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- All Subjects: Post-Traumatic Stress Disorder
- Creators: Kinnier, Richard
Description
This study examined four research questions investigating relationships among the experience of trauma, identity development, distress, and positive change. There were 908 participants in the study, ranging in age from 18 to 24 which is known as the period of emerging adulthood. Participants completed an online survey regarding their exposure to trauma and reactions to these experiences. The first research question examined the experience of trauma for the sample. The second question examined group differences among the participant's identity status, gender, and posttraumatic stress disorder (PTSD) diagnostic status on the hypothesized variables. In general, comparisons among the four identity status groups found participants who experienced greater identity exploration (diffused and moratorium) experienced more distress, whereas the identity status groups that reported greater identity commitments (foreclosed and achieved) were associated with positive change. Similar findings were found for PTSD diagnostic status indicating more distress and identity exploration for participants with the diagnosis and more positive change and identity commitments for participants without the diagnosis. Female participants were found to experience more PTS symptoms, centrality of the trauma event, and positive growth than males. Examination of the relationships between trauma severity and posttraumatic growth revealed an inverted U-shaped relationship (quadratic) that was a significant improvement from the linear model. An S-shaped relationship (cubic) was found for the relationship between trauma exposure and posttraumatic growth. Regression analyses found the centrality of the trauma event to one's identity predicted identity distress above and beyond the experience of trauma. In addition, identity distress and the centrality of the trauma contributed to the variance for identity exploration, while only identity distress contributed to identity commitments. Finally, identity development significantly predicted positive change above and beyond, identity distress, centrality of the trauma event, and the experience of trauma. Collectively, these results found both distress and growth to be related to the experience of trauma. Distress within one's identity can contribute to difficulties in the psychosocial stage of identity development among emerging adults. However, the resolution of identity exploration towards commitments to goals, roles, and beliefs, can help trauma survivors experience resilience and growth after stressful experiences.
ContributorsWiley, Rachel (Author) / Robinson-Kurpius, Sharon (Thesis advisor) / Stamm, Jill (Committee member) / Kinnier, Richard (Committee member) / Arizona State University (Publisher)
Created2013
Description
Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD) are highly prevalent illnesses that can result in profound impairment. While many patients with these disorders present in primary care, research suggests that physicians under-detect and suboptimally manage MDD and PTSD in their patients. The development of more effective training interventions to aid primary care providers in diagnosing mental health disorders is of the utmost importance. This research focuses on evaluating computer-based training tools (Avatars) for training family physicians to better diagnose MDD and PTSD. Three interventions are compared: a "choice" avatar simulation training program, a "fixed" avatar simulation training program, and a text-based training program for training physicians to improve their diagnostic interviewing skills in detecting and diagnosing MDD and PTSD. Two one-way ANCOVAs were used to analyze the differences between the groups on diagnostic accuracy while controlling for mental health experience. In order to assess specifically how prior mental health experience affected diagnostic accuracy the covariate of prior mental health experience was then used as an independent variable and simple main effects and pairwise comparisons were evaluated. Results indicated that for the MDD case both avatar treatment groups significantly outperformed the text-based treatment in diagnostic accuracy regardless of prior mental health experience. For the PTSD case those receiving the fixed avatar simulation training more accurately diagnosed PTSD than the text-based training group and the choice-avatar training group regardless of prior mental health experience. Confidence ratings indicated that the majority of participants were very confident with their diagnoses for both cases. Discussion focused on the utility of avatar technology in medical education. The findings in this study indicate that avatar technology aided the participants in diagnosing MDD and PTSD better than traditional text-based methods employed to train PCPs to diagnose. Regardless of experience level the fixed avatar group outperformed the other groups for both cases. Avatar technology used in diagnostic training can be user-friendly and cost-effective. It can also have a world-wide reach. Additional educational benefit could be provided by using automated text analysis to provide physicians with feedback based on the extent to which their case diagnostic summaries cover relevant content. In conclusion, avatar technology can offer robust training that could be potentially transferred to real environment performance.
ContributorsSatter, Rachel (Author) / Kinnier, Richard (Thesis advisor) / Mackenzie, James (Committee member) / Claiborn, Charles (Committee member) / Arizona State University (Publisher)
Created2012