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Background: Women with female genital mutilation/cutting are known to have psychological sequelae from the cutting and other traumatic experiences. However, very few studies report immediate psychological sequelae of genital reconstructive surgery in this population. The present case is the first to our knowledge to report post-traumatic stress disorder symptoms immediately following defibulation, a procedure common in women with female genital mutilation/cutting type III., Case Presentation: We present the case of a 31-year-old Sudanese nulliparous woman in the second trimester of pregnancy with female genital mutilation/cutting type IIIa who was referred for antepartum defibulation to facilitate a vaginal birth. Immediately after an uncomplicated surgery under local anesthesia and just before the first micturition, she developed post-traumatic stress disorder symptoms and suddenly recalled the traumatic experience of her first micturition after female genital mutilation/cutting when she was a child in Sudan. The woman was offered psychiatric follow-up with psychotherapy for 4 months and a short course of benzodiazepines. She had fully recovered by the time of delivery, 4 months after surgery., Conclusions: We discuss the possibility of recall of a past traumatic experience of female genital mutilation/cutting during defibulation or other genital surgeries. We review the benefits and risks of defibulation, the impact of this procedure, and the setting and timing in which it is performed, focusing on women's mental health and psychological support., (© 2022. The Author(s).)

Background: The effect of dissociation and parenting style on the relationship between psychological trauma and psychotic symptoms has not previously been investigated., Objective: The aim of this study was to develop a moderated mediation model to assess whether the association between psychological trauma and psychotic symptoms is mediated by dissociation and moderated by parental maltreatment., Methods: Inpatients with major depressive disorder (MDD) and bipolar depression (BP) were recruited. Self-reported and clinical rating scales were used to measure the level of dissociation, psychotic symptoms, history of psychological trauma and parental maltreatment. The PROCESS macro in SPSS was used to estimate path coefficients and adequacy of the moderated mediation model. High betrayal trauma (HBT), low betrayal trauma (LBT), paternal maltreatment, and maternal maltreatment were alternatively entered into the conceptual model to test the adequacy., Results: A total of 91 patients (59 with MDD and 32 with BP) were recruited, with a mean age of 40.59 ± 7.5 years. After testing with different variables, the moderated mediation model showed that the association between LBT and psychotic symptoms was mediated by dissociation and moderated by maternal maltreatment. A higher level of maternal maltreatment enhanced the effect of LBT on dissociation., Conclusions: Healthcare workers should be aware of the risk of developing psychotic symptoms among depressive patients with a history of LBT and maternal maltreatment., Competing Interests: The authors declare that they do not have any conflict of interest with respect to this research study and paper., (© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Shifts in migration and border control policies may increase the likelihood of trauma exposure related to child-parent separation and result in costs to the health system and society. In the present study, we estimated direct and indirect costs per child as well as overall cohort costs of border control policies on migrant children and adolescents who were separated from their parents, detained, and placed in the custody of the United States following the implementation of the 2018 Zero Tolerance Policy. Economic modeling techniques, including a Markov process and Monte Carlo simulation, based on data from the National Child Traumatic Stress Network's Core Data Set (N = 458 migrant youth) and published studies were used to estimate economic costs associated with three immigration policies: No Detention, Family Detention, and Zero Tolerance. Clinical evaluation data on mental health symptoms and disorders were used to estimate the initial health state and risks associated with additional trauma exposure for each scenario. The total direct and indirect costs per child were conservatively estimated at $33,008, $33,790, and $34,544 after 5 years for No Detention, Family Detention, and Zero Tolerance, respectively. From a health system perspective, annual estimated spending increases ranged from $1.5 million to $14.9 million for Family Detention and $2.8 million to $29.3 million for Zero Tolerance compared to baseline spending under the No Detention scenario. Border control policies that increase the likelihood of child and adolescent trauma exposure are not only morally troubling but may also create additional economic concerns in the form of direct health care costs and indirect societal costs., (© 2020 The Authors. Journal of Traumatic Stress published by Wiley Periodicals LLC on behalf of International Society for Traumatic Stress Studies.)

