About 4 % women in general population and up to 19 % women in at-risk population suffer from PTSD related to childbirth. The main risk factors for postpartum PTSD are negative birth experience and obstetric emergencies. However, the findings about risk factors and prevalence rates vary across studies, which is mainly due to the inconsistency in the diagnostics of postpartum PTSD. Researchers use various PTSD measures that differ in the number and type of symptoms monitored and many of these measures do not cover all DSM criteria for PTSD. Furthermore, the PTSD diagnostic criteria have been significantly modified in the new DSM-5 and the existing instruments need to be revised. The first part of the thesis presents the concept of PTSD related to childbirth. Special attention is paid to the risk factors identified in previous research and to the analysis of PTSD diagnostic and screening measures used in the postpartum context. The aim of the second part of the thesis is to evaluate the psychometric properties of the unpublished Childbirth-Related PTSD Questionnaire on a sample of 620 Czech women. The factor validity of the scale, the internal consistency of the total scale and the subscales resulting from the factor analysis; and the criterion validity of the instrument are verified. With regard to...

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Excerpt: The above study has many of strengths, including an important topic, excellent sample size, well-articulated design and questionnaire, thorough factor analysis with goodness-of-fit tests, a clear explanation of the rationale for the findings, as well as their current applications in the medical field. Despite these strengths, the fit of the findings to the five-factor model of Elhai and Palmieri (2011) would appear to be lower than the fit to a two-factor model, a model that explains the data well. Therefore, we recommend that practitioners refrain from adopting and implementing the five-factor model for PTSD treatment in traumatic spinal injury victims due to insufficient support at this time.

Veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn are presenting for treatment with high rates of combat-related posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI), spurring a need for clinical research on optimal treatment strategies. While exposure therapy has long been supported as an efficacious treatment for combat-related PTSD, some clinicians are hesitant to utilize this treatment for veterans with TBI history due to presumed cognitive deficits that may preclude successful engagement. The purpose of this study was to compare exposure therapy process variables in veterans with PTSD only and veterans with PTSD+TBI. Results suggest that individuals with PTSD+TBI engage successfully in exposure therapy, and do so no differently than individuals with PTSD only. Additional analyses indicated that regardless of TBI status, more severe PTSD was related to longer sessions, more sessions, and slower extinction rate during imaginal exposure. Finally, in a subset of participants, self-report of executive dysfunction did not impact exposure therapy process variables. Overall, findings indicate that exposure therapy should be the first-line treatment for combat-related PTSD regardless of presence of TBI history.

Many factors can discourage survivors of sexual assault from reporting their assaults. Even those survivors who disclose, their reporting experiences may not leave them feeling empowered or that they have received adequate support to begin the healing process after disclosure. Using a mixed methods approach, we examined the relationship between religious and spiritual coping strategies, the experience of social disclosure, and symptoms of posttraumatic stress disorder (PTSD) and depression using confirmatory factor analysis (CFA) and structural equation modeling (SEM). We further used qualitative data examining the ways that participants used religious/spiritual coping strategies in response to the trauma of sexual assault. In total, 94 female or non-binary participants were enrolled. The CFA showed good model fit for all latent factors except positive religious coping and positive social responses. The SEM path analysis found a significant relationship between the latent factor Distract and PTSD symptoms. No other variables were significant in the SEM model, likely due to the small sample size. Qualitative data themes were identified such as respondent-supported healing, responses promoting shutting down/isolation, and responses affecting self-blame for social disclosure and positive and negative religious coping. Finally, this study substantiates the importance of research assessing the needs and experiences of sexual assault survivors, as this is a population that is particularly vulnerable, and struggles to get adequate support and resources. An increase in understanding about the experiences, needs, and coping strategies of sexual assault survivors will help both informal and formal interventions become more effective.

The aim of this study was to look at the impact of post-traumatic stress disorder (PTSD) on the hippocampus, specifically any variations in volume between individuals with PTSD and a control group. Two databases, PubMed and Web of Science, were utilised to locate literature, with a focuson recent (5-year) articles. These were the study's inclusion requirements: (1) inclusion of adults with PTSD; (2) MRI as a method of studying changes in the brain ; (3) Comparison of outcomes with a control group with or without trauma. This studys exclusion criteria were: (1) non-English language papers, (2) non- adults participants, and (3) other imaging method than MRI. These criteria were intended to ensure the selection of appropriate articles and the uniformity of the systematic review. All the studies looked at MRI to investigate structural changes in the volume of the hippocampus. In the end I investigated 10 studies with a total of 3,826 participants and the findings of these investigations revealed that some studies shown dicreasing of hippocampal volume between patients with PTSD and the control group, whereas others found no such changes as the result of the investigation. These disparate findings show a lack of agreement in the available literature on the influence of PTSD on hippocampus volume. The selection of only recent (5 years) papers and the limited number of studies were the constraints. However, due to a lack of time, broader research could not be done, which made it difficult to draw more accurate conclusions from the study.

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) frequently co-occur. Comorbid PTSD+SUD confers heightened risk of other mental health concerns, suicidality, mortality, and functional impairment. Current treatments for comorbid PTSD+SUD show inconsistent results, highlighting the need for a more comprehensive understanding of the associations between PTSD and SUD symptoms. The current dissertation aimed to characterize the associations between PTSD and SUD using structural equation modelling among three different samples with differing clinical severity and presentation: (1) concurrent disorders sample with a high prevalence of PTSD; (2) an in-patient sample seeking treatment for PTSD; and (3) a subclinical sample of healthcare workers and public safety personnel. Data were extracted from multiple clinical databases across different studies to evaluate the associations between PTSD symptoms and alcohol/cannabis/substance use-related problems. Furthermore, the role of underlying mechanisms such as dissociation and emotion dysregulation, which are associated with both PTSD and SUD, were analyzed. All analyses used a structural equation modelling framework to represent the complex clinical presentation of comorbid PTSD+SUD analytically. A relatively consistent pattern of results was observed across the three samples. Global PTSD symptoms were significantly associated with cannabis-related problems, alcohol-related problems, and other illicit substance-related problems. Among PTSD symptoms, the reactivity symptom cluster (characterized by symptoms of hypervigilance, irritability, reckless behaviour, problems with concentration and sleep disturbances) was significantly associated with alcohol/cannabis/substance-related v problems across among the three samples. Furthermore, underlying mechanisms such as dissociation and emotion dysregulation significantly mediated the relations between PTSD symptoms and alcohol/cannabis/substance-related problems. Overall, the current results contribute to the limited literature examining the associations between PTSD and SUD symptoms. Lastly, the current results have important clinical implications for identifying efficacious treatment targets for comorbid PTSD+SUD. / Dissertation / Doctor of Philosophy (PhD) / Psychological distress following a traumatic event, known as traumatic stress, is often associated with problematic alcohol and/or substance use. The co-occurrence of these two confers a heightened risk of other mental health problems. As such, studying how these phenomena are associated with one another and what about each thing is more important to the association is important to understand. The purpose was to examine the connection between these phenomena among three different groups of people: two treatment-seeking groups and non-treatment seeking group one group. Traumatic stress was associated with problematic substance use in all three groups. In addition, other factors like mentally escaping from your body and having difficulties with regulating your emotions explained how traumatic stress and problematic substance use were connected to each other. These findings can help clinicians hone their treatment programs to better help individuals struggling with traumatic stress and problematic substance use.

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