Violent Trauma Research Articles

There Is No Strength in Emotions: The Role of Street Enculturation in Influencing How Victimized Homeless Women Speak About Violence.

This article is based on analysis of 76 in-depth qualitative interviews conducted with homeless women in Los Angeles. What is revealed are three patterns of street enculturation-"low-," "medium-," and "high street"- which are linked to attitudes women professed to hold about violence. In essence, the degree to which a woman had adopted a "street orientation" is seen to influence how she spoke of violence during earlier portions of the interview. However, several "medium-street" and "high-street" women subsequently acknowledged (directly or indirectly) that they were "fronting" for the interviewer to preserve a tough façade. When they opened up about their real feelings, the extent to which they had internalized the trauma of violence was revealed. Implications of these findings are explored.

Orbital Comminutid Roof Fracture: Report of Two Cases

Orbital roof fractures are typically associated with trauma of the frontal bone in violent trauma. It may disrupt the oculomotricity and allow a frontal asymmetry. The patients usually apply correction.

The Development of the Scale of Protective Factors: Resilience in a Violent Trauma Sample.

This research developed the Scale of Protective Factors (SPF-24) to measure protective factors contributing to resilience. We investigated the factor structure of 35 items. After exploratory factor analysis, we subjected 25 items representing 2 social-interpersonal and 2 cognitive-individual factors to confirmatory factor analysis. The sample consisted of 942 college students from 3 studies and 2 institutions. To examine the diagnostic function of the SPF, we used clinical criteria to identify a subsample of participants who had experienced violent trauma and scored low, moderate, or high on an established resilience scale. Results showed that the low-resilient group scored significantly lower on all subscales of the SPF with marked differences in prioritizing/planning behavior. Implications for the research and clinical settings are discussed.

Racial Appraisal: an integrated Cultural and Structural Response to African American Experiences with Violent Trauma

Racial appraisal is discussed as an integrative approach in response to experiencing violent victimization for African Americans. The research asserts that the process of coping with trauma for direct and indirect victims of violence is both structural and cultural. The paper references sociology and social work research that illustrates the use of racial appraisal to understand the ways in which race-based structural inequality limits and facilitates the interactions and cognitions of victims of violence,thereby impacting the allocation of social, psychological, and cultural resources from which African American survivors can draw upon to manage trauma related symptoms. Implications for research and practice are discussed.

Medical News From Scientific Analysis of the Turin Shroud

This paper synthetizes a series of works recently published in reference to medical studies regarding both the physical conditions of the Man who was wrapped in the Turin Shroud (TS) and the tortures to which this Man was subjected. An event that influenced the rapid course of the Passion and the cause of death of the TS Man was the fall under the weight of the cross. This Man shows, on the right side, shoulder lowering, flat hand and henophthalmos, revealing a violent blunt trauma, from behind, to neck, chest and shoulder, with the entire brachial plexus injury and muscular damage to the neck bottom with the head bent forward and turned to the left, on the cross, as he had a stiff neck. Most likely, falling the body forward, the chest trauma caused a heart and lung contusion with hemothorax. The wrists were easily nailed in the Destot space with ulnar artery cutting and partial tear of the ulnar nerve cause of the thumb retraction and its disappearance on the Shroud. The nail in the right foot was driven in the tarsal bones. The right foot was probably dislocated to the ankle. The lance penetrated in the sixth intercostal space. The likely cause of immediate death was a myocardial infarction with rupture, haemopericardium and heart tamponade of a subject with cardiac contusion. Tortures and other medical conditions have only accelerated the death.

An Exceptional Case of Bilateral Radiocarpal Dislocation with Fracture of the Radial Styloid Associated to a Tiered Trauma of the Upperlimb

Radiocarpal dislocation is a particular entity, infrequent, representing only 0.2% of all dislocationsas evidenced by the scarcity of publications, which mainly affects young patients, and most often the result of violent trauma. We reported a case of a 35-year-old male patient who sustained dorsal radiocarpal dislocation after a fall from a high place, with fracture of the radial and ulnar styloid process in both wrists, associated to a tiered trauma of the right upperlimb. He was treated with closed reduction and immobilized by cast for the bilateral radiocarpal dislocation, and treated surgically for the tiered trauma of the upperlimb. The evaluation at 3 months showed favorable results. This case is one of the few similar cases reported because it is an uncommon pathology and it is even less frequent because the injury involves both wrists and the upperlimb.

