Alison Holman

• PhD, Health Psychology, FNP
• Professor (Full) at University of California, Irvine

Introduction: Strokes lead to acute deficits with wide-ranging severity. Genetic variation may explain some of these inter-subject differences. The current report examined the relationship that candidate genetic variants have with acute injury and acute behavioral deficits. We hypothesized that variants known to be associated with poorer stroke rec...

Background: Stroke is a major cause of long-term disability and has widely varying recovery outcomes. While clinical factors like stroke severity play a role, genetic factors are increasingly recognized as important contributors to stroke recovery. This study aims to identify genetic variants associated with recovery phenotypes through genome-wide...

Introduction: Childhood trauma exposure (CTE) is a known risk factor for poor adult mental&physical health, higher mortality, and disability. Understanding the psychosocial mechanisms by which CTE affects functional outcomes could help identify intervention targets to improve outcomes after stroke. We examine post-stroke mental health and lonelines...

COVID-19 created a health threat that discriminated by age: older adults were at greatest risk for health complications and mortality, but younger adults reported the highest rates of emotional distress. Cross-sectional studies consistently documented age differences in distress, but few studies have examined age-related differences over time. We e...

Objective: We examined whether perceived trust in media was associated with post-Hurricane Harvey traumatic stress symptoms and tested whether it buffered the association between hurricane-related media exposure and post-Hurricane Harvey traumatic stress symptoms. Method: A probability-based, representative sample of Texas residents, drawn from the...

Objetivo: Durante la pandemia de COVID-19, factores estresantes colectivos sin precedentes alteraron las asunciones de seguridad y protección. Las estrategias cognitivas, como encontrar beneficios durante la adversidad, pueden facilitar el afrontamiento en momentos de alteración social al reducir la angustia o motivar conductas protectoras de la sa...

BACKGROUND Genetic association studies can reveal biology and treatment targets but have received limited attention for stroke recovery. STRONG (Stroke, Stress, Rehabilitation, and Genetics) was a prospective, longitudinal (1-year), genetic study in adults with stroke at 28 US stroke centers. The primary aim was to examine the association that cand...

Media exposure to graphic images of violence has proliferated in contemporary society, particularly with the advent of social media. Extensive exposure to media coverage immediately after the 9/11 attacks and the Boston Marathon bombings (BMB) was associated with more early traumatic stress symptoms; in fact, several hours of BMB-related daily medi...

Objective: Betrayal Trauma Theory posits that victims of trauma are more prone to developing psychological and physical problems if the traumatic event includes the element of betrayal. We sought to evaluate the impact of betrayal trauma versus nonbetrayal trauma and no trauma exposure on the risk of patients’ reporting somatic symptoms in six doma...

Background Individuals confronting health threats may display an optimistic bias such that judgments of their risk for illness or death are unrealistically positive given their objective circumstances. Purpose We explored optimistic bias for health risks using k-means clustering in the context of COVID-19. We identified risk profiles using subject...

Introduction: The STRONG (Stroke, sTress, RehabilitatiON, and Genetics) study performed detailed behavioral phenotyping to evaluate genetic variants in relation to stroke recovery and stress responses. Methods: Adults with a new stroke enrolled at 28 US sites were assessed 4 times over 1 year. Three pre-specified gene variants (ApoE-e4, rs6265 (BDN...

Introduction: The STRONG (Stroke, sTress, RehabilitatiON, and Genetics) study has documented the role of cumulative lifetime stress/trauma exposure (LSE) in stroke recovery. Understanding the types of trauma most closely linked with functional outcomes may identify specific risk factors for stroke recovery. We examined specific types of life stress...

In several highly publicized hearings, Dr. Christine Blasey Ford and Judge Brett Kavanaugh presented two opposing accounts of an alleged sexual assault. In the wake of these proceedings, partisans appeared similarly divided in how they regarded this political event. Using a U.S. national sample ( N = 2,474) and a mixed-methods design, we investigat...

This systematic review examines the impact of parental preconception adversity on offspring mental health among African Americans (AAs) and Native Americans (NAs), two populations that have experienced historical trauma and currently experience ethnic/racial mental health disparities in the United States. PsycINFO, PubMed, CINAHL, Scopus, and Web o...

