History Of Traumatic Experiences Research Articles

Hyperbaric oxygen therapy vs. pharmacological intervention in adults with fibromyalgia related to childhood sexual abuse: prospective, randomized clinical trial

Fibromyalgia syndrome (FMS) is a chronic pain syndrome characterized by disruptions in pain processing within the central nervous system. It exhibits a high prevalence among patients with a history of traumatic experiences, notably childhood sexual abuse (CSA). This study compared the efficacy of hyperbaric oxygen therapy (HBOT) to the current pharmacological standard of care for individuals suffering from CSA-related FMS. Forty-eight participants diagnosed with FMS and a history of CSA were randomly assigned to either the HBOT group (60 sessions of 100% oxygen at 2 ATA for 90 min, with air breaks every 5 min) or the medication (MED) group (FDA-approved medications, Pregabalin and Duloxetine). The primary endpoint was the Fibromyalgia impact questionnaire (FIQ) score, while secondary endpoints encompassed emotional status and daily functioning questionnaires, as well as pain thresholds and conditioned pain modulation tests. Brain activity was evaluated through single photon emission computed tomography (SPECT). Results revealed a significant group-by-time interaction for the FIQ score favoring HBOT over MED (p < 0.001), with a large effect size (Cohen's d = − 1.27). Similar findings were observed in emotional symptoms and functional measures. SPECT imaging demonstrated an increase in activity in pre-frontal and temporal brain areas, which correlated with symptoms improvement. In conclusion, HBOT exhibited superior benefits over medications in terms of physical, functional, and emotional improvements among FMS patients with a history of CSA. This associated with increased activity in pre-frontal and temporal brain areas, highlighting the neuroplasticity effect of HBOT.

Translation and Validation of the City Birth Trauma Scale With Lithuanian Postpartum Women: Findings and Initial Results.

The childbirth experience and birth-related trauma are influenced by various factors, including country, healthcare system, a woman's history of traumatic experiences, and the study's design and instruments. This study aimed to validate the City Birth Trauma scale for Lithuanian women post-childbirth. Using a descriptive, cross-sectional survey with a nonprobability sample of 794 women who gave birth from 2020-2021, the study found good validity, reliability, and presented the prevalence of birth-related stress symptoms. A bifactor model, consisting of a general birth trauma factor and two specific factors for birth-related symptoms and general symptoms of PTSD, showed the best model fit. The Lithuanian version of the City Birth Trauma scale can be effectively used in research and clinical practice to identify birth-related trauma symptoms in women after giving birth.

Dissociation and other trauma symptomatology are linked to imbalance in the competing neurobehavioral decision systems.

Dissociation is a conscious state characterized by alterations in sensation and perception and is thought to arise from traumatic life experiences. Previous research has demonstrated that individuals with high levels of dissociation show impairments in cognitive-emotional processes. Therefore, using the Competing Neurobehavioral Decisions System (CNDS) theory, we used statistical modeling to examine whether dissociative experience and trauma symptoms are independently predicted by impulsivity, risk-seeking, affective state (i.e., anxiety, depression, stress, and negative affect), and trauma history. In this cross-sectional study design, data were collected via Amazon Mechanical Turk from a total of n = 557 English-speaking participants in the United States. Using Qualtrics, participants answered a series of self-reported questionnaires and completed several neurocognitive tasks. Three independent multiple linear regression models were conducted to assess whether impulsivity, risk seeking, affective state, and trauma history predict depersonalization, trauma symptoms, and PTSD symptoms. As hypothesized, we found that depersonalization and other trauma symptoms are associated with heightened impulsivity, increased risk-seeking, impaired affective states, and a history of traumatic experiences. We demonstrate that an imbalanced CNDS (i.e., hyperimpulsive/hypoexecutive), as evidenced by decreased future valuation, increased risk seeking, and impaired affective states, predicts heightened depersonalization and other trauma and PTSD symptomatology. This is the first time that dissociation has been connected to delay discounting (i.e., the tendency to place more value on rewards received immediately compared to farther in the future). Interventions that positively impact areas of the CNDS, such as episodic future thinking or mindfulness meditation, may be a target to help decrease dissociative symptoms.

