The aims of this thesis were to estimate the lifetime prevalence of physical, sexual, and psychological abuse in a random population-based sample of women aged 18-60 years; to estimate current suffering thereof; and to investigate associations between abuse and health problems, more specifically to study abuse related variables associated with somatization and PTSD, respectively. The studies had a cross-sectional design. Studies I and II comprised 4150 women 18-60 years. Study III included 547 women, and study IV consisted of 213 women, randomly selected from the population-based sample of the first two studies. The first study found lifetime prevalence rates of 19.4% for physical abuse, 9.2% for sexual abuse, and 18.2% for psychological abuse. Abused women reported more ill-health and a less advantageous social situation than non-abused women. There was an association between magnitude of abuse and health problems. Even a low magnitude of abuse was substantially associated with ill-health. In the second study we found that of the 27.5% of women who had reported any kind of abuse in the first study, 69.5 % reported current suffering thereof. Abused suffering women reported more health problems than abused non-suffering women and non-abused women, and abused non-suffering women reported more health problems than non-abused women. In study three, psychological abuse and sexual abuse without penetration were found to be associated with somatization. Physical abuse and sexual abuse with penetration were not associated with somatization, when adjustments for other kinds of abuse were made. In study four, PTSD and somatization were found to be separately reported phenomena in abused women, although PTSD was positively associated with having somatic symptoms. Women with PTSD reported higher total magnitude of abuse and a higher number of perpetrators than women with somatization. Sexually abused women with PTSD more often described their experience as an act of abuse compared with sexually abused women with somatization. The present thesis demonstrates that even a low magnitude of abuse is associated with health problems. It also shows that a majority of the abused women, when investigating lifetime history of abuse, reported current suffering thereof, which warrants considering abuse an important societal problem. The relationship between somatization and posttraumatic stress in abused women is discussed in relation to abuse variables. Other factors than severity of abuse, such as whether the abused woman herself perceives her experience as abuse, seem to be more decisive for development of somatization in abused women. The findings suggest that PTSD is not a necessary mediator between abuse and somatization.

This study examined the role of filial responsibility as a mediator between parental depression and posttraumatic stress symptomatology (PTSS) in Bosnian youths. The sample consisted of 145 6PthP-8PthP grade boys and girls and their parents. Unfairness and caregiving scales were combined in an interaction term to test the hypothesis. Parental depression significantly predicted parental report of adolescent PTSS but the filial responsibility variables did not significantly mediate the relationship between parental depression and PTSS. A post-hoc analysis examined the role of filial responsibility mediating the relationship between parental education level and PTSS. The interaction terms did not significantly mediate the relationship but the unfairness variable significantly mediated the relationship between parental education level and adolescent report of PTSS.

First responders who participate in disaster are at risk of posttraumatic stress disorder (PTSD). Because of nurses’ unique role as professional and volunteer responders, there is a need to know more about risks of PTSD in this group. Using a cross-sectional correlational design, associations between disaster exposure, problem focused coping (PFC), emotion-focused coping (EFC) and PTSD symptoms (Impact of Events Scale-Revised (IES-R) scale) were explored. A random sample (n= 995) was drawn from a list of nurses from the New Orleans region. Each nurse was mailed an invitation to participate in an online survey. Three post-card reminders were sent. The sample was divided into nurses who participated in disaster activities (n=76) and those who did not (n=32). Prevalence of PTSD in the PIDA nurses was 13.2%. Almost half the PIDA nurses (48.7%) reported symptoms of PTSD, and increased use of substances to cope (31.5%). Only 9.2% sought psychological care post-event. Regression analyses, controlling for history of trauma, marital status, and gender found EFC accounted for a significant amount of the variance of symptoms of PTSD (R2 = 0.32, F (1, 67) = 25.09, p < 0.001) (B=0.4, SE=0.01, p Prevalence of PTSD among PIDA nurses was lower than other groups of professional responders (17.4% in firefighters), but greater than the general public (6.8%). Presence of PTSD in PIDA nurses five years after Hurricane Katrina is associated with the increased use of EFC and substances.

