Experience Of Psychological Trauma Research Articles

Interface of resilience with other related concepts in physiological and psychosocial/spiritual domains.

Interface of resilience with other related concepts in physiological and psychosocial/spiritual domains.

Integration of Trauma-informed Care Into the Doctor of Pharmacy Curriculum

Trauma-informed care (TIC) is a framework based on understanding and responding to individuals’ experiences of psychological trauma (defined as harmful circumstances that have a lasting impact on emotional well-being), as well as fostering their sense of safety and empowerment. Health profession degree programs are increasingly integrating TIC training into their curricula. Although literature is scarce regarding TIC education in academic pharmacy, student pharmacists will likely encounter patients, co-workers, and peers who have experienced psychological trauma. Students may also have experienced psychological trauma themselves. Therefore, student pharmacists would benefit from TIC learning, and pharmacy educators should consider implementing trauma-informed education. This commentary defines the TIC framework, explores its benefits, and considers an approach to implementing the TIC framework in pharmacy education with little disruption to existing curricula.

Trauma-informed care in the emergency department: concepts and recommendations for integrating practices into emergency medicine

ABSTRACT The experience of psychological trauma is common and has become even more prevalent during the COVID-19 pandemic for both health care workers and the general population [1–3]. Traumatic experiences can have varied and lasting physical and mental health effects on patients, beyond what we are privy to in the acute environment of the emergency department. The effects of these prior traumatic experiences can be exacerbated by interaction with the healthcare system, and yet emergency medicine physicians have no standardized methods for working with patients in a trauma-informed way. The systematic implementation of trauma-informed care (TIC) practice requires the cooperation of multiple domains within the health care system, including focus on the physical environment, direct care, and administrative practices. Here we provide recommendations specific to emergency medicine for the development and implementation of TIC in the regular patient-clinician interaction, situated within the context of the TIC framework as outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA) [4].

Traumatic Events and Vaccination Decisions: A Systematic Review

Despite the apparent relationship between past experiences and subsequent vaccination decisions, the role of traumatic events has been overlooked when understanding vaccination intention and behaviour. We conducted a systematic review to synthesize what is known about the relationship between traumatic events and subsequent vaccination decisions. MEDLINE, PsycINFO and CINHAL electronic databases were searched, and 1551 articles were screened for eligibility. Of the 52 articles included in full-text assessment, five met the eligibility criteria. Findings suggest that the experience of trauma is associated with individual vaccination decisions. Social and practical factors related to both trauma and vaccination may mediate this relationship. As this is a relatively new field of inquiry, future research may help to clarify the nuances of the relationship. This review finds that the experience of psychological trauma is associated with vaccination intention and behaviour and points to the potential importance of a trauma-informed approach to vaccination interventions during the current global effort to achieve high COVID-19 vaccine coverage.

Trauma-informed sentencing of serious violent offenders: an exploration of judicial dispositions with a gendered perspective

Experience of psychological trauma is correlated with violent offending, with exposure reported for most offenders entering the criminal justice system. The practice of trauma-informed sentencing recognises this complex and consistent relationship, and endeavours to respond in a way that avoids re-traumatisation and reduces harm to offenders and victims. Trauma-informed approaches to offenders improve safety in custodial settings, enhance prospects of correctional rehabilitation and recovery from mental illness and promote the health and welfare of staff working with offenders. This quantitative pilot study examines the identification and impact of trauma – as recorded in sentencing decisions – for homicide perpetrators in Victoria, with particular attention to trauma-informed sentencing and whether or not gender makes a difference. Traumatic experiences were described in a high proportion of cases but only explicitly recognised in a minority. Trauma-informed sentencing recommendations were rare. Collaboration between clinical and legal professionals to inform and enhance trauma-informed procedures is recommended.

Trauma: phenomenological causality and implication

The relationship between traumatic experiences and subsequent distress is not well understood, and little research focuses on the lived experience of psychological trauma. I draw on Louis Sass’s phenomenological taxonomy to address this lacuna. I present his differentiation between relations of phenomenological causality and implication and demonstrate that his taxonomy can be applied to experiences of trauma. Relations of phenomenological causality and implication can be identified in the genesis and constitution of post-traumatic distress. My adaptation of Sass’s taxonomy will furthermore offer an extension and development of his account, applying it to the study of post-traumatic experiences and elaborating it in the process. I shall demonstrate that whether experiences occur synchronically or diachronically is not essential to their categorization in terms of phenomenological implication and causality, respectively. I will show that an alteration in perception or behavior post trauma might temporally succeed the traumatizing event while, at the same time, being implied in the experience of the event. Thereby, I demonstrate how phenomenology may contribute to a detailed understanding of experiences of trauma. Scrutiny of traumatic experiences furthermore promises to contribute to the philosophical discourse on causality, implication, and temporal experience.

Trauma-Informed Care Training in Family Medicine Residency Programs Results From a CERA Survey.

