Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder


Posttraumatic Stress Disorder is a condition from which nearly 10% of
Americans suffer. It, unlike other afflictions, is associated with a wide
variety of circumstances. Many war veterans suffer from Posttraumatic Stress
Disorder. However, a new group of people are quickly emerging as common suffers
of Posttraumatic Stress Disorder-sexually abused children. Posttraumatic Stress
Disorder is a prevalent problem associated with children who are victims of
sexual assault.
Posttraumatic Stress Disorder is classified as an anxiety disorder under
the Diagnostic and Statistical Manual of Disorders (DSM-III). The diagnoses for
Posttraumatic Stress Disorder was not formally diagnosed as part of DSM-III
until 1980. According to Famolaro, "the diagnoses of Posttraumatic Stress
Disorder requires: (a) experience of a significant traumatic events; (b) re-
experiencing of the trauma in one of several different thought, emotional, or
behavioral forms; (d) persistent symptoms of increased arousal, Particularly
when exposedto stimuli concretely or symbolically reminiscent of the trauma; (e)
symptoms lasting at least one month. (Famolaro, Maternal and Child
Posttraumatic... 28)".
Children are now becoming realized as significant sufferers of
Posttraumatic Stress Disorder. Posttraumatic Stress Disorder is particularly
bad for children under the age of 11, because they lack many of the skills
needed to protect themselves. Furthermore, this vulnerability is enhanced when
the child is exposed to any maltreatment. According to recent studies,
"Posttraumatic Stress Disorder is a common sequella of severe or chronic
maltreatment of children, particularly among sexually maltreated children (
Famularo, Symptom Differences... 28)". Posttraumatic Stress Disorder can be
caused if the child is exposed to just one traumatic episode (rape, witnessing a
violent crime, physical abuse); However, the child will become more susceptible
to Posttraumatic Stress Disorder if the maltreatment continues. Moreover, a
child is most likely to suffer from symptoms associated with Posttraumatic
Stress Disorder when sexual assault is involved(28).
Because children have not yet developed cognitively emotionally and are
very immature, they are likely candidates to develop symptoms related to
Posttraumatic Stress Disorder. As a child matures he/she becomes better
equipped to deal with and prevent contributing factors to the eventual suffering
from Posttraumatic Stress Disorder. Up to age two, young children can recreate
stressful events and even imagine such events recurring; However, the mind is
not developed enough to identify, anticipate, or prevent future traumatic
occurrences. At age three, children cannot, "distance themselves, in time,
appreciate roles and differences in behavior, access situation, or adopt
nonegocentric causality (Saigh 189)". This flaw opens them up to the impact of
trauma because the child cannot anticipate and protect themselves. By age four,
children have the ability to protect themselves by avoiding traumatic encounters.
They also have the ability to suppress their anxiety when it becomes difficult
to cope with. Because children do not have this ability any earlier they are
vulnerable to physical and sexual assault. Children continue as such until they
become concrete operational at about age six or seven (190).
Children who have been sexually abused develop many of the syndromes
associated with Posttraumatic Stress Disorder, some of which are, the inability
to establish normal relationships with adults and peers, to make a normal
transition from adolescence to adulthood, as well as to develop skills required
to progress in school. However, this was not the case with all sexually
assaulted children. Walder states, "not all those so exposed will develop a
Posttraumatic Stress Disorder reaction; some may have a certain "hardiness" that
helps them cope without any noticeable residual effects while others may have a
severe psychological reaction that renders them unable to function (Walker
130)."
Knowledge of sexual assaults has recently become more common. Random
surveys of adults indicate that approximately 28% of women and 16% of men were
victims of sexual abuse before the age of sixteen (Valentier 455). The nature
of the abuse stretched from fondling to sexual intercourse committed by an adult
that was five years older than the victim (Wolf et al). Women are more often
the victims of child sexual assault then men. According to John B. Murry, women
are the victims of child hood sexual abuse at a ratio of 10:1 over men (Murry
658). Furthermore, children of lower income families are also common victims of
sexual assault. But, as Murry points out, sexual abuse occurs in all types of
families regardless of their income; and, sexual assaults are usually committed
by a member of the family. It is difficult to get an accurate record of the
actual number of children that have been sexually abused. Many cases never come
to light and because of differences in definitions of sexual assault , some
cases are missed.(658).
Researchers have begun to explore the concept of Posttraumatic Stress
Disorder with children and adults that were victims of sexual assault. Many
times people associate particular events with particular stimuli. For example,
certain orders, colors, sounds, and people can trigger a memory of a past event.
This is more true for victims of sexual assault. According to Wolf, Sas, and
Wekerle, "traumatic episodes become associated with particular eliciting stimuli
and can lead to maladaptive or a typical reactions. Such conditioning can play
an important role in the formation of children's adjustment disorders subsequent
to sexual abuse (Wolf et al 38)." Because people do not anticipate an abusive
episode there are usually things the victim can not control. Sexual abuse is
just such a stressful event that will produce a form of a coping reaction.
Because children are impressionable the perpetrator may consult, threaten of
confuse the child to confession. Child victims of child sexual assault are also
tortured by nightmares, recurring images of the event and troubling memories.
"Based on interviews with children who have been exploited by adults through sex
rings and pornography, 65 of 60 children reported intrusive thoughts, flashbacks,
and nightmares. Physical symptoms (eg. Somatic complaints, sleep problems,
excessive crying) and greater social withdraw and distrust of others were also
noted among a sizeable proportion of this sample (Wolf et al 39)."
Posttraumatic Stress Disorder is diagnosed with the Posttraumatic Stress
Disorder Symptom Checklist. The test consists of a list of 43 "adjustment
problems" with 23 items spanning the range of symptoms characterizing
Posttraumatic Stress Disorder as defined in the DSM-III Categories for
Posttraumatic Stress Disorder. Participants were considered Posttraumatic
Stress Disorder positive if they indicated on the test that they had
reexperienced the traumatic event, became avoident, and had increased arousal.
The test also indicated whether or not the participant had a "moderate problem"
or "partial" Posttraumatic Stress Disorder (Rowan 55)." In one study using the
PTSD symptom checklist on 42 sexually abused children, 64% of the participants
were considered PSD"positive", with another 19% meeting the criteria for
"partial" PTSD(56)."
The sample of nighty children comprised of 21 boys and 69 girls. The
average age was 12.4 years old. Based on the most severe forms of abuse
reported by these children, 52.2% had alleged sexual touching (including
fondling of genitals, masturbation, 34.4% reported oral, anal, or vaginal
intercourse with the offender, 10% reported attempted or simulated intercourse,
and the remaining 3,3% reported being the victim of indecent exposure. Out of
the sample, 44.7% had been abused only once, 32.9% of the sample were abused two
to ten times, 7.1% were abused ten to twenty times, and 15.3% more than twenty
times. Almost all alleged perpetrators were persons known to the child, 54.4%
were non-family members, 25.6% were abused by a parent or stepparent, 20% were
abused by a member of the extended family or a stranger (Findelnor 1406).
The results of the test indicated that of the ninety children tested, 44
showed positive signs of PTSD and 46 did not. Of the 44 children testing
positive, 49.8% self-reported showing total fear, 53.2% indicated fears of abuse,
57.7% showed anxiety ,and 59.3% felt depressed. Guilt and self-blame were also
diagnosed at 25% and 11% respectively. Parents of the 44 children that tested
positive, 64.2% internalized their anxiety while 61.5% externalized (140).
In a separate study done by Famularo, he evaluated a test group for both
acute and chronic PTSD. Sexually abused children which had an onset of symptoms
within six months of the abuse and a duration of symptoms lasting longer than
six months were diagnosed as having acute PTSD. Conversely, sexually abused
children with symptoms lasting longer thatn six months were diagnosed with
chronic PTSD. Twenty-four of the 28 sexually abused children tested showed
evidence of either acute or chronic symptoms of PTSD. Of this group 3.1% had
recurrent intrusive recollections and 3.33% recreated the trauma in their play.
2.61% experienced nightmares, 3.33% of the group acted as if the event were
occurring.
Distress of exposure to symbolic real re-exposure was experienced by
2.1% of the children. 3.49% of the victims avoided thoughts related to the
event and activities that arouse recollections of the event. Furthermore, 1.8%
of the children could not recall aspects of the trauma. 3.2% demonstrated a
diminished interest in games and recreational activities. 16.3% of those tested
suffered regression. Of these victims, 3.14% detached and estranged themselves
from others. Sadly, 2.61% of these traumatized children exhibited and expressed
the belief that their lives would be short. While 2.9% felt that life was going
to be difficult and long(144).
Until recently, sexually abused children were never studied for symptoms
of PTSD. As the aforementioned case studies suggest, it as a problem that
deserves attention. These children do suffer the symptoms of PTSD and should be
diagnosed and treated accordingly. This could be difficult as many instances of
sexual abuse remain unreported; however, their problems are real and deserve the
help that further research could facilitate.

