History Of Trauma Research Articles

Medically Unexplained Behaviors and Symptoms in Consultation-Liaison Psychiatry: Biopsychosocial and Psychodynamic Considerations.

Medically Unexplained Behaviors and Symptoms in Consultation-Liaison Psychiatry: Biopsychosocial and Psychodynamic Considerations.

Device Survival After Pediatric Cochlear Implant Surgery: A 15-Year Single-Center Retrospective Analysis.

To evaluate device survival and identify risk factors for failure in pediatric cochlear implant (CI) surgery to guide strategies for minimizing failure rates and improving survival outcomes. A retrospective analysis was conducted on pediatric patients who underwent CI surgery at the Children's Hospital, Zhejiang University School of Medicine, from September 2008 to September 2023. Device survival was assessed using the Kaplan-Meier method while independent factors influencing device survival were analyzed using the log-rank test and Cox regression model. Among 602 children, the mean age at first CI surgery was 50.3 months (range = 8-155 months). The cohort included 353 males (58.6%) and 249 females (41.4%). Revision surgery was required in 28 cases (4.7%), primarily due to device failure (17/28, 60.7%), including 14 hard and 3 soft failures. Kaplan-Meier analysis showed CI survival rates of 99.1%, 98.1%, 96.7%, 96.4%, and 96.4% at 1, 2, 3, 5, and 10 years post-surgery, respectively. The log-rank test identified sex, age, and history of head trauma as significant factors affecting device survival (P < .05). Multivariate Cox regression confirmed that male sex, first implantation ≤3 years of years, and postoperative head trauma were independent risk factors for device failure. Pediatric cochlear implantation is generally safe and effective, though device failure remains a concern, necessitating revision surgery remains. Male children who undergo cochlear implantation at ≤3 years of age or have a history of postoperative head trauma require enhanced postoperative care. This includes avoiding vigorous head impacts and increasing follow-up visits to monitor device function and speech recovery. Manufacturers should prioritize developing more durable, impact-resistant cochlear implants to reduce failure rates and improve long-term device survival.

Ophthalmology Examinations in Children With Skull Fractures and Underlying Focal Hemorrhage.

To assess the frequency and yield of retinal examination in children below 2 years old undergoing abuse evaluations in the setting of skull fracture(s) and small underlying intracranial hemorrhage. This cross-sectional study used CAPNET, a multicenter child physical abuse network, to identify children below 2 years with a skull fracture(s) and intracranial injury limited to an underlying small focal intracranial hemorrhage undergoing subspeciality child abuse evaluations. Our outcomes of interest were (1) the performance of a retinal examination, (2) the identification of retinal hemorrhages, and (3) associations of clinical factors and CAPNET site with the performance of retinal examinations. We hypothesized that retinal hemorrhages would be identified in <5% of patients. Of 242 children who met inclusion criteria, the majority (189, 78.1%) presented with a reported history of accidental trauma, and most (211, 87.2%) lacked additional injuries. Only 9 (3.7%) had loss of consciousness and/or seizures/seizure-like activity. The majority (201, 83.1%) had low concern for abuse. Overall, 104 (43.0%) children underwent retinal examinations, of which 0 had retinal hemorrhages (one-sided 95% CI: 0-2.8%). Children without a reported accidental mechanism of injury (P=0.004), those with intermediate/high concern for abuse (P<0.001), and children with occipital fractures (P=0.008) were more likely than their counterparts to undergo retinal examination. The proportion of children undergoing retinal examination varied by CAPNET site (P<0.001). Our findings suggest that it may be reasonable to forgo retinal examinations in children below 2 years of age with skull fracture(s) and intracranial injury limited to an underlying small focal hemorrhage who are overall neurologically well-appearing.

