The role of anxiety sensitivity in the relationship between posttraumatic stress symptoms and negative outcomes in trauma-exposed adults

Background: The development of posttraumatic stress symptoms (PTSs) following a trauma is related to impairment, diminished quality of life, and physical health issues. Yet it is not clear why some trauma-exposed individuals experience negative outcomes while others do not. The purpose of this study was to determine the role of several influential factors related to PTS severity and negative outcomes. Methods: One hundred and twenty-two trauma-exposed adults were administered the following self-report measures: the Posttraumatic Stress Disorder Checklist-Civilian, the Trauma History Questionnaire-Short, the Anxiety Sensitivity Index-3, Depression and Anxiety Stress Scale 21, Sheehan Disability Scale, World Health Organization Quality of Life-BREF, and an abbreviated Patient Health Questionnaire. Primary Results: PTS severity was positively correlated with depressive symptom severity (r = 0.54, p < 0.001), chronicity of the most distressing trauma (r = 0.21, p = 0.017), and number of traumas (r = 0.22, p = 0.012). Main effects were found for PTS severity (β = ?0.38, p < 0.01) and anxiety sensitivity (AS; β = ?0.39, p < 0.01) on quality of life. No interaction was found between PTS severity and AS with any negative outcome. PTS severity mediated the relationship between AS and physical health issues (0.05; 95% CI: 0.02–0.08). Conclusion: This study helps clarify the role of various factors in the relationship between trauma and negative outcomes. Clinical and research implications are discussed.     

The stigma of widowhood in war and disaster affected communities of Sri Lanka: Contextual paths between trauma exposure and mental health distress

To add to the dialogue regarding the long-term recovery and wellbeing of war and tsunami-affected women in Sri Lanka, we utilised the Conservation of Resources Theory (COR, Hobfoll, 2009) to inform an investigation of direct and indirect effects. The study was specifically designed to assess how traumatic exposure may represent a form of loss which may associate with related losses in the form of external and internal stigma which may then associate with poor mental health outcomes. The data for this study were collected in 2016 from a sample of 379 widowed women in Eastern Sri Lanka; participant spouses died in the civil war, in the tsunami, or from health or other problems. Our analyses yielded a model suggesting associations between remembered trauma event exposure from war and disaster, external stigma, internalised stigma and mental health symptom distress. Results further yielded direct and indirect effects suggesting that trauma may represent a form of loss, and potentially lead to distress through the weight and challenges of stigma.     

The role of childhood and adulthood trauma and appraisal of self-discrepancy in overgeneral memory retrieval

The aim of this study was to examine the contributory role of childhood and adulthood trauma events and the appraisal of self-discrepancy (the magnitude and distress) in overgeneral memory retrieval (OGM) using a non-clinical sample. Participants with a history of childhood trauma (n=29); adulthood trauma only (n=17) or no-trauma (n=26) participated in this study. The childhood trauma group showed a significantly higher level of general negative memory retrieval than the no-trauma group. Conversely, the adulthood trauma group showed a significantly higher level of general threat memory retrieval than the no-trauma group. The perceived similarity and distress relating to the perceived similarity between participants' “actual self” and “feared self” significantly predicted the level of OGM, even after controlling for the impact of a history of adult or child trauma.     

Simulation-based research to improve infant health outcomes: Using the infant simulator to prevent infant shaking

Simulation is a technique that creates a situation or environment to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions. We will first provide an introduction to simulation in healthcare and describe the two types of simulation-based research (SBR) in the pediatric population. We will then provide an overview of the use of SBR to improve health outcomes for infants in health care settings and to improve parent-child interactions using the infant simulator. Finally, we will discuss previous and future research using simulation to reduce morbidity and mortality from abusive head trauma, the most common cause of traumatic death in infancy.     

The Psychology of Health and Illness: The Mental Health and Physiological Effects of Intimate Partner Violence on Women

Violence against women is a global public health problem with about one in three women experiencing either physical and or sexual intimate partner violence during their lifetime. Globally as many as 38% of homicides committed against women are by a male intimate partner. Violence against women may have negative effects on their mental, physical, and reproductive health (WHO fact sheet, 2016). Untreated individuals who have experienced violence or life-threatening situations may develop posttraumatic stress disorder (PTSD). This disorder has the potential to be life-changing and cause negative psychological and medical issues (Rokach, Ahmed, & Patel, 2017). This potentially life-changing nature and consequence of violence affecting women world-wide deserves greater attention to ensure elimination of risk factors, financial support of investigational studies to promote detection of victims, and research to increase therapeutic efficacy of remediation. These efforts should be bolstered by all physicians, mental health experts, social service specialists, and public health advocates.     

Working with Italian patients in Munich – The case of Penelope1

Abstract

With their book Psychoanalytic perspectives on migration and exile (1989), L. Grinberg and R. Grinberg (1984) opened up a new clinical field, which had been neglected for a long time in the psychoanalytic community, although Freud’s multilinguistic competence had greatly contributed to the creation of psychoanalysis. With their book The Babel of the unconscious, Jacqueline Amati Mehler, Simona Argentieri, and Jorge Canestri were able to confirm the hypothesis that it is possible to help multilingual patients to integrate the different aspects of their self which are bound to their mother tongue and to their foreign tongue(s), and thus to allow them to develop a new identity. The author, who has been a psychoanalyst in Munich since 1999, works every day with his Italian patients in this new clinical field, that is in their common mother tongue and at the two levels of their old Italian and their new German identity. Through the detailed presentation of a clinical case, he furthermore shows how, on the one hand, the migration creates a new space in which therapy actually becomes possible, and on the other hand, not only therapy, but also the kind of relationship developed by the patients to their “new country” plays a decisive role in the whole process. Such a frame proved to be particularly good for the emergence, revisitation, and reelaboration of the transgenerational trauma around which the case of Penelope is centered. The author further assumes that the theme of “migration and identity” is becoming more and more important in our globalized world, with clinical consequences whose elaboration requires a specific cultural and technical preparation.     

Foster Parents’ Knowledge of Child Trauma: An Exploratory Study

To promote trauma-informed professional supports and services to maltreated youth, it is imperative that researchers explore foster parents’ knowledge of child trauma. However, there is a dearth in the literature related to this topic. This exploratory study utilizes a convenience sample (N = 219) of foster parents in one southeastern state. Variables of interest include actual and perceived knowledge about child trauma. After a terse review of background literature, this paper will explicate key results, discuss these findings, and identify salient practice and policy implications derived from this study. The paper will conclude by delineating apposite areas for future research.