School-based psychosocial and educational interventions for children and adolescents after the 1999 Marmara earthquakes in Turkey: A review on lessons learned.

The massive earthquakes experienced in August and November 1999 affected thousands of people in the Marmara region, the most densely populated and industrialized part of Turkey. The humanitarian and economic cost was so enormous, and these earthquakes have changed the Turkish disaster management system and the Turkish people's approach to disasters. Marmara earthquakes are also considered as a milestone in the provision of psychosocial services for disaster victims. This paper aims to review the psychosocial interventions targeting children, adolescents, and their families after the 1999 earthquakes in Turkey. The progression from initial responses to more organized psychosocial interventions is outlined. Conducting the interventions at schools has ensured that thousands of children, teachers, and parents are reached in the most efficient and effective way possible. The significance of the school context in designing psychosocial interventions is highlighted and implications of the lessons learned for traumatic experiences of children and parents are also explored. It is evaluated that these inferences obtained from the Marmara earthquake in Turkey can be used in disasters around the world.

Inducing emotionally negative nonbelieved memories using negative pictures.

Memories that can be recalled but are no longer believed are termed nonbelieved memories. The current studies examined the creation of emotionally negative nonbelieved memories after viewing negatively valenced pictures. In both experiments, participants took part in two sessions. In Session 1, after being presented with a set of neutral and negative pictures, participants had to rate their emotional state. One week later, in Session 2, participants had to complete a recognition task to identify pictures that had appeared during the previous session. During this task, participants' memories for some pictures were challenged by telling them that their answers were incorrect in order to evoke nonbelieved memories. The experimental procedure was successful in creating nonbelieved memories in the participants. Specifically, in Experiment 1 (N = 35), we induced nonbelieved true memories for both negative and neutral pictures. We found a significant decrease in both belief and recollection after the challenge, with the change in belief being twice as large as the change in recollection. In Experiment 2 (N = 43), we successfully induced both nonbelieved true and false memories for negative pictures. Again, the reduction of belief was significantly greater than that of recollection. In general, participants evinced better memory for negative pictures, but following challenges people were just as likely to accept false social feedback and change their memories regarding other types of pictures. In both experiments, our challenges did not lead to notable changes in emotional state. In general, our findings show that emotionally negative nonbelieved memories can be successfully evoked in an experimental setting.

A multidisciplinary evaluation, exploration, and advancement of the concept of a traumatic birth experience.

BACKGROUND: Understanding a woman's traumatic birth experience benefits from an approach that considers perspectives from various fields of healthcare and social sciences. AIM: To evaluate and explore the multidisciplinary perspectives surrounding a traumatic birth experience to form a theory and to capture its structure. METHODS: A multidisciplinary advanced principle-based concept analysis was conducted, including the following systematic steps: literature review, assessment of concept maturity, principle-based evaluation, concept exploration and advancement, and formulating a multidisciplinary concept theory. We drew on knowledge from midwifery, psychology, childbirth education, bioethics, obstetric & gender violence, sociology, perinatal psychiatry, and anthropology. RESULTS: Our evaluation included 60 records which were considered as 'mature'. Maturity was determined by the reported concept definition, attributes, antecedents, outcomes, and boundaries. The four broad principles of the philosophy of science epistemology, pragmatics, linguistics, and logic illustrated that women live in a political, and cultural world that includes social, perceptual, and practical features. The conceptual components antecedents, attributes, outcomes, and boundaries demonstrated that a traumatic birth experience is not an isolated event, but its existence is enabled by social structures that perpetuate the diminished and disempowered position of women in medical and institutionalised healthcare regulation and management. CONCLUSION: The traumatic childbirth experience is a distinctive experience that can only occur within a socioecological system of micro-, meso-, and macro-level aspects that accepts and allows its existence and therefore its sustainability - with the traumatic experience of the birthing woman as the central construct.

TOWARD A HEALTHY SOCIETY: WHEN TRAUMA AFFECTS GROUP IDENTITY.