Chapter 22 - Occupational mononeuropathies in industry

Peripheral nerve injuries have the potential to cause significant disability and can be commonly associated with recreational and occupational activities. Acute nerve injuries are mainly related to violent trauma, while repeated mechanical trauma due to external forces or repetitive motions can produce chronic nerve compression injury. This chapter will present a narrative review of the existing evidence of the association between peripheral compressive nerve disorders and work-related risk factors. Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy in the general population and in working populations employed in manual repetitive and forceful activities. The work-relatedness of CTS is essentially based on epidemiologic evidence and the results of experimental studies showing the capability of repetitive wrist extreme postures, associated with hand-wrist forceful exertions, to increase the pressure inside the carpal tunnel and to compress the median nerve. Assembly industry, food processing and packaging, hand-arm vibrating tools, and jobs involving high-repetition, high-force tasks put workers at risk for CTS. Less strong evidence exists of the association between ulnar elbow neuropathy and manual tasks or repetitive stretch on squatting and peroneal nerve neuropathy at the fibular head. Very few reports are available about the association between occupation and other compressive peripheral nerve injuries.

Exposure to trauma-relevant pictures is associated with tachycardia in victims who had experienced an intense peritraumatic defensive response: the tonic immobility.

Tonic immobility is an involuntary, last-ditch defensive reaction characterized by physical inactivity in a context of inescapable threat that has been described in many species, including humans. The occurrence of this defensive response is a predictor of the severity of psychiatric disorders and may be considered as an index of an intense reaction to a traumatic event. Here, we investigated whether the retrospective reports of peritraumatic tonic immobility reaction in participants exposed to a traumatic event would modify their cardiac responses to pictures related to their trauma. Using a questionnaire of life-threating events, we selected students who experienced violent crime as their most intense trauma and students who had never experienced a violent crime trauma, but experienced other traumatic events. All participants completed a questionnaire that estimated the intensity of tonic immobility during their most intense trauma. Electrocardiographic recordings were collected during exposure to pictures. Participants viewed emotional pictures (human attack with guns) and neutral pictures. These emotional stimuli were selected to be trauma-relevant to the violent crime group and non trauma-relevant to the no violent crime trauma group. Violent crime group showed a positive correlation between heart rate changes after viewing trauma-related pictures and tonic immobility scores. We observed that low tonic immobility scores were associated with bradycardia and high scores with tachycardia in response to trauma-relevant pictures. For the no violent crime group, no significant correlation was detected. These results suggest that the relevance of the stimuli and the magnitude of the defensive response during a previous trauma event were important factors triggering more intense defensive responses.

Psychotherapy with Refugees: Emerging Paradigm

Much clinical and trauma work has focused on interventions with individuals experiencing interpersonal violence and past traumas. Refugees' experiences include past and present and chronic intergroup and interpersonal traumas with cumulative linear and nonlinear dynamics. Refugees face unique social and political traumatogenic ecologies that can play at least an equivalent or even more significant role in traumatic stress compared with that of survivors of interpersonal trauma who do not experience atrocities such as exile, political and religious persecution, and torture. Evolving paradigms of intervention need to be developed to integrate individual and ecological models of recovery that focus on the whole person within her or his social and political ecology and on past as well as present traumatogenic experiences; in addition, these paradigms need to mobilize refugees' resilience.

Ganga hospital open injury score in management of open injuries.

