Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT April 4, 2002 "If you can find a path with no obstacles, it probably doesn't lead anywhere." - Frank A. Clark
Short Subjects
LINKS Mental Health Moment Online CONFERENCES AND WORKSHOPS:
Rocky Mountain Region
Disaster Mental Health Institute -
SPRING WORKSHOP SERIES
March 22 - Religious Aspects of
Domestic Violence
- Pat Bradley, MA, NACC, LAT
April 23, 24, 25 -
Crisis Counseling, Trauma, and Response:
A Multi-level Approach
- Marguerite McCormack, MA, LPC
May 3 - Suicide Risk Assessment and Risk Reduction: Tactics For The Trenches
- Jon Richard, PsyD
Disaster Mental Health Services-I (DMHS-I)
(Red Cross Course)
Location: Salt Lake City, UT
Dates: May 6-7, 2003
Contact: Lucy Houser
Email: houserlc@crossnet.org
The Australasian Critical Incident
Stress Association Conference
The Right Response in the
21st Century
Location: Carlton Crest Hotel
Melbourne Australia
Friday October 3, 2003 thru
Sunday October 5, 2003
For further information
please contact the conference organisers:
ammp@optushome.com.au
Conference Website:
http://www.acisa.org.au/ conference2003/Summer Intensive Program
Graduate Certificate in
Disaster Mental Health
Disaster Mental Health Institute (University of South Dakota)
Location: Union Building
University of South Dakota Campus Vermillion, SD
Contact: Disaster Mental Health Institute
University of South Dakota
SDU 114 414 East Clark St
Vermillion, SD 57069-2390
Phone: 605-677-6575 or 800-522-9684
Fax: 605-677-6604
http://www.usd.edu/dmhi/Third Biennial International Conference
on Intercultural Research (IAIR)
May 16 - 19, 2003
Location: Taipei, Taiwan Contact: 2003 IAIR International Conference
C/o College of Education
NTNU, PO Box 7-763
Taipei, Taiwan 106
Tel: +(886)2-2321-3142
Fax +(886)2-2394-9243
Email: t14004@cc.ntnu.edu.tw
VIII European Conference
on Traumatic Stress(ECOTS)
May 22 - 25, 2003
Location: Berlin, GERMANY
Contact: Scientific Secretariat
VIII ECOTS Berlin 2003
c/o Catholic University of
Applied Social Sciences
Koepenicker Allee 39-57
D-10318 Berlin
Tel: +49-30-50 10 10 54
Fax: +49-30-50 10 10 88
E-mail: trauma-conference@kfb-berlin.de
Annual Conference Society for
Industrial/Organizational Psychology (SIOP)
April 12 - 14, 2003
Location: Orlando, Florida
USA
Contact: lhakel@siop.bgsu.edu
4th International Symposium on Bilingualism
April 30 - May 3, 2003
Location: Tempe, Arizona, USA
Contact:
4th International Symposium on Bilingualism
Arizona State University
PO Box 870211
Tempe, AZ 85287-0211, USA
Email: isb4@asu.edu
A HEARTBEAT CHAPTER FORMING IN LARAMIE
This is a support group for persons who have lost a significant other through suicide. Meetings will be the 2nd Tuesday of the month, beginning on April 8, from 6:30-8:00pm at the Newman Center on East Grand. Persons desiring additional information can call Well Aware at Ivinson Memorial Hospital (IMH) (307) 742-2141. Referrals from local mental health professionals who may be aware of individuals who have experienced such a loss would be greatly appreciated.
