Posttraumatic growth following pregnancy termination for fetal abnormality: the predictive role of coping strategies and perinatal grief

Background: Research about termination for fetal abnormality (TFA) suggests that it is a traumatic event with potential negative psychological consequences. However, evidence also indicates that following traumatic events individuals may experience growth. Although TFA’s negative psychological outcomes are well documented, little is known of the potential for growth following this event. Therefore, the study’s objectives were to measure posttraumatic growth (PTG) post-TFA, examine the relationship between PTG, perinatal grief and coping, and determine the predictors of PTG.

Design: An online, retrospective survey was conducted with 161 women.

Methods: Eligible participants were women over 18 who had undergone TFA. Participants were recruited from a support organisation. They completed the Brief COPE, Short Perinatal Grief Scale and Posttraumatic Growth Inventory. Data were analysed using regression analyses.

Results: Moderate levels of PTG were observed for “relating to others,” “personal strengths” and “appreciation of life.” “Positive reframing” was a significant predictor of PTG. Despite using mainly “adaptive” coping strategies, women’s grief levels were high.

Conclusions: “Adaptive” coping strategies such as, “positive reframing” are relevant to TFA. They may act as protective factors against distress and as foundations for growth, implicating that interventions such as Cognitive Behavioural Therapy, which aim to reframe women’s experience, may be beneficial.     

Bilinguals who stutter: A cognitive perspective

PurposeBrain differences, both in structure and executive functioning, have been found in both developmental stuttering and bilingualism. However, the etiology of stuttering remains unknown. The early suggestion that stuttering is a result of brain dysfunction has since received support from various behavioral and neuroimaging studies that have revealed functional and structural brain changes in monolinguals who stutter (MWS). In addition, MWS appear to show deficits in executive control. However, there is a lack of data on bilinguals who stutter (BWS). This literature review is intended to provide an overview of both stuttering and bilingualism as well as synthesize areas of overlap among both lines of research and highlight knowledge gaps in the current literature.MethodsA systematic literature review on both stuttering and bilingualism studies was conducted, searching for articles containing “stuttering” and/or “bilingualism” and either “brain”, “executive functions”, “executive control”, “motor control”, “cognitive reserve”, or “brain reserve” in the PubMed database. Additional studies were found by examining the reference list of studies that met the inclusion criteria.ResultsA total of 148 references that met the criteria for inclusion in this paper were used in the review. A comparison of the impact of stuttering or bilingualism on the brain are discussed.ConclusionPrevious research examining a potential bilingual advantage for BWS is mixed. However, if such an advantage does exist, it appears to offset potential deficits in executive functioning that may be associated with stuttering.     

Spirit breaking: When the helping professions hurt

Abstract

Too often the human services dehumanize and depersonalize those who come to receive services, as well as those professionals who provide physical disabilities and people with psychiatric disabilities are frequently hurt by helping professionals, the phenomenon of “spirit breaking” is introduced. Suggestions for re‐humanizing the human services are made, including new models for clinical interaction that serve to empower rather than disempower service recipients, and the contributions that people with disabilities are making in their own state and national movements for social justice and the right to humane treatment and rehabilitation services.     

Comment on Delgado-Romero and Howard

Abstract

Too often the human services dehumanize and depersonalize those who come to receive services, as well as those professionals who provide physical disabilities and people with psychiatric disabilities are frequently hurt by helping professionals, the phenomenon of “spirit breaking” is introduced. Suggestions for re‐humanizing the human services are made, including new models for clinical interaction that serve to empower rather than disempower service recipients, and the contributions that people with disabilities are making in their own state and national movements for social justice and the right to humane treatment and rehabilitation services.     

Unique Eyes and Different Windows of Opportunity

Abstract

The writer discusses her personal experiences of being a consumer of mental health services and, at the same time, working as a mental health professional. She includes the challenges and benefits of this experience, as well as the “sparks, pushes, and bumps” of this dual role. Also included are current and future trends of mental health recovery, suggested to be the key to wellness for consumers.     

