Background: The development of posttraumatic stress symptoms (PTS) following a traumatic event is related to significant functional impairment, diminished quality of life, and physical health issues. Yet it is not entirely clear why some traumatized individuals experience negative outcomes while others do not. The purpose of this study is to determine the role of several influential factors related to PTS severity and negative outcomes, such as diminished quality of life and physical health issues, following traumatic events. Method: One hundred and twenty-two trauma-exposed adults were recruited through the University of South Florida’s SONA system and through flyers on campus. Subjects were administered the following self-report measures in a counter-balanced manner: the PTSD Checklist-Civilian, the Trauma History Questionnaire-Short, The Anxiety Sensitivity Index-3, Depression and Anxiety Stress Scale 21, Sheehan Disability Scale, WHOQOL-BREF, and the Economic Impact Questionnaire-Revised. Results: Posttraumatic stress symptom severity was positively correlated with depressive symptom severity, chronicity of the most distressing trauma and number of traumas. Posttraumatic stress symptom severity and anxiety sensitivity were significantly related to all of the outcomes examined including three domains of disability, four domains of quality of life, burden and physical health issues. Main effects were found for PTS severity, anxiety sensitivity, and depressive symptom severity on quality of life domains. Posttraumatic stress symptom severity mediated the relationship between anxiety sensitivity and physical health issues such that the relationship between AS and physical health issues is dependent on PTS severity. Implications: This study helps clarify the role of various factors in the relationship between trauma and negative outcomes. Clinical and research implications are discussed, including early detection of PTS and an increased awareness of the relationship between PTS, anxiety sensitivity and physical health issues.

This is a study of three contemporary Colombian novels using combat trauma theory as an interpretive model. Following the method of psychological literary criticism that psychiatrist Jonathan Shay used in his books Achilles in Vietnam: Combat Trauma and the Undoing of Character (1994) and Odysseus in America: Combat Trauma and the Trials of Homecoming (2002) to analyze the characters Achilles and Odysseus, I propose to analyze characters in Fernando Vallejo’s La virgen de los sicarios ‘Our Lady of the Assassins’ (1994), Darío Jaramillo Agudelo’s Cartas cruzadas ‘Crossed Letters’ (1995), and Juan Gabriel Vásquez El ruido de las cosas al caer ‘The Sound of Things Falling’ (2011) to extend Shay's theories of combat trauma to a broad cultural context. While Colombia has not been engaged in a conventional, state-to-state war, it has been at a constant level of large-scale internal violence for over fifty years, perpetrated by a complex mix of paramilitaries, guerillas, narcotraffickers, and state-sponsored organizations: Colombia has consistently ranked among the top countries in the world for rates of homicide and displaced peoples. Shay’s model allows me to argue this kind of radically epistemologically and phenomenologically destabilizing environment in which non-combatants as well as combatants live under the constant threat of violence as producing severe psychological trauma. These texts have an additional cultural-psychological function. Shay identifies as an effective coping strategy the victims' act of integrating the traumatic memory into a coherent narrative, in order to both regain authority over their consciousness and to give social testimony to the injustice of the traumatic event. I will show how the characters in the texts I analyze make themselves psychologically whole in direct relation to the success with which they can narrate the story of their own trauma: those who fail do so in large part because the discourses available to them are inadequate to articulate the profundity of the trauma; those who succeed do so because they have found a form and structure that allows them to construct a coherent narrative of Self that incorporates the traumatic memory of the nation's failure.

Sexual assault and the resulting impact within the African American community continues to be an under researched phenomenon (Bryant-Davis, Chung, & Tillman, 2009). Although positive affect was presented as a protective model within the general population (Fredrickson, 1998), empirical research exploring its potential for use within the African American community is sparse. The objective of this study was to investigate the mediating role of positive affect in the development of Posttraumatic Stress Disorder (PTSD) post sexual assault in African American women, within an economically disadvantaged community. Thus, this study tested the hypotheses that Positive Affect (PA) would mediate the effects of sexual assault occurring before age 13 (FSC < 13), between ages 14 and 17 (FSC 14-17), and after age 17 (FSC > 17) on PTSD related symptoms (MPSS). Data from 749 African American were analyzed. A bias-corrected bootstrapping analysis revealed that PA mediated the effect of FSC < 13 on MPSS, 95% CI [.418, 1.778]. The indirect effect of PA accounted for 12.3% of the effect of FSC < 13 on MPSS. A second bias-corrected bootstrapping analysis revealed that PA mediated the effect of FSC 14-17 on MPSS, 95% CI [.671, 2.344]. The indirect effect of PA accounted for 14.8% of the effect of FSC 14-17 on MPSS. A third bias-corrected bootstrapping analysis revealed that PA mediated the effect of FSC > 17 on MPSS, 95% CI [.741, 2.568]. The indirect effect of positive affect accounted for 14.0% of the effect of FSC > 17 on MPSS. The results of this study suggest that women who are higher in positive affect are less likely to endorse symptoms related to PTSD post sexual assault, while those presenting with lower levels of positive affect are more likely to endorse PTSD related symptoms post sexual assault. The results of these analyses appear to be consistent with Fredrickson’s (1998) theory that positive affect enhances psychological resources for the individual.

