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Farley M, Kennedy MA. Torture and its sequelae among prostituted women in the United States. Eur J Psychotraumatol 2024; 15:2404307. [PMID: 39351700 PMCID: PMC11445917 DOI: 10.1080/20008066.2024.2404307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 09/04/2024] [Accepted: 09/05/2024] [Indexed: 10/04/2024] Open
Abstract
Background: Extreme violence and psychological abuse have been extensively documented and are pervasive in prostitution. Survivors of prostitution report high levels of posttraumatic stress disorder, dissociation, depression, and self-loathing. These are the same sequelae reported by torture survivors.Objective: Severe forms of violence have been categorized as torture by experts. The authors note that torture is commonly suffered during prostitution and should be appropriately named.Method: Using standardized measures and including a new measure of torture, we interviewed 45 women in the United States about their torture experiences in prostitution and their symptoms of PTSD, dissociation, childhood trauma, health status and somatic symptoms. The interviewees had exited prostitution and were in supportive programmes.Results: Formerly prostituted interviewees reported acts of physical, sexual, and psychological torture, including strangulation, rape, beatings, restriction of movement, denial of privacy, sleep, or food, and being forced to witness the torture of others. The 45 women had high levels of PTSD and dissociation. They endorsed needs for individual counselling, substance abuse treatment, and other medical care.Conclusions: A recognition of the physical, sexual, and psychological torture experienced in prostitution would strengthen psychological and medical interventions for survivors. Naming specific acts of prostitution as torture will reduce the survivor's shame and self-blame. Holistic treatment includes medical and psychological interventions and peer support, as seen in torture rehabilitation programmes for survivors of state-sponsored torture. This research supports the perspective that private or non-state-sponsored torture against women and marginalized populations should be clinically and legally understood in the same way as state-sponsored torture.
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Affiliation(s)
| | - M Alexis Kennedy
- Department of Criminal Justice, University of Nevada, Las Vegas, USA
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2
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Zoromba MA, El-Gazar HE, Elkalla IHR, Amr M, Ibrahim N. Association between cumulative trauma and severity of psychotic symptoms among patients experiencing psychosis. Arch Psychiatr Nurs 2024; 51:54-61. [PMID: 39034095 DOI: 10.1016/j.apnu.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/22/2023] [Accepted: 05/18/2024] [Indexed: 07/23/2024]
Abstract
Psychosis-related trauma is a prevalent condition that significantly impacts patients and often leads to an increased reliance on psychiatric nursing services. This study aimed to provide a deeper understanding of the complex relationship between cumulative trauma and the severity of psychosis symptoms among patients experiencing psychosis. Utilizing a cross-sectional research design, data were collected from 76 community-dwelling patients recruited. Patients' sociodemographic and clinical data, Cumulative Trauma Measure scores, and psychosis symptom severity scale scores were collected. A significant difference was observed between collective identity trauma and the presence of hallucinations and abnormal psychomotor behavior (Z = 4.1 and 2.69, respectively). Significant differences were also observed between role identity trauma and the presence of delusions and abnormal psychomotor behavior (Z = 3.86 and 2.06, respectively); attachment trauma and the presence of hallucinations, abnormal psychomotor behavior, and mania (Z = 2.16, 2.12, and 2.11, respectively); and survival trauma and the presence of disorganized speech (Z = 2.61). Moreover, there was a significant difference regarding secondary trauma and the presence of hallucinations, delusions, disorganized speech, abnormal psychomotor behavior, depression, and mania (Z = 4.29, 2.15, 2.11, 2.12, 4.42, and 3.39, respectively). In conclusion, total cumulative trauma explained 44.2 %, 25.8 %, 24.7 %, 16.2 %, 13.6 %, and 13.2 % of the severity of delusion, hallucination, depression, mania, abnormal psychomotor behavior, and disorganized speech, respectively, among patients experiencing psychosis. Implication for nursing practice, by recognizing the nuanced interplay between cumulative trauma and diverse manifestations of psychosis symptoms, nursing professionals can tailor their approaches to provide more holistic and patient-centered care that may significantly contribute to improved patient outcomes and the overall well-being of individuals navigating the complex landscape of psychosis-related trauma.
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Affiliation(s)
- Mohamed A Zoromba
- College of Nursing, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia; Psychiatric and Mental Health Nursing Department, Mansoura University, Egypt.
| | - Heba E El-Gazar
- Nursing Administration Department, Port Said University, Egypt
| | | | - Mostafa Amr
- Psychiatry Department, Mansoura University, Egypt
| | - Nashwa Ibrahim
- Psychiatric and Mental Health Nursing Department, Mansoura University, Egypt; Mental Health Nursing Department, Faculty of Nursing, The British University in Egypt (BUE), Cairo, Shorouk City, Egypt
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3
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Kira IA, Alpay EH, Shuwiekh HAM, Türkeli A. A type
III
continuous trauma perspective on the effects of increased ongoing hostility, discrimination, community violence and poverty on refugees' mental health and cognitive functioning: A longitudinal study. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2023. [DOI: 10.1002/casp.2693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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4
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Kira IA, Shuwiekh HA, Ashby JS, Elwakeel SA, Alhuwailah A, Sous MSF, Baali SBA, Azdaou C, Oliemat EM, Jamil HJ. The Impact of COVID-19 Traumatic Stressors on Mental Health: Is COVID-19 a New Trauma Type. Int J Ment Health Addict 2023; 21:51-70. [PMID: 34248442 PMCID: PMC8259553 DOI: 10.1007/s11469-021-00577-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 02/07/2023] Open
Abstract
COVID-19 is a new type of trauma that has never been conceptually or empirically analyzed in our discipline. This study aimed to investigate the impact of COVID-19 as traumatic stress on mental health after controlling for individuals' previous stressors and traumas. We utilized a sample of (N = 1374) adults from seven Arab countries. We used an anonymous online questionnaire that included measures for COVID-19 traumatic stress, posttraumatic stress disorder, anxiety, depression, and cumulative stressors and traumas. We conducted hierarchical multiple regression, with posttraumatic stress disorder, depression, and anxiety as dependent variables. In the first step, in each analysis, we entered the country, gender, age, religion, education, and income as independent variables (Kira, Traumatology 7(2):73-86, 2001; Kira, Torture, 14:38-44, 2004; Kira, Traumatology, 2021, https://doi.org/10.1037/trm0000305). In the second step, we entered cumulative stressors and traumas as an independent variable. In the third step, we entered either COVID-19 traumatic stressors or one of its subtypes (fears of infection, economic, and lockdown) as an independent variable. Finally, we conducted structural equation modeling with PTSD, depression, and anxiety as predictors of the latent variable mental health and COVID-19 as the independent variable. Results indicated that COVID-19 traumatic stressors, and each of its three subtypes, were unique predictors of PTSD, anxiety, and depression. Thus, COVID-19 is a new type of traumatic stress that has serious mental health effects. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-021-00577-0.
