Relationships between Past Trauma Exposures and PTSD among Survivors of Intimate Partner Violence

This study examined child abuse and community violence exposure as potential risk factors in the development of posttraumatic stress disorder (PTSD) symptoms following exposure to intimate partner violence (IPV). In a community sample of 51 primarily low-income women who had experienced IPV, childhood exposure to child abuse made a unique contribution to PTSD symptom severity from subsequent IPV. Community violence also accounted for variance in PTSD symptom severity, but in the opposite direction, with individuals exposed to community violence reporting lower levels of PTSD symptoms from IPV. These findings suggest the need for further research to identify which factors related to community violence exposure might inoculate individuals against the development of PTSD following IPV exposure.     

The Psychology of Health and Illness: The Mental Health and Physiological Effects of Intimate Partner Violence on Women

Violence against women is a global public health problem with about one in three women experiencing either physical and or sexual intimate partner violence during their lifetime. Globally as many as 38% of homicides committed against women are by a male intimate partner. Violence against women may have negative effects on their mental, physical, and reproductive health (WHO fact sheet, 2016). Untreated individuals who have experienced violence or life-threatening situations may develop posttraumatic stress disorder (PTSD). This disorder has the potential to be life-changing and cause negative psychological and medical issues (Rokach, Ahmed, & Patel, 2017). This potentially life-changing nature and consequence of violence affecting women world-wide deserves greater attention to ensure elimination of risk factors, financial support of investigational studies to promote detection of victims, and research to increase therapeutic efficacy of remediation. These efforts should be bolstered by all physicians, mental health experts, social service specialists, and public health advocates.     

Gender and Changes in Trauma Narrative Following CBT for PTSD

Our study explored whether the characteristics of pretreatment trauma narratives could be used as indicators of posttraumatic stress disorder (PTSD) symptom severity before treatment. We also studied whether pretreatment characteristics could predict treatment efficacy. Although several studies suggest that fragmentation, proportion of internal events, and length in trauma narratives are associated with PTSD symptomatology, there are contradictions in the findings. Given the differences in trauma response between men and women, we considered the potential influence of gender. Before beginning a cognitive-behavioral therapy treatment, 66 participants verbally recounted their traumatic event during a diagnostic interview. After treatment, 48 participants once again provided a trauma narrative. PTSD symptom severity was assessed using the Clinician-Administered PTSD Scale. Linear regression analyses revealed that none of the pretreatment characteristics predicted treatment efficacy. Furthermore, the length of the trauma narrative was the only pretreatment characteristic that correlated with pretreatment PTSD symptomatology. This suggests that more severe symptomatology is associated with shorter narratives. We only found a significant gender difference in narrative length, which was longer in women than in men. Our findings not only highlight the need for additional research on the link between trauma narratives and PTSD symptomatology, but also stress the necessity of considering gender in this field of research. This could allow for enhanced treatments to target gender-specific needs, thus leading to more individualized care for PTSD patients.     

Unrecognized Posttraumatic Stress Disorder as a Treatment Barrier for a Gang-Involved Juvenile Offender

This study examines the case of GH, an 18-year-old Latino male participating in an employment-based delinquency intervention for gang-affiliated youth. Although postintervention measures revealed that GH showed gains on key outcomes (i.e., delinquency, employment), he experienced sporadic treatment setbacks (e.g., work absenteeism, fighting) that disrupted his progress. A comprehensive psychological assessment suggested that his aggressive, illegal behavior and difficulty maintaining employment could have been influenced by previously undiagnosed posttraumatic stress disorder (PTSD). Excerpts from counseling sessions illustrated how reactive aggression, hypervigilance, sleep disruptions, and emotional numbing could have interfered with treatment gains and ultimately contributed to GH's re-arrest. Implications for early, accurate identification of PTSD in delinquency interventions for gang youth are discussed.     

Toward a Public Mental Health Approach for Survivors of Terrorism

Abstract

Although most people exposed to bioterrorism or mass casualties will be extremely distressed during the immediate aftermath, only a minority (approximately 30%) will develop clinically significant psychiatric disorders. From a public mental health perspective, the challenge is to provide both preventive programs for the entire population and early detection and intervention for those at greatest risk for PTSD or other post-traumatic psychiatric disorders. Both individual and soci-etal preventive and early intervention approaches are reviewed. Utilization of the media, especially television, is presented as an example of one of many potential community/societal public mental health approaches.     

Family Violence and Health Among Elderly in Croatia

This article presents the research carried out on a sample of 303 elderly men and women. In the last year they reported experiencing violence in the family as follows: psychological abuse (24.1%), financial exploitation (6.4%), physical abuse (4.4%), and sexual abuse (2.1%). The abusers were most often husbands (30.15%), sons (16.64%), daughters (14.01%), and wives (9.21%). In the partner relationship, 44%?of the women and 35%?of the men had experienced at least some form of violence. The results showed that elderly men and women who were victims of family abuse had poorer psychological health than those without such experiences. Elderly who had experienced partner violence consumed alcohol more often than those who had experienced violence by other household members.     

