Social sharing of emotional experiences in Asian American and European American women

The present study investigated the relationships among ethnicity and social sharing of traumatic experiences in a sample of 88 East Asian and 88 European American women. Participants were asked to write about a traumatic experience for twenty minutes and then to rate how upsetting the experience was, how often they thought about it, how often and to whom they had previously disclosed the experience, as well as the perceived appropriateness of sharing the experience with different target audiences, e.g., friends and family members. The results indicated that Asian Americans reported speaking to others less frequently about the traumatic event and sharing it with fewer individuals, and tended to be more likely to share the event with friends than with family members when compared to European Americans. Asian Americans also reported thinking about the upsetting event less frequently than European Americans even though both groups reported that the events were equally upsetting. The more upsetting events were, the more often they were shared in the European American group, but there was no relationship between how upsetting events were and the degree to which they were shared in the Asian American group.     

Amnesia,flashbacks, nightmares,and dissociation in aging concentration camp survivors

The current study examined to what extent war memories of Dutch survivors of Japanese/Indonesian concentration camps display characteristics that are often believed to be typical for traumatic memories. Twenty-nine survivors were interviewed about amnesia, flashbacks, nightmares and the sensory quality of their most upsetting war memories. In addition, they completed self-report scales measuring post-traumatic stress symptoms and dissociation. In contrast to prevailing notions, amnesia, flashbacks and nightmares were not typical for this sample. Neither were traumatic memories characterized by a particularly strong sensory loading. Post-traumatic stress symptoms were not related to dissociative experiences. At least for this group of aging survivors, it appears that the pathogenic potential of traumatic memories has more to do with their extremely aversive content than with a qualitatively different type of organization of these memories.     

STRUCTURAL MODELS OF THE RELATIONS OF ASSAULT SEVERITY, SOCIAL SUPPORT, AVOIDANCE COPING, SELF-BLAME, AND PTSD AMONG SEXUAL ASSAULT SURVIVORS

A number of studies have identified which survivors of sexual assault are more likely to develop symptoms of posttraumatic stress disorder (PTSD). Most correlates that have been identified have been at the individual level. Insufficient attention has been given to whether survivors' social interactions impact their individual responses to assault and subsequent levels of psychological symptomatology. In this study, a large, diverse sample of community-residing women ( N = 636) was surveyed. Structural equation modeling was used to examine the relationships between assault severity, global support, negative social reactions, avoidance coping, self-blame, traumatic life experiences, and PTSD symptoms. The results suggest that negative social reactions and avoidance coping are the strongest correlates of PTSD symptoms and that the association typically observed between victim self-blame and PTSD symptoms may be partially due to the effect of negative social reactions from others. These reactions may contribute to both self-blame and PTSD. Implications for future research and clinical practice are discussed.     

Do Suicides’ Characteristics Influence Survivors’ Emotions?

The suicide of a related person can often induce severe negative emotional reactions. The objective of this study was to explore the relationships between sociodemographic and diagnostic data of suicides and survivors' emotions and to close this substantial gap. The main outcome of this study was that survivors' severity of emotional disturbance was inversely correlated with age of suicides. In the multivariable approach, only age remained related to the majority of the assessed survivors' emotions, whereas other characteristics, such as gender, presence of psychiatric disorder, or suicide method were not associated with survivors' emotions. Age had a dominant impact on the relationship between suicides' characteristics and survivors' emotional reactions and supersedes the effect of most suicides' characteristics including diagnoses.     

Relational Couple Therapy with Post-Traumatic Survivors: Links Between Post-Traumatic Self and Contemporary Intimate Relationships

The present article describes a clinical case study of relational couple therapy with post-traumatic spouses. Survivors, who were infants and toddlers during the Holocaust, disclose tremendous difficulties in their intimate relationships. The early loss of parental figures, and cumulative traumatic experiences throughout survivors' lives in the post war era hampered their capacity for intimate partnership despite its ultimate necessity. Relational couple therapy creates an unfamiliar experiential space with the couple's bond. This experiential space enables each partner to change destructive emotional patterns within one's inner psychic reality as well as the couple's emotional system. In addition, the therapeutic triangle creates partial transformational boundaries between past traumas and the couple traumatic bonds.     

