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.

The Relationship between Childhood Trauma and Suicidal Ideation: Role of Maltreatment and Potential Mediators

OBJECTIVE: Childhood trauma is recognized as an important risk factor in suicidal ideation, however it is not fully understood how the different types of childhood maltreatment influence suicidal ideation nor what variables mediate the relationship between childhood trauma and suicidal ideation. This study examined the path from childhood trauma to suicidal ideation, including potential mediators. METHODS: A sample of 211 healthy adults completed the Childhood Trauma Questionnaire (CTQ), Beck scale for Suicidal Ideation (BSI), Functional Social Support Questionnaire (FSSQ) and Hospital Anxiety and Depression Scale (HADS). Path analysis was used to investigate the relationship among study variables. RESULTS: Of the several types of childhood maltreatment we considered, only childhood sexual abuse directly predicted suicidal ideation (β=0.215, p=0.001). Childhood physical abuse (β=0.049, 95% confidence interval: 0.011–0.109) and childhood emotional abuse (β=0.042, 95% confidence interval: 0.001–0.107) indirectly predicted suicidal ideation through their association with anxiety. Childhood neglect indirectly predicted suicidal ideation through association with perceived social support (β=0.085, 95% confidence interval: 0.041–0.154). CONCLUSION: Our results confirmed that childhood sexual abuse is a strong predictor of suicidal ideation. Perceived social support mediated the relationship between suicidal ideation and neglect. Anxiety fully mediated the relationship between suicidal ideation and both physical abuse and emotional abuse. Interventions to reduce suicidal ideation among survivors of childhood trauma should focus on anxiety symptoms and attempt to increase their social support.

Atos obsessivos e experiências traumáticas em Freud e Winnicott: uma análise de caso / Obsessive actions and traumatic experiences by Freud and Winnicott: a case study / Actos obsesivos y experiencias traumáticas en Freud y Winnicott: análisis de un caso / Actes obsessifs et expériences traumatiques chez Freud et Winnicott: une analyse de cas

Este artigo discute a relação entre atos obsessivos e experiências traumáticas em Freud e Winnicott, mediante o estudo de um caso clínico em que a problemática foi levantada. A sintomatologia dessa estrutura clínica é formada como um recurso que permite ao Eu lidar com uma situação que evoca perigo. Para Freud, essa situação de perigo está sempre ligada ao desejo sexual infantil, proibido e reprimido, gerador de angústia e de sintomas obsessivos, com a finalidade de anular a situação traumática geradora dos sintomas. Para Winnicott, embora o conflito edipiano ocupe o lugar central, a ênfase do perigo é deslocada para os impulsos agressivos-destrutivos, que são disfarçados pela produção de uma confusão, inconscientemente mantida, no mundo interno e de uma dissociação da esfera mental do sujeito, que, compulsivamente, procura reorganizar fora o que permanece (e tem de permanecer) confuso dentro.

The author discusses the relation between obsessive actions and traumatic experiences in Freud's and Winnicott's work by studying a clinical case in which that issue arose. The symptomatology of this clinical structure is formed as a resource which enables the ego to handle a situation that evokes danger. According to Freud, this dangerous situation is always connected to infantile sexual abuse, which is forbidden, repressed, and generates anguish and obsessive symptoms in order to eliminate the traumatic event (which caused those symptoms). Winnicott considers that, although the Oedipus complex plays a central role, the emphasis of danger is shifted to the aggressive-destructive impulses. Those impulses are disguised by a confusion, unconsciously maintained in the inner world, and by a dissociation of the mental sphere of the subject, who compulsively attempts to rearrange outside what remains (and must remain) confused inside.

