Clinical Education: Addressing Prior Trauma and Its Impacts in Medical Settings.

Prior trauma exposure significantly increases the risk of developing PTSD following medical stressors and may contribute to the development of medically induced PTSD. However, healthcare systems often overlook the interaction between prior trauma and current medical stressors, contributing to negative psychosocial and health-related outcomes for patients. Integration of both trauma-informed and trauma-focused practices into psychosocial programming in medical settings may be key to effectively addressing the needs of trauma-exposed patients.

Medical traumatic stress: Integrating evidence-based clinical applications from health and trauma psychology.

Medical events in both childhood and adulthood, including components of the illness or injury and subsequent medical intervention, recovery, and disability, are increasingly being recognized as potentially traumatic. There has been an increased focus on scholarly work related to medical trauma and medically induced posttraumatic stress disorder (PTSD). Existing evidence suggests that trauma-focused treatment can promote both physical and psychological recovery.

Prospective Predictors of Work Limitations in Young Adult Lesbian and Bisexual Women: An Examination of Minority Stress, Trauma Exposure, and Mental Health.

Trauma exposure and mental health problems adversely affect work functioning. Sexual minority women are at increased risk for trauma exposure, depression, and PTSD. Sexual minority women also experience unique stressors related to their sexual orientation, which can directly impact work functioning.

Perceptions of tech-based mental health screening.

Background: An estimated one-third of patients experience post-traumatic stress disorder (PTSD) or depression in the year following a traumatic injury. The American College of Surgeons requires postinjury PTSD and depression screening in trauma centers, although implementation has been limited. Tech-based solutions have been proposed to improve uptake of postinjury mental health screening.

Effectiveness of a Self-Administered Computerized Mental Health Screening Tool in the Emergency Department.

Objective: The authors sought to determine the effectiveness of a self-administered computerized mental health screening tool in a general acute care emergency department (ED).

Methods: Changes in patient care (diagnosis of a past-year psychiatric disorder, request for psychiatric consultation, psychiatric referral at discharge, or transfer to psychiatric facility) and patient ED return visits (3 months after discharge vs. 3 months before) were assessed among ED physicians (N=451) who received patients' computerized screening reports (N=207) and those who did not (N=244).

Reflections on 10 years of effectiveness-implementation hybrid studies.

This article provides new reflections and recommendations from authors of the initial effectiveness-implementation hybrid study manuscript and additional experts in their conceptualization and application. Given the widespread and continued use of hybrid studies, critical appraisals are necessary. The article offers reflections across five conceptual and methodological areas.

Breaking Silos to Address Medical Trauma: The Need for Integration of Trauma and Health Psychology Training.

Posttraumatic Stress Disorder (PTSD) following a traumatic injury is a significant public health concern impacting approximately a third of traumatically injured patients. In 2018, the American College of Surgeons (ACS) Committee on Trauma recommended implementation of PTSD screening and brief intervention in level 1 trauma centers to meet the mental health needs of this underserved population. In March 2022, ACS revised its standards to include a requirement for mental health screening and referral process in level 1 and level 2 trauma centers.

Increases in Violence and Changes in Trauma Admissions During the COVID Quarantine.

Background: The COVID-19 pandemic caused an abrupt change to societal norms. We anecdotally noticed an increase in penetrating and violent trauma during the period of stay-at-home orders. Studying these changes will allow trauma centers to better prepare for future waves of COVID-19 or other global catastrophes.

COVID-19 Is Connected with Lower Health Literacy in Rural Areas.

The relationship between social determinants of health (SDoH) and health outcomes is established and extends to a higher risk of contracting COVID-19. Given the factors included in SDoH, such as education level, race, rurality, and socioeconomic status are interconnected, it is unclear how individual SDoH factors may uniquely impact risk. Lower socioeconomic status often occurs in concert with lower educational attainment, for example.

Challenges and Potential Solutions to Implementing Phone Coaching in Dialectical Behavior Therapy.

