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Psychological and Physiological Trauma Research
Seize Your Journeys
_______________________ Traumatic stress is found in many competent, healthy, strong, good people. No one can completely protect themselves from traumatic experiences. Many people have long-lasting problems following exposure to trauma. Up to 8% of persons will have PTSD at some time in their lives. People who react to traumas are not going crazy. What is happening to them is part of a set of common symptoms and problems that are connected with being in a traumatic situation, and thus, is a normal reaction to abnormal events and experiences. Having symptoms after a traumatic event is NOT a sign of personal weakness. Given exposure to a trauma that is bad enough, probably all people would develop PTSD. By understanding trauma symptoms better, a person can become less fearful of them and better able to manage them. By recognizing the effects of trauma and knowing more about symptoms, a person will be better able to decide about getting treatment. _______________________
Secure Attachments as a Defense Against Trauma “All people mature and thrive in a social context that has profound effects on how they cope with life’s stresses. Particularly early in life, the social context plays a critical role in suffering an individual against stressful situations, and in building the psychological and biological capacities to deal with further stresses. The primary function of parents can be thought of as helping children modulate their arousal by attuned and well-timed provision of playing, feeding, comforting, touching, looking, cleaning, and resting—in short, by teaching them skills that will gradually help them modulate their own arousal. Secure attachment bonds serve as primary defenses against trauma-induced psychopathology in both children and adults (Finkelhor & Browne, 1984). In children who have been exposed to severe stressors, the quality of the parental bond is probably the single most important determinant of long-term damage (McFarlane, 1988).” van der Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds. 1996. Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York and London: Guilford Press. .p. 185 Affect Dysregulation in Traumatized Individuals “As children mature, they gradually become less vulnerable to over-stimulation and learn to tolerate higher levels of excitement. Over time, their need for physical proximity to their primary caregivers to maintain comfort decreases, and children start spending more time playing with their peers and with their fathers (Field, 1985). Secure children learn how to take care of themselves effectively as long as the environment is more or less predictable; simultaneously, they learn how to get help when they are distressed. In contrast, avoidant children learn how to organize their behavior effectively under ordinary conditions, but they remain unable to communicate or interpret emotional signals. In other words, they know how to handle cognition, but not affect (Crittenden, 1994 Cole and Putnam (1992) have proposed that people’s core concepts of themselves are defined to a substantial degree by their capacity to regulate their internal states and by their behavioral responses to external stress. The lack of development, or loss, of self-regulatory processes in abused children leads to problems with self-definition: (1) disturbances of the sense of self, such as a sense of separateness, loss of autobiographical memories, and disturbances of body image; (2) poorly modulated affect and impulse control, including aggression against self and others; and (3) insecurity in relationships, such as trouble functioning in social settings; they tend either to draw attention to themselves or to withdraw from social interactions. Thus, they tend to display either angry, threatening, fearless, acting-out behavior or meek, submissive, fearful, incompetent behavior. Problems in articulating cause and effect make it hard for them to appreciate their own contributions to their problems and set the stage for paranoid attributions.” van der Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds. 1996. Traumatic stress: The effects o overwhelming experience on mind, body, and society. New York and London: Guilford Press. .p. 187 Manifestations of the Absence of Self-Regulation “The lack or loss of self-regulation is possibly the most far-reaching effect of psychological trauma in both children and adults. The DSM-IV field trials for PTSD clearly demonstrated that the younger the age at which the trauma occurred, and the longer its duration, the more likely people were to have long-term problems with the regulation of anger, anxiety, and sexual impulses (van der Kolk, Roth, Pelcovitz, & Mandel, 1993). Pitman, Orr, and Shalev (1993) have pointed out that in PTSD, hyperarousal goes well beyond simple conditioning. The fact that the stimuli that precipitate emergency responses are not conditioned enough and that many triggers not directly related to the traumatic experience may precipitate extreme reactions is merely the beginning of the problem. Loss/lack of self-regulation may be expressed in many different ways: as a loss of ability to focus on appropriate stimuli; as attentional problems; as an inability to inhibit action when aroused (loss of impulse control); or as uncontrollable feelings of rage, anger, or sadness. The results of a study by McFarlane, Weber, and Clark (1993) of event-related potentials in people with PTSD illustrate these various effects.” Van der Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds. 1996. Traumatic stress: The effects o overwhelming experience on mind, body, and society. New York and London: Guilford Press. .p. 187 Self-Mutilation Eating Disorders Substance Abuse Dissociation ________________
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Attachment
Traumatic Separation, Coping and Trauma
Title: An art therapy group for children traumatized by parental violence and
separation.