动作疗法在灾后心理康复中的运用

在四川经历了汶川大地震后两年,青海又发生了玉树地震。地震灾害不仅对灾区幸存者造成了身体上的伤害,让人们失去家园和亲人,在心理上也给他们造成了严重的创伤。因此,对于这类人群的灾后心理康复治疗尤为重要。然而,幸存者心理的康复,单纯依靠心理辅导和治疗是不够的,而肢体上的运动能够起到缓解心理症状的良好效果。动作疗法就是一种行之有效的疗法。本文将介绍动作疗法在灾后心理康复的治疗中的运用,并提出具有针对性的动作疗法的措施。     

A combination of combat experience,early abduction,and severe traumatization fuels appetitive aggression and violence among abductees of rebel war in Northern Uganda

Individuals who perpetrate violence may likely perceive violence as appealing and infliction of violence to derive pleasure is termed as appetitive aggression. Individuals who were abducted as children into an armed group often experience a higher number of traumatic event types, that is traumatic load and are usually socialized in a violence-endorsing environment. This study aims to investigate the interaction between age at initial abduction with that of traumatic load, and their influence on appetitive aggression along with perpetration of violent acts by former members of an armed rebel group of both sexes. Semi-structured interviews were conducted among a target group of formerly abducted rebel-war survivors (including participants with and without combat experience) from Northern Uganda. Participants included 596 women and 570 men with N = 1,166 (M_age = 32.58, SD_age = 9.76, range: 18–80 years). We conducted robust linear regression models to investigate the influence of age at initial abduction, traumatic load, combat experience, and biological sex on appetitive aggression as well as their perpetrated violent acts. Our study shows, appetitive aggression and the number of perpetrated violent acts were specifically increased in individuals who were abducted young, experienced several traumatic events in their lifetime, and with previous combat experience. For perpetrated violence men showed increased levels whereas for appetitive aggression the association was independent of biological sex. Therefore, early abducted individuals with a higher traumatic load, who have combat experience, need to be given special intervention to prevent any further violence.     

Memory of the traumatic event as a risk factor for the development of PTSD: lessons from the study of traumatic brain injury

Traumatic memories, and the mechanisms by which they operate, continue to occupy a central role in the scientific investigation of risk factors for the development of posttraumatic stress disorder (PTSD). However, empirically based studies are constrained by practical and ethical considerations and are limited to naturalistic models. Consequently, the paradigms most appropriate for the exploration of the relationship between traumatic memories and PTSD have been identified in conditions involving traumatic events where memories may be compromised. Indeed, traumatic brain injury, a condition that is commonly associated with memory impairment, has often been utilized as a naturally occurring model for the study of traumatic memory and its contribution to the development of PTSD. This article presents a critical review of these research efforts and discusses their theoretical and clinical implications.     

THE NEED FOR POWER IN WOMEN WHO WERE SEXUALLY ABUSED AS CHILDREN An Exploratory Study

Ten women who had been sexually abused as children and a matched group of women who had not been sexually abused participated in a preliminary study to explore the hypothesis that feelings of powerlessness and a compensatory need for power continue into adulthood for survivors of childhood sexual abuse. The Picture-Story Exercise (PSE) was used as an indirect assessment technique to determine the level of the need for power (McClelland, 1985; Winter, 1973, 1988). Results indicated that the stories of women with sexual abuse histories revealed a higher need for power and greater fear of power than those of nonabused women. Further content analysis of the PSE revealed that sexual abuse survivors' stories also contained more references to Finkelhor and Browne's (1986) dynamics of powerlessness, traumatic sexualization, betrayal, and stigmatization. These findings suggest important directions for future research as well as areas for therapeutic exploration.     

Children with Autistic Spectrum Disorders: Individual Differences,Affect, Interaction,and Outcomes

In this article, we have drawn upon the attachment motivational system (Bowlby, 1988; Lichtenberg, 1989; Shane, Shane, and Gales, 1997) as a guide to providing “positive new experience” as the cornerstone of therapeutic progress. We see positive new experience as paramount, over and above insight and/or interpretation because insight and interpretation are so varied among different theories. The common denominator that is effective in therapy, then, must be something beyond insight and interpretation. We call that therapeutic factor the positive new experience and will draw from attachment theory to understand its components. In addition, using the attachment motivation system and trauma research, we elaborate on why certain types of negative experiences in psychotherapy and psychoanalysis should be avoided. We address, in particular, harmful repetitions of traumatic relational patterns or traumatic events in the transference, overemphasis on “the empathic stance,” and the search for motivation in patients' behaviors where such a search may be based on the false assumption that all behavior is motivated. This latter category addresses aspects of behaving that may not be motivated; that is, they just “are,” and as such, the search for and attribution of meaning in such instances may lead to failed understanding and insight and to faulty correctives. We have illustrated with clinical examples both positive new experience and three types of negative experiences to be avoided in treatment.     

