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A dissertation submitted to the Faculty of Humanities in partial fulfilment of the requirements of the degree of Master of Arts Organisational Psychology University of the Witwatersrand March 2016 / Emergency first responders such as firefighters are exposed to higher levels of traumatic events through the course of their work. Accordingly, chances of such exposure resulting in negative psychological consequences are elevated. Previous research implicates the experience of trauma incident(s) and other organisational factors, among other factors, as causes of the development of consequences such as posttraumatic stress disorder and the variance thereof. However, research exploring these implications is limited. As a result, firefighters in the Emergency Medical Services were surveyed in the attempt to identify experiences of posttraumatic stress symptoms resulting from history of exposure to work-related traumatic events, perceived life threat during those incidents, general work-related stress and their perceived organisational support. The purpose of this study was to explore the predictive relationship PTSD symptoms and four predictors namely; perceived life threat, perceived organisational support, history of trauma and job-related stress, among Johannesburg firefighters. The sample was drawn from the City of Johannesburg Emergency Medical Services. A sample (N=100) of trauma-exposed firefighters was recruited for the study. Participants were recruited using a non-probability, convenience sampling strategy in which participation in the study was voluntary. The sample was made of 89 male participants and 11 female participants. All variables included in the study were measured using self-report instruments. Participants completed a demographic questionnaire to gather information pertaining to gender, age, organisational tenure and race. The following questionnaires were used to ascertain scores for the predictor variables: Survey of perceived Organisational Support, General Work Stress scale, Life Threat scale and a self-developed history of trauma scale. The Revised Impact of Event scale was used to measure the firefighters’ experience of PTSD related symptoms. Participants reported an average score of 29 on the IES-R scale indicating a stress reaction with the possibility of posttraumatic stress disorder. However, using a multiple regression analysis, this present study found that the four predictor variables explored did not have a substantial impact on the development of PTSD among firefighters. Secondary analyses were conducted to explore the individual association between each independent variable and PTSD. The results are reported. Overall, the results yielded suggest that there are other factors that exert a greater impact on the development of PTSD among firefighters. Future research among firefighters could focus on exploring other risk and protective factors associated with the development of PTSD. Alternatively, if this study is to be replicated, the researcher could employ a longitudinal, qualitative approach to explore the predictive relationship between history of trauma, perceived life threat, perceived organisational support, work-related stress and PTSD related symptoms. KEYWORDS: Post-traumatic stress disorder, perceived life threat, perceived organisational support, job-related stress, history of trauma

Introduction: Headache is one of the most common disorders of the nervous system and several of its subtypes lead to substantial levels of disability. Cervicogenic headache is a condition characterised by chronic hemi-cranial pain that is referred to the head from either bony structures or soft tissues of the neck. One of the common factors associated with all forms of headaches is the presence of trigger points. The aim of this study was to compare the sensitivity of trigger points, descriptive characteristics and level of disability in patients with cervicogenic and in patients with non-cervicogenic headaches. Methodology: The study was conducted as a quantitative, cross sectional, descriptive study. Forty participants (20 with cervicogenic and 20 non-cervicogenic headache) were included into this study sample. The classification of patients as having cervicogenic or non-cervicogenic headache was done according to the guidelines of Zito et al (2006). The sensitivity of trigger points in the upper trapezius, sternocleidomastoid, posterior cervical and temporalis muscles were established using a hand-held digital algometer with 1cm2 round head. Their level of disability was compared using the Henry Ford Headache Disability Inventory (HDI). The demographic and clinical presentation of both the groups was also compared including age, sex, duration of headache and pain rate scale. The above mentioned variables were compared using student t-test and chi-square test. Results: Descriptive characteristics, pain intensity and level of disability did not attain a statistical significant difference between the two groups. The results found evidence of a statistically significant difference with respect to trigger points sensitivity in right upper trapezius (p=0.02) and left upper trapezius (p=0.01). The sensitivity of trigger points of upper trapezius were higher in cervicogenic groups but none of the other muscles tested showed difference in sensitivity between both groups. Discussion Similarities in the descriptive characteristics, pain intensity and level of disability of both groups suggest that both types of headaches cannot be differentiated in terms of a specific age, sex, body mass index, pain intensity or level of disability. Increased sensitivity of trigger points especially in upper trapezius may be used as an additional diagnosing factor of cervicogenic headache group. Conclusion: The results of this study found that patients with cervicogenic headache had an increased sensitivity of the upper trapezius muscles compared to patients with non-cervicogenic headache. Since physiotherapists play an important role in the treatment of trigger points the value of physiotherapy treatment in the management of cervicogenic headache releasing the trigger points in the upper trapezius may result in a decrease in symptoms and an associated improvement in quality of life.

