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Women in resource-constrained, postdisaster, urban enclaves, such as Haiti’s Cité Soleil, are at risk for nonpartner sexual violence (NPSV) by multiple perpetrators, and subsequently, psychological trauma and sexually transmitted infections (STIs), including HIV/AIDS. These biopsychosocial risks suggest that NPSV victims may benefit from an adapted evidence-based intervention for sexually transmitted infection (EBI-STI) that includes a trauma component. Yet there is a dearth of knowledge on trauma symptoms experienced by victims in Haiti. We administered a Haitian Kreyòl version of Trauma Symptom Checklist (TSC-40), including its subscales (depression, dissociation, anxiety, sexual problems, sleep disturbance, sexual abuse trauma) to women in Cité Soleil, comparing victims’ scores ( n = 54) with those of nonvictims ( n = 179). After controlling for child sexual abuse, arrest, transactional sex, and sociodemographics, being a victim was associated with higher scores on the full TSC-40, and subscales of anxiety and sexual abuse trauma index. These increased scores of victims underscore the need to incorporate trauma in adaptation of EBI-STI for Haitian NPSV victims like our sample.

Objective: The present study examined the protective role of partner support in reducing daily experiential avoidance (EA) associated with trauma symptoms in a sample of 154 couples during pregnancy. Background: Although psychological distress during pregnancy may hinder the developing bond between parents and infants after birth, high quality intimate partner support has the potential to enhance psychological wellbeing during pregnancy, particularly in the context of trauma. Specifically, partner support might mitigate the impact of trauma symptoms on maladaptive coping strategies such as EA by enabling individuals to safely encounter their distress. Method: Participants completed a semi-structured clinical interview of support and a PTSD symptom inventory, followed by home surveys of EA over 14 days. We examined growth trajectories of EA over 14 days using latent trajectory modeling within a dyadic framework. Results: Trauma symptom severity was associated with higher levels of EA across the 2 weeks; however, among women, the impact of trauma symptoms on EA was no longer significant when support from a partner was above average quality or higher. Findings also revealed partner effects; to the extent that women reported higher levels of trauma symptoms, their partners had higher levels of EA. Conclusion: Findings highlight the protective role of high quality support from intimate partners and suggest that trauma-related interventions targeting partner support processes, especially those implemented during pregnancy, might enhance recovery and prevent further distress and dysfunction among pregnant women experiencing trauma symptoms.

Individuals with intellectual disabilities (IDs) are at increased susceptibility to adverse life experiences and trauma sequelae. There is a disparate range of therapeutic interventions for post-traumatic stress disorder (PTSD) and associated symptoms. This systematic review aimed to appraise the effectiveness of both cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) for PTSD and associated symptoms for both adults and children with mild, moderate, or severe intellectual delay. A systematic search, in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, of the PsychInfo, PubMed, Cochrane Database of Systematic Reviews, and MEDLINE databases were performed, and all relevant articles published between 2010 and March 2020 were included. A total of 11 articles were included, eight that focused on EMDR and three on CBT. The methodological quality of many of these articles was generally weak. Tentative findings suggest that EMDR and CBT are both acceptable and feasible treatment options among adults and children with varying levels of intellectual delay, but no firm conclusions can be drawn regarding effectiveness due to small sample sizes, lack of standardized assessment, and a paucity of methodological rigorous treatment designs. This review highlights the continued use of therapeutic approaches with clients presenting with IDs and PTSD. It adds to the extant literature by providing an expansive and broad overview of the current effectiveness of both EMDR and CBT. Further high-quality research is needed to provide more conclusive findings regarding treatment effectiveness and modifications to treatment needed with this population.

Tragic collective events bring about long-term consequences for affected groups. These effects not only affect the immediate victims of trauma, but can also influence subsequent generations. In the present research, we examined the effects of minority language use on historical trauma. In a study of 237 Lemko participants, members of a severely victimized ethnic minority in Poland, we tested the effects of cognitive availability of historical trauma on three categories of trauma-related symptoms: emotional, behavioral, and depressive. The study found that minority language use is positively related to cognitive availability of trauma, but it also limits the effects of such availability on trauma-related symptoms. Based on this finding, we discuss the potential of minority language use to act as a social cure protecting from the negative psychological consequences of historical trauma.

