Almost 700,000 cases of child abuse and neglect have been substantiated annually, with many more un-reported children being exposed to community and interpersonal violence (U.S. Department of Health and Human Services, 2017). Exposure to chronic or multiple potentially traumatic events places large numbers of children to grow up into emotionally and physically at-risk adults (Felitti et al., 1998). Although some helpful treatments already exist, examination of tailored alternative approaches is needed to address the broader somatic and psychological problems associated with complex trauma exposure. The current study involved developing and evaluating a pilot integrative group therapy treatment for adults who have experienced complex trauma. The treatment components draw from the field of interpersonal neurobiology and polyvagal theory. Interpersonal neurobiology approaches treatment through the lens of the embodied brain, including both the brain and the nervous system (Siegel, 2012). Polyvagal theory brings greater nuance to the interplay between experiencing trauma and the impacts on the autonomic nervous system via the dorsal and ventral vagal nerves (Porges, 2011). The group treatment combined process-oriented therapy with trauma-sensitive yoga delivered once weekly over the course of eight weeks. The treatment offered participants psychoeducation, opportunities for trauma processing, and various meditative grounding exercises. The study examined feasibility, acceptability, and preliminary efficacy across a range of psychological and physiological domains including complex traumatic stress, depression, anxiety, sleep disturbance, and physical pain. Participants were recruited by flyers and an informational website through which interested individuals could message the lead researcher. Thirty eligible individuals completed intake procedures and ten participants were lost or dropped out before the treatment began. Participants (N=20) were randomly assigned to either the treatment or waitlist control group with ten participants falling into each condition. The sample included nineteen women and one man, were 60% White, with a mean age of 25.3 years. Independent samples t-tests indicated that at the time of intake there were no significant differences across the treatment and waitlist control conditions for all reported participant characteristics. Participants in the treatment condition felt that the group members accepted one another, that despite having differences, the group felt secure, and that the members felt that what was happening was important and there was a sense of participation. Paired samples t-tests examined change in depression, anxiety, complex traumatic stress symptoms, sleep disturbance, and physical pain intensity for each condition, but the only significant change was sleep disturbance between pre- and post-treatment for the treatment condition. Treatment effect sizes calculated at the conclusion of the study showed that the treatment condition saw moderate to large reductions in their complex traumatic stress symptoms (d = .64), and large reductions in their sleep disturbances (d = 1.09). Despite paired samples t-tests indicating no significant differences for the waitlist control condition, effect sizes also indicated that the waitlist control condition had moderate increases in their physical pain intensity (d = -.56) and small to moderate reductions in their complex traumatic stress symptoms (d = .38).

Compared to similarly integrative trauma treatments (Nguyen-Feng et al., 2019; Niles et al., 2018), the current study found comparable reductions in symptoms of traumatic stress and depression and fewer reductions in anxiety as indicated by treatment effect size calculations. The current study was subject to some unexpected situations that may have affected results. First, the final group session and post-treatment survey coincided with a period of multiple stressors and uncertainty due to ongoing campus strikes, and the onset of the COVID-19 pandemic social distancing efforts. This may have affected participants’ current stress levels when completing the survey. This study supports that it is feasible to take a combined psychological and physiological approach to trauma treatment through combining trauma-sensitive yoga with more traditionally process- and trauma-oriented talk therapy for survivors of complex traumatic stress. Last, given the study findings and participant feedback, further research into the use and ways of combining somatic and psychological trauma treatment approaches is warranted.