OBJECTIVE: The aim: The purpose of the article is to identify the essence and causes of collective trauma and reveal its consequences for group identity. PATIENTS AND METHODS: Materials and methods: The authors used an interdisciplinary approach along with the principles of objectivity, tolerance, and impartiality. The analysis of the texts was conducted according to the basic principles of hermeneutics, namely the inexhaustibility of the authentic text and immanent critique. In addition, the method of conceptual and categorical analysis was applied, as well as induction, deduction, generalization, etc. The data collection was carried out using PubMed, Scopus, Google Scholar databases. Research papers were identified according to search terms: "trauma", "traumatic experience", "collective trauma", "traumatization", "stress", "historical trauma", "defeat", "the Holocaust", etc. CONCLUSION: Conclusions: Collective trauma is a mental wound caused by the direct or indirect traumatic experience - a stressful situation that becomes a source of emo¬tional tension due to an unexpected threat to the life of a group of people. Collective trauma occurs, on the one hand, due to the awareness of helplessness in the face of danger and, on the other hand, due to the excessiveness of traumatic experience, which turns it into the eternal present and destroys identity. Historical traumas arise in the process of conscious exploitation of traumatic experience by political or other leaders in order to achieve emotional unity and group consolidation. Without appropriate processing, they can cause antisocial behavior of the traumatized persons that manifests in seeking revenge. Social partnership can help us to avoid the negative consequences of collective trauma and achieve social consensus.

Home-based pulmonary rehabilitation for adults with severe asthma exposed to psychosocial chronic stressors.

OBJECTIVE: To evaluate the effects of a home-based pulmonary rehabilitation (PR) programme on hyperventilation symptoms, anxiety and depressive symptoms, general fatigue, health-related quality of life (HRQoL) and exercise capacity in adults with severe asthma who have been exposed to psychosocial chronic stressors. METHODS: Data on 111 non-selected consecutive adults with severe asthma who enrolled in an 8-week home-based PR programme (weekly supervised 90-min session) was retrospectively analysed. Chronic stressors included physical, sexual and psychological violence and/or a traumatic experience related to an intensive care unit stay. Hyperventilation symptoms (Nijmegen questionnaire), Hospital Anxiety and Depression Scale, Fatigue Assessment Scale, COPD Assessment Test, Six-Minute Stepper Test and Timed-Up and Go test were assessed at baseline and after PR. RESULTS: At baseline, participants who have been exposed to chronic stressors (n = 48, 43.2%) were younger, more often female, more often treated for anxiety and depressive disorders, and had a higher score for anxiety symptoms, hyperventilation symptoms and a poorer HRQoL, compared to those who had not been exposed to chronic stressors (p < 0.05). All the study assessments were statistically improved after PR for both groups (p < 0.001). Anxiety and depressive symptoms, fatigue and health-related quality of life questionnaires were also clinically improved based on the minimal clinically important difference. CONCLUSION: A large proportion of adults with severe asthma, mainly women, have been exposed to chronic stressors at the time of starting a PR programme, resulting in higher anxiety symptoms and hyperventilation symptoms. However, it did not prevent these individuals from benefiting from PR.

The rocky road to freedom: number of countries transited during defection and risk of metabolic syndrome among North Korean Refugees in South Korea.

OBJECTIVES: North Korean Refugees (NKRs) undergo defection, and this has been shown to impact their current health status in South Korea. However, little is understood about how the defection process is related to metabolic syndrome (MetS). This study regarded the defection process to be a quasi-measurement of traumatic experience and investigated whether defection was a risk factor for MetS among NKRs living in South Korea. STUDY DESIGN: This cross-sectional study obtained data from the Korea University Anam Hospital in Seoul. NKRs (N = 847) voluntarily completed questionnaires and underwent at least one medical examination between October 2008 and July 2021. METHODS: Multivariable logistic regression models were used to evaluate whether the number of countries transited by NKRs was associated with MetS by controlling for covariates. RESULTS: The prevalence of MetS among male and female NKRs in South Korea was 12.3% and 13.3%, respectively. The highest prevalence of MetS (33.4%) was among NKRs who had transited two countries. The number of months in transit countries (mean: 49.9 ± 51.7) and period of residence in South Korea (mean: 40.9 ± 40.9 months) were also considered. NKRs who transited three countries had a higher probability of MetS (odds ratio [OR] 2.660, 95% confidence interval [CI] 1.161-6.097) than those who travelled directly to South Korea. NKRs who transited three countries and had only resided in South Korea for a short period had a higher probability of MetS (OR 3.424, 95% CI 1.149-10.208) than those who have lived in South Korea for a longer period. CONCLUSIONS: Considering the social vulnerability of NKRs and consequential health problems, there is an urgent need for appropriate support from the government and society.

