ratio (AOR) followed by a 95% confidence interval was calculated to determine the level of significance with a p-value less than 0.05.

Results

Out of 865 patients in the cohort eligible for the 12-month follow-up, 734 (85%) participated in the study. The prevalence of PTSD was 26.43% (95% CI: 23.36–29.75). Factors associated with PTSD on multivariate analysis were female gender (adjusted odds ratio (AOR) = 2.14, 95% CI: 1.38–3.33), hospitalization (AOR = 1.87, 95% CI 1.21–2.89), negative impact of the accident on income (AOR = 4.22, 95% CI: 2.16–8.25), and no return to work (AOR = 3.17, 95% CI: 1.99–5.06).

Conclusion

The prevalence of PTSD is high in road accident survivors in Benin. The results of this study highlight the need for early diagnosis and a multidisciplinary approach to the management of PTSD patients in Benin’s hospitals.

No buffer effect of perceived social support for people exposed to violence during the COVID-19 pandemic: a cross-sectional community study

Background

The COVID-19 pandemic has represented a burden to communities worldwide. Research indicates that this burden is not equally distributed in the community, and vulnerable groups, such as violence-exposed individuals may pay a particularly high prize. Perceived social support is known to buffer against negative effects of trauma and adversity, but it is not clear whether this is the case during times of social restrictions and lockdowns. In this study, we tested if perceived social support could buffer the link between pandemic worry and psychological distress in a community sample and in the subgroup exposed to violence during the pandemic.

Methods

A stratified, presumed representative sample of the Norwegian population (N = 1,041, response rate = 39.9%) responded to a cross-sectional web survey in May 2020. Fifty-nine participants (5.7%) had been exposed to physical, sexual, and/or psychological violence during the last month.

Results

Current violence, pandemic worry, and perceived social support were independently associated with psychological distress. In the total sample, perceived social support moderated the relationship between pandemic worry and psychological distress. However, this was not found in individuals who were exposed to current violence.

Conclusions

Even though high levels of perceived social support can protect against psychological distress in the face of pandemic worry in the community, it seems that this resource is not as useful for individuals exposed to current violence. Outreach health and care services are warranted to support the needs of this particular vulnerable group.