Dr. Kaysen is a clinical psychologist and Professor in the Psychiatry and Behavioral Sciences Department at Stanford University. Previously she was a Professor in the Psychiatry and Behavioral Sciences Department at University of Washington. She is currently the President-Elect for the International Society for Traumatic Stress Studies (www.istss.org). She has received grants from several federal funders including NIAAA, NIDA, the Department of Defense, and USAID and is active in disseminating her work, with over 120 published peer reviewed articles. Her research is situated at the interface of posttraumatic stress disorder (PTSD) and addictions, and includes both etiologic and prevention/treatment-oriented studies. In addition she is one of the leading experts in research on adapting Cognitive Processing Therapy for diverse populations.
Dr. Kaysen is board certified in Cognitive and Behavioral Psychology and she maintains an active clinical presence. She conducts trainings in Cognitive Processing Therapy across the U.S. and internationally.
Objective: Sexual minority women (SMW) evidence elevated rates of trauma exposure, posttraumatic ... more Objective: Sexual minority women (SMW) evidence elevated rates of trauma exposure, posttraumatic stress (PTS), and alcohol consumption. Self-medication models of drinking suggest that individuals may drink to cope with symptoms of PTS, but this possibility remains untested among SMW. Method: The current study used data from drinking days collected via daily diary assessments from 81 trauma-exposed SMW. Participants were mostly White (72.8%) and ranged in age from 18 to 25 (M = 23.8). Participants were followed over 2 14-consecutive-day measurement bursts (720 person-days reported). Analyses were conducted to examine whether coping drinking motives (vs. social, enhancement, and conformity drinking motives), as assessed by an adapted Drinking Motives Questionnaire, mediated the daily level relationship between PTS symptoms (assessed by the PTSD Checklist) and the number of standard drinks per drinking day. Results: Results from multilevel structural equation models indicated that day-to-day fluctuations in PTS symptoms, as well as average levels of PTS symptoms, were associated with increased coping drinking motives. Coping drinking motives, but not other drinking motives, mediated within-person associations between PTS and drinking, such that daily fluctuations in PTS symptoms were associated with stronger-than-normal coping drinking motives, which in turn predicted more drinks per drinking day. Conclusions: Results highlight the importance of coping drinking motives and suggest that alternative coping strategies may help trauma-exposed SMW to manage heightened PTS symptoms without increasing their alcohol consumption. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
The impact of changes to posttraumatic stress disorder (PTSD) diagnostic criteria from Diagnostic... more The impact of changes to posttraumatic stress disorder (PTSD) diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) to Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) within diverse communities is unclear. Young adult sexual minority women are at high risk for interpersonal violence and other forms of trauma exposure compared with heterosexual populations and sexual minority men. They are also at heightened risk of PTSD. As a result, young adult sexual minority women are a key population of interest when examining the impact of diagnostic criteria changes. The goal of the current study was to evaluate the impact of changes to PTSD diagnostic criteria in sexual minority women. Using an online survey, we administered both the original PTSD Symptom Checklist-S (based on DSM-IV criteria) and a version adapted to assess DSM-5 criteria to a national, nonclinical sample of young adult sexual minority women (N = 767). The DSM-5 symptom criteria fit the data well in confirmatory factor analysis. Current PTSD prevalence was higher under the DSM-5 diagnostic algorithm compared with DSM-IV (18.6% vs. 22.9%; d = 0.15). Compared with DSM-IV, associations between PTSD and depression were stronger using DSM-5 criteria, whereas associations between PTSD and high-risk drinking were reduced. Findings suggest that changes to PTSD diagnostic criteria do not have a major impact on prevalence of PTSD among sexual minority women but may have some impact on observed comorbidities.
