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.

The current study determined if a professional development on PTSD would improve pre-service teachers’ self-efficacy for helping students with posttraumatic stress disorder (PTSD) to learn. Participants consisted of 59 college students from one large, comprehensive, Mid-Southern university who were enrolled in an education program and an educational psychology course. Using a quasi-experimental method, participants either received the PTSD professional development (treatment) or regular instruction (control group). All participants completed a measure of demographics, a pre-test measure of selfefficacy for helping students with PTSD to learn, which was further dissected into four constructs (i.e., self-efficacy for identifying students with PTSD, adapting instruction to maximize learning, creating a safe and secure environment, and finding help), and a posttest measure of the same self-efficacy items. A one-way MANOVA indicated statistically significant differences between the two groups in self-efficacy for identifying students with PTSD. Furthermore, a paired-samples t-test revealed that the treatment groups’ selfefficacy scores on all four constructs significantly improved from pre- to post-test. Information is offered to support this finding; additionally, possible reasons for nonsignificant findings are discussed.

Past research has found inconsistent effects of posttraumatic stress disorder (PTSD) status on cardiovascular responding. Inconsistencies may be explained by demographic differences in study samples. In this study, the influence of gender and ethnicity on the relationship between PTSD status and cardiovascular responding was explored. Participants’ (N = 245) heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) readings were taken throughout baseline and anger recall periods. For all gender by ethnicity groups, baseline HR was higher in participants with PTSD than without PTSD, except for Black men. Whites with PTSD had lower baseline SBP than Whites without PTSD; the opposite was true for Blacks. Men and Blacks with PTSD had larger HR increases during anger imagery than men and Blacks without PTSD, whereas women and Whites showed the opposite pattern. Results suggest demographic variables may account for inconsistent effects of PTSD on cardiovascular responding.

A growing body of research is examining effective treatment(s) for individuals with comorbid posttraumatic stress disorder (PTSD) and alcohol dependence (AD). However, treatments for this comorbid population have been inadequately studied in the longer term. This study represents a long-term follow-up assessment of a randomized controlled trial that compared combined therapy (prolonged exposure + naltrexone) with monotherapies (prolonged exposure or naltrexone) for patients with PTSD and AD (see Foa, Yusko, McLean et al., 2013). Attempts were made to contact 120 participants 5-10 years after the original trial to assess the maintenance of treatment gains. Nineteen individuals were located and agreed to participate. A series of mixed ANCOVAs were conducted with PTSD symptom severity and percentage of days drinking and heavy drinking as the dependent variables. Findings revealed that reductions in PTSD symptoms and drinking behaviors generally were maintained 5-10 years after treatment. There was some relapse in heavy drinking days, and combination treatment was most effective for long-term PTSD outcomes. Challenges of conducting follow-up research with this population, implications and limitations of the present findings, and directions for future research are discussed.

Distress tolerance (DT) is considered to be a trait-like factor encompassing an individual’s behavioral and/or perceived ability to withstand negative affective states. Behavioral measures of DT are being increasingly utilized, however, these tasks have been implemented in studies prior to thoroughly establishing the psychometric properties. The present study aimed to evaluate the reliability of two DT behavioral tasks (Breath-Holding Task [BHT], computer-based Paced Auditory Serial Addition Task [PASAT-C]) in different settings (laboratory, online) among a sample of college students. Participants completed the tasks during two sessions, approximately one week apart. 52 participants were in the laboratory condition, and 65 were in the online condition. There were three main findings: a) test-retest reliability estimates were within acceptable ranges for both the BHT and PASAT-C, b) BHT performance differed significantly by modality while PASAT-C performance did not, c) number of distractors endorsed was not significantly associated with quit latency on either task.

Post Traumatic Stress Disorder (PTSD) is an anxiety disorder that occurs when people are exposed to stressful, life-threatening experiences. Consequently, after exposure to such an event, many people may experience fear, guilt, or anger and may believe the trauma is reoccurring. According to the National Institute of Mental Health, approximately 5.2 million U.S. adults age 18-54 have PTSD in any given year. The prevalence of PTSD is even more problematic within the military where an estimated 30% of those who have spent time in war zones experiences PTSD. Researchers have been examining the impact of veterans’ PTSD symptoms on family relationships, and on children in particular yet there is little understanding of the residual impact of PTSD or its secondary effects on children. This study aims to begin to understand how the health care providers’ experiences and acumen may assist patients with addressing PTSD. Additionally, by exploring the treatments and experiences of physicians, further insight and a deeper understanding may be gained on how PTSD impacts family relationships, specifically, hardiness and parental skills. A secondary aim of this study is identify those factors that promote resiliency in hopes of creating new interventions to lessen the residual effects of PTSD and prevent intergenerational trauma. This study begins to explore the residual impact of PTSD and will contribute to inform future research to design new methods and tools which may assist physicians to address intergenerational PTSD. This study was approved by Virginia Commonwealth University (VCU) Institutional Review Board (IRB).

