Types Of Interpersonal Trauma Research Articles

The prevalence, latent structure and psychosocial and cognitive correlates of complex post-traumatic stress disorder in an adolescent community sample

Complex PTSD has received growing attention in recent years. However, the validity, prevalence and risk factors of this diagnosis remain unclear. This study examined PTSD presentations in adolescents using diagnostic criteria and latent class analysis (LCA). It then explored the role of demographics factors, trauma history factors, psychopathology factors and cognitive factors in predicting different PTSD presentations. A cross-sectional data comprising self-report measures of 342 community adolescents (12–15 years) were collected and analysed. 2.3 %, 5.6 % and 10 % of adolescents met the criteria for PTSD, CPTSD and disturbances in self-organisation (DSO) respectively. A three-class model (healthy class, CPTSD class and DSO class) were generated from LCA. Adolescents with CPTSD were most likely to be female and endorsed the most overall trauma types, interpersonal trauma types, depression, anxiety and maladaptive cognitive processes, followed by adolescents with DSO and subsequently healthy adolescents. CPTSD appeared to be a more common presentation than PTSD among community adolescents. The relatively high prevalence of DSO is noteworthy and suggests that DSO is not necessarily accompanied by PTSD. Given the strong associations between CPTSD and cognitive processes implicated in PTSD, CPTSD as a construct might be conceptually similar to PTSD.

50.7 History of Interpersonal Trauma as a Risk Factor for Psychiatric Rehospitalization Among Children and Adolescents: A Narrative Review

Childhood and adolescent psychiatric rehospitalizations are prevalent and overtaxing for patients, their families, and healthcare systems and can in themselves be traumatic to all parties involved. Understanding their causes is crucial to reduce this burden. This narrative literature review investigates the growing evidence identifying history of interpersonal trauma—defined as a type of trauma that occurs between people by acts of commission or omission, such as abuse, neglect, and bullying—as a risk factor for psychiatric rehospitalization among children and adolescents. The literature review was conducted on PubMed with the following key terms: (childhood OR adolescent OR children) AND (readmission OR rehospitalization) AND ([(interpersonal OR mental OR psychiatric) AND trauma)] OR PTSD). Three independent reviewers screened for eligible studies that discussed interpersonal trauma and psychiatric rehospitalization risk in patients aged 0 to 18 years. PubMed queries yielded 63 records with the key terms. After 3 independent reviews, 4 eligible records were found. Among the 4 retrospective studies with sample sizes between 100 and 783, three studies reported that children and adolescents who experienced neglect, bullying, physical abuse, or sexual abuse had higher psychiatric rehospitalization rates than those without. The fourth study found no significant association between interpersonal trauma and psychiatric rehospitalization but stated that underreporting of childhood interpersonal trauma may attribute to this lack of significance. All 4 studies focused on diagnosis of PTSD to account for trauma, while some, but not all, took into consideration family structure, history of abuse, and further mental health diagnosis. Current literature is limited but supports the interpretation that interpersonal trauma history is a risk factor for psychiatric rehospitalization among children and adolescents. However, the degree to which various factors, such as age, number of traumas, and types of interpersonal trauma experienced, impact this relationship remains unknown. Therefore, further studies are warranted to explore and elaborate on such elements in this emerging association.

Patterns of conflict-related trauma exposure and their relation to psychopathology: A person-centered analysis in a population-based sample from eastern DRC