Psychiatry in the labyrinth: Deconstructing deviancy

Abstract

Deviancy is a key concept in psychiatry and other therapeutic disciplines, because it dramatizes the way in which they depend on the establishment of norms, in order to justify their theory and practice. The writings of Derrida as well as Goethe provide a different view: that “deviation” from a “norm” can be fundamentally important to the well‐being of the norm. Thus deviancy can be viewed not as something to be “corrected” but rather as a creative possibility to be encouraged and shaped in productive ways. As a case of “deviancy” we have selected the writings of John Perceval, whose Narrative provides a critique of the mental‐health establishment of his day, particularly the asylum, and offers an alternative to 19th‐century views of “lunacy.” We see his “schizophrenic” commentary on his “psychosis” and its treatment as analogous to the deconstructive, “schizophrenic” discourse of postmodernity which is similarly critical of the reigning, modernist psychiatric order.     

Maslow's Puzzle: A Reconfiguration

Abstract

A.H. Maslow (1963, 1993) characterized the “creative attitude” in ways such as giving up the past and future, loss of ego or self-forgetfulness, Taoistic receptivity, and innocence. He suggested that underlying these and related characteristics may be “certain prerequisites,” which he offered to us as a “puzzle.”

“Maslow's puzzle” may be considered in relation to what he regarded as a sine qua non of creativeness: “fusion of person and world.” The greater intimacy of such a relationship means that the individual has more fully extended self into that which lies beyond self, that is, into transpersonal realms or fields. A study of such fields, based on representations of fields in general, may provide a different insight into “Maslow's puzzle” and the enhanced creativity with which it is associated.     

A study identifying the origins of different types of drink driving events through the lens of deterrence: Is it alcohol abuse or avoiding detection?

BackgroundWhile attempts to identify the mechanisms to effectively deter drink driving remains a central focus for road safety researchers, scant scientific enquiry has simultaneously examined perceptions of apprehension risk in combination with substance abuse. This may be considered a significant oversight given that such constructs may create opposing forces, or alternatively, alcohol abuse and punishment avoidance may create cumulative effects and promote offending behaviours.MethodThis paper reports on an investigation of 718 Queensland motorists' self-reported perceptions of classical and reconceptualised deterrence constructs (as well as alcohol consumption) in order to determine what factors have the greatest effect on promoting drink driving, particularly alcohol consumption or punishment avoidance. The sample completed an online or paper version of the questionnaire.Results“Possible” drink driving events were slightly more common (25.5%) than “acknowledged” drink driving events (16.6%). Future intentions to drink and drive (23.4%) were more common among those who reported an “acknowledged” drink driving event (63.5% reported future intentions to drink drive) than a “possible” drink driving event (47.5%). Sequential binary logistic regression models conducted for each drink driving category revealed that having “risky” drinking behaviour and both direct personal and indirect experience of punishment for a drink driving offence were predictors of “possible” drink driving events. Similarly, “acknowledged” drink driving had the same significant predictors with the addition of increases in age and punishment severity reducing the likelihood of drink driving and direct punishment avoidance having a positive effect. However, and importantly, only direct punishment avoidance and past “possible” and “acknowledged” drink driving events predicted future intentions to offend in the final model, which further reinforces that drink driving is a deliberate decision (rather than stemming primarily from impairment).Practical applications: The findings provide support for increased policing efforts to identify drink drivers.     

Patients' intentions in primary care: Measurement and preliminary investigation

Abstract

A questionnaire to assess patients' intentions in primary care was completed by 206 patients. Patients also rated the amount of help with their presenting problem which they thought could be provided by each of 11 secondary services. A principal components analysis of the intentions revealed 4 components: “Explanation and understanding,” “Support,” “Medical treatment” and “Information-seeking.” Individual patients' intentions were quantified on each of these dimensions. Requests for “Explanation and understanding” did not correlate with expectation of help from any of the 11 sources. In contrast, each of the remaining 3 types of request correlated with expectation of help from a number of sources. These results show, first, a way of measuring patients' intentions on multiple independent dimensions. Secondly, they indicate that patients look solely to the general practitioner for general information and reassurance about their problems. For emotional support they look to additional, mainly psychiatric, sources. This calls into question the view that general practitioners are seen by patients as more appropriate providers of emotional support than specialist services.     

