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This quasi-experimental study examines the effects of the Somatic Experience Stabilization Program (SESP) on post-traumatic stress, mindfulness, and social support levels among refugee women. This study was conducted with 22 women who applied to a non-governmental organization for social and psychological support. Impact of Event Scale Revised (IES-R), Mindfulness Attention Awareness Scale (MAAS) and Multidimensional Scale of Perceived Social Support (MSPSS) were utilized for pre-test, post-test, and follow-up tests. While experimental group received a six-session SESP intervention developed by the researcher, control group received no intervention. SESP for refugee women was found to be significantly effective in decreasing post-traumatic stress and increasing mindfulness and social support levels. The effects of the program persisted during the follow-up test.

The COVID-19 pandemic has led to increases in U.S. residents' stressors while limiting many of the resources previously available to cope with stress. Coping behaviors may contribute to the prevention or proliferation of psychological distress during and after the pandemic. Understanding these coping behaviors and associated psychological outcomes can help health educators develop programs that encourage effective coping and promote mental health. This study used a sequential mixed-methods approach informed by Roth and Cohen's conceptualization of coping to understand the use of approach coping behaviors--which are active and directed toward the perceived threat--and avoidance coping behaviors--which include activity directed away from perceived threat during the COVID-19 pandemic. U.S. residents (N = 2,987) were surveyed online in April 2020 and again in September 2021. Open-ended responses at baseline were thematically analyzed to illustrate coping behaviors in participants' own words. At baseline, more than half (56%) of the sample met criteria for probable depression, 51% for acute stress symptoms, and 42% for moderate to severe hopelessness. At follow-up, 45% meet criteria for probable depression and 23% for acute stress. However, the proportion of the sample who reported moderate to severe hopelessness increased to 48%. We used mixed-effects general linear models to examine changes over time and found that increases in approach coping behaviors were associated with decreases in depressive symptoms and hopelessness; increases in avoidance coping were associated with higher levels of depressive symptoms and higher levels of hopelessness. Increases in both types of coping were associated with increases in acute stress symptoms related to COVID-19. Although there was some attenuation in distress in our sample between April 2020 and September 2021, our findings suggest a need for interventions that encourage the use of approach coping behaviors and that both increase access to and decrease stigma for mental health support.

COVID-19 related social isolation measures and school closures have likely increased students' stress levels. In our study, we assess the level of psychological distress and psychosocial factors among students in Mexico at the beginning of the pandemic. We conducted a cross-sectional exploratory study with 848 participants, the majority undergraduate or postgraduate (79.7%). Participants completed the Impact of Event Scale--Revised to measure emotions, and a COVID-19 questionnaire. We conducted a logistic regression analysis to find variables associated with stress: 36% (n = 309) had elevated stress, 31.4% (n = 266) anxiety, and 18.2% (n = 154) sadness often or all the time. Those who identified as women and reported a reduction in their incomes also reported a higher stress level. Stress was positively correlated with anxiety, anger, sadness, days in isolation, and hours watching TV daily; and negatively correlated with relaxation and happiness. The variable most strongly correlated with stress was a high perception of infection risk. Our findings will inform mental health strategies for students who are at higher risk of stress due to the COVID-19 pandemic response.

Background: Speech and language therapists (SLTs) working with dysphagia have had to radically alter diagnostic and rehabilitation services during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, hereafter referred to as coronavirus disease (COVID-19). Given the aerosol-generating procedures inherent in swallow assessment and interventions, these SLTs have also been particularly susceptible to virus exposure. Aims: To investigate the psychological impact of COVID-19 on SLTs working with adult dysphagia across the Republic of Ireland and to identify the personal and professional factors associated with depression, anxiety, stress and post-traumatic stress disorder (PTSD). To explore SLT perspectives regarding their experiences during the COVID-19 pandemic. Methods & Procedures: A cross-sectional 34-item online survey was developed and piloted. The survey collected demographic details and professional factors and it incorporated the Depression, Anxiety, and Stress Scale--21 (DASS-21) and the Impact of Event Scale--Revised (IES-R). The survey also sought SLT perspectives regarding their experiences during the pandemic. It was distributed to Irish SLT managers, the Irish Association of Speech and Language Therapists (IASLT) and the Irish Dysphagia Special Interest Group (SIG) for dissemination. Outcomes & Results: A total of 94 SLTs working with adults with dysphagia across Ireland responded. In total, 60% of respondents screened positive for depression, anxiety, stress and/or PTSD. Based on the DASS-21, 38% screened positive for depression (mean score = 8.0; SD = 6.3), 36% screened positive for anxiety (mean score = 6.5; SD = 6.0), and 49% screened positive for stress (mean score = 15.4; SD = 6.9). A total of 26% of respondents screened positive for PTSD (mean IES-R total score = 22.6; SD = 16.0). Factors associated with depression, anxiety, stress and PTSD were young age (p = 0.002), limited clinical experience (p = 0.01) and not living with children (p = 0.02). A thematic analysis of SLT perspectives identified four main themes: 'fear of COVID-19 infection and transmission', 'uncertainty regarding policies and procedures', 'changes in SLT roles and responsibilities' and 'increased workload'. Conclusions & Implications: This study highlights the psychological impact of COVID-19 on SLTs working with adults with dysphagia in Ireland and identifies SLTs who are at risk of depression, anxiety, stress and PTSD during the COVID-19 pandemic. Findings may assist employers to identify staff who require psychological support and long-term follow-up during this pandemic and any future health emergencies.

