Author: Anne P. DePrince, PhD

Anne is a Professor and Chair in the Psychology Department and Director of the Center for Community Engagement to advance Scholarship and Learning (CCESL) at the University of Denver. She directs the Traumatic Stress Studies Group.

Building an Antiracist Action Plan for the Long Haul

June 3, 2020

The world has always been on fire for those who are marginalized and minoritized. Black people of all genders are murdered on the streets and in their homes. Indigenous women are killed at rates ten times the national average. Black, Indigenous, People of Color (BIPOC) are dying from COVI19 at rates that far exceed those among white people.

Maybe you just noticed the fire. Maybe you’ve fanned the flames. Maybe you want do to something about the burning.

I’m one of many well-intentioned white people who wants to do something. As the saying goes, though, the road to hell is paved with good intentions.

Some things that white people are doing are harmful and just need to stop. We have to stop asking Black people what we should do when we feel helpless or uncertain. We have to stop going into BIPOC spaces and taking over in subtle and overt ways. We have to stop seeking consolation from the people who are being oppressed when we feel painful emotions.

Unfortunately, saying what not to do doesn’t help people figure out what to do, as any psychologist can attest. And figuring out what to do in the midst of emotions and crisis is fraught with the potential to cause harm (see above).

Seems to me that we each need an intentional antiracist action plan that lays out what we personally commit to do week-by-week for the long haul — not just when headlines overwhelm us or we’re inspired to make a sign for a protest.

At my house, we’re building our action plan. There are six steps (so far). No one step is sufficient (that’s right: you’re not done after that protest you marched in last week). And still, all six steps together aren’t enough. But we have to get started somewhere.

In talking with white friends about my household’s action plan (see #6), some asked to see it. So here it is in case it can help as you make your own plan. Under each step, I’ve included suggestions, which I’ll be updating. So check back. But ultimately, you have to make your own plan that reflects your values and commitment.

1. Donate.

Got privilege? Then spend it. Figure out what donating meaningfully means for you given your life circumstances. Read what folks who think critically and thoughtfully about generational wealth and privilege have to say about donating, such as the Chinook Foundation.

2. Individual reading/watching and reflection.

People with privilege need to keep building our muscles to learn and respond reflectively so that we can listen with humility, advocate fiercely (when the space is one where we should be the ones advocating), amplify the voices of those who are marginalized and minoritized, and debate effectively.

Everything I know as an educator tells me that we each have to do our own individual and ongoing reflection. Think of this as a self-paced class in terms of reading and watching a curated list of things each week. Lives depend on this class. Take it seriously.

Reactionary reading of whatever pops up in social media feeds or perusing the newspaper doesn’t count here. Yes, we all have to stay informed of news and should be reading diverse voices for commentary and analysis. But this action item is about reading to understand the stories behind the news, to learn about the longstanding, root causes of problems. To say “I read today – check” after consuming Twitter or news headlines just doesn’t cut it.

There are lots of antiracist reading lists circulating. Check them out and make your syllabus today. For example:

3. Be counted showing up to listen to BIPOC voices.

Beyond reading in private or watching videos above, sign up and show up for forums, information sessions, or other conversations led by BIPOC communities. Be counted so that events can say X-hundred or Y–thousand people signed on to listen. And then listen as if lives depended on it.

4. Go to trainings that focus on building skills.

This is different from attending something to listen and be counted (#3 above) or reading/watching (#2 above). Those things can help develop awareness, but awareness is pretty useless without skills. We all need to build and practice skills.

Go to trainings even if they initially sound like they are (too) basic. If they turn out to be, great — then we have a chance to practice the skill of humility as we keep listening. Because here’s the reality: There is always something to learn when we engage topics that are steeped in hundreds of years of oppression, silence, and lies.

When you register, ask if you can pay for two people so that someone else can go for free (that’s an option with the Racial Equity Foundations training below, for example).

5. Direct Action.

Showing up for one-time protests can demonstrate the sheer number of people who care, build solidarity, and bring attention to problems. However, when demonstrations aren’t organized by the communities affected or around a specific solution to a problem, they risk not leading to real or sustainable change.

Focus on participating in direct actions recommended by organizations who are doing community organizing for the long haul. Check that actions are led by BIPOC individuals/organizations or those who have clear accountability to BIPOC communities, as recommended by Showing Up for Racial Justice, Denver Chapter.

