This research explores the beliefs and behaviour of individuals who have suffered a traumatic experience, specifically the violent crimes of assault, motor vehicle hijackings and armed robbery. The researcher focuses on the occurrence of residual, subclinical symptoms of PTSD that individuals experience subsequent to the specified violent crimes. By identifying and describing trends in commonalities that exist between research participants’ accounts of such residual, subclinical symptoms the research aims to explore and describe these trends, enabling a common understanding and awareness of the longstanding effects that these experiences have on individuals. The qualitative research design allowed for an exploration aimed at understanding the meaning that individuals ascribe to specific events. Three case studies were examined. The researcher ensured the exclusion of individuals who met the criteria for PTSD by making use of the PCL-S. From this approach a thematic analysis was done using the transcriptions of audiotaped interviews with the participants. The three participants chosen for the study were aged twenty-nine (29), thirty (30) and thirty-one (31) independently. Two of the participants experienced an armed robbery, which were, independently, followed by non-violent crime of housebreaking and theft. A third participant experienced an armed robbery during her early childhood, and an additional crime of aggravated robbery in adulthood. The studied violent crimes had taken place between one year eleven months and six years prior to this study. None of the participants have received therapy following their traumatic experience. Five important findings were identified and discussed. Firstly, some individuals still meet the requirements for a diagnosis of PTSD, even years following their experiences with traumatic events. Secondly, following the experience of a violent crime some individual’s core cognitive schemas regarding themselves, their world and their relationships undergo various changes. Thirdly, some individuals experience numerous posttraumatic symptoms, which are not extensive enough to validate the diagnosis of PTSD, but that affect the individual’s life on a regular basis. Nine symptoms were identified in this study. Fourthly, some individuals may experience additional effects following exposure to violent crimes, e.g. physical illness, that is not classified as posttraumatic symptoms. Fifthly, a few individuals who have been the victim of more than one crime may experience cumulative or diminished effects when one explores the overall effects of revictimisation. Results also indicated that individuals may experiences similar posttraumatic symptoms, but that the presentation of these symptoms are unique and are influenced by an individual’s history, cognitive schemas and the characteristics of the crimes that they have experienced. Finally, these findings explored and described the phenomenon of partial posttraumatic stress disorder in order to expand the understanding of this occurrence. / Dissertation (MA)--University of Pretoria, 2014. / tm2015 / Psychology / MA / Unrestricted

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<p>Up to two million women worldwide have obstetric fistula, a maternal morbidity prevalent in developing countries that causes uncontrollable leaking of urine and/or feces and a persistent bad odor. There is both theoretical and empirical evidence for psychopathology in patients presenting for fistula surgery, albeit with methodological limitations. The current studies sought to improve on past limitations of study design. Study A compared psychological symptoms and social support between fistula patients and a comparison group recruited from gynecology outpatient clinics. Measures included previously validated psychometric questionnaires, administered orally by data collectors. Results showed that compared to gynecology outpatients, fistula patients had significantly higher levels of depression, traumatic stress, somatic symptoms and avoidant coping, and had lower social support. Study B investigated changes in psychological symptoms, stigma and social support between the time of admission for fistula repair and 3 months after discharge from the hospital. At follow-up, fistula patients reported significant improvements in all study outcome variables. Exploratory analysis revealed that the extent of leaking was associated with depression and PTSD. These results indicate the potential benefit of mental health interventions for this population. Additionally, future research may clarify the relationship between residual leaking after fistula surgery, and its effect on post-surgery mental health outcomes.</p> / Dissertation