Author(s)/Editor(s): Kozlowska, Kasia; Hanney, Lesley
Source/Citation: Clinical Child Psychology & Psychiatry; Vol 6(1) Jan 2001,
England: Sage Publications Ltd; 2001, 49-78
Abstract/Review/Citation: Describes the treatment of five traumatized children
(aged 4-8 yrs) using adjunctive group art therapy, and reviews the theoretical
basis for such a treatment strategy. All the children had been exposed to
cumulative traumatic experiences of parental violence. The children presented
symptoms of post-traumatic stress, developmental problems related to trauma,
had difficulties with any discussion of traumatic events or family concerns,
and reacted with hyperarousal and/or an 'emotional shutdown' response.
Previous treatments included a combination of social, family, psychological
and biological interventions. The group was a therapeutic intervention
developed by a child psychiatrist and an art therapist to facilitate further
therapeutic change. The therapeutic use of artworks facilitated exposure to
traumatic cues in a less direct manner, allowed for desensitization of anxiety
and unpleasant body sensations, helped the children recount the story of the
parental separation and to label and articulate affective states using art and
narrative. Positive family changes and coping skills the children were using
to manage ongoing stresses were made overt. Positive expectations of the
future were promoted. Key therapeutic and theoretical aspects of the group
intervention are described.
========================================
Title: Trauma and extended separation from family among Latin American and
African refugees in Montreal.
Author(s)/Editor(s): Rousseau, Cecile; Mekki-Berrada, Abdelwaheed;
Moreau, Sylvie
Source/Citation: Psychiatry: Interpersonal & Biological Processes: Special
Issue: Vol 64(1) Spr 2001, US: Guilford Publications; 2001, 40-59
Abstract/Review/Citation: Surveyed 113 refugees from Latin America and Africa
living in Canada to assess the impact of premigration trauma and prolonged
separation resulting from migration on emotional distress, and the role of
family as an anchor of emotion and identity. Semistructured interviews were
conducted and life stories related by 20 Salvadoran and Congolese Ss were
collected. The emotional profile of the Ss was measured using the Symptom
Checklist. Trauma was assessed to create 3 weighted scores for personal,
family, and global trauma. A content analysis was conducted of the interviews
and life stories of Ss. Data reveal a similar pattern of family separation for
both groups of refugees. The relationship between personal trauma and
psychological distress is reversed when Ss are with all or part of their
families. Severe trauma resulting from armed conflict, under certain
circumstances, strengthened S's ability to face migration and associated
losses. The data also suggest that family trauma is a much more important
issue to African Ss. Data support the clinical literature indicating that
cultural characteristics may modulate the development of various family
strategies for coping with separation and trauma.
========================================
Title: Commentary on "Trauma and extended separation from family among
Latin American and African Americanin Montreal": The trauma story: A
phenomenological approach to the traumatic life experiences of refugee
survivors. .
Author(s)/Editor(s): Mollica, Richard F.
Source/Citation: Psychiatry: Interpersonal & Biological Processes: Special
Issue: Vol 64(1) Spr 2001, US: Guilford Publications; 2001, 60-63
Abstract/Review/Citation: Comments on the article by C. Rousseau, A.
Mekki-Berrada, and S. Moreau (see record 2001-06736-006) regarding the impact
of trauma and prolonged family separation on the emotional distress of Latin
American and African refugees in Canada. The article raises a number of
methodological issues in the study of the lifes of traumatized persons. The
article comments on Roussea, Mekki-Berrada, and Moreau's use of life stories
to study the impact of premigration trauma and family separation on on the
refugees' resettlement and adaptation.
========================================
Title: Commentary on "Trauma and extended separation from family among
Latin American and AFrican reAfricanin Montreal": Forced relocation: A
family researcher/clinician's perspective. .
Author(s)/Editor(s): Steinglass, Peter
Source/Citation: Psychiatry: Interpersonal & Biological Processes: Special
Issue: Vol 64(1) Spr 2001, US: Guilford Publications; 2001, 64-68
Abstract/Review/Citation: Comments on the article by C. Rousseau, A.
