Psychological Trauma: Theory, Research, Practice, and Policy

The function of power: A herstorical model of power, trauma, and policing African Americans.
Objective: Transmitting trauma narratives is intergenerational by nature. Few studies have taken a qualitative approach to analyzing the most pervasive trauma of the United States: the chattel slavery of Black people. Examining the lived experiences of the formerly enslaved, through their childhood and adult narrative memories of personal and second-hand interactions with White authority figures, is critical to the recognition of today’s ongoing impact of policing, generational trauma, and mental health in the African American community. Method: Using interviews archived in the Library of Congress from women (N = 19) who were identified as being members of the last living generation of formerly enslaved African Americans, researchers used a feminist-forward grounded theory methodology to understand the following: (a) What are the historical relationships between African Americans and White authority figures? (b) What are the memories associated with the interactions between African Americans and White authority figures? (c) How did these interaction processes come to be? and (d) How did these memories get passed on? Results: The analysis of childhood memories and interactions between enslavers and African Americans close to home (i.e., on the plantation) produced six themes: (a) enmeshment with enslaver, (b) enslaver as good, (c) caretaking by enslaver, (d) enslaver control, (e) violent control by policing figures, and (f) following orders. Theoretical coding led to the formation of a full model of the function of power within the herstorical policing of African Americans close to home. Conclusions: The themes uncovered highlight the potentially traumatic violence and control that characterized the environment in which enslaved children lived and the systems through which White power was maintained. The herstorical analysis and results confirm the ways police violence has sought to control and harm African Americans for over 400 years and underscores the role that police violence has played in the perpetuation of intergenerational trauma and the maintenance of White power. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
An investigation of the associations between trauma exposure, racial stereotypes, and racist beliefs.
Objective: Given the concerning rise in hate crimes in recent years, it is critical to better understand factors associated with racist beliefs. As suggested by terror management theory (TMT), trauma exposure and posttraumatic stress symptoms (PTSS) may activate existential distress and anxiety, which may strengthen worldviews, including prejudiced beliefs (Greenberg & Kosloff, 2008; Weise et al., 2012). Although PTSS include negative alterations in beliefs about other people and the world, the connection between trauma and racist beliefs has not been investigated. There may also be key differences in terms of types of trauma exposure, such as interpersonal and noninterpersonal trauma, and racial beliefs. Method: The present study aimed to determine: (a) whether cumulative trauma exposure and PTSS are associated with endorsement of racist perceptions and stereotypes regarding Black people, and (b) if interpersonal trauma is more strongly tied to prejudiced and stereotyped beliefs than noninterpersonal trauma among 277 White undergraduates (Mage = 23.33, SD = 6.11; 76.4% female). Results: Neither cumulative trauma nor PTSS were found to be related to elevated racist beliefs or positive or negative stereotypes. However, noninterpersonal trauma exposure was associated with stronger endorsement of racist beliefs and negative stereotypes (ηp² = .03, .01). Surprisingly, interpersonal trauma exposure corresponded with lower racist beliefs (ηp² = .02). Conclusions: Noninterpersonal trauma exposure may thus activate TMT and strengthen prejudiced ideology, whereas interpersonal traumatic experiences and PTSS may not. More research is needed to better understand how types of traumatic events may relate to the development of prejudiced beliefs. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Correction to Chachula and Ahmad (2022).
