Psychiatry and Psychology Commons^™

The Prevalence Of Moral Injury Among Veterans Diagnosed With Post-Traumatic Stress Disorder (Ptsd): Analyses By Combat Exposure, Gender, Age Group, And Military Service, Carl B. Forkner

Doctoral Dissertations and Projects

The attacks on the United States on September 11, 2001, and the ensuing wars in Afghanistan and Iraq, heralded in a new concept affecting our combat and support military personnel. This concept is known today as moral injury. Military personnel were already familiar with post-traumatic stress disorder (PTSD), whether from personal experience or from reading and training on the subject, but no training addresses the prevalence or effects of moral injury. The term moral injury (MI) was first coined by psychiatrist Jonathan Shay and his colleagues based on feedback from military and veteran patients in 1998; however, it remains that …

A Phenomenological Study On The Lived Experiences Of Military Spouses With Secondary Traumatic Stress Who Are Married To Veterans Diagnosed With Ptsd, Trisha R. Perry

Doctoral Dissertations and Projects

The purpose of this hermeneutical phenomenological study was to understand the lived experiences of Secondary Traumatic Stress (STS) in military spouses whose partners have Post-Traumatic Stress Disorder (PTSD). The theory guiding this study was Lazarus and Folkman’s Transactional Model of Stress and Coping (TMSC). The central research question was: What are the lived experiences of STS in spouses married to a service member with PTSD? Additional sub-questions addressed changes in worldview, marital satisfaction, and daily functioning. Criterion and snowball sampling were used to select participants who were married to service members with PTSD for the study. Following the hermeneutical phenomenological …

Anhedonia Underlies The Association Between Childhood Unpredictability And Adult Ptsd Symptoms: Evidence From Three Independent Longitudinal Cohorts, Christopher Hunt, Laura M. Glynn, Elysia Poggi Davis, Tallie Z. Baram, Caroline M. Nievergelt, Giovanni Castillo, Christian Cortes, Christine Y. Chang, Dewleen Baker, Victoria B. Risbrough

Psychology Faculty Articles and Research

Background

Unpredictability in the child’s environment has recently emerged as a significant and unique form of early life adversity (ELA). Cross-sectional studies have linked childhood unpredictability with increased post-traumatic stress disorder (PTSD) symptoms in adults; however, no prospective studies have tested the link between childhood unpredictability and PTSD risk in later life, nor what processes, such as increased anhedonia symptoms, might mediate such risk. Here, we leveraged three distinct prospective, longitudinal cohorts to test the hypothesis that unpredictability during childhood contributes to adult PTSD via worsening anhedonia symptoms.

Methods

Participants were male service members (n=314), adult females (n=170), and adolescents …

Neural Rewiring Of Resilience: The Effects Of Combat Deployment On Functional Network Architecture, Noga Yair, Tom Zalmenson, Omer Azriel, Dana Shamai-Leshem, Yaron Alon, Niv Tik, Lucian Tetse-Laur, Ariel Ben-Yehuda, Daniel Samuel Pine, Anderson M. Winkler, Ido Tavor

School of Medicine Publications

Background: Although combat-deployed soldiers are at high risk for developing trauma-related psychopathology, most will remain resilient for the duration and aftermath of their deployment tour. The neural basis of this type of resilience is largely unknown, and few longitudinal studies exist on neural adaptation to combat in resilient individuals for whom a pre-exposure measurement was collected. Here, we delineate changes in the architecture of functional brain networks from pre- to postcombat in psychopathology-free, resilient participants.

Methods: Tier 1 infantry recruits (n = 50) participated in this longitudinal, functional magnetic resonance imaging study together with a comparison group of university students …

