MOD 2: Historical Trauma and vicarious trauma

Question 1

What is historical trauma?

Answer 1

Cumulative emotional and psychological wounding across generations, including the lifespan, which emanates from massive group trauma.

Question 2

Features of historical trauma

Answer 2

collective: Experienced by a group of people who share an
identity, affiliation, or circumstance
across time and gen: Can affect generations that didn’t directly experience
the events

Question 3

Historical trauma response

Answer 3

• Unresolved, complicated, and/or prolonged grief from cumulative losses
• PTSD
• Depression
• Substance abuse

Question 4

Comparison to other trauma types

Answer 4

Historical trauma= Loss
Criterion A trauma= Fear
Moral injury= Guilt/shame

Question 5

Historical trauma construct is used to explain
— among Native
Americans

Answer 5

poorer mental and physical health

Question 6

Compared to whites,- have higher death rates

Answer 6

Native Americans
- Native Americans are much more likely 
to die from diabetes, chronic liver 
disease and suicide as well as accidents 
and homicides

Question 7

1. Studies using historical loss self-report scales

Answer 7

• Many Native Americans do think about these losses at least occasionally and these thoughts cause distress
• Most studies find significant relations between
  scores on the Historical Loss or Historical Loss
  Associated Symptoms scale and health outcomes
  including substance abuse, depression and anxiety
  symptoms, and suicidality

Question 8

Example study using self-report scale

Answer 8

• About 20% said they think about losing their culture and
losses from effects of alcoholism at least daily
• Sadness and anger most common emotions (about 50%
report these at least sometimes)

Question 9

Scores on symptom scale related to more PTSD symptoms,
substance dependence, anxiety/mood disorder diagnosis;
historical loss only associated with

Answer 9

substance dependence

Question 10

2. Studies assessing whether ancestor

attended Indian boarding school

Answer 10

Indigenous people who reported that an ancestor attended a
boarding school generally fared worse on health outcome
measures
- Suicidality, depression symptoms, substance use

Question 11

Why is there a link between ancestors being in a boarding school and current mental health?

Answer 11

• Many children were exposed to physical, sexual, and emotional
  abuse in boarding schools
• They were also deprived of traditional parental role models
• Damage from boarding school abuse, loneliness, lack of love, and
  lack of parenting are seen as key factors in the illnesses that plague tribes today
• The damage can pass from one generation to the next and
  manifest in high rates of poverty, substance abuse, domestic
  violence, depression, and suicide

Question 12

Historical trauma response

Answer 12

Unresolved grief/loss, PTSD, depression, substance abuse

Question 13

what is vicarious trauma?

Answer 13

Reaction to intensive indirect exposure to clients’ traumatic stressor experiences

Question 14

does vicarious trauma include symptoms and changes to world views

Answer 14

yes

Question 15

related terms of vicarious trauma

Answer 15

secondary traumatic stress

compassion fatigue

Question 16

what are the two primary measures of vicarious trauma

Answer 16

life scale and secondary trauma scale

Question 17

life scale

Answer 17

compassion satisfaction and compassion fatiuge

Question 18

prevalence of secondary traumatic stress using STSS

Answer 18

Juvenile justice workers = 39%

Child protection workers = 34%

Question 19

added what to DSM-5 (2013) as Criterion A event

Answer 19

vicarious trauma
Repeated or extreme indirect exposure to aversive details of event(s),
usually in the course of professional duties (e.g., first responders, child
protection workers)

Question 20

Themes in qualitative meta-synthesis: Beyond PTSD

1: Emotional and Somatic reactions

Answer 20

Emotional responses
• Sadness, anger, fear, frustration, powerlessness, irritability
• Immediate symptoms sometimes lingered (continued
memories)
Somatic responses
• Numbness, nausea, fatigue

Question 21

Themes in qualitative meta-synthesis: Beyond PTSD

2: changes to schema and behaviors

Answer 21

Negative changes to beliefs about the world, life, themselves
Changes in daily life
Positive changes reported too (similar to PTG)
- wiser, inspired, appreciation

Question 22

largest risk and protective factors for secondary traumatic stress

Answer 22

risk
- emotional involvement: .27 
- same trauma as client: .24 
Protective 
- social support: -.26 
- work support: -.17

Question 23

Using STSS, prevalence is

Answer 23

15% to 39% across studies