Indiana University-Purdue University Indianapolis (IUPUI) / This study investigates differences between Veterans and non-Veterans with severe mental illness (SMI) regarding perceptions of their illness, themselves, and treatment. I compare patient interviews (using the Indiana Psychiatric Illness Interview, IPII) of Veterans (N=20) and non-Veterans (N=26). Modified grounded theory and qualitative coding software Atlas-TI were used to develop codebooks for each group, and these were compared for differences. I examined differences in both code frequency and meaning. Statistically, more Veterans were male, employed, married, had higher income, and had higher education. Statistical differences in code frequency included: more Veterans discussing boredom, regret/guilt/loss, and wanting to be “normal.” More non-Veterans had codes of pessimism and religion/spirituality, wanting a different future, bringing up mental health, family, future: no change, life goals, and relapse. Key differences in narrative themes included: (1) Veterans’ “military mindset”/discussion of anger as part of mental illness, (2) non-Veterans’ focus on mental-illness, (3) differing attitudes regarding stigma, (4) active versus passive attitudes toward treatment, and (5) degree of optimism regarding the future. Differences are described and then potential relationships and interactions are proposed. Veterans appear to have several protective factors (i.e., finances, employment, marriage). Additionally, Veterans’ military-mindset seems to encourage greater stigma-resistance, and thereby also facilitate Veterans being more active and optimistic toward treatment and recovery. By contrast, non-Veteran focus on mental illness may be related to increased self-stigma, passive and pessimistic attitudes. I propose that Veteran identity can serve as an additional protective factor against stigma, pessimism, and passivity. Veteran-identity may also be a useful framework clinically, to help promote active approaches to treatment (e.g., “fighting symptoms”). Further, Veterans emphasized issues relating to anger as important and part of their mental health. It may be that Veterans are more comfortable discussing mental health in the language of “anger,” given stigma. Finally, findings suggest that helping individuals in both groups engage in meaningful, non-mental illness-related life activities may help shape self-perception, and thereby responses to stigma, attitudes toward treatment, and hope for the future.

Ciliary neurotrophic factor (CNTF) is produced by astrocytes which have been implicated in regulating stress responses. We found that CNTF in the medial amygdala (MeA) promotes despair or passive coping, i.e., immobility in an acute forced swim stress, in female mice, while having no effect in males. Neutralizing CNTF antibody injected into the MeA of wildtype females reduced activation of downstream STAT3 (Y705) 24 and 48 h later. In concert, the antibody reduced immobility in the swim test in females and only after MeA injection, but not when injected in the central or basolateral amygdala. Antibody injected into the male MeA did not affect immobility. These data reveal a unique role of CNTF in female MeA in promoting despair or passive coping behavior. Moreover, 4 weeks of chronic unpredictable stress (CUS) increased immobility in the swim test and reduced sucrose preference in wildtype CNTF+/+, but not CNTF-/- littermate, females. Following CUS, 10 min of restraint stress increased plasma corticosterone levels only in CNTF+/+ females. In males, the CUS effects were present in both genotypes. Further, CUS increased CNTF expression in the MeA of female, but not male, mice. CUS did not alter CNTF in the female hippocampus, hypothalamus and bed nucleus of stria terminalis. This suggests that MeA CNTF has a female-specific role in promoting CUS-induced despair or passive coping, behavioral anhedonia and neuroendocrine responses. Compared to CNTF+/+ mice, CNTF-/- mice did not show differences in CUS-induced anxiety-like behavior and sensorimotor gating function as measured by elevated T-Maze, open field and pre-pulse inhibition of the acoustic startle response. Together, this study reveals a novel CNTF-mediated female-specific mechanism in stress responses and points to opportunities for developing treatments for stress-related disorders in women.

