Emma C. Lathan

• PhD
• Professor (Assistant) at Auburn University

Aims: A mixed-methods study details a multidisciplinary team's efforts to assess and transform police response to sexual assault in a mid-size community. Method: A police department-wide survey (n = 331) determined baseline levels of officer exposure to trauma-informed training, rape myth acceptance, and awareness of community and nationwide sex...

Low rates of reporting sexual assault to law enforcement have been attributed to a culture of rape myth acceptance. Yet, rape myth acceptance rates and specific barriers to reporting have not been examined by sexual assault and reporting histories. This study compared the rape myth acceptance levels of reporting survivors, non-reporting survivors,...

Despite serving patients with especially high rates of trauma exposure and related sequelae, many primary care providers do not receive specialized training in the provision of trauma-informed care (TIC). This study sought to document primary care providers' baseline rates of TIC training and their knowledge, perceptions, and practice of TIC at a l...

The BITTEN theoretical framework conceptually links patient’s past healthcare betrayal and trauma experiences with their current and future healthcare interactions. BITTEN was used to examine whether healthcare experiences, behaviors, and needs differ between those with and without a history of sexual violence exposure. College students at two publ...

Objective: Suicide rates for Black Americans continue to increase, pointing to the need for additional research on potential risk factors for suicidal ideation and attempts in this population. While race-related stress and dissociation symptoms are consistently associated with suicidal ideation and attempts, the indirect effect of race-related stre...

Sexual assault case attrition is significant during the judicial process, necessitating a better understanding of how juror-level factors, such as personal connection to sexual assault, impact rape myth beliefs and conviction decisions. Our study examined the differential influence of mock jurors’ degree of personal connection tosexual assault—via...

A BSTRACT Introduction Patients seeking primary care often present with health concerns related to psychological trauma, highlighting the importance of health care providers’ (HCPs) comfort discussing trauma in the primary care setting. This study used mixed methods, including qualitative content analysis, to (1) document HCPs’ trauma-related comf...

Low-income, urban-dwelling Black adults are disproportionately affected by traumatic experiences, post-traumatic stress disorder (PTSD), and depression and encounter inequities in treatment access. In addition to the benefits Mindfulness-Based Cognitive Therapy (MBCT) for depression, there is preliminary evidence of successful symptom reduction in...

Objective: Public health systems need evidence-based, feasible, and acceptable preventive interventions for trauma-exposed Black Americans. Self-compassion often serves as a protective factor following trauma exposure, but whether it alleviates risk for posttraumatic stress disorder (PTSD) symptoms and the extent to which it buffers against the del...

Black pregnant and postpartum individuals are at risk for intimate partner violence (IPV), and those with a history of childhood maltreatment and IPV are even more likely to be re-victimized during pregnancy. However, it is unknown if specific types of child maltreatment predict later IPV with and without a weapon better than others. The current st...

Mindfulness-based cognitive therapy (MBCT) offers promise as a group-based intervention to alleviate posttraumatic stress disorder (PTSD) and depression symptoms in traumatized Black adults. Given the high level of barriers that exist for low-income Black adults, virtual delivery of MBCT may be helpful. This pilot randomized controlled trial assess...

Background: Although trauma exposure is universally prevalent, the ways in which individuals respond to potentially traumatic events vary. Between-country differences have been identified as affecting the development and manifestation of transdiagnostic psychological symptoms, but it remains unclear how stress and trauma-related transdiagnostic sym...

Trauma-informed care (TIC) training may be valuable for patient-facing health care providers within primary care in urban health care settings serving patients with high levels of trauma exposure. This study tested the pilot effectiveness of a clinic-wide TIC initiative to enhance providers’ knowledge, comfort in caring for trauma-exposed patients,...

Objective: Black pregnant individuals are at disproportionate risk for posttraumatic stress disorder (PTSD) compared to other groups. A wealth of literature suggests racial stress contributes to this inequity, but cultural and structural mechanisms, such as perceived barriers to mental health treatment, underlying the relationship between racial st...

