Recently, the literature concerned with the possibilities and limitations of working memory training has been growing rapidly. Nonetheless, there are still no clear answers about the principles of its effectiveness or transfer effect. The main questions we ask are about effectiveness of cognitive training in patients after stroke or TBI. To our knowledge this group hasn't been studied in this context yet. To do this, we compare two types of cognitive training - extensively studied N-back training (n=11) and still more popular group cognitive therapy (n=9) with a placebo control group (n=5) who recieves "training" in a simple computer game. The placebo control group then continues in N-back training. Our hypothesis is that after 3 weeks the two trainings should lead to significantly higher gains in cognitive tests scores than the placebo condition. Also, we expected N-back to be more effective than group cognitive training in domains more closely related to executive control. We tested attention, fluid intelligence, short-term and working memory. We also recorded participants well-being. Following training, there were no significant differences between N-back and group training. N-back group scored significantly higer on Trail Making Test A than control group (p=0,026). Although our study doesn't...

This diploma thesis is focusing on the posttraumatic growth in professional fire fighters. The theoretical part deals with models of the posttraumatic growth and factors which affect this process. Another constituent of the work is a treatise about psychological aspects of the fire fighter job execution. One section of the work, the empirical section, is based on the Czech version of a questionnaire method called "Posttraumatic Growth Inventory ". It is a questionnaire that discovers the level of achieved posttraumatic growth in 5 areas; personal strength, new possibilities, relating to others, appreciation of life and spiritual change. The research sample that consisted of 100 professional firemen verified the relationship between the posttraumatic growth and other aspects of respondents' lives. The research showed following discovery. The marital status, the fact if the respondent has a family, the time which passed since experiencing a difficult incident, the subjectively perceived intensity of an event, the level of distress, psychological well-being, behaviour of type A, cognitive resilience of an individual, strategy of bearing the burden of "negative view", "the concentration on a problem" and "the mineralization of threats" is not connected with the grade of obtained posttraumatic growth....

National concern over traumatic brain injury (TBI) is growing rapidly. Recent focus is on mild TBI (mTBI), which is the most prevalent injury level in both civilian and military demographics. A preeminent sequelae of mTBI is cognitive network disruption. Advanced neuroimaging of mTBI victims supports this premise, revealing alterations in activation and structure-function of excitatory and inhibitory neuronal systems, which are essential for network processing. However, clinical neuroimaging cannot resolve the cellular and molecular substrates underlying such changes. Therefore, to understand the full scope of mTBI-induced alterations it is necessary to study cortical networks on the microscopic level, where neurons form local networks that are the fundamental computational modules supporting cognition. Recently, in a well-controlled animal model of mTBI, we demonstrated in the excitatory pyramidal neuron system, isolated diffuse axonal injury (DAI), in concert with electrophysiological abnormalities in nearby intact (non-DAI) neurons. These findings were consistent with altered axon initial segment (AIS) intrinsic activity functionally associated with structural plasticity, and/or disturbances in extrinsic systems related to parvalbumin (PV)-expressing interneurons that form GABAergic synapses along the pyramidal neuron perisomatic/AIS domains. The AIS and perisomatic GABAergic synapses are domains critical for regulating neuronal activity and E-I balance. In this dissertation, we focus on the neocortical excitatory pyramidal neuron/inhibitory PV+ interneuron local network following mTBI. Our central hypothesis is that mTBI disrupts neuronal network structure and function causing imbalance of excitatory and inhibitory systems. To address this hypothesis we exploited transgenic and cre/lox mouse models of mTBI, employing approaches that couple state-of-the-art bioimaging with electrophysiology to determine the structural- functional alterations of excitatory and inhibitory systems in the neocortex.

