Cognitions and Distress in Caregivers after Their Child's Sexual Abuse Disclosure

The impact of child sexual abuse on children is well documented, but few studies have examined the impact of a child's sexual abuse disclosure on maternal caregivers. The studies that have been conducted suggest that parental response postdisclosure is variable. The present study examined the association between maternal attributions and abuse-specific cognitions with depression and trauma symptoms postdisclosure. Participants included 68 nonoffending maternal caregivers of children between the ages of 3 and 17 years who experienced child sexual abuse. Findings indicated that caregivers' abuse-specific cognitions were the best predictor of self-reported symptoms of depression after controlling for general negative attributions. These findings suggest that in order to reduce caregivers' distress and to enhance their support of their children, it is important to assess and treat caregivers' abuse-specific cognitions.

     

Children Exposed to Community Violence: Issues for Assessment and Treatment

Community violence is increasingly recognized as a risk factor for serious psychological problems with children particularly vulnerable to its effects. This article summarizes the existing knowledge on the effects of chronic exposure to community violence, highlights essential issues in assessing children for both exposure and resulting trauma from community violence, and provides treatment guidelines for those affected children.     

Adoption Issues in Perspective: An Introduction to the Special Issue

The process and dynamics of adoption have changed considerably in the last 50 years, assisted by both social change and new knowledge of human development. The current status of 3 important aspects of adoption is reviewed: 1) the general effects of relinquishment and adoption, 2) the effects of secrecy in adoption, and 3) the need to add information on the dynamics of adoption to the training of therapists. The articles contained in this special adoption issue of the Journal of Social Distress and the Homeless are summarized and are placed in context of the 3 aspects reviewed.     

Peace education with refugees: case studies

The authors suggest the possibility of using concepts and practices drawn from peace education to assist in the treatment and education of refugees suffering from post-traumatic stress. They introduce four basic principles of peace education, which permit students/clients to work through memory and present conflicts, and calls on therapists/teachers to be flexible in their approaches. Three case studies are offered: Bosnian youth in a community center in Chicago, adult male Bosnian refugees in Berlin participating in a social integration project and recently arrived Syrian and Afghani youth living in a transitional setting in Leipzig. There is potential for work undertaken with refugees using principles of peace education to resolve ongoing internal conflicts, while helping to prevent the creation of new social conflicts in the process of integration.     

Does ethno-cultural betrayal in trauma affect Asian American/Pacific Islander college students' mental health outcomes? An exploratory study

Objectives: Interpersonal trauma has deleterious effects on mental health, with college students experiencing relatively high rates of lifetime trauma. Asian American/Pacific Islanders (AAPIs) have the lowest rate of mental healthcare utilization. According to cultural betrayal trauma theory, societal inequality may impact within-group violence in minority populations, thus having implications for mental health. In the current exploratory study, between-group (interracial) and within-group (ethno-cultural betrayal) trauma and mental health outcomes were examined in AAPI college students. Participants: Participants (N = 108) were AAPI college students from a predominantly white university. Data collection concluded in December 2015. Methods: Participants completed online self-report measures. Results: A multivariate analysis of variance revealed that when controlling for interracial trauma, ethno-cultural betrayal trauma significantly impacted dissociation, hallucinations, posttraumatic stress symptoms, and hypervigilance. Conclusions: The results have implications for incorporating identity, discrimination, and ethno-cultural betrayal trauma victimization into assessments and case conceptualizations in therapy.     

The National Elder Mistreatment Study: An 8-year longitudinal study of outcomes

Objectives: To conduct an 8-year follow-up of the National Elder Mistreatment Study (NEMS) and specify risk ratios for negative outcomes of elder abuse, including DSM-5 defined depression, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and poor self-reported health.

Methods: Attempts were made to re-contact, via Computer Assisted Telephone Interview, all 752 NEMS participants who reported mistreatment since age 60 at Wave I, as well as a randomly selected sample of non-mistreated NEMS participants

Results: 183 NEMS Wave I elder abuse victims and 591 non-victims provided data. In bivariate analyses, elder mistreatment 8 years earlier increased risk of negative outcomes by 200–700%. However, multivariate analyses revealed that Current (Wave II) social support was highly protective against most negative outcomes (excepting PTSD), and even appeared to nullify effects of mistreatment on GAD and poor self-reported health.

Conclusions: Outcomes of elder mistreatment have not been studied prospectively in a national sample. The NEMS 8-year follow-up findings indicate a strong relationship between elder mistreatment at Wave I and negative emotional and physical health 8 years later. Fortunately, current (Wave II) social support appears to be both consistently and powerfully protective against most negative outcomes.     

