Individual Trauma Research Articles

Israel–Palestine: Unresolved group trauma is an obstacle for peace

This article explores key aspects of man-made human suffering from a psychoanalytic, group-analytic and group attachment standpoint. It postulates that, when unresolved individual and group trauma remains untreated, it can be a fuel for vicious cycles of hatred, terror and destruction. In order to explore this, the article focuses on the intractable Israel–Palestine conflict; it invites the reader to reflect on the Jewish Holocaust and the Palestinian Nakba and their role in the perpetuation of the ongoing conflict. It includes a clinical case study of a Holocaust survivor who benefited from combined individual and group psychotherapy and became able to come to terms with her traumatic past. The aim of the present research is to encourage working harder for peace, endeavouring to achieve a deeper understanding of unconscious individual and group psychological defence mechanisms in the clinical setting as well as the sociopolitical context.

Addressing the Triple Trauma of Factors Leading to Perinatal Health and Mental Health Consequences in Two Upstate New York Communities.

This article focuses on the impact of trauma experienced by individuals, families and groups, and neighborhoods in Rochester and Syracuse, New York. Using the levels of analysis put forward in Bronfenbrenner's ecological systems theory (i.e., individual, family, and community), we argue that trauma operates at each of those levels. This mixed-methods study reviews the findings of seven previously published studies (with data collection ranging from 2000 to 2019), each of which addresses trauma among low-income residents. Specific methods include secondary analyses of births, qualitative interviews of persons who delivered a baby within the past two years, a community survey of residents living in high-crime areas, and secondary birth data to document the impact of socio-ecological risk factors on the trauma of birthing persons, their children, and their partners. Individuals and families living in high-risk neighborhoods (e.g., where residents experience frequent gun shots, racially disproportionate incarceration, and poverty) had more negative health outcomes including posttraumatic stress disorder, intrauterine growth restriction, and depression. Interventions focused on community-based practices that address individual, family, and community-level trauma must also address the multiple risk factors for trauma located in the environmental and social stressors.

Overlapping Traumas: Revisiting Trauma in Post-apocalyptic World of Anna Kavan’s Ice

This article offers a critical exploration of Anna Kavan’s Ice which includes a literary representation of trauma and its correlation with the concept of post-apocalypse. Establishing a preliminary dialogue between post-apocalyptic and trauma narratives, it investigates the individual and post-apocalyptic trauma both separately and holistically through a single text. The abandonment trauma and the traumatic glacial apocalypse create an interrelated discourse of post-apocalyptic trauma that encompasses changes on the protagonist of the novel and collectivities. Following Hobbesian discussion of social contract together with Golding’s Lord of the Flies, apocalyptic trauma and its symptoms are traced as disturbing demonstration of humanity’s primitive urges in the absence of social, religious, political, and moral orders. The analysis of the protagonist’s unrelenting quest and obsessive psychology through Lacanian concept objet a allows the discussion to diversify to address the individual trauma. Instead of casting Kavan’s novel as purely trauma narrative or post-apocalyptic account, this article reads her novel in a focused attentiveness to analyse different types of trauma and their merge with each other.

