Rates Of Trauma Exposure Research Articles

Pilot of a screening, brief intervention and referral to treatment process for symptoms of trauma among primary care patients.

For populations with high rates of trauma exposure yet low behavioural health service use, identifying and addressing trauma in the primary care setting could improve health outcomes, reduce disability and increase the efficiency of health system resources. To assess the acceptability and feasibility of a screening, brief intervention and referral to treatment (SBIRT) process for trauma and symptoms of posttraumatic stress disorder (PTSD) among American Indian and Alaska Native people. We also examine the short-term effects on service utilization and the screening accuracy of the Primary Care Posttraumatic Stress Disorder Screen. Cross-sectional pilot in two tribal primary care settings. Surveys and interviews measured acceptability among patients and providers. Health service utilization was used to examine impact. Structured clinical interview and a functional disability measure were used to assess screening accuracy. Over 90% of patient participants (N = 99) reported the screening time was acceptable, the questions were easily understood, the right staff were involved and the process satisfactory. Ninety-nine percent would recommend the process. Participants screening positive had higher behavioural health utilization in the 3 months after the process than those screening negative. The Primary Care Posttraumatic Stress Disorder Screen was 100% sensitive to detect current PTSD with 51% specificity. Providers and administrators reported satisfaction with the process. The SBIRT process shows promise for identifying and addressing trauma in primary care settings. Future research should explore site specific factors, cost analyses and utility compared to other behavioural health screenings.

Preliminary psychometrics of the Structured Trauma-Related Experiences and Symptoms Screener for Adults (STRESS-A) in an urban prenatal healthcare clinic.

The primary objective of the current study was to examine preliminary psychometric characteristics of the Structured Trauma-Related Experiences and Symptoms Screener for Adults (STRESS-A), a novel self-report instrument that inventories childhood and adulthood trauma-related experiences and assesses symptoms of posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual for Mental Disorders (5th ed.; [DSM-5] American Psychiatric Association, 2013). Designed for efficient administration and interpretation by nonclinically trained professionals, the STRESS-A is a promising tool for use in settings where mental health professionals are lacking. A sample of 170 women in their third trimester of pregnancy and receiving services at an urban prenatal health care clinic completed the STRESS-A and a battery of instruments measuring mental health functioning, perceived stress, and emotion dysregulation. Tests of reliability and validity were conducted, including confirmatory factor analysis to examine the fit of STRESS-A symptom criteria relative to PTSD symptom structures supported in the literature. Results provide initial support for internal consistency, reliability, and convergent and construct validity in a largely Hispanic pregnancy sample. The STRESS-A symptom structure fit well with several that have been supported in the literature, including the 4-factor model of the DSM-5. The STRESS-A is a promising tool for assessing risk associated with trauma exposure and probable DSM-5-based PTSD. Findings support its utility in a high-risk pregnancy cohort, a population that is underserved, yet shows high rates of trauma exposure and associated symptoms. Addressing maternal trauma-related impairment may have important implications for healthy fetal and child development. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Elder Abuse in American Indian Communities: An Integrative Review.

American Indian elders have one of the lowest life expectancies in the United States. Disproportionate disease burden, socioeconomic disparities, and higher rates of violence across the lifespan are thought to contribute to higher rates of elder abuse. Elder abuse and higher rates of trauma exposure are linked with adverse outcomes. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the methodology and assessment of the literature on elder abuse among American Indians. Of the nine studies published in the last 30 years, rates of elder abuse varied by study, location, and tribal affiliation from 4.3% to 45.9%. Large studies with comparison populations found higher rates for American Indians. There was a consensus for three risk factors: substance abuse, mental health problems, and caregiving issues. Importance of tribal norms, the notion of respect conferred to elders, and the concept of acculturation were major culturally relevant themes. Perceived tribal norms and strengths, for example, respect for elders, were at odds with abuse experiences, particularly financial exploitation and neglect. Historical trauma, shame, and fear impacted reporting. There was little consistency in study designs, most were qualitative or mixed methods, samples were small, there was no common measurement tool or time frame for abuse, and there was only one intervention study. High rates of abuse suggest healthcare providers should be encouraged to screen and intervene despite the lack of empirical evidence. Providers should not assume that traditional culturally ascribed strengths, such as honor and respect for elders, provide any degree of protection against elder abuse.