社会工作在灾后心理援助中的作用 ———以2009年母亲节“希望花”项目为例

目的：探讨社会工作在震后心理援助中的作用,考察手工制作丝绒康乃馨对极重灾区群众心理健康的影响。方法：采用测量和筛查创伤后应激障碍的PCL-C量表和测量一般心理症状（主要包括焦虑和抑郁）的HSCL-25为测量工具,以永兴板房区灾民70人为对象（主要是成年女性）,在丝绒花制作活动前后进行两次问卷调查。结果：手工制作丝绒花活动对于缓解一般的心理症状（焦虑和抑郁）作用不大,但却显著降低了PTSD的症状,主要表现为＂闪回＂和＂过度警觉＂反应的减少。结论：诸如丝绒花的手工制作活动可以有效降低地震造成的PTSD症状。     

Sleep among youths in foster care: Associations with potentially traumatic events,PTSD and mental health

Among maltreated youth in foster care, little is known about frequency of sleep problems and its association to potential traumatic events (PTEs) and mental health. Among youths in foster care, we examined: (1) sleep patterns, difficulties initiating and maintaining sleep (DIMS) and related functional impairment; (2) whether exposure to PTEs, symptoms of post‐traumatic stress disorder (PTSD) and general mental health problems are associated with DIMS and related functional impairment, controlling for age, gender and time in foster care; and (3) whether PTSD and general mental health problems mediate the association between PTEs and DIMS. Foster youths in Norway (n = 299) completed a survey on sleep behaviour, the Child and Adolescent Trauma Screen, and the Strengths and Difficulties Questionnaire. Overall, 53.2% reported DIMS. For 82.1%, these sleep problems had lasted 3 months plus. Increased PTEs, PTSD and general mental health problems were all associated with increased DIMS score. Increased rate of PTEs was associated with decreased sleep duration. PTSD and general mental health problems partially mediated the association between PTEs and DIMS. Youth in foster care are at high risk of sleep problems, related to traumatic experiences and mental health problems. Treatment of PTSD may improve sleep problems among maltreated youth.     

Clinical Results Using Virtual Reality

Abstract

Virtual Reality (VR) technology offers new opportunities for the development of innovative clinical research, assessment, and intervention tools. VR-based testing, training, teaching, and treatment approaches that would be difficult, if not impossible to deliver using traditional methods are now being developed that take advantage of the assets that are available with VR technology. As research evidence continues to indicate clinical efficacy, VR applications are being increasingly regarded as providing innovative options for targeting the cognitive, psychological, motor, and functional impairments that result from various clinical health conditions. VR allows for the precise presentation and control of stimuli within dynamic multisensory 3-D computer generated simulations as well as providing advanced methods for capturing and quantifying behavioral responses. These characteristics support the rationale for the use of VR applications in clinical assessment, intervention, and training. This article begins with a brief review of the history and rationale for the use of VR with clinical populations. We then detail one use-case for the clinical application of VR—the exposure therapy treatment of anxiety disorders and post-traumatic stress disorder. While significant work is cited in other areas of Clinical VR (e.g., pain management, cognitive/physical assessment/rehabilitation, eating disorders, social skills/clinical training, etc.), a full overview of such a broad literature is beyond the scope of this article. Thus, we have opted to provide more in-depth analysis of one specific clinical area that clearly illustrates how VR has been successfully applied and is supported by an encouraging and evolving scientific literature.     

Children in families of torture victims: transgenerational transmission of parents' traumatic experiences to their children

This article details a study to test the hypothesis that immigrant children whose parents have been tortured before coming to Sweden suffer from depressive symptoms, post-traumatic stress symptoms, somatisation and behavioural disorders. Fifteen families where at least one of the parents had experienced torture were compared with fifteen families from a similar ethnic and cultural background where their parents might have experienced violence but not torture. The parents were investigated using interviews, the Karolinska Scales of Personality (KSP) and Harvard/Uppsala Trauma Questionnaire (H/UTQ). The children were assessed using the DICA-interview according to DSM-IV. On the H/UTQ test, traumatised parents scored higher with respect to post-traumatic stress disorder, depression, somatisation, anxiety and psychosocial stress symptoms. On the KSP, they scored higher on nine of the fifteen sub-scales. The fathers in the tortured group scored higher than their wives only on the sub-scale for guilt. According to the DICA-interviews, the children of tortured parents had more symptoms of anxiety, depression, post-traumatic stress, attention deficits and behavioural disorders compared with the comparison group. Social workers, psy-chiatrists, psychologists and teachers need to be aware of a possible transmission of parents' traumatic experiences to their children and to develop treatment methods for children of torture victims.