Dialectical Behavioral Therapy (DBT) is an effective treatment for borderline personality disorder (BPD), yet many healthcare facilities struggle to implement one of the modes of DBT, phone coaching. The aims of this study were to present barriers and reported solutions regarding the implementation of DBT phone coaching. We conducted a sequential mixed methods national program evaluation that included a quantitative self-report survey completed by Department of Veterans Affairs (VA) facilities (N=59) offering any of the four modes of DBT.

"It's been like a miracle": Low-income Arkansans and access to health care services following Medicaid reform.

This article reports qualitative results from a mixed-methods evaluation of the Arkansas Health Care Independence Program. Qualitative data was collected using telephone interviews with 24 low-income Arkansans newly enrolled in Medicaid or a Qualified Health Plan in 2014. We used methods developed for rapid qualitative assessment to explore a range of general barriers and facilitators to accessing health care services.

Factors Associated with Sexual Satisfaction among Veterans Who Have Experienced Military Sexual Trauma.

Veterans who have experienced military sexual trauma (MST) report lower sexual satisfaction than veterans without a history of MST. The current study examined the relationship between demographic, physical health, mental health, and trauma variables and sexual satisfaction among a national sample of U.S.

The Relationship Between Provider Gender Preferences and Perceptions of Providers Among Veterans Who Experienced Military Sexual Trauma.

Previous research has demonstrated that most veterans who have experienced military sexual trauma (MST) have provider gender preferences. Although provider gender mismatch, defined as not receiving a provider of the gender of one's preference, may deter veterans from disclosing MST or seeking MST-related care, there is little research that has examined this issue. The current study aimed to explore how provider gender mismatch is related to veterans' comfort with providers, perception of their providers' competency, and their endorsement of perceived provider barriers when communicating about MST.

Reprint of: An introduction to effectiveness-implementation hybrid designs.

The traditional research pipeline that encourages a staged approach to moving an intervention from efficacy trials to the real world can take a long time. To address this issue, hybrid effectiveness-implementation designs were codified to promote examination of both effectiveness and implementation outcomes within a study. There are three types of hybrid designs and they vary based on their primary focus and the amount of emphasis on effectiveness versus implementation outcomes.

Barriers to and facilitators of a screening procedure for PTSD risk in a level I trauma center.

Background: Patients admitted to the hospital after an injury are at a greater risk for developing post-traumatic stress disorder (PTSD) due to the nature of the injury and the traumatic nature of necessary medical interventions. Many level I trauma centers have yet to implement screening protocols for PTSD risk. The goal of the study was to characterize the barriers to and facilitators of implementation of a screening procedure for PTSD risk in a level I trauma center.

An introduction to effectiveness-implementation hybrid designs.

The traditional research pipeline that encourages a staged approach to moving an intervention from efficacy trials to the real world can take a long time. To address this issue, hybrid effectiveness-implementation designs were codified to promote examination of both effectiveness and implementation outcomes within a study. There are three types of hybrid designs and they vary based on their primary focus and the amount of emphasis on effectiveness versus implementation outcomes.

Testing and Exploring the Limits of Traditional Notions of Fidelity and Adaptation in Implementation of Preventive Interventions.

This commentary reflects on key challenges raised across the articles of this special issue, notably the tension between fidelity and adaptation, the importance of articulating core components and principles of evidence-based programs, the need for pragmatic measures, and the challenges associated with articulating and testing mechanisms of implementation strategies. These challenges are amplified in the context of prevention research where task shifting, or revising professional roles, is especially common. Synergies with work emerging from the Society for Implementation Research Collaboration are highlighted throughout.

Sexual Dysfunction Problems in Female College Students: Sexual Victimization, Substance Use, and Personality Factors.

Little empirical information is available on sexual dysfunction (SD) among college women even though college years represent a critical period in the development of sexuality. The current study aimed to identify factors associated with the presence, number, and type of SD problems among 547 female college students in the United States. Racial minority status, problematic drinking behaviors, and past sexual victimization were positively related to the presence of SD problems, whereas hormonal contraceptive use and past sexual victimization were associated with a greater number of SD problems.