A Solution-Focused Intervention with a Youth in a Domestic Violence Situation: Longitudinal Evidence

This article reports on a 4-year therapeutic intervention combining in-person and email communication with a 13-year-old Greek-Cypriot teenager who witnessed and later was the victim of severe domestic violence. The intervention is based on an empowerment philosophy and solution-focused strategies, and its usefulness is evaluated by three standardized measures at five time points between the years 1999 and 2003. Pertinent cultural and ethical dynamics of the interventional context are highlighted. The intervention may have helped to produce better perpetrator–youth relations, remission of the client’s depression and post-traumatic stress symptoms, and improvement in his academic performance. Implications and limitations are discussed.     

酒依赖与酒文化

作为一种精神障碍,越来越多的与饮酒有关的问题在我国引起了专业人员的重视。酒依赖不仅对个体的心理和躯体健康有害,还会引起一系列的社会问题。对酒这种精神活性物质作了多维度的评价,描述了形形色色的酒文化现象,探讨了我国酒文化在饮酒及饮酒相关问题发生中的作用。     

Feasibility and Acceptability of Group-Facilitated Prolonged Exposure Therapy for PTSD in VA Residential Rehabilitation Treatment Programs

Prolonged Exposure therapy (PE) is a first-line treatment for posttraumatic stress disorder (PTSD); however, few VA patients receive this treatment. One of the barriers to PE receipt is that it is only available in an individual (one-on-one) format, whereas many VA mental health clinics provide the majority of their psychotherapy services in group format. In particular, PTSD residential rehabilitation treatment programs (RRTPs) offer most programming in group format. Consequently, strategies are needed to improve the scalability of PE by adapting it to fit the delivery setting. The current study was designed to pilot test a group-facilitated format of PE in RRTPs. Thirty-nine Veterans who were engaged in care in the PTSD RRTP at a Midwestern VA were recruited to participate in a Group-facilitated PE protocol. Participants engaged in twelve 90-minute sessions of Group PE over the course of 6 weeks, plus six 60-minute individual sessions for imaginal exposure. Group treatment followed the PE model and consisted of psychoeducation, treatment rationale, and in vivo exposure to reduce trauma-related avoidance and thereby improve PTSD symptoms. PTSD symptoms were measured via the PTSD Checklist for DSM-5 (PCL-5) and depression symptoms were measured via the Patient Health Questionnaire (PHQ-9) at baseline, endpoint (6 weeks), and at 2-month follow-up. Thirty-nine individuals initiated Group-facilitated PE and 34 completed treatment. The average number of group sessions attended was 11 out of 12. Acceptability ratings were high. Mean change (improvement) in the intent-to-treat sample at 2-month follow-up was 20.0 points on the PCL-5 (CI 18.1, 21.9; Cohen’s d = 1.1) and 4.8 points on the PHQ-9 (CI 4.1, 5.5, d = .8). These results suggest that adapted evidence-based interventions for PTSD can improve treatment access and efficiency for the RRTP setting. A group-based approach has the potential to improve the scalability of PTSD treatment by reducing required resources. A fully powered trial is now needed to test the effectiveness of Group-facilitated PE in the RRTP setting.     

Effects of live exposure on symptoms of posttraumatic stress disorder: the role of reduced behavioral avoidance in improvement

Although the effectiveness of cognitive-behavioral treatment in posttraumatic stress disorder (PTSD) is well established, few studies examined its effects on individual PTSD symptoms and possible mechanisms of improvement in symptoms. In a previous randomized controlled study [Ba?og lu, M., Salciog lu, E., Livanou, M., Kalender, D., & Acar, G. (2005). Single-session behavioral treatment of earthquake-related posttraumatic stress disorder: A randomized waitlist controlled trial. Journal of Traumatic Stress, 18, 1-11] a single session of behavioral treatment involving self-exposure instructions was highly effective in reducing earthquake-related PTSD. In the present study we examined the effects of treatment on each PTSD symptom and which symptoms improved early in treatment. Because the intervention focused solely on behavioral avoidance, we hypothesized that avoidance would be the first symptom to change and that reduction in avoidance would generalize to all other symptoms. The results showed significant between-groups treatment effect on only behavioral avoidance early in treatment (week 6). At 6 months post-treatment recovery rates ranged from 60% to 89% for 15 PTSD symptoms, including the numbing symptoms. Lack of improvement in avoidance was associated with lack of improvement in 12 symptoms. The critical process in recovery thus appeared to be increased sense of control associated with reduction in avoidance. These findings imply that live exposure to fear cues designed to enhance sense of control might be sufficient for recovery from PTSD.     