Investigating the Association Between Posttraumatic Risky Behavior and Offending in Adolescents Involved in the Juvenile Justice System.

Risky behavior is common among traumatized youth and is associated with juvenile offending. This study examined predictors of posttraumatic risky behavior, the unique contribution of posttraumatic risky behavior in predicting offending, and tested whether a distinct class of youth was characterized by high levels of posttraumatic risky behavior. Participants were 400 adolescents (25% girls) between the ages of 12 and 19 years old (M = 15.97, SD = 1.25) who were involved in the Utah juvenile justice system. Approximately 54% of the sample identified as an ethnic minority. Youth completed self-report measures of trauma exposure, posttraumatic risky behavior, posttraumatic stress symptom severity, and offending. Formal legal records of offending were also collected. The results indicated that female sex was significantly related to posttraumatic risky behavior, though age was not significantly associated with posttraumatic risky behavior. Age and ethnicity were associated with both self-reported and formal offending, and male sex was associated with formal offending. Posttraumatic risky behavior was not related to formal offending, but was related to self-reported offending in some of the tested models. Latent class analysis identified 92 youth characterized by high levels of posttraumatic risky behavior; these youth also evidenced the highest rates of trauma exposure, posttraumatic stress symptom severity, and self-reported offending. There were no ethnic, age, or sex differences between youth in the high and low posttraumatic risky behavior groups. These results add to the extant literature documenting the associations among exposure to trauma, posttraumatic stress, and juvenile offending.

Functional impairment as a proxy measure indicating high rates of trauma exposure, post-migration living difficulties, common mental disorders, and poor health amongst Rohingya refugees in Malaysia

A major challenge in the refugee field is to ensure that scarce mental health resources are directed to those in greatest need. Based on data from an epidemiological survey of 959 adult Rohingya refugees in Malaysia (response rate: 83%), we examine whether a brief screening instrument of functional impairment, the WHO Disability Assessment Schedule (WHODAS), prove useful as a proxy measure to identify refugees who typically attend community mental health services. Based on estimates of mental disorder requiring interventions from analyses of epidemiological studies conducted worldwide, we selected a WHODAS cutoff that identified the top one-fifth of refugees according to severity of functional impairment, the remainder being distributed to moderate and lower impairment groupings, respectively. Compared to the lower impairment grouping, the severe impairment category comprised more boat arrivals (AOR: 5.96 [95% CI 1.34–26.43); stateless persons (A20·11 [95% CI 7.14–10); those with high exposure to pre-migration traumas (AOR: 4.76 [95% CI 1.64–13.73), peri-migration stressors (AOR: 1.26 [95% CI 1.14–1.39]) and postmigration living difficulties (AOR: 1.43 [95% CI 1.32–1.55); persons with single (AOR: 7.48 [95% CI 4.25–13.17]) and comorbid (AOR: 13.54 [95% CI 6.22–29.45]) common mental disorders; and those reporting poorer general health (AOR: 2.23 [95% CI 1–5.02]). In addition, half of the severe impairment grouping (50.6%) expressed suicidal ideas compared to one in six (16.2 percent) of the lower impairment grouping (OR: 2.39 [95% CI 1.94–2.93]). Differences between the severe and moderate impairment groups were similar but less extreme. In settings where large-scale epidemiological studies are not feasible, the WHODAS may serve as readily administered and brief public health screening tool that assists in stratifying the population according to urgency of mental health needs.

Cumulative Trauma Exposure, Emotion Regulation, and Posttraumatic Stress Disorder Among Incarcerated Women.

Incarcerated women report high rates of trauma exposure and posttraumatic stress disorder (PTSD). Emotion regulation has been identified as a potential mechanism that contributes to the association between trauma exposure and PTSD severity. The present study examined associations among cumulative trauma exposure, emotion regulation difficulties, and current (30-day) PTSD in 152 randomly selected women in prison. Utilizing structural equation modeling (SEM), results indicated cumulative trauma was significantly associated with emotion regulation difficulties, β = .31, SE = .13, p = .005; and PTSD symptom severity, β = .41, SE = .14, p = .005. We identified a significant indirect effect, 0.11, z = 2.37, p = .018, of emotion regulation on the association between cumulative trauma exposure and severity of current PTSD symptoms. These findings are consistent with previous longitudinal research suggesting that emotion regulation is significantly affected by trauma exposure, and they support previously identified associations between emotion regulation difficulties and severity of PTSD. Further, these findings have the potential to inform current efforts to identify and implement effective PTSD-focused interventions with incarcerated women. In particular, it appears that emotion regulation skills may be an important component of effective PTSD focused interventions for this population.