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Affiliation(s)
- Ibrahim A. Kira
- grid.256304.60000 0004 1936 7400Center for Cumulative Trauma Studies, Stone Mountain, GA, & Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, 4906 Woodhurst Way, Stone Mountain Atlanta, GA 30088 USA
| | | | - Jeffrey S. Ashby
- grid.256304.60000 0004 1936 7400Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA
| | | | | | | | | | | | - Enas. M. Oliemat
- grid.33801.390000 0004 0528 1681Hashemite University, Zarqa, Jordan
| | - Hikmet J. Jamil
- grid.17088.360000 0001 2150 1785Department of Family Medicine, Michigan State University, Lansing, MI USA
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Sen Mukherjee A, Barr M. ‘A blessing and a burden’: Exploring post traumatic growth in doctors with acquired invisible disability—An interpretative phenomenological analysis. Br J Health Psychol 2022; 28:586-603. [PMID: 36526305 DOI: 10.1111/bjhp.12642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 11/03/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Qualitative studies of the relationship between acquired invisible disability (AcqID) and posttraumatic growth (PTG) are scant, especially in the context of healthcare professionals. This study aimed to explore in-depth accounts of the lived experience of PTG in doctors with AcqID arising from physical illness with cognitive dysfunction. DESIGN Five doctors who had been diagnosed in the last decade with a physical illness with cognitive dysfunction resulting in an AcqID, and who self-reported at least one feature of PTG participated in this qualitative research study. METHODS Semi-structured interviews were used to collect data, which were analysed using interpretative phenomenological analysis. RESULTS This study recognized that AcqID supported a process of PTG for participants. Three superordinate themes were apparent across the sample: identity (The human left behind), self (Acceptance of the disabled self), and rebirth (The phoenix rises from the ashes). Human connection, service as a value, and the role of the body were found to be key facilitators of PTG in these participants. This study offers new perspectives on cognitive-embodied appreciation in facilitating PTG in doctors with AcqID. CONCLUSIONS While the participants perceived AcqID with cognitive dysfunction to be a trauma, they also experienced PTG, Corporeal PTG and a new considered domain, Cognitive-Embodied PTG. The unrealised potential of PTG can be harnessed if doctors with disability are viewed as assets to the medical profession, and diversity is promoted through the provision of appropriate support. Thus, there is potential to cultivate a flourishing, inclusive, and compassionate culture within medicine.
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Affiliation(s)
| | - Margaret Barr
- School of Psychology University of East London London UK
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6
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Kira IA, Shuwiekh H. Development and validation of the brief pathological dissociation scale PDS(B): Initial psychometrics. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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7
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Kira IA, Shuwiekh H, Laddis A. The Linear and Non-Linear Association between Trauma, Dissociation, Complex PTSD, and Executive Function Deficits: A Longitudinal Structural Equation Modeling Study. JOURNAL OF LOSS & TRAUMA 2022. [DOI: 10.1080/15325024.2022.2101734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Ibrahim Aref Kira
- Center for Cumulative Trauma Studies, USA
- Center for Stress, Trauma, and Resilience, Georgia State University, Atlanta, USA
| | - Hanaa Shuwiekh
- Department of Psychology, Fayoum University, Fayoum, Egypt
| | - Andreas Laddis
- Private practice in Psychiatry and Neurology is in Framingham, Framingham, MA, USA
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8
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Kira IA, Al Ibrahim B, Aljakoub J, Shuwiekh HAM. The Effects of Torture in the Context of COVID-19 and Continuous Type III Trauma’s Variants: The Peri-Post Type III Trauma Mental Health Syndrome in Syrian Torture Survivors. JOURNAL OF LOSS & TRAUMA 2022. [DOI: 10.1080/15325024.2022.2070967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ibrahim Aref Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
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9
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Kira IA, Rice K, Ashby JS, Shuwiekh H, Ibraheem AB, Aljakoub J. Which Traumas Proliferate and Intensify COVID-19 Stressors? The Differential Role of Pre- and Concurrent Continuous Traumatic Stressors and Cumulative Dynamics in Two Communities: USA and Syria. JOURNAL OF LOSS & TRAUMA 2022. [DOI: 10.1080/15325024.2022.2050067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA, & Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
| | - Kenneth Rice
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
| | - Jeffery S. Ashby
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
| | - Hanaa Shuwiekh
- Department of Psychology, Fayoum University, Fayoum, Egypt
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10
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Kira IA, Aljakoub J, Al Ibraheem B, Shuwiekh HAM, Ashby JS. The Etiology of Complex PTSD in the COVID-19 and Continuous Traumatic Stressors Era: A Test of Competing and Allied Models. JOURNAL OF LOSS & TRAUMA 2022. [DOI: 10.1080/15325024.2022.2028094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, Georgia, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, Georgia, USA
| | | | | | | | - Jeffrey S. Ashby
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, Georgia, USA
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11
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Kira IA, Shuwiekh HAM, Ahmed SAE, Ebada EE, Tantawy SF, Waheep NN, Ashby JS. Coping with COVID-19 Prolonged and Cumulative Stressors: the Case Example of Egypt. Int J Ment Health Addict 2022; 21:1-22. [PMID: 35035314 PMCID: PMC8741582 DOI: 10.1007/s11469-021-00712-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 12/20/2022] Open
Abstract
The current study aimed to explore how COVID-19-traumatized populations cope using a coping model based on wills to exist, live, and survive (WTELS) that leads to positive coping and posttraumatic growth (PTG). We used data from 11 Arab countries (N = 2732), including Egypt (N = 831), and included measures for COVID-19 stressors (COVID-fear, economic, lockdown, and grief stressors), WTELS, resilience, religiosity, spirituality, social support, and PTG. We conducted ANOVA on the main sample to explore the differences between Arab countries, hierarchical regressions, and path analysis on the Egyptian subsample to test a model of the effects on WTELS. In the path model, WTELS was the independent variable. Other coping strategies were mediating variables, and COVID-19 stressor types were outcome variables. ANOVA on the main sample indicated that Egypt was the highest on COVID-19 stressors (infection fears, economic, lockdown, and grief stressors), actual infection, and WTELS. Hierarchical regression indicated that social support, resilience, and WTELS were positive predictors of PTG, with WTELS had the highest effect size (β = .41) and WTELS being a negative predictor of COVID-19 stressors, while resilience and social support were not. Path analysis indicated that WTELS predicted higher religiosity, spirituality, social support, resilience, and lower COVID-19 stressors. Religiosity predicted higher spirituality, social support, and resilience and lower COVID-19 stressors. Interfaith spirituality predicted higher resilience and lower COVID-19 grief stressors. The results validated the central role of WTELS. Results helped to identify potentially effective interventions with COVID-19 victims that focus on WTELS, spirituality, and religiosity. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11469-021-00712-x.