Women who have experienced violence in their intimate partnerships have consistently reported poorer physical and mental health and higher medical care utilization than women who have not experienced intimate partner violence. Because of the many deleterious impacts of relationship abuse, investigations into coping processes among women who have experienced intimate partner violence take on heightened importance. The complexity of circumstances and the unique responses to intimate partner violence indicate that women employ as many coping strategies as are available to them at the time. Effective coping behaviours and the recovery environment are critical for battered women’s positive adjustment (Carlson, 1997; Sullivan & Bybee, 1999). This study examined the relationships between emotion-focused coping, symptoms of post-traumatic stress and exposure to intimate partner violence in a sample of 670 women across the Prairie Provinces. The Composite Abuse Scale, Emotion-Focused Coping Strategies questionnaire, and the Posttraumatic Stress Checklist were used to measure the variables. Findings confirmed a strong correlation between greater exposure to abuse and symptoms of posttraumatic stress. They also confirmed that greater use of emotion-focused coping strategies was associated with escalation of abuse and more symptoms of posttraumatic stress within this group of women. This study adds to the current body of literature on ways women cope with intimate partner violence.

Traditionally, it was believed that young children did not experience long-term negative effects resulting from a traumatic experience. Many professionals continue to assume that the effects of trauma on infants (0-3 years) are transient and that intervention is unnecessary. However, research has shown that infants and young children can develop posttraumatic stress disorder (PTSD; Scheeringa, Peebles, Cook, & Zeanah, 2001). Symptoms consistent with older children and adults (i.e., re-experiencing, avoidance/emotional numbing, and hyperarousal) have been found with infants and young children exposed to trauma. The purpose of this dissertation was to better understand the nature of trauma in early childhood using a multidimensional approach. Three studies were conducted to determine the effects of trauma and PTSD on young children. Study 1 considered the effectiveness of using the Child Behaviour Checklist (CBCL), a popular measure of childrens adjustment, to screen for PTSD symptoms in a sample of young children. Results suggested that the PTSD subscale of the CBCL correctly identified 71% of children with PTSD. Study 2 examined the role that potentially traumatic events, as well as family and child characteristics, play in the development of symptoms of PTSD by surveying a community sample. Results suggested that certain events were more likely to be associated with symptoms of PTSD and that children with younger mothers and higher rates of internalizing problems were more likely to experience symptoms of PTSD. Study 3 explored the effects of trauma on young childrens emotional, physiological and relational functioning, and was conducted in two phases: Phase I considered PTSD symptom expression, physiological stress-response (i.e., salivary cortisol) and quality of attachment in children recruited from a community sample; and Phase II considered PTSD symptoms, quality of attachment and maternal psychological distress in the development of PTSD in a clinical sample of young children. Results found that in Phase I PTSD symptoms were not associated with either cortisol level or quality of attachment, although effect sizes were moderate. Phase II results found a direct and significant association between quality of attachment and PTSD symptoms. A non-significant but moderate effect size was found for the link between maternal psychological distress and PTSD symptoms. Findings are discussed with regards to their implications for future research and clinical practice.

