Trauma Blog

Research Methods: The Case for Nonlinear Dynamic Systems
Nonlinear dynamic systems (NDS) is a general theory that describes and predicts changes over time (i.e., dynamics; Gregson & Guastello, 2011). Whereas a linear approach assumes that input is proportional to output, NDS allows us to model sudden changes, such as properly timed jumps from small inputs producing vast changes to a system. Although a substantial body of research has identified variables critical to understanding trauma exposure and its aftereffects—such as factors related to resilience or vulnerability—it often attempts to examine these dynamic constructs in a static, linear fashion. I will briefly discuss why the general linear approach may fall short and how NDS allows us to look at critical variables in ways that capture complex relationships.
 

Clinician's Corner: The Pregnant Moms’ Empowerment Program
StressPoints
Intimate partner violence (IPV) includes physical, sexual or psychological abuse from a current or former partner. The prevalence of IPV is high across the globe, with an estimated one in three women experiencing this form of violence in their lifetime (Devries et al., 2013). Notably, the risk for IPV is heightened during pregnancy, which can lead to negative health effects not only for pregnant women, but also for their developing children. Given the potential for intergenerational and long-term consequences of IPV, it is critical to develop effective interventions to support pregnant women who have experienced this type of adversity (Howell et al., 2017). In response to this need, we developed the Pregnant Moms’ Empowerment Program (PMEP) to meet the unique developmental needs of pregnant women as well as the common mental health challenges associated with IPV exposure.

Research Methods During COVID-19: Critique and Recommendations for Trauma Researchers
StressPoints
In response to COVID-19, pandemic scientists, including trauma scholars, have made herculean efforts to develop successful treatments, vaccines, and effective mitigation strategies and to understand the impact of the pandemic on public mental health. The need to socially distance made survey research a popular tool for some of this work: A web search of science for “COVID-19” and “survey” produces 23,174 articles as of March 16, 2022. Translating these findings into effective public health policy, however, has faltered as the public has struggled to cope with conflicting messages, misinformation, and disinformation (Dhawan et al., 2021). The result has been shifting guidelines, public confusion, and a declining trust in public health agencies like the U.S. Centers for Disease Control (CDC; RAND Corporation, 2021). Inconsistencies in messaging have also fueled the sense of uncertainty created by the pandemic, which could further undermine public trust in the guidelines suggested to mitigate COVID-19 risk. To remedy this situation, we need to recognize how science itself may have contributed to the problem.  

SIG Spotlight: Addressing Traumatic and Minority Stress among Transgender and Gender ‎Diverse Individuals
StressPoints
Transgender Day of Visibility (TDOV) is an internationally recognized event held annually on March 31. The event seeks to bring awareness to the disproportionate rates of discrimination and violence experienced by transgender and gender diverse (TGD) communities, as well as to celebrate the immense contributions of TGD individuals to our society. Despite progress being made in the global recognition of the disparate impact of trauma and violence on TGD populations, anti-transgender legislation in the United States has grown in the past few years, threatening to exacerbate preexisting health disparities for TGD populations (Barbee et al., 2022). Thus, in a cultural climate that subjects TGD individuals to chronic experiences of invalidation, discrimination and harm, it is imperative that traumatic stress researchers and clinicians acknowledge, address and seek to prevent trauma and minority stress for TGD individuals.
 

President’s Message
Pakistan has experienced historic and devastating flooding resulting from the interaction between melting glaciers in the northern regions of the country and monsoon rains. Over 1,400 lives have been lost, and over 33 million people are directly affected, experiencing loss of housing, property, livestock, crops, and infrastructure. In addition to the direct effects of the flooding, the country now faces food shortages and the spread of infectious diseases, exacerbated by the potential of the flooding taking months to recede. In addition to the physical health needs of those affected, the mental health toll of the disaster will no doubt be high. The need for scalable prevention and early interventions for trauma-related psychological distress is clear. Building from the knowledge base of the ISTSS Treatment Guidelines, the Executive Committee coordinated ISTSS’s collaboration with the World Health Organization, and partner Phoenix Australia, to contribute to further guideline development in this area.  

Military Matters: Veteran Psychotherapy and the Use of Military Metaphor
StressPoints
The use of military metaphor in the health sciences has been a topic of recurrent interest and debate for several decades. In that time, writers have decried how “wars” against such scourges as cancer, drugs, and, more recently the COVID-19 pandemic, can shape conceptualizations of these maladies and their treatments in unproductive ways (see, for example, Hauser & Schwarz, 2020; Nie et al., 2016; for an earlier and seminal statement of this position, see Sontag, 1978). Fuks (2010) cautions against this militarized language, in which providers wage war against disease, concerned not only that the disease might supplant the patient as the focus of attention but also that providers themselves might be adversely affected: “it is not simply for patients that medicine must create new metaphors. What is also at stake is the very persona of the physician whose own identity cannot be rooted in warfare and assaults” (Fuks, p. 64). Other writers have readily embraced war metaphors. War metaphors can bespeak a shared knowledge, garner attention and invoke a sense of urgency (Flusberg et al., 2018). Indeed, through their ebook of the same name, Nold and Nold (2021) offer a review of adjunctive treatments marshalled in support of a Total War on PTSD.
 

Student Perspectives: Supporting Clinical Students Providing Care for Individuals Following Communal Trauma
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According to the Gun Violence Archive, a mass shooting occurs when four or more people, not including the person(s) responsible for the shooting, are shot or killed in a single incident. In 2022, the United States saw over 600 mass shootings with loss of life exceeding 650 people (Gun Violence Archive, 2023). As students working at an outpatient specialty trauma clinic and in a Level 1 trauma center in Colorado Springs, this topic hits close to home following the November 19, 2022 mass shooting at a Colorado Springs LGBTQIA+ nightclub in Colorado Springs. Our community joined together to provide crucial resources and support to those affected by the incident, which included graduate student clinical psychology trainees providing numerous hours of free coping support in the hospital, as well as outpatient therapy. Clinical psychology graduate training involves providing clinical services, which are often free or low-cost, to community members. Given that graduate students also face numerous personal and professional transitions and challenges during training (e.g., managing coursework, balancing multiple practicum placements, conducting dissertations), and are in the earliest stage of their career, it is crucial that training programs provide adequate support to these students who are increasingly at the frontline of service provision following mass trauma. 

Trauma and World Literature: Approaching the War in Ukraine Through Poetry on the Eve of its First ‎Anniversary
StressPoints
February 24, 2023 marked one year since Ukraine was last invaded. I’m still trying to come to grips with this as a mental health professional who has spent his career working with combat veterans and other survivors of psychological trauma.