Traumatology

The purpose of this study was to investigate the New Orleans Police Department's (NOPD) responses to domestic violence both pre— and post—Hurricane Katrina. This study employed a secondary analysis of data collected by the NOPD in New Orleans, Louisiana, from 2002 through 2006. Analysis indicated that the NOPD actively responded to domestic violence calls following Hurricane Katrina and that domestic violence did not get relegated to secondary status as a consequence of rising demand for police intervention in the city following the crisis precipitated by the hurricane. This article concludes with a discussion of the NOPD's response to the community need for more intensive policing following the storm, particularly to the increase in domestic violence calls, and of the rate of domestic violence occurring in New Orleans following the hurricane.

This article describes an investigation into the relationship between exposure, avoidant coping, and posttraumatic stress disorder (PTSD) in Hurricane Katrina evacuees. Specifically, this study examines the unique contribution of the dose of exposure to variance in PTSD and provides a mediational analysis to deter mine the degree to which avoidant coping affects the relationship between exposure and PTSD. Findings reveal that the dose of exposure is a strong predictor of threshold-level PTSD at 1 year postdisaster and identifies avoidant coping strategies as a partial mediator between exposure and the development of PTSD. Identification of avoidant coping as a significant factor in the causal pathway between exposure and PTSD provides a clearly definable and specific target for clinical intervention.

This article has been retracted due to the republishing of this article in the December 2009 issue of Traumatology, 15(4). The republishing is due to the necessity of including this article as a part of a Special Issue on “History, Memory and Trauma” in 15(4), for which this article was originally picked by Special Issue Guest Editor, Dr. Joseph Gabriel. Please find the republished article now in Traumatology, 15(4) 35–43. DOI: 10.1177/1534765609359729.

Fifty female veterans of the wars in Iraq and Afghanistan completed an Internet survey related to their mental health needs, service utilization, and barriers to seeking mental health care within the Veterans Administration (VA) system. Veterans completed several self-report measures including the PTSD Checklist—Military, Center for Epidemiologic Scales—Depression, and Hopkins Symptom Checklist—21. The most frequently reported concerns for which participants indicated they needed counseling were depression, relationship issues, anxiety, and anger management. Although 78% of respondents reported that they felt they needed treatment in the past year, 42% of these individuals indicated that they did not seek counseling. Two commonly reported barriers to seeking mental health services in the VA were long waiting periods for appointments and prior bad experiences. Mental health concerns and symptoms of returning female veterans indicate the need for treatment, but a significant gap remains in the self-reported need for assistance and seeking of services.

Victims of traumatic experiences such as rape often report a variety of symptoms in the acute aftermath of trauma. Reactions to trauma may take the shape of acute stress disorder (ASD), which may later develop into posttraumatic stress disorder, or they may be symptoms of more general distress. The purpose of the present cross-sectional study was to test the hypothesis that symptoms of ASD and general stress, though correlated, represent two independent ways of reacting to trauma. Acute reactions to trauma were examined in a population of 150 female victims of sexual assault. Respondents were interviewed about demographic data and peritraumatic factors and filled out self-administered questionnaires concerning pretraumatic and posttraumatic factors including two dissociative items, ASD symptoms measured by the Acute Stress Disorder Scale and symptoms of general distress measured by a modified version of the Trauma Symptom Checklist. Two separate regression analyses were carried out to examine whether ASD and general distress are mediated by the same variables in the aftermath of rape. Dissociation significantly predicted ASD severity but not general distress, whereas relational problems and functional impairment emerged as significant predictors of general distress but not of ASD symptoms. Thus, even though symptoms of ASD and general distress were highly related to one another, the finding that the variables predicting ASD were different from those predicting general distress supports the assumption that ASD and general distress represent distinct trauma reactions. This finding is in accordance with previous research.

Recent studies on the factor structure of posttraumatic stress disorder (PTSD) symptoms tend to support one of two four-factor structures; however, little research has examined the structural invariance of PTSD structure across trauma groups. Five previously tested models of PTSD structure were compared in a large sample (N = 2,378) of female undergraduates who are survivors of sexual and/or physical abuse or assault, using the Posttraumatic Stress Disorder Questionnaire (PTSD-Q). The four-factor model of PTSD that included correlated factors of reexperiencing, avoidance, dysphoria, and hyper-arousal exhibited the best fit for the data and was structurally invariant across the five abuse groups. Support for the four-factor dysphoria model may have important implications for revisions of the current PTSD diagnosis.

