Psychological impact of remote combat/graphic media exposure among US Air Force intelligence personnel

Since 2001 there has been a significant increase in the use of intelligence, surveillance, and reconnaissance (ISR) analysis for tactical, operational, and strategic decision makers engaged in global operations. To meet this demand, US Air Force intelligence personnel participate in remote combat and graphic media exploitation operations (e.g., review of still imagery, video, and audio), the long-term psychological effects of which are not well understood. Research to date has focused primarily on outcomes related to how intelligence personnel work, versus the specifics of what they do. Military psychologists embedded in ISR units conducted studies to address this gap. Intelligence analysts participated in focus groups and surveys assessing the frequency of exposure, previous exposures to other potentially traumatic events, symptoms of PTSD, moral injury, and other psychosocial experiences. Results showed that exposure levels, albeit virtual, rivaled or exceeded those reported by a sample of special operations forces. Results also showed that specific types of exposures (e.g., witnessing US military casualties, civilian casualties, atrocities committed by the enemy) are related to increased posttraumatic stress and other sequelae that may not adequately be captured by standard posttraumatic stress disorder screening measures. The results contribute to the existing literature on posttraumatic stress, shed new light on the emerging construct of moral injury, and highlight challenges presented by remote combat and graphic media exploitation operations to force health sustainment and performance optimization. The authors provide directions for future research and recommendations for ongoing assessment, monitoring, and selection and training of ISR personnel.     

Neuropsychological profiles of six children with anoxic brain injury

Anoxic brain injury (ABI) often results in severe memory impairment and other cognitive and behavioral deficits, although limited information is available regarding pediatric cases. This study reported the neuropsychological outcomes in six children and adolescents who sustained ABI. Profiles were compared by mechanism of injury (ischemic vs. hypoxemic) and three cases were evaluated more than once. Severe intellectual, attention, memory, and behavioral impairments were observed in all six cases although academic achievement, internalizing behavioral problems, and visuospatial deficits were in general less severe than other cognitive and behavioral deficits. The longitudinal case studies varied but showed steady increases in memory and intellectual performance in the younger children with strongest improvement in nonverbal abilities and little change in parent-reported behavior. This study raises several possible hypotheses about specific cognitive and behavioral outcomes observed in pediatric ABI.     

Agreement between Parents and Children on Ratings of Post-Concussive Symptoms Following Mild Traumatic Brain Injury

The level of parent-child agreement on post-concussive symptoms (PCS) was examined in children following mild traumatic brain injuries (TBI). As part of a larger longitudinal study, 186 children with mild TBI and 99 with orthopedic injuries (OI), from 8 to 15 years of age, were recruited prospectively. Parents and children completed the PCS Interview (PCS-I) and the Health and Behavior Inventory (HBI) at 2 weeks, 1 month, 3 months, and 12 months postinjury. Item-level correlations between child and parent ratings on both measures of PCS were significant but modest in both groups. Parent-child correlations for composite scales on the HBI and the total score on the PCS-I were significant in both groups, but somewhat higher in the OI group than in the mild TBI group. Mean symptom ratings tended to be significantly higher for children as compared to parents, especially for somatic symptoms. Parents and children display modest agreement when reporting PCS; their ratings correlate significantly, but children report higher mean levels of symptoms than parents.     

Parenting and the dysregulation profile predict executive functioning in children with acquired brain injury

Background: Children with acquired brain injury (ABI) present with high rates of psychological disorders commonly accompanied by deficits in hot and cold executive functions (EFs). Impairments in EFs have been reported to precede mental health problems. Moreover, children who are vulnerable to developing mental health problems in adulthood frequently present with a dysregulation profile in childhood, characterized by impairments in cognitive, behavioral and emotional regulation. Objective: To identify profiles of behaviors associated with impairment in hot and cold EFs and compare injury factors, environmental stressors and dysregulation profile between them. Methods: A latent profile analysis was conducted with 77 children with ABI aged between 6 and 12. Injury factors, child IQ, environmental stressors and the dysregulation profile were compared between these behavioral profiles. Logistic regressions were conducted to predict profile membership. Results: Two profiles were identified: Profile M, with mild deficits (1–2 SD above the mean) in working memory and social skills, and profile C, presenting clinically significant deficits (2–3 SD above the mean) in shift, initiate, working memory, planning and social skills and mild deficits in inhibit, emotional control and task monitor. Proximal environmental stressors (dysfunctional parenting practices, parental stress, parent’s executive dysfunction, anxiety-trait, and depressive symptoms) and dysregulation symptoms predicted profile membership, whereas injury factors, child IQ and distal environmental stressors did not. Conclusion: Following ABI, children with profile C are at risk of mental health problems and present with more proximal stressors. The dysregulation profile may be useful as a proxy for risk for later mental health problems in children with ABI.     

