Assumptive World of Traumatized South African Adults

Abstract

One way of understanding the impact of traumatic events is through exploration of cognitive changes that confront a traumatized individual. The author investigated changes in individuals' basic assumptions after traumatic experiences. The participants were 65 people who had been traumatized by representatives of the South African apartheid government. From the total sample, 36 participants had witnessed the violent death of a close relative (sibling, mother, or father). The remaining 29 had been tortured and detained. The author administered the World Assumption Scale (R. Janoff-Bulman, 1989), a semistructured questionnaire on basic assumptions developed for the present study, and the Post-Traumatic Stress Disorder Clinical Checklist (American Psychiatric Association, 1994). Traumatic events affected the participants' basic assumptions about the meaning and benevolence of the world. The tortured and detained group and the bereaved group showed differences in their assumptions of self-worth following the trauma. Cognitive approaches can yield invaluable therapeutic insights into strategies for coping with trauma.     

Clinical Practice With Cases of Extreme Traumatization 40 Years After the Military Coup in Chile (1973–1990): The Impact on the Therapists

This paper presents our clinical experience with patients who were severely traumatized by the systematic violation of human rights during the military dictatorship in Chile (1973–1990). The lack of recognition of trauma of sociopolitical origin encapsulates the traumatic experience and forces it to remain as part of the present. Clinical vignettes of two therapeutic processes—mother and son—are presented: The mother was detained; sexually tortured; and, as a result of this, gave birth to the torturer’s son. Her therapeutic process is an account of her ambivalence towards her son, of how his origins were kept a family secret, and of how this secret was unconsciously transmitted. The young man’s therapeutic process centers on the transgenerational transmission of trauma and how the torturer–tortured dynamic seeps into the relationship with the analyst. The impact on the analysts’ subjectivity in working with extreme trauma is described.     

Interapy: treatment of post-traumatic stress via the internet

This paper describes the theoretical background and procedures (including psycho-education, screening, treatment protocol and outcome measurement) involved in a protocol-driven internet treatment of post-traumatic stress and grief in a group of people who have suffered from mild to relatively severe trauma. The paper examines the results of 3 outcome and process studies, which were carried out initially in a student population and subsequently in the general population of highly traumatized people. In the latter study, participants in the experimental condition (n = 69) improved significantly more than participants in the waiting list control condition (n = 32), with respect to trauma-related symptoms and general psychopathology. The effect sizes were large. More than 50% of the participants treated showed reliable change and clinically significant improvement after treatment for avoidance and depression. Treatment proved most beneficial for participants who had suffered from intentional trauma and those who had not previously discussed the traumatic events with significant others. Content analysis of the publications indicates a remarkable increase in cognitive coping during treatment. The possibilities for future research into internet-driven treatment of post-traumatic stress symptomatology are discussed, including the proposal to study the effects of sending a final written letter to a significant other person.     

Irrational Beliefs and Basic Assumptions in Bereaved University Students: A Comparison Study

Several authors have argued that the loss of a loved one triggers changes in people's beliefs and assumptions, and that these changes play a role in emotional problems after bereavement. The present study was an attempt to investigate these hypotheses. Thirty students who had been confronted with the death of a parent or sibling, on average nearly 3 years ago, were compared with 30 nonbereaved matched control subjects on different measures assessing basic assumptions and irrational beliefs as defined in REBT. In line with the notion that bereavement has an impact on people's basic assumptions, results showed that bereaved students had a less positive view of the meaningfulness of the world and the worthiness of the self than their nonbereaved counterparts. Also, in accord with the notion that the tendency to think irrationally is likely to increase after a stressful life event, the bereaved were found to have higher levels of irrational thinking. Furthermore, it was found that the degree to which bereaved individuals endorsed general as well as bereavement-specific irrational beliefs was significantly associated with the intensity of symptoms of traumatic grief. Conversely, none of the basic assumptions was associated with traumatic grief. Beliefs reflecting low frustration tolerance explained most variance in traumatic grief. Clinical and theoretical implications of these findings are discussed.     

Altering traumatic memory

Can you experimentally contaminate memory for truly traumatic events? We investigated this question in a study in which 80 Russian participants reported on their memories for one of two terrorist bombings. Half the participants recalled the 1999 attacks on Moscow apartment buildings while the others recalled the 2001 attacks on the World Trade Center in New York. Participants recalled the events on two separate occasions over a six month period. Just prior to the second recall, we strongly suggested to all participants that they had seen a wounded animal in the attacks and had mentioned it in their original memory reports. While none of the WTC group were convinced by the suggestion, 12.5% of the Moscow group did so, and even elaborated with sensory detail (e.g., a bleeding cat lying in the dust). This group was more susceptible to contamination despite the greater emotion that they experienced about the Moscow terrorist attacks. These findings support the notion that even traumatic memories are experimentally malleable.     

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.     

