cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.21829431.v1
title: Prior adversities predict posttraumatic stress reactions in adolescents following the Oslo Terror events 2011

description: Former studies suggest that prior exposure to adverse experiences such as violence or sexual abuse increases vulnerability to posttraumatic stress reactions in victims of subsequent trauma. However, little is known about how such a history affects responses to terror in the general adolescent population. To explore the role of prior exposure to adverse experiences as risk factors for posttraumatic stress reactions to the Oslo Terror events. We used data from 10,220 high school students in a large cross-sectional survey of adolescents in Norway that took place seven months after the Oslo Terror events. Prior exposure assessed was: direct exposure to violence, witnessing of violence, and unwanted sexual acts. We explored how these prior adversities interact with well-established risk factors such as proximity to the events, perceived life threat during the terror events, and gender. All types of prior exposure as well as the other risk factors were associated with terror-related posttraumatic stress reactions. The effects of prior adversities were, although small, independent of adolescents’ proximity to the terror events. Among prior adversities, only the effect of direct exposure to violence was moderated by perceived life threat. Exposure to prior adversities increased the risk of posttraumatic stress reactions equally for both genders, but proximity to the terror events and perceived life threat increased the risk more in females. Terror events can have a more destabilizing impact on victims of prior adversities, independent of their level of exposure. The findings may be relevant to mental health workers and others providing post-trauma health care.
DOI: 10.6084/m9.figshare.21829434
title: Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

description: There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD) is distinct from Borderline Personality Disorder (BPD) when the latter is comorbid with PTSD. To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD. A latent class analysis (LCA) was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD. The LCA revealed four distinct classes of individuals: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness. Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning.
DOI: 10.6084/m9.figshare.21829434.v1
title: Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

description: There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD) is distinct from Borderline Personality Disorder (BPD) when the latter is comorbid with PTSD. To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD. A latent class analysis (LCA) was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD. The LCA revealed four distinct classes of individuals: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness. Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning.
DOI: 10.6084/m9.figshare.21829437
title: Predictors of change in mental health and distress among women attending a women's shelter

description: Intimate partner violence (IPV) is detrimental to mental health. The Domestic Violence Survivor Assessment (DVSA), which includes a mental health assessment, is often used to evaluate abuse survivors in a counseling situation. The DVSA seeks to outline the cognitive state of women as per the stages of change as they attempt to move toward a life with no IPV. The objective of this study was to explore predictors of change in mental health and distress among women who entered a women's shelter more than once. Women entering a women's shelter more than once over a 3-year period were assessed by a trained social worker using the DVSA. A logistic regression analysis examined relationships between the chosen characteristics and the participants’ mental health through the DVSA stages of change. We analyzed complete data for 94 women who entered the shelter a mean of 3.3 times (range 2–8) over a mean period of 16.1 days (range: 1–391). Thirty-six women (36/94; 38.3%) progressed through the stages. The average number of visits among women who progressed through the stages was 4. Our multivariable logistic regression showed women who had more visits to the shelter were almost twice as likely to progress through the stages compared to women who entered the shelter fewer times (OR=1.928; 95% CI=1.292–2.877; p=0.001). In the univariate analysis, only increased number of visits was significantly associated with progressing through the stages of change (OR=1.694; 95% CI=1.237–2.322; p=0.001). The other factors were not significantly associated with a change in mental health and distress (p&gt;0.05). Women who enter women's shelters more frequently may be more likely to progress through the DVSA mental health stages compared to other women. Women's shelters may be helpful in assisting progression through the stages of change, thereby improving their mental health after abuse.
DOI: 10.6084/m9.figshare.21829437.v1
title: Predictors of change in mental health and distress among women attending a women's shelter