Open injuries of the limbs offer challenges in management as there are still many grey zones in decision making regarding salvage, timing and type of reconstruction. As a result, there is still an unacceptable rate of secondary amputations which lead to tremendous waste of resources and psychological devastation of the patient and his family. Gustilo Anderson's classification was a major milestone in grading the severity of injury but however suffers from the disadvantages of imprecise definition, a poor interobserver correlation, inability to address the issue of salvage and inclusion of a wide spectrum of injuries in Type IIIb category. Numerous scores such as Mangled Extremity Severity Score, the Predictive Salvage Index, the Limb Salvage Index, Hannover Fracture Scale-97 etc have been proposed but all have the disadvantage of retrospective evaluation, inadequate sample sizes and poor sensitivity and specificity to amputation, especially in IIIb injuries. The Ganga Hospital Open Injury Score (GHOIS) was proposed in 2004 and is designed to specifically address the outcome in IIIb injuries of the tibia without vascular deficit. It evaluates the severity of injury to the three components of the limb--the skin, the bone and the musculotendinous structures separately on a grade from 0 to 5. Seven comorbid factors which influence the treatment and the outcome are included in the score with two marks each. The application of the total score and the individual tissue scores in management of IIIB injuries is discussed. The total score was shown to predict salvage when the value was 14 or less; amputation when the score was 17 and more. A grey zone of 15 and 16 is provided where the decision making had to be made on a case to case basis. The additional value of GHOIS was its ability to guide the timing and type of reconstruction. A skin score of more than 3 always required a flap and hence it indicated the need for an orthoplastic approach from the index procedure. Bone score of 4 and 5 will require complex reconstruction procedures like bone transport, extensive bone grafting or free fibular graft. Regarding the timing of reconstruction, injuries with a score of 9 or less indicated a low violence trauma and were amenable for early soft tissue reconstruction whereas injuries with a score of 10 or more indicated high violence injuries where a staged reconstruction policy must be followed. Ganga Hospital Open Injury Score was found to be highly useful in decision making regarding salvage in IIIB injuries. The individual tissue scores were also useful to provide guidance regarding the timing and type of bone and soft tissue reconstruction.

Operation CeaseFire-New Orleans: an infectious disease model for addressing community recidivism from penetrating trauma.

CeaseFire, using an infectious disease approach, addresses violence by partnering hospital resources with the community by providing violence interruption and community-based services for an area roughly composed of a single city zip code (70113). Community-based violence interrupters start in the trauma center from the moment penetrating trauma occurs, through hospital stay, and in the community after release. This study interprets statistics from this pilot program, begun May 2012. We hypothesize a decrease in penetrating trauma rates in the target area compared with others after program implementation. This was a 3-year prospective data collection of trauma registry from May 2010 to May 2013. All intentional, target area, penetrating trauma treated at our Level I trauma center received immediate activation of CeaseFire personnel. Incidences of violent trauma and rates of change, by zip code, were compared with the same period for 2 years before implementation. During this period, the yearly incidence of penetrating trauma in Orleans Parish increased. Four of the highest rates were found in adjacent zip codes: 70112, 70113, 70119, and 70125. Average rates per 100,000 were 722.7, 523.6, 286.4, and 248, respectively. These areas represent four of the six zip codes citywide that saw year-to-year increases in violent trauma during this period. Zip 70113 saw a lower rate of rise in trauma compared with 70112 and a higher but comparable rise compared with that of 70119 and 70125. Hospital-based intervention programs that partner with culturally appropriate personnel and resources outside the institution walls have potential to have meaningful impact over the long term. While few conclusions of the effect of such a program can be drawn in a 12-month period, we anticipate long-term changes in the numbers of penetrating injuries in the target area and in the rest of the city as this program expands. Therapeutic study, level IV.

Community reintegration for widows suffering religious minority violence: personalism as therapy

Each year around the globe millions of people experience religiously motivated, traumatic violence. In the absence of assisted care those affected often suffer permanent psychological impairment, failing to reintegrate successfully into stable self-subsistent communities. We report here on the success of a personalistic therapy used to assist community recovery in a dispersed widow population suffering religiously motivated violence. In 2008, Orissa Hindu nationalists blamed local Christians for their leader’s assassination; the subsequent retaliation led to murders, destruction of churches, schools, homes, and physical assaults. Subsequent recovery efforts were premised upon a psychotherapeutic restoration keyed to a personalistic, Catholic/Christian psychological framework (Vitz, 2011) as a necessary contingent for community reintegration and economic self-sufficiency. Assaultive trauma, personal valuation, interpersonal psychosocial functioning, agency, and sense of trust in committed care were monitored. Our results indicate, among others, that self-valuation generally paralleled growth in trust commitment, but the latter depended on the perception of the caregiver’s commitment to faith values. Therefore, we propose an assault recovery model in which self-esteem and trust in committed care are constructed through the perception of a personalistic commitment grounded on faith values. ©2014 European Journal of Research on Education by IASSR.

