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Physical Health, Psychological Distress, and Betrayal Trauma.
Freyd, J.J., Klest, B., & Allard, C.B.
Numerous studies have revealed an association between trauma and adverse
physical and mental health status. While the relation is well established,
the mechanisms underlying this link are less well understood. In the current
study we sought to distinguish impact on health arising from types of
trauma as indicated by betrayal trauma theory (Freyd 1996, 2001), with
an eye toward eventually uncovering mechanisms and developing interventions.
Betrayal trauma theory distinguishes two dimensions as primary for events
that cause long lasting harm to people: life-threat (e.g. major car accident;
urban violence) and social betrayal (e.g. abuse by a close other). We
recruited 99 community adults who reported at least 12 months of chronic
medical or pain problems for a longitudinal intervention study. Participants
were assessed for trauma history and physical and mental symptoms. Trauma
assessment included measuring exposure to both traumas high in betrayal
and traumas low in betrayal (but high in life-threat). Associations between
overall trauma exposure and negative health and mental status were found.
High betrayal was particularly potent. For instance, exposure to traumas
with high betrayal is significantly correlated with number of physical
illness symptoms (r=.37), anxiety symptoms (r = .49), and depression symptoms
(r=.45). Multiple regression analyses predicting these symptoms from betrayal
trauma exposure reveal that adding exposure to trauma with less betrayal
into the model changes R-square statistics very little, and these changes
are not significant. This pattern of results has been replicated with
data recently collected in our laboratory using a different population.
In addition, interesting gender effects are emerging. With the large amount
of variance in symptoms predicted by exposure to high betrayal trauma,
we are focusing on uncovering mechanisms and evaluating the health consequences
of an intervention that involves writing about reactions to these events.
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Why not ask about abuse? Beliefs that hold researchers back.
Becker-Blease, K.A., & Freyd, J.J.
For related manuscript (Becker Blease, K.A. & Freyd, J.J. (under
review) Research participants telling the truth about their lives: the
ethics of asking and not asking about abuse, contact kblease@cisunix.unh.edu
)
Abuse survivors are silenced in gendered ways (men cannot show weakness,
women are not supported in holding abusers responsible). At the same time
researchers are often reluctant to ask about abuse. We address common
beliefs about abuse research and present data on harm resulting from not
asking about abuse. Belief-1: Asking about abuse requires reporting. We
summarize research on ways to assess abuse ethically without reporting.
Belief-2: Reporting means losing participants. We summarize ways to report
abuse that retain and empower participants. Belief-3: Asking exposes participants
to upsetting stimuli, beyond everyday life. We review literature indicating
that sensory experiences are more likely triggers than survey questions.
Belief-4: Asking causes harm. We contrast distress with harm while emphasizing
the role of the abuser in causing harm. Belief-5: Abuse survivors are
emotionally unstable. Rather than viewing survivors as overly fragile,
we emphasize survivors' strengths while describing supportive debriefing.
Belief-6: Asking has no benefits to participants. We review research documenting
the benefits survivors see to abuse-focused research. Belief-7: There
are no costs to NOT asking. Avoiding asking harms participants, science
and society. Science is at risk when we fail to include abuse in statistical
models to account for phenomena related to abuse. We present data on correlations
between abuse, demographics, and mental health in a community sample of
80 preschool children to demonstrate this point. Correlations with abuse
are: Female sex: 0.36; 2-parent family: -0.40; married parents: -0.28;
household income: -0.34; parent's education: -0.30; internalizing symptoms:
0.30; externalizing symptoms: 0.27 (p < 0.05). Relations between abuse
and internalizing and externalizing symptoms remain significant after
controlling for the other factors (0.32 and 0.36 respectively). Researchers
studying internalizing, externalizing, or any phenomena related to these
demographic factors may be missing important information if abuse history
is omitted.
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Harmful Taboo? Fear of Harm in Asking about Trauma History
DePrince, A.P., & Freyd, J.J.
Institutional Review Boards and other entities continue to raise concerns
about potential harm to participants of asking about trauma history. This
reflects a pervasive assumption that asking about trauma history - particularly
interpersonal trauma perpetrated by a trusted other - causes harm. Given
this assumption, researchers risk failing to gather information critical
to women's experiences. Data consistently reveal that females report more
instances of victimization at the hands of a trusted other than males,
yet this is precisely the topic that many entities argue should not be
queried for fear of harming the participant. We will argue that there
is harm in neglecting to ask these questions that may help explain important
and consistent differences between men and women's mental health. To evaluate
the cost-benefit ratio in both undergraduate and community samples, we
asked over 500 participants to respond to three questions on their experience
of completing a 12 item behaviorally defined self-report trauma measure.
