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Lewis, Stephanie J., Karestan C. Koenen, Antony Ambler, Louise Arseneault, Avshalom Caspi, Helen L. Fisher, Terrie E. Moffitt, and Andrea Danese. "Unravelling the contribution of complex trauma to psychopathology and cognitive deficits: a cohort study." British Journal of Psychiatry 219, no. 2 (May 11, 2021): 448–55. http://dx.doi.org/10.1192/bjp.2021.57.
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BackgroundComplex traumas are traumatic experiences that involve multiple interpersonal threats during childhood or adolescence, such as repeated abuse. These traumas are hypothesised to cause more severe psychopathology and poorer cognitive function than other non-complex traumas. However, empirical testing has been limited to clinical/convenience samples and cross-sectional designs.AimsTo investigate psychopathology and cognitive function in young people exposed to complex, non-complex or no trauma, from a population-representative longitudinal cohort, and to consider the role of pre-existing vulnerabilities.MethodParticipants were from the Environmental Risk Longitudinal Twin Study, a population-representative birth cohort of 2232 British children. At age 18 years (93% participation), we assessed lifetime exposure to complex and non-complex trauma, past-year psychopathology and current cognitive function. We also prospectively assessed early childhood vulnerabilities: internalising and externalising symptoms at 5 years of age, IQ at 5 years of age, family history of mental illness, family socioeconomic status and sex.ResultsParticipants exposed to complex trauma had more severe psychopathology and poorer cognitive function at 18 years of age, compared with both trauma-unexposed participants and those exposed to non-complex trauma. Early childhood vulnerabilities predicted risk of later complex trauma exposure, and largely explained associations of complex trauma with cognitive deficits, but not with psychopathology.ConclusionsBy conflating complex and non-complex traumas, current research and clinical practice underestimate the severity of psychopathology, cognitive deficits and pre-existing vulnerabilities linked with complex trauma. A better understanding of the mental health needs of people exposed to complex trauma could inform the development of new, more effective interventions.
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Toof, Jennifer, Justina Wong, and James M. Devlin. "Childhood Trauma and Attachment." Family Journal 28, no. 2 (January 27, 2020): 194–98. http://dx.doi.org/10.1177/1066480720902106.
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This article describes the relationship between trauma in early childhood and attachment style, with the goal that clinicians can more effectively tailor individualized interventions to their clients. Recognizing how and why trauma influences attachment styles will provide the clinician with a more thorough understanding of the client and the client’s family system and will allow the clinician to select the most appropriate treatment interventions. Implications are provided for marriage, relationship, and family counselors. Furthermore, recommendations for future research are provided.
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Lewis, Stephanie J., Karestan C. Koenen, Antony Ambler, Louise Arseneault, Avshalom Caspi, Helen L. Fisher, Terrie E. Moffitt, and Andrea Danese. "Psychopathology and cognitive deficits in young people exposed to complex trauma." BJPsych Open 7, S1 (June 2021): S36—S37. http://dx.doi.org/10.1192/bjo.2021.149.
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AimsComplex traumas are traumatic experiences that involve multiple interpersonal threats during childhood or adolescence, such as repeated abuse. This type of trauma is hypothesized to lead to more severe psychopathology and poorer cognitive function than other non-complex traumas, such as road traffic accidents. However, empirical testing of this hypothesis has been limited to clinical or convenience samples and cross-sectional designs. To better understand this topic, we aimed to investigate psychopathology and cognitive function in young people exposed to complex, non-complex, or no trauma from a population-representative longitudinal cohort, and to consider the role of pre-existing vulnerabilities.MethodParticipants were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a population-representative birth-cohort of 2,232 children born in England and Wales in 1994-95. At age 18 years (93% participation), we assessed lifetime exposure to complex and non-complex trauma. We also assessed past-year psychopathology including general psychopathology ‘p’ and several psychiatric disorders, as well as current cognitive function including IQ, executive function, and processing speed. Additionally, we prospectively assessed early childhood vulnerabilities including internalizing and externalizing symptoms at age 5, IQ at age 5, family history of mental illness, family socioeconomic status, and sex.ResultWe found that participants who had been exposed to complex trauma had more severe psychopathology and poorer cognitive function across wide-ranging measures at age 18, compared to both trauma-unexposed participants and those exposed to non-complex trauma. Early childhood vulnerabilities had an important role in these presentations, as they predicted risk of later complex trauma exposure, and largely explained associations of complex trauma with cognitive deficits, but not with psychopathology.ConclusionBy conflating complex and non-complex traumas, current research and clinical practice under-estimate the severity of psychopathology and cognitive deficits linked with complex trauma, as well as the role of pre-existing vulnerabilities. A better understanding of the mental health needs of people exposed to complex trauma and underlying mechanisms could inform the development of new effective interventions.
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Onwumere, J., P. Bebbington, and E. Kuipers. "Family interventions in early psychosis: specificity and effectiveness." Epidemiology and Psychiatric Sciences 20, no. 2 (April 13, 2011): 113–19. http://dx.doi.org/10.1017/s2045796011000187.
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The first episode of psychosis frequently occurs during adolescence and early adulthood, and is associated with high levels of trauma, affective disturbance and suicide. The social networks of service users often decrease significantly following the first onset, although many will remain in close contact with some family members particularly during the early phases. However, the negative impact of psychosis on families and their relationship with the identified service user are well documented. Family intervention is a recommended and evidence-based treatment in later psychosis. In this paper, we review the literature on family interventions in early psychosis in the context of new evidence for its efficacy and its routine incorporation in early intervention services for psychosis.
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Hopkins, AG. "The trauma nurse's role with families in crisis." Critical Care Nurse 14, no. 2 (April 1, 1994): 35–43. http://dx.doi.org/10.4037/ccn1994.14.2.35.
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Trauma occurs suddenly and without warning, leaving the family ill-prepared to deal with the stressful event. Because this experience is often the first of its kind for the family, they may have no experience in dealing with these situations. Depending upon which member of the family is injured, a family's entire lifestyle could be disrupted, necessitating a shift in family roles and responsibilities. Previous coping skills are generally inadequate, and feelings of helplessness and powerlessness abound. The unknown time frame for recovery from the traumatic event is an additional stressor. Loss of the traditional family structure and inadequate support systems require that the trauma nurse be able to assist families of trauma victims in this time of crisis. To effectively support the family, the nurse must understand the impact of trauma and typical family responses to crisis. The key to effective management of these families is early assessment and appropriate intervention through providing information, active listening, facilitating flexibility in visiting, and family conferences.
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Marcellus, Lenora, and Shannon Cross. "Trauma-Informed Care in the NICU: Implications for Early Childhood Development." Neonatal Network 35, no. 6 (2016): 359–66. http://dx.doi.org/10.1891/0730-0832.35.6.359.
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AbstractInfants and families who have received care through NICUs experience multiple prolonged physiological, social, and emotional challenges. In addition to their NICU experiences, many families are presenting with increasingly diverse family structures and complex social conditions. In this article, the current state of knowledge on the concept of trauma-informed care will be reviewed from the perspective of infant and early childhood mental health development. This is the second part of a two-part series on trauma-informed care. The first part addressed this approach from a woman-centered care perspective. Recognizing the impact of trauma and implementing trauma-informed practices in the NICU holds potential for improving outcomes for infants.
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Jansen, K., T. A. Cardoso, G. R. Fries, J. C. Branco, R. A. Silva, M. Kauer-Sant'Anna, F. Kapczinski, and P. V. S. Magalhaes. "Childhood trauma, family history, and their association with mood disorders in early adulthood." Acta Psychiatrica Scandinavica 134, no. 4 (January 30, 2016): 281–86. http://dx.doi.org/10.1111/acps.12551.
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Cortizo, Rosita. "Prenatal and Perinatal EMDR Therapy: Early Family Intervention." Journal of EMDR Practice and Research 14, no. 2 (March 3, 2020): 104–15. http://dx.doi.org/10.1891/emdr-d-19-00046.
