The diploma thesis deals with psychotherapy of victims of violent relationships (primarily victims of sexual violence). The work aims to look at individual experiences with these clients through interviews with experts on the issue and to examine the influence of therapeutic effects on client's personality. The theoretical part is divided into two basic chapters: Sexual Violence and Psychotherapy, it provides readers with professional information on both topics and provides key literary resources on issues in academia. Due to research goals, a qualitative methodology was chosen in the form of semi-structured interviews. The research group consists of five respondents (psychologists, therapists, social workers with psychotherapeutic education) who specialize in the issue of sexual or domestic violence. The interview was primarily about capturing and understanding the uniqueness of each respondent's professional experience. Furthermore, an analysis of the therapeutic process was performed on individual respondents, when the positive effects of the therapeutic effect appeared in their client. Respondents were asked about cases where the therapist himself does not perceive a positive change in the personality of his client after the therapeutic intervention (provided that he has encountered such a case...

Funktionella neurologiska symtom är vanliga och funktionsnedsättande symtom som ofta anses svårbehandlade. En vanlig förklaringsmodell har varit att den drabbade varit med om något stressande och traumatiskt som lett till kroppsliga symtom. Denna förklaringsmodell leder till frågan om psykologisk behandling med fokus på trauma kan påverka funktionella neurologiska symtom. En systematisk litteraturöversikt, i enlighet med riktlinjer från Statens beredning för medicinsk och social utvärdering, har genomförts för att undersöka om psykologisk traumabehandling med kognitiv beteendeterapi och Eye Movement Desensitization and Reprocessing Therapy kan minska funktionella neurologiska symtom vid symtom på komorbid posttraumatiskt stressyndrom. Resultaten av litteraturöversikten består av totalt 10 artiklar, merparten fallstudier. Slutsatsen av litteraturöversikten tyder på att den forskning som gjorts visar på minskning av funktionella neurologiska symtom efter behandling av symtom på posttraumatiskt stressyndrom. Detta forskningsområde är dock väldigt litet och består främst av fallstudier med något bristande kvalitet. Trots detta anser vi att det finns underlag för att rekommendera att det bör finnas ett fokus på erfarenheter av trauma vid bedömning av funktionella neurologiska symtom.

Understanding temporal relations among posttraumatic stress disorder (PTSD) symptom dimensions has received increasing attention in research. However, current findings in this area are limited by group-level approaches, which are based on inter-individual variation. PTSD is a heterogeneous syndrome and symptoms are likely to vary across individuals and time. Thus, it is important to examine temporal relations among PTSD symptom dimensions as dynamic processes and at the level of intra-individual variation. The aim of the present study was to capture temporal dynamics among PTSD symptom dimensions at an individual level using unified structural equation modeling (uSEM). World Trade Center (WTC) 9/11 responders (N = 202) oversampled for current PTSD (18.3% met criteria in past month) were recruited from the Long Island site of the WTC health program. Using ecological momentary assessment (EMA), PTSD symptoms were assessed three times a day over seven consecutive days. The person-specific temporal relations among PTSD symptom dimensions were estimated with individual-level uSEM. For the sample as a whole, hyperarousal played a key role in driving the other three symptom dimensions longitudinally, with the strongest effect in intrusive symptoms. However, daily temporal relations among PTSD symptoms were idiosyncratic. Although hyperarousal was a strong predictor of subsequent symptom severity, only 33.95% of the sample showed this predictive effect while others showed more evident temporal relations between intrusion and avoidance. Implications for personalized health care and recommendations for future research using individual-level uSEM in psychopathology are discussed.