A first-line screening instrument, the Preschool Inventory of Trauma Symptoms (PITS), was developed to assess trauma symptoms with a diverse sample of 150 toddlers and preschoolers ( M = 2.49 years; SD = 1.12). Items reflected the current trauma literature, assessment measures, and diagnostic criteria for very young children. A principal component analysis produced a 34-item, four-factor model: Arousal and Hyper-Reactivity, Fearful Attachment, Intrusion and Re-Experiencing, and Avoidance and Negative Cognition and Mood. One validity scale, Response Style, was also developed. All scales significantly correlated ( r = .45 to .81; p < .01) with preestablished trauma measures and demonstrated adequate internal consistency (α = .68 − .87). A receiver operating characteristics curve analysis identified a cut-score with good discrimination ability (.88), sensitivity (.81), and specificity (.81). In a preliminary pilot study, PITS also was found to be sensitive to trauma symptom change following participation in an evidence-based trauma informed treatment program. A copy of the PITS is included in the Appendix for free use by qualified professionals.

Background The trauma experienced as a paramedic can have a devastating psychological impact on both professionals and students in training, and increases the risk of developing post-traumatic stress disorder (PTSD). Paramedics are often placed in high-risk situations involving multiple or sustained trauma and also experience high levels of occupational stress, which can produce adverse psychological and physiological responses. Despite these risks, understanding trauma and its various manifestations in paramedicine has not been well documented. Methods This narrative review describes the history and changes in diagnostic criteria, and contrasts the methods of measuring PTSD symptomology with the current criteria. Results PTSD was first defined in the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III) in 1980, however the diagnostic criteria and associated measurement tools failed to reflect the repeated and vicarious traumatic events experienced by paramedics. Currently, the majority of the measurement tools used to assess post-traumatic stress are still aligned with superseded diagnostic criteria and many only classify the symptoms of PTSD as present or absent with little consideration given to symptom severity. Consequently, these existing measurements of PTSD are out dated and inefficient in their ability to identify and measure PTSD using the revised criteria. Conclusion The development of a more specific measurement tool, which reflects the DSM-5 diagnostic criteria of trauma-related stressors within this population, will allow for a more comprehensive measurement of symptoms. Future research undertaken in this specific field will also help to inform education and training programs to assist with the negative impacts of trauma and aid in management and treatment of PTSD in paramedics.

Background: Prescription drug–related overdose deaths have increased dramatically in recent years. Women in the justice system experience high rates of drug use, victimization, trauma symptoms, and other health problems and would appear to be at high risk for nonmedical use of prescription drugs (NMUPD). This study will be among the first to describe prevalence and correlates of NMUPD among this population. Methods: This cross-sectional study collected data from 406 victimized women on probation and parole between 2010 and 2012. In a multiple logistic regression model, we differentiated women who reported past-year NMUPD from those who did not using demographic, health, other drug use, substance use treatment, and trauma symptom severity variables. Results: Past-year NMUPD was reported by 26.8% ( n = 109) of the overall sample. Women reporting NMUPD were significantly younger and more likely to be white. Past-year use of alcohol (adjusted odds ratio [AOR]: 3.3; 95% confidence interval [CI]: 1.8–6.1), marijuana (AOR: 3.6; 95% CI: 1.8–7.0), methamphetamines (AOR: 6.1; 95% CI: 1.7–21.3), and heroin (AOR: 8.4; 95% CI: 2.0–35.2) were significantly associated with NMUPD. Additionally, each unit increase in the measure assessing bodily pain was associated with a 40% increase (AOR: 1.4; 95% CI: 1.1–1.7) in the odds of NMUPD. Finally, meeting diagnostic criteria for posttraumatic stress disorder almost doubled (AOR: 1.9; 95% CI: 1.1–3.4) the odds of reporting past-year NMUPD. Conclusions: Victimized women on probation and parole report high rates of NMUPD, and this behavior intersects with other complex social, behavioral, psychological, and physical needs. The authors recommend increased access to trauma-informed correctional care among women in the justice system.

This study examined whether police involvement in intimate partner violence (IPV) incidents is associated with women’s trauma symptoms. Participants were 95 women recruited from domestic violence shelters. Women reported on their trauma symptoms, the frequency of IPV victimization, the use of a weapon during IPV, and police involvement over the year following shelter departure. Police involvement in IPV was associated with higher levels of reexperiencing trauma symptoms 1 year after shelter departure, even after controlling for baseline trauma symptoms, the frequency of IPV, and the use of a weapon during IPV. Women’s race and ethnicity did not moderate the results. These findings suggest police involvement in IPV incidents may be associated with higher levels of trauma symptoms experienced by women. Further investigation into law enforcement practices and policies to help reduce women’s distress is needed.

