• Sertraline as a treatment for PTSD: A systematic review and meta-analysis

      Mooney, Paul; Oakley, Janette; Ferriter, Michael; Travers, Raymond F. (2004)
      Objective: Post-traumatic stress disorder (PTSD) is one of the most prevalent psychological disorders. Methods to alleviate its symptoms range from 'talking therapies' to pharmaceutical interventions. Our objective was to carry out a systematic review of the effectiveness of sertraline, an SSRI, as a treatment for PTSD. Method: Databases were searched to identify relevant research on sertraline as a treatment for PTSD. Results: Five randomised control trials were identified, along with seven open trials and case series studies. Conclusions: The review and meta-analysis supported the use of sertraline for PTSD though further research on sub-group differences (eg. gender) is required.
    • Staff well-being: a survey of stress and stressors in a community mental health service

      Diamond, Ross; McAdam, Melanie (1999)
      Working in the health service, and in mental health in particular, is acknowledged to be one of the most stressful occupations. MELANIE McADAM and ROBERT DIAMOND report the findings of a survey of its staff by one mental health trust and discuss the implications for service organization and management.
    • A study of outcomes of patients treated at a UK major trauma centre for moderate or severe injuries one to three years after injury

      das Nair, Roshan (2017)
      Objective: To assess return to work outcomes of major trauma patients treated at a level 1 UK major trauma centre and evaluate factors associated with improved outcomes. Design: Cross-sectional cohort design. Subjects: In total, 99 patients at one, two or three years post-discharge from a Major Trauma Centre with an injury severity score above 9, in full-time work or education prior to injury, aged 18-70 and discharged between April 2012 and June 2015. Main Measures: Self-report questionnaire including the Trauma Outcome Profile, the Multiple Sclerosis Neuropsychological Screening questionnaire and questions pertaining to work and education. Results: Of the 99 patients in full-time work pre-injury, 65 made a complete return to work, 15 made an incomplete return to work and 19 did not return to work, where incomplete return to work was defined as working below 80% of previous working hours. In all, 25 participants scored below the cut-off point on physical disabilities, 46 below the cut-off point on mental functioning and 38 below the cut-off point on social interaction. Reduced anxiety and higher mental functioning were consistently associated with complete return to work. Conclusion: In all, 66% of patients with moderate to severe injuries made a complete return to work. A range of psycho-social, physical and functional health issues were persistent at long-term follow-up.
    • The diversity of trauma research: Contexts, approaches and controversies

      Regel, Stephen (2009)
      In this issue we have brought together papers that approach the topic of trauma from less familiar angles. The first two papers are case studies that focus on the importance of the relationship. The next two studies are qualitative investigations. Moving to a more theoretical level, the next paper questions what we know about intrusive imagery and the use of dream work. Of the final three papers, the first is a review paper which reminds us that trauma is part and parcel of the lives of the most vulnerable, and often those with the least voice in society. The second reviews the evidence for vicarious traumatisation in practitioners who work with adult survivors of sexual violence and child sexual abuse. The last provides a new conceptual model for multidisciplinary team working. These are articles written by practitioners and as such speak to the needs of other practitioners in a way that research papers often do not. As such we hope this special issue will inspire practitioners to pick up on some of the themes that arise from these articles and to think about how they can contribute to the diversity of research in the field of trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • The prevalence of post traumatic stress disorder in a special hospital population of legal psychopaths

      Kruppa, Ilona; Hickey, Nicole; Hubbard, Caroline (1995)
      This paper describes a study conducted at Rampton Hospital, a maximum security facility for mentally disordered offenders, to examine the prevalence of Post Traumatic Stress Disorder (PTSD) in samples of male and female patients in the legal category of psychopathic disorder. High prevalence rates of both current and lifetime PTSD diagnoses were found in both groups and in a significant number of cases the trauma associated with the PTSD symptoms was the offence that led to the individual's admission. There is evidence to suggest that the pattern of symptoms presented in offence-related and non-offence related PTSD may be trauma specific. Despite the small sample sizes involved, it is concluded that there is sufficient evidence to suggest the need for a larger scale investigation of PTSD in this population. © 1995, Taylor & Francis Group, LLC. All rights reserved.
    • The Psychological Well-Being-Post-Traumatic Changes Questionnaire (PWB-PTCQ): Reliability and Validity

