Stress ist Teil unseres Lebens und unsere Stressreaktion oft adaptiv. Unter extremen Bedingungen oder chronischem Stress kann diese Stressantwort jedoch maladaptiv werden und das Gehirn, Verhalten und Kognition negativ beeinflussen. Die Erfahrung von militärischen Kampfeinsatz ist eine spezifische Form von anhaltendem Stress, die aufgrund einer zunehmenden Anzahl und zunehmender Intensität militärischer Konflikte auf der ganzen Welt an Bedeutung gewinnt. In der vorliegenden Dissertation untersuche ich stressbedingte Verluste und erholungsbedingte Gewinne der grauen Hirnsubstanz, hauptsächlich in militärischen Populationen. Diese Dissertation trägt auf vier Wegen zum Wissen über die Beziehung zwischen Stress und Gehirn bei: Sie untersucht (a) den Zusammenhang zwischen Stressbelastung und Gehirn in subklinischen Populationen, (b) mögliche funktionelle Mechanismen für die Entwicklung und Aufrechterhaltung von Posttraumatischer Belastungsstörung (PTBS) bedingt durch militärischen Einsatz, (c) Veränderungen im Volumen der grauen Substanz nach therapeutischen Interventionen für einsatzbedingte PTBS, und (d) die neuronalen Korrelate der Symptomübertreibung in PTBS. Die Dissertation ist publikationsorientiert und besteht aus sechs Artikeln. Zum Zeitpunkt der Einreichung sind Artikel I, Artikel II, Artikel III und Artikel IV veröffentlicht. Artikel V und Artikel VI wurden eingereicht und werden derzeit überprüft. / Stress is an unavoidable part of life and the stress response is often highly adaptive. However, under conditions of extreme or chronic stress, the stress response can become maladaptive and can negatively impact the brain, behavior, and cognition. Combat exposure is a specific instantiation of prolonged stress, and one that is growing in relevance due to an increasing number and escalating intensity of military conflicts across the globe. In this dissertation, I investigate stress-related losses and recovery-related gains in gray matter volume, mainly in combat-exposed military populations. The present dissertation contributes to knowledge about the relationship between stress and the brain in four ways: (a) it investigates the relationship between stress exposure and the brain in subclinical populations, (b) it investigates potential functional mechanisms for the development and maintenance of combat-related posttraumatic stress disorder (PTSD), (c) it investigates alterations in grey matter volume following therapeutic interventions for combat-related PTSD, and (d) it investigates the neural correlates of symptom exaggeration in PTSD. The dissertation is publication-orientated and consists of six papers. At the time of submission, Paper I, Paper II, Paper III and Paper IV have been published. Paper V and Paper VI have been submitted and are currently under review.

The materials of war, defined as what soldiers carry into battle and off the battlefield, have much to offer as a means of identifying and analyzing the culture of those combatants. The Vietnam War is extremely rich in culture when considered against the changing political and social climate of the United States during the 1960s and 70s. Determining the meaning of the materials carried by Vietnam War soldiers can help identify why a soldier is fighting, what the soldier’s fears are, explain certain actions or inactions in a given situation, or describe the values and moral beliefs that governed that soldier’s conduct. “Carry,” as a word, often refers to something physical that can be seen, touched, smelled, or heard, but there is also the mental material, which does not exist in the physical space, that soldiers collect in their experiences prior to, during, and after battle. War changes the individual soldier, and by analyzing what he or she took (both physical and mental), attempts at self-preservation or defense mechanisms to harden the body and mind from the harsh realities of war are revealed. In the same respect, what the soldiers brought home is also a means of preservation; preserving those memories of their experiences adds validity and meaning to their experiences. An approach employing aspects of psychology, sociology, and cultural theory demonstrates that any cookie-cutter answer or characterization of Vietnam veterans is unstable at best, and that a much more complex picture develops from a multidisciplinary analysis of the soldiers who fought the war in Vietnam.

