Trauma appraisals and posttraumatic growth among survivors of sexual assault.

OBJECTIVE: Trauma survivors often endorse some level of posttraumatic growth (PTG), referring to positive outcomes after trauma related to meaning-making and strengthened perceptions of the self. While extant research points to cognitive processes at the root of PTG, posttrauma cognitions such as shame, fear, and self-blame have thus far only been linked to negative outcomes of trauma exposure. The current study examines the association between posttrauma appraisals and PTG among victims of interpersonal violence. Findings will reveal whether appraisals directed toward the self (shame and self-blame), toward the world (anger and fear), or those directed toward relationships (betrayal and alienation) are most conducive to growth. METHOD: A sample of 216 adult women aged 18-64 years were interviewed at baseline and 3, 6, and 9 months later as part of a larger study on social reactions received when disclosing sexual assault. As part of the interview battery, they were administered the Posttraumatic Growth Inventory (PTGI) and Trauma Appraisal Questionnaire. Posttrauma appraisals were used as time-invariant predictors of PTG (PTGI score) at each of the four time points. RESULTS: Posttrauma appraisals of betrayal were associated with initial PTG and alienation appraisals predicted increases in PTG over time. However, self-blame and shame did not predict PTG. CONCLUSIONS: Results suggest that a violation to one's views of interpersonal relationships, reflected in experiences of alienation and betrayal posttrauma, may be especially relevant for growth. As PTG reduces distress among trauma victims, this finding suggests targeting maladaptive interpersonal appraisals is an important intervention target. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Women's Experiences of Social Reactions From Informal and Formal Supports: Using a Modified Administration of the Social Reactions Questionnaire.

A growing literature links social reactions to disclosures of intimate violence to posttraumatic outcomes. The Social Reactions Questionnaire (SRQ), a widely used measure developed to assess social reactions, asks about reactions received from people generally. The ability to examine the impact of social reactions from specific groups of people-such as criminal justice personnel versus community-based providers-has become increasingly more important from both research and practice perspectives. For example, as sexual assault responses nationally have relied on community-coordinated models that involve both criminal justice and community-based systems, tools are lacking to systematically assess the impact of social reactions from criminal justice personnel and community-based providers on survivors. Using the SRQ, the current study asked women to report separately on reactions received from criminal justice personnel, community-based providers, and informal supports. We recruited a diverse community sample of women (N = 228, ages 18-63, 19% lesbian/bisexual, 44% ethnic minority) who experienced a sexual assault in the previous year and disclosed to the criminal justice system and/or a community-based provider. Multilevel analyses revealed considerable variability in the social reactions reported by women across criminal justice personnel, community-based providers, and informal supports. Analyses supported a seven-factor structure for the SRQ when the measure is yoked to particular experiences of disclosure, in this case to criminal justice personnel, community-based providers, or informal supports. The utility of this modified administration and scoring of the SRQ and the importance of considering reactions across different groups are described.

Social Reactions and Women's Decisions to Report Sexual Assault to Law Enforcement.

Following sexual assault, little is known about how the social reactions women receive from informal supports and community-based providers relate to decisions to report to law enforcement. Among 213 diverse women who had disclosed a recent sexual assault to a community-based provider, 56% reported to law enforcement. Law enforcement reporting was associated with more positive (tangible aid) and less negative (distraction, being treated differently) reactions from informal supports and more tangible aid and less emotional support from community-based providers. Tangible aid from community-based providers predicted law enforcement reporting over the subsequent 9 months among women who had not initially reported.

Institutional Responses to Campus Sexual Assault: Examining the Development and Work of A Multidisciplinary Team.

Responding to campus sexual assault can involve complex processes and procedures that span campus, criminal justice, and community-based institutions, particularly when there are co-occurring Title IX and criminal investigations. This study investigated the development of a multidisciplinary team (MDT) that involved campus, criminal justice, and community-based institutions seeking to improve coordinated responses to campus sexual assault. Data included observations of MDT monthly meetings over 16 months as well as individual interviews with MDT members. Transcripts of the MDT meetings and individual interviews were coded to capture major themes. The MDT meetings were dynamic and flexible with a structure that involved intentional agenda setting along with responsiveness to current events and collaborative processes. The MDT invested more time during the meetings addressing the complexity of navigating existing procedures than developing new protocols. Individual interviews with MDT members highlighted logistical challenges that were relevant to MDT effectiveness, such as consistent attendance, supervisor legitimacy, and differences in stakeholder priorities. Implications for future MDT work are discussed.

Victim-perpetrator dynamics through the lens of betrayal trauma theory.

