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Violence and Trauma: SBM's New SIG and the People Who Started It

Emily F. Rothman, ScD, Violence and Trauma SIG chair

The Society of Behavioral Medicine's (SBM's) new Violence and Trauma Special Interest Group (VT SIG) recently interviewed Pamela Behrman, PhD, professor of psychology at the College of Mount Saint Vincent, and Julie Schnur, PhD, assistant professor in the Department of Oncological Sciences at the Icahn School of Medicine at Mount Sinai, co-director of the Integrative Behavioral Medicine Program, and licensed clinical psychologist, about the new SIG. They have been members of SBM since 2005 and are founding members of the VT SIG.

VT: Why do you think now is the right time for a VT SIG to be established?

Schnur: I think any time would have been the right time for this SIG. It seems particularly timely to introduce the VT SIG now, given how widespread the national conversation on trauma has become. From the Affordable Care Act's attention to domestic violence, to PTSD in the military, to campus rapes, to gun violence, to trauma informed care, the influence and pervasiveness of trauma in our society is clear. SBM's inclusion of a VT SIG is reflective of the impact of trauma on health.

Behrman: Researchers have been calling attention to violence and trauma as public health issues since the 1980s, with a recent emphasis on primary prevention. It's now well-known that trauma and violence can have long-term, often irreversible, cognitive, psychological, and somatic health consequences for children and adults. In the U.S. there has been a heightened awareness of the importance of public policy aimed at reducing violence and trauma in the past several decades, which has prompted federal legislation such as the Violence Against Women Act and renewed calls for the public funding of research on gun violence.

VT: How will SBM be enriched by the existence of a VT SIG?

Schnur: Too often, trauma and behavioral medicine research are in separate silos, and consequently are investigated by separate researchers, in separate organizations, at separate conferences. To comprehensively address the healthcare needs of trauma survivors requires that trauma researchers and healthcare researchers learn from and talk to each other. SBM seems like the ideal place to bridge the gap between these two fields.

Behrman: While other SIGs address trauma as aspects of their specialties, no other SIG uniquely focuses on understanding how violence and trauma impacts on individuals, communities, and society. This opens the door for many potential contributions from our SIG members to the SBM community at large. I feel we have some important things to say regarding the importance of protective factors, risk factors, and consequences of trauma, which can lead to our contributing to SBM's proud history of influencing and shaping public-health driven government policy and funding initiatives.

VT: In general, how can the field of behavioral medicine benefit from including violence and trauma as topics that are addressed and attended to in our work?

Schnur: I work with women with breast cancer. And those with a history of childhood sexual abuse have told me how their history has affected their reactions to nearly every part of their cancer treatment. They are often extremely anxious during screenings and often delay or avoid screenings. They fear being anesthetized during surgery and being touched and viewed while unconscious, and they find that radiotherapy, which involves darkness, a need to be positioned/touched/exposed, and a need to remain still, reminds them of their abuse experiences. This healthcare re-traumatization affects quality of life during treatment, adherence to treatment, and interactions with the healthcare team. A better understanding of trauma and its impact can potentially guide the development of provider training, more sensitive and trauma informed healthcare delivery, and interventions to improve patient experience, adherence, healthcare costs, and provider-patient collaboration.

Behrman: If the goal of behavioral medicine is improved prevention, diagnosis, treatment, and rehabilitation for individuals suffering from a broad array of medical problems, it's critical that we understand how to recognize and treat patients' trauma to prevent them from being injured, killed, psychologically harmed, or sexually assaulted. We have an obligation to attend to people's safety and well-being with regard to violence and trauma because these are important health problems in their own right, and also because we know from decades of research that violence and trauma exposure underlie many of the chronic health conditions upon which behavioral medicine experts focus.