Childhood Maltreatment Increases the Risk of Intimate Partner Violence via PTSD and Anger Personality Traits in Individuals Consulting for Sexual Problems

Childhood maltreatment is a significant risk factor for the perpetration of intimate partner violence (IPV) in adulthood. This study tested, in a clinical sample, a conceptual model suggesting that childhood maltreatment contributes to the development of anger personality traits, directly and indirectly via posttraumatic stress disorder (PTSD), and that anger personality traits, in turn, are associated with IPV. Adults consulting for sex therapy (n = 114) completed self-report measures of childhood maltreatment, PTSD, anger, and IPV. Participants were exposed to high rates of childhood maltreatment (83%). Path analysis supported the hypothesized model: Exposure to child maltreatment was associated with anger personality traits, and this association was partially mediated by PTSD symptoms. Anger personality traits were highly correlated with IPV.     

Guest referees for 17(4)

Background and objectives: Although intimate partner violence (IPV) has demonstrated strong associations with anxiety and posttraumatic stress, these constructs have rarely been examined simultaneously in IPV research. Gaps in knowledge remain as to their differential associations to substance use problems among IPV-victimized women. Design: A sample of 143 community women self-reported on their current IPV victimization, mental health and substance use problems. Method: Hierarchical entry multiple regressions were used to test for the direct and indirect effects of psychological, physical, and sexual IPV to alcohol and drug problems through anxiety and posttraumatic stress. Results: Higher anxiety symptom severity and higher physical IPV severity were associated with greater alcohol and drug problems. Higher posttraumatic stress symptom severity was associated with greater alcohol and drug problems. Mediation analyses indicated (i) significant indirect pathways of IPV types to alcohol problems through posttraumatic stress symptom severity controlling for anxiety symptom severity and (ii) significant indirect pathways of IPV types to drug problems through anxiety symptom severity controlling for posttraumatic stress symptom severity. Conclusions: In examining the indirect pathways of psychological, physical, and sexual IPV to substance use problems this study highlights that anxiety and posttraumatic stress symptom severity have unique effects on alcohol and drug problems among IPV-victimized women.     

Exploring the Relationship Between Child Maltreatment,Intimate Partner Violence Victimization,and Self-Injurious Thoughts and Behaviors

Child maltreatment is considered a significant risk factor for young adult self-injury; however, the mechanisms that underlie this relationship are not yet understood. To elucidate this association, the mediating role of intimate partner violence victimization in the relationship between child maltreatment and self-injurious thoughts and behaviors was investigated. The sample consisted of 406 young adults (346 females; M_age = 19.87 years; SD = 1.72) involved in a couple relationship. Results of bootstrapping procedures demonstrated that intimate partner violence victimization mediated the relationship between child maltreatment and self-injurious behaviors but did not mediate the association between child maltreatment and self-injurious thoughts. Results suggest that young adults with a history of child maltreatment may be more likely to be exposed to IPV victimization, which, in turn, is associated with the use of self-injurious behaviors, but not the use of self-injurious thoughts. Findings highlight the utility of examining models that incorporate distal and proximal factors contributing to self-injury, and provide direction toward better understanding the relationship experiences of self-injuring young adults.     

Maltreated Adolescents

Abstract

The authors review literature on the developmental tasks of adolescence and the unique problems faced by adolescent victims of maltreatment. The developmental domains addressed include cognition, identity, behavior and affect regulation, family and peer relationships, and sexuality. Research on the co-occurrence of multiple types of victimization is discussed. The relationship between multiple victimization and violent crime, with a focus on parricide, is examined. The authors call for greater attention to the assessment and study of multiple forms of maltreatment and its outcomes in adolescence, since adolescence is one of the least researched developmental periods in terms of single or multiple victimization.     

