Past Trauma Research Articles

Lean Into the Uncomfortable: Using Trauma-Informed Care to Engage in Shared Decision-Making With Racial Minorities With Hematologic Malignancies.

Discussions involving racial health disparities must include pathways for engaging in shared decision-making with racial/ethnic minorities. Research demonstrates glaring racial and ethnic disparities when it comes to hematologic malignancies from the time of diagnosis to treatment and even at the end of life. Unfortunately, decision-making in these circumstances may be streamlined, given the urgency of the disease, prognostic uncertainty, and varying treatment options. Being diagnosed with cancer is undoubtedly a traumatic experience and a patient's race and/or ethnicity add an important dimension to their experience. The tenets of trauma-informed care (TIC) are anchored in recognizing that trauma can manifest in several ways and acknowledging the impact of past trauma on a patient's present and future behaviors. We argue that using a TIC approach may help hematologists create a space for decision-making while minimizing the risk of re-traumatization and perpetuating racial disparities. Using the foundation of TIC, an interprofessional team can begin addressing manifestations of trauma and hopefully mitigate racial and ethnic disparities.

“They Helped Me the Best They Could”: Experiences of Women Sexual Assault Survivors With Police in the Early Aftermath of Assault and Associations With Past Trauma History and Acute Psychological Responses

Approximately 100,000 adult women sexual assault (SA) survivors each year receive emergency care and forensic evidence collection. These women are also contacted/interviewed by police.

Abnormal Cardiac Repolarization After Seizure Episodes in Structural Brain Diseases: Cardiac Manifestation of Electrical Remodeling in the Brain?

BackgroundAbnormal cardiac repolarization is observed in patients with epilepsy and can be associated with sudden death. We investigated whether structural brain abnormalities are correlated with abnormal cardiac repolarizations in patients with seizure or epilepsy.Methods and ResultsWe retrospectively analyzed and compared 12‐lead ECG parameters following seizures between patients with and without structural brain abnormalities. A total of 96 patients were included: 33 women (17 with and 16 without brain abnormality) and 63 men (44 with and 19 without brain abnormality). Brain abnormalities included past stroke, chronic hematoma, remote bleeding, tumor, trauma, and postsurgical state. ECG parameters were comparable for heart rate, PR interval, and QRS duration between groups. In contrast, corrected QT intervals evaluated by Fridericia, Framingham, and Bazett formulas were prolonged in patients with brain abnormality compared with those without (women: Fridericia [normal versus abnormal], 397.4±32.7 versus 470.9±48.9; P=0.002; Framingham, 351.0±40.1 versus 406.2±46.1; P=0.002; Bazett, 423.8±38.3 versus 507.7±56.6; P<0.0001; men: Fridericia, 403.8±30.4 versus 471.0±47.1; P<0.0001; Framingham, 342.7±36.4 versus 409.4±45.8; P<0.0001; Bazett, 439.3±38.6 versus 506.2±56.8; P<0.0001). QT dispersion and Tpeak−Tend intervals were comparable between groups. We also observed abnormal ST‐segment elevation in 5 patients. Importantly, no patients showed fatal arrhythmias during or after seizures.ConclusionsOur study demonstrated that brain abnormalities can be associated with abnormal cardiac repolarization after seizures, which might be a manifestation of electrophysiological remodeling in the brain.

Fibro-osseous pseudotumor of the hand: a case report of a 22-year-old young woman

We present a case of a 22-year-old patient with an important expansive neoformation of the soft tissues near the proximal phalanx of the fourth finger of the right hand. There was no evidence of past direct traumas, wounds, or local infections. The Rx, CT scan and MRI exams showed a lesion of the soft tissues measured around 3 × 2 × 2.8 cm, without hinting at a connection with the bone structure with a hypointense signal in T1 and an isointense signal in T2. First diagnostic speculations pointed at a giant cell tumor of the tendon sheath (GCTTS). Since there seemed to be no indication of a malignant tumor, it was decided to execute an excisional biopsy on the patient, rather than an eco-guided core needle. The imaging studies of the histological characteristics showed spindle-shaped elements with low-grade atypia, fibromyxoid and osseous stroma in different maturity stages, and always delimited by osteoblast cells. Osteoclastic giant cells were also found, as well as foci of osseous metaplasia peripherally aligned around proliferating cell aggregates. Considering all the following data, the final diagnosis clearly indicated a fibro-osseous pseudotumor of digits (FOPD). At the last checkup after 6 months, the wound healed correctly and without any restriction in finger movement. Level of evidence: Level V, diagnostic study.

