Trauma exposure during childhood has a well-documented negative impact on a variety clinical outcomes. Yet, many survivors are resilient. Our laboratory includes a focus on better understanding risk and protective factors associated with psychological difficulties and resiliency in individuals across the lifespan. Dr. Wamser-Nanney has a particular interest examining these associations in young children (birth to age 6), parents, and families. It is the unfortunate reality that for many trauma survivors, exposure to traumatic events is not a singular experience- but repeats again (and again). Our lab also has a particular focus on examining complex trauma, or interpersonal trauma that is chronic/multiple and begins early in life, as well as revictimization.
Further, evidence-based trauma-focused treatments are often necessary to combat the variety of adverse outcomes that may develop in the aftermath of trauma. The THRIVE lab also conducts research regarding treatment issues among trauma-exposed children such as caregivers’ help seeking behaviors, caregiver-child symptom concordance, premature termination from trauma-focused therapy, and treatment efficacy. Dr. Wamser-Nanney also has a strong interest in the development and dissemination of evidenced-based trauma-focused treatments for children. As noted below, she is currently the Co-Project Director of the Central Missouri- Child Trauma Initiative (CM-CTI), a Category III grant, funded by the National Child Traumatic Stress Network (NCTSN) with her colleagues at the University of Missouri- Columbia.
Parent’s exposure to trauma and trauma-related symptoms can make it more challenging to be a parent. Further, parents of trauma-exposed children may also have unique difficulties as they try to support their child’s recovery. It is also possible that trauma exposure and PTSD symptoms may alter perceptions of parenting, even among individuals who have yet to become a parent. Nonetheless, there is relatively little research in the areas of parenting and trauma. In a series of studies, we are working to better understand how trauma exposure and trauma reactions may influence aspects of parenting and children’s functioning among parents as well as pre-parenthood beliefs among individuals who are not currently a parent. These studies include a focus on intergenerational trauma. We are also investigating the potential role of children’s trauma exposure in relation to parenting outcomes.
The overarching goal of the Central Missouri- Child Trauma Initiative (CM-CTI) is to increase access to sustainable, trauma-focused, evidence-based practices (EBPs) for trauma-exposed culturally diverse children (ages 0-18) and their families throughout central Missouri. Trauma-exposed children in central MO currently suffer from very limited options to access EBPs for trauma and our region has high rates of child maltreatment and opioid misuse. Further, our area does not currently have a child trauma specialty clinic that provides a variety of trauma-focused EBPs. Specific aims of the CM-CTI project are to: 1) increase children’s access to three leading trauma-focused, EBPs: Child Parent Psychotherapy (CPP), Trauma and Grief Component Therapy (TGCT), and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT); 2) significantly mitigate children’s trauma-related symptoms by posttreatment as well as reduce trauma symptoms among caregivers receiving CPP; 3) Build a sustainable child trauma workforce in central MO by hosting Learning Total Collaboratives (LCs) for each of these EBPs (i.e., CPP, TGCT, and TF-CBT). We are partnering with three NCTSN Category II Sites: University of California San Francisco (UCSF); Texas Children’s; and Children’s Advocacy Services of Greater St. Louis (CASGSL) to host these LCs through the use of their CPP, TGCT, or TF-CBT trainers, respectively. 4) As a result of their participation in the LCs, trainees will provide CPP, TF-CBT, and TGCT to families in our region. 5) Provide outreach and engagement to increase access to trauma-focused EBP. We have just completed the first year of this five year project. Dr. Wamser-Nanney and the CM-CTI team will be conducting research to examine the efficacy of these treatments, as well as predictors of dissemination and implementation success.
Research has documented that exposure to traumatic event is related to a host of physical health conditions including cancer, metabolic syndrome, and heart disease. However, the role of trauma exposure on fertility outcomes has not been determined. As trauma exposure is associated with chronic alterations in the hypothalamic pituitary adrenal (HPA) axis, increased levels of inflammation, and biological changes, it is plausible that fertility may also be negatively impacted. Further, epidemiological studies have indicated that exposure to stress prior to conception and during pregnancy are related to poor obstetric outcomes such as low birthweight, although research has not examined the role of trauma exposure on obstetric outcomes. Individuals exposed to traumatic events, particularly those who meet criteria for PTSD, may exhibit symptoms of hyperarousal and have a tendency to over-respond to stressful events. A hyper-sensitivity to stress, as well as trauma-related symptoms, may result in pregnancy complications or even impair fetal development via the HPA axis and inflammation. In this study, we are investigating the roles of trauma exposure and PTSD on both fertility and obstetric outcomes.
