Pervasive Trauma Research Articles

Profiles of refugee-related trauma exposure and depression among North Korean refugees in South Korea: A latent class analysis.

North Korean refugees (NKRs) exhibit alarmingly high levels of depression prior to or immediately after entering South Korean society, which is likely attributable to their pre-migration traumatic experiences. However, prior research on NKRs has simply examined the cumulative effect of trauma on depression. Despite calls for research identifying trauma exposure patterns that co-occur among refugees, to date, no study has investigated distinct profiles of NKRs' pre-migration trauma exposure and their associations with depression in this high-risk population. To better understand the unique mental health needs of NKRs and provide them with tailored care, it is imperative to identify meaningful subgroups of NKRs with distinct profiles of trauma exposure. Using latent class analysis (LCA), which is a person-centered approach, this study aimed to identify subgroups of NKRs based on trauma exposure and their associations with sociodemographic characteristics and depression levels. A sample of NKRs (N = 405) in South Korea were assessed for depression, pre-migration trauma, and sociodemographic covariates through a self-administered survey. LCA was conducted to identify trauma exposure classes and multivariate ordinary least squares regression analysis was performed to examine associations between trauma exposure classes and depression. The prevalence of clinically significant depression was 47.2% for our study sample. Three classes of trauma were identified: deprivation trauma and witnessing death (59.3%), complex and pervasive trauma (23.7%), and low exposure (17.0%). Members in the complex and pervasive trauma class demonstrated very high probabilities of exposure to all traumatic events and had the strongest association with elevated depression. Our findings underscore the importance of identifying subgroups of NKRs to unravel heterogeneity in trauma exposure and provide more nuanced explanations for different risk profiles regarding depression. These findings also provide evidence for a framework for clinicians to provide individualized resources and trauma-informed services to NKRs.

The function of power: A herstorical model of power, trauma, and policing African Americans.

Transmitting trauma narratives is intergenerational by nature. Few studies have taken a qualitative approach to analyzing the most pervasive trauma of the United States: the chattel slavery of Black people. Examining the lived experiences of the formerly enslaved, through their childhood and adult narrative memories of personal and second-hand interactions with White authority figures, is critical to the recognition of today's ongoing impact of policing, generational trauma, and mental health in the African American community. Using interviews archived in the Library of Congress from women (N = 19) who were identified as being members of the last living generation of formerly enslaved African Americans, researchers used a feminist-forward grounded theory methodology to understand the following: (a) What are the historical relationships between African Americans and White authority figures? (b) What are the memories associated with the interactions between African Americans and White authority figures? (c) How did these interaction processes come to be? and (d) How did these memories get passed on? The analysis of childhood memories and interactions between enslavers and African Americans close to home (i.e., on the plantation) produced six themes: (a) enmeshment with enslaver, (b) enslaver as good, (c) caretaking by enslaver, (d) enslaver control, (e) violent control by policing figures, and (f) following orders. Theoretical coding led to the formation of a full model of the function of power within the herstorical policing of African Americans close to home. The themes uncovered highlight the potentially traumatic violence and control that characterized the environment in which enslaved children lived and the systems through which White power was maintained. The herstorical analysis and results confirm the ways police violence has sought to control and harm African Americans for over 400 years and underscores the role that police violence has played in the perpetuation of intergenerational trauma and the maintenance of White power. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of Racial Trauma on Black Students’ College and Career Outcomes: An Antiracist Approach

Black students experience a unique form of pervasive trauma based on their racial identity. Discrimination—a social determinant of health (Social determinants of health)—results in racial trauma that negatively affects students’ college and career outcomes, such as career adaptability, career thoughts, career decision making, and postsecondary attainment. We share recommendations for school counselors to adopt an antiracist and trauma-informed approach to implementing career development interventions that address SDOH-related challenges for Black students.

"No safe place": Applying the transactional stress and coping model to active warfare.

The mental health consequences of political violence arise within active, dynamic processes of appraisal and coping. Understanding the psychological sequela of war is an urgent task; yet, we have little on the ground exploration of the quotidian events within and the accompanying psychological responses of the totalizing experience of war. Using a transactional-based model of stress and coping, in this study, we use a novel method-retrospective diaries-to explore the shifting, unpredictable, and traumatic nature of life during a major military operation. Our sample consisted of 21 Palestinian women recruited via an intervention for teachers in Gaza. Women's retrospective chronological diaries were analyzed using content analysis. Our analysis drew out the cyclical process of coping within political violence, demonstrating five essential temporal dimensions: warning; bombings, with injuries, death, and destruction; reintegrating within flight and resettlement; ongoing political insecurity within precarious truces and rampant loss and destruction; and persevering: restarting life amid pervasive trauma. Our findings draw attention to vital temporal dimensions and the cyclical nature of stress and coping that underlie the sequela of mental health in a highly charged context. In tracing warfare, its psychosocial consequences, and distinct patterns of emotional and logistical survival, our study contributes to the growing field of psychological epidemiology of war. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Refugee-related trauma patterns and mental health symptoms across three generations of Hmong Americans.