Summary in Afrikaans and English / Although the rights of children in South Africa are being regulated by legislation, statistics prove that statutory services on behalf of children annually increase. Scientific accountable information regarding the child can be obtained by the assessment of the child. The purpose of this investigation was to identify the gaps in the existing assessment guidelines, as well as the needs of social workers regarding assessments. The sequential exploratory strategy was utilized, as quantitative data supported qualitative findings. The investigation showed that minimal assessment literature is available in South Africa and internationally, although assessment is the basis evidence of the social worker. The biggest gap in assessment guidelines is that assessment does not carry weight in the court. There is a need for social workers to be trained in relevant assessment skills based on a specific frame of reference. Gestalt therapy can provide a suitable theoretical frame of reference for assessment, and can serve as scientific foundation for social workers during the statutory process. A framework for an assessment guideline was thus proposed. / Ten spyte daarvan dat die regte van kinders in Suid-Afrika deur wette gereguleer word, bewys statistiek dat statutere dienste aan kinders jaarliks toeneem. Wetenskaplik verantwoordbare inligting ten opsigte van die kind kan bekom word deur die kind te assesseer. Die doel van hierdie ondersoek was om leemtes wat in bestaande assesseringsriglyne is vas te stel, asook die behoeftes wat by maatskaplike werkers ten opsigte van assessering bestaan. Die opeenvolgende verkennende strategie is tydens hierdie ondersoek gevolg, aangesien kwantitatiewe data gebruik is om die kwalitatiewe bevindings te ondersteun. Die ondersoek het getoon dat min literatuur ten opsigte van assessering in Suid-Afrika en internasionaal beskikbaar is, ten spyte daarvan dat assessering die basis van die getuienis van die maatskaplike werker vorm. Die grootste leemte wat in assesseringsriglyne ge'identifiseer is, is die feit dat assessering nie gewig in die hof dra nie. 'n Behoefte ten opsigte van opleiding in toepaslike assesseringsvaardighede vanuit 'n spesifieke teoretiese verwysingsraamwerk bestaan. Gestaltterapie kan 'n teoretiese verwysingsraamwerk vir assessering bied en kan dien as wetenskaplike fundering vir optrede van maatskaplike werkers tydens die statutere proses. 'n Raamwerk vir 'n assesseringsriglyn is voorgestel. / Social Work / M. Diac. (Play Therapy)

Text in Afrikaans / Indigenous literature about the experience of a couple, where one of the spouses experiences a spinal cord injury, is scarce in the frame of social work. The experience of 5 couples (10 participants), after a spinal cord injury of one of the spouses was researched in this qualitative study. The aim of this research study is: • to reconnoiter participants’ experience of a spinal cord injury of a spouse, through semi-structured interviews with a purposeful chosen sample • to subject the research findings to a literature control • to make recommendations about how spouses can support each other, as well as how professional people can support client systems, where one of the spouses experience a spinal cord injury From the data it was determined that a spinal cord injury had significantly influenced the couples: - emotions - needs - perceptions (origination of experiences) Recommendations to couples as well as to professional people have been made. / Social Work / Thesis (M. Diac.)

This study focuses on the psycho-social challenges faced by HIV/AIDS lay counsellors at a Voluntary Counselling and Testing (VCT) site in Tshwane, South Africa. A qualitative approach was employed by using semi-structured interviews with open-ended questions to obtain information from four lay counsellors, who provide pre- and post-test counselling at a VCT site. The results indicate that the management of clients’ emotions and needs pose enormous challenges to HIV/AIDS lay counsellors who do not receive any formal psycho-social support at VCT sites. The research participants in this study resort to their own coping mechanisms to deal with the challenges – with varying degrees of success. The recommendation is made that a formal support programme should be put in place at VCT sites, which will allow HIV/AIDS lay counsellors to respond to the many demands placed on them. Such a programme can help prevent burnout and a high turnover in lay counsellors. / Social Work / M. A. (Social Behaviour Studies in HIV/AIDS)

The experience of complex childhood trauma produces a ripple-effect that psychologically impacts trauma survivors’ functioning in multiple areas. The aim of the current study was to investigate and describe the interplay between complex trauma, subsequent personality development and later psychopathology by means of the multiple case study method of six female psychiatric patients attending treatment at a tertiary psychiatric hospital within Gauteng, South Africa. This was accomplished by assessing and qualitatively analysing the results of a carefully selected battery of personality and other psychometric assessments presented to study participants. The results indicated that the experience of complex childhood trauma impacted the study participants’ personality in predictable ways, which further influenced the psychopathology they displayed as psychiatric patients. These findings aid in describing the psychological impact of complex trauma on the research participants, and also offers support for reconnecting past traumas to the current psychopathologies of psychiatric patients. / Psychology / M.A. (Clinical Psychology)

