European Journal of Trauma & Dissociation最新文献

Survival in an extreme environment places high physiological and cognitive demands on the individual. These environments are characterized by specific stimuli, including unusual sensory stimulation and uncertainty, which induce intense stress. Thus, the aims of this study are: i) to evaluate the impact of a five-day survival at sea simulation on human adaptive capacities, based on the assessment of psychological, cognitive, physiological, and sensorial measures; and ii) to assess recovery. Twenty-one healthy participants were enrolled in a 5-day simulation onboard a lifeboat or an inflatable raft. Psychological, physiological, sensory, and cognitive measurements were recorded before leaving (baseline), at the end of the experiment (post) and during the week that followed (recovery). Our results are unequivocal. The harshness of the environment affected the majority of the organism's responses. On the cognitive level, performance significantly deteriorated. On the psychological level, there was low mood, a decrease in subjective exteroceptive acuity and sleep disorders, increased energy, and less perceived stress. On the physiological level, a decline was recorded with respect to autonomous nervous system measurements. On the sensory level, we observed a state of hypervigilance and hypersensitivity to stimuli from the external environment. Proprioception was deeply impacted. Moreover, at recovery, many individuals did not fully recover or deteriorated further, especially regarding sleep, interoceptive abilities and sensory distortion. It appears that participants entered a state of psychological hibernation, associated with increased physical and cognitive load, and sensory hypervigilance. These results raise the question of the risks that may be incurred during future long-term space missions, as astronauts will have to maintain their cognitive performance at a high level to be able to respond to environmental demands and remain alive. It is essential to continue to explore countermeasures that will support adaptation in future spacecraft crew.

Childhood trauma has been identified as an important etiological risk factor for depressive symptoms, but there are other modifiable social environmental factors that may be equally, if not more, important. This study aimed to improve our understanding of the social determinants of depressive symptoms among young people while taking childhood trauma into account. We analyzed survey data from a convenience sample of Chinese young adults aged between 18 to 24 (N = 205). Participants completed standardized assessments of childhood trauma (the Brief Betrayal Trauma Survey), depressive symptoms (the PHQ-9), and social environmental stressors (the Social Environmental Stress Questionnaire). Social environmental stressors had the strongest relationship with depressive symptoms (β = .416, p < .001), above and beyond the effects of childhood trauma. We also identified some specific modifiable and targetable social environmental stressors (e.g., school work and occupation issues, high expectations from others, sleep environment) that were positively correlated with depressive symptoms, even when the Bonferroni correction was applied. Although childhood trauma is a well-documented risk factor for mental health problems, there are modifiable factors associated with depressive symptoms, above and beyond the effects of childhood trauma. Educators, healthcare practitioners, social service providers, and policymakers can play a vital role in changing the trajectory of depression in the community.

Objective

This paper describes the development and pilot evaluation of a single-session 20-minute educational video program for people with PTSD symptoms.

Methods

A pilot randomized waitlist controlled trial was conducted with an international sample of adults with PTSD symptoms (N = 54).

Results

Within-subjects analyses showed that participants in the intervention group had statistically significant decreases in self-stigma (F = 4.388, p < .05, ηp2 =.188, large effect) and post-traumatic maladaptive beliefs (F = 7.757, p < .01, ηp2 = .290, large effect), while participants in the control group did not have such changes. No significant between-subjects effects were observed.

Discussion

Despite several major limitations, including a high attrition rate, a small sample size, and the use of self-report assessments, the preliminary findings revealed that watching the 20-minute video was associated with decreases in self-stigma and post-traumatic maladaptive beliefs in people with PTSD symptoms. Further evaluation using a more rigorous study design and a larger sample size is needed, after making modifications and enrichments to the program.

Background

For the past twenty years, veterans have sustained an unprecedented operational tempo, which can lead to co-occurring mental health disorders. When veterans present for clinical services, the symptom constellation can be challenging to treat due to the overlap of posttraumatic stress, depression, and generalized anxiety symptoms. With limitations, researchers have traditionally used latent variable models to investigate the association between these constructs, whereas network analysis provides a novel approach to study symptom- and disorder-level associations.

