Thesis (J.C.L.)--Catholic University of America, 1986. / Bibliography: leaves 117-129.

Thesis (Ph.D.)--York University, 2005. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 137-151). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pNR11561

Recent global conflicts have increased North American military involvement, leading to higher rates of combat-related stress amongst soldiers. Although physical activity is directly correlated with improvements in mental health, the relationship between physical activity and combat-related stress has not been investigated. Using a mixed methodology approach, in this study, local military and ex-military personnel from Winnipeg, Canada, participated in a six week physical activity program in order to examine the influence of physical activity on combat-related stress. It was found that Canadian military members regularly deal with post-combat stressors, value camaraderie, and consider post-deployment support inadequate. The findings may lead to the integration of physical activity into the healing options of war related emotional stress. Future recommendations from this study are proposed. / February 2016

The thesis includes three papers: paper 1 is a literature review, paper 2 is an empirical study and paper 3 is a critical reflection. Paper 1 and 2 have been prepared for submission to Clinical Psychology and Psychotherapy. Paper 1 systematically reviews the qualitative literature pertaining to individual experiences of psychotherapy for PTSD. A meta-synthesis of twelve studies was facilitated using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) principles. The meta-synthesis aimed to explore aspects of psychotherapy for PTSD that were deemed helpful or unhelpful. The strengths and limitations of the study are considered, as are their implications for clinical practice. Paper 2 was a qualitative exploration of basic emotions and the affective phenomena of PTSD. Semi-structured interviews were conducted with ten participants and transcripts were analysed using a deductive-inductive thematic analysis. The results highlight the importance of considering a range of basic emotions in the assessment, formulation and psychotherapy relating to PTSD. The strengths and limitations of the study are considered, as are their implications for clinical practice. Paper 3 is not intended for publication and is a critical reflection of the overall study process. It evaluates the strengths and limitations of both paper 1 and paper 2 in more detail, in addition to offering a critical and reflective account of conducting the research.

Background: Post-traumatic stress and exposure to early traumatic events are often characterised by negative self-cognitions and experiences of shame, guilt or blame. These symptoms are theoretically linked to the concept of self-compassion which is an important factor in affect regulation, and is predictive of mental wellbeing and psychological distress. Interventions aimed at increasing acceptance, non-judgement and self-compassion such as mindfulness may be useful in the treatment of post-traumatic stress symptoms. Methods: The first part of this portfolio presents a systematic review which aimed to collate and evaluate the existing research for the use of mindfulness based interventions to treat post-traumatic stress symptoms. The search process involved a systematic search of relevant research databases, hand search of relevant journals, and relevant authors were contacted. The second part of this portfolio presents a quantitative research study which explored the relationship between the experience of childhood trauma and self-compassion; and whether self-compassion was predictive of post-traumatic stress and growth in an adult clinical sample. Data were collected through postal survey and analysed using correlation and hierarchical regression analysis. Systematic Review Results: The systematic review resulted in 12 studies which met eligibility criteria, the majority of studies indicated positive outcomes with improvements in post-traumatic stress symptoms, particularly in reducing avoidance. Many of these studies lacked methodological rigour and further studies with more robust research design are required. Research Study Results: The quantitative study showed that greater experience of childhood emotional abuse, neglect, punishment and sexual abuse were significantly correlated with lower self-compassion in adulthood. Hierarchical regression showed that self-compassion was predictive of total post-traumatic stress symptoms, post-traumatic avoidance and intrusion when age, gender, exposure to traumatic events and childhood trauma were controlled. The experience of post-traumatic growth showed no significant relationship with self-compassion. Conclusions: Studies indicate that mindfulness interventions show promise for the treatment of PTSD symptoms, although further research with more robust methodology is needed. Greater experience of childhood abuse is related to lower self-compassion in adulthood and lower self-compassion is predictive of higher PTSD avoidance and intrusion symptoms. This suggests that future research investigating self-compassion interventions may be beneficial in treating PTSD.

No description available.

