High Trauma Exposure Research Articles

Cumulative Trauma Exposure and Mindfulness in College Students

The authors evaluated the cumulative effects of multiple trauma exposure and examined discrete mindfulness facets concerning trauma‐related outcomes among undergraduate students (N = 157). By using self‐report questionnaires, the authors found that higher trauma exposure was associated with more severe trauma symptomatology and psychological distress as well as lower quality of life. Furthermore, 4 mindfulness facets differentially predicted trauma outcomes. The authors discuss implications for college counseling counselors and researchers.

Trauma Education and Stigma Reduction in Global Settings: An Evaluation of the Impact of a One-Day Trauma Psychoeducation Workshop with Community Stakeholders in the Caribbean Nation of Saint Lucia.

The independent island nation of Saint Lucia and surrounding Caribbean countries have fairly well-documented high reported rates of trauma, but limited training infrastructure for trauma-related mental health support and treatment services. This study addresses this disparity between high trauma exposure and sparse trauma-related resources by studying how a one-day training workshop impacted self-rated knowledge about trauma and stigma towards trauma survivors. The training was provided by a licensed clinical psychologist in partnership with a local women’s rights group. Participants (n = 41) included school counselors, nurses, psychiatric providers, health educators, and advocates on the island. Participants completed pre- and post-workshop measures examining the variables of interest. The one-day workshop provided training on trauma types, post-trauma reactions, options for treatment, and hands-on training for trauma crisis-management and short-term interventions. Following the workshop, participants reported increased knowledge of trauma, more accurate perceptions of its prevalence, better understanding of evidence-based treatments, and lower trauma survivor-related stigma. This is the first trauma-focused workshop tested in St. Lucia, where the need for such training is considerable given few treatment options for trauma survivors in this area. Work is underway to provide more expansive services for trauma across the Caribbean region, given these preliminary promising findings.

Abstract P244: Association Between Early Life Trauma and Change in HRV During Mental Stress Among Patients With Recent Myocardial Infarction

Background: Early-life traumatic experiences have been associated with increased cardiovascular disease risk. Little is known about how early-life traumatic experiences may affect changes in autonomic function during mental stress among young subjects post-MI. Objective: We hypothesized that those with high exposure to early-life trauma, compared to those with low exposure to early-life trauma, would have increased autonomic dysfunction at baseline, worse stress reactivity, and slower autonomic recovery. Methods: We evaluated 321 subjects with a history of recent myocardial infarction who underwent a laboratory-based mental stress speech task. HRV was measured at rest (T0), during mental stress (T1), and during recovery (T2) with ambulatory electrocardiographic monitoring. We evaluated low frequency (LF) HRV as the primary outcome because of its relationship with baroreflex sensitivity, psychological stress, and cardiovascular disease outcomes. Early life trauma was assessed using the Early Trauma Inventory Self Report - Short Form (ETI-SF) and a binary variable was calculated using one SD above the mean of the ETI-SF score, a previously validated cutpoint, to indicate high early-life trauma exposure and low otherwise. Sociodemographic factors, including race, highest education attained, age, and gender, were considered as potential confounders in multiple linear regression models. Differences amongst stress, rest, and recovery metrics were evaluated as outcomes in separate models. Results: Of 321 subjects with HRV data, 284 were included in the final analytic sample after excluding those with missing covariates. The mean age was 50.7 ± 6.7, 49% were female (139), and 64% were African-American (182); 260 (88.4%) reported experiencing high levels of early-life trauma. There were no associations between early-life trauma during baseline HRV (T0), reactivity to stress (T1 - T0), and prolonged reactivity (T2 - T0). However, those with high early-life trauma had reduced HRV during recovery from stress compared to those with low early-life trauma (T2 - T1; Beta (95% CI) = -0.37 (-0.73, -0.01)). Results were similar after adjustment for sociodemographic factors and did not vary by race/ethnicity or gender. Conclusion: Among subjects with recent MI, high exposure to early-life trauma is associated with prolonged stress-induced autonomic dysfunction during stress and recovery, while the low exposure subjects revert to baseline HRV levels during recovery. This may indicate greater stress-induced cardiotoxicity in those exposed to early life trauma.