Implementing Trauma Screening, Brief Intervention, and Referral to Treatment (T‐SBIRT) within Employment Services: A Feasibility Trial

Research suggests that low-income adults accessing employment services have experienced high levels of trauma exposure and associated consequences. Moreover, the health-related effects of trauma undermine employment and employability. A trauma-informed protocol-trauma screening, brief intervention, and referral to treatment or T-SBIRT-was therefore implemented within employment service programs serving low-income urban residents. To assess the feasibility of integrating T-SBIRT within employment services, five domains were explored as follows: suitability, acceptability, client adherence, provider adherence or fidelity, and intended outcomes. With a sample of low-income adults (N=83), the study revealed that T-SBIRT is suitable for employment service participants given high rates of trauma exposure (90.4% experienced two or more lifetime traumas), along with high rates of positive screening results for post-traumatic stress disorder (48.8%), major depression (35.4%), and generalized anxiety (47.6%). Study participants appeared to find T-SBIRT acceptable as evidenced by an 83% acceptance rate. All participants accepting T-SBIRT services completed them, revealing strong client adherence. Provider adherence or model fidelity was high, that is, 98.5%. Finally, the majority of participants accepted a referral to a mental health care (i.e., 56.6%), and over three-quarters accepted a referral to any outside service including primary or mental health care. Implications of findings are discussed.

Nightmares in Treatment-Seeking Youth: the Role of Cumulative Trauma Exposure.

Although nightmares are frequently endorsed symptoms in children who have experienced trauma, limited research has been conducted on how nightmares vary with different forms of trauma exposure. Our goal was to assess the relationship between nightmares, trauma exposure, and symptoms of Posttraumatic Stress Disorder (PTSD) in youth. A total of 4440 trauma exposed treatment-seeking youth (ages 7 to 18) were administered the UCLA PTSD Reaction Index. Different trauma types, total traumas experienced, and PTSD symptoms were analyzed with correlations and a logistic regression in relation to nightmare frequency. Overall, 33.1% of participants reported experiencing clinically-significant nightmares. 79.1% of the sample experienced more than one trauma type, with an average of 3.06 trauma types endorsed. A binary logistic regression demonstrated the odds of reporting clinically-significant nightmares increased by 1.3 times for every additional type of trauma experienced. Lastly, nightmares were positively correlated with all PTSD criterion. The current study provides prevalence rates of trauma exposure and nightmares in a large, statewide sample of treatment-seeking youth. Each new trauma type experienced resulted in a greater likelihood of endorsing clinically-significant nightmares. This study provides useful information related to assessing and addressing nightmares in youth who have experienced trauma.

(317) Development of a Semi-Structured Interview to Understand VA Treatment Barriers for Clinicians Treating Women Veterans with Fibromyalgia: A Qualitative Pilot Study

Fibromyalgia (FM) is a vexing pain condition that primarily impacts women with a history of trauma. Women veterans experience posttraumatic stress disorder in their lifetime almost twice as often as their civilian counterparts (13.4% vs. 8.0%). Due to their high rates of trauma exposure, women veterans are at an increased risk of developing FM, with rates higher than those in the civilian population (5.1% vs. 2.0%). The present pilot study seeks to identify preferences for care for women veterans with FM at the Boston VA Healthcare System (VABHS) through qualitative interviews with patients and health care providers. Data from patient interviews (n = 13) has identified several themes including a desire for improved multidisciplinary care and provider education on FM. Using this information, we developed a semi-structured interview script for providers who are most likely to serve as a primary care physician for FM patients including neurologists, rheumatologists, pain specialists, and women's health clinicians. The script also includes open-ended questions about provider knowledge of FM, preferred treatment options, utilization of multidisciplinary teams/resources, and successes and difficulties in providing optimal care to FM patients. Provider and patient interview data are expected to reveal details about the VABHS's efficacy in providing adequate care to an expanding population of women veterans. We hope to use this information to create educational materials on FM and methods to improve communication between providers. This project was funded by the Veterans Affairs Central Office. (Wolfe, Arthritis Rheumatol, 1995; Al-Allaf, Rheumatology, 2002; Lehavot, Am J Prev Med, 2018; Mohanty, Med Care, 2015)

