The trouble with trauma and triggering.
The trouble with trauma and triggering.
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创伤和触发的麻烦。
DOI：
10.1016/s2215-0366(23)00112-8
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Bhui K
中科院分区：
文献类型：
--
作者：
Bhui K
评论www.我的天使com/psychiatry 2023年7月10日479在实践中提出问题（例如，通过游戏，创造性方式或相关的开放式访谈，而不是封闭式问题）。听到一些人经历的痛苦生活是困难的，但如果要在其历史和传记背景下理解创伤，这是必不可少的。临床医生（以及研究人员、政策制定者和专员）必须注意培养管理他们的反应和潜在替代性创伤的技能。触发警告是有用的，如果仔细放置和措辞，但它们不应夸大对再次创伤的恐惧，例如，过于频繁地重复或假设每个人都会正确地预测问题中的内容。“内容说明”可能是一个有用的替代短语。过于关注创伤也可能会分散对个人情况或潜在神经分歧的更好评估。触发警告可能是为患有特定疾病的人量身定制的，例如癫痫，但除此之外，它们无法预测个人的反应，因为还有许多其他中介和调节影响。一些从业者指出，触发警告可能会鼓励患有创伤后应激障碍的个人避免与创伤有关的线索。7-9一些研究甚至表明，触发警告可能没有区别，不应该使用。8.重复的提问会产生相当大的情绪需求，应该避免。还应该有一个动态的同意过程，以确保人们总是知道他们的数据可能会被如何使用，谁在保护他们的数据，以及他们的数据可能会与谁共享。询问和了解不良经历和生活事件至关重要。创造力提供了调节情绪和探索多种感官模式的机会，这些感官模式可能会安抚和激活反思和情绪处理。为了满足这一需求，我们正在使用共同设计制定指导方针，以增强与服务用户，年轻人和公共服务利益攸关方合作的方式。对于那些有感觉或沟通障碍的人，需要额外的量身定制的方法。与此同时，我们敦促在研究或临床服务评估中为受影响者提供尽可能多的代理和选择，以回答有关逆境的问题。
Comment www. thelancet. com/psychiatry Vol 10 July 2023 479 asking questions in practice (eg, through play, creative modalities, or relevant open-ended interviews rather than closed questions). Hearing about the painful lives some people have experienced is difficult, but it is essential if trauma is to be understood in its historical and biographical contexts. Clinicians (and researchers, policy makers, and commissioners) must take care to develop the skills to manage their responses and potential vicarious trauma. Trigger warnings are useful, if carefully placed and worded, but they should be designed not to overstate fears of re-traumatisation, for example, by being repeated too frequently or by assuming each person will correctly anticipate what is to come in the questions.“Content notes” might be a useful alternative phrase. Too much of a focus on trauma might also distract from better assessment of the personal situation or of underlying neurodivergence. Trigger warnings might be tailored to people with specific conditions, such as epilepsy, but otherwise they cannot predict individuals’ responses because there are so many other mediating and moderating influences. Some practitioners state that trigger warnings might encourage the avoidance of trauma-related cues in individuals with a post-traumatic stress disorder. 7–9 Some studies even suggest trigger warnings might make no difference and should not be used. 8 Repeated questioning can create considerable emotional demands and should be avoided. There should also be a dynamic consent process to ensure people are always aware of how their data might be used, who is protecting their data, and with whom their data might be shared.Asking and learning about adverse experiences and life events is crucial. Creativity provides opportunities to modulate emotions and to explore experiences in multiple sensory modalities that might soothe and activate reflection and emotional processing. In response to this need, we are developing guidance, using co-design, on empowering ways of working with service users, young people, and public service stakeholders. Additional tailored approaches are needed for those with sensory or communication impairments. In the meantime, we urge that those affected are provided as much agency and choice as possible to answer questions about adversity, either in research or in clinical service assessments.
影响因子：
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作者：
Kessler, RC;Berglund, P;Walters, EE
通讯作者：
Walters, EE
DOI：
10.1016/j.jbtep.2018.07.002
发表时间：
2018-12-01
影响因子：
1.8
作者：
Bellet, Benjamin W.;Jones, Payton J.;McNally, Richard J.
通讯作者：
McNally, Richard J.
不良童年经历和成年后的多种心理健康结果：一项前瞻性出生队列研究
DOI：
10.1101/2021.02.23.21252273
发表时间：
2021
期刊：
The journal of nutrition, health & aging
影响因子：
--
作者：
D. Gondek;P. Patalay;R. Lacey
通讯作者：
R. Lacey