Subjective Experience Of Trauma Research Articles

The "3 Es" of trauma-informed care in a federally qualified health center: Traumatic Event- and Experience-related predictors of physical and mental health Effects among female patients.

Federally Qualified Health Centers (FQHCs) are a fast-growing source of healthcare for women with intersectional identities, or those most frequently exposed to and negatively impacted by interpersonal trauma. According to the "3 E" conceptualization of trauma, certain Event- and Experience-related characteristics of a trauma predict victims' physical and mental health Effects. The "3 Es" have yet to be studied in female FQHC patients. The current study examined the prevalence of interpersonal trauma and interrelationships among traumatic Event-related factors (e.g., cumulative trauma by victim-perpetrator relationship), Experience-related factors (e.g., betrayal, resilience), and Effects (e.g., somatic symptoms, posttraumatic stress (PTS), anxiety/depression, mistrust, reduced sense of safety) among 138 predominantly Black (89.1%) women receiving care at an FQHC in the southeastern U.S. Roughly 65% of participants (n = 86) endorsed exposure to at least one type of interpersonal trauma. More cumulative trauma was significantly correlated with more somatic, PTS, and anxious/depressive symptoms,and a reduced sense of safety. Experiences of betrayal and/or resilience were better predictors of PTS and anxious/depressive symptoms and lack of safety than Event-related factors. Findings support the need for the implementation of trauma-informed care within community-based health centers. Healthcare providers should consider women's subjective experience of trauma when screening for exposure and providing trauma-sensitive care.

Traumatic landscapes: Two geographies of addiction

The confluence of the contemporary opioid crisis and the Great Recession has renewed interest in theories of addiction that can account for the relationship between individual symptoms and large-scale socio-political forces. Gesler's (1992) theory of ‘therapeutic landscapes’ examines the ways that social, political, and cultural forces, embedded in place, contribute to health and wellbeing. This article considers the inverse of the therapeutic landscape: the traumatic landscape that harms its inhabitants, proposing it as one way of understanding how addiction is related to place. I draw on research in health geography, medical anthropology, and critical psychology to develop a novel theorization of the relationship between place, trauma, and addiction. Drawing on eighteen months of ethnographic fieldwork with drug users exiting the prison system in Chicago, Illinois, the article considers the life histories of two men whose addictions to drugs and alcohol are profoundly related to place. Through close readings of these cases, I develop two readings of addiction-in-place, one in which addiction is the result of environmental stresses that produce a need to use drugs as a form of self-medication, and another in which the landscape acts as a container for histories of trauma and produces an addiction resembling a psychoanalytic symptom, expressed in self-destructive acts. Finally, through my use of the case history method, I contribute to methodological debates about how to research experiences of place and health, arguing that close attention to lived experience is necessary to draw links between macro-level arguments about structural violence and the subjective experience of trauma that lies at the heart of addiction.

Evaluación del control inhibitorio verbal con el test de Stroop en primeros episodios de psicosis con experiencia de trauma en la infancia

Data from clinical experience highlight the high prevalence of traumatic experiences in subjects with schizophrenia spectrum disorder. However, much is left to examine about the effect of traumatic experiences in the development and severity of psychosis. The Stroop Test assess the verbal response inhibition, an executive function which allows to stop an automatic response and makes possible the inhibition of new behaviours, depending on the situation. To examine the relationship between subjective experience of trauma, verbal response inhibition in the Stroop Test, and severity of the diagnosis at six months from the onset of the disease, in patients with first episode psychosis. Data were obtained from a longitudinal intervention program of first-episode of psychosis (PAFIP) conducted at the University Hospital Marques de Valdecilla, Spain. The variables of interest in the present study were the Stroop Test and the Childhood Trauma Questionnaire as part of the neuropsychological assessment of PAFIP. Statistically significant differences were obtained in verbal response inhibition, being more subjects with high response inhibition when the said trauma was of low intensity. These data support the relationship between intensity of the traumatic experience in childhood and response inhibition dysfunction in people with first episode psychosis, although we cannot conclude a more severe diagnosis at six months from the onset of psychosis in people with traumatic experiences more intense.

