Factors associated with traumatic symptoms and internalizing problems among adolescents who experienced a traumatic event

Abstract

The aim of the present study was to identify factors that are related to the traumatic symptoms and problem behavior among adolescents who experienced the New Years fire in 2001 in Volendam, The Netherlands. Three groups of factors were considered: pre-trauma (personality and coping), trauma-related (physical and emotional proximity to disaster), and post-trauma factors (received social support). Forty-five adolescents completed the questionnaire. Two years after the disaster, these adolescents experienced significant traumatic stress reaction (70% within the clinical range) and showed clinically significant levels of internalizing problems (37%). Pre-trauma, individual factors were identified as the most important predictors of distress, followed by received social support. The indicators of physical and emotional proximity to disaster explained little variance in distress.     

Lived Experiences of Subclinical Eating Disorder: Female Students' Perceptions

The aim of this study was to obtain an “insiders' perspective” on the lived experience of Subclinical Eating Disorder (SED) in female university students. Participants were 30 white, undergraduate females from the Potchefstroom campus of the North-West University in South African, (age range 18 years 6 months to 22 years). Data were collected using focus group interviews, drawings, letter-writing and self-reflective researcher field notes (Brocki & Wearden, 2006; Morse, 2003). For the analysis, the constant comparative text analysis method (Willig, 2001) was used. Emergent themes from the analysis included four main categories namely: Intra-, Interpersonal, Existential and Body-image. Subcategories of these themes spanned the following: Personal Brokenness, Personal Shame, Perceived Personal Inadequacy and Enslavement, Existential Vacuum, Perceived Social Pressure, Perceived Social Isolation and Body-image Dysfunction. Results were indicative of underestimation of SED-severity, its detrimental impact on participants' psychological well-being and high risk for escalation into full-blown eating disorders. An integrated, risk-protective model of secondary prevention, contextualised within psycho-social developmental perspectives is essential to understand SED in young adults.     

Mechanisms of Risk and Resilience in Military Families: Theoretical and Empirical Basis of a Family-Focused Resilience Enhancement Program

Recent studies have confirmed that repeated wartime deployment of a parent exacts a toll on military children and families and that the quality and functionality of familial relations is linked to force preservation and readiness. As a result, family-centered care has increasingly become a priority across the military health system. FOCUS (Families OverComing Under Stress), a family-centered, resilience-enhancing program developed by a team at UCLA and Harvard Schools of Medicine, is a primary initiative in this movement. In a large-scale implementation project initiated by the Bureau of Navy Medicine, FOCUS has been delivered to thousands of Navy, Marine, Navy Special Warfare, Army, and Air Force families since 2008. This article describes the theoretical and empirical foundation and rationale for FOCUS, which is rooted in a broad conception of family resilience. We review the literature on family resilience, noting that an important next step in building a clinically useful theory of family resilience is to move beyond developing broad “shopping lists” of risk indicators by proposing specific mechanisms of risk and resilience. Based on the literature, we propose five primary risk mechanisms for military families and common negative “chain reaction” pathways through which they undermine the resilience of families contending with wartime deployments and parental injury. In addition, we propose specific mechanisms that mobilize and enhance resilience in military families and that comprise central features of the FOCUS Program. We describe these resilience-enhancing mechanisms in detail, followed by a discussion of the ways in which evaluation data from the program’s first 2 years of operation supports the proposed model and the specified mechanisms of action.     

Use of Gilliam Asperger's disorder scale in differentiating high and low functioning autism and ADHD

Little is known about the validity of Gilliam Asperger's Disorder Scale (GADS), although it is widely used. This study of 199 children with high functioning autism or Asperger's disorder, 195 with low functioning autism, and 83 with attention deficit hyperactivity disorder (ADHD) showed high classification accuracy (autism vs. ADHD) for clinicians' GADS Quotients (92%), and somewhat lower accuracy (77%) for parents' Quotients. Both children with high and low functioning autism had clinicians' Quotients (M=99 and 101, respectively) similar to the Asperger's Disorder mean of 100 for the GADS normative sample. Children with high functioning autism scored significantly higher on the cognitive patterns subscale than children with low functioning autism, and the latter had higher scores on the remaining subscales: social interaction, restricted patterns of behavior, and pragmatic skills. Using the clinicians' Quotient and Cognitive Patterns score, 70% of children were correctly identified as having high or low functioning autism or ADHD.     

Pr?diktoren tumorassoziierter Fatigue

Fatigue is a serious cancer-related syndrome reported by cancer patients during and after treatment. Especially the impact of chronic fatigue on quality of life is substantial. The aim of this study was to identify predictors of fatigue after finishing treatment from an early stage of the cancer treatment. A sample of 551 cancer patients with heterogeneous diagnoses completed questionnaires assessing fatigue, psychological and psychosomatic data plus treatment data. The patients were recruited from an acute care hospital (t1) and the participants completed the questionnaire 2?C2.5 years after treatment (t2). Regression analysis showed that the strongest predictor of later fatigue was fatigue during the therapy. Other impact factors are radiotherapy and pain. The results suggest that the diagnosis and treatment of acute fatigue should be carried out at an early stage of cancer treatment to prevent chronic fatigue. Suitable diagnostic methods and treatment options will be presented.     