India enforced one of the world's largest lockdowns in the last quarter of March 2020 to minimize the impact of the COVID-19 pandemic. This commentary focuses on the mental health implications of the ongoing pandemic as well as the lockdown that lasted for more than two months and is still in place in certain areas. Whereas loneliness, stress, anxiety, and depression have been widespread, vulnerable sections of the population, including daily wage workers, migrant laborers, religious minorities, women and children, and the elderly, have been facing various forms of economic, sociopolitical, and familial stigma, racism, and violence. By and large, the COVID-19 pandemic has widened all forms of societal disparities in India. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Adverse childhood experiences, which is defined by different forms of abuse, neglect, and household dysfunction occurring before the age of 18 years, is a major public health problem in the United States that has the potential to worsen in the current COVID-19 pandemic. Moreover, the challenge is even greater for children and youth from low-income communities and communities of color. Thus, there is a greater need for investments in youth-serving systems within and beyond health care and public health to effectively address adverse childhood experiences and prevent its short- and long-term negative health and social sequelae well beyond the current public health crisis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The novel coronavirus (SARS-CoV-2) and the associated disease it causes, COVID-19, have caused unprecedented social disruption. Due to sweeping stay-at-home orders across the United States and internationally, many victims and survivors of domestic violence (DV), now forced to be isolated with their abusers, run the risk of new or escalating violence. Numerous advocates, organizations, and service centers anticipated this: Upticks in domestic violence were reported in many regions soon after stay-at-home directives were announced. In this commentary, we delineate some of the recent events leading up to the reported spike in DV; review literature on previously documented disaster-related DV surges; and discuss some of the unique challenges, dilemmas, and risks victims and survivors face during this pandemic. We conclude with recommendations to allocate resources to DV front-liners and utilize existing DV guidelines for disaster preparedness, response, and recovery. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The present article assesses the effects of shattered social identity and moral injuries experienced by health care professionals (HCPs) due to the COVID-19 pandemic. Professional expertise and emotional-cognitive demands as key aspects of HCPs' social identity are introduced, and the effects of moral injuries-in terms of violation of medical-ethical and social-ethical norms-on the mental health of HCPs are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The ubiquitous exposure to COVID-19 argues for governments to use a trauma-informed response as a universal precaution, with the goal of promoting the recovery and resilience of their residents. How a system defines trauma will drive its administrative policies, research, and clinical services. The Substance Abuse and Mental Health Services Administration's Concept of Trauma and Guidance for a Trauma-Informed Approach offers governments a framework to define trauma and incorporate trauma-informed principles and tasks into their COVID-19 responses. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The current COVID-19 pandemic places maternity staff at risk of engaging in clinical practice that may be in direct contravention with evidence; professional recommendations; or, more profoundly, deeply held ethical or moral beliefs and values, as services attempt to control the risk of cross-infection. Practice changes in some settings include reduction in personal contacts for tests, treatments and antenatal and postnatal care, exclusion of birth partners for labor and birth, separation of mother and baby in the immediate postnatal period, restrictions on breastfeeding, and reduced capacity for hands-on professional labor support through social distancing and use of personal protective equipment. These enforced changes may result in increasing levels of occupational moral injury that need to be addressed at both an organizational and a personal level. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The COVID-19 pandemic has changed the way doctors approach palliative and end-of-life care, which has undoubtedly affected the mental health of patients, families, and health care professionals. Given these circumstances, doctors working on the front line are vulnerable to moral injury and compassion fatigue. This is a reflection of 2 junior doctors experiencing firsthand demands of caring for patients during the outbreak. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Religious leaders are at risk of psychological trauma and moral injury during the COVID-19 pandemic. This article highlights potentially traumatic or morally injurious experiences for religious leaders and provides evidence-based recommendations for mitigating their impact. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The COVID-19 pandemic is placing enormous stress on U.S. health care workers. Prior studies of infectious disease outbreaks and other catastrophic events have shown the damaging mental health impacts caused by these events. Implications for the policy and treatment of health care workers facing the COVID-19 crisis are discussed in this commentary. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The infection of the novel coronavirus that originated from Wuhan, China in December 2019 converted rapidly into a pandemic by March 11, 2020. Whereas the infection mortality rate is not completely understood, it seems to be significantly beyond that of other recent pandemics (e.g., H1N1 pandemic). This paper discusses moral injury in the context of disaster and epidemic and how easily the moral psychology of individuals and society can be shaken. Moral injury is a multiscientific concept involving psychology, culture, and religion. Amid the outbreak of the novel coronavirus pneumonia, immoral behaviors and events such as violence, injury, and illness have also caused different degrees of impact on the moral standards of individuals, confusing moral cognition, destroying moral emotion, and weakening moral toughness, resulting in varying degrees of moral injury. If there is no national health, there will be no positive society for all. Based on this, the public needs to pay close attention to the moral health of the whole people and effectively avoid the occurrence of moral injury. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Although little is known about moral injury in nonmilitary populations, the COVID-19 pandemic has made it clear that moral injury's relevance extends beyond the battlefield. Health care providers are experiencing potentially morally injurious events that may violate their moral code or values, yet almost no research has been conducted on moral injury among health care providers to date. The purpose of this commentary is to describe the relevance of moral injury to health care providers and to spark a dialogue that motivates future research, prevention, and intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The COVID-19 pandemic is projected to cause an economic shock larger than the global financial crisis of 2007-2008 and a recession as great as anything seen since the Great Depression in 1930s. The social and economic consequences of lockdowns and social distancing measures, such as unemployment, broken relationships and homelessness, create potential for intergenerational trauma extending decades into the future. In this article, we argue that, in the absence of a vaccine, governments need to introduce universal basic income as a means of mitigating this trauma. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The physical and social isolation measures associated with the 2019 novel coronavirus (COVID-19) outbreak, although certainly necessary to contain the spread of the virus, represent a particularly distressing aspect that might accentuate the fears and pain associated with the disease, especially for patients, their family members, and health-care professionals. Affiliative responses to the crises are emerging as ad hoc or formally endorsed practices within COVID-19 facilities in Italy, aimed at establishing links of communication between patients and family members by using new communication technologies. Tending to the emotional needs of patients and mending the affiliative connections interrupted by the disease are good examples of interdisciplinary cohesion and affiliative responses to the COVID-19 emergency. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

