Peritraumatic dissociation and posttraumatic stress symptoms: the moderating role of perceived threat.

Background: Although peritraumatic dissociation (PD) is viewed as a risk factor for posttraumatic stress disorder (PTSD), prospective studies taking into account other well-known risk factors for PTSD have been scarce, and the exploration of potential moderators within the relations between PD and PTSD has been lacking.Objective: Filling this gap, this prospective study explored the moderating role of perceived threat within the relations between PD and PTSD, above and beyond age, gender, education, and early trauma-related symptoms.Method: A convenience sample of 200 Israeli civilians filled out self-report questionnaires during the peritraumatic phase (T1) and one to two months after the posttraumatic phase (T2) of being exposed to rocket attacks.Results: The results showed that perceived threat and PD were associated with early trauma-related symptoms and PTSD symptoms. Moreover, perceived threat moderated the relationship between PD and all PTSD symptom clusters apart from avoidance.Conclusions: The present results suggest that the implications of PD are shaped by levels of perceived threat, so that detriments of PD are evident when the trauma is appraised as being highly threatening. Therefore, early interventions that aim to decrease PD may be beneficial in preventing PTSD symptoms of intrusion, hyper arousal, and negative alterations in mood and cognition, for individuals who perceive traumatic events as highly threatening.

Perceived threat was related to early trauma-related symptoms and PTSD symptoms.Peritraumatic dissociation was related to early trauma-related symptoms and PTSD symptoms.Perceived threat moderated the link between peritraumatic dissociation and PTSD symptoms.

War: Mentalization and Totalitarian State of Mind.

For most residents of Europe, war is a new experience in which they find themselves both as witnesses and participants. In this paper the war in Ukraine serves as an illustration and case example. Like any unfamiliar experience, war elicits profound emotional responses which can be so overwhelming that an individual may be unable to fully process them and to create mental representations of the reality of war. When the psyche becomes entrapped in an unprocessed state, without the capacity to derive meaning from it, this results in the "fossilization" of the psyche akin to what McGinley and Segal describes as a totalitarian state of mind. Subjectivity and individual differences come under collective or personal attack, or both. This state of being prioritizes the needs of the collective psyche over the individual psyche. The image of Gorgon Medusa, who transformed living people into "fossilized" ones, is presented as a metaphor of total identification with the collective dimension. In contrast, the psyche can reveal a creative approach to resolving war-induced trauma. This is depicted in the concept of the Alchemical Stone and its creation, which symbolizes a harmonious connection between the external and internal realms, the subjective and objective experiences, and the real and the imaginal dimension.

Pour la plupart des habitants de l'Europe, la guerre est une nouvelle expérience dans laquelle ils se retrouvent à la fois témoins et participants. Dans cet article, la guerre en Ukraine sert d'illustration et de cas exemplaire. Comme toute expérience qui sort de l'ordinaire, la guerre suscite des réactions émotionnelles profondes qui peuvent être si accablantes qu'un individu peut se trouver incapable de les traiter pleinement et de créer des représentations mentales de la réalité de la guerre. Lorsque la psyché se retrouve piégée dans un état qu'elle ne peut pas traiter, sans la capacité d'en tirer un sens, il en résulte une « fossilisation ¼ de la psyché, semblable à ce que McGinley et Segal a décrit comme un état d'esprit totalitaire. La subjectivité et les différences individuelles font l'objet d'attaques collectives ou personnelles, ou des deux. Cet état d'être donne la priorité aux besoins de la psyché collective plutôt qu'à la psyché individuelle. L'image de la Gorgone Méduse, qui a transformé des êtres vivants en êtres «fossilisés¼, est présentée comme une métaphore de l'identification totale à la dimension collective. En revanche, la psyché peut révéler une approche créative pour résoudre les traumatismes induits par la guerre. Ceci est représenté par le concept de la Pierre Alchimique et de sa création, qui symbolise un lien harmonieux entre les royaumes extérieur et intérieur, les expériences subjectives et objectives, et les dimensions réelles et imaginales.

Para la mayoría de los habitantes de Europa, la guerra es una experiencia nueva en la que se encuentran tanto como testigos y como participantes. En este artículo, la guerra en Ucrania sirve como ilustración y ejemplo de caso. Como cualquier experiencia desconocida, la guerra provoca profundas respuestas emocionales que pueden ser tan abrumadoras que un individuo puede ser incapaz de procesarlas completamente y de crear representaciones mentales de la realidad de la guerra. Cuando la psique queda atrapada en un estado, sin posibilidad de elaborar y sin la capacidad para hallarle un sentido, se produce una "fosilización" de la psique similar a lo que McGinley Segal describe como un estado mental Totalitario. La subjetividad y las diferencias individuales son objeto de ataques colectivos o personales, o ambos. Este estado de ánimo prioriza las necesidades de la psique colectiva sobre la individual. La imagen de la Gorgona Medusa, que transformó a las personas vivas en "fosilizadas", se presenta como una metáfora de la identificación total con la dimensión colectiva. Por el contrario, la psique puede revelar un enfoque creativo para resolver el trauma inducido por la guerra. Esto se representa en el concepto de la Piedra Alquímica y su creación, que simboliza una conexión armoniosa entre los reinos externo e interno, las experiencias subjetivas y objetivas, y las dimensiones real e imaginal.

Overcoming the civil wars: the role of attachment styles between the impact of war and psychological symptoms and post-traumatic growth among Libyan citizens.