Reports an error in "Professional quality of life, stress, and trauma in nursing students: Before and during the novel coronavirus pandemic" by Kathryn M. Chachula and Nora Ahmad (Psychological Trauma: Theory, Research, Practice, and Policy, 2022[Nov], Vol 14[8], 1333-1337). In the article, the values 7.6% and 1.2% were changed to 19.1% and 2.9%, respectively, in the following text in the second paragraph of the “Comparisons Pre-Pandemic and amid the Pandemic” section of the Results: “exploration of the frequencies revealed that fewer students reported high levels of CS during the pandemic (19.1%) than prior (24.7%) and 2.9% of students reported high levels of STS compared to 0% the year prior.” In addition, the percentages listed in the “During Pandemic” section of Table 4 were incorrectly reported and have been amended. Nevertheless, the interpretation of the overall results remains unchanged. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2022-27230-001). Objective: The aim of the study was to assess the levels of stress, burnout, primary and secondary trauma, and self-efficacy before and during the novel coronavirus pandemic in a sample of baccalaureate nursing and psychiatric nursing students, a population which has seldom been studied regarding these factors. Method: The study used a nonexperimental, cross-sectional methodology at 2 time-points. Nursing and psychiatric nursing students enrolled at 1 western Canadian university were invited to participate in an online, anonymous survey in 2020 prior to the pandemic and in 2021 during Canada’s third-wave. Survey measures included the Professional Quality of Life Scale (includes Compassion Satisfaction, Burnout, and Secondary Traumatic Stress), the Perceived Stress Scale, the Life Events Checklist to assess the amount of prior traumatic experiences, and the Core Self-Evaluations Scale. Results: Statistically higher significant differences in prior traumatic experiences measured by the Life Events Checklist were found in the midpandemic cohort in comparison to the prepandemic 2020 student cohort (t(159) = −2.32, p <.05, 95% CI [−2.23, −.18]). Strong correlated relationships were found in many of the study variables (ranging from r = .301 to −.745, p ≤ .001). Conclusion: This preliminary study is the first to reveal that students in the nursing field experienced more traumatic events during the pandemic than before. The findings imply that access to greater support for experiences of trauma may be needed to support undergraduate students entering the health care arena amid the novel coronavirus pandemic. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Indirect effect of negative evaluations of therapy on the association between racial stress and posttraumatic stress disorder symptoms in pregnant Black persons.
Objective: Black pregnant individuals are at disproportionate risk for posttraumatic stress disorder (PTSD) compared to other groups. A wealth of literature suggests racial stress contributes to this inequity, but cultural and structural mechanisms, such as perceived barriers to mental health treatment, underlying the relationship between racial stress and PTSD symptoms remain understudied. Negative evaluations of psychotherapy and stigma represent potential mechanisms, though no previous studies have examined these associations. To address this gap, we tested an indirect effect of racial stress on PTSD symptoms through perceived barriers to mental health treatment in pregnant Black individuals. Method: Mediation analyses were used to assess an indirect relationship between racial stress and PTSD symptoms through perceived barriers to mental health treatment. Results: At the bivariate level, racial stress was significantly associated with PTSD symptoms (r = .20, p = .03) and negative evaluations of therapy (r = .22, p = .02), but not with stigma (r = .140, p = .147). Negative evaluations of therapy were also associated with PTSD symptoms (r = .43, p <.001). There was an indirect effect of racial stress on PTSD symptoms through a negative evaluation of therapy, β = .08, SE = 0.04, CI [0.01, 0.18]. More specifically, racial stress was associated with a more negative evaluation of therapy, which was in turn associated with more PTSD symptoms. Conclusions: Results highlight the need for accessible and culturally competent mental health care for pregnant Black individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Measurement invariance of a Posttraumatic Stress Disorder symptoms measure (PCL-5) in college student and Amazon’s mechanical TURK samples.
Objective: College student and Amazon’s Mechanical TURK (MTURK) samples are regularly utilized in trauma research. Recent literature, however, has criticized these samples for not being generalizable to the general U.S. population. The purpose of this study was to determine whether college student (n = 255) and MTURK (n = 316) samples are invariant on the Posttraumatic Stress Disorder Checklist for DSM-5. Method: Measurement invariance using confirmatory factor analyses was used to determine whether groups are invariant across factor structure, factor loadings, item intercepts, and residual error variances on a given measure of Post-traumatic Stress Disorder (PTSD) symptom severity. Results: Model fit indices indicated the seven-factor Hybrid model was the best-fitting model, but the six-factor Anhedonia model was the most parsimonious model. Both models demonstrated equivalence in factor at the strictest level, indicating MTURK and college student samples are similar in regard to PTSD symptom severity. Conclusions: These findings provide evidence that these groups can be combined in future studies to increase sample size for trauma research. Only the Anhedonia factor exhibited mean differences between groups, which may be related to true differences between college students and MTURK survey-takers. This study provides further evidence that the findings from trauma studies using these populations are generalizable to each other. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Psychometric properties of the PTSD checklist for DSM-5 in treatment-seeking Black veterans.