During the COVID-19, psychotherapists are often exposed to traumatic material in their sessions, potentially leading to vicarious traumatization. We surveyed 339 therapists about their professional practices and experiences during the pandemic. Results showed that on average therapists experienced moderate levels of vicarious trauma, whereas about 15% experienced high levels of vicarious trauma. A higher level of vicarious trauma was associated with younger age, less clinical experience, and negative online treatment experiences. The results imply a need for personal and professional support for therapists working remotely amid a global health crisis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

During the unprecedented COVID-19 pandemic, people around the world have faced a myriad of heart-rending and ethically difficult scenarios (e.g., not being able to tend to a sick or dying loved one) that may lead to subsequent guilt, shame, or moral injury. Trauma-informed guilt reduction therapy is a brief intervention that helps clients accurately appraise their role in a stressful event (such as those experienced during the COVID-19 pandemic) and find positive ways to express important values going forward. Future studies of trauma-informed guilt reduction therapy with those affected by COVID-19 will be helpful for clarifying its effectiveness with this population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

As the COVID-19 pandemic wears on, its psychological, emotional, and existential toll continues to grow and indeed may now rival the physical suffering caused by the illness. Patients, caregivers, and health-care workers are particularly at risk for trauma responses and would be well served by trauma-informed care practices to minimize both immediate and long-term psychological distress. Given the significant overlap between the core tenets of trauma-informed care and accepted guidelines for the provision of quality palliative care (PC), PC teams are particularly well poised to both incorporate such practices into routine care and to argue for their integration across health systems. We outline this intersection to highlight the uniquely powerful role PC teams can play to reduce the long-term psychological impact of the COVID-19 pandemic., (Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

