Type of Traumatic Events,Mental Health Problems,and Posttraumatic Cognitions Among Eastern Anatolian Women

Abstract

Both severity and type of trauma play a role in mental health consequences. Interpersonal trauma, especially sexual abuse and intentional assaultive violence, form a risk for posttraumatic stress disorder (PTSD). However, few studies have factually compared the impact of trauma types on mental health. This study examined whether interpersonal violence (IPV), natural disasters and accidents (NDA), and life-threat and war (LTW) are differently associated with mental health problems among women. It further examined the mediating role of posttraumatic cognitions (PTCs) among the abovementioned three types of traumatic events and mental health problems. The participants were 1,569 Eastern Anatolian women (16-72 years of age). Traumatic events were assessed with the Life Events Checklist (LEC), mental health with the Diagnostic and statistical manual of mental disorders (5th ed.; DSM-5) diagnostic criteria for PTSD, psychiatric distress symptoms with the GHQ-28 (General Health Questionnaire) scales, and PTCs with the self-related and other-related scales of the Posttraumatic Cognitions Inventory (PTCI). As hypothesized, IPV was more significantly associated with PTSD, anxiety, and somatization symptoms than with NDA. The LTW was significantly associated with all symptoms. Both self-related and other-related PTCs partially mediated the association of both IPV and NDA with mental health problems. The findings are discussed from the perspectives of women and human rights, emphasizing also the importance of cognitive processing of traumatic experiences in enhancing good mental health.

Keywords

type of trauma PTSD depression interpersonal violence women posttraumatic cognitions

Get full access to this article

View all access options for this article.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Bacchus

L. J.

Ranganathan

Watts

Devries

(2018). Recent intimate partner violence against women and health: A systematic review and meta-analysis of cohort studies. BMJ Open, 8, e019995. doi:10.1136/bmjopen-2017-019995

Belsher

B. E.

Ruzek

J. I.

Bongar

Cordova

M. J.

(2012). Social constraints, posttraumatic cognitions, and posttraumatic stress disorder in treatment-seeking trauma survivors: Evidence for a social-cognitive processing model. Psychological Trauma: Theory, Research, Practice, and Policy, 4, 386-391. doi:10.1037/a0024362

Bentler

P. M.

(2007). On tests and indices for evaluating structural models. Personality and Individual Differences, 42, 825-829.

Breslau

(2009). The epidemiology of trauma, PTSD, and other posttrauma disorders. Trauma, Violence, & Abuse, 10, 198-210.

Burstow

(2003). Toward a radical understanding of trauma and trauma work. Violence Against Women, 9, 1293-1317.

Burstow

(2005). A critique of posttraumatic stress disorder and the DSM. Journal of Humanistic Psychology, 45, 429-445.

Canino

Alegría

(2008). Psychiatric diagnosis—Is it universal or relative to culture? Journal of Child Psychology and Psychiatry, and Allied Disciplines, 49, 237-250. doi:10.1111/j.1469-7610.2007.01854.x

Christiansen

D. M.

Elklit

(2008). Risk factors predict post-traumatic stress disorder differently in men and women. Annals of General Psychiatry, 7, 24-36. doi:10.1186/1744-859X-7-24

10.

Creamer

Burgess

McFarlane

A. C.

(2001). Post-traumatic stress disorder: Findings from the Australian National Survey of Mental Health and Well-Being. Psychological Medicine, 31, 1237-1247. doi:10.1017/S0033291701004287

11.

Cumming

(2009). Inference by eye: Reading the overlap of independent confidence intervals. Statistics in Medicine, 28, 205-220. doi:10.1002/sim.3471

12.

Cusack

Jonas

D. E.

Forneris

C. A.

Wines

Sonis

Middleton

F. C.

. . . Gaynes

B. N.

(2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical Psychology Review, 43, 128-141. doi:10.1016/j.cpr.2015.10.003

13.

Daie-Gabai

Aderka

I. M.

Allon-Schindel

Foa

E. B.

Gilboa-Schechtman

(2011). Posttraumatic Cognitions Inventory (PTCI): Psychometric properties and gender differences in an Israeli sample. Journal of Anxiety Disorders, 25, 266-271.

