共情对灾后青少年亲社会行为的影响：感恩、社会支持和创伤后成长的中介作用

以雅安地震极重灾区芦山县的542名中学生为被试, 在地震发生3.5年后, 采用人际反应指数量表测查被试的共情能力, 并在震后4.5年采用感恩问卷、社会关系网络问卷、创伤后成长问卷和亲社会行为问卷测查被试的感恩、社会支持、创伤后成长(posttraumatic growth, PTG)和亲社会行为, 从追踪的视角考察地震后青少年的共情能力对亲社会行为的影响, 并探讨感恩、社会支持和创伤后成长(PTG)在其中的中介作用。结果显示, 共情可直接正向预测亲社会行为; 共情对亲社会行为的预测可分别通过感恩、社会支持和PTG的中介进行; 共情还可以分别通过感恩经社会支持、感恩经PTG、社会支持经PTG、感恩经社会支持再经PTG的链式中介对亲社会行为起到正向预测作用。这一发现提示, 未来的创伤后心理辅导工作应更加关注青少年的积极心理和社会行为的发展。     

"Thanks for sharing that": ruminators and their social support networks.

Receiving positive social support after a trauma generally is related to better adjustment to the trauma. The personality of trauma survivors may affect the extent to which they seek social support, their perceived receipt of social support, and the extent to which they benefit from social support. The authors hypothesized that people with a ruminative coping style, who tended to focus excessively on their own emotional reactions to a trauma, compared to those without a ruminative coping style, would seek more social support, and would benefit more from social support, but would report receiving less social support. These hypotheses were confirmed in a longitudinal study of people who lost a loved one to a terminal illness.     

Exposure,Loss, and Support Predicting the Dimensions of Posttsunami Trauma

This study examined whether exposure, resource loss, and social support predicted the posttsunami trauma of PTSD, depression, negative affect, and physical health problems of the 2004 tsunami survivors. Four hundred sixteen survivors were interviewed in Tamil Nadu (India) 14 months posttsunami. Loss of life followed by loss of property and disaster exposure positively predicted the dimensions of trauma. Survivors having lower social status and income received less material and informational support than their equally affected counterparts, which furthered stress and distress. The survivors’ trauma can be arrested, minimizing the exposure and tangible resource loss, and improving the delivery of social support.     

Anticipatory Anxiety of an Imminent Economic Collapse

This article describes a prospective study of 1,200 participants, half of whom were offspring of trauma survivors, and their emotional symptom levels before and after the Corralito, an economic crisis that occurred in Argentina at the end of 2001. The authors report pre- and postcrisis data on anxiety and depression in a group of adult offspring of victims of the Dirty War (1976–1983) in an attempt to ascertain whether they are at greater risk than a control group for developing anxiety and depression in response to an economic crisis. The results indicated the offspring of war victims experienced greater emotional distress than the control subjects before, but not after the imposition of the Corralito.     

灾后儿童心理创伤及危机干预

地震后,幸存下来的儿童可能比成人心理承受的压力更大,及时地对他们进行危机干预,帮助他们进行灾后心灵的重建是非常重要的。本文就儿童心理创伤反应、危机、危机干预、展开,针对儿童较成人的特殊性提出了对儿童进行危机干预的具体措施。     

Predicting posttraumatic growth among Hurricane Katrina survivors living with HIV: the role of self-efficacy,social support,and PTSD symptoms

Abstract

The study tested the model of adaptation after trauma by Benight and Bandura (2004) indicating that posttraumatic recovery may be predicted directly by coping self-efficacy (CSE) and indirectly by social support. These relations were investigated in the context of posttraumatic growth (PTG) among Hurricane Katrina survivors living with HIV. Additionally, it was hypothesized that among individuals with more intensive Posttraumatic Stress Disorder (PTSD) symptoms, those with strong CSE would experience the strongest PTG. Cross-sectional data were collected among 90 patients with HIV who reinitiated care at the HIV outpatient clinic. Questionnaires were administered approximately 14 months after the hurricane. Higher CSE was related to higher PTG among the survivors who suffered from more intensive PTSD symptoms. Received social support was directly related to only one index of PTG, relating to others. Furthermore, although there was a significant relationship between social support and CSE, the indirect conditional effect of received social support on PTG was not confirmed. Similar results were obtained across the indices of PTG, controlling for the level of exposure to hurricane-related trauma. Cross-sectional design and convenience character of the sample warrants replications.     

