Trauma Recovery in the Transgender and Gender Diverse Community: Extensions of the Minority Stress Model for Treatment Planning

Transgender and gender diverse (TGD) populations, including those that do not identify with gender binary constructs (man or woman) are increasingly presenting for treatment of posttrauma sequelae. Providers who offer services for trauma survivors including posttraumatic stress disorder (PTSD) treatment should be knowledgeable about evidence-based care and have some cultural familiarity with TGD experiences. Indeed, the Minority Stress Model suggests that the combination of distal and proximal minority stressors can combine to produce increased mental health symptoms as compared with cisgender peers, though this model has yet to be fully tested. Clients often present with a complicated picture of experiences, which include a variety of minority stressors, microaggressions, discrimination, and traumatic events that can all be related to their identity. However, conceptualizations of trauma treatment in the context of extensive minority stress are lacking. This paper summarizes the existing literature and offers guidance to mental health providers who are well positioned to address stigma, discrimination, violence, and related symptoms that arise from micro-, mezzo- and macro-level spheres of TGD individuals’ experience.     

The importance of distinguishing between harassment-only and assault military sexual trauma during screening

Extant research demonstrates that a history of military sexual trauma (MST) is associated with PTSD and depression diagnoses as well as heightened risk for suicidal ideation and death by suicide. Past studies of MST and its sequelae typically collapse harassment-only and assault MST screening items into a single response, recorded as positive or negative for a history of MST. It is presently unclear whether assault is associated with poorer mental health outcomes relative to harassment-only MST. Female service members/Veterans (n = 656) completed an online survey assessing history (present, absent) and type (harassment-only, assault) of MST, PTSD, depression, sexual satisfaction and function symptoms, as well as suicidal ideation. Findings revealed that those who reported a history of MST, and assault more specifically, were more likely to report higher PTSD symptoms and probable PTSD diagnosis, higher depression symptoms and probable depression diagnosis, worse sexual function and probable sexual function diagnosis, lower sexual satisfaction, and presence of suicidal ideation. Those who reported harassment-only MST also reported higher PTSD severity and probable PTSD diagnosis, but the magnitude of the association of harassment-only MST and PTSD severity relative to assault MST and PTSD severity was substantially lower. Findings suggest it is critical to distinguish between history and type of MST during screening as a combined screening item loses sensitivity to identify those at heightened risk for distress and dysfunction.     

Implications of research for the treatment of depressive disorders during childhood

Basic research into the prevalence, natural course, and phenomena of comorbidity of depressive disorders during childhood are reviewed and implications of this research for treating depressed youths are noted. Results of investigations into the biological aspects of depression are integrated into a multifactorial model of depressive disorders during childhood and the efficacy of pharmacological interventions is discussed. Cognitive theory is integrated with attachment theory to explain a possible avenue to the development of depressive disorders during childhood. Interpersonal therapy has emerged as a potentially effective intervention for depressed youths. Basic tenets of this treatment model are compared and contrasted to a cognitive-behavioral treatment model, and a hybrid treatment referred to as “cognitive therapy within the interpersonal context” is proposed.     

Evidence for an age-independent process in category learning

After learning to categorize a set of alien-like stimuli in the context of a story, a group of 5-year-old children and adults judged pairs of stimuli from different categories to be less similar than did groups not learning the category distinction. In a same-different task, the learning group made more errors on pairs of non-identical stimuli from the same category than did the other groups, suggesting increased within-category item similarity, or compression. These expansion and compression effects add further support to the view that concept formation involves systematic changes in the metric of similarity space within which objects are represented. They also suggest that these processes do not vary with age, which is at least consistent with the hypothesis that they are fundamental to the mechanisms underlying concept formation.     

