The purpose of this research is to document the response of a rape survivor to a treatment based on Ehlers and Clark's (2000) therapy model and to use the material to evaluate the effectiveness of this kind of therapy in the South African context. In so doing, the specific local cultural and contextual factors, which may affect the overall effectiveness of the treatment, will be highlighted and discussed.

This essay discusses the perceived case of post-traumatic stress disorder in Leslie Marmon Silko's character Tayo from the novel Ceremony, using personal accounts of actual PTSD-suffering war veterans as a point of reference. The goal is to fathom the influence that culture may have in the development and healing of PTSD, and to identify possible trans-cultural aspects. The main focus of the analysis is therefore on personal background, interpersonal relationships, post-war experiences, and experienced symptoms.

Post-traumatic stress disorder (PTSD) is a disabling condition that afflicts 1-10% of the general population, with twice as high lifetime prevalence for women than men. Treatments exist, but none have proven reliable and consistent efficacy. A large minority of patients remain treatment-resistant despite undergoing several different types of treatment over extended periods of time. Recently completed studies in the U.S. and in Switzerland have demonstrated the potential of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for treatment-resistant PTSD. One of the major problems of treating PTSD is the patients’ fear state and inability to form a therapeutic alliance. Both these issues can be facilitated through administration of MDMA; the psychological effects - such as heightened empathy, increased openness and diminished anxiety – seem well-suited for therapeutic purposes. The rationale behind treating PTSD with MDMA has been indicated in neuroimaging studies; MDMA affects some of the neural structures altered in patients with PTSD, most notably the amygdala and the ventromedial prefrontal cortex. Using the Schedule 1 substance MDMA for this purpose is however controversial; animal studies have indicated that MDMA is neurotoxic, although no adverse effects on humans related to incidental use of MDMA in a controlled setting have been found. In conclusion, the data support that MDMA may be an efficient tool for treating PTSD, as well as safe and effective to use in a clinical context.

M.A. (Clinical Psychology) / The high incidence of suicide and medical boardings for psychological reasons in the South African Police Service necessitated an investigation into whether officers who seek medical help have been exposed to more traumatic violence than those who do not seek assistance. A Group of policemen who had sought psychiatric help was compared with a control group of officers who had not sought assistance in terms of the nature and seriousness of posttraumatic stress disorder. depression. anxiety and other stress factors. The experimental group revealed significantly higher levels of posttraumatic stress disorder. depression and anxiety than the control group. This was related to more exposure to situations of personal threat and a predisposition to trait anxiety. Other negative life experiences did not have a meaningful impact. Of importance is the fact that the control group that did not seek assistance. in comparison with the general population. nonetheless displayed significant levels of posttraumatic stress disorder. This group however responded more stable family relationships and social support than the officers seeking psychiatric help. These variables may play a moderating role in the prevention of psychiatric symptomatology in members of the South African Police Service who are exposed to traumatic stress.

M.A. (Psychology) / The present study was undertaken in an attempt to understand and ascertain the nature of PTSD in the South African Police leading to chronic illness and work-related dysfunctions as well as to investigate the possibility of triggering events leading to the loss of latency in PTSD. The specific hypothesis for this study was that a significant proportion of members of the SAP who report for medical treatment of stress-related physical or psychological complaints, will show PTSD in conjunction with a triggering stimulus event prior to the manifestations of the first clinical signs of PTSD. The testing of the hypothesis, entailed utilizing an experimental group. consisting of a number of police officers, who had been referred for psychological and/or medical treatment for work-related disorders. None of these subjects had previously been diagnosed with PTSD. A control group was used that consisted of police officers who had not seen active duty in an area where a traumatic stress disorder event could take place. These subjects were subjected to assessment of PTSD by means of the Mississippi Scale for Combat-Related PTSD, and concomitant stress-related events by means of the Life Experiences Survey. Alienation was assessed by the means of the VSVA. Indices of psychophysiological reactivity were obtained by means of galvanic skin response deviation and heart rate deviation to specific stimuli, including neutral stimuli, war-related stimuli and stimuli with political content.

M.A. / This study, regarding the long-term effects of the Westdene bus-disaster, which was undertaken after a period of seven years, has the following objectives: A survey of the literature regarding disasters and posttraumatic stress. An investigation of the long-term effects of the trauma on the secondary victims of the trauma, namely the family systems of the primary victims. The role and function of the family in the primary victims' coping and recovery from the trauma. The effect the trauma has on the family system after a period of seven years. A survey to establish the long-term effects of the therapeutic inputs regarding the secondary victims after the trauma. The first part of the study explores the theory regarding posttraumatic stress. The study comes to the conclusion that stress and trauma cannot only be viewed as a linear matter, but that psychological and contextual factors play an important role in the extent to which an event is experienced as stressful or not. It seems clear that the trauma does not only affect the individual victim, but the family system of which the individual forms a part of, is also affected by the stressful events. The study therefore examines the family of the primary victim with a systems theory approach. Therefore: How the family encounters and copes with stress, and how the family affects/influences the coping strategies of the primary victim. The study differentiates between normative and non-normative stressors and family adjustment. The study was conducted from a qualitative perspective. A certain amount of stress is already present in the family of the adolescent. This is the result of the adolescents' development towards independence and the forming is disrupted by the occurrence of a stressful non-normative event. The primary victim can therefore not be studied in isolation, but other mediating factors should be included in the investigation. One of these factors is the family of the victim, who plays an important part in the coping with the stressful event. With regard to psychological therapy and the long-term effects of such interventions, the researcher comes to the conclusion that developmental processes in interaction with a supportive psychological climate contributes to the realistic coping and acceptance of the trauma. The following points of criticism against the study can be raised: Other factors, such as divorce, "empty-nest-syndrome" and the death of a family member can have an effect on the current functioning of the family system. The family of the primary victim has experienced normative adjustment and changes during the seven year that has lapsed since the disaster. The families that have experienced the most trauma as a result of the disaster, did not partake in this study. The study made the following recommendations: That intensive studies, on the short-term and the long-term, should be undertaken of the families of disaster victims; that research and literature regarding posttraumatic stress should place more emphasis on the role, function and effect of the trauma on the family systems of the disaster victims; the establishing of a natural institute, which includes the extended family, for the minimising of the long-term effects of a trauma. Although trauma is defined in a linear perspective, it should be seen within a bigger ecosystemic content, which includes the systems of the disaster victims. This view would probably result in more positive coping strategies regarding traumatic events.

