Digital Commons Network^™

Trauma Mediating The Severity Of Depressive Symptoms In Veterans With Ptsd, Meghan Curtin

Dissertations

Trauma serves as a risk factor for developing both posttraumatic stress disorder (PTSD) and depression. The purpose of this study was to examine trauma type as a mediator in the relationship between gender and severity of depressive symptoms among veterans with PTSD. The literature shows trauma type plays a role in developing PTSD and depressive symptoms. The first hypothesis was that female veterans who met the diagnostic criteria for PTSD would report higher levels of depressive symptoms than their male counterparts. The second hypothesis was that this gender difference would be partly mediated by levels of interpersonal trauma experience. Self-report …

Investigating The Differences Between Neuropsychological And Physiological Markers In A Ptsd-Only Group Among Vietnam Veterans, Ashtan Madsen

Dissertations

Individuals diagnosed with posttraumatic stress disorder (PTSD) have demonstrated extinction-resistant symptoms and long-lasting impacts on the brain’s functional activity (Krystal et al., 2017; Stark et al., 2015). PTSD illustrates a strong relationship with cognitive functioning, and research has found lower parietal and hippocampal volume and deterioration in brain function and structure, resulting in executive dysfunction, attentional deficits, mood dysregulation, and memory difficulties (Krystal et al., 2017; Stark et al., 2015; Weiner et al. 2017). Sleep has been investigated to better understand its contribution to AD pathologies as well as its impact on PTSD treatment and prognosis. Although sleep’s functions are …

Treatment Outcome From Cognitive Processing Therapy Examined Three Ways, Sophie Haven

Dissertations

Cognitive Processing Therapy (CPT), a Cognitive Behavioral Therapy for treating Post Traumatic Stress Disorder (PTSD), is an evidence-based treatment that has been demonstrated to be effective in treating PTSD. Nonetheless, CPT can have a high rate of treatment non-completion. Attrition from therapy has been operationally defined using multiple contrasting methods. Understanding attrition using a definition with the most clinical utility is essential to improving outcomes from efficacious treatments. Two clinically relevant definitions for attrition, session attendance and symptom improvement, are critical to understanding attrition. Combining information from both definitions, to create four separate groups, will provide more accurate information about …

Mental Health Impacts On Personnel Responding To An Active Shooter Incident Within A Large Public Service Utility Company, Michael Weber

Dissertations

This study explores the long-term mental health impacts experienced by individuals who were both impacted by an active shooter event within their own organization and participated in the response operation to said event. Through purposive sampling, a population of 278 individuals from a large privately-owned public utility company, with greater than 20,000 employees, were provided a cross-sectional survey to assess for the presence and severity of indicated PTSD. This assessment was conducted using the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT) survey tool. A total of 118 participants completed the survey, the results of which determined that PTSD occurred in …

First Responder Coping And Its Impact On Resilience, Ptsd Symptomology, And Hypervigilance, Bianca Bullock

Dissertations

The present study investigated coping strategies utilized by first responders and how those strategies relate to resilience, PTSD symptomology, and hypervigilance. The purpose of this study is to help provide more detailed information as to how first responders’ coping impacts their overall functioning. First responders (N = 181), including law enforcement officers, firefighters, paramedics, and emergency medical technicians, completed online surveys measuring whether engaged or disengaged coping strategies were used to manage stressful situations. Self-perceived resilience, PTSD symptoms, and hypervigilance were also measured. A one-way between-groups multivariate analysis of variance was performed to test the relationships between engaged versus disengaged …

Determining The Effectiveness Of Virtually-Delivered Written Exposure Therapy For Treatment Of Posttraumatic Stress Symptoms, Stephanie M. Haft

Dissertations

The COVID-19 pandemic has disproportionately impacted individuals with mental health issues (Swendsen, 2020). Although the peak destruction of the COVID-19 pandemic has passed, the psychological fallout remains. Social isolation, home confinement, and travel restrictions have exacerbated mental health issues during the COVID-19 pandemic, contributing to negative psychological distress (Smith et al., 2020). Survivors of trauma have higher vulnerability to prolonged psychological distress than the general population and others with non-trauma-related mental health conditions, which has been exacerbated during and following the COVID-19 pandemic. For these reasons, survivors of trauma may particularly benefit from virtual-delivery of trauma-focused treatments. Mental health providers …

Multi-Method Approach To Examining Psychosocial Responses And Reactions To Covid-19 In The Us And China, Fan Li

Dissertations

Objective

The purpose is to examine health care providers’ psychosocial responses to COVID-19 in China and the US via exploring relationships among psychological responses and describing experiences of working at the epicenter during the pandemic.

