Traumatology recent issues

The Attachment Characteristics of Combat Veterans with PTSD

Renaud, E. F. — 2008-08-19

Posttraumatic stress disorder (PTSD) from combat exposure has been found to have more disruptive effects on interpersonal and family functioning than trauma from other sources. Attachment theory and Foa's cognitive—behavioral model of PTSD suggest pathways by which the symptoms of PTSD may contribute to social impairment. Forty-nine self-selecting male veterans with combat-related PTSD were administered the Experience of Close Relationships (ECR) Scale, the Posttraumatic Cognitions Inventory (PTCI), the Mississippi Scale for combat PTSD, and a demographic questionnaire to test for relationships between attachment avoidance, attachment anxiety, cognitive distortions associated with PTSD, and PTSD symptom severity. Veterans were found to generally endorse avoidant attachment styles. Attachment avoidance and ambivalent attachment were associated with more PTSD symptoms. A hypothesis for the effects of PTSD symptoms on attachment characteristics, situating the findings within existing theory, is proposed.

Vicarious Resilience: A Qualitative Investigation Into Its Description

Engstrom, D., Hernandez, P., Gangsei, D. — 2008-08-19

This study further explores an investigation into the formulation of vicarious resilience with a U.S. sample. In semistructured interviews, 10 mental health providers working with survivors of torture were affected by their clients' stories of resilience. A grounded theory analysis of the transcripts found that participants were positively affected by the resilience of clients, their perspectives on life were altered, and they valued their therapy work with clients. These elements make up the phenomenon of vicarious resilience. Conceptual differences between vicarious resilience, posttraumatic growth, and empathic responses in trauma work are discussed.

Mothers' Awareness of Self-Harm Behaviors in Their Children

Sansone, R. A., Wiederman, M. W., Jackson, J. — 2008-08-19

This study examined mothers' awareness of seven self-harm behaviors in their adolescents who were being seen in an outpatient psychiatry clinic—namely, cutting self, burning self, hitting self, banging head, scratching self, preventing wounds from healing, attempting suicide. Using a cross-sectional self-report survey method with 71 mother—adolescent pairs, the study found (a) that self-harm behaviors were reported by 63.4% of the adolescent participants, most commonly, preventing wounds from healing and scratching self; (b) that there was a moderate level of concordance between mother and adolescent with regard to behaviors that were not being performed; (c) that in most cases of discordance, the mother denied a behavior that the adolescent indicated as having actually performed, most commonly, preventing wounds from healing; and (d) that mothers were significantly less likely to acknowledge self-harm behaviors in their adolescents as the number of self-harm behaviors reported by offspring increased (r = —.87, p < .001).

Relationships Between Psychopathological and Demographic Variables and Posttraumatic Growth Among Holocaust Survivors

Lurie-Beck, J. K., Liossis, P., Gow, K. — 2008-08-19

The relationship between posttraumatic growth and posttraumatic stress disorder (PTSD) symptoms, depression, anxiety, and vulnerability, as well as demographic differences in growth was examined in a group of 23 Holocaust survivors. The posttraumatic growth aspect of spiritual change was found to correlate positively and significantly with the PTSD symptom clusters of intrusion, avoidance, and hyperarousal. Numerous demographic variables were also found to relate to posttraumatic growth including survivors' age during the Holocaust; the nature of their Holocaust experiences; and whether they were ever alone, without family, during their Holocaust experiences as well as survivor support group membership.

Teaching Trauma Without Traumatizing: A Pilot Study of a Graduate Counseling Psychology Cohort

Black, T. G. — 2008-08-19

The author presents the findings of a pilot study examining students' experiences of Black's (2006) model for teaching a graduate trauma counseling course. Ten counseling psychology graduate students were administered an exit questionnaire following a trauma-counseling course in a Canadian university and, 9 questionnaires were returned. The pilot study is unique, and findings include the fact that students reported feeling more competent in dealing with trauma not only in their roles as counselors but also in their personal lives. Implications of the pilot study for future research and current teaching practice are discussed, along with recommendations for teaching counseling in general. Limitations of the pilot study include issues related to sample size and demographics, descriptive nature of the data, timing of the administration of the questionnaire, and the nature of self-report data. Results support the use of Black's (2006) model of teaching trauma to graduate students.

A Pilot Study of Posttraumatic Stress and Associated Functioning of Army National Guard Following Exposure to Iraq Warzone Trauma

2008-08-19

This study examines the experiences of a convenience sample of Army National Guard soldiers who were combat exposed during the Iraq War. Thirty-one men volunteered to complete an interview and questionnaires during training weekends. Participants reported significant posttraumatic stress disorder (PTSD) symptoms (68% reported re-experiencing and 93% hyperarousal symptoms) based on a PTSD research interview. PTSD severity was associated with more alcohol consumption, illicit drug use, and poorer mental health functional status. These data suggest that combat-exposed soldiers may be at risk for significant PTSD symptoms, higher consumption of substances, and decreased quality of life.