Психологічна підтримка осіб з ознаками соціально тривожного розладу, який асоціюється з травматичним досвідом

Background. Considering the high prevalence of social anxiety disorder and its impact on quality of life and occupational functioning, research aimed at effective and accessible interventions can help reduce the burden of this disorder and improve patient well-being. Understanding traumatic experiences' influence on social anxiety development is critical for developing effective interventions. Studies exploring the link between traumatic experiences and the severity of anxiety disorders can shed light on this mechanism and provide more effective support to those who have experienced trauma. One of the challenges in treating social anxiety disorder is the low readiness of individuals to seek professional help. Low-intensity interventions may become more accessible and acceptable to patients, increasing their awareness of mental health issues and motivation for self-help or seeking specialized assistance. Previous research has shown the effectiveness of specific intervention methods for social phobias, but further studies are needed to test the stability of these results over time. Considering the above, research can help improve the understanding and psychological support for individuals with social anxiety disorder and develop more accessible and effective preventive measures for patients with a history of traumatic experiences. Objective. To study the effectiveness of a low-intensity cognitive-behavioral therapy psychosocial support program for individuals with social anxiety disorder associated with a history of traumatic experiences. Materials and Methods. The study group consisted of 179 individuals who reported significant emotional and psychological discomfort due to avoiding social situations and exhibited symptoms typical of social anxiety disorder for over six months in the past. At the initial stage, 109 individuals without signs of social phobia but with limitations in social interaction, including issues with adaptation and traumatic experiences in the past, were included as a control group. The mental state was assessed using The MINI: International Neuropsychiatric Interview. Psychopathological symptoms were analyzed using self-report questionnaires and the IAPT complex scales, while the quality of life was assessed using the self-report Q-LES-Q-SF questionnaire. In the second stage of the program evaluation, data analysis was conducted solely within the leading group, excluding the control groups, based on their classification according to associated traumatic experiences. Results. In the study, for the subgroup of individuals who participated in combat, experienced immediate life-threatening situations, or witnessed such events, it was found that traumatic experiences and distress related to social avoidance accounted for 56% of the variance in overall and work-related functioning after the program and throughout one month. Depressive symptoms ceased to be statistically significant predictors after participating in the program. The reduction in the impact of traumatic experiences and anxiety-related avoidance accounted for 27% of the variance in social interaction limitations and overall distress. In the subgroup of individuals who experienced loss and were influenced by social events they considered traumatic, no initial reduction in distress related to social avoidance was observed after the interventions. However, further reduction in distress in daily life and work was associated with reduced social phobia symptoms and increased awareness and acceptance of their emotional experiences. Depressive symptoms and the impact of traumatic experiences ceased to be predictive factors for overall distress. The research confirms the importance of understanding the influence of traumatic experiences and social avoidance on the development and manifestation of comorbid conditions in social phobia during the planning and implementation of psychosocial support. Furthermore, it is considered essential to consider that the role of traumatic experiences may be mediated by the circumstances of the study's time frame. Additional research will help better understand the relationships between traumatic experiences and vulnerability to comorbid psychopathology during adaptation to emergency circumstances and develop more effective psychosocial interventions for individuals with social phobia.

General Practitioners' Own Traumatic Experiences and Their Skills in Addressing Patients' Past History of Adversities: A Cross-Sectional Study in Portugal.

Addressing trauma has been found to be important for primary care patients, as it can improve their health-related outcomes. We aimed to assess how Portuguese general practitioners' (GPs) past history of traumatic events (TEs) and adverse childhood experiences (ACEs) influence their clinical communication skills when addressing their patients' past history of adversities. An online survey was circulated by email to GPs' associations and through GPs' social media groups. A sample of 143 GPs participated in this study. GPs' exposure to ACEs and TEs was assessed using the Childhood Trauma Questionnaire-Short Form and the Life Events Checklist for the DSM-5. To evaluate clinical communication skills, we adapted the Self-confidence Scale and used the Jefferson Scale of Physician Empathy. GPs identified barriers to addressing trauma routinely, including a lack of time (86.7%) and a fear of causing further patient suffering (56.6%). GPs' exposure to TEs and ACEs was positively correlated with scores in some dimensions of self-confidence and empathy (r values varying from 0.170 to 0.247). GPs exposed to traumatic experiences felt more confident when addressing their patients' adversities and were more empathic when conducting therapeutic relationships. This study shows that GPs with a history of traumatic experiences are able to address their patients' adversities; however, they lack proper training and better patient care conditions, such as more time and more resources available for patient guidance.

