The increased intensity of modern life and the experiences in combat situations has brought on enormous stress and has led many individuals to develop posttraumatic stress disorder (PTSD). Hypnosis is one of the treatment methods available to professionals and has been proven to provide fast, reliable results in multiple studies. Despite these results, the lack of understanding of the physiological effects of hypnosis on the brain has prevented its use as a common treatment method for PTSD. By examining the differences between the effectiveness of hypnosis in military and civilian populations, the aim of this meta-analysis was to isolate the ideal personal characteristics and causes of the trauma that make hypnosis an effective treatment. The first 2 research questions compared the mean effect sizes and their ranges between the 2 populations and extracted the personality characteristics that would make treatment of PTSD by hypnosis successful based on the comparison itself and analysis of the populations from the currently available research and the biases in the studies. The final research question was aimed at comparing the success of cognitive behavioral therapy (CBT) in combination with hypnosis and the duration of the treatment method. The analyses based on the quantitative results led to the conclusion that military personnel experience a higher successful rate of treatment for PTSD through hypnotherapy combined with CBT. This suggests that hypnotherapy can be recommended for individuals who have respect toward authority and schedules. The provided guidelines were intended to increase the popularity of hypnosis, and if implemented, will produce positive social change because more people will be able to find faster, more reliable relief from PTSD, improving not only the patient's quality of life but also the quality of life of those around him.

Female veterans' combat exposure to trauma places them at risk for developing posttraumatic stress disorder (PTSD), which has consequences for healthful reintegration to family and civilian life. Previous research found that wives who provide continuous care to male veterans with PTSD experience symptoms of psychological distress; however, little research has been conducted on the influence of female veterans' PTSD on their intimate male partners' (IMPs) psychological well-being. A multivariate correlational design was used to examine the influence of female veteran PTSD on psychological distress and relationship quality in IMPs. The couples' adaption to traumatic stress model was used as the theoretical framework. The research questions examined (a) the difference between female veterans with and without PTSD on the length of time in the relationship, combat experience, the total number of deployments, and IMP psychological distress and (b) the influence of female veterans' combat experience, PTSD, and IMP psychological distress on relationship quality. A sample of 71 IMPs between the ages of 18 and 65 provided survey research data on the variables of interest. Psychological distress, number of partner deployments, and length of time in relationship discriminated significantly between IMPS whose partners were diagnosed with PTSD, not diagnosed, or did not know about the PTSD diagnosis. The regression results revealed that the psychological distress of IMPs and the number of partner deployments positively predicted relationship quality. Attention to female veterans and their families can contribute to increased retention of female service members in the Army and successful integration into family and civilian life.

The purpose of this study was to analyze the effectiveness of acceptance and commitment therapy (ACT) in a group setting for 8 weeks on the symptoms of posttraumatic stress disorder (PTSD) for women diagnosed with PTSD due to childhood trauma who have not served in the military. ACT was developed using contextualism with relational frame theory being the foundation for contextualism. Women diagnosed with PTSD due to childhood trauma were found to have higher rates of attempted suicide, higher rates of mental health disorders, as well as higher rates of medical disorders than those who were not diagnosed with PTSD. The PTSD symptoms were measured using the PTSD checklist-civilian (PCL-C). The PCL-C was completed during Session 1 and Session 8 of ACT group therapy. There was a total of 24 PCL-C score sheets utilized for this study and only the score sheets of women diagnosed with PTSD due to childhood trauma who did not have a thought disorder were included. The research design was considered a pre-experimental design and the statistical design used was ANOVA with repeated measures using subject x trials. Cohen's estimate of small effect size was used. Secondary data analysis was conducted using archival data from a community mental health agency. According to the statistical measure of the repeated ANOVA the null hypothesis was rejected as there was sufficient evidence to support that using ACT in a group setting for 8 weeks can decrease PTSD symptoms as measured by the PCL-C. This study contributes to social change by decreasing symptoms of PTSD, therefore decreasing suicidal thoughts, as well as behaviors, and lead to an increase in overall functioning and prosocial behaviors.