Beyond figuring out who is organizing in your community and getting involved, learn how to show up for direct actions as a white person. You can read more here from Showing up for Racial Justice, Denver Chapter.

 6. Direct Talk.

The time for awkward silences, complicit gaze-aversion, or “we just don’t talk about politics” excuses among white people has long passed. White people need to talk to white people to persuade them to act in antiracist ways.

I’m asking myself to talk to white people, including those in my life who don’t share my worldview. I hope you do too.

I started with a family member whose political views are quite different from mine. When we talked the other night, I told them what I saw happening across the country. They said “well, all we can do is pray.” I said “actually, that’s not true” and rattled off a list of actions — the start of this list, as it turns out. The next morning, I sent them actions to take, framed around how they think about things (instead of only how I think about things) — that is, framed around their self interests.

Now I’m planning the next intentional conversations I’ll have with white people in my life, including those who don’t necessarily agree with me. Who will you talk to?

***

Note: Thank you to Dr. Ann Chu and Kathleen Ferrick for invaluable input on earlier versions.

Older Adult Exploitation and Housing

May 7, 2020

by Anne P. DePrince, PhD and Leslie Hasche, PhD

From the Democratic presidential debate stage to op-ed pages, the affordable housing crisis hitting communities across the country has received much needed attention.

As a trauma psychologist and social worker, we applaud the national spotlight on housing affordability. Yet, that’s only part of the conversation we need to have to develop effective housing solutions. Now we need to talk about the role that abuse and exploitation play in housing instability, from adolescence to adulthood — and as our research team recently discovered, even into older adulthood.

The vast majority of youth experiencing homelessness say they left home to escape child abuse. This is especially true for LGBTQ youth who are more likely to be abused and kicked out of their homes than their peers. Once on the streets, sexual and physical victimization is common. Victimization on the streets then contributes to serious and costly health problems, such as depression, PTSD, and substance abuse.

In adulthood, domestic violence drives housing instability and homelessness among women and their children. Women fleeing their abusers may spend time in shelters or move multiple times. Women may also face tremendous economic instability when leaving abusers, making it difficult to get basic needs met, including finding and keeping housing.

Among older adults, our team’s new research points out risks that a lack of affordable housing is poised to create a perfect storm that leads to the exploitation of older adults. Nationally, concerns for affordability and accessibility of housing for older adults is only increasing. Plus, older adults who experience homelessness also face physical and sexual victimization that could be reduced by reentering housing. Housing insecurity is a pressing issue for older adults, and it becomes more complicated by the potential risk for victimization within one’s own home.

…we have to grapple with the ways that abuse and exploitation create housing instability.

Our team reviewed police reports of abuse and exploitation of more than 500 older adults. Nearly one in ten of the police reports described situations where another person – most often a family member – was exploiting an older adult’s residence in ways that put the older adult’s housing at risk.

What we read in police reports lined up with what practitioners working with older adults to prevent and respond to elder abuse also noticed. To get a sense of these cases, imagine an adult daughter living in her aging mother’s apartment in violation of the terms of the lease, which says only the mother can live there. By violating the lease, the older adult risks eviction. That housing instability can put their psychological and physical wellbeing at risk. Once evicted, the older adult will face housing shortages. She might find herself homeless, living out of a car or moving from shelter to shelter, making it difficult or impossible to access assistive medical devises. Or imagine an adult grandchild who sells drugs out of his grandfather’s living room. The grandchild stops people from coming over to the house, including the person the grandfather called to repair the roof. Unaddressed, that small leak grows into a chronic moisture problem that affects the older adult’s health.

Researchers have long recognized that people providing care for older adults may feel entitled to their resources, which can lead to exploitation. The current shortage of affordable housing in many communities may increase the likelihood that family members and other trusted adults exploit access to older adults’ residences.

From adolescence to the older adult years, abuse and exploitation are tangled up with housing issues. Solutions to the national housing crisis cannot focus on affordability alone. Instead, we have to grapple with the ways that abuse and exploitation create housing instability. Effective housing policies have to also work to decrease child abuse and domestic violence. At the same time, housing conditions can affect risk for victimization, as seen among youth living on the streets. There are hints that older adults maybe the next group to fall victim to exploitation because of the housing crisis. We need policies that address affordability and availability of housing for all Americans across the life span at the same time as abuse and exploitation if we are to end the housing crisis in America.