Post-Traumatic Stress Disorder

Table of Contents

Introduction………………………………………………………………………………………..3
Risk Factors……………………………………………………………………………………….3
Pathophysiology…………………………………………………………………………………...4
Clinical manifestation……………………………………………………………………………..5
Diagnostic criteria…………………………………………………………………………………5
Laboratory and Diagnostic test……………………………………………………………………6
Evaluation & Treatment…………………………………………………………………………...6
Prognosis…………………………………………………………………………………………..6
Summary…………………………………………………………………………………………..7


There are hundreds of different kinds of psychiatric disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV). One of them is called Post-traumatic stress disorder (PTSD). Based on the research, post-traumatic disorder usually occurs following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape (Harvard Women's Health Watch, 2005). The purpose of this paper is to discuss the risk factors, pathophysiology, clinical manifestation, diagnostic criteria and tests, treatment, prognosis and future research and approaches to treat this psychiatric illness of post-traumatic stress disorder.
Risk Factors
As to all other kinds of disorders, determining the risk factors is a major influential aspect of a person's life in exposing herself to such diseases and illnesses. The factors that put people at risk for post-traumatic disorder are having a history of physical, emotional and sexual abuse. In addition to that, people who have been abused as children or who have had other previous traumatic experiences at a time in their lives are more highly to develop the disorder (Harvard Women's Health Watch, 2005). Other risk factors that contribute to PTSD include motor vehicle crashes, disasters, torture, and comorbid substance abuse (Miller, 2000). The most common precipitating events for PTSD in women were rape and physical assault. For men, physical assault and other traumas were the most prevalent. However, both genders are at heightened risk for PTSD when it comes to motor vehicle accidents. These are the major risk factors people may face that predict the likelihood of post-traumatic stress disorder to occur. Furthermore, according to Harvard Women's Health Watch 2005, people do not necessary have to encounter the traumatic events directly in order for PTSD to develop.

Pathophysiology
Until now, there has not been a definite understanding of how post-traumatic stress disorder occurs in the brain. The exploration into its pathophysiology is fairly recent. However, there is research around it discussing about PTSD's pathophysiology and coming to a complete understanding. In a normal person without the disorder, a stress hormone, adrenaline, releases from the body and prepares it to flee or fight from any stressful, traumatic events. "In the brain, adrenaline and the brain chemical norepinephrine stimulate the amygdala, a deep brain structure that spurs the formation of vivid, emotional memories of the threat," (Harvard Women's Health Watch, 2005, p. 5). In contrast, a post-traumatic stress disorder person's system would seem to be oversensitive. Source says the amygdala may look to be over reactive in PTSD, but it posts a question upon if the amygdala is already over reactive in itself or it could naturally be over reactive responding to trauma (Harvard Women's Health Watch, 2005). With the help of imaging techniques and its imaging studies, it shows that the hippocampus and the anterior cingulated cortex found to be smaller in PTSD. The two areas of the brain which help maintain the amygdala in check seem to have trouble functioning properly in people with PSTD (Harvard Women's Health Watch, 2005). Another thought that involves the pathophysiology of PTSD is the role of basal catecholamines. However, the subject is controversial (Miller, 2000). There has been a hypothesis made that cerebrospinal fluid (CSF) corticotrophin-releasing hormone (CRH) concentrations increase in people with PTSD from a study comparing combat veterans and normal volunteers (Miller, 2000). As with any disorder of the brain, the complexities of PTSD are extensive and require a lot of integrating components. Therefore, the pathophysiology of PTSD is unclear.

Clinical Manifestation
Post-traumatic stress disorder falls into three general categories of symptoms: Intrusion, avoidance, and arousal. Intrusion is repeatedly re-living the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma, causing intense emotional and physical distress (Harvard Women's Health Watch, 2005).
Second category of PTSD symptoms, avoidance, involves the numbing of general responsiveness and the avoidance of stimuli associated with the trauma. Those include places, thoughts, activities, and many more (Harvard Women's Health Watch, 2005).
Finally, symptoms of arousal include difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hypervigilance, and an easy startle response (Harvard Women's Health Watch, 2005). These symptoms are usually experienced after a trauma and are considered chronic PTSD if lasting more than three months.
Having diagnosed with PTSD can also manifest other disorders as symptoms such as depression, anxiety disorder.
Diagnostic Criteria
Four categories of criteria are needed to accurately diagnose PTSD (Table 1).
First, a traumatic event occurred in which the person witnessed or experienced actual or threatened death or serious injury and responded with intense fear, horror or helplessness. Second, on exposure to memory cues, the person has re-experiencing symptoms, such as intrusive recollections, nightmares, flashbacks or psychologic distress. Third, the patient avoids trauma-related stimuli and feels emotionally numb. Fourth, the person has increased arousal, manifested by hypervigilance, irritability or difficulty sleeping. The symptoms persist for at least one month and significantly disturb the patient's social or occupational functioning (American Psychiatric Association, 1994).
Laboratory and Diagnostic Tests
There are no tests that can be done to make the diagnosis of PTSD. The diagnosis is made based on a certain set of symptoms that persist after a history of extreme trauma. Doctor does psychiatric and physical examinations to rule out other illnesses. Table 1 is a list of criteria that clinicians use to diagnose PTSD. See Appedix A. A diagnostic screening questionnair screens people to find who is positive for PTSD, but this tool does not necessary diagnosed them with PTSD. Those who are positive for PTSD are referred for consultation with a structured interview (Miller, 2000). See Appendix B for questionnaires.
Evaluation and Treatment
"… treatment isn't a bout forgetting a trauma or feeling as if it never happened. The goal is to eliminate or reduce its ability to dirupt your life," (Harvard Women's Health Watch, 2005, p. 5). Research has demonstrated the effectiveness of cognitive-behavioral therapy, group therapy, and exposure therapy, in which the patient repeatedly relives the frightening experience under controlled conditions to help him or her work through the trauma. Medications have also been shown to help ease the symptoms of depression and anxiety and help promote sleep: SSRIs (Harvard Women's Health Watch, 2005). See Appendix C. Treating a disorder whose components are not fully understood is a little bit difficult.
Prognosis
The best outcome of PTSD depends on some factors. The factors include whether it was a simple trauma or a complicated one. A single traumatic event or a short period of a trauma happens later on in life minus the involvement of human violence is considered as simple trauma (Miller, 2000). On the other hand, complicated trauma is the opposite. It involves a series of events over a long duration and usually starts in childhood (Miller, 2000). One would think that receiving treatment early would help with the onset and progress with the disorder. However, it is unfortunate that it does not work that way. "An expert review of studies by the international nonprofit Cochrane Collaboration concluded that it may interfere with natural recovery from trauma and should be compulsory for any trauma victims, (Harvard Women's Health Watch, 2005).
Summary
Overall, if understanding the pathophysiology of post-traumatic stress disorder is unclear, then there is not really a potent treatment to PTSD. However, the future holds a lot of key ideas to potential treatments in PTSD. A relatively new therapy called Eye Movement Desensitization and Reprocessing (EMDR) has shown to be effective, but not all mental health practitioners know the method due to its recency (Miller, 2000). Another new brief treatment called Metacognitive therapy is say to process "the strengthening of a cognitive plan that can guide thinking and behaviour in future potential encounters with trauma…," (Wells & Sembi, 2004, p. 308). Future research also includes postmortem brain studies because it is significant in understanding psychiatric disorders to the neurobiology level (Soboslay, Martin, & Kleinman, 2004). Scientists are attempting to determine which treatments work best for which type of trauma.

