• Childhood determinants of suicidality: comparing males in military and civilian employed populations

      Syed Sheriff, Rebecca (2018)
      BackgroundTo better understand the associations of childhood trauma and childhood disorder with past-year suicidality (thoughts, plans or attempts), we compared male military and civilian populations aged 18–60 years old.MethodsData derived from the 2010 Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study and the 2007 Australian Bureau of Statistics Australian National Survey of Mental Health and Wellbeing were compared using logistic regression and Generalized Structural Equation Modelling (GSEM).ResultsA greater proportion of the ADF experienced suicidality than civilians. Those who experienced childhood trauma that was not interpersonal in nature were not at increased odds of suicidality, in either population. A higher proportion of the ADF experienced three or more types of trauma in childhood and first experienced three or more types of trauma in adulthood. Both were associated with suicidality in the ADF and civilians. Childhood anxiety had a strong and independent association with suicidality in the ADF (controlling for demographics and childhood trauma, adult trauma and adult onset disorder). Childhood anxiety fully mediated the relationship between childhood trauma and suicidality in the ADF, but not in civilians.ConclusionsThese data highlight the need to take a whole life approach to understanding suicidality, and the importance of categorizing the nature of childhood trauma exposure. Importantly, childhood anxiety was not only associated with suicidality, it fully mediated the relationship between childhood trauma and suicidality in the more trauma exposed (military) population only. These findings have the potential to inform the development of strategies for suicide prevention.
    • Childhood trauma and childhood mental disorder in military and employed civilian men

      Syed Sheriff, Rebecca (2020)
      We aimed to retrospectively investigate childhood trauma and childhood mental disorder in military and employed civilian men aged 18 to 54 years. Data, derived from the 2010 Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study and the 2007 Australian Bureau of Statistics National Survey of Mental Health and Wellbeing Study, were analyzed and compared using direct age standardization and logistic regression. A greater proportion of ADF reported childhood trauma, multiple trauma types, trauma onset below 12 years of age, and interpersonal trauma than civilian employed men. A greater proportion of ADF reported childhood noninterpersonal trauma, such as accidents, than civilian employed men, with a marked difference in those aged 45 to 54 years. In both populations, childhood disorder was associated with childhood trauma; however, childhood depression was not associated with childhood noninterpersonal trauma in either population. A deeper understanding of the longer-term risk and resilience conferred by different childhood trauma profiles is needed.
    • Commonalities and new directions in post-trauma support interventions: From pathology to the promotion of post-traumatic growth

      Regel, Stephen (2012)
      This chapter will aim to address a number of issues in order to lend clarity to the debate by beginning with (1) providing a brief overview of the development of Psychological Debriefing (PD) and the direction of research in the field; (2) examining the current trend to re-invent the wheel by renaming CISM and PD interventions; (3) deconstructing some of the myths surrounding PD, especially that of retraumatization through the provision of PD; and (4) examining and illustrating how the literature has added to the lack of clarity and confusion. The chapter will also go on to examine some key issues in the provision of PD within the context of post-trauma support, such as training in PD, the role of assessment prior to initiating peer support group crisis intervention meetings, and what the NICE Guidelines for PTSD really recommend with regard to early interventions. We will then move on to argue for the use of CISM, PD, and other workplace trauma support interventions within the context of social and organizational support given that there is significant evidence to indicate that social support is seen as a significant protective factor following exposure to traumatic events and the lack of social support as a major risk factor. Finally we will argue for a more sophisticated approach to research and practice in the field of workplace trauma support by suggesting a new paradigm for understanding the rationale for providing such support. This will be through addressing issues related to measuring the effectiveness of interventions within the context of post-traumatic growth rather than the presence or absence of pathology, an issue, which has dominated the literature with regard to assessing the effectiveness of early interventions. The promotion of psychological well-being (PWB) and resilience will also be addressed. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: chapter)
    • Early interventions following traumatic bereavement

      Regel, Stephen (2014)
      A 'traumatic bereavement' is such when the loss is sudden, violent or unexpected; for example, a road traffic collision, suicide or homicide. The experience is terrifying and shocking; individuals cannot prepare for, or protect themselves from, the event. Many traumatically bereaved people find their profound shock, loss or grief is compounded by a lack of help at this terrible time. They need early support, information and advice to help them cope, understand the reactions they are experiencing, and make sense of what has happened. Accessing early support following a traumatic bereavement can make a significant difference to someone's long-term recovery. This report explores: common reactions to traumatic bereavement and how they develop; the role of assessment; and some strategies to manage the challenges that arise as a consequence.
    • Expanding the bounds of military psychiatry: Three clinical encounters