EARLY FLASH FLOOD WARNING SYSTEM MAY SAVE LIVES, PROPERTY
Weather forecasters may soon be able to predict deadly flash floods several days in advance using a new technique developed by Penn State researchers and the National Weather Service (NWS). If successful, this approach could be extended to other types of extreme weather, such as severe thunderstorms, record heat and cold, and winter storms, according to Paul Knight, Penn State meteorologist and State Climatologist. "We can't stop the flooding," Knight says, "but we may, with this technique, be able to foresee it even further in advance." Knight, along with several NWS colleagues and Penn State undergraduate Justin M. Brolley, presented their work recently at a meeting of the American Meteorological Society. The technique is based on a chronological listing by state of extreme weather events, maintained by the National Climatic Data Center, and a 50-year government database of ground observations and measurements collected by weather balloons. For the full story by Todd Johnston, visit http://www.psu.edu/ur/2003/flashflood.html
When The Media Is A Disaster Victim. How One Small Paper Kept The World Informed
When disaster strikes, news outlets sometimes escape unscathed. Sometimes they don't. But when the media become disaster victims, the public loses its source of emergency information. Fortunately for those living on Guam, the news media there has learned the lessons of previous typhoons. They know that preparedness pays off—for everyone. For the full story, go to: http://www.fema.gov/nwz03/nwz03_media.shtm
UNICEF calls for shielding children from ‘silent dangers’ of abuse, violence, exploitation
4 April – Warning that tens of millions of children every year suffer long-term health damage from exploitation, abuse, and violence, hazards often overlooked in public health planning, the United Nations Children’s Fund (UNICEF) called on governments and communities today to assure the "protective" environment essential to keeping every youngster out of harm's way. For the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=6663&Cr=world&Cr1=health
UN aid agencies step up supplies in Iraq but concerned over Baghdad's water
UN aid agencies step up supplies in Iraq but concerned over Baghdad's water 4 April – With growing concern now focusing on the water supply for the 5 million residents of Baghdad, United Nations relief agencies today reported "some hopeful and positive steps" in moving humanitarian aid into other parts of Iraq. For the full story, go to: http://www.un.org/apps/news/story.asp?NewsID=6664&Cr=iraq&Cr1=relief
STUDY OF HISTORY INDICATES IRAQI WAR WILL LAST TWO TO 10 MONTHS
A statistical analysis of key factors in wars fought over the past nearly 200 years indicates that the Iraqi war will last two to 10 months, according to a Penn State political scientist. "While the media have given frenzied coverage to the short-term ups and downs of the still-early war with Iraq, history would never have suggested that the war would be as short as some pundits predicted," says D. Scott Bennett, associate professor of political science. "Rather, history reveals that half of the wars fought since 1816 have lasted more than five months, with the average length of a war being 17 months." Bennett is co-author of the forthcoming book, "The Behavioral Origins of War: Cumulation and Limits to Knowledge in Understanding International Conflict" (University of Michigan Press), with Allan C. Stam, an associate professor at Dartmouth College in New Hampshire. Read the full story at http://live.psu.edu/index.php?sec=vs&story=2547
OPERATION COMFORT (from CAMFT)
There exists a tremendous amount of uncertainty in the world right now, and this holds especially true for families who have a loved one fighting in the Middle East. At a time when many predicted that victory would be close at hand, the war in the Middle East is only just beginning. As a result, it is survival rather than victory that is often in the minds and hearts of friends and families at home. This Middle East war is far different from the air campaign in the Persian Gulf a decade ago. The United States involvement in the Persian Gulf necessitated a minimal deployment of ground troops and resulted in a fewer number of casualties than have already befallen the Coalition Forces.
In the current conflict, each day brings news of more POWs, men and women missing in action, casualties, and the threat of chemical warfare. Tens of thousands of American soldiers are scheduled to depart for the Middle East to join the more than 300,000 American and British forces already engaged in this conflict.
Family members are living in uncertainty, not knowing when their husbands, wives, sisters, brothers, sons, or daughters will be returning. For those of us who do not have a loved one participating in this war, we can only imagine the hardship of coping with world events along with demands of daily living. Certainly, every "war family" is proud of the men and women, all of whom, have volunteered their service to the armed forces. Operation Comfort is entirely a volunteer effort which provides support to "war families" who are struggling under the tremendous burden of stress, anxiety, fear, helplessness, and loss.
On May 27th, Dr. Jose David Cohen, a psychotherapist based in North Hollywood, California, made a commitment to provide free psychotherapy to family members who had a loved one fighting in the Middle East. The following day, Dr. Cohen contacted a multitude of news agencies, political figures, fellow clinicians, and advocacy groups in an effort to initiate a grass roots effort that he has called "Operation Comfort." By the end of the day, Dr. Cohen's efforts were recognized by a number of radio and television stations, including a segment on ABC Eyewitness News.
