New PTSD program answers need for comprehensive treatment

July 02, 2009

Jul 02, 2009 (DEFENSE DEPARTMENT DOCUMENTS AND PUBLICATIONS/ContentWorks via COMTEX) — 7/1/2009 – LANDSTUHL REGIONAL MEDICAL CENTER, Germany (AFNS) — Symptoms of combat stress and post-traumatic stress disorder for wounded warriors include continual nightmares, avoidance behaviors, denial, grief, anger and fear.

Some servicemembers battling these and other symptoms, can be treated successfully as an outpatient while assuming their normal duties, but for others; however, returning to work and becoming their old selves again were challenges recognized by several mental health professionals across the European theater.

“We were looking at how we can best meet the needs of our clientele, and we were identifying that a lot of the Soldiers needed more than once a week outpatient, individual therapy and probably needed more than once or twice a week group therapy,” said Joseph Pehm, the chief of Medical Social Work at Landstuhl Regional Medical Center.

The solution came in the creation of an intensive eight-week therapeutic Post-Traumatic Stress Disorder Day Treatment Program called “evolution” that began in March 2009 at LRMC. During the eight-hour days, patients enrolled in the program participate in multiple disciplines and interests, including art therapy, yoga and meditation classes, substance abuse groups, anger and grief management, tobacco cessation, pain management and multiple PTSD evidence-based practice protocols.

“I am a great believer in the kitchen sink, meaning I throw everything, including the kitchen sink, and something will stick,” said Dr. Daphne Brown, chief of the Division of Behavioral Health at LRMC. “And so we’ve come with all the evidence-based treatment for PTSD that we know about. We’ve taken everything that we can think of that will be of use in redirecting symptoms for these folks and put it into an eight-week program.”

Doctor Brown, Mr. Pehm and Sharon Stewart, a Red Cross volunteer who holds a Ph.D. in psychology, said the program is designed from research into the effects of traumatic experience and mirrors successful PTSD programs at Walter Reed Army Medical Center and the Department of Veterans Affairs, as well as programs run by psychologists in the U.S.

“We are building on the groundbreaking work that some of our peers and colleagues have done and just expanding it out,” Doctor Brown said.

During treatment, patients begin the day with a community meeting where they discuss how well they feel and any additional issues or concerns since their last meeting. The remainder of the day depends on the curriculum scheduled for that week.

The first few weeks focus on learning basic coping skills such as how to reduce anxiety and fight fear, as well as yoga and meditation for relaxation. Eye Movement Desensitization and Reprocessing, an evidence-based practice for treating PTSD, is also conducted during the early phases of the treatment program.

“The concept behind EMDR is that, essentially, memories become fixed in one part of our brain and they maintain their power and control over our emotions as long as they are fixed there,” Doctor Brown said. “And if we can activate a different part of the brain while we’re experiencing that memory, we can help to remove some of that emotional valence from it. So we use physiological maneuvers to activate both sides of the brain.”

The goal at the beginning of the PTSD program is to provide patients with a number of tools they can use to help them calm down when feeling overwhelmed, especially before more intense therapy begins in the latter weeks. Cognitive processing therapy is used throughout the program. EMDR and prolonged exposure therapy are also available on an individual basis at the Soldier’s request. All three techniques are research-based treatments.

When life-changing events occur, Doctor Brown said perceptions about the world may change. For example, before Soldiers experience combat trauma they may think the world is safe. Following combat, a Soldier’s perceptions may change; a majority of the world may now seem unsafe. Cognitive processing therapy attempts to readdress experiences and reshift a Soldier’s perceptions.

Prolonged exposure therapy is behaviorally based and addresses a Soldier’s fears, which are seen as reflex reactions to a stimulus. To decondition the reactions, a patient is continually exposed to the stimulus by retelling the story repeatedly, minus the negative outcome. Doctor Brown compared it to riding a roller coaster over and over again to overcome a fear of roller coasters.

“So they’re getting EMDR, they’re getting cognitive processing therapy, they’re getting individual therapy, they’re getting group therapy, they’re getting education, anger management, self-esteem, relationship issues, grief and loss, yoga, meditation exercise, skill building — a little bit of everything across the board,” Doctor Brown said. “Not everything’s going to resonate with everyone who comes through, but something’s going to resonate for everyone who comes through.”

In addition to the overall core curriculum, Doctor Brown and her staff have programs such as pain management, relationship enrichment and tobacco cessation to help individualize treatment.

