A Cross-Lagged Panel Approach to Understanding Social Support and Chronic Posttraumatic Stress Disorder Symptoms in Veterans: Assessment Modality Matters

Although there is a strong and consistent association between social support and posttraumatic stress disorder (PTSD), the directionality of this association has been debated, with some research indicating that social support protects against PTSD symptoms, whereas other research suggests that PTSD symptoms erode social support. The majority of studies in the literature have been cross-sectional, rendering directionality impossible to determine. Cross-lagged panel models overcome many previous limitations; however, findings from the few studies employing these designs have been mixed, possibly due to methodological differences including self-report versus clinician-administered assessment. The current study used a cross-lagged panel structural equation model to explore the relationship between social support and chronic PTSD symptoms over a 1-year period in a sample of 264 Iraq and Afghanistan veterans assessed several years after trauma exposure. Approximately a third of the sample met criteria for PTSD at the baseline assessment, with veterans’ trauma occurring an average of 6 years prior to baseline. Two separate models were run, with one using PTSD symptoms assessed via self-report and the other using clinician-assessed PTSD symptoms. Excellent model fit was found for both models. Results indicated that the relationship between social support and PTSD symptoms was affected by assessment modality. Whereas the self-report model indicated a bidirectional relationship between social support and PTSD symptoms over time, the clinician-assessed model indicated only that baseline PTSD symptoms predicted social support 1 year later. Results highlight that assessment modality is one factor that likely impacts disparate findings across previous studies. Theoretical and clinical implications of these findings are discussed, with suggestions for the growing body of literature utilizing these designs to dismantle this complex association.     

Asian American Women Sexual Assault Survivors’ Choice of Coping Strategies: The Role of Post-Assault Cognitive Responses

ABSTRACT

Even though approximately one in three Asian American (AA) and Pacific Islander women experience sexual assault victimization, there is a dearth of literature examining how AA women sexual assault survivors cope with this traumatic experience. This study examined AA female sexual assault survivors’ choice of coping strategies post-assault and how their cognitive responses toward sexual assault victimization (e.g., attributions of self-blame, perceived control over the recovery process) relate to their use of coping strategies. Using the AA subsets of two large community studies, a total of 64 AA women ages 18 to 58 with unwanted sexual experiences after the age of 14 years were included in the analyses. Results indicated that AA survivors used Acceptance and Self-Distraction the most to cope with sexual assault. In addition, those who perceived they had less control over their recovery process tended to use more maladaptive coping strategies, such as substance abuse and behavioral disengagement (e.g., giving up). The discussion includes clinical implications and recommendations for using language, modalities, and foci of interventions that are consistent with clients’ and their families’ worldviews (e.g., indirect inquiries, solution-focused).     

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.     

Legacies of War: Asian American Women and War Trauma

ABSTRACT

Although Asian Americans are diverse in many ways, such as language, culture, ethnicity, religion, generational status, and more, many share a common experience: that of having experienced war first hand or being progeny of war survivors. World War II, the Korean War, the Vietnam War, the Cambodian genocide, along with centuries of oppressive and authoritarian rule, have brought experiences of trauma, directly and historically, to the lives of many Asians. Subsequent experiences of migration and resettlement, as well as life in the United States as an ethnic minority, have also compounded the layers of oppression for many Asian Americans. Sexism in our cultures of origin, as well as sexism in the U.S., represents additional realities and traumas faced by Asian American women. In this article, we explore the experiences of war and subsequent traumas in the lives of Asian American women. We present a brief review of the current state of mental health as it relates to the experiences of war trauma, with the goal of providing a crucial contextual backdrop for our review of the best practices in mental health services to Asian American women. We review some of the best practices and conclude with a narrative reflection based on our own involvement in a small professional women’s group that yielded insights, discoveries, healing, and empowerment from the legacy of war trauma.     

