Background and objectives Research suggests that parents of children supported on Extracorporeal Membrane Oxygenation (ECMO) may be at risk of posttraumatic stress symptoms (PTSS), although no specific investigations have been carried out. The current study explored PTSS in this group. Associations with family functioning and parenting self-esteem were also investigated. Method Parents were identified from the hospital database and recruited in a cross-sectional, single group design by postal invite. Participants (n = 52) completed questionnaires measuring PTSS, family functioning, parenting self- esteem, depression and anxiety. Results Participants reported levels of intrusion and hyperarousal symptoms which were not statistically different to those found in parents from a comparison paediatric population. Avoidance symptoms were significantly higher in the current sample. Participants reported significantly more effective family functioning than parents from a comparison paediatric population. Family functioning and parenting self-esteem were also greater than that reported in community samples. Family functioning was not independently 3 I DClinPsy project: PARENT EXPERIENCE OF ECMO associated with PTSS and PTSS were not independently associated with parenting self-esteem. Conclusions PTSS appear to be a problem for some parents of children supported on ECMO. While associations exist between family functioning, PTSS and parenting self-esteem, it seems likely that these are indirect relationships. 4

Eye Movement Desensitization and Reprocessing (EMDR) was developed by Shapiro (1989a, 2001) and was designed to facilitate the processing of distressing memories. It has since evolved into a standardised intervention for post-traumatic stress disorder (PTSD) that utilises elements from many different treatment approaches. EMDR has generated considerable debate, perhaps due to a lack of understanding of how it works. One aspect of EMDR procedure that has remained particularly controversial is the use of eye movements. Over the past twenty years there have been a number of studies investigating whether eye movements contribute to outcome in EMDR. Much of the research suffered from methodological flaws and therefore was inconclusive. More recently, researchers have begun to investigate why eye movements may be useful in EMDR by looking into possible psychological and neurophysiological mechanisms. This review provides an overview of research so far, including a description of two prominent theories of how eye movements might contribute to outcome in EMDR: the interhemispheric interaction account and the working memory account. Implications for clinical practice and future research are discussed.

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A recent Dual Representation Model of intrusive memory proposes that intrusions reflect involuntary reactivation of egocentric/hippocampally dependent representations in the absence of a corresponding allocentric/hippocampally independent representation (Brewin, Gergory, Lipton, & Burgess, 20 I 0). We investigated allocentric processing, following trauma, and examined whether PTSD sufferers have impaired performance indicative of reduced hippocampal functioning. Trauma-exposed individuals with (N=29) and without a diagnosis of PTSD (N=29) completed two tests of allocentric spatial processing. The first, a topographical recognition task comprising perception and memory components. The second, a virtual environment in which objects are presented and recognition memory is tested from either the same viewpoint as presentation (tapping egocentric memory) or a different viewpoint (tapping alloeentric memory). Participants in the PTSD group performed significantly worse on both tests of allocentric spatial processing than trauma-exposed controls. Groups performed comparably on egocentric memory and a non-spatial memory task of object list learning. These results show an unambiguous impairment in hippocampally dependent cognitive processes. As predicted by the Dual Representation Theory-Revised those with PTSD display impaired allocentric processing indicative of reduced hippocampal function . The clinical and research implications of this result will be discussed.

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In this research, two studies were conducted in order to examine the psychological, social, somatic and educational effects of chronic traumatic experience on Palestinian children over the six years of the Al-Aqsa Intifada (2000-2006). Firstly, a quantitative study was conducted which aimed to explore the long-term effects of war and occupation on the Palestinian children in the Gaza Strip. The sample consisted of 1,137 children aged between ten and 18 years randomly selected from all parts of the Gaza Strip to participate in the study. The participants completed a Checklist of Traumatic Experiences (CTE), a Symptoms of Post Traumatic Stress Disorder Scale (SPTSDS), a Network of Psycho-Social Support (NPSS) and a Personality Assessment Questionnaire (PAQ). This study found that every child in Palestine is likely to have been exposed to at least three traumatic events. Importantly, this study also found that 41% of the participants suffered from Post-Traumatic Stress Disorders (PTSD). This indicates that there are potentially more than 300,000 children in the Gaza Strip in need of psychological, social,and medical services in the areas of rehabilitation and therapeutic treatment. The study revealed that the support of family, friends, relatives, teachers, and spiritual leaders can be of great help. In addition to this, positive traits of personality can reduce the effects of PTSD. Secondly, a qualitative study aimed to explore, in more depth, the moderating factors relating to Palestinian children who have been exposed to chronic traumatic experiences, particularly the children who show low levels of PTSD. The sample consisted of six children interviewed in Arabic by using a semi-structured interview. They were aged between 13-18 years. The participants were selected according to the amount of traumatic events and level of PTSD experienced by the children who took part in the first study. This study found that the moderating factors and levels of influence which protected them from developing PTSD are positive personality traits and ideological commitment, psychosocial support, entertainment and adaptation or acclimatization. This research concluded that having a normal childhood in Palestine is unlikely in the current circumstances and the future psychological well-being of Palestinian children is at risk of being compromised by on-going traumatic experiences.

Text in Afrikaans / This study is aimed at the development of strategies for therapists to be used with adolescents and late adolescents (15 to 20 years of age) who have lost a loved one. This will be done by focussing on the redefining of identity as a way of becoming. The starting point of the study is to be found in the problem formulation that the process of becoming of adolescents who have suffered the loss of a loved one, may be blocked because they do not have the necessary skills to overcome the loss. The second problem is that therapists do not have the necessary skills to empower these adolescents so that the redefining of identity can be achieved. / Social work / D. Diac. (Spelterapie)

Text in Afrikaans / This study is aimed at the development of strategies for therapists to be used with adolescents and late adolescents (15 to 20 years of age) who have lost a loved one. This will be done by focussing on the redefining of identity as a way of becoming. The starting point of the study is to be found in the problem formulation that the process of becoming of adolescents who have suffered the loss of a loved one, may be blocked because they do not have the necessary skills to overcome the loss. The second problem is that therapists do not have the necessary skills to empower these adolescents so that the redefining of identity can be achieved. / Social work / D. Diac. (Spelterapie)