The role of exposure to a human-made disaster and the subsequent development of post-traumatic stress reactions were examined. Subjects included 49 males and 30 females who were variously exposed to the Luby's shooting incident in Killeen, Texas in October of 1991. Post-traumatic stress symptomatology was measured by the SCL-90R. Exposure was operationalized by using a scenario-rating scheme with independent raters estimating each subject's level of exposure. A regression and commonality analysis revealed that exposure is an important predictor in post-traumatic symptomatology. Premorbid functioning and gender were also found to play important roles, with females expressing higher levels of symptomatology.

An understanding of factors that contribute to Complex Post Traumatic Stress Disorder (CPTSD) is of considerable importance to inform the prevention and treatment of the disorder. Moreover, gaining a better understanding of the factors that contribute to the etiology of CPTSD is of interest since most research to date focuses on the etiology of PTSD. Therefore, the purpose of the current study is to test the hypothesized prediction between childhood exposure to violence, childhood attachment, current interpersonal factors, and CPTSD symptoms. Using data from a community clinic and shelter serving victims of domestic violence and sexual assault, a partial least squares path analysis approach was employed to test the model’s strength in predicting contributing factors of CPTSD. Results support the proposed model, however, an alternative and more parsimonious model was found to be superior and revealed relationships between interpersonal variables and CPTSD. Specifically, women who reported child abuse and poor attachment with either parent, a perceived lack of current emotional and tangible support, and recent intimate partner violence (IPV) also reported symptoms of CPTSD. However, other variables, such as adult attachment avoidance and anxiety did not influence IPV or CPTSD as expected. Ultimately, the current findings lend support for Herman’s (1992) original conceptualization of CPTSD symptoms observed in survivors of prolonged and repeated trauma. Implications of these findings are discussed and results highlight the importance of assessing the contextual factors (e.g., social support, family environment) when a victim of prolonged trauma comes for treatment. Lastly, treatment implications and specific points of intervention are presented.

Post-traumatic stress disorder (PTSD) is classified as an anxiety disorder in the Diagnostic and Statistical Manual IV of the American Psychiatric Association. It is characterised by three main symptom clusters: re-experiencing (of which flashbacks are the hallmark symptom); hyperarousal; and avoidance. Diagnosis requires not only the occurrence of a traumatic event but also an intense emotional (fear, horror, or helplessness) reaction to it. Epidemiological data suggest that 80% of people will experience at least one qualifying event in their lifetime. However, prevalence rates of PTSD are much lower. Additionally, individuals with PTSD tend to experience flashbacks of only two or three particular ‘hot-spots’ of the entire trauma. Therefore, the question arises: why do some moments of trauma flash back and not others? Clinical-cognitive theories of PTSD suggest that shifts in information processing at the time of the trauma (i.e. peri-traumatically) are the mechanism whereby flashbacks are created. However, for ethical and practical reasons peri-traumatic processes in real trauma are seldom studied. An analogue traumatic event has been developed to help study peri-traumatic processes – the trauma film paradigm. This paradigm is used through-out this thesis with the goal of investigating peri-traumatic cognitive mechanisms in flashback formation. Studies 1 and 2 extend previous work using dual tasks to manipulate intrusions in-line with clinical-cognitive theories. Studies 3 and 4 use neuroimaging techniques to investigate brain regions involved in real-time peri-traumatic encoding of analogue flashbacks. Chapter 9 presents heart rate data relating to peri-traumatic physiological response to flashback encoding. All of these studies support the notion that peri-traumatic shifts in processing are involved in flashback formation. In particular, Study 3 suggests that there may be a particular neural signature associated with the formation of flashbacks. Investigation of these brain areas may help solve the questions of why some individuals are more vulnerable to PTSD and why only a few specific moments of a trauma subsequently flashback. Furthermore, an improved understanding of the cognitive mechanisms involved in flashback formation may allow theory and evidence led improvements in PTSD treatments.