Exposure to disasters and the life stress that can result in the aftermath has been associated with subsequent mental health (MH) problems in up to about 30% of affected individuals (Bonanno et al. 2010). Young adults, ages 18-30 may be more vulnerable to the impact of disaster than older adults (Acierno et al., 2006; Bonanno et al., 2007). Increased levels of MH symptom severity have been observed among young adults over the past two decades (Twenge et al., 2019; Twenge et al., 2020), as well during the COVID-19 pandemic (National Center for Health Statistics, 2021). Additional research investigating risk and resilience factors associated with long-term patterns of MH is needed (Chen & Bonanno, 2020), particularly among disaster-exposed young adults during the COVID-19 pandemic.Originally intended to understand young adult psychosocial adjustment after exposure to natural disasters in 2017 and 2018, the current longitudinal study also examined impacts of the COVID-19 pandemic on MH across four waves (two pre-pandemic and two during-pandemic). This presented a unique opportunity to evaluate the associations among prospective data collected prior to the pandemic, and pandemic functioning among disaster-exposed young adults in the mainland U.S. and Puerto Rico. The current study had the following aims: 1) identify pre-pandemic, and pandemic risk and protective factors predicting pandemic-MH; 2) examine the shape of MH symptom trajectories over time, from pre to during-pandemic; and 3) examine whether pre-pandemic factors were associated with differences in MH trajectory starting points, or with increases or decreases in MH growth rates over time. Data were collected at universities in California, Florida, Texas, and Puerto Rico through online Qualtrics questionnaires in English and Spanish. The Wave (W) 1 surveys were distributed in the mainland U.S. in 2018, about three to six months after several natural disasters; the Spanish survey was distributed in Puerto Rico also in 2018, a little over one year after several hurricanes occurred. W1 participants indicated whether they agreed to be contacted for subsequent follow-up surveys as part of a longitudinal study. A subset of participants (n = 466) agreed and were contacted via personal email to participate in Ws 2-4. W2 data collection occurred in October through December 2019, W3 data collection occurred in summer of 2020 during the COVID-19 pandemic, and W4 data collection took place between late February and early April 2021. Compensation differed slightly across waves; at W1, participants chose to either receive research credit or to enter a raffle to win one of many e-gift cards ($25.00), while at Ws 2-4, each participant received an e-gift card. Pre-pandemic factors were measured at W1 and included prior trauma history, disaster exposure (e.g., specific to hurricanes, wildfires, mudslide), life stressors since disaster, and MH. Pandemic risk factors were measured at W3 and included COVID-19 fear, COVID-19-related experiences, and life stressors during the pandemic. Also measured at W3, pandemic protective factors included perceived social support, self-compassion, and coping self-efficacy. MH outcomes were measured across Ws 1-4 and included anxiety, depression, and post-traumatic stress symptoms (PTSS). To evaluate aim one, a subsample of 120 young adults who experienced a natural disaster during college and who had complete Ws 1 and 3 data were selected. Participants were mostly female (88%), and half identified as Latinx and from Puerto Rico. The majority (69.2%) had reported been exposed to a hurricane, and the remainder experienced wildfires. At W1, participants were on average 20.3 years of age. Three separate multiple linear regression analyses for each W3 pandemic-MH outcome (anxiety, depression, and PTSS) were conducted using Mplus Version 8. In summary, W1 MH or prior MH functioning was the only pre-pandemic factor significantly associated with pandemic MH. Pandemic risk factors (W3 COVID-19 