Traumatic Events (traumatic + event)

Distribution by Scientific Domains
Distribution within Psychology

Selected Abstracts

Does low-intensity pulsed ultrasound stimulate maturation of tissue-engineered cartilage?

Georg N. Duda
Abstract Traumatic events are a primary cause of local lesions of articular cartilage. Tissue engineered, cartilage-like structures represent an alternative to current treatment methods. The time necessary for tissue maturation and the mechanical quality of the regenerate at implantation are both critical factors for clinical success. Low-intensity pulsed ultrasound has proven to accelerate chondrogenesis in vitro. The goal of this study was to evaluate whether low-intensity pulsed ultrasound is capable of accelerating the process of cartilage maturation and increasing regenerate stability. Hyaline-like cartilage specimens were generated in vitro and subcutaneously implanted in the backs of nude mice. Twenty-eight animals received 20 min of low-intensity pulsed ultrasound treatment daily, and 28 animals received a sham treatment. Specimens were explanted after 1, 3, 6, and 12 weeks, mechanically tested with the use of an indentation test, histologically examined, and processed for RT-PCR. The Young's moduli significantly increased from 3 to 12 weeks, and at 6 weeks were comparable to those of native articular cartilage. In histological examination, specimens showed neocartilage formation. There was no significant difference between ultrasound-treated and sham-treated groups. The mechanical stability of the neocartilage specimens increased with treatment time and reached values of native cartilage after 6 weeks in vivo. Low-intensity pulsed-ultrasound stimulation showed no stimulatory effect on tissue maturation. In contrast, ultrasound-treated specimens showed a reduced Col 2 expression at 1 week and were significantly less stiff compared to native cartilage at 6 and 12 weeks. An acceleration of the maturation of tissue-engineered neocartilage in a clinical setting by means of low-intensity pulsed ultrasound therefore appears rather unrealistic. © 2003 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 68B: 21,28, 2004 [source]

Traumatic events and alcohol use disorders among American Indian adolescents and young adults

Alison J. Boyd-Ball
This study examined the relationship between severe traumatic events and alcohol use disorders in American Indian adolescents and young adults. Interviews of 432 adolescents and young adults who were enrolled tribal members living on or near two closely related American Indian reservations were used. Results indicated that severe trauma increased the odds of alcohol use disorders (p <.001), with the number of traumas having a dose-dependent effect. The authors conclude that trauma is associated with alcohol use disorders in this population. This study's findings yield important insights into the risks in American Indian adolescents and young adults that may result from early trauma, as well as implications for the timing and possible settings for intervention. [source]

The prevalence of traumatic events in young Japanese women

Ichiro Mizuta
In an effort to address important cross-cultural considerations in the study of posttraumatic stress disorder (PTSD), the present study is the first to assess the prevalence of a variety of potentially traumatic events among young Japanese women across life phases. Overall, our results proved similar to those reported in previous Western studies: Traumatic events were quite common among our participants (80.3%; n = 883). This finding is not surprising given that many of them lived through the 1995 Kobe earthquake. Yet our study found that even when "natural disaster" was excluded, the rate remained 53.1%. Comparing four life phases, we found the most consistent differences between preschool and other life phases. The prevalence of potentially traumatic events and the percentage of most distressing events that participants reported were significantly lower in the preschool phase. [source]

Impact of environmental and hereditary risk factors on the clinical manifestation of thrombophilia in homozygous carriers of factor V:G1691A

