Examination of the Relationship Between PTSD and Distress Tolerance in a Sample of Male Veterans With Comorbid Substance Use Disorders

Distress tolerance (DT), the perceived or actual ability to tolerate negative emotional or physical states, is inversely related to posttraumatic stress disorder (PTSD) symptoms in civilian, community samples. No studies to date have examined the relationship between DT and PTSD in clinical samples of veterans with a comorbid diagnosis of PTSD and a substance use disorder (SUD). Thus, the present study examined the relationship between DT and PTSD in a sample of predominately African American, male veterans (n = 75) diagnosed with comorbid PTSD and SUD (according to a structured clinical interview). Results of hierarchical linear regression models indicated that DT was inversely related to total PTSD symptom severity score, above and beyond depressive symptoms and SUD severity. Of the 4 symptom clusters, DT was inversely associated with intrusions and hyperarousal. These findings are discussed in light of previous work with civilian samples. Determining whether treatment incorporating DT skills would be useful for veterans undergoing PTSD treatment should be evaluated.     

Critical reflections on postgraduate andragogy from the points of view of a Kenyan student and an Australian academic

In this paper, we use Critical Reflective Practice to give voice to the experience of a Kenyan teacher who travelled to Australia to undertake advanced coursework in leadership and inclusive education studies. It also reflects upon an Australian academic as she tries to be more culturally responsive in her andragogy when teaching, supervising and mentoring postgraduate international students. We use reflective practices over an extended period to lessen the power imbalance between them as academic supervisor and postgraduate student. This eventually allowed for the student to teach and the academic to learn; and together we here shed light on what it is like to study and teach within an Australian university that annually enrols 6000 students from more than 100 countries around the globe.     

Self-Efficacy as a Mediator of Caregiver Coping: Development and Testing of an Assessment Model

Development and utilization of two self-efficacy measures thought to be relevant to stressed family caregivers, Caregiver Self-Care Self-Efficacy and Caregiver Problem-Solving Self-Efficacy, are described. Data obtained in the context of a psychoeducational intervention program are available for 217 caregivers of frail and/or cognitively impaired elders. Analyses of psychometric properties of the efficacy measures demonstrate good internal consistency and test-retest reliability for both measures. In addition, both measures of self-efficacy are related to depression as measured by the Beck Depression Inventory and caregiver distress as measured by the Zarit Burden Scale. Problem-Solving Self-efficacy also is related to subjective caregiver burden as measured by Zarit's Memory and Behavior Problem Checklist. Results are promising in terms of the utility of the measure and the application of self-efficacy theory to the caregiving situation. Limitations of these measures are discussed and suggestions made for improved second-generation self-efficacy scales.     

Health Programming for Clergy: An Overview of Protestant Programs in the United States

The health of clergy is important, and clergy may find health programming tailored to them more effective. Little is known about existing clergy health programs. We contacted Protestant denominational headquarters and searched academic databases and the Internet. We identified 56 clergy health programs and categorized them into prevention and personal enrichment; counseling; marriage and family enrichment; peer support; congregational health; congregational effectiveness; denominational enrichment; insurance/strategic pension plans; and referral-based programs. Only 13 of the programs engaged in outcomes evaluation. Using the Socioecological Framework, we found that many programs support individual-level and institutional-level changes, but few programs support congregational-level changes. Outcome evaluation strategies and a central repository for information on clergy health programs are needed.     

Healing the wounds and the wounds of healing: a journey of the spirit

This article is a reflective narrative about the death of a parent told from the perspective of her daughter. It is an experience-based account. This shared journey of mother and child links the familiar realm of the conscious and known self to a realm that is not known in the same way and is not merely the self. It is as if one end is in the midst of life's struggles and crises and the other in another realm; yet the whole works together as a single force. In this way the idea is introduced that the very challenges and trauma of life can be a wound that is a healing of wounds, in so far as it prompts recognition of the realm that is out of sight, though the wound certainly is real enough.