A group of suburban/rural general and special education teachers (n = 260) responded to an electronic survey. The survey was designed to measure the prevalence of an under researched area of compassion fatigue and compassion satisfaction among teachers working in suburban/rural public schools. The current study hypothesized that the relationship among compassion fatigue, compassion satisfaction, demographic variables, and teacher stress factors (time management, discipline, motivation, professional distress, and professional investment) would correlate with an increase in compassion fatigue (burnout and secondary traumatic stress) for general and special education teachers working in suburban/rural public schools; furthermore, it predicted a positive correlation among burnout, compassion fatigue, and compassion satisfaction. Findings indicate that both burnout and compassion fatigue have a negative impact on general education or special education teachers (Billingsley & Cross, 1992; Koenig, Rodger, & Specht, 2018; Kokkinos, 2007). The results also indicate a positive correlation between compassion fatigue and teacher burnout, which are negatively related to compassion satisfaction. Implications and future research are discussed.

Understanding the neuronal basis of learning and memory is a fundamental problem in neuroscience. A leading theory, the origins of which date back to the beginning of the twentieth century, is that the neural basis for memory resides in engrams (also called memory traces), ensembles of cells that are activated during learning and reactivated during memory retrieval. Recent genetic tools have allowed researchers to visualize and manipulate memory traces in small brain regions; however, the ultimate goal is to analyze memory traces across the entire brain in order to better understand how memories are stored in neural networks and how multiple memories may coexist. In order to do so, methods and technologies need to be developed that allow labeling of engram cells throughout the brain, visualization of these cells, and automated quantification of cells in an anatomically precise manner. The first of these challenges has been addressed through the development over the past several years of different mouse models that permit the labeling of active cells throughout the brain at multiple time points. One of the most powerful models, the ArcCreERT2 mouse line, uses drug-induced genetic recombination to indelibly label cells throughout the brain in an activity-dependent manner. In this thesis, I present our work utilizing this model to solve the second and third challenges: imaging of brain-wide memory traces and automated quantification of labeled cells, as well as the application of these novel methods to understanding the engram network changes following fear extinction. Intact tissue clearing and imaging is a new and rapidly growing area of focus that holds great promise for enabling the brain-wide visualization of memory traces. We utilized the leading protocols for whole-brain clearing and applied them to the ArcCreERT2 mice. We found that CLARITY and passive clarity technique (PACT) greatly distorted the tissue, and immunolabeling-enabled three-dimensional imaging of solvent-cleared organs (iDISCO) quenched enhanced yellow fluorescent protein (eYFP) fluorescence and hindered immunolabeling. Alternative clearing solutions, such as tert-Butanol, circumvented these harmful effects, but still did not permit whole-brain immunolabeling. Clear unobstructed brain imaging cocktails and computational analysis (CUBIC) and CUBIC with Reagent 1A produced improved antibody penetration and preserved eYFP fluorescence, but also did not allow for whole-brain memory trace visualization. We developed CUBIC with Reagent-1A*, a modified CUBIC protocol that resulted in eYFP fluorescence preservation and immunolabeling of the immediate early gene (IEG) Arc in deep brain areas; however, optimized memory trace labeling still required tissue slicing into mm-thick tissue sections. Nonetheless, our data show that CUBIC with Reagent-1A* is the ideal method for reproducible clearing and immunolabeling for the visualization of memory traces in mm-thick tissue sections from ArcCreERT2 brains. Recent developments in brain-wide engram tagging strategies, primarily through the use of transgenic mouse models such as the ArcCreERT2 line, and whole brain imaging strategies, such as CLARITY, CUBIC, and iDISCO, have created the circumstances to, for the first time, be able to visualize throughout the brain neuronal activity that is directly linked to behavior. However, as noted above, quantifying and analyzing these brain-wide memory traces presents its own challenge, and widely applicable, readily accessible solutions to this problem have thus far been limited. Although a handful of freely available programs and suites do exist, such as CellProfiler and ClearMap, these are generally tailored to specific approaches, and in particular, no currently available solution exists for quantifying multi-labeled engram cells imaged in three dimensions along the coronal plane, a relatively common scenario that is sure to become even more prominent as greater adoption of the underlying technologies progresses. Using ImageJ and R, we developed an image analysis pipeline to solve precisely this problem. Our strategy allows for the segmentation of both the encoding and retrieval populations, including identification of the reactivated cells, and registration of segmented cells to an anatomical atlas in order to analyze cell activity in a region- and layer-specific manner. Post-traumatic stress disorder (PTSD) can develop following a traumatic event and results in heightened, inappropriate fear and anxiety. Approximately 8% of the US population suffers from PTSD, the main treatment for which is repeated exposure to triggering stimuli under controlled conditions. A better understanding of the neural circuits modified during this process would help advance therapeutic treatment for PTSD. We sought to determine the brain-wide neuronal activity changes underlying fear extinction, the best laboratory model of exposure therapy, by using the ArcCreERT2 x eYFP mice and our newly developed brain-wide segmentation and registration pipeline. ArcCreERT2 x eYFP mice were administered a 4-shock contextual fear conditioning (CFC) paradigm followed by either a 10-day extinction protocol or re-exposure to the aversive context without extinction. Following the final exposure session, mice were euthanized, and active cells were quantified throughout the brain using the pipeline. We found that fear learning leads to increased functional connectivity of amygdalar and hypothalamic regions, and extinction leads to a decentralization of the fear memory network and disengages the thalamus and striatal amygdala. Additionally, coordinated reactivation of the basomedial amygdala and secondary somatosensory cortex with frontal association regions are differentially modulated following extinction, and we identified the temporal association area and medial habenula as novel brain regions involved in modulating freezing behavior. In summary, in this thesis, we have developed a novel engram analysis pipeline and shown its potential for quantifying brain-wide memory traces. This is the first study to analyze brain-wide functional connectivity following fear learning and extinction of a recent fear memory, as well as the first study to analyze fear memory trace reactivation patterns across the brain and relate all three measures to behavioral output. This work both greatly enhances our understanding of the neural underpinnings of fear extinction and provides a toolset for readily exploring the neural underpinnings of other behaviors and types of associative memory.

