SAMMANFATTNING Syfte: Att beskriva förekomst av posttraumatisk stress och behov av känslomässigt stöd bland föräldrar till barn med hjärntumör vid två månader efter barnets diagnos (T2) respektive 12 månader efter avslutad cytostatika-/strålbehandling eller 18 månader efter operation av barn som inte fått cytostatika-/strålbehandling (T6). Syftet var också att jämföra behovet av känslomässigt stöd bland föräldrar med möjlig PTSD och hos de föräldrar som inte visar symtom på möjlig PTSD vid T2 respektive T6. Urval: 42 föräldrar till barn med hjärntumör deltog i studien: 20 mödrar och 22 fäder. Metod: Designen var deskriptiv longitudinell. Nivåer av PTSS och förekomst av möjlig PTSD mättes med PTSD Checklist Civilian, föräldrars behov av känslomässigt stöd mättes med ett studiespecifikt formulär. Resultat: Nivåer av PTSS hos föräldrar till barn med hjärntumör var lägre vid T6 än vid T2. Vid T2 hade 17 % möjlig PTSD jämfört med 5 % vid T6. Behovet av att samtala med psykolog var oförändrat lågt mellan T2 och T6, men behovet minskade över tid gällande att samtala med läkare, sjuksköterska, kurator, partner, vänner och övriga. Slutsats: Även om nivåer av PTSS och behovet av känslomässigt stöd på gruppnivå minskar över tid, bör vårdpersonal ändå uppmärksamma förälderns individuella behov av stöd. / ABSTRACT Aim: To describe occurrence of posttraumatic stress and the need of emotional support among parents of children with brain tumour two months after the child has been diagnosed (T2) respectively 12 months after completed chemo-/radiotherapy or 18 months after surgery of those children who did not receive chemo-/radiotherapy (T6). The aim was also to compare the need of emotional support between parents with occurrence of potential PTSD and parents who did not show any symptoms of potential PTSD at T2 and T6 respectively. Sample: 42 parents of children with brain tumour participated in the study: 20 mothers and 22 fathers. Method: The design was descriptive longitudinal. Levels of PTSS and occurrence of potential PTSD was measured by PTSD Checklist Civilian. Parents’ need of emotional support was measured with a study specific questionnaire. Results: Levels of PTSS was lower at T6 than T2. At T2 17 % had possible PTSD compared with 5 % at T6. The need to talk to a psychologist was unchanged low between T2 and T6, but the need declined over time concerning to talk with a doctor, nurse, welfare officer, partner, friends and others. Conclusion: Even if levels of PTSS and the need of emotional support in group level decline over time, nursing staff should still be ware of the parents’ individual need of support.

Antalet barn som upplever våld i familjen är stort och upplevelsen kan leda till utveckling av Posttraumatisk stresstörning (PTSD). Syftet med studien är att fördjupa kunskapen om barn som upplevt våld i familjen och som visar tecken på PTSD. Frågeställningar som studien avser att besvara är (1) vilken betydelse har våldets karaktär för utvecklingen av PTSD hos barn? (2) vilken betydelse har barnets psykosociala hälsa för utvecklingen av PTSD? (3) hur kan tillfrisknandeprocessen hos barn som visar tecken på PTSD förstås? Studien har både en kvantitativ och en kvalitativ ansats samt en pre-post design. Studien inkluderar 14 barn som upplevt våld i familjen och som besvarat Children´s revised imapct of event scale (CRIES) vid Trappan-enheten i Uppsala under 2007. Resultatet visar att många barn visar tecken på PTSD till följd av våld i familjen. Våldets karaktär samt tiden som våldet pågått är avgörande faktorer för om barn visar tecken på PTSD eller inte. Resultatet visar även att god psykosocial hälsa inte motverkar utveckling av PTSD hos barn. Vid andra mätningen är det färre barn som visar tecken på PTSD. / A large number of children experience domestic violence and this experience can lead to the development of Posttraumatic stress disorder (PTSD). The purpose of this study is to create a deeper knowledge regarding children who have experienced domestic violence and are showing signs of PTSD. The research questions of this study are (1) to what extent does the type of violence matter for the development of PTSD in children? (2) to what extent does the child’s psychosocial health matter for the development of PTSD? (3) how can the recovery process in children who show signs of PTSD be understood? The approach of the study is both quantitative and qualitative and the design is pre-post. The study includes 14 children who all have experienced domestic violence and who have answered Children´s revised impact of event scale (CRIES) at Trappan-enheten in Uppsala during 2007. The result shows that many children show signs of PTSD after the experience of domestic violence. The type of violence and the duration of violence are essential factors for the development of PTSD. The results also show that good psychosocial health does not prevent the development of PTSD. At the second measuring fewer children show signs of PTSD.