The South African Truth and Reconciliation Commission (TRC) sought to promote healing and reconciliation, and thereby bring closure to a past era of oppression. The process of public testimony was assumed to provide for a revealing of the truth of the period, and to promote forgiveness thus enabling victims to heal from the traumas of the past. This qualitative study sought to explicate the subjective meaning of the experiences of victims who testified at the TRC. Data derived from transcripted open-ended interviews with twelve victims were analysed using an empirical-phenomenological method. The sample group of 12 volunteers comprised eight black females, two black males, one Indian male and one white female. The subjects were interviewed nine to eighteen months after they had testified as victims at the KwaZulu-Natal regional hearings of the TRC. The findings of this study challenge the one-dimensional assumption that testifying at the TRC would promote a therapeutic outcome for victims. Analysis of the data revealed that public testimony is a dialectic and interpersonally constituted phenomenon, which in certain circumstances may facilitate healing. Victims described symptoms of anticipatory anxiety, and typically experienced the opportunity to testify as an "approach-avoidance" phenomenon. The TRC was perceived with the potential either to bring closure to the past, or to re-open old wounds without meeting the raised expectations for justice to be served and reparations to be provided. Victims experienced secondary traumatisation as they testified and simultaneously bore witness to their painful life-stories. The circumstances for a therapeutic outcome emerged as those in which forgiveness could take place through hearing the confession of a perpetrator, or through dialogue with a significant other who could stand for the perpetrator. In either case, an acknowledgement of the truth was required as a co-constituted reality. The study concludes with a call for post-testimony psychological support for victims given the limited resources of the TRC to provide follow-up counselling services. / Thesis (DPhil (Psychotherapy))--University of Pretoria, 2007. / Psychology / unrestricted

The present study presents three individual cases; all three clients had endured a traumatic event, namely rape, and all three met the criteria for PTSD. Despite the fact that each of the clients was initially assessed as being a suitable candidate for psychological treatment, none of the cases proceeded to the therapy phase of treatment. A number of obstacles, both personal and contextual, were encountered during treatment implementation, preventing or limiting a successful outcome of psychological treatment in each case. An examination of these cases highlights a few of the many obstacles frequently faced when delivering psychological treatment to the South African context. In so doing, this research provides an opportunity to consider the possible reasons for the limited documentation of treatment efficacy within the South African context, as well as to enhance our understanding of and sensitivity towards the cultural and contextual factors playing a role in psychological treatment.

M.Sc. / With the changes in the South African political and economic climate in the past years, an increase in violent crime has become one of the most significant issues affecting the people of this country. Among them is car hijacking, which has reached epidemic proportions. As a result of this traumatic experience, many of the victims of hijacking develop posttraumatic stress disorder or symptoms thereof. From the literature it would seem that certain . variables may increase the vulnerability for the development of this disorder. This study sought to investigate a number of these variables, namely, demographic information, attributional style, personality style, and both premorbid depression and anxiety. The purpose was to establish whether pre-existing risk factors, that were found in the literature to play a role in the development of PTSD, also apply to the South African population, as well as to victims of car hijacking specifically. As this situation is unique to South Africa, there is a great need for information in this area. If these risk factors could be isolated, more effective treatment may be developed for victims. A sample of 38 hijack victims was approached to complete a battery of psychometric tests to assess the above mentioned variables as well as a measure of posttraumatic stress syrnptomology. The Revised Impact of Events Scale, Attributional Style Questionnaire, Millons Clinical Multiaxial Inventory, State- Trait Anxiety Inventory and Beck Depression Inventory were used as psychometric instruments for this study. Inferential statistical analyses as well as descriptive statistical analyses were performed on the data. In general, no specific constellation of premorbid factors contributing to the impact of the event were found. Depression and state anxiety showed significant contribution to the impact of the hijacking but these variables measured current symptoms rather than premorbid. No other variables proved to be significant. This result may have been strongly influenced by the fact that the sample was very homogenous. The findings therefore offer difficulties as far as generalizability is concerned. It is recommended that this study be performed on a larger, more representative and diverse sample in the future.

M.A. / This phenomenological study was designed to explore the victim's lived experience of undergoing a motor vehicle hijacking. The aim of the study was to add to the knowledge and understanding of this complex phenomenon. The design of the study was qualitative. Data was collected through in depth unstructured interviews with four people who had very recently been hijacked. The interviews were recorded on audio tape and transcribed verbatim for each subject. An intra-individual analysis of each subject's account rendered an understanding of the experience in context for that individual, while an inter-individual analysis of the accounts permitted a discussion of common and contrasting themes and patterns. The nature of the subjects' experiences during, immediately after and in the days following the hijacking trauma is elucidated in detail. Based both on the literature reviews of trauma and hijacking, and the findings of this study, suggested contributions towards a theoretical framework for understanding the victim's experience of motor vehicle hijacking are proposed. The findings of this study will hopefully increase understanding of what it is like to be hijacked, provide relevant information and guidelines to clinicians working with these trauma victims, and provide suggestions for future research in this field.