Armed Conflict's Impact on Children: A UN Report
By Ellen Frey-Wouters, PhD, LLB, ISTSS Representative to the United Nations
The Attack on Children
In 1996, 30 major armed conflicts raged in different locations around the world.They took place within states, between factions split along ethnic, religious and cultural lines. In the past decade, an estimated 2 million children were killed in armed conflict and three times as many seriously injured or permanently disabled. There is no way to measure the impact on a child who sees her family killed or to quantify the emotional and psychological toll on children who live for years in fear of bombings, mutilation or death. In recent decades the proportion of war victims who are civilians has leapt dramatically from 10 percent to more than 90 percent. Human rights violations against children occur in unprecedented numbers. Many of today's conflicts last the length of a childhood, so that from birth to early adulthood, children experience multiple and accumulative assaults. Disrupting the social networks and primary relationships that support a child's physical, emotional, moral, cognitive and social development in this way has profound physical and psychological implications.
Those facts about our world are brought chillingly home in a recent report to the United Nations. It was based on two years of study, including visits to wartorn countries in Asia, Africa, the Middle East, Europe and Latin America, by a team headed by Graça Machel, the widow of President Samora Machel of Mozambique. Machel was the country's minister of education for 10 years. She is a lawyer, and her report marshals the facts like a compelling legal opinion.
Machel wrote: "The statistics are shocking enough, but they suggest something worse. More and more of the world is being sucked into a desolate moral vacuum. This is a space devoid of the most basic human values; a space in which children are slaughtered, raped and maimed; a space in which children are exploited as soldiers. There are few further depths to which humanity can sink"
In August 1996, the report, titled "The Impact of Armed Conflict on Children," was submitted to the UN General Assembly by the secretary-general. The General Assembly gave thorough consideration to this study and to the mechanism required for following up the implementation of the recommendations.
Promoting Psychosocial Well-Being
The report points out that "armed conflict affects all aspects of child development - physical, mental and emotional - and to be effective, assistance must take account of each. Historically, those concerned with the situation of children during armed conflict have focused primarily on their physical vulnerability. The loss, grief and fear a child has experienced must also be taken into account. Armed conflict destroys homes, splinters communities and breaks down trust among people, undermining the very foundations of children's lives
"All phases of emergency and reconstruction assistance programmes should take psychosocial considerations into account. They should give priority to preventing further traumatic experiences, such as preventing family separation, undertaking practical measures to prevent gender-based violence and avoiding the isolation and stigmatization that can result from institutionalization
"Psychosocial programmes should incorporate knowledge and respect for local culture and traditions and ensure ongoing consultation and participation with local authorities and communities. The most effective and sustainable approach is to mobilize the existing social care system. This may, for example, involve mobilizing a refugee community to support suitable foster families for unaccompanied children. Through training and raising the awareness of central caregivers, including parents, teachers and community and health workers, a diversity of programmes can enhance the community's ability to provide care for its children. Experience has shown that with supportive caregivers and secure communities, most children will achieve a sense of healing.
"Integrating modern knowledge of child development and child rights with traditional concepts and practices may take time, but will result in more effective and sustainable ways to meet children's needs. A number of principles and activities have been identified to promote healing by fostering a sense of purpose, self-esteem and identity. These include establishing a sense of normalcy through daily routines such as going to school, preparing food, washing clothes and working in the fields. Children also need the intellectual and emotional stimulation that is provided by structured group activities. The most important factor contributing to a child's resilience is the opportunity for expression, attachment and trust that comes from a stable, caring and nurturing relationship with adults.
"Families and communities can better promote the psychosocial well-being of their children when they themselves feel relatively secure and confident about the future. Recognizing that families and communities are often fragmented and weakened by armed conflict, programmes should focus on supporting survivors in their efforts to heal and rebuild their social networks."
The report pays special attention to refugee and internally displaced children, children in camps, the impact of land mines on children, the use of children as soldiers, the problem of social reintegration, gender-based violence, child victims of prostitution and sexual exploitation.
To keep the issues of children and armed conflict high on the international human rights agenda and to ensure follow-up, the secretary-general is called upon to appoint a special representative, who will foster international cooperation between governments, UN bodies, specialized agencies and other competent bodies, including nongovernmental organizations like ISTSS.
ISTSS actively participated in the annual sessions of the General Assembly, ECOSOC and UNICEF and has kept the issue of traumatic stress on their agendas. The Society has also been a consultant in the establishment of UNICEF's Trauma Recovery Programme, including the National Trauma Centers in Rwanda, Zaire and other countries. During the coming years, ISTSS representatives at the United Nations will maintain their vigilance.
