Psychological trauma : theory, research, practice and policy最新文献

Objective: The objective of this article is to explore the relationships between two significant predictors, as indicated by existing literature, of posttraumatic stress disorder (PTSD) symptoms: guilt and alexithymia. The investigation centers on a clinical sample of women who have encountered intimate partner violence (IPV).

Method: A total of 740 women who had experienced IPV (M_age = 42.84, SD = 11.092) were recruited to participate in this study. Mediation analysis was employed to examine the mediating role of guilt and alexithymic difficulties in the relationship between IPV and PTSD symptoms.

Results: The findings of this study provide empirical support for the mediating effects of guilt and alexithymia in the link between IPV and PTSD symptoms. Specifically, higher levels of guilt and alexithymia were found to be associated with an increased likelihood of experiencing symptoms of PTSD among women with an IPV experience.

Conclusion: The results of this study have important implications for the development of interventions tailored to the specific needs of women who have experienced IPV. In particular, interventions that target and address guilt and alexithymia hold promise for effectively mitigating symptoms of PTSD in this population. By addressing these underlying factors, interventions can help women navigate their trauma, facilitate emotional processing, and support their journey toward recovery and well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Several studies have demonstrated robust protective effects of childhood family support and cohesiveness on adult stress-related psychopathology. However, there is little evidence regarding the prospective relationship between the perceived childhood family environment and the in-theater emergence of war-zone stress-related psychological symptoms. The present report is from data collected from the Texas Combat PTSD Risk Project, which aims to identify risk and resilience factors at predeployment that predict the subsequent impact of war-zone stressors in terms of psychological symptom emergence in U.S. soldiers deployed to Iraq.

Method: Soldiers (N = 150) completed a battery of standardized interview and self-report assessments at predeployment, including a measure of perceived childhood family cohesion. Once deployed, soldiers completed monthly web-based self-report assessments of war-zone stressors, posttraumatic stress symptoms, depression, and anxiety.

Results: Consistent with predictions, greater perceived childhood family cohesiveness prior to deployment robustly mitigated subsequent in-theater symptoms. However, contrary to predictions, childhood family cohesiveness did not reliably moderate the linkage between war-zone stressors and in-theater symptoms.

Conclusions: Consistent with a wealth of other evidence demonstrating protective stress resilience effects of childhood family cohesion that extend across the lifespan, the present findings suggest they also extend to the war-zone environment among deployed soldiers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Chronic pain often co-occurs with posttraumatic stress disorder (PTSD). The mutual maintenance hypothesis proposes that there may be shared underlying mechanisms of symptoms of pain exacerbating PTSD, and vice versa. The association between PTSD and pain intensity remains understudied. To elucidate the relationship, the present study examined the temporality of changes in PTSD severity and pain intensity in veterans undergoing intensive PTSD treatment.

Method: Data from 332 veterans undergoing intensive 2-week cognitive processing therapy- (CPT-) based treatment (ITP) with adjunctive components (i.e., mindfulness, art therapy). Random intercepts cross-lagged panel models (RI-CLPMs) were used to examine within-subjects relationships between pain intensity and PTSD severity over the course of the program.

Results: Veterans experienced large PTSD severity reductions (Essg = 1.20; p < .001) and small pain severity reductions (Essg = 0.21; p < .001) over the course of treatment, despite pain not being a treatment target. RI-CLPMs revealed that PTSD severity significantly predicted subsequent pain severity. Results indicate the absence of a bidirectional relationship in that changes in pain intensity did not predict later PTSD severity improvement during the ITP. Time trends for both PTSD severity and pain intensity were generally consistent with respect to baseline demographic characteristics.

Conclusion: Our findings support the mutual maintenance regarding the association between PTSD and pain intensity. Future research should investigate temporal associations in other evidence-based PTSD treatments and formats and evaluate the long-term impacts of PTSD treatment on pain intensity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Posttraumatic stress symptoms (PTSS) can have detrimental influences on both individual and couple functioning, including how individuals respond to stressors and regulate emotions. Respiratory sinus arrhythmia (RSA) can serve as a key indicator of emotion regulation; however, few studies have examined psychophysiological stress reactions within a couple's context.

Method: Forty-three couples (N = 86 individuals) with a trauma history were assessed for PTSS and RSA at baseline. One partner then completed a stressor task using a film-clip depicting sexual assault. Afterward, the couple was reunited and completed a dyadic discussion task where both partners' RSA was continuously measured while they discussed the stressed partner's thoughts and feelings about the stressful film-clip.

