Psychosocial Trauma Research Articles

Bir ÇEMATEM kliniğinde yatan ergen hastalarda madde kullanım eğilimleri, psikososyal travmalar, psikiyatrik komorbiditeler ve cinsiyet farklılıkları

Objective: The aim of the present study was to determine sociodemographic and clinical characteristics, substance use patterns, psychosocial traumas, and gender differences among adolescent inpatients at an addiction treatment center. Method: Participants were 105 adolescents consecutively admitted and hospitalized at the Children and Adolescent Alcohol and Drug Dependency Research Treatment and Training Center of Bakirkoy Prof Dr. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery between February and December 2017. Kiddie-Schedule for Affective Disorders and Schizophrenia, present and lifetime version, Hamilton Anxiety and Depression Rating Scales, Conners-Wells’ Adolescent Self-Report Scale, Adolescent Dissociative Experiences Scale, Childhood Trauma Questionnaire, Addiction Profile Index-Practitioner Form, and Inventory of Parents and Peer Attachment were administered to all participants. Results: Of all cases, 31.4% were girls. Criminal history, a diagnosis of conduct disorder, substance use in the family, emotional abuse, and heroin use were frequently revealed. Among the girls, the substance use period was shorter and ecstasy use, traumatic experiences, diagnosis of post-traumatic stress disorder (PTSD) and severity of comorbidities were prominent; among the boys, synthetic cannabinoid use was more prevalent. While synthetic cannabinoid and alcohol use were frequent among the cases with a diagnosis of attention deficit hyperactivity disorder, heroin use was prominent among cases with depression diagnosis and ecstasy use among cases with PTSD. Conclusion: Among children and adolescents, substance use trends, childhood traumatic experiences, and severity of comorbidities may differ according to gender. It is important to take these differences into consideration in the treatment process.

Understanding disasters: managing and accommodating different worldviews in humanitarian response

Over the past decade, humanitarian events affected on average 120 million people annually. Whilst many of these events are human-induced, a large number of the 400 or so complex humanitarian emergencies that require international response each year are natural. Such events result in loss of life, injure and maim survivors, destroy infrastructure and give rise to psycho-social trauma. Aid agencies working alongside affected communities must address all these consequences as part of their responses. What is also required though is an appreciation that worldviews will inform how affected communities both understand the cause of the event, their role in the event and how they will subsequently participate in rebuilding or reconstruction programs. Disasters can be affected by religious beliefs. With more than 85% of the global population self-professing religious belief, these worldviews are often shaped in whole or in part by sacred texts, religious teachings and sectarian practices. In this regard, it is not uncommon for those affected by disasters (particularly natural disasters) to genuinely describe these events as ‘acts of God’. Effective responses require the local context to be central in assessing needs and determining capacities. This must include an understanding of and authentic engagement with religious beliefs and how this may affect how the humanitarian event interacts with these beliefs. There is though little evidence as to how professional humanitarian workers accommodate the religious beliefs of local populations in their planning, implementation and evaluation of humanitarian responses. This paper draws on the experiences of humanitarian workers based in the USA and Australia from both faith-based and secular international non-governmental organizations to consider both how these workers themselves accommodate the religious views of affected communities in their responses and also their experience as to how such views affect the effectiveness of responses. This paper will consider why aid agencies must incorporate (and appreciate) different worldviews around disasters in order to more effectively respond to the needs of communities affected by humanitarian events. It will also identify difficulties and opportunities experienced by individual humanitarian practitioners as well as agencies when working in such environments.