D.Litt. et Phil. / The negative psychological effect of rape on survivors has been extensively researched, with most studies emphasising rape-related Post Traumatic Stress Disorder (PTSD) its symptoms, diagnosis and treatment. Interventions described in the current literature mainly aim at measuring and reducing symptoms, and restoring functioning in rape survivors. Group art therapy has been used with adult and adolescent survivors of incest with encouraging results, but little research has been published regarding its use with rape survivors. My intention in the current study is to examine the utility of a group art therapy intervention with adult female rape survivors in a South African context. I selected a postmodern feminist theoretical basis for the study, and examined the societal discourses that promote women’s disadvantaged status and high levels of rape in South Africa. I used qualitative methods to analyse the art works, journals and transcripts produced by three participants during seven weekly group art therapy sessions. I used postmodern feminist research methods, such as participant observation, reflexivity, and concepts such as situatedness, bodiliness, relatedness and plurality of explanations to assess the women’s lived experience of rape, their recovery from it, and the intervention itself. The current study proposes that analysing the data reveals metaphors, symbols and meanings that represent the lived experience of the women participants in the group art therapy intervention. I used a grounded theory approach to data analysis, as well as methods from content analysis, visual anthropology, iconography, social semiotics and visual cultural studies in order to assist with triangulation of the visual and verbal data. The data was voluminous and rich, and fourteen strands of meaning emerged from the data, consisting of vivid metaphors, visual and verbal symbolic language, and insights into the challenges and victories of each of the participants. I gathered these strands under two overarching themes: one of themes related to the rape, and the other related to the group art therapy experience. I conclude that group art therapy was useful to the participants, and that the data analysis gave considerable insight into the individual nature of recovery from rape, such as coping mechanisms, influence of personality on recovery, the dialectical nature of recovery and the difficulty of recovering from a trauma that affects every area of functioning. The current study provides a structured format for clinicians interested in group art therapy, and I have provided suggestions for those who wish to replicate the intervention. My findings propose that the intervention was a powerful therapeutic tool for the participants, and that it provides a structured short-term group outline for use with the vast numbers of rape survivors in South Africa.

M.Cur.

Deficits in executive function are commonly reported following Traumatic Brain Injury (TBI) and are important for establishing functional impairments. Understanding the nature of executive dysfunction following TBI is often complicated by secondary factors that can impact measured ability. This study sought to clarify the persistent effects of TBI on executive function, as measured by the Wisconsin Card Sorting Test (WCST), while accounting for effort given during testing, as measured by the Portland Digit Recognition Test. Results suggested a dose-response relationship between TBI severity and subsequent WCST deficits. Mild TBI patients who provided good effort during testing showed no observable differences from locally matched controls on WCST performance. Effort during testing was found to have a larger overall effect on WCST performance than moderate-to-severe TBI or dementia. The present study highlights the need to account for secondary factors, such as effort during testing, to accurately measure cognitive dysfunction following compensable injuries.

Iris Fitzgerald struggles to make it day to day after she is raped and stabbed while out on an early morning run. Her story is told through her relationships, not only with her new, scared self, but also with her overbearing mother, her best friend, her rescuer and her antagonistic roommate. She has just moved to a strange city and still has not found a job. So, she has the overwhelming stress of the attack to contend with and the added pressure of running quickly out of money in the expensive city of San Francisco. She uses her painkillers as an escape from her stab wound as well as her emotional pain. Claiming Iris is about self-preservation, relationships, addiction and continuing on with life.

