Bioecological Implications of Narrative Exposure Therapy in Low‐Resource Settings: Individual,Family, Community,and Socio‐Political Contexts

Traumatic stress can have detrimental effects on individuals, families, and communities. Narrative exposure therapy (NET) is an evidence‐based intervention for decreasing individuals’ post‐traumatic stress disorder (PTSD) symptoms and has been tested in some of the most challenging contexts, such as in post‐conflict refugee camps. Although the focus of NET is on reducing individual PTSD symptoms, the impact of NET can be seen beyond the individual level. The purpose of this paper is to examine some of the ecological implications of using NET with trauma‐affected populations in low‐resource settings. We describe the implications of NET at the family, community, and sociopolitical levels using several case examples. Finally, we outline limitations and future directions for improving the delivery of NET in settings with limited resources.     

The family caregiving context among adults with disabilities: A review of the research on developmental disabilities,serious mental illness,and traumatic brain injury

ABSTRACT

A majority of adults with serious disabilities are cared for in the home by family members. Guided by an ecological framework, this article presents the findings of a literature review of research on family caregiving and family support for adults with disabilities. This review included 33 research studies published between 2000 and 2015 focused on three disabilities: Developmental disabilities, serious mental illnesses, and traumatic brain injury. A synthesis of the findings underscores the critical role that family caregivers occupy in addressing the needs of their loved one with a disability; however, the needs of the caregiver are insufficiently met by existing service approaches. A better understanding of the unique needs and strengths of the family support context of caregivers and care recipients is needed, giving greater attention to ethnic, racial, and cultural considerations in future research.     

硫酸镁对创伤性脑损伤大鼠血清NSE含量的影响

目的探讨硫酸镁对创伤性脑损伤大鼠血清神经元特异性烯醇化酶（neuron specific enolase,NSE）水平的影响。方法选用健康Sprague-Dawley（SD）大鼠,随机分为假损伤组、单纯脑损伤组、损伤给药组。然后制备自由落体脑损伤模型,损伤给药组大鼠在致伤后5分钟予25%硫酸镁（MgSO4）140mg/kg,腹腔注射,损伤24小时后分别测定脑组织含水量、放射免疫分析法测定大鼠血清NSE水平。结果与假损伤组比较,脑损伤24小时大鼠脑组织含水量明显增高（P〈0.01）,血清NSE水平升高（P〈0.05）。与单纯脑损伤组比较,损伤给药组可降低脑组织含水量（P〈0.05）,降低血清NSE水平（P〈0.05）。结论 MgSO4可以改善大鼠急性脑损伤后的脑水肿,降低血清NSE水平,改善创伤性脑损伤后继发性脑损害,具有神经保护作用。     

Conscription of children in armed conflict—a form of child abuse. A study of 19 former child soldiers

Armed combat in childhood is a form of child abuse. It may lead to serious consequences, including post‐traumatic stress disorder. The inherent emotional abuse and acts or omissions by caregivers may cause behavioural, cognitive, emotional or mental disorder in the child. Nineteen former child soldiers were interviewed in a rehabilitation centre using a standard questionnaire. Reasons for recruitment included: volunteered (18), hatred of enemy (revenge) (5), virtue of being a freedom fighter (martyrdom) (9), as a means of supporting their family (economic) (3). One child was abducted, 7 joined for fear of the ‘enemy’ abducting them, and in 5 a family member was killed by ‘enemy’ or own group. The children were involved in manual labour (15), guard duty (15), front‐line fighting (7), bomb manufacture (5), setting sea/land mines (5) and radio and communication (2). Fifteen were trained in firearms and 14 in self‐destruction. Twelve children attempted to or did run away and 11 refused to obey orders or argued. This led to various punishments, including kitchen duty, beatings, imprisonment, blackmail or death threats. A majority of the children felt sad and emotionally upset when they remembered their mother and family. Children's involvement in war, whatever the ‘justifications’ may be, should always be considered as forced, as they cannot truly comprehend their action in war. The responsibility must be taken by the adult caregivers. The following definition of the abuse of children in armed conflict is proposed: ‘The involvement of dependent, developmentally immature children and adolescents in armed conflict they do not truly comprehend, to which they are unable to give informed consent, and which adversely affects the child's right to unhindered growth and identity as a child’. Firm international agreement on guidelines for the lower age limit of recruitment of children into armed forces is required. Copyright © 2001 John Wiley & Sons, Ltd.     