Penyuluhan Kesehatan Tentang Kesehatan Jiwa Usia Muda (Remaja) Pendekatan Keluarga Dan Agama Sebagai Preventif Psychosocial Trauma

The general objective of community service with Health Education on Young Mental Health (Adolescents) this Family and Religion approach as Psychosocial Trauma is to increase promotive efforts to stimulate the creation of mental health for young people (adolesencents) in LPKA class IIB Sungai Raya by optimizing the role of the family and religious base, is expected to be able to form characteristics of adolesecents who always have strong religious beliefs in thinking and acting, positive thinking, actualizing themselves well, and having a better outlook on life. The PKM method is to use lecture and discussion techniques. The target of this activity is young people (adolesencents) who inhabit LPKA class IIB Sungai Raya Pontianak Regency. The PKM implementing team is a lecturer involving, educational staff and students of the STIK Muhammadiyah Pontianak. The results of the implementation of the PKM showed the enthusiasm of active participants because the theme of health was never known by students in the LPKA class IIB Sungai Raya and the activities took place in an orderly manner. Of the 25 health participants, 80% of participants were able to answer correctly from the 5 questions given during the summative evaluation. an increase in knowledge of the participants about mental health.

Awareness and psychosocial support for breast cancer patients and its public health implications

Breast cancer is the most common and steeply rising cancer among women in Bangladesh. This qualitative observational study is done to assess the psychosocial sufferings of breast cancer patients. The purpose of the study is to evaluate eradication of social obstacles and to amend the overall level of distress and stigma associated with breast cancer. The observational prospective study was conducted on 240 patients aged 30 to 70 years at Combined Military Hospital, Dhaka, Bangladesh from January 2014 to July 2017. The study was measured on breast cancer awareness and psychosocial support for breast cancer patients. In this study, the educational status of the most participants 126 (53%) was up to primary level. Maximum participants (91%) had strong misconception on breast cancer and they lead life with social disgrace. One hundred and forty seven (61%) members have poor, eighty (33%) members have average and the remaining thirteen (6%) have good awareness about breast cancer. Three fourth (75%) of the patients face negligence from community where few feels suicidal and became victim of psychosocial torture from close ones. The last section consists of family member’s view where most of them (93%) provide support to the patient. In contrary, two third (67%) of the family members do not give psychological support to the patient. The study suggested lack of familial and social consciousness and embarrassment of the cancer patients are the main obstacles to improve the quality of life. To overcome these challenges, emphasis should be on personal and public health education and psychosocial supports, as well as providing counseling, awareness and spiritual support by the caregivers and family members. Key words: Psychosocial Support, Stigma of Breast Cancer, Misconception on Breast Cancer, Family and Caregiver Support for Breast Cancer Patients, Breast Cancer Awareness, Psychosocial Trauma.

Emotional Awareness and Expression Therapy for Chronic Pain: Rationale, Principles and Techniques, Evidence, and Critical Review.

Patients with chronic pain, especially primary or centralized pain, have elevated rates of psychosocial trauma and intrapersonal or intrapsychic conflict. To address these risk factors and potentially reduce pain, the authors developed emotional awareness and expression therapy (EAET). This article presents the rationale for EAET, describes its principles and techniques, reviews its development and early testing as well as recent clinical trials, and critically analyzes the evidence base. Four initial trials (between 2006 and 2011) demonstrated the efficacy of earlier versions of EAET. Four recent randomized, controlled trials of different EAET durations (1 to 8 sessions) and formats (individual or group) in patients with fibromyalgia, irritable bowel syndrome, pelvic pain, or medically unexplained symptoms support the earlier findings. EAET reliably reduces pain and interference, although improvements in anxiety and depression are less reliably achieved and may be delayed. The largest and best conducted trial found superiority of EAET over cognitive-behavioral therapy for fibromyalgia. Patient retention in EAET is high, and adverse events are rare. EAET merits inclusion as a treatment option for primary pain conditions, and it may be the preferred treatment for some patients. Research is needed on EAET with other pain conditions and samples, using better controls and comparison conditions, and on additional ways to motivate and help patients engage in successful emotional processing.

