Refugee survivors of inter-ethnic warfare vary greatly in the extent and range of their trauma ex... more Refugee survivors of inter-ethnic warfare vary greatly in the extent and range of their trauma experiences. Discerning which experiences are most salient to generating and perpetuating disorders such as posttraumatic stress disorder (PTSD) is critical to the mounting rational strategies for targeted psychosocial interventions. In a sample of Bosnian Muslim refugees (n=126) drawn from a community centre and supplemented by a snowball sampling method, PTSD status and associated disability were measured using the clinician-administered PTSD Scale (CAPS) for DSM-IV. A principal components analysis (PCA) based on a pool of trauma items yielded four coherent trauma dimensions: Human Rights Violations, Threat to Life, Traumatic Loss and Dispossession and Eviction. A cluster analysis identified three subgroupings according to extent of trauma exposure. There were no differences in PTSD risk for the group most exposed to human rights violations (internment in concentration camps, torture) compared to the general war-exposed group. Logistic regression analysis using the dimensions derived from the PCA indicated that Threat to Life alone of the four trauma factors predicted PTSD status, a finding that supports the DSM-IV definition of a trauma. Both Threat to Life and Traumatic Loss contributed to symptom severity and disability associated with PTSD. It may be that human rights violations pose a more general threat to the survivor's future psychosocial adaptation in areas of functioning that extend beyond the confines of PTSD.
Although separation anxiety disorder appears to be common among children exposed to disasters, th... more Although separation anxiety disorder appears to be common among children exposed to disasters, there are no data focusing on the impact of trauma on adult separation anxiety disorder. The present exploratory study examined the relationship of adult separation anxiety disorder with other psychological reactions (posttraumatic stress disorder [PTSD], complicated grief, depression) and dimensions of trauma among 126 war‐affected Bosnian refugees resettled in Australia. Adult separation anxiety disorder was associated with PTSD, but not with complicated grief or depression. Although adult separation anxiety disorder was weakly linked with traumatic losses, this association was nonspecific. Further research is needed to clarify the pathogenic pathways leading to the comorbid PTSD–adult separation anxiety disorder pattern and its clinical implications.
... Page 2. SHAKEH MOMARTIN, DERRICK SILOVE, VIJAYA MANICAVASAGAR, AND ZACHARY STEEL ... bonding ... more ... Page 2. SHAKEH MOMARTIN, DERRICK SILOVE, VIJAYA MANICAVASAGAR, AND ZACHARY STEEL ... bonding system, since separations and losses are often multiple and prolonged; (c) the justice system, since torture and other extreme abuses threaten to divest persons of ...
There is tentative evidence supporting a familial basis for separation anxiety. The present study... more There is tentative evidence supporting a familial basis for separation anxiety. The present study aimed to examine parent-child concordance for that subtype of anxiety. Fifty-four children diagnosed with anxiety disorders and their parents (54 mothers and 29 fathers) were recruited from two juvenile anxiety clinics. Sixty-three percent of children diagnosed with juvenile separation anxiety disorder had at least one parent who suffered from the putative adult variant of the disorder (odds ratio = 11.1) (P < 0.001). Affected parents reported high levels of separation anxiety in their own childhoods. Juvenile separation anxiety disorder in children was not associated with any other parental diagnosis. The small sample size and other potential biases caution against definitive conclusions being drawn, but the present data add to existing evidence that separation anxiety may aggregate in families.
Unauthorized immigrants arriving in Western countries increasingly are being subjected to stringe... more Unauthorized immigrants arriving in Western countries increasingly are being subjected to stringent restrictions while their residency claims are assessed. The present study was a investigation of premigration exposure to organized violence and postmigration stressors in 40 individuals seeking asylum who were attending a community welfare center in Sydney, Australia. Almost 80% reported exposure to premigration trauma such as witnessing murders, having their lives threatened, being separated from family members, and brainwashing; 25% had been tortured. Asylum seekers reported a marked decline in socioeconomic status. Common ongoing sources of severe stress included fears of being repatriated, barriers to work and social services, separation from family, and issues related to the process of pursuing refugee claims. More than one third had problems obtaining health services in Australia--the same number who reported similar difficulties in their home countries. Although based on a selective and culturally heterogeneous sample, the results suggest that salient aspects of the asylum-seeking process may compound the stressors suffered by an already traumatized group.
