Traumatology recent issues

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

Editorial

Figley, C. R. — Mon, 22 Jun 2009 01:50:31 PDT

Examining the Impact of Hurricane Katrina on Police Responses to Domestic Violence

Buttell, F. P., Carney, M. M. — Mon, 22 Jun 2009 01:50:32 PDT

The purpose of this study was to investigate the New Orleans Police Department's (NOPD) responses to domestic violence both pre— and post—Hurricane Katrina. This study employed a secondary analysis of data collected by the NOPD in New Orleans, Louisiana, from 2002 through 2006. Analysis indicated that the NOPD actively responded to domestic violence calls following Hurricane Katrina and that domestic violence did not get relegated to secondary status as a consequence of rising demand for police intervention in the city following the crisis precipitated by the hurricane. This article concludes with a discussion of the NOPD's response to the community need for more intensive policing following the storm, particularly to the increase in domestic violence calls, and of the rate of domestic violence occurring in New Orleans following the hurricane.

Exposure, Avoidance, and PTSD Among Hurricane Katrina Evacuees

Sprang, G., LaJoie, A. S. — Mon, 22 Jun 2009 01:50:32 PDT

This article describes an investigation into the relationship between exposure, avoidant coping, and posttraumatic stress disorder (PTSD) in Hurricane Katrina evacuees. Specifically, this study examines the unique contribution of the dose of exposure to variance in PTSD and provides a mediational analysis to deter mine the degree to which avoidant coping affects the relationship between exposure and PTSD. Findings reveal that the dose of exposure is a strong predictor of threshold-level PTSD at 1 year postdisaster and identifies avoidant coping strategies as a partial mediator between exposure and the development of PTSD. Identification of avoidant coping as a significant factor in the causal pathway between exposure and PTSD provides a clearly definable and specific target for clinical intervention.

History, Memory, and Disasters Among Older Adults: A Life Course Perspective

Shenk, D., Ramos, B., Kalaw, K. J., Tufan, I. — Mon, 22 Jun 2009 01:50:32 PDT

This article is based on a review of a growing literature that examines disasters as experienced globally by older adults. The authors utilize a life course perspective that allows them to view the impact of experiencing a disaster for individuals within the context of their life experiences, memories, values, and views. The authors urge consideration of how individual and social history and memory affect the experience, coping strategies, and effects of disasters on older adults. The analysis is organized by the following four themes derived from the literature: (a) physical impact, (b) psychological impact, (c) social support issues, and (d) predictors of mental health distress. The authors highlight the challenges and issues of disasters, specifically for the aging population, including age, gender, and coping styles.

A Preliminary Investigation of Mental Health Needs and Barriers to Mental Health Care for Female Veterans of Iraq and Afghanistan

Owens, G. P., Herrera, C. J., Whitesell, A. A. — Mon, 22 Jun 2009 01:50:32 PDT

Fifty female veterans of the wars in Iraq and Afghanistan completed an Internet survey related to their mental health needs, service utilization, and barriers to seeking mental health care within the Veterans Administration (VA) system. Veterans completed several self-report measures including the PTSD Checklist—Military, Center for Epidemiologic Scales—Depression, and Hopkins Symptom Checklist—21. The most frequently reported concerns for which participants indicated they needed counseling were depression, relationship issues, anxiety, and anger management. Although 78% of respondents reported that they felt they needed treatment in the past year, 42% of these individuals indicated that they did not seek counseling. Two commonly reported barriers to seeking mental health services in the VA were long waiting periods for appointments and prior bad experiences. Mental health concerns and symptoms of returning female veterans indicate the need for treatment, but a significant gap remains in the self-reported need for assistance and seeking of services.

