Research Research On The Influence Of Trauma Centrality On Ptsd Symptom Severity

[Gradstudent]

<American Participants Only>

Hello,

My name is Ilea Bain and I am a second-year graduate student in the clinical doctoral program at Pacific University. My faculty advisor, Lisa Christiansen, Psy.D, and I invite you to participate in my thesis research titled “The Epicenter of PTSD? A closer look at the influence of trauma centrality on PTSD symptom severity”. Your participation would involve taking a short online survey consisting of questions about trauma history, demographics and two brief assessment measures. You are eligible to participate if you are at least 18 years of age and can read and understand English. Your participation will enhance the literature on trauma and posttraumatic stress disorder. You do NOT need to have a diagnosis of PTSD or necessarily be experiencing symptoms in order to participate.

Should you decide to participate in the study you will be asked to follow the link provided below to surveymonkey.com where you will complete an informed consent form, the PTSD symptom checklist- civilian, the Centrality of Events Scale, questions about trauma history and basic demographics. The total survey should not take more than 20 minutes.

I need responses in order to post the link to my survey. I appreciate your time and help!

Thanks.

 

[PTSD sufferer]

Hi Gradstudent,

I am a little confused by your title. PTSD is caused BY trauma, so am I to understand that you are theorising that different types of trauma (severity defined by whom/ what theories/ academic scale are being used?) causes different severities of PTSD symptomatology?

Where is your PTSD symptom check list from? (DSM or self generated). Generally, to determine PTSD is a lengthy process that is qualitative in nature and not a 'tick the box' diagnostic option.

I also question the attempt to create classifications of 'severity of trauma', as I have never seen any academic theories classify such things other than self reported severity. It is not as simple as saying a car crash is less severe than a rape, or vice versa - the illness does not work that way.

Also, concerned about whether you are really able to cover the breadth of trauma experiences, and multiple traumas through a 20 minute questionnaire?

How far are you into your your Phd - are you scoping pre lit review, at lit review stage, 1st year/ 7th year, or already published your theories in journals?

 

[Zef]

Gradstudent,
I'm not seeing a link.

 

[Gradstudent]

Zef, I am unable to post the link until I receive more responses.

As for the first comment, I appreciate your skepticism and will try to answer your questions accordingly. The purpose of my study is not to diagnose anyone, but rather to assess the correlations between trauma centrality (regardless of type of trauma) and potential PTSD symptom severity. So in a way yes, I am interested in seeing if there are any trends among types of trauma and severity of symptoms, however that is not the main focus. I am looking to test a theory developed by Berntsen & Rubin, (2006) hypothesizing that the more an individual believes a trauma to be integral to who they are as a person, the more severe their PTSD symptoms may be. By no means am I attempting to claim or say that one trauma is more severe than another. As you said, it is a very subjective experience.

The PTSD checklist is a well-established and validated measure (Weathers, et al., 1993) that assesses key symptoms of PTSD and has been used to both screen and diagnose the disorder.

 

[LawPhotos]

I would suspect that you will find that most of us who experienced early, frequent and repeated trauma from a "caregiver" spanning most, if not all of our childhood, and who then likely went on to replicate that dysfunctional relationship in adulthood, would be hard pressed not to consider the trauma to be integral to who they are as a person. It would seem that the brain and personality developing in a child while consistently bathed in abuse would have little choice. It is understandable then that the adult whose identity emerged under such conditions would exhibit more severe and even treatment resistant PTSD symptoms.

I look forward to the posting of your link

 

[Meadowsweet]

It sounds like an interesting study. I'm quite interested in the way trauma type corresponds with the way symptoms are experienced. For instance, one person might avoid by never going out, another might avoid by drinking. I think because of the different ways people react to symptoms, it can be quite difficult to measure the severity of symptoms.

I'm a bit dubious about measuring trauma type severity too. You can maybe compare certain aspects within the same trauma type to see if there are correlations. But I don't believe measuring one type of trauma (eg combat) against another (eg sexual abuse) in terms of its severity can be done with any accuracy, because they are so very different.

the more an individual believes a trauma to be integral to who they are as a person, the more severe their PTSD symptoms may be.

I'm interested to see the questionnaire, because I don't know how you're going to work this out, because ptsd symptoms take over, so even if there was a time that I didn't think trauma was integral to who I am, I can't remember it at the moment. But I';m not sure if that was a factor in causing ptsd, or if that is an effect of the symptoms of ptsd.

 

[PTSD sufferer]

Agree with you meadowsweet.