A study was conducted to describe and interpret the personal strategies that South African Police Service officers in the Vhembe District, Limpopo Province, use in their line of work. These are strategies to deal with the impact of the primary victims’ critical incidents of rape, domestic violence, murder and road accidents. The focus was on describing the impact of the critical incidents that the officers are exposed to, which manifest in a form of traumatic stress, namely, vicarious traumatisation, and management of this impact. Twenty participants were selected through purposive and theoretical sampling techniques from the family violence, child protection and sexual offences, domestic violence, field training, detective and social crime prevention units. Unstructured open-ended interviews, diaries and follow-up telephone interviews were used as data collection methods and data were collected in the participants’ home languages, Tshivenda and Xitsonga. Data gathered necessitated looking into both the aspects of the officers’ organisational and operational work. Data were thus analysed through the content thematic and constant comparative data analysis methods. The results first presented a profile of police vicarious traumatisation in the Vhembe District, which include the types of critical incidents exposed to, the organisational and operational stressors that lead to vicarious traumatisation, and the description of vicarious traumatisation symptoms. Second, a theoretical framework of the process of police critical incidents impact management (PCIIM) was developed. The framework shows that the management of the impact of the encountered incidents is inspired by various coping needs and subcultures of the officers, and the management takes place through the use of two styles of trauma management, namely, the linear and multilateral styles, which refer to application of coping strategies successively and the combination of horizontal and vertical application of coping strategies, respectively. The coping strategies used by the officers help them to have an objective understanding of the critical incidents encountered, have less severe symptoms of vicarious traumatisation, some symptoms last for shorter periods than before, and other symptoms are no longer experienced. Resilience to the encountered incidents is shown through the development of coping strategies to handle the incidents, facing them, and showing cognitive hardiness. The officers also manage to reflect on the experiences encountered, engage in narratives about them and mutual help thus still working towards attaining posttraumatic growth. / Psychology / D. Litt. et Phil. (Psychology)

Post-crisis intervention care in situations of danger in the Police of the Czech Republic. The topic of this diploma thesis consists in taking a deeper view into post-crisis intervention care in the Czech Police. The primary goal of the diploma thesis is to verify whether in the Czech Police a functional system of post-crisis intervention care is created that policemen or also their families can use if necessary. Further, we were interested whether there are opinions, attitudes and prejudice among policemen concerning the use of post-crisis intervention care. Therefore, in the theoretical part the diploma thesis deals with basic psychological terms that are closely related to the field of post-traumatic care in the Czech Police and summarizes issues of psychological care in the Czech Police. The entire object of the research is mapping the current situation of providing post-crisis care to policemen, the degree of awareness of this service, attitudes of policemen to using this service and last, but not least, purposefulness and efficiency of this service. An integral part of the goal of the work was an analysis of factors that facilitate or complicate the process of providing post-crisis care and suggestion of possible measures to make its functioning more efficient as well as finding main causes of insufficient utilisation of post-crisis intervention care by policemen. In compliance with the goal of the thesis a quantitative survey was carried out and the most suitable methods were used in such a way that the specified goal could be achieved in the most efficient way. The results of the survey carried out by us have confirmed that in the Czech Police a functioning system of post-crisis intervention care is created that policemen can use if necessary. The survey has also indicated that policemen are sufficiently informed about the system of post-crisis intervention care and that this system corresponds to the needs of police practice. However, the survey has also revealed that negative opinions, attitudes and prejudice concerning the psychological service of the Czech Police persist in policemen's minds. Reducing these negative tendencies would certainly contribute to more efficient utilisation of this service.

This study examined the relationship between perceived social support and negative mental health outcomes in battered women. Correlations between perceived social support and depression, anxiety, and post-traumatic stress disorder were analyzed. Perceived social support, particularly from family members, was found to be significantly related to mental health outcomes. Results indicate that agencies that work with battered women should include social support in the assessment and intervention processes. The study utilized a quantitative survey design with a sample of 120 battered women from four domestic violence agencies throughout Riverside and San Bernardino counties. Quantitative data analysis procedures, such as multivariate analysis and logistic regression, were used to further examine variables. Samples of the instruments used in the study are included.