ISTSS 1996 Annual Meeting Report
The ISTSS 12th Annual Meeting established a high water mark for attendance and sessions, with more than 900 people participating in 126 sessions. The conference also included two poster sessions and a full day of premeeting institutes.
Yet the meeting was more than just quantity - it was about quality presentations and opportunities to interact with colleagues. Ninety-five percent of attendees rated the educational content excellent or good. The conference theme, "Trauma and Controversy," was played out in the variety of topics and animated discussion in sessions and the hallways of the Sheraton Palace Hotel.
Plenary sessions featured explorations of provocative topics and revolutionary approaches. Plenary sessions included two contrasting presentations on "Prevention of Interpersonal Violence: Criminal Justice vs. Public Health Approaches," Jennifer Freyd's keynote address on "The Logic of Forgetting Abuse: Cognitive Science and Betrayal Trauma Theory" and perspectives on "The Law and Clinical Practice with Child Victims: Traveling Companions Whether We Like It or Not."
Social events and the exhibit and poster area provided opportunities for informal exchanges throughout the conference.
ISTSS Awards: Herman Recognized for Lifetime Achievement
Judith Herman, MD, received ISTSS' highest award, the Lifetime Achievement Award. The award is presented to an individual who has made great lifetime contributions to the field of PTSD. The award was formerly known as the Pioneer Award.
Two individuals received The Sarah Haley Memorial Award for Clinical Excellence. Awardees were Mary Harvey, PhD, of The Cambridge Hospital Victims of Violence program, Cambridge, Mass., and Laurie Anne Pearlman, PhD, Traumatic Stress Institute/Center for Adult and Adolescent Psychotherapy, South Windsor, Conn. The award is given to a clinician in direct service to traumatized individuals and whose written and/or verbal communications to the field exemplify the work of Sarah Haley.
The Robert S. Laufer, PhD, Memorial Award for Outstanding Scientific Achievement was presented to ISTSS President Terence Keane, PhD, National Center for PTSD, Boston. The award is give to an individual who has made an outstanding contribution to research in the PTSD field.
The Chaim Danieli Young Professional Award recognizes excellence in service or research in the field of traumatic stress by an individual age 35 or younger. The 1996 award was presented to J. Douglas Bremmer, MD, National Center for PTSD, West Haven, Conn.
Outgoing ISTSS President Matt Friedman, MD, presented the awards following the Evening in Chinatown Banquet at the Annual Meeting. Awards Committee members include Edna Foa, PhD, chair; Sandra Bloom, MD; Bonnie Green, PhD; Charles Marmar, MD; Arieh Shalev, MD; and Steven Southwick, MD.
ISTSS Greets New Year on Solid Ground
By Terence Keane, PhD
San Francisco's meeting was a huge success! Attended by more than 900 professionals, it was our largest ever. The quality and quantity of presentations was unparalleled in any existing mental health conference, making this year's conference a monumental achievement of which we can all be proud. I deeply appreciate the efforts of Paula Schnurr, PhD, and Dean Kilpatrick, MD, who in conjunction with the Sherwood Group staff, assembled such an outstanding meeting.
I would like to recognize the strong presidential leadership of Matt Friedman, MD, during 1996. Matt leaves us with an organization that is healthy, growing (2,500 members!) and mature. He also leaves us on strong financial footing, something that could not be said as recently as four years ago. We owe him and his predecessors a debt of gratitude. The Society is today an outstanding and vibrant organization.
As I assume the presidency, I look forward to working with Matt as pastpresident and Sandy Bloom, our recently named president-elect. Together with a talented executive committee, I'm certain we will achieve the board's goals for the coming year.
On Jan. 1, Dean Kilpatrick became editor-elect of the Journal of Traumatic Stress. I had the pleasure of chairing the Editor Selection Committee and reviewing the credentials of many outstanding candidates. Dean was chosen for his amazing level of sustained productivity over the years, the high impact of his work, his experience on editorial boards and review panels, and his vision for the Journal. Under his leadership, we look forward to the continued ascendancy of JTS as the world's premier trauma journal.
There are a few activities that you may wish to know about or for which you might volunteer. First, Susan Roth, PhD, has been creating a pamphlet to address the issue of trauma and memory in an even-handed, scholarly way. She has enlisted the help of a virtual who's who in the area to contribute to this effort. This document will be useful for clinicians, legislators, policy-makers, those involved in the judicial process and anyone affected by this debate. A final document is expected this spring.