The Better Angels of their Nature: Declining Violence through Time Among Prehispanic Farmers of the Pueblo Southwest

The central Mesa Verde and the northern Rio Grande regions housed two of the densest populations of prehispanic Pueblo peoples in the North American Southwest. We plot incidence of violent trauma on human bone through time in each region. Such violence peaked in the mid-A.D. 1100s in the central Mesa Verde, and in general was higher through time there than in the northern Rio Grande region. In the central Mesa Verde, but not in the northern Rio Grande, there is a tendency for violence to be greater in periods of low potential maize produccción per capita and high variance in maize produccción, though these structural tendencies were on occasion overridden by historical factors such as the expansion and demise of the Chacoan polity and the regional depopulation. Violence generally declined through time in the northern Rio Grande until the arrival of the Spanish, even as populations increased. We propose that this decline was due to the combination of increased social span of polities, the importance of inter-Pueblo sodalities, the nature of religious practice, “gentle commerce,“ and increased adherence to a set of nonviolent norms.

Old before their time: the impossibility of childhood innocence in The Walking Dead

Many in Western culture see childhood as innocent and children as pure, even though this is often not the case. Because of this inaccurate view, many contemporary narratives push back against the feasibility of maintaining childhood innocence. One such narrative is Robert Kirkman’s serialised comic book The Walking Dead, in which children are exposed to potentially traumatic events, like death and violence, on a daily basis. The comic book juxtaposes images and situations containing children and youth against the horrific environment in which the characters find themselves, often with devastating results. These juxtapositions demonstrate the impossibility of maintaining innocence in a dangerous world. The child Carl’s rapid movement towards adulthood is also analogous to the transition towards more adult content in comic books. The movement towards more adult content in a form that some thought was, or should be, strictly for children is, in some ways, representative of the futility in attempting to shelter children from adult content.

COMING TO TERMS WITH TERRORISM. SERGIO CORBUCCI’S DONNE ARMATE AND THE TRAUMA OF THE ANNI DI PIOMBO

Since Italy’s transition to the Second Republic in the early 1990s, a period marked by attempts to come to terms with the traumatic experience of the violent 1970s, cinema and television have increasingly been (ab)used for the rewriting of national history, often within a revisionist framework, and for the promotion of new discourses of reconciliation. The miniseries Donne armate (Sergio Corbucci, 1991) is one such attempt to work through the trauma of political violence by rehumanizing — in the words of Giancarlo Lombardi (2009) — the demonized figure of the terrorist. Produced in the same period as Sergio Zavoli’s television documentary La notte della repubblica, where former terrorists from both sides of the ideological spectrum are offered the chance to publicly express their personal reflections and regrets, Donne armate also promotes a discourse of reconciliation by bringing together two women belonging to different sides of the law: a terrorist and a policewoman. This reconciliation with Italy’s violent past is reinforced by the casting of Lina Sastri in the role of the terrorist, calling back memories of Giuseppe Bertolucci’s Segreti segreti (1984), where Sastri interpreted a ruthless terrorist killer who is eventually defeated by the law. Drawing, among other things, on theories of cultural memory and trauma, this article discusses — through an analysis of both Donne armate and a number of television programmes on terrorism broadcast in the early 1990s — the political potentialities and limits of television in processes of healing and national reconciliation.

Post-traumatic Injury of the Brachiocephalic Artery: On-pump Beating Heart Repair

We report the case of 54 year-old man who presented with an injury of the brachiocephalic artery secondary to a violent blunt chest trauma. The patient underwent urgent open surgical repair. The procedure was achieved on on-pump beating heart approach. The subsequent course was uneventful.

Children and adolescents treated for post-traumatic stress disorder at the Free State Psychiatric Complex

