• Rorschach indices and autonomic stress reactivity

      Tong, John E.; Murphy, I. C. (1960)
      A Rorschach test and laboratory stress techniques were administered to 200 male inmates of a state hospital for mental defectives. The findings were compared via correlational techniques to validate Rorschach indices of anxiety and emotional reactivity. The results showed that color responses were highly correlated with the laboratory stress measures, and the shading responses were slightly associated with the laboratory measures indicating anxiety. The skin temperature reaction to experimental frustration was the only index which was consistently related to the Rorschach indices. Some questions were raised concerning the level of the validity of Rorschach test in its present form, and the hypothesis was advanced that the Rorschach test may primarily measure particular anxiety reactions associated with ego involvement rather than other indices. From Psyc Abstracts 36:02:2HN24T. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • The prevalence of post traumatic stress disorder in a special hospital population of legal psychopaths

      Kruppa, Ilona; Hickey, Nicole; Hubbard, Caroline (1995)
      This paper describes a study conducted at Rampton Hospital, a maximum security facility for mentally disordered offenders, to examine the prevalence of Post Traumatic Stress Disorder (PTSD) in samples of male and female patients in the legal category of psychopathic disorder. High prevalence rates of both current and lifetime PTSD diagnoses were found in both groups and in a significant number of cases the trauma associated with the PTSD symptoms was the offence that led to the individual's admission. There is evidence to suggest that the pattern of symptoms presented in offence-related and non-offence related PTSD may be trauma specific. Despite the small sample sizes involved, it is concluded that there is sufficient evidence to suggest the need for a larger scale investigation of PTSD in this population. © 1995, Taylor & Francis Group, LLC. All rights reserved.
    • An investigation of the prevalence of psychological morbidity in burn-injured patients

      Tedstone, Josephine E. (1997)
      Research on the psychological impact of burn injuries has concentrated on major burns, while small burns have been largely neglected. In a prospective study, 45 patients with burn injuries ranging from 1 per cent or less up to 40 per cent total body surface area were assessed using semi-structured interviews within 2 weeks of sustaining the burn, and followed-up at approximately 3 months postburn to investigate the prevalence of mental health problems. The prevalence of clinically significant levels of anxiety, intrusions and avoidance remained similar at 2 weeks and 3 months postburn, however, the prevalence of depression and Post Traumatic Stress Disorder (PTSD) increased 6- and 4-times, respectively, by 3 months. Patients with small burn injuries of 1 per cent or less also experienced clinically significant levels of psychological difficulties postburn. The implications for the identification of patients at risk of future psychological morbidity are discussed.;
    • Alternative therapy or good nursing care? Therapeutic touch with mentally disordered offenders

      Brimsted, Anne; Miller, A.; Robinson, David K. (1998)
      Therapeutic touch (TT) is an alternative therapy that has been used for many years within the general nursing and medical context and is becoming increasingly popular in psychiatry. This paper gives an account of TT in a selected patient and explores its potential as an alternative therapy with patients in forensic psychiatric care.
    • An investigation of the factors associated with an increased risk of psychological morbidity in burn injured patients

      Tedstone, Josephine E. (1998)
      Previous research aimed at identifying factors that increase the risk of major burns patients experiencing psychological problems post-burn has generally ignored the potential role of psychological factors. In a prospective study, patients with burn injuries ranging from < 1 per cent up to 40 per cent were interviewed within 2 weeks of sustaining the burn and followed up at ca 3 months post-burn in order to assess the effects of both non-psychological and psychological factors on their subsequent mental health. The factors investigated included burn related information, demographic information, previous psychiatric history, levels of psychological morbidity at 2 weeks post-burn, responsibility for the injury, previous life events, compensation claims and factors from the coping literature including appraisal, coping strategies and coping efficacy. Forward stepwise multiple regression analyses were used to investigate the relationships between these factors and subsequent mental health. Post-burn psychological morbidity was strongly associated with psychological factors including levels of psychological morbidity in the first 2 weeks of sustaining the injury and factors from the coping literature.;
    • Staff well-being: a survey of stress and stressors in a community mental health service

      Diamond, Ross; McAdam, Melanie (1999)
      Working in the health service, and in mental health in particular, is acknowledged to be one of the most stressful occupations. MELANIE McADAM and ROBERT DIAMOND report the findings of a survey of its staff by one mental health trust and discuss the implications for service organization and management.
    • Families of homicide victims: Psychiatric responses and help-seeking