Association of MAOA genetic variants and resilience with psychosocial stress: A longitudinal study of Syrian refugees.

Early childhood trauma can have profound and lifelong effects on adult mental health and psychosocial wellbeing. Nevertheless, responses to trauma are highly variable. Genetic variants may help explain variation in responses to trauma by identifying alleles that associate with changes in mental health measures. Protective factors, such as resilience, likely also play an important role in responses to trauma. The effects of genetic variants, in combination with protective factors, on psychosocial health are not well understood, particularly in non-Western contexts. In this study, we test the relative influence of genetic variants of monoamine oxidase A (MAOA, a gene proposed to influence the impact of childhood trauma on adult violence and antisocial behavior), levels of resilience, and exposure to traumatic events on psychosocial stress and mental health trajectories over time. We use data from a cohort of 12-18-year-old Syrian refugees who were forcibly displaced to neighboring Jordan (n = 399). DNA samples and survey data on trauma exposure, resilience (CYRM-12), and psychosocial stress were collected at three time points: baseline, ~13 weeks, and ~48 weeks. Using multilevel models, we identified an association of MAOA variant, in males only, with symptom scores of psychosocial stress on the Perceived Stress Scale (PSS) over time (p = 8.1 x 10−4). We also found that resilience is strongly associated with PSS (p = 7.9 x 10−9), underscoring the importance of protective factors in influencing levels of psychosocial stress. Furthermore, there was an additive effect wherein the sharpest reductions in perceived psychosocial stress are seen in low-activity MAOA males with low trauma exposure or high resilience levels. Our results highlight the value of studies that integrate genetic and psychosocial factors to better understand complex phenotypes, such as responses to trauma in contexts of high trauma exposure.

Mental Health of Refugees and Torture Survivors: A Critical Review of Prevalence, Predictors, and Integrated Care.

Civilian war trauma and torture rank among the most traumatic life experiences; exposure to such experiences is pervasive in nations experiencing both internal and external conflict. This has led to a high volume of refugees resettling throughout the world with mental health needs that primary care physicians may not be screening for and prepared to effectively address. In this article, we review the literature on demographics, predictors, mental health outcomes of torture, and integrated care for the mental health needs of refugees. We searched PubMed and PSYCINFO databases for original research articles on refugees and mental health published in the English language between 2010 and present. Nine percent of 720 adults in conflict areas in Nepal, with predominance of literate married males, met the threshold for Post-Traumatic Stress Disorder (PTSD), 27.5% for depression, and 22.9% for anxiety. While, PTSD rate has been documented as high as 88.3% among torture survivors from Middle East (ME), Central Africa (CA), South Asia (SA), Southeast Europe (SE). Depression was recorded as high as 94.7% among 131 African torture survivors and anxiety as high as 91% among 55 South African torture survivors. Torture severity, post-migration difficulties, and wait time to receive clinical services were significantly associated with higher rate of mental health symptoms. Mental health screening is not a standard component of initial physical exams for refugees, yet these individuals have had high trauma exposure that should inform clinical care. Integrated care models are lacking but would greatly benefit this community to prevent progression to greater severity of mental health symptoms.