Post-traumatic stress and related symptoms among juvenile detention residents: Results from intake screening

Juvenile justice-involved youth have high rates of trauma exposure, physical and sexual abuse and PTSD. Several factors have been found to be related to PTSD symptoms in youth including number and chronicity of traumatic events. To simultaneously examine the relationships between allostatic load (defined here as number of traumatic experiences), poly-victimization (exposure to two or more forms of victimization based on 5 of the 6 categories in Ford et al.'s 2010 study), physical/sexual abuse and PTSD in justice-involved youth. The sample consisted of 1984 youth in juvenile detention in a Northeastern city. The sample was 73.4% male and the majority of youth were either African American or Hispanic. Clinicians collected demographic and psychosocial information, and measured symptoms of PTSD, depression, and problematic substance use. Results showed that youth with more traumas, those who experienced poly-victimization and those who experienced physical/sexual assault/abuse were not only more likely to have PTSD, but also more likely to have depression, thoughts of suicide/self-harm, and problematic substance use (as indicated by the presence of 2 or more of 6 possible indicators). Poly-victimization was a stronger correlate of PTSD than number of traumas or physical/sexual assault/abuse. However, among youth with PTSD, number of traumas was associated with co-occurring problems while poly-victimization and physical/sexual assault/abuse were not. Findings can be used to help direct resources to juvenile justice-involved youth who are most in need of treatment.

Preliminary efficacy and mediators of interpersonal psychotherapy for reducing posttraumatic stress symptoms in an incarcerated population

Objective: Incarcerated individuals have high rates of trauma exposure. IPT reduces posttraumatic stress disorder (PTSD) symptoms in non-incarcerated adults, but has not been examined in prison populations. Moreover, little is known about the mechanisms through which IPT reduces PTSD symptoms. The current study investigated the direct and indirect effects of IPT on PTSD symptoms. We hypothesized that IPT would decrease PTSD symptoms by enhancing social support and decreasing loneliness (theorized IPT mechanisms). Method: A sub-sample of trauma-exposed participants (n = 168) were drawn from a larger randomized trial (n = 181) of IPT for major depressive disorder among prisoners. We examined a series of mediation models using non-parametric bootstrapping procedures to evaluate the indirect effect of IPT on PTSD symptoms. Results: Contrary to hypotheses, the relation between IPT and PTSD symptoms was significantly mediated through improvements in hopelessness and depressive symptoms (mechanisms of cognitive behavioral interventions), rather than through social support and loneliness. Increased social support and decreased loneliness were associated with decreased PTSD symptoms, but IPT did not predict changes in social support or loneliness. Conclusions: IPT may reduce PTSD symptoms in depressed prisoners by reducing hopelessness and depression. (ClinicalTrials.gov number NCT01685294)

Abstract P6-15-01: Military sexual trauma is associated with an increased prevalence of mastectomy versus breast conserving surgery in a population of female veterans with early stage breast cancer

