Creating a ‘psychological nest’ for vulnerable infants and children: an interview with Annette Mendelsohn

This is an edited version of a recent interview with Annette Mendelsohn, Child and Adolescent Psychotherapist at the Royal Free Hospital, London, UK. It aims to make available in published form Mendelsohn's thinking and approach in relation to her work with traumatised children in a hospital setting. Mendelsohn also discusses her work in a neonatal intensive care setting and the way in which approaches to psychosocial care in the hospital setting have changed over the course of her professional life.     

Two boys—one event

The background of this paper is an investigation of child survivors from the Holocaust; in a study of interviews of these survivors, it could be concluded that past traumatic experiences are recovered not as memories (in the usual sense of the word), but as affects invading the present. Accordingly, affects seem to tell the story of the past traumatic experiences. In this paper, the author investigates two accounts (separately told by two survivors) of the same event in the Kielce ghetto. The two accounts present similarities, but also differences, and the author discusses these in relation to the concepts of historical and narrative truth, as well as in relation to construction and reconstruction, concluding that the interviews give a sketch of how the experiences have become idiosyncratically registered in the minds of the interviewees.     

Marital role strain,illness intrusiveness,and their impact on marital and individual adjustment in end-stage renal disease

Abstract

A marital role theory approach was used to investigate individual psychosocial well-being and marital adjustment in 89 end-stage renal disease (ESRD) patients and their spouses. Four different patient groups were selected according to a continuum of clinical milestones in the treatment of ESRD, including pre-dialysis (n=17), incenter dialysis (n=18), home dialysis (n=19), and posttransplant patients (n=17). A nephrology clinic control group (n=18) was also included. Standardized instruments were employed to investigate marital role strain (Marital Role Questionnaire, KDS-15), marital adjustment (Locke-Wallace Marital Adjustment Test), subjective well-being (Affect Balance Scale, Rosenberg Self-Esteem Inventory), and psychopathology (Symptom Checklist 90-R). Hierarchical multiple regression analyses provided strong and consistent support for the major hypotheses relating elevated marital role strain to compromised marital adjustment and individual well-being. Further analyses demonstrated that increased perceived intrusiveness of ESRD was significantly related to greater marital role strain, poorer marital adjustment, and decreased individual well-being. This is consistent with the idea that perceived intrusiveness may be an important mediator of marital role strain and of coping with chronic illness. “Objective” intrusiveness, defined in terms of patient group, was not significantly related to marital or individual well-being. These findings support a dyadic approach to the psychosocial study of chronic illness.     

The job demand-control(-support) model and physical health outcomes: A review of the strain and buffer hypotheses

Abstract

This review of the Job Demand-Control (JDC) model and the expanded Job Demand-Control-Support (JDCS) model and employees' physical health, focuses on the two prevalent views on these models. According to their view on the models researchers study different hypotheses: (a) the (iso)strain hypothesis, stating that the highest level of ill health is expected when the job is characterized by high demand and low control (and low social sup port), ot (b) the buffer hypothesis, predicting that control (and social support) can buffer the potential negative effects of high demands on physical health. It is argued that these hypotheses reflect theoretical distinct models, and that the practical implications associated with these models differ.

The review of 51 studies on the JDC(S) model reveals that the “strain” hypothesis predominates in studies of all-cause mortality, cardiovascular disease (CVD) related and specific non-CVD related health outcomes. In contrast, the “buffer” hypothesis is most prevalent in research on self-reported (psycho)somatic complaints. For the strain hypothesis as well as the buffer hypothesis the results are equivocal. Working in a high (iso)strain job appears to be associated with an elevated risk for cardiovascular disease and negative pregnancy outcomes, and increased (psycho)somatic complaints. Conclusions on other physical outcomes seem premature, considering the limited number of studies. The buffer hypothesis is supported in the few studies on CVD endpoints and in some studies on (psycho)somatic complaints.

A comparison of the validity of the two hypotheses is problematic, because they are mostly applied to a different set of outcomes. Furthermore, the analyses employed in the testing of the two hypotheses are of a different nature (non-linear versus linear).

The main recommendation for future research is to examine the validity of the strain and the buffer hypothesis concurrently, and to further explore the nature of the relationships.     

One ‘knows’: self-rated health and telomere length among ex-prisoners of war

Abstract

Objective: Ill-health and early mortality are amongst the most significant ramifications of trauma. Furthermore, trauma alters the subjective perception and experience of the body. The aim of this study is to examine the extent to which deteriorations in perceived health among traumatised individuals are associated with cellular health as manifested in telomere length.

Methods: Specifically, 88 former prisoners of war (ex-POWs) evaluated their health (self-rated health; SRH) at 18 (T1), 35 (T2) and 42 (T3) years after the war, and were assessed for telomere length at T3. Health behaviour, BMI, morbidity and PTSD were also examined at T3.

Results: The findings demonstrated that SRH was cross-sectionally correlated with telomere length. Furthermore, a significant sequential indirect effect was found, in which worse SRH in T1 was associated with shorter telomere length at T3, through worse SRH at T2 and at T3.

Conclusions: These findings demonstrate that long-term deteriorations in the subjective evaluations of health are implicated in actual cellular health among individuals exposed to trauma.     

Work strain and the post-discharge adjustment of patients following a heart attack

Abstract

The role of work characteristics in determining return to work after an acute coronary event was examined. One hundred and forty nine patients were enrolled. One year post-discharge, 74 had returned to work. Work characteristics (decision latitude, and opportunity for social interaction at work), together with age, depression, and medical prognosis, correctly classified work status in 78% of cases. At 12 months post-discharge, patients who had not returned to work recorded significantly poorer levels of adjustment compared to those who had returned to work. A better quality of life is associated with a lower level of depression pre-hospitalization, ownership of a larger home, being male, and having a more positive work environment. The findings suggest that the pre-illness work environment of the patient is a factor influencing return to work, which needs to be considered in rehabilitation programmes.     

Supersonic crack motion in a harmonic lattice

Antiplane shear cracks in a harmonic square lattice have been studied in a molecular dynamics simulation. They can reach velocities larger than the shear wave velocity.     

Electromechanical behavior of single-walled carbon nanotube thin films

Carbon nanotubes have been intensively studied owing to their great potential in nanoelectronics and nanomechanical devices. Recently, experimental results have shown that single-walled carbon nanotubes (SWCNTs) change their electronic properties when subjected to strain. In this study, the electromechanical characteristics of SWCNT networks were investigated for the application of printable strain sensors on flexible substrates. SWCNT films were formed on plastic substrates of poly(ethylene terephthalate) using a spray process. In this manner, we were able to control the transparency and obtain uniform electrical properties of the films. The films are isotropic on account of the random orientation of bundles of SWCNTs. Experimental results showed a nearly linear change in the resistance across a film when it was subjected to tensile strain, even in the inelastic range of the flexible substrate. The results demonstrate the potential use of SWCNT films for highly sensitive printable strain sensors on a macroscale.