Traumatology current issue

Editorial

Figley, C. R. — Tue, 22 Sep 2009 23:57:16 PDT

Investigating the "Rescue Personality"

Wagner, S. L., Martin, C. A., McFee, J. A. — Tue, 22 Sep 2009 23:57:16 PDT

Mitchell and Bray use the term rescue personality as a way of describing characteristics of individuals who serve in the emergency services and describe emergency service workers as inner-directed, action oriented, obsessed with high standards of performance, traditional, socially conservative, easily bored, and highly dedicated.This rescue personality has provided an important foundation for the controversial Critical Incident Stress Management model; however, little empirical evidence is available demonstrating its existence.Previous literature has primarily considered emergency service personality characteristics as predictors of posttraumatic symptoms and/or effective job performance. Consequently, a gap in the literature exists with respect to research investigating the existence of a particular personality type for emergency service workers, as compared with those working in nonemergency occupations. The present project compared a group of paid professional firefighters (n = 94) with a comparison group (n = 91) who worked in nonemergency occupations. The hypotheses were guided by Mitchell’s description of the rescue personality.That is, according to Mitchell’s description, firefighters were expected to self-report lower levels of the characteristic openness to experience, higher levels of the characteristic conscientiousness, higher self-reported Type A behavior, and higher self-reported tolerance for risk-taking behavior. None of these hypotheses were supported; however, firefighters reported the characteristic of extraversion at significantly higher rates than did comparison participants.

Post-War Mental Health,Wealth, and Justice

Abi-Rached, J. M. — Tue, 22 Sep 2009 23:57:16 PDT

The paper launches a normative debate on an under-assessed health policy problem, namely post-war mental health. It explores its ethical dimensions and argues for a strong moral claim to invest in it as a form of reparation that must be added to the jus post-bellum’s truncated list of recommendations. Many countries are currently involved in armed conflict and many more still recovering from past wars. These generally belong to the low-to-middle income group that spend minimally on social and health expenditures.The problem worsens post-war for these countries are burdened with an increased prevalence of mental health disorders with far-reaching repercussions. Failure to recognize in particular war-related psychosocial sequels could weaken capacity to recover and may contribute to a nation’s socio-political unrest that could perpetuate throughout generations. The paper argues that reconstructing war-torn societies should be achieved by rebuilding first and foremost the shattered individual. Policy-makers have a stronger positive obligation to invest in post-war mental health because of a shared responsibility for the harm inflicted. This consequently means a shared responsibility in building a sustainable and viable post-war ‘minimally just state’.The paper draws on Pogge’s ‘relational conceptions of justice’ and the concept of‘shared responsibility’ used in contemporary environmental discourses. It challenges the old paradigmatic model of the just-war tradition which views the world as an archipelagos of well-delineated, self-contained and atomized actors. It also aims to set the stage for an ‘ethics of post-war mental health’ in line with what Ricoeur calls ‘an ethics of memory’.

Two Persisting Pathophysiological Visual Phenomena Following Psychological Trauma and Their Elimination With Rapid Eye Movements: A Possible Refinement of Construct PTSD and Its Visual State Marker

Tym, R., Beaumont, P., Lioulios, T. — Tue, 22 Sep 2009 23:57:16 PDT

This study reports practice-based clinical evidence related to observations of two novel pathophysiologic visual phenomena reported by certain patients to have persisted following the psychological trauma of an acute-fear experience. The initially obscure visual phenomena were initially investigated heuristically in psychiatric, psychological, and ophthalmic practices and subsequently characterized over 25 years.The first phenomenon:"A visual image of what had been seen and felt during the most frightening moment of an acute-fear experience is immediately stored abnormally, and subsequently recalled abnormally as an experiential hallucinatory-like visual-image and other sensory-memory flashback." The second phenomenon:"An abnormality of vision of peripheral oscillopsia, persisting from the time of the same acute-fear experience." The third phenomenon: "A high probability of stepwise simultaneous elimination of both visual phenomena follows the maneuver of repeatedly exposing each voluntarily evoked visual-image and other sensory memory to volitional rapid side-to-side eye movements, as per one aspect of eye movement desensitization and reprocessing.This maneuver leaves the memory stored and recalled normally (i.e., nonexperientially) and vision oscillopsia-free." Clinical features of patients with the visual phenomena are unique to each patient.The authors report further observations over 25 years on the wide spectra of difficulty, intensity, and/or obtrusiveness of each of the three visual phenomena and of three closely related clinical features. Relevant clinical findings pertaining to the visual phenomena in 100 recent consecutively referred patients are reported.The strong inference of these observations induces a schema: a further refinement of the construct posttraumatic stress disorder, together with a visual state marker.

