Rolbiecki A, Subramanian R, Crenshaw B
… +3 more, Albright DL, Perreault M, Mehr D
Traumatology (Tallahass Fla)
· 2017 Mar · PMID 33500683
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An estimated 100 million Americans are living with chronic pain. The majority of the chronic pain literature focuses on the biological impact of the condition and very little attention is given to patients' lived experie...An estimated 100 million Americans are living with chronic pain. The majority of the chronic pain literature focuses on the biological impact of the condition and very little attention is given to patients' lived experience with chronic pain and the enactment of their resiliency. Yet, resiliency may play a critical role in patients' experience of pain intensity as well as self-efficacy to manage their pain. The main objective of this study was to explore the origin and enactment of resiliency across a sample of 12 chronic pain patients. In-depth phone interviews were conducted, and data were analyzed using thematic analysis. Results indicate that patients exhibited resiliency in four ways: (1) developing a sense of control - independently seeking information and cross-checking this information with their doctors' recommendations (2) active engagement in medical and complementary treatment; (3) establishing social connections; and (4) exhibiting pain acceptance and positive affect. This study lays the foundation to explore whether resiliency improves clinical outcomes among patients living with chronic pain. The findings support the need for clinicians to evaluate and treat chronic pain patients through the lens of resiliency.
Traumatology (Tallahass Fla)
· 2016 Jun · PMID 27458331
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BACKGROUND AND OBJECTIVES: The degree to which a traumatic event is seen as central to one's sense of self (trauma centrality) has been associated with posttraumatic stress disorder (PTSD) symptoms. Based on cognitive mo...BACKGROUND AND OBJECTIVES: The degree to which a traumatic event is seen as central to one's sense of self (trauma centrality) has been associated with posttraumatic stress disorder (PTSD) symptoms. Based on cognitive models of PTSD that highlight the role that maladaptive appraisals play in generating PTSD symptoms, we hypothesized that appraising a trauma as violating one's core beliefs and goals mediates the link between trauma centrality and PTSD symptoms. Further, we reasoned that coping ability moderates the direct and indirect link as those with better coping ability will have more adaptive appraisals. DESIGN: Hypotheses were examined in a cross-sectional sample of 367 undergraduates who have experienced a traumatic event. METHODS: Data were collected via an online survey. RESULTS: Overall, results of the moderated mediation analysis were consistent with the hypothesized mediating role for appraised violations and moderating role for coping ability. CONCLUSIONS: Findings highlight the importance of considering individual differences and trauma appraisals in understanding the relationship between trauma centrality and PTSD - trauma centrality may be related to PTSD symptoms more so among people with poorer coping ability who appraise a trauma as violating their core beliefs and goals.
Traumatology (Tallahass Fla)
· 2016 Jun · PMID 27398074
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OBJECTIVE: Posttraumatic Stress Disorder (PTSD) has been linked to problematic alcohol use. Those with PTSD have greater difficulty regulating emotions, which may help to explain the PTSD-drinking co-occurrence. However,...OBJECTIVE: Posttraumatic Stress Disorder (PTSD) has been linked to problematic alcohol use. Those with PTSD have greater difficulty regulating emotions, which may help to explain the PTSD-drinking co-occurrence. However, emotion regulation as a mediator of PTSD-alcohol associations has been limited. In the present study, we examined this association. METHOD: College students ( = 466, M = 19.5, 53% female) were assessed for PTSD by structured clinical interview, and were categorized into three groups: those who had not experienced a significant trauma (No Trauma, = 182), those who had experienced a significant trauma but did not have current PTSD symptoms (Trauma Only, = 171), and those with significant trauma and with current PTSD (partial or full; PTSD, = 113). Alcohol use over the past six months and emotion regulation were assessed via self-report (DDQ; Collins, Parks, & Marlatt, 1985; DERS; Gratz & Roemer, 2004). RESULTS: Findings revealed that those with trauma and clinically significant PTSD reported greater difficulty with emotion regulation than those who had not been exposed to trauma, which in turn significantly predicted alcohol use. This mediating effect was not found in those with trauma exposure alone, suggesting an important role for PTSD in this pathway. Findings also indicated that the ability to control emotion-based impulses is a particularly relevant mediating facet of emotion regulation. CONCLUSION: These results implicate emotion regulation as a potential explanatory link between PTSD and alcohol use, lending further support to the inclusion of emotion regulation training in PTSD treatment.
