Current military operational environments are highly improvised and constantly evolving, threatening the lives of U.S. warfighters. For instance, since 2001, 60% of all hostile casualties and 65% of hostile injuries in the Middle East theater have been attributed to improvised explosive devices (IEDs). IEDs are powerful physical weapons, and the stressful atmosphere they, and other operational challenges create, can also result in a range of psychological dysfunctions, including anxiety, depression, alcohol abuse, and Post-Traumatic Stress Disorder (PTSD). Not only are these issues concerning for mental health reasons, they are also problematic in terms of combat performance. Extreme arousal (i.e., stress) negatively affects performance through the suppression of cognitive and physiological resources, which inhibits verbal, perceptual, and motor performance. Perceptual abilities are particularly susceptible to the effects of acute hyperarousal, and the degradation of these abilities may limit warfighters’ threat detection skills. Therefore, military researchers are interested in whether and how the visual perceptual field is changed under stress, and the Services are making predeployment training programs a priority, in an attempt to mitigate these concerns. This dissertation first outlines the cognitive processes related to visual perceptual abilities and how these processes are negatively affected by acute arousal. Current training programs in perceptual skills and stress tolerance are then described, along with recommendations for areas of improvement within the status quo. Based on these recommendations, an experimental procedure and five hypotheses were designed to assess training effects on visual perceptual skills and performance under stress. Experimental outcomes suggest that participants who were trained using a novel integrated perceptual skills plus stress resilience (“perceptual resilience”) program performed faster and with higher accuracy during a stressful threat detection task than participants trained using a perceptual skills-only program and participants trained using an existing status-quo knowledge trainer. Participants in this perceptual resilience training group also reported lower feelings of acute stress and anxiety immediately post-task than the two other training groups who did not receive the stress resilience training component. Based on these outcomes, implications for future military-specific training development, study limitations, and recommendations for future research is presented.

Background Post Traumatic Stress Disorder (PTSD) is a psychiatric debilitating condition that can occur in individuals who experience extremely stressful or traumatic life events. Sexual assault is considered as one of the most traumatic stressor in life. Although few studies investigated the association between history of sexual assault and PTSD, no studies have examined the impact of age at sexual assault on PTSD.Method A cross-sectional telephone survey was conducted among adult female residents of Virginia from November 2002 to February 2003. A total of 1,769 women aged 18 and older were interviewed using a random digit dialing method. Detailed screening questionnaire was utilized to ascertain the occurrence of sexual assault, age at sexual assault and PTSD. The DSM-IV diagnostic criteria were used to define PTSD.Result The prevalence of PTSD among women with no history of sexual assault, those victimized before the age of 18 and 18 and above was 8.1%, 35.3%, and 30.2% respectively. Multivariate logistic regression model showed an increase risk of PTSD among women assaulted at a younger age. Compared to women with no history of sexual assault, women who were victimized before their 18th birthday were 2.8 times more likely to suffer from PTSD [OR=2.78 (95% C1=1.87- 4.23)]. The risk of PTSD among women victimized as adults was 2.6 times higher compared to women with no history of sexual assault [OR=2.59 (95%CI =1.43-4.70)].Conclusion This study provided important information on the association between PTSD and age at sexual assault. The risk of PTSD is relatively higher among those assaulted before the age of 18. The adverse effect of sexual assault as a risk for PTSD in addition to other negative health problems is a major public health concern. Primary prevention strategies should be in place to detect sexual assault victims and prevent the occurrence of PTSD.

D.Litt. et Phil. / The negative psychological effect of rape on survivors has been extensively researched, with most studies emphasising rape-related Post Traumatic Stress Disorder (PTSD) its symptoms, diagnosis and treatment. Interventions described in the current literature mainly aim at measuring and reducing symptoms, and restoring functioning in rape survivors. Group art therapy has been used with adult and adolescent survivors of incest with encouraging results, but little research has been published regarding its use with rape survivors. My intention in the current study is to examine the utility of a group art therapy intervention with adult female rape survivors in a South African context. I selected a postmodern feminist theoretical basis for the study, and examined the societal discourses that promote women’s disadvantaged status and high levels of rape in South Africa. I used qualitative methods to analyse the art works, journals and transcripts produced by three participants during seven weekly group art therapy sessions. I used postmodern feminist research methods, such as participant observation, reflexivity, and concepts such as situatedness, bodiliness, relatedness and plurality of explanations to assess the women’s lived experience of rape, their recovery from it, and the intervention itself. The current study proposes that analysing the data reveals metaphors, symbols and meanings that represent the lived experience of the women participants in the group art therapy intervention. I used a grounded theory approach to data analysis, as well as methods from content analysis, visual anthropology, iconography, social semiotics and visual cultural studies in order to assist with triangulation of the visual and verbal data. The data was voluminous and rich, and fourteen strands of meaning emerged from the data, consisting of vivid metaphors, visual and verbal symbolic language, and insights into the challenges and victories of each of the participants. I gathered these strands under two overarching themes: one of themes related to the rape, and the other related to the group art therapy experience. I conclude that group art therapy was useful to the participants, and that the data analysis gave considerable insight into the individual nature of recovery from rape, such as coping mechanisms, influence of personality on recovery, the dialectical nature of recovery and the difficulty of recovering from a trauma that affects every area of functioning. The current study provides a structured format for clinicians interested in group art therapy, and I have provided suggestions for those who wish to replicate the intervention. My findings propose that the intervention was a powerful therapeutic tool for the participants, and that it provides a structured short-term group outline for use with the vast numbers of rape survivors in South Africa.