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This article discusses the integration of eye movement desensitization and reprocessing (EMDR) therapy with a family therapy treatment, which was designed for treating mothers and their babies from conception through the first year of life. The Calming Womb Family Therapy Model (CWFTM) is a multidisciplinary, Integrative, early intervention approach. Its foundations originate from Murray Bowen's family model of understanding the individual in the context of their families as emotional interactive systems; Selma Fraiberg's psychodynamic work and psychoeducational interventions with mothers and infants to resolve maternal trauma and transference reactions to their babies followed by educational guidance in infant development through the first year of their lives; and EMDR therapy. EMDR therapy can improve internal resources for expectant mothers; monitor their levels of psychological distress; and enable them to access and process traumatic memories, other adverse life experiences, recent stressors, and pre-perinatal concerns and bring them to adaptive resolution. EMDR therapy can also help pregnant mothers develop imaginal templates of future events that incorporate in utero developmental prenatal education and deepen their bonds with their babies. The pre-perinatal psychotherapist's knowledge of infant development and capacity for interpersonal warmth, affect tolerance, somatic resourcing, reflective stance, and relational attunement can provide a fertile ground for the expectant mother and womb baby relationship and enriching life together. The ultimate goal is to conceive and rear healthy children.
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Williams, Marian E. "Integrating Early Childhood Mental Health and Trauma-Informed Care for Homeless Families With Young Children." Pragmatic Case Studies in Psychotherapy 12, no. 2 (June 29, 2016): 113. http://dx.doi.org/10.14713/pcsp.v12i2.1968.
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<p>Rogers, Bobich, and Heppell’s (2016) case study illustrating the successful application of an "Incredible Years" intervention with a 4-year-old girl and her family in the context of a homeless shelter provides an opportunity to consider the intersecting perspectives of infant and early childhood mental health and trauma-informed care. Cathy’s exposure to intimate partner violence, her mother’s chronic depression, and her homelessness occurred during the critical developmental stages of prenatal development and the first four years of life, impacting her developing understanding of relationships and her emotion regulation. A trauma-informed perspective provides an understanding of the links between Cathy’s history of trauma and her presenting symptoms of tantrums, aggression, and "moodiness," leading to recommended parenting strategies that support co-regulation and eventually self-regulation of emotions. Although the Incredible Years intervention was successful in reducing Cathy’s symptoms, the addition of trauma-focused interventions may have the added benefit of helping Cathy to directly play and talk about her experience, together with her mother, so that both can understand and integrate their traumatic experiences and her mother can restore her role as a "protective shield" for her family. Finally, the opening provided by implementation of a successful parenting intervention could lead to a broader consultation aimed at creating a trauma-informed organization within the transitional living shelter.</p>
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Alakkas, Aljoharah, Aaron Meyer, Eric Debbold, Raisa Yagudayeva, and Jonathan Bui. "Early-Onset Alzheimer’s Disease Masquerading as Catatonia." Case Reports in Neurological Medicine 2020 (September 14, 2020): 1–5. http://dx.doi.org/10.1155/2020/1493481.
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A 35-year-old woman with a history of sexual trauma was brought in by her family for further evaluation of depressive symptoms and progressive decline in activities of daily living. She was admitted to the inpatient psychiatric unit for the treatment of suspected catatonia. After failure to respond to standard medical treatment, she received an extensive workup, which ultimately revealed a PSEN1 mutation consistent with early-onset Alzheimer’s disease. Diagnosis was challenging because of her young age, lack of reliable family history, and reports of recent sexual abuse by her biological father. This case is a cautionary reminder for clinicians that end stages of dementia can present similar to catatonia with mutism, lack of spontaneous movement, and refusal to eat. The clues to the diagnosis were profound cortical atrophy and lack of improvement with optimal medical management.
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Faravelli, C., E. Sacchetti, A. Ambonetti, G. Conte, S. Pallanti, and A. Vita. "Early Life Events and Affective Disorder Revisited." British Journal of Psychiatry 148, no. 3 (March 1986): 288–95. http://dx.doi.org/10.1192/bjp.148.3.288.
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The incidence of traumatic events during the first ten years of life was investigated in two groups of patients suffering from major affective disorder, as well as in mixed psychiatric patients and in healthy subjects. While there were no significant differences between the two groups of affective patients or between the two control groups, the incidence of subjects who underwent such trauma was significantly higher in depressives, compared with controls. These differences are small and are further reduced if events secondary to psychiatric disturbances of family members are excluded.
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Mandelli, L., C. Petrelli, and A. Serretti. "The role of specific early trauma in adult depression: A meta-analysis of published literature. Childhood trauma and adult depression." European Psychiatry 30, no. 6 (June 13, 2015): 665–80. http://dx.doi.org/10.1016/j.eurpsy.2015.04.007.
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AbstractBackgroundA large literature has long focused on the role of trauma in childhood and risk for psychological disorders in adulthood. Despite several studies performed, to date, it is not clear which weight have different childhood stressors specifically on the risk for depression in adult life. In the present study, we performed a meta-analysis of the literature in order to assess the effective role of childhood traumas as risk factor in the onset of depressive disorders in adults.MethodsPreviously published papers investigating the exposure to childhood trauma and their association with depression in adult subjects were retrieved in literature through common databases. Meta-analysis was conducted by the RevMan software. The quality of studies was evaluated by an adapted version of the New-Ottawa Quality Assessment Scale; bias publication was evaluated by the Egger's test. Meta-regression analysis was employed to detect potential confounders and/or moderating variables. Finally, a sensitivity analysis was post-hoc performed to control for potential confounders.ResultsEmotional abuse showed the strongest association with depression (OR = 2.78) followed by neglect (OR = 2.75) and sexual abuse (OR = 2.42). Significant associations were also found for domestic violence (OR = 2.06) and physical abuse (OR = 1.98). Nevertheless, in post-hoc analysis, emotional abuse and neglect showed the strongest associations with depression as compared to other kinds of child trauma.ConclusionsThese findings support the role of neglect and emotional abuse as significantly associated to depression. Sexual/physical abuse or violence in family may be unspecific risk factors for mental disturbance. Other kind of trauma may play a less relevant role in risk of adult depression, though they should be not underestimated.
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Anderson, Keith A., Noelle L. Fields, and Lynn A. Dobb. "Caregiving and Early Life Trauma: Exploring the Experiences of Family Caregivers to Aging Holocaust Survivors." Family Relations 62, no. 2 (March 4, 2013): 366–77. http://dx.doi.org/10.1111/fare.12000.
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Koilor, Christopher, Hannah Peifer, and Meghan Lane-Fall. "847: THE FAMILY VIEW OF TRAUMA ICU RECOVERY: EARLY RESULTS FROM A LONGITUDINAL QUALITATIVE STUDY." Critical Care Medicine 46, no. 1 (January 2018): 408. http://dx.doi.org/10.1097/01.ccm.0000528856.55367.01.
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Turner, Stuart W., Brian K. Toone, and Jane R. Brett-Jones. "Computerized tomographic scan changes in early schizophrenia – preliminary findings." Psychological Medicine 16, no. 1 (February 1986): 219–25. http://dx.doi.org/10.1017/s003329170000266x.
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SynopsisThirty patients who fulfilled DSM–III criteria for schizophrenia but who were within 2 years of presentation were compared with 26 age–matched normal volunteers with respect to CT scan appearances. In the index group the ventricle–brain ratio (VBR) was significantly greater. The VBR values were positively correlated with average alcohol intake and with early physical trauma, and negatively correlated with a family history of schizophrenia. The implications of these findings are discussed in the context of the present uncertainty about the meaning of CT scan findings in schizophrenia.
