Gendered Power in Cultural Contexts: Part I. Immigrant Couples

Immigration is a world-wide phenomenon and practitioners are increasingly called on to work with issues related to it. The authors examine the experience of couples who are immigrants to the United States in regard to gender and power issues. Although the study limited participation to one religious group in order to hold that aspect of culture and gender attitudes constant, the experiences of these couples help to make visible the link between microlevel couple interaction and larger social processes. The results show how the couples manage a delicate balance between the push for gender change and avoiding too much conflict as male power is challenged.     

Post-Traumatic Stress Disorder Among Salvadoran Women:

Previous research has documented post-traumatic stress disorder among Salvadoran refugees in this country, but information on refugees living in El Salvador is not available. This study investigated the patterns of psychological distress and documented the existence of PTSD in Salvadoran refugee women in El Salvador. A team of U.S. mental health workers traveled to a refugee camp in El Salvador to interview women about their traumatic experiences and current symptoms of distress. This study provides strong evidence that many refugee women in El Salvador have developed PTSD and that many others show significant signs of distress. Data from this study also provided insight into clinical issues for Salvadoran women experiencing PTSD. In response to requests from Salvadoran mental health providers, a treatment program was developed to help Salvadoran women reduce their distress. Goals of the treatment included associating distress with the trauma as a normal reaction to a very abnormal event, reducing feelings of loss of control, reducing "survivor guilt," and lessening anxiety and high arousal level. These goals were accomplished using cognitive-behavioral and community-oriented strategies.     

Attachment Theory and Post-Traumatic Stress Disorder

Attachment theory is applied to understanding and treatment of the anxiety condition of post-traumatic stress disorder in adults. Conceptualized as intensified attachment behavior which is elicited at separation or loss or threat of separation, PTSD responses represent an inherent, though exaggerated, attempt to ensure protection and security. The secure base of a therapeutic relationship reduces the intensity of responses and provides an opportunity to review experiences relevant to current distress in order to affirm emotional reactions and come to terms with distressing events. Implications for prevention are discussed.     

创伤后应激障碍病因及发病机制的研究进展

创伤后应激障碍(post-traumatic stress disorder,PTSD)是一种严重的应激相关障碍,指个体面临异常强烈的精神应激后延迟发生的精神障碍,文献报告PTSD的终生患病率为1%～14%,高危人群研究发现PTSD的患病率为3%～58%,女性约为男性的两倍[1].PTSD的病因及发病机制较为复杂,涉及很多方面,本文将对PTSD病因及发病机制的研究进展进行综述.     

创伤后应激障碍病因及发病机制的研究进展

创伤后应激障碍(post-traumatic stress disorder,PTSD)是一种严重的应激相关障碍,指个体面临异常强烈的精神应激后延迟发生的精神障碍,文献报告PTSD的终生患病率为1%～14%,高危人群研究发现PTSD的患病率为3%～58%,女性约为男性的两倍[1]。PTSD的病因及发病机制较为复杂,涉及很多方面,本文将对PTSD病因及发病机制的研究进展进行综述。     

Post-Traumatic Stress and World Assumptions: The Effects of Religious Coping

Religiosity has been shown to moderate the negative effects of traumatic event experiences. The current study was deigned to examine the relationship between post-traumatic stress (PTS) following traumatic event exposure; world assumptions defined as basic cognitive schemas regarding the world; and self and religious coping conceptualized as drawing on religious beliefs and practices for understanding and dealing with life stressors. This study examined 777 Israeli undergraduate students who completed several questionnaires which sampled individual world assumptions and religious coping in addition to measuring PTS, as manifested by the PTSD check list. Results indicate that positive religious coping was significantly associated with more positive world assumptions, while negative religious coping was significantly associated with more negative world assumptions. Additionally, negative world assumptions were significantly associated with more avoidance symptoms, while reporting higher rates of traumatic event exposure was significantly associated with more hyper-arousal. These findings suggest that religious-related cognitive schemas directly affect world assumptions by creating protective shields that may prevent the negative effects of confronting an extreme negative experience.     

