This study was conducted to identify gaps in existing knowledge regarding impacts of combat-related PTSD on the spouse and to gain an understanding of the lived experience of Appalachian Spouses of combat veterans with PTSD. A systematic literature review was conducted to identify research and findings on the impacts of combat-related PTSD on spouses of veterans and a qualitative study was conducted to gain an understanding of the lives of Appalachian spouses of combat veterans with PTSD. The systematic review identified 16 qualitative studies conducted between 1988 and 2016 in five countries spanning five wars. Regardless of the country of study or the war, the spouses experienced problems dealing with the symptoms of PTSD, emotional distress, impacts to relationships and caregiver burden. The systematic literature review revealed limited information on minority or underserved populations. Qualitative interview data from ten Appalachian spouses of combat veterans with PTSD were examined to gain an understanding of their lives. Data were obtained from semi-structured interviews. Findings indicate Appalachian Vietnam veteran spouses experience similar problems dealing with the veteran’s symptoms of PTSD, relationship problems, mental health problems and caregiver burden. The veterans in this study were not diagnosed with PTSD until later in life so they spent the majority of their life without knowledge or treatment for the illness. The women in this study expressed concerns that government and society have marginalized Vietnam veterans. This research highlights the need for outreach and PTSD education for Vietnam veterans and their spouses. Future research is recommended to expand the body of knowledge on the impacts of PTSD on the spouse with particular attention to other cultures, minority and underserved populations.

The purpose of this quantitative study was to examine whether the post-deployment screening instrument currently utilized to assess active-duty Marines for symptoms of PTSD upon their return from a combat deployment can be solely relied upon to accurately assess for PTSD. Additionally, this study sought to compare the number of Marines who have sought trauma-related mental health treatment based on their answers on the Post-Deployment Health Assessment (PDHA) to the number who have sought trauma-related mental health treatment based on their answers on their PTSD Checklist - Military Version (PCL-M). The participants in this study were comprised of a sample of active-duty Marines that had recently returned from a combat deployment. A quantitative secondary data analysis used Item Response Theory (IRT) to examine the answers provided by the participants on both the PDHA and PCL-M. Both instruments proved to be effective when assessing symptoms of PTSD and the participants identified as having symptoms of PTSD were referred for mental health services as required. According to the results, more Marines were identified as having symptoms of PTSD using both assessment instruments (PDHA and PCL-M) compared to those identified using just the PDHA. The result was a better understanding of predictors of Marines who may later develop PTSD. The results of this study can also assist the Marine Corps with its post-deployment screening for symptoms of PTSD which in turn can provide appropriate mental health referrals for Marines if deemed appropriate.

This thesis presents an eclectic mix of studies which consider laterality in the context of previous findings of increased prevalence of Posttraumatic Stress Disorder (PTSD) in male combat veterans with non-consistent right hand preference. Two studies extend these findings not just to civilian populations and women, but to left handers and find that left, rather than mixed, handedness is associated with increased prevalence of PTSD in both general population and clinical samples, and to severity of symptoms in the former. To examine issues relevant to the fear response in healthy populations, a movie excerpt is shown to be theoretically likely to target the emotion of fear and to generate subjective and physiological (skin conductance) responses of fear. The film is used as a laboratory analogue of fear to examine possible differences in left and right handers in memory (for events of the film) and in an emotional Stroop paradigm known to produce a robust and large effect specifically in PTSD. According to predictions based on lateralisation of functions in the brain relevant to the fear response, left handers show a pattern of enhanced memory for visual items and poorer memory for verbal material compared to right handers. Immediately after viewing the film, left handers show an interference effect on the Stroop paradigm to general threat and film words and increased response latency compared to right handers, approaching performance of previously reported clinical samples with PTSD. A novel non-word Stroop task fails to show these effects, consistent both with accounts of interference as language processing effects and compromised verbal processing in PTSD. Unexpected inferior performance of females in memory for the film, contrary to previous literature, may also be amenable to explanations invoking compromised left hemisphere language functions in fear situations. In testing one theory of left handedness as due to increased levels of in utero testosterone, the 2D:4D (second to fourth digit ratio) provides mixed evidence in two samples. A possible association of more female-like digit ratios in males with PTSD is a tentative finding possibly relevant to sex differences in prevalence of PTSD. A critique of existing and inadequate theoretical accounts of handedness concludes the thesis and proposes a modification of the birth stress hypothesis to one specifically considering peri-natal trauma to account for the above findings. This hypothesis remains to be empirically tested.

