Maternal attitudes towards pre-natal substance abuse,medical care,and treatment in a historically disadvantaged South African community

This study explored maternal substance abuse and the access to pre-natal medical care and treatment for substance abuse during pregnancy. Respondent mothers (n?=?102; mean age?=?27.8 years, SD?=?10.9 years) were from Mitchell’s Plain, a historically disadvantaged South African community. The mothers completed a mixed methods interview on the context and influences of their substance abuse during their pregnancy. Findings suggest that these mothers adopt the drug taking behaviour in their social environment. Women with prior histories of substance abuse were active consumers and dependent on drugs while childbearing. These findings may be important for possible intervention strategies among this particular group of vulnerable women.     

Supporting the Need for an Integrated System of Care for Youth with Co-occurring Traumatic Stress and Substance Abuse Problems

Adolescents are at high risk for violence exposure and initiation of drug use. Co-occurring substance use and trauma exposure are associated with increased risk of mental health disorders, school underachievement, and involvement with multiple systems of care. Coordination and integration of systems of care are of utmost importance for these vulnerable youth. This study delineates the negative sequelae and increased service utilization patterns of adolescents with a history of trauma, substance abuse, and co-occurring trauma and substance abuse to support the need for integrated mental health and substance abuse services for youth. Data from two national sources, the National Child Traumatic Stress Network and Center for Substance Abuse Treatment demonstrate the increased clinical severity (measured by reports of emotional and behavioral problems), dysfunction, and service utilization patterns for youth with co-occurring trauma exposure and substance abuse. We conclude with recommendations for an integrated system of care that includes trauma-informed mental health treatment and substance abuse services aimed at reducing the morbidity and relapse probability of this high-risk group.     

MEMORIES OF CHILDHOOD SEXUAL ABUSE

Women involved in out-patient treatment for substance abuse were interviewed to examine their recollections of childhood sexual abuse. Overall, 54% of the 105 women reported a history of childhood sexual abuse. Of these, the majority (81 %) remembered all or part of the abuse their whole lives; 19% reported they forgot the abuse for a period of time, and later the memory returned. Women who remembered the abuse their whole lives reported a clearer memory, with a more detailed picture. They also reported greater intensity of feelings at the time the abuse happened. Women who remembered the abuse their whole lives did not differ from others in terms of the violence of the abuse or whether the violence was incestuous. These data bear on current discussions concerning the extent to which repression is a common way of coping with childhood sexual abuse trauma, and also bear on some widely held beliefs about the correlates of repression.     

Development of an Abuse Screening Tool for Women with Disabilities

Abstract

Women with disabilities are at increased risk for violence, including forms of abuse that can be experienced by all women as well as forms unique to women with disabilities, such as abuse by personal assistants. The purpose of this study was to develop an abuse-screening tool unique to women with disabilities. The tool, which was based on previous research, was field-tested with 47 women who experienced physical and/or cognitive disabilities. Final refinement of the tool's wording and formatting was accomplished through focus groups and individual interviews. Women with disabilities were receptive to participating in screening, which facilitated the identification of abuse and risk factors. Recommendations for abuse screening and risk assessment with women who have disabilities are presented.     

Chronic Pain Syndromes and Violence Against Women

Abstract

Chronic pain is a common form of disability, and is often reported among women with a history of victimization. In the present study, we combine six pain symptoms into a measure of self-reported pain, and compare women who have experienced child or domestic abuse with those who do not report such a history. A sample of 110 female patients (57 abused, 53 non-abused controls) was drawn from an adult primary-care practice of 905 patients in a small, affluent, predominantly Caucasian community in northern New England. The subjects ranged in age from 18 to 88 (M = 47). Subjects completed a self-administered questionnaire that was used clinically as part of the new-patient work-up. Women who reported either child or domestic abuse were significantly more likely to report pain symptoms than women in the control group. There was no significant difference between women who had experienced domestic abuse vs. child abuse alone. These findings held true even after controlling for depression.     

Assessing the Effectiveness of a Trauma-Oriented Approach to Treating Prostituted Women in a Prison and a Community Exiting Program

Women who have been prostitutes are social work clients in many clinical, correctional, and community settings. Unique programming that addresses the high levels of trauma symptoms reported by prostituted women has yet to be explored. The purpose of this study is to explore the effectiveness of a group trauma and abuse intervention for prostituted women from two settings, prison and a community exiting program. A quasi-experimental research design was used. Twenty-nine women participated in a 12-week psychoeducational trauma and abuse intervention program called Esuba. All participants reported decreases in trauma symptoms, but the prison group showed a greater number of significant changes in trauma symptomology than the community group. Implications for practice and future research implications are discussed.     