Post-Traumatic Stress Disorder: Reliving And Still Feeling The Fear

Everyday millions of people in the United States alone deal with anxiety disorders that complicate and impair their life. No defiant numbers are available but it is thought to be in the five to seven million range. The lack of numbers is due mainly to people not realizing that there is something wrong with them, often putting off their disorder as over acting or excessive worrying. Another reason that we do not know the exact amount is due to the social stigma of having a mental condition, and how society often looks down upon those that are not as "strong" as the social norms. Some of the stigma is gone in today's society, yet people still feel they must hide any imperfection in themselves from the world. However, there is an exception, there are people who feel they get the attention that they crave by being "sick" and often claim many diseases.
Anxiety disorders are broken down into five subcategories and many smaller categories. The five main subcategories are panic disorder, phobias, generalized anxiety disorder, obsessive compulsive disorder and post- traumatic stress disorder. Panic disorder, which are episodes of intense fear along with distressing psychological and physical symptoms. Phobias are fears of certain social situations, or specific things such as flying and spiders. Obsessive-Compulsive disorder is a ritual based disorder in which the sufferer uses the ritualistic behaviors to push away disturbing thoughts in their heads. They believe if they stop the rituals the thoughts would overwhelm them or something bad will happen to them or someone they love, some even believe the world will end if they stop this behavior. Generalized Anxiety disorder is characterized by a constant feeling of nervousness or unease. Finally, Post-Traumatic Stress disorder, which is a condition that develops after a terrifying experience, such as near death or rape. Common in these sufferers and apparent in a significant amount of patients treated for post- traumatic disorder is depression, anxiety along with flashbacks of the traumatic event and nightmares that plague their sleep. The main focus of this paper is a more in-depth look at post- traumatic stress disorder who it effects, why and how to treat and diagnose people suffering from post- traumatic stress disorder.
Post-traumatic stress disorder is the development of symptoms after an emotionally traumatic event. It is easy to determine why a person would suffer from stress after a traumatic event but often people believe that people suffering from this disorder are being overly dramatic. The main reason is that trauma happens and the person's psychological system can not handle the event in the usual ways that most handle trauma, so their mind reacts in an adverse way.
The symptoms of post- traumatic stress often occur right after the even and with in a short time afterwards. Although this disorder can effect anyone regardless of age, it shows differently in younger children than in adults. Children may become mute refusing to talk or refuse to talk about what has happened to them. Though the child is being silent, he or she is still remembering what has happened to them. The younger the child the less likely they are to know that what they are going through is reliving the past, they believe that what has happened is happening again to them. Often they believe they have monsters in the closet or will reenact the event. One of the weirdest occurrences in children is their change in the way they see the future. Often becoming, in their own thoughts, clairvoyant or thinking themselves able to see future events. Believing they can see the future, though they are not seeing a future marriage, children, or career they see tragic events that are yet to come. Some children seem just to be having more physical illness symptoms, which makes it harder for their parents to see anything emotionally wrong with their children. Common bonds in all children suffering from post- traumatic stress are, disinterest in activities that once held the child's attention and heightened arousal (easily excitable).
There is no evidence that this disorder is prevalent in one sex over the other. Nor is there a number count on the amount of people suffering from post- traumatic stress disorder. The lack of people thinking that they have a disorder after a tragic event that put it down to regular stress or grief keeps the ability to get a number amount of sufferers impossible to achieve. The victims or sufferers are from different social-economic backgrounds with varying ranges in education. There is no set person that will get this disorder. Anyone from any background from royalty to poverty are eligible and able to develop post-traumatic stress disorder.
The on-set of this disorder is a traumatic event, though there is no set event that causes this to be worse or more apt to happen in a patient. However, a few events that most patients have experienced are more likely to cause them to develop post- traumatic stress disorder. Trauma for this even can happen alone or within a group of people. There is no set amount of people present at the event that will either encourage or discourage post- traumatic stress from developing. The development comes from a lack of coping skills within the human psyche. Since each person has a different point in which they can cope with certain situations, each person will come out of an event with some different perspective and way of coping. Some of the events that are most likely to cause the development of post- traumatic stress are, rape or assault, war and military combat, natural disasters, terrorist attacks, car accidents and near death experiences. Though these causes are not the sole stimuli to development of post-traumatic stress disorder they are the most likely stressors.
The traumatic event that sets off the development of post- traumatic stress disorder are relived in variety of ways within the sufferer. From memory flashbacks and disturbing nightmares, the sufferers' mind completely invaded by the traumatic event. In some sever cases of post- traumatic stress disorder the sufferer deals with dissociative states, where they do not know where they are and in their mind they are in the event which triggered their disorder. Yet, the most common characteristic is heightened arousal in the sufferer, which can stimulate the flashbacks even more and make them worse then a flashback than a person without post-traumatic stress disorder would have.
Though trauma is what begins the development of post- traumatic stress disorder, there is evidence pointing to previous psychological conditions in some cases. However, not all of the sufferers have to have a predisposed psychological disorder to develop post- traumatic stress disorder. Anyone of any mental capacity is able to get the disorder all depending on the traumatic event and the amount of stress their own psyche could accept at the onset of the disorder.
The complications of post- traumatic stress disorder vary from very mild to the extremity of severe. With a simple discomfort in certain situations with or without mild depression, which is another complication of post- traumatic stress disorder. On the opposite end is the severe total life encompassing side of the complication. The sufferer's life is completely ruined, they can not have relationships with anyone and often shut themselves of from the whole world. Agoraphobia is not uncommon amongst the worst sufferers of post- traumatic stress disorder. Feelings of guilt, self blame on what happened to them and self hatred are also often present in most cases of post- traumatic stress disorder. Some of the extreme cases tend to be suicidal and emotionally a wreak in all parts of their lives. While impairments are present in even the mildest post- traumatic stress sufferer, the amount of impairments and complications in the severe cases are so many that all of the complications and impairments are not yet known to therapist and psychologist. Anxiety, severe depression and heightened arousal also are factors of post-traumatic stress disorder.
Often miss diagnosed, as post- traumatic stress disorder is adjustment disorder, which is less severe and much easier to cure. Adjustment disorder is more within the human psyche to heal itself. Though it presents many of the same criteria of post- traumatic stress disorder and that is why it is often misdiagnosed as post- traumatic stress disorder. However, it lacks the amount of heightened arousal that is the main characteristic of post- traumatic stress disorder. Adjustment disorder also lacks the amount of aggression that post- traumatic stress sufferers seem to have. The length of time Adjustment disorder last is also much shorter then the average post- traumatic stress period, which without therapy could last the whole of a person's life time.

The following information is taken directly from the DSM and is the diagnostic criteria for post- traumatic stress disorder. Therapist and psychologist must uses this criteria to diagnose their patients correctly.

Diagnostic Criteria for Post- Traumatic Stress Disorder
The person has experienced or witnessed an event that is outside the range of usual human experience and that would be markedly distressing to almost anyone, e.g., serious threats to one's life or physical integrity; serious threat or harm to one's children, spouse or other close relatives or friends; sudden destruction of one's home or community; seeing another person who has recently been, or is being, seriously injured or killed as the result of an accident of physical violence.
The traumatic event is persistently re-experienced in at least one of the following ways:
recurrent and intrusive distressing recollections of the event (in young children, repetitive play in which themes or aspects of the trauma are expressed)
recurrent distressing dreams of the event.
sudden acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative {flashbacks} episodes, even those that occur upon awakening or when intoxicated)
Intense psychological distress at exposure to events that symbolize or resemble an aspect of the traumatic event, including anniversaries of the trauma.
Persistent avoidance of stimuli associated with the trauma or numbing of the general responsiveness (not present before the trauma), as indicated by at least three of the following:
efforts to avoid thoughts or feelings associated with the trauma
efforts to avoid activities or situations that arouse recollections of the trauma
inability to recall an important aspect of the trauma (psychogenic amnesia)
markedly diminished interest in significant activities (in young children loss of recently acquired developmental skills such as toilet training or language skills)
feeling detachment or estrangement from others
restricted range of affect, e.g., unable to have loving feelings
sense of foreshortened future, e.g., does not expect to have a career, marriage, or children, or a long life
Persistent symptoms of increased arousal (not present before the trauma), as indicated by at least two of the following:
difficulty falling or staying asleep
irritability or outburst of anger
difficulty concentrating
hypervigilance
exaggerated or startle response
physiologic reactivity upon exposure to events that symbolize ore resemble an aspect of the traumatic event (e.g., a woman who was raped in an elevator breaks into sweat when entering any elevator)
Duration of the disturbance (symptoms in B,C, and D of at least one month)

Specify delayed onset if the onset of symptoms was at least six months after the trauma.

Treatment for post- traumatic stress disorder has changed a lot in the past five years. One psychologist, Dr. John A. Talbott, who is well read and known in the post-traumatic stress study field, said at a conference at the University of Colorado recently, "The state of therapeutics in post traumatic stress disorder can be described in one word as confusing. Frankly, it's a mess. The literature is not great but it's an intriguing field in many ways. It's ever-evolving. It's so different than it was 20 or 30 years ago. (Jancin)" An Example is, therapist once believed that therapy within seventy-two hours of the traumatic event helped to stop the onset of post-traumatic stress. This therapy known as "one shot approach" once common now found ineffective and may even slow down the recovery processes (Sherman). In the last ten to twenty years the one shot debriefing became customary and then in some cases, such as rape, mandatory. Therapist believed that relieving the events and talking about them soon after the event happened would help to relieve any lingering distress about the event. The one shot debriefing was never really studied until the late nineteen nineties, at which time psychologist found many flaws in this process. As studies on this form of therapy continued, increasingly evidence appeared showing that this therapy causes more harm then good. A control group of motor vehicle accident survivors was done breaking into two groups. One group getting the one shot therapy and the other getting forty five weekly sessions of therapy over a two to five week time period after the accident. The studies at first showed no difference with the newer therapy verses the one shot at three months. Though at thirteen-months into the control groups studies showed that the one shot therapy patients doing much worse then the other groups and fifteen percent meeting the criteria for post- traumatic stress disorder. In more studies done over longer time periods it has been found that the victims that receive the one shot debriefing remain more significantly in post- traumatic stress symptom and diagnose criteria area then their counterparts (Sherman).
A more controversial therapy that happened between the one shot debriefing and today's newer therapy was a mix between cognitive behavioral therapy and exposure therapy. The exposure therapy, a modern version of ventilation and reexperiencing therapy, had the patient relieve over and over the traumatic event (Jancin).
Today's therapy is more main stream with the ideology of the time, more so then past therapies. It used to be very controversial to "vent" out your problems to a psychologist; today it seems most people have at least once seen an analyst or therapist or had a close relative or friend see one. These days people joke about being on or needing the psychiatrist wonder drug Prozac. Post- traumatic stress disorder today is a combination of drugs and psychotherapy. The drugs most often prescribed are selective reuptake inhibitor, Zoloft (sertraline) which is started at a recommended 20 mg a day and increased by 10mg if needed until the patient has leveled off generally around 20 to 50 mg. Paxil has also been found effective as drug therapy for post- traumatic stress sufferers. After a twelve-week study of patients, taking Paxil showed that 62% of the patients on 20mg a day and 54% of those on 40mg a day improved significantly. This is in contrast to the 35% on placebo that showed improvement. Paxil users have also made great improvements on reducing the amount of flashbacks and hyperarousal, yet it does not cause patients to have insomnia like Zoloft can (Mechcatie). Side effects of Paxil are impotence, nausea, abnormal ejaculation, diarrhea, somnolence (drowsiness or sleepiness) and asthenia (loss or lack of bodily strength).
Along with drug therapy, cognitive behavioral therapy is still used. The patient is taught to identify the underlying problem and turn the negative thinking around the problem. The patient develops coping skills and the goal is a more positive behavior adaptation about the problem and the way to deal with it.
With therapy and drug treatment many post-traumatic stress sufferers are able to live fairly normal lives. They can get back to their day to day activities and even learn to deal with the past events. Though little is known about the patients that do not seek treatment, we do know that those who do not seek treatment often get worse, and have a fairly high suicide rate. As Dr. Talbott said the field of study on post-traumatic stress disorder is confusing and intriguing all at the same time. Further efforts need to be made and people surviving traumatic events that the authorities know about should have mandatory referrals and checkups on the survivors and families to check for signs of post-traumatic stress.

