Mothering, substance use disorders and intergenerational trauma transmission : an attachment-based perspective

Background: A growing body of research underlines that interpersonal trauma in childhood leads to heightened susceptibility for substance use disorders (SUDs) in later life. Little research has been conducted on parenting experiences of mothers in recovery from substance use, taking into account their own upbringing as a child and the potential aftermath of interpersonal childhood trauma. Methods: Through in-depth qualitative interviews, 23 mothers with SUDs reflected on parenting experiences and parent-child bonding, related to both their children and parents. Interviews were transcribed verbatim and data were analyzed adopting thematic analysis. Results: Throughout the narratives, consequences of trauma on mothers' sense of self and its subsequent impact on parenting arose as salient themes. Five latent mechanisms of intergenerational trauma transmission were identified: 1) early interpersonal childhood trauma experiences in mothers; 2) trauma as a precursor of substance use; 3) substance use as a (self-fooling) enabler of parental functioning; 4) continued substance use impacting parental functioning; and 5) dysfunctional parental functioning and its relational impact upon offspring. Discussion: Findings suggest disruptive attachment can increase the vulnerability for SUDs on the one hand, but can be an expression of underlying trauma on the other, hence serving as a covert mechanism by which trauma can be transmitted across generations. Results indicate the need for preventive, attachment-based and trauma-sensitive interventions targeted at disruptive intergenerational patterns

Possible Causes of Increased Domestic Violence among Military Veterans: PTSD or Mefloquine Toxicity?

After more than a decade at war, our returning service members and their families are facing enormous amounts of difficulty when returning home. PTSD and TBI, the signature wounds of these wars, have been well covered in the media. The family struggles have remained hidden and mostly undiscussed. These families are facing very specific issues in military relationships like infidelity, substance misuse, and intimate partner violence; the latter of which military families are three times more likely to experience when compared to the civilian population. There is a potential effect on caregiver burden in the role of PTSD as a factor for relationship difficulties as well. Many times, spouses can struggle with no longer a being just a wife; they have become full-time, exclusive caregivers. This loss of personal identity is one of many things that can cause a cascade of mental health problems for the spouse. As much as spouses are excited to have their service member home, incorporating the service member back into the family can be stressful. Spouses may be taken off guard to find themselves experiencing deep sadness at the changes they perceive in their veteran. These are some of the more common relationship issues in a marriage where PTSD is present. Yet there seems to be a darker side to all of this. With the higher rates of domestic violence, this paper is researching the possibility of being wrong about PTSD or potentially there may be some previously unrecognized confounder that has not been looked at yet. Mefloquine is an anti-malaria pill given to our military members that is already known to confound the diagnoses of PTSD and TBI. This literature review will assess the difficulties that these veterans and family members are facing by looking at the different possibilities of what could be making veterans more violent

Responding sensitively to survivors of child sexual abuse: an evidence review

This report summarises what the evidence tells us about the characteristics of adults who were sexually abused as children and how to most effectively support them.

Dissociation and interpersonal autonomic physiology in psychotherapy research: an integrative view encompassing psychodynamic and neuroscience theoretical frameworks

Interpersonal autonomic physiology is an interdisciplinary research field, assessing the relational interdependence of two (or more) interacting individual both at the behavioral and psychophysiological levels. Despite its quite long tradition, only eight studies since 1955 have focused on the interaction of psychotherapy dyads, and none of them have focused on the shared processual level, assessing dynamic phenomena such as dissociation. We longitudinally observed two brief psychodynamic psychotherapies, entirely audio and video-recorded (16 sessions, weekly frequency, 45 min.). Autonomic nervous system measures were continuously collected during each session. Personality, empathy, dissociative features and clinical progress measures were collected prior and post therapy, and after each clinical session. Two-independent judges, trained psychotherapist, codified the interactions\u2019 micro-processes. Time-series based analyses were performed to assess interpersonal synchronization and de-synchronization in patient\u2019s and therapist\u2019s physiological activity. Psychophysiological synchrony revealed a clear association with empathic attunement, while desynchronization phases (range of length 30-150 sec.) showed a linkage with dissociative processes, usually associated to the patient\u2019s narrative core relational trauma. Our findings are discussed under the perspective of psychodynamic models of Stern (\u201cpresent moment\u201d), Sander, Beebe and Lachmann (dyad system model of interaction), Lanius (Trauma model), and the neuroscientific frameworks proposed by Thayer (neurovisceral integration model), and Porges (polyvagal theory). The collected data allows to attempt an integration of these theoretical approaches under the light of Complex Dynamic Systems. The rich theoretical work and the encouraging clinical results might represents a new fascinating frontier of research in psychotherapy

