The Political Consequences of Combat: Post‐Traumatic Stress and Political Alienation Among Vietnam Veterans

On average, veterans are more civically and politically engaged than civilians. Previous research on the effects of military service, however, did not account for differences in veterans’ combat experiences. Using survey data from a representative sample of Vietnam veterans, this study presents evidence that veterans who were exposed to severe combat trauma and veterans who exhibited attitudes and fears associated with post‐traumatic stress had significantly lower levels of political efficacy and trust. The negative consequences of combat exposure and post‐traumatic stress are not mitigated when veterans have quality social support or when they seek professional counseling. These findings inform political psychology and hold implications for claims regarding the empowering influence of service in the U.S. military, increased political engagement, in particular. Among Vietnam veterans, exposure to severe combat trauma and post‐traumatic stress were both associated with reduced political efficacy and trust.     

Secondary Traumatic Stress in Social Science Researchers of Trauma-Exposed Populations

There is an expanding research database regarding secondary trauma exposure among helping professionals across disciplines and settings. However, there is limited research on the incidence of secondary traumatic stress in social science researchers studying traumatized populations. Various disciplines engage in this area of research, which exposes them to the details of aversive events, especially those engaging in qualitative research. This study explores the impact of such exposure by measuring indicators of secondary traumatic stress (STS), burnout (BO), and compassion satisfaction in a group of 104 researchers. Findings revealed high rates of exposure to traumatic material and a subset of researchers at risk for STS. Regression analyses revealed potential risk factors for STS and BO, and qualitative analysis was conducted to further explore the effects of this work on researchers from multiple disciplines.     

Some Considerations in the Study of Traumatic Stress1

This paper examines the concept of traumatic stress within the broad domain of current stress and health research. The unique nature of “trauma” is rejected because a) clear defining criteria for a unique stimulus condition do not exist, and b) studies of special outcomes, such as PTSD, can be done without postulating a unique stimulus condition. Instead, an integration of the different areas of stress research is advocated. The paper offers methodological recommendations about measurement, which are offered within a framework that emphasizes assessments of objective dimensions of stressful exposures.     

Early Traumatic Stress Responses in Parents Following a Serious Illness in Their Child: A Systematic Review

A systematic review of the literature investigating the early traumatic stress responses in parents of children diagnosed with a serious illness/injury. A literature review was conducted (September 2013) using Medline, PsycINFO, and CINAHL databases. Twenty-four studies related to parents of children hospitalized due to diagnosis of cancer, type 1 diabetes, meningococcal disease, trauma or serious injury, preterm birth and other serious illnesses requiring admission to intensive care were included. Parents were assessed for early traumatic stress symptoms within 3 months of their child’s diagnosis/hospitalization. Prevalence rates of acute stress disorder in parents ranged from 12 to 63 %. Prevalence of posttraumatic stress disorder ranged from 8 to 68 %. Variability was related to methodological factors including differences in study design, timing of assessments, measurement tools, and scoring protocols. Psychosocial factors rather than medical factors predicted parent distress. This review integrates and compares early traumatic reactions in parents with children suffering a range of serious illnesses. Findings suggest a high prevalence of acute and posttraumatic stress symptoms in parents. Methodological inconsistencies made comparison of early traumatic stress prevalence rates difficult. Risk factors associated with traumatic stress symptoms were identified.     

Comparing Factors Associated with Maternal and Adolescent Reports of Adolescent Traumatic Event Exposure

Existing research indicates that there is very little agreement between youth and their parents on youth trauma exposure and subsequent treatment. Few studies, however, have attempted to examine factors that may contribute to this lack of agreement. This study addressed this gap by examining youth and maternal‐reported youth traumatic event exposure using a sample of 100 urban, African American adolescent–maternal dyads. Cumulative report of youth potentially traumatic event exposure (57%) was higher than youth (41%) and maternal (27%) reports. Findings indicate that there was agreement for sexual assault, being shot or stabbed, and auto accidents. Maternal depression was the only factor that was associated with both youth and maternal report of youth qualifying event. Other factors that distinguished youth reports included maternal event exposure, substance use disorder, antisocial personality behaviors, and youth reports of arguments with the mother and running away from home. Implications for reconciling reports of trauma exposure among youth and their mothers are discussed.     

