Trauma exposure correlates among patients receiving care in federally qualified health centers.

Over 80% of adults in the general population experience trauma. Rates of patients with posttraumatic stress disorder (PTSD) are high in primary care settings and are likely to be even higher in federally qualified health centers (FQHCs). Trauma exposure has been linked to psychiatric symptoms and physical health comorbidities, though little research has focused on FQHC patients. This study addresses this by examining clinical and sociodemographic correlates of specific trauma types among FQHC patients. We analyzed secondary data from patients who screened positive for PTSD and were receiving health care in FQHCs in a clinical trial (N = 978). Individuals who did versus did not experience a specific trauma type were compared using between-group tests. In the sample, 91.3% of participants were exposed to a DSM-5 Criterion A traumatic event, with 79.6% experiencing two or more trauma types. Witnessing a life-threatening event (57.3%) and physical assault (55.7%) were the most common traumatic experiences. Physical health comorbidities and worse physical health functioning were associated with a higher likelihood of exposure to all trauma types, with effect sizes larger than PTSD, ds = 0.78-1.35. Depressive and anxiety symptoms were also associated with a higher likelihood of experiencing nearly all trauma types to a lesser magnitude. People of color, OR = 2.45, and individuals experiencing financial inequities, OR = 1.73, had higher odds of experiencing serious accidents as well as other trauma types. The findings highlight the need for trauma-informed care, including routine trauma and PTSD screening, for FQHC patients.

Relationship between suboptimal cognitive effort and the clinical scales of the Personality Assessment Inventory.

Little research has examined the relationship between the Personality Assessment Inventory (PAI) and cognitive effort. The current study extends the research on personality assessment and suboptimal cognitive effort by evaluating the relationship between the PAI clinical scales and the Test of Memory Malingering (TOMM) in a neuropsychological population. Utilizing corrections for multiple comparisons, rank-order correlations with the TOMM Trial 2 (T2) and the PAI clinical scales indicated a significant relationship with the SOM (rho = -.26, p <.001), with additional scales (SCZ, ANX, and DEP) trending toward significance. Analysis of SOM subscales indicated a significant relationship between SOM-C and T2 as well. To further explore the relationship between SOM and the TOMM, ANOVA results indicated that individuals scoring within normal limits on the SOM had higher mean TOMM scores than those with extremely elevated SOM. Additional analyses indicated that utilizing the cut-off for extreme responding on the SOM scale (T > 87) had adequate sensitivity (93%) and specificity (76%) in predicting TOMM performance, with a positive predictive power of 54% and a negative predictive power of 97%, resulting in a 91% correct classification rate. Thus, the evidence suggests that extreme scores on SOM should prompt careful evaluation for suboptimal cognitive effort.