Bakgrund: Krig har en negativ effekt på människors psykiska hälsa. När människor utsätts för starka negativa påfrestningar kan de utveckla posttraumatiskt stressyndrom, PTSD. PTSD kan manifestera hos både soldater och civila. Dessa grupper av människor förekommer som veteraner eller flyktingar i icke-stridande länder som Sverige och kräver i allmänhet större mängd vård inom såväl psykiatrin som somatiken än personer utan PTSD på grund av PTSD's höga co-morbiditet. För att behandla dessa patienter korrekt behöver vårdpersonal vara medveten om hur patienter med PTSD ska bemötas. Syfte: Att belysa faktorer som påverkar vårdpersonalens bemötande av personer med PTSD i vården med trauma relaterat till krig. Metod: De artiklar som användes i studiens resultat var kvalitativa och hittades med hjälp av databaserna CINAHL, MedLine och PubMed. Datan samanställdes med kvalitativ innehållsanalys med induktiv metod. Resultat: Denna studie presenterade tre kategorier som påverkade vårdpersonalens bemötande av patienter med PTSD; faktorer relaterade till relationen med patienten, faktorer relaterade till vården och sociokulturella faktorer. Mötet mellan vårdpersonal och patienter med PTSD påverkades av patienternas inställning till vården, bakgrund och erfarenheter. Ett gott samspel mellan vårdpersonal och patient utgjorde basen för en fungerade relation. Slutsats: Det finns en brist på studier som undersöker mötet mellan patienter med PTSD och vårdpersonal. Patienter riskerar onödigt lidande när bemötandet från vården brister.  Klinisk betydelse: Denna studie kommer förhoppningsvis hjälpa till att lägga grunden för vidare forskning i ämnet och utvecklingen av hälso- och sjukvårdsplaner för att medvetandegöra vikten av ett gott bemötande / Background: War has a negative effect on people's mental health. When people are exposed to strong negative strains they can develop post-traumatic stress disorder, PTSD. PTSD can manifest in both combatants and civilians. These groups of people are found as veterans or refugees in non-warring countries like Sweden and generally require a greater amount of healthcare in both psychiatric and somatic care than the average person due to PTSD´s high co-morbidity. In order to treat these patients properly healthcare personnel need to be aware of how to meet patients with PTSD. Aim: To highlight factors that influence the meeting between healthcare personnel and people with PTSD in healthcare. Methods: The articles used in this studies result where qualitative and were found using the electronic databases CINAHL, MedLine and PubMed. The data was compiled using a qualitative content analysis with an inductive method.  Results: This study found three major categories that effected the meeting between patients with PTSD and health care personnel; factors related to the relationship with the patient, factors related to health care and sociocultural factors. The meeting between healthcare personnel and patients with PTSD was affected by the patient’s attitudes to care, backgrounds and experiences. A good interaction between healthcare personnel and patients formed the basis for a working relationship. Conclusion: There is a lack of studies that investigate the meeting of patients suffering from PTSD and health care personnel. Patients risk unnecessary suffering when the meeting with healthcare personnel fails. Clinical significance: This study will hopefully help lay the foundation for further research in this subject and the development of health care plans dedicated to raise the awareness of the importance of a good meeting.

