Responding to victimized Alaska Native women in treatment for substance use

Trauma-informed Approaches to Substance Use Interventions with Indigenous Peoples: A Scoping Review

Indigenous Peoples experience disproportionately higher rates of problematic substance use. These problems are situated in a context of individual and intergenerational trauma from colonization, residential schools, and racist and discriminatory practices, policies, and services. Therefore, substance use interventions need to adopt a trauma-informed approach. We aimed to synthesize and report the current literature exploring the intersection of trauma and substance use interventions for Indigenous Peoples. Fourteen databases were searched using keywords for Indigenous Peoples, trauma, and substance use. Of the 1373 sources identified, 117 met inclusion criteria. Literature on trauma and substance use with Indigenous Peoples has increased in the last 5 years (2012-2016, n = 29; 2017-2021, n = 48), with most literature coming from the United States and Canada and focusing on historical or intergenerational trauma. Few articles focused on intersectional identities such as 2SLGBTQIA+ (n = 4), and none focused on veterans. There were limited sources (n = 25) that reported specific interventions at the intersection of trauma and substance use. These sources advocate for multi-faceted, trauma-informed, and culturally safe interventions for use with Indigenous Peoples. This scoping review illuminates gaps in the literature and highlights a need for research reporting on trauma-informed interventions for substance use with Indigenous Peoples.

Mental Pain and Suicidal Tendencies in Sexual and Physical Abuse Victims

We examine differential effects of mental pain and suicidal tendencies in female victims who have been sexually and physically abused, hypothesizing that sexual abuse victims report more mental pain and suicidal tendencies than physical abuse victims. A group of 98 women completed questionnaires that measured mental pain, suicidal tendencies and thoughts, and demographic details. Sexual abuse victims suffered more mental pain than physical abuse victims while the physical abuse victims demonstrated more repulsion by life than sexual abuse victims. Only sexual abuse victims demonstrated less attraction to life and only physical abuse victims showed more attraction to death.

Youth perspectives on sexually transmitted infections and sexual health in Northern Canada and implications for public health practice

OBJECTIVE

High rates of sexually transmitted infections in the Arctic have been a focus of recent research, and youth are believed to be at greatest risk of infection. Little research has focused on understanding youth perspectives on sexual health. The goal of this study was to collect the perspectives of youth in Nunavut on sexual health and relationships with the intent of informing public health practice.

METHOD

This qualitative research study was conducted within an Indigenous knowledge framework with a focus on Inuit ways of knowing. Data were collected through face-to-face interviews in three Nunavut communities with 17 youth between the ages of 14 and 19 years. Participants were asked open-ended questions about their experiences talking about sexual health and relationships with their family, peers, teachers or others in the community.

RESULTS

There are four key findings, which are important for public health: (a) Parents/caregivers are the preferred source of knowledge about sexual health and relationships among youth respondents; (b) youth did not report using the Internet for sexual health information; (c) youth related sexual decision-making to the broader community context and determinants of health, such as poverty; and (d) youth discussed sexual health in terms of desire and love, which is an aspect of sexual health often omitted from the discourse.

IMPLICATIONS AND CONTRIBUTION

The youth in this study articulated perspectives on sexual health, which are largely neglected in current public health practice in the North. The findings from this study underscore the important role of community-led participatory research in contributing to our understanding of the public health challenges in our communities today, and provide direction for future interventions and research.

Inuit parent perspectives on sexual health communication with adolescent children in Nunavut: "it's kinda hard for me to try to find the words"

BACKGROUND

For Inuit, the family unit has always played a central role in life and in survival. Social changes in Inuit communities have resulted in significant transformations to economic, political and cultural aspects of Inuit society. Where the family unit was once the setting for dialogue on family relations and sexuality, this has largely been replaced by teachings from the medical community and/or the school system.

OBJECTIVE

The purpose of this study was to explore Inuit parent perspectives on sharing knowledge with teenage children about sexual health and relationships.

METHOD

A qualitative Indigenous knowledge approach was used for this study with a focus on Inuit ways of knowing as described in the Piliriqattigiinniq Community Health Research Partnership Model. Interviews were conducted with 20 individual parents in 3 Nunavut communities in 2011. Parents were asked about whether and how they talk to their children about sexual health and relationships. An analytical approach building on the concept of Iqqaumaqatigiiniq ("all knowing coming into one"), which is similar to "immersion and crystallization," was used to identify story elements, groupings or themes in the data. The stories shared by parents are honoured, keeping their words intact as often as possible in the presentation of results.

RESULTS

Parents shared stories of themselves, family members and observations of the community. Fifteen of 17 mothers in the study reported having experienced sexual abuse as children or adolescents. Parents identified the challenges that they have and continue to experience as a result of forced settlement, family displacement and the transition of Inuit society. They expressed a desire to teach their children about sexual health and relationships and identified the need for emotional support to do this in the wake of the trauma they have experienced. Parents highly valued elders and the knowledge they have about family relationships and childrearing.

CONCLUSION

There are powerful, unresolved healing issues in Inuit communities. The traumatic experiences of the settlement and residential school era continue to have an impact on present-day family relationships. To support parent-child dialogue on sexual health and relationships, parents identified a need to repair relationships between youth and elders, and to provide culturally sensitive support to parents to heal from trauma.

Body image among victims of sexual and physical abuse

This study tries to understand the differences in body experience between victims of sexual abuse and physical abuse. Ninety-eight women completed questionnaires that measured personal information, body-image aberration, body sensitivity and control, and body investment. Findings indicated that victims of sexual abuse demonstrate less body maintenance and protection in addition to greater injury to body sensitivity and control than victims of physical abuse. Moreover, comparing victims of sexual abuse to physical abuse, findings revealed that only victims of sexual abuse report body-image aberrations. Thus, sexual and physical abuse should be addressed discretely because each has differential effects on bodily attitudes of victims.

Interpersonal violence in the lives of urban American Indian and Alaska Native women: implications for health, mental health, and help-seeking

OBJECTIVE

We surveyed American Indian/Alaska Native (AIAN) women in New York City to determine the prevalence of 3 types of interpersonal violence among urban AIAN women and the behavioral health and mental health factors associated with this violence.

METHODS

Using a survey, we questioned 112 adult AIAN women in New York City about their experiences with interpersonal violence, mental health, HIV risk behaviors, and help-seeking. The sampling plan utilized a multiple-wave approach with modified respondent-driven sampling, chain referral, and target sampling.

RESULTS

Among respondents, over 65% had experienced some form of interpersonal violence, of which 28% reported childhood physical abuse, 48% reported rape, 40% reported a history of domestic violence, and 40% reported multiple victimization experiences. Overwhelmingly, women experienced high levels of emotional trauma related to these events. A history of interpersonal violence was associated with depression, dysphoria, help-seeking behaviors, and an increase in high-HIV risk sexual behaviors.

CONCLUSIONS

AIAN women experience high rates of interpersonal violence and trauma that are associated with a host of health problems and have important implications for health and mental health professionals.