Trauma, posttraumatic symptoms, and health in Hawaii: Gender, ethnicity, and social context

xv, 134 p. : ill. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number.Prior research finds that exposure to traumatic stress negatively impacts physical and mental health, and that the social context in which trauma occurs is an important predictor of symptom development. Eight-hundred thirty-three members of an ethnically diverse longitudinal cohort study in Hawaii were surveyed about their personal exposure to several types of traumatic events, socioeconomic resources, mental health symptoms, and health status. Rates of trauma exposure were predicted to vary as a function of type of trauma and participant gender and ethnicity. In addition, access to social resources and the relational context of trauma were predicted to be associated with symptom reports in this ethnically diverse sample of men and women. Results replicated findings that while men and women are exposed to similar rates of trauma overall, women report more exposure to traumas high in betrayal. while men report exposure to more lower-betrayal traumas. Women also reported more mental health symptoms, and traumas higher in betrayal were generally more predictive of symptoms. Ethnic group variation in trauma exposure and physical and mental health symptoms was also present: ethnic groups with lower socioeconomic status generally reported more trauma exposure and symptoms, although in some cases the pattern of results was not straightforward. This study adds new information about the prevalence of traumatic stress and mental health symptoms across ethnic groups in Hawaii, and how these relate to social context. In addition, this study provides preliminary information on the independent contribution of neglect and household dysfunction to the prediction of symptoms. The relevance of these results can be summarized with three main arguments. First, measures of trauma exposure must include events that occur across relational contexts if they are to be gender equitable and most predictive of symptoms. Second, gender and ethnic group differences in symptoms are largely explained by differential trauma exposure and differential access to educational and economic resources. Third, prevention and intervention efforts must address both trauma exposure and social context, as each is implicated in the presentation of symptoms.Committee in charge: Jennifer Freyd, Chairperson, Psychology; Anne Simons, Member, Psychology; Gerard Saucier, Member, Psychology; Debra Merskin, Outside Member, Journalism and Communicatio

Dissociation and Memory for Neutral and Traumatic Stories

Previous research has consistently found a positive correlation between history of trauma and dissociation, and recent research (DePrince and Freyd, 1999; 2004) suggests that people who score high on a measure of dissociation may have enhanced abilities at dividing attention and suppressing traumatic information from consciousness. The current study set out to replicate these findings using more complex stimuli than have been used previously. Fifty-two subjects, half scoring high and half low on the Dissociative Experiences Scale, watched neutral videos while listening to neutral and trauma related stories. High dissociators remembered significantly more than low dissociators when listening to neutral stories, and performed no differently than low dissociators when listening to trauma related stories. This interaction was significant, t (50) = 1.72, p < .05 (one-tailed), and this finding is consistent with previous research.Supported in part by the Trauma and Oppression Research Fund at the University of Oregon Foundation

Global Coding of Trauma Essays Predicts Health

Past research has demonstrated in a variety of contexts that writing about emotional topics can benefit physical health and general well being. Most of this prior research has used a computer program, but not global essay ratings, to assess what aspects of written essays might be associated with such benefits. Yet scoring rubrics are commonly used in the field of education to score global aspects of student writing. The current study used a sub-sample of essays from a larger research project on trauma, writing and health to develop a global rating rubric for essays about trauma based on rubrics used in education. The resulting rubric was reliably applied to participants' essays about trauma. Global ratings of the coherence or organization of participants' essays were correlated with improvements in physical and mental health measures at a six-month follow-up. Possible implications of these findings and future research directions are discussed.Supported in part by a grant from the Northwest Health Foundation of Portland Oregon (Grant Number 2001-255, "Child Abuse and Health: An Intervention," PI: Jennifer Freyd), and by the Trauma and Oppression Research Fund at the University of Oregon Foundation

Physical Health, Psychological Distress, and Betrayal Trauma

Numerous studies have revealed an association between trauma and adverse physical and mental health status. While the relation is well established, the mechanisms underlying this link are less well understood. In the current study we sought to distinguish impact on health arising from types of trauma as indicated by betrayal trauma theory (Freyd 1996, 2001), with an eye toward eventually uncovering mechanisms and developing interventions. Betrayal trauma theory distinguishes two dimensions as primary for events that cause long lasting harm to people: life-threat (e.g. major car accident; urban violence) and social betrayal (e.g. abuse by a close other). We recruited 99 community adults who reported at least 12 months of chronic medical or pain problems for a longitudinal intervention study. Participants were assessed for trauma history and physical and mental symptoms. Trauma assessment included measuring exposure to both traumas high in betrayal and traumas low in betrayal (but high in life-threat). Associations between overall trauma exposure and negative health and mental status were found. High betrayal was particularly potent. For instance, exposure to traumas with high betrayal is significantly correlated with number of physical illness symptoms (r=.37), anxiety symptoms (r = .49), and depression symptoms (r=.45). Multiple regression analyses predicting these symptoms from betrayal trauma exposure reveal that adding exposure to trauma with less betrayal into the model changes R-square statistics very little, and these changes are not significant. This pattern of results has been replicated with data recently collected in our laboratory using a different population. In addition, interesting gender effects are emerging. With the large amount of variance in symptoms predicted by exposure to high betrayal trauma, we are focusing on uncovering mechanisms and evaluating the health consequences of an intervention that involves writing about reactions to these events.This research was supported by the Northwest Health Foundation Grant Number 2001-255 Child Abuse and Health: An Intervention (Freyd, PI). The manuscript preparation was also supported in part by the Trauma and Oppression Research Fund at the University of Oregon Foundation

Adult trauma and adult symptoms: Does childhood trauma drive the relationship?

We used structural modeling to examine observed relationships between childhood trauma, adult trauma, and adult dissociation and mental health. We propose a model in which childhood betrayal trauma predicts adult betrayal trauma and dissociation, and dissociation predicts mental health. Paths between adult betrayal trauma and dissociation, and adult betrayal trauma and mental health were set at zero. This model was tested using questionnaire data from 307 undergraduates. The model fit the data very well (comparative fit index = .98, chi-square(df = 8) = 21.99), and performed as well as other less parsimonious models. Alternative equivalent models and implications of these findings are discussed. The pattern of parameter estimates generated for this model suggests that childhood trauma drives the relationship between trauma and symptoms.Supported in part by the Trauma and Oppression Research Fund at the University of Oregon Foundation