Over the last 20 years, advances in our understanding of the pathophysiology of severe traumatic brain injury (TBI) and in particular the contribution of secondary injury to poor outcome, has served to improve clinical management and reduce the mortality in these patients. However despite many promising preclinical studies there has been a failure to introduce a specific therapeutic intervention to further improve outcome. Inflammation, with cytokine release and leucocyte infiltration, is a significant secondary injury processes. However the inflammatory response to brain injury, its control and modulation remain incompletely described. Chemotactic cytokines, known as chemokines, are mediators of leucocyte recruitment and activation. Expression of chemokines and the resultant recruitment of leucocytes into the brain are generally thought to be integral to the enlargement of cerebral contusions which accompany clinical deterioration following severe TBI. Previous studies indicated that the main neutrophil chemokine, macrophage inflammatory protein-2 (MIP-2/CXCL2) and the monocytic chemokine, monocyte chemoattractant protein-1 (MCP-1/CCL2) are derived from glial. However the origin of these chemokines following TBI, has not been established. Furthermore, little is known about the modulation of these chemokines: The relationship of serum levels of pro-inflammatory mediators such as the human neutrophil chemokine, interleukin-8 (IL-8/CXCL8; a functional homologue of MIP-2/CXCL2), MCP-1/CCL2 and soluble interleukin-6 receptor (sIL-6R) to contusion enlargement has not been investigated. In this thesis, I investigated chemokine expression and modulation both in in-vitro, in-vivo models and in a clinical study. Initially, I compared chemokine expression in rodent and human glial cell cultures and investigated the modulation of chemokine expression by interleukin-6, the glucocorticoid dexamethasone and the immunosuppressant agent FK506. To investigate chemokine expression in-vivo I established the rat lateral fluid percussion injury (LFPI) model of TBI and measured MIP-2/CXCL2 and MCP-1/CCL2 expression in the brain following injury. Inhibition of this expression by dexamethasone and FK506 was then investigated. To identify the cellular source of chemokine expression I developed an immunohistochemical protocol for MIP-2/CXCL2 and MCP-1/CCL2. Finally, in a clinical study of serum chemokine and sIL-6R concentrations after severe TBI, I examined the relationship between these inflammatory mediators and clinical deterioration. Rat glia (microglia and astrocytes) produce chemokines with a response profile that was qualitatively similar to that of human derived cells. These chemokines were increased in the ipsilateral hemisphere following TBI. Surprisingly, immunohistochemical studies identified marked chemokine expression localised to cells with the morphology of degenerating neurones in contused tissue, rather than in glia. Furthermore, while dexamethasone significantly inhibited both MIP-2/CXCL2 and MCP-1/CCL2 expression in a rat astrocyte derived cell line, only MCP-1/CCL2 expression was reduced by steroid treatment in-vivo. Clinically, serum IL-8/CXCL8, MCP-1/CCL2 or sIL-6R were not significantly different in patients that deteriorated due to contusion enlargement from those that remained stable. However these inflammatory mediators were significantly increased in those patients that died. These studies indicate that astrocytes may not be the major source of chemokines following TBI and highlight the need for caution when inferring pathophysiological mechanisms from in-vitro studies.