Racially minoritized women with limited socioeconomic resources are at increased risk for adverse psychological outcomes in response to the coronavirus disease 2019 (COVID‐19) pandemic. Disproportionate rates of trauma exposure and economic insecurity likely heighten risk for these outcomes among socioeconomically vulnerable individuals, but the un...

Experiencing racism is linked to lower subjective social status (SSS), defined as one's perception of their position in society. SSS is influenced by power, prestige, and objective socioeconomic status (SES). Previous findings suggest that race-related stress may be related to adverse mental health outcomes through SSS in Black Americans, a populat...

Background: Moral injury references emotional and spiritual/existential suffering that may emerge following psychological trauma. Despite being linked to adverse mental health outcomes, little is known about the neurophysiological mechanisms of this phenomenon. In this study, we examined neural correlates of moral injury exposure and distress usin...

Appraisal of trauma is a critical factor in the development of impairing post-traumatic stress symptoms, such as dissociation. Individuals may appraise trauma as morally injurious (i.e., moral injury exposure [MIE]) and experience subsequent moral distress related to this exposure (i.e., moral injury distress [MID]). To date, however, investigation...

Black individuals are at particularly high risk for birth-related posttraumatic stress disorder (PTSD) symptoms, in part due to a lack of opportunity to lead maternity care decisions. Maternal care providers need evidence-based ways to reduce pregnant persons' risk for birth-related PTSD symptoms despite reduced autonomy in decision making resultin...

Background: Dissociative and posttraumatic stress disorder (PTSD) symptoms are commonly co-occurring responses to psychological trauma. Yet, these two groups of symptoms appear to be related to diverging patterns of physiological response. To date, few studies have examined how specific dissociative symptoms, namely, depersonalization and derealiz...

Background: Although exposure to potentially traumatic events (PTEs) for Black and Latinx may be comparable or lower than their White counterparts, type of trauma experiences differ such as more interpersonal trauma and violence reported by Black people, who also experience higher rates of PTSD. In this retrospective study, we examined the associat...

Despite prevalent trauma exposure among patients seeking health care, as well as widespread frameworks for enacting trauma-informed care, the uptake of trauma-informed practices such as trauma screening and referral among health-care providers remains relatively low. The current study sought to assess the roles of health-care providers' personal hi...

The properties and utility of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) remain unstudied in community-based populations. This study evaluates the performance of the PC-PTSD-5 to determine whether it can be used as a brief alternative to the PTSD Checklist for DSM-5 (PCL-5) in a large public hospital in the southeastern United States. Parti...

The co-occurrence of substance use disorder (SUD) and posttraumatic stress disorder (PTSD) is common, and is associated with greater severity of symptoms, poorer treatment prognosis, and increased risk of return to substance use following treatment. Screening for PTSD is not routinely implemented in substance use treatment programs, despite clinica...

Objective: There is support for the use of mindfulness-based approaches with trauma-exposed adults. However, limited data are available on feasibility and acceptability of group-based mindfulness interventions in urban medical clinics serving primarily Black adults with low socioeconomic resources, where rates of trauma exposure are high. The prese...

Past findings have indicated that sexual and gender minority (SGM) individuals experience disproportionate rates of emotional, physical, and sexual assault compared to their heterosexual/cisgender counterparts. While these findings are robust, many studies report homogenous groupings of SGM participants. This practice likely masks important between...

Healthcare-related institutional betrayal has been used to examine how patients' previous negative healthcare experiences influence their current provider-level trust and future interactions with the healthcare system. However, healthcare-related institutional betrayal has rarely been considered among emerging independent users of the healthcare sy...

Background Moral injury exposure (MIE) and distress (MID) may indirectly affect the relationship between trauma exposure and alterations in autonomic regulation [assessed via high-frequency heart rate variability (hfHRV)] in civilians, but this has not been tested in prior research. We conducted two exploratory studies to examine trauma types' asso...

There is debate about the validity of the complex posttraumatic stress disorder (CPTSD) diagnosis and whether disturbances in self-organization (DSO) in CPTSD can be differentiated from borderline personality disorder (BPD). How PTSD is defined may matter. The present study used exploratory structural equation modeling (ESEM) to replicate and exten...