Hmong adults who are Vietnam War refugees have been exposed to refugee-related trauma, but little is known about associations between patterns of trauma exposure and mental health outcomes in Hmong adults. We examined patterns of trauma exposure and mental health symptoms (i.e., somatization, depression, anxiety, and probable posttraumatic stress disorder [PTSD]) in three generations of Hmong adults (N = 219). Trauma exposure and probable PTSD were measured using the Harvard Trauma Questionnaire-Hmong Version. Somatization, depression, and anxiety symptoms were measured using the Brief Symptom Inventory. Latent class analysis (LCA) and auxiliary analysis of sociodemographic characteristics and mental health symptoms were performed. The best-fitting LCA model described three distinct classes: complex and pervasive trauma (60.3%), combat situation and deprivation trauma (26.0%), and low exposure to refugee-related trauma (13.7%). Participants in the complex and pervasive trauma class were the oldest, had the shortest U.S. residency, were the least proficient in English, and reported the most severe mental health symptoms; those in the combat situation and deprivation trauma class were the youngest, moderately proficient in English, and reported moderate mental health symptoms; and those in the low exposure to refugee-related trauma class were the most proficient in English, had the longest U.S. residency, and reported the least severe mental health symptoms. Our findings call for surveillance and a trauma-informed approach for Hmong elders with limited English proficiency, who have a high risk of experiencing accumulative effects of refugee-related trauma and are susceptible to poor mental health outcomes.

Profiles of exposure to potentially traumatic events in refugees living in Australia.

Refugees and asylum-seekers are typically exposed to multiple potentially traumatic events (PTEs) in the context of war, persecution and displacement, which confer elevated risk for psychopathology. There are significant limitations, however, in extant approaches to measuring these experiences in refugees. The current study aimed to identify profiles of PTE exposure, and the associations between these profiles and key demographics, contextual factors (including ongoing stressors, method of travel to Australia and separation from family), mental health and social outcomes, in a large sample of refugees resettled in Australia. Participants were 1085 from Arabic, Farsi, Tamil and English-speaking refugee backgrounds who completed an online or pen-and-paper survey in their own language. Constructs measured included PTE exposure, demographics, pre-displacement factors, ongoing stressors, post-traumatic stress disorder symptoms, depression symptoms, anger reactions, plans of suicide and social engagement. Latent class analysis identified four profiles of PTE exposure, including the torture and pervasive trauma class, the violence exposure class, the deprivation exposure class and the low exposure class. Compared to the low exposure class, participants in the trauma-exposed classes were more likely to be male, highly educated, from Farsi and Tamil-speaking backgrounds, have travelled to Australia by boat, experience more ongoing stressors and report both greater psychological symptoms and social engagement. This study found evidence for four distinct profiles of PTE exposure in a large sample of resettled refugees, and that these were associated with different demographic, psychological and social characteristics. These findings suggest that person-centred approaches represent an important potential avenue for investigation of PTE exposure in refugees, particularly with respect to identifying subgroups of refugees who may benefit from different types or levels of intervention according to their pre-migration PTE experiences.

Adverse childhood experiences and domain-specific cognitive function in a population-based study of older adults in rural South Africa.

Research on early life adversity and later-life cognitive function is conflicting, with little evidence from low-income settings. We investigated associations between adverse childhood experiences and cognitive function in an older population who grew up under racial segregation during South African apartheid. Data were from 1,871 adults aged 40-79 in the population-representative "Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa" in 2015. The adverse childhood experiences were having a parent unemployed for > 6 months; having parents who argued or fought often; having a parent who drank excessively, used drugs, or had mental health problems; and physical abuse from parents. Executive function, language, visuospatial ability, and memory were assessed with the Oxford Cognitive Screen-Plus, a validated cognitive assessment designed for low-income, low-literacy settings. We estimated associations between adverse childhood experiences and latent cognitive domain z-scores using multiple-indicator, multiple-cause structural equation models. Childhood adversities were reported by 15% (parental unemployment for > 6 months), 25% (parents argued or fought often), 25% (a parent drank excessively, used drugs, or had mental health problems), and 35% (physical abuse from parent) of respondents. They were not associated with cognition, except that having a parent who drank excessively, used drugs, or had mental health problems was associated with lower memory z-scores (-0.07; 95% CI [-0.13, -0.01]). This is one of the first investigations into later-life cognitive outcomes associated with early adversity in a population with a historical context of pervasive trauma, and suggests that later-life memory may be vulnerable to early adversity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Iwankapiya American Indian pilot clinical trial: Historical trauma and group interpersonal psychotherapy.