description: Intimate partner violence (IPV) is detrimental to mental health. The Domestic Violence Survivor Assessment (DVSA), which includes a mental health assessment, is often used to evaluate abuse survivors in a counseling situation. The DVSA seeks to outline the cognitive state of women as per the stages of change as they attempt to move toward a life with no IPV. The objective of this study was to explore predictors of change in mental health and distress among women who entered a women's shelter more than once. Women entering a women's shelter more than once over a 3-year period were assessed by a trained social worker using the DVSA. A logistic regression analysis examined relationships between the chosen characteristics and the participants’ mental health through the DVSA stages of change. We analyzed complete data for 94 women who entered the shelter a mean of 3.3 times (range 2–8) over a mean period of 16.1 days (range: 1–391). Thirty-six women (36/94; 38.3%) progressed through the stages. The average number of visits among women who progressed through the stages was 4. Our multivariable logistic regression showed women who had more visits to the shelter were almost twice as likely to progress through the stages compared to women who entered the shelter fewer times (OR=1.928; 95% CI=1.292–2.877; p=0.001). In the univariate analysis, only increased number of visits was significantly associated with progressing through the stages of change (OR=1.694; 95% CI=1.237–2.322; p=0.001). The other factors were not significantly associated with a change in mental health and distress (p&gt;0.05). Women who enter women's shelters more frequently may be more likely to progress through the DVSA mental health stages compared to other women. Women's shelters may be helpful in assisting progression through the stages of change, thereby improving their mental health after abuse.
DOI: 10.6084/m9.figshare.21829443
title: Trauma-related altered states of consciousness in women with BPD with or without co-occurring PTSD

description: A “4-D model” was recently described as a theoretical framework for categorizing trauma-related symptoms into four phenomenological dimensions (the experience of time, thought, body, and emotion) that can present either in the form of normal waking consciousness (NWC) or as dissociative experiences, that is, trauma-related altered states of consciousness (TRASC). The present study examined the predictions of the 4-D model in 258 persons with borderline personality disorder (BPD) with (<i>n</i>=126) versus without (<i>n</i>=132) posttraumatic stress disorder (PTSD). As measured by the <i>Borderline Symptom List</i>, consistent with the predictions of the 4-D model, in comparison with symptom endorsements theorized to be associated with NWC, measures of TRASC were less frequent, and more strongly correlated with both <i>Dissociative Experience Scale</i> scores and severity of childhood emotional neglect, particularly in persons with both BPD and PTSD. Our prediction that symptoms of TRASC would be less intercorrelated in comparison with distress associated with NWC symptoms, however, was not supported. Findings are discussed as they pertain to the symptomatology of BPD, PTSD, and dissociation.
DOI: 10.6084/m9.figshare.21829443.v1
title: Trauma-related altered states of consciousness in women with BPD with or without co-occurring PTSD

description: A “4-D model” was recently described as a theoretical framework for categorizing trauma-related symptoms into four phenomenological dimensions (the experience of time, thought, body, and emotion) that can present either in the form of normal waking consciousness (NWC) or as dissociative experiences, that is, trauma-related altered states of consciousness (TRASC). The present study examined the predictions of the 4-D model in 258 persons with borderline personality disorder (BPD) with (<i>n</i>=126) versus without (<i>n</i>=132) posttraumatic stress disorder (PTSD). As measured by the <i>Borderline Symptom List</i>, consistent with the predictions of the 4-D model, in comparison with symptom endorsements theorized to be associated with NWC, measures of TRASC were less frequent, and more strongly correlated with both <i>Dissociative Experience Scale</i> scores and severity of childhood emotional neglect, particularly in persons with both BPD and PTSD. Our prediction that symptoms of TRASC would be less intercorrelated in comparison with distress associated with NWC symptoms, however, was not supported. Findings are discussed as they pertain to the symptomatology of BPD, PTSD, and dissociation.
DOI: 10.6084/m9.figshare.21829446
title: Psychometric properties of the Questionnaire for Secondary Traumatization