Betrayal trauma theory (see Freyd, 1996) posits betrayal events often require "betrayal blindness" in order to limit awareness or memory of information regarding the betrayal. This occurs in order to maintain a connection that is necessary for survival. BTT may be applied to events that generally would not be considered traumatic, such as adultery or discrimination. In order to maintain connections within relationships, institutions, and social systems upon which there is a dependency, people (acting as victims, perpetrators, and witnesses) may show betrayal blindness. This dissertation consists of two studies investigating betrayal blindness and betrayal trauma history as they relate to charitable behavior. Study 1 included 467 college students at the University of Oregon who completed self-report measures of trauma history and a behavioral measure requesting a hypothetical donation. Contributions were requested for three scenarios that varied in level of betrayal: natural disaster, external genocide, and internal genocide. Results indicated no significant main effects for trauma history or type of event. However, people were less willing to donate to the group of recipients and the genocide conditions at low levels of emotional arousal. Additionally, those who have experienced high betrayal traumas also were less likely to donate at low emotional response values. Given the lack of significant findings in this experiment, a second study was conducted using a repeated measures design. Study 2 involved 634 undergraduate students at the University of Oregon. In addition to the measures from Study 1, participants also completed additional self-report measures assessing trait measures of prosocial tendencies, social desirability, personality, emotion regulation, and betrayal awareness. There were no main effects on charitable behavior for personality traits, prosociality, emotion regulation, social desirability, or betrayal awareness. Significant order effects were observed when comparing the type of event and betrayal level of event. A between-subjects approach revealed people donated less money to the higher betrayal versions of both types of scenarios. Across both studies, increased affect, particularly guilt, was associated with more charitable behavior. Although there are several limitations of these studies, the findings represent an important first step exploring prosocial behavior within a betrayal trauma framework.

Magistro darbo objektas – Socialinės ir kultūrinės traumos eksponavimas Lietuvos muziejuose. Darbo tikslas – išanalizuoti socialinės ir kultūrinės traumos eksponavimo problemą Lietuvos muziejuose. Pagrindiniai darbo uždaviniai: išnagrinėti smurtinio paveldo įtaką muziejus lankytojui; surasti subtilesnes socialinės bei kultūrinės traumos eksponavimo galimybes. Naudoti metodai: dokumentų analizės; bibliografinis; sociologinė apklausa derinant kokybinį bei kiekybinį metodus. Apklausa labiau orientuota į kokybinį metodą, tačiau pateikus skaičius ir procentus buvo gauta kiekybinė išraiška. Buvo pasitelktas klasikinės atrankos principas – apklausti muziejaus lankytojai. Taip pat remtasi tikslinės atrankos principu – apklausti muziejų darbuotojai, giluminis ekspertų interviu. Tai galima pavadinti optimalios atrankos principu: kuo geresnė atranka su esamais ribotais resursais. Prieita prie išvados, jog nagrinėjant istoriją, susiduriama su individo sąmonės ir grupės, besivadovaujančios vienodais dorovės ir gyvensenos principais savimonės ugdymo suderinamumo problema. Šiuo atveju kyla reali grėsmė, kad mokydamiesi istorijos iš vadovėlių ar muziejinių ekspozicijų, žinodami savo tėvų ir senelių patirtį, žmonės pasiklys painiuose istorinės sąmonės labirintuose. Siekiant sušvelninti ideologijos poveikį istorijos didaktikai, labai padėtų multikultūrinio švietimo principų taikymas muziejuje. Tai sudarytų sąlygas ne ideologizuoti, o supažindinti visuomenę su savos šalies istorija, parodant... [toliau žr. visą tekstą] / SUMMARY REFLECTION OF A SOCIAL AND CULTURAL TRAUMA IN AN EXHIBITION OF A MUSEUM By Vitalija Moisaitė-Žilinskienė First of all, museums are meant to satisfy visitors’ curiosity and their needs of information, aesthetics and education. It is not an easy task. So, what has to be done in order to meet those needs and to get out of those difficulties? In a modern museum it is not enough to display the relics of the past in its show windows. By means of performance as well as audio and visual media visitors are being invited to participate in the process of the reconstruction of the past. Museums are also keepers and caretakers of the past and memories about it in order to preserve it for would be generations. In this case we encounter not only the means of exhibiting but moral and ethics problems as well. How to avoid insulting and to remain impartial at the same time while exhibiting the period of war or post-war or discussing the subjects of genocide, holocaust, deportation or resistance? A lot of people are concerned. Events of such a kind are considered to be standard examples of the psychological trauma. How to arrange the exhibition and to display the events that caused the psychological and physical violence without distressing the eye-witnesses or their family members and relatives? Might it be so, that the mission of a museum is not only an impartial reconstruction of the history but subtle ways of presenting it to the visitors? In this case, museums are seen not only as... [to full text]

