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Bhattacharya A, Casey EA. Help-Seeking Patterns Among Students Experiencing Sexual Harassment: A Latent Class Analysis. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:3543-3565. [PMID: 38415625 DOI: 10.1177/08862605241233269] [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: 02/29/2024]
Abstract
Sexual harassment continues to be a pervasive problem in institutes of higher education. Despite this, there are significant gaps in research and our understanding related to students' help-seeking associated with sexual harassment. Understanding students' help-seeking patterns is critical in improving and streamlining campus-wide resources. The following study uses a latent class analysis to examine whether unique patterns of help-seeking exist among students experiencing sexual harassment and whether there are meaningful differences between help-seeking groups with respect to incident characteristics, campus climate, and demographic profiles. Data used in this analysis are from an anonymous, web-based campus climate survey across a university system that included 7,318 undergraduate and 3,484 graduate students. Of these, 704 undergraduates and 229 graduate students reported experiencing sexual harassment. Our results indicated four help-seeking groups: Comprehensive help-seeking group (engaged in multiple types of formal and informal help-seeking), Informal help-seeking group (relied exclusively on friends as sources of support), Low help-seeking group (individuals in this group told virtually no one about their experience, including friends or family), and Unsure group (reached out to friends in large numbers but universally characterized themselves as not knowing what to do). Across classes, findings highlight significant differences related to incident characteristics (offender identity and incident location), student status, and racial identity. Our results point to the heterogeneity of patterns and responses in help-seeking for students experiencing sexual harassment. Variations in help-seeking across different classes highlight that students' perceptions and preferences for formal and informal support depend on their specific type. Our study is a reminder that survivors access support through diverse ways; understanding these distinct patterns in help-seeking behaviors based on specific subgroups will help universities tailor programs that better align with students' contextual needs and realities.
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Lee C, Park S, Lee J. Familial Abuse During Childhood and Later-Life Health: Exploring the Role of Victim-Perpetrator Relationships. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae065. [PMID: 38629850 DOI: 10.1093/geronb/gbae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Indexed: 06/09/2024] Open
Abstract
OBJECTIVES Childhood abuse has been extensively studied in relation to later-life health, yet relatively little attention has been given to understanding the nuanced dynamics across victim-perpetrator relationships. This study addresses this gap by identifying typologies of familial perpetrators of childhood abuse in a national sample and examining their associations with various health outcomes, including physical and mental health as well as substance abuse. METHODS We used 2 waves of data from the Midlife in the US Study (n = 6,295, mean age = 46.9 at baseline). The analysis was completed in 3 stages. Using Latent Class Analysis (LCA), we identified subpopulations of victims with distinct familial perpetrator histories. With assigned LCA memberships and propensity score weighting, we investigated the extent to which specific victim-perpetrator relationships are associated with health outcomes measured at baseline and a 10-year follow-up adjusting for other early-life risks. We evaluated whether the observed associations differ across the waves. RESULTS Parental and sibling abuse commonly co-occur, surpassing the occurrence of single perpetrators. Although minimal health disparities are evident between sibling-only abuse and no/little abuse groups at baseline, parent-only abuse is associated with compromised health outcomes. Severe abuse from both siblings and parents is linked to the most adverse health outcomes. At the follow-up survey, the associations between familiar abuse and health outcomes weakened, particularly for substance abuse. DISCUSSION This study, delving into family relationships, family violence, and health disparities, provides new evidence to augment our comprehension of the enduring link between childhood abuse and health within the family context.
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Affiliation(s)
- Chioun Lee
- Department of Sociology, University of California, Riverside, Riverside, California, USA
| | - Soojin Park
- School of Education, University of California, Riverside, Riverside, California, USA
| | - Juha Lee
- Department of Sociology, University of California, Riverside, Riverside, California, USA
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Nightingale SD, Cousineau S. Institutional Courage in the College Context: A Mixed-Methods Analysis of Campus Victim Advocate Perceptions and Experiences. Violence Against Women 2024:10778012241234893. [PMID: 38425275 DOI: 10.1177/10778012241234893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
How institutions of higher education respond to campus sexual assault impacts the well-being and academic success of student survivors. Researchers at the Center for Institutional Courage developed an 11-step framework for campuses to respond to sexual assault in a manner that minimizes harm. This mixed-methods study uses the framework to understand college victim advocate perceptions of campus response to sexual assault. Results from a national survey and four focus groups found that advocates identify courageous response efforts as strong relationships across campus units, availability of trauma-informed services, and when resources were available to meet students' direct needs. The critical role of leadership throughout the framework was also identified. Implications for policy and practice are discussed.
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Affiliation(s)
- Sarah D Nightingale
- Department of Sociology, Anthropology, Criminal Justice, and Social Work, Eastern Connecticut State University, Willimantic, CT, USA
| | - Shannon Cousineau
- Department of Social Work, University of North Carolina at Pembroke, Pembroke, NC, USA
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4
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Ford JD. Complex Trauma and Dissociation: Charting a Course Forward for the Journal and the Field. J Trauma Dissociation 2024; 25:145-152. [PMID: 38384168 DOI: 10.1080/15299732.2024.2307079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Affiliation(s)
- Julian D Ford
- Schools of Medicine and Law, University of Connecticut
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5
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Hall L, Gómez JM, Lichtenberg PA. Trust and betrayal in older adult financial exploitation. Aging Ment Health 2023; 27:2466-2473. [PMID: 37079000 PMCID: PMC10587358 DOI: 10.1080/13607863.2023.2199688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/29/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVES Although the knowledge base regarding the financial exploitation of older adults is expanding, work to understand the subpopulations of older adult financial exploitation victims and their experiences is greatly needed. This study uses betrayal trauma theory (BTT) as the foundation for conceptualizing the harm that arises from elder family financial exploitation. METHODS The study uses a cross-sectional design to investigate group differences among a total sample of 95 community-dwelling older adults, 32 of the participants (33.7%) were older adult victims of family financial exploitation and the remaining 63 (66.3%) were victims of financial exploitation perpetrated by strangers. RESULTS The group of older adults who were victims of elder family financial exploitation had significantly lower functional ability scores, higher stress and financial exploitation vulnerability scores and lost more money on average than those victimized by strangers. CONCLUSION The present study provides support that BTT provides a valuable framework for understanding why older adult family financial exploitation victims are more vulnerable than victims of exploitation committed by strangers. Attention to this subgroup of financially exploited older adults will provide improved understanding of the unique challenges these victims face and inform prevention and intervention services.
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Affiliation(s)
- LaToya Hall
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Jennifer M Gómez
- School of Social Work, Clinical Practice Department, and Center for Innovation in Social Work and Health (CISWH), Boston University, Boston, MA, USA
- Center for Institutional Courage, Palo Alto, CA, USA
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6
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Walsh C, Cunningham T. THE PAINS OF PARAMILITARISM: The Latent Criminogenic Effects of Exposure to Paramilitary Violence Among Young Men in a Post-Conflict Society. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:547-558. [PMID: 37593052 PMCID: PMC10427590 DOI: 10.1007/s40653-023-00516-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 08/19/2023]
Abstract
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.
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Affiliation(s)
- Colm Walsh
- Queen’s University Belfast, Belfast, United Kingdom
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Kaliush PR, Kerig PK, Raby KL, Maylott SE, Neff D, Speck B, Molina NC, Pappal AE, Parameswaran UD, Conradt E, Crowell SE. Examining implications of the developmental timing of maternal trauma for prenatal and newborn outcomes. Infant Behav Dev 2023; 72:101861. [PMID: 37399664 PMCID: PMC10528968 DOI: 10.1016/j.infbeh.2023.101861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/25/2023] [Accepted: 06/27/2023] [Indexed: 07/05/2023]
Abstract
Separate literatures have demonstrated that mothers' experiences with trauma during childhood or pregnancy are associated with maternal prenatal health risks, adverse childbirth outcomes, and offspring internalizing and externalizing disorders. These literatures largely align with the intergenerational transmission or fetal programming frameworks, respectively. However, few studies have tested the effects of maternal childhood and prenatal trauma simultaneously on mothers' and infants' health outcomes, and no studies have examined these effects on newborn neurobehavioral outcomes. Thus, in the present study, we examined how the developmental timing of pregnant women's traumatic life experiences associated with their physical health and psychopathology (Aim 1) as well as their newborns' birth and neurodevelopmental outcomes (Aim 2; for pre-registered aims and hypotheses, see https://osf.io/ygnre/?view_only=cbe17d0ac7f24af5a4d3e37e24eebead). One hundred and fifty-two 3rd trimester pregnant women (Mage = 29 years; 17.1% Hispanic/Latina) completed measures of trauma history and psychopathology. Then, 24-48 h after birth, trained clinicians conducted newborn neurobehavioral exams (n = 118 newborns; 52.6% female). Results indicated that lifetime traumatic experiences associated with multiple prenatal maternal health outcomes, including depression, anxiety, emotion dysregulation, and pregnancy complications. Pregnant women's experiences with childhood trauma, but not adulthood or prenatal trauma, predicted higher neurobehavioral attention scores among female newborns. Our discussion highlights the importance of considering the developmental timing of maternal trauma on perinatal outcomes and contextualizes our findings within the intergenerational transmission and fetal programming literatures. DATA AVAILABILITY: Data pertaining to R01MH119070 (MPIs Crowell & Conradt) and that support these findings are uploaded to the NIMH repository.