Contrasting effects of feature-based statistics on the categorisation and basic-level identification of visual objects

Conceptual representations are at the heart of our mental lives, involved in every aspect of cognitive functioning. Despite their centrality, a long-standing debate persists as to how the meanings of concepts are represented and processed. Many accounts agree that the meanings of concrete concepts are represented by their individual features, but disagree about the importance of different feature-based variables: some views stress the importance of the information carried by distinctive features in conceptual processing, others the features which are shared over many concepts, and still others the extent to which features co-occur. We suggest that previously disparate theoretical positions and experimental findings can be unified by an account which claims that task demands determine how concepts are processed in addition to the effects of feature distinctiveness and co-occurrence. We tested these predictions in a basic-level naming task which relies on distinctive feature information (Experiment 1) and a domain decision task which relies on shared feature information (Experiment 2). Both used large-scale regression designs with the same visual objects, and mixed-effects models incorporating participant, session, stimulus-related and feature statistic variables to model the performance. We found that concepts with relatively more distinctive and more highly correlated distinctive relative to shared features facilitated basic-level naming latencies, while concepts with relatively more shared and more highly correlated shared relative to distinctive features speeded domain decisions. These findings demonstrate that the feature statistics of distinctiveness (shared vs. distinctive) and correlational strength, as well as the task demands, determine how concept meaning is processed in the conceptual system.     

A pilot randomised controlled trial of an Internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue

The majority of people affected by Multiple Sclerosis (paMS) experience severe and disabling fatigue. A recent randomised controlled trial (RCT) showed that cognitive behaviour therapy with a clinical psychologist was an effective treatment for MS fatigue. An Internet-based version of this intervention, MS Invigor8, was developed for the current study using agile design and input from paMS. MS Invigor8 includes eight tailored, interactive sessions. The aim was to test the feasibility and potential efficacy and cost-effectiveness of the programme in a pilot RCT. 40 patients were randomised to MS Invigor8 (n=23) or standard care (n=17). The MS Invigor8 group accessed sessions over 8-10 weeks and received up to three 30-60min telephone support sessions. Participants completed online standardised questionnaires assessing fatigue, mood, quality of life and service use at baseline and 10 weeks follow-up. Large between group treatment effects were found for the primary outcomes of fatigue severity (d=1.19) and impact (d=1.02). The MS Invigor8 group also reported significantly greater improvements in anxiety, depression and quality-adjusted life years. These data suggest that Internet-based CBT may be a clinically and cost-effective treatment for MS fatigue. A larger RCT with longer term follow-up is warranted.     

Behaviorally inhibited temperament is associated with severity of post-traumatic stress disorder symptoms and faster eyeblink conditioning in veterans

Prior studies have sometimes demonstrated facilitated acquisition of classically conditioned responses and/or resistance to extinction in post-traumatic stress disorder (PTSD). However, it is unclear whether these behaviors are acquired as a result of PTSD or exposure to trauma, or reflect preexisting risk factors that confer vulnerability for PTSD. Here, we examined classical eyeblink conditioning and extinction in veterans self-assessed for current PTSD symptoms, exposure to combat, and the personality trait of behavioral inhibition (BI), a risk factor for PTSD. A total of 128 veterans were recruited (mean age 51.2 years; 13.3% female); 126 completed self-assessment, with 25.4% reporting a history of exposure to combat and 30.9% reporting current, severe PTSD symptoms (PTSS). The severity of PTSS was correlated with current BI (R(2) = 0.497) and PTSS status could be predicted based on current BI and combat history (80.2% correct classification). A subset of the veterans (n = 87) also completed the eyeblink conditioning study. Among veterans without PTSS, childhood BI was associated with faster acquisition; veterans with PTSS showed delayed extinction, under some conditions. These data demonstrate a relationship between current BI and PTSS, and indicate that the facilitated conditioning sometimes observed in patients with PTSD may partially reflect personality traits such as childhood BI that pre-date and contribute to vulnerability for PTSD.     

Interactive Influences of Gender Identity and Gender Typing on Early Adolescents’ Well-Being

We examined whether protective forms of gender identity (typicality, contentedness) ameliorate the negative influences of self-perceived cross gender typing (gender differentiated friendship styles) on early adolescents’ well-being. Early adolescents (N?=?244, 123 girls, M age 12.77 years) in Surrey, England responded to self-reports of friendship styles (preoccupied, avoidant), gender identity (typicality, contentedness), and well-being (self-esteem, depression). Girls reported higher scores than boys on the preoccupied friendship style, and lower scores than boys on the avoidant friendship style. Children who reported a cross gender style (preoccupied for boys and avoidant for girls) also reported poor well-being, indicating that self-perceived cross gender typing is distressing. However, these influences were buffered for youths who reported high levels of gender typicality and gender contentedness. Results suggest that gender identity plays a self-regulatory role in discounting self-perceived gender-atypical attributes that interfere with early adolescents’ sense of well-being.