Posttraumatic Stress Disorder in Maltreated Youth: A Review of Contemporary Research and Thought

Youths who have been maltreated often experience symptoms of posttraumatic stress disorder (PTSD), and this special population has received increased attention from researchers. Pathways toward maladaptive effects of maltreatment and PTSD are remarkably similar and reflect specific biological diatheses and psychological vulnerabilities that produce wide-ranging self-regulation deficits. Developmental models of effects of maltreatment and of PTSD are thus increasingly intertwined and have begun to inform specialized assessment and treatment strategies for this population. This review covers key aspects of posttraumatic stress disorder in maltreated youth, including epidemiology, symptomatology, outcome, and risk factors as well as assessment and treatment strategies and challenges for these youths.     

Is John Henryism a resilience factor in women experiencing intimate partner violence?

Background: Research suggests that posttraumatic stress disorder (PTSD) and depression are two common mental health problems in intimate partner violence (IPV) survivors. Research has found that while Black women consistently report higher rates of victimization than White women, they also report less severe PTSD and depressive symptoms, suggesting that Black IPV survivors might be more resilient to PTSD and depression than are White survivors. Design: We implemented a correlational study with 81 Black and 100 White female survivors of IPV to determine if John Henryism (JH; i.e., a predisposed active coping mechanism) contributes to the resilience observed in Black IPV survivors. Methods: Participants completed the John Henryism Active Coping Scale, Center for Epidemiological Studies Depression Scale, Davidson Trauma Scale, and the Abusive Behavior Inventory. Results: Results demonstrated that White woman endorsed more severe depressive symptoms as compared to Black women. Severity of PTSD symptoms and JH was not significantly different between races. JH did not moderate the relationship between race and depression; however, for PTSD, JH was found to be protective of PTSD in White women, while demonstrating little impact on Black women. Conclusions: The implications of these findings are discussed in terms of the minority stress model.     

The associations between adult attachment,posttraumatic symptoms,and posttraumatic growth

Background and Objectives: Individual differences after trauma vary considerably and can range from posttraumatic stress disorder (PTSD) to posttraumatic growth (PTG). Current theoretical models cannot fully explain this variability. Therefore, we integrated attachment theory with Ehlers and Clark's model of PTSD to understand whether attachment style is associated with negative appraisals of a traumatic event(s), posttraumatic stress symptoms (PTS), and PTG. Our aim was to test this integrated model PTSD in an analog sample who had experienced at least one traumatic event. Design: We used structural equation modeling to test the association of adult attachment and posttraumatic cognitions (self and world/others) with PTS and PTG using a cross-sectional, correlational design. Methods: The sample comprised 393 university staff and students (Range_Age= 18–49, 85% females) who completed online measures. Results: Attachment anxiety and negative posttraumatic self-cognitions were positively associated. Negative posttraumatic self-cognitions were positively associated with PTS. Attachment anxiety had an indirect effect (via negative posttraumatic self-cognitions) on PTS, whereas attachment avoidance predicted more negative posttraumatic world cognitions and lower perceived PTG. Conclusions: The study highlights the importance of considering how attachment styles influence posttraumatic emotion regulation and cognitive processing of the trauma to determine posttraumatic mental health.     

Cognitive Behavioral Treatment for Insomnia in Veterans with Long-Standing Posttraumatic Stress Disorder: A Pilot Study

This uncontrolled pilot study assessed the effects of cognitive behavioral therapy for insomnia in veterans with long-standing posttraumatic stress disorder. Male veterans with current chronic insomnia and PTSD (n?=?8; M age = 58.6, SD?=?3.0; 87.5% African American, 12.5% European American; 87.5% Vietnam Veterans, 12.5% 1st Gulf War Veterans) reported a trauma related to their military service. Participants appeared for five weekly individual sessions of cognitive behavioral therapy for insomnia and completed one-week assessments of objective sleep (actigraphy) and subjective sleep (sleep diaries), the Insomnia Severity Index, and measures of functioning, posttraumatic stress disorder, and psychological distress both before and after treatment. Paired t tests revealed significant posttreatment improvements for various subjective assessments of sleep patterns but actigraphy-defined sleep was unchanged. Measures of functioning, nightmares, and posttraumatic stress disorder severity were also unchanged at posttreatment. Preliminary results were encouraging in improving subjective perceptions of sleep in individuals with posttraumatic stress disorder, warranting further study with more rigorous methodology.     

