Mental health problems among internally displaced persons in Darfur

War victims are regarded as one of the highest risk groups for mental disturbances. This study investigated the effects of the Darfur conflict on mental health of 430 internally displaced persons (IDPs) from three camps located around Fasher and Nyala towns. A stratified random sampling technique was used to select participants. Male participants represented 50.6% of the sample while female participants represented 49.4%. The Posttraumatic Stress Disorder Checklist and the General Health Questionnaire (GHQ-28) were used in addition to a questionnaire measuring demographic variables and living conditions. It was hypothesized that high prevalence of posttraumatic stress disorder (PTSD) symptoms and of nonpsychotic psychiatric symptoms will be evident. Results showed a high dissatisfaction rate (72%) with living conditions among IDPs. There was also high prevalence of PTSD (54%) and general distress (70%) among IDPs. Female participants showed more somatic symptoms than their male counterparts. Married participants were more distressed, anxious, and showed more social dysfunction, while single ones reported more avoidance symptoms. Significant differences related to date of displacement were found in PTSD and hyperarousal. The group of IDPs displaced in 2003 scored higher on these scales than those displaced in 2004 and 2005. There was also significant difference related to date of displacement in distress, somatic symptoms, depression, anxiety, and social dysfunction. IDPs displaced in 2003 scored higher on these scales. Results are discussed in light of the study hypotheses and previous findings. It is concluded that three factors might affect the dissatisfaction of IDPs with living conditions inside camps. These are: lack of employment, unsuitability of food items, and lack of security around camps. It was recommended that psychological support services should be among the prime relief services provided by aid agencies.     

Issues in group work with older lesbians

This article outlines considerations in group interventions with older lesbians. It is intended for mental health professionals who work—as leaders, supervisors, and consultants—with various kinds of groups in their professional practice, including therapy, psychoeducational, support, growth, recreational, and self-help groups. First, unique issues in the life circumstances of older lesbians are addressed. Next, five case examples are presented that illustrate the usefulness of group interventions with this population. The article concludes with recommendations for effective practice.     

Treating persons with ARC and AIDS in group psychotherapy

The authors describe a range of critical issues that are common within homogeneously composed groups for patients suffering from Acquired Immunodeficiency Syndrome (AIDS) and AIDS Related Complex (ARC). They examine the need for these patients to understand their physical symptomatology, to reconsider life's priorities, and to confront their ethical and moral dilemmas. The authors also highlight special effects, unique group atmosphere and process, and the nature of the group contract that is essential for these patients.     

Reality at odds with perceptions: narcissistic leaders and group performance

Although narcissistic individuals are generally perceived as arrogant and overly dominant, they are particularly skilled at radiating an image of a prototypically effective leader. As a result, they tend to emerge as leaders in group settings. Despite people's positive perceptions of narcissists as leaders, it was previously unknown if and how leaders' narcissism is related to the performance of the people they lead. In this study, we used a hidden-profile paradigm to investigate this question and found evidence for discordance between the positive image of narcissists as leaders and the reality of group performance. We hypothesized and found that although narcissistic leaders are perceived as effective because of their displays of authority, a leader's narcissism actually inhibits information exchange between group members and thereby negatively affects group performance. Our findings thus indicate that perceptions and reality can be at odds and have important practical and theoretical implications.     

Effective group work with delinquents in Hong Kong

The principle of matching services to needs suggests that group work would be most effective when it targets those most in need of the services--delinquents with low involvement with the family and high involvement with friends. Less time with the family indicates a greater need for conventional social control, while more time with friends may entail a greater need for learning social skills in order to resist delinquent peer influences. To address these needs, developmental group work is appropriate for delinquents identified by social workers. The effectiveness of services tend to be contingent upon the delinquents' relationship with family and friends. To test this hypothesis, the present study collected data from 190 delinquents in Hong Kong. It was found that developmental group activities were beneficial to delinquents who spent less time with family and/or more time with friends. For delinquents in general, developmental group activities were helpful in diminishing delinquency. Moreover, the help was significantly greater for delinquents who spent more time with friends.     

