Traumatic stress: A theory based on rapid loss of resources

Abstract

Applied Hobfoll's (1988; 1989) Conservation of Resources (COR) stress theory to the instance of traumatic stress. COR theory posits that stress occurs when resources are threatened, when resources are lost, or when individuals invest resources without gaining adequate resources in return. Traumatic stress is seen as particularly threatening to resources and results in rapid resource depletion when it occurs. The rapidness of resource loss is related to the fact that traumatic stressors (1) often attack people's basic values, (2) often occur unexpectedly, (3) make excessive demands, (4) are outside of the realm for which resource utilization strategies have been developed, and (5) leave a powerful mental image that is easily evoked by cues associated with the event. Results from research on traumatic stress are used to illustrate these points and implications for treatment are discussed.     

What will the future bring? Thoughts of children after missile bombardment

Abstract

We examined how cognitive views of the future relate to degree of exposure to trauma and to posttraumatic stress reactions in children. Following the experience of Scud missile bombardment during the Persian Gulf war, 492 Israeli pupils from grades 5, 7, and 10 from regions actually hit and from regions under threat but not hit, described what they thought life would be like next year for children of their age. Based on recent cognitive theories, it was expected that children who experienced higher levels of stress would also express more pessimistic views of the future. We found that children's dominant perception of the future was positive. However, children who expressed stronger postwar reactions also tended to have more pessimistic future views, especially in areas that were hit by missiles. Discussion focused upon views of the future as a direct consequence of the stress as well as a means of coping with stress.     

Religious Care in Coping with Terrorism

Abstract

Spiritual care has taken an important role in the aftermath of 9/11. The shattering of numerous basic assumptions by this attack has created many spiritual and existential questions. In this article, we explore different aspects of spiritual care after major disasters and the different roles that clergy can fulfill. As the field of spiritual trauma care is in a rudimentary stage, best practices for spiritual care need to be developed. In the second part of the article, different elements of the training for spiritual caregivers are described. In order to assure appropriate caregiving, guidelines for training of clergy need to be developed.     

Responding to Terrorism in the USA

Abstract

In this article, career firefighters from Oklahoma City, New York City, and Arlington County, VA, and volunteer firefighters from Pennsylvania, share their on-site experiences and the emotional aftermath of responding to terrorism. The authors acted as facilitators, compilers, and organizers so that major themes firefighters have raised are presented to inform the work of first responders and others seeking to understand the experiences of firefighters during and after terrorist incidents. The authors conclude by presenting survey data indicating high levels of firefighter job satisfaction and the major sources of emotional support they use following exposure to terrorism.     

Vicarious Trauma in Social Workers: The Role of Trauma History,Social Support,and Years of Experience

Vicarious trauma, a disruption in schemas and worldview often accompanied by symptoms similar to those of posttraumatic stress disorder, occurs as a result of chronic secondary exposure to traumatic material. The aim of this study was to examine the role of personal trauma history, social support, and experience level in the development of vicarious trauma among licensed social workers in Maryland (N = 160). Results indicated an increase in social support and in experience level of social workers predicted less severe vicarious trauma. In addition, an interaction effect between trauma history and social support trending on significance indicated higher levels of social support might help protect those without a trauma history but not those with a trauma history against vicarious trauma. Research and clinical implications are discussed.     

Risk and Protective Factors for Comorbid Posttraumatic Stress Disorder among Homeless Individuals in Treatment for Substance-Related Problems

Homeless individuals undergoing treatment for substance use disorders (SUD) can pose clinical challenges. Posttraumatic stress disorder (PTSD) symptoms have been observed in the most difficult clients. The study sample consisted of 51 homeless individuals, 9 women and 42 men, undergoing consultation for SUD in Montreal. The mean age was 46 years (SD = 7.19). Of the sample, 49% had a potential PTSD diagnosis. Most participants had the following characteristics: an alcoholic parent, a history of an early trauma, and little social support. The participants with a potential PTSD diagnosis were significantly more likely to have had an alcoholic parent, to have experienced an early trauma, and to use more maladaptive coping strategies. The study results and limits are discussed.     

Health Outcomes by Closeness of Sexual Abuse Perpetrator: A Test of Betrayal Trauma Theory

Summary

In this chapter, practicing attorney Brooks Cooper illuminates how the legal tradition of applying different standards to the ad-missibility of expert and lay opinions as evidence in litigation complicates delayed-discovery sexual abuse cases. Admissibility standards have long been a source of controversy, and recent developments in law, such as the pre-trial evidentiary hearings that invoke the “gatekeeper” function of the judge under the standard enunciated in Daubert v. Mer-rell-Dow Pharmaceuticals, have become a favored strategy by the defense in an effort to bar delayed memory testimony by characterizing it as the product of unreliable science. To overcome this litigation hurdle, Mr. Cooper contextualizes the present controversy in the history of scientific evidence admissibility, tracing emerging trends in judicial opinion on scientific evidence from expert witnesses from the 1923 case Frye v. United States through the present, and offers strategies and techniques to maintain admissibility of the evidence before and during all phases of the trial.     

A Review of Reviews Examining Neurological Processes Relevant to Impact of Parental PTSD on Military Children: Implications for Supporting Resilience

In this study, 10 recent meta-analytic and systematic review studies were synthesized on the neurological underpinnings of stress and trauma with implications for the impact of parental post-traumatic stress disorder (PTSD) and resilience among military children. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) group guidelines and utilizing a validated quality assessment tool, this systematic review of reviews incorporated results from more than 35,971 individuals with stress exposures, effects, or disorders and healthy controls. This synthesis found support for important gene, physiology, and environment correlations and interactions that predict increased risk for stressful life events and PTSD, but not direct transmission, among military children. Future research is needed to determine if these constitute indirect pathways of intergenerational transmission in military children.     

Transitioning from the Battlefield to Home: An Innovative Program for Israeli Soldiers

Soldiers moving from the army to civilian life encounter significant challenges during this time of transition, both in Israel and internationally. Identifying this period of time as a critical one, the Peace of Mind program is an innovative intervention designed specifically to address the issues occurring therein. This unique model focuses on mental health and normalization of responses, as well as on the processing of traumatic experiences. It is based on the considerable experience at the Israel Center for the Treatment of Psychotrauma in the fields of resilience building and trauma treatment. After reviewing the literature on returning soldiers, the model is described and several vignettes are presented.     

The Impact of Childhood Physical Abuse and Age of Sexual Initiation on Women's Maladaptive Posttraumatic Cognitions

Child abuse survivors often exhibit long-standing maladaptive beliefs. Sexual risk-taking could contribute to the maintenance of such beliefs by reinforcing cognitions that originally resulted from child abuse. In this study, 64 community women, most with elevated posttraumatic stress disorder symptoms, completed measures of childhood abuse, sexual risk-taking, and posttraumatic cognitions. Age of first consensual sexual intercourse mediated the relationship between childhood physical abuse and maladaptive posttraumatic cognitions in adulthood. Thus, age of sexual intercourse initiation might play an important role in women's recovery from childhood physical abuse. Clinicians should consider the possible impact of women's sexual history when challenging their cognitions during trauma-based cognitive behavioral therapy. Further, decreasing risky sexual behavior might partially protect against the negative effects of trauma.