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Deuschle, Michael, Ferdinand Hendlmeier, Stephanie Witt, Marcella Rietschel, Maria Gilles, Alberto Sánchez-Guijo, Lourdes Fañanas, Sabine Hentze, Stefan A. Wudy, and Rainer Hellweg. "Cortisol, cortisone, and BDNF in amniotic fluid in the second trimester of pregnancy: Effect of early life and current maternal stress and socioeconomic status." Development and Psychopathology 30, no. 3 (March 26, 2018): 971–80. http://dx.doi.org/10.1017/s0954579418000147.
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AbstractThe prenatal environment shapes the offspring's phenotype; moreover, transgenerational stress and stress during pregnancy may play a role. Brain-derived neurotrophic factor (BDNF) and glucocorticoids influence neurodevelopment during pregnancy, and there is evidence that BDNF in amniotic fluid is mainly of fetal origin, while the source of glucocorticoids is maternal. We tested the hypothesis that maternal early life stress, psychiatric diagnoses, anxiety, perceived stress, and socioeconomic status influence BDNF and glucocorticoid concentrations in amniotic fluid in the second trimester. We studied 79 pregnant women who underwent amniocentesis in the early second trimester and analyzed BDNF, cortisol, and cortisone concentrations in amniotic fluid. The endocrine data were related to maternal early life adversities (Childhood Trauma Questionaire), perceived stress (Perceived Stress Scale), anxiety, socioeconomic status (family income), and the presence of psychiatric diseases. We found BDNF in amniotic fluid to be positively related to maternal early adversity (Childhood Trauma Questionaire). Low family income (socioeconomic status) was related to high amniotic fluid glucocorticoid concentrations. Neither glucocorticoid concentrations nor hydroxy steroid dehydrogenase (HSD2) activity could be related to BDNF concentrations in amniotic fluid. Early maternal adverse events may be reflected in the fetal BDNF regulation, and it should be tested whether this relates to differences in neurodevelopment.
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Raju, V. "(A299) Comparison of Imbalance in Psyche as Sequel in Amputations and Salvage in Trauma of Extremities." Prehospital and Disaster Medicine 26, S1 (May 2011): s84. http://dx.doi.org/10.1017/s1049023x11002834.
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AimComparative analysis of under considered psychological implications in earning members of family who happen to be victims of trauma and end up in early or delayed amputations to those in whom salvage to acceptable or useful function was possible.MaterialWorking and ably earning members who sustained traumatic wounds in industry, domestic, traffic, calamity, war, homicide, suicide, etc. Age groups from 1 to 75 years studied. Grade I,II,III A and III B compound wounds included. Psychological evaluation in early and delayed amputations compared with those salvaged to partial / useful function.MethodsPeriodic and frequent counseling as integral part of treatment regime to victims of trauma and their peers, family members, employers, police and lawyers.DiscussionClassification, incidence and outcome of post traumatic psychosis. Need of effective counseling to reduce post traumatic psychological imbalance and improve quality of life.ObservationsBehavioral changes and suicidal tendency are profound and pronounced in traumatic and early amputees compared to subjects of delayed and revision amputations. Acceptance and adaptability with limb / extremity salvage is encouraging with minimal post traumatic psychosis.ConclusionFrequent and repetitive counseling aids reduce post traumatic psychosis. Depressive psychosis is much less prevalent even in partially functionally acceptable traumatic limb salvage than in early or delayed amputations, though salvage takes a long course in management, rehabilitation and changed occupation by relocation.
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Guillamondegui, Oscar D. "Traumatic Brain Injury: A Trauma Surgeon's Perspective." Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders 22, no. 3 (October 2012): 82–89. http://dx.doi.org/10.1044/nnsld22.3.82.
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Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.
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Smart, C., G. Strathdee, S. Watson, C. Murgatroyd, and R. H. McAllister-Williams. "Early life trauma, depression and the glucocorticoid receptor gene – an epigenetic perspective." Psychological Medicine 45, no. 16 (September 21, 2015): 3393–410. http://dx.doi.org/10.1017/s0033291715001555.
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Background.Hopes to identify genetic susceptibility loci accounting for the heritability seen in unipolar depression have not been fully realized. Family history remains the ‘gold standard’ for both risk stratification and prognosis in complex phenotypes such as depression. Meanwhile, the physiological mechanisms underlying life-event triggers for depression remain opaque. Epigenetics, comprising heritable changes in gene expression other than alterations of the nucleotide sequence, may offer a way to deepen our understanding of the aetiology and pathophysiology of unipolar depression and optimize treatments. A heuristic target for exploring the relevance of epigenetic changes in unipolar depression is the hypothalamic–pituitary–adrenal (HPA) axis. The glucocorticoid receptor (GR) gene (NR3C1) has been found to be susceptible to epigenetic modification, specifically DNA methylation, in the context of environmental stress such as early life trauma, which is an established risk for depression later in life.Method.In this paper we discuss the progress that has been made by studies that have investigated the relationship between depression, early trauma, the HPA axis and the NR3C1 gene. Difficulties with the design of these studies are also explored.Results.Future efforts will need to comprehensively address epigenetic natural histories at the population, tissue, cell and gene levels. The complex interactions between the epigenome, genome and environment, as well as ongoing nosological difficulties, also pose significant challenges.Conclusions.The work that has been done so far is nevertheless encouraging and suggests potential mechanistic and biomarker roles for differential DNA methylation patterns in NR3C1 as well as novel therapeutic targets.
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KOENEN, KARESTAN C., TERRIE E. MOFFITT, RICHIE POULTON, JUDITH MARTIN, and AVSHALOM CASPI. "Early childhood factors associated with the development of post-traumatic stress disorder: results from a longitudinal birth cohort." Psychological Medicine 37, no. 2 (October 20, 2006): 181–92. http://dx.doi.org/10.1017/s0033291706009019.
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Background. Childhood factors have been associated with increased risk of developing post-traumatic stress disorder (PTSD). Previous studies assessed only a limited number of childhood factors retrospectively. We examined the association between childhood neurodevelopmental, temperamental, behavioral and family environmental characteristics assessed before age 11 years and the development of PTSD up to age 32 years in a birth cohort.Method. Members of a 1972–73 New Zealand birth cohort (n=1037) who were assessed at ages 26 and 32 years for PTSD as defined by DSM-IV.Results. We identified two sets of childhood risk factors. The first set of risk factors was associated both with increased risk of trauma exposure and with PTSD assessed at age 26. These included childhood externalizing characteristics and family environmental stressors, specifically maternal distress and loss of a parent. The second set of risk factors affected risk for PTSD only and included low IQ and chronic environmental adversity. The effect of cumulative childhood factors on risk of PTSD at age 26 was substantial; over 58% of cohort members in the highest risk quartile for three developmental factors had PTSD as compared to only 25% of those not at high risk on any factors. Low IQ at age 5, antisocial behavior, and poverty before age 11 continued to predict PTSD related to traumatic events that occurred between the ages of 26 and 32.Conclusions. Developmental capacities and conditions of early childhood may increase both risk of trauma exposure and the risk that individuals will respond adversely to traumatic exposures. Rather than being solely a response to trauma, PTSD may have developmental origins.
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Brooks, Samantha J., Vanesh Naidoo, Annerine Roos, Jean-Paul Fouché, Christine Lochner, and Dan J. Stein. "Early-life adversity and orbitofrontal and cerebellar volumes in adults with obsessive–compulsive disorder: Voxel-based morphometry study." British Journal of Psychiatry 208, no. 1 (January 2016): 34–41. http://dx.doi.org/10.1192/bjp.bp.114.162610.