The relationship between childhood traumatic experience and suicidal tendency in non-suicidal self-injury behavior patients.

BACKGROUND: Individuals with non-suicidal self-injury (NSSI) behavior are usually prone to repeated, intentional, direct harm to their own bodies that is not allowed by society without suicidal ideation. Under this behavior guidance, childhood traumatic experience may easily cause a series of psychological comorbidity symptoms, such as anxiety and depression, finally leading to a suicidal tendency. METHODS: A total of 311 adolescent NSSI behavioral patients were recruited at the Ningbo Kangning hospital, Zhejiang Province according to the DSM-5 diagnostic criteria. Demographic data, childhood abuse and neglect, internet addiction, self-esteem, anxiety, and suicidal tendency were evaluated. A structural equation model with a path induction mechanism was constructed to evaluate the relationship between distal and proximal factors related to suicidal tendencies due to childhood traumatic experiences in NSSI behavioral individuals. RESULTS: Among the 311 subjects included in the survey, 250 (80.39%) suffered traumatic experiences, such as emotional abuse/physical abuse/sexual abuse/emotional neglect or physical neglect in their childhood, 303 (97.43%) had suicidal ideation, 271 (87.14%) showed the total score of self-esteem, 148 (47.59%) had different degrees of Internet addiction tendency, and 286 (91.96%) showed obvious anxiety. The established path model fit well (GFI = 0.996, RMSEA = 0.03), and the model showed that self-esteem, anxiety, and childhood traumatic experience had standardized coefficients of -0.235 (z = -4.742, p < 0.01), 0.322 (z = 6.296, p < 0.01), 0.205 (z = 4.047, p < 0.01), respectively, with suicidal ideation path, suggesting that self-esteem, Internet addiction, and anxiety showed significant mediating effects in the process of childhood traumatic experience affecting suicidal ideation. CONCLUSION: In the context of childhood traumatic experience, it is often accompanied by a series of regulatory behaviors such as Internet addiction, self-esteem, and so on, which finally leads to anxiety, mental symptoms, and even suicidal tendencies. The results provide effective support for the structural equation modeling to evaluate the multi-level influence of NSSI behavior individuals and emphasize that childhood familial factors may lead to psychiatric comorbidity symptoms and suicidal behavior.

The Relationship between Trauma and Attachment in Burundi's School-Aged Children.

The exposure of children and adolescents to trauma is one of the most important public health challenges. These childhood experiences play a role in children's attachment patterns with their parents and peers. The objective of this study was to examine the relationship between exposure to trauma and the degree of attachment representations in school-aged children in Burundi. One hundred thirteen vulnerable children aged 7 to 12 years were recruited and referred by their teachers. We used an event list including the post-traumatic reaction index to measure their exposure to traumatic events and the People in My Life instrument to measure attachment representations. The results revealed that the children had experienced or witnessed at least one traumatic event. The results indicated that secure attachment representations were highest among children with their parents and lowest among children with their peers. The relationship between trauma experiences and children's attachment representations was significant with their parents and with their peers. Children's attachment representations with their parents and peers predicted their traumatic experiences. Future research should focus on how attachment relationships can facilitate counselors and clinicians in providing preventive psycho-education to adults and children to develop healthier functioning, through better knowledge of the complex interplay between traumas.

Coping with Secondary Traumatic Stress.

