Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

En référence au développement croissant ces dernières décennies des témoignages écrits autour des expériences traumatiques comme le génocide arménien, la Shoah, le Cambodge, l‟Indochine, l‟Algérie, le Rwanda, l‟ex-Yougoslavie, les dictatures européennes, d‟Amérique latine, les Goulags, force est de constater que nombre de ces témoins expriment cependant l‟impossibilité de communiquer de telles réalités qui ont été invivables. Dès lors, comment comprendre que malgré cette « incapacité » d‟écrire l‟expérience telle qu‟elle a été vécue, des textes foisonnent à tel point que l‟on parle d‟un « nouveau genre littéraire » ? Or, s‟il est vrai que les témoignages se sont multipliés depuis la Seconde Guerre mondiale, nous verrons qu‟écrire l‟expérience traumatique existe depuis bien longtemps. L‟hypothèse centrale est la suivante : le témoignage de l‟expérience traumatique est une réappropriation d‟une histoire par/pour ceux qui l‟ont vécue. Le témoignage est une révélation aux autres, un acte d‟exhumation, une libération. Mais le problème ne s‟arrête pas là, les autres générations se verront elles aussi confrontées à la question d‟élucider leurs histoires, à témoigner. Une problématique fondamentale accompagne l‟ensemble de la recherche, celle de donner du sens au non-sens. / When looking at the increasing number of written testimonies about traumatic experiences in the past decades, such as the Armenian Genocide, the Holocaust, Cambodia, Indochina, Algeria, Rwanda, ex-Yugoslavia, and in European and Latin American dictatorships, the Gulags, we cannot but stress that most of these accounts express the virtual impossibility of communicating unbearable realities. Consequently, how is it that in spite of this apparent « inability » to write about one‟s experience, so many texts have been produced and that while these experiences are qualified as inexpressible and unspeakable, the emergence of a « new literary genre » has been identified? The central assumption is as follows: The testimony of the traumatic experiment is a reappropriation of a history for those which lived it, and makes it possible to emerge from this same history. But the question will also arise for those which did not live the experiment directly. Fundamental problems accompany the unit by research, that to give sense to the nonsense.

M.A. / The prevalence of rape in the world and particularly in South Africa, calls for the understanding of the factors involved in rape. In particular, it is necessary to understand rape in terms of the victim, not just in terms of the prevalence, causes and social consequences of rape. The victim’s experience of rape is complicated and takes place over a journey that progresses from the assault, through her responses and psychological and social reactions to her recovery from the trauma. It is imperative that a clear understanding of previous research is gained in order to understand the existing epistemological picture of the rape victim’s experience. This dissertation has intended to achieve this understanding by reviewing the literature that has explored rape victim’s responses after the rape, the psychological and social impact the rape has had and the recovery process after the rape. In each of these instances the factors that are identified by research as influencing the rape victim’s experience are surveyed. The victim’s responses to rape are traumatic. It is therefore important to understand the nature of trauma and in particular Post Traumatic Stress Disorder (PTSD). Rape Trauma Syndrome (RTS) in particular describes the traumatic responses of a rape victim. There are factors that influence the extent that the victim experiences responses to a rape. These factors include the extent to which a victim is believed about the rape, the extent to which it is thought that the victim precipitated the assault. Her own attributions about the rape will also influence her responses, as well as the nature of the assault, the level of violence, prior victimisation, past psychological treatment or mental illness, poor social support and other life stresses experienced at the same time as the rape. The victim does not only respond to the traumatic experience after a rape, but may also experience the psychological impact a rape may have. Reactions such as fear, anxiety, anger, aggression, guilt, shame, doubt, depression and psychopathology may be experienced as psychological reactions to a rape. The victim may also experience the impact a rape can have on her social functioning. She may withdraw socially and experience problems in her sexual functioning. The research reviewed indicated that there are factors that influence the extent that these reactions may impact on the victim’s life, if at all. These factors include: participation in the justice system, social support received after the rape, 8 cognitive appraisals made by the victim and possible psychological problems prior to the assault. The final part of a victim’s journey is the recovery. Recovery can be described the psychological work that is required by the victim. As with the responses and reactions that a rape victim experiences, the recovery process is also a journey that is dependent on many influencing factors. The factors that are identified as influencing the recovery process of the victim, both by enhancing it and by hindering it, include: demographic variables of the victim, previous victimisation, functioning before the rape (including chronic life stress and family grief, the nature of the assault, the relationship of the victim to the assailant, social support received after the rape, and the meaning the victim gives to the ordeal. This study of the existing literature concerning the journey of the rape victim through the responses she has after the rape, to the impact of the rape on her psychological and social functioning, to her recovery has highlighted the importance of influencing factors on this journey. It has also been noted by this study that there is a lack of evidence that can shed light on the factors that may influence the South African rape victim’s experience.