Um Corpo Marcado, Lugar Secreto das Palavras

O filme A vida secreta das palavras realça o caráter traumático do sofrimento e a função da fala. Nele, o corpo se apresenta como palco dos efeitos da experiência dolorosa. A experiência subjetiva do trauma, inapreensível e difícil de ser suportada, volta sempre ao mesmo lugar, mas escapa; encontrá-la é impossível, por isso o sujeito repete a tentativa, insistentemente. Nessa perspectiva, pensamos a clínica psicanalítica como lugar de ressignificação da experiência afetiva traumática e a fala metafórica como recurso terapêutico de simbolização. O objetivo deste artigo é apresentar o filme A vida secreta das palavras, articulando-o à repetição, no contexto da clínica psicanalítica, e à fala como recurso terapêutico, considerando as incidências do trauma no corpo. Tendo como referência o conceito psicanalítico de repetição, utilizaremos a teoria de Freud e de Lacan para fazer nossas reflexões. A partir do filme, apresentaremos o conceito de repetição, elaborado por Freud e por Lacan; situaremos a clínica psicanalítica como lugar da palavra, destacando a sua função metafórica, com o relato de uma observação clínica. Concluímos que a própria repetição porta a diferença, cabe ao analista intervir sobre ela, fazendo surgir a palavra, o que vai além do esvaziamento da tensão.

Transforming Trauma: The Relational Unconscious and "Chemistry" in the Treatment of a Paraplegic Patient.

Therapeutic action with a traumatized paraplegic patient highlights the evocative-and transformative-influence of the relational unconscious. The patient's triumphant resolution suggests that formative bipersonal dynamics (including transference, countertransference, and mutual projective identifications) create an ongoing intersubjective enactment and relational chemistry pivotal to psychic shift. A broad systems perspective highlights contextual communication and the interweaving of the analyst's etiological contributions and subjective experience of trauma. Ultimately, an unconscious, co-created dynamic challenges traumatic fixations, supporting a reintegration of narcissistic, gender, and erotic representations and ego capacities. An eclectic perspective that illuminates the analyst's role-receptivity encompasses classical, object relations, relational, systems, and self psychological paradigms.

Predicting Posttraumatic Stress Following Pediatric Injury: A Systematic Review

To review the recent empirical literature concerning development of posttraumatic stress symptoms following pediatric injury and summarize risk and predictive factors that will inform clinical practice and research. A systematic search of online databases such as PsycInfo, PILOTS, MedLine, and PubMed was performed. Further studies were identified through the reference lists of selected articles. Pre-injury psychological problems, the child's subjective experience of trauma severity/life threat, elevated heart rate immediately following the trauma, beliefs regarding initial symptoms, active thought suppression, and parental posttraumatic stress appear to be consistent predictors of persisting posttraumatic stress in children following injury. Specific variables may be useful in predicting posttraumatic stress following injury, which are discussed in terms of existing models of pediatric traumatic stress. Methodologies of included studies are also discussed.

The Subjective Experience of Trauma and Subsequent PTSD in a Sample of Undocumented Immigrants

Although a subjective component of trauma is commonly recognized in diagnosing posttraumatic stress disorder (PTSD), there are few studies that specifically address Criterion A2, and none addressing this issue among undocumented immigrants. We assessed 212 arriving undocumented immigrants with diverse trauma histories to investigate concordance between objective and subjective factors of trauma (Criteria A1 and A2) and across different types of trauma and PTSD. Concordance between Criteria A1 and A2 varied, with highest rates found for political violence. Interpersonal violence in general was associated with higher rates of PTSD. We identified a dose-response effect for PTSD, but this was not dependent on other events (i.e., other doses) meeting Criterion A2. Discussion focuses on Criterion A within the phenomenology of PTSD and the need to gauge subjective interpretations of trauma events among this population.

Causal attributions in posttraumatic stress disorder: Implications for clinical research and practice.

In this paper we seek to illuminate connections among basic research findings in cognition and causal inference, clinical research on the treatment of Posttraumatic Stress Disorder (PTSD), and the practices of clinicians who work with trauma survivors. We examine one particular (and, we believe, important) aspect of PTSD: The creation and maintenance of causal attributions about trauma. We suggest that elements of two principal theories of causal induction (the connectionist model and the "Power PC" causal power model) clarify the role of causal attributions in creating and sustaining the symptoms of PTSD. By exploring the role of causal attributions in creating and sustaining posttraumatic symptoms, we hope to understand better the subjective experience of trauma and its sequelae. We then suggest new directions for clinical research on cognitive restructuring in PTSD patients as well as ideas for optimizing attribution-based therapies for trauma survivors. (PsycINFO Database Record (c) 2010 APA, all rights reserved).