Mean Number Of Traumatic Events Research Articles

Trauma-focused cognitive behavioral therapy with Puerto Rican youth in a post-disaster context: Tailoring, implementation, and program evaluation outcomes

PurposeTrauma-Focused Cognitive Behavioral Therapy (TF-CBT) has not yet been systematically evaluated in the Caribbean context, particularly with Hispanic youth exposed to multiple disasters. The objective of this project was twofold: 1) to train mental health providers in Puerto Rico in TF-CBT as part of a clinical implementation project within the largest managed behavioral health organization (MBHO) on the island, and 2) to conduct a program evaluation to determine the feasibility of implementation and the effectiveness of the treatment. MethodFifteen psychologists were trained in TF-CBT. These psychologists then provided TF-CBT to 56 children and adolescents, ages 5–18, in community-based mental health clinics and one primary care clinic with a co-located psychologist in Puerto Rico. The mean number of traumatic events reported by youth referred for TF-CBT was 4.11. ResultsThirty-six out of 56 children enrolled in the project (64.3%) successfully completed all components of TF-CBT. Results demonstrated large effect sizes for reduction in youth-reported posttraumatic stress symptoms (PTSS) (Cohen's d = 1.32), depressive symptoms (Cohen's d = 1.32), and anxiety symptoms (Cohen's d = 1.18). ConclusionsThese results suggest that it was feasible to train providers in TF-CBT, that providers were able to deliver TF-CBT in community-based settings both in person and via telehealth (due to the COVID-19 pandemic), and that TF-CBT was an effective treatment option to address trauma-related concerns for youth in Puerto Rico in a post-disaster context. This project is an important first step in the dissemination and implementation of evidence-based trauma-focused treatment for Hispanic youth and disaster-affected youth in the Caribbean.

Trauma, Resilience, and Mental Health in Migrant and Non-Migrant Youth: An International Cross-Sectional Study Across Six Countries.

Resilience is a dynamic process of positive adaptation to significant adversity. While there has been substantial focus on risks and negative outcomes associated with youth migrancy, there is limited evidence of the relationship between the adversity of migration, and resilience, wellbeing, and positive mental health in adolescents. This international study aimed to explore the differences in resilience, wellbeing, and mental health behaviors in migrant and non-migrant adolescents tested across six countries (Australia, New Zealand, UK, China, South Africa, and Canada) with varying levels of trauma exposure. The study was a cross-sectional survey design with a convenience sample of 194 10–17 year old migrants and non-migrants. The migrant sample included both “internal” migrants (change of residence within a country) and “external” migrants (change of residence across national borders) for comparison. Across the sites, migrants reported a higher mean number of traumatic events for the past year than non-migrants, with internal migrants reporting more events than external migrants overall. South African adolescents reported a higher mean number of traumatic events for the past year than all other sites. External migrants reported higher resilience scores yet reduced prosocial behaviors relative to internal migrants and non-migrants, whereas both internal and external migrants reported higher peer problems than non-migrants. When considering the interacting effects of trauma, the presence or absence of trauma did not appear to impact migrant scores in terms of resilience, wellbeing, or conduct problems. In comparison, trauma-exposed non-migrants showed detriments relative to trauma-exposed migrant peers for all of these measures. In conclusion, the survey tool was found to be reliable and acceptable for use in international studies of different samples of adolescent migrants. Overall, migrant adolescents showed greater resilience resources than non-migrants and, although the migrants experienced more traumatic events, the impact of trauma on mental health outcomes was greater in the non-migrants. There is a need for further research with larger prospective sample sizes to investigate how levels of resilience and wellbeing vary over time and across countries, and the ways resilience can be promoted in adolescents exposed to trauma, regardless of migrancy status.

Traumatic life events and development of post-traumatic stress disorder among female factory workers in a developing country.

