Trauma Symptom Severity Research Articles

The Impact of Social Support and Social Network Characteristics on Trauma Symptoms Among Violence-Exposed Women with Substance Use Disorders

Background: Women with substance use disorder (SUD) experience higher rates of violence exposure, post-traumatic stress disorder (PTSD), and post-traumatic stress symptoms (PTSS) than their non-substance-using peers. Exposure to violence in women with SUD is associated with PTSS symptom severity and leads to lower rates of treatment adherence, poorer treatment outcomes, and a higher risk for relapse. Little is known about the buffers to PTSS among violence-exposed women with SUD. Methods: A sample of 375 women with SUD were recruited from three inner-city intensive treatment centers, in a midwestern city. Using ordinary least squares regression models, we sought to identify the direct effects of violence, general social support, recovery-specific social support, and social network composition on PTSS. Moderation was also examined using the Bootstrapping function in PROCESS macro for SPSS. Results: General social support, recovery social support, and greater duration of network relationships were associated with lower trauma symptom scores. General social network composition variables were directly associated with lower trauma symptom severity. Recovery-specific social network variables moderated the association between violence exposure and PTSS for Black participants only. Conclusions: These data suggest that providers should target the quality of the client’s interpersonal relationships to reduce PTSS among violence-exposed women with SUD. Maintaining social network relationships should be the focus of treatment interventions for women with SUD who have experienced violence.

Mixed-methods analysis of satisfaction during a 12-session mindfulness-based intervention for women with a substance use disorder and trauma symptomatology

Satisfaction with an intervention influences the uptake of behavior changes and the long-term efficacy of the intervention. Therefore, it is crucial to assess satisfaction by participant profile when creating and adapting behavior interventions for minoritized populations. Qualitative and quantitative data on participant trauma symptom severity and intervention satisfaction were collected through self-report surveys from 54 women. The sample was 59.3% Hispanic, with an average age of 33.21 (SD = 10.42), who were in residential treatment for substance use disorders (SUDs) and participated in a 12-session mindfulness-based intervention. Qualitative responses were coded using thematic analysis, and an integrative mixed-methods approach was used to compare qualitative theme frequency between high-trauma (N = 28) and low-trauma (N = 26) groups at session 2 and session 11. High- and low-trauma groups were determined by interquartile ranges (bottom 25% = low; top 75% = high). In session 2, the low-trauma group reported significantly higher satisfaction (M = 4.20, SD = 0.55) than the high-trauma group (M = 3.77, SD = 0.89); t(43) = 1.90, p = 0.03. In session 11, there was no significant difference between groups. The mixed-methods analysis revealed that “trouble focusing” appeared more frequently in the high-trauma group than in the low-trauma group during session 2, but the theme was not present in either group at session 11, suggesting that this might pose an initial barrier for individuals with high trauma but subsides as the intervention progresses. This speaks to the importance of retention strategies tailored for participants with SUDs and high trauma while they adjust to the intervention. Assessing initial challenges with satisfaction may help facilitators intervene to increase participant satisfaction.

Young Trauma-Exposed Women with Low Sleep Effciency have Blunted Sympathetic Baroreflex Sensitivity and Higher Muscle Sympathetic Nerve Activity

