Current Treatment Strategies for Dissociative Identity Disorders in Adult Sexual Abuse Survivors

SUMMARY

During the past decade, increasing numbers of clinicians and researchers have suggested that the dissociative disorders, including dissociative identity disorder (DID), may be more prevalent than previously hypothesized. The “rediscovery” of DID is due, in part, to the recognition that early childhood trauma in conjunction with the propensity to dissociate, are etiologic factors for the development of DID. The purpose of this article is to raise clinical consciousness regarding DID, discuss the definition and etiology of the dissociative disorders, their assessment, and an approach to treatment of the sexual abuse survivor who has DID. This treatment program, while integrating some of the techniques recommended by others, is unique in its step-by-step flexible organization as well as its multifaceted format. The author's experience to date suggests that the sooner that a dissociative disorder can be identified in the adult sexual abuse survivor client, the more rapid the therapeutic progress.     

Workplace Violence and Worker Injury in Elderly Care Settings

Abstract

Many incidents of injury, assault, and abuse occur in health care settings. To better examine the situational context of the workplace, this paper examines whether workers providing care to elderly persons experience injuries that are consistent with the “for-profit” and “interpersonal conflict” explanations of elder abuse or neglect. Using data from the Bureau of Labor Statistics, results indicate that nursing home workers and home health care workers have higher rates of workplace injuries resulting from assaults and overexertion than do other workers. The data suggest that there are unique structural and situational factors present in the nursing home, which create a work setting vulnerable to conflict, violence, and elder abuse.     

Childhood Maltreatment and PTSD: Spiritual Well-Being and Intimate Partner Violence as Mediators

Childhood maltreatment places individuals, including African American women who are undereducated and economically disadvantaged, at risk for developing posttraumatic stress disorder (PTSD) symptoms. Participants were 192 African American women with a history in the prior year of both a suicide attempt and intimate partner violence (IPV) exposure. They were recruited from a public hospital that provides medical and mental health treatment to mostly low-income patients. A simple mediator model was used to examine if (a) existential well-being (sense of purpose) or religious well-being (relationship with God) mediated the link between childhood maltreatment and adult PTSD symptoms. Sequential multiple mediator models determined if physical and nonphysical IPV enhanced our understanding of the mediational association among the aforementioned variables. Findings suggest that existential well-being mediated the association between childhood maltreatment and adult PTSD symptoms in a simple mediator model, and existential well-being and recent nonphysical IPV served as sequential multiple mediators of this link. However, religious well-being and physical IPV were not significant mediators. Findings underscore the importance of enhancing existential well-being in the treatment of suicidal African American women with a history of childhood maltreatment and IPV.     

Establishing a Link Between Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder and Childhood Physical Abuse

Attention deficit disorder and attention deficit/hyperactivity disorders (ADD/ADHD) are found in approximately 5% to 10% of school-aged children. This study examined whether childhood physical abuse was associated with ADD/ADHD. Data were derived from a population-based sample of 13,054 adults from the 2005 Canadian Community Health Survey. We used logistical regression analysis in 2 models, both of which had ADD/ADHD as the criterion variable. There were 7 times higher odds of ADD/ADHD among those who reported they had been abused after controlling for several potential mediating factors, including age, race, gender, and 3 other types of adverse childhood experiences (parental divorce, parental addictions, and long-term parental unemployment) in comparison to those who were not abused. The results of this analysis show a strong link between childhood abuse and ADD/ADHD, an association that requires further study.     

Gender Differences in the Association of Intimate Partner Violence and Relationship Values among College Students

Although research has indicated that cognitions and situational factors play a role in relationship satisfaction and aggression, few studies have investigated the association between intimate partner violence (IPV) and relationship values. We addressed this gap by measuring college students’ perpetration of and victimization by four types of IPV; namely, physical violence, sexual violence, threats, and psychological aggression over the past year. One-way ANOVAs and multiple regression analyses were used to measure the association between IPV and the endorsement of relationship values. The results suggest that past IPV perpetration and victimization correlated with the current endorsement of relationship values for males more than females. In general, male perpetrators rated relationship values such as security, investment, others’ approval, and daily conflict as less important than non-perpetrators. Although male victimization explained significant variance in security, investment, and others’ approval, the results were somewhat mixed as to whether victimization related to higher or lower ratings of relationship values, with the majority of the results suggesting an inverse correlation between relationship value endorsement and IPV experience. Future research can investigate mediating factors in the relationship between IPV and relationship value endorsement, as well as look at how IPV and relationship values influence decisions concerning relationship maintenance.     

Sole Expression: A Trauma-Informed Dance Intervention

The primary treatment for individuals who have encountered violence and/or abuse is trauma-focused cognitive and behavioral modalities. However, these therapeutic approaches are not always effective for youth who have encountered this type of trauma. Trauma is often communicated through the body via physical ailments, particularly when words are insufficient to capture an individual’s experience or when adequate processing of the trauma is not possible due to profound stress. Dance offers an alternative form of therapy that can address “where” the trauma is held, relieve tension, and restore a sense of ownership with one’s body and mind. In this article, we discuss the development of Sole Expression, a trauma-informed hip-hop dance program for youth who have experienced abuse and/or exposure to violence. We provide an overview of establishing the team, securing funding, trauma training, program curriculum, and the related research. We conclude with recommendations for best practices that benefit both practitioners and the young people served.     

Foster Care Youth Share Stories of Trauma Before,During, and After Placement: Youth Voices for Building Trauma-Informed Systems of Care

Many research studies address child trauma experiences that take place before foster care placement. However, few studies focus on the types and patterns of trauma experiences that reportedly take place during and after foster care placement; that is, after entry into adult living. This study examined the testimony of 43 foster care youth who spoke to a listening panel comprised of state legislators, child welfare professionals, and university educators. Qualitative analyses of transcribed text data revealed 3 main themes. First, the youth reported experiencing trauma before, during, and after placement. Second, the youth described trauma events and situations that were chronic (i.e., intense, composite, or cumulative). Third, youth offered suggestions for reducing traumatic experiences for foster care youth. They recommended earlier family interventions, access to people who listen and care, improved parenting skills for foster parents, continuity of relationships, and opportunities for leadership for foster youth. Foster youth voices offer important suggestions for building, strengthening, and evaluating trauma-informed systems of care.     

Violence against Women in Contemporary Ghanaian Society

Abstract

Overcoming violence against women requires critical reflective questioning both by individuals and human societies. At stake are not just questions of whether we respond to situations of violence but more importantly, where, when and how we respond. This paper examines the problem with respect to new dimensions arising from existing interventions on violence against women in the Ghanaian context. It calls for well-planned and sustained strategies to help break the cycle of violence being created.

The paper also calls upon the Church to look within its own resources for strategies that are life transforming to help break the vicious cycle. It notes that the Church is not only well placed to respond appropriately but it has been commissioned and given the requisite tools to do so. The call is therefore for the Church to enlist these foundational resources available to it and to put them to good use as it is demanded by its calling.     

Crossnational deviance in the workplace: Diverging impact of organizational commitment in Canada and Belgium

Using a self-report questionnaire from the aggressor's point of view, this study contrasted employees' frustration, perception of procedural justice, organizational commitment, and their relationships to interpersonal deviance in Canada and Belgium. Significant main effects were found in both countries for frustration and procedural justice on psychological and physical violence. Moreover, hierarchical regression analyses revealed significant interactions of country by normative and continuance commitment in interpersonal deviance, indicating the unique patterns relationships in Canada and Belgium. Hofstede's model of cultural dimensions was used to discuss the results.