The present study examined pornography viewing, rape myth acceptance, and sexist attitudes. Data came from 392 male and 903 female participants. Multigroup SEM indicated neither pornography viewing, nor hardcore pornography viewing, were related to rape myth acceptance when controlling for sexist attitudes among men. Wald tests indicated hostile se...

The City of Mobile Police Department’s (MPD) multidisciplinary Sexual Assault Kit Initiative team sought to identify and amend factors that theoretically contribute to high rates of sexual assault case attrition. First, the current study examined cross-sectional relations among officers’ rape myth endorsement, perceived understanding of trauma-info...

Exchange sex places individuals with cocaine use disorder (CUD) at particularly high risk for deleterious safety and health outcomes. A substance use treatment provider who is aware of a patient's exchange sex behavior is better able to provide appropriate screening, care, and/or referral to risk reduction services. However, little is known about e...

The BITTEN theoretical framework of trauma-informed healthcare proposes that each patient presents to a healthcare encounter with a baseline level of historical institutional B etrayal and trauma exposure that interacts with their I ndicator for healthcare engagement to potentially T rigger trauma symptoms, impacting patients' T rust in healthc...

Background While studies have investigated the effects of posttraumatic stress disorder (PTSD) symptoms on substance use, information on these associations in the context of drug cue reactivity is lacking, which can provide meaningful information about risk for relapse. The current study assessed the associations between PTSD symptom clusters and r...

Introduction Patients with rare and/or care-intensive conditions, such as Ehlers-Danlos Syndrome (EDS), can pose challenges to their healthcare providers (HCPs). The current study used the BITTEN framework ¹ to code EDS patients’ open-ended written responses to a needs survey to determine their self-reported prevalence of healthcare institutional b...

Patients with complex medical conditions may have a medical history that includes multiple negative/traumatic experiences with the health care system over the course of their diagnosis and treatment. The BITTEN (Betrayal history by health-related institutions; Indicator for health care engagement; Trauma symptoms related to health care; Trust in he...

Nurse practitioners regularly treat primary care patients with trauma histories. By incorporating trauma-informed care into practice, nurse practitioners can enhance the provision of clinical care and, ultimately, improve patient health outcomes. This brief report demonstrates how to actively incorporate the principles and practices of the 4R frame...

Burnout, an occupational syndrome characterized by feelings of emotional exhaustion, depersonalization of victims, and diminished personal accomplishment, is highly prevalent among police officers, perhaps as a result of regular and repeated exposure to job-related stressful events. Burnout might be especially problematic for officers working with...

Federally Qualified Health Centers (FQHCs) are a fast-growing source of healthcare for women with intersectional identities, or those most frequently exposed to and negatively impacted by interpersonal trauma. According to the “3 E” conceptualization of trauma, certain Event- and Experience-related characteristics of a trauma predict victims’ physi...

Federally Qualified Health Centers (FQHCs) are a fast‐growing source of healthcare for women with intersectional identities, or those most frequently exposed to and negatively impacted by interpersonal trauma. According to the “3 E” conceptualization of trauma, certain Event‐ and Experience‐related characteristics of a trauma predict victims’ physi...

Experiential avoidance is a common psychological process, a core component of third-wave behavioral therapies, and a robust predictor of general psychopathology. The Acceptance and Action Questionnaire (AAQ version II [AAQ – II]; Bond et al. 2011) is a popular and widely used measure of experiential avoidance. However, studies examining the measure...

Nurses need a pragmatic theory to understand and respond to the impact of vulnerable patients’ previous healthcare experiences, as these are likely to influence response and adherence to treatment plans. The authors of this paper present the new BITTEN (Betrayal history by health-related institutions, Indicator for healthcare engagement, Traumas re...

Pornography viewing is a growing practice that has been understudied in samples of women. As an answer to calls within the literature, we explored the role of problematic pornography viewing constructs, body image, and relationship satisfaction in a sample of women (n = 949). Structural equation modeling indicated pornography viewing frequency, per...