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What should we prioritize in addressing mental health after trauma?

Sexual assault is a common form of trauma with significant consequences for survivors. My research has demonstrated that sexual assault is associated with increased risk for a variety of mental disorders, including PTSD, depression, and anxiety.

Many trauma survivors with PTSD also have substance use disorders, and my research has explored associations between these conditions. For example, my research demonstrates that cannabis use may fluctuate in response to long-term patterns of PTSD symptoms rather than daily PTSD symptom fluctuation. In addition, my work suggests that the functional relationship between PTSD and substance use may differ across substances.

What she found, Dworkin says, is strong evidence that sexual assault is associated with an increased risk for multiple forms of psychological harm ‘across most populations, assault types and methodological differences in studies.’
— NPR, 2018
A 2009 literature review in the journal Trauma, Violence & Abuse by Rebecca Campbell, Emily Dworkin and Giannina Cabral found ‘rape is one of the most severe of all traumas, causing multiple, long-term negative outcomes.’
— Washington Post, 2018

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How can friends, family members, and romantic partners promote healing?

Trauma recovery unfolds in social contexts that vary in their helpfulness to trauma survivors.

Many survivors turn to their friends, family, and others for support. For these survivors, their loved ones can provide much-needed support, but may also offer problematic social reactions like blame, encouragement to avoid trauma reminders, or discouragement from accessing needed services. This may be particularly true for highly-stigmatized traumas like sexual assault. My research demonstrates that, across studies, these negative reactions are associated with mental health problems cross-sectionally and longitudinally.

For those who do not directly reach out to their social supporters for help or stop disclosing, social contexts can still affect recovery processes by, for example, communicating social norms about trauma or help-seeking, encouraging emotional avoidance or other unhelpful coping strategies, or providing ongoing social support. In addition, clients’ ability to benefit from treatment for trauma-related psychopathology likely is affected by their social contexts.

Thus, my work investigates the role of social contexts in trauma recovery with the goal of informing clinical interventions that target social contexts to mitigate the harm of trauma.

Dr. Emily Dworkin...who researches the use of social support among trauma victims, explained that trauma survivors can regain a sense of power over their experience when they ‘feel through those tough feelings’ instead of tuning out.
— New York Times, 2018

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How can trauma survivors get effective help when gold-standard treatments are hard to access?

Although highly effective treatments for posttraumatic stress and other trauma-related disorders exist, few survivors have access to these treatments.

In both my research and applied work, I am interested in identifying innovative ways to increase trauma survivors’ access to cognitive-behavioral approaches, given that these treatments have the strongest evidence for their ability to reduce symptoms quickly and permanently.

Potential avenues to increase the reach of these interventions include designing technologically-based interventions, delivering targeted prevention strategies, and training laypeople to provide evidence-based peer support.