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

Objective: Fatal and nonfatal overdoses involving opioids have increased to crisis levels in recent years. Laypersons have been increasingly tasked with responding to these events by administering naloxone, performing rescue breaths/cardiopulmonary resuscitation, and calling for medical assistance. However, little is known about the development of posttraumatic stress disorder (PTSD) related to opioid overdose responding among laypersons. To this end, we sought to determine the factors associated with PTSD stemming from responding to an opioid overdose event.

Method: From April 2021 to October 2021, structured interviews were conducted with layperson responders who had responded to an opioid overdose. Participants were administered structured diagnostic interviews, Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and completed validated self-report measures.

Results: In total, 101 layperson adults who responded to an opioid overdose were recruited for the present study (M_age: 34, 65% identified as women, 79% as White, and 11% as Hispanic/Latino). Of the 80 participants who completed the Clinician-Administered PTSD Scale for DSM-5, 100% met Criteria A for PTSD related to overdose responding, and over one quarter (27.5%) met current PTSD diagnosis criteria related to overdose responding. Current PTSD related to overdose responding was associated with depression symptoms, generalized anxiety symptoms, and presence of law enforcement or professional first responders during the most distressing overdose responding event.

Conclusions: Responding to opioid overdoses is traumatizing for many and results in a considerable burden of PTSD among layperson responders. As such, we call for trauma-informed interventions that cater to the unique experiences of layperson opioid overdose responders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The Pulse Nightclub shooting is the deadliest act of violence against the lesbian, gay, bisexual, transgender, and queer community in U.S.

History: After the shooting, communities came together to process the violence and grieve the victims. Conceptualizing the Pulse Nightclub shooting as a cultural trauma, this article examines the impact of the shooting on gay, bisexual, and queer (GBQ+) Latinx men and how these men coped following the Pulse Nightclub shooting.

Method: Semistructured qualitative interviews were conducted with Latinx gay, bisexual, and queer men in the United States. Transcripts were analyzed with thematic analysis.

Results: The interviews (n = 10) revealed five main themes related to distress, coping, and belonging.

Conclusions: Cultural trauma events impact community members who share identities with the direct victims. Our findings suggest that after experiences of cultural trauma, lesbian, gay, bisexual, transgender, and queer Latinx individuals may seek collective-level coping strategies, even when they are not directly targeted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Spouses of military combatants often experience adverse outcomes, including posttraumatic stress symptoms (PTSS) in the event of ambiguous loss (AL). AL refers to an uncertain situation regarding a person's status as alive or as cognitively present. The former ambiguity is categorized by the term physical AL (PAL), which refers to the continued psychological presence of a person, despite their physical absence. The latter ambiguity, categorized by the term psychological AL or ambiguous presence, refers to when a person is emotionally absent, despite their physical presence. Though AL has been widely researched, there are still gaps around the AL-posttraumatic stress disorder (PTSD) relationship, especially regarding dyadic variables that can moderate this relationship. Also, most of the AL military-related studies are qualitative, with only a few that combine qualitative and quantitative research methods. We address these gaps in an innovative mixed-methods study examining the emotional experience of Israeli veterans' spouses with a focus on the relationship between AL, PTSS, and dyadic adjustment (DA).

Method: The study included 63 participants, all spouses of Israeli veterans. We used self-report questionnaires (AL, Dyadic Adjustment Scale, and PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition) and a semistructured narrative interview.

Results: Our results revealed positive correlations between AL-PTSS and PAL-PTSS. Also, an interaction effect was found in which the lower the DA level, the stronger the PAL-PTSS correlation. Conversely, the higher the DA level, the stronger the ambiguous presence-PTSS correlation. Qualitative findings identified themes in the experience of these situations, including uncertainty and ambivalence.

Conclusions: Our qualitative and quantitative results combined suggest that the way military couples deal with AL may be an important emotional experience requiring specific attention from mental health professionals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Trauma, depressive symptoms, and the use of alcohol and drugs are common among youth, especially those with marginalized racial/ethnic identities, sexual and gender minority youth (SGMY), and those with low socioeconomic status, homelessness, and HIV-positive status. However, most research on trauma, depression, and substance use among such youth is cross-sectional. This article examines these patterns over time.