Psychologists' diagnostic choices when the specificity of child sexual abuse in a clinical vignette is varied was examined. The degree to which Posttraumatic Stress Disorder (PTSD) was judged to be a viable diagnostic choice among a set of diagnoses was analyzed under conditions with sexual abuse stated, implied, not stated, and excluded. PTSD was rated as more likely for the stated and implied sexual abuse vignettes than for the not stated and excluded vignettes.

While current research indicates that traumas high in social betrayal are more closely associated with symptoms of posttraumatic stress and identity disturbances than are traumas low in betrayal, the psychological mechanisms by which identity problems occur are less understood. The current project explored the relationships between traumas high and low in betrayal and their influence on self-complexity, through the RFT and ACT conceptualization of three types of self-experiencing: self-as-content, self-as-process, and self-as-context. The roles of experiential avoidance, dissociation, and severity of PTSD symptoms were also considered within this framework. A sample of 548 undergraduate students at the University of North Texas completed online self-report questionnaires, and results suggested that self-as-context more strongly predicted PTSD symptoms than trauma exposure, dissociation, and experiential avoidance. Moreover, high betrayal trauma was found to be a stronger negative predictor of self-as-context than low betrayal trauma. Exposure to trauma was found to significantly predict self-complexity, and self-as-context more strongly predicted self-complexity than did self-as-process. Interestingly, self-as-context did not moderate the relationship between trauma exposure and PTSD symptoms, nor between trauma exposure and self-complexity. Implications of the current study’s findings, as well as suggestions for further research related to the impact of interpersonal betrayal on the self and psychological health, are discussed.

Although men are more likely to experience traumatic events, the risk of developing Posttraumatic Stress Disorder is at least twice as high in women than in men after exposure to comparable traumas. These findings are more consistent in response to some types of trauma (e.g., assaultive violence) than others (e.g., natural disaster). There has been very little systematic study of the sources of these gender differences. This study began to explore the contribution of gender-related beliefs about appropriate responses to trauma by investigating the impact of victim sex and trauma type as well as participant sex, sex-role orientation, and personal trauma history on attitudes towards victims. Ninety-three male and 179 female students were administered the Bem Sex Role Inventory, the Trauma History Questionnaire, and a vignette measure of attitudes towards victims. Participants evaluated male victims significantly less favorably than female victims, and females had more positive attitudes towards victims than males. Feminine sex-typed and androgynous women rated victims more favorably than masculine sex-typed men and women. The interaction between sex of victim and trauma type was not significant. A positive relation was observed between personal trauma exposure and attitudes towards male victims among male participants only. These findings contribute towards a theoretical understanding of gender and PTSD, and also have important clinical applications.

The purpose of this study was to compare pre- and post-treatment differences in posttraumatic stress disorder (PTSD) symptoms in male adolescents with conduct disorder. The Children's PTSD Inventory and the PTSD Reaction Index were used to diagnose PTSD and determine trauma type (Type I single trauma or Type II recurring trauma). Pre- and post-treatment measures included the PTSD Reaction Index, the Children's Depression Inventory, the State-Trait Anxiety Inventory, the State-Trait Anger Expression Inventory, the Dissociative Experiences Scale, and the Youth Self-Report. The six-week, biweekly group treatment included education, exposure, and cognitive elements. Primary hypotheses that the abused group would statistically differ from the non-abused group in terms of pre- and post-treatment levels of avoidance, dissociation, anger/aggression, self-destructiveness, social problems, and overall levels of PTSD symptoms, were not confirmed. Overall, group therapy participants experienced statistically significant decreases in PTSD symptoms over the course of therapy. Results are discussed in light of clinical implications, recommended cautions given the lack of a robust control group, and directions for future research.