Operation Comfort, Mission: To create a network of mental health providers across the country who are willing to offer their services, free of charge, to family members who have a loved one fighting in the Middle East.
If you are interested in participating in Operation Comfort, please contact OPERATION COMFORT (866) NEAR TO U (866-763-2868) or by email: Dr. Steven Sherman at sbsdoc@earthlink.net . The website: thehttp://www.operationcomfort.com . CAMFT will soon post a link to it from CAMFT and TherapistFinder websites.
WAR AND ANXIETY
A war or a national crisis situation is accompanied by an increase in stress and anxiety levels within the population - among civilians as well as military. It also results in posttraumatic stress in both populations which can last for very extended periods of time. For example, Lindorff (2002) notes that little is known about the psychological effects of war service on Australian World War II veterans. In an attempt to understand some of these effects, 88 survivors (aged 75-91 yrs) of one of the war's most intense actions (the Isurava battle on the Kokoda Track in Papua in August 1942) responded to a survey asking for their recollections of the battle, and for a description of its effect on them. Many said that they had yet to recover from the experience. Large numbers indicated continuing ill effects. These included nightmares, sleeplessness, negative imagery, "flashbacks", problems with concentration, weeping, generalized anxiety, and distress caused by situations recalling the battle. Many commented that they had never talked to anyone about their war experiences, or the effects of these experiences. Only two veterans reported seeking or receiving any treatment for their symptoms (Lindorff, 2002) .
Stress
The experience of wartime stress may change a certain aspect of an individual's personality, in particular the personality trait of neuroticism defined as 'proneness to distressing emotional states' such as anxiety, depression, and anger. Bramsen, van der Ploeg, van der Kamp & Ader (2002) examined this by studying Ss from a random community sample of 455 Dutch survivors (aged 63-72 yrs) of World War II. The relationship between wartime stress and the personality trait of neuroticism turned out to be fully mediated by the development of a negative world view. Empirical support was found for the notion that traumatic events force the survivor to change the personal theory of the world and make him/her more vulnerable to distressing emotional states and symptoms of post-traumatic stress disorder.
In a previous study with a similar population, Bramsen and Ploeg (1999) examined the current psychological adjustment of World War II (WW II) survivors, including survivors of bombardments, persecution, resistance, combat, and other violence. Ss were 1461 Dutch adults born during the period 1920-1929, who answered both a mailed questionnaire and a follow-up questionnaire. Results showed that, even 50 yrs later, a modest but statistically significant relationship was found between exposure to shocking war events and current psychological adjustment in terms of symptoms of posttraumatic stress disorder (PTSD), anxiety, and anger. 66 respondents (4.6%) met the criteria for PTSD. The highest level of current PTSD (13%) was found among survivors of persecution. The lowest level of PTSD (4%) was found among civilian war victims and resistance participants, while military veterans had an intermediate score (7%). Most WW II survivors in this sample had no severe symptoms of PTSD.
The impact of stress was investigated among Israeli soldiers during the Gulf War. Barak, Bodner, Klayman, Ring & Elizur (2000) studied 40 healthy young adults (18-21 yrs old) in active service. Their scores on the Hamilton Anxiety Rating Scale were evaluated during the first week of the war. The Ss were divided into two equal sub-groups of 20 Ss each; combatants and auxiliary personnel. Higher levels of anxiety were found among the combatants. Factor analysis revealed three differing factors: arousal symptoms, numbing, and distraction.
Simms, Watson, & Doebbelling (2002) used confirmatory factor analysis to compare 6 models of posttraumatic stress disorder (PTSD) symptoms, ranging from one to four factors, in a sample of 3,695 deployed Gulf War veterans (N = 1,896) and nondeployed controls (N = 1,799). The four correlated factors-intrusions, avoidance, hyperarousal, and dysphoria-provided the best fit. The dysphoria factor combined traditional markers of numbing and hyperarousal. Model superiority was cross-validated in multiple subsamples, including a subset of deployed participants who were exposed to traumatic combat stressors. Moreover, convergent and discriminant validity correlations suggested that intrusions may be relatively specific to PTSD, whereas dysphoria may represent a nonspecific component of many disorders.
