A preliminary study of group intervention along with basic canine training among traumatized teenagers: A 3-month longitudinal study

The current study aimed to reduce the psychological distress of teenage girls who were exposed to traumatic event (physical or sexual abused), through using dogs-assisted therapy. Two sets of designs conducted: 1) longitudinal design which aims to answer the question: does dog assisted therapy will reduce psychological distress (namely depressive symptoms, post-traumatic symptoms), improve self confidence and subjective well being among these teenage girls? 2) Cross-sectional design that aims to compare the treatment group (dogs-assisted therapy) with comparison group at baseline and after the last session. The groups (intervention vs. matching) were compared on socio-demographic variables (only for time 1), subjective well-being, coping with stressful life events, PTSD symptoms, and depressive symptoms at base line (time 1) and at the end of the intervention (time 2). Findings from the longitudinal perspective have shown a rapid decline at the level of PTSD symptoms in the intervention group, along with significant reduction in the proportion of participants with elevated risk for PTSD. The main significant findings from the cross-sectional design were: lower level of subjective well-being, higher level of PTSD symptoms and depressive symptoms among the intervention group compared to the matching group at base line. However, these differences became non-significant at the end of the intervention. Various explanations for these findings are discussed.     

Differentiation of the Self and Posttraumatic Symptomatology Among ex-POWs and Their Wives

War captivity is a highly traumatic experience which sometimes has deleterious effects on both ex-POWs and their wives. This study examined the relationships between posttraumatic stress disorder (PTSD) symptoms and differentiation among male ex-prisoners of war (ex-POWs; n  = 103), their wives ( n  = 82), and comparable controls. Results show that ex-POWs and their wives endorsed more PTSD symptoms than controls. Ex-POWs endorsed more cut-off and fusion than controls, while their wives endorsed only more fusion than control wives. Finally, the relationship between differentiation and PTSD was found to be stronger among ex-POW couples than among control couples. The unique characteristics of war captivity and the relationships between avoidance symptoms and cut-off were suggested as possible explanations .     

Changes in parenting behaviors, attachment, depressive symptoms, and suicidal ideation in attachment-based family therapy for depressive and suicidal adolescents

This study examined whether Attachment-Based Family Therapy (ABFT) was associated with decreases in maternal psychological control and increases in maternal psychological autonomy granting, and whether such changes were associated with changes in adolescents' attachment schema and psychological symptoms. Eighteen suicidal adolescents and their mothers received 12 weeks of ABFT. Maternal psychological control and autonomy granting behaviors were observationally coded at sessions 1 and 4. Adolescents' reports of perceived maternal care and control, attachment-related anxiety and avoidance, and depressive symptoms and suicidal ideation were collected at baseline, 6, 12 weeks (posttreatment), and 36 weeks. Results indicated that from session 1 to session 4, maternal psychological control decreased and maternal psychological autonomy granting increased. Increases in maternal autonomy granting were associated with increases in adolescents' perceived parental care from pre to mid-treatment and decreases in attachment-related anxiety and avoidance from pre to 3 months posttreatment. Finally, decreases in adolescents' perceived parental control during the treatment were associated with reductions in adolescents' depressive symptoms from pretreatment to 12 weeks posttreatment. This is the first study examining the putative change mechanisms in ABFT.     

Incidence and correlates of posttrauma symptoms in children from backgrounds of domestic violence

In recent years, evidence has emerged of the presence of posttrauma symptoms in children from backgrounds of domestic violence. The present study examined the incidence and correlates of posttrauma symptoms in 56 children of mothers who had been residents in women's shelters in Adelaide, South Australia. The most frequently endorsed symptoms among this sample of children were being troubled by distressing thoughts, conscious avoidance, hypervigilance, and sleep difficulties. Twenty percent of children met the criteria for a diagnosis of posttraumatic stress disorder (PTSD). Children meeting full PTSD criteria scored significantly higher on measures of anxiety, depression, and dissociation. Results support the use of a posttrauma framework for understanding the effects on children of living with domestic violence.     

