Impact News

Responding to Violence, Suicide, Psychosis and Trauma

Facing Danger in the Helping Professions

Just received a copy and I have to say it’s a great read! Get a copy – available via Amazon or through the Open University Press – recommend it to friends and review it on Amazon.

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Filed under: Impact Training, Other Mental Health, psychosis, trauma, Violence, , , , , , , ,

Open Courses “Trauma: Post-incident Staff Support”

The Post-incident Staff Support course is now available to individual applicants through SITRA:

    SITRA – Post-incident Staff Support

Trauma: post incident support staff

24 May 2012, Southampton

14 November 2012, Southampton

Suitable for all managers and supervisors who have responsibility for supporting staff after an incident at work e.g. an assault, a suicide, an allegation.

By the end of the course participants should:

• Have a good understanding of the psychological and emotional needs of staff following an incident at work

• How to prepare themselves in anticipation of an untoward incident at work

• Be clear as their own role in the immediate aftermath of incident

Trainer: Dr Iain Bourne

Price: member £89/ non-members £129

Book now

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Open Courses “Trauma”

The “Trauma” course is now available to individual applicants through SITRA:

SITRA – Trauma

Trauma: frontline staff

16 April 2012, Southampton

23 October 2012, Southampton

For anyone who wishes to gain a clearer overview of psychological trauma, whether it is the result of a recent overwhelming event, or the effect of prolonged childhood trauma.

By the end of the course participants will:

• Understand the difference between Type 1 traumas (recent overwhelming events) and Type 2 traumas (prolonged/repeated childhood abuse)

• Understand how both types of trauma lead to different outcomes and support needs in adult life

• Be aware of the range of strategies available to assist service users, both immediately and in the long-term

Trainer: Dr Iain Bourne

Price: member £89/ non-member £129

Book now

Filed under: Impact Training, trauma, , , , ,

Validating female psychopathy subtypes: Differences in personality, antisocial and violent behavior, substance abuse, trauma, and mental health

Finally, I present this bit of research. Interesting because it unusually looks at female rather than male psychopathy.

However, you cannot understand it if you don’t not know what is understood by the terms primary and secondary psychopathy. I can only offer an abstract of the article (above) – academics can follow this up, for most practitioners it may just be food for thought.

[Journal Article]
Validating female psychopathy subtypes: Differences in personality, antisocial and violent behavior, substance abuse, trauma, and mental health.
Hicks, Brian M.; Vaidyanathan, Uma; Patrick, Christopher J.
Personality Disorders: Theory, Research, and Treatment, Vol 1(1), Jan 2010, 38-57. doi: 10.1037/a0018135
Abstract

1. Recent empirical investigations utilizing male prisoners have begun to validate clinical conceptualizations of primary and secondary psychopathy subtypes. We extended this literature by identifying similar psychopathic subtypes in female prisoners on the basis of personality structure using model-based cluster analysis. Secondary psychopaths (n = 39) were characterized by personality traits of negative emotionality and low behavioral constraint, an early onset of antisocial and criminal behavior, greater substance use and abuse, more violent behavior and institutional misconduct, and more mental health problems, including symptoms of posttraumatic stress disorder and suicide attempts. Primary psychopaths (n = 31) exhibited few distinguishing personality features but were prolific criminals especially in regards to nonviolent crime, and exhibited relatively few mental health problems despite substantial exposure to traumatic events. The results support alternative etiological pathways to antisocial and criminal behavior that are evident in personality structure as well as gender similarities and differences in the manifestation of psychopathic personalities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

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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.”

——

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, , , , ,

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.


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.


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, , , , ,

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.


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.


Adapted from materials provided by University of California – Irvine.

Filed under: Other Mental Health, 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.”


Adapted from materials provided by Elsevier, via AlphaGalileo

Filed under: Other Mental Health, trauma, , ,

Psychologist Says There Is No ‘Right’ Way To Cope With Tragedy

Article Date: 18 Feb 2009

After a collective trauma, such as Thursday’s crash of Continental Flight 3407, an entire community (or even the nation) can be exposed to the tragedy through media coverage and second-hand accounts, according to Mark Seery, Ph.D., University at Buffalo assistant professor of psychology. “Individuals potentially suffer negative effects on their mental and physical health, even if they have not ‘directly’ experienced the loss of someone they know or have not witnessed the event or its aftermath in person,” Seery says. In this type of situation, it is common for people to think that everyone exposed to the tragedy will need to talk about it, and if they do not, they are suppressing their “true” thoughts and feelings, which will only rebound later and cause them problems. This is not always the case, Seery explains. “Expressing one’s thoughts and feelings to a supportive listener can certainly be a good thing, whether it is to family and friends or to a professional therapist or counselor. However, this does not mean that it is bad or unhealthy to not want to express thoughts and feelings when given the opportunity.” Seery’s perspective results from his research of people’s responses following the terrorist attacks of 9/11. He and colleagues studied a national sample of people, most of whom did not witness the events in person or lose a loved one. They did, however, experience the events through media coverage. “We found that people who chose not to express at all or who expressed only a small amount in the immediate aftermath of the tragedy were better off over the following two years than people who expressed more. Specifically, they reported lower levels of mental and physical health symptoms.” From this research Seery concludes there is no single correct or healthy way to deal with a tragedy such as the crash of Flight 3407, which claimed 50 lives. “People are generally resilient and have a good sense of what coping strategies will work for them,” Seery says. “If they need to talk, they will talk, and friends and family can help by listening supportively. At the same time, they should not force the issue or make anyone feel like something is wrong with them if they do not want to talk about it.”

