Experts in traumatology have postulated traumatized children play differently than non-traumatized children. These differences are called posttraumatic play and include the behaviors of intense play, repetitive play, play disruption, avoidant play and negative affect. The purpose of this study is the continued development of the Trauma Play Scale through the addition of a normative sample. The Trauma Play Scale is an observation-based instrument designed to distinguish the play behaviors of children in play therapy with a history of interpersonal trauma when compared to non-traumatized children. The present study compares two samples of children. One group (n=6) currently in play therapy with a history of interpersonal trauma and another group (n=7) considered normally developing (cognitively, emotionally, socially, and physically) by their parents with no known history of interpersonal trauma. Trained raters blind to the trauma history of the children rated a series of eight consecutive video-recorded play therapy sessions for each participant. One-way analysis of variance statistics, including effect sizes were compute to determine the discriminant validity of the Trauma Play Scale. Traumatized children scored significantly higher on the Trauma Play Scale than non-traumatized children on all domains of the scale as well as the overall Average Trauma Play Scale score. Large effect sizes indicated strong relationships between group membership (trauma history versus normally developing) and scores on the Trauma Play Scale.

Terapeuter ingår i riskgruppen för utvecklandet av psykisk ohälsa. Det finns både risk- och skyddsfaktorer som påverkar compassion fatigue (CF) - empatitrötthet - och sekundär traumatisk stress (STS) hos terapeuter. Forskningen visar att traumaarbete upplevs såväl positivt som negativt. Syftet i föreliggande studie var att beskriva terapeuters upplevelser om CF och STS. Därtill att ta reda på om detta kunde relateras till terapeuten själv och arbetsvillkoren samt vad som tycktes ha betydelse för att undvika CF och STS. En litteraturstudie gjordes där artiklarna analyserades genom kvalitativ innehållsanalys. Resultatet innehåller ett huvudtema; Att arbeta med människors trauma är ett privilegium, samtidigt har det sitt pris och sju subteman. I studien diskuteras CF och STS utifrån att det som terapeut i traumaarbete är oundvikligt att drabbas samt att dessa fenomen behöver vara pratbara. Dessutom framkom källor till resiliens. / Therapists are at risk of developing mental illness. Research shows that working with traumatreatment gives both positive and negative experiences. There are both risk and protective factors that affect Compassion Fatigue (CF) and Secondary Traumatic Stress (STS). The aim of this study was to describe therapists' experiences of CS and STS. Furthermore finding out if they could be related to the therapist in person and working conditions as well as if certain elements were important to avoid CF and STS. A literature study was carried out where articles were analyzed using a qualitative content approach. The result includes a main theme; “Working with people ́s trauma is a privilege, at the same time it has its price” and seven subthemes. CF and STS are thereafter discussed based on the idea of the importance that these phenomena are known and that as a traumatherapist it is inevitable to be affected. In addition sources of resilience emerged.

Every day people are exposed to crimes in Sweden, which can lead to both emotional and practical difficulties. Having the opportunity to get support and help after a traumatic incident can reduce the negative consequences of a crime, such as posttraumatic stress disorder and secondary victimization. In many communities in Sweden there are local support services for the crime victims, but in the district of Östra Norrbotten there are no support activities that specifically address this issue. The purpose of this thesis is to investigate if the police in Östra Norrbotten feel that they can offer the crime victim sufficient support or refer to such support. Eight police officers in the district were interviewed to learn about their experiences. The results show that the majority of respondents felt that there are gaps in the field they can´t provide the crime victims to a support that they deem as sufficient or refer to such support. The fact that crime victims do not receive support can lead to negative impact on the recovery from all events. / <p>Validerat; 20130317 (global_studentproject_submitter)</p>

American children growing up in poor urban communities experience a disproportionate amount of direct and indirect violence in addition to the challenges of growing up with limited resources. Due to high amounts of physical and structural violence in these communities, urban youth are at increased risk for complex post-traumatic stress disorder (C-PTSD) and its associated sequelae, such as asthma, obesity, diabetes, and behavioral problems. Evidence demonstrates that sexual abuse and repeated interpersonal trauma leads to more intense symptomatology than traditional post-traumatic stress disorder (PTSD), and traumatic events in early childhood predisposes one to a C-PTSD reaction. This literature review of complex trauma serves to further validate the need for modern psychiatry to recognize C-PTSD as a diagnosis and to identify treatment interventions for this vulnerable population. / Urban Bioethics

The relation between dissociative symptoms and posttraumatic stress disorder (PTSD) was investigated in women who had experienced trauma or sexual assault. Subjects were administered the Dissociative Experiences Scale (DES), the Sexual Experiences Scale (SES), and the PTSD Interview (PTSD-I). Subjects were grouped according to their scores on the SES and the PTSD-I. Analysis of variance revealed a relation between DES scores and PTSD symptom severity scores. Correlational analyses showed a relation between dissociative symptoms and PTSD symptom severity but not recency of trauma. Three factors from a previously published factor analysis of the DES were found to contribute to the DES scores of PTSD subjects.

