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Post-traumatic stress disorder (PTSD) can affect anyone as the result of public or personal disaster, but is particularly associated with defence and emergency services personnel. Professor McFarlane's research has focused on the epidemiology and longitudinal course of PTSD, and the neuroimaging of cognitive deficits associated with this disorder. Professor McFarlane described how dysfunctional brain-stem arousal may disrupt basic cognitive processes and maintain pathological features of PTSD such as dissociation, and may also lead to novel treatments such as stellate ganglion block. [Extracted from the article]

Objective: To describe key practical knowledge and skill components required for clinicians involved with the assessment of military personnel and veterans.Conclusions: Assessment of military and veterans' mental health issues involves a tailored history-taking process that includes specific aspects of service, transition and reporting requirements. Recommendations for the detailed assessment of military personnel and veterans are provided. Comorbid conditions, chronic pain and the needs of both women and older veterans are also discussed. [ABSTRACT FROM AUTHOR]

Objectives: The poor mental health of asylum seekers and refugees in immigration detention has consistently been reported in peer-reviewed literature internationally; however, data on the mental health of asylum seekers and refugees detained in Australian immigration has been very limited.Methods: We re-analysed mental health screening data obtained by the Human Rights Commission.Results: Longer time in detention was associated with higher self-reported depression scores, with female individuals being more vulnerable to time in detention than those of male gender. Approximately one-half of the refugee group who agreed to complete the Harvard Trauma Questionnaire had post-traumatic stress disorder symptoms. On clinician-rated measures, one-third of the children, adolescents and adults suffered with clinical symptoms requiring tertiary outpatient assessment.Conclusions: This paper consolidates the findings of the 2014 Australian Human Rights Commission report and it provides an argument for public reporting of refugee data. [ABSTRACT FROM AUTHOR]

This systematic review synthesized current knowledge about the prevalence of adverse childhood experiences (ACEs) among young people known to have offended and examined evidence of associations between ACEs, trauma symptoms, and offending behavior. A systematic search of English-language, peer-reviewed studies published from the year 2000 onwards was conducted. A final pool of 124 studies that reported quantitative data were included in the review. The Cambridge Quality Checklist for the assessment of studies on offending was used to assess methodological quality of included studies. Pooled data indicated that almost 87% of justice-involved young people across 13 countries experienced at least one traumatic event. The odds of experiencing at least one ACE were over 12 times greater for justice-involved young people compared with nonjustice-involved young people. Prevalence of individual ACEs ranged from 12.2% for childhood sexual abuse to 80.4% for parental separation among justice-involved young people. Those who reported both a higher number and multiple types of ACEs were more likely to be diagnosed with post-traumatic stress symptoms. However, when considering only high-quality studies, there was minimal evidence to suggest that a higher incidence of ACEs predicted trauma symptoms or that trauma symptoms mediated the association between ACEs and offending behavior. Further research is needed to elucidate factors that differentiate young people exposed to ACEs who go on to offend from those who do not. This research is essential to understanding whether ACEs and trauma are drivers of offending behavior and for informing prevention and intervention strategies. [ABSTRACT FROM AUTHOR]

Objective: Psychosocial trauma was associated with developing conversion disorder (also known as functional neurological disorder) before Freud, though why a particular symptom should arise is unknown. We aimed to determine if there was a relationship between trauma type and symptom.Methods: We retrospectively reviewed the medical records of patients attending Australia's first functional neurology clinic, including referral, clinic letters and a clinic questionnaire.Results: There were 106 females, 43 males and five transgender patients. Sensory (51%), motor (47%) and seizures (39%) were the commonest functional symptoms. Most patients (92%) reported stressors associated with symptom onset. Multiple trauma/symptom type associations were found: patients with in-law problems experienced more cognitive symptoms (p = .036), for example, while expressive speech problems more commonly followed relationship difficulties (p = .021).Conclusion: Associations were found between type of traumatic events and type of symptoms in conversion disorder. This will require verification in a larger sample. [ABSTRACT FROM AUTHOR]

Objective: The aims of this paper are to determine the risk factors for combat-related posttraumatic stress disorder (PTSD) and to examine the relative contribution of pre-military factors, pre-trauma psychiatric diagnoses, military factors such as combat posting, and combat and casualty stress exposure. Method: An epidemiological cohort study using standardised psychiatric, social and health interviews was undertaken with a national random sample of male Australian Army Vietnam veterans. Multivariate logistic regression was used to examine the relative contribution of factors derived from interview and from military records in four categories: pre-enlistment circumstances including home life, education, major life stress; pre-Vietnam psychiatric diagnoses; military experiences before and during Vietnam; and combat and stress experiences. Results: Of the 128 data items examined, significant associations were found for 39, in addition to combat stress. Pre-enlistment items accounted for about 3% of the deviance towards PTSD diagnosis, pre-enlistment psychiatric diagnosis about 13%, military variables about 7% and combat stress about 18%; all factors together accounted for 42%. Conclusions: The results confirm that pre-military and military variables make only a small but significant contribution to PTSD either alone or after controlling for combat stress; that psychiatric diagnoses of depression, dysthymia and agoraphobia make strong contributions to PTSD; but that combat stress makes the largest contribution even after controlling for the effects of other variables. Psychiatric diagnoses and combat stress appear to be independent in their effects on PTSD. [ABSTRACT FROM AUTHOR]

Objective: To examine psychological distress in healthcare workers (HCWs) during the COVID-19 pandemic in April–May 2020. Methods: A cross-sectional survey examining demographic, employment and mental health characteristics of HCWs in a large metropolitan hospital in Australia. Results: HCWs showed significant symptoms of moderate-severe level depression (21%), anxiety (20%) and posttraumatic stress disorder (PTSD; 29%), associated with burnout, prior psychiatric history, profession and resilience. Conclusion: Despite low levels of COVID contact, moderate to high levels of psychological distress were reported. Continued monitoring and support for HCWs' mental well-being is warranted as the COVID-19 pandemic develops. [ABSTRACT FROM AUTHOR]