Methods

In manuscript one, a cross-sectional study was conducted in nurse and physician volunteers who provided direct care to COVID-19 patients in Wuhan (volunteers) and those with no COVID-19 contact outside of Wuhan (non-volunteers). A path analysis theoretical model was developed to illustrate the relationships among psychosocial variables and was separately applied to volunteer and non-volunteer groups.

In manuscript two, a cross-sectional study was conducted …

A Phenomenological Replication Study On The Unique Challenges Experienced By Veterans Diagnosed With Posttraumatic Stress Disorder (Ptsd) While Attending A California State University (Csu) In Riverside, San Diego, San Bernardino, Or Orange County, Ralph Martinez

Dissertations

The purpose of this qualitative phenomenological replication study was to understand the unique challenges experienced by veterans diagnosed with Posttraumatic Stress Disorder (PTSD) while attending a California State University (CSU) in Riverside, San Diego, San Bernardino, or Orange County. Furthermore, it was the intent of this study to explore the current and prospective services veteran students believe were helpful or would be helpful in promoting positive academic outcomes.

A phenomenological approach was utilized in the development of this qualitative research study to explore the lived experiences of veteran students diagnosed with PTSD attending a California State University (CSU) in Riverside, …

Secondary Traumatic Stress In Intimate Partners And Children Of Service Members, Amber Foreman

Dissertations

This literature review addresses secondary traumatic stress (STS) in intimate partners and children of service members. More specifically, this literature review aims to explore if intimate partners and children of military service members are at risk for developing secondary traumatic stress. Secondly, this review aims to explore if there are specific risk factors associated with the development of secondary traumatic stress in intimate partners and children of service members. Finally, this review examines if there are other stressors and outcomes for intimate partners and children of service members. A systematic review of peer-reviewed research was explored to accomplish addressing the …

Mental Health Concerns Of Frontline Registered Nurses Associated With The Covid-19 Pandemic, Julie Ingle

Dissertations

Problem

COVID-19 caused local healthcare facilities to admit patients with COVID-19 at increasing rates, critically overloading healthcare system resources. Caregiver-related stress associated with the COVID-19 pandemic placed frontline registered nurses (RNs) at risk for mental health consequences (Havlioglu & Demir, 2020; Shechter et al.,2020).

Methods

This quality improvement project used a descriptive design to administer a collection of validated instruments assessing anxiety, depression, posttraumatic stress disorder (PTSD), and demographics. A purposive sample of RNs were recruited from the COVID-19 units in a local hospital, and the survey was distributed via email.

Results

During the implementation period (April 4, 2021-May 15, …

Mindfulness And Technology: Evaluating An Online Mindfulness Intervention For Symptoms Related To Sexual Assault, Erica Catherine Johnson

Dissertations

Sexual assault has been found to increase the risk of distressing psychological symptoms including PTSD, depression, somatization, drug and substance use, lower quality of life and experiential avoidance. As such, interventions for reducing the distress and negative impacts of sexual assault are of importance. Mindfulness is of particular interest as it addresses one of the prominent factors known to maintain psychological distress after trauma, experiential avoidance (Polusny et al., 2004; Merwin et al., 2009). Furthermore, an online mindfulness-based intervention can increase the accessibility and reduce the barriers to treatment. A within subjects repeated measures open clinical trial design was used …

Exploring The Maladaptive Cognitions Of Moral Injury, Rachel L. Martin

Dissertations

Moral injury and Post-Traumatic Stress Disorder (PTSD) are two prominent mental health problems that affect military personnel. Moral injury results when the individual is exposed to a situation or event that violates their moral code; however, PTSD results when there is a substantial threat of harm. Moral injury is a relatively new construct within the literature with research starting in the late 2000s. Although distorted cognitions are core components of PTSD symptomatology, there has been no research of cognitions in moral injury. The current study sought to differentiate PTSD and moral injury using the specific maladaptive cognitions associated with trauma …

