The Indirect Effect of Child Maltreatment Severity on Adult PTSD Symptoms through Anxiety Sensitivity

Although the rate of posttraumatic stress disorder (PTSD) among survivors of child maltreatment is high, individuals differ in symptom severity and many do not experience clinically significant levels of psychopathology. The present study tested the indirect effects of child maltreatment severity on adult PTSD, suicidal ideations, and alcohol dependence via anxiety sensitivity. A sample of 336 participants (mean age of 22.81 years, SD = 8.93; 70.2% female) completed an online survey of child abuse and neglect, anxiety sensitivity, PTSD symptom severity, suicidal ideation severity, and alcohol dependence severity. The results revealed significant indirect effects of child maltreatment on PTSD symptom severity through cognitive and social concerns, but not physical concerns. No direct or indirect effects were demonstrated for suicidal ideations or alcohol dependence severity. These findings elucidate mechanisms in the robust relationship between child maltreatment and adult PTSD symptoms and can potentially inform future research on mechanisms of change in psychotherapy.     

Integrating self-care into clinical practice with trauma clients

ABSTRACT

Self-care is recognized as an important aspect of social work practice. Beginning in educational settings, developing social workers are encouraged to learn about and practice self-care. However, self-care is typically promoted through strategies and approaches outside of the practice context. Social workers are oftentimes encouraged to use individualized self-care plans, which often feature a variety of relaxation and secondary techniques; focus on self-awareness and self-reflection; and have proper use of supervision. Although these strategies are invaluable, they do little to directly benefit the social worker during direct practice or while in session with a client which is a time period when clinicians are particularly vulnerable to distress or burnout. The importance of real-time self-care strategies is particularly critical for clinicians, especially those who engage in trauma work, given the sensitivity of topics that clients may have endured or benefit from assistance in processing. Further, little information has been published on the use of self-care techniques during a session with a client or in a clinical context. The purpose of the present paper is to discuss self-care strategies that can be useful both outside of and within a clinical setting and present a model of such strategies that focus on integrating self-care in clinical practice particularly for those engaging in trauma work. The paper will conclude by discussing the relevancy of the developed model in practice.     

Digital crime,trauma, and abuse: Internet safety and cyber risks for adolescents and emerging adults in the 21st century

ABSTRACT

The shift in the technology landscape has altered the technology ecosystem of adolescents and emerging adults in the 21^st century. Yet, with greater use of digital gadgets comes greater mental health risks that technological advancement brings. This study provides a narrative review of contemporary cyber risks faced by adolescents and emerging adults. In particular, this review will cover dangers and effects of cyber-bullying, social media, cyber-dating violence, sextortion, sexting, revenge porn, online dating, catfishing, and scammers, with an emphasis to raise awareness and encourage proactive efforts dedicated to address these social concerns as the digital era continues to evolve.     

Assessing the role of hope in processes of transitional justice: mobilizing and disciplining victims in Sierra Leone’s truth commission and reparations programme

Existing studies have not been able to take the role of hope in processes of transitional justice (TJ) into account, as they focus on how TJ changes institutions and the relationships between individuals and therefore conclude that failed processes of TJ have no effect. In contrast to this approach, a different understanding of power as productive helps to understand how TJ-instruments create hope and which effects this has on how people conceive of themselves and the world they live in. A framework for analysing such processes is introduced that brings together individual meaning-making of hope and hopelessness with the role of the state in the provision of hope in the context of uncertainty. Transitional justice is therefore discussed as a performative project that aims at triggering specific emotions among the persons taking part in it and the broader society and at creating a vision of a better future based on social equality through the protection and fulfilment of human rights. By applying this framework to the case of the Sierra Leone truth and reconciliation commission and the reparations programme, it is argued that hope had a mobilizing as well as a disciplining function in these instruments. The promise of support mobilized victims to provide statements to the truth commission, and therefore enabled the commission to work in the first place. However, it failed in its attempt to discipline victims in their feelings about the past violence. The reparations programme constituted the embodiment of these promises, but victims interpreted its inadequate benefits and bad management as a proof that the state still does not care for them and competition over benefits is the norm despite their entitlement to support. This experience destroyed the hopes of many victims and created social envy among them, preventing the development of solidarity among victims and the chance for resistance against this policy.     

Ice pack induced perineal analgesia after spontaneous vaginal birth: Randomized controlled trial

Background

Ice-pack is widely used for alleviating postpartum perineal pain sustained after birth related perineal trauma. However, it lacks robust evidence on timing and frequency of applications, to ensure the effective and safe use of this therapy.