Bakgrund: Ambulanspersonal riskerar dagligen att exponeras för mänskligt lidande med risk för att utsättas för traumatisk stress. Mycket forskning finns om vad som är psykiskt påfrestande, men behov finns av en djupare förståelse av hur ambulanspersonalen påverkas psykologiskt av sitt arbete och vilka strategier personalen använder sig av. Syfte: Syftet med studien är att beskriva ambulanspersonalens strategier för att hantera psykiskt påfrestande situationer i sitt arbete. Metod: Deltagarna i studien valdes ut selektivt från två ambulansstationer i mellersta Sverige. Narrativa intervjuer genomfördes och analyserades genom kvalitativ innehållsanalys. Sju män och tre kvinnor, mellan 33-56 år, medverkade i studien vilka representerades av ambulanssjukvårdare, sjuksköterskor och ambulanssjuksköterskor. Resultat: Ambulanspersonalen hanterade psykiskt påfrestande situationen genom skapa en handlingsplan och på detta sätt känna kontroll över situationen. Stöd från omgivningen, från de närmaste kollegorna och familjen var viktigt för att kunna finna lugn, också att kunna reflektera på händelsen och prata om den under debriefing. Distans till händelsen krävdes ibland för att kunna få möjlighet att tänka på något annat. Slutsats: För att kunna hantera psykiskt påfrestande situationer på ett tillfredställande sätt behövdes en handlingsplan men framförallt en trygg arbetsplats samt en stark ambulansorganisation för att kunna fånga upp personer som mår psykiskt dåligt. Det var också av yttersta vikt att få tid för återhämtning. Att kunna visa sig stark och därigenom kunna hjälpa kollegor som behöver stöd var minst lika viktigt som att själv kunna visa sig sårbar för att ta emot tröst från kollegor och familj.

Inom ambulanssjukvården utsätts personalen dagligen för olika stressmoment och detta kan leda till att ambulanssjuksköterskor drabbas av posttraumatiskt stress syndrom. Flera olika stressfaktorer påverkar arbetet och därmed den enskilde ambulanssjuksköterskans psykiska och fysiska hälsa. Syftet med denna litteraturstudie är att belysa yrkesrelaterade stressfaktorer inom ambulanssjukvården och vilka copingstrategier som ambulanssjuksköterskan använder sig av i sitt dagliga arbete. Studien har en deskriptiv design och genomfördes som en litteraturstudie. Vi har använt oss av tre olika databaser, PsycINFO, PubMed och CINAHL. Vi har använt oss av 10 artiklar, 3 artiklar med kvalitativ och 7 med kvantitativ ansats. Artiklarna var från Sverige och engelsktalande länder. Resultatet visar att traumatiska incidenter som involverar barn är de jobbigaste att hantera och att stress kan inverka negativt på individens psykiska och fysiska hälsa samt att detta kan få sociala konsekvenser. Socialt stöd, kognitiva metoder samt humor är viktiga copingmetoder för att kunna hantera traumatiska incidenter.

Syftet med denna studie var att undersöka hur anhöriga upplever det när närstående befinner sig i ett allvarligt sjukdomstillstånd, samt hur sjuksköterskan upplever mötet med anhöriga och hur sjusköterskan kan påverka deras krisbearbetning. Metod: Studien genomfördes som en systematisk litteraturstudie. Vetenskapliga artiklar söktes via databaserna ELIN@Dalarna och PubMed. Artiklarna som användes var tillgängliga i fulltext, skrivna på engelska och publicerade mellan 2000-2008. Resultat: Anhöriga kan ha svårt att ta in och bearbeta den information som de fått om patientens sjukdomstillstånd. Anhöriga som upplevde att de fick otillräcklig information om patientens sjukdomstillstånd hade en ökad risk att senare utveckla PTSD. Oavsett ålder på patienter med allvarligt sjukdomstillstånd så upplever de anhöriga stress och ett behov av att få vara nära patienten. Anhöriga upplever situationer olika och är därför i olika behov av hjälp och stöd. Diskussion: För att kunna bemöta anhöriga i deras upplevelse av att ha en närstående i ett allvarligt sjukdomstillstånd, behöver sjuksköterskan mer utbildning och praktisk övning av dessa situationer för att kunna ge adekvat vård. Både patient och anhöriga behöver information och stöd för att kunna gå vidare i sin krisbearbetning.