As the Society grows, we are increasingly interested in affiliations with like-minded organizations. ISTSS has received numerous requests from groups wishing to affiliate with us. Matt Friedman has agreed to head a committee to construct guidelines for such affiliations. At the 1997 ISTSS Annual Meeting, we will share presentations with the International Society for the Study of Dissociation, which is holding its annual meeting immediately after ours at the same location. Danny Kaloupek, our program chair, and Marlene Steinberg, MD, the ISSD program chair, have met to plan a jointly sponsored program. We will continue to look for such opportunities to expand the Society's breadth and depth.
We are also working with the Sherwood Group to enhance our offerings to members via the Internet. As most of you are aware, ISTSS has a Web page that receives thousands of hits a month. With a large portion of the Society ordering the 199697 Membership Directory on disk, it seems that the time is right for us to move assertively in increasing communications via the Internet. A lengthy discussion of the possibilities occurred at the Board of Director's meeting in San Francisco and several ideas will be implemented this year.
Let me conclude by saying that I am delighted to be leading ISTSS at this time. The study of psychological trauma is vital and exciting, and we are at the cutting edge of research in many areas, facts to which our journal and conference attest. We are attracting more professionals to study trauma and PTSD. The number of submissions to journals, the number of grants submitted in the area and the increase in dissertations and theses on trauma are indicators of the field's vibrancy. The multidisciplinary integration of science and clinical practice is the hallmark of the ISTSS. It is what will lead us into the next century and what will keep us as the Society for the study of psychological trauma.
'97 Board Takes Office; Bloom Voted President-Elect
Each year, ISTSS elects roughly a third of its 21 board members and a president-elect. The 1997 ISTSS Board of Directors, elected in August via mail ballot, took office following the annual business meeting held during the San Francisco conference in November.
Sandra Bloom, MD, the new ISTSS president-elect, is a clinical psychiatrist and is director of The Sanctuary, Friends Hospital, Philadelphia. She is also assistant professor of psychiatry, Temple University School of Medicine. She serves as president of the Alliance for Creative Development and president of the Philadelphia Chapter of Physicians for Social Responsibility.
During her term, Bloom hopes to address the ongoing challenge of "balancing our dedication to sharing research with the needs of clinicians and our stated commitment to public policy concerns." She will assume the office of president at the 1997 Annual Meeting in Montreal.
Newly elected board members are Frank Putnam, MD, Christine Courtois, PhD, Laurie Pearlman, PhD, Berthold Gersons, MD, and Steven Southwick, MD. Reelected board members are John Briere, PhD, Edna Foa, PhD, and Arieh Shalev, MD (returning). Board members serve three-year terms. Continuing Board members are Bob Pynoos, MD, Susan Roth, PhD, Bessel van der Kolk, MD, John Fairbank, PhD, Jessica Wolfe, PhD. Sandy McFarlane, MBBS, Susan Solomon, PhD, Mary Beth Williams, PhD, and Rachel Yehuda, PhD.
Board members whose terms ended at the San Francisco conference are Charles Figley, MD, Ellen Frey-Wouters, PhD, LLB, Betsy Brett, PhD, David Foy, PhD, William Yule, PhD, Tom Lundin, MD, and Fred Gusman, MSW.
The new board held its first meeting at the conference. At the meeting, the board approved ISTSS President Terence Keane's executive committee proposal. In addition to Keane, Bloom and Past President Matt Friedman, MD, the 1997 Executive Committee consists of Edna Foa, vice president, John Fairbank, treasurer, and Alexander McFarlane, secretary.
ISTSS committee chairs will be listed in the next issue of StressPoints. To obtain a current listing, visit the ISTSS Web site (http://www.istss.org) or contact headquarters to request a list.
Keane will appoint an additional board member to fill the term of Dean Kilpatrick, who will resign his position on the board to assume the role of editor-elect for the Journal of Traumatic Stress. The JTS editor serves as an ex-officio member of the Board.
Twenty-six percent of ISTSS members returned ballots, which is a slightly lower percentage than in the 1995 election. More members actually cast ballots, however, due to the Society's expansion.
Emergency Service May Abandon Critical Incident Stress Debriefing
By Roderick Orner
The spring 1996 issue of the ESTSS Newsletter featured an article describing the process by which the Lincolnshire Joint Emergency Service was established through the early part of this decade. Although principally an educational strategy for all emergency services in this county, the initiative has also developed a psychological debriefing resource consisting of about 30 individuals who have participated in an introductory workshop on the Mitchell Model of Critical Incident Stress Debriefing. To date approximately 40 debriefings have been held, and systematic evaluation of the impact of these has been carried out by Matthew Hutt as part of a doctorial dissertation presented to Sheffield University.