Post-traumatic stress disorder (PTSD) may be more prevalent and burdensome in developing countries. The goals of this study were to (1) determine the prevalence of PTSD, (2) identify types and number of traumas related to screening positive for PTSD and (3) determine other sociodemographic risk factors and health/medical conditions that may be correlated to PTSD among garment-factory workers and a comparable working population in Bangladesh. A survey was administered to a convenient sample of 607 lower socio-economic status (SES) working women in Bangladesh, 310 of who were garment workers. The primary outcome PTSD was measured by the PTSD Checklist. The Life Events Checklist determined the number and type of traumatic events. The prevalence of PTSD was found to be 17.79% - 7.25% in garment workers and 21.55% in the comparison worker group. In multivariate analysis, PTSD was found to be significantly associated with age, income, chronic pain and number of stressful events. Participants between 45-50 years of age had the greatest odds of reporting PTSD - 15.68 fold (95% confidence interval (CI) = 4.08, 60.29) compared with those younger than 24 years. PTSD was more common in those with lower income (2,000-4,000 taka) (odds ratio (OR) = 1.60; 95% CI = 0.79, 3.26), who had chronic pain (OR = 2.48; 95% CI = 1.51, 4.07) and who experienced over three traumatic life events (OR = 11.25; 95% CI = 4.59, 27.59). The mean number of traumatic events experienced by this entire population was 4.9 with PTSD being more likely in those who experienced physical assault (OR = 6.35; 95% CI = 4.07, 9.90), who caused serious harm or death to someone else (OR = 4.80; 95% CI = 1.36, 16.87) and who had exposure to combat or war (OR = 4.76; 95% CI = 1.17, 19.34). Undiagnosed and untreated PTSD impacts the quality of life and decrease worker productivity among working-age women in this developing country.

Trauma exposure, posttraumatic stress disorder and risk for alcohol, nicotine, and marijuana dependence in Israel

BackgroundSubstance dependence is more common among trauma-exposed individuals; however, most studies suggest that Posttraumatic Stress Disorder (PTSD) accounts for the link between trauma exposure (TE) and substance dependence. ObjectivesThis study examined associations between TE and substance dependence (alcohol, nicotine, and marijuana), and whether PTSD accounted for this association. Method1317 Jewish Israeli household residents completed in-person structured interviews assessing TE, PTSD, and substance (alcohol, nicotine, marijuana) dependence between 2007 and 2009. Regression analyses examined associations among TE, PTSD, and substance dependence. ResultsIn the full sample, mean number of traumatic events was 2.7 (sd=2.2), with 83.7% experiencing at least one event. In the full sample, mean number of PTSD symptoms was 2.5 (sd=3.4), with 13.5% meeting PTSD diagnostic criteria. Prevalence of alcohol dependence was 13.4%; nicotine dependence 52.8%; and marijuana dependence 12.1%. Number of traumatic events was associated with increased odds of alcohol (OR=1.3; 95% CI=1.2–1.4) and nicotine (OR=1.2; 95% CI=1.1–1.3) dependence. Similarly, any traumatic event exposure was associated with increased odds of alcohol (OR=3.1; 95% CI=1.6–6.0) and nicotine (OR=1.9; 95% CI=1.2–2.9) dependence. PTSD symptoms were associated with increased odds of alcohol (OR=1.2; 95% CI=1.1–1.3), nicotine (OR=1.1; 95% CI=1.1–1.2), and marijuana (OR=1.1; 95% CI=1.04–1.2) dependence; similarly, a PTSD diagnosis was associated with increased odds of alcohol (OR=3.4; 95% CI=2.1–5.5), nicotine (OR=2.2; 95% CI=1.4–3.4), and marijuana (OR=2.6; 95% CI=1.2–5.9) dependence. PTSD symptoms accounted for a sizeable proportion of the TE effect on alcohol (46%) and nicotine dependence (31%). ConclusionIndividuals with more traumatic events had heightened risk for alcohol and nicotine dependence, and PTSD symptoms partially accounted for this risk. However, marijuana dependence was only significantly related to PTSD symptoms. Clinicians and researchers should separately assess different types of dependence among trauma-exposed individuals both with and without PTSD symptoms.

