150 likes | 396 Views
The Life Long Legacy of Trauma in Women Abused as Children. Congressional Briefing June 21, 2004 Mary W. Armsworth, Ph.D. University of Houston. What is Trauma?.
E N D
The Life Long Legacy of Trauma in Women Abused as Children Congressional Briefing June 21, 2004 Mary W. Armsworth, Ph.D. University of Houston
What is Trauma? Trauma is an emotional state of discomfort or stress resulting from memories of an extraordinary catastrophic experience which shattered the survivor’s sense of invulnerability to harm
What are Traumatic Events? • Child Abuse and Neglect • Physical, Psychological, Sexual • Rape and Sexual Assault • Combat • Terrorism • Captivity/Torture • Motor Vehicle Accidents • Domestic and Community Violence • Disasters
Who Experiences Trauma? • Approximately 60% of men and 51% of women will be exposed to at least one traumatic event in their lifetime • An estimated 5% of Americans -- more than 13 million people -- have Post Traumatic Stress Disorder (PTSD) at any given time • The majority will be able to absorb the trauma, while about 8% develop PTSD
Risk Factors for PTSD • Gender • Human caused • Repeated • Unpredictable • Sadistic • Experienced in childhood • Perpetrated by a caregiver
What is Post Traumatic Stress Disorder (PTSD)? • An emotional disorder caused by exposure to a traumatic event • The traumatic event must: • Include actual or perceived threat to life or physical integrity • Elicits intense fear, horror, or helplessness. • PTSD symptoms usually appear within several weeks of the trauma, but some people don't experience symptoms until months or even years later
The Event has Ended, but the Response Remains • Re-living the event • Recurring nightmares • Intrusive images • Extreme emotional or physical reactions (e.g., panic, flashbacks) • Avoiding reminders of the event • Avoid places, people, thoughts or activities associated with trauma • Emotional detachment from friends and family • Loss of interest in everyday activities • Being on guard or hyper-aroused • Irritability or sudden anger • Difficulty sleeping or a lack of concentration • Easily startled
PTSD in Women • An estimated 1 out of 10 women will develop PTSD at some time in their lives • Women are about twice as likely as men to develop PTSD • Women with PTSD may also exhibit: • Depression • Anxiety • Dissociative disorders • Personality disorders • Health risk behaviors (e.g., smoking, drinking, overeating, promiscuity, and substance abuse – coping devices for chronic stress
Common Causes of Anxiety for Older Women • Past Trauma Memories • Poverty • Medical Illness and High cost of Healthcare • Loss of Connections • Environmental Stressors • Early Dementia • Difficulty structuring one’s time • Loss of hope for the future
The Aging Female Survivor • May be developmentally stuck at age of trauma • Current high level of distress years after trauma • Maintains silence about trauma • May be avoidant or encounter fear of new experiences • May be more vulnerable to health issues • Survivors who maintained “healthy” family/social connections have more mature adaptation and development
The Effect of Silence on Aging Female Survivors “If you cannot go into your head to think about or talk about the trauma, you will go into your body” • Unresolved trauma leads to disguised presentation, resulting in increased physical symptoms, including: • Insomnia • Tension Headaches • Gastrointestinal disturbances • Abdominal, back or pelvic pain • Choking, Nausea
The High Cost of Trauma • Many of the most common causes of death and disability are linked to adverse emotional or physical experiences in childhood • People with PTSD have among the highest rates of healthcare service use • The annual cost to society of anxiety disorders is estimated to be approximately $42.3 billion (psychiatric and nonpsychiatric medical treatment costs, indirect workplace costs, mortality costs and prescription drug costs) • More than half of these costs are attributed to repeat use of healthcare services to relieve anxiety-related symptoms that mimic those of other physical conditions
Treatments for PTSD in Older Adults • Cognitive Behavioral Therapy • Psychodynamic Therapy • Group Psychotherapy Interventions • Cognitive Processing Therapy • Reminiscence Therapy (Life Review)
Policy Recommendations • Support for Prevention/Early Intervention Programs • Support for Research Related to Women and Trauma • Increased Access to Services for Female Survivors and their Families • Systematic Training (Healthcare Providers, Law Enforcement, Caregivers, Native/Indigenous Leaders) • Support for Systematic Life Long Trauma Screening • Integrative Systems of Care (Primary Care and Mental Health)
Positive Aging in the Aftermath of Trauma • Positive Aging is to love, to work, to learn something we did not know yesterday, and to enjoy the remaining precious moments with loved ones • It’s not the bad things that happen to us that doom us, it’s the good people who happen to us at any age that facilitate enjoyable aging (Vaillant, 2004)