American Indians face pervasive trauma exposure, collective histories of communal suffering, and elevated risk for depression and posttraumatic stress disorder. In addition to socioeconomic barriers, access to culturally responsive treatment is limited, which may compromise treatment engagement. The Iwankapiya study piloted the Historical Trauma and Unresolved Grief Intervention (HTUG), combined with Group Interpersonal Psychotherapy (IPT), to reduce symptoms of depression and related trauma and grief. The study hypothesized that HTUG + IPT would lead to greater group engagement and decreased depression and related symptoms compared with IPT-Only. American Indian adults (n = 52) were randomized into one of two 12-session interventions, HTUG + IPT or IPT-Only, at two tribal sites: one Northern Plains reservation (n = 26) and one Southwest urban clinic (n = 26). Standardized measures assessed depression, posttraumatic stress disorder, grief, trauma, and substance use. Data were collected at screening, baseline, end of intervention, and 8 weeks postintervention; depression and group engagement measures were also collected at Weeks 4 and 8 of the intervention. Depression scores significantly decreased for both treatments, but there were no significant differences in depression between the two groups: IPT-Only (30.2 ± 6.4 at baseline to 16.7 ± 12.1 at follow-up) and HTUG + IPT (30.2 ± 8.1 at baseline to 19.9 ± 8.8 at follow-up). However, HTUG + IPT participants demonstrated significantly greater group engagement. Postintervention, clinicians expressed preference for HTUG + IPT based upon qualitative observations of greater perceived gains among participants. Given the degree of trauma exposure in tribal communities, these findings in a relatively small sample suggest HTUG should be further examined in context of treatment engagement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

From Punk Love to Compa Love: A Pedagogical Paradigm to Intervene on Trauma

Emerging research shows that the number of young people experiencing trauma is alarmingly high and continuously increasing. In the midst of such pervasive trauma, teachers generally—and particularly in urban schools—must be equipped with a language and paradigm that prepares them to intervene in the traumatic stressors impacting the lives of students. Recent educational and trauma—informed scholarship suggest that in order for young people to heal from trauma and develop higher levels of resiliency, they must be around loving adults. By drawing from research that spans the fields of public health, psychiatry, psychotherapy, and education, as well as literature about love, critical pedagogy, and culturally sustaining pedagogies, I theorize and illustrate how Compa Love is a framework that enables us to practice love as an intervention to trauma within the context of urban classrooms.

Terapia di coppia e trattamento del disturbo post-traumatico del partner

This contribution tells about a couple therapy required for obvious relational difficulties (bad communication, absent sexual intercourse, violation of the couple’s contract, ecc.) that after consultation faces the need to deal with the prolonged and pervasive trauma of one of the partners. It was decided not to send to another colleague for individual therapy, but to work both in the individual and the couple format to aim at securing and trauma processing. Couple therapy becomes a widening and safe base to treat a partner’s post traumatic behavior. The concept of wounded child is central, that is, unresolved post traumatic individual suffering, which helps us to better understand what is behind the couple stalemate, a tangle between the visible and the concealed, that Mara Selvini Palazzoli called an iron clad door.

The impact of patterns of trauma exposure among low income children with and without histories of child maltreatment

Previous research has revealed a large prevalence of trauma experienced by children, creating high risk for the development of psychopathology. Research investigating the negative impacts of child maltreatment and other traumas has typically examined these experiences individually, controlling for co-occurring traumas, or has combined these experiences into a general variable of risk, thereby obscuring the complex relationships among environmental traumas and maltreatment. The current study expands on previous research by elucidating relationships between multiple contexts of overlapping traumas and maltreatment experienced by children, and by categorizing how these experiences join together to impact internalizing and externalizing symptomatology. Participants included 316 maltreated children and 269 nonmaltreated children (M age = 9.4, SD = 0.88) who attended a summer day camp research program for low-income children. Latent Class Analysis (LCA) identified three differential patterns of trauma exposure across children: 1) community violence and loss; 2) pervasive trauma; and 3) low trauma. Covariate analyses demonstrated that child maltreatment was significantly associated with class membership, suggesting that maltreated children were more likely to experience diverse traumas extending beyond their maltreatment experiences (pervasive trauma class). A two-way analysis of variance also demonstrated that trauma latent class membership and child maltreatment each represented unique predictors of internalizing and externalizing symptoms, with each having an independent effect on symptomatology. This investigation provides unique insight into the differential impact of patterns of trauma exposure and child maltreatment, providing support for further research and clinical practice addressing multiple levels of a child’s ecology.

