MN667 PMHNP Diagnosis and Management Across a Lifespan III

LGBTQI Trauma

Trauma is a significant problem affecting most people belonging to the LGBTQIA community. According to research, trauma affects LGBTQIA+ individuals more frequently than it does cisgender, heterosexual individuals (Keating, Muller & Wyers, 2021). All facets of life, particularly familial connections, work, school, as well as their physical well-being can be significantly impacted by these experiences. For LGBTQIA+ people, it is crucial to have a safe, accepting society and top-notch services.

Epidemiology and Economic Costs

The most vulnerable individuals are disproportionately affected by trauma. It’s been hypothesized that the trauma experienced by LGBTQI people is more severe than that of the rest of the population. The most frequent traumas are domestic assault, physical abuse, and acts of xenophobia (discrimination or violence motivated by factors such as gender, sexual orientation, race, etc.) (Levenson, Craig & Austin, 2023). The overall number of homicides committed against LGBT and HIV-positive people in 2015 increased by 20% from the prior year due to hate and violence. This has contributed to increasing trauma rates among the LGBTQI. Lesbian (40.4%) and bisexual women (56.9%) have higher lifetime domestic violence incidence rates than heterosexual women (32.3%).

There are many economic costs of LGBTQI-related trauma. Because of unemployment and wage disparity based on gender identity and sexual preference, millions of dollars are likely to be lost. Also, health inequalities, that LGBTQI individuals endure cost a lot and pose a significant challenge when individuals try to access healthcare services. As a result of sexual assault, which LGBTQI adults face at an exceedingly high rate, between US$ 10.5 million to US$ 64.8 million is lost in the U.S.

Assessment and Tools to Assess/DSM-5

An effective tool that can be used to assess trauma in LGBTQI individuals is the Developing Trauma-Informed Organizations: A Tool Kit. The Tool Kit was created to assist organizations in raising the standard of services provided by incorporating an awareness of the effects of trauma and violence into their policies, practices, and relationships with persons they are trying to help. Another effective tool is the Trauma-Informed Program Self-Assessment Scale (Kelly et al., 2020). Individuals complete the Self-Assessment at once or in segments. To go through the Self Assessment in its entirety at once, individuals can allow 30 to 40 minutes. Trauma-informed System Change Instrument is another effective tool. It has established a paradigm for system change monitoring that included interconnections (between people and between agencies) as well as policy and organizational practice.

Pharmacological Interventions

Dynamics: In numerous research, the potential to prevent Trauma has been examined for the beta-adrenergic antagonist propranolol, which passes the blood-brain barrier. 30-32 The effectiveness of propranolol in lowering the response of the body during distressing imagery, the intensity of symptoms associated with Trauma, or the frequency of Trauma diagnostic outcomes has not yet been demonstrated in studies comparing propranolol to a placebo (Levenson, Craig & Austin, 2023).

Kinetics: After being taken by mouth, propranolol is entirely absorbed and dispersed through most tissues. Elimination is almost entirely carried out through liver metabolic conversion and elimination through the urine of the byproducts.

Contraindications: Bronchial asthma, cardiogenic shock, sinus bradycardia, and more than first-degree block are contraindications to taking propranolol. However, if the condition known as congestive heart failure is caused by a tachyarrhythmia that may be treated with propranolol, then it is safe to use propranolol.

Side Effects: Side effects of propranolol include headaches, feeling drained, unsteady, or feeble, and stomach pains.

Plan of Care

An effective collaborative intervention for treating trauma in LGBTQI individuals is social support. According to Kelly et al. (2020), social support may be a protective factor for LGBTQI populations, helping to lessen mental symptoms and suicide ideation. The ability of a survivor to reevaluate the incident more adaptably may also be influenced by social support.

An effective psychotherapeutic intervention for LGBTQ trauma is cognitive-behavioral therapy. CBT will help them learn specific skills for improving their symptoms and build their confidence in managing the symptoms and avoiding the triggers (Keating, Muller & Wyers, 2021). Since CBT focuses on updating unhelpful thinking patterns and finding active coping strategies, it is likely to work well with a patient who is experiencing several mental health issues.

References

Keating, L., Muller, R. T., & Wyers, C. (2021). LGBTQ+ people’s experiences of barriers and welcoming factors when accessing and attending intervention for psychological trauma. Journal of LGBTQ Issues in Counseling, 15(1), 77-92. https://doi.org/10.1080/15538605.2021.1868376

Kelly, M., Lubitow, A., Town, M., & Mercier, A. (2020). Collective trauma in queer communities. Sexuality & Culture, 24, 1522-1543. https://doi.org/10.1007/s12119-020-09710-y

Levenson, J. S., Craig, S. L., & Austin, A. (2023). Trauma-informed and affirmative mental health practices with LGBTQ+ clients. Psychological Services, 20(Suppl 1), 134–144. https://doi.org/10.1037/ser0000540