***

Acknowledgements

Our research on older adults was supported by the National Institute of Justice [Grant #2013-MU-CX-0032]. The views expressed are those of the authors and do not necessarily represent the views or the official position of the National Institute of Justice or any other organization. Thank you to the Denver Forensic Collaborative for At-Risk Adults for their collaboration to make research with older adults possible, particularly Denver City Attorney’s Office (especially Linda Loflin Pettit), Denver District Attorney’s Office (especially Maro Casparian), Denver Human Services-Adult Protective Services, and Denver Police Department; and the Traumatic Stress Studies Group. 

Bringing Trauma Science to the 2020 News Cycle

May 7, 2020

The news in 2020 has been fast and furious.

In January and February, the world watched as Harvey Weinstein stood trial for (and was convicted on) multiple counts of sexual assault.

By March, our worlds were turned upside down by the coronavirus crisis.

These whirlwind events have had numerous implications for victims, survivors, and service providers. At the same time, these events can be better understood by learning from victims, survivors, and service providers. Therefore, our team has been focused on trying to bring victim-focused research into local and national conversations.

I hope you enjoy some of the TSS Group op-eds that have appeared across the country:

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Acknowledgements: The image at the top of this article is a screenshot from Newsweek.

Sexual Assault Awareness in a Pandemic

May 7, 2020

Last month’s Sexual Assault Awareness Month looked different from past years.

Instead of group shots on Denim Day, the TSS Group found ourselves piecing together photo montages from different corners of Denver and the world.

TSS Denim Day

Instead of showing up to events focused on consent or what it means to start by believing, we’ve found ourselves hanging out in virtual spaces. For example, I did a video for Denver’s Start by Believing Campaign. The video summarizes some of the advice we heard from more than 200 women who disclosed sexual assault to a victim service provider (such as medical professional, police officer, counselor, victim advocate).

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Pictures and videos are important. But they aren’t the same as talking with people about sexual assault. That’s why our team also used DU’s A Community Table program to facilitate an action-oriented online discussion about sexual assault.

A Community Table was modeled after the Chicago Community Trust’s On the Table program to promote civic and civil conversations about important public issues. The goal of DU’s program is to get people to host small-group conversations focused on issues we care about in our communities to identify ways we can work together for sustainable change. Any feedback that people share from those conversations then guides the next steps in DU’s university-wide initiative: DU Grand Challenges.

A Community Table seemed the perfect platform for conversation because we need to talk about sexual assault as much now as ever – and it is way past time for change. Turns out, that’s exactly the focus of this year’s A Community Table theme: How do we overcome barriers to take action together?

I grabbed the host guide and used the conversation prompts to talk in new ways with student researchers from our team about sexual assault. The students identified lots of barriers that they see getting in the way of people taking action around sexual assault — everything from the pressures people feel to be quiet and taboos to the impact that leaders and institutions have on amplifying or silencing conversations.

The students had some great ideas, too, for what we can do differently together. We sent those ideas to DU’s A Community Table team so that the students’ voices are part of DU Grand Challenges going forward.

A Community Table is a potentially powerful way to keep conversations going about sexual assault past April. I can attest that it’s really easy to host a conversation because the DU Grand Challenges team has built up lots of user-friendly resources. A facilitation guide suggests questions and gives tips on how to effectively facilitate online conversations. There’s a training video if you want one, information on online tools for hosting the conversation, and more!

A Community Table runs through June 11, so there’s still time to host a conversation about taking action on sexual assault — or other issues you care about. I hope you’ll check it out!

What’s in a Measure? Developing the Trauma Appraisal Questionnaire

February 4, 2020

Clinicians and researchers have long recognized that violence and abuse affect how people make meaning — of the world and themselves. For example, survivors might blame themselves or feel rage at others. Those appraisals of the trauma can, in turn, affect psychological distress and healing. Measuring appraisals, then, can be important to both clinical work and research.

What would it take, though, to develop a self-report measure of posttraumatic thoughts and feelings that clients could fill out for clinical assessments or research? Here’s your answer!

Back in 2004, we set out to design a way to quickly and easily measure survivors’ posttraumatic appraisals. We hoped having a self-report measure of appraisals would help clinicians and researchers better explore the ways that thoughts and feelings were linked to psychological distress and even physical health. Eventually, our efforts would lead to the Trauma Appraisal Questionnaire, or TAQ.

