Doctoral Dissertation
University of Oregon

Defended & Completed May 2009
PhD granted 2010 after clinical internship

Advisor Freyd, Jennifer J.

Dissertation Abstract

Prior research finds that exposure to traumatic stress negatively impacts physical and mental health, and that the social context in which trauma occurs is an important predictor of symptom development. Eight-hundred thirty-three members of an ethnically diverse longitudinal cohort study in Hawaii were surveyed about their personal exposure to several types of traumatic events, socioeconomic resources, mental health symptoms, and health status.  Rates of trauma exposure were predicted to vary as a function of type of trauma and participant gender and ethnicity.  In addition, access to social resources and the relational context of trauma were predicted to be associated with symptom reports in this ethnically diverse sample of men and women. Results replicated findings that while men and women are exposed to similar rates of trauma overall, women report more exposure to traumas high in betrayal, while men report exposure to more lower-betrayal traumas. Women also reported more mental health symptoms, and traumas higher in betrayal were generally more predictive of symptoms. Ethnic group variation in trauma exposure and physical and mental health symptoms was also present: ethnic groups with lower socioeconomic status generally reported more trauma exposure and symptoms, although in some cases the pattern of results was not straightforward.  This study adds new information about the prevalence of traumatic stress and mental health symptoms across ethnic groups in Hawaii, and how these relate to social context. In addition, this study provides preliminary information on the independent contribution of neglect and household dysfunction to the prediction of symptoms. The relevance of these results can be summarized with three main arguments. First, measures of trauma exposure must include events that occur across relational contexts if they are to be gender equitable and most predictive of symptoms. Second, gender and ethnic group differences in symptoms are largely explained by differential trauma exposure and differential access to educational and economic resources. Third, prevention and intervention efforts must address both trauma exposure and social context, as each is implicated in the presentation of symptoms.

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