Court cases involving sexual assault and police violence rely heavily on victim testimony. We consider what we call the “Traumatic Untrustworthiness Argument (TUA)” according to which we should be skeptical about victim testimony because people are particularly liable to misremember traumatic events. The TUA is not obviously based in mere distrust of women, people of color, disabled people, poor people, etc. Rather, it seeks to justify skepticism on epistemic and empirical grounds. We consider how the TUA might appeal to the (...) psychology and neuroscience of memory for empirical support. However, we argue that neither support the TUA. (shrink)

Measuring neuronal activity with electrophysiological methods may be useful in detecting neurological dysfunctions, such as mild traumatic brain injury (mTBI). This approach may be particularly valuable for rapid detection in at-risk populations including military service members and athletes. Electrophysiological methods, such as quantitative electroencephalography (qEEG) and recording event-related potentials (ERPs) may be promising; however, the field is nascent and significant controversy exists on the efficacy and accuracy of the approaches as diagnostic tools. For example, the specific measures derived from an (...) electroencephalogram (EEG) that are most suitable as markers of dysfunction have not been clearly established. A study was conducted to summarize and evaluate the statistical rigor of evidence on the overall utility of qEEG as an mTBI detection tool. The analysis evaluated qEEG measures/parameters that may be most suitable as fieldable diagnostic tools, identified other types of EEG measures and analysis methods of promise, recommended specific measures and analysis methods for further development as mTBI detection tools, identified research gaps in the field, and recommended future research and development thrust areas. The qEEG study group formed the following conclusions: 1. Individual qEEG measures provide limited diagnostic utility for mTBI. However, many measures can be important features of qEEG discriminant functions, which do show significant promise as mTBI detection tools. 2. ERPs offer utility in mTBI detection. In fact, evidence indicates that ERPs can identify abnormalities in cases where EEGs alone are nondisclosing. 3. The standard mathematical procedures used in the characterization of mTBI EEGs should be expanded to incorporate newer methods of analysis including nonlinear dynamical analysis, complexity measures, analysis of causal interactions, graph theory and information dynamics. 4. and 5. are too long to include here. (shrink)

New coverage of the recent wars in Afghanistan and Iraq, and the ensuing public education campaigns by the Department of Veterans Affairs and private veterans advocacy groups combine to call the public's attention to the many potential mental health problems associated with traumatic event exposure. Indeed, since 2001, Operation Iraqi Freedom and Operation Enduring Freedom combat and peacekeeping missions have been characterized by high levels of exposure to acts of extreme violence, with often gruesome effects. Less publically discussed is the (...) fact that a surprisingly large number of United States civilians also report exposure to traumatic events, such as severe interpersonal violence, natural disasters, and serious automobile accidents. In fact, approximately 70% of randomly sampled respondents indicated that they have experienced an incident characterized by significant perceived life threat at some point during their lives. (shrink)

This paper focuses on local constructions of 'nature' in governance processes, and the importance of historical and institutional contexts for their genesis and functioning. Through extensive field study in the Romanian Danube Delta, it is demonstrated that the origin and distribution of certain concepts can be credited to a history of conflicts over land and resource use. Considering the implications for participatory natural resource governance, we argue that this capacity of the governance context to produce and transform concepts of nature, (...) poses real challenges. To these challenges can be added legacies of disempowerment and marginalisation, evident in local inhabitants' images and concepts of nature, which we seek to understand by developing a theory of traumatic nature. (shrink)

Post-Traumatic Stress Disorder is a major public health concern in both civilian and military populations, across race, age, gender, and socio-economic status. While PTSD has been around for centuries by some name or another, its definition and description also continue to evolve. Within the last few years, the American Psychological Association has published the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, which includes some major changes in the diagnostic criteria for PTSD. Recent data on epidemiology, etiological (...) theories, and empirically supported methods of treatment, as well as implications for legal processes and criminal justice system personnel, are discussed. (shrink)

This is a public philosophy piece that explores some questions around heroes, trauma, and wrongdoing.

