Having a secure attachment to God may act as a buffer against stress. Secure attachment to God has been positively associated with adaptive outcomes following stress, such as higher levels of stress-related growth and fewer maladaptive symptoms including depression, prolonged grief, and traumatic distress. However, relatively few studies have empirically tested the relationship between attachment to God and resilience and posttraumatic growth. Thus, the current study explored the potential associations and pathways through which attachment to God is associated with resilience and posttraumatic growth in a sample of 303 suddenly and/or traumatically bereaved individuals. The current study found that (a) God attachment avoidance is a unique negative predictor of resilience and posttraumatic growth even when controlling for adult attachment, (b) self-compassion and meaning-making mediate the association between God attachment anxiety and resilience/posttraumatic growth, (c) secure attachment to God is associated with higher levels of resilience than insecure attachment styles, but not with posttraumatic growth, and (d) an increased number of secondary losses is associated with lower levels of resilience. I conclude by discussing my findings in light of the extant literature on attachment to God, resilience, and posttraumatic growth. By better understanding attachment to God and how it may relate to resilience and posttraumatic growth, clinicians will be better equipped to interact with clients of diverse religious/spiritual (R/S) identities, potentially utilizing R/S as a strength or addressing maladaptive aspects of R/S in the wake of life stressors.

Objectives: The purpose of this study was to compare hearing difficulties and hearing aid outcomes in veterans with Posttraumatic Stress Disorder (PTSD) to a group of veterans with no medical diagnosis of PTSD. Our hypothesis was that veterans with PTSD would have poorer hearing aid outcomes in certain domains (e.g., those related to loudness or interactions with the environment) relative to patients without PTSD. Assessing these differences could help identify unique factors that may lead to the development of tailored aural rehabilitation for hearing aid users with PTSD. Design: This descriptive study employed subjective outcome measures and surveys; the Abbreviated Profile for Hearing Aid Benefit (APHAB) served as the primary outcome measure. An additional questionnaire was developed to assess views of the subjects’ hearing in unaided and aided conditions in an effort to explore the relation between hearing aid benefit and PTSD symptoms. A total of 60 veterans with sensorineural hearing loss and bilateral hearing aid use were recruited from the Audiology Clinic at the James H. Quillen Veterans Affairs Medical Center in Mountain Home, TN. Participants were divided into two groups of subjects either with or without PTSD (n=30 in each). Diagnosis of PTSD was confirmed via a chart review of the veteran’s medical record. Results: Results from the APHAB revealed a significant difference between groups in global benefit scores as well as the aversiveness subscale in the unaided condition. Overall, the PTSD group showed lower benefit scores, however outcomes indicated that both groups received benefit when aided. Results from the study questionnaire showed a significant difference between the two groups in both unaided and aided conditions for the questions focused on hyper-arousal and re-experiencing symptoms. Conclusions: Hearing aid users with PTSD perceive less benefit from hearing aid use on traditional hearing aid outcome measures. Additionally, these hearing aid users were more affected by hyper-arousal, re-experiencing symptoms, and avoidance compared to hearing aid users without PTSD. The clinical implications of this work suggest that hearing aid users with PTSD may need modified hearing aid fittings and/or additional counseling to meet their unique listening needs.

Women with posttraumatic stress disorder (PTSD) often develop alcohol use disorders (AUD) resulting from the use of alcohol to self-medicate from negative affect. Research supports the relationship between comorbid PTSD and AUD, and studies with women additionally identify the role of rumination, or excessive thinking about distress and its causes, as a precipitating aspect leading to self-medication. Female-based data is sparse, however, regarding specific thought patterns and factors which trigger the need to self-medicate with alcohol. Numerous researchers have studied the relationship between stress, anxiety, and alcohol use, although, there exists a need for qualitative studies providing thick, rich information. Applying the self-medication model and rumination theory, the purpose of this study was to use a transcendental research framework as a lens to explore and describe the phenomenon of how women with comorbid PTSD and AUD make sense of their dual disorder. Qualitative data were gathered from in-depth interviews of 12 women who participated in Alcoholics Anonymous groups in a large Southeastern city. The women collectively described their lived experience with the phenomenon as an internally-focused strategy premised on the notion of a 'Higher Power.' They reported using this strategy to manage thoughts, feelings, and behaviors which triggered negative self-assessment and the need to self-medicate with alcohol. This research contributes to the literature by offering a more detailed understanding of comorbid PTSD and AUD. Positive social change can be achieved with a better understanding of the etiology of female trauma and the factors that trigger alcohol relapse in women with PTSD.