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Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, 4906 Woodhurst Way, Stone Mountain, GA 30088 USA
- Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA
| | | | | | | | | | | | - Jeffrey S. Ashby
- Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA
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12
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Kira IA, Rihan Ibrahim ES, Shuwiekh HAM, Ashby JS. Does Intersected Discrimination Underlie the Disproportionate Impact of COVID-19 Infection and Its Severity on Minorities? An Example from Jordan. JOURNAL OF LOSS & TRAUMA 2021. [DOI: 10.1080/15325024.2021.1992224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
| | | | | | - Jeffrey S. Ashby
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
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13
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Potluri S, R Patel A. Using a Continuous Traumatic Stress Framework to Examine Ongoing Adversity Among Indian Women from Slums: A Mixed-Methods Exploration. J Trauma Stress 2021; 34:917-928. [PMID: 34462969 DOI: 10.1002/jts.22699] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/10/2021] [Accepted: 04/20/2021] [Indexed: 01/22/2023]
Abstract
Gender-based violence (GBV) is pervasive among Indian women. Although posttraumatic stress disorder (PTSD) is a psychological outcome of GBV, it might not accurately capture the experiences of Indian women from slums, who face continued stressors (i.e., ongoing adversity). Continuous traumatic stress (CTS) is a framework used to characterize experiences of ongoing adversity. This mixed-method study investigated the applicability of the CTS framework for characterizing ongoing adversity and the psychological impacts of ongoing adversity among GBV-exposed Indian women from slums. Indian women from slums (N = 100) completed all study measures; a subset (n = 47) completed qualitative interviews analyzed using deductive coding and thematic analysis to identify core CTS characteristics. To examine the impact of ongoing adversity on participants' psychological symptom severity in the full sample, we performed an ANCOVA on PTSD symptom severity and an ANOVA on anxiety and depression symptom severity. Interviewed participants described the context of stressor conditions as pervasive, reported stressor conditions existed in the present or future rather than the past, had difficulty discriminating between real versus imagined threat, and demonstrated absent external protective systems. Results indicated that ongoing adversity was associated with significantly more severe PTSD, F(1, 96) = 9.86, p < .001; anxiety, F(1, 98) = 20.31, p < .001; and depression, F(1, 98) = 25.24, p < .001. The CTS framework is valuable for characterizing ongoing adversity and its related mental health impacts among GBV-exposed Indian women from slums. Assessment and intervention in slum communities must account for ongoing adversity.
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Affiliation(s)
- Sriramya Potluri
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Anushka R Patel
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma, USA.,Trauma Recovery Center, University of California San Francisco, San Francisco, California, USA
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Elshahat S, Moffat T. Mental Health Triggers and Protective Factors Among Arabic-Speaking Immigrants and Refugees in North America: A Scoping Review. J Immigr Minor Health 2021; 24:489-505. [PMID: 33987797 DOI: 10.1007/s10903-021-01215-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 08/22/2023]
Abstract
Poor mental health (MH) is a substantial public health problem, affecting over 13% of the population worldwide. Arabic-speaking immigrants and refugees (ASIR) are at high risk of MH problems due to intercultural adjustment stress, racism and discrimination. This scoping review of 49 studies explored pre- and post-migration MH determinants among ASIR in North America. Pre-migration MH determinants were politically related. English illiteracy was a significant triggering factor for distress and depression. Post-migration sociocultural MH protective factors included positive ethnic identity, spirituality, family support and social cohesion. Resilience, expressed as hope, significantly protected ASIR against depression and distress. MH triggering factors, emanating from social inequalities, were domestic violence, discrimination, stigmatization and poverty. Mixed-methods studies are needed to inform culturally-congruent, MH-promoting and resilience-building interventions. Intersectoral collaboration and Healthy Public Policy, based on the WHO Health in All Policies framework, are required to address social and health inequities, reducing MH challenges among ASIR.
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Affiliation(s)
- Sarah Elshahat
- Department of Anthropology, Faculty of Social Sciences, McMaster University, CNH 527, Hamilton, ON, L8S 4L9, Canada.
| | - Tina Moffat
- Department of Anthropology, Faculty of Social Sciences, McMaster University, CNH 527, Hamilton, ON, L8S 4L9, Canada
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15
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Kira IA, Alpay EH, Ayna YE, Shuwiekh HAM, Ashby JS, Turkeli A. The effects of COVID-19 continuous traumatic stressors on mental health and cognitive functioning: A case example from Turkey. CURRENT PSYCHOLOGY 2021; 41:7371-7382. [PMID: 33897228 PMCID: PMC8057920 DOI: 10.1007/s12144-021-01743-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 12/12/2022]
Abstract
There is a need to accurately assess the specific impacts of the various traumatic stressors caused by COVID-19 on mental health. The goal was to evaluate the impact of different types of COVID-19 stressors (infection fears, lockdown, and economic stressors) on mental health and cognitive functioning. We used a sample of 262 Turkish adults. We administered an online questionnaire that included measures of COVID-19 traumatic stressors, PTSD, depression, anxiety, executive function deficits, and cumulative stressors and traumas (CST). The analyses included correlations, hierarchical regression, path analysis, and PROCESS mediation analysis. All COVID-19 traumatic stressors types and their cumulative load predicted PTSD, depression, anxiety, and executive function deficits after controlling for previous cumulative stressors and traumas and COVID-19 infection. COVID-19 lockdown’s stressors were the strongest predictors, compared to COVID-19 fears and economic stressors. Path analysis and PROCESS mediation results indicated that COVID-19 traumatic stressors had direct effects on working memory deficits, direct and indirect effects on PTSD, depression, and anxiety, and indirect effects on inhibition deficits. Anxiety, depression, and inhibition deficits mediated its indirect effects on PTSD. The results have conceptual and clinical implications. COVID-19 continuous posttraumatic stress syndrome that includes comorbid PTSD, depression, anxiety, and executive function deficits is different and does not fit within the current trauma frameworks. There is a need for a paradigm shift in current stress and trauma frameworks to account for the COVID-19 continuous global stressors and for clinical innovations in intervention to help its victims.