We surveyed 525 graduate students (61.7% females and 38.3% males) regarding their exposure to sexual and gender-based harassing events. Thirty-eight percent of female and 23.4% of male participants self-reported that they had experienced sexual harassment from faculty or staff; 57.7% of female and 38.8% of male participants reported they had experienced sexual harassment from other students. We explored the relation between sexual harassment and negative outcomes (trauma symptoms, campus safety, and institutional betrayal) while also considering associations with other types of victimization (sexual assault, stalking, and dating violence) during graduate school. Our results update and extend prior research on sexual harassment of graduate students; graduate-level female students continue to experience significantly more sexual harassment from faculty, staff, and students than their male counterparts, and sexual harassment is significantly associated with negative outcomes after considering other forms of ...

The current study investigated a model explaining sexual assault victims’ severity of trauma symptoms that incorporated multiple stigma constructs. Integrating the sexual assault literature with the stigma literature, this study sought to better understand trauma-related outcomes of sexual assault by examining three levels of stigma—cultural, social, and self. Results showed self-stigma was significantly and positively related to trauma symptom severity. Thus, results revealed that the internalized aspect of stigma served as a mechanism in the relation between sexual assault severity and increased levels of trauma symptom severity, highlighting the importance of assessing self-stigma in women reporting sexual assault experiences.

Objectification has been conceptualized as a form of insidious trauma, but the specific relationships among objectification experiences, self-objectification, and trauma symptoms have not yet been investigated. Participants were women with ( n = 136) and without ( n = 201) a history of sexual trauma. They completed a survey measuring trauma history, objectification experiences (body evaluation and unwanted sexual advances), constructs associated with self-objectification (body surveillance and body shame), and trauma symptoms. The relationships among the variables were consistent for both women with and without a history of sexual trauma. Our hypothesized path model fit equally well for both groups. Examination of the indirect effects showed that experiencing unwanted sexual advances was indirectly related to trauma symptoms through body shame for those with and without a history of sexual trauma. Additionally, for women with a history of sexual trauma, the experience of body evaluation was indirectly related to trauma symptoms through the mediating variables of body surveillance and body shame. The data indicate that the experience of sexual objectification is a type of gender-based discrimination with sequelae that can be conceptualized as insidious trauma. Clinicians may consider the impact of these everyday traumatic experiences when working with women who have clinical symptoms but no overt trauma history.

This study examined the relationship between heart rate variability, trauma symptom expression, and psychological distress in a sample ( N = 28) of African Americans with traumatic spinal cord injury. Participants’ heart rate (R-R interval) was recorded at baseline, during a mental arithmetic task, and then again at recovery. Heart rate variability was indexed as the root mean square of successive difference (rMSSD) of participants’ R-R interval. Following this procedure, participants were administered a battery of surveys to assess levels of trauma and psychological distress. Findings indicated that there was a statistically significant relationship between heart rate variability, trauma symptoms, and psychological distress. Implications of the study’s findings are discussed in the context of future research and clinical interventions.

Posttraumatic stress disorder (PTSD) is a mental disorder that is known to have deleterious psychological, physical, and social impacts on individuals. Recognition of PTSD in older adults is difficult due to the complicated presentation taking into account that PTSD symptoms may be masked by other psychiatric and/or somatic diagnoses that are more common in older adults. Furthermore, some older adults may underreport their PTSD symptoms, and the relationship between current symptoms and distant traumas may be difficult to detect. Limited empirical research has been done on the manifestation, course, and treatment of PTSD in older adults. In this article, the literature on PTSD in older adults is reviewed, including discussion of common diagnostic problems, illustrated by a case report of an older woman with late-onset PTSD after a cerebral vascular accident (CVA). In conclusion, identifying PTSD in older adults can be difficult. However, detecting PTSD in older adults is critically important so that possibly hidden or masked trauma symptoms can be addressed in treatment, even if there are complicating factors such as a CVA.

Eye movement desensitisation and reprocessing (EMDR) is an effective treatment for alleviating trauma symptoms, and the positive effects of this treatment have been scientifically confirmed under well-controlled conditions. This has provided an opportunity to explore how EMDR works. The present paper reports on the findings of a long series of experiments that disproved the hypothesis that eye movements or other ‘dual tasks’ are unnecessary. These experiments also disproved the idea that ‘bilateral stimulation’ is needed; moving the eyes up and down produces the same effect as horizontal eye movement, and so do tasks that require no eye movement at all. However, it is important that the dual task taxes working memory. Several predictions can be derived from the working memory explanation for eye movements in EMDR. These seem to hold up extremely well in critical experimental tests, and create a solid explanation on how eye movements work. This paper discusses the implications that this theory and the empirical findings may have for the EMDR technique.