Evidence‐Based Human Trafficking Policy: Opportunities to Invest in Trauma‐Informed Strategies

Human trafficking is a critical social issue characterized by chronic trauma among victims, and frequently preceded by traumatic experiences that contribute to risk of victimization. Therefore, the research‐based practice of trauma‐informed care is a highly appropriate lens for both prevention and intervention. This work examines federal legislation in the United States related to human trafficking for references to trauma, as well as how the use of research could implicitly direct public policy responses toward trauma‐informed approaches. Legislation on human trafficking has risen substantially since 1989, and the use of research and trauma language within these policies has also observed substantial increases. While the use of trauma language was associated with limited progression in the policy process, legislation using research language was more likely to pass out of Committee and become enacted. Moreover, legislation may leverage research in ways that have the potential to bolster trauma‐informed practice among human trafficking victims. Specifically, research can be used to describe the problem and causal mechanisms (e.g., impact of trauma), guide “best practice” for service delivery, and generate knowledge through studies and evaluations that guide future policy. Therefore, human trafficking legislation that implicitly guides trauma‐informed practice via the use of research may be particularly promising for the field.     

Adolescents in Secure Accommodation in Scotland: Exposure and Impact of Traumatic Events

The current study sought, for the first time, to assess the nature of trauma exposure and resultant symptoms in adolescents (n = 17) in secure accommodation in Scotland. A case study mixed methods design involved analysis of case files, trauma history interviews, and standardized trauma symptom questionnaires with adolescents and program staff in 1 facility. A developmental trauma framework was applied to file analysis. Despite extensive abuse and resultant symptoms identified in files, few explicitly reported traumatization. Adolescents in interview, however, reported numerous domestic and institutional traumatic events. High levels of posttraumatic stress (65%), depression (65%), and dissociation (18%) were identified. It appears adolescent traumatization is pervasive in 1 secure accommodation facility in Scotland. Studies across Scotland’s secure facilities are needed to assess reliability of findings. Indications are that staff in secure accommodation need to have an understanding of trauma exposure, resultant symptoms, and how to respond to traumatized adolescents.     

Traumatic stress at work: A public health model

The emergence of the 'New Public Health' movement provides a framework for an integrated and co-ordinated policy for responding to traumatic stress in the workplace. A review of the clinical literature on post-traumatic stress reveals that the components of this framework are available: the challenge is to put in place all the various elements. An organisational response is described which tries to use primary, secondary and tertiary prevention strategies to reduce the impact of traumatic incidents-in this case, armed robberies-on employees of a financial services company. Inter-departmental working, appropriate use of management and social support, pre-trauma training and cognitive-behavioural counselling techniques are all used in an attempt to tailor support to the individual's own needs. Binding the process together is a simple psychological health screening process, offering as a by-product information to improve the responsiveness of the service.     

Traumatic stress and quality of attachment: Reality and internalization in disorders of infant mental health

This article describes the interface between the fields of attachment and child trauma, their respective contributions to an understanding of infant mental health disturbances, and the clinical applications of an integration between attachment theory and trauma‐informed treatment and research. The organizing theme is that a dual attachment and trauma lens must be used in the assessment and treatment of infants and toddlers with mental health and relationship problems. The quality of attachment is an important factor in children's capacity to process and resolve traumatic experiences. At the same time, traumatic events often have a damaging effect on the quality of existing attachments by introducing unmanageable stress in the infant–parent relationship. It is argued that trauma in the first years of life needs to be assessed and treated in the context of the child's primary attachments. Reciprocally, the etiology of attachment disturbances should include an assessment of possible exposure to trauma in the child and in the parents. Current conceptualizations of attachment and trauma are reviewed from this perspective, and a clinical illustration is presented to highlight how a traumatic stressor can trigger behaviors reminiscent of disorganized attachment.     

Post‐Traumatic Symptoms Among Victims of Workplace Bullying: Exploring Gender Differences and Shattered Assumptions

The aims of the present study were twofold: assessing the prevalence and intensity of post‐traumatic stress disorder (PTSD) symptoms in victims of bullying, and exploring whether victims of bullying differ in their basic assumptions compared to a control group. A total of 183 victims of bullying and 183 control group participants took part in the research. The results showed that 42.6% of the total sample met all DSM‐IV‐TR criteria for PTSD, whereas 54.1% did not fulfill the A1 criterion. Post‐traumatic symptoms were more prevalent among women (49%), as compared to men (35.3%). Furthermore, victims showed significantly more negative beliefs about the world, the people, and themselves, compared to their non‐bullied controls. These results fit well with cognitive theory of trauma.     