Background Despite the growth of psychotherapy trials in low- and middle-income countries, there ... more Background Despite the growth of psychotherapy trials in low- and middle-income countries, there have been limited follow-up studies of more than 2 years. This study follows up female sexual violence survivors approximately 6 years after completing a 12-session group cognitive processing therapy (CPT) program in the eastern Democratic Republic of Congo. Methods Baseline trial data were collected in December 2010 from 134 women in 7 study villages randomly allocated to CPT. Study women were over 18 years, reported personally experiencing or witnessing sexual violence, and reported elevated depression, anxiety and/or posttraumatic stress symptoms. Women were followed up (1) post-treatment (6-months after baseline); (2) 6 months later; (3) 12 months later; and (4) in March 2017 (6.3 years after baseline). At the long-term follow-up, 103 women (77%) in 6 of 7 CPT villages were re-assessed; one village was not visited due to ongoing insecurity. Results We found strong continued intervent...
Prior research on the effects of sexual trauma has examined dissociation but not emotional numbin... more Prior research on the effects of sexual trauma has examined dissociation but not emotional numbing during sex and has relied exclusively on retrospective surveys. The present experiment examined associations among distal factors of childhood sexual abuse (CSA), adolescent/adult sexual assault (ASA), and trauma symptoms and the proximal factor of acute alcohol intoxication on in-the-moment dissociation, emotional numbing, and sexual risk intentions. Young adult female drinkers (N = 436) at elevated sexual risk were randomized to receive alcohol (target peak breath alcohol concentration = .10%) or no alcohol. They then read an eroticized sexual scenario and reported on their dissociation and emotional numbing experiences, unprotected sex refusal self-efficacy, and unprotected sex intentions. Path analysis revealed that CSA was indirectly associated with increased unprotected sex intentions through increased ASA severity, increased trauma-related symptoms, increased emotional numbing, and decreased unprotected sex refusal self-efficacy. Further, alcohol intoxication was indirectly associated with increased unprotected sex intentions through increased emotional numbing and decreased unprotected sex refusal self-efficacy. Emotional numbing, but not dissociation, was associated with unprotected sex intentions and may be one potential target for interventions aimed at reducing HIV/STI-related risk among women with a history of sexual trauma.
This study identified subgroups of female sexual assault survivors based on characteristics of th... more This study identified subgroups of female sexual assault survivors based on characteristics of their victimization experiences, validated the subgroup structure in a second cohort of women recruited identically to the first, and examined subgroups' differential associations with sexual risk/safety behavior, heavy episodic drinking (HED), psychological distress symptomatology, incarceration, transactional sex, and experiences with controlling and violent partners. The community sample consisted of 667 female survivors of adolescent or adult sexual assault who were 21 to 30 years old (M = 24.78, SD = 2.66). Eligibility criteria included having unprotected sex within the past year, other HIV/STI risk factors, and some experience with HED, but without alcohol problems or dependence. Latent class analyses (LCA) were used to identify subgroups of women with similar victimization experiences. Three groups were identified and validated across 2 cohorts of women using multiple-group LCA:...
Abuse in childhood has been established as a predictor of adult abuse, with the strongest associa... more Abuse in childhood has been established as a predictor of adult abuse, with the strongest associations found between childhood sexual abuse (CSA) and adult sexual victimization. Revictimization has been demonstrated among women, and there is a growing literature on revictimization experiences among men who have sex with men (MSM). No studies have assessed revictimization among MSM living with HIV, despite strong evidence for disproportionately high rates of life span abuse among this group, along with the added vulnerability of living with HIV and sexual minority stress. In this study, we contribute to the literature by exploring associations between multiple types of childhood and adult abuse experiences (physical, sexual, and psychological; perpetrated by partners and non-partner), rather than examining sexual victimization alone. A sample of 166 HIV-positive MSM attending primary HIV health care clinics in Seattle, Washington, completed a one-time questionnaire. Results of regres...
American journal of community psychology, Jan 9, 2015
Family support and rejection are associated with health outcomes among sexual minority women (SMW... more Family support and rejection are associated with health outcomes among sexual minority women (SMW). We examined a social ecological development model among young adult SMW, testing whether identity risk factors or outness to family interacted with family rejection to predict community connectedness and collective self-esteem. Lesbian and bisexual women (N = 843; 57 % bisexual) between the ages of 18-25 (M = 21.4; SD = 2.1) completed baseline and 12-month online surveys. The sample identified as White (54.2 %), multiple racial backgrounds (16.6 %), African American (9.6 %) and Asian/Asian American (3.1 %); 10.2 % endorsed a Hispanic/Latina ethnicity. Rejection ranged from 18 to 41 % across family relationships. Longitudinal regression indicated that when outness to family increased, SMW in highly rejecting families demonstrated resilience by finding connections and esteem in sexual minority communities to a greater extent than did non-rejected peers. But, when stigma concerns, concea...
