All human experiences have an effect on the brain, and in the form of memories and cognitive biases, affect the response of the individual to future events. When people experience traumatic events the brain is sometimes impacted in extreme ways, with major consequences for the individual in the form of psychiatric illness. This study is concerned with examining the way in which the prior experience of traumatic events affects the processing of simple stimuli under experimental conditions, in order to understand better the types of cognitive biases involved in psychiatric illnesses. The study used a well-established computerized test of selective attention, inhibition of return (IOR), and a newer task involving facial expressions and gaze cues. A review of the use of the IOR paradigm in different adult psychiatric disorders was conducted in order to aid interpretation of the findings. The mental health status of the participants was described by use of a number of standardized questionnaires. Participants were people in contact with Adult Mental Health services who had experienced trauma, including those with Posttraumatic Stress Disorder (PTSD), Psychosis and other psychiatric diagnoses. Results were compared with a healthy control group. Despite small sample sizes and heterogeneity within the groups, the study indicated that significant trauma can be associated with different types of mental health problem, and that different mental health problems are associated with different types of cognitive processing difficulty. The Psychosis group showed a lack of inhibitory processing, which is likely to be associated with increased distractibility, and, for example, lack of the ability to follow a train of thought. This is different from the distractibility seen in PTSD, which can be characterized as a tendency for attention to be captured by a salient stimulus without appropriate subsequent disengagement.

Aims and objectives. The aim of this study was to explore how clients perceived, and experienced NEST group therapy. Study design. A qualitative longitudinal design was adopted to explore the impact of treatment over time. Participants. Six participants, abuse survivors, five females and one male, aged between 25 and 61 years, all from Northern Ireland bar one who lived in the Republic of Ireland, volunteered to participate in the study. Data generation. Data was yielded from recorded semi structured interviews conducted with the six participants from two NEST groups, pre, middle and end of therapy and at three and six months post treatment, a total of thirty. For the purpose of verifying findings, focus group discussions were held and recorded with each group post interviews for the first four data collection phases, eight in total. Procedures. Ethical approval to conduct this study was obtained from NEST Board and the University of Ulster Filter Committee. Data analysis. Transcribed interviews and focus discussions were analysed using grounded theory (Strauss and Corbin, 1998) with the assistance of Nvivo 9. Results. The core category of the study "From the Pupa to the Butterfly, a new way of living, a new way of being" describes the metamorphosis of change r witnessed in participants. From pre NEST treatment when "My life was really nothing", positive changes were experienced by participants in several areas of functioning including emotional wellbeing "1 feel that I've got wings and it's just amazing", self esteem, "A sense of wholeness", cognitive "I have a new vision", coping capacity, "The eyes to the soul, I see, I know where I am going" and relational improvement "Reaching out to others". NEST had a positive and powerful impact on participants conceptualised in the category "NEST saved me, I got soul from NEST."

Females are more than twice as likely to have a diagnosis of Post-traumatic Stress Disorder (PTSD) making PTSD particularly relevant to female mentally disordered offenders (MDOs). Female offenders have been observed to report higher levels of trait anger and anger expression compared to males. Exploration of the relationship between anger and PTSD is in its infancy among MOOs. This study investigated gender differences in the levels of PTSD and anger and in the relationship between PTSD and anger in a sample of 66 MOOs using a cross sectional design. Participants completed self- report measures of posttraumatic symptomatology, trait anger, anger expression, depression, anxiety and social desirability. Results indicated that PTSD was particularly prevalent among female MOOs, which was independent of potential con founders, however none of the participants had received a formal diagnosis. A gender difference was found on the measure of trait anger in the univariate analysis but did not remain significant when controlling for confounding variables in the multivariate analysis. A gender difference was not found on measures of anger expression in the univariate and multivariate analysis. Consistent with previous research a positive relationship was found between PTSD symptomatology and trait anger, and this correlation remained significant for males and females separately. A positive relationship was found between PTSD symptomatology and anger expression, however this correlation remained significant for females only. However, a gender difference between the relationships of PTSD and trait anger and PTSD and anger expression was not found. The limitations and strengths of the study are outlined, and the clinical, theoretical and research implications of the findings discussed.

