My research focused on five women in Aotearoa naming and defining their experiences ten or more years after leaving an intimate partner violence relationship. An increasing amount of literature has been published reporting the prevalence of intimate partner violence among women in our society, including surveys documenting devastating short and long-term health effects. However, little has been published about the long-term experiences of women who have survived such abuse. I was interested in making more visible the experiences of long-term survivors of intimate partner violence. I wondered what the challenges and legacies from experiences of intimate partner violence are and what contributes to women rebuilding their lives after intimate partner violence. In this research utilised a participatory action research approach informed by a critical feminist theoretical perspective. I selected two data collection methods, individual interviews followed by a focus group interview bringing the participants together. The findings identified nineteen themes emerging from the individual and focus group interviews. Some expressed the long-term challenges and legacies of intimate partner violence, such as feelings of powerlessness, guilt and shame and feeling silenced. Others reflected ways women rebuilt their lives, such as empowerment, resilience, courage and the importance of education and meaningful work. Interpreting the findings, empowerment was often juxtaposed with powerlessness, living side by side within the inner world of the long-term survivor of intimate partner violence in equal tension. This study affirms that challenges and legacies from intimate partner violence continue to affect women many years after leaving violence. Despite these challenges and legacies, women work very hard to rebuild their lives, care for their children and attain autonomy, independence and control of their lives. Women spent time and energy to recover ‘well enough’ from such violence, in order to lead a productive and functioning life.

The psychological trauma from a traumatic event is known to be 'contagious' for a witness. Psychotherapists who work with traumatised clients can potentially experience terror, anger and despair; causing secondary traumatic stress that can lead to compassion fatigue and burnout. So, how do psychotherapists, who often carry their own trauma histories, bear such fear and pain when being with and listening empathically to traumatised clients without feeling overwhelmed or losing a sense of hope? The purpose of this grounded theory study was to identify the main concerns of psychotherapists when working with traumatised clients and to describe and generate a conceptual model that explains the processes therapists use to continually manage these concerns. Over a period of ten months, eleven psychotherapists with a minimum of five years work experience were recruited from the New Zealand Association of Psychotherapists (NZAP). Constant comparative analysis of eleven interviews generated through open-ended questions was carried out. A total of twenty-one drawings obtained at different stages of the participant interviews, were used to fully capture the inner world of the traumatic impact. The emerging theory, whose development is grounded in the data, shows that psychotherapists grow through three main psychosocial developmental stages of balancing the impact of trauma: DOING to protect from pain and fear, BALANCING doing with being, and BEING with trust, pain and joy. The participants, however, were likely to involuntarily recycle the three stages when experiencing personal traumatic stress or organisational stressors, in addition to holding clients' trauma. The intention of this research was to raise awareness of work-related traumatic stress, and to provide an educational conceptual model to assist psychotherapists' understanding of how to positively manage secondary traumatic stress and its impact on the physical, emotional and spiritual, before it manifests in burnout, disillusionment or illness.

Posttraumatic Stress Disorder (PTSD) is a psychiatric condition that can develop following exposure to a traumatic event involving actual or threatened death or serious injury. Responses include intense fear, helplessness or horror. Symptoms are characterised into clusters, described as re-experiencing, avoidance, and arousal. These symptoms, which are also evident in other conditions, have been associated with dysfunctions in the central acetylcholinergic system. Benefits from administering acetylcholinesterase inhibitors (AChEI) to people suffering these symptoms have been demonstrated. Donepezil hydrochloride, a reversible inhibitor of the enzyme acetylcholinesterase, is used in the treatment of conditions with difficulties in cognitive function, but has not been used in PTSD. The aim of this thesis was to determine (1) whether there was a difference in the ACh system in people with PTSD and (2) whether administration of an AChEI would change the symtomatology. IDEX (I¹ ² ³ iododexetimide) has been useful in imaging muscarinic-ACh receptors using Single Photon Emission Computerised Tomography (SPECT) and was utilised to investigate whether cholinergic activity in PTSD is altered. One hundred and sixty eight potential subjects were screened and eleven PTSD subjects were enrolled in the IDEX SPECT study. Three healthy non-PTSD control subjects also completed the study. Due to technical complications only the data obtained from eight PTSD and two control subjects was available for analysis. Imaging data for 2 further healthy non-PTSD control subjects were obtained from another study. Sixteen subjects were enrolled in the donepezil open label study (assessed at baseline, Week 2, 6 and 10). Nine PTSD subjects completed the 10-week trial and seven withdrew prematurely (at or after Week 2) due to side effects or a worsening of PTSD symptoms. For the IDEX SPECT study, a voxel-by-voxel statistical analysis of the PTSD subject group versus the control group showed both areas of reduced and increased IDEX uptake. Significant clusters in the PTSD group with a reduced IDEX uptake centred around the bilateral hippocampus, left insula and right precuneus, while increased IDEX uptake appeared in the caudate head. For the donepezil study, in the per-protocol analysis (including only the 9 subjects that completed the protocol), all psychological assessments revealed a difference between the totals obtained at the Week 10 visit compared to those at the Baseline visit and the improvement was in the order of 51%. The intention-to-treat analysis (including all 16 subjects), a repeated measures Analysis of Variance (ANOVA) with a mixed models approach showed that all psychological measures demonstrated statistically significant benefits of the treatment. All subjects who completed the protocol recounted considerable improvement in their overall PTSD symptom profile, which covered symptoms in each of the three clusters. The results of the IDEX SPECT study suggest that alterations in ACh binding in PTSD are evident and may begin to explain a part of the altered cognitive symptomatology apparent in this condition. The pilot open label donepezil trial provided some preliminary evidence that treatment with an AChEI can lessen the intrusions and distress associated with traumatic memories in people with PTSD. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1374974 / Thesis (M.Med.Sc.) -- University of Adelaide, School of Medicine, 2009