Military Sexual Trauma In Veterans: Consequences, Treatment, And Therapeutic Implications, Chelsey Siville

Dissertations

Amongst Veterans served within the Veterans Affairs healthcare system, approximately 1 in 50 men and 1 in 3 women have experienced military sexual trauma (MST). While every individual is different, a common characteristic or identity amongst those who have served is that of a warrior – someone perceived as strong and ready to defend both their country and fellow soldier. Experiencing military sexual trauma can create a painful and discrepant identity as well as impact almost all domains of functioning. Unfortunately, trauma is an all too common occurrence in the lives of many service members and the multifinality of trauma …

Neurobiological Mechanisms Of Cognitive Processing Therapy For Post-Traumatic Stress Disorder: A Brain Network Approach, Tessa Vuper

Dissertations

Psychotherapy research is increasingly targeting both psychological and neurobiological mechanisms of therapeutic change. This trend is evident in and applicable to post-traumatic stress disorder (PTSD) treatment research given the high nonresponse rate of individuals with PTSD who undergo cognitive-behavioral therapy (CBT). A review of the literature investigating neurobiological mechanisms of CBT in PTSD reveals inconsistent results that fail to fully support dual process or learning models of CBT effects in the brain. However, network-based models of psychopathology provide a new framework from which to understand both mental disorder symptoms and therapeutic mechanisms. The current study investigated a) whether brain networks …

Ptsd Symptom Interaction Among Victims Of Interpersonal Violence: A Network Analysis, Robert Graziano

Dissertations

Along with numerous combinations of symptoms, posttraumatic stress disorder (PTSD) is linked to high dropout and non-response rates in treatment. Poor treatment response may be due to an inaccurate conceptualization of PTSD. One newer approach to the conceptualization of psychopathology is network theory. Network theory posits that symptoms both directly and indirectly reinforce each other, with connections between symptoms varying in strength. Previous studies of network theory and PTSD have found intrusive symptoms to be highly central, but have not included samples of individuals traumatized by interpersonal violence. Because trauma type has been shown to predict symptom presentations, this represents …

Service To American Heroes: Exploring The Experiences Of Veterans Suffering From Ptsd Transitioning From Military Service To Civilian Careers, Samuel Scaife

Dissertations

Purpose. The purpose of this multiple case study was to explore the experiences of post-9/11 veterans suffering from PTSD residing in California who transitioned from military service to civilian careers within the last 3-5 years, through the lens of Schlossberg’s 4S factors of situation, self, social support, and strategies.

Methodology. A qualitative case study was used allowing for in-depth exploration. A multiple case study was selected to explore the lived experiences of PTSD veterans who recently transitioned from military service to civilian careers in San Diego, CA. The primary method of data collection was semi-structured interviews to gather the …

The Relationship Between Frequency Of Yoga And Meditation On Ptsd Symptoms In Individuals Who Have Experienced Intimate Partner Violence, Kimberly Polignani

Dissertations

Intimate partner violence (IPV) has become a growing phenomenon in the United States,

affecting nearly 13% of the population. The adverse mental health outcomes from people who experience IPV are prevalent and more than half have a diagnosis of posttraumatic stress disorder (PTSD). Therefore, therapeutic techniques for PTSD appear to be feasible for IPV survivors and their mental health issues. Complementary and alternative medicine has become a widely accepted approach for PTSD. Being two complementary and alternative medicine techniques, yoga and meditation are effective forms of therapy in many diagnoses, including PTSD. This study utilized a not-for-profit organization called the …

Examining The Gender- And Sexuality-Related Cognitive “Stuck Points” Of Men And Women With Experiences Of Adult Sexual Assault: Implications For Cognitive Processing Therapy, Marin Beagley

Dissertations

Cognitive Processing Therapy (CPT) is considered a gold-standard psychotherapy protocol for the treatment of posttraumatic stress symptoms secondary to a variety of traumatic events. Despite its demonstrated efficacy, there is research to suggest CPT may not be as effective in reducing PTSD symptoms for men with an adult sexual assault trauma as it is for their female counterparts. The purpose of the present study was to determine whether CPT treatment outcome discrepancies may be attributable to gender differences in posttraumatic cognitions, or “stuck points.” As the act of sexual victimization is incongruent with socially prescribed masculine gender norms, it was …