The unseen cost of justice: post-traumatic stress symptoms in Canadian lawyers

ABSTRACTLimited research has been conducted on the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5; 2013) exposure criterion: ‘work-related exposure to aversive details of traumatic events’. This study investigated the presence and severity of post-traumatic stress disorder (PTSD) symptomatology among a national cross-sectional sample of practicing Canadian lawyers (N = 476). Participants were categorized into three groups: no, moderate, and high work-related exposure to potentially traumatic material. As hypothesized, lawyers in the moderate and high work-related trauma exposure groups obtained more elevated (severe) mean scores of PTSD symptoms, psychological distress, and reported a poorer quality of life (p < .05) compared to their unexposed colleagues. An important proportion of lawyers scored above the clinical threshold for probable PTSD (9%), psychological distress (23%), and unsatisfactory quality of life (23%). Trauma-exposed lawyers were 2.62 times (95%CI: 1.12–6.12, p = .027) more likely to meet the probable PTSD threshold than the unexposed lawyers. Congruent with the DSM-5 reformulation of trauma exposure, lawyers exposed to aversive details of traumatic events are at increased risk of developing PTSD symptoms requiring an intervention. Future research using random sampling and face-to-face interviews should be conducted to further establish the human cost of this emerging problem.

Emergency Department Use Following Pediatric Psychiatric Hospitalization.

Emergency department (ED) use has increased disproportionately for pediatric psychiatric care. This study aimed to identify predictors of ED use within 30 days of discharge from a pediatric psychiatric hospitalization. ED use was assessed in the 30 days after discharge. Univariate logistic regression modeling identified predictors of ED use, which were used in subsequent multivariate modeling. Greater number of trauma types (odds ratio [OR]=1.92, 95% confidence interval [CI]=1.50-2.45, z=2.67, p=0.008), generalized anxiety disorder (OR=3.20, 95% CI=1.78-5.76, z=1.98, p=.048), and longer length of stay (OR=1.05, 95% CI=1.03-1.07, z=2.74, p=0.006) were associated with increased ED use within 30 days of discharge. ED use may be an important marker of negative outcomes within 30 days of discharge from pediatric psychiatric hospitalization. Patients with high trauma exposure, anxiety, and acuity marked by increased length of stay may require additional services to prevent unplanned ED use for psychiatric crises.

Long-term psychological distress of Bosnian war survivors: an 11-year follow-up of former displaced persons, returnees, and stayers

BackgroundResearch on the long-term mental health consequences of war and displacement among civilians who live in post-conflict countries is rare. The aim of this study was to examine the developmental trajectories and predictors of general psychological distress in three samples of Bosnian war survivors over an 11-year period.MethodsIn 1998/99, about three years after the war in Bosnia and Herzegovina, a representative sample of 299 adult Sarajevo citizens was examined in three subsamples: individuals who had stayed in Sarajevo throughout the siege, individuals who had been internally displaced, and refugees who had returned. Of the 138 study participants who could be located 11 years later, 100 were re-assessed (71%) using the Brief Symptom Inventory.ResultsOver time, psychological symptoms and general psychological distress decreased in those survivors who had stayed and increased in returnees. Former displaced persons did not show any significant changes. After controlling for other factors, cumulative trauma exposure before and during the war predicted general psychological distress at baseline. Eleven years later, higher trauma exposure during and after the war, returnee status, and more current stressors were all associated with higher levels of general psychological distress.ConclusionsLevels of psychological symptoms remained high in three subsamples of Bosnian war survivors. The differential symptom trajectories may correspond to distinct war experiences and contemporary stressors. Still, the cumulative effect of war traumata on mental distress persisted more than a decade after war and displacement, although the influence of current stressors seemed to increase over time.

Association of the Trauma of Hospitalization With 30-Day Readmission or Emergency Department Visit