Canterbury, New Zealand, was struck by two major earthquakes in 2010 and 2011. Using a dyadic and developmental perspective, the current thesis first aimed to determine how the experience of earthquake-related stressors (including loss of material resources, trauma exposure, and ongoing earthquake-related stressors) and stress (posttraumatic stress symptoms) impacted individuals’ intimate relationship quality (Part 1). Data were collected from a sample of 99 couples at four time points over a period of approximately 15 months, with Time 1 completed 14 months after the 2010 earthquake (eight months post the 2011 earthquake). Data were analysed using moderated growth curve modelling in an Actor-Partner Interdependence Model framework. In line with expectations, posttraumatic stress symptoms were the strongest predictors of relationship quality. More specifically, individuals’ (actor) posttraumatic stress symptoms and their partner’s posttraumatic stress symptoms had an adverse effect on their relationship quality at Time 1. Demonstrating the importance of taking a developmental perspective, the effect of partner posttraumatic stress symptoms changed over time. Although higher partner posttraumatic stress symptoms were associated with worse relationship quality in individuals (actors) at Time 1, this was no longer the case at Time 4. Differences were also found between men and women’s actor posttraumatic stress symptom slopes across time. Using the same data and analyses, Part 2 built on these findings by investigating the role of a possible posttrauma resource available within the relationship – support exchanges. Overall, results showed that individuals were protected from any adverse effects that posttraumatic stress symptoms had on relationship quality if they had more frequent support exchanges in the relationship, however, differences between men and women and slopes across time were found. Although not the case initially, individuals’ relationship quality was worse in the longer-term if their partner reported receiving lower support from them when they were experiencing high posttraumatic stress symptoms. Results also suggested that although women coped better (as evidenced through slightly better relationship quality) with higher symptoms and lower support than men initially, these efforts diminished over time. Furthermore, men appeared to be less able to cope (i.e., had worse relationship quality) with their partner’s stress when they were not receiving frequent support. Contrary to expectations, negative exchanges in the relationship did not exacerbate any adverse effects that posttraumatic stress symptoms (experienced by either individuals or their partner) had on an individuals’ relationship quality. The theoretical and practical implications and applications of these findings are discussed.

The field of psychology has traditionally focused on the deleterious effects of adversity to the exclusion of positive effects. However, a literature on positive sequelae of traumatic events has burgeoned over the past decade. The issue of whether individual's reports of positive changes are merely illusory self-enhancing biases or are reflective of objective, quantifiable change is perhaps the most contentious in the posttraumatic growth research at this time. This dissertation begins with a broad overview of the extant research on posttraumatic growth, then presents the evidence supporting each side of the validity debate. As the population studied in this dissertation is adults with traumatic-onset spinal cord injuries, a presentation of research that ties disability to the posttraumatic growth literature follows. Finally, the introductory chapter concludes with an argument for the importance of including a disability perspective in psychological science. Three papers follow, each taking up aspects of this relatively new focus on positive aspects of disability. / Psychology

Despite high rates of alcohol and marijuana use and dating violence among individuals between the ages of 15 and 24, limited research has examined a link between substance use and dating violence within adolescent samples. Moreover, although both problem drinking and dating violence perpetration have been linked to a history of childhood maltreatment (CM), few studies have examined the potential mechanisms of a relationship between these variables. The current study tested the predictive role of CM in adolescent alcohol and cannabis use and dating violence perpetration in a sample of youth with CM histories; in particular, we were interested in predicting the temporal co-occurrence of these behaviours. It was hypothesized that trauma symptomatology would play a mediating role in this relationship. Results demonstrated that only witnessing emotional domestic violence predicted the co-occurrence of substance use and dating violence; in general, trauma symptomatology was not found to be a significant mediator.

This thesis explores distress and reactions after crime by a previously unknown perpetrator in a two-year perspective. Distress was investigated at eight months and two years, using quantitative and qualitative methods. The specific aims of the thesis were (I) to explore the level of distress and the role of risk factors for post-traumatic and general symptoms eight months post crime, (II) to examine the natural course of adjustment at a two-year follow-up in female and male victims of interpersonal violence, III) to investigate the relationship between shame, guilt, and distress among 35 victims of a single severe violent crime, and (IV) to use qualitative analysis to describe individual post-crime trajectories. The following questionnaires were used: Symptom Check List 90 (Derogatis &amp; Cleary, 1977), Harvard Trauma Questionnaire (Mollica et al., 1992), the Test for Self-Conscious Affect (Tagney et al., 1989). Data were also obtained via semi-structured interviews, including the use of visual analog scales for subjective mental health measures. The participants in paper I were male and female Swedish adult victims of reported interpersonal violence eight months earlier. Participants were between 18 and 66 years of age (n=41). At follow-up (Paper II) the sample size had decreased (n=35). In paper III, adult victims (aged 18-64) of reported interpersonal violence were assessed within two weeks of reported crime (n=35). In paper IV a subsample of 11 adult crime victims were drawn from among the participants from papers I and II. Paper I showed that women reported more distress than men. Prior trauma, adverse childhood, female sex, previous psychiatric history, and unemployment were all associated with more distress. Peritraumatic reactions (especially secondary emotions following cognitive appraisals after the event) predicted the three core PTSD symptoms and comorbid conditions, together with female sex and psychiatric history. Paper II confirmed most of the risk factors at eight months and that, in general, no further recovery took place between eight months and two years. Paper III showed that shame-proneness and event-related shame were highly intercorrelated and related to higher symptoms levels, while the guilt measures were unrelated to each other as well as to symptoms. Paper IV explored narratives of victimization; the results suggest that individual differences within the same trajectories of recovery should be expected.