Introduction: Poor sleep, a known risk factor for cardiovascular disease (CVD) and one of the American Heart Association’s essential 8th, is common after trauma-exposure. Although premenopausal women are thought to be protected from CVD, trauma exposure might increase their CVD risk. In a recent large epidemiological study examining sleep-related CVD comorbidities, the empirical cut off point for optimal sleep effciency (SE) was set at 83%, distinguishing between good and poor sleep effciency. Studies have suggested an overactive sympathetic nervous system and an impaired baroreflex sensitivity (BRS) as potential mechanisms of increased CVD risk. However, the impact of poor sleep effciency on muscle sympathetic nerve activity (MSNA) and BRS in young trauma-exposed women is unknown. We hypothesized that young trauma-exposed women with poor sleep effciency will present with impaired BRS and increased MSNA at rest. Methods: We collected data on 30 women (18 – 40 years) from diverse backgrounds who had been exposed to trauma. Sleep data was acquired via ActiWatch for 7 days and used to categorize our participants into two groups: good effciency (SE > 83%, n=17) and poor effciency (SE < 83%, n=13), with SE calculated as the percentage of time spent asleep while in bed. Additionally, we collected continuous noninvasive blood pressure (BP), heart rate (HR), and MSNA (burst frequency, incidence, and total activity) during 10 minutes of quiet rest. Sympathetic BRS was determined as the slope of the regression between individual sympathetic bursts and diastolic BP bins (3 mmHg), weighted against the number of cardiac cycles, utilizing an automated program (Ensemble, NZ). Results: There were no significant differences in trauma symptom severity, resting BP and HR between the two groups (p>0.05 for all). However, resting sympathetic BRS was blunted in the poor SE (-0.10±0.88 bursts/100hb/mmHg) compared to the good SE (-1.44±1.58 bursts/100hb/mmHg, p=0.006) group, even after adjusting for age (p=0.009). Likewise, resting total MSNA was higher in the poor SE compared to the good SE after adjusting for age (p=0.028). MSNA burst frequency and burst incidence were comparable between the groups (p>0.05). Conclusion: Our analyses revealed that poor sleep effciency is associated with decreased sympathetic baroreflex sensitivity and higher total muscle sympathetic activity at rest, regardless of age. Blunted sympathetic BRS may contribute to increased sympathetic activity in young women with poor sleep effciency. Future studies testing strategies to improve sleep effciency in this population could provide potential long-term cardiovascular benefits. UL1TR002494 and NIH K01HL161027 No disclosure. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Objective Sleep Effciency Is Negatively Associated with Resting Heart Rate in Young Trauma-Exposed Women with Poor Sleep

Introduction: Women are twice as likely as men to develop post-traumatic stress disorder (PTSD), a debilitating mental health disorder caused by a traumatic event that can lead to a higher risk of developing cardiovascular disease (CVD). Sleep is currently recognized as an essential component of cardiovascular health by the American Heart Association. Further, a large epidemiological study empirically set the cut-off point for normal sleep effciency (SE) at 83%, differentiating good sleep from poor sleep. Trauma-provoked sleep disturbances such as disruptive nocturnal behaviors and nightmares are a hallmark of PTSD. Yet, the impact of sleep disturbances on cardiovascular biomarkers such as blood pressure (BP) and heart rate (HR) in young trauma-exposed women is unknown. Therefore, the aim of our study was to investigate how objectively recorded sleep measures are associated with HR and BP in these young trauma-exposed women. We hypothesized that sleep quality will predict HR and/or BP, independently of the severity of trauma symptoms. Methods: We recruited 93 trauma-exposed young women (18-40 years). During the in-person visit, we measured BP and HR using an automated vital signs monitor. Additionally, we assessed trauma symptom severity using the PTSD checklist for DSM-5 (PCL5). After the laboratory visit, we sent participants home with a sleep watch (Philips Respironics) for 7 consecutive days, to quantify the percentage of time spent asleep while in bed. Given that a minimum of 83% SE is considered effcient sleep, we separated our data into two groups based on SE [good effciency (SE >83%, n= 42) and poor effciency (SE <83%, n= 51)]. Results: Participants’ mean age and body mass index were 26 ± 7 years and 25.7 ± 6.6 kg/m2 respectively. Pearson correlations revealed a negative correlation between resting HR and SE (r= -0.486, p< 0.001) and HR and age (r= -0.246, p= 0.085) in the SE <83% group. In contrast, there was no correlation between resting HR and SE (r= 0.025, p= 0.861) in the SE >83% group. Therefore, we conducted further analysis in the SE >83% group only. We observed a negative correlation between HR and the trauma symptoms subcluster of hyperarousal (r= -0.285, p= 0.045) in this poor SE group. Next, we ran a multiple linear regression predicting HR with SE, age, and the subclusters of hyperarousal and intrusion (affected by disruptive nocturnal behaviors and nightmares) as predictors. The model predicting HR was significant (R2= 0.366, p< 0.001) and SE remained the strongest predictor (β= -0.458, p= 0.001) even when controlling for age, and trauma symptom subclusters, followed by age (β= -0.263, p= 0.037). Conclusion: Our analyses reveal that sleep effciency in trauma-exposed women is a strong predictor of resting HR, even when controlling for age and trauma symptoms subclusters of intrusion and hyperarousal. These findings suggest that in the context of trauma, it is the reduction in sleep effciency that has the greatest impact on resting heart rate, and ultimately mental health-associated CVD. K01HL161027 and UMN CTSI UL1TR002494 No Disclosure. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Trauma Exposure, Suicidality, and Symptom Severity Among Young Adults Seeking Counseling Who Report Childhood Emotional Abuse