Dissociative experiences in individuals with subclinical psychosis and a history of developmental trauma: a qualitative study

ABSTRACT Background: Among individuals with psychotic experiences, those with a history of developmental trauma face greater symptom severity and worse clinical outcomes compared to those without. Dissociation constitutes a prominent, characteristic of this group’s clinical presentation, whose nuances and associated characteristics remain however understudied in psychosis research. We aimed to address this gap by conducting a qualitative study to investigate the phenomenology, context, and impact of dissociative experiences in individuals with subclinical psychosis and a history of developmental trauma. Methods: 25 UK-based participants with a history of developmental trauma and meeting criteria for subclinical psychosis, based on the CAPE-15, were recruited via social media. Participants attended semi-structured interviews online, which were transcribed verbatim and analysed with thematic analysis by two researchers. Results: Thematic analysis yielded the following themes: (1) Phenomenology of Dissociation; (2) Context of Dissociation; (3) Impact of Dissociation; (4) Dissociation and Psychotic-like Phenomena. Participants described experiences of detachment and compartmentalisation, which when experienced were confusing and often distressing. Dissociation was linked to affective experiences, their history of developmental trauma and psychotic-like experiences. Conclusion: This study elucidates the complex and varied nature of dissociative experiences in individuals with subclinical psychosis with a history of developmental trauma. These findings highlight the need for further research to understand the manifestation of dissociation in this population and the links with distress and other aspects of psychopathology. Importantly, it is essential to use this understanding to inform the development of interventions and improve clinical recognition and management.

A Rare Case of Primary Synovial Chondromatosis of Unilateral Knee Joint in Female Patient: A Clinical Image

A 37 year old non-diabetic, non-hypertensive female, housewife presented in OPD with left knee joint pain and swelling for the last 3 years. There was a restricted range of motion of the left knee joint. There was no any history of trauma or injury to the left knee joint. There was no history of fever or discharge from the joint. On examination, diffuse swelling involving the left knee, non-erythematous, soft, non-tender, with crepitus and palpable hard nodules of varying size was observed. Her knee flexion was limited to 50°. X-Ray of affected knee joint revealed Primary synovial chondromatosis as rare entity.

Delayed Traumatic Diaphragmatic Hernia Presenting as Pneumothorax: A Case Report

Traumatic diaphragmatic hernias (TDHs) are a serious complication of both blunt and penetrating trauma, often requiring prompt surgical intervention. While most TDHs present acutely, a subset of cases may have a delayed presentation, posing diagnostic and management challenges. This case report describes a 66-year-old woman who developed a delayed left-sided TDH following a motor vehicle accident, initially misdiagnosed as pneumothorax. A 66-year-old female presented to our hospital with complaints of severe left-sided chest pain and progressive dyspnea four days after a motor vehicle accident. Initial assessment at another hospital revealed rib fractures and pneumothorax, for which a chest tube was inserted. However, her respiratory symptoms persisted, prompting further evaluation. A chest X-ray and subsequent thoracoabdominal CT scan revealed a large left-sided diaphragmatic hernia with herniation of abdominal viscera into the thoracic cavity. The patient underwent emergency laparotomy and diaphragmatic hernia repair with primary closure. Postoperatively, the patient's symptoms improved significantly, and she was discharged home with complete resolution of her complaints. In conclusion, this case highlights the importance of maintaining a high index of suspicion for TDH in patients with a history of trauma, even in the absence of initial suggestive findings. Delayed presentation of TDH can occur, and a thorough evaluation, including imaging studies, is crucial for accurate diagnosis and timely management.

Chronic Cutaneous and Mucosal Mucormycosis: Rhizopus arrhizus as a Major Pathogenic Fungus.

Chronic cutaneous mucormycosis is a rare condition distinct from the acute form, characterized by a prolonged, indolent course and varied clinical presentations. This study presents a 5-year experience from a tertiary dermato-mycology clinic, identifying six cases, the majority of whom were immunocompetent, with trauma history reported in four patients. The median duration from symptom onset to diagnosis was 60 months. The primary pathogens identified were Rhizopus arrhizus, Mucor variabilis, and Lichtheimia ramosa. Histopathological analysis demonstrated the absence of fungal angioinvasion, a hallmark of acute mucormycosis, which likely accounts for the slower progression observed in chronic cases. Systemic Amphotericin B treatment achieved favourable outcomes in most patients, though significant morbidity persisted in some cases. This case series underscores the clinical and pathological distinctions of chronic cutaneous mucormycosis, highlighting the potential influence of host factors and environmental conditions on chronicity. The predominance of Rhizopus arrhizus suggests that chronicity is driven more by host-pathogen interactions than fungal species-specific factors. Increased recognition of the atypical clinical features, such as diverse cutaneous manifestation and slower progression course, as well as the utilization of diagnostic tools including histopathology, fungal culture, and advanced molecular techniques, is essential for timely diagnosis of this rare presentation.

