Background Posttraumatic stress disorder (PTSD) brings with it diagnostic symptoms that can be debilitating and persist for years. Left untreated, PTSD can have far-reaching and damaging consequences – for the individual, families, communities, and society at large. While early detection and intervention is recognized as key to the effective treatment of PTSD, many who suffer from PTSD do not seek essential health services. The aim of this study was to answer the research question: based on existing literature, what are the barriers and facilitators to help-seeking for individuals with PTSD? Methods A systematic review, modeled on the Joanna Briggs Institute (JBI) methodology for systematic reviews, examined studies cited in PsycINFO, Medline, Embase, CINAHL and PILOTS published from January 2000 to November 2015. Eligible studies measured barriers and facilitators to help-seeking for adults with PTSD. Two reviewers independently screened citations and double data extraction was exercised. Results Of 1,759 potentially relevant citations, sixteen studies were included, published between 2003 and 2015 and based in five countries, predominantly within the United States (n=12). Thirteen studies focused on military as a target population. Eight principal barrier themes and seven principal facilitator themes were identified, under which supportive subthemes were categorized. Conclusions In identifying prominent barriers and facilitators to help-seeking for individuals with PTSD, this review highlights opportunities to inform policies and programs that educate and promote PTSD knowledge and recognition, reduce public and personal stigma, improve access and availability of care, and encourage social support for patients and families living with PTSD.

Human immunodeficiency virus (HIV) is a virus that affects the body’s immune system (Centers for Disease Control [CDC], 2016a). HIV is a worldwide epidemic and disproportionately impacts youth in the United States. Youth living with HIV (YLWH) face significant mental health problems, namely depression, anxiety, and posttraumatic stress disorder (PTSD) with rates of these disorders discrepant from those in the general population. In addition to psychological difficulties, health literacy is another factor that influences individuals with HIV and is a priority of research with adolescents (Kalichman et al., 2000; Manganello, 2008). The National HIV/AIDS Strategy: Update 2020 (White House Office of National AIDS Policy, 2015) identified youth, ages 13 to 24 years, as a key population needing broad support not only for HIV prevention but also engagement in care including improving mental health and health literacy. The current study explored the extent to which YLWH were health literate in addition to the extent to which they exhibited psychological symptoms of depression, anxiety, and posttraumatic stress disorder. Furthermore, the study examined the extent to which health literacy and psychological symptoms were associated with health outcomes. A total of 145 YLWH between the ages of 13 and 25 years participated in the study. Participants completed the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977), Generalized Anxiety Disorder-7 Item Scale (GAD-7; Spitzer, Kroenke, Williams, & Lowe, 2006), Primary Care-PTSD Screen (PC-PTSD; Prins et al., 2003), and Brief Estimate of Health Knowledge and Action-HIV Version (Osborn, Davis, Bailey, & Wolf, 2010). Of the 145 participants, 103 completed the CES-D, 144 completed the GAD-7, 131 completed the PC-PTSD, and 102 completed the BEHKA-HIV. In addition, participants’ biological markers of immune functioning (i.e., CD4 count and viral load) were obtained from medical abstraction. Results indicated the sample reported high levels of symptoms of depression, anxiety, and PTSD. Thirty-five percent of participants screened positive for depressive symptoms, 26% screened positive for anxiety symptoms, and 21% screened positive for PTSD symptoms. Participants had a moderate amount of HIV knowledge and the majority reported taking their medications under most conditions. Age was a significant predictor of CD4 count and viral load such that increasing age was associated with worse immune system functioning. Educational attainment was a significant predictor of CD4 count and to a lesser extent viral load indicating that greater education was associated with better immune system functioning. There was an interaction between mode of transmission and psychological symptoms. For perinatally infected youth, greater psychological symptoms were associated with a decline in CD4 count. The same decline was not seen for behaviorally infected youth. Health literacy (knowledge and action) added significantly to the explanation of the variance in viral load. Decreasing action scores were statistically associated with an increased likelihood of having a detectable viral load. These findings point to the need for prevention and intervention mental health services for YLWH. Future research should determine prevention and intervention strategies for mental health issues with YLWH in particular. Additionally, health literacy is an important factor that should be addressed by practitioners working with YLWH. More research needs to be conducted to determine the best way to measure health literacy in YLWH and how to intervene with improving health literacy.

