This study investigated links between sexual assault experiences, posttraumatic stress symptoms (PTSS), and adverse physical health outcomes among adult women. Existing models in which posttraumatic stress disorder (PTSD) mediate the relationship between trauma exposure and physical health outcomes have been established within a variety of trauma populations, but had yet to be specifically tested with the trauma of sexual assault. Through the use of structural equation modelling (SENT), support was found for a model in which posttraumatic stress symptom (PTSS) severity partially mediates the association between sexual assault exposure and physical health problems. While PTSS severity served as a partial mediator, it was revealed that depression symptoms did not A multivariate multiple regression was conducted to test whether the three PTSD symptom clusters (i.e., reexperiencing, avoidance, and hyperarousal symptoms) were differentially related to physical health outcomes, but it was found that no single symptom cluster explained the association between PTSD and adverse physical health outcomes. It was revealed, however. that reexperiencing symptoms and avoidance symptoms had unique associations with health care utilization and health perceptions, respectively. Finally. A unique relationship between sexual assault exposure and reproductive and sexual health problems was revealed, suggesting that this is a particularly important area of health concern among sexual assault survivors.

Transition to parenthood can be a stressful time for a couple, especially for couples at risk for substance misuse and intimate partner violence. Relationship satisfaction tends to decline in the first year of parenthood as the partners are adjusting to the demands of their new roles as parents. History of trauma and current symptoms of Post-traumatic Stress (PTS) have been associated with decreased intimacy, communication, and relationship adjustment, yet there is a lack of research on how PTS symptoms and trauma history affect parents and families. The current study investigated how PTS symptoms and trauma history affect new parents’ relationship satisfaction in the presence of substance misuse and intimate partner violence. Ninety eight heterosexual couples filled out questionnaires one year after the birth of their first child. Hierarchical multiple regression results indicated that PTS symptoms predicted relationship satisfaction over and above IPV victimization and substance misuse for men. However, for women, psychological IPV victimization was the only significant multivariate predictor for women. Additionally, for men, PTS symptoms interacted with harmful drinking to predict relationship satisfaction. The results suggest that women’s relationship functioning is particularly affected by psychological aggression while men’s relationship functioning is particularly susceptible to effects of harmful drinking and their own PTS symptoms. Implications are discussed. / Graduate

This study investigated the resourcing experiences of children and youth attending office-based, tri-phasic trauma treatment. Ten participants were recruited from both private and agency based clinical psychology or counselling practices. During semi-structured, in-depth interviews participants described their resourcing experiences. The data were analyzed using the descriptive, phenomenological, and psychological method of Amedeo Giorgi. The results revealed a basic structure in the resourcing experiences of the child participants which was comprised of 12 constituents: (a) perceived attitude of the therapist, (b) personal and contextual relevance, (c) currency, (d) choice and control, (e) calming, (f) unsticking, (g) experiential, (h) triumph, (i) internal ease, (j) needing a guide, (k) naming the resource, and (l) betterment. The findings contribute to an understanding of the resourcing experience of youth in trauma therapy by adding the client’s voice to the therapeutic process. Implications for clinical practice and further research are presented. / Graduate