This commentary article provides observations on the psychosocial consequences of the coronavirus disease 2019 (COVID-19) among people in China and articulates a population health perspective to understand and address identified issues. We highlight key psychosocial effects of COVID-19, such as anxiety, insomnia, and trauma response, in the context of salient factors that shape Chinese people's psychological experiences, including the availability of Internet and technology, large-scale quarantine, economic impact, and the rise of xenophobia globally. Further, from a population health perspective, we make recommendations in COVID-19-related research and interventions that aim to promote the psychosocial health of Chinese people. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

In the wake of the 2019 novel coronavirus (COVID-19) pandemic and the psychological consequences that will follow, it is critical to acknowledge and understand the unique vulnerabilities of lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) populations in order to provide equitable mental health intervention that reaches these highly at-risk groups. It is well established that LGBTQ persons face social disadvantages and mental health disparities, which may be exacerbated as a result of COVID-19 pandemic trauma and social isolation measures. This commentary highlights structural, social, and individual-level challenges among LGBTQ populations in the context of COVID-19 and proposes prevention recommendations to mitigate the psychological ramifications of COVID-19 pandemic-related trauma among LGBTQ persons. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

As of May 20, 2020, the COVID-19 death toll in Japan was 771. The 2020 Tokyo Olympics/Paralympics had to be postponed to 2021 because of the pandemic. Not only the infected patients but also health care workers have been affected from adverse societal dynamics because of COVID-19, such as discrimination and stigmatization. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The COVID-19 crisis can be defined as a collective trauma, which contributes to an upheaval of community connection and functioning. The current pandemic has also illuminated disparities in mental health supports. In this commentary, we highlight one community organization, located in metro Detroit, that has responded to the trauma by bolstering resources and supports for residents, many of whom are ethnoracial minorities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

We measured maladaptive daydreaming (MD) and psychosocial indices among 194 participants, aged 18-56  years: 99 female survivors of childhood sexual abuse (CSA) and 95 control respondents with no reported history of sexual abuse. Our data show that survivors of CSA scored higher on MD compared to controls. Survivors of CSA with probable MD scored higher on psychological distress, social phobia, and social isolation compared to survivors of CSA without suspected MD, implying that MD might exacerbate the psychosocial problems linked with CSA. MD psychological screening of female survivors of CSA and the development of a treatment module for MD could improve the quality of clinical services provided to survivors.

Background: Sri Lanka is a South-Asian nation with a multi-ethnic population. A 26-year-old armed conflict ended in 2009 and the relative stability over the last decade was unexpectedly disrupted by the Easter Sunday Bombings of Catholic Churches and luxury hotels in 2019. More than 250 were killed and most of the deaths were reported from the St. Sebastian's Church in Negombo in the District of Gampaha. This article describes how mental health services of the District of Gampaha, with a population of 2.3 million and only one child and adolescent psychiatrist responded to the psychological trauma in children., Activities: The child and adolescent psychiatry response to the mass trauma was a collaboration between health, educational and voluntary organisations. The psychological support was provided at affected villages, schools and hospital settings. Medical and non-medical personnel were able to refer affected children directly to the child and adolescent psychiatrist. Children who had developed psychological consequences of trauma were provided with evidence-based psychotherapies and psychopharmacology where necessary. In addition, health staff members and teachers were trained to provide psychological support and a booklet was prepared in the local language based on trauma-focused cognitive behaviour therapy. Psychoeducation about the psychological response to trauma was provided through electronic, printed and social media. The limited number of trained psychotherapists and experts in child mental health were a major barrier to implement effective management strategies., Conclusion: Due to the severe shortage of child mental health experts, practical low-cost methodologies were employed to provide an early response to trauma. Traditional ways of mental health service provision were modified to be implemented via non-experts.

