The possibility of positive psychological change following traumatic life experiences has now been well documented in the literature. This phenomenon is most commonly referred to as posttraumatic growth. Several theoretical models have sought to explain the development of posttraumatic growth, many of which have emphasised the important role of cognitive processing (Calhoun, Cann & Tedeschi, 2010; Tedeschi & Calhoun, 2004a). This thesis sought to further our understanding of the nature of posttraumatic cognitive processing and its association with psychological growth following trauma and adversity. A narrative review of the existing literature on cognitive processing and posttraumatic growth was conducted (Chapter 2) and suggested that cognitive processing might be best understood as comprising intrusive, deliberate and ruminative subtypes. Two cross-sectional studies and one longitudinal study were then conducted to develop and test this conceptualisation using samples of survivors of sexually traumatic experiences (Study 1; n = 123), trauma-exposed individuals recruited from trauma-focused websites and support forums (Study 2; n = 254), and trauma-exposed students from the University of Nottingham (Study 3; n = 174). The influence of these three subtypes of cognitive processing on levels of growth following adversity were also tested using the expressive writing intervention (Study 4; n = 24). Taken together, findings from the four studies supported the conceptualisation of cognitive processing as multidimensional, comprising intrusive, deliberate and ruminative subtypes that are differentially associated with posttraumatic growth. Results also provided consistent evidence to suggest that deliberate processing is especially important in the occurrence of growth following trauma and adversity. Unexpectedly, intrusive processing was not found to positively influence posttraumatic growth in the ways hypothesised by existing theoretical models. Implications of these findings with respect to both further research and clinical work with trauma survivors were reviewed in the final chapter.

Threat based risk factors previously found to be associated with PTSD were investigated in a clinical population of treatment seeking individuals. Building on previous research, within evolutionary psychology, this study conceptualised experiential avoidance, shame and self-critical processes as activators of an individual’s threat based affect system, following a trauma. These processes may play a central role in the sense of ongoing current threat found in PTSD sufferers. The concept of self-compassion was also investigated; this concept has been implicated in regulating threat based processes and moderating threat based responses. This study hypothesised that individuals higher in levels of self-compassion would demonstrate lower levels of PTSD symptomatology and that levels of self-compassion would moderate the effect of each threat based risk factor on PTSD symptom severity. Correlation and hierarchical multiple regression analyses were conducted and all hypotheses were either fully or partially upheld. An interesting and unexpected moderation effect was found between self-criticism and self-compassion. It was expected that self-compassion would fully moderate the relationship between self-criticism and PTSD symptom severity, however, results show that self-compassion only moderated this relationship when the level of self-criticism was low. This suggests that the interaction between self-criticism and self-compassion is more complex than originally thought. Implications of the findings as well as ideas for future research are discussed.

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Background: Differential relationships of the dimensions of psychopathy with external factors indicate that psychopathy can be conceptualised as a multifaceted syndrome comprised of distinct subgroups of psychopaths (Blackburn, 1988). However, it is not known whether similar subtypes of psychopathy exist across cultures. The research question which this thesis sought to answer was: Do subtypes of psychopathy exist among murderers, and if so, might the prevalence of these subtypes differ across cultures? Three aims were addressed: i) to compare the trauma histories, dissociative experiences and psychopathic features of British and South African men convicted of murder and the associations among them; ii) to test potential aetiological models of psychopathy; and iii) to explore whether subtypes of psychopathy could be identified among men convicted of murder. Method: Participants were 120 adult male prisoners serving sentences for murder. Sixty participants were British and incarcerated in prisons in England and 60 participants were South African and incarcerated in South Africa. Trauma, dissociation and psychopathy were measured using the Trauma History Questionnaire (THQ; Green, 1996), the Dissociative Experiences Scale (DES; Carlson & Putnam, 1993) and the Psychopathy Checklist-Revised Second Edition (PCL-R; Hare, 2003a), respectively. Results: South African participants reported significantly more traumatic and dissociative experiences and possessed more psychopathic features than their British counterparts. Structural equation modelling (SEM) analyses of the entire sample revealed that trauma was positively and directly related to the behavioural features of psychopathy, whereas trauma was positively and indirectly related to the affective features of psychopathy via the partial mediating role of dissociation, suggesting that subtypes of psychopathy may exist among murderers. In addition, cluster analyses identified subtypes of psychopathy, two of which parallel variants of primary and secondary psychopathy described in the literature. Conclusions: Dissociation may mediate the relationship between trauma and psychopathy among individuals who have experienced high levels of trauma, suggesting that there may be a threshold or a ‘cut-off’ level at which witnessing or experiencing trauma becomes detrimental for one’s psychological health. The prevalence of certain subtypes of psychopathy may differ across cultures. Findings have theoretical implications as well as implications for the treatment and risk assessment of offenders.