Populations in war-torn regions are exposed to a wide array of traumatic events that can cause an enormous psychological burden. Individual characteristics influence the likelihood of being exposed to certain events, pointing to systematic interindividual differences in trauma exposure. However, there is a dearth of studies examining potential patterns of trauma exposure in war regions. In this cross-sectional epidemiological study, we applied a person-centered approach to identify patterns in the exposure to conflict-related traumatic events and determine their impact on commonly reported mental health problems in a population-based sample (N ​= ​1000) from the eastern Democratic Republic of Congo. We implemented multi-stage random cluster sampling to randomly select adults from 100 villages. Of 1000 adults (Mage ​= ​43.19 years) included in the study, 50% were female. Results showed high prevalence of PTSD (17.0%), depression (27.8%), anxiety (25.4%) and suicidality (15.1%) following exposure to conflict-related traumatic events since 2002. Latent Class Analysis identified three distinct classes of trauma exposure: Class 1 “low-trauma-exposure” (51.4%, n ​= ​514) was characterized by the lowest probabilities of trauma exposure. Class 2 “non-physical-trauma” (39.1%, n ​= ​391) consisted of individuals with a high probability for exposure to non-physical trauma types only. Class 3 “interpersonal-trauma” (9.5%, n ​= ​95) had the overall highest probability of exposure to traumatic events and was the only class affected by interpersonal-trauma types. Class membership was related to gender, age and place of living. Vulnerability to mental health problems increased from low-trauma-exposure to non-physical-trauma to interpersonal-trauma class. Our findings indicate that the exposure to traumatic events in conflict-affected populations underlies distinct patterns, with interpersonal trauma as a distinguishing marker. Vulnerability to psychopathology varies with trauma patterns, revealing patterns that include both non-physical and interpersonal traumata as most detrimental for mental health. Identification of underlying trauma patterns and their effects may improve mental health care in war-affected populations.

Relationships among non-interpersonal and interpersonal trauma types, posttraumatic stress, and posttraumatic growth.

Adults seeking behavioral health or medical treatment (N = 158) were recruited from a community healthcare agency and a residential support program in the southeastern United States. Individuals who reported interpersonal trauma had significantly higher total PTS severity and symptom clusters. No significant difference was found in perceived PTG based on trauma type. No significant curvilinear relationship between PTS and perceived PTG was found. A significant negative linear relationship was observed between PTS and perceived PTG for non-interpersonal trauma, but not interpersonal trauma. Trauma type may influence the PTS and perceived PTG relationship and, while associated with PTS, seems less important to reporting of perceived PTG.

Bullying Victimization and Trauma.

Bullying victimization and trauma research traditions operate quite separately. Hence, it is unclear from the literature whether bullying victimization should be considered as a form of interpersonal trauma. We review studies that connect bullying victimization with symptoms of PTSD, and in doing so, demonstrate that a conceptual understanding of the consequences of childhood bullying needs to be framed within a developmental perspective. We discuss two potential diagnoses that ought to be considered in the context of bullying victimization: (1) developmental trauma disorder, which was suggested but not accepted as a new diagnosis in the DSM-5 and (2) complex post-traumatic stress disorder, which has been included in the ICD-11. Our conclusion is that these frameworks capture the complexity of the symptoms associated with bullying victimization better than PTSD. We encourage practitioners to understand how exposure to bullying interacts with development at different ages when addressing the consequences for targets and when designing interventions that account for the duration, intensity, and sequelae of this type of interpersonal trauma.

The "3 Es" of trauma-informed care in a federally qualified health center: Traumatic Event- and Experience-related predictors of physical and mental health Effects among female patients.

Federally Qualified Health Centers (FQHCs) are a fast-growing source of healthcare for women with intersectional identities, or those most frequently exposed to and negatively impacted by interpersonal trauma. According to the "3 E" conceptualization of trauma, certain Event- and Experience-related characteristics of a trauma predict victims' physical and mental health Effects. The "3 Es" have yet to be studied in female FQHC patients. The current study examined the prevalence of interpersonal trauma and interrelationships among traumatic Event-related factors (e.g., cumulative trauma by victim-perpetrator relationship), Experience-related factors (e.g., betrayal, resilience), and Effects (e.g., somatic symptoms, posttraumatic stress (PTS), anxiety/depression, mistrust, reduced sense of safety) among 138 predominantly Black (89.1%) women receiving care at an FQHC in the southeastern U.S. Roughly 65% of participants (n = 86) endorsed exposure to at least one type of interpersonal trauma. More cumulative trauma was significantly correlated with more somatic, PTS, and anxious/depressive symptoms,and a reduced sense of safety. Experiences of betrayal and/or resilience were better predictors of PTS and anxious/depressive symptoms and lack of safety than Event-related factors. Findings support the need for the implementation of trauma-informed care within community-based health centers. Healthcare providers should consider women's subjective experience of trauma when screening for exposure and providing trauma-sensitive care.