Objective: Despite widespread use of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders—fifth edition (PCL-5) across various trauma-exposed populations, little is known about the psychometric properties of the instrument in certain ethnic minority groups with increased risk of trauma exposure, including Black veterans. To this end, the current study examined the internal consistency of the PCL-5, convergent validity using correlations between the PCL-5 and another measure of PTSD, and discriminant validity using correlations between the PCL-5 and other commonly occurring psychiatric symptoms, including depression as well as alcohol and substance misuse. Method: The sample was composed of 327 Black veterans (84% male, Mage = 51.87, SD = 13.72) presenting to a PTSD specialty clinic at a large Veterans Affairs hospital in the Midwest United States to receive psychological services. In addition to a diagnostic interview, veterans were asked to complete a brief battery of self-report questionnaires to assist with diagnostic clarification and treatment planning. Results: The PCL-5 demonstrated excellent internal consistency. Furthermore, the PCL-5 was significantly and positively correlated with PTSD diagnostic status, suggesting evidence of convergent validity. Finally, the PCL-5 was strongly correlated with symptoms of depression and moderately correlated with alcohol and substance misuse. Conclusions: Findings suggest that the PCL-5 is a psychometrically sound measure to assess PTSD symptoms among Black veterans. Considering the brevity of PCL-5 administration, clinicians should consider utilizing this and other psychometric tests in clinical care to reduce disparities in health equity among Black patients. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Development and initial validation of the Mount Sinai Resilience Scale.
Objective: The construct of psychological resilience has received increasing attention in the mental health field. This article describes the development and initial validation of a novel self-report resilience scale, which addresses gaps in the resilience measurement literature by assessing thoughts and behaviors that help promote resilience rather than traits, and simultaneously evaluating multiple factors previously associated with resilience. Method: Following consensus meetings focused on scale development, we conducted an online study (n = 1,864) of U.S. adults to develop and validate an initial version of the Mount Sinai Resilience Scale (MSRS). Results: An exploratory factor analysis in a random 50% of the sample suggested a seven-factor solution; this solution was then generally supported by a follow-up confirmatory factor analysis in the remaining 50% of the sample. After removing poor-fitting items, a revised 24-item scale correlated in the expected directions with established measures of perceived resilience and resilience-related constructs (e.g., social support and optimism). Conclusions: Collectively, the results of this study provide initial support for the convergent and discriminant validity of the MSRS and describe its factor structure. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Emotional Betrayal From Child Sexual Abuse Measure (EBSCAM): A psychometric analysis.
Objective: This study examined the psychometric properties of a new scale, the Emotional Betrayal from Child Sexual Abuse Measure (EBCSAM), which assesses feelings of betrayal in adult survivors of child sexual abuse (CSA). Emotional betrayal is examined with respect to the perpetrator as well as others in the survivor’s immediate environment (i.e., family, friends, etc.) during the time of the abuse. Method: A sample of 342 CSA survivors were anonymously surveyed online in order to examine the psychometric properties of the EBCSAM. Results: The original 16-item measure did not produce a good-fitting model, nor was it considered reliable or valid. Instead, a shortened six-item measure produced a successful model, was reliable (overall Cronbach’s α = .85), and exploratory/confirmatory factor analyses suggested two valid latent subscales (Perpetrator Betrayal and Environmental Betrayal). Conclusion: This measure could be useful to clinicians treating survivors of child sexual abuse, as well as researchers, to reveal and evaluate aspects of emotional betrayal that impacted survivors.CSA). Emotional betrayal is examined with respect to the perpetrator as well as others in the survivor’s immediate environment (i.e., family, friends, etc.) during the time of the abuse. Method:A sample of 342 CSA survivors were anonymously surveyed online in order to examine the psychometric properties of the (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Psychometric properties of the PTSD Checklist for DSM-5 (PCL-5) anchored to one's own suicide attempt.