There is limited research regarding childhood emotional abuse (CEA) and its influence on mental health across development, as most studies of childhood maltreatment to date have focused on childhood sexual and physical abuse. We conducted a cross-sectional study on 2,604 young adults seeking counseling services at a large post-secondary institution in the southwestern United States. Participants were screened for trauma exposure, mental health issues, and suicidality. Findings indicated that CEA was significantly associated with higher rates of exposure to other traumatic events, more severe depression, generalized anxiety, social anxiety, academic distress, eating concerns, family distress, hostility, and substance use. CEA exposure was also significantly associated with more frequent suicidal ideation, suicide attempt, and non-suicidal self-injury prior to seeking counseling services. As CEA was associated with elevated symptom presentation and more severe risk for suicide, recommendations for counseling practice and future research are discussed.

Neural Correlates of Symptom Remission Among Adults Receiving EMDR Therapy for PTSD: A Systematic Review and Meta-Analysis of 20 Years of Research

The present systematic review and meta-analysis provide an updated assessment of how eye movement desensitization and reprocessing (EMDR) therapy affects the human brain during treatment for posttraumatic stress disorder (PTSD). Brain region activity was assessed using resting-state functional magnetic resonance imaging, and trauma symptom severity was measured using the PTSD Checklist for the DSM-5 (PCL-5). We used PubMed, EMBASE, and ScienceDirect as our primary databases. Selected articles were subjected to seven eligibility criteria, and 22 articles remained for statistical analysis. Article quality was measured using the QUADAS-2 instrument, which showed that our review sample comprised high-quality articles. Statistical analyses implicated a forest plot meta-analysis of PCL-5 scores pretreatment and posttreatment, an activation likelihood estimation (ALE) meta-analysis of brain region activation after treatment, and a linear regression analysis that served as our method of statistical synthesis between forest plot and ALE results. Our forest plot showed that EMDR had a robust effect on decreasing PCL-5 scores during treatment (g= −2.92). Our ALE meta-analysis indicated the activation of different regions in the default mode and salience, limbic, and ventral attention networks. Statistical synthesis showed a robust correlation between PCL-5 score decrease and increased brain function (β = −.94). We also measured publication bias in our review sample with a funnel plot and Egger’s test of random effects (p= .280).

Examining biopsychosocial predictors of risk for cognitive impairment among a racially diverse sample of men who have sex with men living with HIV.

Cognitive decline among people living with HIV (PLWH) is growing concern as world populations become increasing older including higher proportions of PLWH. It is vitally important to understand psychosocial predictors of age-related cognitive decline men who have sex with men (MSM) living with HIV. The current study seeks to examine psychosocial risk factors the contribute to the risk of age-related cognitive impairment as measured by Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score in a racially diverse sample of MSM living with HIV. The present analysis utilizes data from the baseline (n = 196) and 6-month follow-up (n = 135) time points of a longitudinal cohort study of PLWH. Using a self-report survey, we examine the associations between psychosocial predictors (e.g. trauma, mental health, chronic pain, sleep disturbance, etc.) and risk of dementia using the CAIDE risk score. Analyses include linear and logistic regression. In adjusted model stress, chronic pain, Black racial identity, and having a sexual identity that is bisexual or another category are all positively associated with CAIDE scores. Childhood sexual abuse history was negatively associated with CAIDE scores indicating a protective effect. Sleep disorder has a positive association with CAIDE scores after adjusting for the baseline CAIDE scores. These results indicate modifiable correlates of cognitive risk (stress and chronic pain). Interventions should seek to address these comorbid factors including the consideration of minority stress and stigma. Interventions should seek to reach Black and bisexual men living with HIV, including possible cultural tailoring to interventions and messaging. Lastly, future research should examine the impact of variation within childhood sexual abuse histories to better understand their association with cognitive impairment later in life. This may include considering the nature, severity, and potential treatment of trauma symptoms.

