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.

Objectives To gain deeper understanding of the long-term lived experiences of adults affected by the 2003 Canberra bushfire, approximately five to six years after the disaster. Method We present an overview of themes that emerged from thematic analysis of transcripts of indepth semi-structured interviews of 25 adults directly affected by the 2003 Canberra bushfire interviewed from April 2008 to March 2009. Coincidentally, six of these participants were interviewed following the 2009 Victorian Bushfires and, where relevant, this is noted. Results The overarching themes that emerged were sensory memory from the day of the fires, emotions, relationships, and other life events. Participants reported an extraordinary sensory experience. They also reported and demonstrated mixed emotions over five years after the incident, such as fear, grief and anger, intertwined with gratitude and a sense of achievement. The disaster experience bonded some relationships, strained others, and often simultaneously supported and caused difficulties in close relationships. In terms of other life events, participants gauged the impact of the fires in relation to other significant personal life events before or after the fire. A few reported a sense of having to face a series of hardships; however, others reported that experiencing other hardships put the bushfires in perspective. Those interviewed following the 2009 Victorian bushfires also presented an interplay between emotions relating to their own experience and their thoughts and feelings relating to the more recent bushfire in Victoria. Conclusions Findings highlighted how the subjective experiences, perceived supportive and unsupportive factors, and meaning-making of people affected by disaster are embedded in the context of their lives in a dynamic and multi-dimensional way.

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Beverley Raphael

Papers

ORIGINAL RESEARCH Disaster experience in the context of life: Perspectives five to six years after the 2003