      Regel, Stephen (2012)
      The Psychological Well-Being Post-Traumatic Changes Questionnaire (PWB-PTCQ) is an 18 item self-report measure to assess perceived changes in psychological well-being following traumatic events. The aim was to test its psychometric properties. Across three samples, evidence is provided for a single factor structure (invariant across clinical and general populations), high internal consistency (alpha > .87), six month stability, incremental validity over and above existing measures of posttraumatic growth as a predictor of subjective well-being, convergent validity with existing measures of posttraumatic growth (r = .50-.56. p < .001), concurrent validity with personality and coping measures, predictive validity of change in well-being over time, discriminant validity with social desirability, and prediction of clinical caseness.
    • The relationship between coping style and psychological distress in people with head and neck cancer: A systematic review

      Morris, Nicole; Tickle, Anna C.; Biswas, Sanchia (2017)
      OBJECTIVE: Individuals diagnosed with head and neck cancer (HNC) are at an elevated risk of experiencing psychological distress and a reduced quality of life. The aim of this review was to systematically examine and assess the quality of empirical evidence on the associations between coping mechanisms and psychological distress among people with HNC. METHODS: CINAHL, MEDLINE, PsycINFO, EMBASE and Web of Science were accessed to conduct this review. Studies were included if they used reliable and valid measures to investigate the relationship between coping style and psychological distress. Study quality was assessed and rated according to pre-set criteria, and showed variability in relation to selection methods. RESULTS: 12 studies (nine cross-sectional and three prospective designs) involving 1281 patients were reviewed. There was considerable heterogeneity in study samples and coping measures. Moderate to large associations between disengagement coping mechanisms (e.g. avoidance) and psychological distress were observed. Engagement coping strategies (e.g. direct action) were not consistently associated with psychological distress across studies. CONCLUSIONS: Several studies observed a significant relationship between coping styles aimed at disengaging and distancing from cancer and increased psychological distress. To understand directionality of these associations and further develop an understanding of temporal features of the relationship between coping styles and distress, longitudinal designs could be used in future research.
    • The therapy seesaw: Achieving therapeutically balanced approaches to working with emotional distress

      Talkes, Kirsty; Tennant, Allison (2004)
      This paper has been written following an influential therapeutic encounter that we experienced while working with an emotionally distressed woman. The barriers that can get in the way of providing a structured therapeutic approach are discussed. The paper focuses on dialectical behaviour therapy as a treatment model, and discusses how the concept of 'dialectics' can provide an over-riding context for case conceptualisation (Linehan, 1993). The dialectical dilemmas and powerful dynamics that can be enacted between individuals, teams and patients in their endeavours to cope with distress will be illustrated. The dialectical philosophy is described and elaborated upon, providing a framework for the synthesis of clinical interpersonal encounters and metaphorical concepts of a therapy seesaw. The paper discusses how these ideas can guide us in our work with emotionally distressed individuals. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(journal abstract)
    • Trauma and post-traumatic stress disorder (PTSD) in a high secure forensic learning disability population: Future directions for practice

      Brackenridge, Irene; Morrissey, Catrin (2010)
      Literature on trauma and post-traumatic stress disorder (PTSD) has neglected the needs of people with intellectual disability, particularly those in forensic settings. The National Centre for High Secure Learning Disability Services at Rampton Hospital conducted a service evaluation on aspects of trauma experience and post-trauma symptoms in the current population. File information and self-reports indicated that most individuals had experienced a great deal of lifetime trauma, typically multiple types of abuse. A high rate of potentially trauma-related symptoms was noted in files. However, file records of potentially traumatic events, including abuse, were often lacking in detail. There was limited information about the events themselves, and there was no information to suggest that any trauma-specific assessments had been used to measure trauma exposure or symptoms. PTSD as a diagnosis was rarely considered, and there was little consideration of trauma-specific interventions. While some individuals said that their experiences had resulted in a lot of distress, others could not talk about the past at all. This paper discusses the problem of assessing past trauma and response in a forensic intellectual disability population, and future directions for practice in forensic services. The service under study plans to address the needs of patients who have experienced trauma and abuse by conducting routine structured assessments, offering adapted evidence-based psychological interventions where appropriate, and providing trauma-specific education for staff to promote a compassionate approach. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(journal abstract)
    • Trauma: A unifying concept for social work

      Joseph, Stephen; Murphy, David (2014)
      The aim is to show how traumatic stress provides a unifying concept for social work. In the last ten years, there have been significant changes in the nature of organisations that provide social care for people in the UK, with social work practice no longer confined to traditional local authority services. Increasingly, social workers are taking up posts in a variety of settings and sectors demanding new knowledge and skills. The field of traumatic stress is not currently viewed as a social work discipline. However, trauma cuts across a range of contexts and client groups and, as such, needs to be a core component of education and training in social work. The concept of trauma and recent developments in post-traumatic growth offer a new way of thinking that necessitates the development of genuinely psycho-social and relationship-based help and support for individuals, families, groups, communities and organisations affected by adversity.
    • Vicarious traumatization: Implications for the mental health of health workers?