This study examined the interactive effect of mothers' exposure to caregiver intimate partner violence (IPV) during childhood and the amount of violence experienced with a current partner on negative parenting practices. Mothers ( N = 119) were recruited from community sites serving individuals experiencing IPV. Findings indicated that the following childhood IPV exposure variables moderated the association between current IPV severity and negative parenting practices: total types of IPV witnessed ( B = 0.01, t = 2.65, p < .01), witnessing sexual IPV ( B = 0.02, t = 2.16, p < .05), and witnessing psychological IPV ( B = 0.03, t = 2.79, p < .01). Results highlight the intergenerational effect of violence and the importance of addressing trauma across the family system.

This article analyzes the narratives of survivors of father-daughter incest using 20 in-depth interviews with women, each asked to choose a title for her life-story and reflect on its meaning. Three narratives emerged: "Surviving" tells of a struggle for personal achievement in an independent life alongside intensely traumatic experiences and negative feelings, "Fighting Back/Seeking Vengeance" tells of aspiring to strength by acting on their will to fight back and desire for revenge, and "Growing" reflects the wish to fight and win a place in the world through a "rebuilding" process. The conceptualization of incest survivors' life-narratives is based on the dialectical perspective.

Older adults who are the victims of previous physical and emotional sibling violence may be more vulnerable to acts of elder abuse. Research establishes that elder abuse is traumatic, as is sibling violence. However, little is known regarding the likelihood of victims of sibling violence becoming victims of elder abuse. To date, no research has identified the trauma associated with sibling violence to be a risk factor for experiencing elder abuse. This conceptual article describes the potential influence of trauma due to sibling violence on later vulnerability to elder abuse. The paper presents definitions of sibling violence, elder abuse, etiology, and risk factors as well as descriptions of trauma associated with elder abuse and sibling violence. The impact of the trauma of sibling abuse as a potential risk factor for elder abuse is discussed. Finally, practical implications and directions for future research in this area are presented.

This work gives an overview of the methods of scenic expression which can be used to help cope with the crisis caused by the global threat of the coronavirus pandemic. The virus is new, the vaccine has not been developed yet and there are no unified prevention and post-prevention policies. In the following lines some modified elements of psychodrama interventions are presented including the ways of preventing the retraumatization of the patient (protagonist). This can be achieved by conscious reliving of the trauma and by activating new, transformative roles to guide the protagonist on his way to recovery.

The dynamics of transmission between Tamil parents who fled the civil war in Sri Lanka and their children born in France were studied. The possible trauma that results from the transmission can affect the following generations in a more or less conscious way. The qualitative methodology was based on T-MADE, a method of transcultural analysis of the children's drawings, linked to the analysis of the parents' narrative., (Copyright © 2020. Published by Elsevier Masson SAS.)

Human trafficking is a crime associated with serious adverse health and mental health outcomes. It has been estimated that more than 40 million people worldwide have been victimized, which has resulted in high rates of traumatic injuries, unwanted and high-risk pregnancies, mental illness, substance use disorders; and suicidality among trafficked persons. Little is known as to what models of health care delivery are best in engaging and sustaining the involvement of trafficked individuals with health care and trafficked individuals have reported discouragement and/or re-traumatization as a result of inadequate or fragmented care. To address the gap in knowledge regarding best practices for engaging and sustaining trafficked patients with health care, the authors of this study set out to identify and describe medical and mental health specialty clinics that work exclusively with trafficked adults, with the goal of assisting organizations and health care providers in program development and to improve clinical outcomes. A patient-centered, comprehensive, interdisciplinary, and trauma informed approach to clinical care is recommended for the treatment of trafficked patients. The authors strongly suggest that human trafficking specialty clinics prioritize psychiatric care and mental health services given the high rate of trauma and mental health issues among trafficked persons.