Method

In our evaluation of symptom co-occurrence among veterans, we used a sample of treatment-seeking veterans (N = 591) who completed self-report measures of PTSD, depression, and generalized anxiety.

Results

Our cross-sectional network analysis yielded five empirically distinct communities: intrusion and avoidance, hyperarousal and numbing, negative alterations, depression, and generalized anxiety symptoms.

Limitations

The data is cross-sectional and should be modeled in longitudinal networks.

Conclusions

Network associations underscore the heterogeneity of PTSD and also highlight overlapping and diverging symptoms of depression and generalized anxiety. These findings are discussed within the context of existing research on veterans, and recommendations for further study and treatment interventions are provided.

Objective

To (i) explore whether or not the deep brain reorienting (DBR) method ameliorates countertransference reactions and distress in psychotherapists who provide trauma therapies and (ii) describe specific burdens on psychotherapists, who work with severe traumatization and dissociation.

Methods

All participants in this small, naturalistic study (n = 16) were experienced trauma psychotherapists who were in ongoing consultations. When they raised relational difficulties and/or distress related to their clinical work, they were offered an opportunity to process their reactions with DBR during the consultation hours. The participants’ self-assessed experiences of discomfort before and after DBR processing were measured with the Subjective Units of Distress Scale (SUDS). They also provided verbal and written statements regarding their experiences after DBR intervention.

Results

SUDS ratings/values related to participants’ experiences of discomfort before and after the DBR moment were all lowered (p = 0.00003, binomial calculation). Also lowered after the DBR moment (p = 0.00024, binomial calculation) were ratings related to how disturbing it was for the participants after their clients left their last session – compared to how disturbing the participants thought that it would be when their clients would leave the next session. These subjective ratings were aligned with the participants’ summarized verbal and written statements.

Conclusions

Preliminary results are promising. Potentially, DBR seems to diminish trauma-generated countertransference and related reactions. Use of DBR during consultation must be further researched; interventions for ameliorating countertransference reactions have been requested in contemporary research. New knowledge must be further acquired and implemented in clinical work and consultation/supervision – regarding ways in which traumas affect the brain's functional networks and subcortical regions in those suffering severe traumatization (and vicariously their therapists). Whether or not DBR is a helpful method during consultations (among more inexperienced colleagues) should be investigated.

Objectives

Despite its centrality to clinical psychology, research regarding psychological formulation has primarily focused on the perspectives of clinicians and researchers. ‘Bottom-up’ research into client experiences remains in its infancy. This study aimed to explore participants’ experience and understanding of their formulations before and after completing a group intervention designed to increase self-awareness and comprehension of personal formulations.

Methods

Reflexive Thematic Analysis (RTA) was used to analyse data and develop themes summarising essential experiences. Twenty-one adults attending two streams of a novel Group Formulation Programme participated in semi-structured interviews pre-programme, with fifteen taking part post-programme. The groups comprised 8 and 12 sessions between May 2022 and January 2023. Analysis produced five overarching themes across Pre/Post-Programme: Understanding, Coping, Self, Journey, and The Group. Analysis of pre-data produced four themes: 1) Challenging Life Experiences, 2) The Cyclical Nature of Coping, 3) At an Impasse, and 4) Fractured Self. Post-intervention data produced four themes: 1) New Understandings, 2) Repairing the Relationship with Self, 3) Peaks, Valleys, and the Road Ahead, and 4) Group Experience.

Results

Results indicated that pre-intervention, participants had a good understanding of potential factors contributing to their difficulties but reported confusion around coping and self-relating, which impacted psychological and psychosocial functioning. Post-intervention, participants reported an increased sense of how past and present related to difficulties and decreased self-blame.

Conclusions

Participants noted benefits in line with other research in this area but also noted challenges associated with formulation, including feelings of overwhelm and grief.

Background and purpose

Psychosexual trauma can have a serious impact on the psyche and emotional state of victims, it can cause post-traumatic stress disorder (PTSD), depression, anxiety and other mental disorders that are difficult to treat, so the issue of psychosexual trauma is constantly discussed and researched by scientists, which indicates its relevance and importance for society. The study aims to examine the features of psychosexual trauma and its consequences to develop an effective programme to raise awareness of this problem in society.