Interpersonal trauma and discharge symptom severity among individuals with psychotic disorders: A population-based cohort study in Ontario

Interpersonal trauma is associated with poorer prognoses for individuals with psychotic disorders; however, its association with symptom severity at hospital discharge is unknown. Among 57,106 individuals hospitalized for a psychotic disorder in Ontario, Canada (2009–2019), 12,805 (22.4 %) with and 44,301 (77.6 %) without a history of interpersonal trauma were compared on the positive symptom scale (PSS) score at discharge. In a subcohort of individuals with an elevated PSS score of at least 6 on admission, we calculated the relative risk of positive symptom remission (PSS<6) at discharge comparing those with and without interpersonal trauma. Interpersonal trauma was associated with a higher PSS discharge score. Effect sizes were greater for those with who experienced interpersonal trauma in the past year. Results were similar by type of trauma (physical, sexual, emotional) and specific diagnosis (schizophrenia, schizoaffective disorder, other psychotic disorder). In the subcohort, fewer inpatients with vs. without a history of interpersonal trauma had PSS<6 at discharge. Thus, individuals with psychotic disorders who have a history of interpersonal trauma are at risk for elevated symptom burden at hospital discharge. Integration of trauma-informed frameworks and trauma-focused therapies in the inpatient psychiatric setting may optimize outcomes at discharge.

B - 63 Relationship between Executive Functioning and Trauma Symptom Report in Healthy Older Adults.

The study investigated the relationship between trauma symptoms and executive functioning (EF) in healthy older adults, emphasizing the importance of assessing the trauma history of those with subclinical trauma and stressor-related disorders in neuropsychological evaluations. It was hypothesized that age is negatively correlated with trauma symptoms, and trauma symptoms are negatively correlated with EF performance. This cross-sectional investigation included 520 adults ages 50-85 (67.9% Female; Education: 15.95(2.31); 87.9% White, 7.7% Black, 3.3% Asian, 0.6% Native American, 0.6% Other) from the Nathan Kline Institute's Rockland Sample. Trauma was measured by the total raw score of the Trauma Symptom Checklist-40 (TSC-40) and six subscale scores. EF was measured by performance on selected D-KEFS measures. Separate Pearson correlations were used to compare age to trauma scores, and EF performance to trauma scores. The anxiety subscale of TSC-40 showed a significant weak correlation with age, r (518) = -0.138, p = 0.001. Age was not correlated with any other TSC-40 subscales. The TSC-40 sexual abuse (SA) subscale showed a significant weak correlation with Color-Word Inhibition r(518) = -0.096, p = 0.031 and Trail Making-Switching r(518) = -0.106, p = 0.016. The remaining TSC-40 subscales were not correlated with other EF measures. The study demonstrated that the overall severity of trauma symptoms is not associated with age in older adults. Older adults with fewer symptoms associated with SA showed higher EF abilities. Future investigations will assess how gender and socioeconomic status affect the association between trauma and EF in older adults.

Early intervention for residential out-of-home care staff using eye movement desensitization and reprocessing (EMDR).

Residential out-of-home care (OoHC) staff regularly experience workplace-related trauma. This may contribute to the future development of a trauma- or stressor-related disorder. Eye movement desensitization and reprocessing (EMDR) is an effective treatment for stress disorders but is largely unstudied in OoHC staff. The objective of the current study was to determine if EMDR, provided early within 3 months of an incident, reduced trauma symptom severity in OoHC staff. During a 3-year pilot study (2018-2020), a trained clinician delivered the Recent Traumatic Episode Protocol (R-TEP) and Group Traumatic Episode Protocol (G-TEP) EMDR to OoHC staff from one community service organization in Victoria, Australia. Retrospective data from the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) were deidentified and analyzed using descriptive statistics and analysis of variance. Due to the COVID-19 pandemic, individual EMDR (R-TEP) was provided via telehealth in 2020 in comparison with face-to-face sessions during 2018-2019. Overall, a significant decrease in PCL-5 scores was seen from baseline to follow up, and staff who received R-TEP or G-TEP experienced reductions in symptoms. Both face-to-face and online modalities showed significant reductions in PCL-5 scores. No significant differences were found between the online or face-to-face modes of delivery, suggesting both options are effective. No adverse reactions were reported among the 144 staff who participated. This study provides evidence for the efficacy of EMDR in reducing traumatic stress symptom severity for residential OoHC staff. A larger, prospective research study is needed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