Obstetric fistula is a condition that affects women and can lead to identity changes because of uncontrolled urinary and/or fecal incontinence symptom experiences. These symptoms along with different emerging identities lead to family and community displacement. Using narrative inquiry methodology that concentrates on the stories individuals tell about themselves; interviews were conducted for 15 fistula survivors to explore their perception of identities of living with obstetric fistula. Within a sociocultural context, these identities consist of the "leaking" identity, "masu yoyon fitsari" (leakers of urine) identity, and the "spoiled" identity, causing stigmatization and psychological trauma. The "masu yoyon fitsari" identity, however, built hope and resilience for a sustained search for a cure. Identity is a socially constructed phenomenon, and the findings reveal positive community involvement which reduces obstetric fistula stigmatization and improves women's identity. Sexual and reproductive health issues remain of grave concern within a contextualized societal identity of women's role.

Purpose: As midwives witness and attend the whole process of childbirth, they have a better understanding of which factors may cause traumatic childbirth. However, because most of the studies paid their attention on mothers, little is known about psychological birth trauma from the perspective of midwives. This study aims to gain a full understanding of which factors may contribute to psychological traumatic childbirth from the perspective of midwives., Methods: A qualitative research was conducted using in-depth interviews, which involved fourteen midwives from the maternal ward of a tertiary hospital. The interviews were recorded and transcribed, and then, Colaizzi's method was used to analyze the contents of the interviews., Results: We proposed four themes and eight subthemes on the influencing factors of psychological traumatic childbirth from the perspective of midwives: low perceived social support (lack of support from family and lack of support from medical staff), hard times (protracted labor in the first stage and futile efforts during the second stage), poor birth outcomes (poor birth outcomes of the mother and poor birth outcomes of the baby), and excruciating pain (unbearable pain of uterine contraction and labor pain was incongruent with the mother's expectations)., Conclusion: Medical staff should pay attention to psychological traumatic childbirth and its effects, and emphasis on the screening and assessment of birthing women with negative feelings so that their psychological traumatic childbirth can be prevented and decreased., (Copyright © 2019. Published by Elsevier B.V.)

The psychological burdens that patients experience while undergoing treatment for infertility in both men and women are well known and documented, especially within African populations. There are not many tested practical solutions to the problem, and clinical personnel have little time for personal counselling. This article described the development and delivery of an intervention designed to manage the psychological trauma that patients experience while dealing with infertility in resource poor settings. The Fertility Life Counselling Aid (FELICIA) has been developed to manage the psychological morbidity associated with infertility using cognitive behavioural therapy (CBT) based strategies. FELICIA provides a structured step by step guide to infertility counselling and is designed to be used by general community or hospital health workers rather than specialist psychologists or psychiatrists. This should make it a cost-effective option to deliver holistic care to patients treated for infertility, especially in resource poor settings.

Background: The symptoms following a traumatic event as well as the coping strategies can be culture specific. The objective of the present study was to analyse the transcultural differences of psychologically traumatized children and adolescents with and without migration background., Methods: The medical files of 199 psychologically traumatized children and adolescents (99 native Austrian, 100 Turkish-speaking) who were treated at the Department of Child and Adolescent Psychiatry in Vienna were retrospectively analysed., Results: The most frequently observed causes of trauma in patients with Turkish migration background were intra-familial conflicts, forced separation from parent(s), and conforming to a new environment. In native Austrian patients, forced separation from parent(s) and divorce or separation of parents were the leading causes of trauma. Trauma-related symptoms like changed mood, cognitive and perceptual disturbance, social withdrawal, sleeping problems, somatisation and behavioural problems were similarly observed in both groups; "sleeping problems" were more often observed in Austrian patients, and "behavioural problems" were more often observed in Turkish patients. More Austrian patients (32.7%) obtained psychiatric and psychotherapeutic treatment. Turkish-speaking patients mostly obtained psychiatric treatment only. Patients with migration background were more compliant compared to indigenous patients., Conclusions: Both study groups differed in type, causes and symptoms of trauma, and in preferred therapy. Turkish-speaking patients were more compliant with therapy, as they received culture and language-sensitive medical advice and treatment in their mother tongue. Considering the cultural background of patients can optimize service delivery and therapy outcomes among children and adolescents with stressful and traumatic experiences.

