Altered neural response to rejection-related words in children exposed to maltreatment

BACKGROUND: Children exposed to maltreatment show neural sensitivity to facial cues signalling threat. However, little is known about how maltreatment influences the processing of social threat cues more broadly, and whether atypical processing of social threat cues relates to psychiatric risk. METHODS: Forty-one 10- to 14-year-old children underwent a social rejection-themed emotional Stroop task during functional magnetic resonance imaging: 21 children with a documented history of maltreatment (11 F) and 19 comparison children with no maltreatment history (11 F). Groups were matched on age, pubertal status, gender, IQ, socioeconomic status, ethnicity and reading ability. Classic colour Stroop stimuli were also administered in the same paradigm to investigate potential differences in general cognitive control. RESULTS: Compared with their peers, children who had experienced maltreatment showed reduced activation in the Rejection versus Neutral condition, across circuitry previously implicated in abuse-related posttraumatic stress disorder (PTSD), including the left anterior insula, extending into left ventrolateral prefrontal cortex/orbitofrontal cortex; left amygdala; left inferior parietal cortex (STS); and bilateral visual association cortex, encompassing the cuneus and lingual gyrus. No group differences in neural or behavioural responses were found for the classic colour Stroop conditions. Significant negative associations between activity in bilateral cuneus and STS during the rejection-themed Stroop and higher self-reported PTSD symptomatology, including dissociation, were observed in children exposed to maltreatment. CONCLUSION: Our findings indicate a pattern of altered neural response to social rejection cues in maltreated children. Compared to their peers, these children displayed relative hypoactivation to rejection cues in regions previously associated with PTSD, potentially reflecting an avoidant coping response. It is suggested that such atypical processing of social threat may index latent vulnerability to future psychopathology in general and PTSD in particular

Nurse resilience: A concept analysis

Nurse resilience is attracting increasing attention in research and practice. Possession of a high level of resilience is cited as being crucial for nurses to succeed professionally and manage workplace stressors. There is no agreed definition of nurse resilience. A concept analysis was undertaken to examine nurse resilience using a priori selected analysis framework. This concept analysis aims to systematically analyse resilience as it relates to nurses and establish a working definition of nurse resilience. Sixty-nine papers met the search criteria for inclusion. Key attributes of nurse resilience were social support, self-efficacy, work–life balance/self-care, humour, optimism, and being realistic. Resilience enables nurses to positively adapt to stressors and adversity. It is a complex and dynamic process which varies over time and context and embodies both individual attributes and external resources. Sustaining nurse resilience requires action and engagement from both individuals and organizations

In their own words: The experience of mothering as a survivor of childhood sexual abuse

AbstractThis article reviews past research on the parenting characteristics of childhood sexual abuse survivors and presents the results of a qualitative study exploring the women's perspectives on mothering as a survivor. Grounded theory was used in the collection and analysis of the data. Data sources included the narrative responses of 79 women (mean age = 38.2 years) and in-depth interviews of a purposive sample of 15 women (mean age = 39 years). They had an average of 2.2 children, ranging in age from 5 months to young adulthood. The theoretical model identified through analysis of data using the constant comparison method was entitled “The Hard Work of Mothering as a Survivor.” Processes emerged that described the ways participants managed the work of mothering in light of memories of the abuse and attempts to heal from this earlier trauma. The conditions for committing to the work included becoming aware of and accepting the reality of the abuse and how it affected one's life, and taking on the hard work of developing a mothering self. This included expanding awareness, developing and evaluating a personal model of mothering, navigating typical and abuse salient parenting challenges, mothering through the pain of recovery, and battling for balance. The findings highlighted the dynamic, multifaceted nature of recovery and resilience for these mothers and the need for an increased focus on parenting in counseling with childhood sexual abuse survivors. Provision of anticipatory guidance regarding commonly experienced stressors at varying stages of the child's development and the mother's stage of recovery and methods for coping with these challenges, would benefit these mothers and promote parenting competence. Specific implications for psychotherapy and directions for future research are discussed.</jats:p