Traumatization Through Human Agency: “Embodied Witnessing” is Essential in the Treatment of Survivors*

The American Journal of Psychoanalysis - The importance of human relations in understanding and treating trauma is evident not only from the severity of traumatization inflicted by human agency and...     

Development of the Meaning in Life Measure

To correct problems identified in existing measures of meaning in life (MIL) (lack of inclusion of items related to felt sense, mattering, and reflectivity), a new 8-item Meaning in Life Measure (MILM) was developed. Two subscales emerged: Experience (MILM-E, with items related to felt sense, mattering, goals, coherence) and Reflectivity (MILM-R, with items related to valuing thinking about meaning). High internal consistency and test–retest reliability were found for both subscales. Concurrent validity was demonstrated by a strong positive correlation between MILM-E and the Meaning in Life Questionnaire-Presence (MLQ-P), and a moderate correlation between MILM-R and the Meaning in Life Questionnaire-Search (MLQ-S). For both subscales, small to moderate positive correlations were found with subjective well-being, extraversion, conscientiousness, openness, agreeableness, self-deception, and impression management; moderate negative correlations were found with depression and emotional instability. Participants who were older, female, of higher income, and married with children scored slightly higher than their counterparts on MILM-E; women scored slightly higher than men on MILM-R. We concluded that the MILM has good psychometric properties and that MIL seems to be composed of two factors.     

Ferenczi’s Revolutionary Therapeutic Approach*

Many of the revolutionary principles introduced by Ferenczi in his clinical practice have now been widely accepted especially in the field of trauma and trauma therapy. Examples of these innovative views include his emphasis on empathy as opposed to technical neutrality and his stress on the real conditions of child caring and family environmental deficits and on the consequences of interpersonal violence and abuse that lead to “identification with the aggressor” by the victim thereby resulting in the internalization of both aggressiveness and guilt (the split guilt of the abuser). The resulting “fragmentation” of the personality, which is now considered dissociation (instead of Freud’s “repression”), is at the root of several severe disorders, characterized by distortion of reality, loss of touch with one’s body and loss of trust in the other. Therefore “abreaction is not enough”. A new, positive relational experience must be re-inscribed at the level of implicit memory.     

Spirituality and Religion: Neglected Factors in Preventing Veteran Suicide?

The Clay Hunt Suicide Prevention for American Veterans Act, enacted in 2015, aimed to increase access to treatment for U.S. military veterans; however, poor attendance at aftercare and high rates of treatment refusal suggest that, even when treatment is accessible, it may not be acceptable. Often, it is difficult to acknowledge the need for help and to commit to treatment. The stigma of mental illness diminishes the self-respect of individuals with mental health problems and may be especially acute for veterans because of the centrality of resilience in military culture. This stigma also can jeopardize current employment or prospects for future employment. This paper proposes a partial answer to the question, “What more might be done to engage and effectively treat veterans who are at high risk of suicide?” The meaning of spiritual and/or religious expression in human development, well-being, and social functioning has long been of great interest to theorists in disciplines as diverse as sociology, theology, and psychology. Some empirical studies have further suggested that certain religious and/or spiritual beliefs, practices, and/or affiliations may be protective against suicide. This paper (a) summarizes these perspectives, (b) considers how clinical inquiry into the role of religion and/or spirituality in the lives of veterans at high risk of suicide fits into the suicide prevention program of the U.S. Department of Veterans Affairs, and (c) offers specific recommendations to practitioners.     

Zika virus and pregnant women: A psychological approach

Zika virus presents risk of physical harm to pregnant women, but the fear of infection is also affecting women around the world. There is a gap in the research on Zika virus in the areas involving the impact on the psychosocial well-being of pregnant women. Therefore, this study is aimed at the investigation of the psychosocial adjustment of pregnant women to the risks of Zika virus infection during pregnancy. We investigated 14 pregnant women who were classified in three different groups: six in the first trimester, five in the second trimester and three in the third trimester, aged from 28 to 40 years (33.43 ± 3.76 years). Content analysis was used to interpret data. Our results show that the psychosocial adjustment of participants was significantly negative and included five aspects: (1) negative feelings, (2) changes in family planning, (3) adopting new customs (avoiding places of risk, use of specific clothes and use of repellent), (4) changed attitudes regarding body image and (5) feeling of external demand regarding prevention. The fear of Zika virus infection and all its associated risks have a negative biopsychosocial impact on the pregnant women in this study.     