Background: Civil wars in Libya have impacted the mental health of the general population. The ways in which individuals cope with traumatic events are influenced by several psychological variables.Objectives: The present study aimed to investigate how post-traumatic stress symptoms (PTSS) are associated with psychological symptoms and post-traumatic growth (PTG), and to evaluate the role of avoidant and anxious attachment dimensions as mediators in these associations, among Libyan citizens.Method: Three-hundred participants (147 females; age 31.0 ± 8.4 years) completed the Impact of Event Scale - Revised, Experiences in Close Relationships, Patient Health Questionnaire, and Post-traumatic Growth Inventory - Short Form.Results: The structural equation model revealed that insecure attachment dimensions mediated the association between PTSS and psychological symptoms and PTG. PTSS were positively associated with psychological symptoms, PTG, and both insecure attachment dimensions. Insecure attachment dimensions were positively associated with psychological symptoms and negatively with PTG.Conclusion: The present findings contribute to growing empirical research on the roles of insecure attachment dimensions in the association between the impact of war, psychological symptoms, and PTG.

Insecure attachment dimensions mediated the association between the impact of war and psychological symptoms, as well as posttraumatic growth, among Libyan citizens.Higher psychological symptoms were negatively correlated with posttraumatic growth.Psychological interventions should consider insecure attachment dimensions, when evaluating the consequences of prolonged and repeated wars.

Bioterrorismo y armas biológicas: caracterización y respuesta frente a las amenazas actuales / Bioterrorism and biological weapons: characterization and response to current threats

El uso de agentes biológicos con fines terroristas constituye una amenaza singular. Aunque poco probable, su materialización puede ser difícilmente evitable en el futuro. Este artículo revisa el fenómeno del bioterrorismo, examinando los posibles riesgos y vulnerabilidades, los mecanismos de respuesta y las nuevas amenazas para la bioseguridad. (AU)

The use of biological agents for terrorist purposes is a unique threat. Although unlikely, it may be difficult to prevent in the future. This article provides an overview of the phenomenon of bioterrorism, examining potential risks and vulnerabilities, response mechanisms and emerging threats to biosecurity. (AU)

Cuidados en la Cataluña rural de postguerra. José Quílez, practicante de Almenar / Cuidado na Catalunha rural do pósuerra. José Quílez, praticante de Almenar / Care in postwar rural Catalonia. José Quílez, practitioner from Alme- nar

This paper aims to present the testimony of the midwife and practitioner José Quílez, who developed his professional practice in Almenar (small town in the province of Lleida), in order to show how the professional provision of care in rural postwar Catalonia was developed by this civil servant of the local administration. A qualitative study of historical research is developed using the biographical interview as a resource, framed in the phenomenological paradigm, using direct oral sources that have been triangulated with the interviewee's own written sources, bibliographic sources, as well as documentation from the archives of the Official College of Nurses of Lleida. The testimony highlights a noble character forged by the miseries of postwar Spain, which led to his emigration for work reasons from Aragon to Catalonia, where he had the opportunity to develop a solid family project, as well as a strong professional commitment in the provision of care, which is manifested in the rigor in the application of the protocols of the time, as well as the basic principles of ethics and privacy with which he attended to patients.(AU)

Este trabajo pretende dar a conocer el testimonio del comadrón y practicante José Quílez, que desarrolló su ejercicio profesional en Almenar (pequeño pueblo de la provincia de Lleida), con el fin de dar a conocer como se desarrollaba la prestación profesional de cuidados en la Cataluña rural de postguerra por parte de este funcionario de la administración local. Se desarrolla un estudio cualitativo de investigación histórica que utiliza la entrevista biográfica como recurso, enmarcado en el paradigma fenomenológico, utilizando fuentes orales directas que se han triangulado con fuentes escritas propias del entrevistado, bibliográficas, así como documentación del archivo del Colegio Oficial de Enfermeras y Enfermeros de Lleida. Del testimonio destaca un carácter noble forjado por las miserias propias de la España de postguerra, que conllevaron a su emigración por motivos laborales desde tierras aragonesas a Cataluña, donde tuvo ocasión de desarrollar un proyecto familiar sólido, así como un fuerte compromiso profesional en la prestación de cuidados, que se manifiesta en el rigor en la aplicación de los protocolos de la época, así como los principios básicos de la ética y privacidad con la que atendía a los pacientes.(AU)

O objectivo deste estudo é apresentar o testemunho do parteiro e praticante José Quílez, que exerceu a sua actividade profissional em Almenar (uma pequena aldeia na província de Lérida), a fim de mostrar como a prestação de cuidados profissionais na Catalunha rural do pós-guerra foi realizada por este funcionário público da administração local. É realizado um estudo de investigação histórica qualitativa utilizando a entrevista biográfica como recurso, enquadrado no paradigma fenomenológico, utilizando fontes orais directas que foram trianguladas com as próprias fontes escritas do entrevistado, fontes bibliográficas, bem como documentação dos arquivos do Colégio Oficial de Enfermeiras e Enfermeiros de Lleida. O testemunho destaca um carácter nobre forjado pelas misérias da Espanha do pós-guerra, que levou à sua emigração por razões de trabalho de Aragão para a Catalunha, onde teve a oportunidade de desenvolver um sólido projecto familiar, bem como um forte empenho profissional na prestação de cuidados, que se manifesta no rigor na aplicação dos protocolos da época, bem como nos princípios básicos de ética e privacidade com que atendeu os doentes.(AU)

Prácticas de enfermería en la reeducación profesional de los soldados en la Casa Pía de Lisboa durante la Primera Guerra Mundial / Práticas de Enfermagem na Reeducação Profissional de Soldados na Casa Pia de Lisboa durante a I Guerra Mundial / Nursing Practices in the Professional Re-education of Soldiers at Casa Pia of Lisboa during the First World War