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BackgroundEarly-life adversity is a risk for obsessive–compulsive disorder (OCD), but the impact at the neural level is less clear.AimsTo investigate the association between brain volumes and early-life adversity in individuals with a diagnosis of OCD only.MethodThe Childhood Trauma Questionnaire (CTQ-28) was used to assess early-life adversity in 21 participants with OCD and 25 matched healthy controls. The relationship between global and regional brain volume and early-life adversity was measured using voxel-based morphometry (VBM). All data were corrected for multiple comparisons using family-wise error (FWE) at P<0.05.ResultsIn the OCD group, correlations with total CTQ scores were positively associated with a larger right orbitofrontal cortex volume. Physical neglect was higher in the OCD group than in controls and was positively associated with larger right cerebellum volume in the OCD group only.ConclusionsLarger brain volumes may reflect underlying developmental neuropathology in adults with OCD who also have experience of childhood trauma.
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McLoughlin, Pauline J., and Rudy Gonzalez. "Healing Complex Trauma through Therapeutic Residential Care: The Lighthouse Foundation Therapeutic Family Model of Care." Children Australia 39, no. 3 (September 2014): 169–76. http://dx.doi.org/10.1017/cha.2014.22.
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Therapeutic Residential Care (TRC) has attracted increasing interest in Australia, as a specialised out-of-home care option for children with complex needs. Extending beyond the limitations of traditional residential programmes, TRC aims to address the impact of trauma and promote positive development and wellbeing. The Lighthouse Foundation is a not-for-profit organisation based in Melbourne, providing a long-term programme of TRC to young people aged 15 to 22 at intake. The organisation has developed an attachment and trauma-informed therapeutic community approach, embodied in the Therapeutic Family Model of Care. This discussion paper explores how the therapeutic community approach taken by Lighthouse provides a different experience of the cultural ‘sites’ in which early traumatic experiences occur – including the home environment, experiences of family, and the wider community. In doing so, we propose that an important dimension of TRC is the capacity to challenge traumatic relational blueprints of abuse and neglect. This, in turn, supports children to form and sustain positive and reciprocal relationships, and to live inter-dependently in the community.
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Poulos, Marie G., and William G. Webster. "Family History as a Basis for Subgrouping People Who Stutter." Journal of Speech, Language, and Hearing Research 34, no. 1 (February 1991): 5–10. http://dx.doi.org/10.1044/jshr.3401.05.
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Of a clinical population of 169 adult and adolescent stutterers, 112 members (66%) reported a family history of stuttering. Only 3 (2.4%) of these reported any birth or early childhood factors or events that were thought to be associated with stuttering onset or that potentially might have precipitated stuttering. In contrast, 21 (37%) of the 57 members without a family history of stuttering reported such a factor or event. On the basis of this retrospective investigation of family history, the stutterers could be segregated in ways that may be informative relative to etiology and underlying mechanisms despite being apparently similar with respect to time of stuttering onset, dysfluency characteristics, and emotional concomitants. It is suggested that these data are consistent with a hypothesis that within the clinical population of adults presenting as developmental stutterers there are really two subgroups. One subgroup is thought to consist of individuals with a genetically inherited predisposition for stuttering, and the second of individuals without such a predisposition but who may have sustained some form of early brain damage. The incidence of false negatives in the 36 individuals classified as having no family history and no known early physical trauma remains to be ascertained. Implications for research on both brain mechanisms of stuttering and responsiveness to clinical treatment and fluency maintenance are discussed.
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Altunsoy, Mustafa, and Mehmet Selim Bilgin. "Management of an intruded primary central incisor with a natural crown under general anesthesia." European Journal of Dentistry 08, no. 02 (April 2014): 265–68. http://dx.doi.org/10.4103/1305-7456.130632.
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ABSTRACTTooth intrusion is the most common trauma during early infancy. Primary maxillary central incisors are the most affected teeth. There are a few treatment approaches which depend upon the severity of the trauma, and the treatment must be managed professionally. In this case report, a 3-year-old girl with a history of trauma 40 days before referring to our pediatric clinic is presented. Deciduous maxillary right central incisor was intruded through labial and alveolar socket and completely covered with soft tissue. The intruded deciduous incisor tooth was surgically extracted and impression was taken under general anesthesia. The removable partial prosthesis was completed by using the patient's own extracted tooth. Using natural crown on removable prosthesis gives psychological satisfaction to the patient and his/her family, and can be better tolerated since its shape, size, and color are exactly in harmony.
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Holttum, Sue. "Research watch: trauma-informed mental health care and avoiding exclusion of people with a psychosis diagnosis from trauma therapies." Mental Health and Social Inclusion 25, no. 2 (May 7, 2021): 109–16. http://dx.doi.org/10.1108/mhsi-02-2021-0006.
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Purpose This paper aims to highlight emerging research relating to the need to recognise and address trauma in mental health service users. Design/methodology/approach The author searched for papers on trauma-informed care, published in the past two years. Findings One paper reports ideas of service users and family members for trauma-informed mental health services. A second paper describes an online survey seeking agreement between staff and service users of early intervention services for psychosis about practices of trauma-informed care. Both papers feature themes about safety and staff having training and support for asking about and responding to trauma. A third paper reports on specific therapies for trauma with people who experience psychosis. It found some evidence for talking therapies but noted that people with a psychosis diagnosis are rarely offered such therapies. Originality/value These papers highlight an emerging consensus about essential components of trauma-informed care and the need for staff training and support to realise it. The exclusion of people with a psychosis diagnosis from specific trauma therapies might begin to be addressed if services were more able to recognise trauma. There is some evidence that talking therapies for childhood trauma can be helpful for people who have a psychosis diagnosis. However, evidence reviews should be broadened to include a range of distressing experiences recognised to follow childhood trauma irrespective of whether the person has a psychosis diagnosis.
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Brumann, M., M. Matz, T. Kusmenkov, J. Stegmaier, P. Biberthaler, K. G. Kanz, W. Mutschler, and V. Bogner. "Impact of STAT/SOCS mRNA Expression Levels after Major Injury." Mediators of Inflammation 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/749175.
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Background. Fulminant changes in cytokine receptor signalling might provoke severe pathological alterations after multiple trauma. The aim of this study was to evaluate the posttraumatic imbalance of the innate immune system with a special focus on theSTAT/SOCSfamily.Methods. 20 polytraumatized patients were included. Blood samples were drawn 0 h–72 h after trauma; mRNA expression profiles of IL-10, STAT 3, SOCS 1, and SOCS 3 were quantified by qPCR.Results. IL-10 mRNA expression increased significantly in the early posttraumatic period. STAT 3 mRNA expressions showed a significant maximum at 6 h after trauma. SOCS 1 levels significantly decreased 6 h–72 h after trauma. SOCS 3 levels were significantly higher in nonsurvivors 6 h after trauma.Conclusion. We present a serial, sequential investigation in human neutrophil granulocytes of major trauma patients evaluating mRNA expression profiles of IL-10, STAT 3, SOCS 1, and SOCS 3. Posttraumatically, immune disorder was accompanied by a significant increase of IL-10 and STAT 3 mRNA expression, whereas SOCS 1 mRNA levels decreased after injury. We could demonstrate that death after trauma was associated with higher SOCS 3 mRNA levels already at 6 h after trauma. To support our results, further investigations have to evaluate protein levels of STAT/SOCS family in terms of posttraumatic immune imbalance.
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Mullan, Eleanor, and Martin Orrell. "Early life experience in elderly women with a history of depression: a pilot study using the Brief Parenting Interview." Irish Journal of Psychological Medicine 13, no. 1 (March 1996): 18–20. http://dx.doi.org/10.1017/s0790966700002238.
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AbstractObjective: The relationship between early adverse experience and psychological illness has been studied in younger adults, but not in the elderly. This study investigated early adverse experience in elderly women with a history of severe depression by using a semi-structured interview.Method: Women admitted with a history of severe depression were identified and interviewed using the Brief Parenting Interview (BPI)(n=14).Results: The majority of elderly women (71%) with a history of severe depression had suffered significant childhood trauma. Eight (57%) women reported parental loss, six (49%) reported tension or discord in the family home and one woman reported severe child sexual abuse. The majority of the women (87%) did not find the questionnaire distressing and all found it acceptable.Conclusions: Considering the high prevalence of childhood trauma in this group and the problems treating severe depressive illness in the elderly, this area deserves further study. The BPI is well tolerated in elderly women with a history of depression.
