This study aimed to investigate the serial-multiple mediation effect of professional identity, psychological capital, work-related stress, and work-related wellbeing among intensive care unit nurses in China. The cross-sectional survey was conducted from January 2017 to May 2017 in two Grade III A general hospitals in Jining, Shandong Province, China. Cluster sampling was used to recruit participants from the two hospitals. A total of 330 ICU nurses participated in the study. The nurses’ work stress scale, Chinese nurse’s professional identity (...) scale, the PsyCap questionnaire, and Chinese work-related wellbeing scale were used to collect the data. Descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson correlation analysis, linear regression analysis, and structural equation modeling were used to analyze the data. The average score for the work-related wellbeing of ICU nurses was 85.91 ± 13.94. Work-related stress, professional identity, and PsyCap correlated significantly with work-related wellbeing. The major predictors of work-related wellbeing were PsyCap, work-related stress, professional identity, and monthly salary. The serial-multiple mediation effects of professional identity and PsyCap in the relationship between work-related stress and work-related wellbeing were statistically significant. Positive professional identity and PsyCap were sequentially associated with decreased work-related stress, which in turn was related to increased work-related wellbeing among ICU nurses. Therefore, this study aims to explore the impact of ICU nurses’ work-related stress on work-related wellbeing, as well as the mediating effect of professional identity and PsyCap. It is hoped that hospital care managers will pay attention to the mental health of ICU nurses, increase their professional identity, and reduce work-related stress to improve the quality of the ICU nursing service and stabilize nursing work. (shrink)

BackgroundResearch during 2020 has been rapidly attending to the impact of COVID-19 on various dimensions of wellbeing on adults and children around the world. However, less attention has focused on the psychoeducational impact on children and their families. To our knowledge, no currently available studies have looked specifically at the impact of COVID-19 on students with dyslexia and their families. Research on this topic is needed to offer greater support for this population of students and their families.ObjectiveThe main objective of (...) this paper is to examine the psychoeducational impact of the required COVID-19 quarantine in Spain among children with dyslexia and their families.MethodA sample of 32 children with dyslexia and their mothers participated in this study.MeasuresChildren and adolescents with dyslexia and their mother completed several measures before the required national quarantine in Spain and again during the quarantine. Children completed measures of depression, state anxiety, reading activity, and reading motivation. Mothers provided demographic information and completed measures related to students’ emotional and behavioral difficulties as well as parenting stress, parental distress, and a questionnaire about educational problems during quarantine.ResultsMajor findings showed that during quarantine, children with dyslexia had increased levels of depression and anxiety symptoms, and parents perceived their children as having more emotional symptoms, hyperactivity-inattention, and conduct problems. During quarantine, children and adolescents with dyslexia also showed less reading activity and less reading motivation. Parents also reported significantly more stress, during quarantine compared to pre-quarantine conditions. Some demographic and psychological variables predicted children’s state anxiety as well parental stress. The questionnaire related to impacts of quarantine also revealed several important findings. For example, nearly all parents of children with dyslexia reported difficulties in establishing study routines, that the quarantine negatively affected their child’s learning, and that they did not receive sufficient help from teachers on how to support their child’s learning. Additionally, the vast majority of the parents were very worried about the child’s learning and school success, the child’s motivation and interest in reading, the child’s peer relations, and the professional skills of the child’s teacher.ConclusionThis study offers a preliminary investigation into this topic and elucidates several psychoeducational challenges that children with dyslexia and their families have experienced during the quarantine in Spain. Study findings highlight the need to provide immediate support for children with dyslexia and emphasizes the importance of developing prevention programs to mitigate any future negative impacts of COVID-19 on children with dyslexia and their parents. (shrink)

