Impact Of Traumatic Experiences Research Articles

Impact of traumatic experiences and violent acts upon response to treatment of a sample of Colombian women with eating disorders

The current article compared the impact of exposure to sexual trauma and other types of physical threats against the patient or the patient's family on response to treatment, relapse, and dropout rates in 160 Colombian women between 12 and 49 years of age with eating disorders. A comparison was made to 70 cases with unsatisfactory response to treatment and 90 controls with a better response to treatment goals. Forty-five percent had a history of sexual abuse, other violent traumas, or both. Significant statistical differences were observed between both groups in exposure variables. The highest probability of poor outcome was observed in patients with sexual abuse and exposure to other violent acts (odds ratio [OR] = 6.37, 95% confidence interval [CI] = 2.1-19.07). The risk of dropout or relapse was, respectively, 10 and 3 times greater among those exposed. Violent social conditions should be noted as another form of trauma with potential impact on outcome in Colombian women with eating disorders. (

Dissociation of the “Bad” Parent, Preservation of the “Good” Parent

Steven Marmer, the psychoanalyst, observed that the term dissociation suffers from “multiple meaning disorder” (personal communication, 1991). Dissociation is variously used to describe a range of normal psychological phenomena related to everyday aspects of divided attention (Hilgard 1986); a “continuum” of psychiatric symptoms and disorders sometimes termed “pathological dissociation” (Waller and Ross 1997); a complex psychobiological process hypothesized to protect the person from the immediate impact of traumatic experiences (Spiegel 1984); and an intrapyschic defense conceptualized as attempting to isolate and control autobiographical memory of previously experienced trauma (Loewenstein and Ross 1992). Further, these differing theoretical domains concerning dissociation can overlap considerably. Modern conceptual izat ions of dissociative disorders view them primarily as posttraumatic conditions (Spiegel 1991). Treatment is based on the notion that these conditions primarily result from an originally adaptive, protective intrapsychic process that allows for psychological survival and growth despite overwhelming and/or catastrophic circumstances (Armstrong 1995; Putnam and Loewenstein 2000). On the other hand, recent research on “peritraumatic dissociation” suggests that dissociation is a robust predictor of poorer clinical outcome after trauma (Birmes et al. 2003; Marmar et al. 1998). Freud’s original concept of repression as defending against recall of traumatic memories was related to Janet’s ideas about dissociation, hysteria, and hypnosis (Breuer and Freud 1893-1895; Janet 1901). Despite the disavowal of Janetian ideas in subsequent Freudian writings, and very different later psychoanalytic conceptualizations of repression, the linkage of the terms “dissociation” and “repression” has persisted (Rapaport 1942). This may partly explain the conflation of these two terms in the recent “memory wars”—the socio-political, forensic, media, and academic controversies over the existence of delayed recall for traumatic experiences. In a courageously honest narrative of her own struggles with childhood sexual abuse and its impact upon her, Penelope Hollander illustrates several of these different ideas about dissociation and its clinical manifestations. For example, she reports, “my Psychiatry 67(3) Fall 2004 256

Sensing the invisible: differential sensitivity of visual cortex and amygdala to traumatic context

To what extent does emotional traumatic context affect sensory processing in the brain? A striking example of emotional impact on sensation is manifested in posttraumatic stress disorder (PTSD), in which a severe emotional trauma produces recurrent and vivid unpleasant sensory recollections. Here we report on an fMRI study exploring the sensory processing of trauma-related pictures in the visual cortex and amygdala in respect to PTSD. The impact of traumatic experience on brain responses was tested in relation to stimuli content and its level of recognition in a parametric factorial design. Twenty combat veterans, 10 with and 10 without PTSD, viewed backward-masked images of combat and noncombat content, presented at below, near, and above recognition thresholds. The response to combat content evoked more activation in the visual cortex in PTSD subjects than in non-PTSD subjects, only when images were presented at below recognition threshold. By contrast, the amygdala demonstrated increased activation in PTSD subjects irrespective of content and recognition threshold of the images. These intriguing findings are compatible with the notion that in PTSD, emotional traumatic experience could modify visual processing already at the preattentive level. On the other hand, lack of content specificity in the amygdala point to a possible predisposed mechanism for pathological processing of traumatic experience. The differential sensitivity of the amygdala and visual cortex to traumatic context implies distinct roles of limbic and sensory regions in the registration and recollection of emotional experience in the brain.

