The Psychophysiology of Orthostatic Panic in Cambodian Refugees Attending a Psychiatric Clinic

Orthostatically triggered panic was examined in female Cambodian refugees. Heart rate, blood pressure (BP), panic, and dizziness responses were assessed during orthostatic challenge in three diagnostic groups: orthostatic panic without comorbid posttraumatic stress disorder (PTSD), orthostatic panic with PTSD, and other mental disorders without orthostatic panic or PTSD. During orthostatic challenge, the panic group without PTSD showed a significant drop, whereas the group with other mental disorders showed an increase in systolic BP. The group with panic and PTSD showed a blunted systolic BP response during orthostasis that fell between the responses of the other groups. Catastrophic, culturally specific cognitions present during orthostatic challenge were significantly correlated with the amount of reported panic upon standing. Some patients recalled previous traumatic events during the orthostatic challenge. The findings suggest that orthostatically induced panic attacks in Cambodian refugees are generated by an interaction of orthostasis physiology, catastrophic cognitions, and trauma associations.     

Improving the Emotional Adjustment and Communication Patterns of Incarcerated Mothers: Effectiveness of a Prison Parenting Intervention

Incarcerated mothers at a state prison participated in an eight-session parenting class designed to help them manage the stress of separation from children and to improve communication patterns with children and home-caregivers. In comparison to a waitlist control group (n = 46), inmates who received immediate intervention (n = 60) experienced less parenting distress regarding upcoming visitation experiences; however, waitlist and immediate treatment groups did not differ on other intervention measures. Additional analyses contrasted pre- and post-intervention differences on adjustment measures for inmates from either treatment condition who completed the parenting program (N = 90). After intervention, mothers reported reduced parenting stress, improved alliance with home caregivers, increased letter-writing, and reduction of mental distress symptoms. Large drop-out rates in both subgroups may have reduced the benefits of the random assignment used to form groups. Results support the value of interventions for incarcerated mothers that focus on ways to manage the emotional distress and poor communication patterns associated with being a parent in prison.     

Culturally adapted CBT (CA-CBT) for Latino women with treatment-resistant PTSD: a pilot study comparing CA-CBT to applied muscle relaxation

We examined the therapeutic efficacy of a culturally adapted form of CBT (CA-CBT) for PTSD as compared to applied muscle relaxation (AMR) for female Latino patients with treatment-resistant PTSD. Participants were randomized to receive either CA-CBT (n = 12) or AMR (n = 12), and were assessed before treatment, after treatment, and at a 12-week follow-up. The treatments were manualized and delivered in the form of group therapy across 14 weekly sessions. Assessments included a measure of PTSD, anxiety, culturally relevant idioms of distress (nervios and ataque de nervios), and emotion regulation ability. Patients receiving CA-CBT improved significantly more than in the AMR condition. Effect size estimates showed very large reductions in PTSD symptoms from pretreatment to posttreatment in the CA-CBT group (Cohen’s d = 2.6) but only modest improvements in the AMR group (0.8). These results suggest that CA-CBT can be beneficial for previously treatment-resistant PTSD in Latino women.     

The enigmatic signifier and the decentred subject

相似文献   

The Divine Horizon: Rethinking Political Community in Luce Irigaray's “Divine Women”

The question of the transcendent, that which operates above and beyond the material stuff of the world, remains an enduring one for feminism, bound up as it is with the foundations of feminism's corporeal politics and the definition of its political subject. With the specificity of the situated and meaningful body grounding feminist politics, the universal and neutral status of the speaking subject has been diagnosed as masculine, and unable to properly account for sexed differences. On this basis, political community, collectivity forged along the lines of a common identity, is considered important in the realization of feminist political goals, yet is also problematic in view of its reliance upon a universal category of identity through which to motivate for political change. Acknowledging these tensions, this paper revisits Luce Irigaray's essay “Divine Women” to suggest that in her rethinking of the divine as a shared horizon through which women can potentially achieve autonomy, the nature of the transcendent, the universal, and the identity of the feminine are also reconfigured in surprising ways. In a specific address to the dilemma of political community, Irigaray makes available a notion of the divine that is already differently inhabited.     

Anxiety sensitivity in traumatized Cambodian refugees: a discriminant function and factor analytic investigation

We examined the psychometric properties and factor structure of a Cambodian translation of the Anxiety Sensitivity Index (ASI) and an Augmented ASI (the ASI supplemented with a 9-item addendum that assesses additional Cambodian concerns about anxiety-related sensations). Both the ASI and the Augmented ASI distinguished among three diagnostic groups: highest score, PTSD with panic disorder (PP group); next, panic disorder without PTSD (P group); and then, other disorders than PTSD or panic disorder (O group). In the discriminant function analysis using the Augmented ASI, the best classificatory predictor (PP vs. P vs. O) was an Addendum item (“It scares me when I stand up and feel dizzy”). The principal component analysis (oblimin rotation) of the ASI yielded a 3-factor solution (I, Weak Heart Concerns; II, Control Concerns; III, Social Concerns) and of the Augmented ASI, a 4-factor solution (I, Weak Heart Concerns; II, Control Concerns; III, Wind Attack Concerns; IV, Social Concerns). The item clustering within the factor solution of both the ASI and Augmented ASI illustrates the role of cultural syndromes in generating fear of mental and bodily events.     

Cardiac and electromyographic indices of attention: suggested situational adaptation effects.

Neck muscle action potentials and heart rate variability were recorded on 30 male hospital patients prior to and during performing on a short-lasting test of detecting auditory lateral shifts. A positive correlation (r = 0.49) was found during the second day but not during the first day of testing. The correlation is compatible with Obrist's somatic coupling hypothesis. Its absence during the first day suggests that subjects must adapt to the test situation before any reliable relations between physiological measures can be observed.     

Can we neurologise about spiral after effect duration?

Spiral After Effect (SAE) durations and measures of judgmental delay on an audio shift task were taken from 26 subjects. The importance of a general dispositional factor relative to specific neurological factors in determining SAE duration was investigated.A significant correlation was found between the two test measures (r = 0.79, P < 0.001). The validity of the SAE as a measure of ‘arousal modulation’ (Claridge, 1967; Blowers, 1979) is brought into question, and an alternative account of the reported duration of after-effect is given in terms of a general disposition for decision making under conditions of uncertainty, determined by social conditioning factors.     

Sex differences in self-reported coronary-prone factors

The FABA self-report questionnaire on coronary-prone behaviour was applied to 628 GDR subjects (343 males, 285 females), who included students, blue- and white-collar workers, and hypertensive patients, all split into three age groups (18–30, 31–50, and 51–65 years). Four scales had been previously established by factor analysis: Work Obsession (WO), Dominance/Competition (DC), Reactive Uncontrol (RU), and Need for Planning (PN). Two-tailed MANOVA and ANOVA were applied to analyse the effects of sex, age, and type of respondent (i.e. student, worker, or hypertensive) on scale means, using the defined sub-groups. No significant sex differences on WO and PN were found. With regard to DC, males of all sub-groups consistently rated themselves as more dominant and competitive than females. These differences were highly significant. RU was higher only in female students and female hypertensives. There was a significant age effect on DC and PN: the older the workers and hypertensives of both sexes, the more dominant and obsessed with planning they were. No influence of the type of respondent was apparent. Results are discussed in the light of cross-cultural research on gender differences and the particular socio-economic situation of the former GDR. © 1998 John Wiley & Sons, Ltd.