Several authors have argued that traumatic experiences are processed and remembered in a qualitatively different way from neutral events. To investigate this issue, we interviewed 121 Croatian war veterans diagnosed with posttraumatic stress disorder about amnesia, intrusions , and the sensory qualities of their most horrific war memories. Additionally, they completed a self-report scale measuring dissociative experiences. In contrast to what one would expect on the basis of theories emphasizing the special status of traumatic memories, amnesia, and high frequency intrusions (...) were not particularly typical for our sample of traumatized individuals. Moreover, traumatic memories were not qualitatively different from neutral memories with respect to their stability and sensory qualities. The severity of PTSD symptoms was not significantly correlated with dissociative experiences. Our findings do not support the existence of special memory mechanisms that are unique to experiencing traumatic events. (shrink)

It is well documented that people with moderate-to-severe traumatic brain injury (TBI) can undergo personality changes, including becoming more impulsive in terms of how they behave. Legal guidance and academic commentary support the view that impulsiveness can render someone decisionally incompetent as defined by English and Welsh law. However, impulsiveness is a trait found within the healthy population. Arguably, impulsiveness is also a trait that gives rise to behaviours that should normally be tolerated even when they cause harm to the (...) person enacting the behaviours. The purpose of this paper is to show why both of these considerations present as significant challenges to the law in England and Wales. (shrink)

Perceived discrimination has consistently been shown to be associated with diminished mental health, but the psychological processes underlying this link are less well understood. The present series of four studies assessed the role of a history traumatic events in generating a proliferation of discrimination stressors and threat appraisals, which in turn predict psychological distress (depressive and posttraumatic stress symptoms) (mediation model), or whether prior traumatic events sensitize group members, such that when they encounter discrimination, the link to stress-related symptoms is (...) heightened (moderation model). Each of the studies assessed a different marginalized group in Canada, including Indigenous peoples, Blacks, Jews, and a diverse sample of women. Participants completed measures assessing history of traumatic events, perceived explicit and ambiguous discrimination, discrimination threat appraisals, and symptoms of depression and posttraumatic stress. The four populations varied in their experiences, with Indigenous peoples encountering the highest levels of trauma, discrimination, and psychological distress symptoms. A mediated model was evident among Indigenous peoples and women, possibly reflecting the role of systemic processes that engender discrimination when traumatic events are experienced. There was evidence for a moderating role of a history of traumatic events on the relations between discrimination and depressive symptoms among Jewish and Black participants. Although the hypothesized synergistic effects of traumatic experiences were noted when assessing the relation between perceived discrimination and depressive symptoms among Jews, the presence of trauma blunted these relations among Blacks. The results suggest that trauma-informed approaches to addressing stress-related processes and psychological outcomes need to consider the unique social context of members of various socially marginalized groups. (shrink)

BackgroundIn Italy, the COVID-19 pandemic has caused a collective trauma. Post-traumatic growth has been defined as the subjective experience of positive psychological changes as a result of a traumatic event. PTG can involve changes in five psychological main dimensions: relating to others, new possibilities, personal strength, spiritual change, and appreciation of life. In the context of national emergencies, those PTG dimensions encompassing changes at the social level can play a role in coping strategies that involve a renewed sense of self (...) and one’s social identities, including national identities, and in turn, foster a stronger sense of trust and connection to others.AimTo investigate how each of the five PTG dimensions mediates the association between the salience of national identity and interpersonal trust in a sample of Italian young adults. Trust in national and European institutions were expected to positively predict the strength of the Italian national identity which in turn was expected to be positively associated with interpersonal trust, and the PTG relating to others dimension to mediate this association.MethodThis study involves the secondary analysis of data from a representative sample of 2,000 Italian young adults. Participants completed a web survey during the peak of the COVID-19 crisis in Italy with measures of trust in EU and national institutions, national identity, interpersonal trust, and the PTG Inventory. Structural equation modeling procedures were employed for key hypotheses tests.ResultsTrust in national institutions positively predicted national identity, which in turn was positively associated with interpersonal trust. Evidence of a full mediation effect of the PTG relating to others dimension on the association between national identity and interpersonal trust was found.DiscussionFindings contribute to clarify the psychological responses to collective traumas. In the context of Italy’s COVID-19 crisis, trust in national institutions reinforced Italian national identity, which was in turn associated with greater interpersonal trust, but only when psychological responses to the trauma involved changes in how individuals perceived and related to others, and not merely a focus on the self. Theoretical and practical implications are discussed. (shrink)

The appropriate goal of care for a person with a traumatic brain injury is rehabilitation in the broad, etymological sense of the word. The task is to bring the person back to the conditions of the living of a life. This requires the rehabilitation of the mind—the reconstruction of a subject.

