Sadie E. Larsen

Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis

BACKGROUND It is unclear how many children and adolescents develop post-traumatic stress disorder (PTSD) after trauma. AIMS To determine the incidence of PTSD in trauma-exposed children and adolescents as assessed with well-established diagnostic interviews and to examine potential moderators of the estimate. METHOD A systematic literature search identified 72 peer-reviewed articles on 43 independent samples (n = 3563). Samples consisting only of participants seeking or receiving mental health treatment were excluded. Main analyses involved pooled incidence estimates and meta-analyses of variance. RESULTS The overall rate of PTSD was 15.9% (95% CI 11.5-21.5), which varied according to the type of trauma and gender. Least at risk were boys exposed to non-interpersonal trauma (8.4%, 95% CI 4.7-14.5), whereas girls exposed to interpersonal trauma showed the highest rate (32.9%, 95% CI 19.8-49.3). No significant difference was found for the choice of assessment interview or the informant of the assessment. CONCLUSIONS Research conducted with the best available assessment instruments shows that a significant minority of children and adolescents develop PTSD after trauma exposure, with those exposed to interpersonal trauma and girls at particular risk. The estimates provide a benchmark for DSM-5 and ICD-11.

Evaluations of Sexy Women In Low- and High-Status Jobs

We hypothesized that women who dress in a sexy versus business-like manner evoke negative emotions and perceptions of lesser competence if employed in high- (but not low-) status jobs. Male and female undergraduates evaluated a videotaped female target whose physical attractiveness was held constant, but who was (a) dressed in sexy or businesslike attire and (b) allegedly either a manager or a receptionist. Participants exhibited more negative affect toward the sexily attired manager and rated her as less competent than the neutrally attired manager. This effect was fully mediated by emotional reactions. In contrast, the appearance manipulation had no effect on emotions toward or competence ratings of the receptionist. These findings suggest that a sexy self-presentation harms women in high-, but not low-, status jobs.

Men’s and Women’s Experience of Intimate Partner Violence: A Review of Ten Years of Comparative Studies in Clinical Samples; Part I

The present paper reviews literature published between 2002 and 2013 regarding gender differences in the perpetration, motivation, and impact of intimate partner violence (IPV) in clinical samples in order to update and extend a previous review by Hamberger (2005). Results showed that although both women and men are active participants in acts of physical IPV and emotional abuse, women’s physical violence appears to be more in response to violence initiated against them. Although both men and women participate in emotional abuse tactics, the type and quality appears to differ between the sexes. Men tend to use tactics that threaten life and inhibit partner autonomy; women use tactics that consist of yelling and shouting. Men are the predominant perpetrators of sexual abuse. Analysis of patterns of violence and abuse suggests that women are more highly victimized, injured, and fearful than men in clinical samples. Research and clinical implications are discussed.

PTSD Symptoms and Sexual Harassment: The Role of Attributions and Perceived Control

Researchers have compiled significant evidence demonstrating that sexual harassment leads to psychological harm, including the full symptom picture of PTSD, but few have examined the psychological processes involved. Research on attributions among trauma victims would suggest that causal attributions and perceptions of control may be important predictors of outcomes. The authors discuss a study involving a path model that used data from 189 women involved in sexual harassment litigation. Results indicate that both self-blame and harasser blame were positively related to PTSD symptoms. Control over recovery and the perception that future harassment is unlikely were both related to fewer PTSD symptoms. Unexpectedly, perceived control over future harassment is related to higher levels of PTSD symptoms. Implications for research and practice are discussed.

Council‐Based Approaches to Reforming the Health Care Response to Domestic Violence: Promising Findings and Cautionary Tales

Councils are commonly formed to address social issues including intimate partner violence (IPV). Research suggests that councils may be well positioned to achieve proximal outcomes, but that their success may depend on contextual factors. The current study compared providers and health care settings at two points in time to explore the degree to which the Health Care Council achieved proximal outcomes in the health care response to IPV, including: (a) providers’ reported capacity to screen for IPV, (b) providers’ beliefs about IPV as a health care issue and about the IPV screening process, (c) providers’ screening behaviors and (d) organizational policies and protocols to encourage screening. This study, while preliminary, provides support for council-based efforts to stimulate change in the health care response to IPV and also highlights the central role that organizational environment plays in shaping desired outcomes.

Comparing the effect of DSM-congruent traumas vs. DSM-incongruent stressors on PTSD symptoms: A meta-analytic review.

