PERINATAL AND FAMILY SERVICES

Trauma

This webpage identifies the major literature in the field of perinatal and family services: trauma. The time frame is from January 2000 through December 2014.

Babcock, R. L., DePrince, A. P. (2013). Factors contributing to ongoing intimate partner abuse: childhood betrayal trauma and dependence on one’s perpetrator. Journal of Interpersonal Violence, 28(7), pp. 1385-1402. DOI: 10.1177/0886260512468248

This study assessed prospectively whether childhood betrayal trauma (BT) history and women’s potential dependence on their perpetrators (unemployment, number of children below 13) increased women’s risk of ongoing victimization, while controlling for trauma-related symptoms (PTSD, depression, dissociation). Results of the study showed that higher levels of childhood BT were associated with ongoing victimization over the course of 6 months. Women’s unemployment status predicted greater physical and sexual aggression and injuries. Higher levels of depression and lower levels of PTSD symptoms were also associated with increases in physical, sexual, and psychological aggression, and bodily injury. The findings have important implications for interventions by demonstrating the need to process women’s betrayal trauma experiences, target depression symptoms, and increase women’s economic opportunities to prevent further victimization.

Calms, S. M., Laux, J. M., Holly, L. S., Reynolds, J. R., Roseman, C. P., & Piazza, N. J. (2013). Childhood psychological trauma and first-year college students’ substance dependence. The American Counseling Association, 34(2), pp. 70-80. DOI: 10.1002/j.2161-1874.2013.00016.x

The purpose of this study is to determine if there is a relationship between adverse childhood events and substance use in a 1st-year college student sample. First-year college students (N = 143) completed the Substance Abuse Subtle Screening Inventory-3 and a questionnaire about childhood traumatic experiences. According to the authors’ findings, as the number of traumatic experiences increases, so does the likelihood of substance use in college.

Clark, C. B., Reiland, S., Thorne, C., & Cropsey, K. L. (2014). Relationship of trauma exposure and substance abuse to self-reported violence among men and women in substance abuse treatment. Journal of Interpersonal Violence, 29(1), pp. 1514.

This article presents the findings of a study looking at the relationship between substance use, trauma, and aggression. The study included 615 individuals in substance abuse treatment program for individuals under criminal justice supervision. Findings suggest that individuals with history of trauma and regular substance use reported the highest rates of homicidal ideation, problem behaviors, and person offences, this group also reported greater desire for help in the management of their stress and tension, dealing with problems in intimate relationships, developing healthier relationships, and learning how to express their feelings. Participants who experienced trauma presented with more externalizing behaviors, and greater desire for coping- and social-skills training than those who did not report experiencing trauma.

Cohen, L. R., Field. C., Campbell, A. N. C., & Hien, D. A. (2013). Intimate partner violence outcomes in women with PTSD and substance use: A secondary analysis of NIDA Clinical Trials Network “Women and Trauma” Multi-site Study. Addictive Behaviors, 38(7), pp. 2325-2332.

The current study is a secondary analysis of a larger NIDA Clinical Trials Network study exploring the effectiveness of two behavioral interventions for women with comorbid PTSD–SUD. Participants of the study were assigned to either Seeking Safety (SS), a cognitive-behavioral treatment that focuses on trauma and substance abuse symptoms, or to Women's Health Education, a psychoeducational group. Findings of the study showed that at a trend level participants with recent interpersonal trauma at baseline and higher total of lifetime trauma exposures were more likely to report IPV during follow-up. The authors indicate that an integrated treatment for PTSD and SUD was associated with significantly better IPV outcomes for some individuals. The possibility that women with PTSD–SUD may differentially benefit from SS has important clinical implications. Further research examining the intersection of PTSD, SUD and IPV, and the impact of treatment on a range of outcomes is needed.

Cordovilla Guardia, S., Rodriguez-Bolanos, S., Guerrero Lopez, F., Lara-Rosales, R., Pino Sanchez, F., Rayo, A., & Fernandez-Mondejar, E. (2013). Alcohol and/or drug abuse favors trauma recurrence and reduces the trauma-free period. Med Intensiva, 37(1), pp. 6-11.

This study seeks to look at the influence of alcohol and/or drug abuse upon recurrence of trauma, with an analysis of the influence of such abuse upon the time to appearance of first injury in patients without antecedents of trauma. According to the study results, alcohol and/or drug abuse increases the likelihood of recurrent trauma and may shorten the mean trauma-free period among patients without a history of trauma by almost 15 years.

Cross, P. T., Mathews, B., Tonmyr, L., Scott, D. & Ouimet, C. (2012). Child welfare policy and practice on children’s exposure to domestic violence. Child Abuse and Neglect, 36(3), pp. 210-216.

This article reviews research, policy and programming in Australia, Canada and the US on the child welfare response to Exposure to Domestic Violence. The authors summarizes current knowledge on the prevalence of EDV and on child welfare service policies and practices that may reduce the impact and frequency of EDV. The authors suggest that empirical data are limited, but current research and practice experience suggest that child welfare agencies seeking to improve the response to EDV should collaborate with other disciplines involved with preventing and responding to DV, seek resources to support training and programming, consider methods that avoid stigmatizing parents, and build in a program evaluation component to increase knowledge about effective practice.