In the late 1990s, much of the traumatic stress studies field was focused on fear, anger, and horror after trauma – inspired, at least in part, by a focus on combat trauma and the criteria at the time for posttraumatic stress disorder (PTSD). Other researchers, though, were hearing from survivors of intimate violence who were grappling with feelings of betrayal, self-blame and shame.

Ever wondered what it would take to develop a self-report measure?

For example, Dr. Susan Roth (Duke University) was among those in the United States who pioneered research on sexual abuse and violence. In focus groups with women who had been sexually assaulted, Roth and colleagues heard about all sorts of reactions – many of which were also attracting the attention of other researchers, such as shame and self-blame. Roth’s team also heard women talking about feeling alienated; however, researchers rarely focused on alienation as the literature on posttraumatic thoughts and feelings grew.

Roth and her team’s approach to studying women’s thoughts and feelings after sexual violence was incredibly time intensive. Researchers had to make word-for-word transcriptions in order to carefully code the many themes that women described in focus groups and interviews. This made measuring thoughts and feelings as part of routine clinical work or research terribly infeasible. Building on Roth’s work, though, my team was interested in developing a self-report measure that would allow researchers and clinicians to readily measure survivors’ self-reports of their thoughts and emotions. We received a grant from the National Institute of Mental Health to do so.

Developing a self-report survey requires many iterative steps – and our work on the TAQ was no different. We started by asking two key questions. First, what thoughts and feelings should be included in a new measure? And second, how should those thoughts and feelings be phrased? To answer these questions, we turned to survivors. We interviewed more than 70 people who had survived all sorts of traumas, from combat and natural disasters to sexual assault, child abuse, and domestic violence. We asked them to talk about whichever thoughts and feelings were important to them — and we transcribed everything they said.

From the transcripts, we identified the thoughts and feelings that survivors had in common and that they said were important. Using interviews was an essential step in making sure that we prioritized survivors’ voices instead of relying on what thoughts and feelings researchers believed were important. We then brought survivors’ own words into the process of drafting items that could be used in the self-report measure. We checked in with expert researchers along the way to help us edit, combine, and refine what was initially a very long list of potential items for the measure.

IMG_1721

Graduate student researchers have played a critical role in our research into posttraumatic appraisals.

Once we had a strong list of items that seemed to cover the many thoughts and feelings survivors told us were important, we asked more than 700 college students to fill out a measure that listed all the items. We also asked the students about their own experiences of trauma.

And so began the process we used to determine if the items we had developed were working the way we hoped they would. For example, survivors told us self-blame was important during the interviews. Therefore, we had drafted several items that we thought measured different aspects of self-blame. With the large sample of college students who filled out the measure, we could examine patterns to figure out if people answered all of the items that we thought measured self-blame in a similar way. If, however, people answered any one item quite differently than the others, that would tell us that the item might actually be measuring something other than self-blame.

Next, we continued the process of evaluating whether the items really measured what we hoped they would measure. We invited more than 100 survivors from the community to fill out the new measure as well as take part in an interview about their thoughts and feelings. We transcribed and carefully coded survivors’ interviews to evaluate whether what they said in the interview — when they had lots of time to explain themselves — corresponded with their responses to the TAQ items. This was a critical test to see if a handful of self-report items could capture the complexity of thoughts and feelings described in an interview. The TAQ passed this critical test.

By going through this multi-year, multi-step process, we arrived at a final version of the TAQ. We also learned a lot along the way about meaning-making after intimate abuse and violence. For example, we discovered that fear, shame, self-blame, anger, betrayal, and alienation were all common appraisals described by survivors. However, survivors of interpersonal violence rarely described feeling horror, which had been central to PTSD research and diagnosis for so long.

Since we published the TAQ in 2010, other research teams have translated the measure into multiple languages. Today, the TAQ is being used around the globe to answer questions about coping and healing in the aftermath of trauma. For example, you can read more here about what a team in Northern Ireland just learned about trauma, alienation, and posttraumatic symptoms.

If you’re interested in seeing or using the TAQ, just click here.

Alienation after Trauma

February 4, 2020

Even though I had friends, I was still lonely.

My friends didn’t understand my reactions.

There was a huge void inside me.

These are some of the ways that survivors describe feeling alienated after trauma, particularly after intimate violence such as sexual assault or domestic violence.

