Expressive Writing (EW) involves asking participants to write emotionally about stressful life events and has been associated with improvements in psychological and physical health. The purpose of the current study was to extend previous work by examining the moderating and mediating role of emotion regulation within the EW intervention. Sixty participants who had experienced a traumatic event were recruited from the community and were assigned to an EW or control writing condition. Measures assessing emotion regulation and indices of psychological and physical health were administered at baseline and one month follow-up to determine changes in symptomatology. In comparison to control writing, EW led to significant improvements in depression, emotional clarity, and to a lesser degree emotional awareness. Although no other group differences were found, all participants demonstrated significant improvements in their symptoms of posttraumatic stress, reported physical health, overall emotion regulation abilities, their ability to accept their emotions, engage in goal directed behaviour when distressed, and access emotion regulation strategies they perceive as effective. No support was found for our moderation hypothesis. However, a significant moderation was discovered revealing that difficulties engaging in goal directed behaviour when distressed moderated improvements in posttraumatic stress symptoms. Specifically, control participants with this emotion regulation deficit demonstrated significantly poorer outcomes than control participants without this deficit; in comparison to the EW group participants who improved similarly on posttraumatic stress symptoms regardless of their level of difficulties at baseline engaging in goal directed behavour when distressed. Additionally, baseline emotion regulation abilities predicted improvements on psychological health (but not physical health) outcome measures for both groups. No support was found for our mediation hypothesis. Exploratory analyses revealed that the EW group demonstrated greater emotional arousal in response to their writing in sessions 1 and 2, but that by session 3 their arousal had significantly decreased and was equivalent to that of the control group, which showed no changes in arousal across sessions. No support was found for the moderating or mediating influence of arousal on outcome. Results will be discussed within a model of emotional expression and emotion regulation and compared to the existing EW literature.

<p>Posttraumatic stress disorder (PTSD) is common, chronic, and associated with greater risk of postoperative mortality in veterans. Therefore, the purpose of this dissertation was to determine if elective outpatient surgery had a persistent and deleterious effect on the physical or mental health of veterans, and also to explore factors that contributed to postoperative health change in this population. A longitudinal, mixed method, quasi-experimental, nonequivalent control group study was conducted. Physical and mental health, depressive symptom severity, posttraumatic symptom severity, and pain severity were measured in 29 veterans with PTSD before undergoing outpatient elective surgery, one week after surgery, one month after surgery, and three months after surgery. For comparison, parallel data were collected from a control group of 31 veterans with PTSD at enrollment, one week after enrollment, one month after enrollment, and three months after enrollment. Subjects who displayed clinically significant or distressing changes in health status after surgery were interviewed to identify factors associated with postoperative health change. Subjects in the surgical group reported significant declines in subjective physical and mental health at one week, but not one or three months after outpatient elective surgery. Depressive symptoms severity and posttraumatic symptom severity were unchanged after surgery by surgery. Subjects reported that this physical and mental distress was driven by acute postoperative pain, but that underlying chronic pain remained influential throughout their postoperative course.</p> / Dissertation

Posttraumatic stress disorder (PTSD) is a debilitating condition that results from the experience of a traumatic event. Natural kinds are mind-independent entities found in nature and are the objects of scientific inquiry. It is common to deny that PTSD is a natural kind, but extant denials assume a thesis of natural kinds that can be called “essentialism”. According to essentialism, many entities are not natural kinds that one would expect should be natural kinds. The homeostatic cluster view of natural kinds offers an alternative that accommodates these cases, including, superficially, the claim that PTSD is a natural kind. I introduce two novel objections to this claim and recommend a distinction aimed to resolve the newly introduced problems.

Childhood maltreatment increases risk for Posttraumatic Stress Disorder (PTSD). Maladaptive patterns of attention to threat-related stimuli warrant examination as possible contributing risk factors. It remains unclear whether persistent threat-processing biases are differentially apparent in adults who were maltreated as children and either did, or did not, develop later PTSD. The present study examined associations among attention bias, childhood maltreatment, and PTSD in adults. We hypothesized that attentional bias toward threat significantly mediates associations between childhood maltreatment and adult PTSD symptoms. 183 adults with and without childhood maltreatment histories participated in this study, which involved completion of a range of clinical measures; attention bias was measured by the Dot Probe task. We found that attention bias toward happy faces partially mediated the relationship between childhood maltreatment and PTSD avoidance and numbing symptoms. Childhood maltreatment, happy face attention bias, and perceived racially discriminative experiences all accounted for significant variance in PTSD symptoms.

