Cumulative Trauma, Personal and Social Resources, and Post-Traumatic Stress Symptoms Among Income-assisted Single Mothers (original) (raw)
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Single Mother’s Adverse and Traumatic Experiences and Post-Traumatic Stress Symptoms
Journal of Family Violence, 2011
A random sample of 247 Canadian single mothers currently receiving social assistance participated in a study designed to: a) provide a comprehensive description of mother’s lifetime exposure to 11 adversities, four psychological traumas, and eight assaultive traumas; b) examine the association between exposure to childhood and adulthood adversities and traumas, and mother’s current post-traumatic stress symptom. Of those surveyed, 31% met the criteria for a probable PTSD diagnosis. Between 78% and 80% reported 1 or more lifetime adversity, psychological trauma, and assaultive trauma. Rates of adversities were similar to the general female population. However, rates of psychological and assaultive trauma were six to ten times greater than the general female population. Results show that level of exposure to psychological and assaultive traumas, but not adversity, differentially impacted both the patterning and severity of mothers’ current PTSD symptoms. Psychological trauma exposure was the only event type that differentiated the mean scores for the re-experiencing, avoidance/numbing, and hyper-arousal symptom clusters. While exposure to assaultive trauma differentiates mean scores primarily for the avoidance/numbing symptoms cluster. Implications for health promotion initiatives across health and social service sectors are discussed.
Canadian Journal of Community Mental Health, 2013
In this study, data from 181 income-assisted single mothers residing in Ontario, Canada, is used to examine the process through which childhood abuse and intimate partner violence (IPV) affect current post-traumatic stress disorder (PTSD) symptom levels. Structural equation modelling is used to examine the mediating effects of empowerment, social support, and interpersonal conflict on the trauma–PTSD process. Empowerment and social support are highlighted as key protective factors that may be compromised by exposure to abuse/violence and interpersonal conflict. Implications include understanding the ways in which women’s empowerment may be enhanced particularly in the post-trauma period.
Journal of Urban Health, 2008
Posttraumatic stress disorder (PTSD) is an anxiety disorder that occurs after a traumatic event and has been linked to psychiatric and physical health declines. Rates of PTSD are far higher in individuals with low incomes and who reside in urban areas compared to the general population. In this study, 250 urban health care-seeking women were interviewed for a diagnosis of PTSD, major depressive disorder, and also the experience of traumatic events. Multivariate logistic regressions were used to determine the associations between traumatic events and PTSD development. Survival analysis was used to determine if PTSD developed from assaultive and nonassaultive events differed in symptom duration. Eighty-six percent of women reported at least one traumatic event, 14.8% of women were diagnosed with current PTSD, and 19.6% with past PTSD. More than half of women with PTSD had comorbid depression. Assaultive traumatic events were most predictive of PTSD development. More than two thirds of the women who developed PTSD developed chronic PTSD. Women who developed PTSD from assaultive events experienced PTSD for at least twice the duration of women who developed PTSD from nonassaultive events. In conclusion, PTSD was very prevalent in urban health care-seeking women. Assaultive violence was most predictive of PTSD development and also nonremittance. 693 mediate MDD development in traumatized individuals. 4,5 Lastly, MDD has been shown to co-occur in almost half of individuals who develop PTSD, compounding psychological and physical health impairments. Women develop PTSD at twice the rate of men, 1-3,8-10 and also experience PTSD symptoms for longer periods than men. 2 Women's vulnerability for PTSD development may be related to the experience of assaultive events. Assaultive traumatic events including rape, sexual assault, physical assault, or being robbed, mugged, shot, or stabbed have been shown to result in substantially higher risk for PTSD development than non-assaultive events. Individuals who experienced one traumatic event were not at any greater risk to develop PTSD compared to nontraumatized controls; however, individuals who reported experiencing two or three traumatic events were two to three times more likely to develop PTSD than nontraumatized controls. 