Trauma history questionnaire research deepens insight into vulnerable women

Exposure to trauma is associated with many negative outcomes, particularly for at-risk groups such as incarcerated women and perinatal women. The Trauma History Questionnaire (THQ) is a commonly used measure of trauma exposure, but no published studies have validated the instrument with these two understudied groups.

In a new study published in Women & HealthResearchers at Idaho State University (ISU) examined the THQ to gain more insight into these groups.

“Given the long-term physical and mental health risks associated with trauma exposure, particularly in vulnerable populations, valid measures of different types of trauma exposure are critical,” explained Shannon Lynch, a professor of psychology at ISU who co-authored the study. Lynch is an expert whose work is promoted by the NCJA Crime and Justice Research Alliance.

More than half of women in the United States will experience at least one traumatic event in their lifetime. Exposure to trauma is associated with increases in rates of depression, anxiety, substance abuse, social isolation, and chronic health problems, the effects of which are particularly concerning for women who are incarcerated or pregnant. The risky life circumstances of these women can impact the way they experience and recover from traumatic events in a variety of ways.

The THQ is commonly used to assess traumatic experiences in a variety of populations. In this study, researchers sought to address the lack of studies on the validity of the instrument in incarcerated and perinatal women. They analyzed two samples of incarcerated women (the Trauma Exposure and Treatment Needs Study and the Seeking Safety Study) and one sample of prenatal women, that is, women immediately before and after the birth of their child (the IDAHO Mom Study); all three studies were conducted in the northwestern United States.

Specifically, the study examined construct validity with other measures and indices of trauma, convergent validity with related constructs (i.e., depression, anxiety, somatic symptoms, social support), and the predictive validity of prenatal THQ scores with postnatal depression. The study also compared incarcerated women with perinatal women to identify unique interactions between gender and life circumstances in relation to trauma.

The THQ results were approximately as expected in the perinatal and incarcerated samples and demonstrated adequate psychometric properties for use in future research with these populations.

It demonstrated strong relationships with a comparable trauma measure (the Severity of Violence Against Women Scale) for both groups of women, as well as relationships with relevant constructs of depressive symptoms, posttraumatic stress disorder, and psychological distress in these samples. Incarcerated women had significantly higher THQ scores than perinatal women, and prenatal women’s THQ scores predicted later postpartum depressive symptoms.

Based on these findings, the authors suggest that while trauma exposure may differ within subgroups of understudied female populations, robust associations exist between trauma and mental health problems across life circumstances.

Given the increased levels of trauma exposure in the two groups of incarcerated women, and the strong associations between trauma and negative mental health outcomes, they recommend increased attention to mental health services in women’s prisons. And given the association between trauma and depression in the perinatal group and research on the negative effects of trauma and depression on maternal and fetal well-being, they recommend increased mental health services and support for women exposed to trauma in the perinatal period.

Among the study’s limitations, the authors note that each study used different measurements, which limits direct comparisons across samples. In addition, data for the studies were collected at different time points. Finally, all three studies were conducted in the same region, which limits the generalizability of the results to other demographically distinct regions.

“Our findings advance our understanding of the types of trauma experienced by incarcerated and perinatal women and may contribute to the utility of trauma assessments for these vulnerable populations,” said Lillian Bengtson, a doctoral candidate in clinical psychology at ISU who led the study.

“By accurately measuring trauma in these groups, researchers and professionals can gain better insight into risk factors and long-term consequences. They can also focus on prevention and treatment of vulnerable groups of women.”

Provided by Crime and Justice Research Alliance