Browsing by Subject "PTSD"
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Item Clinical overlap between Posttraumatic Stress Disorder and Borderline Personality Disorder in male veterans(Texas A&M University, 2006-10-30) Boggs, Christina DanielleThe associated features, high rates of comorbidity and chronicity of Posttraumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD) raise questions regarding the distinctiveness of the two disorders. The present study expands upon previous literature by providing an investigation of clinical features across two groups: PTSD only and comorbid PTSD and BPD in a sample of male veterans (n=178). Results suggest that the two groups were distinct, with the comorbid group displaying higher levels of depression, hostility, alcohol use and general psychopathology. Groups did not differ on rates of personal trauma, adult sexual abuse, childhood sexual abuse, attack, accident or disaster. The two groups did differ significantly on rates of childhood violence.Item Effectiveness of Equine Assisted Psychotherapy in the Treatment of Veterans with Posttraumatic Stress Disorder(2013-12-03) Craven, Maria BeatrizEquine Assisted Psychotherapy (EAP) is a non-traditional form of psychotherapy that addresses treatment goals with the use of horses. This small pilot study consisting of 5 veterans examines the effectiveness of EAP in the treatment of veterans with posttraumatic stress disorder (PTSD). The Equine Assisted Growth and Learning Association?s model of EAP was used. With the vast majority of available literature being qualitative in nature and consisting largely of participant anecdotes, this study has aimed to provide a more controlled, quantitative approach. Results from this small sample study tentatively suggest that EAP was an effective form of treatment for veterans with PTSD. Results indicated that 2 out of 5 participants experienced a statistically significant reduction in PTSD symptoms and 3 out of 5 participants no longer met DSM-IV diagnostic criteria for PTSD by follow-up. All participants demonstrated a statistically significant increase in positive affect and 4 out of 5 participants demonstrated decrease in negative affect following each session. Clear evidence of treatment effects in social and interpersonal functioning was not found with only minor benefit reported for improvement in social functioning for 2 of 5 veterans and minor improvement reported in only 1 out of 5 veterans in interpersonal functioning. These data were acquired using the Posttraumatic Stress Disorder Checklist ? Civilian version (PCL ? C), The Patient-Reported Outcomes Measurement Information System (PROMIS) Social Health measures, Outcome Questionnaire 45 ? Interpersonal Roles subscale, and a visual analog adaptation of the Positive and Negative Affect scale (VPANAS). Recommendations for future research are also discussed including a need for a more comprehensive theoretical understanding of how change occurs in EAP and stronger study designs. Implications for practice are included as well.Item The impact of combat-related PTSD on employment(2010-12) Foster, Michael Ben; Parker, Randall M., 1940-; Schaller, James L.; Reith, Herbert J.; Seay, Penny C.; De La Garza, Denise; Brooks, Gene I.PTSD (Post Traumatic Stress Disorder) has impacted veterans of combat throughout history. With current advances in protective combat armor and in combat medical treatment, more and more of the soldiers who would have perished in the battlefield are being saved and returned home. While their physical wounds may heal, the traumatic events experienced on the battlefield continue to impact their personal, social, and vocational lives. This study explores the perceptions of veterans with respect to their vocational stability and the impact that PTSD has had on their vocational functioning. Eleven veterans were selected to participate in this qualitative study. These veterans were all veterans of combat actions ranging from the Vietnam War to the current military actions in Iraq and Afghanistan. Once selected, these veterans participated in interviews which explored their vocational history, their perceptions of their employment instability, and their perceptions of the impact that PTSD had on their vocational functioning and employment instability. Once the interviews were completed, they were transcribed and analyzed using open coding to identify common themes throughout the data. These themes included behavioral issues, perception of treatment, and their military experiences. Each theme was explored and interpreted to identify how PTSD impacted these participants in maintaining employment instability. Interpretations of the data lead to the conclusion that combat-related PTSD does, as the literature identifies, cause vocational instability. However, the data shows that while the participants did experience vocational instability, it was not because they were typically fired or dismissed from employment, but rather, they quit jobs prior to being fired. The participants were able