War and disaster in Sri Lanka: Implications for widows' family adjustment and perception of self‐efficacy in caring for one's family

The data for this study were collected in 2014 from widows in Eastern Sri Lanka whose spouses died in the civil war, tsunami, or from health‐related problems. Conservation of resources (COR) theory was used as a lens to examine the extent to which war and tsunami‐related damages and family problems predict variation in social support, family adjustment and a perception of self‐efficacy in caring for one's family as reported by widowed women. We also investigated whether social support from the community and social support from family and friends mediated those relationships. Results of a path model fit to the data suggested variation in family adjustment to be negatively predicted by war‐related family problems and positively predicted by the social support of friends and family. Additionally, a sense of self‐efficacy in caring for one's family was found to be inversely predicted by war‐related family problems and tsunami damages. Clinical, social and theoretical implications are discussed as well as directions for further research.     

‘Just black sometimes’, part 2: reflections on an adolescent's journey

In this second article about work at a refugee centre for unaccompanied minors in Berlin, the author discusses his encounter with Syrian and Afghani adolescents who were enrolled in the program. Issues around adaptation to a new culture are explored with attention to the dynamics of conformity and marginalization. The questions of what happens to adolescent refugees separated from their families, and how their identity formation is shaped by this burden is explored in relation to the author's meeting with a Syrian adolescent living in Berlin. To illustrate the long reach of a missing father who has been left behind, characters from Virgil's Aeneid are discussed to amplify heroic and spiritual aspects within father‐son relationships. The interplay between needing help and allowing for resilience is explored as an important aspect of refugees’ transitions, while also considering variables such as dependence and independence, foreign and familiar, being with or without family, and adjusting to the present and/whilst relating to the past; tensions between these alternatives can create various psychosocial challenges for adolescent refugees.     

Binding legacies: ancestor,archetype and Other

This article discusses the multicultural interconnection between Jungian analysts’ training and Africanist training candidates. The importance of ancestral lineage and archetypal influences in the clinical setting are explored for better understanding of issues related to the transference and therapeutic interventions. A discussion of racial relations and racism is addressed as a frequently missing element in the psychoanalytical training of future Jungian analysts.     

The role of early care and education in addressing early childhood trauma

Young children's experience of trauma is associated with a wide range of adverse events and circumstances, including abuse and neglect, domestic violence, loss of a parent, and community violence. Policymakers and practitioners are increasingly aware that trauma during the first few years of life is especially widespread, and there is growing interest in new ways to support these young children and their families. Many young children who experience trauma attend early care and education (ECE) programs, and these settings offer important opportunities to promote their well‐being. This paper examines strategies currently being implemented in ECE to address early childhood trauma. The paper first examines research on how trauma affects young children's development, ECE environments, and society. We then describe the unique needs of young, traumatized children and features of trauma‐informed care that can address their needs, along with emerging interventions and supports that can be incorporated into or linked with ECE settings as part of a trauma‐informed approach. We conclude with a discussion of future directions for ECE and trauma research, policy, and practice, bearing in mind both the promise of new approaches and a limited evidence base to date.     

When Treatment is Traumatic: An Empirical Review of Interventions for Pediatric Medical Traumatic Stress

Pediatric medical traumatic stress (PMTS) is common among injured/ill children and is associated with elevated distress, treatment non‐adherence, and poor health outcomes. As survivorship of life‐threatening pediatric injury and illness continues to increase alongside rapid medical advancements, rates of PMTS and negative sequelae are expected to grow; however, research on prevention and treatment of PMTS is limited. The current study sought to systematically review the literature using a developmental framework to highlight research gaps. Sixteen peer‐reviewed studies were identified via a systematic literature search. Consistent with best practices for treatment of childhood trauma, caregiver involvement and CBT principles served as the foundation for most interventions. All studies reported improvements in PMTS; however, among the most methodologically rigorous, few found statistically superior reductions in PMTS between intervention and control groups. While many studies focused on a specific developmental stage and discussed developmental considerations, others took a “one‐size‐fits” approach. Interventions that demonstrated the most promising findings were online, self‐guided, or time‐limited. Future research would benefit from expanding diversity of participants, continuing to evaluate novel delivery methods, and integrating developmental considerations along with trauma‐informed care (TIC) approaches, given their useful framework for understanding child traumatic stress responses and avenues for prevention and treatment.     

