A Trauma-Informed Call to Action: Culturally Informed,Multi-Disciplinary Theoretical,and Applied Approaches to Prevention and Healing,Part II

The prevalence of trauma and its negative impact on humankind have created a burgeoning awareness of the need for systems that are trauma-informed across the lifespan. A collaborative project with the National Partnership to End Interpersonal Violence (NPEIV) sought out research as a call-to-action to mitigate the impact of trauma. The following is Part II of an introduction to a special double-issue focused on theoretical and applied approaches to using trauma-informed care in multi-disciplinary, mental and physical health, criminal justice, school-based, and community settings. Consideration is given to essential issues such as resilience, self-care, and intersectional cultural awareness. Introspective exploration of biases was encouraged to address barriers to implementing trauma-informed care.     

Family structure and community connectedness: Their association with teenage pregnancy in South Africa

This study aimed to examine the relationships between family structure and community connectedness on the one hand, as well as risk for teenage pregnancy on the other. Data were from the South African General Household Surveys 2011, 2012, 2013; N = 279 042, female teenagers = 9.9%, age range 10 to 19; black teenagers = 81%. We applied multilevel binary logistic regression to predict risk for teenage pregnancy by family structure and community affinity variables. Findings suggest teenage female teenagers from single-headed households and with higher numbers of male relatives are at elevated risk for teenage pregnancy. Similarly, female teenagers from families with parental divorce were at higher risk for pregnancy as were those from communities with lower coherence.     

Causal explanations for lack of pregnancy applying the common sense model of illness representation to the fertility context

Abstract

Objectives: The current study explored causal explanations for lack of pregnancy and association with help-seeking behaviour. Differences based on gender and country Human Development Index were examined.

Design: A mixed method design was used.

Main outcome measures: Data were drawn from the International Fertility Decision-Making Study, a cross-sectional study of 10,045 individuals (1690 men; 8355 women) from 79 countries. Respondents rated to what extent they believed their lack of pregnancy was due to something they or their partner had done/not done or other factors and described their reasons for making this rating.

Results: Respondents were aged 18–50 (M?=?31.83) years, partnered and had been trying to achieve a pregnancy/father a child for over six months (M?=?2.8 years). Men and women primarily believed their lack of pregnancy was due to medical problems or chance/bad luck. Thematic analysis of textual responses from 29.7% of the sample found that respondents focused on their personal experience or a salient life event when describing the cause of their lack of pregnancy. Women expressed more regret and helplessness about causes than men. Significant country differences were observed.

Conclusions: Individuals may develop inaccurate causal explanations based on their personal experiences. Access to accurate information is necessary to facilitate timely help-seeking.     

Effectiveness of online word of mouth on exposure to an Internet-delivered intervention

The use of online word of mouth (WOM) seems a promising strategy to motivate young people to visit Internet-delivered interventions. An Internet-delivered intervention aimed at changing implicit attitudes related to alcohol was used in two experiments to test effectiveness of e-mail invitations on a first visit to the intervention. The results of the first experiment (N = 196) showed that an invitation by e-mail from a friend was more effective to attract young adults (aged 18–24 years) to the intervention website than an invitation from an institution. A 2 × 2 design was used in the second experiment (N = 236) to test manipulations of argument strength and the use of peripheral cues in invitations. Results showed that weak arguments were more effective to attract young adults to the intervention website when an incentive was withheld. These results need to be taken into account when using online WOM as a strategy to improve exposure to Internet-delivered interventions.     

Breast cancer: The intention to have a mammography and a clinical breast examination - application of the theory of planned behavior

Abstract

The purpose of these cross sectional studies was to identify the psychosocial factors explaining women's intention to have a mammography within the next two years and their intention to have a clinical breast examination (CBE) by a professional within the next year. Two random samples of women aged 40–69 years (n_a = 354, n_b = 344) completed a self-administered questionnaire that investigated theoretical constructs of the theory of planned behavior. The results of structural equation modeling showed that subjective norms and perceived behavioral control explained 81 % of the variance in intention of having a mammography. Sixty-five percent (65%) of the variance in intention of having a CBE was explained by attitude and perceived behavioral control. In conclusion, women need to be better informed, have better skills to overcome psychological and physical barriers in performing preventive breast behaviors, and promotion of preventive breast cancer methods should consider people significant for women.     

