Posttraumatic stress symptoms in context: Examining trauma responses to violent exposures and homicide death among Black males in urban neighborhoods.

Abstract

Concentrated disadvantage in urban communities places young Black men at disproportionate risk for exposure to violence and trauma. Homicide, a health disparity, positions Black males vulnerable to premature violent death and traumatic loss, particularly when peers are murdered. Posttraumatic stress disorder (PTSD) has been demonstrated as a health consequence for middle-income and White homicide survivors; however, understandings of traumatic stress among young Black men situated in contexts of chronic violence exposure remains limited. Guided by phenomenological variant of ecological systems theory (PVEST), the current study used in-depth qualitative interviews (average length: 90 min) to examine the presence and expression of traumatic stress symptoms among 37 young Black men (18-24) in Baltimore who experienced the homicide death of a loved one. Participants were recruited over 18 months through fieldwork at a large organization that serves Baltimore youth and young adults. Confidential participant interviews were audio recorded, transcribed verbatim, coded, and analyzed in ATLAS.ti. Pseudonyms were assigned to all participants. More than 70% of participants reported experiencing 2 or more Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V)-defined posttraumatic stress symptoms. Hypervigilance was most frequently experienced and expressed as being on point. Findings identify the prevalence of traumatic stress symptoms among young Black men in urban contexts; identify contextually specific expressions of traumatic stress; and, present implications for the mental health and clinical treatment of Black males living in environments where no "post" exists. (PsycINFO Database Record

Examining a Dual‐Process Model of Desensitization and Hypersensitization to Community Violence in African American Male Adolescents

“…For example, ECV is associated with alterations in salivary cortisol responses (Aiyer, Heinze, Miller, Stoddard, & Zimmerman, 2014;Kliewer, 2016;Peckins, Dockray, Eckenrode, Heaton, & Susman, 2012;Suglia, Staudenmayer, Cohen, & Wright, 2010) and more self-reported hyperarousal symptoms (Fowler et al, 2009;Margolin & Gordis, 2000;Mazza & Reynolds, 1999;Paxton, Robinson, Shah, & Schoeny, 2004;Singer, Anglin, Song, & Lunghofer, 1995) in African American adolescents. Further, the most commonly experienced symptom of PTSD in young adult African American men is physiological hyperararousal, exhibited in direct response to the threat of community violence (Rich & Grey, 2005;Smith & Patton, 2016).…”

The Code of the Street Fights Back! Significant Associations with Arrest, Delinquency, and Violence Withstand Psychological Confounds

“…This suggests that more universal antisocial features not specific to a street code are also driving violent responses to interpersonal affronts and disputes. In a qualitative study of young, African American males who were co-victims of homicide, [31] reported high prevalence of Posttraumatic Stress Disorder (PTSD) symptoms, including acute stressors (100% prevalence), intrusion/thought intrusion (46% prevalence), avoidance (46% prevalence), negative alterations in cognition and mood (65%), and alterations in arousal and reactivity/hypervigilance (68%). Although code of the street normative valuations were present in their data, their study reveals that exposure to acute levels of crime, disorder, and violence works to cultivate a psychological state where violence is often potentiated.…”

Experiences and Strategies of Young, Low-Income, African-American Men and Families Who Navigate Violent Neighborhoods and Low-Performing Schools

“…Studies have consistently found a relationship between exposure to violence in the neighborhood and poorer mental health [12][13][14]. In a qualitative systematic review of the literature on high-risk urban neighborhoods and exposure to violence, authors found that young African-American men had higher rates of depression and psychological distress, but called for more research on the specific variables and pathways in those neighborhoods that predict poor mental health [12].…”

“…In a qualitative systematic review of the literature on high-risk urban neighborhoods and exposure to violence, authors found that young African-American men had higher rates of depression and psychological distress, but called for more research on the specific variables and pathways in those neighborhoods that predict poor mental health [12]. Smith conducted a qualitative study of the symptoms of post-traumatic stress disorder (PTSD) discussed by young, African-American men who have lost a loved one to homicide, and found that more than 70% of those youth identified symptoms of PTSD, and most frequently, the need to be on point or hypervigilant [13]. Additionally, in a quantitative study of Black youth, Assari found that adolescent African-American males who reported living in unsafe neighborhoods were at greater risk for major depressive disorder (MDD) than African-American females and Caribbean Black males and females [14].…”