Objectives: Suicide is an Aboriginal and Torres Strait Islander (hereafter 'Indigenous') population health issue. Over 2015-2016, the Aboriginal and Torres Strait Islander Suicide Prevention Project (ATSISPEP) aimed to identify success factors in Indigenous suicide prevention.Conclusions: For non-Indigenous practitioners working with indigenous clients at risk of suicide, ATSISPEP identified important considerations to make treatment more effective. The start is acknowledging the differences in the historical, cultural, political, social and economic experiences of Indigenous peoples, and their greater exposure to trauma, psychological distress and risks to mental health. These mental health difficulties are specific and more prevalent amongst Indigenous peoples and communities due to the ongoing impacts of colonisation in Australia including a range of social determinants impacting on the well-being of Indigenous peoples today. Working effectively with Indigenous clients also includes being able to establish culturally safe work environments, and the ability of non-Indigenous practitioners to work in a culturally competent and trauma-informed manner. There are also considerations regarding time protocols and client follow-up. Further, postvention responses might be required. Supporting selective suicide prevention activity among younger people (and other groups at increased risk) and community-level work is an important complement to working with Indigenous individuals at risk of suicide. [ABSTRACT FROM AUTHOR]

Objective: The objective of this article is to highlight the pitfalls of translating historical cases of wartime psychiatric trauma into modern post-traumatic stress disorder (PTSD).Method: We examined all available primary sources relating to the case of Martin O'Meara VC (1885-1935).Results: We found that O'Meara's symptoms are not consistent with a diagnosis of PTSD.Conclusions: It is more likely that O'Meara developed a form of schizoaffective disorder, or long-lasting trauma-induced psychosis, after World War I. [ABSTRACT FROM AUTHOR]

Objectives: National suicide rates fall during times of war. This fits with the notion of the population coming together against a common foe. But, what happens in the case of a war which is not fully supported, which draws the population and families apart? We consider this question by examining the Australian suicide rates during the divisive Vietnam War.Methods: We graphed and examined the Australian suicide figures for 1921-2010.Results: We found clear evidence of a decrease in the suicide rate for World War II (consistent with other studies), but a marked elevation of suicide during the Vietnam War.Conclusions: The elevation of the Australian suicide rate during the Vietnam War is consistent with Durkheim's social integration model - when social integration is lessened, either by individual characteristics or societal characteristics, the risk of suicide rises. [ABSTRACT FROM AUTHOR]

Disclosure of traumatic experiences is related to health benefits and is central to therapy for individuals with posttraumatic stress disorder (PTSD). However, neither naturalistic patterns of trauma disclosures nor the outcomes of such disclosures have been established empirically. This article reports the development and preliminary psychometric evaluation of a 16-item instrument assessing characteristics of traumatic event disclosure- inhibition, emotional disclosure, and cognitive disclosure-to spouses. Furthermore, the association between the trauma disclosure of 103 Australian police officers and their adjustment is presented. The disclosure subscales demonstrate adequate internal consistency and also predict several psychological outcomes. Consistent with prior literature, officers who did not discuss their trauma experience experienced more psychological distress and traumatic stress. However, failure to observe benefits for cognitive disclosure is discussed with regard to the role of negative appraisals in PTSD and differences between naturalistic and experimental disclosure. [ABSTRACT FROM AUTHOR]

Objective: To investigate post-traumatic stress disorder (PTSD) symptomatology in servicemen hospitalized 1942-1952. Method: Hospital files of servicemen (n = 590) were studied and PTSD symptoms in groups, based on service experience, were compared. Results: Based on their hospital files, 19% of servicemen were classified as having partial PTSD. No full cases of PTSD were identified, due primarily to the small number of recorded avoidance symptoms and the limited information in relation to the stressor criterion. Prisoners of war had the highest reported avoidance and lowest intrusive symptoms compared with other combatants. Conclusions: PTSD symptoms may have been common during and after World War II. At that time avoidance was not considered a symptom of disorder. Intrusive and arousal symptoms may be the core symptoms of PTSD and avoidance symptoms need to be reconsidered. [ABSTRACT FROM AUTHOR]

Objectives: To study patterns of posttraumatic stress in a group of rural road accident victims for 12 months post accident, identifying posttraumatic stress or ‘subsyndromal’ posttraumatic stress on each measurement occasion and documenting changes in diagnostic status over time. Method-Design: A prospective longitudinal study of road accident victims over 12 months. Sample: Seventy-two people who consented to the study from a group of consecutive attendees to hospital following road accidents. Three, six and twelve month follow-ups were completed by 61, 62 and 57 people, respectively. Chief Outcome Measures: Posttraumatic stress as diagnosed using the Posttraumatic Stress Disorder Interview. Results: Initially after the accident 23.6% of participants had posttraumatic stress, 11.5% at 3 months, 9.7% at 6 months and 7.0% at 12 months. There was overall decline in symptoms with time but with some individuals being symptomatic later despite being asymptomatic earlier. Conclusion: A meaningful proportion of Australian rural road accident victims had symptoms of posttraumatic stress on each measurement occasion. This would justify follow-up by hospitals or provision of information to alert patients to possible psychological sequelae of accidents. [ABSTRACT FROM AUTHOR]

The article offers the author's insights on the importance of training in psychotherapy. Topics mentioned include the treatment for emotional trauma, the development in psychotherapy, and the treatment for post-traumatic stress disorder. Also mentioned are the cooperation of therapist and patient during psychotherapy and the development of art therapy.