The experiences of transgender and non-binary children and young people and their parents in healthcare settings in England,UK: Interviews with members of a family support group

Abstract

Background: Transgender and non-binary children and young people and their parents in England, UK are poorly served across a range of healthcare settings. Whilst UK equalities legislation and international guidance on transgender healthcare pathways protects this group from discrimination and mandates an affirmative approach, services in England are not keeping pace.

Aims: This study aims to draw on the experiences of transgender and non-binary children, young people and their parents in a support group in England in order to investigate their experiences of healthcare provision, and to develop some ideas for improvement.

Method: Data was collected with participants in a family support group which offers a parent helpline service, social groups for children and parents, and training for schools and other organizations. 65 parents and children from 27 families from the family support group attended participatory workshops where they were given a range of briefs: “health,” “family,” “friends,” and “education.” Their participation involved being asked to define their own interview questions and collect data by interviewing each other. Their interview notes constituted the raw data. Data was coded inductively by the author with respondent checking as a second stage.

Results: Results constitute the views of a small group of people, so cannot be generalized. However, they do illustrate some of the issues which may arise. Participants’ experiences elicited five key themes: professionals’ perceived lack of clinical and therapeutic knowledge; mental distress caused by excessive waiting lists; professionals’ stereotyped gender assumptions; direct discrimination within healthcare settings; and a lack of attention to parent and child voice, especially in terms of school-based experiences and where a patient had a diagnosis of autism.     

Immigration: The “Illegal Alien” Problem

ABSTRACT

The present paper explores the “immigration crisis” both in the United States and in countries around the world. Consideration is given to what is typically absent in public discourse—that is, that immigration is inflected with race, class, ethnicity, religion, and language. Drawing on the work of several leading scholars in philosophy and linguistics, with particular attention to how metaphor shapes thinking, the “immigration problem” is unpacked to examine the issues embedded within its characterization as a “crisis” and for whom that might be so. Examined as well are the larger sociopolitical issues beyond the worldwide public outcry about securing borders. The paper rests analysis of both how the immigrant “other” is characterized and the larger sociopsychological significance of that characterization within the idea of the social unconscious. Finally, the paper explores the role of the group analyst as “citizen therapist” in expanding empathic engagement among groups affected by the huge migration flows. Included are recommendations for the role the group analyst may play in addressing the issue of immigration in our groups and communities.     

Ego transcendence in postmodern perspective

Based on the author's previous specification of the conventional ego mind as the primary barrier to “realization of the ground of consciousness,” postmodern perspectives on the ego mind barrier are compared with premodern and modern approaches. Postmodernists view the ego as a socio‐linguistic construct. Modern assumptions of consistent subjectivity and a unitary self or identity are rejected, and reduction of the ego mind barrier to transcendence is seen to follow from exploration of alternative self‐concepts. This perspective is manifest in theories of “possible selves” and in the contrast between formulations such as the “saturated self vs. the “empty self.” Though forms of ego transcendence likely in postmodern cultures will differ from those in premodern cultures, many of the same functions will be served, as may be observed in such phenomena as “ecomysticism.”     