This century,this country: One survivor's story of posttraumatic stress syndrome

Abstract

Posttraumatic stress syndrome, also called posttraumatic stress disorder (PTSD), affects people who have experienced extremely traumatic events. Individuals who live with posttraumatic stress syndrome must continually overcome many obstacles to live their daily lives. The following is one woman's story of abuse, its after effects, and survival. By telling her story, I hope to make her suffering that much more meaningful. In addition, I wish to call attention to what goes on behind closed doors and explain what we can do about it.     

The role of emotional maltreatment and looming cognitive style in the development of social anxiety symptoms in late adolescents

Background: Social looming constitutes a specific cognitive vulnerability that acts as a danger schema and biases the processing of threat-related information associated with the development of social anxiety disorder. This model characterizes early negative experiences as critical to the formation of looming cognitive style. Furthermore, research has found links between parental emotional abuse and peer victimization and social anxiety. Design: A three-wave longitudinal design was used to analyze the role of parents’ emotional abuse and peer victimization in the onset of social anxiety symptoms through the development of this cognitive style. Methods: The final sample was made up of 307 females and 243 males (M_age?=?16.97, SD_age?=?.81). Perceived parents’ emotional abuse and peer victimization by participants were measured at Time 1, social looming was measured at Time 1 and 2, and social anxiety symptoms were measured at Times 1, 2, and 3. Results: Parents’ emotional abuse and peer victimization were related to social anxiety cross-sectionally. Longitudinally, social looming acted as a mediator in the relationship between parents’ emotional abuse and social anxiety. Conclusions: These findings highlight the need to better understand the mechanisms through which emotional abuse and peer victimization impact social looming and contribute to social anxiety.     

Intergenerational Continuity in Maltreatment

Identification of the causes of child maltreatment perpetration is prerequisite for developing efficacious prevention initiatives to reduce its occurrence. Earlier maltreatment victimization is often suggested as an important cause of subsequent maltreatment perpetration. This study investigates a) whether maltreatment victimization causes subsequent perpetration and b) whether the timing of maltreatment victimization—childhood versus adolescence—alters this relationship. We use data from the Rochester Youth Development Study, a longitudinal study begun in Rochester, New York in 1988, based on a stratified random sample of 1000 seventh and eighth graders. At the most recent followup, 80 % were reinterviewed. Child Protective Services data were collected on substantiated incidents of maltreatment victimization from birth to age 17 and on maltreatment perpetration through average age 33, n?=?816. Using propensity score models to control selection effects, we find that a history of maltreatment victimization significantly increases the odds of becoming a perpetrator of maltreatment. Although childhood-limited maltreatment does not significantly increase the odds of maltreatment perpetration, maltreatment that occurs in adolescence or that begins in childhood and persists into adolescence does. Adolescent maltreatment was found to be more serious in terms of type, chronicity, and severity than childhood-limited maltreatment, offering a possible explanation for this finding. Therefore, maltreatment victimization, especially during adolescence, is a likely cause of subsequent perpetration. Clinical services to interrupt the cycle of maltreatment are needed to protect subsequent generations from experiencing maltreatment and from experiencing the health-risking behaviors that often flow from maltreatment.     

The structure of DSM-5 posttraumatic stress disorder symptoms in war veterans

Background and Objectives: The present research examined the underlying factor structure of posttraumatic stress disorder (PTSD) as conceptualized in the recently published fifth edition of the Diagnostic and statistical manual of mental disorders (DSM-5). Design: Participants were 258 trauma-exposed Iraq/Afghanistan war veterans. Methods: A self-report measure of PTSD symptoms was administered to all participants and confirmatory factor analysis (CFA) was used to compare several different models of PTSD. Results: CFA revealed that the best-fitting model was a six-factor model in which symptoms loaded onto the factors of intrusion, avoidance, negative affect, anhedonia, dysphoric arousal, and anxious arousal. Conclusions: These findings have important implications for ongoing conceptualization of PTSD and suggest that additional modifications to the diagnostic criteria for PTSD may still be warranted to more accurately reflect the underlying structure of PTSD symptoms.     