Caregivers frequently find the premature birth of a child as a crisis. This pilot study explored the perceived types of stress experienced by parents of premature infants and the impact on caregiving. Caregivers completed the Impact of Events Scale-Revised (IES-R; n = 4) and participated in a focus group (n = 3) or interview (n = 1). Caregivers' total scores on the IES-R ranged from 2 to 42. Themes included: emotions experienced at birth through the present, occupational loss, and the role of occupational therapy in the home. Although preliminary, findings indicated caregivers experienced high levels of stress that may impact co-occupations with premature infants.

This study explores psychological trauma as a reason for computer game addiction among adolescents. The findings of this study show that there is a connection between psychological trauma and computer game addiction. Some psychologists note that the main cause of any type of addiction derives from psychological trauma, and that finding such underlying causes can help understand the particular need to gamble. The strong connection between computer game addiction and psychological trauma shown in this study can have a significant impact on adolescents' personal growth.

Introduction: Post-traumatic stress disorder (PTSD) may be under-recognized in people with intellectual disabilities (PWID) and reviews on appropriate screening tools and prevalence are lacking. This review aims to identify PTSD screening tools for PWID and estimate the prevalence of PTSD within this population. Method: Medline, PubMed, Embase, PsycINFO, Cochrane, Global Health, and Web of Science databases were searched (inception to October 2017) to identify eligible literature. Papers were also found via manual searches of the references of eligible studies. Studies were reviewed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines, subjected to exclusion criteria and quality appraised using STROBE criteria for observational studies and an adapted form of the Newcastle-Ottawa scale for cross-sectional studies. Seven studies were identified. Meta-analysis was carried out on the prevalence studies and heterogeneity quantified using I[superscript 2]. Results: Three tools for screening PTSD in PWID were found: two for use in adults (the Lancaster and Northgate Trauma Scale and the Impact of Event Scale -- Intellectual Disabilities) and the Adapted Anxiety Disorders Interview Schedule for Children with PTSD. Five studies reported PTSD prevalence in PWID. The weighted pooled prevalence of PTSD in PWID was found to be 10%, 95% CI [0.4%, 19.5%], toward the upper limit of estimated PTSD prevalence in the general population (5-10%). Conclusion: PTSD can be diagnosed in PWID but may go unrecognized by health-care professionals. The identified tools should be further compared and assessed for acceptability and efficacy to improve the identification of PTSD in PWID.

The study assessed the prevalence and predictors of post-traumatic symptomatology and emotional and behavioral difficulties in siblings of children who incurred war-related injuries. It was predicted that injury severity, gender and attributional style would account for a significant amount of the variance in post-traumatic stress symptoms and emotional and behavioral difficulties in those siblings. The sample consisted of 406 siblings of both genders with a mean age of 12.50 years. The results indicated that injury severity, gender and attributional style were related to emotional and behavioral difficulties and symptoms of post-traumatic stress, except for gender and post-traumatic stress .Siblings of children with severe injury appeared to be at greater risk for intrusive thoughts and avoidance as well as emotional and behavioral difficulties. Females exhibited more emotional and behavioral problems than did males. Siblings with more maladaptive attributional styles endorsed more emotional-behavioral problems and symptoms of post-traumatic stress. Techniques for strengthening coping abilities designed to enhance cognitive control may be used with siblings at risk, particularly females and siblings of children who sustained a severe injury. Treatments such as trauma-focused cognitive behavior therapy may incur positive results. (Contains 3 tables.)

The cross-sectional field survey examined the roles of mathematics anxiety, self-esteem, proactive coping, and test stress in mathematics achievement among 204 (151 females) randomly selected Year 8-10 Brunei secondary school students. The negative dimensions of mathematics anxiety, self-esteem, and proactive coping correlated negatively with mathematics achievement and were both poor predictors of and barriers to mathematics achievement. Both test stress components (intrusive and avoidance) also related negatively with mathematics grades and were poor predictors of mathematics achievement. In addition, females scored significantly higher on negative self-esteem and intrusive stress variables than males. Furthermore, mathematically less able students scored significantly higher on the negative mathematics anxiety and negative self-esteem domains than more able peers. Moreover, positive proactive coping was a good predictor of mathematics achievement. Overall, the findings have practical significance indicating psychological areas where attention, counselling efforts and educational interventions need to be directed to help the at-risk and vulnerable students.

