Breast Cancer as Trauma: Posttraumatic Stress and Posttraumatic Growth

Diagnosis and treatment of cancer has been associated with both posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG). This cross-sectional study sought to assess the frequency, common predictors, and interrelationships of PTSD symptoms and PTG in breast cancer survivors (n = 65). In this sample, symptoms of PTSD and reports of PTG were common and were not significantly related to one another. Greater social constraints on talking about breast cancer and perception of cancer as a traumatic stressor were associated with greater PTSD symptomatology. Younger age and perception of cancer as a traumatic stressor were associated with greater PTG. Findings suggest the central role of subjective appraisal in adjustment to cancer. Psychosocial interventions should be sensitive to the potential for PTG, both in treatment design and in assessment of outcomes.     

Event Centrality,Posttraumatic Cognitions,and the Experience of Posttraumatic Growth

This study tested the extent to which negative appraisals following traumatic events and the centrality of traumatic events predicted posttraumatic growth (PTG; Tedeschi &; Calhoun, 1996 Tedeschi, R. G. and Calhoun, L. G. 1996. The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9: 76–80. [Crossref] , [Google Scholar]). Participants were 405 undergraduates at a Midwestern university who reported experiencing at least one traumatic event. Regression analyses indicated that the centrality of the event was a significant predictor for all five domains of PTG. Negative appraisals of the world were related to some domains of growth, but neither negative cognitions about the self nor self-blame was a significant predictor of any of the growth domains. Interpretation of these results is considered in light of the consistencies with Janoff-Bulman's (2004) Janoff-Bulman, R. 2004. Posttraumatic growth: Three explanatory models. Psychological Inquiry, 15: 30–34. [Crossref], [Web of Science ®] , [Google Scholar] explanatory models of development of PTG.     

Posttraumatic Stress,Posttraumatic Growth,and Satisfaction With Life in Military Veterans

Objective: Military veterans are more likely than civilians to experience trauma and posttraumatic stress disorder (PTSD). Research suggests, however, that some people who experience trauma, including veterans, report posttraumatic growth (PTG), or positive personal changes following adversity. In this study, we tested a comprehensive model of PTG, PTSD, and satisfaction with life in a veteran population, exploring the roles of challenges to core beliefs, types of rumination, sex, and time since event. Method: Data were collected via Amazon’s Mechanical Turk, an online crowdsourcing website, from veterans (N = 197) who had experienced a stressful event within the last 3 years (M = 16.66 months, SD = 12.27 months). Structural equation modeling was used to test an integrated conceptual model of PTG, PTSD, and satisfaction with life. Results: Results showed that challenge to core beliefs was directly associated with both deliberate and intrusive rumination. Deliberate rumination was positively related to PTG; intrusive rumination was positively related to symptoms of PTSD. PTG and PTSD, in turn, mediated the relationship between rumination styles and satisfaction with life; PTG was related to higher satisfaction with life; and PTSD was negatively related to satisfaction with life. Results failed to show differences on any model variables as a function of time since event or sex. Conclusion: Results indicate that the intentional facilitation of PTG may be a complementary and alternative option to the reduction of PTSD symptoms for improving satisfaction with life. Findings suggest that efforts to facilitate PTG should be focused on strategies for promoting deliberate rumination.     

Posttraumatic Growth in Combat Veterans

Combat veterans and their families face significant challenges not only to their abilities to cope, but often to their fundamental belief systems. Traumatic events represent assaults on core beliefs, yet at times, produce cognitive processing that can ultimately result in personal transformations called posttraumatic growth (PTG). Clinicians can utilize a systematic therapeutic approach to facilitate PTG as they carry out a relationship of expert companionship. PTG in service members is described in this article, as well as the approach to facilitation of PTG.     