Dam, D., Ehring, T., Vedel. E., & Emmalkamp, P. M. G. (2013). Trauma-focused treatment for posttraumatic stress disorder combined with CBT for severe substance use disorder: a randomized controlled trial. BMC Psychiatry, 13, pp. 172.

This article investigated the effectiveness of a combined treatment for comorbid Posttraumatic Stress Disorder (PTSD) and severe Substance Use Disorder (SUD). The authors investigated the effectiveness of adding PTSD treatment to the intensive SUD treatment program compared to Treatment as usual. The author’s findings provide preliminary evidence that adding a trauma-focused treatment on to standard SUD treatment may be beneficial.

Devries, K. M., Child, J. C., Bacchus, L. J., Mak, J., Falder, G., Graham, K., Watts, C., & Heise, L. (2014). Intimate partner violence victimization and alcohol consumption in women: a systematic review and meta-analysis. Addictions, 109, pp. 379-391.

The authors of this article conducted a review of the literature examining 1) the evidence of association between women’s alcohol use, alcohol use disorders and experience of physical and/or sexual intimate partner violence victimization; 2) the direction, magnitude and consistency of the association and; 3) sources of heterogeneity in estimates. The authors conclude that women’s drinking and victimization from IPV are linked but the causal direction of relationship is not clear. Authors state that further studies looking at victimization and perpetration are needed to further understand the relationship between IPV experience and alcohol use.

Horwitz, M. S., Hurlburt, S. M., Heneghan, A., Zhang, J., Rolls-Reutz, J. Fisher, E…Stein, R. E. (2012). Mental health problems in young children investigated by U.S. child welfare agencies. Journal of the American Academy of Child & Adolescent Psychiatry, 51(6), pp. 572-581.

This article examines the prevalence/predictors of mental health (MH) problems and services used by families with 12- to 36-month-old children who have been investigated for maltreatment. According to the authors, the data suggests that there is a high rate of MH problems in very young children with history of maltreatment. Identifiable MH problems are common, but few children receive services for those problems. The lack of services received by these young, multi-challenged children is a services systems and social policy failure.

Kisiel, C. L., Fehrenbach, T., Torgensen, E., Stolbach, B., McClelland, G., Griffin, G., & Burkman, K. (2014). Constellations of interpersonal trauma and symptoms in child welfare: Implications for a developmental trauma framework. Journal of Family Violence, 29, pp. 1-14.

This study seeks to identify youth with histories of interpersonal trauma exposure upon entry to the child welfare system, determine whether there are differences in symptom patterns and severity for these young, and determine if youth with specific constellations of trauma exposure are more likely to have negative child welfare-related outcomes. Findings suggest a developmental trauma framework can more adequately capture the spectrum of needs of these multiply traumatized youth than existing diagnostic formulations. Utilizing this framework for assessment, treatment planning, and intervention can lead to more targeted and effective services for these children.

Lamers-Winkelman, F., Willemen, M. A. & Visser, M. (2012). Adverse childhood experiences of referred children exposed to intimate partner violence: consequences for their wellbeing. Child Abuse and Neglect, 36(2), pp. 166-179.

This study investigated the relationships among Adverse Childhood Experiences (ACEs) in a sample of Dutch children whose mothers were abused by an intimate partner, and the severity of behavioral and emotional problems and trauma symptoms. The results showed that child witnesses of IPV were also exposed to other adverse experiences, such as abuse, household dysfunction and neglect. The number of ACEs children were exposed to was unrelated to the level of emotional and behavioral problems, except for trauma related symptoms reported by parents. This study shows that children who witnessed IPV were also exposed to other adverse experiences. The results of this study may imply that in this high-risk clinical sample of children exposed to IPV, additional adverse experiences have a limited relationship to psychological outcomes. A thorough assessment and inclusion of all Adverse Childhood Experiences is necessary for a comprehensive treatment program.

Lawson, K. M., Back, S. E., Hartwell, K. J., Moran-Santa Maria, M., Brady, K. T. (2013). A comparison of trauma profiles among individuals with prescription opioid, nicotine, or cocaine dependence. The American Journal on Addictions, 22(2), pp. 127-131. DOI: 10.1111/j.1521-0391.2013.00319.x

This study compared the trauma histories (general, sexual, physical and emotional) of non‐treatment seeking outpatients dependent on prescription opioids, nicotine, or cocaine. The Life Stressor Checklist—Revised (LSC‐R) was completed by participants to assess childhood and adult trauma. The findings revealed that all three groups endorsed high levels of trauma exposure, with 96.5% of the entire sample experiencing at least one traumatic event in their lifetime. The prescription opiate group experienced a greater number of general and total traumas than the nicotine group. However, no group differences in the number of emotional, physical, or sexual traumas were revealed. The prescription opiate group reported a younger age of first traumatic event than the cocaine group, and was significantly more likely to report childhood traumatic events than both the cocaine and nicotine groups. The findings provide clinically relevant information that may help improve screening, interventions, and preventative efforts.

