Psychological distress and quality of life of people living with HIV/AIDS in a Nigerian teaching hospital

Presence of psychological distress and poor quality of life (QoL) may affect the outcome of HIV/AIDS. One hundred and seventeen consecutive and consenting participants were interviewed using a Socio-demographic questionnaire, Kessler Psychological Distress Scale (K10) and World Health Organization Quality of Life-HIV Bref. Fifty-six (47.9%) participants scored 20 and above on K10 Scale. QoL was significantly higher in married participants, those who perceived their state of health as being good, asymptomatic participants and those who scored well–mild on K10. The older age group scored higher on QoL Scale than the younger age group in the physical health domain while the married participants scored higher in the domains of physical health, psychological health, environment and spiritual/religion. The participants who perceived their state of health as being good scored higher than those who perceived their health as poor in all domains. There is a high level of psychological distress and poor QoL in people living with HIV/AIDS.     

Posttraumatic Stress in Survivors of Childhood Cancer and Mothers: Development and Validation of the Impact of Traumatic Stressors Interview Schedule (ITSIS)

This study presents initial data validating the use of a new instrument, the Impact of Traumatic Stressors Interview Schedule (ITSIS), to assess the occurrence of cancer-related posttraumatic stress in childhood cancer survivors and their mothers. Sixty-six child/adolescent cancer survivors and 64 of their mothers, as well as 130 young adult survivors, completed the ITSIS and other measures of posttraumatic stress and general distress. Five ITSIS factors were identified for the mothers and for the young adult survivors, and three ITSIS factors were identified for the child/adolescent survivors. Factors in all three samples reflected symptoms of posttraumatic distress, concern over medical late effects, communication, and changes in self due to cancer. Only young adult survivors had a factor reflecting a positive engagement with the cancer history. Factors correlated with validation measures in predicted ways. The findings further the conceptualization of posttraumatic stress in pediatric cancer by describing the traumatic experience for survivors and mothers. Comparing factors across samples allows an examination of different influences of cancer within families and over the course of development.     

Relationships among parental reports of child, parent, and family functioning.

Most children with psychosocial problems do not present for treatment in mental health settings. They are managed by primary care physicians. Children with psychosocial problems often have parents and/or families with psychosocial distress. The present study measured associations between parental reports of child, parent, and family functioning in individuals in the general population. Participants were 226 parents of children, aged 2-16 years, who presented for routine primary care. Parents reported on the psychosocial functioning of themselves, their child, and their family. All correlations of measures were significant, ranging from .55 to .23. Similar to data from psychiatric samples, the psychological functioning of children, parents, and families were significantly correlated. Unlike in psychiatric settings, child mental health problems were not as closely related to parent or family distress as parent and family distress were related to each other and to child behavior problems.     

Transformation of Perception of Trauma by Child Survivors of the Holocaust in Group Therapy

Intensive work with child survivors of the Holocaust has made us aware of the clinical importance of understanding the ways children perceive their traumas and the conclusions they draw about how they must live their lives. When these perceptions are transformed congruently with the child's development, the survivors can cope quite well. In this paper we refer to now middle-aged survivors who are still guided by their child perceptions. We will describe how we have used conjoint group psychotherapy to facilitate processes of transformation even at this late stage. The model we provide for trauma work with Holocaust survivors whose traumatization occurred decades ago may well provide tools to reduce future suffering of children who are victims of massive traumatization today.     

BETWEEN RECEPTION AND SELF-PERCEPTION: TESTIMONIES OF HOLOCAUST SURVIVORS IN ISRAEL

Based on survivors’ testimonies the article discusses the encounters of Holocaust survivors in Palestine/Israel between 1945 and 1955. After addressing the issues of the historiography of these Holocaust survivors and the value of using their testimonies, it examines the interactions of survivors with official authorities: work, housing, kibbutzim, education, and the pre-military/IDF. It sheds light on the meaning of silence and the manifestation of stereotyping for the survivors themselves, and it assesses the impact of families and creating families. The article also examines the validity of these testimonies by studying some testimonies of Holocaust survivors who emigrated from Israel and those who immigrated directly from Europe to North America. The study concludes that although contemporary collective views influenced survivors’ perceptions, cases of their ill-treatment were not isolated. They were more the result of the attitudes of individuals than the policy of the state. Veteran Israelis' insensitivity affected survivors. Stigmatizing ostracized them. Lack of empathy and discrimination caused survivors to feel unwanted and lonely, which resulted in many volunteering for the military, or in self-isolation, or in getting married as quickly as possible. Lack of study and job opportunities for women were more difficult to overcome.     

