Traumatic Loss: Conceptual and Empirical Links Between Trauma and Bereavement

Abstract

This article focuses on conceptual issues and empirical studies regarding the topic of traumatic loss (i.e., loss that occurs suddenly and under violent circumstances) as a method for linking the field of trauma, and that of grief and bereavement. Several definitions of trauma are presented that include the concept of loss, and additional concepts are suggested that may be helpful in thinking about the two areas together. Also, modes of death associated with poor recovery are noted, and it is argued that these modes are those that make a bereavement more “traumatic”. Some empirical studies on the psychological outcomes associated with traumatic loss are reviewed, and preliminary findings from a new study of traumatically bereaved women are briefly presented     

Detection of auditory signals presented at random times

One hundred msec tones of 1000 Hz at four intensities were presented according to two Poisson schedules in a background of wide band noise and as increments to a 1000 Hz tone. Each 15 minute test session was run under fixed conditions and one of three instructions to detect the signals; the two Ss were free to respond at any time. The data analyzed were several inter-response and signal-response distributions, and they were compared with a theory due to Luce. Discrepancies between the theory and data indicate needed modifications of both the theory and the procedure.     

An experimental comparison of Pycnogenol and methylphenidate in adults with Attention-Deficit/Hyperactivity Disorder (ADHD)

Twenty-four adults (24 to 53 years old) with Attention-Deficit/Hyperactivity Disorder (ADHD), Combined Type, were studied in a double-blind, placebo-controlled, crossover study of Pycnogenol and methylphenidate. Pycnogenol is an antioxidant derived from the bark of the French maritime pine tree. Methylphenidate is a standard pharmaceutical intervention for ADHD. Anecdotal reports suggest that Pycnogenol improves concentration in adults with ADHD without adverse side effects. Participants received Pycnogenol, methylphenidate, and placebo, each for three weeks, in a randomized and counterbalanced order. Although ADHD symptoms improved during treatment, neither methylphenidate nor Pycnogenol outperformed the placebo control, as measured by self-report rating scales, rating scales completed by the individual's significant other, and a computerized continuous performance test. The conservative dosage levels and relatively brief length of treatment may have contributed to the absence of significant differences among treatment conditions. Implications for future research are noted.     

Who is exaggerating cognitive impairment and who is not?

This chart review examined the effects of effort on neuropsychological assessment and test performance patterns among genuine and exaggerating patients, with and without neurological findings, as aids to diagnosing symptom exaggeration. The sample consisted of 561 consecutive patients involved in compensation claims. With a flexible neuropsychological test (NPT) battery, the claims were assessed over 2 days. The sample included 303 patients evaluated for traumatic brain injury, 55 patients with neurological disease, and 203 patients assessed for other conditions (eg, depression or chronic pain). An average of 38 ability measures per patient were used to generate an overall NPT domain score. Composite scores were also computed for symptom validity tests, self-report measures of psychiatric symptoms, and memory complaint inventory. Seven NPT cognitive subdomain scores were multiply regressed onto the symptom validity test composite, accounting for 45% of its total variance. Patients were also assigned to Genuine or Exaggerator groups based on symptom validity test performance. The NPT for Exaggerating patients averaged 1.43 standard deviations below that of Genuine patients, suggesting that NPT scores for most Exaggerating patients are underestimates of their true ability. Factor analysis results differed between these groups. As a result, clinicians might avoid falsely identifying genuine patients as exaggerating by incorporating their self-reports of psychiatric symptoms and memory complaints into the diagnostic process.     

On the self-protective nature of inconsistency-negativity management: using the person memory paradigm to examine self-referent memory

How do individuals remember feedback that is inconsistent or negative? According to the inconsistency-negativity resolution model, individuals are motivated to reduce uncertainty and resolve inconsistency even when threat to self is potential. They more deeply process and better remember negative self- than other-referent information. According to the inconsistency-negativity neglect model, individuals are motivated to protect the self against threat. They engage in more shallow processing and remember less negative self- than other-referent information. Participants read and recalled either self- or other-referent mixed-valence information. The neglect model was supported in personality and minimal feedback settings. A chronometric exploration of processing mechanisms and the ruling out of a retrieval interference account clarified aspects of the model. Individuals are hypersensitive to threat potential: They will protect the self against even hypothetical threat.     

Prefrontal brain activity predicts temporally extended decision-making behavior

Although functional neuroimaging studies of human decision-making processes are increasingly common, most of the research in this area has relied on passive tasks that generate little individual variability. Relatively little attention has been paid to the ability of brain activity to predict overt behavior. Using functional magnetic resonance imaging (fMRI), we investigated the neural mechanisms underlying behavior during a dynamic decision task that required subjects to select smaller, short-term monetary payoffs in order to receive larger, long-term gains. The number of trials over which the longterm gains accrued was manipulated experimentally (2 versus 12). Event-related neural activity in right lateral prefrontal cortex, a region associated with high-level cognitive processing, selectively predicted choice behavior in both conditions, whereas insular cortex responded to fluctuations in amount of reward but did not predict choice behavior. These results demonstrate the utility of a functional neuroimaging approach in behavioral psychology, showing that (a) highly circumscribed brain regions are capable of predicting complex choice behavior, and (b) fMRI has the ability to dissociate the contributions of different neural mechanisms to particular behavioral tasks.     

An evaluation of the Psychache Scale on an offender population

This study examined the generalizability of a self-report measure of psychache to an offender population. The factor structure, construct validity, and criterion validity of the Psychache Scale was assessed on 136 male prison inmates. The results showed the Psychache Scale has a single underlying factor structure and to be strongly associated with measures of depression and hopelessness and moderately associated with psychiatric symptoms and the criterion variable of a history of prior suicide attempts. The variables of depression, hopelessness, and psychiatric symptoms all contributed unique variance to psychache. Discussion centers on psychache's theoretical application to the prediction of suicide.