Interoceptive Exposure Therapy Combined with Trauma‐related Exposure Therapy for Post‐traumatic Stress Disorder: a Case Report

Trauma‐related exposure therapy is a useful but not universally effective treatment for post‐traumatic stress disorder. Anxiety sensitivity may play an important role in this disorder, as it does in panic disorder. Studies have shown that interoceptive exposure therapy reduces anxiety sensitivity in panic disorder. The present case study was a preliminary investigation of the merits of including interoceptive exposure therapy in the treatment of post‐traumatic stress disorder, in order to improve treatment outcome for a patient who had no history of panic disorder or panic attacks. Interoceptive exposure therapy (4 sessions) was one component of treatment, combined with trauma‐related exposure therapy (4 sessions of imaginal exposure followed by 4 sessions of in vivo exposure). Treatment outcome was assessed with the Clinician‐Administered Post‐traumatic Stress Disorder Scale, a self‐report measure of post‐traumatic stress disorder symptoms, and measures of symptoms and cognitions commonly associated with post‐traumatic stress disorder. Scores on all outcome measures decreased over the course of treatment, with gains maintained at 1‐ and 3‐month follow‐up. Symptoms of anxiety sensitivity and post‐traumatic stress disorder decreased during interoceptive exposure therapy. The results indicate that interoceptive exposure therapy is a promising adjunctive intervention for post‐traumatic stress disorder. Further research is needed into the merits of combining interoceptive exposure therapy and trauma‐related exposure therapy as a means of boosting treatment efficacy.     

Working in the Midst of Unfolding Trauma and Traumatic Loss

Abstract

Training developed for New York City social workers in the evolving aftermath of September 11, 2001 is introduced, offering a conceptual framework for clinical practice in the midst of unfolding trauma and traumatic loss. A focus is placed on the shared, collective process of learning and discussion among colleagues, as an effort parallel to work with clients, progressing together to establish meaning and hope through relationships. Professional training framing this catastrophe within trauma and traumatic loss perspectives, and addressing its impact on clinician, client, work, and treatment relationship, is needed. Also providing on-going support, a process of continuity, and a context of community, this training becomes a collective response to the profound impact and complex, evolving needs of this time.     

Trauma in Early Childhood: A Neglected Population

Infants, toddlers and preschoolers are a high risk group for exposure to trauma. Young children are also vulnerable to experiencing adverse outcomes as they are undergoing a rapid developmental period, have limited coping skills and are strongly dependent on their primary caregiver to protect them physically and emotionally. However, although millions of young children experience trauma each year, this population has been largely neglected. Fortunately, over the last 2 decades there has been a growing appreciation of the magnitude of the problem with a small but expanding number of dedicated researchers and clinicians working with this population. This review examines the empirical literature on trauma in young children with regards to the following factors: (1) how trauma reactions typically manifest in young children; (2) history and diagnostic validity of posttraumatic stress disorder (PTSD) in preschoolers; (3) prevalence, comorbidity and course of trauma reactions; (4) developmental considerations; (5) risk and protective factors; and (6) treatment. The review highlights that there are unique developmental differences in the rate and manifestation of trauma symptomatology, the current Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV-TR) PTSD criteria is not developmentally sensitive and the impact of trauma must be considered within the context of the parent–child relationship. Recommendations for future research with this population are also discussed.     

Developmental Indices Among Central American Immigrants Exposed to War‐Related Trauma: Clinical Implications for Counselors

In this study, the authors examine the separate levels of depression, anxiety, and posttraumatic stress (PTS) among 68 Central American immigrants who had been exposed to war‐related trauma, as a function of developmental disruptions resulting in mistrust, identity confusion, and isolation. Findings indicate that variance in depression, anxiety, and PTS could be explained by the examined developmental disruptions. Clinical implications for counselors engaging in culturally sensitive trauma treatment and suggestions for research are discussed.     

Self-Report Measures to Identify Post Traumatic Stress Disorder and/or Mild Traumatic Brain Injury and Associated Symptoms in Military Veterans of Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)

Individuals serving in Iraq and Afghanistan sustain injuries associated with physical and psychological trauma. Among such injuries, mild traumatic brain injury (mTBI) and post traumatic stress disorder (PTSD) are common. Self-report measures are frequently used to identify mTBI and/or PTSD and symptoms associated with these conditions. In addition to providing information regarding mTBI and PTSD, the goal of this literature review was to identify and present information on the psychometric properties of measures used to obtain information regarding these common conditions among Veterans who have returned from Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF). A comprehensive review of studies in which self-report measures were used to evaluate mTBI, PTSD, and associated symptoms among OEF/OIF Veterans is presented. Findings suggest that additional work is needed to identify psychometrically sound and clinically useful self-report measures that assess mTBI and PTSD and associated symptoms among OEF/OIF Veterans.     