Exposure to the traumatic experiences of others can lead to secondary traumatization (STS), a condition comprising trauma-related symptoms. There is a lack of evidence on efficient ways to mitigate STS among professionals working with refugees, who are secondarily exposed to traumatic content. This study examines the latent structure of coping mechanisms and explores the predictive power of coping strategies for STS in a sample of professionals working with refugees. A total of 288 participants (age: M = 34.01, SD = 10.03; 57.3% female) working with refugees completed the COPE Inventory and Secondary Traumatic Stress Scale. Factor analysis of the COPE Inventory showed that coping mechanisms are grouped around four interrelated factors-Problem-focused, Socially supported emotion-focused, Avoidant, and Passive coping-which accounted for 46.7% of the variance. The regression model showed that Avoidant coping positively predicts negative alterations in cognition, mood, and reactivity (NACMR) and intrusions, and Passive coping was positively associated with NACMR and avoidance. Problem-focused coping was related to lower NACMR and avoidance, while Socially supported emotion-focused coping was not associated with any of the STS symptoms. In total, coping factors accounted for 10.8%, 6.3%, and 4.3% of the variance of NACMR, intrusions, and avoidance, respectively. The study provides a foundation for programs to mitigate STS among professionals working with refugees.

Using EMDR to treat intimate partner relationship break-up issues.

The Break-Up Aid Procedure (BUAP) is a proposed EMDR intervention designed to address the difficulties that some patients experience when trying to overcome a complex break-up. The procedure aims to not only target the consequences of the break-up, but also the difficulties that may be present in starting a new relationship. The latter is often the case when there are either unresolved consequences from the previous break-up or untreated early adverse experiences. By structuring the treatment in three sequential stages (outlined in this article) and including interventions and adaptations to the standard EMDR protocol, we aim to facilitate the clinician's therapeutic approach to intervening for this specific presenting concern and maximizing success.

MENTAL HEALTH AFTER TRAUMA: INDIVIDUAL AND COLLECTIVE DIMENSIONS.

OBJECTIVE: The aim: The article is devoted to uncovering the essence of the trauma, identifying the cause of its formation, and investigating the consequences for the person and the community. PATIENTS AND METHODS: Materials and methods: The methodological basis of the given study is the interdisciplinary and hermeneutic approach, which was used in combination with the methods of retrospective, analysis, synthesis, and extrapolation, as well as the methodological apparatus of memory studies with its inherent intention of the problem of group identity formation. A prominent place in the process of writing the work played the method of critical literature review. Sources reflecting research on individual and collective dimensions of trauma were found in PubMed, Scopus, and Google Scholar. Research articles were found using the keywords "trauma", "traumatic experience", "victim", "violence", "collective trauma", "cultural trauma", "memory", etc. CONCLUSION: Conclusions: Modern studies of traumatic experience are inextricably linked with the scientific work of Sigmund Freud, who was one of the first to explicate trauma as a destroyer of "protection". This gave reason to modern researchers to consider it an emotional reaction of the psyche to mental, physical, or cultural violence directed against the identity of an individual or an entire community. Whether inflicted on an individual or a community as a whole, trauma invariably seeks testimony in order to produce meanings and mechanisms capable of preventing violence and preserving the mental health of both the individual and the community as a whole.

Ferenczian Elasticity in the Analysis of an Adolescent.

Psychoanalytic work with adolescents poses a challenge for analysts who adhere to standard analytic technique as many adolescents who need analytic intervention resist such a structured approach to analysis. The author finds that elasticity of technique is currently widely used by analysts when working with this difficult age group even though they may be unaware that this is, in fact, a Ferenczian technique. Clinical examples are presented to illustrate how frequently the technique is used in cases of resistant, troubled youth. The author outlines an approach that is sensitive to these resistances and makes compromises in technique based on the principle that engaging a troubled youth in a therapeutic venture is preferable to refusing treatment based on the patient's not being able to adhere to standard analytic technique. In this sense, Ferenczi was an early herald of the type of contemporary analytic work that is practiced currently especially with a difficult population of patients.

[Posttraumatic stress disorder and emergency cesarean delivery: Incidence and risk factors]. / Stress post traumatique et césarienne en extrême urgence : incidence et facteurs de risque.