M.Fam.Med., Faculty of Health Sciences, University of the Witwatersrand, 2011 / Purpose: To determine the prevalence of post-traumatic stress disorder (PTSD), and the extent of resilience among former national servicemen who had matriculated from a Johannesburg high school from 1975 to 1988. Design & Methods: A quantitative design which utilised an anonymous, internet-based questionnaire accessed a sample of former national servicemen. Demographic data such as year of intake to national service, current occupation, the type of service unit, combat exposure, drug and alcohol use, exposure to other traumatic events, and recourse to medication and counselling were obtained. The Impact of Event Scale –Revised (IES-R) was used to measure prevalence of PTSD and the Connor Davidson Resilience Scale (CDRISC) was chosen to provide a measure of coping. A sample of 109 men was traced out of a possible population of 1527. They were contacted via email and invited to participate in the anonymous web-based questionnaire. Data was processed from the Wits Health Sciences website via a Microsoft Excel worksheet to the STATA version 11 statistical software package and were subjected to regression analysis using the chi square test and Spearman’s rho. Results: The response rate was 49.5% of the sample of 109. The PTSD level in this sample was 33% and was statistically significantly associated with combat exposure. There was no association between the IES-R and the CD-RISC. Only 5.6% of respondents scored in the range for PTSD on the CD-RISC suggesting high levels of resilience in this sample. Current cannabis use was significantly linked with PTSD. Conclusions. The PTSD prevalence in this population of former national servicemen is higher than in comparable international studies. The primary care practitioner needs to consider prior exposure to national service or combat in routine history-taking and to consider PTSD when former national servicemen present with anxiety symptoms, depression, somatisation disorder, irritable bowel syndrome, chronic pain or substance abuse disorder.

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

The present study was carried out to examine long-term psychological difficulties associated with war experience. 731 World War Two and Korean War veterans completed a questionnaire supplying biographical details, war-related experience, and present day psychological health. A significant proportion had war-related psychological difficulties, these problems correlating more strongly with war-related intrusive thoughts and avoidance than with actual combat experiences. A subgroup of 25 veterans were selected for depth interview. The results of these interviews supported the finding that many veterans have war-related problems, and that they related more to intrusion and avoidance than to actual experiences. For some veterans these problems have been present since the war, but for many they only started after retirement, when they have had more time to think about their past experiences. The problems include nightmares, intrusive thoughts, depression and anxiety. Coping is expressed by these veterans in terms of a) developing a narrative about their experiences which allows them to consciously control their traumatic recollections, or b) avoidance, where veterans avoid potential stimulus material, eg war films. Other forms of coping such as social support are secondary. Even after 50 years, veterans still experience traumatic recollections, memories which, to them at least, are accurate and detailed pictures of the events that occurred. The findings are explained in terms of a theoretical model which examines the role of traumatic recollections as conditioned responses that are out of conscious control, and likely to emerge into consciousness when the veteran is reminded of the war through some stimulus, eg the anniversary of a battle. Implications for post-traumatic stress disorder, ageing, and treatment models are considered.

Thesis (DPsych) -- Bond University, 2005. / "A thesis submitted to Bond University in partial fulfillment of the requirements for the Degree of Doctor of Psychology"-- t.p. Bibliography: leaves 81-103. Also available via the World Wide Web.

Thesis (M.A.)--Kent State University, 2009. / Title from PDF t.p. (viewed Mar. 8, 2010). Advisor: Douglas Delahanty. Keywords: PTSD; injury severity; moderators. Includes bibliographical references (p. 41-53).

Thesis (D. H. Sc.)--Deakin University. / "February 2005." Title taken from title screen (viewed October 8, 2007). Includes bibliographical references (p. 345-370) and appendices.