This study examined chronic psychological and psychophysiological post-traumatic sequelae among eleven adolescent survivors of a fatal bus crash by means of a multimethod strategy. Measures included a structured DSM-m-R post-traumatic stress disorder (PTSD) interview using the Diagnostic Interview for Children and AdolescentsRevised (DICA-R), self-report measures of PTSD symptoms with the Reaction Index, and the Impact of Events Scale. Other measures of stress-related symptomatology included the State-Trait Anxiety Inventory, Fear Survey Schedule-IT, Anxiety Sensitivity Index, Anxiety Frequency Index, and Beck Depression Inventory. In addition, heart rate (HR) reactivity to mental arithmetic (MA), demographic questions, and crash questions was assessed. Survivors were compared to control subjects matched for age, gender, race, and socioeconomic status, among other demographic characteristics. Multivariate analyses of the psychiatric interview data indicated that survivors evidenced significantly higher levels of past PTSD symptoms experienced after the crash, with a significant group by gender interaction, F (3,17) = 5.22, P = .01. Current (past month) levels of PTSD symptoms were also significantly higher among survivors four years after the crash, F (3,17) = 8.82, P < .01, although PTSD symptomatology decreased overall during that time, F (3,17) = 15.52, P < .01. Survivors and controls did not differ significantly on other measures of PTSD and other stress-related symptomatology. Repeated measures analyses of HR response scores revealed greater HR reactivity to questions about the crash among survivors, F (1, 14) = 18.55, P < .01, and by gender, F (1, 14) = 5.21, P = .04. Similar analyses found greater variability in survivors' HR standard deviations (an index of autonomic lability) F (1,14) = 5.21, P = .03 in response to the crash interview. Survivors' HR did not differ from controls' on the MA task. Findings are discussed theoretically and methodologically within the contexts of neurological and conditioning models of PTSD. No relationship between HR reactivity and psychiatric symptomatology was found. Furthermore, this investigation did not find support for the neurological kindling theory. Areas of future research using psychophysiological assessment are proposed to more specifically elicit autonomic arousal. Detailed case studies of four individual response patterns are included as a heuristic for further physiological research and for clinical applications with adolescent trauma victims. / Ph. D.

A delayed type of combat-related disorder among Vietnam veterans has resulted in increasing numbers of such veterans seeking mental health assistance and the inclusion of post-traumatic stress disorder (PTSD) as a new classification in the DSM III. With symptoms of re-experiencing, emotional numbing, hyper-alertness, sleep disturbance, survival guilt and avoidance, PTSD can be extremely disruptive of social, intellectual, and occupational functioning. While imaginal flooding of combat scenes has been shown to dramatically reduce PTSD symptomatology, the only supporting evidence published to date has been case studies. This is the first controlled study of the treatment using a clinical sample of the population. Subjects were sixteen male Vietnam combat—exposed veterans who sought out patient treatment at the VAMC in Salem, Virginia. Aged 33 to 40, they all suffered from PTSD. A yoked design was utilized in which one group (£;8) received a supplemental flooding treatment and the other (ns=8) did not. All subjects received standard hospital out patient treatment which generally consisted of both Vietnam Veteran group and individual therapy. / Ph. D. / incomplete_metadata

The Supporting Transformation and Resilience (STAR) program is a groundbreaking doctoral project in the field of occupational therapy designed to enhance the resilience, quality of life, and overall well-being of adult survivors of childhood trauma who are raising a child with a disability. Childhood trauma can profoundly impact an individual's life, and caring for a child with a disability can introduce additional challenges, making it essential to develop a comprehensive support program tailored to this specific population. STAR uses a mixed-method experimental design with a waitlist control group. The STAR program leverages a hybrid approach, combining psychoeducational and experiential components underpinned by a peer mentor model. The in-person sessions are proposed to be held at the YMCA, spanning a 12-week period with weekly in-person gatherings. Furthermore, participants will engage in a once-weekly asynchronous email support group and have access to online modules available around the clock. The waitlist control group will be granted access to the online modules, offering a basis for comparison with the participants actively engaging in the in-person and online aspects of the program. The aim of the STAR program is not only to gather critical data but also to offer support and resources for survivors of childhood trauma, creating a holistic approach that addresses their unique needs and circumstances. The STAR program holds the potential to shed light on the impact of a novel occupational therapy health promotion initiative on the resilience, quality of life, and overall well-being of its participants. This project anticipates significantly contributing to the occupational therapy and trauma fields. It has the potential to enhance the lives of those who face the challenges of both childhood trauma and caring for a child with a disability.

