Running head FIRST RESPONDERS RISK FOR PTSD .docx

Running head: FIRST RESPONDERS RISK FOR PTSD
Do First Responders Have an Increased Risk of Developing Post
Traumatic Stress
Disorder?
Student Name
Do First Responders Have an Increased Risk of Developing Post
Traumatic Stress
Disorder? Introduction
This topic is important to me, my husband was a first responder,
many of his former crew members have suffered from PTSD, are

currently suffering, and have even taken their own life since his
line of duty death. I would like to research if mandatory
counseling or if a critical stress debriefing after a traumatic
incident could lessen the effects of PTSD however, there was
not an ample amount of research.
First responders are those that respond to any emergency event.
They can be firefighters, paramedics, emergency medical
technicians (EMTs), law enforcement officers, trauma nurses,
etc. With first responder suicides on the rise and the number of
first responders suffering from posttraumatic stress disorders
(PTSD) on the upswing (Kimbrel, Steffen, Meyer, Kruse,
Knight, Zimering, and Gulliver, 2011) it seemed of importance
to research if first responders do have a higher risk of
development for PTSD. Proving that the risk of PTSD is higher
in those occupations, could lead to programs for first responders
to combat posttraumatic stress disorder.
Literature Review:
In the Chopko, Palmieri, and Adams 2018 path analysis there
really was not a specific claim as to what they thought the
outcome would be because they were trying to determine the
relationships between traumatic experience, posttraumatic stress
disorder (PTSD) and posttraumatic growth (PTG) for police
officers. In this cross-sectional study, the authors conducted
their research with a goal to better understand and help police
officers experiencing
PTSD (Chopko, Palmieri, & Adams 2018).
The methods used were pretty straightforward, the first author
Brian A. Chopko attended roll calls at three different police
departments and training sessions at the state training center, he
invited 364 officers to participate in the anonymous survey only
53% of those asked, accepted and returned their surveys
(Chopko, Palmieri, & Adams 2018). The participants were of
varying levels of ranks including patrol officers, detectives,
administration, and other positions. The subjects were
predominately white males and mostly married (Chopko,
Palmieri, & Adams

2018, p.183).
The subjects were given a self-assessed questionnaire to
measure Posttraumatic Growth
Inventory with 21 questions, 10 questions on behavioral growth
and 11 for cognitive growth (Chopko et al, 2018). They
responded to the Posttraumatic Stress Disorder checklist, and
also the Critical Incident History Questionnaire that assesses 34
incidents that are commonly experienced by officers in the field
19 of those questions ask about direct involvement ( shooting
at someone/being shot at) and 15 items about indirect
involvement for example:
encountering a child that was beaten or sexually abused, and
one question on personal relationship stress was asked(Chopko
et al, 2018)
The research design helped gather the correct information
needed to assess relationships among traumatic experiences. I
am not sure that the research was ethical, it is not clear how
secure the anonymity was. Also, if the researcher was at role
calls and classes asking those to participate who is to say they
did not feel coerced into participating if their supervisors were
on board.
Schutt and Marotta’s “Personal and Environmental Predictors of
Posttraumatic Stress in
Emergency Management Professionals” they claim emergency
management professionals
(EMPs) relationship with PTSD could be influenced by
personality, context, burn out, and compassion satisfaction
(Schutt and Marotta, 2011). Some of their claims seemed to be
substantiated by their research as ethnicity identity showed a
significant correlation with PTSD, as did neuroticism
(personality) and burnout (Schutt and Marotta, 2011).
In this longitudinal study Schutt and Marotta recruited the
population from four different emergency management
associations through email, they found 269 participants 175 men
and 94 women with an average age of 46, a little over half
participants were married and mostly white (Schutt and Marotta,

2011). Personality was measured with the NEO Five Factor
Inventory to measure their traits, the multigroup ethnic identity
measure – revised was used to measure ethnicity, they used a
trauma history questionnaire to determine if the types of
traumatic events encountered, the PTSD Checklist- civilian
version to determine presence and severity of PTSD and finally
a demographic questionnaire (Schutt and Marotta, 2011). There
was a contact person at each management facility that
distributed the email to participants with the surveys.
The experiment seems to be conducted in an ethical manner,
informed consent was given when surveys were returned and
there is a social and clinical value to this test . One must
question the article as it reports in one paragraph 175 men and
94 women which totals only 269 but two paragraphs later Schutt
and Marotta write “Two hundred eighty-four individuals
completed the full or partial survey” (p.10). Also, it is looking
for ethic diversity having an impact yet the majority of the
respondents are white.
In Skogstad, Fjetland, and Ekeberg 2015 correlational study
about exposure and PTSD symptoms of first responders of terror
attacks in Norway they hoped to “investigate the degree of
perceived peritraumatic strain as well as the prevalence and
predictors of PTSS among first responders” (np). It was
thought that since victims of traumatic events, victims and
victim’s families of terror attacks have an increased risk of
developing PTSS or PTSD that first responders responding to
the terror attacks would have an increased chance of developing
PTSS and PTSD as well (Skogstad, Fjetland, & Ekeberg, 2015).
The 2015 Skogstad, Fietland & Ekeberg study they found there
were low rates of PTSD and PTSS. The study was done ethically
and the “Oslo University Hospital’s Privacy Protection
Supervisor approved the study” (Skogstad, Fjetland, & Ekeberg,
2015).
The methods used were as follows, an anonymous questionnaire
was sent to police, fire, and ambulance personnel directly
involved with the terror attacks that occurred in Norway on July