The words of the body: psychophysiological patterns in dissociative narratives

Trauma has severe consequences on both psychological and somatic levels, even affecting the genetic expression and the cell\u2019s DNA repair ability. A key mechanism in the understanding of clinical disorders deriving from trauma is identified in dissociation, as a primitive defense against the fragmentation of the self originated by overwhelming experiences. The dysregulation of the interpersonal patterns due to the traumatic experience and its detrimental effects on the body are supported by influent neuroscientific models such as Damasio\u2019s somatic markers and Porges\u2019 polyvagal theory. On the basis of these premises, and supported by our previous empirical observations on 40 simulated clinical sessions, we will discuss the longitudinal process of a brief psychodynamic psychotherapy (16 sessions, weekly frequency) with a patient who suffered a relational trauma. The research design consists of the collection of self-report and projective tests, pre-post therapy and after each clinical session, in order to assess personality, empathy, clinical alliance and clinical progress, along with the verbatim analysis of the transcripts trough the Psychotherapy Process Q-Set and the Collaborative Interactions Scale. Furthermore, we collected simultaneous psychophysiological measures of the therapeutic dyad: skin conductance and hearth rate. Lastly, we employed a computerized analysis of non-verbal behaviors to assess synchrony in posture and gestures. These automated measures are able to highlight moments of affective concordance and discordance, allowing for a deep understanding of the mutual regulations between the patient and the therapist. Preliminary results showed that psychophysiological changes in dyadic synchrony, observed in body movements, skin conductance and hearth rate, occurred within sessions during the discussion of traumatic experiences, with levels of attunement that changed in both therapist and the patient depending on the quality of the emotional representation of the experience. These results go in the direction of understanding the relational process in trauma therapy, using an integrative language in which both clinical and neurophysiological knowledge may take advantage of each other

Differences in sympathetic nervous response due to gender

Thesis (M.A.)--Boston UniversityThe sympathetic nervous system, in addition to its many roles as part of the autonomic nervous system, utilizes contact with many organs in the body to recruit them for an immediate response to danger. The multiple survival responses that the sympathetic nervous system manifests are typically known as the fight, flight or freeze response. The freeze response, otherwise referred to as tonic immobility, is being explored here for its survival value in the specific context of gender. It is our belief that in situations of interpersonal aggression, females may be more suited to survive by utilizing a tonic response when they are confronted with violence. Research in the areas of both tonic immobility and gender differences will be explored and compared, as well as animal origins of tonic immobility. It is our hope that by looking at the various studies already conducted on these topics, a path for future research on gender and sympathetic response may be illuminated in the field of physiological psychology

Mental Health in the Workplace: Situation Analyses, Poland

[From Introduction] The workplace is an appropriate environment in which to educate and raise individuals’ awareness about mental health problems. For example, encouragement to promote good mental health practices, provide tools for recognition and early identification of the symptoms of problems, and establish links with local mental health services for referral and treatment can be offered. The need to demystify the topic and lift the taboos about the presence of mental health problems in the workplace while educating the working population regarding early recognition and treatment will benefit employers in terms of higher productivity and reduction in direct and in-direct costs. However, it must be recognised that some mental health problems need specific clinical care and monitoring, as well as special considerations for the integration or re-integration of the individual into the workforce

What differentiates prisoners who attempt suicide from those who experience suicidal ideation? A nationally representative study

Objective: Many people who think about suicide do not engage in suicidal behavior. Identifying risk factors implicated in the process of behavioral enaction is crucial for suicide prevention, particularly in high-risk groups such as prisoners. Method: Cross-sectional data were drawn from a nationally representative sample of 17,891 prisoners (79% men) in the United States. We compared prisoners who attempted suicide (attempters; n = 2,496) with those who thought about suicide but never made an attempt (ideators; n = 1,716) on a range of established risk factors. Results: More than half (59%) of participants who experienced suicidal ideation had also attempted suicide. Violent offending, trauma, brain injury, alcohol abuse, and certain mental disorders distinguished attempters from ideators. Conclusion: Our results fit within recent ideation-to-action theories that emphasize the role of a capability for suicide in the transition from thoughts to acts of suicide

Towards an artificial therapy assistant: Measuring excessive stress from speech

The measurement of (excessive) stress is still a challenging endeavor. Most tools rely on either introspection or expert opinion and are, therefore, often less reliable or a burden on the patient. An objective method could relieve these problems and, consequently, assist diagnostics. Speech was considered an excellent candidate for an objective, unobtrusive measure of emotion. True stress was successfully induced, using two storytelling\ud sessions performed by 25 patients suffering from a stress disorder. When reading either a happy or a sad story, different stress levels were reported using the Subjective Unit of Distress (SUD). A linear regression model consisting of the high-frequency energy, pitch, and zero crossings of the speech signal was able to explain 70% of the variance in the subjectively reported stress. The results demonstrate the feasibility of an objective measurement of stress in speech. As such, the foundation for an Artificial Therapeutic Agent is laid, capable of assisting therapists through an objective measurement of experienced stress

Diagnostic, demographic, memory quality, and cognitive variables associated with acute stress disorder in children and adolescents

To date, no studies have investigated factors associated with acute stress disorder (ASD) in children and adolescents. Relationships between ASD and a number of demographic, trauma, cognitive, and trauma memory variables were therefore investigated in a sample (N=93) of children and adolescents involved in assaults and motor vehicle accidents. Several cognitive variables and the quality of trauma memories, but not demographic or trauma variables, were correlated with ASD and also mediated the relationship between peritraumatic threat and ASD. Finally, nosological analyses comparing ASD with indexes of posttraumatic stress disorder in the month posttrauma revealed little support for the dissociation mandate that uniquely characterizes ASD. The results are discussed with respect to assessment and treatment for the acute traumatic stress responses of children and young people