Sensory contact to the stressor prevents recovery from structural and functional heart damage following psychosocial trauma

Cardiovascular disorders (CVD) and posttraumatic stress disorder (PTSD) are highly comorbid, but the underlying mechanisms are not fully understood. Chronic psychosocial stress was induced in male mice by chronic subordinate colony housing (CSC), a pre-clinically validated mouse model for PTSD. Cardiac structure and function were assessed on day 20 of the CSC paradigm. Following CSC, mice were kept in different sensory contact modalities to the last aggressor for 30 days, and development of cardiac function and behavioral aspects were determined. Here we show that psychosocial trauma affects heart structure by disturbing cell-to-cell integrity of cardiomyocytes, causes tachycardia, disturbance of diurnal heart rate rhythmicity and behavioral deficits in a mouse model for PTSD. Structural and functional alterations were also found in cardiomyocytes upon in vitro treatment with pro-inflammatory cytokines typically increased after psychosocial trauma. Interestingly, sensory contact to the aggressor subsequent to psychosocial trauma prohibits functional and structural heart recovery, while isolation was beneficial for cardiac but detrimental for mental health. These findings contribute to our understanding of potential mechanisms underlying the high comorbidity of CVD and PTSD.

Psychotic experiences and trauma predict persistence of psychosocial problems in adolescence.

Psychosocial problems during adolescence are heterogenic, rather common, and unstable. At the same time, they are associated with an elevated risk of developing psychiatric disorders later in life. We aimed to describe the trajectories of psychosocial problems during adolescence and examine potential markers of persistence as compared to remission of these problems. At baseline, 1841 adolescents (51.4% female) were included. Of these adolescents, 1512 (mean age = 12.6 [range 11-14years]; 52.8% female) completed the first and second self-report questionnaires on psychosocial problems (measured with the Strengths and Difficulties Questionnaire), psychotic experiences, trauma, self-esteem and somatic symptoms at two time points over a 1-year period. Regression analyses were used to examine the association between potential predictors and the trajectory of psychosocial problems (remitting versus persistent). Four trajectories were distinguished: 75.6% of the sample showed no problems (the 'none' trajectory), 11.9% were in a 'remitting' trajectory, 9.7% were in an 'incident' trajectory and 2.8% were in the 'persistent' trajectory. Hallucinatory experiences and trauma at baseline were significantly associated with persistence of psychosocial problems compared to those with remitting psychosocial problems. Low rather than high self-esteem was associated with lower risk for persistent problems. Risk of persistence of psychosocial problems increased with accumulation of predictors. Psychotic, especially hallucinatory, experiences and trauma predict persistence of psychosocial problems in adolescents. This underlines the need to assess psychotic experiences and trauma in mental health screening programs.

Editorial introductions

Editorial introductions

Authoritarianism, trauma, and insecure bonds during the Greek economic crisis

This correlational study investigated the link between authoritarian attitudes, psychosocial trauma, and attachment insecurity in the context of a significant community and personal threat – the recent economic crisis in Greece. The study utilised a large community sample and five self-report measures - Right-Wing Authoritarianism Scale-S, Social Group Attachment Scale, Relationship Questionnaire, Perceived Cohesion Scale, and Impact of Events Scale-R. It was hypothesised that authoritarianism would be independently linked with insecurity in two types of bond (person-to-person and person-to-state) via the experience of post-traumatic stress and perceptions of social cohesion. Structural Equation Modelling indices suggested that the model had a very good fit.

Painful Pleasure: The Politics and Aesthetics of Psychosocial Trauma in Impunity

Continuous trauma syndrome (CTS) is the foundation for the characters in the film Impunity. The aesthetic choices in the narrative structure are an exploration of the discursive nature of violence and trauma in contemporary South African society. The theorising of continuous stress trauma provides the necessary challenge to the more conventional understanding of post-traumatic stress syndrome and informs the underlying analysis of the film. This analysis is offered in an interlocutory manner with psychology theorist Garth Stevens who provides a hermeneutic reading of Impunity that draws directly from his own research and others in the field of psychology. The paper is offered as an examination of an artistic research, film practice. The practice itself constitutes a theoretical expression which connects the aesthetic and structural choices of the film with the disciplinary observations made by Stevens. It suggests two theoretical approaches from different disciplines brought in conversation with each other to inform the reading of Impunity as artistic expression. The paper puts at its centre the discursive approach to the study of violence and trauma to suggest how the film’s structure and its aesthetics may be connected to research in the field of psychology.