Normative roles,conceptual variance,and ardent realism about normativity

ABSTRACT

In Choosing Normative Concepts, Eklund considers a “variance thesis” about our most fundamental (and seemingly most “authoritative”) normative concepts. This thesis raises the threat of an alarming symmetry between different sets of normative concepts. If this symmetry holds, it would be incompatible with “ardent realism” about normativity. Eklund argues that the ardent realist should appeal to the idea of “referential normativity” in response to this challenge. I argue that, even if Eklund is right in his core arguments on this front, many other important challenges for ardent realism remain that also stem from the issues about possible variance in normative concepts that he considers. Following this, I introduce further issues about conceptual variance. These are issues that arise within the context of the framework that Eklund proposes the ardent realist use to confront the variance theses he considers. In particular, the issues concern what normative role as such is, as well as, relatedly, which roles associated with a concept (or predicate) get to count as part of its normative role. The upshot is that issues about conceptual variance in normative domains might be even more challenging for the ardent realist to deal with than Eklund argues.     

Where the Rainbow Speaks and Catches the Sun

Abstract

Living with a neurobiological brain disorder, commonly known as a mental illness, requires a lifetime of diligent work toward recovery and wellness. This paper outlines the story of one occupational therapist's journey with her own mental illness. She prefers to call her own road of “recovery” one of “discovery,” as it has led her to discover true talents and gifts (strengths) even amongst encounters with old models that emphasize weaknesses and disability over abilities and capabilities. The following journey unfolds as advances in research, changes in services, increased focus on consumer as leader and increased tools and resources available lead the way toward a more positive ability to live a purposeful life, engaging in meaningful activities in spite of an illness. This paper gives a personal account as a tool to be used by other therapists as they travel along their own treatment journeyswhether with, or as consumers, of mental health services.     

Latent classes of posttraumatic stress and growth

Background and Objectives: Potentially traumatic events may lead to different patterns of posttraumatic stress symptoms and posttraumatic growth. The objective of the present study was to identify subgroups with different patterns of posttraumatic reactions, and to determine whether these subgroups differed in terms of personal and social resources and indicators of adjustment. Design: This study used survey data collected 10 months after the 2011 Oslo bombing attack to investigate patterns of reactions among ministerial employees (N = 1970). Methods: We applied latent class analyses with covariates to extract subgroups of individuals. Results: Three classes of individual reactions were extracted, and these were similar among those who were and those who were not physically proximate to the bombing attack: “High stress/high growth” (27% and 11%, respectively), “Low stress/high growth” (74% and 42%, respectively), and “Low stress/low growth” (only among the not physically proximate: 47%). The classes differed in terms of gender, neuroticism, and social support as well as life satisfaction and daily functioning. Conclusions: Heterogeneous patterns of posttraumatic reactions were found. Physical proximity is not necessary to experience posttraumatic stress or growth after political violence. Among individuals with low stress, posttraumatic growth may not encompass higher life satisfaction or functioning.     

Beyond stigma: Understanding the “inclined abstainers” in military behavioral health-care utilization

ABSTRACT

Low treatment utilization in Soldiers with combat-related Posttraumatic Stress Disorder (PTSD) is an ongoing issue. The critical concern is to better understand factors which prohibit a Soldier with PTSD who wants help from seeking treatment (an “inclined abstainer”). A total of 537 Active Duty Soldiers on a US Army post completed a brief survey comprising psychometrically validated measures of stigma, behavioral health treatment beliefs, resilience, PTSD symptoms, and treatment intentions. Health-care records were prospectively tracked for 12 months to determine the relation between survey answers and treatment utilization. Sixty-three percent of those who acknowledged having a mental health-related problem did not seek help within a one-year period. Greater severity of PTSD symptoms was associated with an increased likelihood of behavioral health engagement. Soldiers that were classified as “inclined abstainers” were also more likely to endorse negative beliefs about psychotherapy and report higher levels of resilience as compared to “inclined actors.” These results suggest that a treatment model of PTSD emphasizing self-efficacy and self-reliance, while addressing negative beliefs about psychotherapy, may help promote engagement of behavioral health services among Active Duty Soldiers.     

