Intercultural attention in trauma treatment: Western trauma treatment negotiated and modified in Sudan

Western therapeutic methods have increasingly been implemented in non-Western contexts as treatment for traumatic stress reactions. There is a growing awareness of the need for such implementations to incorporate cultural specificity, and discussions are needed on the suitability of Western psychological approaches and theories in different parts of the world. The objective of this paper is to explore the intercultural applicability of trauma treatment through a case study in Sudan. We look at how Western methods are applied and potentially modified in Sudan to fit social-cultural realities – and how specific contexts affects treatments. Such data from a non-Western context is invaluable to the discussion of transcultural aspects of mental health care. This paper presents interview data, where counsellors in a trauma centre in Sudan were asked how they are implementing Western methods, and how these treatments are negotiated and potentially modified to fit the context. The interviewed counsellors emphasise the contextual factors influencing the treatment and the need to modify therapeutic methods to the specific cultural setting. Three themes are discussed: stigma towards mental health and sexual assaults; the negotiation of treatment alongside traditional healers; and the modification of treatments to the cultural context. The findings suggest that although Western methods can be useful in non-Western settings, these need to be carefully modified to the context as well as to each individual client. The study offers valuable insights into such modifications.     

Trauma appraisals,emotion regulation difficulties,and self-compassion predict posttraumatic stress symptoms following childhood abuse

Experiencing traumatic events and abuse is unfortunately common in general, non-clinical samples. Recent research indicates that the ways in which individuals interpret traumatic experiences, as well as the ways that they manage challenging emotions in general, may statistically predict post-traumatic stress disorder (PTSD) symptoms to a greater extent than does trauma itself. Negative trauma appraisals, generalized emotion regulation (ER) difficulties, and low levels of self-compassion have each been shown to influence the connection between trauma exposure and subsequent PTSD symptoms. However, little is known regarding how these processes interact, or their relative contributions to mental health after trauma. The current study analyzed data from 466 university students who completed self-report measures of childhood abuse, PTSD symptoms, trauma appraisals, ER difficulties, and self-compassion. Childhood abuse exposure and PTSD symptoms were positively associated with negative trauma appraisals and ER difficulties, and negatively associated with self-compassion. Self-compassion was inversely associated with negative trauma appraisals and ER difficulties. Multiple mediation analyses demonstrated that negative trauma appraisals, ER difficulties, and levels of self-compassion fully explained the link between abuse exposure and PTSD symptoms via several specific pathways. These findings suggest that researchers, clinicians, and abuse survivors can benefit from addressing these interconnected domains during treatment and recovery processes.     

Childhood adversity and behavioral health outcomes for youth: An investigation using state administrative data

This study aimed to measure the relative contribution of adverse experiences to adolescent behavioral health problems using administrative data. Specifically, we sought to understand the predictive value of adverse experiences on the presence of mental health and substance abuse problems for youth receiving publicly funded social and health services. Medicaid claims and other service records were analyzed for 125,123 youth age 12–17 and their biological parents. Measures from administrative records reflected presence of parental domestic violence, mental illness, substance abuse, criminal justice involvement, child abuse and/or neglect, homelessness, and death of a biological parent. Mental health and substance abuse status of adolescents were analyzed as functions of adverse experiences and other youth characteristics using logistic regression. In multivariate analyses, all predictors except parental domestic violence were statistically significant for substance abuse; parental death, parental mental illness, child abuse or neglect and homelessness were statistically significant for mental illness. Odds ratios for child abuse/neglect were particularly high in both models. The ability to identify risks during childhood using administrative data suggests the potential to target prevention and early intervention efforts for children with specific family risk factors who are at increased risk for developing behavioral health problems during adolescence. This study illustrates the utility of administrative data in understanding adverse experiences on children and the advantages and disadvantages of this approach.     

我国少年艺术体操运动员运动损伤的训练学致因研究

采用文献资料法、调查法、比较法、数理统计法等方法,从训练学角度对我国少年艺术体操选手运动损伤的训练学致因进行了调查分析。依据少年选手的生理发育特点,从训练学角度提出合理的训练学建议,为少年艺体教练员的训练提供了科学的依据。     

Body mass index and anxiety/depression as mediators of the effects of child sexual and physical abuse on physical health disorders in women

The relation between childhood sexual abuse (CSA) and physical health disorders in adulthood, and what factors may serve as mediators, remains poorly understood. Using data from the 2007 Adult Psychiatric Morbidity Survey (N = 3,486), we tested whether CSA was associated with physical health disorders in adult women and if mediated effects via body mass index (BMI), anxiety/depression, alcohol dependence, and smoking were present. Compared to women with no CSA, women who had experienced CSA involving intercourse had more than twice the odds of being obese, more than 3 times the odds of experiencing mental health disorders, more than 4 times the odds of being alcohol dependent, more than 5 times the odds of being drug dependent, and more than 6 times the odds of attempting suicide. Those experiencing both CSA and child physical abuse (CPA) were on average over 11 kg heavier than those with neither CSA nor CPA. After controlling for demographics, CPA, and childhood bullying, CSA was associated with the majority of physical health disorders studied (typically 50–100% increases in odds). Evidence was found consistent with mediation by BMI (typically accounting for 5–20% increases in odds) and anxiety/depression (typically accounting for 8–40% increases in odds), in a dose-response manner, for the majority of physical health disorders. Bidirectional relations among these mediators and physical health disorders, and residual confounding, may have led to overestimation of mediation through BMI and anxiety/depression and underestimation of mediation through alcohol/smoking. Relations between both CPA and childhood bullying and physical health disorders in adulthood were also found. Longitudinal studies employing more sensitive measures of potential mediators are now required.     