Vicarious Causes
The overabundant use of TV footage, both live and on tape, allows traumatic events to be shown to vast audiences who may never have been exposed to such events previously. Presenting such events live in real time can contribute to stress and anxiety in a population that is not directly affected by the event(s). Lutenberg (2002) discusses the peculiar and antithetical combination of hope and death that occur in a population at the moment when it is overcome by collective, traumatic events, sealed by uncanny situations. Lutenberg presents some meta-psychological and psychodynamic difficulties related to the articulation between the inner and outer world of people undergoing this problem. According to these variables, the emotion emerging like an ego alert against danger will be anxiety or terror. Facing fanaticism, everything turns into something else (terror or anxiety disappear). Lutenberg suggests that we have entered a new historical period. Its starting point was signalled by the TV transmission of The Gulf War. He contends that the border between the actors of the tragedy and the TV audience has been broken. The concept of war and war front has changed. This gives birth to patterns of what is known as "Civilization and its Discontents." Under such circumstances, social reality turns uncanny, that is, unfamiliar. The ego and the super-ego are open structures that regress when facing an uncanny culture. Lutenberg considers it indispensable to revise the clinical descriptions of psychopathological structures, in the light of violence. TV coverage of the current Iraq War is likely to have similar effects and will likely promote anxiety, stress and trauma experiences in some viewers.
Subsequent Trauma Situations
Somasundaram (2001) examined the types of war related stress and their psychosocial sequelae in individuals seeking health care in a situation of chronic conflict. A random sample of 36 Ss at General Hospital Jaffna and 32 Ss at District Hospital Tellipallai were administered the Stress Impact Questionnaire. The stress experienced, somatization and psychosocial symptoms described by the Ss were graded on severity as mild, moderate and severe. A stress score was calculated for each patient. A psychiatric diagnosis was made for those with minor mental health disorders. Findings revealed that patients tended to be slightly older than the general population and female. The majority belonged to the lower SES. Indirect stresses due to war like displacement (68%), unemployment (55%), economic difficulties (84%), and lack of food (68%) were very common. Of the direct war stressors, 25% had been detained, while 23% had been assaulted and 7% tortured. Thirty percent had experienced direct bombing, shelling, or gunfire. Death of relations and friends (45%) and damage or loss of property (54%) were also frequent stresses. There was considerable somatization (56.9%), usually coexistent with mild organic illness. Forty-two percent had posttraumatic stress disorder (PTSD). Anxiety (47.6%) and depression (33.3%) were also found.
Toren, Wolmer, Weizman, Magal-Vardi & Laor (2002) investigated the development of traumatic-spectrum symptoms among individuals re-exposed to traumatic events. 27 individuals (mean age 45.3 yrs) residing in Tel-Aviv who had been previously exposed to missile attacks during the Gulf War in 1991 were assessed during the first week of a 1998 threat of missile attacks and three months later using: (1) the Structural Clinical Interview for Mental Disorders-III-Revised (DSM-III-R)--Nonpatient Version (R. L. Spitzer et al, 1989), the Impact of Event Scale (M. J. Horowitz et al, 1979), and the state subscale of the State-Trait Anxiety Inventory (C. D. Spielberger, 1983). Results show that, at the acute stage, Ss attained significantly higher scores concerning intrusion, avoidance, state anxiety, and state anger than did controls having no previous traumatic exposure to missile attacks. At three month follow-up, previously traumatized Ss and controls were similar regarding the symptom domains of intrusion, avoidance, and state anxiety. However, previously traumatized Ss reported marginally higher symptoms of state anger.