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There is growing evidence to suggest that post-traumatic stress disorder (PTSD) can occur in a minority of people after an acute life-threatening illness such as myocardial infarction (MI), cardiac arrest (CA), cerebrovascular accident (CVA) and haemorrhage. To date, there has been no attempt to link these research findings with psychological models of PTSD. The purpose of this literature review was to investigate whether Ehlers and Clark's cognitive model (2000) is a useful framework for conceptual ising illness-related PTSD. The introduction describes the search strategy used, the diagnostic criteria for PTSD and the prevalence of illness-related PTSD. Ehlers and Clark's cognitive model of PTSD (2000) is outlined and the rationale for using this particular model is explained. The relationships between each component of the model are then discussed with regard to the illness-related PTSD literature and the evidence to support the use of the cognitive model within a medical population is critically evaluated throughout. Methodological limitations are discussed as they arise, with common problems being discussed more fully at the end. A small modification to the model is proposed, to account for the impact of medical symptoms on the PTSD experience. Finally, the clinical implications of the review are discussed.

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Objective. Previous empirical studies provide support for the development of posttraumatic stressed is order following traumatic brain injury. This study investigated the nature of intrusive symptoms experienced by people with traumatic brain injury and explored the relationship between the severity of brain injury, PTSD symptomse, motional adjustment and appraisals. Method. Twenty four patients with traumatic brain injuries who had no explicit memory for the accident were interviewed using the CAPS and were asked to complete four questionnaires on PTSD severity, posttraumatic cognitions and emotional adjustment. Results. A descriptive analysis of participants' reports indicated a considerable number of intrusive symptoms among the sample with intrusions relating to the accident, waking up in hospital and preoccupation regarding the changes in people's lives following TBI. Correlations provided no evidence for an association between PTSD severity and severity of brain injury. The findings suggest that negative posttraumatic appraisals are associated with severity of PTSD type symptoms as well as with emotional maladjustment in this client group. Conclusions. It is suggested that PTSD models can be useful in understanding the mechanisms involved in the posttraumatic reactions and difficulties of emotional adjustment following traumatic brain injuries. This has serious clinical implications that need to be examined further.

Background Post Traumatic Stress Disorder (PTSD) describes a cluster of symptoms that commonly occur as a reaction to a traumatic event. Hallmark symptoms are intrusive memories of these events. Such intrusive re-experiencing in the initial aftermath of trauma is a common experience and is believed to be part of normal adaptation. However in some individuals these symptoms will persist with often devastating consequences. Little is known about factors which might determine differential presentation following trauma. Evidence suggests that characteristics of early intrusions, including whether they are experienced as distressing or not, are predictive of PTSD. A factor implicated in such a negative experience is maladaptive appraisal of the trauma event and its aftermath (Ehlers & Clark, 2000). Studies have shown relationships between maladaptive trauma-related thoughts and beliefs (such as those measured by the Post Traumatic Cognitions Inventory (PTCI; Foa, Ehlers, Clark, Tolin, & Orsillo, 1999) and level of post-traumatic psychopathology. Method This study directly manipulated these potentially maladaptive cognitions, using Cognitive Bias Manipulation (CBM) techniques, with the intention of altering the quality/quantity of intrusions following an analogue trauma experience. Participants completed negative or positive training designed to alter trauma related beliefs, before experiencing distressing films. In the week following the laboratory session, participants completed diaries recording quantity and quality of their film related intrusions. Results Intrusion number was not influenced by CBM training condition, but the distress experienced during the intrusion was, with positively trained individuals experiencing less distress. CBM training succeeded in influencing both degree of distress from intrusions and the post-film scores on the PTCI, which were themselves correlated with participants' distress. Conclusion This study is the first of its kind to show that it is possible to manipulate appraisal of trauma-related beliefs, and furthermore that such an intervention affects analogue trauma symptoms. Implications for clinical application are discussed.