No description available.

The purpose of this study is to examine the structure of neurobehavioral symptoms in service members with physical and/or psychological trauma to determine the diagnostic specificity of these symptoms. Previous literature has demonstrated that orthopedic injured, mild traumatic brain injury (MTBI), and healthy controls shared similar levels of postconcussive symptom complaints, which suggest that postconcussion-like symptoms are not unique to MTBI. To the best of my knowledge, this is the first study examining this phenomenon in a sample of recently redeployed service members. Dimensional analysis of the PCL-C and NSI using SEM did not produce a model that was consistent with previous literature and principle component analyses did not produce a simple solution for posttraumatic stress or neurobehavioral symptoms. Thus, the study does not provide evidence for construct validity for either instrument. Implications for these findings are that clinicians need to be aware that these instruments may not be measuring coherent constructs within this population as purported and should judiciously interpret and report the results of these instruments.

No description available.

No description available.

This study examines the effectiveness of internet-based poetry therapy on symptoms of secondary posttraumatic stress disorder (SPTSD) in domestic violence counselors, and explores correlations between demographic, workplace and personality variables with SPTSD symptoms in this population. Domestic violence counselors, at risk for SPTSD due to their exposure to the traumatic material of clients, need effective interventions that combat symptoms of SPTSD. Poetry therapy is a form of expressive arts counseling used increasingly by psychologists and mental health counselors. Expressive writing therapies in general have been shown to be effective in reducing symptoms of stress, and in increasing mental and physical health and well-being. In this study, data was collected from 97 participants who participated anonymously by completing some assessments and activities accessed via the website set up for the study. Results of t tests indicate that in this sample, participants in the internet poetry therapy group showed a decrease in symptoms of SPTSD following treatment, though additional analyses also show that there was a decrease in symptoms on post tests for all participants in the study. Regression analyses indicate that openness to experience and years working with trauma significantly predicted symptoms of SPTSD in this sample.

The terrorist attacks of September 11, 2001, provided a unique, though unfortunate, opportunity to study Americans' sleep reactions to a traumatic event. Questionnaires were distributed electronically to a web-based panel whose demographic distribution closely matched current U.S. census counts. Prior to 9/11/01, participants reported whether they had ever been diagnosed with anxiety, depression, or insomnia. Two weeks following the terrorist attacks, they completed an acute stress questionnaire (SASRQ) which included questions about 9/11-related difficulty falling or staying asleep and nightmares. They later completed a posttraumatic stress symptom questionnaire at two time points: 2 months and 6 months post-9/11. This instrument, the IES-R, included questions about 9/11-related difficulty falling asleep, difficulty staying asleep, and dreams. A total of 782 adults (50.4% male; mean age = 49.6 years) responded.Two weeks following the terrorist attacks, 23% of the sample reported having 9/11-related difficulty falling or staying asleep; 9% reported 9/11-related nightmares. Two months following the attacks, 27% reported having at least some difficulty falling asleep related to 9/11, 33% reported having difficulty staying asleep, and 17% reported having 9/11-related dreams. When assessed again at 6 months post-9/11, levels of these three sleep issues dropped significantly to 14%, 15%, and 8%, respectively. Females reported higher levels of 9/11-related sleep difficulties than males both at 2 weeks and 2 months after the attacks. By 6 months post-9/11, this sex difference had all but disappeared. Older respondents were slightly less likely than younger ones to report nightmares 2 weeks post-9/11 and dreams 2 months post-9/11. Those with pre-9/11 diagnoses of anxiety, depression, and insomnia generally had higher rates of 9/11-related sleep difficulties at all time points assessed.When tested with a hierarchical regression model, difficulty falling or staying asleep at 2 weeks post-9/11 significantly predicted posttraumatic stress symptoms experienced 6 months (but not 2 months) following the attacks. This was true even when taking into account the contribution of pre-existing psychiatric diagnoses and non-sleep-related acute stress symptoms. These findings raise the possibility that the experience of disturbed sleep soon after a trauma directly contributes to the eventual development and exacerbation of posttraumatic stress symptoms.