D. Ed. / Trauma can be described as the emotional shock response to a physical or emotional injury that is overwhelming and has a lasting effect on a person. Based on this definition, trauma can be considered an integral part of life in South Africa. The consequences and effects of trauma are severe, both on individual and society levels. Nobody escapes the effects of trauma, but women and children are particularly vulnerable. Unfortunately the vast majority of South Africans have little or no access to mental health services. Some people, however, seem to be resilient in response to trauma and hardship. Although various definitions of resilience can be found in the literature, resilience is defined in this thesis as the ability and characteristics that enable a person to endure, recover from, and be strengthened to grow personally, regardless of exposure to traumatic life events. Women are generally the primary educators of children in the South African society, whether it be their own children, grandchildren or others. If South African women were equipped with skills that could enable them to deal more effectively with trauma, they would – as primary educators – naturally transfer their skills and knowledge to the children in their care. There exists a need for preventative interventions that may equip women to cope effectively with trauma. Certain educational interventions may provide avenues through which this may be achieved. Educational drama is one such avenue through which women of diverse educational, socio-economical, and cultural backgrounds may be reached in a comprehensible, accessible and non-discriminatory way. In this study a number of issues pertaining to the prevalence of resilience in South African women have been explored and described. The purpose of this study was to create an interactive educational play aimed at facilitating mental health in women exposed to traumatic life events.

M.Cur.

Iris Fitzgerald struggles to make it day to day after she is raped and stabbed while out on an early morning run. Her story is told through her relationships, not only with her new, scared self, but also with her overbearing mother, her best friend, her rescuer and her antagonistic roommate. She has just moved to a strange city and still has not found a job. So, she has the overwhelming stress of the attack to contend with and the added pressure of running quickly out of money in the expensive city of San Francisco. She uses her painkillers as an escape from her stab wound as well as her emotional pain. Claiming Iris is about self-preservation, relationships, addiction and continuing on with life.

M.A. / The Truth and Reconciliation Commission (TRC) Act was passed in 1995 and the TRC started its hearings in 1996. The purpose of the TRC was to promote national unity and reconciliation by establishing as complete a picture as possible of the human rights violations that had occurred during the apartheid era and to offer reparations to those who had been affected, as well as to grant amnesty to those who had committed these human rights violations. The TRC had to appoint people to help carry out its functions and deliver a report about human rights violations. Most of the people employed by the TRC to help carry out these functions were South African. Furthermore every South African had been involved in the past in one way or another, purely by being a South African. In this project the author explores, analyses and interprets the experiences of some of the people who were employed by the TRC. The focus of this project is to find out whether being employed by the TRC and having to listen to the stories being brought to the TRC exposed anyone to the possibility of developing what is called secondary traumatisation. This kind of traumatisation is different from the traumatisation that the people relating the stories had gone through during the apartheid years. This kind of traumatisation is said to develop from being exposed to traumatised people.

The South African service (SAPS) has a reputation for being resilient despite the amounts of trauma they are exposed to. Research has shown that this occupation is one of the most stressful. However, research surrounding the SAPS suggests that police work is one of society’s most stressful occupations. The way in which individuals respond to such traumatisations is dependent on numerous factors, two being personality and coping. In so far, this study investigated three main areas around police reservists – a unit within the SAPS - in order to understand their responses to trauma: whether personality factors were related to post-traumatic stress symptomatology (PTSS) in the police reservist population; whether coping moderated the relationship between personality factors and PTSS; whether a personality factors predict coping style. A quantitative analysis was conducted among a sample of 36 reservists in the Gauteng area of South Africa. This study found that the relationship between Neuroticism and PTSS is mediated by coping, specifically Emotion-Focused and Dysfunctional Coping styles. A relationship between Conscientiousness and PTSS showed to be prevalent, however this is not due to the mediation affect of coping. Furthermore, Neuroticism and Extraversion showed to predict coping style. Specifically, Neuroticism showed to affect EFC and DC and Extraversion showed to affect EFC. The descriptive statistics showed that this sample of police reservists is suffering from PTSD. Implications of these findings are discussed and directions for future research are explored.