Social workers are increasingly using eye movement, desensitization, and reprocessing (EMDR) to help clients recover from trauma. Little is known about how social workers who work with traumatic client material while using EMDR as their main psychotherapeutic modality experience vicarious trauma. The purpose of this phenomenological study was to explore the experience of vicarious trauma among social workers in Eastern Canada who used EMDR in their practice with clients. Constructivist self-development theory was the framework that informed this study. Data were collected using semistructured interviews with 7 EMDR social work participants who were selected using purposive sampling. Participants were required to have a masters level social work designation, EMDR training, and practice with trauma material at least 40% of the time they see clients. Findings from the narrative analysis showed that participants' concepts of 'self' changed over time, with the changes becoming less acute. Understanding how EMDR social workers experience vicarious trauma has implications for policy, practice, future research, and for social change related to trauma. Social workers who are less likely to become traumatized may fit a prototype that may be more appealing to organizational stability. Clinicians may be able to see the signs and symptoms of vicarious trauma and take more time for education and self-care. Finally, study findings may further research on vicarious trauma and EMDR.

Telecommunicators (e.g., dispatchers and 911 operators) experience firsthand the death and suffering of friends, family, peers, and strangers in a chaotic work environment characterized by chronic stress and lack of support. Previous research has demonstrated telecommunicators are at increased risk for negative health outcomes; however, existing research does not identify predictive pathways to posttrauma symptoms in telecommunicators. In an application of the transactional theory of stress and coping, I used structural equation modeling to examine occupational antecedents, work-family conflict, negative appraising, and coping as predictors of posttraumatic stress symptoms in telecommunicators. A convenience sample of 103 telecommunicators, recruited through agencies across the United States, completed a series of PTSD, stress, and coping surveys. Results supported three theorems from the transactional theory of stress and coping: (a) Chronic antecedents are correlated with work-family conflict (r = .54, p < .01), (b) work-family conflict predicted negative appraising ( β = .64, p < .01), and (c) coping predicted posttraumatic stress symptoms in telecommunicators ( β = .30, p = .01). These findings contribute to the current body of occupational health literature by expanding understanding of telecommunicators'€™ occupational experiences and appraisals and provide insights into modifiable processes and policies that can enhance and protect telecommunicator long term health. Specifically, employee-focused policies directed at preserving work-home balance and reducing chronic stressors in the workplace are recommended. Additionally, further research can be initiated to evaluate effectiveness of policy changes in telecommunicator appraising, health, and wellbeing.

Research has been accumulating on the positive outcomes that people may experience following trauma. However, scholarly literature is deficient in the area of investigating the association among centrality of event (CE), posttraumatic growth (PTG), and health behaviors of women with histories of sexual trauma. The purpose of this quantitative cross-sectional study was to (a) determine the extent of the relationship between CE and PTG, (b) explore the relationship between PTG and health behaviors (i.e., drug, alcohol, and tobacco use, and physical activity), and (c) to determine whether general self-efficacy (SE) mediated these relationships. The theoretical frameworks used to inform this study were the theories of PTG and SE. A sample of 123 women with histories of sexual violence completed the Posttraumatic Growth Inventory, the Centrality of Events Scale-SF, the New General Self-Efficacy Scale, the Drug Abuse Screening Test-10, and health behavior questions from the Behavioral Risk Factor Surveillance System. The majority of participants reported that their experiences were highly central. Simple regression analysis indicated a marginal relationship between CE and PTG as well as a significant relationship between PTG and SE. PTG was not directly related to the health behaviors in this study. However, a bootstrap mediation analysis indicated that SE significantly mediated the relationship between PTG and physical activity. This study contributes to positive social change by helping women understand how their cognitions influence their SE and behaviors. Likewise, this study can inform practitioners on developing interventions through a lens of positive psychology to promote beneficial health behaviors.

The goal of the study was to determine the effect of the neurolinguistic programming procedure of visual-kinesthetic dissociation on symptoms of posttraumatic stress disorder in a sample of Vietnam combat veterans. Thirty-eight veterans in a Veterans Administration treatment program were given three sessions of either visual-kinesthetic dissociation or regular program activities. Overall post-traumatic symptoms, re-experiencing symptoms, and amount of sleep were measured before and after treatment and at a three month follow-up. Results indicated that the treatment program itself had no significant effect on symptoms measured, nor did the addition of visual-kinesthetic dissociation provide any incremental symptom relief.