Purpose: This purpose of this article is to frame firearm violence as a health and public health problem, to illustrate the magnitude of the problem, to examine factors that increase the risk to be injured by a firearm, or conversely, that confer protection, and to identify relevant priority areas for nursing science., Organizing Construct: Firearm violence results in physical and psychological injuries and is a global health priority. Firearm violence is categorized as intentional (interpersonal and self-inflicted) and unintentional (interpersonal and self-inflicted) and accounts for an estimated 196,000 to 220,000 nonconflict deaths annually., Methods: We reviewed the theoretical and scientific literature to analyze the magnitude and geographic distribution of firearm violence, the factors associated with firearm injury, the consequences of firearm violence, and areas where nursing science can make an impact on prevention, outcomes, and recovery., Findings: Firearm violence is a significant public health problem that affects the health of individuals, families, and communities. The burdens and contributors to firearm violence vary worldwide, making it important to understand the local context of this global phenomenon. Relevant areas of inquiry span primary prevention focusing on individual and environmental risk factors; and focus on managing the physical and psychological consequences postinjury; and mitigating long-term consequences of firearm violence., Conclusions: Reducing the global burden of firearm violence and improving the health and safety of individuals, families, and communities provide compelling reasons to integrate this area into nursing science., Clinical Relevance: The goals of nursing are to keep people healthy and safe and to help return those injured to their optimal levels of health and well-being. Understanding the factors that come together to injure people with a firearm in various physical, social, economic, and cultural environments positions nurses to both extend the dialogue beyond pro-gun versus anti-gun and to design and carry out rigorous studies to reduce firearm violence., (© 2018 Sigma Theta Tau International.)

We examined the effect of political rhetoric on the targets of that rhetoric. Drawing from scholarship on anti-Mexican and anti-immigrant rhetoric found readily in various media and scholarship on emotions, we tested four hypotheses. Hypotheses 1 and 2 predicted that positive and negative political rhetoric would increase and decrease positive and negative emotions, respectively. Hypotheses 3 and 4 then predicted that emotional responses to positive or negative political rhetoric would influence perceived stress, subjective health, and subjective well-being. Data collection occurred between August 2016 and June 2017 at a university in California. A sample of 280 Mexican-origin youth, defined broadly as having at least one ancestor born in Mexico or the participant themselves born in Mexico, participated in an experiment where they were randomly assigned to one of three study conditions: viewing (1) positive or (2) negative political rhetoric about immigrants and Latinos in general, or (3) neutral rhetoric as a control condition before providing qualitative responses to open-ended questions and completing measures of positive and negative affect, perceived stress, subjective health, and subjective well-being. Qualitative responses indicated that negative and positive political rhetoric elicited a range of negative emotions and positive emotions, respectively. Quantitative analysis with independent samples t-tests, ANOVA, and linear regression models found that negative political rhetoric elicited higher negative affect than positive and neutral rhetoric, and positive rhetoric elicited higher positive affect than negative and neutral rhetoric. Negative emotional responses, in turn, were associated with participants' higher perceived stress, lower subjective health and lower subjective well-being. Conversely, positive emotional responses were associated with lower perceived stress, higher subjective health, and higher subjective well-being. Positive political rhetoric, by eliciting positive emotions, can have a salubrious effect. Altogether, these findings suggest that political rhetoric matters for the targets of that rhetoric., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Aim: Information is scarce about the issues faced by street working. This study examined traumatic events experienced by boys working on the streets of Iraq compared to schoolboys., Methods: We compared 100 street working boys aged 8-16 years who were attending a drop-in centre for street working children in Duhok City, Kurdistan, Iraq, in 2004/2005 with 100 age-matched schoolboys randomly selected from six local schools. The instruments that were used included the Harvard-Uppsala Trauma Questionnaire for Children., Results: Most of the street working boys were involved in activities such as selling goods or shoe shining, and some were stealing or begging. None were involved in drugs or prostitution. The street working boys showed a significantly higher rate of traumatic events than the control group (96% versus 64%, p < 0.001) and higher rates of moderate to severe trauma levels (78% versus 25%, p < 0.001). A varying degree of association was found for reporting different traumatic events. The largest effect size was found for torture, with an odds ratio of 28.4, and the smallest for maltreatment or assault (2.7)., Conclusion: Street working boys in Iraq faced a higher risk of exposure to traumatic events than age-matched schoolboys., (©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Objectives: To examine whether baseline measures of resilience among active first responders predicts future mental health symptomology following trauma exposure., Methods: Multivariate linear regression examined the associations between baseline resilience and future mental health symptomatology following repeated trauma exposure. Symptomatology at 6-month follow-up was the dependent variable., Results: The associations between baseline resilience and future posttraumatic stress disorder (PTSD) (P = 0.02) and depression (P = 0.03) symptoms were statistically significant. Those reporting higher resilience levels had lower symptomology at 6-month follow-up. Eighty percent of first-responders who screened positive for low resilience went on to develop more PTSD symptoms., Conclusions: Examining resilience may serve as a more effective means of screening, given resilience is a malleable construct which can be enhanced via targeted interventions. Higher levels of resilience may protect the long-term mental health of first-responders, particularly in regard to future PTSD.