Childhood Maltreatment and Risk of Harm to Self and Others: The Role of Sex and Polyvictimization

Objectives: Research has shown that children who experience abuse and neglect are at much higher risk of experiencing negative outcomes such as physical and mental health problems, social skill deficits, and poor quality of life. The goal of this paper was to examine the relationship between polyvictimization and risk of harm to self and others, taking into account both age and sex differences. Methods: A total of 8980 participants (4156 with maltreatment history) were recruited from over 50 mental health facilities in Ontario, Canada. Group comparisons were completed to examine types of trauma experienced, and risk of harm to self and others. Results: Among our sample, we found that 29% of children and youth had experienced multiple types of interpersonal trauma. We also found that while female children and youth who had experienced trauma were at greater risk of harm to themselves, males were at greater risk of harming others. Further, our results highlight that children and youth who had experienced multiple types of maltreatment, regardless of age or sex, were at the greatest risk of harm to self and others. Implications: Findings from this research highlight that interpersonal trauma is multifaceted and add to existing evidence that there is a cumulative relationship between experiencing multiple types of maltreatment and risk in relation to harming oneself or others. Our findings underscore the importance of a background assessment that takes into account all forms of maltreatment in order to properly understand risk of harm and inform intervention.

Couples and Trauma History: A Descriptive Overview of Interpersonal Trauma and Clinical Outcomes

While it is likely that Couple and Family Therapists will treat clients with interpersonal trauma history, not much is known about how interpersonal trauma history associates with the therapy process in couple and family therapy settings. The aims of this study were twofold: (1) describe the types of interpersonal trauma that couples, seeking treatment for relationship issues, have experienced, and (2) investigate how this history of interpersonal trauma was associated with the process of treatment, including therapeutic alliance, number of sessions attended, and termination status. Data were collected through a survey distributed upon consent at an on-campus couple and family therapy clinic. Participants included 73 couples who were assessed for physical abuse, sexual abuse, and experiences of abandonment using Carlson et al.’s (Psychol Assessment 23(2):463, Carlson et al., Psychological assessment 23:463, 2011) Trauma History Screen. Using content analysis, responses were categorized into three groups: both partners, only one partner, and no partners reported having experienced an interpersonal trauma. Results revealed that just under 50% of individuals had experienced some type of interpersonal trauma, affecting 71.2% of couples. Quantitative analyses were conducted to assess for significant differences, and effect sizes, among trauma categories in terms of number of sessions attended, termination status, and therapeutic alliance. Results suggested that couples who had previously experienced interpersonal trauma, particularly when both partners reported interpersonal trauma, may be more likely to terminate without agreement or no-show. Future researchers should continue to investigate how the presence of interpersonal trauma in dyads associates with the therapeutic process and clinical outcomes to better inform couples’ therapy treatment.

Exploring stress, cognitive, and affective mechanisms of the relationship between interpersonal trauma and opioid misuse.

