One ‘knows’: self-rated health and telomere length among ex-prisoners of war

Abstract

Objective: Ill-health and early mortality are amongst the most significant ramifications of trauma. Furthermore, trauma alters the subjective perception and experience of the body. The aim of this study is to examine the extent to which deteriorations in perceived health among traumatised individuals are associated with cellular health as manifested in telomere length.

Methods: Specifically, 88 former prisoners of war (ex-POWs) evaluated their health (self-rated health; SRH) at 18 (T1), 35 (T2) and 42 (T3) years after the war, and were assessed for telomere length at T3. Health behaviour, BMI, morbidity and PTSD were also examined at T3.

Results: The findings demonstrated that SRH was cross-sectionally correlated with telomere length. Furthermore, a significant sequential indirect effect was found, in which worse SRH in T1 was associated with shorter telomere length at T3, through worse SRH at T2 and at T3.

Conclusions: These findings demonstrate that long-term deteriorations in the subjective evaluations of health are implicated in actual cellular health among individuals exposed to trauma.     

Adolescent Boys' Talk about Absent Fathers

The objective of this study was to explore how adolescent boys talk about absent fathers in Alexandra Township, a historically working-class and black community in Gauteng, South Africa. Individual and group interviews were conducted with 30 adolescent boys between the age of 14 and 18 years in two high schools in Alexandra Township. The results reveal that many of the adolescent boys in the study did not know their fathers or their fathers had separated with their mothers. Despite this, some of the boys were able to construct positive male identities that were not risk-taking. This process involved certain psychical and defensive manoeuvres such as fantasy and an idealized self representation of wanting to become ‘different’ fathers as compared to their own biological fathers. Young adolescent boys' positive voices about future fathering and fatherhood could be supported.     

Generational forgiveness and historical injustices: perspectives of descendants of victims of Apartheid-era gross human rights violations in South Africa

This study explored the issue of generational forgiveness in the political sphere in contemporary South Africa. It is based on qualitative interviews conducted with 20 children and grandchildren (females?=?10, males?=?10) of victims of Apartheidera gross human rights violations. The interview data were interpretively analysed to uncover underlying meaning. The results yielded three main themes namely: the myth of forgiveness in politics; political forgiveness as an inherently difficult human enterprise; and the intrinsic value of political forgiveness. Findings suggest that political forgiveness is likely if solutions are found to persistent poverty and inequality, which are structural legacies of the past.     

Addressing Urgent Community Mental Health Needs in Rwanda: Culturally Sensitive Training Interventions

Rwandan leaders in the health and educational sectors have begun to discuss the necessity for establishing culturally appropriate community-based mental health counselling services in Rwanda, especially trauma counselling. The need for a community psychology approach is anchored in the lingering effects of the genocide and the continuing post-traumatic stress symptoms suffered by many in the population. Capacity building in an effort like this would require the design of multi-level counselling curricula that are sensitive to the social structures within Rwandan culture. These curricular endeavours call for the development of a National Counselling Centre to serve as a structural mechanism for organizing community-based counselling initiatives. We consider the community health services needs in Rwanda here, along with associated challenges and strategies for effective mental health services in a country with a recent history of genocide. A community psychology approach to mental health would benefit Rwandan society by making trauma counselling and recovery services available and accessible to citizens throughout the country.     

Therapeutic outcomes in the Welsh Government's school‐based counselling strategy: An evaluation

Aims: The purpose of this study was to evaluate the outcomes of school‐based counselling, as delivered in the Welsh Government's School‐based Counselling Strategy, for reducing psychological distress in young people aged 11–18. Method: The study used a quantitative cohort design, comparing levels of distress on either the Young Person's CORE (YP‐CORE) or the Strengths and Difficulties Questionnaire (SDQ) from baseline to endpoint. Data were available on 3613 episodes of counselling, across 42 datasets. Meta‐analytical procedures were used to identify the mean effect size and predictors of outcomes. Results: Within each dataset, counselling was associated with significant reductions in psychological distress, with a mean effect size (d) of 0.93(95% CI = 0.89–0.97) using a fixed effects model and 1.09 (95% CI = 0.97–1.22) using a random effects model. Datasets using the YP‐CORE had larger effect sizes than those using the SDQ, and datasets with more complete response rates had lower outcomes than those with poorer response rates. Conclusion: The results confirm that school‐based counselling, as delivered in the UK, is associated with significant reductions in psychological distress, comparable to adult counselling and psychotherapy services.     

Languages of trauma; towards a phenomenological response

In this article, I explore the possibilities of a phenomenological perspective on trauma in psychoanalytic practice. I highlight the problem of interpretations that universalise experiences of trauma, provide explanations in terms of ‘causes’ and assume particular processes/stages of ‘recovery’ from it. The notion of trauma challenges dichotomies of ‘internal’ and ‘external’ worlds. Traumatic experiences always have a context – that of the immediate relational circumstances of the individual suffering from the trauma, including the wider social/relational context, and the person’s history. I argue for an attunement to the language and specificity of the meanings, verbal and non-verbal, conscious and unconscious, of the client’s suffering within the analytical relationship. This requires the therapist to avoid ‘ready-made’ interpretations from psychoanalytic theory and to be open to the poiesis of the speech, which emerges between therapist and client. My discussion of my reading of the Chilean documentary film, Nostalgia for the Light, which focuses on the traumatic experiences of those who survived Pinochet’s military regime (1973–1989), highlights how diverse responses to trauma are. The originality of the language of the film calls on us as therapists to discover new ways of listening and speaking to our clients’ suffering.     

Working in the Midst of Unfolding Trauma and Traumatic Loss

Abstract

Training developed for New York City social workers in the evolving aftermath of September 11, 2001 is introduced, offering a conceptual framework for clinical practice in the midst of unfolding trauma and traumatic loss. A focus is placed on the shared, collective process of learning and discussion among colleagues, as an effort parallel to work with clients, progressing together to establish meaning and hope through relationships. Professional training framing this catastrophe within trauma and traumatic loss perspectives, and addressing its impact on clinician, client, work, and treatment relationship, is needed. Also providing on-going support, a process of continuity, and a context of community, this training becomes a collective response to the profound impact and complex, evolving needs of this time.     

Multiple Attachment Representations in Clinical Practice: Case Study of a Six-Year-Old Maltreated Child

Research on attachment predominantly traces the effect of a single or primary attachment and/or attachment style on working models and behavior. However, most children form multiple attachments. This article reviews research on multiple attachment representations in children and considers how such information can usefully be applied to clinical settings. Through the case study of a six-year-old adopted boy with a history of maltreatment, it explores how those internal working models can be assessed in treatment and the clinical value of recognizing different attachment representations and styles. Implications for treatment interventions are explored.     

A Review of Eating Disorders in Athletes

SUMMARY

The current review aims to evaluate the literature on eating disorders and athletes with the purpose of making recommendations for sport psychologists and other relevant personnel on how to proceed in identifying, managing, and preventing eating disorders in school settings. Whereas the intention of this review is to make recommendations for secondary educational settings, research on other populations such as collegiate and young adult athletes was also reviewed where helpful or where information on adolescent athletes was not available. Recommendations for prevention and intervention include ongoing education of athletes and coaches regarding nutrition, body composition, and performance, using appropriate screening to detect eating disorders, and use of a sport management team to aid in athlete recovery.