Trauma cognitions as intervening variables in the relation of chronic child abuse and thwarted interpersonal needs.

OBJECTIVE: Chronic childhood trauma is consistently linked to negative mental health outcomes in adulthood, but research exploring specific paths of risk remains limited. The aims of the current study were to examine trauma cognitions as intervening variables in the relation of chronic victimization with perceived burdensomeness and thwarted belongingness, variables implicated in transdiagnostic risk for psychopathology. METHOD: Semistructured interviews were used to identify university students reporting exposure to systematic physical and/or sexual violence prior to age 18 (n = 101) versus those experiencing other Criterion-A events (n = 254). Trauma cognitions (self, world, and self-blame) and thwarted interpersonal needs (burdensomeness and thwarted belongingness) were measured using scores from the posttrauma cognitions inventory (PTCI) and the Interpersonal Needs Questionnaire-10 (INQ-10). Path models in these cross-sectional data were evaluated to assess the indirect effects of chronic abuse on burdensomeness and thwarted belongingness through self, world, and blame cognitions. RESULTS: An initial model indicated associations of chronic victimization on self (p = .044) and world (p = .005) scales of the PTCI and a unique effect of self-beliefs on INQ-10 burdensomeness (p < .001). An indirect effect of abuse on burdensomeness through self-beliefs was supported (p = .050). A second model identified direct effects of PTCI self (p < .001) and world (p < .001) scores on thwarted belongingness as well as an indirect effect of chronic abuse on belongingness through world beliefs (p = .026). CONCLUSIONS: While typically assessed within the context of posttraumatic stress disorder, results suggest that shifts in fundamental beliefs about the self and the world may have more general impacts on perceptions of burdensomeness and belonging in survivors of early, systematic abuse. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Evidence-based posttraumatic stress disorder treatment in a community sample: Military-affiliated versus civilian patient outcomes.

Posttraumatic stress disorder (PTSD) is a significant mental health issue among military service members and veterans. Although the U.S. Department of Veterans Affairs (VA) provides crucial resources for behavioral health care, many veterans seek mental health services through community clinics. Previous research illustrates that military and veteran patients benefit less from evidence-based treatments (EBTs) for PTSD than civilians. However, most PTSD treatment outcome research on military and veteran populations is conducted in VA or military settings. Little is known about outcomes among military-affiliated patients in community settings. The primary aim of this study was to directly compare civilian versus military-affiliated patient outcomes on PTSD and depression symptoms using the PTSD Checklist for DSM-5 (PCL-5) and the nine-item Patient Health Questionnaire (PHQ-9) in a community setting. Participants (N = 502) included military-affiliated (veteran, Guard/Reservist, active duty) and civilian patients who engaged in cognitive processing therapy (CPT) or prolonged exposure (PE) for PTSD in community clinics. Both groups demonstrated significant reductions on the PCL-5, military-affiliated: d = -0.91, civilian: d = -1.18; and PHQ-9, military-affiliated: d = -0.65, civilian: d = -0.88, following treatment. However, military-affiliated patients demonstrated smaller posttreatment reductions on the PCL-5, Mdiff = 5.75, p = .003, and PHQ-9, Mdiff = 1.71, p = .011, compared to civilians. Results demonstrate that military-affiliated patients benefit from EBTs for PTSD, albeit to a lesser degree than civilians, even in community settings. These findings also highlight the importance of future research on improving EBTs for military personnel with PTSD.

Public beliefs about trauma and its consequences: Profiles and correlates of stigma.

Public stereotypes about trauma exposure and its likely consequences have the potential to influence levels of support extended to survivors in the larger community. The current project sought to examine unique profiles of stereotype endorsement both within and across participants sampled from distinct populations. Trauma-related stereotypes involving symptom course, dangerousness, employability, social functioning, predictability, character, and treatment need were examined in undergraduate (N 1 = 404; N 2 = 502) and MTurk (N 3 = 364) samples. Sympathizing [low overall endorsement], Fearful [high overall endorsement], Pejorative [high endorsement + moralizing beliefs], Safety-Focused [intermediate endorsement + dangerousness], and Performance-Focused [intermediate endorsement + employability] groups were replicated in latent profile models across all samples. Stereotype profiles demonstrated hypothesized associations with general perspectives of mental illness although support for consistent relations with respondent characteristics (e.g., sex; personal exposure to trauma; reported exposure in friends/family) was limited. Data suggest that trauma stereotypes are endorsed at high frequencies in the general community and conform to systematic patterns of prejudice that may be overlooked in more global assessments of stigma.