Mekki-Berrada, and S. Moreau regarding the impact
of trauma and prolonged family separation on the emotional distress of Latin
American and African refugees in Canada. The present author addresses two
issues highlighted by Rousseau, Mekki-Berrada, and Moreau: the key role of the
family in regulating emotions and as the source of personal identity, and the
positive as well as negative implications of challenges from outside
stressors. These issues raise three questions addressed in this article: the
utility of conceptualizing political relocation as a stress family event; the
characterization of the study from the perspective of a family research; and
the conclusions that might be drawn from this and other studies about service
delivery to refugee populations who have been forcefully relocated.
========================================
Title: The assault on basic trust: Disappearance, protest, and reburial in
Argentina.
Author(s)/Editor(s): Robben, Antonius C. G. M.
Source/Citation: Cultures under siege: Collective violence and trauma., New
York, NY, US: Cambridge University Press; 2000, (xiv, 285), 70-101
Publications of the society for psychological anthropology.
Abstract/Review/Citation: Analyzes the "dirty war" disappearances in
Argentina between 1976 and 1983. It is argued that the disappearances
carried out in the intimacy of the home invaded the primary object relation of
parent and child, and provoked intense guilt feelings among the surviving
parents about having failed to protect their adult and adolescent children.
Most of the disappeared were killed within days or weeks after their detention
by the security forces, and their bodies interred in mass graves. Parents were
deliberately left in the dark about the fate of their missing children, and
were thus denied the right to properly bury and mourn their dead. It was at
this intersection of the political and domestic domain that parental trust and
protection became mobilized. The author concludes that the politicization of
the dead by the military led mothers to cope with their separation anxiety
either by a projective search for the human remains or by an introjective
vindication of the revolutionary ideals embraced by many disappeared before
their abduction. Topics discussed include: the transgression of inner and
outer boundaries, desecration of the corpse in Argentine political culture,
contested exhumations and revolutionary protest, and reburial and collective
mourning.
========================================
Title: PRISM: Pictorial Representation of Illness and Self Measure: A brief
nonverbal measure of illness impact and therapeutic aid in psychosomatic
medicine.
Author(s)/Editor(s): Buechi, Stefan; Sensky, Tom
Source/Citation: Psychosomatics; Vol 40(4) Jul-Aug 1999, US: American
Psychiatric Press, Inc.; 1999, 314-320
Abstract/Review/Citation: A novel instrument is described that, according to
preliminary data, measures what in German is termed Leidensdruck--the
perceived burden of suffering due to illness. The measure--Pictorial
Representation of Illness and Self Measure (PRISM)--takes less than 5 min to
complete and is unusual in relying only minimally on language. The modified
version of the PRISM task (called PRISM+) uses colored disks placed on a white
board to represent the relationship between a patient's life as it is, self,
illness, and other aspects of life. The main outcome measure of the PRISM is
Self-Illness Separation, the distance in centimeters between the centers of
the self and illness disks. The PRISM is being developed as a research tool
and has been used effectively in routine clinical practice. To illustrate the
latter application, 3 case vignettes are presented, demonstrating how the
PRISM can enhance the patient's description and understanding of his/her
illness and circumstances, facilitate patient-clinician communication, and
help to monitor salient changes with treatment. The patients discussed in the
case vignettes are a 54-yr-old man with cancer who had an acute stress
reaction, a 33-yr-old woman coping with multiple sclerosis, and a 58-yr-old
man coping with severe multiple trauma.
========================================
Title: A preliminary framework for managing stress in deployed operations.
Author(s)/Editor(s): Marshall, R. P.
Source/Citation: Australian Army Psychology Corps 1st Psychological Research
Unit Research Report; AR-009-047 Dec 1997, Australia: 1st Psychological
Research Unit; 1997, 1-38
Abstract/Review/Citation: Presents as a guide to commanders, debriefers and
counsellors an overview of stress responses both adaptive and dysfunctional
which occur in personnel engaged on deployed operations. This technical report
aims to provide a conceptual framework from which to refine and evaluate
stress management interventions. The proposed model of stress responses
contains factors that are related to health and psychological problems in
deployed military personnel. Within the categories of stress responses
resulting from exposure to extreme levels of stress in deployed operations, 3
levels are distinguished: (1) A transient stress response to the aversive
stimuli of the deployment or the disruption of separation and coping in a
foreign environment; (2) An acute (Combat) stress reaction which incapacitates
a soldier in the short-term, either during or immediately after exposure to a
traumatic experience; and (3) posttraumatic stress disorder (PTSD) where the
duration of trauma-related symptoms has lasted or is expected to last for at
least 1 mo. Implications for a more detailed typology of abnormal reactions
for the management of stress in deployed operations and the identification and
treatment of severe or protracted stress reactions are proposed.
========================================
Title: Post-traumatic stress and coping in an inner-city child: Traumatogenic
witnessing of interparental violence and murder.
Author(s)/Editor(s): Parson, Erwin Randolph
Source/Citation: Psychoanalytic Study of the Child; Vol 50 1995, US: Yale Univ.
Press; 1995, 272-307
Abstract/Review/Citation: Introduces the use of A. Freud's Diagnostic Profile
system with an inner city child who, at the age of 4, witnessed his mother
fatally stab his father with a kitchen knife and at age 11 was assessed and
treated by the author. Application of the Profile may offer some direction
with children who witness interparental violence; a panoramic view of their
painful mood, their hypervigilance and distrust, fears, separation and
annihilation anxieties, nightmares (with murder imagery), developmental
anomalies and arrests is presented with clarity and force. The therapist uses
countertransference responses to monitor the affect tolerance in the child and
to determine the appropriate dosages of awareness the child can integrate from
1 moment to the next. The therapist also serves as the child's external
stimulus barrier and explores feelings about media-driven portrayals of
violence, stereotypes, and inner-city children and youth. The utility of the
Profile as a diagnostic system that documents vial economic, dynamic,
structural, genetic, and adaptive-coping information about the child is
discussed as is the Profile's added benefit of possibly guarding against
misdiagnosis and charting a course for psychotherapy.
========================================
Title: Patterns of coping and characteristics of high-functioning incest
survivors.
Author(s)/Editor(s): DiPalma, Linda M.
Source/Citation: Archives of Psychiatric Nursing; Vol 8(2) Apr 1994, US: WB
Saunders Co; 1994, 82-90
Abstract/Review/Citation: Examined methods of coping and adaptation to
facilitate a healthy adjustment after sexual abuse among 15 high-functioning,
female incest survivors. Data were collected through 2 in-depth interviews. Ss
indicated that their childhood coping strategies included avoidance,
psychological escapes, and compensation. These strategies helped explicate the
adult coping processes of separation, self-discovery, and revisiting the past
trauma. The victim's cognitive appraisals and responses emerged as important
variables in managing the trauma of sexual abuse. The capacity to protect the
integrity of the self was central to the adult developmental process of
integrating the incest experience. Common characteristics that helped Ss cope
with abuse included determination, a sense of responsibility, an ability to
fantasize and make use of creativity, a need to succeed, and resourcefulness.
========================================
Title: Psychological well-being of refugee children.
Author(s)/Editor(s): Ajdukovic, Marina; Ajdukovic, Dean
Source/Citation: Child Abuse & Neglect; Vol 17(6) Nov-Dec 1993, US: Elsevier
Science Inc; 1993, 843-854
Abstract/Review/Citation: Data about the family situation and the psychosocial
adaptation to displacement of refugee children in Croatia was gathered during
detailed structured interviews with their mothers, while the study families (N
= 183) were accommodated in either a collective shelter (n = 65) or with host
families (n = 118). A considerable range of stress-related reactions was
identified (e.g. sleeping and eating disorders, separation fears, and
withdrawal or aggression). Refugee children exhibited a significantly higher
incidence of stress reactions if their mothers had difficulty coping with the
stress of displacement. Children in the collective shelter were at greater
mental health risk than children housed with host families.
========================================
Title: The emotional and play needs of the dying child.
Author(s)/Editor(s): Gray, Ellen
Source/Citation: Issues in Comprehensive Pediatric Nursing: Special Issue: The
death of a child: II; Vol 12(2-3) Mar-Jun 1989, US: Taylor & Francis;
1989, 207-224
Abstract/Review/Citation: Discusses the role of the recreation therapist with
children who have faced death from trauma or illness. Goals include developing
a relationship with the child, allowing the child appropriate control, and
creating some normalcy. Children can be helped to express thoughts and
feelings, assimilate reality, resolve internal conflict, achieve mastery, and
cope effectively through play. Basic reactions and concerns that most of these
children have at various ages involve anxiety related to abandonment and
separation from the family, the feeling that he/she is being punished,
dependency, concerns with mutilation or death, phobic and obsessive fear
reactions, decrease in self-esteem, and concerns about body image. A
discussion of coping strategies and preparing for the dying process is
included.
Title: An art therapy group for children traumatized by parental violence and
separation.
Author(s)/Editor(s): Kozlowska, Kasia; Hanney, Lesley
Source/Citation: Clinical Child Psychology & Psychiatry; Vol 6(1) Jan 2001,
England: Sage Publications Ltd; 2001, 49-78
Abstract/Review/Citation: Describes the treatment of five traumatized children
(aged 4-8 yrs) using adjunctive group art therapy, and reviews the theoretical
basis for such a treatment strategy. All the children had been exposed to
cumulative traumatic experiences of parental violence. The children presented
symptoms of post-traumatic stress, developmental problems related to trauma,
had difficulties with any discussion of traumatic events or family concerns,
and reacted with hyperarousal and/or an 'emotional shutdown' response.
Previous treatments included a combination of social, family, psychological
and biological interventions. The group was a therapeutic intervention
developed by a child psychiatrist and an art therapist to facilitate further
therapeutic change. The therapeutic use of artworks facilitated exposure to
traumatic cues in a less direct manner, allowed for desensitization of anxiety
and unpleasant body sensations, helped the children recount the story of the
parental separation and to label and articulate affective states using art and
narrative. Positive family changes and coping skills the children were using
to manage ongoing stresses were made overt. Positive expectations of the
future were promoted. Key therapeutic and theoretical aspects of the group
intervention are described.
========================================
Title: Trauma and extended separation from family among Latin American and
African refugees in Montreal.
Author(s)/Editor(s): Rousseau, Cecile; Mekki-Berrada, Abdelwaheed;
Moreau, Sylvie
Source/Citation: Psychiatry: Interpersonal & Biological Processes: Special
Issue: Vol 64(1) Spr 2001, US: Guilford Publications; 2001, 40-59
Abstract/Review/Citation: Surveyed 113 refugees from Latin America and Africa
living in Canada to assess the impact of premigration trauma and prolonged
separation resulting from migration on emotional distress, and the role of
family as an anchor of emotion and identity. Semistructured interviews were
conducted and life stories related by 20 Salvadoran and Congolese Ss were
collected. The emotional profile of the Ss was measured using the Symptom
Checklist. Trauma was assessed to create 3 weighted scores for personal,
family, and global trauma. A content analysis was conducted of the interviews
and life stories of Ss. Data reveal a similar pattern of family separation for
both groups of refugees. The relationship between personal trauma and
psychological distress is reversed when Ss are with all or part of their
families. Severe trauma resulting from armed conflict, under certain
circumstances, strengthened S's ability to face migration and associated
losses. The data also suggest that family trauma is a much more important
issue to African Ss. Data support the clinical literature indicating that
cultural characteristics may modulate the development of various family
strategies for coping with separation and trauma.
========================================
Title: Commentary on "Trauma and extended separation from family among
Latin American and African Americanin Montreal": The trauma story: A
phenomenological approach to the traumatic life experiences of refugee
survivors. .
Author(s)/Editor(s): Mollica, Richard F.
Source/Citation: Psychiatry: Interpersonal & Biological Processes: Special
Issue: Vol 64(1) Spr 2001, US: Guilford Publications; 2001, 60-63
Abstract/Review/Citation: Comments on the article by C. Rousseau, A.
Mekki-Berrada, and S. Moreau (see record 2001-06736-006) regarding the impact
of trauma and prolonged family separation on the emotional distress of Latin
American and African refugees in Canada. The article raises a number of
methodological issues in the study of the lifes of traumatized persons. The
article comments on Roussea, Mekki-Berrada, and Moreau's use of life stories
to study the impact of premigration trauma and family separation on on the
refugees' resettlement and adaptation.
========================================
Title: Commentary on "Trauma and extended separation from family among
Latin American and AFrican reAfricanin Montreal": Forced relocation: A
family researcher/clinician's perspective. .
Author(s)/Editor(s): Steinglass, Peter
Source/Citation: Psychiatry: Interpersonal & Biological Processes: Special
Issue: Vol 64(1) Spr 2001, US: Guilford Publications; 2001, 64-68
Abstract/Review/Citation: Comments on the article by C. Rousseau, A.
Mekki-Berrada, and S. Moreau regarding the impact
of trauma and prolonged family separation on the emotional distress of Latin
American and African refugees in Canada. The present author addresses two
issues highlighted by Rousseau, Mekki-Berrada, and Moreau: the key role of the
family in regulating emotions and as the source of personal identity, and the
positive as well as negative implications of challenges from outside
stressors. These issues raise three questions addressed in this article: the
utility of conceptualizing political relocation as a stress family event; the
characterization of the study from the perspective of a family research; and
the conclusions that might be drawn from this and other studies about service
delivery to refugee populations who have been forcefully relocated.
========================================
Title: The assault on basic trust: Disappearance, protest, and reburial in
Argentina.
Author(s)/Editor(s): Robben, Antonius C. G. M.
Source/Citation: Cultures under siege: Collective violence and trauma., New
York, NY, US: Cambridge University Press; 2000, (xiv, 285), 70-101
Publications of the society for psychological anthropology.
Abstract/Review/Citation: Analyzes the "dirty war" disappearances in
Argentina between 1976 and 1983. It is argued that the disappearances
carried out in the intimacy of the home invaded the primary object relation of
parent and child, and provoked intense guilt feelings among the surviving
parents about having failed to protect their adult and adolescent children.
Most of the disappeared were killed within days or weeks after their detention
by the security forces, and their bodies interred in mass graves. Parents were
deliberately left in the dark about the fate of their missing children, and
were thus denied the right to properly bury and mourn their dead. It was at
this intersection of the political and domestic domain that parental trust and
protection became mobilized. The author concludes that the politicization of
the dead by the military led mothers to cope with their separation anxiety
either by a projective search for the human remains or by an introjective
vindication of the revolutionary ideals embraced by many disappeared before
their abduction. Topics discussed include: the transgression of inner and
outer boundaries, desecration of the corpse in Argentine political culture,
contested exhumations and revolutionary protest, and reburial and collective
mourning.
========================================
Title: PRISM: Pictorial Representation of Illness and Self Measure: A brief
nonverbal measure of illness impact and therapeutic aid in psychosomatic
medicine.
Author(s)/Editor(s): Buechi, Stefan; Sensky, Tom
Source/Citation: Psychosomatics; Vol 40(4) Jul-Aug 1999, US: American
Psychiatric Press, Inc.; 1999, 314-320
Abstract/Review/Citation: A novel instrument is described that, according to
preliminary data, measures what in German is termed Leidensdruck--the
perceived burden of suffering due to illness. The measure--Pictorial
Representation of Illness and Self Measure (PRISM)--takes less than 5 min to
complete and is unusual in relying only minimally on language. The modified
version of the PRISM task (called PRISM+) uses colored disks placed on a white
board to represent the relationship between a patient's life as it is, self,
illness, and other aspects of life. The main outcome measure of the PRISM is
Self-Illness Separation, the distance in centimeters between the centers of
the self and illness disks. The PRISM is being developed as a research tool
and has been used effectively in routine clinical practice. To illustrate the
latter application, 3 case vignettes are presented, demonstrating how the
PRISM can enhance the patient's description and understanding of his/her
illness and circumstances, facilitate patient-clinician communication, and
help to monitor salient changes with treatment. The patients discussed in the
case vignettes are a 54-yr-old man with cancer who had an acute stress
reaction, a 33-yr-old woman coping with multiple sclerosis, and a 58-yr-old
man coping with severe multiple trauma.
========================================
Title: A preliminary framework for managing stress in deployed operations.
Author(s)/Editor(s): Marshall, R. P.
Source/Citation: Australian Army Psychology Corps 1st Psychological Research
Unit Research Report; AR-009-047 Dec 1997, Australia: 1st Psychological
Research Unit; 1997, 1-38
Abstract/Review/Citation: Presents as a guide to commanders, debriefers and
counsellors an overview of stress responses both adaptive and dysfunctional
which occur in personnel engaged on deployed operations. This technical report
aims to provide a conceptual framework from which to refine and evaluate
stress management interventions. The proposed model of stress responses
contains factors that are related to health and psychological problems in
deployed military personnel. Within the categories of stress responses
resulting from exposure to extreme levels of stress in deployed operations, 3
levels are distinguished: (1) A transient stress response to the aversive
stimuli of the deployment or the disruption of separation and coping in a
foreign environment; (2) An acute (Combat) stress reaction which incapacitates
a soldier in the short-term, either during or immediately after exposure to a
traumatic experience; and (3) posttraumatic stress disorder (PTSD) where the
duration of trauma-related symptoms has lasted or is expected to last for at
least 1 mo. Implications for a more detailed typology of abnormal reactions
for the management of stress in deployed operations and the identification and
treatment of severe or protracted stress reactions are proposed.
========================================
Title: Post-traumatic stress and coping in an inner-city child: Traumatogenic
witnessing of interparental violence and murder.
Author(s)/Editor(s): Parson, Erwin Randolph
Source/Citation: Psychoanalytic Study of the Child; Vol 50 1995, US: Yale Univ.
Press; 1995, 272-307
Abstract/Review/Citation: Introduces the use of A. Freud's Diagnostic Profile
system with an inner city child who, at the age of 4, witnessed his mother
fatally stab his father with a kitchen knife and at age 11 was assessed and
treated by the author. Application of the Profile may offer some direction
with children who witness interparental violence; a panoramic view of their
painful mood, their hypervigilance and distrust, fears, separation and
annihilation anxieties, nightmares (with murder imagery), developmental
anomalies and arrests is presented with clarity and force. The therapist uses
countertransference responses to monitor the affect tolerance in the child and
to determine the appropriate dosages of awareness the child can integrate from
1 moment to the next. The therapist also serves as the child's external
stimulus barrier and explores feelings about media-driven portrayals of
violence, stereotypes, and inner-city children and youth. The utility of the
Profile as a diagnostic system that documents vial economic, dynamic,
structural, genetic, and adaptive-coping information about the child is
discussed as is the Profile's added benefit of possibly guarding against
misdiagnosis and charting a course for psychotherapy.
========================================
Title: Patterns of coping and characteristics of high-functioning incest
survivors.
Author(s)/Editor(s): DiPalma, Linda M.
Source/Citation: Archives of Psychiatric Nursing; Vol 8(2) Apr 1994, US: WB
Saunders Co; 1994, 82-90
Abstract/Review/Citation: Examined methods of coping and adaptation to
facilitate a healthy adjustment after sexual abuse among 15 high-functioning,
female incest survivors. Data were collected through 2 in-depth interviews. Ss
indicated that their childhood coping strategies included avoidance,
psychological escapes, and compensation. These strategies helped explicate the
adult coping processes of separation, self-discovery, and revisiting the past
trauma. The victim's cognitive appraisals and responses emerged as important
variables in managing the trauma of sexual abuse. The capacity to protect the
integrity of the self was central to the adult developmental process of
integrating the incest experience. Common characteristics that helped Ss cope
with abuse included determination, a sense of responsibility, an ability to
fantasize and make use of creativity, a need to succeed, and resourcefulness.
========================================
Title: Psychological well-being of refugee children.
Author(s)/Editor(s): Ajdukovic, Marina; Ajdukovic, Dean
Source/Citation: Child Abuse & Neglect; Vol 17(6) Nov-Dec 1993, US: Elsevier
Science Inc; 1993, 843-854
Abstract/Review/Citation: Data about the family situation and the psychosocial
adaptation to displacement of refugee children in Croatia was gathered during
detailed structured interviews with their mothers, while the study families (N
= 183) were accommodated in either a collective shelter (n = 65) or with host
families (n = 118). A considerable range of stress-related reactions was
identified (e.g. sleeping and eating disorders, separation fears, and
withdrawal or aggression). Refugee children exhibited a significantly higher
incidence of stress reactions if their mothers had difficulty coping with the
stress of displacement. Children in the collective shelter were at greater
mental health risk than children housed with host families.
========================================
Title: The emotional and play needs of the dying child.
Author(s)/Editor(s): Gray, Ellen
Source/Citation: Issues in Comprehensive Pediatric Nursing: Special Issue: The
death of a child: II; Vol 12(2-3) Mar-Jun 1989, US: Taylor & Francis;
1989, 207-224
Abstract/Review/Citation: Discusses the role of the recreation therapist with
children who have faced death from trauma or illness. Goals include developing
a relationship with the child, allowing the child appropriate control, and
creating some normalcy. Children can be helped to express thoughts and
feelings, assimilate reality, resolve internal conflict, achieve mastery, and
cope effectively through play. Basic reactions and concerns that most of these
children have at various ages involve anxiety related to abandonment and
separation from the family, the feeling that he/she is being punished,
dependency, concerns with mutilation or death, phobic and obsessive fear
reactions, decrease in self-esteem, and concerns about body image. A
discussion of coping strategies and preparing for the dying process is
included.
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