Magister Psychologiae - MPsych / Significant research efforts have focused on developing treatments for trauma survivors and evaluating their effectiveness. However, little attention has been given to understanding the impact of working with trauma survivors on psychologists. This research aimed to address this gap in the literature. In South Africa, there is a scarcity of published qualitative studies that focus on the experiences of VT among psychologists who work with survivors of trauma. Given the increasing prevalence of traumatic events in South Africa and increasing patient load, psychologists may be vulnerable to the development of VT. Beneficial treatments for trauma survivors largely depend on psychologists who can effectively handle their clients' intense traumatic material. If a psychologist is adversely affected by the work of trauma, the quality of treatment for trauma survivors will be compromised (Figley, 1999). Hence, it is critical that research continues to explore the effects of VT and ways to ameliorate them. Aim: to explore the experiences of VT among a group of psychologists from Cape Town, South Africa, who work with trauma survivors and the related coping strategies used by them. This research aimed to expand the local research on the phenomenon of VT. Findings of the study will help to facilitate a better understanding of vicarious impact of trauma work as well as the related coping techniques used by psychologists. Identification of protective factors and effective coping mechanisms of those professionals in this study was a distinct contribution to the South African literature base. This study has practical implications for training, supervision and clinical practice for psychologists in South Africa to enhance the efficiency of psychological service delivery. Exploring the challenges South African psychologists experience as a result of working with trauma survivors may help inform policy and develop effective programmes to address the effects of VT. As such, psychologists would be better equipped to care both for themselves and their clients, and to ensure ethical and professional practice.

The cross-cultural applicability of the PTSD diagnosis has been widely disputed in recent years. Consequently, an examination of the psychometric properties of instruments that are used to assess traumatized individuals of various cultures is of utmost importance. To respond to this need, the overall goal of this dissertation was to evaluate the psychometric properties of the Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992), a measure that was developed to assess trauma symptoms across cultures. In the first study, I conducted a search of all publications and dissertations that used the symptoms scales of the HTQ. This search revealed that the HTQ is commonly used by trauma researchers, however only a minority of them reported using established translation and cultural adaptation procedures to adapt the instrument for their specific sample. In addition, of the 384 studies considered for inclusion, only 44% of them reported internal consistency estimates of their sample. I then performed reliability generalization analyses on Cronbach’s alpha coefficients to assess the reliability properties of the HTQ symptom scales. Overall, 103 samples were included in the analyses, representing various cultures, languages and countries of study. The findings of this study indicated that both the HTQ-16 and 30 symptom scales are likely to provide reliable scores across diverse populations. However, the evidence supporting the reliability of scores produced for the re-experiencing, avoidance/numbing and arousal subscales is less strong. Significant moderating effects were found for various sample and methodological variables, such as the gender composition of the sample, cultural group, cultural orientation of the country of origin and trauma type. Building upon the findings of study 1, I performed validity generalization (VG) analyses to assess the overall construct validity of the HTQ symptom scales in Study 2. Seventy-five independent samples were included in the VG that evaluated the convergent and discriminant validity properties of both the HTQ-16 and HTQ-30. The findings revealed that the convergent validity properties of the HTQ-16 are supported to some extent, but the discriminant validity properties are not. Furthermore, there was limited support for either the convergent or discriminant validity of the HTQ-30. Several significant moderating effects were also found for both scales (i.e. age, gender, cultural group, recruitment site, trauma type, being an original sample). Although these studies shed some light into the overall psychometric strength of the HTQ symptom scales, the decision whether to use this instrument for the assessment of PTSD should also be guided by evidence-based assessment guidelines.

Research findings across a variety of samples (e.g., clinical, shelter, hospital) estimate that 31% to 84% of women who have experienced intimate partner violence (IPV) exhibit symptoms of posttraumatic stress disorder (PTSD). The current study sought to further investigate the abuse-trauma link by examining the relationship between lifetime trauma exposure, type of abuse (i.e., physical, psychological), and perspective-taking abilities (i.e., here-there, now-then). The role of experiential avoidance in the development of PTSD symptoms was also examined. Results indicated that lifetime trauma exposure (β = .31) and psychological abuse (β = .34) were significant predictors of PTSD symptomatology. Additionally, analyses revealed that experiential avoidance (β = .65) was a significant predictor of PTSD symptoms that partially mediated the relationship between IPV and PTSD symptomatology. Implications of findings are discussed as well as future suggestions for research examining type of IPV and PTSD.

abstract: With the rise of Posttraumatic Stress Disorder (PTSD) among adults in the United States, understanding the processes of trauma, trauma related disorders, and the long-term impact of living with them is an area of continued focus for researchers. This is especially a concern in the case of current and former military service members (veterans), whose work activities and deployment cycles place them at an increased risk of exposure to trauma-inducing experiences but who have a low rate of self-referral to healthcare professionals. There is thus an urgent need for developing procedures for early diagnosis and treatment. The present study examines how the tools and findings of the field of linguistics may contribute to the field of trauma research. Previous research has shown that cognition and language production are closely linked. This study focuses on the role of prosody in PTSD and pilots a procedure for the data collection and analysis. Data consist of monologic talk from a sample of student-veterans and analyzed with speech software (Praat) for pauses greater than 250 milliseconds per 100 words. The pause frequency was compared to a PCL-5 score, an assessment used to check for PTSD symptoms and evaluate need for further assessment and possible diagnosis of PTSD. This pilot study found the methods successfully elicited data that could be used to measure and test the research questions. Although the findings of the study were inconclusive due to limitations of the participant pool, it found that the research model proved effect as a model for future linguistic research on trauma. / Dissertation/Thesis / Masters Thesis English 2020

No description available.