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Lampe, Urška. "Kako je ujetništvo spremenilo družinsko življenje: primer deportirancev iz Julijske krajine v Jugoslavijo po drugi svetovni vojni." Studia Historica Slovenica 20 (2020), no. 3 (December 20, 2020): 773–810. http://dx.doi.org/10.32874/shs.2020-22.
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The article discusses individual and social consequences of captivity in the case of Italian prisoners of war in Yugoslavia, emphasizing the fate of those who were interned in Slovenia (most of them were the so-called deportees from the Julian March). Based on available memoirs, archival sources, and oral testimonies, the article aims to understand if and how the experience of captivity affected prisoners' social and family life and their reintegration into society after returning home. Since these memories in the early years and decades were often pushed into oblivion, the article also highlights the importance of oral history and empathy in dealing with traumatic events and starting writing trauma instead of writing about trauma.
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Riggs, Shelley A., Gayla Sahl, Ellen Greenwald, Heather Atkison, Adrienne Paulson, and Colin A. Ross. "Family Environment and Adult Attachment as Predictors of Psychopathology and Personality Dysfunction Among Inpatient Abuse Survivors." Violence and Victims 22, no. 5 (October 2007): 577–600. http://dx.doi.org/10.1891/088667007782312159.
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The current study explored the role of early family environment and adult attachment style in explaining long-term outcomes among child abuse survivors. Adult patients (N = 80) in a trauma treatment program were assessed for clinical diagnosis and administered a multiscale questionnaire. Hierarchical regression analyses were significant for dissociative identity disorder (DID), substance abuse, anxiety disorder, posttraumatic stress, somatization, and six personality disorder dimensions. Adult attachment styles were significant predictors of most outcome variables. Of particular note was the strong contribution of attachment avoidance to DID. Five family environment scales (Independence, Organization, Control, Conflict, Expressiveness) also contributed to various psychopathological outcomes. Evidence emerged supporting a mediating role for attachment style in the link between family independence and five personality disorder dimensions.
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Itskovich, Galina. "Infant and Parent Mental Health: developmental trajectory as a communal concern." Mental Health: Global Challenges Journal 1, no. 1 (March 3, 2019): 29–31. http://dx.doi.org/10.32437/mhgcj.v1i1.14.
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This article covers recent research in the field in the context of lifelong growth and mastering developmental milestones. It denotes intrinsic connection between parental and child’s psychological well being, including patterns of early attachment. There is also well documented connection between deviations in early attachment and consequent adult functioning. “The bigger picture” approach based on the DIR method is proposed as one of the crucial components of mitigating early trauma. It includes comprehensive multidisciplinary diagnosis, parent education and play interventions based on immediate interests, needs and resources of the family. It targets all areas of development and builds foundation for the emergence and maintenance of healthy attachment. Other successful approaches, implications for clinical work and social organization of early intervention services are also discussed.
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Turner, Heather A., David Finkelhor, Richard Ormrod, Sherry Hamby, Rebecca T. Leeb, James A. Mercy, and Melissa Holt. "Family context, victimization, and child trauma symptoms: Variations in safe, stable, and nurturing relationships during early and middle childhood." American Journal of Orthopsychiatry 82, no. 2 (April 2012): 209–19. http://dx.doi.org/10.1111/j.1939-0025.2012.01147.x.
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McIntosh, Iris, and Giles W. Story. "Psychotic PTSD? Sudden traumatic loss precipitating very late onset schizophrenia." BMJ Case Reports 14, no. 1 (January 2021): e235384. http://dx.doi.org/10.1136/bcr-2020-235384.
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Early theories of schizophrenia considered the illness as a fragmentation of mental content in response to psychological trauma. Here we present a case of very late onset schizophrenia in a previously high-functioning man in his mid-60s, precipitated by having lost his family in a terrorist attack, while he was living in Africa. He presented with symptoms consistent with post-traumatic stress disorder, however also exhibited visual and auditory hallucinations and marked deterioration in daily functioning. He showed mild impairment on cognitive testing, however brain imaging and screening for reversible causes of cognitive impairment were normal. The case highlights the need for a formulation-based approach to understanding and managing responses to severe trauma, from resolution through to psychotic disintegration.
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Melville, Alysse. "Trauma-Exposed Infants and Toddlers: A Review of Impacts and Evidence-Based Interventions." Advances in Social Work 18, no. 1 (September 24, 2017): 53–65. http://dx.doi.org/10.18060/21287.
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Infants and toddlers are exposed to abuse and neglect at disproportionate rates compared to other children, setting a trajectory for disrupted developmental processes and increased vulnerability to future traumatic exposure. Social workers encounter trauma–exposed young children across a number of systems, including but not limited to early childcare, family physical and mental health, court, and child welfare. It benefits social workers to have a working understanding of current research related to the bio–psycho–social impact of trauma on infants and young children and an awareness of current, research-driven interventions that can support young, at–risk children and families. This article reviews trauma-impacted development throughout the first two years of life with a discussion of current research exploring attachment and brain development and then discusses caregiver–child based interventions that work to repair disrupted attachment patterns, repair impaired regulatory processes, and return the caregiver–child relationship to a healthy developmental path.
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Jankowski, M. Kay, Karen E. Schifferdecker, Rebecca L. Butcher, Lynn Foster-Johnson, and Erin R. Barnett. "Effectiveness of a Trauma-Informed Care Initiative in a State Child Welfare System: A Randomized Study." Child Maltreatment 24, no. 1 (September 10, 2018): 86–97. http://dx.doi.org/10.1177/1077559518796336.
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Trauma-informed care (TIC) initiatives in state child welfare agencies are receiving more attention, but little empirical evidence exists as to their efficacy. The purpose of this study was to assess changes in self-reported practices and perceptions of child welfare staff involved in a multifaceted, statewide TIC intervention. Ten child welfare offices were matched and randomized to an early or delayed cohort. Staff were surveyed at Time 1 prior to any intervention, Time 2 postintervention for Cohort 1, and Time 3 postintervention for Cohort 2. The survey covered six domains: trauma screening, case planning, mental health and family involvement, progress monitoring, collaboration, and perceptions of the state’s overall system performance. Linear mixed modeling assessed the effect of the intervention. Cohort by time interaction was significant for three intervention targets. We demonstrate, using a rigorous study design, the mixed results of a multimodal intervention to improve trauma-informed attitudes, practices, and system performance. TIC initiatives must account for complex, dynamic contextual factors.
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Manohar, Harshini, Rajendra Kiragasur Madegowda, and Shekhar P. Seshadri. "Addressing Emotional Issues in an Adolescent with Vitiligo and Early Child Sexual Abuse—Therapeutic Challenges." Indian Journal of Psychological Medicine 43, no. 5 (April 19, 2021): 442–45. http://dx.doi.org/10.1177/02537176211000772.
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Chronic medical conditions in children and adolescents have a significant impact on development and quality of life. Children with vitiligo experience depression, anxiety and guilt, body image concerns, and conflicts of acceptance–rejection among peers. Understanding issues of relevance through a developmental perspective is pivotal. Here, we report the experiences of working with an adolescent who presented with depressive symptoms, mood dysregulation, and self-harm, in the background of vitiligo and child sexual abuse. We describe the unique therapeutic challenges, focusing on the interplay between depressive psychopathology, childhood trauma, and normative adolescent development. Therapeutic strategies for patient-centered psychological interventions are discussed. The therapy processes focused on a narrative approach, with the active involvement of the family.
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Tumarkin, Maria. "Crumbs of memory: Tracing the ‘more-than-representational’ in family memory." Memory Studies 6, no. 3 (June 28, 2013): 310–20. http://dx.doi.org/10.1177/1750698013482648.