Predictors of Acute Stress Symptoms in Rape Victims

Elklit, A., Due, L., Christiansen, D. M. — Mon, 22 Jun 2009 01:50:32 PDT

Victims of traumatic experiences such as rape often report a variety of symptoms in the acute aftermath of trauma. Reactions to trauma may take the shape of acute stress disorder (ASD), which may later develop into posttraumatic stress disorder, or they may be symptoms of more general distress. The purpose of the present cross-sectional study was to test the hypothesis that symptoms of ASD and general stress, though correlated, represent two independent ways of reacting to trauma. Acute reactions to trauma were examined in a population of 150 female victims of sexual assault. Respondents were interviewed about demographic data and peritraumatic factors and filled out self-administered questionnaires concerning pretraumatic and posttraumatic factors including two dissociative items, ASD symptoms measured by the Acute Stress Disorder Scale and symptoms of general distress measured by a modified version of the Trauma Symptom Checklist. Two separate regression analyses were carried out to examine whether ASD and general distress are mediated by the same variables in the aftermath of rape. Dissociation significantly predicted ASD severity but not general distress, whereas relational problems and functional impairment emerged as significant predictors of general distress but not of ASD symptoms. Thus, even though symptoms of ASD and general distress were highly related to one another, the finding that the variables predicting ASD were different from those predicting general distress supports the assumption that ASD and general distress represent distinct trauma reactions. This finding is in accordance with previous research.

A Test of Structural Invariance of Posttraumatic Stress Symptoms in Female Survivors of Sexual and/or Physical Abuse or Assault

Hetzel-Riggin, M. D. — Mon, 22 Jun 2009 01:50:32 PDT

Recent studies on the factor structure of posttraumatic stress disorder (PTSD) symptoms tend to support one of two four-factor structures; however, little research has examined the structural invariance of PTSD structure across trauma groups. Five previously tested models of PTSD structure were compared in a large sample (N = 2,378) of female undergraduates who are survivors of sexual and/or physical abuse or assault, using the Posttraumatic Stress Disorder Questionnaire (PTSD-Q). The four-factor model of PTSD that included correlated factors of reexperiencing, avoidance, dysphoria, and hyper-arousal exhibited the best fit for the data and was structurally invariant across the five abuse groups. Support for the four-factor dysphoria model may have important implications for revisions of the current PTSD diagnosis.

Description and Application of Personal Boundary Theory in Traumatized Adults Through the Use of Russian Stacking Dolls

Stiles, A. S., Wilson, D., Thompson, K. — Mon, 22 Jun 2009 01:50:32 PDT

Personal Space Boundary theory, developed by the first author in 1986, explains the complexities of privacy and intimacy within human beings. The way that people choose to relate to others is dependent on the permeability and flexibility of their personal space boundaries. The experience of trauma can damage the functioning of one's boundaries. The introduction of a new analog model of the theory, Russian Stacking Dolls, will demonstrate how the theory provides insight and facilitates healing in adults who have suffered some sort of trauma. The purpose of this article is to review the theory's evolution and provide clinical examples of how this theory is currently being used in practice with Russian Stacking Dolls. Limitations and cautions for use with certain clients are explicated.

Global Traumatic Stress: Hypothetical Events and Possible Solutions

Goldberg, J. S. — Mon, 22 Jun 2009 01:50:32 PDT

The purpose of this article is to heighten awareness of the potential psychiatric consequences of a global traumatic event such as widespread use of weapons of mass destruction, encounter with an extraterrestrial life form, Earth's collision with an asteroid, paralysis of telecommunication or power systems, or pandemics. Because such events have never occurred, the traumatic affects on the human mind can only be postulated. There is sparse if any literature that addresses this problem. Many of the assumptions of what may happen and possible solutions are within the speculative imagination of the author. It is important that the traumatic stresses of a global event at least be recognized in the medical literature rather than be exclusively the domain of science fiction or cinematography.

On the Neural Basis of EMDR Therapy: Insights From qEEG Studies

Harper, M. L., Rasolkhani-Kalhorn, T., Drozd, J. F. — Mon, 22 Jun 2009 01:50:32 PDT

Eye movement desensitization and reprocessing (EMDR) therapy has been shown by empirical studies to be effective in relief from psychological traumas including posttraumatic stress disorder (PTSD). Several logical concepts regarding the origin of the EMDR effect have been presented, but no detailed neural explanation is available. This lack of a widely accepted scientific explanation for the EMDR effect has led to skepticism about the therapy by many therapists and potential clients. The authors present evidence based primarily on quantitative electroencephalogram studies that the neural basis for the EMDR effect is depotentiation of fear memory synapses in the amygdala during an evoked brain state similar to that of slow wave sleep. These studies suggest that brain stimulation during EMDR significantly increases the power of a naturally occurring low-frequency rhythm in memory areas of the brain, binding these areas together and causing receptors on the synapses of fear memory traces to be disabled. This mechanical change in the memory trace enables it to be incorporated into the normal memory system without the extreme emotions previously associated with it. EMDR is a medical procedure because it changes the physical structure of the brain to modify problematically stored memories.