S. Ehrenforth
Summary.,Background:,Limited data exist on the clinical manifestations of homozygous factor (F)V:G1691A mutation (FV Leiden) and the impact of environmental and genetic risk factors. Objectives:,To assess the contribution of these factors on the thrombophilic phenotype. Patients and methods:,In a retrospective multicenter cohort study 165 individuals with homozygous FV:G1691A mutation, of whom 129 had previous venous thromboembolism (VTE), were included. To study the role of environmental risk factors, patients were compared by the use of a standardized questionnaire to 165 sex- and age-matched individuals (reference group A); of these, two had previous VTE. To assess the role of genetic risk factors, factor (F)II:G20210A and MTHFR:C677T were determined in individuals homozygous for FV:G1691A and in 177 healthy individuals without previous VTE (reference group B). Results:,The first VTE occurred significantly earlier in women (median age 25 years) than men (35.5 years). In 81% of women and 29% of men an environmental risk factor was present before first VTE. Oral contraceptives increased the risk of thrombosis 4-fold [odds ratio (OR) 4.0, 95% confidence interval (CI) 1.7, 10.4] in women with homozygous FV:G1691A. Postoperative and post-traumatic VTE as first manifestation occurred in 13% and 15% of surgical/traumatic events in patients and in 0.7% and 1.8% in reference group A, respectively (OR 19.7, 95% CI 2.5, 154 and OR 9.2, 95% CI 1.1, 79.4). Heterozygous FII:G20210A was more prevalent in symptomatic patients (11.7%) compared with reference group B (2.8%, OR 4.6, 95% CI 1.6, 13.2). The prevalence of homozygous MTHFR:C677T genotype was similar in patients and reference group B. Conclusions:,Our study supports the concept of thrombophilia as a multifactorial disorder. The knowledge of coexisting factors predisposing to VTE is useful for medical advice for primary and secondary prophylaxis in these patients. [source]

Initial symptoms and reactions to trauma-related stimuli and the development of posttraumatic stress disorder

Karin Elsesser Ph.D.
Abstract We investigated laboratory and experimental variables as predictors of the development of posttraumatic stress disorder (PTSD). Evoked heart rate response to trauma-related pictures, attentional bias in the dot-probe task, and viewing time were assessed in 35 victims of a traumatic event and again after 3 months. Data was compared to 26 control participants. At first assessment trauma victims showed heart rate (HR) acceleration and controls showed HR deceleration to trauma-related material. The group of trauma victims improved clinically over time. Predictors of the number of PTSD symptoms after 3 months were re-experiencing (33% of the variance) and amplitude of the evoked HR reaction to trauma-related pictures (15%). The two variables were highly correlated. Trauma victims were also more anxious, viewed trauma-related pictures for a longer time, and had a longer reaction time in the dot-probe task (but no distinct attentional bias) than control participants. Results indicate that specific fear responses and re-experiencing contribute to the development of posttraumatic stress disorder. Depression and Anxiety 21:61,70, 2005. © 2005 Wiley-Liss, Inc. [source]

Experience of trauma and conversion to psychosis in an ultra-high-risk (prodromal) group

A. Bechdolf
Bechdolf A, Thompson A, Nelson B, Cotton S, Simmons MB, Amminger GP, Leicester S, Francey SM, McNab C, Krstev H, Sidis A, McGorry PD, Yung AR. Experience of trauma and conversion to psychosis in an ultra-high-risk (prodromal) group. Objective:, We aimed to replicate a recent finding of high prevalence of trauma history in patients at ,ultra-high risk' (UHR) of psychotic disorder and to investigate whether trauma predicts conversion to psychosis in this population. Method:, A consecutive sample of UHR patients was assessed. History of trauma was accessed with the General Trauma Questionnaire. Cox regression models were used to explore relationship between conversion to psychosis and trauma. Results:, Of 92 UHR patients nearly 70% had experienced a traumatic event and 21.7% developed psychosis during follow-up (mean 615 days). Patients who had experienced a sexual trauma (36%) were significantly more likely to convert to first-episode psychosis (OR 2.96) after controlling for meeting multiple UHR intake groups. Conclusion:, UHR patients have a high prevalence of history of trauma. Previous sexual trauma may be a predictor of onset of psychotic disorder in this population. [source]

Chronic cognitive sequelae after traumatic brain injury are not related to growth hormone deficiency in adults