Objective: Emerging evidence indicates that a nontrivial proportion of suicide attempt (SA) survivors develop clinically significant posttraumatic stress disorder (PTSD) symptoms related to their suicide attempt (SA-PTSD). However, SA-PTSD is rarely assessed in either clinical practice or research studies, due at least in part to a lack of research examining approaches to assessing SA-PTSD. This study examined the factor structure, internal consistency, and concurrent validity of scores on a version of the PTSD Checklist for DSM-5 (PCL-5) specifically anchored to one's own SA (PCL-5-SA). Method: We recruited a sample of 386 SA survivors who completed the PCL-5-SA and related self-report measures. Results: A confirmatory factor analysis (CFA) that specified a 4-factor model consistent with the DSM-5 conceptualization of PTSD indicated that the PCL-5-SA had acceptable fit in our sample, χ²(161) = 758.03, RMSEA = 0.10, 90% CI =[0.09–0.11], CFI = 0.90, and SRMR = 0.06. The PCL-5-SA total and subfactor scores demonstrated good internal consistency (ωs = 0.88–0.95). Significant positive correlations of PCL-5-SA scores with anxiety sensitivity cognitive concerns, expressive suppression, depression symptoms, and negative affect provided evidence for concurrent validity (rs = .25–.62). Conclusion: Results suggest that SA-PTSD, when measured with a specific version of the PCL-5, is a conceptually coherent construct that operates consistent with the DSM-5 conceptualization of PTSD stemming from other traumatic events. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Low reliability when determining criterion a for posttraumatic stress disorder from self-report descriptions of traumatic events: The need for transparent methods.
Objective: Exposure to a traumatic event is a primary criterion (Criterion A) for meeting Posttraumatic Stress Disorder (PTSD). Using self-report to establish diagnostic criteria in research has become more common, especially with internet-based research. However, some individuals may construe events as traumatic when they do not meet Criterion A. There has yet to be a test of interrater reliability (IRR) from self-report of traumatic events. Method: Three graduate students in clinical psychology and three licensed psychologists rated Criterion A using the life events checklist (LEC), as well as the three modified LEC versions (specification of up to three index traumas; extension of part 2 of the LEC) aimed to increase IRR. One hundred participants completed each of the four versions of the LEC (N = 400). Bootstrapped permutation tests were used to estimate differences in IRR and to generate 95% confidence intervals (CIs). Results: Overall, findings indicated fair–moderate IRR (Fleiss’s kappa) κ = 0.428, 95% CI [0.379, 0.477]. The other versions of the LEC (including additional clarifying questions in part 2 of the LEC and/or opportunities to describe up to three traumas) did not meaningfully increase IRR. Conclusions: Findings indicate that relying on self-report from the LEC alone and/or single-rater assessment of open-text trauma descriptions is not recommended for determining whether a traumatic event meets Criterion A. We conclude that it is critical when collecting self-reported PTSD symptoms to provide a clear description of how Criterion A was assessed, initial agreement between raters, and how disagreements were resolved. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
The parallax: The possible errors in the quantification of human decision-making behavior in the experiment of neuroeconomics—A perspective from psychoanalysis.
Objective: With the development of neuroscience and technology, economics, which focuses on the selection and decision-making of human behavior, has also entered the field of neuroeconomics. Based on rational biological humans, neuroeconomics assumes that humans are rational biological individuals and behaviors of biological humans can be monitored and quantified in the nervous system through brain imaging technologies such as functional MRI and positron emission tomography. Method: As an emerging discipline, neuroeconomics inevitably encounters obstacles in methodology and epistemology, showing excessive constraints in its understanding of rationality and facing basic conceptual disputes on the theoretical basis of “clear uncertainty monism.” In neuroeconomics experiments, measurability will inevitably be traced back to quantification, but when faced with a complex and ever-changing social field, what can be predicted is only probability rather than behavior. Not all human behaviors and decisions can be quantified. Therefore, such research may be biased. Psychoanalysis, a major branch of psychology that is quite similar to neuroeconomics research in subject and object, can greatly correct these basic concepts. Results: Seen from the perspective of psychoanalysis, the existence of these unquantifiable things conversely plays a decisive role and cannot be ignored. Conclusions: This article analyzes the core rational behavior detection of neuroeconomics from the perspective of psychoanalysis and proposes suggestions from the epistemology and methodology of experimental design as well as basic concept discrimination and so forth. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Survival sex among a diverse sample of women with histories of intimate partner violence: Results from a domestic violence shelter.
