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.

Posttraumatiska stressyndrom (PTSS) är en diagnos som hittills har omfattat vuxna, men på senare år även kommit att gälla barn som upplevt traumatiska händelser. Syftet med studien är att belysa PTSS och ge en förklaring av vad diagnosen innebär. Jag vill också dra relevanta slutsatser för förskolan. Det teoretiska underlaget är hämtat från forskning kring ämnet och har analyserats i ett förskoleperspektiv. Studiens empiriska underlag är en enkätstudie. Resultatet av enkätstudien omfattar uttalanden som till viss del stärker forskarnas påpekanden.

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Magister Curationis / Hierdie studie is 'n poging om die probleem synde die voorkoms van Post Traumatiese Stressteuring (PTSS) by kinders in die Wes-Kaap aan te spreek. Dit is 'n retrospektiewe studie wat baseer word op die inligting wat vanuit pasiënte-lêers verkry is gedurende die periode 1994 -1996, by die Kinder- en Adolessente Psigiatrie Eenheid by Tygerberg Hospitaal in die Wes-Kaap. Volgens hierdie inligting kom dit voor asof die professionele verpleegpraktisyn geen noemenswaardige rol speel in die voorkoming en waar dit nie moontlik is nie, in die vroeë identifisering en dienooreenkomstige tussentrede van PTSS by kinders nie.Hoofstuk Een fokus op die oriëntering tot die terrein van die studie synde die voorkoms van PTSS by kinders in die Wes-Kaap, die motivering vir die studie, die probleemformulering en die organisering van die daaropvolgende hoofstukke. Ten einde die probleem te definieer en te kontekstualiseer en die situasie waarbinne die betrokke probleem geïdentifiseer is, omvat Hoofstukke Twee, Drie en Vier 'n omvangryke literatuurstudie in verband met die geskiedenis, etiologie, bydraende faktore, patogenese en simptomatologie, die hantering en die rol van die professionele verpleegpraktisyn in die voorkoming en vroeë opsporing en tussentrede van PTSS by kinders. Hoofstuk Vyf handelaar die navorsingsmetodologie, terwyl Hoofstukke Ses en Sewe die gevolgtrekkings, aanbevelings en die beperkinge van die studie toelig.

Denna uppsats undersöker effekter av psykologisk debriefing och avlastningssamtal efter traumatiska händelser hos brandpersonal. Enkätstudiens fokus låg på brandpersonalens känslomässiga påverkan av traumatiska händelser i arbetet. Femtionio personer deltog i enkätstudien, varav 91 procent upplevt en traumatisk händelse. Det fanns inga signifikanta skillnader i posttraumatiska stressreaktioner och psykologiskt välbefinnande hos brandmän efter traumatisk händelse beroende av huruvida brandmännen deltagit i tidig intervention i form av avlastningssamtal, psykologisk debriefing eller inte medverkat i någon form av tidig intervention. / This study investigated the effectiveness of psychological debriefing after traumatic events among professional firefighters. We sought to understand the emotional effect of traumatic events in daily work. To examine this, a survey was conducted with 59 firefighters and among these 91 percent had experienced a traumatic event. There were no significant difference in post trauma reactions and psychological well being among firefighters after traumatic event depending on participate or not participate in psychological debriefing.