Secondary Trauma in Children of Parents with Mental Illness

Lombardo, K. L., Motta, R. W. — 2008-08-19

In this study, the relationship between parental mental illness with and without comorbid traumatic symptoms, and secondary trauma in children was explored. There were three groups of parent-child dyads (N = 106). Group I included parents with mental illness and comorbid traumatization, and their children. Group II included parents with mental illness and no traumatization, and their children. Group III included non-mentally ill parents and their children. The measures used in the study consisted of the Secondary Trauma Scale, the Center for Epidemiological Studies Depression Scale for Children, the Revised Children's Manifest Anxiety Scale, the Depression Anxiety and Stress Scale 21-Item Version, and the Modified PTSD Symptom Scale — Self Report. Results indicated that children of parents with mental illness experience significantly more secondary trauma than children of non-ill parents, regardless of parental traumatization. In addition, secondary trauma in children was correlated with depression and anxiety.

Eastern and Western Spiritual Beliefs and Violent Trauma: A U.S. National Community Survey

Lee, L.-C., Connor, K. M., Davidson, J. R. T. — 2008-08-19

Spirituality is relevant to overall health and well-being, yet little is known about spiritual beliefs (SBs) in community samples. This report examined the associations between SBs and trauma history, and SBs and post-traumatic stress disorder (PTSD) symptoms. Data were collected through an online survey from community samples that were representative of the U.S. adult population (n = 1,969) in 2001. Measures of SB comprised concepts and beliefs familiar to both Western and Eastern cultures. We found that Eastern SBs (ESBs), but not Western SBs (WSBs), were associated with a history of violent trauma. Among those who had experienced violent traumas, agreements with ESBs and WSBs were related to more severe PTSD symptoms. The mechanism of acquisition and effects of SBs remain unknown. For clinicians who decide that inquiry into the SBs of a patient is indicated, it may be of value to keep in mind that differences between SB types, as described in this article, may exist and to take these differences into account, as appropriate, in patient management. Some clinical and scientific implications of this work are discussed.

Understanding the Impact of Trauma on Family Life From the Viewpoint of Female Caregivers Living in Urban Poverty

Kiser, L. J., Nurse, W., Lucksted, A., Collins, K. S. — 2008-08-19

Children and their families living in poor, inner-city neighborhoods are at high risk for experiencing multiple traumas. This article describes findings from a qualitative study designed to explore the impact of chronic traumas on family life through the voices of primarily African American caregivers coping with urban poverty. Structured interviews are conducted with 16 caregivers of children ages 6 to 9 years who had been exposed to multiple traumas and had symptoms of posttraumatic stress disorder. Caregivers explain changing daily routines to accommodate child distress and promoting positive family processes such as increased protectiveness. They also describe various roles that religion/spirituality play in their coping with trauma, including finding comfort in the faith that God controls what happens in their lives. These themes are discussed with regard to theory and practical applications for assisting traumatized families.

Shame and Guilt, Misconceptions and Controversies: A Critical Review of the Literature

Blum, A. — 2008-08-19

The literature on shame and guilt is very heterogeneous. Researchers and theorists in the field have used a number of definitions, approaches, and measurement methods, rendering futile any attempt at a comparative analysis. The article reviews the relevant literature and summarizes the different approaches to shame and guilt while highlighting relevant conceptual issues. The literature review is followed by a thorough delineation of the two constructs. Affective, cognitive, and phenomenological definitions are discussed for a fuller understanding of the phenomena. The cognitive attributional theory is discussed and is also used to explain the process of elicitation. The delineation of shame and guilt is followed by a comprehensive discussion of parsimony. In addition to drawing attention to the current multiplicity of definitions in the literature, the article intends to serve as a more unified framework for future studies of shame and guilt.

Somatic Therapy Treatment Effects With Tsunami Survivors

Parker, C., Doctor, R. M., Selvam, R. — 2008-08-19

This is an uncontrolled field study of the outcome effects of a somatically based therapy with tsunami victims in southern India. One hundred and fifty (150) participants, prescreened for trauma symptoms, received 75 minutes of somatic therapy and training in affect modulation and self-regulation. The results indicate a reliable and significant treatment effect at immediate, 4-week, and 8-month follow-up assessments. At the 8-month follow-up, 90% of participants reported significant improvement or being completely free of symptoms of intrusion, arousal, and avoidance. The results support the effectiveness and reliability of this modified version of Somatic Experiencing Therapy in working with trauma reactions and invite future controlled trials of this therapy.