The radical changes deriving from the COVID-19 emergency have heavily upset some of the most familiar routines of daily work life. Abruptly, many workers have been forced to face the difficulties that come with switching to remote working. Basing on the theoretical framework proposed by the Job Demands-Resources model, the purpose of this paper was to explore the effect of work overload, on behavioral stress, meant as an outcome linked to the health impairment process. Furthermore, the aim of the (...) study was to explore the mediating role of job crafting, considered as a second-order construct consisting of two dimensions in the abovementioned relation. Participants were 530 workers experiencing remote working or work-from-home during the first COVID-19 lockdown in Italy. Hypotheses were explored by using three different latent variables, measured reflexively through indicators on a 5-point scale, extracted from validated questionnaires. Data analysis was performed through Structural Equation Modeling; to test the mediation, bootstrap validation was computed. Results showed that the mediation of job crafting was partial. More specifically, the direct effect between work overload and behavioral stress was positive; moreover, the indirect, negative effect through the mediation of job crafting was also significant. Therefore, results showed that job crafting can play a crucial role as a protective factor supporting the activation and adjustment of suitable resources; these resources can be useful to deal with the negative effects of work overload, particularly under the condition of heavy remote working and use of technologies, on individual outcomes. Starting from the current global scenario of the pandemic that has not yet ceased its effects, the study suggested decisive theoretical and practical implications. Accordingly, findings extended the current trends in occupational health psychology research, with special reference to the mainstream topic “work and COVID-19” in the Italian context. Finally, results can give suggestions to companies engaged in managing change, recommending that they build a collaborative workplace at the individual and collective level to implement job crafting interventions and enrich the personal and organizational resources of workers, which is useful cope with the current demands. (shrink)

Religion and faith are often central aspects of an individual’s self-concept, and yet they are typically avoided in the workplace. The current study seeks to replicate the findings about the role of religious beliefs and practices in shaping an employee’s reactions to stress/burnout and job attitudes. Second, we extend the literature on faith in the workplace by investigating possible relationships between religious beliefs and practices and citizenship behaviors at work. Third, we attempted to study how one’s perceived freedom to (...) express his/her religious identity at work was related to workplace attitudes and behaviors. Mixed results suggest that religiosity can be related to stress and burnout, job satisfaction, organizational commitment, and Organizational Citizenship Behavior. More research is needed to further qualify the results and explore the effects of one’s perceived freedom to express his/her religious identity in the workplace. (shrink)

Re-analysis of the data provided in the target article reveals a lack of evidence for a strong, universal relationship between parasite stress and the variables relating to sociality. Furthermore, even if associations between these variables do exist, the analyses presented here do not provide evidence for Fincher & Thornhill's (F&T's) proposed causal mechanism.

One of the many drastic changes caused by Covid-19 was the quick implementation of distance learning which represented a great technological challenge to many teachers and students. In fact, Italy ranks 24th amongst the 27-EU member countries in digital competitiveness which testifies to the significant delays and gaps in basic digital skills amongst the population. Based on the difficulties encountered in organizing distance learning, we assumed that teachers' perceived stress increased. Given that transversal skills can be associated with this (...) relationship, we hypothesized that among these skills, self-efficacy mediated the relationship between the difficulties in organizing distance learning and perceived stress. Since we targeted teachers from Italy and other European countries, we also hypothesized that this mediator effect would be different for both samples. Our sample was composed of a total of 366 primary/middle school teachers of which 86% female. After doing a mediation analyses with Process, Hayes' Model 4, we confirmed H1 but not H2: resulting in a partial mediation effect of self-efficacy for each individual group of teachers. Since difficulties of distance learning can affect the perception of stress, we believe that the promotion of transversal skills, such as self-efficacy, can better equip teachers when facing stressful situations. (shrink)

Zen monk Jikisai Minami takes the things we are supposed to strive for and turns them on their head. The [38] short, thought-provoking essays in this book are divided into four chapters about our sense of self, our hopes and dreams, our personal relationships and how to face death. Each essay begins with a deliberately controversial point of view to help us look at life's problems through fresh eyes."--Amazon.com.

Early life adversity, such as child maltreatment or child poverty, engenders problems with emotional and behavioral regulation. In the quest to understand the neurobiological sequelae and mechanisms of risk, the amygdala has been of major focus. While the basic functions of this region make it a strong candidate for understanding the multiple mental health issues common after ELA, extant literature is marked by profound inconsistencies, with reports of larger, smaller, and no differences in regional volumes of this area. We believe (...) integrative models of stress neurodevelopment, grounded in “allostatic load,” will help resolve inconsistencies in the impact of ELA on the amygdala. In this review, we attempt to connect past research studies to new findings with animal models of cellular and neurotransmitter mediators of stress buffering to extreme fear generalization onto testable research and clinical concepts. Drawing on the greater impact of inescapability over unpredictability in animal models, we propose a mechanism by which ELA aggravates an exhaustive cycle of amygdala expansion and subsequent toxic-metabolic damage. We connect this neurobiological sequela to psychosocial mal/adaptation after ELA, bridging to behavioral studies of attachment, emotion processing, and social functioning. Lastly, we conclude this review by proposing a multitude of future directions in preclinical work and studies of humans that suffered ELA. (shrink)