En förutsättning för att undvika depression och istället uppleva posttraumatiskt växande (PTG), efter att ha upplevt belastande livshändelser, kan vara känslan av sammanhang (KASAM). Denna studie syftar till att undersöka om det finns en skillnad mellan belastande livshändelser avseende negativa utfallet depression samt undersöka om en stark KASAM kan vara avgörande för att individen istället utvecklar PTG. I studien undersöks 150 studerande vid Örebro universitet. Av resultatet framgår det att studenterna med högt värde av belastande livshändelser är mer deprimerade än studenterna med lågt värde, oberoende av KASAM. Dock hittades ingen signifikant skillnad mellan belastande livshändelser och KASAM avseende PTG.Huruvida belastande händelser utvecklar en positiv eller negativ förändring hos individen kan istället avgöras av personens tolkning, hantering av situationen. / A basis to avoid depression and instead experience posttraumatic growth (PTG), after stressful life events, may be a sense of coherence (SOC). This study investigates whether there is a difference between stressful life events regarding the negative outcome depression and to examine whether a strong sense of coherence can be essential to develop PTG instead. 150 students at Örebro University were examined. The result showed that students with high value of stressful life events are more depressed than students with low value, independent of SOC. However, no significant difference was found between stressful life events and SOC regarding to PTG.Whether a stressful event develops a positive or negative change in the individual may instead be determined by how the person interprets and handles the situation.

This study aims to examine the prevalence of traumatic events among university students and to evaluate the predictive values of socio-demographic variables, trauma characteristics, attachment styles and coping styles in posttraumatic growth. 321 students from the Middle East Technical University and Hacettepe University participated in the study. A trauma checklist, Posttraumatic Growth Inventory, Relationship Scales Questionnaire, Attachment Style Questionnaire and Ways of Coping Inventory were administered. The results showed that living a disaster, death of a family member, living a serious accident or a serious health problem, a suicidal attempt or the suicide of a significant other or a friend and losing a significant other in an accident or in an act of violence are the traumas which were reported by the participants. In the regression analysis, gender, felt horror and helplessness during the traumatic event, optimistic coping style and fatalistic coping style are found to be significant predictors of posttraumatic growth. The results are discussed within the existing literature findings. The clinical implications are offered.

The current study aimed to examine two potential positive outcomes of an earthquake experience, namely posttraumatic growth (PTG) and earthquake preparedness behavior. Variables that may be related to PTG and earthquake preparedness behavior were examined after earthquake victimization by using two models, which were the Person Relative to Event (PrE) Model (Mulilis &amp / Duval, 1997) to understand earthquake preparedness behavior, and Model of Life Crises and Personal Growth (Schaefer &amp / Moos, 1992) to understand PTG. In order to examine earthquake preparedness behavior, the roles of demographic variables, event-related variables, cognitive appraisal factors, and coping strategies, and in order to examine PTG, environmental factors, system factors, event related factors, earthquake specific coping and cognitive appraisal factors, and general ways of coping responses factors were examined. Data was collected by a questionnaire consisting of three parts. The first part was a socio-demographic information form. The second part of the questionnaire included set of items designed to examine past earthquake experience, the severity of past earthquake experience and reasons to prepare for a possible future earthquake. The third part of the questionnaire consisted of eight scales. These scales were Ways of Coping Inventory (WCI) to measure coping strategies used in stressful situations, Revised and Translated Mulilis-Lippa Earthquake Preparedness Scale (MLEPS) to measure the level of earthquake preparedness behavior, perceived difficulty and perceived effectiveness of being prepared, Religiousness Scale (RS) to measure the level of religious resources of participants, The Multidimensional Scale of Perceived Social Support (MSPSS) to measure perceived adequacy of social support, The Quality of Life Scale (WHOQOL) to measure the quality of life of the participants, Psychological Well-Being Scale to measure the level of psychological well-being of participants, Traumatic Stress Symptom Checklist (TSSC) to measure posttraumatic stress, and Post-traumatic Growth Inventory (PTGI) to measure stress-related growth. One hundred ninety nine adults (105 females and 94 males with an age range of 18 to 73) were participants of the study. The participants were from Kaynasli, D&uuml / zce. The participants were selected on the basis of their age, gender, and the type of their houses. They were contacted through home visits. In the result section, the level of the different categories of earthquake preparedness behavior, self-efficacy and outcome efficacy / the reasons of preparedness and nonpreparedness for earthquakes, the variables related to earthquake preparedness behavior and PTG were presented. Hierarchical regression analysis results revealed that perceived responsibility to prepare for earthquakes, outcome efficacy, and problem-focused coping were positively and posttraumatic stress was negatively related to earthquake preparedness behavior. As a result of the regression analysis, it was found that being married, perceived social support, well-being, problem-focused coping, and seeking social support coping were significant predictors of the level of PTG. The results of regression analysis also showed that, general problem focused coping was more efficient than earthquake specific active coping after earthquake victimization for the development of PTG. The results of the study were discussed within the relevant literature, shortcomings of the current study, clinical implications and suggestions for future research were proposed.

