Much being Written about Us, not much being Written with Us: Examining how alcohol and other drug use by indigenous Australians is portrayed in Australian Government policies and strategies: A discourse analysis

BACKGROUND

Using critical discourse analysis, this study examined the portrayal of Aboriginal and Torres Strait Islander people in Australian Government policies regarding alcohol and other drug (AOD) use.

METHODS

We used critical discourse analysis, informed by an Indigenous Research Paradigm, to analyse texts and contexts of six key Australian Government AOD drug policies; two Aboriginal AOD data documents, two reporting documents and two AOD strategy documents.

RESULTS

The social practice analysis found issues of power imbalance relating to the socio-political situation the documents were created in. Textual analysis identified: culture being performative or functional in documents; cultural unsafety in construction of targets and outcomes, and; the decentring of Aboriginal peoples in the framing of the documents. The discourse analysis identified that the documents often wrote about Aboriginal peoples rather than writing documents with or by Aboriginal peoples. This typically: absented complexities of consultation occurring within a complex power imbalanced cultural interface; did not support an Aboriginal paradigm; centred Gubba people in power and; promoted a paternalistic view of 'helping' Aboriginal people.

CONCLUSIONS

There is an urgent need to move from policy relating to Aboriginal affairs that relies on a deficit discourse, to more effective AOD policy that improves power balance in policy development, is written with or by Aboriginal people, is inclusive of Aboriginal epistemologies and ontologies, and represents a paradigm-shift to a strength-based approach.

Prevalence of Poor Mental Health Among Adolescents in Kabul, Afghanistan, as of November 2021

This cross-sectional study assesses the mental health of adolescents in Afghanistan and evaluates their risk of having a psychiatric disorder by age and sex.

Social Functioning in Individuals Affected by Childhood Maltreatment: Establishing a Research Agenda to Inform Interventions

Childhood maltreatment (CM) is linked to impairments in various domains of social functioning. Here, we argue that it is critical to identify factors that underlie impaired social functioning as well as processes that mediate the beneficial health effects of positive relationships in individuals exposed to CM. Key research recommendations are presented, focusing on: (1) identifying attachment-related alterations in specific inter- and intrapersonal processes (e.g., regulation of closeness and distance) that underlie problems in broader domains of social functioning (e.g., lack of perceived social support) in individuals affected by CM; (2) identifying internal (e.g., current emotional state) and external situational factors (e.g., cultural factors, presence of close others) that modulate alterations in specific social processes; and (3) identifying mechanisms that explain the positive health effects of intact social functioning. Methodological recommendations include: (1) assessing social processes through interactive and (close to) real-life assessments inside and outside the laboratory; (2) adopting an interdisciplinary, lifespan perspective to assess social processes, using multi-method assessments; (3) establishing global research collaborations to account for cultural influences on social processes and enable replications across laboratories and countries. The proposed line of research will contribute to globally develop and refine interventions that prevent CM and further positive relationships, which - likely through buffering the effects of chronic stress and corresponding allostatic load - foster resilience and improve mental and physical health, thereby reducing personal suffering and the societal and economic costs of CM and its consequences. Interventions targeting euthymia and psychological well-being are promising therapeutic concepts in this context.

Ngarratja Kulpaana: Talking together about the impacts of lateral violence on aboriginal social and emotional well-being and identity

OBJECTIVE

Lateral violence occurs when oppressed group members take out their anger and frustrations, due to their experiences of oppression, on members of their own group. It is common among Indigenous people, including Aboriginal Australians. Limited literature exists on the holistic impacts of lateral violence on Aboriginal Australians. This study investigated the impacts of lateral violence on Aboriginal social and emotional well-being (SEWB) and identity.

METHOD

Seventeen Aboriginal knowledge-holders (53% males, 47% females) participated in either a yarning circle or individual yarn. Knowledge-holders were aged from 18 to 65 years. Yarns were analyzed using thematic analysis and yarn summaries.

RESULTS

Themes identified included: (a) influences of lateral violence on SEWB (subthemes: mind and emotions, body, family and kinship, community, culture, Country, and spirit); (b) lateral violence and identity (subthemes: "genuine" Aboriginal and confidence in identity); and (c) interconnected influences of lateral violence on identity and SEWB. The influences of lateral violence were found to encompass all domains of SEWB. Lateral violence also impacts Aboriginal identity and creates notions of an (in)authentic Aboriginal person, which can further undermine Aboriginality and SEWB.

