How Art Therapy Can Help Survivors of Trauma Access an Embodied Sense of Safety: A Literature Review

Traumatic stress can disrupt systemic rhythms in the brain and body that enable a person to feel safe in the world. Therefore, the initial phase of trauma treatment must focus on establishing an embodied sense of safety. This literature review examined cross-disciplinary data to assess whether art therapy can help trauma survivors access an embodied sense of safety, and if so, what therapeutic mechanisms contribute to its effectiveness. The data indicated that trauma-informed art therapy can support an embodied sense of safety through activating key therapeutic factors that downregulate instinctual defense mechanisms which can occur as a result of traumatic stress. Results revealed seven therapeutic factors that contributed to feelings of safety: therapeutic alliance; group belonging; synchrony with the natural world; affect regulation; sensory integration; a positive emotional state; and a sense of agency. Additionally, the paper outlines specific art therapy interventions that exemplify each therapeutic factor, and mechanisms that can illuminate how these therapeutic factors support an embodied sense of safety

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Chronic alcohol remodels prefrontal neurons and disrupts NMDAR-mediated fear extinction encoding

Alcoholism is frequently co-morbid with post-traumatic stress disorder, but it is unclear how alcohol affects the neural circuits mediating recovery from trauma. We found that chronic intermittent ethanol (CIE) impaired fear extinction and remodeled the dendritic arbor of medial prefrontal cortical (mPFC) neurons in mice. CIE impaired extinction encoding by infralimbic mPFC neurons in vivo and functionally downregulated burst-mediating NMDA GluN1 receptors. These findings suggest that alcohol may increase risk for trauma-related anxiety disorders by disrupting mPFC-mediated extinction of fear