Background Stroke is a sudden-onset, uncontrollable event; stroke-related stress may impede rehabilitation and recovery. Lifetime stress may sensitize patients to experiencing greater stroke-related stress and indirectly affect outcomes. We examine lifetime stress as predictor of poststroke acute stress and examine lifetime and acute stress as pred...

When an individual or group trauma becomes a shared public experience through widespread media coverage (e.g., mass violence, being publicly outed), sharing a social identity with a targeted individual or group of victims may amplify feelings of personal vulnerability. This heightened perceived threat may draw people to engage with trauma-related m...

Over the past two decades of research, increased media consumption in the context of collective traumas has been cross-sectionally and longitudinally linked to negative psychological outcomes. However, little is known about the specific information channels that may drive these patterns of response. The current longitudinal investigation uses a pro...

Understanding population‐level variability in responses to pathogens over time is important for developing effective health‐based messages targeted at ideologically diverse populations. Research from psychological and political sciences suggests that party and elite cues shape how people respond to major threats like climate change. Research on res...

Background: Stroke is a leading cause of long-term disability. Greater rehabilitation therapy after stroke is known to improve functional outcomes. This study examined therapy doses during the first year of stroke recovery and identified factors that predict rehabilitation therapy dose. Methods: Adults with new radiologically confirmed stroke we...

Background: Stroke is a sudden-onset, unexpected life event over which individuals have little control. These features can make the experience of having a stroke extremely stressful, which may potentiate its debilitating effects. We previously identified short-term associations among lifetime stress/trauma exposure (LSE), post-stroke acute stress (...

Introduction: Measures of genetic variation have provided insight into underlying biology and treatment approaches in a number of medical sciences. The STRONG (“The Stroke, sTress, RehabilitatiON, and Genetics Study”) Study evaluated genetic polymorphisms in relation to stroke recovery. Methods: The STRONG Study recruited patients with a new stroke...

Background: Stroke is a leading cause of disability. Greater rehabilitation therapy after stroke improves functional outcomes but is often not provided. This study examined amount of rehabilitation therapy during the first year after stroke in the U.S. and identified factors that predict rehabilitation therapy dose. Methods: Adults with new radiolo...

Trauma survivors often report experiencing temporal disintegration (e.g., time slowing down, the present feeling disconnected from the past and future) during and after trauma, yet how these distorted time perceptions relate to psychological adjustment and views of the future is poorly understood. We examined the relationships between prior adversi...

Objective: The COVID-19 pandemic has generated debate as to whether community-level behavioral restrictions are worth the emotional costs of such restrictions. Using a longitudinal design, we juxtaposed the relative impacts of state-level restrictions and case counts with person-level direct and media-based exposures on distress, loneliness, and tr...

Background: The COVID-19 pandemic has affected the well-being of nursing professionals, especially long-term and acute care nurses, many of whom are nurses of color. Purpose: We examine the evidence and gaps in the literature addressing psychological well-being of racial/ethnic minority RN's in the U.S. during COVID-19. Methods: We searched ei...

Objective: During the protracted collective trauma of the COVID-19 pandemic, lay of distorted perceptions of time (e.g., time slowing, days blurring together, uncertainty about the future) have been widespread. Known as "temporal disintegration" in psychiatric literature, these distortions are associated with negative mental health consequences. H...

We examined media exposure, psychological fear and worry, perceptions of risk, and health protective behaviors surrounding the 2014 Ebola virus outbreak in a probability-based, representative, national sample of Americans (N = 3447). Structural equation models examined relationships between amount (hours/day) and content (e.g., graphic images of de...

Importance: During the past century, more than 100 catastrophic hurricanes have impacted the Florida coast; climate change will likely be associated with increases in the intensity of future storms. Despite these annual threats to residents, to our knowledge, no longitudinal studies of representative samples at risk of hurricane exposure have exam...

Rationale Coronavirus (COVID-19) disproportionately affects people of color (e.g., Black and Latinx individuals) in the U.S., increasing their morbidity and mortality relative to White people. Despite this greater threat to their well-being, the mental health impact of COVID-19 on people of color remains poorly understood. Perseverative cognition (...

