Organic vs. functional neurological disorders: The role of childhood psychological trauma

Although the relationship between psychological trauma and medically unexplained symptoms (MUS) is well established, this relationship is less well understood in people with medically unexplained neurological symptoms. In the present study, we set out to compare people with functional neurological disorders, and organic neurological disorders, in terms of childhood and adulthood traumatic events, traumatic stress, emotional dysregulation and symptoms of depression and anxiety. We have hypothesised that those with functional neurological disorders would be more likely to report childhood and adulthood traumatic life events, traumatic symptomatology, emotional dysregulation and symptoms of anxiety and depression, compared to those with organic neurological disorders. Sample consisted of a consecutive series of people with functional neurological disorders and with organic neurological disorders (n = 82) recruited from a hospital in Scotland. Participants completed measures of life events, traumatic stress, emotional regulation, anxiety and depression. The two groups were found to significantly differ in relation to all measures, with the MUS group being more likely to report childhood and adulthood life events, more severe emotional dysregulation, traumatic stress and symptoms of anxiety and stress. Logistic regression analysis revealed that exposure to childhood traumatic life events, specifically childhood sexual abuse, and childhood physical neglect, were the only factors which were significantly associated with membership of the medically unexplained neurological symptoms group. Although further research is required to confirm our findings, our results suggest that identifying and addressing the impact of childhood trauma, may alleviate distress and aid recovery from functional neurological disorders.     

心理学专业学习者创伤共情的ERP探析

为了探索心理学专业学习者创伤共情的特征,采用事件相关电位技术(ERP),以创伤和非创伤图片作为实验材料,让心理学专业被试和普通被试做图片性质判断任务。结果发现:心理学专业被试在观看创伤和非创伤图片时ERP波形差异显著,在观看创伤图片时,N110的潜伏期更短、P2的潜伏期更长,P2的波幅更高、P300的波幅更低,与普通被试相比,心理学专业被试受创伤事件的影响更小;在观看非创伤图片时,二者没有显著差异。实验说明心理学专业学习者不容易受消极图片的影响,有更好的应对创伤事件的能力。     

Extended follow-up of neurological,cognitive, behavioral and academic outcomes after severe abusive head trauma

Studies about long-term outcome following abusive head trauma (AHT) are scarce. The aims of this study were to report long-term neurological, cognitive, behavioral and academic outcomes, ongoing treatments and/or rehabilitation, several years after AHT diagnosis, and factors associated with outcome. In this retrospective study, all patients admitted to a single rehabilitation unit following AHT between 1996 and 2005, with subsequent follow-up exceeding 3 years, were included. Medical files were reviewed and a medical interview was performed with parents on the phone when possible. The primary outcome measure was the Glasgow Outcome Scale (GOS). Forty-seven children (out of 66) met the inclusion criteria (mean age at injury 5.7 months; SD = 3.2). After a median length of follow-up of 8 years (range 3.7–12), only seven children (15%) had “good outcome” (normal life – GOS I) and 19 children (40%) presented with severe neurological impairment (GOS III and IV). Children sustained epilepsy (38%), motor deficits (45%), visual deficit (45%), sleep disorders (17%), language abnormalities (49%), attention deficits (79%) and behavioral disorders (53%). Most children (83%) had ongoing rehabilitation. Only 30% followed a normal curriculum, whereas 30% required special education services. Children with better overall outcome (GOS I and II) had significantly higher educated mothers than those with worse outcomes (GOS III and IV): graduation from high school 59% and 21% respectively (p = 0.006). This study highlights the high rate of severe sequelae and health care needs several years post-AHT, and emphasizes the need for extended follow-up of medical, cognitive and academic outcomes.     

South African Counsellors' Attitudes Towards Cognitive Behavioural Techniques to Ameliorate Trauma: Effects of a Training Workshop

Despite its successes in the United States and Europe, cognitive behavioural therapy (CBT) has a short history in South Africa. Local cultural realities and social conditions have been cited as obstacles to the implementation of CBT at community health centres. Yet, CBT's successes in ameliorating a variety of psychological conditions, including symptoms of PTSD, necessitate examination of its relevance and applicability in South African communities. The present study reports on counsellors' attitudes and opinions to CBT for the treatment of psychological trauma. We presented a two-day workshop on CBT and assessed counsellors' opinions and attitudes prior to and following the workshop. Results are discussed in the context of the high rate of traumatic events that occur in South African communities.     

New understandings of communities and ourselves: community-based participatory research with Alaska Native and Lower 48 youth

In the summer of 2014, students from universities in the contiguous United States (Lower 48) and Inupiat youth from Alaska carried out a pilot project as participants/co-researchers in a process called Intergenerational Dialog, Exchange, and Action (IDEA). This action-oriented, community-based, and participatory research method was first developed in 2008, as a platform for structuring dialog between adults, Elders and youth within a community, and for extending resonant ideas emerging from these discussions through Photovoice and digital storytelling amongst youth participants. This pilot study was designed to investigate the feasibility and potential of university students from the Lower 48 and Indigenous youth from Alaska to carry out the IDEA process together as co-researchers. The results of the pilot suggest that it is both possible and meaningful for IDEA to be conducted by a team of youth co-researchers. We found that participation in IDEA expanded the perspectives of youth co-researchers from both Alaska and the Lower 48 in parallel, yet different ways. Exploring the strengths of older community members, being exposed to different ways of living and being, and having opportunities to reflect on and build narratives around these ideas, allowed all the co-researchers to develop a new understanding of their own communities and their roles and responsibilities within them. This paper shares youth co-researcher reflections of the process and the ways in which the process prompted these new perspectives about themselves, their respective communities and their roles within them.     

Addressing children's life changes in the early childhood curriculum

Young children may experience stress from changes in their lives. These changes may be developmental, critical, or catastrophic. Early childhood educators need to establish partnerships with parents to help families cope with all three types of changes. Teachers can facilitate children's emotional expressions, build understanding through the use of dramatic play, provide a stable routine, monitor post-traumatic play, and discuss events that affect individual children, the entire class, or the community. Teachers can also serve as a resource to families by providing books for parents and children, and building a referal file of agencies and helping professionals.     

地震灾区儿童心理创伤及其干预策略

5·12大地震,使灾区儿童在重建家园的同时,亦需重视心灵重建。本文介绍了创伤、心理创伤与创伤后应激障碍的概念,创伤后应激障碍的测量及各种干预策略,以期为灾区儿童健康心理素质的重塑提供方法上的指导。     

120例口腔颌面部外伤的临床护理体会

通过临床护理120例口腔颌面部外伤病人，针对不同的情况作出相应的处理，并总结临床护理体会。