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Affiliation(s)
- Ibrahim A Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA USA.,Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA
| | - Emre Han Alpay
- Department of Psychology, Mersin University, Mersin, Turkey
| | | | | | - Jeffrey S Ashby
- Center for Stress, trauma, and Resiliency, Georgia State University, Atlanta, GA USA
| | - Aras Turkeli
- Department of Psychology, Mersin University, Mersin, Turkey
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16
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Quinn KG, Spector A, Takahashi L, Voisin DR. Conceptualizing the Effects of Continuous Traumatic Violence on HIV Continuum of Care Outcomes for Young Black Men Who Have Sex with Men in the United States. AIDS Behav 2021; 25:758-772. [PMID: 32944841 PMCID: PMC7886964 DOI: 10.1007/s10461-020-03040-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 01/06/2023]
Abstract
The United States (US) is on track to achieve the 90-90-90 targets set forth by UNAIDS and the National HIV/AIDS strategy, yet significant racial disparities in HIV care outcomes remain, particularly for young Black men who have sex with men (YBMSM). Research has demonstrated that various types of violence are key aspects of syndemics that contribute to disparities in HIV risk. However, little research has looked collectively at cumulative violent experiences and how those might affect HIV treatment and care outcomes. Drawing on extant literature and theoretical underpinnings of syndemics, we provide a conceptual model that highlights how continuous traumatic violence experienced by YBMSM may affect HIV outcomes and contribute to racial disparities in HIV outcomes. The findings of this focused review suggest a need for research on how continuous exposure to various types of violence influence HIV prevention and treatment outcomes for young Black MSM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, 2071 N. Summit Ave., Milwaukee, WI, 53202, USA.
| | - Antoinette Spector
- Medical College of Wisconsin, Institute for Health Equity, Milwaukee, USA
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17
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Does favoring male gender hurt or benefit men? the linear and non-linear dynamics of the impact of favoring male gender by family and society on men’s mental health in two cultures. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-018-9970-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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18
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Kira IA, Alpay EH, Turkeli A, Shuwiekh HAM, Ashby JS, Alhuwailah A. The Effects of COVID-19 Traumatic Stress on Executive Functions: The Case of Syrian Refugees in Turkey. JOURNAL OF LOSS & TRAUMA 2021. [DOI: 10.1080/15325024.2020.1869444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA
- Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
| | - Emre Han Alpay
- Department of Psychology, Eastern Mediterranean University, Famagusta, North Cyprus
| | - Aras Turkeli
- Department of Psychology, Mersin University, Mersin, Turkey
| | | | - Jeffrey S. Ashby
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
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Moss D, Majadle G, Milhem J, Waterston T. Mental health impact on children of forcible home invasions in the occupied Palestinian territory. BMJ Paediatr Open 2021; 5:e001062. [PMID: 34604544 PMCID: PMC8449953 DOI: 10.1136/bmjpo-2021-001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dana Moss
- Physicians for Human Rights—Israel, Tel Aviv, Israel
| | - Ghada Majadle
- Physicians for Human Rights—Israel, Tel Aviv, Israel
| | - Jumana Milhem
- Physicians for Human Rights—Israel, Tel Aviv, Israel
| | - Tony Waterston
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
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Psychological distress related to COVID-19 - The contribution of continuous traumatic stress. J Affect Disord 2020; 277:129-137. [PMID: 32818776 PMCID: PMC7416772 DOI: 10.1016/j.jad.2020.07.141] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The novel coronavirus (COVID-19) is a substantial stressor that could eventuate in psychological distress. Evidence suggests that individuals previously exposed to traumatic events, and particularly to continuous traumatic stress (CTS), might be more vulnerable to distress when facing additional stressors. This study aimed to investigate these suppositions in the context of the ongoing shelling of Israel from the Israel-Gaza border, which continues even amidst the COVID-19 crisis. METHOD An online survey was conducted among Israel's general population. The sample included 976 participants. Seven-hundred-and-ninety-three participants had been exposed to traumatic events, with 255 participants reporting CTS. Trauma exposure, COVID-19-related stressors, and psychological distress related to COVID-19 (anxiety, depression, and peritraumatic stress symptoms) were assessed. RESULTS Most participants reported experiencing at least one psychiatric symptom related to COVID-19. Being younger, female, not in a relationship, having a below-average income, being diagnosed with the disease, living alone during the outbreak, having a close other in a high-risk group, and negatively self-rating one's health status were associated with elevated distress. Individuals who had been exposed to trauma, and to CTS in particular, had elevated anxiety, depression, and peritraumatic stress symptoms compared to individuals without such a history or to survivors of non-ongoing traumatic events. CTS moderated the relations between PTSD symptoms, anxiety symptoms, and peritraumatic stress symptoms, with significantly stronger relations found among individuals exposed to CTS. LIMITATIONS This study relied on convenience sampling. CONCLUSIONS Trauma survivors, and particularly traumatized individuals exposed to CTS, seem at risk for psychological distress related to COVID-19.
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Kira IA, Shuweikh H, Al-Huwailiah A, El-Wakeel SA, Waheep NN, Ebada EE, Ibrahim ESR. The direct and indirect impact of trauma types and cumulative stressors and traumas on executive functions. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:1078-1094. [PMID: 33245250 DOI: 10.1080/23279095.2020.1848835] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The goal was to measure the effects of trauma types, cumulative trauma, posttraumatic stress disorder (PTSD), existential annihilation anxiety (EAA), and posttraumatic growth (PTG) on executive functions. The study sample consists of 1155 from Egypt and Kuwait. Measures included adults working memory deficits (WMD) and inhibition deficits (ID), and cumulative stressors and traumas (CST) and trauma types, PTSD, EAA, and PTG. We used Stepwise regression and PROCESS macro to analyze the data. Results indicated that survival and cumulative traumas have direct effects on a lower WMD and ID, attachment traumas and gender discrimination by parents have direct impacts on higher WMD and ID, while personal identity, status identity, secondary trauma, gender discrimination by society, community violence do not have any direct effects on WMD or ID. All traumas have indirect effects on higher WMD or/and ID via PTSD. Gender discrimination by society, community violence, and CST has an additional indirect higher impact on WMD and ID via EAA. There were indirect trajectories from survival trauma, personal identity, status identity trauma, secondary trauma, gender discrimination by society, and CST on lower WMD or/and ID via PTG. Attachment trauma, gender discrimination by parents, perpetration traumas, and community violence were not associated with PTG and its trajectories of lower WMD or/and ID. We discussed the research and clinical implication for these results.