Method: Participants were youth with multiple life challenges (N = 1,728) recruited from 13 community-based agencies and health centers in Los Angeles, CA, and New Orleans, LA, and reassessed twice at 4-month intervals over 8 months (follow-up > 70%). Youth were predominantly Black, Latiné, and SGMY, with an average age of 21 years (range 12-24). We analyzed the association between trauma, depression, and substance use using a Bayesian approach to latent growth curve modeling.

Results: Trauma had a robust, positive association with depressive symptoms and substance use, although this association differed depending on whether alcohol or cannabis use was examined. Higher levels of trauma were also associated with a slower decline in depressive symptoms over time.

Conclusion: Study findings highlight the longitudinal association between trauma and both depression and substance use. This suggests the potential utility of trauma-focused interventions among vulnerable youth with one or both of these issues. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Dissociation is thought to be traumagenic, though this conceptualization is not without misunderstanding and stigma. There is little research regarding people's conceptualizations of their dissociative experiences and client-clinician discrepancies in understanding dissociation.

Method: An online survey assessed 208 self-reported dissociative participants' understandings of their dissociation and their beliefs about their clinicians' understanding of dissociation via two open-ended questions. Template analysis, a codebook thematic analysis approach, was employed to explore and compare the ways people understand their dissociation and their perceptions of their clinicians' conceptualizations.

Results: Four themes were developed to capture participants' perspectives: (1) Dissociation as Stigmatized and Underexplored (n = 83; 39.90%); (2) Dissociation as Individualized and Normalized Lived Experience (n = 173; 83.17%); (3) Dissociation as Clinical and/or Pathological (n = 112; 53.85%); and (4) Dissociation Through Etiological Frameworks (n = 67; 32.21%). Overall, 73.48% of participants indicated discrepancies between their understandings of their dissociation and those of their clinicians. Participants understood their dissociation through a lens of individualized and normalized lived experiences (100.00%) more often than their clinicians (23.12%). They believed their clinicians held more clinical understandings of dissociation (81.25%) than themselves (69.64%).

Conclusions: Given the perceived discrepancies between clients' and clinicians' understandings of dissociation, clinicians should engage in discussions with their clients about their dissociation-related lived experiences with awareness that they may have been misunderstood by previous providers. Client-clinician discrepancies should be addressed, as failure to do so could lead to misunderstandings and ruptures in the therapeutic relationship. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: In trauma research, it is common for researchers to characterize participants as either "trauma exposed" or "not trauma exposed" regardless of nuanced differences of the potentially traumatic event (PTE). To our knowledge, no study has simultaneously examined differences across both PTEs and exposure types.

Method: Using latent class analysis, we investigated latent homogeneous subgroups of individuals following experiences of 16 PTEs via three exposure types (i.e., direct, indirect, and/or occupational). We further examined class differences regarding posttraumatic stress disorder (PTSD) symptom clusters, event centrality, depression, and anxiety. Our sample included 2,663 participants (M_age = 22.33; 56.0% female).

Results: Results indicated four latent subgroups: (a) occupational trauma (OT), (b) direct interpersonal trauma (DIT), (c) indirect trauma (IT), and (d) low trauma exposure (LTE). Individuals in the OT class reported the highest levels of all symptoms except for PTSD avoidance and event centrality (which were highest in the DIT class), and individuals in the LTE class reported the lowest levels of all symptoms. Several nuanced between-class differences were found regarding posttrauma outcomes.

Conclusions: Findings further support the notion that dichotomizing participants as "trauma exposed" or "not trauma exposed" is overly simplistic and ignores important variability in trauma research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This study investigated the prevalence of probable alcohol use disorder (AUD), drug use disorders (DUDs), and posttraumatic stress disorder (PTSD) among psychology doctoral students. Additionally, it explored the unique relationships between risk factors (lifetime trauma, recent stressful experiences, COVID-19-related stress, general stress, financial stress) and AUD, DUD, and PTSD while accounting for demographic factors.

