Posttraumatiskt stressyndrom (PTSD) kännetecknas av tre huvudsymptom: undvikande, förnekande och hyperspändhet. Även koncentrationssvårigheter, ångest, depression, flashbacks och mardrömmar är vanligt förekommande hos individer med PTSD. Flyktingar i Sverige som har varit med om krig kan uppvisa dessa symptom. Syftet med denna studie är att undersöka terapeuters upplevelser av arbete med patienter med krigsrelaterat PTSD. Intervjuer med åtta terapeuter utfördes. Gemensamma mönster i deltagarnas svar var att det är fördelaktigt att skapa en bra relation till patienter. Det är viktigt att prata om krigstrauma och de som får behandling mår bättre. Patienter är präglade av sorg och skuld och det är viktigt för dem att känna tillit och trygghet. Kropp och själ hänger ihop och det är olika och beroende på många faktorer hur individer drabbas av krig. Ofta är det andra svåra upplevelser som förvärrar krigstrauma. Terapeuter upplever sitt arbete som roligt samtidigt som tungt och anser att det är viktigt med teamarbete.

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.

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.

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.

Thesis (Ph.D.)--Kent State University, 2008. / Title from PDF t.p. (viewed Sept. 28, 2009). Advisor: Stan Wearden. Keywords: journalism; trauma; broadcasting; reporting; television; posttraumatic stress; compassion fatigue. Includes bibliographical references (p. 164-184).

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 140-151). Available also in a digital version from Dissertation Abstracts.

The experience of psychosis (e.g. threatening symptoms such as persecutory delusion and terrifying hallucinations) and its treatment (e.g. coercive measures such as involuntary admission and seclusion) are distressing. In view of the potential severity of the distress associated with psychosis, previous research has applied the trauma model to understand the experience of psychosis and its treatment and found that 11-67% of psychotic patients presented with clinically significant PTSD reactions in response to their psychosis and treatment experience. This phenomenon is termed as post-psychotic PTSD (PP-PTSD). However, previous research generally failed to find consistent relationship between PP-PTSD reactions and objective psychotic and treatment experiences (except for positive psychotic symptoms). Cognitive conceptualization of PTSD opines that it is the cognitive appraisal of the traumatic event, rather than the trauma per se, that is related to the development of PTSD. The present study aims to contribute to a better understand of PP-PTSD through a cognitive perspective. The present study applies Ehlers and Clark’s cognitive model of PTSD in understanding PP-PTSD. It explores the roles of fear of relapse and perceived risk of relapse, attribution of the causes of psychosis, perceived stigma and rejection and perceived consequence of the psychotic illness in PP-PTSD. The present study was a cross-sectional study and recruited 38 patients with schizophrenia-spectrum disorders. Semi-structured interview was used to determine whether the patients met the PP-PTSD diagnosis. The patient’s positive psychotic symptoms and social and occupational functioning were assessed by semi-structured interview while their PP-PTSD symptoms, trauma history and cognitive appraisals were measured using self-report questionnaires. Results showed that 15.8% of patients meet the full criteria of PP-PTSD and more than 50% of patients demonstrated some PP-PTSD reactions, which provides support for the application of the PP-PTSD construct in the local context. Treatment experiences were found to induce more severe PP-PTSD reactions than psychotic experience. Cognitive appraisals were found to be associated with PP-PTSD and there was some support for the application of Ehlers and Clark’s model in PP-PTSD. Specially, the present study found that fear of relapse, higher perceived risk of relapse, perceived helplessness and self-blame of causing the onset of psychosis, stable attribution of the cause of psychosis onset, perceived stigma, perceived large and chronic consequence of psychosis were all associated with more severe PP-PTSD reactions. Fear of relapse was also found to predict PP-PTSD severity. Clinical implications on the prevention, assessment and treatment with reference to the present results are discussed. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

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The long-term psychological effects of surviving a major disaster are poorly understood. A survey of survivors of the Piper Alpha oil platform disaster (1988) was undertaken to examine the role of factors relating to: the trauma; the survivors, and the survivors’ circumstances in relation to long-term outcome. Methods: Ten years after the disaster 78% (46/59) of the survivors were located, and, of these, 72% (33/46) agreed to be participate in a study conducted by questionnaire, diagnostic interview and semi-structured interview. In total, 61% of all survivors participated in this study. A further three individuals (7%) completed postal self-report measures. Results: High levels of physical disorder, general psychopathology and post-traumatic symptoms were reported. Twenty one percent (7/33) of the survivors who participated in the study still met the most stringent diagnostic criteria for PTSD over 10 years after the disaster; 73% met the same rule within three months of the disaster. Features such as physical injury, personal exposure to certain stressors during the trauma, survivor guilt, anger and employment difficulties were significantly correlated with long-term general and specific post-traumatic psychopathology and with social and occupational function. Features of the legal proceedings were also associated with long-term outcome. Whilst the media was experienced as intrusive, no statistically significant associations with long-term outcome were found. Treatment was generally accessible to participating survivors (97%) with non-professional help (82%) and outreach (69%; 25/36) widely used. Although many difficulties were experienced 61% of participants could identify some positive outcomes from the experience. Discussion: This study emphasises the need to consider a broad range of factors affecting outcome including the individual’s experience during a traumatic event, pre-existing stressors and factors relating to the response to the disaster and their environment. High rates of help-seeking were found to co-exist with high symptoms levels and this may relate to treatment effectiveness or failure to apply appropriate treatment in disaster populations. Attention to issues such as employment difficulties and compensation processes may improve survivor well-being in the long-term after disasters. Conclusions: This long-term follow-up of survivors of a major disaster has confirmed that the impact of a disaster is durable and extensive with psychological services required over prolonged periods.

This report examines the state of research regarding the psychological impact of war on American soldiers deployed in military operations in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom). Particular focus is given to examination of marital and relationship satisfaction within the Hispanic soldier and veteran population. A wide range of research examines the traumatic aftereffects of wartime service with predominant themes of posttraumatic stress, depression, anxiety, and substance abuse appearing across the literature. Examination of the Hispanic population is disputed with researchers producing conflicting findings: some researchers have indicated an increased risk of psychological disturbances in Hispanic wartime veterans while other have found no such difference between the Hispanic and majority groups. Attempts to explain these discrepant results have ranged from differences in acculturation, to potentially increased traumatic exposure, or to underlying feelings of persecution and alienation. However, consistent results were found in regards to the negative relationship between traumatic exposure and romantic relationship satisfaction. Younger males of lower socioeconomic status with increased trauma exposure and comorbid mental health diagnoses consistently reported less relationship satisfaction than their peers. Given the nature of family and the importance of close relationships within the Hispanic culture, it is increasingly necessary for clinicians working with Hispanic veterans to be aware of these findings. This author purposes that future researchers explore this concept of relationship satisfaction within the Hispanic veteran population with attention given to potentially mediating variables such as level of acculturation and traumatic experience exposure. / text