Thesis (M.A.(Industrial Psychology)--University of the Witwatersrand, Arts Faculty, 1996 / At a primary level the current study sought to investigate the post-traumatic stress responses of a sample of black township residents who were victims and witnesses of continuous civil violence [Abbreviated abstract. Open document to view full version]

La thèse a pour objectifs d’étudier les liens entre les mécanismes de régulation émotionnelle (RE) et les psychotraumatismes de type I et II. Elle s’intéresse également aux indicateurs physiologiques caractérisant ces processus de RE et leurs éventuelles modifications dans les cas de Stress Post-Traumatique (SPT) ou d’exposition à des événements aversifs (trauma complexe). Pour cela nous avons mené trois études. La première étude s’intéresse à mettre en évidence des prédicteurs du développement d’un SPT complet ou subsyndromique, suite à un accident de la voie publique. Les résultats font apparaître que plus d’un quart des participants présente un subsyndrome traumatique ; pour 7,7% de patients avec un SPT complet. Parmi de nombreuses variables, le meilleur prédicteur est la perception d’une menace vitale. Des liens forts sont également observés entre d’une part, la détresse péritraumatique et les symptômes de reviviscence et d’hyperactivité neurovégétative, et d’autre part entre la dissociation traumatique et l’évitement. La seconde étude s’intéresse à évaluer la variabilité du rythme cardiaque (VRC) comme biomarqueur des difficultés de régulation émotionnelle (DRE) en population non-clinique. Les résultats montrent que le groupe qui a peu de DRE présente une diminution de la VRC durant une phase d’induction émotionnelle puis une augmentation jusqu’à un niveau statistiquement équivalent à sa ligne de base en phase de récupération post-induction. Cette réponse sympathoexcitatrice adaptative est modifiée dans le groupe avec beaucoup de DRE : la VRC n’augmente pas en récupération. Ces données suggèrent que la VRC est un biomarqueur pertinent des DRE. Enfin, la dernière étude cherche à évaluer l’impact d’un trauma complexe (TC) sur plusieurs processus émotionnels. Les DRE et la dissociation somatoforme discriminent le mieux les groupes d’adolescentes présentant un TC des adolescentes contrôles. De plus, les mesures physiologiques montrent que le niveau de VRC au repos est plus faible dans le groupe TC et que le pattern typique de réaction sympathoexcitatrice est absent, à la différence du groupe contrôle. Les analyses de régressions précisent que le manque de conscience émotionnelle prédit le niveau de VRC au repos alors que c’est le niveau de dépression qui prédit le mieux la diminution phasique de VRC. Ajoutée à un taux d’erreur plus important pour évaluer subjectivement les stimuli émotionnels dans le groupe TC, les événements aversifs répétés semblent perturber à la fois des processus liés à l’évaluation des signaux émotionnels et leur intensité, mais aussi les processus psychologiques et physiologiques liés à la régulation des émotions. Ces résultats qui confirment le rôle important des DRE dans les psychotraumatismes seront discutés par rapport à la littérature actuelle pour proposer des pistes thérapeutiques spécifiques. / This thesis aims to explore the links between emotion regulation (ER) mecanisms and type 1 and 2 psychotrauma. We also investigate physiological marker of those ER processes and the potential disturbances caused by Post-Traumatic Stress Disorder (PTSD) and adverse life events (complex trauma). Three studies were carried out. The first study assesses some predictors of the development of a complete or subsyndromic PTSD following a motor vehicule accident. Results reveal that more than one quarter of the sample exhibits subsyndromic PTSD and 7.7% was diagnosed with complete PTSD. Among several variables, the strongest predictor is the perceived life threat. Also, strong correlations are observed between 1) peritraumatic distress and persistent re-experiencing or hyperarousal and 2) dissociation score and avoidance strategy. The second study evaluates Heart Rate Variability (HRV) as a potential biomarker of emotion regulation difficulties (ERD) in a non-clinical population. Results for the low ERD group show that HRV decreases from baseline to elicitation and then increases from elicitation to recovery (no difference between recovery and baseline levels). This adapatative sympato-excitatory pattern is altered in the high ERD group in which HRV do not increase from elicitation to recovery. Those data suggests that HRV could be an unbiased biomarker of ERD. The last study examines the effects of complex trauma (CT) on several emotional processes. ERD and somatoform dissociation best discrimate between CT and control teenagers. Moreover, physiological measures show that HRV level at rest is lower in CT than control and typical sympato-excitatory response is not observed in CT contrary to control group. Regressions analyses further reveal that the lack of emotional awareness predicts HRV level at baseline whereas the level of depression best predicts phasic HRV decrease. Added to greater errors in the subjective assessment of emotional stimuli in the CT group, adverse life events seem to disrupt processes involved in the labelling of emotions and intensity as well as psychological and physiological processes linked to ER. These results which confirm the importance of ERD in psychotrauma are discussed in regard to contemporary literature in order to suggest some specific therapeutic approaches.