Attenuated psychotic symptoms, substance use and self-reported PTSD in adolescence

ABSTRACT Background: The occurrence of attenuated psychotic symptoms (APS) is a major concern in populations with substance use disorders (SUDs). However, APS also frequently develop in the course of Post-Traumatic Stress Disorder (PTSD). This study explores how the prevalence of APS differs between adolescent patients with only SUD, SUD with a history of traumatic experiences (TEs), and with SUD and self-reported PTSD. Methods: We recruited n = 120 treatment-seeking adolescents at a German outpatient clinic for adolescents with SUD. All participants filled out questionnaires assessing APS (PQ-16, YSR schizoid scale), trauma history, PTSD symptoms (both UCLA PTSD Index), and SUD severity (DUDIT) next to an extensive substance use interview. We performed a multivariate analysis of co-variance with the four PQ-16 scales and the YSR scale as outcomes and PTSD status as predictor. Additionally, we performed five linear regressions predicting each PQ-16 score and YSR score based on tobacco, alcohol, cannabis, ecstasy, amphetamine, and methamphetamine use. Results: Participants with co-occurring SUD and self-reported PTSD showed significantly higher APS prevalence rates (PQ-16 score, p = .00002), more disturbed thought content (p = .000004), more perceptual disturbances (p = .002), more negative symptoms (p = .004) and more thought problems (p = .001) compared to adolescents with SUD and a history of trauma and adolescents with only SUD. Past-year substance use was not predictive for APS prevalence (F(75) = 0.42; p = .86; R 2 = .04). Conclusion: Our data suggests that the occurrence of APS in adolescents with SUD is better explained by co-occurring self-reported PTSD than by substance use frequency or substance class. This finding might indicate that APS might be reduced through treating PTSD or focusing on TEs in SUD therapy.

Eye Movement Desensitization and Reprocessing (EMDR) as a Possible Evidence-Based Rehabilitation Treatment Option for a Patient with ADHD and History of Adverse Childhood Experiences: A Case Report Study

Children with Attention Deficit Hyperactivity Disorder (ADHD) having a history of adverse childhood experiences (ACEs) could be very difficult to treat with standard psychotherapeutic approaches. Some children diagnosed with ADHD may have Post-Traumatic Stress Disorder (PTSD) or have had experienced a significant traumatic event. Trauma and PTSD could exacerbate ADHD core symptoms and be a risk factor of poor outcome response. to report for the first time the history of a patient with ADHD and ACE successfully treated with an EMDR approach. EMDR could be a promising treatment for ADHD children with a history of traumatic experiences in addition to pharmacological treatments.

Insecure adult attachment and reflective functioning as mechanisms of the relationship between traumatic life events and suicidal ideation: A path analysis.

The relationship between traumatic life events and increased suicide risk has been well reported in literature. However, the complex nature of suicidality phenomena still hinders our ability to comprehend the mediation mechanism underlying this association. In this study, we examined the mediating role of adult attachment and reflective functioning in the relationship between traumatic life events and suicidal ideation. Nine hundred and fifty Italian adults completed an online survey evaluating traumatic life events, adult attachment, reflective functioning and suicidal ideation. The path analysis showed that the positive relationship between traumatic life events and suicidal ideation was partially mediated by attachment anxiety and reflective functioning. From a clinical point of view, these results support the relevance of evaluating and improving patients’ ability to mentalize as a part of psychotherapeutic intervention aimed at reducing suicidality in people with a history of traumatic experiences and attachment anxiety.

Are Defense Styles Mediators between traumatic Experiences and Maladaptive Daydreaming?

Maladaptive daydreaming (MD) is a new proposed mental disorder in which an excessive absorption in vivid, narrative fantasies generates impairments in various life domains. This study aimed to examine the role of traumatic life experiences and immature, neurotic, and mature defense styles in MD. Three hundred and fifty-six Italian adults, ranging in age from 18 to 60 years completed an online survey, including measures of MD, traumatic life events, and defense styles. A multiple mediation model showed that immature, neurotic, and mature defense styles fully mediated the relationship between traumatic life experiences and MD. These findings suggest that clinical interventions for people with a history of traumatic experience who developed MD should aim to help them acquire more adaptive coping strategies to deal with traumatic memories.