The Psychosocial Condition of Syrian Children Facing a Precarious Future

This study investigates the psychosocial conditions of Syrian refugees and vulnerable Lebanese children in Lebanese public schools. A survey was conducted with Syrian and Lebanese children and their parents. Interviews with public school staff were also carried out. The study found that poverty and war play equal roles in affecting children’s emotional well-being as Syrian and Lebanese children manifest similar levels of anxiety and hyperactivity. While the past presents significant stressors, present and future stressors were also identified amongst refugees. This article critiques the prime emphasis of psychosocial intervention paradigms on past trauma, which risks overlooking present and future stressors. It argues that the psychosocial conditions of refugees are interpreted in isolation from refugees’ poverty, subordinated social status, and the local injustices to which they are subject.

Re-membering Syria’s Traumatic Past: Gender, Poetics, and Loss in Manhal al-Sarrāj’s As a River Should

Abstract In a system where the state maintains a monopoly over historical interpretation, aesthetic investigations of denied traumatic memory become a space where the past is confronted, articulated, and deemed usable both for understanding the present and imagining the future. This article focuses on Kamā yanbaghī li-nahr (As a river should) by Manhal al-Sarrāj, one of the first Syrian novels to openly break the silence on the “1982 Hama massacre.” Engaging the politics and poetics of trauma remembrance, al-Sarrāj places the traumatic history of the city of Hama within a longer tradition of loss and nostalgia, most notably the poetic genre of rithāʾ (elegy) and the subgenre of rithāʾ al-mudun (city elegy). In doing so, Kamā yanbaghī li-nahr functions as a literary counter-site to official histories of the events of 1982, where threatened memory can be preserved. By investigating the intricate relationship between armed conflict and gender, the novel mourns Hama’s loss while condemning the violence that engendered it. The novel also makes new historical interpretations possible by reproducing the intricate relationship between mourning, violence, and gender, dislocating the binary lines around which official narratives of armed conflicts are typically constructed.

‘All my Relations’ in Ruby Slipperjack’s Silent Words (1992)

This presentation examines the extent of which Nature in Ruby Slipperjack’s Silent Words (1992) serves to reconnect 11-year-old protagonist, Danny, to his Anishinaabe identity. When Danny flees his run-down house in a settler-colonial town, he finds limitless support from the plant and animal life of Northern Ontario. The relationship between boy and Nature transcends the boundary between the human and the more-than-human world and becomes that of a student and teacher. Danny’s reconnection to Nature and his willingness to listen to its many abstract teachings are central to the reclamation of his indigeneity. With the help of some human interpreters, Danny develops the epistemological tools and the humility to allow Nature to heal his past traumas as well. The Anishinaabe medicine wheel teachings profess that a holistically healthy person seeks to find balance among their intellectual, spiritual, emotional, and physical self. Danny achieves this on his journey through the woods while decolonizing and re-indigenizing himself. This reading of the role of more-than-humans in Silent Words also identifies Nature’s propensity to share Anishinaabe teachings in subtle and unexpected ways for those who are willing to listen. Though it is a fictional text, the transformative learning and healing processes Danny goes through after reconnecting with Nature are generalizable to the real-world. In many ways Danny’s reclamation of his Indigenous identity mimics the large-scale Indigenization movement happening throughout Turtle Island today.

The mental health of aid workers: risk and protective factors in relation to job context, working conditions, and demographics.

This study utilised a cross-sectional survey of 369 participants in 77 countries to examine 15 possible risk and protective factors pertaining to the mental health of aid workers-many of which have not been assessed before-in the categories of job context, working conditions, and demographics. Risk factors associated with job context include emergency postings and being an international worker. No significant differences were found between humanitarian and development workers and none between organisation type; the number of past traumas was not associated with negative mental health outcomes. Protective factors with regard to working conditions include higher income, long-term contracts, previous psychosocial training, and voluntary postings. With respect to demographics, protective factors include older age, more work experience, and greater religiosity and spirituality, while female gender was a risk factor. Ultimately, this study provides a more nuanced understanding of the aid worker sector, which can inform the development of more targeted mental health support.

Adopting a "Compound" Exposome Approach in Environmental Aging Biomarker Research: A Call to Action for Advancing Racial Health Equity.