Posttraumatic stress among Palestinian adolescents in the Gaza Strip: An analysis of event-related and demographic factors

Objective: This study investigates the impact of ongoing traumatic events on Palestinian adolescents’ posttraumatic stress according to event-related and demographic factors. Method: A sample of 368 Palestinian adolescents (49.2% males, mean age 17.03) was drawn from different areas of the Gaza Strip. Students were investigated on exposure to traumatic events and posttraumatic stress symptoms (PTSS) and disorder (PTSD). Results: The mean number of traumatic events experienced by the adolescents was 9.9 (SD = 3.20). Boys were significantly more exposed than girls, as were adolescents living in villages compared to those living in Gaza city or refugee camps. Adolescents mainly and pervasively experienced objective, non-personal material exposure (such as witnessing bombardments) (85% to 96%) and media exposure (95%). Up to 17% of the adolescents experienced direct, physical exposure (7% personal injury), exposure through injury and death of relatives. In this context, two fifths of the adolescents experienced mild, two fifths moderate and one fifth severe PTSS. Remarkably, adolescents did not differ significantly in PTSS despite exposure differences across gender, place of residency and family income. Conclusion: Near half of the investigated adolescents living in the Gaza Strip experience moderate to severe levels of posttraumatic stress, for around one fifth this amounts to a probable posttraumatic stress disorder. These findings urge toward providing psychological support programs to Palestinian adolescents to enhance current wellbeing and limit further developmental risks. Furthermore, the findings suggest the need to investigate the role of appraisal and coping to understand the pathways through which differences in trauma exposure lead to similar posttraumatic stress outcomes.

A Preliminary Exploration of Trauma, Dissociation, and Positive Psychotic Symptoms in a Spanish Sample

The purpose of this research was to study traumatic and dissociative experiences in a sample of Spanish psychotic patients. A total of 37 psychotic patients filled out the Dissociative Experiences Scale (E. B. Carlson & F. W. Putnam, 1993), a questionnaire on traumas (J. R. E. Davidson, D. Hughes, & D. G. Blazer, 1990), and the Positive and Negative Syndrome Scale delusion and hallucinations items (S. R. Kay, L. A. Opler, & J. P. Lindenmayer, 1988). The results showed that 40.5% of the subjects in the sample had undergone at least 1 traumatic experience as children and 64.9% had as adults. Patients with hallucinations had experienced a higher mean number of childhood traumatic experiences than patients without hallucinations. No significant difference in the mean number of traumatic events was found between patients with and without delusions. There was no significant difference in the mean number of adulthood traumatic events between patients with and without hallucinations and delusions. Subjects with childhood traumas scored higher on the Dissociative Experiences Scale than those who had had such experiences as adults. Patients with hallucinations and delusions also scored higher on the dissociation scale than patients who did not show those positive psychotic symptoms.

Impact of Self-Reported Life Events on the Profile of Opioid Dependence Syndrome

Aim: The aim of this work was to investigate the impact of life events on the profile of opioid dependent patients. Method: Recruitment was achieved through outpatient drug treatment clinic in Birmingham, UK, and data were collected through semistructured interviews. One-hundred and twenty subjects with opioid dependence syndrome were interviewed, and 100 controls of non-drug-using family members and friends. Result: The mean age of the opioid group was 33.3 years, SD = 8.8. The majority individuals of the sample were White British (80.8%), unemployed (69.2%), and male (75%). The mean severity of dependence as measured by two scales indicated severe level of dependence according to the authors of each scale. The mean number of traumatic events for the opioid dependence group was 4.8, SD = 3.57 vs. 3.55; SD = 3.65 in control group with significant difference (t = 2.56, df = 218, p = .01). Significant predictors of severe opioid dependency were age of second exposure to events, change of residence, break-up with boy/girlfriend, and conflict with father. Conclusion: The data presented indicate that a significant group of opioid dependent patients experience adverse life events in both childhood and adulthood. It is by attending to and addressing these issues that health care workers can alleviate ongoing distress and promote confidence.

Characteristics of traumas and PTSD symptom among perpetrators of domestic violence

Objective To explore characteristics of traumatic events and posttraumatic stress disorder (PTSO)symptom among perpetrators of domestic violence(DV).Methods A structured psychiatric interview,self-report Traumatic Life Events Questionnaire(TLEQ)and Impact of Event Scale-revised(IES-R)were administered to 50 male perpetrators of DV and 80 controls matched by age,education and family structure,who were selected from certain community in Mianyang city,Sichuan province,China.Results (1)80%of perpetrators of DV(n=40)had experienced more than three traumatic events,significantly higher than that in the controls (46.2%)(x2=21.70,P=0.000),and the mean number of traumatic events in perpetrators of DV was significantly higher than that in the controls(5.5:3;Z=3.94,P=0.000).(2)The perpetrators of DV had experienced more types oftraumatic events than the controls,such as sudden death of a close friend or aloved one(x2=3.74),witness to domestic violence(x2=6.24),intimate partner abuse(x2=10.06)and childhood sexual abuse(x2=4.53～8.45),with all significant differences(P＜0.05).(3)The total score of IES-R and its'three subscale sores among perpetrators of DV were all significantly higher than those among the controls(P＜0.05).Conclusion In the perpetrators of DV,exposure to traumatic events were very conunon.The importance of screening and early intervention and prevention programmes for psychological traumas among perpetrators of DV was highly emphasized. Key words: Domestic violence; Cross-section survey; Psychological trauma; Childhood abuse