Youth Needs at Intake into Trauma‐Informed Group Homes and Response to Services: An Examination of Trauma Exposure,Symptoms, and Clinical Impression

Trauma‐informed care is recommended to improve the quality of group home services for youth. Youth exposure to trauma and associated symptoms are important factors involved in making the clinical impression that determines treatment services. This study considered three dimensions of trauma (exposure, symptoms, and clinical impression) to determine associations with behavioral incidents of youth in trauma‐informed group homes and how trauma was related to changes in psychopathology from intake to discharge. Archival records of youth (N = 1,096), age 9–18 (M = 15.7 years) who received services from January 2013 to December 2017, and departed the program were used. Statistical procedures included hierarchical linear modeling and analysis of covariance. Results indicated trauma symptoms predicted emotional problems and self‐injurious behavior. Youth in high‐ and low‐trauma groups both showed decreases in behavioral incidents and psychopathology, but clinical impression of trauma moderated the change in emotional problems from intake to discharge. Youth deemed by clinicians to have lower trauma (based on history of maltreatment and expression of trauma symptoms) had greater decrease in emotional problems from admission to discharge. Limitations and implications for further research on implementation and effectiveness of trauma‐informed models are discussed.     

Post-Traumatic Reactions in Adolescents: How Well Do the DSM-IV PTSD Criteria Fit the Real Life Experience of Trauma Exposed Youth?

This study examined the structure and symptom specific patterns of post traumatic distress in a sample of 1,581 adolescents who reported exposure to at least one traumatic event. Symptom reporting patterns are consistent with past literature in that females reported more symptoms than males and older youth reported more symptoms than did their younger peers. Young people reporting exposure to exclusively violent type traumas were also found to be more likely to endorse symptoms than peers exposed exclusively to non violent type traumas. Confirmatory factor analysis provided stronger support for a four-factor model of PTSD than either the DSM-IV model or an alternate model. Further examination of the four factor model revealed gender differences in factor loadings with small to moderate effect sizes for recurrent, distressing memories, flashbacks, restricted affect, difficulty remember details, detachment, limited future orientation, hypervigilance and startle symptoms. Differences in factor loadings with the four factor model were also noted between younger and older adolescents, with medium to large effect sizes on the arousal items. In contract, comparison of the factor loadings revealed only small differences between youth exposed exclusively to violent traumatic stressors and those exposed exclusively to non violent traumatic stressors, suggesting relative similarity between these two groups.     

Improving psychological adjustment following a first episode of psychosis: A randomised controlled trial of cognitive therapy to reduce post psychotic trauma symptoms

There are few evaluated psychological interventions or theoretical approaches which are specifically aimed at reducing problems related to adjustment and adaptation following a first episode of psychosis. The present study tests the efficacy of a form of CBT (Cognitive Recovery Intervention; CRI) in reducing trauma, depression and low self esteem following a first episode of psychosis, in a single-blind randomised controlled trial. A total of 66 patients who had recently experienced a first episode of psychosis were randomly assigned to CRI or treatment as usual (TAU) and followed up at 6 and 12 months. People receiving CRI tended to have lower levels of post-intervention trauma symptoms and demonstrated greater improvement than those receiving TAU alone. This was especially the case at 6 months for those with high pre-treatment levels of trauma. There was, however, no advantage for the CRI group with regards to reduced depression or improved self esteem. In conclusion, CRI appears to be an effective intervention to help young people adapt to the traumatic aspects of a first episode of psychosis although further evaluation in a larger study is warranted.     

Youth and Trauma: Terror,War, Murder,Incest, Rape,and Suicide

College students in the United States post-9/11 face a different world than did their predecessors. In short vignettes this article reveals some of the numerous traumas that have been reported in a full-service counseling center at a small state university. Exploration of the impact of traumas past and present is interwoven with commentary on the impact of systems dynamics. A brief theoretical exploration is included of post-trauma resilience and the ongoing sense of threat that many traumatized persons experience.     

Tonic immobility and childhood sexual abuse: a preliminary report evaluating the sequela of rape-induced paralysis

The present study examined tonic immobility (TI) in victims of childhood sexual abuse (CSA). Female undergraduates (n=39) and female psychiatric inpatients (n=41) who experienced CSA completed a series of questionnaires assessing aspects of their victimization history, psychological functioning, and TI symptoms. Over fifty-two percent of all participants reported TI in response to CSA. Episodes of CSA involving attempted or completed penile/vaginal penetration were more likely to be associated with an increased likelihood of experiencing TI, and report of TI was associated with greater current psychological impairment. The implications of these findings are discussed, and suggestions for future research are offered.