Research
My research interests reflect a synthesis of (1) the trauma-affected clinical populations that I am most interested in serving, (2) a commitment to community-based participatory research (CBPR), and (3) an enthusiasm for implementing innovative methodology that seeks to emulate the dynamic interrelationships between variables as they occur in clinical populations. Much of my research has investigated culturally-specific biopsychosocial risk and protective factors that are salient in posttraumatic recovery with attention to intersectional identities, including among immigrants, refugees, and trauma-exposed adolescents in Bosnia and India. My commitment to conducting research that has tangible implications for clinical practice is evident in the dissemination of my work not only at peer-reviewed scientific conferences, but also through workshops and didactic seminars delivered to community organizations, local nonprofits, and healthcare systems.
Published Works
Dixon, K.E., Layne, C. M., Ho Misiaszek, K., & Golden, C. (2024). Interpersonal, not existential, adversities predict post-war deterioration in youth social support. Academia Medicine, advance online publication. https://doi.org/10.20935/AcadMed6252
This longitudinal study (N = 1,590 war-exposed Bosnian adolescents) used structural equation modeling to compare and contrast the predictive potency of three hypothesized contributors to adolescents’ postwar perceived social support: (a) prewar disruptions in early attachment relationships, (b) wartime and postwar interpersonal adversities, and (c) wartime and postwar adverse living conditions. Results have implications for theory building, research methods, risk screening, and intervention efforts for countless youth exposed to war and its aftermath.
Dixon, K. E. (2024). The Brain Under Sexual Attack: A Review of Neurobiological Disturbances in Trauma Memory. Psychological Trauma: Theory, Research, Practice, & Policy, advance online publication. https://doi.org/10.1037/tra0001694
This review integrates empirical findings from studies of trauma memory disturbance, and more specifically the impacts of glucocorticoid activation in sexual assault memory, contextualizing through the lens of implications for sexual assault litigation. Specifically, I provide suggestions and future directions to aid in the adjustment of witness testimony procedures for survivors of sexual assault in order to optimize survivor psychological outcomes via reduction of stress. Findings synthesized are also important in providing a roadmap for conditions under which the veracity and justness of judicial outcomes may be enhanced by increasing the propensity for accurate testimony and concordant ability for perpetrator prosecution.
Patel, A. Dixon, K. E., & Nadkarni, A. (2024). Unpacking the ‘black box’ of suicide among Indian women: A latent class analysis predicting risk and resilience profiles of suicidal ideation in a large longitudinal cohort of Indian girls. PLOS Global Public Health, 4(5), e0003130. https://doi.org/10.1371/journal.pgph.0003130
As suicide is a growing concern among adolescent girls in India, identifying social determinants of suicide with this group is imperative to inform prevention. Using longitudinal data from a prospective cohort of adolescent girls from Northern India, we performed latent profile analysis (LPA) to classify profiles of sociodemographic risk. Multinomial logistic regression was then performed to examine odds ratios for suicidal ideation at three-year follow-up. Disrupting cycles of psychological distress and substance use, increasing access to behavioral interventions, and intervening to mitigate intergenerational violence may be particularly impactful with this population.
Patel, A., Dixon, K. E., Rojas, S., Gopalakrishnan, L. & Carmio, N. (2024). Explaining suicide among Indian women: Applying the Cultural Theory of Suicide to Indian survivors of gender-based violence reporting suicidal ideation. Journal of Interpersonal Violence, advance online publication. https://doi.org/10.1177/08862605241254145
Indian women account for 36.6% of suicide-related deaths worldwide. The cultural theory of suicide (CTS) synthesizes risk factors and explanations of suicide among racial/ethnic minorities; our study applied the CTS to Indian women from Bombay slums reporting GBV to explore (1) culturally relevant risk pathways towards suicidal ideation using qualitative analyses, and test (2) the association between idioms of distress and suicidal ideation. Findings suggest that culturally responsive suicide prevention among Indian women can include assessing idioms of distress, improving family support, and educating to reduce stigma and enhance help-seeking.