A severe burn is one of the most traumatic injuries a person can experience. Posttraumatic stress disorder (PTSD) is relatively common after burns, and can be devastating for the individual’s possibilities for recovery. The principal aims were to gain knowledge regarding posttraumatic stress symptoms and cognitive processes after burn and to evaluate methods for assessing symptoms of PTSD up to one year after burn. The psychometric properties of a Swedish version of the Impact of Event Scale-Revised (IES-R) were examined. The results indicate that the IES-R is a valid screening instrument for measuring PTSD symptoms in patients with burns and it can be used during hospitalisation to identify resilient individuals. The pattern of PTSD symptoms over time was also investigated. Four distinct trajectories of PTSD symptoms were identified, i.e. four groups of patients with significantly different onsets and courses. The trajectories differed in the expected direction regarding several risk factors associated with PTSD symptoms. Several previously known risk factors for PTSD symptoms were also identified including burn severity, psychiatric history, previous life events, early psychological symptoms, neuroticism-related personality traits, avoidant coping and low social support. The risk factors correspond well with those reported in the international trauma literature, which strengthens the findings in this thesis. Finally, using the emotional Stroop task at one year post burn it was found that burn-specific attentional bias was common and associated with more previous life events, more perceived life threat, larger burns and higher levels of PTSD symptoms. In summary, there are individual differences in the development and course of PTSD symptoms after burn and attentional bias is a common cognitive phenomenon related to these symptoms. The findings also support the use of the IES-R as a screening instrument for PTSD symptoms in patients with burns.

Tyrimo tikslas – ištirti žmonių, patyrusių apatinių galūnių amputaciją, potrauminio streso sutrikimo simptomų, jų įveikos strategijų ir psichologinio atsparumo sąsajas. Buvo ištirti 120 tiriamųjų (92 vyrai ir 28 moterys), kurie patyrė apatinių galūnių amputaciją. Tyrime buvo naudojami trys klausimynai: 1. DRS-15 (Dispositional Resilience Scale) skirtas matuoti psichologinį atsparumą, kaip asmenybės savybę. 2. Streso įveikos klausimynas, kuris naudojamas matuoti įveikos strategijoms. 3. Įvykio poveikio skalė - revizuota (IES-R) skirsta potrauminio streso sutrikimo simptomams nustatyti. Tyrimo rezultatai atskleidė, jog psichologinis atsparumas nėra susijęs su potrauminio streso sutrikimo simptomais tiesiogiai. Bet nustatyta, jog jaunesnių su žemesniu nei aukštuoju išsilavinimu vyrų didesnis bendras psichologinis atsparumas ir psichologinio atsparumo įsipareigojimas susijęs su dažniau naudojama problemų sprendimo įveikos strategija, o dažnesnis šios strategijos naudojimas susijęs su mažesniu potrauminio streso sutrikimo vengimo simptomo kiekiu. Jaunesnių su žemesniu nei aukštuoju išsilavinimu asmenų bendras psichologinis atsparumas ir jo bruožai (kontrolė, įsipareigojimas) teigiamai susiję su problemų sprendimo įveikos strategijos naudojimu. Vyresnių su žemesniu nei aukštuoju išsilavinimu žmonių grupėje rastas toks pat ryšys tarp bendro psichologinio atsparumo bei jo kontrolės bruožo ir problemų sprendimo įveikos strategijos. Vyresnių asmenų didesnė psichologinio atsparumo... [toliau žr. visą tekstą] / The aim of the study was to examine associations between posttraumatic stress disorder (PTSD) symptoms, coping strategies and hardiness among people with lower limb amputations. There were examined 120 patients (92 men and 28 women) who suffered a lower limb amputation. In the study were used three questionnaires: 1. DRS-15 (Dispositional Resilience Scale) which is designed to measure hardiness as a characteristic of personality. 2. Coping with stress questionnaire, which is used to measure coping strategies. 3. The Impact of Event Scale-Revised (IES-R) is used to measure PTSD symptoms. Results showed that hardiness was not directly associated with PTSD symptoms. But there were found that higher overall hardiness and commitment characteristic were associated with a more frequent usage of problem solving coping strategy and more frequent usage of this coping strategy was associated with less PTSD avoidance symptom amount among men who were younger and had lower than higher education. Among people who were younger and had lower than higher education there were found that higher overall hardiness and its characteristics (control, commitment) were associated with a more frequent usage of problem solving coping strategy. In the older age group of people with lower than higher education overall hardiness and its control characteristic were positively associated with problem solving coping strategy. In older age group there were found that hardiness control characteristic was... [to full text]

Introduction: This thesis examined the impact of PTSD with Major Depressive Disorder on PTSD severity among Toronto Transit Commission employees who were exposed to a workplace traumatic event, and also the predictors of PTSD severity, mental health treatment seeking, and return to work over the six month study period. Methods: This study utilized data that was collected prospectively from the APT study participants. Information about Axis-I diagnosis and PTSD severity were collected from the SCID-I and the Modified PTSD Symptom Scale respectively. Results: PTSD without MDD (N=29) and PTSD with MDD (N=37) groups were compared. The variables: depression severity (p=0.01), female (p=0.01), non-Caucasian (p=0.01), workplace related stress (p=0.02), and lifetime trauma (p=0.01) significantly predicted PTSD severity. The BPI group significantly predicted mental health treatment seeking (p<0.01) after controlling other variables. Conclusion: This study highlights the substantial risk for experiencing greater PTSD severity after a workplace traumatic event in TTC employees.