A significant subset of mild traumatic brain injury (mild TBI) and chronic pain (CP) patients report, and sometimes show objective evidence of, persisting cognitive problems. Despite differences in injury mechanisms, there is considerable overlap in the types of persisting cognitive symptoms that are reported by the two populations. Psychogenic, rather than physiogenic, factors are thought to play an important role in the maintenance of these persisting symptoms. The current investigation examined the contributions somatization, depression, and anxiety had on an objective measure of “working attention.” In order to best elucidate the influences these psychological factors had on attentional performance, only individuals who passed well-validated and popular indicators of cognitive and self-report validity were included in the study. Two hundred and forty-nine individuals (n = 116 TBI; n = 133 CP) met the inclusionary criteria for the study. Psychological factors were assessed using Scales 1 (Hypochondriasis), 2 (Depression), 3 (Hysteria), and 7 (Psychasthenia) of the Minnesota Multiphasic Personality Inventory-II. “Working attention” was measured using the demographically-adjusted T-scores for the Working Memory and Processing Speed Indexes of the Wechsler Adult Intelligence Scale- 3. Results indicated that a high rate of psychological complications was observed in the mild TBI and CP groups but not the moderate-severe traumatic brain injury (M/S TBI) comparison group. Analysis indicated that psychological elevations were not significantly related to spontaneously-reported symptoms or working attention deficits for the mild TBI group but were for the CP and M/S TBI groups. The current results are important for understanding the psychological complications that may occur in individuals exhibiting persisting cognitive problems in these clinical populations.

Purpose: Describe the meaning of compassion fatigue (CF) as experienced by the U.S. military registered nurse (RN) post-deployment from Iraq and Afghanistan. Background: CF is characterized by deep emotional and physical exhaustion, and may resemble posttraumatic stress disorder (PTSD). Often this causes a shift in confidence and clouds RN perceptions. Symptoms include difficulty concentrating, intrusive imagery, hopelessness, exhaustion, and irritability leading to profound alterations in one's view of the world, patients, family, and friends. Outcomes include depersonalizing patients, poor coping mechanisms, lowered standards, clinical errors, and blurring boundaries, all can contribute to a toxic work environment and RNs leaving the profession. Method: Hermeneutic phenomenological methodology facilitated a description of CF in words and meaning expressed by U.S. military RNs (i.e., Army, Navy). The sample was obtained through the snowball method and aided by key informants. Data were collected through interviews and observations with each active duty or reservist RN (N = 8) on three occasions. Participants described their military and nursing backgrounds and experiences of CF through hermeneutic interview. Analysis was ongoing during the interview process and included continual questioning, reflecting, and validating. This process allowed for understanding through engagement of text (e.g., dialogue, transcriptions). Journaling and self-reflection assisted with trustworthiness. Findings: Participants shared many experiences. While some had unique experiences, their feelings and perceptions resonated with other participants and informed the emergence of four shared meanings and shared concerns: (a) the term CF does not fit me, manifested by expressions of the meaning of CF; (b) compassion fatigue as all encompassing, manifested by physical, emotional, relational, and spiritual experiences; (c) compassion fatigue will not interfere with my military duty, manifested by the pervasive military lens that the meaning of the experiences are filtered, and (d) compassion fatigue affects people long after deployment . . . gone, but not forgotten, manifested by the lasting effects of CF. Implications: While CF among military RNs has many similarities with the general nursing population, the practice environment appears to create additional triggers and manifestations. This study provides an understanding of the progression of CF in this population. Implementing interventions before and after trauma exposure can preserve the care in military caregivers.

M.A. / The Truth and Reconciliation Commission (TRC) Act was passed in 1995 and the TRC started its hearings in 1996. The purpose of the TRC was to promote national unity and reconciliation by establishing as complete a picture as possible of the human rights violations that had occurred during the apartheid era and to offer reparations to those who had been affected, as well as to grant amnesty to those who had committed these human rights violations. The TRC had to appoint people to help carry out its functions and deliver a report about human rights violations. Most of the people employed by the TRC to help carry out these functions were South African. Furthermore every South African had been involved in the past in one way or another, purely by being a South African. In this project the author explores, analyses and interprets the experiences of some of the people who were employed by the TRC. The focus of this project is to find out whether being employed by the TRC and having to listen to the stories being brought to the TRC exposed anyone to the possibility of developing what is called secondary traumatisation. This kind of traumatisation is different from the traumatisation that the people relating the stories had gone through during the apartheid years. This kind of traumatisation is said to develop from being exposed to traumatised people.