Several years ago, we developed the Trauma Appraisal Questionnaire (TAQ), which measured alienation and other common posttraumatic appraisals (such as self-blame and shame). The alienation scale included items that reflected survivors’ experiences of being disconnected from themselves and others.

Over the years, we observed that alienation was linked with many different forms of psychological distress; whereas, other reactions, such as shame, are linked with specific kinds of distress. For example, feeling more alienated was associated with worse PTSD, depression, and dissociation symptoms. Yet, shame was linked specifically to PTSD and not to depression or dissociation. The links between alienation and posttraumatic symptoms showed up in adult and adolescent survivors of child abuse as well as domestic violence survivors.

The recurring pattern led us to ask if alienation might play a particularly important role in more severe and complex trauma responses. Thus, we tested whether alienation could distinguish people with similar trauma histories who have had different symptom trajectories as part of a collaboration with Dr. Rafaele Huntjens (University of Groningen, Holland) and Dr. Martin Dorahy (University of Canterbury, New Zealand). In a sample of people diagnosed with either PTSD or Dissociative Identity Disorder (DID), alienation appraisals distinguished the two groups. Specifically, the group diagnosed with DID reported more severe alienation than people diagnosed with PTSD. This work suggested that alienation may play a role in initiating and/or maintaining serious and complex responses to trauma.

Yet, we were left wondering if the TAQ alienation items might just be measuring something about social support, loneliness, or even just a more general difficulty identifying emotions (called alexithymia) – each of which could also be linked with posttraumatic distress. If something like social support could better explain symptoms than alienation, that would change how to make sense of the implications of the findings for coping and healing.

And that’s how we get to this issue’s new research finding!

Rachel McIlveen and Dr. Donncha Hanna brought a team together in Northern Ireland for a study that involved 100 college students as well as 93 adults seeking services who had survived trauma (McIlveen et al., 2019). They asked participants questions about trauma history, alienation, social support, loneliness, and alexithymia while also measuring PTSD and depression symptoms.

They found that alienation was associated with posttraumatic stress in both the student and clinical samples, even when they took into account social support, loneliness, and alexithymia. (You can read  about the study here.) This finding suggests that there is, indeed, something important about the feelings of disconnection that survivors experience for understanding psychological distress that can’t be explained by these other factors, such as loneliness.

These findings make me think about the actions that advocates take every day to communicate – in big and small ways – to survivors that they are not disconnected; that they are not alone; that someone does understand.

And then I think back to the Denver Triage Study, which looked at the impact of community-coordinated responses to domestic violence several years ago. Women who got phone calls from victim advocates after domestic violence had less severe PTSD and depression symptoms than women who did not receive phone calls more than a year after the violence occurred. But, the women who got the phone calls didn’t necessarily talk to the advocates who called or seek out services. So, why did a phone call make a difference?

For some women, the phone call reassured them that they were not alone. I recall a woman describing that she hadn’t answered the call or called the advocate back. Yet, she said that the call meant something to her. Because of the call, she knew people in the community cared about the violence she had survived; people cared what had happened to her; and she had somewhere to turn later as needed.

All these years after the Denver Triage Study, I can’t help but wonder if the simple dignity and humanity of someone reaching out after violence can lessen the alienation that survivors feel. And in turn, help them cope and heal in the aftermath of violence.

Reference
McIlveen, R., Mitchell, R., Curran, D., Kyer, K., Corry, M., DePrince, A.P., Dorahy, M. & Hanna, D. (advance online, November 2019). Exploring the relationship between alienation appraisals, trauma, posttraumatic stress and depression. Psychological Trauma: Theory, Research, Practice, and Policy. http://dx.doi.org/10.1037/tra0000523

 

With Sexual Assault in the Spotlight, Sharing Science

February 3, 2020
hillscreenshot

Screenshot from The Hill. Click here to read.

 

What does research have to say about common myths that might come up during sexual assault trials?

What does science have to say about so-called false memories of sexual assault?

Questions like these have come to the forefront with the start of the trial of media mogul Harvey Weinstein on multiple counts of sexual assault. Dr. Joan Cook and I set out to use research to answer these questions in two recent pieces.

The first piece, featured at The Hill, focuses on three things that we wish jurors knew about sexual assault.

convoscreenshot

Screenshot from The Conversation. Click here to read.

The second piece, which appeared last week in The Conversation, explains that science does not support claims that survivors suffer from so-called false memories of sexual assaults that never happened.

I hoped you’ll take a look at both pieces and share with your networks!