Posttraumatic stress disorder (PTSD) is an anxiety disorder that may follow exposure to severe emotional trauma and presents with various symptoms of anxiety, hyperarousal and cognitive anomalies. Interestingly, only 10-30% of an exposed population will go on to develop full-blown PTSD. Cholinergic neurotransmission is implicated in anxiety as well as other typical manifestations of PTSD, particularly cognitive changes. The frontal cortex and hippocampus regulate and in turn are affected by stress, and have also been implicated in the underlying neuropathology of PTSD. These areas are densely innervated by cholinergic neurons originating from the basal forebrain. In this study, the time dependent sensitization (TDS) model was used to induce symptoms of PTSD in animals. The study was designed to determine the long-term effects of an intense, prolonged aversive procedure on central muscarinic acetylcholine receptor (mAChR) characteristics and the correlation if any of those findings to cognitive aspects and general arousal as characteristics associated with PTSD. In order to achieve this goal, male Sprague-Dawley rats were exposed to the TDS stress paradigm with behavioral/neuro-receptor assessments performed on day 7 post re-stress (duration of each experiment in whole is 14 days). Acoustic startle reflex (ASR) was used to determine emotional state (hyperarousal), while the conditioned taste aversion (CTA) paradigm was implemented in order to assess aversive memory. Muscarinic receptor binding studies were performed in the frontal cortex and hippocampus. Moreover, both the stress-exposed and control animals were pre-tested in the acoustic startle chamber in order to attempt to separate stress sensitive from stress-resilient animals based on predetermined ASR criteria. The ASR niodel was previously validated in our laboratory, while the CTA model was validated in this project before application. In the CTA model, an i.p. injection with lithium chloride (LiCl) (associated with digestive malaise), was used as unconditioned stimulus (US) and was paired with a saccharinlcyclamate drinking solution as conditioned stimulus (CS) to induce aversion to the novel taste (CS) when presented in the absence of the US. Population data of animals tested in the ASR experiment indicated no statistical significant difference between stressed and control animals. However, when each animal was assessed individually, 22.5 % of the exposed population displayed all increase above the predetermined criteria of 35 % in startle response, indicating a state of heightened arousal. In contrast, only 4.2 O h of control animals (no stress) displayed an increase in arousal based on the above mentioned criteria. Muscarinic receptor densities (Bm,) in the total population of animals exposed to stress showed a statistical significant increase in both the hippocampus and frontal cortex when compared to controls, with no changes in & values observed in either one of the areas. In the CTA experiment, TDS stress was implemented as US paired with a saccharinlcyclamate drinking solution as CS. An acute session of prolonged stress (as used in the TDS model) effectively induced aversion to a novel taste and a subsequent reminder of the stress (restress) paired with the CS sustained the acquire adversive memory. Furthermore, LiCl was reintroduced as US in order to assess the effect of prior exposure to two types of stress (acute and TDS) on subsequently acquired CTA memory. Prior exposure to acute stress had no significant effect on subsequently acquired aversive memory when measured either 3- or 7 days post-conditioning (CS-US). Stress-restress (TDS) exposure, however, indicated a significant decrease in aversive memory from 3- to 7 days post-conditioning (CS-US) as well as a significant decrease in aversive memory between the control- and the TDS group 7 days post-conditioning. The mAChR density (B,,) in the frontal cortex; but not in the hippocampus, was elevated at the same point in time (7 days post CS-US pairing) that CTA memory was impaired following TDS stress (stress-restress). Ultimately, these data support an association between altered cholinergic receptors and hyperarousallanxiety in an animal model of PTSD. The data also support the phenomenon of individual susceptibility to stress in animals that parallels that observed in humans exposed to severe trauma. Impaired aversive memory (CTA) is a consequence of prior exposure to TDS stress, but not acute stress, and is likewise mediated by an altered central cholinergic transmission displayed as an increase in mAChRs in the frontal cortex. The lack of studies regarding the influence of the cholinergic system in PTSD related behavior earns ,this project value as inimitable PTSD research. / Thesis (M.Sc. (Pharmacology))--North-West University, Potchefstroom Campus, 2007.

Thesis (M.Sc. (Pharmacology))--North-West University, Potchefstroom Campus, 2007.

