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

Objective: Latinx asylum-seeking families report posttraumatic distress that is 161-204% higher than in nonimmigrants, with adverse consequences for health and well-being. Recent U.S. policies have further embedded trauma in the asylum-seeking process by forcing families to remain in Mexico, enduring dire living conditions in tent encampments near the border while awaiting processing. These families are now entering the United States in large numbers. This article sheds light on their recent experiences and mental health needs, using a mixed methods-grounded theory design, presenting quantitative and qualitative data to describe the experiences of six asylum-seeking families who waited for 1-2 years in the refugee camp in Mexico.

Method: Quantitative data was obtained from the Brief Symptom Inventory-18 and the Harvard Trauma Questionnaire while qualitative interviews provided insight into reasons for migration and trauma at different stages of the migration process.

Results: All participants experienced multiple traumas and endorsed trauma related symptoms. Important themes of psychological distress and trauma emerged, including unending suffering, hunger, and worry for the safety of their children while living in the refugee camp. Asylum-seeking families experienced substantial distress and trauma secondary to their stay in Mexico and COVID-19.

Conclusion: Families arriving to the United States have experienced significant trauma, separation, and loss before and during their journey. Interactions with an unprepared and overwhelmed immigration system further compromises their psychological well-being. It is imperative that first-person narratives inform policy that addresses their complex needs and protects their human rights. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This study is to explore identifiable psychological differences and predictors for the subgroup of refugees who at a very early age moved from a totalitarian country to a westernized democracy, ultimately to improve policies and reduce the maladaptation of refugees to a new society. More specifically, it is to fill in significant gaps in understanding and predicting refugee tendencies toward depression, social withdrawal, aggression, and posttraumatic growth.

Method: Latent class analysis was conducted to identify subgroups based on symptom profiles within a sample of 201 North Korean adolescent refugees residing in South Korea.

Results: Four subgroups were identified: (a) High growth, (b) Low trauma with high adaptive aggression, (c) Low trauma with high social withdrawal/depression, and (d) High trauma with high comorbidity. Predictors were physical health, self-esteem, peer support, teacher support, and school adjustment.

Conclusion: Current refugee policies in South Korea would benefit from refining services to allow customization to the specific needs and characteristics of each adolescent rather than continue the current model of homogeneity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: The number of unaccompanied children (UC) arriving in the United States has increased significantly in recent years. UC often encounter traumatic events in their home country, during their migration journey, and upon resettlement. This article describes a congressionally-funded initiative to provide trauma-informed mental health services to UC and children separated from their parents upon arrival in the United States. It also identifies facilitators and barriers to working with UC and offers lessons learned to help inform future practice and policy development aimed at assisting this vulnerable population.

Method: Data were derived from qualitative interviews and a survey administered to grantees.

Results: In total, grantees served 1,195 youth and families across 11 states, including UC, asylees, and new immigrants during the period of December 2018 through September 2019. Youth and families served spoke 16 languages and originated from diverse nations. Services provided included direct services to youth and families; training for providers and community members; partnerships and collaborations; and resource/product development or adaptations.

Discussion: Lessons learned and recommendations derived from this initiative can assist others interested in promoting trauma-informed practice and policies for migrant children and their families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: The most frequently used measure of the 11th edition of the International Classification of Diseases (ICD-11) complex posttraumatic stress disorder (CPTSD) is the International Trauma Questionnaire (ITQ). While there is strong support for the psychometric properties of the ITQ, few studies have assessed its reliability and validity in nationally representative samples. Additionally, several correlates of ICD-11 CPTSD have been identified; however, few studies have assessed multiple correlates simultaneously.

Objective: To assess the factorial validity and internal reliability of the ITQ in a nationally representative sample of adults living in Ireland (N = 1,100); determine the prevalence rates of ICD-11 posttraumatic stress disorder (PTSD) and CPTSD; and identify correlates of CPTSD symptoms and how CPTSD symptoms relate to risk of suicide.

Method: Confirmatory factor analysis was performed to evaluate the factorial validity of the ITQ, and structural equation modeling (SEM) was used to determine the unique multivariate associations between 10 predictor variables (age, sex, urban dwelling, unemployment status, number of traumatic events, COVID-19 infection, knowing someone who died from COVID-19, loneliness, social support, and sleep problems) and symptoms of CPTSD, and the unique associations between CPTSD symptoms and suicide risk.