Structural and Functional Neuroplasticity in Relation to Traumatic Stress

ABSTRACT— The body's stress response is an essential adaptive and protective mechanism to cope with threatening situations. However, chronic or traumatic stress leads to structural and functional alterations in the traumatized brain. We argue for a building-block effect: Exposure to different types of traumatic events increases the probability of developing posttraumatic stress disorder (PTSD), via incremental enlargement of a fear network. We summarize evidence of brain changes in PTSD, including recent results from research on animal models of stress-related neuroplastic remodeling, with an emphasis on structural and functional changes in the hippocampus, the amygdala, and the medial prefrontal cortex.     

Coping with Crises: An Examination of the Impact of Traumatic Events on Religious Beliefs

The impact of traumatic events on empirical and metaphysical assumptions was examined, by comparing assumptions of a group of 25 persons who had recently experienced a major stressor with assumptions of a group of 25 persons who had not had such an experience. Each group was composed of 22 women and 3 men, with a mean age of 20 years. Participants completed written measures assessing level of adjustment, empirical world assumptions, religious motivation, and religious and spiritual experiences. Naturalistic interviews were conducted with the trauma group. The trauma group obtained significantly higher scores on symptoms of psychological distress but did not differ in evaluations of the empirical world as predictable, safe, or controllable. Interviews suggested that the metaphysical assumptions were not challenged by trauma; rather, they provided a framework for understanding and coping with trauma.     

The relative importance of needs among traumatized and non-traumatized samples

Typically, people rate enhancement needs as more important than security needs to their well-being. Two studies tested whether event valence and prior trauma moderate relative need importance. Traumatized (hurricane survivors) and non-traumatized (control) participants recalled the most “distressing” (security-relevant) or “satisfying” (enhancement-relevant) event they had recently experienced and rated the importance of 10 needs in defining the event. In both studies, event valence moderated relative need importance on explicit (salience) and implicit (affect) measures as enhancement needs were more important for enhancement-relevant (satisfying) events whereas security needs were more important for security-relevant (distressing) events. However, results also suggest that differences in traumatic experience across samples moderated the effect of event valence on relative need importance. Unlike non-traumatized (control) participants, traumatized (hurricane survivors) participants did not reassign greater importance to enhancement over security needs when event valence shifted to enhancement-relevant (satisfying) memories. We close by discussing implications for human motivation.     

累积创伤对儿童复杂性创伤后应激障碍的影响：经验回避与消极认知情绪调节策略的中介作用

为探讨儿童的累积创伤与复杂性创伤后应激障碍(CPTSD)的关系机制,研究以方便取样法选取河南省7所小学的3478名4~5年级、有创伤经历的儿童为被试,采用创伤经历核查表、抑郁的行为激活问卷、认知情绪调节问卷和国际创伤问卷进行测试。结果发现:(1)累积创伤、经验回避、消极认知情绪调节策略和CPTSD之间具有显著相关性,且累积创伤能够显著正向预测CPTSD;(2)经验回避和消极认知情绪调节策略在累积创伤和CPTSD之间起显著的中介作用。具体为:一是经验回避的中介作用;二是灾难化的中介作用;三是经验回避-自责、经验回避-沉思、经验回避-灾难化的链式中介作用。因此,减少创伤事件的发生,激活儿童行为,调整消极认知情绪是改善和预防儿童CPTSD的重要途径。     

Early Eye Movement Desensitisation and Reprocessing (EMDR) intervention in a disaster mental health care context

‘Early psychological intervention’ is defined as commencing treatment within three months of the traumatic event, with the aim to prevent or treat posttraumatic stress disorder, ongoing distress or acute stress disorder. In natural disaster situations, specific issues may limit the amount of time available for treatment and the possibility of interventions. Eye Movement Desensitisation and Reprocessing (EMDR) can be used without regard to these limits. The aim of the study is to evaluate the effects of EMDR, Recent Traumatic Episode Protocol (R-TEP) provided within three months of the traumatic event to a large sample of individuals exposed to the earthquake that hit Emilia Romagna Region (Northern Italy) in 2012. This study is based on a retrospective review of medical records collected during the activities of psychological and psychosocial unit in the immediate aftermath of earthquake. In total, 529 participants completed the Impact of Event Scale Revised (IES-R) (pre e post treatment). In order to provide a comparison similar to a waitlist-like control group, a method of cohort analysis was applied. In addition, possible time dependent effect was tested. ET (early-treated sample, participants treated within one month after the earthquake) and LT (late-treated sample, participants treated after the first month from the earthquake) reported at post-treatment an improvement to a level below the IES-R cutoff (65.8% of the ET sample and 64.02% of the LT sample). Control group analogue and time-outcome correlation suggest that positive changes in symptoms were likely due to the treatment provided and not merely to the time lapse from the traumatic event. The results of this study suggest that EMDR is a viable treatment option in response to a disaster crisis and in reducing psychological distress of acutely traumatized individuals within the context of a natural disaster.     