D. Pavlovic
Objective:, The objective of the study was to asses the possible influence of hypothalamo,pituitary deficiencies, and growth hormone (GH) deficiency in particular, on cognition in adult patients with traumatic brain injury (TBI). TBI is a recently identified risk factor for cognitive deficits and hypopituitarism. Even the patients with favorable outcome after TBI may present with persistent bodily, psychosocial, and cognitive impairments, resembling patients with untreated partial or complete pituitary insufficiency. Design:, We performed retrospective and cross-sectional study of endocrine and cognitive function in TBI in 61 patients (aged 37.7 ± 1.7 years) of both sexes (44 m,17 f), at least 1 year after TBI (3.9 ± 0.6 years). Serum insulin-like growth factor 1 (IGF-I), thyroxin, thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (in men), prolactin, and cortisol were measured, and GH secretion was assessed by growth hormone releasing hormone (GHRH) + growth hormone releasing peptide-6 (GHRP-6) test. Cognitive function was assessed by using a standard neuropsychological battery. Results:, GH deficiency (GHD) and GH insufficiency (GHI) were found in 20 patients (32.8%). After adjustment for confounders [age, body mass index (BMI), education level, time elapsed from TBI], there were no significant differences in results of neuropsychological tests between patients with TBI with GHD, GHI, and normal GH secretion. There were no correlations of neuropsychological variables with stimulated peak GH secretion or IGF-I level. Conclusions:, GHD persists long after the TBI, independently of trauma severity and age at traumatic event. GH secretion is more sensitive to TBI than other pituitary hormones. No evidence is found for an association of cognitive function impairment and somatotropic axis impairment in adult patients tested more than 1 year after the TBI. [source]

MEGX disposition in critically-ill trauma patients: subsequent assessments during the first week following trauma

Federico Pea
ABSTRACT The objective of this study was to evaluate MEGX disposition as a surrogate marker in assessing the influence that injury may exert on liver function during the first week after the traumatic event in young vs. elderly patients. The MEGX exposure over time was assessed at 0.25, 0.5, 1, 2, 4 and 6 h after the intravenous administration of a 1 mg/kg lidocaine test dose in 12 young and 7 elderly trauma patients on days1, 4 and 7 after a severe injury (Apache II score > 10). MEGX plasma concentration,time profiles were consistently different on day 1 in the elderly vs. young, consistent with a statistically significant lower rate of both lidocaine clearance and MEGX formation, and with a considerably longer MEGX elimination in the elderly than in the young. This suggests an impairment of liver blood flow as a result of splanchnic vasoconstriction occurring mainly in elderly trauma patients. A significant improvement in MEGX disposition occurred on days 4 and 7 vs. the day of trauma in most elderly, whereas minor changes were observed in the young. Multiple factors may account for these major changes in the elderly: the more severe status, the major sensitivity to the pathophysiologic changes induced by trauma, and also at least partially the ageing processes. Although referring to a limited number of observations, our findings on MEGX disposition suggest that liver function may be affected by the severity of injury, even if the influence of age should not be underestimated in these patients. [source]

"Grab the Signatures and Run": Federal Unity Strategy in Canada from the Referendum to Patriation

Neal Carter
Whether as a traumatic event or great accomplishment, the legacy of the First Ministers' Conference of 1981 lives on in Canadian politics. Constitutional negotiations among the prime minister and provincial premiers in 1981 produced the only "packaged" agreement since Confederation to achieve even the minimal support necessary to achieve ratification. The resulting Constitution Act of 1982, which included the Charter of Rights and Freedoms, remains in place and is the principal manifestation of intergovernmental bargaining from over two decades ago. This study reevaluates the strategic interaction and conflict processes that took place between Ottawa and the provinces in negotiations leading up to that fateful November 1981 conference. We apply the sociological framework for assessment of the dynamics of identity contention adopted from McAdam, Tarrow, and Tilly (2001) and find tentative support for its propositions. After an overview of the article's agenda, we present an analytic framework for the study of conflict processes. Second, the background to the constitutional crisis of 1980-81 is summarized. Using the analytic framework, the third section focuses on the federal strategy in the crisis as suggested by minutes from cabinet meetings, and the fourth section examines key events of the First Ministers Conference of November 1981. Fifth, and finally, the contributions of the preceding sections are summed up and ideas are put forward for further research. [source]