Experiences of psychological trauma are common among primary care patient populations, and adversely affect patients' health and health care utilization. Trauma-informed care (TIC) is a framework for identifying and responding to patients' experiences of psychological trauma to avoid retraumatization. The purpose of this study was to evaluate the current state of TIC training in family medicine residency programs in the United States in order to identify opportunities for and barriers to TIC training. Items addressing the four core domains of TIC were incorporated into the 2017 Council of Academy Family Medicine Educational Research Alliance (CERA) survey of program directors. The items assessed the presence, content, and sufficiency of TIC curriculum, as well as barriers to further integration of TIC training. Approximately 50% of programs responded to the survey. Of 263 respondents, 71 (27%) reported TIC training in their curriculum, but the majority devoted less than 5 hours annually to core content. The content most commonly addressed recognizing signs of trauma, most frequently using didactic formats. Overall, just over one-half of the programs reported that their curriculum met patients' TIC needs "somewhat" (48.5%) or "a great deal" (4.6%). Lack of a champion followed by lack of time were the most commonly cited barriers to integrating TIC training. Despite the acknowledged importance of effects of trauma in health care, this study identified insufficient exposure to training in the core TIC domains in family medicine residency programs, underscoring a need for greater integration of TIC training during residency.

Psychosocial spiritual healing

Palliative care providers have for a long time recognized that there are seriously ill or terminal patients who progress beyond the experiences of psychological trauma, coping, and acceptance.

“There's Nothing So Black as the Inferno of the Human Mind”: Infernal Phenomenal Reference and Trauma in Mark Z. Danielewski's House of Leaves

The archetypal descent into hell can provide a paradigm for the representation of trauma, which is often theorized as being unrepresentable. Mark Z. Danielewski's House of Leaves (2000) models the experience of psychological trauma on the archetypal descent into hell, or katabasis. House of Leaves thus challenges a certain strand of poststructuralism that has become dominant within literary critical circles of trauma studies. Ultimately, Danielewski manipulates the paradigm of katabasis to forge what I style an infernal phenomenal reference system to represent the hell of trauma.

FC01-02 - Homelessness and experiences of psychological trauma in the western world: A research review and a qualitative study

Over the last forty years, and particularly within the last decade, homelessness is recognised as a multifaceted problem. Homelessness is associated with poverty, because the ability to access employment is limited by the lack of a stable address. Secondly, homeless people often experience severe difficulties with housing related services, health services and education. These problems are often sustained or exacerbated by, e.g., poor physical and mental health and the need to support alcohol or drug dependencies. What role does traumatic events, in particular childhood trauma and abuse, have in the lives of the homeless? The negative effects of psychological trauma on psychosocial functioning and wellbeing in the general population are well documented; a quick review of the research on homelessness and trauma suggested that more work is needed.The objectives of this paper are to review research on homelessness and experiences of psychological trauma and evidence from a sample of single homeless adults.The aim of this paper is two-fold: to provide a systematic review of studies on the relationship between childhood trauma and homelessness and to present findings from a qualitative study of adult people who are homeless in London and Nottingham, UK.The systematic review examines research published in the Western world, 1990 - July 2010. The qualitative study collected data through semi-structured interviews with 103 single people, aged 18–69 years.A summary of the results from the review and qualitative study and guidance for further research on the relationships between traumatic experiences and homelessness will be provided.

Trauma, posttraumatic stress disorder, and ethnoracial minorities: Toward diversity and cultural competence in principles and practices.

Psychological trauma and posttraumatic stress disorder (PTSD) affect persons and communities of all ethnocultural backgrounds. In light of the substantial evidence of intra- and intergroup diversity in the experience of psychological trauma and PTSD, it is essential first to reconsider the ways in which ethnocultural identity is defined and classified, in order to meaningfully study the relationship of race, ethnicity, and culture to the risk and adverse outcomes of psychological trauma. The role of racism as a risk factor for exposure to psychological trauma and PTSD, as well as a potential traumatic stressor with intergenerational effects, also requires careful study. Culturally competent psychological interventions to prevent or treat PTSD require informed practitioners who do not make stereotypic assumptions or inadvertently replicate racial biases.

