The role of anxiety sensitivity in the relationship between posttraumatic stress symptoms and negative outcomes in trauma-exposed adults

Background: The development of posttraumatic stress symptoms (PTSs) following a trauma is related to impairment, diminished quality of life, and physical health issues. Yet it is not clear why some trauma-exposed individuals experience negative outcomes while others do not. The purpose of this study was to determine the role of several influential factors related to PTS severity and negative outcomes. Methods: One hundred and twenty-two trauma-exposed adults were administered the following self-report measures: the Posttraumatic Stress Disorder Checklist-Civilian, the Trauma History Questionnaire-Short, the Anxiety Sensitivity Index-3, Depression and Anxiety Stress Scale 21, Sheehan Disability Scale, World Health Organization Quality of Life-BREF, and an abbreviated Patient Health Questionnaire. Primary Results: PTS severity was positively correlated with depressive symptom severity (r = 0.54, p < 0.001), chronicity of the most distressing trauma (r = 0.21, p = 0.017), and number of traumas (r = 0.22, p = 0.012). Main effects were found for PTS severity (β = ?0.38, p < 0.01) and anxiety sensitivity (AS; β = ?0.39, p < 0.01) on quality of life. No interaction was found between PTS severity and AS with any negative outcome. PTS severity mediated the relationship between AS and physical health issues (0.05; 95% CI: 0.02–0.08). Conclusion: This study helps clarify the role of various factors in the relationship between trauma and negative outcomes. Clinical and research implications are discussed.     

Trading Sex for Money or Compensation: Prevalence and Associated Characteristics from a Sexually Transmitted Infection (STI) Clinic Sample

The purpose of this study was to determine the prevalence and individual risk factors of people who trade or sell sex among sexually active individuals seeking HIV and sexually transmitted infection (STI) testing. Using electronic agency records, an analysis of the characteristics of 5,029 youth and adults who voluntarily obtained HIV and STI testing was conducted. Multiple imputation procedures for missing data from 3 variables and logistic regression were conducted. A total of 128 individuals reported having traded sex. Nine variables had statistically significant associations with trading sex. Individuals who identified as White and female had lesser odds of trading sex, whereas individuals who were transgender, were living in a shelter, had been sexually assaulted, had a previous STI, had high-risk sex, or used drugs had greater odds of trading sex. Elevated levels of high-risk behavior in addition to sexual trauma should be considered in intervention research and community health practice. Implications for service providers and researchers are discussed.     

Sexual Coercion,Trauma, and Sex Work in Justice-Involved Women with Substance Use Disorders

Sexual victimization is associated with mental health problems, trauma, substance use, and incarceration. We recruited 200 formerly incarcerated women with substance use disorders in Chicago. We examined whether empowerment moderates relationships between trauma symptoms, trading sex, and being forced to have sex. There was a significant 3-way interaction among sexual coercion, trading, and empowerment scores on trauma symptoms. For women who have not traded sex, lower levels of empowerment were associated with a larger difference in trauma symptoms between women who have been coerced or traded sex. For women who had been coerced, lower levels of empowerment were associated with a larger difference in trauma symptomatology between those who have traded sex or not. Promoting empowerment in sexually traumatized women might reduce the harm that results from being victimized. Furthermore, providing interventions that educate women regarding gender and cultural roles could help women avoid situations that result in exploitation.     

Is Physical Abuse,Neglect, or a Combination of Both More Predictive of Delinquent Behavior in a High-Risk Population?

This study explored early abuse type and severity in relation to delinquency utilizing an archival longitudinal data set. These data were collected every 2 years, starting at age 4, from the individuals, caregivers, and teachers. Mean differences tests were conducted to determine how delinquency scores varied by abuse type and severity. These analyses used Child Protective Services reports of the type and severity of abuse as independent measures and the behavior problem scale from the Child Behavior Checklist, Youth Self Report, and Teacher Report Form as independent measures. Follow-up analyses of variance and post-hoc tests were conducted as necessary to clarify the relationship between abuse and delinquency. Although results did not reach significance, a relatively small mean difference was discovered between severity types (more severe maltreatment history demonstrating higher levels of delinquency) for teacher ratings of delinquency.     