22, 2011 this study sent the questionnaire from 8-11 months
after the attacks with an information letter and if questionnaire
was returned that implied consent (2015). The questionnaire
questioned sociodemographic such as age, sex, and occupation,
there were also questions to determine how greatly the attacks
were witnessed respondents would circle yes or no then chose to
which degree they witnessed the events, ie. Viewing dead
bodies, smelling strong odors, seeing body parts, etc. (Skogstad,
Fjetland, & Ekeberg, 2015). The study also asked 4 questions
regarding perceived threats measured on a Likert scale. The
participants were all male, police officers, firefighters and
ambulance personnel most between 30-49 years of age with the
majority of participants having over 5 years of work history
(Skogstad, Fjetland, & Ekeberg, 2015).
Boyd, Protopopescu, O’Connor, Neufeld, Jetly, Hood, Lanius,
and McKinnon’s 2018 study they “sought to identify trauma
related symptoms most strongly associated with functional
impairment in a sample of military members, veterans, and first
responders” (Boyd et al., 2018, np). The study hypothesized
that the dissociative symptoms would mediate the PTSD
symptoms and functional impairments (Boyd et al., 2018). It
concluded that military members and veterans had higher levels
of trauma related symptoms than first responders.
In this correlational study, the researchers reviewed eighty- one
charts retrospectively of patients that were in an inpatient
treatment for PTSD recovery of those eighty-one charts only
sixty-two subjects were found to be satisfactory for the study.
The methods used in the study was the World Health
Organization Disability Assessment Schedule 2.0 (WHODAS) it
is a selfreport inventory as is the PTSD Checklist for DSM-5
that was used. The Multiscale Dissociation Inventory is used to
measure the frequency that individuals experience the
dissociative symptoms, the Difficulties in Emotion Regulation
Scale was used to assess the six dimensions of difficulties in
emotional regulation, the Toronto Alexithymia Scale is a 20
item self-report that measures difficulties naming or

recognizing ones emotions, the Depression Anxiety Stress Scale
was used to measure symptoms of depression, stress, and
anxiety and finally the Adverse Childhood Experience
Questionnaire was used to assess 10 commonly experienced
adverse experiences (Boyd et al., 2018).
The study seems to have been conducted ethically and with
proper permission it was approved by the Homewood Health
Centre Research Ethics Board.
In the longitudinal 2011 study performed by Kimbrel,
Steffen, Meyer, Knight,
Zimering, & Gulliver the researchers questioned the validity of
the Sources of Occupational Stress scale (SOOS) and if it was
the best instrument to measure the occupational stress of first
responders. The first responders and clinicians treating them
have objected to the SOOS for being too long and redundant.
The goal of Kimbrel et al was to improve and shorten the
SOOS. (Kimbrel et al., 2011). The researchers found that while
the SOOS 14, the abbreviated version exhibited good internal
consistency, and good validity across two independent samples
there needs to be additional studies to replicate.
The first study was with firefighters from large cities
across the United States, mostly male and an average of 42
years the majority had served in fire service for greater than 7
years and over half were non-Hispanic Caucasian with African
Americans making up 12 % it aimed to prove a shortened SOOS
could work (Kimbrel et al., 2011). The subjects took both the
SOOS and the SOOS 14 along with other tests. Study 2 used
different participants all active duty fire personnel from large
urban fire departments. The average age was 41 and while half
were non- Hispanic white there was a larger number of African
Americans 32%. Informed consent was obtained and the same
tests were given which helps to determine the testing as ethical.
In conclusion of the literature review, I still feel there is further
research necessary to determine if first responders are at an
increased risk of PTSD. While there are plenty of studies and
research, I feel a more comprehensive study can be done. I

believe I would use the full SOOS even though Kimbral et al.,
2018 showed that the SOOS 14 could work it does not have
enough testing and I would want a full range of testing. I feel
as though a large sample size that is much more diverse would
be beneficial to any study. Some of the research such as Shutt
and
Marotta’s 2011 study have been largely dominated by white
males and while this might be representative of the field, I
would further research the field and try to take a more diverse
slice of population. I also would make sure to use only members
that are active duty. Methodology
Research design:
I have chosen the quantitative approach for the research. I felt
quantitative would be the best since I am planning to study a
larger more diverse population of first responders. The
independent variable will be the first responders and the
dependent variable will be to what degree the first responders
develop posttraumatic stress disorder. Since I would like to
measure possible PTSD in the first responder field across the
country it is impossible to find first responders that have been
on the same degree of traumatic calls.
Participants:
· I will be gathering participants from stations chosen from four
categories at random in every state; included in the first
category will be the largest/EMS police stations, the second
category are medium size/medium call volume EMS and police
stations, the third category will be the smallest/slowest EMS
and police station in every state. For the fourth category I
would like to add in a large/busy private ambulance from each
state as well to make sure all areas of first response are
represented in the study. I would obtain the information
necessary for determining station selection by using data
collected from the National Fire Protection Agency and The
National Association of Police officers. Once the stations are
chosen in each state, I would contact the public liaison for each
department and ask to have the questionnaires distributed to all

first responders at those stations. I anticipate having at least
300 surveys returned from each state with a total of 15,000
participants.
· The cluster sampling will be employed in this experiment
since it seems to be the best fit for a full random sample of the
first responder community.
· There will be groups assigned but only assigned by
professional title for example, the groups will be broken into
Fire, Police, Paramedic, and Emergency Medical Technicians
(EMTs). The groups could determine if some professions
develop PTSD easier than others and if those groups are
recognized as having higher probability for PTSD the
preventative measures could be concentrated on them.
· The demographics of the study will more than likely be
predominately male and predominately white. According to the
National Fire Protection Agency’s (NFPA, 2019) and the
National Police Officer Association’s (NPOA, 2019) statistics,
both fields are predominantly made up of white males between
the ages of 20-49 years of age. The
National Fire Protection Agency’s 2017 United Fire Department
Profile Report 7% of firefighters are women, Data USA is
currently reporting that 21% of police officers are female.
Procedures:
· I plan on conducting this study online through a portal that has
an access code given to participants. I think this would be the
easiest way to have the data returned and the most cost-
effective way to collect it. The date will however, be analyzed
at a
University and only approved researchers will have access to it.
· I would give the participants 60 days to complete the surveys.
Measures:
· This will be a self-report study
· As in Kimbrel et al 2011 study I would like to use the PTSD
Checklist (PCL-5
Weathers, Lita, Herman, Huska, & Keane, 1993) and also the
Critical Incident History Questionnaire that assesses 34

incidents that are commonly experienced by officers in the field
19 of those questions ask about direct involvement (shooting at
someone/being shot at) and 15 items about indirect involvement
for example:
encountering a child that was beaten or sexually abused
(Chopko et al, 2018). I would also like to use the Sources of
Occupational Stress (SOOS) even though the 2018 study by
Kimbrel et al showed the abridged 14 question SOOS was valid
I would like to go more in depth. Unfortunately, I was only
able to find one example of the tests I would like to administer
the PTSD Checklist by Weathers et al, 1993 is attached.
· The PTSD Checklist (PCL-5 Weathers et al, 1993) “is a 17-
item self-report measure designed to assess PTSD symptom
severity that has demonstrated excellent reliability and validity”
(Kimbrel et al, 2011. np).
· I will include all surveys on the portal in different sections,
breaks may be taken and they can work at their own pace (save
and come back later).
· The above-mentioned surveys will all be done through self-
reporting questionnaires
Ethical:
· I plan on keeping the study ethical by conferring and receiving
permission by our IRB at the University, obtaining a properly
written informed consent, and protecting the anonymity of the
subjects. It will also be stated on the informed consent that
participation is voluntary.
PTSD Checklist by Weathers et al, 1993
Discussion:
The findings of this research prove that first responders do have
a higher risk of developing Post traumatic stress disorder
(PTSD). The findings would be of great importance to help
implement programs to lessen the chances of PTSD in first
responders. It is also in the findings of this report that the
amount of trauma witnessed, long hours, and anxiety of being

