Implementing Trauma-Informed Care in Primary Medical Settings: Evidence-Based Rationale and Approaches

ABSTRACT

Chronic stress stemming from trauma exposure and posttraumatic stress disorder (PTSD) leads to many health problems that are typically seen by primary care providers. Unfortunately, providers rarely identify trauma as the root cause of patient difficulties. The present paper provides an evidence-based rationale for implementing trauma-informed care principles and processes into medical primary care systems. Beginning with a review of prevalence of trauma exposure and PTSD in primary care clinics, this article elucidates relationships between trauma exposure and behavioral and medical health problems, as well as clinical and physiological pathways that lead from trauma exposure to illness. The article concludes with exposition of trauma-informed interventions that can be implemented in primary care clinics, and discussion of future directions.     

Support for rejection and reception policies toward asylum seekers in Italy: The role of conservative ideologies and legitimizing myths

ABSTRACT

Based on Social Dominance Theory (SDT), this study investigates the relationships between ideologically conservative attitudes (social dominance orientation, SDO; right-wing authoritarianism, RWA), legitimizing myths (false belief in asylum seekers as bogus; perception of in-group threats), and citizens’ support for restricted reception and rejection of asylum policies. A sample of 539 people living in Italy filled in an anonymous questionnaire administered using a cross-sectional design. The results support the expectations, showing that people high in SDO and RWA were more likely to hold the belief that asylum seekers are making false claims and to perceive that the latter pose a threat to the in-group, which in turn increased support for both of restrictive policies. Findings suggest that conservative ideologies can positively affect citizens’ support for restrictive asylum seeker policies based on both rejection and restricted reception by supplying ideological justification for not accommodating them in the host society.     

Gender stereotypes underlie child custody decisions

Using hypothetical divorce cases we examine the role of gender stereotypes in decisions about child custody. Good mothers received greater custody allocations than did good fathers across a tightly matched pair of vignettes in three culturally distinct samples: Argentina, Brazil, and the United States (Study 1). Two follow-up studies indicated that the warmth dimension of stereotype content partly accounted for the asymmetry in custody awards: The proportion of maternal-primary custody was predicted by the tendency to ascribe warmth-related traits—such as friendliness, generosity, or trustworthiness—to mothers (Study 2) and associate them with female over male nouns (Study 3). We also found that endorsing shared custody mitigated the asymmetry in custody awards documented in our studies. Together, these results highlight the interplay of stereotyped attitudes and egalitarian commitments in the context of judicial decisions about child custody.     

Personality and environmental variables associated with dental anxiety

94 adult dental patients' anxiety was assessed. Scores on Spielberger, et al.'s inventory showed attractiveness of the waiting room, age, and Edwards' Harmavoidance were significantly related to anxiety.