Fetal exposure to prenatal maternal stress can have lifelong consequences, with different types of maternal stress associated with different areas of child development. Fewer studies have focused on motor skills, even though they are strongly predictive of later development across a range of domains. Research on mechanisms of transmission has identified biological cascades of stress reactions, yet links between psychological stress reactions are rarely studied. This study investigates the relationship between different aspects of disaster-related prenatal maternal stress and child cognitive and motor development, and proposes a cascade of stress reactions as a potential mechanism of transmission. Mothers in the Queensland Flood Study (QF2011) exposed to a major flood during pregnancy completed questionnaires assessing flood exposure, symptoms of peritraumatic distress, dissociation, and posttraumatic stress (PTSD), and cognitive appraisal of the overall flood consequences. At 16 months post-partum, children's (N = 145) cognitive and motor development was assessed using the Bayley-III. Flood exposure predicted child cognitive development and maternal PTSD symptoms and negative cognitive appraisal were significantly negatively related to child motor development, with all relationships moderated by timing of exposure. Together, a cascade of stress reactions linked maternal flood exposure to poorer fine motor development. These findings suggest that the way stress reactions operate together is as important as the way they operate in isolation, and identifies a potential psychological mechanism of transmission for the effects of prenatal stress. Results have implications for conceptualizing prenatal stress research and optimizing child development in the wake of natural disasters.

Problem-solving skills training is an intervention designed to teach coping skills that has shown to decrease negative affectivity (depressive symptoms, negative mood, and post-traumatic stress symptoms) in mothers of children with cancer. The objective of this study was to see whether mothers of children recently diagnosed with autism spectrum disorder would be receptive to receiving problem-solving skills training (feasibility trial). Participants were recruited from a local outpatient developmental clinic that is part of a university department of pediatrics. Participants were to receive eight 1-h sessions of problem-solving skills training and were asked to complete assessments prior to beginning problem-solving skills training (T1), immediately after intervention (T2), and 3?months after T2 (T3). Outcome measures assessed problem-solving skills and negative affectivity (i.e. distress). In total, 30 mothers were approached and 24 agreed to participate (80.0%). Of them, 17 mothers completed problem-solving skills training (retention rate: 70.8%). Mothers of children with autism spectrum disorder who completed problem-solving skills training had significant decreases in negative affectivity and increases in problem-solving skills. A comparison to mothers of children with cancer shows that mothers of children with autism spectrum disorder displayed similar levels of depressive symptoms but less negative mood and fewer symptoms of post-traumatic stress. Data suggest that problem-solving skills training may be an effective way to alleviate distress in mothers of children recently diagnosed with autism spectrum disorder. Data also suggest that mothers of children with autism spectrum disorder were moderately receptive to receiving problem-solving skills training. Implications are that problem-solving skills training may be beneficial to parents of children with autism spectrum disorder; modifications to improve retention rates are suggested.

For approximately 35 seconds on January 10, 2010, an earthquake measuring 7.0 on the Richter scale struck the small Caribbean nation of Haiti. This research used a preexperimental one-shot posttest to examine the incidence of posttraumatic stress disorder (PTSD) and associated trauma symptomatology from the earthquake experienced by a sample of adult Haitians who were living in temporary shelters located in "tent cities" in Port-au-Prince and a comparative group of displaced individuals who left the capital city and took up residence in the northern rural town of Terrier Rouge. Sixty-five (N-65) participants completed the Impact of Events Scale-Revised (IES-R) to assess the severity of trauma symptomology in the study groups. Data presented are comparisons between the groups on total IES-R scores and the measure subscales for intrusion, avoidance, and hyperarousal. Based on the scores on the measure for the comparison groups 4 months after the earthquake, the findings suggests that all participants in the study exceeded the threshold of an acute stress disorder and most likely experienced PTSD. Implications of using the data in future longitudinal studies on trauma in Haiti are also discussed.

Context: Research has indicated that returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans are experiencing mental health concerns following deployment. Increasing numbers of veterans are enrolling in higher education institutions; there is a scarcity of empirical research investigating student veterans' experiences as they transition into college. Objective: To examine the effects of psychological distress and social support on academic adjustment among a sample of student veterans who were previously deployed. Design, Setting, and Participants: Participants were 117 military veterans enrolled in college. Questionnaires were administered via SurveyMonkey from June 2012 to April 2013. Results: Results indicated that military unit support during deployment, current social support, anxiety, and posttraumatic symptoms, but not depressive symptoms, were significantly associated with academic adjustment. Conclusions: Results from the current study can be used by college administrators and counseling centers to improve service delivery and programming specifically for student veterans.

Maternal support offered to sexually abused children following disclosure may be a crucial factor in children's recovery. A person-centered approach was used to examine how profiles of nonoffending mothers could better describe their ability to support their children after disclosure. Cluster analyses based on a total of 226 nonoffending mothers recruited from child protective services yielded four distinctive groups of mothers: resilient, avoidant-coping, traumatized, and anger-oriented reaction. These profiles differed on measures of support, parenting, and variables related to attitude following disclosure. The discussion underscores the relevance of adopting a tailored approach to intervention with mothers of sexually abused children. (Contains 3 tables.)

Grieving is infused by memories and emotions. In this study, bereaved participants recalled either death-related or fond memories of their loved ones. Their emotional arousal was examined via physiologic and voice analytic measures. Both death-related and fond memories generated an acoustic profile indicative of sadness (reflected by voice quality related parameters). Death-related memories, moreover, lead to bodily tension reflected by increased diastolic blood pressure levels and mean fundamental frequency of the voice signal. Consistent with the continuing bond and attachment perspectives, "death," a reminder of the irrevocability of the loss, induced distress/anxiety. In contrast, fond memories lead to more moderate, melancholic sadness, presumably because of their association with the soothing qualities of the attachment figure. (Contains 3 tables, 2 footnotes, and 1 figure.)

