Cumulative estrogen exposure and prospective memory in older women

This study looked at cumulative lifetime estrogen exposure, as estimated with a mathematical index (Index of Cumulative Estrogen Exposure (ICEE)) that included variables (length of time on estrogen therapy, age at menarche and menopause, postmenopausal body mass index, time since menopause, nulliparity and duration of breastfeeding) known to influence estrogen levels across the life span, and performance on prospective and retrospective memory measures in a group of 50 postmenopausal women (mean age=69.3years) who, if they were current or former users of estrogen therapy, had started therapy within 5years of menopause. The ICEE was found to be a significant predictor of performance on the Prospective Memory task (F(1)=4.21, p=.046, η(p)(2)=.084). No significant relationship was noted between the ICEE and performance on measures of retrospective memory. The results suggest that the level of cumulative lifetime exposure to estrogen a woman has influences her prospective memory performance later in life and that the influence of reproductive and biological markers of endogenous estrogen exposure are relevant factors to consider when studying the effect of estrogen therapy on cognitive functioning in postmenopausal women. In addition, the finding that performance on a measure of prospective memory, but not performance on measures of retrospective memory, was associated with the ICEE adds further support to the theory that the frontal cortex may be especially sensitive to estrogen.     

Cognitive Processing Therapy Versus Supportive Counseling for Acute Stress Disorder Following Assault: A Randomized Pilot Trial

The study tested the efficacy and tolerability of cognitive processing therapy (CPT) for survivors of assault with acute stress disorder. Participants (N = 30) were randomly allocated to CPT or supportive counseling. Therapy comprised six individual weekly sessions of 90-min duration. Independent diagnostic assessment for PTSD was conducted at posttreatment. Participants completed self-report measures of posttraumatic stress, depression, and negative trauma-related beliefs at pre-, posttreatment, and 6-month follow-up. Results indicated that both interventions were successful in reducing symptoms at posttreatment with no statistical difference between the two; within and between-group effect sizes and the proportion of participants not meeting PTSD criteria was greater in CPT. Treatment gains were maintained for both groups at 6-month follow-up.     

Research trauma in incarcerated spaces: Listening to incarcerated women's narratives

This paper discusses researcher emotional experiences evoked while conducting narrative interviews in a research project that explored the rehabilitation experiences of 18 incarcerated women. I highlight the significance of listening as a methodology in spaces of incarceration. The importance of retrospective reflexivity in locating experiences of trauma encountered during the research process is discussed. The paper also brings to the fore the transformative power of stories for listeners as I share how my prejudices and attitudes regarding incarcerated women, as people who are framed as dangerous, were challenged. Experiences with interviewing and connecting with the incarcerated women further emphasised the importance of proactive self-care for researchers, with the significance of reflexivity as a self-care tool when doing qualitative research with vulnerable populations.     

Dreaming the other's past: Why remembering may still be relevant to psychoanalytic therapy,at least in some traditions

Against the background of a reconstruction of the reasons for the vanishing role of remembering in the history of psychoanalysis, Botella's (2014, Int J Psychoanal, 95 ) arguments regarding the therapeutic significance of reconstruction and remembering and of the therapist's role are discussed. The difference between intellectual reconstruction and actual emotional remembering are underlined, the term regredience is compared to competing concepts such as equally suspended attention, countertransference and reverie. It is argued that to conceptualize the use of countertransferential associations for reconstructing past traumatic events is difficult with a monadic conception of the unconscious and problematic both in terms of truth claims and in terms of achieving a shared creative atmosphere in which therapist and patient participate alike. It is concluded that historical truth may be important for traumatic experiences, and that biographical reconstruction and change in the subjective life story help to make sense of neurotic patterns and integrate diachronic identity.     

Sexual Assault Training in the Military: Evaluating Efforts to End the “Invisible War”

Sexual assault is an insidious problem in the United States military. In 2005 the Department of Defense (DoD) created the Sexual Assault Prevention and Response Office, which centralizes responsibility for sexual assault training. However, this training initiative has undergone little evaluation by outside researchers. Addressing this need, we analyzed responses from over 24,000 active duty personnel who completed the 2010 DoD Workplace and Gender Relations Survey. We assessed whether sexual assault training exposure (None, Minimal, Partial, or Comprehensive) predicted accurate knowledge of sexual assault resources and protocols. Using a social-ecological framework, we investigated whether institutional and individual factors influenced Service members’ training exposure and judgment of training effectiveness. According to our results, exposure to comprehensive training predicted lower sexual assault incidence and superior knowledge. However, comprehensive training differed as a function of military branch, rank, gender, and sexual assault history. Judgments of training effectiveness also varied across these dimensions. Our results highlight the importance of considering context, gender, and victimization history when evaluating institutional efforts to end sexual violence. The DoD’s 2010 annual report on military sexual assault concluded that “most Active Duty members receive effective training on sexual assault” (p. 104). Our results cast doubt on that assertion.     

