In the year of 2003, the SARS epidemic was spreading in our country, lasting for almost 4 months. Until July 5,2003, there were 346 confirmed victims. Among them,37 died directly of SARS, which is shown in their death certificates. Numbers of medical workers infected were 68,19.7%. During the SARS epidemic.6 hospitals were reported transmissions inside their wards and were closed. In the duration, Taiwan was once the most significant spread region of the disease in the world. General public, patients and their family members, and health-care workers were all unprecedented threatened. During the epidemic, health-care workers faced unfamiliar, insecure, critical menace strong contagious and of high mortality circumstances. What did this affect first line health-care workers? This research was done in three dimensions , work value, Organizational Commitment and Post Traumatic Stress Disorder, sampling every grade of health-care workers in teaching hospitals and above national wide between Dec. 20, 2003 and Jan. 20, 2004. The design of questionnaire was based on level of hospitals, divided into medical centers, regional hospitals and local teaching hospitals. 282 of the questionnaires were returned and valid, including 42 doctors, 130 nurses, and 110 hospital staffs, representing a response rate of 31.33%. One way ANOVA and Independent T test were conducted in the research to analyze characteristics of workers and differences between hospital organizations. Correlation analysis and regression analysis were used to find their relationships. The research has shown that while facing SARS epidemic, health-care workers : 1.with the change of work values, nurses scored highest ,then others, and doctors lowest; with positional type social status, activity preference and job involvement, high and middle level administrator got better grade than professional and basic level worker; with attitude toward earning, basic level worker acquired highest scores and high level administrator lowest; with activity preference¤Îpride in work, regional hospital obtained the highest score while the medical center got the lowest. 2.with the transition of Organizational Commitment, in terms of position, high level administrator is highest, while basic level worker is lowest; in respect of referee, regional hospital graded highest while medical center lowest; in view of marital status, people who are unmarried are better than those who are married. 3.with the,PTSD, considering referee of hospital, medical centers are highest; in terms of ownership,private hospital is highest and religional hospital is lowest. 4.workers who considered that the hospitals took proper protections have better Organizational Commitment and their PTSD are lower.

Of the approximately 1 million Army Soldiers who deployed to Iraq or Afghanistan at least one time between 2001 and 2007, 18.5% screened positive for posttraumatic stress disorder symptoms post-deployment (Tanielian et al., 2008). Deployed Soldiers are at a high risk for unsuccessful reintegration as evidenced by the presence of mental health symptoms. Because of the lack of evidence demonstrating the relationships between resilience and other factors that may contribute to mental health outcomes in active duty Soldiers, the purpose of this study was to determine if relationships existed among these variables in Soldiers with a recent deployment history. An adaptation of Richardson’s Metatheory of resilience guided this study. A convenience sample of 350 active duty army junior enlisted and Non-Commissioned Officers (NCOs) who were within 6 - 12 months from returning from deployment to Iraq or Afghanistan and stationed at Fort Campbell were recruited to participate in this cross-sectional, descriptive, correlational study. Seven self-report instruments were used to collect data: (1) Demographic Survey, (2) Connor-Davidson Resilience Scale, (3) Deployment Risk and Resiliency Inventory (DRRI), (4) Daily Spiritual Experiences Scale, (5) Generalized Anxiety Disorder-7, (6) Center for Epidemiological Studies Depression Scale, and (7) Post-Traumatic Stress Disorder Checklist-Military Version. Data were entered into SPSS 18 and analyzed using descriptive statistics, correlations, and hierarchical linear regression. Results revealed many statistically significant correlations. Ten predictors resulted from this analysis and were placed into separate regression analyses with the three mental health outcomes. Each of the mental health outcome variables (anxiety, depression, and PTSD symptoms) accounted for a significant amount of variance in the other. In addition to PTSD and depression, post-deployment life events, deployment environment, and resilience accounted for the most significant amount of variance in anxiety symptoms. In addition to anxiety and PTSD symptoms, post-deployment life events accounted for the most significant amount of variance in depression symptoms. Deployment environment, post-deployment life events, and post-deployment support accounted for the most significant amount of variance in PTSD symptoms, in addition to anxiety and depression. The implications of the findings and recommendations for future nursing practice, education, and research opportunities are abundant. / text

