David W. Foy

Bio: David W. Foy is an academic researcher from Pepperdine University. The author has contributed to research in topics: Poison control & Sexual abuse. The author has an hindex of 41, co-authored 73 publications receiving 6920 citations. Previous affiliations of David W. Foy include Fuller Theological Seminary.

Trauma and posttraumatic stress disorder in severe mental illness.

Abstract: This research assessed the lifetime prevalence of traumatic events and current posttraumatic stress disorder (PTSD) in 275 patients with severe mental illness (e.g., schizophrenia and bipolar disorder) receiving public mental health services in Concord and Manchester, New Hampshire, and Baltimore, Maryland. Lifetime exposure to traumatic events was high, with 98% of the sample reporting exposure to at least 1 traumatic event. The rate of PTSD in our sample was 43%, but only 3 of 119 patients with PTSD (2%) had this diagnosis in their charts. PTSD was predicted most strongly by the number of different types of trauma, followed by childhood sexual abuse. The findings suggest that PTSD is a common comorbid disorder in severe mental illness that is frequently overlooked in mental health settings. Language: en

Randomized Trial of Trauma-Focused Group Therapy for Posttraumatic Stress Disorder: Results From a Department of Veterans Affairs Cooperative Study

Abstract: Background Department of Veterans Affairs Cooperative Study 420 is a randomized clinical trial of 2 methods of group psychotherapy for treating posttraumatic stress disorder (PTSD) in male Vietnam veterans. Methods Vietnam veterans (360 men) were randomly assigned to receive trauma-focused group psychotherapy or a present-centered comparison treatment that avoided trauma focus. Treatment was provided weekly to groups of 6 members for 30 weeks, followed by 5 monthly booster sessions. Severity of PTSD was the primary outcome. Additional measures were other psychiatric symptoms, functional status, quality of life, physical health, and service utilization. Follow-up assessments were conducted at the end of treatment (7 months) and at the end of the booster sessions (12 months); 325 individuals participated in 1 or both assessments. Additional follow-up for PTSD severity was performed in a subset of participants at 18 and 24 months. Results Although posttreatment assessments of PTSD severity and other measures were significantly improved from baseline, intention-to-treat analyses found no overall differences between therapy groups on any outcome. Analyses of data from participants who received an adequate dose of treatment suggested that trauma-focused group therapy reduced avoidance and numbing and, possibly, PTSD symptoms. Dropout from treatment was higher in trauma-focused group treatment. Average improvement was modest in both treatments, although approximately 40% of participants showed clinically significant change. Conclusions This study did not find a treatment effect for trauma-focused group therapy. The difference between the effectiveness and adequate dose findings suggests the possible value of methods to enhance the delivery of cognitive-behavioral treatments in clinical practice settings.

An Exploration of the Viability and Usefulness of the Construct of Moral Injury in War Veterans

Abstract: It is widely recognized that, along with physical and psychological injuries, war profoundly affects veterans spiritually and morally. However, research about the link between combat and changes in...

Posttraumatic stress disorder in a national sample of female and male Vietnam veterans: risk factors, war-zone stressors, and resilience-recovery variables.

Abstract: Relationships among pretrauma risk factors (eg, family instability, childhood antisocial behavior), war-zone stressors (eg, combat, perceived threat), posttrauma resilience-recovery variables (eg, hardiness, social support), and posttraumatic stress disorder (PTSD) symptom severity were examined Data from a national sample of 432 female and 1,200 male veterans were analyzed using structural equation modeling For both genders, direct links to PTSD from pretrauma, war-zone, and posttrauma variable categories were found; several direct associations between pretrauma and posttrauma variables were documented Although war-zone stressors appeared preeminent for PTSD in men, posttrauma resilience-recovery variables were more salient for women Researchers, policymakers, and clinicians are urged to take a broad view on trauma and its sequelae, especially regarding possible multiple exposures over time and the depletion and availability of important resources

Posttraumatic stress disorder among battered women: Risk and resiliency factors.

Abstract: This study proposed that diagnosable levels of PTSD would be found among battered women and that the level of exposure to violence in the battering relationship would be an important contributing factor to the development of PTSD while other pre-trauma and post-trauma variables such as social support, intercurrent life events, religiosity, and developmental family stressors would also be related to PTSD symptom levels. Fifty-three battered women were given standardized self-report measures to assess these variables. As hypothesized, a significant proportion of battered women in the sample were diagnosed as PTSD positive. Multiple regression analyses revealed that violence exposure severity, recency of the last abusive episode, social support, intercurrent life events, intrinsic religiosity, and developmental family stressors predicted 43% of the variance in PTSD symptomatology. Language: en

Loss, Trauma, and Human Resilience Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events?