During traumatic events, individuals can experience dissociative symptoms related to changes in cognitively processing; these changes are suggested to impact on the development of posttraumatic stress disorder (PTSD) symptoms. Past literature has proposed two forms of peritraumatic dissociation (compartmentalisation and detachment), however little quantitative research has focussed on separately manipulating these experiences in order to further our understanding of their aetiology. The current study addressed this knowledge gap and additionally sought to understand the role of cognitive processing in the dissociation-intrusion relationship. Using an audio-only adaption of the trauma film paradigm, 60 participants were divided into three conditions and presented with different visual tasks - mirror staring, dot-staring or neutral images – that were hypothesised to induce the two forms of dissociation. Post-audio, a number of factors were assessed, including state dissociation, perceptual priming and conceptual priming, as well as intrusions over the following days. As hypothesised, participants in the dissociation conditions displayed an increase in perceptual priming compared the control conditions, and reported more severe intrusions. However, no differences were found in conceptual priming, in the overall number of intrusions between conditions, or in dissociative symptoms between the dissociation conditions. The current study utilised new techniques in the analysis of PTSD and its origins, and showed their potential in the experimental study of dissociation and analogue trauma techniques. The findings also contributed to the growing body of knowledge investigating the impact that dissociation and cognitive processing has on the aetiology of PTSD.

The research on pastoral counseling of persons struggling with complex trauma was undertaken with the aim of designing a practice-orientated model for pastoral counseling in order to guide such persons to emotional healing, stability and spiritual growth. An exegetical study throws light on the role of prayer and trust in God. One can entrust to God one's problems and one's supplication for help in the firm belief that He will provide a way out. An investigation into counseling perspectives in the Scriptures and in the literature on Christian counseling brought to light that pastoral counseling, which is a mandate given to believers, affords a unique opportunity for lovingly encouraging and consoling people with complex trauma. Contributions by psychiatry and psychology emphasise the phase approach. They stress security and stability, the processing of the traumatic memory and mourning, as well as a renewed commitment to new relationships. The core of the findings is that persons with complex trauma - which is an intricate syndrome relating to a spectrum of post-traumatic disturbances following intense, protracted and repeated trauma - can be guided by pastoral counseling to emotional healing, stability and spiritual growth. Specific reference is made to victims of prolonged family violence and/or physical and/or emotional and/or sexual abuse and/or protracted physical and/or emotional neglect in family context. The empirical research confirmed that the children of the Abraham Krielkinderhuis, Potchefstroom, who were subjected to these traumatic experiences in their parental homes exhibit the typical symptomatology of complex trauma. These entail emotional disturbances like anger and self-injury, disturbances of consciousness like dissociation, disturbances of self-image like stigma, guilt and shame, disturbances in the image of the perpetrator, like unrealistic expectations and finally disturbances in relationships like distrust and loss of faith. The principles and outcome of the empirical research are eventually applicable to all persons struggling with complex trauma. A practice-orientated counseling model was designed which focuses on stabilisation and security, the processing of the traumatic memory and mourning, as well as a renewed commitment to life in abundance and new relationships. In this therapeutic relationship of faith the distress narrative and the narrative of the past are central. God allows everything to turn out for the best for those who trust in Him. In Christ people are more than victors through God's will for their lives. / Thesis (Ph.D. (Pastoral))--North-West University, Potchefstroom Campus, 2006.