Between Culture and Family: Jewish-Israeli Young Adults Relation to the Holocaust as a Cultural Trauma

Lazar, A., Litvak-Hirsch, T., Chaitin, J. — 2008-08-19

This study assessed how Jewish-Israeli young adults perceive the impacts of the Holocaust on themselves, their family, and Israeli society. The written responses of 180 respondents, 90 of whom were grandchildren of Holocaust survivors (GHSs) and 90 were without a direct family connection (NGHSs), connected the Holocaust with issues of security, education, and culture and the impact, or lack of it, on family and self. These responses also suggest that NGHS relate to the Holocaust only through sociocultural mechanisms, and that GHSs are influenced by the same sociocultural mechanisms yet are also divided by the perceived impact of intergenerational processes on their personal and family lives. The overall results of the study suggest that regardless of family connection to the Holocaust, in Israel there are sociocultural mechanisms at work that affect the perception of the Holocaust on the third generation of Holocaust survivors as a cultural trauma.

Book Review: The Trauma Spectrum: Hidden Wounds and Human Resiliency, by Robert C. Scaer. New York: Norton, 2005

Robinson, R. — 2008-08-19

Teaching Trauma-Related Insight Improves Attitudes and Behaviors Toward Challenging Clients

2008-06-26

Effective dissemination of treatment methods requires not only training in high-profile interventions but also in cases of conceptualization and treatment planning skills that facilitate use of the interventions. In a series of six studies, the authors tested one training module with 303 paraprofessionals and mental health professionals in various training settings and five countries. Participants completed self-report ratings in response to a challenging acting-out client, both before and after completing a trauma-informed case-formulation exercise. The training intervention led participants to report decreased distress while considering challenging work-related scenarios, increased empathy and caring toward challenging clients, and increased comfort and confidence in their helping roles. In the final two studies, a trauma-informed treatment planning module was added, yielding additional benefit. At follow-up participants reported that the effects persisted and led to improved behaviors toward the clients. Such empirical validation of training methodologies can lead to more reliably effective dissemination.

Recovery Following Hurricane Rita: A Pilot Study of Preexisting and Modifiable Aspects of Positive Change

Borja, S. E., Callahan, J. L. — 2008-06-26

Facets of personality from the Big 5 model, familial coping mechanisms, and interpersonal support were selected to predict perceived benefits and subjective well-being with 43 participants from varied ages, income levels, and ethnicities who experienced a natural disaster. Results indicate positive changes were predicted by distinct variables (mental healthiness was predicted by high agreeableness, passive appraisal, and reframing, accounting for 43% of the variance, whereas perception of benefits was predicted by high conscientiousness and seeking social support, which accounted for 50% of the variance). Thus, it appears that long-standing, pretraumatic individual and familial differences predict these posttraumatic outcomes.

The Emotional Impact on and Coping Strategies Employed by Police Teams Investigating Internet Child Exploitation

Burns, C. M., Morley, J., Bradshaw, R., Domene, J. — 2008-06-26

Work on Internet child exploitation (ICE) teams require individuals to perform a number of investigative tasks, including viewing graphic images and videos of young children being sexually assaulted and tortured, to identify victims and locate perpetrators. Individuals involved in this work may be at higher risk for experiencing secondary traumatic stress because of the graphic images and sounds to which they are exposed. The impact of ICE investigations and what helps and hinders coping with the work was explored using the Critical Incident Technique with 14 members of a Royal Canadian Mounted Police integrated ICE team. Results suggest that there are a number of organizational and personal strategies that can assist those who work in this field to cope more effectively.

Helping Till It Hurts? A Multimethod Study of Compassion Fatigue, Burnout, and Self-Care in Clinicians Working With Trauma Survivors

Killian, K. D. — 2008-06-26

There is burgeoning interest in secondary traumatic stress, compassion fatigue, and self-care in the helping professions. This multimethod study focused on therapists' stress and coping in their work with trauma survivors, identifying factors related to resilience and burnout. Semistructured interviews were conducted with 20 clinicians subscribing to a systems perspective, and 104 clinicians were administered a questionnaire inquiring about their caseloads, trauma history, coping styles, emotional self-awareness, work stress, compassion satisfaction, compassion fatigue, and burnout. Interview data demonstrated that therapists detect job stress through bodily symptoms, mood changes, sleep disturbances, becoming easily distracted, and increased difficulty concentrating. Self-care strategies included processing with peers/supervisor, spirituality, exercise, and spending time with family. In the quantitative study, social support, work hours, and internal locus of control accounted for 41% of the variance in compassion satisfaction. Multiple regression procedures accounted for 54% of the variance in compassion fatigue and 74% of the variance in burnout. Implications for clinical training and organizational policy are discussed.