Neuroscientific research on the removal of unpleasant and traumatic memories is still at a very early stage, but is making rapid progress and has stirred a significant philosophical and neuroethical debate. Even if memory is considered to be a fundamental element of personal identity, in the context of memory-erasing the autonomy of decision-making seems prevailing. However, there seem to be situations where the overall context in which people might choose to intervene on their memories would lead to view those actions (...) as counterproductive. In this article, I outline situations where the so-called composition effects can produce negative results for everyone involved, even if the individual decisions are not as such negative. In such situations medical treatments that usually everyone should be free to take, following the principle of autonomy, can make it so that the personal autonomy of the individuals in the group considered is damaged or even destroyed. In these specific cases, in which what is called the “conformity to context” prevails, the moral admissibility of procedures of memory-erasing is called into question and the principle of personal autonomy turns out to be subordinate to social interests benefitting every member of the group. (shrink)

In this paper, we will attempt to describe an integrative model that links stress, trauma, and post-traumatic health disorders through biological, psychological, and behavioral mechanisms of influence. Each of these phenomena has its specificities but also shares common characteristics (sources, symptoms, and consequences) related to health and an individual’s functioning. Prolonged stress and sudden experiences can lead to trauma, and repeated experiences of trauma over time can result in the development of post-traumatic stress disorder (PTSD). This key mechanism illustrates how (...) long-term stress and trauma can lead to severe health impairment. A review of the literature on this topic, along with our many years of experience and research in these areas, reveals that the majority of authors in their research primarily focus on one of these topics, usually stress. There are fewer studies that provide a comprehensive representation of both stress and trauma. We have not come across any research that unifies all three topics in their presentation, highlighting the common elements as well as the specificities and differences. The aim of this paper is to demonstrate, through an integrative approach, the combined impact of these three phenomena on health and an individual’s functioning. First, we will describe each of these phenomena along with their respective specifications. Finally, we will attempt to integrate the knowledge of physiological and psychological mechanisms for dealing with stress, trauma, and post-traumatic stress disorder. Although challenging, we will also touch upon prevention strategies towards the end. (shrink)

The coronavirus disease 2019 pandemic has enkindled many mental health problems across the globe. Prominent among them is the prevalence of post-traumatic stress with hosts of its precipitating factors being present in the surrounding. With India witnessing severe impact of the second wave of COVID-19, marked by a large number of hospitalizations, deaths, unemployment, imposition of lockdowns, etc., its repercussions on children and adolescents demand particular attention. This study aims to examine the direct and the indirect exposure of COVID-19-related experiences (...) on children and adolescents and its subsequent relationship with PTS and post-traumatic growth. The direct exposure was operationalized in terms of death or hospitalization in the family, while the indirect exposure was gauged in terms of exposure to media reports of the COVID situation. Data from 412 children and adolescents aged 9–20 years, collected online, revealed 68.9% of them with PTS. Interestingly, 39.8% of those reporting PTS were also experiencing PTG. Arousal appeared to be the most frequently reported characteristics of trauma. The multivariate analysis of variance endorses significant difference between those with direct and indirect exposures to hospitalization. Those with direct exposure to hospitalization reported higher PTS. The indirect exposure of COVID-19-related news through electronic media was also significantly associated with higher PTS. Exposure through print media did not lead to significant difference in PTS, but those reading only magazines reported significantly higher PTG than not reading magazines. The findings are analyzed in the light of unfolding of events during the second wave of COVID-19 in India. (shrink)

The idea that acquired brain injury (ABI) caused by stroke, hemorrhage, infection or traumatic insult to the brain can result in post-traumatic growth (PTG) for individuals is increasingly attracting psychological attention. However, PTG also attracts controversy as a result of ambiguous empirical findings. The extent that demographic variables, injury factors, subjective beliefs, and psychological health are associated with PTG following ABI is not clear. Consequently, this systematic review and meta-analysis explores the correlates of variables within these four broad areas and (...) PTG. From a total of 744 published studies addressing PTG in people with ABI, eight studies met inclusion criteria for detailed examination. Meta-analysis of these studies indicated that growth was related to employment, longer education, subjective beliefs about change post-injury, relationship status, older age, longer time since injury, and lower levels of depression. Results from homogeneity analyses indicated significant inter-study heterogeneity across variables. There is general support for the idea that people with ABI can experience growth, and that various demographics, injury-related variables, subjective beliefs and psychological health are related to growth. The contribution of social integration and the forming of new identities post-ABI to the experience of PTG is explored. These meta-analytic findings are however constrained by methodological limitations prevalent in the literature. Clinical and research implications are discussed with specific reference to community and collective factors that enable PTG. (shrink)

This study aimed to investigate the status and risk factors of post-traumatic stress disorder in patients with acute myocardial infarction after emergency percutaneous coronary intervention in acute and convalescence phases. A longitudinal study design was used. Two questionnaire surveys were conducted in the acute stage of hospitalization, and 3 months after onset in patients. Logistic regression was used to analyze the risk factors for PTSD in AMI patients. The incidence of PTSD was 33.1 and 20.4% in acute and convalescent patients, (...) respectively. The risk factors related to PTSD were door-to-balloon time, left ventricular ejection fraction, smoking, anxiety, and depression. AMI patients after PCI had PTSD in the acute and convalescent stage. The findings indicate that tailored measures should be developed and carried out to prevent PTSD and improve the mental health of patients with AMI after undergoing PCI. (shrink)