Posttraumatic stress disorder (PTSD) is an anxiety disorder that may follow exposure to severe emotional trauma and presents with various symptoms of anxiety, hyperarousal and cognitive anomalies. Interestingly, only 10-30% of an exposed population will go on to develop full-blown PTSD. Cholinergic neurotransmission is implicated in anxiety as well as other typical manifestations of PTSD, particularly cognitive changes. The frontal cortex and hippocampus regulate and in turn are affected by stress, and have also been implicated in the underlying neuropathology of PTSD. These areas are densely innervated by cholinergic neurons originating from the basal forebrain. In this study, the time dependent sensitization (TDS) model was used to induce symptoms of PTSD in animals. The study was designed to determine the long-term effects of an intense, prolonged aversive procedure on central muscarinic acetylcholine receptor (mAChR) characteristics and the correlation if any of those findings to cognitive aspects and general arousal as characteristics associated with PTSD. In order to achieve this goal, male Sprague-Dawley rats were exposed to the TDS stress paradigm with behavioral/neuro-receptor assessments performed on day 7 post re-stress (duration of each experiment in whole is 14 days). Acoustic startle reflex (ASR) was used to determine emotional state (hyperarousal), while the conditioned taste aversion (CTA) paradigm was implemented in order to assess aversive memory. Muscarinic receptor binding studies were performed in the frontal cortex and hippocampus. Moreover, both the stress-exposed and control animals were pre-tested in the acoustic startle chamber in order to attempt to separate stress sensitive from stress-resilient animals based on predetermined ASR criteria. The ASR niodel was previously validated in our laboratory, while the CTA model was validated in this project before application. In the CTA model, an i.p. injection with lithium chloride (LiCl) (associated with digestive malaise), was used as unconditioned stimulus (US) and was paired with a saccharinlcyclamate drinking solution as conditioned stimulus (CS) to induce aversion to the novel taste (CS) when presented in the absence of the US. Population data of animals tested in the ASR experiment indicated no statistical significant difference between stressed and control animals. However, when each animal was assessed individually, 22.5 % of the exposed population displayed all increase above the predetermined criteria of 35 % in startle response, indicating a state of heightened arousal. In contrast, only 4.2 O h of control animals (no stress) displayed an increase in arousal based on the above mentioned criteria. Muscarinic receptor densities (Bm,) in the total population of animals exposed to stress showed a statistical significant increase in both the hippocampus and frontal cortex when compared to controls, with no changes in & values observed in either one of the areas. In the CTA experiment, TDS stress was implemented as US paired with a saccharinlcyclamate drinking solution as CS. An acute session of prolonged stress (as used in the TDS model) effectively induced aversion to a novel taste and a subsequent reminder of the stress (restress) paired with the CS sustained the acquire adversive memory. Furthermore, LiCl was reintroduced as US in order to assess the effect of prior exposure to two types of stress (acute and TDS) on subsequently acquired CTA memory. Prior exposure to acute stress had no significant effect on subsequently acquired aversive memory when measured either 3- or 7 days post-conditioning (CS-US). Stress-restress (TDS) exposure, however, indicated a significant decrease in aversive memory from 3- to 7 days post-conditioning (CS-US) as well as a significant decrease in aversive memory between the control- and the TDS group 7 days post-conditioning. The mAChR density (B,,) in the frontal cortex; but not in the hippocampus, was elevated at the same point in time (7 days post CS-US pairing) that CTA memory was impaired following TDS stress (stress-restress). Ultimately, these data support an association between altered cholinergic receptors and hyperarousallanxiety in an animal model of PTSD. The data also support the phenomenon of individual susceptibility to stress in animals that parallels that observed in humans exposed to severe trauma. Impaired aversive memory (CTA) is a consequence of prior exposure to TDS stress, but not acute stress, and is likewise mediated by an altered central cholinergic transmission displayed as an increase in mAChRs in the frontal cortex. The lack of studies regarding the influence of the cholinergic system in PTSD related behavior earns ,this project value as inimitable PTSD research. / Thesis (M.Sc. (Pharmacology))--North-West University, Potchefstroom Campus, 2007.

Antalet flyktingar i Sverige ökar och därmed behovet av behandling. Multidisciplinär behandling används för flyktingar då de ofta lider av post-traumatiskt stress syndrom (PTSD), psykisk och somatisk komorbiditet, samt social problematik. Studiens syfte var att undersöka behandlingseffekter på PTSD-symtom och komorbida ångest- och depressionssymtom, samt undersöka prediktorer för utfall. Mätningar från 49 patienter på två specialistkliniker användes för att undersöka skillnader mellan före och efter behandling på skalorna PTSD Checklist-Civilian och Hopkins Symtom Checklist-25.Resultaten visade statistiskt signifikant effekt på både PTSD-symtom (p &lt; 0,001,d = 1,46) och komorbida symtom (p &lt; 0,001, d = 1,28). Prediktorer som hade samband med utfallet var ålder och nivå av PTSD-symtom innan behandling. Resultaten påvisar en begränsad kliniskt signifikant effekt av behandling och en modell för prediktion som förklarar en stor del av variansen (R 2 = 33 %). Stort bortfall mellan mätning före och efter behandling minskar generaliserbarheten.