Mary W. Armsworth

Differentiating incest survivors who self-mutilate

OBJECTIVE This study was an exploratory analysis of the variables which differentiated incest survivors who self-mutilate from those who do not. METHOD A sample of women incest survivors (N = 84) were divided into two groups based on the presence or absence of self-mutilation. Participants included both community and clinical populations. A packet consisting of a demographic questionnaire, Sexual Attitudes Survey, Diagnostic Inventory of Personality and Symptoms, Dissociative Events Scale and the Beck Depression Inventory was completed by each participant. RESULTS Demographic, incest, and family of origin variables distinguished the self-mutilating women from those who did not. These include ethnicity and educational experiences; duration, frequency, and perpetrator characteristics regarding the incest; and multiple abuses, instability, birth order, and loss of mother in ones family of origin. Psychological and physical health concerns also differentiated between the two groups. CONCLUSIONS Many variables may differentiate between women incest survivors who self-mutilate from those who do not. A rudimentary checklist to describe the lives of incest survivors who self-mutilate resulted from these findings. The importance of the concept of embodiment is also discussed.

Therapy of incest survivors: Abuse or support?☆

A preliminary study examined the self-reports of 30 adult incest survivors related to professional help received for personal concerns and incest-related problems. Subjects rated the helpfulness of services received from 12 categories of professionals or groups commonly sought for counsel. Subjects utilized 113 professionals (53 male, 60 female) and spent an average of 36 sessions (9 months) in helping relationships. Chi-square analysis indicated a significant relation (p less than .001) between sex of professional or helper and rating of helpfulness of individual sessions. The trend indicated by this data suggests that male helpers were seen longer and rated lower than females. Additional information provided indicated that the most helpful categories of interventions included (1) validation; (2) advocacy; (3) empathic understanding; and (4) absence of derision or contempt. Practices or attitudes considered harmful were (1) blaming the victim; (2) lack of validation; (3) negative or rejecting responses; and (4) exploitation or victimization of the client. Sexual involvement with the person in the helping role was reported by 23% of the sample; an additional 23% reported other forms of exploitation or victimization. Results of the study are discussed using the conceptual framework of trauma-based disturbances. Reliving experiences, revictimization dynamics, and dissociative processes are speculated to be involved in the high incidence of exploitation of adult incest survivors by persons in helping roles.

Emotional response to abortion: a critical review of the literature.

Anti-abortion groups in the US cite the existence of a post-abortion syndrome--a sense of loss, emptiness, and grief similar to that reported by trauma survivors. Although research on the longterm effects of induced abortion is marred by methodological errors, most studies have found no adverse psychological sequelae; rather, there appears to be a sense of relief and opportunity for personal growth. Nevertheless, there is a small group of women who do experience emotional distress after abortion and it is important to identify the demographic, social, and psychological factors that place women at risk of such a reaction. In terms of demographic factors, young age (adolescence), low or nulliparity, 2nd-trimester procedures, and Catholicism have been characteristics of women who suffered post-abortion depression. Of the social variables that have been examined, a lack of support from significant others (parents or partner) has been linked in some studies to emotional distress after abortion. A relatively consistent finding is that women who feel coerced to abort or are ambivalent about their decision at the time of the procedure are most likely to experience regret, depression, and anger. Women whose coping style involves avoiding responsibility are also prone to post-abortion distress. As noted, the literature does not support the contention that abortion causes longterm trauma. On the other hand, given the fact that 1.5 million abortions take place each year in the US, the existence of some post-abortion distress in even as small percentage of acceptors is enough to indicate a need for pre- and post-abortion counseling to help women determine the meaning of the experience and own their decisions.

Cue Reactivity in Virtual Reality: The Role of Context

Cigarette smokers in laboratory experiments readily respond to smoking stimuli with increased craving. An alternative to traditional cue-reactivity methods (e.g., exposure to cigarette photos), virtual reality (VR) has been shown to be a viable cue presentation method to elicit and assess cigarette craving within complex virtual environments. However, it remains poorly understood whether contextual cues from the environment contribute to craving increases in addition to specific cues, like cigarettes. This study examined the role of contextual cues in a VR environment to evoke craving. Smokers were exposed to a virtual convenience store devoid of any specific cigarette cues followed by exposure to the same convenience store with specific cigarette cues added. Smokers reported increased craving following exposure to the virtual convenience store without specific cues, and significantly greater craving following the convenience store with cigarette cues added. However, increased craving recorded after the second convenience store may have been due to the pre-exposure to the first convenience store. This study offers evidence that an environmental context where cigarette cues are normally present (but are not), elicits significant craving in the absence of specific cigarette cues. This finding suggests that VR may have stronger ecological validity over traditional cue reactivity exposure methods by exposing smokers to the full range of cigarette-related environmental stimuli, in addition to specific cigarette cues, that smokers typically experience in their daily lives.