to identify their triggers and stressors to the point that they simply quit their jobs when these triggers and stressors arose. Thus, much of their vocational instability may possibly have been prevented had they been able to effectively communicate their stressors and triggers to their employers and co-workers. Limitations of the study as well as implications for practice and future research are discussed.Item Living with the invisibly wounded: how female partners of male OEF/OIF/OND veterans with PTSD understand their experiences(2015-12) Farmer, Annie Elizabeth; Ainslie, Ricardo C.; Suizzo, Marie-Anne; Reddick, Richard; Hammond, Ryan; Sanchez, DelidaThis study builds on the literature demonstrating systemic effects of PTSD on spouses of military veterans. An interpretive phenomenological approach was utilized for interviewing and analyzing data from twelve female partners of veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn who have PTSD. Half of these women had begun their relationships prior to the veterans’ deployments and half had met their partners after their military service. Seven themes emerged from the analysis of participants’ narratives that captured the confusion, uncertainty, and emotional distress often central to women’s experiences and highlighted their sense of responsibility to their partners, the challenges with trust and intimacy in their relationships, shifts in their identities, and the strategies they used to cope. Noteworthy was the fact that women’s descriptions of listening to veterans’ trauma disclosures did not support the construct of vicarious traumatization as a primary mechanism to explain participants’ distress. Women’s narratives did lend support to the relevance of the theories of ambiguous loss, caregiver burden, and appraisal theory to understanding the heightened psychological distress and relationship distress in this population.Item Network mechanisms underlying susceptibility to helplessness and response to the antidepressant fluoxetine(2010-05) Padilla, Eimeira; González-Lima, Francisco, 1955-; Delville, Yvon; Domjan, Michael P.; Dominguez, Juan M.; Beevers, Christopher G.Depression and post-traumatic stress disorder are common psychiatric comorbidities related to stress. These conditions are frequently treated with antidepressants such as selective serotonin reuptake inhibitors (SSRI’s). However, there are individual differences in susceptibility to stress-induced psychopathologies and response to antidepressants. Therefore, there is a need to identify biologic factors that predict vulnerability to stress and response to treatment. Furthermore, few studies have examined the neural correlates of antidepressant treatment response in a stress-susceptible animal model. This dissertation had three specific aims: 1) to characterize behavioral predictors of stress vulnerability by studying three dimensions of temperament (reward dependence, novelty-specific activity and harm avoidance) before stress exposure using a stress-susceptible rat strain, 2) to identify the neural network effects of response and non-response to SSRI treatment using a stress-susceptible animal model, and 3) to determine the neurophysiologic correlates of helplessness susceptibility. This was examined via measurement of regional brain metabolic capacity and functional connectivity within relevant neural circuits, and measurements of corticosterone and heart rate. These effects were studied in rats that underwent inescapable shock exposure followed by escape testing. Holtzman rats showed greater predisposition to helpless behavior following inescapable shock compared to Sprague Dawley and Long-Evans strains. Also, increased activity in a novel environment and low heart rate appeared to be markers of helplessness susceptibility in Holtzman rats. Limbic-cortical network effects were identified that distinguished between responders and non-responders to antidepressant treatment in the Holtzman strain. Finally, hypermetabolism of the lateral habenula and a less interactive prefrontal-limbic cortex were identified in subjects with higher susceptibility towards helplessness within the Holtzman strain. Similar findings have been reported with other depression animal models and human neuroimaging studies. These findings support that the helpless dimension of mood disorders can be accurately modeled with the Holtzman rat strain and confirm that the lateral habenula and prefrontal cortex are key regions mediating the helpless phenotype and response to SSRI treatment.Item Post-deployment social support and social conflict in female military veterans(2010-08) Nayback-Beebe, Ann Marie; Yoder, Linda H.; Carter, Patricia A.; Harrison, Tracie C.; Angel, Jacqueline L.; Gaylord, Kathryn M.BACKGROUND: There have been prevailing gender differences in negative mental health outcomes for U.S. female service members (FSMs) returning from combat deployments with rates of depression and post-traumatic stress nearly twice that of their male peers. AIM: The aim of this research study