The psychological impact of quarantine and how to reduce it: rapid review of the evidence.

Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology’s knowledge about how adults cope with loss or trauma has come from individuals who sought treatment or exhibited great distress, loss and trauma theorists have often viewed this type of resilience as either rare or pathological. The author challenges these assumptions by reviewing evidence that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience. M ost people are exposed to at least one violent or life-threatening situation during the course of their lives (Ozer, Best, Lipsey, & Weiss, 2003). As people progress through the life cycle, they are also increasingly confronted with the deaths of close friends and relatives. Not everyone copes with these potentially disturbing events in the same way. Some people experience acute distress from which they are unable to recover. Others suffer less intensely and for a much shorter period of time. Some people seem to recover quickly but then begin to experience unexpected health problems or difficulties concentrating or enjoying life the way they used to. However, large numbers of people manage to endure the temporary upheaval of loss or potentially traumatic events remarkably well, with no apparent disruption in their ability to function at work or in close relationships, and seem to move on to new challenges with apparent ease. This article is devoted to the latter group and to the question of resilience in the face of loss or potentially traumatic events. The importance of protective psychological factors in the prevention of illness is now well established (Taylor, Kemeny, Reed, Bower, & Gruenewald, 2000). Moreover, developmental psychologists have shown that resilience is common among children growing up in disadvantaged conditions (e.g., Masten, 2001). Unfortunately, because most of the psychological knowledge base regarding the ways adults cope with loss or potential trauma has been derived from individuals who have experienced significant psychological problems or sought treatment, theorists working in this area have often underestimated and misunderstood resilience, viewing it either as a pathological state or as something seen only in rare and exceptionally healthy individuals. In this article, I challenge this view by reviewing evidence that resilience in the face of loss or potential trauma represents a distinct trajectory from that of recovery, that resilience is more common than often believed, and that there are multiple and sometimes unexpected pathways to resilience.

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Loss, Trauma, and Human Resilience Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events?

Meta-analyses were conducted on 14 separate risk factors for posttraumatic stress disorder (PTSD), and the moderating effects of various sample and study characteristics, including civilian/military status, were examined. Three categories of risk factor emerged: Factors such as gender, age at trauma, and race that predicted PTSD in some populations but not in others; factors such as education, previous trauma, and general childhood adversity that predicted PTSD more consistently but to a varying extent according to the populations studied and the methods used; and factors such as psychiatric history, reported childhood abuse, and family psychiatric history that had more uniform predictive effects. Individually, the effect size of all the risk factors was modest, but factors operating during or after the trauma, such as trauma severity, lack of social support, and additional life stress, had somewhat stronger effects than pretrauma factors.

Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults.

* Caring for children * The origins of attachment theory * Psychoanalysis as art and science * Psychoanalysis as a natural science * Violence in the family * On knowing what you are not supposed to know and feeling what you are not supposed to feel * The role of attachment in personality development * Attachment, communication, and the therapeutic process * Developmental psychiatry comes of age

A Secure Base. Parent-Child Attachment and Healthy Human Development. New York (Basic Books) 1988.

From social integration to health: Durkheim in the new millennium.

strongly associated with later epilepsy, particularly with complex partial seizures, was a focal febrile convulsion, which seems most likely to reflect a pre-existing focal abnormality. Three practical messages emerge. Parents should be reassured about the generally excellent prognosis of febrile convulsions. Prolonged convulsions should still be prevented,5 and to this end parents may give rectal diazepam, though the working party did not resolve whether this should be done as soon as a convulsion begins or only after five minutes.11 Prophylactic anticonvulsants are rarely needed, and there is no evidence that they have any long term benefit in febrile convulsions. ROGER J ROBINSON Emeritus Professor of Paediatrics, BM7, London WC1H 9JR

https://www.bmj.com/content/bmj/303/6814/1346.full.pdf

Rescuers' psychological responses to disasters

Domestic violence and health professionals.

Mental health promotion has received increasing attention in NSW, as well as nationally and internationally. Strong evidence highlighting the efficacy and effectiveness of programs aimed at promoting mental health and preventing mental health problems and disorders is now available.

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Mental health promotion in NSW: conceptual framework for developing initiatives

The experience of trauma, loss and bereavement during childhood have both immediate and long-term consequences for health and general wellbeing. Children who have experienced the death of a parent or witnessed violent and/or traumatic events report more psychological symptoms than those who have not (Cerel, Fristad, Verducci, Weller, & Weller, 2006; Freeman, Mokros, & Poznanski, 1993). Children's exposure to violence has also been associated with lower IQ scores and poorer reading ability (Delaney-Black et al., 2002). Further, retrospective reports of physical and sexual abuse and maltreatment during childhood have consistently been linked to an increased likelihood of depression (Chapman et al., 2004; Diaz, Simantov, & Rickert, 2002; Molnar, Buka, & Kessler, 2001), suicidality (Mullen, Martin, Anderson, Romans, & Herbison, 1996), low self-esteem (Diaz et al., 2002; Mullen et al., 1996) and alcohol and drug use during adolescence and adulthood (Diaz et al., 2002; Molnar et al., 2001).

Children's Exposure to Parental and Familial Adversities: Findings from a Population Survey of Australians

As medicine increasingly acknowledges and even welcomes the active participation of patients and their families in medical care, it is timely to investigate the attitudes of relatives towards necropsies. Any request for a necropsy is necessarily conducted at a time of greatest grief, distress, and uncertainty; and those deaths where a necropsy is required are often those where the bereavement is sudden or otherwise traumatic, and thus likely to be associated with shock, denial, and dissociation. The relatives' mental state is likely to make the request more difficult to deal with and the ultimate outcome of the loss more problematic.1 Thus, requests may be countered with anger, resentment, or rejection.

Attitudes towards necropsy are shaped by personal and cultural …

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Beverley Raphael

Papers

Rescuers' psychological responses to disasters

Domestic violence and health professionals.

Mental health promotion in NSW: conceptual framework for developing initiatives

Children's Exposure to Parental and Familial Adversities: Findings from a Population Survey of Australians

Requesting necropsies: Greater humanity and awareness of suffering will help doctors and patients alike