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Elomaa-Krapu M, Kaunonen M. Shattered childhood: Experiences of polio survivors in Finland 1950s and 1960s. J Adv Nurs 2024; 80:2860-2868. [PMID: 37849063 DOI: 10.1111/jan.15903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 10/01/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023]
Abstract
AIM To describe the childhood experiences of patients with polio from the acute phase of the disease during post-war Finland in the 1950s and 1960s. DESIGN Qualitative empirical study based on self-reported history of nursing rooted in the past, a history of experiences. METHODOLOGY Interview materials were gathered in the form of themes (45) and written interviews (4) (29 September 2018 to 30 June 2019). Data were analysed by reflexive thematic analysis to highlight hidden and latent experiences. This approach generated the study's main theme, themes and subthemes. RESULTS The main theme, 'shattered childhood', generated from the study results and was then divided into two themes, both of which were influenced in part by the loss of a familiar childhood, the changed environment, the breakdown of the body and the absence of control. Through their childhood memories, polio survivors described their broken childhoods using the following themes: 'betrayal by their bodies' and 'isolation'. In the narratives, the theme 'betrayal by one's own body' was generated by the following subthemes: 'suddenness of the affliction', 'paralysis' and 'being moved to the hospital'. The 'isolation' theme developed from the subthemes 'isolation from the body and surroundings' and 'emotional and social loneliness'. CONCLUSION Polio survivors' experiences during the acute stage of the disease were traumatic and demonstrated children's inferior nursing position in Finland in the 1950s and 1960s. IMPACT The study increases our understanding of the history of caring for children and families who were affected and disabled by polio and the importance of their experiences in society and healthcare settings. PATIENT OR PUBLIC CONTRIBUTION The authors collaborated with the Finnish Polio Association to recruit study participants and plan the study. Patients with polio during childhood underwent interviews, and their experiences formulated the data, which were analysed and the basis of the results. REPORTING METHOD Consolidated criteria for reporting qualitative research (COREQ), a 32-item checklist for interviews and focus groups, have been used as a reporting and checklist tool. All authors have agreed on the final version and the use of the COREQ criteria, relationship with participants, theoretical framework, setting, data collection and data analysis and report.
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Affiliation(s)
- Minna Elomaa-Krapu
- Faculty of Social Sciences, Nursing Science, Tampere University, Tampere, Finland
- Metropolia University of Applied Sciences, Helsinki, Finland
| | - Marja Kaunonen
- Faculty of Social Sciences, Nursing Science, Tampere University, Tampere, Finland
- General Administration, Wellbeing services county of Pirkanmaa, Finland
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Cheung CTY, Cheng CMH, Lee VWP, Lam SKK, He KL, Ling HWH, Lee K, Ross CA, Fung HW. COULD FAMILY WELL-BEING MODERATE THE RELATIONSHIP BETWEEN ADVERSE CHILDHOOD EXPERIENCES AND SOMATOFORM DISSOCIATION? A PRELIMINARY INVESTIGATION. J Trauma Dissociation 2024; 25:153-167. [PMID: 37424207 DOI: 10.1080/15299732.2023.2233095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 06/05/2023] [Indexed: 07/11/2023]
Abstract
The impacts of adverse childhood experiences (ACEs) have been well documented. One possible consequence of ACEs is dissociation, which is a major feature of post-traumatic psychopathology and is also associated with considerable impairment and health care costs. Although ACEs are known to be associated with both psychoform and somatoform dissociation, much less is known about the mechanisms behind this relationship. Little is known about whether social and interpersonal factors such as family environments would moderate the relationship between ACEs and somatoform dissociation. This paper discusses the importance of having a positive and healthy family environment in trauma recovery. We then report the findings of a preliminary study in which we examined whether the association between ACEs and somatoform dissociation would be moderated by family well-being in a convenience sample of Hong Kong adults (N = 359). The number of ACEs was positively associated with somatoform dissociative symptoms, but this association was moderated by the level of family well-being. The number of ACEs was associated with somatoform dissociation only when the family well-being scores were low. These moderating effects were medium. The findings point to the potential importance of using family education and intervention programs to prevent and treat trauma-related dissociative symptoms, but further investigation is needed.
