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Although extant research examining predictors of development of Posttraumatic Stress Disorder (PTSD) have focused primarily on fear and anxiety, recent research suggests that a range of different emotional reactions may occur in response to traumatic events. For example, specific aspects of traumatic exposure frequently include either experiencing or witnessing events that may elicit disgust, including injury, death, or sexual assault (e.g., Dalgleish and Power in Behav Res Ther Spec Issue Festschrift Spec Issue John Teasdale 42(9):1069-1088, 2004); McNally in J Anxiety Disord 16(5):561-566, 2002). However, no published research has specifically examined the role of disgust propensity in the development and maintenance of PTSD. Thus, the aim of the present study was to evaluate the relationship between disgust propensity and intrusive symptoms. To this end, 30 undergraduates without symptoms of PTSD were recruited to participate in a distressing film paradigm (for a review of this paradigm see Holmes and Bourne in Acta Psychol 127(3):553-566, 2008). Anxiety, depression, and trait disgust scores were entered hierarchically into a regression equation to predict the number of intrusions during a post-film thought monitoring period. Results indicated that disgust propensity predicted intrusions independent of anxiety and depression. Although still preliminary, results suggest that disgust propensity may be one factor that predicts frequency of intrusive memories after witnessing injury or bodily harm.
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PMID:Disgust Propensity as a Predictor of Intrusive Cognitions Following a Distressing Film. 2266 95

This study examined patterns of nine types of violence against women (VAW) and associated mental health problems. The following self-reported, lifetime violence victimization was examined among 1424 employed women: (1) childhood physical abuse, (2) childhood sexual abuse, (3) physical abuse between parents/guardians during childhood, (4) psychological intimate partner violence (IPV), (5) physical IPV, (6) sexual IPV, (7) adult physical or sexual assault by a non-intimate partner, (8) physical workplace violence, and (9) psychological workplace violence. Latent class analysis was used to identify homogenous patterns, called "classes," of women's "yes/no" responses to experiencing these types of violence. The best model consisted of 4-classes characterized by the following probabilities: low violence (class 1: 63.1%), high psychological and physical IPV (class 2: 15.6%), high physical and psychological workplace violence (class 3: 12.4%), and moderate to high childhood abuse (class 4: 9.0%). When compared to class 1 (low violence), membership in classes 2 (IPV) and 4 (childhood abuse) was associated with screening positive for depression in the past week at baseline after controlling for the influence of demographic characteristics on class membership. Also, when compared to class 1 (low all), membership in class 2 (IPV) was associated with greater odds of screening positive for posttraumatic stress disorder in the past month at the six month follow-up assessment. Findings document distinct patterns of VAW and associated proximal and distal mental health outcomes. Implications for interventions aimed to improve employed women's health are discussed.
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PMID:Patterns of Violence Against Women: A Latent Class Analysis. 2266 84

The current study reports results from a pilot randomized controlled trial evaluating the feasibility and efficacy of Risk Reduction through Family Therapy (RRFT) for reducing substance use risk and trauma-related mental health problems among sexually assaulted adolescents. Thirty adolescents (aged 13-17 years; M = 14.80; SD = 1.51) who had experienced at least one sexual assault and their caregivers were randomized to RRFT or treatment as usual (TAU) conditions. Participants completed measures of substance use, substance use risk factors (e.g., family functioning), mental health problems (i.e., posttraumatic stress disorder, depression, and general internalizing/externalizing symptoms) and risky sexual behavior at four time points (baseline, posttreatment, and 3- and 6-month follow-up). Mixed-effects regression models yielded significantly greater reductions in substance use, specific substance use risk factors, and (parent-reported) PTSD, depression, and general internalizing symptoms among youth in the RRFT condition relative to youth in the TAU condition. However, significant baseline differences in functioning between the two conditions warrant caution in interpreting between-groups findings. Instead, emphasis is placed on replication of feasibility findings and within-group improvements over time among the RRFT youth.
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PMID:Reducing substance use risk and mental health problems among sexually assaulted adolescents: a pilot randomized controlled trial. 2268 69

