Experience of a Lifetime: Study Abroad,Trauma, and Institutional Betrayal

This study is the first to expand the investigation of study-abroad risks to include a range of traumatic experiences for male and female students and to examine effects of institutional betrayal (i.e., an institution’s failure to prevent trauma or support survivors). In an online survey of 173 university students who had studied abroad, many respondents (45.44%, n = 79) reported exposure to at least 1 traumatic experience while abroad, most frequently natural disasters, sexual assault, and unwanted sexual experiences. Of students exposed to potentially traumatic events, more than one third (35.44%, n = 28) also reported at least 1 form of related institutional betrayal, which uniquely correlated with posttraumatic distress in some participants, when controlling for lifetime trauma history.     

A Threatened Identity: The Mental Health Status of Syrian Refugees in Egypt and Its Etiology

This study utilized the development-based trauma framework on identity traumas to study the cumulative effects of trauma on the identities of Syrian refugees. Participants included 196 Syrian refugees residing in Cairo, Egypt (Mean age = 35.99, SD = 11.05). The rate of post-traumatic stress disorder was 33.5%, and the rate of depression was around 30%; the level of comorbidity was high with a high rate of suicidal plans or attempts (13.7%). Analyses indicated that existential annihilation anxieties, moderated by identity salience, mediated the effects of cumulative trauma on mental health. The results confirmed the utility and validity of the identity trauma model and provided evidence of the dire mental health needs of Syrian refugees.     

Alexithymia Predicts Posttraumatic Growth and Distress After Trauma

The present study sought to investigate how alexithymia (a deficit in identifying and describing emotions) may hinder the development of posttraumatic growth (PTG) and contribute to ongoing distress. Participants were 250 undergraduate college students who had experienced a highly stressful event in the past six months. Regression analyses were conducted to examine how alexithymia contributes to PTG and distress in addition to other known predictors. Analyses revealed that alexithymia was a significant negative predictor of PTG, and a significant positive predictor of distress. It was also found that Difficulty in Identifying Feelings was the alexithymia component that best predicted PTG and distress.     

Exposure,Loss, and Support Predicting the Dimensions of Posttsunami Trauma

This study examined whether exposure, resource loss, and social support predicted the posttsunami trauma of PTSD, depression, negative affect, and physical health problems of the 2004 tsunami survivors. Four hundred sixteen survivors were interviewed in Tamil Nadu (India) 14 months posttsunami. Loss of life followed by loss of property and disaster exposure positively predicted the dimensions of trauma. Survivors having lower social status and income received less material and informational support than their equally affected counterparts, which furthered stress and distress. The survivors’ trauma can be arrested, minimizing the exposure and tangible resource loss, and improving the delivery of social support.     

Therapeutic response to Cognitive Processing Therapy in White and Black female veterans with military sexual trauma-related PTSD

Cognitive Processing Therapy (CPT) is an evidence-based treatment (EBT) for posttraumatic stress disorder (PTSD) which has been validated for female veterans with military-related PTSD. Existing trials have enrolled predominantly White veterans with some studies documenting higher rates of early termination from EBTs among Black females when compared to White females. Data from a previously published randomized clinical trial were used to evaluate the effectiveness of CPT for Black female veterans with military sexual trauma (MST)-related PTSD. Reductions in PTSD symptom severity, number of sessions attended, and early termination rates were compared between Black (n = 20) and White (n = 16) female veterans. A hierarchical linear modeling approach was used, with PTSD symptom severity over the course of treatment and follow-up entered as a level-1 variable and race (Black or White) entered as a level-2 predictor. Piecewise growth curves analyses revealed that both Black and White female veterans experienced significant reductions in PTSD symptom severity over the course of treatment and gains were maintained up to 6 months post-treatment. Race was not found to be a significant predictor of change in the slope of PTSD symptom severity over the course of CPT treatment. Additionally, number of sessions attended and rates of early termination did not significantly differ based on race. Results suggest that CPT was a well-tolerated and effective psychotherapeutic treatment for this sample regardless of racial self-identification.     