Millions of children each year are exposed to violence in their homes, schools, and communities as both witnesses and victims. As a result, evidence-based programs for children and adolescents who have been exposed to traumatic events (CEV-EBPs) have been widely disseminated but rarely evaluated in their real-world applications. One crucial aspect of conducting such evaluations is finding appropriate measures that can be of use both to the practitioner and to the researcher. This review aims to provide guidance to the field by first identifying any gaps in the availability of psychometrically tested measures for certain outcome domains and age ranges and then recommending the measures that are most appropriate for use by both researchers and practitioners. Interviews with content experts in the measurement of trauma symptoms and parent-child relationships were conducted to identify the key outcome domains for measurement that are critical to the evaluation of CEV-EBPs and the criteria for dual-use measures, defined as measures that are useful to both researchers and practitioners. A database of 46 relevant measures was created by compiling measures from existing repositories and conducting a focused literature review. Our review of these measures found that existing repositories had few measures of depression, a major gap that should be addressed. Further, there were few measures for young children ages 0-3 years (n = 15) and only a handful of measures (n = 9) had both a child and parent version of the measure. Overall, although the different repositories that currently exist are helpful, researchers and practitioners would benefit from having a single reputable source (e.g., a centralized repository or item bank) to access when searching for measures to use in evaluating CEV-EBPs. Such a tool would hold promising to narrow the current gap between research and practice in the field of children's exposure to violence.

Eye movement integration therapy (EMI) is a relatively new therapeutic modality, based on a neurobiological model of trauma. This article advances the empirical knowledge base of EMI, by assessing its utility with a cohort of 12 adolescents, aged 14 to 16 years, in South Africa. The results indicate a reduction in a range of trauma symptoms, based on the Trauma Symptom Checklist for Children and post-EMI interviews with the children's care workers. A number of clinical practice issues regarding the utilization of EMI with children are discussed and illustrated with case material.

Few studies have examined the adjustment of battered women and their children after exiting domestic violence shelters. Participants were 62 women who had endured severe partner abuse, completed a shelter program with their children, and resided in the community for at least 6 months. Field interviews concerned mothers' and children's abuse histories and included measures of maternal depression, maternal trauma, and child behavior problems. Nearly all women had lived violence free since shelter exit. Child internalizing behaviors were associated with direct abuse, maternal depression, and shelter program. Externalizing behaviors were related to maternal depression and shelter program. Neither severity of interparental violence nor maternal trauma symptoms was related to child behavior problems. Mothers' family of-origin abuse predicted current satisfaction with child functioning, beyond the effects of maternal depression and child behavioral problems. Findings suggest a need for postshelter therapeutic services and further research addressing the adjustment of such families.

Research on adult reactions to potentially traumatic events has focused almost exclusively on post-traumatic stress disorder (PTSD). Although there has been relatively little research on the absence of trauma symptoms, the available evidence suggests that resilience following such events may be more prevalent than previously believed. This study examined the prevalence of resilience, defined as having either no PTSD symptoms or one symptom, among a large (n = 2,752) probability sample of New York area residents during the 6 months following the September 11th terrorist attack. Although many respondents met criteria for PTSD, particularly when exposure was high, resilience was observed in 65.1% of the sample. Resilience was less prevalent among more highly exposed individuals, but the frequency of resilience never fell below one third even among the exposure groups with the most dramatic elevations in PTSD.

Cohen and Mannarino (2004) define childhood traumatic grief (CTG) as “a condition in which trauma symptoms impinge on children's ability to negotiate the normal grieving process” (p. 819). Brown and Goodman (2005) add further clarification, “According to our current understanding of CTG and normal grief, thoughts and images of a traumatic nature are so terrifying, horrific, and anxiety provoking that they cause the child to avoid and shut out these thoughts and images that would be comforting reminders of the person who died. In contrast, a child who does not have intrusive reminders, or who did not experience the death as traumatic, is able to access the person in memory in a manner that is positive and beneficial to integrating the death in his or her total life experience” (pp. 255, 257). The distressing and intrusive images, reminders, and thoughts of the traumatic circumstances of the death, along with the physiological hyperarousal associated with such re-experiencing, prevent the child from proceeding in a healthy way with the grieving process. In addition, while such children are ordinarily excluded from studies of empirically validated treatment studies because of severity and co-morbidity of their conditions, clinicians often see youngsters where traumatic death has been superimposed on a history of multiple losses and in some cases socio-cultural trauma and/or major psychiatric disorders in the child or family. The projective drawing and storytelling strategies and the evocative technique described in this article are intended to offer clinicians additional tools to deal with such seriously impacted youth so that the trauma work can be approached in the relative safety of symbolism and metaphor prior to directly confronting the trauma events.