This study examined the influence of social support on the relationship between posttraumatic stress disorder and comorbid psychopathology, suicidal behaviour, and mental and physical health functioning in the general population. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (N=34,653). Results showed a differential impact of posttraumatic stress disorder and social support depending on gender. For men, social support had a moderating effect, where social support had a greater influence on the prevalence of comorbid psychopathology for men with posttraumatic stress disorder compared to those without the disorder. In contrast, social support had an additive effect for women, where social support was associated with decreased psychopathology and posttraumatic stress disorder was associated with increased psychopathology. This study suggests that social support should be included in the treatment of men with posttraumatic stress disorder and encouraged among women regardless of mental disorder diagnosis.

Introduction: This thesis examined the impact of PTSD with Major Depressive Disorder on PTSD severity among Toronto Transit Commission employees who were exposed to a workplace traumatic event, and also the predictors of PTSD severity, mental health treatment seeking, and return to work over the six month study period. Methods: This study utilized data that was collected prospectively from the APT study participants. Information about Axis-I diagnosis and PTSD severity were collected from the SCID-I and the Modified PTSD Symptom Scale respectively. Results: PTSD without MDD (N=29) and PTSD with MDD (N=37) groups were compared. The variables: depression severity (p=0.01), female (p=0.01), non-Caucasian (p=0.01), workplace related stress (p=0.02), and lifetime trauma (p=0.01) significantly predicted PTSD severity. The BPI group significantly predicted mental health treatment seeking (p<0.01) after controlling other variables. Conclusion: This study highlights the substantial risk for experiencing greater PTSD severity after a workplace traumatic event in TTC employees.

Many survivors of sexual trauma describe the forensic rape exam as a second rape (Campbell et al., 1999; Parrot, 1991). Rape crisis medical advocates (RCMAs) assist survivors through this process, a time of particular vulnerability to retraumatization (Resnick, Acierno, Holmes, Kilpatrick, & Jager, 1999), by providing emotional support, education, and advocacy for comprehensive and respectful services. Campbell (2006) stated that the primary role of the RCMA is to reduce victim-blame, or the tendency to blame the victim of a crime for the crime or the circumstances leading up to it. The literature has consistently shown that survivors who worked with RCMAs received more medical and legal services and were less likely to feel revictimized (Campbell, 2006; Resnick et al., 1999; Wasco et al., 2004), but the impact of the work on RCMAs has not been sufficiently examined. Previous research has shown that many advocates experienced anger and fear in relation to the work (Wasco & Campbell, 2002), that RCMAs who witnessed more victim-blame reported less satisfaction with the work and lower levels of affective commitment to the job (Hellman & House, 2006), and that professional counselors who worked with trauma survivors reported higher levels of vicarious trauma than those who did not (Schauben & Frazier, 1995). Other researchers have shown that counselors who worked with trauma survivors reported higher traumatic stress than those who did not, and counselors who worked with victims of sexual trauma endorsed more disruptive beliefs about self, others, and the world (Bober & Regehr, 2005). However, the appropriateness of generalizing results observed among counselors to RCMAs is unclear. The purpose of this study was to examine possible predictors of RCMAs’ experiences of vicarious trauma (VT) and vicarious post-traumatic growth (VPTG). Since a great deal of research examining the effects of trauma on care-providers focuses on individual-level contributing variables like personality style, coping skills, and history of victimization (Kelley, Schwerin, Farrar, & Lane, 2005; King, King, Fairbank, & Adams, 1998; Pearlman & Mac Ian, 1995), in this study I examined the predictive ability of several environmental/contextual/systemic variables on RCMAs ratings of VT and VPTG, including caseload, amount of formal individual and group supervision received, ratings of social community at work, meaning of the work, emotional demands of the work, and perceptions of witnessing VB by police and medical staff. One hundred and sixty-four RCMAs participated in this internet-based survey research. A series of hierarchical regression analyses demonstrated that higher ratings of VT were predicted by younger age, lower amounts of formal group supervision received, and lower ratings of the social community at work and the meaning of the work. Ratings of VPTG were significantly and positively predicted by amount of formal individual supervision received, and negatively predicted by age and educational achievement. Interpretations and recommendations are provided to assist rape crisis agencies in supporting RCMAs in their work.