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Affiliation(s)
- Cherry T Y Cheung
- School of Professional Education and Executive Development, The Hong Kong Polytechnic University, Hong Kong
| | | | - Vincent Wan Ping Lee
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kyle Langjie He
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Po Fok Lam, Hong Kong
| | - Kunhua Lee
- Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu, Taiwan
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas, USA
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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Fung HW, Chien WT, Lam SKK, Ross CA. The Relationship Between Dissociation and Complex Post-Traumatic Stress Disorder: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:2966-2982. [PMID: 36062904 DOI: 10.1177/15248380221120835] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Complex post-traumatic stress disorder (CPTSD) has recently been recognized as an official psychiatric diagnosis in ICD-11, after years of research and advocacy in the field. It has been suggested that dissociative symptoms are a major feature of CPTSD. This scoping review aimed to summarize the existing knowledge base on the relationship between dissociation and CPTSD, and to identify relevant research gaps. We searched the two largest and most widely used academic databases (i.e., the Web of Science and Scopus databases) and the ProQuest database and identified original studies published in English relevant to our research questions, namely: (1) Would CPTSD be associated with dissociative symptoms? 2) How common are dissociative symptoms among people with CPTSD? (3) What are the correlates of dissociative symptoms among people with CPTSD? In all, 26 studies were included. We found 10 studies which reported that people with CPTSD scored significantly higher on a dissociation measure than those without CPTSD, and 11 studies reported a positive correlation between CPTSD symptoms and psychoform/somatoform dissociation scores. While very few studies reported the prevalence and correlates of dissociative symptoms among people with CPTSD, there may be a considerable subgroup of people with CPTSD who have clinically significant levels of dissociative symptoms (e.g., 28.6-76.9%). Dissociation may also be associated with other comorbidities (e.g., DSM-IV Axis II features, shame, somatic symptoms) in people with CPTSD. We recommend that more studies are needed to investigate the prevalence of dissociative symptoms among people with CPTSD and examine how these symptoms are associated with other comorbid conditions and clinical needs in this vulnerable group.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas, USA
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Return to understanding dissociative symptoms as manifestations of a division of the personality: A rejoinder. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Fung HW, Ross CA, Lam SKK, Hung SL. Recent research on the interventions for people with dissociation. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Sarasso P, Francesetti G, Roubal J, Gecele M, Ronga I, Neppi-Modona M, Sacco K. Beauty and Uncertainty as Transformative Factors: A Free Energy Principle Account of Aesthetic Diagnosis and Intervention in Gestalt Psychotherapy. Front Hum Neurosci 2022; 16:906188. [PMID: 35911596 PMCID: PMC9325967 DOI: 10.3389/fnhum.2022.906188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
Drawing from field theory, Gestalt therapy conceives psychological suffering and psychotherapy as two intentional field phenomena, where unprocessed and chaotic experiences seek the opportunity to emerge and be assimilated through the contact between the patient and the therapist (i.e., the intentionality of contacting). This therapeutic approach is based on the therapist’s aesthetic experience of his/her embodied presence in the flow of the healing process because (1) the perception of beauty can provide the therapist with feedback on the assimilation of unprocessed experiences; (2) the therapist’s attentional focus on intrinsic aesthetic diagnostic criteria can facilitate the modification of rigid psychopathological fields by supporting the openness to novel experiences. The aim of the present manuscript is to review recent evidence from psychophysiology, neuroaesthetic research, and neurocomputational models of cognition, such as the free energy principle (FEP), which support the notion of the therapeutic potential of aesthetic sensibility in Gestalt psychotherapy. Drawing from neuroimaging data, psychophysiology and recent neurocognitive accounts of aesthetic perception, we propose a novel interpretation of the sense of beauty as a self-generated reward motivating us to assimilate an ever-greater spectrum of sensory and affective states in our predictive representation of ourselves and the world and supporting the intentionality of contact. Expecting beauty, in the psychotherapeutic encounter, can help therapists tolerate uncertainty avoiding impulsive behaviours and to stay tuned to the process of change.