Abstract Background: The National Accreditation Program for Breast Centers (NAPBC), in a 2014 statement of standards, endorsed breast conservation surgery (BCS) for women with AJCC stage 0,I, or II breast cancer, with a target of 50% BCS. Women comprise the fastest growing segment of Veteran's Health Administration (VA) enrollees, and have high rates of trauma exposure including military sexual trauma (MST). The VA conducts universal screening of all Veterans for MST. Implications for medical care, e.g. an increased rate of hysterectomy among survivors of MST, have been reported. While the numbers of breast cancers treated in VA are relatively small compared to non-VA centers, a trend toward decreasing rates of BCS in VA from 2000-2006 has been reported. Reasons for declining rates of BCS within VA, and the lower rates of BCS in the VA compared to the private sector remain unclear. The objective of this study was to identify determinants of mastectomy versus BCS in women Veterans with early stage breast cancer and to examine whether history of MST was associated with choice of mastectomy versus BCS. Methods: As a quality improvement study, we conducted a retrospective review of all early-stage (0,I,II) female breast cancer patients identified in the tumor registry between 2006-2015 at one Northeastern VA to determine rates of mastectomy and BCS. Through chart review, we examined potential determinants of BCS including age, stage, distance from treating VA facility, genetic testing, contralateral prophylactic mastectomy, and reconstructive surgery. History of MST was documented through chart review. Analyses were performed using unpaired t-test for age and distance from treatment facility and Fisher's exact test for significance comparing history of MST between surgical groups. Results: 70 women with early stage breast cancer were eligible for BCS. Of these, 39 underwent BCS and 31 underwent mastectomy (55% rate of BCS). Age and distance to treating VA were not significant. Women who underwent mastectomy were on average younger (p=0.21) and lived farther away (p =0.42) and were more likely to undergo genetic testing. Of the women who underwent genetic testing (10/70), none had mutations. The biggest difference seen between surgical groups was in history of MST, with women in the mastectomy group having more than twice the prevalence of MST, 58%, vs 31% in the BCS group (p = 0.0154 ). Patient characteristics by type of surgery performed BCS N=39Mastectomy n=31Age (mean)63.559.3Distance from VA56.7 miles67.7 milesGenetic testing (no mutations found)4 (10%)6 (19%)Reconstructive surgery05Prophylactic contralateral mastectomy011MST11(28%)18(58%) Conclusion: These data suggest that MST is associated with choice of mastectomy over BCS. MST results in poor body image which may impact decisions about breast surgery. Trauma-informed strategies for counseling women about options for surgical management of early stage breast cancer may be needed to ensure that women with MST and other forms of trauma pursue evidence-based cancer treatment. Further work with a larger cohort is needed to better understand these findings. Citation Format: Oshry LJ, Naomi K, Megan GR. Military sexual trauma is associated with an increased prevalence of mastectomy versus breast conserving surgery in a population of female veterans with early stage breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-15-01.

Attention bias toward threatening faces in women with PTSD: eye tracking correlates by symptom cluster

ABSTRACT Maladaptive patterns of attention to emotional stimuli are a common feature of posttraumatic stress disorder (PTSD), with growing evidence supporting sustained attention to threatening stimuli across trauma samples. However, it remains unclear how different PTSD symptom clusters are associated with attentional bias patterns, particularly in urban civilian settings with high rates of trauma exposure and PTSD. The present study examined associations among these variables in 70 traumatized primarily African American women. PTSD was measured using the Clinician Administered PTSD Scale, and eye tracking was used to measure patterns of attention as participants engaged in an attention bias (dot probe) task to emotional faces; average initial fixation (1 s) and dwell duration (overall time spent looking at emotional face versus neutral face across the 5 s task) were used to assess attention bias patterns toward emotional faces. Women with PTSD showed significantly longer dwell duration toward angry faces than women without PTSD (F = 5.16, p < .05). Bivariate correlation analyses with the PTSD symptom clusters showed a significant association between average initial fixation toward angry faces and higher levels of avoidance symptoms (r = 0.29, p < .05) as well as sustained attention to angry faces and higher levels of re-experiencing symptoms (r = 0.24, p < .05). Using separate linear regression models based on initial significant correlations, we found that PTSD avoidance symptoms were significantly related to average initial fixation toward angry faces (R 2 ∆ = 0.09, p < .05) and PTSD re-experiencing symptoms were significantly related to dwell duration toward angry faces (R 2 ∆ = 0.06, p < .05). These findings contribute to evidence that PTSD is related to both initial vigilance and sustained attention to threat and that certain symptom clusters may either drive or be more impacted by attentional biases, highlighting the benefits of addressing attentional biases within treatment.

What Trauma Looks Like for Incarcerated Men: A Study of Men's Lifetime Trauma Exposure in Two State Prisons.

While it is understood that high rates of trauma exposure are common among incarcerated male populations, there is limited data on the nature of the trauma exposure. This study sought to develop foundational knowledge about the trauma experiences of incarcerated men in order to provide a basis for further theory building in this area. This study used a quantitative-qualitative approach to examine the trauma histories of a randomly selected sample of 67 men incarcerated in the Missouri Department of Corrections. The analyses revealed several patterns among study participants, including near universal trauma exposure in adolescence with the most frequent exposures involving witnessing or being proximate to violent deaths of family and friends. The mean age of exposure for all trauma exposure types measured was 17 years old. We found that for this group of incarcerated men, trauma exposures in childhood tended to result more from community violence than child maltreatment (e.g., abuse and neglect by caregivers). The study results suggested that further research may be needed into the effects of close proximity to violent death during this particular window in adolescent development. Neuroscience research has shown that this is a "sensitive period" in brain development with potential negative outcomes in early adulthood, including emotional regulation deficits that can potentially lead to increased risk of arrest. Further research on trauma exposure within this population is needed both to appropriately serve men while in prison or in the process of reentering society and to support efforts to reduce mass incarceration.

