Common health problems in safety-net primary care: Modeling the roles of trauma history and mental health

J Clin Psychol. 2019 Jan;75(1):146-164. doi: 10.1002/jclp.22694. Epub 2018 Oct 6.

Abstract

Objective: This study described trauma exposure and investigated mediational effects of mental health on the relationships between trauma and pain, sleep, smoking, and general health.

Method: Participants were 210 low-income primary care patients. The study used a crosssectional, self-report survey design.

Results: Eighty-five percent of the sample reported adult trauma and 54% reported four or more childhood traumas. Moderate or higher depression and anxiety levels were present in 59% and 48% of participants, respectively. Structural equation model fit was good for sleep, pain, and general health, showing that trauma indirectly affected health variables via mental health.

Conclusions: Participants endorsed substantial adult and childhood trauma, which likely had cascading effects on mental health and common primary care presenting health issues.

Keywords: primary care psychology; safety net; trauma.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Adverse Childhood Experiences / statistics & numerical data*
  • Anxiety Disorders / epidemiology*
  • Cross-Sectional Studies
  • Depressive Disorder / epidemiology*
  • Female
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Poverty / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*
  • Psychological Trauma / epidemiology*
  • Safety-net Providers / statistics & numerical data*
  • Self Report
  • United States / epidemiology