Indigenous aid workers carry out the majority of humanitarian aid work, yet there is little empirical information available on their support needs in different contexts. Focus groups (N = 26: Study 1) and a survey (N = 137; Study 2) were conducted with Guatemalan aid workers to explore their exposure to violence, posttraumatic stress symptoms, burnout, support needs, and motivators. Participants reported experiencing an average of 13 events of community violence and 17% reported symptoms consistent with posttraumatic stress disorder (PTSD). Direct community violence exposure and levels of emotional exhaustion were positively related to PTSD symptoms, while levels of personal accomplishment were inversely related to PTSD symptoms. Expressed support needs, motivators and rewards for aid work in the face of adversity are also reported as potential protective factors for further exploration. Implications for training and support of aid workers in similar contexts are also suggested.
Remarkably little is known about patterns of emergence of specific symptoms in the early course of nonaffective psychotic disorders. Some 159 well-characterized first-episode psychosis patients were categorized into those with: (1) delusions only (n=29, 18.2%); (2) delusions that emerged at least one month before hallucinations (n=31, 19.5%); (3) hallucinations that began at least one month before delusions (n=26, 16.4%); and (4) delusions and hallucinations that emerged concomitantly, within the same month (n=73, 45.9%). These four groups were compared across a number of clinical features, including duration of untreated psychosis, symptom severity, insight, and functioning, while controlling for potential confounders. Patients with delusions and hallucinations emerging within the same month had a shorter duration of untreated psychosis than those in whom one psychotic symptom emerged greater than one month before the other. The delusions-only group had significantly less severe positive, negative, and general psychopathology symptom scores, as well as better social and occupational functioning. Replication and further elucidation of specific patterns of symptom emergence would deepen the field’s understanding of early-course phenomenology, and may inform efforts to improve upon nosology, prognostication, and treatment selection.
This study explores exposure to community violence (CV) and traumatic loss and their relation to posttraumatic stress disorder (PTSD) and grief symptoms among Guatemalan aid workers. Out of 135 workers surveyed, 79% reported that someone close to them had died, and 33% reported a loss that was rated as traumatic. The average number of lifetime incidents of CV reported was 13, and the highest was 32. In all, 36% of the sample reported symptoms that meet criteria for PTSD. Those participants who reported a traumatic loss also reported significantly higher complicated grief (CG) scores, and those who reported a traumatic human-perpetrated loss also reported significantly higher levels of hyperarousal PTSD symptoms than those who reported a traumatic loss that was nonhuman perpetrated.
Research findings are mixed as to whether or not the inability to taste phenylthiocarbamide (PTC) might represent an endophenotypic trait marker for schizophrenia. We hypothesized associations between PTC-tasting status and select clinical characteristics and trait markers in patients with psychotic disorders that, if present, would provide support for the inability to taste PTC as a trait marker. In a first-episode psychosis sample (n=93), we measured PTC tasting, family history of psychosis, age at onset of prodrome and psychosis, severity of positive and negative symptoms, global impairment in functioning, neurological soft signs, and four neurocognitive domains (verbal learning/memory, visual learning/memory, verbal working memory, and spatial working memory). Associations between PTC-non-tasting and clinical/neurocognitive variables were examined with χ2 tests and independent samples t tests. Among participants, 67.7% tasted PTC in comparison to a strip of control paper, and 25.8% were non-tasters. Tasters and non-tasters did not statistically significantly differ with respect to family history, age at onset, severity of symptoms, neurological soft signs, or the four neurocognitive domains. In conjunction with other findings, it is unlikely that PTC-non-tasting is a trait marker of schizophrenia, though a conclusive study is warranted.
This study documents Guatemalan aid workers' and parents' definitions of child sexual abuse (CSA), understandings of indicators and etiology of CSA, and training needs. Focus groups were conducted with aid workers and parents living in the Guatemala City dump. Conceptualizations of CSA included rape, contact molestation, and noncontact molestation. Aid workers and parents identified emotional and behavioral symptoms as indicators of CSA. Parents reported systemic understandings of CSA, such as poverty and the cycle of violence. Parents requested education on positiveparenting; aid workers wanted training about working effectively with the legal system. Prevention and intervention implications are discussed.
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