No association between war-related trauma or PTSD symptom severity and epigenome-wide DNA methylation in Burundian refugees

ABSTRACT Background: War-related trauma is associated with varying posttraumatic stress disorder (PTSD) prevalence rates in refugees. In PTSD development, differential DNA methylation (DNAm) levels associated with trauma exposure might be involved in risk versus resilience processes. Studies investigating DNAm profiles related to trauma exposure and PTSD among refugees remain sparse. Objective: The present epigenome-wide association study investigated associations between war-related trauma, PTSD, and altered DNAm patterns in Burundian refugee families with 110 children and their 207 female and male caregivers. Method: War-related trauma load and PTSD symptom severity were assessed in structured clinical interviews with standardised instruments. Epigenome-wide DNAm levels were quantified from buccal epithelia using the Illumina EPIC beadchip. Results: Controlling for biological confounders, no significant epigenome-wide DNAm alterations associated with trauma exposure or PTSD were identified in children or caregivers (FDRs > .05). Co-methylated positions derived as modules from weighted gene correlation network analyses were not significantly associated with either war-related trauma experience in children or caregivers or with PTSD. Conclusions: These results do not provide evidence for altered DNAm patterns associated with exposure to war-related trauma or PTSD.

Effects of prenatal exposure to the 1944–45 Dutch famine and glucocorticoid receptor polymorphisms on later life PTSD susceptibility

ABSTRACT Background: Exposure to adversity in utero is thought to increase susceptibility to develop posttraumatic stress disorder (PTSD) following later life trauma, due to neurobiological programming effects during critical developmental periods. It remains unknown whether effects of prenatal adversity on PTSD susceptibility are modulated by genetic variations in neurobiological pathways implicated in PTSD susceptibility. Objective: We investigated whether genetic variation in the glucocorticoid receptor (GR) modulated effects of prenatal famine exposure on late adulthood PTSD symptom severity after trauma exposure in childhood and mid-to-late adulthood. Method: We included N = 439 term-born singleton adults (mean age: 72 years, 54.2% women) from the Dutch Famine Birth Cohort, born around the time of the Dutch Famine of 1944/1945, divided into exposure and control groups based on timing of the famine during gestation. Participants filled out self-report questionnaires on childhood (Childhood Trauma Questionnaire) and mid-to-late adulthood (Life Events Checklist for DSM-5) trauma, and current PTSD symptom severity (PTSD Checklist for DSM-5). GR haplotypes were determined from four functional GR single nucleotide polymorphisms (ER22/23EK, N363S, BclI and exon 9β) in previously collected DNA. Linear regression analyses were performed to investigate associations of GR haplotype and prenatal famine exposure in conjunction with later life trauma on PTSD symptom severity. Results: We observed a significant three-way interaction between the GR Bcll haplotype, famine exposure during early gestation, and adulthood trauma exposure on PTSD symptom severity in late adulthood. Only participants exposed to famine during early gestation without the GR Bcll haplotype showed a significantly stronger positive association between adulthood trauma and PTSD symptom severity than non-exposed participants, indicating increased PTSD susceptibility. Conclusions: Our results illustrate the importance of integrated approaches considering genetics and environmental contexts throughout various life periods, including the rarely investigated prenatal environment, to elucidate how PTSD susceptibility evolves throughout life. HIGHLIGHTS Adversity during pregnancy is thought to increase offspring’s PTSD risk following later life trauma, but exact neurobiological mechanisms underlying this process remain unknown. We found that effects of prenatal famine exposure on PTSD symptom severity were influenced by genetic variation in the glucocorticoid receptor, which signals effects of the stress hormone cortisol. Integrated approaches considering genetics and environmental contexts throughout both early and later life are important to understand how PTSD risk evolves throughout life.