Sources of “relational homes”: a qualitative study of cancer survivors’ perceptions of emotional support

The aim of this article is to shed light on the different ways in which a group of Danish cancer survivors fulfil their need of emotional support. The study comprised participant observation at a Danish cancer rehabilitation centre, individual semi-structured interviews and focus group interviews with course participants. The analytical process combined the inductive approach of interpretative phenomenological analysis with a deductive theoretical strategy. Key concepts from Robert D. Stolorow's existential-phenomenological trauma theory were used as interpretative framework. Findings suggest that cancer survivors’ perception of emotional support is captured by the theoretical concept a “relational home,” understood here as a supportive and caring environment. A relational home may include different dimensions in various situations and contexts, including an existential and metaphysical dimension in which God/a higher power may provide emotional support similar to that obtained in human relationships.     

Peritraumatic and persistent panic attacks in acute stress disorder

This study examined the prevalence of peritraumatic and persistent panic symptoms following trauma. Survivors of civilian trauma (n=30) with either acute stress disorder (ASD) or no acute stress disorder (non-ASD) were administered the Panic Module of the Structured Clinical Interview for DSM-IV (SCID). Participants also completed the Impact of Event Scale, Acute Stress Disorder Scale, Beck Depression Inventory, Beck Anxiety Inventory, and the Anxiety Sensitivity Index. Panic attacks were experienced by 77% of participants during their trauma, and 47% reported recurrent panic attacks post-trauma. ASD participants demonstrated more panic symptoms during and after their trauma than non-ASD participants. Posttraumatic panic was most strongly associated with anxiety sensitivity. These findings are discussed in terms of cognitive factors that may mediate posttrauma panic and treatment implications for managing posttraumatic anxiety.There is increasing evidence that panic attacks play a role in psychopathological response to trauma. A significant proportion of people with panic disorder report a history of trauma (). Moreover, two-thirds of trauma survivors report panic attacks within the previous 2 weeks (). There is also evidence that people with posttraumatic stress disorder (PTSD) display elevated levels of anxiety sensitivity (). Recent attention has focused on acute panic reactions because of proposals that panic during trauma may condition trauma-related cues to subsequent panic (). There is evidence that panic attacks occur in 53-90% of trauma survivors during the traumatic experience (). Further, people with acute stress disorder (ASD) are more likely to report peritraumatic panic attacks than non-ASD individuals. ASD is a useful framework in which to investigate the role of panic in posttraumatic stress because ASD describes acute responses to trauma that are strongly predictive of chronic PTSD ().This study investigated the relationship between peritraumatic panic and ongoing panic attacks following trauma. Specifically, we indexed panic attacks during trauma and subsequent to trauma in trauma survivors with and without ASD. We also indexed the extent to which distorted interpretations about somatic sensations may be associated with panic attacks following trauma. We considered that the strong evidence that maladaptive appraisals of somatic sensations mediate panic () is directly relevant to posttraumatic panic. We hypothesized that ASD participants would report more peritraumatic and persistent panic than non-ASD participants, and that this panic would be associated with dysfunctional interpretations about somatic stimuli.     

Preliminary Findings from a Qualitative Study of Trauma Survivors in Treatment: Changes in Personal Narratives

This article seeks to document the characteristics and themes of later trauma recovery using a grounded theory analysis of interviews with trauma survivors enrolled in outpatient treatment. Little research exists that speaks to patients’ own accounts of the process of trauma recovery. Such accounts might elucidate how psychotherapy helps survivors make and remake meaning of their lives, their experience of traumatic events, and the resources they might call on in psychotherapy to secure recovery. This study examined narrative material gathered in a series of interviews with trauma survivors (n?=?14) who had been in treatment for an average of 8 months and could be described as in a later phase of the recovery process. Two significant themes emerged from the analysis: (a) greater coherence to the trauma narrative, and (b) the emergence of a more reflective and observational stance with respect to one's history. Implications for trauma-informed therapy are discussed.     

Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology

This study examined whether peritraumatic dissociation serves as a proxy risk factor for experiential avoidance in its relationship with posttraumatic stress disorder (PTSD) symptomatology. One hundred eighty-five trauma survivors completed measures that assessed for peritraumatic dissociation, experiential avoidance, and PTSD symptom severity. The results indicated that peritraumatic dissociation and experiential avoidance were significantly related to PTSD symptomatology at baseline. However, after initial levels of PTSD symptomatology were taken into account, only experiential avoidance was related to PTSD symptoms both 4- and 8-weeks later. These results indicate that peritraumatic dissociation is not a proxy risk factor for experiential avoidance and contributes to the growing body of literature indicating that experiential avoidance is an important factor related to the psychological symptoms experienced by trauma survivors.     

