Iris Fitzgerald struggles to make it day to day after she is raped and stabbed while out on an early morning run. Her story is told through her relationships, not only with her new, scared self, but also with her overbearing mother, her best friend, her rescuer and her antagonistic roommate. She has just moved to a strange city and still has not found a job. So, she has the overwhelming stress of the attack to contend with and the added pressure of running quickly out of money in the expensive city of San Francisco. She uses her painkillers as an escape from her stab wound as well as her emotional pain. Claiming Iris is about self-preservation, relationships, addiction and continuing on with life.

M.A. / The Truth and Reconciliation Commission (TRC) Act was passed in 1995 and the TRC started its hearings in 1996. The purpose of the TRC was to promote national unity and reconciliation by establishing as complete a picture as possible of the human rights violations that had occurred during the apartheid era and to offer reparations to those who had been affected, as well as to grant amnesty to those who had committed these human rights violations. The TRC had to appoint people to help carry out its functions and deliver a report about human rights violations. Most of the people employed by the TRC to help carry out these functions were South African. Furthermore every South African had been involved in the past in one way or another, purely by being a South African. In this project the author explores, analyses and interprets the experiences of some of the people who were employed by the TRC. The focus of this project is to find out whether being employed by the TRC and having to listen to the stories being brought to the TRC exposed anyone to the possibility of developing what is called secondary traumatisation. This kind of traumatisation is different from the traumatisation that the people relating the stories had gone through during the apartheid years. This kind of traumatisation is said to develop from being exposed to traumatised people.

Thesis (M.A.(Industrial Psychology)--University of the Witwatersrand, Arts Faculty, 1996 / At a primary level the current study sought to investigate the post-traumatic stress responses of a sample of black township residents who were victims and witnesses of continuous civil violence [Abbreviated abstract. Open document to view full version]

La thèse a pour objectifs d’étudier les liens entre les mécanismes de régulation émotionnelle (RE) et les psychotraumatismes de type I et II. Elle s’intéresse également aux indicateurs physiologiques caractérisant ces processus de RE et leurs éventuelles modifications dans les cas de Stress Post-Traumatique (SPT) ou d’exposition à des événements aversifs (trauma complexe). Pour cela nous avons mené trois études. La première étude s’intéresse à mettre en évidence des prédicteurs du développement d’un SPT complet ou subsyndromique, suite à un accident de la voie publique. Les résultats font apparaître que plus d’un quart des participants présente un subsyndrome traumatique ; pour 7,7% de patients avec un SPT complet. Parmi de nombreuses variables, le meilleur prédicteur est la perception d’une menace vitale. Des liens forts sont également observés entre d’une part, la détresse péritraumatique et les symptômes de reviviscence et d’hyperactivité neurovégétative, et d’autre part entre la dissociation traumatique et l’évitement. La seconde étude s’intéresse à évaluer la variabilité du rythme cardiaque (VRC) comme biomarqueur des difficultés de régulation émotionnelle (DRE) en population non-clinique. Les résultats montrent que le groupe qui a peu de DRE présente une diminution de la VRC durant une phase d’induction émotionnelle puis une augmentation jusqu’à un niveau statistiquement équivalent à sa ligne de base en phase de récupération post-induction. Cette réponse sympathoexcitatrice adaptative est modifiée dans le groupe avec beaucoup de DRE : la VRC n’augmente pas en récupération. Ces données suggèrent que la VRC est un biomarqueur pertinent des DRE. Enfin, la dernière étude cherche à évaluer l’impact d’un trauma complexe (TC) sur plusieurs processus émotionnels. Les DRE et la dissociation somatoforme discriminent le mieux les groupes d’adolescentes présentant un TC des adolescentes contrôles. De plus, les mesures physiologiques montrent que le niveau de VRC au repos est plus faible dans le groupe TC et que le pattern typique de réaction sympathoexcitatrice est absent, à la différence du groupe contrôle. Les analyses de régressions précisent que le manque de conscience émotionnelle prédit le niveau de VRC au repos alors que c’est le niveau de dépression qui prédit le mieux la diminution phasique de VRC. Ajoutée à un taux d’erreur plus important pour évaluer subjectivement les stimuli émotionnels dans le groupe TC, les événements aversifs répétés semblent perturber à la fois des processus liés à l’évaluation des signaux émotionnels et leur intensité, mais aussi les processus psychologiques et physiologiques liés à la régulation des émotions. Ces résultats qui confirment le rôle important des DRE dans les psychotraumatismes seront discutés par rapport à la littérature actuelle pour proposer des pistes thérapeutiques spécifiques. / This thesis aims to explore the links between emotion regulation (ER) mecanisms and type 1 and 2 psychotrauma. We also investigate physiological marker of those ER processes and the potential disturbances caused by Post-Traumatic Stress Disorder (PTSD) and adverse life events (complex trauma). Three studies were carried out. The first study assesses some predictors of the development of a complete or subsyndromic PTSD following a motor vehicule accident. Results reveal that more than one quarter of the sample exhibits subsyndromic PTSD and 7.7% was diagnosed with complete PTSD. Among several variables, the strongest predictor is the perceived life threat. Also, strong correlations are observed between 1) peritraumatic distress and persistent re-experiencing or hyperarousal and 2) dissociation score and avoidance strategy. The second study evaluates Heart Rate Variability (HRV) as a potential biomarker of emotion regulation difficulties (ERD) in a non-clinical population. Results for the low ERD group show that HRV decreases from baseline to elicitation and then increases from elicitation to recovery (no difference between recovery and baseline levels). This adapatative sympato-excitatory pattern is altered in the high ERD group in which HRV do not increase from elicitation to recovery. Those data suggests that HRV could be an unbiased biomarker of ERD. The last study examines the effects of complex trauma (CT) on several emotional processes. ERD and somatoform dissociation best discrimate between CT and control teenagers. Moreover, physiological measures show that HRV level at rest is lower in CT than control and typical sympato-excitatory response is not observed in CT contrary to control group. Regressions analyses further reveal that the lack of emotional awareness predicts HRV level at baseline whereas the level of depression best predicts phasic HRV decrease. Added to greater errors in the subjective assessment of emotional stimuli in the CT group, adverse life events seem to disrupt processes involved in the labelling of emotions and intensity as well as psychological and physiological processes linked to ER. These results which confirm the importance of ERD in psychotrauma are discussed in regard to contemporary literature in order to suggest some specific therapeutic approaches.