Experiences of student veterans with social anxiety and avoidance: A qualitative study

Eight-to-ten percent of returning combat veterans report symptoms of Posttraumatic Stress Disorder (PTSD), of which 7–13% also report symptoms of Social Anxiety Disorder. Both disorders are characterized by maladaptive patterns of social functioning, which can have significant effects on the lives of returning combat veterans and increase suicidal risk. The objective of the present study was to identify elements of the lived experience of college student veterans experiencing social anxiety and avoidance. Twelve student veterans with post-9/11 active duty service were interviewed about their lived experiences with social anxiety/avoidance within the framework of phenomenological theory. Data was analyzed using multilevel coding and theme analysis. Analysis of interview themes (n = 12) clarified university campus environments that induce social anxiety/avoidance and the impact on personal and professional relationships, learning, and navigation of physical space. Implications of this study include addressing student veterans’ needs through clinical intervention and further representative research on prevalence rates of these risk factors in various university and community college settings.     

Changes in Relationship‐Specific Attachment in Emotionally Focused Couple Therapy

Emotionally focused couple therapy (EFT; Johnson, The practice of emotionally focused couple therapy (1st/2nd edition). Brunner‐Routledge, New York, 2004) is an effective treatment of relationship distress (Johnson et al., Clinical Psychology: Science and Practice, 1999; 6, 67). However, less is known about EFT's impact on couples' relationship‐specific attachment bond. Using hierarchical linear modeling with a sample of 32 couples, we examined session‐by‐session changes in couples' relationship‐specific attachment anxiety and avoidance and pre‐ to posttherapy changes in their relationship‐specific attachment behaviors. Couples significantly decreased in relationship‐specific attachment avoidance, and those who completed a blamer softening significantly decreased in relationship‐specific attachment anxiety. Couples' attachment behavior significantly increased toward security. Finally, session‐by‐session decreases in relationship‐specific attachment anxiety and avoidance were significant associated with increases in relationship satisfaction across sessions. These results provide empirical support for the attachment‐based assumptions of EFT. Video abstract accessible by clicking here     

Acute stress reactions to everyday stressful life events among sexual abuse survivors with PTSD

This study examined symptoms of Acute Stress Disorder (ASD), which is often thought of as a precursor to PTSD, among 54 women who already had PTSD for childhood sexual abuse for which they were seeking treatment. We examined the prevalence of ASD symptoms as well as their relationships to trauma symptoms measured by the Trauma Symptom Checklist-40. The ASD diagnosis requires the occurrence of a traumatic life event as well as meeting specific symptoms criteria. We found that fourty-four percent of participants met all symptom criteria for ASD, but only three of these 24 participants described a traumatic life event. Moreover, ASD symptoms were significantly related to trauma symptom scores. These findings suggest that a significant proportion of women with PTSD for childhood sexual abuse may be highly symptomatic for everyday stressful events that would not be experienced as traumatizing to others. Thus, these individuals need assistance in coping with everyday life stressors that do not involve a serious threat or injury in addition to needing help to alleviate their trauma symptoms.     

Event-related clinical distress in college students: Responses to the 2016 U.S. Presidential election

Abstract

Objectives: College students have cited the 2016?U.S. presidential election as a significant source of stress. The current study examined the prevalence and demographic correlates of clinically significant election-related avoidance and intrusion symptoms among college students 2–3?months after the election. Participants: College students attending a large public university (N?=?769; M_age?=?19.19; 48.2% female; 58.4% White) were surveyed in January and February 2017. Methods: Participants completed a validated measure of clinically significant event-related distress symptoms (eg, intrusive thoughts, avoidance) and demographic questions. Results: One out of four students met criteria for clinically significant symptoms related to the election. Regression analyses suggested that sex, political party, religion, and perceived impact of the election on relationships were more useful predictors of stress symptoms than race or social class. Conclusions: The high level of event-related distress is concerning because elevated symptoms of event-related stress are predictive of future distress and subsequent PTSD diagnoses.     