harmed have caused an increase in severity of PTSD in first
responders. This information will help a great deal in the first
responder community to find preventative measures, whether
limiting hours worked, mandating clinical debriefing after
severe calls, or helping new first responders during training to
prepare better mentally for the job.
Even though great measures were taken to ensure a large
number of diverse first responders and departments were taken
into account I believe the same research with the same number
of participants from different areas should be conducted again
to add a larger sample. I would also like to see results from a
study done after additional mental health training has occurred
with new recruits and trainees cope mentally with the stressors
of the job.
The possible limitations to this study could lie in the
differences between urban and rural departments that see
different types of calls. I also see limitations in the fact that all
participants were given the same questionnaires. It might have
been beneficial to give the first responders different job specific
questions since they were already broken into groups. Also, fish
and wildlife and forest ranger were not included. I would also
like to see highway patrols included into the law enforcement
group in future studies.
I did not see any ethical issues that were encountered. The
voluntary surveys were given through a password protected
website identifying only the test not the participant by number.
There is no way of knowing which participant took the test.
Informed consent was given.
Permission was granted through the University’s review board.
Validity:
The internal validity is the extent to which we can say that only
the independent variable caused the changes in the dependent
variable (Cozby & Bates, 2018). I believe history is a threat to
this study. Who is to say the participants did not have a
previous history that we did not ask about, and therefore was
not taken into consideration? I did not ask how many were

veterans and if the PTSD came from their time in active duty
military. Also, what happened to them before becoming a first
responder? Were they involved in a tragedy that caused PTSD
symptoms to be easily triggered?
Construct validity of refers to the accuracy of measurement
(Cozby & Bates, 2018). I did wonder about reactivity to the
experiment by the participants. Did the participants feel that
they could be matched with their answers so they did not
necessarily answer truthfully? It would be suggested that a
survey is given to participants from this experiment about how
anonymous they thought the survey was. One can also wonder
if cues from the experimental questions caused the participants
to answer higher or lower on the PTSD scale since they knew
from the material that was being tested.
In conclusion I feel that the study is valid, ethical, and will
prove to be very helpful in the future. If the findings of this
research are shared with the community it could make our first
responders healthier and proved for a stronger mental health in
the community.
References
Boyd, J. E., Protopopescu, A., O’Connor, C., Neufeld, R. W.,
Jetly, R., Hood, H. K., . . . Mckinnon, M. C. (2018).
Dissociative symptoms mediate the relation between PTSD
symptoms and functional impairment in a sample of military
members, veterans, and first responders with
PTSD. European Journal of Psychotraumatology,9(1), 1463794.
doi:10.1080/20008198.2018.1463794
Chopko, B. A., Palmieri, P. A., & Adams, R. E. (2018).
Relationships Among Traumatic
Experiences, PTSD, and Posttraumatic Growth for Police
Officers: A Path Analysis.
Psychological Trauma: Theory, Research, Practice, and
Policy,10(2), 183-189.
doi:10.1037/tra00
Cozby, P. C., & Bates, S. (2018). Methods in behavioral

research. New York, NY: McGraw-Hill
Education.
Kimbrel, N. A., Steffen, L. E., Meyer, E. C., Kruse, M. I.,
Knight, J. A., Zimering, R. T., & Gulliver, S. B. (2011). A
revised measure of occupational stress for firefighters:
Psychometric properties and relationship to posttraumatic stress
disorder, depression, and substance abuse.
Psychological Services,8(4), 294-306. doi:10.1037/a0025845
National Police Officer Association. 2019
National Fire Protection Agency. 2019
Schutt, J. M., & Marotta, S. (mar. 2011). Personal and
Environmental Predictors of Posttraumatic
Stress in Emergency Management Professionals. Pyschological
Trauma: Theory, Research,
Practice, and Policy,3(1), 8-15. doi:10.1037/e517292011-473
Skogstad, L., Fjetland, A. M., & Ekeberg, Ø. (2015). Exposure
and posttraumatic stress symptoms among first responders
working in proximity to the terror sites in Norway on July 22,
2011 – a cross-sectional study. Scandinavian Journal of Trauma,
Resuscitation and Emergency Medicine,
23(1). doi:10.1186/s13049-015-0104-4
1
FIRST RESPONDERS RISK FOR PTSD 2
FIRST RESPONDERS RISK FOR PTSD 2
Weathers, Litz, Keane, Palmieri, Marx, & Schnurr -- National
Center for PTSD PCL-5 (8/14/2013)
My research proposal is PTSD in Veterans and suicide
1) My question is what are the causes of PTSD in veterans and
how successful is the current treaments and support systems in
place to help them.
2) These are my articles

· Alyson K. Zalta, Philip Held, Dale L. Smith, Brian J. Klassen,
Ashton M. Lofgreen, Patricia S. Normand, … Niranjan S.
Karnik. (2018). Evaluating patterns and predictors of symptom
change during a three-week intensive outpatient treatment for
veterans with PTSD. BMC Psychiatry, (1), 1. https://doi-
org.ucamia.cobimet4.org/10.1186/s12888-018-1816-6
i) This article is about the intense study of evident based study
on the treatment and success of a three-week outpatient
program. It shows the statistics on the success rate of the
program and how it can be implemented and modified to get the
most optimal success rates.
· Ashley N. Clausen, Joan Thelen, Alex J. Francisco, Jared
Bruce, Laura Martin, Joan McDowd, & Robin L. Aupperle.
(2019). Computer-Based Executive Function Training for
Combat Veterans With PTSD: A Pilot Clinical Trial Assessing
Feasibility and Predictors of Dropout. Frontiers in Psychiatry.
https://doi-org.ucamia.cobimet4.org/10.3389/fpsyt.2019.00062
i) This article is about a new treatment to explore the feasibility
of placebo-controlled, computerized, home-based executive
function training (EFT) on psychological and
neuropsychological function and brain activation in combat
veterans with PTSD
· Dorthe Varning Poulsen. (2017). Nature-based therapy as a
treatment for veterans with PTSD: what do we know? Journal of
Public Mental Health, 16(1), 15–20. https://doi-
org.ucamia.cobimet4.org/10.1108/JPMH-08-2016-0039
i) This paper is about an alternative method of treating PSTD
and it has to do with a more holistic approach and a more
natural treatment method instead of strong medications.
· Harold G. Koenig, Donna Ames, & Arndt Büssing. (2019).
Editorial: Screening for and Treatment of Moral Injury in