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Affiliation(s)
| | | | - K Lee Raby
- Department of Psychology, University of Utah, USA
| | | | - Dylan Neff
- Department of Psychology, University of Utah, USA
| | - Bailey Speck
- Department of Psychology, University of Utah, USA
| | | | | | | | - Elisabeth Conradt
- Department of Psychiatry and Behavioral Sciences, Duke University, USA
| | - Sheila E Crowell
- Department of Psychology, University of Utah, USA; Department of Obstetrics and Gynecology, University of Utah, USA; Department of Psychiatry, University of Utah, USA
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Kidwell MC, Kerig PK. To Trust is to Survive: Toward a Developmental Model of Moral Injury. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:459-475. [PMID: 37234829 PMCID: PMC10205960 DOI: 10.1007/s40653-021-00399-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 05/28/2023]
Abstract
Research on trauma- and stressor-related disorders has recently expanded to consider moral injury, or the harmful psychological impact of profound moral transgressions, betrayals, and acts of perpetration. Largely studied among military populations, this construct has rarely been empirically extended to children and adolescents despite its relevance in the early years, as well as youths' potentially heightened susceptibility to moral injury due to ongoing moral development and limited social resources relative to adults. Application of the construct to young persons, however, requires theoretical reconceptualization from a developmental perspective. The present paper brings together theory and research on developmentally-oriented constructs involving morally injurious events, including attachment trauma, betrayal trauma, and perpetration-induced traumatic stress, and describes how they may be integrated and extended to inform a developmentally-informed model of moral injury. Features of such a model include identification of potentially morally injurious events, maladaptive developmental meaning-making processes that underlie moral injury, as well as behavioral and emotional indicators of moral injury among youth. Thus, this review summarizes the currently available developmental literatures, identifies the major implications of each to a developmentally-informed construct of moral injury, and presents a conceptual developmental model of moral injury for children and adolescents to guide future empirical research.
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Affiliation(s)
- Mallory C. Kidwell
- Department of Psychology, University of Utah, 380 S 1530 E, Salt Lake City, UT 84112 USA
| | - Patricia K. Kerig
- Department of Psychology, University of Utah, 380 S 1530 E, Salt Lake City, UT 84112 USA
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PettyJohn ME, Kynn J, Anderson GK, McCauley HL. Secondary Institutional Betrayal: Implications for Observing Mistreatment of Sexual Assault Survivors Secondhand. JOURNAL OF INTERPERSONAL VIOLENCE 2023:8862605231171414. [PMID: 37129414 DOI: 10.1177/08862605231171414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Institutional betrayal has been used to describe the experiences of sexual assault survivors who are harmed by institutions which they rely on for safety or survival. This concept has primarily been studied in the context of survivors' direct relationships with institutions they are members of (e.g., universities, churches, military) and how the said institutions either failed to protect them or were unsupportive following their disclosure. Institutional betrayal can exacerbate negative mental and physical health outcomes for survivors, highlighting a need to hold institutions accountable for harm they cause. A limitation to this conceptualization is that many adults in the general public are not proximally connected to institutions (as they have historically been defined), and the majority of survivors do not formally report. Drawing on semi-structured interviews conducted with young women survivors (n = 12), the present study aims to address this gap by abstracting the conceptualization to a more macro level, proposing the term secondary institutional betrayal. Secondary institutional betrayal refers to survivors' feelings of mistrust and disillusionment toward institutions they are distally connected to which are not directly involved in their own assault (e.g., the media, U.S. government, U.S. criminal legal system, their university), yet still have influence over their personal safety and survival. This sense of betrayal stems from secondhand observations, through the news media, of how other survivors are treated by these institutions. Many survivors in the present study reported their secondhand observations of institutional betrayal would likely deter them from reporting future assaults. Establishing research in this area is important to understand how survivors in the general public are impacted by news stories which highlight institutional betrayal, particularly in the context of ongoing social movements (e.g., #MeToo) which amplify public discourse about sexual assault.
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Affiliation(s)
| | - Jax Kynn
- Michigan State University, East Lansing, MI, USA
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10
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Cohodes EM, McCauley S, Pierre JC, Hodges HR, Haberman JT, Santiuste I, Rogers MK, Wang J, Mandell JD, Gee DG. Development and validation of the Dimensional Inventory of Stress and Trauma Across the Lifespan (DISTAL): A novel assessment tool to facilitate the dimensional study of psychobiological sequelae of exposure to adversity. Dev Psychobiol 2023; 65:e22372. [PMID: 37073593 DOI: 10.1002/dev.22372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/16/2022] [Accepted: 01/04/2023] [Indexed: 04/20/2023]
Abstract
Decades of research underscore the profound impact of adversity on brain and behavioral development. Recent theoretical models have highlighted the importance of considering specific features of adversity that may have dissociable effects at distinct developmental timepoints. However, existing measures do not query these dimensions in sufficient detail to support the proliferation of this approach. The Dimensional Inventory of Stress and Trauma Across the Lifespan (DISTAL) was developed with the aim to thoroughly and retrospectively assess the timing, severity (of exposure and reaction), type, persons involved, controllability, predictability, threat, deprivation, proximity, betrayal, and discrimination inherent in an individual's exposure to adversity. Here, we introduce this instrument, present descriptive statistics drawn from a sample of N = 187 adults who completed the DISTAL, and provide initial information about its psychometric properties. This novel measure facilitates the expansion of research focused on assessing the relative impact of exposure to key dimensions of adversity on the brain and behavior across development.
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Affiliation(s)
- Emily M Cohodes
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sarah McCauley
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jasmyne C Pierre
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - H R Hodges
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jason T Haberman
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Isabel Santiuste
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Marisa K Rogers
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jenny Wang
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jeffrey D Mandell
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, Connecticut, USA
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Sosnowski DW, Rojo-Wissar DM, Smail EJ, Musci RJ, Wilcox HC, Johnson SB. Expanding on Threat and Deprivation: Empirical Examination of Adversity Dimensions and Psychiatric Outcomes Among Emerging Adults. EMERGING ADULTHOOD (PRINT) 2023; 11:431-443. [PMID: 36969950 PMCID: PMC10038124 DOI: 10.1177/21676968221114260] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Dimensional models of adversity, whereby experiences lie along dimensions of threat and deprivation, are increasingly popular; however, their empirical validation is limited. In a sample of emerging adults (N=1,662; M age =20.72; 53% female; 72% Black), we conducted exploratory factor analyses using adversities derived from items probing family relationships and a validated assessment of traumatic events. Resulting factors were used to test associations with odds of lifetime diagnosis of a substance use disorder, other mental health disorders, and suicide attempt. Results supported a four-factor solution: threat (non-betrayal), emotional deprivation, sexual assault, and threat (betrayal). Threat (betrayal) summary scores were most strongly associated with increased odds of substance use and other disorders, whereas sexual assault was most strongly associated increased odds of lifetime suicide attempt. Findings provide some empirical support for categorizing adversity along dimensions of threat and deprivation. However, it also suggests the possibility of further divisions within these dimensions.
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Affiliation(s)
- David W Sosnowski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | | | - Emily J Smail
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Rashelle J Musci
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Holly C Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Sara B Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
- Department of Pediatrics, School of Medicine, Johns Hopkins University
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12
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Yahalom J, Yarns BC, Clair K, Cloitre M, Lang AJ, Hamilton AB. Patient experiences and reported effectiveness of a multimodal short-term pilot therapy group for veteran men with military sexual trauma. J Clin Psychol 2022; 78:2410-2426. [PMID: 35332551 DOI: 10.1002/jclp.23353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/31/2022] [Accepted: 03/10/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Despite recognition of its prevalence and impact, little is known about treatment for veteran men with a history of military sexual trauma (MST). While research suggests that such veterans may suffer from gender-based distress that poses unique treatment challenges, MST-focused treatment draws upon contemporary PTSD best practices that may overlook gender. The current initial pilot study evaluated a multimodal, time-limited men's MST group therapy that integrated exposure- and mindfulness-based, psychoeducational, and psychodynamic group interventions. METHOD This study examined pre- and posttreatment data from patients who completed group treatment (n = 24). Three-fourths of patients were 60 years or older, over 80% Black, Indigenous, People of Color. Assessment data were collected using the PTSD Checklist (PCL-5), an adaptation of the Recovery Assessment Scale, and open-ended written responses. Paired-samples t tests and effect sizes (Hedge's g) were calculated. Indictive thematic analysis was used for qualitative analysis. RESULTS Qualitative and quantitative data showed improvements in shame, self-forgiveness, and belonginess. There were significant reductions from pre- to posttreatment in total PCL-5 score (g = -0.69) and all 4 symptom clusters (g = -0.51--0.71), and significant improvements in 8 out of 10 recovery items (g = 0.44-2.46). CONCLUSIONS More research is needed to assess whether veteran men with a history of MST benefit from treatment that provides multimodal, multitheoretical interventions that address gender-based symptoms in addition to PTSD. The results of this study support future research in a randomized controlled study.
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Affiliation(s)
- Jonathan Yahalom
- US Department of Veterans Affairs, Health Services Research & Development, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Brandon C Yarns
- US Department of Veterans Affairs, Health Services Research & Development, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Kimberly Clair
- US Department of Veterans Affairs, Health Services Research & Development, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Marylene Cloitre
- US Department of Veterans Affairs, National Center for PTSD Dissemination and Training Division, Palo Alto, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA
| | - Ariel J Lang
- US Department of Veterans Affairs, Center of Excellence for Stress and Mental Health, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, California, USA
| | - Alison B Hamilton
- US Department of Veterans Affairs, Health Services Research & Development, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
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Mazzarello O, Gagné ME, Langevin R. Risk Factors for Sexual Revictimization and Dating Violence in Young Adults with a History of Child Sexual Abuse. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:1113-1125. [PMID: 36439663 PMCID: PMC9684360 DOI: 10.1007/s40653-022-00462-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 06/16/2023]
Abstract
Interpersonal revictimization, through sexual violence and psychological or physical dating violence, is one of the many consequences of childhood sexual abuse (CSA). This study examined how childhood maltreatment, sociodemographic characteristics, mental health, relational factors, and community factors are associated with 1) sexual revictimization 2) psychological dating violence victimization, and 3) physical dating violence victimization in a sample of young adults reporting a history of CSA. A sample of 190 young adults (18-25 y.o.) with self-reported experiences of CSA completed an online survey measuring childhood maltreatment (e.g. neglect, physical abuse, witness to domestic violence), sociodemographic characteristics (e.g. material deprivation, education), mental health (dissociation, posttraumatic stress symptoms), relational factors (e.g. insecure attachment style), and community factors (e.g. neighborhood disadvantage). Hierarchical logistic regressions indicated that once all risk factors were entered in the models, PTSD was positively associated with psychological dating violence, while dissociation was positively associated with physical dating violence. Physical abuse in childhood was positively associated with sexual revictimization. The present study shows the importance of simultaneously considering the impact of multiple characteristics surrounding CSA survivors when evaluating risks of revictimization. Additionally, it highlights the importance of providing CSA survivors with adequate mental health support for trauma-related disorders, as it may be crucial to prevent revictimization.