Sutker, Corrigan, Sundgaard-Riise, Uddo & Allain (2002) explored the impact of psychological outcomes to war on response to subsequent natural disaster. Ss were 312 military personnel (aged 18-64 yrs) 66% of whom saw Gulf War duty. All were exposed to the 1992 Hurricane Andrew. Ss were compared on reported traumatic events, hurricane impact responses, and psychological symptoms in subgroups defined by war or no war exposure prior to hurricane and by presence or absence of war-related posttraumatic stress disorder (PTSD). Data were gathered in face-to-face clinical assessments. War trauma prior to hurricane was associated with more reported traumatic events, greater fears for safety during the hurricane, and heightened psychological symptoms. Ss with pre-existing war-related PTSD showed more adverse psychological hurricane sequelae and reported more traumatic events, higher depression, anxiety, anger, PTSD symptoms, and physical symptoms, and lower self-esteem than those free of diagnoses. Results point to the negative influence of exposure to one traumatic event on the experience of and response to a subsequent stressor. This could have implications for those exposed to the Gulf War and the current Iraq War (including vicarious exposure).
Effects on Disabled
Sternik, Solomon, Ginzburg, & Enoch (1999) studied the implications of war stress in the emotional and cognitive responses of psychiatric patients. 39 Israeli hospitalized schizophrenics and 39 comparable controls were assessed during the 1991 Gulf War. Ss filled out questionnaires evaluating anxiety, war-related symptomatology, and world assumptions. Results revealed that while psychiatric patients reported significantly higher levels of trait anxiety than controls, the 2 groups did not differ in war-related distress. Moreover, on most indices, hospitalized schizophrenics held more positive world assumptions than controls.
Tobin (2000) notes that the civilian population of southern Lebanon has endured military conflict, civil war, and 2 invasions since the foundation of the State of Israel in 1948. He had the opportunity to observe and to treat the mental health problems of the civilian population who were living under long-term artillery bombardment and living with continuous fluctuating conflict. Utilizing his own observations and those of his translator, Tobin assessed how the civilian population coped with what was difficult circumstances. He found that psychiatric illness is associated with significant stigma by the local population. A lot of stress- and anxiety-related problems were presented in a psychosomatic mode.
Starcevic, Kolar, Latas, Bogojevic, Kelin (2002) assessed the impact of real danger on several aspects of panic disorder (PD) patients' psychopathology and level of disability. At the time of the NATO air strikes on Belgrade, 84 PD patients (mean age 35.32 yrs) who were in partial or comp remission were administered the Panic and Agoraphobia Scale (PAS). All had been treated previously, and the majority were taking anti-panic medications. The PAS, which was used as part of the regular follow assessment battery for PD patients, measures the overall severity of PD and severity of key aspects and components of PD. Compared to the PAS assessments made before the onset of air strikes, the PAS assessments made at the time of strikes sbowed significant differences in terms of decreased overall severity of PD, fewer health concerns, decrease in the level of disability, and great intensity and frequency of anticipatory anxiety. Differences on the measured panic attacks and agoraphobic avoidance were negligible. Results suggest that there is no relationship between panic attacks and real danger and lend support to the notion that panic attacks and fear induced by real danger are different phenomena.
Effects on Military
Singh, Banerjee & Chaudhury (2001) examined trends in psychiatric disorders during war among military personnel who served in the United Nations peacekeeping force in Congo (now Zaire). The study included all personnel admitted to the O.N.U.S. Hospital in Leopoldville, Congo, during the period October 1960 to August 1961. The maximum incidence of psychiatric disorders occurred among soldiers, with civilian personnel making up 10% of the psychiatric casualties. The incidence of psychiatric disorders was significantly higher in young (i.e., 20-35 yr olds vs 60-41+ yr olds), inexperienced individuals with a relatively short length of service, who had neither participated in war nor experienced war-like conditions before, and who had never been out of their home country. Maximum incidence was noted in the first three months after arrival in the Congo. The most common disorders were anxiety disorders, followed by hysterical reactions. A small proportion of cases also suffered from psychoses and psychopathic personality disorders. 30.25% of Ss returned to their units following treatment, while 69.74% cases returned home for further treatment. Implications of the study and other subsequent studies of similar situations with young military personnel suggest monitoring of military personnel in the Iraq War for similar and related symptoms. Adequate debriefing upon disengagement and return home should be considered as vital to help mitigate future post-trauma related problems.