Climate change is the greatest threat to global health in human history. It has been declared a public health emergency by the World Health Organization and leading researchers from academic institutions around the globe. Structural racism disproportionately exposes communities targeted for marginalization to the harmful consequences of climate cha...

Objective: Health care and non-health care essential workers working in face-to-face interactions during the coronavirus disease 2019 (COVID-19) pandemic may be vulnerable to psychosocial distress. Limited empirical research on COVID-19-related psychosocial outcomes has utilized probability-based samples including both health care and non-health ca...

Background: This systematic review explores the empirical literature addressing the association between parental preconception adversity and offspring physical health in African-American families. Method: We conducted a literature search in PubMed, Web of Science, PsycINFO, CINAHL, and Scopus through June 2021. Articles were included if they: repor...

Background: Much of human behavior revolves around use of the hand, yet distal arm motor deficits are not part of the NIH Stroke Scale (NIHSS), and so their measurement is omitted from many guidelines and care pathways. We examined the frequency of distal arm motor deficits and their functional implications. Methods: Patients in the STRONG Study we...

Introduction: The modified Rankin Scale (mRS) of clinician-rated global disability is commonly used to measure functional outcome after stroke but has limitations such as low granularity and ceiling effects. Measures of functional outcomes with higher resolution could provide improved insights into outcomes and therapeutic efficacy. Here we evaluat...

Background: Stroke is a sudden-onset, unexpected life event over which individuals have little control. These features can make the experience of having a stroke extremely stressful, which may potentiate its debilitating effects. Yet the role of lifetime stress/trauma exposure (LSE) and post-stroke acute stress (AS) have received limited attention...

Understanding psychosocial correlates of engaging in health-protective behaviors during an infectious disease outbreak can inform targeted intervention strategies. We surveyed a national probability-based sample of 6,514 Americans, with three separate, consecutive representative cohorts between March 18, 2020 and April 18, 2020, as the U.S. COVID-1...

The year 2020 has been marked by unprecedented cascading traumas, including the COVID-19 pandemic, an economic recession, race-driven social unrest and weather-related disasters. Mental health consequences of direct and media-based exposure to compounding stressors may be profound. Policymakers must act to ease the burden of trauma to protect publi...

The COVID-19 pandemic is a collective stressor unfolding over time, yet rigorous published empirical studies addressing mental health consequences of COVID-19 among large probability-based national samples are rare. Between 3/18-4/18/20, during an escalating period of illness and death in the United States, we assessed acute stress, depressive symp...

Objective: At the time, the 2016 Pulse Nightclub massacre in Orlando, Florida, was the most devastating mass shooting in the United States, with 49 people dead and dozens more injured. We examined American attitudes about gun legislation in its aftermath, paying particular attention to the importance of media exposure to the event. Method: Starting...

Humans seek consistency between their internal thoughts and the outside world. Thus, when legal authorities make decisions, people are likely to accept and obey these decisions in order to remain consistent with the societies in which they live. Few studies have explored these biases in an applied context. We examined the relationship between the s...

Collective trauma, like the COVID-19 pandemic, can dramatically alter how we perceive time and view our futures. Indeed, the pandemic has challenged us to cope with an ambiguous, invisible threat that has changed our way of life and made our futures, both near and far, less certain. In this commentary, we review existing literature on time percepti...

Indirectly experienced negative life events are not considered Criterion A traumatic events per DSM‐5 posttraumatic stress disorder diagnostic criteria, yet individuals indirectly exposed to trauma via the media may report these events as peak traumatic experiences. We studied which events people considered to be the “worst” in their lifetimes to g...

The 2019 novel coronavirus (COVID-2019) has led to a serious outbreak of often severe respiratory disease, which originated in China and has quickly become a global pandemic, with far-reaching consequences that are unprecedented in the modern era. As public health officials seek to contain the virus and mitigate the deleterious effects on worldwide...

Background: Negative childhood experiences are associated with poor health and psychosocial outcomes throughout one's lifespan. Objective: We examined associations between childhood bullying and maltreatment and several adulthood outcomes: psychological distress, functional impairment, generalized fear, and physician-diagnosed mental and physica...