We investigated the effects of the Gulf War on two groups of Kuwaiti children and youth. Those children experiencing war-related traumatic events and those who did not experience or witness a war-related traumatic event participated. Data were obtained from the mother of each child. Each mother completed a structured Interview which Included Child Traumatic Reaction Index, developed according to the DSM-IV (1994) criteria for Post Traumatic Stress Disorder (PTSD). The data indicated a significant interaction effect observed by mothers according to the child's gender, experience of war traumatic events, and PTSD. The results are discussed In terms of the diagnostic criteria for PTSD, the necessity of early Identification, and the difficulty associated with the diagnosing PTSD in children.

Recent studies of children and adolescents who have experienced a residential, industrial, or wild fire have suggested a causal link between fire disaster and PTSD related psychological distress. Not everyone, however, is equally affected by the stress of experiencing such an event, and the role of coping in this process may be an important mediating factor. Additionally, several studies have found that girls and African Americans report more distress following disasters than do boys and Caucasians. The current study sought to investigate the roles of exposure/loss, coping efficacy, and coping strategy in mediating psychological distress in adolescents after a disaster. The current study included a representative sample of 206 9th graders from a Central Florida High School affected by severe wildfires who were assessed via self-report measures 3- and 10- months after the fires, in a latent variable path analysis to assess the fit of a model including exposure/loss, coping efficacy, coping strategy, and PTSD, depression, and anxiety scores. Moreover, acculturation level and SES were included along with gender and ethnicity in testing for the moderating role of sociodemographics, as little research has delved into the important proximal factors affecting reported racial differences, as ethnicity is better conceptualized as a distal variable that works through a variety of proximal variables to affect outcomes. Results indicated that although the assessment of the global fit of the latent variable path model revealed it to be a poor fit to the data, component fit of the model pointed to a possible mediating role of coping efficacy between exposure/loss and psychological distress, as well as coping efficacy being associated negatively with avoidant coping strategies. Likewise, post hoc regression analyses indicated an important role for exposure/loss, coping efficacy, and coping strategy as they related to PTSD symptomatology in adolescents at both Time 1 and Time 2. Finally, although relationships between the proposed variables and PTSD did not interact with gender, acculturation, SES, or ethnicity, there was a significant interaction between acculturation and ethnicity signifying that for African American youth, high acculturation levels were predictive of less PTSD symptomatology. / Ph. D.