CONCLUSION

As a population who already experience poor SEWB, the additional negative consequences of lateral violence further deteriorate the SEWB of Aboriginal Australians. Lateral violence must be addressed urgently. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Examining Cultural Differences in the Associations between Appraisals and Emotion Regulation and PostTraumatic Stress Disorder in Malaysian and Australian Trauma Survivors

Appraisals and emotional regulation play a central role in posttraumatic stress disorder (PTSD). Despite research demonstrating cultural differences in everyday appraisals and emotion regulation, little research has investigated the influence of culture on these processes in PTSD. This study examined cultural differences in the associations between appraisals, emotion regulation and PTSD symptoms using trauma survivors from an individualistic Western culture (Australia) and a collectivistic Asian culture (Malaysia). Trauma survivors (N = 228; 107 Australian with European cultural heritage, 121 Malaysian with Malay, Indian or Chinese cultural heritage) completed an on-line survey assessing PTSD (PTSD Checklist for the DSM-5 with Life Events Checklist), appraisals (trauma-related, fatalism, cultural beliefs about adversity) and emotion regulation (suppression, reappraisal, interpersonal). The Malaysian group reported significantly greater fatalism, cultural beliefs about adversity, suppression and interpersonal emotion regulation than the Australian group. Greater trauma-specific appraisals, greater suppression, fewer cultural beliefs about adversity, and less use of social skills to enhance positivity were generally associated with greater PTSD symptom severity, with little evidence of cultural group moderating these associations. Interdependent self-construal mediated the relationships between cultural adversity beliefs, enhanced positivity, reappraisal, perspective taking and PTSD symptoms. Independent self-construal mediated the relationships between fatalism and perspective taking and PTSD symptoms. Cultural group did not moderate these indirect effects. Interdependent self-construal mediated the associations between interpersonal regulation strategies of soothing and social modelling with PTSD symptoms for the Malaysian but not the Australian group. These findings demonstrate the importance of considering self-construal and culture in understanding factors associated with PTSD.

Moderating role of moral injury in the mental health of adolescent refugees

OBJECTIVE

This study investigated whether moral injury appraisals moderated the relationships between trauma, postmigration living difficulties, resilience, and mental health outcomes in adolescent refugees.

METHOD

Eighty-five adolescent refugees from a community sample completed an online survey.

RESULTS

A significant interaction was found between moral injury and discrimination for externalizing and posttraumatic stress disorder (PTSD) symptoms; adolescents whom had experienced high levels of discrimination combined with high levels of moral injury had poorer mental health. A significant interaction was found between moral injury and resilience for internalizing symptoms: high levels of resilience appeared to buffer the association between moral injury and internalizing symptoms. Contrary to predictions, stressful life experiences and postmigration living difficulties did not interact significantly with moral injury to predict mental health.

CONCLUSIONS

Discrimination may contribute to perpetuating poor mental health in adolescent refugees with high levels of moral injury. Resilience may buffer some of the negative effects of moral injury.

Investigating the Feasibility, Acceptability and Efficacy of Using Modified-Written Exposure Therapy in the Aftermath of a Terrorist Attack on Symptoms of Posttraumatic Stress Disorder Among Afghan Adolescent Girls

BACKGROUND

The aim of this study was to assess the efficacy, acceptability and feasibility of using modified written exposure therapy (m-WET) to treat symptoms of posttraumatic stress disorder (PTSD) in Afghan adolescent girls in the aftermath of a terrorist attack.

METHODS

120 Afghan (Hazara) adolescent girls who had been exposed to the Sayed al-Shuhada school terrorist attack were randomly assigned to the m-WET (n = 40), trauma-focused cognitive behavior therapy (TF-CBT) (n = 40), or control groups (n = 40). m-WET involved five consecutive daily group sessions where participants simply wrote about the terrorist attack including thoughts and feelings. TF-CBT was an intensive five-session group intervention. The control group had no additional contact. The trial was undertaken at a local non-government organization in Kabul. The primary analysis was comparing PTSD symptoms (Child Revised Impact of Event Scale-13) in the three groups at post-intervention and three-month follow-up.

RESULTS

Overall, participant and facilitator satisfaction with m-WET was high. Acceptability of m-WET was relatively high, with 15% drop-out in the m-WET group and all m-WET sessions were attended. While the groups did not differ significantly in PTSD symptoms at baseline, the m-WET group had significantly lower levels of PTSD symptoms compared to the control group at post-intervention and follow-up. There was no significant difference between the m-WET and TF-CBT groups.

CONCLUSION

The findings suggest m-WET may be promising intervention for the treatment of PTSD among adolescent girls in humanitarian settings. Further research in the area is warranted.

