Special section: innovations in trauma research methods.
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Biomedical subjects
Publications and source records attributed to Lynda A King.
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Despite the proliferation of longitudinal trauma research, careful attention to timing of assessments is often lacking. Patterns in timing of assessments, alternative time structures, and the treatment of time as an outcome are discussed and illustrated using trauma data.
In this article, the authors introduce a latent difference score (LDS) approach to analyzing longitudinal data in trauma research. The LDS approach accounts for internal sources of change in an outcome variable, including the influence of prior status on subsequent levels of that variable and the tendency for individuals to experience natural change (e.g., a natural decrease in posttraumatic stress disorder [PTSD] symptoms over time). Under traditional model assumptions, the LDSs are maximally reliable and therefore less likely to introduce biases into model testing. The authors illustrate the method using a sample of children who experienced significant burns or other injuries to examine potential influences (i.e., age of child-adolescent at time of trauma and ongoing family strains) on PTSD symptom severity over time.
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Findings indicate that war-zone exposure has negative implications for the postdeployment adjustment of veterans; however, most studies have relied on limited conceptualizations of war-zone exposure and focused on male samples. In this study, an array of deployment stressors that were content valid for both female and male Gulf War I military personnel was examined to elucidate gender differences in war-zone exposure and identify gender-based differential associations between stressors and mental health outcomes. While women and men were exposed to both mission-related and interpersonal stressors and both stressor categories were associated with mental health outcomes, women reported more interpersonal stressors and these stressors generally had a stronger impact on women's than on men's mental health. Exceptions are described, and implications are discussed.
Findings indicate that war-zone exposure has negative implications for the postdeployment adjustment of veterans; however, most studies have relied on limited conceptualizations of war-zone exposure and focused on male samples. In this study, an array of deployment stressors that were content valid for both female and male Gulf War I military personnel was examined to elucidate gender differences in war-zone exposure and identify gender-based differential associations between stressors and mental health outcomes. While women and men were exposed to both mission-related and interpersonal stressors and both stressor categories were associated with mental health outcomes, women reported more interpersonal stressors and these stressors generally had a stronger impact on women's than on men's mental health. Exceptions are described, and implications are discussed.
This longitudinal study examined posttraumatic stress disorder (PTSD) symptoms among current and former female partners (N = 96) of men participating in a group treatment program for partner abuse perpetrators. Female partner probable PTSD rates, obtained during time points corresponding with pretreatment, posttreatment, and 6-month follow-up for the male clients, were 52%, 34%, and 29%, respectively. Psychological abuse exposure was more strongly and uniquely associated with PTSD symptoms than was physical abuse exposure. Among psychological abuse ratings, denigration, restrictive engulfment, and dominance/intimidation behaviors evidenced the strongest associations with PTSD symptoms. Findings from this study suggest the association between psychological abuse and PTSD is complex and multidetermined.
In this study, the authors identified potential risk factors for partner violence perpetration among a subsample (n=109) of men who participated in a national study of Vietnam veterans. Partner violent (PV) men with posttraumatic stress disorder (PTSD) were compared with PV men without PTSD and nonviolent men with PTSD on family-of-origin variables, psychiatric problems, relationship problems, and war-zone factors. PV men with PTSD were the highest of the 3 groups on every risk factor other than childhood abuse. Group contrasts and a classification tree analysis suggest some potential markers and mechanisms for the association between PTSD and partner violence among military veterans and highlight the need for theory development in this area of inquiry.
This study examined partner violence and perceived family functioning among a sample of 298 male veterans and their female partners. Partner violent men were higher than partner violent women on measures of partner violence severity, although differences did not reach statistical significance. Among couples experiencing unidirectional violence, female victims of partner violence reported significantly poorer family functioning than male victims of partner violence. Data appear to suggest that the effects of male-perpetrated partner violence on perceived family functioning may be larger than that of female-perpetrated partner violence.
This study examined relationships between posttraumatic stress disorder (PTSD) symptoms and parenting satisfaction. Total PTSD severity scores and avoidance and emotional numbing symptoms were significantly associated with parenting satisfaction. These associations remained significant even after controlling for partner violence, major depression, and alcohol abuse/dependence. Results suggest that higher levels of PTSD symptoms and avoidance and emotional numbing symptoms in particular may have a deleterious effect on parent-child relationship satisfaction.
A review of articles in Psychological Assessment reveals that many researchers develop instruments without the benefit of consultation with members of the target population. To the extent that researchers do consult the target population, most fail to bring consultation in early enough to inform the identification and specification of key constructs. Moreover, this consultation typically takes the form of one-to-one interviews. The authors' goal in this article was to elaborate on the importance of population consultation as part of content validation and to critically evaluate the potential of one method of consultation, focus groups, to inform multiple stages of instrument development. The authors suggest that this method holds promise for enhancing the content validity of instruments and, ultimately, the validity of research findings.
Traditional methods for analyzing trends in longitudinal data have typically emphasized average group change over time. In this article, we propose multilevel, regression-based methods for examining inter-individual differences in intra-individual change and apply these methods to research in trauma and posttraumatic stress disorder (PTSD). The outcome or dependent variable of interest is reconceptualized as an index of dynamic change reflecting the trend or trajectory of an individual's PTSD symptom severity scores across time. A basic statistical model is presented, and analyses and findings are demonstrated with an existing database used in previously published studies. The methods offer promise for future study of the natural course of PTSD chronicity or recovery, risk and resilience factors that influence individual growth or decline, and critical timepoints for intervention.
Using structural equation modeling, we examined the impact of early-life stressors, war-zone stressors, and PTSD symptom severity on partner's reports of recent male-perpetrated intimate partner violence (IPV) among 376 Vietnam veteran couples. Results indicated that several variables demonstrated direct relationships with IPV, including relationship quality with mother, war-zone stressor variables, and PTSD symptom severity. Importantly, retrospective reports of a stressful early family life, childhood antisocial behavior, and war-zone stressors were indirectly associated with IPV via PTSD. One of our 2 war-zone stressor variables, perceived threat, had both direct and indirect (through PTSD) relationships with IPV. Experiencing PTSD symptoms as a result of previous trauma appears to increase an individual's risk for perpetrating IPV. Implications for research and treatment are discussed.
Despite growing recognition of substantial interpersonal impairment among many war-zone veterans with posttraumatic stress disorder (PTSD), little is known about the association between PTSD symptomatology and veterans' relationships with their children. This study examined the differential pattern of associations between the symptom clusters of PTSD and the perceived father-child relationships of 66 male Vietnam veterans. Analyses revealed that only the emotional numbing cluster was significantly related to perceived quality of all relationship domains. The association between emotional numbing and perceived relationship quality remained significant in regression analyses even after controlling for fathers' family-of-origin stressors, combat exposure, depression, and substance abuse. Findings suggest that emotional numbing may be the component of PTSD most closely linked to interpersonal impairment in war-zone veterans.