BackgroundPeople with a history of interpersonal trauma, including intimate partner violence, sexual assault, and adverse childhood experiences, are disproportionately affected by the current opioid epidemic. Interpersonal trauma has been shown to increase risk for chronic pain conditions, prescription opioid use, and opioid misuse. Stress, cognition, and affective function have been examined as potential mechanisms that may influence opioid misuse among individuals with a history of interpersonal trauma. However, no studies have examined these factors simultaneously, despite their interrelatedness.ObjectiveThe purpose of this study was to 1) examine perceived stress, perceived cognitive function, depressive symptoms, and PTSD symptoms as potential mechanisms of opioid misuse among individuals with a history of interpersonal trauma, 2) examine the types of interpersonal trauma that are associated with opioid misuse, and 3) assess the mediating role of pain and opioid prescription.MethodsA cross-sectional, observational study design was conducted. Data were collected through a confidential self-report online survey using validated instruments (n = 230). A series of regression analyses were conducted to identify mechanistic factors and interpersonal trauma types associated with opioid misuse, opioid prescription, and pain intensity. Structural equation modeling was used to examine mediating effects of pain intensity and opioid prescription.ResultsOpioid prescription, depressive symptoms, and intimate partner violence increased the odds of reporting opioid misuse. Pain intensity and adverse childhood experiences increased the odds of opioid prescription. Higher levels of perceived stress and depressive symptoms were associated with increased pain intensity. Pain intensity emerged as a mediator of the relationship between depressive symptoms and opioid misuse.ConclusionsOur work shows that there are likely several pathways through which interpersonal trauma can lead to opioid misuse. Interventions aimed at improving depressive symptoms and coping with traumatizing events should be included as part of comprehensive trauma-informed pain management practices.

The Effects of Co-Occurring Interpersonal Trauma and Gender on Opioid Use and Misuse.

The association between interpersonal trauma (IPT) and opioid misuse is well established. There are important gaps, however, in our understanding of this relationship. Studies often do not account for the co-occurrence of IPT across time (i.e., multiple experiences of the same type of IPT) and contexts (i.e., experiences of different types of IPT). In addition, few studies have examined the relationship between IPT and prescription opioid use or gender differences. To address these gaps, this study examines the impact of IPT co-occurrence and gender on prescription opioid use and opioid misuse. Data were collected through a cross-sectional online survey of 235 adults with a self-reported history of IPT (i.e., intimate partner violence, sexual assault, adverse childhood experiences). IPT co-occurrence and interactions between IPT, as continuous scales, were assessed as correlates of opioid use and misuse using multinomial regression models. IPT was associated with opioid misuse, but not use, adjusting for gender. The relationship between sexual assault and opioid misuse was confounded by exposure to other types of IPT. Intimate partner violence was associated with opioid misuse among men. Adverse childhood experiences were associated with misuse among women. The interaction between intimate partner violence and sexual assault increased odds of opioid use among women. This study highlights the importance of accounting for IPT co-occurrence and examining gender differences in clinical practice and research related to opioid use/misuse. These approaches are important for understanding the relationship between IPT and opioid use/misuse by more accurately representing the complexity of the lives of survivors.

Transit Migration and Trauma: the Detrimental Effect of Interpersonal Trauma on Syrian Children in Transit in Italy

Following the humanitarian crisis caused by the Syrian war, the shortages in European Union’s reception system exposed numerous children to a prolonged period of transit within frontier countries (e.g., Italy), during which they were considered “invisible” and received no legal recognition and protection. This situation offered a unique possibility to study the psychological dimensions involved in the elaboration of trauma during a migratory journey characterized by the lack of reception services. The present study, conducted on a group of Syrian children (n = 271) in transit to Italy with their families while on their journey to Northern Europe, aimed to explore the mental health of this population, focusing on the impact of interpersonal trauma as risk factors and resilience as protection for children’s mental health outcomes. The children were assessed for dose of exposure to traumatic experiences, post-traumatic symptomatology, social impairment dimensions, and resilience. A hierarchical multiple regression analysis was performed to check for the effects of dose of exposure and specific type of interpersonal trauma on post-traumatic symptomatology. Results showed that traumatic experiences affecting interpersonal relationships (family torture, serious deprivation, and bereavement) predict higher levels of PTSD, while the protective role of resilience on PTSD outcomes turned out to be inhibited. The paper also discusses the implications for stakeholders and policy makers and defines the theoretical future developments of the research.

When Nowhere Is Safe: Interpersonal Trauma and Attachment Adversity as Antecedents of Posttraumatic Stress Disorder and Developmental Trauma Disorder.