fear, W3 COVID-19 experiences, and W3 life stressors) were significantly associated with anxiety and PTSS during the pandemic, but not depressive symptoms. W3 coping self-efficacy was associated with decreased risk for depression and PTSS during the pandemic. Lastly, W3 self-compassion and W3 social support were not significantly associated with any pandemic MH outcomes, and no pandemic protective factors were associated with anxiety during the pandemic. To evaluate aims two and three, a subsample of 205 young adults who completed W1 and one or more of the subsequent three waves of data collection were selected. Participants were again mostly female and about half identified as Latinx and from Puerto Rico. Three separate MH trajectories (anxiety, depression, and PTSS) were plotted using hierarchical linear modeling analyses (HLM) and HLM8 statistical software. Associations among pre-pandemic factors and young adults’ MH starting points and trajectories were examined. MH symptom trajectories of young adults with higher levels of prior trauma history, disaster exposure, and life stressors since disaster were hypothesized to be more severe at W1 and decelerate more slowly across subsequent waves than those without. The anxiety trajectory did not differ among individuals and changes in anxiety symptom levels across Ws 1-4 were non-significant. The only significant pre-pandemic factors associated with W1 anxiety (trajectory starting point) were past trauma history (p = .042) and W1 life stressors since the disaster (p = .027). Similarly, the depression trajectory did not differ among individuals and changes in depression symptom levels across Ws 1-4 were non-significant. The only significant pre-pandemic factors associated with W1 depression (trajectory starting point) were also past life trauma (p = .01), and W1 life stressors since the disaster (p = .005). Significant differences among PTSS were found across Ws 1-4. The PTSS trajectory followed an S-shaped cubic trend. From Ws 1-2 (post-disaster to pre-pandemic), the PTSS trajectory was observed to be linear and slightly decreasing, from Ws 2-3 (pre-pandemic to during-pandemic), the trajectory significantly increased and from Ws 3-4 (during-pandemic to one-year-during-pandemic) it gradually declined. The PTSS trajectory model statistics with all time-level predictors included were significant and showed improvements in fit. Significant pre-pandemic factors associated with W1 PTSS (trajectory starting point) were prior trauma history (p = .042), W1 life stressors since the disaster (p = .003), and region (p = .03). Young adults from Puerto Rico and those with higher levels of prior trauma history or W1 life stressors since the disaster on average endorsed higher levels of PTSS post-disaster and at the start of the PTSS trajectory (W1), than those who did not. No other person-level factors significantly predicted changes among PTSS over time. In summary, a close examination of both environmental and individual risk and protective factors can help to predict subsequent MH outcomes after collectively experienced disasters. The current study results suggest that prior-MH functioning, COVID-19 fear, pandemic life stressors, COVID-19 related experiences, and coping self-efficacy may predict pandemic-MH outcomes among disaster-exposed young adults. Additionally, young adults who have experienced greater levels of prior trauma history or W1 life stressors following a disaster are more likely to experience higher levels of initial MH outcomes after a collectively experienced trauma, like the pandemic, as well as young adults from Puerto Rico, in comparison to young adults from the mainland U.S. Increases in PTSS may also occur after the experience of another collective trauma. These findings can help to identify young adults that may benefit from MH support. Increased support and protections can be provided accordingly to those at greater risk of developing more severe MH symptoms, particularly at the university level.