Reference
American Psychiatric Association [APA], (2000). DSM -IV-TR, p. 465-468
Cruz, Jessi (1998, January 9) Anxiety disorders separated into 5 categories. Knight Ridder / Tribune News Service p.109 v. K7309
Jancin, Bruce (2001, December) PTSD responds to Mix to Drugs, Psychotherapy.(Consider CBT, SSRI). Clinical Psychiatry News p. 40 v. 29
Sherman, Carl (2002, February) Prolonged exposure therapy works, debriefing does not. (In Trauma's Shadow). Clinical Psychiatry News p. 36 v. 30
Mechcatie, Elizabeth (2002, January 15). Paxil. (New and Approved). Internal Medicine News p.8 v.35 i2

A Discussion Of The Advances Of Post Traumatic Stress Disorder (Ptsd) Management And The Lessons Applicable To Future Occupational Stress Management'.

HUMAN RESOURCE MANAGEMENT
ESSAY II
‘A discussion of the advances of Post Traumatic Stress Disorder (PTSD) management and the lessons applicable to future Occupational Stress management'.


Health and Safety in the workplace has become more prolific over the past 25 years. The strength of the unions and increased public awareness of corporate responsibility have demanded that organisations accept a greater responsibility for the health and safety of their employees. Whilst progress is being made, the wealth of compensation claims and massive corporate fines for negligence, however, suggests that health and safety has yet to reach the top of the priority list for some organisations. In fact, a 2001 Canadian Human Resource (HR) Reporter's survey of HR professionals indicated that only 30% ranked health and safety and 16% ranked wellness as being ‘very important'. More recently, the Institute of Occupational Safety and Health (IOSH) published their Value of Health and Safety Report (2005) highlighting that most health and safety professionals spend less than a quarter of their time tackling occupational health issues; one of which is occupational stress. These reports not only indicate the low commitment from HR practitioners towards health and safety, it also identifies a more worrying position for occupational health.

Organisations with a poor occupational health record face problems associated with absenteeism and the threat of compensation related legal action. The Chartered Institute of Personnel Development Absence Management Survey (2005), indicates sickness absence accounts for 4% of working time, equivalent to 8.4 working days or $1200 per employee per year. In addition, the courts are awarding employees significant damages for work related stress. With both impacting on the ‘bottom line', it is therefore not surprising that absence management and workplace wellness is becoming one of ‘HR professionals' top three agenda items' (Human Resources Canada, 2002). According to the Health and Safety Executive, this progress is crucial as ‘stress is likely to become the most dangerous risk to business in the early part of the 21st Century'.
There is currently no statute specifically covering the issue of stress in the workplace and the law governing stress has evolved mainly from case law rather than legislation. Under existing health and safety legislation, employers have a duty to undertake risk assessments and manage activities to reduce the incidence of stress at work. Examples include the European Union Framework Directive 89/391 and the United Kingdom Health and Safety Executives ‘Management Standards for Work-Related Stress' (2004). Although these standards are still voluntary, the Health and Safety Executive has indicated that they will be used as evidence against employers that continue to ignore their responsibilities in managing stress under the Health and Safety at Work Act 1974.

In response to the above as well as the knowledge that both employees and employers have become more cognisant of the effects of work-related stress, HR departments of organisations have begun to implement measures to address occupational health issues. At the strategic level, some organisations have implemented a ‘Stress or Well Being Policy'. This requires organisations to undertake an audit of their policies, procedures and systems to ensure that they provide a working environment that protects the well being of their workforce whilst also being able to identify troubled employees and provide them with the appropriate level of support. At a more tactical level, HR practitioners and supervisors are using approaches that look to identify the occupational health related problem through the risk assessments discussed above whilst also examining sickness absence levels, claims for compensation and performance deficits. Operational level approaches include those that take a more proactive stance and look towards identifying ways of creating a healthy workforce through education, employee counselling and stress management training.

Falling under the occupational health umbrella is the form of occupational stress described as Post Traumatic Stress Disorder (PTSD). Being hailed as ‘a phenomenon of the 21st Century' (Meighen, 2005), the term PTSD was introduced in 1980 to describe a pattern of symptoms associated with the reaction to the aftermath of a traumatic event. Whilst it is considered normal for people to show some reaction in the immediate to short term, Hoge et al (2004) suggests that between 10-30% of people exposed to a traumatic event will go on to experience a range of traumatic symptoms in the longer term. Symptoms include persistent flashbacks of the event, avoidance of any of the reminders of the event, feelings of emotional detachment and numbness and an exaggerated ‘startle' response or hyper vigilance. Although concerns about the psychological effects of trauma were initially raised in the aftermath of the Vietnam War, it is only in the last decade that governments and military institutions have begun to take any action.

Initial research into PTSD focused
on employees whose jobs were more likely to put them at risk such as emergency service personnel and members of the armed forces with combat experience. More recent studies have shown that any occupation can be susceptible to traumatic events as a result of workplace accidents and injuries. Since organisations are already adhering to forms of health and safety legislation that seek to reduce workplace accidents, there are two reasons why they should also consider the need for a trauma management strategy. Firstly, workplace trauma may have an effect on the ability of employees to function on both a personal and a professional level and, secondly, the significant legal implications associated, not just with the nature of a workplace accident but also the organisations response and after care, can be financially costly. Since, however, the majority of information and media speculation regarding PTSD focuses primarily on the armed forces, the remainder of this essay will concentrate specifically on this occupational group.

For the United States (US) Military the wars in Iraq and Afghanistan have been the most sustained combat operations since Vietnam, while it is possible that they may be as prolonged. It took the Vietnam War for the military community to understand and accept the effects of traumatic experiences on psychological well being; since war veterans began legal proceedings against governments for failing to recognise or treat their stress, PTSD has become a household term. With increasing numbers of western military personnel currently engaged in combat operations there is a fear that cases of PTSD will intensify. The numbers of those affected is already concerning. The most recent public study to evaluate active duty soldier's reports of various war zone experiences and rates of mental health problems estimates that levels of PTSD in the US military was around 18% for Iraq and 11% for Afghanistan (Hoge et al 2004). The United Kingdom government is more guarded of its combat and non-combat casualty statistics, but a study published by the British Journal of Psychiatry estimates that 10% of troops airlifted out of Iraq between January and October 2003 suffered from psychological symptoms. Statistics from 2002 indicate a level of only 2.8% within the Canadian military, probably attributable to Canada not arriving in Afghanistan until 2003 and their non-participation in the Iraq conflict. In all cases there was a positive relationship between the number of combat deployments and incidences of PTSD. This is concerning as the above conflicts are likely to persist, implying the same soldiers will be required to return on second or subsequent deployments. This is reflected in Hoge et al's (2004) statistics that predict that the cases of PTSD in soldiers returning from Iraq are likely to increase to 20%.
The overall situation is even worse as the accuracy of the figures is suspect due to under reporting. Paton, (2004) suggests that half of the servicemen who suffer psychiatric illness as a result of traumatic events do not seek medical help, or do so up to 15 years later when the damage to marriages, careers and mental well being is irreparable. Some under reporting has been attributed to a purely British ‘stiff upper lip' phenomenon where servicemen and women refuse to accept that they have a problem and are reluctant to discuss emotional issues for fears of being considered ‘sick' or ‘weak' in a demanding mental and physical occupational environment. Furthermore, PTSD is still viewed in the United Kingdom with a great deal of suspicion; especially amongst serving soldiers and a generation that lived through the horrors of the Second World War, the Korean War and the daily struggle against terrorism in Northern Ireland.

"Psychological stress is a symptom of political correctness in the 21st Century where everyone has to be stressed or depressed" (Bremer, 2005)

According to Elliott (2005), ‘the stigma attached to mental health problems puts many soldiers off asking for help'. In a culture of mental and physical toughness soldiers remain concerned that admitting to psychological problems will have a negative impact on their career.

"PTSD is seen as a career stopper in the Army" (Skelton, 2005)

Although the research to illustrate the effects of PTSD on a soldier's performance at work is limited, there has been an increase in the litigation against government bodies for negligence. Soldiers in Northern Ireland involved in Bloody Friday, the Omagh bombing and Enniskillen bombing are suing the Ulster Defence Regiment for failure to diagnose and treat their PTSD (BBC News Online). Similarly, in Canada, a former solider who served in Cyprus, Somalia, Bosnia and Haiti has initiated legal proceedings against the federal government seeking $88 million in compensation (Vaidynanath, 2005), while in the United Kingdom, a former soldier was awarded £620,000 damages from the Ministry of Defence for stress suffered while on duty (Greene, 2005). With such high financial consequences for failing to recognise the impact and management of PTSD, it is not surprising that governments and armed forces have begun to implement trauma management strategies that better cater for the needs of their employees.

Even though the military do not have HR managers per se, their HR is done through various branches of the service as well as through the chain of command; it is traditionally the responsibility of the officer in charge to manage their subordinates in terms of both their career and welfare. Although the measures implemented by civilian organisations on occupational stress can be assimilated with those used by the military for PTSD, the latter have a more grand strategic and government level commitment. Within the North Atlantic Treaty Organisation (NATO), an exploratory team of psychologists and psychiatrists have been tasked to investigate issues of stress and psychological support within the military institutions of its member countries. This grand strategic policy is still in its infancy and has yet to be released but will address areas of psychological stress, the psychological preparation of military personnel, screening, psychological support during and after deployment and methods of support for families. It is anticipated that this policy will provide more formal, regulatory direction for NATO countries on the management of PTSD in their armed forces.
At a more strategic level, Veterans Affairs Canada and the Department for National Defence opened the Saint Anne's National Occupational Stress Injuries Centre in 2002. This joint venture gives the centre sole responsibility for advances in mental health clinical care through program development, research, education and outreach activities. Minister Guarnieri, the Minister for Veterans Affairs commented that,

"It is important that Canada's military – whether they are still in uniform or already released – have access to mental health care that is comprehensive, integrated and that delivers services consistently to a standard of excellence" (Guarnieri, 2005)

The Department of National Defence also has a Veterans Affairs Centre for the support of injured and retired members and their families. This centre has an operational stress injury social support program that specifically targets those affected by operational stress injuries such as PTSD, and delivers educational and professional development modules for the Canadian Forces. The new Veterans Charter (2005) offers veterans and serving members of the Canadian Forces more access to services like rehabilitation, assistance to overcome economic loss, health services and job placement.