The Secondary Traumatic Stress Scale (STSS)

SUMMARY

The Secondary Traumatic Stress Scale (STSS; Bride, Robinson, Yegidis, & Figley, 2004) is an easy to administer 17-itemself-report measure of secondary trauma. Bride et al. (2004) reported a measure of three domains of traumatic stress specifically associated with secondary exposure to trauma: intrusion, avoidance, and arousal. The STSS was reported to have high levels of internal consistency reliability and indicated evidence of convergent, discriminant, and factorial validity. The purpose of this paper is to examine the reliability and validity of the STSS with a national, random sample of mental health social workers. To assess the fit of the data to the three-factor structure proposed by Bride et al., a confirmatory factor analysis was performed on data from 275 social workers who indicated exposure to client trauma. The model fit the data adequately although high factor intercorrelations strongly suggest a unidimensional scale. Subsequent confirmatory factor analysis of a unidimensional scale and a second order factor analysis yielded similar results. Findings indicate the need for further scale validation. Challenges remain for measuring and distinctly differentiating between secondary trauma symptoms of arousal, avoidance, and intrusion. Implications and suggestions for future research are discussed.     

Efficacy of a Group Therapy for Sexually Abused Adolescent Girls

ABSTRACT

The effects of a group therapy program for teenage girls reporting child sexual abuse were evaluated by means of a pretest/post-test design with a control group. The psycho-educational intervention consisted of an average of 20 weekly two-hour meetings. Results of the repeated analyses of variance (ANOVA) revealed a sig-nificant improvement in youth participating in the therapy when compared with the control group on measures of post-traumatic stress, internalizing and externalizing behavior problems, coping strategies, relation- ship with the mother, and sense of empowerment. The findings suggest that the group therapy offered by the Centre d'Intervention en Abus Sexuels pour la Famille (CIASF) was effective in reducing symptoms for sexually abused teenagers.     

A Cognitive Approach to Direct Practice with the Aging

The recent prominence of cognitive approaches in psychotherapy and more recently in social casework holds considerable promise for direct practice with olderpersons on both an individual and group basis. Several central concepts in cognitive theory are delineated and found to have particular advantages for the aging. First, they deal with conscious concerns and avoid the dangers of affective or regressive approaches in breaking down defenses. Second, they are heavily concerned with questions of meaning and self-concept, issues that are central to the last stage of life, as delineated by Erikson, and the task of achieving ego integrity over despair. Two case illustrations of the application of a cognitive approach in a group context are given.     

《长日留痕》中的创伤书写

《长日留痕》是主人公史蒂文森对个体创伤历史的记忆。他书写了个体创伤所造成的父子爱之痛、两性爱之痛和事业之痛。他的书写还映射了英国管家集体所遭受的创伤。史蒂文森通过写作来揭示伤痛,对个体创伤进行了宣泄,从而减轻了个体伤痛,而且通过“被倾听”一定程度上治疗了创伤。《长日留痕》对个体创伤的关注再现及疗救,表明了石黑一雄对人类生存状况的关怀,有助于受创伤者建立创伤疗救的希望。     

创伤记忆书写与自我灵魂救赎———解读《血色昏黄》创作与修改中文学与历史的复杂纠缠

通过对《血色黄昏》三个版本的详细比较,文章论述了其创伤记忆书写的意义（自我心理创伤疗救;历史启蒙、“引起疗救的注意”）、创伤记忆书写的方式（十分浓厚的私人化色彩和无拘无束的自由叙述）,长期无法出版的原因（意识形态与文学成规）和出版后的巨大轰动（实现了治疗心理创伤的巨大功能）以及小说在忠于记忆（治疗创伤）与忠于历史（历史见证）之间的犹疑。在此基础上,文章认为《血色黄昏》的创作与修改是一个矛盾体,其边缘缠绕着文学治疗与历史见证、历史档案与文学作品之间的复杂关系。因此,就创伤记忆书写及其与意识形态之间的关系、见证文学及其记忆的真实性这些纠缠在一起的复杂问题而言,《血色黄昏》是一个十分难得的研究文本：它不仅使我们看到了一代人对历史创伤的真实记忆,而且也让我们看到了他们走出创伤记忆的艰难历程。     

对《宠儿》中赛斯杀婴原因的研究*

对于美国著名黑人女作家莫里森的《宠儿》中备受争议的黑人母亲杀婴的主题，很多评论者从不同角度给予过阐释和分析。这里认为书中黑人母亲赛斯的杀婴行为是一种必然。要读懂小说的这一主题，就必须对造成这种行为的原因进行探索。从这一点出发，通过结合创伤理论以及对小说特殊写作背景的探讨，对赛斯的杀婴行为作以分析，并以此深入地拓展奴隶制下黑人母亲杀婴行为的解读。