Searching for and finding meaning in collective trauma: results from a national longitudinal study of the 9/11 terrorist attacks

The ability to make sense of events in one's life has held a central role in theories of adaptation to adversity. However, there are few rigorous studies on the role of meaning in adjustment, and those that have been conducted have focused predominantly on direct personal trauma. The authors examined the predictors and long-term consequences of Americans' searching for and finding meaning in a widespread cultural upheaval--the terrorist attacks of September 11, 2001--among a national probability sample of U.S. adults (N=931). Searching for meaning at 2 months post-9/11 was predicted by demographics and high acute stress response. In contrast, finding meaning was predicted primarily by demographics and specific early coping strategies. Whereas searching for meaning predicted greater posttraumatic stress (PTS) symptoms across the following 2 years, finding meaning predicted lower PTS symptoms, even after controlling for pre-9/11 mental health, exposure to 9/11, and acute stress response. Mediation analyses suggest that finding meaning supported adjustment by reducing fears of future terrorism. Results highlight the role of meaning in adjustment following collective traumas that shatter people's fundamental assumptions about security and invulnerability.     

Initial Reliability and Validity of the Life Satisfaction Scale for Problem Youth in a Sample of Drug Abusing and Conduct Disordered Youth

Responses to Life Satisfaction Scale for Problem Youth (LSSPY) items were examined in a sample of 193 substance abusing and conduct disordered adolescents. In responding to the LSSPY, youth endorse their percentage of happiness (0 to 100%) in twelve domains (i.e., friendships, family, school, employment/work, fun activities, appearance, sex life/dating, use of drugs, use of alcohol, money/material possessions, transportation, control of one's life). Results indicated that the LSSPY yielded three factor structures (i.e., Social Satisfaction, External Obligations Satisfaction, Substance Use Satisfaction), demonstrated good initial psychometric properties, and appears to be a useful instrument in the evaluation of treatment outcome in problem youth. Males were more satisfied in the Social and External Obligations domains than females, although no gender differences were indicated in Substance Use Satisfaction. Caucasian, African-American, and Hispanic youths responded to LSSPY items similarly. Future directions are discussed in light of these results.     

A Community Responds to Collective Trauma: An Ecological Analysis of the James Byrd Murder in Jasper, Texas

The brutal murder of James Byrd Jr. in June 1998 unleashed a storm of media, interest groups, high profile individuals and criticism on the Southeast Texas community of Jasper. The crime and subsequent response—from within the community as well as across the world—engulfed the entire town in a collective trauma. Using natural disaster literature/theory and employing an ecological approach, Jasper, Texas was investigated via an interrupted time series analysis to identify how the community changed as compared to a control community (Center, Texas) on crime, economic, health, educational, and social capital measures collected at multiple pre- and post-crime time points between 1995 and 2003. Differences-in-differences (DD) analysis revealed significant post-event changes in Jasper, as well as a surprising degree of resilience and lack of negative consequences. Interviews with residents conducted between March 2005 and 2007 identified how the community responded to the crisis and augmented quantitative findings with qualitative, field-informed interpretation. Interviews suggest the intervention of external organizations exacerbated the severity of the events. However, using strengths of specific local social institutions—including faith based, law enforcement, media, business sector and civic government organizations—the community effectively responded to the initial threat and to the potential negative ramifications of external entities.     

Predicting outcome of insanity acquittees released to the community

This research developed a model for forensic release decisions that incorporated actuarial and psychiatric predictors. The model was based on research that compared 127 insanity acquittees in the State of Maryland with a matched control group of 127 convicted felons and a comparison group of 135 mentally disordered prison transfers. The three cohorts were followed for an average of 10 years after release from hospital or prison. Findings on two outcome indicators are reported in this article: rearrests within 5 years after release and overall functioning in the community during 2½ years after release. Discriminant analysis was performed on the outcome variable of rearrest; it was found to accurately predict the outcome of 75% of the subjects with the following six variables: adjustment in hospital, clinical assessment of hospital staff, Global Assessment Scale score at release, functioning prior to instant offense, heroin addiction, and birth order. A second discriminant analysis identified seven variables that accurately predicted the overall functioning of 80.4% of the insanity acquittees.     