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Affiliation(s)
- Ibrahim Aref Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA, USA.,Affiliate of the Center of Stress Trauma and Resiliency, Georgia State, University, Atlanta, GA
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Amone-P’Olak K, Letswai NK. The relationship between adverse childhood experiences and depression: A cross-sectional survey with university students in Botswana. S Afr J Psychiatr 2020; 26:1444. [PMID: 33240547 PMCID: PMC7669992 DOI: 10.4102/sajpsychiatry.v26i0.1444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/05/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with severe life-long negative outcomes, including depression. Particularly in low- and middle-income countries, few studies have been conducted to assess the impact of ACEs. AIM To assess the influence of ACEs on depression among young adults. SETTING Participants were students at a large university in Gaborone, Botswana. METHODS Using a cross-sectional design, we investigated the associations between ACEs and depression in young adults in Botswana (n = 392, mean age = 22.2, ± 2.5, 53.4% female). Bivariate correlation analyses, t-tests and analyses of variance (ANOVA) were performed to assess associations and compare ACEs at different levels of depression. RESULTS A total of 73% (n = 287) reported one or more ACEs, whilst 15% (59) reported five or more ACEs. About 64% (38) of those who reported five or more ACEs were female respondents. Prevalence of specific ACEs ranged from 9.5% (child neglect) to 36.3% (separation and divorce). One in three respondents reported parental separation or divorce, psychological abuse and family dysfunction, whilst 19% (11% moderate and 8% severe) reported significant depressive symptoms. Adverse childhood experiences significantly predicted depression (β = 0.27, 95% confidence interval [CI]: 0.18, 0.37). Respondents at different levels of depression significantly differed on reporting ACEs (F (3, 389) = 11.43, p < 0.001). CONCLUSION Adverse childhood experiences are highly prevalent and key determinants of depression in young adulthood. A multifaceted and cross-system intervention (e.g. schools, social work, psychological services, health services and law enforcement) is required to protect, prevent and treat survivors of childhood adversity.
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Affiliation(s)
- Kennedy Amone-P’Olak
- Department of Psychology, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
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Shuwiekh HAM, Kira IA, Sous MSF, Ashby JS, Alhuwailah A, Baali SBA, Azdaou C, Oliemat EM, Jamil HJ. The differential mental health impact of COVID-19 in Arab countries. CURRENT PSYCHOLOGY 2020; 41:5678-5692. [PMID: 33162726 PMCID: PMC7605480 DOI: 10.1007/s12144-020-01148-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2020] [Indexed: 11/29/2022]
Abstract
COVID-19 pandemic’s mental health impact on Arab countries is under-researched. The goal of this investigation was to study the differential impact of COVID-19 on the mental health of Arab countries. A questionnaire including measures of COVID-19 traumatic stress, PTSD, depression, anxiety, and cumulative stressors and trauma was distributed anonymously online in seven Arab countries (Egypt (N = 255), Kuwait (N = 442), Jordan (N = 216), Saudi Arabia (N = 212, Algeria (N = 110), Iraq and Palestine (N = 139)). We used ANOVA and stepwise regression to analyze the data. For each country, regression, PTSD, depression, and anxiety were dependent variables; we entered in the first-step, gender, age, religion, education, and income. In the second step, we entered “cumulative stressors and traumas.” In the third step, we entered COVID-19 traumatic stress. The ANOVA results indicated that the differences in COVID19 traumatic stress, PTSD, depression, and anxiety between the countries were significant. Post-hoc analysis indicated that Egypt is significantly higher than all the other Arab countries in COVID-19 traumatic stress, PTSD, anxiety, and depression. The subsample from Palestine and Iraq had a significantly higher cumulative trauma load than the other Arab countries but did not have higher levels of COVID-19 traumatic stress or PTSD. Stepwise regression indicated that COVID-19 traumatic stress accounted for significant variance above and beyond the variance accounted for by previous cumulative stressors and traumas for anxiety in all countries and PTSD and depression in all countries except for Algeria. We discussed the implications for these results for the urgent mental health needs of Arab countries.
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Affiliation(s)
| | - Ibrahim A Kira
- Center for Cumulative Trauma Studies, 4906 Woodhurst Way, Stone Mountain, GA 30088 USA.,Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA
| | | | - Jeffrey S Ashby
- Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA
| | | | | | | | | | - Hikmet J Jamil
- Department of Family Medicine, Michigan State University, Lancing, Michigan USA
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Cole AR, Jaccard J, Munson MR. Young adult trauma symptoms in the context of community violence exposure. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:2517-2531. [PMID: 32906193 DOI: 10.1002/jcop.22437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 07/28/2020] [Indexed: 06/11/2023]
Abstract
AIMS The primary purpose of this study is to understand how community violence exposure is associated with both common and unique variance characterizing posttraumatic stress (PTS) symptoms among young adults living in a low-resourced setting. METHODS Data were collected using a cross-sectional survey design. Participants were recruited from public housing developments in a city in the eastern United States. Participants completed a survey that included questions related to community violence, PTS symptoms, and optimism. Data were analyzed using structural equation modeling. RESULTS We found a relationship between a generalized PTS response and each of the PTS symptom categories. Experiencing community violence was significantly related to generalized PTS response over and above other traumatic events. CONCLUSION Young adults who experience community violence have a general distress response to those experiences, and yet, beyond that general response, there are ways in which each symptom is distinct from a generalized distress reaction.
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Affiliation(s)
- Andrea R Cole
- New York University Silver School of Social Work, New York City, New York, USA
| | - James Jaccard
- New York University Silver School of Social Work, New York City, New York, USA
| | - Michelle R Munson
- New York University Silver School of Social Work, New York City, New York, USA
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25
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Marie M, SaadAdeen S, Battat M. Anxiety disorders and PTSD in Palestine: a literature review. BMC Psychiatry 2020; 20:509. [PMID: 33066736 PMCID: PMC7566157 DOI: 10.1186/s12888-020-02911-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 10/09/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The WHO reports that anxiety disorders are the most common mental disorders worldwide. Most people who experience such events recover from it; however, people with post-traumatic stress disorder (PTSD) continue to be severely depressed and anxious for several months or even years following the event. Palestinians are particularly at a higher risk for developing anxiety disorders and PTSD due to the continuous exposure to political violence, prolonged displacement, and other limitation on professional, educational, financial opportunities, and mental health services. This paper aims to provide a systematic review of the literature and established studies concerning Anxiety disorders besides PTSD in Palestine. METHODS PubMed, Science Direct, Google Scholar was used to search for materials for the critical analysis of empirical articles. The following aspects were taken into consideration: study type, sample, and key findings. RESULTS In this review, we included about twenty-four studies from Palestine (West Bank and Gaza). Five studies relate to children, five relate to adolescents, three relate to women, three relate to physical diseases, and four relate to gender and age differences. Results show that anxiety disorders and PTSD are one of the most common mental disorders in Palestine. Anxiety and PTSD develop from a complex set of risk factors, including genetics, personality, and life events. They are mostly associated with low quality of life and disability. The results indicate that a significant proportion of Palestinian experiencing serious issues that deal with several challenges, distinct barriers including; inconsistent availability of medications, absence of multidisciplinary teamwork, insufficient specialists, fragmented mental health system, and occupation. CONCLUSION As primary prevention, the occupation has to have considered as the main source of anxiety and other mental health disorders in Palestine. Besides, there is a need to implement a mental health care system through multidisciplinary work and raising awareness regarding the prevalence of mental disorders.
