Caregiver Behaviors and Child Distress in Trauma Narration and Processing Sessions of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an effective treatment for children impacted by trauma, and non-offending caregivers play an important role in this treatment. This study aims to identify correlates of four caregiver variables that have been identified as predictors of child outcomes in TF-CBT: support, cognitive-emotional processing, avoidance, and blame/criticism. Audio recorded sessions were coded from a community effectiveness trial of TF-CBT that included 71 child-caregiver dyads participating in the trauma narration and processing phase of treatment. Regression analyses were conducted to examine caregiver trauma history and child baseline symptoms (internalizing, externalizing, and posttraumatic stress disorder [PTSD] symptoms) as predictors of caregiver behavior during the trauma processing sessions. Caregivers who reported exposure to more trauma types exhibited more in-session avoidance and also processing during the trauma processing phase of treatment. Child symptoms at baseline did not predict caregiver in-session behaviors. Bivariate correlations were used to investigate concurrent associations between mean levels of in-session caregiver behaviors and in-session child distress (negative emotion, hopelessness, negative behaviors). More caregiver blame/criticism was associated with more in-session child distress on all three measures. Caregiver avoidance was associated with more child negative emotion and hopelessness. Findings may help identify therapeutic targets when working with caregivers to promote change and enhance TF-CBT outcomes.     

PTSD易感性人格特质、工作记忆能力和创伤期间认知加工对模拟创伤闪回的影响

基于模拟创伤研究范式, 采用道路交通事故影片对159名健康大学生进行模拟创伤, 考察PTSD易感性人格特质(特质焦虑、特质分离和神经质)、工作记忆能力(注意控制和工作记忆容量)和创伤期间认知加工(数据驱动加工和概念加工)对模拟创伤后不同时段闪回的影响。运用结构方程模型分析数据, 结果发现：(1)数据驱动加工正向预测不同时段闪回(即时闪回、一周闪回和触发闪回)的数量、生动性、痛苦度以及一周侵入频率; (2)神经质正向预测触发闪回痛苦度, 注意控制和工作记忆容量负向预测一周侵入频率; (3)概念加工在注意控制与即时闪回痛苦度之间起中介作用。研究结果提示：数据驱动加工是创伤后不同时段闪回的主要影响因素; 概念加工主要作用于早期急性应激反应, 注意控制是其保护因素; 神经质和工作记忆能力对闪回具有较长期的影响, 且工作记忆能力具有一定的保护作用。     

Cultural and Telehealth Considerations for Trauma‐Focused Treatment Among Latinx Youth: Case Reports and Clinical Recommendations to Enhance Treatment Engagement

Given that trauma exposure among youth, particularly those from communities of color, is high, there is a dire need to improve trauma-focused treatment for young people of color. Growing research has documented that integrating cultural and telehealth considerations into trauma-focused treatment can enhance treatment engagement and lead to positive treatment outcomes. Therefore, the purpose of this paper is to demonstrate how to incorporate cultural and telehealth considerations concurrently to enhance treatment engagement for Latinx youth and their caregivers. Specifically, we describe the process of delivering Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) to three trauma-exposed Latinx youths through the use of telehealth technology. Clinical recommendations are discussed to improve treatment engagement of Latinx youth and other young people of color.     

儿童期创伤与有留守经历大学生负性情绪：心理韧性的调节作用

本研究旨在考察有留守经历的大学生儿童期创伤与负性情绪关系,以及心理韧性在其间的调节作用。对391名有留守经历的大学生进行间隔3个月的两次问卷调查。结果:(1)相较于没有儿童期创伤的个体,有儿童期创伤的个体心理韧性更低,抑郁、焦虑、压力水平更高;(2)在控制性别、城乡来源、是否独生、年龄与T1时间点负性情绪的作用后,T1时间点的儿童期创伤、心理韧性均能显著预测T2时间点的负性情绪;(3)低心理韧性水平下,儿童期创伤显著预测留守经历大学生的负性情绪;高心理韧性水平下,预测作用不再显著。表明儿童期创伤是有留守经历的大学生负性情绪的风险因素,心理韧性可以调节儿童期创伤对有留守经历大学生的负性情绪的预测。     