was to examine the extent to which the absence or presence of social support, social conflict, and stressful life events either facilitated or hindered optimal mental health during the post-deployment period and shaped FSMs’ mental health in the context of the post-deployment experience. RESEARCH QUESTIONS: What was the nature of the relationship between social support, social conflict, and stressful life events and mental health symptoms (PTSD, depression, anxiety, and alcohol abuse) in FSMs after deployment to Iraq? And was the degree of social support or the degree of social conflict more highly associated with negative mental health symptoms (greater PTSD symptoms, greater depression symptoms, greater anxiety symptoms, and greater alcohol abuse symptoms) in FSMs after deployment to Iraq? THEORETICAL FRAMEWORK: The theoretical framework for this study was derived from Vaux’s theory of social support (Vaux, 1988) and from a model developed by Berkman and Glass (2000) that hypothesized how social support and social networks have direct effects on an individual’s physical, mental, and social health. These two frameworks were viewed from a feminist standpoint perspective. METHODS: This descriptive, correlational, cross-sectional design used a convenience sample of 150 active duty FSMs who were 6-12 months post-deployment from Iraq and stationed at Fort Campbell, Kentucky. FINDINGS: During preliminary exploratory data analyses and statistical assumption testing, significant between group differences were found between the officer and enlisted FSMs on four variables: annual household income, stressful life events, education, and prior exposure to violence (physical assault, sexual assault, or domestic violence). Additionally, significant differences emerged in bivariate correlations between the predictor and outcome variables when the 13 officer FSMs were separated out from the original sample during statistical analyses. These findings suggested these were two distinct populations; therefore, the sample was divided into two groups based on rank. For the officer FSMs, there were no significant bivariate correlations between social support, social conflict, or post-deployment stressful life events and any of the mental health outcomes although a one-tailed analysis was conducted due to low sample size (n = 13). In contrast, the two-tailed analysis of the enlisted FSMs (n = 137) showed significant positive bivariate correlations (p < .01) between social conflict and stressful life events and the outcome variables depression, PTSD, and anxiety symptom severity. Furthermore, the analysis demonstrated a significant inverse correlation between social support and the outcome variables depression, PTSD, and anxiety symptom severity. Hierarchical linear regression of the enlisted FSM group showed that depression symptom severity was best explained by the presence of comorbid PTSD symptoms and the absence of social support. The presence of social conflict was excluded in the final model, and stressful life events were not found to be significant in explaining depression symptom severity. Overall, comorbid PTSD symptom severity and the absence of social support accounted for 71% of the variance in depression symptom severity in this group of enlisted FSMs. In contrast, greater PTSD symptom severity in the post-deployment period was best explained by greater comorbid depression symptom severity, the presence of social conflict, and greater stressful life events. The absence of social support did not significantly contribute to the model for PTSD symptom severity. Comorbid depression symptom severity, stressful life events, and the presence of social conflict, which were entered in three steps, accounted for 74% of the variance in PTSD symptom severity reported by this group of enlisted FSMs. And finally, greater anxiety symptom severity was best explained by greater comorbid depression symptom severity, the presence of social conflict, and the absence of social support. The presence of social conflict had a stronger relationship with anxiety symptom severity than the absence of social support in the final model. In addition, the presence of more stressful life events did not significantly contribute to the overall variance in anxiety symptom severity. Comorbid depression symptom severity, the absence of social support, and the presence of social conflict accounted for 68% of the variance in anxiety symptoms reported by this group of enlisted FSMs. The implications and recommendations based on these findings span strategic planning for the military, nursing practice, and future research.Item Post-Traumatic Stress Disorder (PTSD) Symptoms as Predictors of Suicide Behavior Among Veterans with and without a History of Traumatic Brain Injury (TBI)(2012-10-19) Villarreal, Edgar JavierPrior research has established that a history of post-traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI) increases the risk of suicide behavior. Few studies have examined the role of specific PTSD symptom clusters