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Affiliation(s)
| | - Marie-Emma Gagné
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Rachel Langevin
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
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Şar V. Dialectical Dynamic Therapy (DDT): Allowing Progressive Change Through the Subtle Repair of Master-Identity. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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15
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Maharaj R, Tineo K, Flores-Ortega M, Cordova DA, Iskhakova A, Linn R, Nikulina V. The association between COVID-19-related stressors and mental health outcomes for survivors of past interpersonal and non-interpersonal trauma. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022; 6:100300. [PMID: 37520402 PMCID: PMC9547392 DOI: 10.1016/j.ejtd.2022.100300] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/18/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022]
Abstract
The mental health difficulties of trauma survivors during the COVID-19 pandemic have been under-reported. This study explored the moderating role of trauma history and trauma type (interpersonal and non-interpersonal) in the association between COVID-19-related stressors and depression, anxiety, and stress. A sample of n = 321 participants ages 19 to 71 (M = 36.63, SD = 10.36) was recruited from across the United States through MTurk. Participants reported the number of COVID-19-related stressors, trauma history and psychological symptoms. Hierarchical multiple regression analyses, controlling for age, race, ethnicity, gender, education, and income levels, were used to determine (a) whether COVID-19-related stressors are associated with adverse mental health outcomes; (b) whether trauma history and (c) trauma type moderated this association. Results revealed significant interactions; for those with a trauma history, exposure to COVID-19-related stressors was associated with higher levels of depression (β = .21, p < .05) and anxiety (β = .19, p < .05). For those with a history of interpersonal trauma specifically, COVID-19-related stressors were associated with depression (β = .16, p < .05) more so than for those without a trauma history. These findings highlight the vulnerability of trauma survivors to the unprecedented COVID-19-related stress.
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Affiliation(s)
- Reena Maharaj
- Department of Psychology, Queens College, City University of New York, United States
| | - Katherine Tineo
- Department of Psychology, Queens College, City University of New York, United States
| | - Marisol Flores-Ortega
- Department of Psychology, Queens College, City University of New York, United States
| | - Diego A Cordova
- Department of Psychology, Queens College, City University of New York, United States
| | - Alexandra Iskhakova
- Department of Psychology, Queens College, City University of New York, United States
| | - Rose Linn
- Department of Psychology, Queens College, City University of New York, United States
| | - Valentina Nikulina
- Department of Psychology, Queens College, City University of New York, United States
- The Graduate Center, City University of New York, United States
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Brits B, Walker-Williams H, Fouché A. Experiences of Women Survivors of Childhood Sexual Abuse in Relation to Nonsupportive Significant Adults: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:1027-1047. [PMID: 33468018 DOI: 10.1177/1524838020985550] [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: 06/12/2023]
Abstract
Childhood sexual abuse (CSA) is a complex trauma with devastating long-term, negative effects on survivors. This study extended the understanding of experiences of women survivors of CSA in relation to nonsupportive significant adults documented in literature, as to date, there exists no summary in literature on this particular topic. As such, a scoping review was conducted on publications between 1980 and January 2020. A total of 26 733 were selected for analysis in accordance with the search terms. After duplicates were removed and the exclusion criteria were applied, a total of 58 articles were selected for inclusion in the review. Thematic analysis was conducted on the studies included, and three themes were developed pertaining to the experiences of women survivors of CSA in relation to nonsupportive significant adults. Theme 1 identified nonsupportive behaviors experienced before disclosure or discovery of abuse. Theme 2 identified nonsupportive behaviors experienced during or after disclosure or discovery of abuse. Theme 3 identified the long-term negative consequences of nonsupportive experiences. These three themes support the findings of Freyd's betrayal trauma theory and Bowlby's attachment theory, extend on the global knowledge base of this topic, and identify gaps for further exploration.
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Affiliation(s)
- Bianca Brits
- School of Psychosocial Health, Faculty of Health Sciences, 56405North-West University, Vanderbijlpark, South Africa
| | - Hayley Walker-Williams
- School of Psychosocial Health, Faculty of Health Sciences, 56405North-West University, Vanderbijlpark, South Africa
| | - Ansie Fouché
- School of Psychosocial Health, Faculty of Health Sciences, 56405North-West University, Vanderbijlpark, South Africa
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Yoon S, Yoon D, Latelle A, Kobulsky JM. The Interaction Effects Between Father-Child Relationship Quality and Parent-perpetrated Maltreatment on Adolescent Behavior Problems. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP15944-NP15969. [PMID: 34107809 DOI: 10.1177/08862605211021977] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Despite ample evidence supporting the positive and important role fathers play in youth well-being, currently little is known about the potential buffering effects of positive father-child relationships on adolescent behavioral functioning, especially within the context of child maltreatment. Clarifying whether positive parent-child relationships are helpful in the presence of maltreatment perpetrated by the same or another parent is critical for designing and implementing successful family-based interventions for positive youth development. Thus, the present study aimed to investigate the unique and combined effects of the perpetrator of child maltreatment (i.e., maltreatment perpetrated by fathers versus mothers alone) and father-child relationship quality on adolescent internalizing and externalizing problems. A series of Ordinary Least Squares multiple regressions were conducted on a sample of 14-year-old high-risk youth (N = 661) drawn from the Longitudinal Studies of Child Abuse and Neglect. The results indicated that both father-perpetrated maltreatment and mother-alone maltreatment were associated with higher levels of internalizing and externalizing problems. Higher quality of father-child relationships was associated with lower levels of internalizing but was not significantly associated with externalizing problems. Higher quality father-child relationships had a buffering impact against adolescent internalizing and externalizing problems when adolescents were maltreated by mothers alone. The findings suggest that policy and practical efforts seeking to build resilience of youth should strive to nurture and leverage positive, non-maltreating father-child relationships. Such efforts may support the positive development of adolescents, even in the face of mother-perpetrated maltreatment.
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Affiliation(s)
- Susan Yoon
- The Ohio State University, Columbus, OH, USA
| | - Dalhee Yoon
- Binghamton University- State University of New York, Binghamton, NY
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18
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Panisch LS, Rogers RG, Breen MT, Nutt S, Dahud S, Salazar CA. Childhood betrayal trauma, dissociation, and shame impact health-related quality of life among individuals with chronic pelvic pain. CHILD ABUSE & NEGLECT 2022; 131:105744. [PMID: 35749903 DOI: 10.1016/j.chiabu.2022.105744] [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: 02/22/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND High betrayal trauma (HBT), or interpersonal trauma perpetrated by someone close, is linked to dissociation and shame, while trauma perpetrated by someone less close, low betrayal trauma (LBT) is associated with post-traumatic stress disorder (PTSD). OBJECTIVE Child interpersonal trauma is common among women with chronic pelvic pain (CPP) and can negatively impact physical and mental health-related quality of life (HRQOL). Our study investigates unexplored connections between these variables. PARTICIPANTS & SETTING Survey data were analyzed from 96 English-speaking female patients with CPP at a women's health clinic (mean age = 33, 59 % White non-Hispanic, 62 % married or cohabitating, 61.5 % completed post-high school degree); prevalence of HBT and LBT were 65.2 % and 45.6 %, respectively. METHODS Multiple regression analyzed relationships between mental and physical HRQOL and dissociation, shame, and PTSD. Parallel mediation analyses examined indirect relationships between mental and physical HRQOL and exposure to childhood HBT and LBT. RESULTS Dissociation was related to worse physical HRQOL, while shame was related to worse physical and mental HRQOL. Dissociation and shame mediated relationships between childhood HBT and current mental (R2 = 0.08, p = .01) and physical (R2 = 0.11, p = .002) HRQOL. Shame, but not PTSD, mediated relationships between childhood LBT and current mental (R2 = 0.14, p < .001) and physical (R2 = 0.16, p < .001) HRQOL. CONCLUSIONS Our study provides preliminary evidence that dissociation and shame negatively impact HRQOL among individuals with CPP in the context of exposure to different types of childhood betrayal trauma. Replication studies to validate our results with larger samples and longitudinal designs are encouraged.