Thesis (MA)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: Treatment outcome research strives towards objective estimates of disorder-specific treatment efficacy and has been applied to most psychiatric disorders. However, due to shortcomings in outcome research designs, problems still remain regarding the interpretation and generalisability of treatment outcomes. This is despite the development of research methodology criteria such as the Gold Standards, currently viewed as essential criteria for well-controlled cognitive-behavioural outcome research. The objectives of this assignment are (a) to assess the Gold Standards as criteria for treatment outcome research by means of a qualitative overview and evaluation of exposure treatment studies for PTSD, and (b) to make recommendations for the expansion and/or modification of these criteria. An assessment of five selected treatment outcome trials, based on the Gold Standards, showed significant limitations in the scope of the Gold Standards regarding (a) the inclusion of target symptoms in the research hypotheses, (b) estimates of treatment adherence, (c) guidelines for statistical analyses of attrition points, (d) the ethical implementation of exposure treatment, and (e) estimates of significant clinical change. It is concluded that the Gold Standards are not sufficient to ensure valid and reliable treatment outcomes. Recommendations are made for the expansion of four of the existing Gold Standards parameters and three additional criteria are proposed. Key words: treatment outcome research, Gold Standards, post-traumatic stress disorder, exposure therapy. / AFRIKAANSE OPSOMMING: Navorsing oor behandelingsuitkoms streef na objektiewe resultate oor die uitkoms van behandeling vir spesifieke psigiatriese versteurings. Nogtans, weens tekortkominge in die ontwerp van uitkomsstudies, word talle probleme steeds ervaar met die interpretasie en veralgemeenbaarheid van die resultate van die studies. Dit is die geval ten spyte van die ontwikkeling van navorsingskriteria soos die "Gold Standards" wat huidig as die belangrikste kriteria vir uitkomsstudies op die gebied van die kognitiewe gedragsterapie aanvaar word. Hierdie projek het ten doelom (a) die Gold Standards as kriteria vir uitkomsnavorsing te assesseer deur middel van 'n kwalitatiewe oorsig en evaluering van vyf geselekteerde uitkomsstudies van blootstellingsterapie vir post-traumatiese stresversteuring, en (b) om aanbevelings te maak ter aanvulling enJofwysiging van die Gold Standards. Evaluasie van die studies het betekenisvolle beperkings in die Gold Standards se omvattenheid uitgelig in terme van (a) die insluiting van teikensimptome in die navorsingshipoteses, (b) die skatting van behandelingvoitrekking ("treatment adherence"), (c) riglyne vir die statistiese analise van data oor attrisie, (d) die etiese implementering van blootstellingsterapie, en (e) skattings van betekenisvolle kliniese verandering. Dit blyk dat die Gold Standards nie voldoende is om geldige en betroubare resultate oor behandelingsuitkomste te verseker nie. Aanbevelings word gemaak vir die hersiening van vier van die Gold Standards kriteria en drie addisionele kriteria word voorgestel. Sleutelwoorde: behandelingsuitkomsnavorsing. Gold Standards, post-traumatiese stresversteuring, blootstellingsterapie.

Re-experiencing trauma in the form of intrusive, image-based memories (here referred to as flashbacks) is a hallmark symptom of Post-Traumatic Stress Disorder (PTSD). There are successful treatments available for full-blown PTSD; however, these can only be administered one month post trauma. There are limited interventions that can be administered to reduce flashbacks in the early aftermath of trauma. The overarching aim of this thesis was to use an experimental psychopathology approach, the trauma film paradigm, to investigate the reduction of flashbacks post-trauma using the cognitive task, Tetris. Chapter 1 provides a literature review of experimental research that has used the trauma film paradigm. Chapter 2 reviews experimental work on disrupting memory reconsolidation in humans. Chapter 3 details pilot work on the development of an experimental protocol based upon these literature reviews. Experiment 1 (Chapter 4) investigated disrupting reconsolidation for a 24 hour old analogue trauma (aversive film material) using the cognitive task, Tetris. A procedure designed to disrupt flashback reconsolidation (a memory reactivation task for the film followed by playing the computer game Tetris) was compared with a no-task Control. Compared to Control, those in the Tetris condition reported fewer flashbacks to the film in an intrusion diary across the subsequent week and on convergent measures of flashback frequency. Experiment 2 (Chapter 5) provided a test of replication for findings from Experiment 1, in addition to extending findings by dismantling the procedure’s component parts. Participants who underwent Tetris only (without memory reactivation) or memory reactivation (without Tetris) did not demonstrate a reduction in flashbacks and were comparable to the no-task control condition. Both a memory reactivation task plus Tetris in combination were critical for reducing subsequent flashbacks for a consolidated memory for a trauma film. Experiment 3 (Chapter 6) tested whether playing Tetris could help disrupt flashback memories for an analogue trauma (film) if administered prior to film viewing, relative to a no-task control condition. Results showed that playing Tetris before a trauma film did not reduce flashbacks, as demonstrated via an intrusion diary and convergent flashback measures. Chapters 7 reviews email feedback relating to playing Tetris after experiencing real-life adversity from members of the public. Chapter 8 explores a form of treatment for trauma in a NHS, complex patient setting. Chapter 9 discusses the findings from all chapters with reference to their implications and limitations, and new directions for future research. Overall, findings using analogue trauma suggest that memory reactivation followed by playing Tetris may be promising for development as a post-trauma ‘cognitive vaccine’ to disrupt the both the consolidation and potential reconsolidation of flashback memories.