Objective: The current study sought to investigate the prevalence and correlates of survival sex among a diverse sample of women residing in a domestic violence (DV) shelter. Method: Two hundred seven women (44% Black, 37.7% White, 10.6% Multiracial, 4.3% Latina, 1% Arab, 1% Asian/Pacific Islander, and 1.4% Indigenous or Aboriginal) residing in a Summit County, Ohio, DV shelter completed a survey assessing their involvement in survival sex, the associated contextual factors (e.g., age at first incidence of survival sex, the reason for engaging in survival sex), and self-report measures assessing substance use, post-traumatic stress disorder (PTSD) symptoms, intimate partner violence (IPV) victimization, adverse childhood experiences (ACEs), and empowerment. Results: More than two-thirds of participants reported engaging in survival sex, and participants who did were more likely to have elevated rates of substance use, PTSD symptoms, ACEs, and IPV victimization, along with lower empowerment. Most commonly, women reported engaging in survival sex for fear that the other person would take away valuable support or things they needed. Participants also reported engaging in survival sex for securing shelter, for money, for food, and to obtain drugs or alcohol. Notably, a sizable minority of women first engaged in survival sex as minors, suggesting overlap with the phenomenon of domestic minor sex trafficking. Conclusions: Engaging in survival sex may be commonly experienced by women residing in DV shelters and is associated with trauma history and post-traumatic stress symptoms. Despite the small, non-representative sample, results indicate education for providers is necessary to interact effectively with this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Violence in intimate relationships: Symptomatology and motivation for change.
Objective: This study aimed to analyze the experiences of victims of violence in intimate relationships (VIRs) who remain in, return to, or abandon the abusive relationship, as well as examine the type of violence suffered, the existing symptoms, and the motivation to change as explained by the Transtheoretical Model of Change. Method: The participants were 38 victims, three males and 35 females, who completed an online questionnaire comprising a section on sociodemographic data, and three instruments, the Self-Reporting Questionnaire 20 (SRQ-20), Marital Violence Inventory (MVI), and the University of Rhode Island Change Assessment (URICA). Results: Data analysis has shown that psychological violence was the type of violence most frequently experienced followed by physical and verbal violence, the house of the victims was the local where the violence mostly took place, the help-seeking behaviors were mostly directed to the family and attempts to leave from the abusive relationship is related to the experience of family violence in childhood. Participants were all in the action stage of the change, but aggressor's expectation/promise to change, the existence of children and maintaining the family or marriage, as well as economic difficulties are the main factors that contribute to both remaining in, or returning to, the abusive relationship. Conclusion: We will reflect on the social, clinical, and legal implications for the future of research with victims of VIR. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Gender differences in intimate partner violence: Risk factors and associations with suicide.
Objective: This study sought to provide updated estimates of the occurrence of intimate partner violence (IPV) in the general adult population of Ireland and to better understand gender-specific profiles of IPV, their risk factors, and their relationship with suicidality. Method: Data (N = 1,098) from Wave 4 of the Irish arm of the COVID-19 Psychological Research Consortium (C19PRC) study were used. Results: 32.1% of the sample experienced lifetime IPV, with IPV more common among females. Latent class analysis results showed that females had a more complex profile of IPV (four classes) than males (three classes). Risk factors for females included younger age, having children, lower income level, lower social support, and lower social contact, while risk factors for males were living in an urban environment, having children, and lower social support. All IPV exposure was found to be associated with a significantly higher likelihood of experiencing multiple suicide-related phenomena for males and females. Conclusion: IPV is a major public social health issue affecting approximately one-in-three females and one-in-four males in Ireland and is strongly associated with suicide-related phenomena. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Self-endorsed history of abuse and wellbeing in a community sample of Jewish Orthodox single individuals.