Trauma Training, Trauma Practices, and Secondary Traumatic Stress Among Substance Abuse Counselors

Bride, B. E., Smith Hatcher, S., Humble, M. N. — Mon, 22 Jun 2009 01:50:32 PDT

A mailed survey of 225 National Association of Alcohol and Drug Addiction Counselors members was conducted to examine trauma training, trauma practices, and secondary traumatic stress among substance abuse counselors. Results indicate that most substance abuse counselors are not being prepared for practice with traumatized populations in their formal academic training, although many obtained some trauma training through continuing education activities. There is a great deal of variation in terms of counselors' practices in the assessment and treatment of traumatic stress. Last, substance abuse counselors are highly likely to be secondarily exposed to traumatic events through their work with traumatized populations, and many experience at least some symptoms of secondary traumatic stress. The experience of secondary traumatic stress is believed to contribute to turnover and may reduce the quality and effectiveness of services. These findings highlight the need to attend to the issue of secondary traumatic stress among substance abuse counselors.

Book Review: Sherman, M. D., & Sherman, D. M. (2006). I'm Not Alone: A Teen's Guide to Living With a Parent Who Has a Mental Illness. Edina, MN: Beaver's Pond Press

Arata-Maiers, T. L. — Mon, 22 Jun 2009 01:50:32 PDT

Sustaining a Positive Altruistic Identity in Humanitarian Aid Work: A Qualitative Case Study

McCormack, L., Joseph, S., Hagger, M. S. — Mon, 22 Jun 2009 01:50:32 PDT

This case study explores the interpersonal and intrapersonal experiences of a single individual who spent more than 35 years in humanitarian aid work. Using interpretative phenomenological analysis, one superordinate theme, altruistic identity (AI), emerges. On return home following a humanitarian mission, AI requires (a) strong perception of empathic validation for intimate reintegration and (b) self-acceptance of personal involvement. However, AI disruption is related to (a) a perception of rejection or weak empathic validation for intimate reintegration and (b) self-blame leading to isolation from intimate others. With AI disruption, validation is alternately sought from humanitarian colleagues and/or by returning to the field. Results suggest that postmission reintegration processes are important determinants of psychological well-being. The authors also discuss the organization's role in addressing the psychosocial care of their staff on return from mission to reduce long-term social disruption and psychological distress.

Notes From the Field: Research in a Complex Bureaucracy

Beder, J. — Mon, 22 Jun 2009 01:50:32 PDT

Field research is always a challenge. It involves going to the source of information, often doing face-to-face interviewing, and depending on the largesse and kindness of others to help facilitate the interview schedule. I recently initiated a field study involving social workers who work in the military. I anticipated numerous challenges in accessing participants, in finding departments of social work willing to participate, and so on. However, I could never have anticipated the actual struggles that I encountered well before participants became an issue. This article will explain some of those challenges.

Introduction to the Special Issue on Culture and International Contributions

Figley, C. R. — Thu, 02 Apr 2009 00:49:40 PDT

Tibetans' Coping Mechanisms Following Torture: An Interview Study of Tibetan Torture Survivors' Use of Coping Mechanisms and How These Were Supported by Western Counseling

Elsass, P., Phuntsok, K. — Thu, 02 Apr 2009 00:49:40 PDT

Western fascination with Buddhism means that Westerners consider Buddhist psychology for building up resilience regarding mental disorders and for creating building blocks for "the art of happiness." This study evaluates the effect of Buddhist spirituality on resilience to torture. In all, 102 Tibetan torture survivors were interviewed about their coping mechanisms in overcoming trauma; 36 of these survivors were receiving counseling, and both the 16 professionals and their clients were interviewed after the treatment with open-ended questions about what was helpful and not helpful. Our results from both the assessment and the counseling study support the claim that Tibetan torture survivors use their political engagement and Tibetan Buddhism as an important coping mechanism. All clients expressed satisfaction with the counseling even if it did not enhance the political and spiritual coping. But nobody mentioned counseling in any open-ended interview, except when directly asked.

