Population Health and Trauma‐Informed Practice: Implications for Programs,Systems, and Policies

Population studies indicate that trauma exposure is ubiquitous and has a significant impact on health. Trauma‐informed practice seeks to address the health consequences of trauma through integrative responses that incorporate an understanding of the effects of trauma, the multiple pathways to recovery, and the potential for re‐traumatization. Current trauma‐informed practice considers trauma exposure an individual clinical problem rather than a societal problem with population health consequences. Population health refers to the aggregated health status of individuals who share some characteristic, such as trauma exposure, and includes the study of determinants that shape the distribution of health outcomes in specific populations. In this paper, we describe a population health perspective for trauma‐informed practice that complements the current clinical perspective, and then discuss implications of that perspective for programs, systems, and policies. We summarize essential concepts about trauma over the life course and describe principles of population health science relevant to trauma‐informed practice. We then discuss implications of these principles by identifying four priorities for trauma‐informed practice from a population health perspective: (a) adopting trauma‐informed policies to prevent trauma exposure and to foster resilience in the aftermath of trauma; (b) infusing trauma‐informed practice into everyday activities so it is a routine part of interpersonal transactions; (c) incorporating trauma‐informed practices into existing service systems; and (d) adapting existing treatments to incorporate trauma‐informed principles for population health impact.     

Option weights should be determined empirically and not by experts when assessing knowledge with multiple‐choice items

Multiple‐choice tests are frequently used in personnel selection contexts to measure knowledge and abilities. Option weighting is an alternative multiple‐choice scoring procedure that awards partial credit for incomplete knowledge reflected in applicants’ distractor choices. We investigated whether option weights should be based on expert judgment or on empirical data when trying to outperform conventional number‐right scoring in terms of reliability and validity. To obtain generalizable results, we used repeated random sub‐sampling validation and found that empirical option weighting, but not expert option weighting, increased the reliability of a knowledge test. Neither option weighting procedure improved test validity. We recommend to improve the reliability of existing ability and knowledge tests used for personnel selection by computing and publishing empirical option weights.     

Emotional distress and tobacco demand during the menstrual cycle in female smokers

Fluctuations in ovarian hormones over the menstrual cycle contribute to cigarette reward, however less is known about menstrual cycle influences on emotional distress in female smokers. We examined between-group differences in emotional distress (negative affectivity, emotion dysregulation, distress intolerance) and hypothetical cigarette purchasing (i.e. tobacco demand) among female smokers at three different menstrual stages. Women (n = 32) were non-treatment seeking daily smokers not on hormonal contraceptive, and were currently in their follicular (estradiol-dominant; n = 10), early-mid luteal (progesterone-dominant; n = 15), and late-luteal phase (decreasing progesterone/estradiol; n = 7). Effect sizes are reported given the small sample. Women in the late-luteal phase, relative to the follicular and early-mid luteal phases, reported higher levels of negative affectivity (d = 0.69), emotion dysregulation (d = 1.03), and distress intolerance (d = ?0.86). Compared to the early-mid luteal and late-luteal phases, women in the follicular phase reported the highest hypothetical cigarette consumption when cigarettes were free (d = 0.71) and made the largest maximum expenditures on cigarettes (d = 0.74). Findings offer preliminary evidence that the late-luteal phase is characterized by emotional distress, and the follicular phase is associated with elevated tobacco demand, which if replicated could implicate ovarian hormones in emotion-focused smoking.     

Rape Myth Acceptance in Sexually Assaulted Adolescents' School Contexts: Associations with Depressed Mood and Alcohol Use

High school students exposed to sexual assault (SA) are at risk for negative outcomes like depressed mood and high‐risk drinking. Although evidence suggests that both social contexts and internalized stigma can affect recovery from SA, no research to date has directly examined the presence of stigma in social contexts such as high schools as a correlate of adjustment after SA. In this study, the self‐reported rape myth acceptance (RMA) of 3080 students from 97 grade cohorts in 25 high schools was used to calculate grade‐mean and school‐mean RMA, which was entered into multilevel models predicting depressed mood and alcohol use among N = 263 SA survivors within those schools. Two forms of RMA were assessed (i.e., rape denial and traditional gender expectations). Results indicate that higher grade‐mean rape denial was associated with higher risk for depressed mood among high school boys and girls exposed to SA, and higher grade‐mean traditional gender expectations were associated with higher risk for alcohol use among girls exposed to SA. Survivors' own RMA and school‐level RMA were not significantly associated with their depressed mood or alcohol use. Although causality cannot be concluded, these findings suggest that interventions that reduce stigma in social contexts should be explored further as a strategy to improve well‐being among high‐school‐aged survivors of SA.     