Developmental trauma disorder (DTD) has been proposed as clinical framework for the sequelae of complex trauma exposure in children. In this study, we investigated whether DTD is associated with different traumatic antecedents than posttraumatic stress disorder (PTSD). In a multisite sample of 236 children referred from pediatric or mental health treatment, DTD was assessed using the DTD Structured Interview. Trauma history was assessed using the Traumatic Events Screening Instrument (TESI). On an unadjusted basis, both DTD, odds ratios (ORs) = 2.0–3.8, 95% CI [1.17, 7.19]; and PTSD, ORs = 1.8–3.0, 95% CI [1.04, 6.27], were associated with past physical assault and/or abuse, family violence, emotional abuse, neglect, and impaired caregivers; and DTD was associated community violence, OR = 2.7, 95% CI [1.35, 5.43]. On a multivariate basis after controlling for the effects of PTSD, DTD was associated with family and community violence and impaired caregivers, ORs = 2.0–2.5, 95% CI [1.09, 5.97], whereas PTSD was only associated with physical assault and/or abuse after controlling for the effects of DTD, OR = 2.4, 95% CI [1.07, 4.99]. Exposure to both interpersonal trauma and attachment adversity was associated with the highest DTD symptom count, controlling for the PTSD symptom count. Although childhood PTSD and DTD share several traumatic antecedents, DTD may be uniquely associated with pervasive exposure to violent environments and impaired caregiving. Therefore, DTD warrants further investigation as a framework for the assessment and treatment of children with histories of interpersonal victimization and attachment adversity.

Interpersonal trauma and aging-related genitourinary dysfunction in a national sample of older women

Among reproductive-aged women, exposure to interpersonal trauma is associated with genitourinary symptoms. Little is known about the relationship between these exposures and the genitourinary health of older women, who tend to experience different and more prevalent genitourinary symptoms because of menopause and aging. In this study, we examined relationships between common types of interpersonal trauma and aging-related genitourinary dysfunction among older women. We analyzed data from the National Social Life, Health, and Aging Project, a national area probability sample of older community-dwelling adults born between 1920 and 1947. We used cross-sectional data from home-based study visits conducted in 2005-2006 to examine interpersonal violence exposures (any lifetime sexual assault, past-year emotional and physical abuse), and past-year genitourinary symptoms (urinary incontinence, other urinary problems, and vaginal pain/lubrication problems with sexual intercourse) among women participants. Multivariable logistic regression models were used to relate interpersonal violence and genitourinary symptoms, adjusting for age, race/ethnicity, body mass index, education, marital status, parity, hormone therapy, depressive and anxiety symptoms, and self-reported health. In exploratory models, we further adjusted for vaginal maturation, a tissue-specific marker of aging-related urogenital atrophy obtained from vaginal self-swabs. In this national sample of 1551 older women (mean age 69 ± 2 years), 9% reported sexual assault, 23% reported emotional abuse, and <1% reported physical abuse. Urinary incontinence and other urinary problems were reported by 42% and 17%, respectively, and 42% of sexually active women (n= 527) reported vaginal symptoms with intercourse. In multivariable regression analyses adjusted for age, race/ethnicity, education, marital status, parity, hormone therapy, anxiety, depressive symptoms, and self-reported health, women with any lifetime history of sexual assault had 2.5 times the odds (95% confidence interval, 1.0-6.3) of vaginal symptoms, while women who reported past-year emotional abuse had higher odds of urinary incontinence (odds ratio, 1.7, 95% confidence interval, 1.2-2.4) and other urinary problems (odds ratio, 1.8, 95% confidence interval, 1.2-2.8). Among women who provided vaginal self-swabs (n= 869), adjustment for vaginal maturation-attenuated associations with other urinary problems (odds ratio, 1.6, 95% confidence interval, .9-2.6) and vaginal symptoms (odds ratio, 2.2, 95% confidence interval, 0.8-5.8). Sexual assault and emotional abuse may play a role in the development or experience of aging-related genitourinary dysfunction in older women. Clinicians caring for older women should recognize the prevalence and importance of traumatic exposures in health related to menopause and aging.