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Affiliation(s)
- Mohammad Marie
- Mental Health at Faculty of Medicine and Health Sciences at An-Najah National University, Nablus, Palestine.
| | - Sana SaadAdeen
- grid.11942.3f0000 0004 0631 5695Nurse at primary health care centers-Ministry of Health-Palestine, Community Mental Health Nursing program at An-Najah National University, Nablus, Palestine
| | - Maher Battat
- grid.11942.3f0000 0004 0631 5695Nurse at primary health care centers-Ministry of Health-Palestine, Community Mental Health Nursing program at An-Najah National University, Nablus, Palestine ,Adult oncology/Hematology Ward – An-Najah National University Hospital, Nablus, Palestine
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Anxiety, Depression, and Trauma Among Immigrant Mexican Women up to Two-Years Post-partum. J Immigr Minor Health 2020; 23:470-477. [PMID: 32980976 DOI: 10.1007/s10903-020-01096-1] [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] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
Anxiety has significant consequences for maternal and infant health, and Mexican immigrant mothers are at significantly high-risk. This study examined whether maternal depressive symptoms and trauma are related to anxiety symptoms in perinatal Mexican immigrants. Data were collected from 103 Mexican women residing in the Midwestern United States who were pregnant or up to two years postpartum. Half were aged 30-34. The majority had two or more children and low socio-economic status. Linear regression analyses predicted current anxiety symptoms from current maternal depression symptoms, trauma history, and socio-demographics. Anxiety symptoms were significantly related to depressive symptoms (B = 0.87, 95% CI 0.73, 1.01) and trauma. Compared to women with no trauma history, women who experienced more than ten traumas had increased anxiety symptoms (B = 7.15, 95% CI 0.34, 13.96). Perinatal Mexican women with higher depression symptoms and trauma have increased anxiety symptoms, increasing the need for more comprehensive screening.
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Kira IA, Shuwiekh HAM, Rice KG, Ashby JS, Elwakeel SA, Sous MSF, Alhuwailah A, Baali SBA, Azdaou C, Oliemat EM, Jamil HJ. Measuring COVID-19 as Traumatic Stress: Initial Psychometrics and Validation. JOURNAL OF LOSS & TRAUMA 2020. [DOI: 10.1080/15325024.2020.1790160] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, Georgia, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, Georgia, USA
| | | | - Kenneth G. Rice
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, Georgia, USA
| | - Jeffrey S. Ashby
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, Georgia, USA
| | | | | | | | | | - Chafika Azdaou
- Department of Psychology, University of Algiers, Algiers, Algiers
| | - Enas. M. Oliemat
- Department of Special Education, Hashemite University, Zarqa, Jordon
| | - Hikmet J. Jamil
- School of Medicine, Wayne State University, Detroit, Michigan, USA
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El-Khodary B, Samara M. The relationship between multiple exposures to violence and war trauma, and mental health and behavioural problems among Palestinian children and adolescents. Eur Child Adolesc Psychiatry 2020; 29:719-731. [PMID: 31352503 DOI: 10.1007/s00787-019-01376-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 07/15/2019] [Indexed: 10/26/2022]
Abstract
The current study aims to investigate the effect of cumulative exposure to violence on mental health amongst children and adolescents living in the Gaza Strip. The sample consists of 1029 children and adolescents aged 11-17 years. Of them, 533 (51.8%) were female and 496 (48.2%) were male. War-traumatic events were measured using the War-Traumatic Events Checklist (W-TECh). Violence was derived from the Multicultural Events Schedule for Adolescents (M.E.S.A.) containing three domains: violence at home, violence in the neighbourhood, and violence at school. Emotional and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ). Posttraumatic Stress Disorder was measured using the Post-Traumatic Stress Disorders Symptoms Scale (PTSDSS). Finally, depression symptoms were measured by the Depression scale. Around two thirds of the children (64.5%, N = 665) reported that they were exposed to violence at home, 48.2% (N = 497) to violence in the neighbourhood, 78.2% (N = 806) to violence at school. In addition, boys significantly showed more exposure to violence compared to girls. Moreover, the prevalence of PTSD according to DSM-5 is 53.5% (N = 549). The results also showed that cumulative effect of exposure to violence in more contexts (political war trauma, violence at home, neighbourhood and/or school) predicted higher levels of PTSD, social and emotional problems, depression, and overall mental health problems amongst children. Cumulative exposure to violence may increase the propensity of developing mental health problems such as PTSD, emotional and behavioural problems, and depression symptoms and thus interventions should be targeted to these populations.
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Affiliation(s)
- Basel El-Khodary
- Department of Psychology, Kingston University London, Penrhyn Road, Kingston upon Thames, KT1 2EE, UK.