1,3,12 Assaultive events perpetrated by a known assailant and which may take place over time, such as childhood sexual abuse and intimate partner violence (IPV), place women at high risk for PTSD development. Longitudinal and cross-sectional studies have shown the duration and severity of abuse to be related to the risk for PTSD development, particularly in individuals who experienced IPV or childhood physical or sexual abuse. PTSD is more prevalent among individuals seeking health care, with rates more than triple the national rate, resulting in current PTSD rates between 8% and 14%. 2,11,18 Furthermore, in samples of more-urban and less-insured individuals, extremely high rates of PTSD have been reported, including a study in which 30% of health care-seeking urban women were diagnosed with lifetime PTSD. Individuals with PTSD may be more prominent in primary care settings because of greater use of out-patient services 20-23 and the experience of additional medical conditions. African Americans who live in urban economically disadvantaged areas experience higher rates of trauma and PTSD than the general population. 1,3,6,26 In a sample of health care-seeking urban African-American women, rates of current PTSD were as high as 23%. In a large epidemiologic study, rates of PTSD for nonwhites was twice as high as whites (14% versus 7%); however, these higher rates were attributed to socioeconomic status and urban residence, suggesting that these factors may congregate and result in increased risk. The chronic stress of poverty and urban living may contribute to PTSD risk. Low-income urban women are confronted with chronic stressors including economic hardship, which extends to nearly every aspect of ordinary life, from difficulties meeting daily needs to dangers of substandard housing and dangerous neighborhood environments. The cumulative burden of economic hardship, witnessing violent crimes, limited health care resources, and high risk for direct victimization may tax urban women's psychological resources, increasing the risk for psychiatric and physical health declines. Although high rates of trauma and PTSD have been reported in samples of urban African-American women, the nature of PTSD risk has not been wellcharacterized. Therefore, this study was undertaken in a health care-seeking urban sample of predominantly African-American women, and was guided by four specific aims: (1) to determine how many women experienced traumatic events and also the percentage who developed PTSD and MDD, (2) to identify traumatic events that were associated with an increased risk for PTSD development, (3) to determine if assaultive precipitating trauma increased the duration of PTSD, and (4) to describe the association between PTSD and MDD. GILL ET AL. 694 PTSD IN UNINSURED HEALTH CARE-SEEKING WOMEN 695
Resource Loss and Naturalistic Reduction of PTSD Among Inner-City Women
Journal of Interpersonal Violence, 2008
Halting the process of psychosocial and material resource loss has been theorized as being associated with the reduction of posttraumatic stress disorder (PTSD). This study examines how the limiting of resource loss is related to alleviation of PTSD symptoms among 102 inner-city women, who originally met diagnostic criteria for PTSD after experiencing interpersonal traumatic events such as child abuse, rape, and sexual assault. Participants whose PTSD symptoms improve and become nondiagnostic for PTSD are compared with those who remain diagnostic. The two groups are not significantly different at pretest. However, at the 6-month time point, those who become nondiagnostic for PTSD report less resources loss in three of four domains. This pattern suggests that as PTSD symptoms decrease, women's material and psychosocial resource loss diminishes, which in turn, may aid their recovery process.
Anxiety, Stress, & Coping
Background/Objectives: Inner-city Black women may be more susceptible to post-traumatic stress disorder (PTSD) than White women, although mechanisms underlying this association are unclear. Living in urban neighborhoods distinguished by higher chronic stress may contribute to racial differences in women's cognitive, affective, and social vulnerabilities, leading to greater trauma-related distress including PTSD. Yet social support could buffer the negative effects of psychosocial vulnerabilities on women's health. Methods/Design: Mediation and moderated mediation models were tested with 371 inner-city women, including psychosocial vulnerability (i.e., catastrophizing, anger, social undermining) mediating the pathway between race and PTSD, and social support moderating psychosocial vulnerability and PTSD. Results: Despite comparable rates of trauma, Black women reported higher vulnerability and PTSD symptoms, and lower support compared to White Hispanic and non-Hispanic women. Psychosocial vulnerability mediated the pathway between race and PTSD, and social support moderated vulnerability, reducing negative effects on PTSD. When examining associations by race, the moderation effect remained significant for Black women only.