Women's perceptions and experiences of a traumatic birth: a meta-ethnography

Rakime Elmir
elmir r., schmied v., wilkes l. & jackson d. (2010) Women's perceptions and experiences of a traumatic birth: a meta-ethnography. Journal of Advanced Nursing,66(10), 2142,2153. Abstract Aim., This study presents the findings a meta-ethnographic study reporting women's perceptions and experiences of traumatic birth. Background., Childbirth is viewed by many as a life transition that can bring a sense of accomplishment. However, for some women, birth is experienced as a traumatic event with a minority experiencing post-traumatic stress. A traumatic birth experience can have a significant impact on the physical and emotional well-being of a woman, her infant and family. Data source., The CINAHL, MEDLINE, Scopus and PubMed databases were searched for the period January 1994 to October 2009 using the keywords birth trauma, traumatic birth, qualitative research, birth narrative and birth stories. Review methods., A meta-ethnographic approach was used. Quality appraisal was carried out. An index paper served as a guide in identifying particular findings and comparing them with other findings. This ,reciprocal translation' process started with a search for common themes, phrases and metaphors. Results., Ten qualitative studies were included in the final sample. Six major themes were identified: ,feeling invisible and out of control', ,to be treated humanely', ,feeling trapped: the reoccurring nightmare of my childbirth experience', ,a rollercoaster of emotions', ,disrupted relationships' and ,strength of purpose: a way to succeed as a mother'. Conclusions., It is evident that a small percentage of women experience a traumatic birth. Although some women who experience a traumatic birth do not necessarily have physical or psychological adverse outcomes, others identify a significant personal impact. Healthcare professionals must recognize women's need to be involved in decision-making and to be fully informed about all aspects of their labour and birth to increase their sense of control. [source]

The Effects of Values on Worries Associated With Acute Disaster: A Naturally Occurring Quasi-Experiment,

Dwight D. Frink
On April 12, 1995, a bomb exploded in Oklahoma City, Oklahoma, destroying a federal office building, killing 168 people, and upending American notions of safety and security in the heartland. Using data collected before, immediately after, and 1 year after the bombing from 3 samples living within 25 miles of the explosion in a naturally occurring quasi-experiment, research examined effects of values on people's worries in the context of a macrolevel traumatic event. High self-transcendence and conservation values correlated with higher macro-worries immediately after vs. before the explosion, but these worries were lower 1 year later. Findings indicate that values emphasizing broader social perspectives were associated with higher macrolevel worries, while values emphasizing one's own life and welfare were not. [source]

Brief psychodynamic treatment of PTSD

Janice L. Krupnick
This article describes a brief psychodynamic psychotherapy for adults suffering from PTSD following exposure to a single traumatic event, such as tragic bereavement, assault, or loss of a body part through surgery. It uses a supportive therapeutic relationship to uncover what the specific event and circumstances that follow mean to the individual and the obstacles to normal psychological processing of these events. Using this 12-session treatment model, therapists pay particular attention to the individual's current phase of response and the typical ways that the individual avoids threatening information. Making links among the recent trauma, earlier developmental experiences that may have rendered the individual vulnerable to the development of PTSD, and ways that conflicts are reenacted in the therapeutic dyad, dynamic therapists seek to help traumatized individuals re-establish a sense of coherence and meaning in their lives. A case illustration is provided to demonstrate the phases and techniques in this approach. © 2002 Wiley Periodicals, Inc. J Clin Psychol/In Session 58: 919,932, 2002 [source]

EMDR: A putative neurobiological mechanism of action

Robert Stickgold
Numerous studies have provided evidence for the efficacy of eye movement desensitization and reprocessing therapy (EMDR) in the treatment of posttraumatic stress disorder (PTSD), including recent studies showing it to be more efficient than therapist-directed flooding. But few theoretical explanations of how EMDR might work have been offered. Shapiro, in her original description of EMDR, proposed that its directed eye movements mimic the saccades of rapid eye movement sleep (REM), but provided no clear explanation of how such mimicry might lead to clinical improvement. We now revisit her original proposal and present a complete model for how EMDR could lead to specific improvement in PTSD and related conditions. We propose that the repetitive redirecting of attention in EMDR induces a neurobiological state, similar to that of REM sleep, which is optimally configured to support the cortical integration of traumatic memories into general semantic networks. We suggest that this integration can then lead to a reduction in the strength of hippocampally mediated episodic memories of the traumatic event as well as the memories' associated, amygdala-dependent, negative affect. Experimental data in support of this model are reviewed and possible tests of the model are suggested. © 2002 John Wiley & Sons, Inc. J Clin Psychol 58: 61,75, 2002. [source]

High-pressure paint-gun injury of the finger simulating giant cell tumor of tendon sheath