Adherence to national trauma triage criteria in Norway: a cross-sectional study

BackgroundNorwegian hospitals employed individual trauma triage criteria until 2015 when nationwide criteria were implemented. There is a lack of empirical evidence regarding adherence to Norwegian national criteria for activation of the trauma team (NTrC) and the decision-making processes regarding trauma team activation (TTA) within Norwegian trauma hospitals. The objectives of this study were to investigate institutional adherence to the NTrC and to investigate similarities and differences in the decision-making process leading to TTA in Norwegian trauma hospitals.MethodsA digital semi-structured questionnaire regarding adherence to criteria, TTA decision-making and criteria documentation was distributed to all Norwegian trauma hospitals (n = 38) in the spring of 2022. Contact details of trauma coordinators and registrars were provided by the Norwegian Trauma Registry secretariat. Follow-up telephone interviews were conducted at the investigator’s discretion in cases of non-respondents or need to clarify answers.ResultsThirty-eight trauma hospitals were invited to answer the survey, where 35 hospitals responded (92%), making 35 the denominator of the results. Thirty-four (97.1%) hospitals stated that they followed NTrC. Thirty-three (94.3%) of the responding hospitals provided documentation of their criteria in use, of which twenty-eight (80%) of responding hospitals adhered to the NTrC. Three (8.6%) hospitals employed a tiered TTA approach with different sized teams. In addition four hospitals (11.4%) used specialized teams to meet the needs of defined patient groups (e.g. geriatric patients, traumatic brain injury). Twenty-one (60%) of the responding hospitals had written guidelines on who could perform TTA and in 18 hospitals (51.4%) TTA could be performed by pre-hospital personnel. Twenty-three (65.7%) of the hospitals documented which criteria that were used for TTA.ConclusionThere is good adherence to the national criteria for activation of the trauma team among Norwegian trauma hospitals after implementation of national guidelines. Individual hospitals argue the use of certain local criteria and trauma team activation decision-making processes to increase their precision in specific patient populations and demographics. Further steps should be done to reduce the variation in TTA decision-making processes among hospitals and improve documentation quality.

“I see it running through my family”: The intergenerational and collective trauma of gender-based violence

This article uses two paradigmatic case studies to build on the theories of intergenerational and collective trauma to argue that dissociation should be a key target of prevention strategies for gender-based violence. To illustrate this point, we draw on the life histories of two Australian grandmothers, Kylie and Louise, who described how abuse in early childhood shaped their experiences of violence in adulthood, which in turn impacted their children and, consequently, their grandchildren. We trace the parallels and intersections between individual and collective trauma through their narratives, as well as the silencing of these traumas, with a focus on how children and women are forced to adapt to gender-based violence in the context of collective forgetting and dissociative responses embedded in communities and institutions. We identify a dialectic relationship between individual and collective dissociation, whereby dissociogenic communities and institutions with entrenched defense mechanisms against the recognition of gender-based violence force victims to dissociate at the individual level, thus maintaining collective dissociative structures while increasing the risk of future victimization for women and their children. We argue that the primary prevention of gender-based violence would be enhanced by addressing the prevalence and burden of trauma for affected individuals and families, thereby interrupting intergenerational transmission and addressing the dissociative underpinnings of collective failures to protect women and children from violence.

(Re)Framing the Spectrum of Trauma(s) Experienced During the Sri-Lankan Civil War: A Critical Exploration of the Graphic “Non-fiction-fiction” Vanni

Ethno-graphic narratives have increasingly served as an alternate politico-historical commentary on traumatic events, and Vanni is no exception. By analyzing the iconical language embedded in this graphic ‘non-fiction-fiction’, the article portrays the varied aspects of trauma experienced by individuals and the collective during the prolonged Sri Lankan conflict, thereby documenting the enduring biopsychosocial impacts of the trauma of dwelling, living through, and leaving conflict zones. To elaborate, the paper explores the visual and verbal mechanisms through which the spectrum of trauma, namely intergenerational, collective, and individual trauma, finds representation in this ethnographic text. Firstly, the article explores how Vanni represents the protracted conflict that impacts generations of the Tamil community through the visual-verbal mode of the text, thereby showcasing the mechanisms of understanding intergenerational trauma. Secondly, it analyses the varied aspects through which collective trauma finds representation in the ethnographic narrative, and finally, the study outlines select individual experiences of trauma within the frame of collective suffering. By decoding the lexical and imagistic expressions of trauma in Vanni, the article argues that the graphic narrative form has been able to memorialize the abysmal trauma(s) experienced during the Sri Lankan conflict, thereby serving as a site of memory and countering collective amnesia.

Writing Lifes: A Biopoetical Approach to María Teresa León’s Literary Production

This article proposes a biopoetical analysis of a selected number of texts written by María Teresa León (1903‑1988), especially during her Argentinian (1940‑63) and Roman exile (1963‑77). It becomes apparent that the majority of her literary production is dedicated to the writing or re-writing, always mixing fact with fiction, of several biographies of the protagonists of the Spanish cultural background and mythology, including her own autobiography, Memoria de la melancolía (1970). According to this corpus, the study will focus on two main aspects: the implications and influences of biology – in its meaning of science of life – in the field of narratology – as the science of narration – and the use of narration as a therapy against individual and collective trauma.