The present research is a field investigation of trauma and its cognitive and emotional consequences. One hundred and nineteen sex trade workers were interviewed about sexually traumatic experiences. The primary focus of this research was an examination of the quantity and quality of memory for sexual trauma. Various predisposing, precipitating, and perpetuating factors were examined regarding their influence on memory and posttraumatic stress. One objective of this study was to test certain assumptions of the biopsychosocial model of eyewitness memory (Hervé, Cooper, & Yuille, 2007), which proposes that individuals differ along a continuum of arousal sensitivity and predicts the quantity and quality of recall. Up to three types of memory narratives were elicited from each participant: (a) one positive event (b) one well-remembered sexual assault, and (c) one sexual assault for which the participant had poor recollection. Each memory was assessed for peritraumatic and posttraumatic factors. The participants also filled out a number of individual differences measures. The results indicated that the participants had extensive histories of trauma, many of which began in their childhood. It was shown that well-remembered sexual assaults contained more narrative details than memories of positive events and less-well-remembered sexual assaults. Such variability of memory for sexual violence is in line with Hervé et al.'s model as well as other field studies of traumatic memory. This was the first study to demonstrate such variability within-subjects. Various moderating factors of memory were examined, for example, dissociation and different symptoms of posttraumatic stress. Some of the findings were at odds with traditional theories, laboratory findings, and certain assumptions held by many eyewitness memory experts regarding the relationship between stress and memory. A second objective of this dissertation was to examine predictors of post traumatic stress disorder. The findings largely confirmed the literature. Men and women did not differ in their levels of posttraumatic stress. Overall, the complexity of clinical symptoms in survivors of repeated sexual violence is highlighted. The results are discussed in terms of their implications for theory development, future research, the criminal justice system, and in terms of their relevance for treatment providers and assessors.

The present research is a field investigation of trauma and its cognitive and emotional consequences. One hundred and nineteen sex trade workers were interviewed about sexually traumatic experiences. The primary focus of this research was an examination of the quantity and quality of memory for sexual trauma. Various predisposing, precipitating, and perpetuating factors were examined regarding their influence on memory and posttraumatic stress. One objective of this study was to test certain assumptions of the biopsychosocial model of eyewitness memory (Hervé, Cooper, & Yuille, 2007), which proposes that individuals differ along a continuum of arousal sensitivity and predicts the quantity and quality of recall. Up to three types of memory narratives were elicited from each participant: (a) one positive event (b) one well-remembered sexual assault, and (c) one sexual assault for which the participant had poor recollection. Each memory was assessed for peritraumatic and posttraumatic factors. The participants also filled out a number of individual differences measures. The results indicated that the participants had extensive histories of trauma, many of which began in their childhood. It was shown that well-remembered sexual assaults contained more narrative details than memories of positive events and less-well-remembered sexual assaults. Such variability of memory for sexual violence is in line with Hervé et al.'s model as well as other field studies of traumatic memory. This was the first study to demonstrate such variability within-subjects. Various moderating factors of memory were examined, for example, dissociation and different symptoms of posttraumatic stress. Some of the findings were at odds with traditional theories, laboratory findings, and certain assumptions held by many eyewitness memory experts regarding the relationship between stress and memory. A second objective of this dissertation was to examine predictors of post traumatic stress disorder. The findings largely confirmed the literature. Men and women did not differ in their levels of posttraumatic stress. Overall, the complexity of clinical symptoms in survivors of repeated sexual violence is highlighted. The results are discussed in terms of their implications for theory development, future research, the criminal justice system, and in terms of their relevance for treatment providers and assessors.