| | - Muthanna Samara
- Department of Psychology, Kingston University London, Penrhyn Road, Kingston upon Thames, KT1 2EE, UK
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29
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Ersahin Z. Post-traumatic growth among Syrian refugees in Turkey: the role of coping strategies and religiosity. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00763-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kira IA, Özcan NA, Shuwiekh H, Kucharska J, Amthal HAH, Kanaan A. The Cross-National Validity and Structural Invariance of the Existential Annihilation Anxiety Scale. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-019-00591-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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31
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Kira I, Barger B, Shuwiekh H, Kucharska J, Al-Huwailah A. The Threshold Non-linear Model for the Effects of Cumulative Stressors and Traumas: A Chained Cusp Catastrophe Analysis. ACTA ACUST UNITED AC 2020. [DOI: 10.4236/psych.2020.113025] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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32
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Kerig PK. Linking childhood trauma exposure to adolescent justice involvement: The concept of posttraumatic risk‐seeking. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2019. [DOI: 10.1111/cpsp.12280] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Do adding attachment, oppression, cumulative and proliferation trauma dynamics to PTSD Criterion “a” improve its predictive validity: Toward a paradigm shift? CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00206-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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34
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Kira I, Shuwiekh H, Kucharska J, Al-Huwailah A. The Integrated Structural and Measurement Models of Existential Annihilation Anxieties (EAA) and Their Potential Contribution to Clinical Science: Two Studies on Western and Non-Western Samples. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/psych.2019.104031] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kira I, Barger B, Shuwiekh H, Kucharska J, Al-Huwailah AH. Cumulative Stressors and Traumas and Suicide: A Non-Linear Cusp Dynamic Systems Model. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/psych.2019.1015128] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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36
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Kira I. Toward an Integrative Theory of Self-Identity and Identity Stressors and Traumas and Their Mental Health Dynamics. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/psych.2019.104027] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cantrick M, Anderson T, Leighton LB, Warning M. Embodying Activism: Reconciling Injustice Through Dance/Movement Therapy. AMERICAN JOURNAL OF DANCE THERAPY 2018. [DOI: 10.1007/s10465-018-9288-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Eleftherakos C, van den Boogaard W, Barry D, Severy N, Kotsioni I, Roland-Gosselin L. "I prefer dying fast than dying slowly", how institutional abuse worsens the mental health of stranded Syrian, Afghan and Congolese migrants on Lesbos island following the implementation of EU-Turkey deal. Confl Health 2018; 12:38. [PMID: 30202431 PMCID: PMC6123956 DOI: 10.1186/s13031-018-0172-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/09/2018] [Indexed: 11/10/2022] Open
Abstract
Background In 2015 and early 2016, close to 1 million migrants transited through Greece, on their way to Western Europe. In early 2016, the closure of the "Balkan-route" and the EU/Turkey-deal led to a drastic reduction in the flow of migrants arriving to the Greek islands. The islands became open detention centers, where people would spend months or years under the constant fear of being returned to Turkey.Syrians were generally granted refugee status in Greece and those arrived before the 20th of March 2016 had the option of being relocated to other European countries. Afghans had some chances of being granted asylum in Greece, whilst most migrants from the Democratic Republic of Congo were refused asylum.In a clinic run by Médecins sans Frontières on Lesbos Island, psychologists observed a deterioration of the migrant's mental health (MH) since March 2016. In order to understand the MH needs for this stranded population it was essential to explore how, and by what factors, their mental health (MH) has been affected on Lesbos Island due to the EU/Turkey-deal. Methods This was a qualitative study in which eight service providers' interviews and 12 focus group discussions with male and female Syrian, Afghan and Congolese migrants in two refugee camps on Lesbos Island. Thematic-content analysis was manually applied and triangulation of findings was undertaken to enhance the interpretation of data. Results Three main themes were generated: 1) Institutional abuse, 2) Continuous traumatic stress (CTS) and 3) MH service provision. Institutional abuse was expressed by inhumane living conditions, lack of information in order to make future decisions, humiliation and depersonalization. This led to CTS that was expressed through being in a state of permanent emergency under lack of protective measures. Delays in appointments, lack of psychiatric care and differences in MH perceptions amongst migrants highlighted the provision of MH services. Conclusion The EU/Turkey-deal reduced migrant flows at a very high price. Decongestion of the camps and the elimination of institutional abuse is urgently needed to reduce CTS and improve migrants' MH.
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Affiliation(s)
- Christos Eleftherakos
- Médecins Sans Frontières, Operational Centre Brussels, Mythimnis 27 A, Kypseli, Athens, Greece
| | - Wilma van den Boogaard
- 2Médecins Sans Frontières, Operational Research Unit, 68 rue Gasperich, L-1617 Luxembourg City, Luxembourg
| | - Declan Barry
- Médecins Sans Frontières, Operational Centre Brussels, Theofanous 19-21, Ampelokipi, Athens, Greece
| | - Nathalie Severy
- 4Médecins Sans Frontières, Operational Centre Brussels, Medical Department, Rue de l'Arbre Bénit, 1050 Brussels, Belgium
| | - Ioanna Kotsioni
- Médecins Sans Frontières, Operational Centre Brussels, Mythimnis 27 A, Kypseli, Athens, Greece
| | - Louise Roland-Gosselin
- Médecins Sans Frontières, Operational Centre Brussels, Theofanous 19-21, Ampelokipi, Athens, Greece
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Johnson R, Leighton L, Caldwell C. The Embodied Experience of Microaggressions: Implications for Clinical Practice. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2018. [DOI: 10.1002/jmcd.12099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Rae Johnson
- Depth Psychology Program, Pacifica Graduate Institute
| | - Lucia Leighton
- Clinical Mental Health Counseling Department, Naropa University
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Kira IA, Shuwiekh H, Al Ibraheem B, Aljakoub J. Appraisals and emotion regulation mediate the effects of identity salience and cumulative stressors and traumas, on PTG and mental health: The case of Syrian’s IDPs and refugees. SELF AND IDENTITY 2018. [DOI: 10.1080/15298868.2018.1451361] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Ibrahim Aref Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
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Contractor AA, Caldas S, Fletcher S, Shea MT, Armour C. Empirically derived lifespan polytraumatization typologies: A systematic review. J Clin Psychol 2018; 74:1137-1159. [DOI: 10.1002/jclp.22586] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 09/18/2017] [Accepted: 11/14/2017] [Indexed: 11/07/2022]
Affiliation(s)
| | - Stephanie Caldas
- Department of Psychology; University of North Texas; Denton TX USA
| | - Shelley Fletcher
- Psychology Research Institute, Coleraine Campus; Ulster University; Northern Ireland
| | - M. Tracie Shea
- Department of Veteran Affairs; Providence VA Medical Center; Providence RI USA
- Department of Psychiatry and Human Behavior; Warren Alpert Medical School of Brown University; Providence RI USA
| | - Cherie Armour
- Psychology Research Institute, Coleraine Campus; Ulster University; Northern Ireland
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Kira IA, Templin T, Lewandowski L, Shuwiekh H. A Conceptual Model and Measurement of Identity-Based, Existential Annihilation Anxieties (EAA). ACTA ACUST UNITED AC 2018. [DOI: 10.4236/psych.2018.96080] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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43
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Relation between lifespan polytrauma typologies and post-trauma mental health. Compr Psychiatry 2018; 80:202-213. [PMID: 29128858 PMCID: PMC5726595 DOI: 10.1016/j.comppsych.2017.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 10/11/2017] [Accepted: 10/13/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Most individuals experience more than one trauma. Hence, it is important to consider the count and types of traumas (polytraumatization) in relation to post-trauma mental health. METHOD The current study examined the relation of polytraumatization patterns to PTSD clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], and alterations in arousal and reactivity [AAR]), depression, and impulsivity facets (lack of perseverance, lack of premeditation, negative urgency, sensation seeking) using a web-based sample of 346 participants. Age, gender, race, and ethnicity were covariates. RESULTS Results of latent class analyses indicated a three-class solution: Low Experience, Moderate Experience - Predominent Threat/Indirect PTEs (Moderate Experience), and High Experience - Predominant Interpersonal PTEs (High/Interpersonal). Multinomial logistic regression results indicated that ethnicity and gender were significant covariates in predicting Low versus High/Interpersonal Class, and Moderate Experience versus High/Interpersonal Class membership, respectively. The High/Interpersonal Class had higher scores on most PTSD clusters, depression, and the impulsivity facets of lack of perseverance and negative urgency compared to the other classes. The Low and Moderate Experience Classes differed on PTSD's avoidance and AAR clusters (lower in the former). CONCLUSIONS Individuals exposed to multiple PTE types, particularly interpersonal traumas, may be at risk for more severe post-trauma symptoms.