Trauma of hospitalization refers to the depersonalizing and stressful experience of a hospital admission and is hypothesized to increase the risk of readmission after discharge. To characterize the trauma of hospitalization by measuring patient-reported disturbances in sleep, mobility, nutrition, and mood among medical inpatients, and to examine the association between these disturbances and the risk of unplanned return to hospital after discharge. This prospective cohort study enrolled participants between September 1, 2016, and September 1, 2017, at 2 academic hospitals in Toronto, Canada. Participants were adults admitted to the internal medicine ward for more than 48 hours. Participants were interviewed before discharge using a standardized questionnaire to assess sleep, mobility, nutrition, and mood. Responses for each domain were dichotomized as disturbance or no disturbance. Disturbance in 3 or 4 domains (the upper tertile) was considered high trauma of hospitalization, and disturbance in 0 to 2 domains (the lower 2 tertiles) was considered low trauma. The primary outcome was readmission or emergency department visit within 30 days of discharge. The association between trauma of hospitalization and the primary outcome was examined using logistic regression, adjusted for age; sex; length of stay; Charlson Comorbidity Index Score; Laboratory-Based Acute Physiology Score; and baseline disturbances in sleep, mobility, nutrition, and mood. A total of 207 patients participated, of whom 82 (39.6%) were women and 125 (60.4%) were men, with a mean (SD) age of 60.3 (16.8) years. Among the 207 participants, 75 (36.2%) reported sleep disturbance, 162 (78.3%) reported mobility disturbance, 114 (55.1%) reported nutrition disturbance, and 48 (23.2%) reported mood disturbance. Nearly all participants (192 [92.8%]) described a disturbance in at least 1 domain, and 61 participants (29.5%) had high trauma exposure. A statistically significant 15.8% greater absolute risk of readmission or emergency department visit was found in participants with high trauma (37.7%; 95% CI, 25.9%-51.1%) compared with those with low trauma (21.9%; 95% CI, 15.7%-29.7%), which remained statistically significant after adjusting for baseline characteristics (adjusted odds ratio, 2.52; 95% CI, 1.24-5.17; P = .01) and propensity score matching (odds ratio, 2.47; 95% CI, 1.11-5.73; P = .03). Disturbances in sleep, mobility, nutrition, and mood were common in medical inpatients; such trauma of hospitalization may be associated with a greater risk of 30-day readmission or emergency department visit after hospital discharge.

Trauma exposure and aggression toward partners and children: Contextual influences of fear and anger.

Trauma exposure is a consistent correlate of intimate partner aggression (IPA) and parent-to-child aggression (PCA) perpetration, and difficulties with emotions (particularly fear and anger) are hypothesized to underlie these relations. However, the absence of knowledge of the immediate, contextual influence of emotions on aggression renders existing conclusions tenuous. This study illustrates a new method for studying contextual influences on aggressive behavior. Quarterly for 1 year, 94 men and 109 women with children age 2.5 years at study commencement were interviewed to measure the sequence of behaviors during aggressive incidents as well as the intensity of their emotions immediately prior to initiation of aggression. Within aggressive incidents, the number of acts of men's PCA was predicted by men's greater fear, anger, and trauma exposure, and the positive association between men's trauma exposure and PCA perpetration was especially strong under conditions of high fear and anger. In contrast, men's IPA was predicted by greater fear and anger, but not trauma exposure. Men with low trauma exposure engaged in more IPA under conditions of high fear; among men with high trauma exposure, fear inhibited their IPA persistence. Trauma exposure and fear interacted in the same manner to predict women's IPA, but many other findings among men did not generalize to women's aggression. This study illuminates the utility of simultaneously examining aggression across genders and family dyads, and serves as a foundation for refining theories of trauma and family aggression to account for emotion as a factor that can both motivate and inhibit aggression. (PsycINFO Database Record

The relationship between moral injury appraisals, trauma exposure, and mental health in refugees.

