Personal Traumatic Experiences Research Articles

Averting adverse events in communication skills training: A case series

Objective To document cases of adverse or near adverse events in communication skills training (CST) and to identify risk factors and strategies to reduce the likelihood of their occurrence. Methods Six physician CST cases meeting criteria for an adverse or near adverse collected from experienced facilitators are analyzed and discussed. Results Three types of adverse CST events are described: traumatic personal experiences or losses evoked by training; perception that feedback is not empathic; and where trainees are referred for remedial CST as a risk management strategy. Conclusion Early identification of risk factors and emotional cues of trainees is a key first step that facilitates implementation of remedial strategies to avert potential adverse events. Consideration of ways that physicians’ personal experiences impact communication and good feedback techniques are vital. The implications of physicians sent to CST for risk management purposes is a new scenario that deserves special consideration. Practice implications To make CST safer and to optimize learning, early recognition of potential adverse events is essential. Specific feedback techniques should be mastered by all CST facilitators.

Proactive responses to delinquent behaviours in out-of-home care

The transition from childhood to young adulthood is often associated with a range of challenges that can be overwhelming for a young person. For young people in out-of-home care, complex histories that may include traumatic personal experiences can make this transition even more problematic, both for the young person and their carers. This is the final paper in a series of four which has focussed on a range of challenging behaviours in children and young people in out-of-home care. This paper examines delinquency and its associated effects on young people and carers and outlines specific considerations for carers and other health professionals in responding appropriately to delinquent behaviours in young people.

Surface and Deeper Meaning: Some Hermeneutic Questions in an Intercultural Perspective

The question of a deeper meaning of artworks is a hermeneutic question. If the artworks in question have been created by an artist of a different culture and artworld, the hermeneutic question becomes an intercultural question. And if the artworks have been created by an artist, whose education took place not only in his own country and culture, but also in foreign countries with their own cultural heritages, to which the artist feels a deep inclination, then the intercultural question becomes part of a globalized culture with its polymorphic structures and products. In my opinion, the work of Hsien-Yueh Lin is embedded in a globalized culture, centred in Taiwan. Therefore the question of a deeper meaning along the metaphorical question for the actual roots of his artworks leads to at least five sub-questions: Does the root of Lin's art lie in Taiwanese culture? Or in his genius? In his traumatic personal experiences? In the essence of the things painted? In art as such? Only two of these of course interrelated questions could be commented on. First, and in greater detail, the root in Taiwanese culture, second, and rather shortly, the root in art as such. Although hermeneutic questions transcend the sphere of what can be seen on the canvasses, they try to deepen the understanding of the visual surface of Lin's paintings.

Measuring post-traumatic changes in spirituality/religiosity

Changes in spirituality and religiosity may play a vital role in understanding individuals’ post-traumatic growth, the experience of positive outcomes from difficult or traumatic personal experience. Although assessment of post-traumatic growth has been addressed by the development of several measures, these measures fail to capture the domain of spiritual/religious change. In this manuscript, we review 12 quantitative measures of post-traumatic growth, focusing on the degree to which these measures allow an adequate assessment of changes in religiosity and/or spirituality. We consider these concepts in the context of understanding the role of these domains in post-traumatic growth and in facilitating clients’ transitions through adversity.

The Dynamics of Oppression

Asian Indians arrived in South Africa in 1860 during the era of the British Empire. Three occupational groups were represented: indentured agricultural workers, business entrepreneurs and a few professionals. Their presence was not welcomed by White South Africa. The ideology of Apartheid (“separateness”) ushered in oppressive legislation for all Non-Whites from 1948 until the first democratic elections of 1994, a period of trauma, violence and pain for Non-White peoples. This report centres on traumatic personal experiences during Apartheid of 100 Asian Indians, 54 males and 46 females, professional and business people, Hindus, Muslims and Christians, living in segregated racial zones of metropolitan Durban, South Africa. These traumatic incidents yielded six basic themes identified by the technique of constant comparative analysis, a central qualitative analytical approach in grounded theory. Four themes related directly to Apartheid laws; two themes to interactions with the White public and police, invariably involving abuse. The experiences created emotional distress, powerlessness, anger and fear. Few risked protesting discriminatory laws as most were immobilised by fear. Forty-six % judged they adapted to the Apartheid system, and most were aware of its psychological effects. Illustrating with excerpts from the reported experiences, a psycho-socio-political analysis of the dynamics of oppression is presented in the context of the stages of conscientisation to empowerment (Prilleltensky & Gonick, 1996).