Posttraumatic stress disorder (PTSD) is complex and no one theory can fully explain the development and maintenance of PTSD symptoms. In Scotland, where trauma focused care initiatives are being considered, little is known about the extent of trauma history and associated symptoms presenting in primary care services. Furthermore, subthreshold posttraumatic stress disorder (sPTSD) has recently been associated with clinically significant impairment. With PTSD symptoms often comorbid with other psychopathology such as depression, individuals potentially seek treatment for these symptoms rather than underlying trauma which therefore may go unrecognised. Studies on the effectiveness of psychological treatment for PTSD demonstrate reasonable efficacy for well developed interventions. However, up to half of individuals may not make significant clinical improvements and withdrawal rates are high. This suggests that current treatments are not acceptable to some individuals and may be ineffective for others. In light of such clinical challenges the aim of the thesis was to investigate the incidence and nature of trauma symptoms in an Adult Psychological Therapies Service. Firstly, a systematic review was conducted to appraise the current level of evidence for prevalence and impairment associated with sPTSD. Secondly, an empirical study was undertaken to review the prevalence of trauma history and symptoms in the service. This was followed by an investigation of the relationships between processes posited to underpin many forms psychological distress by a promising new treatment approach called Acceptance and Commitment Therapy (ACT). These include; cognitive fusion, experiential avoidance and valued action. A quantitative cross sectional design collecting self report questionnaire data was used and mixed statistical methodology employed. Results from the systematic review suggest that PTSD was associated with the most impairment, followed by sPTSD, then no PTSD. Subthreshold PTSD was reported to be as, or more prevalent than, PTSD. The results from the empirical study found 89 per cent reported exposure to one or more traumatic events, 51 per cent met PTSD screening criteria, whilst a further 7 per cent reached a sPTSD diagnostic cut-off. Trauma history was positively correlated with increased psychological distress at initial assessment. Cognitive fusion, experiential avoidance and valued action were all correlated with trauma symptom severity. Both cognitive fusion and experiential avoidance mediated the relationship between number of traumatic events and trauma symptom severity in a simple mediation model. However, multiple mediation analysis demonstrated that experiential avoidance, over and above cognitive fusion, explained 33 per cent of the variance. In addition, cognitive fusion and experiential avoidance jointly had a significant indirect effect on the relationship between trauma history and valued action. The implications of the findings and further directions are discussed.

The central aim of the current study is to examine structural models of posttraumatic stress symptoms, as measured by the Harvard Trauma Questionnaire-Revised (HTQ-R; Mollica et al., 1992; Mollica, McDonald, Massagli, & Silove, 2004). Participants were international torture survivors who sought psychological treatment from a torture rehabilitation center in the United States. It was hypothesized that the factor structure of posttraumatic stress reactions among this heterogeneous sample of torture survivors would be consistent with the aroused intrusion model (Rasmussen, Smith, & Keller, 2007) rather than the dysphoria model (Simms, Watson, & Doebbelling, 2002). In order to evaluate model superiority, confirmatory factor analyses (CFAs) were conducted. It was also hypothesized that avoidance and numbing are two discrete factors in the aroused intrusion model. To determine whether these two constructs are distinct, convergent and discriminant validity were examined. Lastly, it was hypothesized that there is no difference in the means of the latent variable emotional numbing across culture. A one-factor ANOVA was conducted to compare means of the numbing construct between ethnic groups. The findings indicate that the dysphoria model was marginally more preferential than the aroused intrusion model (Rasmussen, Smith, and Keller, 2007; Simms, Watson, & Doebbeling, 2002). The results of a post hoc CFA support previous research, which suggests that a four-factor structure is preferred over the previously accepted three-factor model (American Psychiatric Association, 2000). The findings also suggest that emotional numbing and avoidance are two separate factors. Lastly, the ANOVA resulted in the failure to reject the null hypothesis. Future research is needed to establish model superiority for posttraumatic stress reactions among torture survivors and the generalizability of the model across cultures.