Subjective Sleep Disturbances in Sexual Assault Survivors: Associations With Trauma and Posttraumatic Stress Disorder Symptom Severity

Prior work implicates sleep disturbance in the development and maintenance of posttraumatic stress disorder (PTSD). However, the majority of this literature has focused on combat veteran men, and limited work has examined links between sleep disturbance and PTSD symptoms in sexual assault survivors. This is a notable gap in the literature, as sexual trauma is disproportionately likely to result in PTSD and is more common in women. We sought to examine the relations between subjective sleep disturbance, sexual assault severity, and PTSD symptoms in a sample of sexual assault survivors with PTSD (PTSD+), without PTSD (PTSD-), and healthy controls. The sample (N = 60) completed the Insomnia Severity Index and prospectively monitored their sleep for 1 week using the Consensus Sleep Diary. The sexual assault survivors also completed the Sexual Experiences Survey and PTSD Checklist-5. Results of group comparisons found that the PTSD+ group reported significantly higher insomnia symptoms, longer sleep onset latency, more nocturnal awakenings, and lower sleep quality compared to the healthy control group and higher insomnia symptoms compared to the PTSD- group. Results of regression analyses in the sexual assault survivors found that insomnia symptoms and number of nocturnal awakenings were significantly associated with higher PTSD symptoms, and sexual assault severity was significantly associated with higher insomnia symptoms, longer sleep onset latency, and lower sleep quality. These findings highlight specific features of sleep disturbance that are linked to trauma and PTSD symptom severity among sexual assault survivors.

Cultural determinants and resilience and recovery factors associated with trauma among Aboriginal help-seeking clients from an Aboriginal community-controlled counselling service

In addition to resilience and resistance, collective and personal experiences of trauma are commonly cited within the context of Aboriginal and Torres Strait Islander and other Indigenous First People’s experiences of colonisation. This study investigated whether a range of risk and protective factors, including cultural determinants of social and emotional wellbeing, were associated with posttraumatic stress outcomes among 81 Aboriginal help-seeking clients from an Aboriginal community-controlled counselling service in Melbourne, Australia. The study explored potential relationships between trauma exposure, child removal from natural family, experiences of racism, gender, and trauma symptom severity. The study also investigated whether personal, relationship, community and cultural strengths and determinants of wellbeing, as detailed in the Aboriginal Resilience and Recovery Questionnaire, moderated the relationship between trauma exposure and posttraumatic stress symptom severity. Participants commonly endorsed symptoms of distress consistent with Posttraumatic Stress Disorder and cultural idioms of distress as documented in the Aboriginal Australian Version of the Harvard Trauma Questionnaire. Two generations of child removal from one’s natural family, experiences of racism, stressful life events experienced during the past 12 months, being male, and not having access to funds for basic living expenses were all associated with greater trauma symptom severity. Conversely, participants self-reported access to personal, relationship, community and cultural strengths was associated with lower trauma symptom severity. Regression analysis revealed that trauma exposure, stressful life events, access to basic living expenses, and personal, relationship, community, and cultural strengths were all important predictors of posttraumatic stress symptom severity. Participant access to strength and resources that included connections to community and culture, moderated the relationship between trauma exposure and trauma symptom severity.

Family Matters: Trauma and Quality of Life in Family Members of Individuals With Prader-Willi Syndrome.

BackgroundPrader-Willi syndrome (PWS) is a potentially life threatening, genetic developmental disorder that requires lifelong medical treatment and behavioral management. PWS has a major impact on the patient's social environment. In this study, we have explored traumatic life events and symptoms of posttraumatic stress disorder (PTSD) in family members of individuals with PWS. We have also assessed quality of life in relation to trauma manifestations. In addition, we have evaluated demographic characteristics such as living setting of PWS patients as well as PWS symptom severity.MethodsData of this observational study were obtained by means of the Life Events Checklist DMS-5, the Posttraumatic Stress Disorder Checklist DSM-5, the abbreviated World Health Organization Quality of Life questionnaire, the Lancashire Quality of Life Profile questionnaire, and a short demographic inventory. The study sample includes 98 adults aged 19 to 80 years (M = 49, SD = 15), who are relatives of 69 individuals with PWS aged 0 to 58 years (M = 19, SD = 13). Participants were recruited via the two Dutch patient associations PWS and the Dutch Digital Center of Expertise PWS.ResultsLife time prevalence of traumatic events (93%) was higher in family members of PWS patients (“PWS relatives”) than in the general Dutch population (81%). Of those who reported any traumatic event, almost half reported PWS-related events. The prevalence of probable PTSD was higher in PWS relatives (12.1%) than the general lifetime prevalence of PTSD (worldwide, and in the Netherlands 7.4%). Predominant trauma symptoms in PWS relatives were “negative changes in arousal and reactivity” and “negative changes in cognition and mood;” both significantly negatively related to quality of life. Symptom severity of PWS individuals, as well as the associated trauma symptom severity of their relatives increased with age of the PWS individual. The presence of trauma symptoms was less frequent among relatives of PWS individuals living in a care facility.ConclusionsHaving a relative with PWS is associated with higher prevalence of traumatic experiences and greater vulnerability to PTSD. Raising awareness in health care professionals of trauma symptoms in PWS relatives may contribute to effective treatment of their psychosocial stress. In addition, timely interventions might prevent family members from developing psychopathology like PTSD.