Trauma is thought to interfere with normal grief by superimposing symptoms of posttraumatic stress disorder. This exploratory pilot study examined the association between traumatic grief and objectively measured physiological reactivity to a trauma interview in 13 children who lost relatives in the Oklahoma City bombing as well as a potential link between children and their maternal figures in physiological reactivity. Although the authors found no association between posttraumatic stress and objectively measured physiological reactivity among children, they found significant differences in objectively measured reactivity associated with loss and grief. Children who lost "close" relatives evidenced greater objectively measured reactivity than those who lost "distant" relatives. For the most part, children with higher levels of grief evidenced greater objectively measured reactivity than those with lower levels of grief. The most interesting of the findings was the parallel pattern in objectively measured physiological reactivity between children and their maternal figures along with a positive association between children's objectively measured physiological reactivity and maternal figures' self-reported physiological reactivity. Research using larger representative samples studied early and over time is indicated to determine the potential significance of these findings. (Contains 1 table.)

There is much literature on crisis support in schools but little on how school staff are affected. This research had two aims: to begin to explore the coping strategies used by school staff after a crisis event, and to investigate measures that might prove valuable for future research. Seven cases are presented using three measures: the WHO (Five) Wellbeing Index, the Impact of Event Scale-Revised, and the Ways of Coping-Revised. Results from this initial study show great variation in the range of responses reported by teachers.

This study examined gender differences in responses to sexual coercive experiences in mixed-sex (male-female) relationships. Participants were 112 women and 28 men who had experienced sexual coercion and completed measures of cognitive (attributions to self, attributions to the coercer, internal attributions) and affective (guilt, shame) self-blame, trauma symptoms, and upset at the time of the incident) with respect to their most serious or upsetting sexually coercive experience. The women were more upset than were the men at the time of the incident. Contrary to predictions, the men and women did not differ in the extent to which they attributed blame to themselves or the strength of their internal attributions, guilt, or shame. Both the men and women attributed more blame to the coercer than to themselves; however, the women attributed more blame to the coercer than did the men. The women reported more trauma symptoms than the men did which was related to the finding that more women than men had experienced sexual coercion involving physical force. These results are discussed in terms of the similarities and differences between men's and women's cognitive and affective responses to sexual coercion. (Contains 1 table.)

The authors examined how many bereaved relatives of Norwegian tourists who perished in the 2004 Southeast Asian Tsunami had visited the site of death and the most important outcome from the visit. We conducted in-depth interviews (n = 110) and used self-report questionnaires (Impact of Event Scale--Revised, Inventory of Complicated Grief, and General Health Questionnaire) in a total of 130 first-degree family members 2 years post-disaster. Results showed that the majority of participants (n = 113; 87%) had visited the site of death. The most important outcome was gaining an increased understanding of what occurred (61%) and a feeling of closeness to the deceased (21%). Those who had visited the site of death reported lower avoidance behavior and higher degree of acceptance of the loss than non-visitors. Although this could be a cause as well as a consequence of the visit, visiting the site of death may be an important part of the support offered to bereaved families after experiencing a disaster loss. (Contains 4 tables and 1 figure.)

This study examined the severity of posttraumatic stress disorder (PTSD) symptoms and the coping strategies of 51 aging hidden children (28 women and 23 men) 65 years after the Holocaust. Results indicated a positive relation between age and PTSD symptoms that was fully mediated by sense of danger and education. Regression analyses showed that lower educational level ([beta] = -0.32) and more reappraisals ([beta] = -0.38) were associated with severity of PTSD symptoms. Reappraisal also predicted intrusions ([beta] = 0.36) and arousal ([beta] = 0.37). (Contains 1 figure and 4 tables.)

Objectives: The focus of this study was to examine the relationship among precursors to physical activity, including exercise self-efficacy, perceived exertion, stress, and demographic factors, among college students. Design: This study employed an associational design. Setting: The study population was college freshmen in southeast Louisiana who were between the ages of 18 and 24 years. Method: A path analysis was used to examine the strength and directional relationship among variables depicted in Pender's Health Promotion Model (HPM) and to determine the structure of the relationships among the variables in the conceptual map. Path coefficients were used to determine whether the independent variables (exercise self-efficacy, stress, perceived exertion, demographic factors) as depicted in the path diagram made a unique contribution to predicting physical activity (dependent variable) or if the relationships between stress, perceived exertion, and physical activity, are mediated by exercise self-efficacy. Results: Study results portrayed a relationship between perceived exertion and exercise self-efficacy and a relationship between a person's belief in their ability to stick to an exercise programme (self-efficacy) and their level of activity. Compared to their counterparts, this study's population had lower levels of usual physical activity, but heightened levels of physical activity immediately following hurricanes Katrina and Rita. Conclusion: This study adds to the body of knowledge related to predictors of physical activity and the applicability of Pender's HPM to such studies. The study also provides insight into the impact of a natural disaster on physical activity. (Contains 1 figure.)