Traumatology (Tallahass Fla)
· 2015 Jun · PMID 26633944
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The purpose of this cross-sectional study was to investigate to what extent young adults with close ties to Mexico were at greater risk for self-reported negative mental health outcomes than comparison groups during drug...The purpose of this cross-sectional study was to investigate to what extent young adults with close ties to Mexico were at greater risk for self-reported negative mental health outcomes than comparison groups during drug-related armed conflict from 2008 through 2012, and the effect of type and number of traumatic events on mental health outcomes. Using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist, 202 university students living in the El Paso-Ciudad Juárez border region were surveyed for symptoms of depression, anxiety, and posttraumatic stress. Students with close ties to Mexico reported symptoms of anxiety and posttraumatic stress at significantly higher rates compared with those without connection to Mexico, but there was no significant difference in rates of depression. Although more than a third of participants reported experiencing 5 or more traumatic events connected with the drug war, being confined to home had the most significant effect. Frequency of traumatic events reported by students as well as rates of anxiety and posttraumatic stress symptoms were higher among students with greater connection to Mexico. Rates of clinically-significant depressive symptoms among all students were higher than expected for U.S. adults but comparable with all U.S. college students. This study presents important new data on the mental health effects of Mexico's drug war.
Traumatology (Tallahass Fla)
· 2015 Mar · PMID 26005396
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This study sought to evaluate changes in written trauma narratives completed during a course of Cognitive Processing Therapy (CPT). Participants were 22 female survivors of interpersonal assault who represented a subset...This study sought to evaluate changes in written trauma narratives completed during a course of Cognitive Processing Therapy (CPT). Participants were 22 female survivors of interpersonal assault who represented a subset of participants from two larger CPT treatment trials. Participants completed two written trauma narratives over the course of treatment. We predicted that narratives would increase in length and peritraumatic detail, and that participants would perceive an increase in their recall ability for important aspects of the trauma. Although narrative length and amount of peritraumatic detail did not change significantly from first to final narrative, participants evidenced changes in the content of the peritraumatic details. Patients commonly omitted assaultive acts from one of their narratives. There was a greater degree of fluctuation within the reporting of sexual assaults, as compared to physical assaults, with 55% of participants reporting a forced sexual act in one narrative, but not the other. Participants did not report significant changes in perceived recall ability for the traumatic event after completing the narratives, but did report improvements in perceived recall from pre to posttreatment. Overall, findings indicate that clients included different details (but not more details) in their final narrative, and that perceived increases in recall ability may not be a typical experience for clients as they complete written narratives in the context of trauma treatment.
Loew B, Carter S, Allen E
… +3 more, Markman H, Stanley S, Rhoades G
Traumatology (Tallahass Fla)
· 2014 Sep · PMID 25530729
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Post-traumatic distress after military combat is a major cost of war. One under-investigated factor potentially associated with PTSD symptoms is specific beliefs about one's military service. This study examined post-dep...Post-traumatic distress after military combat is a major cost of war. One under-investigated factor potentially associated with PTSD symptoms is specific beliefs about one's military service. This study examined post-deployment self-reports from 272 active-duty U.S. Army soldiers, to investigate potential associations between military-related PTSD symptom severity and three beliefs about the military: the importance and value ascribed to one's own work in the Army, to current military operations in Iraq and Afghanistan, and to military service in general. Higher scores on these three beliefs were negatively correlated with military-related PTSD symptom severity. However, in a combined regression model that controlled for recent combat exposure, only the belief about current military operations had a significant, unique association with PTSD symptom severity. That is, more positive beliefs about the value of operations in Iraq or Afghanistan were associated with lower PTSD symptoms.