Objective: The current study explored the prevalence rates of physical, sexual, and emotional abuse as well as the relationship between abuse and mental health within the Jewish Orthodox nonmarried community. Method: To reduce response bias, abuse and mental health measures were added to a larger survey that was being conducted in the area of dating. Participants responded to an abuse question and completed the Center for Epidemiological Studies Depression Scale (CESD-10), the Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Satisfaction with Life Scale (SWLS). Results: Of the 274 respondents, 29.2% endorsed emotional abuse, 13.5% endorsed sexual abuse, and 9.2% endorsed physical abuse. Participants that endorsed overall abuse scored significantly higher on the depression and anxiety inventories and significantly lower on the life satisfaction inventory compared with those that did not endorse abuse. Conclusion: This study is helpful in garnering communal and clinical awareness regarding abuse prevalence and mental health risks among this insular population where those abused are at times shunned. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
The unique effects of hope and gratitude on psychological distress and well-being in trauma-exposed Hispanic/Latino adults.
Objective: Gratitude and hope are well-established predictors of well-being and buffers against posttraumatic stress disorder (PTSD) and anxiety symptoms. However, scarce literature exists that investigates these relationships in a Hispanic/Latino sample. The current study investigates gratitude’s and hope’s relationship to PTSD and anxiety symptoms and different domains of well-being in trauma-exposed Hispanic/Latino young adults at a large southern university. Method: The sample was composed of 732 undergraduate students who were mostly female (80.7%) and young adults, (Mage = 21.8, SD = 4.3), who endorsed experiencing one or more traumatic events via the Life Events Checklist. Students completed an online survey for course credit. Results: Structural equation models were used to analyze the data. Gratitude had a stronger inverse relationship with PTSD symptoms (β = −.43, 95% CI [−0.50, −0.35]) and anxiety symptoms (β = −.28, 95% CI [−0.36, −0.20]) compared to hope (β = .06, 95% CI [−0.01, 0.14]) (β = −.06, 95% CI [−0.14, 0.02]). Both gratitude and hope were robust predictors of the three domains of well-being. Conclusions: The current study found that hope and gratitude predicted resilience in trauma-exposed Hispanic/Latino young adults. Decreased levels of gratitude were a stronger predictor of psychological distress and subjective well-being than decreased levels of hope, but hope was a robust predictor of the three well-being domains. The findings of this study may lend support for the development of hope and gratitude interventions in a Hispanic/Latino population for the prevention of PTSD symptoms and anxiety symptoms via engendering higher levels of resilience. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Polyvictimization, polystrengths, and their contribution to subjective well-being and posttraumatic growth.
Objective: The negative biopsychosocial outcomes associated with exposure to victimization are well-known, however, limited research has examined the protective factors that can enhance well-being and growth following polyvictimization from in-person and digital sources. This study examines the contribution of adversities and a range of psychological and social strengths on perceptions of subjective well-being and posttraumatic growth (PTG). Method: A sample of 478 individuals aged 12–75 (57.5% female; Mage = 36.44) from a largely rural Appalachian region of the United States completed a survey on victimization experiences, other adversities, psychosocial strengths, subjective well-being, and PTG. Results: Approximately 93.3% of individuals reported at least one digital or in-person victimization, with 82.8% reporting two or more forms of victimization. Hierarchical logistic regression analyses indicated that strengths explained more than three times the variance in subjective well-being and PTG compared to adversities, with both models explaining about half of the variance in these outcomes (49% and 50%, respectively). Psychological endurance, sense of purpose, teacher support, and polystrengths were significantly associated with better well-being and/or PTG. Conclusion: Some strengths hold more promise than others for promoting well-being and PTG following polyvictimization. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Social support in relation to posttraumatic stress disorder symptoms among patients with violent versus nonviolent injury.