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.

The literature on clinical interventions for suicide prevention indicates that low-income, suicidal African American females are an historically underserved population. Contributing to this lack of service are the intersecting influences of race, ethnicity, culture, gender, sexual orientation, socioeconomic status and related oppressions (APA, 2007). In suicidal African American females, a higher level of reported symptoms of posttraumatic stress disorder has been found in suicide attempters as compared to nonattempters (Kaslow et al., 2000), and PTSD has been shown to be associated with heightened risk of an ensuing suicide attempt (Wilcox, Storr, & Breslau, 2009). One factor affecting manifestation of PTSD symptoms is attachment style. When a person with an insecure attachment style experiences a traumatic event(s), they are more likely to develop PTSD (Dieperink, Leskela, Thuras, & Engdahl, 2001). However, if effective coping methods are learned, more severe symptoms of PTSD are less likely (e.g., DeRoma et al., 2003; Johnsen, Eid, Laberg, & Thayer, 2002). Multiple studies examining the relationship between attachment style and coping find insecure attachment linked to poor coping skills (e.g., Schmidt, Nachtigall, Wuethrich-Martone, & Strauss, 2002; Yih-Lan, 2003). Those with insecure attachment styles are more likely to employ less effective coping methods leading to increased distress and interpersonal problems. However, there is research to support the possibility of insecure attachment style shifting to a more secure form, potentially through learning coping skills that offset maladaptive coping. This study examined the mediating role of coping on the relationship between attachment style and PTSD symptoms. One hundred and fifty African American women enrolled in a project designed to understand the experiences of low income, African American women completed a Demographic Data Questionnaire, The Relationship Style Questionnaire (RSQ) (Griffin & Bartholomew, 1994), The Ways of Coping, Revised (Folkman & Lazarus, 1985), and The Posttraumatic Diagnostic Scale (PDS) (Foa, Cashman, Jaycox, & Perry, 1997). The relationships among factors were examined using Structural Equation Modeling. Results indicated a significant direct path between Insecure Attachment and PTSD Symptoms of moderately weak strength, between Insecure Attachment and Emotion-Focused Coping of moderate strength, and between Insecure Attachment and Problem-Focused Coping of moderately weak strength. However, neither Emotion-Focused nor Problem-Focused Coping mediated the relationship between Insecure Attachment and PTSD symptoms. Clinical implications, limitations of the study, and future directions are discussed in terms of these results.