Understanding Comorbid Depression In The Context Of Ptsd Through Underlying Dimensions, Melissa Turkel

Dissertations

Depression co-occurs with Posttraumatic Stress Disorder at a high rate, resulting in numerous complications for pathology and treatment. More research is needed regarding variables that may explain this common comorbidity. One possible variable is that of underlying dimensions, latent factors that give rise to these manifestations of psychopathology. This study explored potential underlying mechanisms of comorbid PTSD and depression, including negative affect, rumination, emotion dysregulation, neuroticism, and behavioral inhibition. While previous studies have investigated these dimensions individually, there is a dearth of research that simultaneously investigates multiple dimensions or determines the relative contributions of underlying dimensions to psychopathology. Thus, the …

The Relationship Between Combat Experience, Veteran Pathology And The Pathology Of Their Intimate Partners: What Factors Predict The Pathology Of Veterans And Their Intimate Partners, Edwin A. Brennan

Dissertations

Problem Statement

Military members and their family members who are part of the Global War on Terrorism have experienced deployments and war for over sixteen years and with the resulting toll on both the veteran and their intimate partner. As a result, higher levels of pathology, such as PTSD, Anxiety, and Depression have been experienced by this population. While research has studied the effect of combat on military members, very little research has addressed the effects on family members. Further, no research that has been found by this researcher, has addressed the concept of resonating of pathology between the combat …

Beta-Testing Of An Interactive Multimedia Computer Program Of Exposure Therapy For Ptsd, Marie C. Barrett

Dissertations

Posttraumatic Stress Disorder (PTSD) results in significant impairment for the individual and substantial costs to society. Research indicates that cognitive behavioral psychotherapy (CBT) is the most effective treatment for PTSD and that among CBT treatments, exposure therapy is the treatment technique with the strongest evidence to recommend it for PTSD treatment. Computerized programs that deliver evidenced-based treatments offer a potential solution to barriers that prevent individuals from accessing and completing treatment. The present study evaluates the clinical and practical functionality of a computer-based program designed for the treatment of PTSD. Results indicate that completion of the program is associated with …

Clinician Bias In The Diagnosis Of Posttraumatic Stress Disorder: How Clinician Characteristics And Training May Relate To Diagnosis, Renee Boeck

Dissertations

As our understanding of PTSD has advanced, changing demographics in the United States over the past few decades have led to a growing awareness of the mental health needs of an increasingly diverse and multicultural population. Research on ethnoracial differences in PTSD has had mixed results and additional research exploring possible contributing factors is needed to better explain observed differences. This study explored the presence of and contributing factors to clinician bias in the diagnoses of PTSD based on race and context. It examined whether clinicians were more likely to diagnose PTSD in a Black or White man due to …

From War To Home: The Systematic Issues Operation Enduring And Iraqi Freedom Veterans Face Transitioning With Ptsd, Tiffany D. Ware

Dissertations

Purpose: The purpose of this phenomenological study was to describe the perceptions of Operation Enduring and Iraqi Freedom veterans with PTSD, who are transitioning from active duty to civilian life, regarding their participation in the Disabled Transition Assistance Program.

Methodology: The methodology for this research study will be qualitative from a phenomenological perspective. When thinking of research as it pertains to qualitative methods, it is appropriate to use when a researcher is trying to study the lived experiences of individuals (Flipp, 2014; Patton, 2015). This method will describe perceptions of Operation Enduring and Iraqi Freedom veterans with PTSD, who are …

An Examination Of Subtypes Of Posttraumatic Stress Disorder Utilizing Latent Profile And Taxometric Analyses, Joseph Finn

Dissertations

Prior studies examining PTSD subtypes have yielded mixed results, likely stemming in part from the use of divergent samples and measurement techniques. This study aimed to expand upon these findings by utilizing a large nationally-representative sample in combination with sophisticated statistical analyses. Utilizing a sample of 2496 adults with a diagnosis of PTSD, latent profile analysis was used to determine the optimal number and composition of latent classes of individuals diagnosed with PTSD, and then taxometric analysis was utilized to determine whether these classes differed not only in degree, but in kind.

