Childhood Psychological Trauma Research Articles

Childhood psychological trauma correlates with unsuccessful lumbar spine surgery.

In a retrospective study of 86 patients who underwent lumbar spine surgery, patients who had three or more of a possible five serious childhood psychological traumas (risk factors) had an 85% likelihood of an unsuccessful surgical outcome. Conversely, in patients with a poor surgical outcome, the incidence of these traumas was 75%. In the group of 19 patients with no risk factors, there was only a 5% incidence of failure. This study shows that a highly significant correlation exists between unsuccessful lumbar spine surgery and a history of childhood traumas. Although recognition of predictors for unsuccessful outcome can be useful in avoiding surgery in patients whose indications for surgery are borderline, the greater challenge is to help the patient who, despite being at high psychological risk for negative outcome, has severe spinal pathology that will likely require surgery. In such cases, psychiatric treatment is critical. In the group of 19 patients with no risk factors, single-level laminectomies and discectomies were performed on 6 patients. The other 13 cases were complex, involving a combination of repeat surgeries (n = 4) fusions (n = 3), and/or multilevel laminectomies and discectomies (n = 11).

Childhood Psychological Trauma and Successful Surgery

Childhood Psychological Trauma and Successful Surgery

Psychotherapy of nine successfully treated cocaine abusers: Techniques and dynamics

The author reviews a series of nine cocaine abusers successfully treated with long-term, in-depth, dynamic psychotherapy begun on an inpatient drug abuse unit and continued after hospitalization. He finds his patients to have been victims of unrecognized psychological trauma in childhood. He argues that the cocaine abuse, in addition to functioning as a form of self-medication, was functioning as a component of a repetition compulsion in which old psychological traumas were symbolically recreated in the post-drug dysphoria. In a retrospective assessment, the author delineates four steps he used in the treatment process: 1) he looked for traumatic or abusive conditions; 2) he established emotional contact; 3) he helped the patient to appreciate how the abuse had affected him; 4) he helped the patient to master the traumatic experiences. A clinical vignette and the relevant literature on the psychodynamics of cocaine abuse are discussed.