Psychology of sexual orientation and gender diversity, 2014
Sexual minorities have higher rates of depression and anxiety than their heterosexual counterpart... more Sexual minorities have higher rates of depression and anxiety than their heterosexual counterparts. This elevated risk of psychological distress has generally been hypothesized to be a result of the effects of discrimination including internalized negative beliefs about sexual minorities. However, little research has examined the role of various types of coping in mediating between internalized homophobia and mental health. We tested the direct relationship between internalized homophobia and psychological distress and evaluated general and sexual minority-specific coping strategies as potential mediators using structural equation modeling. Data are from a national sample of 1,099 young adult sexual minority women who were on average 20.86 (SD= 2.12) years old, participating in a study on mental health and substance use. The model demonstrated acceptable fit, χ(2) (83) = 402.9, p <.001, CFI=.94, TLI=.92, SRMR= .07, and RMSEA=.06, accounting for 73% of variance in psychological di...
Comorbidity between alcohol use and posttraumatic stress disorder (PTSD) has been well documented... more Comorbidity between alcohol use and posttraumatic stress disorder (PTSD) has been well documented. However, there are few longitudinal studies with acute trauma samples. The present study examined symptoms of alcohol use disorders (AUDs) and PTSD longitudinally after assault. Female sexual (n = 69) and physical assault victims (n = 39) were assessed 2 to 4 weeks and 3 months post trauma. Women who had lifetime AUD had higher intrusive and avoidance symptoms than those who did not have AUD. Women who had any alcohol problems had higher PTSD symptoms. Participants who had alcohol problems had the same pattern of symptom recovery as those who did not have alcohol problems but remained more symptomatic over the 3 months. These findings suggest that early intervention strategies for women who have previous histories of alcohol problems and seek medical attention early post trauma may be indicated.
PTSD is a risk factor for alcohol problems and both in turn have been independently associated wi... more PTSD is a risk factor for alcohol problems and both in turn have been independently associated with increased health problems. However, it is unclear whether alcohol use moderates the relationship between PTSD and health. Participants were battered women (N = 336) recruited from local domestic violence shelters and non-shelter victim-assistance agencies. A 2 (PTSD diagnosis) x 3 (abstainer, infrequent/light, regular/heavy drinking) ANCOVA was conducted, with injuries and length of abuse as covariates and health concerns as the dependent variable. Main effects for PTSD and alcohol use were significant but not the interaction. Women with PTSD reported the greatest number of health concerns. Women who abstained from drinking and those who drank regularly/heavily reported more health concerns than the infrequent/light drinkers. Health concerns associated with PTSD do not appear to be due to problem drinking. In addition, infrequent/light drinking, even for women with PTSD, may be associ...