Individual and Group Treatment and Self and Other Representations Predicting Posttraumatic Recovery Among Former Political Prisoners

Salo, J., Punamaki, R.-L., Qouta, S., El Sarraj, E. — 2008-06-26

The role of individual and group treatment and self and other representations in predicting posttraumatic symptoms and growth was examined among 115 Palestinian former political prisoners. Twenty participated in individual therapy and 19 in group therapy; 76 belonged to the control group. The results showed that posttraumatic symptoms decreased only in the individual therapy, whereas no decrease was found in group therapy or control groups across 1 year. Somatic symptoms decreased generally, whereas no general or treatment-related change was found in posttraumatic growth. As hypothesized, representations characterized by positive contents (benevolent, ambitious, and nonpunitive) predicted decrease in symptoms and increase in posttraumatic growth. Furthermore, positive content and mature, differentiated, and nonambivalent structure of representations predicted decrease in posttraumatic symptoms and increase in posttraumatic growth in group therapy, but not in individual therapy. The role of cognitive-emotional reworking of interpersonal representations in trauma therapies is discussed.

Measuring Cumulative Trauma Dose, Types, and Profiles Using a Development-Based Taxonomy of Traumas

2008-06-26

This study presents a new short scale for measuring cumulative trauma dose, types, and profiles that is based on the APA (American Psychological Association) trauma Group (currently division 56) definition of trauma and a new, two-way development-based taxonomy of trauma. The new measure was tested using a sample of 501 Iraqi refugees who are one of the most traumatized groups. The following six salient factors were found: collective identity, family, personal identity, interdependence or secondary, man-made or nature-made survival, and abandonment types of traumas. The study provided evidence of adequate reliability; construct, convergent, divergent and predictive validity of the new scale and provided partial confirmation of the validity of the development-based taxonomy of traumas. A new method was introduced to measure trauma types and profiles and their differential association with different symptom configurations and health disorders. The newly developed measure can be used in clinical trauma-informed settings and in research.

Post-Katrina Storm Disorder and Recovery in Mississippi More Than 2 Years Later

Scurfield, R. — 2008-06-26

This commentary describes a Katrina survivor and provider's dual perspective 2 years post—Hurricane Katrina. Highlights of the impact on individual, family, community, and regional levels and on social, economic, and mental health levels are identified. This includes discussion of "post-Katrina storm disorder," the plight of the poor and near-poor and immigrants, a cognitive reframing intervention for disaster relief agency workers, helpful clinical strategies, impact on religious and spiritual beliefs, and a modified "six stages of disaster recovery." Finally, positive developments are elaborated concerning changes in personal priorities, life in a FEMA trailer, metamorphosis of the University of Southern Mississippi Gulf Coast campus, the role of volunteers, and resident self-help and personal life commitments.

Book Review: Collaborative Treatment of Traumatized Children and Teens: The Trauma Systems Therapy Approach, by G. N. Saxe, B. H. Ellis, & J. B. Kaplow. New York: The Guilford Press, 2007

Readdick, C. A. — 2008-06-26

Editorial

Figley, C. R. — 2008-06-11

The 2007 Virginia Tech Shootings: Identification and Application of Lessons Learned

Figley, C. R., Jones, R. — 2008-06-11

The Tragic Shootings at Virginia Tech: Personal Perspectives, Prospects, and Preventive Potentials

Geller, E. S. — 2008-06-11

This discussion article reviews events and personal reactions following the mass killing at Virginia Tech that took the lives of 27 students and 5 professors, while injuring 29 more, on April 16, 2007. A positive view is attempted by exemplifying incredible campus leadership and resolve throughout the painful aftermath, as well as "reaching-out" communication revealing worldwide concern and compassion. The implementation of certain intervention strategies to increase proactive interpersonal communication for safety, security, and human welfare is advocated to prevent similar catastrophes. The author calls this intervention focus "actively caring," and discusses ways to increase the quantity and quality of this behavior, as gleaned from empirical research and industry-based applications. It is hoped that this presentation will activate relevant conversations, action plans, and research proposals.

Seeing the Picture From Inside the Frame: Two Therapists' Observations Following the Virginia Tech Tragedy

Keeling, M. L., Piercy, F. P. — 2008-06-11

Helping in the Wake of Disaster: A Graduate Student's Perspective in the Aftermath of the VT Tragedy

Yoder, M. — 2008-06-11

This article reviews the shootings at Virginia Tech and the subsequent community reactions from the perspective of a graduate student in clinical psychology. Graduate students in the psychology department took on various roles in the aftermath of the disaster and were thus exposed to different attempts at helping from both outside and within the Blacksburg community. Experiences and perspectives of the author are discussed and three observations are made regarding the nature of giving aid in the wake of a community trauma. These observations address (1) the strong desire to help, (2) nuances of social support, and (3) community resilience and healing.