Mahoney, C. T., Beck, B., Dixon, K. E., Horne, S., & Lawyer, S. (2024). Conceptualizing impulsivity as a construct in relation to PTSD symptom severity among women. Journal of Traumatic Stress, advance online publication. http://doi.org/10.1002/jts.23060
Despite the established association between PTSD and impulsivity, the literature is limited regarding impulsivity as a multifaceted construct. This study used structural equation modeling to examine associations between PTSD symptoms and specific components of impulsivity as measured by distinct self-report instruments in a sample of undergraduate college women. Results have implications for precision medicine approaches that emphasize targeting these specific facets of impulsivity, with likely downstream effects on health risk behaviors for emerging adult women.
Dixon, K. E., Owens, A., Lac, A., Samuelson, K. W., & Mahoney, C. T. (2024). Do coping self-efficacy, coping flexibility, and substance use coping serially mediate the connection from PTSD to problematic alcohol use behaviors? Journal of Psychopathology and Behavioral Assessment, advance online publication. https://doi.org/10.1007/s10862-024-10128-1
The self-medication hypothesis postulates that those with posttraumatic stress symptoms are more likely to develop problematic drinking behaviors due to reliance on alcohol use to cope with trauma symptoms. This study aimed to identify if coping meta-skills – trauma coping self-efficacy and coping flexibility – as well as substance use (SU) coping mediated the pathways from PTSD symptoms to alcohol use using structural equation modeling. PTSD symptoms had a significant indirect effect on problematic alcohol use behaviors via trauma coping self-efficacy and substance use coping; these novel findings help to identify critical factors within the comorbid PTSD-alcohol use connection that may serve as intervention targets.
Mahoney, C. T., Dixon, K. E., Daugherty, Y. T., Bindbeutel, K. M., Horne, S. D., Littleton, H., Dworkin, E. R., Livingston, N. A., & Galano, M. M. (2023). Structural pathways between PTSD symptoms and alcohol use consequences among women. International Journal of Mental Health and Addiction, advance online publication. https://doi.org/10.1007/s11469-023-01068-0
College women face heightened risk of interpersonal trauma, which is associated with co-occurring posttraumatic stress disorder (PTSD) and alcohol use. We aimed to identify emotional and cognitive processes (i.e., emotion dysregulation and alcohol use motives) that mediate the relation between PTSD symptom severity and alcohol use consequences among women interpersonal trauma survivors. PTSD symptoms predicted more emotion dysregulation, which predicted higher alcohol use to cope, which was associated with worse consequences, nullifying the direct effect of PTSD on alcohol use consequences. These findings could enhance evidence-based practices surrounding screening, assessment, and intervention for posttraumatic sequelae and improve quality of life for survivors of interpersonal violence.
Dixon, K. E., Bindbeutel, K. M., Daugherty, Y. T., Robertson, A. C., Lee, M., Galano, M. M., & Mahoney, C. T. (2023). The differential impact of childhood trauma on adult impulsivity and impulse control. Traumatology, advance online publication. https://doi.org/10.1037/trm0000440
Child maltreatment can impact impulsivity and impulse control via disruption of adaptive socialization and neural mechanisms. However, little research has explored the impact that timing of trauma exposure has on domain-specific impulsivity deficits in adulthood. The present study aimed to address this gap by examining how differences in the timing of exposure to child maltreatment confer persistent, specific deficits in impulsivity. Impulse control difficulties significantly differed by age at onset of child maltreatment, and those who experienced onset of child maltreatment at 0–5 years old had significantly higher impulse control difficulties than those whose age of onset of child maltreatment was at 13–17 years old. Findings provide insight into ways in which age of trauma exposure catalyzes distinct and enduring self-regulatory deficits.