Background The postpartum period represents a major transition in the lives of many women, a time when women are at increased risk for the emergence of psychopathology including depression and PTSD. The current study aimed to better understand the unique contributions of clinically significant postpartum depression, PTSD, and comorbid PTSD/depression on mother–infant bonding and observed maternal parenting behaviors (i.e., behavioral sensitivity, negative affect, positive affect) at 6 months postpartum. Methods Mothers (n=164; oversampled for history of childhood maltreatment given parent study's focus on perinatal mental health in women with trauma histories) and infants participated in 6-month home visit during which dyads engaged in interactional tasks varying in level of difficulties. Mothers also reported on their childhood abuse histories, current depression/PTSD symptoms, and bonding with the infant using standardized and validated instruments. Results Mothers with clinically significant depression had the most parenting impairment (self-report and observed). Mothers with clinically significant PTSD alone (due to interpersonal trauma that occurred predominately in childhood) showed similar interactive behaviors to those who were healthy controls or trauma-exposed but resilient (i.e., no postpartum psychopathology). Childhood maltreatment in the absence of postpartum psychopathology did not infer parenting risk. Limitations Findings are limited by (1) small cell sizes per clinical group, limiting power, (2) sample size and sample demographics prohibited examination of third variables that might also impact parenting (e.g., income, education), (3) self-report of symptoms rather than use of psychiatric interviews. Conclusions Findings show that in the context of child abuse history and/or current PTSD, clinically significant maternal depression was the most salient factor during infancy that was associated with parenting impairment at this level of analysis.

While it is commonly known that combat-related posttraumatic stress disorder (PTSD) has profound, long-term effects on soldiers, its effects on spouses of affected soldiers are less understood. Some spouses who provide care for soldiers with PTSD develop symptoms that are similar in nature. These symptoms include but are not limited to depression, anxiety, isolation, hypervigilance, and a strong startle effect. This study explored the lived experiences of 8 spouses of Army Reservists who returned from deployment in either Iraq or Afghanistan with combat-related PTSD. This study used the couple adaptation to traumatic stress model to explore the couple's response to traumatic stress. The study also includes a discussion of the history of PTSD, including changes in criteria with the revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), including the most recent change in the latest version (DSM 5). Although secondary traumatic stress is not recognized in the DSM 5, an increase in awareness may result in a better understanding of mental health needs within the military culture. The study consisted of 8 semi-structured interviews among 8 female spouses of Army Reserve soldiers, using Colaizzi's method of data analysis. The results of this study identified psychological distress in all participants in connection with relationship changes, psychological distress, and lack of available mental health services. The results of this study may assist mental health professionals understand that the mental health needs of spouses of Reservists often differ from those of active duty spouses. This study may support social change by promoting the need for additional training for counselors who work with this population.

Compassion fatigue and work-related burnout are harmful reactions to patient situations and work environments that negatively affect nurses' well-being and ability to provide safe, effective patient care. However, research is needed to understand how reflection as a self-care response to patient situations is related to nurses' development of work burnout, compassion fatigue, and secondary traumatic stress, a type of compassion fatigue. The purpose of this correlational, cross-sectional quantitative study was to determine the relationship between hospital-based acute care nurses' levels of reflection and their levels of compassion fatigue, secondary traumatic stress, and work burnout. The study was based on Hentz and Lauterbach's model for reflective practice and Kearney, Weininger, Vachon, Harrison, and Mount's self-awareness-based model of self-care. Internet-based surveys consisting of demographic items, the Groningen Reflective Ability Scale, and the Compassion Fatigue-Short Scale were distributed to a randomly selected sample of 2,000 registered nurses in the southeastern United States. Spearman correlation, Pearson correlation, and binary linear regression analyses revealed no significant relationship between the variable of reflection and the variables of compassion fatigue, secondary traumatic stress, and work burnout among hospital-based acute care nurses. Incidental findings revealed significant positive correlations among compassion fatigue, secondary traumatic stress, and work burnout. The study findings can be used to effect positive social change and inform future research within the nursing profession by highlighting reflective nursing practice and providing awareness of the positive relationships among compassion fatigue, secondary traumatic stress, and work burnout in nurses.