Medical Ethics in Clinical Practice in Nepal: Challenges and Way Forward

Ethics for health care professional have many components. Among them, medical ethics is one of the important but neglected component which deals with issues related to confidentiality, beneficence and non-maleficence between health care providers and stake holders. Four basic principles of medical ethics are autonomy, justice, beneficence and non- maleficence which form the foundation of ethical clinical practice. The level of knowledge on medical ethics that medical students receive during the training is meagre and inadequate. In recent years, clinical practice has become more challenging. This is primarily due to increased opposition, aggression and violence against medical professionals at health care settings. As a result, the gap between clinicians and patients is increasing leading to diminishing trust and real/perceived allegations. In addition, the widening gap between doctors and patients has provided a space for middle men/broker to meddle, oppose and flare up the violence against treatment providers. Doctors and other medical professionals have been increasingly facing such challenges leading to circumspection in their practice, despondence, psychosocial trauma and depression. There is an urgent need of incorporation of medical ethics in undergraduate curriculum and independent hospital ethics committee consisting of experts from the hospital and outside to monitor and provide rational reasons to minimize such challenges.

Trance, Dissociation, and Shamanism: A Cross-Cultural Model

AbstractReligious practices centered on controlled trance states, such as Siberian shamanism or North African zar, are ubiquitous, yet their characteristics vary. In particular, cross-cultural research finds that female-dominated spirit possession cults are common in stratified societies, whereas male-dominated shamanism predominates in structurally flatter cultures. Here, we present an agent-based model that explores factors, including social stratification and psychological dissociation, that may partially account for this pattern. We posit that, in more stratified societies, female agents suffer from higher levels of psychosocial trauma, whereas male agents are more vulnerable in flatter societies. In societies with fewer levels of formal hierarchy, males come into informal social competition more regularly than in stratified contexts. This instability leads to a cultural feedback effect in which dissociative experiences deriving from chronic psychosocial stress become canalized into a male religious trance role. The model reproduces these patterns under plausible parameter configurations.

The efficacy of traditional cultural practices in the rehabilitation of victims of torture in Nigeria's Niger Delta.

Traditional methods of purification and healing carried out by healers and priests are of utmost importance for the mental and spiritual rehabilitation of victims of torture and perpetrators. The efficacy of traditional practices in the rehabilitation of victims of torture in Nigeria is examined. Data is derived from 60 interviews with key informants and eight Focus Group Discussions (FGDs) conducted with victims of torture, youth militias, priests, secret cults, community leaders, women leaders, youth leaders, security agencies, and others, in local communities in the Niger Delta states of Bayelsa and Ilaje, Ondo. By means of reconciliation rituals, both the perpetrators and the victims are re-integrated into the community. The mental healing of victims, who were deeply traumatized by the experiences of torture during violent conflict, is an aspect of community peacebuilding that is at least as important as material reconstruction. Traditional forms of justice and reconciliation that can address the psychosocial trauma of victims of torture may be helpful in the rehabilitation process. This paper suggests that healing and reconciliation rituals have been an essential component of rehabilitation processes in many local communities in the Niger Delta region. International, regional and national actors and institutions must recognize the cultural importance of such rituals and their potential relevance and significance for victims of torture, but their complex dynamics need to be better understood in order to safely and effectively apply them programmatically to achieve reconciliation and rehabilitation outcomes.

Bullying; A Psychosocial Stressor

Background: The bullying incidences have been increasing in the past few years resulting in a number of psychosocial traumas including depression, anxiety, violence and many other health concerns. Despite being a global issue, not a large number of studies have addressed this distressing act. This social threat causes negativity on both sides whether the victim or the perpetrator. The aim of the study was to evaluate the prevalence of this psychosocial stressor, its associated characteristics and bullying perceptions among the study population.
 Methodology: A cross-sectional observational study was conducted for 5 months from July 2017 to December 2017. Data was collected from 399 victims between the age of 15-27 years via a structured questionnaire inquiring victim’s demographics and its associated psychosocial outcomes. Collected data was then analyzed using SPSS ver. 22.
 Results: Out of the total study subjects there were 204 females and 195 males with the mean age of 25.10 + 5.70 years. Around 76% participants reported daily bullying events. Bullying incidences were found more common in females i.e. 48.6% of the females were bullied by called out with mean names while only 45.8% males reported so. Majority of the bullying cases were reported from educational institutes. The most prominent psychological outcomes observed and reported by the victims in response to bullying was getting revengeful thoughts for the bully.
 Conclusion: In conclusion, the study evaluated the psychological distress resulting from bullying incidences. Our study indicated a high prevalence of this public health concern in both genders and majorly in educational sectors.