<p>Grief research generally demonstrates that children and teenagers who have lost a parent in suiciderisk developing severe psychological and physical morbidity, as well as social disabilities, in adultlife as a result of traumatic aspects of the death and complicated grief reactions. The youngbereaved also run a highly increased risk of developing suicidal behaviour or to commit suicidethemselves. Despite these alarming reports, the research field is poorly explored and studies thattake an interest in the long-term consequences and the subjective experiences of the bereavedyoungsters are lacking. A qualitative study using narrative methods has been carried out toexamine the experiences of four young women, who during adolescence lost a father in suicide.The study specifically focuses on the grief process, the short- and long-term consequences, and theneed for social support in relation to family, extended network and society. The study reveals thatthe women’s traumatic loss has shattered their basic assumptions about the world as a safe andmeaningful place. A fear of losing another significant person, i.e. the remaining parent, siblings ora life partner is also a common denominator. The women have experienced complicated griefreactions such as guilt, shame, anger, feelings of abandonment and “why-questions” regardingtheir fathers’ suicide motives. They have found it difficult to receive social support due to moralaspects of suicide as a death cause – sometimes even within their own family – and due to a fear ofbeing condemned or regarded abnormal if they told others about their trauma. The time aspect isnot found to have affected the grief process. This process has been facilitated, however, throughsocial support from family, relatives, friends and professionals. Moreover, “sense-making”, or thecapacity to construct an understanding of the loss experience, as well as the active process of“re-membering”, has been found valuable in the grief process as it contributes to the constructionof an inner representation of the father. A continued relationship to the father after his death has inmost cases been regarded as helpful in the grief process. The women describe that the father’ssuicide has affected their self-conception and their life contents. Coping with the loss the womenseem to have developed stronger self-esteem, but at the same time some of them have come toregard themselves as “odd” and more mature in comparison with their peers. All women talk abouttheir fathers’ deaths with high actuality, indicating that the grief is most present. The womendescribe a re-priority of what they find important in life; close relationships are portrayed as moreimportant, as well as being helpful to others.</p>

<p>Traumatic brain injury (TBI) renders the brain more vulnerable to secondary insults. The increased vulnerability can probably be explained by a combination of disturbances in hemodynamics, metabolism and craniospinal dynamics. Reduced ability to compensate for added intracranial volume, i.e. reduced intracranial compliance (IC), is one possible mechanism. The <i>aim</i> of this thesis was to study the role of IC on the effect of secondary insults after TBI. </p><p>A rat TBI model was developed where IC could be altered without causing pathological increases in intracranial pressure (ICP). Reduction of IC was made by placing rubber film between the dura mater and bilateral bone flaps. A reduction of IC in terms of reduced Pressure Volume Index was confirmed. Microdialysis (MD) of extracellular fluid was used to monitor neurochemical changes. Reduced IC after TBI proved to increase the vulnerability of the brain to secondary intracranial volume insults according to neurochemical microdialysis markers. Reduced IC or intracranial volume insults alone did not cause any metabolic changes as compared to controls. Moderate posttraumatic hypotension (50mmHg for 30 min) induced 2 hrs after TBI, did not aggravate posttraumatic extracellular neurochemical changes significantly, irrespective of the level of IC. Although controversial, a mild to moderate hypotensive insult after initial posttraumatic stabilization may not be as detrimental as earlier believed.</p><p>The Spiegelberg Compliance Monitor and MD were simultaneously used in 10 TBI patients to get an impression of the clinical value of IC monitoring and the relationship between IC, temperature and MD Lactate/Pyruvate ratio. IC and MD could be monitored simultaneously in TBI patients. Higher L/P ratios were seen when IC was low. Patients with induced coma treatment had significantly higher average L/P ratios, possibly due to their poorer neurological condition. An indication was also found that in TBI patients with high temperatures, L/P ratio rose as IC decreased, but in patients with low temperature there was no effect of IC on L/P ratio. These data suggest the importance of avoiding hyperthermia in TBI patients, especially in patients with low or decreased IC (monitored or anticipated).</p>

