To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This chapter calls attention to the violence of everyday life in the Roman world as the backdrop to the more extraordinary violence of war. Drawing specifically on archaeology, which is poorly equipped, it is argued, to reveal war violence but well situated to reveal the unusual volatility of living in the Roman world, it describes the ordinary upheavals of daily life. In particular, it examines the archaeological evidence for volatility in domestic circumstances, in how one made a living, and the physical trauma experienced by working bodies.
Blunt and penetrating trauma are common in many disasters, including hurricanes. Injured patients can present to the hospital during the event or up to several days after. Patients often present with lacerations and abrasions, but well-appearing patients still require a thorough physical exam and appropriate imaging with necessary consults. During disasters, patients can overwhelm the hospital and traditional imaging modalities (CTs); therefore, ultrasound can assist in patient triage and diagnoses during these times while accelerating patient care.
This response provides two examples for which an understanding of the biology of stress has informed approaches to supporting children. In the first, educators at the University of Cambridge Primary School are trained to view children’s behavior as a reflection of their needs and to utilise a variety of support strategies, including coaching, non-violent communication, careful language choices and emotional health education. In the second, the Yoga Story Time project, implemented in an at-risk school in Sicily, aimed to support the well-being of children who had experienced trauma. Through interactive storytelling, creative activities and yoga poses, the project sought to improve children’s communication skills, emotional regulation and social interaction.
In this chapter, the intersection of systemic inequality, oppression, and trauma are explored. We outline outlines the deep historical and contemporary roots of oppression and trauma, explores the multifaceted impact on individuals and communities, and suggests practical strategies for dismantling these systems, all with an eye toward long-term healing and justice.
Creative engagement with the Arthurian myth has been prolific in the modern period and shows no sign of abating. This chapter provides a panoramic shot, an overview of how and where the Arthurian myth surfaces in texts in English in Great Britain and Ireland from 1920 to the present. Additionally, it provides close-ups, more detailed readings of selected works that capture the critical concerns of modern artists and their audiences, foregrounding especially trauma and the impacts of war and industrialised culture; expressions of the interconnectedness between all living things, often in response to contextual ecopolitical crises; and human interactions, including tragic relationships and empowering female networks. The discussion breaks materials into broad categories that are loosely determined by form – poetry, prose and drama – and moves between foundational works and newer narratives. Where possible, the discussion foregrounds Arthuriana that has previously received little or no attention, especially works by women.
This chapter explores the evolving depiction of the Land of Israel in Hebrew poetry, reflecting the creation of modern Hebrew culture. It contrasts ancient expressions of longing for Zion with the transformed image of Israel as a tangible landscape. The chapter examines how poets from various Zionist immigration periods depicted their encounters with the land, ranging from messianic ecstasy to realistic sobriety. Each era produced poets who articulated their complex experiences, as exemplified by Noah Stern’s poem “Smells” (1935), which captures the blend of hallucinations, disappointments, tortures, pleasures, closeness, and alienation. Each poem is a new chapter in the ongoing narrative of encountering the land.
Armed conflict devastates children across all regions and ideologies – inflicting profound and lasting harm on their bodies, minds, and developmental trajectories. While all sides may commit atrocities, the experience of children is tragically consistent: they are the least responsible, yet often the most harmed. This article traces the evolving global understanding of war’s impact on children, charting a journey in modern history to present-day realities. It begins with the landmark 1996 UN report by Graça Machel, which exposed the wide-ranging and systematic nature of the effects of war on children – where violence, displacement, and severed attachments force children into premature adulthood. Building on this, the 2009 and 2013 UN efforts codified the “Six Grave Violations” against children in armed conflict, now central to global monitoring and advocacy. Despite these frameworks and legal protections, including the Convention on the Rights of the Child, the 2024 UN Secretary-General’s report shows violations have surged – up 21% in the past year alone. To bring these patterns into focus, the article concludes with a case study of Gaza. Chosen for its immediacy and visibility, Gaza is emblematic of the ongoing failure to shield children from war’s worst impacts. Similar suffering persists in Sudan, Myanmar, and Ukraine. The article calls for an urgent, universal imperative: end hostilities to protect children. A trauma-informed, attachment-sensitive approach – grounded in lessons from Rwanda, Bosnia, and Syria – is essential. Clinicians, humanitarians, and policymakers must place children at the heart of all post-conflict recovery and accountability efforts.
Dissociative identity disorder (DID) manifests with distinct trauma-avoidant and trauma-related identity states. Overtly conscious trauma-related knowledge processing is identity state-dependent. Previous research on covertly subconscious knowledge processing in DID lacks subject-specific trauma-related stimuli.