The purpose of this study is to investigate the current state of post-traumatic growth and identify its influencing factors in discharged COVID-19 patients. PTG refers to individual experiences of significant positive change arising from the struggle with a major life crisis. This descriptive cross-sectional study used the convenient sampling method to recruit 140 discharged COVID-19 patients in Hunan, China. The results show that the PTG of the discharged COVID-19 patients was positively correlated with self-esteem, post-traumatic stress disorder, coping style tendency, (...) and social support, but negatively correlated with the time from onset to diagnosis. Our findings could provide guidance on improving the psychological state and well-being of discharged COVID-19 patients. (shrink)

As far back as we know, there have been individuals incapacitated by memories that have filled them with sadness and remorse, fright and horror, or a sense of irreparable loss. Only recently, however, have people tormented with such recollections been diagnosed as suffering from "post-traumatic stress disorder." Here Allan Young traces this malady, particularly as it is suffered by Vietnam veterans, to its beginnings in the emergence of ideas about the unconscious mind and to earlier manifestations of traumatic memory like (...) shell shock or traumatic hysteria. In Young's view, PTSD is not a timeless or universal phenomenon newly discovered. Rather, it is a "harmony of illusions," a cultural product gradually put together by the practices, technologies, and narratives with which it is diagnosed, studied, and treated and by the various interests, institutions, and moral arguments mobilizing these efforts. This book is part history and part ethnography, and it includes a detailed account of everyday life in the treatment of Vietnam veterans with PTSD. To illustrate his points, Young presents a number of fascinating transcripts of the group therapy and diagnostic sessions that he observed firsthand over a period of two years. Through his comments and the transcripts themselves, the reader becomes familiar with the individual hospital personnel and clients and their struggle to make sense of life after a tragic war. One observes that everyone on the unit is heavily invested in the PTSD diagnosis: boundaries between therapist and patient are as unclear as were the distinctions between victim and victimizer in the jungles of Southeast Asia. (shrink)

This essay addresses the question: What is the probative value of including neuroscience data in court cases where the defendant might have had a traumatic brain injury? That is, this essay attempts to articulate how well we can connect scientific data and clinical test results to the demands of the Daubert standard in the United States’ court system, and, given the fact that neuroimaging is already being used in our courts, what, if anything, we should do about this fact. Ultimately, (...) I am not sure that there are completely satisfactory answers to this query at this particular time in our legal history. I briefly rehearse the recent use of brain research in our legal system, summarize how neuroscience data regarding TBI and its relation to poor behavioral outcomes are currently used in the courtroom, review challenges with using these data, and highlight fundamental tensions between how the legal system views the causes of behavior and how medicine, neuroscience, and psychology do. Until these tensions are resolved, it is unclear the place neuroscience data should have in courts. (shrink)