Experiential avoidance (EA) has been conceptualized as the tendency to avoid negative internal experiences and is an important concept in numerous conceptualizations of psychopathology as well as theories of psychotherapy. Existing measures of EA have either been narrowly defined or demonstrated unsatisfactory internal consistency and/or evidence of poor discriminant validity vis-a-vis neuroticism. To help address these problems, we developed a reliable self-report questionnaire assessing a broad range of EA content that was distinguishable from higher order personality traits. An initial pool of 170 items was administered to a sample of undergraduates (N = 312) to help evaluate individual items and establish a structure via exploratory factor analyses. A revised set of items was then administered to another sample of undergraduates (N = 314) and a sample of psychiatric outpatients (N = 201). A 2nd round of item evaluation was performed, resulting in a final 62-item measure consisting of 6 subscales. Cross-validation data were gathered in 3 new, independent samples (students, N = 363; patients, N = 265; community adults, N = 215). The resulting measure (the Multidimensional Experiential Avoidance Questionnaire, or MEAQ) exhibited good internal consistency, was substantially associated with other measures of avoidance, and demonstrated greater discrimination vis-a-vis neuroticism relative to preexisting measures of EA. Furthermore, the MEAQ was broadly associated with psychopathology and quality of life, even after controlling for the effects of neuroticism. (Contains 7 tables.)

The authors investigated posttraumatic stress disorder (PTSD) symptoms in Japanese bereaved family members using a questionnaire. Participants were bereaved as a result of suicide and homicide (n = 51 and 49, respectively), with natural death (n = 56) as a control; and their relationships to the deceased were parent-child (n = 79), conjugal (n = 42), and others (n = 35). With regard to the 3 main PTSD-related criteria, (a) re-experiencing symptoms were not dependent on the manner of death or the relationship to the deceased; (b) avoidance behaviors were more highly related to homicide than natural death for relatives other than parent-child and conjugal relationships; and (c) hyperarousal and maladaptation symptoms were more serious for conjugal loss. These findings suggest that avoidance behaviors in homicidal cases are more closely associated with a distant family relationship, whereas conjugal loss is traumatic, irrespective of the manner of death, often causing hyperarousal and maladaptation symptoms. (Contains 4 figures.)

Background: While the current knowledge base on the mental health effects of displacement is mainly limited to refugees residing in industrialised countries, this paper examines the impact of war-induced displacement and related risk factors on the mental health of Eastern Congolese adolescents, and compares currently internally displaced adolescents to returnees and non-displaced peers. Methods: Data were collected from a community sample of 819 adolescents aged 13 to 21 years, attending one of 10 selected schools across the Ituri district in the Democratic Republic of Congo. Respondents completed culturally adapted self-report measures of posttraumatic stress symptoms (using the Impact of Event Scale-Revised) and internalising and externalising behaviour problems (by means of the Hopkins Symptoms Checklist--37 for Adolescents). Associated factors studied were age, sex, parental death, exposure to war-related violence and daily stressors. Results: Internally displaced persons (IDPs) reported highest mean scores for the IES-R and the HSCL-37A internalising scale, followed by returnees, while non-displaced adolescents scored significantly lower. However, ANCOVA tests showed that posttraumatic stress and internalising symptoms were mainly associated with traumatic exposure and daily stressors and not with displacement status. Externalising problem scores were associated with traumatic exposure, daily stressors and displacement. Remarkably, death of father was associated with fewer externalising problems. Sex was differently associated with internalising and externalising problems through traumatic and daily stressors. Conclusions: As IDPs are highly exposed to violence and daily stressors, they report most psychological distress, when compared to returnees and non-displaced peers. The distinct mental health outcomes for returned youngsters illustrate how enhancing current socio-economic living conditions of war-affected adolescents could stimulate resilient outcomes, despite former trauma or displacement.

Three studies involving 328 married couples were conducted to validate the Marital Offence-Specific Forgiveness Scale, a new measure assessing offence-specific forgiveness for marital transgressions. The studies examined the dimensionality; internal consistency; and discriminant, concurrent, and predictive validity of the new measure. The final scale comprised 2 distinct correlated dimensions, 1 positive (Benevolence) and 1 negative (Resentment-Avoidance), both of which had adequate internal consistency. The 2 dimensions discriminated marital forgiveness from affective empathy, rumination, attributions, and marital quality. Convergent validity of the new scale was indicated by significant relationships between its underlying dimensions and a host of predicted sociocognitive, relationship, trait, and well-being correlates of forgiveness. Providing evidence for predictive validity, forgiveness dimensions accounted for variability in relationship variables over a 6-month period. (Contains 4 footnotes, 5 tables and 1 figure.)

The Impact of Event Scale-Revised (D. S. Weiss & C. R. Marmar, 1997) was used to obtain self-reported trauma levels from 587 young adults recalling childhood or adolescence experiences as witnesses to common forms of repetitive abuse defined as bullying. Mean participant scores were in a range suggesting potential need for clinical assessment at the time these events occurred. Multiple regression analysis identified significant predictors of distress levels, with intensity of abuse being the strongest. Additional results and implications of findings are discussed.

Studies have shown that posttraumatic growth is associated with greater well-being. However, it is not clear whether posttraumatic growth is related to subjective well-being (SWB) or psychological well-being (PWB). Whereas SWB is derived from the hedonistic tradition, PWB is derived from the eudaimonic tradition. In a sample of 125 college students who had experienced a distressing event, we found evidence that growth is related to PWB rather than SWB. (Contains 1 table.)