This study examines how people who have survived trauma have encountered healing following spiritual experiences. The significance of this research lies in its unique findings, contributing to the body of literature on trauma recovery. Qualitative methodology and thematic analysis were used to explore the research question that guided this study. Six individuals who had survived traumatic events participated in narrative interviews and were asked to tell the story of how their spiritual experiences impacted their healing from trauma. Findings show that these participants‘ spiritual experiences helped them to cultivate a foundation to return to in future moments of challenge, impacted the body‘s healing, and served as a guide. Further research in the field is suggested, including investigating how experiences with Kundalini energy impact trauma recovery, the relationship between spiritual experiences and physical healing, and how people from diverse cultural backgrounds experience trauma recovery in the wake of a spiritual experience. / Graduate

Cette thèse repose sur une recherche longitudinale portant sur l’évolution de la résilience chez des adultes confrontés à un risque de mort, évalués à 4 reprises : deux mois après le traumatisme puis après 9 mois, 17 mois et 24 mois. La résilience biologique est évaluée par l’évolution des dosages de cortisol analysés par prélèvement salivaire. La résilience psychologique a fait l’objet d’une évaluation multifactorielle à l’aide d’une échelle de résilience (Wagnild), d’échelles cliniques permettant de s’assurer de l’absence de séquelles sur le plan de l’angoisse (STAY de Spielberger), de la dépression (BDI 2), du syndrome post- traumatique (Traumaq) et du fonctionnement intrapsychique (Rorschach). L’analyse des résultats portant sur 30 sujets étudiés permet de développer une réflexion clinique comparative sur les paramètres et processus impliqués dans la construction de la résilience ou de son échec, en mettant en relation la dimension neurobiologique avec la dimension psychologique / This thesis is based on a longitudinal survey of the evolution of resilience for adults who faced a risk of death. Resilience has been measured 4 times: two months after the trauma, after 9 months, 17 months and 24 months. Biological resilience is measured by monitoring salivary cortisol. Psychological resilience was assessed multifactorially using the Wagnild scale ; several clinical scales to ensure absence of anxiety (Spielberger’s STAY), depression (BDI 2), post-traumatic syndrome (Traumaq) and intrapsychic functioning (Rorschach). Analysis of the results for 30 subjects allows to develop a comparative clinical thinking on the parameters and processes involved in the construction of resilience or its failure, linking the neurobiological dimension with the psychological dimension

The dissertation argues that depictions of cultural trauma in literature are a natural progression from depictions of individual trauma by tracing the development of trauma studies from its roots in Freudian psychoanalysis to its current position as an interdisciplinary field of study. It accomplishes this by focusing on one symptom of Posttraumatic Stress Disorder, a tendency to perceive illusory patterns - patterns that do not really exist, such as conspiracy theories - in response to feelings of helplessness that stem from a traumatic event. This study contends that depictions of illusory pattern perceptions, while they may initially suggest a simple and definitive answer to healing from the traumatic event if the individual can fully grasp the pattern and get others to see it, actually demonstrate an extension of the trauma by forcing the individual to continuously relive it. Through the use of poetry, fiction, film, and graphic novels from three lingering national crises - a chapter each for the Kennedy assassination, the Vietnam War, and 9/11 - this study demonstrates that the perception of an illusory pattern is a simplistic attempt to deal with the ramifications of a traumatic event which must be dismissed in favor of embracing the complexities of the trauma in order to move beyond it. Finally, in the conclusion this study argues that depictions of memorials in literature can serve as a positive alternative to the destructive force of illusory pattern perception.

The present research examined the effects of compound bows and crossbows on the remains of Sus scrofa and Odocoileus virginianus. Isolated pig heads and white-tailed deer necks were impacted by three forms of arrow heads: the broad-head tip, conical field-tip, and bullet field-tip from both the compound bow and the crossbow. The structural design of the arrowheads was examined to understand their level of impact, as well as, the velocities of the compound bow and crossbow were calculated and compared. The total number of impact marks for the experiment was 55. It was hypothesized that the compound bow would have a greater extent of trauma to bone than the crossbow due to the higher velocity created from a longer power stroke. It was also hypothesized that the broad-head arrow tip will create larger fracture patterns on bone due to the three-blade-prong design compared to the oval shape of both the conical field-tip and bullet field-tip. Through the use of one-way ANOVA and Pearson’s Chi-Square, the results show no direct correlation between the difference in the type of weapon used or the arrow tip used. The results show the vast majority of impacts are penetration with shapes that roughly resemble the cross-section of the type of tip used. The results, however, did not support both hypotheses due to the limited number of impact marks and sample size of the experiment. Further experiments are required to assess the extent to which it is possible to distinguish between arrow related osseous trauma.