In the period of the First Republic in Portugal, during the First World War, professional re-education was implemented, based on the teaching experience of Casa Pia in Lisbon, and was particularly important in the recovery of mutilated and maimed soldiers. Objective: To interpret and analyse the nurses' practices in the professional re-education of Portuguese soldiers at the Santa Izabel Institute for the Re-education of War Mutilates at Casa Pia in Lisbon during the First World War. Methodology: Use of the historical method to synthesise the historical narrative. Results: Important references can be found in the Casa Pia of Lisbon Yearbooks to the functions carried out by the nurses, namely "the propaganda that the nurses made to the wounded about the advantages of re-education"; the "massotherapy treatment"; "the massage treatments" and also to the "extremely important role" of the ladies (nurses) in the "small infirmary" headed by Dr V. Pontes where there was a small "massotherapy" service, a "provisional prothesis" workshop and a laboratory for examining aptitudes. Conclusion: This confirms that the nurses played an important role in the "preparatory re-education" services at the Santa Izabel Institute for the Re-education of Mutilated People at Casa Pia in Lisbon, intervening in a distinctive and effective way, earning good recognition.(AU)

En el período de la Primera República en Portugal, durante la Primera Guerra Mundial, se implantó la reeducación profesional, basada en la experiencia pedagógica de la Casa Pia de Lisboa, y fue particularmente importante en la recuperación de soldados mutilados. Objetivo: Interpretar y analizar las prácticas de las enfermeras en la reeducación profesional de los soldados portugueses en el Instituto Santa Izabel de Reeducación de Mutilados de Guerra de la Casa Pia de Lisboa durante la Primera Guerra Mundial. Metodología: Utilización del método histórico para sintetizar el relato histórico. Resultados: Se encuentran importantes referencias en los Anuarios de la Casa Pia de Lisboa a las funciones desempeñadas por las enfermeras, a saber: "la propaganda que las enfermeras hacían a los heridos sobre las ventajas de la reeducación"; el "tratamiento de masoterapia"; "los tratamientos de masaje" y también al "importantísimo papel" de las señoras (enfermeras) en la "pequeña enfermería" dirigida por el Dr. V. Pontes, donde había un pequeño servicio de "masoterapia", un taller de "prótesis provisionales" y un laboratorio de examen de aptitudes. Conclusión: Esto confirma que las enfermeras desempeñaron un papel importante en los servicios de "reeducación preparatoria" del Instituto de Reeducación de Mutilados Santa Izabel, de la Casa Pia de Lisboa, interviniendo de forma diferenciada y eficaz, mereciendo un buen reconocimiento.(AU)

No período da Primeira República em Portugal, no decorrer da I Guerra Mundial, implementou-se, com base na experiência de ensino da Casa Pia de Lisboa, a reeducação profissional tendo sido particularmente importante na recuperação de mutilados e estropiados de guerra. Objetivo: Interpretar e analisar quais as práticas das enfermeiras na reeducação profissional de soldados portugueses no Instituto de Reeducação de Mutilados de Guerra de Santa Izabel na Casa Pia de Lisboa durante a I Guerra Mundial. Metodologia: Recurso ao método histórico para a síntese da narrativa histórica. Resultados: Encontram-se referências importantes nos Anuários da Casa Pia de Lisboa a funções exercidas pelas enfermeiras nomeadamente “a propaganda que as sr.as enfermeiras fizeram junto dos feridos sobre as vantagens da reeducação”; o “tratamento massoterápico”; “os tratamentos pela massagem” e ainda ao “papel importantíssimo” das senhoras (enfermeiras) na “pequena enfermaria” chefiada pelo Dr. V. Pontes onde havia um pequeno serviço de “massotherapia”, uma oficina de “prothese provisória” e um laboratório de exame de aptidões. Conclusão: Confirma-se que as enfermeiras desempenharam um papel importante nos serviços de “reeducação preparatória” no Instituto de Reeducação de Mutilados de Santa Izabel da Casa Pia de Lisboa, intervindo de forma diferenciadora e eficaz, obtendo um bom reconhecimento.(AU)

Experiences of grief and moral sentiments in survivors of the armed conflict in Medellín, Colombia.

The objective of the study is to understand the experience of grief and moral sentiments in survivors of the armed conflict in the city of Medellín, Colombia, through qualitative research. In total, 32 people affected by different victimising acts in the context of the armed conflict participated. There is a direct relationship between moral sentiments and the processes of handling and processing loss. Moral sentiments frame the experience of emotions in the victim, after the events have occurred, which influence the way in which the pain experienced is processed. These sentiments permeate the processes of dealing with the incident in survivors, the ways in which they perceive themselves and the perpetrators, and the social stances they adopt to face life. We conclude that moral factors play a role in the emotional recovery of victims and are indicative the possibility or difficulty of processing the events that occurred.

La Defensa Pasiva y su división médica de emergencia / Passive Defense and its emergency medical division / Passive Defence e sua divisão médica de emergência

Durante la Segunda Guerra Mundial el gobierno de Uruguay intentó prepararse para una eventual defensa militar del territorio y la defensa de la población civil en caso de sufrir ataques aéreos. La Defensa Pasiva, fue la estructura gubernamental que junto a la voluntad en todas las clases sociales, funcionó en todo el territorio nacional con la finalidad de proteger a la población civil de los ataques aéreos y guerra química, generando un espíritu de solidaridad a través de su División Médica de Emergencia.

During the Second World War, the government of Uruguay tried to prepare for an eventual military defense of the territory and the defense of the civilian population in case of air raids. The Passive Defense was the governmental structure that, together with the will of every social class, operated throughout the national territory with the purpose of protecting the civilian population from air raids and chemical weapons, generating a spirit of solidarity through its Emergency Medical Division.