Male leaders with paternity leaves: effects of work norms on effectiveness evaluations

ABSTRACT

With the growing relevance of work–family balance and gender equality at work, researchers have extensively recognized the importance of men’s greater home involvement. Yet, little is known about how people evaluate men and particularly male leaders with involved fathering behaviours, such as taking a long paternity leave. Using a social normative perspective, we explore whether cultural standards providing social approval for work–life balance influence competence evaluations of male leaders who request a paternity leave. Results from three experimental and field studies suggest that perceptions of a supportive work-family culture favour more positive evaluations of male leaders with a paternity leave. Associations were stronger for people with leadership aspirations and roles. Several main effects emerged too: male leaders taking a leave beyond the standard (from 2 weeks to 3 months) received more negative evaluations than male leaders with a shorter, statutory leave (from 2 days to 2 weeks), and employees’ sexism predicted negative evaluations. Also, slightly lower status was attributed to male compared to female leaders who requested a leave. Findings are discussed in terms of how male managers’ domestic behaviour should be further reinforced with organizational discourses and practices.     

Professional issues in group work

This article first describes the explosion of interest in and practice of group work, with the resultant lag between the development both of standards for training and practice and of a code for ethical behavior/ practice. We used a questionnaire to fill in some gaps regarding the number of cases of unethical behavior/practice in group work and the respondents' recommendations for dealing with the problems raised both externally by the public media and internally by professional association members. The data from the questionnaire are summarized, analyzed, and made relevant to the problem of ethics for group practices. We drew conclusions from these data, from others who have addressed themselves to the problems, and from our own experiences in the group field. From these conclusions we list recommendations for alleviating the problem.     

Managing persons with multiple personality disorder in a heterogeneous inpatient group

Experts advise against referring persons with multiple personality disorder to diagnostically heterogeneous groups. As more multiples are admitted to inpatient units this presents a problem. Excluding persons of a particular diagnosis from groups makes it difficult to promote a cohesive therapeutic milieu. I have found that multiples can be managed successfully in mixed groups. The leader is advised to adhere to a reliable structure and pay close attention to boundary issues. Themes for discussion must be judiciously evaluated so that effectiveness is not undermined. Patients with different diagnoses can come to appreciate their similarities and benefit from groups.     

Interpersonal problems of persons with personality disorders and group outcomes

This article examines the interpersonal problems of 42 persons referred for brief group treatment at a community mental health center. Measures of symptom severity, self-esteem, and interpersonal problems were administered pre- and posttreatment. Study participants' scores were analyzed to determine possible differences in the interpersonal problems experienced by those diagnosed with personality disorders and those without them. Results revealed that both groups improved significantly on the overall measure of symptom severity. Findings further revealed that self-esteem improved significantly more for those diagnosed with personality disorders. Analysis of interpersonal problems scores revealed differences between the two groups in the areas of support and involvement prior to treatment, but not after. Possible explanations for these differences and implications for treatment are discussed.     

Treating work inhibition in group psychotherapy

Work Inhibition, defined as an impaired ability to pursue one's career goals, may be treated by combined individual and group therapy. The author presents a method for assessing the degree of work difficulty, a psychodynamic understanding of the problem, and an approach to treatment. He proposes that helping the patient work more actively in group will generalize to the workplace and reduce inhibition. A clinical illustration is provided.     

Role of event centrality and emotion regulation in posttraumatic stress disorder symptoms among internally displaced persons

Background: Event centrality and emotion regulation in relation to posttraumatic stress disorder (PTSD) have been documented in various global samples especially in Western cultures; but internally displaced persons (IDPs) still constitute an underrepresented population in psychotraumatology literature. This study tested the roles of event centrality and emotion regulation strategies (cognitive reappraisal and expressive suppression) in PTSD symptoms among IDPs in Nigeria.

