Slides for panel presentation at the 2009 Sloan ALN Conference. Presents information regarding the definition and symptoms of PTSD and the potential impact on online educators. Also presents data from a 2009 survey of online faculty capturing information about their experiences and their students' experiences in hig-stress situations.

1. Stress Zones, Online Faculty, & PTSD Preliminary Survey, 2009 Fred Stielow, Ph.D. John D. Moore, Ph.D. Carol Passman, Ph.D. Philip McNair, U.S. Army (ret)

2. Meet the Panel Introduction: Dr. Fred Stielow Defining & Exploring PTSD: Dr. John Moore AMU Faculty Survey Results: Dr. Carol Passman Thoughts & Discussion: COL Phil McNair

3. Professors: I wanted to thank you for your assistance during my enrollment at AMU … You really showed me how great a professor you can be during times when education is taking a back seat. I recently completed, what was once a fast-burning run through life… In Dec 08 as I was diagnosed with PTSD. Since returning from my 8 month tour in Iraq in Dec 07…. Without complaint you stepped in and helped me complete my entire academic plan … I greatly appreciate your extreme display of concern and understanding while enrolled in your class. I did not expect the support I received; yet it has gotten me where I am today. Excerpted Student Comment, 09/2009

4. Introduction Memoriam: Andrew Baggs, Ph.D., USN (ret) Frequency study of faculty awareness of students in high stress areas and dangerous events Follow-up/Implications for further study- Can study in online universities while in high stress zones ameliorate the subsequent onset of PTSD?- Or facilitate reintegration into society?- Given onset of GI-Bill students in traditional schools, do online instructors have PTSD practices to share?- How do the frameworks of online and land-based universities differ in terms of students with PTSD?

5. John D. Moore, Ph.D. Defining and Exploring PTSD in an Online Educational Environment

7. Diagnostic Criterion

8. Impact on the Student

9. Impact on the EducatorA. PTSD in Broader Context

11. PTSD is a qualified psychiatric condition that appears in the Diagnostic and Statistical Manual of Mental Disorders

12. PTSD is different than a person experiencing normal “Stress”What is PTSD?

13. Irritable Unable to fall asleep Easily Startled Problems With Focus Hyper Increased Substance Use Angry Outbursts PTSD = Increased Agitation

14. Posttraumatic Stress Disorder DSM IV Diagnostics Criterion A. The person has been exposed to a traumatic event in which both of the following were present: 1.Person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others Person's response involved intense fear, helplessness, or horror.

15. PTSD—DSM IV Diagnostics, Continued, 1 Criterion B. The traumatic event is persistently re-experienced in one (or more) of the following: recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. recurrent distressing dreams of the event. acting or feeling as if the traumatic event were recurring (a sense of reliving the experience, illusions, hallucinations & dissociative flash-back episodes, including those that occur awakening or intoxicated). intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event physiological reactivity on exposure to internal or externalcues that symbolize or resemble an aspect of traumatic event

16. PTSD—DSM IV Diagnostics, Continued, 2 Criterion C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more): efforts to avoid thoughts, feelings, or conversations associated with the trauma efforts to avoid activities, places, or people that arouse recollections of the trauma inability to recall an important aspect of the trauma markedly diminished interest or participation in significant activities feeling of detachment or estrangement from others restricted range of affect (e.g., unable to have loving feelings) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

17. PTSD—DSM IV Diagnostics, Continued, 3 Criterion D: “Hyperarousal responses" (two or more of the following) difficulty falling or staying asleep irritability or outbursts of anger difficulty concentrating Hypervigilance exaggerated startle response Criterion E: Duration of more than one month Criterion F: Distress or impairment to functioning

18. B. Psychological Pathways 1 Impact of PTSD 2 Impact of PTSD on E-Educators 3 Vicarious Trauma

20. Fear

21. Uncertainty

22. Anger

23. Helplessness

24. Depression

25. Fidelity Concerns

27. Fear

28. Guilt

29. Anger

30. Helplessness

31. Depression

32. Fidelity Concerns

34. PTSD = FAMILY IN CRISIS PTSD Student Loved Ones Children CRISIS CRISIS CRISIS

35. How does PTSD Impact E-educators? E-Educators Student Outbursts Confusion/Distraction Vicarious Trauma Online Institution

36. Student Outbursts Students who may be living with PTSD can sometimes present as irritable, uncooperative or disengaged in the classroom. Using the psychological concept of displacement, students will sometimes “rage” against a faculty member or other student in moments of high stress, anxiety or depression.

37. Confusion for E-faculty When a students discloses that he or she has been through a traumatic event or perhaps previously diagnosed with PTSD, this can sometimes cause confusion for the e-educator. In brick and mortar institutions, there is often an ability to refer the student to a student counseling center. This is generally not the case for online institutions, leaving the e-educator asking the question: What can I do to help?

38. Vicarious Trauma Vicarious Trauma (aka: secondary trauma) occurs whenever a person is exposed to a first hand account of a traumatic event by another person. An example of this might be a faculty member being told by a student that he or she was involved in a life threatening incident. Over the course of time, these kinds of repeated exposures to secondary trauma can have a negative impact on the individual. EACH TIME A FACULTY MEMBER IS EXPOSED TO PAINFUL MATERIAL THAT FACULTY MEMBER EXPERIENCES VICARIOUS TRAUMA

39. Vicarious Trauma Irritable Sleep Problems Fatigue Problems With Focus Burnout Increased Substance Use Feeling Drained Vicarious Trauma

40. Faculty Awareness of Students in High Stress Situations & Events Survey Overview Carol Passman, Ph.D.

41. Survey Background Run Dates: Aug 18th – Sep 8th, 2009 Subjects: APUS (American Military University & American Public University) Faculty Response Rate: 465 of 845 = 55% response rate

42. A. Faculty Demographics Online Teaching Experience

43. Other Experience/Areas Served* * Multiple responses allowed ** Other category included CIA, Civilian Military Employee, DEA, Government Contractor, Homeland Security, Defense Analyst, Military Spouse, TSA…

44. Involvement in Dangerous Situations

45. B. Awareness of Students in High Stress Settings

46. Timing of Awareness

47. How Did Faculty Become Aware of High Stress Occupational Settings

48. C. Awareness of Students in Dangerous Encounters

49. Timing of Awareness of Dangerous Encounters

50. D. Faculty/Student Interactions Student in-class discussions on such situations Student comment to faculty on dangerous situations

51. Summary- Phil McNair But first – 2 brief anecdotes What we know:- Some percentage of students have PTSD- PTSD can affect student behavior What we don’t:- Who those students are- What online faculty are supposed to do- The impact of online learning on students with PTSD

52. Thoughts? Comments? We welcome your input as we think about the implications of this for further study and research. Want to join us? Fred Stielow: fstielow@apus.edu Phil McNair: pmcnair@apus.edu