Durante a Segunda Guerra Mundial, o governo uruguaio tentou se preparar para uma eventual defesa militar do território e para a defesa da população civil em caso de ataques aéreos. A Defesa Passiva era a estrutura governamental que, juntamente com a vontade de todas as classes sociais, operava em todo o território nacional com o objetivo de proteger a população civil de ataques aéreos e da guerra química, gerando um espírito de solidariedade por meio de sua Divisão Médica de Emergência.

Delayed-onset posttraumatic stress disorder with response to methylphenidate / Trastorno por estrés postraumático de expresión retardada con respuesta a metilfenidato

Introduction: Posttraumatic stress disorder (PTSD) is extremely frequent in war veterans and has been widely studied. However, the efficacy of currently available pharmacological and psychotherapeutic treatments of war PTSD and other causes of PTSD is very limited. Method We present a case of war PTSD with delayed expression, with a good response to complementation with methylphenidate after a failed treatment with venlafaxine and risperidone. Results We review the role of dopamine in the pathophysiology of PTSD and the scarce studies in the treatment of PTSD with dopaminergic drugs that show an improvement in re-experimentation and in affective symptoms, especially anhedonia and cognitive impairment. Conclusions We conclude that the use of methylphenidate and other dopaminergic drugs can be a promising treatment for PTSD, a high prevalent disease with a high resistance to treatment, for which we encourage the use of large sample studies. (AU)

Introducción: El trastorno por estrés postraumático (TEPT) es extremadamente prevalente en veteranos de guerra y ha sido ampliamente estudiado. Sin embargo, la eficacia de los tratamientos farmacológicos y psicoterapéuticos disponibles es aún muy limitada, tanto en el TEPT de guerra como en el TEPT por otras causas. Método Presentamos un caso de TEPT de guerra con expresión retardada, con una buena respuesta al metilfenidato a su tratamiento con venlafaxina y risperidona, que había resultado ineficaz. Resultados Revisamos el rol de la dopamina en la psicopatología del TEPT y los pocos estudios del tratamiento del TEPT con fármacos dopaminérgicos, en los que se muestra una mejoría en los síntomas de reexperimentación y los síntomas afectivos, especialmente la anhedonia y los déficits cognitivos secundarios. Conclusiones Consideramos que el uso del metilfenidato y de otros fármacos dopaminérgicos podrían ser prometedores el tratamiento del TEPT, un trastorno altamente prevalente y con alta resistencia al tratamiento habitual. Por esto, animamos a realizar estudios con muestras amplias. (AU)

Análisis dinámico de un equipo interprofesional que implementa un programa de atención psicosocial a víctimas de la guerra / Dynamic analysis of an interprofessional team implementing a psychosocial intervention program for war victims

Resumen Este estudio analiza los cambios estructurales experimentados por un equipo interprofesional que implementa un programa de intervención psicosocial dirigido a víctimas de la guerra en Colombia. Los equipos están compuestos por psicólogos, trabajadores sociales y facilitadores comunitarios que proporcionan atención a nivel individual, familiar y comunitario. Se aplicaron métodos de evaluación estructural para identificar cambios en la cohesión de las redes de reconocimiento entre profesionales, así como la preferencia para colaborar y el intercambio de información enviada y recibida. La recogida de información se produjo en dos series temporales -tiempo 1 (T1) y tiempo 2 (T2)- con un intervalo de tres meses. Se utilizó una estadística aplicada al análisis de datos relacionales para determinar los cambios en las redes en T1 y T2. En el período de referencia se incrementó la densidad en las redes de reconocimiento [. = 1.7105, (IC 95 %: -.0123 - .185), . < .0444] y de preferencia para trabajar [. = 2.0942, (IC 95 %: .005 - .1521), . < .0218]. Las redes de intercambio de información no experimentaron cambios significativos. Las regresiones múltiples a nivel diádico indican que la preferencia para trabajar e intercambiar información en T1, predicen el intercambio de información relativo tanto a peticiones de información recibidas como enviadas en T2. Se discuten los resultados para optimizar la implementación de programas de intervención psicosocial desarrolladas por equipos interprofesionales.

Abstract The study analyzes the structural changes experienced by an interprofessional team implementing a psychosocial intervention program for victims of war in Colombia. The program is called "PAPSIVI" (Programa de Atención Psicosocial y Salud Integral a Víctimas), which has been operating in Colombia since 2013, thanks to Law 1448 of 2011 to improve the quality of life and repair the damage of the victims of the armed conflict in Colombia. It only served people registered in the Single Registry of Victims (RUV), which had 9'165,126 records throughout the country until September 2021. This program follows a comprehensive and restorative approach that defines victims as protagonists of their own process of empowerment and positive change (Laplante and Holguin, 2006; Thompson, 1996). For this purpose, a multilevel intervention is carried out at the individual, family and community levels. The program is implemented by teams of professionals (psychologists, social workers and community facilitators) of varying sizes depending on the number of victims served in the municipalities. Psychologists provide individual psychological care and, to a lesser extent, family therapy is also offered to try to repair psychosocial damage from exposure to situations of violence (Oficina de Promoción Social, 2017). Social workers carry out community interventions to promote the associative fabric and social capital. Community promoters are facilitators and connect professionals with the potential beneficiaries of the intervention. The latter are very important, having themselves the status of victims, which increases the ecological validity of the intervention. Due to the characteristics of the implementation of this initiative, which takes into account the difficulties of the context (with situations of deprivation and vulnerability), as well as the particularities of the participants, it is valid to ask in this research what are the structural changes experienced by the teams of professionals who implement PAPSIVI. For this, structural evaluation methods were applied to identify changes in the cohesion of recognition networks among professionals, the preference to collaborate and the exchange of information sent and received. Data collection took place in two time series (T1 before - T2 after) with an interval of three months. Statistics applied to relational data analysis were used to determine changes in the networks at time T2. In the results it was found that in the baseline period the density in the recognition [t = 1.7105, (95 % CI: -.0123 - .185), p < .0444] and work preference [t = 2.0942, (95 % CI: .005 - .1521), p < .0218] networks increased. Information exchange networks did not experience significant changes. Multiple regressions at the dyadic level indicate that the preference for working and exchanging information at T1 predicts information exchange relative to both information requests received and sent at T2. It is concluded that the results shed light for: (a) optimize the design of psychosocial intervention teams; (b) improve their functioning by introducing horizontal organizational communication tools (among the members of each team), transversal (among the members of the teams implementing the program in different municipalities), and vertical (by promoting communication between professionals and program managers/responsible persons), and (c) achieve that changes in the structure of the teams serve as a diagnostic tool for functional problems of the team associated with the exchange of professional information and the referral of users. Ultimately, better integration of the teams leads to better psychosocial profiles of the users of programs such as PAPSIVI and allows them to better adapt their activities to the needs of the users, which improves the effectiveness of the intervention (Virto, 2021).

