Post-Traumatic Distress in Israeli Adolescents Exposed to Ongoing Terrorism

Summary

This article examines the impact of exposure of ongoing terrorism on post-traumatic stress disorder (PTSD) symptoms, functional impairment, somatization, and depression among Israeli adolescents in the context of the Al Aqsa Intifada. An in-school screening of 1,010 adolescents was conducted in Jerusalem and nearby settlements that were subjected to intensive terrorist attacks. The screening procedure proved effective in identifying posttraumatic distress and triaging students for school-based treatments. The relationship between level of exposure and gender and the psychological sequelae, the differences between adolescents in Jerusalem and the settlements, and the role of spirituality and community are discussed.     

Exposure therapy for post-traumatic stress disorder: Its relative efficacy,limitations and optimal application

Abstract

Post-traumatic stress disorder (PTSD) is a very debilitating psychological disturbance that follows the experience of traumatic events. Exposure therapy has shown good treatment efficacy in earlier treatment outcome studies on PTSD. Only a few other behavioral treatments have shown equal effectiveness, and exposure is usually a necessary treatment component in the others. This paper presents a short review of controlled treatment outcome studies on PTSD. The relative efficacy of exposure therapy compared to other treatments is discussed and factors that can hinder and enhance its effectiveness are reviewed. In the discussion section some methodological pitfalls in the treatment outcome studies are discussed.     

Impact of Peer Support on PTSD,Hope, and Functional Impairment: A Mixed-Methods Study of Child Soldiers in Nepal

The experience of child soldiers during postwar civilian reintegration is recognized as a major contributor to mental health. For some children, postwar social relations may be more important than war trauma in determining psychosocial well-being. Mixed methods incorporating epidemiology and qualitative case studies were employed to evaluate the effects of family, peer, and community relations after reintegration on psychosocial outcomes: hope, functional impairment, and post-traumatic stress disorder (PTSD). Participants were 142 child soldiers, including 9 qualitative case studies. Peer support predicted increased hope, decreased functional impairment, and decreased PTSD symptoms. Conversely, problems with peer relations predicted less hope and more PTSD symptoms. Maximizing peer support and minimizing stigma from peers should be prioritized within psychosocial reintegration programs, especially among former child soldiers with PTSD.     

Therapeutic response to Cognitive Processing Therapy in White and Black female veterans with military sexual trauma-related PTSD

Cognitive Processing Therapy (CPT) is an evidence-based treatment (EBT) for posttraumatic stress disorder (PTSD) which has been validated for female veterans with military-related PTSD. Existing trials have enrolled predominantly White veterans with some studies documenting higher rates of early termination from EBTs among Black females when compared to White females. Data from a previously published randomized clinical trial were used to evaluate the effectiveness of CPT for Black female veterans with military sexual trauma (MST)-related PTSD. Reductions in PTSD symptom severity, number of sessions attended, and early termination rates were compared between Black (n = 20) and White (n = 16) female veterans. A hierarchical linear modeling approach was used, with PTSD symptom severity over the course of treatment and follow-up entered as a level-1 variable and race (Black or White) entered as a level-2 predictor. Piecewise growth curves analyses revealed that both Black and White female veterans experienced significant reductions in PTSD symptom severity over the course of treatment and gains were maintained up to 6 months post-treatment. Race was not found to be a significant predictor of change in the slope of PTSD symptom severity over the course of CPT treatment. Additionally, number of sessions attended and rates of early termination did not significantly differ based on race. Results suggest that CPT was a well-tolerated and effective psychotherapeutic treatment for this sample regardless of racial self-identification.     