Advancing Models Of Ptsd-Aud Comorbidity: Protocol For A Multimethod Framework Using Genetics And Ecological Momentary Assessment, Elizabeth A. Stinson, Samhita Lellapalli, Sage E. Hawn, Natalie Merrill, Lance M. Rappaport, Christina M. Sheerin, Vasiliki Michopoulos, Silviu-Alin Bacanu, Roseann E. Peterson, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), which are moderately heritable, frequently co-occur and contribute to significant public health burdens, particularly among economically disadvantaged urban communities. There are noted sex differences in PTSD and AUD outcomes, with evidence suggesting women have heightened susceptibility to stress-related alcohol use. Preliminary PTSD-AUD ecological momentary assessment (EMA) findings support bidirectional associations across clinical outcomes. However, no studies to date have used PTSD-AUD comorbidity models as organizing frameworks to examine the temporal ordering and stability of within-person symptom dynamics underlying the maintenance or exacerbation of PTSD and AUD symptoms, including bidirectional and …

The Use Of Virtual Reality In Ptsd Research And Practice, Kenneth B. Abrams, Lindsay Okindo, Marta E. Bacon, Yiking Skylar Yu, Sofia Santamaria Germani, Malvika Malhotra, Nancy A. Cullen

Psychology Faculty Work

In the aftermath of traumatic events such as combat, sexual violence, or a natural disaster, individuals may develop posttraumatic stress disorder (PTSD). Technological advancements in virtual reality (VR) over the past few decades have opened new avenues for improving the assessment, treatment, and understanding of PTSD. VR allows users to be immersed in interactive, computer-generated environments that simulate real-world scenarios, such as a warzone or assault location, that would be difficult or unsafe to reproduce using traditional methods. The present paper offers an overview of how VR technology has been employed in both clinical and research settings related to PTSD. …

Positive Psychology Interventions For Posttraumatic Stress Disorder (Ptsd) Among Earthquake Survivors In Nepal, Niusha Karki, Melissa C. Henry, Mark M. Leach

Trauma Counseling and Resilience

Natural disasters produce both community and individual trauma; Nepal’s 2015 and 2023 earthquakes exemplify this enduring impact. Previous literature has discussed the effects of PTSD and other mental health concerns post-disasters, providing some context to the difficulties in providing counseling services to those in need. However, little is known about unique psychological, cultural, and contextual factors in Nepal and how their influence and understanding may result in modifying traditional PTSD counseling interventions found in much of the existing professional literature. The purpose of this conceptual paper is to propose a culturally responsive, strengths-based framework that integrates positive psychology interventions, positive …

Can Interpersonal Trust Predict And Account For Symptom Change During Group Cognitive Processing Therapy For Ptsd? An Investigation Of The Iterated Trust Game, M Wright Williams, Christopher Hunt, David P Graham, Matt Estey, Lia Smith, Katherine Mccurry, Brooks King-Casas, Pearl Chiu

Faculty, Staff and Students Publications

Objective: Group cognitive processing therapy (GCPT) is frequently utilized to treat PTSD within the VA healthcare system, but its mechanisms are not well understood. Interpersonal trust could be an important change process in GCPT given its relevance to group-based therapy and its role in CPT, but self-report measures are inadequate for capturing the dynamic interplay that defines interpersonal trust. Here, we examined the degree to which interpersonal could predict and account for PTSD symptom change in GCPT using the iterated trust game (ITG)-a behavioral task used to approximate real-world trust behavior.

Methods: Participants were Veterans with PTSD who participated in …

Prevalence And Factors Associated With Depression, Anxiety And Post-Traumatic Stress Disorder Among Healthcare Workers From Sub-Saharan Africa: Systematic Review, Ezra Too, Peninah Wachira, Solomon Njenga, Sabina Odero, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Depression, anxiety and post-traumatic stress disorder (PTSD) are prevalent among healthcare workers (HCWs), including those from sub-Saharan Africa (SSA). However, there are limited summary data on the burden and factors associated with these disorders in this region. We conducted this systematic review (registration no. CRD42022349136) to fill this gap.

Aims: The aim of this review was to systematically summarise the available evidence on the prevalence and factors associated with depression, anxiety and PTSD, or their symptoms, among HCWs from SSA.