      Evans, Chris (2002)
      The number of homicides in the UK is increasing: 850 homicides were recorded in England and Wales last year, but little is known about their impact on surviving family members. This study describes their psychological and social effects. Relatives seeking help from Victim Support were surveyed about their experiences, responses and help-seeking and asked to complete a number of psychological measures. Victim Support workers provided additional information. High levels of post-traumatic stress symptomatology and generalized distress were identified, as well as an increase in prescribed psychotropic medication. Other effects included increases in anger and irritability, cigarette consumption and loss of employment. However, few family members had been referred for professional treatment.
    • Psychosocial care of mothers after stillbirth [1] (multiple letters)

      Turton, Penelope; Hopper, Earl; Evans, Chris (2002)
    • Posttraumatic stress disorder following medical illness and treatment

      Tedstone, Josephine E. (2003)
      Studies describing posttraumatic stress disorder (PTSD) as a result of physical illness and its treatment were reviewed. PTSD was described in studies investigating myocardial infarction (MI), cardiac surgery, haemorrhage and stroke, childbirth, miscarriage, abortion and gynaecological procedures, intensive care treatment, human immunodeficiency virus (HIV) infection, awareness under anaesthesia, and in a group of miscellaneous conditions. Cancer medicine was not included as it had been the subject of a recent review in this journal. Studies were reviewed in terms of the prevalence rates for PTSD, intrusive and avoidance symptoms, predictive and associated factors and the consequences of PTSD on healthcare utilization and outcome. There was considerable variability both in the study methodology and design and in the results. The highest prevalence rates were identified in patients treated in intensive care units (ICUs) and those with HIV infection. Irrespective of the physical illness, posttraumatic symptomatology is more common than PTSD caseness. Existing characteristics of the patient may well predispose individuals to the development of PTSD as do other factors such as poor social support and negative interactions with healthcare staff. Generally, the severity of the illness itself is not predictive of PTSD. Issues relating to sampling, attrition, diagnosis, the course of symptoms, aetiological pathways, and the consequences of the disorder are discussed. The presence of PTSD most probably influences the patient's use of healthcare resources and may affect their clinical outcome.;
    • Korean War flashbacks: Treating PTSD

      Musruck, Dass (2003)
      United Kingdom military personnel have been involved in the recent Iraq war. While fatalities and casualties were relatively light compared to other conflicts historically, individual incidents can, nevertheless, have a lasting impact on individuals who witness them or are involved. Subsequent wars, though not participated in, can lead to a recurrence of damage. In this care study, Alan Pringle and Dass Musruck illustrate the use of scripted exposure and eye movement desensitisation and reprocessing (EMDR) in the treatment of John, an English veteran of the Korean War who presented with post traumatic stress disorder (PTSD). Scripted exposure involves the patient keeping a written record of their most intrusive and distressing thoughts and feelings.
    • Vicarious traumatization: Implications for the mental health of health workers?

      Sabin-Farrell, Rachel (2003)
      It has been suggested that a unique feature of some mental heath practitioners' work is exposure through their role as therapists to clients' descriptions of and reactions to trauma, and that these experiences may actually indirectly cause distress and traumatization to the therapist. This proposed phenomenon has been termed "vicarious traumatization" (VT) and is the focus of the current review. The concept of VT, together with other related concepts such as "burnout," "compassion fatigue," "secondary traumatic stress" (STS), and "work stress" are appraised. Psychological mechanisms that might be theoretically involved in VT are considered. The measurement of VT is reviewed alongside the limited research evidence supporting its existence. Factors such as direct trauma exposure and the personal attributes of mental health workers, which have been suggested to be associated with VT, are also assessed. It is concluded that the evidence to support the existence of VT is meager and inconsistent. Future research needs to be directed at distinguishing VT from other sources of distress arising within the workplace. Finally, the organizational relevance of VT and its possible implications for the management of mental health workers are critically appraised.;
    • Sertraline as a treatment for PTSD: A systematic review and meta-analysis