Posttraumatic Growth (PTG), known as antithesis of Post Traumatic Stress Disorder (PTSD) (Tedeschi, Park, &amp / Calhoun, 1998, p.3), has been highlighted in the literature as a positive outcome of the trauma.In the literature, environmental resources (e.g., social and familial support), individual resources (e.g., personality traits, socio-demographic variables), perception of the event (e.g., type of trauma, duration of trauma), cognitive processing (e.g. impact of event, religious participation), and coping (e.g. problem focused coping, emotion focused coping) were found as possible factors on the development of PTG. In the present study, a model to predict PTG in the patients suffering from myocardial infarction (MI / heart attack) and their spouses was tested on the basis of environmental and personal resources, the perception of the event and cognitive processing as latent variables. The model, developed by Schaefer and Moos (1998), was empirically analyzed for the first time with patients suffered from myocardial infarction and their spouses by structural equation model (SEM) using AMOS program. MI patients getting the treatment in various hospitals in the city of Bolu (N=151) and their spouses (N=137) completed the measures in 1.5-2 hours sessions. The analysis of the model with the MI patients&amp / #8217 / data revealed that both environmental resources and individual resources demonstrated indirect effects on PTG via the effect of the perception of the event, cognitive processing and coping. On the other hand, the analysis of the model for the spouses revealed that individual resources demonstrated indirect effects on PTG through the effect of the perception of the event, cognitive processing and coping while environmental resources did not show significant indirect effects on PTG.The findings were discussed in the context of recent theoretical models of PTG, shortcomings of the current study, clinical implications, and suggestions for future research.

The aim of the present study is to investigate the relationship of posttraumatic growth with basic personality traits and locus of control, and the mediator role of coping strategies in these relationships. One hundred and fourteen women with breast cancer undergoing chemotherapy/radiotherapy treatment or come to the hospital for their post-operational follow-up appointments were recruited. Seventy two mediation models were performed for posttraumatic growth and its factors as dependent variables. The independent variables were basic personality traits (extraversion, conscientiousness, agreeableness, neuroticism, openness to experience, and negative valence) and locus of control. The mediators were coping strategies that is problem-focused coping, emotion-focused coping, and seeking social support (indirect coping). The results suggested that problem-focused coping was a significant mediator in PTG&mdash / some basic personality traits (extraversion, openness to experience, conscientiousness, agreeableness) and PTG&mdash / external locus of control relationships. Moreover, emotion-focused coping was a significant mediator in the relationship of PTG with some personality traits (conscientiousness, agreeableness, and openness to experience) and external locus of control. Seeking social support did also mediate PTG&mdash / external locus of control relationship. The implications of the findings, and the strengths and limitations of the study were also discussed in the light of the literature.

<p>Up to two million women worldwide have obstetric fistula, a maternal morbidity prevalent in developing countries that causes uncontrollable leaking of urine and/or feces and a persistent bad odor. There is both theoretical and empirical evidence for psychopathology in patients presenting for fistula surgery, albeit with methodological limitations. The current studies sought to improve on past limitations of study design. Study A compared psychological symptoms and social support between fistula patients and a comparison group recruited from gynecology outpatient clinics. Measures included previously validated psychometric questionnaires, administered orally by data collectors. Results showed that compared to gynecology outpatients, fistula patients had significantly higher levels of depression, traumatic stress, somatic symptoms and avoidant coping, and had lower social support. Study B investigated changes in psychological symptoms, stigma and social support between the time of admission for fistula repair and 3 months after discharge from the hospital. At follow-up, fistula patients reported significant improvements in all study outcome variables. Exploratory analysis revealed that the extent of leaking was associated with depression and PTSD. These results indicate the potential benefit of mental health interventions for this population. Additionally, future research may clarify the relationship between residual leaking after fistula surgery, and its effect on post-surgery mental health outcomes.</p> / Dissertation

No description available.