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that is caused by exposure to traumatic or stressful events in life. 3,4-Methylenedioxymethamphetamine (MDMA) has been shown to be an effective agent in drug-assisted psychotherapy for PTSD. In this systematic review, we aim to evaluate the effect MDMA has on functional connectivity in healthy individuals and individuals with PTSD and investigate the potential mechanisms via which MDMA exerts its effects in MDMA-assisted psychotherapy for PTSD patients. A total of 134 articles from Web of Science and Medline EBSCO were screened and 5 articles relevant for the systematic review were identified. After MDMA administration, an increase and decrease in functional connectivity in multiple brain areas and networks was observed, such as the thalamus, visual cortex, anterior cingulate cortex, hippocampus, amygdala, prefrontal cortex, default mode network, cerebellar network, sensorimotor network, salience network, and executive network. Notably, MDMA increased amygdala-hippocampal functional connectivity which may link to improved emotion regulation and fear extinction in patients receiving MDMA-assisted therapy. The findings evidence the complex effects of MDMA on brain connectivity and highlight the need for further research in this area, although MDMA-assisted therapy does prove to be a promising alternative for treating PTSD.

Survivors of natural disaster may suffer from Post Traumatic Stress Disorder (PTSD). In developing nations, such as the Honduras, poverty and limited resources mean that disaster relief from outside the country is needed. Researchers (Crigger, Holcomb, and Weiss, 1999) interviewed survivors of Hurricane Mitch. They reported overwhelming feelings of helplessness/powerlessness among disaster survivors. They also raised the question of whether this was evidence of the presence of PTSD. The purpose of this retrospective analysis of symptoms reported by urban Hondurans in the aftermath of Hurricane Mitch was to examine the possibility that these symptoms were related to PTSD. A sample of 345 clinic health forms was analyzed. The research questions were: 1) What were the chief complaints of urban Hondurans seen in the mission clinics over a 5-day period in March of 1999? 2) Do the urban Hondurans attribute their illness to the effects of Hurricane Mitch? 3) Are reported symptoms consistent with a diagnosis of Post Traumatic Stress Disorder? 4) What are the nursing implications for future post-disaster interventions in developing nations? While the findings of this study are not statistically significant, the clinical significance cannot be ignored. Several symptoms which have been well documented to be associated with PTSD were reported with nearly twice the expected frequency by subjects who also reported being sick as a consequence of Hurricane Mitch. In PTSD, early identification and intervention, is directly related to the reduced rate of comorbidity and chronicity of the disorder.

Text in Afrikaans / During her theoretical training as an educational psychologist, the researcher became acquainted with the relations theory. The researcher became aware of the fact that persons who have experienced psychological trauma, commonly practice irrational inner dialogue/self talk. From her own experience, it also became clear that traumatized persons deal with their trauma more effectively when they have good relations with others. Due to the fact that these aspects are significant aspects of the relations theory, the researcher began to wonder whether this theory could possibly be of value in therapy with traumatized persons. On the basis of a qualitative study of limited scope, it was found that, with certain reservations, the educational psychological relations theory could be a workable theory in therapy and that relations therapy could make a valuable contribution to the success of therapy with traumatized persons. / In die loop van haar teoretiese opleiding as opvoedkundige sielkundige het die navorser kennis gemaak met die relasieteorie. Die navorser het bewus geword van die feit dat mense wat 'n sielkundige trauma in hulle lewens beleef het, oor die algemeen irrasionele selfspraak beoefen. Na aanleiding van haar eie ervaring, het dit ook duidelik geword dat getraumatiseerde persone meer effekttef deur hulle trauma kan werk indien hulle relasies toereikend is. Omdat hierdie aspekte juis baie gewig dra in die relasieteorie, het die navorser begin wonder of die relasieteorie nie moontlik van waarde kan wees in terapie met getraumatiseerdes nie. Op grond van 'n kwaiitatiewe studie van beperkte omvang is daar bevind dat, met sekere voorbehoude, die opvoedkundig-sielkundige relasieteorie wel 'n werkbare teorie in terapie kan wees en dat relasieterapie 'n waardevolle bydrae tot die sukses van terapie met getraumatiseerdes kan iewer. / Educational Studies / M.Ed. (Guidance and Counselling)

Critical care nurses experience stressful situations in their daily working environments. The question arises for nurses: are there adequate support systems in the critical care environment and what are critical care nurses doing to mantain their own health and well-being. Facilitating conscious awareness among critical care nurses could enhance their resiliency and their hardiness, strengthening their coping capacities in stressful working situations. The contextual framework adopted for this research was the Neuman Systems Model. A qualitative research approach (exploratory, descriptive and contextual) was used to explore and describe the stress experienced by critical care nurses. Focus group interviews were conducted with critical care nurses and individual interviews with nurse managers. The results revealed their perceptions and experiences about the effects of stress in the critical care environment, as well as some of their coping strategies. Raising critical care nurses' levels of conscious awareness about their coping strategies with stressful events in their daily working lives, could enhance their resiliency and hardiness, enabling them to continue working effectively in stressful environments. This could enhance the general well-being of individual critical care nurses, the nursing care rendered to critically ill patients, and save money for the health care services by reducing turnover rates among critical care nurses. / Health Studies / D.Litt. et Phil. (Health Studies)