This thesis documents the design process for an out-patient mental health facility for veterans of war. Here are some questions that drove my design work. How are stories told in design? How are stories generated from users within a designed space? Can users participate in contributing to a space's design? Many structures create psychological stories through graphics, color, and layout to involve users in their procedures. For example, commercial retailers will setup a story line to promote a more personalized connection with their customers which encourages repeat business, while places of worship also use this narrative strategy to evoke a spiritual experience. Many historical museums are also terrific examples of involving people in a story line to explain their contents. Thus, spaces can also tell stories and involve occupants within these set story lines, but this document and the resulting designed space explore the potential for interior design to generate stories from its users.

There is a growing body of research in support of the relationship between self-compassion and psychological health (Neff, Kirkpatrick & Rude, 2007). However, studies are limited on the malleability of self-compassion specifically within clinical populations, and its influence on psychiatric symptom reduction (Raes, 2011). This study therefore aimed to explore self-compassion, through examination of the underlying components (self-kindness, common humanity and mindfulness), and their impact on maladaptive functioning, specifically for participants diagnosed with PTSD. The study used an exploratory mixed methods design, with eight participants recruited by their attendance at two PTSD CBT/IPT (with self-compassion) group treatment interventions. Participants were adults, with a diagnosis of PTSD and a history of recurrent or current depression. Participants attended a group interview and two therapists who facilitated each treatment group were also interviewed. Participants completed quantitative measures pre and post intervention; Self-Compassion Scale (Neff, 2003a) and Clinician-Administered PTSD Scale (Blake et al., 1995), and session data was recorded using the PTSD checklist (PCL-C; Weathers, Litz, Huska & Keane, 1994) and the Session Feedback Form (AccEPT Primary Care Psychological Therapies Service). The findings demonstrate the importance that individuals place on self-compassion in their PTSD recovery, particularly in relation to self-kindness and the generation of positive self-belief and a compassionate inner-voice. The study also indicates that a clinically significant change in self-compassion is possible for individuals with PTSD, supporting the malleability of self-compassion within clinical populations.

Thesis advisor: James E. Lubben / This study examined the roles cohesion, coping, and perceived threat have in buffering the effect of war-zone stress on mental health symptoms. Specifically, six factors were tested as potential moderators of the relationship between combat-related stressors and posttraumatic stress symptomatology (PTSS), including horizontal (peer) cohesion, vertical (NCO) cohesion, vertical (officer) cohesion, problem-focused coping, emotion-focused coping, and perceived threat. In addition, direct effects and curvilinear interaction effects were examined. This study was a secondary analysis of Mental Health Advisory Team (MHAT) VI data collected by military researchers as part of an ongoing effort to assess soldiers' behavioral health. This study analyzed data from a total of 1,824 male and female U.S. Army soldiers from 15 active-duty brigades who anonymously completed the Walter Reed Army Institute of Research (WRAIR) Deployment Well-Being Survey during their deployment to Iraq in support of Operation Iraqi Freedom (OIF). PTSS, combat-related stressors, horizontal (peer) cohesion, vertical (NCO) cohesion, vertical (officer) cohesion, problem-focused coping, emotion-focused coping, and perceived threat were measured. Hierarchical multiple regression analysis was used to identify both risk factors and protective factors for PTSS. The analysis revealed three risk factors and four protective factors. During a war-zone deployment, higher levels of combat-related stressors, problem-focused coping, and perceived threat (i.e., risk factors) were independently associated with greater report of PTSS. Higher levels of horizontal (peer) cohesion, vertical (NCO) cohesion, vertical (officer) cohesion, and emotion-focused coping (i.e., protective factors) were independently associated with decreased levels of PTSS. Hierarchical moderated multiple regression analysis indicated that vertical (NCO) cohesion, vertical (officer) cohesion, and emotion-focused coping buffered the effect of combat-related stressors on PTSS; soldiers higher in vertical (NCO) cohesion, vertical (officer) cohesion, and emotion-focused coping showed weaker relationships between combat-related stressors and PTSS. No support for curvilinear interaction effects were found, suggesting that for this population of soldiers deployed to Iraq, the moderating effect of vertical cohesion and emotion-focused coping on the relationship between combat-related stressors and PTSS is linear in nature. / Thesis (PhD) — Boston College, 2012. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

Thesis advisor: Ce Shen / A compelling body of literature suggests that negative appraisal may be associated with adverse reactions to traumatic stress (Ehlers & Clark, 2000). However, very few studies have examined how cognitive appraisal influences posttraumatic adaptation in people with serious mental illness (SMI) despite evidence of disproportionately high prevalence rates of trauma exposure and Posttraumatic Stress Disorder (PTSD) in this population. The major purpose of this study was to examine the relationship between negative appraisal and PTSD symptoms among adults diagnosed with SMI. It was hypothesized that negative appraisal would have a positive and significant association with traumatic stress symptoms in a clinical sample of community clients diagnosed with major mood and schizophrenia-spectrum disorders when controlling for gender, total lifetime trauma, substance use, and severity of symptoms associated with SMI. Multiple regression was employed to conduct a secondary analysis of clinical data from 291 community support clients who were receiving services from three community mental health centers in the state of Rhode Island during March to September 2009. Results supported the main hypotheses that all three types of negative appraisal with respect to self, world /others, and self blame as well as overall appraisal were positively and significantly associated with PTSD symptoms. / Thesis (PhD) — Boston College, 2011. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.