Este artículo discute la relación entre los actos obsesivos y las experiencias traumáticas en Freud y Winnicott, mediante un caso clínico en que se planteó la problemática. La sintomatología de esa estructura clínica se forma como un recurso que le permite al Yo lidiar con una situación que evoca peligro. Para Freud, esta situación de peligro está siempre vinculada al deseo sexual infantil, prohibido y reprimido, generador de angustia y síntomas obsesivos, con la finalidad de anular la situación traumática generadora de los síntomas. Para Winnicott, aunque el conflicto edípico ocupa un lugar central, el énfasis del peligro se desplaza hacia los impulsos agresivos y destructivos, que son disfrazados por la producción de una confusión que se mantiene inconsciente en el mundo interno y una disociación de la esfera mental del sujeto, que intenta reorganizar compulsivamente afuera lo que permanece (y tiene que permanecer) confuso adentro.

Cet article discute le rapport entre des actes obsessifs et des expériences traumatiques chez Freud et Winnicott, moyennant l'étude d'un cas clinique où la problématique se pose. La symptomatologie de cette structure clinique est formée comme une ressource qui permet au Moi de faire face à une situation qui évoque le danger. Pour Freud, cette situation de danger est toujours liée au désir sexuel enfantin, interdit et refoulé, générateur d'angoisse et de symptômes obsessifs, ayant pour but d'annuler la situation traumatique génératrice des symptômes. Pour Winnicott, même si le conflit œdipien occupe la place centrale, l'emphase du danger est déplacé vers des impulsions agressives-destructives qui sont dissimulées par la production d'un trouble, inconsciemment maintenu dans le monde interne et d'une dissociation de la sphère mentale du sujet qui recherche compulsivement à réorganiser dehors ce qui demeure (et il faut qu'il demeure) confus dedans.

Estado e grupos armados na Colômbia: carrascos, salvadores e experiência traumática / Estado y los grupos armados en Colombia: los verdugos, los equipos de rescate y de la experiencia traumática / State and armed groups in Colombia: the executioners, rescuers and traumatic experience

Objetiva-se compreender as implicações psicossociais da elaboração da experiência traumática em familiares de desaparecidos forçados do conflito armado colombiano, a partir de uma perspectiva histórico-cultural da Psicologia Social. A pesquisa foi desenvolvida numa abordagem qualitativa de estudo de casos múltiplos. Utilizaram-se um instrumento de complementação de frases, entrevistas em profundidade e grupos de discussão. A análise das informações foi realizada em uma unidade hermenêutica no programa Atlas-ti 6.2. Depreende-se que os familiares de desaparecidos forçados permanecem em um estado de enlutamento, o que produz uma fratura na memória pela incerteza sobre o que ocorreu com o ente querido e, ao mesmo tempo, constroem sentidos contraditórios a respeito do Estado e dos grupos armados. Concluiu-se que a possibilidade de elaboração do luto envolve dimensões individuais, sociais e institucionais. Enfim, grupos armados, sociedade e Estado têm uma função fundamental na tentativa de significação da experiência traumática.

Este artículo presenta las implicaciones psicosociales de la elaboración de la experiencia traumática en familiares de desaparecidos forzados del conflicto armado colombiano, a partir de una perspectiva histórico-cultural de la Psicología Social. Se realizó un estudio cualitativo de casos múltiplos, utilizando entrevistas en profundidad, grupos de discusión y un instrumento de complementación de frases. Los datos fueron analizados en una unidad hermenéutica en el programa Atlas-ti 6.2. Encontramos que los familiares de desaparecidos forzados pueden permanecer sin realizar el duelo: se produce una fractura en la memoria debido a la incertidumbre sobre lo que sucedió con el ser querido. Al mismo tiempo, construyen sentidos contradictorios sobre el Estado y los grupos armados ilegales. Concluimos que la posibilidad de elaborar el duelo implica dimensiones individuales, sociales e institucionales. Finalmente, los grupos armados ilegales, la sociedad y el Estado tienen una función fundamental en el proceso de significación de la experiencia traumática.

Based on a historical-cultural perspective of social psychology, the aim of this study was to understand the psychosocial implications of traumatic experience in relatives of forced disappearances in the Colombian armed conflict. The research grew out of a study of multiple cases. Eighteen interviews with three focus groups were conducted and a sentence completion tool was used. The information produced was integrated in a hermeneutics unit using the Atlas-ti 6.2 program and for data analysis was used abductive reasoning. Relatives of forced disappearances remain in a state of mourning: a fracture in memory caused by the uncertainty of what happened to their loved one. It was found that relatives of forced disappearances construct contradictory meanings about State and illegal armed groups. We conclude that the overcoming of grief involves individual, historical and institutional dimensions. Thus armed groups, society and State have a crucial role to the significance of traumatic experience.

