Det finns en väldigt begränsad mängd med studier som beskriver erfarenheter och upplevelser i det dagliga livet hos personer som lever med svår dissociation och diagnoser såsom dissociativ identitetsstörning. En ökad kunskap inom området är av yttersta vikt för att öka förståelsen, minska risken för feldiagnostiseringar med komorbida diagnoser och minska stigmatiseringen för denna utsatta patientgrupp. Syftet med studien var att beskriva erfarenheter av det dagliga livet hos personer som upplever svår dissociation ofta efter svåra eller upprepade trauman. Elva stycken texter skrivna av personer med svår dissociation, analyserades med kvalitativ innehållsanalys. Resultatet beskriver textförfattarnas erfarenheter av det dagliga livet med svår dissociation i temat “Att överleva det som borde ha förintat oss” med subteman “Frånvaro är livräddande, men det är i nuet som livet, smärtan och hoppet finns”; “Att behöva ta hänsyn till olika viljor som inte är integrerade”; “Att behöva lägga energi på att hantera sitt inre liv”; “Jag öser några skopor från mitt översvämmade inre, men är det någon som hör?” och “Hur kan någon som förväntas älska och skydda mig göra så mot oss?”. Slutsatsen är att det är svårt och smärtsamt att leva med svår dissociation, men att det trots all smärta och lidande finns hopp om att överleva det som borde ha förintat en.

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This paper depicts a U.S. veteran and graduate student’s experience using meditation, artmaking, and journaling to target the effects of trauma and its symptoms of post-traumatic stress disorder and dissociation. This is a self-study utilizing art as the main method for communication and knowing. The data was gathered by using a combination of Pat Allen’s Open Studio Process and elements of the Art Therapy Trauma Protocol using bilateral artmaking in a five-session process conducted in a local art studio in San Diego. The meditation was conducted as a contemplative practice with attention and intention focusing on traumatic experiences. Fragmented memories and phenomenological experiences were stimulated during the research process through metaphoric content in the art and archetypal visualizations during meditation. These were explored through the multiple phases of meditation, artmaking, observing, and journaling. This process allowed for integration and healing through meaning making, bilateral stimulation, and somatic experiencing.

Objective: Many women experience traumatic events already prior to or during pregnancy, and delivery of a child may also be perceived as a traumatic event, especially in women with prior post-traumatic stress disorder (PTSD). Birth-related PTSD might be unique in several ways, and it seems important to distinguish between lifetime PTSD and birth-related traumatization in order to examine specific consequences for mother and child. This post-hoc analysis aims to prospectively examine the relation of both, lifetime PTSD (with/without interpersonal trauma) and birth-related traumatization (with/without postpartum depression) with specific maternal and infant outcomes. Methods: In the prospective-longitudinal Maternal in Relation to Infants’ Development (MARI) study, N = 306 women were repeatedly assessed across the peripartum period. Maternal lifetime PTSD and birth-related traumatization were assessed with the Composite International Diagnostic Interview for women. Maternal health during the peripartum period (incl. birth experience, breastfeeding, anxiety, and depression) and infant outcomes (e.g., gestational age, birth weight, neuropsychological development, and regulatory disorders) were assessed via standardized diagnostic interviews, questionnaires, medical records, and standardized observations. Results: A history of lifetime PTSD prior to or during pregnancy was reported by 25 women who indicated a less favorable psycho-social situation (lower educational level, less social support, a higher rate of nicotine consumption during pregnancy). Lifetime PTSD was associated with pregnancy-related anxieties, traumatic birth experience, and anxiety and depressive disorders after delivery (and in case of interpersonal trauma additionally associated with infant feeding disorder). Compared to the reference group, women with birth-related traumatization (N = 35) indicated numerous adverse maternal and infant outcomes (e.g., child-related fears, sexual problems, impaired bonding). Birthrelated traumatization and postpartum depression was additionally associated with infant feeding and sleeping problems. Conclusion: Findings suggest that both lifetime PTSD and birth-related traumatization are important for maternal and infant health outcomes across the peripartum period. Larger prospective studies are warranted. Implications: Women with lifetime PTSD and/or birth related traumatization should be closely monitored and supported. They may benefit from early targeted interventions to prevent traumatic birth experience, an escalation of psychopathology during the peripartum period, and adverse infant outcomes, which in turn may prevent transgenerational transmission of trauma in the long term.

