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The Official Publication of the Canadian Academy of Audiology, Marc Fagelson writes about how awareness and consideration of the special needs of patients with PTSD – the increased need to monitor the acoustical environment

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The purpose of study was to explore depression among Hmong refugees and the ways they use their coping skills to deal with stressful life events.

Despite the growing need, prior research on how the civilian work domain may affect posttraumatic stress is scarce. Moreover, few if any studies have investigated how perceptions of one's job and insomnia may shape traumatic stress symptoms, post-combat. Presently, about 4 million Americans have served in the "Global War on Terrorism," including nearly 1 million reservists. By contrast, 8.7 million Americans served in the Vietnam War: over twice the number of U.S. military personnel who have fought since 9/11. Surprisingly, combat experiences alone do not explain the majority of posttraumatic stress disorder cases, even after multiple deployments, suggesting the presence of moderators of the stressor-strain conceptual model. Based in occupational stress theories of allostatic load, job demands-resources, strain, and social support this thesis applied frequentist and Bayesian analytical strategies to investigate the psychological experiences and occupational health of three subgroups of combat veterans. In the present study, sleep quality and a job situation characterized by isolated, demanding civilian work with low decision authority (i.e., "iso-strain") were hypothesized to moderate the effect of combat experiences on posttraumatic stress. As part of the larger SERVe reintegration project, survey data were collected among a baseline sample (N=382) of post-9/11 veterans living in the Pacific Northwest. The research question of whether greater perceived psychosocial stressors among active reservists driving that group's higher perceived levels of poor sleep, iso-strain, and posttraumatic stress was unfounded. Overall, however, the central hypotheses of the simple effects of iso-strain and sleep quality on posttraumatic stress following combat were significant.

While multiple Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans suffer from mild Traumatic Brain Injury (mTBI), Post-traumatic Stress Disorder (PTSD), and co-morbid mTBI and PTSD, there remains difficulty disentangling the specific symptoms associated with each disorder using self-report and neurocognitive assessments. We propose that neurological soft signs (NSS), which are tasks associated with general neurologic compromise, may prove useful in this regard. Based on our review of the literature we hypothesized that individuals with PTSD would present with a greater number of NSS than controls or individuals with mTBI. Further, we hypothesized a synergistic effect, such that individuals with mTBI + PTSD would present with the greatest number of NSS. To test these hypotheses, we analyzed a subset of individuals (N=238) taken from a larger study of neurocognitive functioning in veterans. Participants completed a battery of neuropsychological measures, which included the Behavioral Dyscontrol Scale (BDS), the current study’s measure of NSS. A subset of other neuropsychological measures were also included to examine the utility of NSS over and above traditional neuropsychological measures. Individuals were removed from the study if they sustained a moderate/severe TBI or did not meet validity criteria on the Green’s Word Memory Test or the Negative Impression Management subscale of the Personality Assessment Inventory. Binomial logistic and multinomial logistic regression were used to examine the ability of NSS to discriminate between the study groups, first by themselves and then after the variance explained by the traditional neuropsychological measures was accounted for. Exploratory cluster analyses were performed on neuropsychological measures and NSS to identify profiles of cognitive performance in the data set. Results indicated that individuals in the mTBI and/or PTSD group had more NSS compared to controls. Of the individual NSS items only a go/no-go task of the BDS discriminated between groups, with worse performance among individuals in the mTBI, PTSD, and mTBI + PTSD group compared to controls. In contrast, the overall BDS score and individual NSS, in general, did not discriminate between the mTBI, PTSD, and mTBI + PTSD group. Overall, the current study suggests that, when eliminating participants who do not meet validity criteria, NSS do not aid in discriminating between individuals with mTBI, PTSD, and mTBI + PTSD.

Urban violence has become common in lower-income communities that have high rates of shootings and African-American victims. Urban violence causes victims and their family and friends to experience trauma and puts them at risk for post-traumatic stress disorder (PTSD) injuries. However, there is a gap in knowledge in the framework of urban communities and their range of needs to address PTSD. The purpose of this quantitative study was to examine whether a relationship exists between reinforcement of needs, membership, influence, shared emotional connection, and post-traumatic stress symptomology (PTSS) of urban violence victims in a large metropolitan city. Albert Bandura's self-efficacy theory and social conflict theory comprised the theoretical framework for this research. A correlational design was employed with a convenience sample of 83 respondents drawn from urban violence victims using an internet-based survey instrument designed to assess the elements of sense of community. The research questions examined participants' perceptions of reinforcement of needs, membership, influence, shared emotional connection, and PTSS. Pearson's correlation coefficient and multiple linear regression analyses were performed on the collected data to test the hypotheses. The findings did not show a statistically significant relationship between participants' perceptions of sense of community and PTSD. However, victims of urban violence can use the results of this study to expand understanding of PTSD to address the realities of living in lower-income geographical locations, therefore leading to positive social change.