Many survivors of gender based violence (GBV) in the Democratic Republic of Congo (DRC) report barriers to access health services including, distance, cost, lack of trained providers and fear of stigma. In 2004, Foundation RamaLevina (FORAL), a Congolese health and social non-governmental organization, started a mobile health program for vulnerable women and men to address the barriers to access identified by GBV survivors and their families in rural South Kivu province, Eastern DRC. FORAL conducted a case study of the implementation of this program between July 2010-June 2011 in 6 rural villages. The case study engaged FORAL staff, partner health care providers, community leaders and survivors in developing and implementing a revised strategy with the goal of improving and sustaining health services. The case study focused on: (1) Expansion of mobile clinic services and visit schedule; (2) Clinical monitoring and evaluation system; and (3) Recognition, documentation and brief psychosocial support for symptoms suggestive of anxiety, depression and PTSD. During this period, FORAL treated 772 women of which 85% reported being survivors of sexual violence. Almost half of the women (45%) reported never receiving health services after the last sexual assault. The majority of survivors reported symptoms consistent with STI. Male partner adherence to STI treatment was low (41%). The case study demonstrated areas of strengths in FORAL's program, including improved access to health care by survivors and their male partner, enhanced quality of health education and facilitated regular monitoring, follow-up care and referrals. In addition, three critical areas were identified by FORAL that needed further development: provision of health services to young, unmarried women in a way that reduces possibility of future stigma, engaging male partners in health education and clinical care and strengthening linkages for referral of survivors and their partners to psychosocial support and mental health services. FORAL's model of offering health education to all community members, partnering with local providers to leverage resources and their principal of avoiding labeling the clinic as one for survivors will help women and their families in the DRC and other conflict settings to comfortably and safely access needed health care services.
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PMID:A Congolese community-based health program for survivors of sexual violence. 2293 49

Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD). Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack), being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed "acute PTSD," otherwise, it is called "chronic PTSD." 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%-40%; the rate in rescue workers was 10%-20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%-32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%), firefighters (21%), and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work-related PTSD. Working with severely ill patients, journalists and their families, and audiences who witness serious trauma and war at higher risk of PTSD.The intensity of trauma, pre-trauma demographic variables, neuroticism and temperament traits are the best predictors of the severity of PTSD symptoms. About 84% of those suffering from PTSD may have comorbid conditions including alcohol or drug abuse; feeling shame, despair and hopeless; physical symptoms; employment problems; divorce; and violence which make life harder. PTSD may contribute to the development of many other disorders such as anxiety disorders, major depressive disorder, substance abuse/dependency disorders, alcohol abuse/dependence, conduct disorder, and mania. It causes serious problems, thus its early diagnosis and appropriate treatment are of paramount importance.
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PMID:Post-traumatic Stress Disorder. 2302 45

How a support provider responds to disclosure of sexual victimization has important implications for the process of recovery. The present study examines the associations between various positive and negative social reactions to sexual assault disclosure and psychological distress, coping behavior, social support, and self-esteem in a sample of college women (N = 374). Social reactions to assault disclosure that attempted to control the survivor's decisions were associated with increased symptoms of posttraumatic stress, depression, and anxiety and lower perceptions of reassurance of worth from others. Blaming social reactions were associated with less self-esteem and engagement in coping via problem solving. Social reactions that provided emotional support to the survivor were associated with increased coping by seeking emotional support. Contrary to expectations, social reactions that treated the survivor differently were associated with higher self-esteem. Implications are discussed.
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PMID:Social reactions to disclosure of sexual victimization and adjustment among survivors of sexual assault. 2330 Jan 95