M.A. (Clinical Psychology) / The post-traumatic stress syndrome has traditionally been defined and treated as pathology residing within the individual. The systemic interactional approach which is favoured in this study, however, holds that all subsystems of the larger system are interconnected and that change within the individual subsystem therefore constitutes change in other subsystems. The question that is posed in this thesis, is whether the theoretical assumptions of the systemic approach may be applied to create a better, fuller understanding of the post-traumatic stress syndrome. Theoretical discussion of both a traditional and a systemic approach to the post-traumatic stress phenomenon, as well as their practical application by means of a case study, indicates that the traditional perspective on the posttraumatic stress syndrome is valuable in terms of diagnosis of the disorder and identification of possible causitive stressful life events. It is, however, very limiting in its specificity and does not allow for a full understanding of the diversity of behaviours presented by a system that has been traumatized, directly or indirectly. In this respect, the systemic interactional approach allows the therapist a wider perspective in which individual behaviour may be systemically contectualized, rendering the behaviour interactionally meaningful. Although the system typically presents with one member who apparently suffers from post-traumatic stress disorder, this study indicates that the whole fa~ily system may in fact come to crisis if the traumatic event cannot be accommodated within the existing interactional patterns. Under such conditions it may be functional to the family system to keep one subsystem overtly symptomatic in order-to focus its attention away from its own pain, thereby trapping theindividual in his symptomatic behaviour. The study thus aims to indicate the value that a systemic interactional approach may have in dealing with the effects of trauma on both the individual and the larger system.

Background Individually both migraine and post-traumatic stress disorder (PTSD) prevalence estimates are higher among women. However, there is limited data on the association of migraine and PTSD in women during pregnancy. Methods We examined the association between migraine and PTSD among women attending prenatal clinics in Peru. Migraine was characterized using the International Classification of Headache Disorders (ICHD)-III beta criteria. PTSD was assessed using the PTSD Checklist-Civilian Version (PCL-C). Multivariable logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (CI) after adjusting for confounders. Results Of the 2922 pregnant women included, 33.5% fulfilled criteria for any migraine (migraine 12.5%; probable migraine 21.0%) and 37.4% fulfilled PTSD criteria. Even when controlling for depression, women with any migraine had almost a 2-fold increased odds of PTSD (OR: 1.97; 95% CI: 1.64–2.37) as compared to women without migraine. Specifically, women with migraine alone (i.e. excluding probable migraine) had a 2.85-fold increased odds of PTSD (95% CI: 2.18–3.74), and women with probable migraine alone had a 1.61-fold increased odds of PTSD (95% CI: 1.30–1.99) as compared to those without migraine, even after controlling for depression. In those women with both migraine and comorbid depression, the odds of PTSD in all migraine categories were even further increased as compared to those women without migraine. Conclusion In a cohort of pregnant women, irrespective of the presence or absence of depression, the odds of PTSD is increased in those with migraine. Our findings suggest the importance of screening for PTSD, specifically in pregnant women with migraine.

This research involved the holistic, individualized treatment of patients with post traumatic stress disorder (PTSD), employing homoeopathic medicine. Post traumatic stress disorder can lead to a variety of complications which may diminish or destroy interpersonal relationships, may handicap the patient occupationally or recreationally, or may lead to substance abuse. Research has indicated that patients with PTSD are more likely to have a personality disorder; a previous history of depression, abuse or substance abuse or a family history of psychopathology. Given this, it is presumed that PTSD can occur in anyone who has experienced trauma and sufficient stress. In order to reduce post traumatic stress severity, treatment should emphasise and acknowledge that mental, emotional, behavioural and social factors contribute to trauma. This study involved ten patients (plus two additional) who participated in five homoeopathic consultations, over a period of four months. The appropriate homoeopathic remedy, or similimum, was determined using each patient’s distinguishing mental, emotional and physical symptoms. Each participant completed the Researcher’s Questionnaire at each consultation and recorded their stress episodes on a calendar to be handed in at each follow-up appointment. These results, together with holistic progress as noted by the researcher at every consultation, were used to determine the efficacy of homoeopathy on post traumatic stress disorder. The intent of the research was to prove that treatment should be specific and individualistic, irrespective of the diagnosis. This study aimed to provide a holistic therapy for PTSD and the results indicated that the similimum treatment in sufferers of post traumatic stress disorder was effective in reducing post traumatic stress frequency, severity, and intensity. Moreover, improvement in mental and emotional wellbeing, sleep patterns, appetite, and energy levels were noted in all the patients. / Dr. R. Mistry Dr. A. Fourie