      Moldavsky, Daniel (2008)
      This paper deals with clinical situations frequently encountered in military psychiatry. Using three narratives of soldiers assessed at the Israeli Defence Forces (IDF) during a period of marked conflict between Israel and the Palestinian Authority, the author portrays ethical dilemmas generated during assessments for fitness to go to combat. When the focus of the assessment is the soldier's refusal to serve in the army, particularly during periods of increased conflict, the psychiatrist faces a dilemma because of double loyalties, to the army of which he is a part, and to the soldier and his right to live. Based on previous literature and experience, some cases of refusal to serve may be understood going beyond the boundaries imposed by the medical model. The author discusses these issues in the context of Israeli society. In Israel, conscription is universal, and the army is not professional. However, given the lack of social legitimacy in Israel for refusal to serve in the IDF due to conscientious objection, soldiers who are otherwise aware of the ethical dilemmas imposed upon them by the harsh Israeli reality are left with no option other than to get exempted from military duties on psychiatric grounds. The author discusses how social and historical factors contribute to the construction of psychiatric and psychological symptoms.;
    • 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)
    • Growth in relationship: A post-medicalized vision for positive transformation

      Murphy, David; Joseph, Stephen (2011)
      In this chapter we set out a vision for the future with regard to the understanding of trauma and helping survivors of potentially devastating events. There is little doubt that when unexpected events happen we will be faced with challenges we had previously not considered. We need to deal with what had hitherto been the unthinkable. In this chapter we begin by outlining some of the unthinkable yet common things that happen to people, and review the evidence that suggests that the way people respond to traumatic events is often transformational in nature. Whilst we recognize the deleterious effects of trauma and the legitimate suffering many incur as a result, the struggle with trauma is also known to provide a springboard to greater psychological well-being. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(chapter)
    • Open forum

      Brooks, Val (2007)
    • Psychological and physical health impacts of forensic workplace trauma

      Mistry, Dipti; Gozna, Lynsey (2021)
      Purpose: Health-care professionals working in inpatient forensic mental health settings are exposed to a range of traumatic and distressing incidents with impacts discussed variously as “burnout”, “compassion fatigue”, “secondary trauma stress” and “vicarious traumatisation”. This study aims to explore the short- and long-term psychological and physical health effects of trauma exposure in the workplace for frontline staff in a forensic setting. Design/methodology/approach: Semi-structured interviews were conducted with 14 nursing staff members working in the male personality disorders care stream in a Medium Secure Hospital. Findings: Thematic analysis yielded five themes: categories of trauma; how well-being is impacted; ways of coping and managing; protective factors; and systemic factors, with sub-themes within each of the superordinate themes. Practical implications: The findings demonstrate that some staff members were affected both physically and psychologically as a result of trauma-focused work whereas other staff members were unaffected. The psychological and physical health effects were broadly short-term; however, long-term effects on staff member’s social networks and desensitisation to working conditions were observed. A broad range of coping methods were identified that supported staff member’s well-being, which included both individual and organisational factors. Staff member’s health is impacted by exposure to workplace trauma either directly or indirectly through exposure to material, and there is a greater need to support staff members after routine organisational provisions are complete. Staff should receive education and training on the possible health effects associated with exposure to potentially traumatic material and events. Originality/value: This research has further contributed to understanding the staff needs of nursing staff members working with the forensic personality disorder patients within a secure hospital setting. This research has identified the following service developments: the need for ongoing support particularly after organisational provisions are complete; further prospects to engage in psychological formulations; greater opportunities for informal supervision forums; staff training to understand the potential health impact associated with trauma-focused work; supervisors being appropriately trained and supported to elicit impacts of trauma-focused work on staff members; and additional opportunities to discuss well-being or monitor well-being.
    • Resilience in trauma and disaster

      Regel, Stephen (2007)
      This chapter examines resilience in relation to trauma and disaster. The past decade has seen an increasing focus and consensus on the importance of providing psychosocial support following disasters and complex emergencies and many professionals with expertise in palliative care are being increasingly called upon to use their experience of working with loss to assist in post-disaster interventions. This chapter explains that the psychosocial well-being of individuals and communities can be defined with reference to three core domains: human capacity, social ecology, and culture and values. © Oxford University Press 2007. All rights reserved.
    • The diversity of trauma research: Contexts, approaches and controversies