Aims
Our controlled functional magnetic resonance imaging (fMRI) study explored neural and behavioural differences of overt and covert knowledge processing of individualised self-relevant words in DID.
Method
Behavioural data were gathered while 56 participants underwent task-based fMRI: 14 with DID, 14 DID simulators and a paired control group of 14 healthy controls and 14 participants with post-traumatic stress disorder. Individuals with DID and simulators participated in a trauma-avoidant and a trauma-related identity state. Reaction times and brain activation following overtly and covertly presented individualised words were statistically analysed.
Results
Behavioural analyses showed a main effect of consciousness (P < 0.001). Post hoc between-group pairwise comparisons revealed slower reaction times for individuals with DID compared with simulating (P < 0.05) and paired controls (P < 0.05). Neural data analyses showed increased brain activation in frontal and parietal regions within the diagnosed DID group, especially during overt processing. Between-group comparisons mostly showed less pronounced activation in frontal, occipital and temporal areas.
Conclusions
The present study showed increased cognitive control during overt self-relevant knowledge processing in the trauma-avoidant identity state of DID, in line with previous research. The slower reaction times and increased frontoparietal activation shown in individuals with diagnosed DID, as compared with both control groups, support the notion of cognitive avoidance of trauma-related information in DID and further reinforce the authenticity of DID experiences.
The present study examined developmental pathways beginning in pregnancy and extending into early childhood that contribute to child emotion regulation (ER). Leveraging data from a sample of 157 mixed-sex couples, who largely identified as White and non-Hispanic/Latino, and their typically developing children (50.3% female), we examined whether parental emotion-related socialization behaviors (ERSBs; i.e., general emotion talk, specific supportive and nonsupportive responses to children’s negative emotions) at preschool age (child age 3) mediated the link between parental trauma-related distress spanning pregnancy to toddler age (2-years postpartum) and child maladaptive ER at the transition to formal schooling (age 5). Chronic elevations in maternal trauma-related distress contributed directly and indirectly to child maladaptive ER at age 5, and maternal nonsupportive responses emerged as a potential pathway driving the intergenerational transmission of emotion dysregulation. In contrast, paternal trauma-related distress neither undermined ERSBs nor contributed to child maladaptive ER. Instead, chronic elevations in paternal trauma-related distress predicted more supportive responses to children’s negative emotions. Results highlight the utility of repeated screening for trauma-related distress and prevention and early intervention efforts targeting parental trauma-related distress and nonsupportive responses to children’s negative emotions. These strategies may help promote adaptive ER at school entry and reduce risk for later psychopathology.
Chapter 3 considers the self-help of time management, productivity, and creative timeflow in conversation with the work of Tao Lin and Myriam Gurba. First, I examine Lin’s autofictional novels, especially Taipei (2013), exploring how his relationship with time management evolves through ideas of micromanaged self-control, a self-tracking ‘virtual self’, and psychedelic, aleatory, and New Age temporalities. Then, by attending to Gurba’s memoir, Mean (2017), as well as the self-help advice podcast she co-hosted, I look at how her sense of therapeutic ‘trauma time’ and queer Chicanx asynchronic time combine to produce a form of ‘writer’s block’ that challenges the notion of literary production as a rational activity. The chapter argues that both authors play with diverse self-help discourses to explore agency and control in the processes of writing and life, illuminating broader tensions in contemporary culture between ideas of writers as disciplined, entrepreneurial craftspeople or as recalcitrant, romantic artists.
Early life adversity (ELA) is common and cross-sectionally associated with brain gray matter structure, including cortical thickness, cortical surface area, and subcortical volumes in childhood. However, to which degree ELA influences the trajectory of gray matter macrostructural and microstructural development during childhood and adolescence remains largely unexplored.
Methods
We included 6414 participants from the Adolescent Brain Cognitive Development study at ages 9–11, where 1923 were followed to ages 11–13. We used linear mixed-effects models to test for associations between MRI-derived longitudinal measures of gray matter macro- (cortical thickness, surface area, subcortical volume) or microstructure (T1w/T2w ratio) and trauma exposure, parental acceptance, household abuse, and being resilient or susceptible to trauma in terms of developing an internalizing disorder.
Results
At ages 9–11, higher levels of parental acceptance, trauma exposure, and being trauma resilient were associated with lower levels of cortical thickness. In contrast, being trauma susceptible was negatively related to hippocampal volume and cortical surface area. Longitudinally, more parental acceptance at baseline was associated with more cortical thinning between ages 9–11 and 11–13, while more household abuse was associated with less change in T1w/T2w ratio over time.