Embodied Trauma in the Lord of the Rings

ABSTRACT The portrayal of embodied trauma in Lord of the Rings is varied and pervasive. Characters manifest their trauma as physical, psychosomatic pain, as well as difficulty regulating their emotions and behaviours. The treatment methods in Lord of the Rings are less medical in nature and more to do with healing the spirit, but nonetheless indicate an awareness of the importance of methods like verbalising trauma and avoiding patients' isolation. The variety of portrayals reflects the real-world fact that every individual experiences and internalises trauma differently, and the fact that the trilogy was published at such a moment in history – following two world wars, one of which the author actively fought in – serves to heighten the impressive real-world applicability of these portrayals. Whether Tolkien was reflecting his own experience, or the literary tradition of war in fiction, the corporeal effects of trauma on characters is recognisable and engaging.

Impact of extracorporeal blood pump gap sizes on the performance and hemocompatibility under off-design operation.

Hemocompatibility remains the dominant challenge in rotary blood pumps, and more information on the relationship between individual pump design features, hemodynamics, and blood trauma in various operation conditions is necessary. The study evaluated the variation of gap sizes in extracorporeal blood pumps concerning their influence on blood compatibility, particularly during off-design conditions. We developed a parametric generic blood pump framework for in-silico and in-vitro design feature analysis. Thirty-six designs with varying axial and radial gap sizes between 0.5 mm and 3 mm were generated. CFD was applied to calculate and compare device hemodynamics and evaluate the performance and hemocompatibility during off-design and target operation conditions. The following quantities were analyzed: pressure difference, hemolysis potential, residence times, hydraulic efficiency, and recirculation ratio. The in-vitro prototype showed excellent agreement with in-silico predictions regarding hydraulic performance (R2 = 0.996 with a RMSE = 2.07). Our results show a modest impact of gap size variations ±10% on key metrics. Domain-resolved analyses revealed a significant contribution of the gap regions to the device's overall hemolytic performance, with an increasing contribution for off-design flow rates. Overall elevated hemolysis levels were identified if at least one gap size was held minimal. We introduced and showed the feasibility of a parametric rotary blood pump framework to systematically investigate design feature impact. Results suggest, larger and uniformly sized gaps being overall beneficial regarding hemocompatibility.

Long-term PTSD prevalence and associated adverse psychological, functional, and economic outcomes: a 12–15 year follow-up of adults with suspected serious injury

ABSTRACT Background: An increasing number of longitudinal studies investigates long-term PTSD, related outcomes and potential gender differences herein. However, a knowledge gap exists when it comes to studies following individual civilian trauma beyond a decade post-trauma. Objective: To investigate the long-term PTSD prevalence, associated adverse psychological, functional and economic outcomes related to (suspected) serious injury of 12–15 years ago in Dutch adults, as well as potential gender differences herein. Method: N = 194 trauma-exposed adults (34% women) admitted to an emergency department following suspected serious injury completed a follow-up assessment 12–15 years (M = 14.30, SD = 1.00) post-trauma. Participants completed assessments of clinician-rated PTSD symptom severity, as well as self-report questionnaires on psychological, functional and economic outcomes. Results: Nine participants (4.8%) fulfilled the DSM-5 diagnostic criteria for PTSD related to the index trauma of 12–15 years ago. Results showed that PTSD symptom severity (CAPS-5) was significantly associated with more severe symptoms of anxiety (HADS) and depression (QIDS), lower well-being (WHO-5) and (health-related) quality of life (WHOQOL; EQ-5D-5L), but not with alcohol use (AUDIT), productivity loss at work (iPCQ) and health care use (iMCQ). No significant gender differences in the long-term PTSD prevalence nor in its related psychological, functional and economic outcomes were found. Conclusions: Our findings underscore the long-term presence of PTSD and associated adverse psychological and functional outcomes in a proportion of adults who experienced (suspected) serious injury over a decade ago. PTSD is already widely recognized for its substantial impact in the aftermath of a trauma. The current study emphasizes the potential long-term consequences of individual civilian trauma, highlighting the importance of accurate screening and prevention for PTSD.