Hutt's research and that of others confirm a high degree of consumer satisfaction with debriefing meetings. The evidence for a distinct therapeutic effect of this intervention is far from decisive. Rather, the limitations of this critical incident stress management service becomes more and more conspicuous when the data is examined. For instance, Hutt and others report data suggesting that the rated helpfulness of psychological debriefing is inversely proportional to the reported impact of a critical incident on emergency responders. So, the less affected a responder, the more likely it is the intervention will be considered helpful - hardly a resounding endorsement from those who might be in greatest need of staff support and follow-up services.
In light of this evidence, the Strategic Development Group of the Lincolnshire Joint Emergency Services has decided to review and reconsider the advisability of continuing psychological debriefings using the format proposed by Mitchell et al. After consultation with the members of the Debriefer Group, alternative procedures may be formulated for providing this form of critical incident stress management service. There may be a need to reformulate the aims of psychological debriefing in terms of its being part of an assessment process that explicitly seeks to identify those individuals who may be considered most at risk following critical incidents. This will require changes to the structure and content of debriefing meetings, and it confers centrality to the longer-term follow-up arrangements an emergency service may be advised to put in place.
The hope is to reformulate the protocol for psychological debriefing in time to convene a symposium on this subject during this year's ESTSS conference.
Contact for ESTSS meeting is...
c/o V V A A Conference Services
P.O. Box 8153
3503 RD Utrecht
phone 31/30/247 44 50
fax 31/30/247 46 47
UW journalism and Trauma Project Scripts New Approaches to Victims
By Frank Ochberg, MD
Contributing editor, media matters
"So long as men can breathe or eyes can see, So long lives this, and this gives life to thee."
Shakespeare wrote those lines 400 years ago, attesting to the immutability of the written word. His lover would fade and die, but her memory, his sonnet, would survive. And the Bard was correct: his words live on.
No wonder we trauma therapists care about media portraits of our patients - those depictions live on with impact. They are portrayals that capture pain and loss, shock and grief, but rarely the larger picture of a human life: who that person really is, how they cope and whom they encourage by their example of survival. Too often our clients are memorialized as afterthoughts and sound bites - inadvertent, unconsenting, two-dimensional examples of the impact of cruel events. Where is Shakespeare when we need him?
Perhaps he lurks in Seattle, a spirit that guides the work of Professor Roger Simpson and his colleagues in the Journalism and Trauma Project of the University of Washington. The project teaches journalism students how to approach survivors of traumatic stress, how to portray the whole person and how to appreciate the media's power to help and to indelibly harm.
Last month the program launched a Web site (http://weber.u.washington.edu/~jtrauma/) with information about curricula, new courses, research, conferences, interview guidelines and outreach to traumatized communities. Reading between the lines, we discover journalism professors who understand that journalism needs reform. Here are media professionals who will join the ISTSS to learn with us and about us.
Simpson recently wrote, "Understanding of the intersection of trauma and journalism has developed slowly While traumatic events - wars, earthquakes, fires and murders - remain the mainstay of daily journalism, most reporters still treat the afflicted in much the same way they did at midcentury. While print journalism for the most part hides the interchange between victim and reporter from public view, television every day affirms the harsh, sometimes brutal, character of the reporter's interview with the traumatized person. Indeed, the ambush interview sometimes produces a state like trauma in the unsuspecting person as the audience watches.
Journalistic practice appears to assume that all trauma survivors are equally ready to report their experiences and mental state to the mass audience, a fact directly contradicted by substantial clinical literature (unpublished draft, available by e-mail: firstname.lastname@example.org). This paper goes on to explain how students, through role-play and debriefing, are prepared to adopt new insights and values as trauma reporters.
ISTSS members with similar examples of enlightenment among media professionals are encouraged to correspond with me, so that this column can fan the flames of progress.
1996 ISTSS Membership Survey:
By John Fairbank, PhD, Lori Ebert, and Arthur Bonito, Research Triangle Institute
As part of the ISTSS Board of Directors' efforts to plan for the organization's future a questionnaire was developed to examine the membership's views on important issues, most notably ISTSS activities and the substantive areas represented in its journal and annual meeting.
Mailed in mid-April to 1,800 ISTSS members, the survey garnered 528 responses (29.3 percent of the members). Based on demographic data - years of membership in the organization, gender, nationality and highest attained degree - survey respondents were a good representation of the overall membership.
Results suggest that ISTSS members attach different values to the organization's various activities. The activities that a majority of members deemed essential or very important, are (1) sharing research findings and practice innovations at the annual meeting, (2) developing and disseminating information to providers, (3) providing networking opportunities and (4) serving as an educational resource to the public at large.