Unrealistic optimism and genetic risk

The study examined whether life stress moderated the effects of a physical activity intervention. Women (n = 184) and 154 men (61% non-Hispanic white, average age 24 years) from an urban university participated. Data were analyzed separately for men and women using a 2 × 2 ANCOVA adjusting for baseline physical activity (intervention vs. control × high life stress vs. low stress) with total physical activity at one-year and two-year assessments as dependent variables. No significant main effect for stress or condition was found. The interaction was significant (p = 0.015) for men at one-year, indicating that men in the intervention group with high stress were more active than low stress intervention men. Instruction received in the intervention group on the stress-relieving properties of physical activity may have helped men with high stress to adopt or maintain physical activity.     

Delays in seeking cancer diagnosis in relation to beliefs about the curability of cancer in patients with different disease locations

This study is aimed at investigating factors leading to delayed oncologic examinations versus immediate consultation with a physician in patients with various cancers. We analysed the results of a study of patients (n?=?291) reporting for their first oncologic examinations. We conducted structured interviews containing social, demographic and clinical data, the Spielberger State-Trait Anxiety Inventory, the Beck Depression Inventory and Harris and Guten's health appraisal scores. Based on an analysis of decision-making trees, the results indicate that it is possible to predict beliefs regarding the curability of cancer and immediate versus delayed reporting to a physician. Delayed reports may be predicted on the basis of two factors: (1) a belief that cancer is incurable combined with increased state anxiety, ‘good’ or ‘very good’ self-appraisal of health and low depression; and (2) a belief that cancer is incurable accompanied by increased anxiety and depression. The characteristics of patients delaying a visit to the oncologist suggest the existence of three independent factors leading to both considerable (longer than nine months) and minor (up to one month) delays in seeking treatment.     

Randomised controlled pilot trial of mindfulness training for stress reduction during pregnancy

This randomised controlled pilot trial tested a six-week mindfulness-based intervention in a sample of pregnant women experiencing high levels of perceived stress and pregnancy anxiety. Forty-seven women enrolled between 10 and 25 weeks gestation were randomly assigned to either a series of weekly Mindful Awareness Practices classes (n = 24) with home practice or to a reading control condition (n = 23). Hierarchical linear models of between-group differences in change over time demonstrated that participants in the mindfulness intervention experienced larger decreases from pre-to post-intervention in pregnancy-specific anxiety and pregnancy-related anxiety (PRA) than participants in the reading control condition. However, these effects were not sustained through follow-up at six weeks post-intervention. Participants in both groups experienced increased mindfulness, as well as decreased perceived stress and state anxiety over the course of the intervention and follow-up periods. This study is one of the first randomised controlled pilot trials of a mindfulness meditation intervention during pregnancy and provides some evidence that mindfulness training during pregnancy may effectively reduce PRA and worry. We discuss some of the dilemmas in pursuing this translational strategy and offer suggestions for researchers interested in conducting mind-body interventions during pregnancy.     

The Challenge of Information Technology for Literary Studies

ABSTRACT

This paper identifies the challenge and shows how research done on the Kierkegaard corpus is meeting the challenge. It presents eighteen studies, tracing the development of computer based Kierkegaard research, and suggesting that the computer might be used to produce more than word counts and locations of words or strings of texts. The study introduces the idea of a multi-dimensional concordance as evidenced by recent research on Fear and Trembling.     

Community Screening for Preschool Child Inhibition to Offer the ‘Cool Little Kids’ Anxiety Prevention Programme

Temperamental inhibition has been identified as a key risk factor for childhood anxiety and internalizing problems. An efficacious early prevention programme for shy/inhibited children has been developed; however, accurate, efficient and acceptable screening is needed to support wider implementation. We explore community screening options in the context of a trial implementing the Cool Little Kids prevention programme for anxiety disorders. In comparison to the Australian Temperament Project's inhibition scale, we examine the Strengths and Difficulties Questionnaire's (SDQ) ability to screen for inhibited preschool children. Parents of 6307 children aged 3 to 6 years enrolled in preschool programmes from eight socio‐economically diverse districts in Melbourne, Australia, first completed the measures of inhibition and SDQ. Parents with inhibited children then enrolled in the Cool Little Kids randomized trial (n = 545). Of these, 88% provided feedback about inhibition screening. Parents allocated to the intervention also provided feedback on the Cool Little Kids parenting programme. Results demonstrated that parents of preschool children (i) find inhibition screening acceptable, (ii) take up this parenting programme and (iii) report favourable feedback. The SDQ emotional symptoms subscale demonstrated acceptable sensitivity but insufficient specificity to identify inhibited preschool children. Presenting parents with a brief, validated inhibition scale could be a low‐cost option for identifying inhibited preschool children in the community to offer early anxiety prevention. Copyright © 2014 John Wiley & Sons, Ltd.