Thesis (MA)--University of Stellenbosch, 2001. / ENGLISH ABSTRACT: This study investigated the incidence of depression, post-traumatic stress symptomatology, anger and guilt in a shelter sample of 40 battered women. In addition, the presence of dysfunctional, evaluative beliefs, as viewed from a Rational-emotive perspective, was investigated, as well as the relationship between dysfunctional beliefs and symptoms of psychopathology. Participants completed the Beck Depression Inventory, Post-traumatic Stress Diagnostic Scale, Anger Diagnostic Scale, Trauma Related Guilt Inventory and Survey of Personal Beliefs. It was found that 63% of the participants showed moderate to severe levels of depression, while 59% manifested high post-traumatic stress symptomatology. Between 38% and 50% experienced problems with anger whilst 48.5% showed moderate guilt. In general, these symptoms did not correlate with the age of participants or with the duration or frequency of abuse, except for anger which was related to a history of childhood sexual and/or physical abuse. The results of the Survey of Personal Beliefs indicated that the group displayed Otherand Self-directed Demands, Awfulizing, Low Frustration-tolerance and Negative Selfworth. Only Low Frustration-tolerance (underestimation of coping skills) correlated significantly with levels of depression, anger and guilt. / AFRIKAANSE OPSOMMING: Hierdie studie het die insidensie van depressie, post-traumatiese stressimptome, woede en skuldgevoelens in 'n groep van 40 vroulike slagoffers van gesinsgeweld, wat die huweliksverhouding verlaat het en in 'n skuiling vir mishandelde vroue opgeneem is, ondersoek. Die disfunksionele, evaluerende kognisies, soos deur die Rasioneel-emotiewe gedragsterapie gepostuleer, asook die korrelasie tussen hierdie kognisies en die simptome van psigopatologie, is ook ondersoek. Deelnemers het die Beck Depression Inventory, Post-traumatic Stress Diagnostic Scale, Anger Diagnostic Scale, Trauma-Related Guilt Inventory en Survey of Personal Beliefs voltooi. Die resultate het aangedui dat 63% van die deelnemers matige tot ernstige vlakke van depressie getoon het, terwyl hoë post-traumatiese stressimptomatologie by 59% voorgekom het. Tussen 38% en 50% het probleme met woede getoon, terwyl matige skuldgevoelens by 48.5% voorgekom het. Oor die algemeen het hierdie simptome nie verband getoon met die ouderdom van deelnemers of met die duur of frekwensie van die mishandeling nie, behalwe die vlak van woede wat 'n verband getoon het met 'n geskiedenis van kindermolestering. Tellings op die Survey of Personal Beliefs het aangedui dat die groep die disfunksionele, evaluerende kognisies van Self- en Ander-gerigte Eise, Katastrofering, Lae Frustrasie - toleransie en Negatiewe Selfwaarde getoon het. Slegs Lae Frustrasie-toleransie (onderskatting van hanteringsvaardighede) het beduidend met vlak van depressie, woede en skuldgevoelens gekorreleer.

This study began testing the Sewell and Williams (in press) model that differing trauma types yield differing presentations in social versus event processing domains. Other hypotheses explored trauma type with levels of guilt, and shame-proneness with anxiety. Volunteers were 44 male combat veterans being treated for PTSD. Data analyses determined whether trauma type related to guilt and perceived social support and whether shame-proneness related to levels of anxiety. High shame persons may process anxiety and social support differently than low shame persons. Results can assist professionals understand how a person's functioning is affected by certain types of trauma. Future research should focus on increasing social support for persons who have experienced trauma.