Catherine M. Stefanato
At this pressure, paint will penetrate the skin and spread quickly through fascial planes and tendon sheaths. The present case is that of a lesion from the finger of a 35-year-old white male in whom a history was initially unavailable. Histologic examination revealed diffuse fibrohistiocytic proliferation and giant cells, with numerous darkly pigmented, uniformly small-sized particles throughout the lesion. The initial impression was that of a giant cell tumor of tendon sheath. However, the pigment particles were negative for Perls stain, and polariscopic examination revealed clear refractile fragments. These findings raised the possibility that the lesion was the result of a traumatic event. On further inquiry, it was revealed that the patient had sustained a high-pressure paint-gun injury 1 year earlier. The simulation, histopathologically, of a giant cell tumor of tendon sheath by a high-pressure paint-gun injury has not, to our knowledge, been reported previously, nor has the histologic finding of small, uniformly sized pigment particles and polarizable refractile fragments in this particular type of injury. [source]

Detection of Malingered PTSD: An Overview of Clinical, Psychometric, and Physiological Assessment: Where Do We Stand?

Ryan C. W. Hall M.D.
ABSTRACT: Posttraumatic stress disorder (PTSD) is a condition that can be easily malingered for secondary gain. For this reason, it is important for physicians to understand the phenomenology of true PTSD and indicators that suggest an individual is malingering. This paper reviews the prevalence of PTSD for both the general population and for specific events, such as rape and terrorism, to familiarize evaluators with the frequency of its occurrence. The diagnostic criteria for PTSD, as well as potential ambiguities in the criteria, such as what constitutes an exposure to a traumatic event, are reviewed. Identified risk factors are reviewed as a potential way to help differentiate true cases of PTSD from malingered cases. The question of symptom overreporting as a feature of the disease versus a sign of malingering is discussed. We then examine how the clinician can use the clinical interview (e.g., SIRS, CAPS), psychometric testing, and the patient's physiological responses to detect malingering. Particular attention is paid to research on the MMPI and the subscales of infrequency (F), infrequency-psychopathology (Fp), and infrequency-posttraumatic stress disorder (Fptsd). Research and questions regarding the accuracy of self-report questionnaires, specifically the Mississippi Scale (MSS) and the Personality Assessment Inventory (PAI), are examined. Validity, usability, and cutoff values for other psychometric tests, checklists, and physiological tests are discussed. The review includes a case, which shows how an individual used symptom checklist information to malinger PTSD and the inconsistencies in his story that the evaluator detected. We conclude with a discussion regarding future diagnostic criteria and suggestions for research, including a systematic multifaceted approach to identify malingering. [source]


Rachel Lev-Wiesel
In this study, we examined the issue of secondary traumatic stress (STS) among spouses of Holocaust survivors who were children during the World War II. STS is defined as comprising the same components as posttraumatic stress disorder (PTSD), except that the person evidencing the symptoms has not actually been exposed to the traumatic event(s), but has developed them as a result of caring for someone with PTSD. Participants were 90 couples who completed self-report questionnaires regarding posttraumatic symptoms, psychological distress, and marital quality. The results showed that about one-third of the spouses suffered from some degree of STS symptoms. Secondary traumatic stress symptoms and psychological distress among spouses were significantly related to hostility, anger, paranoia, and interpersonal sensitivity in the survivor, but unrelated to whether the survivor had shared his/her reminiscences with the spouse. Female spouses were found to suffer more distress than male spouses, especially when their partner suffered high levels of PTSD. The results suggest that STS is, to a large degree, related to the demands of living with a symptomatic survivor, possibly more than to the empathic element thought to be central to this syndrome. [source]

The impact of a large-scale traumatic event on individual and organizational outcomes: exploring employee and company reactions to September 11, 2001

Kristin Byron
Much of the literature on stress and organizational outcomes has focused on organizational factors and has ignored extraorganizational stressors that lead to perceived stress. However, research in other fields and recent studies in management suggests that acute-extraorganizational stressors, such as traumatic events, may have potentially negative and costly implications for organizations. This study tests a theoretical model of traumatic stress and considers the relationship between strain from an acute-extraorganizational stressor, the terrorist attack on September 11, 2001, and absenteeism. Using a sample of 108 MBA and MPA students, this study suggests that strain caused by an acute-extraorganizational stressor can have important consequences for organizations. Namely, employees who report more strain from a traumatic life event are more likely to be absent from work in the weeks following the event. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Factors associated with trauma and posttraumatic stress disorder among homeless youth in three U.S. cities: The importance of transience,