Mudança psíquica à luz do pensamento clínico contemporâneo / Mudança psíquica à luz do pensamento clínico contemporâneo / Cambio psíquico a la luz del pensamiento clínico contemporáneo

Por meio deste trabalho, propõe-se o modelo do palco para entender o processo de mudança psíquica na clínica psicanalítica atual, repleta de problemáticas narcísicas, depressões e fenômenos limítrofes, que se mesclam ou se associam às patologias neuróticas clássicas sob a forma de correntes psíquicas. O modelo do palco se insere na concepção contemporânea da psicanálise, a qual, de acordo com Urribarri (2012), baseia-se em uma leitura renovada de Freud, que revaloriza a metapsicologia e o método freudianos como fundamentos da psicanálise, a apropriação crítica e criativa das principais contribuições pós-freudianas, juntamente com um diálogo com autores contemporâneos de diversas correntes, e a ampliação da clínica aos desafios da prática relativa aos quadros não neuróticos.

In this article, the stage model is proposed for the understanding of the process of psychic change in the current psychoanalytic clinic, full of narcissistic problems, depressions and borderline phenomena which mix or associate with classic neurotic pathologies in the form of psychic currents. The stage model is inserted in the contemporary conception of psychoanalysis, which, according to Urribarri (2012), bases itself in a new interpretation of Freud which revalues Freud's metapsychology and method as foundations of psychoanalysis, the critical and creative appropriation of the main post-Freudian contributions, together with a dialog with contemporary authors of different currents, and the expansion of the clinic to the challenges of the practice related to non-neurotic cases.

A través de este trabajo se propone el modelo de escenario para entender el proceso de cambio psíquico en la clínica psicoanalítica actual, colmada de problemáticas narcisistas, depresiones y fenómenos limítrofes que se mezclan o se asocian a las patologías neuróticas clásicas bajo la forma de corrientes psíquicas. El modelo del escenario se inserta en la concepción contemporánea del psicoanálisis, la cual, de acuerdo con Urribarri (2012), se basa en una lectura renovada de Freud que revaloriza la metapsicología y el método freudianos como fundamentos del psicoanálisis, la apropiación crítica y creativa de las principales contribucionesposfreudianas, juntamente con un diálogo con autores contemporáneos de diversas corrientes, y la ampliación de la clínica a los desafíos de la práctica relativa a los cuadros no neuróticos.

Trauma precoce e transtornos de humor em jovens / Early trauma and mood disorders in youngsters

OBJETIVO: Verificar vivências precoces de abuso e negligência na infância entre jovens com transtorno bipolar (TB), transtorno depressivo maior (TDM) e controles populacionais. MÉTODO: Estudo de caso-controle aninhado a um estudo transversal de base populacional. A confirmação do diagnóstico foi realizada por meio de entrevista clínica estruturada para transtornos de eixo I do DSM-IV (SCID) e os eventos traumáticos foram verificados pelo Questionário sobre traumas na infância (CTQ). RESULTADOS: A amostra foi composta por 231 jovens, sendo 95 indivíduos no grupo controle, 82 com TDM e 54 com TB (32 do tipo I e 22 do tipo II). A prevalência de trauma na infância foi de 42,2%, sendo 54,7% entre aqueles com TB, 62,2% entre os jovens com TDM e 18,1% entre o grupo controle. Os jovens com TB ou TDM apresentaram maiores médias no CTQ total e entre seus componentes quando comparados aos jovens do grupo controle, exceto o componente abuso sexual, em que se observou diferença estatística apenas entre o grupo controle e o grupo de jovens com transtorno bipolar. CONCLUSÃO: O relato de vivências traumáticas precoces foi mais presente entre os jovens com transtornos de humor do que na população geral, confirmando o que a literatura traz sobre o tema. Nesse sentido, as vivências de trauma na infância parecem contribuir para o aparecimento dos transtornos de humor.