Childhood trauma and Axis I disorders in borderline personality disorder: a correlational study

BackgroundAxis 1 disorders often occur in combination with borderline personality disorders (BPD), which complicates treatment and diagnosis. Also, childhood trauma is found to be an underlying factor in patients with BPD. Considering the various statistics and the importance of accompaniment, this study aims to determine the prevalence of Axis 1 disorders in BPD and evaluate the association with childhood trauma.Materials and methodsIn this descriptive-analytical study, 239 patients with BPD were examined among patients referred to the psychiatric hospital in Sari, North of Iran. To confirm the diagnosis, the semi-structured clinical interview for DSM-IV (SCID-1) was performed, and the history of childhood trauma was assessed with the Early Trauma Inventory-Self Report. Data after collection was entered into SPSS software and using descriptive statistics like absolute and relative abundance. Mean and standard deviation and inferential statistics were analyzed.ResultsThe prevalence of major depressive disorder (MDD) was 59.8%, obsessive–compulsive disorder (OCD) 53.1%, generalized anxiety disorder (GAD) 17.6%, and phobias 23.4% in BPD. There was also a significant association between childhood emotional trauma and MDD (P = 0.03) and substance use disorder (SUD, P = 0.008), neglect trauma with post-traumatic stress disorder (PTSD, P = 0.03), phobia (P = 0.001) and GAD (P = 0.02), and physical and sexual trauma with SUD (P = 0.02).ConclusionAxis 1 disorders are common in patients with BPD. Childhood trauma with its effects on the brain of children and adolescents can lead to chronic disabilities in coping with arousal fluctuations and consequently to increased emotional disturbances including BPD and depression, which in turn leads to self-injurious behavior.

Pattern and Trends in Management of Deep Neck Abscesses

Abstract Introduction: Deep neck spaces are potential spaces at risk for infections and abscess collections, they continue to be a source of significant morbidity and mortality which may reach as high as 48% and 2%, respectively. The diagnosis and treatment of these conditions are challenging. Clinical signs and symptoms can differ from one patient to another according to affected space. Review of contemporary literature revealed several aspects of diversity regarding the incidence, etiology, diagnosis, and treatment of such infections. Aim of Study: This retrospective study aims to clear the points of diversity and to determine modalities of different types of neck space abscesses. Materials and Methods: This is a descriptive retrospective study design conducted at Ohud Hospital, Medinah, Saudi Arabia. A total of 18 cases of deep neck space infection (DNSI) met our inclusion criteria. A datasheet that has the parameters - age, gender, symptoms, site involved, bacteriology, culture growth, intervention required, complications - was used. The data in our research were analyzed and compared to other papers to figure out and suggest the latest recommendations. Results: Eight patients (44.5%) presented primarily with retropharyngeal abscesses and four patients (22%) had Ludwig’s angina, the remaining six patients (33.5%) presented with submandibular or submental abscesses. Four patients (50%) of the retropharyngeal abscess group had history of trauma to the pharynx by sharp objects while two patients (25%) the abscess was tuberculosis. Five patients out of 10 (50%) who had Ludwig’s angina or submandibular abscess had a dental infection as a predisposing cause. Leukocytosis and fever were the most common clinical presentation. Lateral neck view was done in 17 patients, which was positive in 16 (94%). Computed tomography scan was used in only seven patients (39%) and was positive in all of them (100%). Bacteriologic study was done in only 14 patients (78%) and was positive in 12 cases. All patients were subjected to surgical drainage either due to no improvement or worsening of symptoms after 24 h. Conclusions: Many studies discussed different aspects of DNSI including the presentations, causes, microbiology, investigations, complications, and management. The results and conclusions may or may not match in the studies. We present our experience and clarify pattern and the trends of the management.