Randomized controlled trial of brief cognitive behavioral intervention for depression and anxiety symptoms preoperatively in patients undergoing coronary artery bypass graft surgery

OBJECTIVE The goal of this study was to examine the feasibility, acceptability, and efficacy of a brief, tailored cognitive-behavioral intervention for patients with symptoms of preoperative depression or anxiety before undergoing a coronary artery bypass graft (CABG) operation. METHODS Patients were recruited from a university teaching hospital between February 2007 and May 2009. Patients were randomly assigned to receive treatment as usual (TAU) or a cognitive behavioral therapy (CBT) intervention called Managing Anxiety and Depression using Education and Skills (MADES). A total of 100 subjects were randomized into the study. Length of hospital stay was assessed with a 1-way analysis of variance. Depression, anxiety, and quality of life were assessed with mixed-model repeated measures analyses. RESULTS Overall, the intervention was feasible, and patients had a positive impression of the MADES. Patients in the TAU group stayed longer in the hospital than did those in the MADES group (7.9 days ± 2.6 vs 9.2 days ± 3.5; P = .049). Depressive symptoms increased at time of hospital discharge for the TAU group, whereas the MADES group had a decrease in depressive symptoms at the time of discharge. Quality of life and anxiety symptoms improved in both groups at 3 to 4 weeks of follow-up. However, the MADES group had greater improvements than did the TAU group. CONCLUSIONS This study demonstrated that brief, tailored CBT targeting preoperative depression and anxiety is both feasible and acceptable for patients undergoing CABG surgery. Most important, this intervention improved depressive and anxiety symptoms, as well as quality of life. Moreover, it reduced in-hospital length of stay. This study found that a cognitive-behavioral intervention for patients undergoing CABG surgery for symptoms of preoperative depression/anxiety is both feasible and acceptable. Most important, this intervention improved depressive and anxiety symptoms, as well as quality of life. It also reduced in-hospital length of stay.

Rorschach responding in traumatized children and adolescents

At this time there are no published articles which would allow an interpreter to determine if children or adolescents have been traumatized on the basis of responses on the Rorschach. It is important to identify these children when planning counseling interventions and academic programs since information concerning victimization experiences of children is often withheld by parents or guardians. In a preliminary study, ten Rorschach variables were investigated and results show significant differences between the traumatized group and the Exner Comprehensive System normative data for children and adolescents for the following variables: space, texture, W Sum C, D Score, passive movement, X+%, and 3r+2/R. Hypothesized significant differences in active movement, and morbid or aggressive responses were not found.

A Log-Linear Analysis of Variables Associated With Self-Mutilation Behaviors of Women With Histories of Child Sexual Abuse

This study was an exploratory analysis of variables differentiating child sexual abuse (CSA) survivors who self-mutilate from those who do not. Women with histories of CSA (N = 84) were placed into two groups based on the presence or absence of self-mutilating behavior. A log-linear logit analysis was conducted to compare participants on several psychological, demographic, family-of-origin, and abuse-related variables. The model that best fit the data indicated that self-mutilators were more likely to have experienced physical or physiological abuse in their families of origin and have a history of eating disorders and currently were more depressed and dissociated.

Grief and Trauma in Children After the Death of a Sibling

Parent loss is understood as a fundamental loss to a child, but less is known about the consequences of a sibling’s death. The present study explored self-reported grief and trauma among 26 sibling-bereaved children to help inform effective support interventions. Grief and trauma scores were highly correlated in our sample, and there were no definitive differences based upon type of loss. The main limitation was a small sample, but our results provide ecologically valid information rather than data from children recruited for research purposes. Implications for continued data collection and publication from naturalistic settings and meta-analytic recommendations are discussed.

Ego development in women with histories of sexual abuse

As many as a third of the women in this culture experience sexual abuse prior to reaching age 18. Recent literature and research have presented divergent views related to the impact of early abuse on ego development, with arguments supporting both ego fragmentation and ego acceleration. This preliminary study compared the level of ego development, as measured by Loevingers Washington University Sentence Completion Test (SCT), of 30 women with histories of childhood sexual victimization, and 30 women with no history of abuse. Results indicated no significant difference between the ego levels of the sexually abused and nonabused groups, with a slight trend toward higher ego development in the abused group. Factors contributing to these findings are discussed and recommendations for future research are suggested.