创伤后心理复原的生理机制

心理复原是个体在经历对生命具有威胁的事件或严重的创伤后仍然能回复到良好适应状况的现象。对心理复原生理机制的研究存在两种研究取向：或从个人能力的角度,或从发展结果的角度。创伤记忆的抑制、大脑的可塑性、神经生物的调节以及基因、气质、情绪调节、认知过程、早期经验等保护因子的影响机制是研究的主要内容。文章最后对今后的研究进行了展望     

Trauma Competency: An Active Ingredients Approach to Treating Posttraumatic Stress Disorder

Meta‐analytic studies have extracted 4 common elements among effective posttraumatic stress disorder treatments: cognitive restructuring and psychoeducation, a deliberate and continually improving therapeutic relationship, relaxation and self‐regulation, and exposure via narrative of traumatic experiences. The authors present a clinical treatment structure catalyzing these active ingredients into discrete therapeutic tasks that counselors can focus on to maximize treatment effectiveness. The 4 tasks represent an attempt to identify critical competencies and baseline standards for the field of trauma counseling.     

The concept of psychical trauma: A bridge in interdisciplinary space1

The concept of trauma currently occupies a central position in interdisciplinary dialogue. Using the concept of psychical trauma as a bridge, the author attempts an interdisciplinary dialogue with psychiatry, biology and neuroscience. Beginning with the concept of psychical trauma in Freud, the author reviews the evolution of Freud's thinking, and links it with the ideas of Ferenczi and post‐Freudian psychoanalytical authors. From a different framework, he considers the present state of research on post‐traumatic stress disorder in current psychiatric nosography and attempts an interdisciplinary approximation to the concept of psychical trauma. Interesting ideas like the traumatic situation, trauma spectrum and psychopathological spectrum emerge, which enable a better understanding of the concept of psychical trauma through its relatedness, as a bridge connecting a broad psychopathological range extending from normality to psychosis. The ensuing possible relative loss of nosographical rigour is more than compensated by the resulting increased understanding and enlarged therapeutic possibilities. In the second part of the paper, the author attempts a dialogue with neuroscience, taking into account new advances in current research on emotion and memory, and making them compatible with the psychoanalytical concept of trauma. In this sense, the paper underlines the importance of emotion and crucially of memory, regarded as a fundamental axis of the subject explored in this paper. Here a substantial distinction which is pertinent for analytical work appears: declarative memories versus non‐declarative or procedural memories. In a concluding discussion the author argues that, taking into account the implications of these current notions regarding a number of theoretical and technical aspects, psychoanalysis currently holds a privileged position, both in its potential for prevention and regarding the treatment of patients, in so far as, through interdisciplinary dialogue, psychoanalysis can be receptive to and be enriched by the contributions of other disciplines, just as it enriches them with its own contributions.     

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.     

Co-Occurring Traumatic Brain Injury,PTSD Symptoms,and Alcohol Use in Veterans

Traumatic brain injury (TBI) has been identified as a significant health problem among veterans. Recent research demonstrates the potential interaction and magnification of symptoms of posttraumatic stress disorder (PTSD) and substance use disorders (SUD) in veterans with a history of TBI; however, there is very limited research on the co-occurrence of the three conditions. Veterans (N = 115) with comorbid PTSD and SUD completed a baseline assessment for enrollment into a larger treatment study. As part of that assessment, participants completed a TBI screener as well as self-report measures for pain and physical health, affective symptoms, and substance use. Almost half of the sample (48 %) endorsed a history of a previous head trauma with loss of consciousness (LOC). Participants with and without head trauma with LOC were compared across various measures of functioning. Increased severity of physical health complaints and affective symptoms were reported by the TBI group compared to controls. However, the increases in affective symptoms were relatively small. No group differences were observed for alcohol use. Together, the findings suggest that treatment-seeking veterans with a history of head trauma with LOC may present with roughly equivalent symptoms of PTSD and SUD to those without said history.