Post-traumatic stress in war veterans and secondary traumatic stress among parents of war veterans five years after the 2014 Israel-Gaza military conflict.

Secondary traumatic stress (STS) has been studied in therapists, spouses, and mainly in children of traumatised individuals. To date, the relationship between children's posttraumatic stress disorder (PTSD) symptoms and their parents' mental health outcomes have been understudied, and specifically, long term STS symptoms of parents of war veterans were not investigated. The current study examined PTSD symptoms among veterans of the 2014 Israel-Gaza war and STS among their parents, five years after the war. The control group consisted of veterans from combat military units who were on active duty at the time of the war but did not actively participate in the war (stand-by units) - providing a natural experiment condition. We found that PTSD symptoms were almost twice as high in the directly active war veterans (DAV, N = 32) group compared to the indirectly active war veterans (IAV, N = 26) group. Results showed that mothers had higher STS symptoms in general, and DAV PTSD symptoms correlated with their fathers STS symptoms. The current study provides novel evidence for: (a) subclinical PTSD symptoms in war veterans 5 years after the war, and (b) transmission of trauma from war veterans to their parents. The overall negative effect of sending a child to war on the parents are also discussed.

The current study examined post-traumatic stress symptoms among undiagnosed war veterans of the 2014­2014 Israel-Gaza Military Conflict compared to matched control who were on active military duty at the same time but did not actively participate in the war. We found higher post-traumatic stress symptoms in the veterans who actively participated in the war, roughly five years after the war.Parents of veterans who actively participated in the war exhibited higher secondary traumatic stress compared to parents of veterans who did not actively participate in the war. This is especially interesting given that parents of all veterans were not aware of their whereabouts during the war. Overall, mothers exhibited higher secondary traumatic stress compared to fathers. However, fathers were more 'in-sync' with their sons' traumatic experience as evident by a significant correlation between the war veterans' post-traumatic stress and the fathers' secondary traumatic stress symptoms.

No association between war-related trauma or PTSD symptom severity and epigenome-wide DNA methylation in Burundian refugees.

Background: War-related trauma is associated with varying posttraumatic stress disorder (PTSD) prevalence rates in refugees. In PTSD development, differential DNA methylation (DNAm) levels associated with trauma exposure might be involved in risk versus resilience processes. Studies investigating DNAm profiles related to trauma exposure and PTSD among refugees remain sparse.Objective: The present epigenome-wide association study investigated associations between war-related trauma, PTSD, and altered DNAm patterns in Burundian refugee families with 110 children and their 207 female and male caregivers.Method: War-related trauma load and PTSD symptom severity were assessed in structured clinical interviews with standardised instruments. Epigenome-wide DNAm levels were quantified from buccal epithelia using the Illumina EPIC beadchip.Results: Controlling for biological confounders, no significant epigenome-wide DNAm alterations associated with trauma exposure or PTSD were identified in children or caregivers (FDRs > .05). Co-methylated positions derived as modules from weighted gene correlation network analyses were not significantly associated with either war-related trauma experience in children or caregivers or with PTSD.Conclusions: These results do not provide evidence for altered DNAm patterns associated with exposure to war-related trauma or PTSD.

The study examines an understudied population in epigenome-wide association studies.Burundian refugees' war-trauma, PTSD, and DNA methylation were studied.Epigenome-wide DNA methylation was not significantly associated with war-trauma or PTSD in the conflict-affected sample.

Global financial crisis and musculoskeletal pain: systematic review / Crise financeira mundial e dores musculoesqueléticas: revisão sistemática

ABSTRACT BACKGROUND AND OBJECTIVES: In recent history, major catastrophes are followed by economic crisis, which are commonly succeeded by high levels of psychological stress related to financial hardships. The relationship between this financial stress (FS) and musculoskeletal pain (MP) is not elucidated. The aim of this systematic review was to critically evaluate the evidence of the relationship between these financial difficulties and MP. METHODS: A comprehensive search was conducted on the following databases: Medline, LILACS, Scielo and PsycINFO. Studies included were observational, among adults, measuring FS and its association with MP worsening or development, recruiting participants or data from any setting, and providing outcome data for at least one pain outcome measure. RESULTS: 445 potentially relevant citations was identified, which included 438 unique citations, 419 of which did not meet inclusion criteria. Final search included nine studies. The most frequent pain types reported were low back pain and neck pain. Descriptions of financial stress varied. Overall, exposure to financial stress was determined according to some difficulty in relation to afford necessities. All studies, except one, found significant associations between some type of MP and FS. CONCLUSION: This systematic review brought the available data on the relationship between FS and MP. It is possible to state that there is reasonable evidence of FS as a strong predictor for the onset of MP. It is necessary to be aware of this issue when dealing with pain patients during the current humanitarian crisis.