S133. THE RELATIONSHIP BETWEEN EXPOSURE TO TRAUMA DURING CHILDHOOD AND ADOLESCENCE AND PSYCHOTIC EXPERIENCES AT 18 YEARS OLD IN A NON-CLINICAL POPULATION

BackgroundChildhood trauma (CT) is an established risk factor for the onset and development of psychotic experiences (PEs), with some evidence that interpersonal traumas being more strongly associated with risk of PEs than accidental injury or adversities such as parental divorce. However, it is not clear whether specific types of interpersonal trauma, such as emotional neglect or sexual abuse, are more strongly associated with risk of PEs than others, or whether there are critical or sensitive periods within which exposure to these carries the greatest risk.MethodsOur study aimed to extend this literature by comparing the presence of multiple exposures to identify the most important types of trauma exposure and examining the association of trauma exposure with PEs throughout childhood in a large sample. We investigated whether different trauma exposures at different points of development from 0–17 years old are associated with PEs in The Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. The measures of different types of trauma (physical abuse, emotional abuse, bullying, domestic violence, sexual abuse, emotional neglect) at different time-points (0–5 years old, 5–11 years old, 11–17 years old) were derived from questions asked throughout the longitudinal study. PEs were assessed by the face-to-face, semi-structured, Psychosis-Like Symptoms interview (PLIKSi) at 18 years old. The primary outcome was suspected or definite psychotic experiences (PEs). Multivariable logistic regression was used to examine the effects of exposure to specific types of trauma, and of exposure to trauma across specific age periods, before and after adjusting for the presence of other traumatic exposures and for confounders, including measures of socio-economic measures (parental income, maternal education, crowded living conditions at birth), sex, measures of parental mental health, parental drug use, parental trouble with the law, IQ and genetic risk for schizophrenia, bipolar disorder and major depressive disorder. The robustness of these findings will be explored by using penalised-regression and MI methods to test specific competing hypotheses and address potential bias due to missing data.ResultsAll trauma types exposed to between 0–17 years of age were strongly associated with PEs (adjusted ORs 1.64 – 2.13). When controlling for the presence of other trauma exposures and confounders, exposure to domestic violence at 0–5 (adjusted OR 1.67, 95% CI 1.24 – 2.26), bullying at 5–11 (adjusted OR 1.83, 95% CI 1.34, 2.48) and sexual abuse, emotional neglect and bullying at 11–17 (adjusted ORs 2.04 – 2.39) were the traumas most strongly associated with PEs (p<.001). Whilst exposure to any trauma at each of the age-periods was associated with PEs (adjusted ORs 1.55–2.11), the strongest association was for exposure at ages 11–17 years. The cumulative risk of reporting multiple types trauma exposures at each time-point further increased the risk of reporting PEs. Adjusting for confounders did not alter the association between trauma exposures and PEs.DiscussionPrevious studies have shown that different types of trauma during childhood increase the risk of PEs. Our results show that the association between trauma and PEs is not explained by a broad range of potential confounders, including genetic risk for schizophrenia, supporting a causal effect of trauma exposure on psychosis. Our findings do not support the presence of a critical period of risk, but indicate that exposure to trauma during any period of childhood or adolescent development increases risk of psychotic experiences.

Transformational change in parenting practices after child interpersonal trauma: A grounded theory examination of parental response

Child interpersonal trauma is associated with a host of negative outcomes, both concurrently and in adulthood. Parental responses following trauma can play an important role in modulating child responses, symptoms, and post-trauma functioning. However, parents themselves are also impacted after their child experiences trauma, reporting distress, psychopathology, concerns about the child’s safety, changes in discipline and protectiveness, and feelings of blame. Most of this previous research, however, suffers from methodological limitations such as focusing on description and correlations, providing static “one shot” assessments of parenting after trauma, and relying mainly on results related to child sexual abuse. This project developed a comprehensive, explanatory theory of the dynamic process by which parenting changes in response to a range of child trauma, using a sample of parents whose children had experienced a range of interpersonal trauma types. Grounded theory analyses revealed a three-phase dynamic model of discontinuous transformation, in which parents experienced destabilization, recalibration, and re-stabilization of parenting practices in response to child trauma. Parents were focused on Protecting and Healing the child victim, often at the expense of their own needs. Most parents reached a phase of posttraumatic growth, labelled Thriving Recovery, but processes that hindered this recovery are also discussed. This study provides the first evidence that dynamic systems of change as well as vicarious posttraumatic growth can apply to parents of child trauma victims. Generating an explanatory theory provides important avenues for future research as well as interventions and services aimed at families who have experienced child trauma.

