Thesis (Ph.D.)--Baylor University, 2006. / Includes bibliographical references (p. 123-135).

Thesis (M MSc (Clinical Psychology))--University of Limpopo,2010. / The phenomenon of trauma from violent crime is deeply rooted within the South African community (Human Rights Watch, 2008). Various studies has researched the resulting post-traumatic stress reaction (PTSR) of the trauma victim, with far-reaching implications for an understanding of the emotional, cognitive, physiological, and social level of functioning of the victim (Edwards, 2005). Punctuating from the general systems theory, however, it is clear that the trauma victim does not function in isolation, but forms part of certain circular patterns of interaction within a family system. Change in one part of this system will induce change in the system as a whole (Becvar & Becvar, 2006). The aim of this research project was to move away from exclusively focusing on the trauma victim and to investigate the effects, if any, on the whole family system if one of its members experienced a PTSR. Data was collected from qualitative interviews with a family member of each trauma victim, someone who had not directly experienced the traumatic incident. The data was transcribed verbatim and analysed, in accordance with qualitative methodology by three independent, systemically trained clinicians. The findings indicate that there is a significant effect on the whole family system, and that all the members of this system experience some form of PTSR as a secondary traumatic experience. The ability of the system to cope effectively with this environmental demand is based largely on the effectiveness of its patterns of communication. These findings have important implications for our understanding of the phenomenon of trauma, trauma prevention and intervention strategies.

Thesis (Ph. D.)--Auburn University, 2008. / Abstract. Vita. Includes bibliographical references (p. 49-57).

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2008. / Typescript. Includes bibliographical references (leaves 81-85).

No description available.

No description available.

No description available.

Inledning: Sedan PTSD har blivit en diagnos i den psykiatriska diagnosmanualen DSM har forskningen i detta område ökat mycket. Samtidigt har man kunnat se att tidiga traumatiska upplevelser framför allt med anknytningspersoner ökar prevalensen för utveckling av psykiatriska och somatiska sjukdomar. Detta har lett till hypotesen att ett anknytningstrauma kan vara en predisponerande faktor för utveckling av PTSD eller att en trygg anknytning kan vara en skyddande sådan. Som kollektiv i studier valdes mest veteraner, våldäkts- eller brottsoffer. Denna pilot-studien väljer ett annat patientkollektiv. Frågeställning: Vilka anknytningsmönster som finns hos 10 patienter med exilbakgrund, vilka har varit utsatta för krig och/eller tortyr. Method: Undersökningen görs med hjälp av två skattningsinstrument, PCL-5, som undersöker graden av PTSD-symtom och ASQ, som undersöker anknytningsmönstret. Undersökningen görs med både kvalitativ metod genom att undersöka deltagarnas individuell anknytningsmönster genom utvärderingen och tolkningen av svaren i ASQ-testet och kvantitativ genom att utvärdera korrelationer mellan graden av PTSD-symtom och anknytningsmönstren. Resultat: I den kvalitativa delen visar det sig att nästan alla deltagare visar ett otryggt anknytningsmönster och i den kvantitativa delen ses det några intressanta tendenser, såsom att höga poäng på distansskalan har en stark korrelation till höga PTSD-score och en icke-signifikant negativ korrelation med tillits-skalan. I delgrupperna (män/kvinnor) ses tendenser som är signifikanta trots det låga deltagartalet. Diskussion: Undersökningen bekräftar hypotesen att patienter anknytningssystemet har drabbats hos patienter med PTSD och exilbakgrund. Resultatet ses som underlag till vidare forskning med en större population. / Introduction: Since PTSD has become a distinct diagnosis in the psychiatric manual of diagnoses (DSM) a lot of research has been done in this field. At the same time has research in the field of attachment produced evidence that early traumatic events, especially in relation to children´s attachment figures, rises the prevalence of psychiatric illness. This led to the hypothesis that attachmenttrauma could be a predisposing factor for development of PTSD or that a secure attachment could be a protective one. Most researchers chose veterans or violence/rape or crime-victims. This pilot-study chooses a different studypopulation. Issues: Which attachment patterns show patients with exile-background who became victims of war and/or torture. Method: The study uses two rating-scales for this, the PCL-5 to establish the participants PTSD-symptom-score and the ASQ to show the attachment pattern. In the qualitative part of the study the individual attachment patterns are established by evaluating and interpreting the answers in the ASQ-scale. The quantitative part of the study shows the correlations between the PTSD-totalscore and the attachment pattern. Results: The qualitative part shows that nearly all participants with a high PTSDsymptom-score show an insecure attachment. The quantitative part shows some interesting tendencies like a positive correlation between high PTSD-total-score and high score in the ASQ-dimension “discomfort with closeness” and a nonsignificant negative correlation between high PTSD-total-score and confidence. Discussion: The study confirms the hypothesis that PTSD-patient´s attachmentsystem is troubled. This result takes as a basis for more research with a bigger sample.