Displacement-related stressors in a Sri Lankan war-affected community: Identifying the impact of war exposure and ongoing stressors on trauma symptom severity

In recent years, there has been a shift in the literature towards identifying how ongoing stress adversely affects mental health beyond the effect of direct exposure to war-related violence. The goal of the current study was to investigate the relationship between displacement-related stressors and trauma symptom severity. Participants (N ​= ​1015) were recruited from primary healthcare clinics (PHCs) in Northern Sri Lanka and completed a demographic and displacement history questionnaire, the Stressful Life Events Checklist, and the Harvard Trauma Questionnaire. Four latent stressor constructs were identified through exploratory and confirmatory factor analyses: 1) personal safety concerns; 2) war-related loss; 3) material loss, and 4) personal hardships. Structural equation modeling was used to examine the relationship between stressors and trauma symptom severity. In the final structural equation model, war-related loss and material loss were positively related to symptom severity whereas psychosocial hardship was found to be negatively related to symptom severity. Results highlight how an integrated model of mental health can more fully inform the needs stemming from displacement-related stressors.

Trauma-focused EMDR for Personality disorders among Outpatients (TEMPO): study protocol for a multi-centre, single-blind, randomized controlled trial

BackgroundExisting recommended treatment options for personality disorders (PDs) are extensive and costly. There is emerging evidence indicating that trauma-focused treatment using eye movement desensitization and reprocessing (EMDR) therapy aimed at resolving memories of individuals’ adverse events can be beneficial for this target group within a relatively short time frame. The primary purpose of the present study is to determine the effectiveness of EMDR therapy versus waiting list in reducing PD symptom severity. Furthermore, the effects of EMDR therapy on trauma symptom severity, loss of diagnosis, personal functioning, quality of life, and mental health outcomes will be determined. In addition, the cost-effectiveness of EMDR therapy in the treatment of PDs is investigated. Moreover, predictors of treatment success, symptom deterioration and treatment discontinuation will be assessed. Lastly, experiences with EMDR therapy will be explored.MethodIn total, 159 patients with a PD will be included in a large multicentre single-blind randomized controlled trial. The Structured Clinical Interview for DSM-5 Personality Disorders will be used to determine the presence of a PD. Participants will be allocated to either a treatment condition with EMDR therapy (ten biweekly 90-min sessions) or a waiting list. Three months after potential treatment with EMDR therapy, patients can receive treatment as usual for their PD. All participants are subject to single-blinded baseline, post-intervention and 3-, 6- and 12-month follow-up assessments. The primary outcome measures are the Assessment of DSM-IV Personality Disorders and the Clinician-Administered PTSD Scale for DSM-5. For cost-effectiveness, the Treatment Inventory of Costs in Patients with psychiatric disorders, EuroQol-5D-3L, and the Mental Health Quality of Life Questionnaire will be administered. The PTSD Checklist for DSM-5, Brief State Paranoia Checklist and Difficulties in Emotion Regulation Scale will be used to further index trauma symptom severity. Type of trauma is identified at baseline with the Childhood Trauma Questionnaire-SF and Life Events Checklist for the DSM-5. Personal functioning and health outcome are assessed with the Level of Personality Functioning Scale-BF 2.0, Outcome Questionnaire-45 and Mental Health Quality of Life Questionnaire. Experiences with EMDR therapy of patients in the EMDR therapy condition are explored with a semi-structured interview at post-intervention.DiscussionIt is expected that the results of this study will contribute to knowledge about the effectiveness, and cost-effectiveness of trauma-focused treatment using EMDR therapy in individuals diagnosed with a PD. Follow-up data provide documentation of long-term effects of EMDR therapy on various outcome variables, most importantly the reduction of PD symptom severity and loss of diagnoses.Trial registrationNetherlands Trial Register NL9078. Registered on 31 November 2020

