This study used mixed methods to examine the impact of service-members‟ knowledge and acknowledgement of Posttraumatic Stress Disorder (PTSD) on relationship satisfaction of both the service-members and their spouses. Family stress theory was used to conceptualize the relationship between the occurrence of PTSD and relationship satisfaction. Forty individuals (i.e., 20 couples) completed questionnaires containing self-report measures of knowledge of PTSD, experience of PTSD symptoms, severity of PTSD symptoms, and relationship satisfaction. Participants also completed semi-structured interviews concerning PTSD symptoms, impact of PTSD symptoms on their relationship, and attitudes observed about PTSD. No significant links were found between knowledge, acknowledgement, and relationship satisfaction. Qualitative analysis of semi-structured interviews found that the couples‟ experiences of PTSD symptoms and the impact of PTSD on the couple relationships were consistent with the existing literature. Common attitudes regarding PTSD were reported by the couples, indicating a persistent negative attitude of PTSD.

Veterans of the Iraqi and Afghanistan conflicts have frequently returned with injuries such as mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD). More recently, concern has been raised about the large number of returning soldiers who are diagnosed with both. Literature exists on the neuropsychological factors associated with either alone, however far less research has explored the effects when combined (PTSD+mTBI). With a sample of 206 OEF/OIF veterans, the current study employed neuropsychological and psychological measures to determine whether participants with PTSD+mTBI have poorer cognitive and psychological outcomes than participants with PTSD-o, mTBI-o, or veteran controls (VC), when groups are matched on IQ, education, and age. The PTSD+mTBI and mTBI-o groups exhibited very similar neuropsychology profiles, and both PTSD+mTBI and mTBI-o performed significantly (α=.01) worse than VC on executive functioning and processing speed measures. There were no significant differences between VC and PTSD-o on any notable neuropsychology measures. In contrast, on the psychological measures, the PTSD+mTBI and PTSD-o groups were identical to each other and more distressed than either mTBI-o or VC. These findings suggest there are lasting cognitive impairments following mTBI that are unique to the condition and cannot be attributed to known impairments associated with distress.

In einer längsschnittlichen Untersuchung wurden 64 Patienten der unfallchirurgischen Abteilung einer Universitätsklinik 10 Tage und 3 Monate nach einem Verkehrsunfall untersucht. Erhoben wurden die posttraumatische Belastungssymptomatik und Gedankenkontrollstrategien. Zum ersten Untersuchungszeitpunkt (10 Tage) zeigt sich eine der Posttraumatischen Belastungsstörung (PTB) äquivalente Belastungssymptomatik bei 14,1% und nach 3 Monaten eine PTB-Prävalenz von 39,1%. Es zeigen sich Zusammenhänge zwischen einigen Gedankenkontrollstrategien und PTB-Symptomatik nach 10 Tagen und, in schwächerer Ausprägung auch nach 3 Monaten. Im Ergebnis einer explorativen Auswertung zeigt sich, daß insbesondere die Strategien «Ablenkung» und «Sorgen» eine relevante Rolle im Zusammenhang mit der PTB-Symptomatik spielen. / In a longitudinal survey 64 inpatients of an emergency clinic were examined 1 week as well as 3 months after a motor vehicle accident. Posttraumatic stress symptoms and strategies of thought control were assessed. Ten days after the accident, a posttraumatic stress symptomatology is observable in 14.1% of patients, 3 months after the accident the prevalence of posttraumatic stress disorder (PTSD) is 39.1%. Strategies of thought control are correlated with posttraumatic symptomatology 10 days after the accident and after 3 months. The result of an explorative data analysis shows an important role of the control strategies ’distraction’ and ’worry’ in correlation with posttraumatic stress symptoms. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