The psychodynamic of panic attacks: A useful integration of psychoanalysis and neuroscience1

This article tries to explain, in the light of some neuroscientific and psychoanalytical considerations, the repetitive pattern of panic attacks. Freud considered the panic attack as an ‘actual neurosis’ not involving any conflictual process. Recent neuroscientific findings indicate that psychosomatic reactions, set off by a danger situation, depend on the primitive circuit of fear (including the amygdala) characterised by its speed, but lack accurate responses and may also be activated by harmless stimuli perceived erroneously as dangerous. The traumatic terror is stored in implicit memory and may be set off by a conditioned stimulus linked to a previous danger situation. In the panic attack, the traumatic event is created by the imagination and this construction (a micro‐delusion), built in loneliness and anxiety, has the same power as the real trauma. A mutual psychosomatic short‐circuit between body and psyche, in which terror reinforces the somatic reactions and the psychic construction, is established. Therefore, it is important to highlight these constructions in order to analyse and transform them. In the second part of the article the author reviews the main psychoanalytical theories about panic attacks, stressing how, in his opinion, panic attack is a consequence of the breakdown of the defence organisation at various levels and may appear during periods of life crisis. Two patients suffering from a deficit of personal identity are presented. The various organisations and the different levels (biological, neuroscientific, associative, traumatic) of the panic attack determine different kinds of therapeutic approaches (pharmacological, cognitive and psychoanalytical). While the psychopharmacological treatment is aimed at reducing the neurovegetative reaction and the cognitive method is attempting to correct the associative and perceptive processes of fear signals, psychoanalytical therapy represents both a specific means to free patients from panic attacks as well as an indispensable route for their emotional growth.     

新形势下的危机干预:2001年"9.11"事件后的新泽西

提供了一个研究参与式心理教育研习班发展的事例.作为对世贸遭袭一事的回应,这种研习班迅速发展并传播开来,成为一种有影响力的团体.它为个人及团体提供了以概念和经验为基础的训练,以应对灾难,精神创伤,恢复力,忍耐力以及同情心的疲乏等问题.     

创伤后成长:概念、影响因素、与心理健康的关系

创伤后成长是指在与生活中具有创伤性质的事件或情境进行抗争后体验到的心理方面的正性变化。许多因素,包括人口统计学、创伤事件的特征、人格与认知、社会支持与应对方式等都对创伤后成长有影响。创伤后成长与心理健康的关系未有一致的结论,两者间关系的不一致有四种可能的解释。未来研究应注意创伤后成长与相关概念的区别,探寻确证成长有效性的新证据和新方法。     

创伤性分离个体注意加工的Stroop效应

研究采用Stroop色词命名任务。实验主要考察创伤性分离个体注意的加工模式。实验中,高分离个体在标准Stroop任务条件,明显受到Stroop效应的干扰,对创伤性词汇反应时间减慢。实验结果表明,创伤性分离个体的集中注意能力遭到破坏,实验符合创伤的回避加工理论,创伤性分离个体运用分离无意识忽略注意伤害性的刺激,如果无法忽略,则会有意识的回避加工。     

Childhood trauma and psychosis: Review of the evidence and directions for psychological interventions

There is controversy over whether childhood trauma (CT) is a causal risk factor for psychosis. The aim of this study was to provide psychologists with a brief overview of the research into relationship between childhood trauma and psychosis and directions for psychological interventions. It details six of the highest quality studies in the area and tentatively concludes from these that there is evidence for a relationship between CT and psychosis. Hallucinations and delusions have been implicated as important factors in the relationship between CT and psychotic disorder and these are discussed, along with post‐traumatic intrusions and schemas, which have been conceptualised as part of the psychological mechanisms whereby CT confers a risk for psychosis. The development of psychological interventions for people with psychosis who have experienced CT is in its infancy but has been based on evidence‐based cognitive behavioural interventions in psychosis and post‐traumatic stress disorder. A formulation‐based approach is described in this paper, along with a case study.