A Controlled Pilot-Outcome Study of Sensory Integration (SI) in the Treatment of Complex Adaptation to Traumatic Stress

This study tested whether sensory integration (SI) treatment combined with psychotherapy would improve symptom outcome over psychotherapy alone in the treatment of complex posttraumatic stress, as measured by the Disorders of Extreme Stress Not Otherwise Specified (DESNOS) clinical construct in a group of 10 adult patients with histories of childhood abuse. DESNOS symptoms were assessed at three time periods (T1, baseline; T2, after experimental group SI treatment; and T3, after wait-list control group SI treatment) using the Structured Interview for Disorders of Extreme Stress (SIDES). The Sensory Learning Program? (SLP), developed by the Sensory Learning Institute of Boulder, Colorado, was used as the SI treatment modality. Results indicated significant differential improvement for the group treated with SLP in SIDES Total Score (T1/T2 and T2/T3), Self Perception (T1/T2 and T2/T3), Affect Regulation (T2/T3), and Alterations in Meaning (T1/T2).     

PTSD and Epigenetic Research: Decentering the Physical Body

To prevent youth violence, the GREAT Families program was implemented with a selective sample of 1,196 families of sixth-grade children from low-income schools in 4 cities making the transition to adolescence. To assess intervention effects, we used pre- and posttest data to estimate a structural model to test the hypothesis that random assignment to the intervention would predict changes in parenting practices, which in turn would predict changes in exposure to violence (i.e., a mediational model). We found that participation in GREAT was significantly related to changes in parenting practices and these changes significantly predicted changes in violence exposure. Furthermore, adolescents who reported greater increases in exposure to violence also tended to experience greater decreases in parental monitoring, discipline, and involvement. Implications for future research and prevention efforts are discussed.     

Childhood Abuse,Head Injuries,and Use of Medical Emergency Services in People with Severe Mental Illness

People with severe mental illness (SMI) report high rates of traumatic experiences. This study analyzes data collected from 183 people diagnosed with SMI on reports of childhood trauma, head injuries, and emergency room (ER) services. More than half the cohort (56.7%) reported 3 to 7 cooccurring categories of childhood abuse (CAB). People who reported 6 and 7 categories of CAB had a 5-fold risk of experiencing a head injury. If they have used the ER for reasons other than psychiatric illness they endorse more traumatic experiences in their childhood when compared to those who did not. People with SMI and cooccurring CAB experiences might be predisposed to a higher risk of head injuries and more frequent use of the ER.     

Applying Motivational Interviewing in a Domestic Violence Shelter: A Pilot Study Evaluating the Training of Shelter Staff

ABSTRACT

This pilot study examined the use of motivational interviewing (MI) with 20 women receiving services at a domestic violence shelter. The experimental group (n = 10) received regular treatment services (RTS) from shelter counselors who were trained in MI; the control group (n = 10) received RTS only. Fisher's exact test showed that participants who received MI-enhanced RTS were significantly more motivated for change (p = .029), as measured through a dichotomous readiness for change motivational variable on the University of Rhode Island Change Assessment (URICA; Center on Alcoholism, Substance Abuse, &; Addiction Research Division, 1996 Center on Alcoholism, Substance Abuse, &; Addiction Research Division. 1996. University of Rhode Island Change Instrument (URICA) Scale, Albuquerque, NM: Author.  [Google Scholar]). Findings suggest that MI can be helpful in increasing the readiness for change in domestic violence survivors who contemplate leaving abusive relationships.     

PTSD Symptoms in College Students Exposed to Interparental Violence: Are they Comparable to those that Result from Child Physical and Sexual Abuse?

Undergraduate students completed the Trauma Symptom Inventory and a childhood history questionnaire that assessed their experience of three types of childhood traumatic events: physical abuse (CPA), sexual abuse (CSA), and interparental violence (CPV). Six posttraumatic stress disorder (PTSD) subscales previously found to be associated with these types of abuse (anxious arousal, anger/irritability, intrusive experiences, depression, tension reduction behaviors, and defensive avoidance) were examined through multiple regression analyses to determine the extent to which each type of trauma history was most predictive of elevated symptomatology. For several subscales, having exposure to interparental violence was the strongest predictor of elevated symptomatology, suggesting that CPV is at least as powerful as CPA or CSA in producing symptoms of PTSD in adulthood.     

The Role of Trauma in Conduct Disorder

Summary

Trauma is proposed as a key to understanding the development and persistence of conduct disorder, in conjunction with other contributing factors. Trauma history is ubiquitous in the conduct disordered population, and trauma effects can help to account for many features of conduct disorder, including lack of empathy, impulsivity, anger, acting-out, and resistance to treatment. The current standard of care fails to fully address trauma, which may partially explain the low success rate of extant treatment approaches. A trauma-informed perspective is introduced to current models of conduct disorder. Research, prevention, and treatment implications are discussed.     

Caring for Carers in the Aftermath of Trauma

The potential impact on psychological well-being of working in the caring professions in the aftermath of trauma and disaster has been recognized for many years, with terms such as burnout, compassion fatigue, and vicarious traumatization coined to describe stress-related conditions. Although prevalent, these conditions do not affect all workers in the field. Various studies have investigated potential risk and protective factors. It is argued that the outcomes of this research should be used to guide practical interventions in the workplace designed to minimize stress-related problems. A framework that incorporates interventions at the primary, secondary, and tertiary prevention levels is outlined, and research investigating the efficacy of interventions at each of these levels is recommended.     

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.     

Does Bullying Victimization Suppress IQ? The Effects of Bullying Victimization on IQ in Iraqi and African American Adolescents: A Traumatology Perspective

This study explored the effects of bullying victimization (BV), as a Type II traumatic stressor, on intelligence quotient (IQ), posttraumatic stress disorder (PTSD), and complex PTSD symptoms. Participants were 390 African American and Iraqi refugee adolescents. Measures of BV, cumulative life trauma, PTSD, discrimination, and IQ were administered. Correlational, multilevel regression, and path analyses were conducted. BV, independent of cumulative trauma, and discrimination were found to have significant direct effects on increased PTSD symptoms and significant direct and indirect negative effects on perceptual reasoning, processing speed, and working memory. BV was also associated with increases in the discrepancy between perceptual reasoning and verbal comprehension. The implications of these results for the prevention and treatment of bullying victims are discussed.     

PTSD Symptom Patterns Following Traumatic and Nontraumatic Events

This study extends research examining posttraumatic stress disorder symptoms following different types of potentially traumatic events. Specifically, the study examined and compared the symptom patterns observed in those who suffered a major accident, the unexpected death of a loved one, or sexual assault. Based on recent findings, this project also examines those who reported nontraumatic (but stressful) events, as well as comparing symptom patterns across gender. Findings suggest different types of traumas might be associated with differences in severity and patterns of symptoms for women (but not for men), suggesting symptom patterns manifest differently in men and women. Results also call into question the assumption that traumatic events demonstrate different symptom patterns than other types of events.