Impact of trauma on sexual functioning and sexual relationships

This paper considers the impact of traumatic experiences on sexual functioning and sexual relationships. There is a large literature on the way sexual trauma affects later sexual functioning and relationships. Non-sexual traumatic experiences also affect these domains. The focus here is on the latter, with reference to the literature and to case examples. Some comments are also made on clinical treatment issues.

Impact of trauma on sexual functioning and sexual relationships

This paper considers the impact of traumatic experiences on sexual functioning and sexual relationships. There is a large literature on the way sexual trauma affects later sexual functioning and relationships. Non-sexual traumatic experiences also affect these domains. The focus here is on the latter, with reference to the literature and to case examples. Some comments are also made on clinical treatment issues.

Western conceptualizations and eastern experience: A cross‐cultural study of traumatic stress reactions among Tibetan refugees in India

This study investigated the nature and impact of traumatic experiences among Tibetan refugees in India. It explored the applicability of western conceptualizations of reactions to traumatic events among this cultural group. A randomly selected sample of refugee camp students was assessed on measures of psychological and physical complaints, and on impact as well as severity of traumatic experiences. Respondents had experienced multiple traumatic events. The majority reported ongoing health problems. More than half demonstrated symptoms of intrusion-avoidance. Those with more traumatic experiences reported more symptoms of anxiety and depression (psychologically and, particularly, somatically manifested). Cultural differences in types of experienced traumatic events and manifestations of distress are discussed, as are implications for cross-cultural trauma research using western conceptualizations and instruments.

Cognitive impact of traumatic events.

The impact of traumatic experiences on cognitive processes, especially memory, is reviewed. The major psychological sequelae of trauma (reexperiencing, avoidance, hypervigilance) and posttraumatic stress disorder (PTSD) are noted and related to traditional views of fear conditioning. Evidence indicating enhanced memory for the gist of emotional events is reviewed as are psychological and neurophysiological mechanisms underlying this enhancement. This view is updated by introducing the distinction between explicit and implicit memory and its relevance to traumatic memory and PTSD. The central role of "the experiencing ego" in the storage and retrieval of episodic memories is postulated. This leads into discussion of dissociative experiences during traumas and the occasional amnesia for voluntary recall of the trauma accompanied by involuntary, uncontrollable flashbacks of it. The relationship of dissociative experiences to hypnotizability and to pathological reactions to traumas is discussed, although the interpretation of those correlations is questioned. The article concludes by noting that beyond conditioning of fear, traumas often violate and shake the victims' basic assumptions about the benevolence, justice, and meaningfulness of their physical and social worlds. Psychotherapy with trauma victims then needs to attend not only to extinguishing the victims' fear and feelings of extreme vulnerability, but also to rebuilding their basic beliefs about the relative benevolence of the world.

Is it possible to assess the impact of abuse on children with pervasive developmental disorders?

Although it is now recognized that children may exhibit widespread symptoms of stress following exposure to abuse or neglect, the impact of traumatic experiences on children with pervasive developmental disorders has received little attention. The present paper describes a strategy devised to assess the long-term effects of abuse on a group of children who had attended a specialist autistic school where physical and emotional mistreatment of pupils was well documented. Because most of the children had very limited communication skills, the evidence relied heavily on retrospective parental reports. Despite the problems inherent in using such data it was possible to derive reliable measures that could be used to test hypotheses about predicted patterns of behavioral change, based on work with other children who have been abused. In most cases, too, parental reports could be corroborated by information from other sources. Consistent patterns in both the nature and timing of behavioral disturbances were found, which seemed to relate specifically to the period of abuse at the school.