Secondary traumatic stress and adjustment in therapists who work with sexual violence survivors: the moderating role of posttraumatic growth

ABSTRACT

Due to their secondary exposure to the traumatic events disclosed by clients, therapists who work with sexual violence survivors are at risk of experiencing secondary traumatic stress. We examined whether the negative effects of secondary traumatic stress on therapist adjustment would be buffered by posttraumatic growth. Sixty-one therapists who work with sexual violence survivors completed measures of secondary traumatic stress, posttraumatic growth and a range of adjustment indicators. Hierarchical multiple regression analyses demonstrated that posttraumatic growth moderated the negative impact of secondary traumatic stress on therapist depression, anxiety, personal meaning and satisfaction with life. Posttraumatic growth sustained positive affect through a direct effects model only. This study provides support for the protective role of posttraumatic growth in adjustment to secondary traumatic stress.     

The Forensic Examination of Posttraumatic Stress Disorder

Abstract

The diagnosis of posttraumatic stress disorder (PTSD) has achieved a major level of significance in our judicial system. The forensic examination of PTSD is identified as a specialized assessment that is non-biased and non-prejudicial. This article attempts to provide a standard methodology to offer an objective and neutral forensic assessment and diagnosis of PTSD that will stand up to legal scrutiny by identifying problems in diagnosing PTSD and establishing a six-step methodology for the differential diagnosis of the disorder. Procedures for providing a forensic examination of PTSD and details of the author's methods of providing a forensic examination are presented.     

Predicting adolescent posttraumatic stress in the aftermath of war: Differential effects of coping strategies across trauma reminder,loss reminder,and family conflict domains

Background and Objectives: The vast majority of youth who lived through the Bosnian war were exposed to multiple traumatic events, including interpersonal violence, community destruction, and the loss of a loved one. This study examined factors that predict post-war psychological adjustment, specifically posttraumatic stress, in Bosnian adolescents. Design: Regression analyses evaluated theorized differential relations between three types of post-war stressors – exposure to trauma reminders, loss reminders, and intrafamilial conflict – specific coping strategies, and posttraumatic stress symptom dimensions. Methods: We examined 555 Bosnian adolescents, aged 15–19 years, to predict their long-term posttraumatic stress reactions in the aftermath of war. Results: Findings indicated that post-war exposure to trauma reminders, loss reminders, and family conflict, as well as engagement and disengagement coping strategies, predicted posttraumatic stress symptoms. Secondary control engagement coping responses to all three types of post-war stressors were inversely associated with posttraumatic stress symptoms, whereas primary control engagement coping responses to family conflict were inversely associated with hyperarousal symptoms. Disengagement responses to trauma reminders and family conflict were positively associated with re-experiencing symptoms. Conclusions: These findings shed light on ways in which trauma reminders, loss reminders, and family conflict may intersect with coping responses to influence adolescent postwar adjustment.     

Specificity of peer difficulties to social anxiety in early adolescence: categorical and dimensional analyses with clinical and community samples

Background and Objectives: We investigated the specificity of social difficulties to social anxiety by testing associations of social anxiety and other anxiety presentations with peer acceptance and victimization in community and treatment-seeking samples of adolescents aged 12–14 years.

Design: Cross-sectional, quantitative survey.

Methods: Adolescents from the community (n?=?116) and a clinical setting (n?=?154) completed ratings of anxiety symptoms, perceived social acceptance, and peer victimization. Their parents also completed ratings of the adolescents’ anxiety and social acceptance.