A growing body of research has indicated that the levels of suicidal behaviour are particularly heightened among individuals with Posttraumatic Stress Disorder (PTSD). Two theoretical models of suicide, the Cry of Pain Model of suicide (CoP; Williams, 1997) and the Schematic Appraisals Model of Suicide (SAMS; Johnson, Gooding & Tarrier, 2008) have proposed that perceptions of defeat and entrapment are key components of the psychological mechanisms which drive suicidal behaviour. The SAMS has also emphasized the importance of psychological resilience factors for preventing suicide risk. Resilience to suicide has been recently defined as a set of appraisals which buffer the impact of risk factors on suicidal behaviour. The first aim of this thesis was to investigate the role of perceptions of defeat and entrapment in suicidal behaviour in those with full or subthreshold PTSD. The second aim of this thesis was to obtain empirical evidence for the presence of resilience factors to suicidal behaviour in PTSD. Initially, a comprehensive narrative review and a meta-analysis were conducted to examine the magnitude of the association between various forms of suicidal behaviour and a PTSD diagnosis and the role of comorbid depression in this association. Both, the narrative review and the meta-analysis demonstrated a strong positive association between suicidal behaviour and PTSD, and supported the mediating impact of comorbid depression in this association. A re-analysis of a previous dataset of individuals with PTSD was also pursued to establish the relevance of negative perceptions/appraisals to suicidal behaviour in those with PTSD. Next, three empirical studies were designed to investigate the utility of perceptions of defeat and entrapment in explaining suicidal behaviour in those with full or subthreshold PTSD. The outcomes across the three studies supported the hypothesis that defeat and entrapment represent the proximal psychological drivers of suicidal behaviour in PTSD and fully account for the suicidogenic effects of negative self-appraisals and PTSD symptoms. Two additional empirical studies were conducted to examine resilience factors to suicidal behaviour among individuals with full or subthreshold PTSD. The first of these studies provided evidence that high levels of perceived social support buffered the impact of PTSD symptoms on suicidal behaviour. The last study supported the efficacy of a resilience-boosting technique, the Broad-Minded Affective Coping procedure (BMAC), to enhance the experience of positive emotions and improve mood amongst individuals diagnosed with PTSD. Together, the current results support the SAMS' postulation concerning the role of perceptions of defeat and entrapment in the emergence of suicidal behaviour in PTSD and highlight the importance of boosting resilience as a means of targeting suicidal behaviour in those with PTSD. Clinical implications of these findings are outlined throughout the thesis.

South African society has been a ected either directly or indirectly by some degree of trauma. Therefore the presence of a trauma unit within a hospital created the ideal opportunity for novice trauma counsellors to have practical experience. The present research is an exploratory study, designed in accordance with ethno- graphic principles in order to understand the psychological e ects of trauma on novice trauma counsellors. It focuses on themes that reverberate throughout the participants narratives. Vicarious trauma and compassion fatigue are two such e ects that were explored in this study. Research into compassion fatigue and vi- carious trauma span over several decades and researchers have moved from merely describing the symptoms of secondary traumatic stress to explaining it in terms of models that highlight the role of various factors that contribute vicarious trauma or compassion fatigue. This study concludes with recommendations to counter the e ects of experiencing secondary trauma. / (M.A. (Clinical Psychology))