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This article concerns itself with exploring some of the ways in which we can move beyond the ‘cognitive bias’ within social memory studies. A key obstacle to engaging with the kinds of manifestations of remembering that cannot be reduced to intentional and conscious articulations or representations of the mediated past is a deeply entrenched opposition between representational and non-representational (or declarative and non-declarative) mnemonic practices. It strikes me that this opposition is, at least partially, a product of early thinking on memory and trauma, in which affect and representation were opposed to each other, and the notion of non-representational memory was subsumed in the idea of the traumatic. In this article, I intend to try out the idea of ‘more-than-representational’ coined in the field of human geography to reach out to mnemonic processes and practices that operate on various levels not fully reducible to cognition, with the products of these processes exceeding representational form (rather than being completely outside or beyond it).
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M. Pastor, Brígida. "Almodovarian mother figures: early films=Figuras maternas almodovarianas: primeras películas." Cuestiones de género: de la igualdad y la diferencia, no. 16 (June 29, 2021): 82. http://dx.doi.org/10.18002/cg.v0i16.6969.
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<p><strong>Abstract</strong></p><p>In Pedro Almodóvar´s early films, the portrayal of unconventional maternal figures come in varying forms - more than often she (or he) is an unrelated outsider who eventually comes to replace a child’s absent or indifferent biological mother. This study aims to show how Almodóvar's families are formed by accident or necessity regardless of gender, sexuality, fertility, age or class, with the “Mother” figure as the uniting force. We will argue that in Almodóvar’s films the trauma of hostile urban life is often the catalyst for the breakdown of the family bonds, resulting in the search for an alternative mother substitute, while subsequently a return to one’s rural origins is often the key to repairing a damaged relationship between mother and child.</p><p><strong>Resumen</strong></p><p>En los primeros filmes de Pedro Almodóvar, sus figuras maternas, alejadas del rol tradicional, destacan por su diversidad; la mayoría de las veces, ella (o él) se revela como un personaje extraño que, eventualmente, reemplaza a la madre biológica ausente o indiferente. Las familias en el cine de Almodóvar se forman accidentalmente o por necesidad, sin que importe el género, la sexualidad, la fertilidad, la edad o la clase, siendo la figura de la “Madre” una fuerza unificadora. Este estudio pretende demostrar que en el cine de Almodóvar el trauma de la vida urbana hostil es a menudo el catalizador de la ruptura de los lazos familiares, desembocando en la búsqueda de “una madre” alternativa, mientras que posteriormente el retorno a los orígenes rurales es a menudo el factor clave para reparar una relación dañada entre madre e hijo.</p>
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Manley, Lynda, Ruth Barr, and Patricia McNamara. "Strengthening Trauma-informed Therapeutic Practice Approaches in Out-of-home Care." Children Australia 39, no. 4 (December 2014): 216–20. http://dx.doi.org/10.1017/cha.2014.33.
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This paper provides a snapshot of early work undertaken to develop a trauma-informed complex case management and therapeutic practice model for kinship and foster care within a family and community services agency. The approach taken has initially involved supporting case workers and carers and working towards organisational cultural change. The shift in focus described arose from a concern that stability and healing goals were not well supported within the existing programmatic framework and practice approaches. Purposeful integration of theory with practice has been central to the change process. There is a clear rationale that working from a strong evidence base can create better outcomes for children and young people in out-of-home care. The paper reflects on work in progress. Action taken to date has educated the workforce around trauma-informed responses, developed clear protocols and a set of practice tools. This has embedded a strong foundation for further development as resources become available.
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Patil, Aditya, Nishant Goyal, Garga Basu, Rajnish Kumar Arora, Jitender Chaturvedi, and Priyanka Gupta. "Surgery for Spinal Trauma: Early Days at a Young Institution in a Hilly State." Indian Journal of Neurotrauma 17, no. 02 (June 18, 2020): 090–94. http://dx.doi.org/10.1055/s-0040-1713330.
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Abstract Background Spinal trauma is associated with significant morbidity and affects the overall quality of life of the patient as well as their family. The aim of this study was to study the epidemiology, in-hospital outcome, and follow-up of patients undergoing surgery for spinal trauma. Methods All patients who underwent surgery for spinal trauma at the Department of Neurosurgery between June 2016 and October 2019 were studied retrospectively. Data collected from patient record included demographic profile, mode of injury, level of injury, neurological status at admission, time from injury to operative intervention, hospital stay, neurological outcome at discharge, and follow-up. Postoperative computed tomography scans were done in all patients to check for adequacy of screw placement. Results A total of 70 patients (45 males, 25 females) with a mean age of 36 years (range: 16–65 years) were operated for spinal injuries at our department during the study period. Fall was the most common mode of injury (77.1%), followed by road traffic accident (28.5%). Most common site of injury was lumbar spine (38.6%), followed by dorsal (32.9%) and cervical (28.5%). Out of the total, 27.1% of our patients were American Spinal Injury Association (ASIA) grade A at presentation whereas 18.6% were ASIA E. Remaining 54.3% patients had incomplete injuries (ASIA B, C, and D). Burst fracture was the most common morphology of injury (60%), followed by translational injuries (30%). Mean duration between injury and operative intervention was 20.8 days. The mean duration of hospital stay was 21.4 days (range: 8–90 days). Six patients expired during hospitalization. All these six cases had cervical spinal injury. One patient of dorsal spine injury with a complete neurological injury expired 6 months after discharge from the hospital (cause unknown). Nine of our cases showed neurological improvement on follow-up and in rest of the patients, neurological status remained same as preoperative status. Conclusion Neurological status at admission (ASIA grade) and level of injury remain the most important predictor of the outcome. Spinal injury patients must be managed with a holistic and multidisciplinary approach. Rehabilitation is important for helping these patients in leading a productive life.
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Stubberud, Anker, Emer O’Connor, Erling Tronvik, Henry Houlden, and Manjit Matharu. "R1352Q CACNA1A Variant in a Patient with Sporadic Hemiplegic Migraine, Ataxia, Seizures and Cerebral Oedema: A Case Report." Case Reports in Neurology 13, no. 1 (February 16, 2021): 123–30. http://dx.doi.org/10.1159/000512275.
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Mutations in the <i>CACNA1A</i> gene show a wide range of neurological phenotypes including hemiplegic migraine, ataxia, mental retardation and epilepsy. In some cases, hemiplegic migraine attacks can be triggered by minor head trauma and culminate in encephalopathy and cerebral oedema. A 37-year-old male without a family history of complex migraine experienced hemiplegic migraine attacks from childhood. The attacks were usually triggered by minor head trauma, and on several occasions complicated with encephalopathy and cerebral oedema. Genetic testing of the proband and unaffected parents revealed a de novo heterozygous nucleotide missense mutation in exon 25 of the <i>CACNA1A</i> gene (c.4055G>A, p.R1352Q). The R1352Q <i>CACNA1A</i> variant shares the phenotype with other described <i>CACNA1A</i> mutations and highlights the interesting association of trauma as a precipitant for hemiplegic migraine. Subjects with early-onset sporadic hemiplegic migraine triggered by minor head injury or associated with seizures, ataxia or episodes of encephalopathy should be screened for mutations. These patients should also be advised to avoid activities that may result in head trauma, and anticonvulsants should be considered as prophylactic migraine therapy.
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Lv, Xiaodan, Fengxia Lv, Guimei Yin, Ju Yi, Yi Liu, and Ying Tian. "Curative Effect of Early Full Nursing Combined with Postdischarge Continuation Nursing on Patients after Craniocerebral Trauma." Evidence-Based Complementary and Alternative Medicine 2021 (September 4, 2021): 1–8. http://dx.doi.org/10.1155/2021/7424855.
