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The Supporting Transformation and Resilience (STAR) program is a groundbreaking doctoral project in the field of occupational therapy designed to enhance the resilience, quality of life, and overall well-being of adult survivors of childhood trauma who are raising a child with a disability. Childhood trauma can profoundly impact an individual's life, and caring for a child with a disability can introduce additional challenges, making it essential to develop a comprehensive support program tailored to this specific population. STAR uses a mixed-method experimental design with a waitlist control group. The STAR program leverages a hybrid approach, combining psychoeducational and experiential components underpinned by a peer mentor model. The in-person sessions are proposed to be held at the YMCA, spanning a 12-week period with weekly in-person gatherings. Furthermore, participants will engage in a once-weekly asynchronous email support group and have access to online modules available around the clock. The waitlist control group will be granted access to the online modules, offering a basis for comparison with the participants actively engaging in the in-person and online aspects of the program. The aim of the STAR program is not only to gather critical data but also to offer support and resources for survivors of childhood trauma, creating a holistic approach that addresses their unique needs and circumstances. The STAR program holds the potential to shed light on the impact of a novel occupational therapy health promotion initiative on the resilience, quality of life, and overall well-being of its participants. This project anticipates significantly contributing to the occupational therapy and trauma fields. It has the potential to enhance the lives of those who face the challenges of both childhood trauma and caring for a child with a disability.

The relationship between alexithymia, PTSD symptoms, attachment, and depression was examined using archival data from a university-based trauma clinic. Participants were 62 women and 20 men, ages ranging from 17 to 59, with childhood histories of physical or sexual abuse. Measures included the Structured Clinical Interview on Childhood Sexual Abuse History (SI-SA), Impact of Events Scale-Revised (IES-R), Attachment Style Questionnaire (ASQ), Beck Depression Inventory-Second Edition (BDI-II), and Toronto Alexithymia Scale-20 (TAS-20). As predicted, alexithymia, PTSD symptoms, and depression were negatively correlated with secure attachment and positively correlated with insecure attachment. Also as predicted, depression and insecure attachment styles containing negative models of the self (need for approval, discomfort with closeness) mediated the relationship between alexithymia and PTSD symptoms while styles involving positive models of the self (confidence, relationships as secondary) did not. Preoccupation with relationships was excluded from mediation analyses because alexithymia was not a significant predictor of this construct. Results suggest that the symptom profile of adult survivors of childhood abuse can be complex and may require interventions that target a broad range of symptoms and difficulties including alexithymia, attachment, and depression.

There are substantial data exploring the link between religiosity and health, yet there is no consensus regarding the appropriate measurement tool for assessing religiosity in health psychology settings. The purpose of this study was to identify a set of items that could serve as a reliable and valid proxy measure of religiosity. Participants included 251 (M=19.02; range = 17-25) young adults who completed self-report measures of religiosity (Intrinsic-Extrinsic/Revised, Quest Scale, Faith Maturity Scale), psychological distress (SCL-90-R), and personality (NEOPI-R). Individual item pools for religiosity were developed by identifying significant correlations between each of the religiosity measures and the SCL-90-R items. Exploratory factor analyses and item-level analyses were conducted and convergent and discriminant validity were examined for each proposed measure. A group of items were identified that were associated with previously validated measures of religiosity. These religiosity measures were also associated with the personality domains of Openness to Experience and Agreeableness but were not associated with Neuroticism. There was insufficient evidence, however, to conclude that the proposed measures could serve as true proxy measures of religiosity as they were more strongly associated with Neuroticism than the religiosity measures from which they were derived. The results of this study underscore the importance of the religiosity construct to health-related outcomes, yet much work remains to delineate the optimal means of measuring the construct and the specific pathways by which religiosity may exert its influence on both mental and physical health.

EMS providers work in a high-stress environment and are routinely exposed to critical incidents. Many providers are left to deal with the chronic stress on their own, either because of lack of effective employer-based programs or a culture that discourages its use. The extent to which these factors -- as well as personal characteristics such as resilience, PTG, and coping skills -- influence PTSD and suicide ideation among EMS providers has not been well studied among EMS providers. An online survey was administered to a convenience sample of EMS providers. Of the 2,683 respondents, more than one quarter (27.7%) met the PTSD criteria of 50 or higher on the PCL-M. Close to half of the respondents (42.0%) reported having contemplated suicide in the last six months. Of those who had contemplated suicide in the last 30 days, nearly one third (27.1%) thought about suicide 10 or more days in the last 30 days. EMS culture and resilience were negatively associated with PTSD, while positive associations were found with some coping styles. PTSD scores and suicide ideation frequency were highest when post-incident services were not available in the workplace. No significant relationships were found between personal factors and suicide ideation.