Experts have long debated how to define the PTSD traumatic stressor criterion. Prior research demonstrates that PTSD symptoms (PTSS) sometimes stem from events that do not meet the DSM requirements for Criterion A (e.g., divorce, bereavement, illness). This meta-analysis of 22 studies examined whether PTSS differ for DSM-congruent criterion A1 traumatic events vs. DSM-incongruent events. The overall effect was significant, albeit small, suggesting that PTSS were greater for individuals who experienced a DSM-congruent event; heterogeneity analyses also indicated further exploration. Two significant moderators emerged: assessment of both A1 and A2 (vs. A1 alone) yielded a significant effect for higher PTSS following traumas vs. stressors. Likewise, self-report assessment of life threat (Criterion A1)-vs. rater or a priori assessment of A1-yielded a significant effect for higher PTSS following traumas. Our results indicate that higher levels of PTSS develop following traumas, and highlight important methodological moderators that may affect this relationship.

Are Specific Emotion Regulation Strategies Differentially Associated with Posttraumatic Growth Versus Stress

Extremely few studies have examined emotion regulation strategies as predictors of posttraumatic growth (PTG). This study aimed to examine several specific emotion regulation strategies, along with meaning making, as predictors of PTG, as opposed to posttraumatic distress. Participants were 107 adult women who had experienced a very stressful or traumatic event within the past 3 years and completed questionnaires measuring emotion regulation, meaning making, distress, and PTG. Emotion suppression positively predicted distress, but not PTG. Meaning making positively predicted PTG and negatively predicted distress. Bootstrapped mediation models showed that emotional processing has a significant indirect effect on PTG and distress through its effect on meaning making. Results indicate that researchers should pay closer attention to emotional processes involved in etiological models of PTG. It might also be helpful to examine specific emotion regulation strategies, as these can point to ways to help people navigate recovery from trauma.

Men’s and Women’s Experience of IPV Part II: A Review of New Developments in Comparative Studies in Clinical Populations

The present paper reviews literature on gender differences in the perpetration, motivation, and impact of intimate partner violence (IPV) in clinical samples published between 2002 and 2013 to update and extend a previous review by Hamberger (Violence & Victims, 20, 131–151, 2005). Results showed that women are likely to incur more costs related to abuse. Men arrested for IPV have more extensive criminal histories and higher recidivism rates than women. When identified as suspects, men and women are equally likely to be arrested, taking into account other relevant factors. Women are less likely to be prosecuted and more likely to be granted restraining orders at lower levels of violence. Female perpetrators have higher levels of psychopathology except for antisocial personality traits. Findings regarding drug and alcohol use are as yet conflicting; although there are gender differences, it is difficult to generalize from the present findings. Research and clinical implications are discussed.

Methodological contributions to the gender symmetry debate and its resolution

The concept of gender symmetry in intimate partner violence (IPV) may be an artifact of three factors. 1) Methodology: Subject recruitment frequently excludes clinical samples. Cross-sectional designs negate the ability to evaluate recidivism and do not account for women’s greater likelihood of leaving violent relationships. 2) Narrow Focus: Researchers focus on frequency of physical aggression, while excluding other types of aggression (e.g., sexual IPV, life-threatening violence, use of firearms), or the impact of such aggression (e.g., fear, depression, injury). 3) Measurement: Surveys are hindered by varying interpretations of seemingly face-valid items, effects of item instructions, and lack of multi-method assessment approaches. Strategies for addressing these problems and resolving the gender symmetry controversy are outlined.

The effect of participating in a trauma- and stressful event-focused study.

OBJECTIVE Researchers have increasingly examined whether participants who have experienced a traumatic event should be considered vulnerable research populations. Studies have typically asked participants in trauma-focused research whether they were upset by the study or perceived any benefit from it. The current study extends such research by measuring mood and exploring potential moderators of the impact of study participation. METHOD Participants were 107 women who experienced a traumatic or stressful event and completed an event-focused research protocol. Negative affect was measured, using the Positive and Negative Affect Schedule, at the time of the study and 1 week later. RESULTS Participants reported significantly lower levels of negative affect in the week after the study than before it. Decreases in negative affect were greatest for those with highest levels of depression at the time of interview. CONCLUSIONS Participation in a trauma- or stressful-event-focused study is not harmful and may even be beneficial, especially among depressed participants.