Trauma-informed care (TIC) incorporates evidence about the prevalence and impact of early trauma on behavior across the lifespan. TIC is a person-centered response that focuses on improving client functioning by viewing and responding to maladaptive behavior in the context of traumatic experiences. TIC is grounded in the Adverse Childhood Experiences (ACE) study, a collaborative research project between the Centers for Disease Control and Prevention and Kaiser Permanente (Centers for Disease Control and Prevention, 2013a). The ACE study began in 1997 to collect information (n=17,337) via a 10-item survey about adverse childhood experiences related to abuse (emotional, physical, and sexual), neglect (emotional and physical), and household dysfunction (domestic violence, divorce, death of a parent, or the presence of a substance-abusing, mentally ill, or incarcerated member in the household). The ACE score reflects the total number of adverse experiences endorsed by that individual. Dozens of publications analyzing ACE data have revealed staggering evidence of the pervasive and enduring nature of early trauma. Findings are clear and consistent, demonstrating that as the number of early adverse experiences increases, the risk for myriad health, mental health, and behavioral problems in adulthood also increases in a robust and cumulative fashion (Centers for Disease Control and Prevention, 2013b). For example, as ACE scores increase, so does the likelihood of alcohol and drug abuse, smoking, chronic obstructive pulmonary disease, depression, suicide attempts, fetal death, obesity, heart disease, liver disease, intimate partner violence, early initiation of sexual activity, multiple sexual partners, sexually transmitted diseases, and unintended pregnancies. Furthermore, childhood adversity is associated with adult criminality, including sexual offending; sex offenders report significantly higher ACE scores than the general population (Reavis, Looman, Franco, & Rojas, 2013). Reavis et al. (2013) opined that it is therefore unsurprising that offense-specific models of sex offender treatment have produced mixed results in terms of effectiveness, and suggested that treatment programs should more strongly emphasize the role of early trauma on self-regulation and attachment. This 90-minute workshop will first provide an overview of the principles of trauma informed care. Participants will learn about the various ways that early trauma lays the groundwork for a range of interpersonal problems and maladaptive coping skills stemming from longstanding relational deficits and distorted cognitive schema about oneself and others. Then, workshop participants will learn to incorporate an interpersonal process approach to sex offender treatment, which combines elements of developmental, family systems, and cognitive models to conceptualize adult client behavior in the context of childhood trauma (Teyber & McClure, 2011). Participants will learn how to establish a nonthreatening sex offender treatment environment that facilitates trust, emotional safety, and intimacy. Participants will learn to utilize immediacy interventions to create corrective experiences; when clinicians respond effectively to relational themes and patterns as they present themselves in individual and group therapy, client skills can be enhanced, practiced, and reinforced. This workshop will reflect the conference theme of "Shouldering Responsibility: Making Society Safer" by introducing an innovative model and framework for promoting change. TIC recognizes the role of traumatic events in the development of high-risk behavior and values the subjectivity of trauma as a central function in the healing process. By exploring and understanding maladaptive and abusive behavior through the lens of early trauma, clinicians can help sex offender clients learn and generalize new skills, enhance their interpersonal relationships, and improve their general well-being (Teyber & McClure, 2011). This type of personal growth would be expected to mitigate future potential to reoffend as the client incorporates more healthy and successful strategies for relating to others and meeting emotional needs.