Refugees are often exposed to multiple traumatic experiences, leading to elevated rates of psychological disorders. There is emerging evidence that appraisals of traumatic events as violating deeply held moral beliefs and frameworks (i.e., moral injury) impact negatively on refugee mental health. Despite this, no research has systematically investigated moral injury appraisals in refugees. Participants were 222 refugees from diverse backgrounds who had recently resettled in Australia. They completed measures of mental health in Arabic, Farsi, Tamil, or English through an online survey. This study first investigated the factor structure of the Moral Injury Appraisals Scale (MIAS), and then examined the relationship between the moral injury factors and key predictor (age, gender, trauma exposure) and outcome (Posttraumatic stress disorder [PTSD] symptom clusters, anger, and depression) variables. Confirmatory factor analyses of the MIAS supported a two-factor model, comprising a Moral Injury-Other (MI-Other) factor (i.e., interpreting the violation as being enacted by others) and a Moral Injury-Self (MI-Self) factor (i.e., interpreting the violation as being enacted by oneself). Structural equation modeling analyses indicated that both factors were predicted by higher trauma exposure, and both predicted more severe anger and depression. Notably, while MI-Other was associated with more severe PTSD, MI-Self was associated with lower levels of intrusions. These results suggest that there may be subtypes of moral injury appraisals that are associated with different mental health outcomes. These findings have potential implications for designing treatments that address the psychological impact of the refugee experience.

Factors that contribute to help-seeking among homeless, trauma-exposed youth: A social-ecological perspective

Homeless youth are at great risk of Posttraumatic Stress Disorder (PTSD) and posttraumatic stress symptoms (PTSS) during homelessness. The social-ecological framework provides a lens to examine the multifaceted characteristics that promote various types of help-seeking among homeless youth with high trauma exposure. The present study uses baseline data from homeless youth interviewed in a longitudinal study to examine utilization of physical health, vocational, and mental health services among this population. The study explores the following research question: What social-ecological factors are associated with physical health, vocational, and mental health help-seeking among homeless youth with PTSS? Homeless youth, aged 13 to 26, who used drop-in services at collaborating sites were recruited and interviewed. Youth participants with PTSS were included in this study. Logistic regression models were conducted to analyze individual, family/peer, and community contextual factors in relation to three types of service utilization (i.e., physical health, vocational, and mental health services). Among individual factors, duration of homelessness was associated with increased physical and mental health service utilization, injection drug-use was linked to decreased mental health services, and race/ethnicity was associated with increased help-seeking across all three service types. For family/peer level factors, foster care involvement was linked to increased mental health help-seeking and social support from street-based peers was associated with greater vocational service utilization. Among community-level factors, youth who reported receiving social support from community-based providers were more likely to seek out mental health services. Implications of the findings are discussed.

Risk and resilience among young adults experiencing homelessness: A typology for service planning

PurposeThis study examined risk and resilience indicators in a sample of young adults experiencing homelessness to identify subgroups with different service needs. MethodsData came from a 2014 survey of homeless young adults (age 18–24) in Houston (n = 374). Participants self-reported risk and resilience indicators which were used to fit a latent class model. ResultsA four-class solution was the best fit. Group-1 (n = 73), had high adult support and low trauma. Group-2 (n = 60) had low trauma but low adult support. Group-3 (n = 151), had high trauma exposure, high rates of mental health problems and low substance use. Group-4 (n = 90), had high rates across all risk variables. ConclusionTrauma, adult support, and substance use were key distinguishing features to inform screening and service planning.

Trauma exposure, discrimination, and romantic relationship functioning: A longitudinal investigation among LGB young adults.

Sexual orientation-related discrimination is common among sexual minority individuals, but its influence on romantic relationship functioning remains unclear. Further, exposure to potentially traumatic events may influence the association between discrimination and relationship functioning, but this has not been tested among sexual minority couples to date. The current study examines breadth of lifetime trauma exposure as a moderator of the associations between recent discrimination and changes in relationship functioning (satisfaction, commitment, and trust) over twelve months among 86 racially/ethnically diverse sexual minority young adults in relationships. For those with low trauma exposure, discrimination was associated with increases in satisfaction and commitment, but not trust. In contrast, for those with high trauma exposure, discrimination was not associated with changes in relationship functioning. Thus, some partnered sexual minority young adults may experience resilience in the face of discrimination, such that discrimination may promote positive relationship functioning. However, this does not appear to extend to those with more extensive trauma exposure histories. With an eye toward informing interventions, these findings call for additional research on individual differences in responses to discrimination, such as support seeking and dyadic coping.