Rug lass, L. M., Hien, D. A., Hu, M., & Campbell, A. N. C. (2014). Associations between post‐traumatic stress symptoms, stimulant use, and treatment outcomes: a secondary analysis of nida’s women and trauma study. The American Journal on Addictions, 23(1), pp. 90-95.

This study’s aim was to examine the associations between post‐traumatic stress disorder (PTSD) symptoms, stimulant use, and treatment outcomes among dually diagnosed women. The findings of the study suggest that integrated treatment of co‐occurring PTSD and addictions may be more effective than general health education approaches for heavy stimulant users. Assessment of frequency of stimulant use among individuals with PTSD symptoms may inform treatment selection for this population.

Salter, M., & Breckenridge, J. (2014). Women, trauma and substance abuse: Understanding the experiences of female survivors of childhood abuse in alcohol and drug treatment. International Journal of Social Welfare, 23(2), pp. 165-173. DOI: 10.1111/ijsw.12045

This article draws on qualitative study of adult women with histories of childhood sexual abuse to explore their experience of AOD treatment in New South Wales, Australia. The authors argue that the generalist ‘one size fits all’ approach of many AOD services is not gender neutral but should be understood as implicitly gendered in that it neglects the specificity of women’s needs in relation to abuse, mental illness and parenting. The discussion presented in this article is based on a qualitative study of the experiences of adult women with histories of childhood sexual abuse and/or domestic violence in AOD treatment. By examining the ways in which AOD treatments effectively ignore or minimize gender, this article uncovers intervention practices that efface the complexities underpinning AOD use among women and suggests ways in which alternative models of service delivery can create more validating and supportive environments.

Schwandt, M. L., Heilig, M., Hommer, D. W., George, D. T., & Ramchandani, V. A. (2013). Childhood trauma exposure and alcohol dependence severity in adulthood: mediation by emotional abuse severity and neuroticism. Alcoholism: Clinical and Experimental Research, 37(6), pp. 984-992.

The authors seek to investigate the prevalence of multiple types of childhood trauma in treatment-seeking alcohol-dependent patients, and the associations between childhood trauma and AD severity. The authors conclude by stating that childhood trauma is highly prevalent in treatment-seeking alcoholics and may play a significant role in the development and severity of AD through an internalizing pathway involving negative affect. Our findings suggest that alcoholics with a history of childhood emotional abuse may be particularly vulnerable to severe dependence.

Sprang, G., Staton-Tindall, M., & Clark, J. (2008). Trauma exposure and the drug endangered child. Journal of Traumatic Stress, 21(3), pp. 333-339.

This study examines the differences in trauma exposure and the response to those events between drug endangered children (DEC) and non-drug endangered children involved in the child welfare system. This data represents the experiences of 1,127 children randomly selected from the state's child protective service database and represents 20% of all open cases during 2005–2006. Archival data were analyzed to determine the presence of exposure using DSM-IV-TR posttraumatic stress disorder (PTSD) Criterion A1, and whether or not the child’s response to exposure met PTSD Criterion A2. Results reveal high rates of trauma exposure in the DEC group and indicate that trauma exposure and trauma response did significantly vary across groups. Implications for the assessment and treatment of child welfare-involved children are drawn.

Sprang, G., Craig, C. D., Clark, J. J., Vergon, K., Stanton-Tindall, M., Cohen, J., & Gurwitch, R. (2013). Factors affecting the completion of trauma-focused treatments: What can make a difference? Traumatology, 19(1), pp. 28-40. DOI: 10.1177/1534765612445931

This study expands our understanding of treatment attrition by investigating factors predicting treatment dropout in a large national data set of clinic-referred children and parents seeking trauma-specific psychotherapy services. The findings of this study suggest that African American race, placement in state custody, and a diagnosis of posttraumatic stress disorder, oppositional defiant disorder, and major depressive disorder predict treatment attrition. Based on the findings of this study, dropout management recommendations are made, as are implications for further research and ongoing practice.

Waldrop, A. E., & Cohen, B. E. (2014). Trauma exposure predicts alcohol, nicotine, and drug problems beyond the contribution of PTSD and depression in patients with cardiovascular disease: Data from the heart and soul study. The American Journal on Addictions, 23(1), pp. 53-61. DOI: 10.1111/j.1521-0391.2013.12053.x

This study examined the role of lifetime trauma exposure in a longitudinal study of adults with cardiovascular disease to determine the unique contribution of trauma exposure to risk for drug and alcohol problems and smoking. Lifetime exposure to a higher number of trauma types predicted substance use outcomes beyond risk explained by PTSD and depression. In addition, across trauma types, interpersonal traumas were most strongly associated with substance use problems. Results suggest that, though PTSD and depression play a role in the association between trauma exposure and substance use, many other factors also contribute; therefore focusing on these psychological comorbidities alone is not sufficient. The integration of mental health care and/or case management support with primary and specialty medical care may improve detection and treatment for patients with substance use and comorbid mental and physical health problems. Screening for trauma exposure is an important part of good clinical care.

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