Posttraumatic stress disorder (PTSD) is a trauma-related disorder that may develop in response to traumatic or stressful events. Dysfunction of the Hypothalamic-Pituitary-Adrenal (HPA) axis has been implicated in the disorder. Studies support such dysfunction as being a consequence of PTSD, rather than a precursor. However, most studies of the HPA are either cross-sectional or have been carried out in adults. The aim of the present study was to identify whether HPA dysregulation interacts with stressful experiences to increase the likelihood of developing PTSD symptoms in a community-recruited sample of healthy adolescent girls. Adolescent girls (N = 550) and one of their parents participated. Adolescents’ clinical symptoms were assessed at baseline and at a nine month follow-up. Saliva samples were collected from all adolescent participants at waking, 30 minutes after waking, and 8 pm on 3 consecutive days. Flattened diurnal slope of cortisol at baseline was associated with increased PTSD symptoms nine months later. Baseline cortisol awakening response (CAR) per se was not prospectively related to developing PTSD symptoms, but its interactions with stressful experience was associated with elevated PTSD symptoms at follow-up. Effects were small and need to be replicated in samples with more severe stressors, as well as more clinical levels of PTSD. Nevertheless, findings suggest that dysregulated basal HPA functioning may be involved in the development of PTSD symptoms.

Exposure to traumatic situations is routine for child welfare workers in California, and the attrition rate for newly hired social workers in some states is estimated to be nearly 50% in the 1st year of employment. Prior research has indicated that reasons for dissatisfaction included dysfunctional organizational climate and culture. The purpose of this study was to examine the extent to which trauma exposure contributed to secondary traumatic stress and intent to quit and to examine the degree to which organizational climate moderated the exposure among direct service child welfare employees. Kurt Lewin's field theory, Figley's theory of secondary traumatic stress or compassion fatigue, and McCann and Pearlman's constructivist self-development theory were foundational for this study. The research questions determined whether a) trauma exposure to would relate positively with secondary traumatic stress and intent to quit, b) organizational climate would relate negatively with secondary traumatic stress and intent to quit, and c) organizational climate would moderate the relationship between trauma exposure and secondary traumatic stress as well as intent to quit. Pearson correlations indicated that exposure to traumatic situations was statistically related to secondary traumatic stress but not intent to quit, and organizational climate was statistically significant in relation to secondary traumatic stress and intent to quit. Hierarchical regression analysis indicated no interaction effect on either dependent variable but might have approached significance with a larger sample. Positive social change can occur through child welfare organizations emphasizing strategies that can reduce secondary traumatic stress and turnover.

This study aimed to assess the impact of an Mindfulness-based stress reduction (MBSR) intervention in a program serving women who survived Intimate partner violence (IPV). The biopsychosocial model, formulated by Engel, was the theoretical basis of this study. The impact of the MBSR intervention was assessed by qualitatively evaluating researcher notes and 5 participants' journals and reflections, and quantitatively evaluating 16 participants' self-reported stress, mindfulness, well-being, and optimism before and after the intervention. The themes that emerged from the qualitative data included participants' feelings of relaxation or balance, improved self-awareness, mindfulness exercises becoming easier over time, and improved intentionality. The Kentucky Inventory of Mindfulness Skills (KIMS) self-report inventory was used to assess participants' mindfulness. The KIMS instrument is composed of four subscales: observe, describe, act, and accept. There were significant improvements in the describe and accept dimensions of mindfulness from pretest to posttest, after Bonferroni adjustment. The subscale describe measures how well the participants report being able to describe, identify, or observe mental phenomena in a nonjudgmental manner. There were no significant differences from pre to posttest on stress, well-being, and optimism, a non-equivalent dependent variable not expected to change as a result of the intervention, as optimism is presumed to be a stable personality trait. This study may provide a valuable link to the development of coping and treatment strategies for IPV survivors that can be integrated into therapy programs and individual treatment.

Over the past 15 years, mental health professionals have seen an increasing number of Vietnam combat veterans suffering from stress disorders resulting from the trauma of combat and continued exposure to life threatening situations. Prior to 1980, professional repudiation of and hostility toward Vietnam veterans and toward a clinical reality of Post Traumatic Stress Disorder was common while nondiagnosis and nontreatment was prevalent

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A dissertation submitted in partial fulfilment of requirements for the degree of Master of Arts At the University of Witwatersrand Johannesburg 2016 / This study explored the subjective experiences of a population who appear to be at relatively high risk of potential violence and harm, specifically female university students who are compelled to commute by taxi on a daily basis. The study aimed to explore and document the psychological experiences of these female university students including their anxieties, levels of traumatic stress related responses, cognitions and fantasies, and conscious and unconscious adaptations to their circumstances. It was hoped that information gleaned would contribute to, and possibly expand the understanding of what the lived experience of Continuous Traumatic Stress (CTS) might entail. In order to investigate the research questions, ten students who were identified as being compelled to use minibus taxis as their primary mode of transport to and from university participated in semi-structured interviews on the topic of their experiences in this space and how they adapt to and survive in their circumstances. The study was located in the qualitative research tradition and the interview transcripts were analysed using critical thematic analysis. The main themes were identified and presented under four sections; exposure to traumatic events, the effects and impacts of these events, managing and coping, and gender related experiences in the taxi commuting space. Exposure to traumatic events included taxi driver aggression, motor vehicle accidents, crime and violence, xenophobic attacks and gender related trauma. The most prominent effects or impacts that were identified were firstly, anxiety, fear and preoccupation with danger and secondly, numbing, resignation and hopelessness. The tactics which were employed by participants in managing and coping with their circumstances included, prayer and observation and management of their commuting environment. It was through observation and self-management that participants practiced strategies that allowed them some measure of control in terms of how they conducted themselves in the taxi commuting space. Under the final section, participants revealed their gender related experiences reporting a sense of being exploited, being subject to sexual harassment, and the constant fear of rape or sexual violation. The links between these participants’ experience and the concept of CTS are presented and it is argued that many aspects of their experience appear consistent with CTS. / GR2017