Robert Brandom grants that an individual can know even if she cannot provide a reasoned defense of her non-accidentally true beliefs about the world. Brandom is wrong, I argue, to suggest that this phenomenon of super blindsightedness is rare or fringe. This oversight becomes clear when we turn from the eccentric example of the industrial chicken-sexer to the case of the survivor of sexual violence. What we have in this instance is a subject who, qua survivor, has certain reliably formed, (...) that is, non-accidentally true, beliefs about which she has deep conviction, but which she cannot defend because she has blocked from memory the details of her traumatic experience. She is super blindsighted. In light of the universality and everydayness of sexual violence this phenomenon is, I conclude, run of the mill. Thus, even if Brandom is right that reliabilism cannot replace reason-giving from its central role in a cognitive practice, it takes up a vital role alongside it. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Post-Traumatic Hermeneutics: Melancholia in the Wake of TraumaAngelika Rauch (bio)1Classical Analysis: Problems for Trauma TherapyAccording to the Journal of the American Psychoanalytical Association, American ego psychology has taken a leading role in debunking what it considers antiquated Freudian approaches to the study of trauma. As neutral observers and students of the facts, ego psychologists have purportedly reclaimed the study of trauma as the search for an objectifiable traumatic event (...) in the past, one that can be accessed as recovered memory, as a specimen of pathogenic development, or as cognitive and behavioral effects that point to an inaccessible implied memory buried in the psyche. Central to this revision of psychoanalytical trauma therapy is the dismissal of Nachträglichkeit as an antiquated and irrelevant concept. Harold P. Blum, for instance, writes in a recent article of JAPA that “‘deferred action’ is an ambiguous concept, a dubious, antiquated, theoretical legacy.” According to Blum, “deferred action overlooks the immediate and potentially powerful effects of preoedipal trauma and is dissociated from considerations of cumulative trauma and developmental disturbance.” [1155]. With respect to Freud’s case of the Wolf-Man, Blum states that “[d]eferred action emphasized traumatic events and memory rather than cumulative developmental effects of shock and strain trauma, and pathogenic object relationships.” Key to Blum’s view, then, is the assertion that “the concept of deferred action deterred consideration of real infantile experience and the complex overdetermination of pathogenesis through development” [1156]. Blum apparently takes the side of those who like to argue that trauma is more real than imagined. Whereas oedipal trauma is an imaginary or illusory trauma, preoedipal trauma is comprehensible as real shock and, as such, is empirically true. This is an idea that is very compatible with “recovered memory” therapy, a subject that has become controversial in recent debates about child abuse and recovered memory syndrome.In contrast, Arnold H. Modell in Other Times, Other Realities points out that “[t]he concept of Nachträglichkeit is virtually unknown among American psychoanalysts. This may be due in part to Strachey’s faulty translation; but this idea is also inconsistent with the belief in an orderly hierarchical psychic development such as that envisioned by ego psychologists.” [3]. In other words, Freudian Nachträglichkeit violates the principles of space and time assumed by empirical scientists whose conceptions are founded on the causality of such principles as stimulus/response. It is here, of course, that ego psychology’s treatment of trauma would come into conflict not only with Freudian analysis, including its French Freudian variants, but with the kind of trauma studies being conducted by the contributors to Cathy Caruth’s Trauma: Explorations in Memory. They include Bessel [End Page 111] van der Kolk, Onno van der Hart, Shoshana Felman, Dori Laub, Robert Lifton, and, of course, Cathy Caruth herself.Emphasis on the reality of traumatic shock (as abuse, stress, accident, and so on), however important it may be, loses sight of a hermeneutical dimension of psychoanalytic therapy that Caruth and her contributors emphasize: the question of how meanings are associated or bound to the understanding of life’s events. My own clinical approach to psychoanalysis favors the introduction of an even stronger hermeneutical perspective that is sensitive to the kinds of issues raised by philosophers like Dilthey, Heidegger, Benjamin, and Gadamer, for whom the question of experience is not reducible to restricted understandings of stimulus/response, nor—as in the case of Caruth (for example, in Unclaimed Experience)—to the privileging of language as a formal (that is, literary) construct. Rather, I am interested in emphasizing a hermeneutics of the therapeutic encounter within which questions of language, culture, history, and behavior are situated. With respect to trauma therapy, I will introduce a number of well-known analytical contributions even as I take the following statement of Arnold Modell’s as my point of departure:The analyst or therapist becomes an unwitting collaborator in the recreation of the past, while still retaining a proximity to present time. The therapist becomes the person with whom one can reexperience trauma within a new context or experience for the first time what has been absent in the past. Affects belonging to... (shrink)

In many cases of family trauma, victims are left with the burden of rebuilding relationships that have been damaged. This paper illustrates that inappropriate pressure to forgive can harm victims of abuse. This pressure can come from a combination of assumptions. Firstly, often forgiveness is conflated with reconciliation, and those who put pressure on victims to forgive do so to avoid uncomfortable blame or estrangement. Secondly, anger is often inappropriately understood as a morally blameworthy emotion to hold. I draw on (...) Amia Srinivasan’s (2018) work on affective injustice to address this assumption and argue that pressure to forgo anger, forgive, and reconcile stems from a mistaken interpretation of these concepts and is ultimately harmful. I demonstrate this by using examples where victims have found their voices stifled by the mistaken coding of anger as morally blameworthy and forgiveness as morally required. (shrink)

This essay reads Sylvia Wynter’s only novel The Hills of Hebron as a modern tragedy, one that both challenges and builds upon Raymond Williams’s concept of modern tragedy. The essay’s main argument is that tragedy, as a literary form, and the tragic, as a philosophical concept, are fundamental to Wynter’s project of creating forms of counterpoieses. Engaging Wynter’s interlocution with tragedy is crucial for comprehending how she is able to transform loss into a condition of possibility, primarily for the writing (...) of what she calls “traumatic time.” Instead of only blocking mental representation, traumatic loss in Wynter becomes the first gesture of a philosophical activity that makes presentable that which has been lost or abandoned to a state of ruin, an argument that Walter Benjamin, another writer in dark times, had earlier made in The Origin of German Tragic Drama. Occupying the temporality of the tragic, Wynter has always made the re-assumption of the past—“slave, slave masters and all,” as she says—central to her project of critiquing and dismantling the “descriptive statement” of Man as the only permissible version of the Human. In my reading of The Hills of Hebron, I show how the novel utilizes the aesthetic, particularly the medium of theatricality, as the grounds for a theoretical framework that makes, in a manner redolent of Antigone, “the wretched of the earth” presentable not as “symbolic death” but rather as allegories of resistance. (shrink)