Posttraumatic Growth, Posttraumatic Stress Symptoms and Mental Health Among Coronary Heart Disease Survivors

The present study aimed to estimate posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among heart disease survivors and examine whether PTG moderates the association between PTSS and mental health. Data from 82 myocardial infarction and acute coronary artery bypass graft survivors (aged 46–82) was obtained at admission to a cardiac rehabilitation unit. Mental status was assessed by the PTSD Inventory, Posttraumatic Growth Inventory (PTGI), Mental Health Inventory and Health Related Quality of Life (HRQOL). 17.1 % of the participants suffered significantly from PTSS and most of the study sample (71.2 %) reported PTG. PTSS were positively associated with PTG and psychological distress and negatively with well-being and HRQOL. PTG moderated the association between PTSS and most mental health outcomes. We conclude that posttraumatic growth may attenuate the negative effect of posttraumatic stress symptoms on mental health.     

Medication for Complex Posttraumatic Disorders

Treatment guidelines and reviews of outcome studies agree that drugs are valuable for moderation of irrational moods and impulsivity that interfere with thoughtfulness and cooperativeness. As such, they empower patients to make good use of psychotherapy for mastery of the risk of betrayal in intimate relationships, which is the typical recurrent traumatic event in complex posttraumatic disorders. Psychotherapy, for its part, has demonstrated correction and lasting remission of disorder in the aftermath of certain kinds of single trauma and promises further development to achieve similar efficacy for complex posttraumatic disorders. This article summarizes the strengths and limitations of each class of psychiatric drugs. It explains how the natural course of complex posttraumatic disorders greatly contaminates observations of medication efficacy and fosters unrealistic expectations for drug development.     

Posttraumatic Stress Disorder and Vietnam Veterans

Many unemployed Vietnam veterans may be sufferers of posttraumatic stress disorder (PTSD). Symptoms and behaviors of PTSD are reviewed to assist employment counselors in identifying such individuals, and suggestions for referral are made.     

创伤后应激障碍的民族差异问题

创伤后应激障碍(PTSD)的民族差异主要体现在少数民族PTSD的发生率较高和症状反应与症状结构的差异。以美国代表的西方国家的研究表明, 这些差异主要是源于暴露水平、少数民族的社会地位以及不同的文化背景。汶川地震后, 有研究也发现羌族PTSD发生率高于汉族, 然而对于羌汉民族间症状反应的具体差异及其原因, 还并不十分明确。因此, 有必要在中国进行PTSD民族差异系统深入的研究, 这既有助于灾后心理援助工作更加有针对性的开展, 也能够为从东方文化视角下理解PTSD提供理论依据。     

Neurocognitive Functioning in Posttraumatic Stress Disorder

This paper reviews the literature on performance on standard neuropsychological tests among individuals with posttraumatic stress disorder (PTSD). Of 19 studies, 16 reported impairment of attention or immediate memory (or both); however, most of these studies included PTSD patients with significant psychiatric comorbidity, so that the extent to which the observed deficits are specifically attributable to PTSD remains unclear. Other potential confounds, including medical illness, substance abuse, and motivational factors, further preclude definitive conclusions at present. Results of structural and functional neuroimaging studies of PTSD are also summarized. Two studies have reported correlations between hippocampal volume and cognitive findings in PTSD patients; functional studies have indicated specific findings in limbic regions, although the relationship of these results to neuropsychological performance remains to be explored.     

创伤后应激障碍中的非适应性泛化现象

过度泛化现象是区分普通心理问题和严重心理问题的重要指标。创伤后应激障碍(posttraumatic stress disorder, PTSD)患者在创伤事件后会出现非适应性的泛化。现有研究结果表明非适应性泛化(maladaptive generalization)可能是PTSD发生发展的一个重要因素, 但也有研究支持PTSD是导致了泛化从适应性向非适应性化转变的原因。虽然泛化现象的变化与PTSD症状的发展有相同趋势, 且具有共同的生理基础：记忆相关神经结构, 但二者之间的关系尚无明确定论。阐明PTSD与非适应性泛化之间的关系对PTSD的预测、诊断和治疗均有推进作用。     