Kimberly Bender
Homeless youth experience disproportionately high rates of trauma and posttraumatic stress disorder (PTSD). This study examined correlates of trauma and PTSD among homeless youth with a focus on the impact of homeless culture, substance addiction, and mental health challenges. Homeless youth (N = 146) from Los Angeles, California, Denver, Colorado, and St. Louis, Missouri, were recruited from organizations providing services to homeless youth using comparable methods. Results indicate that 57% of respondents had experienced a traumatic event and 24% met criteria for PTSD. A multinomial logistic regression model revealed greater transience, alcohol addiction, mania, and lower self-efficacy predicted PTSD whereas trauma exposure was associated with alcohol addiction only. Findings have implications for screening and intervening with traumatized homeless youth across service settings. [source]

Exploring the links between posttraumatic stress disorder and social support: Processes and potential research avenues

Stéphane Guay
Social support after a traumatic event is linked to posttraumatic stress disorder (PTSD). However, little is known about the ways in which social support influences the adaptation to trauma and development of PTSD. The aim of the present article is threefold: to outline the various processes by which social support is linked to PTSD, to review the most relevant research in the field, and to suggest potential future research. [source]

Children's memory for trauma and positive experiences

Lucy Berliner
Abstract Characteristics of children's memory for a trauma and for a positive event were compared and relationships of memory characteristics to trauma symptoms examined in 30 children who experienced a traumatic event. Results revealed that memories for trauma tended to have less sensory detail and coherence, yet have more meaning and impact than did memories for positive experiences. Sexual traumas, offender relationship, and perceived life threat were associated with memory characteristics. Few relationships between memory characteristics and trauma symptoms were found. Therapist ratings of child memory characteristics were correlated with some child trauma memory characteristic reports. These results are consistent with other studies. Possible explanations include divided attention during the traumatic event and cognitive avoidance occurring after the event. [source]

Posttraumatic stress disorder in a general psychiatric inpatient population

Alexander C. McFarlane
Abstract This study examined the incidence of traumatic experiences and prevalence of lifetime posttraumatic stress disorder (PTSD) in a sample of 141 general hospital psychiatric inpatients. Sixty-one percent of the patients reported at least one traumatic event during their lifetime and 28% met the formal DSM-III-R criteria for a lifetime diagnosis of PTSD. A high degree of comorbidity between PTSD and other psychiatric disorders was found, but PTSD was the incident disorder in at least 50% of cases. The experience of trauma and its associated complex patterns of symptomatology suggest that PTSD complicates the process of recovery from another disorder. [source]

Trauma: physiology, pathophysiology, and clinical implications

Abstract Objective: To review the physiology, pathophysiology, and consequences of trauma. The therapeutic implications of hypovolemia, hypotension, hypothermia, tissue blood flow, oxygen delivery, and pain will be discussed. Data Sources: Human and veterinary clinical and research studies. Human and veterinary data synthesis: Trauma is defined as tissue injury that occurs more or less suddenly as a result of violence or accident and is responsible for initiating hyothalamic,pituitary,adrenal axis, immunologic and metabolic responses that are designed to restore homeostasis. Tissue injury, hemorrhage, pain, and fear are key components of any traumatic event. Trauma and blood loss result in centrally integrated autonomic-mediated cardiovascular responses that are designed to increase heart rate, systemic vascular resistance, and maintain arterial blood pressure (ABP) to vital organs at the expense of blood flow to the gut and skeletal muscle. Severe trauma elicits exuberant physiologic, immunologic, and metabolic changes predisposing the animal to organ malfunction, a systemic inflammatory response, infection, and multiple organ dysfunctions. The combination of both central and local influences produces regional redistribution of blood flow among and within tissue beds which, when combined with impaired vascular reactivity, leads to maldistribution of blood flow to tissues predisposing to tissue hypoperfusion and impaired oxygen delivery and extraction. Gut blood flow and viability may serve as a sentinel of patient survival. These consequences are magnified in animals suffering from pain or that become hypothermic. Successful treatment of traumatized animals goes beyond the restoration of blood pressure and urine output, is dependent on a fundamental understanding of the pathophysiologic processes responsible for the animals current physical status, and incorporates the reduction of pain, stress, and the systemic inflammatory response and methods that restore microcirculatory blood flow and tissue oxygenation. Conclusions: Severe trauma is a multifaceted event and is exacerbated by hypothermia, pain, and stress. Therapeutic approaches must go beyond the simple restoration of vascular volume and ABP by maintaining tissue blood flow, restoring tissue oxygenation, and preventing systemic inflammation. [source]