Method: We searched African Index Medicus, African Journals Online, CINAHL, PsycINFO and PubMed for articles published, from database inception …

Evaluating The Use Of Repetitive Transcranial Magnetic Stimulation In A Patient With Treatment Resistant Depression, Autism Spectrum Disorder, And Post-Traumatic Stress Disorder: A Case Report, Luke Fritsch Ba, Mba, Msiv, Oluwafunke O. Ogunremi Bs, Msiv, Alexandra R. Job Bs, Msiv, James Hellekson Md

Aesculapius Journal (Health Sciences & Medicine)

Despite a wide array of therapeutic modalities, many patients with Major Depressive Disorder (MDD) experience no significant improvement in symptoms with traditional treatment. Given the prevalence of Treatment Resistant Depression (TRD), other alternative therapeutic modalities for MDD are being researched. Repetitive Transcranial Magnetic Stimulation (rTMS) is one modality that continues to show successful therapeutic outcomes for those with TRD. The aim of this study is to highlight a case of rTMS being used on a patient with TRD, autism spectrum disorder (ASD), post-traumatic stress disorder (PTSD), and substance use.

Methods:

Our patient is a 53-year-old female who first presented to …

Assessing The Efficacy Of Using The Ptsd Coach Mobile Application For Managing Ptsd Symptoms: Results Using The Hopkins Symptom Checklist-21, Muntaha Rana, Kaylea Shoulders, Deep Patel, Anne Jones

Rowan-Virtua Research Day

Background: Primary care settings often become the first place where patients with mental health concerns go, especially with shortages of mental health providers. During Covid-19 mental health concerns increased, increasing the demand of primary care providers to help assist patients navigate their concerns. Hypothesis: Participants that use the PTSD Coach App for 30 days will have reduced HSCL-21 follow-up scores compared to their intake. Methods: Patients were recruited from the Rowan-Virtua family medicine office in Sewell. The PCL-5 with the HSCL-21 was administered, with patients then using the PTSD Coach app for 30 days. Researchers followed up with patients after …

Literature Review: Prazosin Used For Ptsd In Pregnancy, Afshan Khan, Natali Sharma, Rebekah M. Dietrich, Martin Forsberg

Rowan-Virtua Research Day

Posttraumatic Stress Disorder (PTSD) affects 3–4% of pregnant and postpartum individuals and is associated with complications such as preterm birth, low birth weight, and postpartum depression. Pharmacologic treatment options during pregnancy are limited by concerns about fetal safety.

Methods: A literature review was conducted focusing on studies reporting maternal or neonatal outcomes following prazosin exposure in pregnancy.

Results: One observational study of 11 pregnancies found 54.5% had uneventful outcomes, with rates of preterm birth, miscarriage, and preeclampsia similar to the general population. Hypotension and limited lactation data remain concerns.

Conclusion: Early evidence suggests prazosin may be a relatively safe and …

Spirituality And Ptsd Outcomes Among Service Members And Military Veterans, Jennifer Urbina Dmsc, Pa-C

Lynchburg Journal of Medical Science

Post-traumatic stress disorder (PTSD) is a prevalent and debilitating condition among military service members and veterans, often co-occurring with moral injury (MI) and spiritual distress (SD). While conventional PTSD treatments include cognitive behavioral therapy (CBT), exposure-based therapies, and pharmacological interventions, growing evidence suggests that spirituality may play a vital role in improving PTSD outcomes. This paper explores the integration of spirituality in PTSD treatment, examining its potential to mitigate symptoms, enhance resilience, and facilitate post-traumatic growth. Military chaplaincy, spiritually integrated therapies, and Department of Defense (DoD) holistic health models provide frameworks for addressing the spiritual dimensions of PTSD. Studies indicate …

Assessment, Decision, Adaptation, Production, Topical Experts-Integration, Training, And Testing (Adapt-Itt) Framework To Tailor Evidence-Based Posttraumatic Stress Disorder Treatment For People With Hiv To Enhance Engagement And Adherence: Qualitative Results From A Feasibility Randomized Controlled Trial, Cristina M. Lopez, Angela D. Moreland, Stephanie Amaya, Erin Bisca, Christin Mujica, Tayler Wilson, Nathaniel Baker, Lauren Richey, Allison Ross Eckard, Patricia A. Resick, Steven A. Safren, Carla Kmett Danielson

