Physical and Mental Health and Functioning Among Traumatic Brain Injury Close Relatives: The Role of Posttraumatic Stress Symptoms

Severe Traumatic brain injury (sTBI) often instigates widespread long-lasting disability and is accompanied by extensive rehabilitation. Unsurprisingly, sTBI also holds malignant consequences for patients’ close relatives. The burden caused by the injury and its severity explains some of the ramifications for the relatives. Additionally, some findings demonstrate that patients with sTBI and their relatives develop posttraumatic stress (PTS) symptoms. However, although the link between PTS symptoms and physical and mental health is well-documented in literature, the effect of PTS symptoms on relatives of patients with sTBI has barely been examined. This study examines the influence of PTS symptoms of patients with sTBI and their relatives on the physical and mental health and functioning of the relatives. Patients who sustained a severe sTBI (Abbreviated Injury Scale of the head region > 3) and close relatives were included in a multi-center, prospective cohort study (TRAST-MI). One-hundred patients and their relatives were assessed at 2, 6, and 12 months post injury. Outcome variables included health-related quality of life (SF-12) as well as emotional, cognitive, interpersonal, and total functioning (PCRS). Relatives’ physical health was predicted by relatives’ PTS symptoms (Slope=−1.76; p = .043), and mental health was predicted by both patients’ (Slope=−2.77; p = .034) and relatives’ (Slope=−6.59; p < .001) PTS symptoms. Functioning level was only predicted by patients’ PTS symptoms (Slope=−.25; p_<.001). The findings emphasize that TBI should be considered a comprehensive traumatic experience reaching further than mere physical damage to the brain and its direct consequences, affecting the injured individual and close relatives.     

From horror to ethical responsibility: Carl Gustav Jung and Stephen King encounter the dark half within us,between us and in the world

This paper explores the experience of horror. The term is usually understood collectively to refer to experiences of terrorism, racism and other conflicts; however, the paper explores the equal horror for the individual of facing deep and painful psychic contents and traumatic experiences. The paper explores the way that both C.G. Jung, through analysis of the psyche, and the author Stephen King, through his horror novels, have accepted and explored the experience of encountering ‘the dark half’ or ‘It’ that is the other within themselves, forming images and symbols capable of linking their personal experience to that of the collective. This encounter is transformed, as far as Jung is concerned by analytical psychology and for King by fiction, through an attitude of active imagination. This led both men to developing an ethical responsibility towards the images of the unconscious, as well as the personal and collective contents of human life. The paper depicts how encountering the ‘dark half’, through Jung and King can provide a Jungian analyst with a special attitude with which to deeply explore and ethically process the experience of horror in different fields, including therapeutic practice, analytical training and in the traumatic and conflictual facing of the other, with which, today as always, the world presents us.     

Public involvement in social and political participation processes: A gender perspective

One interesting perspective from which to investigate participation processes is that of gender (Angelique & Culley, 2007). The disparity between male and female participation is evident, in particular when dealing with politics. The research reported here examines any differences between men and women in three different groups: non‐participants (N = 201), social participants (N = 167) and political participants (N = 184). Two specific aspects were considered: (a) the perception of sociopolitical control, that is leadership competence and policy control, and (b) the perception of costs and benefits derived from participation. In focusing on such perceptions, if any difference could be evidenced, we aimed to investigate if this difference was determined by gender, by the type of participation or by the interaction of gender and participation. Data show that leadership competence and policy control were both influenced by the type of participation. An interaction effect of gender and type of commitment for policy control was observed and gender had a direct effect on leadership competence. These results suggest that the gender gap seems to be connected more to the context than to effective gender characteristics. Other data on the perception of costs and benefits are discussed. Copyright © 2009 John Wiley & Sons, Ltd.     

Where Am I? A new case of developmental topographical disorientation

Recently, developmental topographical disorientation (DTD) was described (Bianchini et al., 2010, J Clin Exp Neuropsychol, 20, 807–27; Iaria & Barton, 2010, Exp Brain Res, 206, 189–96; Iaria, Bogod, Fox, & Barton, 2009, Neuropsychologia, 47, 30–40) as a navigational deficit in the absence of neurological or psychiatric disorders. Here, we reported the case of a healthy subject who presented this disorder. Dr. WAI was a 29‐year‐old right‐handed man with normal development and no clinical history of neurological or psychiatric diseases who was affected by a very pervasive topographical orientation and navigational disorder. A neuroradiological exam confirmed the absence of structural and anatomical alterations of the brain. Dr. WAI was submitted to an extensive neuropsychological examination and to a battery of tests specifically developed to assess developmental topographical disorder. Using this battery, we analysed Dr. WAI's acquisition of navigational information and re‐orientation processes. He showed severe DTD accompanied by deficits of different cognitive processes directly or indirectly involved in navigational skills. Dr. WAI showed a deficit in developing cognitive maps, already found in previous cases, plus difficulties in evaluating distances and computing metric environmental features. He represents a further confirmation of the existence of DTD suggesting dissociations within the disorder related to the level of development of the ability to build cognitive maps and the association of different imagery deficits. Dr. WAI can help in shedding some light on the mechanisms underlying lack of development of navigational skills.     

Reciprocal Relations Between Emotional Self‐Efficacy Beliefs and Ego‐Resiliency Across Time

The present study examined the longitudinal relations of adolescents' self‐reported ego‐resiliency to their emotional self‐efficacy beliefs in expressing positive emotions and in managing negative emotions as they moved into early adulthood. Participants were 239 females and 211 males with a mean age of 17 years (SD = .80) at T1, 19 years (SD = .80) at T2, 21 years (SD = .82) at T3, and 25 years (SD = .80) at T4. A four‐wave cross‐lagged regression model and mediational analyses were used. In a panel structural equation model controlling for the stability of the constructs, reciprocal relationships across time were found between ego‐resiliency and emotional self‐efficacy beliefs related to the expression of positive emotions and to the management of negative emotions. Moreover, the relation between ego‐resiliency assessed at T1 and T3, and ego‐resiliency assessed at T2 and T4, was mediated through emotional self‐efficacy beliefs (at T2 and T3, respectively), and vice versa. The posited conceptual model accounted for a significant portion of variance in ego‐resiliency and has implications for understanding the development of ego‐resiliency.     

DS14 is more likely to measure depression rather than a personality disposition in patients with acute coronary syndrome

It has been suggested that Type D Personality is a risk factor for acute coronary syndrome (ACS) and the DS14 has been developed for its assessment. However, some of the items on the DS14 seem to evaluate depressive symptoms rather than personality features. Therefore, the present study aims to verify whether an overlap exists between the constructs of Type D Personality and depression. Three‐hundred‐and‐four consecutive patients who were both presenting their first ACS and had no history of major depression completed the Hospital Anxiety and Depression Scale (HADS) and the DS14 to assess Type D personality at baseline and have been re‐evaluated at 1, 2, 4, 6, 9 and 12‐month follow‐ups. Out of 304 subjects (80.6% males), 40 were diagnosed as depressed. An exploratory factor analysis of HADS and the DS14 in the second month revealed that four out of seven items on the depressive subscale of HADS (HADS‐D) and six out of seven items on the Negative Affectivity (NA) subscale of the DS14 segregated on the same factor. Results were verified by a Partial Confirmatory Factor Analysis performed at the twelfth month when most of the patients achieved complete remission from the depressive episode. Temporal stability was poor for NA and Type D Personality and these construct co‐vary with HADS‐D over time. Our data suggests that NA and depression are overlapping constructs, supporting the idea that the DS14 measures depressed features, rather than a personality disposition.