Training analysis in the dutch society for psychoanalytic psychotherapy: A survey of attitudes and feasibility

SUMMARY

As is the case in many training courses in psychoanalytic psychotherapy, one of the training requirements of the Dutch Society for Psychoanalytical Psychotherapy (NVPP) is a training analysis, currently a minimum duration of 700 hours. During the last few years, this requirement has become somewhat controversial. Because the NVPP does not have information about the current interest in NVPP membership, the Board of the NVPP decided to do a survey. Of 995 psychiatrists, clinical psychologists and psychotherapists, who had recently completed their training, or were still in training, 623 filled in a questionnaire. Of those who are interested in the NVPP training, 39 per cent judged the training analysis as not feasible in terms of time, and 61 per cent in terms of money. Forms of personal treatment thought desirable for anyone who wishes to become a psychoanalytic psychotherapist at a specialist level are, in descending order, psychoanalytic psychotherapy (63%), psychoanalysis (39%), psychoanalytic group psychotherapy (25%), and psychoanalytic marital or family therapy (6%). Respondents who judge personal analysis as not feasible, also tend to judge psychoanalysis to be equivalent to other forms of psychoanalytic psychotherapy, whereas those who judge personal analysis as feasible, tend to think that personal analysis is essential for a psychoanalytic psychotherapist at the specialist level.     

The Higher Structural Phases of Concept Formation of Children

By means of a 2 × 2 × 4 way analysis of variance, modified when needed, the self-disclosing ability (as measured by the Jourard Self-Disclosure Questionnaire) of freshman college students from divorce and nondivorce homes was analyzed. The results of the study provide evidence that, generally, a person from a female-based home of the divorce type does not disclose the self any more or any less than a person from a nondivorce home situation. Also, the father does not play a major role in determining or directing the self-disclosure process of his children.     

Thinking and Being: Heidegger and Wittgenstein on Machination and Lived-Experience

Heidegger's treatment of 'machination' in the Beiträge zur Philosophie begins the critique of technological thinking that would centrally characterize his later work. Unlike later discussions of technology, the critique of machination in Beiträge connects its arising to the predominance of 'lived-experience' ( Erlebnis ) as the concealed basis for the possibility of a pre-delineated, rule-based metaphysical understanding of the world. In this essay I explore this connection. The unity of machination and lived-experience becomes intelligible when both are traced to their common root in the primordial Greek attitude of techne , originally a basic attitude of wondering knowledge of nature. But with this common root revealed, the basic connection between machination and lived-experience also emerges as an important development of one of the deepest guiding thoughts of the Western philosophical tradition: the Parmenidean assertion of the sameness of being and thinking. In the Beiträge 's analysis of machination and lived-experience, Heidegger hopes to discover a way of thinking that avoids the Western tradition's constant basic assumption of self-identity, an assumption which culminates in the modern picture of the autonomous, self-identical subject aggressively set over against a pre-delineated world of objects in a relationship of mutual confrontation. In the final section, I investigate an important and illuminating parallel to Heidegger's result: the consideration of the relationship between experience and technological ways of thinking that forms the basis of the late Wittgenstein's famous rule-following considerations.     

On the Interaction of Prior Knowledge and Stimulus Structure in Category Learning

Contemporary theories of categorization propose that concepts are coherent in virtue of being embedded in a network of theories about the world. Those theories function to pick out some of the many possible features of a set of objects as most salient for purposes of classification, a process that is complex and still poorly understood (Murphy & Medin, 1985). Part of what makes this account incomplete is a lack of information as to (1) what makes a feature salient on a given occasion and (2) how feature salience interacts with category structure to determine the course of learning. We report on the results of three studies of category learning using complex schematic drawings to show that (1) the contrast set defined by one's initial encounters with category exemplars can be a source of individual differences in feature salience assignments; (2) such effects are short-lived in the face of clear evidence about actual feature diagnosticity; and (3) more robust prior hypotheses interact with category structure to either enhance learning or impede it. The enhancement occurs when the hypothesis emphasizes category-relevant features, even if the hypothesis is in fact incorrect. A hypothesis that assigns high salience to irrelevant features impedes learning. Learning does occur as feedback concerning category structure leads to enhanced salience for relevant features. Salience of irrelevant features remains high, however, suggesting that such learning as occurs involves augmentation and not total revision of the (incorrect) prior hypothesis.