Background: Physiological changes during pregnancy are often accompanied by reduced sleep quality, sleep disruptions, and insomnia. Studies conducted among men and non-pregnant women have documented psychiatric disorders as common comorbidities of insomnia and other sleep disorders. However, no previous study has examined the association between stress-related sleep disturbances and psychiatric disorders among pregnant women. Methods: This cross-sectional study included a total of 2051 pregnant women in Peru. The Spanish-language version of the Ford Insomnia Response to Stress Test (FIRST-S) was used to assess sleep disruptions due to stressful situations. Symptoms of antepartum depression, generalized anxiety disorder, and posttraumatic stress disorder (PTSD) were examined using the Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7 and PTSD Checklist – Civilian Version, respectively. High risk for psychosis was assessed using the Prodromal Questionnaire. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CI). Results: Stress-related sleep disturbance was reported by 33.2% of women. Of all women, 24.9% had antepartum depression, 32.2% had generalized anxiety disorder, 30.9% had PTSD, and 27.6% were assessed as having a high risk of psychosis. After adjusting for confounders, women with stress-related sleep disturbances were more likely to experience antepartum depression (OR = 2.74; 95%CI: 2.22–3.38), generalized anxiety disorder (OR = 2.48; 95%CI: 2.04–3.02), PTSD (OR = 2.36; 95%CI: 1.93–2.88), and high risk for psychosis (OR = 2.07; 95%CI: 1.69–2.54) as compared to women without stress-related sleep disturbances. Conclusions: Stress-related sleep disturbances during pregnancy are associated with increased odds of psychiatric disorders. Inquiring about stress related sleep disturbances during antenatal care may be beneficial for identifying and caring for women at high risk of psychiatric disorders. / Revisión por pares

This study examined the potentially differing emotional consequences of sexual versus non-sexual traumas in both a student and a community residing treatment seeking sample of women. The extent to which a trauma survivor considers the traumatic event central to her identity (CES) was examined as a potential mediator between traumatic events and PTSD. Additionally, the extent to which a women views herself and her body as a sexual object, to be valued based on her appearance and sexual usefulness to others (sexual self-objectification: OBCS), was examined as a potential mediator between traumatic event and event centrality. Study results showed survivors of sexual assault reported greater CES and PTSD symptoms (PCL-S) than non-sexual trauma survivors in the student population. Mediation results showed sexual self-objectification (OBCS-Shame) significantly mediated the relationship between trauma type and CES, and CES significantly mediated the relationship between type of trauma and PTSD symptoms in the student population only. Data from the community sample did not support these conclusions as women from this sample reported higher PCL-S, CES, and OBCS-Shame scores across categories of trauma.

Includes bibliographical references / Objective: The main aim of this thesis is to analyze data from the South African Stress and Health (SASH) study and , for the first time, generate information on the epidemiology of traumatic event s (TEs) and posttraumatic stress disorder (PTSD), and on the association of TEs with other psychopathological and physical health outcomes. Methods: A literature review was done to provide information current knowledge in the field. Cross - tabulations, Chi - squared tests and logistic regression analyses were then conducted SASH data to determine the prevalence of the different types of trauma and PTSD and the associations between the sociodemographic variables and TEs and PTSD on the one hand, and TEs and PTSD, other psychopathology and chronic physical conditions on the other . Results: The most common traumatic events were the unexpected death of a loved one and witnessing trauma. Lifetime prevalence of PTSD was 2.3%, and the conditional prevalence of PTSD after trauma exposure was 3.5%. PTSD conditional risk and burden were both highest for witnessing trauma. Witnessing trauma was commonest among males and those with low - average education. There was statistically significant association between witnessing and PTSD, mood, and anxiety disorders. Exposure to any TE significantly increased the odds of all the physical conditions, and the odds of having a physical condition were directly related to the number of lifetime traumatic events. Sexual violence and unexpected death of a loved one significantly increased the odds of all the e physical conditions assessed, while war events were only associated with respiratory conditions. Apart from war events, accidents and witnessing trauma were associated with the fewest physical conditions. Conclusions: Consistent with the literature, trauma and PTSD in South Africa are not distributed according to the socio - demographic factors or trauma types observed in other countries. Witnessing trauma is common in South Africa and increases the risk of mood and anxiety disorders. Finally, TE exposure is associated with chronic physical conditions in a dose - response manner. Trauma interventions must therefore focus also on those not directly affected, and routine evaluation for chronic physical conditions is recommended for survivors of all trauma.