The inter-generational transmission of trauma: The effects of abuse on the survivor's relationship with their children and on the children themselves

This paper explores some of the potential consequences of childhood abuse in adulthood, in terms of the effects on parenting, and on the child of the abuse survivor. Reference is made, and parallels drawn where appropriate, to the experiences of survivors of the Holocaust in respect of both these themes. the clinical experience of the author vis-à-vis survivors of abuse and parenting has strong similarities to some of the findings of those researching this subject from the perspective of the Holocaust. While the primary focus is on the experiences of survivors of childhood abuse these similarities and parallels are also acknowledged.     

Enfants juifs cachés (1940-1944) : une littérature récente

The psychological literature about child survivors of the Holocaust, including “hidden children”, is recent and essentially American and Israeli. Trauma of child survivors of the Holocaust has been recognized in the 1980s. First articles have been published in the United States and Israel. All the clinicians identify traumatic symptomatology. The diagnosis of PTSD is questioned. Literature about “hidden children” has been written after 1991. After recognition of their suffering, articles and books emerged, especially American and Israeli studies. In Europe, only a few articles come out, they are mostly from Netherlands. This article presents a review of the psychological literature, predominantly American and Israeli concerning child survivors of the Holocaust and “hidden children” according to qualitative and quantitative methodology. Recently, a few researches start coming out and are published in French journals.     

"Living with" the past: coping and patterns in families of Holocaust survivors

This exploratory study looks at how families of Holocaust survivors work through the traumatic past by considering the coping patterns adapted by family members. Life-story interviews (Rosenthal, 1993) with 57 individuals from 20 families, in which there were two to three generations, were used in order to learn about the significance they attach to the Holocaust past. The interviews were analyzed using Rosenthal's methods and Danieli's (1988) typology of post-war adaptation (victim families, fighter families, those who made it, and numb families). Results showed that in order to differentiate between the coping styles exhibited by the families, two new categories had to be added to Danieli's typology. These were entitled "life goes on" and "split families." It was concluded that survivor families exhibit heterogeneity in the ways in which they cope with the Holocaust past.     

A Family Therapeutic Approach to Transgenerational Traumatization

The phenomenon of transgenerational traumatization has currently become widely recognized and described, although the task of disentangling the underlying interactional mechanisms remains a difficult one. These transgenerational mechanisms were first detected in families of the survivors of the Holocaust, but they may be equally prominent in families of parents who have been traumatized in other ways, for example, as victims of child neglect and abuse, as orphaned children, or during military service. In cases in which parents have themselves been subjected to early parental deprivation, one or more children may become projectively identified with a parent's (posttraumatic) "bad child"-self, whereas the parent him/herself has identified with — enacts the role of — the idealized internal "martyr" parent. A case study is presented describing the individual and family therapeutic treatment of a woman who, as a child, had been traumatically separated from her parents.     

Parent–adolescent communication in foster,inter‐country adoptive,and biological Italian families: Gender and generational differences

There is a paucity of studies aimed at comparing how parents and children in different family structures cope with the challenges posed by the adolescence transition; in particular, there are few studies aimed at comparing adoptive and foster families. In order to partially fill this gap, the principal aims of the present study were to verify whether there are differences in parent–child communication among foster, intercountry adoptive, and biological families according to the adolescents' gender, and to compare the perceptions of parents and adolescents concerning parent–child communication. Data were elaborated on two levels: a generational level (adolescent's and his/her parents' perceptions among the three family groups) and a dyadic level (mother–child and father–child perceptions). The sample was composed of 276 Italian families with adolescents aged between 11 and 17 (81 foster, 98 international adoptive, and 97 biological families). Subjects (mothers, fathers, and children) filled out a questionnaire including the Parent–Adolescent Communication Scale (Barnes & Olson, 1985 ). Results highlighted that in foster families, parent–child communication showed more difficulties from both the adolescent's and the parents' point of view. Adoptive adolescents, however, reported a more positive communication with both their parents than did their peers living in biological and foster families. At a dyadic level, some differences emerged among the three groups. In biological families, a more pronounced distance emerged between parents and children. In adoptive families, father and adolescent shared more similar perceptions, whereas a significant discrepancy emerged between mother and child. A higher level of perceptual congruence between adolescents and parents was found in foster families. Gender differences were also seen: Mothers experienced a more open communication with their children than did fathers, and adolescents, and above all females, communicated better with their mothers than with their fathers in all three family groups.     