Consolidated memories can become reactivated in order to permit the integration of new information into the memory trace. Blockade of the resultant process, reconsolidation, with NMDA receptor antagonists or protein synthesis inhibition can lead to a decrease in subsequent memory expression. This may offer a potential tool for the treatment of psychiatric disorders characterised by maladaptive memories, including drug addiction and post-traumatic disorder. Given the importance of instrumental associations in supporting drug addiction experiments in Chapters 3 & 4 aimed to disrupt reconsolidation of these memories. Treatment with an NMDA receptor antagonist prior to retrieval sessions of various durations was not able to consistently prevent reconsolidation of these associations. Drug addiction is characterised by memories that have been formed not over days or weeks, but months or years. Experiments in Chapters 5 & 6 therefore investigated how the extent of training affects the propensity of an appetitive pavlovian memory to reconsolidate. Experiments in Chapter 5 were not able disrupt reconsolidation of these memories after a relatively short period of training. In Chapter 6 attempts to disrupt reconsolidation of a cocaine-seeking memory having undergone extensive training (>1 month, designed to promote the formation of drug-seeking habits) were also unsuccessful. However, when animals were trained in a similar fashion to respond for a food reinforcer treatment with a NMDA receptor antagonist prior to a reactivation session resulted in a decrease in food-seeking behaviour the following day. However, this deficit was only found in the first test session; drug treatment had no effect on responding following reminder of the memory. If data from preclinical studies are to inform future psychiatric treatments the findings from these works must be robust and replicable. Experiments in previous chapters encountered several issues in this regard, namely the repeated inability to prevent reconsolidation with NMDA receptor antagonism. Given that reconsolidation of auditory fear memories is well characterised a final series of experiments in Chapter 7 used this procedure to explore the possible reasons for the fleeting or absent effects of disrupted memory reconsolidation in previous chapters. Despite the use of similar methods as published reports showing decreases in memory expression as a result of blockade of reconsolidation it was not possible to disrupt this process with NMDA receptor antagonism or protein synthesis inhibition. Results suggested that the failure to observe reactivation-dependent amnesia was due to the amnestic agent used not being able to prevent reconsolidation, should it be taking place, and a failure of the given retrieval trial to result in memory reactivation. On numerous occasions throughout this thesis it was not possible to disrupt memory reconsolidation. One difficulty in interpreting null data of this nature is that it is often unclear whether the results are due to insufficient retrieval conditions to result in memory reconsolidation, or an inability of the pharmacological agent to disrupt this process. The final experiments of this thesis raised the possibility both of these issues may have contributed in tandem towards this inability to prevent memory reconsolidation.