School of Medicine Faculty Publications

BACKGROUND: Individuals with co-occurring posttraumatic stress disorder (PTSD) and HIV are at high-risk for negative HIV-related outcomes, including low adherence to antiretroviral therapy, faster disease progression, more hospitalizations, and almost twice the rate of death. Despite high rates of PTSD in persons with HIV (PWH) and poor HIV-related health outcomes associated with PTSD, an effective evidence-based treatment for PTSD symptoms in PWH does not exist. OBJECTIVE: This study aimed to describe the adaptation and theater testing of an evidence-based intervention designed for people with co-occurring PTSD and HIV. METHODS: The Assessment, Decision, Adaptation, Production, Topical experts-integration, Training, and Testing (ADAPT-ITT) …

Evaluation Of A 20-Item Version Of The Trauma-Related Drinking To Cope Questionnaire, Sage E. Hawn, Lauren Smith, Kaytlin Armitage, Selah Ball, Cathy Lau-Barraco, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Objectives: This study sought to develop and psychometrically evaluate an expanded version of the Trauma-Related Drinking to Cope (TRD) scale, a four-item self-report tool, which was developed to address a crucial gap in self-medication research. Before the development of the TRD, no measures existed which assessed alcohol use for coping with symptoms of posttraumatic stress disorder (PTSD) specifically. Previous work showed that the TRD has strong psychometric properties and clinical utility in its ability to identify individuals with PTSD who may be at risk for developing comorbid alcohol use disorder (AUD). The aim of the present study was to develop …

Psychometric Evaluation Of A Novel Measure Of Trauma-Related Cannabis Use To Cope, Sage E. Hawn, Terrell A. Hicks, Christopher Latourrette, Anita Thomas, Daniela Chaname, Sarah Ehlke, Abigail Powers Lott

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) are commonly comorbid and are associated with many negative public health outcomes. One plausible explanation for this comorbidity comes from a self-medication framework, which suggests people use cannabis to cope with PTSD symptoms. Despite theoretical and empirical evidence for PTSD-related cannabis use to cope, no measure of this construct exists.

Objective: We sought to address this gap by developing and validating a novel measure of PTSD-specific cannabis self-medication, which we have termed the Trauma-Related Cannabis Use to Cope (TRCU) questionnaire.

Method: The psychometric properties of the TRCU and how it …

Distinguishing Symptoms Of Racial Trauma From Conventional Trauma, Michelle Yoong

West Chester University Doctoral Projects

Trauma research in psychology has traditionally been shaped by a White-centric framework, leading to the underrepresentation of racial and ethnic minority experiences. This study aims to establish racial discrimination as a distinct traumatic stressor with significant psychological consequences by exploring the distinction between racial and conventionally recognized traumatic stressors and posttraumatic stress symptoms (PTSS). It also aims to address inconsistent and exclusionary assessment methodology involving underrepresented racial minority (URM) populations, including the neglect of racial trauma and discrimination measures in trauma research. Participants consisted of URMs who sought enrollment in a clinical trial for opioid use disorder at a community …

Evaluating The Acceptability Of Ptsd Treatment Among Justice-Involved Women In Kentucky With Histories Of Opioid Use, Jesse P. Mccann

Theses and Dissertations--Psychology

Rates of trauma and PTSD as well as histories of opioid use are high among justice-involved women, particularly in Kentucky. However, there are many barriers to receiving treatment. There is a pressing need for brief, trauma-focused interventions that can be more feasibly delivered in jail or prison settings as well as by community clinicians serving women on probation or parole. This study explores the acceptability of treatment for PTSD, particularly Written Exposure Therapy (WET), among justice-involved women on probation or parole with a history of illicit or nonmedical prescription opioid use. The research aims to deepen our understanding of factors …

Assessing Post Traumatic Stress Disorder In The Addiction Assessing Post Traumatic Stress Disorder In The Addiction Population, Yagmur Beaman, Paula Suarez, Srinidhi Manchiraju, Sanket Patel, Corey Hopkins, Pooja Paunikar

South Atlantic Division GME Research Day 2025

No abstract provided.