Prevalence and predictors of PTSD among a college sample

Objective:This study examined the prevalence and correlates of probable posttraumatic stress disorder (PTSD) in freshman entering college and prospective associations of probable PTSD with additional outcomes. Participants: 2,310 students with data collected from Fall 2014 through Spring 2015. Methods: Incoming freshman completed a survey assessing for relevant variables at the beginning of fall semester and during the spring semester. Results: Seventy percent of the sample endorsed experiencing at least one potentially traumatic event (PTE). 34.4% of PTE exposed individuals met criteria for probable PTSD. Female sex, higher depressive and anxiety symptoms, and interpersonal PTE count were positively associated with PTSD symptoms. Higher PTSD symptoms were associated with higher anxiety and depressive symptoms, and new-onset interpersonal PTE. Conclusions: Identification of factors contributing to risk for PTSD is essential to inform prevention and intervention efforts. Intervention efforts should be targeted to students experiencing PTSD symptoms as they enter college.     

Social skills of adopted Chinese girls at home and in school: Parent and teacher ratings

This study examines adopted Chinese girls' social skills at home and in school as well as the effect of pre-adoption adversity on these skills. Parent ratings of 869 girls and teacher ratings of 611 of the 869 girls were obtained using the Social Skills Rating System for parent (SSRS-P) and teacher (SSRS-T) respectively. The girls were adopted on average at 15.6 months (SD = 13.9) and were in three age groups, including preschool, elementary school, and secondary school. Data on five indicators of pre-adoption adversity (i.e., signs/symptoms, delays at adoption, initial refusal/avoidance of adoptive mothers, crying/clinging behaviors, and age at adoption) were obtained from the same adoptive parents 2 years prior. Findings suggest that both parents and teachers rated the girls as either similar to or better than US norms on the SSRS. Parent–teacher agreement on SSRS subscales was significant but modest (rs = 0.12–0.25). Two indicators of pre-adoption adversity (i.e., delays at adoption and initial refusal/avoidance of adoptive mothers) predicted poorer social skills at home; two other indicators of pre-adoption adversity (i.e., signs/symptoms and age at adoption) predicted poorer social skills in school.     

Intimate partner violence and PTSD: the moderating role of emotion-focused coping

Intimate partner violence (IPV) affects millions of women every year, often resulting in posttraumatic stress disorder (PTSD). The strength of the relationship between IPV and PTSD has been shown to be affected by factors such as the amount of violence exposure and the style of coping in which the individual engages. For example, emotion-focused coping has been shown to be strongly related to IPV exposure and the expression of PTSD symptoms. This topic was explored in IPV survivors, with the finding that more frequent use of emotion-focused coping was associated with both higher violence exposure and heightened PTSD symptoms. Regression analyses revealed that emotion-focused coping moderated the relationship between IPV exposure and PTSD symptoms. More specifically, the results suggest that while individuals low on emotion-focused coping had fewer PTSD symptoms than women who frequently used emotion-focused coping, these individuals reported higher PTSD symptoms in the presence of frequent violence exposure. For individuals who frequently engaged in emotion-focused coping, violence exposure was less strongly associated with symptoms of PTSD.     

PTSD symptoms among men and women survivors of intimate partner violence: the role of risk and protective factors

The purpose of this cross-sectional analysis of the National Violence Against Women Survey was to characterize current symptoms of posttraumatic stress disorder (PTSD) among 185 men and 369 women survivors of intimate partner violence (IPV). In this subsample, 24% of women and 20% of men had current moderate-to-severe PTSD symptoms. PTSD scores were higher for women than men. Protective factors that appear to increase resiliency of survivors were higher education and income, being currently married, and reporting that IPV had stopped. Higher physical or psychological IPV scores, current depressive symptoms, and the survivor having left the relationship at least once were associated with risk of moderate-to-severe symptoms of PTSD. Protective factors may be used to boost resiliency of IPV survivors and reduce PTSD symptoms.     

