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Trauma, posttraumatic stress disorder, s Trauma, posttraumatic stress disorder, s... - PDF Document (3 M)
Trauma, posttraumatic stress disorder, suicide and aspects of well being among aboriginal adolescents in the Kimberley / Naomi Ralph
[Truncated abstract] The current research was guided by the findings of the Choose Life Report (Kimberley Aboriginal Medical Services Council [KAMSC], 1999), in which Kimberley Aboriginal youth described a context of family deaths, interpersonal violence, unsafe environments, lack of self esteem and a general sense of failure, to underlie the suicidal behaviour of peers (in 1998 suicide amongst Aboriginal youth in the region had escalated to a rate per capita 12 times the national average). The concept of cumulative trauma was introduced to represent the impact of multiple layers of trauma on the developing well being of Aboriginal adolescents in the region, and included; the adolescents chronic exposure to the trauma of significant others and the long term effects of this trauma on others, the adolescents' own direct exposure to trauma and victimisation, and the transgenerational transposition of an entity of unresolved historical trauma and grief. It was argued that the structure for transgenerational trauma was forged in colonial and post colonial periods, and that sociopolitical influences continued to exacerbate the experiences of contemporary Aboriginal children and adolescents. It was thought that the Aboriginal adolescents would report considerable lifetime direct and secondary trauma exposure, and the manner in which this was manifest in posttraumatic stress disorder (PTSD) symptoms, suicidal ideation, depression and substance misuse was to be examined. At the same time, the influence of anger, shame, coping strategies, hopelessness, self esteem and cultural identity on this dynamic were also to be explored.
The sample comprised 327 Aboriginal adolescents (M=14 years, SD=1.4 years) and 283 non- Aboriginal adolescents (M=14 years, SD=1.2 years) predominantly drawn from secondary schools (and minimally from youth oriented services) in rural towns and remote communities across the Kimberley. This sample constituted one tenth of both the estimated region Aboriginal and non-Aboriginal youth populations aged 12 to 25 years. For the population 12 to 14 years, 22% of the Aboriginal population and 45% of the non-Aboriginal populations were included (ABS 2001). After thorough consultation, a research partnership was formalised with KAMSC. A questionnaire was developed in focus groups with Aboriginal and non-Aboriginal health professionals from KAMSC, which was then trialled with their adolescent children in Broome before being piloted in a remote community. The questionnaire included specially adapted or developed measures of each indicator of trauma exposure, psychological distress and wellbeing. Parental consent was obtained prior to testing. The informed consent protocol and the questionnaire were delivered by young male and female Aboriginal research assistants, who achieved fantastic rapport with the adolescents. Post testing, participants received mental health information packs with contact details for support services. Individuals who indicated risk of self harm or sexual abuse were later seen for a brief clinical interview and appropriate referrals were made. The Aboriginal adolescents reported considerable lifetime exposure to self directed violence, interpersonal violence and unsafe environments...
Thesis (Ph.D.)--University of Western Australia, 2012
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