Department of Psychology, California State University, Monterey Bay, Seaside, California, USA.
J Trauma Stress. 2021 Apr;34(2):309-321. doi: 10.1002/jts.22651. Epub 2021 Jan 22.
Limited research has examined the links among violent victimization, mental health, and service utilization among gang-involved individuals. This mixed-methods preliminary study examined narratives of psychiatric distress, current psychiatric morbidity, and mental health treatment experiences among a sample of former gang members (N = 32; M age = 44.4 years, 87.5% male; 56.3% Hispanic or Latino, 31.3% African American). Participants completed online questionnaires to assess trauma exposure and current psychiatric symptoms as well as a semistructured interview to examine histories of psychiatric distress and mental health treatment. Participants reported exposure to an average of 10.2 discrete traumatic events (range: 3-21). On average, participants reported exposure to five to six community violence-related events, ranging from never or one time up to monthly and weekly exposure. Participants generally described histories of depression, anxiety, posttraumatic stress disorder (PTSD), and substance abuse, although a thematic analysis revealed PTSD symptoms predominated the psychiatric distress described, including symptoms related to intrusions, avoidance, negative alterations in cognitions and mood, and alterations in arousal. Grounded theory analysis revealed barriers to traditional models of mental health treatment included self-isolation, gang rules, and social stigma, especially in the context of interpersonal disconnect with providers. Given conditions of limited resources to access treatment, participants engaged in peer support services, which may have reduced their psychiatric distress to currently low levels. Implications for understanding these notable findings of recovery and resilience for some individuals and building trauma-informed communities that improve access to traumatic stress resources for marginalized populations are discussed.
有限的研究考察了有帮派背景的个体中暴力受害、心理健康和服务利用之间的联系。本混合方法初步研究考察了一组前帮派成员（N=32；平均年龄=44.4 岁，87.5%为男性；56.3%为西班牙裔或拉丁裔，31.3%为非裔美国人）的精神困扰、当前精神疾病发病率和心理健康治疗经历的叙述。参与者完成了在线问卷，以评估创伤暴露和当前的精神症状，以及半结构化访谈，以检查精神困扰和心理健康治疗的历史。参与者报告平均经历了 10.2 次离散创伤事件（范围：3-21）。平均而言，参与者报告了五次到六次与社区暴力相关的事件，从从未或一次到每月和每周暴露。参与者通常描述了抑郁、焦虑、创伤后应激障碍（PTSD）和药物滥用的病史，尽管主题分析显示 PTSD 症状是描述的精神困扰的主要表现，包括与闯入、回避、认知和情绪的负性改变以及唤醒改变相关的症状。扎根理论分析揭示了传统心理健康治疗模式的障碍，包括自我孤立、帮派规则和社会耻辱，尤其是在与提供者人际脱节的情况下。考虑到获得治疗的资源有限，参与者参与了同伴支持服务，这可能降低了他们的精神困扰，目前处于较低水平。讨论了理解这些对一些人来说具有恢复和韧性的显著发现，并建立创伤知情社区，以改善边缘化人群获得创伤应激资源的机会的意义。
