A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an african refugee settlement.

Abstract: Abstract Objective This study investigates the impact of childhood maltreatment on treatment outcomes among male ex-combatants in a randomized controlled trial (RCT) of Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET), a specialized psychotherapy used to treat trauma sequelae including symptoms of posttraumatic stress disorder (PTSD), compared with treatment as usual (TAU). Specifically, we aim to compare former child and adult male soldiers who experienced childhood sexual abuse (CSA) with those who did not. Methods We conducted a sub-analysis of data from Koebach et al. [J Consult Clin Psychol. 2021], focusing on a sample of male former soldiers in the eastern Democratic Republic of Congo (DRC). Participants were categorized into two groups based on their history of CSA. Outcome measures included the prevalence of lifetime sexual assaults, perpetration of sexual violence against others, appetitive aggression, current violent behavior, symptoms of PTSD and depression and responses to two treatment modalities: TAU and FORNET. Results The group with a history of CSA had significantly higher rates of re-experiencing sexually assaults, especially by superiors, and of perpetrating sexual assaults against others. In addition, this group presented elevated baseline scores in all outcomes (appetitive aggression, current violent behavior, symptoms of PTSD and depression). Regarding effectiveness of treatment arms, the FORNET group demonstrated significantly greater reductions in appetitive aggression levels, PTSD symptoms and depressive symptoms compared to the TAU group, with no difference in treatment effectiveness between participants with and without a history of CSA. However, individuals with CSA showed statistically superior improvements in current violent behavior, with similar score levels to those without CSA after 6–9 months. Conclusion CSA among former soldiers was significantly associated with a higher prevalence of PTSD and increased risk of both sexual revictimization and the perpetration of sexual and other violent acts. FORNET demonstrates effectiveness in reducing appetitive aggression, PTSD symptoms, and violent behavior even in the subgroup highly affected by CSA - showing an even greater impact on current violent behavior. The ability of NET to address trauma and perpetration in a chronological sequence and adapt to the specific challenges of CSA likely account for its effectiveness in treating this complexly traumatized population, ultimately contributing to a reduction of violence in post-conflict communities. Special attention should be paid to revictimization during the rehabilitation process of ex-combatants.

TL;DR: In this article , the authors investigate barriers to healthcare system access faced by Yazidi refugees in the Midwestern United States, and interpret their findings through a social-ecological lens.

TL;DR: In this paper , the authors present evidence on the efficacy of psychosocial interventions aiming to promote mental health and/or to prevent mental symptoms by fostering transdiagnostic skills in forcibly displaced persons of all ages.

TL;DR: This review highlights the epidemiology, classification, pain sequelae, and clinical treatment guidelines of torture victims and the role of pharmacologic and psychologic interventions is explored in the context of rehabilitation.

Abstract: 1. The integrated wholeness of the organism must be one of the foundation stones of motivation theory. 2. The hunger drive (or any other physiological drive) was rejected as a centering point or model for a definitive theory of motivation. Any drive that is somatically based and localizable was shown to be atypical rather than typical in human motivation. 3. Such a theory should stress and center itself upon ultimate or basic goals rather than partial or superficial ones, upon ends rather than means to these ends. Such a stress would imply a more central place for unconscious than for conscious motivations. 4. There are usually available various cultural paths to the same goal. Therefore conscious, specific, local-cultural desires are not as fundamental in motivation theory as the more basic, unconscious goals. 5. Any motivated behavior, either preparatory or consummatory, must be understood to be a channel through which many basic needs may be simultaneously expressed or satisfied. Typically an act has more than one motivation. 6. Practically all organismic states are to be understood as motivated and as motivating. 7. Human needs arrange themselves in hierarchies of prepotency. That is to say, the appearance of one need usually rests on the prior satisfaction of another, more pre-potent need. Man is a perpetually wanting animal. Also no need or drive can be treated as if it were isolated or discrete; every drive is related to the state of satisfaction or dissatisfaction of other drives. 8. Lists of drives will get us nowhere for various theoretical and practical reasons. Furthermore any classification of motivations

TL;DR: Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions.

TL;DR: A cognitive model of persistence of PTSD is proposed that is consistent with the main clinical features of PTSD, helps explain several apparently puzzling phenomena and provides a framework for treatment by identifying three key targets for change.