Post-Traumatic Stress Disorder Among College Student Victims of Acquaintance Assault

Summary

Post-traumatic stress disorder symptomatology was evaluated among 316 college women who reported coercive sexual experiences. History of victimization, attributions of blame, and current symptoms were assessed. Acquaintance assault victims reported significantly higher levels of Post-Traumatic Stress Disorder (PTSD) symptoms than non-victims, and one-third exceeded criteria for clinical levels of distress. Situational variables, including the type of assault, were not associated with PTSD status or symptoms. Cognitive appraisals, however,'were significantly associated with PTSD symptomatology. Attributions of blame were all associated with PTSD status, with characterological self-blame also being associated with level of current symptomatology. The results document the negative psychological consequences of acquaintance assaults among college students and help to focus the efforts of treatment programs for acquaintance assault victims. In addition, the results highlight the importance of cognitive appraisals in mediating effects of sexual victimization.     

Posttraumatic stress disorder (PTSD) symptoms among firefighters: Roles of resilience and locus of control

Firefighting is a an extremely stressful occupation that risks exposure to traumatic events as part of the job. Despite this, the literature on stress and trauma pays little attention to this occupation and its generalization to other, high risk occupations. This study examined resilience and work locus of control as predictors of posttraumatic stress disorder (PTSD) symptoms among Nigerian firefighters. Participants were 116 paid, professional firefighters (98 males and 18 females) who completed the Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C), Resilience Scale (RS-14), and Work Locus of Control Scale (WLCS) and provided vital demographic information. Multiple regression analysis was used to analyze the data. Results showed that resilience negatively predicted PTSD symptoms such that higher resilience was associated with fewer symptoms of PTSD. Work locus of control was a positive predictor of PTSD symptoms, indicating that externality of control beliefs in the workplace was associated with more PTSD symptoms. Relevant demographic factors especially higher years of service, being a senior firefighter, and higher educational status were associated with lower PTSD symptoms. Findings underscore the potential value of resilience training and implementing behavioral health programs to modify firefighters’ external locus of control beliefs. Interventions should consider resilience and locus of control focused interventions as protective factors for PTSD.     

Effects of trauma exposure on anger, aggression, and violence in a nonclinical sample of men

This study assessed the impact of traumatic exposure and posttraumatic stress disorder (PTSD) symptoms on anger, aggression, and violence among civilian male college students. Results suggest that civilian men who have been exposed to a potentially traumatic event (PTE) and report symptoms of PTSD indicate more trait anger, more internal anger and hostility, and more aggression and violence than men who do not report symptoms of PTSD. Results are contrasted to those found in clinical samples of male veterans with PTSD and discussed in terms of understanding and treating anger and aggression in non-clinical, trauma-exposed populations.     

Cognitive behavioural psychotherapy intervention in childhood sexual abuse: identifying new directions from the literature

The short‐ and long‐term consequences of childhood sexual abuse have been extensively reported. However, for many years there has been an absence of psychological conceptual frameworks for understanding and treating abuse trauma symptoms. This paper reviews a number of outcome studies for the treatment of child sexual abuse where a post‐traumatic stress disorder (PTSD) conceptualization was used to plan treatment interventions. The paper concludes that, contrary to some concerns expressed by clinicians, sexually abused children and their non‐abusing carers can signi?cantly bene?t from cognitive behavioural interventions which use reliving and confrontation of the abusive experience. Notwithstanding this, there is a need for further controlled outcome research of cognitive behavioural interventions using reliving techniques to explore how and why these interventions help in reducing abuse‐related PTSD symptoms. Copyright © 2004 John Wiley & Sons, Ltd.     

