Secondary trauma.

A review of secondary trauma is presented. Secondary trauma involves the transfer and acquisition of negative affective and dysfunctional cognitive states due to prolonged and extended contact with others, such as family members, who have been traumatized. As such, secondary trauma refers to a spread of trauma from the victim to those who have close contact with the traumatized individual. It is claimed by some that exposure to intense video presentations of traumatic events can also lead to secondary traumatization. Assessment devices are reviewed and most of these appear to be designed to assess secondary or vicarious traumatization in therapists rather than in the general population. Most scales lack cutoff scores and this is a significant weakness. The modified Stroop procedure is presented as a non-paper and pencil method of assessing secondary trauma reactions. The evaluation of the efficacy of therapeutic interventions for secondary traumatization is virtually non-existent. Systematic studies of secondary trauma are in their infancy and a good deal of further research is needed.

The effects of aerobic exercise on childhood PTSD, anxiety, and depression.

The purpose of the present study was to investigate the effects of aerobic exercise on childhood PTSD, depression, and anxiety. Fifteen participants, ages 14 to 17, who met DSM-IV Criteria for PTSD were recruited from an all female residential treatment center Participants engaged in an aerobic exercise program for 40 minutes, three times per week, for a total of 8 weeks. Measures included were the Children's PTSD Inventory, the UCLA Post-Traumatic Stress Disorder Reaction Index for DSM-IV, Children's Depression Inventory, and the Revised Children's Manifest Anxiety Scale. Measures were administered twice at pre-intervention, again at mid-intervention, post-intervention, and at a one-month follow-up. This small n study utilized a staggered baseline, pre/post repeated measures design. Results of this study provided support for the positive effects of aerobic exercise on reducing PTSD, depression, and anxiety. Fewer participants met full criteria for PTSD after exercising. This research is a starting point toward satisfying the essential need to establish efficacious methods to treat PTSD and associated symptoms in child/adolescent populations.

An investigation of potential Holocaust-related secondary traumatization in the third generation.

This study investigated whether grandchildren of Holocaust survivors placed in concentration camps were more prone to PTSD symptoms than grandchildren of Jewish non-immigrants (native-born) and grandchildren of Non-Jewish immigrants. It has been well established that PTSD symptoms can be transmitted from Holocaust survivor parents to their children. Previous research has not yet established whether an identical transmission of PTSD symptoms can occur from the second generation to the third. The measures employed in conducting this study were the Secondary Trauma Scale (STS), the Impact of Events Scale-Revised (IES-R), the State-Trait Anxiety Inventory (Form Y) (STAI), and a Modified Stroop Procedure which was comprised of colored Holocaust trauma-related words, positive words, neutral words and obsessive compulsive disorder words. Results indicate that all three groups exhibited longer response latency for the PTSD Holocaust-related stimuli card thereby indicating an increased sensitivity across all populations regardless of race or religion. The grandchildren of Holocaust survivors and the grandchildren of Non-Jewish immigrants scored significantly higher than the grandchildren of Jewish Americans on the Secondary Trauma Scale as well as the Avoidance subscale of the IES-R. This finding suggests a possible immigration effect for these groups. There were no other significant differences across the other measures employed in this study. These conclusions can be construed as persuasive evidence that, with respect to Holocaust-induced secondary trauma, the residual impact is diminished to such an extent by the third generation that the differences between grandchildren of Holocaust survivors and the overall population are statistically non-significant.

The impact of an exercise program on posttraumatic stress disorder, anxiety, and depression.

This preliminary study assessed the impact of a 12-session aerobic exercise program on symptoms of Posttraumatic Stress Disorder (PTSD), anxiety, and depression. Overall results show no symptom reduction during baseline phases but significant reductions in PTSD, anxiety, and depression following the exercise intervention. Reductions were maintained during a 1 month follow-up. Results suggest that exercise programs may be valuable resources for managing treatment-resistant participants with PTSD and may also have a beneficial effect on anxiety and depression.

Assessment of PTSD symptoms in emergency room, intensive care unit, and general floor nurses.

A total of 125 registered nurses participated in an investigation of Posttraumatic Stress Disorder (PTSD) related symptoms and various levels of nursing care. The sample included 43 emergency room nurses (ER), 51 intensive care unit nurses (ICU), and 31 general floor nurses (GF). All participants were assessed on measures of PTSD, social support, dissociation, anxiety, depression, and demographics. Contrary to expectations, the ER nurses were not found to be uniquely stressed by their work when compared to the other nursing groups. Results indicated that all nurses experienced a significant level of anxiety but were not in the clinically significant range for PTSD, depression, or dissociation. It was inferred that social support played a significant role in helping nurses cope with work-related stress. Nevertheless, the high anxiety levels of all nurses were highlighted as a concern. It was suggested that exposure to numerous traumatic experiences over a lifetime of nursing, and a lack of control over these experiences, contributed to the high anxiety levels seen in all nursing groups.

Objective assessment of secondary trauma.

This study reports on the continued development of the Secondary Trauma Scale (STS) and the establishment of cutoff scores. Cutoff scores are unavailable for existing secondary trauma scales. Participants were 118 young adult volunteers who reported having had close and continued exposure to a person or persons who had been traumatized. Sub-samples were drawn from the initial pool, and these sub-samples showed mild to severe anxiety and depression along with problematic levels of intrusion and avoidance. STS scores of 38 or higher were associated with mild to severe anxiety and depression and with problematic intrusion and avoidance symptoms. It was suggested that at STS scores of 45 or higher, clinicians and researchers should be particularly concerned. The STS demonstrated strong psychometric characteristics and was significantly correlated with known measures of emotional distress and dissociation.

Gender related correlates of posttraumatic stress symptoms in a World Trade Center tragedy sample.

Previous research has documented that women are more susceptible to developing posttraumatic stress disorder than men. This study examines the relationships between gender, ruminative coping, traditional gender role characteristics, trauma-related cognitions, and posttraumatic stress symptoms. Participants were 123 victims of the September 11, 2001, terrorist attacks, including 72 males and 51 females. Results indicated that female victims had more posttraumatic stress symptoms than male victims. Ruminative coping was positively correlated with posttraumatic stress symptoms. Victims who were categorized as 'feminine' had significantly higher levels of posttraumatic stress symptoms than victims categorized as 'androgynous.' Multiple regression and path analyses were used to determine whether ruminative coping, traditional gender role characteristics, and trauma-related cognitions mediated the gender difference in posttraumatic stress symptoms. The mediational model was not supported by these data.