Frequency of Interpersonal Trauma Types, Avoidant Attachment, Self-Compassion, and Interpersonal Competence: A Model of Persisting Posttraumatic Symptoms

ABSTRACTGiven limited knowledge about how psychosocial factors interact to modulate posttraumatic stress symptoms, this study evaluated an integrative model proposing that experiencing more interpersonal trauma types (e.g., abuse, assault, rape, etc.) leads to greater avoidant attachment and lower self-compassion, which limits the development and use of effective interpersonal skills. In turn, lower levels of self-compassion and interpersonal competence perpetuate posttraumatic symptoms. Anonymous trauma-experienced adults (n = 132) completed self-report measures in an online study hyperlinked on trauma support websites. Data were subjected to confirmatory factor analysis and structural equation modeling, which provided support for the hypothesized model. Specifically, higher frequency of interpersonal trauma types experienced was linked to higher avoidant attachment and lower self-compassion, which in turn were associated with lower interpersonal competence, which correlated with greater posttraumatic stress symptoms. Although cross-sectional data cannot address directionality of associations, this study’s findings emphasize the potential utility of future longitudinal research designed to examine possible causal relationships among these specific psychosocial factors. For example, study findings suggest that those who experience more types of interpersonal trauma and who are characterized by avoidant attachment and lower self-compassion and interpersonal competence may be the most susceptible to experiencing severe posttraumatic symptoms. However, findings also suggest that efforts to increase self-compassion and interpersonal skills may help reduce symptoms.

Childhood trauma perpetrated by close others, psychiatric dysfunction, and urological symptoms in patients with interstitial cystitis/bladder pain syndrome

BackgroundA psychosocial phenotype of interstitial cystitis/bladder pain syndrome (IC/BPS), a urogenital condition without known organic causes, was proposed. While psychosocial variables, including interpersonal maltreatment and negative affect, were studied in association with IC/BPS, the specificities of the relationships between childhood trauma by close others, psychiatric dysfunctions (negative affect and post-traumatic psychopathology), and urogenital symptoms have not been established. Methods94 IC/BPS patients were recruited together with 47 patients with acute cystitis who served as clinical controls. Standardized scales were used to assess various potentially traumatizing events in childhood and adulthood as well as psychiatric (dissociation and negative affect) and urogenital symptoms. ResultsAmong the potentially traumatizing events, those perpetrated by close others during childhood were found to be the most salient features discriminating the IC/BPS group from the control group. When divided into 2 subgroups according to their history of childhood trauma by close others, only IC/BPS patients with childhood trauma by close others had more dissociative and anxiety symptoms compared with the control group. These two subgroups did not differ in urogenital symptom severity. ConclusionsChildhood trauma by close others, rather than other types of interpersonal trauma, was a differentiating characteristic in IC/BPS patients, and a childhood trauma related psychosocial phenotype with a distinct clinical profile of dissociation and anxiety proneness was identified. Future studies should investigate whether a distinct set of pathogenic factors exists in IC/BPS patients with a history of childhood trauma by close others, even if this subgroup is not readily differentiated by urogenital symptoms.

Cumulative trauma and current posttraumatic stress disorder status in general population and inmate samples.

