International Society for Traumatic Stress Studies

Articles Published in 2013 - January

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Child Trauma Treatment

Posted 22 January 2013 in StressPoints by Judith A. Cohen, MD - 2012 ISTSS Sarah Haley Memorial Award Recipient

I was extremely honored to receive the 2012 ISTSS Sarah Healy Memorial Award for Clinical Excellence. ISTSS has been very important to me and I appreciate this opportunity to reflect on how child trauma treatment has changed in the past 30 years.
     
Child trauma treatment has moved into the mainstream: Child trauma treatment was on the outer fringes of child psychiatry when I completed training in 1984. Aside from a small group of child abuse colleagues, mental health professionals generally ignored child trauma—except when they disparaged it. When I decided to focus on child trauma treatment I was asked “Why don’t you study something important?” Attitudes changed after the September 11, 2001 terrorist attacks killed more than 3000 people and dramatically raised public and professional awareness about trauma. A few weeks later, the Substance Abuse and Mental Health Services Administration funded the National Child Traumatic Stress Network (NCTSN) to raise the standard of care for traumatized children and families, providing sustained national attention on child trauma and the need for effective treatment. High profile disasters such as Hurricane Katrina and the recent school shootings in Connecticut continue to maintain public awareness about the importance of child trauma treatment. Child trauma treatment is now in the mainstream of child mental health, hopefully to stay.

“Get it Right”: Reducing Stigma for Veterans in Need of Treatment for the Destructive Psychological Effects of Combat

Posted 17 January 2013 in StressPoints by Howard Lipke, PhD - Rosalind Franklin University of Health Science

The fact that stigma (being marked or believing one is marked as disgraced) is a primary barrier to veterans seeking help to overcome the destructive psychological effects of trauma is a cultural phenomena which is easy to see, widely acknowledged, and also evidenced by research (Hoge et al.,  2004). As is often pointed out, stigma has two manifestations: the belief by others that the need for psychological help is a sign of essential inferiority, and the same belief held by the self (Corrigan, 2004). Both are important, but self-stigma can be the most damaging.

Efforts to overcome stigma related to psychological problems, for veterans in particular, seem to have focused on three approaches: (a) viewing the psychological effects as a normal response to an abnormal situation; (b) interpreting the effects as a medical rather than a characterological problem (e.g., “Not all wounds are visible”); or (c) framing the seeking of help as a responsibility of the individual to fulfill his or her own potential—in other words, recognizing that seeking help takes strength (e.g., “It takes the strength of a warrior to seek help.”). All of these have had some success, yet the problem of stigma persists as a barrier to treatment-seeking among veterans (Hoge, 2010).

Media Coverage of Traumatic Events: A Summary of Selected Research Findings

Posted 16 January 2013 in StressPoints by Kathryn Becker-Blease, PhD - School of Psychological Science, Oregon State University

In the days after news of traumatic events breaks, journalists often turn to various experts for information on how to explain these events to children who learn about them through the media. ISTSS members are likely to be asked for their advice not only by journalists, but by clients, childcare and school professionals, and friends. All of us will have some helpful information to share.

What follows is a brief selective review of research on trauma-related media coverage. When we explain the research behind our advice we not only help people cope, but also to understand the scientific basis for our answers.

Epigenetic Mechanisms in Post-Traumatic Stress Disorder

Posted 16 January 2013 in StressPoints by Andrea Burri, PhD; Andreas Küffer, MSc; Andreas Maercker, MD, PhD; Department of Psychology, University of Zürich, Switzerland; University Research Priority Program “Dynamics of Healthy Aging,” University of Zürich, Switzerland

Evidence from quantitative and molecular genetic studies have repeatedly demonstrated the involvement of genes in post-traumatic stress disorder (PTSD), but also highlighted the importance of environmental factors in disease development and/or resilience. The emerging field of epigenetics is particularly attractive because of its ability to account for individual differences in response to trauma based on environmental exposures that alter gene function. As such, investigation of specific epigenetic markers may provide quantifiable measures of lifetime environmental stress or heritable predisposition to PTSD and can thus offer a biological framework for the interactive causes underlying PTSD. In this mini-review we will discuss the relevance of epigenetic research to PTSD and provide a summary of recent developments revealing epigenetic alterations in response to adversities, trauma and PTSD.
 
Epigenetics Explained in Brief

Coined by Waddington, the term “epigenetics” was originally used to describe how genes interact with the cellular environment to produce a phenotype (Waddington, 1942). Nowadays, the term is applied more narrowly referring to the reversible regulation of various genomic functions, occurring independently of DNA sequence, mediated principally through changes in DNA methylation and chromatin structure. In other words, epigenetics defines cellular modifications that can be heritable but appear largely unrelated to DNA sequence changes, and that can be modified by environmental stimuli (Holliday, 1994, Russo et al., 1996). Such modifications are stable and long lasting and can in some cases be transmitted inter-generationally (Meaney & Szyf, 2005). At present, epigenetic mechanisms typically comprise DNA methylation and histone modifications. DNA methylation is strongly linked to a number of genomic functions, including the regulation of gene expression, with many genes demonstrating an inverse correlation between the degree of methylation and the level of expression (Jaenisch & Bird, 2003). Genome-wide DNA methylation variation is a new way of looking at complex diseases such as PTSD because it responds to the environment and governs gene expression - thus potentially mediating a path from environmental effects to gene expression to disease.

Child Abuse and Neglect: A Global Problem in Need of a Global Solution ISTSS joins Global Collaboration

Posted 15 January 2013 in StressPoints by Karestan C. Koenen, PhD

I was 24 years old and working in a preschool the first time I called child protective services. Robbie, not yet even 3 years old, was already considered the class troublemaker. When the other children sat in their chairs eating snacks, Robbie would push the back of their chairs, causing the children to fall onto the hard tile floor. He seemed to enjoy breaking toys too, especially the dolls, which he destroyed by ripping off their limbs. One morning, I discovered bruises and handprints all over Robbie’s back. When I brought this to the attention of the head teacher she said, “We don’t interfere with how parents discipline their children.”