Linda Lewandowski

The Traumatogenic Dynamics of Internalized Stigma of Mental Illness Among Arab American, Muslim, and Refugee Clients.

Understanding the dynamics of mental health stigma through existing frameworks, especially in minorities with higher stigma, is problematic. There is a need to reconceptualize stigma, particularly in highly traumatized groups. The current study examines the validity of a new development-based trauma framework that conceptualizes stigma as a type III chronic trauma that contributes to negative mental health effects. This framework proposes that public stigma is a unique chronic traumatic stress that mediates the effects of similar trauma types in mental health patients. To test this proposition, this study explores the relationships between internalized stigma of mental illness (ISMI), different trauma types, and posttrauma spectrum disorders. ISMI, posttraumatic stress disorder, other posttrauma spectrum disorders, and cumulative trauma measures were administered to a sample of 399 mental health patients that included Arab (82%), Muslim (84%), and refugee (31%), as well as American patients (18%). Age in the sample ranged from 18 to 76 years (M = 39.66, SD = 11.45), with 53.5% males. Hierarchical multiple regression, t tests, and path analyses were conducted. Results indicated that ISMI predicted posttraumatic stress disorder and other posttrauma spectrum disorders after controlling for cumulative trauma. ISMI was associated with other chronic collective identity traumas. While Arab Americans, Muslims, and refugees had higher ISMI scores than other Americans, the elevated chronic trauma levels of these groups were significant predictors of these differences. The results provide evidence to support ISMI traumatology model. Implications of the results for treating victims of ISMI, especially Arab Americans, Muslims and refugees are discussed.

Violence Exposure and Teen Dating Violence Among African American Youth

This study examines the relationships between exposure to violence in the community, school, and family with dating violence attitudes and behaviors among 175 urban African American youth. Age, gender, state support and experiences with neglect, school violence, and community violence were the most significant predictors of acceptance of dating violence. Experiences with community violence and age were important predictors of dating violence perpetration and victimization. Findings highlight the importance of planning prevention programs that address variables affecting attitudes and behaviors of high-risk youth who have already been exposed to multiple types of violence.

Does bullying victimization suppress IQ? The effects of bullying victimization on IQ in Iraqi and African American adolescents: a traumatology perspective

This study explored the effects of bullying victimization (BV), as a Type II traumatic stressor, on intelligence quotient (IQ), posttraumatic stress disorder (PTSD), and complex PTSD symptoms. Participants were 390 African American and Iraqi refugee adolescents. Measures of BV, cumulative life trauma, PTSD, discrimination, and IQ were administered. Correlational, multilevel regression, and path analyses were conducted. BV, independent of cumulative trauma, and discrimination were found to have significant direct effects on increased PTSD symptoms and significant direct and indirect negative effects on perceptual reasoning, processing speed, and working memory. BV was also associated with increases in the discrepancy between perceptual reasoning and verbal comprehension. The implications of these results for the prevention and treatment of bullying victims are discussed.

TRAINING WITH O (OBSERVING) AND T (TREATMENT) TEAMS IN LIVE SUPERVISION: REFLECTIONS IN THE LOOKING GLASS*

Working with a treatment and observing team at the same time, behind the oneway mirror, offers a variety of ways to: (a) generate multiple realities; (b) work with two different models of family therapy simultaneously; and (c) provide feedback on the teams own roles, rules and group process. The process that 6 trainees and two supervisors used with T and O teams to examine their own coevolution as a therapeutic system using the Milan model of family therapy and Ericksonian hypnotherapy is described. The article concludes with a discussion of the advantages and pitfalls of this type of dual supervision.

Psychometric assessment of the Arabic version of the Internalized Stigma of Mental Illness (ISMI) measure in a refugee population

The study explored the psychometric properties of the Arabic version of the ISMI measure on an Arab sub-sample (Nu2009=u2009330) in a health clinic that served mostly refugees in Michigan, USA. Study measures included the ISMI, PTSD, depression, anxiety, CTD (Cumulative Trauma Disorders), and traumatic stress measures. Data analysis included factor analysis, correlation, and multiple regression analysis. The Arabic form of the measure was found to have robust psychometric qualities, with high reliability construct and predictive validity. Factor analysis identified a general stigma factor and different levels of stigma resistance factors. General stigma was significantly associated with and predicted post-trauma symptoms of depression, anxiety, PTSD and CTD (complex PTSD), while tough stigma resistance was associated negatively with PTSD and depression and positively with positive appraisal of traumatic events.

Iraqi American Refugee Youths’ Exposure to Violence: Relationship to Attitudes and Peers’ Perpetration of Dating Violence

This exploratory study examines the relationships between exposure to violence in the community, school, home and dating relationships among Iraqi American youth. As Iraqi American youth are traditionally not allowed to date, dating violence measures focused on attitudes about and perceptions of abuse occurring in the relationships of friends. The number of friends known who were secretly dating was the most significant predictor of acceptability of dating violence and perceived prevalence of abuse. Youth who experienced child abuse perceived higher rates of dating violence among their peers. Findings highlight the complexities of prevention and intervention of teen dating violence within secretive relationships.

Trauma proliferation and stress generation (TPSG) dynamics and their implications for clinical science.

The current research and clinical focus on single traumas fails to assess numerous important trauma dynamics including trauma proliferation. In this study, 2 trauma proliferation pathways were identified that utilize a developmentally based trauma framework (DBTF). Data previously collected from 6 different cultural groups (N = 2279; 2 mental health clinics in Egypt and the United States, Native Americans, Palestinian adults in Gaza, and college students in Poland and Egypt) were reanalyzed. The 6 studies utilized DBTF-based measures of cumulative trauma and trauma types. Path analysis was used to test the trauma proliferation model and PROCESS software was used to identify mediators and their effect sizes. Results of the analyses indicated that attachment trauma and collective identity trauma independently predicted (directly and through mediators) personal identity trauma, role identity trauma, secondary trauma, and survival trauma. The pattern of proliferation was configurally invariant across the 6 groups and strictly invariant across genders. Implications for the consideration of trauma global dynamics, such as trauma proliferation, are discussed.