Trauma‐Informed Interventions in Parent–Child Contact Cases

Parent–child contact problems may arise in the context of high conflict separation/divorce dynamics between parents. In cases where there are parent–child contact problems and children resist or refuse contact with one of their parents, there may also be incidents of child maltreatment, intimate partner violence, or compromised parenting that can be experienced by a parent or child as traumatic. The circumstances around separation and/or post‐divorce often result in intense stress for families. In this paper we distinguish between the stressful circumstances that may arise as a result of high interparental conflict and pulls for alignment from a parent, and the real or perceived trauma as a factor which contributes to resistance or refusal of a child to have contact with a parent. Interventions to address both trauma responses and the resist‐refuse dynamics are differentiated and discussed. After screening and assessment, the intent is to treat trauma responses with short‐term, evidence‐based therapy, either before or concurrent with co‐parent and family intervention.     

Posttraumatic Stress as a Mediator of the Relationship Between Trauma and Mental Health Problems Among Juvenile Delinquents

This study investigated the interrelationships among trauma exposure, PTSD, and mental health problems in a sample of 289 adolescents (199 male, 90 female) detained in a juvenile correctional facility. Mean differences were found in that females scored higher than males on measures of interpersonal trauma exposure and symptoms of both simple and complex PTSD. Females also endorsed more mental health problems in the areas of depression/anxiety, somatic complaints, and suicidal ideation. For all youth, trauma exposure, PTSD, and mental health problems were correlated. Results of structural equation modeling were consistent with the hypothesis that PTSD mediates the relationship between interpersonal trauma and mental health problems for all youth, although the results were stronger for females.

Do Not Make their Trauma Your Trauma: Coping with Burnout as a Family Law Attorney

In the field of family law, attorneys frequently expose themselves to highly emotional and traumatized clients. Litigation is by nature a high‐stress occupation, demanding a high level of intellectual and emotional engagement from the contesting lawyers. Adding the burden of inherently distressing content to litigation can impair a lawyer's functioning. The effects are often referred to as “secondary trauma.” This Note proposes that state bar associations should take a more active role in providing mental health support to prevent burnout in family law attorneys by (1) offering voluntary classes to educate attorneys about the dangers of, and ways to cope with, the burnout that comes with working with traumatized clients in family law and (2) organizing support groups among local family law communities.

Key Points for the Family Court Community:
• Claims against family law practitioners account for the third highest percentage of all malpractice claims against lawyers.
• Burnout is a serious problem for family law attorneys.
• Programs sponsored by state bar associations are available and need to be expanded.
• The American Bar Association's Model Rules require that a lawyer shall not represent a client or, where representation has commenced, shall withdraw from the representation of a client if the lawyer's physical or mental condition materially impairs the lawyer's ability to represent the client.
• The unique nature of family law, centered on relationships and emotions, puts family law attorneys at a higher risk for experiencing the effects of secondary trauma than other areas of law.
• Lawyers at risk for secondary trauma can avoid its effects by educating themselves about such effects.

     

钝力性心脏外伤实验性研究——隐囊流体压力冲击心前区

本文应用隐囊流体冲击心前区，成功地制造了钝力性心脏外伤，包括心脏震荡、心脏挫伤，心脏裂伤等原发性心脏外伤以及外伤性冠脉血管炎。心肌炎血栓形成，心肌缺血坏死（外伤性心肌梗死）等继发性或迟发性外伤性损伤，指出：心肌膜爆裂（ｍｅｍｂｒａｎｅｂｕｒｓｔ），相应纤维横向膨出畸型变可以作为心脏震荡性外伤的形态学指征：钝力作为原始致伤因素作用于心前区通过压，拉，旋转或剪切力引起心脏各部，包括刺激传导系统，心脏神经组织损伤；心脏挫裂伤等见于左右心壁室中隔，心内膜下并呈播散分布。     

219例损伤与疾病关系的尸检案例分析

目的探讨损伤与疾病关系案例的特点。方法对本教研室近20年的219例涉及损伤与疾病关系的尸检案例进行回顾性研究。结果①219例中,20~59岁青壮年占71.7%;伤后<24h死亡占48.9%。②损伤以拳、足等钝器伤为主,以擦伤和挫伤多见,主要位于头、胸部。③疾病以心血管疾病最多,CNS疾病次之。④损伤与疾病相关的案例占71.2%,最常见的是“疾病为主、损伤为辅”。结论损伤与疾病关系案例的死者多为男性青壮年,冠心病和病理性脑出血是两个主要的疾病;将损伤与疾病关系分为“单纯损伤致死、单纯疾病致死、损伤为主疾病为辅和疾病为主损伤为辅”四类简单而实用。     