The coronavirus disease (COVID-19) which was declared a global pandemic on March 11, 2020, has had devastating consequences on the mental health of people worldwide (World Health Organization, 2020). Latinx and other ethnic minorities in the United States are experiencing substantial distress secondary to the COVID-19 pandemic (Garcini et al., 2020). Notably, Latinx have been shown to be over-represented in COVID- 19 cases and deaths (Center for Disease Control, 2022). Among the possible reasons for these disparities are a variety of contextual factors (e.g., employment in essential work that cannot be performed remotely); many Latinx often live in crowded spaces that limit social distancing; and some have difficulty obtaining health insurance and medical services due to financial difficulties or immigration status (Hayes-Bautista, 2020). These disparities as well as pandemic-related stressors have led to concerns about the consequences of this disaster on the mental health of vulnerable Latinx (Garcini et al., 2020).

There is also growing evidence about the psychosocial impact that the COVID-19 pandemic has had on younger populations from racial and ethnic minority groups (Penner et al., 2021; Villatoro et al., 2022). Emerging adulthood is a developmental stage (ages 18-29 years old) that is characterized by identity exploration, instability, self-focus, feeling “in between” and having a sense of possibilities (Arnett, 2015). According to recent studies, Latinx emerging adults have experienced significant socio-emotional consequences as a result of the COVID-19 pandemic (Goodman et al, 2020). The current pandemic has affected the developmental trajectory of emerging adults, particularly in terms of education, employment opportunities, and short-and long-term wellbeing (Halliburton et al., 2021). Latinx young adults may now be contending with other responsibilities and potential disaster-related stressors that may compound their risk for mental health problems. Prior to the COVID-19 pandemic, research documented that Latinx emerging adults experienced acculturative stress and served as language and cultural brokers for their immigrant families, including mediating health-related information (Sim et al., 2010; Villanueva & Buriel, 2010). In addition, this population has been shown to navigate high levels of family obligations and responsibilities associated with the collectivistic family expectations (Stein et al., 2019). Often, Latinx emerging adults are first-generation university students and must negotiate a variety of contextual roles including completing academic tasks and balancing financial expenses. In light of this, it is imperative to understand more about the impact of the COVID-19 pandemic on Latinx emerging adults in order to better meet their specific needs, identify protective factors, and implement culturally sensitive interventions to prevent psychological maladjustment.

The aim of this study was to explore the psychosocial impact of the COVID-19 pandemic on Latinx emerging adults (N = 31; ages 18-29) in California and Florida through online focus group interviews. A qualitative constructivist grounded theory approach was used in an effort to develop empirical knowledge, as research on the psychosocial impact of the COVID-19 pandemic was limited when this study began. This approach served to capture the richness of the experiences and context of participants by allowing analytic codes and categories to drive theory development (Charmaz, 2014). This study addressed the following research questions:

1. What is the impact of the COVID-19 pandemic on the psychosocial functioning of Latinx emerging adults residing in California and Florida?2. How are Latinx emerging adults negotiating their identities, roles, and cultural values as a result of the COVID-19 pandemic?

Participants in California and Florida were recruited through flyers posted on social media, word of mouth, and some were recruited from a prior multi-site study looking at natural disasters. Data was collected with participants in California and Florida in order to obtain diversity with regards to context of Latinx and varied experiences during the COVID-19 pandemic. In total, seven focus groups were held and participants attended a virtual focus group with other Latinx emerging adults from their state. The focus groups were transcribed verbatim and coded using constructivist grounded theory (Charmaz, 2001). The qualitative process facilitated the in-depth exploration and understanding of an understudied phenomenon. It also took into consideration how cultural factors, values, and beliefs, could influence the experiences of Latinx emerging adults during the pandemic.

There were six themes identified from the data concerning the impact of the pandemic on Latinx Emerging adults. These themes centered around systemic and environmental factors, pandemic-related communication, career and academic disruptions, navigating family factors, mental health experiences, and the adaptation process. From these themes, two theoretical models were constructed to explain how the pandemic has impacted the psychological wellbeing and adjustment of Latinx emerging adults California and Florida. Additionally, familismo and multigenerational values were found as protective factors for Latinx emerging adults.

The high levels of psychological distress reported in this sample reflect emerging research showing that young adults have experienced an alarming increase in adverse mental health outcomes during the COVID-19 pandemic (Conrad et al., 2021, Villatoro et al., 2022). The findings are also consistent with a qualitative study that found that Latinx college students reported fear and disillusionment about the future as a result of undergoing the COVID-19 pandemic and being exposed to social injustices (Morgan & Zetzer, 2022).The study has important implications for helping to advance science in a variety of areas such as increasing knowledge regarding the consequences of pandemics on mental health and cultural considerations that may influence disaster recovery. Examples of these cultural considerations include multigenerational values, heightened responsibilities and mediating pandemic information. This research is needed to inform public health efforts to support emerging adults as they navigate changes brought about by the pandemic and to prevent adverse psychosocial outcomes for this population. Results may inform universities and mental health efforts on how to increase support and resources for Latinx emerging adults in order to address the psychological difficulties resulting from the COVID-19 pandemic.