Veterans/Active Duty Military With PTSD. Frontiers in
Psychiatry. https://doi-
org.ucamia.cobimet4.org/10.3389/fpsyt.2019.00596
i) this article is about a new form of PTSD called MI or moral
injury. MI defined as the emotional, spiritual, and moral
consequences of committing and/or observing others commit
transgressions and how it affects them.
· Katherine D. Hoerster, Sarah Campbell, Marketa Dolan,
Cynthia A. Stappenbeck, Samantha Yard, Tracy Simpson, &
Karin M. Nelson. (2019). PTSD is associated with poor health
behavior and greater Body Mass Index through depression,
increasing cardiovascular disease and diabetes risk among U.S.
veterans. Preventive Medicine Reports. https://doi-
org.ucamia.cobimet4.org/10.1016/j.pmedr.2019.100930
i) This article talks about how PTSD is associated and is
clinically proven to worsen and lead to poor health behaviors,
depression which leads to CVD and diabetes.
Running head: VETERANS PTSD CAUSES, TREATMENTS,
AND SUPPORT SYSTEMS 1
VETERANS PTSD CAUSES, TREATMENTS, AND SUPPORT
SYSTEMS 3
Veterans PTSD Causes, Treatments, and Support systems
Veterans PTSD Causes, Treatments, and Support systems

Evaluations on Post Traumatic Stress Disorder (PTSD)
among veterans is imperative for a positive health outcome. The
evaluations and analysis of the results ensure that barriers to
treatment are addressed and have access to the available support
systems. Studies carried out have depicted the successes of the
treatments and support programs in the health systems to
veterans. Modifications on the systems have also been
recommended to combat and control PTSD. Alternative
approaches such as computerized systems, natural treatment
methods, and home-based systems are also essential in
providing a holistic approach in PTSD treatments. Treatment
methods success ensures that veterans do not fall victim to
depression, which can result in chronic diseases. This can be as
a result of negative health behaviors and lifestyles.
Understanding the consequences of PTSD among veterans will
ensure that approaches utilized offer not only treatment methods
but also offer support systems for general wellbeing.
The first source focuses on the treatment and success of
three-week outpatient program by “evaluating patterns and
predictors of symptom change during a three-week intensive
outpatient treatment for veterans with PTSD.” The study is
evidence-based on statistics drawn from the program and
modifications for optimal success rates. 191 veterans were the
participants in the research comprising of a daily group and
individual Cognitive Processing Therapy (Zalta et al., 2018).
The data was analyzed from the sample cohorts in accordance
with military and demographic characteristics. Measures in the
study involved treatment engagement as well as comparison of
pre-treatment and post-treatment changes (Zalta et al., 2018).
The results showed progress in the evaluation of predictors and
patterns in treatment changes. Procedures utilized involved
group sessions with daily activities for the development of the
treatment program. Self-report metrics were also applied in the
procedures as control groups were challenging in the study.
Modified and intensive outpatient (IOP) treatment to veterans
showed high success levels in the program (Zalta et al., 2018).

The second source examines a new treatment in exploring
the feasibility of computerized, placebo-controlled, and home-
based executive function training (EFT) on psychological and
neuropsychological functions. The source titled “Computer-
based executive function training for combat veterans with
PTSD” shows trials in assessing feasibility and predictors
output. The study shows how the functions can be useful in
brain activation combating PTSD in veterans. Symptoms
experienced after treatment on PTSD cases are stimulated
through neural and cognition reactivity, which can be controlled
through the new methods (Clausen et al., 2019). The study
comprised of 52 male combat veterans from a community
sample. The participants were recruited via advertisements and
informational flyers. Procedures involved neuropsychological
assessment and fMRI scans (Clausen et al., 2019). Data logistic
regression models were utilized for data analysis. Additionally,
linear mixed models were integrated into the analysis to assess
changes in brain processing. The research designs enabled the
researchers to create evidence-based arguments on EFT
integration and acceptance in PTSD treatment.
The third source on “nature-based therapy as a treatment
for veterans with PTSD” provides an alternative in PTSD
treatment methods. The holistic approach can be used
successfully instead of strong medications to veterans (Poulsen,
2017). Nature-based Therapy (NBT) can be effective in
reducing conventional treatment methods used. Negative
outcomes can be recorded from data analysis on medical
intervention approaches (Poulsen, 2017). The study used search
papers published between 1995 and 2016. Procedures in the
approach involved review and testing of medical intervention
effectiveness. Reviews on the papers included qualitative data
assessment before analysis following various documented
recommendations. Literature review from existing research data
on veterans involved an examination of different interventions
used. The deeper insights provided through the papers
contributed to different perspectives (Poulsen, 2017).

Frequency, length, and outcome measures of medical
interventions were effective in the research design. The
methodologies also utilize comparison of therapies in different
target groups according to diagnosis to provide results.
The fourth study, “screening and treatment of moral injury
(MI) in veterans/active duty military with PTSD,” articulates
the new form of PTSD. Moral injury is referred to “as the
spiritual, emotional, and moral consequences of committing or
observing others’ transgressions” and their impacts (Koening et
al., 2019). Combat experiences and military-related trauma as a
new syndrome requires more evaluations and studies. New
approaches in treating the syndrome as it is associated with
PTSD can be essential in the reintegration of veterans to civil
life (Koening et al., 2019). The study involved a review of
veterans, investigators, clinical officers, and nurses in
identifying the syndrome in clinical practice. 427 veterans were
chosen to evaluate combat-related PTSD syndromes, which
result in Moral Injury. The procedures involved the review of
Koening articles in the identification and addressing the
syndrome. The methodology is effective in explaining why
forgiveness healing moral injuries are entwined for positive
mental health outcomes (Koening et al., 2019).
The last article is based on “PTSD is associated with poor
health behavior and greater body mass index through
depression, increasing cardiovascular disease and diabetes risk
among U.S veterans.” The authors depict how PTSD can worsen
other health aspects of the veterans due to adopted health
behaviors. Poor health behaviors act as risk factors in diabetes
and cardiovascular diseases (Hoerster et al., 2019). Depression
results in unhealthy behaviors increasing body mass, smoking
habits, reduced physical activity, and poor diets. Research
methods involved sampling of veterans with the chosen been
emailed surveys. 1804 participants were selected with, 717
veterans completing the surveys. $10 canteen coupons were
awarded to veterans who completed the survey. Data analysis
was through “descriptive statistics and bivariate correlations