Interpersonal trauma exposure is linked with a host of seemingly disparate outcomes for victims, such as psychological distress, post-trauma appraisals (e.g., alienation, shame), poor cognitive functioning, expectations of harm in relationships, and revictimization risk. The presence of interpersonal trauma alone may not fully explain this range of outcomes. The current paper applies Betrayal Trauma Theory (BTT), which was originally articulated two decades ago as a framework for understanding memory disruptions following interpersonal trauma, as a framework to understand the diverse outcomes that can occur when interpersonal trauma is perpetrated by a close other. Implications for clinical work and future research are considered.

Head injury screening and intimate partner violence: A brief report.

OBJECTIVE: Although the importance of traumatic brain injury has gained public attention in recent years, relatively little attention has been paid to head injuries among women who have experienced intimate partner violence (IPV). The present study screened for lifetime exposure to mild traumatic brain injuries (mTBIs) among a sample of women who had experienced recent IPV (median days since target incident = 26). METHOD: Participants included ethnically diverse women whose IPV experiences were reported to law enforcement. Women (n = 225) were asked about injuries to the head sustained during the target IPV incident as well as over the lifetime, and related symptoms. RESULTS: The vast majority of women (80%) reported a lifetime head injury. More than half (56%) screened positive for mTBI, defined as at least one instance in which they experienced a change in consciousness or a period of being dazed and confused as a result of a head injury. A minority of women (13%) reported injuries to the head during the target IPV incident. Most women who had experienced a lifetime head injury reported frequent and current cognitive difficulties. CONCLUSION: These findings highlight the importance of assessing head injuries and related symptoms among women who have experienced IPV, pointing to important implications for policy and practice.

Betrayal trauma and child symptoms: The role of emotion.

Both mothers' and children's exposures to interpersonal violence-including betrayal traumas-are linked with heightened risk for children developing internalizing and externalizing symptoms. Despite this association, little research has examined additional factors that may explain this risk, such as emotion skills. The current study examined the relationship between mother-child emotion understanding abilities and use of emotion language on a behavioral facial affect perception task and betrayal trauma exposure in relation to child internalizing/externalizing symptoms. The sample included 47 ethnically diverse female guardians (ages 25-51 years old; M age = 37.7) and their children (ages 7-11 years old; M age = 9.1). Results indicated that maternal provision of a spontaneous, unprompted reason for emotions during the facial affect perception task was significantly associated with lower child internalizing/externalizing symptoms when both mothers' and children's betrayal trauma histories were controlled. The results suggest that emotion skills (in particular, the way mothers talk about emotions) warrant greater attention in research on the development of child internalizing/externalizing problems.

Borderline personality disorder in suicidal adolescents.

The diagnosis of borderline personality disorder (BPD) in adolescents has been controversial. Thus, few studies have examined BPD in suicidal adolescents, even though it is strongly associated with suicidal behaviours in adults. This study examines differences between suicidal adolescents with (n = 47) and without (n = 72) BPD on history and characteristics of suicidal behaviour, Axis I co-morbidity, affect regulation and aggression. Assessments were completed with both adolescents and parents, and consensus ratings based on best available data were analysed. BPD participants were more likely to have a history of suicide attempts and to have been admitted because of a suicide attempt (vs. suicidal ideation). There were no significant differences in self-injurious behaviours or degree of suicidal ideation. BPD participants also had more psychiatric co-morbidity and higher aggression scores but no significant differences in affective dysregulation compared with suicidal adolescents without BPD. Diagnostic stability over 6 months was modest. Our results demonstrate that, compared with other acutely suicidal adolescents, the clinical profile of BPD participants is unique and suggests an increased risk for suicidal behaviours. This extends upon other studies that support the construct validity of BPD during adolescence and suggests that BPD should be considered in suicide risk assessment for adolescents.

History of interpersonal violence, abuse, and nonvictimization trauma and severity of psychiatric symptoms among children in outpatient psychiatric treatment.

In a clinical sample of child psychiatry outpatients, chart review data were collected for 114 consecutive admissions over a 1-year period at a Child and Adolescent Outpatient Psychiatry Clinic. Data included history of documented maltreatment, potentially traumatic domestic or community violence, neglect or emotional abuse, and noninterpersonal stressors as well as demographics, psychiatric diagnoses, and parent-rated child emotional and disruptive behavior problems. On a bivariate and multivariate basis, any past exposure to interpersonal violence-but not to noninterpersonal traumas-was related to more severe disruptive behavior problems, independent of the effects of demographics and psychiatric diagnoses. Noninterpersonal trauma and psychiatric diagnoses were associated with emotional problems; exposure to interpersonal violence appeared to partially account for this relationship despite not being independently associated with emotional problem severity. History of exposure to interpersonal violence warrants clinical and research attention as a severity marker and potential treatment focus in psychiatric outpatient services for children, particularly those with disruptive behavior problems.