Depression and post-traumatic stress disorder are common psychiatric comorbidities related to stress. These conditions are frequently treated with antidepressants such as selective serotonin reuptake inhibitors (SSRI’s). However, there are individual differences in susceptibility to stress-induced psychopathologies and response to antidepressants. Therefore, there is a need to identify biologic factors that predict vulnerability to stress and response to treatment. Furthermore, few studies have examined the neural correlates of antidepressant treatment response in a stress-susceptible animal model. This dissertation had three specific aims: 1) to characterize behavioral predictors of stress vulnerability by studying three dimensions of temperament (reward dependence, novelty-specific activity and harm avoidance) before stress exposure using a stress-susceptible rat strain, 2) to identify the neural network effects of response and non-response to SSRI treatment using a stress-susceptible animal model, and 3) to determine the neurophysiologic correlates of helplessness susceptibility. This was examined via measurement of regional brain metabolic capacity and functional connectivity within relevant neural circuits, and measurements of corticosterone and heart rate. These effects were studied in rats that underwent inescapable shock exposure followed by escape testing. Holtzman rats showed greater predisposition to helpless behavior following inescapable shock compared to Sprague Dawley and Long-Evans strains. Also, increased activity in a novel environment and low heart rate appeared to be markers of helplessness susceptibility in Holtzman rats. Limbic-cortical network effects were identified that distinguished between responders and non-responders to antidepressant treatment in the Holtzman strain. Finally, hypermetabolism of the lateral habenula and a less interactive prefrontal-limbic cortex were identified in subjects with higher susceptibility towards helplessness within the Holtzman strain. Similar findings have been reported with other depression animal models and human neuroimaging studies. These findings support that the helpless dimension of mood disorders can be accurately modeled with the Holtzman rat strain and confirm that the lateral habenula and prefrontal cortex are key regions mediating the helpless phenotype and response to SSRI treatment. / text

Följande undersökning behandlar förskolans uppdrag och samverkan kring barn som upplevt trauma. Syftet är att undersöka hur olika professionsföreträdare för yrken närliggande förskolepersonalens (BVC-sjuksköterskor, socionomer, förskolepsykologer & förskolechefer) upplever förskolans roll i arbetet med barn som drabbats av trauma. Studien fokuserar hur olika professionsföreträdare nära förskolan upplever förskolans uppdrag och vilken relevans deras förväntan har gentemot de styrdokument som förskolan lyder under. Därtill undersöks hur samverkan för att öppna möjligheter för barn som drabbats av trauma, att utvecklas, lära och bidra, ser ut i praktiken. Kvalitativa intervjuer har genomförts med åtta personer. Intervjuer och styrdokument har bearbetats fenomenologiskt så att essensen av det sagda och skrivna tagits fram. Resultatet visar på förväntan på att förskolan tar en aktiv roll i arbetet för barn som upplevt trauma. Förskolans omgivning önskar enligt intervjupersonerna ett mer tillitsfullt samarbete mellan förskolepersonal och vårdnadshavare. Likaså efterlyses ett förebyggande hälsoarbete mellan deltagarnas egna professioner och  förskolepersonal. Ett inslag av misstro mot förskolepersonal blandas med tilltro till förskolan som potentiell arena för positiv samhällsutveckling. Resultatet analyseras först i jämförelse mellan intervjuer och styrdokument. Därvid framkommer att intervjupersonernas förväntan på förskolan är i samklang med styrdokumentens uppdragsbeskrivning. Samverkansupplevelserna analyseras utifrån Danermarks teori för samverkanskvalitet vilket visar på samverkansbrister i styrning, struktur och samsyn enligt intervjupersonernas upplevelser. Ett tänkt barn sätts som fallstudie in i Bronfenbrenners utvecklingsekologiska modell, som belyses med Ungars, Ghazinours och Richters resiliensteori. Då synliggörs hur intervjupersonernas upplevelse av samverkan kring barn som erfarit trauma berör hela barnets utvecklingsekologiska sammanhang. Analysen visar att kvalitativ samverkan är en förutsättning för att barnet ska ta sig ur ett posttraumatiskt stress-syndrom. Det samhälleliga uppdraget för förskola och nätverk blir att ge barnet många användbara verktyg och tillfällen för att ta sig genom kaos till fortsatt utveckling och lärande.

Members of the SAPS come into contact with violent crimes on a daily basis. They also have to deal with changes on an organisational level, as well as large amounts of administrative work. The Coping Orientations to Problems Experienced Questionnaire (COPE) was completed by police members in the North West Province, and eight items focusing on emotion-focused coping were added. The objectives of this study were to assess the construct validity and internal consistency of the COPE in the SAPS, with added scales for emotional processing and emotional expression. Another objective was to conceptualise coping, and specifically coping within the policing context from the literature. Finally, analyses of the differences between the coping strategies of different demographic groups in the SAPS were conducted. A cross-sectional survey design was used. The study population (N=229) included samples of police personnel across the North West Province. In addition to the COPE, a biographical questionnaire compiled by the researcher, was administered. The dispositional version of the COPE was used, consisting of 53 items. Eight additional items which measure emotional processing and emotional expression were also used. Initial analysis revealed the COPE subscales to be unreliable. Subsequent analysis indicated that two coping mechanisms which reflected emotionality in broad terms were employed by SAPS members. These factors were termed Active Emotional Expression and Emotional Reappraisal, and showed acceptable Cronbach Alpha coefficients. Item bias analysis was conducted and two items indicated uniform bias, and another two non-uniform bias. Tucker's phi coefficients for Active Emotional Expression and Emotional Reappraisal were all acceptable, indicating equivalence for both the Afrikaans and "other" languages groups. With regard to the two coping factors, no significant differences were found between the created language categories, or gender. Differences between the coping strategies of police members with different ranks, marital states and salary categories were also not significant. Recommendations for the organisation and future research were made. / Thesis (M.A. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2006.