The authors assessed burnout, compassion fatigue, secondary trauma symptoms, and compassion satisfaction in relation to experienced therapists' perceptions of the working alliance. Participants, 106 specialists in the treatment of clients who commit sexual abuse, completed the Working Alliance Inventory-Short Form (T. J. Tracey & A. M. Kokotovic, 1989) in relation to 1 of their male clients; the Professional Quality of Life Scale-Revised (B. H. Stamm, 2005), which assesses 3 components of work-related adjustment; and the Impact of Events Scale (D. S. Weiss & C. R. Marmar, 1995), a measure of secondary trauma. Results of the hierarchical regression analyses showed that perceived alliances were strongest for therapists who had been working relatively longer in this specific field. When the 4 work-related experiences were added to the demographic characteristics, compassion satisfaction was the only unique predictor of alliance ratings. Descriptive analyses showed low mean scores on secondary trauma symptoms and compassion fatigue and generally high levels of compassion satisfaction. (Contains 2 tables and 1 footnote.)

Depression and posttraumatic stress disorder (PTSD) are highly comorbid conditions that may arise following exposure to psychological trauma. This study examined their temporal sequencing and mutual influence using bivariate latent difference score structural equation modeling. Longitudinal data from 182 emergency room patients revealed level of depression symptom severity to be positively associated with changes in PTSD intrusion, avoidance, and hyperarousal over 3 time intervals, beginning shortly after the traumatic event. Higher scores on depression anticipated increases (or worsening) in PTSD symptom severity. The pattern of influence from PTSD symptom severity to change in depression symptom severity simply followed the general trend toward health and well-being. Results are discussed in terms of the dynamic interplay and associated mechanisms of posttrauma depression and PTSD symptom severity. (Contains 2 figures, 5 tables, and 4 footnotes.)

Background: To investigate the level of posttraumatic stress and depressive symptoms, and background risk and protective factors that might increase or ameliorate this distress amongst unaccompanied asylum-seeking children and adolescents (UASC). Methods: Cross-sectional survey carried out in London. Participants were 78 UASC aged 13-18 years, predominantly from the Balkans and Africa, compared with 35 accompanied refugee children. Measures included self-report questionnaires of war trauma, posttraumatic stress and depressive symptoms. Results: UASC had experienced high levels of losses and war trauma, and posttraumatic stress symptoms. Predictors of high posttraumatic symptoms included low-support living arrangements, female gender and trauma events, and increasing age only amongst the UASC. High depressive scores were associated with female gender, and region of origin amongst the UASC. Conclusion: UASC might have less psychological distress if offered high-support living arrangements and general support as they approach the age of 18 years, but prospective studies are required to investigate the range of risk and protective factors.

Connections between exposure to bullying and trauma were explored with 91 sixth-grade adolescents who experienced exposure to bullying in a school environment. Levels of trauma were rated as high with greater exposure to bullying. Significant predictors were frequency of exposure to bullying and participant sex. Implications for school counselors working with students who experience bullying-related trauma are discussed. (Contains 2 tables.)

This study aimed to assess the prevalence of war experiences and the use of specific cognitive emotion regulation strategies in response to these experiences among 294 formerly abducted adolescents at three rehabilitation centres in Uganda. Cognitive strategies were measured by Cognitive Emotion Regulation Questionnaire (CERQ). Symptoms of psychopathology were measured by the Impact of Events Scale-Revised (IES-R) and the Youth Self-Report (YSR). Relationships were studied by means of descriptive statistics, correlations and Multiple Regression Analyses. Strong relationships were found between specific cognitive emotion regulation strategies and posttraumatic stress (PTS), Internalizing and Externalizing symptoms. The results may have implications for intervention strategies.

Toddler toy play evolves in a predictable manner and provides a valid, nonverbal measure of cognitive function unbiased by social behaviors. Research on prenatal maternal stress (PNMS) indicates that exposure to stress in utero results in developmental deficits. We hypothesized that children exposed to high objective PNMS from a natural disaster early in pregnancy would exhibit higher rates of stereotypical play and lower rates of mature functional play than their low-stress counterparts would. We examined the functional play abilities of 52 2-year-olds exposed to low or high objective PNMS from a natural disaster within a nonstructured play session. Toddlers exposed to high objective PNMS, subjective PNMS, or both exhibited less functional and more stereotypical toy play, with less diversity, compared to toddlers exposed to low PNMS. PNMS appears to affect functional play development in toddlers negatively. These results replicate delays in language and intellectual functioning observed in these toddlers using the Bayley Scales. (Contains 3 tables and 2 figures.)

The Akkaraipettai village of the Nagapatinam district of Tamilnadu, India, was one of the areas most affected by the tsunami that hit the Indian Ocean on December 26, 2004. This study was conducted to assess the psychological effect of the tsunami on adolescents. The impact of the trauma was both measured and examined from a cultural perspective. The Impact of Event Scale, (IES), the Children's Revised Impact of Event Scale, (CRIES), and the Pediatric Emotional Distress Scale (PEDS) were administered to 130 subjects (69 boys and 61 girls). Results showed that the children measured high on posttraumatic stress and all three factors of the PEDS. Further, a sex difference was recorded, with females exhibiting more likelihood of trauma than males. Loss of family members significantly determined all of the factors of the IES and CRIES except intrusion.