The membership also expressed preferences for areas where greater attention should be paid in the Journal of Traumatic Stress and at the annual meetings. Three areas which the membership clearly feels deserve greater emphasis, based on a majority of the respondents rating them as being essential or very important, are (1) child abuse, (2) urban violence and (3) child development.
The survey also tried to ascertain members' opinions about ISTSS aggressively attempting to increase the size of its membership. More than a third (37.1 percent) of respondents do not support such an expansion effort. Many individuals expressed a preference for a more gradual process of growth in which qualified people, mainly involved in trauma research or treatment, are attracted to the organization by its excellence and benefits. Additionally, two-thirds of the membership favored collaborative arrangements with professional organizations that have substantive interest in traumatic stress.
These and survey findings will guide the Board and ISTSS membership as they plan strategically for the organization's future.
ISTSS Membership on the Rise; (Don't Let Yours Lapse)
New members joining at the Annual Meeting in San Francisco pushed ISTSS membership over 2,500 for the first time. More members brings more opportunities for services to members and the community.
If you joined ISTSS or paid your dues before October 1996, it's time to renew your commitment to ISTSS. Your membership renewal will continue your access to great resources, including the growing, dynamic community of ISTSS members. ISTSS benefits include:
- Networking and learning with colleagues at the Annual Meeting;
- A subscription to the highly respected Journal of Traumatic Stress;
- A Membership Directory, your who's who in the field (Now on disk!)
- Issues and trends in the improved Traumatic StressPoints newsletter.
- Online resources via the ISTSS Web site (http://www.istss.org);
- New for '97! The '97 Conference Committee has planned dozens of new programs and events for Montreal, November 610;
- New for '97! You'll benefit from opportunities through new cooperative programs and affiliations with organizations around the world like the International Society for the Study of Dissociation;
- New for '97! Chat with leaders in the trauma field from your home or office with a new series of live, on-line forums;
- New for '97! Internet Interest Group.
Please return your dues payment and database update form promptly. And don't forget your gift to the ISTSS Conference Scholarship Fund. Recipients of ISTSS scholarships bring the benefits of their ISTSS experience back to their communities around the world. In 1996, ISTSS supported conference attendees from Libya, Georgia (former Soviet Union) and South Africa.
Addressing PTSD and Trauma-Related Symptoms among Criminally Involved Male Adolescents
By Elana Newman, PhD, Carlo Morrissey, Robert McMackin, and Brigette Erwin
Most secure juvenile treatment facilities address certain problems linked to perpetration, such as substance abuse, anger management, development of pro-social skills and empathy, and relapse prevention, but they fail to address post-traumatic stress disorder.
This is a major omission since criminally involved adolescents are exposed to numerous risk factors for PTSD. This article reviews preliminary results regarding the prevalence of PTSD among incarcerated youth and outlines the utility of addressing PTSD symptoms in juvenile prisons.
In a collaborative study between the National Center for PTSD Behavioral Sciences Division and the Massachusetts Department of Youth Services, we are assessing the prevalence of potentially traumatic life events, criterion A events and PTSD. Among 42 adolescents interviewed thus far, 14 percent met DSM-IV criteria for current PTSD, and 21 percent met criteria for past PTSD. In addition, on a self-report instrument, 72 percent met current criteria for PTSD. These results indicate that a significant group of incarcerated adolescents are affected by trauma-related symptoms and require interventions.
These adolescents' PTSD symptoms may be misdiagnosed, and associated trauma-related problems may not be addressed in the context of trauma.
Symptoms of conduct disorder, attention deficit disorder and major affective disorder may reflect trauma-related symptoms and require trauma-specific interventions. For example, the high incidence of substance abuse disorders in incarcerated adolescents may represent the youth's attempt to self medicate against traumatic intrusive thoughts and feelings, numbness and psychological distress. Directly addressing trauma-related symptoms would help incarcerated youth take responsibility for their crimes, increase empathy and perspective-taking capacity, and facilitate anger management.
For example, denying responsibility for a crime may be associated with trauma-related avoidant coping styles and intrusions that prevent perpetrators from examining the negative affect associated with violent and abusive life experiences. Additionally, the capacity for empathy and perspective taking among youth with PTSD can be hampered by numbing symptoms.
Effective PTSD treatment paradigms have not been integrated into the rehabilitation of incarcerated juveniles. Direct exposure therapies such as flooding may prove useful in extinguishing arousal, maladaptive beliefs and negative affect associated with traumatic experiences. Cognitive-behavioral and psychoeducational group formats could be readily integrated into juvenile treatment programs in a cost-effective manner. Tailoring inpatient PTSD programs in the Veterans Administration system to younger clientele may serve as a useful model for helping these youth reduce their violent behavior.
