M.A. / The current social and political situation in South Africa has resulted in an extremely violent climate in which the incidence of highly stressful events experienced by people on the whole is extremely high. The severe and pathological negative symptoms that often follow the experience of highly stressful events are defined as Post-traumatic Stress Disorder (PTSD) in the Diagnostic and Statistical Manual for Mental Disorders - IV (DSM-IV)(APA, 1994). An improved understanding of the factors involved in the development, treatment and prevention of PTSD is important considering the potentially debilitating effects of this disorder. With the increasing emphasis being placed on 'positive' psychology, the salutogenic orientation was given focus in this study. Antonovsky (1979, 1987) defines salutogenesis as 'the origins of health', and the emphasis is on identifying those factors in which health originates and is promoted. This study aimed to investigate two specific variables, sense of coherence (Antonovsky, 1979, 1987) and self-efficacy (Bandura, 1977, 1986) as two potential psychological resilience factors that may positively contribute to effective functioning after the experience of a highly traumatic event. The research tested a postulated model which suggested that the two resilience variables influence the presentation of PTSD symptoms after exposure to a traumatic event. The research was conducted in a police and banking environment with 50 participants, all of whom had experienced a traumatic event as defined by the criteria in the DSM-IV. Three measuring instruments were used to measure the constructs of interest. PTSD symptomatology was measured by means of Horowitz's "Impact of Events Scale - Revised" (Weiss & Marmar, 1997), self-efficacy in the face of a traumatic event was measured by means of a specific questionnaire constructed by the researcher for this study (SEFTE), and sense of coherence was measured by means of Antonovsky's "Orientation to Life" questionnaire, or Sense of Coherence Scale (1983). The results of the study indicated that a relationship does exist between the three constructs of interest. A higher sense of coherence. contributes to higher selfefficacy expectations in the face of a traumatic event, and both these variables reduce the level of PTSD symptomatology after exposure to a traumatic event. In conclusion, the importance of understanding some of the psychological resilience factors which may help to prevent PTSD after exposure to a traumatic event, or at least reduce the severity of the symptoms, was highlighted. By doing so, emphasis can be moved from the treatment of PTSD after the event, to the prevention of the disorder, by strengthening the resilience of those people at risk of exposure to a highly traumatic event, before the event occurs.

M.A. / Hijacking has become so prevalent that the South African Police Service created a separate division to attend to these priority crimes, The Crime Information Analysis Centre. This division coordinates statistics and information and analyse factors leading to crime in order to plan a strategy to prevent it. The reasons for the multiplication of hijacking can be found in economic benefits, urbanization, dehumanization, inefficiency of law enforcement, the role of syndicates, security mechanisms in cars, and the ready availability of weapons. Few subjects are as relevant as trauma counseling, with few South Africans who have not experienced at some stage a crisis, shock or trauma due to crime, violent deaths, hijackings, rape, molesting and abuse, murder of farmers, and HIV and Aids. Trauma counseling is the professional treatment of a person experiencing problems, through constructive growth in faith and renewal, based on the atonement with God through Christ. It is important that the Bible be utilised in Christian counseling as the Spirit of God speaks through it. The counselor can help the traumatized patient by giving them the 12 opportunity to communicate their pain, anguish, fright, terror and anger in an honest way to God. Healing occurs when the traumatized find a (new) reason to live, through faith in the goodness of God. The counselor does not teach positive thinking but rather the truth of the Word of God instead of wrong thought processes and perceptions. In the end the client is taught to find meaning in their lives in the midst of tragic events and crises. With the help of God they are enabled top look back at what happened in the trauma and to realize that it makes sense. Even though Christians do not always understand God’s meaning with what He allows in their lives, they learn to trust Him. When they learn to look at their lives through God’s eyes, they realize the limitations of their own vision. Even pain has a purpose and can be the cause of growth and a sharper focus. It reminds us of the need to trust in God so that hijacking is not the end of life but the beginning of a new life.

