Psychiatric reactions to continuous traumatic stress: A Latent Profile Analysis of two Israeli samples

Many individuals worldwide are exposed to continuous traumatic stress (CTS). However, the psychiatric sequela of CTS and the relevance of posttraumatic stress disorder (PTSD) diagnostic criteria in this situation have yet to be determined. Filling this gap, the present study assessed psychiatric reactions to CTS and the relationship between such reactions and functional impairment among two representative samples of adults exposed to ongoing shelling over 6 (n=387) and 9 years (n=468). Assessment included PTSD symptomatology (i.e., intrusion, avoidance, hyperarousal), anxiety, somatization, and depression. Profile categorization aimed to underscore variations in symptom clustering and severity, and determine whether or not a profile is dominated by PTSD symptoms. Latent Profile analyses (LPA) of sample I revealed four distinct symptoms profiles: (1) 'symptomatically resilient'; (2) 'symptomatically low-moderate'; (3) 'symptomatically moderate-high'; and (4) 'symptomatically overall high'. LPA of sample II revealed three distinct symptoms profiles: (1) 'symptomatically resilient'; (2) 'symptomatically low-moderate'; (3) "symptomatically moderate-high". Moreover, profile variation was implicated in dysfunction. Consistent with studies focusing on single trauma exposure, the findings revealed that the most prevalent profile was the symptomatically resilient, indicating that most people exposed to CTS seem to evince a scarce number of psychiatric symptoms. Moreover, reactions to CTS proved broader than the existing PTSD symptomatology. Examining symptom dominance and severity in relation to impairment and dysfunction, and clinical considerations are discussed.

Child Rape: Extending the Therapeutic Intervention to Include the Mother-Child Dyad

In this his paper the authors describe therapeutic interventions with survivors of child rape and sexual abuse at Alexandra Clinic in Gauteng. Cases presenting at this community clinic are described, in the context of the startling increase in crimes against children and particularly sexual offences. The literature pertaining to the effects of trauma on children, important mediating factors in the child's experience and existing interventions with child trauma survivors are then reviewed. Attention is focused on studies taking into account the impact of the trauma on the child's familial environment. A description of the general intervention approach employed is followed by a deeper exploration of two core issues which characterised this approach — the identification of both mother and child as clients and the use of the mother-child relationship as a central focus for therapeutic intervention. It is suggested that these strategies enable greater access to the experience of the younger child in particular, address the effects of secondary traumatisation upon care-takers and ensure that the gains of therapy are extended to the child's larger social network.

Differences in resting cardiovascular parameters in 10- to 15-year-old children of different ethnicity: the contribution of physiological and psychological factors

BACKGROUND

The health status of children in the North West Province of South Africa was examined using the Transition and Health during Urbanization in South Africa in Children study. This is an epidemiological, cross-sectional study for which 1,244 children between 10 and 15 years of age were recruited from 44 schools.

PURPOSE

Our objective was to investigate whether differences exist between resting cardiovascular parameters of Black, White, colored, and Indian children and evaluate the contribution of physiological and psychological factors.

METHODS

Blood pressure was monitored with the Finapres apparatus. By means of the Fast Modelflo software program, the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure, heart rate, cardiac output (CO), total peripheral resistance (TPR), and "Windkessel" compliance (Cw) of the arterial system were obtained. The psychological data were obtained by validated questionnaires.

RESULTS

After correction for body mass index, the SBP of the White children was significantly higher (p < .05) than the SBP of the other ethnic groups. The DBP showed no significant differences. The TPR measurements of the Black and colored children were significantly higher (p < .05) than the TPR of the White children, and the Cw measurements of the Black and colored children were significantly lower than the Cw of the White children. Significant correlations (p < .05) were found between the SV, CO, TPR, Cw, and the total score on violence in the Black and colored children.

CONCLUSIONS

There are differences in the resting cardiovascular parameters in the different ethnic groups studied. The higher levels of violence to which the Black and colored children are exposed could alter vascular sensitivity to sympathetic stimulation. This may contribute via the higher -adrenergic sensitivity to the pathogenesis of hypertension in their later lives.

Stressful life events and psychological status in black South African women

The relationship between stressful life events and psychological status in Black South African women was explored, using a semistructured interview that consisted of a demographic questionnaire; the Xhosa Life Event Scale (XLES; Swartz, Elk, Teggin, & Gillis, 1983), which comprises mainly personal stressors; the Township Life Event Scale (TLES; Bluen & Odesnik, 1988), which comprises mainly sociopolitical stressors; and the General Health Questionnaire (GHQ, Goldberg, 1972, 1978). The participants were a random sample of 100 Black women living in a South African township. There were significant positive correlations between psychological distress and (a) undesirable life changes, (b) recurring stressful events of a sociopolitical nature (but not of a personal nature), and (c) continuous stressful events of a sociopolitical nature (but not of a personal nature). The results indicated that adverse sociopolitical conditions and the stress that accompanied them had a stronger negative effect than stressful events of a personal nature did on the women's mental health.

Children's experience of conflict related emergencies: some implications for relief policy and practice

This paper challenges the limited models of childhood, conflict and relief which determine most humanitarian interventions targeting children in conflict related emergencies. In particular, it notes the tendency of relief programmes to focus on "spectacular" groups of children (orphans, child combatants and refugees) at the expense of larger child populations indirectly affected by conflict. This relief bias is attributed to an inappropriate 'apocalypse model' of conflict which sees relief interventions only as repair. The bias also lies in a mistakenly universalist model of childhood and a medical paradigm which pathologizes children's experience in conflict and characterizes children as passive victims rather than active survivors. The paper argues for greater recognition of the wider social experience of children in conflict, and for relief practice which takes account of childhood resilience and children's different roles and capacities in coping with conflict. Appropriate interventions must engage with the wide variety of indigenous coping mechanisms involving children and not simply replicate a standard package of relief interventions in every emergency, based on simplistic and universalist interpretations of children's experience of conflict.

Seeking Identity — Township youth and Social Development

The potential of South African youth to play an economically productive and socially reconstructive role in society has been questioned. In this article it is argued that personal development is central to social development, and that appropriate intervention programmes which target the psychological functioning of youth will substantially enhance the chances of youth playing socially constructive roles in society. A framework for such interventions is suggested. The article applies Erikson's theory of identity development to township youth, first within an historical perspective and then to current youth. It is argued that both historically and currently, identity for many young people has been integrally linked with struggle for political change. A major challenge facing psychologists and other change agents is to help youth shift from this identity, to one in which youth see themselves as builders of and contributors towards a new democratic society. Key elements derived from Eriksonian theory which might facilitate this change are presented.