Cook JM, Dinnen S, Simiola V
… +3 more, Bernardy N, Rosenheck R, Hoff R
Traumatology (Tallahass Fla)
· 2014 · PMID 25411565
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Thirty-eight U.S. Department of Veterans Affairs's (VA) residential treatment programs for posttraumatic stress disorder took part in a formative evaluation of their programmatic services, including perceptions of effect...Thirty-eight U.S. Department of Veterans Affairs's (VA) residential treatment programs for posttraumatic stress disorder took part in a formative evaluation of their programmatic services, including perceptions of effective treatment. From July 2008 through March 2011, face-to-face qualitative interviews were conducted with over 250 VA residential staff. A wide variety of perceived effective treatment elements were noted. The most frequently mentioned elements were evidence-based treatments, frequency and intensity of milieu, staff cohesion, varied programming, and individualized treatment. Implications for VA managers and policy-makers as well as non-VA health care systems and health care providers are discussed.
Traumatology (Tallahass Fla)
· 2014 Sep · PMID 25379029
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This exploratory study examined how demographics, child sexual abuse (CSA), assault-related factors, and post-assault responses predict posttraumatic growth in a diverse sample (N = 1863) of female adult sexual assault v...This exploratory study examined how demographics, child sexual abuse (CSA), assault-related factors, and post-assault responses predict posttraumatic growth in a diverse sample (N = 1863) of female adult sexual assault victims. Multiple regression analysis showed that demographics (older age, ethnic minority race, less education) were all significantly related to greater posttraumatic growth, while CSA was unrelated to posttraumatic growth. Assault characteristics were weaker predictors of posttraumatic growth; whereas women's perception of life threat during the assault was related to greater posttraumatic growth. Post-assault factors including: greater levels of maladaptive coping, characterological self-blame, negative social reactions from others, and posttraumatic stress disorder (PTSD) symptoms were all related to less posttraumatic growth. Conversely, positive social reactions from others, perceived control over recovery, adaptive individual coping, and disrupted core beliefs were all related to greater posttraumatic growth. Clinicians should facilitate these modifiable social psychological factors when treating survivors.
Traumatology (Tallahass Fla)
· 2014 Mar · PMID 25110466
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During the most intense period of armed conflict related to the drug trade in Mexico, forty students attending the Universidad Autónoma de Ciudad Juárez (UACJ) in Ciudad Juárez, Chihuahua, Mexico, were surveyed in this p...During the most intense period of armed conflict related to the drug trade in Mexico, forty students attending the Universidad Autónoma de Ciudad Juárez (UACJ) in Ciudad Juárez, Chihuahua, Mexico, were surveyed in this pilot study for symptoms of depression, anxiety and post-traumatic stress using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist. The percentage of participants who scored positively for symptoms of PTSD depression and anxiety were 32.5%, 35% and 37.5%, respectively. Criteria for post-traumatic stress were analyzed separately. The most frequently-reported traumatic events included extortion or robbery, confinement to home, injury to loved one, being in an armed conflict, witnessing a killing or dead body and being beaten. Trauma events positively associated with depression, anxiety and PTSD symptoms included robbery or extortion, armed conflict situation, exposure to frequent arms fire, and witnessing a killing or dead body.
Nachar N, Guay S, Beaulieu-Prévost D
… +1 more, Marchand A
Traumatology (Tallahass Fla)
· 2013 Mar · PMID 23766669
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Although a wide array of the scientific literature explores the links between posttraumatic stress disorder (PTSD) symptoms, coping strategies, and social support and health-related quality of life (HRQoL) as an outcome...Although a wide array of the scientific literature explores the links between posttraumatic stress disorder (PTSD) symptoms, coping strategies, and social support and health-related quality of life (HRQoL) as an outcome variable, their connections remain unclear. It is unknown whether PTSD symptom severity, coping strategies, and social support explain each a unique portion of variance of HRQoL of individuals with PTSD. In the current study, based on pretreatment results of a broader study assessing a specific intervention for PTSD, 94 individuals with PTSD were screened for psychiatric disorders and completed several questionnaires concerning social support, coping strategies, PTSD symptoms, and HRQoL. Coping strategies, social support, and PTSD all appeared to be predictors of HRQoL; however, PTSD seemed to constitute the major predictor among these variables. Indeed, coping strategies and social support did not explain a unique share of variability of HRQoL beyond that of PTSD symptomatology. A causal pathway integrating these variables should be tested in future studies.