Post-traumatic stress disorder: overview

The impact of traumatic events and the experience of psychological trauma have been depicted in myth, legend, art and literature throughout human history (for instance [1,2]). They have, for the last generation, been psychiatrically classified as post-traumatic stress disorder (PTSD) and as acute stress disorder (ASD). The papers in this In-Depth Review serve both to describe the status of current thinking in regard to the scientific conceptualization of psychological trauma and to raise questions in regard to our understanding of the contextualization of traumatic experience within occupational settings. For many years, occupational medicine and health and safety legislation has focused upon observable injury and illness caused by single events. These articles play a timely role in reminding us that many health and welfare concerns with far-reaching effects within organizational environments may be psychological, social and complex in nature and have enduring effects over a considerable span of time. In the first paper, Bisson [3] introduces the diagnostic categories of PTSD and ASD and presents an overview of the characteristics of the Diagnostic and Statistical Manual of Mental Disorders and International Statistical Classification of Diseases and Related Health Problems [4,5], describing prevalence and risk factors in the development of traumatic symptoms. The variation in diagnostic features between these two classification systems serves to illustrate the ongoing development and refinement of our contemporary understanding of traumatic experience. Bisson signals our increasing awareness of resilience as opposed to the pathology of trauma. The concept of a resilience trajectory may challenge the reader to query whether employee resilience can be strengthened through processes of selection, screening and organizationally based support systems. These issues are addressed and developed in the following papers. While the first article focuses upon individual outcomes of treatment, Bisson suggests that individual prediction of risk is indeed a poor predictive tool and stresses that the degrees of support, connection and affirmation within the organizational context will contribute to recovery. Using the National Collaborating Centre for Mental Health Guidelines for intervention (the development of which he played a significant part), Bisson briefly considers the viability of particular interventions. He signals the issues concerning early intervention in the workplace that the following articles then address. In particular, he stresses that the emotional component of single-session interventions termed as psychological debriefing (PD) should be avoided, suggesting that in many situations practical and pragmatic support provided by an informed peer group is both necessary and sufficient an intervention. Utilizing their extensive experience in Australia, McFarlane and Bryant [6] then focus specifically upon the impact of trauma in occupational settings acknowledging that individuals and groups within some occupations and workplaces experience higher risk factors than others. They introduce notions of cumulative risk and secondary stressors and suggest preventive or minimization strategies for the management of trauma within the workplace. Management strategies such as systematic assessment, reduction of exposure and rotation of duties are noted alongside the repetition of Bisson’s caution that there is inherent difficulty in providing accurate and ethical prediction of risk on an individual basis. They suggest that employers and supervisors nevertheless have a duty of care to identify and support those individuals adversely affected by traumatic events. The authors raise issues of legal and employer liability and financial compensation, a key factor in the ongoing debate about effective support for workers. Such risks are balanced against acknowledgement of the financial costs of providing support systems and the necessary cost-benefit analysis evaluation of any intervention adopted by an organization. They argue that early intervention or treatment to prevent further injury is crucial. The need for an evidence-based choice of intervention is stressed, an issue of particular importance in evaluation of PD and other structured interventions. Their acknowledgement of cumulative effects and potential sensitization to recurrent occupational stressors signals a need for occupational health practitioners to remain aware of the latest research in regard to complex PTSD and to constructivist interpretations of the relationship between cumulative stress and traumatic events. c/o School of Applied Psychosocial Studies, Faculty of Health and Social Work, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK.

Prevalence and predictors of women's experience of psychological trauma during childbirth.

The increased acceptance of the prevalence of trauma in human experience as well as its psychological consequences has led to revisions of diagnostic criteria for the disorder. The three purposes of this study were to examine the rates at which women experienced psychological trauma in childbirth, to explore possible causal factors, and to examine possible factors in the development of the disorder. One hundred and three women from childbirth education classes in the Atlanta metropolitan area completed a survey in late pregnancy and a follow-up interview approximately 4 weeks after the birth. The childbirth experience was reported as traumatic by 34 percent of participants. Two women (1.9%) developed all the symptoms needed to diagnose posttraumatic stress disorder, and 31 women (30.1%) were partially symptomatic. Regression analysis showed that antecedent factors (e.g., history of sexual trauma and social support) and event characteristics (e.g., pain in first stage of labor, feelings of powerlessness, expectations, medical intervention, and interaction with medical personnel) were significant predictors of perceptions of the childbirth as traumatic. The pain experienced during the birth, levels of social support, self-efficacy, internal locus of control, trait anxiety, and coping were significant predictors of the development of posttraumatic stress disorder symptoms after the birth. These findings suggest several intervention points for health care practitioners, including careful prenatal screening of past trauma history, social support, and expectations about the birth; improved communication and pain management during the birth; and opportunities to discuss the birth postpartum.

Hypnosis can not be fully nor reliably excluded from the courtroom.

Abstract Because hypnosis has the potential to irrevocably alter cognition, perception, and recall, and to increase an eyewitness' subjective certitude, many jurisdictions have excluded all posthypnotic testimony from the courtroom. Because “hypnotic” elements pervade the phenomena and transactions of everyday living, this process can only exclude procedures deliberately labeled as “hypnosis.” This pseudosolution side-steps a greater issue, yet unresolved: how the courts should deal with altered volition, cognition, perception, and recall that occur outside the hypnotist's consulting room. These spontaneous hypnotic-like states are amplified by the experience of psychological trauma, common in the aftermath of violent crime and terror. Rather than per se exclusion, courts are advised to scrutinize all testimony for its “hypnotic” influences, and judge accordingly. Suggested criteria for exclusion in a particular case include: (1) hypnosis must be a separable state, (2) hypnosis must be the dominant source...