This study compared the Children’s Depression Inventory (CDI) scores of traumatized youth with or without PTSD to the scores of a nonclinical comparison group. Diagnostic interviews identified children with PTSD (28), traumatized PTSD negatives (64), and a nonclinical comparison group (41). In the absence of major comorbid disorders, the CDI scores of children and adolescents with PTSD significantly exceeded the CDI scores of traumatized PTSD negatives and controls on the CDI Total, Negative Mood, Ineffectiveness, and Anehdonia scales. The PTSD group also had significantly higher scores than the traumatized PTSD negatives on the Negative Self Esteem scale. Furthermore, as hypothesized, the CDI scores of the traumatized PTSD negatives and controls were not significantly different on any of the six subscales measured. On the other hand, there were three unexpected nonsignificant findings. First, the PTSD group mean CDI Interpersonal Problems score did not significantly differ from the traumatized PTSD negative group. Second, the PTSD group mean CDI Interpersonal Problems score also did not significantly differ from the control group. Finally, the PTSD group mean CDI Negative Self Esteem score did not significantly differ from the control group. Overall, PTSD was associated with increased depression across the majority of the CDI scales and trauma exposure without PTSD was not. Implications for research and practice are considered.

The present study was conducted to help understand the impact of living with multiple sclerosis (MS), an unpredictable, chronic illness that is widely known to have a large influence on psychosocial functioning, mental health, and life satisfaction (Motl & Gosney, 2007; Weiner, 2004). Recent research has begun to position certain chronic illnesses, such as MS, as traumatic events that influence mental health in both beneficial and detrimental ways. Thus, the present study investigated the positive and negative consequences of centralizing one’s identity within their MS experiences as related to trauma, growth, and psychosocial influences via a path model with 616 individuals with MS. The results indicate strong support for the hypothesized paths between the variables of interest—centrality of MS, posttraumatic stress, posttraumatic growth, social support, personal mastery, depression, and life satisfaction. Specifically, results indicate that posttraumatic stress and posttraumatic growth partially mediated the relations between centrality of MS with depression and life satisfaction. Moderation analyses indicated that social support and personal mastery did not moderate any relations between centrality of MS with depression and life satisfaction. Rather, additional analyses suggest social support and personal mastery may be viewed as additional mediators between centrality and posttraumatic stress and posttraumatic growth. The results of the present study is the first known study to extend trauma literature to the population of MS in order to provide an approach to help understand the high rates of depression and inconsistent findings on quality of life for this population. Implications for practice, theory and research are discussed.

This study compared the Family Adaptability and Cohesion Evaluation Scales, Second Edition (FACES II) scores of traumatized youth diagnosed with posttraumatic stress disorder (PTSD) to the scores of trauma-exposed youth without PTSD and a non-traumatized comparison group. Child diagnostic interviews determined that all participants were free of additional major comorbid disorders. The FACES II scores of children and adolescents with PTSD were not significantly different from the FACES II scores of trauma-exposed youth without PTSD and the non-traumatized comparison group. FACES II scores were also not significantly different between the trauma-exposed youth without PTSD and the non-traumatized comparison group. Accordingly, PTSD and trauma-exposure without PTSD were not associated with variations in the perception of family functioning as measured by the FACES II. Implications for research and practice are considered.