Hintergrund: Der Zweite Weltkrieg und die damit verbundenen traumatischen Ereignisse können auch Jahrzehnte später bei der ehemaligen Kriegsgeneration Deutschlands mit langfristigen und schwerwiegenden gesundheitlichen Folgen einhergehen. Insbesondere die Erforschung von Langzeitverläufen traumatisierender Erlebnisse befindet sich noch in ihren Anfängen. Ziele: Es werden die Auswirkungen traumatischer Erfahrungen und posttraumatischer Belas-tungssymptomatik auf die heutige gesundheitsbezogene Lebensqualität der älteren Bevölkerung Deutschlands (bis 1948 geboren) untersucht. Die Zusammenhänge werden unter dem Einfluss komorbider Depressivität, somatischer Symptome und körperlicher Erkrankungen analysiert. Material und Methoden: Diese Arbeit untersucht die physische und psychische gesund-heitsbezogene Lebensqualität (SF12v2-Fragebogen zur gesundheitsbezogenen Lebensqua-lität), traumatische Erfahrungen (Traumaliste des M-CIDI), Posttraumatische Belastungsstörung (PTBS) entsprechend des DSM-IV, partielle PTBS (Posttraumatic Diagnostic Scale, PDS), körperliche Erkrankungen (Multimorbiditätsfragebogen), Depressions- und Somatisierungssymptomatik (Patient Health Questionnaire, PHQ-D) in einer repräsentativen Stichprobe der 60-85 jährigen Bevölkerung Deutschlands (N = 1659) mit Hilfe von Selbstbeurteilungsverfahren. Ergebnisse: Personen mit traumatischen Erfahrungen in der Lebensgeschichte berichten eine niedrigere Lebensqualität als Personen ohne traumatische Erfahrungen. Zudem findet sich mit steigender Anzahl der traumatischen Erfahrungen eine niedrigere physische und psychische Lebensqualität. Auch haben Personen mit einer Vollbild- oder partiellen PTBS eine niedrigere körperliche und psychische gesundheitsbezogene Lebensqualität. Beeinträchtigungen in der physischen gesundheitsbezogenen Lebensqualität werden hauptsächlich durch komorbide depressive und somatische Symptome und körperliche Erkrankungen erklärt. Auf die Beeinträchtigungen der psychischen gesundheitsbezogenen Lebensqualität haben sowohl traumatische Erfahrungen und posttraumatische Belastungssymptomatik als auch komorbide Depressions- und Somatisierungssymptomatik Einfluss. Die PTBS führt sowohl bei kategorialer als auch bei dimensionaler Betrachtung zur Beeinträchtigung der gesundheitsbezogenen Lebensqualität; stärkster Einfluss wird auf die psychische Dimension genommen. Schlussfolgerung: Selbst nach Jahrzehnten können potentiell traumatisierende Erlebnisse in der Folge mit erheblichen körperlichen und psychosozialen Beeinträchtigungen einhergehen. Im Umgang mit Älteren sollten neu auftretende oder zunehmende gesundheitliche Beschwerden immer vor dem Hintergrund der historisch-biographischen Perspektive betrachtet werden. Dabei sollte auch subsyndromalen Störungsbildern genügend Beachtung zukommen. Dem Einsatz von Messinstrumenten zur Erfassung der Lebensqualität in der Diagnostik und zur Verlaufsbeurteilung sollte mehr Bedeutung beigemessen werden.

Threats and violence, or the risk of being subjected to threats and violence in the workplace, is a major health and safety problems that exists in many professions. To be exposed to threats and violence can have serious consequences for the employee's health but also for the organization in question. The aims of this study was to investigate the prevalence of threats and violence at the Swedish Migration Board detention, and to examine whether there were health problems among employees who may be exposed to threats and violence. A web-based questionnaire was answered by 29 employees (response rate = 51 percent). The results showed that more employees had been exposed to verbal threats (66 percent), compared to physical violence (10 percent), and they showed a greater tendency to report physical violence, as opposed to verbal threats. The participants indicated that factors such as working alone, convey rejection decisions and escape attempts increased the risk of threats and violence. However, the majority of the participants reported that the preventive work, including, alarms, training and available equipment, worked fine. Further everyone reported that they received good support from colleagues when they were subjected to a threat or violent situation. Generally the employees reported that their health was good, which might partly be related to an experience that the preventions worked well at this workplace. Future research should investigate such a relationship.

