Understanding emotional responses to traumatic injury key to planning, treatment efforts

Injuries are a major public health problem in the United States, accounting for nearly 60 percent of all deaths among Americans between the ages of 1 and 44 years. Survivors of traumatic injuries often face significant physical and mental health challenges, including depression and post-traumatic stress disorder.

Because black men in the United States are disproportionately affected by traumatic injuries, they merit focused attention on the mental health effects of trauma and how those effects may vary by the intentionality of the injury. A study from the University of Pennsylvania School of Nursing (Penn Nursing) explored the emotional responses of urban black men after acute traumatic injury within the context of injury intentionality (e.g., gun violence and assault versus falls and motor vehicle accidents).

"Understanding emotional responses to intentional and unintentional injuries can help inform and improve public health planning and treatment efforts for individuals who experience emotional responses after injury that are concerning or problematic," explains principal investigator Therese S. Richmond, PhD, CRNP, FAAN, the Andrea B. Laporte Professor of Nursing and Associate Dean for Research & Innovation. The research is available now online here and will be published in a future edition of the journal Injury.

This study shows that regardless of intent, these men experience emotional responses including nightmares, avoiding places or people that remind them of the injury, feeling jumpy, depressed and angry, and worry about their recovery. The primary finding was that emotional responses to traumatic injuries can differ by injury intentionality among urban black men, with those who are intentionally injured experiencing heightened feelings of fear and distrust of other people's intentions after their injuries. Survivors of intentional injuries who experience social withdrawal due to distrust of others may not receive adequate social support or weaken already fragile support, the study found.

"This research particularly emphasizes the need for further investigation of the mental health effects of trauma and how intentional injuries may exacerbate emotional responses in men living in marginalized or disadvantaged communities and who have chronic exposure to violence in their neighborhoods," says Richmond.

"Intentional injuries among black men in the US are a critical public health problem that can have a significant impact on men's emotional and mental health. Future work is needed to develop trauma-informed interventions that address trauma histories and current adversity among intentionally-injured Black men," said first-author Tammy Jiang, a doctoral student in epidemiology at the Boston University School of Public Health.