W.G. Sebald’s Austerlitz and the Problems of Representation

Abstract: In W.G. Sebald’s novel Austerlitz (2001), the eponymous protagonist’s investigation into his origins induces a dynamic reinterpretation of his past and consequent reformulation of his identity that is deeply informed by cultural and historical determinants. Austerlitz and his unnamed interlocutor’s conversations over a period of 30 years not only explore the nature and impact of individual and collective trauma, but also enact the inherent ambiguities of its narrative representation, raising worthwhile concerns about reliability and validity. At the confluence of personal and historical memory, where archive serves an end that is aesthetic as much as efferent, this ongoing phenomenological-hermeneutic effort at negotiating meaning ultimately rehearses the possibilities and limitations of literature as a source of knowledge.

Resilience and Engagement in Crisis: Fostering Trauma-Informed Care and Patient Partnerships Into the Future.

The COVID-19 pandemic has significantly disrupted patient engagement and exposed long-standing inequities within Canada's healthcare system. As a patient partner and caregiver, the author reflects on the exacerbated challenges during the pandemic, particularly for hardly reached communities and those managing chronic conditions. The crisis highlighted the absence of opportunities for patient partnership, with healthcare organizations halting engagement activities despite an increased need for communication and community involvement. The pandemic underlined the necessity of trauma-informed care and engagement-capable environments (ECE). To address these challenges, the author advocates for integrating trauma-informed practices with ECEs, thereby promoting a healthcare model that is both structurally supportive and responsive to individual trauma and resilience. By focusing on compassion, recognizing trauma and fostering engagement, such an approach could enhance patient outcomes and create a more adaptive, inclusive healthcare environment.

Ментальна топографія травми (за романом володимира рафєєнка петрикор – запах землі після дощу)

The article is research into the traumatic experience of war, based on the Volodymyr Rafieienko’s novel Petrichor – Smell of the Earth after the Rain. It’s logical to examine this text from the position of trauma studies, which have become very actual in the context of the Russian-Ukrainian war and its consequences. The writer represented the prospect of overcoming collective and individual trauma in a very original way. He describes in details the painful experiences caused by the forced resettlement of people, and most of all – the feeling of guilt due to the death of close ones. Rafieienko’s novel reflects the world of imagination of a person with a disturbed psyche. In such a way, he suggests a new kind of narration where imaginarium (the world of fantasy, visions and the dreams of the characters) and the pictures of an unbearable reality, which must be recalled to understand the depth of the pain in order to continue living, are crossed in a natural way. Petrichor… represents the author’s individual vision of the cultural trauma, which causes a radical change in human identity. This new identity is the creative force and at the same time, it impresses on one the state of total danger, nationwide mobilization and solidarity. The writer raises the issue of sacred sacrifice. We mean the price that must be paid for the renunciation of the difficult past. All this leads to a persistent psychological disorder within the novel’s characters. Thus, Rafieienko carries out a mental topography of trauma, indicating its important markers and motives within a specific geocultural space.

A trauma expert consensus: Capabilities are required early to improve survivability from traumatic injury.