The purpose of this study was to examine the beliefs and attitudes of United States Marines towards mental health services.

A study was conducted to describe and interpret the personal strategies that South African Police Service officers in the Vhembe District, Limpopo Province, use in their line of work. These are strategies to deal with the impact of the primary victims’ critical incidents of rape, domestic violence, murder and road accidents. The focus was on describing the impact of the critical incidents that the officers are exposed to, which manifest in a form of traumatic stress, namely, vicarious traumatisation, and management of this impact. Twenty participants were selected through purposive and theoretical sampling techniques from the family violence, child protection and sexual offences, domestic violence, field training, detective and social crime prevention units. Unstructured open-ended interviews, diaries and follow-up telephone interviews were used as data collection methods and data were collected in the participants’ home languages, Tshivenda and Xitsonga. Data gathered necessitated looking into both the aspects of the officers’ organisational and operational work. Data were thus analysed through the content thematic and constant comparative data analysis methods. The results first presented a profile of police vicarious traumatisation in the Vhembe District, which include the types of critical incidents exposed to, the organisational and operational stressors that lead to vicarious traumatisation, and the description of vicarious traumatisation symptoms. Second, a theoretical framework of the process of police critical incidents impact management (PCIIM) was developed. The framework shows that the management of the impact of the encountered incidents is inspired by various coping needs and subcultures of the officers, and the management takes place through the use of two styles of trauma management, namely, the linear and multilateral styles, which refer to application of coping strategies successively and the combination of horizontal and vertical application of coping strategies, respectively. The coping strategies used by the officers help them to have an objective understanding of the critical incidents encountered, have less severe symptoms of vicarious traumatisation, some symptoms last for shorter periods than before, and other symptoms are no longer experienced. Resilience to the encountered incidents is shown through the development of coping strategies to handle the incidents, facing them, and showing cognitive hardiness. The officers also manage to reflect on the experiences encountered, engage in narratives about them and mutual help thus still working towards attaining posttraumatic growth. / Psychology / D. Litt. et Phil. (Psychology)

The purpose of this study was to examine the role childhood sexual abuse (CSA), social support and a person's worldview (i.e., optimistic or pessimistic attitudes) had on Post Traumatic Stress Disorder (PTSD).

This study investigates the relationship between traumatic events and PTSD among police officers in KwaZulu-Natal and the mediating effects of coping and social support. The aim of the study was to determine the incidence of PTSD among police officers and whether coping and social support structures act as mediating variables in the stress-illness realtionship. In order to achieve this aim an assessment battery containing Biographical Checklist, the Ways of Coping Checklist, The Index of Social Support and the Dutch Post Traumatic Stress Scale was distributed to a sample of police officers in Kwazulu-Natal. The findings indicate a high incidence of PTSD, among policemen although no significant relationship was found between exposure to traumatic events and PTSD. Further, emotion­ focused coping strategies, namely, self-blame and wishful thinking, were found to be predictive of PTSD. No significant relationship was established between the availability of social support and satisfaction with social support and PTSD. / Industrial and Organisational Psychology / M.A. (Industrial Psychology)

Text in Afrikaans / The aim of the study is to describe the ecology of ideas in a family after the traumatic experience of a child. The focus is on developing a new context through which set meanings can expand. Therapeutic conversations and flexible hypnotic techniques, as part of a co-constructured process, are the "instruments" through which new ideas can be formed. The epistemological and theoretical framework of the study is postmodern, social constructionist ideas. Modernistic explanations are provided to fit in with the postmodern "both/and" focus of the study. A social constructionist position implies that the focus is placed on the multiple trauma perceptions of the family and social-cultural domain. Symptoms are viewed as part of the meaning systems in the family. The interconnection between dominant and non-dominant trauma stories is explained. Themes and relationship patterns are exposed and described according to the researcher's own epistemology, reflections and interpretations of the literature. / Clinical Psychology / M.A. (Clinical Psychology)