OBJECTIVE: To verify early experiences of childhood abuse and neglect among young with bipolar disorder (BD), major depression (MDD), and controls. METHOD: Case-control study nested to a population-based cross-sectional study. The diagnosis was performed via the structured clinical interview for DSM-IV Axis I Disorders (SCID). Traumatic events were analyzed using the Portuguese version - Questionário sobre Traumas na Infância (CTQ) - based on the Childhood Trauma Questionnaire. RESULTS: The sample comprised 231 adolescents with 95 individuals in the control group, 82 with MDD and 54 with BD (32 of type I and 22 type II). The prevalence of trauma or violence in childhood was 42.2%; among those, 54.7% had BD, 62.2% had MDD and 18.1% were in the control group. Young people with BD or MDD obtained higher means in total CTQ and among their components when compared with those in the control group. DISCUSSION: Reports on early traumatic experiences were more frequent among young people with mood disorders than in the general population, corroborating the literature on the subject. In this sense, the traumatic experiences during childhood seemed to contribute to the onset of the disorder.

Characteristics of childhood traumatic experiences in borderline personality disorder in college students / 中国心理卫生杂志

Objective: To examine the characteristics of childhood traumatic experiences in borderline personality disorder (BPD) in college students. Methods: The Personality Diagnosis Questionnaire-~(4+) (PDQ-~(4+)), Personality Disorder Interview- Ⅳ (PDI - Ⅳ) and Childhood Trauma Questionnaire -28 Short Form (CTQ-SF) were administered to 3227 college students of sophomore and junior. Results: (1) In the investigation of PDQ-~(4+), 31 subjects with childhood traumatic experiences (0.96%) were diagnosed as BPD, and the total score of BDL sub-scale was (2. 62 ± 1.70), including 18 females and 13 males. In CTQ test, the scores of bad environment in females were significantly higher than that in males [(13.63±4.54) vs. (9.83±1.95), P<0.01] . (2) Subjects with BPD got higher scores than normal controls in CTQ-SF, such as the emotional abuse [(2.11 ±0.77) vs. (1.66±0.49), P<0.01] .Conclusion: college students with borderline personality disorder mostly have d different childhood traumatic experiences, and there exists a sex difference.

The study of childhood trauma experience and family environment with obsession / 中华行为医学与脑科学杂志

Objective This study aimed to explore the relationship between the traumatic experience in childhood and onset of obsession in adulthood,and the character of family environment of obsession patients.Methods Using Y-BOCS and CAT and FES-CV to evaluate 41 cases with OCD and 36 normal subjects respectively.Baaed on these scales,an edited interview schema for a semi-structured interview was choosed with both groups for 50 minutes respectively.Results ①Tbe whole score and scores of two subscales on punishment,negative-environment in CAT were all obviously higher in patients with obsession [(50.16± 21.03),(12.03±4.24),(19.77±9.74),for punishment:P<0.05,for others:P<0.01],and there were a significant difference in the two groups[(35.35±14.78),(9.92±2.51),(12.54±8.14)].The negative environment was chosen in regress equation,and could explain 14.67% of outcome of obsession. ②The scores of 4 ubacaies like cohesion,expressiveness,intellectual-cultural orientation,active-recreational orientation [(5.13±2.28),(4.10±2.12),(2.71±1.87),(2.52±2.34)] ,were all obviously lower than the normal control in FES-CV.While the subscore of conflict (5.03±2.21) was higher than the normal control(3.50±2.40),and all these differences were significant.When two factors of active-recreational orientation and cohesion in FES-CV were put into regression equation( R2 =0.2078 ,R2 =0.2784),they contribute 27.84% and the disease,and the active-recreational orientation factor can explain 20.78%.③The result of interview found significant difference between obsession groupand control group in parental personality,own personality,childhood experience,and family environment.Condusion The traumatic experience in childhood and unhealthy family environment do have association with onset and development of obsession,also they have a close relationship with the development of personality after adulthood.