description: During the past several years, there has been a growing interest in the negative effects that providing therapy may have on therapists. Of special interest is a phenomenon called secondary traumatization, which can arise while working with traumatized clients. To develop a simple screening tool for secondary traumatization, a quantitative assessment instrument was constructed using a data-driven approach based on qualitative interviews with affected trauma therapists as well as experienced supervisors in trauma therapy. The aim of the current study was to analyze the psychometric properties of the newly developed Questionnaire for Secondary Traumatization (FST) acute and lifetime version and to determine the most appropriate scoring procedure. To this end, three independent samples of psychotherapists (<i>n</i>=371), trauma therapists in training (<i>n</i>=80), and refugee counselors (<i>n</i>=197) filled out an online questionnaire battery. Data structure was analyzed using factor analyses, cluster analyses, and reliability analyses. Factor analyses yielded a six-factor structure for both the acute and the lifetime version with only a small number of items loading on differing factors. Cluster analyses suggested a single scale structure of the questionnaire. The FST total score showed good internal consistencies across all three samples, while internal consistency of the six extracted factors was mixed. With the FST, a reliable screening instrument for acute and lifetime secondary traumatization is now available which is free of charge and yields a sum score for quick evaluation. The six-factor structure needs to be verified with confirmatory factor analyses.
DOI: 10.6084/m9.figshare.21829446.v1
title: Psychometric properties of the Questionnaire for Secondary Traumatization

description: During the past several years, there has been a growing interest in the negative effects that providing therapy may have on therapists. Of special interest is a phenomenon called secondary traumatization, which can arise while working with traumatized clients. To develop a simple screening tool for secondary traumatization, a quantitative assessment instrument was constructed using a data-driven approach based on qualitative interviews with affected trauma therapists as well as experienced supervisors in trauma therapy. The aim of the current study was to analyze the psychometric properties of the newly developed Questionnaire for Secondary Traumatization (FST) acute and lifetime version and to determine the most appropriate scoring procedure. To this end, three independent samples of psychotherapists (<i>n</i>=371), trauma therapists in training (<i>n</i>=80), and refugee counselors (<i>n</i>=197) filled out an online questionnaire battery. Data structure was analyzed using factor analyses, cluster analyses, and reliability analyses. Factor analyses yielded a six-factor structure for both the acute and the lifetime version with only a small number of items loading on differing factors. Cluster analyses suggested a single scale structure of the questionnaire. The FST total score showed good internal consistencies across all three samples, while internal consistency of the six extracted factors was mixed. With the FST, a reliable screening instrument for acute and lifetime secondary traumatization is now available which is free of charge and yields a sum score for quick evaluation. The six-factor structure needs to be verified with confirmatory factor analyses.
DOI: 10.6084/m9.figshare.21829455
title: Design, delivery, and evaluation of early interventions for children exposed to acute trauma

description: Exposure to acute, potentially traumatic events is an unfortunately common experience for children and adolescents. Posttraumatic stress (PTS) responses following acute trauma can have an ongoing impact on child development and well-being. Early intervention to prevent or reduce PTS responses holds promise but requires careful development and empirical evaluation. The aims of this review paper are to present a framework for thinking about the design, delivery, and evaluation of early interventions for children who have been exposed to acute trauma; highlight targets for early intervention; and describe next steps for research and practice. Proposed early intervention methods must (1) have a firm theoretical grounding that guides the design of intervention components; (2) be practical for delivery in peri-trauma or early post-trauma contexts, which may require creative models that go outside of traditional means of providing services to children; and (3) be ready for evaluation of both outcomes and mechanisms of action. This paper describes three potential targets for early intervention—maladaptive trauma-related appraisals, excessive early avoidance, and social/interpersonal processes—for which there is theory and evidence suggesting an etiological role in the development or persistence of PTS symptoms in children.
DOI: 10.6084/m9.figshare.21829455.v1
title: Design, delivery, and evaluation of early interventions for children exposed to acute trauma

description: Exposure to acute, potentially traumatic events is an unfortunately common experience for children and adolescents. Posttraumatic stress (PTS) responses following acute trauma can have an ongoing impact on child development and well-being. Early intervention to prevent or reduce PTS responses holds promise but requires careful development and empirical evaluation. The aims of this review paper are to present a framework for thinking about the design, delivery, and evaluation of early interventions for children who have been exposed to acute trauma; highlight targets for early intervention; and describe next steps for research and practice. Proposed early intervention methods must (1) have a firm theoretical grounding that guides the design of intervention components; (2) be practical for delivery in peri-trauma or early post-trauma contexts, which may require creative models that go outside of traditional means of providing services to children; and (3) be ready for evaluation of both outcomes and mechanisms of action. This paper describes three potential targets for early intervention—maladaptive trauma-related appraisals, excessive early avoidance, and social/interpersonal processes—for which there is theory and evidence suggesting an etiological role in the development or persistence of PTS symptoms in children.
DOI: 10.6084/m9.figshare.21829461
title: The impact of the therapeutic alliance on treatment outcome in patients with dissociative disorders