In this article post-shooting trauma is utilized as an arbitrary punctuation to indicate how police officers communicate their distress during this period of rapid transition in South Africa. It is argued that the medical model (with its attendant lineal causal explanations and descriptions) is inhibitively limited in describing what police officers are presently experiencing. The author motivates the advantages of perceiving and describing events from an ecosystemic perspective (which provides a contextual understanding and emphasizes relationships} . "Stress" is described as an aspect of the system as a whole and not singularly attributable to individuals alone. Among others new policing rules and roles, the turnover in personnel, and the rate of's'ocio-political changes are shown to contribute. It is argued that the Police, as society's guardians of "power" have become the "symptom bearers" for a society in the painful process of adapting to change. Recommendations regarding possible interventions are made. / Psychology / M.A. (Clinical Psychology)

Text in Afrikaans / Die studie fokus op die effek van krisiswerk op die helper in terme van stres, die uitbrandingsindroom en posttraumatiese stresversteuring (PTSV). Salutogeniese konstrukte as moderatorveranderlikes in die stres-siekte-verhouding word ook ondersoek. 'n Beskikbaarheidsteekproef van 52 ambulansmanne en 52 kontrolegroepwerkers is verkry. Biografiese, koherensie-, uitbrandings-, PTSV- en stresvraelyste is ingevul en statisties verwerk. Resultate dui daarop dat ambulansmanne hul werk as buitengewoon stresvol beleef en dat meer ambulansmanne diagnoseerbare PTSV vertoon. Daar blyk geen verskil tussen die twee groepe te wees nie met betrekking tot die voorkoms van uitbranding en streservaring. 'n Negatiewe verband tussen koherensiebelewing en die voorkoms van stressimptome en uitbranding is verkry. Ambulansmanne het 'n buitengewoon stresvolle werk en vertoon meer simptome van stresversteurings as mense in ander beroepe. Aanbevelings word gedoen oor hoe om die negatiewe konsekwensies van stres te verminder. / The study focuses on the effect of crisis work on the assistant in terms of stress, the burnout syndrome and post-traumatic stress disorder (PTSD). Salutogenic constructs as moderator variables in the stress-illness relationship are also investigated. An availability sample of 52 ambulancemen and 52 control group workers was obtained. Biographic, coherence, burnout, PTSD and stress questionnaires were completed and statistically processed. Results indicate that ambulancemen experience their work as exceptionally stressful and that more Ambulancemen display diagnosable PTSD. There appears to be no difference between the two groups in respect of the incidence of burnout and experience of stress. A negative connection between the experience of coherence and the incidence of stress symptoms and burnout was obtained. Ambulancemen have an exceptionally stressful job and display more symptoms of stress disorders. Recommendations are made on how to reduce the negative consequences of stress. / Industrial and Organisational Psychology / M. Com. (Bedryfsielkunde)

Text in English / Police workers have to contend with a variety of traumatic incidents in their daily work. This includes work, personal and socio-economic stressors. These, if not managed, may lead to Post Traumatic Stress Disorder (PTSD). The aim of this study was to develop guidelines to assist the South African Police Service (SAPS) organisation to provide appropriate interventions for workers diagnosed with work and non-work-related PTSD in the Mahikeng area of the North West Province in South Africa. The study further sought to assist the workers’ immediate family members to cope with living with a member diagnosed with PTSD. A qualitative research method was used. Data was collected using self-administered in-depth interviews. The study sample comprised of 19 SAPS workers and 23 family members. Data was analysed using the Statistical Package for the Social Sciences (SPSS) version 20.0. The Excel computer program was used to identify and analyse common themes. A lower PTSD prevalence rate of 0.76% was yielded by the results. Work-related traumatic incidents were linked to possible PTSD development for most SAPS workers. Exposure to traumatic incidents might have had a substantial effect on participants’ health and social lives as most developed varying health conditions post to the PTSD diagnosis. Living with a member diagnosed with PTSD brought trauma, financial problems and constant worry among families. Families coped by supporting each other. The provision of counseling services and active participation in PTSD support groups and sport activities were identified by most participants as fundamental in coping with the effects of PTSD. The provision of sufficient integrated family counseling and life skills programmes by the SAPS organisation was identified as crucial by most families in coping with the effects of living with a member diagnosed with PTSD. / Health Studies / D. Litt. et Phil. (Health Studies)