Background:In June 2020, the National Academies of Sciences, Engineering, and Medicine hosted a virtual workshop focused on integrating the science of aging and environmental health research. The concurrent COVID-19 pandemic and national attention on racism exposed shortcomings in the environmental research field’s conceptualization and methodological use of race, which have subsequently hindered the ability of research to address racial health disparities. By the workshop’s conclusion, the authors deduced that the utility of environmental aging biomarkers—aging biomarkers shown to be specifically influenced by environmental exposures—would be greatly diminished if these biomarkers are developed absent of considerations of broader societal factors—like structural racism—that impinge on racial health equity.Objectives:The authors reached a post-workshop consensus recommendation: To advance racial health equity, a “compound” exposome approach should be widely adopted in environmental aging biomarker research. We present this recommendation here.Discussion:The authors believe that without explicit considerations of racial health equity, people in most need of the benefits afforded by a better understanding of the relationships between exposures and aging will be the least likely to receive them because biomarkers may not encompass cumulative impacts from their unique social and environmental stressors. Employing an exposome approach that allows for more comprehensive exposure–disease pathway characterization across broad domains, including the social exposome and neighborhood factors, is the first step. Exposome-centered study designs must then be supported with efforts aimed at increasing the recruitment and retention of racially diverse study populations and researchers and further “compounded” with strategies directed at improving the use and interpretation of race throughout the publication and dissemination process. This compound exposome approach maximizes the ability of our science to identify environmental aging biomarkers that explicate racial disparities in health and best positions the environmental research community to contribute to the elimination of racial health disparities. https://doi.org/10.1289/EHP8392

Touched by the Past

Recent work on trauma, especially in the field of Holocaust studies, has tackled the question of how the “generation after” relates, and relates to, the trauma of its immediate ancestors as it navigates between the poles of remembrance and appropriation. Other studies have shifted focus towards the effects of trauma upon narration, in part through critiquing the prevailing psycho-analytic model of trauma as an unrepresentable event that evades/forecloses language. Aeschylus’ Suppliants, with its chorus of fifty female Danaids who react to their traumatic present by recourse to tales of the traumatic past of their ancestor Io and her son Epaphos (“Touch”), offers a productive stage for testing the applicability of these theoretical frames to the genre of ancient Greek tragedy. The Danaids’ turn to the past explores the agency of an ancestral trauma that reaches into their present, and in doing so highlights the unsteady inheritance of trauma both for those who relate and for those who witness these acts of testimony. The act of supplication itself is defined in part by physical contact between the suppliant and the supplicandus, yet this ritual emphasis on touch is amplified by the play’s consistent focus upon a series of real and hypothesized touches, from the traumatic to the salvific. Through this engagement with the haptic context of trauma and traumatic recall, Aeschylus’ play proposes an enlarged aetiology of touch—across cognitive, affective, and physical registers—for the ritual of supplication itself.

Community-based participatory research: Suicide prevention for youth at highest risk in Guyana.

We measured psychiatric symptoms, childhood traumas, and cortisol to identify correlates with recurrent suicide attempts. Poisson regression tested the association between psychiatric symptoms, trauma, and cortisol levels on number of suicide attempts among 50 youths from three child welfare orphanages in Guyana. Sixty-six percent were female, and the average age was 14years. DSM-5 symptom measure was administered and saliva samples collected. Fifty percent of the youth endorsed suicide attempt. Within this subsample, a minimum of one and maximum of five suicide attempts were self-reported. Participants' number of suicide attempts was positively associated with number of past traumas, psychosis, and depression symptoms. Suicide prevention screening among at-risk youth should target severity of psychosis and depression reports and number of traumatic life experiences.

“A Star Is Born”: Gender, Soft Power and Biopics in the Cold War Romanian Cinema Darclée (1961)