This study discusses the potential of virtual reality therapy to treat traumatic experiences. It considers the main advantages of exposure therapy through virtual reality in comparison with traditional exposure therapy. In order to explain the effectiveness of using virtual reality to treat trauma, the main research question that was asked was how to conceptualize it. It was assumed that the trauma was a deviation from the normal narrative that people create for a particular crisis event. The results of the empirical (...) research prove that virtual reality therapy can be considered a powerful tool for treating traumatic experiences, as cyberspace allows reformulation of self-images, experimenting and practicing coping skills, creating a new life story, and finding meaning in certain crisis events. (shrink)

Background: Mild traumatic brain injury results from an external force to the head or body causing neurophysiological changes within the brain. The number and severity of symptoms can vary, with some individuals experiencing rapid recovery, and others having persistent symptoms for months to years, impacting their quality of life. Current rehabilitation is limited in its ability to treat persistent symptoms and novel approaches are being sought to improve outcomes following mTBI. Neuromodulation is one technique used to encourage adaptive neuroplasticity within (...) the brain.Objective: To systematically review the literature on the efficacy of neuromodulation in the mTBI population.Method: A systematic review was conducted using Medline, Embase, PsycINFO, PsycARTICLES and EBM Review. Preferred Reporting Items for Systematic Reviews and the Synthesis Without Meta-analysis reporting guidelines were used and a narrative review of the selected studies was completed. Fourteen articles fulfilled the inclusion criteria which were published in English, investigating an adult sample and using a pre- and post-intervention design. Studies were excluded if they included non-mild TBI severities, pediatric or older adult populations.Results: Thirteen of fourteen studies reported positive reductions in mTBI symptomatology following neuromodulation. Specifically, improvements were reported in post-concussion symptom ratings, headaches, dizziness, depression, anxiety, sleep disturbance, general disability, cognition, return to work and quality of life. Normalization of working memory activation patterns, vestibular field potentials, hemodynamics of the dorsolateral prefrontal cortex and excessive delta wave activity were also seen. The studies reviewed had several methodological limitations including small, heterogenous samples and varied intervention protocols, limiting generalisability. Further research is required to understand the context in which neuromodulation may be beneficial.Conclusions: While these positive effects are observed, limitations included unequal representation of neuromodulation modalities in the literature, and lack of literature describing the efficacy of neuromodulation on the development or duration of persistent mTBI symptoms. Better clarity regarding neuromodulation efficacy could have a significant impact on mTBI patients, researchers, clinicians, and policy makers, facilitating a more productive post-mTBI population. Despite the limitations, the literature indicates that neuromodulation warrants further investigation. PROSPERO registration number: CRD42020161279. (shrink)

Explore the aftermath of traumatic stress as it affects various populations, including therapists themselves! This book will educate you about the aftermath of traumatic stress as it impacts people in a variety of settings. It explores the factors that lead to increased or reduced vulnerability to the effects of traumatic stress, emphasizing the impact of cumulative/multiple trauma rather than the effects of a single traumatic incident, to help you design and implement effective prevention and intervention programs. The specific populations and (...) groups addressed in this important book include: adolescent girls involved in armed conflict in Colombia’s guerilla war urban African-American youth—a theoretical model for risk and resiliency people with strong spiritual/religious beliefs—how spirituality can affect a person’s reaction to traumatic stress women in recovery in a community aftercare shelter female trauma therapists—factors affecting vicarious traumatization of helping professionals college students with histories of abuse Providing a framework for understanding traumatic stress-related issues based on a variety of methodologies and measures, Traumatic Stress and Its Aftermath addresses important questions, such as: What is the relationship between the experiences of trauma or other stressful life events, and subsequent traumatic stress? What are the protective factors that can buffer or ameliorate the development of traumatic stress in the face of adverse life experiences, trauma, or other stressful events? How do these questions evolve in different cultural or community contexts, and with different populations? What are the implications for interventions for community institutions and mental health workers? What roles do self-esteem and spirituality play in a person’s reaction to traumatic stress? How do reactions to traumatic stress differ between women who have been sexually abused as children and women who have not? From editor Sandra S. Lee: “Contemporary developments in the study of traumatic stress are shifting. This book reflects an emphasis on the study of traumatic stress in normal community, cultural, or college student populations and groups, while other literature has focused on individuals specifically diagnosed with PTSD. In addition, Traumatic Stress and Its Aftermath: Cultural, Community, and Professional Contexts emphasizes the search for risk and protective factors and factors that can buffer the relationship between trauma exposure and subsequent distress.”. (shrink)