What do Suicide Survivors Tell Us They Need? Results of a Pilot Study

Few studies have examined the natural coping efforts used by suicide survivors, or have identified specific problems and needs survivors experience following the death of a significant other by suicide. In the present study, we used a newly developed needs assessment survey to examine four areas of natural coping efforts: practical, psychological, and social difficulties; formal and informal sources of support; resources utilized in healing; and barriers to finding support since the loss. Sixty-three adult survivors of suicide were recruited from suicide survivor conferences and support groups. Results indicate that participants experienced high levels of psychological distress since the suicide, including elevated symptoms of depression, guilt, anxiety, and trauma. Participants experienced substantial difficulties in the social arena (e.g., talking with others about the suicide). The majority of the sample viewed professional help as beneficial; although many informal sources of support were also valued (e.g., one-to-one contact with other survivors). Depression and a lack of information about where to find help served as barriers to help-seeking behaviors for our participants. Participants who reported higher levels of functional impairment were more likely to report higher levels of psychological distress, social isolation, and barriers to seeking help. Future research with a longitudinal and more inclusive sample is needed to build on these preliminary findings and to provide a solid foundation for evidenced-based interventions with survivors.     

Family Therapy with Families of Holocaust Survivors

This is a clinical review of 7 families of Holocaust survivors who presented for treatment because of problems with an adolescent of the third generation. In 3 cases the problem was anorexia, and the remaining 4 had various clinical presentations, mostly related to separation-individuation issues. A common thread in the narratives that unfolded was that the trauma of the grandparent/survivors had been transmitted across subsequent generations to exercise significant influence on the children and grandchildren. Often, a more recent death or separation crisis had been the catalyst for these difficulties or a trigger that activated the Holocaust trauma. An outline of the therapeutic intervention is presented; it was based on a combination of systemic, structural, strategic, and psychodynamic approaches. It is suggested that open acknowledgment of the transgenerational issues played a critical role in moving families toward a more differentiated outcome.     

我国灾害心理与行为研究

我国是灾害多发的国家, 重大灾害事件不仅导致人民巨大的生命伤亡和经济财产的损失, 而且也给亲历灾害的幸存者带来了严重的个体、家庭和集体的心理创伤。本文重点回顾了5·12汶川大地震以来, 我国研究者在灾后心理创伤领域内的研究进展, 包括灾后心理创伤的流行病学调查, 灾后心理创伤的行为特征、认知功能变化、免疫功能变化以及灾后社会群体心理与行为表现与特征。同时, 分析了我国未来灾后心理与行为研究可能的发展方向。     

The influence of breast cancer survivors' Perceived partner social support and need satisfaction on depressive symptoms: A longitudinal analysis

The present study examines the ways in which breast cancer survivors’ perceptions of emotional and instrumental social support from an intimate partner and need satisfaction in their partner role influence depression during and after breast cancer treatment. Our sample was comprised of 163 women who were an average of 57 years old, mostly White/Caucasian, and diagnosed primarily with early-stage breast cancer. Longitudinal data were analysed using both multilevel and structural equation modelling. Results reveal that (a) greater perceived partner emotional support is associated with lowered levels of depression at each wave, (b) partner-role need satisfaction mediates the relationship between perceived partner emotional support and depression at each wave, (c) perceived partner emotional support predicts subsequent changes in depression by way of need satisfaction and (d) depression prospectively predicts lowered perceptions of partner emotional and instrumental support. The findings confirm that basic need satisfaction, within intimate relationships, is an important predictor of lowered depression among breast cancer survivors.     

Measuring grief after sudden violent death: Zeebrugge bereaved at 30 months

The Expanded Texas Inventory of Grief was used to measure the intensity of grief reactions in those bereaved by the Zeebrugge Disaster 30 months on. “View of Life” items were also included. The ETIG scores reported confirm the view that those bereaved by disaster or other sudden death score higher than those affected by bereavements which are expected. Further, the scores of the bereaved, who did not experience the impact, are somewhat higher than the scores of the survivors, who did, on all the measures used. The ETIG as a whole correlates highly with measures of general psychological symptoms and intrusive and avoidant trauma reactions, although there are indications that each measure relates to different areas of symptoms. There is strong support for the idea that avoidance and denial are central to prolonged grief reactions as well as to post-traumatic reactions. “View of Life” items did not correlate with other measures and seem to have little value in predicting psychological symptoms. The use of these items, which appear in later revisions of the scale (TRIGVOL) may indicate that this particular version has reduced clinical utility. A short form of the ETIG is suggested.     