Nagrinėti tyrimai rodo, jog depresija, stresas, jo įveika bei emociniai veiksniai yra susiję su didesne mirštamumo nuo širdies ligų rizika, didesne infarkto tikimybe ir neigiamomis operacijos pasekmėmis, tačiau į tai menkai atsižvelgiama. Norint pasiekti sėkmingus rezultatus tiek paciento fiziologinės, tiek psichologinės sveikatos atžvilgiu, reikia ilgalaikio ir nuoseklaus komandos darbo. Psichosocialiniai veiksniai tiek gydytojų, tiek pačių pacientų vertinami gana skeptiškai, todėl dažnai pakankamai neatsižvelgiama į paciento psichinės būklės įtaką sveikatai, ligos vystymuisi ir gijimui, todėl svarbu atskleisti širdies kraujagyslių sistemos ligomis sergančių asmenų emocinės būklės bei stresogeninių situacijų įveikimo strategijų ypatumus ir jų sąsajas. Anketinėje apklausoje dalyvavo 169 dalyviai: 52 Kauno medicinos universiteto klinikos Kardiologinių bei Širdies centro skyrių pacientai, besigydantys stacionare, kuriems buvo atlikta širdies kraujagyslių operacija ir 67 Kauno medicinos universiteto klinikos Kardiologinių bei Širdies centro skyrių pacientai, besigydantys stacionare be kardiochirurginių intervencijų bei 50 asmenų, profilaktiškai besitikrinantys Kauno medicinos universiteto šeimos klinikoje, kurie sudarė kontrolinę grupę. Tyrime dalyvavę pacientai užpildė HAD (depresijos ir nerimo įvertinimo klausimyną), įveikos strategijų klausimyną – COPE bei potrauminio streso sindromo simptomų skalę (PSS-SR). Kontrolinės grupės respondentai nepildė potrauminio streso... [toliau žr. visą tekstą] / Despite, it is known from previous research that depression, stress, coping and other emotional factors contribute to cardiac patients’ mortality, higher risk of myocardial infarct and operation complications, attention is insufficiently paid on psychological factors. It is necessary long-term and consecutive team work, so as to achieve great physiological and psychological patients’ health. Doctors and patients usually devalue the impact of psychosocial factors on cardiac patients health, therefore it is important to reveal cardiac patients’ the emotional conditions, coping strategies and their connections. 169 participant were chosen for this research: 52 cardiac patients with surgery intervention, 67 cardiac patients without surgery intervention and 50 participants in control group. Research participant were asked to fill in Hospital Anxiety and Depression scale (HAD), coping questionnaire – COPE and PTSD Symptom Scale – self report version (PSS-SR). The control group were not asked to fill in PTSD Symptom Scale – self report version (PSS-SR). It was found that cardiac patients have high level of anxiety and depression. Cardiac patients with a surgery intervention more often use emotion oriented coping strategies than healthy persons. Post-traumatic stress disorder prevalence among cardiac patients is running 25%. Poor emotional state is not linked with problem oriented coping among cardiac patients; it is associated with focus on and venting of emotions and... [to full text]