"An estimated 80 percent of individuals living in the United States have experienced at least one traumatic event during their lifetime, with nearly one in eight developing symptoms of Posttraumatic Stress Disorder (PTSD) as a result (Breslau & Kessler, 2001). Prevalence rates, however, are higher among females, particularly female survivors of interpersonal trauma (Kessler, 2000; Olff, Langeland, Draijer, & Gersons, 2007; Tolin & Foa, 2006). Of the numerous factors that influence PTSD, social support has been identified as one of the foremost predictors of both symptom severity and duration (Brewin, Andrews, & Valentine, 2000; Ozer, Best, Lipsey, & Weiss, 2003). However, research routinely assesses social support based solely on subjective measures of perceived support and has yet to elucidate whether individuals with PTSD have the neurophysiological capacity to accurately perceive and maintain available support networks. /DISS_para Following trauma, the compromised ability of the prefrontal cortex to optimally regulate affective processing centers of the brain, accompanied by the dysregulation of an individual's autonomic nervous system, underlie the hyperarousal and affective numbing characteristic of PTSD (Garfinkel & Liberzon, 2009; Glover, 1992; Ogden, Minton, & Pain, 2006; Porges, 2011; Siegel, 1995; van der Kolk, 2006). Further still, such dysregulated neurological functioning occurs in tandem with a maladaptive cascade of regulatory hormones known to influence social functioning as well as empathy (Hurlemann et al., 2010; Porges, 2003; Seng, 2010; Steuwe et al., 2012). In this way, neurophysiological corollaries of trauma may inhibit an individual's ability to both experience and express empathy, preventing survivors from recognizing and drawing upon the viable social support available to them (Nietlisbach & Maercker, 2009). As such, the present study explored the relationship between PTSD symptom severity, emotional numbing, empathy, and perceived social support in female survivors of interpersonal trauma. Findings revealed that the difficulties in empathy experienced among survivors were directly related to PTSD symptom severity. However, such impairments appeared to be dictated by the survivor's degree of emotional numbing rather than the severity of the PTSD symptoms specifically. Emotional numbing, and difficulty perceiving or expressing positive emotions in particular, was found to also predict perceptions of social support. Furthermore, although empathy exhibited a direct relationship with perceived support, impairments in empathy did not mediate the relationship between positive emotional numbing and perceptions of the social support availability and valence as originally hypothesized. However, the severity of a survivor's comorbid depression appeared to confound nearly all of the relationships between the study variables. Nevertheless, emotional numbing, a condition common to both depression and PTSD, continued to show a strong relationship with empathy even when accounting for depression. DISS_para Such insights have marked implications on the way counselors understand and work with female survivors of interpersonal trauma and suggest that experiences of emotional numbing and comorbid depression should be central foci in early therapeutic interventions. Interventions aimed at regulating the autonomic nervous system have shown success in alleviating both emotional numbing and struggles with depression and may be appropriate in this regard. The need to assess for and work with symptoms of emotional numbing and depression early in therapy may serve to enhance empathic capacity in survivors, facilitate the development of a strong therapeutic relationship and cultivate the interpersonal resources necessary for lasting change and healing to occur. Future research will serve to expand the many potential advantages that such findings can have on better conceptualizing the influence of interpersonal trauma on a survivor's ability to experience and express empathy and a full range of emotional experiences and benefit from the positive social support that exists around her."--Abstract from author supplied metadata.

The experience of intimate partner violence (IPV) is a type of trauma that can greatly affect health and social functioning. Posttraumatic stress disorder (PTSD) and depression are the two most common mental health problems that develop following IPV. IPV is also commonly associated with negative self-based emotions (shame and guilt) and lower levels of perceived social support. Few empirical studies have examined the unique impact that negative self-based emotions have on the maintenance of PTSD and depression, and the role that social support may have on these associations following IPV. This report will address the gaps in the current research and examine how social support may intervene in the association between negative self-based emotional states and mental health functioning. The present study included 152 help-seeking female IPV survivors. Results indicated that shame and guilt were significantly associated with both PTSD and depression. As well, shame and guilt were negatively associated with social support. There was a significant indirect associated noted between shame and guilt via social support such that higher perceptions of social support were associated with lower levels of shame and depression. No other significant indirect associations emerged. These results suggest that negative self-based emotions may contribute to mental health problems after IPV. Future interventions for IPV survivors should make an effort to address negative self-based emotions for women experiencing symptoms of both depression and PTSD. Additionally, interventions geared at increasing perceptions of social support may also help in alleviating post-trauma depression. Results are discussed in light of these findings. .