BACKGROUND: Posttraumatic stress disorder (PTSD) is declared in 3 to 6 % of postpartum women (PP) and up to 18.5 % in cases of complications of pregnancy or childbirth. The objective of this study is to assess the prevalence of PTSD after a red code cesarean section and to identify the risk factors among the prenatal vulnerability factors, the birth alert factors and the maintenance factors in PP. METHOD: A phone or computerized questionnaire including an Questionnaire de stress immédiat and the Posttraumatic Stress Disorder Checklist for DSM-5 was offered to patients who had a red code cesarean section between 05/12/2015 and 02/28/2021 at the University South Hospital of Reunion Island. RESULTS: Among the 555 cesarean sections selected, 329 parturients responded. The prevalence of PTSD was 20.1 % and was stable over time. The 2 risk factors found were the negative experience of childbirth and the proven traumatic experience. Prenatal vunerability factors were not found to be statistically significant. Almost 3 in 4 women had not been informed of the risk of cesarean section and more than 1 in 2 women did not have an explanation in PP. CONCLUSION: Red code cesarean sections cause PTSD in 1 in 5 women. This lasting disorder can last up to 6 years after childbirth. This indicates the seriousness of this disorder and the need to prevent it. The risk of developing it is 4 times greater in the event of a traumatic experience proven in the Questionnaire de stress immédiat. Offering this questionnaire in the maternity could be an important element of secondary prevention. The role of health personnel remains essential.

Interventions Focused by Nurses for Reducing Negative Effect of Traumatic Experience on Victims of Sexual Violence: A Scoping Review.

Sexual violence has increased quite rapidly. Sexual violence can be in the form of physical or verbal violence. The impact of sexual violence causes a traumatic experience that causes physical problems, psychological problems, loss of the future, and causes the risk of death. Nurses have an important role in reducing the impact of sexual violence on victims. The purpose of this study is to describe nursing interventions to reduce the impact of traumatic experiences experienced by victims of sexual violence. This study used a scoping review method. The literature used in this study is from CINAHL, PubMed, and Scopus. Keywords in this study are sexual violence, traumatic experience, impact, and victims. Search strategy used PRISMA Extension for Scoping Reviews to select articles for this study. The inclusion criteria were that the sample was female victims of sexual violence, studies employed a randomized control trial or quasi-experimental research design, and the publication period was of the last 10 years (2013-2022). We found 10 articles that matched the inclusion and exclusion criteria. The findings from this scoping review show that nursing interventions can reduce the impact of traumatic experiences on victims of sexual violence. There are three methods of nursing intervention, namely cognitive behavior, counseling, and web-based intervention. The samples are from developing and developed countries. The range of the samples are from 35-1250 respondents. Nursing interventions focus on victims in order to improve mental health and reduce the traumatic impact experienced by victims of sexual violence. The activities carried out were psychoeducation, keeping a daily journal, and discussions related to the traumatic experiences experienced. Nurses as health workers have a role to provide comprehensive nursing care to victims of sexual violence by taking into account the characteristics and impact of trauma experienced by victims of sexual violence.

Qualitative study on post-traumatic experience of inpatients with simple maxillofacial trauma / 中国实用护理杂志

Objective:To investigate the post-traumatic experience of inpatients with simple maxillofacial trauma, and to provide a theoretical basis for the construction of post-traumatic intervention programs.Methods:A qualitative approach was used to conduct semi-structured interviews with 17 inpatients with simple maxillofacial trauma in Affiliated Hospital of Nantong University from January to April, 2020, and Colaizzi phenomenological analysis was used to analyze the interview data.Results:The post-traumatic experience of inpatients with simple maxillofacial trauma mainly included five themes: acute impairment of maxillofacial function, change of comfort, disorder of self-image, transformation from negative psychological experience to positive psychological experience, and lack of coping resources.Conclusions:Medical staff should pay attention to the functional recovery, body image and psychological intervention of inpatients with simple maxillofacial trauma, provide more professional support, and promote the physical and mental recovery of patients.

Absence of negative associations of insular and medial frontal gray matter volume with dissociative symptoms in schizophrenia.