Loneliness and Belonging: A Reflection on the Meanings and Values of Social Networks in the Wake of the Virginia Tech Shootings

Gervich, C. D. — 2008-06-11

This reflection draws on the author's personal and professional interest in social networks, social capital, and community to explore the implications of losing significant members of one's social network to catastrophic events such as the April 16, 2007, Virginia Tech (VT) shootings. Social theorists posit that the strength of weak ties comes from the opportunities that they present. Weak ties offer opportunities to meet others, expand networks, and become more embedded in our communities. Therefore, for the author, the events of 4/16 represent not only the loss of a friend but also a loss of opportunity. The VT shootings have pushed him to consider whether personal relationships and social networks can be objectified to the point that they may be managed. On a second analytical level, the shootings have pushed him to ask how local governments may incorporate social networks, community, and social capital into emergency planning and recovery efforts.

From Individual to Community: The "Framing" of 4-16 and the Display of Social Solidarity

Ryan, J., Hawdon, J. — 2008-06-11

On April 16, 2007, a lone gunman killed 32 people at Virginia Tech. In this essay, we discuss what we personally experienced on 4-16 and what we did as faculty members of the sociology department in the first few weeks after 4-16. We place these events in the context of framing theory and the social construction of reality. We then offer insights regarding the surge in community spirit we witnessed immediately after the event. We discuss the well-documented relationship between tragedies and social solidarity. Although the surge in solidarity witnessed at Virginia Tech after the shootings often occurs after tragedies, we argue that social solidarity does not automatically follow tragedy. Instead, the tragedy must meet at least four specific conditions that allow individual interpretations of the event to blend with collective interpretations in a manner that produces a synergistic effect.

A Narrative of Personal Experiences and Recovery Efforts Carried Out in the Wake of the Virginia Tech Shootings

Immel, C. S., Hadder, J. M. — 2008-06-11

This article will serve as a forum for two graduate students enrolled in Virginia Tech's clinical psychology doctoral program to discuss their experiences on the day of the shootings of April 16, 2007, describing both their personal reactions to the events as well as the playing out of their professional roles immediately following the shootings. Topics discussed include therapeutic clinical work carried out with survivors and family members of the victims on the day of the shootings, clinical work with ongoing patients affected by the shootings, the gathering and developing of training materials for clinicians, teaching courses in the wake of the shootings, and completing assessments of members of the Virginia Tech community for the University's needs-based assessment. The article concludes with a discussion of lessons learned and recommendations for future community disaster relief.

Anger, Aggression, and Psychology: Personal and Professional Reflections on the Virginia Tech Tragedy

Cox, D. E. — 2008-06-11

Anger and aggression make up one of the most substantial bodies of literature within the behavioral sciences. The importance of fully understanding the nature of these phenomena are made painfully clear in the wake of violent tragedies such as the one that occurred on the campus of Virginia Tech. Inevitably, the question is how may we, as social scientists, do a better job at predicting and preventing such events? Although a definitive answer to this question may not be immediately obtainable, the current review and discussion attempts to illuminate how the integration of the diverse concentration areas of psychology may provide a starting point. Neuropsychology, social psychology, and clinical psychology (in all manifestations) can be utilized in a cohesive manner that will improve the prediction and prevention of aggression. The events of April 16th are examined from personal and professional viewpoints to provide relevant and salient examples.

A Digital Library for Recovery, Research, and Learning From April 16, 2007, at Virginia Tech

2008-06-11

The authors are developing a digital library to help during the long-term recovery from the mass shooting on April 16, 2007 at Virginia Tech. Content comes from uploaded texts, images, videos, and other files, as well as pages crawled from the Web and information collected, with permission, from those working with Web 2.0 sites such as Facebook and Flickr. The authors are applying data/text mining, social network analysis, and information visualization methods to facilitate systems science, providing key added-value services, especially to social and behavioral scientists seeking faster and easier ways to analyze, model, understand, and test hypotheses. The article also considers how technologies influence communications. The authors aim to support the university, local community, region, nation, and the world, as it seeks to learn from a tragic event.

When Hometown News Becomes Worldwide News

Alvis-Banks, D. — 2008-06-11

Editor's Note: This reporter is a 2007 winner of a Dart Center for Journalism and Trauma Fellowship based on her reporting of the April 16, 2007, shootings at Virginia Tech. Following the same structure of other articles in this special issue, this one first describes her personal experiences with the shootings in chronological order and offers some lessons learned while applying the knowledge and perspectives of a professional journalist.