Media exposure to collective trauma is associated with acute stress (AS) and posttraumatic stress symptoms (PTSS). Qualities of media exposure (e.g., amount, graphic features) contributing to this distress are poorly understood. A representative national sample (with New York and Boston oversamples; N = 4,675) completed anonymous, online surveys 2...

Objective: The objective of the study was to explore how type and timing of prior negative life experiences (NLEs) may be linked to responses to subsequent collective trauma, such as a terrorist attack. Method: Using a longitudinal design, we examined relationships between prior NLEs and responses to the 2013 Boston Marathon bombings (BMB). Shortly...

The established link between trauma-related media exposure and distress may be cyclical: Distress can increase subsequent trauma-related media consumption that promotes increased distress to later events. We tested this hypothesis in a 3-year longitudinal study following the 2013 Boston Marathon bombings and the 2016 Orlando Pulse nightclub massacr...

In the wake of collective traumas and acts of terrorism, media bring real graphic images and videos to TV, computer, and smartphone screens. Many people consume this coverage, but who they are and why they do so is poorly understood. Using a mixed-methods design, we examined predictors of and motivations for viewing graphic media among individuals...

Importance Exposure to disaster-related media coverage is associated with negative mental health outcomes. However, risk factors that render individuals vulnerable to this exposure are unknown. Hurricane-associated media exposure was expected to explain the association between forecasted posttraumatic stress (PTS) and adjustment after the hurricane...

People often perceive that their homes provide refuge from stress, but some homes may provide more stress-buffering resources than others. In particular, single-family homes may provide greater resources, such as status or defensible territory, compared to multi-family homes. Given historical links among gender, home-based status, and territory def...

Objective: Disasters are place-based traumatic events, yet contemporary understandings of disaster recovery often do not consider the role of community organizations. We examine organization type and proximity as they relate to post-disaster mental health in a longitudinal study following the 2013 Boston Marathon bombings. Method: Residents of m...

How does media coverage of traumatic events affect people? Do their different political affiliations have anything to do with their mental health? We analyzed over 4,500 individuals’ responses in the aftermath of two collective traumatic events: Boston Bombings (2013) and Ebola outbreak (2014). The poster shows how party affiliation moderates the e...

Objective: Ebola media coverage directed public attention to potential disease carriers: residents or travelers from West Africa. We investigated the role of neighborhood population factors (i.e., the concentration of West African foreigners, non-West African foreigners, non-Hispanic Blacks) on individual responses to the Ebola outbreak in the Uni...

Background and purpose: High acute stress may presage the development of subsequent cardiovascular ailments. Understanding how best to assess acute stress may inform early interventions seeking to prevent long-term morbidity/mortality following stroke. A mixed methods approach examined early post-stroke acute stress symptoms using the post-traumat...

Ebola was the most widely followed news story in the United States in October 2014. Here, we ask what members of the U.S. public learned about the disease, given the often chaotic media environment. Early in 2015, we surveyed a representative sample of 3,447 U.S. residents about their Ebola-related beliefs, attitudes, and behaviors. Where possible,...

Covering both natural and man-made scenarios including war and terrorism, the Textbook of Disaster Psychiatry is a vital international reference for medical professionals, community leaders and disaster responders a decade after its initial publication. Spanning a decade of advances in disaster psychiatry, this new and updated second edition brings...

The 2014 Ebola crisis received unprecedented media attention in the United States, despite low risk of transmission. We examined theoretically derived correlates of psychological response to the crisis, including Ebola-related media exposure, prior mental health history, and stress response to a recent prior collective trauma (the 2013 Boston Marat...

Terrorist attacks target innocent civilians, spreading fear and anxiety throughout the population. Postattack, many people exhibit resilience, yet deleterious physical and mental health outcomes are also common. Directly exposed individuals may experience significant physical, mental, and/or social injury. Indirect exposure (i.e., media-based) diff...

Traditional and new media inform and expose the public to potentially distressing graphic content following disasters, but predictors of media use have received limited attention. We examine media-use patterns after the Boston Marathon bombings (BMB) in a nationally representative U.S. sample (n=2,888), with representative oversamples from metropol...

Despite the prominence of time in influential aging theories and the ubiquity of stress across the life span, research addressing how time perspective (TP) and adversity are associated with well-being across adulthood is rare. Examining the role of TP in coping with life events over the life span would be best accomplished after large-scale populat...