Effects of Emotional Disclosure on Psychological and Physiological Outcomes in Patients with Rheumatoid Arthritis: An Exploratory Home-based Study

The effects of an exploratory, home-based emotional disclosure intervention on psychological and physiological outcomes were assessed in patients with rheumatoid arthritis. Patients were randomly assigned to a disclosure group (n = 19) in which they wrote/talked about traumatic personal experiences, or to a control group (n = 15) in which they wrote/talked about the events of a particular day. Participants undertook these tasks for periods of 20 minutes on 4 consecutive days. The disclosure group demonstrated increases in negative mood and objective markers of disease activity at 1 week post-intervention. However, there were significant trends for the disclosure group to demonstrate minor improvements in mood and stability in disease activity, compared with the control group. These group differences appeared to be due to deteriorations in the control group more than improvements in the disclosure group.

Written Emotional Expression Produces Health Benefits in Fibromyalgia Patients

Written expression of traumatic experiences, an intervention found to have health benefits in rheumatoid arthritis, asthma, and breast cancer, was tested in a randomized, controlled trial with female fibromyalgia patients. It was hypothesized that relative to controls, patients engaging in the writing intervention would experience improved status on psychological well-being and physical health variables. Patients (N = 92) were randomized into a trauma writing group, a control writing group, or usual care control group. The two writing groups wrote in the laboratory for 20 minutes on 3 days at 1-week intervals. Psychological well-being, pain, and fatigue were the primary outcome variables. Assessments were made at pretreatment, posttreatment, 4-month follow-up, and 10-month follow-up. The trauma writing group experienced significant reductions in pain (effect size [ES] = 0.49) and fatigue (ES = 0.62) and better psychological well-being (ES = 0.47) at the 4-month follow-up relative to the control groups. Benefits were not maintained at the 10-month follow-up. Fibromyalgia patients experienced short-term benefits in psychological and health variables through emotional expression of personal traumatic experiences.

Mental health issues in Tamil refugees and displaced persons. Counselling implications

Fifty-one Sri Lankan Tamil refugees/displaced persons living in South India completed the Hopkins Symptom Checklist-58. In addition, in interviews they answered open-ended questions about personal loss, personal traumatic experiences, negative feelings, living in camps, and the availability of support. The health of the respondents was poor. Moreover, experiences such as watching the killing of family members and being wounded were mentioned as reasons to flee. Many respondents said they experienced negative feelings. Social support was reasonably available although family members were often not situated in the same camp.

Unpaid work in the community: An account of becoming a community activist

Academics, policy makers, and practitioners are slow to listen to the needs and experiences of poor people, even about their experiences of poverty [P. Beresford & S. Croft (1995) It's our problem too! Challenging the exclusion of poor people from poverty discourse. Critical Social Policy Issue, 44/45, 75-95]. Angela is a young middle-aged British woman who has survived numerous traumatic personal, family and social experiences. She has read copies of this journal and is convinced that discussions between academics, professionals, policy makers and poor people will lead to better mutual understanding, a view reflected in a recent multinational project [ATD Fourth World (1999) Introducing the knowledge of people living in poverty into an academic environment: Synopsis. London: ATD Fourth World UK]. Through discussions with one of the editors, Angela has contributed this account which highlights the emotional aspects of being at the receiving end of public services as well as of becoming active in a community.

"Traveling affectively alone": a personal derailment in analytic listening.

Questioning whether or not we have entered a new "two-person" paradigm, the author shares a traumatic personal experience, considers its impact on her work with a patient, and discusses some clinical and epistemological dilemmas in self-disclosure.