Design: The multi-group cross-sectional design was adopted.

Methods: Tiv language versions of the Centrality of Events Scale, Emotion Regulation Questionnaire, and Harvard Trauma Questionnaire were completed by 859 IDPs in two camps located in Benue State, North-central region of Nigeria.

Results: Hierarchical multiple linear regression results indicated that event centrality positively predicted PTSD symptoms. Cognitive reappraisal was a negative predictor of PTSD symptoms while expressive suppression was a positive predictor of PTSD symptoms. Bonferroni corrections indicated that expressive suppression was the strongest predictor of total PTSD symptoms, avoidance/numbing symptoms, and hyper-arousal symptoms; but event centrality was the most robust predictor of PTSD intrusion/re-experiencing symptoms.

Conclusion: The findings underscore recent developments in psychotraumatology indicating that the extent to which individual differences impact the development of PTSD is essential in clinical psychology research and practice.     

Employing persons with severe disabilities: much work remains to be done

This article presents statistical data depicting the employment of persons with disabilities at a federal installation using a recruitment intervention designed to increase the presence of persons with disabilities. The data were obtained by reviewing archival recruitment accessions that span 5 years (1999–2003). The organization under study is a highly technical Department of Defense organization constituted primarily of engineers and scientists and has been in existence and a major contributor in national defense for many years. Earlier recruitment data are not available.     

A DBT Skills training group for family caregivers of persons with dementia

A Dialectical Behavior Therapy Skills training manual (DBT Skills) was adapted for use with caregivers of individuals with dementia. Implementation occurred in a community clinic with a heterogeneous caregiver group at risk for elder abuse. Sixteen caregivers completed the 9-week group. The results point to improved psychosocial adjustment, particularly increased problem-focused coping, enhanced emotional well-being, and less fatigue. Caregivers tended to utilize individual therapeutic services at a higher rate during the period of group attendance, indicative of appropriate help-seeking behavior in highly demanding situations. Six of the 16 caregivers repeated the training sequence in “booster” groups. Follow-up data from the booster groups suggest that high-risk caregivers may require continuing support to maintain treatment gains. In addition to demonstrating the feasibility of DBT Skills with caregivers, the results warrant a controlled outcome evaluation.     

Prolonged grief disorder symptoms in bereaved internally displaced Tiv persons in Nigeria: associations with rumination,rebirth concerns and gender

ABSTRACT

There is burgeoning research on prolonged grief disorder (PGD) among several vulnerable populations but PGD symptoms have been scarcely examined among bereaved internally displaced persons (IDPs). This study investigated the associations of rumination, rebirth concerns and gender with symptoms of PGD following conflict-related bereavement. Participants were 379 Nigerian IDPs who were of the Tiv ethnic group. They provided demographics and completed self-report measures grief and rumination, while concern about rebirth status of the deceased was assessed using a single item which requested participants to indicate whether they had any concerns about the re-incarnation of the deceased. Results showed that gender was not associated with PGD symptoms. High intrusive rumination and high deliberate rumination were associated with increased PGD symptoms in males and females. Rebirth concern was associated with high PGD symptoms in males but not in females. Findings highlight the need for socio-culturally-informed screening/intervention in the wake of conflict-related bereavement.     

Preventive work in a toddler group and nursery

This paper is about the sort of preventive work which can be carried out in early child care settings where incipient disturbance can be picked up and worked with promptly and effectively. It shows how toddler groups and nurseries can offer relationships and experiences which encourage mutuality and progressive development, while at the same time addressing difficulties before they have become fully internalized. It gives a detailed account of work with a single mother and her son who attended first a toddler group run by a child psychotherapist and her trainee assistant, and then a nursery where staff were in regular consultation with the child psychotherapist who also worked individually with the mother. It argues that the effectiveness of such early interventions can be conceptualized in terms of supplying maternal and paternal functioning at a time when children and parents alike are particularly needful of and responsive to this sort of help.