The Holocaust and Its Effects on Survivors: An Overview

The Nazi Holocaust has had continuing and widely reverberating consequences not only for the Jewish survivors but for the world at large. These consequences are detailed, first through a personal account of an Auschwitz survivor, and then through a discussion of the adaptive measures of concentration camp inmates and the long-term psychiatric and psychological effects on survivors and their families. The Survivor or Concentration Camp Syndrome and its relationship to the Post-Traumatic Stress Disorder is described. Indirect effects of the Holocaust have been manifested in various ways, particularly through various levels of psychologic denial displayed by Holocaust criminals and (at least during the early postwar period) by the German public. The Holocaust has had profound effects on the ways the Jewish people regard themselves and are seen by others. Finally, the Holocaust can be seen as offering a kind of paradigmatic signature to the worldview of the end of the 20th century, emphasizing the persistence of evil and the limitations of the idea of progress.     

PROFESSIONALIZING SURVIVAL: THE POLITICS OF PUBLIC MEMORY AMONG HOLOCAUST SURVIVOR-EDUCATORS IN MONTREAL

The majority of Holocaust survivors never speak publicly about their experiences, but those who do tend to find themselves at the centre of commemorative work in their communities. As Holocaust scholars, Holocaust education institutions, and members of the general public become increasingly interested in how to ethically universalize the lessons of the Holocaust, the public Holocaust survivor's role has broadened. It is no longer enough to recount one's own experience; survivors are expected to speak to current human rights abuses and genocides.In Montreal, Canada, a city which once claimed the third largest survivor population in the world, public survivors do a great deal of work. They give testimony in schools and at commemorative events, organize book clubs, write plays, direct films, teach, act as museum docents, and assume roles as community spokespeople. Given their dedication to this work, and a push to get them to speak beyond their personal experiences, we argue that there is a major shift taking place: the act of giving public Holocaust testimony is being professionalized. This professionalization raises unique questions about how people who lived through the Holocaust conceptualize themselves and their identities as survivors. By treating testimony as professional work, survivors contemplate, on a daily basis and in an applied manner, their stances on big questions regarding hierarchies of suffering, comparability, the connection between the personal and the political, blame and forgiveness, as well as many other relevant themes that are central to Holocaust and memory scholarship. All of this plays out in their testimonies.     

Social comparisons and quality of life among survivors of childhood cancer and their mothers

Abstract

Sixty-three survivors of childhood cancer (mean age 17 years), currently well and off-treatment, and their mothers were interviewed individually about their experiences and the impact of their illness on their lives. Survivors also completed four questionnaire measures of different aspects of quality of life (perceptions of illness experience, future worries, health problems and body image satisfaction), whereas mothers recorded their perceptions of their child's quality of life on the same four scales. These scales showed good internal consistency and convergent validity for both survivors and mothers. Mothers also completed a measure of their own quality of life (the SF-36). The interviews with both survivors and mothers were content-analysed for statements expressing social comparisons. These statements were coded according to whether the comparison implied a favourable, neutral or unfavourable evaluation of the individual survivor. Mothers who made a higher proportion of unfavourable comparisons reported worse adjustment for their child on all four scales and described their own quality of life more negatively. Among survivors, those who made a higher proportion of unfavourable comparisons gave significantly more negative self-ratings on one of the four scales. Correlations between survivors' and mothers' ratings on the four scales were positive, but comparatively low. This reinforces concerns about using parents as proxy judges of young people's quality of life, although the correlations were more satisfactory in the case of younger rather than older (>18.5 years) survivors. Mothers who rated their own quality of life as less satisfactory reported more problems for their child on all four scales, irrespective of how the survivors described themselves.     

Motives for Fostering Children with Alcohol-Related Disabilities

A sample of 63 licensed foster parents was asked, “What motivates you to foster a child who has a fetal alcohol spectrum disorder?” The responses to this question were grouped together by licensed foster parents. The grouped data were subjected to multidimensional scaling and cluster analysis. Results indicated that foster parents were motivated to care for children with alcohol-related disabilities by witnessing positive changes in the children in their care, helping children focus on their strengths, using their own parenting experience, earning an income, assisting children who have disabilities, and helping children stay connected to their families and communities. Foster parents who foster children with alcohol-related disabilities foster for similar reasons to those who foster children with special needs in general. Differences between the literature on foster parent motives and study results were described. Foster parents who are caring for children with alcohol-related disabilities see their care as specialized, see their roles as long-term helpers facilitators to children, their birth families and home communities, and emphasize positive experiences of fostering.     