14.

Diehle

Schmitt

Daams

J. G.

Boer

Lindauer

R. J. L.

(2014). Effects of psychotherapy on trauma-related cognitions in posttraumatic stress disorder: A meta-analysis. Journal of Traumatic Stress, 27, 257-264. doi:10.1002/jts.21924

15.

Ehlers

Clark

D. M.

(2000). A cognitive model of posttraumatic stress disorder. Behavior Research and Therapy, 38, 319-345. doi:10.1016/S0005-7967(99)00123-0

16.

Ellsberg

Jansen

H. A.

Heise

Watts

C. H.

Garcia-Moreno

(2008). Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: An observational study. The Lancet, 371, 1165-1172.

17.

Ertem

Kocturk

(2008). Opinions on early-age marriage and marriage customs among Kurdish-speaking women in southeast Turkey. Journal of Family Planning and Reproductive Health Care, 34, 147-152. Available from http://jfprhc.bmj.com

18.

Foa

E. B.

Ehlers

Clark

D. M.

Tolin

D. F.

Orsillo

S. M.

(1999). The posttraumatic cognitions inventory (PTCI): Development and validation. Psychological Assessment, 11, 303-314. doi:10.1037/1040-3590.11.3.303

19.

Foa

E. B.

Hembree

Rothbaum

B. O.

(2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences. New York, NY: Oxford University Press.

20.

Foa

E. B.

Steketee

Rothbaum

B. O.

(1989). Behavioral/cognitive conceptualization of post-traumatic stress disorder. Behaviour Therapy, 20, 155-176.

21.

Frazier

Nguyen-Feng

Fulco

Anders

Shallcross

(2017). Mediators of the relation between sexual victimization and distress: Comparison to bereavement. Psychological Trauma-Theory Research Practice and Policy, 9, 96-104. doi:10.1037/tra0000166

22.

Ganchimeg

Ota

Morisaki

Laopaiboon

Lumbiganon

Zhang

. ; WHO Multicountry Survey on Maternal Newborn Health Research Network. (2014). Pregnancy and childbirth outcomes among adolescent mothers: A World Health Organization multicountry study. An International Journal of Obstetrics and Gynaecology, 121(Suppl. 1), 40-48. doi:10.1111/1471-0528.12630

23.

Gilfus

M. E.

(1999). The price of the ticket: A survivor-centered appraisal of trauma theory. Violence Against Women, 5, 1238-1257.

24.

Goldberg

D. P.

Gater

Sartorius

Ustun

T. B.

Piccinelli

Gureje

Rutter

(1997). The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine, 27, 191-197. doi:10.1017/S0033291796004242

25.

Goldberg

D. P.

Hillier

V. F.

(1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139-145.

26.

Haj-Yahia

M. M.

(2003). Beliefs about wife beating among Arab men from Israel: The influence of their patriarchal ideology. Journal of Family Violence, 18, 193-206.

27.

Hopkins

C. Q.

Koss

M. P.

(2005). Incorporating feminist theory and insights into a restorative justice response to sex offences. Violence Against Women, 11, 693-723.

28.

Jakob

J. M.

Lamp

Rauch

S. A.

Smith

E. R.

Buchholz

K. R.

(2017). The impact of trauma type or number of traumatic events on PTSD diagnosis and symptom severity in treatment seeking veterans. The Journal of Nervous and Mental Disorders, 205, 83-86. doi:10.1097/NMD.0000000000000581

29.

Janoff-Bulman

(1992). Shattered assumptions: Towards a new psychology of trauma. New York, NY: Free Press.

30.

Jensen

Thornton

(2003). Early female marriage in the developing world. Gender & Development, 11, 9-19.

31.

Kessler

R. C.

Davis

C. G.

Kendler

K. S.

(1997). Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychological Medicine, 27, 1101-1119.

32.

Kılıç

(1996). Genel Sağlık Anketi: Güvenilirlik ve geçerlilik çalışması [General health survey: Reliability and validation]. Türk Psikiyatri Dergisi/Turkish Psychiatric Journal, 7, 3-9. (In Turkish)

33.