“The core of the group and individual education is consistent for everyone,” Doctor Brown said. “But we recognize that every patient is different, and we have to tailor make it to give an individualized treatment plan. We don’t keep people in pain management if they’re not in pain. We don’t give them tobacco cessation if they’re not smoking. So we do try and tailor as much of it as we can.”

Spirituality, relationship enrichment and gender-specific issues are also areas of focus.

“The program is holistic,” Mr. Pehm said. “It looks at people from different spheres, not just the medical model because everything is impacted when someone has combat stress or PTSD; not just the individual Soldier, but everybody who comes in contact with them.”

The intensity, length and “kitchen sink” qualities are not the only aspects that make this program unique, Doctor Brown said. It is a joint military and civilian effort accomplished entirely by volunteers. The staff is as diverse as the therapy options, and includes chaplains, social workers, Red Cross volunteers, psychiatrists, a nurse practitioner, enlisted psychiatric technicians, and graduate students. Brown said having a sundry of personnel keeps the program fresh and the staff excited.

“The patients get perspectives from people from a number of different backgrounds,” Doctor Brown said.

Thus far, the staff outnumbers the program’s participants.

“By design we started out small, and we were able to establish a really good working relationship with the local Warrior Transition Unit people … It’s been a wonderful working relationship with them,” Mr. Pehm said.

Evolution is currently on it second eight-week course, with five patients enrolled. The first class had four. The goal is to keep the class size small in order to benefit from the program’s intensity. Thinking small also helps keep the impact large by successfully returning Soldiers to their units, while also expanding access outside the WTUs. However, Mr. Pehm said they would like to expand the program to include patients from throughout the European Command.

“Ideally, we’d like to max it at about 10 because it is so intensive,” Doctor Brown said. “These are folks we hope to remediate and return to the Army to be functional members again. Also, if they go back to their communities and their providers or spouses see the changes that have come about, that will increase the willingness or desire of more people to be here.”

Though few have completed this young program, signs of success have already started to surface.

“With the last group, the shift from ‘I have to be here’ to ‘I’m so glad I came’ was really phenomenal,” Mr. Pehm said.

“One of them said that he didn’t think he was getting anything out of the program,” Doctor Brown said. “It was about week six until he saw himself react differently to a situation that came up, and watched himself do it differently using skills that he didn’t know he learned. He went, ‘Wow, maybe I am getting something out of this.’”

It is too early, and the numbers are too small, to generalize the early trends, but self-completed PTSD checklists showed a significant decrease in reported symptoms for three of the four patients in the first cohort. Additionally, anxiety and depression symptom measures decreased.

“The whole idea is that we know all the changes aren’t going to take place here,” Doctor Brown said. “But we hope we give them enough learning to send them in a different direction. My hope is that we can build a program to provide valid, effective treatment to folks who have put themselves in harm’s way at the request of their country, and help them live happier and better lives.”

Filed under: Other Mental Health, trauma , Military, PTSD, Symptoms, Treatment

Professor helps train mental-health workers in Iraq

July 04, 2009

Victims of traumatic events sometimes get so hung up thinking about what happened to them that they can’t let go of their torment.

Rigid, “black-and-white kinds of thoughts” play over and over in their minds and keep them from moving forward in life, says University of Richmond researcher Kristen P. Lindgren.

“Those kinds of thoughts can keep people stuck in their lives,” she said.

A licensed clinical psychologist, Lindgren has studied a technique called cognitive processing therapy that helps people escape those thoughts.

She worked at the Department of Veterans Affairs hospital in Seattle with veterans of wars from Vietnam to Iraq. They suffer from post-traumatic stress disorder and depression, and Lindgren says the therapy was so helpful that the VA plans to use it as a treatment model nationally.

And now, it might also help victims of torture in Iraq.

Lindgren, an assistant professor of psychology at UR for the past year, recently spent eight intensive days training mental-health workers in the Kurdish region of Iraq.

Their goal is to help victims of the violence waged against the people of Kurdistan during the 1980s and 1990s.

It was the most attentive class she has ever had, Lindgren said. The workers, primarily physician assistants at community clinics who have limited opportunities for advanced training, were eager to learn new techniques.

“I’ve never had a group of students who were so focused and literally writing down every word,” she said.

Lindgren describes herself as “very much the junior partner” on the pilot project organized by Johns Hopkins University. The team included Johns Hopkins researchers Paul Bolton and Judith K. Bass, as well as Debra Kaysen, Lindgren’s mentor when she did postdoctoral studies at the University of Washington.