Gun violence is a serious public health concern and severe, and often lethal, form of trauma exposure. Yet, the research regarding gun violence is nascent. The THRIVE lab is conducting several studies in the area of gun violence and has developed a measure of gun behaviors and beliefs, the Gun Behaviors and Beliefs Scale (GBBS), as well as developed and piloted a Motivational Interviewing (MI) based gun violence prevention intervention. We are also working to understand risk and protective factors for gun violence, such as PTSD and trauma-related beliefs.
For the past several decades, the importance of cognition-in particular beliefs about the self, world, and others-has been emphasized in the theory of PTSD. Further, in our most recent conceptualization of PTSD in DSM-5, changes in cognitive beliefs after the traumatic event are now also a symptom of PTSD. Trauma exposure and PTSD may also be related to alterations perceptions of racial minorities, belief in racial stereotypes, attitudes towards race-related shootings and discrimination; however, these associations have not been previously examined. Nonetheless, trauma exposure and PTSD may be related to alterations in these beliefs based on other theoretical frameworks. Specifically, terror management theory (TMT) postulates that increases in an individual’s sense of mortality salience may lead to increases in stereotypic thinking (Greenberg, Solomon, & Pyszczynski, 1997; Schimel et al., 1999). Trauma exposure certainly may increase one’s sense of mortality, thus it is plausible that trauma exposure and PTSD may result in more negative perceptions of racial minorities and the belief in racial stereotypes. Similarly, these beliefs may extend to beliefs regarding race related police shootings. Among Black individuals, traumatic exposure may also increase perceptions regarding racism via mortality salience as well; however, this has not been empirically examined. This study is focused on understanding the possible links between trauma exposure, PTSD and race perceptions, discrimination, and beliefs regarding race-related shootings, with a particular emphasis on the death of Michael Brown in Ferguson, Missouri.
Trauma exposure and PTSD are related to a variety of somatic complaints and increased risk for poor health outcomes. Adults who experienced trauma are more likely to experience a host of costly and chronic physical health conditions such as metabolic syndrome, heart disease, and obesity. Further, a few studies have found that individuals with PTSD are less likely to engage in exercise. It is unclear of trauma exposure is also related to changes in diet, higher BMIs, and whether individuals were engaging in exercise prior to the trauma and then subsequently discontinued their exercise use after experiencing the trauma. The aim of this study is to investigate whether trauma exposure and PTSD are risk factors for poor health behaviors.
Impact of Early Life Stress on Brain Integrity Among Adolescents with Cannabis Use Disorder (NIH 1 R03 DA042183-01A1)
Cannabis is the most widely used illicit substance in the United States. Cannabis use disorder (CUD) is one of the most common psychiatric disorders and is associated with numerous physical and psychological conditions and decreased academic and occupational achievement. However, there is high variability in cognitive functioning in individuals with CUD. Research is needed to clarify the relationship between CUD and brain integrity as white matter (WM) abnormalities and cognitive deficits have important implications for cognitive functioning and mental health. Early life stress (ELS) may alter the relationship between CUD and brain integrity. ELS is common among adolescents with CUD and is associated with the initiation and exacerbation of cannabis use and the development of CUD. However, to date, prior work has not investigated the influence of ELS on WM integrity among adolescents with CUD, which represents a critical gap in the research literature. The primary aim of this NIDA R03 grant is to investigate the impact of ELS on WM integrity and neuropsychological performance among adolescents with CUD.
Exposure to traumatic events is quite common and may result in PTSD and other trauma-related difficulties such as depression and somatic complaints. Adults who experienced trauma are more likely to experience a host of costly and chronic physical health conditions such as metabolic syndrome, heart disease, and obesity. Exercise is effective in reducing the factors that lead to these health problems; however, individuals with PTSD are less likely to engage in exercise. Exercise has demonstrated some efficacy in mitigating anxiety and depression; however, it is unclear if it can be used as a treatment for PTSD. PTSD is a complicated psychological disorder that is no longer classified as an anxiety disorder and has been found to be more difficult to treat than other disorders. Therefore the aim of this research grant is to determine if exercise a successful treatment for adults diagnosed with PTSD. This grant is investigating: 1) if exercise is a successful “stand alone” treatment for PTSD and 2) if exercise is a supplemental treatment that enhance efficacy of an evidence-based trauma-focused psychotherapy, Cognitive Processing Therapy (CPT). If exercise can be utilized to effectively treat PTSD, it may be used as a cost-effective alternative or supplemental PTSD treatment, improving the mental and physical health of individuals with PTSD.