description: Research has shown that the therapeutic alliance plays an important role in enhancing treatment outcome among individuals with a variety of disorders, including posttraumatic stress disorder (PTSD). However, the therapeutic alliance and treatment outcome has not yet been studied in dissociative disorders (DD). The current study sought to investigate the impact of alliance on treatment outcome for DD patients. Data from a naturalistic, longitudinal international treatment study of DD patients and their therapists were analyzed to determine if the alliance, as reported by patients and therapists, was associated with treatment outcome. Patients with higher self-rated alliance had fewer symptoms of dissociation, PTSD, and general distress, as well as higher levels of therapist-rated adaptive functioning. Over time, self-rated alliance scores predicted better outcomes, after controlling for patient adaptive capacities including symptom management at the time when the alliance ratings were made. Patient-rated alliance was more strongly associated with outcome than therapist-rated alliance. Therapists who work with DD patients should understand the importance of the alliance on treatment outcome. These findings are consistent with previous literature demonstrating the importance of developing and maintaining a strong therapeutic alliance, although the effect sizes of individuals with DD were stronger than what has been found in many other patient groups. A greater understanding of the impact of the alliance in traumatized individuals may contribute to better outcomes for these individuals.
DOI: 10.6084/m9.figshare.21829461.v1
title: The impact of the therapeutic alliance on treatment outcome in patients with dissociative disorders

description: Research has shown that the therapeutic alliance plays an important role in enhancing treatment outcome among individuals with a variety of disorders, including posttraumatic stress disorder (PTSD). However, the therapeutic alliance and treatment outcome has not yet been studied in dissociative disorders (DD). The current study sought to investigate the impact of alliance on treatment outcome for DD patients. Data from a naturalistic, longitudinal international treatment study of DD patients and their therapists were analyzed to determine if the alliance, as reported by patients and therapists, was associated with treatment outcome. Patients with higher self-rated alliance had fewer symptoms of dissociation, PTSD, and general distress, as well as higher levels of therapist-rated adaptive functioning. Over time, self-rated alliance scores predicted better outcomes, after controlling for patient adaptive capacities including symptom management at the time when the alliance ratings were made. Patient-rated alliance was more strongly associated with outcome than therapist-rated alliance. Therapists who work with DD patients should understand the importance of the alliance on treatment outcome. These findings are consistent with previous literature demonstrating the importance of developing and maintaining a strong therapeutic alliance, although the effect sizes of individuals with DD were stronger than what has been found in many other patient groups. A greater understanding of the impact of the alliance in traumatized individuals may contribute to better outcomes for these individuals.
DOI: 10.6084/m9.figshare.21829464
title: When the world collapses: changed worldview and social reconstruction in a traumatized community

description: Traumatic experience can affect the individual's basic beliefs about the world as a predictable and safe place. One of the cornerstones in recovery from trauma is reestablishment of safety, connectedness, and the shattered schema of a worldview. This study explored the role of negatively changed worldview in the relationship between war-related traumatization and readiness for social reconstruction of intergroup relations in a post-conflict community measured by three processes: intergroup rapprochement, rebuilding trust, and need for apology. It was hypothesized that more traumatized people are less supportive of social reconstruction and that this relationship is mediated by the changed worldview. The study included a community random sample of 333 adults in the city of Vukovar, Croatia, that was most devastated during the 1991–1995 war. Six instruments were administered: Stressful Events Scale, Impact of Event Scale-Revised, Changed Worldview Scale, and three scales measuring the post-conflict social reconstruction processes: Intergroup Rapprochement, Intergroup Trust and Need for Apology. Mediation analyses showed that the worldview change fully mediated between traumatization and all three aspects of social reconstruction. In a population exposed to war traumatization the worldview change mediates post-conflict social recovery of community relations.