Resiliency
Peddle (2001) explored and described the relationship between trauma recovery/resiliency (r/r) and forgiveness among a selected group of adolescent and adult refugees who had experienced the trauma of war. The purpose of this study was to understand the trauma recovery/resiliency and forgiveness processes and the relationship between the two in efforts to find better ways to elevate individual and societal suffering, as in the case of symptoms of trauma and in the case of vengeful acts with their roots in trauma. The research presented builds on two conceptual models: Trauma and Recovery Stage Model (Herman, 1992) and Forgiveness Process Model (Enright & Human Development Study Group, 1991). Both trauma recovery and forgiveness are linked to the alleviation of anxiety, hopelessness, depression, and low self-esteem. The relationship between trauma recovery/resiliency (r/r) and forgiveness was studied in a convenience sample of 83 adolescent and adult refugees who had experienced war from 1 year to 59 years prior to the study and were between the ages of 13 and 85 in the Chicago, IL, area. Three demographic variables: Age, Number of Years Since Experienced War, and Religion were examined for their influence on both trauma recovery/resiliency and forgiveness. These data supported the notion of a relationship between trauma recovery/resiliency (r/r) and forgiveness and their elements. The findings also show that age, number of years since experienced war and religion explained the variation in the dependent variables recovery/resiliency and forgiveness. Twenty-four theme elements were identified that were reduced to five theme categories: faith, possibility to forgive the unforgivable, struggle to make meaning, view of the injurer, and process that helped in the understanding of the phenomenon. The data indicate that forgiveness significantly correlates with trauma recovery/resiliency, which is suggestive of a 'preventive and/or treatment' factor. Findings suggest that the fields of trauma recovery and forgiveness have commonalties that can contribute to recovery from exposure to war and that intervention and prevention psychosocial programs broaden their focus to include forgiveness skills. This may be of particular relevance in the aftermath of the Iraq War, both in the United States as well as Iraq and other nations with large Arab and/or Muslim populations.
Hyman (2001) investigated whether there was a relationship between perceived social support and cumulative levels of secondary traumatic stress symptoms of intrusion, avoidance, increased arousal, anxiety and numbing/depression in disaster workers. The study also explored whether there was a relationship between the perceived severity of combat experience, personal trauma and disaster work which had occurred prior to the study, and levels of cumulative secondary traumatic stress symptoms. The research was conducted in 1999 in Israel. Of 165 forensic technicians working at the time in the Israeli Police Forensic Identification Unit, 125 were contacted either directly or by mail. The total sample included 90 forensic technicians (74% response rate). Eighty one of the respondents were interviewed, and nine responded by mail. The sample was predominantly male (94.5%). In their work, which included handling of human remains following terrorist attacks, severe car accidents and homicides, these technicians fulfilled a disaster relief function that is regarded as extremely stressful. Furthermore, the sample and their whole community had been living under prolonged war and terrorism-related stress. A questionnaire consisting of four sections was administered to the participants in face-to-face interviews that were conducted at 12 of the 15 Forensic Investigation Unit regional offices scattered throughout Israel. Questionnaires were filled in anonymously. The four sections of the questionnaire included the following tools: (a) the Impact of Event Scale (Horowitz, Wilner, & Alvarez, 1979) to measure intrusion and avoidance; (b) the 12 item General Health Questionnaire (Goldberg, 1972) to measure the distress symptoms of increased arousal, anxiety and numbing/depression; (c) the Social Support Questionnaire (Sarason, Levine, Basham, & Sarason, 1983) to measure the perceived social support; and (d) a demographic sheet, including items measuring the perceived severity of combat, personal trauma and disaster work prior to the study. Findings did not indicate that there was a relationship between perceived social support and levels of cumulative secondary traumatic stress and distress symptoms. The study did not find evidence of a relationship between the perceived severity of prior combat experience and cumulative levels of secondary traumatic stress and distress symptoms. However, findings did indicate that the more severe prior personal trauma (as well as disaster work done till the time of the study) was perceived to have been, the higher the levels of cumulative secondary traumatic stress symptoms were. Findings suggest that avoidance rather than perceived social support was used to cope with cumulative levels of work-related stress. This indicates that subjective assessment of the severity of prior traumatic events, such as personal trauma and disaster relief work done before the study, might be related to current stress responses in disaster workers. It also suggests that traumatic stress, such as combat related stress, can be resolved over time. Results support the notion that human responses to disaster work are complex and varied, and that experienced disaster workers utilize innate resiliency to adapt to their work-related stresses. Further research is needed in order to investigate coping strategies with traumatic stress when the perceived social support system is itself under threat. Gender differences and secondary traumatic stress also require further exploration.