Melancholy and Mourning in Jonathan Safran Foer's Extremely Loud and Incredibly Close

Sien Uytterschout
Whereas melancholy (or ,acting out') entails a complete repression of all trauma-related memory, mourning (or ,working through') is an endeavour to remember the traumatic event and fit it into a coherent whole. In Extremely Loud and Incredibly Close, these two ways of reacting to and dealing with trauma are embodied respectively by the protagonist's paternal grandfather and by his paternal grandmother, both survivors of the Allied firebombing of Dresden in 1945. Foer ties up this ,old' trauma with a fresh one , 11 September 2001 , by having the Schells lose their only son, the protagonist's father, in the attacks on the World Trade Center. Aspects of both acting out and working through are in turn synthesised in the protagonist himself , Oskar Schell. In his behaviour, the boy displays characteristics of both a melancholic and a mourner. [source]

Cumulative Adversity and Posttraumatic Stress Disorder: Evidence From a Diverse Community Sample of Young Adults

Donald A. Lloyd PhD
The authors hypothesized that a history of adversities, whether they were objectively traumatic or not, predicts risk for 1st onset of PTSD. Survival analysis in a community sample of 1,803 young adults revealed that risk is associated with retrospectively reported adverse experiences that occurred in years prior to the focal traumatic event. Analyses control for clustering of events proximal to onset. Implications for etiology and preventive intervention are noted. [source]

A national survey of support and counselling after maternal death,

ANAESTHESIA, Issue 11 2009
S. McCready
Summary The 2000,2002 Confidential Enquiry into Maternal and Child Health report highlighted several cases of maternal death where the staff who had been involved, were not offered support. The report recommended that ,Trusts must make provision for the prompt offer of support and/or counselling for all staff who have cared for a woman who has died.' We conducted a postal survey to firstly establish whether Trusts had implemented this, and also to ascertain the experience of consultant obstetric anaesthetists. Of 706 respondents (response rate 64%), 60% involved in a maternal death or other traumatic event received no offer of support, 65% were unaware of potential sources of support and only 5% received details of further help available. Furthermore, 69% were unaware of policies within their own Trusts for the provision of support services. We suggest that a formal structure should exist within all units that offers confidential support services and/or debriefing facilities to all staff involved in a maternal death or other traumatic event. [source]

Relationship closeness and trauma narrative detail: A critical analysis of betrayal trauma theory

Katie M. Lindblom
Betrayal Trauma Theory (BTT) holds that certain traumas, such as incest, should be uniquely categorized as betrayal trauma: a subcategory of trauma in which the violation of trust, within a close relationship, occurs in the context of a traumatic event. According to BTT, betrayal trauma results in either partial or complete traumatic amnesia because repression is adaptive when a victim depends on a perpetrator for physical or emotional needs. In a test of BTT, undergraduates screened for betrayal and non-betrayal trauma histories provided detailed accounts of these events. In order to account for threats to internal validity that are often overlooked by traumatic amnesia researchers, we also assessed factors known to compromise narrative detail. Consistent with BTT predictions, more betrayal was associated with less detailed trauma narratives. However, this relationship was no longer significant after controlling for survivor age, avoidance symptoms, gender and purposeful omission of detail. Copyright © 2008 John Wiley & Sons, Ltd. [source]

The Effects of the 1999 Turkish Earthquake on Young Children: Analyzing Traumatized Children's Completion of Short Stories