M.A. / It is now well known that HIV/AIDS-sufferers face profound psychological, psychiatric and neurological sequelae as the disease progresses. However, studies indicate that women diagnosed with HIV-infection are twice more likely to be depressed, to suffer from PTSD and other psychiatric morbidity than men. Yet very few studies have attempted to investigate the role that gender plays in reacting to the illness. Finding out that one is HIV-infected is one of the most significant discoveries. This is due to the fact that in receiving an HIV-positive diagnosis individuals are exposed to news of prodigious personal consequence. And yet very few studies have focused on how the impact of finding out that one is HIV-positive may affect their adjustment to the illness. Moreover, how men and women are likely to react to such news. It is against this background that the current study was conducted. The aim of the current study was to compare post traumatic symptoms in men and women upon hearing news of their HIV-positive status and to investigate to what extent such reactions may be similar or different and to further assess how their reactions are likely to affect disease progression and adjustment. A total of one hundred participants (38 Male, 63 female) diagnosed with HIV/AIDS participated in the study. These men and women were obtained from support groups in the Gauteng region. The Impact of Event Scale-Revised and Mental Adjustment to HIV-Scale questionnaires were used to collect data over a period of a month. A large majority of 60.2% of the total sample (n = 87) reported experiencing feelings of shock upon hearing about their HIV-positive status, 66.0% of the total sample (n = 94) of those who responded to this item reported trying to remove the issue from their mind. A further 59.6% of the total sample of (n = 94) indicated feeling as though news about their HIV-positive status were not real suggesting that the incident was traumatic. There were no significant gender differences in how both men and women reacted to news of their HIV-positive diagnosis. However, significant differences were found in relation to adjustment. Men were found to be more likely to have more Fighting Spirit which is indicative of adaptive adjustment as compared to women. Women on the other hand were found to be more likely to be Hopeless which is indicative of maladaptive coping.

One of the serious public health problems is the Traumatic Brain Injury, also known as silent epidemic, affecting millions every year. Management of these patients essentially involves neuroimaging and noncontrast CT scans are the first choice amongst doctors. Significant anatomical changes identified on the neuroimages and volumetric assessment of haemorrhages and haematomas are of critical importance for assessing the patients’ condition for targeted therapeutic and/or surgical interventions. Manual demarcation and annotation by experts is still considered gold standard, however, the interpretation of neuroimages is fraught with inter-observer variability and is considered ’Achilles heel’ amongst radiologists. Errors and variability can be attributed to factors such as poor perception, inaccurate deduction, incomplete knowledge or the quality of the image and only a third of doctors confidently report the findings. The applicability of computer aided dianosis in segmenting the apposite regions and giving ’second opinion’ has been positively appraised to assist the radiologists, however, results of the approaches vary due to parameters of algorithms and manual intervention required from doctors and this presents a gap for automated segmentation and estimation of measurements of noncontrast brain CT scans. The Pattern Driven, Content Aware Active Contours (PDCAAC) Framework developed in this thesis provides robust and efficient segmentation of significant anatomical landmarks, estimations of their sizes and correlation to CT rating to assist the radiologists in establishing the diagnosis and prognosis more confidently. The integration of clinical profile of the patient into image segmentation algorithms has significantly improved their performance by highlighting characteristics of the region of interest. The modified active contour method in the PDCAAC framework achieves Jaccard Similarity Index (JI) of 0.87, which is a significant improvement over the existing methods of active contours achieving JI of 0.807 with Simple Linear Iterative Clustering and Distance Regularized Level Set Evolution. The Intraclass Correlation Coefficient of intracranial measurements is >0.97 compared with radiologists. Automatic seeding of the initial seed curve within the region of interest is incorporated into the method which is a novel approach and alleviates limitation of existing methods. The proposed PDCAAC framework can be construed as a contribution towards research to formulate correlations between image features and clinical variables encompassing normal development, ageing, pathological and traumatic cases propitious to improve management of such patients. Establishing prognosis usually entails survival but the focus can also be extended to functional outcomes, residual disability and quality of life issues.

Studies have indicated that the loss of a child to violence is a traumatic experience that can leave mothers in an unmitigated state of suffering and trepidation. Available research suggests that Black mothers who suffer disproportionately from violent loss, their experience of loss while individualized, is grounded in social contexts. The following phenomenological study explores the lived experiences of three Black mothers who have lost a child to homicide. This study explores the social phenomenon associated with losing a “Black” child to homicide and the grieving and bereavement experience of the surviving mother. Analysis revealed that the themes of race, gender and class are defining facets that intensify and compound the conditions of grief for Black mothers. This study concludes with recommendations in hopes of helping others begin to understand all that is lost and what must be understood when a Black Mother losses her child to homicide.

Magister Psychologiae - MPsych / This study focused on trauma and seeked to demonstrate that the application of a Buberian understanding to the experience of trauma can help shed light on the impact of trauma on a sufferer's life. The aim of the study was to gain an understanding of the impact of trauma on interpersonal relationships as well as to determine components of psychotherapy found most helpful in the recovering process. / South Africa