Disillusionment, Faith, and Cultural Traumatization on a Northern Plains Reservation

Jervis, L. L., AI-SUPERPFP Team — Thu, 02 Apr 2009 00:49:40 PDT

Many American Indian people experience traumatization related to their postcolonial status that extends beyond the individual. This article explores experiences of cultural traumatization among 44 Northern Plains American Indians who were part of a population-based psychiatric epidemiological study. Of special interest were the ways in which cultural trauma was expressed in this community's sociality and worldview (e.g., disillusionment with community leaders, grief about perceived culture loss) and the complex connections between traumatization at the level of the individual and the community. Spirituality/religion served as a primary means for reconnecting with traditional culture, which proved crucial in people's attempts to cope with community traumatization. The uneasy coexistence of disillusionment, grief over culture loss, and faith cautions against embracing simplistic notions of Native reactions to cultural trauma.

The Relationship Between Religiosity and Subjective Well-being: A Case of Kuwaiti Car Accident Victims

Ridha Ashkanani, H. — Thu, 02 Apr 2009 00:49:40 PDT

Researchers have long recognized the influence of religion on a person's health and well-being. This study explores the influence of religion on the well-being of traumatized people. The study population included people who had experienced significant trauma in their lives from a severe car accident. The study sample included individuals who had been traumatized through severe injury in car accidents, families of those who have been badly injured, and families of those who were killed in car accidents. Demographic and socioeconomic variables served as independent factors in measuring subjective well-being. Descriptive, bivariate, and multiple regression analyses were used to measure the relationship between religiosity and subjective well-being of a traumatized person. Results showed that there was a positive relationship between religiosity and well-being, that income of the traumatized affected well-being positively, and that age of the traumatized affected well-being negatively. There was no effect of group difference (severely injured, family of severely injured, and family of a killed one) on well-being.

Job Satisfaction Among Counselors Working at Stress Center--Social Development Office--in Kuwait

Fahad Alqashan, H., Alzubi, A. — Thu, 02 Apr 2009 00:49:40 PDT

The focus of the study is to measure the job satisfaction level among Counselors working at a stress center in the Social Development Office (SDO) in Kuwait. Several research questions were presented to examine and answer the relationships of the study's variables. These questions were as follows:

(a) What is the average level of job satisfaction expressed by counselors working at a stress center? (b) Is there gender difference in the average satisfaction among counselors working at a stress center? and (c) What are most predictable factors to the overall level of job satisfaction among counselors working at a stress center?

Workers were asked to complete a self-report questionnaire on job satisfaction in a general scale— Minnesota Satisfaction Questionnaire. Areas such as social service, social status, achievement, variety, and ability utilization were reported the most satisfied. Meanwhile, compensation, office policies, and supervision-human relations were least satisfied in this study.

Companion Recovery Model to Reduce the Effects of Profound Catastrophic Trauma for Former Child Soldiers in Ganta, Liberia

Gregory, J., Embrey, D. G. — Thu, 02 Apr 2009 00:49:40 PDT

This article describes a companion recovery model designed to reduce the symptoms of PTSD in 130 former child soldiers in Ganta, Liberia. Male and female participants were conscripted by force between 6 and 13 years of age. The article discusses a model applied to a two-weeks group training and one-on-one companion intervention. The model teaches nine conceptual modules (overwhelming events, encapsulation, somatization, recognition, release, resilience, integration, new-self, and rebuilding) and a commencement ceremony to help reintegrate participants into their communities. Two case studies involving male and female participants highlight the application of this model. The study findings reveal that the participants showed significant (p ≤ .001) recovery from profound catastrophic trauma (PCT).

