Displacement as trauma and trauma as displacement in the experience of refugees

This paper investigates the relations between displacement, home, trauma and the self in the experience of refugees, which has become an issue of unexpected and far-reaching proportions in recent times. It questions to what extent and under what conditions displacement in the world may be traumatic and how trauma may be considered the effect of an inner displacement. Refugees’ lives are marked by forced migration that is related to a certain suffering due to the changes in their family, relational, social and cultural lives. The paper explores the extent to which these changes can represent a break so significant as to be traumatic. It outlines the way in which traumatic experiences can produce an inner displacement and reorganization of one’s mental life that leads to a focus on traumatic complexes. Under the most severe traumatic conditions, this can be understood as a displacement of the central axis of Self, in which the ego complex yields its position to other complexes, with a deep change in the organization and functioning of self. The experience of refugees highlights the way in which we live in a matrix of conscious and unconscious links between inner and outer worlds that need deeper and simultaneous consideration to understand their implications and mutual resonances for the psyche. Clinical cases of refugees will illustrate some aspects of these interconnections.     

Race-Based Stress in White Adults: Exploring the Role of White Racial Identity Status Attitudes and Type of Racial Events

The impact of racial experiences on Whites has been underresearched and has rarely been considered traumatic. To understand these experiences, it is important to consider variation in one's orientation to their racial group (i.e., racial identity) and the type of racial encounter. Using a White adult sample and hierarchical cluster analysis, the authors found that reactions to race-based encounters were associated with varying levels of psychological distress and well-being and racial identity statuses. Clinical implications are discussed. El impacto de las experiencias raciales en personas blancas no ha sido suficientemente investigado y en raras ocasiones ha sido considerado traumático. Para comprender estas experiencias, es importante considerar la variación en la orientación de cada individuo hacia su grupo racial (es decir, la identidad racial) y el tipo de encuentro racial. Usando una muestra de personas adultas blancas y un análisis jerárquico de clústeres, los autores hallaron que las reacciones a los encuentros raciales estaban asociadas a niveles variables de malestar psicológico, así como de estados de bienestar e identidad racial.     

Social Identity,Groups, and Post‐Traumatic Stress Disorder

As with the identification and labelling of many mental health problems, the adoption of PTSD within DSM can be said to arise from contemporaneous social and political contexts: specifically the return to the United States of many war‐affected veterans from Vietnam ( Scott, 1993 ). The specific circumstances of the recognition of PTSD within DSM‐III have led several commentators to discuss it in terms of social construction (e.g., Summerfield, 2001 ). The current review argues that the orientation of theory and research aimed at understanding PTSD has been particularly informed by Western individualistic constructions of social phenomena. Our review calls for a blending of approaches to understanding post‐traumatic stress by considering the social structures and contexts in which it is expressed and in particular by considering how a group‐level analysis can inform incidence, diagnosis, and expression of post‐traumatic symptoms.     

Post‐Traumatic Growth and Optimism as Outcomes of an Internet‐Based Intervention for Complicated Grief

This explorative study examines the effects of an internet‐based cognitive‐behavioural therapy for complicated grief on post‐traumatic growth and optimism. The study is part of a larger randomized controlled trial described in Wagner, Knaevelsrud, and Maercker (2006) Wagner, B., Knaevelsrud, C. and Maercker, A. 2006. Internet‐based cognitive‐behavioral therapy for complicated grief: a randomized controlled trial.. Death Studies, 30: 429–453. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]. The patients were randomly assigned to either a treatment group (n = 26) or a waiting list control condition (n = 25). The internet‐based intervention consisted of exposure to bereavement cues, cognitive reappraisal exercises, and a module on integration and restoration. A short form of the Post‐traumatic Growth Inventory (PTGI), the Life Orientation Test‐Revised (LOT‐R), and measures of complicated grief and psychopathological outcomes were administered. Results indicate that post‐traumatic growth increased in the treatment group. No treatment effect was found for optimism. These findings contribute to the growing literature on personal growth in psychotherapy.     

Perceived lack of training moderates relationship between healthcare providers’ personality and sense of efficacy in trauma-informed care

ABSTRACT

Background and Objectives: Medical patients often have trauma histories that are not routinely assessed, which can adversely affect health outcomes. Despite growing awareness of this issue, there is limited understanding of factors that influence provider competency in trauma-informed care (TIC). The study examined healthcare providers’ personality traits in relation to their sense of TIC efficacy, taking into account perceived barriers to TIC and professional quality of life.

