Nonpathologizing trauma interventions in abnormal psychology courses.

Because abnormal psychology courses presuppose a focus on pathological human functioning, nonpathologizing interventions within these classes are particularly powerful and can reach survivors, bystanders, and perpetrators. Interventions are needed to improve the social response to trauma on college campuses. By applying psychodynamic and feminist multicultural theory, instructors can deliver nonpathologizing interventions about trauma and trauma response within these classes. We recommend class-based interventions with the following aims: (a) intentionally using nonpathologizing language, (b) normalizing trauma responses, (c) subjectively defining trauma, (d) challenging secondary victimization, and (e) questioning the delineation of abnormal and normal. The recommendations promote implications for instructor self-reflection, therapy interventions, and future research.

DL-based inpainting for metal artifact reduction for cone beam CT using metal path length information.

BACKGROUND: Metallic implants, which are inserted into the patient's body during trauma interventions, are the main cause of heavy artifacts in 3D X-ray acquisitions. These artifacts then hinder the evaluation of the correct implant's positioning, thus leading to a disturbed patient's healing process and increased revision rates. PURPOSE: This problem is tackled by so-called metal artifact reduction (MAR) methods. This paper examines possible advances in the inpainting process of such MAR methods to decrease disruptive artifacts while simultaneously preserving important anatomical structures adjacent to the inserted implants. METHODS: In this paper, a learning-based inpainting method for cone-beam computed tomography is proposed that couples a convolutional neural network (CNN) with an estimated metal path length as prior knowledge. Further, the proposed method is solely trained and evaluated on real measured data. RESULTS: The proposed inpainting approach shows advantages over the inpainting method used by the currently clinically approved frequency split metal artifact reduction (fsMAR) method as well as the learning-based state-of-the-art (SOTA) method PConv-Net. The major improvement of the proposed inpainting method lies in the ability to correctly preserve important anatomical structures in those regions adjacent to the metal implants. Especially these regions are highly important for a correct implant's positioning in an intraoperative setup. Using the proposed inpainting, the corresponding MAR volumes reach a mean structural similarity index measure (SSIM) score of 0.9974 and outperform the other methods by up to 6 dB on single slices regarding the peak signal-to-noise ratio (PSNR) score. Furthermore, it can be shown that the proposed method can generalize to clinical cases at hand. CONCLUSIONS: In this paper, a learning-based inpainting network is proposed that leverages prior knowledge about the metal path length of the inserted implant. Evaluations on real measured data reveal an increased overall MAR performance, especially regarding the preservation of anatomical structures adjacent to the inserted implants. Further evaluations suggest the ability of the proposed approach to generalize to clinical cases.

Assault Injury and Community Violence.

Community violence happens between unrelated individuals, who may or may not know each other, generally outside the home, and often results in assaultive injuries. Community violence interventions can prevent assaultive injuries and assist victims of community violence. Trauma-informed care is foundational to the success of community violence intervention. Place-based environmental interventions can decrease community violence on the population level, and further research and developments are needed in this area. Substance use is a significant barrier to intervention program involvement and greater research and program development is needed to support substance use treatment of those impacted by community violence.

Virtual Trauma Interventions for the Treatment of Post-traumatic Stress Disorders: A Scoping Review.

Some post-traumatic stress disorder (PTSD) patients do not benefit from imaginal exposure therapy. One possible approach to reach such patients are virtual trauma interventions. Herein, a qualitative scoping review was conducted. Different types of virtual trauma exposure interventions were identified. For each type of virtual trauma exposure interventions it was examined in detail: (1) which in sensu trauma exposure approach serves as therapeutic framework, how it was transferred into virtual reality, and if it was manualized; (2) which hardware and software were used; (3) whether the influence of spatial and social presence on the efficacy of virtual trauma interventions have been measured, and (4) whether the efficacy of virtual trauma interventions for PTSD patients having imagination difficulties was evaluated. These research questions were analyzed qualitatively. Accordingly, an extensive literature search was conducted using the databases Web of Science, PsycINFO, LIVIVO, PTSDpubs, and PubMed for scientific articles published between January 2013 and July 2020. Only studies aimed to reduce PTSD symptoms using virtual trauma interventions were included. The literature search was not limited to a specific study design, treatment/intervention method, or a minimum sample size. Eighteen studies were identified, which reported three different virtual trauma intervention approaches, namely, virtual reality exposure therapy (VRET), multi-modular motion-assisted memory desensitization and reconsolidation (3MDR), and action-centered exposure therapy (ACET). Seven randomized controlled trials (RCTs), two pilot studies, and one case study were focused on VRET; while two RCTs, one pilot study, and three case studies focused on 3MDR, and two case studies on ACET. Regarding the first research question (1), the results show that VRET is based on prolonged exposure, aiming for a virtual re-creation of the patient's traumatic recounting. Several treatment protocols exist for VRET. 3MDR is based on eye movement desensitization and reprocessing, aiming to reduce the patient's avoidance behavior. In 3MDR patients walk toward individualized trauma-related symbolic images in a cave automatic virtual environment (CAVE). One treatment protocol exists for 3MDR. ACET is based on the inhibitory learning theory, aiming for active interactions with a virtual trauma-associated environment to alter the anxiety structure through new secondary inhibitory learning. One treatment protocol exists for ACET. For the second research question (2), the results indicate that all VRET studies used head-mounted displays (HMDs) with a virtual version of the Iraq/Afghanistan or the World Trade Center attacks, while 3MDR studies utilized two different versions of a CAVE with personalized trauma-related images, and the ACET studies used HMDs with virtual street scenarios. For the third research question (3), the results demonstrate that the influence of spatial or social presence on the efficacy of virtual trauma interventions was not examined in any of the included studies. Similarly, for the fourth research question (4), the results show that empirical evidence for the efficacy of virtual trauma interventions on PTSD patients having imagination difficulties was lacking. Therefore, such empirical studies are needed to fill these research gaps.