Kumpula

M. J.

Pentel

K. Z.

Foa

E. B.

LeBlanc

N. J.

Bui

McSweeney

L. B.

. . . Rauch

S. A. M.

(2017). Temporal sequencing of change in posttraumatic cognitions and PTSD symptom reduction during prolonged exposure therapy. Behavior Therapy, 48, 156-165. doi:10.1016/j.beth.2016.02.008

34.

LeBeau

Mischel

Resnick

Kilpatrick

Friedman

Craske

(2014). Dimensional assessment of posttraumatic stress disorder in DSM-5. Psychiatry Research, 218, 143-147. doi:10.1016/j.psychres.2014.03.032

35.

LoSavio

S. T.

Dillon

K. H.

Resick

P. A.

(2017). Cognitive factors in the development, maintenance, and treatment of post-traumatic stress disorder. Current Opinion in Psychology, 14, 18-22.

36.

MacKinnon

D. P.

Lockwood

C. M.

Williams

(2004). Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivariate Behavioral Research, 39, 99-128. doi:10.1207/s15327906mbr3901_4

37.

Martin

C. G.

Cromer

L. D.

DePrince

A. P.

Freyd

J. J.

(2013). The role of cumulative trauma, betrayal, and appraisals in understanding trauma symptomatology. Psychological Trauma: Theory, Research, Practice, and Policy, 5, 110-118. doi:10.1037/a0025686

38.

McMillan

K. A.

Asmundson

G. J.

(2016). PTSD, social anxiety disorder, and trauma: An examination of the influence of trauma type on comorbidity using a nationally representative sample. Psychiatry Research, 246, 561-567. doi:10.1016/j.psychres.2016.10.036

39.

Moussawi

Chatterji

Verdes

Tandon

Patel

Ustun

(2007). Depression, chronic diseases, and decrements in health: Results from the World Health Surveys. The Lancet, 370, 851-858. doi:10.1016/S0140-6736(07)61415-9

40.

O’Donnell

M. L.

Elliott

P. W.

Wolfgang

Creamer

(2007). Posttraumatic appraisals in the development and persistence of posttraumatic stress symptoms. Journal of Traumatic Stress, 20, 173-182. doi:10.1002/jts.20198

41.

Olff

Langeland

Draijer

Gersons

B. P.

(2007). Gender differences in posttraumatic stress disorder. Psychological Bulletin, 133, 183-204. doi:10.1037/0033-2909.133.2.183

42.

Patel

Kirkwood

B. R.

Pednekar

Weiss

Mabey

(2006). Risk factors for common mental disorders in women: Population-based longitudinal study. The British Journal of Psychiatry, 189, 547-555. doi:10.1192/bjp.bp.106.022558

43.

Pineles

S. L.

Hall

K. A. A.

Rasmusson

A. M.

(2017). Gender and PTSD: Different pathways to a similar phenotype. Current Opinion in Psychology, 14, 44-48. doi.org/10.1016/j.copsyc.2016.11.002

44.

Plümper

Neumayer

(2007). The gendered nature of natural disasters: The impact of catastrophic events on the gender gap in life expectancy. Annals of the Association of American Geographers, 97, 551-566.

45.

Porter

K. E.

Pope

E. B.

Mayer

Rauch

S. A.

(2013). PTSD and pain: Exploring the impact of posttraumatic cognitions in veterans seeking treatment for PTSD. Pain Medicine, 14, 1797-1805. doi:10.1111/pme.12260

46.

Reichert

E. L.

Flannery-Schroeder

(2014). Posttraumatic cognitions as mediators between childhood maltreatment and poorer mental health among young adults. Journal of Child & Adolescent Trauma, 7, 153-162.

47.

Robinaugh

D. J.

Marques

Traeger

L. N.

Marks

E. H.

Sung

S. C.

Gayle

B. J.

Simon

N. M.

(2011). Understanding the relationship of perceived social support to post-trauma cognitions and posttraumatic stress disorder. Journal of Anxiety Disorders, 25, 1072-1078. doi:10.1016/j.janxdis.2011.07.004

48.