To explain delinquency, General Strain Theory (GST) focuses on negative relationships with others. As one type of victimization, exposure to violence is significantly related to juvenile crime and substance abuse. In addition, victimized adolescents commonly experience post-traumatic stress disorder (PTSD). However, little research has investigated the mediating role of PTSD in the association between violent victimization and juvenile delinquency. Using data from the National Survey of Adolescents (1995), the present study examines the direct effects of sexual assault, physical assault, and witnessing violence on inner- (alcohol and illicit drug use) and outer-directed behaviors (property and violent crime). This study also examines the mediating role of PTSD, based on an overall scale of PTSD as well as the individual components of PTSD (re-experiencing, avoidance/numbing, and hyperarousal). Logistic regression analyses and the Sobel test were used to examine the hypotheses. Findings in the study provide support for the proposition of GST that violent victimization increases the risk of juvenile crime and substance use. Findings also indicate that exposure to violence results in a higher probability of exhibiting PTSD symptoms. Finally, PTSD clusters partially mediate the link between violent victimization and outer-directed responses. However, the expected mediating effect between violent victimization and inner-directed responses was not found. Theoretical implications and limitations are discussed.

Unfortunately, one rite of passage of childhood is often serious injury that carries psychological impact along with the obvious physical repercussions. Prior studies have found conflicting results for protective/risk factors, thus this study attempted to explore PTSD in a sample of children ages seven to thirteen years of age with moderate to severe injuries. In this study (N = 32), 31.3% of children experiencing such a sudden injury requiring hospitalization at the University of Kentucky Childrens Hospital demonstrated significant indications of post-traumatic stress disorder (PTSD) following the injury. Several pre, peri, and post-trauma variables from during the childs hospitalization to the follow-up period four to five weeks later were correlated with this outcome including age, ethnicity, acute stress disorder (ASD) with or without dissociation criteria being met, prior medical experience, parents score on the BSI-18 while the child is still in this hospital, chronic illness status, gender, number of coping strategies reported by the child while in the hospital, the number of negative coping strategies reported, the amount of pain reported, and several follow-up variables (parents BSI-18 score, number of coping strategies reported, number of negative and positive coping strategies reported, injury threat, and total number of impairments reported by the child and by the parent). Negative coping did not significantly change from the in-hospital period to the follow-up period. Surprisingly, the STEPP, a current screener described and supported by some past research, was not successful in identifying these at-risk children; however, a new screening prototype was developed including age, acute stress disorder (ASD), and pain that did successfully predict 80% of those with PTSD and 85% of those without later PTSD. A follow-up screener consisting solely of parental items (parental symptoms on the BSI-18 and parental rating of child impairments) was also created and found to sensitively predict 90% of those children with PTSD. Implications from these findings along with study strengths and weaknesses were highlighted.

Traumatic experiences can have a profound and lasting impact on the mental health of children and adolescents. In this meta-analysis, psychosocial interventions for children and adolescents who have been exposed to traumatic experiences were systematically reviewed. Twelve main intervention components were identified. Of the main intervention components, cognitive Behavioural Therapy (CBT) was the most common and the most effective at reducing Post-traumatic Stress Disorder (PTSD) /Post-traumatic Stress Symptoms (PTSS) in children and adolescents. These findings on the effectiveness of CBT add to the findings of previous reviews on intervention effectiveness on alleviating trauma symptoms in children and adolescents. Components of Cognitive Behavioural Therapy (CBT), Exposure Therapy, Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing Therapy (EMDR), Meditation- Relaxation Therapy, Family-Focused Therapy, Psychological Debriefing, Resiliency-Focused Therapy, Sensory Therapy, Psychoeducational Therapy, Time-Limited Dynamic Therapy (TLDP-A), and general unspecific counselling were used in the various treatments. Taking into account methodological quality, there was evidence for effectiveness for school-based and sexual trauma-based interventions in alleviating trauma symptoms. More research is needed to understand the effect of methodological quality on effect sizes based on intervention type. The implications for researchers and clinicians are discussed.