Psykisk hälsa/ohälsa är ett svårdefinierat begrepp som sätter fingret på ett av de största folkhälsoproblemen i vårt land, där depression är en av de vanligaste diagnoserna. Manualerna DSM-IV TR och ICD-10 används inom stora delar av sjukvården, världen över, i syfte att ge kunskap om lämpligast behandling till patienter med psykiska besvär. Denna studie syftar till att, genom en kvalitativ analys, undersöka vilka grunder som finns bakom de vanligast använda diagnosmanualerna och vilka kriterier som krävs för att uppfylla två vanligt förekommande diagnoser, PTSD och svår depression. Vidare syftar studier till att belysa eventuella likheter och olikheter mellan dessa diagnoser och vad det kan föra med sig. Såväl psykologisk forskning som klinisk praktik utgår idag mestadels från psykiatriska diagnoser, vilket kan ha såväl fördelar som nackdelar, men samtidigt diskuteras huruvida man istället ska lägga fokus på en annan mer underliggande nivå, nämligen processerna som sträcker sig över diagnosernas gränser. Fördelarna med ett transdiagnostiskt perspektiv är att det delvis kan ge en förklaring till den höga komorbiditet som finns i kliniska grupper och som skulle kunna iakttas även i de sjukdomsbilder som denna studie fokuserar på. Unified Protocol är en annan behandlingsmodell som tas upp i studien, vilken baseras på en betydande fenotypisk över-lappning mellan olika ångeststörningar hos patienter, där personer med subkliniska nivåer av symtom ändå kan ha en nedsatt funktionsnivå och ett subjektivt lidande, fastän de inte uppfyller alla de diagnostiska kriterierna för en specifik störning. Resultatet visar på möjligheten att se över diagnosgränser, för att öka chanserna för ett tillfrisknande hos patienten. Människans upplevelser av olika situationer den befinner sig i formas av personens egen uppfattning om sin förmåga, eller oförmåga, att påverka resultatet. Att uppleva sig ha mist kontroll över sitt eget liv kan i sig leda till såväl depression som suicidala tankar/-handlingar. Om symtomen för depression jämförs med kriterierna som står att finna under diagnosbilden “Posttraumatiskt stressyndrom” under kapitlet “ångestsyndrom”, kan många likheter konstateras. Slutsatsen blir att likheterna i symtombild skulle ge patienter med PTSD en behandlingsrekommendation som inte alls överensstämmer med de rekommenderade riktlinjer som är utformade för PTSD. Trots diagnosernas likheter rekommenderas olikartad behandling, och även olika förutsättningar för att fungera i kombination med förvärvsarbete påvisas. Vid så lika symtombilder, men ändå så skilda rekommenderade behandlingsplaner utifrån de olika diagnoserna, torde risken för en felaktig rehabiliteringsplan vara över-hängande. / Mental health/illness is complex to define and this highlight of the biggest public health problems in our country, in which depression is one of the most common diagnoses. The manuals DSM-IV TR and ICD-10 is used in much of health care, worldwide, in order to provide knowledge of appropriate treatment for patients with mental disorders. This study aims to, through a qualitative analysis, examine the grounds behind the most commonly used diagnostic manuals and the criteria required to meet two common diagnoses, PTSD and severe depression. Further studies aimed to highlight any similarities and differences between these diagnoses and what it can bring. Both psychological research and clinical practice today is based mostly from psychiatric diagnoses, which can have both advantages and disadvantages, but also discussed whether they should instead focus on another more underlying level, namely the processes that extend across the diagnostic boundaries. The advantages of a trans-diagnostic perspective are that it may partly explain the high co-morbidity found in clinical groups and that could be observed even in those syndromes which this study focuses on. Unified Protocol is a different treatment model that is entered in the study, which is based on a significant phenotypic overlap between anxiety disorders in patients, where individuals with subclinical levels of symptoms still can have a reduced level of functionality and a subjective suffering, although they do not meet all the diagnostic criteria for a specific disorder. The result shows at the opportunity to review the diagnostic boundaries, to increase the chances for a recovery of the patient. The human experiences of different situations it is in the form of personal self-perception of their ability, or inability, to influence the outcome. To experience they have lost control over his own life in itself can lead to both depression that suicidal thoughts / actions. If the symptoms of depression compared with criteria that are to be found during diagnostic image "Post-traumatic stress disorder" in the chapter "disorder" can be found many similarities. The discourse comes to that the similarities in symptoms would provide patients with PTSD, a treatment recommendation, which did not conform to the recommended guidelines that are designed for PTSD. Despite the diagnosis, the similarities are recommended disparate treatment, and also different conditions to work in conjunction with work shown. At this same symptom pictures, yet so different recommended treatment plans based on the different diagnoses, would risk a false rehabilitation plan to be imminent

This project developed a model to account for an obesity outcome in children who have posttraumatic stress disorder (PTSD) and whose parents have posttraumatic stress symptoms (PTSS) or PTSD. A literature review provided the basis for the model and covered the areas of childhood obesity, parental PTSS, childhood PTSD, adverse childhood experiences, relational PTSD, ineffective parent support, and the stress response. A model to explain the outcome of obesity in children with PTSD as mediated by parental support provided after a traumatic event was developed: The Parental PTSSChildhood Obesity Model. The literature review supports a relational perspective for viewing child outcomes from trauma. When the relational perspective is applied to parents who themselves are experiencing PTSS, several parent response patterns were supported. These response patterns are considered to detrimentally impact the parent’s ability to provide an environment that is safe, predictable and responsive. Therefore the parent experiencing PTSS will evidence less effective parenting. Thus the child’s environment will be more stressful, increase the child’s symptomology and promote ineffective coping skills resulting in obesity. The strengths, limitations, and contributions of the model are discussed, as well as recommendations made for further research.

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