At a more operational level, Canada has established five Operational Trauma and Stress Support Centres (OTSSC's) in military bases across the country that assist Canadian Force members and their families in dealing with the effects of operational stress. There is also a Canadian Forces Member Assistance Program which offers a 24/7 confidential referral service for external, short term counselling for those who prefer to seek help outside of the military health services. Canada has also included in its pre-deployment package for servicemen and women, mandatory courses on stress coping skills, unit cohesion and social support as well as awareness of the potential effects of stress.

The US Department of Defence uses a very employee centred approach that aims to improve psychological resilience among troops. This involves developing tools to measure stress in the field, establishing a suicide surveillance system, identifying factors that lead to high rates of mental disorders and developing psychological screening and debriefing. Further down the line, this programme intends to develop ways of identifying vulnerable soldiers within both training and operational environments. The US Army is also working with German and Austrian armies to develop a protocol to assess voice changes under stress, making it easier to separate the physical from psychological when it comes to measuring stress levels. Unlike other countries, the US has also made a concerted effort to integrate their returning reserve soldiers back into the workplace. Andrews (2004) describes how HR practitioners within organisations have worked towards facilitating the reservist's reintegration back into the workplace through options that include flexible work arrangements or gradual re-entry processes. For example, General Electric Energy have produced individualised reintegration plans for employees that include a full year of extra training if required, whilst The Link Agency have prepared a scrapbook that includes photos of staff and samples of recent work and alerted colleagues so that those who want to can send welcome back cards.

The British Ministry of Defence's strategic level Stress Management policy was published in 2001 and, for the first time, recognised stress as a debilitating condition. This policy has been implemented at the tactical and operational level, like Canada, through a series of annual mandatory health, safety and stress management training programmes for all members of the Armed Forces, as well as including more PTSD specific training for those deploying on operations.

"The measures now in place to combat PTSD have evolved and have been enhanced over a number of years to reflect our improving knowledge of the condition, its effects and the best methods of remediation. Each service runs active programmes aimed at prevention and treatment. Measures include pre-deployment and post-deployment briefing and, when practicable, availability of counselling in theatre" (Moonie, UK Minister for Veterans Affairs, 2005)

Two new defence community psychiatric centres have also been established in England and Scotland and the Army Welfare Service is available to soldier's families.

This essay has described the ongoing progress of health and safety with regard to occupational health and PTSD in particular. The degree of HR uptake in occupational health and safety is improving and HR professionals are beginning to implement a series of occupational stress measures in the workplace. While such improvement is the result of a myriad of factors, the more litigious society we now live in will continue to demand greater efforts by employers or face the inevitable financial penalties issued by the courts. A significant amount of progress has been made in the area of PTSD, some of which sets an excellent example for HR practitioners seeking new ways or methods to cater for occupational stress in their workplace. Although the response of governments has been reactionary, various defence ministries have implemented a number of problem and employee centred initiatives aimed at reducing the impact of PTSD, including policy directives, national centres of PTSD excellence, psychological screening, education, training and support assistance. Furthermore, as in the case of the United States, HR professionals are introducing re-integration and training methods to assist returning reserve servicemen and women in their transition back to work. PTSD prevention and treatment is set to remain at the very forefront of occupational stress management due to the continued commitment of armed forces in Afghanistan and Iraq and research evidence that identifies a positive link between the frequency of exposures to a traumatic event and PTSD. For national governments success is to be measured by a reduction in the number of successful compensation claims from former service personnel, despite their continued commitment in high-risk areas. Such success may well provide a blue print for HR practitioners of the future as they seek to improve occupational health and reduce costly court cases.

REFERENCES

Andrews, L W (2004) Aftershocks of War. Human Resource Management

BBC News Online (2005) ‘Police Officers seek trauma compensation' (Nov 2005) Accessed at: http://news.bbc.co.uk/2/hi/uk_news/northern_ireland/4413762.stm

BBC News Online (2005) ‘Ex Soldier Wins Stress Damages' (July 2005) Accessed at: http://news.bbc.co.uk/2/hi/uk_news/wales/4725455.stm

BBC News Online (2005) ‘Northern Ireland Soldiers face Combat Stress' Accessed at: http://news.bbc.co.uk/2/hi/uk_news/northern_ireland/4285696.stm

Bremer (2005) ‘UK Troops face trauma after Iraq, Accessed at BBC News Online; http//news.bbc.co.uk/2/hi/uk_news/4632263.stm

British Journal of Psychiatry, (2003) Cited in Greene, R A (2005) ‘UK Troops face trauma in Iraq'. BBC News Online, UK

Canadian HR Reporter's (2001) Strategic HR Survey. Cited in Schwind, H., Das, H & Wager, T. (2005) Human Resource Management: A Strategic Approach, 7th Edition. McGraw Hill, Ryerson.

Chartered Institute for Personnel Development Absence Management Survey (2005) Accessed at www.cipd.co.uk

Elliott (2005) ‘NI soldiers face combat Stress'. Accessed at BBC News Online, http://news.bbc.co.uk/2/hi/uk_news/northern_ireland/4285696.stm

European Framework Directive 89/311. Accessed at: www.ilo.org/public/english/protection/ safework/integrap/docs/english/replies/fra_e.pdf

Hoge C. W., Castro C. A., Messer S. C., McGurk D. Cotting, D. I & Koffman, R L (2004). Combat duty in Iraq and Afghanistan: mental health problems and barriers to care. New England Journal of Medicine 352, 13-22.

Greene, R A (2005) ‘Combat Stress: As old as War itself'. Accessed at: www.news.bbc.co.uk/2/hi/americas/4124558.stm

Greene, R A (2005) ‘UK Troops face trauma in Iraq'. BBC News Online, UK

Guarnieri, (2005) ‘IVAC, DND unveil PTSD Support Strategy'. Accessed at VAC Canada Website

Health and Safety at Work Act (1974) Accessed at: www.healthandsafety.co.uk

Health and Safety Executive (2004) ‘Management Standards for Work-Related Stress'. Accessed at: www.hse.gov.uk

HR Development Canada (2002). ‘Occupational Injuries and their cost in Canada' (1993-1997), Cited in Cited in Schwind, H., Das, H & Wager, T. (2005) Human Resource Management: A Strategic Approach, 7th Edition. McGraw Hill, Ryerson.

Institute of Occupational Safety and Health (2005) Health & Safety Professionals say Companies are neglecting Occupational Health. Accessed at: www.iosh.co.uk

Moonie, (2005) Cited in Paton, N (2005) Combating Stress. Occupational Health Magazine.

Skelton, (2005) ‘Wounded in Action'. The Guardian Newspaper, United Kingdom.

The Guardian Newspaper (Feb 2005) ‘Wounded in Action' (Feb 2005) Accessed at: www.guardian.co.uk

Vaidyanath (2005) CF Battle PTSD. Epoch Times, Ottawa Staff.

BIBLIOGRAPHY

Canadian Community Health Survey: CF supplement in Mental Health. The Daily, Canada

IVAC, DND Unveil PTSD Support Strategy (Nov 2005) VAC Website, Canada

Litz, B T (2003) The Unique Circumstances and mental health impact of the wars in Afghanistan and Iraq. National Centre for PTSD, USA

Occupational Health and Organisational Effectiveness (July 2005). Fact sheet issued by the Institute for Personnel Development, United Kingdom

Paton, N (2004) Combating Stress. Occupational Health Magazine

PTSD in CF Members (Nov 2005) www.forces.gc.ca/site/newsroom

Schwind, H., Das, H & Wager, T. (2005) Human Resource Management: A Strategic Approach, 7th Edition. McGraw Hill, Ryerson.

Whealin, J, Morgan, C & Hawlett, G (2004) The Role of Military Studies in Enhancing our Understanding of PTSD. PTSD Research Quarterly, Vol 12, No 1.