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Affiliation(s)
- Lisa S Panisch
- Wayne State University School of Social Work, 5447 Woodward Avenue, Detroit, MI 48202, United States of America.
| | - Rebecca G Rogers
- Department of Obstetrics and Gynecology, Albany Medical Center, 391 Myrtle Ave #2, Albany, NY 12208, United States of America
| | - Michael T Breen
- Department of Women's Health, University of Texas at Austin, 1601 Trinity Street, Bldg. A, 9th Floor, Austin, TX 78712, United States of America; Dell Medical School, University of Texas at Austin, 1501 Red River St, Austin, TX 78712, United States of America
| | - Stephanie Nutt
- Department of Women's Health, University of Texas at Austin, 1601 Trinity Street, Bldg. A, 9th Floor, Austin, TX 78712, United States of America
| | - Soraya Dahud
- Department of Women's Health, University of Texas at Austin, 1601 Trinity Street, Bldg. A, 9th Floor, Austin, TX 78712, United States of America
| | - Christina A Salazar
- Department of Women's Health, University of Texas at Austin, 1601 Trinity Street, Bldg. A, 9th Floor, Austin, TX 78712, United States of America; Dell Medical School, University of Texas at Austin, 1501 Red River St, Austin, TX 78712, United States of America
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19
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Simpson F, Haughton M, Van Gordon W. An Identity Process Theory Account of the Impact of Boarding School on Sense of Self and Mental Health: an Interpretative Phenomenological Analysis. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00503-4] [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: 10/22/2022] Open
Abstract
AbstractBoarding schools exist to provide education for children, but this involves the child leaving the family home and residing in an educational institution. Identity Process Theory suggests that such a change in circumstances can threaten the child’s identity, which triggers coping strategies and impacts on the individual’s self-concept during both childhood and adulthood. This study undertook an Interpretative Phenomenological Analysis of semi-structured interviews conducted with five adults who boarded as children. The focus was on exploring participants’ beliefs in terms of how the boarding experience affected their sense of self. Emerging themes relate to the (i) coping strategies used by participants during childhood, such as amnesia, compartmentalising, compliance and acceptance, and (ii) long-term effects of boarding on identity, self-concept and intimate relationships. Findings also highlight the interplay of factors such as privilege and social class, which were reported as motives for participants’ parents choosing boarding for their children. The study raises important questions about the long-term health impacts of sending children away to board.
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20
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Berardelli I, Sarubbi S, Rogante E, Erbuto D, Giuliani C, Lamis DA, Innamorati M, Pompili M. Association between Childhood Maltreatment and Suicidal Ideation: A Path Analysis Study. J Clin Med 2022; 11:jcm11082179. [PMID: 35456272 PMCID: PMC9027208 DOI: 10.3390/jcm11082179] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/23/2022] [Accepted: 04/05/2022] [Indexed: 02/04/2023] Open
Abstract
Epidemiological studies have suggested that childhood maltreatment increases suicidal ideation, and dissociative symptoms and hopelessness are involved in this relation. To better address this issue, we used a path analysis model to examine the role of different types of childhood maltreatment on suicidal ideation, investigating whether hopelessness and dissociative symptoms mediated this relation. A sample of 215 adult psychiatric inpatients was enrolled between January 2019 and January 2020, at the psychiatric unit of Sant’Andrea Medical Center in Rome, Italy. The Childhood Trauma Questionnaire (CTQ), Beck Hopelessness Scale (BHS), Dissociative Experiences Scale (DES-II), and Columbia-Suicide Severity Rating Scale (C-SSRS) were used to test the hypotheses. Results revealed that the presence of sexual abuse directly affected suicidal ideation (β = 0.18, SE = 0.8, p < 0.05), while emotional abuse and neglect indirectly increased suicidal ideation via dissociation (β = 0.05, SE = 0.02, 95% C.I. 0.01/0.09) and hopelessness (β = 0.10, SE = 0.03, 95% C.I. = 0.04/0.16). Professionals working with children should be aware of the long-term consequences of childhood maltreatment, particularly suicide risk. Furthermore, professionals working with adults should inquire about past childhood maltreatment.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy; (I.B.); (D.E.)
| | - Salvatore Sarubbi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy;
| | - Elena Rogante
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy;
| | - Denise Erbuto
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy; (I.B.); (D.E.)
| | - Carlotta Giuliani
- Psychiatry Residency Training Program, Psychiatry Unit, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Dorian A. Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30303, USA;
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy;
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy; (I.B.); (D.E.)
- Correspondence: ; Tel.: +39-063-377-5675; Fax: +39-063-377-5342
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21
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Kantor V, Verginer L, Glück TM, Knefel M, Lueger-Schuster B. Barriers and facilitators to accessing mental health services after child maltreatment in foster care: An Austrian survivors’ perspective. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2021.100228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Bogen KW, Haikalis M, Meza Lopez RJ, López G, Orchowski LM. It Happens in #ChurchToo: Twitter Discourse Regarding Sexual Victimization Within Religious Communities. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:1338-1366. [PMID: 32469670 DOI: 10.1177/0886260520922365] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study sought to characterize online disclosure of, and reactions to, sexual violence victimization via the Twitter hashtag #ChurchToo, which emerged following the hashtag #MeToo as a call for disclosure of victimization within religious contexts. Thematic content analysis of 1,017 original content, English-language tweets containing the hashtag was conducted. Twitter users who chose to disclose personal experiences of violence often shared specific details about their abuse and described institutional harm they experienced. Institutional harm included negative responses from their religious communities (e.g., minimizing, denying, blaming, and silencing). Among tweets categorized as responses to disclosure, subthemes included both positive (e.g., raising awareness, emotional support) and negative (e.g., distracting and egocentric) reactions. The commentary on Twitter reflected a concerted desire to establish accountability for perpetrators of interpersonal violence within religious communities. These data highlight the importance of providing education to religious communities on how to best support and respond to individuals who experience victimization perpetrated by religious leaders or another member of the religious community.
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Affiliation(s)
| | | | | | | | - Lindsay M Orchowski
- Rhode Island Hospital, Providence, USA
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
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23
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Berke DS, Carney JR, Lebowitz L. The Role of Anger in Traumatic Harm and Recovery for Sexual Violence Survivors. J Trauma Dissociation 2022; 23:24-36. [PMID: 34109890 DOI: 10.1080/15299732.2021.1934937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sexual violence is a strong predictor of posttraumatic stress disorder (PTSD). Sexual violence survivors presenting for PTSD treatment may experience and express a range of distressing emotions. An extensive body of research guides clinical conceptualization and targeting of fear responses in PTSD treatment. Models to guide clinicians in working with posttraumatic anger, in contrast, are scarce. To address this gap, we: 1) provide a review of the theoretical and empirical literature on sexual violence, anger, and trauma recovery among sexual violence survivors; 2) integrate this literature with social functionalist theories of anger; and 3) discuss implications of this integration for adaptively leveraging anger in psychological treatment.
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Affiliation(s)
- Danielle S Berke
- Department of Psychology, Hunter College of the City University of New York, USA.,Department of Psychology, The Graduate Center, City University of New York, USA
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24
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Granner JR, Seng JS. Using Theories of Posttraumatic Stress to Inform Perinatal Care Clinician Responses to Trauma Reactions. J Midwifery Womens Health 2021; 66:567-578. [PMID: 34612574 DOI: 10.1111/jmwh.13287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/26/2021] [Accepted: 07/12/2021] [Indexed: 11/28/2022]
Abstract
Understanding of the importance of addressing trauma in health care is increasing rapidly. Health care providers may be actively seeking ways to address trauma sequelae affecting their patients with a trauma-informed continuum of care. Such a continuum includes a universal approach, targeted interventions (ie, practices and programs), and specialist treatment for posttraumatic stress disorder (PTSD), as well as responses to historic and intergenerational trauma. Client presentations and their needs are highly individualized. Therefore, an understanding of prominent theories of what causes PTSD may assist perinatal care professionals in adapting their practice to be trauma-informed and trauma-specific. The purpose of this article is to review 4 theories of PTSD relevant to perinatal practice and present an evidence-based practice framework that encourages collaborative choices consistent with client values and preferences. A brief summary of current evidence-based PTSD treatment guidelines is presented.
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Affiliation(s)
| | - Julia S Seng
- School of Nursing, University of Michigan, Ann Arbor, Michigan
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25
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Şar V, Türk-Kurtça T. The Vicious Cycle of Traumatic Narcissism and Dissociative Depression Among Young Adults: A Trans-Diagnostic Approach. J Trauma Dissociation 2021; 22:502-521. [PMID: 33427111 DOI: 10.1080/15299732.2020.1869644] [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: 10/22/2022]
Abstract
This study was concerned with associations between narcissism, childhood trauma, dissociation, attachment styles, and depression among young adults. Childhood Trauma Questionnaire, Dissociative Experiences Scale (DES), Relationship Styles Questionnaire, Beck Depression Scale, and the Five-Factor Narcissism Questionnaire were administered to 422 college students. Multivariate analyses revealed that childhood sexual abuse, physical neglect, both fearful and secure attachment styles, dissociation, and male gender predicted grandiose narcissism. Vulnerable narcissism was predicted by preoccupied attachment, depression, and female gender. Dissociative taxon members (n = 133, 31.5%) had elevated scores on all childhood trauma types, fearful attachment, and both vulnerable and grandiose narcissism. While there was a link between bodily childhood maltreatment, dissociation, and grandiose narcissism, vulnerable narcissism was related to loss of perceived security in relationships and depression. Representing ambivalence and an indirect link between childhood trauma and vulnerable narcissism, depression was associated with both emotional neglect and overprotection-overcontrol, and fearful and preoccupied attachment. Depression and grandiose narcissism as co-predictors of pathological dissociation fitted the concept of "dissociative depression", which constituted an interface between two aspects of narcissism. Narcissism may be a trans-generational carrier of trauma as a fertile ground for dissociation. The escalation of dissociation among young adults in Turkey to an almost normative level may also be a consequence of the drastic transformations in the country throughout the period of globalism nurturing post-modern individualism in a conservative society. The trans-diagnostic overlap between two psychopathologies suggested that potential interference of concurrent dissociation needs to be considered in psychotherapy of narcissism and vice versa.