A Cross-Lagged Panel Approach to Understanding Social Support and Chronic Posttraumatic Stress Disorder Symptoms in Veterans: Assessment Modality Matters

Although there is a strong and consistent association between social support and posttraumatic stress disorder (PTSD), the directionality of this association has been debated, with some research indicating that social support protects against PTSD symptoms, whereas other research suggests that PTSD symptoms erode social support. The majority of studies in the literature have been cross-sectional, rendering directionality impossible to determine. Cross-lagged panel models overcome many previous limitations; however, findings from the few studies employing these designs have been mixed, possibly due to methodological differences including self-report versus clinician-administered assessment. The current study used a cross-lagged panel structural equation model to explore the relationship between social support and chronic PTSD symptoms over a 1-year period in a sample of 264 Iraq and Afghanistan veterans assessed several years after trauma exposure. Approximately a third of the sample met criteria for PTSD at the baseline assessment, with veterans’ trauma occurring an average of 6 years prior to baseline. Two separate models were run, with one using PTSD symptoms assessed via self-report and the other using clinician-assessed PTSD symptoms. Excellent model fit was found for both models. Results indicated that the relationship between social support and PTSD symptoms was affected by assessment modality. Whereas the self-report model indicated a bidirectional relationship between social support and PTSD symptoms over time, the clinician-assessed model indicated only that baseline PTSD symptoms predicted social support 1 year later. Results highlight that assessment modality is one factor that likely impacts disparate findings across previous studies. Theoretical and clinical implications of these findings are discussed, with suggestions for the growing body of literature utilizing these designs to dismantle this complex association.     

社会支持、创伤后应激障碍与创伤后成长之间的关系:来自雅安地震后小学生的追踪研究

本文采用追踪研究的设计,在雅安地震后的6、12和18个月三个时间点,采用社会支持问卷、儿童创伤后应激障碍症状量表、DSM-5的PTSD核查表和创伤后成长问卷对303名小学生进行调查。通过建立交叉滞后模型,考察社会支持、创伤后应激障碍(PTSD)与创伤后成长(PTG)三者之间的关系,结果发现在震后6至18个月之间,PTG对PTSD没有显著的预测作用,震后6个月的PTSD对震后12个月的PTG具有显著的跨时间点的正向预测作用,但是该作用在震后12至18个月之间不再显著;震后6至12个月之间,社会支持对PTSD发挥单向的缓解作用,但与PTG之间不存在显著的预测作用;在12至18个月之间,PTSD可以单向地降低社会支持,且社会支持与PTG之间也存在显著的正向相互预测作用。     

Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training

Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma’s effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents (n = 17; 2 sites) or community physicians (n = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.     

The role of posttraumatic fear and social support in the relationship between trauma severity and posttraumatic growth among adolescent survivors of the Yaan earthquake

Middle school students in Lushan county (N = 315) were assessed 6 months after the Yaan earthquake using a trauma severity questionnaire, a posttraumatic fear questionnaire, a social support questionnaire and a posttraumatic growth inventory to examine the effects of posttraumatic fear and social support in the relationship between trauma severity and posttraumatic growth (PTG). The results showed that posttraumatic fear mediated the relationship between trauma severity and PTG, and social support moderated the relationship between posttraumatic fear and PTG. These findings suggested that trauma severity could be positively associated with PTG in a direct way or in an indirect way through posttraumatic fear. Moreover, posttraumatic fear had a positive relation to PTG under the condition of high social support level, whereas the relation was non‐significant when the level of social support was low. These results were discussed in terms of their implications for adolescents after trauma.     

Understanding Social Factors in the Context of Trauma: Implications for Measurement and Intervention

One of the most important factors predicting the presence of posttraumatic stress disorder (PTSD) after trauma exposure is social support, yet the construct is theoretically complex and remains variably defined. To better inform the trauma literature on the impact of social factors, a theoretical review of social support and PTSD was conducted, and implications for measurement and intervention are outlined. Type of trauma, sex of participant, timing of social support, and support providers are described as significant moderators of the association between social factors and PTSD. The developmental trajectory of the association between social factors and PTSD occurrence is outlined, emphasizing the positive influence of social support initially following trauma, and the deterioration effect of PTSD symptoms on social support over the longer term. Possibilities for future research and intervention at multiple levels and at different time points are described.