Personal Space Boundary theory, developed by the first author in 1986, explains the complexities of privacy and intimacy within human beings. The way that people choose to relate to others is dependent on the permeability and flexibility of their personal space boundaries. The experience of trauma can damage the functioning of one's boundaries. The introduction of a new analog model of the theory, Russian Stacking Dolls, will demonstrate how the theory provides insight and facilitates healing in adults who have suffered some sort of trauma. The purpose of this article is to review the theory's evolution and provide clinical examples of how this theory is currently being used in practice with Russian Stacking Dolls. Limitations and cautions for use with certain clients are explicated.

The purpose of this article is to heighten awareness of the potential psychiatric consequences of a global traumatic event such as widespread use of weapons of mass destruction, encounter with an extraterrestrial life form, Earth's collision with an asteroid, paralysis of telecommunication or power systems, or pandemics. Because such events have never occurred, the traumatic affects on the human mind can only be postulated. There is sparse if any literature that addresses this problem. Many of the assumptions of what may happen and possible solutions are within the speculative imagination of the author. It is important that the traumatic stresses of a global event at least be recognized in the medical literature rather than be exclusively the domain of science fiction or cinematography.

Eye movement desensitization and reprocessing (EMDR) therapy has been shown by empirical studies to be effective in relief from psychological traumas including posttraumatic stress disorder (PTSD). Several logical concepts regarding the origin of the EMDR effect have been presented, but no detailed neural explanation is available. This lack of a widely accepted scientific explanation for the EMDR effect has led to skepticism about the therapy by many therapists and potential clients. The authors present evidence based primarily on quantitative electroencephalogram studies that the neural basis for the EMDR effect is depotentiation of fear memory synapses in the amygdala during an evoked brain state similar to that of slow wave sleep. These studies suggest that brain stimulation during EMDR significantly increases the power of a naturally occurring low-frequency rhythm in memory areas of the brain, binding these areas together and causing receptors on the synapses of fear memory traces to be disabled. This mechanical change in the memory trace enables it to be incorporated into the normal memory system without the extreme emotions previously associated with it. EMDR is a medical procedure because it changes the physical structure of the brain to modify problematically stored memories.

A mailed survey of 225 National Association of Alcohol and Drug Addiction Counselors members was conducted to examine trauma training, trauma practices, and secondary traumatic stress among substance abuse counselors. Results indicate that most substance abuse counselors are not being prepared for practice with traumatized populations in their formal academic training, although many obtained some trauma training through continuing education activities. There is a great deal of variation in terms of counselors' practices in the assessment and treatment of traumatic stress. Last, substance abuse counselors are highly likely to be secondarily exposed to traumatic events through their work with traumatized populations, and many experience at least some symptoms of secondary traumatic stress. The experience of secondary traumatic stress is believed to contribute to turnover and may reduce the quality and effectiveness of services. These findings highlight the need to attend to the issue of secondary traumatic stress among substance abuse counselors.

This case study explores the interpersonal and intrapersonal experiences of a single individual who spent more than 35 years in humanitarian aid work. Using interpretative phenomenological analysis, one superordinate theme, altruistic identity (AI), emerges. On return home following a humanitarian mission, AI requires (a) strong perception of empathic validation for intimate reintegration and (b) self-acceptance of personal involvement. However, AI disruption is related to (a) a perception of rejection or weak empathic validation for intimate reintegration and (b) self-blame leading to isolation from intimate others. With AI disruption, validation is alternately sought from humanitarian colleagues and/or by returning to the field. Results suggest that postmission reintegration processes are important determinants of psychological well-being. The authors also discuss the organization's role in addressing the psychosocial care of their staff on return from mission to reduce long-term social disruption and psychological distress.

Field research is always a challenge. It involves going to the source of information, often doing face-to-face interviewing, and depending on the largesse and kindness of others to help facilitate the interview schedule. I recently initiated a field study involving social workers who work in the military. I anticipated numerous challenges in accessing participants, in finding departments of social work willing to participate, and so on. However, I could never have anticipated the actual struggles that I encountered well before participants became an issue. This article will explain some of those challenges.