Maladaptive Eating Behaviors and Childhood Trauma: A Focus on Food Addiction.

BackgroundMany studies have highlighted the clinical relevance of food addiction (FA) by showing its association with psychopathological severity and even more when co-occurring with binge eating disorder. It was suggested that the association between FA and greater psychopathological severity could be accounted for by a history of traumatic experiences. The present study examined the relationship between childhood trauma (including peer victimization, abuse, and neglect) and maladaptive eating behaviors (FA, binge eating, and grazing) and explored whether childhood trauma predicts FA when controlling for binge eating, grazing, and other confounding variables.MethodsOne hundred fourteen adult women seeking psychological help for problems related to eating or weight completed questionnaires measuring FA, binge eating, grazing, depressive symptoms, peer victimization, and childhood abuse and neglect.ResultsFA showed significantly small to moderate positive correlations with all measures of childhood trauma, except for physical neglect. A hierarchical regression, including binge eating, grazing, depressive symptoms, age, and childhood trauma explained 55% of FA variance, with 7% of variance explained uniquely by childhood trauma.ConclusionsThis study supports that FA is related to childhood trauma and provides a potential explanation for the association of FA with greater psychopathological severity. From a clinical perspective, FA provides an accurate and quick assessment of psychopathological severity and represents an essential complement to the evaluation of eating disorders related to overweight. Future studies should attempt to estimate the impact of childhood trauma on treatment outcomes.

Factors Affecting Suicidal Thoughts in Breast Cancer Patients.

Background and Objectives: Women diagnosed with breast cancer experience severe trauma. Psychological help for breast cancer patients is not sufficient because of limited professional resources. The goal of this study was to identify groups of breast cancer patients with the greatest suicidal risk, who could be the first target for psychosocial interventions. Materials and Methods: The study included 421 women with stage T1–T3/N0–N3/M0 breast cancer. We provided women with a set of questionnaires 1–2 days prior to breast surgery and one year after surgery. One hundred eighty-eight patients completed the questionnaires after one year. We used the Beck Depression Inventory Second Edition (BDI-II) item Suicidal Thoughts or Intentions for the assessment of suicidal risk. The Impact of Event Scale-Revised (IES-R) was used to measure the risk of PTSD and the Vrana–Lauterbach Traumatic Events Questionnaire-Civilian, TEQ-C (TEQ-CV) was used to measure whether patients had experienced other traumatic events in their lifetime. Results: The incidence of suicidal ideation one year after surgery increased from 4.3% to 12.8% of patients. Patients who lived in rural areas had a two times greater risk of suicidal thoughts than patients who lived in urban areas. Working patients were 2.5 times more likely to have suicidal thoughts prior to surgery. Severely traumatic events increased the chances of suicidal ideation (OR 7.72; 95% CI 1.63–36.6; p = 0.01). The symptoms of PTSD showed a threefold increase in the likelihood of suicidal ideation (OR 2.89; 95% CI 0.98–8.55; p = 0.05). Conclusions: Living in the countryside, having a history of traumatic experience, having a paid job and having symptoms of post-traumatic stress disorder influence suicidal ideation in breast cancer patients. Particular attention should be drawn to individuals with multiple risk factors.

Associations between COVID-19 pandemic impact, dimensions of behavior and eating disorders: a longitudinal UK-based study

