Perceived lack of training moderates relationship between healthcare providers’ personality and sense of efficacy in trauma-informed care

ABSTRACT

Background and Objectives: Medical patients often have trauma histories that are not routinely assessed, which can adversely affect health outcomes. Despite growing awareness of this issue, there is limited understanding of factors that influence provider competency in trauma-informed care (TIC). The study examined healthcare providers’ personality traits in relation to their sense of TIC efficacy, taking into account perceived barriers to TIC and professional quality of life.

Study Design: The study used cross-sectional survey methods to examine our central hypothesis that provider personality traits and perceived barriers to TIC would be associated with TIC-efficacy, and to explore interactions among study variables.

Methods: Survey data were collected from 172 healthcare providers examining TIC knowledge, TIC-efficacy, perceived barriers to TIC, personality traits, and professional quality of life.

Results: TIC-efficacy was positively correlated with “intellectence/openness” and inversely correlated with “neuroticism” and perceived lack of training as a barrier. “Intellectence/openness” interacted with perceived lack of training to predict TIC-efficacy, suggesting that providers with lower “intellectence/openness” report greater TIC-efficacy when lack of training is not perceived as a barrier.

Conclusions: Provider personality traits and perceived barriers to TIC appear related to providers’ TIC-efficacy. Implications for overcoming barriers to TIC through training and implementation are discussed.     

Missed Opportunities: Newspaper Reports of Domestic Violence

News coverage can influence public views of important health problems, including domestic violence (DV). To understand how newspaper reports frame DV, this study examined 187 articles published across a single state over a one-year period. Coded variables included characteristics of the newspapers and articles; incident details; common DV themes (e.g., victim blame; DV as isolated or rare); and education, resources, and community context. Approximately one-third of articles framed DV using themes that might misinform the public about DV (e.g., victim blame). The majority of articles missed opportunities to provide educational information or resources about DV and failed to situate DV in a community context. These findings point to missed opportunities for newspapers to provide comprehensive information and resources to the public.     

Social Construction of Intimate Partner Violence: A Brief Report on Quantitative Grammatical Analysis

This pilot study uses a quantitative linguistic analysis to assess evidence of agency and control, as well as treatment engagement, in letters written by men (N = 46, 37% Latino) participating in a batterer intervention program. At the program’s conclusion, men were asked to imagine their situation in 5 years and write a letter from their “future self” to their “present self.” Letters were scored for grammatical representations of agency and objectification, and temporal complexity. Results showed that the men tended to grant themselves the subject position (conferring agency) and to grant others the object position (deferring or denying agency) by almost equal margins, both rhetorical maneuvers suggesting an objectifying stance toward others. Moreover, they employed several strategies to address temporality, with more complex strategies suggesting greater treatment engagement. Findings suggest that quantitative linguistic analysis is a promising tool for assessing participants’ progress in and engagement with treatment.     

Associations between Thematic Content and Memory Detail in Trauma Narratives

This study examined whether thematic content (e.g., fear, anger, alienation, self‐blame, and spirituality) in trauma narratives predicted memory detail. Trauma‐specific memory models suggest that trauma narrative themes are associated with much sensory detail; general autobiographical memory models suggest that themes are associated with little context detail. Seventy‐one narratives from a diverse community sample exposed to a variety of traumatic events (e.g., sexual assault, natural disasters) were coded for themes and detail. Analyses controlled for narrative length, childhood or adulthood occurrence, self‐reported post‐traumatic stress disorder, depression and dissociation symptoms. Fear themes were associated with greater sensory detail; anger and spirituality themes were associated with less context detail. Findings support a link between thematic content and detail, and may partially explain why details in memory for traumatic events sometimes appear better and other times worse than memory for other events. Memory models may benefit from specification based on themes in trauma narratives. Copyright © 2013 John Wiley & Sons, Ltd.     

Understanding countertransference and object relations in the process of nursing drug-dependent patients

In psychiatric nursing, transference and countertransference dynamics are generally ignored. This paper is an attempt to examine how the transference and countertransference dynamics influenced the nurse-patient relationships on an in-patient drug-dependency unit, and how an understanding of transference was found to be helpful.     

