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Type: Theses
Title: Hyperarousal: the critical determinant of post-trauma sequelae
Author: Blunt, Jason Denis
Issue Date: 2016
School/Discipline: School of Medicine
Abstract: Background: Recent literature has revealed the prognostic role of the hyperarousal criteria as a predictor of further PTSD symptom onset, maintenance, and severity. Despite this, there is a distinct gap in the literature as to the aetiology of hyperarousal, and the impact of these symptoms on an individual’s post-trauma sequelae outside of the PTSD paradigm. Aims: This thesis examined hyperarousal in the context of post-trauma sequelae. Specifically, the chapters of this thesis focus on which trauma-related factors predicted this criterion following a traumatic experience; the role of hyperarousal in the development of psychological disorders other than PTSD; how hyperarousal affects an individual’s quality of life and disability level following a trauma; and finally, delineating the relationships between the individual symptoms of hyperarousal as they manifest longitudinally following a traumatic event. Method: Such a breadth of analysis required the use of data from three very distinct epidemiological data sets. The Military Health Outcomes Program (MILHOP) of research, designed to establish the prevalence of mental disorder and psychological distress in currently serving Australian Defence Force (ADF) personnel, was utilised to assess how different aspects of trauma (i.e. the nature and number of traumas) predict the onset of hyperarousal. The South East Lifetime Impact of Fire Exposure Study (SE LIFE) a longitudinal study of individuals exposed to the Ash Wednesday Bushfires of February 16th, 1983, was utilised to assess whether hyperarousal significantly predicted novel episodes of disorder other than PTSD. Finally, the Injury Vulnerability Study (IVS), a large-scale national multisite study of psychopathology following traumatic injury, was utilised to assess both the impact of hyperarousal on quality of life and disability following trauma and how the symptoms of hyperarousal manifest longitudinally following a traumatic event. Results: Highlighting the significant association between cumulative trauma and the development of hyperarousal, the results presented in this thesis also emphasise the role of hyperarousal criterion in the prediction of both future episodes of PTSD and other anxiety and affective disorders. An examination of the contributions of the different symptom criteria of PTSD in predicting quality of life and disability following trauma highlighted the role of hyperarousal in particular predicting poorer physical and environmental self-reported quality of life and increased disability. A closer examination of the relationships between the symptoms of hyperarousal following a traumatic experience illustrated the significant role that hypervigilance plays in promoting further symptom recruitment within this criteria and perhaps the disorder. Conclusion: The results presented in this thesis highlight the significant role of the hyperarousal criteria post-trauma. Significantly influenced by both the nature and number of traumas experienced, hyperarousal has a prominent role in post-trauma sequelae, predicting future novel episodes of disorder, poorer quality life and an increased level of disability. Suggestions for trauma interventions include early-targeted treatment of hyperarousal symptoms, particularly hypervigilance, which was shown to predict the onset of further hyperarousal symptoms. Future research should focus on expanding the paradigm of hyperarousal and providing a better understanding of the neurological and biological underpinnings of these symptoms, which play a critical role in critical determining post-trauma sequelae.
Advisor: MacFarlane, Sandy
Van Hooff, Miranda
Lawrence-Wood, Ellie
Dissertation Note: Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2016.
Keywords: PTSD
hyperarousal
trauma
Provenance: This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legals
DOI: 10.4225/55/58b7aceaa80e4
Appears in Collections:Research Theses

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