No description available.

Post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder effecting an individual's occupational and social functioning. Psychological theories have attempted to explore the underlying mechanisms that are thought to be involved in the development and maintenance of PTSD. From these theories several treatment approacherhavrbeen developed with the majority relying on exposure. To date the effectiveness of exposure treatment has not been surpassed but outcomes vary, with room for improvement. Few studies have examined predictors of change. The study reported here compared a new treatment metacognitive therapy (MCT) with exposure therapy (EXP) and waitlist control condition (WL) and assessed psychological predictors' of treatment outcome.

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Reliving is an integral part of trauma-focused CBT, a recommended treatment for PTSD with a convincing evidence base supporting its use. However, the literature suggests that clinicians are reluctant to use reliving in therapy. Very few studies have explored clients' experiences of undergoing CBT for PTSD, and it seems none have specifically at reliving. The aim of this study was to explore participants' experiences of undergoing reliving as part of CBT for PTSD and help clinicians understand how clients experience this central element of treatment.

No description available.

No description available.

The experience of a heart attack (MI) can be an event that causes distress severe enough to satisfy DSM-IV criteria for trauma in some individuals. However, research has shown that positive outcomes can also follow traumatic events; this has been defined as Posttraumatic Growth (PTG). This cross-sectional study compared the level and pattern of PTG reported by a post-MI sample (n = 97) with that of a healthy control sample (n = 86); and examined demographic, disease-related, social and psychological correlates and predictors of growth. Post-MI patients reported greater PTG than healthy controls in the areas of 'relating to others' and 'appreciation for life'. Post-MI patients' growth was associated with greater support from family, and was unrelated to distress. Perceived severity of the event had a significant effect on PTG, but objective severity largely did not. Although less overall growth was reported than that following other life-threatening illnesses such as cancer, practitioners should be aware of the possibility for growth. Additionally, the meaning that patients ascribe to their MI has been shown to be more important for psychological adjustment than biological markers because perceived severity of MI had more impact on PTG than objective severity.

While the issue of avoidance in PTSD is well-documented in terms of symptom presentation, little has been done to address the problem posed to therapists of clients engaging in an avoidance of traumatic material within therapy. The current study uses a two-part approach, combining quantitative and qualitative methods to address avoidance in therapy for PTSD. In Part 1, a correlational design is used to compare clients' coping styles of "monitoring" and "blunting" (Miller, 1980) with change in symptoms over a course of therapy. The results indicate some support for the notion that coping style is relevant to symptom change over a course of therapy for PTSD. A blunting coping style was found to be significantly negatively correlated with degree of improvement in intrusive thoughts and a monitoring coping style significantly positively correlated with improvement in avoidance symptoms over the period. However, the possibility that these results are a function of significant correlations at the outset of therapy is considered. Furthermore, the low response rate resulted in the collection of insufficient data to fully test the hypotheses and, as a result, the study was treated as an exploratory, preliminary analysis and used to highlight research questions for a second phase of the research. In Part 2 of the study, a discourse analytic approach was used to generate avoidant discursive practices in transcribed material from therapy sessions with clients with PTSD. Both clients and therapists were found to use a range of discursive practices which resulted in the conversation moving away from expressions of negative affect or an exploration of traumatic material. Putative explanations for the observed behaviours are discussed and the need for therapists to be aware of these processes and their own emotional reactions to client's traumatic memories is emphasised. Differences in presentation between clients with histories of sexual abuse and those experiencing non-abusive isolated experiences of trauma are raised. The nature of avoidance within therapy is discussed and the impact of the overarching discourse of the therapeutic setting and the associated roles and power dynamics within the dyad are explored. Implications for improving the effectiveness of therapy and suggestions for future research in the field of avoidance in PTSD are proposed and, in particular, a call made for a more process-focused and "dyad-orientated" approach to practice and research in this area.