Beaton RD, Johnson LC, Maida CA
… +2 more, Houston JB, Pfefferbaum B
Traumatology (Tallahass Fla)
· 2012 Nov · PMID 23264756
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This case study describes the process and outcomes of the Northwest Center for Public Health Practice Child and Family Disaster Research Training (UWDRT) Program housed at the University of Washington, which used web-bas...This case study describes the process and outcomes of the Northwest Center for Public Health Practice Child and Family Disaster Research Training (UWDRT) Program housed at the University of Washington, which used web-based distance learning technology. The purposes of this program were to provide training and to establish a regional cadre of researchers and clinicians; to increase disaster mental health research capacity and collaboration; and to improve the scientific rigor of research investigations of disaster mental health in children and families. Despite a number of obstacles encountered in development and implementation, outcomes of this program included increased team member awareness and knowledge of child and family disaster mental health issues; improved disaster and public health instruction and training independent of the UWDRT program; informed local and state disaster response preparedness and response; and contributions to the child and family disaster mental health research literature.
Armour C, Shevlin M, Elklit A
… +1 more, Mroczek D
Traumatology (Tallahass Fla)
· 2012 Mar · PMID 22661909
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The research literature has suggested that longitudinal changes in posttraumatic stress disorder (PTSD) could be adequately described in terms of one universal trajectory, with individual differences in baseline levels (...The research literature has suggested that longitudinal changes in posttraumatic stress disorder (PTSD) could be adequately described in terms of one universal trajectory, with individual differences in baseline levels (intercept) and rate of change (slope) being negligible. However, not everyone who has experienced a trauma is diagnosed with PTSD, and symptom severity levels differ between individuals exposed to similar traumas. The current study employed the latent growth mixture modeling technique to test for multiple trajectories using data from a sample of Danish rape victims (N = 255). In addition, the analysis aimed to determine whether a number of explanatory variables could differentiate between the trajectories (age, acute stress disorder [ASD], and perceived social support). Results concluded the existence of two PTSD trajectories. ASD was found to be the only significant predictor of one trajectory characterized by high initial levels of PTSD symptomatology. The present findings confirmed the existence of multiple trajectories with regard to PTSD symptomatology in a way that may be useful to clinicians working with this population.
Traumatology (Tallahass Fla)
· 2010 Jun · PMID 21132049
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This article reports findings from a cross-sectional study exploring relationships between trauma exposure, childhood traumatic stress, and family functioning. Data were collected from a sample of 100 mostly African Amer...This article reports findings from a cross-sectional study exploring relationships between trauma exposure, childhood traumatic stress, and family functioning. Data were collected from a sample of 100 mostly African American, 6- to 9-year-old children and their caregivers who were living in low-income, urban neighborhoods and analyzed using hierarchical multiple regressions. The children experienced high levels of exposure and traumatic stress symptoms. Trauma exposure was correlated with reexperiencing, avoidance, and arousal and also with externalizing behavior problems. Reexperiencing and avoidance symptoms were related to lower ratings of the value of family routines reported by caregivers. Higher ratings of family structure, including both organization and support, were related to fewer internalizing and externalizing behavior problems.
Traumatology (Tallahass Fla)
· 2008 Sep · PMID 21113417
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Children and their families living in poor, inner-city neighborhoods are at high risk for experiencing multiple traumas. This article describes findings from a qualitative study designed to explore the impact of chronic...Children and their families living in poor, inner-city neighborhoods are at high risk for experiencing multiple traumas. This article describes findings from a qualitative study designed to explore the impact of chronic traumas on family life through the voices of primarily African American caregivers coping with urban poverty. Structured interviews are conducted with 16 caregivers of children ages 6 to 9 years who had been exposed to multiple traumas and had symptoms of posttraumatic stress disorder. Caregivers explain changing daily routines to accommodate child distress and promoting positive family processes such as increased protectiveness. They also describe various roles that religion/spirituality play in their coping with trauma, including finding comfort in the faith that God controls what happens in their lives. These themes are discussed with regard to theory and practical applications for assisting traumatized families.