Objective: Violent injuries have become increasingly more common in the United States. Individuals experiencing violent injury are at increased risk for the development of posttraumatic stress disorder (PTSD) as compared to those experiencing nonviolent injury. Social support is touted as a protective factor against various psychiatric symptoms (i.e., PTSD), though little is known about the relation between PTSD symptoms and social support in traumatic injury populations. The aims of the present paper were twofold: (1) examine the prevalence of PTSD as a function of injury type (2) explore differences in levels of social support as a function of injury type and (3) explore the association between injury type and later PTSD symptoms as moderated by baseline social support. Method: Participants were 553 adults from a level-one trauma center in the Southeast United States who experienced a violent injury or nonviolent injury and completed measures of social support at baseline as well as PTSD symptoms at the 30-day follow-up timepoint. The study utilized data from both the baseline timepoint (i.e., upon admission to the trauma surgery unit), as well as a 30-day follow-up timepoint. Results: Results demonstrated that those endorsing nonviolent injury reported lower levels of social support and PTSD symptoms. Social support predicted later PTSD symptoms until injury type was included as a covariate in the model. Social support did not moderate the relationship between injury type and later PTSD symptoms. Conclusions: Findings highlight the interrelatedness of key risk variables (i.e., injury type) with protective factors in influencing the trajectory of psychopathology postinjury. Violence intervention and interruption programs may have the capacity to fill patient needs when social support networks are insufficient. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Associations between International Trauma Questionnaire complex posttraumatic stress disorder symptom clusters and moral injury in a sample of U.K. treatment-seeking veterans: A network approach.
Objective: Complex posttraumatic stress disorder (CPTSD) and moral injury are receiving increasing empirical attention. The network approach offers a novel method to understand the association between such mental health constructs. Method: The present study investigated: (a) the network structure of CPTSD symptom clusters according to the International Trauma Questionnaire to determine centrality (i.e., the most influential symptom cluster) and (b) the network structure of CPTSD symptom clusters and moral injury symptoms according to the Moral Injury Outcome Scale to determine bridge symptoms (i.e., the symptoms linking comorbid presentation of CPTSD and moral injury) within a clinical sample of veterans. Results: Emotional dysregulation, avoidance, and interpersonal difficulties were found to be most central in the CPTSD network, and interpersonal difficulties, negative self-concept, and emotional dysregulation were found to be the strongest bridge symptoms in the CPTSD and moral injury network. Conclusions: The two networks suggest a key role of disturbance in self-organization symptoms in the presentation of CPTSD and its association with moral injury among treatment-seeking veterans. Despite the limitations of the present study, it offers an insightful starting point as the first network analysis study of CPTSD in treatment-seeking veterans as well as its association with moral injury. Implications in terms of points of intervention and further research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Disclosure of traumatic details and obsessive-compulsive contamination symptoms in sexual assault survivors.
Objective: Contamination concerns are common following sexual victimization and are associated with increased attentional bias and difficulty disengaging from contamination cues. While most survivors of sexual trauma disclose their experience to others, it is unclear whether disclosure increases feelings of contamination or whether, consistent with the fever model of disclosure, existing contamination-related distress increases the amount of content shared during disclosure, indicative of attentional bias toward contamination-inducing aspects of the trauma memory. Method: Accordingly, the current study examined the directionality and relationships between contamination symptoms and content shared during sexual assault disclosure in 106 sexual assault survivors (76.4% women). Forced decision regression with subsequent independence test (RESIT) was used to identify directionality of relationships, and multivariate and linear regressions examined these proposed effects in the presence of assault and demographic characteristics. Results: More severe contamination symptoms predicted greater sharing of details during sexual assault disclosure yet had no impact on sharing of emotions, cognitions, and beliefs during disclosures. Although RESIT suggested that contrary to other content domains, disclosure of social experiences may directionally predict contamination symptoms, this relationship did not retain statistical significance in a linear regression model. Conclusions: Findings support the fever model of disclosure and attentional bias theories regarding contamination-related stimuli, and suggest that survivors experiencing postassault contamination symptoms may be more likely fixate on the contamination-invoking details of the trauma memory when disclosing. Such fixation has the potential to interfere with typical treatment-related processes (e.g., habituation) and should be thoughtfully addressed to maximize treatment gains. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Psychological Trauma: Theory, Research, Practice, and Policy - Vol 16, Iss 3