Methods

The following research methods were used: analysis, systematisation, and surveys, which helped to study the issue of psychosexual trauma as an obstacle to a full life for victims in more depth.

Results

The study examined the consequences of psychosexual trauma, including severe psychological stress, traumatic depression, PTSD, adjustment disorders, gender identity disorders, fear of sexual relations, and a sense of isolation. The study identified ways to overcome psychosexual trauma: seeking professional psychological individual and group support, pharmacotherapy, taking care of physical health, having support from family and friends, and contacting a lawyer or human rights organisation. The study conducted a survey, the results of which indicate significant variability in attitudes towards victims of sexual violence, which correlates with the age and gender of the respondents. According to the survey, tolerance and understanding are more prevalent amongst younger age groups and women, while older age groups and men may be more likely to have negative attitudes.

Conclusions

The survey results served as the basis for the development of an information campaign to eliminate stigma against victims of sexual violence. The findings of the study can be used by psychologists, psychotherapists, and educators to develop training programmes on psychosexual trauma and psychological support to raise public awareness of the seriousness of the problem of psychosexual trauma, its prevalence, and the need for support for victims of violence.

Introduction

Children who have experienced potentially traumatic situations within their first attachment relationships (e.g., abuse, neglect) are more at risk of presenting attachment insecurity and disorganization as well as insecure attachment representations. These children would also be more at risk of developing internalized (e.g., anxiety, depression) and externalized behaviors (e.g., aggressivity, opposition).

Objectives

The study aims to provide a portrait of attachment classification and representations and internalized and externalized behaviors in children aged 7 to 12 from three groups: 35 maltreated children, 42 children from a clinical group, and 39 children from a normative group. The study also aims to evaluate associations between attachment and internalized and externalized behaviors and to detect predictors of internalized and externalized behaviors amongst attachment-related variables.

Method

Participants took part in The Attachment Story Completion Task (ASCT) and a semi-structured interview, the Child Attachment Interview (CAI). Caregivers completed the Child behaviour Checklist to assess internalized and externalized behaviors.

Results

Results show lower levels of attachment security as well as higher levels of insecure attachment representations and internalized and externalized behaviors in maltreated children. Only disorganized attachment was found to be associated with internalized and externalized behaviors. The ASCT could not differentiate the groups and showed little association with internalized and externalized behaviors.

Conclusion

Disorganized attachment is mainly associated with maltreatment and internalized and externalized behaviors, contrary to ASCT variables, thus generating questions regarding this tool's suitability for school-aged children.

Background

Spouses of ex-combatants often experience psychological distress due to sharing their lives with a partner who endured traumatic experiences, a phenomenon known as “secondary traumatization”. Self-differentiation is the emotional distance one takes, while keeping an amount of togetherness with significant others. The couple's relationship and self-differentiation can impact the manner and expanse of secondary traumatization experienced by the spouse.

Objective

This study aimed to examine the role of marital adjustment and self-differentiation (an enmeshed vs detached differentiation style), in secondary traumatization among spouses of ex-combatants.

Methods

This study is part of a longitudinal study examining psychological implications of war among Israeli ex-combatants and their spouses. Overall, 267 spouses have been assessed three times (2003;2011;2016). Participants completed self-report questionnaires evaluating secondary PTSD (SPS), general psychiatric distress (GPD), self-differentiation and dyadic adjustment (DAS). Cross-path models were used to assess associations between the variables longitudinally.

Results

Associations were found between both self-differentiation and dyadic adjustment and SPS and GPD. Path models showed that fusioncutoff differentiation predicted more SPSGPD over time and vice-versa. Furthermore, dyadic adjustment mediated the association between fusioncutoff differentiation and SPSGPD. In other words, fusioncutoff differentiation in time 1 predicted dyadic adjustment in time 2, which in turn predicted SPSGPD in time 3.

Conclusions

Our results can be interpreted in conjunction with original theories about secondary traumatization, emphasizing the importance of keeping a balanced emotional distance in the marital relationship as a way of reducing distress and PTSD symptoms following traumatic events.