Work Related Stress (Aug 2005) Fact sheet issued by the Institute for Personnel Development, United Kingdom

10 Most Haunted Places On Earth

10 Most Haunted Places on Earth
Written by tonyleather
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Photo: austinevan
Have you ever visited a place where you found yourself shivering with goosebumps for no apparent reason? Déjà Vu, some call it, while others attribute such feelings to ghosts. In the ten places collected here, the ghosts sometimes really do seem out to get you. Let the haunting commence...
1. Borley Rectory, England
Photo: sconosciutio
The derelict building in the photo above is not a place to enter lightly. Though the small village of Borley, near Sudbury, UK, is not the sort of place one would associate with ghosts, it has a dreadful reputation because it was the site of the infamous Borley Rectory, reputedly the ‘Most Haunted House in England’.
Built in 1863 for the Reverend Henry Bull, it sits on the site of an ancient monastery. The ghost of a mournful nun who patrolled the so-called 'Nun's Walk' had often been seen there. An old story claimed that she had fallen in love with a monk from the Borley Monastery – to much outrage – and the two had tried to elope together but had been quickly tracked down. The monk was executed and the nun bricked up in the cellars of the monastic buildings!
2. The Stanley Hotel, Colorado
Photo: Hustvedt
There are countless tales of ghosts from all over the world, but some are more skin-crawling than most. Many of us remember the superb horror film The Shining, based on the novel by Stephen King. The book was inspired by a stay at the Stanley in Estes Park, Colorado. Assigned Room 217, King reportedly heard ghost children playing in the hallway. Many have experienced paranormal activity here, but these real-life ghosts seem harmless. Many spirits are said to haunt the place, while guests and employees claim to have heard faint music coming from the ballroom and seen the piano keys moving.
3. The Tower of London
Photo: spendtimeinlondon
The picture below is of one of the most famous spirits to haunt the Tower of London: one of the wives of Henry VIII, beheaded in the Tower in 1536. Her ghost has been seen on many occasions, sometimes carrying her head, on Tower Green and in the Tower Chapel Royal.
Photo: unknown artistPortrait by unknown artist of Lady Jane Grey
Other ghosts include those of Henry VI, Thomas Becket and Sir Walter Raleigh. One of the most gruesome ghost stories describes the death of the Countess of Salisbury. According to one account, “the Countess was sentenced to death in 1541 following her alleged involvement in criminal activities (although it is now widely believed that she was probably innocent). After being sent struggling to the scaffold, she ran from the block and was pursued until she was hacked to death by the axe man.” Her execution ceremony has been seen re-enacted by spirits on Tower Green.
4. Woodchester Mansion, England
Photo: Matthew Lister Ttamhew
Woodchester Mansion in Gloucestershire, England, is another building with a ghostly reputation. Building work has never been completed here, and in the last 200 years workers have repeatedly run from the place and seven builders are rumoured to have died in inexplicable accidents.
Strange noises are often heard, like the sounds of crashing masonry or voices wailing, and many ghosts, including those of Roman soldiers and young girls, have reportedly been seen. Regular ghost hunts
are held here.
5. The Paris Catacombs
Photo: Einsamer Schuzter
The Paris Catacombs are a maze of tunnels and crypts underneath the city streets where Parisians placed the bones of their dead for almost 30 years. Prior to the creation of the Catacombs in the mid-1700s, residents buried their dead in cemeteries, but as the city grew, they quickly ran out of space.
The decision was made to use an underground section of quarries in Paris, and the bones from Paris’ city cemeteries were moved underground between 1786 and 1788. The process was conducted with reverence and discretion – the quarry space was blessed before any bones were moved there, bones were always moved in a quiet parade of carts accompanied by priests, and these movements always took place at night. The quarries continued to be used as the collection point for the bones from Paris’ cemeteries through 1814 and now contain the bodies of roughly 6-7 million Parisians. Watching the video above will give you some idea of what a scary place this is.
6. The Skirrid Mountain Inn, Wales
Photo: tripadvisor
One of the most notorious haunted sites in England is the Skirrid Mountain Inn in Llanfihangel Crucorney, Wales. According to folklore, in its 900-year history over 180 people have been hanged from a beam on the staircase, which is still in place today, with rope marks, apparently. The first floor of the inn is thought to have been a courtroom in the past.
Glasses often suddenly fly across the room of their own accord, faces are seen at windows and people feel nooses around their necks. Guests who stay there often report waking to icy room temperatures – even when the heating is on – and the feeling of being watched. 17th-century barmaid Fanny Price is thought to be the most active spirit among many, but everyone agrees that this really is one scary place to stay.
7. Rose Hall, Jamaica
Photo: Urban Walnut
You might not think that Jamaica would be the site of an infamous haunted house, but Rose Hall in Montego Bay is exactly that. This huge house is inhabited by the ghost of voodoo priestess's daughter, Annie Palmer, who reportedly causes bloodstains to appear and disappear randomly. She was murdered in her bed after an 11-year reign of death, torture and nymphomania.
Annie murdered three husbands and a succession of slave lovers by poisoning, strangulation and witchcraft, before forcing other slaves to carry bodies through a tunnel to be buried on a beach. According to legend, it is not just the tormented Annie who roams the house, but also ghosts of the slave babies she sacrificed in rituals. Reports have it that her male victims have actually been not only heard but also captured on camera. Not a pleasant place to spend the night.
8. The Bell Farmhouse, Tennessee
Photo: coutesy of paranormalvideos
The Bell Farm haunting is recognized throughout the paranormal community as the only known account of a ghost that caused the death of a living person. During the years of 1817 and 1821 a woman entity terrorized the Bell family. She became known as the Bell Witch or 'Kate'. She had tortured John Bell so much that it led to his death. He did suffer from a nervous system disorder, and Kate’s antics made his condition worse. Beside John’s deathbed was found a vial of black liquid. When paranormal experts asked Kate what it was, she claimed she gave it to him. It was thought that the liquid Kate gave to John is what killed him. To test the validity of the liquid, they placed a drop of it on the family cat’s tongue which immediately killed it. Current residents near the Bell Farm believe Kate is still up to no good.
9. Edinburgh Castle
Photo: Jordan S Hatcher
Edinburgh Castle is reputed to be one of the most haunted spots in Scotland. And Edinburgh itself has been called the most haunted city in all of Europe. On various occasions, visitors to the castle have reported a phantom piper, a headless drummer, the spirits of French prisoners from the Seven Years War, colonial prisoners from the American Revolutionary War – and even the ghost of a dog wandering in the grounds' dog cemetery.
Photo: Klaus HermsenEdinburgh Castle
This is a historical fortress, parts of which are more than 900 years old. The cells of its ancient dungeon, the site of uncounted deaths, could very well be an eternal place of unrest for numerous spirits.
10. Bhangarh Town and Fort, India
Photo: Saad Ahktar
People in India know all about ghosts. Locals give the Bhangarh fort, and the area around it, a wide berth, due to some popular spooky stories associated with the fort and town. Authorities have told visitors not to enter the ruined city after dusk. It is said that a wicked sorcerer cursed the city after being spurned by a princess. The 17th-century city was soon destroyed by an advancing army, leaving only its temples intact, and has been uninhabited ever since. Visitors say that birds and wildlife fall silent as the spirit of the sorcerer approaches at night, and nobody has ever tried to spend the night there. Just too spooky to take that chance.
Whether or not you give credence to the idea of ghosts, it is difficult to deny that places like this have a certain ‘feel’ to them which makes you want to get out as soon as possible. Overactive imagination, or subconscious warning? You be the judge.

The Church Adorned With the Bones of 40,000 Corpses
Written by Matt Forde
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Photo: Diether
The soil beneath the Cemetery Church of All Saints in Sedlec, Czech Republic embraces a macabre sight. In the shadow of the Baroque church that looms above it a flight of steps descends into the earth and leads to a small, cruciform chamber where vaulted ceilings, candelabras and even large pyramids are richly decorated in what would normally be considered a charming and bijou little locale. But it is most definitely not charming, as upon entering, it quickly becomes apparent that the interior designer was going for a rather ‘gruesome’ look. Housed within the chapel are the bones of 40,000 human corpses, and it is these skeletal remains that make up the chapel’s decorations.
Photo: SoulStealer
Photo: Daniel Wabyick
Photo: Diether
Photo: Ciamabue
A large and elaborate chandelier dominates the central space. Like the other ornamentations it is entirely made up of human remains; femurs, skulls, scapulas and vertebrae combine intricately in an elaborately grisly, nightmarish centrepiece that would not be out of place in Jeffrey Dahmer’s apartment 213. In a nod to macabre completionists, the chandelier uses at least one of every single bone in the human body.
Photo: Todd Huffman
Photo: Todd Huffman
Photo: BrokenSphere
Around the chapel, thousands of skulls stare out at the visitor with blank orbits, their pale features long parted from their mandibles. Pelvic sections make up the petals of skeletal flowers while bony chalices inhabit shallow niches. Festively looping chains of bone are draped from the vaulted ceiling like bunting at a village fete. Arcing lines of skulls accomplish a similar effect over the gateways to the ‘pyramids’, each of which occupies a side of the chapel’s transepts. Essentially huge mounds of bones and skulls, the pyramids would be gruesome reminders of mortality anywhere else on the planet, yet here, surrounded by similar deathly objects, they seem curiously normal.
Photo: CxOxS
Photo: Curry Bet
Photo: Lyng883
The infamous Black Death and the later Hussite Wars (many of the skulls not used in the ossuary for decorative purposes show evidence of battle wounds) caused many thousands of people to be interred in the church’s grounds and eventually meant the cemetery had to be greatly enlarged. Some time around 1400 a lower chapel was excavated to be used as an ossuary for the bones unearthed from the mass graves that were uncovered during building work. Centuries later, in 1870, a local artisan named František Rint was employed by the Schwarzenberg family to establish some order to the piles of skeletal remains. Rint chose to go one step further and he created this bizarre work, even recreating the Schwarzenberg coat-of-arms and his own signature using the bones.
Photo: BrokenSphere
Photo: BrokenSphere
Photo: Marcin Szala

Haunted

Ever been to anywhere in Malaysia and experienced paranormal hauntings? Curious to know where are the places that you can visit to experience one yourself? The below are lists of Malaysia’s top haunted places that you can, may or even experience ghosts.