Examining School Attachment, Social Support, and Trauma Symptomatology Among Court-Involved, Female Students

Court-involved youth (i.e., youth in the foster care and/or juvenile justice systems), and particularly those in residential placement facilities, often present with trauma histories that can impede various areas of development and functioning. These traumatic histories can negatively impact academic performance and school success, leading to poorer outcomes later in life. In particular, female youth in these systems exhibit unique responses to traumatic experiences that further complicate healthy development. This study assesses female, court-involved students (n = 141), exploring the relationship between school attachment and school involvement, school social support (from peers, teachers, and other staff), and trauma symptomatology among a sample of residential placement students exposed to a trauma-informed teaching intervention over the course of a school year. It was hypothesized that higher school attachment/involvement and social support would be associated with lower student trauma symptomatology. As expected, findings demonstrated that students in the sample had experienced high trauma exposure, as indicated by their high trauma symptomatology. Unexpectedly, they also had high school attachment. Furthermore, higher school attachment was associated with lower trauma symptoms among students. On the other hand, students reported lower levels of social support from classmates, which was associated with significantly higher trauma symptomatology. Implications for future research are addressed.

PTSD symptom severity and sensitivity to blood, injury, and mutilation in U.S. army special operations soldiers

Sensitivity to blood, injury, and mutilation (SBIM) may increase risk for posttraumatic stress disorder (PTSD), given that traumatic events often involve actual or perceived threat of bodily harm to oneself and/or others, including exposure to blood and other mutilation-related stimuli. A self-report questionnaire was administered to male, active duty, U.S. Army Special Operations Command soldiers who had deployed to Iraq and Afghanistan (n =694 males). We first used exploratory factor analysis to examine whether the 30-item Mutilation Questionnaire (Klorman et al., 1974) comprised a unitary measure of SBIM, finding that 10 of the items form a cohesive SBIM factor. Summed, those 10 SBIM items had a significant bivariate correlation with PTSD symptom severity. In a multiple regression analysis that included demographic characteristics and lifetime trauma exposure, SBIM was positively associated with PTSD symptom severity. Other significant multivariate predictors were high lifetime trauma exposure and junior enlisted rank. When trait neuroticism was added to the model to test the robustness of these findings, the association of SBIM with PTSD symptom severity remained significant. The results suggest that SBIM may be a risk factor for PTSD in male soldiers. Further research is warranted to improve measurement and understanding of SBIM.

Psychological resilience in U.S. military veterans: A 2-year, nationally representative prospective cohort study

Although many cross-sectional studies have examined the correlates of psychological resilience in U.S. military veterans, few longitudinal studies have identified long-term predictors of resilience in this population. The current prospective cohort study utilized data from a nationally representative sample of 2157 U.S. military veterans who completed web-based surveys in two waves (2011 and 2013) as part of the National Health and Resilience in Veterans Study (NHRVS). Cluster analysis of cumulative lifetime exposure to potentially traumatic events and Wave 2 measures of current symptoms of posttraumatic stress, major depressive, and generalized anxiety disorders was performed to characterize different profiles of current trauma-related psychological symptoms. Different profiles were compared with respect to sociodemographic, clinical, and psychosocial characteristics. A three-group cluster analysis revealed a Control group with low lifetime trauma exposure and low current psychological distress (59.5%), a Resilient group with high lifetime trauma and low current distress (27.4%), and a Distressed group with both high trauma exposure and current distress symptoms (13.1%). These results suggest that the majority of trauma-exposed veterans (67.7%) are psychologically resilient. Compared with the Distressed group, the Resilient group was younger, more likely to be Caucasian, and scored lower on measures of physical health difficulties, past psychiatric history, and substance abuse. Higher levels of emotional stability, extraversion, dispositional gratitude, purpose in life, and altruism, and lower levels of openness to experiences predicted resilient status. Prevention and treatment efforts designed to enhance modifiable factors such as gratitude, sense of purpose, and altruism may help promote resilience in highly trauma-exposed veterans.

