Trauma Exposure in Anxious Primary Care Patients

The present study examined rates of trauma exposure, clinical characteristics associated with trauma exposure, and the effect of trauma exposure on treatment outcome in a large sample of primary care patients without posttraumatic stress disorder (PTSD). Individuals without PTSD (N?=?1,263) treated as part of the CALM program (Roy-Byrne et al., Journal of the American Medical Association 303(19)1921–1928, 2010) were assessed for presence of trauma exposure. Those with and without trauma exposure were compared on baseline demographic and diagnostic information, symptom severity, and responder status six months after beginning treatment. Trauma-exposed individuals (N?=?662, 53 %) were more likely to meet diagnostic criteria for Obsessive Compulsive Disorder and had higher levels of somatic symptoms at baseline. Individuals with and without trauma exposure did not differ significantly on severity of anxiety, depression, or mental health functioning at baseline. Trauma exposure did not significantly impact treatment response. Findings suggest that adverse effects of trauma exposure in those without PTSD may include OCD and somatic anxiety symptoms. Treatment did not appear to be adversely impacted by trauma exposure. Thus, although trauma exposure is prevalent in primary care samples, results suggest that treatment of the presenting anxiety disorder is effective irrespective of trauma history.     

Neuropsychological Functioning in Children with Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) has been associated with deficits in the areas of verbal memory and learning, executive functioning, working memory, and attention in adults. Findings have been less consistent in the few studies examining neuropsychological functioning in childhood PTSD, which are often limited by comparing children with PTSD to children without trauma histories, making it unclear whether observed neuropsychological deficits are related to trauma exposure or to PTSD symptomatology. In an ethnically diverse sample of 62 children who witnessed intimate partner violence (n = 27 PTSD+ and 35 PTSD?), children with PTSD exhibited slower and less effective learning, heightened sensitivity to interference, and impaired effect of rehearsal on memory acquisition on the California Verbal Learning Test – Children's Version, a word list learning task. Both groups performed in the below average range on measures of executive functioning, attention, and intellectual ability.     

Longitudinal Analysis of Associations between 3-D Mental Rotation and Mathematics Reasoning Skills during Middle School: Across and within Genders

ABSTRACT

The development of math reasoning and 3-d mental rotation skills are intertwined. However, it is currently not understood how these cognitive processes develop and interact longitudinally at the within-person level – either within or across genders. In this study, 553 students (52% girls) were assessed from fifth to seventh grades on 3-d mental rotation spatial skills (assessed each fall) and numerical and algebraic math reasoning skills (assessed each spring). Boys outperformed girls on mental rotation tests across all three grades, and on fifth and seventh grade math reasoning tests. Consistent with the literature on between-person comparisons, there was a positive correlation between mental rotation and math reasoning skills in the full sample and for both genders. A random intercept cross-lagged panel model was used to control for these confounding group-level differences in order to isolate within-person associations between earlier and later performance. Initially in fifth grade, math reasoning predicted subsequent sixth grade mental rotation skills. By seventh grade, more advanced mental rotation skills were associated with subsequent math reasoning skills while math reasoning skills were no longer predictive of mental rotation skills. An examination of gender differences revealed that this pattern was driven by boys while girls experienced less within-person change. These findings suggest that boys may initially rely in part on their math reasoning skills to solve 3-d mental rotation tasks. However, as their 3-d mental rotation skills mature, they begin to primarily depend upon these developing spatial skills to solve math reasoning problems rather than the reverse.     

Shame,posttraumatic stress disorder,and intimate partner violence perpetration

Drawing from theoretical and empirical literature linking shame to aggression and violence, the authors propose that shame may be an important variable to examine in studies of posttraumatic stress disorder (PTSD) and intimate partner violence (IPV) perpetration. The authors review the literature linking shame, PTSD, and IPV, propose ideas for future research, and suggest that shame and shame regulation may be a useful target of clinical interventions aimed at violence perpetrators.     

Personality Dysfunction and the Management of Chronic Medical Illness: A Community Health Sample

The purpose of this study was to determine the influence of personality disorders on perceived health status, self-efficacy for management of the chronic illness, and physician perception of patient health. A total of 607 patients with self-identified chronicillness(es) volunteered to participate in the study. Out of this sample, 147 had collaborative physician data indicating a chronic illness. The final sample was 143 due to incomplete data. Results suggested that maladaptive personality characteristics, as measured by the Short-Form of the Coolidge Axis II Inventory (SCATI), were related to a number of important factors that influence self-management of chronic illnesses. When the personality constellations were broken into 3 groups (normal, subclinical, and clinical) significant differences were found on the 3 groups of dependent variables (Subjective Health, Self-Efficacy, Physician Appraisal) for the different personality disorders. These data provide useful information on several factors that influence effective disease management. Clinical implications and directions for future research are provided.     

Ritual in Western Medicine and Its Role in Placebo Healing

Ritual has long been thought to play an important role in the healing processes used by ancient and non-Western healers. In this paper, I suggest that practitioners of Western medicine also interact with patients in a highly ritualized manner. Medical rituals, like religious rituals, serve to alter the meaning of an experience by naming and circumscribing unknown elements of that experience and by enabling patients' belief in a treatment and their expectancy of healing from that treatment. These are all critical elements necessary to mobilize the potent placebo effects reported elsewhere to result from doctor-patient interactions.     

Relative spatial expansion and contraction within the Müller-Lyer and Judd illusions

The shaft portions of Müller-Lyer (M-L) figures, one-ended M-L figures, Judd figures, and their respective control (tails-up) figures were divided by subjects into eight equal-appearing intervals by means of successive bisections. For most of the control stimuli the length of the left half of the shaft tended to be overestimated relative to the length of the right side. For the tails-out version of the M-L figure, there was relative overestimation of segments of the shaft adjacent to the tails, while for the tails-in version there was relative underestimation of these segments. These results indicate that the distortion of perceived length in the M-L illusion is not distributed evenly along the shaft. For the one-ended M-L figures the apparent overestimations and underestimations extended further along the shaft than for the standard figures. For the Judd figure perceived length varied systematically along the length of the shaft from underestimation near the tails-in end of the figure to overestimation near the tails-out end. These results are contradictory to the hypothesis that the M-L illusion results from inappropriate size scaling produced through the operation of size-constancy mechanisms, since this conjecture would predict uniform expansion or contraction. The results are compared with findings that localization responses are accurate for M-L figures but biased for one-ended M-L figures and Judd figures.     

Surviving Abuse: Shame,Anger, Forgiveness

The issue of forgiveness affects everyone at some time or another; whether young or old, male or female, Christian or not. For the survivor of abuse, the issue of forgiveness journeys with them profoundly influencing their life, their recovery, and even their faith. Surviving Abuse: Shame, Anger, Forgiveness is an attempt to develop a theology of forgiveness from the perspective of a survivor of abuse.