Using Medical Family Therapy with Parents of an Adult Child with Traumatic Brain Injury

Abstract

Acquired traumatic brain injury (ATBI) is a public health concern causing approximately 2.5 million emergency room visits in the United States annually. Medical family therapy (MedFT) displays how biological issues impact each area of a client’s life. This paper highlights how MedFT can be utilized with parents of an adult child with ATBI; the case is presented as treatment occurred with benefits of the inclusion of MedFT. Researchers propose a call to the field of marriage and family therapy to increase access of MedFT to afford more opportunities to help families who experience medical conditions.     

外伤性脑梗死的病因分析与防治策略

外伤性脑梗死是颅脑外伤患者比较常见且严重的一种并发症.其病因主要是脑血管壁损伤、血管受机械牵拉挤压、脑血管痉挛及低灌注、氧自由基及其他血管活性物质的改变.随着影像技术的发展进步,外伤性脑梗死的早期诊断已基本能做到,了解其主要发病机制以后,针对性地给予扩容,保证脑灌注压.通过提早预防、早期手术和内科药物、物理治疗方法,改善预后.     

Pediatric traumatic brain injury: Language outcomes and their relationship to the arcuate fasciculus

Pediatric traumatic brain injury (TBI) may result in long-lasting language impairments alongside dysarthria, a motor-speech disorder. Whether this co-morbidity is due to the functional links between speech and language networks, or to widespread damage affecting both motor and language tracts, remains unknown.     

On the Normal and Pathological Middle-age Crisis—Erich Maria Remarque,a Lost Survivor

The case illustration is from a long-term experience of individual psychoanalytic psychotherapy with a male patient, who started therapy when he was 15-years- old. According to DSM-IV criteria, he was diagnosed with a major depressive disorder. A psychological assessment including a Rorschach test showed a poorly integrated but well-adapted Borderline-Narcissistic personality disorder. Various classes of ant-idepressant drugs were used with equivocal or uncertain effects, and the roots and causes of the patient's negative reactions to medication had to be thoroughly investigated and dealt with during psychotherapy. Pharmacotherapy might succeed in targeting the various symptoms of depressive states, but the psychodynamic approach in a psychotherapeutic relationship widens the scope and works introspectively, allowing the patient insights to understanding the symptoms. The use of a psychotropic agent is usually based on trust and belief in its expected effect, but often the effect is not as expected. The psycho- pharmacological drug is also imbued with manifest and latent meanings which can be reached at in the psychoanalytic report. Such meanings and expectancies, and the consequent reactions affect both the patient and the psychotherapist. They have to be dealt with and overcome by psychoanalytic understanding and intervention, as well as experience and skill in use of the medicine concerned.     

The Orsino complex: Men who love themselves as love objects

Abstract

The Duke Orsino, in Shakespeare's Twelfth Night, is cited as the archetypal embodiment of a psychological complex which, it is argued, may affect many men in modern patriarchal societies. This condition named the ‘Orsino complex’ is characterized by the subject's experience of being in love with himself as a love object. It is the consequence of the subject's very early experience of his mother's dual psychological reactions to him as a male child. The first of these, and the more significant, I have called maternal phallic projection, while the second I term maternal withdrawal. I also consider the influence of the father upon this complex.

While this paper remains speculative in its present form—that is, its central thesis is based on fictional and not on clinical material—it might, I hope, assist all of us working psychodynamically in understanding further some of the severe problems that male clients present in their relationships with women, as well as directing further research into the complexities of gender identity in contemporary society.     

Social Skills Training in Two Subtypes of Psychiatric Inpatients with Generalized Social Phobia

The aim of this study was to investigate the differential effectiveness of broad-spectrum group social skills training (SST) in two subtypes of psychiatric inpatients with a DSM-IV diagnosis of generalized social phobia (GSP). SST participants were assigned to two GSP subtypes on the basis of their level of performance in social situations, i.e., a “reticent” subtype ( n = 28) and a “non-reticent” subtype (n = 28). As hypothesized, it was revealed that the benefit of SST did not differ in the two subtypes. These findings support the effectiveness and feasibility of comprehensive SST for patients with two subtypes of generalized social phobia.