The high prevalence of sexual abuse suffered by women as children is well documented, both internationally and in South Africa. The life outcomes of women who had experienced childhood sexual abuse are generally reported as adverse, yet some of these survivors manage to overcome the abusive relationship and experience positive changes in themselves and their lives. Emerging trauma literature thus supports a philosophical shift from a pathogenic to a autogenic paradigm in which the focus is on positive and adaptive post trauma outcomes. Previous trauma models, which were based on a pathogenic model, are now shifting to a positive psychology trend by incorporating a salutary component, which includes a spiritual and existential dimension as well as an area of potential emerging growth. Information on the constructive coping behaviours, posttraumatic growth and psychological well-being of women who had experienced childhood sexual abuse can lead to the formulation of guidelines with strategies for an intervention programme that can facilitate and enhance coping, posttraumatic growth and psychological well-being in survivors of childhood sexual abuse. This research investigated the coping behaviours, posttraumatic growth and psychological well-being of women who had experienced childhood sexual abuse. The research was carried out in South Africa in the greater Gauteng Province and surrounding areas, with women who had experienced sexual abuse in childhood. A mixed method research design was used in which: the first phase was quantitative research conducted with validated psychometric instruments measuring coping behaviour, posttraumatic growth and psychological well-being. These instruments were the COPE (Coping Self-efficacy Scale), the Posttraumatic Growth Inventory, the Mental Health Continuum, Rosenberg’s Self-esteem Scale and the General Health Questionnaire. The second phase was of a qualitative nature, and explored the stories and experiences of women identified as coping constructively, manifesting posttraumatic growth and psychological well-being, by using semi-structured interviews. Lastly, the data obtained was used to formulate guidelines with specific strategies, which can be used by helping professionals in a group context to facilitate and enhance constructive coping, posttraumatic growth and psychological well-being in survivors of childhood sexual abuse. The results of this research were as follows: prevalence of constructive coping, posttraumatic growth and psychological well-being was determined, and indicated that 58% of participants manifested constructive coping, 60% manifested posttraumatic growth and 42% manifested psychological well-being. Semi-structured interviews conducted with the women scoring in the upper range of coping constructively, growing after the trauma and emerging psychologically well were transcribed and analysed by means of interpretative phenomenological analysis, and the following broad themes emerged: psycho-socio spiritual resources, the healing process and positive strengths. These themes and sub-themes produced data which could be used in the formulation of guidelines with strategies for an intervention programme aimed at enhancing and facilitating constructive coping, posttraumatic growth and psychological well-being thereby improving the therapeutic services available to childhood sexual abuse survivors. Finally the study was evaluated and conclusions and recommendations were made. / PhD, Psychology, North-West University, Vaal Triangle Campus, 2012

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: Induced abortion is a common medical intervention. Whether psychological sequelae might follow induced abortion has long been a subject of concern among researchers, and there is lack of knowledge about the relationship between posttraumatic disorder (PTSD) and induced abortion. Aims: To study and compare PTSD, posttraumatic stress symptoms (PTSS) and anxiety- and depressive symptoms among women seeking abortion, allowing for demographic variables. Further aims were to assess risk factors and to assess PTSD and PTSS following induced abortion in relation to experienced care at the clinic. Methods: This was a multi-centre cohort study targeting women who requested an induced abortion at the outpatient clinics of the gynaecology and obstetrics departments of six public hospitals in Sweden. All women who requested an induced abortion before the end of gestational week 12 were approached for participation. PTSD, PTSS, anxiety- and depressive symptoms, personality traits and women’s perceptions of abortion care were measured by means of questionnaires. Measurements were made at the first visit before the abortion as well as three- and six-months thereafter. Data collection was performed from September 2009 to January 2011. Results: 1,514 women filled out the questionnaire before the abortion. Abortion-seeking women did not suffer from PTSD to a greater extent than the general Swedish female population. Few women (51/720) developed PTSD or PTSS after the abortion, 11 did so due to trauma experience related to the abortion. Women at risk of posttraumatic stress were more likely to be young, having anxiety- or depressive symptoms and personality traits related to neuroticism. Furthermore, women with PTSD or PTSS were more likely to perceive certain aspects of the abortion care as deficient. Conclusions: The vast majority of women coped well with the induced abortion. Few developed posttraumatic stress post abortion. The majority did so because of trauma experiences unrelated to the induced abortion. Young women and women with mental distress are vulnerable groups that need to be paid attention to in abortion care. These women are at risk for negative experiences of the abortion care, and may be at risk of PTSD or PTSS post abortion / <p>Contact: Sophiahemmet University, Box 5605, SE-114 86 Stockholm, Sweden</p>