I am also dubious about the severity measure because it is subjective, so even if you can correlated the type of trauma (i.e rape), you probably need to consider variables such as rape at knife point, by a stranger, by an immediate caregiver, by a relative. Then, whether you had support at the time from caregivers, social workers, friends, doctors etc. Then you would also need to consider repeated rapes vs one. Then the even harder to measure variables of the individual psychology or self-beliefs prior and after the trauma. There is just too much subjectivity and too many variables to provide an accurate correlation of these things. PTSD is personal in nature after all.

I guess this is not the point of the thesis and the self reported severity of symptomatology is being used. Which I then agree with Meadosweet again, that severity of symptomatology has more to do with the stage of recovery and immediate environmental triggers ( so good day bad day has a major affect on any quantitative survey as this is a single point in time). This is another set of variables hard to define let alone measure with some accuracy. The resultant 'coping mechanisms' are also subjective in nature.

Also, it seems a little illogical to measure whether symptomatology changes who you are as a person, and whether it is integral to individual personality. Trauma changes people in that they end up with a mental illness like PTSD, anxiety, depression etc. We know this because we can speculate that PTSD is a chemical change in the brain - that changes a person. Personality is hard to define to begin with as it can be fluid and some co-morbidities will affect results.

Personally, I would say when unwell and experiencing environmental triggers, my personality (defined by individual choice, fema and mema type stuff) which is central to my personality, is the same. My behaviours change with the symptoms though. PTSD is not a personality disorder it is an anxiety disorder - although there are co- morbidities that can skew the results of a poorly constructed quantitative measure.

The self reported core of 'who I am defined by me' is also affected by the amount of negative self talk generated by externalities and by environmental triggers at the time (some days I am dong ok, some days I suck). That is when the illness takes over, so at those points in time, yes the symptomatology become integral to my mood and behaviours (which form part of externally discernible personality but do not define it), because that is how the illness works - what it does to people.

If anyone was to ask me if I am a different person to when I was first unwell, the answer is yes, trauma affected my life and brain chemistry and now I have to manage that. Similarly, if anyone was to ask my hubby (non PTSD) the same question as to whether he is a different person to X years ago, he would say yes. It is human nature to grow, learn, refine with age and time, like a fine wine. If you have life long trauma, then it may seem 'normal' to feel like crap, and if you have a more recent trauma then you are likely to be in the early stages of dealing with that trauma and you feel like crap. If you are recovering, well one day you may feel like crap, the next you feel ok. Subjective you see.

I guess, I find the second post that re-frames the thesis a little more palatable than the first (which was a little misleading). And, I acknowledge that the poster has does some lit review work, so I assume it is in the early stages of thesis formation. And, accuracy of diagnosis of the illness does not seem to be considered as central to the hypothesis.

I still wonder whether this research will actually help understanding of the condition and sufferers...because the hypothesis and methodology chosen seem to have flaws and that would result in 'generalisations' which, in my view will not improve the academic body of work, or help sufferers through generating understanding.

This is only my opinion of course, and the upside is that you have received another post to add to the log so that you can post your link regardless of the flaws highlighted in the hypothesis and methodology.

 

[PerfectEmpire]

This sounds great. Post the link!

 

[Tinyflame]

It is my experience that I can have the most positive attitude in the world, and it doesn't necessarily correlate to my symptomolgy. And vice versa. If anything, recognizing I can't control one with the other has alleviated some guilt.

I think there is a lot of misunderstanding reflected in that theorem.
JMHO, and experience.

 

[Zef]

Just adding another post, so Gradstudent can link.

Gradstudent,
It may be able to post the URL in a post without posting a link. If you bring up the front page of your survey in your Internet broswer, you can highlight the URL and try to copy/paste it into a post. Then all we have to do is highlight it and copy/paste it back into our own browser to access the survey.

Mods. . .be gentle with me if what I suggest is outside T&C. . .I apologize in advance. . .

 

[Kaii]

Okay, posting.....

 

[Gradstudent]

I have appreciated the feedback that all of you have given. It has helped me to think about how my research may be interpreted by others and has caused me to think of it from different perspectives. So, thank you. In particular, I think i will choose another way of framing the word "severity". that seems to be gaining a lot of criticism and attention, and rightfully so. By using the word severity, I meant it in terms of how someone "scores" on the PTSD checklist included in my survey. So, in other words, they are endorsing having more or less symptoms of avoidance or hyperarousal, etc which may not equate to or be sensitively captured by the word "severity".

I am not conducting this research to make any causal statements. I understand the perspective that this research will not necessarily be breaking ground in the literature. However, I think that replication of studies is critical for validation of hypotheses and if this study lends further insight into how people are viewing their traumas and life stories, I believe that is valuable for informing clinical practice and conceptualizing the individuals I see as a therapist.