Interpersonal violence directed against girls and women is both widespread and can lead to serious long-term consequences, including the development of co-occurring mental health and substance abuse disorders. This two-part study investigated psychosocial gains following trauma-focused treatment among women with histories of interpersonal violence and co-occurring disorders. The data are drawn from the Los Angeles site of the national Women, Comorbid Disorders and Violence Study (WCDVS), which assessed the effects of integrated substance abuse and mental health treatment using an intent-to-treat quasi-experimental design. A diverse sample of 370 women was interviewed up to five times over 12-months. The first part of the present study established the longitudinal consistency of a measure of posttraumatic stress symptoms. Results indicated that five of the 17 items performed inconsistently across time and were dropped. The second part investigated the impact of a trauma-focused treatment program (Seeking Safety; Najavits, 2002) on posttraumatic stress symptoms and unsafe events. The impact of attendance on outcome measures was assessed using longitudinal structural equation models, and statistically adjusted for days in residential treatment and WCDVS treatment group. Results indicated that while there were significant decreases in posttraumatic stress symptoms across time, level of trauma-focused treatment did not predict these changes. Significant reductions in posttraumatic stress symptoms were predicted by greater use of residential treatment services early in the woman's enrollment in the study. Women in both treatment conditions showed significant reductions in unsafe events at six months. For women in the integrated services group, greater exposure to trauma-focused treatment was associated with fewer unsafe events. Finally, greater participation in trauma-focused treatment predicted greater use of residential services, even after women had completed the trauma-focused treatment program. While the reduction in unsafe events suggests increased use of safety behaviors and coping skills like those taught in Seeking Safety, the reductions in posttraumatic stress symptoms across different residential treatment programs was unexpected. Increased awareness of the negative impact of traumatic experiences and availability of trauma-informed service providers may lead to dissemination of trauma-relevant information into the general treatment programs.
|Commitee:||Hennigan, Karen, McArdle, Jack, Trickett, Penelope|
|School:||University of Southern California|
|School Location:||United States -- California|
|Source:||DAI-B 70/08, Dissertation Abstracts International|
|Subjects:||Womens studies, Clinical psychology|
|Keywords:||Co-occurring disorders, Interpersonal violence, Mental health disorders, PTSD, Substance abuse, Trauma, Treatment, Treatment gains, Women|
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