Having a child diagnosed with cancer is stressful and many parents of children on treatment for cancer report symptoms of posttraumatic stress (PTSS). The overall purpose was to, among parents of children on treatment for cancer, investigate the factor structure of PTSS; investigate the relationships between experiential avoidance (EA), rumination, PTSS and depression; and to develop, test, and evaluate a guided self-help intervention provided via the internet. In a longitudinal study with three assessments (n = 249-203) results indicated that a four-factor solution of PTSS including the factors re-experiencing, avoidance, dysphoria, and hyper-arousal provided best fit and that the pattern and size of factor loadings were equivalent across the three assessments (Study I). In a case study with pre-, post-, and follow-up assessments a guided self-intervention was well received with clinical significant and reliable improvements in PTSS, depression, and quality of life (Study II). Furthermore, in cross-sectional analyses (n = 79) EA and rumination were positively associated with PTSS and depression and provided incremental explanation in depression while controlling for demographic characteristics, anxiety, and PTSS. In longitudinal analyses (n = 20), EA but not rumination predicted PTSS and depression while controlling for initial levels (Study III). Finally, in a randomized controlled trial with parents fulfilling the modified symptom criteria on the PTSD-Checklist allocated to guided self-help via the internet (n = 31) or to a wait-list control condition (n = 27) there was a significant intervention effect with a large effect size for the primary outcome PTSS. Similar results were observed for the secondary outcomes depression and anxiety, but not for EA and rumination. Exploratory analyses suggested that the relationships between EA and PTSS and between EA and depression were weakened in the intervention group (Study IV). The studies included in the current thesis suggest that a four-factor solution should be used when assessing PTSS in parents of children on cancer treatment. Furthermore, rumination and EA in particular seem to be important constructs to consider when understanding PTSS and depression in this population. Finally, guided self-help via the internet shows promise in reducing PTSS and depression among parents of children on cancer treatment who report a high level of PTSS.

Attention biases to trauma-related information contribute to symptom maintenance in Posttraumatic Stress Disorder (PTSD); this phenomenon has been observed through various behavioral studies, although findings from studies using a precise, direct bias task, the dot probe, have been mixed. PTSD neuroimaging studies have indicated atypical function in specific brain regions involved with attention bias; when viewing emotionally-salient cues or engaging in tasks that require attention, individuals with PTSD have demonstrated altered activity in brain regions implicated in cognitive control and attention allocation, including the medial prefrontal cortex (mPFC), dorsolateral prefrontal cortex (dlPFC) and amygdala. However, remarkably few PTSD neuroimaging studies have employed tasks that both measure attentional strategies being engaged and include emotionally-salient information. In the current study of attention biases in highly traumatized African-American adults, a version of the dot probe task that includes stimuli that are both salient (threatening facial expressions) and relevant (photographs of African-American faces) was administered to 19 participants with and without PTSD during functional magnetic resonance imaging (fMRI). I hypothesized that: 1) individuals with PTSD would show a significantly greater attention bias to threatening faces than traumatized controls; 2) PTSD symptoms would be associated with a significantly greater attentional bias toward threat expressed in African-American, but not Caucasian, faces; 3) PTSD symptoms would be significantly associated with abnormal activity in the mPFC, dlPFC, and amygdala during presentation of threatening faces. Behavioral data did not provide evidence of attentional biases associated with PTSD. However, increased activation in the dlPFC and regions of the mPFC in response to threat cues was found in individuals with PTSD, relative to traumatized controls without PTSD; this may reflect hyper-engaged cognitive control, attention, and conflict monitoring resources in these individuals. Additionally, viewing threat in same-race, both not other-race, faces was associated with increased activation in the mPFC. These findings have important theoretical and treatment implications, suggesting that PTSD, particularly in those individuals who have experienced chronic or multiple types of trauma, may be characterized less by top-down “deficits” or failures, but by imbalanced neurobiological and cognitive systems that become over-engaged in order to “control” the emotional disruption caused by trauma-related triggers.

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.

A growing body of literature is focusing on the influence of personality and emotion regulation on psychological health. Using archival data from an expressive writing project, the current study investigated the relationship between perfectionistic self-presentation and emotion regulation, and the influence of the interaction of these variables on psychological health among trauma survivors. The results indicate that both perfectionistic self-presentation and more difficulties in emotion regulation contribute to symptoms of distress. As well, higher levels of perfectionistic self-presentation were associated with more difficulties in emotion regulation. Further, emotion regulation mediated the relationship between perfectionistic self-presentation and psychological distress but not common physical complaints. More specifically, the non-acceptance subscale of emotion regulation was found to be significant in a test of multiple mediator model.