Living Conditions and Psychological Distress in Latino Migrant Day Laborers: The Role of Cultural and Community Protective Factors

The purpose of this study was to examine the relationship between typically difficult living conditions and psychological distress in Latino migrant day laborers (LMDLs), with attention to the potentially protective roles of contact with family in country of origin (i.e., communication, sending money, etc.), availability of local culture (i.e., food, music, people from one's country of origin), and utilization of community resources perceived to be culturally competent (i.e., services that are respectful, able to serve Latinos, able to solve problems, in Spanish, etc.). Participants were 344 LMDLs surveyed in the San Francisco Bay Area. As hypothesized: (a) difficult living conditions were related to depression, anxiety, and desesperación [desperation], the latter a popular Latino idiom of psychological distress recently validated on LMDLs; (b) contact with family moderated the relation between difficult living conditions and depression and desesperación but not anxiety and (c) access to local culture, and utilization of community resources, mediated the relation between difficult living conditions and depression and desesperación but not anxiety. Implications for intervening at local and larger levels in order to provide some protection against distress built into the LMDL experience in the United States are discussed.     

The Stigma of Being Young on the Experience of Rate-Busting as Positive Deviance

This study compares younger and older librarians with regard to how they experience age-related stigma. The purpose was to show how youth, although a culturally valued attribute, can be experienced as stigmatizing (i.e., as a form of positive deviance known as rate-busting). We conducted semi-structured interviews with 26 librarians who ranged in age from 27 to 64. Although both younger and older librarians reported feeling stigmatized because of their age, only younger librarians reported instances of other people drawing unwanted attention to their age. Because librarians are an older demographic, the attention young librarians receive as rate-busters may be due to disconfirming expectations.     

Testing the Ideology of Openness: The Comparative Effects of Talking,Writing, and Avoiding a Stressor on Rumination and Health

A persistent assumption across the psychological literature is that talking and writing about one's stress is inherently more beneficial than avoiding it. This study compared the effects of these stress management strategies on personal and relational health. Two hundred and fifty‐one dating individuals focused on a stressor that was a current source of rumination. Writing about one's stressor for 5 consecutive days (without talking about it) decreased anxiety the most. Talking continuously about one's stressor to a dating partner harmed the relationship more than writing about or avoiding it. The effect of talking repeatedly about one's stressor on relationship quality and brooding, however, depended upon the emotional support received from one's dating partner and the ability to reappraise (positively or neutrally) the stressor.     

Relation Between Aggression Exposure During Youth and Later Resting Skin Conductance Levels

Recent research efforts have focused on examining the relationship between environmental and physiological factors to better understand the effect that childhood chronic stress might have on adult health outcomes. This study examines the relation between childhood parental aggression exposure and the sympathetic nervous system (SNS), as measured by resting skin conductance levels (SCLs). Participants (N = 155) completed retrospective self-report measures of childhood exposure to interparental aggression and physically aggressive parenting. The 2-way interaction between exposure to physically aggressive parenting and interparental aggression accounted for unique variance in adulthood SCL. Sex differences emerged in this relationship. Results suggest that the type of aggression exposure might play an important role in the relationship between stressors in youth and resting SNS activity in adulthood. Future research areas are identified, including the need to examine plasticity in the SNS depending on the age of experienced aggression and the age of intervention.     

The aesthetic appeal of auditory-visual synaesthetic perceptions in people without synaesthesia

The term 'visual music' refers to works of art in which both hearing and vision are directly or indirectly stimulated. Our ability to create, perceive, and appreciate visual music is hypothesised to rely on the same multisensory processes that support auditory visual (AV) integration in other contexts. Whilst these mechanisms have been extensively studied, there has been little research on how these processes affect aesthetic judgments (of liking or preference). Studies of synaesthesia in which sound evokes vision and studies of cross-modal biases in non-synaesthetes have revealed non-arbitrary mappings between visual and auditory properties (eg high-pitch sounds being smaller and brighter). In three experiments, we presented members of the general population with animated AV clips derived from synaesthetic experiences and contrasted them with a number of control conditions. The control conditions consisted of the same clips rotated or with the colour changed, random AV pairings, or animated clips generated by non-synaesthetes. Synaesthetic AV animations were generally preferred over the control conditions. The results suggest that non-arbitrary AV mappings, present in the experiences of synaesthetes, can be readily appreciated by others and may underpin our tendency to engage with certain forms of art.