The effects of occupational stress on public servants who seek to protect and maintain security for the general public have begun to receive more attention in recent years. Most of this research has focused on police officers. Much less attention has been directed towards other first responders (i.e., firefighters, paramedics) except in comparisons with police samples or inclusion in mixed first responder groups. Investigative efforts that specifically target firefighters and their unique responses to occupational stress, the vulnerabilities of negative responses to stress, and the variables that enhance and maintain resiliency in these first responders is limited. Moreover, cardiovascular risk has been recognized in firefighters. However research has been focused on examining physical variables related to this risk with little attention to psychological contributions, particularly the role of posttraumatic stress disorder (PTSD) on cardiovascular disease (CVD). The goals of the current investigation were to (1) review research that has been conducted on stress in firefighters, (2) examine the effects of job stress, length of service, and critical incidents on developing PTSD and CVD risk (3) evaluate the relationship between PTSD and CVD risk in firefighters (4) increase our understanding of the manifestations of stress in this population, and (5) provide organizations and treatment providers potentially useful information for developing and improving assessment and intervention strategies. Firefighters from the Broward Sheriff's Office special operations teams (N=87) were the participants. Self-report measures and annual physical examination data provided information regarding CVD risk (weight, height, blood pressure, cholesterol, smoking, physical exercise), job stress, trauma exposure, service length, and posttraumatic stress symptoms. Results indicated statistically significant relationships between PTSD symptomatology and current smoking status, triglycerides levels, and the number of CVD risk factors. Neither the number of experienced critical incidents, nor the number of service years was associated with PTSD symptomatology. Organizational job stress variables were associated with PTSD symptoms, but not directly with CVD risk. Collectively these findings suggest the reaction to traumatic experiences may be a better indicator of PTSD symptom development, than the actual number of traumatic events experienced. Moreover, the presence of PTSD symptoms may negatively influence overall CVD risk.

Exposure to traumatic events can lead to many varied psychological and physiological difficulties, including an increased risk for chronic physical health problems and chronic pain disorders, which are thought to be mediated through the three major biological systems involved in the human stress response. The objective of the present study was to examine the relationships between psychological symptoms and proinflammatory immune markers, Interleukin-1β (IL-1β) and Interleukin-6 (IL-6), which are thought to be related to many of the physical health problems associated with posttraumatic psychopathology. Female participants (N=12) were recruited from a trauma specialty clinic and participated in approximately one research session per month for up to one year of psychotherapy. Five participants had at least three data points and were further examined for longitudinal correlations. Baseline measurements of urinary IL-1β were associated with self-report measures of trait anxiety and dissociative symptoms. One participant, who completed nine research sessions over nearly 12 months, showed improvements in depressive symptoms, state and trait anxiety, and dissociative symptoms that seemed to correspond with decreases in IL-6. IL-1β did not seem to be related to any of her symptom measures. A second participant, with five data points over almost four months, showed less marked change in symptomatology, but her IL-6 levels seemed to correspond with depressive and dissociative symptoms, and her IL-1β levels seemed to be associated with trends in state anxiety and dissociative symptoms. Three other participants had between three and four data points, and the trends obtained were inadequate to determine whether any true relationship existed among the longitudinal variables. These results provide preliminary evidence that it may be possible to reduce chronic pro-inflammatory dysregulation through psychotherapy-facilitated symptom reduction.