1.Georgetown, Penang – A T-junction better known as The Deadly Junction is located beside the Union High School. It is said that if you ever drive through this lonely road late at night, your care will go out of control and crash due to the too many accidents that happened there. It is also said that there is a tiny unknown tree beside the road which looks like a lady carrying a child. The story was known by some old folks saying that this lady was once a bomoh (witch doctor) who kidnapped her sister’s son. Somehow, they never again appeared anywhere except other than being seen beside this road2.St Michael’s Institution, Ipoh – A group of Catholics missionaries arrived here in 1912 and began building a school next to the famous Kinta River. It did not take long for the missionary brothers who ran the school to have enough funds to erect a huge school building with unique French structural design. When the WW2 broke out, the school was used bu Japanese secret police as their headquarters. Needless to say, there were lots of torturing carried out. The buidling itself had many tunnels which had been sealed off and the tunnels were said to be used by the Japanese to torture prisoners and to store food. Most of the sightings occurs in the Chapel on the fourth floor of the bluiding where a Brother was seen dressed in a black robe holding praying beands in a sitting position facing towards the door (which leads to the brothers quarters) in the very early morning without a head. Those who had witnessed it were asked to keep it a secret
3.Malay College Kuala Kangsar, Kuala Kangsar, Perak – This school is said to be a former site of Japanese occupation camp during WW2. Students would sometimes be awakened by something that stares down directly at them. A marching platoon can be heard in the field and sounds of dragging chains can be heard through the campus corridors. A tree on the campus, which is located right beside a lampost where the light shines down on it, reflects a shadow of a man hanging from the tree! A few other old colonial admin buildings that were used by the Japanese during the Occupation in the 1940s where executions are taken place are buildings like Victoria Institution and Bukit Bintang Girls School
4.MARA Junior Science College, Kuala Kubu Bharu, Selangor – A white flying apparition can be seen in various parts of the building
5.Victoria Institution, Kuala Lumpur – A boys school was tured into a Japanese base during the Occupation. Many British soldiers and locals were brutally tortured to death in the basement and some older buildings on the campus. It is said that not only are apparitions common in the day as well as in the night, there had also been many cases of spirits possessing students. The possessed boys would behave strangely and even violently harming other students and teachers, forcing the stronger teachers and students to restrain him. The possesed boy would only snap out of it a few hours later and remembering nothing
6.Tambun, Ipoh, Perak – Singtings of an old lady on the roadside while driving
7.Tambun Inn, Ipoh, Perak – Lights were reported to turn on and off by itself and sounds of whispering could be heard where no one was around
8.Bukit Tunku, Kuala Lumpur – A spooky place to be even when it is actually one of the most elite residential areas in Kuala Lumpur. This place with its many big and tall trees and very winding roads, has an eerie feeling about it even at broad daylight. It is said that a few years ago two youth embarked on a high speed motorcycle chase around the curvy roads of the area. One of the youth crashed at a dark stretch of the road, which is actually a very sharp corner. There have been claims about sightings of a young man riding a motorcycle at high speed, who mysteriously vanished in the dark
9.Poliklinik Cheras, Kuala Lumpur – Used to be a government hospital but it is being abandoned with no reason. There were rumors that say there are still some dead patients that loiters around the area
10.Genting Highlands Resort, Pahang – A famous hill top resort and casino, many people incurred gambling debts and committed suicide there. Some visitors leaving the hotel lobby reported seeing a man in red jump from the rooftop, just to disappear before he hits the ground. Certain rooms are not available for rent no matter how full the hotel was. Those who have seen the inside reported that it was filled with old Chinese ghost wards. They would subsequently fall sick for days afterwards
11.Highland Towers, Kuala Lumpur – A tragic event where one of the 3 blocks of apartment at this place fell apart due to landslide and heavy downpour prior to that fateful day. Since then, the Highland Towers have become famous for claims of being a very haunted place. Voices of the dead can be heard at night and ghostly figures are said to have appeared at the scene. There are also a story about a taxi driver who picked up a woman passenger at the middle of the night and being asked to drop her at the place.She left a bag and the poor taxi driver found it to be full of blood!
12.Police Station in Tras, Pahang – During the 1950’s, a police corporal and his wife were found in a state of shock and terror after opening their door to an unknown figure. Many police personnel were terrorized by this entity that other policemen would rather resign than being transferred to this remote station
13.Kellies Castle, Perak -Sometimes door are opened themselves and lots of scary screaming voices can be heard.
14.Puchong House, Kuala Lumpur – Evil drawings on the walls. Some say the ghost of a woman who used to stay there haunts the place. Other than that, just stepping into the house is enough to keep you awake for months.
15.S.K (1) Kuala Ampang, Selangor – Could hear taps in the toilet running by itself and sightings of a lady in white walking behind the school compound.

Tourism Of Haunted Houses

Joshua White

Haunted Houses

This paper is taking a look at the haunted houses of America. The three Haunted places I have picked are the Island prison of Alcatraz, The Winchester Mystery House, and the Amityville Horror House. These are places you might have heard of before but until you experience them for yourself you will not be able to form your opinion on whether ghosts actually do exist.

Of all the websites that I visited the website for the Winchester Mystery House was the best. The website offered ticket purchases online and shows that this House has definitely become known for its haunted nature. The house in its design is quite eccentric actually. There are staircases that go down 7 steps before going up 11 steps, another set of staircases has 7 flights of steps with 42 steps but only goes up 9 feet. This mansion itself is a very interesting place and it is said that Mrs. Winchester built it full of secret passages because she was trying to trick any ghosts that might be following her. ““When Mrs. Winchester set out for her Séance Room, it might well have discouraged the ghost of the Indian or even of a bloodhound, to follow her. After traversing an interminable labyrinth of rooms and hallways, suddenly she would push a button, a panel would fly back and she would step quickly from one apartment into another, and unless the pursuing ghost was watchful and quick, he would lose her. Then she opened a window in that apartment and climbed out, not into the open air, but onto the top of a flight of steps that took her down one story only to meet another flight that brought her right back up to the same level again, all inside the house. This was supposed to be very discomforting to evil spirits who are said to be naturally suspicious of traps.”” This quote was taken from the American Weekly published in 1928 and gives you some idea of just how crazy the inside of this house really is. This is definitely one of the oddest houses ever built and it is said that Mrs. Winchester built it to hide from the ghost of every person killed by a Winchester rifle. The tourist attraction is evident in the fact that they offer midnight flashlight tours to scare people though they did have to put a pause in that after someone strayed from the tour group and was not found until the next day. Now people come from all over the world to see this odd and fascinating house.

The Amityville Horror House has quickly become one of New York’s most famous tourist attractions. This was brought on by the book and movie that have been made telling the gruesome story that accompanies this house. The story is that a kid brutally killed his entire family consisting of his parents and 4 siblings, when arrested the child simply said that there were ghosts and voices in his head that told him to do it. The house was sold shortly after this tragedy and the new owners reported doors being torn from their hinges, and strange voices interrupting their phone calls. These owners moved out within 28 days of living there. Though many people feel these people were over exaggerating their experience because the next owners had no such trouble.

The prison of Alcatraz, a cold, dank hellhole, saw many murders, riots, and suicides during its 29 years of service. Along the way it spawned tales of inexplicable sounds, cell doors closing on their own, disembodied screams, and scary apparitions. The island, believed to be an evil place by Native Americans, has seen centuries of death from accidents, murders, and suicides. With this dark history, it's no wonder Alcatraz is said to be one of the most haunted places in the nation. If ghosts return to haunt the places where they suffered traumatic experiences when they were alive, then Alcatraz must be bursting at the seams with spirits. Though the prison is no longer used as a prison it has become somewhat of a tourist trap due to the idea of it being haunted. Alcatraz also known as “The Rock” is responsible for bringing in nearly a million visitors per year. The future development of Alcatraz is somewhat unknown. A few years back there was a push by some people to remove the prison and put something friendlier and less menacing on the island. This idea was opposed greatly by people saying that Alcatraz was a very important part of the city historically and from a tourist standpoint. There has also been talk of fixing up the island because the weather has not been friendly to the prison and many of the buildings are rubble or falling apart, but the state and city did not feel like that was a good investment. So it looks like The Rock will remain a tourist attraction until there are no more buildings to visit. Though people visit this island prison for many different reasons tourist numbers estimate that around 1/3 of the tourists that visit each year are hoping to experience something other worldly. Through my research on this topic I have found many websites devoted to proving that The Rock is really a haunted place, some of these articles are incredibly interesting and convincing, but you will never know for yourself until you visit the island.

The Importance Of Business Ethics In Ireland

The Importance of Business Ethics in Ireland

Sonia Lorena Richards

Cross cultural Human Relations and Negotiations

April 27, 2010

Globalization has created opportunities for countries like Ireland to flourish. “Ireland is now classed as a high income economy by the World Bank on the basis of gross national income (Chhokar 365).” The importance of business ethics is fairly new in Ireland. Explanations for this might be sought in the country’s colonial history and late economic development, its size, the homogeneity of Irish society, and religion (Keating 9). These things need to be considered while doing business in Ireland. There are many opportunities for other countries to do business with Ireland because it is dependent on trade (Chhokar 365). The United States and Ireland’s business ethics are very similar, but do have some differences. The culture of each country determines how business ethics are understood. Due to past corporate and political scandals in the 1990s, Irish corporations emphasize the importance of ethical standards in the place of business (Keating 9). Irish ethical standards start with leadership and its components, as well as the attitudes towards ethics in business.

It wasn’t until the 1990s that people realized the importance of business ethics because it caused them a great of social and economic costs.

“The spate of unethical practices which unfolded in Irish businesses in the summer of 1991 aroused widespread public criticism and anger with senior government and business people. I firmly believe that the revelations and investigations into these events will have restraining effects (Regional Manager, Utility) (Alderson 434).”

While the rest of the world for some years has been addressing issues such as business ethics, Ireland for the most part was focused on its own economic and political problems (Wiley 135). Since the events occurred in the 1990s, Irish attitudes towards business ethics had to change to decrease the social and economic costs. It got to a point that it was affecting the whole country. There have been studies conducted on the new Irish attitudes toward ethics in business which needs to be known by managers of other countries who want to do business with Irish companies.