RESUMO JUSTIFICATIVA E OBJETIVOS: Na história recente, grandes catástrofes são seguidas de crises econômicas, que comumente são acompanhadas por altos níveis de estresse psicológico relacionado a dificuldades financeiras. A relação entre esse estresse financeiro (EF) e a dor musculoesquelética (DME) não está elucidada. O objetivo desta revisão sistemática foi avaliar criticamente as evidências da relação entre tais dificuldades financeiras e a DME. MÉTODOS: Uma busca abrangente foi realizada nas seguintes bases de dados: Medline, LILACS, Scielo e PsycINFO. Os estudos incluídos foram observacionais, entre adultos, aferindo o EF e sua associação com a piora ou desenvolvimento de uma DME, recrutando participantes ou dados de qualquer ambiente, e fornecendo dados de resultado para ao menos uma medida de resultado de dor. RESULTADOS: Foram identificadas 445 citações potencialmente relevantes, que incluíram 438 citações únicas, 419 das quais não atenderam aos critérios de inclusão. A pesquisa final incluiu 9 estudos. Os tipos de dor mais frequentes relatados foram lombalgia e cervicalgia. Descrições de estresse financeiro variaram. No geral, a exposição ao estresse financeiro foi determinada de acordo com alguma dificuldade em relação às necessidades de pagamento. Todos os estudos, exceto um, encontraram associações significativas entre algum tipo de DME e EF. CONCLUSÃO: Este estudo trouxe os dados disponíveis sobre a relação entre EF e DME. É possível afirmar que há razoável evidência do EF como um forte preditor para o aparecimento de DME. É preciso estar ciente dessa questão ao lidar com pacientes com dor durante a atual crise humanitária.

Los conflictos y sus ciclos entre la paz y la guerra

El presente artículo se encuentra enmarcado en un periodo histórico donde se ha derrotado una vez más la posibilidad de mantener la paz. El espectro del conflicto llegó a su punto máximo una guerra fratricida que nadie esperaba y peor aun cuando amenaza con un desenlace de consecuencias catastróficas para la humanidad; por tanto nos volvemos a preguntar ¿por qué la guerra? A quien o a que atribuimos la ruptura de la paz, es difícil comprender las posiciones humanas desde el psicoanálisis, o desde la filosofía de la paz hasta la vieja concepción geopolítica de la guerra. Los Estados a pesar de entender la paz, son llevados a la defensa de sus intereses aunque signifique su propia destrucción, luego el conflicto en su ciclo de la paz a la guerra no puede ser controlado. Actualmente la guerra entre Rusia y Ucrania no sólo promueve la preocupación y la reflexión, del por qué la guerra, sino que, debe llegar a posiciones consensuadas de la comunidad internacional que perpetúe la paz imperfecta.

This article is framed in a historical period where the possibility of maintaining peace has once again been defeated. The specter of conflict reached its peak with a fratricidal war that no one expected, and even worse when it threatens a catastrophic outcome for humanity; therefore we ask ourselves again, why war? It is difficult to understand human positions from psychoanalysis to the philosophy of peace to the old geopolitical conception of war, to whom or what we attribute the breakdown of peace. States, despite understanding peace, are led to defend their interests even if it means their own destruction, then the conflict in its cycle from peace to war cannot be controlled. Currently, the war between Russia and Ukraine not only promotes concern and reflection on the reasons for war, but it must also lead to agreed positions of the international community that perpetuate imperfect peace.

Este artigo está inserido em um período histórico em que a possibilidade de manter a paz foi mais uma vez derrotada. O espectro do conflito atingiu seu auge com uma guerra fratricida que ninguém esperava, e pior ainda quando ameaça um desfecho com consequências catastróficas para a humanidade; portanto, voltamos a perguntar: por que a guerra? É difícil entender as posições humanas do psicanálise à filosofia da paz à velha concepção geopolítica da guerra, a quem ou ao que atribuímos a ruptura da paz. Os Estados, apesar de entenderem a paz, são levados a defender seus interesses mesmo que isso signifique sua própria destruição, então o conflito em seu ciclo da paz à guerra não pode ser controlado. Atualmente, a guerra entre Rússia e Ucrânia não só promove a preocupação e a reflexão sobre as razões da guerra, mas também deve levar a posições consensuadas da comunidade internacional que perpetuem a paz imperfeita. politics.

Redescubriendo al paciente M: Justo Gonzalo Rodríguez-Leal y su teoría de la dinámica cerebral / Rediscovering patient M: Justo Gonzalo Rodríguez-Leal and his theory of the brain dynamics

Introducción: En el transcurso de la Guerra Civil española, Justo Gonzalo Rodríguez-Leal visita al paciente M en el Hospital de Sanidad Militar de Godella (Valencia). Este encuentro marca el inicio de una larga relación entre ambos, que brinda a Justo Gonzalo la oportunidad de estudiar la organización funcional cerebral y articular una original concepción de la neurofisiología basada en las leyes de la excitabilidad nerviosa. El objetivo de este trabajo es redescubrir al paciente M y la interpretación fisiológica de la dinámica cerebral de Gonzalo.Desarrollo: Tomando como piedra angular al paciente M, Gonzalo postula que el efecto de una lesión cortical depende de su magnitud y posición: la magnitud condiciona la intensidad del trastorno; la posición, el tipo de trastorno. Entre 1945 y 1950 desarrolla en profundidad estas y otras hipótesis, basadas en observaciones clínicas, en la obra Dinámica cerebral, La actividad cerebral en función de las condiciones dinámicas de la excitabilidad nerviosa (Vol. 1, 1945; Vol. 2, 1950). A partir de 1952 proporciona una versión ampliada de su teoría sobre dinámica cerebral, fundamentándola no sólo en conceptos fisiológicos, sino también en la idea de gradientes cerebrales, e introduciendo los conceptos de similitud y alometría de los sistemas dinámicos.Conclusiones: Durante siglos, el conocimiento sobre la organización funcional del cerebro se ha asentado en el estudio de casos únicos. El paciente M constituye un ejemplo más de esta tradición, ayudando a establecer las bases de la teoría de dinámica cerebral desarrollada por Justo Gonzalo.(AU)