Finally, class relationships with a number of external …

Fidelity To The Cognitive Processing Therapy Protocol: Further Evaluation Of Critical Elements, Courtney Chappuis Farmer

Dissertations

Despite advancements in the field of trauma-focused treatment, a close examination of the literature reveals three concerns. First, a significant number of RCT participants either do not respond to treatment or drop out prematurely. Second, despite significant dissemination of evidence-based interventions, fidelity to those interventions beyond trainings is not well understood. And finally, the effectiveness of trauma-focused interventions in the “real-world” community setting remains unclear. Literature suggests that identification of key treatment components could help to address these three concerns. This study focused on one evidence-based treatment in particular, Cognitive Processing Therapy (CPT), and aimed to extend the current literature …

Understanding Factors Related To Negative Mental Health Outcomes Following Childhood Unintentional Injuries, Jennifer T. Kuhn

Dissertations

Unintentional injuries are the leading cause of death for children ages 0-19 and account for 9.2 million emergency room visits in the United States each year (Borse et al., 2008). Research shows that approximately 20% of children meet criteria for PTSD following an unintentional injury (Ostrowski et al., 2011). There are several factors that may contribute to the development of PTSD including caregivers’ posttraumatic stress symptoms after the injury event. Research has not explained the association between caregivers’ PTSD and children’s risk for PTSD symptoms, but it is possible that caregivers with PTSD may be modeling anxious behaviors to their …

Assessing U.S. Veterans' Work Role Functioning: Influences Of Posttraumatic Stress, Sense Of Coherence, And Vocational Identity, Lauren Kelly Osborne

Dissertations

Since beginning military operations in Iraq and Afghanistan following the September 11, 2001 terrorist attacks that now characterize the Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) combat eras, unique stressors and conditions have faced service members. Advancements in military medicine have resulted in greater survival rates of combat veterans, but have also increased rates of chronic psychological distress (Schnurr, Lunney, Bovin, & Marx, 2009). Research regarding these concerns has increased as these service members are now returning home and re-entering civilian life and many studies show the detrimental effects on psychosocial functioning following combat including employment difficulties. As …

The Associations Among Expressed Emotion, Relationship Satisfaction, Ptsd Symptoms, Alcohol Use, And Depression: A Longitudinal Investigation With A Military Sample, Laci Lee Zawilinski

Dissertations

PTSD in military personnel is highly prevalent and accompanied by elevated rates of additional issues such as depression, problematic alcohol use, and interpersonal relationship problems. Family members and spouses of military personnel have also been shown to be negatively impacted by PTSD symptoms. Previous research has indicated that family members and spouses’ expressed emotion regarding the PTSD patients’ symptoms negatively impacts treatment outcome in civilian populations. However, studies have yet to investigate the effect of expressed emotion on the course of PTSD symptoms and associated problems in military personnel. Therefore, the purpose of the present investigation was to examine the …

The Psychological Flexibility Model And Ptsd Intrusion Symptoms, Kaylin Jones

Dissertations

The psychological flexibility model offers a lens through which to view the development and maintenance of PTSD symptoms. The model consists of six behavioral processes, including cognitive fusion, experiential avoidance, and lack of contact with the present moment, which are said to interact with each other to either resolve or maintain symptoms of PTSD. The mediation models proposed within the psychological flexibility model have yet to be examined within any sample. This study examined the relationships between cognitive fusion, experiential avoidance, lack of contact with the present moment, and PTSD intrusion symptoms within a sample of trauma-exposed adults experiencing symptoms …

Tales From The Field: A Phenomenological Study On The Unique Challenges Iraq/Afghanistan Ptsd Veterans Experience While Attending A Community College In Southern California, Nick N. Arman

Dissertations

With the downsizing of U.S. military personnel and increased educational benefits offered by the Post-9/11 G.I. Bill, many Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans will enroll in a community college for education and training opportunities (Vacchi, 2012). A review of literature revealed the majority of OIF/OEF combat veterans in higher education suffered from symptoms consistent with posttraumatic stress disorder (PTSD; Ackerman, DiRamio, & Garza Mitchell, 2009; American Council on Education, 2009; Cate, 2014). The purpose of this phenomenological study was to understand the unique challenges experienced by OIF/OEF veterans diagnosed with PTSD when attending community college …