According to Siobhan Alderson there are four keys that changed: attitudes towards implementing ethics in business, influences of top management, attitudes towards ethical issues in business, and the perceptions of responsibility towards key stakeholders in business. Some of the implementations that Alderson discovered were that Irish managers believe that business schools need to include more ethics training to make sure what occurred in the 1990s does not occur again (APPENDIX A). A management consultant was interviewed by Alderson on the matter and believes strongly on education in the schools systems. “Although business ethics is given its best start in the home, some enhancement could be effected through training at school, college, and business school. (Management Consultant) (Alderson 435).” Most managers believe this as well. I interviewed Ann Hinds who works at the law firm Matheson Ormsby Prentice in Dublin, Ireland. Since the 1990s, business ethics have been incorporated in the school systems. She explained to me at her firm it is an absolute essential to have learned or taken a business ethics course before working in the firm. She not only explained about the importance of her firm, but for all businesses in Ireland. “Corporations are more focused on business ethics due to the financial crisis we are going through right now (Ann Hinds).” With this said, It will be important for foreign managers who want to work in Ireland to be educated in their code of ethics before arriving to work because of how they believe their top management’s behaviors influence their peers. It will give them a better advantage over the competition. The Irish believe that the behavior of management or leaders influence ethical and unethical behaviors within an organization (Alderson435) (Appendix B). There has been a comparative study done on the effects of ethical leadership in Ireland and the United states. Even though they are very similar and from the same cluster, they differ in some aspects (Keating 10). Keating explains that “ethical leadership focuses on how leaders use their social power in the decision they make, actions they engage in and ways they influence others (Keating 7).” According to Keating, there are 6 attributes of ethical leadership: character/integrity, ethical awareness, community/people orientation, motivational, encouraging/empowering and ethical accountability. It is important for managers to know that leadership varies from country to country because of different cultural norms and values. History can also tie in differences of leadership. The only difference between the United States and Ireland was the character/integrity attribute.

“In Ireland, leadership is characterized by a strong charismatic, team-oriented approach coupled with a participative and human orientation. In Irish society, character and integrity are rooted more strongly in relationships within one’s social network than in a set of obligations to outsiders (Keating 17).”

The United States is the opposite where it is more individualistic and focuses on individuals then the society. They are required to just know the code of ethics and circulate it to all the employees and stressed upon induction (Alderson 435). Alderson’s study pointed out that Irish managers believe that top management’s behaviors influence the peer’s ethical and unethical behavior. It has to come from the leaders to make a difference with the followers.

“While legislation provides a framework, it is largely up to senior management to effect ethics, based on reasoned judgment and situational feedback. A senior manager, (ideally the CEO), should be custodian of ethical standards for the company. (Senior Manager, Financial Institution)(Alderson 435).”

The Government in Ireland did have to make changes because of the scandals, but if it wasn’t for the businesses that were not corrupt during the 1990s, the country would still be considered behind in the study and practice of good business ethics. They had to take the good with the bad. Some companies saw this from the start and took action. Wiley pointed out some examples of some companies during that time that did something to change the ethical standards in Ireland were Bord na Mona (the TurflPeat Board) which operated an audit committee which reports any conflicts directly to the Chairman and by-passes the board.

“Radio Telefis Eireann (RTE) and the Electricity Supply Board (ESB) had sections in their establishing statutes requiring directors to disclose any conflicts. Telecom Eireann, the semi-state company responsible for the telephone system, is considered to be exceptional among semi-state companies in having a written code of conduct dating from 1987. Activities which constitute an actual or potential conflict of interest, and activities which hinder or may hinder an employee’s ability to discharge his/her obligations to the company may be precluded by the code. An employee who breaches the requirements could be faced with dismissal (Wiley 137).”

Going through those scandals actually helped Ireland in the long run. They became aware of business ethics. The government and businesses in Ireland responded in time before the social and economic costs were devastating.

The Irish strongly believe in motivation and encouragement. Due to the economic and social growth that followed after the scandals of the 1990s and with the rising competition from globalization, performance management type systems introduced by the United States have contributed to the growth of a performance ethic (Keating 21). Ireland is characterized by team orientation. They work together because they want to use everyone’s skills to their full potential to achieve their goal. They are effective because of how they trust each other and how honest the group members are (Keating 17). Although Keating describes that relying on honesty characterizes the Irish society to have strong relationships within one’s social network instead of outsiders. With this said, it will be hard to earn a way into one’s network in Ireland. It is important to build a relationship first so the deal can go smoothly. Many countries vary when dealing with relationships with business partners. When people do business in other countries, they need to know this type of information in order to succeed. In Ireland, teams succeed because everyone is looked upon equally. According to GLOBE data, power distance is revealed to be high (Chhokar 370). “Power distance is the degree to which members of a society expect power to be distributed equally (Keating 11).” The Irish can be considered an informal society because they treat everyone equal and do not have title, but they do know their place. (Chhokar 370). With all the honest, trust, and encouragement comes a high humane orientation. “Humane orientation refers to how much a society rewards its members for being fair, altruistic and caring to others (Keating 20).” They believe in rewards to motivate their employees. Everything ties in together and that is why their power distance works in their culture. Even though they view everyone equally, that is completely not the case when it comes to gender.

A study on masculinity done by Hofstede in the workforce in 1980 revealed that woman just did not work in the labor force and it didn’t change for years. Although education did try to reinforce gender equality, but it wasn’t until 1991-2000 that women in the labor force increased from 35.9% to 47% and keeps on rising (Chhokar 371).

It is important for foreign managers to know that Ireland looks at gender slightly different, but it is changing slowly. Even though there is evidence of a breakthrough in females in the workforce, few will reach the top floor (Chhokar 378). During my interview with Ann Hinds I asked how women are viewed in the workforce. Ann Hinds pointed out that women are not excluded from top managerial positions, but there is still less than 50 % in those positions. Although, she said there are a few companies like her firm that have a 50/50 male to female ratio in top managerial positions. Matheson Ormsby Prentice is one of the # 1 practices in Dublin. With all this said by Ann Hinds, if foreign companies what to send women into top managerial positions in Ireland, they would have to find a company that has a good amount of women in the board room. Research is vital when doing business in other countries because each country is different in many aspects. Companies sending people to work in other countries need to know this information. Women are not looked down upon in Ireland, but it is unusual to see a female in top management.

There are many opportunities in Ireland. It is important to know their code of ethics and how they view ethical behavior when doing business within the country. It is vital to do Business ethics training before working in Ireland. They strongly believe in business ethics since the scandals in the 1990s cost them a great deal of money and issues. Once they concentrated on the study of business ethics and changed their ways of running companies, the issues declined greatly. In Ireland, employees rely on top management to set the bar for the code of ethics within a company. Since their attitude toward business ethics changed, Ireland has thrived and became a high income economy (Chhokar 365). Their business ethics is very similar to the United States which has thrived in the past for many years.

Appendix

Appendix A

Table 2 Cross-cultural Differences in Attitudes to the Implementation of Ethics in Business
Mean scores *
Attitude UK Irish US Sig T
Every company should have a code of ethics 5.0787 5.5758 5.7266 0.0001
Every industry should have a code of ethics 4.3244 5.0990 5.2400 0.0000
Business schools should include more ethics training for their students 4.9828 5.6500 6.3549 0.0011
Business school education has raised manager’s ethical standards 3.3078 3.6200 3.8007 0.0409
Outside intervention or consultancy would help managers in dealing with
Ethical issues 4.2792 4.2673 4.7216 0.0124
Ethical beliefs and standpoints should be a consideration in the selection
of managers 5.4751 5.9192 5.6724 0.0169
A major influence on business persons to behave ethically is increasing
public concern about ethical standards in business 4.5723 5.0808 5.1111 0.0010
λ 1 = strongly disagree
7 = strongly agree
434 EUROPEAN MANAGEMENT JOURNAL Vol 12 No 4 December 1994 (ALDERSON 434)

Appendix B

Table 3 Percentage of largish Managers Identifying
People-related Influences on Ethical and Unethical
Behavior in Organizations as Important
-
Attitude %
A culture of ethical behavior must come from
Top management in an organization 96
An implant contribution to ethical behavior
among business persons is ethical behavior
among top management 95
An important contribution to ethical behavior
among business persons is ethical behavior
among their peers 91
An important contribution to unethical behavior
among business persons is unethical behavior
among top management 88
An important contribution to unethical behavior
among business persons is unethical behavior
among their peers 84

435 EUROPEAN MANAGEMENT JOURNAL Vol 12 No 4 December 1994 (ALDERSON 435)

Work Cited

ALDERSON, S, & KAKABADSE, A. (1994). Business ethics and Irish management: a cross-cultural study. European Management Journal vol 12; 4 pg 432-441, 1994. Retrieved from

http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6V9T-45MGSG7-B-1&_cdi=5907&_user=2139755&_pii=0263237394900299&_orig=search&_coverDate=12%2F31%2F1994&_sk=999879995&view=c&wchp=dGLzVzb-zSkzk&_valck=1&md5=17d452acba62bbe690ede80acbfc9a5e&ie=/sdarticle.pdf

Ann Hinds
Matheson Ormsby Prentice
70 Sir John Rogerson's Quay
Dublin 2
Ireland
T: +353 1 232 2000
F: +353 1 232 3333
E: ann.hinds@mop.ie

Chhokar, J. S., Brodbeck, F. C., & House, R. J. (2007). Culture and leadership across the world The GLOBE

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Endorsement of Ethical Leadership in Ireland and the United States. Irish Journal of Management, 28(1), 5-30. Retrieved April 6, 2010, from ABI/INFORM Global. (Document ID: 1429543051). http://proquest.umi.com/pqdweb?index=0&did=1429543051&SrchMode=1&sid=1&Fmt=6&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1272311814&clientId=3326