The effect of childhood trauma on the severity of obsessive-compulsive symptoms: A systematic review

BACKGROUND

Childhood trauma is associated with a range of psychiatric disorders, including obsessive-compulsive disorder (OCD). However, our understanding of the different types of childhood trauma and its impact on the different types and severity of obsessive-compulsive symptoms (OCS) is still in its infancy.

AIMS

We conducted a systematic review to synthesise the current knowledge on the possible relationships between childhood trauma and obsessive-compulsive symptoms in clinical and non-clinical populations.

METHODS

We systematically searched four electronic databases for studies reporting on childhood trauma and OCS severity. Subsequently, we qualitatively synthesised results of eligible studies and effect sizes were also calculated.

RESULTS

Twenty-four studies were included in this systematic review. Most studies used OCD samples (k = 16), with a few studies using a sample comprising of a range of psychiatric disorders (k = 6) and some studies using a general community sample (k = 2). Overall, there was support for a significant relationship between childhood trauma and OCS severity (8 out of 16 of the studies using OCD clinical samples, both studies using general population samples, and 5 out of 6 studies used mixed psychiatric samples).

CONCLUSIONS

We found evidence of a significant relationship between exposure to childhood trauma and OCS severity across clinical and non-clinical populations. Our results also suggest that a range rather than a single type of childhood trauma was associated with OCD.

"Connection to Culture Is Like a Massive Lifeline": Yarning With Aboriginal Young People About Culture and Social and Emotional Wellbeing

Culture is an important social and emotional wellbeing factor for Aboriginal peoples in Australia, particularly regarding recovery from colonization. However, little is understood about how culture and wellbeing interact for young urban Aboriginal people. This study used Yarning methods to explore experiences and perceptions of culture and wellbeing for young urban Aboriginal people in Narrm, Australia. Findings indicate that culture is experienced as connection, and that perceived connection or disconnection has an essential influence on the wellbeing of young people. Through sharing young people stories, a range of factors, including colonization, relationships, cultural knowledge, community support, and agency, were identified as affecting perceptions of connectedness, and therefore on wellbeing. Youth were able to develop strategies to increase connection and provided illuminating advice and suggestions for improving connection for future generations. This study thus contributes to efforts to improved understanding of Aboriginal perspectives about social and emotional wellbeing and culture.

Postmigration stress and sleep disturbances mediate the relationship between trauma exposure and posttraumatic stress symptoms among Syrian and Iraqi refugees

STUDY OBJECTIVES

Sleep disturbance is common in those who experience trauma. In a sample of nontreatment-seeking refugees, we examined the associations between trauma exposure, postmigration stress, sleep symptoms, and posttraumatic psychological symptoms.

METHODS

Syrian and Iraqi refugees (n = 86; 51% female; mean age = 45 years) residing in Australia were recruited from the local community. Cross-sectional descriptive design, multinominal regression analyses, and mediation analyses were used. Participants completed measures in Arabic assessing premigration trauma exposure, postmigration stress, sleep symptoms, and mental health. They also completed 7 days of sleep diaries and actigraphy.

RESULTS

We identified 34.9% of the participants as normal sleepers, 32.6% as probably having insomnia, and 32.6% as likely having insomnia. Variables associated with greater sleep disturbance (McFadden's R² = 0.57) included greater trauma exposure, increased time of resettlement, greater postmigration stress, and greater presleep arousal. The association of premigration trauma exposure to current posttraumatic symptoms was mediated sequentially by postmigration stress and sleep symptoms.

CONCLUSIONS

Our findings highlight the extent of sleep disturbance in refugees. We found evidence for an indirect pathway between trauma exposure and posttraumatic symptoms through premigration stress and sleep (particularly presleep arousal). In the current global refugee crisis, improving the existing system of care in countries experiencing increased migration is critical. Because sleep disturbance is a modifiable condition associated with mental health, targeting sleep could be an important component of psychological interventions for refugees.

Proactive Interference in Posttraumatic Stress Disorder

Deficits in working memory (WM) have a role in maintaining posttraumatic stress disorder (PTSD) symptoms, including intrusions, which are a hallmark of PTSD symptomatology. As intrusions are distressing and uncontrollable, it is important to investigate whether PTSD is associated with altered control of proactive interference in WM. Moreover, it is important to consider both verbal and visual WM, as previous research has demonstrated a visual versus verbal dissociation in PTSD. Although previous studies have explored proactive interference in visual and verbal stimuli using a recent probe task, the stimuli used thus far have been non-trauma-related. Therefore, we aimed to investigate proactive interference in PTSD using trauma-related verbal and visual stimuli. Road traffic accident (RTA) survivors with (n = 60) and without PTSD (n = 30) completed a recent probe task to assess proactive interference of visual and verbal trauma-related material. Participants with PTSD displayed significantly more proactive interference than trauma-exposed controls for visual, η_p ² = .40, and verbal material, η_p ² = .10, indicating that proactive interference is significantly impaired in PTSD. This demonstrates that further research is warranted and highlights the possibility of considering proactive interference of trauma-related stimuli in therapeutic approaches.