Method: The sample included 889 clinical and counseling psychology doctoral students, and the Alcohol Use Disorders Identification Test, Screen of Drug Use, and Primary Care PTSD Screen for Diagnostic and Statistical Manual of Mental Disorders (5th ed.) were used to measure current probable AUD, DUD, and PTSD, respectively.

Results: Approximately 43.8% had probable AUD, 23.2% had probable DUD, and 14.7% had probable PTSD. The univariate analysis results indicated a pattern of elevated risk among Black, Indigenous, and people of color, lesbian, gay, bisexual, queer, and other (LGBQ+) individuals, and women students. The results of the multivariate logistic regression analyses revealed that increased lifetime trauma and COVID-19-related stress were associated with higher adjusted odds of probable PTSD. Higher adjusted odds of probable AUD were observed among individuals experiencing elevated levels of COVID-19-related stress and among younger, women, and non-Hispanic White individuals. LGBQ+ individuals and those with no religious affiliation were found to have higher adjusted odds of probable DUD.

Conclusions: These findings underscore the alarming prevalence of AUD, DUD, and PTSD in this population, raising concerns that warrant attention. Women; Black, Indigenous, and people of color; and LGBQ+ individuals face heightened risks of PTSD, AUD, and DUD, emphasizing the urgent need for mental health care for psychology doctoral students and marginalized groups. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The prevalence of previous trauma exposure among university students is widespread. Trauma can have a serious impact on students' mental health, university experience, and academic persistence. This is the first study to use latent profile analysis to assess how differing levels of psychosocial variables combine with trauma exposure to draw together psychological profiles among university students.

Method: A total of 452 U.K. students completed a battery of questionnaires from a cross-sectional survey examining the number of traumatic events and psychosocial factors (loneliness, social support, self-efficacy, coping strategies, personality, and resilience) to determine mental health and academic persistence.

Results: A latent profiling analysis obtained a five-profile solution, demonstrating a unique combination of psychosocial factors and trauma exposure: distressed (11.2%), thriving (31.4%), vulnerable (19.5%), flourishing (3.5%), and diffident (34.4%). Analyses of variance were used to compare scores on the anxiety and depression measures and academic persistence measures between the participants within each profile. Significant differences among profiles were present with the distressed profile being more at risk for mental health and academic issues and the flourishing profile demonstrating high levels of trauma exposure and a positive academic experience.

Conclusions: Given that there is a large proportion of students in higher education reporting previous traumatic experiences, trauma-informed principles are warranted, with a focus on supporting staff to understand the impact of trauma on students' experiences, in an inclusive and nonjudgmental way. This study provides a model of the factors involved in fostering psychological well-being and positive university experiences for students who have experienced trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Driven by research demonstrating the pervasiveness of trauma, forensic mental health (FMH) and intellectual disability services are increasingly adopting a trauma-informed approach to caring for patients. However, there has been limited attention to exploring what trauma-informed care (TIC) means to patients in these settings and what practices enable or restrict them in adapting positively after experiences of trauma. This study aimed to understand how TIC is conceptualized by people admitted to an FMH and intellectual disability service.

Method: Focus groups were facilitated with 10 people residing in three low-secure units in the South East of the United Kingdom. Focus groups explored participants' perceptions and experiences of TIC with reference to the guiding principles of safety, trustworthiness, choice, collaboration, and empowerment. Audio recordings of the focus groups were transcribed and analyzed using reflexive thematic analysis.

Results: Three themes were generated to capture participants' perceptions that a trauma-informed approach in an FMH and intellectual disability service should entail promoting a sense of safety, fostering a sense of belonging, and encouraging the development of an autonomous identity.

Conclusions: The findings indicate that prioritizing social-interpersonal relationships is crucial to providing care that enables people admitted to FMH and intellectual disability services to adapt positively after experiences of trauma. The findings support previous research regarding recovery in secure services, indicating the value of creating sufficiently safe conditions for people to connect with others and develop a positive and independent sense of self. (PsycInfo Database Record (c) 2024 APA, all rights reserved).