In 1997, Ohta, Mine, Wakasugi, Yoshimine, Himuro, Yoneda, Yamaguchi, Mikita & Morikawa (2000) used a mental health survey consisting of a 30-item General Health Questionnaire (GHQ-30) and an interview survey of an atomic bombing experience with survivors of the Nagasaki atomic bombing. At home visit interviews, complete answers to the GHQ-30 were obtained from 3,756 subjects (aged 51-99 yrs). Overall psychological distress measured on the basis of the GHQ-30 was greater in the atomic bombing survivors than in the controls. As for the contents of psychological distress, those concerning emotion such as anxiety and depression were milder in survivors than in the controls. However, those related to social activities such as apathy, disturbance of human relations, loss of enjoyment of living were more severe. Recurring and distressing recollection of the experience of the atomic bombing, suspicion over the relationship between the atomic bombing and an unhealthy physical condition, and the experience of witnessing death or severe injury of close relatives due to the atomic bombing were significantly related to the degree of psychological distress of the survivors.
Conclusion
The effects of war on military personnel, civilians involved in conflicts, vicarious exposure to traumatic events and previous exposure to traumatic events will all be factors that will impact Americans, Iraqis, British, and others directly or indirectly involved. Mental health professionals must be ready for responding to these in each of their own communities.
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REFERENCES Barak, Yoram, Bodner, Ehud, Klayman, Nimrod, Ring, Aliza & Elizur, Avner (2000). Anxiety among Israeli soldiers during the Gulf War. European Archives of Psychiatry & Clinical Neuroscience, Vol 250(3), pp. 148-151. Journal URL: http://link.springer.de/link/service/journals/00406/index.htm
Bramsen, I., Vrije & Ploeg, H. M. van der (Nov 1999). Fifty years later: The long-term psychological adjustment of ageing World War II survivors. Acta Psychiatrica Scandinavica, Vol 100(5), pp. 350-358.
Bramsen, Inge, van der Ploeg, Henk M., van der Kamp, Leo J. Th. & Ader, Herman J.(Mar 2002). Exposure to traumatic war events and neuroticism: The mediating role of attributing meaning. Personality & Individual Differences, Vol 32(4), pp. 747-760. Journal URL: http://www.elsevier.com/inca/publications/store/6/0/3/
Hyman, Ofra (2001). Perceived social support and symptoms of secondary traumatic stress in disaster workers. Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 61(12-B), pp. 6747.
Lindorff, Margaret (2002). After the war is over...PTSD symptoms in World War II veterans. Australasian Journal of Disaster and Trauma Studies, Vol 6(2), pp. [np]. Journal URL: http://www.massey.ac.nz/~trauma/
Lutenberg, Jaime Marcos (2002). Malestar en la Cultura Contemporanea. Lo Siniestro. Translated Title: Discontent in contemporary civilization: The uncanny. Psicoanalisis: Revista de la asociacion Psicoanalitica de Buenos Aires, Vol 24(1-2), pp. 111-127. Journal URL: http://www.apdeba.org/publicaciones
Ohta, Yasuyuki, Mine, Mariko, Wakasugi, Masako, Yoshimine, Etsuko, Himuro, Yachiyo, Yoneda, Megumi, Yamaguchi, Sayuri, Mikita, Akemi & Morikawa, Tomoko (Feb 2000). Psychological effect of the Nagasaki atomic bombing on survivors after half a century. Psychiatry & Clinical Neurosciences, Vol 54(1), pp. 97-103. Journal URL: http://www.blackwell-science.com/-cgilib/jnlpage.asp?Journal=xpcn&File=xpcn
Peddle, Nancy Ann (Dec 2001). Forgiveness in recovery/resiliency from the trauma of war among a selected group of adolescents and adult refugees. Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 62(5-B), pp. 2252.