among variables.” Procedures involved measures variable
selection as hypothesized in the parent study. Additionally, the
variables were categorized as exogenous or endogenous against
the time frame and score ranges (Hoerster et al., 2019). This
methodology provided evidence on depression symptoms, which
can trigger poor health behaviors in negative health outcomes.
I find the studies to have observed ethical standards in the
research. Participants’ confidentiality, as well as anonymity, is
retained in all studies. Additionally, researchers were able to
join efforts with other organizations concerned with veterans to
obtain data in an ethical manner. Participants are also able to
participate willingly in the sample population. Approval and
consent to participate are obtained on study assessments as part
of ethical care in procedures. Offering the veterans, a canteen
coupon for participation is within the ethical approvals of
research. The coupon is given on the consent of the participant
to offers information to contribute towards the study.
Additionally, data sets in the sample population are not made
available as only the authors of the articles have the right to
utilize them.
In my opinion, evaluations of PTSD symptoms among veterans
can result in different treatment methods that are more effective
and successful in health. This will involve understanding the
consequences and burdens the veterans bear in overcoming
events witnessed during the serving period. The integration of
both medical and conventional intervention methods can be
useful in improving cognitive and neural performances. Clinical
symptoms also have to provide appropriate predictions for
effectiveness in treatment and support systems. This will
require more investigations and reviews on the cognitive
processing of veterans through post-treatment and pre-treatment
tests. The evaluations will enhance the consistency of
approaches adopted to deliver treatment to veterans who have
PTSD.
Causes, treatments, and support systems in veteran PTSD
clinical settings utilize different approaches for success.

Through the studies reviewed, different symptoms are displayed
in different sample population members. Evaluation of the
approaches is imperative in ensuring consistency and quality in
treatment delivery services as well as modifications in the
programs. Different responses are expected from the programs
as each veteran is unique in terms of neural and cognitive
processing. The integration of interventions with support and
care can be effective in improving accessibility to treatment.
Additionally, identification of Moral Injury symptoms is
essential in helping the veterans reintegrate into civilian life.
Emotional and spiritual wellbeing matters in the integration
process. This can be through forgiveness programs as supported
by churches and families. Depression, due to PTSD, can result
in poor health behaviors. Such behaviors impact lifestyles
negatively, resulting in chronic diseases that are challenging to
manage. Treatment adherence is also promoted through the
success of the programs reducing dropout rates in medical
interventions. Therefore, treatment and support programs are
essential in reducing PTSD and depression symptoms among
veterans.
References
Clausen, A., Thelen, J., Francisco, A., Bruce, J., Martin, L.,
McDowd, J. & Auppperle, L. (2019). Computer-based executive
function training for combat veterans with PTSD: a pilot
clinical trial assessing feasibility and predictors dropout.
Frontiers in psychiatry. Retrieved from https://doi-
Hoerster, K., Campbell, s, Dolan, M., Stappenbeck, C, Yard, S.,
Simpson, T. & Nelson, K. (2019). PTSD is associated with poor
health behavior and greater Body Mass Index through
depression, increasing cardiovascular disease and diabetes risk
among U.S veterans. Preventive medicine reports 15. Retrieved

from https://doi-
org.ucamia.cobimet4.org/10.1016/j.pmedr.2019.100930
Koening, H., Ames, D. & Bussing, A. (2019). Editorial:
screening for and treatment of moral injury in veterans/active
duty military with PTSD. Frontiers in psychiatry. Retrieved
from https://doi-
Poulsen, D. (2017). Nature-based therapy as a treatment for
veterans with PTSD: what do we know?journal of public mental
health 16(1). Retrieved from https://doi-
org.ucamia.cobimet4.org/10.1108/JPMH-08-2016-0039
Zalta, A., Held, P., Smith, D, Lofgreen, A., Brenna, M.,
Rydberg, T., Boley, R., Pollack, M. & Karnik, N. (2018).
Evaluating patterns and predictors of symptom change during a
three-week intensive outpatient treatment for veterans with
PTSD. BMC psychiatry 18(242). Retrieved from https://doi-
org.ucamia.cobimet4.org/10.1186/s12888-018-1816-6
Overview: As the final project for this course, you will be
creating a hypothetical study. You are not and should not be
conducting human subject research for this project. It is not
necessary for the purposes of this assignment. All human
subject research requires written approval from the AU
Institutional Review Board in order to protect the welfare and
ensure ethical treatment of the subjects. This assessment will
help you recognize the value of research in psychology and the
value of supporting your claims with established views and
research.
Prompt: For this final paper you will be sewing together the
information and ALL the critical elements discussed and
presented in the previous milestones. IT should be a complete
and polished paper and it should reflect the incorporation of the

feedback that has been given to you throughout the course. This
submission will be graded with the Final Project Rubric
(below).
Specifically, the following critical elements must be addressed
for the final paper (for additional details for each section refer
back to the individual rubric for that respective milestone):
I. Topic Proposal: Provide the research question that your
research paper will be attempting to explore. In other words,
create a question that you could answer through research.
Explain why you are interested in researching this topic.
II. Literature review:
A. Summarize the claims made by the authors of the existing
research in the field regarding the topic you have chosen.
B. Describe the specific research designs used in the presented
research and explain how these designs were used to address the
research topic.
C. How did the research designs used by researchers help in
conducting their research?
D. Do you think the research in each of the articles was
conducted in an ethical manner? Why or why not?
E. What overall conclusions can be reached by you, based on
your own review and presentation of these studies and
references?
III. Method Section:
A. Reiterate your research question. What is the purpose of your
hypothetical study?
B. Determine an appropriate research design that addresses your
research question regarding your chosen topic and explain why
this design was chosen. Also, what will your dependent (DV)
and independent (IV) variables be for this study?
C. How many participants do you envision having for this
hypothetical study and how will you select them (where will