Objective: Sexual minority women (SMW) evidence elevated rates of trauma exposure, posttraumatic ... more Objective: Sexual minority women (SMW) evidence elevated rates of trauma exposure, posttraumatic stress (PTS), and alcohol consumption. Self-medication models of drinking suggest that individuals may drink to cope with symptoms of PTS, but this possibility remains untested among SMW. Method: The current study used data from drinking days collected via daily diary assessments from 81 trauma-exposed SMW. Participants were mostly White (72.8%) and ranged in age from 18 to 25 (M = 23.8). Participants were followed over 2 14-consecutive-day measurement bursts (720 person-days reported). Analyses were conducted to examine whether coping drinking motives (vs. social, enhancement, and conformity drinking motives), as assessed by an adapted Drinking Motives Questionnaire, mediated the daily level relationship between PTS symptoms (assessed by the PTSD Checklist) and the number of standard drinks per drinking day. Results: Results from multilevel structural equation models indicated that day-to-day fluctuations in PTS symptoms, as well as average levels of PTS symptoms, were associated with increased coping drinking motives. Coping drinking motives, but not other drinking motives, mediated within-person associations between PTS and drinking, such that daily fluctuations in PTS symptoms were associated with stronger-than-normal coping drinking motives, which in turn predicted more drinks per drinking day. Conclusions: Results highlight the importance of coping drinking motives and suggest that alternative coping strategies may help trauma-exposed SMW to manage heightened PTS symptoms without increasing their alcohol consumption. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
The impact of changes to posttraumatic stress disorder (PTSD) diagnostic criteria from Diagnostic... more The impact of changes to posttraumatic stress disorder (PTSD) diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) to Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) within diverse communities is unclear. Young adult sexual minority women are at high risk for interpersonal violence and other forms of trauma exposure compared with heterosexual populations and sexual minority men. They are also at heightened risk of PTSD. As a result, young adult sexual minority women are a key population of interest when examining the impact of diagnostic criteria changes. The goal of the current study was to evaluate the impact of changes to PTSD diagnostic criteria in sexual minority women. Using an online survey, we administered both the original PTSD Symptom Checklist-S (based on DSM-IV criteria) and a version adapted to assess DSM-5 criteria to a national, nonclinical sample of young adult sexual minority women (N = 767). The DSM-5 symptom criteria fit the data well in confirmatory factor analysis. Current PTSD prevalence was higher under the DSM-5 diagnostic algorithm compared with DSM-IV (18.6% vs. 22.9%; d = 0.15). Compared with DSM-IV, associations between PTSD and depression were stronger using DSM-5 criteria, whereas associations between PTSD and high-risk drinking were reduced. Findings suggest that changes to PTSD diagnostic criteria do not have a major impact on prevalence of PTSD among sexual minority women but may have some impact on observed comorbidities.
Background Despite the growth of psychotherapy trials in low- and middle-income countries, there ... more Background Despite the growth of psychotherapy trials in low- and middle-income countries, there have been limited follow-up studies of more than 2 years. This study follows up female sexual violence survivors approximately 6 years after completing a 12-session group cognitive processing therapy (CPT) program in the eastern Democratic Republic of Congo. Methods Baseline trial data were collected in December 2010 from 134 women in 7 study villages randomly allocated to CPT. Study women were over 18 years, reported personally experiencing or witnessing sexual violence, and reported elevated depression, anxiety and/or posttraumatic stress symptoms. Women were followed up (1) post-treatment (6-months after baseline); (2) 6 months later; (3) 12 months later; and (4) in March 2017 (6.3 years after baseline). At the long-term follow-up, 103 women (77%) in 6 of 7 CPT villages were re-assessed; one village was not visited due to ongoing insecurity. Results We found strong continued intervent...
Prior research on the effects of sexual trauma has examined dissociation but not emotional numbin... more Prior research on the effects of sexual trauma has examined dissociation but not emotional numbing during sex and has relied exclusively on retrospective surveys. The present experiment examined associations among distal factors of childhood sexual abuse (CSA), adolescent/adult sexual assault (ASA), and trauma symptoms and the proximal factor of acute alcohol intoxication on in-the-moment dissociation, emotional numbing, and sexual risk intentions. Young adult female drinkers (N = 436) at elevated sexual risk were randomized to receive alcohol (target peak breath alcohol concentration = .10%) or no alcohol. They then read an eroticized sexual scenario and reported on their dissociation and emotional numbing experiences, unprotected sex refusal self-efficacy, and unprotected sex intentions. Path analysis revealed that CSA was indirectly associated with increased unprotected sex intentions through increased ASA severity, increased trauma-related symptoms, increased emotional numbing, and decreased unprotected sex refusal self-efficacy. Further, alcohol intoxication was indirectly associated with increased unprotected sex intentions through increased emotional numbing and decreased unprotected sex refusal self-efficacy. Emotional numbing, but not dissociation, was associated with unprotected sex intentions and may be one potential target for interventions aimed at reducing HIV/STI-related risk among women with a history of sexual trauma.