What Abandoned Children Construe as Stressful Experiences: Implications for Psychoanalytic Relational Theory and Child Psychotherapy

As part of psychological evaluations to determine whether interventions were needed, 106 abandoned children (aged 5 to 19 years) residing in SOS-Kinderdorf International Children's Villages in Spain were individually administered a structured interview to learn what each child construed as upsetting. Before admission, each child had been exposed to one of three traumatic, interpersonal experiences: excessive neglect; physical abuse; and parents who were prostitutes, abusing drugs, or both. In an unexpected finding, the events these children discussed most often as having upset them did not focus on abandonment or on traumatic conditions they had endured. Rather, converging with reports of public school children residing with their families in the United States, the events they discussed concerned harm to loved ones (e.g., accident, illness, hospitalization). In addition, children who had been visiting relatives while residing in a Children's Village differed from those who had not visited relatives in what they experienced as traumatic. The results are examined in terms of implications for psychoanalytic-relational theory and for planning treatment programs for children who have been abandoned or are living in institutions.     

Psychoanalyse mit Traumatisierten

Extreme and complex traumatisation represents a severe problem in today’s world. There is a need to develop treatment approaches that are efficient for traumatised persons who often live under very difficult circumstances. There are moreover certain societal conditions that are important for the treatment and rehabilitation of the traumatised patient. The paper will discuss how psychoanalytic therapy may be helpful for severely traumatised patients and what are the mechanisms of change in the therapeutic process. A focus is on how traumatic experiences are actualised in the transference and brings the analyst in a situation where enactments inevitably occur. It will be demonstrated how these processes may lead to symbolisation of these traumatic experiences. What are the therapeutic and societal preconditions for treating traumatised patients?     

Intrusive re-experiencing in post-traumatic stress disorder: phenomenology, theory, and therapy

The article describes features of trauma memories in post-traumatic stress disorder (PTSD), including characteristics of unintentional re-experiencing symptoms and intentional recall of trauma narratives. Reexperiencing symptoms are usually sensory impressions and emotional responses from the trauma that appear to lack a time perspective and a context. The vast majority of intrusive memories can be interpreted as re-experiencing of warning signals, i.e., stimuli that signalled the onset of the trauma or of moments when the meaning of the event changed for the worse. Triggers of re-experiencing symptoms include stimuli that have perceptual similarity to cues accompanying the traumatic event. Intentional recall of the trauma in PTSD may be characterised by confusion about temporal order, and difficulty in accessing important details, both of which contribute to problematic appraisals. Recall tends to be disjointed. When patients with PTSD deliberately recall the worst moments of the trauma, they often do not access other relevant (usually subsequent) information that would correct impressions/predictions made at the time. A theoretical analysis of re-experiencing symptoms and their triggers is offered, and implications for treatment are discussed. These include the need to actively incorporate updating information ("I know now ...") into the worst moments of the trauma memory, and to train patients to discriminate between the stimuli that were present during the trauma ("then") and the innocuous triggers of re-experiencing symptoms ("now").     

Design of the Steps to Health Study of Physical Activity in Survivors of Endometrial Cancer: Testing a Social Cognitive Theory Model

Physical activity has been shown to benefit cancer survivors' physical functioning, emotional well-being, and symptoms. Physical activity may be of particular benefit to survivors of endometrial cancer because they are more likely to be obese and sedentary than the general population, as these are risk factors for the disease, and thus experience a number of related co-morbid health problems. However, there is little research systematically studying mechanisms of physical activity adherence in cancer survivor populations. This paper describes the design of the Steps to Health study, which applies a Social Cognitive Theory-based model of endometrial cancer survivors' adoption and maintenance of exercise in the context of an intervention to increase walking or other moderate intensity cardiovascular activity. In Steps to Health we will test the influence of self-efficacy and outcome expectations on adherence to exercise recommendations, as well as studying the determinants of self-efficacy. Endometrial cancer survivors who are at least 6 months post-treatment are provided with an intervention involving print materials and telephone counseling, and complete assessments of fitness, activity, self-efficacy and outcome expectations, and determinants of self-efficacy every two months for a six month period. In addition to testing an innovative model, the Steps to Health study employs multiple assessment methods, including ecological momentary assessment, implicit tests of cognitive variables, and ambulatory monitoring of physical activity. The study results can be used to develop more effective interventions for increasing physical activity in sedentary cancer survivors by taking into account the full complement of sources of self-efficacy information and outcome expectations.     