A sizeable number of U.S. veterans of all ages experience post-traumatic stress disorder (PTSD) which can impact their quality of life; physically, mentally and socially. Consequences of PTSD are associated with physical and emotional disabilities, including ideation of self-harm and even suicide. Increasingly, animal-assisted therapies (AAT) are used to treat PTSD and other physical and behavioral conditions in veterans. Over the decades, AATs have used dogs, cats, horses, and dolphins among other animals. The purpose of this integrative review is to examine the use of AAT focusing on canine assisted therapy (CAT) among veterans diagnosed with PTSD. The methodology involved database searches, including MEDLINE, PubMed, PsychInfo, EBSCOhost, along with textbooks and popular media published from 2000 to 2016. Associated with the lack of more recent research, relevant articles published before 2000 were included in the review. Search terms included, ‘veterans,’ ‘service dogs,’ ‘service animals,’ ‘animal-assisted therapy,’ ‘canine therapy,’ ‘PTSD,’ ‘post-traumatic stress disorder,’ ‘psychiatric,’ ‘U.S. veterans,’ ‘equine therapy,’ ‘horse therapy,’ ‘pet therapy,’ and ‘military veterans.’ A total of ten relevant studies were identified which focused on the use of AAT among veterans diagnosed with PTSD. Different populations diagnosed with PTSD and other behavioral and psychiatric health conditions using AAT were examined as well. These articles were read, analyzed, and synthesized. Results of the review offer some support that AAT has psychological, physiological and psychosocial benefits for some populations across the lifespan with various diagnoses. Consistent and conflicting findings along with gaps in the literature are highlighted. Limitations and implications for nursing practice, research, policy and education also are noted in this thesis.

Post-traumatic stress disorder (PTSD) is a psychiatric condition caused by exposure to a traumatic event. Veterans are at especially high risk of PTSD. In Canada, in a survey conducted in 2016, 16% of Regular Force Veterans released during 1998-2015 reported having PTSD, which is at least two times higher than the estimated prevalence rate in the general population. Individuals with PTSD experience a range of debilitating symptoms, such as the intrusion of unwanted and distressing memories, persistent flashbacks, hypervigilance and nightmares. The neuropathophysiological mechanisms underlying symptoms of PTSD are not well understood, which remains a significant barrier to developing effective treatments. Hallmark PTSD symptoms such as hyperarousal and sleep disturbances may be related to dysregulation of noradrenaline (NA), a neurotransmitter produced in the locus coeruleus (LC) known to modulate cognition, arousal and sleep. This thesis examines the possible associations between dysregulation in rapid-eye-movement (REM) sleep and dysfunction in NA-containing neurons in the LC among veterans with PTSD. Twenty-two operationally deployed veterans with a history of PTSD were recruited through the Royal Ottawa Mental Health Centre in Ontario, Canada. A novel, non-invasive neuroimaging method, neuromelanin-sensitive magnetic resonance imaging (NM-MRI), was used to detect a by-product of NA called neuromelanin (NM) in the LC of each participant. Then a contrast-to-noise ratio (CNR) was calculated to obtain a marker of the NA function. The LC was segmented into three subdivisions to assess whether the association between NM and REM sleep may differ across regions of the LC. As hypothesized, we observed different associations between NM and REM sleep across regions of the LC. After controlling for antidepressant usage, there was (i) a moderate, negative, significant correlation between the percentage of REM sleep and rostral LCCNR, r(19) = -.476, p = .029, (ii) a weak positive non-significant correlation between the percentage of REM sleep and caudal LCCNR, r(19) = .33, p = .145, and (iii) no significant correlation between REM sleep percentage and LCCNR in the middle LC, r(19) = -.04, p = .876. This thesis is the first study to show that NM and REM sleep may be related in veterans with PTSD and that this relationship may vary across subdivisions of the LC. These results improve understanding of REM sleep among individuals with PTSD. The results may stimulate the investigation of novel pharmacotherapy focused on sleep disturbances in PTSD, the development of personalized treatments for PTSD, and the search for clinical biomarkers of PTSD based on brain function. The current study also made methodological contributions that may be applicable beyond the research on PTSD to the field of REM sleep and the NA system. Specifically, the current study showed the suitability of the NM-MRI method for examining the connections between NM and REM sleep, and it showed that segmenting the LC can lead to a more nuanced understanding of its role in the human body.

Abortion can be a significant event in a woman's life. Some women are found to be affected by severe negative psychological complications following abortion. A synthesis of the current research on post abortion grief and support implications was conducted for this literature review. Those women who have ineffective coping post abortion were described to have dysfunctional grief. The uniqueness of the loss and the stigma attached to abortion, which has prevented women from seeking help, contributes to the dysfunctional grief. Screening and assessment of women have been found to be beneficial in identifying those who were suffering. Validation of the feelings that women ' express has been cited in the literature as one of the most significant supportive interventions that can be provided to women who are coping ineffectively. Education can be helpful in guiding nurses, practitioners, and students to evaluate, and provide support for women who are grieving ineffectively, thus initiating healthy grieving in this population. The implications for nurses to assess for pregnancy loss, educate and promote healthy grieving in women are supported by this literature review.