术后镇痛对创伤患者围术期细胞因子和胰岛素抵抗的影响研究

研究术后镇痛对创伤患者围术期细胞因子IL 6、TNFα和胰岛素抵抗(IR)的影响.选取60例患者,随机分为两组,A组患者应用一次性术后镇痛泵,加入舒芬太尼2.5μg/kg+盐酸托烷司琼4mg,用生理盐水稀释至100ml,2ml/h持续注入.B组患者为术后根据临床需要临时给予杜冷丁每次50mg～100mg肌肉注射,每日不超过3次.发现两组患者术后镇痛效果比较,A组患者舒适程度要优于B组,随访患者无与药物相关的不良反应.术后两组患者血浆IL-6、TNF-α水平均开始升高,术后12h左右达峰值,24h后开始回落,但均明显高于术前.血糖和血胰岛素值也在术后升高,术后24h左右达峰值,之后逐渐回落.ISI在术后开始降低,术后24h降到最低,之后逐渐回升,但均低于术前,说明IL-6、TNF-α水平升高与创伤后胰岛素抵抗有相关性.A组患者术后12h、24h、36h、48h的血糖、血胰岛素、IL-6、TNF-α水平与B组比较明显降低,而且术后48h基本可以恢复术前水平.应用舒芬太尼术后镇痛可以通过抑制血浆中IL-6和TNF-α水平,从而抑制围术期胰岛素抵抗,降低应激反应,从而达到减轻免疫抑制和降低或缩短IR时间的目的.     

Psychological Consequences of Pregnancy Loss and Infant Death in a Sample of Bereaved Parents

This study aimed to explore a broad range of psychological reactions to trauma in a sample of bereaved parents in order to assess whether the traumatic framework is adequate for describing the entire range of emotional reactions to infant death. A sample of bereaved parents (N = 455) who lost their child through perinatal or postnatal loss were compared to a control group of parents (N = 110) who gave birth to a healthy child. Multivariate regression analysis clearly demonstrated that bereaved parents scored significantly higher on the Depression, Anxiety, Dissociation, Sleep Disturbances, Somatization, Interpersonal Sensitivity, and Aggression subscales of the Trauma Symptom Checklist. Consistent with previous studies, the results showed that for up to 5 years postloss bereaved parents expressed elevated levels of trauma-specific and psychological outcomes, in particular interpersonal sensitivity and aggression.     

Thoughts on representation in therapy of Holocaust survivors1

This paper presents the problems of representation and lack of representation in treating Holocaust survivors, through clinical vignettes and various theoreticians. The years of Nazi persecution and murder brought about a destruction of symbolization and turning inner and external reality into the Thing itself, the concrete, or, in Lacan’s words, ‘The Thing’. The paper presents two ideas related to praxis as well as theory in treating Holocaust survivors: the first is related to the therapist’s treatment of the Holocaust nightmare expressing the traumatic events just as they happened 63 years previously; the second deals with the attempt at subjectification, in contrast to the objectification forced by the Nazis on their victims.     

Top Ten Questions Male Sexual Abuse Survivors Want to Know from Health Care Research

Sexual abuse is an often overlooked public health issue for boys and men. Given its prevalence and well-documented connection to mental and physical health disorders, the relevance of male survivor input and engagement in health care research is profound. Using a community-based participatory research design, an in-person focus group with male survivors of sexual abuse and researchers was conducted. This paper describes the top ten research questions male sexual abuse survivors would like to have answered. Survivors were most interested in knowing how sexual abuse and assault impact men’s emotional and sexual functioning, what factors are involved in preventing and treating sexual assault-related emotional distress, and what can be done to prevent sexual abuse of boys and men. The fact that some of the questions survivors expressed an interest in knowing about have actually previously been investigated by researchers suggests a disconnect in translating evidence-based findings. Clinical and research implications include designing outreach interventions and gender-specific psychoeducation to increase engagement and access to care for men.     

A National Survey of Trauma Training in Psychology Internships

Directors from psychology internship programs across the United States were asked to participate in a survey regarding their sites’ provision of services to traumatized populations and didactic and supervisory training offered to interns. All totaled, 259 training directors completed the survey. Using a point system, an impact score of training saturation was determined based on the content and frequency of training offered in didactic, supervision, or combined formats. Of these, all reported at least one trauma training opportunity in either didactic or supervision format. More than half indicated that they offered at least 1 to 3 hours of didactics on trauma per week (62.2%) and slightly less offered supervision-specific training opportunities (54.5%). However, only 30.8% identified training opportunities in trauma/posttraumatic stress disorder that reached a high level of saturation in training, meaning they offered training activities above the median impact score. The most commonly reported barrier to offering trauma training was related to being busy meeting other specialty or program requirements. Findings provide a preliminary overview of current training practices that can be useful to students seeking trauma internship placements and administrators and faculty who are looking to revise their curriculum.