Results: Moderated repeated measures actor-partner interdependence models were conducted, examining the self and coregulation of RSA and moderation of such regulation by PTSS. There was significant self-regulation from both partners, and a coregulation process whereby the nonstressed partner's RSA influenced the rate of change in RSA of their stressed partner. Additionally, greater PTSS in the nonstressed partner was associated with a weakening of both self and coregulation.

Conclusion: Patterns of both self- and coregulation, within and between romantic partners emerged and illustrate the impact of PTSS within these dyadic physiologic processes. Findings have theoretical and clinical implications in physiological dyadic interactions and potential stress recovery, particularly emphasizing the relevance of examining biomarkers such as RSA among partners with a trauma history during recovery from stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

One in three women 15 years and older will experience interpersonal violence (IpV), including physical or sexual violence, at some point in their life. While the general psychological benefits of religion and spirituality (RS) are well known, research has not thoroughly examined RS coping and psychological outcomes in IpV-exposed women. When evaluating generational differences in RS concepts, literature reveals concepts such as God image vary across generation; however, literature does not address generational differences in RS coping, particularly in IpV-exposed women.

Objective: This study seeks to examine the psychological outcomes and religious coping styles of women who are exposed to IpV as it relates to generational differences.

Method: A national stratified convenience sample of women in the United States (N = 1,165) was recruited online using the Qualtrics crowdsourcing service. Participants (n = 538) who reported having experienced interpersonal violence (i.e., sexual assault, physical assault, assault with a weapon) were designated as the IpV group. Those (n = 627) who reported no exposure to these events were designated as a no IpV comparison group (Non-IpV).

Results: Several two-way analyses of variance revealed that there was a statistically significant interaction between generations and IpV for depression, F(2, 1159) = 3.78, p = .023, anxiety, F(2, 1159) = 4.77, p = .009, stress, F(2, 1159) = 4.10, p = .017, and positive religious coping, F(2, 1,159) = 3.57, p = .028.

Conclusions: These results suggest that generational differences may exist in psychological outcomes and RS coping in women who have experienced IpV compared to comparison groups. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Given the high prevalence of posttraumatic stress disorder (PTSD) symptoms in incarcerated forensic populations, this meta-analysis estimated the efficacy of interventions in this field and explored predictors of intervention outcomes.

Method: Twelve randomized controlled trials of psychological interventions for PTSD symptoms in incarcerated forensic populations were included. A combined Hedges's g effect size was synthesized, quality assessments and risk of bias analyses were performed, and publication bias was assessed. Gender and type of control group were explored as predictors.

Results: Thirteen comparisons from 12 studies were included in the main analysis. A small to medium combined effect size (g = 0.43, p = .005) was found at posttreatment. The type of control group (p = .156) and gender (p = .953) did not predict outcomes. When we analyzed the available follow-up data (k = 5), the effect was nonsignificant (g = 0.36, p = .123). Study quality was poor and risk of bias high, and studies of first-line PTSD treatments were not found in the literature.

Conclusions: A few studies suggest that PTSD treatment may improve symptoms in incarcerated forensic populations, at least temporarily. Follow-up data are still too scarce to draw conclusions about long-term outcomes. Findings of this study indicate that methodologically rigorous outcome research in these populations is needed, with a specific focus on first-line PTSD treatments, long-term efficacy, measurement of recidivism, as well as addressing comorbid conditions given the common complex clinical and social needs in this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Trauma systems therapy for refugees (TST-R) is a trauma-focused, culturally responsive mental health prevention and intervention model designed to meet the needs of children and families who are fleeing their home countries and seeking humanitarian refuge. TST-R provides trauma-focused mental health treatment and addresses problems in part exacerbated by harsh U.S. immigration policies (e.g., poor mental health, stigma, fear) that have implications for the psychosocial well-being of immigrant children and families, especially those who have experienced migration-related trauma.

Method: Informed by a community-based participatory research approach, TST-R was developed as an adaptation of trauma systems therapy to address common barriers to care experienced by those of refugee and immigrant backgrounds, including mental health stigma, distrust of service systems, and cultural and linguistic barriers.

Results: TST-R is a multitiered and phase-based intervention that strategically addresses stressors and needs across levels of the social ecology. Most TST-R services are delivered in easily accessible, nonstigmatizing settings (e.g., school) by a cultural broker and a clinician who work in partnership. TST-R has been disseminated and implemented with multiple cultural groups (e.g., Somali, Bhutanese) across the United States and Canada.