Doing Community Research Without a Community: Creating Safe Space for Rape Survivors

This paper describes how the values of a feminist research team influenced methodological decisions in a study of rape survivors. Building upon concepts from community psychology and urban sociology, the authors created a community-based research design that respected the emotional needs of rape survivors without sacrificing methodological rigor. We developed relationships with community members in diverse settings, such as nail and hair salons, child care centers, churches, and bookstores, to advertise the study and recruit participants. Consistent with feminist approaches to interviewing, our goal was to create a safe setting for survivors to tell their stories. Although the purpose of this study was research rather than intervention, most survivors reported that participating in these interviews was healing. Our experiences in this project suggest that allowing values to influence the process of research may have beneficial outcomes for both researchers and participants.     

Age differences in veridical and false recall are not inevitable: The role of frontal lobe function

The relationship of neuropsychological measures of frontal lobe function to age differences in false recall was assessed using the Deese/Roediger-McDermott associative false memory paradigm (Deese, 1959; Roediger & McDermott, 1995). As other studies have found, older adults were less likely to correctly recall studied items and more likely to falsely recall highly related but nonpresented items than were younger adults. When older adults were divided based on a composite measure of frontal lobe functioning, this age difference was found only for low frontal lobe functioning individuals. High frontal lobe functioning older adults and young adults had equivalent levels of false recall, as well as equivalent levels of veridical recall. These results suggest that age differences in memory may be due to declines in frontal lobe function. More important, our findings indicate that declines in veridical recall and increases in false recall are not an inevitable consequence of aging.     

Response monitoring, the error-related negativity, and differences in social behavior in autism

Children with autism not only display social impairments but also significant individual differences in social development. Understanding the source of these differences, as well as the nature of social impairments, is important for improved diagnosis and treatments for these children. Current theory and research suggests that individual differences in response monitoring, a specific function of the anterior cingulate cortex (ACC), may contribute to social-emotional and social-cognitive impairments and individual differences in autism. To examine this hypothesis, we used a modified flanker task to assess an ERP index of response monitoring, the error-related negativity (ERN), in a sample of higher function children with autism (HFA) and an IQ-matched control sample. The results revealed a significant Diagnostic group by Verbal IQ interaction on ERN amplitude indicating that the most verbally capable HFA children displayed significantly larger ERN amplitudes than did the control children. Within the HFA sample, greater ERN amplitude was also related to parent reports of fewer symptoms of social interaction impairments, fewer internalizing problems, but more externalizing problems, although these associations were reduced to nonsignificance when medication status was controlled. The latter results complement previous observations from imaging studies of a significant association between ACC activity and social symptoms and impairments in autism. The implications of these results for future research on brain-behavior relations, as well as treatment related research with children with autism are discussed.     

Clinical features of muscle dysmorphia among males with body dysmorphic disorder

Muscle dysmorphia – a pathological preoccupation with muscularity – appears to be a form of body dysmorphic disorder (BDD) with a focus on muscularity. However, little is known about muscle dysmorphia in men with BDD, and no study has compared men with BDD who do and do not report muscle dysmorphia. To explore this issue, we reviewed the histories of 63 men with BDD; we compared those rated as having a history of muscle dysmorphia with those who had BDD but not muscle dysmorphia in several domains. The 14 men with muscle dysmorphia resembled the 49 comparison men in demographic features, BDD severity, delusionality, and number of non-muscle-related body parts of concern. However, those with muscle dysmorphia were more likely to have attempted suicide, had poorer quality of life, and had a higher frequency of any substance use disorder and anabolic steroid abuse. Thus, muscle dysmorphia was associated with greater psychopathology.     

Quantifying visual field shape for improving accuracy of search performance prediction

The current study calculated a set of 16 shape indices of six subjects (4 men and 2 women, 21-28 years old) for easy and precise quantification of visual lobe shapes using Visual Lobe Measurement System (VILOMS) software. The indices can be used in mathematical models of visual search for better understanding of search behaviour and higher accuracy of search performance prediction. General patterns in the shape indices showed that visual lobes of the subjects were slightly irregular, with low sphericity, a moderately rough boundary, horizontally elongated and slightly asymmetric along both axes. Given the complex relationships among visual lobe area, lobe shape, and search strategy, it seems that a more detailed analysis than hitherto attempted will be necessary. Quantifying lobe shape with the 16 shape indexes is a useful step to performing such analysis.