创伤暴露程度对青少年物质滥用的影响：创伤后应激障碍与依恋的中介作用

为了考察汶川地震后青少年的创伤暴露程度、创伤后应激障碍（PTSD）、父母依恋和同伴依恋与物质滥用之间的关系,采用创伤暴露程度问卷、儿童创伤后应激障碍症状量表、父母与同伴依恋问卷和物质滥用问卷对汶川县和茂县的1435名中学生进行调查,选取有物质滥用的青少年354名作为本研究的对象。结果发现：创伤暴露程度可以直接正向预测作用物质滥用。不过,在创伤暴露与物质滥用直接关系之间加入PTSD、父母和同伴依恋之后,创伤暴露程度对物质滥用的直接预测作用不再显著,并且创伤暴露程度不能通过同伴依恋预测物质滥用,也不能通过PTSD经同伴依恋对物质滥用发挥多重中介作用;但创伤暴露程度能通过PTSD正向预测物质滥用,可以通过父母依恋负向预测物质滥用,并且创伤暴露程度还可以通过PTSD经过父母依恋对物质滥用发挥正向的多重中介作用。     

Characteristics of Traumatic Experience and Survivor Perceptions of Mental Health Services: The 2004–2005 Erie County Community Trauma Survey

Trauma is associated with severe mental illness and substance abuse problems, yet it typically is not addressed sufficiently in treatment. This article reports on an assessment of mental health service recipients and their experience of traumatic events and perceptions of service providers' sensitivity, helpfulness, and knowledge regarding their trauma and service needs using a community-based participatory research model. Demographic characteristics and status of co-occurring disorders were measured. Participants perceived that individual therapists and peer service providers were sensitive to and knowledgeable about their trauma. Group treatment and peer programs were seen as being most helpful. Psychiatric services were seen as being the least sensitive to trauma issues. Implications for practice and research are discussed.     

Relationship between Trauma and Risky Behavior in Substance-Abusing Parents Involved in a Family Dependency Treatment Court

This exploratory study examined participants in a Family Dependency Treatment Court (FDTC), designed for substance-abusing parents whose children were removed from the home. Twenty-five participants were interviewed one year after FDTC enrollment to assess retrospectively the relationship between trauma history and risky behaviors. Treatment compliance rates were found to be high, and most participants had negative urinalysis results. Qualitative analyses revealed that approximately half of the participants attributed decreases in risky behaviors to the FDTC program. This study increases understanding of the effect of substance abuse and trauma on high-risk behaviors and might help to improve services for substance-abusing parents involved in the child welfare system. Finally, the future success of reducing child abuse and neglect and parental substance use could hinge on the partnership between judicial and substance abuse treatment through FDTCs. Findings from this exploratory pilot study should be replicated with more representative and larger samples.     

The Role of Sexual Trauma in the Treatment of Chemically Dependent Women: Addressing the Relapse Issue

A review of the literature indicates a high incidence of sexual trauma among women who seek treatment for substance abuse. Additionally, clients who have experienced sexual trauma appear to be more susceptible to relapse, the return to substance abuse. This article explores issues surrounding sexual trauma and chemical dependency. It aims to provide direction for relapse prevention with a relapse-prone population. Application of traditional milieu substance abuse treatment for sexual trauma survivors is explored. Recommendations for working with sexual trauma survivors who are also substance abusers are presented, as are suggestions for research.     

Measuring Abuse Sequelae: Validating and Extending the Trauma Symptom Checklist–40

This study used the Trauma Symptom Checklist–40 (TSC–40) to index both childhood sexual abuse (CSA) and childhood physical abuse (CPA) in a college student sample of both men and women (N = 441). Although the TSC–40 was designed as a measure of CSA trauma, this study concludes the measure is appropriately reliable for indexing the traumatic sequelae of CPA as well as CSA in nonclinical samples. This study also explored the effects of gender and abuse severity on resulting symptomatology, finding that women and severely abused individuals report the most negative sequelae. Both CSA and CPA emerged as significant explanatory variables in TSC–40 scale scores beyond gender, supporting its validity for indexing traumatic sequelae in nonclinical samples.     

Women Experiencing Psychological Abuse: Are They a Homogenous Group?

Dichotomizing women as “abused” versus “not abused” assumes that any psychological maltreatment results in similar outcomes. A national sample of women in conflictual relationships completed an online survey. Women with no incidence (N = 33), the lowest quartile (N = 86), and the top quartile (N = 81) of psychological maltreatment demonstrated significant differences in reactions to the maltreatment, mental health indicators, personality variables, perceived harm, problematic relationship schemas, and response styles. Women with no psychological abuse and women in the lowest quartile produced similar scores that were typically distinct from the top-quartile women. Effective treatment of women with lower amounts of psychological abuse might not require a unique intervention likely necessary for women experiencing much psychological abuse.     