Does war contribute to family violence against children? Findings from a two-generational multi-informant study in Northern Uganda

After 20 years of civil war in Northern Uganda, the continuity of violence within the family constitutes a major challenge to children's healthy development in the post-conflict era. Previous exposure to trauma and ongoing psychopathology in guardians potentially contribute to parental perpetration against children and dysfunctional interactions in the child's family ecology that increase children's risk of maltreatment. In order to investigate distal and proximal risk factors of child victimization, we first aimed to identify factors leading to more self-reported perpetration in guardians. Second, we examined factors in the child's family environment that promote child-reported experiences of maltreatment. Using a two-generational design we interviewed 368 children, 365 female guardians, and 304 male guardians from seven war-affected rural communities in Northern Uganda on the basis of standardized questionnaires. We found that the strongest predictors of self-reported aggressive parenting behaviors toward the child were guardians’ own experiences of childhood maltreatment, followed by female guardians’ victimization experiences in their intimate relationship and male guardians’ posttrautmatic stress disorder (PTSD) symptoms and alcohol-related problems. Regarding children's self-report of victimization in the family, proximal factors including violence between adults in the household and male guardians’ PTSD symptom severity level predicted higher levels of maltreatment. Distal variables such as female guardians’ history of childhood victimization and female guardians’ exposure to traumatic war events also increased children's report of maltreatment. The current findings suggest that in the context of organized violence, an intergenerational cycle of violence persists that is exacerbated by female guardians’ re-victimization experiences and male guardians’ psychopathological symptoms.     

Relational trauma in the context of intimate partner violence

The relational model of trauma (Scheeringa & Zeanah, 2001) proposes that infants’ trauma symptoms may be influenced by their mothers' trauma symptoms and disruptions in caregiving behavior, although the mechanisms by which this occurs are less well understood. In this research, we examined the direct and indirect effects of a traumatic event (maternal intimate partner violence [IPV]), maternal trauma symptoms, and impaired (harsh and neglectful) parenting on infant trauma symptoms in a sample of mother–infant dyads (N = 182) using structural equation modeling. Mothers completed questionnaires on IPV experienced during pregnancy and the child's first year of life, their past-month trauma symptoms, their child's past-month trauma symptoms, and their parenting behaviors. Results indicated that the effects of prenatal IPV on infant trauma symptoms were partially mediated by maternal trauma symptoms, and the relationship between maternal and infant trauma symptoms was fully mediated by neglectful parenting. Postnatal IPV did not affect maternal or infant trauma symptoms. Findings support the application of the relational model to IPV-exposed mother–infant dyads, with regard to IPV experienced during pregnancy, and help identify potential foci of intervention for professionals working with mothers and children.     

A Traumatic Reading of Twentieth-Century Rhetorical Theory: The Belgian Holocaust,Malines, Perelman,and de Man

In this essay, I seek to read the rhetorical theories set forth by Belgians Chaïm Perelman and Paul de Man as responses to the Holocaust. To accomplish this aspiration, I draw from Dominick LaCapra's framework for the analysis of trauma and its expression in historical and theoretical texts. Reading the rhetorical theories of Perelman and de Man, two of the most prominent of the twentieth century, through a lens of trauma theory allows critics to see them as post-war efforts to deal with the implications of the absence of meaning, the murder and loss of 25,257 Belgian Jews, Fascism, genocide, and de Man's collaboration with the Nazis. I argue that Perelman's rhetoric theory better “works-through” the Belgian Holocaust than the one offered by de Man because it offers a vision of reason that can yield justice and places collaborators in the “grey zone” of totalitarian societies and logical positivism, thereby offering de Man partial absolution for his endorsement of the German occupation and anti-Semitism. De Man's rhetorical theory appears to act out the Belgian Holocaust, for it rehearses the act of deconstruction, does not name its traumatic exigence, lacks the theoretical resources to deal with the material past, fails to offer better choices for the present, or provide a vision of the future. Reading rhetorical theories as responses to the exigences of trauma calls for a reconsideration of the contexts and motives driving the creation of the major rhetorical theories of the twentieth century, including those of Heidegger and Grassi.     

A Rhetoric of Traumatic Nationalism in the Ground Zero Mosque Controversy

In the summer of 2010, a national controversy erupted suddenly as a majority of Americans protested the building of an Islamic community center near Ground Zero. In this essay, I suggest the so-called “Ground Zero mosque” controversy makes visible the emergence of a rhetoric of traumatic nationalism that articulates suffering to citizenship and reproduces national crisis through a motif of consecration whose upshot is a conservative, bipartisan moralism. An anti-political discourse of victimization masquerading as a memory discourse of righteous sacrifice, traumatic nationalism serves as an alibi that excuses the United States from answering responsibly for the war on terror and prevents critical examination of the state of the union.