Introduction: Children and adolescents who are victims of sexual abuse or severe mistreatment are exposed to secondary victimization -understood as the revictimization resulting from the cons tant memory of the mistreatment or the abuse suffered when they are subject of multiple questions about what happened- when they have contact with the justice system. In 2012, the Chilean State implemented a pilot Gesell dome in order to reduce this risk and move towards a single interview process, with probative value in the context of the judicial process., Objective: To systematize the implementation process of a Gessel Dome in a chilean Family Court., Subjects and Method: Qualita tive, non-experimental, exploratory and descriptive study. Ten representatives of institutions of the inter-institutional network of the Family Court at the city of Melipilla were interviewed. Purposive sampling was used for the selection of participants, which seeks to obtain a representative discour se of the participants. The Semi-structured Individual Interview was used, based on seven research dimensions: 1) knowledge of the Gesell dome; 2) knowledge of the right of the child to be heard; 3) knowledge regarding severe mistreatment and sexual abuse; 4) knowledge about secondary victi mization; 5) organization and operation of the institutional network; 6) training; and 7) general eva luation of the Gesell dome of the Melipilla Family Court., Results: There are differences in knowledge and information management among the institutions associated with the project. Coordination diffi culties of the local network that affect the objectives of the project are identified., Conclusions: There are problems of coordination and networking in the implementation and use of the Gesell dome. In order to achieve the objective of reducing secondary victimization, in addition to the investment in physical facilities and specialized training, a strong investment in local network management and coordination is required. The results facilitate the development of plans to avoid such difficulties in the future implementation of Gesell domes as public policy.

Objective: Service members deployed to war are at risk for moral injury, but the potential sources of moral injury are poorly understood. The aim of this qualitative study was to explore the types of events that veterans perceive as morally injurious and to use those events to develop a categorization scheme for combat-related morally injurious events., Method: Six focus groups with US war veterans were conducted., Results: Analysis based on Grounded Theory yielded two categories (and eight subcategories) of events that putatively cause moral injury. The two categories were defined by the focal attribution of responsibility for the event: Personal Responsibility (veteran's reported distress is related to his own behavior) versus Responsibility of Others (veteran's distress is related to actions taken by others). Examples of each type of morally injurious event are provided., Conclusions: Implications for the further development of the moral injury construct and treatment are discussed., (© 2018 Wiley Periodicals, Inc.)