Trauma symptomatology: implications for return to work

Research has suggested that individuals who experience work related injuries may be at an increased risk for developing trauma symptoms or Posttraumatic Stress Disorder (PTSD). The purpose of this article is to provide a brief overview of PTSD from both a categorical and dimensional perspective and discuss implications for rehabilitation planning with workers with industrial injuries. The negative impact of trauma symptoms and PTSD is profiled according the following four areas that are important for effective career and vocational behavior: (a) making occupational adjustments, (b) adjusting performance to meet specific work demands, (c) utilizing appropriate social and interpersonal skills in the work setting, and (d) meeting the production and time requirements associated with the specific job. Recommendations are then offered to increase the effectiveness of rehabilitation professionals working with industrial injured workers who may be experiencing trauma symptoms or PTSD.     

Reliability and Validity of the Global Assessment of Relational Functioning (GARF) in a Psychiatric Family Therapy Clinic

The reliability and validity of the Diagnostic and Statistical Manual of Mental Disorders-IV Global Assessment of Relational Functioning (GARF) was evaluated in consenting participants presenting to a family therapy training clinic. The purpose of this study was to (a) assess whether the GARF could be administered quickly in a marriage and family therapy training clinic, (b) assess the inter-rater and internal reliability of GARF ratings of intake sessions, (c) examine the relationship of GARF ratings to established measures of relationship functioning, and (d) compare GARF ratings to a measure of depressive symptoms. Study participants completed the General Functioning Subscale of the Family Assessment Device (GFS/FAD), the Quality of Marriage Index (QMI), and the Center for Epidemiologic Studies–Depression Scale (CES-D). After intake sessions were conducted with study participants, GARF ratings were made by an American Association for Marriage and Family Therapy Approved Supervisor or Supervisor-in-Training, a therapist trainee, and two observing trainees who had observed the session from behind a one-way mirror. Cronbach’s coefficient alphas and the average intraclass correlation coefficients were both .82 when ratings of the supervisor and two observers were compared and .78 and .79, respectively, when ratings of the supervisor, two observers, and therapist were evaluated. There was significant agreement between GARF ratings made by the supervisor and therapist (but not observers) and scores on the GFS/FAD, QMI, and CES-D. Results suggest that GARF ratings can be made quickly and reliably, especially among raters with greater clinical experience, and are related to measures of relational functioning and depression. Implications for research and marriage and family therapy training are discussed.     

Which therapist perceptions best predict client outcomes? A naturalistic examination

Examining associations between therapists' perceptions of therapy sessions and client-reported outcomes in naturalistic settings (real-life therapy settings) can provide valuable guidance for the assessment, treatment, and monitoring of clients. This study included data of 1334 sessions from 127 clients (86 individual and 41 couple cases) and 15 therapists, collected at a therapy training center. Clients reported their personal functioning and individual symptoms before each session. Therapists rated clients' participation, receptivity, session progress, goal progress, and therapeutic alliance at the end of each therapy session. Multilevel Structural Equation Modeling analyses revealed that therapist-rated client participation and goal progress predicted better personal functioning, beyond clients' previous personal functioning scores. In contrast, none of therapist-rated session variables predicted clients' individual symptoms, beyond previous symptom scores. Power analyses suggested sufficient statistical power to detect small effect sizes. Findings of the current study have clinical implications for treatment planning and progress monitoring.     

Assessing Posttraumatic Stress Disorder Using the Trauma Symptom Checklist for Young Children∗

ABSTRACT

This pilot study assessed the performance of the Trauma Symptom Checklist for Young Children (TSCYC) in correctly classifying the presence or absence of PTSD, as determined by the Diagnostic Interview for children and Adolescents-Parent (DICA-P). Participants included 34 children, ages 4 to 12, referred for outpatient treatment. The 11 PTSD-positive participants scored significantly higher than the 23 PTSD-negative participants on scales assessing intrusive symptoms, arousal symptoms, and total posttraumatic stress (PTS). A model including the PTS-Intrusion, PTS-Avoidance, and PTS-Arousal scales, and the sexual concerns, dissociation, and anger/aggression scales correctly classified 100% of the PTSD-negative and 72.7% of the PTSD-positive participants. These findings suggest that the TSCYC may be used as an economical and time-efficient screening device for PTSD.