Förlossningsrädsla kan beskrivas som specifik rädsla kopplat till förlossning som i någon grad påverkar det dagliga livet på ett negativt sätt. Rädslor kan innefatta att kvinnan själv eller barnet ska skadas under förlossningen, tappa kontrollen, vara beroende av andra eller ha en koppling till fobier som rör sjukhusmiljön. Förlossningsrädsla ökar risken att få en negativ förlossningsupplevelse. Tidigare forskning visar också att den enskilt viktigaste riskfaktorn för svår förlossningsrädsla hos flerföderskor är en tidigare traumatisk förlossningsupplevelse. Prevalensen för förlossningsrädsla varierar mellan länder från 14 till 23 procent, få studier på förlossningsrädsla är gjorda i utvecklingsländer. Förlossningsrädsla kan drabba alla kvinnor men riskfaktorer är depression och ångest, bristande socialt stöd, låg smärttröskel, tidigare psykiskt förlossningstrauma, tidigare våld eller sexuella övergrepp samt annan kulturell bakgrund. Barnmorskan är central för att identifiera och stödja kvinnor med förlossningsrädsla. Hjälpen som kvinnorna får för sin rädsla varierar internationellt. Behandlingen kan bestå av stödsamtal, olika former av terapi, planlagd förlossning eller kejsarsnitt samt barnmorskeledda kontinuitetsmodeller. Konsekvenser av förlossningsrädsla är utdragna förlossningar med fler interventioner inklusive akuta kejsarsnitt, sänkt smärttröskel, psykiska svårigheter i efterförloppet som PTSD, fördröjning till nästa graviditet samt undvikande att skaffa fler barn. Förlossningsrädda kvinnor önskar sig i högre utsträckning kejsarsnitt vilket kan innebära fler risker än vaginal förlossning när det inte finns en medicinsk indikation. Syftet med denna litteraturöversikt var att belysa förlossningsrädda kvinnors upplevelser av föregående födsel som orsakat förlossningsrädsla. Metoden för arbetet var en allmän litteraturöversikt med kvalitativ ansats. Artiklar som granskats och använts i resultatet har baserats på intervjuer och skriftliga kommentarer från kvinnor med förvärvad förlossningsrädsla. Data har analyserats med kvalitativ innehållsanalys. I resultatet identifierades tre kategorier: ”Vikten av stöd”, ”Att tappa kontrollen över sin förlossning” och ”Att gå vidare”.  Vidare kunde flera underkategorier urskiljas under varje kategori. ”Vikten av stöd” innefattade både bristfälligt bemötande och bristande fysisk närvaro av personal vilket skapade oro och en känsla av att vara betydelselös. ”Vikten av stöd” innefattade även upplevelser när vårdpersonal varit betydande för att ta sig igenom en traumatisk förlossning. ”Att tappa kontrollen över förlossningen” kunde innebära att bli exkluderad genom bristfällig kommunikation, dåliga attityder eller att medicinska ingrepp skedde utan samtycke. Detta kunde leda till att kvinnorna började tvivla på vårdpersonalens kompetens, kände sig felbehandlade, emotionellt frånvarande eller fråntagna sin förlossning. ”Att gå vidare” berörde hur kvinnorna hade hanterat sina traumatiska upplevelser, hur de förhållit sig till en ny graviditet och vilka rädslor som var kopplade till en eventuellt kommande förlossning. Slutsatsen är att vårdpersonalens stöd innan, under och efter förlossningen är av största vikt för att förlossningsrädda kvinnor ska kunna gå igenom en förlossning och äga sin upplevelse genom bevarad kontroll, samt för att kunna gå vidare efter en tidigare traumatisk förlossning. / Fear of childbirth can be described as specific fear linked to childbirth that to some extent affects daily life in a negative way. Fears may involve the woman herself or the child being injured during childbirth, losing control, being dependent on others or phobias concerning the hospital environment. Fear of childbirth increases the risk of having a negative experience of childbirth. Previous research also shows that the single most important risk factor for severe fear of childbirth is a previous traumatic birth experience. The prevalence of fear of childbirth varies between countries from 14 to 23 percent, few studies on fear of childbirth have been done in developing countries. Fear of childbirth can affect all women, but risk factors are depression and anxiety, lack of social support, low pain threshold, previous psychological birth trauma, previous violence or sexual abuse and different, cultural backgrounds. The midwife is central to identifying and supporting women with fear of childbirth. The help that women receive varies internationally. The treatment can consist of counseling, various forms of therapy, induced delivery or caesarean section as well as midwife-led continuity models. Consequences of fear of childbirth are delayed births with more interventions including emergency caesarean section, lowered pain threshold, mental difficulties in the aftermath such as PTSD, delay to the next pregnancy and avoidance of having more children. Women who are afraid of childbirth want a caesarean section to a greater extent, which entails more risks than vaginal birth when there is no medical indication. The purpose of this literature review was to shed light on women's birth experiences that´s caused a fear of childbirth. The method of this study a general literature review with a qualitative approach. Articles reviewed and used in the results have been based on interviews and written comments from women with a fear of childbirth. Data have been analysed with qualitative content analysis. The results identified three main categories: "Support", "Losing control of childbirth" and "Moving on". Furthermore, several subcategories could be identified under each main category. The category “support” included both inadequate treatment and lack of physical presence of staff, which lead to anxiety and a feeling of being insignificant. “Support” also included experiences of the staff being important in getting through a traumatic birth. “Losing control of childbirth” meaning being excluded because of the staff´s poor communication, bad attitudes or medical interventions without the woman´s consent. This could make the women doubt the staff´s competence, feeling mistreated, emotionally absent or deprived of their birth. “Moving on” concerned how women handled their traumatic experiences, how they related to a new pregnancy and fears linked to a possible future birth. The conclusion is that the care staff's support before, during and after the birth is of the utmost importance for women who are afraid of giving birth to be able to go through a birth with preserved control and to be able to move on after a previous traumatic birth.