The complex care of a torture survivor in the United States: The case of Joshua.

Introduction: Torture is an assault on the physical and mental health of an individual, impacting the lives of survivors and their families.The survivor's interpersonal relationships, social life, and vocational functioning may be affected, and spiritual and other existential questions may intrude. Cultural and historical context will shape the meaning of torture experiences and the aftermath.

Testimonial Psychotherapy in Immigrant Survivors of Intimate Partner Violence: A Case Series.

Testimonial psychotherapy is a therapeutic ritual for facilitating the recovery of survivors of human rights violations that focuses on sharing the trauma narrative. Originally developed in Chile as a method for collecting evidence during legal proceedings, testimonial therapy has been widely applied transculturally as a unique treatment modality for populations that are not amenable to traditional Western psychotherapy. In this case report, we first review the literature on testimonial therapy to this date.

Pharmacological treatment of depression in geriatric chronic pain patients: a biopsychosocial approach integrating functional restoration.

A recent literature review concluded that the comorbidity of chronic pain and depression in adults is approximately 50%-65%. Physical and cognitive declines, concurrent multiple health conditions, and complex medication regimens add to the unique and complex challenges of effectively treating pain in particularly geriatric populations. Interdisciplinary medical intervention and monitoring for psychiatric sequelae, such as depression, cognitive change, and synergistic physical side effects are necessary.

Torture survivors' symptom load compared to chronic pain and psychiatric in-patients.

Before their entry into the rehabilitation program at the Rehabilitation and Research Centre for Torture Victims ('RCT') in Copenhagen, the degree of symptoms of a group of resettled traumatized refugees was assessed by means of two rating scales: the Disability Rating Index (DRI) (n=197), measuring pain-related functional disability, and the Hospital Anxiety and Depression Scale (HADS) (n=147). The results obtained were compared with other patient populations, which included (1) a large Swedish mixed pain group and (2) various groups of pain patients previously investigated in the validation study of the DRI scale. The DRI scores of the refugee group were comparable to, or higher than, those of the pain groups, except for patients suffering from multiple sclerosis.

Needs Assessment of Hurricane Katrina Evacuees Residing Temporarily in Dallas.

This study assessed the psychosocial needs of Hurricane Katrina evacuees temporarily residing in Dallas, TX, after sheltering but prior to their permanent resettlement. Common trauma exposures were physical exposure to flood water, seeing corpses, witnessing death, and loss of family, friends, or home. Fewer than 10 % met symptom criteria for disaster-related posttraumatic stress disorder (PTSD).

Testimonial Therapy: Impact on social participation and emotional wellbeing among Indian survivors of torture and organized violence.

Introduction: Traumatizing events, such as torture, cause considerable impairments in psycho-social functioning. In developing countries, where torture is often perpetrated, few resources exist for the provision of therapeutic or rehabilitating interventions. The current study investigated the effectiveness of Testimonial Therapy (TT) as a brief psycho-social intervention to ameliorate the distress of Indian survivors of torture and related violence.

Testimony ceremonies in Asia: integrating spirituality in testimonial therapy for torture survivors in India, Sri Lanka, Cambodia, and the Philippines.

This study explores the therapeutic implications of including culturally adapted spiritual ceremonies in the process of testimonial therapy for torture survivors in India, Sri Lanka, Cambodia, and the Philippines. Data were collected through an action research process with Asian mental health and human rights organizations, during which the testimonial method was reconceptualized and modified to include four sessions. In the first two sessions, community workers assist survivors in the writing of their testimony, which is their narrative about the human rights violations they have suffered.

The land of milk and honey: a picture of refugee torture survivors presenting for treatment in a South African trauma centre.

Intake data obtained from 55 refugee torture survivors accessing trauma treatment services at a centre in Johannesburg, South Africa, paints a picture of suffering beyond the torture experience. The intake forms part of a more comprehensive monitoring and evaluation system developed for the work done with torture survivors accessing psychosocial services. The diverse sample with different nationalities highlights that torture occurs in many countries on the African continent.

Testimonial therapy. A pilot project to improve psychological wellbeing among survivors of torture in India.

Introduction: In developing countries where torture is perpetrated, there are few resources for the provision of therapeutic assistance to the survivors. The testimonial method represents a brief cross-cultural psychosocial approach to trauma, which is relatively easy to master. The method was first described in Chile in 1983 and has since been used in many variations in different cultural contexts.

Prescription opioid dependence is associated with poorer outcomes in disabling spinal disorders.

Study Design: Prospective outcomes study involving patients with chronic disabling occupational spinal disorders (CDOSD) diagnosed with (n = 199) or without (n = 1124) postinjury opioid-dependence disorder (ODD), based on the Diagnostic and Statistical Manual of Mental Disorders-fourth edition cirteria.

Objective: To determine whether prescription opioid dependence, assessed at the beginning of rehabilitation treatment, is associated with poorer treatment outcomes in patients with CDOSDs attending an interdisciplinary rehabilitation program.

Summary Of Background Data: Controversy exists regarding the risk of iatrogenic ODD and treatment outcomes when long-term opioid therapy is used in the treatment of chronic nonmalignant pain conditions.

