Modelling the relationships among trauma history, intimate partner violence and mental health

Abstract

Classification of mental health symptomology is complex as individuals and their life experiences are heterogeneous in nature. Comorbidity is also often present among experience of mental health disorders. Recent empirical literature has attempted to reduce this heterogeneity by producing subtypes for patterns of negative life experiences. This method, creating profiles of trauma histories can account for individual differences and can better inform aetiology of mental health disorders. Generating profiles of trauma and associated outcomes will enhance clinical practise by enabling informed prevention and strategies for individual tailored treatment plans. This thesis has utilised a variety of structural modelling techniques, to elucidate heterogeneity in negative life experiences and associated mental health symptomology. Person centred profiles of negative lifetime experiences have been produced to substantiate current understanding of mental health diagnoses. Data were from the 2004- 2005 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

Previous literature has intended to identify trauma experiences with associated mental health implications. As a precursor to previous literature, this thesis outlines a series of measurement models which convey experiences of childhood adversities, childhood/ adulthood traumas, intimate partner violence and DSM-IV mental health disorders. Latent class analyses have identified three subgroups for the experience of childhood adversities, these were labelled low adversities, high adversities and high physical abuse and family violence. A further three subgroups were identified for experience of childhood and adulthood traumas, low traumas, high traumas and highloss/ other indirect traumas. Confirmatory factor analysis mapped out a uni-dimensional factor structure for perpetration and victimization of intimate partner violence. Common DSM-IV mental health disorders also mapped onto an internalising/ externalising dimension of psychopathology. To extend and substantiate each of these individual analyses a range of demographic covariates were incorporated into each measurement model. Subsequently, to provide a comprehensive investigation, all of the defined measurement models were examined simultaneously by estimating a final structural equation model.

Understanding mental health symptomology and the intricate pathways which impact outcomes for individuals has major clinical and public health significance. This thesis, expanding on previous literature, recommends that clinicians and practitioners should demonstrate particular consideration when assessing clients who present with trauma or mental health problems. Subtyping of patient trauma histories can lead to the delivery of more successful and informed treatment interventions. Results from this thesis have many relevant and useful implications for both research and practise.

Date of Award	Oct 2013
Original language	English
Sponsors	Department of Education and Learning (NI)
Supervisor	Gary Adamson (Supervisor) & Maurice Stringer (Supervisor)