This study identified subgroups of female sexual assault survivors based on characteristics of th... more This study identified subgroups of female sexual assault survivors based on characteristics of their victimization experiences, validated the subgroup structure in a second cohort of women recruited identically to the first, and examined subgroups' differential associations with sexual risk/safety behavior, heavy episodic drinking (HED), psychological distress symptomatology, incarceration, transactional sex, and experiences with controlling and violent partners. The community sample consisted of 667 female survivors of adolescent or adult sexual assault who were 21 to 30 years old (M = 24.78, SD = 2.66). Eligibility criteria included having unprotected sex within the past year, other HIV/STI risk factors, and some experience with HED, but without alcohol problems or dependence. Latent class analyses (LCA) were used to identify subgroups of women with similar victimization experiences. Three groups were identified and validated across 2 cohorts of women using multiple-group LCA:...
Abuse in childhood has been established as a predictor of adult abuse, with the strongest associa... more Abuse in childhood has been established as a predictor of adult abuse, with the strongest associations found between childhood sexual abuse (CSA) and adult sexual victimization. Revictimization has been demonstrated among women, and there is a growing literature on revictimization experiences among men who have sex with men (MSM). No studies have assessed revictimization among MSM living with HIV, despite strong evidence for disproportionately high rates of life span abuse among this group, along with the added vulnerability of living with HIV and sexual minority stress. In this study, we contribute to the literature by exploring associations between multiple types of childhood and adult abuse experiences (physical, sexual, and psychological; perpetrated by partners and non-partner), rather than examining sexual victimization alone. A sample of 166 HIV-positive MSM attending primary HIV health care clinics in Seattle, Washington, completed a one-time questionnaire. Results of regres...
American journal of community psychology, Jan 9, 2015
Family support and rejection are associated with health outcomes among sexual minority women (SMW... more Family support and rejection are associated with health outcomes among sexual minority women (SMW). We examined a social ecological development model among young adult SMW, testing whether identity risk factors or outness to family interacted with family rejection to predict community connectedness and collective self-esteem. Lesbian and bisexual women (N = 843; 57 % bisexual) between the ages of 18-25 (M = 21.4; SD = 2.1) completed baseline and 12-month online surveys. The sample identified as White (54.2 %), multiple racial backgrounds (16.6 %), African American (9.6 %) and Asian/Asian American (3.1 %); 10.2 % endorsed a Hispanic/Latina ethnicity. Rejection ranged from 18 to 41 % across family relationships. Longitudinal regression indicated that when outness to family increased, SMW in highly rejecting families demonstrated resilience by finding connections and esteem in sexual minority communities to a greater extent than did non-rejected peers. But, when stigma concerns, concea...
Psychology of sexual orientation and gender diversity, 2014
Sexual minorities have higher rates of depression and anxiety than their heterosexual counterpart... more Sexual minorities have higher rates of depression and anxiety than their heterosexual counterparts. This elevated risk of psychological distress has generally been hypothesized to be a result of the effects of discrimination including internalized negative beliefs about sexual minorities. However, little research has examined the role of various types of coping in mediating between internalized homophobia and mental health. We tested the direct relationship between internalized homophobia and psychological distress and evaluated general and sexual minority-specific coping strategies as potential mediators using structural equation modeling. Data are from a national sample of 1,099 young adult sexual minority women who were on average 20.86 (SD= 2.12) years old, participating in a study on mental health and substance use. The model demonstrated acceptable fit, χ(2) (83) = 402.9, p <.001, CFI=.94, TLI=.92, SRMR= .07, and RMSEA=.06, accounting for 73% of variance in psychological di...
Comorbidity between alcohol use and posttraumatic stress disorder (PTSD) has been well documented... more Comorbidity between alcohol use and posttraumatic stress disorder (PTSD) has been well documented. However, there are few longitudinal studies with acute trauma samples. The present study examined symptoms of alcohol use disorders (AUDs) and PTSD longitudinally after assault. Female sexual (n = 69) and physical assault victims (n = 39) were assessed 2 to 4 weeks and 3 months post trauma. Women who had lifetime AUD had higher intrusive and avoidance symptoms than those who did not have AUD. Women who had any alcohol problems had higher PTSD symptoms. Participants who had alcohol problems had the same pattern of symptom recovery as those who did not have alcohol problems but remained more symptomatic over the 3 months. These findings suggest that early intervention strategies for women who have previous histories of alcohol problems and seek medical attention early post trauma may be indicated.