Lindgren hopes that if the mental-health workers find that the technique helps their patients, she can return to Iraq within the year to expand the training.

The therapy technique encourages people to identify thoughts that are stuck in their minds and to challenge that way of thinking, she said.

The patients learn to come up with thoughts that are more flexible but believable.

“It’s not about thinking with rosecolored glasses,” she said.

Lindgren is optimistic the treatment will help the Kurds. In Iraq, the technique had to be adapted to account for cultural differences. Self-esteem, for example, didn’t translate very well. “The closest we could get was respect,” Lindgren said.

They also had to account for illiteracy because the technique involves written homework for patients.

If the therapy with those adaptations proves successful in Iraq, that should help answer lingering questions about its worth back home, she said. Because the technique is research-based and developed in university settings, some still question how well the therapy works in the real world, she said.

“If this is not the real world, I don’t know what is in terms of getting outside the ivory tower.”

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Contact Karin Kapsidelis at (804) 649-6119 or kkapsidelis@timesdispatch.com. To see more of the Richmond Times-Dispatch, or to subscribe to the newspaper, go to http://www.timesdispatch.com. Copyright (c) 2009, Richmond Times-Dispatch, Va. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

Filed under: Other Mental Health, trauma , cognitive behavioural therapy, Iraq, mental health, PTSD, trauma

Where Fear Is Stored In The Brain

ScienceDaily (July 8, 2009) — Fear is a powerful emotion, and neuroscientists have for the first time located the neurons responsible for fear conditioning in the mammalian brain. Fear conditioning is a form of Pavlovian, or associative, learning and is considered to be a model system for understanding human phobias, post-traumatic stress disorder and other anxiety disorders.

Using an imaging technique that enabled them to trace the process of neural activation in the brains of rats, University of Washington researchers have pinpointed the basolateral nucleus in the region of the brain called the of amygdala as the place where fear conditioning is encoded.

Neuroscientists previously suspected that both the amygdala and another brain region, the dorsal hippocampus, were where cues get associated when fear memories are formed. But the new work indicates that the role of the hippocampus is to process and transmit information about conditioned stimuli to the amygdala, said Ilene Bernstein, corresponding author of the new study and a UW professor of psychology.

The study is being published on July 6, in PLoS One, a journal of the Public Library of Science.

Associative conditioning is a basic form of learning across the animal kingdom and is regularly used in studying how brain circuits can change as a result of experience. In earlier research, UW neuroscientists looked at taste aversion, another associative learning behavior, and found that neurons critical to how people and animals learn from experience are located in the amygdala.

The new work was designed to look for where information about conditioned and unconditioned stimuli converges in the brain as fear memories are formed. The researchers used four groups of rats and placed individual rodents inside of a chamber for 30 minutes. Three of the groups had never seen the chamber before.

When control rats were placed in the chamber, they explored it, became less active and some fell asleep. A delayed shock group also explored the chamber, became less active and after 26 minutes received an electric shock through the floor of the chamber. The third group was acclimated to the chamber by a series of 10 prior visits and then went through the same procedure as the delayed shock rats. The final group was shocked immediately upon being introduced inside the chamber.

The following day the rats were individually returned to the chamber and the researchers observed them for freezing behavior. Freezing, or not moving, is the most common behavioral measure of fear in rodents. The only rats that exhibited robust freezing were those that received the delayed shock in a chamber which was unfamiliar to them.

“We didn’t know if we could delay the shock for 26 minutes and get a fear reaction after just one trial. I thought it would be impossible to do this with fear conditioning,” said Bernstein. “This allowed us to ask where information converged in the brain.”

To do this, the researchers repeated the procedure, but then killed the rats. They then took slices of the brains and used Arc catfish, an imaging technique, which allowed them to follow the pattern of neural activation in the animals.

Only the delayed shock group displayed evidence of converging activation from the conditioned stimulus (the chamber) and the unconditioned stimulus (the shock). The experiment showed that animals can acquire a long-term fear when a novel context is paired with a shock 26 minutes later, but not when a familiar context is matched with a shock.

“Fear learning and taste aversion learning are both examples of associative learning in which two experiences occur together. Often they are learned very rapidly because they are critical to survival, such as avoiding dangerous places or toxic foods,” said Bernstein.