      Mooney, Paul; Oakley, Janette; Ferriter, Michael; Travers, Raymond F. (2004)
      Objective: Post-traumatic stress disorder (PTSD) is one of the most prevalent psychological disorders. Methods to alleviate its symptoms range from 'talking therapies' to pharmaceutical interventions. Our objective was to carry out a systematic review of the effectiveness of sertraline, an SSRI, as a treatment for PTSD. Method: Databases were searched to identify relevant research on sertraline as a treatment for PTSD. Results: Five randomised control trials were identified, along with seven open trials and case series studies. Conclusions: The review and meta-analysis supported the use of sertraline for PTSD though further research on sub-group differences (eg. gender) is required.
    • The therapy seesaw: Achieving therapeutically balanced approaches to working with emotional distress

      Talkes, Kirsty; Tennant, Allison (2004)
      This paper has been written following an influential therapeutic encounter that we experienced while working with an emotionally distressed woman. The barriers that can get in the way of providing a structured therapeutic approach are discussed. The paper focuses on dialectical behaviour therapy as a treatment model, and discusses how the concept of 'dialectics' can provide an over-riding context for case conceptualisation (Linehan, 1993). The dialectical dilemmas and powerful dynamics that can be enacted between individuals, teams and patients in their endeavours to cope with distress will be illustrated. The dialectical philosophy is described and elaborated upon, providing a framework for the synthesis of clinical interpersonal encounters and metaphorical concepts of a therapy seesaw. The paper discusses how these ideas can guide us in our work with emotionally distressed individuals. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(journal abstract)
    • Eye movement desensitisation and reprocessing: An update

      Coetzee, Rikus H.; Regel, Stephen (2005)
      Eye movement desensitisation and reprocessing (EMDR) is a relatively recent therapeutic approach to the treatment of traumatic memories in the wake of psychological trauma such as those found in post-traumatic stress disorder (PTSD). It is based on the theory that bilateral stimulation, mostly in the form of eye movements, allows the processing of traumatic memories. While the patient focuses on specific images, negative sensations and associated cognitions, bilateral stimulation is applied to desensitise the individual to these memories and more positive sensations and cognitions are introduced. Although there is still uncertainty about the theoretical concepts underlying EMDR and the role of bilateral stimulation, it is an effective and proven treatment for PTSD and traumatic memories. It should form part of treatment approaches offered to individuals with PTSD.
    • Is post‐traumatic stress disorder a helpful concept for adults with intellectual disability?

      Clegg, Jennifer (2005)
      Background Research using the concept of Post-Traumatic Stress Disorder (PTSD) with adults with intellectual disability (ID)assumes they perceive and react to traumatic events in a similar way to non-disabled adults. Reactions to trauma displayed by children may be relevant to adults with ID as well. Methods Two focus groups were held with professionals and practitioners to explore the relevance of criteria from child as well as adult literature to adults with ID who experience trauma. Descriptive thematic analysis was carried out. Results Abuse, parental bereavement, and having children removed were considered common sources of trauma. Similarities identified between disabled and non-disabled adults were flashbacks and nightmares; distressed by reminders; avoidance; hypervigilance and increased arousal. Differences were the frequent occurrence of multiple rather than single events, which were considered significant in generating chronic problems similar to those described as PTSD; also the occurrence of physical health problems and behavioural re-enactments. Discussion and conclusions Experienced professionals and practitioners considered most of the ideas from PTSD research with non-disabled adults to be relevant to adults with ID who experience trauma, but that some behaviour reported in research with children was also relevant. Topics and questions for use in clinical and research practice with individuals who have experienced trauma were proposed.
    • Exploring the meaning of trauma with adults with intellectual disabilities

      Clegg, Jennifer (2006)
      Background: Previous research investigating post-traumatic stress disorder assumed that adults with intellectual disabilities would react to trauma in the same way as those in the non-disabled population. This study explored the personal experience of trauma in a small group of adults with intellectual disabilities. Methods: Semi-structured interviews, developed from a pilot study involving focus groups, were used to interview six adults with mild intellectual disabilities from a clinical population, about their experiences of trauma. The transcripts were analysed using Interpretative Phenomenological Analysis (IPA). A quantitative measure, the Posttraumatic Diagnostic Scale [PDS; Foa et al. (1997) Psychological Assessment vol. 9, pp. 445-451] was used in conjunction with the individual interviews. Results: One theme, whether individuals perceived the world to be a dangerous or a safe place, connected the five themes that emerged from the data. The themes were identified as: (i) how the trauma affected me, (ii) I avoid things that remind me of the trauma, (iii) I am prepared for danger in the future, (iv) the tension of talking or not talking and (v) the struggle of who to blame. Conclusions: The results were related to previous theoretical frameworks and the methodological limitations of the research acknowledged. The clinical implications of the findings for disclosure, assessment and therapeutic intervention were discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)
    • Histories of trauma in client members of therapeutic communities