Australian and New Zealand Journal of Psychiatry, Jul 11, 2016
Australian & New Zealand Journal of Psychiatry, 50(8) abnormalities in AN, all of which are c... more Australian & New Zealand Journal of Psychiatry, 50(8) abnormalities in AN, all of which are consistent with saccadic disinhibition and dysfunction of gamma-aminobutyric acid (GABA) in the superior colliculus (SC). These are as follows: (1) hyperscanning (i.e. increased fixations of shorter duration) during two different tasks of face and body viewing, respectively (Phillipou et al., 2015a, 2015b); (2) shorter prosaccade latencies (Phillipou et al., 2016); (3) increased inhibitory errors on a memory-guided saccade (oculomotor delayed response) task (Phillipou et al., 2016); and (4) increased rate of saccadic intrusions, called square wave jerks, during a fixation task, which in combination with anxiety levels were identified as a potential biomarker of AN (Phillipou et al., 2014b). These findings have encouraged the development of a hypothesis for a novel neurobiological underpinning to AN, and have implicated a brain region and neurotransmitter system in the aetiology of the illness that have been previously overlooked. Although further research is required to gain a better understanding of how these findings relate to AN symptomatology, they do emphasise the need for more high-quality studies aimed at elucidating the role of specific brain regions and neurotransmitter systems in this illness. Utilising tasks known to employ specific neural networks and specialised neuroimaging methods (e.g. magnetic resonance spectroscopy to investigate neurotransmitter levels in different brain regions) is critical for our understanding of the underlying neurobiology of AN, and for the progression of new and more effective therapeutic interventions for this significant mental illness.
Abstract In the process of refining our understanding of separation anxiety disorder (SEPAD) as a... more Abstract In the process of refining our understanding of separation anxiety disorder (SEPAD) as a mental disorder, it is vital to examine the extent to which the category overlaps with other common mental disorders and behavioural patterns. Unravelling the commonalities and interactions with other response patterns in psychiatry may cast new light on the nature of SEPAD both in terms of its aetiology and the boundaries that divide that diagnosis from others. In the process of examining these issues, it is important to keep in mind the complexities that still remain to be clarified regarding the boundary between normative and pathological forms of separation anxiety (SA) and the variation in patterns and course of symptoms. For example, SA is likely to be a normal response amongst women in the vulnerable time of pregnancy and the perinatal period and the upper boundary of what his normative during that phase still requires clarification. Moreover, there are various pathways that SEPAD follow during the course of maturation. Children can manifest SEPAD for a period of time but not experience any further episodes throughout their lives; conversely, in some, SEPAD can be lifelong pattern either as a persisting problem or fluctuating according to exposure to external stressors; and for others, SEPAD may have its first onset in adulthood.
Refugee survivors of inter-ethnic warfare vary greatly in the extent and range of their trauma ex... more Refugee survivors of inter-ethnic warfare vary greatly in the extent and range of their trauma experiences. Discerning which experiences are most salient to generating and perpetuating disorders such as posttraumatic stress disorder (PTSD) is critical to the mounting rational strategies for targeted psychosocial interventions. In a sample of Bosnian Muslim refugees (n=126) drawn from a community centre and supplemented by a snowball sampling method, PTSD status and associated disability were measured using the clinician-administered PTSD Scale (CAPS) for DSM-IV. A principal components analysis (PCA) based on a pool of trauma items yielded four coherent trauma dimensions: Human Rights Violations, Threat to Life, Traumatic Loss and Dispossession and Eviction. A cluster analysis identified three subgroupings according to extent of trauma exposure. There were no differences in PTSD risk for the group most exposed to human rights violations (internment in concentration camps, torture) compared to the general war-exposed group. Logistic regression analysis using the dimensions derived from the PCA indicated that Threat to Life alone of the four trauma factors predicted PTSD status, a finding that supports the DSM-IV definition of a trauma. Both Threat to Life and Traumatic Loss contributed to symptom severity and disability associated with PTSD. It may be that human rights violations pose a more general threat to the survivor's future psychosocial adaptation in areas of functioning that extend beyond the confines of PTSD.
Although separation anxiety disorder appears to be common among children exposed to disasters, th... more Although separation anxiety disorder appears to be common among children exposed to disasters, there are no data focusing on the impact of trauma on adult separation anxiety disorder. The present exploratory study examined the relationship of adult separation anxiety disorder with other psychological reactions (posttraumatic stress disorder [PTSD], complicated grief, depression) and dimensions of trauma among 126 war‐affected Bosnian refugees resettled in Australia. Adult separation anxiety disorder was associated with PTSD, but not with complicated grief or depression. Although adult separation anxiety disorder was weakly linked with traumatic losses, this association was nonspecific. Further research is needed to clarify the pathogenic pathways leading to the comorbid PTSD–adult separation anxiety disorder pattern and its clinical implications.
