Continuous Traumatic Stress Symptoms In Young Adults Living In Public Housing

Background and Purpose

Continuous Traumatic Stress (CTS) is defined as the experience of ongoing threat that communities around the world experience, including those facing war, genocide, and gang violence (Eagle, et al., 2013; Lahav, 2020). It is distinct from Post-traumatic Stress Disorder (Type 1) and complex trauma (Type 2). Arguably, young adults living in public housing and experiencing community violence may show signs of CTS. CTS is proposed to involve symptoms beyond standard PTSD and complex trauma, including exhaustion/detachment, rage/betrayal, and fear/helplessness (Goral et al., 2021). The purpose of this study was to explore if and how CTS may be experienced by young adults living in public housing in an urban area of the United States.

Methods

Data were collected as part of a concurrent mixed methods study, recruiting young adults living in three public housing developments (Range 18-30). We used a hybrid recruitment approach, which consisted of random sampling of apartment units (> 50%), fliers distributed in the neighborhood, and snowball sampling. Data were collected using one-on-one, face-to-face interviews. Five qualitative questions were posed, for example, how safe do you feel in this neighborhood and how has safety/lack of safety in this neighborhood impacted you? Data were analyzed by two coders following the steps of thematic analysis, including constant comparison. Coders met to discuss codes, grouped codes, and emerging themes, which evolved through the development of a project codebook.

Results

The analytic sample includes young adults (n = 50, 66% female, 52% Latinx, 24% Black/African American), who reported high rates of community violence exposure, when compared to other samples of young adults. Five themes connected to CTS emerged from the data: 1) Detachment, where participants described feeling numb, detached, or unfeeling, for example, “I tend to ignore it and keep to myself.” 2) Rage, when participants described feeling rageful or angry in connection with neighborhood experiences, for example, “There are racist people and people who consume hate in their hearts. I just refuse to be a victim.” 3) Betrayal, when participants described feeling hurt or betrayed by others in the neighborhood, for example, “People see us differently. They give us disgusting looks.” 4) Fear, where participants described feeling fearful or scared, for example, “I feel unsafe because of the killings and all the violence. It doesn’t go away,” and 5) Helplessness, when participants describe feeling helpless in the neighborhood, like they cannot protect themselves, for example, “It doesn’t matter where you go...no matter which neighborhood you’re in, there’s a risk wherever you go.”

Conclusions and Implications

The results suggest the concept of CTS may apply to young adults living in neighborhoods in the United States where they experience community violence, expanding on the previous understanding of CTS occurring primarily in war and ongoing conflict-impacted areas (Greene, 2018). Social workers can potentially improve mental health treatment for this population with a better understanding of the emerging concept of CTS and how it presents in urban young adults.