The cross-cultural applicability of the PTSD diagnosis has been widely disputed in recent years. Consequently, an examination of the psychometric properties of instruments that are used to assess traumatized individuals of various cultures is of utmost importance. To respond to this need, the overall goal of this dissertation was to evaluate the psychometric properties of the Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992), a measure that was developed to assess trauma symptoms across cultures. In the first study, I conducted a search of all publications and dissertations that used the symptoms scales of the HTQ. This search revealed that the HTQ is commonly used by trauma researchers, however only a minority of them reported using established translation and cultural adaptation procedures to adapt the instrument for their specific sample. In addition, of the 384 studies considered for inclusion, only 44% of them reported internal consistency estimates of their sample. I then performed reliability generalization analyses on Cronbach’s alpha coefficients to assess the reliability properties of the HTQ symptom scales. Overall, 103 samples were included in the analyses, representing various cultures, languages and countries of study. The findings of this study indicated that both the HTQ-16 and 30 symptom scales are likely to provide reliable scores across diverse populations. However, the evidence supporting the reliability of scores produced for the re-experiencing, avoidance/numbing and arousal subscales is less strong. Significant moderating effects were found for various sample and methodological variables, such as the gender composition of the sample, cultural group, cultural orientation of the country of origin and trauma type. Building upon the findings of study 1, I performed validity generalization (VG) analyses to assess the overall construct validity of the HTQ symptom scales in Study 2. Seventy-five independent samples were included in the VG that evaluated the convergent and discriminant validity properties of both the HTQ-16 and HTQ-30. The findings revealed that the convergent validity properties of the HTQ-16 are supported to some extent, but the discriminant validity properties are not. Furthermore, there was limited support for either the convergent or discriminant validity of the HTQ-30. Several significant moderating effects were also found for both scales (i.e. age, gender, cultural group, recruitment site, trauma type, being an original sample). Although these studies shed some light into the overall psychometric strength of the HTQ symptom scales, the decision whether to use this instrument for the assessment of PTSD should also be guided by evidence-based assessment guidelines.

Considerable research has demonstrated a link between thoughts of revenge, or vengeful rumination, and the development of posttraumatic stress disorder (PTSD) symptoms, particularly in situations involving interpersonal trauma. Personality factors have been related to both vengefulness and PTSD. No study to date has simultaneously examined the unique contributions of vengefulness and personality factors in the development of PTSD symptoms. Therefore, the present study addressed these questions in an inpatient sample by comparing contributions of the Big Five personality factors and vengeful rumination to the development of PTSD symptoms through correlation, hierarchical regression, and omnibus regression analyses. Results showed that Neuroticism predicted PTSD symptoms better than other personality factors, that Neuroticism and Agreeableness predicted vengeful rumination in opposite directions, and that personality factors and vengeful rumination each added unique variance in the prediction of PTSD symptoms. Future directions and implications are discussed.

The purpose of this study was to develop a manualized therapy group for wives or significant others of veterans with posttraumatic stress disorder and to evaluate its effectiveness in reducing wives' psychological symptoms. A second aim of the study was to determine if women's involvement in the wives group resulted in decreases in their husbands' PTSD symptoms. Women recruited for the study were administered pre-test measures during a screening session. They then participated in a 9-session manualized therapy group designed by the researcher that included psychoeducational, process, and support components. Examples of group topics included psychoeducation regarding PTSD, assertiveness and communication, intimacy, self-care, and stress management. After completing the group sessions, participants were asked to complete post-test measures. Other factors explored in this study included marital satisfaction, perceived social support, general satisfaction with the group, and demographic variables. Results indicated that wives who participated in the group treatment exhibited significant decreases in secondary stress symptoms and increases in marital satisfaction from pre-test to post-test. The majority of participants also reported high levels of satisfaction with the group process. Therefore, it appears that the group protocol presented in this study could be a useful tool in the treatment of wives of veterans with PTSD. The results of this study have potential implications regarding the clinical treatment of families of veterans with PTSD and the development of future programs within the VA system.

abstract: With the rise of Posttraumatic Stress Disorder (PTSD) among adults in the United States, understanding the processes of trauma, trauma related disorders, and the long-term impact of living with them is an area of continued focus for researchers. This is especially a concern in the case of current and former military service members (veterans), whose work activities and deployment cycles place them at an increased risk of exposure to trauma-inducing experiences but who have a low rate of self-referral to healthcare professionals. There is thus an urgent need for developing procedures for early diagnosis and treatment. The present study examines how the tools and findings of the field of linguistics may contribute to the field of trauma research. Previous research has shown that cognition and language production are closely linked. This study focuses on the role of prosody in PTSD and pilots a procedure for the data collection and analysis. Data consist of monologic talk from a sample of student-veterans and analyzed with speech software (Praat) for pauses greater than 250 milliseconds per 100 words. The pause frequency was compared to a PCL-5 score, an assessment used to check for PTSD symptoms and evaluate need for further assessment and possible diagnosis of PTSD. This pilot study found the methods successfully elicited data that could be used to measure and test the research questions. Although the findings of the study were inconclusive due to limitations of the participant pool, it found that the research model proved effect as a model for future linguistic research on trauma. / Dissertation/Thesis / Masters Thesis English 2020

No description available.