Stroke remains a major source of adult disability in the USA and worldwide. Most patients show some recovery during the weeks to months following a stroke, but this is generally incomplete. An emerging branch of therapeutics targets the processes underlying this behavioral recovery from stroke toward the goal of reducing long-term disability. A key...

Traumatic events can profoundly affect perceptions of time with significant impacts—altered time perspective (TP) promotes peritraumatic dissociation, a component of acute stress and predictor of posttraumatic stress disorder. Social relationships also play a critical role in shaping how we respond to trauma. This chapter explores the interplay bet...

The role of repeated exposure to collective trauma in explaining response to subsequent community-wide trauma is poorly understood. We examined the relationship between acute stress response to the 2013 Boston Marathon bombings and prior direct and indirect media-based exposure to three collective traumatic events: the September 11, 2001 (9/11) ter...

Research conducted in the early years after the September 11, 2001 (9/11) terrorist attacks demonstrated that both directly and indirectly-exposed Americans experienced adverse psychological outcomes. However, little is known about the impact of this collective trauma over time. Beginning in December, 2006, a 3-year longitudinal study of a national...

Objective Trauma exposure can precipitate acute stress (AS) and cardiovascular disorders (CVD). Identifying AS-related physiologic changes that affect CVD risk could inform development of early CVD prevention strategies. The endocannabinoid system (ECS) regulates hypothalamic-pituitary-adrenal axis and stress-related cardiovascular function. We exa...

Significance Media coverage of collective traumas may trigger psychological distress in individuals outside the directly affected community. We examined whether repeated media exposure to the Boston Marathon bombings was associated with acute stress and compared the impact of direct exposure (being at/near the bombings) vs. media exposure (bombing-...

Objective: Stressful life events experienced during childhood and as an adult negatively impact mental and physical health over the life span. This study examined polymorphisms from 2 hypothalamic-pituitary-adrenal axis-related genes previously associated with posttraumatic stress disorder-FKBP5 and CRHR1-as moderators of the impact of child abuse...

Millions of people witnessed early, repeated television coverage of the September 11 (9/11), 2001, terrorist attacks and were subsequently exposed to graphic media images of the Iraq War. In the present study, we examined psychological- and physical-health impacts of exposure to these collective traumas. A U.S. national sample (N = 2,189) completed...

Child abuse substantially increases the risk for impaired physical and psychological health in adulthood (Dong et al., 2004). Increased vulnerability to mental and physical health problems may occur through stress-related biological processes, such as dysfunctional growth, development, or activation of the brain’s stress response system—the hypotha...

Negative social interactions (e.g., social conflict) influence both cardiovascular disorders (CVD) and depression but the pathways underlying these associations remain unclear. Given the known comorbidity between CVD and depression, it seems plausible that negative interactions trigger physiologic processes common to both ailments. Yet some individ...

@ Purpose/Aims: This presentation highlights the collaboration between the Nursing Science faculty at (blinded) CTSA across the campus, with the goal of providing examples of how nursing can have a strong voice in their own CTSAs. Rationale/Background: With funding by NIH of CTSAs across the country, nurse scientists must be vigilant about beco...

We examined whether the oxytocin receptor gene (OXTR) single nucleotide polymorphism (SNP) rs53576 genotype buffers the combined impact of negative social environments (e.g., interpersonal conflict/constraint) and economic stress on post-traumatic stress (PTS) symptoms and impaired daily functioning following collective stress (September 11th terro...

Providing help or support to others buffers the associations between stress and physical health. We examined the function of the neurohormone oxytocin as a biological mechanism for this stress-buffering phenomenon. Participants in a longitudinal study completed a measure of charitable behavior, and over the next two years provided assessments of st...

Cardiovascular disorders (CVD) are associated with acute and posttraumatic stress responses, yet biological processes underlying this association are poorly understood. This study examined whether renin-angiotensin-aldosterone system activity, as indicated by a functional single nucleotide polymorphism (SNP) in the angiotensin converting enzyme (AC...

Genetic and genomic research is transforming health care decision-making, clinical treatment, and management of a vast array of health issues. As primary healthcare providers, professional nurses educate patients about both their risk for disease and the recommended treatment options. Thus, understanding how findings from laboratory-based genomic r...