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Affiliation(s)
- Vedat Şar
- Department of Psychiatry, Koç University School of Medicine, Istanbul, Turkey
| | - Tuğba Türk-Kurtça
- Department of Guidance and Counseling, School of Education, Edirne, Turkey
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26
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Chana SM, Wolford-Clevenger C, Faust A, Hemberg J, Ramaswamy M, Cropsey K. Associations among betrayal trauma, dissociative posttraumatic stress symptoms, and substance use among women involved in the criminal legal system in three US cities. Drug Alcohol Depend 2021; 227:108924. [PMID: 34333280 PMCID: PMC8464486 DOI: 10.1016/j.drugalcdep.2021.108924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Betrayal trauma, as defined by (Freyd, 1996), refers to a subcategory of trauma characterized by a significant violation of trust surrounding interpersonal maltreatment (physical, sexual, or emotional). Previous research has shown that people with betrayal trauma histories experience greater dissociative symptoms of posttraumatic stress disorder and co-morbid substance use disorder symptoms. Women in the criminal legal system commonly have significant histories of betrayal trauma and related posttraumatic stress symptoms and substance use. However, no studies have specifically explored the impact of dissociative posttraumatic stress symptoms on substance use outcomes in this population. Additionally, no studies have explored whether betrayal trauma relates to nonfatal overdoses. METHODS This cross-sectional survey study of N = 508 women with criminal legal system involvement examined the indirect effects of betrayal trauma history on substance use outcomes through dissociative posttraumatic stress symptoms. RESULTS Multivariate analyses supported an indirect effect of betrayal trauma on substance use severity, daily substance use, and history of overdose, but not alcohol use severity, through dissociative symptoms. CONCLUSIONS Women in the criminal legal system with betrayal trauma and dissociative symptoms may be at risk for substance use and related outcomes (i.e., overdose). Future work is needed to examine whether targeting such symptoms may improve substance use treatment and prevention of serious outcomes in this population.
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Affiliation(s)
- Sofía Mildrum Chana
- Department of Psychiatry and Behavioral Neurobiology, Volker Hall L107, 1670 University Blvd., Birmingham, Alabama 35233 USA
| | - Caitlin Wolford-Clevenger
- Department of Psychiatry and Behavioral Neurobiology, Volker Hall L107, 1670 University Blvd., Birmingham, Alabama 35233 USA
| | - Alexandra Faust
- Department of Psychiatry and Behavioral Neurobiology, Volker Hall L107, 1670 University Blvd., Birmingham, Alabama 35233 USA
| | - Jordana Hemberg
- Community Health and Implementation Research Program, RTI International, 2150 Shattuck Avenue, Suite 800, Berkeley, California 94704 USA
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas School of Medicine, 3901 Rainbow Blvd, MS 1008, Kansas City, Kansas 66160
| | - Karen Cropsey
- Department of Psychiatry and Behavioral Neurobiology, Volker Hall L107, 1670 University Blvd., Birmingham, Alabama 35233 USA
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27
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Bertule M, Sebre SB, Kolesovs A. Childhood abuse experiences, depression and dissociation symptoms in relation to suicide attempts and suicidal ideation. J Trauma Dissociation 2021; 22:598-614. [PMID: 33427600 DOI: 10.1080/15299732.2020.1869652] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to examine associations between suicide attempts (SA), suicidal ideation (SI), depression, dissociative symptoms, emotional abuse, physical abuse and sexual abuse, and to explore predictors of SA and SI, as well as possible mediating factors. We also aimed to examine support for a dissociative depression subgroup. Participating in this study were 342 adults, of these were 138 respondents with a diagnosis of depression (DG), and 204 respondents comprising a community sample (CS). Respondents completed the Center for Epidemiologic Studies Depression Scale - Revised (CESD-R), Childhood Trauma Questionnaire - Short Form (CTQ-SF), and Dissociative Experience Scale (DES). All but two (DES-Absorption and DES - Depersonalization/Derealization) of the study variable mean scores were higher in the DG than in the CS group. Regression analysis showed that SA was predicted by sexual abuse and DES-Amnesia in the CS group. Structural equation modeling revealed that in both groups the types of abuse were reciprocally correlated, emotional abuse was linked to dissociation, which in turn was related to depression, which is turn was predictive of suicide ideation. Depression had a full mediating effect between dissociation and suicide ideation in the CS, and a partial mediating effect in the DG. Sexual abuse had a direct effect upon depression and suicide ideation in the DG. Cluster analysis provided support for a dissociative depression subtype.
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Affiliation(s)
- Marika Bertule
- Department of Psychology, University of Latvia, Riga, Latvia
| | - Sandra B Sebre
- Department of Psychology, University of Latvia, Riga, Latvia
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28
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Hughesdon KA, Ford JD, Briggs EC, Seng JS, Miller AL, Stoddard SA. Interpersonal Trauma Exposure and Interpersonal Problems in Adolescent Posttraumatic Stress Disorder. J Trauma Stress 2021; 34:733-743. [PMID: 34021624 DOI: 10.1002/jts.22687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 02/24/2021] [Accepted: 03/22/2021] [Indexed: 11/12/2022]
Abstract
Traumatic experiences have been differentiated as interpersonal (i.e., the direct result of actions by other people) or noninterpersonal (i.e., other life-threatening events, such as severe accidents). Interpersonal trauma exposure generally has been shown to be associated with more severe posttraumatic stress disorder (PTSD) symptoms than noninterpersonal trauma exposure. Interpersonal problems also tend to be associated with trauma exposure and PTSD symptoms, but it is unclear whether a mediating association exists between trauma type, interpersonal problems, and PTSD symptoms. A clinical sample of 4,275 adolescents (age range: 12-18 years) from the National Child Traumatic Stress Network Core Data Set were classified as having experienced interpersonal trauma, noninterpersonal trauma, or both. Interpersonal problems were operationalized by social problem behaviors (e.g., immature and dependent behaviors) and aggressive behaviors on the Child Behavior Checklist. The results of path analyses showed that cumulative interpersonal trauma exposure was both directly and indirectly associated with PTSD symptoms via social problem behaviors but not aggressive behaviors, total effect β = .20, 95% CI [.17, .23]. In a second model, path analyses showed that cumulative interpersonal trauma exposure was associated directly and indirectly via PTSD symptoms with social problem behaviors, total effect β = .15, 95% CI [.11, .18], and aggressive behaviors, total effect β = .13, 95% CI [.09, .17]. These findings suggest that during adolescence, interpersonal problems play an important role in the association between interpersonal trauma exposure and PTSD symptoms.
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Affiliation(s)
| | - Julian D Ford
- Department of Psychology, University of Connecticut, Farmington, Connecticut, USA
| | | | - Julia S Seng
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Alison L Miller
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sarah A Stoddard
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
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29
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Brown WJ, Hetzel-Riggin MD, Mitchell MA, Bruce SE. Rumination Mediates the Relationship Between Negative Affect and Posttraumatic Stress Disorder Symptoms in Female Interpersonal Trauma Survivors. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:6418-6439. [PMID: 30556467 DOI: 10.1177/0886260518818434] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Prior research has identified both rumination and negative affect (NA) as dimensional constructs related to the development and maintenance of posttraumatic stress disorder (PTSD). While both dimensions demonstrate significant positive relationships with symptoms of PTSD, the relationship between the two within the context of the disorder has yet to be explored. Consistent with prior research in the social anxiety literature, the present study seeks to examine a model of mediation by which rumination accounts for the significant relationship between NA and PTSD symptoms. Participants included 65 female interpersonal trauma survivors diagnosed with PTSD using structured, clinician-administered interviews. Both NA and rumination were observed as significant predictors of PTSD symptoms, and the variables were significantly associated with each other. However, NA was no longer a significant predictor of PTSD symptoms when rumination was entered into the mediation model, suggesting full mediation of the relationship by rumination. Results from the current study suggest a complex relationship between NA and rumination in interpersonal trauma survivors with PTSD, such that a ruminative cognitive coping style may either mitigate or exacerbate PTSD symptoms in the presence of sustained negative emotion. The current findings provide support for a cognitive model of PTSD, within which PTSD symptoms are influenced via negative, ruminative cognitions. Primary implications of these results include (a) the consideration of assessment of rumination in interpersonal trauma survivors with PTSD in clinical settings; (b) the selection of treatment that may address a ruminative cognitive style in this population, given the mediation between subjective distress and PTSD symptoms by rumination; and (c) the necessity for the validation of this mediation model within other traumatized populations.
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Affiliation(s)
- Wilson J Brown
- Pennsylvania State University, The Behrend College, Erie, USA
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Panisch LS, Currin-McCulloch J, Covington E. Dissociation among individuals receiving cancer care: a scoping review. J Psychosoc Oncol 2021; 40:541-560. [PMID: 34190678 DOI: 10.1080/07347332.2021.1930324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PROBLEM IDENTIFICATION Dissociation is a common presentation of trauma, distinguishable from classic post-traumatic stress disorder (PTSD) symptoms. While pre-cancer and cancer-related traumatic experiences are prevalent among cancer-affected individuals, the specific impact of traumatic dissociation is unclear. LITERATURE SEARCH This scoping review includes a search of English articles published between 1980 and 2019 referencing dissociation in the context of cancer-affected adults. DATA EVALUATION/SYNTHESIS Articles assessed how dissociation was addressed in relation to pre-cancer and cancer-related trauma exposure and treatment. Out of 1,265 articles, 71 met inclusion criteria, and 15 underwent a full review. Two studies addressed dissociation related to pre-cancer trauma, nine in regard to cancer-related trauma only, and four in relation to both trauma types. No studies included experimental designs or described interventions. CONCLUSIONS Despite high rates of trauma exposure among cancer-affected adults, limited studies specifically address the impact of dissociation. Further inquiry on this topic is needed, especially on treatment implications.