Reducing the Effects of Profound Catastrophic Trauma for Former Child Soldiers: Companion Recovery Model

Gregory, J., Embrey, D. G. — Thu, 02 Apr 2009 00:49:40 PDT

This pilot study evaluated the ability of a companion recovery model to decrease the effects of profound catastrophic trauma in 130 male and female former child soldiers in Liberia, West Africa. This 2-week intervention model was field-tested to determine its ability to reduce the symptoms of posttraumatic stress disorder (PTSD). Clinical Assessment of PTSD Scale was used to evaluate pretreatment and posttreatment symptoms of PTSD. Results showed a significant reduction (p ≤ .001) in PTSD symptoms by 33%. Early findings suggest that the model may be helpful in reducing the symptoms of trauma in former child soldiers.

The Posttraumatic Growth Model: An Expansion to the Family System

Berger, R., Weiss, T. — Thu, 02 Apr 2009 00:49:40 PDT

This article focuses on expanding Calhoun and Tedeschi's model of posttraumatic growth (PTG) to the family system level. PTG has been conceptualized as an outcome on multiple levels, including individuals, families, and communities. However, in the original model the family is mostly viewed as the context for individual growth, whereas in this article the family is the unit that grows. The proposed conceptualization is consistent with the paradigmatic shift from a deficit-based perspective to a strength-based perspective of family functioning in general and in the aftermath of trauma in particular. The first part of the article briefly introduces the PTG model. The second part identifies and illustrates the family system parallels of the six components of the model: pretrauma characteristics, a traumatic/ highly stressful event, challenges, rumination, social context, and posttraumatic growth. The third part addresses future directions.

Effects of Traumatic Stress on Firefighters' World Assumptions

Wagner, S. L., McFee, J. A., Martin, C. A. — Thu, 02 Apr 2009 00:49:40 PDT

Male firefighters (n = 94) were compared with male workers (n = 91) from a variety of blue-collar, non—emergency service occupations. Responses on the World Assumptions Scale were examined in combination with the Impact of Events Scale—Revised and the Symptom Checklist-90. Initial hypotheses suggested that firefighters would report disrupted world assumptions and that these disrupted assumptions would be linked with greater mental health symptomatology. Results revealed that firefighters were not different from controls on world assumptions and that world assumptions were unrelated to years of service. These results suggest that the psychological reactions of workers exposed to high levels of job-related traumatic stress may not be consistent with that described in previous literature regarding primary victims. Consequently, it is suggested that more research is needed that specifically addresses psychological outcomes for firefighters and other high-trauma occupations. The findings also suggest that benevolence may be particularly important in relation to mental health in firefighters and that this belief may be useful in the prevention of posttraumatic symptomatology.

Thought Field Therapy and QEEG Changes in the Treatment of Trauma: A Case Study

Diepold, J. H., Goldstein, D. M. — Thu, 02 Apr 2009 00:49:40 PDT

As identified by quantitative electroencephalography, statistically abnormal brain wave patterns were observed when a person thought about a trauma when compared with thinking about a neutral (baseline) event. Reassessment of brain wave patterns (to the traumatic memory) immediately after thought field therapy diagnosis and treatment revealed that the previous abnormal pattern was altered and was no longer statistically abnormal. An 18-month follow-up indicated that the patient continued to be free of all emotional upset regarding the treated trauma. This case study supports the concept that trauma-based negative emotions do have a correlated and measurable abnormal energetic effect. In addition, this study objectively identified an immediate energetic change after thought field therapy in the direction of normalcy and health, which has persisted.

Assessing Trauma and Traumatic Stress via the Internet: Measurement Equivalence and Participant Reactions

Read, J. P., Farrow, S. M., Jaanimagi, U., Ouimette, P. — Thu, 02 Apr 2009 00:49:40 PDT

Though relatively understudied, trauma exposure and resulting posttraumatic stress symptoms are common in college students. Web-based surveys allow for private, cost-effective, and time-efficient assessment of trauma and its sequelae in this at-risk population. This study examines two issues pertinent to Internet assessment of trauma and posttraumatic stress: (a) the reliability of the Internet compared with paper-and-pencil and interview assessments and (b) the acceptability of this assessment modality to students. College students (N = 38) completed a posttraumatic stress disorder (PTSD) clinical interview and paper-and-pencil and online versions of trauma and PTSD questionnaires. Results showed in-person and online trauma and PTSD assessments to be significantly associated with each other and with the clinical interview. Participants reported positive reactions to the online survey. Findings suggest that the Internet can reliably and unobtrusively assess potentially sensitive topics in college students.