<p><strong>Background.</strong> Children and adolescents can develop post-traumatic stress disorder (PTSD) after exposure to a range of traumatic events, including domestic, political or community violence, violent crime, physical and sexual abuse, hijacking, witnessing a violent crime and motor vehicle accidents. This is particularly critical given the substantial challenge that PTSD poses to the healthy physical, cognitive and emotional development of children and adolescents.</p><p><strong>Methods.</strong> The clinical records of 1 229 children (age 2 - 11 years) and adolescents (age 12 - 18 years) treated at the Child Mental Health Unit of the Free State Psychiatric Complex (FSPC) were screened for the diagnosis of PTSD and analysed for the purpose of this study.</p><p><strong>Results.</strong> Forty-nine (4.0%) of the children and adolescents treated at the unit were diagnosed with PTSD, of whom most were female (63.3%). Approximately 22% of the participants had comorbid major depressive disorder. The main traumatic event in both groups was witnessing the death of a close relative (32.7%), followed by sexual assault (25%), rape (25%) and physical attack (10.2%). Associated stressors identified included problems at school (55.1%), isolation (39%), fear or anxiety (37%), problematic family relationships (29%), emotional (27%) and physical (23%) abuse, and lack of social support (23%). Most of the participants (59.2%) received psychotherapy.</p><p><strong>Conclusions.</strong> Children and adolescents referred to the FSPC are also exposed to traumatic events which lead to the development of PTSD. The Free State is a sprawling province with remote areas where specialist services and facilities are limited. It is therefore recommended that preventive programmes, training opportunities and consultation services are implemented to identify and treat children and adolescents with PTSD. Schools with limited access to psychological services and large classrooms, impeding the diagnosis and treatment of PTSD specifically, face similar challenges. Reinforcement of professional services and the upgrading of facilities will decrease the burden on the Child Mental Health Unit, but will require collaborative efforts from role players such as the National Departments of Health and Education.</p>

Children and adolescents treated for post-traumatic stress disorder at the Free State Psychiatric Complex

Background. Children and adolescents can develop post-traumatic stress disorder (PTSD) after exposure to a range of traumatic events, including domestic, political or community violence, violent crime, physical and sexual abuse, hijacking, witnessing a violent crime and motor vehicle accidents. This is particularly critical given the substantial challenge that PTSD poses to the healthy physical, cognitive and emotional development of children and adolescents. Methods. The clinical records of 1 229 children (age 2 - 11 years) and adolescents (age 12 - 18 years) treated at the Child Mental Health Unit of the Free State Psychiatric Complex (FSPC) were screened for the diagnosis of PTSD and analysed for the purpose of this study. Results. Forty-nine (4.0%) of the children and adolescents treated at the unit were diagnosed with PTSD, of whom most were female (63.3%). Approximately 22% of the participants had comorbid major depressive disorder. The main traumatic event in both groups was witnessing the death of a close relative (32.7%), followed by sexual assault (25%), rape (25%) and physical attack (10.2%). Associated stressors identified included problems at school (55.1%), isolation (39%), fear or anxiety (37%), problematic family relationships (29%), emotional (27%) and physical (23%) abuse, and lack of social support (23%). Most of the participants (59.2%) received psychotherapy. Conclusions. Children and adolescents referred to the FSPC are also exposed to traumatic events which lead to the development of PTSD. The Free State is a sprawling province with remote areas where specialist services and facilities are limited. It is therefore recommended that preventive programmes, training opportunities and consultation services are implemented to identify and treat children and adolescents with PTSD. Schools with limited access to psychological services and large classrooms, impeding the diagnosis and treatment of PTSD specifically, face similar challenges. Reinforcement of professional services and the upgrading of facilities will decrease the burden on the Child Mental Health Unit, but will require collaborative efforts from role players such as the National Departments of Health and Education.

Trauma exposure, posttraumatic stress disorder symptomatology, and aggression in male juvenile offenders.

Juvenile offenders have a high prevalence of trauma exposure and posttraumatic stress disorder (PTSD) symptoms, as well as aggressive behavior. However, relationships between exposure to different specific types of traumatic events, PTSD symptoms, and aggression have not been systematically investigated. Subgroups of male juvenile offenders were identified based on their self-reported exposure to different types of traumatic events. Male juvenile offenders who endorsed multiple types of trauma exposure or traumatic exposure involving violence endorsed higher levels of PTSD symptomatology but not self-reported aggression. In addition, meeting the DSM-IV PTSD diagnosis Criterion A for traumatic exposure was associated with more severe emotional and behavioral problems in the youth who were exposed to community violence. Implications for theory and research on violent trauma and polyvictimization, and the use of self-report trauma history and PTSD measures for screening, with youth involved in the juvenile justice system, are discussed.

A GIS-based spatiotemporal analysis of violent trauma hotspots in Vancouver, Canada: identification, contextualisation and intervention

BackgroundIn 2002, the WHO declared interpersonal violence to be a leading public health problem. Previous research demonstrates that urban spaces with a high incidence of violent trauma (hotspots) correlate with...