'You get used to it': Working with trauma in a burns unit of a South African children's hospital

I report here on the first stages of my work as a consultant clinical psychologist in a burns unit of a South African children's hospital. I show how the enormous trauma of the work leads inevitably to the adoption of defences on the part of staff against the pain and load of their work. I use the writing of Menzies Lyth and other authors as a basis for understanding staff defences in their daily work. I then describe the process whereby it has become possible to institute a form of group support for the staff. It has been important to think not only of the maladaptive but also of the helpful function of defences, and to recognize the staff's need for continuity and acceptance on the part of the consultant.     

Negative life events, cognitive emotion regulation and emotional problems

A new questionnaire, named the Cognitive Emotion Regulation Questionnaire, has been constructed, measuring nine cognitive coping strategies people tend to use after having experienced negative life events. A test–retest design was used to study the psychometric properties and relationships with measures of depression and anxiety among 547 high school youngsters. Principal component analyses supported the allocation of items to subscales, while alphas of most subscales exceeded 0.80. Cognitive coping strategies were found to play an important role in the relationship between the experience of negative life events and the reporting of symptoms of depression and anxiety. The results suggest that cognitive coping strategies may be a valuable context of prevention and intervention     

A Preventive Coping Perspective of Individual Response to Terrorism in Canada

A plethora of studies on terrorism underscores the challenges of managing the psychological and behavioural impacts of terrorist events. This literature also emphasizes the idea that the global pending threat of terrorism, prior to the occurrence of any event, may also give rise to significant reactions among members of the public. Drawing from the literature on proactive coping, the current study presents the results of factor analyses performed on sections of a national survey that assessed appraisals of as well as actual responses to the threat of terrorism in Canada (N = 1,502). Findings revealed that items assessing individual response to terrorism were represented by three factors in this context: Individual Preparedness, Information Seeking, and Avoidance Behaviour. Further analyses demonstrated a tendency for actual preparedness behaviours to be associated with decreased psychological stress, and actual avoidance behaviours to be associated with heightened psychological stress. Furthermore, the divergent patterns of relationships of terrorism response appraisals and corresponding actual responses with psychological stress emphasized the need to distinguish different stages in the process of preventive coping with terrorism. Theoretical and practical implications of findings for individual preparedness in Canada are discussed.

Parental Attachment and Adjustment to College: The Mediating Role of Avoidant Coping

Many studies have documented an association between parental attachment and college student adjustment. Few studies have explored the mechanisms underlying this association. The authors asked college students nearing the end of their first academic year to complete instruments measuring parental attachment, coping, and adjustment to college. Structural equation modeling was used to model mediation separately for attachment to mother and father. Avoidant coping mechanisms (operationalized as denial, mental disengagement, behavioral disengagement, and substance use) significantly mediated the parental attachment and adjustment to college relationship. Self-sufficient coping mechanisms (operationalized as planning, positive reinterpretation, acceptance, active coping, and suppression) did not mediate the parental attachment and adjustment to college relationship.     

无聊倾向对青少年网络成瘾的影响：一个有调节的中介模型

为探究无聊倾向对青少年网络成瘾的预测作用和影响机制,选取云南省和山东省5所普通中学的1553名青少年进行调查。结果发现：（1）青少年无聊倾向显著正向预测网络成瘾;（2）学习倦怠在青少年无聊倾向与网络成瘾之间起中介作用;（3）积极应对方式在无聊倾向与学习倦怠之间起调节作用。本研究结果揭示了青少年网络成瘾形成的内部机制,并基于I-PACE模型构建了青少年网络成瘾的形成过程模型,为青少年网络成瘾的干预提供决策依据。     

Anger-associated panic attacks in Cambodian refugees with PTSD; a multiple baseline examination of clinical data

Despite the increasing recognition of the importance of anger as a key aspect of post-traumatic stress disorder (PTSD), the presence of anger-induced panic attacks has been understudied in traumatized groups. The present investigation determines the prevalence of anger-associated panic attacks among Cambodian refugees suffering from PTSD. Specific characteristics of these episodes that were examined included frequency, symptoms, and cognitions (in particular, fear of death from bodily dysfunction). In a survey of 100 Khmer patients suffering PTSD, 58% reported anger-associated panic attacks in the last month. These attacks occurred at a mean rate of 6.2 attacks a month and were characterized by extreme arousal and in 81% of these cases, fears of death due to bodily dysfunction during the anger-induced panic. Mechanisms for this high rate of fear of death during anger arousal are discussed with a focus on culture-specific catastrophic cognitions.     

我国民众对SARS信息的风险认知及心理行为

采用分层抽样的调查方法,对全国17个城市的4231名市民进行了SARS疫情中风险认知特征和心理行为的研究。结果发现：（1）负性信息,包括患病信息和与自身关系密切的信息,更易引起民众的高风险认知; 正性信息,包括治愈信息和政府防范措施的信息,能降低个体风险认知水平。（2）我国民众5月中旬风险认知因素空间位置分析结果表明, SARS病因处于不熟悉和难以控制一端,“愈后对身体的影响和有无传染性”处于不熟悉一端,这是引起民众风险意识的主要因素。（3）结构方程分析结果表明,SARS疫情信息是通过风险认知对个体的应对行为、心理健康产生影响的, 并初步验证了风险评估、心理紧张度、应对行为和心理健康等指标对于危机事件中民众心理行为的预测作用     

Battered women's coping strategies and psychological distress: differences by immigration status

People are rarely passive, and battered women are no exception. This study investigated the types of coping strategies women of Japanese descent (both Japan-born and U.S.-born) chose and their perceived effectiveness in dealing with their partners' violence. Japan-born respondents were significantly less likely to use active strategies and perceived them to be less effective than did U.S.-born respondents. For the Japan-born, the more effective they perceived active strategies, the higher their psychological distress, whereas the more effective they perceived passive strategies, the lower their psychological distress. In contrast, for the U.S.-born, the higher the perceived effectiveness of active strategies, the lower their psychological distress, and the perceived effectiveness of passive strategies had little effect on their psychological distress. The complex relationship between individuals' country of birth, the choice and perceived effectiveness of coping strategies, and psychological distress calls for increased attention to the role of culture in studies of coping and domestic violence.     

At-Risk for Diabetes: Coping with the News

This study assessed 37 children's and 38 adults', as well as their family members' (39 mothers and 26 spouses), coping responses to the news that they (or a loved one) were islet-cell antibody positive (ICA+) and at risk for type 1 diabetes. The Ways of Coping Checklist (WCC) was administered 4 months after ICA+ notification and at follow-up 10 months later. Participants' state anxiety was measured a few days after ICA+ notification and again 4 months later, at the time of the initial WCC administration. Children's coping strategies differed from those of adults, and mothers' coping strategies differed from spouses'. Initial state anxiety in response to ICA+ notification was related to how participants subsequently coped with the news. Coping, in turn, was related to maintenance of state anxiety over time.     

An abbreviated PTSD checklist for use as a screening instrument in primary care

Although the importance of recognizing posttraumatic stress disorder (PTSD) in primary care has been well-established, routine screening for PTSD remains unfeasible for many primary care clinics because of the length of the available screening instruments. Thus, the purpose of this work was to develop and validate a brief screening tool for PTSD. In Study 1, four short forms of the PTSD Checklist-civilian version were identified that captured a majority of the variance in the measure. In Study 2, the performance of these short forms was evaluated in a separate sample of primary care patients. We found that both two-item and six-item versions have adequate psychometric properties for screening purposes and suggest that the selection of one version over the other depends on the specific needs of each primary care clinic.