Wendy D’Andrea

Physical Health Problems After Single Trauma Exposure: When Stress Takes Root in the Body

Research has established that chronic stress, including traumatic events, leads to adverse health outcomes. The literature has primarily used two approaches: examining the effect of acute stress in a laboratory setting and examining the link between chronic stress and negative health outcomes. However, the potential health impact of a single or acute traumatic event is less clear. The goal of this literature review is to extend the literature linking both chronic trauma exposure and posttraumatic stress disorder to adverse health outcomes by examining current literature suggesting that a single trauma may also have negative consequences for physical health. The authors review studies on health, including cardiovascular, immune, gastrointestinal, neurohormonal, and musculoskeletal outcomes; describe potential pathways through which single, acute trauma exposure could adversely affect health; and consider research and clinical implications.

Play to the Whistle: A Pilot Investigation of a Sports-Based Intervention for Traumatized Girls in Residential Treatment

Adolescents in residential treatment settings have symptoms that prevent them from participation in normal youth activities, which in turn prevent development of social skills and competencies. A sports-based intervention called “Do the Good” (DtG) was designed for this population using trauma-informed treatment principles. This paper describes the intervention model and presents outcome data. A total of 88 female residential students aged 12 to 21 participated, including 62 students voluntarily enrolled in the sports league and 26 treatment-as-usual (TAU) comparisons. Positive behaviors (e.g., helping peers, perseverance) during games were observed and coded for sports league participants and their coaches. Mental health charts of DtG and TAU participants were reviewed for behavior and symptoms prior to program participation, and again post-program. Girls in the sports league exhibited reductions in restraints and time-outs, as well as internalizing and externalizing symptoms. These data provide evidence that sports-based interventions present a promising adjunctive approach for traumatized youth.

Creating Trauma-informed Sports Programming for Traumatized Youth: Core Principles for an Adjunctive Therapeutic Approach

ABSTRACT Youth who have experienced trauma may find opportunities for recovery in community settings, such as team sports. Sports and other community settings may provide an important structure, a venue for persevering toward goals, and a place to connect with mentors and friends. However, the symptoms with which such youth present, such as hyperarousal and aggression, may serve as a barrier to the potentially supportive environment that sports may provide. The typical means of coaching in such environments may be adapted to increase accessibility to youth. In this article, we describe principles of trauma-informed sports programming, including adaptations to play structures, that draw from gold-standard trauma-informed psychotherapy approaches. These techniques may help youth workers adapt their settings to meet a broader range of needs and aspire to provide clinicians with tools for collateral work with trauma-exposed clients.

Social Context and Violence Exposure as Predictors of Internalizing Symptoms in Mothers and Children Exposed to Intimate Partner Violence

Family and social environment may play a part in children’s post-violence adjustment. The goal of this paper is to examine which factors are related to internalizing symptoms in mothers and their children exposed to intimate partner violence. Participants were 208 mothers exposed to domestic violence. Mothers responded using the Conflict Tactics Scale, Beck Depression Inventory, and other standardized scales. They also reported on their children’s internalizing symptoms using the Child Behavior Checklist (CBCL). For the whole group, children’s CBCL scores were related to higher maternal depression and lower maternal self-esteem. Factors determining internalizing in children varied based upon the child’s race. This study illustrates the importance of factors, such as maternal depression, maternal self-esteem, violence exposure, and social support, in determining whether a child exposed to domestic violence develops internalizing symptoms, and that ecological factors may have different effects on children based on race.

Anhedonia in Trauma Related Disorders: The Good, the Bad, and the Shut-Down

The present chapter reviews the evidence for anhedonia in trauma-related disorders. Clinical observations and empirical evidence are presented as arguments for distinguishing between two clinical presentations of anhedonia in trauma-related disorders: (1) Hedonic Deficit, defined as an inability to experience positive affect, and (2) Negative Affective Interference, defined as the experience of negative emotions in situations that normally would be considered positive. We situate these two forms of anhedonia within existing models of affective experience, suggest ways in which this formulation may be tested empirically, and argue for the clinical relevance of increasing understanding of positive affect intolerance in trauma-related disorders.

When stress becomes the new normal: Alterations in attention and autonomic reactivity in repeated traumatization

ABSTRACT There is need for further work clarifying attention-physiology interactions by degree of exposure to early victimization, as it is clear that cumulative trauma in childhood, that is, polyvictimization, may have lasting effects on the stress response that differ from those of acute traumatization. The present study examined relationships between baseline and task-related physiology (indexed by respiratory sinus arrhythmia [RSA] and heart rate [HR], respectively), and attention biases (via the dot probe task), in 63 community-dwelling adult women stratified on the basis of self-reported exposure to multiple types of childhood interpersonal victimization (i.e., sexual, physical, and emotional abuse). Consistent with hypotheses, a pattern of threat hypervigilance was found in the single victimization group, while threat avoidance was found in the polyvictimization group. Additionally, avoidance of threat in the polyvictimized group was associated with lower baseline RSA. Moderation analyses indicated that condition-wise HR moderated the relationship between level of exposure and attention biases in the high-threat condition. The present findings may clarify basic regulatory mechanisms that play a role in lifetime revictimization in individuals with cumulative childhood trauma exposure and may have implications for their prognostic and therapeutic outcomes.

Psychology of European American Adults: Challenges, Advantages, and the Push for Further Growth

This chapter presents information on mental health issues in European American (White) adults, focusing on poverty, traumatic experience, and alcohol abuse as major challenges to the maintenance of mental health in this group; access to health care, willingness to seek assistance for mental health issues, and selected cognitive factors as strengths contributing to resilience in this group; and how some of the advantages enjoyed by Whites in the United States can be furthered to strengthen the overall mental health of this group.