Research across racial and ethnic groups that have experienced genocide, oppression, and other historical and ongoing traumas has delineated the way trauma can be transmitted across generations. Race-based and historical trauma can have deleterious long-term effects for African Americans (Carter & Barket-San, 2015). The subsequent trauma from the systematic oppression of a particular racial or ethnic group requires moving beyond an individual’s experiences and toward addressing the collective nature of such traumas (Comas-Díaz, 2000). Interdisciplinary research across sociology, psychology, social work, and psychiatry has made strides in documenting the legacy of trauma within marginalized communities in the United States. As a consequence of this interdisciplinary focus, the literature interchangeably uses the terms historical trauma, cultural trauma, raced-based trauma, transgenerational trauma, intergenerational trauma, collective trauma, and vicarious trauma to articulate the legacy of trauma across generations (Mohatt et al., 2014). Intergenerational trauma was first introduced to describe the trauma-related symptoms and experiences in the children and grandchildren of Holocaust survivors and has since been adapted to articulate experiences of other systematically oppressed groups (Rakoff, 1966; Barocas & Barocas, 1973). For decades, research has demonstrated that offspring of trauma survivors reported higher rates of depression, guilt, aggression, and inhibited autonomous growth (Barocas &Barocas, 1973), anxiety and pressure to provide meaning to their parents’ life and losses (Rakoff, 1966), and survivors guilt (Russell, 1974). Of note, epigenetic research recently identified biological mechanisms by which trauma and stress can cause changes in gene expression and gene inheritance thus providing support for such transmission of trauma (Glausiusz, 2014; Bale, 2015; Skinner; 2014; Gapp et al., 2014). If trauma and stress can be inherited through parenting, modeling, conditioning, and biological means, can the same be said for resiliency and healing? Recently, research has begun to explore how intergenerational trauma has manifested itself within African American communities by way of DeGruy’s Posttraumatic Slave Syndrome, but no current study has explicitly explored how intergenerational trauma is experienced by African Americans. Additionally, even less is known about intergenerational healing. Henderson and colleagues (2021) identified this gap in African American intergenerational trauma research and initiated the exploration of intergenerational healing using a historical trauma framework. This research contributed a conceptual model known as Intergenerational Transmission of Healing and Well-Being, which delineated the adaptive mechanisms that allowed the transmission of healing that ensured African American survival through and beyond enslavement (Henderson et al., 2021). Henderson and colleagues (2021) however, evaluated a historical text and less is known about intergenerational healing in present-day African Americans. Intergenerational trauma is a rapidly evolving body of research with potentially momentous implications for intergenerational healing. The aim of the current study was to explore present day experiences of intergenerational trauma and intergenerational healing African Americans. This study used a phenomenological qualitative design to highlight the depth of the lived experience, knowledge, and context of a diverse sample of African Americans. These participants engaged in focus groups to answer the following questions: 1. How has intergenerational trauma impacted African Americans’ mental health and families? 2. In what ways have previous generations contributed to current African Americans’ healing from intergenerational trauma? a. How has intergenerational healing impacted African Americans’ day to day lives and mental health? Participants were recruited through social media flyer posts, email listservs, and by word of mouth (N=22; ages 19-66). A pilot focus group (n=2) was held to assess the clarity and accessibility of the proposed semi-structured interview question. Based on feedback from this pilot focus group, all questions were retained. A total of seven focus groups were conducted with a diverse sample of African Americans across generations and across the nation. The focus groups were transcribed via zoom and coded by the research team including the lead researcher and three Black undergraduate women. Pseudonyms are used throughout to maintain participant confidentiality. A total of 11 themes emerged from the data with five intergenerational trauma themes (17 focused codes) and six intergenerational healing themes (27 focused codes). Themes within intergenerational trauma include Familial Patterns of Mental Health, Communication, Aspects of Parenting, Societal and Familial Expectations, and Instability. Additionally, themes within intergenerational healing include Communication, Family, Coping Practices, Positive Aspects of Parenting, Faith, and Identity. The five themes of intergenerational trauma include Familial Patterns of Mental Health (substance abuse, fear and anxiety, anger, and lack of explicit guidance to heal), Communication (lack of communication, dismissal of experience, and secrets), Aspects of Parenting (discipline, lack of displays of affection, colorism, and racial socialization), Societal and Familial Expectations (gendered experience