It has been shown that various types of stress initiate different physiological and neuroendocrine disorders. Oxytocin is mainly produced in the supraoptic nucleus and paraventricular nucleus of the hypothalamus. Hypothalamic OT has antistress effects and attenuates the hypothalamic–pituitary–adrenal axis. One mechanism behind the antistress effects of OT is mediated through the inhibition from GABAA receptors on corticotropin-releasing factor expression at the PVN. Various manual therapies such as acupuncture, transcutaneous electrical nerve stimulation, and massage initiate the stimulation of somatosensory neurons (...) of the body. It is well-known that TENS simulates OT expression, while it inhibits CRF expression at the PVN following chronic stress loading in rodents. Upregulation of OT expression at the hypothalamus is activated by the somatosensory stimulation, which is mediated via the spinothalamic pathway. Thus, somatosensory stimulation is beneficial in treating stress-associated symptoms. Hypothalamic OT is associated with the social behaviors, including maternal care and affiliation. Childhood neglect and/or child abuse are severely responsible for deleterious long-term effects on the cognitive/social activity and behavioral development. At parturition, a profound amount of OT is released into the systemic circulation in response to vaginal and cervical stimulation caused by the body of fetus, which induces the onset of maternal behavior. Peridural anesthesia effectively impairs the sensitivity to vaginal and cervical stimulation at parturition. OT levels in cerebrospinal fluid is significantly reduced following peridural anesthesia. The vaginal delivery mothers had significantly more OT pulses than the caesarian section mothers. Due to low levels of endogenous OT, maternal behavior could be interrupted by epidural anesthesia and CS at parturition because of the reduction of the usual sensory input from the genitalia. (shrink)

Background and Objective: Understanding how trauma impacts the self-structure of individuals suffering from the Post-Traumatic Stress Disorder (PTSD) symptoms is a complex matter and despite several attempts to explain the relationship between trauma and the “Self”, this issue still lacks clarity. Therefore, adopting a new theoretical perspective may help understand PTSD deeper and to shed light on the underlying psychophysiological mechanisms. Methods: In this study, we employed the “three-dimensional construct model of the experiential selfhood” where three major components of (...) selfhood (phenomenal first-person agency, embodiment, and reflection/narration) are related to three Operational Modules (OMs) of the self-referential brain network. These modules can be reliably estimated through operational synchrony analysis of the Electroencephalogram (EEG). Six individuals with PTSD symptoms and twenty-nine sex-, age- and demographic- (race, education, marital status) matched healthy controls underwent resting state EEG signal acquisition with the following estimation of the synchrony strength within every OM. Results: Our results indicate that subjects with PTSD symptoms had significantly stronger EEG operational synchrony within anterior and right posterior OMs as well as significantly weaker EEG operational synchrony within left posterior OM compared to healthy controls. Moreover, increased the functional integrity of the anterior OM was positively associated with hyperactivity symptoms, reduced synchrony of the left posterior OM was associated with greater avoidance, and increased right posterior OM integrity was positively correlated with intrusion and mood symptoms. Conclusion: The results are interpreted in light of the triad model of selfhood and its theoretical and clinical implications (including a new treatment approach) are discussed. (shrink)

Recent models of cognition in Posttraumatic Stress Disorder predict that trauma-related, but not neutral, processing should be differentially affected in these patients, compared to trauma-exposed controls. This study compared a group of 50 patients with PTSD related to the war in Bosnia and a group of 50 controls without PTSD but exposed to trauma from the war, using the DRM method to induce false memories for war-related and neutral critical lures. While the groups were equally susceptible to neutral critical (...) lures, the PTSD group mistakenly recalled more war-related lures. Both false and correct recall were related more to depression than to self-rated trauma. Implications for accounts of false memories in terms of source-monitoring are discussed. (shrink)