Thesis (M.A.)--York University, 2004. Graduate Programme in Social Anthropology. / Typescript. Includes bibliographical references (leaves 233-250). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url%5Fver=Z39.88-2004&res%5Fdat=xri:pqdiss&rft%5Fval%5Ffmt=info:ofi/fmt:kev:mtx:dissertation&rft%5Fdat=xri:pqdiss:MQ99313

Thesis (Ph. D.)--Brigham Young University Dept. of Marriage and Family Therapy, 2006. / Includes bibliographical references (p. 60-64).

The mental health field lacks an array of effective interventions designed to assist women victims of intimate partner violence (IPV). Moreover, treatment modalities responsive to the needs of racially and ethnically diverse populations are under researched. This presents a significant challenge to serving ethnic minority women who are known to experience more crime, violence victimization, and psychological trauma than their dominant-ethnic group counterparts. This study integrated research and theory of trauma with current IPV literature and tested the utility of a brief trauma-based approach in reducing trauma related symptomatology in a predominantly Latina and African American clinical sample. Traumatic Incident Reduction (TIR) is a time limited intervention that seeks to resolve trauma and psychological symptoms through various memory-based methods, guided exposure techniques, and the use repetitious story-telling of traumatic event(s). By taking this approach, this research sought to add to the emerging literature on the effects of TIR in alleviating symptoms associated with trauma exposure. Treatment effects in 106 survivors of IPV were examined (age = 36, SD=9, 80.2% Latina, 19.8% African American, mean hours spent in TIR treatment M = 6.4, SD = 5.28). Paired t-tests supported the hypotheses that TIR significantly (p < .001) reduced symptoms of PTSD, anxiety, and depression and increased self-concept. Multiple regression analyses found that as the hours in TIR increased so did the participants self-concept (R2 = .179, F(4, 75) = 4.08, p = .005). Multiple regression analysis also supported the hypothesis that as the total number of crimes as a victim increased Depression increased significantly (R2 = .125, F(4, 76) = 2.72, p = .036). Chi squares and t-tests found no differences between those who remained in treatment versus those who terminated prematurely.

This dissertation was an exploratory research study using a cross-sectional survey design to examine the impact of ecological, environmental, psychological, and financial hardship on counselors of the U.S. Gulf Region. Since 2005, the U.S. Gulf Region, unlike any other region of the United States, has faced multiple disasters including Hurricanes Katrina, Rita, Ike and Gustav (Walsh, 2010), the Great Recession (Conant, 2010), and the largest ecological disaster in the history of the United States, the BP Oil Spill (Gray, 2010). The purpose of this study was to explore the attitudes and characteristics of counselors in one U.S. Gulf State, specifically Mississippi, to obtain valuable information about compassion fatigue and compassion satisfaction of counselors as measured by the Professional Quality of Life (ProQOL) (Stamm, 2009). The researcher used a demographic survey and the ProQOL (Stamm) for analyses. The researcher collected the ProQOL (Stamm) sub-scale scores of 282 Mississippi counselors who attended the 60th Annual Mississippi Counseling Conference. The counselors recorded high compassion satisfaction scores, low burnout scores and low secondary traumatic stress scores. Additionally, the researcher used one-way MANOVAs to examine the main effects of counselor characteristics such as educational level, gender, geographic location, self-care methods, and years of experience on the ProQOL (Stamm) sub-scale means of compassion satisfaction, burnout, and secondary traumatic stress. The researcher found two statistically significant differences in gender and years of experience. Male participants’ burnout and secondary traumatic stress scores were significantly less than female participants’ burnout and secondary traumatic stress scores. Participants with 1-10 years of experience recorded statistically significant higher burnout scores and lower compassion satisfaction scores than participants with less than one year of experience, 10-20 years of experience, and more than 20 years of experience. In contrast to assumptions related to the ecological, environmental, psychological, and financial hardship present in this region, high levels of satisfaction was found in counselors who serve this region. The researcher found that despite the impact of these multiple traumatic events these counselors were satisfied with their work.

Thesis (M.Sc.)--Memorial University of Newfoundland, 2005. / Bibliography: leaves 44-54.