Traumatic Experiences and Mental Health of North Korean Refugees in South Korea

OBJECTIVE: This study was conducted at Hanawon-a government sponsored educational facility for the settlement of North Korean refugees during their initial phase in South Korea-in 2004 to explore their mental health status and traumatic experiences in North Korea and during their escape period. METHODS: A survey was conducted in November 2004 with 62 North Korean refugees at Hanawon, and the Trauma Checklist was used to measure their traumatic experiences. To measure their psychological-mental health status, the Personality Assessment Inventory was administered. RESULTS: In comparison with the traumatic experiences of the North Korean refugees found in the study conducted in 2001 at Hanawon using the same methods, the current study showed a relatively lower frequency of traumatic experiences among the participants. The Personality Assessment Inventory results revealed that the study participants scored higher than average South Koreans in all clinical scales. Particularly, their mania (62.51) and schizophrenia (61.75) scores were above 60, a clinically meaningful score. In the gender comparison, the males exhibited meaningfully higher levels of alcohol problem, non-support, and warmth scale scores. CONCLUSION: Compared to the 2001 study, the overall traumatic experiences among North Korean refugees participated in this study. But continous support is necessary for their successful adaptation to South Korean Society have declined. The North Korean refugees at Hanawon experienced difficulties maintaining their mental health and the men in particular requested more intensive care and support for this purpose.

Estrés y trastornos mentales: aspectos neurobiológicos y psicosociales / Stress and mental disorders: neurobiological and psychosocial aspects

An important challenge faced by clinical psychiatrists is how to integrate new findings from neurobiology with clinical experience and data from the social sciences, for a better understanding of genetic and neurochemical substrates, personality, traumatic experiences and social events in the etiopathogenesis of mental disorders. A model based on current concepts of stress may help. With this objective in mind, the author reviews the relevant literature and attempts to illustrate the relationship between stress, neurobiology and mental disorder. Also, a brief review of possible causal paths between psychosocial stress and psychiatric morbidity is offered. Finally, the possibility of convergence between both models is proposed.

Uno de los desafíos que enfrentan los psiquiatras clínicos es cómo integrar los nuevos aportes de la neurobiología con los datos provenientes de la experiencia clínica y de las ciencias sociales, para una comprensión más completa de la interacción entre sustratos genéticos, neuroquímicos, personalidad, experiencias traumáticas y eventos sociales en la etiopatogenia de los trastornos mentales. Un modelo basado en conceptos actualizados de estrés nos puede ayudar en esa tarea. Con ese objetivo, se intenta ilustrar la relación entre estrés, neurobiología y trastornos mentales. Luego, se revisa someramente algunas de las posibles vías causales entre estrés psicosocial y morbilidad mental. Finalmente, se propone una posibilidad de convergencia entre ambos niveles de análisis.

Effect of the Early Traumatic Experience on the Mental Health of the Elderly / 영남의대학술지

This study was intended to analyze the relation between the psychic traumatic experience and the psychological health of the aged. The authors carried out this study by means of the combined anxiety-depression scale (CADS) and the preadolescence traumatic experience scale (PTES) with 278 aged men and women residing in Taegu from September to October 1988. The results were as follows: 1. Based on the scores evaluated by CADS, the scores of the both groups showed that comparative group was accounted for 40.15±6.19, while the experimental group for 57.75±6.37, which showed significantly higher score in the experimental group (p<0.001). 2. The experimental group showed significantly higher early experience score than the comparative group in the dietary difficulty, alcoholism among family members, disunion between husband and wife, trouble between mother and children, early mother loss, parent's indifference and unwanted birth (p<0.001). 3. The experimental group showed higher early experience score than the comparative group by sex, age, marital status and grown location (p<0.001). 4. When the subjects were included in the unemployed and in the middle or low classes and their parents were engaged in agriculture and commercial business and believing in buddhism or no-religion, showed higher experience score (p<0.001).