and suicide attempts. The current study is among a handful of studies that have examined the association between the presence of PTSD symptom clusters and suicide attempts among Veterans with PTSD and/or TBI. The study utilized archival data from a sample of 137 Veterans receiving mental health treatment at the Denver Veteran Affairs Medical Center. Results from logistic regression analyses indicated that PTSD symptom clusters were not associated with an increased risk for suicide behavior among individuals with and without a history of TBI. Results suggest that looking at the presence of PTSD symptoms is not sufficient to account for the risk of suicide behavior. Clinical and research implications on the need to examine the role of PTSD symptom severity and suicide behavior are discussed.Item Posttraumatic stress disorder in contemporary Colombian literature(2015-08) Flynn, Michael Anthony; Arens, Katherine, 1953-; Polit Dueñas, Gabriela; Salgado, César; Domínguez-Ruvalcaba, Héctor; Palaima, ThomasThis is a study of three contemporary Colombian novels using combat trauma theory as an interpretive model. Following the method of psychological literary criticism that psychiatrist Jonathan Shay used in his books Achilles in Vietnam: Combat Trauma and the Undoing of Character (1994) and Odysseus in America: Combat Trauma and the Trials of Homecoming (2002) to analyze the characters Achilles and Odysseus, I propose to analyze characters in Fernando Vallejo’s La virgen de los sicarios ‘Our Lady of the Assassins’ (1994), Darío Jaramillo Agudelo’s Cartas cruzadas ‘Crossed Letters’ (1995), and Juan Gabriel Vásquez El ruido de las cosas al caer ‘The Sound of Things Falling’ (2011) to extend Shay's theories of combat trauma to a broad cultural context. While Colombia has not been engaged in a conventional, state-to-state war, it has been at a constant level of large-scale internal violence for over fifty years, perpetrated by a complex mix of paramilitaries, guerillas, narcotraffickers, and state-sponsored organizations: Colombia has consistently ranked among the top countries in the world for rates of homicide and displaced peoples. Shay’s model allows me to argue this kind of radically epistemologically and phenomenologically destabilizing environment in which non-combatants as well as combatants live under the constant threat of violence as producing severe psychological trauma. These texts have an additional cultural-psychological function. Shay identifies as an effective coping strategy the victims' act of integrating the traumatic memory into a coherent narrative, in order to both regain authority over their consciousness and to give social testimony to the injustice of the traumatic event. I will show how the characters in the texts I analyze make themselves psychologically whole in direct relation to the success with which they can narrate the story of their own trauma: those who fail do so in large part because the discourses available to them are inadequate to articulate the profundity of the trauma; those who succeed do so because they have found a form and structure that allows them to construct a coherent narrative of Self that incorporates the traumatic memory of the nation's failure.Item The psychometric properties and clinical utility of the Air Force Post-Deployment Health Reassessment (PDHRA) for airmen with posttraumatic stress disorder (PTSD) or depression(2011-05) McCarthy, Michael Damian; Thompson, Sanna J.; Springer, David W.; Schwab, Arthur J.; Greene, Roberta R.; Ozanian, Alfred J.Operation Enduring Freedom (OEF) (Afghanistan) and Operation Iraqi Freedom (OIF) represent one of the longest wartime deployments in the history of the American military. To date, 1.6 million American military members have deployed. Of these, an estimated 300,000 have returned with a mental health condition, such as depression or PTSD. The Department of Defense has established a robust screening program to identify and track deployment-related physical and psychiatric illnesses. The Post-Deployment Health Reassessment (PDHRA) is a primary tool to identify physical and psychiatric risk following a deployment. The PDHRA is a web-based survey, which is administered between 90-180 days after a deployment. This study seeks to evaluate the psychometric properties and clinical utility of the Post-Deployment Health Reassessment (PDHRA) for accurately identifying truama and depression among Airmen following a deployment. Descriptive statistics, confirmatory factor analysis and structural equation modeling were used to address separate research aims. Study aims assessed the impact of deployment on military members and the clinical utility and psychometric properties of the Post-Deployment Health Reassessment. Findings suggest that the Post-Deployment Health Reassessment is a useful triage tool to identify trauma and depression among Airmen following deployment. The study makes recommendations for improving the clinical utility and psychometric properties of the Post-Deployment Health Reassessment (PDHRA).Item Self- Versus Informant Reports of Posttraumatic Stress Disorder: An Application of Item Response Theory(2012-09-27) Fissette, Caitlin 1984-As men and women return from serving on the frontlines of Operations Enduring Freedom (OEF; Afghanistan) and Iraqi Freedom (OIF; Iraq), many struggle with emotional or behavioral difficulties stemming from the stresses of battle. However, research has shown that these service members may be unwilling or unable to recognize or report such difficulties due to such factors as amnesia, avoidance, or cognitive impairment. Hence, the burden to recognize distress and encourage treatment increasingly falls on peers, friends, and especially intimate partners. Given that this responsibility is often placed on significant others, it is imperative to determine which symptoms are amenable to detection by informants and which are not. The current study examined the ability of female spouses of Vietnam veterans to report on various indicators of posttraumatic stress disorder (PTSD) using the Mississippi Scale for Combat-Related PTSD. Item response theory (IRT) analyses were conducted with a dataset composed of both self- and informant reports using the same items regarding the same individual in order to examine the item-level properties. Results from these analyses indicated that the ability of both spouses and veterans to detect PTSD symptoms varies across item content and that items themselves do not relate equally to, or become diagnostic at the same level of, PTSD. Overall, veterans showed greater sensitivity to their own symptoms and were able to provide more information than their spouses for nearly every item rated by independent experts to be overt or covert. However, some items provided greater information when endorsed by the spouse versus the veteran even though, consistent with the majority of other items, these items were endorsed by the spouse only once the PTSD symptoms had reached greater severity. Implications of these findings as well as future directions for research regarding observer reports of PTSD symptomatology were explored.Item The impact of poetry therapy on symptoms of secondary posttraumatic stress disorder in domestic violence counselors(2009-05-15) Boone, Beth CarolThis study examines the effectiveness of internet-based poetry therapy on symptoms of secondary posttraumatic stress disorder (SPTSD) in domestic violence counselors, and explores correlations between demographic, workplace and personality variables with SPTSD symptoms in this population. Domestic violence counselors, at risk for SPTSD due to their exposure to the traumatic material of clients, need effective interventions that combat symptoms of SPTSD. Poetry therapy is a form of expressive arts counseling used increasingly by psychologists and mental health counselors. Expressive writing therapies in general have been shown to be effective in reducing symptoms of stress, and in increasing mental and physical health and well-being. In this study, data was collected from 97 participants who participated anonymously by completing some assessments and activities accessed via the website set up for the study. Results of t tests indicate that in this sample, participants in the internet poetry therapy group showed a decrease in symptoms of SPTSD following treatment, though additional analyses also show that there was a decrease in symptoms on post tests for all participants in the study. Regression analyses indicate that openness to experience and years working with trauma significantly predicted symptoms of SPTSD in this sample.Item Veteran's Odyssey : combat trauma and the long road to treatment (report from VFW Post 6974)(2011-08) Bicknell, Michael John; DeCesare, Donna; Minutaglio, WilliamCombat veterans often return from war with psychological as well as physical injuries. Armed service members who are bodily injured routinely go to hospitals for treatment, first at military hospitals and later in the U.S. Department of Veterans Affairs (VA) system. But those with psychological injuries like post-traumatic stress disorder (PTSD) often go years, if not a lifetime, without treatment, in large part because the VA denies their claims with dubious justification. Veterans’ service organizations like the Veterans of Foreign Wars (VFW), the American Legion, and others, as well as state and county governments, have knowledgeable service officers whose job is to help guide veterans through the VA system and through the many appeals that are often needed to get treatment and an adequate disability rating that could result in monetary payments. This report tells the story of one VFW post in Burnet, Texas, its veterans, their families, and how their success in getting treatment for PTSD has positively affected their lives. It has also enabled them, as they recover, to help other veterans seek treatment and win compensatory disability ratings too. The report focuses on one Vietnam veteran, who four decades after his discharge from the Army came to be treated for PTSD.