Objective: This article examines survivor perspectives of the effectiveness of two different treatments for trauma symptoms among adult female survivors of childhood sexual abuse—Eye movement Desensitization and Reprocessing (EMDR) and eclectic therapy. Method: Qualitative interviews obtained in the context of a mixed-methods study were conducted with 38 adult female survivors of childhood sexual abuse. Results: Two major differences in outcomes between the two treatment approaches were observed. There were considerable distinctions between the two treatment groups in terms of the importance and effect of the client-therapist relationship, and in terms of the depth of change reportedly caused by the different therapies. Conclusions: Survivors’ narratives indicate that EMDR produces greater trauma resolution, while within eclectic therapy, survivors more highly value their relationship with their therapist, through whom they learn effective coping strategies.

Few epidemiological studies of traumatic events amongst tertiary students have been conducted in South Africa. The aims of this study were to quantify the number of traumatic events experienced by Technikon Pretoria students in the preceeding year and to record the types of trauma symptoms experienced as a result of these traumatic events. The incidence of 10 traumatic event categories have been measured by means of the Traumatic Stress Schedule in a convenience sample (N = 245). The sample consisted of females (n = 183) and males (n = 61). It was found that more than two thirds (70,6%) of the sample reported one or more traumatic events during the preceeding year, with the most frequent traumatic event categories being the death of a loved one, negative change in life circumstances and witness to injury/death. The least frequent traumatic event categories were natural disasters and motor vehicle accidents. Females reported a significantly higher incidence of unwanted sexual activity than males. Intrusive thoughts, particularly amongst female students, was the most frequent symptom associated with 8 of the 10 traumatic event categories, while physical injuries was the least frequent symptom associated with all the traumatic event categories.

The posttraumatic stress symptoms of 39 children who had witnessed domestic violence and 23 children who were living in families with domestic violence were assessed by maternal report. Two measures of PTSD were used and compared, one based on the DSM-IV symptom list and one from the CBCL. Although all children had experienced at least one symptom of trauma, only 3% or 24% of the children, depending on the measure used, met criteria for PTSD based on the DSM-IV. Children with reexperiencing trauma symptoms also had more externalizing behavior problems. The applicability of DSM-IV criteria for young children and the use of the CBCL to assess trauma symptoms were questioned.

Many measures exist to evaluate posttraumatic stress disorder (PTSD), bur there are few ways of assessing secondary traumatic stress disorder and these are Limited to specific populations. Secondary traumatic stress disorder involves the transfer of trauma symptoms from those who have been traumatized to those who have close and extended contact with trauma victims. Thus, family members of those who have been traumatized and therapists who treat trauma survivors are vulnerable to developing secondary traumatic stress disorder. In this initial evaluation of the newly developed Secondary Trauma Questionnaire, 261 mental health professionals and 157 college students were evaluated. Analysis indicated that the questionnaire showed good internal consistency and was significantly correlated with known measures of trauma. The Secondary Trauma Questionnaire is presented as a promising way to measure secondary trauma symptoms and further research using this questionnaire appears to be warranted.

The posttraumatic stress symptoms of 64 children ages 7 to 12 were assessed by their mothers, who had experienced emotional and physical abuse during the past year. A measure of child symptoms based on DSM-IV criteria was used. Of the children exposed to violence, 13% qualified for a complete posttraumatic stress disorder (PTSD) diagnosis. However, 52% suffered from intrusive and unwanted remembering of the traumatic event(s), 19% displayed traumatic avoidance, and 42% experienced traumatic arousal symptoms. Children with PTSD symptoms had significantly more internalizing behavioral problems, as expected; they also had more externalizing problems than did children without trauma symptoms.

Many studies have reported that during high fertility points in the menstrual cycle, women demonstrate increased preference for men with masculinized faces and bodies. In this study, we analyzed whether appetitive aggression in men serves as an additional signal for a favored partner choice. Appetitive aggression describes the intrinsic motivation to act violently even when not being threatened. This study evaluated the responses of 1212 women to one of four descriptions regarding a soldier's experience after returning from war. The four vignettes included trauma related symptoms with high or low appetitive aggression, or no trauma related symptoms with high or low appetitive aggression. Participants rated their desirability for the soldier in regards to potential long-term and short-term relationships. Results indicate that women preferred a soldier high in appetitive aggression as a short-term mate but not as a long-term relationship. This preference for the “warrior” was higher for women in their fertile window of the menstrual cycle. We conclude that women in their fertile window prefer men exhibiting higher appetitive aggression as a short-term partner, revealing appetitive aggression in men may serve as a signal for a higher genetic fitness.