PTSD is a risk factor for alcohol problems and both in turn have been independently associated wi... more PTSD is a risk factor for alcohol problems and both in turn have been independently associated with increased health problems. However, it is unclear whether alcohol use moderates the relationship between PTSD and health. Participants were battered women (N = 336) recruited from local domestic violence shelters and non-shelter victim-assistance agencies. A 2 (PTSD diagnosis) x 3 (abstainer, infrequent/light, regular/heavy drinking) ANCOVA was conducted, with injuries and length of abuse as covariates and health concerns as the dependent variable. Main effects for PTSD and alcohol use were significant but not the interaction. Women with PTSD reported the greatest number of health concerns. Women who abstained from drinking and those who drank regularly/heavily reported more health concerns than the infrequent/light drinkers. Health concerns associated with PTSD do not appear to be due to problem drinking. In addition, infrequent/light drinking, even for women with PTSD, may be associ...
Objectives:
1.) Discuss prevalence of stressors, trauma exposure, mental health symptoms, and haz... more Objectives: 1.) Discuss prevalence of stressors, trauma exposure, mental health symptoms, and hazardous drinking among lesbian and bisexual women. 2.) Describe at least one model for association between sexual orientation and hazardous drinking among lesbian and bisexual women. 3.) Articulate implications of the higher risk status of lesbians and bisexual women for clinical practice and research.
Complex relationships between PTSD and problem drinking have been well-documented. Although some ... more Complex relationships between PTSD and problem drinking have been well-documented. Although some studies have demonstrated PTSD increasing drinking, others suggest alcohol problems may be associated with a more severe course of PTSD. However, little longitudinal research with acute trauma samples has been conducted. The present study examines the impact of alcohol use and consequences on the course of PTSD. Participants were seen 1, 3, and 6 months after exposure to a sexual or physical assault (n = 65). Measures include the Timeline Followback procedure, the Drinc, and the Clinician Administered PTSD Scale. There was a significant interaction between current AUD and days since the assault such that those with alcohol abuse/dependence have a slower recovery from PTSD symptoms. The model suggested participants with current AUD have fewer PTSD symptoms immediately after the trauma, but do not show the typical recovery curve. On average, they changed little over the 6 months. Higher levels of drinking consequences also appeared to predict slower recovery, predominantly at high levels of alcohol consequences. Results highlight the importance of longitudinal methodologies in elucidating the nature of the relationship between PTSD and alcohol misuse. Findings suggest early intervention strategies for women presenting post-trauma with alcohol problems may be indicated.
Chronic traumatic events like domestic violence, child physical abuse, and child sexual abuse, ha... more Chronic traumatic events like domestic violence, child physical abuse, and child sexual abuse, have been associated with an increased risk for a wide variety of problems including emotional instability, depression, dissociation, anger, sexual difficulties, self-destructive behaviors, suicide, substance abuse, and impaired interpersonal relationships, and PTSD symptoms, have been described as “complex PTSD”. Clients with Complex PTSD present unique challenges for clinicians. American Indian and Alaska Native (AIAN) communities are at greater risk for exposure to chronic traumatic events, in addition to the impact of colonization and historical trauma. Complex PTSD may be one useful way of understanding psychological distress from exposure to chronic and historical trauma within this community Dr. Kaysen will discuss what is known about the effects of chronic traumatic events exposure to historical trauma on symptoms. She will then discuss treatment options including information on Cognitive Processing Therapy, a therapy for PTSD with comorbid conditions, as one possible treatment option. She will discuss practical clinical strategies for ways to use this therapy with complex PTSD.