Psychosocial Challenges of Invasive Meningococcal Disease for Children and their Families

ABSTRACTInvasive Meningococcal Disease (IMD) is an uncommon but potentially severe illness that disproportionally affects babies, children, and adolescents and can cause significant disability. Such outcomes have devastating impact on families and caregivers. This study aimed to identify the current level of social work intervention in cases of IMD, identify how psychosocial needs are met during an IMD admission; and identify the opportunities for social workers to support and meet the needs of patients, families, and carers during an IMD admission and beyond. A mixed methods approach was employed including: a medical record review of IMD cases; semistructured interviews with families who had experienced a child or young person with an IMD diagnosis; and a structured interview with a key informant to explore the potential social work role. The results from this small study indicate that the psychosocial needs of family members may not be being adequately met, highlighting an opportunity for social workers to provide holistic assessment and support including crisis intervention, advocacy, and anticipatory guidance to those experiencing IMD and their families.IMPLICATIONSInvasive meningococcal disease can have devastating physical outcomes for the infected individual and those around them may endure psychosocial traumas with this sudden, severe illness.Social workers can provide support at critical times during the medical emergency to reduce distress and improve communication to better support individuals and their families in the medical setting.Continuing social work support may reduce long-term distress.

DNA Methylation Age-Environmental Influences, Health Impacts, and Its Role in Environmental Epidemiology.

DNA methylation-based aging biomarkers are valuable tools for evaluating the aging process from a molecular perspective. These epigenetic aging biomarkers can be evaluated across the lifespan and are tissue specific. This review examines the literature relating environmental exposures to DNA methylation-based aging biomarkers and also the literature evaluating these biomarkers as predictors of health outcomes. Multiple studies evaluated the association between air pollution and DNA methylation age and consistently observed that higher exposures are associated with elevated DNA methylation age. Psychosocial exposures, e.g., traumas and adolescent adversity, and infections are also associated with epigenetic aging. DNA methylation age has been repeatedly associated with mortality, cancer, and cognitive impairment. DNA methylation age is responsive to the environment and predictive of health outcomes. Studies are still needed to evaluate whether DNA methylation age acts as a mediator or modifier of environmental health effects and to understand the impact of factors such as race, gender, and genetics.

COUNSELLING FOR MITIGATING THE PSYCHO-SOCIAL TRAUMA OF FLOOD DISASTER VICTIMS

Psycho-social trauma comes about when a traumatic event overloads an individual’s capacity to cope with his or her usual emotional state. Psycho-social trauma cannot be predicted based on the events that precede them. Flood is an environmental hazard that occurs naturally and relatively sudden as a result of climate change. It happens in a devastating way and are brought down in good numbers. The resultant effects are particularly damaging in terms of properties and other economic/income generation structures. The focus of this work is on the psychosocial wellbeing of the victims. There is an assumption that women are more likely to suffer disproportionately in most disasters more especially flood, thee is hence they are more vulnerable due to minimal access to source of emergency. The core concept here is to prevent stress disorder in the victims of flood and provide coping interventions for traumatized people from the aftermath of major flood disaster leading to displacement from homes and work place. Most flood victims make more emotional investment and are more likely to experience more post traumatic stress disorder associated with flood and consequently become more devastated emotionally and psycho-socially as it happens. The authors hold a strong view that if psycho-social therapy is applied to victims irrespective of standing, it will remove ugly memories of the disturbance; extinguish the fears associated with the stressful events especially that which relates to re-location and loss of victims’ property. The conclusion implies an integrative approach involving experts from diverse field of human being endeavours particularly counselors who are expected to mitigate victims’ state of depression, anxiety and other flood inducing.

Intradermal Scalp Closure Using Barbed Suture in Cranial Tumor Surgeries: A Technical Note.