To examine the context of sexual assault and postassault actions and consequences among women attending historically Black colleges or universities (HBCUs), web-based surveys were administered in November 2008 to 3,951 undergraduate women attending four HBCUs. Data on the context in which assaults occurred were generated for women who had been sexually assaulted since entering college (n = 358). Multivariate models were run on the full sample to examine the association between sexual assault and symptoms of depression and posttraumatic stress disorder (PTSD). Results indicated that most survivors were assaulted by assailants well known to them and when the survivor and perpetrator were drinking alcohol. Very few survivors disclosed their experiences to formal sources of support. Survivors had significantly more symptoms of depression and were more likely to screen positive for PTSD than nonvictims. Further research on disclosure and its moderating role on the mental health consequences of sexual assault is needed.
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PMID:The context and consequences of sexual assault among undergraduate women at Historically Black Colleges and Universities (HBCUs). 2351 64

A sizable body of research supports trauma's cumulative nature. However, few studies have evaluated potential mechanisms through which the experience of multiple traumas leads to elevated distress. The current study sought to evaluate differences between sexual trauma victims and women who had not experienced sexual trauma in their adjustment following a mass trauma (college women exposed to the 2007 Virginia Tech campus shooting). In addition, the study examined whether maladaptive schema change (lower self-worth and less belief in benevolence) and social support mediated the relationship between experiencing multiple traumas (sexual trauma and the campus shooting) and distress. The sample consisted of 215 college women who were assessed preshooting as well as two months and one year following the campus shooting. Women who had experienced sexual trauma (either contact sexual abuse or sexual assault) were compared to those who had not on their one-year postshooting PTSD and depressive symptoms. Results supported that sexual trauma victims reported significantly more depressive symptoms and shooting-related PTSD as well as less belief in benevolence and lower family support. Family support and benevolence beliefs at the two month postshooting assessment were significant medi-ators of the association between sexual trauma history and depression and PTSD. Implications of the findings for future research evaluating the cumulative impact of multiple traumatic experiences are discussed.
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PMID:Prior Sexual Trauma and Adjustment Following the Virginia Tech Campus Shootings: Examination of the Mediating Role of Schemas. 2379 37

Building on the simulated-amnesia work of Christianson and Bylin (Applied Cognitive Psychology, 13, 495-511, 1999), the present research introduces a new paradigm for the scientific study of memory of childhood sexual abuse information. In Session 1, participants mentally took the part of an abuse victim as they read an account of the sexual assault of a 7-year-old. After reading the narrative, participants were randomly assigned to one of four experimental conditions: They (1) rehearsed the story truthfully (truth group), (2) left out the abuse details of the story (omission group), (3) lied about the abuse details to indicate that no abuse had occurred (commission group), or (4) did not recall the story during Session 1 (no-rehearsal group). One week later, participants returned for Session 2 and were asked to truthfully recall the narrative. The results indicated that, relative to truthful recall, untruthful recall or no rehearsal at Session 1 adversely affected memory performance at Session 2. However, untruthful recall resulted in better memory than did no rehearsal. Moreover, gender, PTSD symptoms, depression, adult attachment, and sexual abuse history significantly predicted memory for the childhood sexual abuse scenario. Implications for theory and application are discussed.
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PMID:Memory for child sexual abuse information: simulated memory error and individual differences. 2383

Existing research indicates that there is very little agreement between youth and their parents on youth trauma exposure and subsequent treatment. Few studies, however, have attempted to examine factors that may contribute to this lack of agreement. This study addressed this gap by examining youth and maternal-reported youth traumatic event exposure using a sample of 100 urban, African American adolescent-maternal dyads. Cumulative report of youth potentially traumatic event exposure (57%) was higher than youth (41%) and maternal (27%) reports. Findings indicate that there was agreement for sexual assault, being shot or stabbed, and auto accidents. Maternal depression was the only factor that was associated with both youth and maternal report of youth qualifying event. Other factors that distinguished youth reports included maternal event exposure, substance use disorder, antisocial personality behaviors, and youth reports of arguments with the mother and running away from home. Implications for reconciling reports of trauma exposure among youth and their mothers are discussed.
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PMID:Comparing factors associated with maternal and adolescent reports of adolescent traumatic event exposure. 2420 43


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