Results: Social acceptance was lowest among adolescents with social anxiety disorder (SAD) and lower among adolescents with other anxiety disorders than in the community sample. Anxiety symptoms were negatively correlated with social acceptance, but these associations were not unique to social anxiety symptoms. Girls in the community sample reported more overt victimization than girls with SAD and with other anxiety diagnoses. Relational victimization was associated with social and nonsocial anxiety symptoms only in the community sample.

Conclusions: Our findings supplement recent laboratory-based observational studies on social functioning among adolescents with SAD and other anxiety disorders. Although social anxiety may be associated with unique social skill deficits and impairment, concerns about peer relations should also be considered among adolescents with other anxiety symptoms.     

Preface

Abstract

Child victimization is a serious and on-going problem in the United States and throughout the world. In 2000, an estimated 900,000 children were victims of abuse and neglect in the United States. New and different responses to child maltreatment will have to be developed and implemented in response to the increasingly diverse contexts and situations within which maltreatment occurs. Emerging trends in adult-child boundary violations are explored within this volume from a cross-section of disciplines, including law, sociology, criminal justice, psychology, and health services. The selections analyze issues critical to child maltreatment and offer intriguingly different perspectives of present and future issues related to child abuse.     

Posttraumatic Stress,Posttraumatic Growth,and Satisfaction With Life in Military Veterans

Objective: Military veterans are more likely than civilians to experience trauma and posttraumatic stress disorder (PTSD). Research suggests, however, that some people who experience trauma, including veterans, report posttraumatic growth (PTG), or positive personal changes following adversity. In this study, we tested a comprehensive model of PTG, PTSD, and satisfaction with life in a veteran population, exploring the roles of challenges to core beliefs, types of rumination, sex, and time since event. Method: Data were collected via Amazon’s Mechanical Turk, an online crowdsourcing website, from veterans (N = 197) who had experienced a stressful event within the last 3 years (M = 16.66 months, SD = 12.27 months). Structural equation modeling was used to test an integrated conceptual model of PTG, PTSD, and satisfaction with life. Results: Results showed that challenge to core beliefs was directly associated with both deliberate and intrusive rumination. Deliberate rumination was positively related to PTG; intrusive rumination was positively related to symptoms of PTSD. PTG and PTSD, in turn, mediated the relationship between rumination styles and satisfaction with life; PTG was related to higher satisfaction with life; and PTSD was negatively related to satisfaction with life. Results failed to show differences on any model variables as a function of time since event or sex. Conclusion: Results indicate that the intentional facilitation of PTG may be a complementary and alternative option to the reduction of PTSD symptoms for improving satisfaction with life. Findings suggest that efforts to facilitate PTG should be focused on strategies for promoting deliberate rumination.     

Preface

Summary

Child victimization is a serious and on-going problem in the United States and throughout the world. In 2000, an estimated 900,000 children were victims of abuse and neglect in the United States. New and different responses to child maltreatment will have to be developed and implemented in response to the increasingly diverse contexts and situations within which maltreatment occurs. Emerging trends in adult-child boundary violations are explored within this volume from a cross-section of disciplines, including law, sociology, criminal justice, psychology, and health services. The selections analyze issues critical to child maltreatment and offer intriguingly different perspectives of present and future issues related to child abuse.     

Support for the location of negative posttraumatic cognitions in the diagnosis of posttraumatic stress disorder

ObjectiveTo investigate the extent to which negative posttraumatic cognitions predict, and so can be best located within, the DSM-5 (APA, 2013) individual symptom clusters of posttraumatic stress disorder (PTSD).MethodAn online survey of traumatic experiences, featuring 528 adults.ResultsNegative posttraumatic cognitions seem best placed within the Numbing/Detachment symptom cluster. Negative posttraumatic cognitions relating to the self predict higher levels of symptoms across the clusters. While negative cognitions relating to the world contributed to most symptom groups, self-blame cognitions did not.ConclusionsOur findings support the placement of posttraumatic cognitions as part of the Numbing/Detachment symptom cluster within the DSM-5rather than the Intrusion, Avoidance and Hyperarousal clusters.