Building Resilience: A Specialty Clinic Tailored To Older Adults At Risk For Violence And Abuse, Melba A Hernandez-Tejada, Deborah M Little, Madeline J Bruce, Sarly Butte, Jason Burnett, Leila Wood, Ron Acierno

Faculty, Staff and Student Publications

Objective: Both structural (e.g., ageism) and personal (e.g., stigma) barriers hinder older adults' access to and engagement with mental health care. These barriers are particularly problematic for those vulnerable to interpersonal violence and abuse (e.g., due to social isolation). This study presents a quality improvement program aimed at older adults who have experienced significant stressful events, particularly elder mistreatment, within a larger trauma specialty clinic. Leveraging home-based telemedicine, the clinic provides evidence-based psychotherapy tailored to the needs of older adults.

Methods: From 2021 through 2023, the authors retrospectively examined treatment initiation, engagement, completion, and clinical outcomes among 231 older adults …

Neural Correlates Of Socially Rewarding Memories In Posttraumatic Stress Disorder, Kyle P. Blidy

MUSC Theses and Dissertations

Significance. Memory disturbances for emotional content are central to PTSD, yet most research focuses on trauma memories. Recent evidence suggests that enhancing access to positive memories could improve mood, affect regulation, self-esteem, and integration of trauma memories. However, the neurocognitive mechanisms underlying positive memory encoding in PTSD are poorly understood. No study has examined memory for positive social items in PTSD, which is important because PTSD entails social withdrawal and reduced accessibility to positive memory. Additionally, positive memories embedded in a social context have enhanced subjective value and strengthening their accessibility may confer greater benefits to wellbeing compared to non-social …

Infusing Values Into Written Exposure Therapy: A Comparison Study, Maegan Campbell

Dissertations

Written Exposure Therapy is a brief, efficacious intervention for the treatment of PTSD symptoms. The WET protocol calls for the infusion of values into therapeutic work, however, does not detail how to incorporate these values work into the highly scripted treatment. This study compared the standard WET protocol with WET infused with values. The study examined differences across the two conditions on seven variables (PTSD scores, depression scores, value importance and consistency, quality of life, psychological flexibility, customer satisfaction, and therapeutic alliance). The sample was largely homogenous in gender, ethnicity, sexuality, and reported index trauma. The sample was largely white …

The Dry Bloodletting: A History Of The Diagnosis And Treatment Of Posttraumatic Stress Disorders In Military Service Members, Kevin Johnson

Masters Theses, 2020-current

This work is a close look at how veterans of war have been treated medically for ailents of the mind. This work looks closely at the many therapies and pharmaceutical remedies that have been perscribed to veterans with the advent of the field of psycology at the trun of the century. Sources included the Diagnostic and Statistical Manual (DSM), multiple clinical trials and white papers, records from the VA, etc. The reader should walk away with a better understanding of how the path towards healing invisble wounds has been mired with revictimization and controversy.

Investigation Of The Utility Of A Ptsd Coaching Mobile App To Address Mental Health Services Demand In A Primary Care Clinic: Analysis Of Caps-5 Measures, Sindhura Nemani, Danielle Rae Schweitzer, Anne C. Jones

Rowan-Virtua Research Day

The COVID-19 pandemic affected countless people globally, resulting in a greater need for mental health professionals and resources¹. The demand for mental health care is soaring yet the limitation of resources has strained the healthcare system, making it challenging to help patients in a timely manner². This poster represents a snapshot of a larger project that is striving to investigate an intervention to help bridge the gap between patient need and prompt referral through a warm handoff approach and use of the PTSD Coach mobile application as well as exploring patients’ satisfaction^3,4,5,6,8,9. In this …

Doxazosin Immediate Release As Alternative Treatment For Nightmares In Post-Traumatic Stress Disorder: A Case Report, Danyaal Khan, Christie Richardson, Martin Forsberg

Rowan-Virtua Research Day

Nightmares and flashbacks are common debilitating symptoms of post-traumatic stress disorder (PTSD) that can disrupt daily functioning in patients. Prazosin, an alpha-1 adrenergic antagonist, has been commonly used off-label for the treatment of PTSD intrusion symptoms, although its short half-life is limiting. Doxazosin, another alpha-1 antagonist, is starting to be investigated in the treatment of PTSD-related nightmares due to its smaller side effect profile and longer half-life. In our case report, we present a case of a patient with PTSD-related nightmares who was successfully treated with doxazosin following relapse of symptoms after discontinuation of prazosin. The success of doxazosin immediate …

