Dysfunctional posttraumatic cognitions: Can we reduce the gap between research and practice?

Anke de Haan A new guestpost!

Anke de Haan from the University Children’s Hospital in Zurich talks about the place that children’s post-trauma cognitions have in clinical practice:

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Posttraumatic cognitions have been a topic in child trauma research for a few years now. Nevertheless, my impression is that they have not yet been established in clinical practice.

Why not? Are they not practically relevant? Are they too difficult to assess? Before I discuss these questions, I will briefly describe what I mean with dysfunctional posttraumatic cognitions. Continue reading

Refugees in Europe: A crisis?

Fresh Eyes on the Refugee Crisis - image by Tom Turley

Over 1 million people arrived in Europe by sea in 2015. And since the conflict in Syria continues, this influx will not halt.

It is the biggest refugee crisis since World War II according to the UNHCR. The journey by sea is dangerous, the circumstances in refugee camps and asylum seeker centers are far from ideal – to say the least – and tensions between host countries make it difficult to find constructive solutions.

With such big numbers and their political, social and logistical complexities, it’s easy to feel powerless as an individual.

Still, there are opportunities. As Margaret Mead has famously been quoted:

“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it’s the only thing that ever has.”

Continue reading

Getting rid of the Ghost People

child soldierPatrick became a child soldier at the age of 13. He was abducted by Ugandan rebels, who kept him for 3 years.

Schultz and Weisaeth (2015) describe Patrick’s story, his mental health problems, and his treatment, a local cleansing ritual. They conclude that the ritual is safe, effective, and perhaps even more powerful than Western-style therapy. That sounds fascinating and important, right?

In interviews Patrick told about his experiences, including an attack on a convoy:

“Everybody was screaming…The road was all red from the blood… My body was shaking, but I managed to appear calm. If not they would have killed me. The next day I experienced the Ghost People for the first time. I could see them get chopped up and sliced apart with axes. I saw the same scenes over and over again.”

The Ghost People only showed up when Patrick was alone, and scared him enormously. He also suffered from concentration problems and sleeping difficulties. He was clinically depressed and had moderate to severe PTSD.

When his nightmares were occurring twice a week and he saw the Ghost People every day – about 8 years after the convoy attack –, he stated that his life was ruined. He wanted to do a cleansing ritual. Continue reading

Children in the Emergency Department

Children Emergency DepartmentJonas was a master tree climber.

Until today.

Now his left leg has a strange angle, and he has been knocked out by the fall.

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Every year, millions of injured children require treatment at a hospital Emergency Department. Approximately 1 in 6 of them develop persistent stress symptoms, such as nightmares, concentration difficulties and negative thoughts.

Emergency Department doctors and nurses provide physical care but they can also support children’s emotional wellbeing. How well are they equipped to do so? Continue reading

Why demographics – including sexual orientation – matter in PTSD research

A while ago I started Paper in a Day to get young trauma researchers together. It has been engaging and productive (if you’re interested, the upcoming ISTSS conference will feature one). In a recent edition, four clever minds – Drs Averill, Eubanks Fleming, Holens and Larsen – have thought through research gaps in the PTSD literature. They published a commentary and I wanted to share their thoughts here. They reflect on one of the biggest areas of trauma research, the experiences of military personnel:

As the wars in Afghanistan and Iraq continue, and military service members continue to return home from these two conflicts, more research has been conducted to examine rates of PTSD among these service members (known in the US as OEF/OIF Veterans i.e. Veterans of Operation Enduring Freedom/Operation Iraqi Freedom). This research is important so that we have an understanding of the need for healthcare in newer returning Veterans (which may differ from previous generations). In reviewing some of these articles, many of which are quite well-designed, we noticed a need for some further study to understand the nuances of who develops PTSD and why.

In particular, it would be useful to examine how PTSD prevalence in US OEF/OIF Veterans depends on 1) Veterans Affairs services use (with a particular focus on non-VA users), 2) relationship status, and 3) sexual orientation. Continue reading