you be gathering your participants from)?
D. What type of sampling method will you use and why?
E. Will you be assigning participants to groups? Yes, no and
explain why
F. What will the demographics of your participants be (gender,
ethnicity, age range(s), SES, educational criteria (if relevant),
history of medical and/or mental health diagnosis (if relevant)?
G. Where the study will take place (e.g. online, a lab, a
university, a medical or mental health setting, a natural
environment, etc.)? Explain why you have selected that
particular setting.
H. Over what period of time will data be collected?
I. Explain what the measure’s purpose is and what it studies
J. Explain what type of measure it is (self-report, therapist,
rating, teacher rating, parent rating, etc.) and explain why you
consider it appropriate for your research study
K. Describe how many items the measure has and any subscales
it might include
L. How/when will this measure be used and why (e.g. at the
beginning of the study (pre-test), at the end of the study (post-
test), etc.)
M. Explain how you will account for ethical issues associated
with your proposed research. In other words, how will you
ensure that ethical guidelines will are followed appropriately
and adequately?
IV. Discussion Section:
A. Assuming that the results of your hypothetical study support
your research question, discuss how your hypothetical findings
contribute to the knowledge of your research question and the
problem you were studying. This should include future research
questions that are inspired by yourhypothetical study as well as
possible practical applications for the field.
B. Describe the possible limitations your study had with regard
to the design, the procedure, the subjects, and the measures
used.

C. Discuss any ethical issues your hypothetical study might
have encountered and how it could be resolved in the future.
D. Discuss threats to the validity of your hypothetical study.
E. Provide a short conclusion that sums up the essence of the
paper (a brief integrative summary).
Guidelines for Submission: You will upload the paper as a Word
document to Blackboard for grading and feedback. Your
submission for this milestone must be follow APA paper
guidelines. It should include a cover page and reference page,
be written with 12-point Times New Roman font and double
spacing, and you will follow proper APA citation and reference
format. You can use headings to differentiate between sections.
Any thoughts that are not your own MUST be cited in proper
APA format. Direct quotes (short and long) MUST be cited and
formatted following APA guidelines. Even if you paraphrase
information, it MUST be cited. Papers are being evaluated
through SafeAssign. Plagiarism will NOT be tolerated. If
plagiarism is discovered, it will result in a grade of 0 for the
assignment and possible disciplinary action. AU’s writing
center can assist you if you are unsure. You can also use the
following Purdue OWL link:
https://owl.english.purdue.edu/owl/resource/560/01/to help you
with your citations and references and you can avoid plagiarism
by also usingone of the following plagiarism checking links:
https://papersowl.com/free-plagiarism-checker,
https://www.grammarly.com/plagiarism-checker,
andhttps://smallseotools.com/plagiarism-checker/

Final Paper Rubric
Critical Elements
Exemplary (100%)
Proficient (80%)
Needs Improvement (60%)
Not Evident (0%)
Value
Research Question
Meets “Proficient” criteria and presentation of the research
question and why it was
selected is especially detailed and clear
Develops a basic research question and explains interest in
researching the topic
Develops a basic research question and explains interest in
researching the topic,
but research question and explanation are
cursory and/or unclear
Does not develop a basic research question or explain the
interest in researching the
topic
4points
Literature
Summary & Claims
Meets “Proficient” criteria and summary of the claims and
conclusions is especially detailed and clear
Summarizes the claims and conclusions presented in the
selected articles
Summarizes the claims and conclusions presented in the
selected articles, but
summary is cursory, unclear, and/or
contains inaccuracies

Does not summarize the claims and conclusions presented in the
selected articles
6points
Research Design description
Meets “Proficient” criteria and description of the research
designs and their use is especially detailed and clear
Describes the specific research design(s) used in the selected
articles AND explains how they
were utilized
Describes the specific research design(s) used in the selected
articles AND explains
how they were used, but description is cursory and/or contains
inaccuracies
Does not describe the specific research design(s) used in the
selected articles nor explains how they were used
6points
Research design help
Meets “Proficient” criteria and description of how the
research designs assisted in
the research was presented in rich detail
Describes how the research designs used in the presented
articles assisted in conducting
the research
Describes how the research designs used in the presented
articles assisted in
conducting the research but description is cursory and/or
contains inaccuracies
Does not describe how the research designs used in the
presented articles assisted in conducting the research
6points
Ethics
Meets “Proficient” criteria and description of whether or not the
presented research was
conducted ethically is detailed

and uses specific examples to demonstrate this
Explains whether or not the presented research was
conducted in an ethical manner
Explains whether or not the presented research was conducted
in an ethical manner but description is cursory,
contains inaccuracies, and/or lacks examples from the articles
Does not explain whether or not the presented research
was conducted in an ethical
manner
6points
Overall conclusions
Meets “Proficient” criteria and demonstrates a sophisticated
awareness of the conclusions
that can be reached based on the analysis of the research
Explains the overall conclusions that can be reached based on
analysis of the selected articles
Explains the overall conclusions that can be reached based on
analysis of the selected research but description is cursory
and/or contains inaccuracies
Does not explain overall conclusions based on the analysis of
the selected articles
6points
Research Question
& Purpose
Meets “Proficient” criteria and restatement of research
question and the purpose of
the study is especially clear
and detailed
Briefly but completely restates the research question and
explains the purpose of the
study
Restates the research question and explains the purpose of the
study but description is cursory and/or lacks clarity
Does not restate the research question nor explains the purpose

of the study
3points
Research Design &
DV/IV
Meets “Proficient” criteria and clearly identifies and describes
the chosen research design, explains why it was chosen, and
identifies the DV & IV. All descriptions use rich detail
Describes the specific research design that has been selected,
clearly explains why it was
chosen & clearly identifies the
DV & the IV of the study
Describes the specific research design that has been selected,
explains why it was
chosen & identifies the DV & the IV of the
study but description is cursory, contains inaccuracies, or is
missing a required
element
Does not describe the specific research design, does not
explain why it was chosen and
does not identify the DV and the IV of the study
6points
Participants
Meets “Proficient” criteria and described clearly and using rich
detail.
ALL required participant elements are addressed and described
clearly
Participant elements are addressed but description is cursory,
contains inaccuracies, or required elements are
missing
Required participant elements are not described at all
6points
Procedures