“People have phobias that often are set off by cues from something bad that happened to them, such as being scared by a snake or being in a dark alley. So they develop an anxiety disorder,” she said.

“By understanding the process of fear conditioning we might learn how to treat anxiety by making the conditioning weaker or to go away. It is also a tool for learning about these brain cells and the underlying mechanism of fear conditioning.”

Co-authors of the study, all at the UW, are Sabiha Barot, who just completed her doctoral studies; Ain Chung, a doctoral student; and Jeansok Kim, an associate professor of psychology.

Journal reference:

1. Sabiha K. Barot, Ain Chung, Jeansok J. Kim, Ilene L. Bernstein. Functional Imaging of Stimulus Convergence in Amygdalar Neurons during Pavlovian Fear Conditioning. PLoS ONE, 2009; 4 (7): e6156 DOI: 10.1371/journal.pone.0006156

Adapted from materials provided by University of Washington.

Filed under: Other Mental Health, trauma , amygdala, Brain, emotion, fear, limbic system

Writing After Terrorist Attack Has Positive Medium Term Effects

ScienceDaily (Mar. 18, 2009) — A new study has analysed the expressive writing of terrorism victims to analyse their psychosocial processes following the terrorist attacks in New York and Madrid. Despite the cultural differences of the people involved, the results show that the feelings and thoughts experienced following this type of traumatic event are universal.

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The people who experienced the September 11 terrorist attacks in New York and the March 11 2004 train attacks in Madrid needed to be able to express their feelings, thoughts and emotions. The aim of the study published in the International Journal of Clinical and Health Psychology was to compare how people from both nations reacted to such violent acts through expressive writing.

“After the Madrid attacks we were unfortunate enough to be able to ask people who had lived through this experience, either directly or indirectly, what they thought and how they felt following the terrorist attacks,” Itziar Fernández, the study’s author and a professor at the National University of Distance Education (UNED), told SINC.

“Following the attacks, there was a great fear that people would be affected by post-traumatic stress disorder. In the end, however, although they were in shock, people were able to deal with had happened and adapt to the situation,” says the researcher.

Based on the comments recorded by 325 people living in the United States and 333 in Spain, the researcher and her team looked into how both groups put their feelings and thoughts into words.

A linguistic analysis of the texts, carried out by using the Linguistic Inquiry and Word Count (LIWC) programme, showed that the victims who benefited most from recording the traumatic events were those who use more cognitive words (introspective and causal ones), use a high number of positive emotional words, and changed the use of pronouns and references to themselves.

The results show that feelings about the events (anger, impotence, fear) were similar between the two countries during a period between the third and eighth weeks after the attacks, both inclusive.

However, the data collected does show a significant difference. “While the Americans had a more individualistic view of events, the Spaniards talked more about social processes.” For example, there were not the same enormous public demonstrations following September 11 as there were following the attacks in Spain.

The study concludes that writing about a traumatic event can have positive effects over the medium term (from two months afterwards). Although the participants’ symptoms worsened over the short term (relating an event makes people relive it, and worsens their negative emotions), they felt better and paid less visits to the doctor over the medium and long term.

The effect was the opposite in the case of excessive consumption of media coverage of such an event, however. Data about news consumption throughout the population following the attacks showed that, over the long term (two months after the Madrid attacks), people who were repetitively viewing images of the attacks felt worse than those who rarely watched the television.

Tackling post-traumatic stress

The benefits of talking about traumatic events forms part of cultural belief systems. Therapists always seek to make people reconstruct a narrative and a testimony about what has happened. They are asked to talk about their lives before the traumatic event, and to reconstruct images and their sensations and feelings in order to give them meaning (why and how the event took place).

The first studies of post-traumatic stress disorder (PTSD) were conducted following the Vietnam War (1958-1975). It is a psychological illness classified within the group of anxiety disorders, which arises as a result of exposure to a traumatic event involving physical harm.

PTSD, which is diagnosed two months after a stressful life event, is a severe emotional reaction. It is characterised by symptoms such as loss of appetite, sadness and disturbed sleep, and lasts for more than two months after the event.

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Journal reference:

1. Itziar Fernández, Darío Páez y James W. Pennebaker. Comparison of expressive writing after the terrorist attacks of September 11th and March 11th. International Journal of Clinical and Health Psychology, Vol. 9, Nº 1, pp.89-103, 2009

Adapted from materials provided by Plataforma SINC, via AlphaGalileo.