Dixon, K. E., Mahoney, C. T., & Samuelson, K. (2022). Conceptualizing and assessing ongoing traumatic stress response during a global pandemic. Psychological Trauma: Theory, Research, Practice, & Policy, 15(5), 808-818. https://doi.org/10.1037/tra0001360
The COVID-19 pandemic has been conceptualized as a potentially traumatic event, although heterogeneity in experience (e.g., isolation) and in type and severity of traumatic stress response (e.g., hygiene hypervigilance) query the applicability of the PTSD diagnostic construct. Using exploratory latent profile analysis, we modeled the latent structure of traumatic stress response to COVID-19 in order to evaluate possible nuanced patterns of symptoms differentiating PTSD from a transient ongoing trauma response. Findings from this study shed light onto those who may be especially at risk for development of traumatic stress during COVID-19 by identifying events (e.g., death of a loved one) as predictors of increased PTSD, and provides recommendations on specific ways in which PTSD treatments may need to adapt to help clients make sense of a stress response to the ongoing threat of the pandemic.
Layne, C. M., Ruzek, J. I., & Dixon, K. (2021). From resilience and restoration to resistance and resource caravans: A developmental framework for advancing the disaster field. Psychiatry, 84(4), 393-409. https://doi.org/10.1080/00332747.2021.2005444
Interventions that focus primarily on ameliorating post-disaster distress reactions carry at least four potential limitations. These include: (a) adopting a short term outlook; (b) adopting a reactive, rather than proactive and preventive, orientation toward responding to disasters and their aftermath; (c) prioritizing resilient recovery among exposed subgroups over promoting population-level stress resistance, wellness, and growth; and (d) lost opportunities to build an array of coping resources that are sustainable, developmentally appropriate, and adaptable to a broad array of stressors across the life course. We propose a more proactive, expansive, and developmentally-tailored conceptual framework - and suggest specific ways in which the disaster field can evolve to encompass a more long term, proactive, wellness-based, and growth oriented approach.
Samuelson, K. W., Dixon, K., Jordan, J. T., Powers, T., Sonderman, S., & Brickman, S. (2021). Mental health and resilience during the coronavirus pandemic: A machine learning approach. Journal of Clinical Psychology. https://doi.org/10.1002/jclp.23254
This study explored risk and resilience factors of mental health functioning during the coronavirus disease (COVID‐19) pandemic. Using supervised machine learning models, we identified psychosocial factors as the primary significant predictors across psychological outcomes (depression, anxiety, and PTSD). Greater trauma coping self‐efficacy and forward‐focused coping, but not trauma focused coping, were associated with better mental health. When accounting for psychosocial resilience factors, few external resources and demographic variables emerged as significant predictors. With ongoing stressors and traumas, employing coping strategies that emphasize distraction over trauma processing may be warranted - and outreach efforts should target trauma coping self‐efficacy to bolster resilience during a pandemic.
Chaby, L. E., Sadik, N., Burson, N., Lloyd, S., O’Donnel, K., Winters, J., Conti, A., Liberzon, I., & Perrine, S. (2020). Repeated stress exposure in mid-adolescence attenuates behavioral, noradrenergic, and epigenetic effects of trauma-like stress in early adult rats. Scientific Reports. https://doi.org/10.1038/s41598-020-74481-3
We investigated the effects of adolescent-stress on adult vulnerability to severe stress using the single prolonged stress (SPS) model in male rats. Adolescent-stress prior to SPS eliminated this deficit, suggesting adolescent-stress conferred resiliency to adult severe stress. Adolescent-stress also conferred region-specific resilience to norepinephrine changes. HDAC4 and HDAC5 were down-regulated following SPS, and these changes were also modulated by adolescent-stress. Regulation of HDAC levels was consistent with the pattern of cognitive effects of SPS; only animals exposed to SPS without adolescent-stress exhibited reduced HDAC4 and HDAC5 in the prelimbic cortex, hippocampus, and striatum. Thus, HDAC regulation caused by severe stress in adulthood interacts with stress history such that seemingly conflicting reports describing effects of adolescent stress on adult PTSD vulnerability may stem in part from dynamic HDAC changes following trauma that are shaped by adolescent stress history.