一种自下而上的方法,用于为跨性别者和性别多样化者开发统一的创伤-少数群体压力模型。
A bottom-up approach to developing a unified trauma-minority stress model for transgender and gender diverse people.
作者信息
Salomaa Anna C, Livingston Nicholas A, Bryant William T, Herbitter Cara, Harper Kelly, Sloan Colleen A, Hinds Zig, Gyuro Lisa, Valentine Sarah E, Shipherd Jillian C
机构信息
VA Boston Healthcare System.
Department of Psychiatry, Boston University School of Medicine.
出版信息
Psychol Trauma. 2023 May;15(4):618-627. doi: 10.1037/tra0001373. Epub 2022 Oct 6.
OBJECTIVE
Transgender and gender diverse (TGD) people are at heightened risk of both Criterion A trauma exposure and other bias-related minority stressors (e.g., discrimination, rejection). In the absence of a unified trauma-minority stress theory, it remains unclear how to best conceptualize psychopathology for people who experience both trauma and minority stress.
METHOD
Using a participant-driven q-sort methodology and network analytic approach, we analyzed card sort data from 18 TGD people and 16 providers with expertise in TGD care to derive thematic networks of trauma and minority stress experiences, as they connected to transdiagnostic symptoms (e.g., hyperarousal, avoidance).
RESULTS
The TGD participants' resulting network illustrates conceptualizations of identity- and nonidentity-based Criterion A traumas as similar and only related to psychiatric symptoms via the shared connection through other minority stressors. The provider network was more granular, although the general pattern was consistent with TGD participants, demonstrating similar perceptions of how these experiences are associated.
CONCLUSIONS
Evidence of inextricable links between trauma and psychiatric symptoms through the conduit of minority stressors lays the groundwork for novel, integrated models of trauma, minority stress, and their transdiagnostic symptom sequelae. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
目的
跨性别者和性别多样化(TGD)人群遭受A类创伤暴露以及其他与偏见相关的少数群体应激源(如歧视、排斥)的风险更高。在缺乏统一的创伤-少数群体应激理论的情况下,对于同时经历创伤和少数群体应激的人群,如何最好地概念化精神病理学仍不清楚。
方法
我们采用参与者驱动的Q分类方法和网络分析方法,分析了18名TGD人群和16名在TGD护理方面具有专业知识的提供者的卡片分类数据,以得出创伤和少数群体应激经历的主题网络,因为它们与跨诊断症状(如过度唤醒、回避)相关。
结果
TGD参与者得出的网络表明,基于身份和非身份的A类创伤的概念化是相似的,并且仅通过与其他少数群体应激源的共同联系与精神症状相关。提供者网络更细化,尽管总体模式与TGD参与者一致,表明对这些经历如何关联的看法相似。
结论
通过少数群体应激源的渠道,创伤与精神症状之间存在不可分割联系的证据为创伤、少数群体应激及其跨诊断症状后遗症的新型综合模型奠定了基础。(PsycInfo数据库记录(c)2023美国心理学会,保留所有权利)