Filed under: Other Mental Health, trauma , narratives, PTSD, Terrorism, trauma, writing

How Brain Remembers Single Events

ScienceDaily (Mar. 18, 2009) — Single events account for many of our most vivid memories – a marriage proposal, a wedding toast, a baby’s birth. Until a recent UC Irvine discovery, however, scientists knew little about what happens inside the brain that allows you to remember such events.

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In a study with rats, neuroscientist John Guzowski and colleagues found that a single brief experience was as effective at activating neurons and genes associated with memory as more repetitive activities.

Knowing how the brain remembers one-time events can help scientists design better therapies for diseases such as Alzheimer’s in which the ability to form such memories is impaired.

“Most experiences in life are encounters defined by places, people, things and times. They are specific, and they happen once,” says Guzowski, UCI neurobiology and behavior assistant professor. “This type of memory is what makes each person unique.”

It is well known that a brain structure called the hippocampus is critical to memory and learning, but many questions exist about how brief experiences trigger the physical changes necessary for memory. In his study, Guzowski set out to learn how neurons in the hippocampus react to single events – particularly in the CA3 region, which is thought to be most critical for single-event memory.

Guzowski and postdoctoral researcher Teiko Miyashita put groups of rats on a rectangular track. Some rats took one lap; others did multiple laps. Inspecting the brains of rats that took one lap, they found that 10-15 percent of neurons in the CA3 region activated. The same percentage of CA3 neurons fired in the brains of rats that walked multiple laps.

Though previous computer simulations predicted that brief and repetitive experiences would activate CA3 neurons similarly, this is the first study to actually show that is the case.

Miyashita and Guzowski arrived at the percentages by examining the activation of a gene called “Arc” within hippocampal neurons. Past studies have shown that turning on Arc is required to convert experience into long-term memory.

“Together with our past findings, this study provides key insight into how fleeting experiences can be captured by the brain to form lasting memories,” Guzowski says.

Arc activation is disrupted in mouse models of mental retardation and Alzheimer’s disease.

“Our findings on Arc regulation in CA3 neurons should prove useful to researchers testing new therapies for Alzheimer’s disease,” Guzowski says. “If you understand how the hippocampus works, it is much easier to understand and potentially treat diseases that affect memory.”

UCI researchers Stepan Kubik, Nahideh Haghighi and Oswald Steward also worked on this study, published in The Journal of Neuroscience. The National Institutes of Health supported this research.

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Adapted from materials provided by University of California – Irvine.

Filed under: Other Mental Health, trauma , Brain, memories, trauma

New Strategy To Weaken Traumatic Memories

ScienceDaily (Mar. 17, 2009) — Imagine that you have been in combat and that you have watched your closest friend die in front of you.  The memory of that event may stay with you, troubling you for the rest of your life.  Posttraumatic stress disorder (PTSD) is among the most common and disabling psychiatric casualties of combat and other extremely stressful situations. People suffering from PTSD often suffer from vivid intrusive memories of their traumas.

Current medications are often ineffective in controlling these symptoms and so novel treatments are needed urgently.  In the February 1st issue of Biological Psychiatry, published by Elsevier, a group of basic scientists shed new light on the biology of stress effects upon memory formation.  In so doing, they suggest new approaches to the treatment of the distress related to traumatic memories.  Their work is based on the study of a drug, RU38486, that blocks the effects of the stress hormone cortisol.

Using an animal model of traumatic memory, investigators at the Mount Sinai School of Medicine show that treatment with RU38486 selectively reduces stress-related memories, leaving other memories unchanged.  They also found that the effectiveness of the treatment is a function of the intensity of the initial “trauma.”  Although this particular study was performed in rats, their findings help to set the stage for trials in humans.

Cristina Alberini, Ph.D., corresponding author on this article, explains how their findings will translate into developing clinical parameters: “First, the drug should be administered shortly before or after recalling the memory of the traumatic event. Second, one or two treatments are sufficient to maximally disrupt the memory. Third, the effect is long lasting and selective for the recalled memory. Finally, the time elapsing between the traumatic experience and the treatment seems to be an important parameter for obtaining the most efficacious treatment.”

Dr. John Krystal, Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, discusses the significance of the findings: “When treating PTSD, clinicians often attempt to reduce the negative distortions of traumatic memories so that people can better cope with their traumas.  The new study by Taubenfeld and colleagues suggests that blocking the effects of cortisol may be one strategy to promote the ‘normalization’ of traumatic memories.”  Dr. Alberini agrees, noting that “these results suggest that carefully designed combinations of behavioral and pharmacological therapies may represent novel, effective treatments for PTSD or other anxiety disorders.”

