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In 2009, South African police statistics revealed that more than 68 332 women were raped in the country. The evidence from independent researchers has shown that SAPS statistics are highly susceptible to under-reporting and the actual figure is more than double this amount. One pervasive feature of the phenomenology of rape is post-traumatic stress disorder (PTSD). PTSD is a highly debilitating condition with severe individual and societal costs. The condition takes a critical toll on occupational functioning, schooling and personal relationships and is associated with depression, suicide risk, self-harming behaviours and alcohol-abuse problems. The Ehlers and Clark (2000) cognitive model represents the most efficacious treatment for PTSD but the approach is severely under-utilised by South African practitioners working with sexual trauma. The reasons for such under-utilisation relate to a lack of exposure and training surrounding the model and concerns about the transportability of the treatment to a multi-cultural context. One method of addressing these barriers to treatment delivery is through systematic case-based research. Systematic case-based research offers a complementary means of refining theory and developing evidence-based practice in the context of a developing country. The method offers an intensive analysis and description of the particular phenomena under study within its real-life context. It allows the researcher to intensively examine and identify the specific aspects of the therapist’s responses and client’s reactions that contributed to significant change. Unlike efficacy studies, generalisability in case-study research is based on replication on a case-by-case basis and the creation of case law. This research study uses a systematic-case study approach to investigate the applicability of the Ehlers and Clark (2000) model in the treatment of rape-related PTSD in South Africa. The study aims to demonstrate the transportability of the model and develop a needed evidence base for service providers in the country. Seven women participated in the project and lent their treatment process to the research. The participants varied in terms of age, race, culture, socio-economic status and the nature of their sexual trauma. Through synoptic thematic analysis of their therapy process specific client-related personal aspects, client-related contextual factors and state-level factors were found to impede treatment delivery and implementation. The implications of these aspects for clinical practice and social policy are comprehensively discussed.

This study uses a multiple regression correlational (MRC) analytic approach to examine the association between witnessing violence and reactive aggression, post-traumatic stress, and insecure attachment. One hundred adult male California State University students were surveyed using the Conflict Tactics Scale, the Adolescent Anger Rating Scale, the Inventory of Parent and Peer Attachment scale, the Child Report of Post Traumatic Symptoms scale, the Conduct Disorder scale, and the Modified Impact of Events scale.

Thesis (Ph.D. (Social Work)) -- University of Limpopo, 2021 / An Emergency Medical Service (EMS) is considered one of the most stressful work environments. Copious literature has demonstrated that emergency service work has an undesirable impact on the health and wellbeing of personnel. In South Africa, research findings described that emergency services personnel are among the highest group of professionals at risk of suffering from job-related stress. In spite of the fact, previous studies have examined the association between critical incidents and Post Traumatic Stress Disorder (PTSD) symptoms including the psychological influence of trauma, a minority studies have explored the EMS personnel’s traumatic experiences and the subsequent coping strategies applied. This study sought to explore and describe the lived experiences of Emergency Medical Personnel in Capricorn District and to develop a user led model for mitigating occupational stress among EMS personnel. The principal aim of this study was achieved through the following objectives; to profile work related stress and the lived experiences of EMS personnel in Capricorn District, to Identify and appraise coping strategies employed by EMS personnel, to establish how accessible and user friendly EAP services are to EMS personnel, to determine the nature of social support (colleagues and supervisors) EMS personnel receive and to develop a user-led model for EMS personnel. This study was rooted in three theories, namely; trauma theory, resilience theory and the strengths perspective theory. The three theories were appropriate in this study to offer a perspective of situation and to analyse the situation under study to provide an understanding into the way in which EMS personnel make sense of their situation of the challenges they come across and make use of the available resources. The three theories interlaced together played a critical role in this study as they both align with building resilience, recognise individual’s innate strengths and coping in the face of hardship. Owing to the inimitability role of the emergency personnel and the services’ work context, the study adopted a qualitative approach. The purpose of the study was exploratory descriptive in nature. Exploring both their experience of critical incidents and the coping strategies employed by them to mitigate work-related stress and traumatic incidents from this qualitative perspective allowed the researcher to employ phenomenological research design for this study. A sample size of 21 emergency employees comprising 7 station managers and 14 EMS personnel) was obtained through purposive sampling technique. Thematic analysis was used to analyse data.  The findings suggest that life in the emergency field can possibly have an undesirable long-term effect on employees’ overall health and welfare and higher risk of PTSD. The distressing incidents were those in which the participants experienced feelings of vulnerability and had no control of the situations. The study established that emergency personnel find it most hard to deal with incidents involving children and colleagues. Emergency personnel suffer from emotional and physical stress owing to high job demands and repeated exposure to traumatic incidents. Regardless of the traumatic nature of emergency work and the inimitable role of emergency personnel, this study discovered that fact several stressors originate from organisational failure such lack of involvement in decision-making process, lack of training and shortage of staff. Unsupportive work environment, Lack of personal and job resources were found to be the extensive contributory factors to the job pressure experienced by which lead to compassion fatigue and exhaustion. It was also discovered the current EAP programme in the Department of Health (DoH) is not known and inaccessible to EMS personnel. The coping strategies utilised by emergency personnel were not adequate to prevent the aftermath of critical incidents. However collegial and social support from supervisors were found helpful in dealing with work-related stress. The study findings revealed that emergency personnel were unaware of the available support services within the DoH in Capricorn District. Collectively, the findings confirm that there is a need for an extensive marketing strategy of the EAP services and the user-led model which will be implemented by the organisation. The researcher recommends that EAP policies should form part of package given to new recruits during induction or orientation programme and diverse marketing strategies should be adopted to familiarise employees with EAP services available to them. The DoH should consider decentralisation of EAP services to enhance accessibility.