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Affiliation(s)
- Lisa S Panisch
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, USA
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31
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Tirone V, Orlowska D, Lofgreen AM, Blais RK, Stevens NR, Klassen B, Held P, Zalta AK. The association between social support and posttraumatic stress symptoms among survivors of betrayal trauma: a meta-analysis. Eur J Psychotraumatol 2021; 12:1883925. [PMID: 33968319 PMCID: PMC8075088 DOI: 10.1080/20008198.2021.1883925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Betrayal traumas have a particularly deleterious effect on mental health. Although social support is a robust predictor of posttraumatic stress disorder (PTSD) symptom severity, it is not clear what factors may impact this relationship among betrayal trauma survivors. Objective: This study sought to describe the association between social support and PTSD symptom severity among survivors of betrayal trauma and examine whether methodological, sample, trauma, and social support characteristics moderated this association. Method: A comprehensive search identified 29 studies that assessed the cross-sectional association between PTSD symptom severity and social support among 6,510 adult betrayal trauma survivors. Results: The average effect size (r = -.25; 95% CI: -.30, -.20) was small to medium, with significant heterogeneity between studies (I2 = 71.86). The association between PTSD and social support was stronger when the trauma was perpetrated by a romantic partner compared to mixed perpetrators, even after accounting for covariates. There was also a significant effect of support type depending on whether the support was provided in the context of trauma disclosure. Specifically, positive reactions to trauma disclosure were not associated with PTSD symptoms whereas general positive social support (not disclosure focused) was associated with fewer PTSD symptoms. Negative reactions to trauma disclosure were associated with more PTSD symptoms. None of the included studies measured general negative social support outside of trauma disclosure. Conclusions: Our findings suggest that social support may be a particularly important buffer against PTSD symptoms when experiencing traumatic betrayal by an intimate partner. Additionally, our results suggest that social support interventions for those experiencing betrayal trauma should focus on reducing negative responses to disclosure and bolstering general satisfaction with social support.
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Affiliation(s)
- Vanessa Tirone
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Daria Orlowska
- University Libraries, Western Michigan University, Kalamazoo, MI, USA
| | - Ashton M Lofgreen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Rebecca K Blais
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Natalie R Stevens
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Brian Klassen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Philip Held
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Alyson K Zalta
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.,Department of Psychological Science, University of California, Irvine, CA, USA
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Abstract
Public discussions about trauma are circulating exponentially in the wake of global movements against structural violence, and efforts to mainstream “trauma-informed” approaches in mental health, human services, and organizational contexts. Within these discussions, the term “institutional trauma” is increasingly being deployed to make sense of structural violence and its impacts. However, such discussions typically reproduce highly individualistic understandings of trauma. Recent feminist advances in trauma theory articulate trauma as a distinctly socio-political form of distress, and critical feminist psychological work argues that gender and other institutions play a substantial role in defining and mediating experiences of trauma. However, the role of institutions in the (re)production of trauma remains under-theorized in the psychological literature. This paper applies feminist, critical mental health, and decolonial perspectives to identify the limitations of mainstream psychological perspectives on trauma and proposes a critical psychological theory of “institutional trauma”. I apply this critical analytic to argue that dominant biomedical and neoliberal frameworks fail to adequately account for the socio-political dimensions of trauma. I then consider institutional theory as a useful feminist psychological analytic through which to expand trauma theory and subvert pathologizing accounts of trauma as disordered and maladaptive.
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Maja RA, Kilshaw RE, Garcia-Barrera MA, Karr JE. Current Posttraumatic Stress Symptoms Mediate the Relationship Between Adverse Childhood Experiences and Executive Functions. Psychol Rep 2021; 125:763-786. [PMID: 33573503 DOI: 10.1177/0033294120979690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Adverse childhood experiences (ACEs) and posttraumatic stress disorder (PTSD) are both associated with lower performances on executive function tasks. However, few researchers have evaluated ACEs, posttraumatic stress (PTS) symptoms, and executive function difficulties in conjunction. Using an online micropayment service, the current study assessed whether PTS symptoms mediated the relationship between ACEs and executive functions. In total, 83 participants (54.2% female, age: M = 28.86, SD = 7.71) were administered the ACE questionnaire, PTSD Checklist for DSM-5 (PCL-5), and the Executive Function Index (EFI). A higher number of reported ACEs was related to greater PTS symptom severity (β = .40, p < .001) and worse self-rated executive functions (β = -.32, p = .002). Controlling for the number of reported ACEs, current PTS symptom severity was related to worse executive functions (β = -.45, p < .001). A bootstrapped 95% confidence interval (CI) indicated a significant indirect effect, β = -.18 (95% CI: -.30, -.08), by which current PTS symptoms mediated the relationship between the number of reported ACEs and executive functions. These results suggest that psychological interventions targeting PTS symptoms, in the context of a history of childhood trauma, may concurrently improve executive functions in adult populations.
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Affiliation(s)
- Rachel A Maja
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC, Canada
| | - Robyn E Kilshaw
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | | | - Justin E Karr
- Department of Psychology, 4530University of Kentucky, Lexington, KY, USA
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34
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Paulus FW, Ohmann S, Möhler E, Plener P, Popow C. Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review. Front Psychiatry 2021; 12:628252. [PMID: 34759846 PMCID: PMC8573252 DOI: 10.3389/fpsyt.2021.628252] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/27/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature. Methods: This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2-17 years) using the following search terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED. Conclusion: Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning.
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Affiliation(s)
- Frank W Paulus
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Susanne Ohmann
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christian Popow
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria.,Department of Child and Adolescent Psychiatry and Psychotherapy, Regional Psychiatric Hospital, Mauer, Austria
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35
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Şar V, Necef I, Mutluer T, Fatih P, Türk-Kurtça T. A Revised And Expanded Version Of The Turkish Childhood Trauma Questionnaire (CTQ-33): Overprotection-Overcontrol As Additional Factor. J Trauma Dissociation 2021; 22:35-51. [PMID: 32437267 DOI: 10.1080/15299732.2020.1760171] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study was concerned with a culture-sensitive revision of the Turkish version of the Childhood Trauma Questionnaire (CTQ-28) and expansion of the instrument through integration of a dimension assessing overprotection - overcontrol (OP-OC). Participants (n = 783) were 37 dissociative and 78 non-dissociative and non-psychotic psychiatric outpatients, and 668 non-clinical people. They completed the revised and expanded version of the CTQ, Dissociative Experiences Scale, Beck Depression Scale, and Relationship Scales Questionnaire. A test-retest assessment was conducted on 25 non-clinical individuals. Among twenty-one alternative and the twenty-five original statements, the items of subsections were selected by correlations between item and item deleted total scores for each subset of original and alternative statements. The 33-item final version (CTQ-33) included five statements for each subsection including OP-OC and three denial items. The principal component analysis on items of the CTQ-33 with a varimax rotation yielded six factors including OP-OC. The inner consistency and the test-retest reliability were good. OP-OC correlated particularly with emotional abuse and neglect, and other types of trauma. There were significant correlations between CTQ-33 and depression, dissociation, and fearful attachment scores. The CTQ-33 differentiated psychiatric from non-clinical groups. The Turkish CTQ-33 is a reliable and valid instrument. OP-OC by caregivers may be as traumatic as other types of childhood adversities. Cross-cultural research would illuminate the significance of OP-OC beyond Turkish culture. The possibility of intergenerational transmission of trauma through OP-OC by fearful parents in and after times of cultural upheaval and political oppression should be considered for future research.
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Affiliation(s)
- Vedat Şar
- Department of Psychiatry, Koç University School of Medicine , Istanbul, Turkey
| | - Işıl Necef
- Department of Psychiatry, Koç University Hospital , Istanbul, Turkey
| | - Tuba Mutluer
- Department of Child and Adolescent Psychiatry, Koç University School of Medicine , Istanbul, Turkey
| | | | - Tuğba Türk-Kurtça
- Department of Guidance and Counseling, School of Education, Trakya University , Edirne, Turkey
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36
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Contractor AA, Weiss NH, Natesan P, Elhai JD. Clusters of Trauma Types as Measured by the Life Events Checklist for DSM-5. INTERNATIONAL JOURNAL OF STRESS MANAGEMENT 2020; 27:380-393. [PMID: 35311212 PMCID: PMC8932936 DOI: 10.1037/str0000179] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Experiences of potentially traumatic events (PTE), commonly assessed with the Life Events Checklist for DSM-5 (LEC-5), can be both varied in pattern and type. An understanding of LEC-assessed PTE type clusters and their relation to psychopathology can enhance research feasibility (e.g., address low base rates for certain PTE types), research communication/comparisons via the use of common terminology, and nuanced trauma assessments/treatments. To this point, the current study examined (1) clusters of PTE types assessed by the LEC-5; and (2) differential relations of these PTE type clusters to mental health correlates (i.e., posttraumatic stress disorder [PTSD] severity, depression severity, emotion dysregulation, reckless and self-destructive behaviors [RSDBs]). A trauma-exposed community sample of 408 participants was recruited via Amazon's Mechanical Turk (M age = 35.90 years; 56.50% female). Network analyses indicated three PTE type clusters: Accidental/Injury Traumas (LEC-5 items 1, 2, 3, 4, 12), Victimization Traumas (LEC-5 items 6, 8, 9), and Predominant Death Threat Traumas (LEC-5 items 5, 7, 10, 11, 13-16). Multiple regression analyses indicated that the Victimization Trauma Cluster significantly predicted PTSD severity (β = .23, p <.001), depression severity (β = .20, p =.001), and negative emotion dysregulation (β = .22, p <.001); and the Predominant Death Threat Trauma Cluster significantly predicted engagement in RSDBs (β = 31, p <.001) and positive emotion dysregulation (β = .26, p <.001), accounting for the influence of other PTE Clusters. Results support three PTE type classifications assessed by the LEC-5, with important clinical and research implications.