Personal Reflections on the Virginia Tech Tragedy From a Victim's Spouse With Commentary by a Close Colleague

Nowak, J., Veilleux, R. E. — 2008-06-11

This is a story of one of the Virginia Tech professors whose wife, a charismatic French instructor, Jocelyne Couture-Nowak, was killed in her Norris Hall classroom on April 16, 2007 while trying to protect her students from the armed, deranged student-shooter threatening her classroom. Jerzy is the head of the Horticulture Department at Virginia Tech. The author reflects on his and his youngest daughter's posttraumatic and secondary traumatic experiences, focusing mostly on the interface between family and his profession. Jerzy's reflections are complemented by those of Richard Veilleux (text in italics), a professor in Jerzy's department who served as acting head while Jerzy was coping with primary needs after his wife was slain. As a plant stress physiologist/eco-physiologist, Jerzy sees a more generic biological pattern of adaptation to extreme situations by comparing the role that community played in his and his family's posttraumatic adaptation to everyday life to the alliances that plants form with soil microorganisms that help them to withstand stresses.

4-16: Who's Looking Out for the Kids?

Jones, R. T. — 2008-06-11

The present article describes the events of April 16, 2007, from the author's perspective. Initial steps, including interaction with graduate students, community partners, and university administrations are detailed. Additionally, the development of a working model to guide mental health efforts in both the university and local community is described. The steps in the designing and administration of a needs assessment followed by lessons learned are also presented.

Vicarious Trauma: The Impact on Solicitors of Exposure to Traumatic Material

Vrklevski, L. P., Franklin, J. — 2008-06-11

This study explored vicarious trauma in the legal profession. A random sample of male and female criminal law (n = 50) and noncriminal law (n = 50) solicitors completed a research pack containing the following questionnaires: a demographic questionnaire; Vicarious Trauma Scale; Satisfaction With Work Scale; Depression, Anxiety, and Stress Scales; Impact of Event Scale—Revised; and Trauma and Attachment Belief Scale. Criminal lawyers reported significantly higher levels of subjective distress and vicarious trauma, depression, stress, and cognitive changes in relation to self-safety, other safety, and other intimacy. No significant differences were found between the two groups on measures of satisfaction with work or coping strategies in relation to work-related distress. Multiple trauma history was associated with higher scores on measures of symptomatic distress.

Encoding States: A Model for the Origin and Treatment of Complex Psychogenic Pain

Ruden, R. A. — 2008-06-11

Pain that is "unanatomical" in distribution, for which there is no recent history of trauma, no evidence of a peripheral lesion and that resists traditional treatment, should be considered to be of psychogenic origin. The term complex psychogenic pain can be used when autonomic changes such as temperature abnormalities and physical findings such as tenderness accompany the pain. It is proposed that complex psychogenic pain is co-encoded centrally during a traumatizing event where the person experiences rage or fear with concomitant pain but is constrained from responding to the circumstances. Complex psychogenic pain is encoded as dissociated from the event. However, subsequent subconscious stimuli that recreate similar emotional, somatosensory, or cognitive states can activate a re-perception of the traumatic pain and engage various vasomotor processes. It is speculated that complex psychogenic pain is generated from amygdala efferents and is encoded in such a manner that precludes simple forgetting. Therapy consists of either delinkng the amygdala-based connection between the memory of the event and the emotional/somatosensory response or directly inhibiting amygdala outflow. Successful therapy extinguishes the pain.

Energy Psychology in Disaster Relief

Feinstein, D. — 2008-06-11

Energy psychology uses cognitive operations such as imaginal exposure to traumatic memories or visualization of optimal performance scenarios—combined with physical interventions derived from acupuncture, yoga, and related systems—to induce psychological change. Although a controversial approach, this combination purportedly brings about, with unusual speed and precision, therapeutic shifts in affective, cognitive, and behavioral patterns that underlie a range of psychological concerns. Energy psychology has been applied in the wake of natural and human-made disasters in the Congo, Guatemala, Indonesia, Kenya, Kosovo, Kuwait, Mexico, Moldavia, Nairobi, Rwanda, South Africa, Tanzania, Thailand, and the United States. At least three international humanitarian relief organizations have adapted energy psychology as a treatment in their postdisaster missions. Four tiers of energy psychology interventions include (1) providing immediate relief/stabilization, (2) extinguishing conditioned responses, (3) overcoming complex psychological problems, and (4) promoting optimal functioning. The first tier is most pertinent in psychological first aid immediately following a disaster, with the subsequent tiers progressively being introduced over time with complex stress reactions and chronic disorders. This article reviews the approach, considers its viability, and offers a framework for applying energy psychology in treating disaster survivors.

