Perceived severity of childhood emotional, sexual, and physical abuse: Comparisons across psychologists, students, and the general public.

OBJECTIVE: Childhood emotional abuse has been linked with mental and physical health concerns yet may be perceived as less severe than other forms of childhood abuse. The present study aims to (a) understand perceptions of childhood abuse forms across psychologists, general college-level students, and the general public and (b) investigate whether personal emotional abuse history affects perceptions of emotional abuse. METHOD: Participants (N = 444) completed the Childhood Trauma Questionnaire-Short Form and provided perceived abuse severity and offender responsibility on eight case vignettes of emotional, physical, sexual, and no abuse. Research Question 1 was tested with a two-way (Vignette Type × Participant Type) multivariate analysis of variance performed on perceived severity and offender responsibility scores. Research Question 2 included abuse history as a third factor to examine potential moderation. RESULTS: All three groups perceived scenarios regarding emotional abuse as less severe and the offender less responsible than scenarios regarding sexual or physical abuse. Unexpectedly, psychologists were just as variable in their perceptions of abuse severity across abuse forms, as compared to the general public and college students. However, psychologists with emotional abuse histories provided more severe ratings on emotional abuse items, more in line with general public perceptions. College students' and the general public's relative ratings were roughly equivalent regardless of emotional abuse history. CONCLUSIONS: The study calls for more attention to emotional abuse in psychologist training programs. Research and training to increase understanding of emotional abuse and its sequelae could move forward related educational outreach and legal proceedings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Types of trauma-related blame following interpersonal trauma.

OBJECTIVE: The Diagnostic and Statistical Manual of Mental Disorders (DSM) now includes trauma-related blame as a symptom of posttraumatic stress disorder (PTSD Criterion D3; American Psychiatric Association, 2013). To date, most blame research has utilized quantitative scales, primarily for self-blame, with little attention to other forms of blame. The aims of this study were to (a) identify the common blame types reported by interpersonal trauma survivors through open-ended statements, and (b) explore how well these blame types converge with the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) screener's blame item and total scores. METHOD: Using a mixed-method design, interpersonal trauma survivors (N = 132) completed the Life Events Checklist and the PCL-5. They also provided a written statement indicating why they believe their traumatic event occurred, which was later coded into types of blame by three independent raters. RESULTS: Five blame types emerged from survivors' statements: self, perpetrator, other, global, and circumstance. However, in most cases the presence or absence of each of the blame types was not reliably associated with posttraumatic distress. CONCLUSION: The findings suggest that trauma-related blame attributions are more nuanced than is typically measured and that factors such as the degree of distress caused by a particular blame attribution, or how believable the thought is to the survivor, might be more clinically meaningful than the specific content of the belief. Clinicians and researchers might benefit from the development of a more nuanced measure of trauma-related blame. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Are Survivors of Sexual Assault Blamed More Than Victims of Other Crimes?

Although victim blaming in the context of sexual assault is often emphasized, little research has compared rates of victim blaming following sexual assault relative to other forms of victimization. This research investigated whether there is a crime-specific bias toward blaming victims of sexual assault. Victim blaming was assessed via different methods from the observer perspective in vignette-based studies, as well as survivors' accounts of social reactions they received. In Study 1, participants were asked to rate how much the survivor was to blame in three vignettes, each with a different randomized crime outcome: rape, physical assault, or theft. Study 2 assessed blame for a vignette that either ended in rape or theft, via a causal attribution statement. Study 3 asked interpersonal trauma survivors who had experienced at least two forms of victimization (i.e., sexual assault, physical assault, or theft) to report the social reactions they received following disclosure of each of these crimes. Across all three studies, victim blaming occurred following multiple forms of victimization and there was no evidence of a particular bias toward blaming survivors of sexual assault more so than other crimes. However, results of Study 3 highlight that, following sexual assault, survivors receive more silencing and stigmatizing reactions than they experienced after other crimes. Interpersonal traumas (i.e., sexual or physical assault) also resulted in more egocentric responses compared to theft. Altogether, there does not appear to be a crime-specific bias for victim blaming; however, crime-specific bias is apparent for some other, potentially understudied, social reactions. Implications of these findings highlight the value of victim blaming education and prevention efforts through trauma-informed services and outreach following victimization. Furthermore, service providers and advocates might especially seek to recognize and prevent silencing and stigmatizing reactions following sexual assault disclosures.

Are psychotherapies with more dropouts less effective?

Psychotherapy dropout is often regarded as an indicator of treatment failure; however, evidence of a relationship between dropout and outcome has not been well established. The current research consisted of three meta-analytic studies, the results of which found (a) individuals who dropped out began treatment more distressed than those who completed therapy, (b) individuals who dropped out of therapy were more distressed at posttreatment than individuals who completed therapy, and (c) treatments with higher rates of dropout were also less effective for the treatment completers. Dropout may particularly signal poor outcomes for shorter treatments. The continued ambiguity in the meaning of dropout is discussed as well as the promising potential for future research in the area of dropout as it relates to outcome.

Consumer satisfaction with antipsychotic medication-monitoring appointments: the role of consumer-prescriber communication patterns.

OBJECTIVE: The study was designed to explore patterns of prescriber communication behaviors as they relate to consumer satisfaction among a serious mental illness sample. METHODS: Recordings from 175 antipsychotic medication-monitoring appointments between veterans with psychiatric disorders and their prescribers were coded using the Roter Interaction Analysis System (RIAS) for communication behavioral patterns. RESULTS: The frequency of prescriber communication behaviors (i.e., facilitation, rapport, procedural, psychosocial, biomedical, and total utterances) did not reliably predict consumer satisfaction. The ratio of prescriber to consumer utterances did predict consumer satisfaction. CONCLUSIONS: Consistent with client-centered care theory, antipsychotic medication consumers were more satisfied with their encounters when their prescriber did not dominate the conversation. PRACTICE IMPLICATIONS: Therefore, one potential recommendation from these findings could be for medication prescribers to spend more of their time listening to, rather than speaking with, their SMI consumers.