Das überwiegend männliche Einsatz- und Rettungspersonal (Polizei, Feuerwehr, Sanitäter, Justizvollzugsbedienstete) zeigt nach berufsbedingten Traumata häufig Schwierigkeiten bei der Akzeptanz von psychotherapeutischen Hilfsangeboten. Im vorliegenden Beitrag wird diese Problematik anhand von Fallbeispielen sowie konzeptuellen Überlegungen des Zusammenhangs zwischen Männlichkeit und Therapiemotivation diskutiert. Klinische Erfahrungen zu männerspezifischen Komplikationen der Posttraumatischen Belastungsstörung (PTBS) und das Modell eines Risikoprofils männlicher Traumaopfer in Einsatzberufen («Alpha-Männer») werden dargestellt, sowie theoretische Einordnungen in sozialkognitive Theorien der Männlichkeit und Entstehungsmodelle von Traumafolgen vorgenommen. Der Beitrag schließt mit der Skizzierung eines Interventionsvorschlags für berufsbedingte Traumata in den männertypischen Berufsbereichen. / Persons in the predominately male domains of high-risk occupational groups (police, fire department, rescue teams, prison guards) often show difficulties in accepting psychological help after traumatization. The paper presents case reports and conceptual discussion of the relationship between masculinity and treatment motivation. Clinical experiences on male-specific complications of posttraumatic stress disorder (PTSD) and a high risk profile of male work-related trauma victims (‘alphaman’) are discussed. Theoretical discussion furthermore includes social cognitive theories of masculinity and of development of PTSD. The paper concludes with suggestions for interventions relevant to the outlined problems. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

The aims of the dissertation were to assess: the psychological peculiarities of Lithuanian Afghanistan war veterans; the risk factors and the intensity of risk factors relations with posttraumatic reactions. A sample of 268 Lithuanian men who served in the Soviet Army in 1979–1989 was investigated on the average 17 years after the service: 174 men – study group and 94 – comparison group. The questionnaire was completed focusing on life-threatening experience, posttraumatic stress reactions, and mediating variables – social support, adaptation, sense of coherence, consumption of alcohol and drugs (HTQ, TSC-35, CSS, SOC13, structured and open questions). Lithuanian Afghanistan war veterans have more long-term psychological after-effects than the comparison group. Lithuanian Afghanistan war veterans experienced significantly more service-related and non-service-related traumatic events and conditions. Their adaptation after the service and nowadays were poorer and alcohol consumption is far more hazardous than in the comparison. Sense of coherence, adaptation after the service, violent assault, loss of the family member and alcohol consumption nowadays predict PTSD. The model of Afghanistan war veterans’ psychological after-effects is presented and discussed. / Tyrimo tikslai buvo nustatyti: 1) kokie psichologiniai ypatumai būdingi Lietuvos Afganistano karo veteranams; 2) veiksnius, susijusius su vyrų dalyvavusių Afganistano kare potrauminės simptomatikos išreikštumu ir įvertinti tų veiksnių sąsajų su potraumine simptomatika stiprumą. Tyrimo dalyviai – 268 Lietuvos vyrai atlikę privalomąją karo tarnybą Sovietų armijoje 1979-1989 metais. Tiriamoji grupė – 174 vyrai tranavę Afganistano-Sovietų Sąjungos kare, palyginamoji grupė – 94 vyrai tarnavę SSRS teritorijoje, kur karo veiksmų nebuvo. Jie buvo apklausti vidutiniškai 17 metų po sugrįžimo iš tarnybos. Klausimyną sudarė Harvardo traumos klausimynas, Traumos simptomų klausimynas, Paramos krizėje skalė, Vidinės darnos skalė ir struktūruoti bei atviri klausimai apie trauminį patyrimą, potraumines pasekmes bei tarpinius kintamuosius – prisitaikymą, socialinę paramą, vidinę darną bei alkoholio ir narkotikų vartojimą. Lietuvos Afganistano karo veteranų ilgalaikiai potrauminiai padariniai yra sunkesni, nei palyginamosios grupės. Lietuvos Afganistano karo veteranų traumininė patirtis, susijusi su tarnyba ir viso gyvenimo yra sunkesnė, adaptacija iš karto po tarnybos ir dabartiniu metu prastene bei jiems labiau būdingas žalingas alkoholio vartojimas dabartiniu metu, nei palyginamosios grupės vyrams. Potrauminio streso sutrikimo pasireiškimą geriausiai prognozavo vidinė darna, prisitaikymas po tarnybos, patirtas smurtinis užpuolimas, šeimos nario netektis ir alkoholio vartojimas dabartiniu... [toliau žr. visą tekstą]