Posttraumatic Stress and Somatization in Abused Women

Samelius, L., Wijma, B., Wingren, G., Wijma, K. — Thu, 02 Apr 2009 00:49:40 PDT

This study examines the relationship between posttraumatic stress disorder (PTSD) and somatization in abused women; 213 abused women were assessed for PTSD, somatization, health care contacts, and abuse-related variables. The main analyses in this exploratory study are based on the 91 respondents reporting either PTSD or somatization. We found no association between the occurrence of PTSD and somatization in abused women. Women with PTSD reported higher total magnitude of abuse and a larger number of perpetrators than women with somatization. Sexually abused women with PTSD more often described their experience as an act of abuse compared with sexually abused women with somatization. Results suggest that PTSD might not be a necessary mediator between abuse and somatization and that variables other than abuse magnitude are decisive for the development of somatization in abused women.

Book Review: Kolditz, T. A. (2007). In Extremis Leadership: Leading as if Your Life Depended On It. San Francisco: Jossey-Bass

Mathewson-Chapman, M. — Thu, 02 Apr 2009 00:49:40 PDT

Editorial

Figley, C. R. — Wed, 17 Dec 2008 19:20:23 PST

An Introduction to the Special Issue: Identification and Applications of Lessons Learned by the Tulane University Community

Figley, C. R., Marks, R. E. — Wed, 17 Dec 2008 19:20:23 PST

Life Lessons from Inside the Storm

Cowen, S. S. — Wed, 17 Dec 2008 19:20:23 PST

Hurricane Katrina was an unprecedented event in U.S. history in terms of its impact-psychologically, emotionally and financially. The storm took its devastating toll on individuals and institutions, a toll which is still present in many ways. This paper describes the impact Katrina had on Tulane University from the immediate aftermath of the storm to the university's recovery and renewal. It also articulates the lessons learned from this experience, which Tulane found valuable in maintaining and supporting its community during the crisis.

Canoeing Home: A Personal and Professional Journey through Murky Waters

Marks, R. E. — Wed, 17 Dec 2008 19:20:23 PST

The Aftermath of Hurricane Katrina: A Trauma Researcher's Perspective

Vasterling, J. J. — Wed, 17 Dec 2008 19:20:23 PST

In this article, the author describes from her personal perspective the progression and range of emotional reactions of the New Orleans community to Hurricane Katrina and its aftermath. The article further discusses the author's observations of the facilitators and barriers to emotional recovery that have unfolded as New Orleans continues to recover as a city. Lessons learned center on (a) the longitudinal phenomenology of emotional and psychobiological stress responses in a context in which the aftermath of the initial event is characterized by a set of pronounced and enduring stressors and (b) the value of institutional and social support networks in confronting and overcoming these challenges.

Scarred but Smarter: Personal and Professional Lessons Learned From Surviving a Hurricane

Buttell, F. P. — Wed, 17 Dec 2008 19:20:23 PST

This article reviews the author's experiences before, during, and after Hurricane Katrina and the impact of this experience on his personal and professional life. The article details the impact of the disaster on creating a transformative experience for the author and identifies the ways in which the experience was simultaneously horrendous and uplifting.

A Student Social Worker's Reflection of the Self and Professional Identity Following the Impact of Hurricane Katrina on New Orleans

Boyer, E. — Wed, 17 Dec 2008 19:20:23 PST

This paper examines the professional identity development of a graduate social work student who was on the verge of completing her degree from Tulane University just as Hurricane Katrina struck New Orleans. The author discusses how being a victim of the same trauma from which her clients are suffering, as well as experiencing the same emotional impact, affects the development of her role as a social worker. The author draws comparisons to social work students experiencing the terror of the second intifada as they too developed their own senses of professional identity and how their experiences affected the meaning of their profession. The author reflects on her struggle to recapture a sense of personal self once everything she knows is gone, in order to determine under which role she serves her clients as they suffer from the same loss.