March 28, 1997
Trauma, Memory and Disruption of Attachment (featured speaker Bessel van der Kolk, MD) Trauma & Dissociation Study Group of Southeast Michigan
Michigan State University
Contact: Don Novak, 313/281-7030
April 56, 1997
Workshop: Advances in Diagnosing and Treating Abuse Survivors
Chicago, Ill. (also Apr. 1920 in Chelan, Wash.)
Contact: SCID-D Institute,888/55-SCIDD
April 1013, 1997
First Annual Conference of the Green Cross Projects: "Active Ingredients in Eliminating Traumatic Stress,"
Contact: Teresa Descilo, 305/255-1619
April 1719, 1997
Second Annual Northwest Conference on Trauma and Dissociation
Campbell's Resort and Conference Ctr.
Contact: Erika Clasen, 206/270-8444
May 710, 1997
Australasian Critical Incident Stress Association Annual Conference
Contact: ACISA, tel./fax 61-2-630-0570
June 2529, 1997
5th International Conference on Grief and Berievement in Contemporary Society; 19th Annual Conference of the Association for Death Education and Counseling
Contact: ADEC, 860/586-7503; e-mail: ADECoffice@aol.comJune 29 July 3, 1997
ESTSS Fifth European Conference on Traumatic Stress
Maastricht, The Netherlands
Contact: VVAA Conference Services, tel. (31) 30 247 4450; fax (31) 30 247 4647
July 1315, 1997
Trauma Recovery Training: Lessons Learned
Society for Psychological Assistance
Contact: Ksenija Kontak, tel. +385 1 4553 154; fax +385 1 4553 128; e-mail, email@example.com; http://www.dpp.hr
November 610, 1997
ISTSS 13th Annual Conference
Queen Elizabeth Hotel
Montreal, Quebec, Canada
Contact: Deb Pederson,
tel. 847/480-9028; fax 847/480-9282e-mail firstname.lastname@example.org; latest details at http://www.istss.org
ISTSS Sees Role in UN's New CONGO Committee on Mental Health
On May 16, 1996, members of the Conference of Non-Governmental Organizations (CONGO) in Consultative Status with ECOSOC, voted to establish a new Committee on Mental Health at the United Nations. Elections held in June established a nine-member interim bureau whose role was to develop the structure and mission of the Committee, establish bylaws and form a nominating committee for the future election of permanent officers.
The creation of a Committee on Mental Health is unprecedented at the United Nations. This will enable a strong collaboration between NGOs in bringing understanding and appreciation of mental health issues to the global agenda at the UN. The primary work of the Committee will be the promotion of psychological well-being, the improvement of mental health care services, and advocacy and education in the prevention of mental illness. The Committee will work with other CONGO committees, the UN and its specialized agencies to ensure the inclusion of mental health issues within a broader context of concerns, such as vulnerable populations, human rights, poverty, violence, the environment and substance abuse.
The members of the interim bureau and the organizations they represent are Joyce Braak, Institute for Women's Health Research; Eleanor Brown, International Federation of Women Lawyers; Ellen Frey-Wouters, ISTSS; Claire Fulcher, International Federation of Business and Professional Women; Helen Hamlin, International Federation on Ageing; Trudy Mason, American Jewish Congress; Blanche Saia, International Council of Psychologists; Nancy Wallace, convener, World Federation of Mental Health; and Celeste Wallin, secretary, World Association for Psychosocial Rehabilitation.
During the summer, the interim bureau met frequently to draft bylaws for the Committee. This task was finished in the fall, and the bylaws were then presented to CONGO for approval. In January, elections were held to establish a permanent executive board. ISTSS UN Representative Ellen Frey-Wouters was elected as a member of the board. Work will begin on developing a program agenda for 1997 in February.
In addition, an Ad Hoc Program Planning Committee was formed to coordinate a Department of Public Information (DPI) and Non-Governmental Organization (NGO) briefing at the UN in observance of World Mental Health Day, which was held on Oct. 16, 1996. The Committee cosponsored the briefing with the UN DPI, the World Federation for Mental Health and the World Health Organization. The topic of the briefing was "Women and Mental Health" and featured speakers from both the NGO community and the UN.
Peering into the Internet's Future (Part I)
By David Baldwin, PhD
Contributing editor, trauma online
What will the Internet be like in a few months or years? How might it assist you in trauma or disaster work? This twopart series focuses on current uses and exciting future developments, and how these might affect trauma research and clinical work.
Basically, the Internet allows people and organizations from around the world to communicate with others, publicly and privately, in near real time. The Internet means efficient information exchanges, without the normal geographical or hierarchical restrictions. Some of the consequences of this are obvious; some are not.