This quasi-experimental study investigates neuropsychological functioning differences between 63 active duty soldiers who were placed into three groups (MTBI, PTSD, control) to provide better information for differentiating PTSD and MTBI. The ANAM and MicroCog were utilized to measure psychomotor speed, memory, and attention. Participants with PTSD performed worse on most measures of psychomotor speed and attention, and endorsed more symptoms of depression and anxiety when compared to MTBI and control participants. Further, attention appears to be the best cognitive domain for differentiating PTSD from MTBI, whereas memory variables did not differentiate these groups. Clinical and research implications of these findings are discussed.

This study acknowledges the fact that compassionate witnesses working with traumatised clients suffer from secondary traumatisation. Weingarten (2000, 2001, 2003) and Figley (1995) are some of the authors on this subject. The study is based within the Zimbabwean context, which is going through a period of transition involving political and economic factors. Survivors of political violence seek assistance from counselling agencies like CONNECT and Mopane Trust. Mopane Trust chose to specialise in this work through counselling and research. This study explores how Mopane Trust trauma counsellors cope with secondary trauma. / Practical Theology / M.Th. (Pastoral Therapy)

The biological energy concepts used by Freud to account for unconscious mental processes in psychoanalysis are discredited by modem biological findings. As a result, different psychoanalytic schools developed new foundational theories in order to verify unconscious mentation. The present study argues that these theories are unsuccessful for two main reasons. Firstly, replacing Freud's drive energy theory with other equally hypothetical foundational constructs does not solve the problem of finding proof for the existence of unconscious mentation. Secondly, the clinical psychoanalytic definition of unconscious mentation as imaginary, internally generated processes, autonomous from the external world is misguided. External sensory data may play a formative role in producing unconscious mentation. In particular, neurobiological findings on sensory data encoding and storage in human infants may throw light on the nature of unconscious processes. The present study therefore compares ideas derived from Lacanian psychoanalysis with neuropsychological memory and infant research findings to ascertain whether unconscious mentation is linked to the memory encoding of sensory data in infants. This analysis is in tum contrasted with a more contemporary psychoanalytic synthesis of findings on infant memory and unconscious mentation (Lichtenberg, 1989, Lichtenberg, Lachmann, and Fosshage, 1992). The latter theory identifies connections between unconscious mentation and the encoding of sensory memories in infancy, but does not connect the episodic and procedural memory constructs used in this account to specific neurolo·gical mechanisms in the brain. The present study's original contributions therefore involve firstly connecting the development of aversive episodic and procedural memories to neurological mechanisms in the brain during the period between birth and 28 months of age. Secondly, this memory model suggests that the storage of aversive memories in infancy has lasting unconscious motivational significance for subjects. Presymbolic memories may unconsciously manipulate conscious attention and memory retrieval in verbal subjects, inviting comparison with the psychoanalytic concept of dynamic unconscious mentation. Thirdly, the presymbolic memory model contributes towards a novel understanding of false memories of childhood sex abuse, and the dissociation of real traumatic memories that occur in many cases of Post Traumatic Stress Disorder. / Psychology / D.Litt. et Phil. (Psychology)