Male violence against women in intimate partner relationships is a global public health problem and a serious crime, but remains largely underreported. The overall ain of this thesis was, by means of an interdisciplinary approach and from the perspectives of gender, public health and law, to gain a deeper understanding of the situation of abused women, by studying, on one hand, their leaving processes and, on the other, the consequences of the violence for their health. On the basis of this information, a further aim was to increase knowledge of the quality and effect of gender relations in the practical application of the law. The point of departure was that the different perspectives should not be consodered separately but should be seen in context. The thesis describes the prcess for abused women, from the violent relationship and the break-up, the health consequences caused by the violence to the practical application of the law. The thesis consists of four studies (I-IV). An initial qualitative study (I) showed that the leaving process for abused women is fearful, complex and long-lasting. The analysis also revealed a gradual development of strong emotional bonds towards the men on the part of the women. Study II was a combination of qualitative in-depth interviews and quantitative measurements and confirmed former studies regarding the negative health consequences caused by the violence, in particular symptoms of complex PTSD. Study III, examining preliminary investiagtions concerning reported crimes of intimate partner violence, showed that there is still a lack of crminal justice for abused women even if the frequency of cases leading to prosecution was fairly high. In study IV court case records were examined by means of a qualitative method inspired by discourse analysis to determine whether gender is (re)constructed in court practice, and how the process works. The analysis of this particular sample indicated that the practical application of law is influenced by an old-fashioned and stereotypical view of violence, sexuality, men and women. the legal discourses retain and reproduce the gender order. The overall results of the separate studies reinforce the importance of gaining a broader understanding of men's violence against women in intimate partner relationships.

These original data for this research were documented in the clinical diary records of an army psychiatrist on deployment in Vietnam during 1969–70. This study is unique due to the original battlefield diagnosis data used for foundation comparison analysis and longitudinal retrospective case control paired measurement. In battlefield psychiatric assessment diagnostic data recorded in Vietnam during 1969–70 of 119 Australian military servicemen (Experimental group) who presented battlefield trauma exposure reactions were examined. The research case controls (Control group) are 275 Australian Vietnam veterans selected from data at the Australian War Memorial Research Centre. Case control identified participants did not present with medical symptoms in 1969-70 and presented the same demographic profile as the Experimental group population. This research examined whether initial psychiatric illnesses initiated by battlefield trauma exposure in 1969-70 by a cohort of Vietnam veterans would have long term pernicious effects on their physical and psychological health, relationships and employment status. This research compared, PTSD, delayed onset PTSD, severity of combat exposure and depressive symptoms, quality of dyads, general health and quality of life. The analysis of specific demographic variables determined the means, standard deviations, and medians for those continuous variables for both groups from 1969-70 (n=394) and 2006-07 (n=97). The 2006-07 Experimental group (n=21) represents 17.65% and the Control group (n=76) represents 28.15% of the original groups selected and matched from 1969-70 data. These participants completed a battery of psychometric questionnaires and a follow up telephone interview. Demographic variables were evaluated for inclusion as covariates. These demographic variables were correlated with combat exposure and the presentation of PTSD in 1969-70 and 2006-07. PTSD identified in 2006-07 was modelled as a latent variable with three manifest indicators (re-experiencing, hyper-arousal and avoidance). Categorical variables were determined by frequency tables for respective group participants. Group differences in continuous variables were analysed by t-test or the Wilcoxon signed rank sum test accounting for non-normal distributions. Categorical variables, chi-square tests or Fisher's Exact Tests were performed when assumptions of chi-square tests were violated. Research participants from 1969-70 and 2006-07 did not indicate a significant difference in demographic, categorical or continuous variables. Initial 1969-70 battlefield psychiatric diagnosis TSD did indicate of a causal link to delayed onset PTSD in research participants in 2006-07. The PTSD (2006-07 diagnosis) indicated a descriptive difference, 64 of the 76 Control met the diagnostic criteria, while 19 of the 21 Experimental met the criteria. A significant difference was identified in the 2006-07 presence and severity of depression, two symptoms (intrusion and avoidance) of PTSD and the reported combat exposure. The prevalence of delayed onset PTSD was also highlighted. Obtaining original battlefield psychiatric diagnoses is rare. Comparison with an identifiable Control group after 35 years informs knowledge of how military personnel cope with battlefield exposure. Specifically concluding that; battlefield exposures during 1969-70 for the majority of the research participants have impacted detrimentally on their psychological and physical health, relationships, employment and ongoing overall wellbeing to this day. Delayed onset PTSD is the principal indicator of this current state for these veterans. / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008

Thesis (Master of Military Studies)-Marine Corps Command and Staff College, 2008. / Title from title page of PDF document (viewed on: Feb 2, 2010). Includes bibliographical references.

Thesis (MA (Theol.))-University of Pretoria, 2007. / Includes bibliographical references.