Traumatic pre-migration experiences: A population-based study of Russian, Somali and Kurdish origin migrants in Finland

Introduction Ongoing mass conflicts and the resulting flow of displaced persons have increased interest on pre-migration experiences of migrants, but population-based studies of entire migrant groups are still scarce. Objective We aim to assess the prevalence of a variety of possibly traumatic pre-migration experiences among Russian, Somali and Kurdish origin migrants in Finland and to determine which socio-demographic factors are associated with traumatic pre-migration experiences. Methods We used data from the Finnish Migrant Health and Wellbeing Study (Maamu). The survey sample comprised of Russian, Somali and Kurdish origin migrants, aged 18–64 years ( n =1000 per group). The data specified eight different traumatic events common to those exposed to war and conflict. The age-adjusted prevalence of traumatic pre-migration experiences were calculated in the ethnic groups by gender using predicted margins. Results Seventy-seven percent of Kurdish, 58% of Somali, and 21% of Russian origin migrants had experienced at least one traumatic event in the former host country. One third of the Kurdish men had been subject to torture. Surprisingly, migrating as a refugee or asylum seeker was not found to be associated with traumatic pre-migration experiences. Conclusion Results indicated an alarmingly high overall trauma exposure among Kurdish and Somali migrants in Finland. This should be taken into account in the planning of mental health services in the new host country.

Childhood trauma and resilience in old age: applying a context model of resilience to a sample of former indentured child laborers

Objectives: Psychological resilience has been rarely investigated in elderly populations. We applied a more comprehensive model of trauma-specific coping and resilience, which included Ungar's context model and included decentral factors of resilience (i.e., environments that provide resources to build resilience).Method: We assessed resilience in a cohort of former Swiss indentured child laborers (N = 74; 59% males) at two time points; first at the mean age of 80 years and then again 20 months later. At each time point, the following measures of resilience were assessed: resilience indicators of life satisfaction and lack of depression. In addition, resilience predictors of trauma exposure, perceived social support, dysfunctional disclosure of traumatic experiences, social acknowledgment as a victim, and self-efficacy; and decentral resilience factors of education, income, number of children, and physical health were measured.Results: Using path-analysis, we found that life satisfaction and lack of depression were predicted by dysfunctional disclosure, social support, and self-efficacy at various significance levels. Change scores of resilience were predicted by higher trauma exposure, social acknowledgment as a victim, and an interaction between the two. The model for decentral factors also fitted, with physical health and income predicting the resilience indicators.Conclusion: Applying this comprehensive resilience model in a sample of older adults revealed meaningful findings in predicting resilience at a single time point and over time. Atypical coping strategies, such as perceived social acknowledgment as a victim and disclosure, may be particularly important for former victims who have suffered institutional abuse.

The impact of betrayal trauma on the tendency to trust.

Early experiences of violation perpetrated by close others, or betrayal traumas, may interfere with developing social capacities, including the ability to make healthy decisions about whom to trust. Betrayal trauma theory posits that survivors of trauma are at increased risk of making inaccurate trust decisions in interpersonal contexts, thus interfering with intimacy and elevating risk for revictimization. The current study examined the impact of betrayal trauma exposure on trust tendencies using both self-report and behavioral measures in a college sample. Self-report measures were used to explore general and relational (partner-specific) trust. The Trust Game, an experimental economics task, was used to investigate differences in trust tendencies between participants with and without histories of high betrayal trauma. As predicted, and in line with previous findings, high betrayal trauma exposure was associated with lower levels of self-reported general and relational trust. Self-reported general trust correlated positively with behavior during the Trust Game. Contrary to our hypothesis, participants with high betrayal trauma histories were not significantly more or less willing to trust during the Trust Game. Future directions and clinical implications are discussed.