Sticks and Stones May Break My Bones but Words Relate to Adult Physiology? Child Abuse Experience and Women's Sympathetic Nervous System Response while Self-Reporting Trauma

Child abuse predicts a wide range of long-lasting deleterious outcomes, including disruptions in the biological systems central to emotion arousal and regulation. However, little is known about the specific ways in which child abuse affects adulthood sympathetic reactivity and recovery. This study investigated the association between child abuse experience and adult skin conductance level and habituation in 85 at-risk women as they completed a self-report trauma questionnaire. Childhood emotional abuse was independently associated with blunted skin conductance habituation over the course of survey completion after controlling for other abuse subtypes and current trauma symptoms. These results suggest that women emotionally abused as children experience prolonged emotional arousal and poor physiological regulation of emotion in response to reminders of traumatic experiences.     

The Powerless‐Empowerment Scale: Measurement of Substance Abuse Counseling Orientation

The authors describe the development of an instrument to measure substance abuse counseling orientations. The Powerless‐Empowerment Scale, which was developed by investigating its reliability and viability, demonstrated initial promise as an instrument that can be used in a variety of settings in the substance abuse field.     

Gender Disparities in the Mental Health of Urban Survivors of Trauma

Women who experience traumatic events are at higher risk for mental health problems compared to men; however, gaps remain in our understanding of this disparity. A sample of 170 urban adults completed self-report measures. Women were significantly more likely to experience sexual assault and domestic violence compared to men, and they were significantly less likely to experience a robbery or mugging, being threatened with a weapon, or witnessing a death or assault compared to men. Also, women were more likely than men to meet criteria for probable post-traumatic stress disorder (PTSD) and depression after controlling for covariates and trauma level. Our findings suggest a possible differential vulnerability to the development of PTSD and depressive symptoms in women.     

Psychological trauma and PTSD symptoms as predictors of substance dependence treatment outcomes

Psychological trauma and post-traumatic stress disorder (PTSD) may complicate and reduce the effectiveness of treatment for substance use disorders (SUDs). This study assessed trauma history and symptoms of simple and complex PTSD at baseline in a randomized trial of contingency management (CM) compared to standard treatment (ST) with 142 cocaine- or heroin-dependent outpatients. History of exposure to each of eight types of psychological trauma was unrelated to treatment outcome, except for witnessed assaults and emotional abuse. Complex PTSD symptoms were inversely associated with short-term treatment outcomes, and PTSD symptoms were positively related to long-term outcome, independent of the effects of demographics, psychological distress, baseline substance use status, and treatment modality. Complex PTSD symptoms warrant further study as a potential negative prognostic factor in SUD interventions.     

Testing Posttraumatic Stress as a Mediator of Childhood Trauma and Adult Intimate Partner Violence Victimization

This study examined whether potential posttraumatic stress disorder (PTSD) mediated the relationships between different forms of childhood trauma (sexual abuse, physical abuse, violence between caregivers) and intimate partner violence (IPV) victimization (psychological, physical, sexual). Participants were 1,150 female nurses and nursing personnel. Path analytic findings revealed potential PTSD partially mediated the relationships between childhood sexual abuse and psychological IPV and childhood sexual abuse and sexual IPV. Potential PTSD did not mediate the relationship between other types of childhood trauma and IPV. This study adds to the literature indicating PTSD as a risk factor for revictimization in the form of adult IPV among women. Screening for and treatment of PTSD among female child sexual abuse survivors could prevent future IPV victimization.     

Yoga Practice May Buffer the Deleterious Effects of Abuse on Women's Self-Concept and Dysfunctional Coping

Women who experienced abuse as children or adults can suffer from symptoms such as dissociations, physiological regulation difficulties, and mood disturbances that might not respond to traditional interventions. Given the benefits of yoga, we hypothesized that yoga practice would ameliorate the negative impact of abuse on psychological functioning. Our findings suggest that frequent yoga practice might ameliorate the negative impact of abuse history on self-concept and coping skills. In addition, our findings suggest that women who incorporate yoga into other areas of life could get the greatest psychological benefits. Given the preliminary nature of this study, further research into the benefits of yoga on women who have child or adult abuse histories is warranted.     

Pathways Linking Child Physical Abuse,Depression, and Aggressiveness across Genders

Previous research suggests that child physical abuse, depression, and aggressiveness are linked, but gender differences remain poorly understood. This study examined gender differences in the mediational relationships among these constructs, after controlling for the confounding effects of other negative life events. Men and women completed questionnaires about physical abuse and negative life events that occurred prior to age 18, depressive symptoms, and aggressiveness. Results indicated significant gender differences in the pathways between child physical abuse and depression, and between child abuse and aggressiveness, with direct and mediating links pertaining only to men. These findings suggest that links among child physical abuse, depression, and aggressiveness are specific to men, and negative life events might play a more potent role for women.