Post-traumatic stress disorder (PTSD) is a psychiatric condition that can develop when people experience a stressful and life-threatening event. Clinical research indicates that the presence of a state of hyperarousal after a traumatic experience is the best predictor of a subsequent diagnosis of PTSD. The role of arousal peptides called orexins (hypocretins) in a PTSD-like condition produced by exposing rats to a single episode of footshocks (5× 2 s episodes of 1.5 mA) was investigated in this thesis. The first part of my thesis involves the characterization of the footshock model of PTSD and the second part examines the involvement of orexins in this footshock model. The following findings are reported. First, shock rats that exhibited a high level of anxiety to a novel tone (high responders, HR) the day after the footshock exposure subsequently displayed more avoidance when compared to shock rats that exhibited a low level of anxiety (low responders, LR). These results highlight the importance of individual differences in the reaction to a strong fear-inducing experience. Second, the orexin precursor peptide prepro-orexin (ppOX) mRNA was found to be elevated in rats at 6 and 14 days after exposure to footshocks. In addition, ppOX mRNA levels were found to be positively correlated with anxiety at 14 days post-shock. Third, pre-shock injections of the corticotropin releasing factor receptor antagonist antalarmin were found to attenuate the anxiety expressed to the shock chamber and eliminate the correlation between ppOX mRNA levels and anxiety. Fourth, systemic injections of the nonselective orexin receptor antagonist TCS-1102 was found to attenuate the anxiety expressed in rats at 14 days post-shock. Fifth, TCS-1102 was found to have anxiolytic effects that were specific for the HR. The results of these experiments provide evidence linking the orexin system to the anxiety produced by exposure of rats to footshocks. They also provide preclinical evidence in support of the use of orexin antagonists for the treatment of anxiety in PTSD.

During traumatic events, individuals can experience dissociative symptoms related to changes in cognitively processing; these changes are suggested to impact on the development of posttraumatic stress disorder (PTSD) symptoms. Past literature has proposed two forms of peritraumatic dissociation (compartmentalisation and detachment), however little quantitative research has focussed on separately manipulating these experiences in order to further our understanding of their aetiology. The current study addressed this knowledge gap and additionally sought to understand the role of cognitive processing in the dissociation-intrusion relationship. Using an audio-only adaption of the trauma film paradigm, 60 participants were divided into three conditions and presented with different visual tasks - mirror staring, dot-staring or neutral images – that were hypothesised to induce the two forms of dissociation. Post-audio, a number of factors were assessed, including state dissociation, perceptual priming and conceptual priming, as well as intrusions over the following days. As hypothesised, participants in the dissociation conditions displayed an increase in perceptual priming compared the control conditions, and reported more severe intrusions. However, no differences were found in conceptual priming, in the overall number of intrusions between conditions, or in dissociative symptoms between the dissociation conditions. The current study utilised new techniques in the analysis of PTSD and its origins, and showed their potential in the experimental study of dissociation and analogue trauma techniques. The findings also contributed to the growing body of knowledge investigating the impact that dissociation and cognitive processing has on the aetiology of PTSD.