      Regel, Stephen (2009)
      In this issue we have brought together papers that approach the topic of trauma from less familiar angles. The first two papers are case studies that focus on the importance of the relationship. The next two studies are qualitative investigations. Moving to a more theoretical level, the next paper questions what we know about intrusive imagery and the use of dream work. Of the final three papers, the first is a review paper which reminds us that trauma is part and parcel of the lives of the most vulnerable, and often those with the least voice in society. The second reviews the evidence for vicarious traumatisation in practitioners who work with adult survivors of sexual violence and child sexual abuse. The last provides a new conceptual model for multidisciplinary team working. These are articles written by practitioners and as such speak to the needs of other practitioners in a way that research papers often do not. As such we hope this special issue will inspire practitioners to pick up on some of the themes that arise from these articles and to think about how they can contribute to the diversity of research in the field of trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • The Psychological Well-Being-Post-Traumatic Changes Questionnaire (PWB-PTCQ): Reliability and Validity

      Regel, Stephen (2012)
      The Psychological Well-Being Post-Traumatic Changes Questionnaire (PWB-PTCQ) is an 18 item self-report measure to assess perceived changes in psychological well-being following traumatic events. The aim was to test its psychometric properties. Across three samples, evidence is provided for a single factor structure (invariant across clinical and general populations), high internal consistency (alpha > .87), six month stability, incremental validity over and above existing measures of posttraumatic growth as a predictor of subjective well-being, convergent validity with existing measures of posttraumatic growth (r = .50-.56. p < .001), concurrent validity with personality and coping measures, predictive validity of change in well-being over time, discriminant validity with social desirability, and prediction of clinical caseness.
    • Trauma: A unifying concept for social work

      Joseph, Stephen; Murphy, David (2014)
      The aim is to show how traumatic stress provides a unifying concept for social work. In the last ten years, there have been significant changes in the nature of organisations that provide social care for people in the UK, with social work practice no longer confined to traditional local authority services. Increasingly, social workers are taking up posts in a variety of settings and sectors demanding new knowledge and skills. The field of traumatic stress is not currently viewed as a social work discipline. However, trauma cuts across a range of contexts and client groups and, as such, needs to be a core component of education and training in social work. The concept of trauma and recent developments in post-traumatic growth offer a new way of thinking that necessitates the development of genuinely psycho-social and relationship-based help and support for individuals, families, groups, communities and organisations affected by adversity.
    • Visuospatial working memory interference with recollections of trauma

      Sabin-Farrell, Rachel (2009)
      Objectives. Laboratory research using a working memory framework has shown modality-specific reductions in image vividness and emotionality when concurrent tasks are performed while maintaining the image in consciousness. We extended this research to trauma images in a clinical population awaiting treatment for post-traumatic stress symptoms. Design. A within-subjects design was used, with each participant completing an imagery task under three concurrent task conditions: side-to-side eye-movements, counting, and exposure only (no concurrent task). Methods. Eighteen participants selected three images each, the images being those that were the most distressing from participants’ trauma memories and most likely to intrude involuntarily. Participants gave baseline ratings of the vividness and emotionality of each of their trauma images. Each image was assigned to a condition. Each condition comprised 8 trials in which participants recollected the appropriate image for 8 s while performing eye-movements, counting or no concurrent task, and then rated its vividness and emotionality. Follow-up ratings were obtained by telephone 1 week later. Results. The eye-movement task reduced vividness and emotionality of the trauma images relative to the counting task and exposure only, but did so only during the imagery period and not at follow-up. The images were predominantly visual. Conclusions. Concurrent tasks matched to the modality of trauma images may provide a useful treatment aid for temporarily dampening emotional responses to recollections of trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(journal abstract)
    • What doesn't kill us

      Joseph, Stephen (2012)
      The field of psychological trauma is changing as researchers recognise that adversity does not always lead to a damaged and dysfunctional Life. Post-traumatic growth refers to how adversity can be a springboard to higher levels of psychological well-being. This article provides an overview of theory, practice and research. To what extent is post-traumatic stress the engine of post-traumatic growth? How can clinicians measure change? What can help people to thrive following adversity?