Mass Trauma in the African American Community: Using Multiculturalism to Build Resilient Systems

Within the last 4 years, there has been an increasing awareness of traumatic shootings of Black Americans in our society, more specifically Black American males who are likely descendants of slaves and or low socioeconomic status. This increase in media coverage of these shootings has highlighted not only the plight of Black Americans in America but also the real threat of death Black American’s live with. Americans in general have expressed outrage against these fatal shootings, which has been traumatic for many people, especially Black Americans and their community. These shootings severely impact Black American families and communities causing them to become trauma organized; losing basic sense of physical and psychological safety as well as family and community functionality. Understanding the effects these shootings have on the Black American community can help clinicians work more effectively work with this population. This article presents the Multi-Phase Model of Psychotherapy, Counseling, Human Rights and Social Justice (MPM) as a vital and necessary perspective in the treatment of traumatized Black Americans, specifically those effected by mass traumatic events, as well as a case study that applies the MPM using the fatal shooting of Philando Castile.     

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.     

Traumatic memories of war veterans: not so special after all

Several authors have argued that traumatic experiences are processed and remembered in a qualitatively different way from neutral events. To investigate this issue, we interviewed 121 Croatian war veterans diagnosed with posttraumatic stress disorder (PTSD) about amnesia, intrusions (i.e., flashbacks and nightmares), and the sensory qualities of their most horrific war memories. Additionally, they completed a self-report scale measuring dissociative experiences. In contrast to what one would expect on the basis of theories emphasizing the special status of traumatic memories, amnesia, and high frequency intrusions were not particularly typical for our sample of traumatized individuals. Moreover, traumatic memories were not qualitatively different from neutral memories with respect to their stability and sensory qualities. The severity of PTSD symptoms was not significantly correlated with dissociative experiences. Our findings do not support the existence of special memory mechanisms that are unique to experiencing traumatic events.     

Groups for children traumatically bereaved by the attacks of September 11, 2001

The article reviews the use of debriefing and support groups for children who experienced the deaths of family members in the traumatic events of September 11, 2001. An overview of children's normal age-related responses to bereavement and of the special circumstances of trauma and grief provides the foundation for understanding the unique family and community stressors of 9/11 that impacted the children and group leaders. Stress-reduction exercises suitable for use with traumatized children in bereavement groups are presented together with specific drawing and written activities to encourage the processing of feelings.     

The integration of emotions in memories: Cognitive‐emotional distinctiveness and posttraumatic stress disorder

The current study examined cognitive‐emotional distinctiveness (CED), the extent to which emotions are linked with event information, in memories associated with PTSD. Participants either with PTSD (n = 68) or without PTSD (n = 40) completed a modified multidimensional scaling technique to measure CED for their most negative and most positive events. The results revealed that participants in the PTSD group evidenced significantly lower levels of CED. This group difference remained significant when we limited the analysis to traumatic events that led to a PTSD diagnosis (n = 33) in comparison to control participants who nominated a traumatic event that did not result in PTSD (n = 32). Replicating previous findings, CED levels were higher in memories of negative events, in comparison to positive events. These results provide empirical evidence that memories associated with PTSD do contain special organizational features with respect to the links between emotions and memory. Implications for understanding and treating PTSD are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Immigration Enforcement Policies and the Mental Health of US Citizens: Findings from a Comparative Analysis

We examined the differential impact of having a family member, friend, or co-worker/community member detained or deported on the mental health of US citizens. In 2019, a sample of 3446 adult participants of White, Black, and Latinx racial/ethnic descent were recruited to complete an online questionnaire. Participants completed the Patient Health Questionnaire-4 to screen for anxiety, depression, and psychological distress. Analyses were restricted to US citizens (n = 3282). Multivariable logistic and linear regressions were conducted to examine the mental health of US citizens who reported personally knowing a migrant who has been detained or deported and by their relationship to the migrant, overall and among Latinxs only. Among US citizens, 32% reported personally knowing someone who has been detained or deported. In multivariable analyses, US citizens who personally knew a detained or deported migrant were more likely to report anxiety, depression, and greater psychological distress. Associations were more pronounced among those who reported having a family member detained or deported. US-citizen Latinxs with social ties to migrants who have been detained or deported were especially more likely to report poor mental health than White and Latinx participants who did not personally know a migrant who has been detained or deported. It is critical that policy makers consider the potential mental health harms on migrants and its own citizens when designing policies targeting migrant communities.     

Impact of traumatic incidents on family-of-origin functioning: An empirical study

This pilot study was an attempt to empirically validate some of the clinical observations made about traumatic incidents and families in the literature. The study hypothesized that there would be a significant difference in family functioning between those subjects that reported feeling traumatized and those subjects that did not report feeling traumatized, there would be a significant difference in anxiety between the identified trauma group and the identified non-trauma group, and there would be a significant difference in the breadth of support systems between the two groups. The results indicated that there were significant differences between groups of individuals who were identified as traumatized or non-traumatized. The differences included family functioning, individual feelings of anxiety, and report of familial support systems. The findings of this study were congruent with and supportive of much clinical literature on families and traumatic incidents.