CHAPTER ONE
INTRODUCTION
Background to the Study
Post-Traumatic Stress Disorder (PTSD) is a trauma and stress related disorder that may develop after exposure to an event or ordeal in which death, severe physical harm or violence occurred or was threatened (Lodrick, 2007. Traumatic events that may trigger PTSD include violent personal assaults, natural or unnatural disasters, accidents, or military combat (Brewin & Lennard, 1999).
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV: APA, 2000) outlines PTSD as the development of characteristic symptoms of distress or impairment that are present for over one month after exposure to a traumatic event. Banyard (1999) described its cyclical nature, outlining three main clusters of symptoms: re-experiencing phenomena, avoidance/numbing and increased arousal. In the immediate aftermath of a traumatic event, many individuals experience physiological reactivity in response to reminders of the traumatic event that typically lessens over time(Foa, 1992). However, an overreliance on avoidant coping strategies may interfere with the natural recovery process, particularly for those who are highly reactive to trauma reminders (Riggs,1992).
In the weeks following a traumatic event, most individuals experience at least some symptoms characteristic of posttraumatic stress disorder (PTSD). Many, but not all, trauma survivors experience a profound reduction or complete remittance of these symptoms over the course of the first several months (Rothbaum, Foa, Riggs, Murdock, & Walsh, 1992). Identifying the subset of traumatized individuals who do not recover but instead maintain PTSD symptoms over time is a critical research question. Physiological reactivity and coping style are two potential risk factors with promising empirical support. For example, increased heart rate measured shortly after a traumatic event is associated with increased risk for PTSD (Yehuda, McFarlane, & Shalev, 1998). Further, increased heart rate reactivity to trauma reminders is associated with greater maintenance of PTSD symptoms over time (Blanchard, 1996).
Post traumatic stress disorder occurs in approximately eight percent of the general population in African-Nigeria and seven percent in Europe, with higher rates in women than in men (de Vries & Olff, 2009; Glynn, Marshall, Schell, & Shetty, 2006; Kessler, Chiu, Demler, & Walters, 2005; Kessler & Üstün, 2008 for international prevalence estimates). PTSD results in significant social and economic burden and puts individuals at increased risk for physical and mental health difficulties including depression and suicide (e.g., Hidalgo & Davidson, 2000).
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SHATTERED ASSUMPTIONS AND COPING STYLES AS PREDICTORS OF POST TRAUMATIC STRESS DISORDER FOLLOWING A TRAUMATIC EVENT