Summary in Afrikaans and English / Although the rights of children in South Africa are being regulated by legislation, statistics prove that statutory services on behalf of children annually increase. Scientific accountable information regarding the child can be obtained by the assessment of the child. The purpose of this investigation was to identify the gaps in the existing assessment guidelines, as well as the needs of social workers regarding assessments. The sequential exploratory strategy was utilized, as quantitative data supported qualitative findings. The investigation showed that minimal assessment literature is available in South Africa and internationally, although assessment is the basis evidence of the social worker. The biggest gap in assessment guidelines is that assessment does not carry weight in the court. There is a need for social workers to be trained in relevant assessment skills based on a specific frame of reference. Gestalt therapy can provide a suitable theoretical frame of reference for assessment, and can serve as scientific foundation for social workers during the statutory process. A framework for an assessment guideline was thus proposed. / Ten spyte daarvan dat die regte van kinders in Suid-Afrika deur wette gereguleer word, bewys statistiek dat statutere dienste aan kinders jaarliks toeneem. Wetenskaplik verantwoordbare inligting ten opsigte van die kind kan bekom word deur die kind te assesseer. Die doel van hierdie ondersoek was om leemtes wat in bestaande assesseringsriglyne is vas te stel, asook die behoeftes wat by maatskaplike werkers ten opsigte van assessering bestaan. Die opeenvolgende verkennende strategie is tydens hierdie ondersoek gevolg, aangesien kwantitatiewe data gebruik is om die kwalitatiewe bevindings te ondersteun. Die ondersoek het getoon dat min literatuur ten opsigte van assessering in Suid-Afrika en internasionaal beskikbaar is, ten spyte daarvan dat assessering die basis van die getuienis van die maatskaplike werker vorm. Die grootste leemte wat in assesseringsriglyne ge'identifiseer is, is die feit dat assessering nie gewig in die hof dra nie. 'n Behoefte ten opsigte van opleiding in toepaslike assesseringsvaardighede vanuit 'n spesifieke teoretiese verwysingsraamwerk bestaan. Gestaltterapie kan 'n teoretiese verwysingsraamwerk vir assessering bied en kan dien as wetenskaplike fundering vir optrede van maatskaplike werkers tydens die statutere proses. 'n Raamwerk vir 'n assesseringsriglyn is voorgestel. / Social Work / M. Diac. (Play Therapy)

Text in Afrikaans / Indigenous literature about the experience of a couple, where one of the spouses experiences a spinal cord injury, is scarce in the frame of social work. The experience of 5 couples (10 participants), after a spinal cord injury of one of the spouses was researched in this qualitative study. The aim of this research study is: • to reconnoiter participants’ experience of a spinal cord injury of a spouse, through semi-structured interviews with a purposeful chosen sample • to subject the research findings to a literature control • to make recommendations about how spouses can support each other, as well as how professional people can support client systems, where one of the spouses experience a spinal cord injury From the data it was determined that a spinal cord injury had significantly influenced the couples: - emotions - needs - perceptions (origination of experiences) Recommendations to couples as well as to professional people have been made. / Social Work / Thesis (M. Diac.)

This study focuses on the psycho-social challenges faced by HIV/AIDS lay counsellors at a Voluntary Counselling and Testing (VCT) site in Tshwane, South Africa. A qualitative approach was employed by using semi-structured interviews with open-ended questions to obtain information from four lay counsellors, who provide pre- and post-test counselling at a VCT site. The results indicate that the management of clients’ emotions and needs pose enormous challenges to HIV/AIDS lay counsellors who do not receive any formal psycho-social support at VCT sites. The research participants in this study resort to their own coping mechanisms to deal with the challenges – with varying degrees of success. The recommendation is made that a formal support programme should be put in place at VCT sites, which will allow HIV/AIDS lay counsellors to respond to the many demands placed on them. Such a programme can help prevent burnout and a high turnover in lay counsellors. / Social Work / M. A. (Social Behaviour Studies in HIV/AIDS)