Past research on adult memory for childhood sexual abuse (CSA) has provided support for the phenomenon of forgetting and subsequent recovery of the memories, after a period of time. This phenomenon, however, remains a source of debate and is still not fully understood by researchers and psychological and legal practitioners. The research has provided conflicting evidence about the factors which are thought to lead to CSA forgetting for extensive periods of time, in addition to the processes involved in forgetting, triggering and later remembering of the abuse memories by adult survivors. This study utilised a mixed method to investigate and explore the factors and processes associated with CSA forgetting, triggering and later remembering, in a sample of Australian adult CSA survivors (N = 77). Participants were asked to complete a test booklet, containing the Traumatic Events Questionnaire (TEQ), Symptom Checklist-90-Revised (SCL-90-R), Dissociative Experiences Scale II (DES II), Impact of Events Scale - Revised (IES-R), a scale designed to measure persistence of memory (Loftus), and a scale designed to measure emotional intensity at the time of the abuse and now (Williams). Participants were then asked to participate in a semi-structured interview. Seventy-one participants completed the interview process. Five separate analyses were conducted on the data. Methodological issues, such as the use of retrospective data and corroboration of the abuse were outlined. All participants were asked to provide details about any corroboration they had received that the abuse had occurred. The participants were streamed into one of three categories of forgetting (Always Remembered, n = 28; Partial Forgetting, n = 16; and Extensive Forgetting, n = 33). The first analysis (Stage One Analysis One) examined the factors thought to be associated with CSA forgetting, such as abuse parameters (TEQ), current psychological functioning (SCL-90-R), persistence of memory (Loftus), emotional intensity at the time of the abuse and now (Williams), the trauma response experienced at the time of the abuse (IES-R), and current dissociation (DES II), to determine the significant differences between the three groups. A significant difference was found regarding the age at which the abuse commenced, with the Extensive Forgetting group reporting an earlier age at which the abuse commenced. Significant differences were found on the variable that related to being abused by an aunt or uncle, and on the current experience of hostility (SCL-90-R sub-scale), and on the current levels of anger (Williams Emotional Intensity) experienced by the participants. Significant differences between the groups were also found on two of the Persistence of Memory items, namely clarity of memory and participants' memory of the tastes related to the abuse. Finally, a significant difference was found on the participants' current dissociation levels, with the Extensive Forgetting group reporting higher levels of current dissociation than the other two groups. Statistical profiles for each of the three groups were constructed, based on the mean scores of the SCL-90-R, IES-R and DES II, for use in the Stage Two, Analysis Two, profile comparison. Stage Two, Analysis One, provided a qualitative analysis relating to the experience of always remembering the abuse. The aim of this analysis was to provide a deeper understanding of why some participants (n = 23) did not forget about their abuse, when other participants reported being able to forget for a period of time. The results indicated that participants' responses formed clusters, such as older age at abuse onset, failed dissociative mechanisms, constant reminders, and others. Stage Two, Analysis Two, presented and compared each participant's profile against the statistical profiles constructed in Stage One. The participant's profiles included a summary of their TEQ responses and interview responses, in addition to their Stage One test booklet scores. The comparison was made, firstly, on a specific basis against the mean scores obtained by each category of forgetting, and secondly, on a broader basis, against the score range for each measure of the statistical profile. This was done to determine if there was a "typical" member of each category of forgetting and to investigate the within-group differences. The specific profile comparison demonstrated that there was no "typical" member of any of the three groups, with participants varying widely in their scores and patterns of scores. However, when the profile comparison was broadened to include score ranges, 61% of participants, who always remembered the abuse, 44% of participants who partially forgot the abuse, and 47% of participants who extensively forgot their abuse, matched the profile of a "typical" member of their relevant category of forgetting. Stage Two, Analysis Three, provided an in-depth qualitative exploration on the process involved in CSA forgetting, triggering and later remembering, for a selection of participants who reported partially forgetting the abuse (n = 6), and extensively forgetting the abuse (n = 10). Participants' interview responses were transcribed verbatim and analysed, using Interview Analysis. This analysis explored the differences between participants, from the two categories of forgetting, on their experiences of CSA forgetting, triggering and later remembering, in addition to exploring how these participants were able to forget about the abuse; what events triggered their abuse memories; and how the initial memories returned. Issues of memory recovery, while in therapy or under hypnosis, were also explored. Stage Two, Analysis Four, presented the case study of a participant, who had been identified as an "outlier", due to her high score on the DES II, claims of being able to remember abuse incidents that occurred prior to the age of two years, diagnosis of DID, and the substantiated conviction and sentencing of her abuser, based on her recovered memories of the abuse and corroboration from her sister and mother. Her case was examined against some of the criticisms often made by false memory supporters. This thesis found that some CSA survivors forgot about their abuse, either partially or extensively. The thesis also found support for some, but not all, of the factors that previous researchers have identified as being associated with CSA forgetting by adult survivors, specifically the individual's age at the time the abuse commenced and the individual's ability to dissociate from the abuse. The research then explored, in-depth, the issues of: CSA remembering, CSA survivor profiling, and the "how" of CSA forgetting, triggering and later remembering, by adult survivors.

"The first report describes a case of Major Depressive Disorder (MDD) in a pregnant women living in regional Australia. It begins with a discussion of issues of relevance to the treatment of a pregnant woman with MDD. It also describes the evidence based treatment provided and the results achieved for this client. The second report follows the same format to describe a case of PTSD in a married mother living in regional Australia following a suicide attempt. The third report describes a case of Bipolar I disorder in a separated mother living in regional Australia. Finally, fourth report explores the professional and ethical issues associated with the practice of clinical psychology [...]. This report explores professional issues which include self-care requirements and strategies, initial client contact, communication with colleagues and professional development and client records. Ethical issues covered include professional competency, termination of relationships and confidentiality." / Doctor of Psychology (Clinical)

Thesis (MPsy(Clinical))--University of South Australia, 2001.

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

"The first report describes a case of Major Depressive Disorder (MDD) in a pregnant women living in regional Australia. It begins with a discussion of issues of relevance to the treatment of a pregnant woman with MDD. It also describes the evidence based treatment provided and the results achieved for this client. The second report follows the same format to describe a case of PTSD in a married mother living in regional Australia following a suicide attempt. The third report describes a case of Bipolar I disorder in a separated mother living in regional Australia. Finally, fourth report explores the professional and ethical issues associated with the practice of clinical psychology [...]. This report explores professional issues which include self-care requirements and strategies, initial client contact, communication with colleagues and professional development and client records. Ethical issues covered include professional competency, termination of relationships and confidentiality." / Doctor of Psychology (Clinical)

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.

Thesis (MA (Counselling Psychology))--University of Pretoria, 2006. / Includes bibliographical references. Available on the Internet via the World Wide Web.