The time of trauma: Husserl's phenomenology and Post-Traumatic Stress Disorder

The phenomenology of inner temporalizing developed by Edmund Husserl provides a helpful framework for understanding a type of experiencing that can be part of the Post-Traumatic Stress Disorder (PTSD). My paper extrapolates hints from Husserl's work in order to describe those memories — flashbacks — that come so strongly to consciousness as to overtake the experiencer. Husserl's work offers several clues: his view of inner temporalization by which conscious experiences flow in both a serial and a nonserial manner; a characterization of process memory as distinct from representational memory; and the notion of telos, which takes human subjectivity as intrinsically changeable, for example, by means of a retroactive cancellation that would allow the PTSD experiencer to re-process the original meaning of the traumatic experience into a meaning that fits the current situation and thus allows a recovery.     

The Biological Findings in Post-Traumatic Stress Disorder: A Review1

In this paper the authors review the literature on biological and treatment studies of post-traumatic stress disorder (PTSD) and present current unifying hypotheses regarding the pathophysiology. The psychophysiological studies stress overarousal, while endocrine studies suggest a decreased Cortisol production in denial and low symptom states with increases in highly symptomatic states. Suggestive evidence is provided that PTSD is associated with permanent changes in brain mechanisms involving the locus coeruleus, amygdala, and the hypothalamo-pituitary-adrenal axis. Drug treatments are promising but not fully satisfactory as yet. Directions for further research are provided.     

Psychoeducation for Adults with Post-Traumatic Stress Symptomatology: A Systematic Review and Meta-Analysis

Journal of Contemporary Psychotherapy - Post-traumatic stress disorder (PTSD) is a condition that can develop after experiencing a traumatic event. Psychoeducation is a treatment approach often...     

Comorbidity of attention Deficit Hyperactivity Disorder and Post-Traumatic Stress Disorder

Attention Deficit Hyperactivity Disorder (ADHD) and Post-Traumatic Stress Disorder (PTSD) show a high degree of comorbidity in traumatized children. Two hypotheses may help explain this relationship: children with ADHD are at higher risk for trauma due to their impulsivity, dangerous behaviors, and parents who may have a genetic predisposition for impairment of their own impulse control; and hyperarousal induced by severe trauma and manifested by hypervigilance and poor concentration may impair attention to create an ADHD-like syndrome. Four illustrative cases are presented, and implications for treatment are discussed.     

Post-Traumatic Stress Disorder,Sensory Integration,and Aquatic Therapy: A Scoping Review

The prevalence of post-traumatic stress disorder (PTSD) continues to increase. Symptomology of PTSD include sensory deficits much like those displayed in children with sensory integration (SI) disorder. The aim of this scoping review is to review symptoms of PTSD and SI, and make a case of how aquatic therapy may be an effective modality in treating clients with PTSD. Eighteen articles were selected for review. From this review, it is suggested that aquatic therapy can be an effective modality in reducing symptoms of PTSD; however, future research is essential in determining its effectiveness.     

Symptoms of Post-Traumatic Stress Disorder in Bereaved Children and Adolescents: Factor Structure and Correlates

This study investigated the factor structure and correlates of posttraumatic stress-disorder (PTSD) symptoms among children and adolescents confronted with the death of a loved one. Three hundred thirty-two bereaved children and adolescents (aged 8–18; 56.9 % girls) who all received some form of psychosocial support after their loss, completed self-report measures of PTSD, together with measures tapping demographic and loss-related variables, depression, prolonged grief, and functional impairment. Parent-rated indices of impairment were also collected. We first evaluated the fit of six alternative models of the factor structure of PTSD symptoms, using confirmatory factor analyses. Outcomes showed that the 4-factor numbing model from King et al. (Psychological Assessment 10, 90–96, 1998), with distinct factors of reexperiencing, avoidance, emotional numbing, and hyperarousal fit the data best. Of all participants, 51.5 % met DSM-IV criteria for PTSD. PTSD-status and scores on the PTSD factors varied as a function of age and gender, but were unrelated to other demographic and loss-related variables. PTSD-status and scores on the PTSD factors were significantly associated symptom-levels of depression, prolonged grief, and functional impairment. Findings complement prior evidence that the DSM-IV model of the factor structure of PTSD symptoms may not represent the best conceptualization of these symptoms and highlight the importance of addressing PTSD symptoms in children and adolescents seeking help after bereavement.     