From 9/11 to Hurricane Katrina: Helping others and Oneself Cope Following Disasters

Schechter, L. R. — Wed, 17 Dec 2008 19:20:23 PST

There are many psychologists who provided help to others following the terrorist attack of 9/11 and the natural disaster of Hurricane Katrina, but fewer who also experienced both of these tragic events first hand and also served others as a helper. This article is a personal account of a New York psychologist who endured 9/11 and then moved to Louisiana and endured Hurricane Katrina, and the personal and professional impact of these events. The unique and extremely challenging nature of the crisis work under these conditions is discussed, including techniques that seemed to be most effective for providing help to others, as well as techniques and behaviors that were helpful to the psychologist's self-care during and following these catastrophes. The relationship to broader issues in the field of psychology and mental health is also discussed, including the ethics of psychologist self-care and practical recommendations for the providers of disaster mental health services.

Denial of Hurricane Risks: Reflections of an Addictions Researcher

Ager, R. D. — Wed, 17 Dec 2008 19:20:23 PST

In this article, the author describes denial associated with living in a city threatened by hurricanes and with the events leading up to and following Hurricane Katrina. The article draws from the disaster and addictions literature to reflect on the purposes and consequences of denial. For example, denying the true danger associated with the approaching Hurricane Katrina may have been motivated by a need to view one's home as safe or a cultural belief held by a group with deep roots in New Orleans. An unfortunate consequence of extreme denial is putting oneself and one's family in harm's way. Suggested solutions focus on informing government and news agencies that make public service announcements that this resistant population exists. The author also suggests strategies that these agencies should avoid and some that may work.

Reflections from the Field: On the Road to Recovery

Lewis, J. S., Gillis, H. J. — Wed, 17 Dec 2008 19:20:23 PST

As the two faculty members primarily responsible for the field education component of Tulane School of Social Work, the authors put forth their experiences of response and recovery from the trauma and aftermath of Hurricane Katrina—from a personal and professional perspective. Their personal experiences are intertwined as well as uniquely individual. Professionally, this disaster affected their orientation to work and their ways of finding new paths for helping students continue their learning and recovery. The authors discuss specific efforts they made to do meaningful work as they struggled to heal themselves from the trauma they all suffered. Finally, the authors focus on the valuable lessons they have learned, and are still learning, about preparation, response, recovery, and rebuilding from trauma of this scale. These lessons are informed, shaped, and evolving through the lenses of professional and scholarly work throughout their social work careers.

Leaving New Orleans, Again

Fussell, E. — Wed, 17 Dec 2008 19:20:23 PST

After Hurricane Katrina, the author's research on Mexican migration to the United States expanded to include disaster driven migration. This new project, and life in a disaster zone, made achieving a balance between work and family even more difficult than it would normally be for a pre-tenure faculty member and mother of a young child. When the author returned to New Orleans after the evacuation, she began studying the Latino immigrants arriving there to do the construction work that was so critical to the city's recovery. She made the difficult decision to leave New Orleans in July 2007 to balance the competing demands of teaching, research, and family. In the process, she learned about academics' particular vulnerabilities and some coping strategies to manage those.

Pompeii on the Mississippi: The View From New Orleans

Lusnia, S. S. — Wed, 17 Dec 2008 19:20:23 PST

Hurricane Katrina's landfall on August 29, 2005, has had a profound affect on the lives of everyone living in coastal Louisiana and Mississippi. Leaving behind a vast swath of destruction and many dead, the storm has reshaped lives, careers, and perspectives. This article is largely a personal statement about a university professor's experience of teaching a course on Pompeii in post-Katrina New Orleans. For 6 years she has taught a course on the material culture and lives of the Romans at Pompeii. Lecturing on the destruction of that city in January 2006, less than 3 weeks after her own return to New Orleans following Hurricane Katrina, led her to consider what lessons might be gained from Pompeii and other past disasters. The article shares this professor's experience in teaching a freshman orientation course that attempts to understand Hurricane Katrina within a historical framework, examining past catastrophic events in urban areas and developing new approaches to the Pompeii course, linking it to the Katrina disaster and New Orleans' recovery. The author offers some brief comments on an aspect of the public discourse about Katrina, the comparison of New Orleans' disaster with the destruction of Pompeii.

