No description available.

Following exposure to trauma, stress reactions are initially adaptive. However, some individuals’ psychological response can become maladaptive with long-lasting impairment to functioning. Most people with initial symptoms of stress recover, and thus it is important to distinguish individuals who are at risk of continuing difficulties so that resources are allocated appropriately. Investigations of predictors of PTSD development have largely focused on relational and combat-related trauma, with very limited research looking at natural disasters. This study assessed the nature and severity of psychological difficulties experienced in 101 people seeking treatment following exposure to a significant earthquake that killed 185 people. Peritraumatic dissociation, posttraumatic stress symptoms, symptoms of anxiety, symptoms of depression, and social isolation were assessed. Descriptive analyses revealed the sample to be a highly impaired group, with particularly high levels of posttraumatic stress symptoms. Path analysis was used to determine whether the experience of some psychological difficulties predicted experience of others. As hypothesised, peritraumatic dissociation was found to predict posttraumatic stress symptoms and symptoms of anxiety. Posttraumatic stress symptoms then predicted symptoms of anxiety and symptoms of depression. Depression and anxiety were highly correlated. Contrary to expectations, social isolation was not significantly related to any other psychological variables. These findings justify the provision of psychological support following a natural disaster and suggest the benefit of assessing peritraumatic dissociation and posttraumatic stress symptoms soon after the event to identify people in need of monitoring and intervention.

No description available.

Call number: LD2668 .T4 1933 S33 / Master of Science

Traumatiska upplevelser som inte bearbetas kan ge somatiska symtom, i en del fall som uttryck för dissociation, så kallade somatoforma dissociationer. Patienter med dessa symtom söker sig till sjukvården där bristande kunskap om symtom på trauma kan fördröja adekvat behandling. Studiens syfte är undersöka traumainriktade terapeuters erfarenheter av arbete med patienter som har somatoforma dissociationer. Frågeställningarna är: Vilka upplevelser har psykoterapeuter av affektreglering och allians med traumatiserade patienter? Vilka symtom i form av somatoforma dissociationer ses hos patienterna? Hur kan man fånga upp traumarelaterad problematik inom sjukvården? Metoden är en kvalitativ undersökning i form av intervjuer med fem legitimerade psykoterapeuter som arbetar på traumamottagningar. Resultatet visar att somatiska symtom är vanliga hos traumatiserade patienter och att en del av symtomen kan betraktas vara somatoforma dissociationer. De somatiska symtomen kan ses som ett uttryck för obearbetade affekter och affektreglering är en väg till minskning av symtomen. I psykoterapin är tilliten en viktig del i alliansen. Slutsatser som kan dras är att somatoforma dissociationer kan behöva lyftas fram för att tydliggöra de somatiska uttryckens koppling till trauma. Inom sjukvården är det av vikt med ökad kunskap kring trauma så att patienten även får hjälp till affektreglering genom terapi och inte endast t ex fortsatt medicinsk behandling för somatiska och psykiska symtom. / Experiences of trauma that not are taken care of may give somatic symptoms, in some cases as signs of dissociation, so called somatoform dissociations. Patients with these symptoms search for help in the medical care where insufficient knowledge of trauma symptoms can delay adequate treatment. The aim of this study is to investigate therapists’ experiences of therapy with traumatized patients that have somatoform dissociations. The questions to be asked are: Which experiences do psychotherapists have of affect regulation and alliance with traumatized patients? Which symptoms do patients have that can be seen as somatoform dissociations? How can you be aware of trauma related problems in the medical care? The method is a qualitative approach based on interviews of five legitimated psychotherapists working with traumatized patients. The result shows that somatic symptoms are common in traumatized patients and that some symptoms can be seen as somatoform dissociations. The somatic symptoms can be seen as signs of unprocessed affects and affect regulation is a way to reduce the symptoms. In psychotherapy faith is an important part of the alliance. Derived conclusions are that somatoform dissociations need to be highlighted so that the link between somatic symptoms and dissociation can be clarified. In the medical care the knowledge of trauma is essential so that the patient also gets help with affect regulation and not only further medical treatment of somatic and psychological symptoms.

Sammanfattning Denna studie handlar om psykoterapi med patienter som upplevt relationella trauman i sitt vuxna liv eller som barn. Syftet med studien har varit att belysa hur erfarna psykodynamiska psykoterapeuter upplever arbetet med traumatiserade patienter samt hur terapeuterna tar hand om sig själva. Studien genomfördes med intervjuer. Frågeställningarna var; Hur upplever terapeuterna relationen mellan terapeut och patient? Hur upplever terapeuterna terapiprocessen? Hur uppfattar terapeuterna traumapatienten i förhållande till andra patienter? Hur upplever terapeuterna att de tar hand om sig, på arbetet och privat? Tre psykoterapeuter intervjuades som hade erfarenhet av att arbeta med traumatiserade patienter. Intervjuerna analyserades med fenomenologisk analys. Resultatet tyder på att relationen mellan terapeut och patient är det viktigaste för att uppnå resultat i traumaterapi. Att terapiprocessen bör vara fasinriktad och att det finns skillnader i arbetet med traumapatienter i jämförelse med andra. Resultatet visar också att terapeuternas sätt att ta hand om sig, självomhändertagandet, samt stödet från kollegor och ledning är avgörande för att orka med detta arbete.

No description available.

No description available.

No description available.

Cette thèse explore quelques facettes du rôle des infrastructures de transport urbain dans la fluidification des frictions du marché du travail causées par la dissociation spatiale entre les lieux de résidence et les opportunités d'emploi. Pour ce faire, elle est construite en trois chapitres.Dans le premier, nous construisons une série de fonctions d'appariement spatiales entre les travailleurs au chômage et les postes vacants qui tiennent compte de la dimension spatiale de la recherche d'emploi, qui dépendent des paramètres de l'infrastructure de transport et qui ne sont pas conditionnées par la structure de la ville dans laquelle l'appariement se déroule.Dans le second chapitre nous présentons un outil d'évaluation de politiques publiques novateur, utilisé ici pour mesurer l'impact de la performance de l'infrastructure et des services de transports publics franciliens sur les taux de chômage locaux et pour prédire l'impact du Grand Paris Express sur ces taux, mais qui peut être utilisé dans d'autres contextes et pour d'autres régions.Enfin, le troisième chapitre se penche sur les déterminants des distances domicile-travail parcourues par les travailleurs des ménages bi-actifs en région parisienne. L'objectif est de fournir des clés de compréhension de la demande de transport engendrée par l'augmentation constante de la part de ces ménages et de l'anticiper dans l'élaboration des politiques d'aménagement du territoire futures. / We explore in this thesis some aspects of the role played by the urban transport infrastructures in reducing the labor market frictions caused by the spatial separation between the places of residence and the job opportunities locations. To do so, this thesis is written in three chapters.In the first, we build a series of spatial matching functions linking jobless workers to vacant positions. These functions depend on the transport infrastructures parameters and are not conditional on the structure of the city in which the matching process occurs. In the second chapter we present an innovative public policy evaluation instrument used for measuring the impact of the Paris region transport infrastructures performances on the local unemployment rates and for predicting the impact of the Grand Paris Express on these rates. This instrument can be used in other contexts and for other regions. Last but not least, the third chapter analyses the determinants of the home-workplace distance of two-worker households' workers living in Paris region. The objective is to provide some clues to understand the transportation demand generated by the constant growth of the part of this kind of households and to anticipate it while designing the future planning policies.