Book Review: Help for the Helper: The Psychophysiology of Compassion Fatigue and Vicarious Trauma, by B. Rothschild. Norton, New York, 2006

Nader, K. — 2008-06-11

Book Review: Mapping Trauma and Its Wake: Autobiographical Essays by Pioneer Trauma Scholars, edited by Charles R. Figley. New York: Routledge, 2006

Benedek, E. P. — 2008-06-11

Book Review: Compassion Fatigue in the Animal-Care Community, by C. R. Figley and R. G. Roop. The Humane Society of the United States, Washington D. C., 2006

Bride, B. E. — 2008-06-11

Book Review: Cultural Diversity and Suicide: Ethnic, Religious, Gender, and Sexual Orientation Perspectives, by M. M. Leach. New York: Haworth Press, 2006

Campbell, M. H. — 2008-06-11

Media Review: When Helping Hurts: Sustaining Trauma Workers, J. Boaz and A. Panos (Producers), VHS or DVD, 1998 (Distributed by Gift from Within, l6 Cobb Hill Road, Camden, Maine 04843) (Running time 50 minutes, $75.00)

Nader, K. — 2008-06-11

Media Review: When Helping Hurts: Preventing and Treating Compassion Fatigue, J. Boaz, A. Panos, P. Panos, and C. Steele (Producers), VHS or DVD, 2006 (Distributed by Gift from Within, l6 Cobb Hill Road, Camden, Maine 04843) (Running time 17 minutes, $30.00)

Nader, K. — 2008-06-11

Book Review: Stress, Coping, and Development: An Integrative Perspective, 2nd ed., by C. M. Aldwin. New York: Guilford, 2007

Wilkins, B. — 2008-06-11

Retraction of Earlier Article and Letter to Editor on Thought Field Therapy

Pignotti, M. — 2008-06-11

Editorial

Figley, C. R. — 2008-01-29

An Introduction to the Special Issue on the MHAT-IV

Figley, C. R. — 2008-01-29

The Intensity of Combat and Behavioral Health Status

Castro, C. A., McGurk, D. — 2008-01-29

This is part of the fourth report of the US Army's Mental Health Advisory Team but the first to study and report on Marines as well as Soldiers. During 2006, a total of 1,320 Soldiers and 447 Marines were interviewed during their deployment to Iraq, including focus-group sessions that also included behavioral health providers. The Soldier/Marine Well-Being Survey was utilized. Areas covered in the survey included (1) environmental risk factors, (2) protective factors, and behavioral health status and well-being. There were demographic differences between Soldiers (older, more senior ranking, more educated, more likely to be married and have children) compared to Marines. Soldiers were also more likely to be deployed longer (9 months versus 6 months). Among the central findings reported here are that level of combat (intensity) is the main determinant of behavioral health challenges, followed by deployment-related issues (length, frequency, time between deployments).

Battlefield Ethics

Castro, C. A., McGurk, D. — 2008-01-29

This is the second article derived from the MHAT-IV public domain report and is the first attempt to address the issue of battlefield ethics in the current Iraq war. The study summarized here attempted to address the ethical behavior associated with the treatment of insurgents and noncombatants, battlefield ethical actions and decisions associated with perceived rules of engagement, reporting of violation of such rules, and battlefield ethics training. Each area was assessed using either a five- or six-item questionnaire designed for this study. They were part of the same larger MHAT-IV study noted in the previous article. The article reports the results using a series of figures.

Suicide Prevention Down Range: A Program Assessment

Castro, C. A., McGurk, D. — 2008-01-29

This is the fourth attempt to assess the suicide rate and reasons for suicide among soldiers deployed to Iraq, as part of a larger effort of reporting throughout the Army. This article notes that there have been 72 confirmed U.S. soldier suicides in this war to date and describes the procedure for collecting these data, including inclusion criteria. The majority of these deaths involved single, White, male, junior enlisted soldiers, with the cause of death being a self-inflicted gunshot wound and is consistent with profiles of earlier reports. The implications of these findings for improving the Suicide Prevention Program are discussed.

Review: MHAT IV OIF Commentary

Koffman, R. L. — 2008-01-29

Mental Health Advisory Team IV has had a profound impact on military policy, public opinion, and interventional strategies. As an experienced combat veteran, the author characterizes the impact Mental Health Advisory Team IV has had within the military mental health community, as well as on community mental health overall.