Mortality reviews examine US military fatalities resulting from traumatic injuries during combat operations. These reviews are essential to the evolution of the military trauma system to improve individual, unit, and system-level trauma care delivery and inform trauma system protocols and guidelines. This study identifies specific prehospital and hospital interventions with the potential to provide survival benefits. US Special Operations Command fatalities with battle injuries deemed potentially survivable (2001-2021) were extracted from previous mortality reviews. A military trauma review panel consisting of trauma surgeons, forensic pathologists, and prehospital and emergency medicine specialists conducted a methodical review to identify prehospital, hospital, and resuscitation interventions (e.g., laparotomy, blood transfusion) with the potential to have provided a survival benefit. Of 388 US Special Operations Command battle-injured fatalities, 100 were deemed potentially survivable. Of these (median age, 29 years; all male), 76.0% were injured in Afghanistan, and 75% died prehospital. Gunshot wounds were in 62.0%, followed by blast injury (37%), and blunt force injury (1.0%). Most had a Maximum Abbreviated Injury Scale severity classified as 4 (severe) (55.0%) and 5 (critical) (41.0%). The panel recommended 433 interventions (prehospital, 188; hospital, 315). The most recommended prehospital intervention was blood transfusion (95%), followed by finger/tube thoracostomy (47%). The most common hospital recommendations were thoracotomy and definitive vascular repair. Whole blood transfusion was assessed for each fatality: 74% would have required ≥10 U of blood, 20% would have required 5 to 10 U, 1% would have required 1 to 4 U, and 5% would not have required blood products to impact survival. Five may have benefited from a prehospital laparotomy. This study systematically identified capabilities needed to provide a survival benefit and examined interventions needed to inform trauma system efforts along the continuum of care. The determination was that blood transfusion and massive transfusion shortly after traumatic injury would impact survival the most. Expert Opinion; Level V.

Gendered Realities: Reforming Juvenile Justice in India

For the past few decades, the juvenile justice system in India has shifted from a rehabilitative to a retributive paradigm, leading researchers to become increasingly interested in the gendered implications of paradigm change that may exacerbate problems of young offenders, especially females. The current article explores the question of how social attitudes, institutional prejudices, and intersectional identities affect the ways in which female offenders are perceived and treated in India. The framework for the current study includes theoretical concepts of rehabilitation, retribution, and feminist theory. The use of secondary analysis and the description of policy changes and historical context studies are included in the research. Employing a data-driven analysis based on a combination of case studies, quantitative data, and inter-state comparison, the research reveals that female offenders face systemicinstitutional and individual problems, including re-victimization, trauma, and inadequate access to quality rehabilitation services. This article argues for genderresponsive and intersectional juvenile justice policies and redirects attention to rehabilitation available results for future policy and research initiatives

Encounters through books of light: uncanny television and media archaeology in The Living and the Dead

ABSTRACT This article conducts an analysis of the BBC/BBC America supernatural drama The Living and the Dead, which ran for six episodes in 2016. It considers the drama’s association with traditions of uncanny television, and its use of ahistorical objects and artefacts to construct its unique aesthetic. The mutual haunting between main character Nathan (Colin Morgan) in the nineteenth century and his twenty-first century descendant Lara (Chloe Pirrie) is shown to allow the series to pursue a complex engagement with the past. Nathan’s grief over the death of his young son informs his endeavours to understand the supernatural occurrences in the fictional Shepzoy village, leaving him caught between his individual trauma and responsibilities to the community. The drama’s media archaeology is established through its depiction of historical objects and the construction of archival material, most prominent in the motif of photography. The digital recordings of Lara’s iPad in the twenty-first century are compared with the objects of the past and connected to the series’ own mise-en-scène. The end of the series reveals the importance of these artefacts’ appearances across time, the mutual haunting between generations allowing the narrative to reach a resolution.

SOCIO-PSYCHOLOGICAL ASPECTS OF WAR AND THEIR TRANSGENERATIONAL DIMENSION

This paper is about the psychological effect of war. By the welding of the explanatory potential of psychoanalysis and anthropology, it argues that victims of armed conflict, particularly if protracted, construct a melancholic response (Yordanova, 2018). Often, people on the move are met with hostility by the host countries or may find themselves in the social periphery. This fosters ambivalence towards the new environment as an expression of vulnerabilities. The paper suggests an intergenerational aspect to the above dynamic, too. Children, exposed to violence, lack the emotional and cognitive maturity to grasp what they have lived through. Yet, overwhelmed with their own feelings of loss, their parents fail to help them deal with the trauma. Thus, children identify with the parents’ complicated grief and the assumption of an idealized pre-war past versus scarce future opportunities. Finally, the paper examines the intersections between individual war trauma, cultural memory and power dynamics in post-conflict societies. Using my field work in Sarajevo (2012, 2018), I argue that war survivors avoid the construction of a consistent war narrative in the first person because they need the state-recognized version of history to be re-written (Yordanova, 2015). The ambiguity of their experience in war, the inadequacy of language to convey horror, and the clash of private memories with the official discourse drive them to alternative forms of expression. Survivors and their children use art, humour, tattoos, scarring, and landscape to explain the war and get connected to each other. In the post-war environment, the narrative of veterans who were most exposed to warfare becomes muted in order not to challenge the political status-quo.