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.     

Gender Differences in the Effects of Community Violence on Mental Health Outcomes in a Sample of Low-Income Youth Receiving Psychiatric Care

Previous research suggests that community violence impacts mental health outcomes, but much of this research has not (a) distinguished between different types of community violence, (b) examined gender differences, and (c) focused on youth living in urban poverty. The current study addresses these questions. Participants were 306 youth (23 % girls) and one parent/guardian receiving outpatient psychiatric services for disruptive behavior disorders in a large urban city. Youth and parents reported on youth’s experience of different types of community violence (being a direct victim, hearing reports, and witnessing violence), and whether violence was directed toward a stranger or familiar. Outcomes included youth externalizing, internalizing, and posttraumatic stress symptoms assessed via parent and youth reports. Being a direct victim of violence accords risk for all mental health outcomes similarly for both boys and girls. However, gender differences emerged with respect to indirect violence, such that girls who hear reports of violence against people they know are at increased risk for all assessed mental health outcomes, and girls who witness violence against familiars are at increased risk for externalizing mental health symptoms in particular. There are gender differences in violence-related mental health etiology, with implications for intervention assessment and design.     

Prolonged Stress,PTSD, and Depression Among School Aggressors and Victims

Exposure rates to school aggression as an aggressor, victim, aggressive victim, or a bystander is high, with large numbers of school-aged children reporting being subjected to verbal or physical violence. We hypothesized that all 3 clusters of the DSM–IV designation of posttraumatic stress disorder (PTSD; Criterion B: Intrusive recall, Criterion C: Avoidance, and Criterion D: Hypervigilance) would be experienced by pure victims, pure aggressors, and aggressive victims. We also anticipated that PTSD symptoms would lead to depression, primarily for victims. Questionnaires were given to 1,398 students, yielding 1,116 valid questionnaires (80% response rate). Respondents were enrolled in the general education system, from 9 different schools in Israel. Following calibration of the research instruments using exploratory and confirmatory factor analyses, a series of structural equation and reflection models were examined. The path through some of the symptoms of PTSD and depression was apparent only for victims. For the victims, the indirect model through avoidance predicted depression only for relational victimization. No clear linkage was found among aggression, PTSD, and depression for aggressors. For aggressors, physical aggression was linked with the 3 clusters of PTSD symptoms, but not with depression.     

Gender differences in the development of depression

The present study attempted to examine possible gender differences in the vulnerability to depression, specifically with regard to eliciting factors, marital status, age of onset, season of hospitalization, and type of treatment. The records of all patients (67 women and 34 men), treated during 1991 for major depression, dysthymia, or depression NOS at a psychiatric hospital in Southeastern Sweden were examined, and placed in empirically derived categories regarding eliciting factors.
The results indicated significant gender differences with regard to eliciting factors, marital status, and age. The eliciting factor in female depression was most commonly "threat to social bonds" whereas in male depression it was "threat to self esteem" or "threat to self respect". Married women were more prone to depression than were married men, as were men living alone compared to women living alone. Women above 60 years of age were significantly more prone to depression than were men of this age group. The results were discussed from two theoretical perspectives: gender role theory and gender-specific developmental theory.     

Gender Differences in Reporting Psychological Abuse in a National Sample

Understanding the nature and impact of psychological abuse for males and females is crucial because it might be the precursor of other forms of violence. This study examines reported gender differences in psychologically abusive acts using a national sample of U.S. citizens. The data were collected anonymously from an online administration of the Measure of Psychological Abuse (MPAB). Other measures were included to assess outcomes that might occur due to psychological abuse. Results indicate that there are more similarities than differences in the gender reports of psychological abuse. Compared to males' reports, differences include female reports of certain behaviors leading to more negative emotional and behavioral impact and more negative outcomes due to being in a psychologically abusive relationship.     

Utilizing Narrative Methodology in Trauma Treatment with Haitian Earthquake Survivors

An earthquake devastated Haiti in January 2010, killing than over 230,000 and displacing millions. Following this disaster, a culturally specific narrative model was developed for leaders (i.e., teachers, clergy, etc.) to treat trauma symptomatology among Haitians. The Haitian local leaders (n=85) were treated with the narrative model. Data were collected and analyzed, and the results were significant. The leaders’ trauma symptoms decreased following treatment. Following the narrative treatment, they were trained to utilize the model. Recommendations for future research and limitations of the study are discussed.     

Emotional Constriction and Risk for Posttraumatic Stress: The Roles of Trauma History and Gender

Research suggests there are qualitative differences in emotionality across gender, with men being more emotionally constrictive than women. Constrictive emotionality has consistently been linked to posttraumatic stress disorder (PTSD) and because men are generally more emotionally constrictive, one could infer they are at increased risk for PTSD. However, research demonstrates that twice as many women are diagnosed with PTSD than men. In an undergraduate sample, men reported significantly greater emotional constriction, but significantly less posttraumatic stress severity in comparison to women. The gender differences in emotional constriction disappeared in a subsample of students who endorsed experiencing an upsetting event. Emotional constriction mediated the relationship between trauma and posttraumatic stress severity, although it was a stronger mediator for women than men.     