Russians Fleeing Putin’S Country: Trauma, Daily Stressors, Anxiety, Depression, Post Traumatic Stress Disorder, Maria Mccready, David Witherington, Steven Verney, Dmitry Boltyanskiy

Brain & Behavioral Health Research Day

The turmoil unleashed by the Russian invasion of Ukraine in February 2022 triggered a mass migration of individuals from Russia to nearby countries like Armenia and Georgia. Amidst this upheaval, concerns have arisen regarding the mental well-being of Russian emigrants and their experiences during this turbulent period. To bridge this gap in knowledge, our study aims to examine the mental health status of adult Russian emigrants who departed from their homeland after the beginning of the conflict.

Drawing from a sample of 67 participants, comprising 30 females and 3 non-binary individuals, our research focuses on communities in Armenia and Georgia, …

Barriers To Mental Health Seeking Among Army Aviation Personnel: A Preliminary Report, Aric J. Raus

National Training Aircraft Symposium (NTAS)

This research explores barriers to mental health seeking, self-reported symptoms, and perspectives on self-help mental-wellness options among U.S. Army Aviation Personnel. Safe aviation operations require constant focus and mental clarity. These requirements expand when considering the implications and added stress of military operations, especially in combat scenarios. Yet, recent studies demonstrate that aviation personnel avoid seeking healthcare due to fears of losing their medical certification. This report provides preliminary results from the first known study on barriers to mental health seeking among U.S. Army aviation personnel. Utilizing an anonymous survey instrument, facilitated primarily through Social Media recruiting of current and …

Improving Medication-Enhanced Psychotherapy Options For Ptsd: The Potential Of Oxytocin As A Treatment For Hypervigilance In Women With A History Of Childhood Sexual Abuse And Related Ptsd, Elianna Bavuso

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Childhood sexual abuse (CSA) is a notable public health concern, affecting a significant proportion of girls in high-income countries. A considerable number of CSA survivors develop Post-Traumatic Stress Disorder (PTSD) by adolescence, which is often considered to be a lifelong disorder with severe emotional and social consequences. Women with CSA-related PTSD display hypervigilance, which is characterized by significantly increased fear network activity and poor top-down control over the amygdala. This meta-analysis examines the potential of intranasal oxytocin (OT) as a treatment for hypervigilance symptoms in women with CSA-related PTSD. The evidence reviewed suggests that intranasal oxytocin can help normalize the …

Individual And Organizational Challenges To Implementing Prolonged Exposure Therapy In The Military Health System: A Systematic Review Of Client And Provider Perspectives, Paris R. Cloutier

Honors Undergraduate Theses

Military veterans and active-duty service members face high rates of posttraumatic stress disorder (PTSD), a chronic and debilitating condition that is comorbid with other negative psychological and social outcomes. PTSD symptomology in military careers is attributed to unique organizational factors and risks both during and post-deployment. Delivering modern, effective PTSD treatments derived from evidence-based research to the military population is a multi-faceted effort. Among these interventions, prolonged exposure therapy (PE) is a safe and effective trauma-focused treatment for veterans. To yield higher rates of PE success, common challenges faced by both military clients and their clinicians that may be impairing …

Grief On Pain And Quality Of Life In Combat Veterans With Ptsd, Melba A Hernandez-Tejada, Madeleine Desrochers, Ron Acierno

Faculty, Staff and Student Publications

Background: Persistent Complex Bereavement Disorder (PCBD) comprises a set of grief symptoms that are often linked to other psychological conditions such as PTSD and depression, may be prevalent in Veterans with combat experience, and may also impact general health.

Objective: This study investigated the association between grief and sleep, pain, PTSD, and depression, among Veterans participating in a clinical trial for PCBD treatment.

Method: Data from 155 Veterans receiving treatments for PCBD were analysed to explore the association between PCBD and symptoms of sleep pain, PTSD, and depression. Veterans experiencing grief reported symptoms related to physical health, emotional problems, energy, …