IntroductionThere is growing concern about how people with eating disorders are impacted by the widespread societal restructuring during the COVID-19 crisis.ObjectivesWe aimed to examine how factors relating to the impact of the pandemic associate with eating disorders and quantify this relationship while adjusting for concurrent and longitudinal parameters of risk.MethodsWe gathered demographic, behavioral and clinical data pre- and mid-pandemic as well as childhood trauma history from a longitudinal online survey of 489 adults (mean age 23.4 years) recruited from the Neuroscience in Psychiatry Network (NSPN). Using pre-pandemic (T1) and concurrent (T2) data we aimed to predict eating disorders at mid-pandemic (T2). We deployed hierarchical generalized logistic regression to ascertain the strength of longitudinal and concurrent associations.ResultsPre-pandemic eating disorder scores strongly associated with concurrent eating disorder (z=5.93). More conflict at home mid-pandemic (z=2.03), pre- (lower sensation seeking z=-2.58) and mid-pandemic (higher lack of perseverance z=2.33) impulsivity traits also associated with mid-pandemic eating disorder. Significant correlations between pandemic-related disrupted lifestyle and eating disorder psychopathology both pre- and mid-pandemic were observed.Conclusions Conflict at home mid-pandemic and specific aspects of impulsiveness significantly associated with concurrent eating disorder when adjusted for pre-pandemic eating disorder symptoms, baseline demographics, behavioral traits, history of traumatic experiences and concurrent psychopathology. These results provide insight into the struggles of those suffering with eating disorders during the COVID-19 pandemic and highlight the importance of impulsiveness traits and the immediate family environment in their experience of illness during the pandemic.DisclosureNo significant relationships.

The mediating role of complex posttraumatic stress and borderline pattern symptoms on the association between sexual abuse and suicide risk

BackgroundThe 11th revision of the International Classification of Diseases (ICD-11) includes a new diagnosis of complex posttraumatic stress disorder (CPTSD). There has been very little research investigating associations between CPTSD symptoms and suicide risk following sexual abuse. This and questions concerning similarities and differences between CPTSD and borderline personality disorder (BPD), led to the current study that aimed to explore indirect associations between sexual abuse and suicide risk through the symptoms of CPTSD and borderline traits.MethodsThe study sample comprised 103 adults with a history of traumatic experiences (Mage = 32.64, SDage = 9.36; 83.5% female). In total, 26.3% of the participants reported experiencing sexual abuse during their lifetime. The clinician-administered International Trauma Interview (ITI) was used for the assessment of ICD-11 CPTSD symptoms. Self-report measures were used for the evaluation of borderline pattern (BP) symptoms and suicide risk. Mediation analyses were performed to evaluate the mediating effects of CPTSD and BP symptoms for the association between sexual trauma and suicide risk.ResultsIn a parallel mediation model, CPTSD and BP symptoms mediated the association between sexual abuse and suicide risk, following adjustment for the covariates of age, gender, and whether the traumatic experience occurred in childhood or adulthood. Around 73% of participants who met diagnostic criteria for CPTSD reported previous suicide attempt(s).ConclusionsSuicide risk assessment and intervention should be an important part of the management of victims of sexual abuse with CPTSD and BP symptoms.

Cardiovascular reactivity, stress, and personal emotional salience: Choose your tasks carefully.

Both greater cardiovascular reactivity and lesser reactivity ("blunting") to laboratory stressors are linked to poor health outcomes, including among people who have a history of traumatic experiences. In a sample of recently separated and divorced adults (N=96), this study examined whether differences in cardiovascular reactivity might be explained by differences in the personal emotional salience of the tasks and trauma history. Participants were assessed for trauma history, current distress related to their marital dissolution, and cardiovascular reactivity during two tasks, a serial subtraction math stressor task and a divorce-recall task. Participants with a greater trauma history evidenced less blood pressure reactivity to the serial subtraction task (a low personal emotional salience task) when compared to participants with less trauma history. In contrast, participants with a greater trauma history evidenced higher blood pressure reactivity to the divorce-recall task, but only if they also reported more divorce-related distress (high personal emotional salience). These associations were not significant for heart rate reactivity. Among people with a history of more traumatic experiences, a task with low personal salience was associated with a lower blood pressure response, whereas a task with higher personal emotional salience was associated with a higher blood pressure response. Future studies examining cardiovascular reactivity would benefit from determining the personal emotional salience of tasks, particularly for groups that have experienced stressful life events or trauma.