This research was undertaken to examine the role between cumulative exposure to different types of traumatic events and posttraumatic stress disorder (PTSD) status in general population and prison samples. Two archival datasets were examined: the standardization sample for the Detailed Assessment of Posttraumatic States (DAPS; Briere, 2001), and data from a study on trauma and posttraumatic sequelae among inmates and others. PTSD was found in 4% of the general population sample and 48% of the prison sample. Trauma exposure was very common among prisoners, including a 70% rate of childhood sexual abuse for women and a 50% rate for men. Lifetime number of different types of trauma was associated with PTSD in both the general population and prison samples, even when controlling for the effects of sexual trauma. Cumulative interpersonal trauma predicted PTSD, whereas cumulative noninterpersonal trauma did not. In the general population sample, participants who had only 1 type of trauma exposure had a 0% likelihood of current PTSD, whereas those with 6 or more other trauma types had a 12% likelihood. In the prison sample, those with only 1 type of trauma exposure had a 17% percent likelihood of current PTSD, whereas those exposed to 6 or more other trauma types had a 64% chance of PTSD. Cumulative trauma predicts current PTSD in both general population and prison samples, even after controlling for sexual trauma. PTSD appears to develop generally as a function of exposure to multiple types of interpersonal trauma, as opposed to a single traumatic event. (PsycINFO Database Record

The moderating effect between strengths and placement on children's needs in out-of-home care: A follow-up study

The negative impact of childhood maltreatment, which can often extend well into adulthood, consistently appears to be ameliorated if victimized children possess several resiliencies or strengths. However, little is known about how vulnerable children's outcomes are affected by different levels of strengths across different out-of-home placement settings. Hence, this study examined the association of two factors — children's strengths and placement type, with outcomes at two time-points during out-of-home care. The Child and Adolescent Needs and Strengths (CANS) tool was used to assess the outcomes of 285 children placed in residential homes or foster care in Singapore. Multiple regressions were conducted on CANS domain scores to evaluate whether level of baseline strengths and placement type predicted outcomes at two time-points after controlling for race, prior placements, age, gender, interpersonal trauma, and baseline needs scores. Results indicate that relative to residential care, foster care children are reported to be younger, with lower baseline needs, more prior placements, fewer baseline strengths and suffered fewer types of interpersonal trauma. After controlling for covariates, higher baseline strengths significantly predicted lower baseline needs of children across 3 of 4 CANS domains, regardless of placement settings. However, at reassessment 1year later, there were significant interactions between strengths and placement type, whereby baseline strengths significantly predicted lower life functioning needs only in foster care. To conclude, in both residential and foster care, the protective effects of high strengths against child maltreatment were similarly apparent at baseline, despite clear differences in children's profiles across placement types. Over time, these initial benefits appeared to persist somewhat for children in foster care but seemed to diminish in more restrictive, residential settings and this warrants further investigation on children with more similar profiles. Nonetheless, it is clear that the continual development of children's strengths should be prioritized in case planning.

The association of interpersonal trauma with somatic symptom severity in a primary care population with chronic pain: Exploring the role of gender and the mental health sequelae of trauma

ObjectiveFemale trauma survivors develop somatic symptoms more frequently than males. We propose a model for somatic symptom development among trauma survivors, focusing on gender. MethodsAmong 597 urban primary care patients with chronic pain, we examined the association between somatic symptom severity and three interpersonal trauma types: 1) sexual trauma (ST), 2) intimate partner violence (IPV), and 3) childhood trauma history (≥3 adverse childhood experiences (3+ACE)). We developed a structural equation model in which PTSD, depression, and substance abuse were evaluated as potential mediators of the path between trauma exposure and somatic symptom severity, and explored the role of gender in this model. Results350 (59%) respondents were female; the mean age was 47. Women reported significantly more somatic symptoms than men, although somatic symptoms were increased among all interpersonal trauma survivors. In models in which the potential intervening variables are considered in aggregate, we did not find a signficant interaction between gender and trauma on somatic symptom severity, with the exception of 3+ACEs. A structural equation model showed depression and substance abuse, for men, and depression, for women, were associated with somatic symptom severity. PTSD was not associated with somatic symptom severity. Paths from trauma exposures to mental health sequelae were stronger for men. ConclusionsWomen have more severe somatic symptoms. With the exception of 3+ACEs, the association between trauma and somatic symptoms is amplified in both genders. Structural equation models showed the pathways differed by gender in function and strength of association.