D. Litt. et Phil. / This research focuses on the development of a short term action centered clinical personological treatment programme for adult emergency rescue workers who developed secondary traumatic stress disorder (STSD)/compassion fatigue and co-morbid symptoms of burnout as a result of exposure to critical incidents. A programme, comprising three sessions, was developed incorporating previously tested cognitive behavioural techniques with clinical personological theory as well as newly developed behavioural techniques tailored to the cross cultural South African context. The need for the study arose out of the lack of scientific validated data regarding the treatment of STSD/compassion fatigue among emergency rescue workers as well as the need for a cost-effective treatment programme that would address the serious need of emergency rescue workers in South Africa who for the most part need to make do without any employee wellbeing programmes. The effects of STSD/compassion fatigue are often as debilitating as that of PTSD. It hampers the sufferer unable to operate as well as they previously did. As a result they may present with lower productivity at work as well as various psycho-social problems and be at risk of substance abuse. This ultimately has a negative impact on the victims of trauma they are responsible for rescuing. Various theoretical models are discussed on the etiology of STSD/compassion fatigue, including the constructivist development al theory by McCann and Pearlman (1990) as well as Valent’s (2003) bio-social theory on survival strategies. Treatment approaches are investigated and critiqued, including, the accelerated recovery program (ARP) as developed by Gentry, Baranowsky and Dunning (2003) under the direction of Figley (2003) for the treatment and prevention of compassion fatigue, critical incident stress debriefing as first formally described by Mitchell in 1983 for the treatment of acute traumatic stress reactions, as well as Saakvitne and Pearlman’s (1992) constructivist self-developmental treatment program for vicarious traumatization, based on the constructivist self development al theory developed by McCann and Pearlman (1990). The theories and therapies underlying the intervention programme include various cognitive behavioural and personological principles to offer a person specific practical solutions for their personality type and psychological needs. The hypotheses were formulated with regard to significant improvement of symptoms of STSD/compassion fatigue as result of the intervention programme. The co-morbid symptoms of burnout are also evaluated for a decrease, without significantly reducing their capacity for compassion satisfaction. A test re- test quasi-experimental analysis with two independent groups was required, in order to determine whether there will be a statistically meaning full reduction in the prevalence of symptoms of secondary traumatic stress disorder (STSD)/compassion fatigue and the co-morbid symptoms of burnout amongst emergency rescue staff who had been instructed in an Action Centred Personological Treatment Plan. In an effort to attain spatial and temporal control a sample population was selected with a cluster sampling method from the greater Gauteng emergency rescue staff. They included paramedics, fire fighters and ambulance staff. The specific municipality had been incorporated into a greater Gauteng metropolis in the past two years. Potential subjects for both the experimental and control group were obtained through drawing personnel files, using random sampling. A sample of 17 participants was included in the intervention group and 17 participants were included in a non-intervention group. This was representative of 80% of the total population group of emergency rescue staff in this particular municipality. Existing psychometric assessment instruments were utilised to generate data for the experimental analysis. The measurement instruments included, the Millon inventory of personality styles (MIPS) to customise a cognitive behavioural treatment programme, the Compassion fatigue and satisfaction questionnaire to verify symptoms of STSD/compassion fatigue and burnout, and the British Columbia burnout questionnaire to confirm symptoms of burnout. The quantitative data was supported by information gathered from a clinical social history questionnaire. This information was used as part of the discussion of the results as a means to enhance the former descriptive results. The action centred personological treatment programme proved to be effective in the treatment of symptoms of STSD/compassion fatigue and burnout without significantly reducing the candidates’ potential for compassion satisfaction.