Introduction: Posttraumatic stress disorder (PTSD) is a disabling psychological disorder that affects about 7% of adults in the United States. PTSD and its symptoms have consistently been shown to have an inverse relationship with exercise participation. The strongest reported associations have been between high intensity exercise, and the hyperarousal and avoidance symptom clusters. Importantly, resistance training (i.e., weight lifting) is thought to have beneficial effects for several conditions that commonly co-occur with PTSD, such as anxiety, depression, and poor sleep quality. However, no studies have examined the effects of high intensity resistance training on PTSD symptoms. Purpose: This study sought to examine the effects of a 3-week high intensity resistance training program on the PTSD hyperarousal and avoidance symptom clusters, sleep quality, anxiety, and depression symptoms in anxious adults who screened positive for PTSD. Additionally, this study explored potential mechanisms of action (e.g., cognitive appraisal, perceived exertion, acute changes in affect, arousal, and distress) between exercise and PTSD. Methods: Thirty trait anxious individuals who screened positive for PTSD were randomly assigned to either a 3-week high intensity resistance training intervention, or a 3-week time-matched attention control group, while blocking for gender. Both groups were required to attend 3 on-site sessions per week, for 3 weeks (i.e., 9 total sessions). Each resistance training session consisted of a 5-minute warm-up, 20 minutes of high intensity resistance training, and a 5-minute cool-down. Each control session consisted of a brief 30-minute educational video on topics not relating to exercise or PTSD. Changes in PTSD symptoms, sleep quality, anxiety and depression were analyzed using repeated measures ANOVA, and potential mechanisms of action were explored with a series of longitudinal mixed-effects regression models. Results: Participants were 73.3% female, with a mean age of 29.1 years (SD = 7.4), and 63.3% identified as a racial minority. Groups did not significantly differ at baseline. There was a Time*Group interaction for hyperarousal symptoms (F = 4.7, p = .04, η2 .18), demonstrating a significantly larger reduction in hyperarousal symptoms for the resistance training group (d = -1.84) relative to the control (d = -1.13). The Time*Group interaction for avoidance symptoms was not significant (F = 1.7, p = .20, η2 = .08); however, the effect size of resistance training was larger (d = -2.71) than the control (d = -1.16). There was a significant Time*Group interaction for sleep quality (F = 4.7, p = .04, η2 = .19), demonstrating greater improvements in global sleep quality for resistance training (d = -1.06) relative to the control (d = -.15). However, there was no significant effect of Time on PTSD-related sleep disturbances (F = 3.0, p = .1, η2 = .13) nor was there a significant Time*Group interaction (F = .09, p = .80, η2 < .01). Similarly, Time*Group interactions for anxiety (F = 3.5, p = .08, η2 = .14) and depressive symptoms (F = 2.7, p = .12, η2 = .11) were not significant. However, resistance training had a large effect on anxiety (d = -.81), and small effect on depression symptoms (¬d = -.41). Regarding the potential mechanisms of action, changes in cognitive appraisal significantly predicted changes in PTSD symptoms during the resistance training intervention (b = 7.1, SE = 2.9, p = .02). Similarly, changes in perceived exertion during exercise was a significant predictor of PTSD symptoms over the 3-week intervention period (b = -3.1, SE = 1.2, p = .01). However, changes in affect, arousal, and distress did not significantly predict changes in PTSD (p’s >.05). Conclusion: This is the first randomized attention-controlled trial testing the effects of high intensity resistance training on PTSD symptoms. The overall results support the hypothesis that resistance training can beneficially affect PTSD symptoms and its commonly co-occurring conditions, such as poor sleep quality. Future adequately powered studies are warranted.

Objective: Some Veterans who recently served in the military report significant psychological problems based on their experiences in the military. Stressors that these Veterans face when they transition out of the military can exacerbate these problems and negatively impact their long-term physical and psychological well-being. We are conducting a randomized controlled trial (RCT) to evaluate the efficacy of providing Veterans who are transitioning back into their civilian communities trained, peer mentorship (Pro Vetus) and membership in a Veteran Support Organization (VSO- Team Red, White, and Blue) to reduce transition stressors, maintain psychological and physical health, reduce suicides and reduce criminal incidents. Method: Six hundred, New York City area Veterans who transitioned out of the military since 2002 will be randomized to one of three study arms (1. Team Red, White and Blue membership plus trained, peer Pro Vetus mentorship; 2. Team Red, White, and Blue membership; and 3. Waitlist control). Intent-to-treat analysis will compare changes in transition stressors (proximal measures) as well as psychological and physical health, suicide, and criminal incidents (distal measures). For this preliminary investigation of the full RCT, the results of 58 Veterans who completed the pre-intervention and post-intervention were analyzed. For the analysis, the first and second study arms were combined into one intervention arm because of the unbalanced nature of the arms. Results: The preliminary results indicate that Veterans in the combined intervention arm experienced less transition difficulties and had higher levels of social support at the four month post-intervention assessment. Though promising, there are still extensive limitations to the inferences that can be drawn from this research. These limitations will be reduced as data points increase and more Veterans participate in the research study. Keywords: Veterans, transition, peer mentorship, Veteran Support Organization, PTSD, suicide