BACKGROUND: Dissociative symptoms have been constantly found in schizophrenia (SCZ). Traumatic experience seems to relate to dissociative symptoms and brain volume alterations in SCZ. The current study aimed to clarify the inter-relations of dissociative symptoms, traumatic experience, and brain volume in SCZ. METHODS: We employed voxel-based morphometry to compare the distributions of gray matter volumes (GMV) in 37 SCZ patients and 26 healthy volunteers (HV). All participants underwent T1-weighted images on a 1.5 T MRI system. Traumatic experience was examined by the Brief Betrayal Trauma Survey. Pathological and non-pathological dissociation were measured by the Dissociative Symptoms Scale and the Dissociative Experiences Scale, respectively. RESULTS: A GMV reduction was found in SCZ patients in the right thalamus. Importantly, a significant group by pathological dissociation interaction was observed in the medial frontal cortex (MFC), bilateral anterior insular area, and precuneus. A negative correlation between MFC/insular GMV and pathological dissociation was observed in HV; higher non-pathological dissociation and smaller volume in MFC/insula were associated with pathological dissociation. In contrast, higher traumatic experience, higher non-pathological dissociation, and larger volume in MFC/insula were associated with pathological dissociation in SCZ. CONCLUSION: The negative association between MFC/insula GMV and pathological dissociation in HV was not observed in SCZ patients. The absent negative association in SCZ suggests a unique neural underpinning in SCZ with dissociative pathology, in which medial frontal and temporal regions play crucial roles.

Professional Quality of Life Factors and Relationships in Nursing and Psychiatric Nursing Students: An Exploratory Study.

INTRODUCTION: Professional quality of life (ProQOL) that encompasses compassion satisfaction (CS) and compassion fatigue (CF) comprised of burnout (BO) and secondary traumatic stress (STS) has been raised as a world-wide issue for the nursing profession. Limited attention has been paid to the vulnerabilities of nursing students to ProQOL and the associated mechanisms. PURPOSE: Determine what factors are predictive of ProQOL in a population of undergraduate nursing and psychiatric nursing students. Methods: A cross-sectional survey was conducted comprised demographic questions and four validated measures: the Professional Quality of Life Scale (version 5), Core Self-Evaluations Scale, Perceived Stress Scale, and Life Events Checklist (version 5). RESULTS: Students in long-term care-palliative care rotations reported significantly higher levels of BO in comparison to other care areas. Regression analysis revealed students with low self-efficacy and high perceived stress were predictive of BO. Students with increased exposures to prior traumatizing life events were predictive of STS. Students with high levels of self-efficacy and less intent-to-leave were predictive of having CS. CONCLUSION: Findings assist educators, clinicians, and policy makers in understanding at-risk clinical settings and predictors of ProQOL in pre-licensure students. Curricular recommendations that include mindfulness, coping and crisis peer-debriefing, and emotional intelligence are discussed.

Aftershock: CEO Great Famine Experience and Stock Price Crash Risk.

This study examines the effect of CEOs' early-life traumatic experience on firm-specific stock price crash risk. Drawing on the idea of natural experiments, we take the Great Famine in China as an external traumatic event which cannot be selected or controlled by human. The analysis points out that compensation psychology and irrational defense psychology after the trauma of Great Famine are important factors that cause CEOs to hoard bad news. Based on a large sample of Chinese companies from 2007 to 2017, we find evidence that CEOs who experienced the Great Famine during early-life tend to hoard bad news, which result in higher stock price crash risk. The more severe and prolonged the Great Famine that the CEOs experienced, the greater the effect of this traumatic experience. CEOs decision-making power enhances the adverse effect of CEOs' early-life traumatic experiences on crash risk. Findings of this study contributes to the literature by providing a new explanation for the stock price crash risk, which is of great significance for the sustained and healthy development of capital markets.

The Effect of Traumatic Experiences of North Korean Adolescent Refugees upon Their Negative Health Perception: Focusing on Multiple Moderating Effect of Problem-Focused versus Social Support-Focused Coping Strategies.

The health problems of North Korean (NK) refugees living a new life after surviving the dangers of life and death traumas is an issue that must be taken very seriously. Adolescent refugees may be particularly vulnerable to adverse physical and mental health issues because of major physical, cognitive, and psychosocial developmental changes during adolescence. This study examines the positive roles two active coping strategies-problem-focused coping and social support-focused coping-can play in NK refugee adolescents' health self-awareness. The analysis found that "social support-focused coping" alleviates the negative relationship between traumatic experience and health perception, acting as a protective factor. Contrary to our prediction, the protective effect of adopting "problem-focused coping" in this study was not verified. The findings suggest that providing interventions for developing appropriate coping strategies help them live healthier, both physically and mentally, in South Korean society.