Thesis (MA (Psychology))--University of Stellenbosch, 2008. / Few studies have assessed the prevalence of Post-Traumatic Stress Disorder (PTSD) associated with the receipt of an HIV-positive diagnosis and no published studies in South Africa have used a structured clinical interview to assess the above-mentioned. The present cross-sectional study assessed the prevalence of HIV-related PTSD among a sample of recently diagnosed patients attending public health clinics in the Boland region of the Western Cape. The PTSD module of the Composite International Diagnostic Interview (CIDI), together with a battery of self-report instruments assessing symptoms of traumatisation, depression and anxiety were administered to 85 patients who had been diagnosed with HIV in the year preceding data collection. In addition, HIVrelated PTSD and symptomatology were assessed using an adapted version of the PTSD module of the CIDI. The self-report instruments administered were (a) a demographic questionnaire, (b) the Posttraumatic Stress Diagnostic Scale (PDS) which assessed current PTSD symptom severity, and (c) the 25-item Hopkins Symptom Checklist (HSCL-25) which assessed psychological distress, and symptoms and intensity of anxiety and depression. The primary aim of the present study was to determine the prevalence of HIV-related PTSD among a sample of recently diagnosed HIV-positive individuals attending HIV clinics in the Boland region. The second aim was to determine the lifetime prevalence of PTSD among the sample. The third aim was to determine the percentage of the sample that endorsed the DSM-IV’s PTSD A2 criterion and the subsequent HIV-related PTSD symptomatology among those who did and did not meet full criteria for HIV-related PTSD. The fourth aim was to determine the level of psychological distress reported by the sample. The prevalence of lifetime PTSD was 29.4% (95% confidence interval [CI], 20.7% - 39.8%). Sixty-nine of the eighty-five participants (81.2%) endorsed the DSM-IV’s PTSD A2 criterion. Of the total sample, 34 participants (40%) (95% CI, 30.2% - 50.6%) met the full criteria for HIV related PTSD. The majority of participants reported mild PTSD symptom severity (45.8%). Over half the sample (51.4%) experienced clinically significant distress. Of those participants diagnosed with HIV-related PTSD, 82.4% were clinically distressed, and 76.5% and 58.8% experienced high levels of depression and anxiety, respectively. The present study’s findings suggest that receiving an HIV-positive diagnosis and/or being HIVpositive may be considered a traumatic stressor that frequently results in HIV-related PTSD. Findings of the present study indicate the need for adequate support and care for HIV-positive individuals. Given the various barriers to efficient mental health interventions and services in South Africa, there are significant challenges that need to be addressed in order to ensure that the mental health and welfare of HIV-positive individuals are both adequately assessed and appropriately maintained.