The needs of patients who are nursed on the ICU are becoming more widely recognised and services are beginning to reflect this. However there is little research into how patients who have suffered from a severe and progressive muscular paralysis called Guillain-Barré Syndrome (GBS) experience the disease and subsequent hospitalisation. The purpose of this study was to explore how these patients experience the different aspects of the illness, including an extended period of paralysis and treatment on an ICU. This is intended to expand upon the limited research in this area and identify how the findings can inform clinical practice and future studies. Method: A systematic literature search identified research in relation to the experiences of individuals who had GBS which was utilised to form the basis of the understanding for this study. Very little systematic research has looked at individuals‟ experiences of Guillain-Barré Syndrome whilst ill and their subsequent recovery. A mixed methods study was carried out with the aim of adding to this research. Interpretative Phenomenological Analysis was selected as the method of analysis for Study 1, which involved interviews with seven participants who had experienced GBS severe enough to need treatment on an ICU. This then enabled quantitative questionnaires to be disseminated which asked about individuals‟ levels of anxiety, depression and Post Traumatic Stress symptomatology both retrospectively and following recovery in Study 2. Results: Study1 found that participants experienced GBS as either a slow and frustrating, or as a rapid and scary onset. The main themes that were developed included: the paralysis being viewed as multiple losses, frustration, difficulties associated with communication loss, vulnerability and frightening hallucinations. Study 2 utilised non-parametric analyses of the data and found that participants experienced high levels of anxiety and depression at the onset of GBS and that some continued to experience anxiety, depression and post traumatic symptoms after recovery from GBS. Generally the profile suggests predominantly anxiety problems during the acute onset phase and then predominantly depression at the time of follow-up. Aspects of post traumatic stress were positively correlated with duration of mechanical ventilation which in turn was related to duration of paralysis. This challenged the hypothesis that GBS patients habituate to the experience of paralysis. Conclusion: For some individuals, GBS was experienced as a frightening event, but one that they could draw positive things from. However, for others, GBS was experienced as a traumatic event and some of these people continued to exhibit signs of psychological distress even after recovery. It remains important for staff to feel able to speak about distressing situations with their patients and to signpost them to other psychological services if appropriate.

Imagery rescripting (ImRs) is a psychological intervention effective in treating intrusive images in PTSD. Studies have suggested factors in ImRs which may influence outcome; however, research is still in its infancy, with mechanisms of action still unknown and factors which make it successful unclear (Arntz, 2012). This study aimed to investigate therapists' experience of the process of delivering ImRs in PTSD and what they believe make it an effective intervention. The study used a Grounded Theory (GT) approach to investigate eight therapists' experience of using ImRs in PTSD, and their view of what makes it successful. A GT analysis produced a model illustrating the process of using ImRs, consisting of four theoretical themes: using ImRs in PTSD, facing obstacles in working with the imagination, identifying the mechanisms of action and moving from the unknown to the known. The main suggested mechanisms of action involved re-establishing power and enabling an emotional shift to occur. The model highlighted inter-relationships existing, with distinct themes feeding into each other. The GT model suggested more structure and research is required for an increased understanding in ImRs, allowing therapists to feel more confident and comfortable using the perceived anxiety-provoking technique. Future research could focus on interesting findings from this study allowing an already powerful therapeutic tool to develop and become a more widely-used and prioritised treatment technique in PTSD.

Intrusive images are a common phenomenon in post-traumatic stress disorder (PTSD; American Psychological Society, 2013). Imagery-Rescripting (ImRs; Arntz & Weertman, 1999) is an experiential technique for targeting intrusive images and is gaining popularity as a treatment for PTSD (Arntz, 2012). Although there is evidence to suggest that ImRs is an effective treatment of PTSD (see Arntz, 2012), it is currently unclear how ImRs works. The aims of the present study were 1) to develop a coding scheme that captured important factors of ImRs session, and 2) to apply this coding scheme prospectively to investigate how certain factors might relate to treatment outcome. The study used thematic analysis (Braun & Clarke, 2006) to develop an ImRs coding scheme. Next, a single case experimental design was employed to track six participants over the course of their ImRs therapy for PTSD. Session content captured by the coding scheme was compared to changes in weekly outcome measures to investigate whether the presence of certain codes related to a reduction in PTSD symptoms. Results suggested a number of factors might be important for determining treatment outcome. Specifically, Attitude towards ImRs, Activation of the image, Ability to follow ImRs, Activation of original internal processes and internal processes during the re-script, Believability and Attitude towards the outcome are suggested as potentially important factors for determining ImRs efficacy. Study strengths, limitations and clinical implications are discussed. Recommendations for future research, including in-depth investigation of individual factors are suggested.