Self-reported Attitude Towards Speeding and Its Possible Consequences in Five Different Road Contexts

Driving above the permitted speed limit is a common violation on the roads of Great Britain. Moreover, speeding is associated with negative consequences in the form of damage, injury and fatal road traffic accidents. The aim of this study was to assess, by means of self-report, the prevalence of this social problem across five different contexts: a residential road, a busy shopping street, a dual carriageway, a winding country road, and a motorway. The extent to which speeding was perceived to be associated with negative consequences was also assessed. Results suggest that most drivers make judgements about the type of road on which they are driving and the degree of speeding that is acceptable, and that their intentions to speed vary accordingly. Some drivers reported a consistent intention to speed, however, and these people were characterized by greater general deviance on the road (e.g. high violation score), rather than by a stronger tendency to underestimate the negative consequences. In general, however, younger people and those with less regard for negative consequences reported stronger intentions to speed. These results are discussed with reference to strategies for addressing the problem of speeding. © 1997 John Wiley & Sons, Ltd.     

Effects of Equine-Facilitated Psychotherapy on Post-Traumatic Stress Symptoms in Youth

Equine-assisted therapy has become an increasingly popular complementary mental health treatment approach, but there is limited empirical research assessing the effectiveness of this practice. In particular, equine-facilitated psychotherapy has many potential benefits for the treatment of trauma in youth. The purpose of the proposed study was to investigate changes in levels of post-traumatic stress symptomatology and levels of the human-animal bond in children and adolescents ages 10–18 over the course of a 10-week equine-facilitated psychotherapy (EFP) intervention. Youth in the treatment group (n?=?36) participated in 10 weekly two hour EFP sessions, and were compared on changes in post-traumatic stress symptoms with a control group of participants (n?=?32) who continued to receive the already existing traditional therapeutic services provided by their treatment facility or outpatient therapist. Findings suggested a significant decrease in post-traumatic stress symptoms across the intervention for both the treatment and control group, but the treatment group did not decrease significantly more than the control group. These findings suggest that EFP may be an effective additional treatment modality for post-traumatic stress symptoms, but there was no evidence from this initial study that EFP was significantly more effective than traditional office-based therapy. Further research and discussion of the relative benefits of EFP compared to traditional treatment modalities is warranted.     

Pavlovian Eyeblink Conditioning in Combat Veterans With and Without Post-Traumatic Stress Disorder

Several recent studies have investigated relationships between post-traumatic stress disorder (PTSD) and learning and memory problems. These reports have found in general that not only does PTSD affect trauma-related memories, but when patients with PTSD are compared with similar trauma patients without PTSD, general memory impairments have been found. The present paper reports a study in which associative learning, using Pavlovian eyeblink conditioning, was investigated in combat veterans with and without chronic PTSD, using interstimulus intervals of 500 and 1000 msec in two separate experiments. Although several recent reports suggest that larger-magnitude autonomic conditioned responses occur in patients with PTSD during Pavlovian conditioning, the present study found evidence of impaired Pavlovian eyeblink conditioning in combat veterans with and without PTSD, compared to non-combat veterans. Although these data suggest that combat leads to an impaired associative learning process regardless of whether PTSD is apparent, a group of community-dwelling combat veterans not under medical treatment showed normal conditioning, suggesting that variables other than prior combat must also be involved.     