Robinaugh

D. J.

McNally

R. J.

(2011). Trauma centrality and PTSD symptom severity in adult survivors of childhood sexual abuse. Journal of Traumatic Stress, 24, 483-486. doi:10.1002/jts.20656

49.

Robles

T. F.

Slatcher

R. B.

Trombello

J. M.

McGinn

M. M.

(2014). Marital quality and health: A meta-analytic review. Psychological bulletin, 140, 140-187. doi:10.1037/a0031859

50.

Salcioglu

Basoglu

Livanou

(2007). Post-traumatic stress disorder and comorbid depression among survivors of the 1999 earthquake in Turkey. Disasters, 31, 115-129.

51.

Sezgin

Punamäki

R. L.

(2012). Earthquake trauma and causal explanation associating with PTSD and other psychiatric disorders among South East Anatolian women. Journal of Affective Disorders, 141, 432-440. doi:10.1016/j.jad.2012.03.005

52.

Sireci

S. G.

(2011). Evaluating test and survey items for bias across languages and cultures. In Matsumoto

van de Vijver

F. J. R.

(Eds.), Cross-cultural research methods in psychology (pp. 216-240). Cambridge, UK: Cambridge University Press.

53.

Summerfield

(2002). Effects of war: Moral knowledge, revenge, reconciliation, and medicalised concepts of “recovery.” British Medical Journal, 325, 1105-1107.

54.

Thompson-Hollands

Jun

J. J.

Sloan

D. M.

(2017). The association between peritraumatic dissociation and PTSD symptoms: The mediating role of negative beliefs about the self. Journal of Traumatic Stress, 30, 190-194. doi:10.1002/jts.22179

55.

Tolin

D. F.

Foa

E. B.

(2006). Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychological Bulletin, 132, 959-992. doi:10.1037/0033-2909.132.6.959

56.

Tseris

E. J.

(2013). Trauma theory without feminism? Evaluating contemporary understandings of traumatized women. Affilia: Journal of Women and Social Work, 28, 154-164. doi:10.117/0886109913485707

57.

Van der Kolk

B. A

. (2000). Posttraumatic stress disorder and the nature of trauma. Dialogues in Clinical Neuroscience, 2, 7-22.

58.

Weathers

F. W.

Blake

D. D.

Schnurr

P. P.

Kaloupek

D. G.

Marx

B. P.

Keane

T. M.

(2013). The Life Events Checklist for DSM-5 (LEC-5). Retrieved from https://www.ptsd.va.gov/professional/assessment/te-measures/life_events_checklist.asp

59.

Woodward

M. J.

Eddinger

Henschel

A. V.

Dodson

T. S.

Tran

H. N.

. . . Beck

J. G.

(2015). Social support, posttraumatic cognitions, and PTSD: The influence of family, friends, and a close other in an interpersonal and non-interpersonal trauma group. Journal of Anxiety Disorders, 29, 60-67. doi:10.1016/j.janxdis.2015.09.0020/887-6185/

60.

Yağcı-Etkiner

Y. D.

(2010). Travma sonrasi bi̇li̇şler ölçeği̇: Türkçe uyarlama ve üni̇versi̇te öğrenci̇leri̇ üzeri̇nde geçerli̇k güveni̇rli̇k çalişmasi [Post-traumatic cognitions inventory: Turkish adaptation and validity among university students] (Master’s thesis). University of Kocaeli, Turkey. (In Turkish)

61.

Zang

Gallagher

McLean

C. P.

Tannahill

H. S.

Yarvis

J. S.

Foa

E. B.

(2017). The impact of social support, unit cohesion, and trait resilience on PTSD in treatment-seeking military personnel with PTSD: The role of posttraumatic cognitions. Journal of Psychiatric Research, 86, 18-25. doi:10.1016/j.jpsychires.2016.11.005

62.

Zoellner

L. A.

Feeny

N. C.

Eftekhari

Foa

E. B.

(2011). Changes in negative beliefs following three brief programs for facilitating recovery after assault. Depression and Anxiety, 28, 532-540. doi:10.1002/da.20847

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.04 MB