Meets “Proficient” criteria and explanation demonstrates keen
insight into how the procedure of the study would unfold
ALL required procedure elements are addressed and described
clearly
Procedure elements are addressed but description is cursory,
missing
Required participant elements are not described at all
6points
Measures
Meets “Proficient” criteria and explanation demonstrates keen
understanding of the measures(s) and insight into how measures
will be
employed
At least one measure is employed and each measure is described
in rich detail as to its
purpose, how & when it is used,
& its details
At least one measure is employed & each measure is described
as to its purpose,
how & when it is used, & its details but description is cursory,
missing
Does not employ any measures and does not address any of
the other required elements for the measures section
6points
Ethics
Meets “Proficient” criteria and explanation demonstrates a keen
understanding of the how the study would follow ethical
guidelines.
Explains how issues of ethics would be accounted for in the
proposed study

Explains how issues of ethics would be accounted for in the
proposed study but
explanation is cursory and/or contains
inaccuracies
Does not explain how issues of ethics would be accounted for in
the proposed study
6points
Contribution to knowledge
Meets “Proficient” criteria & discusses how the findings
contribute to knowledge. Future research questions and
practical applications are discussed in rich detail
Discusses how the hypothetical findings contribute to
knowledge. Future research questions and practical applications
are discussed
Discusses how the hypothetical findings contribute to
knowledge. Future research questions and practical applications
are discussed but description is cursory and/or
lacks clarity
Does not discusses how the hypothetical findings
contribute to knowledge.
Future research questions and practical applications are not
discussed
6points
Possible limitations
Meets “Proficient” criteria & explains possible limitations the
study might have had with regard to the design, the procedure,
the subjects, and the measures used in rich
detail
Explains the possible limitations the study might have had with
regard to the design, the
procedure, the subjects, and the
measures used
Describes the possible limitations the study might have had with
regard to the design, the procedure, the subjects, and
the measures used but description is
cursory, contains inaccuracies, or is missing a required element

Does not describe the possible limitations the study might
have had with regard to the design, the procedure, the
subjects, and the measures
used
6points
Ethical Issues
Meets “Proficient” criteria & clearly discusses potential ethical
issues & how they could be resolved in the future in rich detail
Discusses potential ethical issues the study may have
encountered & how they could be resolved in the future
Discusses potential ethical issues the study may have
encountered & how they could
be resolved in the future but description is
cursory, contains inaccuracies, or required
elements are missing
Does not discuss potential ethical issues the study may
have encountered & how they could be resolved in the future
6points
Threat to Validity
Meets “Proficient” criteria and discussion is rich in detail and
demonstrates a sophisticated understanding of validity
Discusses threats to the study’s validity. Two general types of
validity and at least one concept
from each category is defined and discussed as it applies to the
hypothetical study.
Discusses threats to the study’s validity but description is
cursory, contains inaccuracies, or required elements are
missing
Does not discuss threats to the study’s validity at all
6points
Conclusion
Meets “Proficient” criteria and summative conclusion that
reflects a keen understanding of the paper’s essence
Provides a short summative conclusion that reflects the essence
of the paper.
Provides a short summative conclusion that reflects the essence

of the paper but description is cursory, unclear, or contains
inaccuracies
Does not provide a conclusion
5points
Writing Mechanics
Submission is free of errors related to APA format,
citations, references,
grammar, spelling, syntax, and organization and is presented
in a professional and easy-toread format
Writing is in APA format, easily understood, clear, and concise
using proper citation methods
where applicable with no major errors in citations, references &
grammar
Writing has major errors with regard to citations, references,
grammar, spelling, syntax, or organization that negatively
impact readability and articulation of main ideas
Writing has critical errors with regard to citations, references,
grammar, spelling, syntax, or organization that prevent
understanding of ideas
4points
Total
100% (100points)
Running head: MENTAL HEALTH BELIEFS 1
MENTAL HEALTH BELIEFS 2

Mental Health Beliefs
Relationship between Mental Health Beliefs and Treatment of
PTSD among Veterans
Purpose:
The study is aimed at answering two primary questions;
· What are the primary factors that discourage veterans from
seeking medical treatment of PTSD?
· Which are the most relevant interventions that can be put in
place to address these variables positively?
Hypothesis: Most veterans do not seek or access medical
treatment because of various mental health beliefs, although
there are channels that can help and benefit them.
METHODOLOGY
Research design:
The study will be conducted using an experimental research
design. The design is the best for this particular investigation as
it will help get first-hand and accurate information that is
relevant to the research questions. It will facilitate the
collection of multiple and distinct data analyzing while creating
a reliable and coherent decision when using a survey as the
research technique. The design is an appropriate guide when
sampling and selecting the best setting to conduct the study. As
such, it will be possible to determine the influence of certain
variables in this research. The factors to be accessed include
stigma, fear, depression, substance use, and individual beliefs.

Participants:
In this particular study, between 500 and 600 participants will
be selected, considering that some are likely to withdraw from
the surveys. It entails that relevant and adequate information
will be obtained from the remaining sample to ensure the
credibility and reliability of the research report. Several
methods will be used to select the participants to ensure the
diversity of ideas and locations. As such, advertisements,
emails, and informational flyers will be used to choose
interested individuals. These methods are practical and efficient
are they will help in gathering many people who are
geographically dispersed of which will reduce bias and
facilitate the accuracy of the analyzed data. From the interested
population, a convenience sampling method will be used to
establish the participants willing to participate in the study as
per the researcher’s guidelines. It is an appropriate technique as
it will enable the participants to make individual decisions
without being scrutinized by anyone; thus, this will guarantee
accuracy.
The remaining sample will be teamed-up in virtual groups
considering that they are geographically dispersed. The intent of
using groups is to encourage the participants to interact and
share their life experiences regarding the study. In groups of
people with similar characteristics, it will be easier for
individuals to share their thoughts freely about seeking medical
health concerning their mental health. So, the data obtained
from each group will be assessed and analyzed to help in
making a relevant inference. Moreover, the study is not based
on a specific sample's demographics since it will include both
male and female veterans who are willing to participate in the
surveys. By doing this way, diverse information will be
obtained and can probably be analyzed in terms of gender for
clarity.
Procedures:
The study will involve online surveys, mostly since the
participants will be interacting in virtual groups. In using the