Mother to Daughter, Wounds to Words: An Analysis of Intergenerational Trauma in Jamaica Kincaid’s Girl

Jamaica Kincaid’s short story, Girl examines the mother-daughter relationship from the perspective of intergenerational trauma and cultural transmission. Written in the form of a one-sentence monologue, the mother describes in great detail how the girl in question, who is her daughter, should behave within the framework of domesticity, sociability, and sexuality. The mother can be seen attempting to protect her daughter from the society that objectifies and undermines women; however, reading the list of warnings that she gives her daughter evokes a poignant discomfort within the reader as well. This paper attempts to interpret Girl from the perspective of intergenerational trauma, an idea described by authors such as Bessel van der Kolk and Maria Yellow Horse Brave Heart as the transmission of historical traumas through personal history. The mother’s behavior as a controlling figure and the silence around her own experiences in life cause confusion and result in submission from the daughter, thus creating a cycle of trauma. Ultimately, Girl might be interpreted as a commentary on the consequences of cultural trauma on personal experience and familial relationships. In this case, healing might be facilitated by open communication lines, trust, and respect, as it provides a way to terminate the cycle of silence. The story calls for empathy and understanding of the painful nature of intergenerational trauma, as the very act of being acknowledged and validated which in turn serves as a powerful means for healing and adaptation.

A network analysis of ICD-11 complex PTSD symptoms in the treatment-seeking population in Iran

IntroductionThe 11th revision of the World Health Organization’s International Classification of Diseases (ICD-11) introduces a new disorder called complex posttraumatic stress disorder. This disorder is heterogeneous, and identifying its core symptoms is important for understanding its different aspects. The network approach to psychopathology allows for examining the structure of Complex PTSD at a symptom level, which helps in analyzing direct interactions between symptoms. This study aimed to explore the symptom structure of complex PTSD and identify critical symptoms in the treatment-seeking population in Iran.MethodsParticipants consisted of 463 people referred to comprehensive health centers in Tehran from September to December 2023 with psychopathological syndromes who had a history of trauma at different developmental stages. Complex PTSD symptoms were assessed using the International Trauma Questionnaire (ITQ) and International Measurement of Exposure to Traumatic Event checklist. Network analysis was applied to identify the most central symptoms (nodes) and associations between symptoms (edges) by the graphical LASSO algorithm and the EBCglasso method for network estimation.ResultsThe result showed that the network of estimated symptoms for Complex PTSD in Iranian culture was highly accurate and stable. The most central symptoms in this network were feelings of failure and worthlessness. Additionally, “long-term upset” was identified as the connection between PTSD symptoms and DSO.ConclusionsThe study determined that feelings of failure and worthlessness are the most central symptoms in the Complex PTSD network. It was suggested that these symptoms should be given priority in theoretical and treatment models of Complex PTSD.

Psychedelic iatrogenic structural dissociation: an exploratory hypothesis on dissociative risks in psychedelic use

Psychedelic iatrogenic structural dissociation: an exploratory hypothesis on dissociative risks in psychedelic use

Evaluation of the psychometric properties of trauma history measures: Assessment of reliability and validity.

