Olof Semb

Distress after a single violent crime: how shame-proneness and event-related shame work together as risk factors for post-victimization symptoms.

To increase understanding of post-victimization symptom development, the present study investigated the role of shame- and guilt-proneness and event-related shame and guilt as potential risk factors. 35 individuals (M age = 31.7 yr.; 48.5% women), recently victimized by a single event of severe violent crime, were assessed regarding shame- and guilt-proneness, event-related shame and guilt, and post-victimization symptoms. The mediating role of event-related shame was investigated with structural equation modeling (SEM), using bootstrapping. The guilt measures were unrelated to each other and to post-victimization symptoms. The shame measures were highly intercorrelated and were both positively correlated to more severe post-victimization symptom levels. Event-related shame as mediator between shame-proneness and post-victimization symptoms was demonstrated by prevalent significant indirect effects. Both shame measures are potent risk factors for distress after victimization, whereby part of the effect of shame-proneness on post-victimization symptoms is explained by event-related shame.

Trauma-related Symptoms after Violent Crime: The Role of Risk Factors before, during and Eight Months after Victimization

The aim of this study was to explore the prevalence of current suffering and the role of peritraumatic emotions and other risk factors for development of post-traumatic and general symptoms eight m ...

Therapeutic decisions in ALS patients: cross-cultural differences and clinical implications

ObjectiveQuantitative analysis of decision-making on therapeutic options in different sociocultural context in amyotrophic lateral sclerosis (ALS).MethodsALS patients (n = 244) were consecutively recruited in Germany (n = 83), Poland (n = 83), and Sweden (n = 78) in a prospective cross-cultural study (www.NEEDSinALS.com). They were interviewed on preferences for therapeutic techniques including invasive (IV) and non-invasive ventilation (NIV), as well as percutaneous endoscopic gastrostomy (PEG) and on hypothetical termination of these using quantitative questions. Using standardized questionnaires, religiousness, personal values, quality of life, and depressiveness were assessed.ResultsNIV was most frequently used in Germany and PEG in Sweden. Swedish patients were most liberal on initiation and termination of PEG, NIV and IV. Polish patients were mostly undecided and were least likely to consider discontinuing supportive management. Current use was partly associated with age, gender and state of physical function; also, financial support explained some variance. Future preferences on therapeutic options from the patient’s perspective were also closely associated with cultural factors. The more oriented towards traditional and conservative values, the less likely patients were to decide for invasive therapeutic devices (IV, PEG), the least likely to have ideations to discontinue any device and the more likely to have an undecided attitude.ConclusionsCurrent use of therapeutic options is determined by medical condition in analogy to clinical guidelines. For future considerations, other factors such as cultural background are crucial, yielding hurdles to be regarded in the implementation of advanced directives in a multicultural environment.

Learning psychology as a challenging process towards development as well as "studies as usual": a thematic analysis of medical students' reflective writing.

Reflective writing in medical training has been shown to be most effective when combined with some form of personal meeting or dialog. During a course in medical psychology for medical students, reflective texts were followed up by an individual personal talk with a teacher from the course. Thematic analysis of the texts revealed four separate sub-themes: 1) the course has enabled me and the class to develop, which is good albeit arduous; 2) understanding myself is a resource in understanding people as well as knowing psychology; 3) the course provided me with new, purely intellectual skills as well as eye-openers; and 4) the receiving teacher is an integral part of my reflective writing. The main theme, capturing the students’ writing process, concluded that students perceive the course as “Learning psychology as a challenging process towards development” as well as “studies as usual”. Ethical, psychological, and pedagogical aspects are discussed in the paper.

Treatment Acceptability among Crime Victims

Crime victims receive relevant treatment too seldom and there is uncertainty as to whether those who need the treatment the most are among those who get it. Fifty-two consecutive adult crime victims were offered 10 sessions of psychotherapy within two weeks after an experienced trauma of criminal victimization. Twenty-six accepted and 26 declined the offer. The aim of the study was to explore some of the differences between these two groups. The results show that the therapy group presented a higher incidence of acute stress disorder, more negative scorings regarding immediate reactions (to the crime), more subjective ratings of physical and psychological health (GAF, according to DSM IV), and more psychiatric and trauma-related symptoms as compared to the non-therapy group. A conclusion was that those who needed treatment the most also accepted it. Traumatized people may, due to avoidant strategies, withdraw from potential treatment. Conversely, the therapy group scored higher on the coping style escape-avoidance.