Conclusions
Parental acceptance and trauma resilience are linked to accelerated pace of apparent cortical thinning in youth aged 9–13 years, while household abuse is associated with slower microstructural development, as reflected by smaller longitudinal changes in the T1w/T2w ratio. Threat and deprivation may be distinctly associated with gray matter developmental trajectories in late childhood.
This chapter takes a new look at Ennius’ Andromacha and particularly at her self-description as arce et urbe orba sum (23 TrRF II). Scholarship has well explicated how the formulaic words arce et urbe characterize Andromacha, to quote Jocelyn, as “a stateless person in terms of Roman law” (Jocelyn 1967). But scholarly focus on the religious formula has obscured the equally poignant allusion encoded in her choice of verb. Orbus is a word whose primary definition is of a child deprived of their parents or, conversely, of a parent who has lost a child. This chapter explores how Ennius boldly harnesses these familial connotations to create an arresting metaphor that totalizes Andromache’s loss. In doing so, he subtly genders Andromacha’s meditation on the loss of her recent past as well as significantly prefiguring the greater loss that the audience (but not yet Andromacha) knows is coming by the tragedy’s end, the tossing of Astyanax from the arx of Troy.
Subjective perspectives on aetiological factors in atypical depression have not been previously explored from the viewpoint of those with lived experience.
Aims
This study aimed to explore individuals’ subjective experiences and explanations of atypical depression, and to examine whether perceived gender-specific influences might contribute to the observed gender disparity in atypical depression prevalence.
Method
Semi-structured, one-to-one interviews were conducted online with 16 individuals. Data were analysed using thematic analysis, employing an inductive approach and interpreted within a constructionist framework. Data coding was conducted using NVivo.
Results
Key themes centred on the prevalence of comorbid conditions and how they affected atypical depression presentation; how trauma was seen as both a causal factor and catalyst; the subjective impact of gender identity and roles; how environmental factors seemed to affect atypical depression onset and presentation; the difficulties experienced with atypical depression symptom variability in daily life; and reported coping behaviours.
Conclusions
These findings highlight how individuals with atypical depression believed onset to be linked to experiences of trauma and comorbidity, in addition to ongoing influences of varied environmental factors. The variability of atypical depression symptoms in both the short and long term appears to be a core challenge in this subgroup. The gender disparity of atypical depression is also explored through the lens of lived experience and gender identity. Future research would benefit from exploring further these potential contributing factors, to provide a better understanding of their complex influences on atypical depression onset and maintenance.
While early-life adverse experiences have been linked to late-life cognitive decline, few studies have explored war exposure. Paradoxically, one study even indicated a late-life cognitive advantage of early-childhood war exposure. In the present study, we explored these associations.
Methods:
We examined older adults exposed to World War II (1940–1944; n = 1179) and the subsequent Civil war (1946–1949; n = 962) in Greece during early and middle childhood with a comprehensive neuropsychological assessment and for ApoE-ε allele status, including demographic information and medical history.
Results:
Higher cognitive performance in language tasks predicted middle childhood, relative to early childhood, WWII-exposure group membership (B = .316, p = .038, OR:1.372, 95%CI:1.018–1.849), primarily for men, while higher attention/speed (B = .818, p = .002, OR:2.265, 95%CI:1.337–3.838) and total cognitive score (B = .536, p = .040, OR:1.709, 95%CI:1.026–2.849) were predictors of belonging to the middle-childhood group, only in men. Individuals who did not meet criteria for Mild Cognitive Impairment (MCI)/dementia were more likely to belong to the middle-childhood war-exposure group. Similarly, for the Civil war, higher cognitive scores and reduced likelihood to meet criteria for MCI/dementia were predictors of middle, relative to early childhood war exposure group membership (visuospatial score: B = .544, p = .001, OR:1.723, 95%CI:1.246–2.381, MMSE: B = .134, p = .020, OR:1.143, 95%CI:1.021–1.297), primarily for women. Results remained consistent when adjusting for multimorbidity, sex, education, current age, depression, and anxiety.
Conclusion:
The present findings suggest that better cognitive performance and lower likelihood of MCI or dementia were associated with being exposed to significant hardships, such as war, during middle childhood, regardless of potentially confounding factors. Further studies are needed to shed light on this relationship.