The moderating role of attitude strength in selective exposure to information

Individuals prefer to receive information that is consistent with their attitudes. Three experiments examined whether attitude strength moderates this selective exposure effect. Experiments 1A and 1B found that participants preferred attitudinally consistent information but that this effect was more pronounced to the extent that the attitude was strongly held. Experiment 2 replicated these findings and ruled out an alternative interpretation that a general tendency to hold strong attitudes rather than issue-specific attitude strength moderates selective exposure. Discussion concerns the implications of these findings and the possibility that other variables moderate the selective exposure effect.     

Offspring Effects of Prenatal Alcohol Exposure from Birth to 25 Years: The Seattle Prospective Longitudinal Study

Before alcohol was generally known to cause birth defects, NIAAA in 1974 began funding a population-based Seattle study on alcohol use and pregnancy outcome. Women receiving prenatal care by mid-pregnancy were recruited (N = 1,529) and interviewed at home. Approximately 500 offspring exposed to a range of alcohol levels were examined on 11 occasions between day 1 and 25 years. Neuropsychological and neurobehavioral performance measures are correlated with prenatal alcohol dose, without substantial confounding by socio-demographic or rearing conditions, smoking, nutrition, or other drugs. Deficits in attention, arithmetic skill, spatial-visual memory, and IQ, as well as increased alcohol problems and psychiatric disorders are among offspring outcomes correlated at several ages with maternal drinking during and before pregnancy recognition. Findings are not confined to women who believed they had alcohol problems. Not all exposed offspring appear affected.     

暴力电子游戏的短期脱敏效应：两种接触方式比较

比较主、被动接触暴力电子游戏的脱敏效应,以44名男性大学生为被试,利用生物反馈仪测量被试主动参与游戏或被动观看游戏录像前后,及随后观看暴力视频过程中皮电与心率的变化（脱敏效应的生理指标）。结果表明：（1）暴力电子游戏可以产生脱敏效应。接触游戏15分钟后,暴力游戏组观看暴力视频过程中皮电的增加值明显小于非暴力游戏组;（2）游戏的接触方式对于脱敏效应的程度无显著影响,但主动参与组对于游戏内容知觉到更高的愉快与更低的沮丧     

某院医务人员职业暴露的现状调查

职业暴露是医务人员最常见的职业伤害,为探求有效的防护方法,对我院2005年至2008年报告的职业暴露进行了分析,结果发现医务人员职业暴露漏报严重,护士发生职业暴露最多（占57．4％）,主要为针刺伤（占85．2％）,暴露源以乙型肝炎为主（占53．2％）。应加强医务人员标准预防和职业安全知识的教育与培训,建立和健全职业暴露的监测体系。     

Adult attachment, perceived stress, and PTSD among civilians exposed to ongoing terrorist attacks in Southern Israel

This study examined the relationships among exposure to terrorism, individual differences in adult attachment dimensions, perceived stress, and posttraumatic stress disorder (PTSD). A representative sample of 254 adults who had experienced more than 7 years of ongoing exposure (OGE) to rocket and mortar fire in southern Israel was compared to 308 individuals with no exposure (NE) to terrorism. OGE individuals reported significantly elevated levels of insecure attachment, perceived stress, and PTSD-symptoms as compared to the NE individuals. The associations between perceived stress and PTSD-symptoms were significantly stronger in the OGE group, compared to the NE group. For OGE individuals, the elevated level of perceived stress mediated the association between Attachment Anxiety and PTSD-symptoms. Theoretical and clinical implications of the findings are discussed.