South African society has been a ected either directly or indirectly by some degree of trauma. Therefore the presence of a trauma unit within a hospital created the ideal opportunity for novice trauma counsellors to have practical experience. The present research is an exploratory study, designed in accordance with ethno- graphic principles in order to understand the psychological e ects of trauma on novice trauma counsellors. It focuses on themes that reverberate throughout the participants narratives. Vicarious trauma and compassion fatigue are two such e ects that were explored in this study. Research into compassion fatigue and vi- carious trauma span over several decades and researchers have moved from merely describing the symptoms of secondary traumatic stress to explaining it in terms of models that highlight the role of various factors that contribute vicarious trauma or compassion fatigue. This study concludes with recommendations to counter the e ects of experiencing secondary trauma. / (M.A. (Clinical Psychology))

Violent crime and trauma are very common within the society and students at the technikon are as exposed to these traumatic situations that characterize the broader national context as anybody. The purpose of this study was to explore therapeutic intervention techniques that can be used by the educational psychologist in assisting students suffering from post-traumatic stress. The phenomena of post-traumatic stress and post-traumatic stress disorder were studied with reference to the DSM IV classification and description. Traumatic events and stressors among students were outlined. A case study was conducted with a subject selected at the technikon who was suffering from post-traumatic stress due to earlier physical abuse and violence she experienced at home. The Trauma-100-Questionnaire was used to investigate the extent of the trauma and the results showed that the subject was involved with negative self-talk and employed ego defence mechanisms. An analysis of the subject's problem was done through the relations theory and various techniques from the literature study were implemented in therapy with the subject. / Educational Studies / M.Ed. (Guidance and Counselling)

This study considers the history of trauma, both as a psychiatric concept and as a diagnosis, and its social and cultural representation from a transnational perspective after WWII. The intellectual evolution of trauma was determined by various medical, social and cultural variables, institutions, and people who wielded influence in the postwar world order as well as diverse local contexts. This thesis focuses on the globalisation and localisation of such concept and diagnosis shaped by international and local mental health experts at the World Health Organization and the National Taiwan University Hospital. Through the efforts of these experts, trauma not only became one of the most globally diffused psychiatric diagnoses, but also a hyperbole appropriated by Taiwanese psychiatrists to account for extreme forms of social suffering. Studies have criticised the universality and the Anglo-American-centred approach to the history of traumatic psychiatry. Scholars have also begun to explore transnational histories of psychiatry by systematically comparing or tracing the diffusion routes of psychiatric topics. Their methods of enquiry and problems solved, however, differ. My research analyses a disparate collection of evidence at the level of international organisations and from local aspects, allowing not only a critical reconsideration of trauma in the trend of global medicine, but also its reception, contestation and appropriation in the non-Western contexts. Guided by the works of medical historians, literary critics and cultural anthropologists, this project combines archival research with oral history interviews to challenge the existing historical accounts of trauma, and provide evidence of the limited capacity of globalised psychiatric norms and their reception and appropriation beyond the imagination of world citizenship. It argues that such scientific artefacts were not only produced through mutual reference between Eastern and Western experiences, but also measures of instrumental rationality employed by postwar internationalists to engineer their modernity in the Global South.

Violent crime and trauma are very common within the society and students at the technikon are as exposed to these traumatic situations that characterize the broader national context as anybody. The purpose of this study was to explore therapeutic intervention techniques that can be used by the educational psychologist in assisting students suffering from post-traumatic stress. The phenomena of post-traumatic stress and post-traumatic stress disorder were studied with reference to the DSM IV classification and description. Traumatic events and stressors among students were outlined. A case study was conducted with a subject selected at the technikon who was suffering from post-traumatic stress due to earlier physical abuse and violence she experienced at home. The Trauma-100-Questionnaire was used to investigate the extent of the trauma and the results showed that the subject was involved with negative self-talk and employed ego defence mechanisms. An analysis of the subject's problem was done through the relations theory and various techniques from the literature study were implemented in therapy with the subject. / Educational Studies / M.Ed. (Guidance and Counselling)