New uses of the Internet are evolving daily. Research projects, for example, can solicit subjects via the 'Net, broadening the available data pool. It is possible to publish an article almost immediately on the Web. Others can review it and comment quickly, allowing a submission to change - as a living document - reflecting new thinking or correcting errors. Web journals, such as Charles Figley's Traumatology (http://psy.uq.edu.au/PTSD/trauma/traumaj.html), are springing up, offering advantages over print. They're faster: e-mail speeds the peer-review process and publication. They're also cheaper: paper and print costs are avoided, and detailed, color figures can be scanned in and easily incorporated within an electronic file. In fact, the Internet was initially developed for this very purpose: to allow distant researchers to discuss their work and collaborate efficiently.
Preprint archives already allow ready access to works in press in standard peer-reviewed paper journals [e.g., Steven Harnad's Behavioral and Brain Sciences, or Psycoloquy (http://cogsci.ecs.soton.ac.uk/cgi-bin/psycoloquy)]. Some fields have adapted to this new medium more rapidly than others. In philosophy, neuroscience and consciousness studies, the Internet is becoming the first place to look for new research information. For a good example of this, visit the International Philosophical Preprint Exchange at http://www.L.Chiba-U.ac.jp/IPPE.html. With a few notable exceptions, psychology and the traumatic-stress field currently lag in adopting the Internet for this purpose.
The Internet's easy access to a fund of current information also benefits clients and clinicians. Clinicians can access research (using either PILOTS or Medline's online databases), read articles, network with peers and participate in mailing lists where cases or treatment issues are discussed. The Traumatic Stress Forum has served this function for almost three years now.
Survivors can also gain from specialized information. I receive frequent e-mail comments from individuals who learned something helpful about their PTSD symptoms from visiting my Web site "I'm not alone" and "I'm not crazy" are two recurrent themes. Sometimes these messages come from countries where PTSD is poorly understood and underdiagnosed, or from individuals who otherwise would not find such detailed information.
Survivors can find support and communicate with others who have similar symptoms in other venues as well, such as the Usenet newsgroup alt.support.trauma-ptsd and others.
In disaster work, the Internet may also play an important role. I saw this happen on the alt.current-events.la-quake newsgroup following the Northridge (Calif.) earthquake. Local phone lines are commonly repaired before long-distance lines. This meant that if someone in Boston wanted to find out how Aunt Susie in Santa Monica was doing, one good way was to join a Usenet newsgroup started shortly after the quake, and ask. Someone in Santa Monica could look out their window or walk down the street, and report perhaps that Aunt Susie's apartment building was condemned, but that everyone had gotten out OK.
The Internet will continue to grow to meet additional needs of the trauma community. Possible future uses will be covered in Part II of this article.
E-mail: email@example.comWWW: http://gladstone.uoregon.edu/~dvb/trauma.htm OR http://www.teleport.com/~dvb/trauma.htm
NIMH Grants Available
The National Institutes of Health (NIH) Office of Behavioral and Social Sciences Research (OBSSR), in conjunction with the National Center of Research Resources, announces a request for applications (RFA) focusing on "Educational Workshops in Interdisciplinary Research." The goal of this RFA is to foster the development of cross-disciplinary communication and research collaboration among various behavioral and social sciences or between behavioral/social sciences and biomedical sciences. To achieve this, short-term (12 week) education programs in interdisciplinary research aimed at social/behavioral and biomedical researchers during their formative stages of their careers will be funded.
The RFA was announced in the winter of 1996, in NIH's weekly Guide for Grants and Contracts. The guide may be found on the NIH home page (http://www.nih.gov) and an announcement is on the OBSSR page (http://www1.od.NIH.gov/obssr/obssr.htm). For information, contact: Gerdi Weidner, PhD, Office of Behavioral and Social Sciences Research, National Institutes of Health, Bldg. 1, Rm. 326, Bethesda, MD 20892-0183; 301/402-1146; e-mail: firstname.lastname@example.org.
Compiled by Arthur S. Blank Jr., MD
Readers who have recently published or have seen a new article on a traumatic stress topic can have it listed here by sending a copy to Art Blank, Jr., Psychiatry Service (116A), VA Medical Center, Minneapolis, MN 55417. If you have recently authored or seen a relevant book, please send a publisher's brochure or other material describing the book.
- "Effects of Trazodone on Sleep in Patients Diagnosed with PTSD," Ashfor J. and Miller T., J. Contemp. Psychother. 26(3): 221 (1996).
- "Antecedents and Consequences of Acute Stress Disorder among Motor Vehicle Accident Victims," Barton K., Blanchard E. and Hickling E., Beh. Res. & Ther. 34(10): 805 (1996).
