The layered imprint of trauma on the self: A multimethod investigation of PTSD and minority stress

Abstract

The impact of trauma can be profound, altering the self at multiple levels (e.g., cognitive, social, and bodily levels), as demonstrated by the manifestations of PTSD symptoms. Importantly, these trauma-related symptoms can also arise from the consequences of minority stress and marginalization. In this vein, the dissertation aims to comprehensively investigate diverse experiences of trauma and stress, as well as to better understand how these experiences contribute to the development and expression of trauma-related symptoms by using a multidimensional research approach, including functional magnetic resonance imaging (fMRI) and mixed-method approaches. The first study investigates how different symptom profiles of PTSD and its dissociative subtype relate to bodily self-consciousness. Using resting-state functional connectivity analysis, it examines the neural circuitry of the temporoparietal junction (TPJ), a critical region involved in this phenomenon, across individuals with PTSD, the dissociative subtype of PTSD, and healthy controls. Findings from this study demonstrate disruptions in the neural circuitry of the TPJ among individuals with PTSD and its dissociative subtype. As the TPJ plays a critical role in integrating multisensory information, these disruptions may have profound effects on various networks in which the TPJ is involved, significantly impacting how individuals engage with the world. Further advancing our understanding of the development and expression of trauma-related symptoms, study two uses a mixed-methods approach to investigate qualitative presentations of potential risk and protective factors among trauma-exposed sexual and gender minorities (SGMs) by comparing individuals quantitatively reporting low vs. high trauma symptom severity. Findings herein reinforce the importance of integrating minority stress and trauma frameworks when contextualizing trauma-related symptoms among SGMs. Lastly, study three examines the intersection of minority stress and moral injury, shedding light on the necessity to expand current trauma-related frameworks when contextualizing trauma-related symptoms among SGMs. Taken together, these findings elucidate the layered impact of trauma on the self, whereby trauma-related symptoms can affect individuals at multiple levels and emerge from diverse experiences, including Criterion A traumatic events and minority stress.