Magister Scientiae (Occupational Therapy) - MSc(OT) / An estimate of 89 000 cases of new traumatic brain injuries (TBI) are reported annually in South Africa. South African legislation advocates for the employment of persons with a disability. Individuals with mild-moderate TBI that do qualify to return-to-work (RTW) often do not have access to vocational rehabilitation (VR) and, as a result, return to the occupational therapy work assessment units for Disability Grant assessments. Not having the necessary insight and understanding about the condition influences the affected individual’s chances of returning to work. Failing to return to work results in dependency on a caregiver. The aim of this study was to explore the perceptions and experiences of employers and caregivers of individuals with mild traumatic brain injury returning to work after completing a VR programme, using the Model of Occupational Self-Efficacy. A purposive sample comprising employers and caregivers of 10 individuals with mild TBI was selected. Semi-structured interviews were completed and data manually managed, with confidentiality and anonymity strictly ensured. The findings of the study were analysed by means of thematic analysis, from which five themes emerged. Themes one and two described the employers’ and caregivers’ experiences and perceptions that hindered the RTW process. Theme three related to the enabling aspects they derived from engaging in the VR process, along with the individual with mild-moderate TBI. Themes four and five presented the coping strategies that aided the employer and caregiver in playing a continued role in the RTW process. The International Classification of Function, Disability and Health (ICF) was used to conceptualise the findings and interpret the perspective of the barriers, enablers and coping strategies as seen through the lens of the employer and caregiver. The results of the study can be used to help individuals with TBI adapt to the work environment, as well as inform policy development regarding social grants and access to rehabilitation services for TBI survivors. Occupational therapists (OT) using the MoOSE should regard the employer and caregiver as key role players during therapy. Employers should gain a better understanding of TBI and allow for sick leave during rehabilitation. Caregivers would benefit from finding or establishing a support network for themselves, and by connecting with employers of the individual with TBI in order to understand the individual’s work environment.

No abstract available / Dissertation (MA (Research in Practical Theology))--University of Pretoria, 2007. / Practical Theology / unrestricted

Suppression of the grief process among males following bereavement, deny the males to express their pain or respond to the realities of what has happened and can be traumatic and subsequently cause death. This study was guided by a qualitative and quantitative research method, and examines loss, and grief that follow the death of loved ones. Gerkin’s Shepherding Model of caring for the individual and the community of faith and Kubler- Ross’ model on grief dynamics are employed. Expression of grief depends on a number of factors that may range from emotional closeness of the family, how the family defines grief, the role and relationship to the deceased, one’s spiritual, psychosocial strength. In most Zimbabwean cultures the grief process is complicated by the delay in the initiation of funeral and mourning rituals as a result of unfinished businesses. Conflict management is pivotal to the process of grief in most African cultures where rituals provide a structured way of affirming that death has occurred and help in reducing suppression of grief. Traditional practices are carried out in a structured way; generally the bereaved needs an authority to give permission to carry out the funeral and mourning rituals, by so doing the society reduces guilty feelings in the bereaved. In this study Chapter 2 traces the theoretical, biblical and the ex-biblical and African perspectives in the process of grief. Chapter 3 provides the methodology in carrying out the research. Chapter 4 details how 13 African males of Murewa circuit have journeyed through the grief process. Their stories indicated how: males are socialized; the expectations of the family, society, culture and church hinder the grief journey, and how male’s view of masculinity has put pressure on them during grief. In chapter 5 concluding thoughts, include the role of practical theology as a social action in helping males to grieve, the role of the community in healing through rituals and how the Church’s theology of grief should equip the Church in helping males to pass through the valleys of grief without shame and a feeling of guilt, by helping them to challenge their “predictable dishonesties of everyday Life” (Egan 2002:192). / Dissertation (MA (Research in Practical Theology))--University of Pretoria, 2007. / Practical Theology / MA / unrestricted

Traumatic brain injuries (TBI) are one of the leading causes of disability worldwide (Zitnay, 2008), yet one of the least understood neurological conditions (Duncan, 2005). Research has examined short-term deficits; however, less focus has been on the consequences of multiple concussions. Previous electroencephalography (EEG) concussion research has examined the N200 and P300 human event-related potential (ERP) components, yielding inconclusive results (Duncan, Kosmidis & Mirsky, 2005). An ERP component not as frequently examined is the reward positivity, generated by the anterior cingulate cortex (ACC), a region which experiences increased anatomical stress following injury. In this study, 51 students from the University of Victoria took a ‘Concussion Survey’ to determine participant history and groups; no history of concussion, a single injury or multiple injuries (2+). Participants performed an oddball and decision-making task while EEG data was collected. No significant differences were found between groups for the N200, P300 or reward positivity peak latencies or amplitudes. Both concussion groups yielded attenuated peak amplitudes, but no differences existed between the group with a single concussion versus multiple. Unexpectedly, N200 and reward positivity peak latencies were greater in the group with single injuries, compared to those with a history of multiple concussions. This study adds to a continuous line of inconclusive research on the N200 and P300, suggesting minimal cognitive deficits result from concussive injuries. Furthermore, no noticeable differences were observed between groups with a single versus multiple injuries. While the ACC is located in a region of increased stress following TBI, functional deficits impacting the reward positivity may not be as significant as previously hypothesized. Results may be impacted by confounding variables, including not reliably being able to account for time since injury, injury severity and differences in gender dispersion of participants. With concussions on the rise, continued research, particularly longitudinally and within-subjects is critical for the advancement of both TBI prevention and management. / Graduate