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Affiliation(s)
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Prathiba Natesan
- Department of Educational Psychology, University of North Texas, USA
| | - Jon D Elhai
- Department of Psychology, University of Toledo, OH, USA; Department of Psychiatry, University of Toledo, OH, USA
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37
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Rawlins B, Brooks M, Khan R. Posttraumatic stress symptoms mediate the relationship between adverse childhood experiences, avoidant personality traits and resilience. ANXIETY STRESS AND COPING 2020; 33:590-601. [DOI: 10.1080/10615806.2020.1768532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Bethan Rawlins
- School of Psychology, University of Central Lancashire, Manchester, UK
| | - Matthew Brooks
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Roxanne Khan
- School of Psychology, University of Central Lancashire, Manchester, UK
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38
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Myers NS, Llera SJ. The Role of Childhood Maltreatment in The Relationship Between Social Anxiety and Dissociation: A Novel Link. J Trauma Dissociation 2020; 21:319-336. [PMID: 32000621 DOI: 10.1080/15299732.2020.1719265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Children that have been maltreated may experience manifold negative effects later in life. Two such sequelae are social anxiety and dissociation. Recent studies have noted their frequent co-occurrence, but no hypothesis has yet been offered explaining how they interact. College undergraduates (N = 198) completed the Child Trauma Questionnaire, Liebowitz Social Anxiety Scale, and Cambridge Depersonalization Scale. Social anxiety significantly predicted severity of dissociation, and self-reported childhood maltreatment (CM) significantly predicted both social anxiety and dissociation. Notably, emotional abuse was the only significant subtype of CM to predict social anxiety. Furthermore, CM moderated the relationship between social anxiety and dissociation, such that the presence of CM strengthened the predictive effect of social anxiety on dissociation. This study was the first to implicate CM as a mechanism in the social anxiety-dissociation relationship. This study was also the first to note a social anxiety-dissociation link in a non-clinical sample, thus demonstrating the existence of this relationship along a continuum of severity - not solely for those with extreme disturbances.
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Affiliation(s)
| | - Sandra J Llera
- Department of Psychology, Towson University, Baltimore, MD, USA
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39
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Williamson RE, Reed DE, Wickham RE. A traumatic dissonance theory of perpetrator‐related distress. JOURNAL OF THEORETICAL SOCIAL PSYCHOLOGY 2020. [DOI: 10.1002/jts5.59] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - David E. Reed
- Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio San Antonio TX USA
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40
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Giarratano P, Ford JD, Nochajski TH. Gender Differences in Complex Posttraumatic Stress Symptoms, and Their Relationship to Mental Health and Substance Abuse Outcomes in Incarcerated Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:1133-1157. [PMID: 29294660 DOI: 10.1177/0886260517692995] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Complex trauma (CT; for example, childhood abuse) has been associated with significant behavioral health problems (i.e., mental health and substance use disorders) and symptoms that are consistent with complex posttraumatic stress disorder (C-PTSD). CT is prevalent in adult forensic populations, and particularly important for women as they tend to report more adverse consequences of exposure to traumatic stressors and are entering the criminal justice system at a heightened rate compared with men. However, no studies have empirically tested the relationship among CT, C-PTSD, and behavioral health problems with gender among incarcerated adults. The present study examined the relationship between gender and childhood abuse history, C-PTSD symptom severity, and behavioral health problems in 497 incarcerated adults. Findings indicate that women were more likely to report a history of childhood abuse, and more severe C-PTSD symptoms and behavioral health problems than men. Childhood abuse history significantly accounted for the gender difference observed in C-PTSD symptom severity. C-PTSD partially mediated the gender difference in psychiatric morbidity and in risk of hard drug use. Implications for trauma-informed and gender-responsive services and research in the adult criminal justice system are discussed.
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41
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Ireland JL, Mann S, Lewis M, Ozanne R, McNeill K, Ireland CA. Psychopathy and trauma: Exploring a potential association. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2020; 69:101543. [PMID: 32241459 DOI: 10.1016/j.ijlp.2020.101543] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 12/13/2019] [Accepted: 01/10/2020] [Indexed: 06/11/2023]
Abstract
This research presents a series of linked studies exploring the association between psychopathy and trauma. It comprises a systematic review (n = 58), followed by an expert Delphi (n = 19), and patient file trawl using a male forensic psychiatric patient sample (n = 66). An association between psychopathy and developmental trauma was predicted. It was further predicted that different types of trauma would be associated with different subtypes of psychopathy and that the severity of trauma would be important. The systematic review identified the following core themes: presence of Post-Traumatic Stress Disorder and/or symptoms; trauma type; trauma/abuse variables; and sex differences. The ensuing Delphi study indicated the specific variant of psychopathy to be important, with secondary psychopathy particularly relevant. The final study found that the severity of developmental trauma related differentially to primary and secondary psychopathy. Implications and directions for future research are discussed, most notably with regards to the conceptualisation of psychopathy.
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Affiliation(s)
- Jane L Ireland
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK.
| | - Sophie Mann
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK
| | - Michael Lewis
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK
| | - Rebecca Ozanne
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK
| | - Kimberley McNeill
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK
| | - Carol A Ireland
- School of Psychology, University of Central Lancashire, Preston & Ashworth Research Centre, Mersey Care NHS Trust, Liverpool, UK
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42
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Ford JD. New findings questioning the construct validity of complex posttraumatic stress disorder (cPTSD): let's take a closer look. Eur J Psychotraumatol 2020; 11:1708145. [PMID: 32082511 PMCID: PMC7006683 DOI: 10.1080/20008198.2019.1708145] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/11/2019] [Accepted: 12/11/2019] [Indexed: 01/19/2023] Open
Abstract
This commentary provides a broader context for interpreting evidence from Latent Class and Latent Profile analyses on complex posttraumatic stress disorder (CPTSD) that was provided in a recent contribution to the European Journal of Psychotraumatology. These data analytic strategies are not alone sufficient to test the construct validity of CPTSD. They base their conclusion on the empirical finding of substantial variation in latent models obtained with different analytic procedures and interpretations of the fit of different latent models, as well as interesting additional evidence of dispersion when individual patients' symptom counts and symptom severity scores on PTSD and CPTSD are examined. However, the results of their analyses actually do provide support for one feature of construct validity, demonstrating discriminant validity by showing a consistent differentiation between PTSD and CPTSD (with expectable variation in both PTSD and CPTSD severity level by persons). Even in a sample of patients diagnosed with PTSD, there may be a Disorders of Self Organization (DSO) sub-group with low PTSD symptom severity. More detailed examination of which DSO symptoms and sub-domains characterize the DSO sub-group and the CPTSD sub-group is needed in order to clarify the nature of the DSO/CPTSD construct. Other analyses needed to fully test construct validity also are described.
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Affiliation(s)
- Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
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43
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Huang YL, Fonagy P, Feigenbaum J, Montague PR, Nolte T. Multidirectional Pathways between Attachment, Mentalizing, and Posttraumatic Stress Symptomatology in the Context of Childhood Trauma. Psychopathology 2020; 53:48-58. [PMID: 32294649 PMCID: PMC7265765 DOI: 10.1159/000506406] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 02/08/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Exposure to traumatic stressful events in childhood is an important risk factor for the development of posttraumatic symptomatology. From a mentalization-based developmental perspective, childhood adversity can affect attachment in children and may result in insecure attachment and impaired mentalizing abilities, which increase the lifetime risk for psychopathology. The present cross-sectional study examined the potential mediating role of attachment insecurity and impaired mentalizing on the relationship between childhood trauma and posttraumatic symptomatology. METHOD Adults who had experienced childhood neglect and abuse (n = 295, 184 patients with personality disorder and 111 community controls) completed self-report measures of posttraumatic stress disorder (PTSD) symptoms, dissociative experiences, adult attachment insecurity, and mentalizing. RESULTS Structural equation modelling results revealed that attachment insecurity together with lower mentalizing mediated the link between childhood trauma and PTSD symptoms, and lower mentalizing mediated the link between childhood trauma and dissociative experiences. CONCLUSION The findings show that attachment insecurity and lower mentalizing play significant mediating roles in the reporting of posttraumatic symptomatology among survivors of childhood abuse and neglect, with treatment implications for mentalization-based therapy as beneficial for individuals with a history of childhood trauma.
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Affiliation(s)
- Yu Lien Huang
- Department of Psychology, Fo Guang University, Yilan, Taiwan
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, UCL, London, United Kingdom
| | - Janet Feigenbaum
- Research Department of Clinical, Educational and Health Psychology, UCL, London, United Kingdom
| | - P Read Montague
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, UCL, London, United Kingdom.,Computational Psychiatry Unit, Virginia Tech Carilion Research Institute, Roanoke, Virginia, USA
| | - Tobias Nolte
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, UCL, London, United Kingdom, .,Anna Freud National Centre for Children and Families, London, United Kingdom,
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44
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Chentsova-Dutton Y, Maercker A. Cultural Scripts of Traumatic Stress: Outline, Illustrations, and Research Opportunities. Front Psychol 2019; 10:2528. [PMID: 31803094 PMCID: PMC6872530 DOI: 10.3389/fpsyg.2019.02528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 10/25/2019] [Indexed: 11/13/2022] Open
Abstract
As clinical-psychological scientists and practitioners increasingly work with diverse populations of traumatized people, it becomes increasingly important to attend to cultural models that influence the ways in which people understand and describe their responses to trauma. This paper focuses on potential uses of the concept of cultural script in this domain. Originally described by cognitive psychologists in the 1980s, scripts refer to specific behavioral and experiential sequences of elements such as thoughts, memories, attention patterns, bodily sensations, sleep abnormalities, emotions and affective expressions, motivation, coping attempts, and ritualized behaviors that are relevant to posttraumatic adjustment. We differentiate between experiences of traumatic stress that are scripted (e.g., cultural explanations are available) versus unscripted. Further characteristics such as script tracks, the effect of script interruptions, and contextual fit of scripts with other cultural models are also described. We consider examples of traumatic stress associated with war and organized, sexualized violence from "Western" and "non-Western" world regions. The concluding part of this review describes a number of possibilities for methodological approaches to assessment of cultural scripts. Capturing central elements of the script(s) of trauma would aid psychological researchers and clinicians in understanding the experiences of trauma in cultural context, which could ultimately lead to better clinical service opportunities worldwide.
