私たちは、生存者の声に耳を傾けることで、彼らにとって重要な経験や概念が明らかになると信じている。 そして、ミックスド・メソッド、認知的インタビュー、国際的な測定器の検証テクニックを用いて、生存者の声を、より多くのサンプルで理論検証に使用できる調査票に変換する。
Recovery and healing after GBV
GBV後の癒し
について Healing after GBV (GBV-Heal) instrument was constructed using Exploratory sequential mixed methods, beginning with items based on healing themes gathered from four studies with survivors of GBV. We then used expert review, cognitive interviewing, and factor analysis with 225 GBV survivors. Factor analysis revealed a four-factor solution has 21 items that explain 58% of the variability and alpha reliability of .93. KMO is .95, and Bartlett’s test is significant (p=.00). The four factors are Self-connection, Regaining Hope and Power, Relatedness, and Self-advocacy.
復旧活動のチェックリスト
助けを求めることに関する研究のほとんどは、サービスの利用に焦点を当てている。一般的に、サービスは法的、社会的、医学的、心理学的と定義されるが、インフォーマルな社会的支援も含まれる研究もある。しかし、我々の聞き取り調査では、生存者は膨大な数の回復行動に従事していることがわかった。そこで、インタビューデータを用いて、調査時点で被災者が行っている回復行動を把握するための45項目のチェックリストを作成した。チェックリスト Recovery Actions Checklist (TRAC) asks participants to check those things they are doing for their recovery, and includes the dimensions of Doing things good for my health; Caring for my emotional and personal needs; Relating with others; Finding community, safety, and justice; Finding Peace, joy and contentment; and Building a new future.
Trauma Recovery Rubric
Research is beginning to examine gender-based violence (GBV) survivors’ recovery, but little is known about diverse recovery trajectories or their relationships with other distress and recovery variables. This interdisciplinary, international multisite mixed-method study developed and used the Trauma Recovery Rubric (TRR) as a researcher or clinician tool to classify survivors’ trauma stages. This study describes the phases of the initial development of the preliminary TRR (Phase 1), refines and calibrates the TRR (Phase 2), and then integrates the TRR into quantitative data from four countries (Phase 3). Seven recovery stages with six domains emerged: Normalizing, Minimizing, Consumed/Trapped; Shut down” or frozen, Surviving, Seeking and fighting for integration, and Finding Integration/Equanimity. Depression scores were related to most recovery domains, and TRR scores had large effect sizes. At the same time, PTSD was not statistically related to TRR scores, but TRR had a medium effect size. Our study found that the TRR can be implemented in diverse cultural settings and promises a reliable cross-cultural tool. The TRR is a survivor-centered, trauma-informed way to understand different survivorship stages and how different stages impact health outcomes. Overall, this rubric provides a foundation for future study on differences in survivor healing and the drivers of these differences. This tool can potentially improve survivor care delivery and our understanding of how to meet best the needs of the survivor populations we intend to serve.
Self Assessment of Trauma Recovery
This study describes the conversion of the Trauma Recovery Rubric into the Self-Assessment for Trauma Recovery Tool (START) and evaluates whether the START can classify survivors of gender-based violence (GBV) into interpretable and clinically useful trauma recovery pathways. Cross-sectional data from 315 American GBV survivors from a major health system in Michigan, U.S., completed online questionnaires between April 2022 and January 2023. We used Latent Class Analysis (LCA) to identify the best model for classifying trauma recovery pathways using the START. Then, we applied Chi-square, t-tests, and ANOVA analyses to clinically relevant measures (depressive symptoms, posttraumatic stress symptoms, internal help seeking barriers, normalization, posttrauma cognitions, trauma-related coping self-efficacy, healing, and meaning) to interpret the class models. LCA and analyses of the other measures determined that a four-class model had the best fit and that participants in each class had interpretable clinical characteristics. The four classes were overwhelmed (Class 1: 38.0%), avoidance (Class 2: 21.4%), seeking integration (Class 3: 23.5%), and finding equanimity (Class 4: 17.1%). The participants in the four classes significantly differed on all other scale scores (p <.001). The results of this study suggest that the START is an interpretable and valuable tool for classifying survivors of GBV into specific types of trauma recovery. These findings may contribute to developing type-specific interventions to enhance the holistic recovery of survivors after GBV.
Barriers and Facilitators to recovery and healing
Barriers to help seeking for Trauma Recovery
について Barriers to help seeking-GBV (BHS-TR) includes perceptions about the availability of relevant help. The BHS-GBV scale was developed using an original 21 item from an epidemiological study of mental health help seeking in Ontario (1). The scale was adapted using focus groups with 24 GBV survivors in Ireland, reviewing the literature on barriers to help seeking for GBV survivors, and used 24 interviews with American GBV survivors to develop ten additional GBV specific barriers. Our psychometric validity study with 326 GBV survivors found nine factors solution that has 34 items and explains 63% of the variance. The nine factors can be grouped conceptually as the Interpersonal dimension barriers (shame, belief that it is normal and paralysis); the Interpersonal dimension barriers (mistrust, needed help was not available); and the Structural dimension barriers (perceived discrimination, financial constraints, and external constraints). Alpha reliability is .91, KMO is .88, and Bartlett’s test is significant (p=.00).我々は、他の国でも検証研究を実施している。
1.リンE、ゲーリングP、オフォードDR、キャンベルD、ボイルMH。オンタリオ州におけるメンタルヘルスサービスの利用：疫学的知見。 カナダ精神医学ジャーナルカナダの精神医学雑誌。 1996;41:572-577
GBVの常態化
について Normalization of GBV (NGBV) instrument was constructed using three triangulated datasets: Voices of GBV survivors, a MiStory intensive cross-cultural comparison of normalization for survivors in 12 countries, and a literature review of existing normalization instruments. The resulting instrument was then translated into 4 other non-English languages (Turkish, Greek, Icelandic and Italian) and cognitive interviewing was carried out. The resulting instrument is currently undergoing a cross-cultural psychometric studies.
Sense of Meaning Inventory
Trauma recovery research requires the development of instruments that capture gender-based violence (GBV) survivor recovery phases. The salutogenic concepts in Antonovsky’s Sense of Coherence (SOC) (manageability, comprehensibility, and meaning) could help capture trauma recovery stages, but the factorial structure of the SOC-13 has remained problematic. Moreover, most SOC revisions generally abandon the original intent of the SOC-13, developing scales that capture essential but different aspects of positive psychology. This study used mixed methods to develop the Sense of Meaning Inventory (SOMI), preserving the original concepts but updating the language, removing cultural idioms, and revising the response scales to stabilize the subscales. The qualitative phase evaluated and updated the items of the scale while retaining the original concepts. The quantitative phase conducted a two-sample psychometrics reliability and validity evaluation of the new scale with GBV survivors, finding a three-factor solution. This scale may be more amenable for international research and theory testing in GBV and other health conditions.