and hyper-independence), and Instability (finances, moving/fleeing, relationships, and living in survival mode). There is significant complexity in these themes in that some themes related to intergenerational trauma transmission may also have proven to be adaptive and contributed to survival while also causing harm. Furthermore, each of these themes provide insight into how intergenerational trauma is transmitted and maintained within families but also provides opportunities for intervention to help disrupt cycles of intergenerational trauma and ameliorate its effects. Nearly every participant across all focus groups spoke to the lack of clear explicit guidance to heal. Although some participants were able to reflect on the ways healing was modeled or instructions to turn to faith for healing, there is a clear lack of explicit dialogue and guidance on how previous generations have coped and healed from intergenerational trauma. We know that healing has occurred across generations even if intergenerational trauma has persisted, but without this direct roadmap to avenues of healing, these cycles of intergenerational trauma may persist longer than they have to. This may also be the most crucial point of intervention by providing families the language and tools to discuss and describe ways they have engaged in healing and how this can be shared with younger generations. The six intergenerational healing themes include Communication (openness, affirmations, recognition/awareness, accountability/apology, narratives, and emotional expression), Family (elders, togetherness, showing up, and resilience), Coping Practices (meditation, alone time, creativity, time in nature, therapy, gratitude, humor, service, movement, productivity, and instructions for survival), Positive Aspects of Parenting (parenting the next generation and intentional change), Faith (organized religion and God, and spirituality), and Identity (pride and education). Together these themes provide insight into methods of intergenerational healing that have been passed across generations as well as those currently employed to facilitate intergenerational healing. These themes highlight some of the strategies and approaches present day African American’s are engaging in to disrupt the cycles of intergenerational trauma. By accessing what families are already doing to break cycles of intergenerational trauma and heal, we can inform the development of interventions to share with other families and healing professionals. Although there was a resounding consensus that there was a lack of explicit guidance to heal, many participants were still able to identify coping strategies that they observed other family members engage in or strategies they implemented themselves to manage the effects of intergenerational trauma. Productivity especially among female-identified participants was noted to be an important part of coping with and healing from intergenerational trauma. This was both modeled and encouraged by previous generations and many participants engaged in keeping busy as a form of distraction or avoidance. This productivity serves an important function of contributing to one’s family or taking on tasks that can improve one’s circumstances, thus it is more than just an avoidance strategy. Transmuting emotions or situations through productivity can be an extremely important form of intergenerational healing especially when paired with additional intergenerational healing strategies. Additionally, instructions for survival have provided necessary life preserving guidance for centuries. Some of these instructions for survival may also contribute to intergenerational trauma, however, this theme is categorized within intergenerational healing because in many contexts without these instructions, survival could be compromised thus intergenerational healing ceases to exist. It is important to highlight the adaptive function of these instructions for survival. This ancestral knowledge may need to be adapted to retain the life extending nature of these messages and forsake the components that contribute to intergenerational trauma. The current study expands our understanding of the variety of mechanisms that occur within African American families that transmit and maintain intergenerational trauma. We can recognize the impact of the legacy of trauma through various family dynamics and patterns including mental health, communication, parenting, expectations, and instability. More importantly, this study also unearths the family practices that contribute to intergenerational healing. This study further contributes to the Intergenerational Transmission of Healing and Well-Being model (Henderson et al., 2021) by expanding some of these mechanisms into present day experiences. Furthermore, the results provide specific insights into strategies that families are already using to healing intergenerational trauma. We may help promote healing by supporting individuals and families in examining the ways healing has already taken place within the family and ways individuals may want to make changes for themselves and future generations. Results may inform entry points for intervention for healer, mental health professionals, and other stakeholders. Additionally, this research sets a foundation for future research that can develop specific interventions based on community wisdom and experience.

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