The aim of this paper was to explore the issue of consent when considering the use of a life saving but not necessarily restorative surgical intervention for severe traumatic brain injury. A previous study has investigated the issue amongst 500 healthcare workers by using a two-part structured interview to assess opinion regarding decompressive craniectomy for three patients with varying injury severity. A visual analogue scale was used to assess the strengths of their opinions both before and after being shown objective (...) outcome data. Opinions were assessed in a number of scenarios, one of which was that the participants themselves were the injured party. The implication, which was clearly stated, was whether they would provide consent for the procedure to be performed. The study demonstrated that participants were relatively risk aversive in regards to survival with severe disability especially when the injury was severe and there was high probability of that outcome occurring. This finding was not however universal and a minority of participants would provide consent even when the possibility of survival with severe disability was very high. The obvious difficulty comes when considering consent in patients who are unable to express their wishes. In order to address this issue we propose a model of consent based on a balance of the various factors that seem to be of material relevance. These include the severity of the injury, the willingness or otherwise to accept survival with severe disability and the willingness to “risk” the possibility of an unacceptable outcome in order to achieve an acceptable outcome. (shrink)

The present paper contributes to the analysis and understanding of post-traumatic stress disorder from the perspective of Husserlian phenomenology. The particular approach taken integrates the experience of a ptsd trigger into Husserl’s descriptive framework of noematic constitution. By analyzing the constituent makeup of a particular object that acts as a trigger for ptsd symptoms, a descriptive account of how an ordinary noematic correlate becomes a pathological traumatic correlate is provided. This is done in three steps. First, the traumatic correlate is (...) shown to emerge by way of a judgment. Then, the role of the Ego will be examined to identify the point where the intentional relation between sufferer and traumatic correlate becomes pathological. Third, a phenomenological description of belief characteristics indicates the mechanism by which this pathology is maintained. I conclude by showing the connection between a phenomenological account of ptsd triggers and the current therapeutic practice of prolonged exposure therapy. (shrink)

The premise of this study is to look at the intergenerational transferal of language and racial trauma of Asian immigrants in general and Korean–American immigrants in particular to a western country, the United States of America. This study investigates trauma from a psychological standpoint, based on Chang-Rae Lee’s novel Native Speaker. In describing a marker of citizenship, the novel’s title also points to who is the native language speaker and who is a native of a country, and why one who (...) is not may be excluded. The Korean immigrants’ vulnerability to the English language and racial differences highlights their status as minority “others,” and they suffer from transgenerational trauma. As a result of transgenerational traumatic effects, Henry has various traumatic side effects such as dysphasia, aphasia, and parasomnia and finally leaves no stone unturned to recuperate from trauma. The Trauma of the Unspeakable theory by Michelle Balaev is used in this article to show how trauma affects people’s minds. (shrink)

AimThe Coronavirus 2019 pandemic represents one of the most catastrophic events of recent times. Due to the hospitals’ emergency situation, the population of healthcare workers was the most affected. Healthcare workers who were exposed to COVID-19 patients are most likely to develop psychological distress and post-traumatic stress disorder. The present study aimed at investigating PTSD in a sample of Italian healthcare workers during this outbreak and to evaluate the effectiveness of the Eye Movement Desensitization and Reprocessing Therapy with this population.MethodsA (...) total of 744 healthcare workers were included. 587 healthcare workers were treated with EMDR, while the other 157 were not treated. Participants were asked to provide sociodemographic information; the post-traumatic symptomatology was evaluated through Impact of Event Scale-Revised and to investigate the level of intensity of emotional activation was used The Emotion Thermometer at two time points.ResultsThe results obtained between EMDR treatment and non-EMDR treatment were evaluated on only 2 hospitals. Treatment group n = 68 vs. waitlist non-treatment group n = 157. All scores pre- and post-EMDR decreased significantly showing an evident effect of EMDR. The differences between pre- and post-treatment of the IES-R scores of subjects in which EMDR was performed as compared to the scores pre- and post-12 weeks of waiting list subjects in which it was not performed were significantly different.LimitationThe emergency situation did not provide an opportunity to explore further aspects that would have been important for research. One limitation is the use and analysis of only two standardized tests. In addition, other psychopathologies were not investigated as outcome measures. A limitation is the comparison of subjects treated online and de visu. Although the protocol used was the same, the mode of intervention may have influenced the results. In addition, the effectiveness of EMDR treatment was only evaluated at two time points with no possibility of follow-up and the lack of a control group.Discussion/conclusionThe findings of the present study suggest that healthcare workers were at high risk of developing PTSD when confronted with COVID-19 outbreak and suggest the importance of psychological support during this humanitarian emergency. (shrink)