Current theorising of trauma continues to suffer from Post-Holocaust understandings that render trauma as indefinable, yet the myriad representations produced across different discursive domains – testimony, documentary, film and art – challenge such claims. Rather it is difficult to define, plagued by the parameters of trauma – as having no “beginning”, “ending”, “during” or “after” as Laub contends – and is further hampered by its clinically inadequate categorisation as Post Traumatic Stress Disorder (PTSD) within the Diagnostic Statistical Manual (DSM). While the inclusion of PTSD in the DSM-III in 1980 promised to normalise the long history of trauma resulting from combat experience, its increasing and continuing expansion of categories since then has undermined this combat-specific diagnosis. Particularly, it fails to recognise the specific traumas intrinsic to soldiers who wage war as an occupation (specifically the act of killing), and the complex way in which PTSD is triggered in veterans (the political deceit and denial that accompanies the experience of the initial event). With 1 in 5 returned soldiers currently screening for PTSD, and more veterans having committed suicide than have died in combat, it is clear that there is a crisis in the way PTSD is theorised, recognised and understood. This thesis provides a discursive analysis of contemporary media texts, proposing that discourses produced within these domains challenge, undermine and potentially remedy combat trauma’s current “crisis of representation.” While professionally produced documentaries and current affairs programmes were found to align with the political and ideological discourses prominent within the military and psychiatric professions, soldier-produced content – through raw video, art and digital pastiche – functioned as traumatic performances that produced personal articulations of trauma. Moreover, the televisual flashback succeeds in conveying the “traumatised subjectivity” through cinematic and aesthetic conventions that allow the viewer to see beyond the confines of the body and into the flashback as it is experienced by the eye-witness. In doing so, these texts help to construct social and cultural knowledge of trauma and PTSD and facilitate acts of bearing witness. Such articulations allow veterans to understand their own disorder as normal and are influential in the processes of healing and recovery.

The purpose of this study was to evaluate masticatory muscle (MM) and temporomandibular joint (TMJ) pain patients regarding the prevalence of Posttraumatic Stress Disorder (PTSD) symptoms, and evaluate the level of psychological dysfunction and its relationship to PTSD symptoms in these patients. This study included 445 adult patients (male = 42, female = 403). Psychological questionnaires included the Symptom Check List-90-Revised (SCL-90-R), the Multidimensional Pain Inventory, the Pittsburgh Sleep Quality Index and the PTSD Check List Civilian. The total sample of patients was divided into two major groups: The MM group (n=242) and TMJ group (n=203). Each group was divided into three subgroups according to the presence of a stressor and severity of PTSD symptoms. Thirty six patients (14.9%) in the MM group and 20 patients (9.9%) in the TMJ group presented symptomatology of PTSD. MM and TMJ pain patients in the positive PTSD subgroups scored higher on all scales of the SCL-90-R (p = .000) than the other two subgroups and reached levels of distress that were indicative of psychological dysfunction. MM and TMJ pain patients in the positive PTSD subgroups were more often classified as dysfunctional than as adaptive copers and presented with more sleep disturbances than patients in the no stressor and negative PTSD subgroups. A somewhat elevated prevalence rate for PTSD symptomatology was found in the MM than in the TMJ group. Significant levels of psychological dysfunction appear limited to temporomandibular disorder patients with symptoms of PTSD.

I samband med att Försvarsmakten år 2000 ändrade fokus från invasionsförsvar till insatsförsvar uppstod nya krav på Sveriges officerare. Syftet med uppsatsen är att undersöka hur kurslitteraturen som används för att utbilda blivande officerare på militärhögskolan Karlberg i stress har förändrats från en försvarsmakt byggd på ett invasionsförsvar till en försvarsmakt byggd på ett insatsförsvar. Eftersom insatsförsvaret ställer nya krav på en officer är det intressant att undersöka om utbildningen förändrats till att möta de nya krav och behov som ett insatsförsvar innebär. Kurslitteratur mellan år 2000-2001 och år 2011-2014 jämförs för att upptäcka om någon förändring skett. Då två enheter jämförs med varandra och kurslitteratur används som underlag har en komparativ litteraturstudie använts som metod. Slutsatsen i uppsatsen är att kurslitteraturen har förändrats för att möta de nya behov som uppstått i och med fokusskiftet till insatsförsvar. En av förändringarna som skett är att det är mer fokus i kurslitteraturen år 2011-2014 på hur stress motverkas och hanteras.