Suicide-related behavior after psychiatric hospital discharge: Implications for risk assessment and management

Suicide-related behavior (SRB), including suicide attempts and instrumental SRB, occurs far more often than completed suicide and exacts a toll on patients, their loved ones, and society. Nevertheless, few prospective studies of SRB have been conducted. In this study, 954 patients were interviewed in a psychiatric hospital and then followed for one year after discharge. During this one-year period, nearly one-quarter of patients (23%) engaged in SRB, with the rate of suicide attempts (18%) three times greater than the rate of instrumental SRB (5%). Risk factors for SRB were demographic (White ethnicity, female gender), clinical (past SRB, depression, impaired functioning), and contextual (unemployment, large social networks). In contrast with other studies, there was no "peak" in the risk of SRB shortly after hospital discharge. Instead, patients' rate of SRB was relatively constant over the one-year follow-up. Implications for risk assessment and management in acute inpatient settings are discussed.     

The effect of UCS intensity in classical and avoidance GSR conditioning

This study compared GSR avoidance and yoked-control conditioning procedures. Classical conditioning at two UCS intensities was followed by extinction and, two months later, by an avoidance session. Matching of Ss was based on GSR responsiveness and classical conditioning in the first session. The strong UCS led to more rapid reduction in CR latency (due to an increase in number of Ss responding) in the first session, and there was a tendency for maximum CR magnitude to occur in fewer trials with the strong UCS. No UCS-intensity difference in level of responding to the CS or UCS was found in the first session. A greater amount of spontaneous recovery in the second session was found in the strong UCS group. The avoidance and yoked control groups did not differ in CR magnitudes, latencies, or frequencies, nor in UCR magnitudes in the second session. They did differ significantly in the rate of decline in intertriai responses, the decline being more rapid in the avoidance condition.     

Women who lead

Summary This essay reviews aspects of historical and cultural changes that now permit women increasing opportunities to lead both women and men. Women assuming leadership responsibilities undergo psychic reorganization, reworking their personal histories and their modes of interaction. The author challenges women who inhibit their leadership potential to scrutinize their attitudes and to consider the implications for the next generation of women. Presented at the American Academy of Psychoanalysis Seminar Series: Clinical Advances in Dynamic Psychotherapy, October 30, 1994, New York University Medical Center Chestnut Lodge Hospital in Rockville, MD. She teaches at the Washington Psychoanalytic Institute, Walter Reed Army Hospital, the Uniformed Services University of the Health Sciences and the Washington School of Psychiatry. She coordinates a Washington School of Psychiatry study group with Maurine Kelly, Ph.D., and Tybe Diamond, LCSW, “Women’s Contributions to Psychoanalysis,” where many of the ideas in this paper were discussed.     

New reproductive technologies in the treatment of human infertility and genetic disease

In this paper I will discuss three areas in which advances in human reproductive technology could occur, their uses and abuses, and their effects on society. First is the potential to drastically increase the success rate and availability of in vitro fertilization and embryo freezing. Second is the ability to perform biopsies on embryos prior to the onset of pregnancy. Finally, I will consider the adding or altering of genes in embryos, commonly referred to as “genetic engineering”. As new reproductive technologies pass from experimental models into the potential for medical utilization, I believe that it will be important for lawmakers everywhere to avoid the impulse to outlaw procedures that a society believes to be ‘unnatural’ at a first glance. Rather, I would hope that they can respond thoughtfully with legislation that serves two purposes — to protect the rights of couples to overcome infertility or to reduce the risk of genetic disease in their children-to-be, and more importantly, to protect children-to-be from the abuses that could result from some of the practices that I will discuss.