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Affiliation(s)
| | - Andreas Maercker
- Department of Psychology, University of Zurich, Zurich, Switzerland.,Institute of Advanced Study Berlin, Berlin, Germany
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45
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Ford JD. Commentary on the Special Section on Complex PTSD: Still Going Strong After All These Years. J Trauma Stress 2019; 32:877-880. [PMID: 31800123 DOI: 10.1002/jts.22474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 11/07/2022]
Abstract
Posttraumatic stress disorder (PTSD) is inherently complex, yet a growing evidence base indicates that a complex variant (CPTSD) can be distinguished from classic PTSD based on evidence of clinically significant affect, interpersonal, and self/identity dysregulation. This Commentary to the Journal of Traumatic Stress special section on CPTSD reviews the results of four new studies that empirically tested the structure, traumatic stressor antecedents, and construct validity of CPTSD in relation to PTSD and borderline personality disorder (BPD). Based on these and prior empirical findings, a reconceptualization of PTSD, CPTSD, and BPD as posttraumatic threat, betrayal, and rejection disorders, respectively, is proposed. Implications for treatment of trauma survivors are discussed in relation to articles in this special section, which describe a modular framework for CPTSD treatment and an innovative attachment and self-regulation focused on the redesign of a traditional outpatient mental health clinic.
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Affiliation(s)
- Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
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46
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Abstract
In recent years, many adolescents in Nepal have been affected by episodes of mass psychogenic illness, which seem to involve dissociative symptoms. To identify the potential contributors to dissociation, the present study examined correlates of dissociative experiences among adolescents in Nepal. In a cross-sectional survey, 314 adolescents were assessed with the Adolescent Dissociative Experiences Scale and measures of childhood trauma exposure, as well as cognitive and personality traits found to be associated with dissociation in studies on other populations. Path analysis confirmed that childhood trauma, cognitive and personality traits, and current distress each predicted dissociative experiences and behaviors. However, an integrated path model found that the effect of childhood trauma on dissociation was mediated either by posttraumatic stress symptoms or by cognitive failures. Future studies should develop and test multifactorial models of dissociation and multiple pathways.
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47
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Isobel S, Goodyear M, Foster K. Psychological Trauma in the Context of Familial Relationships: A Concept Analysis. TRAUMA, VIOLENCE & ABUSE 2019; 20:549-559. [PMID: 29333976 DOI: 10.1177/1524838017726424] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Many forms of psychological trauma are known to develop interpersonally within important relationships, particularly familial. Within the varying theoretical constructs of psychological traumas, and distinct from the processes of diagnosis, there is a need to refine the scope and definitions of psychological traumas that occur within important familial relationships to ensure a cohesive evidence base and fidelity of the concept in application to practice. This review used a philosophical inquiry methodology of concept analysis to identify the definitions, antecedents, characteristics, and consequences of the varying conceptualizations of psychological trauma occurring within important relationships. Interactions between concepts of interpersonal trauma, relational trauma, betrayal trauma, attachment trauma, developmental trauma, complex trauma, cumulative trauma, and intergenerational trauma are presented. Understanding of the discrete forms and pathways of transmission of psychological trauma between individuals, including transgenerationally within families, creates opportunities for prevention and early intervention within trauma-focused practice. This review found that concepts of psychological trauma occurring within familial relationships are not exclusive of each other but overlap in their encompassment of events and circumstances as well as the effect on individuals of events in the short term and long term. These traumas develop and are transmitted in the space between people, both purposefully and incidentally, and have particularly profound effects when they involve a dependent infant or child. Linguistic and conceptual clarity is paramount for trauma research and practice.
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Affiliation(s)
- Sophie Isobel
- 1 Australian Catholic University, School of Nursing, Midwifery and Paramedicine, Melbourne, Australia
- 2 Sydney Local Health District, Mental Health Research, Sydney Australia
| | - Melinda Goodyear
- 3 Monash University, Faculty of Medicine, Nursing and Health Sciences, Victoria, Australia
- 4 Parenting Research Centre, East Melbourne, Victoria, Australia
| | - Kim Foster
- 5 Australian Catholic University, School of Nursing, Midwifery and Paramedicine, Melbourne, Australia
- 6 NorthWestern Mental Health, Victoria, Australia
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Boyraz G, Ferguson AN, Zaken MD, Baptiste BL, Kassin C. Do dialectical self-beliefs moderate the indirect effect of betrayal traumas on posttraumatic stress through self-compassion? CHILD ABUSE & NEGLECT 2019; 96:104075. [PMID: 31336237 DOI: 10.1016/j.chiabu.2019.104075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/16/2019] [Accepted: 07/06/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Traumatic events experienced in childhood, particularly those that are perpetrated by someone whom the child trusts or depends upon (i.e., high betrayal traumas [HBTs], such as abuse by a parent) can lead to long-term negative consequences, including a tendency to see oneself in a negative light, low self-compassion, and posttraumatic stress disorder. Although negative psychological consequences of HBTs are well-documented in the literature, little is known surrounding the protective factors that may reduce the effects of HBTs on individuals' functioning. The present study focused on one potential protective factor, dialectical self-beliefs, that may moderate the negative effects of HBTs experienced in childhood on self-compassion, and hence reduce posttraumatic stress (PTS). OBJECTIVE The present study is aimed at determining whether dialectical self-beliefs moderate the indirect effect of HBTs on PTS via self-compassion. PARTICIPANTS AND SETTING Data of the present study were collected from 747 college students attending a university in the Northeast region of the United States. METHOD Using a correlational study design, the data of this study were collected from college students through an online survey. RESULTS The results of a moderated mediation analysis indicated that the hypothesized model explained 25% of the variance in PTS. After controlling for low betrayal traumas, the indirect effect of HBTs on PTS through self-compassion was moderated by dialectical self-beliefs. These findings provide support for our hypotheses and suggest that having a dialectical self-view may enhance the adjustment of individuals with a history of HBTs by reducing the negative effect of HBTs on self-compassion.
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Affiliation(s)
- Güler Boyraz
- Department of Psychology, Pace University, New York, NY, United States.
| | - Alexis N Ferguson
- Department of Psychology, Pace University, New York, NY, United States
| | - Mali D Zaken
- Department of Psychology, Pace University, New York, NY, United States
| | | | - Cynthia Kassin
- Department of Psychology, Pace University, New York, NY, United States
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Dodier O, Patihis L, Payoux M. Reports of recovered memories of childhood abuse in therapy in France. Memory 2019; 27:1283-1298. [PMID: 31389767 DOI: 10.1080/09658211.2019.1652654] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Recovered memories of abuse in therapy are especially controversial if the clients were not aware they were abused before therapy. In the past, such memory recovery has led to legal action, as well as a debate about whether such memories might be repressed, forgotten, or false memories. More than two decades after the height of the controversy, it is unclear to what degree such memories are still recovered today, and to what extent it occurs in France. In our French survey of 1312 participants (Mage = 33; 53% female), 551 reported having done therapy at some point. Of that 551, 33 (6%) indicated they had recovered memories of abuse in therapy that they did not know about before therapy. Sexual abuse was the most commonly reported type that was recovered in therapy (79%). As in past research, discussing the possibility of repressed memories with therapists was associated with reports of recovered memories of abuse. Surprisingly, memory recovery occurred just as much in behavioural and cognitive therapies as it did in therapies focused on trauma. We found recovered memories in a proportion of clients who began therapy recently. Recovered memories in therapy appears to be an ongoing concern in France.
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Affiliation(s)
- Olivier Dodier
- a CNRS, LAPSCO, Université Clermont Auvergne , Clermont-Ferrand , France
| | - Lawrence Patihis
- b Department of Psychology, University of Southern Mississippi , Hattiesburg , MS , USA
| | - Mélany Payoux
- c Laboratoire de Psychologie des Pays de la Loire, Université de Nantes , Nantes , France
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McWhorter KL, Parks CG, D’Aloisio AA, Rojo-Wissar DM, Sandler DP, Jackson CL. Traumatic childhood experiences and multiple dimensions of poor sleep among adult women. Sleep 2019; 42:zsz108. [PMID: 31260523 PMCID: PMC6941710 DOI: 10.1093/sleep/zsz108] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 03/29/2019] [Indexed: 12/31/2022] Open
Abstract
STUDY OBJECTIVES Exposure to traumatic childhood experiences (TCEs) may contribute to poor sleep in adulthood. Previous studies have been limited to mainly investigating physical and sexual abuse and did not consider betrayal trauma, or whether the victim regarded the perpetrator as someone socially close to them, the age group at occurrence, and trauma-related distress/anxiety. METHODS We used a large cohort of US women, 35-74 years old, enrolled in the Sister Study from 2003 to 2009. Self-reports of specific TCEs occurring before the age of 18 years included sexual, physical, and psychological/emotional trauma; natural disasters; major accidents; and household dysfunction. Participants self-reported average sleep duration (short: <7 hours vs recommended: 7-9 hours), sleep onset latency (SOL) at least 30 vs less than 30 minutes, at least 3 night awakenings once asleep at least 3 times/week (Night awakenings [NA], yes vs no), and napping at least 3 vs less than 3 times/week. RESULTS Among 40 082 women, 55% reported a TCE, with 82% reporting betrayal trauma. Compared to women reporting no TCE, women with any TCE were more likely to report short sleep (prevalence ratio [PR] = 1.08, [95% confidence interval (CI) = 1.04 to 1.11]), longer SOL (1.11, [1.06 to 1.16]), frequent NAs (1.06, [1.00 to 1.11]), and frequent napping (1.05, [0.99 to 1.12]). The relationship between experiencing any TCE and short sleep was stronger for TCEs by a perpetrator considered socially close vs not close (1.12, [1.09 to 1.16]), SOL (1.27, [1.22 to 1.33]), NA (1.20, [1.14 to 1.27]), and napping (1.24, [1.17 to 1.32]). CONCLUSIONS TCEs were associated with poor sleep in women with greater impact when the perpetrator was regarded as close. More research is warranted to better understand pathways between childhood trauma and sleep health in adulthood to develop effective interventions.
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Affiliation(s)
- Ketrell L McWhorter
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
| | - Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
| | | | - Darlynn M Rojo-Wissar
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
- Intramural Program, National Institute on Minority Health and Health Disparities, Department of Health and Human Services, Bethesda, MD
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