Article adapted by Medical News Today from original press release.

The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. UB’s more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities. Source: Patricia Donovan University at Buffalo

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Army suicides at record high, passing civilians

– January 29, 2009

WASHINGTON – Stressed by war and long overseas tours, U.S. soldiers killed themselves last year at the highest rate on record, the toll rising for a fourth straight year and even surpassing the suicide rate among comparable civilians. Army leaders said they were doing everything they could think of to curb the deaths and appealed for more mental health professionals to join and help out.

At least 128 soldiers committed suicide in 2008, the Army said Thursday. And the final count is likely to be even higher because 15 more suspicious deaths are still being investigated.

“Why do the numbers keep going up? We cannot tell you,” said Army Secretary Pete Geren. “We can tell you that across the Army we’re committed to doing everything we can to address the problem.”

It’s all about pressure and the military approach, said Kim Ruocco, 45, whose Marine husband was an officer and Cobra helicopter pilot who hanged himself in a California hotel room in 2005. That was one month before he was to return to Iraq a second time.

She said her husband, John, had completed 75 missions in Iraq and was struggling with anxiety and depression but felt he’d be letting others down if he sought help and couldn’t return.

“He could be any Marine because he was highly decorated, stable, the guy everyone went to for help,” Ruocco said in a telephone interview. “But the thing is … the culture of the military is to be strong no matter what and not show any weakness.”

Ruocco, of Newbury, Mass., was recently hired to be suicide support coordinator for the nonprofit Tragedy Assistance Program for Survivors. She said she feels that the military has finally started to reach out to suicide survivors and seek solutions.

“Things move slowly, but I think they’re really trying,” Ruocco said.

At the Pentagon on Thursday, Col. Elspeth Ritchie, a psychiatric consultant to the Army surgeon general, made a plea for more professionals to sign on to work for the military.

“We are hiring and we need your help,” she said.

Military leaders promised fresh prevention efforts will start next week.

The new suicide figure compares with 115 in 2007 and 102 in 2006 and is the highest since current record-keeping began in 1980. Officials expect the deaths to amount to a rate of 20.2 per 100,000 soldiers, which is higher than the civilian rate – when adjusted to reflect the Army’s younger and male-heavy demographics – for the first time in the same period of record-keeping.

Officials have said that troops are under unprecedented stress because of repeated and long tours of duty due to the simultaneous wars in Iraq and Afghanistan.

Yearly increases in suicides have been recorded since 2004, when there were 64 – only about half the number now. Officials said they found that the most common factors were soldiers suffering problems with their personal relationships, legal or financial issues and problems on the job.

But the magnitude of what the troops are facing in combat shouldn’t be forgotten, said Rep. Joe Sestak, D-Pa., a former Navy vice admiral, who noted he spoke with a mother this week whose son was preparing for his fifth combat tour.

“This is a tough battle that the individuals are in over there,” Sestak said. “It’s unremitting every day.”

Said Dr. Paul Ragan, an associate professor of psychiatry at Vanderbilt University and a former Navy psychiatrist: “Occasional or sporadic visits by military mental health workers are like a Band-Aid for a gushing wound.”

The statistics released Thursday cover soldiers who killed themselves while they were on active duty – including National Guard and Reserve troops who had been activated.

The Centers for Disease Control and Prevention said the suicide rate for U.S. society overall was about 11 per 100,000 in 2004, the latest year for which the agency has figures. But the Army says the civilian rate is more like 19.5 per 100,000 when adjusted.

An earlier report showed the Marine Corps recorded 41 possible or confirmed suicides in 2008 – about 19 per 100,000 troops.

The military’s numbers don’t include deaths after people have left the services. The Department of Veterans Affairs tracks those numbers and says there were 144 suicides among the nearly 500,000 service members who left the military from 2002-2005 after fighting in at least one of the two ongoing wars.

On the Net:

Army suicide prevention http://www.armyg1.army.mil/HR/suicide/default.asp

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Filed under: Suicide, trauma, Violence, , , ,