中学生创伤后成长、创伤后应激障碍的发展趋势:心理复原力的预测效应

以问卷调查的方法对汶川震后初一年级的学生进行2.5年的追踪研究,通过多层线性模型(HLM)来探索创伤后成长(PTG)和创伤后应激障碍(PTSD)的发展趋势以及心理复原力对二者的预测效应。结果发现,随着时间的发展,心理复原力仅在第二次施测时呈显著下降趋势,PTSD与PTG均呈现出先下降后上升的非线性发展趋势;心理复原力的三个因子对PTG均有显著的正向预测作用,力量因子对PTSD有显著负向预测作用,其中,乐观因子可进一步预测PTG的发展速度,力量因子可进一步预测PTSD的发展速度;在灾后中学生PTG的增长、PTSD的降低中,心理复原力可以分别解释18.87%和14.74%的变异。     

Treatment of Prostitution Using Integrative Therapy Techniques: A Case Study

This case study examines a pattern we believe to be common among female prostitutes: a woman (Bonnie) who, like most prostitutes, is a survivor of childhood sexual abuse. Bonnie's prostitution is part of the unconscious repetition compulsion common in trauma victims; by prostituting herself, Bonnie re-creates the scenario of sexual abuse that occurred during her childhood, while maintaining an illusion of control over the situation. We maintain that an effective approach to treatment for Bonnie is integrative therapy, a type of psychological counseling designed to address the major aftereffects of sexual abuse: dissociation from the body and sexuality in general; a profound sense of powerlessness; critically low valuation of the self; and mistrust and fear of intimacy. Bonnie's story shows the dynamics of both prostitute behavior and integrative therapy, providing an example we believe to be applicable far beyond this case study.     

PTSD个体对创伤相关刺激的情绪标识效应研究

采用三因素混合实验设计,结合情绪标识范式考察创伤后应激障碍（PTSD）个体对创伤相关图与负性情绪面孔的情绪标识效应。结果发现：PTSD组的情绪标识任务抑制了创伤相关图对之后奇偶判断任务的干扰,表现出显著的情绪标识效应;而对负性情绪面孔的情绪标识效应不显著。该研究表明将谈话疗法用于PTSD患者的心理危机干预是有效的。     

急性应激障碍（ASD）研究述评

急性应激障碍是个体在亲历、目击或面临一个对自己或他人具有死亡威胁、严重伤害的创伤事件后的2天至4周内所表现的应激反应。急性应激障碍的症状主要表现为分离、再历、回避和过度警觉。文章回顾了以往的相关研究,从急性应激障碍的测评方法、发生率、与创伤后应激障碍和创伤记忆的关系、心理治疗和干预等方面进行了综述。最后对未来可能的研究方向提出了展望     

灾难中的心理危机干预——精神病学的视角

灾难事件是一种特殊类型的生活事件,因其超出个体应对能力,因此灾难事件后常并发一系列的精神卫生问题。急性应激障碍、创伤后应激障碍、抑郁症、自杀是灾后常见精神卫生问题。本文回顾了近年来灾难事件相关精神障碍的研究,并总结了去年发生在我国的两次重大灾难性事件的相关研究结果,从精神病学视角对灾难事件后心理危机干预策略进行了探讨。     

Meta-analysis of the association between rumination and reduced autobiographical memory specificity

The CaRFAX model, proposed by Williams J. M. G. (2006. Capture and rumination, functional avoidance, and executive control (CaRFAX): Three processes that underlie overgeneral memory. Cognition and Emotion, 20, 548–568. doi:10.1080/02699930500450465; Williams, J. M. G., Barnhofer, T., Crane, C., Herman, D., Raes, F., Watkins, E., &; Dalgleish, T. (2007). Autobiographical memory specificity and emotional disorder. Psychological Bulletin, 133(1), 122–148. doi:10.1037/0033-2909.133.1.122) posits that reduced autobiographical memory specificity, a key factor associated with the emergence and maintenance of emotional disorders, may result from heightened rumination. We provide the first meta-analysis of the relation between autobiographical memory specificity and trait rumination. PsycINFO, PsycARTICLES and MEDLINE databases were searched and the following were extracted: the correlation between the number of specific memories recalled in the Autobiographical Memory Test and self-reported trait rumination scores, and its sub-factors – brooding and reflection. The pooled effect size for the correlation between memory specificity and trait rumination was small (d?=??.05) and did not differ significantly from zero (p?=?.09). The effect sizes for the correlation with brooding and reflection were not significantly different from zero. There is limited support for the association between trait rumination and memory specificity suggested in CaRFAX.