Study Design: The study used cross-sectional survey methods to examine our central hypothesis that provider personality traits and perceived barriers to TIC would be associated with TIC-efficacy, and to explore interactions among study variables.

Methods: Survey data were collected from 172 healthcare providers examining TIC knowledge, TIC-efficacy, perceived barriers to TIC, personality traits, and professional quality of life.

Results: TIC-efficacy was positively correlated with “intellectence/openness” and inversely correlated with “neuroticism” and perceived lack of training as a barrier. “Intellectence/openness” interacted with perceived lack of training to predict TIC-efficacy, suggesting that providers with lower “intellectence/openness” report greater TIC-efficacy when lack of training is not perceived as a barrier.

Conclusions: Provider personality traits and perceived barriers to TIC appear related to providers’ TIC-efficacy. Implications for overcoming barriers to TIC through training and implementation are discussed.     

POST-TRAUMATIC STRESS REACTIONS AMONGST RESCUE WORKERS AFTER A MAJOR RAIL ACCIDENT

Abstract

Rescue tasks under heavy strain may act as traumatic events creating stress reactions among the rescue workers. After a major rail accident the rescue workers were examined by questionnaire at 3 and 7 months postaccident using the General Health Questionnaire-28 (GHQ), Impact of Event Scale (IES) and a structured questionnaire made for the purpose. Eighteen percent of the 77 rescue workers who participated in the study had GHQ-case-score and 10% had IES-case-score at 7 months using the usual GHQ-cut-off (4/5) and a low IES-cut-off (19/20). For the case-scorers there was a tendency towards increased GHQ- and IES-scores from 3 to 7 months. Five (6%) had post-traumatic stress disorders (PTSD) of low to moderate severity at 7 months.     

Compassion satisfaction,compassion fatigue,and burnout in a national sample of trauma treatment therapists

Abstract

For behavioral health professionals working with traumatized clients, continuous and prolonged exposure to the stress of working with the myriad of trauma-related stressors experienced by their clients can lead to various responses including burnout, compassion fatigue, and compassion satisfaction. The present study investigates the impact of using evidence-based practices on compassion fatigue, burnout, and compassion satisfaction in a random, national sample of self-identified trauma specialists (N=532). The 30-item Professional Quality of Life Scale (Stamm, 2005) and the 19-item Trauma Practices Questionnaire (Craig & Sprang, 2009) were included in a survey to licensed social workers and psychologists from professional membership rosters. Age and years of experience proved to be powerful predictors of only two of the three criterion variables, with younger professionals reporting higher levels of burnout and more experienced providers endorsing higher levels of compassion satisfaction. The utilization of evidence-based practices predicted statistically significant decreases in compassion fatigue and burnout, and increases in compassion satisfaction. The utility of these findings in understanding the process of trauma transmission between therapist and client as well as directions for future research are discussed.     

An Examination of Posttraumatic Stress Symptoms among Maltreated Multiracial Youth

Symptoms of posttraumatic stress disorder (PTSD) are common among maltreated youth removed from their homes. These symptoms might be particularly evident in multiracial youth, although little research exists on this vulnerable population. A model whereby depression, dissociation, and posttraumatic cognition symptoms contributed to symptoms of PTSD met goodness-of-fit criteria in 160 maltreated multiracial adolescents. Enhanced model fit was found for females and for adolescents 11 to 13 years old. Analyses further revealed that the best predictors of PTSD symptoms were negative cognitions about the world and anhedonia. The findings are discussed within the context of existing theoretical models of PTSD. The results further highlight the importance of ethnically and racially sensitive approaches to assessment and treatment of youth with PTSD symptoms.     

Trauma Affect Regulation Psychoeducation Group and Milieu Intervention Outcomes in Juvenile Detention Facilities

This article reports outcomes of Trauma Affect Regulation: Guide for Education and Therapy (TARGET), a group and milieu intervention, in three juvenile detention facilities, controlling for site, length of stay, ethnicity, number of arrests, mental health and traumatic stress problems, and cohort effects. Linear multiple regression results showed that every session of TARGET received in the first seven days of detention was associated with 54% fewer disciplinary incidents and 72 fewer minutes of disciplinary seclusion ( p < .001) for each youth during the modal stay (14 days) in detention. TARGET group participation was unrelated to recidivism, but recidivism declined significantly following implementation of TARGET. Implementing TARGET in juvenile detention facility milieus might improve safety, reduce punitive sanctions, and potentially reduce recidivism.