Thesis (MEd(Psych)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: This study explores the use of Eye Movement Desensitisation (hereafter referred to as EMDR), a form of psychotherapy on a female adolescent sexual assault survivor. Adolescence as a developmental stage is characterised by specific issues, such as the search for own identity. Sexual trauma may increase the inner conflict, because of the adolescent's ability to deal with the trauma at a higher cognitive level than in earlier childhood. Without support including psychotherapy, the adolescent sexual assault survivor may be at risk of developing mental health problems including Post-traumatic Stress Syndrome (hereafter referred to as PTSD). This research is a qualitative case study, involving only one adolescent participant. Mary (pseudonym) a sexual assault survivor, was selected from referrals the Unit for Educational Psychology at the University of Stellenbosch received from the Child Protection Unit of the South African Police Services. She was referred because she displayed symptoms of depression and PTSD, which affected her relations with her parents, siblings and peers. She also struggled to cope emotionally with the academic demands of school. The ecosystemic approach was chosen as the preferred framework within which to locate this study. In assessment and intervention this framework lends itself to focussing on relationships and systems rather than merely the individual with a problem. The study explores the use of EMDR to alleviate symptoms of depression and PTSD in Mary. She attended thirteen sessions of which the first three were used to assess her level of functioning. Data were collected by means of self-report questionnaires including the Beck's Depression Inventory and the Dissociative Experiences Scale, interviews and therapy sessions during which EMDR was used. The data were analysed using codes, categories and themes, interpreted and the study concluded with a discussion of the findings. The findings suggest that EMDR effectively alleviated Mary's symptoms of depression and PTSD. However, since the study was limited to a single participant, a larger sample is recommended to determine whether EMDR might be a feasible treatment tool for female adolescent sexual assault survivors. / AFRIKAANSE OPSOMMING: Hierdie studie ondersoek die gebruik van Oogbeweging Desensitifisering Herprosessering (hierna verwys as OBDH), 'n tipe psigoterapie, om 'n vroulike adolessente slagoffer van seksuele misbruik te ondersteun. Adolessensie as 'n ontwikkelingsfase word deur spesifieke kwessies gekenmerk, onder andere die soeke na 'n eie identiteit. Seksuele trauma mag die innerlike konflik verhoog, weens die adolessent se vermoeë om dit op 'n hoër vlak van ontwikkeling as die jonger kind te hanteer. Sonder ondersteuning, insluitend psigoterapie, mag die adolessent die risiko loop om geestesversteurings soos Posttraumatiese stresversteuring (hierna verwys as PTSV) te ontwikkel. Hierdie navorsing was 'n kwalitatiewe gevallestudie en slegs een adolessente deelnemer was daarby betrokke. Mary (skuilnaam) 'n seksuele geweld oorwinnaar, is gekies vanuit verwysings wat die Eenheid vir Opvoedkundige Sielkunde van die Universiteit van Stellenbosch van die Kinderbeskermings-eenheid van die Suid-Afrikaanse Polisie Dienste ontvang het. Sy is verwys aangesien sy blykbaar simptome van depressie en PTSV geopenbaar het, wat haar verhoudings met haar ouers, sibbe en portuurgroep beïnvloed het. Sy het ook emosioneel gesukkel om die akademiese eise van die skool te hanteer. Die ekosistemiese benadering is gekies as die raamwerk vir hierdie studie. In assessering en intervensie lê dié benadering groter klem op verhoudings en sisteme, as op 'n individu met 'n probleem. Die doel van hierdie studie was om vas te stelof die gebruik van OBDH verligting van simptome van depressie en PTSV in Mary teweeg sou bring. Sy het dertien sessies bygewoon en die eerste drie is gebruik om haar vlak van funksionering te bepaal. Data is ingesamel deur middel van die Beck's Depression Inventory en die Dissociative Experiences Scale vraelyste, onderhoude en terapie sessies waarin OBDH ook gebruik was. Die data is ontleed deur middel van kodes, kategorieë en temas, geïnterpreteer en die studie eindig met 'n bespreking van die bevindinge. Die bevindinge het aangedui dat OBDH effektief Mary se simptome van depressie en PTSV verlig. Omdat die studie egter beperk was tot 'n enkele deelnemer, word 'n groter getal deelnemers aanbeveel om te bepaal of OBDH moontlik geskik is om vroulike adolesente oorwinnaars van seksueel geweld te ondersteun.

Research psychologists often complain that practitioners disregard research evidence whilst practitioners sometimes accuse researchers of failing to produce evidence with sufficient ecological validity. The tension that thus arises is highlighted, using the specific illustrative examples of two treatment methods for post-traumatic disorder (PTSD): Eye-Movement Desensitisation and Reprocessing (EMDR) and exposure based interventions. Contextual reasons for the success or failure of particular treatment models that are often only tangentially related to the theoretical underpinnings of the models are discussed. Suggestions regarding what might be learnt from these debates are put forward and implications for future research are discussed.