A National Longitudinal Study of Community Trauma Exposure

以社区为基础的创伤是流行病和反复发生的，对个人福祉和社会资源造成严重负担。然而，令人惊讶的是，很少有研究考虑到集体和个人压力的累积暴露如何有助于随着时间的推移而调整模式。社区创伤的影响既可以跨越物理边界，也可以跨越时间边界，广泛的媒体报道将创伤的影响远远传播到直接接触的人群之外，并挑战创伤暴露的传统观点。设计和实施关于集体创伤的研究需要克服这些事件的根本不可预测性造成的艰巨的科学和后勤挑战。以前的研究考察了对社区创伤的适应，通常涉及回忆发生很长时间后的事件，这使得很难消除创伤对后续适应的影响。为了能够得出关于长期创伤反应的更可靠的结论，需要有一个大样本，其中收集了关于事件前心理和身体健康的信息，以及在创伤反应的急性时期对心理反应的基线评估。拟议的工作提供了这样一个机会，利用调查人员在收集了健康和创伤暴露的具有代表性的大样本后进行的先前研究。因此，拟议的工作提供了一个极好的机会来检查个人在较长一段时间内对反复直接和间接暴露于恐怖主义和其他个人和集体创伤的反应。调查人员之前的工作涉及进行一项具有全国代表性的大型纵向研究(包括对波士顿和纽约地区进行过抽样)，在波士顿马拉松爆炸事件(BMB)之后立即对个人进行调查，并在BMB的6个月和12个月周年纪念日上另外两次进行调查。拟议的工作提供了一个独特的机会，可以收集关于这一样本的另外两波数据，以便跟踪随着时间的推移对个人和集体应激源的持续直接和间接暴露，以及它们在调整中的作用。这项研究有三个主要目的：1)前瞻性地调查不同类型的创伤暴露(即基于直接和间接媒体的)如何与集体应激后的长期适应模式(例如BMB)相关联；2)调查先前个人或集体创伤的累积暴露是否使个人对后续事件的负面后果敏感或使其免受后续事件的负面后果的影响；以及3)前瞻性地调查BMB后创伤暴露(例如直接、间接、个人和集体)在多大程度上解释了随时间推移与BMB相关的急性应激反应和适应之间的预测关联。这项研究将增进对个人如何应对集体创伤和高压力事件的了解，进一步了解受恐怖主义创伤的个人的独特需求，无论是直接的，还是间接的，通过接触媒体报道。这项工作将提供信息，帮助确定重大创伤事件后面临后续困难风险的人。此外，这项工作对于指导人们为集体创伤做好准备并帮助他们应对后果的理论和实践具有重要意义。这些发现还将增加知识基础，帮助政策制定者、服务提供商和社区领导人设计具有成本效益并对民众需求敏感的教育和干预努力。

Community-based traumas are pandemic and recurring, profoundly taxing individual well-being and societal resources. Yet surprisingly few studies have considered how cumulative exposure to collective and individual stressors may contribute to patterns of adjustment over time. Effects of community traumas can span physical boundaries as well as temporal boundaries, with widespread media coverage transmitting a trauma's impact far beyond the directly exposed population, and challenging the traditional view of trauma exposure. Designing and implementing research on collective traumas requires overcoming formidable scientific and logistical challenges resulting from the fundamental unpredictability of these events. Previous studies that have examined adjustment to community traumas usually involve recalling events long after it occurred, making it difficult to disambiguate the effects of trauma on subsequent adjustment. To be able to draw more solid conclusions about long-term trauma reactions requires having a large sample in which information about pre-event mental and physical health, and baseline assessments of psychological responses have been collected during the acute period of trauma response. The proposed work provides such an opportunity by leveraging the investigators' previous research following a large representative sample for which health and trauma exposure was collected. As a result, the proposed work provides a remarkable opportunity to examine how individuals respond over an extended period of time to repeated direct and indirect exposure to terrorism and other individual and collective traumas.Previous work by the investigators involved conducting a large, nationally representative longitudinal study (including oversampling of Boston and New York areas) in which individuals were surveyed immediately after a traumatic collective trauma, the Boston Marathon Bombings (BMB), and at two additional times, on the 6- and 12-month anniversaries of the BMB. The proposed work provides a unique opportunity to collect two additional waves of data on this sample in order to track ongoing direct and indirect exposure to individual and collective stressors, and their role in adjustment, over time. The research has three primary aims: 1) To investigate prospectively how different types of trauma exposure (i.e., direct vs. indirect media-based) are associated with patterns of long-term adjustment after collective stress (e.g., the BMB); 2) To investigate whether cumulative exposure to prior individual or collective traumas sensitizes individuals to or inoculates them against the negative consequences of subsequent events; and 3) To investigate prospectively the extent to which post-BMB trauma exposure (e.g., direct, indirect, individual, collective) explains predicted associations between acute BMB-related stress response and adjustment over time. This research will advance knowledge of how individuals cope with collective traumas and highly stressful events, furthering understanding of the unique needs of individuals traumatized by terrorism, both directly, and indirectly, via exposure to media coverage. Such work will provide information to help identify those at risk for subsequent difficulties following major traumatic events. Moreover, the work has important implications for informing the theory and practice of preparing people for collective traumas and helping them cope with the aftermath. These findings will also add to the foundation of knowledge for helping policymakers, service providers, and community leaders design educational and intervention efforts that are cost-effective and sensitive to the needs of the populace.