"“A Star Is Born”: Gender, Soft Power and Biopics in Cold-War Romanian Cinema (Darclée, 1961) Obsessively interested in life writing from the periods of 20th-century dictatorships, Romanian post-communist culture has been dominated, with very few exceptions, by male authors. However, shyly, yet steadily, in this large-scale attempt to retrace and understand the traumatic past, there has been an opening in recent years towards women authors. Although few by comparison, these personal narratives are memorable. In terms of biographical novels and biopics, the most striking feature is the absence of such female representations. Departing from this context of gender oblivion and inequality, and considering the specificities of the life writing genre and its filmic representations, the current paper focuses on Darclée (Mihai Iacob, 1961), one of the very few biopics in Romanian cinema that revolves around a famous woman. Aside from being a rare, female-centered exception among Romanian biopics, the film is also noteworthy for its politicized content and therefore interesting to discuss in relation to the political context, the totalitarian regime present at the time in Romania and its cultural discourse. Despite dealing with a-turn-of-the-century figure of aristocratic and bourgeois origins, the film (with the wife of a communist leader in the leading role) is politically appropriated by the communist regime and announces National Communism in Romanian culture. The analysis will thus consider the political discourse employed in Darclée, with its unexpected nationalist emphasis, as well as the film’s strategies of representation as it covers, in a rare occasion, a female figure. Keywords: life writing, gender, Romanian cinema, Cold War biopic, musical film "

Combining mindfulness and compassion in the treatment of complex trauma – a theoretical exploration

Trauma exposure is widespread in the general population. Despite the proposal that mindfulness practice could be beneficial for treating persons exposed to traumatic events who go on to develop PTSD and/or correlates of past trauma, there are very few mindfulness-skills programs that directly target trauma survivors. This paper seeks to use existing empirical research and theory to explore the potential and challenges of using mindfulness-based interventions to treat trauma-related problems. Through the lens of the group program, Mindfulness and Compassion: the path to growth after trauma (TMC), we explore the potential of integrating trauma-sensitive mindfulness explicitly with compassion training for trauma survivors. This paper seeks to contribute to development of psychological treatment by the methods of mindfulness and compassion training and how they may be used as a complementary or a stand-alone treatment option in phase-based treatment for complex PTSD.

Art therapy with people diagnosed with psychosis: therapists’ experiences of their work and the journey to their current practice

ABSTRACT Background: There was insufficient understanding of how art therapists experience their work with people with psychosis-related diagnoses, and of their practice development. Aims: To understand art therapists’ perceived practise and its development regarding psychosis. Methods: Within a grounded theory framework, interviews and a focus group carried out in the years 2015–2017 elicited the experiences of 18 UK-based art therapists, working in a range of National Health Service (NHS) contexts, concerning art therapy in relation to psychosis and how they developed their current practice. Audio-recordings were transcribed verbatim and analysed to build theory. Results: The grounded theory proposes how practice and its development intertwine. Training confers resilience but therapists learn greatly from their clients, enhancing their ability for alliance-building. Therapists’ early struggles also spur further training. Skills for trauma are helpful. Clients may become stuck or disengage, and/or develop through ongoing engagement with art and the art therapist, who supports their journey. The service and wider societal contexts impact the art therapist's work through their effect on clients and/or the art therapist's ability to attune to clients. Conclusions: The findings concur with previous research regarding common therapeutic factors, especially the alliance, and on other therapists’ practice development. Implications for practice and research: Understanding therapy processes should incorporate service and societal influences on therapist and client. Training needs to include understanding adversity and trauma, and working with trauma. Plain-language summary People who receive a diagnosis of psychosis or schizophrenia are sometimes offered art therapy. However, we did not know enough about exactly what art therapists do. It was also important to understand how art therapists come to know what helps people in art therapy. Art therapy training has to cover many things, not only psychosis, so art therapists learn their skills in various ways. Through interviews and a focus group we talked to 18 UK-based art therapists working in different NHS contexts and digitally recorded the discussions. We made written records of what was said, and analysed these to create a theory of how art therapists work with people who have been given a diagnosis of psychosis or schizophrenia across inpatient and outpatient settings. Our theory proposes that art therapists’ training makes them quite resilient. However, they learn vital things from their clients. This especially helps them to become better at building a helpful relationship with each client. Some art therapists also seek further training when they are newly qualified, especially if they run into difficulties when trying to help a client. Some art therapists find it helpful to have skills for supporting people who have experienced past trauma. Clients develop through art-making and talking with the art therapist. Art therapists find it easier to do their work with clients if the service they work in is supportive. Our theory fits in with previous research, which says that building a good relationship with clients makes an important difference to the outcome in different kinds of therapies. Our theory also fits in with previous research on how other therapists develop their skills. Future research on art therapy should include looking at the service where the therapist works, and how it may affect both therapists and clients. Art therapy training needs to include trauma-related work.