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- "Posttraumatic Stress Disorder and Illness Behaviour in HIV+ Patients," Botha K., Psychol. Reports 79(3): 843 (1996).
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Traumatic StressPoints: Information for Authors
Traumatic StressPoints accepts brief articles (250400 words) on topics related to the study and treatment of traumatic stress related disorders. Topic areas include innovative programs and treatment approaches, assessment/diagnosis, theory on the biological and/or psychological bases of PTSD, policy and legal issues, and other relevant subjects. Articles may deal specifically with particular types of traumatic experiences, including violence, sexual abuse, rape, incest, war, torture & imprisonment, refugees, disasters, emergency service workers, death and bereavement issues, and others.
For more information on the suitability of an article for publication, contact Editor Art Blank, MD, at 612/725-2000 or fax 612/725-2292.
To submit an item for the calendar, contact Elizabeth Elliott at ISTSS, 847/480-9028; fax 847/480-9282; email@example.com.
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U.S. Child Abuse Rates Rise Sharply - DHHS Study
Between 1986 and 1993, the number of abused and neglected children in the United States doubled, increasing from 1.4 million to 2.8 million, according to the National Incident Study of Child Abuse and Neglect. The number of children seriously injured by abuse rose from 143,000 to 570,000 over the same period, a fourfold increase. The study, which was commissioned by the Department of Health and Human Services, identifies poverty as a major risk factor, along with being in a single-parent family. Children in families with annual incomes of less than $15,000 were 22 times more likely to be maltreated than those from families with incomes of about $30,000. Their risk of sexual abuse and serious injury was also much higher. Despite the increase in abuse and neglect, the number of cases investigated by state agencies did not keep pace. The portion of cases investigated by state agencies fell from 44 to 28 percent.
Study Finds Vets Constitute A Third of Homeless
One in three homeless men at shelters across the country are veterans, according to a survey of 10,400 men at 133 shelters, conducted by the International Union of Gospel Missions. The number is up from 29 percent in the years 199193. Veterans Affairs estimates that male veterans represent 19 percent of the general male population.
VA Increases Outreach on Sexual Trauma
The Department of Veterans Affairs' toll-free number for sexual trauma victims (800/827-1000) expanded its operation to nonbusiness hours in November. The expansion was in conjunction with the ABC 20/20 television show's airing of two segments on rape in the military. More than 2,000 calls were received, and many women were referred to counseling resources.
CDC Study Offers Evidence of Increased Illness in Gulf War Vets
Air Force veterans of the 1991 Gulf War are three times more likely to suffer memory loss, joint and muscle pain, and other ills, compared to people who served elsewhere during the same period, according preliminary results of a study by the Centers for Disease Control and Prevention. Researchers interviewed 4,000 Air Force personnel for the study, which will be published later this year.
ISTSS 12th Annual Meeting Audiotapes Now Available
"Trauma & Controversy," the 12th Annual Meeting of the ISTSS, presented some of the most exciting sessions in the areas of traumatic stress research and treatment. If you couldn't attend the meeting, or missed interesting speakers due to concurrent sessions, now you can hear the preeminent experts in the field of traumatic stress present their insights on cassette audiotapes. A total of 145 recorded sessions are available.
Catalog Available, Phone Orders Welcome
Contact: Professional Programs Audio Cassettes, P.O. Box 221466, Santa Clarita, CA 91322-1466, USA Phone: 805/255-7774 Fax: 805/254-4774
Fifth European Conference on Traumatic Stress Approaching
By Didier Cremniter, MD
The Fifth European Conference on Traumatic Stress, sponsored by the European Society for Traumatic Stress Studies (ESTSS), an affiliate of ISTSS, will be held in Maastricht, The Netherlands, from June 29 through July 3. A scientific program under the chair of Wolfgang Schuffel, MD, and Wolter de Loos, MD, will give special attention to the process of coping with traumatic stress.
The call for papers indicates a special interest in coping in a manner which promotes health, as well as transgenerational ways of mastering traumatic stress. Invited speakers will address such issues as trauma and healing from the 199195 Yugoslavian War, gender and the process of coping and recent advances in psychotraumatology.
In addition to formats such as paper sessions, symposia, workshops, video-film sessions and poster sessions, the conference will feature a special format known as "thematic poster sessions," theme-related two-hour sessions including reading of posters, oral summaries and discussion in a moderated session.
Reduced registration fees are available to ISTSS members, with a further discount for registrations prior to March 31. Information may be obtained from ESTSS/VVAA Conference Services, P.O. Box 8153, 3503 RD Utrecht, The Netherlands; fax, +31-(0)30-247 46 47.