Abstract BACKGROUND: The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms among pregnant women. METHODS: A total of 3372 pregnant women who attended their first prenatal care visit in Lima, Peru participated in the study. We assessed the reliability of the PCL-C items using Cronbach's alpha. Criterion validity and performance characteristics of PCL-C were assessed against an independent, blinded Clinician-Administered PTSD Scale (CAPS) interview using measures of sensitivity, specificity and receiver operating characteristics (ROC) curves. We tested construct validity using exploratory and confirmatory factor analytic approaches. RESULTS: The reliability of the PCL-C was excellent (Cronbach's alpha =0.90). ROC analysis showed that a cut-off score of 26 offered optimal discriminatory power, with a sensitivity of 0.86 (95% CI: 0.78-0.92) and a specificity of 0.63 (95% CI: 0.62-0.65). The area under the ROC curve was 0.75 (95% CI: 0.71-0.78). A three-factor solution was extracted using exploratory factor analysis and was further complemented with three other models using confirmatory factor analysis (CFA). In a CFA, a three-factor model based on DSM-IV symptom structure had reasonable fit statistics with comparative fit index of 0.86 and root mean square error of approximation of 0.09. CONCLUSION: The Spanish-language version of the PCL-C may be used as a screening tool for pregnant women. The PCL-C has good reliability, criterion validity and factorial validity. The optimal cut-off score obtained by maximizing the sensitivity and specificity should be considered cautiously; women who screened positive may require further investigation to confirm PTSD diagnosis. / Revisión por pares

Background: Physiological changes during pregnancy are often accompanied by reduced sleep quality, sleep disruptions, and insomnia. Studies conducted among men and non-pregnant women have documented psychiatric disorders as common comorbidities of insomnia and other sleep disorders. However, no previous study has examined the association between stress-related sleep disturbances and psychiatric disorders among pregnant women. Methods: This cross-sectional study included a total of 2051 pregnant women in Peru. The Spanish-language version of the Ford Insomnia Response to Stress Test (FIRST-S) was used to assess sleep disruptions due to stressful situations. Symptoms of antepartum depression, generalized anxiety disorder, and posttraumatic stress disorder (PTSD) were examined using the Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7 and PTSD Checklist – Civilian Version, respectively. High risk for psychosis was assessed using the Prodromal Questionnaire. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CI). Results: Stress-related sleep disturbance was reported by 33.2% of women. Of all women, 24.9% had antepartum depression, 32.2% had generalized anxiety disorder, 30.9% had PTSD, and 27.6% were assessed as having a high risk of psychosis. After adjusting for confounders, women with stress-related sleep disturbances were more likely to experience antepartum depression (OR = 2.74; 95%CI: 2.22–3.38), generalized anxiety disorder (OR = 2.48; 95%CI: 2.04–3.02), PTSD (OR = 2.36; 95%CI: 1.93–2.88), and high risk for psychosis (OR = 2.07; 95%CI: 1.69–2.54) as compared to women without stress-related sleep disturbances. Conclusions: Stress-related sleep disturbances during pregnancy are associated with increased odds of psychiatric disorders. Inquiring about stress related sleep disturbances during antenatal care may be beneficial for identifying and caring for women at high risk of psychiatric disorders. / Revisión por pares

The level of crime in South Africa as reflected by crime statistics affects a high number of adolescents. Trauma and stress associated with interpersonal violence can adversely affect the neurobiology of the individual, since social, emotional and cognitive influences interact in multifaceted ways with neurobiological systems to affect every-day adaptive functioning. This study was embarked upon to determine the difference in the expression of personality between adolescents exposed to community related interpersonal violence and those not exposed to such violence. The 183 research participants were selected from a group of 335 grade 12 learners from a single secondary school in a middle class community. The participants were placed into two sample groups by means of purposive sampling as follows: Sample 1 consisted of all the research participants that reported exposure to community related interpersonal violence during the past 5 years on the self-reporting questionnaire (n = 93). The research participants that did not report exposure to such violence formed Sample 2 (n = 90). Reflecting on the adolescent’s emotional, adaptive functioning and referring to high levels of anxiety and feelings of worthlessness, certain factors of the 16PF questionnaire were predicted to show a statistical significant difference after exposure to community related interpersonal violence after a period of 3 to 5 years. To assess the differences in personality profiles of adolescents exposed to community related interpersonal violence and those not exposed to violence, a MANOVA was used in analysing 16PF results. There were statistically significant differences between the two groups on Factor G (rule consciousness), Factor I (emotional sensitivity) and Factor Q4 (anxiety). This indicated that adolescents exposed to incidents of community related interpersonal violence are inclined to experience more tension, are emotional volatile, depressed and anxious. They tend to be more sensitive to environmental stressors and are likely to give up easily. The group exposed to interpersonal violence (Sample 1) experienced higher levels of PTSD as assessed with the PSD Questionnaire than the group that was not exposed to interpersonal violence (sample 2). The personality profiles of three groups (Sample 1 with high PTSD, Sample 1 with low PTSD and Sample 2) were compared by means of a MANOVA to test whether adolescents who experience high levels of PTSD express their personality different from others. The results identify differences in the expression of personality between adolescents of Sample 1 experiencing higher levels of PTSD and the adolescents who did not experience community related interpersonal violence (sample 2) on Factors G- (Selfindulgent and disregards obligations to people), I + ( Perception might be emotionally influenced) and Q4 + (Elevated levels of anxiety). The coping style (positive or negative coping) of adolescents exposed to community related interpersonal violence was assessed using the Kidcope. This was done to examine the possible influence of coping on the development of posttraumatic stress and differences in the expression of personality. There were no correlations between positive and negative coping and the level of PTSD symptoms and the 16PF. The research could therefore not identify coping as a medicating variable in the development of PTSD and differences in the expression of personality. However, research is required to evaluate coping closer to the time of the actual event. The results of this research are a clear indication that the experience of community-related violence has serious implications for the well-being and development of the personality of adolescents. Violence-exposed adolescents may experience symptoms characteristic of PTSD, including significant difficulty regulating one’s emotions and behaviour impacting on their social, cognitive, physiological and emotional functioning. The original target group for this study was the middle class income population and suburb with relatively good security. The sample was drawn from a typical middleclass environment and adolescents from communities with less protection may present different results if sampled for similar research. / Thesis (PhD)--University of Pretoria, 2014. / tm2015 / Psychology / PhD / Unrestricted