Elif Celebi Oncu
The purpose of this exploratory study was to determine whether projective techniques could identify long-term consequences among children stemming from exposure to a traumatic event. The first group of children (n = 53; 26 female, 27 male) experienced 2 major earthquakes at age 7, 3 months apart, in Turkey, while a similarly matched control group (n = 50; 25 female, 25 male) did not. Both groups of children (current age: 9) completed a series of short stories related to disastrous events. Results indicated that the traumatized group evinced a range of trauma-related symptoms 2 years after experiencing the earthquakes. [source]

Development of a Brief Mental Health Screen for Intimate Partner Violence Victims in the Emergency Department

Debra Houry MD
Background: Emergency physicians routinely treat victims of intimate partner violence (IPV) and patients with mental health symptoms, although these issues may be missed without routine screening. In addition, research has demonstrated a strong association between IPV victimization and mental health symptoms. Objectives: To develop a brief mental health screen that could be used feasibly in an emergency department to screen IPV victims for depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and suicidal ideation. Methods: The authors conducted a pretest/posttest validation study of female IPV victims to determine what questions from the Beck Depression Inventory II, Posttraumatic Stress Diagnostic Scale, and Beck Scale for Suicide Ideation would predict moderate to severe levels of depressive symptoms, PTSD symptoms, and suicidal ideation. A principal components factor analysis was conducted to determine which questions would be used in the brief mental health screen. Scatter plots were then created to determine a cut point. Results: Scores on the brief mental health screen ranged from 0 to 8. A cutoff score of 4 was used, which resulted in positive predictive values of 96% for the brief mental health screen for depression, 84% for PTSD symptoms, and 54% for suicidal ideation. In particular, four questions about sadness, experiencing a traumatic event, the desire to live, and the desire to commit suicide were associated with moderate to severe mental health symptoms in IPV victims. Conclusions: The brief mental health screen provides a tool that could be used in an emergency department setting and predicted those IPV victims with moderate to severe mental health symptoms. Using this tool can assist emergency physicians in recognizing at-risk patients and referring these IPV victims to mental health services. [source]

The Science and Folklore of Traumatic Amnesia

Richard J. McNally
Some clinical theorists believe that certain experiences are so overwhelmingly traumatic that many victims dissociate their memory for the experience (Cleaves, Smith, Butler, & Spiegel, this issue). Unfortunately, clinicians who endorse this hypothesis often exhibit confusion about the very studies they cite in support of it. For example, they often misinterpret everyday forget-fulness that develops after a trauma with an inability to remember the trauma itself; they confuse organic amnesia with traumatic amnesia; they confuse psychogenic amnesia (massive non-organic retrograde amnesia coupled with loss of personal identity) with (alleged) inability to remember a traumatic event; and they confuse not thinking about something (e.g., sexual abuse) for a long period of time with an inability to remember it (i.e., amnesia). The purpose of this commentary is to dispel some of this confusion. [source]

Psychometric properties of the Trauma Assessment for Adults

Matt J. Gray Ph.D.
Abstract Background: The Trauma Assessment for Adults (TAA) was developed to facilitate the assessment of exposure to traumatic events that could result in posttraumatic stress disorder (PTSD). The TAA inquires about numerous potentially traumatic events that an individual may have experienced. Although the TAA has been used extensively for clinical and research purposes, its psychometric properties have never been formally evaluated. The objective of the present investigation was to evaluate the psychometric properties of this frequently used measure. Methods: The studies reported here describe the performance of the TAA in two samples,college undergraduates (N=142) and community mental health center clients (N=67). Among undergraduates, 1-week temporal stability was evaluated and, in both samples, item- and scale-level convergence of the TAA with an established trauma exposure measure was assessed. Convergence of the TAA with clinically related constructs was also evaluated. Results: The TAA exhibited adequate temporal stability (r=.80) and satisfactory item-level convergence with existing measures of trauma history among college students. In the clinical sample, the TAA again converged well with an established measure of trauma exposure (r=.65). It was not as strongly predictive, in either sample, of trauma-related distress relative to an alternate trauma exposure measure. Conclusion: Although it performs satisfactorily, the TAA does not appear to be superior to other existing measures of trauma exposure. Depression and Anxiety, 2009. © 2008 Wiley-Liss, Inc. [source]