Social Science & Medicine, 2012
Hurricane Katrina, which struck the Gulf Coast of the United States in August 2005, exposed area residents to trauma and extensive property loss. However, little is known about the long-run effects of the hurricane on the mental health of those who were exposed. This study documents long-run changes in mental health among a particularly vulnerable groupdlow income mothersdfrom before to after the hurricane, and identifies factors that are associated with different recovery trajectories. Longitudinal surveys of 532 low-income mothers from New Orleans were conducted approximately one year before, 7 e19 months after, and 43e54 months after Hurricane Katrina. The surveys collected information on mental health, social support, earnings and hurricane experiences. We document changes in posttraumatic stress symptoms (PTSS), as measured by the Impact of Event Scale-Revised, and symptoms of psychological distress (PD), as measured by the K6 scale. We find that although PTSS has declined over time after the hurricane, it remained high 43e54 months later. PD also declined, but did not return to pre-hurricane levels. At both time periods, psychological distress before the hurricane, hurricane-related home damage, and exposure to traumatic events were associated with PTSS that co-occurred with PD. Hurricane-related home damage and traumatic events were associated with PTSS without PD. Home damage was an especially important predictor of chronic PTSS, with and without PD. Most hurricane stressors did not have strong associations with PD alone over the short or long run. Over the long run, higher earnings were protective against PD, and greater social support was protective against PTSS. These results indicate that mental health problems, particularly PTSS alone or in co-occurrence with PD, among Hurricane Katrina survivors remain a concern, especially for those who experienced hurricane-related trauma and had poor mental health or low socioeconomic status before the hurricane.
Violence and Victims, 2019
The study used the ecological model of trauma and recovery (Harvey, 1996) to examine the rates of probable posttraumatic stress disorder (PTSD) among female victims of domestic violence. Five hundred and five participants completed questionnaires upon entering shelters in Israel. Analysis showed that 61% of the participants reported probable PTSD. Childhood exposure to violence, violence severity, and feeling helpless were all associated with high PTSD levels. By contrast, Ethiopian ethnicity, social support, and a stronger sense of control were associated with lower PTSD levels. However, the interaction between social support and violence duration showed that social support did not moderate PTSD when exposure to violence endured. The study emphasizes that resources deteriorate, and that policy-augmenting prevention programs would increase treatment potential to strengthen survivors' coping capacities.
PTSD symptoms and partner abuse: Low income women at risk
Journal of Traumatic Stress, 2001
Aspects of partner abuse (types, severity, chronicity, treatment of injury, fear, etc.) were addressed with low income community women, half of whom scored above the cutoff on the Crime Related PTSD scale. Using this cutoff, 47% of women who sustained moderate violence were high in CR-PTSD symptoms. If their partner also raped them, the rate (63%) was similar to women who sustained severe violence (65%) or severe violence and rape (71%). No ethnic differences were found for rates or severity of CR-PTSD symptoms. A MANCOVA by ethnicity (African Americans, Euro-Americans, Mexican Americans) and CR-PTSD symptoms (low vs. high) identified ethnic differences only on total sexual aggression and recent threats of violence. The high symptom group reported more abuse on all measures. Results from the CR-PTSD and the general lack of ethnic differences support the notion that SES contributes more to women's vulnerability to abuse and stress symptoms than does ethnicity.
Research in Nursing & Health, 2007
We examined social support as a protective factor in the relationship between lifetime exposure to traumatic events and Post-Traumatic Stress Disorder (PTSD) symptomatology among urban women. Seventy-six women who sought care in a trauma center for injuries from physical or sexual violence completed an interview. When tangible support, rather than total social support, and the interaction of tangible support and lifetime trauma were tested, tangible support moderated the relationship between lifetime trauma and PTSD. Given the complex etiology of lifetime trauma, risk for future trauma and the health needs of women who have experienced trauma, a broader range of intervention strategies that include attention to tangible support need to be developed and evaluated. ß
The Clinical journal of pain, 2018
Given high levels of traumatic stress for low-income, inner-city women, investigating the link between PTSD and pain is especially important. Using the Conservation of Resources (COR) Theory, we investigated direct and indirect relationships of PTSD symptoms, vulnerability factors (i.e., resource loss, depressive symptoms and social undermining), and resilience factors (i.e., optimism, engagement, and social support) to acute pain reports in a sample of low-income, inner-city women. Participants (N=341; M Age=28▒y; 58.0% African American) were recruited from an inner-city Emergency Department (ED) following presentation with an acute pain-related complaint. Study data were gathered from psychosocial questionnaires completed at a baseline interview. Structural Equation Modeling examined direct and indirect relationships among PTSD symptoms, vulnerability factors and resilience factors on self-reported pain intensity and pain interference. PTSD symptoms were directly related to higher...