Results: The ITQ produces reliable and valid scores, 11.2% of people met requirements for ICD-11 PTSD (2.4%) or CPTSD (8.8%), exposure to a higher number of traumatic life events, higher levels of loneliness, and more sleep problems predicted CPTSD symptoms; and negative self-concept (NSC) symptoms were most strongly associated with suicidality.

Conclusions: Where the risk of suicide is high, treating symptoms of NSC, loneliness, and sleep problems may be advisable. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Trauma-related shame (TR-shame) is associated with Posttraumatic Stress Disorder (PTSD) symptoms. However, research findings are inconsistent regarding the role of TR-shame in PTSD treatment. The purpose of this study was to examine if change in TR-shame predicted change in PTSD symptoms in treatment.

Method: A sample of 462 adults who received PTSD treatment at a Partial Hospitalization Program completed questionnaires measuring TR-shame (i.e., Trauma-Related Shame Inventory; TRSI) and PTSD symptoms (PTSD Checklist for DSM-5; PCL-5). Latent growth curve models were estimated to examine if the rate of change in TRSI predicted the rate of change in PCL-5 by using structural equation modeling. Furthermore, a latent regression model was estimated to predict the intercept and slope of the PCL-5.

Results: Model fits for the PCL-5 and the TRSI linear models were acceptable and both linear slopes were significant. On average, PCL-5 scores reduced 22.18 points from admission to discharge, while TRSI scores reduced 21.9 points from admission to discharge. The results of latent curve regression model suggested that the TRSI linear slope and intercept predicted the PCL-5 linear slope and intercept, respectively. Additionally, post-hoc analyses suggested that the variance in PCL-5 factors at discharge that were explained by TRSI intercept and linear slope ranged from 18.6% to 34.9%.

Conclusions: The results of this study indicated that the rate of change in TR-shame predicted the rate of change in PTSD symptoms. Given the negative impact of TR-shame on PTSD symptoms, TR-shame should be a target in treatment for PTSD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Clinicians, patients, and researchers need benchmarks to index individual-level clinically significant change (CSC) to guide decision making and inferences about treatment efficacy. Yet, there is no consensus best practice for determining CSC for posttraumatic stress disorder (PTSD) treatments. We examined criterion-related validity of the most common approach-Jacobson and Truax's (J&T; 1991) procedures for indexing CSC. We generated and compared four methods of calculating the J&T indices of CSC (two sets of sample-specific inputs, putatively norm-referenced benchmarks, and a combination of sample-specific and norm-referenced criteria) with respect to their association with a criterion index of quality of life (QoL).

Method: Participants were 91 women Veterans enrolled in a randomized clinical trial for PTSD who completed self-report measures on PTSD symptoms and various domains of QoL and functioning, pre- and posttreatment. For each of the four methods used to calculate CSC, the QoL composite was regressed onto the CSC categories.

Results: All methods explained large variance in change in QoL. Across all methods, participants categorized as unchanged had smaller changes in QoL, compared with those who improved or had probable recovery. The norm-referenced benchmarks accounted for the relatively largest amount of variance in QoL, but categorized the fewest patients as having made CSC.

Conclusions: The J&T methodology for indexing CSC in PTSD symptoms has criterion-related validity, and a norm-referenced benchmark appears to be the most potent. However, the norm-referenced parameters may be overly specific, potentially leading to an underestimate of improvement. Research is needed to test the generalizability of these results. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This national study examined whether different types of interpersonal violence and mental disorders were associated with greater risk for attempted suicide among bisexual women than heterosexual women.

Method: Data were used from participants in Wave II of the National Epidemiologic Survey on Alcohol and Related Conditions in the United States of America who identified as female and either heterosexual or bisexual (N = 19,261; 71% White). Logistic regression models tested the main and interactive effects of three types of interpersonal violence (i.e., childhood abuse, childhood neglect, or intimate partner violence [IPV]), four types of mental disorders (i.e., mood, anxiety, substance use, and posttraumatic stress) and sexual orientation (i.e., bisexual vs. heterosexual) on attempted suicide. A post hoc logistic regression also tested the main and interactive effects of four types of anxiety disorders (i.e., panic disorder, social phobia, specific phobia, and generalized anxiety disorder [GAD]) and sexual orientation on attempted suicide.

Results: Sexual orientation moderated the impact of childhood neglect, IPV, and anxiety disorders on attempted suicide. Bisexual women who experienced childhood neglect, IPV, or an anxiety disorder had 3.75, 1.43, and 6.24 greater odds, respectively, of attempted suicide, compared to heterosexual women who reported these problems. Additionally, bisexual women who had GAD had 1.66 greater odds of attempting suicide compared to heterosexual women who had GAD.