Associations between COVID-19 pandemic impact, dimensions of behavior and eating disorders: A longitudinal UK-based study

BackgroundThere is growing concern about how people with eating disorders are impacted by the widespread societal restructuring during the COVID-19 crisis. AimsWe aimed to examine how factors relating to the impact of the pandemic associate with eating disorders and quantify this relationship while adjusting for concurrent and longitudinal parameters of risk. MethodsWe gathered demographic, behavioral and clinical data pre- and mid-pandemic as well as childhood trauma history from a longitudinal online survey of 489 adults (mean age 23.4 years) recruited from the Neuroscience in Psychiatry Network (NSPN). Using pre-pandemic (T1) and concurrent (T2) data we aimed to predict eating disorders at mid-pandemic (T2). We deployed hierarchical generalized logistic regression to ascertain the strength of longitudinal and concurrent associations. ResultsPre-pandemic eating disorder scores strongly associated with concurrent eating disorder (z = 5.93). More conflict at home mid-pandemic (z = 2.03), pre- (lower sensation seeking z = −2.58) and mid-pandemic (higher lack of perseverance z = 2.33) impulsivity traits also associated with mid-pandemic eating disorder. ConclusionConflict at home mid-pandemic and specific aspects of impulsiveness significantly associated with concurrent eating disorder when adjusted for pre-pandemic eating disorder symptoms, baseline demographics, behavioral traits, history of traumatic experiences and concurrent psychopathology. These results provide insight into the struggles of those suffering with eating disorders during the COVID-19 pandemic and highlight the importance of impulsiveness traits and the immediate family environment in their experience of illness during the pandemic.

Phycological debriefing in acute traumatic events: Evidence synthesis.

Stressful life situations can generate chronic symptomatology, so it is of great concern to analyze preventive strategies. Psychological debriefing is an intervention for acute trauma, which verbalizes perceptions, thoughts, and emotions experienced during a recent traumatic event. The evidence surrounding its efficacy is controversial. This article discusses the efficacy of psychological debriefing based on systematic reviews and clinical practice guidelines. In all, nine systematic reviews were included. Only one of them found that psychological debriefing effectively decreased psychological stress, while the remaining eight found no significant effects for outcomes such stress, depressive and anxious symptoms, or development and severity of post-traumatic stress disorder. Moreover, two clinical trials found that the intervention had a significantly deleterious effect. Another study found a worsening in the symptomatology associated with the event. Of the eight clinical practice guidelines incorporated, none recommended psychological debriefing as an intervention for acute trauma. Some phenomena could explain the lack of success of the intervention in the scientific evidence. The bioethical conditions related to the traumatic scenario hinder its research, and its lack of standardization makes its evaluation in clinical trials problematic. Other variables such as ethnicity, personality, culture, gender, and history of traumatic experiences have been little considered in research. Nevertheless, the intervention may hinder the adequate processing of traumatic memory and emotions. Current evidence is consistent in not recommending psychological debriefing as an intervention for acute trauma, so its management should avoid it. It is suggested to promote research on preventive interventions to develop chronic traumatic symptomatology.

How Is the History of Early Traumatic Exposure Associated With the Psychopathological Outcomes of COVID-19 Related Lockdown and Subsequent Re-opening in People With Eating Disorders?

The negative impact of COVID-19 pandemic on people with Eating Disorders (EDs) has been documented. The aim of this study was to evaluate whether a history of traumatic experiences during childhood or adolescence was associated with a higher degree of psychopathological worsening during COVID-19 related lockdown and in the following re-opening period in this group of people. People with EDs undergoing a specialist ED treatment in different Italian services before the spreading of COVID-19 pandemic (n = 312) filled in an online survey to retrospectively evaluate ED specific and general psychopathology changes after COVID-19 quarantine. Based on the presence of self-reported traumatic experiences, the participants were split into three groups: patients with EDs and no traumatic experiences, patients with EDs and childhood traumatic experiences, patients with EDs and adolescent traumatic experiences. Both people with or without early traumatic experiences reported retrospectively a worsening of general and ED-specific psychopathology during the COVID 19-induced lockdown and in the following re-opening period. Compared to ED participants without early traumatic experiences, those with a self-reported history of early traumatic experiences reported heightened anxious and post-traumatic stress symptoms, ineffectiveness, body dissatisfaction, and purging behaviors. These differences were seen before COVID-19 related restrictions as well as during the lockdown period and after the easing of COVID-19 related restrictions. In line with the “maltreated ecophenotype” theory, these results may suggest a clinical vulnerability of maltreated people with EDs leading to a greater severity in both general and ED-specific symptomatology experienced during the exposure to the COVID-19 pandemic.

Aging in Place Among Older Adults With Histories of Traumatic Experiences: A Scoping Review.