Le retentissement psychologique d’événements sources de responsabilité, quels qu’ils soient – acte de terrorisme, perte d’un être cher, harcèlement moral… – est spécifique du fait de ses caractères protéiforme et invisible. Tout d’abord, le premier d’entre eux tient au fait qu’en matière psychologique tant les atteintes que les souffrances en résultant sont diverses. Ainsi, d’un point de vue lésionnel, certains événements vont s’avérer plus traumatisants que d’autres, principalement ceux au cours desquels le sujet a été confronté à sa propre mort. Concernant la souffrance, un sujet peut tout aussi bien souffrir émotionnellement d’une altération de sa propre intégrité – par exemple physique avec le diagnostic d’une pathologie grave – que d’un tort affectant celle d’un proche (e.g. décès, handicap). Un retentissement qualifié d’invisible ensuite, puisqu’il apparaît bien plus aisé d’identifier une atteinte à l’intégrité physique qu’une atteinte à l’intégrité psychique. De plus, certaines atteintes psychologiques sont totalement insaisissables en raison de leur caractère éminemment diffus. L’objet de cette démonstration est donc de savoir comment le droit de la responsabilité civile va appréhender la victime de ce retentissement psychologique. Sa prise en charge ne pourra être que particulière du fait de l’interaction inévitable entre les sphères juridique et psychologique.Afin de le découvrir sera proposée, dans un premier temps, une conceptualisation de la victime psychologique se fondant sur la réalité psychopathologique. Deux grandes distinctions nourrissent cette réflexion. L’une est de nature juridique ; il s’agit de la distinction du dommage et du préjudice. L’autre est d’origine psychopathologique ; elle oppose le choc émotionnel au traumatisme psychique. Leur entrecroisement permettra d’élaborer différents cas de manifestation de la souffrance psychologique et de dessiner les contours de la qualité de victime. Dans un second temps, au titre de l’indemnisation de la victime psychologique, tant l’appréciation que l’évaluation de ses préjudices seront examinées. Les répercussions du traumatisme psychique voire du choc émotionnel vont parfois être si importantes que l’indemnisation ne pourra se cantonner à la seule souffrance éprouvée. Des conséquences de nature différente, par exemple patrimoniales, devront être prises en considération. À cette fin, une typologie des préjudices de la victime sous analyse mérite d’être mise en place. Des règles d’indemnisation distinctes seront érigées en fonction du préjudice subi. Un préjudice présumé, notamment à partir d’un dommage, ne pourra logiquement être compensé de la même façon que des préjudices non présumables, c’est-à-dire soumis à expertise. En somme, le système d’indemnisation à instaurer se devra d’être en phase avec le système de révélation de la souffrance qui aura été précédemment établi.Ainsi, cette étude se propose de construire un réel statut fondateur de la victime psychologique. Une fois cette notion cardinale intégralement conceptualisée, un régime d’indemnisation s’en inférant sera rationnellement avancé. / The psychological impact of the events, which are the source of responsibility, be they acts of terrorism, loss of a loved one, psychological harassment, is specific to characteristics both protean and invisible. The first among them is due to the fact that in psychological matter injuries and the resulting suffering are both varied. As such, from the injury point of view, certain events will prove to be more traumatizing than others. Principally those during which the subject has been faced with his own death. Concerning suffering, a subject can as well emotionally suffer a change in his own integrity – for example the physical one with a diagnosis of a serious illness – that of a sort damage which affects that of a loved one (e.g. death or handicap). Then, the impact is considered invisible. It appears much more simple indeed, to identify harm to physical integrity as a harm to psychic integrity. More so, certain psychological harms are totally imperceptible by reason of their eminently diffuse characteristic. The object of this demonstration is therefore to know how civil liability law will comprehend the victim of such a psychological impact. Its comprehension will be particular given the inevitable interaction between the judicial and psychological spheres.In order to better understand this, we will first propose a conceptualization of the psychological victim that blends into psychopathological reality. Two major distinctions feed this thought. One is legal nature, which relates to the distinction between prejudice and harm. The other is psychopathological in nature which opposes emotional shock and psychic trauma. Their intertwining allows us to elaborate different cases of manifestation of psychological suffering and define the contours of the qualities of the victim. Secondly, regarding compensation for a psychological victim, both the appreciation and the evaluation of these prejudices will be examined. The repercussions of psychic trauma, or even emotional shock can sometimes be so grave that compensation cannot restrict itself only to the experienced suffering. Consequences of different natures, for example patrimonial ones, must be taken into consideration. To this end, a division of the prejudices of the psychological victim should be put in place. Distinct rules of compensation will be established based on the prejudice endured. A prejudice presumed, originating notably from a harm, cannot logically be compensated in the same fashion as non-presumable prejudices that require a forensic assessment. In short, the system of compensation must be in phase with the system of disclosure of suffering that has been previously established. As a result, this study proposes to construct a true founding status of a psychological victim. Once this principal notion has been completely conceptualized, we can use it to create a rational compensation scheme.