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Adapted from materials provided by Elsevier, via AlphaGalileo

Filed under: Other Mental Health, trauma , memories, PTSD, trauma

Tiny Brain Region Key To Fear Of Rivals And Predators

ScienceDaily (Mar. 15, 2009) — Mice lose their fear of territorial rivals when a tiny piece of their brain is neutralized, a new study reports.

The study adds to evidence that primal fear responses do not depend on the amygdala – long a favored region of fear researchers – but on an obscure corner of the primeval brain.

A group of neuroscientists led by Larry Swanson of the University of Southern California studied the brain activity of rats and mice exposed to cats, or to rival rodents defending their territory.

Both experiences activated neurons in the dorsal premammillary nucleus, part of an ancient brain region called the hypothalamus.

Swanson’s group then made tiny lesions in the same area. Those rodents behaved far differently.

“These animals are not afraid of a predator,” Swanson said. “It’s almost like they go up and shake hands with a predator.”

Lost fear of cats in rodents with such lesions has been observed before. More important for studies of social interaction, the study replicated the finding for male rats that wandered into another male’s territory.

Instead of adopting the usual passive pose, the intruder frequently stood upright and boxed with the resident male, avoided exposing his neck and back, and came back for more even when losing.

“It’s amazing that these lesions appear to abolish innate fear responses,” said Swanson, who added: “The same basic circuitry is found in primates and people that we find in rats and mice.”

The study was slated for online publication the week of March 9 in Proceedings of the National Academy of Sciences.

Swanson predicted that his group’s findings would shift some research away from the amygdala, a major target of fear studies for the past 30 years.

“This is a new perspective on what part of the brain controls fear,” he said.

He explained that most amygdala studies have focused on a different type of fear, which might more accurately be called caution or risk aversion.

In those studies, animals receive an electric shock to their feet. When placed in the same environment a few days later, they display caution and increased activity of the amygdala.

But the emotion experienced in that case may differ from the response to a physical attack.

“We’re not just dealing with one system that controls all fear,” Swanson said.

Swanson and collaborators have been studying the role of the hypothalamus in the fear response since 1992.

Because of its role in basic survival functions such as feeding, reproduction and the sleep-wake cycle, the hypothalamus seems a plausible candidate for fear studies.

Yet, said Swanson, “nobody’s paid any attention to it.”

The PNAS study is the most recent of several by Swanson on fear and the hypothalamus. The few other researchers in the area include Newton Canteras of the University of Sao Paulo in Brazil, who collaborated with Swanson on the PNAS study, as well as Robert and Caroline Blanchard of the University of Hawaii.

The other authors on the PNAS study were Simone Motta, Marina Goto, Flavia Gouveia and Marcus Baldo, all from the University of Sao Paulo.

The Brazilian government funded the study.

Journal reference:

1. Simone C. Motta, Marina Goto, Flavia V. Gouveia, Marcus V. C. Baldo, Newton S. Canteras, and Larry W. Swanson. Dissecting the brain’s fear system reveals the hypothalamus is critical for responding in subordinate conspecific intruders. Proceedings of the National Academy of Sciences, 2009; DOI: 10.1073/pnas.0900939106

Adapted from materials provided by University of Southern California.

Filed under: Violence, trauma , amygdala, fear, hypothalamus, limbic sytem, predators

Burnout Among Police Officers: Differences In How Male, Female Police Officers Manage Stress May Accentuate Stress On The Job

ScienceDaily (Feb. 26, 2009)

When male police officers need to de-stress, they might trade war stories — but likely not with their female colleagues. But the guys don’t necessarily have it easy. They are often discouraged from showing emotion when dealing with stress and are expected to uphold the overtly masculine idea of what it means to be a police officer.

Research by a Kansas State University professor has found that the different ways in which men and women in the police force deal with stress may actually cause them more stress. Don Kurtz, an assistant professor of social work at K-State, studied the gender differences in stress and burnout among police officers.

He said it is the first of his research that has examined gender. While completing his doctorate at K-State, Kurtz said he was taking classes on gender and society and was researching police stress. He noticed that there was no research studying the intersection of these two areas.

“I had come from working in social work, where they were very accepting of men in the women-dominated field,” Kurtz said. “In policing, they tend to be suspicious of the abilities of women in the field.”

