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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
A number of screening instruments are used for screening adults for PTSD, such as the Clinician-Administered PTSD Scale for "DSM-5" (CAPS-5), Primary Care PTSD Screen for "DSM-5" (PC-PTSD-5), PTSD Checklist for DSM-5 (PCL-5), and Dissociative Subtype of PTSD Scale (DSPS). The CAPS-5 is considered the gold-standard assessment recommended for use by the U.S. National Center for PTSD.
There are also several screening and assessment instruments for use with children and adolescents. These include the Child PTSD Symptom Scale (CPSS), Clinician-Administered PTSD Scale for "DSM-5" -Child/Adolescent version (CAPS-CA-5), Child Trauma Screening Questionnaire, and UCLA Posttraumatic Stress Disorder Reaction Index for "DSM-IV".
A diagnosis of PTSD requires that the person has been exposed to an extreme stressor such as one that is life-threatening. Any stressor can result in a diagnosis of adjustment disorder and it is an appropriate diagnosis for a stressor and a symptom pattern that does not meet the criteria for PTSD, for example a partner being fired, or a spouse leaving. If any of the symptom pattern is present before the stressor, another diagnosis is required, such as brief psychotic disorder or major depressive disorder. Other differential diagnoses are schizophrenia or other disorders with psychotic features such as Psychotic disorders due to a general medical condition. Drug-induced psychotic disorders can be considered if substance abuse is involved.
The symptom pattern for acute stress disorder must occur and be resolved within four weeks of the trauma. If it lasts longer, and the symptom pattern fits that characteristic of PTSD, the diagnosis may be changed.
Obsessive compulsive disorder may be diagnosed for intrusive thoughts that are recurring but not related to a specific traumatic event.
Psychiatric consultation: Exploration of memories of the traumatic event, relief of associated symptoms and counseling.
The utility of PTSD derived psychotherapies for assisting children with C-PTSD is uncertain. This area of diagnosis and treatment calls for caution in use of the category C-PTSD. Ford and van der Kolk have suggested that C-PTSD may not be as useful a category for diagnosis and treatment of children as a proposed category of developmental trauma disorder (DTD). For DTD to be diagnosed it requires a
'history of exposure to early life developmentally adverse interpersonal trauma such as sexual abuse, physical abuse, violence, traumatic losses of other significant disruption or betrayal of the child's relationships with primary caregivers, which has been postulated as an etiological basis for complex traumatic stress disorders. Diagnosis, treatment planning and outcome are always relational.'
Since C-PTSD or DTD in children is often caused by chronic maltreatment, neglect or abuse in a care-giving relationship the first element of the biopsychosocial system to address is that relationship. This invariably involves some sort of child protection agency. This both widens the range of support that can be given to the child but also the complexity of the situation, since the agency's statutory legal obligations may then need to be enforced.
A number of practical, therapeutic and ethical principles for assessment and intervention have been developed and explored in the field:
- Identifying and addressing threats to the child's or family's safety and stability are the first priority.
- A relational bridge must be developed to engage, retain and maximize the benefit for the child and caregiver.
- Diagnosis, treatment planning and outcome monitoring are always relational (and) strengths based.
- All phases of treatment should aim to enhance self-regulation competencies.
- Determining with whom, when and how to address traumatic memories.
- Preventing and managing relational discontinuities and psychosocial crises.
Rape trauma syndrome (RTS) is the psychological trauma experienced by a rape victim that includes disruptions to normal physical, emotional, cognitive, and interpersonal behavior. The theory was first described by psychiatrist Ann Wolbert Burgess and sociologist Lynda Lytle Holmstrom in 1974.
RTS is a cluster of psychological and physical signs, symptoms and reactions common to most rape victims immediately following and for months or years after a rape. While most research into RTS has focused on female victims, sexually abused males (whether by male or female perpetrators) also exhibit RTS symptoms. RTS paved the way for consideration of complex post-traumatic stress disorder, which can more accurately describe the consequences of serious, protracted trauma than posttraumatic stress disorder alone. The symptoms of RTS and post-traumatic stress syndrome overlap. As might be expected, a person who has been raped will generally experience high levels of distress immediately afterward. These feelings may subside over time for some people; however, individually each syndrome can have long devastating effects on rape victims and some victims will continue to experience some form of psychological distress for months or years. It has also been found that rape survivors are at high risk for developing substance use disorders, major depression, generalized anxiety disorder, obsessive-compulsive disorder, and eating disorders.
RTS identifies three stages of psychological trauma a rape survivor goes through: the acute stage, the outer adjustment stage, and the renormalization stage.