Taped Imaginal Exposure as a Treatment for Post-Traumatic Stress Reactions

The efficacy of taped imaginal exposure as a treatment for Post-Traumatic Stress Reactions (PTSR) was assessed in eighteen consecutive outpatients, including Gulf War veterans. Detailed present-tense scripts of their personal traumatic experiences were prepared and in all but two cases audio-taped and listened to regularly. The severity of PTSR and standard questionnaire scores (including the IES, BDI, GHQ8 and the SCL 90) all showed statistically significant improvements post treatment and at three month follow-up. This case series confirms the potential efficacy of taped imaginal exposure in the treatment of full and partial forms of Post-Traumatic Stress Disorder (PTSD). The simplicity of its administration and acceptability to the individual suggest that it is worthy of more thorough research.

Psychophysiologic assessment of traumatic imagery in Israeli civilian patients with posttraumatic stress disorder

This study used a script-driven imagery technique, previously used with combat veterans, to assess physiologic responses of Israeli survivors of noncombat traumas. Each subject had experienced an event meeting DSM-III-R criterion A for posttraumatic stress disorder (PTSD). The subjects were classified on the basis of the full DSM-III-R criteria into a current PTSD group (N = 13) and a non-PTSD group (N = 13). Thirty-second scripts describing each subject's personal traumatic event, as well as other events, were prepared. The scripts incorporated subjective visceral and muscular responses reported to have accompanied each experience. In the laboratory, the scripts were read one at a time to the subject, who was instructed to imagine each event portrayed as vividly as possible, while heart rate, skin conductance, and left lateral frontalis electromyogram levels were measured. Multivariate analysis of variance revealed that the physiologic responses of the PTSD subjects during imagery of their personal traumatic experiences were significantly greater than those of the non-PTSD subjects. This difference was not explained by age, gender, or rated severity of the traumatic event. A physiologic discriminant function derived from previously studied Vietnam veterans correctly classified nine of the 13 PTSD subjects (sensitivity = 69%) and 10 of the 13 non-PTSD subjects (specificity = 77%). These results replicate previous findings of heightened physiologic responses during personal combat imagery in male American war veterans and extend them to a group of male and female Israeli civilian victims of trauma, supporting the robustness of physiologic responding during personal traumatic imagery as a measure of PTSD.

The effect of training in criteria-based content analysis on the ability to detect deception in adults.

The Criteria-Based Content Analysis (CBCA) technique has been proposed as a way to differentiate truth from falsehood in interviews of children. We studied adults, utilizing 14 of the 19 CBCA criteria. In a 2×2 design, 114 students estimated the truthfulness of the statements of 12 adults; 6 were true and 6 described an invented traumatic personal experience. Subjects viewed a videotape or read a written transcript; half were trained in CBCA and half were not. Trained subjects who saw videotapes performed significantly better than chance and were significantly more accurate than each of the other 3 groups. For the trained subjects, 10 of the 14 CBCA criteria yielded significant differences in the predicted direction between evaluations of truthful and invented statements.

Divorce counseling and values

Because my subject is divorce counseling, I feel it necessary to make some personal statements. I have never been divorced. I have been married for more than 41 years to the same man and have three married children and six grandchildren. I am writing not out of any traumatic personal experience with divorce, but rather out of extensive and intensive professional clinical experience with the divorcing and divorced through many years. I have a law degree. My husband is an active and rather well-known matrimonial lawyer in New York City. For years, I observed the pain and suffering of the divorcing and the divorced and the futile efforts at reconciliation and help by humane lawyers who tried to understand but whose understanding was not supported by clinical training and knowledge. Naively, I thought: "Somewhere there must be people who help these persons in their emotional, physical, social, and economic distress." There was no one: no agency, no therapists, no ministers really equipped to help those either in the process of divorcing or already divorced. As a result of my interest and concern, I determined to enter a doctoral program and eventually become clinically trained in marriage counseling. My research culminated in a doctoral thesis entitled "Education for the Divorced." In 1960, when I was choosing the title for this research, I planned to call it "Education for Divorce." This was immediately rejected. I would never get any population, and it would not be acceptable generally and particularly to the church. Why? It indicated a readiness to prepare people for divorce. This was against public policy. So the title became "Education for the Divorced"?acceptable because it indicated that I was ready to help those who had already gotten a divorce, and if I thought I could help such people?good luck! Now, about 15 years later, I have a book published under the title Divorce: The