Text in Afrikaans / Summaries in Afrikaans and English / Vigs is 'n "sluipende moordenaar "_ Dit toon geen respek vir kultuur, status,ouderdom of geslag nie. Vigs veroorsaak 'n onnnatuurlike dood wat vriende en familie bedreig en vervreem, lank na die dood van die vigsslagoffer. Die navorsingsdoel van hierdie studie was om riglyne daar te stel vir die psigoterapeutiese hantering van die vigslyer en sy gesin. Die navorsing het getoon dat 'n stigma en skuldgevoelens rondom die vigslyer en sy gesin ontstaan het, en dat hulle direk verantwoordelik gehou word vir die siekte bloot omdat hulle betrokke is by mekaar. 'n Vraelys wat aspekte (soos dit uit die literatuurstudie geblyk het) inkorporeer, is opgestel en aan die vigslyer en sy gesin gegee om te voltooi. Van die belangrikste elemente wat na vore gekom het, is die vrees vir die onbekende, die stigma verbonde aan die siekte en die pad wat die siekte loop ten opsigte van naiwiteit en valse gerugte ten opsigte van die siekte. 'n Verdere hoofstuk fokus op die literatuur om die hoofaspekte van die probleem vas le stel, en sodoende riglyne vir 'n terapieprogram daar te stel om die vrese te onderskep en die familie te help om die siekte beter te begryp_ Die doel is om die samelewing te laat begryp dat vigs nie 'n kulturele of "klas" siekte is nie, maar dat dit alle lae van die samelewing kan tref. 'n Afdeling is gewy aan 'n wye verskeidenheid terapeutiese tegnieke wat geimplimenteer kan word tydens hulpverlening aan die vigslyer en sy gesinslede. Verder verskaf hierdie studie ook riglyne om ondersteuning en hulp aan die vigslyer en sy gesin te bied, om sodoende hulle selfkonsep te verbeter. / Aids is a "stalking killer''. It has no respect for culture, breeding, age or sex. It is an unnatural death which offends and alienates many friends and family, even after the victim has died. A questionnaire incorporating important aspects of the cause and effect of aids was compiled and given to the aids sufferers and family to complete. From the responses it was clearly evident that the fears of the unknown, the stigma attached to the victim's close associates and family, was a problem, and the route course of incredible naive and false rumours. A chapter of the research focused on literature to establish what was the major aspects of the problem expressed by the media. Guidelines were provided whereby therapy could address and allay these fears to assist the family to better understand the illness and it's effects. This chapter has in mind to provide the Psychologist with guidelines to provide therapy to both the victim and the family in this regard. This study confirms that the survivors are the actual victims. / Educational studies / M.Ed. (Voorligting)

Text in Afrikaans / Summaries in Afrikaans and English / Vigs is 'n "sluipende moordenaar "_ Dit toon geen respek vir kultuur, status,ouderdom of geslag nie. Vigs veroorsaak 'n onnnatuurlike dood wat vriende en familie bedreig en vervreem, lank na die dood van die vigsslagoffer. Die navorsingsdoel van hierdie studie was om riglyne daar te stel vir die psigoterapeutiese hantering van die vigslyer en sy gesin. Die navorsing het getoon dat 'n stigma en skuldgevoelens rondom die vigslyer en sy gesin ontstaan het, en dat hulle direk verantwoordelik gehou word vir die siekte bloot omdat hulle betrokke is by mekaar. 'n Vraelys wat aspekte (soos dit uit die literatuurstudie geblyk het) inkorporeer, is opgestel en aan die vigslyer en sy gesin gegee om te voltooi. Van die belangrikste elemente wat na vore gekom het, is die vrees vir die onbekende, die stigma verbonde aan die siekte en die pad wat die siekte loop ten opsigte van naiwiteit en valse gerugte ten opsigte van die siekte. 'n Verdere hoofstuk fokus op die literatuur om die hoofaspekte van die probleem vas le stel, en sodoende riglyne vir 'n terapieprogram daar te stel om die vrese te onderskep en die familie te help om die siekte beter te begryp_ Die doel is om die samelewing te laat begryp dat vigs nie 'n kulturele of "klas" siekte is nie, maar dat dit alle lae van die samelewing kan tref. 'n Afdeling is gewy aan 'n wye verskeidenheid terapeutiese tegnieke wat geimplimenteer kan word tydens hulpverlening aan die vigslyer en sy gesinslede. Verder verskaf hierdie studie ook riglyne om ondersteuning en hulp aan die vigslyer en sy gesin te bied, om sodoende hulle selfkonsep te verbeter. / Aids is a "stalking killer''. It has no respect for culture, breeding, age or sex. It is an unnatural death which offends and alienates many friends and family, even after the victim has died. A questionnaire incorporating important aspects of the cause and effect of aids was compiled and given to the aids sufferers and family to complete. From the responses it was clearly evident that the fears of the unknown, the stigma attached to the victim's close associates and family, was a problem, and the route course of incredible naive and false rumours. A chapter of the research focused on literature to establish what was the major aspects of the problem expressed by the media. Guidelines were provided whereby therapy could address and allay these fears to assist the family to better understand the illness and it's effects. This chapter has in mind to provide the Psychologist with guidelines to provide therapy to both the victim and the family in this regard. This study confirms that the survivors are the actual victims. / Educational studies / M.Ed. (Voorligting)

