Models of Trauma Exposure, Depression, and Suicidality in Safety‐Net Primary Care. Issue 6 (9th February 2021)

• Record Type: Journal Article
• Authors: Mladen, Samantha N.; Williams, Allison B.; Griffin, Sarah C.; Perrin, Paul B.; Rybarczyk, Bruce D.
• Other Names: Kerig Patricia K. guestEditor.
• Is Part Of: Journal of traumatic stress. Volume 34:Issue 6(2021)
• Page Start: 1139
• Page End: 1148
• Publication Date: 2021-02-09
• Subjects: Post-traumatic stress disorder -- Periodicals; 616.8521
• DOI: 10.1002/jts.22658
• Languages: English
• ISSNs: 0894-9867

Abstract

Abstract: Suicidality is a major public health concern, particularly for low‐income, trauma‐exposed patients with limited access to mental health providers. However, limited research has modeled pathways of suicidality in safety‐net primary care samples. Patients ( N = 207) in a safety‐net primary care clinic completed measures of childhood and adult trauma exposure, depression, and suicidality. Participants ( M age = 44.8 years, SD = 11.6), were 60.4% male, 63.8% Black/African American, and predominantly low‐income (i.e., 69.1% reported an annual income less than $5, 000 USD). Half of the sample reported at least four childhood traumatic events ( M = 3.9 events, SD = 3.0) and approximately three adult traumatic events (M = 3.0 events, SD = 2.1). Most participants (82.1%) reported significant depressive symptoms, and 43.5% endorsed recent suicidality. Models showing the mediational effect of depression on the association between trauma exposure and suicidality, β = .20, B = 0.23, SE = 0.05, 95% CI [0.16, 0.32], and the moderational effect of trauma exposure on the association between depression and suicidality, β = .16, B = 0.20, SE = 0.08, p = .007, were both supported. These results underscore the high prevalence of trauma exposure, depression, and suicidality in a safety‐net primary care sample. They also highlight the pervasiveness and complexity of suicidality in low‐income primary care patients, emphasize the importance of trauma‐informed suicide assessment, and identify trauma sequelae and depression as potential treatment targets to reduce suicidality. 抽象: Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Traditional Chinese 安全網中的創傷、抑鬱症及自殺的模式 初級保健 摘要 自殺傾向是一個重大的公共衛生問題, 特別是對低收入、受創傷、獲得心理衛生服務的機會有限的臨床治療者而言。然而, 有限的研究對安全網初級保健樣本中自殺的途徑進行了模擬。安全網初級保健診所的臨床治療者(N = 207)完成了對兒童及成人創傷暴露、抑鬱症及自殺的測量。參與者(M年齡=44.8歲, SD=11.6), 60.4%為男性, 63.8%為黑人/非裔美國人, 主要是低收入者(即69.1%報告年收入低於5000美元)。一半的樣本報告了至少四次童年創傷事件(M = 3.9事件, SD = 3.0)及大約三次成人創傷事件(M = 3.0事件, SD = 2.1)。大多數參與者(82.1%)報告有明顯的抑鬱症狀, 43.5%的人表示最近有自殺傾向。模式顯示, 抑鬱對創傷暴露及自殺之間的關係具有中介作用, β=0.20, B=0.23, SE=0.05, 95%CI[0.16, 0.32];創傷暴露對抑鬱及自殺之間的關係具有調節作用, β=0.16, B=0.20, SE=0.08, P=0.007, 均得到支持。這些結果強調了在安全網初級保健樣本中, 創傷暴露、抑鬱症及自殺的高流行率。他們還強調了低收入初級保健臨床治療者自殺的普遍性及復雜性, 強調了以創傷為基礎的自殺評估的重要性, 並將創傷後遺症及抑鬱症作為減少自殺的潛在治療目標。 Simplified Chinese 安全网中的创伤、抑郁症及自杀的模式 初级保健 摘要 自杀倾向是一个重大的公共卫生问题, 特别是对低收入、受创伤、获得心理卫生服务的机会有限的临床治疗者而言。然而, 有限的研究对安全网初级保健样本中自杀的途径进行了模拟。安全网初级保健诊所的临床治疗者(N = 207)完成了对儿童及成人创伤暴露、抑郁症及自杀的测量。参与者(M年龄=44.8岁, SD=11.6), 60.4%为男性, 63.8%为黑人/非裔美国人, 主要是低收入者(即69.1%报告年收入低于5000美元)。一半的样本报告了至少四次童年创伤事件(M = 3.9事件, SD = 3.0)及大约三次成人创伤事件(M = 3.0事件, SD = 2.1)。大多数参与者(82.1%)报告有明显的抑郁症状, 43.5%的人表示最近有自杀倾向。模式显示, 抑郁对创伤暴露及自杀之间的关系具有中介作用, β=0.20, B=0.23, SE=0.05, 95%CI[0.16, 0.32];创伤暴露对抑郁及自杀之间的关系具有调节作用, β=0.16, B=0.20, SE=0.08, P=0.007, 均得到支持。这些结果强调了在安全网初级保健样本中, 创伤暴露、抑郁症及自杀的高流行率。他们还强调了低收入初级保健临床治疗者自杀的普遍性及复杂性, 强调了以创伤为基础的自杀评估的重要性, 并将创伤后遗症及抑郁症作为减少自杀的潜在治疗目标。