Potential risk factors for development of Post-Traumatic Stress Disorder (PTSD) are still unclear. One potential risk factor for the development of PTSD is an individual’s cardiovascular reactivity and recovery in response to stressor tasks. The current study was conducted with 763 Army National Guard and Army Reserve soldiers. Participants completed a stressful induction along with self-report measures prior to deployment. Post-deployment, self-report measures were completed to assess PTSD symptomatology and experiences related to deployment and combat. Multiple regression was used to determine the ability of blood pressure response to stress to predict PTSD symptoms immediately and one-year after return from deployment. Results indicated that soldiers who had a less reactive systolic blood pressure response to and recovery from stressor tasks reported more PTSD symptomatology immediately after and one year after return from deployment. These results suggest that soldiers who develop PTSD after deployment have less pre-deployment emotion regulation ability.

M.A. / On-going traumatic events have become a tragic reality within South African society, with ubiquitous psychological consequences for those involved. The major political upheaval - specifically in the past five years - and the process of transition to a new South Africa has had an impact on all South Africans. Journalists have played a fundamental role in the process of transition, and many have been exposed to scenes of extreme unrest and accompanying violence. It is apparent that the need exists to study the effects of on-going stress in this group of individuals. This study regarding the effects of unabated exposure to violence and trauma in journalists (specifically crime reporters) had the following objectives: (I) A comprehensive literature survey which focuses on the theory and history of combat-related Posttraumatic Stress Disorder. Theory that has developed in response to disaster psychology was included. (ii) An investigation of the effects of exposure to unremitting violence and trauma in a journalistic context. The initial part of the study focuses on a thorough theoretical investigation which provides a systemic framework for the conceptualization of PTSD. The literature reveals that not all individuals develop Posttraumatic Stress Disorder after a traumatic event; PTSD in individuals who have been exposed to on-going violence and trauma cannot be conceptualized on a linear level, whereby following exposure to a specific stressor/trauma, the inevitable outcome would be PTSD. It is clear that although the stressor is necessary, it is not sufficient to cause the disorder. On the contrary, there are other factors which play a fundamental role in whether or not the victim perceives the event as overwhelmingly stressful. These factors are termed - mediating factors" and include pre-existing biological factors, pre-existing psycho-social factors and events that occurred post-trauma (such as the availability of an adequate support system). The fact that insufficient psychological assistance subsequent to exposure to the trauma was available to the group of journalists that took part in the study, was apparent. The reasons for this may have been that due to the "macho-ethic" that pervades their functioning the individuals in question, deny themselves access to a structured and regular way of defusing their experiences. A criticism that could be levelled against this study is that the researcher elected to conduct a single interview with each journalist. The issues that arose as a result of the interviews were real, but were not able to be dealt with and followed up on. A further criticism is that there has been a relatively extended time factor between the heightened trauma and violence to which the journalists were subjected and the interview that provided the material for this study. Trauma has conventionally been defined as a linear occurrence, as an external event which impacts on people's lives in a random, haphazard manner. However, it is strongly felt that it should be seen within a bigger ecosystemic context as an event which has become so much a part of our society as we currently know it. Recommendations were made as a result of the study, and these are: that a follow-up study be conducted which would have as it's aim an in-depth investigation of individual long-term cases in journalists who are victims of violence; that journalists be afforded mandatory psychological intervention following their exposure to violence and trauma as it is clear that psychotherapy is strongly indicated for individuals with PTSD; that group programmes be devised with the objective of educating this group of individuals with regard to PTSD and other severe stress responses.

Cease Fire is a war story told from one woman’s perspective. It’s about a farm girl and her battles fought as young soldier serving on a remote nuke site during the Cold War. It’s the interpretations of lived experiences, highs and lows of a military career fused with family life, and spanning over three decades. Like true war stories, Cease Fire has little to do with actual war. It is a sometimes humorous, but often tragic attempt to make peace and to make sense of the places, comrades and enemies that graced and plagued a career. First names and nicknames were used to protect the privacy of a few and render respect for the surviving children of a fallen two.