      Evans, Chris; Manning, Nick (2006)
      This paper presents further data from the ATC/NLCB Therapeutic Communities Research Project, based on findings from the 306 social histories collected as part of this project. The project focused on people with personality disorders in therapeutic communities, and this paper explores some of the traumatic experiences of this sample of client members prior to their admission to a therapeutic community. We look particularly at early separations from main carers and family of origin; at losses and disability, and at experiences of physical and sexual abuse in childhood and adulthood, and see what, if any, relationship these have with personality disorders for this study sample. We also explore whether the different clients in the different types of therapeutic communities have different traumatic experiences, as evidenced by these social histories. The paper discusses the implications of these findings. © The Authors.
    • Current perspectives on assessment and therapy with survivors of torture: The use of a cognitive behavioural approach

      Regel, Stephen (2007)
      Increasing numbers of refugees are presenting to mental health services in Europe and Scandinavia and pose significant clinical challenges for practitioners. The most clinically challenging to engage in a psychotherapeutic context are survivors of torture and politically organized violence. Much of the literature on therapeutic work with torture survivors has tended to focus on psychodynamic approaches. There have also been attempts to describe other approaches, such as the use of testimony, with some attempts to study and describe cognitive behavioural approaches in torture survivors. It has been demonstrated that cognitive behavioural therapy is effective for PTSD, as recommended by the NICE (2005) guidelines for the assessment and management of PTSD in primary and secondary care. This paper will review and critique the current literature on therapy with refugees and survivors of torture. Through case examples, the use of CBT will be illustrated as an effective treatment intervention for this group. It will be demonstrated that the model can have effective clinical outcomes and provide a practical, problem-orientated approach to working with survivors of torture and political violence. This paper will also describe the use of assessment and treatment approaches using CBT principles, demonstrating the flexibility and applicability of the model. It also demonstrates the utility of CBT in different cultural contexts, despite perceived cultural limitations. Implications for assessment and practice in a cross-cultural setting will be discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(journal abstract)
    • Post-trauma support in the workplace: The current status and practice of critical incident stress management (CISM) and psychological debriefing (PD) within organizations in the UK

      Regel, Stephen (2007)
      Employers' duties of care under both common and statute law include the need to take reasonable care of the health and safety of the workforce. This includes both the moral and legal duties to consider the psychological needs of personnel following exposure to traumatic events related to the workplace. While this has been recognized within many high-risk occupations such the police, fire and rescue services and the military, there is also evidence that post-trauma support in the workplace is increasingly commonly provided not only among health and social services agencies, but within many private sector organizations. Over the past decade, however, there has been considerable controversy over the provision of early psychological support to personnel in the form of critical incident stress management (CISM) processes. In particular, one aspect of CISM, the use of psychological debriefing (PD) has come under scrutiny and criticism as two studies indicated that PD was ineffective and had the potential to do harm. Inevitably, this has provoked much uncertainty and confusion among some organizations as what should be the most appropriate support. It has also led to misconceptions and misunderstandings as to the aims and purpose of PD, together with inaccuracies of terminology, for example describing PD as 'counselling'. Despite the controversy, both CISM and PD continue to be provided on a widespread basis, often utilizing a framework of voluntary peer group support. This paper intends to (i) present a review of the current status of CISM practices, including the use of PD within various organizations in the UK and (ii) provide a clear framework and understanding of the main issues and to clarify conceptual misunderstandings. The history, principles and background of the use of post-trauma support in the workplace, charting trends over the past two decades, previous research, problems with the evidence base and current thinking and practice in the field are reviewed. The relevance and implications of the National Institute for Clinical Excellence Guidelines on the Assessment and Management of Post Traumatic Stress Disorder, which make recommendations for early interventions for post-traumatic stress disorder are discussed. Reference is made to the use of CISM and PD within both statutory and voluntary organizations in an international context.;
    • Open forum

      Brooks, Val (2007)