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Early full nursing helps patients with some dysfunctions speed up the reorganization of central nervous system functions and coordinate muscle and limb activities. Postdischarge continuation nursing for patients who have not fully recovered after being discharged from the hospital can transfer nursing work from the hospital to the family to meet their nursing needs. In this study, early full nursing combined with postdischarge continuation nursing was used for patients with traumatic brain injury to explore its efficacy and its impact on patients' motor function, quality of life, and complications. The results of the study show that the total effective rate of the observation group (95.92%) was higher than that of the control group (85.71%). At discharge and 1 month, 3 months, and 6 months after discharge, the upper limb Fugl-Meyer score, lower limb Fugl-Meyer score, ARAT score, FIM score, 4 dimensions of GQOLI-74 score, and Barthel index scores of the observation group were higher than those of the control group in the same period. The postoperative complication rate (10.20%) of the observation group was lower than that of the control group (26.53%). Early full nursing combined with postdischarge continuation nursing can improve the rehabilitation effect, effectively promote the recovery of motor function in patients with traumatic brain injury, improve the quality of life, and reduce postoperative complications.
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Szeftel, R., and C. Pataki. "An innovative child psychiatry training program using a family-based model for at-risk military families." European Psychiatry 33, S1 (March 2016): S135. http://dx.doi.org/10.1016/j.eurpsy.2016.01.213.
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IntroductionFew child psychiatrists are well trained in family-based interventions for military families who experience significant trauma, intergenerational posttraumatic stress disorder, substance abuse, depression and high rates of suicide (Ramsawh et al., 2014). The innovative VA/UCLA/LACDMH Child and Adolescent Psychiatry Training program, sponsored jointly by the VA Greater Los Angeles Healthcare System (VA) and the Los Angeles County Department of Mental Health (LAC DMH), will address unmet needs of at-risk military families using a family-focused model also applicable to other families exposed to trauma.ObjectivesTo present the curriculum of the VA/UCLA/LACDMH training program and details of the collaboration between the LA VA and LAC DMH.AimsTo highlight how innovative child psychiatry training programs can be developed through creative institutional collaborations.MethodsThe VA/UCLA/LACDMH program family-based model and FOCUS (Lester et al., 2011) intervention were structured to meet regulatory standards of child psychiatry training programs.ResultsA specialized family-based child training program was created to meet the needs of at-risk military families while providing rigorous child and adolescent psychiatry training. Components Early Intervention Family Clinic for At-Risk Children provides family psychoeducation, and identifies children and adolescents at risk.FocusAn evidence-based early intervention for at-risk military families to enhance resilience and mitigate stress through improved coping, increased problem solving, and effective communication.ConclusionsA successful collaboration between the LA VA and LAC DMH can lead to an innovative family-based child psychiatry training program.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Fenton, M. C., T. Geier, K. Keyes, A. E. Skodol, B. F. Grant, and D. S. Hasin. "Combined role of childhood maltreatment, family history, and gender in the risk for alcohol dependence." Psychological Medicine 43, no. 5 (August 10, 2012): 1045–57. http://dx.doi.org/10.1017/s0033291712001729.
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BackgroundStudies of the relationship between childhood maltreatment and alcohol dependence have not controlled comprehensively for potential confounding by co-occurring maltreatments and other childhood trauma, or determined whether parental history of alcohol disorders operates synergistically with gender and maltreatment to produce alcohol dependence. We addressed these issues using national data.MethodFace-to-face surveys of 27 712 adult participants in a national survey.ResultsChildhood physical, emotional and sexual abuse, and physical neglect were associated with alcohol dependence (p<0.001), controlling for demographics, co-occurring maltreatments and other childhood trauma. Attributable proportions (APs) due to interaction between each maltreatment and parental history revealed significant synergistic relationships for physical abuse in the entire sample, and for sexual abuse and emotional neglect in women (APs, 0.21, 0.31, 0.26 respectively), indicating that the odds of alcohol dependence given both parental history and these maltreatments were significantly higher than the additive effect of each alone (p<0.05).ConclusionsChildhood maltreatments independently increased the risk of alcohol dependence. Importantly, results suggest a synergistic role of parental alcoholism: the effect of physical abuse on alcohol dependence may depend on parental history, while the effects of sexual abuse and emotional neglect may depend on parental history among women. Findings underscore the importance of early identification and prevention, particularly among those with a family history, and could guide genetic research and intervention development, e.g. programs to reduce the burden of childhood maltreatment may benefit from addressing the negative long-term effects of maltreatments, including potential alcohol problems, across a broad range of childhood environments.
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Ataliieva, Alla, Bohdan Biron, and Vsevolod Rozanov. "Life Adversities and Trauma as Factors of Addictive Behaviors." Journal of applied health sciences 6, no. 1 (March 4, 2020): 15–24. http://dx.doi.org/10.24141/1/6/1/2.
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Within this study 117 drug and alcohol addicts (97 males and 20 females) were compared with a matching group of healthy controls. All respondents were questioned regarding negative life events (NLE) that have happened to them during different periods of their life, in particular when they were 0-6, 7-14, 15-18 and 19 and more years old. The questionnaire consisted of 69 questions which covered such issues as “assault”, “divorce/separation”, “major financial problems”, “serious illness or injury”, “legal problems”, “loss of confidant”, “serious marital problems”, “being robbed”, “serious difficulties at work”, “serious housing problems” and “job loss”, etc. Events related to the personal network and early life period included death of a parent, loss of an individual in the network, alcohol and drug addiction of a parent, problems in relations with parents, separation from parents, being brought up by persons other than parents, housing problems, having very bad relations with a parent, etc. It was found that the life course of NLE accumulation in addicts is 3 times higher than in controls, the differences were statistically significant (p<0,001) in all life periods. In the hierarchical regression model which was used, accumulation of NLEs in the early childhood and young adulthood (after 19) have a bigger impact than periods of school years and ad-olescence. Analysis of NLEs in the earliest life period (0-6 years) in addicts showed that alcohol problems in parents and perceived feelings that parents do not love them and even torture them emotionally were much more frequent than in controls. Other strong associations were with being brought up by people other than parents and father’s addiction. Physical and sexual violence were not among the priorities and were not so strongly associated with addiction. The results are discussed in terms of possible cultural peculiarities than may influence prioritization of childhood adversities and their relevance for further development of addictive behavior. The results obtained may be helpful while building rehabilitation measures for addicts, especially during family therapy
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Jones, N., N. T. Fear, S. Wessely, G. Thandi, and N. Greenberg. "Forward psychiatry – early intervention for mental health problems among UK armed forces in Afghanistan." European Psychiatry 39 (January 2017): 66–72. http://dx.doi.org/10.1016/j.eurpsy.2016.05.009.
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AbstractBackgroundThis observational study examined return to duty (RTD) rates following receipt of early mental health interventions delivered by deployed mental health practitioners.MethodIn-depth clinical interviews were conducted among 975 UK military personnel referred for mental health assessment whilst deployed in Afghanistan. Socio-demographic, military, operational, clinical and therapy outcomes were recorded in an electronic health record database. Rates and predictors of EVAC were the main outcomes examined using adjusted binary logistic regression analyses.ResultsOverall 74.8% (n = 729) of personnel RTD on completion of care. Of those that underwent evacuation home (n = 246), 69.1% (n = 170) returned by aeromedical evacuation; the remainder returned home using routine air transport. Predictors of evacuation included; inability to adjust to the operational environment, family psychiatric history, previously experiencing trauma and thinking about or carrying out acts of deliberate self-harm.ConclusionDeployed mental health practitioners helped to facilitate RTD for three quarters of mental health casualties who consulted with them during deployment; psychological rather than combat-related factors predicted evacuation home.
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Macniven, Rona, Thomas Lee Jeffries, David Meharg, Folau Talbot, Boe Rambaldini, Elaine Edwards, Ian B. Hickie, Margaret Sloan, and Kylie Gwynne. "What Solutions Exist for Developmental Delays Facing Indigenous Children Globally? A Co-Designed Systematic Review." Children 7, no. 12 (December 10, 2020): 285. http://dx.doi.org/10.3390/children7120285.