Traditional scalp closure technique following elective craniotomy involves placement of staples or a continuous running suture. Despite low complication rates, these techniques are often considered to be disfiguring by patients, contribute to the psychosocial trauma of brain surgery, and are associated with discomfort during postoperative staple or suture removal. Some authors have described scalp closure using intradermal absorbable suture, but this technique likely does not reach the tensile strength of closure using traditional methods, and requires knots at the apices of the incision, which can act as a nidus for infection. We employed a barbed intradermal closure method in supratentorial elective craniotomies for tumor resection. Complication rates were recorded, and cosmetic outcomes were informally assessed. Intradermal closure with barbed sutures was utilized in 76 patients. At the 2-wk postoperative clinic visit, cosmetic outcomes were excellent in all cases. There was 1 superficial wound infection that presented 6 wk after a pterional craniotomy for low-grade glioma. This resolved with superficial wound revision and oral antibiotic therapy. We present a novel scalp closure technique for craniotomies using intradermal barbed Monocryl suture. We have had excellent cosmetic outcomes, and the infection rate of 1.3% compares favorably to published rates. Further studies are required to quantify the improvement in patient satisfaction compared to conventional closure methods.

Effects of Prior Psychosocial Trauma on Subsequent Immune Response After Experimental Thorax Trauma.

Overshooting inflammation during the early phase after blunt thorax trauma promotes the development of acute respiratory distress syndrome, multiple organ failure, and subsequent mortality. Given that individuals diagnosed with stress-related disorders are characterized by chronic low-grade inflammation, we hypothesize that "psychosocial traumatic preload" poses a risk factor for the abovementioned complications after thorax trauma.Here, we used the chronic subordinate colony housing (CSC) paradigm to induce "psychosocial traumatic preload" and systemic low-grade immune activation in male mice, indicated by elevated plasma concentrations of different inflammatory mediators. Subsequent thorax trauma was induced in anaesthetized mice by a single blast wave centered on the thorax; SHAM animals were exposed to anesthesia only. Mice were killed 2, 6, and 24 h after thorax trauma or SHAM treatment.Independent of thorax trauma, CSC caused an increase in adrenal weight, and a decrease in thymus weight, indicating that the stress paradigm worked reliably. Moreover, although lung histology was not affected by prior stress, CSC exposure aggravated the early immune response after thorax trauma, indicated by elevated myeloperoxidase lung concentrations in thorax trauma-exposed CSC versus respective single-housed control (SHC) mice (2 h). Furthermore, thorax trauma caused an increase in total bronchoalveolar lavage fluid (BAL) protein (24 h), BAL C5a (2 h), BAL cell counts (24 h), and BAL keratinocyte chemoattractant (6 h and 24 h) in CSC but not SHC mice.Our data indicate that repeated psychosocial traumatization during adulthood moderately aggravates the local immune response toward thorax trauma, but overall may be considered as a rather minor risk factor in terms of thorax trauma-associated complications.

Interventions that Foster Healing Among Sexually Exploited Children and Adolescents: A Systematic Review

ABSTRACTSexual exploitation of children and adolescents is a pressing, yet largely under-recognized form of child abuse. The goals of this review were to identify interventions that have been implemented with sexually exploited children and adolescents and to better understand their effectiveness for fostering healing with this population. Our systematic search generated 4,358 publications of which 21 met our inclusion criteria. Based on their objectives and delivery, we organized the interventions into five categories: (a) focused health and/or social services, (b) intensive case management models, (c) psychoeducational therapy groups, (d) residential programs, and (e) other. Most programs were gender-specific, targeting girls and young women with just one being for boys and young men only. Studies reported on a range of outcomes including psychosocial outcomes, risky behaviors, trauma responses, mental health, protective factors, and public health outcomes. Despite differences in delivery, most of the interventions did, to some degree, appear to foster healing among sexually exploited children and adolescents. Findings from this review have implications for researchers, policy and program developers, and frontline practitioners who, through partnerships with one another, can advocate for the creation of evidence-informed, purpose-built, and thoughtfully delivered interventions.