The course is fluctuating but recovery can be expected in the majority of cases. Few people may show chronic course over many years and a transition to an enduring personality change
There is no universal cure for genophobia. Some ways of coping with or treating anxiety issues is to see a psychiatrist, psychologist, or licensed counselor for therapy. Some people experiencing pain during sex may visit their doctor or gynecologist. Medicine may also be prescribed to treat the anxiety brought on by the phobia.
Herman believes recovery from C-PTSD occurs in three stages:
1. establishing safety,
2. remembrance and mourning for what was lost,
3. reconnecting with community and more broadly, society.
Herman believes recovery can only occur within a healing relationship and only if the survivor is empowered by that relationship. This healing relationship need not be romantic or sexual in the colloquial sense of "relationship", however, and can also include relationships with friends, co-workers, one's relatives or children, and the therapeutic relationship.
Complex trauma means complex reactions and this leads to complex treatments. Hence, treatment for C-PTSD requires a multi-modal approach. It has been suggested that treatment for C-PTSD should differ from treatment for PTSD by focusing on problems that cause more functional impairment than the PTSD symptoms. These problems include emotional dysregulation, dissociation, and interpersonal problems. Six suggested core components of complex trauma treatment include:
1. Safety
2. Self-regulation
3. Self-reflective information processing
4. Traumatic experiences integration
5. Relational engagement
6. Positive affect enhancement
Multiple treatments have been suggested for C-PTSD. Among these treatments are experiential and emotionally focused therapy, internal family systems therapy, sensorimotor psychotherapy, eye movement desensitization and reprocessing therapy (EMDR), dialectical behavior therapy (DBT), cognitive behavioral therapy, psychodynamic therapy, family systems therapy and group therapy.
There can be many different reasons for why people develop genophobia. Some of the main causes are former incidents of sexual assaults or abuse. These incidents violate the victim’s trust and take away their sense of right to self-determination. Another possible cause of genophobia is the feeling of intense shame or medical reasons. Others may have the fear without any diagnosable reason.
Women's fear of crime refers to women's fear of being a victim of crime, independent of actual victimization. Although fear of crime is a concern for people of all genders, studies consistently find that women around the world tend to have much higher levels of fear of crime than men, despite the fact that in many places, and for most offenses, men's actual victimization rates are higher. Fear of crime is related to perceived risk of victimization, but is not the same; fear of crime may be generalized instead of referring to specific offenses, and perceived risk may also be considered a demographic factor that contributes to fear of crime. Women tend to have higher levels for both perceived risk and fear of crime.
In women's everyday lives, fear of crime can have negative effects, such as reducing their environmental mobility. Studies have shown that women tend to avoid certain behaviors, such as walking alone at night, because they are fearful of crime, and would feel more comfortable with these behaviors if they felt safer.
Survivor guilt (or survivor's guilt; also called survivor syndrome or survivor's syndrome) is a mental condition that occurs when a person believes they have done something wrong by surviving a traumatic event when others did not. It may be found among survivors of murder, terrorism, combat, natural disasters, epidemics, among the friends and family of those who have died by suicide, and in non-mortal situation. The experience and manifestation of survivor's guilt will depend on an individual's psychological profile. When the "Diagnostic and Statistical Manual of Mental Disorders IV" (DSM-IV) was published, survivor guilt was removed as a recognized specific diagnosis, and redefined as a significant symptom of post traumatic stress disorder (PTSD).
Fear of intimacy is generally a social phobia and anxiety disorder resulting in difficulty forming close relationships with another person. The term can also refer to a scale on a psychometric test, or a type of adult in attachment theory psychology.
The fear of intimacy is the fear of being emotionally and/or physically close to another individual. This fear is also defined as “the inhibited capacity of an individual, because of anxiety, to exchange thought and feelings of personal significance with another individual who is highly valued”. Fear of intimacy is the expression of existential views in that to love and to be loved makes life seem precious and death more inevitable. It often results from past traumas such as rape or childhood sexual abuse. Fear of intimacy is also related to the fear of being touched .
The DSM-IV-TR states that the fugue may have a duration from days to months, and recovery is usually rapid. However, some cases may be refractory. An individual usually has only one episode.
People with this fear are anxious about or afraid of intimate relationships. They believe that they do not deserve love or support from others. Fear of intimacy has three defining features: content which represents the ability to communicate personal information, emotional valence which refers to the feelings about personal information exchanged, and vulnerability signifying their regard for the person they are intimate with. Bartholomew and Horowitz go further and determine four different adult attachment types: “(1) Secure individuals have a sense of worthiness or lovability and are comfortable with intimacy and autonomy; (2) preoccupied persons lack this sense of self-worthiness yet view others positively and seek their love and acceptance; (3) fearful people lack a sense of lovability and are avoidant of others in anticipation of rejection; (4) dismissing persons feel worthy of love yet detach from others whom they generally regard as untrustworthy”.