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The dynamics underlying the negative mental health effects of gender discrimination in two samples: Poland and Egypt. CURRENT PSYCHOLOGY 2017. [DOI: 10.1007/s12144-017-9730-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kira IA, Shuwiekh H, Rice K, Al Ibraheem B, Aljakoub J. A Threatened Identity: The Mental Health Status of Syrian Refugees in Egypt and Its Etiology. IDENTITY-AN INTERNATIONAL JOURNAL OF THEORY AND RESEARCH 2017. [DOI: 10.1080/15283488.2017.1340163] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, Georgia, USA
- The Center for Stress, Trauma, and Resiliency, Georgia State University, Atlanta, Georgia, USA
| | - Hanaa Shuwiekh
- The Center for Stress, Trauma, and Resiliency, Georgia State University, Atlanta, Georgia, USA
- South Valley University, Qena, Egypt
| | - Kenneth Rice
- The Center for Stress, Trauma, and Resiliency, Georgia State University, Atlanta, Georgia, USA
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Hetolang LT, Amone-P’Olak K. The associations between stressful life events and depression among students in a university in Botswana. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2017. [DOI: 10.1177/0081246317711793] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Depression is common among university students and often impacts their career development and health. Stressful life events might be associated with depression but remain to be studied among young adults, especially in non-Western settings. Depression and stressful life events were assessed in 304 students at a university in Botswana ( M = 21.56, standard deviation = 1.86) using the 21-item Beck’s Depression Inventory (BDI) and the 26-Item Social Readjustment Rating Scale. Regression models were fitted to study the associations between stressful life events and depression while a one-way between-subjects analysis of variance was performed to compare subjects with minimal, mild, moderate, and severe depression on reporting stressful life events. Depression was present in 22 % of the participants (severe in 8.2% and moderate in 13.8%). More than half of the participants reported 10 or more stressful life events. Stressful life events significantly predicted depression (β = .37, 0.13–0.60). When all the other stressful life events and gender were adjusted for each other, loss of a cell phone, tablet, or laptop and relationship difficulties with peers, parents, and lecturers independently predicted depression. Subjects with minimal, mild, moderate, and severe depression significantly differed on reporting stressful life events ( F(3, 300) = 12.69, p < .001). Depression is not only common but significantly and increasingly associated with reporting more stressful life events. Types of stressful life events such as relationship difficulties and losses were uniquely associated with depression and should be considered in planning interventions and treatment of depression on university campuses.
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Does one size fit all? Nosological, clinical, and scientific implications of variations in PTSD Criterion A. J Anxiety Disord 2016; 43:106-117. [PMID: 27449856 DOI: 10.1016/j.janxdis.2016.07.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/30/2016] [Accepted: 07/04/2016] [Indexed: 11/20/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a psychiatric pathology wherein the precipitating traumatic event is essential for diagnostic eligibility (Criterion A). This link is substantiated throughout PTSD's development as a diagnosis. However, while traumatic events may vary considerably, this variation currently bears nearly no implications for psychiatric nosology. Consequently, PTSD remains a semi-unified diagnostic construct, consisting of no Criterion-A-determined subtypes of adult PTSD. The question addressed by the current paper is then does one size truly fit all? Making an argument for the negative, the paper briefly reviews complex PTSD (CPTSD), ongoing traumatic stress response (OTSR), and cumulative traumas, all of which are exemplars wherein Criterion A specification is crucial for understanding the emerging symptomatology and for devising appropriate interventions. Indicating several overlooked discrepancies in the PTSD literature, the paper urges for the necessity of a more fine-grained differential diagnostic subtyping of PTSD, wherein posttraumatic reactions are more closely associated with their precipitating traumatic events. The paper concludes by suggesting diagnostic, clinical and societal implications, as well as proposing directions for future research.
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Barber BK, McNeely C, Olsen JA, Belli RF, Doty SB. Long-term exposure to political violence: The particular injury of persistent humiliation. Soc Sci Med 2016; 156:154-66. [DOI: 10.1016/j.socscimed.2016.03.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 03/07/2016] [Accepted: 03/10/2016] [Indexed: 01/19/2023]
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Kira IA, Ashby JS, Omidy AZ, Lewandowski L. Current, Continuous, and Cumulative Trauma-Focused Cognitive Behavior Therapy: A New Model for Trauma Counseling. ACTA ACUST UNITED AC 2015. [DOI: 10.17744/mehc.37.4.04] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The current dominant focus on treating single past traumas rarely addresses current, ongoing, or continuous interpersonal, intergroup, and systemic traumas or their cumulative and proliferation dynamics. The goal of this paper is to close this gap by introducing an alternative model that addresses these trauma types. The model incorporates eight precognitive, cognitive, behavioral, and social interventions. The behavioral interventions are (1) prioritizing safety and (2) addressing threats through behavior skills training inclusive of regulating personal and group-based emotions. The precognitive components are (3) stimulating the will to live and positive dispositional qualities and (4) identity work. The cognitive components are (5) psychoeducation, (6) stress inoculation, and (7) trauma narration. The social intervention is (8) advocacy, social justice and reconnecting to social networks. We discuss the evidence for each component and provide a case example to illustrate the model's utility. We also discuss future directions for research and model development.
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Kira IA, Ramaswamy V, Lewandowski L, Mohanesh J, Abdul-Khalek H. Psychometric assessment of the Arabic version of the Internalized Stigma of Mental Illness (ISMI) measure in a refugee population. Transcult Psychiatry 2015; 52:636-58. [PMID: 25665586 DOI: 10.1177/1363461515569755] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study explored the psychometric properties of the Arabic version of the ISMI measure on an Arab sub-sample (N = 330) in a health clinic that served mostly refugees in Michigan, USA. Study measures included the ISMI, PTSD, depression, anxiety, CTD (Cumulative Trauma Disorders), and traumatic stress measures. Data analysis included factor analysis, correlation, and multiple regression analysis. The Arabic form of the measure was found to have robust psychometric qualities, with high reliability construct and predictive validity. Factor analysis identified a general stigma factor and different levels of stigma resistance factors. General stigma was significantly associated with and predicted post-trauma symptoms of depression, anxiety, PTSD and CTD (complex PTSD), while tough stigma resistance was associated negatively with PTSD and depression and positively with positive appraisal of traumatic events.
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Affiliation(s)
| | | | | | - Jamal Mohanesh
- Center for Cumulative Trauma Studies and Access Community Health and Research Center
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