Posttraumatic Stress and Quality of Life in Kidney Transplantation Recipients

Possemato, K., Geller, P. A., Ouimette, P. — Tue, 22 Sep 2009 23:57:16 PDT

Previous research has shown that kidney transplantation is a stressful life event; traumatic stress or posttraumatic stress disorder (PTSD) may hinder posttransplant quality of life (QOL). This study explored whether PTSD symptoms predicted posttransplant QOL among a sample of 63 kidney transplant recipients from a large inner-city hospital. Data were collected 3 to 6 months after transplant, with psychometrically sound self-report measures. PTSD symptoms were common in this sample; 21% reported symptoms consistent with a PTSD diagnosis, and an additional 19% reported significant subthreshold PTSD symptoms. PTSD severity was independently associated with overall QOL and with the emotional reaction and social isolation subscales of the QOL measure. Results suggest that PTSD may affect posttransplant QOL for kidney transplant recipients.

Reports of Community Violence Exposure, Traumatic Loss, Posttraumatic Stress Disorder, and Complicated Grief Among Guatemalan Aid Workers

Tue, 22 Sep 2009 23:57:16 PDT

This study explores exposure to community violence (CV) and traumatic loss and their relation to posttraumatic stress disorder (PTSD) and grief symptoms among Guatemalan aid workers. Out of 135 workers surveyed, 79% reported that someone close to them had died, and 33% reported a loss that was rated as traumatic. The average number of lifetime incidents of CV reported was 13, and the highest was 32. In all, 36% of the sample reported symptoms that meet criteria for PTSD.Those participants who reported a traumatic loss also reported significantly higher complicated grief (CG) scores, and those who reported a traumatic human-perpetrated loss also reported significantly higher levels of hyperarousal PTSD symptoms than those who reported a traumatic loss that was nonhuman perpetrated.

Muslim Men and Women's Perception of Discrimination, Hate Crimes, and PTSD Symptoms Post 9/11

Abu-Ras, W. M., Suarez, Z. E. — Tue, 22 Sep 2009 23:57:16 PDT

This study examined the relationship between race-based stress (racial harassment and discrimination) and PTSD in a sample of 102 New York Muslim men and women post-9/11 while controlling for gender. Bivariate, univariate, and stepwise regression analysis were used to analyze the data. Results of the study show that "feeling less safe" after the events of 9/11 emerged as the only significant predictor of PTSD (F = 10.32; p < .05). Gender discrepancies indicated that men and women differed in symptom expression and reactions. Whereas men were more likely to experience racial harassment, women were more likely to express fear of being in public places. Potential explanations, study limitations and implications are suggested.

Exploring the Helpfulness of Arts-Based Methods With Children Living in Foster Care

Coholic, D., Lougheed, S., Cadell, S. — Tue, 22 Sep 2009 23:57:16 PDT

This article considers the usefulness of arts-based group therapy methods in working with traumatized children. Although traditional effective forms of trauma treatment are necessary for many traumatized children, the authors explore how for some children living in foster care arts-based methods offer an appropriate and helpful approach, conducive to posttraumatic growth, which may be more suited to their particular needs and circumstances. The research is qualitative and sought to develop a better understanding of the impact of arts-based methods on children in care. We discuss how arts-based and experiential methods can help children in care feel better about themselves and develop coping abilities without direct discussion and/or working through of their traumatic life events.

Book Review: Rabbi Steven B. Roberts and Rev. Willard W. C. Ashley Sr. (Eds.). A Review of Disaster Spiritual Care: Practical Clergy Responses to Community, Regional and National Tragedy. Woodstock,VT: Skylight Paths, 2008. 348 pp. Hardcover $40.00. ISBN-13: 978-1-59473-240-9. ISBN-10: 1-59473-240-X

Figley, K. R. — Tue, 22 Sep 2009 23:57:16 PDT