Introduction: During the Spanish Civil War, Justo Gonzalo Rodríguez-Leal visited patient M at the Military Healthcare Hospital in Godella (Valencia). This meeting marked the beginning of a long relationship between the two, which gave Justo Gonzalo the opportunity to study the functional organisation of the brain and to develop an original conception of neurophysiology based on the laws of nervous excitability. The aim of this work is to rediscover patient M and the physiological interpretation of Gonzalo’s brain dynamics.Development: Taking patient M as the cornerstone, Gonzalo postulated that the effect of a cortical lesion depends on its magnitude and position: the magnitude conditions the intensity of the disorder, whereas the position determines the type of disorder. Between 1945 and 1950 he developed these and other hypotheses in depth, based on clinical observations, in his work Dinámica cerebral. La actividad cerebral en función de las condiciones dinámicas de la excitabilidad nerviosa (Vol. 1, 1945; Vol. 2, 1950). From 1952 onwards he provided an expanded version of his theory of brain dynamics, basing it not only on physiological concepts, but also on the idea of brain gradients, and introducing the concepts of similarity and allometry of dynamic systems.Conclusions: For centuries, knowledge about the functional organisation of the brain has been based on single case studies. Patient M is a further example of this tradition that helps to establish the basis of the theory of brain dynamics developed by Justo Gonzalo.(AU)

Implementation of an evidence-based trauma-focused treatment for traumatised children and their families during the war in Ukraine: a project description.

The full-scale invasion of Ukraine by Russia in February 2022 led to an increase of traumatic events and mental health burden in the Ukrainian general population. The (ongoing) traumatisation can have a crucial impact on children and adolescents as they are especially vulnerable for developing trauma-related disorders such as Post Traumatic Stress Disorder (PTSD) or Depression. To date, these children have only very limited access to trauma-focused evidence-based treatments (EBTs) by trained mental health specialists in Ukraine. The fast and effective implementation of these treatments in Ukraine is crucial to improve the psychological wellbeing of this vulnerable population. This letter to the editor describes an ongoing project which implements a trauma-focused EBT called 'Trauma-Focused Cognitive Behavioural Therapy' (TF-CBT) in Ukraine during the war. In collaboration with Ukrainian and international agencies, the project 'TF-CBT Ukraine' was developed and implemented starting in March 2022. The project entails a large training programme for Ukrainian mental health specialists and the implementation of TF-CBT with children and their families in and from Ukraine. All components of the project are scientifically evaluated on a patient and therapist level, cross-sectionally and longitudinally, in a mixed-methods design. All together nine training cohorts with N = 133 Ukrainian therapists started the programme, all monthly case consultations (15 groups) and treatments of patients are still ongoing. Lessons learnt from this first large-scale implementation project on an EBT for children and adolescents impacted by trauma in Ukraine will help inform the field on challenges and also possibilities to expand such efforts. On a broader level, this project could be one small step in the process of helping children overcome the negative effects and experience resilience in the context of a war-torn nation.

Sensory modulation and trauma-related symptoms during rocket attacks.

BACKGROUND: War is a highly traumatogenic experience that may result in trauma-related symptoms during exposure. Although most individuals exhibit recovery after the trauma ends, symptomatology during exposure may serve as an initial indicator underlying symptomatology at the posttraumatic phase, hence the imperative to identify risk factors for trauma-related symptoms during the peritraumatic phase. While research has uncovered several factors associated with peritraumatic distress, such as age, gender, history of mental disorder, perceived threat, and perceived social support, the role of sensory modulation has not been explored. METHOD: To address this gap, 488 Israeli citizens were assessed using an online survey for sensory modulation and trauma-related symptoms during rocket attacks. RESULTS: Analyses revealed that while the association between high sensory responsiveness and elevated levels of specific trauma-related symptoms is somewhat weak (0.19

High sensory responsiveness was related to trauma-related symptoms.Low sensory responsiveness was unrelated to trauma-related symptoms.The risk for elevated trauma-related symptoms during exposure was doubled for each increase in high sensory-responsiveness score.

Associations between coping strategies and psychological distress among people living in Ukraine, Poland, and Taiwan during the initial stage of the 2022 War in Ukraine.

Background: The 2022 War in Ukraine has significantly affected the psychological well-being and daily lives of people in many countries.Objective: Two aims of this transnational study were (1) to compare psychological distress and coping strategies among people living in Ukraine, Poland, and Taiwan, (2) to examine whether the associations between various coping strategies (ie. problem-focused coping, emotion-focused coping, and avoidance) and psychological distress (ie. depression, anxiety, stress, posttraumatic stress disorder symptoms, and hopelessness about the ongoing war) differed among people of various countries during the initial stage of the 2022 War in Ukraine.Method: In total, 1,598 participants (362 from Ukraine, 1,051 from Poland, and 185 from Taiwan) were recruited using an online advertisement to complete online survey questionnaires, including the Brief Coping Orientation to Problems Experienced inventory; the 21-item Depression, Anxiety and Stress Scale; the Impact of Event Scale-Revised; and a questionnaire devised to assess the level of hopelessness about the ongoing war.Results: Psychological distress and adoption of coping strategies differed across people of various countries. Among Taiwanese and Polish respondents, avoidant coping strategies were most strongly associated with all categories of psychological distress compared with problem- and emotion-focused coping strategies. However, the associations of various coping strategies with psychological distress differed to a less extent among Ukrainian respondents. In addition, problem- and emotion-focused coping strategies had comparable associations with psychological distress among the people of Ukraine, Poland, and Taiwan.Conclusions: The 2022 War in Ukraine has affected the psychological well-being of people, especially the Ukrainians. Because of the strong association between the adoption of avoidance coping strategies and psychological distress, despite a less extent among Ukrainian respondents, adaptive coping strategies such as (problem- and emotion-focused) are suggested to help people during times of war.