The response questions were designed to tap (1) participants' perceptions
of whether the trauma history questions were more or less distressing
than things encountered in day-to-day life, (2) how important participants
believe it is for psychologists to ask about these types of events, and
(3) how good of an idea, according to participants, it is to include such
a measure in psychology research. Our data indicate that participants
find on average questions about trauma are neutral compared to day-to-day
experiences. Further, participants rate research asking about stressful
life events as more than "somewhat important" on average. Finally,
taking into account their experience of answering the questions and how
important it is to ask such questions, on average participants indicate
that including such measures is more than "somewhat good". Implications
of these results, as well as the potential harm of excluding measures
of trauma, will be discussed.
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Context for Enhancing Learning about Trauma and Oppression.
Freyd, J.J. & Becker-Blease, K.A.
Courses addressing gender, oppression, trauma, and/or violence may inspire
students to make powerful emotional connections with the intellectual
material. Connections include reminders of personal suffering from oppression
or abuse and discovery of the suffering of others. Emotional connection
with academic content comes with both risk of distress and the potential
to enrich learning and intellectual development. The classroom reality
is situated in a larger culture of silence regarding explicit discussion
of personal victimization. Indeed, students may experience a class on
oppression or trauma as the first time they have permission to speak about
these important matters. The culture of silence may relate to the pervasive
belief that permitting trauma victims to discuss their experiences will
cause psychological harm. This belief manifests in restrictions on research
and an avoidance of the topic in almost all contexts including graduate
training. However, research indicates that while talking about trauma
and abuse is not generally harmful per se (and can be beneficial), social
context and particularly response to disclosures of trauma and abuse can
be either deeply helpful or deeply harmful. We must therefore attend to
context and response. This presentation will combine research findings,
and insights gained through the presenter's experience running a trauma
research laboratory, educating graduate students, and teaching courses
in gender and trauma. Questions to be addressed include: What social contexts
and responses to disclosures of abuse are likely to be beneficial in the
classroom, laboratory, inbox, and faculty office? What is a teacher to
do when students spontaneously disclose abuse? What can be done in advance
to reduce the likelihood of harmful outcome? How can a teacher manage
for her/himself as well as the students the emotional reality of oppression
and trauma, while enhancing the intellectual and academic experience?
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Exploring the Potential of Pennebaker's Writing Paradigm on Betrayal
Trauma Sequelae.
Allard, C.B., Freyd, J.J., & Momiyama, T.
In Pennebaker's writing paradigm, participants are instructed either
to write about emotional events or neutral topics. Those assigned to the
emotional writing condition typically display physical and psychological
health improvements as compared to those who write about something neutral
(Pennebaker, 1997; Smyth, 1998). Up until now, the writing paradigm has
for the most part been applied to events which have been described as
emotional but not specifically traumatic and those few studies that have
looked at the effect of writing about traumatic experiences have only
involved one-time non-complex traumas. There is evidence that the consequences
of one-time traumas are different than those of continuous, complex traumas,
such as child abuse. Furthermore, betrayal trauma theory (Freyd, 1996,
2001) distinguishes traumas on the basis of two event dimensions which
may elicit different reactions: life-threat (e.g. major car accident;
violent rape by a stranger) and social betrayal (e.g. abuse by a close
other). Betrayal trauma is perpetrated by someone who is close to the
victim and/or upon whom the victim is dependent. Such events are associated
with unawareness and impaired memory for the trauma, presumably for the
purpose of preserving the victim-perpetrator relationship. Exposure to
betrayal trauma has been associated with various negative sequelae. The
primary objective of this study was to investigate the generalizability
of Pennebaker's Paradigm to betrayal trauma. A secondary goal of the study
was to help elucidate the mechanism behind this phenomenon by analyzing
the content of the essays using Pennebaker's Linguistic Inquiry and Word
Count (LIWC; Pennebaker, Francis & Booth, 2001), and rating the essays
in terms of characteristics hypothesized to play important roles in the
effect of writing, such as coherence, presence of emotion words, narrative
point of view, and development over time. Sixty-five physically symptomatic
university undergraduates (51 female, 14 male; mean age = 19.94 years,
SD = 3.86) were randomly assigned to one of two writing conditions. Participants
in the traumatic condition were asked to write about a distressing interpersonal
event they experienced during childhood and those in the neutral condition
were asked to write about how they spent their time during the previous
day. They wrote about their assigned topic twice, one week apart. All
participants were administered abuse inventories, and pre and posttest
physical and psychological health questionnaires. Over 50% of all participants
reported having experienced at least one betrayal trauma and women reported
more betrayal trauma than men. Betrayal trauma and health measures were
found to be negatively related. A significant gender by writing condition
interaction emerged, which revealed that, in general, women in the trauma
writing condition benefited more than men. Closer examination of the content
and structure of the essays revealed interesting patterns between certain
writing components and outcome measures. These findings suggest that it
would be fruitful to consider the type of trauma experienced by a person
when determining the best intervention. In addition, directing the writing
process to include those components found to be related to outcomes may
enhance the effectiveness of a writing intervention. This needs to be
tested in a controlled experimental trial. Future research is also recommended
to replicate these findings in a larger and less homogenous population.
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