Gambling Disorder and Childhood Trauma: A Complex Association.

Gambling disorder (GD) is classified as a behavioural addiction and has some phenotypic similarities with substance use disorders (SUDs). Childhood adversity and life stressors are associated with increased risk for SUDs in adulthood. However, there is limited research investigating the association between childhood trauma, stressors and behavioural addictions such as GD. In this case-control cross-sectional study, 31 adult patients with GD were compared to 31 matched healthy controls (HCs) in terms of exposure to early adversity using the Childhood Trauma Questionnaire (CTQ-SF). In addition, past 12-month stressful life event exposure was assessed using the Life Event Stress Scale (LESS) and investigated as a possible moderator of the relationship between childhood trauma and GD by means of a two-way analysis of variance (ANOVA). Logistic regression analyses were used to test if childhood trauma (CTQ-SF) and its subtypes were significant predictors of a diagnosis of GD. Severity of childhood trauma in general, and on all five subtypes, was significantly higher in GD patients compared to HCs. Childhood trauma was a significant predictor of a diagnosis of GD, with physical neglect being the single trauma subtype to significantly increase odds of GD in adulthood. Stressful life events moderated the relationship between childhood trauma and GD, i.e. childhood trauma was significantly higher in GD patients compared to HCs when LESS was low. The findings support a link between childhood trauma and GD, with current stress as a moderating variable, and may be useful for future individualized therapeutic strategies.

"You Just Come to School, If You Made It, Its Grace": Young Black Women's Experiences of Violence in Utilizing Public "Minibus Taxi" Transport in Johannesburg, South Africa.

The "minibus taxi" industry in South Africa is a dominant transport provider for many scholars and students. The industry is characterized by a misogynistic culture and high risk of exposure to violence. What forms of violence are young Black women students in Johannesburg, South Africa, exposed to as commuters compelled to use "minibus taxis" to travel to university? What is the psychological impact of this exposure" What coping mechanisms are employed to manage in this environment? Ten Black female students aged between 19 and 24 registered at a Johannesburg-based university were interviewed. All used "minibus taxis" to travel to and from campus on a daily basis. A qualitative method was employed entailing data collection by means of individual face-to-face interviews conducted by the second author. Data were analyzed according to Braun and Clarke's guidelines for thematic analysis. Key themes related to exposure, impact, and coping were identified and elaborated. Interviewees commonly reported polyvictimization entailing exposure to several different forms of violence, including accident risk and dangerous driving, abuse and aggression by and between drivers, street crime, and sexual harassment and violation. Impact took the form of anxiety and fear, evidenced in conjunction with "thought blocking" and resignation, and showed features consistent with continuous traumatic stress. Both emotion-focused coping, in the form of prayer, and problem-focused coping, in the form of considered choices about conduct within the commuting space, were employed. Greater attention should be paid to the enduringly stressful impact of minibus taxi commuting for young women as exposure to interpersonal violence in public space is commonplace and has significant psychological costs. Policy makers concerned with public safety should intensify the focus on risks of interpersonal violence for women compelled to use public transport systems.

Continuous traumatic stress as a mental and physical health challenge: Case studies from South Africa.

This article discusses the condition of continuous traumatic stress as common on the African continent and in other international settings characterised by very high levels of ongoing violence and threat of community, political or war-related origin. Through consideration of three case studies from South Africa, contexts of continuous traumatic stress are described, and the mental health and physical health effects of living in such contexts are elaborated. Cautions are raised about attempting to transpose existing posttraumatic stress models onto individuals exposed to situations of continuous traumatic stress, and guidelines for optimal interventions with such cases are proposed.

The clinician in the university: Reflections on a South African psychoanalytically oriented doctoral programme.

There is increasing interest, both internationally and in South Africa, in strengthening the relationship between psychoanalytic practice and research. This paper reports on a psychoanalytically oriented doctoral programme offered at the University of the Witwatersrand in South Africa. The programme is described in relation to the broader context of the historical relationship of psychoanalysis to the university as well as to the specific context of the history of psychoanalysis in South Africa. Key challenges of the programme, specifically concerning research tensions and methodological and theoretical tolerance, are subsequently explored. The way in which these challenges manifested within a group context illustrates their potential for conflict as well as productive debate. The paper reflects on how this specific programme illuminates and extends some of the broader debates in the field of psychoanalysis.

Towards a contextually appropriate framework to guide counseling of torture survivors in Sub-Saharan Africa.

INTRODUCTION: If the right to rehabilitation is to become a meaningful reality for torture survivors in sub-Saharan Africa, it is necessary that counseling practice be responsive to the contextual and cultural demands of the region. Recent reviews of evidence-based practice with torture survivors are discussed with a focus on those approaches developed and/or tested with torture survivors in sub-Saharan Africa. METHODS: The results of a mixed methods study of ongoing torture rehabilitation work are reported. This study incorporated a review of 85 case files of torture survivors treated at torture rehabilitation centers in three countries in sub-Saharan Africa, and in depth interviews with fifteen counsellors and fourteen clients at those same centers. Quantitative data are presented in tabular form supported by uni- and bi-variate statistical analyses as appropriate. Qualitative data are presented in terms of themes identified through emergent coding. RESULTS AND DISCUSSION: Help-seeking torture survivors in this region are a diverse and highly symptomatic group, often struggling to survive with their families in precarious circumstances and under ongoing threat. In addition to incorporating key aspects of existing evidence-based practice, counselors also use a range of psychosocial approaches to assist torture survivors to protect and support their families in the face of seemingly overwhelming life challenges. We propose that more systematic methodologies that facilitate the inclusion of the voices of clients and clinicians in ongoing international debates relating to evidencebased practice with torture survivors will enhance the application of such practices in diverse contexts.

The second wave of violence scholarship: South African synergies with a global research agenda.

Violence is a serious public health and human rights challenge with global psychosocial impacts across the human lifespan. As a middle-income country (MIC), South Africa experiences high levels of interpersonal, self-directed and collective violence, taking physical, sexual and/or psychological forms. Careful epidemiological research has consistently shown that complex causal pathways bind the social fabric of structural inequality, socio-cultural tolerance of violence, militarized masculinity, disrupted community and family life, and erosion of social capital, to individual-level biological, developmental and personality-related risk factors to produce this polymorphic profile of violence in the country. Engaging with a concern that violence studies may have reached something of a theoretical impasse, 'second wave' violence scholars have argued that the future of violence research may not lie primarily in merely amassing more data on risk but rather in better theorizing the mechanisms that translate risk into enactment, and that mobilize individual and collective aspects of subjectivity within these enactments. With reference to several illustrative forms of violence in South Africa, in this article we suggest revisiting two conceptual orientations to violence, arguing that this may be useful in developing thinking in line with this new global agenda. Firstly, the definition of our object of enquiry requires revisiting to fully capture its complexity. Secondly, we advocate for the utility of specific incident analyses/case studies of violent encounters to explore the mechanisms of translation and mobilization of multiple interactive factors in enactments of violence. We argue that addressing some of the moral and methodological challenges highlighted in revisiting these orientations requires integrating critical social science theory with insights derived from epidemiology and, that combining these approaches may take us further in understanding and addressing the recalcitrant range of forms and manifestations of violence.