Bedtime

In a review of the responses to British artist Tracey Emin's exhibition of her own bed as an artwork nominated for the 1999 Turner Prize, Merck considers it as a figure of the personal trauma said to be constitutive of subjectivity in the decade. Reviewing theorists of the period including Hal Foster, Marc Augé and Wendy Brown, she considers the artist's work as an illustration of individual isolation assuaged by narcissism. Must the woman artist function as the victim of her own cult of celebrity? In the ensuing months since her nomination, Emin's changing circumstances suggest that other fates- and other histories- may be possible.     

The Language of Hysteria: A Misappropriation of the Master Narratives

Bronfen discusses the language of hysteria in conjunction with recent discussions of ethics, notably in the sense that the hysteric gesture of misappropriating a grand narrative such as humanism confronts the manner in which discussions of gender might traverse alterity without effacing or occluding it.     

Domestic Violence and Maternal Reports of Young Children’s Functioning

Maternal reports of 60 preschool-aged children were used to investigate trauma responses to living in households where domestic violence was present. Post-trauma symptoms were measured using developmentally modified criteria based on the Child Behavior Checklist (CBCL). Mothers’ level of anxiety, depression, somatization, and self-reported parenting stress were also assessed. Results suggested that, in addition to clinical levels of Internalizing, Externalizing and Total Problem scores on the CBCL, young children displayed a range of post-trauma symptoms. Mothers reported a high level of violence, and a significant relationship was found between self-reported levels of distress and parenting stress. Parenting stress was found to be the strongest predictor of children’s scores on the CBCL. Although domestic violence alone was not significantly correlated to child outcomes, results indicated that maternal distress adversely impacted on the parent-child relationship. The importance of the child’s relationship with the primary caregiver was discussed. Implications regarding further research, developmentally appropriate diagnostic criteria, and early interventions with the primary caregiver are highlighted.     

Family Court Enhancement Project: Improving Access to Justice

In 2013, Minnesota's Fourth Judicial District was one of four courts in the country selected by the U.S. Department of Justice, Office on Violence Against Women to receive a Family Court Enhancement Project (FCEP) grant, a multiyear demonstration initiative designed to build the capacity of court systems and partner stakeholders to improve child custody decision making in cases involving domestic violence. The FCEP enabled the project sites to explore, implement, and assess new and innovative court and noncourt procedures and practices. This article is an exploration of the outcomes of this project.     

The routine use of C-reactive protein in forensic investigations

In clinical medicine, C-reactive protein (CRP) is extensively used as a general marker for immune system activation, and post-mortem applicability has been established [M.Q. Fujita, B.L. Zhu, K. Ishida, L. Quan, S. Oritani, H. Maeda, Serum C-reactive protein levels in postmortem blood-an analysis with special reference to the cause of death and survival time, Forensic Sci. Int. 130 (2002) 160-166; L. Uhlin-Hansen, C-reactive protein (CRP), a comparison of pre- and post-mortem blood levels, Forensic Sci. Int. 124 (2001) 32-35]. We have analysed the routine use of CRP in non-selected cases. Scarcity of blood available for analysis is a common problem in forensic investigation, and in response to this we have developed a method using liver as a source. In 50 consecutive autopsy cases, we have evaluated method, validated results and discussed their interpretation. In three cases the analysis was not possible. For each of the remaining cases (n=47) we have analysed whole blood, serum and/or liver samples. 57% (n=25) had serum CRP > 10 mg/L. Serum levels were higher than in whole blood or liver. CRP levels in serum and whole blood samples were stable in more than one month after death, making storage for later analysis possible. Liver levels peaked at one week, but after one month putrefaction was obvious. CRP levels were independent of the post-mortem interval. The use of liver as a source has not yet been described in literature. Our results in liver samples correlate well with plasma results, and liver is a good post-mortem alternative when blood is not available. We conclude that CRP measurements are easy, viable and inexpensive in a forensic setting, and that the number of cases with CRP elevation is high in a non-selected forensic material. In cases of doubt, marked elevation of CRP is an indicator of natural mode of death, and in cases of trauma, it indicates vital reaction. It can be used as a pre-autopsy screening, leading to a more extensive search for diseases not easily diagnosed, such as sepsis or ketoacidosis.