Text in English / The rationale for the study was to investigate the symbiotic connection of trauma and addiction. The focus is on childhood trauma and the turn to addictive practices to quell the memories and experiences endured as children. Chapter One discusses the methodology regarding the approach of the study and includes an introductory literature review of the phenomena. Additional literature is included in the ensuing chapters. A personal account of the motivation behind the research is chronicled in Chapter Two. In this chapter, I share with the readers my personal experiences around trauma and addiction in my family of origin. The notion of the blending of trauma and addiction is the focus of Chapter Three. It includes the approach to treatment of trauma and addiction as well as addiction counsellor training in the South African context. The storied lives of the participants and their experiences of trauma and addiction are encapsulated in Chapter Four. Finally, Chapter Five rounds off the study with the analyses of the narratives of the unique individuals who contributed to this research undertaking. / Psychology / M.A. (Psychology)

Indiana University-Purdue University Indianapolis (IUPUI) / Symptoms of post-traumatic stress disorder (PTSD) are a common comorbidity in veterans seeking treatment of chronic musculoskeletal pain (CMP). However, little is known regarding the mutual influence of PTSD and CMP in this population. Using cross-sectional and longitudinal data from a randomized clinical trial evaluating a stepped care intervention for CMP in Iraq/Afghanistan veterans (ESCAPE), this dissertation examined the relationships between PTSD and CMP along with other factors including depression, anxiety, catastrophizing and health-related quality of life. The Classification and Regression Tree (CART) analysis was conducted to identify key factors associated with baseline PTSD besides CMP severity. A series of statistical analyses including logistical regression analysis, mixed model repeated measure analysis, confirmatory factor analysis and cross-lagged panel analysis via structural equation modeling were conducted to test five competing models of PTSD symptom clusters, and to examine the mutual influences of PTSD symptom clusters and CMP outcomes. Results showed baseline pain intensity and pain disability predicted PTSD at 9 months. And baseline PTSD predicted improvement of pain disability at 9 months. Moreover, direct relationships were found between PTSD and the disability component of CMP, and indirect relationships were found between PTSD, CMP and CMP components (intensity and disability) mediated by depression, anxiety and pain catastrophizing. Finally, the coexistence of PTSD and more severe pain was associated with worse SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Together these findings provided empirical support for the mutual maintenance theory.

Violent cnme is among the most prominent distinguishing characteristics of South African society, it has a severely traumatising effect on the populations concerned. Based on research :findings and existing literature, this study explores traumatic effects of violent crime on the most intimate associate of the victim (the partner). Accordingly, this study deals with the much-neglected topic of secondary trauma, by focusing on the following aspects of or conditions associated with violent crime and the secondary victim: cognitive, emotional and relational effects the experience of trauma, loss, vulnerability, depression and acute stress. It reveals that, depending on the severity of the incident, its consequences for the partner of the victim may range from post-traumatic stress to acute stress or secondary traumatic stress. From the similar results returned for primary and secondary victims, it is apparent that in the future, both victim and supporter should have their needs addressed with equal emphasis. / Educational Studies / M.Ed. (Specialisation in Guidance and Councelling)

The purpose of this study was to analyse the support systems for refugees in Southern Africa with specific reference to the Republic of Botswana. Qualitative framework as described by Lofland and Lofland (1984), Schensus and Schensus (1992) was used to conduct the investigation. Interviews were conducted with thirty refugees who currently living in Botswana as a refugee or asylum seeker. Focus group discussion was also held with twenty-six refugee workers. Interview findings were derived using Glaser and Straus' (1976) and Van Maanen, (1979) constant comparative method of qualitative analysis and were grouped into four major categories. Among the most significant findings were that the subjects agreed that on paper and by design, there are structures for providing the different services to refugees but refugees are not provided with adequate services. The second finding is that the support systems for refugees in Botswana are more focused on the provision of material support with little attention given to the psychosocial needs of the refugees. The third finding is that the Botswana government withheld some of the Articles of the 1951 UN refugee Convention, which deal with the socio-economic rights of refugees in Botswana. The fourth finding is that refugee workers need specialised training to enable them to address a wide rage of psychosocial issues affecting refugees. Last major finding is that there is no established clear system of service delivery in the participating agencies. The researcher concluded that because of trauma and stress experienced by refugees and refugee workers, there is a need to improve on the psychosocial support provided to refugees and refugee workers in Botswana by improving the knowledge and skills of refugee workers and promoting refugee participation. The researcher recommends two urgent actions that should be taken. First, the refugee management in Botswana need to improve on its service quality control mechanism, including evaluating its legal and operational framework. Second, psychosocial components need to be integrated into every aspect of the refugee programmes. This will support recovery for the many traumatised refugees and refugee workers in Botswana. / Social work / DPHIL (SOCIAL WORK)