The aim of the study was to test three mediation and a moderation models in order to investigate the mediating role of coping styles and both mediating and moderating roles of perceived social support between dispositional hope-posttraumatic growth/PTSD relationships among postoperative breast cancer patients. Accordingly, it was hypothesized that 1) Problem-focused coping styles (PFC) would mediate the relationship between dispositional hope and posttraumatic growth among postoperative breast cancer patients. 2) Emotion-focused coping style (EFC) would mediate the relationship between dispositional hope and posttraumatic stress disorder among postoperative breast cancer patients. 3) Perceived social support would mediate the relationship between dispositional hope and posttraumatic growth among postoperative breast cancer patients. 4) Perceived social support would moderate the relationships between dispositional hope and posttraumatic growth among postoperative breast cancer patients. The study was conducted with 73 postoperative breast cancer women (mean age = 44.44, SD = 7.43) who were undergoing postoperative chemotherapy and radiotherapy. Participants were from different cities but receiving treatment from Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital. Measurements were applied orally to participants. According to results of the study, PFC did not mediate the relationship between dispositional hope and PTG and its subscales. Similarly, the relationship between dispositional hope and PTSD and its subscales was not mediated by EFC. Beside, perceived social support and its sources did not mediate the relationship between dispositional hope and PTG and its subscales. However, perceived social support and perceived social support from friend moderated the relationship between dispositional hope and PTG. Results, limitations, clinical implications of the study and directions for future studies were discussed in the light of the literature.

<p>Lucid Dreaming (LD) is defined as the phenomenon of becoming consciously aware of dreaming while still dreaming. In sleep laboratory experiments LD has been verified to occur during REM sleep stage by proficient lucid dreamers who have signaled while becoming lucid through specific pre-determined eye-movements. Using this method, (lucid) dreamed activity has been shown to correlate with both psychophysiological and neurophysiological responses to those observable if the same activity was to be performed during wakefulness. LD has also shown potential to be of therapeutic value, in reducing recurrent nightmare frequency. Recurrent nightmare sufferers engaging in Lucid Dreaming Treatment (LDT) show reduced nightmare frequency after treatment. As such, LDT has been suggested to be effective in the treatment of posttraumatic nightmares in Posttraumatic Stress Disorder (PTSD). The attitude and feeling of control provided by LDT has been shown to be fruitful also in fearful waking situations, indicating that LDT might be effective in disorders epitomized by fear.</p>

Past research has highlighted the importance of better understanding the high rate of smoking among individuals exposed to trauma. However, few studies have investigated the cognitive mechanisms that may contribute to the smoking-trauma relationship. The primary goal of the present study was to examine the associative relationship between smoking and trauma at a cognitive level, by examining the extent to which trauma-relevant pictures primed attentional biases to smoking-related words on a modified Stroop task. Eighty trauma-exposed smokers (classified as having low, medium, or high levels of post trauma symptomatology) ink-named smoking-related and neutral words after being primed with trauma-related, positive, or neutral picture cues. Although participants did not display an overall significant difference in reaction time between smoking words and neutral words, we found a significant prime x word type interaction, with slower reaction time to smoking words after being primed by trauma-related pictures. In addition, we found a significant 3-way interaction between symptom severity level, prime category, and target type. Further analyses revealed that the prime x word type interaction was significant only among individuals with the lowest and highest levels of PTSD symptomatology. A secondary aim of the study was to evaluate the relationship between smoking-related variables and posttraumatic stress disorder symptoms on a dimensional range. We found that participants who were more severely impaired at the time of the study were more likely to report strong cravings to smoke. Overall, findings suggest that smokers who have experienced trauma exhibit an attentional bias to smoking words when primed with trauma-related picture, and that post-trauma symptoms are related to smoking motivation. Implications for treatment are discussed.