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Early childhood is important for future cognitive and educational outcomes. Programs overcoming barriers to engagement in early education for Indigenous children must address family cultural needs and target developmental delays. This systematic review identifies culturally adapted programs to improve developmental delays among young children, in response to an identified priority of a remote Indigenous community. Five databases (the Cochrane Library, Embase, Medline, Scopus and CINAHL) were searched for English language papers in January 2018. Study quality was assessed, and findings were analysed thematically. Findings were presented to the community at an event with key stakeholders, to determine their inclusion and face validity. Seven relevant studies, published between 1997 and 2013, were identified by the researchers and each study was supported by the community for inclusion. Three studies included on Native American children and four studies included children from non-Indigenous disadvantaged backgrounds. Findings were reported narratively across four themes: storytelling to improve educational outcomes; family involvement improved development; culturally adapted cognitive behavioural therapy to reduce trauma; rewards-based teaching to improve child attention. Limited published research on culturally adapted and safe interventions for children with developmental delays exists but these four themes from seven studies identify useful components to guide the community and early childhood program development.
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Kim, Hyun-Ju, Ji Eun Kim, and Sang-Hyuk Lee. "Functional Impairment in Patients with Panic Disorder." Psychiatry Investigation 18, no. 5 (May 25, 2021): 434–42. http://dx.doi.org/10.30773/pi.2020.0425.
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Objective Anxiety and depression and sociodemographic factors such as age, gender, education level, income, and marital status among people with panic disorder (PD) are associated with functional impairment in the areas of work, social, and family. Although both PD-specific scales such as the Panic Disorder Severity Scale (PDSS) and Anxiety Sensitivity Inventory-Revised (ASI-R) and early trauma have been investigated, their relationship with functional impairment in PD patients has not been clarified.Methods This study included 267 PD patients. The PDSS, Beck Depression Inventory (BDI), ASI-R, and Early Trauma Inventory were used. Pearson’s correlation and multiple linear regression analyses were performed. The Sheehan Disability Scale (SDS) was administered to assess the functional impairment level in PD patients.Results Our findings showed that high levels of PDSS, BDI, and ASI-R were significantly correlated with the functional impairment among PD patients. Multiple regression analyses showed that PDSS, BDI, and ASI-R can predict the functional impairment levels, and PDSS and ASI-R were significantly associated with lost and underproductive days in PD patients.Conclusion Panic-specific symptoms, depression, and AS are associated with functional impairment level in PD patients. Elevated symptom severity can play a role by affecting productivity and daily responsibilities in PD patients.
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Jarman, Heather, Robert Crouch, Mark Baxter, Elaine Cole, Bebhinn Dillane, and Chao Wang. "Frailty in major trauma study (FRAIL-T): a study protocol to determine the feasibility of nurse-led frailty assessment in elderly trauma and the impact on outcome in patients with major trauma." BMJ Open 10, no. 8 (August 2020): e038082. http://dx.doi.org/10.1136/bmjopen-2020-038082.
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IntroductionThe burden of frailty on older people is easily recognisable by increasing mortality and morbidity, longer hospital stays and adverse discharge locations. In the UK, frailty screening has recently become part of the best practice commissioning tariff within National Health Service England, yet there is no evidence or consensus as to who should carry out this assessment or within which time frame. As major trauma is an increasing burden for older people, there is a need to focus clinician’s attention on early identification of frailty in the emergency department (ED) in patients with major trauma as a way to underpin frailty specific major trauma pathways, to optimise recovery and improve patient experience. Throughout the patient with major trauma pathway, nurses are perhaps best placed to conduct timely clinical assessments working with the patient, family and multidisciplinary team to influence ongoing care. This study aims to determine the feasibility of nurse-led assessment of frailty in patients aged 65 years or more admitted to major trauma centres (MTCs).Methods and analysisThis is a prospective observational study conducted across five UK MTCs, enrolling 370 participants over 9 months. The primary aim is to determine the feasibility of nurse-led frailty assessment in MTC EDs in patients aged 65 years or more following traumatic injury. The prevalence of frailty and the best assessment tool for use in the ED will be determined. Other outcome measures include quality of life and frailty assessment 6 months after injury, mortality and discharge outcomes.Ethics and disseminationThe study was given ethical approval by the Social Care Research Ethics Committee (REC no 19/IEC08/0006). Findings will be published in scientific journals and presented to national and international conferences.Trial registration numberISRCTN10671514.
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Elder, Catriona. "The Proposition: Imagining Race, Family and Violence on the Nineteenth-Century Australian Frontier." Ilha do Desterro A Journal of English Language, Literatures in English and Cultural Studies 69, no. 2 (June 7, 2016): 165. http://dx.doi.org/10.5007/2175-8026.2016v69n2p165.
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http://dx.doi.org/10.5007/2175-8026.2016v69n2p165This article analyses John Hillcoat’s 2005 film The Proposition in relation to a spate of Australian films about violence and the (post)colonial encounter released in the early twenty-first century. Extending on Felicity Collins and Therese Davis argument that these films can be read in terms of the ways they capture or refract aspects of contemporary race relations in Australia in a post-Mabo, this article analyses how The Proposition reconstructs the trauma of the Australian frontier; how from the perspective of the twenty-first century it worries over the meaning of violence on the Australian frontier. It also explores what has become speakable (and remains unspeakable) in the public sphere about the history of the frontier encounter, especially in terms of family and race. The article argues that The Proposition and other early twenty-first century race relations films can be understood as post-reconciliation films, emerging in a period when Indigenous and non-Indigenous Australians were rethinking ideas of belonging through a prism of post-enmity and forgiveness. Drawing on the theme of violence and intimate relations in the film, this article argues that the challenges to the everyday formulation of Australian history proffered in The Proposition reveal painful and powerful differences amongst Australian citizens’ understanding of who belongs and how they came to belong to the nation. I suggest that by focusing on violence in terms of intimacy, relationships, family and kin, it is possible to see this film presented an opportunity to begin to refigure ideas of belonging.
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Yatsiv, Ido, Maria C. Morganti-Kossmann, Daniel Perez, Charles A. Dinarello, Daniela Novick, Menachem Rubinstein, Viviane I. Otto, et al. "Elevated Intracranial IL-18 in Humans and Mice after Traumatic Brain Injury and Evidence of Neuroprotective Effects of IL-18—Binding Protein after Experimental Closed Head Injury." Journal of Cerebral Blood Flow & Metabolism 22, no. 8 (August 2002): 971–78. http://dx.doi.org/10.1097/00004647-200208000-00008.
Full textAbstract:
Proinflammatory cytokines are important mediators of neuroinflammation after traumatic brain injury. The role of interleukin (IL)-18, a new member of the IL-1 family, in brain trauma has not been reported to date. The authors investigated the posttraumatic release of IL-18 in murine brains following experimental closed head injury (CHI) and in CSF of CHI patients. In the mouse model, intracerebral IL-18 was induced within 24 hours by ether anesthesia and sham operation. Significantly elevated levels of IL-18 were detected at 7 days after CHI and in human CSF up to 10 days after trauma. Published data imply that IL-18 may play a pathophysiological role in inflammatory CNS diseases; therefore its inhibition may ameliorate outcome after CHI. To evaluate the functional aspects of IL-18 in the injured brain, mice were injected systemically with IL-18–binding protein (IL-18BP), a specific inhibitor of IL-18, 1 hour after trauma. IL-18BP—treated mice showed a significantly improved neurological recovery by 7 days, accompanied by attenuated intracerebral IL-18 levels. This demonstrates that inhibition of IL-18 is associated with improved recovery. However, brain edema at 24 hours was not influenced by IL-18BP, suggesting that inflammatory mediators other than IL-18 induce the early detrimental effects of intracerebral inflammation.