Baltimore Health Department Helps Affected Citizens After Riots

Baltimore Health Department Helps Affected Citizens After Riots

I Know That my Redeemer Lives: Relational Perspectives on Trauma, Dissociation, and Faith

This paper focuses the lens of multiplicity on patients’ religious experience in relation to the psychic realities of early or pervasive trauma, where dissociation is not just a normal means of self-regulation, but becomes an entrenched structuring mechanism through which the trauma survivor experiences every relationship, including any relationship to God. What might God or faith look like from the perspective of the traumatized self? This paper considers issues of multiplicity and dissociation as they affect the processing of religious or spiritual experience, with a few brief clinical illustrations, and offers a reading of the biblical book of Job as a metaphor for the inner world of the survivor of early trauma.

Pervasive trauma exposure among US sexual orientation adults linked to posttraumatic stress disorder risk

Pervasive trauma exposure among US sexual orientation adults linked to posttraumatic stress disorder risk

Pervasive Trauma Exposure Among US Sexual Orientation Minority Adults and Risk of Posttraumatic Stress Disorder

We assessed sexual orientation disparities in exposure to violence and other potentially traumatic events and onset of posttraumatic stress disorder (PTSD) in a representative US sample. We used data from 34 653 noninstitutionalized adult US residents from the 2004 to 2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions. Lesbians and gay men, bisexuals, and heterosexuals who reported any same-sex sexual partners over their lifetime had greater risk of childhood maltreatment, interpersonal violence, trauma to a close friend or relative, and unexpected death of someone close than did heterosexuals with no same-sex attractions or partners. Risk of onset of PTSD was higher among lesbians and gays (adjusted odds ratio [AOR] = 2.03; 95% confidence interval [CI] = 1.34, 3.06), bisexuals (AOR = 2.13; 95% CI = 1.38, 3.29), and heterosexuals with any same-sex partners (AOR = 2.06; 95% CI = 1.54, 2.74) than it was among the heterosexual reference group. This higher risk was largely accounted for by sexual orientation minorities' greater exposure to violence, exposure to more potentially traumatic events, and earlier age of trauma exposure. Profound sexual orientation disparities exist in risk of PTSD and in violence exposure, beginning in childhood. Our findings suggest there is an urgent need for public health interventions aimed at preventing violence against individuals with minority sexual orientations and providing follow-up care to cope with the sequelae of violent victimization.

Clinical applications of the attachment framework: Relational treatment of complex trauma

The self and attachment difficulties associated with chronic childhood abuse and other forms of pervasive trauma must be understood and addressed in the context of the therapeutic relationship for healing to extend beyond resolution of traditional psychiatric symptoms and skill deficits. The authors integrate contemporary research and theory about attachment and complex developmental trauma, including dissociation, and apply it to psychotherapy of complex trauma, especially as this research and theory inform the therapeutic relationship. Relevant literature on complex trauma and attachment is integrated with contemporary trauma theory as the background for discussing relational issues that commonly arise in this treatment, highlighting common challenges such as forming a therapeutic alliance, managing frame and boundaries, and working with dissociation and reenactments.

Sexual abuse trauma among Chinese survivors

Objective: As an initial effort to examine Chinese sexual abuse trauma in relation to the cultural construction of sexual victimization of women, this study applies Finkelhor and Browne’s (1985) traumagenic dynamics model to examine post-abuse trauma among Chinese child and adolescent survivors in Taiwan. In analyzing sexual abuse trauma in the context of Chinese patriarchal familialism and cultural fetish for female chastity, this study attempts to explore cultural constructional process of sexual abuse in Chinese society. Method: This study conducted in-depth interviews with 19 survivors of, and three social workers on, sexual abuse in Taiwan. These interviews were guided by a semi-structured questionnaire on sexual abuse incidents and post-abuse responses/concerns, and had generated a total of 84 pages of written reports, which serve as the text-data for the analysis. Results: This study identifies sexual stigmatization and senses of disempowerment and betrayal as the most pervasive trauma complex among Chinese sexual abuse survivors in Taiwan. This study found that, in addition to lowering self-esteem, sexual stigmatization results in polarized sexuality among adolescent survivors, as manifested in aversion to and preoccupation with sexuality. The abuse-induced disempowerment is manifested in the survivors’ fear for personal safety and heightened sense of vulnerability to re-victimization. The sense of betrayal results in interpersonal difficulties as manifested in self-imposed isolation from others and/or suspicious attitudes toward others, which further impair the survivor’s efficacy in meeting her abuse-induced clinging need. Conclusions: Overall, this study observes similar traumatic symptoms between Chinese survivors and their American counterparts as documented in the literature. Nevertheless, this study observes the sexual stigmatization represents the most prevailing post-abuse trauma among Chinese sexual abuse survivors, and reflects the patriarchal fetish for female chastity in the Chinese cultural construction of sexual victimization.