Intergenerational Transmission of Trauma-Related Distress: Maternal Betrayal Trauma,Parenting Attitudes,and Behaviors

The purpose of this study was to elucidate mechanisms involved in the intergenerational transmission of trauma-related distress. This study investigated whether betrayal trauma (BT; abuse by a person close to the victim) and specific parenting attitudes and behaviors among mothers with child abuse histories predicted internalizing and externalizing symptoms in their children. Mothers and children (ages 7–11) were recruited for a project on parenting and stress (N = 72). Maternal betrayal trauma predicted both internalizing (β = 0.33, p < .01) and externalizing symptoms (β = 0.25, p < .05) even when controlling for mothers’ trauma-related symptoms. Negative attitudes toward limit setting predicted externalizing symptoms (β = ?0.33, p < .05). Poorer communication (β = ?0.39, p < .05) but higher parenting satisfaction (β = 0.38, p < .01) predicted internalizing symptoms. These findings demonstrate the importance of assessing maternal trauma and parenting characteristics as part of interventions with symptomatic children.     

Duty-Related Posttraumatic Stress Symptoms in 911 Telecommunicators: The Roles of Childhood Trauma Exposure and Emotion-Focused Coping

A history of childhood trauma exposure has been linked to the development of posttraumatic stress symptoms in adulthood following new exposure. Unhealthy coping behaviors that could develop or be utilized in response to early trauma could lend themselves to psychological issues in adulthood. Emotion-focused and problem-focused coping strategies in relation to stressful duty-related situations are examined as indirect pathways through which childhood trauma exposure could be associated with duty-related posttraumatic stress symptoms in 911 telecommunicators (N = 808). Multiple mediation models revealed that 3 of the 4 emotion-focused coping strategies, but not the problem-focused strategies, functioned as significant mediators in the association between childhood exposure and duty-related posttraumatic stress symptoms. Pairwise comparisons showed that self-controlling and escape-avoidance strategies were the strongest pathways of the indirect childhood trauma exposure–posttraumatic stress symptoms association. Implications of results regarding coping in response to new traumatic events in adulthood and potential research and intervention directions are discussed.     

Phantom narratives and the uncanny in cultural life: psychic presences and their shadows

Abstract

In this paper the author explores the emotional factors that are activated at the level of the cultural unconscious, that produce experiences of the uncanny that are expressed through Phantom Narratives. Phantom Narratives as a hybridized term is the author’s way of linking personal and social activity of unconscious story formation through psychic presences (images). Phantom Narratives are expressions of the unconscious at the level of the group that shows the psyche’s way of narrating its relationship to the group, through the expressions of cultural, social, and political issues. The uncanny, at the level of the social, is seen as those disturbances of feelings that alienate us from the familiar social world of others. What is uncanny about Phantom Narratives is how group emotional dynamics are represented as psychic presences. Making use of the author’s own subjectivity (i.e. psychoanalytic literary genre) he uses an approach from analytic psychology (Jungian) called amplification, which allows for the elaboration of symbolic processes, to create a meaningful (semantic) context for exploration.     

A spectrum of belief: a qualitative exploration of candid discussions of clergy on mental health and healing

Since clergy are often first responders to mental health issues, it is important to understand clergy views on handling such issues. A discussion occurred in 2012 amongst clergy involved in a popular social utility network clergy’s group. One clergyperson asked peers: “If the church is where we are to come for healing, how do we handle people who are depressed, suicidal, suffering from PTSD or anxiety?” Over 140 comments were made during 13 days, and 35 clergy from the United States, Africa, and India contributed to the discussion. Data from this conversation were examined via classic grounded theory. Analysis revealed a spectrum of beliefs that clergy hold regarding the causes and best treatments for emotional issues. Findings shed light on the candid thoughts clergy have about mental health care. The findings provide greater understanding for mental health practitioners with clients who rely on their church for emotional support.     

Sex differences in trauma symptoms,body image and intensity of pain in a Polish sample of patients suffering from chronic pain

The main goal of the current study was to investigate sex differences in the relationship between the level of trauma symptoms appearing in posttraumatic stress disorder (PTSD) and intensity of pain in a sample of 300 Polish patients suffering from chronic pain, specifically rheumatoid arthritis and lower back pain. We also focused on participants’ body image with body esteem as a mediator. To assess the intensity of pain among participants, we used the Numerical Rating Scale. The level of trauma symptoms was assessed with the PTSD Factorial Version Inventory. To measure body image among participants, we used the Body Esteem Scale. The results of our study suggest that trauma symptoms and body image dimensions were significant predictors of pain intensity among men suffering from chronic pain. Moreover, trauma symptoms and age were significant predictors of pain intensity among women suffering from chronic pain. Finally, we demonstrated that sex differentiates the reaction to chronic pain.