Understanding the role of dysfunctional post-trauma cognitions in the co-occurrence of Posttraumatic Stress Disorder and Generalized Anxiety Disorder: Two trauma samples.

This report focuses on the co-occurrence of PTSD-GAD and examines a factor that could operate to maintain both conditions, specifically negative post-trauma cognitions about the self, the world, and self-blame. Two separate help-seeking samples were examined: (a) a mixed gender sample of 301 individuals who had experienced a serious motor vehicle accident (MVA), a single incident, non-interpersonal trauma; and (b) a sample of 157 women who had experienced intimate partner violence (IPV), a recurrent, interpersonal trauma. When examined at the diagnostic level, posttraumatic cognitions for one diagnosis did not vary as a function of whether the other diagnosis was present. In the MVA sample, both diagnosed PTSD and GAD were associated with elevations in negative thoughts about the self. Diagnosed GAD was also significantly associated with negative thoughts about the world. In the IPV sample, diagnosed PTSD was associated with elevations in negative thoughts about the self only. When continuously measured PTSD and GAD were examined, results indicated that negative thoughts about the self showed significant simultaneous associations with PTSD and GAD in both samples. In the MVA sample, negative thoughts about the world and self-blame showed significant associations with PTSD but not with GAD. In the IPV sample, negative thoughts about the world and self-blame were not significantly associated with either PTSD or GAD. Results are discussed in light of current treatment models for these conditions, with emphasis on the potential for addressing transdiagnostic processes as a more effective approach to treating comorbid conditions following trauma.

Social problem solving strategies and posttraumatic stress disorder in the aftermath of intimate partner violence.

Social factors are often associated with the development or maintenance of posttraumatic stress disorder (PTSD) in the aftermath of interpersonal traumas. However, social problem solving strategies have received little attention. The current study explored the role of social problem solving styles (i.e., rational approaches, impulsive/careless strategies, or avoidance strategies) as intermediary variables between abuse exposure and PTSD severity among intimate partner violence survivors. Avoidance problem solving served as an intermediating variable for the relationship between three types of abuse and PTSD severity. Rational and impulsive/careless strategies were not associated with abuse exposure. These findings extend the current understanding of social problem solving among interpersonal trauma survivors and are consistent with more general avoidance coping research. Future research might examine whether avoidance problem solving tends to evolve in the aftermath of trauma or whether it represents a longstanding risk factor for PTSD development.

How do negative emotions relate to dysfunctional posttrauma cognitions? An examination of interpersonal trauma survivors.

In order to broaden theoretical models of adaptation following trauma and inform current diagnostic practices, the goal of the current study was to examine associations between negative emotions and dysfunctional trauma-related cognitions. In a sample of 109 women who were seeking mental health assistance after intimate partner violence (IPV), anxiety, depression, shame, and guilt were explored in association with negative thoughts about the self, negative thoughts about the world, and self-blame. Higher levels of shame and depression were significantly associated with higher levels of negative thoughts about the self. An increased level of guilt was the only significant finding in the analysis involving negative thoughts about the world. Lower levels of depression and higher levels of shame and guilt were significantly associated with increased levels of self-blame. Anxiety did not emerge as a significant predictor in any of these analyses. Implications for current models of posttraumatic stress disorder (PTSD), revisions to diagnostic practices, and treatment of individuals who have experienced interpersonal trauma are discussed.

Does self-blame moderate psychological adjustment following intimate partner violence?

This study explored whether self-blame moderates the relationship between exposure to specific types of abuse and both poor general psychological adjustment (i.e., self-esteem) and specific symptomatology (i.e., posttraumatic stress disorder [PTSD]) among women who had experienced intimate partner violence (IPV). Eighty female IPV survivors were involved in this study. Results indicated that self-blame was negatively associated with self-esteem for physical, psychological, and sexual abuse. Self-blame moderated physical abuse, such that high levels of physical abuse interacted with high levels of self-blame in their association with PTSD. Nonsignificant models were noted for psychological and sexual abuse in association with self-blame and PTSD. These findings support the conceptualization that self-blame is associated with both general and specific psychological outcomes in the aftermath of IPV. Future research examining different forms of blame associated with IPV might further untangle inconsistencies in the self-blame literature.

How do attachment style and social support contribute to women's psychopathology following intimate partner violence? Examining clinician ratings versus self-report.

Concurrent associations between attachment style and social support in posttraumatic stress disorder, depression, and generalized anxiety disorder were explored using regression analyses in a sample of 108 victims of intimate partner violence. To examine whether assessment modality influenced findings, self-report and clinician ratings of psychopathology were compared. Both lower perceived social support and higher attachment anxiety were significantly associated with higher self-reported PTSD; however, only lower social support was significantly associated with clinician assessed PTSD. Lower social support, higher attachment anxiety, and lower attachment closeness were related with higher self-reported depression; however, only lower social support was related to clinician assessed depression. Lastly, only higher attachment anxiety was associated with self-reported GAD, whereas lower attachment dependency showed the only significant association in clinician assessed GAD. Possible explanations for discrepancies between assessment modalities are discussed, with emphasis on application to intimate partner violence and suggestions for future research.