... Page 2. SHAKEH MOMARTIN, DERRICK SILOVE, VIJAYA MANICAVASAGAR, AND ZACHARY STEEL ... bonding ... more ... Page 2. SHAKEH MOMARTIN, DERRICK SILOVE, VIJAYA MANICAVASAGAR, AND ZACHARY STEEL ... bonding system, since separations and losses are often multiple and prolonged; (c) the justice system, since torture and other extreme abuses threaten to divest persons of ...
There is tentative evidence supporting a familial basis for separation anxiety. The present study... more There is tentative evidence supporting a familial basis for separation anxiety. The present study aimed to examine parent-child concordance for that subtype of anxiety. Fifty-four children diagnosed with anxiety disorders and their parents (54 mothers and 29 fathers) were recruited from two juvenile anxiety clinics. Sixty-three percent of children diagnosed with juvenile separation anxiety disorder had at least one parent who suffered from the putative adult variant of the disorder (odds ratio = 11.1) (P < 0.001). Affected parents reported high levels of separation anxiety in their own childhoods. Juvenile separation anxiety disorder in children was not associated with any other parental diagnosis. The small sample size and other potential biases caution against definitive conclusions being drawn, but the present data add to existing evidence that separation anxiety may aggregate in families.
Unauthorized immigrants arriving in Western countries increasingly are being subjected to stringe... more Unauthorized immigrants arriving in Western countries increasingly are being subjected to stringent restrictions while their residency claims are assessed. The present study was a investigation of premigration exposure to organized violence and postmigration stressors in 40 individuals seeking asylum who were attending a community welfare center in Sydney, Australia. Almost 80% reported exposure to premigration trauma such as witnessing murders, having their lives threatened, being separated from family members, and brainwashing; 25% had been tortured. Asylum seekers reported a marked decline in socioeconomic status. Common ongoing sources of severe stress included fears of being repatriated, barriers to work and social services, separation from family, and issues related to the process of pursuing refugee claims. More than one third had problems obtaining health services in Australia--the same number who reported similar difficulties in their home countries. Although based on a selective and culturally heterogeneous sample, the results suggest that salient aspects of the asylum-seeking process may compound the stressors suffered by an already traumatized group.
Australian and New Zealand Journal of Psychiatry, Jul 11, 2016
Australian & New Zealand Journal of Psychiatry, 50(8) abnormalities in AN, all of which are c... more Australian & New Zealand Journal of Psychiatry, 50(8) abnormalities in AN, all of which are consistent with saccadic disinhibition and dysfunction of gamma-aminobutyric acid (GABA) in the superior colliculus (SC). These are as follows: (1) hyperscanning (i.e. increased fixations of shorter duration) during two different tasks of face and body viewing, respectively (Phillipou et al., 2015a, 2015b); (2) shorter prosaccade latencies (Phillipou et al., 2016); (3) increased inhibitory errors on a memory-guided saccade (oculomotor delayed response) task (Phillipou et al., 2016); and (4) increased rate of saccadic intrusions, called square wave jerks, during a fixation task, which in combination with anxiety levels were identified as a potential biomarker of AN (Phillipou et al., 2014b). These findings have encouraged the development of a hypothesis for a novel neurobiological underpinning to AN, and have implicated a brain region and neurotransmitter system in the aetiology of the illness that have been previously overlooked. Although further research is required to gain a better understanding of how these findings relate to AN symptomatology, they do emphasise the need for more high-quality studies aimed at elucidating the role of specific brain regions and neurotransmitter systems in this illness. Utilising tasks known to employ specific neural networks and specialised neuroimaging methods (e.g. magnetic resonance spectroscopy to investigate neurotransmitter levels in different brain regions) is critical for our understanding of the underlying neurobiology of AN, and for the progression of new and more effective therapeutic interventions for this significant mental illness.
Abstract In the process of refining our understanding of separation anxiety disorder (SEPAD) as a... more Abstract In the process of refining our understanding of separation anxiety disorder (SEPAD) as a mental disorder, it is vital to examine the extent to which the category overlaps with other common mental disorders and behavioural patterns. Unravelling the commonalities and interactions with other response patterns in psychiatry may cast new light on the nature of SEPAD both in terms of its aetiology and the boundaries that divide that diagnosis from others. In the process of examining these issues, it is important to keep in mind the complexities that still remain to be clarified regarding the boundary between normative and pathological forms of separation anxiety (SA) and the variation in patterns and course of symptoms. For example, SA is likely to be a normal response amongst women in the vulnerable time of pregnancy and the perinatal period and the upper boundary of what his normative during that phase still requires clarification. Moreover, there are various pathways that SEPAD follow during the course of maturation. Children can manifest SEPAD for a period of time but not experience any further episodes throughout their lives; conversely, in some, SEPAD can be lifelong pattern either as a persisting problem or fluctuating according to exposure to external stressors; and for others, SEPAD may have its first onset in adulthood.
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