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.     

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.     

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 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.     

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.     

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.     

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 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.     

Posttraumatic Therapy in the Age of Neuroscience

When people develop PTSD in the wake of exposure to a traumatic event, the imprint of that trauma comes to dominate how they organize their way in the world. Verbalizing, making meaning, and putting the event in contezt may provide a means of feeling understood, rejoining the human race, and gaining perspective on the experience, but it may do, little toreorganize the person to feel safe and focused on fulfilling the demands of the present. Given the subcortical nature of trauma imprints, effctive therapy needs to help survivors tolerate the sensory reminders of the trauma, and physically experience efficacy and purpose in response to stimuli that once triggered feelings of helplessness and dependence.     

The Forensic Examination of Posttraumatic Stress Disorder

Abstract

The diagnosis of posttraumatic stress disorder (PTSD) has achieved a major level of significance in our judicial system. The forensic examination of PTSD is identified as a specialized assessment that is non-biased and non-prejudicial. This article attempts to provide a standard methodology to offer an objective and neutral forensic assessment and diagnosis of PTSD that will stand up to legal scrutiny by identifying problems in diagnosing PTSD and establishing a six-step methodology for the differential diagnosis of the disorder. Procedures for providing a forensic examination of PTSD and details of the author's methods of providing a forensic examination are presented.     

Posttraumatic Response and Children Exposed to Parental Violence

Summary

In this article some of the literature on children's responses to natural and person-created trauma are discussed. In addition, data relevant to children's posttraumatic response as a result of exposure to interparental violence are presented. Using a factor analytic procedure, the study attempted to examine how the DSM-IV symptom clusters for Posttraumatic Stress Disorder come together for this sample of children. General suggestions are made regarding possible intervention with exposed children experiencing posttraumatic symptoms.     

Reward Processing and Decision-Making in Posttraumatic Stress Disorder

Theory suggests that, in those with posttraumatic stress disorder (PTSD), positive emotion is likely dampened due to reexperiencing of trauma-related stimuli. Prior research has extended positive emotion experiencing to reward processing research but has not yet examined how trauma cues affect reward processing (i.e., the anticipation of and satisfaction with reward) and decision-making in individuals with PTSD. We compared 24 individuals diagnosed with PTSD to 29 trauma-exposed controls in passive and decision-making phases of a wheel-of-fortune task, following both neutral and trauma inductions. Three types of spinners were used in the task: spinners that were obviously advantageous spinners, obviously disadvantageous spinners, and ambiguously advantageous spinners with outcomes averaging to a net gain. We hypothesized that the PTSD group would report lower reward expectation and lower outcome satisfaction and make less advantageous decisions, differences that would be exacerbated following a trauma prime. The PTSD group reported lower reward expectation than controls for the ambiguous spinners only, suggesting that the reduced anticipation of reward associated with PTSD may be specific to ambiguous stimuli. Reward expectation was not affected by the type of prime. Outcome satisfaction was not affected by PTSD or type of prime. Although only marginally significant, the PTSD group played the ambiguous spinners less often than controls, and played the obviously disadvantageous spinners significantly less often than controls, suggesting that those with PTSD are more aversive to loss. Our findings suggest that PTSD-related deficits are more robust for reward expectation than outcome satisfaction, and support future research examining the role of reward-related decision-making in PTSD.     

Posttraumatic growth after childbirth: a prospective study

A growing body of research has examined the potential for positive change following challenging and traumatic events, this is known as posttraumatic growth (PTG). Childbirth is a valuable opportunity to extend previous work on PTG as it allows the role of different variables to be considered prospectively. The aim of this study was to prospectively examine correlates of PTG after birth, including sociodemographic and obstetric variables, social support and psychological distress, using a prospective, longitudinal design. A total of 125 women completed questionnaires during their third trimester of pregnancy and 8 weeks after birth. At least a small degree of positive change following childbirth was reported by 47.9% of women; however, average levels of growth were lower than generally reported in other studies. A regression model of age, type of delivery, posttraumatic stress symptoms during pregnancy and general distress after birth significantly predicted 32% of the variance in growth after childbirth. The strongest predictors of growth were operative delivery (β 0.23-0.30) and posttraumatic stress symptoms in pregnancy (β 0.32). These findings emphasise the importance of assessing pre-event characteristics when considering the development of PTG after a challenging event.