Publication Date

2014-07-30

Availability

Open access

Embargo Period

2014-07-30

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Psychology (Arts and Sciences)

Date of Defense

2013-08-05

First Committee Member

Gail Ironson

Second Committee Member

Neil Schneiderman

Third Committee Member

Rick Stuetzle

Fourth Committee Member

Blanche Freund

Fifth Committee Member

Kent Burnett

Abstract

Low-SES minorities in urban areas experience higher rates of trauma and greater need for treatment than the general population. Individual and trauma factors may determine who benefits most from treatment. Brief intervention and group format may be particularly helpful to fully utilize minimal resources and maximize treatment gain. This study is part of a larger NIH-funded study. We worked in an underserved area with recently traumatized individuals to compare Psychological First Aid (PFA: group format, control), Stress Management Therapy (SMT: group format, trauma-writing component)and Eye Movement Desensitization and Reprocessing (EMDR: individual format) to determine the impact of the interventions and whether certain interventions are better for certain types of people and trauma. 87 low-SES, minority participants were randomized to receive 4 active sessions of PFA, SMT or EMDR (31, 29, 27 participants in each group, respectively). Follow-up assessments were conducted at 1-, 3- and 6-months post-intervention. Outcome measures: PTSD, depressive, physical symptoms. Individual factors: PTSD severity, gender, substance abuse, childhood trauma, borderline personality disorder. Trauma factors: trauma types. HLM statistical methods were used. For the entire sample, EMDR worked best for reducing depressive symptoms, PFA for reducing PTSD symptoms, and SMT for reducing physical symptoms. Within group, EMDR worked best for those high in baseline PTSD and those endorsing borderline personality characteristics. SMT worked best for those who reported using marijuana and those with bereavement trauma. PFA worked best for individuals with a history of childhood sexual abuse and those with a violent trauma. Limitations and future directions are discussed.

Keywords

trauma; PTSD; minorities; brief treatment; EMDR; psychotherapy

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