ABSTRACTDepression is associated with increased emotional response to stress. This is especially the case during the developmental period of adolescence. Cognitive reappraisal is an effective emotion regulation strategy that has been shown to reduce the impact of emotional response on psychopathology. However, less is known about whether cognitive reappraisal impacts the relationship between depressive symptoms and emotional responses, and whether its effects are specific to emotional reactivity or emotional recovery. The current study examined whether cognitive reappraisal moderated the relationship (...) between depressive symptoms and trait or state measures of emotional reactivity and recovery. A community sample of 127 adolescents, at an age of risk for depression, completed self-report measures of trait emotional responding and depressive symptoms. In addition, they completed an in vivo social stress task and were assessed on state emotional reactivity and recove... (shrink)

The environment can have a long‐lasting influence on an individual's physiology and behavior. While some environmental conditions can be beneficial and result in adaptive responses, others can lead to pathological behaviors. Many studies have demonstrated that changes induced by the environment are expressed not only by the individuals directly exposed, but also by the offspring sometimes across multiple generations. Epigenetic alterations have been proposed as underlying mechanisms for such transmissible effects. Here, we review the most relevant literature on these changes (...) and the developmental stages they affect the most. We discuss current evidence for transgenerational effects of prenatal and postnatal factors on bodily functions and behavioral responses, and the potential epigenetic mechanisms involved. We also discuss the need for a careful evaluation of the evolutionary importance with respect to health and disease, and possible directions for future research in the field. (shrink)

ObjectivesThe study aims to investigate the state anxiety of parents of special needs children during the 2019 coronavirus disease epidemic and the influence of parental stress, social support, and other related variables on the anxiety of parents.MethodsBespoke questionnaires of children’s and parent’s mental and behavioral problems during the epidemic were used in the study. We also used the State Anxiety Inventory, the Parenting Stress Index—Short Form-15, the NEO Five-Factor Inventory, and the Multidimensional Scale of Perceived Social Support. The (...) data used in the study were pooled from an online survey of parents of special needs children and analyzed by one-way analysis of variance and multiple linear regression.ResultsOverall, 1,451 individuals were included, of which 402 were fathers and 1,049 were mothers. ANOVA results showed that educational background, family monthly income, and type of their child’s disability made parents’ state anxiety significantly different. The results of multiple linear regression showed that during the epidemic, social support negatively predicted parents’ state anxiety, whereas parenting stress and parental mental and behavioral problems positively predicted parents’ state anxiety.ConclusionsDuring the outbreak of COVID-19, parents of special needs children suffered mental and behavioral problems, together with parenting stress and social support, which influenced their state anxiety. These findings can be used to develop relevant psychological interventions to improve the mental health of vulnerable groups during a pandemic like COVID-19. (shrink)

In psychology, stress is a feeling of emotional strain and pressure. Stress is a type of psychological pain. Small amounts of stress may be beneficial, as it can improve athletic performance, motivation and reaction to the environment. Excessive amounts of stress, however, can increase the risk of strokes, heart attacks, ulcers, and mental illnesses such as depression and also aggravation of a pre-existing condition. Psychological stress can be external and related to the environment but may (...) also be caused by internal perceptions that cause an individual to experience anxiety or other negative emotions surrounding a situation, such as pressure, discomfort, etc., which they then deem stressful. (shrink)