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Affiliation(s)
- Pietro Sarasso
- BraIn Plasticity and Behaviour Changes Research Group, Department of Psychology, University of Turin, Turin, Italy
- *Correspondence: Pietro Sarasso,
| | - Gianni Francesetti
- International Institute for Gestalt Therapy and Psychopathology, Turin Center for Gestalt Therapy, Turin, Italy
| | - Jan Roubal
- Psychotherapy Training Gestalt Studia, Training in Psychotherapy Integration, Center for Psychotherapy Research in Brno, Masaryk University, Brno, Czechia
| | - Michela Gecele
- International Institute for Gestalt Therapy and Psychopathology, Turin Center for Gestalt Therapy, Turin, Italy
| | - Irene Ronga
- BraIn Plasticity and Behaviour Changes Research Group, Department of Psychology, University of Turin, Turin, Italy
| | - Marco Neppi-Modona
- BraIn Plasticity and Behaviour Changes Research Group, Department of Psychology, University of Turin, Turin, Italy
| | - Katiuscia Sacco
- BraIn Plasticity and Behaviour Changes Research Group, Department of Psychology, University of Turin, Turin, Italy
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The online community: DID and plurality. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2021.100257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Can dissociative symptoms exist without an underlying dissociation of the personality? Yes! EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2021.100243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mays I, Flynn J, McGuire B, Egan J. The Role of Attachment Style, Adverse Childhood Experiences and Dissociation in Migraine. J Trauma Dissociation 2022; 23:245-278. [PMID: 34706630 DOI: 10.1080/15299732.2021.1989114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Migraine and chronic migraine are caused by a combination of modifiable and non-modifiable genetic, social, behavioral and environmental risk factors. Further research of possible modifiable risk factors for this headache disorder is merited, given its role as one of the leading causes of years lived with disability per year. The first aim of this online cross-sectional study was to investigate the psychosocial risk factors that predicted chronic migraine and severe migraine-related disability in 507 Irish and UK participants, focusing specifically on childhood maltreatment, attachment and tendency to dissociate, or experience depressed mood and/or anxiety. Additionally, this study aimed to examine variables that mediated the relationships between these psychosocial risk factors and migraine chronicity or severe migraine-related disability. Adjusted binary logistic regression revealed that shutdown dissociation (Odds Ratio [OR] 4.57, 95% Confidence Interval [CI] 2.66-7.85) and severe physical abuse (OR 4.30, 95% CI 1.44-12.83 had significant odds of predicting migraine chronicity, while depression (OR 3.28, 95% CI 1.86-5.77) significantly predicted severe migraine-related disability. Mediation analyses indicated that shutdown dissociation mediated the relationship between seven predictor variables and both chronicity and severe disability including possible predisposing factors emotional abuse, physical neglect, avoidant attachment and anxious attachment. These findings suggest that early life stressors (such as childhood trauma and avoidant attachment style), shutdown dissociation and depression may impact on migraine trajectory. To investigate whether these psychosocial factors are risk factors for migraine chronicity or disability, prospective research should be conducted in this area to account for fluctuations in migraine chronicity over time.
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Affiliation(s)
- Iain Mays
- Department of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Jack Flynn
- Department of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Brian McGuire
- School of Psychology & Centre for Pain Research, National University of Ireland, Galway, Ireland
| | - Jonathan Egan
- Department of Psychology, National University of Ireland Galway, Galway, Ireland
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Massullo C, Imperatori C, De Vico Fallani F, Ardito RB, Adenzato M, Palmiero L, Carbone GA, Farina B. Decreased brain network global efficiency after attachment memories retrieval in individuals with unresolved/disorganized attachment-related state of mind. Sci Rep 2022; 12:4725. [PMID: 35304536 PMCID: PMC8933467 DOI: 10.1038/s41598-022-08685-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
The main aim of the study was to examine how brain network metrics change after retrieval of attachment memories in individuals with unresolved/disorganized (U/D) attachment-related state of mind and those with organized/resolved (O/R) state of mind. We focused on three main network metrics associated with integration and segregation: global (Eglob) efficiency for the first function, local (Eloc) efficiency and modularity for the second. We also examined assortativity and centrality metrics. Electroencephalography (EEG) recordings were performed before and after the Adult Attachment Interview (AAI) in a sample of 50 individuals previously assessed for parenting quality. Functional connectivity matrices were constructed by means of the exact Low-Resolution Electromagnetic Tomography (eLORETA) software and then imported into MATLAB to compute brain network metrics. Compared to individuals with O/R attachment-related state of mind, those with U/D show a significant decrease in beta Eglob after AAI. No statistically significant difference among groups emerged in Eloc and modularity metrics after AAI, neither in assortativity nor in betweenness centrality. These results may help to better understand the neurophysiological patterns underlying the disintegrative effects of retrieving traumatic attachment memories in individuals with disorganized state of mind in relation to attachment.
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Affiliation(s)
| | - Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | | | - Rita B Ardito
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco, 15, 10126, Turin, Italy.
| | - Mauro Adenzato
- Department of Psychology, University of Turin, Turin, Italy
| | - Luigia Palmiero
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Giuseppe Alessio Carbone
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Benedetto Farina
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
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