Risk factors for severe perineal trauma during vaginal childbirth: A Western Australian retrospective cohort study

AimTo determine rates and risk factors for third and fourth degree perineal tears (severe perineal trauma) in a Western Australian context.Design and settingA retrospective hospital-based cohort study was performed using computerised data for 10,408 singleton vaginal deliveries from 28 weeks gestation.MethodsWomen with severe perineal trauma were compared to those without. Logistic regression analysis, stratified by parity, was used to assess demographic and obstetric factors associated with perineal trauma.ResultsSevere perineal trauma incidence was 3% (338/10408), 5.4% (239/4405) for primiparas and 1.7% (99/5990) for multiparas (p < 0.001). Adjusted risk factors associated with trauma and common across parity included Asian or Indian ethnicity, shoulder dystocia and assisted delivery. Epidural analgesia (OR 0.72, 95% CI 0.54–0.96), preterm birth (OR 0.40, 95% CI 0.23–0.72) and episiotomy (OR 0.54, 95% CI 0.39–0.74) were protective in primiparas, while episiotomy was associated with increased risk in multiparas (OR 2.01, 95% CI 1.18–3.45). Additional factors among primiparas were occipito posterior (OP) delivery (OR 3.35, 95% CI 1.75–6.41) and prolonged second stage (OR 1.98, 95% CI 1.46–2.68), and among multiparas included gestational diabetes (OR 1.78, 95% CI 1.04–3.03) and birth weight >4000 g (OR 1.86, 95% CI 1.10–3.15).ConclusionParity differences in risk factors such as episiotomy, infant weight, OP delivery, gestational diabetes and prolonged second stage warrant investigation into clinical management. Although rates differ internationally, and replication evidence has confirmed consistency for certain demographic and obstetric factors, the development of internationally endorsed clinical guidelines and further research around interventions to protect the perineum are recommended.     

Are dual and single exposures differently associated with clinical levels of trauma symptoms? Examining physical abuse and witnessing intimate partner violence among young children

A significant portion of children living in the United States have experienced trauma. Informed by the developmental traumatology model, we explored the effects of physical abuse and witnessing intimate partner violence (IPV) on childhood trauma symptoms. This study utilizes a convenience sample of 580 high‐risk children between 3 and 12 years who received services from one‐child advocacy centre during a 12‐month period. We performed a series of binary logistic regression analyses to examine if physical abuse, exposure to IPV, and dual exposure (i.e., both physical abuse and IPV) are distinctly associated with six trauma symptoms, including anxiety, depression, posttraumatic stress (PTS), dissociation, anger, and sexual concerns. The results indicated that dual exposure was predictive of all trauma symptoms, except for dissociation. Additionally, physical abuse was associated with PTS, anger, and sexual concerns, whereas exposure to IPV was associated with depression, PTS, and sexual concerns. Research and implications for practitioners working with young children are discussed.     

Persistent Risk-Related Worry as a Function of Recalled Exposure to the Deepwater Horizon Oil Spill and Prior Trauma

Large oil spills are disasters associated with psychological effects for exposed communities. The amount of worry that individuals experience after a disaster may be influenced by many factors, such as the type and extent of exposure to disaster impacts, prior trauma, and sociodemographic characteristics. This study examined the nature and predictors of worry about ongoing impacts of the 2010 Deepwater Horizon (DH) oil spill reported by Gulf of Mexico coastal residents. A random sample of 2,520 adult residents of Gulf of Mexico coastal counties were administered a telephone survey in 2016, including items about persistent worry and exposure to DH impacts, prior trauma, residence at the time of the spill, and sociodemographic characteristics. Respondents varied in the amount of worry they reported about ongoing health, social, and economic impacts. Controlling for sociodemographic characteristics, higher exposure to the DH oil spill was related to higher levels of worry about ongoing impacts, with past traumatic events related specifically to worry about health impacts. Unexpectedly, those who moved into the region after the spill showed similar levels of worry to residents exposed to the spill, and higher levels than residents who did not recall being exposed to the DH oil spill. This study highlights the impact of the DH oil spill on coastal residents many years after the DH disaster. The findings underscore the need to examine multiple pathways by which individuals experience disasters and for risk researchers to close knowledge gaps about long-term impacts of oil spills within a multi-dimensional framework.     

Women’s experiences of birth trauma: A scoping review

BackgroundA high number of Australian women report experiencing traumatic birth events. Despite high incidence and potential wide spread and long-lasting effects, birth trauma is poorly recognised and insufficiently treated. Birth trauma can trigger ongoing psychosocial symptoms for women, including anxiety, tokophobia, bonding difficulties, relationship issues and PTSD. Additionally, women’s future fertility choices can be inhibited by birth trauma.AimTo summarize the existing literature to provide insight into women’s experiences of birth trauma unrelated to a specific pre-existing obstetric or contextual factor.MethodsThe review follows 5 stages of Arksey and O’Malley’s framework. 7 databases were searched using indexed terms and boolen operators. Data searching identified 1354 records, 5 studies met inclusion criteria.FindingsThree key themes emerged; (1) health care providers and the maternity care system. (2) Women’s sense of knowing and control. (3) Support.DiscussionContinuity of carer creates the foundations for facilitative interactions between care provider and woman which increases the likelihood of a positive birth experience. Women are able to gain a sense of feeling informed and being in control when empowering and individualized care is offered. Functional social supports and forms of debriefing promotes psychological processing and can enable post traumatic growth.ConclusionExisting literature highlights how birth trauma is strongly influenced by negative health care provider interactions and dysfunctional operation of the maternity care system. A lack of education and support limited informed decision-making, resulting in feelings of losing control and powerlessness which contributes to women’s trauma. Insufficient support further compounds women’s experiences.