Sexual minority women and Cannabis use: The serial impact of PTSD symptom severity and coping motives

Sexual minority women (SMW) report greater rates of cannabis use. Posttraumatic stress disorder (PTSD) symptom severity is related to greater cannabis use among SMW, and it is theorized that this is due to SMW using cannabis in an attempt to manage negative affectivity associated with PTSD symptoms. However, this is the first known study to test this hypothesis. Among undergraduate women who endorsed lifetime cannabis use (N = 439, 10.5% self-identified SMW), SMW reported greater rates of cannabis use, more frequent cannabis use, greater coping-motivated use, and greater PTSD symptom severity than heterosexual women. Serial mediation analyses revealed that SMW reported more frequent cannabis use via the serial effect of PTSD symptom severity and coping-motivated cannabis use. Given the high rates of trauma exposure and cannabis use among SMW, findings suggest that SMW could benefit from exposure-based interventions in addition to cognitive behavioral skills that would teach them more adaptive strategies to manage negative affect associated with trauma exposure and PTSD symptoms.

Effectiveness of evidence-based psychotherapy for posttraumatic distress within a jail diversion program.

Adults with severe mental illness (SMI) who come into contact with the criminal justice system experience high rates of trauma exposure and posttraumatic stress disorder (PTSD). For individuals with SMI, symptoms of PTSD are associated with exacerbated psychiatric symptoms, higher risk of homelessness and-for those with a history of arrest-increased risk of recidivism. The goal of the present study was to assess the effectiveness of evidence-based psychotherapies (EBPs) for trauma-related distress in treating individuals with SMI who have been diverted from jail to receive community-based treatment services. Participants were 97 individuals with SMI referred to the trauma-informed segment of the St. Louis City Jail Diversion Program between 2011-2015. Seventy-two participants began treatment and received Cognitive Processing Therapy (CPT; 53%), Cognitive-Behavioral Therapy (CBT; 39%), and Motivational Interviewing (MI; 8%). Treatment completers (56%) did not differ from noncompleters on any baseline characteristics. Hierarchical Linear Modeling showed significant decreases in symptoms of PTSD and depression throughout the course of treatment for both completers and noncompleters. The addition of emergency/stressor sessions into EBP protocols was associated with greater likelihood of therapy completion. Findings indicate a need for further research that examines barriers to treatment completion for persons with SMI and posttraumatic distress. Results also provide novel evidence for the effectiveness of EBPs for trauma-related distress when delivered in an outpatient setting to individuals with SMI who have come into contact with the justice system. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Posttraumatic stress disorder in interstitial cystitis/bladder pain syndrome: Relationship to patient phenotype and clinical practice implications.

The relationship between exposure to abuse and interstitial cystitis/bladder pain syndrome (IC/BPS) is well-documented. However, studies have yet to examine posttraumatic stress disorder (PTSD), which develops following exposure to trauma and worsens health outcomes in chronic pain. We aimed to assess the prevalence and impact of PTSD in patients with IC/BPS, including their relation to genitourinary symptom presentation and widespread pain phenotype. We recruited 202 participants with chronic pain from an academic medical center and classified 64 individuals as IC/BPS based on validated epidemiological criteria. Participants completed self-reported questionnaires assessing trauma exposure, PTSD symptoms, emotional distress, pain, and urinary symptoms. Wilcoxon rank-sum tests assessed study aims comparing IC/BPS to other chronic pain. Although elevated, IC/BPS trauma exposure rates were equivalent to that of other chronic pain conditions in the sample. Despite this equivalence, in comparison, IC/BPS patients had significantly higher rates of PTSD symptoms, with 42% meeting provisional diagnostic criteria for PTSD. Among IC/BPS, those meeting provisional criteria for PTSD had significantly higher incidence of lifetime sexual abuse, childhood trauma, and presentations consistent with the widespread pain phenotype. In IC/BPS, there was no association between PTSD and genitourinary symptoms, but provisional PTSD was associated with more pain, emotional distress, and poorer quality of life. We recommend that patients with IC/BPS and widespread pain have ongoing screening and monitoring of PTSD. We recommend using trauma-informed care practices with these patients to increase trust and safety, which could improve treatment compliance and follow-up.

