Engagement in Mental Health Services as a Function of Relationship Quality and PTSD Symptom Severity

Complex trauma (CT; for example, childhood abuse) has been associated with significant behavioral health problems (i.e., mental health and substance use disorders) and symptoms that are consistent with complex posttraumatic stress disorder (C-PTSD). CT is prevalent in adult forensic populations, and particularly important for women as they tend to report more adverse consequences of exposure to traumatic stressors and are entering the criminal justice system at a heightened rate compared with men. However, no studies have empirically tested the relationship among CT, C-PTSD, and behavioral health problems with gender among incarcerated adults. The present study examined the relationship between gender and childhood abuse history, C-PTSD symptom severity, and behavioral health problems in 497 incarcerated adults. Findings indicate that women were more likely to report a history of childhood abuse, and more severe C-PTSD symptoms and behavioral health problems than men. Childhood abuse history significantly accounted for the gender difference observed in C-PTSD symptom severity. C-PTSD partially mediated the gender difference in psychiatric morbidity and in risk of hard drug use. Implications for trauma-informed and gender-responsive services and research in the adult criminal justice system are discussed.

Download Full-text

Gender differences in response to war-related trauma and posttraumatic stress disorder – a study among the Congolese refugees in Uganda

BMC Psychiatry ◽

10.1186/s12888-019-2420-0 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Herbert E. Ainamani ◽

Thomas Elbert ◽

David Kani Olema ◽

Tobias Hecker

Keyword(s):

Mental Health ◽

Gender Differences ◽

Symptom Severity ◽

Mental Health Problems ◽

Ptsd Symptom ◽

Traumatic Events ◽

Health Problems ◽

Cumulative Exposure ◽

Men And Women ◽

Ptsd Symptom Severity

Abstract Background The wars in the Democratic Republic of Congo have left indelible marks on the mental health and functioning of the Congolese civilians that sought refuge in Uganda. Even though it is clear that civilians who are exposed to potentially traumatizing events in war and conflict areas develop trauma-related mental health problems, scholarly information on gender differences on exposure to different war-related traumatic events, their conditional risks to developing PTSD and whether the cumulative exposure to traumatic events affects men and women differently is still scanty. Methods In total, 325 (n = 143 males, n = 182 females) Congolese refugees who lived in Nakivale, a refugee settlement in the Southwestern part of Uganda were interviewed within a year after their arrival. Assessment included exposure to war-related traumatic events, and DSM-IV PTSD symptom severity. Results Our main findings were that refugees were highly exposed to war-related traumatic events with experiencing dangerous flight as the most common event for both men (97%) and women (97%). The overall high prevalence of PTSD differed among women (94%) and men (84%). The highest conditional prevalence of PTSD in women was associated with experiencing rape. The dose-response effect differed significantly between men and women with women showing higher PTSD symptom severity when experiencing low and moderate levels of potentially traumatizing event types. Conclusion In conflict areas, civilians are highly exposed to different types of war-related traumatic events that expose them to high levels of PTSD symptoms, particularly women. Interventions focused at reducing mental health problems resulting from war should take the context of gender into consideration.

Download Full-text

Variation in Criminogenic Risks by Mental Health Symptom Severity: Implications for Mental Health Services and Research

Psychiatric Quarterly ◽

10.1007/s11126-020-09782-x ◽

2020 ◽

Author(s):

Tonya B. Van Deinse ◽

Gary S. Cuddeback ◽

Amy Blank Wilson ◽

Daniel Edwards ◽

Michael Lambert

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Symptom Severity ◽

Mental Health Symptom

Download Full-text

Ethnic Differences in Teacher–Student Relationship Quality and Associations With Teachers’ Informal Help for Adolescents’ Internalizing Problems

Journal of Emotional and Behavioral Disorders ◽

10.1177/1063426618763117 ◽

2018 ◽

Vol 27 (2) ◽

pp. 101-109 ◽

Cited By ~ 1

Author(s):

Esmée E. Verhulp ◽

Gonneke W. J. M. Stevens ◽

Jochem Thijs ◽

Trees V. M. Pels ◽

Wilma A. M. Vollebergh

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Relationship Quality ◽

Ethnic Differences ◽

Internalizing Problems ◽

Teacher Student ◽

Teacher Student Relationship ◽

Student Relationship ◽

Informal Help

Ethnic minority adolescents receive not only less formal mental health services than their ethnic majority peers but also less school-based mental health services. Little is known about the extent to which adolescents indicate their teachers help them with their mental health problems. The aim of the current study was to investigate ethnic differences in teacher-provided informal help for adolescents’ internalizing problems, and whether these could be explained by differences in teacher-reported internalizing problems and teacher–adolescent relationship quality. A sample of adolescents at risk of internalizing problems and their teachers participated in the study ( n = 229). Adolescents originated from four ethnic groups in the Netherlands: three ethnic minority groups (Surinamese Dutch, Turkish Dutch, Moroccan Dutch) and the ethnic majority (native Dutch). Results showed that only Moroccan Dutch adolescents reported considerably less informal help from their teachers for their internalizing problems than native Dutch adolescents, whereas Turkish Dutch and Surinamese Dutch adolescents were not found to differ from native Dutch adolescents. Teacher–student relationship quality and teacher-reported internalizing problems could not explain the differences in informal help between Moroccan Dutch and Dutch adolescents. Teachers reported significantly higher levels of conflict in their relationships with Moroccan Dutch than native Dutch adolescents, and for Moroccan Dutch adolescents, higher levels of conflict were associated with lower levels of informal help by the teacher.

Download Full-text

Post-Traumatic Stress Disorder Treatment Outcomes in Military Clinics

Military Medicine ◽

10.1093/milmed/usab454 ◽

2021 ◽

Author(s):

Robert Mclay ◽

Susan Fesperman ◽

Jennifer Webb-Murphy ◽

Eileen Delaney ◽

Vasudha Ram ◽

...

Keyword(s):

Mental Health ◽

Psychological Health ◽

Symptom Severity ◽

Ptsd Symptom ◽

Treatment Success ◽

Clinical Treatment ◽

Mental Health Clinics ◽

Health Clinics ◽

Severity Scores ◽

Ptsd Symptom Severity

ABSTRACT Introduction Despite a wide literature describing the impact of PTSD on military personnel, there is limited information concerning the results of PTSD treatment within military clinics mental health. Having such information is essential for making predictions about service members’ chances of recovery, choosing best treatments, and for understanding if new interventions improve upon the standard of care. Materials and Methods We reviewed data from the Psychological Health Pathways (PHP) database. Psychological Health Pathways is a standardized battery of demographics and psychometric outcome measures, including measurement of PTSD symptom severity, that is collected in military mental health clinics. We examined changes in PTSD symptom severity scores over time and developed logistic regression models to predict who responded to treatment, showed clinical success, or improved to the point that they could likely stay in the military. Results After about 10 weeks in mental health clinics, severity scores for PTSD, sleep, depression, resilience, and disability all improved significantly. Of 681 patients tracked, 38% had clinically significant reductions on the PTSD Checklist (PCL) (i.e., “treatment response”), 28% no longer met criteria for PTSD on the PCL, and 23% did both (i.e., “clinical treatment success”). For the ultimate end point of “military treatment success,” defined as meeting criteria for both clinical treatment success and reporting that their work-related disability was mild or better, 12.8% of patients succeeded. Depression scores were the most powerful predictor of treatment failure. Conclusions Recovery from PTSD is possible during military service, but it is less likely in individuals with certain negative prognostic factors, most notably severe depression.

Download Full-text