Although PTSD is categorized as an anxiety disorder in the DSM, it shows high levels of comorbidi... more Although PTSD is categorized as an anxiety disorder in the DSM, it shows high levels of comorbidity and is associated with elevated depression, anger, and suicidality. For example, 40% to 52% of women with PTSD also meet criteria for depression. Several explanations for this strong comorbidity have been proposed including: (a) depression is a reaction to PTSD; (b) symptom overlap accounts for the co-occurrence; or (c) that PTSD and depression represent separate responses to trauma exposure. However, there is a dearth of studies that have applied intensive longitudinal assessment via experience sampling methodologies to examine how PTSD and daily affect may influence each other on a daily level. The present study examines the impact of PTSD symptoms on subsequent negative affect, arousal, and affect lability. Female college undergraduates with history of sexual victimization were assessed twice daily for 30 days (N = 38). Measures include PTSD Symptom Checklist and the Positive and Negative Affect Schedule (PANAS). Results are considered preliminary as data collection is in progress. At the present time, participant compliance with the assessments is good with 76% of all possible assessments having been completed. Results showed that concurrent assessment of PTSD symptoms and negative affect were strongly associated (B = -0.09, t(763) = -6.3, p < .01, CI = -0.12, -0.06). Moreover, lagged analyses showed that days with higher PTSD symptoms were associated with higher negative affect later in the day (B = -0.04, t(763) = -2.4, p = .02, CI = -0.06, -0.01). In addition, higher PTSD symptoms were associated with more labile affect; that is, there is a significant association between higher PTSD symptoms and greater within subject variability in negative affect (within-subject variance function = 0.21, CI = 0.08, 0.34). Results highlight the importance of more complex longitudinal methodologies in elucidating the nature of the relationship between PTSD and mood. Findings suggest that PTSD may be associated with broader affective changes than just anxiety. Implications for categorizing PTSD as an anxiety disorder and implications for treatment will be discussed.
Chronic traumatic events like domestic violence, child physical abuse, and child sexual abuse, ha... more Chronic traumatic events like domestic violence, child physical abuse, and child sexual abuse, have been associated with an increased risk for a wide variety of problems including emotional instability, depression, dissociation, anger, sexual difficulties, self-destructive behaviors, suicide, substance abuse, and impaired interpersonal relationships, and PTSD symptoms, have been described as “complex PTSD”. Clients with Complex PTSD present unique challenges for clinicians. American Indian and Alaska Native (AIAN) communities are at greater risk for exposure to chronic traumatic events, in addition to the impact of colonization and historical trauma. Complex PTSD may be one useful way of understanding psychological distress from exposure to chronic and historical trauma within this community Dr. Kaysen will discuss what is known about the effects of chronic traumatic events exposure to historical trauma on symptoms. She will then discuss treatment options including information on Cognitive Processing Therapy, a therapy for PTSD with comorbid conditions, as one possible treatment option. She will discuss practical clinical strategies for ways to use this therapy with complex PTSD.
This talk will review the extant literature on comorbidity between alcohol misuse and PTSD, focus... more This talk will review the extant literature on comorbidity between alcohol misuse and PTSD, focusing specifically on women. Data examining the self-medication theory of PTSD/alcohol misuse will be presented including preliminary data from an ongoing study using event-level data collection with female sexual assault survivors. The talk will also present data on how alcohol misuse may affect the course and chronicity of PTSD following victimization. Lastly, implications for clinical practice and for futue research directions will be addressed.
Lesbian, gay, and bisexual (LGB) youth are at higher risk for trauma exposure and substance misus... more Lesbian, gay, and bisexual (LGB) youth are at higher risk for trauma exposure and substance misuse. However, less is understood about mental health outcomes following trauma exposure in this population. Our goals were to evaluate 1) sexual minority status and PTSD symptom severity; 2) trauma exposure and increased alcohol use and consequences and higher marijuana use within GLBT students; and 3) whether trauma exposure and outcomes are moderated by identification with other college students. The sample included 3748 (58.3% female) college students. 134 students identified as GLBT. Students completed the Posttraumatic Stress Diagnostic Scale (PDS) and measures of alcohol and marijuana use and consequences. PTSD was predicted by gender, trauma exposure, sexual minority status, alcohol use and consequences. GLBT trauma survivors had higher marijuana use, although there were no differences in drinking. GLBT students were less likely to identify with the “typical college student”. Among GLBT students, both trauma exposure and PTSD symptoms were associated with lower identification with the “typical college student”. Results suggest GLBT youth may be at risk for negative health outcomes following traumatic events. We will discuss potential theoretical mechanisms to explain these risk factors and treatment implications.