The structure of feared social situations among individuals with a lifetime diagnosis of social anxiety disorder in two independent nationally representative mental health surveys

The present study employed both exploratory and confirmatory factor analytic approaches with nationally representative samples of individuals with a lifetime diagnosis of social anxiety disorder (n=1123; n=3091, respectively) using split-halves of the National Comorbidity Replication Survey (n=9282) and cross-validated with the Canadian Community Health Survey on Mental Health and Wellbeing (n=36,984). Strong support was found for a three-factor solution. This model was obtained from exploratory factor analysis and was further evaluated using two confirmatory factor analytic investigations in the two national samples. The three social situational domains reflected (1) Social Interaction Fears, (2) Observation Fears, and (3) Public Speaking Fears. Individuals with generalized social anxiety disorder (i.e., those who endorsed 7 or more of 13 feared social situations assessed in the survey) were significantly more likely to report Social Interaction Fears and Observation Fears compared to individuals with non-generalized social anxiety disorder (i.e., those who endorsed only 6 or fewer of 13 feared social situations). Individuals with generalized social anxiety were particularly characterized by combinations of Public Speaking Fears plus Social Interaction Fears and Observation Fears. The clinical and classification implications of our study for DSM-V are discussed.     

Factors affecting agreement between severely mentally ill alcohol abusers' and collaterals' reports of alcohol and other substance abuse.

This study examined subject-collateral reports of alcohol use among a sample of 167 dually diagnosed individuals seeking outpatient treatment at a community mental health clinic. All subjects met Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for a schizophrenia-spectrum or bipolar disorder and for alcohol abuse or dependence. Subjects were recruited within 2 weeks of treatment entry and completed measures of cognitive functioning, alcohol dependence severity, psychiatric symptoms, and quantity and frequency of substance use over the previous 60 days using the Timeline Follow-Back interview (L. C. Sobell & M. B. Sobell, 1996). They also provided a urine sample, which was screened for recent drug use. Collateral interviews were conducted by phone and included an assessment of the subject's alcohol and drug use over the same 60-day period. Collaterals also reported their confidence in the accuracy of their reports. Overall, the results indicated generally poor subject-collateral agreement. However, subject-collateral agreement appeared better for those individuals (n = 97) with negative urine drug screens. The most consistent predictor of subject-collateral discrepancy scores was subjects' recent drug use. Recommendations for enhancing the validity of self-reports of substance use in a severely mentally ill population are discussed.     

The Chinese Personality Assessment Inventory as a Culturally Relevant Personality Measure in Applied Settings

This paper introduces the development of the Cross‐Cultural (Chinese) Personality Assessment Inventory (CPAI) as a culturally relevant measure for personality assessment in collectivistic cultures. In addition to universal personality traits, the CPAI included indigenously derived scales that assessed the relational aspects of personality. We reported three studies that illustrated the usefulness of these indigenous scales in Chinese organizational settings. The Interpersonal Relatedness factor scales on the CPAI contributed additional value beyond scales from the universal factors of Social Potency and Dependability in profiling MBA students at senior‐level positions, in assessing hotel workers’ customer orientation, and in predicting senior executives’ leadership behaviors.     

Comparing Performance Standards on the Retention of Words Read Correctly Per Minute

To measure retention of oral reading fluency, three students attending a learning support classroom used a repeating reading strategy with two passages. Each student read one passage to a high performance standard and the other passage to a lower performance standard. Results show it took the students more practice to reach the higher performance standard in regards to both calendar days and practice trials. The retention measures revealed all students had comparable decrements with words read correctly per minute for both the high and low performance standards even though practice varied. During the last retention interval 3½ months after obtaining the performance standard, all students demonstrated the highest terminal frequency of words read correctly per minute in the high performance standard condition.     

How Risk is Perceived, Constructed and Interpreted by Clients in Clinical Genetics, and the Effects on Decision Making: Systematic Review

As an individual’s understanding of their genetic risk may influence risk management decisions, it is important to understand the ways in which risk is constructed and interpreted. We systematically reviewed the literature, undertaking a narrative synthesis of 59 studies presenting data on the ways in which individuals perceive, construct and interpret their risk, and the subsequent effects. While most studies assessed perceived risk quantitatively, the combined evidence suggests individuals find risk difficult to accurately quantify, with a tendency to overestimate. Rather than being a stand-alone concept, risk is something lived and experienced and the process of constructing risk is complex and influenced by many factors. While evidence of the effects of perceived risk is limited and inconsistent, there is some evidence to suggest high risk estimations may adversely affect health and lead to inappropriate uptake of medical surveillance and preventative measures by some individuals. A more focused approach to research is needed with greater exploration of the ways in which risk is constructed, along with the development of stronger theoretical models, to facilitate effective and patient-centered counseling strategies.