Memorias y ficciones en la recreación de un pasado violento. El caso de ETA

El propósito de este artículo es ocuparse de cómo las ficciones participan en la reconstrucción de la memoria colectiva de un pasado traumático, en particular, el de la violencia de ETA. Prestaremos atención a cómo adquieren relevancia trabajos de ficción que tratan de contar ese pasado reciente, despertando reacciones encontradas acerca de su sentido y valor para relatar con verosimilitud lo ocurrido. El esfuerzo narrativo parece toparse con dificultades para construir una memoria colectiva que concite acuerdos sobre su acierto e idoneidad. Igual que viene ocurriendo con la revisión institucional del pasado, objeto de tensiones que se han verbalizado como “batalla por el relato”. Se trata de proponer una reflexión que ahonde en el potencial de la narración para cargar de sentido la mirada hacia el pasado, identificando las tensiones y las claves que redundan en la re-mitificación de la violencia y que se expresan como sospecha contra la crudeza y autenticidad de determinados relatos. Para ello, acudiremos a los vínculos entre memoria, historia y ficción y al cuestionamiento del presupuesto de que puede y debe construirse una narración exenta de posicionamientos morales y juicios de valor. Algo especialmente decisivo cuando el contexto al que se remite es el de aquella violencia legitimada por una parte de la sociedad. Finalmente, recalaremos en el poder de la ficción para definir el mundo, destacando su capacidad para intervenir y añadir sentido en nuestra comprensión de la realidad.

Personality traits and trauma exposure: The relationship between personality traits, PTSD symptoms, stress, and negative affect following exposure to traumatic cues

Exposure to traumatic events can lead to various types of emotional distress. Aside from the exposure itself, numerous factors are relevant for the development of emotional distress following a traumatic event. The present study aimed to examine the relationship between the six HEXACO personality traits and PTSD symptoms, stress, and negative affect following traumatic cues. Two hundred and forty-nine participants (N = 249) completed demographic and personality-trait questionnaires. An hour after filling out those questionnaires, the participants watched a 3-minute video clip of a series of terror attacks. After watching the video clip, they filled out PTSD-symptom, perceived-stress, and negative-affect questionnaires. Structural-equation-model analyses showed that PTSD symptoms were positively associated with past trauma, negatively associated with honesty-humility, positively associated with emotionality, and negatively associated with extraversion. Stress was positively associated with emotionality, negatively associated with extraversion, and negatively associated with agreeableness. Negative affect was negatively associated with honesty-humility, positively associated with emotionality, negatively associated with extraversion, and negatively associated with agreeableness. In addition, positive relationships were found between PTSD symptoms and stress, PTSD symptoms and negative affect, and stress and negative affect. This study demonstrates the importance of HEXACO personality traits in coping with numerous aspects of emotional distress following trauma exposure.

Dignity Therapy and the past That Matters: Dialogues with Older People on Values and Photos

Objectives Dignity therapy (DT) is recognized as a valid form of support for terminally ill patients who have to manage trauma and loss. Given the positive evidence associated with DT, finding ways of adapting it for the older people warrants consideration. Methods The study examines if DT can be improved with the use of an album of family photographs, in order to process the sense of loss of dignity and past traumas. Sixteen institutionalized participants were surveyed, via mixed methods. Results Quantitative data were collected with the help of the Patient Dignity Inventory, and the qualitative analysis was based on generativity documents. Conclusion Results confirmed the feasibility of this approach for this cohort.

Irish on the walls: the branding of a language

By the time the Belfast City Council launched a new logo in 2007, rebranding Belfast had become a central issue. The symbolic center of Belfast, the City Council building, presents itself as a post-modern and fully globalized space, neutralizing the memory of an area stigmatized by decades-long violence known as The Troubles. Like other cities with a traumatic past, such as Berlin, Belfast tries to promote itself as a modern and lively place, well aware of the importance of exploiting memory as a tourist attraction. The article examines the Irish language’s resemantization in Belfast, particularly in the Gaeltacht quarter area, during and after The Troubles. Based on a paper by Siun Carden (2017), the article tries to connect the core of the author’s observations to language’s phatic function. The idea is that the contemporary branding of Irishness through the use of the Irish language on Belfast’s murals works as an effective mythomoteur, a concept comparable to the mythe projectif elaborated by Bertrand (2019) in the case of Paris’s rebranding.

Is There a Geriatric Mental Health Specialist in the House?

Is There a Geriatric Mental Health Specialist in the House?

Review Essay: Kent State at Fifty

Review Essay: Kent State at Fifty