Posttraumatic Growth After Motor Vehicle Crashes

The relationship between sub-dimensions of posttraumatic growth (PTG) and distress was investigated for survivors of motor vehicle crashes (MVC). PTG and symptoms of posttraumatic stress disorder (PTSD) for 1045 MVC survivors who attended the Accident and Emergency Services were examined with the Chinese versions of the Posttraumatic Growth Inventory (PTGI) and the Impact of Event Scale-Revised 1 week after the experience of a MVC. A factor structure, which was different from both the original English version of the PTGI and the Chinese version of PTGI for cancer survivors, was identified. Factors extracted were: (1) Life and Self Appreciation; (2) New Commitments; (3) Enlightenment; and (4) Relating to Others. However, correlation analyses indicated a functional similarity between factors from this study and those from previous studies. Relations between PTG sub-dimensions and PTSD symptoms were identified. Results from hierarchical multiple regression analysis and structural equation modeling show that there were different predictors for different PTG sub-dimensions. Findings suggest that different modes of relationship between PTSD symptoms and PTG sub-dimensions may co-exist.     

Coping Functions of Prayer and Posttraumatic Growth

Research on prayer and posttraumatic growth (PTG) indicates that those who pray report more PTG. Research is beginning to identify which types of prayer may be operating in this relationship. We sought to identify specific prayer functions related to PTG while considering differences due to the types of trauma experienced. Participants were trauma survivors from diverse, Midwestern Christian churches (N = 327). Participants completed questionnaires assessing trauma history, prayer coping functions, and PTG. Multiple linear regression analyses found that praying for calm and focus was independently related to higher levels of PTG. When considering all variables in the model, the relationship between prayer for calm and focus and PTG was not significant for those whose most significant trauma was interpersonal in nature, but significant for those with noninterpersonal trauma.     

Posttraumatic stress disorder: A sensitization reaction

This article discusses past research bearing on the question of the etiology of Posttraumatic Stress Disorder (PTSD). It argues that PTSD can be adequately accounted for by a process of emotional sensitization and that this is a more parsimonious explanation than the two-factor learning theory of Mowrer, now postulated by several writers. In brief, the etiology and subsequent development of PTSD is viewed as the result of the sensitization of fear/anxiety which is linked to a variety of to be conditional stimuli by both backward and forward association: these become conditional stimuli (CSi) once paired with the instigating circumstances. It is furthermore assumed that PTSD will not occur in the absence of a genetic susceptibility that may vary from zero to absolute certainty. Thus far, our evidence is limited to a sensitivity to loud sounds, but it is highly probable that touch and other sensory systems are involved (not necessarily in parallel). The fact that abuse often leads to behavioral disorders, including sexually seductive behaviors in children sexually abused, requires a recognition that emotional reactions other than fear may be sensitized. Fear in combination with pleasure or pleasure alone coupled with a loss of self-esteem may explain these acting-out behaviors.     

Posttraumatic symptomatology in children exposed to war

This study examines affective and behavioral symptomatology in two groups of school-age children who were traumatized to different degrees during the war in Croatia (N = 1034). Six self-reported questionnaires were used to assess the following: number and type of war experiences, PTSD symptoms, anxiety, depression, psychosomatic symptoms, and psychosocial adaptation. Canonical discriminant analysis yielded a significant discriminant function that indicates moderate differentiation between the two groups of children according to the assessed symptoms. The results of a 2 x 2 x 2 ANOVAs (gender x age x level of traumatization) indicate that the children's reactions to war traumata varied in respect to all factors, as well as their interaction. The results indicate that gender differences are more prominent in older children. Older girls report more posttraumatic stress reactions, anxiety and depression, but at the same time seem better adapted than boys. Younger children, particularly those who survived more war even report more PTSD symptoms than older children.