Commentary on MHAT-IV: Struggling to Reduce the Psychological Impact of War

Lyons, J. A. — 2008-01-29

Using data from varied surveys and focus groups, the U.S. military's fourth Mental Health Advisory Team report (MHAT-IV) quantifies the heavy burden of family separation, danger, exhaustion, and heartbreaking moral choices borne by combat troops. Recommendations put forth by MHAT-IV are already influencing training, deployment scheduling, and mental health policies. Such efforts to minimize war stress are commendable. MHAT-IV highlights that unit leadership may be key in reducing combat's impact on mental health. Determining ideal deployment length (both per deployment and cumulative) and interdeployment interval may involve factors not addressed by MHAT-IV. Additional variables for consideration in future assessments are suggested, including survivor guilt (particularly in relation to the suicide-prevention buddy system) and sexual trauma. The findings show that troops, behavioral health personnel, and chaplains each belong to somewhat different cultures. Current debates regarding military ethics indicate that optimally integrating these cultures will likely remain a challenge.

Commentary on the Mental Health Advisory Team IV Operation Iraqi Freedom Final Report

Grantz, K. L. — 2008-01-29

Understanding the fundamental schematic shifts servicemen and women experience as a result of combat is imperative to treating the symptoms and behaviors that may develop postdeployment. Altered perceptions of the world and themselves as a result of combat exposure may include dehumanization of the enemy and perception of the world at large as a fundamentally unpredictable and dangerous place. Although this is an adaptive human response, these altered perceptions may be slow to "reset" on return from combat, disrupting readjustment. Factors that may influence the ability of these perceptions to reset after combat exposure include the type of traumatic events experienced, the ability to identify combatant from noncombatant in the combat arena, one's experience of their own command, and postdeployment experiences that either negate or reinforce the altered perceptions.

A Commentary on the MHAT IV Final Report: A Former Guardsman's Point of View

Chapman, P. L. — 2008-01-29

The Value of Mental Health Assessments

Donahue, P. — 2008-01-29

Commentary on the MHAT IV Recommendations: An Update

Ritchie, E. C. — 2008-01-29

MHAT IV Commentary

Castro, C. A., McGurk, D. — 2008-01-29

Blended Versus Era-Specific Group Therapy for Veterans

Lyons, J. A., Swearingen, A. D. — 2008-01-29

Resilience of Israeli Body Handlers: Implications of Repressive Coping Style

Solomon, Z., Berger, R., Ginzburg, K. — 2008-01-29

This study assessed posttraumatic and psychiatric symptomatology and perception of threat among Israeli rescue workers whose work involves body handling following terrorist attacks. In addition, implications of level of exposure and repressive coping style were examined. Eighty-seven volunteer body handlers filled out a battery of self-report questionnaires. Despite high levels of exposure, results revealed considerable resilience in these men. In addition, repressors reported lower levels of psychiatric symptomatology than nonrepressors. Several explanations are suggested for body handlers' resilience, among them their strong religious beliefs, their motivation as volunteers, and self-selection factors. Implications of repressive coping style are also discussed.

Fearing Future Terrorism: Development, Validation, and Psychometric Testing of the Terrorism Catastrophizing Scale (TCS)

Sinclair, S. J., LoCicero, A. — 2008-01-29

The purpose of this study was to develop a new tool, the Terrorism Catastrophizing Scale (TCS), rooted in terror management theory (TMT) and cognitive-behavioral theory (CBT). Participants were adults sampled from the general U.S. population (N = 503) using internet-based methods. Psychometric analysis indicates a 13-item version of the TCS, measuring three constructs (Rumination, Magnification, and Helplessness), met all tests of scaling assumptions and generally fit a 3-factor model using confirmatory factor analysis (CFA; CFI = 0.96; TLI = 0.98), where CFI is the comparative fit index and TLI is the Tucker-Lewis index. Results also indicate that self-esteem and social connected-ness are negatively associated (P < .0001) with terrorism catastrophizing, as TMT would assume. Finally, terrorism catastrophizing is a significant predictor (P < .0001) of behavioral change and of symptoms of anxiety, depression, and physiological stress, as CBT would maintain. The implications and limitations of this study are discussed.

Book Review: Cognitive-Behavioral Therapy for PTSD: A Case Formulation Approach, by C. Zayfert and C. B. Becker. Guilford Press, New York, 2007

Herman, S. M., Roudebush, R. L. — 2008-01-29

Media Review: Living With PTSD: Lessons for Partners, Friends and Supporters, J. Boaz (Producer) and D. Berez (Director), Motion Picture, 2004 (Available from Gift From Within, 16 Cobb Hill Road, Camden, Maine 04843) (Approximate running time 18 minutes, $30.00)

Herman, S. M., Roudebush, R. L. — 2008-01-29

Media Review: Surviving Trauma & Tragedy: Lessons for Future Physicians, Keith Etheridge and Frank M. D. Ochberg (Producers) and Paul Schneider (Director), DVD, 2006, A Presentation From The Michigan Victim Alliance (Distributed by Gift From Within, 16 Cobb Hill Road, Camden, Maine 04843) (Running time 82 minutes, $50.00)

Martin, J. — 2008-01-29