Posted 1 October 2017 in StressPoints by Juliette Harik, PhD
Last month, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) issued an updated Clinical Practice Guideline for the Management of PTSD.
I was enthusiastic to see that the very first recommendation in this guideline encourages health care providers to engage patients in shared decision making.
As a shared decision making researcher, I have found that most providers are on board with the idea of involving patients in PTSD treatment decisions, but they are often less clear about what shared decision should actually look like in practice or exactly how or why shared decision making is beneficial for patients. To help clarify these issues—and to hopefully inspire you to consider how you can better integrate shared decision making in your own clinical practice—this Clinician’s Corner column addresses some common questions about shared decision making and its role in the treatment of PTSD.
Posted 1 October 2017 in StressPoints by Dieter Wolke, PhD & Slava Dantchev, Bsc
Bullying is a form of systematic abuse by peers, defined as any aggressive behaviour that is inflicted intentionally and repeatedly over time and involves an element of perceived or real power imbalance (Wolke & Lereya, 2015). Bullying can occur directly (e.g., hitting, name calling) or indirectly (e.g., spreading rumours, social exclusion) and includes the use of social media (e.g., cyber bullying) (Wolke & Lereya, 2015; Wolke, Lee, & Guy, 2017). Children that are involved in bullying may assume the role of the victim, bully or bully/victim–a subgroup of victims who also bully their peers. Victimization by peers is most frequently reported with up to 20 percent of children identifying themselves as victims; while those reporting to be bullies or bully/victims is less common with around only 2-5 percent self-reporting to bully and up to 5-10 percent who are bully-victims (Copeland et al., 2013; Wolke & Lereya, 2015).
Posted 1 October 2017 in StressPoints by Nicole A. Sciarrino, MA, MS
Recent trends in novels and associated films have included themes of dystopian societies (e.g., The Hunger Games, Divergent series, The Maze Runner) often depicting fictional locations. In contrast, The Handmaid’s Tale, a recent release on Hulu and novel written by Margaret Atwood, is set in the United States (U.S.) following a takeover of the U.S. government by a totalitarian theonomy called Gilead. The Handmaid’s Tale depicts a dystopian society in which the population has decreased due to rampant infertility associated with pollutants. Women have lost all of their rights—including the right to read and write—and are either forced into labor or, if proven fertile, captured and held as “handmaids.” The sole purpose of the handmaid is to become impregnated, which involves subjection to monthly “ceremonies,” characterized by intercourse with prominent men in the theocracy. The remainder of the handmaid’s day is colored with imprisonment, physical violence, and psychological abuse to maintain control and submission over the women. Meant to be a work of fiction, The Handmaid’s Tale draws parallels to domestic human trafficking, with an emphasis on women in sex trafficking.
Posted 1 October 2017 in StressPoints by Eren Youmans Watkins, PhD, MPH, Kelly Forys Donahue, PhD, Joseph Pecko, PhD, LCSW, and Kenneth Cox, MD, MPH
From a public health perspective, U.S. Army suicides are rare events and the prevalence of suicide in the U.S. Army is low (less than 0.02 percent). However, the impact of even one death, especially a suicide, has a resounding effect on America’s fighting force.
Since 2004, there has been an observed increase in the suicide rate among U.S. Army Soldiers. The U.S. Army’s highest number and rate of suicide among active-duty Soldiers was in 2012. In more recent years, 2013 to 2015, the U.S. Army suicide rate has stabilized and is approaching the rate seen in a matching U.S. population. While not as dramatic, the suicide count and rate in the U.S. general population has also increased in the last several years (Curtin, Warner, and Hedegaard, 2016).
Most risk factors for suicide among U.S. Army Soldiers are not unique to the military. Several studies have demonstrated that a myriad of circumstances, not one single factor, contribute to a person dying by suicide (Millner et al., 2017; Nock et al., 2017; Ursano et al., 2017). Among Soldiers, most suicide cases are young, junior enlisted, white, and male. In general, these characteristics have remained unchanged, but in recent years the rate of suicide among older Soldiers (25-34 years of age) has increased compared to younger Soldiers (17-24 years of age) (Nweke et al., 2016).
Posted 1 October 2017 in StressPoints by Tara Frem, MA
My first article for ISTSS was about the difficulty of obtaining training experiences specialized in trauma without previous experience. I listed recommendations from students and professionals in the field: (i) seek out volunteer opportunities; (ii) ask advice from supervisors and professors; (iii) gain experience in related fields; (iv) complete certifications. Four years later, I am two months into an internship at a consortium site in Louisville, KY. My week consists of various tasks and work with different populations. I conduct psychological testing to inform recommendations regarding competency and criminal responsibility for inmates charged with felonies. I work with refugees and immigrants. And, I am a clinician on team of therapists who work with families referred by the Department of Child Protective Services with children and adults who are survivors or perpetrators of abuse. How did I get here? I want to describe how I put the above-listed recommendations to action.
Posted 1 October 2017 in StressPoints by Kathryn Becker-Blease, PhD
Post-traumatic stress disorder (PTSD) and culturally relevant care are topics that appear in introductory through graduate level courses. This class activity allows instructors to flexibly focus on culture, social psychology, mental health, and/or research design.
People all around the world experience potentially traumatic events, including natural disasters, accidents, child abuse, war, and other forms of violence. Some responses to trauma are nearly universal, but culture influences both the way people respond and the kinds of therapeutic experiences that help people after trauma. Most of what we know about what works to alleviate suffering after trauma comes from people who live in the U.S. and Europe.