Diagnosis can be difficult as symptoms may be nonspecific. A CT scan of the head is typically recommended if a concern is present. While retinal bleeding is common, it can also occur in other conditions.
Survivor guilt was first identified during the 1960s. Several therapists recognized similar if not identical conditions among Holocaust survivors. Similar signs and symptoms have been recognized in survivors of traumatic situations including combat, natural disasters, terrorist attacks, air-crashes and wide-ranging job layoffs. A variant form has been found among rescue and emergency services personnel who blame themselves for doing too little to help those in danger, and among therapists, who may feel a form of guilt in the face of their patients' suffering.
Stephen Joseph, a psychologist at the University of Warwick, has studied the survivors of the capsizing of the MS "Herald of Free Enterprise" which killed 193 of the 459 passengers. His studies showed that 60 percent of the survivors suffered from survivor guilt. Joseph went on to say: "There were three types: first, there was guilt about staying alive while others died; second, there was guilt about the things they failed to do – these people often suffered post-traumatic 'intrusions' as they relived the event again and again; third, there were feelings of guilt about what they did do, such as scrambling over others to escape. These people usually wanted to avoid thinking about the catastrophe. They didn't want to be reminded of what really happened.
Sufferers sometimes blame themselves for the deaths of others, including those who died while rescuing the survivor or whom the survivor tried unsuccessfully to save.
Treatment involves monitoring intracranial pressure (the pressure within the skull), draining fluid from the cerebral ventricles, and, if an intracranial hematoma is present, draining the blood collection.
Though it is not possible for a definitive diagnosis of sexsomnia, a series of factors are considered to determine the presence of the condition. Clinical tests may also be utilized for further study.
Polysomnography is a study conducted while the individual being observed is asleep. A polysomnograph (PSG) is a recording of an individual's body functions as they sleep. Complete sleep studies are most commonly facilitated at a designated sleep center. Specialized electrodes and monitors are connected to the individual and remain in place throughout study. Video cameras can be used in certain cases to record physical behaviors occurring while the individual is asleep. Typically the unwanted sexual behaviors do not present on film, therefore the majority of information is taken from a sleep study.
Social scientists have differing views on the causes of women's fear of crime. Some have argued that women's heightened fear of crime is due to women's higher levels physical vulnerability compared to men, although feminist work generally resists this generalization and often tries to relocate the cause to larger societal factors. It is nonetheless important that most women are aware of pervasive cultural view that women are more vulnerable than men, which may make them think they are more likely to be victimized and therefore contribute to their fear; in this way, it would be perceived vulnerability and not actual vulnerability that is the cause of women's fear. Some research has also suggested that women are in fact not much more fearful about crime than men, but that dominant cultural ideas about masculinity may make men reluctant to talk about their fear or report it in surveys.
Treatment may involve investigation, reassurance and explanation, and possibly specialist treatment such as antidepressants or cognitive behavioral therapy.
Prevention of suspension trauma is preferable to dealing with its consequences. Specific recommendations for individuals doing technical ropework are to avoid exhausting themselves so much that they end up without the energy to keep moving, and making sure everyone in a group is trained in single rope rescue techniques, especially the "single rope pickoff", a rather difficult technical maneuver that must be practiced frequently for smooth performance.
Hybristophilia is a paraphilia in which sexual arousal, facilitation, and attainment of orgasm are responsive to and contingent upon being with a partner known to have committed an outrage, cheating, lying, known infidelities or crime, such as rape, murder, or armed robbery. The term is derived from the Greek word ὑβρίζειν "hubrizein", meaning "to commit an outrage against someone" (ultimately derived from ὕβρις "hubris" "hubris"), and "philo", meaning "having a strong affinity/preference for". In popular culture, this phenomenon is also known as "Bonnie and Clyde Syndrome".
Many high-profile criminals, particularly those who have committed atrocious crimes, receive "fan mail" in prison that is sometimes amorous or sexual, presumably as a result of this phenomenon. In some cases, admirers of these criminals have gone on to marry the object of their affections in prison.
Hybristophilia is accepted as potentially lethal, among other such paraphilias including, but not being limited to, asphyxiophilia, autassassinophilia, biastophilia, and chremastistophilia.
Courtship disorder is a theoretical construct in sexology in which a certain set of paraphilias are seen as specific instances of anomalous courtship instincts in men. The specific paraphilias are biastophilia (paraphilic rape), exhibitionism, frotteurism, telephone scatologia, and voyeurism. According to the "courtship disorder hypothesis", there is a species-typical courtship process in human males consisting of four phases, and anomalies in different phases result in one of these paraphilic sexual interests. That is, instead of being independent paraphilias, this theory sees these sexual interests as individual symptoms of a single underlying disorder.