Includes bibliographical references / Objective: The main aim of this thesis is to analyze data from the South African Stress and Health (SASH) study and , for the first time, generate information on the epidemiology of traumatic event s (TEs) and posttraumatic stress disorder (PTSD), and on the association of TEs with other psychopathological and physical health outcomes. Methods: A literature review was done to provide information current knowledge in the field. Cross - tabulations, Chi - squared tests and logistic regression analyses were then conducted SASH data to determine the prevalence of the different types of trauma and PTSD and the associations between the sociodemographic variables and TEs and PTSD on the one hand, and TEs and PTSD, other psychopathology and chronic physical conditions on the other . Results: The most common traumatic events were the unexpected death of a loved one and witnessing trauma. Lifetime prevalence of PTSD was 2.3%, and the conditional prevalence of PTSD after trauma exposure was 3.5%. PTSD conditional risk and burden were both highest for witnessing trauma. Witnessing trauma was commonest among males and those with low - average education. There was statistically significant association between witnessing and PTSD, mood, and anxiety disorders. Exposure to any TE significantly increased the odds of all the physical conditions, and the odds of having a physical condition were directly related to the number of lifetime traumatic events. Sexual violence and unexpected death of a loved one significantly increased the odds of all the e physical conditions assessed, while war events were only associated with respiratory conditions. Apart from war events, accidents and witnessing trauma were associated with the fewest physical conditions. Conclusions: Consistent with the literature, trauma and PTSD in South Africa are not distributed according to the socio - demographic factors or trauma types observed in other countries. Witnessing trauma is common in South Africa and increases the risk of mood and anxiety disorders. Finally, TE exposure is associated with chronic physical conditions in a dose - response manner. Trauma interventions must therefore focus also on those not directly affected, and routine evaluation for chronic physical conditions is recommended for survivors of all trauma.

The purpose of the current study was to provide both additional evidence of the psychometric properties of the TIPSA by examining reliability and validity coefficients, and to add to the empirical evidence for the application of betrayal trauma theory outside the context of complex and/or historical trauma. It was hypothesized that internal-consistency coefficients for the TIPSA would exceed 0.70; the TIPSA and the PTSD Checklist for DSM 5 (PCL-5) would be significantly positively correlated; the TIPSA and the Composite Codependency Scale (CCS) would not be significantly correlated; and that neither Adverse Childhood Experiences (ACE) nor Benevolent Childhood Experiences (BCE) scores would be significantly correlated with, or have a significant effect on TIPSA or PCL-5 scores. This study was conducted using anonymous survey data from192 female participants who self-identified as partners of sex addicts. Participants completed the TIPSA, PCL-5, CCS, ACE, and BCE measures. All reliability estimates for the TIPSA were above 0.70, as were all total-scale reliability estimates for the additional measures. Correlation between the TIPSA and PCL-5 produced a Pearson's r of 0.851 (p = 5.541 E-55), which indicated a large effect size. Correlations with additional measures produced statistically significant, yet small to weak, effect sizes (CCS: r = 0.292; ACE: r = -0.173; BCE: r = 0.244). Based on study results, there appears to be sufficient evidence to establish convergent validity of the TIPSA as a measure of trauma symptoms. Moreover, statistical evidence indicates only a weak relationship between the TIPSA and the CCS, thus establishing divergent validity of the TIPSA. Finally, neither the BCE nor the ACE was strongly correlated with the TIPSA, which adds to the empirical evidence for utilizing betrayal trauma theory outside the context of complex trauma, and also serves to provide additional evidence for divergent validity of the TIPSA.