Sex Differences in Women's Mental Health Problems and Their Causes

No abstract available for this article.     

Event Centrality as Mediator Between Attributions and Mental Health Outcomes

Consistent with the Reformulated Model of Learned Helplessness, attributions that are more internal, stable, and global have been shown to be associated with greater posttraumatic stress and depression symptoms. Even though the Reformulated Model of Learned Helplessness has been revised to clarify that attributions are most likely to lead to adverse outcomes when the event is considered to be important to the person and the outcomes very negative (Hopelessness Model of Depression), most attribution studies do not account for the importance of the event to the individual. The current study examined whether perceptions of event importance mediated the relationship between attributions and posttraumatic stress and depression symptoms in a sample of 313 college students who reported about their worst life event. Consistent with the Hopelessness Model of Depression, results supported the mediational role of event significance. Findings suggest that maladaptive attributions may contribute to symptoms of posttraumatic stress disorder and depression both directly and through the event’s importance to a person’s sense of identity.     

Gender Differences in Depression

From early adolescence through adulthood, women are twice as likely as men to experience depression. Many different explanations for this gender difference in depression have been offered, but none seems to fully explain it. Recent research has focused on gender differences in stress responses, and in exposure to certain stressors. I review this research and describe how gender differences in stress experiences and stress reactivity may interact to create women's greater vulnerability to depression.     

Refusing to be Marginalized: Groupwork in Mental Health Services for Women Survivors of Childhood Sexual Abuse

Childhood sexual abuse is a major aetiological factor in the development of mental health difficulties experienced by women. Although this conclusion is supported by two decades of extensive research, it has had little impact on the provision of mainstream mental health services. It remains exceptional for there to be specialist therapy or counselling provision for women survivors of childhood sexual abuse within statutory mental health services. This represents a serious gap in service provision and, it is argued, results in extended and inappropriate treatment for women survivors using mental health services. In this article, the development of a multi-agency approach to the provision of groupwork for women survivors of childhood sexual abuse within mental health service is described. A women-centred model of groupwork is outlined. Evaluation and funding are discussed. It is argued that, as a time-limited and effective treatment option, groupwork for women survivors of childhood sexual abuse should form a central part of service provision within statutory adult mental health services.     

The Mental Regulation of Autobiographical Recollection in the Aftermath of Trauma

ABSTRACT— Survivors of psychological trauma are frequently troubled by intrusive recollection of the traumatic event. We describe research showing that attempts to suppress such trauma memories can be associated with paradoxically enhanced remembering of the trauma, enhanced access to other negative personal material, and a lack of specificity in the recollection of the personal past. This suggests that attempted suppression is generally a counterproductive approach to the regulation of traumatic memories in distressed trauma survivors. Working with trauma memories, rather than suppressing them, is more adaptive.     

Pathways to Help-Seeking and Mental Health Service Provision for African Female Survivors of Conflict-Related Sexualized Gender-Based Violence

ABSTRACT

African migration to Canada is a relatively new development. There is a dearth of literature on the mental health of this newer immigrant population, especially those from the conflict zones of Sub-Saharan Africa. Our exploratory study examined the experiences of African female survivors of conflict-related sexualized violence based on the insights of six community mental health professionals. Guided by interpretive inquiry, semi-structured interviews were analyzed thematically and interpreted in light of multicultural feminist and transnational perspectives. Findings highlight refugee women’s resilience in the face of threats of social isolation and stigma. Their prioritization of assistance with practical needs, parenting, community/social supports, and education attainment in the context of counseling raises questions about agency and identity in understanding the relationships between female survivors, what they identify as important to their recovery, and their pathways to accessing mental health services.     

From Victim to Perpetrator of Trauma: Lived Experiences of Gang-Involved Urban Refugee Youth in Kenya

Somali children and youth in displacement are exposed to prolonged trauma and chronic violence. In spite of a striking link among trauma, gang activities, victimization, and perpetration of violence, however, few studies have been conducted with Somali refugee youth in low-resource urban settings. This qualitative study demonstrates how prolonged trauma shapes ecological conditions of refugee life that induce vulnerable youth to forge support systems through gang membership and violence. The accession of the challenges, from loss of family, to discrimination and police brutality, and to chronic impoverishment, forces the high-risk refugee youth to replicate the various forms of violence to which they have been exposed to survive. Undergoing such chronic and cumulated trauma, these youth continue to normalize and become further desensitized to violence. The systems perspective of this study expands understanding of the intersection of trauma and gang membership and implies the need for an expanded approach to trauma and understanding of the complexities of gang involvement, beyond posttraumatic stress disorder treatment and clinical intervention.