The experience of human trafficking is associated with a high prevalence of mental health problems, particularly post-traumatic stress disorder (PTSD), anxiety, and depression, for which cognitive behavioural therapy (CBT) would be indicated as an evidence-based intervention. However, lack of knowledge about trafficking survivors’ psychosocial needs, and the complexity of their presentation and circumstances can deter clinicians and impact on survivors’ access to evidence-based care. This article aims to offer guidance for clinicians working therapeutically with adult survivors of human trafficking. It draws on existing CBT evidence-based interventions, and highlights survivors’ holistic needs. This article proposes the use of an existing three-phased approach to treatment and draws upon cognitive behavioural principles. The psychological impacts of exploitation, key assessment topics, and safeguarding concerns are discussed. Considerations for psychological formulation and intervention are described, with a focus on trauma reactions, including PTSD. The integration of a survivor’s social and cultural context into treatment is also explored. CBT interventions can be adapted and applied effectively to address the mental health needs of survivors of trafficking alongside other support to meet their holistic needs.
Key learning aims
(1) To outline potential impacts of trafficking-related experiences on mental health.
(2) To increase clinicians’ confidence in engaging survivors of trafficking in assessment and evidence-based CBT interventions.
(3) To apply a phased model framework to planning and delivering effective interventions where there may be additional or complex psychosocial needs.
In Chapter 5, I examine how four Pittsburgh Courier writers – Julia Bumry Jones, Alice Dunbar-Nelson, Blanche Taylor Dickinson, and Zora Neale Hurston – code the cabaret flapper’s “sexual spending” within both the ideology of “race motherhood” and what Erin Chapman describes as the “sex-race marketplace.” The Courier’s typical cabaret flapper indulges – in fashion, alcohol, and sexual conquests – even as she must “sell” herself to sustain her rate of consumption. These writers present the Black flapper as threatening the New Negro Man, and by extension the race due to her “wasteful” excesses and dysgenic spending, and affirm the flapper’s foil: a reconceived version of the “race mother” – modern, urban, resilient but pragmatically more conservative versions of the New Negro Woman. With help from Old Negro maternal figures, these New Negro Women fix their flawed relationships or marriages and develop more companionate unions. Refusing to indulge in the shaming of the Black light-skinned elite respectable New Negro Woman, these Old Negro mammy or auntie figures do not represent the race as “progressive and race conscious” modern New Negro mothers, but, rather, they nurture and console the Black female protagonist suffering some form of trauma associated with the Great Migration.
Childhood is an important time for cognitive development, during which time many factors can influence the development of complex functions like decision-making. The relationship between the HPA axis and stress reactions is of particular relevance in the development of decision-making. Fear signals activate the HPA axis, which results in cortisol production. Cortisol acts with adrenaline to form memories associated with emotional responses. This system develops early on and is dependent on exposure to stressful situations. Over activation during development, such as in cases of overexposure to stress, can result in elevated cortisol. Adverse childhood experiences (ACEs) are understood to impact a range of cognitive function; however, the relationship between negative childhood experiences and decision-making is not a linear one; research is ongoing to unravel the complexities of this relationship.
Social psychiatry focuses on the interpersonal and cultural contexts of mental disorder and mental wellbeing. Research in this area examines the relationship between psychiatric disorders and the social environment. This includes the consequences of positive or negative life events at the individual level, as well as broader themes – such as discrimination and inequality - at the societal level. This chapter aims to illustrate how research in social psychiatry has advanced our understanding of the role of social factors in the aetiology and management of mental disorders. We provide breakdowns of six high-impact research studies including summaries of background, methods, results, conclusions, strengths, and limitations. In addition, we provide some information about common pitfalls and methodological considerations that are specifically relevant to social psychiatry for novice researchers in this area, and our thoughts regarding future challenges and opportunities in this field.
Brief, low-intensity interventions may hold untapped promise for bolstering maternal health in low-resource contexts. The current study used propensity score matching (PSM) to evaluate uptake and differential effectiveness of two low-intensity digital perinatal health (PH) support programs in Lima, Peru. Pregnant women (N = 251) were assigned to one of two conditions (PH vs. trauma-focused PH [TF-PH]) and received weekly psychoeducational content via WhatsApp from a lay paraprofessional for 5 weeks. Conditions were not randomly assigned; PSM was used to improve causal inference of the condition. Women were interviewed before participation (T1), immediately following treatment (T2) and at 3 (T3) and 12 months postpartum (T4). Intimate partner violence had strong negative effects on women’s mental health, multisystem resilience and parenting, and single mothers reported higher levels of depression and posttraumatic stress symptoms than did partnered women. Intervention uptake was high, with 77% of women participating in all sessions. There were no significant differences between treatment groups over time, but effect sizes indicated a slight advantage of the TF-PH condition in addressing depression symptoms (dr = −0.29) and multisystem resilience (dr = 0.39). Study findings suggest that brief interventions may be well-received and that trauma-focused supports may also confer additional benefits for addressing depression and resilience.