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.

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.

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]

Posttraumatic Stress Disorder (PTSD) is an anxiety disorder characterised by disturbed arousal, altered attention, and fear processing, and a reduction in the ability to perform cognitive tasks. Predominant neurophysiological models of PTSD have been focused on alterations in fear-related regulation, and few incorporate broader changes in generic executive control which may underlie many of the clinical symptoms and cognitive deficits in PTSD. This thesis aimed to investigate the neurophysiology of executive inhibitory control in PTSD using a Go/NoGo response inhibition task and converging functional imaging, structural imaging and electrophysiological measures. The first series of studies aimed to elucidate a normative neural network model of inhibitory control, and are consistent with normative control involving the activation of a mainly right-lateralised ventral lateral prefrontal cortex (VLPFC) network. Inhibitory control-related activation was found to be affected by levels of anxiety and changes in underlying neural structure; alterations in frontal cortical maturation and volume were related to additional activation of bilateral frontal cortical regions and the dorsal striatum, with anxiety increasing the demand on inhibitory control-related activation. In contrast to healthy participants, PTSD was associated with reduced inhibitory control as indexed by inhibitory behaviour, diminished activation of the right VLPFC, and slowed inhibition-related information processsing. PTSD participants relied on the greater activation of a left fronto-striatal inhibition network to support control, with the activation affected by levels of PTSD severity and comorbid anxiety. This left fronto-striatal activation in PTSD was related to underlying increases in fronto-striatal neural structure. Further, the ability to efficiently engage a left fronto-striatal network in PTSD during inhibitory control predicted better response to cognitive behavior for PTSD, consistent with the proposal that an improved ability to flexibly engage control systems may facilitate the resolution of PTSD symptoms. Taken together, this program of research extends current neurophysiological model of PTSD to show that PTSD involves a fundamental disturbance in the function and structure of key fronto-striatal response control networks associated with inhibitory control.

Doctor of Clinical Psychology/ Master of Science (DCP/ MSc) / A number of international studies reveal high prevalence rates of posttraumatic stress disorder (PTSD) within homeless populations. Recent research on PTSD indicates that cognitive responses to trauma are critical in determining who develops the disorder. In Australia, a number of studies indicate exceptionally high rates of trauma experience among homeless adults, yet PTSD has not been investigated in this cohort. Therefore, the primary aim of this project was to improve understanding of PTSD and related cognitions in a sample of homeless adults in Sydney. The project attempts to determine the prevalence of PTSD and its onset in relation to homelessness (Study One) and also explores the role of cognitions in PTSD (Study Two). The sample consisted of seventy homeless men and women aged 18 to 73 years, who were randomly sampled through eight homeless services. A computer-assisted face-to-face structured clinical interview was conducted for each participant. The majority of the sample stated that they had experienced at least one traumatic event in their lifetime (98.2%). The twelve-month prevalence of PTSD was higher among homeless adults in Sydney in comparison to the Australian general population (41.1% versus 1.5%). In 59.1% of cases, the onset of PTSD was found to have occurred before the age of the first reported homeless episode. In a comparison of those with and without a current diagnosis of PTSD, it was found that those with PTSD scored significantly higher overall on measures of posttraumatic cognitions and early maladaptive schemas. In particular, this group scored higher on schemas that centre on the world being entirely dangerous and the self being totally inept. A mediational analysis showed that when trauma and mental health care were controlled, the relationship between early maladaptive schemas and PTSD symptom severity was mediated by posttraumatic cognitions. It was concluded that homeless adults in Sydney frequently experience trauma and PTSD, which typically precedes homelessness. It was also concluded that among homeless adults, posttraumatic cognitions and early maladaptive schemas appear to play an important role in PTSD and may be associated with symptom severity. These findings have implications for public policy on homelessness and mental health, homeless service provision, PTSD theory, and PTSD treatment for homeless adults.

Posttraumatic stress disorder (PTSD) is a debilitating mental illness that affects thousands of military service members and veterans every year. Strongly associated with PTSD are symptoms of depression, life satisfaction and physical health complaints. Playing video games has been shown in the past to reduce symptoms of PTSD, other mental illnesses, and reduce the experience of pain. The purpose of this study was to examine these relationships, specifically regarding a 3-4 hour per week duration that has been particularly beneficial to military service members in the past. Participants included n = 400 military service members or veterans who had served in a combat zone and was relatively representative of the U.S. military population. Participants completed a number of measures assessing PTSD and depressive symptoms, life satisfaction, physical health, military service, and video game play behaviors. Results indicated that no relationship exists between the duration of video game play PTSD symptoms severity, unless the PTSD symptoms were present first. A linear relationship was also noted between video game play duration and depressive symptoms. No significant relationship was observed between video game play duration and life satisfaction or physical health ailments. These findings seem to contradict some of the previous literature, though may indicate that playing video games as a utilization of an avoidance strategy could be detrimental to one’s mental health.

Sexual trauma, in addition to being a human rights violation, harms people in numerous ways, including negative psychological and physical outcomes. Body-based interventions reduce sexual trauma symptoms, but limited information exists about how these interventions work. Researchers propose changes in internal body sensation awareness (i.e., interoceptive awareness; IA) as a potential mechanistic explanation. We are not aware of any studies testing that claim. Further, there is scant extant information on IA – sexual trauma relationships. Before evaluating mechanistic therapeutic hypotheses, studies need to test sexual trauma – IA associations. We focus on this understudied area here. Through a multi-method study (behavioral, self-report and qualitative data), we tested the associations between IA and sexual trauma among females. Aim 1: Characterize IA among sexual trauma survivors. We hypothesized that survivors would have significantly lower self-reported IA than existing literature. Aim 2: Quantify the amount of variance IA explains in posttraumatic stress disorder (PTSD) symptoms. We hypothesized that IA would predict significant variance in PTSD, such that increases in IA would predict increases in PTSD. We expected that an IA – dissociation symptom interaction would qualify that main effect via weakening it for survivors with higher dissociation. Aim 3: Through a moderated mediation model, test if IA mediates the sexual trauma – PTSD association. We hypothesized that IA would mediate that association. Further, we predicted that the IA – PTSD relationship would be moderated by dissociation: higher dissociation would attenuate the IA – PTSD association. In this manuscript, we report results from two samples: 1) University (n = 153), and 2) community (n = 21) participants. Given ongoing community participant recruitment, the following are university participant results. Aim 1: Self-reported IA is significantly lower among survivors than comparator samples. Aim 2: Behavioral IA explained significant variance in PTSD, though opposite to the direction we predicted: we observed that as IA increased, PTSD decreased. We observed a significant interaction between self-reported IA and dissociation in predicting declines in PTSD. PTSD symptoms were lowest among survivors with high dissociation and high IA. Aim 3: IA did not mediate the sexual trauma – PTSD association. We discuss clinical implications, limitations and future directions.