Delineating Dalit trauma: (re)contextualizing cultural trauma, survivor’s guilt and partial privilege in post millennial Dalit women’s memoirs

ABSTRACT Shilpa Raj’s memoir The Elephant Chaser’s Daughter (2017) and Yashica Dutt’s Coming Out as a Dalit: A Memoir (2019) map a specific kind of individual trauma, along with the cultural trauma that is found in other Dalit life writings. Both the narratives begin with the death of another Dalit individual whom the memoirists consider as a sibling/comrade who lacked the partial ‘privilege’ they enjoyed and the narratives can be read as negotiating this survivor’s guilt. Hence, these life writings are part elegies and part literature of protest. They are also part of biographies, for while the writer’s life story is one centre, these writings also have another centre – the real/imagined life of the dead person. As the writers compare and contrast their different destinies, we argue that these narratives (1) lay bare the complexities and limits of Dalit emancipation in modern India where the caste question has been seemingly resolved (2) call for an extension of the intersectional framework to analyse the concept of ‘partial privilege’ in Dalit life-writing.

Magical Representations of Individual and Collective Trauma in al-Samman’s Beirut Nightmares

This article examines Ghāda al-Sammān’s creative fictional depiction of the causes and the atrocities of the Lebanese Civil War (1975-1990) in her novel, Beirut Nightmares (1976). It investigates the author’s perceptive fusion of different artistic tropes in order to achieve a proper articulation of her sociopolitical commentary on the early years of the conflict. It shows how al-Sammān bears witness to the collective war trauma of the Lebanese people through the individual trauma of a female intellectual. Al- Sammān transcends the realistic representation of events in order to magnify the traumatic experience through her employment of gothic elements and magical realism which purposefully disrupt the chronology of the narrative. The apt employment of different tropes enables her to effectively criticize the legacy of colonization as well as the oppression of current totalitarian regimes. It also concludes that al-Sammān’s artistic techniques which bespeak trauma do not contradict with the intellectual’s attempts to heal her own wounds and to overcome her personal frustrations in order to fulfill her communal mission of enlightening people.

The Impact of Childhood Adversity on Life Course Alcohol Use Patterns and Health Status Among People Living with HIV

Adverse childhood experiences (ACEs) and financial hardship are associated with increased likelihood of heavier alcohol use and health challenges in adulthood among persons living with HIV (PWH). We examined whether retrospectively captured lifetime drinking trajectories are a pathway through which childhood hardships affect current health in a sample of 365 adult PWH. Childhood economic hardship and ACEs were used as main predictors. Measures of alcohol use included age at first drink and lifetime drinking trajectories. Health indicators included health-related quality of life, frailty, number of comorbidities, and symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD). Structural equation modeling (SEM) was applied to estimate both direct and indirect pathways between childhood hardship and physical and mental health. Participants were mostly male; Black (84%); and averaged 48 years of age. SEM results supported both direct and indirect pathways between childhood experiences and adult health. ACEs were connected to physical health directly and mental health both directly and indirectly through age at first drink and drinking heaviness during ages 10–20. Childhood economic hardship related to mental health indirectly through higher drinking levels during ages 10–20. Childhood adverse experiences, economic hardship, and early drinking patterns appear to accumulate, resulting in later life physical and mental health concerns for PWH. Findings support taking a life course approach to health. This includes considering individual trauma histories in HIV care engagement and taking preventative approaches which support the economic and social well-being of vulnerable children to improve health in subsequent decades.