Objective: The purpose of this study is to examine associations between therapist adherence, comp... more Objective: The purpose of this study is to examine associations between therapist adherence, competence, and modifications of an evidence-based protocol (EBP) delivered in routine clinical care and client outcomes. Method: Data were derived from a NIMH-funded implementation-effectiveness hybrid study of Cognitive Processing Therapy (CPT) for PTSD in a diverse community health center. Providers (n 19) treated clients (n 58) as part of their routine clinical care. Clients completed the PCL-S and PHQ-9 at baseline, after each CPT session, and posttreatment. CPT sessions were rated for treatment fidelity and therapist modifications. Results: Overall, therapist adherence was high, although it decreased across sessions suggesting potential drift. Therapist competence ratings varied widely. Therapists made on average 1.6 fidelity-consistent and 0.4 fidelity-inconsistent modifications per session. Results show that higher numbers of fidelity-consistent modifications were associated with larger reductions in posttraumatic stress and depres-sive symptoms. High adherence ratings were associated with greater reductions in depressive symptoms, whereas higher competence ratings were associated with greater reduction in posttrau-matic stress symptoms. Conclusions: The results highlight the importance of differentially assessing therapist adherence, competence, and modifications to EBP in usual care settings. The findings also suggest that effective EBP delivery in routine care may require minor adaptations to meet client needs, consistent with previous studies. Greater attention to fidelity and adaptation can enhance training so providers can tailor while retaining core components of the intervention.
Uploads
1.) Discuss prevalence of stressors, trauma exposure, mental health symptoms, and hazardous drinking among lesbian and bisexual women.
2.) Describe at least one model for association between sexual orientation and hazardous drinking among lesbian and bisexual women.
3.) Articulate implications of the higher risk status of lesbians and bisexual women for clinical practice and research.
American Indian and Alaska Native (AIAN) communities are at greater risk for exposure to chronic traumatic events, in addition to the impact of colonization and historical trauma. Complex PTSD may be one useful way of understanding psychological distress from exposure to chronic and historical trauma within this community
Dr. Kaysen will discuss what is known about the effects of chronic traumatic events exposure to historical trauma on symptoms. She will then discuss treatment options including information on Cognitive Processing Therapy, a therapy for PTSD with comorbid conditions, as one possible treatment option. She will discuss practical clinical strategies for ways to use this therapy with complex PTSD.
The present study examines the impact of PTSD symptoms on subsequent negative affect, arousal, and affect lability. Female college undergraduates with history of sexual victimization were assessed twice daily for 30 days (N = 38). Measures include PTSD Symptom Checklist and the Positive and Negative Affect Schedule (PANAS). Results are considered preliminary as data collection is in progress. At the present time, participant compliance with the assessments is good with 76% of all possible assessments having been completed.
Results showed that concurrent assessment of PTSD symptoms and negative affect were strongly associated (B = -0.09, t(763) = -6.3, p < .01, CI = -0.12, -0.06). Moreover, lagged analyses showed that days with higher PTSD symptoms were associated with higher negative affect later in the day (B = -0.04, t(763) = -2.4, p = .02, CI = -0.06, -0.01). In addition, higher PTSD symptoms were associated with more labile affect; that is, there is a significant association between higher PTSD symptoms and greater within subject variability in negative affect (within-subject variance function = 0.21, CI = 0.08, 0.34). Results highlight the importance of more complex longitudinal methodologies in elucidating the nature of the relationship between PTSD and mood. Findings suggest that PTSD may be associated with broader affective changes than just anxiety. Implications for categorizing PTSD as an anxiety disorder and implications for treatment will be discussed.
American Indian and Alaska Native (AIAN) communities are at greater risk for exposure to chronic traumatic events, in addition to the impact of colonization and historical trauma. Complex PTSD may be one useful way of understanding psychological distress from exposure to chronic and historical trauma within this community
Dr. Kaysen will discuss what is known about the effects of chronic traumatic events exposure to historical trauma on symptoms. She will then discuss treatment options including information on Cognitive Processing Therapy, a therapy for PTSD with comorbid conditions, as one possible treatment option. She will discuss practical clinical strategies for ways to use this therapy with complex PTSD.