This research was conducted in partnership with a Nova Scotain Mi’kmaq (First Nation) community that was interested in learning more about how exposure to violence (EV) might be related to youth alcohol use. There are many consequences of childhood exposure to violence (EV), but two of the more notable consequences of EV are posttraumatic stress (PTS) symptoms and excessive or problematic alcohol misuse. Given the strong relationship in the literature between each of the PTS symptom clusters and alcohol problems, it was hypothesized that these symptom clusters would mediate the relationship between EV and alcohol misuse. Study 1 demonstrated that PTS hyperarousal symptoms, but none of the other PTS symptoms, fully mediated the relationship between EV and alcohol misuse, even after controlling for depressive symptoms, age and gender. The literature on EV also demonstrates that despite its numerous potential negative consequences, some youth continue to thrive. This thriving in the face of hardship is called resilience. Study 2 employed a direct measure of resilience (Child and Youth Resilience Measure; Ungar et al, 2008) to examine which if any aspects of resilience can successfully buffer youth from experiencing negative mental health consequences after EV. Study 2 demonstrated that all three aspects of resilience (i.e., individual, family, and community) moderated the relationship between EV and PTS reexperiencing symptoms. More specifically, at higher levels of resilience, the positive relationship between EV and PTS reexperiencing symptoms was dampened. Study 3 documented the collaborative-research process from beginning (i.e., research question formation) to end (i.e., implementation of action-based recommendations). It highlighted how the research questions outlined in Studies 1 and 2 were relevant to both the specific community in question, as well as some Aboriginal communities more broadly. It also highlighted how the first author participated in a research process that is described by the Canadian Institutes of Health Research (CIHR) as Integrated Knowledge Translation (KT). And finally, it identified via qualitative and quantitative methods how the research process as a whole has helped equip the community with more tools to tackle the problems that its members have identified as important for study and change.

No description available.