Trauma and Posttraumatic Stress Disorder in a Rural Primary Care Population in South Africa

The aim of this study was to assess trauma events experienced and PTSD among 250 consecutive rural primary clinic patients (all Black Africans, 24% male and 76% female; M age 31.1 yr., SD = 11.8; range 18-65 years) in South Africa using the Trauma History Questionnaire and the PTSD Checklist-Civilian Version, interview administered. Results indicated that the mean number of traumatic events reported was 3.5 (SD = 2.9, range = 0-19) and was significantly higher among men (M= 4.9, SD = 3.5) than women (M = 3.0, SD = 2.6). Among the most frequently endorsed traumas among men were seeing someone seriously injured or killed (60%), serious accident (43.3%), and seeing dead bodies (43.3%), and among women natural disaster (mostly floods) (51.6%), news of a serious injury, life-threatening illness or unexpected death of someone close (31.1%), and seeing someone seriously injured or killed (30%). A current diagnosis of PTSD was found in 12.4% of the sample. Trauma incidence figures were high (M = 3.5) and were comparable with an urban Xhosa primary care population in South Africa (M = 3.8). A current indicative diagnosis of PTSD of 12.4% also compares with other studies; 19.9% among urban Xhosa primary care patients and 11.8% among American primary care patients.

TRAUMA AND POSTTRAUMATIC STRESS DISORDER IN A RURAL PRIMARY CARE POPULATION IN SOUTH AFRICA1,2

The aim of this study was to assess trauma events experienced and PTSD among 250 consecutive rural primary clinic patients (all Black Africans, 24% male and 76% female; M age 31.1 yr., SD = 11.8; range 18–65 years) in South Africa using the Trauma History Questionnaire and the PTSD Checklist-Civilian Version, interview administered. Results indicated that the mean number of traumatic events reported was 3.5 (SD = 2.9, range = 0–19) and was significantly higher among men (M = 4.9, SD = 3.5) than women (M = 3.0, SD = 2.6). Among the most frequently endorsed traumas among men were seeing someone seriously injured or killed (60%), serious accident (43.3%), and seeing dead bodies (43.3%), and among women natural disaster (mostly floods) (51.6%), news of a serious injury, life-threatening illness or unexpected death of someone close (31.1%), and seeing someone seriously injured or killed (30%). A current diagnosis of PTSD was found in 12.4%) of the sample. Trauma incidence figures were high (M = 3.5) and were comparable with an urban Xhosa primary care population in South Africa (M = 3.8). A current indicative diagnosis of PTSD of 12.4%) also compares with other studies; 19.9% among urban Xhosa primary care patients and 11.8% among American primary care patients.

Prevalence and Characteristics of Trauma and Post-Traumatic Stress Symptoms in Operational Members of the South African National Defence Force

The prevalence of traumatic event exposure and post-traumatic stress disorder (PTSD) were surveyed in a cohort of 198 full-time operational members of the South African National Defence Force stationed in their "home" unit between deployments. Approximately 90% of members reported having experienced or witnessed trauma in their lifetime (mean number of traumatic events = 4.3 +/- 3.2), whereas 51% reported having inflicted trauma. Twenty-six percent met diagnostic criteria for PTSD on self-report with approximately 29% with PTSD also meeting diagnostic criteria for depression. Few members, however, sought help. PTSD symptom severity was best predicted by trauma type (exposure to physical assault and infliction of life-threatening injury). These findings highlight the high rates of exposure to multiple, noncombat-related trauma in military personnel, the potentially high rates of PTSD, and the role of inflicted trauma as an additional risk factor for PTSD.