Veterans with post-traumatic stress disorder (PTSD) have increased rates of overweight/obesity, higher prevalence of obesity-related medical conditions, and greater morbidity and mortality compared to their peers without PTSD. The aim of this study was to assess the impact of PTSD on weight and metabolic parameters as well as the effect of weight change on metabolic indices. In a case-control cohort, we compared PTSD patients (n=364) with those without mental health disorders (NoMH, n=1,008) at baseline (i.e., eight years prior to enrollment) and on the trajectory of changes before the enrollment in the Miami VA MOVE!® (Weight Management for Veterans) program. Multilevel modeling for change was used to investigate changes in weight and physiological markers over time. The sample consisted of 1,372 veterans (1,208 men and 164 women). Mental health status, weight and metabolic parameters were obtained from medical record. The PTSD group was significantly younger, had lower average BMI at baseline, and higher prevalence of weight-related medical conditions. Groups did not differ by gender, race/ethnicity, or Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) status. At baseline, the PTSD group had significantly lower weight, lower HDL-cholesterol, and higher values for glucose and triglycerides than the NoMH group. The PTSD group had a significantly greater slope than NoMH group for HDL-cholesterol (p¬=.011). The difference in rate of change between groups for weight, glucose, and triglycerides was not significant. The sample as a whole showed a significant increase for weight and glucose while total cholesterol, blood pressure, and triglycerides decreased over time. Despite lower weight, veterans with PTSD had greater prevalence of weight related-medical conditions while rate of change in metabolic parameters over time was comparable to NoMH peers. Exploratory analyses showed that weight had a significant negative effect on total cholesterol and blood pressure. PTSD appears to be a significant risk factor for diabetes and overall metabolic dysfunction. The lack of results with regards to the effect of weight on HDL cholesterol, triglycerides, glucose and hemoglobin A1c are not surprising given the complex relationships among weight and these metabolic indices.

Indiana University-Purdue University Indianapolis (IUPUI) / Intimate partner violence is a problem in the United States (U.S.) military. Previous research has identified factors that increase a couple’s risk for engaging in violence. Most of these factors, such as age, alcohol, and relationship satisfaction are consistent across civilian and military samples. One factor that is unique to military samples is deployment; service members can be exposed to unique traumatic incidents while deployed which are generally unknown to most civilians. Deployments can also increase a service member’s risk for developing Post Traumatic Stress Disorder (PTSD), which can increase their risk for intimate partner violence. Previous research on the effect of deployments on intimate partner violence has produced mixed results. The purpose of this study was to analyze if deployment, total length of deployment, combat experiences from deployment, and PTSD symptoms increased risk for Air Force airmen to perpetrate intimate partner violence at a moderate or severe level of violence. Survey data from a representative sample of active duty Air Force airmen (N = 1,501) was used to conduct Chi-Square analyses and multinomial logistic regression models for perpetrated violence. Results of the study showed that deployment and combat experiences were not significant predictors of perpetrated violence. PTSD symptoms, in addition to alcohol misuse and relationship satisfaction, were significant predictors of moderate and severe perpetrated violence. In terms of practice and policy implications, the study results underscore the importance of widespread screening for these risk factors as well as the availability of interventions focused on alcohol use and relationship issues among service members. Future research could determine if PTSD symptoms moderate the relationship between combat experiences and intimate partner violence.

Student Number : 0102295F - MA research dissertation - School of Psychology - Faculty of Arts / A review of trauma literature indicated that in comparison to PTSD there is very little research into the effects of secondary trauma, especially with regards to trauma workers. The present study explored the psychological impact of trauma workers who work with victims of violent crimes. Both Figley’s (1995) trauma transmission model and Dutton and Rubenstein (1995) ecological model were used to develop a refined trauma model for trauma workers in South Africa, which formed the theoretical basis for the current research. This model looked at the relationships between specific key variables (level of exposure to traumatic material, empathy, and level of perceived social support) and secondary traumatic stress, and their interrelationship. In the present study relevant information was gathered from volunteer trauma workers (N=64) using self-report measures. Data was analysed using the following statistical techniques: Descriptive statistics, Pearson’s Correlation Coefficients, Two Independent Sample T-Test, and a Moderated Multiple Regression. Results indicated that the trauma workers, to some extent, experienced symptoms of secondary traumatic stress. In addition, it was found that previous exposure to traumatic material, level of empathy, and level of perceived social support have a significant relationship with secondary traumatic stress. Social support was not found to have a moderating effect, but empathy emerged as a consistent moderator between the trauma workers previous exposure to traumatic material and secondary traumatic stress. Results also revealed that ones qualification made no difference in the development of secondary traumatic stress. In summary, this study expanded on knowledge into the effects of criminal violence in South Africa, particularly with concern to trauma workers, a population often ignored. This study was considered to be a contribution to trauma literature as it provides much needed empirical evidence.