The Use of Psychoendocrine Strategies in Post-Traumatic Stress Disorder1

An overview is presented of a pilot psychoendocrine study of PTSD inpatients in comparison with several subgroups of schizophrenic and affective disorder patients. Using a hormonal profile including Cortisol, norepinephrine, epinephrine, testosterone, and thyroxine, it was found that the mean values for the PTSD group were at or near the extreme end of the range for every hormone measured, i.e., relatively low for Cortisol and high for the remaining hormones. The possible clinical meaning of these findings is considered in the light of prior psychoendocrine research on chronic stress. The hormonal alterations in PTSD appear to be persistent and suggest the possibility of being linked largely to traits or character structure, perhaps particularly to cognitive variables related to defense and coping mechanisms, as reviewed in detail for each hormonal system. There appears to be a potential for a fruitful union between the traumatic stress and psychoendocrine fields and some future strategies for developing and strengthening such a union are suggested.     

Behavioural Treatment of Post-Traumatic Stress Disorder Associated with Recovered Memories

Post-traumatic stress disorder (PTSD) is sometimes associated with recovered memories (RMs) of traumatic events. That is, the sufferer reports having forgotten traumatic events for a period of time, only to recall them later on. As the memories of traumatic events are recalled, post-traumatic stress disorder may emerge. The cause of recovered memories is uncertain and is the subject of debate. Some recovered memories may be reasonably accurate, while others may be ''recollections'' of imagined rather than actual events. It is unclear whether conventional PTSD therapies, such as behaviour therapy, are appropriate and effective in treating PTSD-RM. The present article considers these issues in the context of a case study, in which a patient with PTSD-RM was treated with behaviour therapy ( in vivo and imaginal exposure). The patient sought treatment because he wanted relief from his PTSD symptoms, regardless of whether his recovered memories were accurate (he was completely convinced in the accuracy of the memories). Treatment outcome was compared with the outcome of 13 PTSD patients who did not have recovered memories, who were also treated with behaviour therapy. Results suggest that PTSD-RM can be effectively treated with behaviour therapy. However, such treatment is unlikely to be appropriate for all cases of PTSD- RM. Selection criteria are discussed.     

When Change Causes Stress: Effects of Self-construal and Change Consequences

Purpose

Organizational change can be a major stress factor for employees. We investigate if stress responses can be explained by the extent to which there is a match between employee self-construal (in personal or collective terms) and change consequences (i.e., does the change particularly have consequences for the individual or for the group). We further investigate if the interactive effect of self-construal and change consequences on stress will be mediated by feelings of uncertainty.

Design/Methodology/Approach

Data were obtained in three studies. Study 1, a laboratory study, focused on physiological stress. Study 2, a business scenario, focused on anticipated stress. Study 3, a cross-sectional survey, focused on perceived stress. Studies 2 and 3 also included measures of uncertainty in order to test its mediating qualities.

Findings

Change is more likely to lead to stress when the change has consequences for matters that are central to employees’ sense of self, and particularly so when the personal self is salient. This effect is mediated by feelings of uncertainty.

Implications

Understanding why some people experience stress during change, while others do so to a lesser extent, may be essential for improving change management practices. It may help to prevent change processes being unnecessarily stressful for employees.

Originality/Value

This is one of the first studies to show that different kinds of change may be leading to uncertainty or stress, depending on employees’ level of self-construal. The multi-method approach boosts the confidence in our findings.

     

A Primer Of Closed Head Injury Sequelae In Post-Traumatic Stress Disorder

Abstract

By definition, an individual diagnosed with post-traumatic stress disorder (PTSD) has been exposed to a serious threat of physical harm that engenders concomitant feelings of fear, helplessness, or horror (American Psychiatric Association, 1994). According to the current diagnostic taxonomy, PTSD may develop when the person witnesses harm against someone else or learns of harm occurring to an intimate other. Yet, all too often, PTSD is associated with the direct experience of physical injury through assault, accident, or other violence. As such, individuals with PTSD are at increased risk of having sustained a head injury, particularly during the traumatic events that elicited the PTSD symptoms (Knight, 1996). Consistent with this assertion, there are indications that individuals who sustain a head injury are increasingly likely to develop subsequent PTSD (Bryant & Harvey, 1998; Chemtob et al., 1998), with the prevalence of PTSD in this population estimated to be as high as 30% (Bryant & Harvey, 1996). Moreover, among people with PTSD, those who have sustained head injuries are apt to have more severe symptoms than those who have not (Chemtob et al., 1998).