Investigating cognitive control and cognitive emotion regulation in Iranian depressed women with suicidal ideation or suicide attempts

OBJECTIVE

This study compared cognitive control (working memory, interference control, perseveration) and cognitive emotion regulation among Iranian women with depression who had attempted suicide, had only suicidal ideation, and healthy controls.

METHOD

Participants (N = 75) completed a clinical interview, cognitive control tasks, and the Cognitive Emotion Regulation Questionnaire.

RESULTS

Those with suicidal ideation or previous attempts had poorer cognitive control and cognitive emotion regulation than controls. Furthermore, those who had attempted suicide had poorer cognitive control and reported greater use of self-blame, rumination, and catastrophizing, and less use of acceptance, than those with suicidal ideation only. There was an indirect effect of cognitive control deficits on suicidality through cognitive emotion regulation (self-blame, acceptance, rumination, catastrophizing).

CONCLUSIONS

Exploring these cognitive deficits and difficulties can assist in further understanding the risk factors for suicidality and improve targeted interventions. This is of particular relevance in Iran where the need for policies and interventions targeting the prevention of suicide has been identified.

Review: The mental health implications for children and adolescents impacted by infectious outbreaks - a systematic review

BACKGROUND

This systematic review synthesized available research on the psychological implications for children and adolescents who either were directly or indirectly exposed to an infectious outbreak. On this basis, the current paper aims to provide recommendations for future research, practice and policy regarding children during pandemics.

METHOD

A total of 2195 records were retrieved from the PsycINFO, SCOPUS and MEDLINE databases, and three from Google Scholar.

RESULTS

Including only those papers that focused on children or adolescent's mental health in association with respiratory infectious outbreaks, 11 articles were identified. The majority of research utilized qualitative or retrospective hospital record data. Children and adolescents reported fear and anxiety, as well as disruptions to their day to day routines as a result of outbreaks. However, children were also able to demonstrate resilience during outbreaks with the right support.

CONCLUSIONS

Children's psychological response to the outbreak appeared to be largely attributed to how their parents, healthcare providers and the media communicated the event. Recommendations for policy, practitioners and researchers concerning the current COVID-19 outbreak concludes the paper.

Sociocultural context and the posttraumatic psychological response: Considering culture, social support, and posttraumatic stress disorder

OBJECTIVE

A lack of posttrauma social support is an important contributor to the maintenance of posttraumatic stress disorder (PTSD). However, there is a paucity of cross-cultural research regarding social support in PTSD. This article considers how culture (with a specific focus on independent and interdependent self-construal) influences posttrauma social support and its relationship with PTSD.

METHOD

We review models of PTSD elucidating the role of social support and explored empirical support for the relationship between social support and PTSD. We consider the role of culture in social support and conducted a review of literature examining culture, social support, and PTSD. Finally, we discuss theoretical and clinical implications and future research directions.

RESULTS

Functional social support tended to be negatively associated with PTSD; supportive social environments tended to foster disclosure of trauma; and increased number, diversity, and continuity of social contact in one's social relationships might reduce the risk of PTSD. In nontrauma research, researchers have identified distinct profiles of culturally appropriate social support, which differs between cultures. Cross-cultural research examining social support in PTSD was limited (k = 14, N = 18,552), and findings were inconsistent.

CONCLUSIONS

The nontraumatic stress literature clearly demonstrates cross-cultural differences in preferences for, and psychological and physiological benefits of, social support. However, the psychotraumatology literature lags concerningly behind. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Associations between relationship quality, social network resources, appraisals, coping, and posttraumatic stress disorder symptoms

Objective: This study aimed to explore whether posttrauma cognitions and maladaptive coping strategies mediated the association between perceived social support (availability of social network and quality of specific relationships) and posttraumatic stress disorder (PTSD) symptoms. Method: A community sample of trauma survivors (N = 67, 84% female) completed self-report measures assessing relationship quality, perceived availability of social network support, PTSD symptoms, negative posttrauma appraisals and maladaptive coping strategies. Results: Posttrauma appraisals mediated the association between quality of relationships (support, conflict and depth) and PTSD symptoms, and between availability of social network support and PTSD symptoms. Further, there was an indirect pathway between social support (quality of relationship and availability of social network) and PTSD symptoms through negative cognitive appraisals and maladaptive coping strategies (serial mediation). Conclusions: Our results are consistent with theoretical predictions that socially supportive (support, depth and social network availability) and unsupportive (conflict) relationships are associated with PTSD, through cognitive appraisal and coping processes. Clinical implications for further integrating interpersonal support into cognitive therapies were discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Emotionally valenced and modality-specific dual tasks: Effects on voluntary reminding and proactive interference in trauma-exposed individuals suffering from PTSD