Preparing the Field for Feasibility Testing of a Parenting Intervention for War‐Affected Mothers in Northern Uganda

In this article, we discuss the successful implementation of an adapted evidence‐based parenting intervention for families affected by two decades of war in Northern Uganda. The adaptation and adoption of such interventions to support mental health and family functioning is widely endorsed by prevention scientists and considered a priority in global mental health. The preparation and early adoption phases of engaging with a highly vulnerable community affected by war trauma are documented in this paper along with a discussion of the steps taken to adapt a parenting intervention for cultural and contextual fit. This study is a component of an overall program of research aimed at reducing the long‐term negative effects of war on parenting practices and childhood outcomes, which have considerable implications for preventing mental, neurological, and substance‐use disorders. The processes described here cover a 4‐year period culminating in the implementation of the nine‐session Enhancing Family Connection intervention piloted with a group of 14 mothers. The lessons in cultural adaptation have been valuable and the feasibility results promising for further testing the intervention.     

Stupidity in the analytic field: Vicissitudes of the detachment process in adolescence

This paper has the objective of broadening the understanding of technical aspects in working with adolescents who defend themselves against detachment from infantile aspects through defensive organizations. These organizations numb the adolescent toward both triangular reality and narcissistic defenses. The families of such young people may be part of the organization and the analyst can also be recruited to participate in it. But the analyst's perception can become blurry and this fact makes him appear stupid. Aspects of the myths of Narcissus and Oedipus are used here as models for studying stupidity. The analysis of a psychotic teenage girl who is symbiotic in relation to her family shows how the analytical field can be invaded by defensive configurations. Collusions of idealization and domination/submission involve the young person, her family and the analyst but the defensive organizations are only identified after their traumatic breakdown. The expansion of the symbolic network allows symbiotic transgenerational organizations to be identified, while models related to enactments prove helpful for understanding technical ups and downs. The paper ends with imaginative conjectures where Oedipus, as ‘patient’, is compared to the patient discussed here. These conjectures lead to reinterpretations of aspects of the Oedipus myth. The reinterpretations, together with the theoretical and clinical study, may serve as models for understanding the technical ups and downs in working with troubled teens.     

Mind,brain and body. Healing trauma: the way forward

The paper explores an interdisciplinary whole person approach to healing from trauma that conserves our rich inheritance from Jung but also takes on board insights from research in the areas of attachment, trauma and the neurobiology of emotion. It is now over 20 years since insights from neurobiology began to be used to inform clinical practice. The paper reviews key insights which have emerged, along with the ways they enable therapists to help mind, brain and body to heal and the ways in which they clarify why, in clinical practice, we do what we do. Traditionally the emphasis has been on words, interpretations, and meaning‐making. Currently there is greater appreciation of the affective, relational, embodied aspects of therapeutic work and the way in which these relate to traumatic early interactive experience that is held outside of human awareness. The ways in which knowledge of particular systems of connectivity inform understanding of the whole mind‐brain‐body relationship are examined. The way forward for clinical practice to become more focused in order to help clients to heal in mind and body is reviewed.     

Why did adolescents have sleep problems after earthquakes? Understanding the role of traumatic exposure,fear, and PTSD

To examine the relationships between trauma exposure, fear, post‐traumatic stress disorder, and sleep problems in adolescents, 746 adolescent survivors of the 2008 Wenchuan earthquake in China were assessed at 1 year (T1) and 1.5 years (T2) after the earthquake using a trauma exposure questionnaire, a fear questionnaire, a child posttraumatic stress disorder symptom scale, and a subscale on child sleep problems. The results showed that T1 trauma exposure were not directly associated with sleep problems at T1 and T2, but played a positive role in sleep problems at both T1 and T2 indirectly through T1 posttraumatic stress disorder and T1 fear. T1 trauma exposure was also positively and indirectly associated with T2 sleep problems through T1 posttraumatic stress disorder via T1 sleep problems, or through T1 fear via the path from T1 posttraumatic stress disorder to T1 sleep problems. These findings indicated that fear and posttraumatic stress disorder 1 year after the earthquake played a mediating role in the relationship between trauma exposure at 1 year after the earthquake, and sleep problems at both 1 year and 1.5 years after the earthquake, respectively. In particular, posttraumatic stress disorder also had a multiple mediating effect in the path from trauma exposure to sleep problems via fear. Furthermore, the findings indicated that sleep problems were relatively stable between 1 and 1.5 years after an earthquake.