This research journey examines the process of co-creating, along with my co-travellers (research participants), a more holistic approach to trauma debriefing. Whilst incorporating elements of Mitchell's (1983) Critical Incidence Stress Debriefing model (C.I.S.D.), our point of difference has been to adopt a narrative pastoral approach. This was achieved by introducing spirituality and narrative therapy practices. Our research pathway has been further shaped by adopting a qualitative research approach within a postmodern, social construction discourse. My research curiosity was invited by both the mind, body and soul divide expressed in psychology; and the healing possibilities of spirituality I have witnessed in both my own and in the lives of others. While my co-travellers predominantly preferred to express their spirituality in terms of Christianity, our narrative pastoral approach to trauma debriefing is offered to people of all religious persuasions. / Practical Theology / M.Th. (with specialisation in Pastoral therapy)

A study was conducted to describe and interpret the personal strategies that South African Police Service officers in the Vhembe District, Limpopo Province, use in their line of work. These are strategies to deal with the impact of the primary victims’ critical incidents of rape, domestic violence, murder and road accidents. The focus was on describing the impact of the critical incidents that the officers are exposed to, which manifest in a form of traumatic stress, namely, vicarious traumatisation, and management of this impact. Twenty participants were selected through purposive and theoretical sampling techniques from the family violence, child protection and sexual offences, domestic violence, field training, detective and social crime prevention units. Unstructured open-ended interviews, diaries and follow-up telephone interviews were used as data collection methods and data were collected in the participants’ home languages, Tshivenda and Xitsonga. Data gathered necessitated looking into both the aspects of the officers’ organisational and operational work. Data were thus analysed through the content thematic and constant comparative data analysis methods. The results first presented a profile of police vicarious traumatisation in the Vhembe District, which include the types of critical incidents exposed to, the organisational and operational stressors that lead to vicarious traumatisation, and the description of vicarious traumatisation symptoms. Second, a theoretical framework of the process of police critical incidents impact management (PCIIM) was developed. The framework shows that the management of the impact of the encountered incidents is inspired by various coping needs and subcultures of the officers, and the management takes place through the use of two styles of trauma management, namely, the linear and multilateral styles, which refer to application of coping strategies successively and the combination of horizontal and vertical application of coping strategies, respectively. The coping strategies used by the officers help them to have an objective understanding of the critical incidents encountered, have less severe symptoms of vicarious traumatisation, some symptoms last for shorter periods than before, and other symptoms are no longer experienced. Resilience to the encountered incidents is shown through the development of coping strategies to handle the incidents, facing them, and showing cognitive hardiness. The officers also manage to reflect on the experiences encountered, engage in narratives about them and mutual help thus still working towards attaining posttraumatic growth. / Psychology / D. Litt. et Phil. (Psychology)

This research journey examines the process of co-creating, along with my co-travellers (research participants), a more holistic approach to trauma debriefing. Whilst incorporating elements of Mitchell's (1983) Critical Incidence Stress Debriefing model (C.I.S.D.), our point of difference has been to adopt a narrative pastoral approach. This was achieved by introducing spirituality and narrative therapy practices. Our research pathway has been further shaped by adopting a qualitative research approach within a postmodern, social construction discourse. My research curiosity was invited by both the mind, body and soul divide expressed in psychology; and the healing possibilities of spirituality I have witnessed in both my own and in the lives of others. While my co-travellers predominantly preferred to express their spirituality in terms of Christianity, our narrative pastoral approach to trauma debriefing is offered to people of all religious persuasions. / Philosophy, Practical and Systematic Theology / M.Th. (with specialisation in Pastoral therapy)

This study examined the relationship between perceived social support and negative mental health outcomes in battered women. Correlations between perceived social support and depression, anxiety, and post-traumatic stress disorder were analyzed. Perceived social support, particularly from family members, was found to be significantly related to mental health outcomes. Results indicate that agencies that work with battered women should include social support in the assessment and intervention processes. The study utilized a quantitative survey design with a sample of 120 battered women from four domestic violence agencies throughout Riverside and San Bernardino counties. Quantitative data analysis procedures, such as multivariate analysis and logistic regression, were used to further examine variables. Samples of the instruments used in the study are included.