ObjectiveTo examine the effect of family and perceived organizational support on the relationship between nurse adaptability and their experience with COVID-related PTSD (post-traumatic stress disorder) symptoms in frontline nurses working on COVID-19 units.BackgroundProximity to and survival of life-threatening events contribute to a diagnosis of PTSD, which is characterized by avoidance of reminders of trauma, intrusive thoughts, flashbacks of events, sleep disturbances, and hypervigilance. Using the job-demands and resource model, we examined the effect of adaptability, family support, and perceived organizational (...) support on PTSD symptoms for nurses during the COVID-19 pandemic. Specifically, we tested whether perceptions of environmental supports—i.e., family and organizational support—moderated the relationship between nurse adaptability and COVID-related PTSD symptoms.MethodsA sample of frontline nurses working on COVID-19 units during the COVID-19 pandemic in Texas (N= 277) participated in this cross-sectional, observational study. Frontline Nurses reported demographic information and completed surveys designed to measure adaptability, perceived organizational support, family support, and COVID-related PTSD symptoms.ResultsAdaptability was significantly positively correlated (medium effects) to perceived organizational and family support (r= 0.51 and 0.56, respectively,p< 0.01). Adaptability and perceived organizational support were also negatively correlated with COVID-related PTSD symptoms (medium effects). Adaptability was negatively correlated with COVID-related PTSD symptoms, supporting Hypothesis 1 (r= −0.43,p< 0.01). Perceived organizational support was also significantly negatively correlated with COVID-19-related PTSD symptoms (r= −0.30,p< 0.01). Family support was not significantly correlated with COVID-related PTSD but was positively related to experiencing COVID-related PTSD after other variables were accounted for.ConclusionFindings suggest that individual adaptability and organizational support may reduce PTSD severity in frontline nurses working during a crisis; however, family support may increase PTSD symptoms. We provide suggestions for strengthening individual adaptability and healthcare leadership including remaining highly engaged to show support by providing rapid communication, remaining calm during difficult circumstances, and maintaining a consistent, physical presence during difficult times. Moreover, our results suggest additional support for nurses with families to adapt to crisis. (shrink)

Growing literature has linked attention bias variability to the experience and treatment of posttraumatic stress disorder. Unlike assessments of attention bias in only one direction, A...

Promyelocytic leukaemia nuclear bodies (PML NBs) are generally present in all mammalian cells, and their integrity correlates with normal differentiation of promyelocytes. Mice that lack PML NBs have impaired immune function, exhibit chromosome instability and are sensitive to carcinogens. Although their direct role in nuclear activity is unclear, PML NBs are implicated in the regulation of transcription, apoptosis, tumour suppression and the anti‐viral response. An emerging view is that they represent sites where multi‐subunit complexes form and where post‐translational modification of (...) regulatory factors, such as p53, occurs in response to cellular stress. Following DNA damage, several repair factors transit through PML NBs in a temporally regulated manner implicating these bodies in DNA repair. We propose that PML NBs are dynamic sensors of cellular stress, which rapidly disassemble following DNA damage into large supramolecular complexes, dispersing associated repair factors to sites of damage. The dramatically increased total surface area available would enhance interactions between PML‐associated factors regulating DNA repair and apoptosis. BioEssays 26:963–977, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Based mainly on research conducted as part of a doctoral thesis (Guimond-Plourde, 2004), this paper introduces an epistemological and methodological framework based on the foundations and characteristics of a qualitative/interpretative approach rooted in hermeneutic phenomenology as conducive to disclosing the meaning that healthy adolescents, aged 15 to 17, attribute to the stress they experience in school and to their coping behaviour. Moving from the empirical to the phenomenal makes it possible to evoke a return to dimensions of meaning which (...) have been set aside or forgotten in the lived experience of stress-coping. By thus bringing stress-coping into focus in a new way, it enables us to glimpse the phenomenon anew, with the prospect of revealing what we haven't yet appreciated. A dual philosophical approach is outlined: a phenomenological perspective apprehends stress-coping as an existential phenomenon, while the hermeneutic focus is on interpreting the links between lived experience and meaning. The kind of knowledge generated by means of this approach offers a new way of understanding that focuses on the unique and personal nature of healthy adolescents' daily life at school and, as such, provides educators with a sensitive account of adolescents' experiences of stress in the school context. (shrink)

The question whether memory aberrations in posttraumatic stress disorder also manifest as an increased production of false memories is important for both theoretical and practical reasons, but is yet unsolved. Therefore, for the present study we investigated veridical and false recognition in PTSD with a new scenic variant of the Deese–Roediger–McDermott paradigm, which was administered to traumatized individuals with PTSD , traumatized individuals without PTSD , and non-traumatized controls . The PTSD group neither produced higher rates of false memories (...) nor expressed more confidence in errors, but did show inferior memory sensitivity. Whereas depressive symptoms did not correlate with veridical nor false recognition, state dissociation was positively associated with false memories. (shrink)

Cultural realities: ethics, values and morals -- Moral stress, distress, and injury -- An ethnography of ethics -- Ethics, geography, and mapping: the failure of the simple -- The tobacco problem -- The morals in the map: stress and distress -- Moral communities and their members -- Mapping poverty: ethics and morals -- An educational example -- Mapping justice as transportation -- Ethics and transplantation -- The ethics of scale, the scale of distress -- It's ... complex.

BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms (...) of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder symptoms, as well as their toddler’s socioemotional development.ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Cultural Context of Post-traumatic Stress DisorderCarolyn Smith-Morris (bio)Keywordspost-traumatic stress disorder (PTSD), culture, medical anthropology, fight-or-flight responseIn his Clinical Anecdote, Dr. Christopher Bailey gamely imagines the evolutionary underpinnings of his patient's distressing lack of war wounds. As part of a careful and engaged discussion of care for his suffering patient, Dr. Bailey suggests that our evolved fight-or-flight response to the alarms of the African savannah may be (...) at work in Colin's distress. The fight-or-flight response is something of great interest to anthropologists, who rely on Darwin's theory of evolution to explain much in human experience. According to Dr. Bailey's application of the theory, Colin's visceral response to threat is protective in the presence of danger, but destructive (particularly to his mental health) in the absence of such challenges. So Dr. Bailey considers whether we may have an evolved “need” for threat, and that Colin's trauma is in part related to the lack of such threat in his wartime experience.According to Darwin's ideas, evolved traits may be adaptive but may also simply be random appearances that have not yet produced cause for evolutionary eradication. The fight-or-flight response, or any of the hypothalamic–pituitary–adrenal axis events initiated under either acute or chronic stress, is therefore occurring in Colin's reactions to everyday frustrations, to wartime exposures, and even during the stressful nontrauma of feeling “wimpy.” Dr. Bailey's idea about an evolved need for threat is tautological. That need is not biological, but cultural.Although post-traumatic stress disorder is medically real, it is an event that develops in a particular place and time. Likewise, gender roles that demand scar battles and trophies of a certain form are culturally determined. Culture is central to this anecdote: a culture-specific occurrence of post-traumatic stress disorder and culturally driven gender roles for men, especially warriors. Stress is indeed present in Colin's life: our postindustrial culture's separation from everyday death and violence make episodes like war and combat all the more shocking or traumatic; the lack of social recognition for his service also seems to be one of Colin's stressors. Both the shock of warfare and the trauma of his social invisibility are as vivid to his evolutionarily informed body as is the presence of a crouching lioness in the room. So it is the host of cultural expectations, and his inability to mobilize social and cognitive resources to respond to them, that is wounding Colin. Talk therapy should draw out these cultural details [End Page 235] and, as Dr. Bailey has already begun to do, emplot Colin into a more heroic (his)story of his service to our nation.Related ArticlesFeature Article: Clinical Anecdotes: A Painful Lack of WoundsCommentary: The Nature of Proof in PsychiatryCommentary: Truth and Healing a Veteran's DepressionCommentary: Inappropriate RegretCommentary: The Cultural Context of Post-traumatic Stress DisorderCommentary: Explication or Explanation?Commentary: The Importance of What Psychiatrists Care AboutCommentary: Mourning or MelancholiaResponse: A Painful Lack of ConnectionCarolyn Smith-Morris Carolyn Smith-Morris is an Associate Professor in the Department of Anthropology at Southern Methodist University in Dallas, Texas. Her work focuses on chronic disease and the health impacts of culture change and acculturative stress in North America. She is engaged in several research programs among migrating Mexican workers, among poor African-Americans in Dallas, and for the Gila (pronounced Hee-la) River Indian Community of Southern Arizona, a tribe that suffers from the highest recorded rates of type 2 diabetes in the world. She also holds a research fellowship with the Foundation for Community Empowerment, serves on the Board of the Society for Medical Anthropology, and is a fellow in the Society for Applied Anthropology. She published Diabetes Among the Pima in 2006 and has several articles detailing her applied research on diabetes, reproduction, health care ethics, and end-of-life care. She can be contacted via e-mail at: [email protected], C. 2009. A painful lack of wounds. Philosophy, Psychiatry, & Psychology 16, no. 3:223–224. [End Page... (shrink)