Trauma exposure across the lifespan among individuals engaged in treatment with medication for opioid use disorder: differences by gender, PTSD status, and chronic pain.

BACKGROUND: There is little study of lifetime trauma exposure among individuals engaged in medication treatment for opioid use disorder (MOUD). A multisite study provided the opportunity to examine the prevalence of lifetime trauma and differences by gender, PTSD status, and chronic pain. METHODS: A cross-sectional study examined baseline data from participants (N = 303) enrolled in a randomized controlled trial of a mind-body intervention as an adjunct to MOUD. All participants were stabilized on MOUD. Measures included the Trauma Life Events Questionnaire (TLEQ), the Brief Pain Inventory (BPI), and the Posttraumatic Stress Disorder Checklist (PCL-5). Analyses involved descriptive statistics, independent sample t-tests, and linear and logistic regression. RESULTS: Participants were self-identified as women (n = 157), men (n = 144), and non-binary (n = 2). Fifty-seven percent (n = 172) self-reported chronic pain, and 41% (n = 124) scored above the screening cut-off for PTSD. Women reported significantly more intimate partner violence (85%) vs 73%) and adult sexual assault (57% vs 13%), while men reported more physical assault (81% vs 61%) and witnessing trauma (66% vs 48%). Men and women experienced substantial childhood physical abuse, witnessed intimate partner violence as children, and reported an equivalent exposure to accidents as adults. The number of traumatic events predicted PTSD symptom severity and PTSD diagnostic status. Participants with chronic pain, compared to those without chronic pain, had significantly more traumatic events in childhood (85% vs 75%). CONCLUSION: The study found a high prevalence of lifetime trauma among people in MOUD. Results highlight the need for comprehensive assessment and mental health services to address trauma among those in MOUD treatment. TRIAL REGISTRATION: NCT04082637.

Spanish-Speaking Mothers' Experiences of School-Based Speech Therapy.

PURPOSE: Spanish-speaking families are a growing population that speech-language pathologists must be prepared to work with. To provide culturally responsive intervention, speech-language pathologists (SLPs) must understand the perspectives of Spanish-speaking caregivers when providing intervention. These values and experiences may differ from those of monolingual, mainstream culture. Understanding the impact of the COVID-19 pandemic on these experiences is also important. In this qualitative study, we explore the experiences of Spanish-speaking mothers whose children have received school-based speech-language intervention and the impact of the COVID-19 pandemic. METHOD: We interviewed five Spanish-speaking mothers who were identified as having bilingual children who had or were currently receiving speech therapy, all through the public school system. The mothers participated in a semistructured interview to share their experiences with their children receiving intervention. We analyzed the transcripts through interpretative phenomenological analysis to identify salient themes among participants. All research team members reviewed and agreed upon themes to ensure credibility. RESULTS: The findings revealed six group experiential themes: (a) lack of services and frustration with and barriers to accessing services, (b) greater improvements in English compared with Spanish, (c) bilingual speech therapy has positive effects on children and Spanish-speaking mothers, (d) family involvement in speech therapy is highly important, (e) family stress related to speech difficulties, and (f) pandemic negatively impacted children's socialization and learning. DISCUSSION: The results are discussed in the context of equity. Through understanding the experiences of Spanish-speaking mothers, SLPs can work to ensure service levels comparable with those of monolingual children and support bilingual acquisition.

The Impact of Adverse Childhood Experiences on Problem Gambling in New Mexico.

The study of Adverse Childhood Experiences (ACEs) has consistently demonstrated a strong relationship with poor behavioral health outcomes. Further research is needed to understand if a specific ACE, or subcategorizations of ACEs, matter more for behavioral health outcomes. A study of the association between ACEs and problem gambling involving a racially mixed sample (13,217 participants) in New Mexico is presented to illustrate how certain ACEs may have a larger impact on behavioral health outcomes. The researchers examined: 1.) the impact that each individual ACE have on participant's reported problem gambling; 2) which group (abuse or household challenges) had a greater odds ratio and marginal impact on participant's self-reported gambling; and 3) which BRFSS subcategories (emotional abuse, physical abuse, sexual abuse, IPV, substance abuse, mental illness, parental separation or divorce, and incarcerated household member) had a greater odds ratio and marginal impact on participant's self-reported gambling. The results of this study indicate ACEs had a significant influence on problem gambling, and data suggests that when BRFSS data is examined in groups or subcategories there is a difference in the influence that ACEs have on problem gambling. In particular, we found that odds ratio to be significant when participants reported mental health problems in the home (OR = 1.34, 95% CI [1.02, 1.76], p < 0.04), living with incarcerated household members (OR = 1.75, 95% CI [1.28, 2.41], p < 0.001), how often adults hit each other (OR = 1.29, 95% CI [1.10, 1.52], p < 0.001), and how often anyone at least 5 years older than them forced them to have sex (OR = 1.42, 95% CI [1.10, 1.82], p < 0.01) In relation to types of abuse, There was a significant difference in self-reported problem gambling for individuals who reported sexual abuse (OR = 1.64, 95% CI [1.10, 2.46], p < 0.016), as well as participants reporting living with an incarcerated household member (OR = 2.08, 95% CI [1.34, 3.22], p < 0.001); approaching significant results also included individuals who witnessed their parents act violent towards one another (OR = 1.52, 95% CI [.99, 2.33], p < 0.055), and having parents who were separated or divorced (OR = 0.68, 95% CI [0.46, 1.00], p < 0.053). Finally, there was a significant difference in self-reported problem gambling for individuals who reported abuse (OR = 1.36, 95% CI [1.11, 1.66], p < 0.003), while participants reporting household challenges did not quite reach statistical significance (OR = 1.49, 95% CI [0.99, 1.33], p < 0.062. These findings show us that the way we ask questions about the precedence and outcomes of risky behavior matter and warrant further attention.

Trauma Exposure Across the Lifespan among Individuals Engaged in Treatment with Medication for Opioid Use Disorder: Differences by Gender, PTSD Status, and Chronic Pain.

Background: There is little study of lifetime trauma exposure among individuals engaged in medication treatment for opioid use disorder (MOUD). A multisite study provided the opportunity to examine the prevalence of lifetime trauma and differences by gender, PTSD status, and chronic pain. Methods: A cross-sectional study examined baseline data from participants (N = 303) enrolled in a randomized controlled trial of a mind-body intervention as an adjunct to MOUD. All participants were stabilized on MOUD. Measures included the Trauma Life Events Questionnaire (TLEQ), the Brief Pain Inventory (BPI), and the Posttraumatic Stress Disorder Checklist (PCL-5). Analyses involved descriptive statistics, independent sample t-tests, and linear and logistic regression. Results: Participants were self-identified as women (n = 157), men (n = 144), and non-binary (n = 2). Fifty-seven percent (n = 172) self-reported chronic pain, and 41% (n = 124) scored above the screening cut-off for PTSD. Women reported significantly more intimate partner violence (85%) vs 73%) and adult sexual assault (57% vs 13%), while men reported more physical assault (81% vs 61%) and witnessing trauma (66% vs 48%). Men and women experienced substantial childhood physical abuse, witnessed intimate partner violence as children, and reported an equivalent exposure to accidents as adults. The number of traumatic events predicted PTSD symptom severity and PTSD diagnostic status. Participants with chronic pain, compared to those without chronic pain, had significantly more traumatic events in childhood (85% vs 75%). Conclusions: The study found a high prevalence of lifetime trauma among people in MOUD. Results highlight the need for comprehensive assessment and mental health services to address trauma among those in MOUD treatment. Trial Registration: NCT04082637.