Psychological trauma is a pervasive, influential antecedent in a variety of mental health presentations; however, the comparative reliability and validity of long-standing self-report trauma history batteries remain unclear despite recent developments in trauma assessment. The present study employed both clinical and nonclinical samples to conduct a range of psychometric analyses on three of the most commonly used "legacy" measures of psychological trauma history: Traumatic Life Events Questionnaire (TLEQ), Trauma History Questionnaire, and Traumatic Events Questionnaire. Criterion and convergent validity were assessed along with test-retest reliability and social desirability effects. Participants were a treatment-seeking sample of mental health patients (N = 79; age = 46.5; 26.0% female) and a student sample (N = 136; age = 21.0; 82.7% female). Traumatic event scores on the measures correlated significantly with each other, indicating acceptable levels of convergent validity (r = .71-.82). Acceptable test-retest reliability was obtained in the student sample (intraclass correlation coefficients = .69-.78), despite several subscales exhibiting some temporal instability. Criterion validity produced a more complex picture. The TLEQ and Traumatic Events Questionnaire correlated significantly with posttraumatic stress disorder symptoms in both samples, whereas the Trauma History Questionnaire did not correlate with posttraumatic stress disorder symptoms in the student sample. All three batteries exhibited significant negative relationships with social desirability, indicating potential reporting bias. Overall, the TLEQ emerged as the most robust legacy measure of trauma history. Future studies should assess its psychometrics in comparison with the new generation of measures (i.e., Life Events Checklist, International Trauma Exposure Measure) to further the development of assessment tools in this area. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Mandibular Turner’s Tooth: A Rare Sequela of Traumatic Dental Injury Observed in Successor Tooth

Abstract Traumatic dental injury has a higher incidence in childhood, specifically during the development of locomotion skills and outdoor activities. Episodes of traumatic dental injuries can occur in both primary and permanent dentition. Impact on primary tooth/teeth leads to sequelae in developing successor tooth bud, which ranges from discoloration to structural defects. The current case report discusses a 9-year-old boy with a history of trauma at the age of 3 years (before the eruption of permanent teeth), which resulted in a rare finding of Turner’s hypoplasia in the left mandibular central incisor. Treatment modality microabrasion followed by composite restoration was suggested to restore the discoloration and structural defect. The case report will enlighten about various treatment modalities with supporting evidence. Treatment of Turner’s tooth addresses complicated issues pertaining to a child’s well-being, function, appearance, and self-confidence.

Childhood Adversity and White Matter Microstructure: White Matter Differences Associated with Trauma Exposure

Current research on the effects of childhood trauma largely focuses on maltreatment. In the current study, we used diffusion tensor imaging (DTI) to determine the association between potentially traumatic exposures not related to maltreatment and fractional anisotropy (FA) in 184 youth aged 9–14 years. The Trauma History Profile was used to determine how many traumatic events in different categories were experienced and create low- and high-trauma groups. FA values were compared between groups in twelve a priori chosen regions of interest (ROIs). Five of the twelve regions showed significantly lower FA in the high-trauma groups when compared to the low-trauma groups, including the body of the corpus callosum, the total corpus callosum, bilateral posterior thalamic radiation, and the left cingulate gyrus projection of the cingulum bundle. Group differences were also observed across a range of behaviors. However, FA was not associated with posttraumatic stress symptomology. The results support the hypothesis that the high-trauma group had lower FA compared to the low-trauma group. The significant ROIs represent a subset of regions identified in studies of adults exposed to traumatic childhood events or children with a history of maltreatment. These results, obtained from typically developing youth, underline the importance of examining childhood trauma exposure in future developmental studies.

Effect of age on the treatment duration and proposed "impacted incisor severity score" of impacted maxillary incisor: A retrospective study.

Effect of age on the treatment duration and proposed "impacted incisor severity score" of impacted maxillary incisor: A retrospective study.

Bolstering family therapy: Assimilating EMDR into ABFT in youth residential treatment.

The psychotherapy field has a long history of integration to improve treatment effectiveness. One type, assimilative integration, offers innovative opportunities to family therapy to incorporate the clinical and research contributions of different approaches. This paper contributes to the literature on integration by exploring how Eye Movement Desensitization and Reprocessing (EMDR) can be assimilated into Attachment-Based Family Therapy (ABFT) for youth in residential psychiatric treatment. ABFT seeks to improve attachment security to parental figures by asking adolescents and young adults to discuss attachment ruptures. This process, specially designed for patients with internalizing disorders, can provoke anxiety, particularly for a patient population that commonly has a history of trauma and adverse life experiences. EMDR is a first-line therapy for post-traumatic stress disorder and has the potential to be effective in treating various other mental health conditions. When patient emotional withdrawal or dysregulation due to breaches in trust between child and parent emerges in ABFT, EMDR may help desensitize associated memories and bolster the family therapy process. The authors provide an overview of both models, and a detailed case study as an example. The paper concludes with a discussion on implications, integration efforts, and limitations.