Modifications des relations intrafamiliales dans les familles françaises de jeunes enfants pendant le premier confinement lié à la COVID-19

IntroductionIn the context of the COVID-19 pandemic, the French state implemented containment measures requiring parents to stay at home with their children, while ensuring, in addition to daily tasks and work, their schooling.ObjectiveThe objective of this publication is to present the modifications of parent-child and spousal relationships during this period and their main sources according to the parents.MethodAn online questionnaire from 28 April 2020 to 29 May 2020 collected data from 490 French families with at least one child from birth to six years old. A content analysis of the discursive corpus was carried out with NVivo software (version 10). Quantitative statistical processing (using STATA software, version 16.1) tested the relationships between socio-demographic variables, as well as those relating to the parents’ experiences, and “strained” and “strengthened” intrafamily relationships.ResultsWhile for 33.3% of the respondents, family relationships did not change, they became stronger for 42.5% and tense for almost a quarter (24.3%).ConclusionUnderstanding the sources of tension experienced by families of young children during lockdown, as well as what enabled other families to better cope with this situation, may enable measures to be implemented to deal with the consequences of the discomfort generated by the lockdown and to avoid further psychological problems during possible future ones.     

When soothing succeeds: Simulating a risk for repeated shaking in abusive head trauma in infants

PurposeTo investigate the observation that perpetrators of abusive head trauma engage in repeated shakings because shaking “works” to quiet the infant.MethodsSixty first-time parent couples individually cared for a programmable model infant in two consecutive 7-min trials. After six minutes of consolable followed by inconsolable crying, parents selected one of three soothing techniques. For trial one, parents were randomized to a “Successful” or “Failed” Soothing Condition. Whether the soothing technique was repeated after trial two was determined by the study investigators. Parents rated their frustration after each trial.ResultsAs hypothesized, parents were more likely to repeat a soothing technique that “worked” in trial one. Compared to fathers, mothers reported more frustration when soothing failed.ConclusionsThat caregivers were more likely to repeat a successful soothing technique converges with perpetrator confessions that crying cessation after shaking may be a reason why shaking is used repeatedly in response to crying.     

Coping strategies used by middle-aged males with noise-induced hearing loss,with and without tinnitus

Abstract

The aim of this study was to examine the relationship between general coping strategies and specific communication strategies, adopted by males with noise-induced hearing loss (NIHL) in order to deal with stressful events and demanding auditory situations. The sample included 72 males with NIHL; 22 without tinnitus, 26 with mild tinnitus, and 24 with severe tinnitus. The following variables were measured: “active coping” “escape coping” and “passive acceptance” (general coping strategies), and “maladaptive behaviours”, “verbal strategies” and “nonverbal strategies” (specific communication strategies). The results showed that males without tinnitus or with mild tinnitus combined “active coping” and “passive acceptance”, whereas males with severe tinnitus supplemented these strategies with “escape coping”. The relationship between general coping and specific communication strategies was weak, although giving a significant correlation between “escape coping” and “maladaptive behaviours”. The results indicate that the hypothesis that a person's general pattern of coping has influence on his/her ability to cope effectively with a hearing impairment can not be supported. Further research should concentrate on the contribution of personality factors as well as environmental factors to the variance in coping with NIHL and tinnitus.     

Some Problems Concerning the Assessment of Job Characteristics in Nursing Work

Abstract

The question of whether one should use subjective rather than “objective” assessments of job characteristics is still the subject of a vigorous discussion in analytical studies of jobs and in job design. In nursing work situations, too, the attention of managers and researchers for such studies is growing. In this article the results of a study are presented in which a comparison is made between two kinds of assessments: job characteristics as judged by task performers (nurses) and job characteristics as judged by non-task performers (nursing management). Differences and agreements between mean scores as well as between correlations with dependent variables like job satisfaction were analysed. Most agreement seems to be on the ratings of “complexity and difficulty”, “work pressure”, and “promotion and growth opportunities”. As to “feedback and clarity”, “autonomy”, and “patient caring opportunities”, differences between the ratings have been found. It appears that a larger number of correlations between the nurse-rated job characteristics and the reaction variables is found to be statistically significant than between the management-rated job characteristics and the reaction variables. Social, organizational, and methodological reasons for the observed differences are put forward.