      Sabin-Farrell, Rachel (2003)
      It has been suggested that a unique feature of some mental heath practitioners' work is exposure through their role as therapists to clients' descriptions of and reactions to trauma, and that these experiences may actually indirectly cause distress and traumatization to the therapist. This proposed phenomenon has been termed "vicarious traumatization" (VT) and is the focus of the current review. The concept of VT, together with other related concepts such as "burnout," "compassion fatigue," "secondary traumatic stress" (STS), and "work stress" are appraised. Psychological mechanisms that might be theoretically involved in VT are considered. The measurement of VT is reviewed alongside the limited research evidence supporting its existence. Factors such as direct trauma exposure and the personal attributes of mental health workers, which have been suggested to be associated with VT, are also assessed. It is concluded that the evidence to support the existence of VT is meager and inconsistent. Future research needs to be directed at distinguishing VT from other sources of distress arising within the workplace. Finally, the organizational relevance of VT and its possible implications for the management of mental health workers are critically appraised.;
    • Visuospatial working memory interference with recollections of trauma

      Sabin-Farrell, Rachel (2009)
      Objectives. Laboratory research using a working memory framework has shown modality-specific reductions in image vividness and emotionality when concurrent tasks are performed while maintaining the image in consciousness. We extended this research to trauma images in a clinical population awaiting treatment for post-traumatic stress symptoms. Design. A within-subjects design was used, with each participant completing an imagery task under three concurrent task conditions: side-to-side eye-movements, counting, and exposure only (no concurrent task). Methods. Eighteen participants selected three images each, the images being those that were the most distressing from participants’ trauma memories and most likely to intrude involuntarily. Participants gave baseline ratings of the vividness and emotionality of each of their trauma images. Each image was assigned to a condition. Each condition comprised 8 trials in which participants recollected the appropriate image for 8 s while performing eye-movements, counting or no concurrent task, and then rated its vividness and emotionality. Follow-up ratings were obtained by telephone 1 week later. Results. The eye-movement task reduced vividness and emotionality of the trauma images relative to the counting task and exposure only, but did so only during the imagery period and not at follow-up. The images were predominantly visual. Conclusions. Concurrent tasks matched to the modality of trauma images may provide a useful treatment aid for temporarily dampening emotional responses to recollections of trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(journal abstract)
    • Voices from the frontline: the psychological impact and coping mechanisms used by healthcare staff during COVID-19

      Majumder, Pallab; Sales, Christian P. (2021)
      Background/Aims Healthcare workers have been affected by the physical and psychological consequences of working during the COVID-19 pandemic. This study explored the effects of the pandemic on the psychological wellbeing of UK healthcare workers, as well as the coping mechanisms used and the workplace support that they found helpful. Methods A self-administered questionnaire was distributed to healthcare workers across various settings, including primary care, community services, hospital settings and specialist or tertiary service settings. A convenience sample was used to select the participants. The responses were collected for 1 month at the height of the first wave of COVID-19 in the UK (10 April 2020-10 May 2020). Results were collated and analysed using the Statistical Package for the Social Sciences software. Results Responses to the questionnaire showed the negative emotional, behavioural and cognitive impact of the pandemic on staff, with many experiencing issues such as anxiety, anger, disrupted sleep and worries about contracting the virus. A concerning number also reported symptoms of severe psychological distress, including depersonalisation, derealisation, self-harm and suicidal thoughts. Practical coping mechanisms were generally preferred. Older, male staff were significantly less likely to reach out for support than their younger and female counterparts. Respondents also expressed a preference for practical support from their employer, such as more managerial support at work, time off and financial incentives.
    • What doesn't kill us

      Joseph, Stephen (2012)
      The field of psychological trauma is changing as researchers recognise that adversity does not always lead to a damaged and dysfunctional Life. Post-traumatic growth refers to how adversity can be a springboard to higher levels of psychological well-being. This article provides an overview of theory, practice and research. To what extent is post-traumatic stress the engine of post-traumatic growth? How can clinicians measure change? What can help people to thrive following adversity?