Theistic Dissonance Among Religious Jewish Holocaust Survivors: A Psychodynamic Perspective

Coining the term theistic dissonance to capture conflicted attitudes and feelings toward God, this article examines faith-based reactions to the Holocaust. The theological weltanschauung of religious Jewish Holocaust survivors is analyzed, with a particular focus on their attempts to reconcile the notion of a benevolent and caring God with their harrowing experience. Basic religious sources and contemporary literature are presented to elucidate the realm of resolutions of theistic dissonance. It is suggested that elements of defense mechanisms are adapted from the emotional into the cognitive realm, and are used by survivors to facilitate respective interpretations of God’s role during the Holocaust. Dissonance resolution is seen as being informed theologically and experientially for these victims who confronted stark challenges to their religious integrity.     

Family Therapy with Families of Holocaust Survivors

This is a clinical review of 7 families of Holocaust survivors who presented for treatment because of problems with an adolescent of the third generation. In 3 cases the problem was anorexia, and the remaining 4 had various clinical presentations, mostly related to separation-individuation issues. A common thread in the narratives that unfolded was that the trauma of the grandparent/survivors had been transmitted across subsequent generations to exercise significant influence on the children and grandchildren. Often, a more recent death or separation crisis had been the catalyst for these difficulties or a trigger that activated the Holocaust trauma. An outline of the therapeutic intervention is presented; it was based on a combination of systemic, structural, strategic, and psychodynamic approaches. It is suggested that open acknowledgment of the transgenerational issues played a critical role in moving families toward a more differentiated outcome.     

The Phenomenology of Posttraumatic Distress in Older Adult Holocaust Survivors

This paper focuses on the effects of the Holocaust on its survivors more than 55 years after the end of World War II. The emphasis is on survivors who were either adults during the Holocaust and who are now over the age of 70, or survivors who were children during the Holocaust and whose age is now between 56 and 70. The central question was: What kinds of posttraumatic phenomena are seen in older adult survivors? After an overview of the field, the situation of survivors in Israel is presented in 2 ways. Results of a survey of survivors who were referred to Amcha, the National Israeli Center for Psychosocial Support of Survivors of the Holocaust, is provided to give some insight in a clinical population. In addition, 2 case histories of survivors are presented to give a more in-depth perspective. The gap between the data from the questionnaires and the clinical material has relevance for the way in which we conceptualize the late consequences of massive trauma.     

Salutogenesis and autobiographical disclosure among Holocaust survivors

Forty-five Holocaust survivors and a comparison group of 21 Jews who had not experienced Nazi persecution completed questionnaires assessing salutogenic (health-enhancing) and pathogenic (illness-inducing) outcomes of Holocaust vs. other traumatic experiences. Salutogenesis and pathogenesis were negatively correlated. Holocaust survivors were consistently higher on the measure of salutogenesis; with marital history held constant, this difference was statistically significant. Neither group reported high incidences of posttraumatic stress symptoms, although survivors reported more. Talking about one's Holocaust experiences was related to more positive and fewer negative responses. Marital history and religious observance mediated some aspects of both positive and negative long-term consequences. The results indicate that the long-term consequences of even extreme trauma may include increased personal strength and growth.     

Transgenerational processes and the trauma of sexual abuse

The process of the unconscious transmission of trauma between generations has been written about within the psychoanalytic field since Freud. the concept was further developed by psychoanalysts in their work with second generation survivors of the Holocaust. the particular characteristic is that it is a transmission that takes place silently and in secret, but actively. It is especially found in families where there is an inhibition against thinking. It is suggested in this paper that the concept could be usefully considered in families where a parent is a survivor of child sexual abuse but has kept the trauma a secret. Clinical examples illustrate how children in such families may carry the unconscious dynamics which can emerge into consciousness through symptomatology in the child.     

Holocaust survivors in long-term care

ABSTRACT

Little research exists on the experience of older trauma survivors in long-term care settings. This study examined the experience of Holocaust survivors in community-based and facility-based long-term care. We wished to know if Holocaust survivors had a systematically different experience in such settings compared to persons without a trauma experience in their backgrounds. Through interviews with survivors, American-born Jews in the same settings, family members, and professional staff, we learned that there were differences in certain aspects of mental health and emotional well-being and that these differences are associated with the relative lack of a network of family members as compared to American-born Jews.