Literature investigating trauma exposure, Posttraumatic stress disorder (PTSD) and cortisol secretion has produced conflicting results with regard to whether cortisol is increased or decreased. With trauma there is also a pro- inflammatory response which is intimately linked with the hypothalamic pituitary axis (HPA). The police population can offer useful information in this regard as they represent a sample that will undergo exposure to traumatic events as part of their normal duties. In South Africa few studies have examined biological correlates of the traumatic stress response in the police population. This study sought to determine whether correlations exist between cortisol and the inflammatory response in terms of the cytokines Interleukin 6 (IL6) and Tumour Necrosis Factor (TNF) in response to trauma exposure in a cohort of newly enrolled metro police officers, previously naïve to the duty related trauma exposure. Personality styles were assessed, as coping skills and personality have been suggested as factors determining responses to trauma. The study participants were followed up for one year with repeated measures analysis of urine, blood, and saliva cortisol as well as blood cytokine determination every 3 months. Measures for PTSD [the Clinician Administered Scale for Posttraumatic stress disorder (CAPS) and the revised version of the Impact of Event Scale (IES-R)] as well as for depression [the Hamilton Depression Rating Scale (HAM-D)] were undertaken. 145 new recruits volunteered for the study, of which 120 completed all 5 visits. There were slightly more females than males in the sample and almost 50% of the sample admitted to alcohol abuse. Trauma exposure on entry into the police force was remarkably high with 99% having been exposed to at least one traumatic event in their lives. The majority (61.1 %) had been exposed to more than one traumatic event. There was evidence for the influence of prior trauma on responses to current traumatic events. MVA’s were very common, both duty and non duty related. Certain traumas were associated with greater changes in scores for PTSD and depression in relation to baseline. Over the 5 visits, only a third submitted valid 24 hour urine samples. Of these, the profile of the entire group indicated that 24 hour urine cortisol tended to initially decrease, and then increase with time. Saliva and blood cortisol, which were more reliably measured, tended to decrease with time. Scores for depression and post traumatic stress disorder were generally low in response to duty related traumatic events, and tended to decrease over time. However, the prevalence of lifetime PTSD as measured by the CAPS was high. There was a strong linear correlation between TNF and IL6. Results indicate a proinflammatory response, particularly with regard to IL6. There were no significant correlations between blood cortisol and HAM-D and between blood cortisol and CAPS (lifetime). There was an inverse relationship between CAPS (current scores) and blood cortisol. Cortisol and IES-R scores were significant at visit 3 (inverse relationship). For saliva, there were no significant associations with any of the variables for PTSD and depression. For personality styles, aggressive and antisocial clinical patterns were associated with lower current CAPS scores, while schizoid clinical pattern and the severe syndrome scale of thought disorder showed an association with lower lifetime CAPS score. For the IES-R, only narcissistic clinical pattern was associated with lower scores. A further analysis of those with low (less than 25% of the median) and high (greater than 25% of the median) cortisol responses was undertaken. The results indicate a similar trend to some studies showing lowered cortisol levels with chronic trauma exposure, but this did not correlate with sufficiently high scores for PTSD as measured by the CAPS. Similarly, proinflammatory cytokine increases are evident with trauma exposure, but not with scores for PTSD and depression. There were more variables significantly associated with the low cortisol responders than the high cortisol responders; with a suggestion of cumulative trauma exposure correlating with low cortisol response and a corresponding pro inflammatory response in terms of IL6. The results are discussed with a view to assisting the metro police force with recruitment and counseling strategies and important future research is recommended.

Objectives: - The present research attempts to elicit children's perceptions and experiences of enduring a road traffic accident (RTA). It also examined their parents experiences of parenting such children and their own experiences and perceptions of the accident. Participants: - The study focussed on 14 children, aged from 9 years 9 months - 14 years and 4 months of age who had endured a RTA from between 9-33 months previously and their parents. Design: - The study employed a non-experimental design with a combination of quantitative and qualitative paradigms. Method: - The participants were identified via the hospital database of all children who had endured a RTA from between 6-24 months previously. Both the children and their parents were interviewed on specifically designed semi-structured interview schedules. Each interview was then tape-recorded and transcribed in its entirety. These transcripts then provided the universe of material for subsequent qualitative analysis. Results:- The results of this study demonstrated that approximately half of the children who had experienced a RTA were suffering from a post traumatic stress disorder (PTSD). In addition, the PTSD case children differed from the non-case children on factors such as awareness of the inpending RTA, feelings of self-blame regarding the accident, and more negative thoughts regarding their experience immediately after the impact and at the time of the assessment. In addition, the parents of the case children displayed similar responses to that of their children. Conclusion: - A theoretical Model was presented to account for the main findings in response to the research questions, also drawing on existing research. It is emphasised that this model is speculative due to the small sample size insofar as it draws upon the present findings, and as such can only relate to this study sample and further research would be required to fully test and validate it. In addition, recommendations were made for service delivery and clinical practice.