HIV/AIDS patients with medication adherence problems are vulnerable to developing drug resistance, immune system degradation, and opportunistic infections. Poor adherence to antiretroviral medication regimens can be aggravated by psychiatric problems, including depression and posttraumatic stress disorder. This article presents the case study of a patient with HIV/AIDS who was unable to adhere to his antiretroviral medication regimen primarily because of PTSD and depressive symptoms resulting from a sexual assault that had caused his seroconversion. Exposure-based cognitive-behavioral therapy was instrumental in helping the patient overcome his PTSD and depressive symptoms so that he could tolerate his HIV medications. The patient's symptom relief was evidenced by improved scores on the Impact of Event Scale and Beck Depression Inventory. The article discusses the importance of accurate assessment, therapist flexibility, and principle-based treatment versus strict adherence to manual-based protocols. (Contains 2 figures and 1 table.)

For many survivors of serious road trauma, the physical and psychological consequences are complex and lifelong. The longer-term psychosocial recovery experience for survivors, however, is rarely documented in the social work literature. This article reports on findings from a study of road trauma recovery experiences. The findings are presented in relation to posttraumatic growth and posttraumatic stress experiences, as measured by the Posttraumatic Growth Inventory and the Impact of Event Scale. Data were collected from 79 anonymous self-administered postal surveys from participants who had received treatment in an Australian rehabilitation center following serious orthopedic injury. One-third of these survivors continued to experience serious psychological distress in the aftermath of road trauma and a range of other psychosocial consequences four years after their accident. Although 87 percent of the sample continued to experience posttraumatic stress difficulties, 99 percent reported experiences of posttraumatic growth. Implications of these findings for social work practice are discussed.

The present study investigates the efficacy of an Internet-based cognitive-behavioral therapy program for bereaved people suffering complicated grief. The program combines established methods of psychotherapy with new technology--therapists and patients communicated exclusively by e-mail. Bereaved individuals diagnosed with complicated grief (n = 55) were randomly assigned to either the treatment group or a waiting list control condition. The 5-week intervention consisted of three modules: (1) exposure to bereavement cues; (2) cognitive reappraisal; and (3) integration and restoration. The Impact of Event Scale (IES), a failure to adapt scale, and the depression and anxiety subscales of the Brief Symptom Inventory (BSI) were used to assess treatment outcomes. Participants in the treatment group (n = 26) improved significantly relative to participants in the waiting condition on symptoms of intrusion, avoidance, maladaptive behavior, and general psychopathology, and showed a large treatment effect. Follow-up results show that this improvement was maintained after 3 months. (Contains 5 tables, 1 figure, and 1 footnote.)

Background: On October 29, 1998, around 400 young people were gathered in an old warehouse in Goteborg, Sweden, for a discotheque party. A fire erupted and spread explosively. Adolescents were exposed to dreadful scenes inside and outside the building. In all, 63 young people were killed and 213 physically injured. An 18-month follow-up with 275 adolescents (126 girls) who survived the fire, regarding the effects of the fire on symptoms of posttraumatic stress, school adjustment and performance, is reported. Methods: Impact of Events Scale (IES), Clinician Administered Posttraumatic Stress Scale (CAPS) and an interview concerning background factors and issues of public and personal support. Results: The level of posttraumatic stress was generally high, and highest among adolescents with an immigrant background. In all, 25% of the participants met DSM-IV criteria for PTSD. Twenty-three percent of the participants reported having either dropped out of school or repeated a class because of the fire. Students' ratings of how their own school handled the situation, and school absenteeism, were related to ratings of their own performance in school as well as to the level of posttraumatic stress. Conclusions: Traditional talking cures were more sought out by girls than boys. Broad-scale interventions must be complemented with special treatment opportunities for the most severely afflicted. Victims who suffer from high levels of posttraumatic stress need special support for a long period of time to minimise the effects on scholastic achievement and adjustment. Studies of the effects of traumatic events on child and adolescent development should measure school-related effects better than has hitherto been the case.

Recent studies have found that chronic avoidance of unpleasant internal experiences (e.g., thoughts, emotions, memories) is a maladaptive means of affect regulation often adopted by women with a history of sexual victimization in childhood. The primary aim of this study was to replicate and extend previous findings suggesting that higher levels of experiential avoidance may account for the relationship between childhood sexual abuse (CSA) and psychological distress in adulthood. It was hypothesized that, in a sample of undergraduate females (n = 151), the relationship between severity of CSA (e.g., frequency, nature of victimization) and trauma-related psychological distress would be mediated by avoidance. Results supported this hypothesis. Findings are consistent with previous studies, and further suggest that the general tendency to avoid or escape from unpleasant internal experiences may be a specific factor that exacerbates psychological distress among women with a history of sexual victimization in childhood. (Contains 2 tables and 1 figure.)