Bakgrund: Empatitrötthet, översatt från engelskans compassion fatigue, är ett komplext begrepp och anses vara en konsekvens av långvarig exponering av utbrändhet och sekundär posttraumatisk stress, som kännetecknas som avsaknad av empati. Empatitrötthet hos yrkesverksamma sjuksköterskor ses som ett problem, då det empatiska bemötandet mot patienterna ligger till grund för en personcentrerad vård. Syfte: Syftet är att belysa empatitrötthet relaterat till sjuksköterskans erfarenhet. Metod: Litteraturstudien är sammanställd av tio primärstudier med kvalitativ ansats, där sjuksköterskor från olika instanser inom sjukvården intervjuats för att undersöka deras erfarenhet av empatitrötthet. Resultat: Tre huvudkategorier uppkom genom analysen: Ro ett sjunkande skepp, Alla känslor spenderas och Att hantera det ohanterbara. Resultatet visar att empatitrötthet påverkar sjuksköterskans välbefinnande negativt och har en inverkan på det patientnära arbetet. Hög arbetsbelastning i kombination med utebliven återhämtning och emotionellt påfrestande scenarion på arbetsplatsen föranledde empatitrötthet. Erfarenheter av empatitrötthet gestaltade sig i distansering och social isolation. Konklusion: Empatitrötthet är ett mångfacetterat fenomen som utvecklas över tid och gör sig uttryck i ett brett spektrum av negativa känslor hos sjuksköterskan. Empatitrötthet resulterade i emotionella och fysiska utmaningar för sjuksköterskor vilket i många fall utmynnade i en emotionell distansering som skapade svårigheter att möta patienternas komplexa behov. Varje enskild sjuksköterska ansågs finna sitt individuella sätt att hantera förlusten av den empatiska förmågan. / Background: Compassion fatigue is a complex concept and is considered to be a consequence of long-term exposure to burnout and secondary post-traumatic stress, which is characterized as a lack of empathy. Compassion fatigue in professional nurses is seen as a problem, as the empathic treatment of patients is the foundation of person-centred care. Purpose: The aim of the current study was to explore compassion fatigue related to the nurse's experience. Method: The literature study is compiled from ten primary studies with a qualitative approach, where nurses from different agencies within the healthcare were interviewed to investigate their experience of empathy fatigue. Results: Three main categories emerged from the analysis: Rowing a Sinking Ship, All Emotions Are Spent, and Dealing with the unmanageable. The results show that empathy fatigue affects the nurse's well-being negatively which leads to an impact on the complex person-centred care. High workload combined with lack of recovery and emotionally stressful scenarios in the workplace caused empathy fatigue. The experiences of empathy fatigue took the form of distancing and social isolation. Conclusion: Empathy fatigue is a multifaceted phenomenon that develops over time and manifests itself in a wide range of negative feelings in the nurse. Empathy fatigue resulted in mental and physical challenges for the nurses, which in many cases resulted in an emotional distancing that created difficulties in meeting the patients' complex needs. Each nurse was considered to find their own individual way of dealing with the loss of the empathic ability.

The purpose of this research study was to explore the symptoms of compassion fatigue as experienced by teachers in grades 9-12 during the COVID-19 pandemic. While the research on the effects of compassion fatigue on educators is relatively sparse, the literature regarding compassion fatigue, secondary traumatic stress, and vicarious trauma in other helping professions revealed a 12-symptom framework. Data collection strategies included individual virtual interviews and field notes. Analysis of data occurred in four phases: (a) analyzing transcripts and identifying themes, (b) categorization of data under the 12 symptoms of compassion fatigue, (c) building the explanation in narrative form, and (d) re-examination of the data. The triangulation of data protected the credibility of the analysis through multiple interview sources and member checking. The results revealed that the physical, emotional, professional, and personal experiences described in the teacher interviews exemplified the 12 established symptoms of compassion fatigue. The results suggested that concern for student experiences during the pandemic combined with other contributing factors to manifest a variety of individual symptoms in participants. The most common contributing factors for participants included concerns for the physical and emotional health and wellbeing of students, student academic issues, feelings of being overwhelmed/overloaded at work, and anger and frustration with the school administration and the school system. The themes that emerged from the data analysis indicate that the most common manifested symptoms include lack of sleep, stress and anxiety, thoughts of leaving the teaching profession, and disconnection from family and friends.

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