For the research published in Feminist Criminology, Kurtz looked at data from a survey of officers in the Baltimore Police Department. As a follow up to this part of the research, Kurtz also interviewed officers from three police departments. He found that male and female police officers have different sources of stress and different ways of dealing with it.

“Telling war stories is almost exclusively a male endeavor,” Kurtz said. “It’s quite often in a group social setting, and officers talk about stressful events that happened. What’s interesting is that they remove the fear and emotion that go along with it and replace it with these superhuman qualities.”

“I found that women felt excluded from war stories. If they started exaggerating the stories in the way that men did, they could be questioned. So it becomes a male-only way of managing stress.”

In the journal article, Kurtz suggests that in some ways women have a better chance to deal with violent cases because it’s more acceptable for women to be upset or vulnerable.

“For male officers to show emotion, it was career suicide,” he said.

Some of the cases that men find the most stressful, Kurtz said, were likely to be given to women.

“One thing I found interesting was that when officers discuss the most stressful things, it’s usually death of a child or the physical or sexual abuse of a child,” he said. “Women are more likely to handle these jobs because large police departments often assign women to these investigative units. However, it’s often seen as lower police work. In large departments where there area lot of juvenile delinquents and child abuse cases, there’s an idea that women are better at managing kids.”

One of the biggest differences Kurtz found was the role that family played in police officers’ stress. Whereas a family life can help male officers deal better with stress from the job, women may not have the same support in their own families.

“Women settle into the role of caretaker and come home to a second shift,” Kurtz said.

The strange hours of police work can be seen as more acceptable for men than women, he said.

“Although family conflicts can be distressful for men, the fact that a male officer is seen as the breadwinner makes it more OK for him to miss a birthday party, for example, so he can go to work.”

Kurtz also looked at how race changes the stress differences between men and women.

“We should expect a difference,” he said. “In American society, race complicates everything.”

For instance, white female officers are more likely to be sexualized, whereas black female officers are often seen as laborers. And, while black male officers report lower levels of stress than white men, they also report a higher rate of burnout.

Kurtz said he hopes his research will help police departments better understand how gender affects stress and that it will spur further academic study in this area.

The work was published in the journal Feminist Criminology in 2008.

Filed under: Other Mental Health, Violence, trauma

Making Sense Of Sentences: How We Think Before We Speak

This may be very relevant to our understanding of how we process traumtic experiences. IB

23 Feb 2009

We engage in numerous discussions throughout the day, about a variety of topics, from work assignments to the Super Bowl to what we are having for dinner that evening. We effortlessly move from conversation to conversation, probably not thinking twice about our brain’s ability to understand everything that is being said to us. How does the brain turn seemingly random sounds and letters into sentences with clear meaning? In a new report in Current Directions in Psychological Science, a journal of the Association for Psychological Science, psychologist Jos J.A. Van Berkum from the Max Planck Institute in The Netherlands describes recent experiments using brain waves to understand how we are able to make sense of sentences.

In these experiments, Van Berkum and his colleagues examined Event Related Potentials (or ERPs) as people read or heard critical sentences as part of a longer text, or placed in some other type of context. ERPs are changes in brain activity that occur when we hear a certain stimulus, such as a tone or a word. Due to their speed, ERPs are useful for detecting the incredibly fast processes involved in understanding language.

Analysis of the ERPs has consistently indicated just how quickly the brain is able to relate unfolding sentences to earlier ones. For example, Van Berkum and colleagues have shown that listeners only need a fraction of a second to determine that a word is out of place, given what the wider story is about. As soon as listeners hear an unexpected word, their brain generates a specific ERP, the N400 effect (so named because it is a negative deflection peaking around 400 milliseconds). And even more interesting, this ERP will usually occur before the word is even finished being spoken.

In addition to the words themselves, the person speaking them is a crucial component in understanding what is being said. Van Berkum also saw an N400 effect occurring very rapidly when the content of a statement being spoken did not match with the voice of the speaker (e.g. “I have a large tattoo on my back” in an upper-class accent or “I like olives” in a young child’s voice). These findings suggest that the brain very quickly classifies someone based on what their voice sounds like and also makes use of social stereotypes to interpret the meaning of what is being said. Van Berkum speculates that “the linguistic brain seems much more ‘messy’ and opportunistic than originally believed, taking any partial cue that seems to bear on interpretation into account as soon as it can.”