Emphasis is placed on the use of empirically supported therapies in clinical practice as a manifestation of the scientist-practitioner approach. The predominant model used to provide empirical support for interventions uses groups of patients in randomised clinical trials in university settings. This model has severe limitations for the clinician. It cannot be assumed that results obtained in university-based, group studies generalise to a clinical practice setting. In addition, the group model does not provide the clinician with a practical approach to evaluate his/her intervention. Single case (N = 1) designs have much to offer the clinician in this regard. Clinicians need to be encouraged to use this approach in evaluating their interventions and journal editors should be encouraged to publish them.

Objective: This article examines survivor perspectives of the effectiveness of two different treatments for trauma symptoms among adult female survivors of childhood sexual abuse--Eye movement Desensitization and Reprocessing (EMDR) and eclectic therapy. Method: Qualitative interviews obtained in the context of a mixed-methods study were conducted with 38 adult female survivors of childhood sexual abuse. Results: Two major differences in outcomes between the two treatment approaches were observed. There were considerable distinctions between the two treatment groups in terms of the importance and effect of the client-therapist relationship, and in terms of the depth of change reportedly caused by the different therapies. Conclusions: Survivors' narratives indicate that EMDR produces greater trauma resolution, while within eclectic therapy, survivors more highly value their relationship with their therapist, through whom they learn effective coping strategies.

Objective: Although not every woman is negatively affected by an abortion, researchers have identified a subgroup of women susceptible to grief and trauma. The primary providers for postabortion grief (PAG) groups are community faith-based agencies. Principle features of PAG are shame and post-traumatic stress disorder (PTSD) symptoms. Method: This study measured the efficacy of a spiritually based grief group intervention for women grieving an abortion. Thirty-five women completed the Impact of Event Scale-Revised (IES-R) and the Internalized Shame Scale (ISS) pre- and postintervention along with posttest open-ended questions. Results: Postintervention measures indicated significant decrease in shame (p less than 0.000) and PTSD symptoms (p less than 0.002). More than 80% reported their religious beliefs and the spiritual intervention played a strong to very strong role in the group. Conclusion: Social workers need to screen for PAG with a postabortive woman and when appropriate refer her to agencies offering such groups.

This 18-month follow-up study builds on the findings of a randomized experimental evaluation that found qualified support for the short-term effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in reducing trauma symptoms among adult female survivors of childhood sexual abuse (CSA). The current study provides preliminary evidence that the therapeutic benefits of EMDR for adult female survivors of CSA can be maintained over an 18-month period. Furthermore, there is some support for the suggestion that EMDR did so more efficiently and provided a greater sense of trauma resolution than did routine individual therapy. (Contains 2 tables.)

Two hundred and eighty-four adults from the metropolitan New York area reported on their history of childhood sexual abuse (CSA), childhood physical abuse (CPA), and on the nature of their exposure to the terrorist attack on the World Trade Center. The respondents also completed the Impact of Events Scale-Revised (IES-R), the Attachment Style Questionnaire (ASQ) and the Dissociative Experiences Scale (DES). Those reporting histories of CSA and/or CPA were found to endorse more serious symptoms of PTSD, as did those who witnessed the terrorist attack live. The presence of secure attachments and dissociative symptoms were related significantly to both CSA and CPA, and to scores on the IES-R. Adult attachment and dissociation were found to mediate the relationship between childhood abuse and severity of PTSD. (Contains 6 tables.)

Maternal support received by sexual abuse victims is considered a key factor in coping with the aftermath of abuse. The present study looked at four groups of potential predictors of maternal support: mother's psychosocial characteristics, abuse characteristics, victim's characteristics, and disclosure characteristics. A total of 120 adolescents aged 12 to 17 years and their mothers, who were recruited from Child Protective Services, completed questionnaires and semi-structured interviews. Multiple regression analyses performed separately on mother and child data sets revealed five significant predictors of maternal support in each analysis, four of which were common to both. The discussion underscores the importance of taking into account both the mother's and the victim's perceptions regarding psychological adjustment and family environment. (Contains 2 tables.)

The Impact of Event Scale (IES) (M. Horowitz, N. Wilner, and W. Alvarez, 1979) and three other measures of stress were administered to 505 adults in the general population who focused on an "upsetting event." Data suggest that an "upsetting event" version of the IES may be useful as a screen for nonarousal-related posttraumatic stress. (SLD)

Significant proportions of participants drop out of cognitive behaviour therapy for post-traumatic stress disorder (PTSD). This study indexed the pretreatment characteristics of civilian trauma survivors who remained in (n = 95) and dropped out (n = 33) of therapy for chronic PTSD. Therapy involved either cognitive behaviour therapy or supportive counselling. Participants who dropped out of therapy had higher scores on the Impact of Event Scale-Avoidance and the Catastrophic Cognitions Questionnaire, controlling for the influence of pretreatment PTSD severity. These findings suggest that retaining participants in therapy for PTSD may be enhanced by focusing initial therapy attention on modification of catastrophic cognitive styles and avoidance tendencies. (Contains 1 table.)

Attempted to validate the Impact of Event Scale (IES) with a large sample of males who had been exposed to combat trauma. The IES was shown to be sensitive to differences between and within the three subject groups (combat stress reaction group, combat control group, noncombat control group). Four basic patterns of intrusion and avoidance were identified. (Author/NB)