Expressions of emotional distress in active duty military personnel with mild traumatic brain injury: A qualitative content analysis

Service members (SMs) who sustain traumatic brain injury (TBI) during deployment have increased risk for mental health issues. Mental health treatment can be challenging in military settings where treatment seeking is often stigmatized. Adequate care relies on accurate interpretations of SMs’ verbal accounts of distress, but little is known about how SMs, embedded in a culture that values resilience and self-reliance, relay emotional distress. We performed qualitative analyses of recordings from a telephone-based intervention with 25 SMs who sustained deployment-related mild TBI (mTBI) to elucidate thematic and dialectal patterns. Consistent with our expectations, SMs rarely used explicit depressive terms while discussing their emotional distress. More prevalent was language suggestive of an overarching theme of loss of control, whereby SMs’ stress, anxiety, and anger were often attributable to SMs’ perceptions that they had incomplete jurisdiction over their own lives. This study may help mental health providers improve engagements with SMs and Veterans, preventing misunderstandings and even improper diagnoses or referrals that could result from a strict reliance on the more customary expressions of distress.     

Memory for traumatic events

This research compares memory for traumatic events with memory for non-traumatic versions of the same event. In Experiment 1, subjects watched an event depicted in slides while focusing and rehearsing the central detail of each slide. They were tested after a short or a longer retention interval (20 min or 2 weeks). Subjects who watched the traumatic version were better able to recall the central details that they had rehearsed, but were less well able to recognize the specific slides that they saw. Better recall for the traumatic group did not occur because the words used to describe the recalled details were inherently more memorable, as shown in Experiment 2. In Experiment 3, subjects watched either a traumatic or non-traumatic version of a filmed event and about 6 months later they were asked to remember the essence of the film. Subjects who saw the traumatic version were better able to recall the essence of the film. A similar finding was obtained with a group of subjects from Experiment 1 who were also contacted about 6 months after their initial participation. These results suggest that some information (the essence, the theme) of a traumatic event might be relatively well retained in memory, while memory is impaired for many of the specific, and especially peripheral, details.     

Is traumatic amnesia nothing but psychiatric folklore?

Some psychotherapists believe that certain experiences are so overwhelmingly traumatic that some victims become incapable of remembering their worst trauma except under special circumstances (e.g. therapy) many years later. Unfortunately, clinicians who endorse this concept of traumatic amnesia often misinterpret the very studies they adduce in support of it. More specifically, they misinterpret other, unrelated memory phenomena as evidence for traumatic amnesia, such as ordinary forgetfulness, psychogenic amnesia, organic amnesia, incomplete encoding of traumatic experiences, non-disclosure of remembered trauma, and simply not thinking about something for a long time. The purpose of this article is to dispel confusions rampant in this literature.     

Couples Therapy with Childhood Sexual Abuse Survivors (CSA) and their Partners: Establishing a Context for Witnessing

This article proposes a clinical practice for therapy with couples in which one partner suffered sexual abuse in childhood. Such couples often encounter unique difficulties with physical contact, intimacy, sexuality, communication, and trust, and their relationship dynamic may be marked by reenactments of past traumatic relational patterns. This clinical practice is founded on the assumption that establishing the witnessing lacking during the traumatic event in childhood can break the traumatic reenactments in adulthood, and spur recovery. The suggested practice may facilitate twofold witnessing: the couple's therapist witnesses the reenactments of the trauma in the couple's relationship; and the survivor's partner witnesses the trauma's effect on the survivor's personal life and relationship. Twofold witnessing can help break the cycle of traumatic reenactment and help the survivor integrate the events of her life into a more coherent, continuous narrative. The partner's presence also facilitates acknowledgement of what happened to the survivor, and helps the survivor elaborate on her stories of resistance, survival, and strength. Finally, each of the partners is able to appear more wholly and fully, and together to tell the preferred stories of their life as a couple, replete with the multiple relational patterns they wish to live, which may contradict the characteristics of the original trauma.     

Psychological resources, positive illusions, and health

Psychological beliefs such as optimism, personal control, and a sense of meaning are known to be protective of mental health. Are they protective of physical health as well? The authors present a program of research that has tested the implications of cognitive adaptation theory and research on positive illusions for the relation of positive beliefs to disease progression among men infected with HIV. The investigations have revealed that even unrealistically optimistic beliefs about the future may be health protective. The ability to find meaning in the experience is also associated with a less rapid course of illness. Taken together, the research suggests that psychological beliefs such as meaning, control, and optimism act as resources, which may not only preserve mental health in the context of traumatic or life-threatening events but be protective of physical health as well.