Long-term effects of psychological trauma on psychosocial functioning

• Published in: Journal of child psychology and psychiatry Vol. 45; no. 5; pp. 1007 - 1014
• Main Authors: Bolton, Derek, Hill, Jonathan, O'Ryan, Dominic, Udwin, Orlee, Boyle, Stephanie, Yule, William
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing 01.07.2004; Wiley-Blackwell; Blackwell; Blackwell Publishing Ltd
• Subjects: ADAPFA; Adolescent; Adolescents; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Child psychology; Childhood experiences; Childhood trauma; Clinical Diagnosis; Control Groups; Correlation; Depression (Psychology); Disasters; Education Work Relationship; Female; Follow-Up Studies; Greece; Humans; impairment; Intimacy; Long term effects; major depression; Male; Measures (Individuals); Medical sciences; Mental Disorders; Mental Health; Miscellaneous; Personality Measures; Posttraumatic Stress Disorder; Psychological trauma; Psychology. Psychoanalysis. Psychiatry; Psychopathology; Psychopathology. Psychiatry; Psychosocial functioning; PTSD; Risk factors; Ships; Social Adjustment; Social Behavior; social functioning; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - psychology; Survivors - psychology; Survivors - statistics & numerical data; Time Factors; Trauma; United Kingdom; Young Adults; Human; Mood disorder; social functioning; Posttraumatic syndrome; Survivor; Anxiety disorder; Social adjustment; Depression; ADAPFA; Long term; Childhood trauma; Stress; PTSD; Symptomatology; impairment; Adolescent; Risk factor; Early traumatism; Antecedent; major depression
• ISSN: 0021-9630; 1469-7610
• DOI: 10.1111/j.1469-7610.2004.t01-1-00292.x

Background:  Most studies of the effects of trauma on mental health have generally not separately assessed psychosocial functioning, and in those that have key issues have received little attention, such as the relation between the time courses of the two kinds of outcome, and detailed assessment of social functioning in a range of domains. The present study made separate assessments with a view to testing four hypotheses. First, that the experience of trauma itself (independently of effects on mental health) has a negative effect on psychosocial functioning; second, that psychopathology following trauma is associated with poorer psychosocial functioning; third, that psychosocial functioning recovers when psychiatric conditions remit; fourth, that post‐traumatic stress and depression have different associations with impairments of psycho‐social functioning. Method:  One hundred and fifteen young adults who had survived a shipping disaster (the sinking of the Jupiter in 1988) between 5 and 8 years previously, and 50 control participants were assessed for psychopathology, and for psychosocial functioning using the Adolescent to Adult Personality Functioning Assessment (ADAPFA). Results:  Results did not support the first hypothesis: survivors who, although experiencing a traumatic event, did not develop Post Traumatic Stress Disorder or other psychopathology warranting diagnosis, when compared with Controls who had no psychopathology since the time of the disaster, showed no significant differences on any ADAPFA domains or on total score. There was partial support for the second hypothesis: survivors with diagnosable disorder during the rating period showed poorer psychosocial functioning in total ADAPFA score and in the domains of Education/Work, Love Relationships, and Non‐specific Social Contacts, though not in other domains. The third hypothesis was supported: recovered Survivors showed no psychosocial impairments compared with unaffected Controls. Results also supported the fourth hypothesis, showing differential effects of post traumatic stress and depression in relation to the extent and kind of psycho‐social impairments. Conclusions:  The results lend support to the general model that effects on psychosocial functioning following traumatic experience are mediated by psychopathology, though further research is needed to establish whether the present pattern of findings applies to other kinds of trauma.