This practical guide presents the cutting-edge work of the Trauma Center’s yoga therapy program, teaching all therapists how to incorporate it into their practices. When treating a client who has suffered from interpersonal trauma—whether chronic childhood abuse or domestic violence, for example—talk therapy isn’t always the most effective course. For these individuals, the trauma and its effects are so entrenched, so complex, that reducing their experience to a set of symptoms or suggesting a change in cognitive frame or behavioral pattern ignores a very basic but critical player: the body. In cases of complex trauma, mental health professionals largely agree that the body itself contains and manifests much of the suffering—self hatred, shame, and fear. Take, for example, a woman who experienced years of childhood sexual abuse and, though very successful in her professional life, has periods of not being able to feel her limbs, sensing an overall disconnection from her very physical being. Reorienting clients to their bodies and building their “body sense” can be the very key to unlocking their pain and building a path toward healing. Based on research studies conducted at the renowned Trauma Center in Brookline, Massachusetts, this book presents the successful intervention known as Trauma-Sensitive Yoga (TSY), an evidence-based program for traumatized clients that helps them to reconnect to their bodies in a safe, deliberate way. Synthesized here and presented in a concise, reader-friendly format, all clinicians, regardless of their background or familiarity with yoga, can understand and use these simple techniques as a way to help their clients achieve deeper, more lasting recovery. Unlike traditional, mat-based yoga, TSY can be practiced without one, in a therapist’s chair or on a couch. Emphasis is always placed on the internal experience of the client him- or herself, not on achieving the proper form or pleasing the therapist. As Emerson carefully explains, the therapist guides the client to become accustomed to feeling something in the body—feet on the ground or a muscle contracting—in the present moment, choosing what to do about it in real time, and taking effective action. In this way, everything about the practice is optional, safe, and gentle, geared to helping clients to befriend their bodies. With over 30 photographs depicting the suggested yoga forms and a final chapter that presents a portfolio of step-by-step yoga practices to use with your clients, this practical book makes yoga therapy for trauma survivors accessible to all clinicians. As an adjunct to your current treatment approach or a much-needed tool to break through to your traumatized clients, Trauma-Sensitive Yoga in Therapy will empower you and your clients on the path to healing.

Three-time recipient of the AJN Book of the Year Award! Praise for the third edition: “This is an outstanding edition of this book. It has great relevance for learning about, developing, and using middle range theories. It is very user friendly, yet scholarly." Score: 90, 4 Stars -Doody's Medical Reviews The fourth edition of this invaluable publication on middle range theory in nursing reflects the most current theoretical advances in the field. With two additional chapters, new content incorporates exemplars that bridge middle range theory to advanced nursing practice and research. Additional content for DNP and PhD programs includes two new theories: Bureaucratic Caring and Self-Care of Chronic Illness. This user-friendly text stresses how theory informs practice and research in the everyday world of nursing. Divided into four sections, content sets the stage for understanding middle range theory by elaborating on disciplinary perspectives, an organizing framework, and evaluation of the theory. Middle Range Theory for Nursing, Fourth Edition presents a broad spectrum of 13 middle range theories. Each theory is broken down into its purpose, development, and conceptual underpinnings, and includes a model demonstrating the relationships among the concepts, and the use of the theory in research and practice. In addition, concept building for research through the lens of middle range theory is presented as a rigorous 10-phase process that moves from a practice story to a conceptual foundation. Exemplars are presented clarifying both the concept building process and the use of conceptual structures in research design. This new edition remains an essential text for advanced practice, theory, and research courses. New to the Fourth Edition: Reflects new theoretical advances Two completely new chapters New content for DNP and PhD programs Two new theories: Bureaucratic Caring and Self-Care of Chronic Illness Two articles from Advances in Nursing Science documenting a historical meta-perspective on middle range theory development Key Features: Provides a strong contextual foundation for understanding middle range theory Introduces the Ladder of Abstraction to clarify the range of nursing’s theoretical foundation Presents 13 middle range theories with philosophical, conceptual, and empirical dimensions of each theory Includes Appendix summarizing middle range theories from 1988 to 2016

Pain is the most common symptom bringing a patient to a physician's attention. Physicians training in pain medicine may originate from different disciplines and approach the field with varying backgrounds and experience. This book captures the theory and evidence-based practice of behavioral, psychotherapeutic and psychopharmacological treatments in modern pain medicine. The book's contributors span the fields of psychiatry, psychology, anesthesia, neurology, physical medicine and rehabilitation, and nursing. Thus the structure and content of the book convey the interdisciplinary approach that is the current standard for the successful practice of pain management. The book is designed to be used as a text for training fellowships in pain medicine, as well as graduate courses in psychology, nursing, and other health professions.

In this pathbreaking book, a well-known feminist and sociologist--who is also the Founding Editor of Gender & Society--challenges our most basic assumptions about gender. Judith Lorber views gender as wholly a product of socialization subject to human agency, organization, and interpretation. In her new paradigm, gender is an institution comparable to the economy, the family, and religion in its significance and consequences. Drawing on many schools of feminist scholarship and on research from anthropology, history, sociology, social psychology, sociolinguistics, and cultural studies, Lorber explores different paradoxes of gender: --why we speak of only two "opposite sexes" when there is such a variety of sexual behaviors and relationships; --why transvestites, transsexuals, and hermaphrodites do not affect the conceptualization of two genders and two sexes in Western societies; --why most of our cultural images of women are the way men see them and not the way women see themselves; --why all women in modern society are expected to have children and be the primary caretaker; --why domestic work is almost always the sole responsibility of wives, even when they earn more than half the family income; --why there are so few women in positions of authority, when women can be found in substantial numbers in many occupations and professions; --why women have not benefited from major social revolutions. Lorber argues that the whole point of the gender system today is to maintain structured gender inequality--to produce a subordinate class (women) that can be exploited as workers, sexual partners, childbearers, and emotional nurturers. Calling into question the inevitability and necessity of gender, she envisions a society structured for equality, where no gender, racial ethnic, or social class group is allowed to monopolize economic, educational, and cultural resources or the positions of power.