The first aim of this thesis was to describe the characteristics of Posttraumatic Stress Disorder (PTSD) and to elucidate its place as a symptom disorder that sometimes develops when people are exposed to a traumatic event. The current major theoretical approaches to account for why some people who are exposed to trauma develop PTSD and the mechanisms by which this occurs were described. Three classes of theories were reviewed: conditioning/learning approach; information processing theories with a particular focus on the meaning of the trauma event; and biological models with an emphasis on recent neurocircuitry and neurochemistry models. Successful treatment approaches were then reviewed which indicated two major contenders for the most efficacious treatment for PTSD: traditional cognitive behaviour therapies (CBT) using either stress inoculation or prolonged exposure; and eye movement desensitisation and processing (EMDR). Prior to the first study (Lee, Gavriel, Drummond, Richards, & Greenwald, 2002), a review of the literature indicated equivalent effects for EMDR and CBT. There had been very few direct comparison studies and each had serious methodological flaws, particularly with respect to random assignment and treatment fidelity. Therefore, the first study ensured adequate attention to these areas and involved a direct comparison between the two procedures using a sample of 24 participants diagnosed with PTSD. EMDR and stress inoculation training with prolonged exposure were found to lead to similar symptom improvement at the end of treatment, apart from a slight advantage for EMDR on intrusion symptoms. Both treatments led to significantly greater symptom reduction than a wait list control condition. At follow-up, EMDR led to greater gains on both self-report and observer rated measures of PTSD and self-report measures of depression. Overall, the findings were similar to those described in previously published studies, with a suggestion that EMDR was slightly more efficient than the standard CBT approach. Given that the evidence suggested that EMDR was a more efficient treatment, it became critical to understand the underlying processes. A process study was undertaken that examined the responses of people with PTSD receiving EMDR treatment (Lee, Taylor, and Drummond, 2006). Guided by process studies of other treatments and theories that might account for why EMDR is effective, participants’ responses were examined to see which models better accounted for symptom improvement. The main analysis tested whether or not the responses were consistent with processes that occurred during traditional CBT treatment, which prior research had identified as reliving, or whether they were more consistent with Shapiro’s proposal that enhanced information processing occurs because there is a dual focus of attention (that is, the person simultaneously focuses on an external stimulus and on the traumatic memory) (Shapiro, 1995). The responses made by 44 participants were coded by an independent rater according to whether they were primarily reliving, distancing, affect or material other than the primary trauma. The coding system was found to have satisfactory inter-rater reliability. Greatest improvement occurred when the participant processed in a more detached or distant manner, whereas reliving responses were not associated with improvement. Cross-lagged panel correlations suggested that processing in a more detached manner was a consequence of the EMDR procedure rather than a measure that co-varied with improvement. The findings underscored a difference in the processes that underlie EMDR and traditional CBT. The major question left unanswered from this second study was what causes this distancing process? Competing views were that it was facilitated by eye movement; alternatively, the therapist’s instructions to participants might have precipitated this distancing phenomenon. The third study tested these ideas by randomly assigning 48 participants to either an eye movement or a no eye movement condition under two types of therapist instructions (reliving or distancing). Participants recalled personal distressing memories, and measures of distress and vividness were taken after treatment and at follow up. Only the eye movements made a significant difference to people’s level of distress. This conclusion appeared at odds with some of the previous literature that had tested the effects of eye movement on levels of distress. A meta-analysis of some of this research had suggested that there was no significant advantage of including eye movement in EMDR treatment unless the person had been diagnosed with PTSD. However, a close examination of this meta-analysis indicated some major methodological flaws in the computation; therefore, this was recalculated. The conclusion from this fourth study was consistent with study three in that EMDR with eye movement was found to lead to significantly greater improvement that EMDR without eye movement. The results of these four studies were then discussed in terms of their implications for the theoretical models presented in Chapter 1. Aspects of learning theory that might account for EMDR efficiency were discussed as well as the failure of this model to account for treatment gains following EMDR. Information processing models were seen to better account for some of the phenomena observed in EMDR and for the findings from the four studies. Some suggestions of how eye movements might facilitate improved information processing were presented. Finally, the relative merits of EMDR and CBT treatments were discussed and suggestions made for when to combine approaches. The conclusions highlight the point that EMDR appears to be the most promising treatment for PTSD.

<p>Inom ambulanssjukvården utsätts personalen dagligen för olika stressmoment och detta kan leda till att ambulanssjuksköterskor drabbas av posttraumatiskt stress syndrom. Flera olika stressfaktorer påverkar arbetet och därmed den enskilde ambulanssjuksköterskans psykiska och fysiska hälsa. Syftet med denna litteraturstudie är att belysa yrkesrelaterade stressfaktorer inom ambulanssjukvården och vilka copingstrategier som ambulanssjuksköterskan använder sig av i sitt dagliga arbete. Studien har en deskriptiv design och genomfördes som en litteraturstudie. Vi har använt oss av tre olika databaser, PsycINFO, PubMed och CINAHL. Vi har använt oss av 10 artiklar, 3 artiklar med kvalitativ och 7 med kvantitativ ansats. Artiklarna var från Sverige och engelsktalande länder. Resultatet visar att traumatiska incidenter som involverar barn är de jobbigaste att hantera och att stress kan inverka negativt på individens psykiska och fysiska hälsa samt att detta kan få sociala konsekvenser.</p><p>Socialt stöd, kognitiva metoder samt humor är viktiga copingmetoder för att kunna hantera traumatiska incidenter.</p>