Genetic markers of acute stress: From genetic testing to secondary prevention Background: Acute and posttraumatic stress can increase vulnerability to cardiovascular disorders (CVD). Identifying physiologic systems underlying the association between acute stress and CVD could open avenues for early secondary prevention of trauma-related CVD. Ai...

Oxytocin, vasopressin, and their receptor genes influence prosocial behavior in the laboratory and in the context of close relationships. These peptides may also promote social engagement following threat. However, the scope of their prosocial effects is unknown. We examined oxytocin receptor (OXTR) polymorphism rs53576, as well as vasopressin rece...

A repeat-length polymorphism of the serotonin promoter gene (5-HTTLPR) has been associated with depression and posttraumatic stress disorder (PTSD) in trauma-exposed individuals reporting unsupportive social environments. We examine the contributions of the triallelic 5-HTTLPR genotype and social constraints to posttraumatic stress (PTS) symptoms i...

The September 11, 2001 terrorist attacks (9/11) presented a unique opportunity to assess the physical health impact of collective stress in the United States. This study prospectively examined rates of physical ailments and predictors of health care utilization in a U.S. nationally representative sample over three years following the attacks. A sam...

Researchers have identified health implications of religiosity and spirituality but have rarely addressed differences between these dimensions. The associations of religiosity and spirituality with physical and mental health were examined in a national sample (N = 890) after the September 11, 2001 terrorist attacks (9/11). Health information was co...

Nurses often help patients cope with loss. Recent research has cast doubt on the validity of early theories about loss and grief commonly taught to nurses. We systematically examined the accuracy of information on coping with loss presented in 23 commonly used undergraduate psychiatric nursing books. All 23 books contained at least one unsupported...

Exposure to adverse life events typically predicts subsequent negative effects on mental health and well-being, such that more adversity predicts worse outcomes. However, adverse experiences may also foster subsequent resilience, with resulting advantages for mental health and well-being. In a multiyear longitudinal study of a national sample, peop...

Previous research has demonstrated an association between lifetime exposure to adverse events and chronic back pain (CBP), but the nature of this relationship has not been fully specified. Adversity exposure typically predicts undesirable outcomes, suggesting that lack of all adversity is optimal. However, we hypothesized that among individuals fac...

Approximately 2 weeks after September 11th, adolescents from a national sample of households who were indirectly exposed to the terrorist attacks through the media completed a Web-based survey that assessed event-related acute stress symptoms. One year later, these adolescents (N = 142) and a randomly selected parent from their household completed...

Time perspective (TP) is a pivotal cognitive process through which people perceive, interpret, and negotiate their physical and social worlds. This study identifies unique patterns in the quality of social relationships that were associated with different TP dimensions. Low support and high conflict with family characterized past-negative TP. Large...

Individuals frequently perceive positive changes in themselves following adversity; after a collective trauma, they may perceive such benefits in others or in their society as well. We examined perceived benefits of the September 11, 2001 (9/11) terrorist attacks in a 3-year study of a national sample of adults (N = 1382). Many individuals (57.8%)...

A longitudinal investigation of psychological responses to the September 11, 2001 terrorist attacks was conducted on a U.S. national probability sample. Using an anonymous Web-based survey methodology, data were collected among over 1,900 adults at 2 weeks and 12 months post-9/11 to consider whether direct and proximal exposure were necessary preco...

The ability to make sense of events in one's life has held a central role in theories of adaptation to adversity. However, there are few rigorous studies on the role of meaning in adjustment, and those that have been conducted have focused predominantly on direct personal trauma. The authors examined the predictors and long-term consequences of Ame...

Collective traumas can negatively affect large numbers of people who ostensibly did not experience events directly, making it particularly important to identify which people are most vulnerable to developing mental and physical health problems as a result of such events. It is commonly believed that successful coping with a traumatic event requires...

The authors conducted confirmatory factor analyses of reports of posttraumatic stress reactions using a national probability sample of individuals indirectly exposed to the terrorist attacks of September 11, 2001 (n = 675). Reactions at three time points in the year after the attacks were best accounted for by a lower-order, 4-factor solution (Reex...