Then, Now, Later, Always

Abstract Considered here are two recent monographs and an essay collection that constitute evidence of a contemporary boom in both historical fiction and critical consideration thereof. In response to Alexander Manshel’s Writing Backwards, Alexandra Lawrie’s Writing the Past in Twenty-First Century American Fiction, and Historical Fiction Now, edited by Mark Eaton and Bruce Holsinger, this essay mediates between competing definitions of the historical and the contemporary proffered by the three works examined, before taking up Manshel’s argument that the ascendancy of historical fiction and the belated canonization of African American authors are not merely coincident. In so doing, this essay posits that a publishing ecosystem increasingly set on framing fictionalized histories of racial trauma as salutary learning experiences may in fact offer (white) readers the opposite—a comforting dislocation of unresolved traumas and complicities into the safety of the past.

Clinical characteristics and analysis of drug treatment efficacy in hospitalized patients with sudden hearing loss due to enlarged vestibular aqueduct syndrome

Objective:To explore the clinical characteristics, audiological outcomes, and factors influencing the efficacy of pharmacological treatment in patients with sudden hearing loss associated with large vestibular aqueduct syndrome（LVAS）. Methods:A retrospective analysis was conducted on the clinical data of 77 bilateral LVAS patients（117 ears） hospitalized for sudden hearing loss from January 1, 2009, to December 31, 2023. The inclusion criteria required that patients to be diagnosed according to the Valvassori standard and had received standardized pharmacological treatment. Clinical features, audiological outcomes, and treatment efficacy were analyzed. Statistical methods were employed to identify factors associated with treatment outcomes. Results:The age of the enrolled patients ranged from 4 to 37 years. The age of onset for the initial hearing fluctuation varied between 0 and 24 years, with a mean age of 5.8 years. The male-to-female ratio was approximately balanced（37 males and 40 females）. The proportion of unilateral to bilateral sudden hearing loss was 1.0︰1.2, with unilateral right ear hearing loss being more frequently occurring（64.9%）. Triggering Factors: Triggers included no identifiable factors in 48.1% of cases, a history of head trauma（24.7%）, upper respiratory tract infections（11.7%）, onset following physical fatigue（11.7%）, and less frequently, noise exposure, alcohol consumption, or emotional stress（each 1.3%）. Clinical Symptoms: Hearing loss was the sole symptom in 35.1% of cases. Concurrent symptoms included vertigo in 44.2% and tinnitus in 46.8%. Patients with a disease duration of ≤14 days demonstrated a treatment efficacy rate of 75.0%. Among those who responded to treatment, 93.0% had profound or greater hearing loss prior to therapy, with an average improvement in hearing thresholds of 32 dB HL. In pretreatment, 68.9% of patients exhibited low-frequency air-bone gaps, increasing to 76.1% post-treatment. Additionally, 17.6% of treated ears demonstrated a ≥15 dB HL improvement in low-frequency bone conduction thresholds. In the non-responsive group, 7.3% of ears still showed some improvement in bone conduction thresholds. Statistically significant differences（P<0.05） were observed between the treatment-effective and non-effective groups concerning the age of initial hearing fluctuation, disease duration, and severity of hearing loss at onset. Conclusion:The efficacy of pharmacological treatment for sudden hearing loss in LVAS patients is influenced by the age at onset, duration of the disease, and severity of hearing impairment. Early diagnosis and timely intervention significantly enhance treatment efficacy, particularly in patients with a disease duration of ≤14 days and an initial sudden hearing loss. Patients with severe hearing loss, especially those with profound or greater impairment, exhibit greater sensitivity to treatment. Pharmacological interventions positively impact both air conduction and bone conduction thresholds, with the observed improvement in bone conduction thresholds warranting further investigation.

Multisite pain among United States Veterans with posttraumatic stress disorder: Prevalence, predictors, and associations with symptom clusters.

Multisite pain among United States Veterans with posttraumatic stress disorder: Prevalence, predictors, and associations with symptom clusters.