Psychiatric comorbidity in chronic disabling occupational spinal disorders has minimal impact on functional restoration socioeconomic outcomes.

Study Design: A prospective study conducted at a tertiary functional restoration center for patients with chronic disabling occupational spinal disorders (CDOSDs), comparing treatment outcome status 1-year posttreatment of patients with specific diagnosed psychiatric disorders to those without.

Objective: To evaluate if diagnosed psychopathology is a significant limiting factor in the successful interdisciplinary rehabilitation of CDOSD patients.

Summary Of Background Data: Research has demonstrated high prevalence rates of psychiatric disorders in patients with CDOSDs.

Do psychiatric disorders first appear preinjury or postinjury in chronic disabling occupational spinal disorders?

Study Design: An epidemiologic prevalence study.

Objectives: To clarify the temporal association between work-related injury claims and psychiatric disorders in patients with chronic disabling occupational spinal disorders (CDOSDs).

Summary Of Background Data: Few empirical data are available regarding the "chicken-or-egg" question of which occurs first: the injury or incident culminating in the painful CDOSD or the psychiatric disturbance.

Psychologic reasons for patients preferring minimally invasive total hip arthroplasty.

Success of an orthopaedic operation depends on patients achieving their primary goal(s) and having satisfaction with the outcome. The enthusiasm of patients for minimally invasive total hip arthroplasty seems related to satisfaction with the operation. We hypothesized patients' attitude toward a small incision would increase their confidence and satisfaction with the operation but the importance of the incision would dissipate after patients realized their goals of pain relief and functional recovery.

Interdisciplinary treatment of failed back surgery syndrome (FBSS): a comparison of FBSS and non-FBSS patients.

Many patients enrolled in chronic pain centers suffer from failed back surgery syndrome (FBSS). However, there has been a paucity of research concerning how these patients differ from other chronic pain patients, and how to most effectively address their complex problems within an interdisciplinary chronic pain treatment environment. The current study represents the first large-scale examination of these issues, with two major aims: (1) to elucidate the differences between FBSS patients and other chronic lumbar pain patients; and (2) to clarify the role of injections in interdisciplinary treatment, particularly with FBSS patients.

A cost-utility analysis of chronic spinal pain treatment outcomes: converting SF-36 data into quality-adjusted life years.

Objectives: The present retrospective case review study sought to analyze the cost-utility, expressed in cost/quality-adjusted life years (QALY), of current chronic spinal pain treatments. In addition, it expands upon previously published data evaluating the efficacy of interdisciplinary pain management in relation to medication management.

Methods: A recently developed algorithm was used to calculate QALYs using SF-36, v.

Prevalence of psychiatric disorders in patients with chronic disabling occupational spinal disorders.

Study Design: A prevalence study.

Objectives: To assess the prevalence of psychiatric disorders among a large group of patients with chronic disabling occupational spinal disorders (CDOSDs), using a reliable and valid diagnostic instrument.

Summary Of Background Data: Although unrecognized and untreated psychiatric disorders have been found to interfere with successful treatment of CDOSD patients, little data are currently available regarding the psychiatric characteristics of patients claiming work-related injuries that result in CDOSDs.

Biopsychosocial profiles of different pain diagnostic groups.

Unlabelled: Different pain diagnoses have been examined separately in various research studies. The major aim of the present investigation was to add to the current understanding of the various groups of patients who make up the chronic pain population. This study expanded the research literature by including 7 different predominantly chronic pain syndromes (fibromyalgia, upper extremity pain, cervical pain, thoracic pain, lumbar pain, lower extremity pain, and headache).

Bioterrorism, stress, and pain: the importance of an anticipatory community preparedness intervention.

This article reviews the accumulating scientific evidence demonstrating the negative impact caused by a cataclysmic event, such as bioterrorism, on the mental health of a community. Moreover, the potential mental health problems created by the continuing threat of possible future events are discussed. This close link among disaster events, stress, pain, and psychopathology is presented from a biopsychosocial perspective.

The management of secondary gain and loss in medicolegal settings: strengths and weaknesses.

Individuals with chronic illness and disability are among the most difficult patients to treat. The health-care provider is faced with an array of physical, psychological, and social factors, requiring adoption of a biopsychosocial approach to treatment. This approach necessitates consideration of the benefits for the patient of remaining ill and disabled.

Psychotropic medication in chronic spinal disorders.

Background Context: Optimal treatment of nonmalignant chronic spinal disorders (CSDs) may require the use of one or more nonopioid psychotropic medications. Vast research literature has documented high rates of psychiatric disorders in patients with CSDs. Psychotropic medications are one type of effective treatment for these disorders.

Development of a self-report screening instrument for assessing potential opioid medication misuse in chronic pain patients.

This study constituted the first step in the psychometric development of a self-report screening instrument for risk of opioid medication misuse among chronic pain patients. A 26-item instrument, the Pain Medication Questionnaire (PMQ), was constructed based on suspected behavioral correlates of opioid medication misuse, which heretofore have received limited empirical investigation. The PMQ was administered to 184 patients at an interdisciplinary pain treatment center.