Background: Preliminary evidence suggests there are differences in how older people and younger people with posttraumatic stress disorder (PTSD) present. However, currently little robust evidence exists relating to the presentation, assessment and intervention of PTSD in a rapidly ageing population. Faced with limited and conflicting evidence, clinical psychologists are reliant on their clinical expertise to make decisions in this context. Method: Eight studies reporting current prevalence of PTSD in older people were systematically reviewed. Semi-structured interviews with eight clinical psychologists with experience of assessment and intervention of post-traumatic stress symptomology in older people were analysed according to grounded theory methods. The analysis abstracted categories of data to construct a substantive theory of clinical decision making in this context. Results: Current and 12 month prevalence of PTSD ranged from 0.7% to 4.0% and 0.2% to 0.4% respectively. Partial PTSD was estimated at 1% to 10%. The quality of evidence limits the generalisability of the results. ‘Balancing complexity, resources and demand’ emerged from participants’ accounts as the core theoretical category, underpinning decision making in this context. Seven sub-categories comprise the model, ‘culture’; ‘NHS’; ‘clinician competencies’; “what the client brings”; ‘reconciling understanding’; ‘tailoring’ and ‘therapeutic relationship’. Conclusions: PTSD appears to be relatively rare among older people but more research is required to better understand the presentation and prevalence of full and partial PTSD. The theoretical model is broadly consistent with extant literature pertaining to the adaptation of psychological therapy for older people, offering further detail on implementation and the influence of treatment non-specific factors.

Bakgrund: Ambulanspersonal är en yrkesgrupp som i sitt yrkesutövanden riskerar att utsättas för traumatiska händelser som kan vara mycket påfrestande och stressfulla. Trots erfarenhet och träning blir vissa trauman stundtals övermäktiga och kan ge reaktioner som posttraumatiskt stressyndrom. Risken att utveckla PTSD ökar med antalet upplevda trauman och prevalensen i yrkesgruppen är hög. Syfte: Syftet var att beskriva vilka traumatiska händelser ambulanspersonalen upplevde som mest stressfulla. Syftet var även att beskriva ambulanspersonalens upplevelser och hantering av posttraumatiskt stressyndrom i relation till traumatiska händelser i sitt yrkesutövande. Syftet var dessutom att granska artiklarnas kvalitet utifrån den metodologiska aspekten undersökningsgrupp. Metod: Beskrivande litteraturstudie innefattande elva vetenskapliga artiklar av både kvalitativ och kvantitativ ansats sökta i medicinsk och omvårdnadsorienterade databas. Huvudresultat: Traumatiska händelser som upplevdes mest stressfulla innefattade händelser som involverade akut sjuka och allvarligt skadade barn, vilka väckte en emotionell respons och där ambulanspersonalen identifierade sig med nödställda. Upplevelser av PTSD kännetecknades av överspändhet, sämre prestation, mental avstängning och återupplevande av minnesbilder. Hantering av PTSD utmärktes av copingstrategier som känslomässig distans, fokusering, stöd, återhämtning, kontroll och förberedelse. Slutsats: Ambulanspersonal upplever i sitt yrkesutövande traumatiska händelser som kan vara mycket stressfulla och som kan leda till posttraumatiskt stressyndrom. Upplevelserna kan ge psykiska och fysiska symtom som påverkar hälsa och funktionsförmåga. Ambulanspersonalen behöver utbildning i copingstrategier för att hantera kritiska incidenter på ett gynnsamt sätt, speciellt händelser som involverar barn. Strategier behövs för att stärka känslan av kontroll och förmågan till fokusering, där förberedelse, socialt stöd och återhämtningstid är betydelsefullt.

Previous literature has shown that combat veteran posttraumatic stress disorder (PTSD) affects attachment quality, as well as sexual satisfaction and functioning. This study used internet survey methods from 253 male combat veterans in committed relationships to analyze the correlations between PTSD symptoms, attachment quality, sexual satisfaction, and sexual functioning in romantic relationships. The results indicate that PTSD symptoms from combat veterans are correlated with attachment quality, sexual satisfaction, and sexual functioning in romantic relationships. Implications for professionals and future research are explored.