The 2022 War in Ukraine affected the psychological well-being in Ukraine and elsewhere.Compared with problem- and emotion-focused coping strategies, avoidant coping strategies had stronger association with psychological distress, but it varied among different cultures.

Consecuencias psicológicas de la exposición a zonas de conflicto en niños, niñas y adolescentes / Conseqüències psicològiques de l’exposició a zones de conflicte en nens, nenes i adolescents / Children and adolescents psychological consequences of exposure to conflict zones

Una de lasprincipales víctimas de las guerras y conflictos armados son los niños, niñas y adolescentes. Las consecuenciasnegativas de los conflictos bélicos en la salud física y mental de esta población han sido señaladas en numerosasocasiones por la literatura científica. El objetivo de este estudio es presentar los resultados de las últimas inves-tigaciones sobre las consecuencias de la exposición a conflictos armados en la salud mental de los niños, niñasy adolescentes, para ayudar a los profesionales del país a tener una mayor comprensión de la problemática yabordarla de forma adecuada. Para ello, se ha llevado a cabo una revisión de artículos científicos publicados enlos últimos cinco años. El trastorno por estrés postraumático es el más observado en los estudios internaciona-les, aunque se detectan otros problemas emocionales y conductuales en los niños, niñas y adolescentes que hanvivido una situación de conflicto armado. Es importante tener en cuenta que la sintomatología clínica continúaincluso bajo medidas protectoras como un desplazamiento forzoso, así como conocer las necesidades específi-cas de esta población para adaptar la intervención clínica de manera adecuada.(AU)

One of the main victimsof wars and armed conflicts are children and adolescents. The negative consequences of war conflicts on thephysical and mental health of this population have been reported on numerous occasions in the scientific litera-ture. The aim of this study is to present the results of the latest research on the mental health consequences inchildren and adolescents who have been exposed to armed conflicts, in order to help the country's professionalsto have a better understanding of the problem and to address it in an appropriate way. To this end, a review ofscientific articles published in the last five years has been carried out. Post-traumatic stress disorder is the mostfrequently observed in international studies, although other emotional and behavioural problems are detectedin children and adolescents who have lived through a situation of armed conflict. It is important to take intoaccount that clinical symptomatology continues even under protective measures such as forced displacement,as well as to know the specific needs of this population in order to adapt the clinical intervention appropriately.(AU)

Una de les princi-pals víctimes de les guerres i conflictes armats són els nens, les nenes i els adolescents. Les conseqüències negati-ves dels conflictes bèl·lics en la salut física i mental d'aquesta població han estat assenyalades moltes vegades perla literatura científica. L'objectiu d'aquest estudi és presentar els resultats de les darreres investigacions sobre lesconseqüències de l'exposició a conflictes armats en la salut mental dels nens, nenes i adolescents, per ajudar elsprofessionals del país a tenir més comprensió de la problemàtica i abordar-la de manera adequada. Per fer-ho, s'hadut a terme una revisió d'articles científics publicats en els darrers cinc anys. El trastorn per estrès posttraumàticés el més observat als estudis internacionals, encara que es detecten altres problemes emocionals i conductualsen els nens, nenes i adolescents que han viscut una situació de conflicte armat. És important tenir en compte quela simptomatologia clínica continua fins i tot sota mesures protectores, com ara un desplaçament forçós, així comconèixer les necessitats específiques d'aquesta població per adaptar la intervenció clínica de manera adequada.(AU)

Uso de los rayos X en la guerra hispano-cubano-norteamericana

En Cuba, el primer departamento de rayos X se inauguró en el año 1907 por Francisco Domínguez Roldán. Poco se divulga un contacto previo durante el siglo XIX, en la guerra hispano-norteamericana. Este artículo describe el uso de los rayos X en la guerra hispano-cubano-norteamericana y su importancia en la historia de la Radiología. Para esta contienda, la parte norteamericana preparó sus barcos hospitales. El ejército habilitó el Relief y el Missouri, mientras que la marina lo hizo con Solace. También se convirtieron en buques hospitales el Olivette y el Bay State. Todos contaban con equipos de rayos X. El capitán Borden publicó un libro en 1900 "El uso de los rayos Roentgen por el departamento médico de la armada estadounidense en la guerra con España (1898)" que marcó un antes y un después en el uso de los rayos X. Este fue un hecho trascendental para la historia de la Radiología y favoreció un avance considerable en la sanidad militar y civil.

In Cuba, the first X-ray department was set up in 1907 by Francisco Domínguez Roldán. Little is reported about a previous contact during the 19th century in the Spanish-Cuban-American war. This article describes the use of X-rays in the Spanish-Cuban-American war and its importance in the history of Radiology. For this war the American side prepared its hospital ships. The Army fitted out the Relief and the Missouri, while the Navy did it with the Solace. The Olivette and the Bay State also became hospital ships. All were equipped with X-ray equipment. Captain Borden published a book in 1900 "The Use of Roentgen Rays by the Medical Department of the U.S. Navy in the War with Spain (1898)" which marked a before and after in the use of X-rays. This was a transcendental fact for the history of Radiology and favored a considerable advance in military and civilian health.