Trauma’s Influence on Relationships: Clients’ Perspectives at an Intimate Partner Violence Intervention Program

Although individuals who engage in intimate partner violence (IPV) report high rates of trauma exposure, it is unclear whether they perceive a link between trauma exposures and relationship problems, which traumas are seen as most influential, and whether such perceptions accurately reflect their relationship difficulties. Ninety-four men presenting for IPV intervention services reported their exposure to 22 adverse and potentially traumatic events (APTEs), and were asked whether these events had influenced the way that they think, act, or feel in relationships. APTEs were categorized based on whether or not they appeared to represent PTSD Criterion A traumatic events. Additionally, participants completed self-report measures of IPV use, partner injuries, emotional abuse, relationship problems, emotion regulation difficulties, and PTSD symptoms. Nearly half (43.6%) of the sample reported that one or more APTEs had influenced the way they function in relationships. Of the 92 reports of non-Criterion A APTEs, 42.4% were endorsed as relationship-influencing, whereas only 19.7% of the 310 occurrences of Criterion A APTEs were endorsed as relationship-influencing. The number of relationship-influencing APTEs reported was positively correlated with emotional abuse, relationship problems, emotion regulation difficulties, and PTSD symptoms. In contrast, the number of non-relationship-influencing APTEs reported was only correlated with emotional abuse. Findings from this exploratory study (1) demonstrate the ability of clients receiving IPV services to discern which APTEs have relevance to their relationships; (2) suggest the benefits of considering non-Criterion A APTEs; and (3) indicate the need for trauma- informed IPV intervention services.

Anxiety sensitivity and acculturative stress among trauma exposed Latinx young adults.

There are elevated rates of trauma exposure, posttraumatic stress symptoms, and greater conditional risk of posttraumatic stress disorder among Latinx relative to other racial/ethnic groups. Such trauma-related health disparities serve to exacerbate or maintain acculturative and other types of stress among the Latinx population. Yet, little research has explored what types of individual difference factors may undergird variability in acculturative stress among trauma-exposed Latinx persons. Accordingly, the present investigation examined individual differences in anxiety sensitivity (fear of the negative consequences of stress sensations) in relation to acculturative stress among a large sample of trauma-exposed Latinx young adults (n = 1,377 persons; Mage = 21.01; SD = 2.50; age range: 18-29 years; 76.7% female). Results demonstrated that anxiety sensitivity explained 10.2% of unique variance in acculturative stress (p < .001, adjusted R² = .188) after accounting for age, sexual minority status, history of trauma exposure, and posttraumatic stress symptom severity. Additionally, each of the 3 subfactors of anxiety sensitivity (Physical, Cognitive, and Social) were directly related to acculturative stress despite sharing variance with one another. Overall, the current findings suggest that anxiety sensitivity may be a heretofore underrecognized individual difference factor that is related to more severe acculturative stress among trauma-exposed Latinx young adults. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Trauma Screening in Recently Immigrated Youth: Data from Two Spanish-Speaking Samples

There have been large, recent increases in the number of children and families migrating from Central America to the U.S. to escape regional cartel and gang violence. The rate of trauma exposure in recently immigrated youth from Central America is therefore alarmingly high and current trauma symptom measures have not been evaluated for use in this population. The broad goal of this study was to report on the psychometric properties of one such measure in two studies of recently immigrated youth. Data collected included self-report of recent immigrants from Central America attending public high school in the Southwestern U.S. and caregiver-report from a sample of Central American immigrants who arrived in the U.S. within the last 24 hours and reported on trauma symptoms in their children. Aims included providing descriptive data and examining inter-item correlations and factor structure. Results indicated trauma symptoms far exceeding published cutoff levels as well as adequate internal consistency and inter-item correlations. Findings of the current studies suggest a pressing need for the assessment of trauma symptoms among recently immigrated youth from Central America, in which the rates of exposure and symptoms were striking.