online platforms as setting, the participants will have the chance
to create trustworthy relationships regardless of their
geographical location wherein they will share self-experiences
during and after military life. The implication is that the
integration will motivate most of them if not all, to give
information relevant to the study such that within the period set
for the surveys, the goal will have been achieved. The sample is
most likely to consist of over 350 participants, who will be
assigned to several groups of 25 people each. They must be
given ample time to integrate and be familiar with each
participant to increase the willingness to share information. As
such, the required data will be collected within 12 months, of
which the first three will involve mostly familiarization and
creating a sense of trust among the group members and the
researcher. Within the next nine months, the participants are
expected to have shared the required information considering
that by this time, they ought to have known and familiarized
themselves with every group member. The groups will have
ample time to interact because they are expected to meet online
for two hours for five sessions per week, implying that they will
have ten hours together weekly.
Measures:
In the study, a test will be used to determine the mental statuses
of the participants. It is an essential process since it helps in
associating the individual's mental health with the response
provided regarding seeking medical treatment. As such, a rating
survey will be used to establish the participants’ symptoms of
PTSD. The average test score of each group will be used to
evaluate the relationship with the information acquired
regarding the variables being assessed. Thus, it will help in
analyzing how the mental condition affects the decision to
access medical treatment. The rating survey, which has 17 items
those are problems that veterans have concerning their stressing
military experience, will be conducted at the end during the
study. It is the final stage because it will be used for assessment
of the association of the information obtained and the

participants' mental to how they access healthcare.
It is important to ensure that ethical guidelines have been
complied with during the study. For these reasons, therefore,
particular components will be included in the final research
report, including the funder's details and approval code from
IRAS. Also included will be copies of the sample’s consent
forms to demonstrate that everybody participated willingly, and
the right procedures were followed during selection. Hence, this
will enhance the credibility of the study for further references
by researchers with similar ambitions.
References
Title: Mental Health Beliefs and Their Relationship with
Treatment Seeking Among U.S. OEF/OIF Veterans.
Dawne, V., Annie, B. F., & Brooke, A. l. D. (2014). Mental
Health Beliefs and Their Relationship with Treatment Seeking
Among U.S. OEF/OIF Veterans. In the Journal of Traumatic
Stress, 27 (307-313). Boston University, Massachusetts, U.S.A.
Poulsen, D. (2017). Nature-based therapy as a treatment for
veterans with PTSD: what do we know?journal of public mental
health 16(1).
PTSD screening. (n.d.). Retrieved from
https://www.myhealth.va.gov/mhv-portal-web/ptsd-
screening#noJavascript
Zalta, A., Held, P., Smith, D, Lofgreen, A., Brenna, M.,
Rydberg, T., Boley, R., Pollack, M. & Karnik, N. (2018).
Evaluating patterns and predictors of symptom change during a
three-week intensive outpatient treatment for veterans with
PTSD. BMC psychiatry 18(242).
Running Head: DISCUSSION SECTION 1

DISCUSSION SECTION 4
Discussion Section of The Hypothesis Study
Discussion Section
My aim in this study was to undertake a comprehensive
evaluation and analysis to show the mental health beliefs that
exist among veterans and how it may affect their access to
medical treatment. According to this research, veterans who are
likely to benefit from mental health treatment programs do not
always seek care. The study has provided an in-depth
examination of beliefs that are related to mental health. The key
reasons why individuals with mental illness may fail to seek
care due to shame and the treatment process they must go
through. Different variables have been used in this research.
They include personal beliefs, stigmas towards mental illness,
stress, depression, and the severity of alcohol abuse.
The stigma was measured by interactions and personal
experience from loved ones and the workplace. Own beliefs
were also measured by collecting surveys about mental illness,
psychiatric treatment, and their feelings about seeking medical
care. A scale consisting of eight statements was used with a 5-
point Likert-type response. The size ranged from 1 (strongly
disagree) to 5 (strongly agree). The 17-item PTSD Checklist-
Military version was used to measure the level of stress.
Depression, on the other hand, was determined using 7-item
Beck Depression Inventory-Primary Care. The scale also ranged
between 1 and 5. The high levels of stigma among the people
are an indication of how negative individuals view this
disorder.
The research was conducted ethically since all principles of

ethics were considered. No harm was caused to respondents,
both mentally and physically. Before emailing the survey
questions to participants, the researcher first asked them if they
were willing to take part in the study. They obtained informed
consent so that participants understood what the research was
taking part in and why the researcher required their responses.
The veterans voluntarily took part in the study, and they were
not deceived or forced to take part. Also another ethical aspect
that was considered is the confidentiality of the respondents.
Data collected was well stored in databases to prevent access to
third parties. Veterans who participated in the study could
withdraw at any time if they felt that the research was violating
their rights. To ensure that no respondents were disrupted from
their regular work schedule, the survey questions were sent to
through emails. They were also given ample time to go through
the items so that they could provide their most appropriate
responses.
My findings have several implications for therapists providing
therapeutic interventions and treatment to veterans with PTSD.
Although my results cannot determine casualty, it seems
prudent for therapists to not only discuss with veterans the
direct dangers of post-traumatic disorders but also review the
observed mental health beliefs that may exist among veterans
and educated them about the misconceptions and stigma that
surround the thought of getting help. When physicians and other
psychologists identify veterans with mental health beliefs on
PTSD, they have a heightened awareness of how it can affect
their access to treatment and potential opportunities for
prevention and education. Educators should consider the higher
likelihood of mental health beliefs on PTSD on soldiers, police
officers, firefighters, emergency service workers, healthcare
professionals, ambulance personnel, and divers. Additionally,
psychiatrists evaluating patients for PTSD should take into
consideration their mental health beliefs as it is a risk factor
for a suicide attempt.
There were a few limitations that should be considered when

interpreting results. First, the study was cross-sectional, thus
limiting the possibility of determining the casualty of outcomes.
However, this study provides a brief overview of PTSD
associated with mental health beliefs. Additional variables such
as performance at work and socioeconomic status were not
considered during the study but may have implications on the
results.
Conclusion
These limitations notwithstanding, I report that veterans who
have mental health beliefs on PTSD are more likely to have
engaged in a broad range of activities such as merciless killings,
accidents, natural disasters, or physical assaults, all of which
contribute to significant adverse health outcomes. Future efforts
should be directed on better understanding of patients with
mental health beliefs on PTSD. Despite the willingness of
veterans to seek help themselves the treatment of PTSD
minimizes the overall risks and effects of PTSD.

Running head FIRST RESPONDERS RISK FOR PTSD .docx

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