M.A. / The literature indicates that journalists who experience work related traumatic situations, are at risk for the development of Posttraumatic Stress Disorder (PTSD) (Teegen & Grotwinkel, 2001). Moreover, some journalists who develop this disorder do so after covering a relatively minor traumatic story (Castle, 2001). Certain temperament traits have been implicated as vulnerabilities to the development of Posttraumatic Stress Disorder (PTSD) in police officers (Henning, 1999). Few research studies have investigated temperament and sense of coherence as mediating factors for occupational stress in journalists exposed to trauma. The aim of the present study was to address this dearth by investigating whether there are statistically significant differences in the experience of trauma, temperament traits and sense of coherence of journalists with varied responses to occupational stress and trauma. The Impact of Event Scale-Revised was used to divide journalists into three groups, namely those with minor reactions to trauma (n=10), moderate reactions (n=24) and severe reactions of clinical importance (n=16). The first group of hypotheses posed in the study pertains to group differences and postulates that the three groups will have statistically significant differences regarding trauma exposure. The second group of hypotheses deals with group differences and postulates that the three groups of journalists will differ regarding certain temperament dimensions. The third group of hypotheses formulated for the study proposes group differences regarding sense of coherence. Analysis of Variance followed by the Scheffé post hoc multiple comparisons technique indicated statistically significant differences between the three groups regarding experience of trauma as measured by the Trauma Questionnaire; certain temperament-personality traits as measured by the Personality Assessment Inventory and the Zuckerman-Kuhlman Personality Questionnaire; and sense of coherence as measured by The Sense of Coherence Questionnaire. The study revealed that the group with severe reactions to stress and trauma had been exposed to intense trauma involving people and that they report significant emotional reactions to the trauma. The Personality Assessment Inventory indicated that the severe reactions group has temperament profiles characterised by somatic complaints, anxiety, depression, paranoia, borderline features, aggression, suicidal ideation, stress and treatment rejection. This group also showed greater neuroticism-anxiety and aggression-hostility prone temperament types than the other two groups as well as lower comprehensibility and manageability as indicated by the Sense of Coherence Scale. The results of the present study exhibit support that there are various factors that could have an impact on how journalists deal with the traumatic stories they cover and what their personal outcomes are after covering these stories. Journalists who develop severe PTSD have different perceptions of the trauma, temperament profiles and sense of coherence that impact on their ways of coping with the traumatic situations they face daily. Criticism of the study deals mainly with gender, age, race and the subjects' pre-testing history, which were not controlled for. Another possible shortcoming of the research is that the journalists were sourced from main stream publications as well as community papers. This might have had an impact on the amount and type of trauma the journalists were exposed to. It would have been preferable to include a greater number of participants in the study to more efficiently address the many variables. Lastly, pre-trauma temperament traits were not controlled for, due to the complexity and ethical complications involved in the subject matter. It is recommended that age, gender, race, pre-testing history and pre-trauma traits is controlled. This will however require a large sample of journalists, which was not available for the present study. It would also be beneficial to compare frequency and type of trauma exposure, PTSD and temperament in a comparative study where community journalists are compared with main stream journalists. Lastly, the development of South African measures for temperament, PTSD and trauma would be highly advantageous to this field of research.

Magister Scientiae (Physiotherapy) - MSc(Physio) / The distressing event of Spinal Cord Injury (SCI) leads to complete or incomplete injury, and results in many complications such as such as neurogenic shock, cardiovascular disease, temperature regulatory problems, respiratory complications, dysphagia, thromboembolism, and pressure ulcers amongst others. These complications limit the individual’s functioning and participation. Participation is fruitful and meaningful when you are actively involved in a specific activity. To understand the lack of participation within a specific setting, it is important to know what the limitations in activities are, and what causes these limitations. The goal of rehabilitation should be to reintegrate patients back into the community so that they can fulfil their roles. Aim: The aim of the study was (1) To determine included participants’ socio-demographic and injury characteristics; (2) To describe healthcare services received by people living with long-term Traumatic Spinal Cord Injury (TCSI) over the past 12 months; (3) To determine the point prevalence of common activity limitations of survivors of TSCI four years after injury; (4) To determine the point prevalence of participation restrictions of survivors of TSCI four years after injury; and (5) To determine factors associated with activity limitations and selected participation restrictions four years after injury.

Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease that is associated with repetitive traumatic brain injury like those sustained in sport, military combat, and other activities with repetitive head impact exposure. Repetitive head impacts typically cause mild traumatic brain injury (mTBI) resulting in both concussive and subconcussive injury. Repeated mTBIs injuries appear to cause an abnormal accumulation of proteins, including hyperphosphorylated tau (p-tau) and TDP-43, progressive axonal failure with gradual structural degradation, microvascular disruption, breach of blood-brain barrier, neuroinflammation and microglial activation; each of these manifestations lead to axonal degeneration and neuronal death, which impairs neuronal pathways and are likely to give rise to CTE symptoms. CTE can be microscopically characterized mainly by p-tau accumulation in perivascular spaces and at the depths of the cortical sulci. Clinical presentation of CTE may include behavioral, mood, cognitive, or motor symptoms. Some of the common symptoms include impulsivity, aggression, anxiety, depression, memory impairment, dementia, and suicidality. The Locus Coeruleus (LC), a nucleus in the pons of the brainstem, is suspected to be involved in CTE. The LC provides the main source of norepinephrine to the entire brain and is critical for its control over arousal, behaviors, attention, and memory. Dysfunction of the locus coeruleus has shown to cause a wide array of symptoms, many of which are similar to those seen in CTE. Furthermore, the LC is affected in many other neurodegenerative diseases and is believed to be responsible for the progressive and widespread nature of the various diseases and their clinical symptoms. Although the LC has been implicated in CTE there have been no studies examining LC pathology in relation to the disease progression or its symptoms. We hypothesize LC CTE pathology should increase with the severity of CTE. Furthermore, increased CTE pathology in the LC should create disturbances to the LC and the LC-NE system and manifest clinically. Specifically, LC CTE pathology may be associated with age of onset of general behavioral and cognitive symptoms as well as individual symptoms and outcomes including impulsivity, depression, depressed mood and death by suicide. To determine this, a postmortem study was performed on 184 individuals with a history of RHI and no comorbid diseases examining the relationship between AT8-immunopositive tau density in the LC and various clinical variables. The study found that LC AT8 density showed a significant positive correlation with duration of repetitive head impact (RHI) exposure when controlled for age. There also was a significant increase in LC AT8-immunoreactive tau in cases with stage III and IV CTE compared to those with no CTE and stage I and II CTE, and AT8 density was predictive of CTE stage when controlled for age. There were no significant relationships found between density of LC AT8-immunoreactive tau and age of any CTE symptom onset or individual symptom (impulsivity, depressed mood, MDD, death by suicide) presence. Future studies should continue to evaluate CTE pathology in the LC and its effects on both the pathological and clinical characteristics of the disease.

Cognitive vulnerabilities have been implicated in the development of post-traumatic stress disorder and alcohol use disorders, two disorders that commonly co-occur. The comorbidity of these two disorders continues to pose a significant threat to the well being of university students. This study investigated the associations between the cognitive vulnerability of negative attributional style and both post-traumatic stress symptoms and alcohol use patterns. The number of reported traumatic events were also included in analyses. A battery of self-report questionnaires was completed by 123 university undergraduate students (mean age of 20.41 years). Negative attributional style was found to be significantly associated with post-traumatic stress symptoms, but not with alcohol use. It was also suggested that multiple traumas have an impact on post-traumatic stress, despite levels of alcohol use. These results suggested that the cognitive vulnerability of negative attributional style is predictive of posttraumatic stress in students and research in this area is valuable for increasing resilience, prevention and recovery among trauma survivors. Recommendations for future research, especially concerning multiple traumatisation is discussed.