Abstract: Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology’s knowledge about how adults cope with loss or trauma has come from individuals who sought treatment or exhibited great distress, loss and trauma theorists have often viewed this type of resilience as either rare or pathological. The author challenges these assumptions by reviewing evidence that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience. M ost people are exposed to at least one violent or life-threatening situation during the course of their lives (Ozer, Best, Lipsey, & Weiss, 2003). As people progress through the life cycle, they are also increasingly confronted with the deaths of close friends and relatives. Not everyone copes with these potentially disturbing events in the same way. Some people experience acute distress from which they are unable to recover. Others suffer less intensely and for a much shorter period of time. Some people seem to recover quickly but then begin to experience unexpected health problems or difficulties concentrating or enjoying life the way they used to. However, large numbers of people manage to endure the temporary upheaval of loss or potentially traumatic events remarkably well, with no apparent disruption in their ability to function at work or in close relationships, and seem to move on to new challenges with apparent ease. This article is devoted to the latter group and to the question of resilience in the face of loss or potentially traumatic events. The importance of protective psychological factors in the prevention of illness is now well established (Taylor, Kemeny, Reed, Bower, & Gruenewald, 2000). Moreover, developmental psychologists have shown that resilience is common among children growing up in disadvantaged conditions (e.g., Masten, 2001). Unfortunately, because most of the psychological knowledge base regarding the ways adults cope with loss or potential trauma has been derived from individuals who have experienced significant psychological problems or sought treatment, theorists working in this area have often underestimated and misunderstood resilience, viewing it either as a pathological state or as something seen only in rare and exceptionally healthy individuals. In this article, I challenge this view by reviewing evidence that resilience in the face of loss or potential trauma represents a distinct trajectory from that of recovery, that resilience is more common than often believed, and that there are multiple and sometimes unexpected pathways to resilience.

The Influence of Culture, Community, and the Nested-Self in the Stress Process: Advancing Conservation of Resources Theory

Abstract: Conservation of Resources (COR) theory predicts that resource loss is the principal ingredient in the stress process. Resource gain, in turn, is depicted as of increasing importance in the context of loss. Because resources are also used to prevent resource loss, at each stage of the stress process people are increasingly vulnerable to negative stress sequelae, that if ongoing result in rapid and impactful loss spirals. COR theory is seen as an alternative to appraisal-based stress theories because it relies more centrally on the objective and culturally construed nature of the environment in determining the stress process, rather than the individual’s personal construel. COR theory has been successfully employed in predicting a range of stress outcomes in organisational settings, health contexts, following traumatic stress, and in the face of everyday stressors. Recent advances in understanding the biological, cognitive, and social bases of stress responding are seen as consistent with the original formulation of COR theory, but call for envisioning of COR theory and the stress process within a more collectivist backdrop than was first posited. The role of both resource losses and gains in predicting positive stress outcomes is also considered. Finally, the limitations and applications of COR theory are discussed.

Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults.

Abstract: Meta-analyses were conducted on 14 separate risk factors for posttraumatic stress disorder (PTSD), and the moderating effects of various sample and study characteristics, including civilian/military status, were examined. Three categories of risk factor emerged: Factors such as gender, age at trauma, and race that predicted PTSD in some populations but not in others; factors such as education, previous trauma, and general childhood adversity that predicted PTSD more consistently but to a varying extent according to the populations studied and the methods used; and factors such as psychiatric history, reported childhood abuse, and family psychiatric history that had more uniform predictive effects. Individually, the effect size of all the risk factors was modest, but factors operating during or after the trauma, such as trauma severity, lack of social support, and additional life stress, had somewhat stronger effects than pretrauma factors.

Social and Psychological Resources and Adaptation

Abstract: Psychology has increasingly turned to the study of psychosocial resources in the examination of well-being. How resources are being studied and resource models that have been proffered are consider...

Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis.

Abstract: A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met criteria for inclusion in a meta-analysis of 7 predictors: (a) prior trauma, (b) prior psychological adjustment, (c) family history of psychopathology, (d) perceived life threat during the trauma, (e) posttrauma social support, (f) peritraumatic emotional responses, and (g) peritraumatic dissociation. All yielded significant effect sizes, with family history, prior trauma, and prior adjustment the smallest (weighted r = .17) and peritraumatic dissociation the largest (weighted r = .35). The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD.