Epidemiology of Trauma and Posttraumatic Stress Disorder in Mexico.

Prevalence rates of trauma and posttraumatic stress disorder (PTSD) were estimated from a probability sample of 2,509 adults from 4 cities in Mexico. PTSD was assessed according to Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) criteria using the Composite International Diagnostic Interview (CIDI; WHO, 1997). Lifetime prevalence of exposure and PTSD were 76% and 11.2%, respectively. Risk for PTSD was highest in Oaxaca (the poorest city), persons of lower socioeconomic status, and women. Conditional risk for PTSD was highest following sexual violence, but nonsexual violence and traumatic bereavement had greater overall impact because of their frequency. Of lifetime cases, 62% became chronic; only 42% received medical or professional care. The research demonstrates the importance of expanding the epidemiologic research base on trauma to include developing countries around the world. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maltreated children's memory: Accuracy, suggestibility, and psychopathology.

Memory, suggestibility, stress arousal, and trauma-related psychopathology were examined in 328 3- to 16-year-olds involved in forensic investigations of abuse and neglect. Children's memory and suggestibility were assessed for a medical examination and venipuncture. Being older and scoring higher in cognitive functioning were related to fewer inaccuracies. In addition, cortisol level and trauma symptoms in children who reported more dissociative tendencies were associated with increased memory error, whereas cortisol level and trauma symptoms were not associated with increased error for children who reported fewer dissociative tendencies. Sexual and/or physical abuse predicted greater accuracy. The study contributes important new information to scientific understanding of maltreatment, psychopathology, and eyewitness memory in children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trauma, dissociation, and conflict: The space where neuroscience, cognitive science, and psychoanalysis overlap.

The authors describe their scientific and clinical interests in developing the panel Trauma, Dissociation, and Conflict: The Space Where Neuroscience, Cognitive Science, and Psychoanalysis Overlap, given at the 22nd Annual Spring Meeting of the Division of Psychoanalysis of the American Psychological Association. They cite the influence of the panelists, Philip M. Bromberg, Wilma Bucci, and Joseph LeDoux, on their own work. Specializing in the treatment of chronic pain, Anderson has developed a relational intersubjective technique informed by this interdisciplinary approach. Gold's work has focused on the distinction between dissociative processes and repression in traumatic memory. The relevance of trauma, dissociation, and conflict, heightened since September 11, 2001, could not have been anticipated in the planning of the panel. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The ethics of asking about abuse and the harm of "don't ask, don't tell."

Replies to comments by J. Read (see record 2007-07130-012), D. Gleaves et al (see record 2007-07130-013), V. Edwards et al (see record 2007-07130-014), M. Black and R. Black (see record 2007-07130-015), and S. Ullman (see record 2007-07130-016), which raised important points about the authors' original article (see record 2006-03947-003). Those comments extend our thinking about how to ask participants about abuse in an ethical way. Together, the comments point to the importance of researchers examining our own reasons for asking--or not asking--about abuse and of paying attention to how we respond when we ask. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress in children and adolescents exposed to family violence: I. Overview and issues.

Exposure to child physical abuse and parents' domestic violence can subject youth to pervasive traumatic stress and can lead to posttraumatic stress disorder (PTSD). This article presents evolving conceptualizations in the burgeoning field of trauma related to family violence exposure and describes how the often repeating and ongoing nature of family violence exposure can complicate a PTSD diagnosis. In addition, recent literature indicates that children exposed to family violence may experience problems in multiple domains of functioning and may meet criteria for multiple disorders in addition to PTSD. Considerations salient to the recognition of traumatic stress in this population and that inform assessment and treatment planning are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Failed empathy--a central theme in the survivor's holocaust experience.

In this article, we concern ourselves with massive traumatic events deliberately inflicted on individuals by fellow human beings. Specifically, we focus on the Holocaust and the fact that massive failure of the environment to mediate needs, as in genocide, will throw into question the existence of empathy, human communication, and ultimately ones own humanity, to which any mirroring ceases to exist. Such a life experience will represent, to the survivor of trauma, failure of a responsive empathic agent or function. Because it is precisely representations of need-satisfying interactions that provide the basis for links between personal existence and social connectedness, undermining the individual's representation of the need-mediating context will deconstruct the link between self and other. Destruction of the victim's representational matrix of interpersonal relatedness results in a vulnerability and loneliness in his or her internal world representation which is the sine qua non of man-made trauma. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' reactions to treatment of survivors of political torture.