Conclusions: Findings elucidate factors that may increase suicide risk in vulnerable populations as called for by the Centers for Disease Control and Prevention's suicide prevention strategic plan. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Interpersonal factors have been linked with psychological adjustment to trauma, but how interpersonal factors influence trauma response is still unclear. Experimental paradigms such as the trauma film paradigm offer a valuable approach for studying this complex dynamic. However, few studies have used the trauma film paradigm to examine the interpersonal context of trauma response, and no studies have incorporated friends into the trauma film paradigm. The purpose of the current study was to examine how inclusion of a friend influenced reactions to a trauma analog.

Method: One hundred young adult females were randomized to watch a brief stressful film of a sexual assault either with or without a friend and the Friend Present condition was given an opportunity to interact following the film. Participants were evaluated on distress during the film, skin conductance, anxiety and negative affect immediately postfilm (preinteraction) and 5 minutes later (postinteraction), and intrusive memories over a three-day period.

Results: No differences were found between conditions on skin conductance or subjective distress during the film. However, the Friend Present condition experienced a greater reduction in state anxiety from preinteraction to postinteraction and greater decreases in intrusive memories over the three-day period.

Conclusions: Findings show the inclusion of a friend mitigated trauma-related stress reactions and suggest that interacting with a friend aided in adaptive processing of the stressor. Findings indicate that additional work is needed to examine how platonic relationships can be targeted to improve prevention and intervention efforts in trauma-related outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Although an emerging body of research has examined the legal causes of wrongful convictions, there is little research that examines the psychological impact of wrongful convictions. This study aims to understand the psychological experiences of exonerees, with a focus on the role of meaning-making in individuals' reactions to trauma. The study also aims to examine exonerees' self-reported trajectories of distress throughout their experience of being wrongfully convicted and subsequently exonerated.

Method: A total of 46 exonerees completed an online survey. Measures included: Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, PTSD Checklist for DSM-5, Posttraumatic Growth Inventory, World Assumptions Questionnaire, Meaning in Life Questionnaire, Satisfaction with Life Scale, and a self-reported retrospective trajectory measure.

Results: Cluster analysis suggested a four-factor solution: Chronic Distress, Relief and Readjustment, Recovery, and Intense Distress with Minimal Recovery. The Recovery cluster (n = 17; 37.0%) had significantly lower levels of PTSD and anxiety symptoms than the other three groups. The Recovery cluster had higher levels of positive world assumptions and lower levels of searching for meaning than the other three clusters, but there were no differences among clusters in level of meaning made, presence of meaning, depression symptoms, and satisfaction with life.

Conclusions: The results revealed that exonerees with more positive world beliefs (conceptualized as an outcome of meaning-making) have lower rates of PTSD and anxiety. Consistent with the literature, results also suggest that the search for meaning may be indicative of increased distress and less recovery. Clinical and policy implications are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The COVID-19 pandemic is a collective trauma causing profound psychological distress and, in some cases, positive psychological changes. The present study ascertained the most influential symptoms and strong connections between posttraumatic stress (PTS) symptoms and posttraumatic growth (PTG) elements. It also examined the symptoms/elements that acted as a bridge between the two, to elucidate how PTS and PTG co-exist.

Method: The PTSD Checklist (PCL-5) and Posttraumatic Growth Inventory (PTGI) were used to assess PTS symptoms and PTG, respectively, in a sample of 509 adults from Kashmir, India.

Results: The network analysis revealed negative trauma-related emotions as the most influential symptom in the PTS network, and the ability to do better things with life as the most influential element in the PTG network. Eight bridge symptoms/elements emerged between the PTS and PTG, namely intrusive thoughts, nightmares, more compassion for others, sleep disturbances, trauma-related amnesia, hypervigilance, willingness to express emotions, and counting on others more.

Conclusions: The study identified the most influential symptom in the PTS network and the bridge symptoms in the combined network of PTS symptoms and PTG elements in the context of the COVID-19 pandemic in the present sample. The bridge symptoms helped in understanding how PTS and PTG co-existed in adults exposed to disasters such as COVID-19. Identification of these symptoms can be highly significant for developing targeted interventions. These implications have been discussed further in the present study. (PsycInfo Database Record (c) 2024 APA, all rights reserved).