While the validity of posttraumatic growth has been repeatedly questioned, the prevalence of growth after exposure to trauma is widely established. Perceptions of posttraumatic growth were examined in a sample of South African adults (N = 135). Participants completed a selfadministered battery of questionnaires via an online trauma survey or in paper format. Data specific to the nature of the traumatic event, particularly the type of trauma, time since the traumatic event, the impact of the event and perceived threat of the event, were collected along with posttraumatic growth (PTG) scores. Age, gender and perceived social support were also assessed as variables. Results of the multivariate analyses indicated that PTG differed significantly as a function of the type of traumatic event. PTG also differed according to the time since the traumatic event, although the relationship was complex and subject to the additional moderating factors of depression, anxiety and stress. Examination of the growth factors further revealed a differential pattern of PTG according to event type, and a variable pattern of relationship to social support, perceived threat and impact of the trauma. The findings supported the view of PTG as a complex, highly subjective perception of growth that may involve many levels and aspects of change. The nature of PTG is important in the context of South Africa, for the individuals, and their families, who have been exposed to high levels of crime, violence, chronic illness and road accidents, and for a nation in the process of rebuilding itself.

Le traumatisme est historiquement une notion centrale dans le champ de la médecine chirurgicale. Avec les revendications des associations de victimes, il est devenu un syndrome psychiatrique. La psychanalyse va s’efforcer tout au long du siècle dernier d’en décrire son fonctionnement. Elle met à l’ordre du jour la responsabilité de chaque sujet traumatisé dans ce qui lui arrive. L’événement vient réactiver un processus psychopathologique dont l’existence serait antérieure à l’accident traumatique. Mais le problème général du traumatisme psychique et de son interprétation reste encore une réalité de nos jours.Cette recherche clinique, effectuée auprès d’enfants et adolescents malades (services pédiatriques) ou blessés (services de chirurgie pédiatrique), généralise la psychopathologie du traumatisme dans le domaine des affections somatiques pédiatriques. Elle établit une différence entre une clinique de l’effroi et une clinique de l’angoisse. L’effroi associé à un mécanisme de sidération se rencontre plutôt dans le domaine des blessures corporelles, l’angoisse articulée au refoulement est plutôt mise en jeu après l’annonce d’une maladie grave, type cancer. / The traumatism is historically a central notion in the field of the surgical medicine. With the claimss of victims' associations, it becomes a psychiatric syndrome. The psychoanalysis will endeavour throughout the last century to describe its functioning. It puts at the day order the responsibility of each traumatized subject in what happens to him. The event comes to reactivate a psychopathological process whose existence would be previous to the traumatic accident. But the general problem of the psychic traumatisme and of its interpretation (performance) still remains a reality nowadays. This clinical research, conducted among children and adolescents sick ( pediatric services) or wounded (pediatric surgery services), generalizes the psychopathology of the traumatism in the domain of pediatric somatic affections. It establishes a difference between a clinic of the dread and a clinic of anguish. The dread (or terror) associated with a mechanisme of sideration, rather occurs in the domain of corporal wounds, the anguish articulated with the repression is rather concerned after the annoncment of a serious disease, such as cancer

Thesis advisor: Stephanie Greene / This paper addresses the recent concerns about concussions in the sport of football and elaborates on the medical findings, litigation, and ethical questions that have surrounded the issue. The goal is to present a compelling case for change in how concussions are viewed and handled in the sport. By using concrete examples to explain the lasting effects concussions have had on players after their careers have ended, I hope to show the need for change. I will explore the most recent developments of chronic traumatic encephalopathy in order to show its harmful reach and will touch upon litigation that has been filed by players who experienced post career problems. In addition, through the insight of current college players as well as referencing my own experience as a Division I College Football player, I wish to establish an emotional connection in the paper and unveil the roots of the problem – the toxic nature of the football culture. I am optimistic that this inquiry will help cultivate a culture change through a variety of approaches. First, I indicate the need for a transformation of the football culture. Second, I suggest a formal, mandatory education to inform players at all levels about concussions, subconcussive hits, and the potential diseases that can stem from. Third, I propose new penalties for players, coaches, support staff, and all involved in player safety in an attempt to further prevent head injuries. This thesis attacks the issue of concussions in football from all angles. It calls for the football community to accept the severity of concussions, educate on concussions, and prevent repeated concussions in order to prompt action. / Thesis (BS) — Boston College, 2016. / Submitted to: Boston College. Carroll School of Management. / Discipline: Departmental Honors. / Discipline: Other.