Conclusions: Given the unique stressors, strengths, and needs of immigrant children and their families, mental health services must be equitable, community based, and sustainable. TST-R demonstrates promise as a prevention and intervention model especially for those experiencing immigration policy-related stressors and may serve as a guide for developing child mental health policies and immigration policies that promote mental well-being for immigrant families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Latinx youth who have experienced caregiver deportation show higher rates of posttraumatic stress disorder (PTSD) and internalizing symptoms compared to Latinx youth who have not. Thus, there is a need for culturally and linguistically appropriate therapeutic approaches to address psychiatric needs related to caregiver deportation. Positive Adaptations for Trauma and Healing (PATH) is a manualized 10-week group therapy for Latinx youth and their caregivers that integrates trauma-informed interventions with positive psychology and resilience interventions. The present study examined PATH for reducing trauma symptomatology for Latinx youth who endured at least three traumatic experiences in their caregiving system as well as differences for Latinx youth who experienced their caregiver's deportation.

Method: Self-identified Latinx youth (N = 31) and their Spanish-speaking caregivers were recruited from two urban hospitals. All youth experienced three or more traumatic events. Pre- to postintervention mean change was measured with t tests; mixed-effects analysis of variance assessed whether the program was feasible for youth who had experienced a caregiver deportation versus Latinx youth who did not.

Results: Assessment with the Trauma Symptom Checklist and the UCLA PTSD Index for Youth showed statistically significant reductions on Anxiety, Depression, Anger, and PTSD subscales. Latinx youth who experienced a caregiver's deportation exhibited larger reductions in anger symptoms and PTSD symptoms.

Conclusion: Study results suggest that the novel group therapy intervention was feasible and acceptable for Latinx youth and their caregivers. Despite a small sample size, the intervention proved feasible for Latinx youth who experienced caregiver deportation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Exposure to migration-related traumatic events may increase the risk for immediate distress upon arrival and complex trauma following resettlement. Record numbers of Latinx immigrant youth are being held in detainment facilities at the border and around the country. However, little research examines the psychological sequelae of trauma among detained youth. Through addressing these gaps, this article can inform policies and best practices that adhere to human rights and foster acculturative adjustment.

Method: This article describes community collaborative research with newcomer Latinx adolescents enrolled in public high schools. Study 1 (n = 127) used quantitative data to examine whether time in detention and trauma exposure were associated with psychosocial adjustment. Study 2 (n = 46) used qualitative data to explore the lived experiences of detainment and related trauma.

Results: Study 1 results found that over a third of participants had been detained for at least 4 weeks (36%) and nearly half the participants witnessed or experienced a traumatic event (46%). Although time in detainment was not related to internalizing or externalizing symptoms, exposure to trauma was associated with more internalizing and more externalizing symptoms. Study 2 results illustrated specific detainment-related stressors, including multiple relocations, inhumane conditions, legal concerns, and family separation, as well as complex psychological sequelae, both during detainment and after resettlement, as well as some satisfactory experiences.

Conclusions: Results contribute new understanding of the unique experiences of immigration detainment and its psychological sequelae and can inform legal, policy, and educational practices that directly impact recently resettled Latinx youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Latinx immigrants are at risk for migration-related trauma that can lead to posttraumatic stress disorder (PTSD). Among parents in immigrant families with undocumented family member(s) (i.e., mixed-status), risk for PTSD may be exacerbated by policies that threaten family separation and exclude immigrants from systems of support. Understanding these relationships in context is important to equip practitioners to address traumatic stress in this population.

Method: Our community-based participatory research (CBPR), mixed-methods study explored migration-related trauma and PTSD among Latinx immigrant parents in a restrictive immigration climate during the COVID-19 pandemic. We conducted 145 surveys with Latinx parents in mixed-status families and conducted multivariable linear analyses to test if immigration policy vulnerability strengthened the relationship between migration-related trauma and PTSD symptoms. Then, we conducted 15 interviews with frontline workers serving Latinx immigrant families to contextualize the relationships between migration-related trauma, immigration-related policies, and PTSD during the COVID-19 pandemic.

Results: Parent surveys revealed was no observed relationship between premigration-related trauma and PTSD symptoms (β = 0.12, p = .15). However, increases in policy vulnerability was associated with PTSD symptoms (β = 0.25, p < .01) and strengthened the relationship between postmigration trauma and PTSD symptoms (β = 0.19, p = .03). Frontline workers described how social isolation due to immigration-related policies worsened under the COVID-19 pandemic and deportation fears remained a constant stressor.

Conclusions: Results from our CBPR study highlight the need for policies and practices that address compounding effects of migration-related trauma, policy vulnerability, and the COVID-19 pandemic to promote mental health equity among Latinx immigrant families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).