Objectives: People suffering from posttraumatic stress disorder (PTSD) often experience distressing traumatic memories. Therapeutic methods that apply a secondary task while clients recall a trauma memory may further assist in modifying the vividness and emotionality of the trauma memory and in reducing intrusions. In this experiment, we aimed to investigate whether the emotional valence (positive vs. neutral) and sensory modality (visual vs. auditory) of a secondary task reduces the vividness and emotionality of the trauma memory and the proactive interference. Method: Sixty PTSD patients exposed to road traffic accident traumas were randomized to one of four groups in a 2 (emotional valence: positive, neutral) × 2 (modality: visual, auditory) design. Participants were then exposed to a positive or a neutral clip that was visual or auditory and were required to recall the trauma memory during exposure to the clip. Vividness and emotionality of the trauma memory and proactive interference were assessed before and after exposure to the clip and at a 1-week follow-up. Results: Results revealed that participants who recalled the trauma memory while exposed to the positive clip reported their trauma memory as being less distressing (but not less vivid) and indicated less proactive interference than did participants exposed to the neutral clip. Nevertheless, modality had no significant effect in attenuating the proactive interference under conditions of modality congruence. Conclusion: Inducing positive emotion while performing a dual task may be an effective module in therapeutic approaches. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

An Exploratory Study on Cross-Cultural Differences in Facial Emotion Recognition Between Adults From Malaysia and Australia

While culture and depression influence the way in which humans process emotion, these two areas of investigation are rarely combined. Therefore, the aim of this study was to investigate the difference in facial emotion recognition among Malaysian Malays and Australians with a European heritage with and without depression. A total of 88 participants took part in this study (Malays n = 47, Australians n = 41). All participants were screened using The Structured Clinical Interview for DSM-5 Clinician Version (SCID-5-CV) to assess the Major Depressive Disorder (MDD) diagnosis and they also completed the Beck Depression Inventory (BDI). This study consisted of the facial emotion recognition (FER) task whereby the participants were asked to look at facial images and determine the emotion depicted by each of the facial expressions. It was found that depression status and cultural group did not significantly influence overall FER accuracy. Malaysian participants without MDD and Australian participants with MDD performed quicker as compared to Australian participants without MDD on the FER task. Also, Malaysian participants more accurately recognized fear as compared to Australian participants. Future studies can focus on the extent of the influence and other aspects of culture and participant condition on facial emotion recognition.

Longitudinal investigation of the relationships between trauma exposure, post-migration stress, sleep disturbance, and mental health in Syrian refugees

Background High prevalence of sleep disturbance, which is associated with poor mental health, has been observed among non-treatment seeking refugees. However, no longitudinal research has investigated the chronicity of untreated sleep disturbance and its impact on refugees' mental health.

OBJECTIVE

This longitudinal study investigated associations between mental health (posttraumatic stress disorder, anxiety, depression), sleep symptoms (insomnia severity, pre-sleep arousal), and factors predicting mental health, over a 12-month period.

METHOD

Syrian refugees (N = 69) from a cross-sectional study (Time 1) participated in the current 12-month (Time 2) follow-up study. Participants completed a series of questionnaires examining sleep, trauma exposure, post-migration living difficulties, and mental health at both time points.

RESULTS

When compared to Time 1, participants showed a significant increase in post-migration stress at Time 2. However, there was an improvement in their mental health and levels of sleep disturbance. Half of the participants met criteria for moderate (36%) or severe sleep disturbance (15%) at Time 2. Forty-two per cent of the participants had moderate to severe sleep disturbance at both Time 1 and Time 2. When predicting mental health at 12-month follow-up, only pre-sleep arousal at Time 1 uniquely predicted mental health at Time 2. Mediation analysis indicated that change in pre-sleep arousal (from Time 1 to Time 2) significantly mediated the relationship between change in post-migration stress and change in mental health symptoms.

CONCLUSIONS

This study demonstrated that sleep symptoms have an indirect and long-term impact on mental health among refugees. Understanding modifiable factors, such as sleep, mediating the relationship between trauma exposure and PTSD symptoms is important, as such factors can be targeted in psychological interventions for refugees.