Adverse childhood and adult experiences can have far-reaching impacts and, when coupled with typical aging-related changes, may impede the achievement of a suitable person-environment fit for aging adults. The objective of our study was to determine whether extant literature connects older adults with trauma history to successfully aging in place. We proposed a conceptual model regarding trauma history, adaptive capacity of aging adults, and trauma-informed supports for aging in place. We conducted a scoping review using 6 databases (keywords: older adult(s), aging in place, housing, trauma), with a full review of 32 articles. Insights included: (a) Aging in place does not have to mean living in the same house over time. (b) The uncertainty of the aging process can be traumatic and can be exacerbated by previous traumatic experiences. (c) Environmental sensitivities can result from previous traumatic experiences and cause further trauma. (d) Housing precarity is a traumatic experience. (e) Permanent supportive housing is an important resource for people in crisis. (f) Community supports are critical to aging in place. Our review revealed insights about aging in place and trauma, but did not connect the vulnerabilities specific to aging adults with personal trauma histories to aging in place. Research is needed that confirms the relationship between history of traumatic experiences and difficulties with aging in place as well as trauma-informed approaches that can mitigate housing-related stressors and foster community-living environments that provide equitable access to aging in place.

Relative effects of sexual assault and other traumatic life events on self-harm

IntroductionSexual assault is a common traumatic stressor that is associated with a number of mental health difficulties among men and women who experience it. Perhaps the most severe of these difficulties are self-harm, a term which encompasses suicidal impulses and behaviors and non-suicidal self-injury. Self-harm is common among those with a history of traumatic experiences, perhaps because it represents a way to escape memories of and emotions related to these experiences. This may particularly be the case for the trauma of sexual assault, on which there is a growing body of research. Although this research suggests a strong association between sexual assault and self-harm, it is less clear whether sexual assault is more strongly associated with self-harm than are other traumatic experiences. Objective/MethodIn this study, we examined the relative effects of sexual assault since the age of fourteen and other traumatic experiences on self-harm in a sample of men and women recruited on Amazon's Mechanical Turk (N = 390) using a Bayesian approach to multiple regression. ResultsResults suggest that sexual assault has a large positive effect on self-harm over and above other traumatic experiences. ConclusionThese results highlight the especially pernicious influence of sexual assault and suggest the need to assess self-harm among those with a sexual assault history.

609 Combined Physical, Occupational, and Psychotherapies in the Holistic Care of the Burn

Abstract Introduction Burn patients often experience pain and fear of the recovery process, negatively impacting their engagement in necessary treatments for maximal functional outcomes. Patients routinely exhibit aversions toward physical and occupational therapies (PT and OT). As a result, therapists have been tasked with managing the patient’s psychological reactions while simultaneously providing rehabilitation. We developed a program for our psychologist to co-treat patients with burn physical and occupational therapists to directly address the painful or feared aspects of burn recovery. These multidisciplinary visits offer in-vivo interventions for managing patient distress and allows therapists the ability to focus solely on their specialized interventions. Methods This program has been active for 12 months and was created during therapy to aid a patient with high distress during PT and OT. Therapists now work with psychology to co-treat improving patient engagement in rehabilitative interventions. During co-treatment, the patients are able to engage in PT and OT more effectively and achieve short-term goals. The burn center psychologist and therapists have developed an interventional method to explore potential generalization of co-treatment effectiveness. Patients are identified based on high need for psychological support during therapy sessions. Each patient case is reviewed and discussed to develop individualized treatment plans and establish goals. Through qualitative review of each co-treatment visit, common barriers have been identified as well as strategies to improve engagement and compliance. Results The common barriers encountered had a high association with a history of traumatic experiences and avoidant coping/low distress tolerance. The most effective co-treatment interventions included: collaboratively setting patient goals with PT, OT and psychology; scheduling patient therapy with burn psychology in advance; teaching distress tolerance skills to manage anticipatory and in-vivo distress related to rehabilitation. Conclusions Treating the emotional aspects of burn recovery during moments of acute distress is integral for holistic patient care. This multidisciplinary approach offers patients increased involvement through collaboratively tailored treatment planning and improved ability to tolerate distressing aspects of recovery. Additionally, therapists were taught various approaches to improve patient engagement and adherence.