If you are vulnerable and you know it raise your hand: Experiences from working in post-tsunami Thailand

Scientific validity has historically been measured against notions of objectivity. However, try as we might, we cannot divorce ourselves from our own personal interests and perceptions that shape the questions we ask, the theoretical filters and methods we choose, and the conclusions we make. We are all human and it is this humanness that is tested and shaped by disasters. Embracing this humanness, this paper reflects upon the experiences and challenges of undertaking longitudinal research in Thailand following the 2004 Tsunami from the perspective of a research student. These include: common logistical and planning challenges in undertaking disaster research in a cross-cultural setting and how positionality, reflexivity, reciprocity and the differing needs of the researcher and participants influence research outcomes. Particular focus is placed on the emotional toll working in unique trauma landscapes has on researchers and the associated threat of secondary trauma stress and vicarious trauma, how this influences a researcher's relationship to place and the ramifications this exchange has on the researcher as a person and their findings. I conclude by offering recommendations on how early career researchers can better prepare for and navigate the disaster landscape and adjustments their mentors and institutions can make to support them.     

THE TEXTURE OF TRAUMATIC ATTACHMENT: PRESENCE AND GHOSTLY ABSENCE IN TRANSGENERATIONAL TRANSMISSION

Work on the transgenerational transmission of trauma refers to unspoken stories across generations, but the actual mode of transmission has remained somewhat mysterious. Utilizing examples from her own life, the author illustrates how attachment patterns are a primary mode of transmission of trauma. When trauma revisits a person transgenerationally through dysregulated and disrupted attachment patterns, it is within the child's empathic attunement and search for a parental bond that the mode of transmission can be found. This will become the texture of traumatic attachment: how it feels to this child to feel connected to the parent.     

HANSEL AND GRETEL: A TALE OF TERROR

In the analysis of a woman with multiple childhood traumas, the fairy tale “Hansel and Gretel” figured prominently. The author discusses the use of the fairy tale in this case at various levels. He suggests an interplay between a national myth, the fairy tale, and a personal myth—the patient's psychodynamics. The fairy tale can be used to illuminate personal meanings derived from it. In the experience of childhood trauma, the repeated reading of a fairy tale can help organize and defend against terrifying anxiety.     

Individual Differences in Diving: Intelligence,Personality, and Underwater Adaptation

Diving is an activity that is carried out in an extreme environment with extraordinary psychophysical demands. It requires the divers to undergo an adaptive process in order to survive, to be able to take advantage of their capabilities, and to achieve an efficient performance. In this ex post facto study, data from a sample of military personnel participating in scuba diving courses (N = 649) were analyzed. Our aim was to verify the role of individual differences in the adaptation to an extreme and hostile environment. The results indicate the existence of psychological variables that differentiate between divers and the general population, those who pass or fail the diving course, and between groups of divers who obtain differential levels of performance in underwater tasks. These findings support that dispositional characteristics have utility for the identification of suitable personnel for professional diving.     

Temporality and the torments of time

Immersion in time gives birth to consciousness, as well as conflict and torment. When human beings developed a sense of future, they also gained the ability to anticipate threats from nature or their fellow beings. They thereby created cultures that are bastions of survival, as well as places of poetry, art and religion where they could band together and reflect upon their common plight. The practice of psychoanalysis is in many ways a temporal process, a process of remembering, for owning and elaborating a past that gives us substance, thereby providing a basis for reflective consciousness. Stimulated by Freud's early writings, Lacan, Laplanche and their successors in particular have focussed extensively on time and psychoanalysis, and their views are a central point of this discussion. A substantial case study is offered that provides concrete examples of these perspectives. A multi‐faceted view of temporality emerges, one that is more syncopated than linear or teleological. In conclusion, I will briefly discuss recent findings in the neuroscience of memory and ‘time travel’ that underpin contemporary psychoanalytic ideas in surprising ways. It is important to remember that acceptance of the contradictory nature of temporal experience can open space for increased freedom and playfulness.