But how does the language brain act so fast? Recent findings suggest that, as we read or have a conversation, our brains are continuously trying to predict upcoming information. Van Berkum suggests that this anticipation is a combination of a detailed analysis about what has been said before with taking ‘quick-and-dirty’ shortcuts to figure out what, most likely, the next bit of information will be.

One important element in keeping up with a conversation is knowing what or whom speakers are actually referring to. For example, when we hear the statement, “David praised Linda because. . .,” we expect to find out more about Linda, not David. Van Berkum and colleagues showed that when listeners heard “David praised Linda because he. . .,” there was a very strong ERP effect occurring with the word “he,” of the type that is also elicited by grammatical errors. Although the pronoun is grammatically correct in this statement, the ERP occurred because the brain was just not expecting it. This suggests that the brain will sometimes ignore the rules of grammar when trying to comprehend sentences.

These findings reveal that, as we make sense of an unfolding sentence, our brains very rapidly draw upon a wide range of information, including what was stated previously and who the speaker is, in helping us understand what is being said to us. Sentence understanding is not just about diligently combining stored word meanings. The brain rapidly throws in everything it knows, and it is always looking ahead.

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Article adapted by Medical News Today from original press release.
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Current Directions in Psychological Science, a journal of the Association for Psychological Science, publishes concise reviews spanning all of scientific psychology and its applications.

Article: “Understanding Sentences in Context: What Brain Waves Can Tell Us”

Source: Barbara Isanski
Association for Psychological Science

Filed under: trauma

Religion and Support for Suicide Attacks

21 Feb 2009

In a new study in Psychological Science, a journal of the Association for Psychological Science, psychologists Jeremy Ginges and Ian Hansen from the New School for Social Research along with psychologist Ara Norenzayan from the University of British Columbia conducted a series of experiments investigating the relationship between religion and support for acts of parochial altruism, including suicide attacks. Suicide attacks are an extreme form of “parochial altruism” – they combine a parochial act (the attacker killing members from other groups) with altruism (the attacker sacrificing themselves for the group).

While the relationship between religion and popular support for suicide attacks is a topic of frequent conjecture, scientific study of the relationship is rare. The researchers found that the relationship between religion and support suicide attacks is real but is unrelated to devotion to particular religious beliefs or religious belief in general. Instead, collective religious ritual appears to facilitate parochial altruism in general and support for suicide attacks in particular.

The researchers surveyed Palestinian Muslims about their attitudes towards religion, including how often they prayed and went to mosque. The researchers found that devotion to Islam, as measured by prayer frequency, was unrelated to support for suicide attacks. However, frequency of mosque attendance did predict support for suicide attacks. In a separate survey of Palestinian Muslim university students, the researchers found again that those who attended mosque more than once a day, were more likely to believe that Islam requires suicide attacks, compared to students who attended mosque less often.

A similar pattern of results was found in research carried out with other religious groups. In another experiment, the researchers conducted phone surveys with Israeli Jews living in the West Bank and Gaza and asked them either how frequently they attended synagogue or how often they prayed to God. All participants were then asked if they supported the perpetrator of a suicide attack against Palestinians. Analysis of the responses showed that 23% of those asked about synagogue attendance supported suicide attacks while only 6% of those queried about prayer frequency supported suicide attacks.

In the last experiment, the psychologists surveyed members of six religious majorities in six nations (Mexican Catholics, Indonesian Muslims, Israeli Jews, Russian Orthodox in Russia, British Protestants and Indian Hindus) to see if the relationship between attending religious services and support for acts of parochial altruism holds up across a variety of political and cultural contexts. These results also showed that support for parochial altruism was related to attendance at religious services, but unrelated to regular prayer.

This study indicates that religious devotion does not cause support for suicide attacks or other forms of parochial altruism. However, the findings suggest that regularly attending religious services may make individuals more prone to supporting acts of parochial altruism. The researchers theorize that collective religious rituals and services create a sense of community among participants and enhance positive attitudes towards parochially altruistic acts such as suicide attacks. Although, the researchers note, the greater sense of community, developed via religious services, may have many positive consequences. They observe, “Only in particular geopolitical contexts is the parochial altruism associated with such commitments translated into something like suicide attacks.”

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Article adapted by Medical News Today from original press release.
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Psychological Science is ranked among the top 10 general psychology journals for impact by the Institute for Scientific Information.

Article: “Religion and Support for Suicide Attacks”

Source: Barbara Isanski
Association for Psychological Science

Filed under: Suicide, Violence, trauma