Simms, Leonard J; Watson, David & Doebbelling, Bradley N. (Nov 2002). Confirmatory factor analyses of posttraumatic stress symptoms in deployed and nondeployed veterans of the Gulf War. Journal of Abnormal Psychology, Vol 111(4), pp. 637-647. Journal URL: http://www.apa.org/journals/abn.html
Singh, Amool R., Banerjee, K. R., Chaudhury, Supraksh (Jul 2001). Mental health during war: An experience and lesson from the past. Journal of Projective Psychology & Mental Health, Vol 8(2), pp. 135-140.
Somasundaram, Daya (Sep 2001). War trauma and psychosocial problems: Patient attendees in Jaffna. International Medical Journal, Vol 8(3), pp. 193-197.
Starcevic, Vladan, Kolar, Dusan, Latas, Milan, Bogojevic, Goran, & Kelin, Katarina, (2002). Panic disorder patients at the time of air strikes. Depression & Anxiety, Vol 16(4), pp. 152-156.
Sternik, Ilana, Solomon, Zahava, Ginzburg, Karni & Enoch, Dan (Nov 1999). Psychiatric patients in war: A study of anxiety, distress and world assumptions. Anxiety, Stress & Coping: An International Journal, Vol 12(3), pp. 235-246. Journal URL: http://www.tandf.co.uk/journals/gb/10615806.html
Sutker, Patricia B.; Corrigan, Sheila A.; Sundgaard-Riise, Kirsten; Uddo, Madeline & Allain, Albert N. (Mar 2002). Exposure to war trauma, war-related PTSD, and psychological impact of subsequent hurricane. Journal of Psychopathology & Behavioral Assessment, Vol 24(1), pp. 25-37. Journal URL: http://www.wkap.nl/journalhome.htm/0882-2689
Tobin, John P. (Feb 2000). Observations on the mental health of a civilian population living under long-term hostilities. Psychiatric Bulletin, Vol 24(2), pp. 69-70. Journal URL: http://pb.rcpsych.org/
Toren, Paz, Wolmer, Leo, Weizman, Ronit, Magal-Vardi, Osnat, Laor, Nathaniel (Jan 2002). Retraumatization of Israeli civilians during a reactivation of the Gulf War threat. Journal of Nervous & Mental Disease, Vol 190(1), pp. 43-45. Journal URL: http://www.jonmd.com/
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RECOMMENDED READING
Counselling and Therapy with Refugees and Victims of Trauma : Psychological Problems of Victims of War, Torture and Repression
by Guus van der Veer
Book Description
The first edition of this book was acclaimed as a practical, insightful and humane guide for professionals in mental health, social work and voluntary and government agencies who are concerned with the care of refugees and other victims of political and military violence. These professionals can develop feelings of irritation, disappointment and hopelessness when their work seems not to have the expected result. Successful counselling and therapy require empathy with such victims of traumatic events. But empathy must be based on, and combined with, expertise and knowledge that is both scientific and research-based, and focused on the special needs of these victims. This book is written from the first-hand experience of a world expert in this field, and provides * A practical guide to clinical work with adult, child and adolescent victims * A conceptual framework which places treatment in the context of the main therapeutic approaches * A review of the research evidence that supports these methods of assessment and treatment * Many clinical examples and a full consideration of the special problems of communication across cultures and language barriers * Recognition of the special problems for professionals and volunteers dealing with these clients This new edition reflects the latest scientific and clinical work and knowledge, and will be essential for mental health professionals as well as for a wider readership of social, legal and administrative professionals who are concerned with the wellbeing of these victims. "A supremely accessible, comprehensive text on the effects of detention, torture, rape, exile, and culture shock, and how to understand and effectively help victims. It is also a vivid insight into traumatization and transgenerational suffering, and into transcultural and transtheoretical therapy. Harrowing yet timely, essential reading for frontline therapists and counsellors." Colin Feltham, PhD, Sheffield Hallam University.
Additional Readings at: Terrorism and Stress in the search engine. Also try looking here for Psychology and Terrorism.
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Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
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George W. Doherty
Rocky Mountain Region
Disaster Mental Health Institute
Box 786
Laramie, WY 82073-0786
MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news
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