Dispositional mindfulness and trauma symptom severity associated with uptake of mindfulness practice among women in treatment for substance use disorder

ABSTRACT Objective This study assessed the preintervention predictors of participant initial satisfaction and uptake of mindfulness practices during an MBI (Moment-by-Moment in Women’s Recovery). Methods Data from 100 women (Mage = 32.38 years, 60% Latina) in residential SUD treatment randomly assigned to the MBI were used to assess baseline participant demographics and clinical characteristics and three acceptability variables (satisfaction and formal and informal mindfulness practice) after the second and third of 12 intervention sessions, respectively. Results: Multiple linear regression analyses found that the frequency of formal mindfulness practice was associated with preintervention mindfulness disposition (β = 0.245, p < .05) and age (β = .266, p < .05; R 2 = .137, F[4, 77] = 3.047, p < .05). The frequency of informal mindfulness practice was associated with preintervention mindfulness disposition (β = .239, p < .05), and preintervention trauma symptom severity was significant (β = .226, p < .05; R 2 = .139, F[4, 77] = 3.116, p < .05). Conclusions It is important to consider participant, and intervention characteristics may be associated with participant adoption of intervention teachings and practices early in intervention implementation. Identifying these characteristics and adapting the intervention accordingly is necessary for the long-term goal of improving intervention acceptability among vulnerable populations at high risk of treatment dropout.

The impact of participation in a mindfulness-based intervention on posttraumatic stress symptomatology among Black women: A pilot study.

Objective: Women, racial/ethnic minorities, and socioeconomically disadvantaged groups experience trauma and PTSD at a rate of up to four times the U.S. national average. The aim of the present study is to assess the association between participation in a mindfulness-based intervention delivered in a community health center and posttraumatic stress symptoms among socioeconomically disadvantaged, Black women with trauma histories. We hypothesized that participants would experience a significant reduction in trauma symptom severity from pre- to post-intervention. Method: Women were recruited from a community health center on the South Side of Chicago, Illinois. Participants completed self-report measures of trauma symptoms, mindfulness, depression, and stress. Pre/postintervention differences in symptom severity were analyzed with paired sample t tests and independent sample t tests. Results: A total of 36 women with trauma symptom data were assessed. There was a significant reduction of trauma symptom severity from baseline to end of treatment. A minority of participants endorsed slightly higher symptomatology at the end of treatment. Women whose trauma symptom severity increased were less symptomatic overall to begin treatment; they had significantly lower trauma and depressive symptom severity at baseline. Conclusions: Socioeconomically disadvantaged, Black women with moderate to severe trauma symptoms benefited from a mindfulness-based intervention delivered in a community health care setting. While some women with mild trauma symptoms may have become more aware of their symptoms through an intervention designed to increase awareness of thoughts and feelings, most women experienced a decrease in trauma symptom severity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

It gets better: childhood sexual abuse and trauma symptoms in female older adults

ABSTRACT While there has been great deal of research conducted on the effects of child sexual abuse (CSA) on trauma symptoms in children and adults, there is less knowledge on the effects on trauma symptoms in female older adult CSA survivors. The aim of this study was to investigate current symptoms of trauma in adult female survivors of child sexual abuse across each successive decade, beginning with eighteen year olds. This retrospective, anonymous online study gathered a sample of 223 adult female survivors of CSA (38 of whom were aged 50–59 (17%), and 20 of whom were 60+ years of age (9%)), and surveyed their trauma history and their current symptomology. In our sample, the survivors with the most severe trauma symptoms were between 18 and 29 years old. Each subsequent decade reported fewer trauma symptoms, with respondents in the 60+ age group reporting the lowest trauma symptom severity. While a cross-sectional study does not allow us to evaluate individuals’ experiences over time, these results suggest that the negative impacts of CSA may abate over the life course. Future research should consider these questions longitudinally to explore whether these results are related to survivorship (those with worse outcomes dying younger) and whether these effects endure as female older adults experience physical and mental challenges in later life.