Wisdom in Wind and Water: Katrina and Other Lessons of a Social Work Educator

Parker, J. — Wed, 17 Dec 2008 19:20:23 PST

The worst natural disaster in U.S. history was anything but natural for the city of New Orleans and the Tulane School of Social Work. The associate dean's account of personal and collective losses and victories in the devastation of Hurricane Katrina and the broken levees in New Orleans provides social work education both confirmation of and challenges to traditional thinking about trauma, recovery, and resilience. Actual accounts of individual and organizational survival are linked to tenets of trauma responses within a framework of lessons that inform the reader on personal, practice, and teaching dimensions.

Progressive Counting for Trauma Resolution: Three Case Studies

Greenwald, R. — Wed, 17 Dec 2008 19:20:23 PST

The counting method is a recently developed psychotherapy technique for resolving trauma memories. It may perform as well as the most efficient leading methods while being simple to implement and easy to teach, thus potentially enhancing dissemination of effective trauma treatment. Progressive counting represents a substantial modification of the counting method, for enhanced efficiency and client tolerance. Three cases are presented illustrating progressive counting's potential utility in treating trauma for a range of presenting problems.

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

Lazar, A., Litvak-Hirsch, T., Chaitin, J. — Wed, 17 Dec 2008 19:20:23 PST

This study assessed how Jewish Israeli young adults perceive the impacts of the Holocaust on themselves, their family and Israel society. The written responses of 180 respondents, 90 of which were grandchildren of Holocaust survivors (GHSs) and 90 which are not grandchildren of survivors (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 impact the perception of the Holocaust on the third generation of Holocaust survivors as a cultural trauma.

Complicated Grief and its Relationship to Mental Health and Well-Being Among Bosnian Refugees After Resettlement in the United States: Implications for Practice, Policy, and Research

Craig, C. D., Sossou, M.-A., Schnak, M., Essex, H. — Wed, 17 Dec 2008 19:20:23 PST

This study investigates mental health and well-being variables in a randomly selected sample of Bosnian refugees. The sample was predominately female (56%), with a mean age of 42, and 56.5% were educated at 12 years of school or less with 43.5% reporting more than 12 years of education. Four standardized research instruments that measured trauma exposure, posttraumatic stress disorder (PTSD) symptomatology, complicated grief, anxiety, depression, well-being, and general mental health (a combined measure of well-being and psychological distress) were randomly disseminated among 500 Bosnian refugees with 126 (25%) surveys returned. Results revealed PTSD (66.6%), complicated grief (54%), anxiety (40%), and depression (31%) symptoms in the clinical range. A sequential regression revealed that 31% of the variance in poor general mental health was accounted for by complicated grief, whereas PTSD symptomatology only accounted for 6% of the variance. Implications for mental health interventions, research, and policy are discussed.

Psychometric Properties of the Dimensions of Stressful Events Rating Scale

Spilsbury, J. C., Fletcher, K. E., Creeden, R., Friedman, S. — Wed, 17 Dec 2008 19:20:23 PST

Unlike other instruments designed to assess DSM-IV Criterion A for posttraumatic stress disorder, exposure to a high-magnitude stressor, the Dimensions of Stressful Events (DOSE) scale assesses not different types of stressors but the specific characteristics of high-magnitude stressor events that the literature indicates increase the likelihood of posttraumatic response to the stressful event(s). This study investigated the DOSE's psychometric properties in a sample of 1,032 children aged 2 to 18 years (mean = 8.5 ± 3.9) exposed to interpersonal violence who participated in a community-based intervention. Findings indicate that the DOSE shows promise as a valid and reliable measure of the traumatic potential associated with diverse stressful experiences. Clinically, it could also be used as an indirect screening measure of the potential for the development of acute or posttraumatic stress disorder. In addition, the DOSE may allow researchers to make comparisons of the impact of different high-magnitude stressors across studies.

Media Review: Bussey, M., & Wise, J. (Eds.). (2007). Trauma Transformed: An Empowerment Response. New York: Columbia University Press

Buttell, F. — Wed, 17 Dec 2008 19:20:23 PST