Within cinematic horror, trauma as a concept has often been used as an allegorical strategy to work through collective anxieties. This article on It Follows (David Robert Mitchell, 2014) and Get Out (Jordan Peele, 2017) strikes another note. It argues that, by their aesthetic qualities, both films are rendered traumatic in their affective orientation, both toward the cinematic world and toward the spectator. It analyses the two films through trauma as an affective-aesthetic strategy that puts emphasis on the edge of (...) the frame as well as on the offscreen space. This strategy evokes a sinister mood that exists independently of the protagonists, allowing us to meaningfully feel the effects of their trauma as we engage with the film. Especially the use of the offscreen space in both films contributes to the “traumatic mood” of the films, but it also functions to immerse the spectator in the invisible filmic world. In this way, It Follows and Get Out embody trauma as a denial of relief from dread, which we both recognize in the characters' experience, and feel in our own bodies through the effective creation of ever-present threat. (shrink)

IntroductionWe aimed to study post-traumatic stress disorder symptoms in breast cancer patients during the coronavirus disease pandemic.Materials and methodsWe included BC patients receiving medical treatment during the first COVID-19 lockdown in France. PTSD symptoms were evaluated using the Impact of Event Scale-Revised questionnaire. Quality of life [Functional Assessment of Cancer Therapy-General ], cognitive complaints [Functional Assessment of Cancer Therapy–Cognitive Function ], insomnia [Insomnia Severity Index ], and psychosocial experiences during lockdown were also evaluated. Multivariable logistic regression was used to identify (...) clinical factors and psychosocial factors associated with PTSD symptoms.ResultsAmong the 253 included BC patients, 46% had metastatic cancer and 52% were treated by chemotherapy alone. COVID-19-induced adjustments in medical oncology practices were experienced by 27% of patients. No case of COVID-19 was reported; 23% of BC patients had PTSD symptoms. Compared to other patients, patients with PTSD symptoms had more fears relative to COVID-19 infection, had more feeling of isolation, and had more prescription or increased use of psychotropic drugs. In the multivariable model adjusted for clinical factors, fears relative to COVID-19 and increased use of psychotropic drugs were independently associated with PTSD symptoms. Besides, patients with PTSD symptoms had poor quality of life, and more cognitive complaints and insomnia.ConclusionPost-traumatic stress disorder symptoms were observed in 23% of BC patients during the first COVID-19 lockdown in France. Psychological supports are needed for patients treated during the COVID-19 pandemic. (shrink)

The National Institute of Mental Health (Bethesda, MD) reports that approximately 5.2 million Americans experience post-traumatic stress disorder (PTSD) each year. PTSD can be severely debilitating and diminish quality of life for patients and those who care for them. Studies have indicated that propranolol, a beta-blocker, reduces consolidation of emotional memory. When administered immediately after a psychic trauma, it is efficacious as a prophylactic for PTSD. Use of such memory-altering drugs raises important ethical concerns, including some futuristic dystopias put forth (...) by the President's Council on Bioethics. We think that adequate informed consent should facilitate ethical research using propranolol and, if it proves efficacious, routine treatment. Clinical evidence from studies should certainly continue to evaluate realistic concerns about possible ill effects of diminishing memory. If memory-attenuating drugs prove effective, we believe that the most immediate social concern is the over-medicalization of bad memories, and its subsequent exploitation by the pharmaceutical industry. (shrink)

The debate regarding representation is haunted by the fact that it takes place within a context of general suspicion whereby everything, it is claimed, is always representation. Such is the hurdle that Foucault identifies and Derrida attempts to elucidate in his debate with Heidegger, in which he takes issue with Heidegger’s critique of the “age of representation.” Derrida’s deconstruction of Heidegger’s account of the history of representation leads to a reconstruction that privileges the motifs of dissemination, of envoi (sending or (...) dispatching). In art too, Derrida confronts Heidegger, this time with the aim of re-thinking the relationship between the work and what lies outside and beyond it. By framing the Derrida/Heidegger debate within a consideration of the Lascaux cave drawings, and by examining the positions of Girard, Bataille and Blanchot in relation to the question of the origins of art, it will be possible to re-draw the boundaries of representation insofar as they lie at the intersection between philosophy and art. (shrink)

Suffering exile is more than the knowing the reality of it. It requires embracing it with all the pain this embrace represents… Suffering exile is accepting the tragedy of rupture, which characteri...