Bakgrund Posttraumatiskt stressyndrom bör betraktas som en folkhälsosjukdom där diagnostisering och behandling behöver uppmärksammas. Ungdomar som överlevt livshotande händelser tenderar att återuppleva dessa traumatiska händelser och undviker att handskas med känslorna som uppkommer, vilket kan leda till psykiska besvär. Syfte Att undersöka riskfaktorer som finns för att utveckla posttraumatiskt stressyndrom bland ungdomar samt undersöka vilka datainsamlingsmetoder de inkluderade artiklarna valt. Metod Deskriptiv design användes i litteraturstudien som inkluderar 13 stycken vetenskapliga artiklar från databaserna PsycInfo och PubMed. Likheter och skillnader i artiklarnas resultat identifierades och använda datainsamlingsmetoder sammanställdes. Huvudresultat Att vara utsatt för våld och traumatiska händelser såsom fysisk skada eller se någon lida/dö, vara tjej, äldre ungdom, utsatt för daglig stress, splittrad familj och sämre socialt stöd var riskfaktorer för att utveckla posttraumatiskt stressyndrom. Tio av tretton artiklar hade kvantitativ ansats och använde frågeformulär för att få svar på vilka riskfaktorer det fanns. En artikel hade kvantitativ ansats men använde inte frågeformulär och två hade endast kvalitativ ansats i form av intervju som datainsamlingsmetod. Slutsats Denna litteraturstudie identifierade olika riskfaktorer som ligger till grund för utveckling av PTSD bland ungdomar. De vanligaste som återkom i nästan alla studier var att utsättas för våld, vara med om traumatiska händelser, vara tjej, sämre socialt stöd inom familj och skola, förlora en anhörig och vardagliga stressorer. Att som sjuksköterska och övrig vårdpersonal inneha denna kunskap kan bidra till att tidigare kunna identifiera ungdomar med PTSD samt anpassa omvårdnaden till denna grupp på bästa sätt. / Background Posttraumatic stress disorder should be considered as a public health disease where diagnosing and treatment require attention. Adolescents who have survived life-threatening events tend to relive these traumatic events and avoid to deal with the emotions that occur, which can lead to mental disorders. Aim Identify which risk factors there is to develop posttraumatic stress disorder among adolescents and examine which data collection methods the included articles have chosen. Method Descriptive design has been used in this literature study including 13 articles collected from the databases PsycInfo and PubMed and has been categorized by similarities and differences. The articles data collection methods has been presented from the methodological aspect. Main results To be exposed to violence and traumatic events as physical injury or see someone suffer/die, be a girl, older adolescent, exposed to daily stress, broken family and have less social support were some risk factors for developing posttraumatic stress disorder. Ten of thirteen articles had a quantitative approach and used questionnaire to get responses for which risk factors there was. One article had a quantitative approach but did not use a questionnaire and two articles had qualitative approach and used interview as data collection method. Conclusion In this literature study different risk factors were identified underlying to develop PTSD among adolescents. The most common risk factors in almost all of the studies were to be exposed to violence, experience traumatic events, be a girl, have less social support from family and school, lose a family member and daily stress. As a nurse it is important to keep this in mind so the care for the adolescents are as good as possible and that coping is used in the right way.

Human immunodeficiency virus (HIV) can result in posttraumatic stress disorder (PTSD) as events related to illness act as traumatic stressors. This study tested some basic hypotheses of Sewell and Cromwell's personal construct model of PTSD in HIV+ women both with and without diagnoses of PTSD. Trauma-related constructs of HIV+ women with PTSD with HIV+ non-PTSD controls at varying stages of illness were compared. The elaboration, rankings, and valence of trauma-related constructs were examined using the Life Events Repertory Grid (LERG) procedure. Findings provided evidence that a clinical diagnosis of PTSD in women was not associated with the degree of construct elaboration. These findings may imply a qualitative difference in cognitive processing of social stressors and violent stressors.

Prior research has identified risk factors that may contribute to the development of maternal stress reactions following childbirth. Specifically, situational factors (e.g., factors associated with childbirth), individual factors, and personality factors, have been explored in a multitude of prior studies. The current study sought to build upon this literature by examining both risk and resilience in a sample of both mothers and fathers via a prospective longitudinal investigation. Baseline assessment of expectant parents occurred prior to the birth of their child, with additional assessment at approximately 1, 6, and 9 weeks post-childbirth. A total of 50 participants completed all four of these assessments. Results indicated approximately 20% (n = 10) of participants endorsed moderate or greater stress symptoms after birth, while 22% (n = 11) also exhibited symptoms of moderate or greater depressive symptoms. Stress reactions were assessed with the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ); validity analyses indicated the PPQ had significantly stronger correlations with convergent measures than discriminant measures. Additionally, participants were randomized into one of two post-delivery study arms: an expressive writing group or an active control group. Although expressive writing results were inconclusive, there was a general effect of time, which may be reflective of a natural recovery process. Given the prevalence of stress and depressive reactions in this sample, and the population, exploration into feasible and accessible treatment interventions is warranted. While these results also suggest a potential natural recovery for some participants, interventions for support in the short-term timeframe after childbirth may continue to be useful.

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.