Working with survivors of political torture and war trauma can trigger strong emotional responses in the therapist. As more survivors seek treatment, it is essential to identify and develop robust support systems for therapists who help their clients confront nearly unspeakable experiences. The emotional reactions of 6 psychotherapists who worked with traumatized survivors in a refugee treatment center were explored. The psychotherapists' reactions were compared with those of therapists who worked in different treatment settings with other presenting problems. The results of the study show that the strong level of responsibility therapists feel for their traumatized clients may hide an emotional strain and may lead to burnout. Suggestions are offered for supporting therapists in this difficult but important work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of the Effects of Developmental Trauma on Neurotransmitter Systems Using Functional Molecular Imaging

Early life stress (ELS) is strongly associated with psychiatric disorders such as anxiety, depression, and schizophrenia in adulthood. To date, biological, behavioral, and structural aspects of ELS have been studied extensively, but their functional effects remain unclear. Here, we examined NeuroPET studies of dopaminergic, glutamatergic, and serotonergic systems in ELS animal models. Maternal separation and restraint stress were used to generate single or complex developmental trauma. Body weights of animals exposed to single trauma were similar to those of control animals; however, animals exposed to complex trauma exhibited loss of body weight when compared to controls. In behavioral tests, the complex developmental trauma group exhibited a decrease in time spent in the open arm of the elevated plus-maze and an increase in immobility time in the forced swim test when compared to control animals. In NeuroPET studies, the complex trauma group displayed a reduction in brain uptake values when compared to single trauma and control groups. Of neurotransmitter systems analyzed, the rate of decrease in brain uptake was the highest in the serotonergic group. Collectively, our results indicate that developmental trauma events induce behavioral deficits, including anxiety- and depressive-like phenotypes and dysfunction in neurotransmitter systems.     

Biofidelic child head FE model to simulate real world trauma

Biomechanics of human head has been widely studied since several decades. At a mechanical level, the use of engineering allowed investigating injury mechanisms developing numerical models of adult head. For children, the problem is more difficult and evaluating child injury mechanisms using data obtained from scaling adult injury criteria does not account for differences in morphology and structure between adults and children. During growth, child head undergoes different modifications in morphology and structure. The present paper compares the anthropometry and numerical simulations of a child head model based on medical CT scans to a child head model developed by scaling an adult head model using the method proposed by Mertz [H.J. Mertz, A procedure for normalizing impact response data, SAE paper 840884, 1984]. These analysis point out significant differences showing that scaling down an adult head to obtain a child head does not appear relevant. Biofidelic and specific child geometry is needed to investigate child injury mechanisms.     

"Evaluation of child witnesses for confrontation by criminal defendants": Erratum.

Reports an error in the original article by M. A. Small and G. B. Melton (Professional Psychology: Research and Practice, 1994[August], Vol 25[3], 228–233). Footnote 1 incorrectly indicates that the Craig brief was written without the aid of private legal counsel. Though the brief in question was written with more APA member involvement than has been the case for other briefs, private legal counsel participated and was listed as a coauthor. (The following abstract of this article originally appeared in record 1994-43476-001.) States have passed legislation governing the procedures by which children may testify in cases of child abuse. In Maryland v. Craig (1990), the US Supreme Court reviewed the constitutionality of these procedures. As a result, psychologists may be asked to perform evaluations regarding the potential trauma a child faces in confronting a defendant in a criminal case. Specifically, opinions of psychologists may be sought as to the potential trauma a child may endure as a result of a face-to-face confrontation with a defendant. Research relevant to this assessment is reviewed, and it is suggested that psychologists may be of most help in preparing children to testify.… (PsycINFO Database Record (c) 2010 APA, all rights reserved)