Telomeres is a manuscript-length lyric essay in many parts that traces the relationship of the narrator and her father as they both navigate the landscape of post-traumatic stress disorder after his return from Vietnam. / by Nicole Oquendo. / Thesis (M.F.A.)--Florida Atlantic University, 2012. / Includes bibliography. / Mode of access: World Wide Web. / System requirements: Adobe Reader.

This is a prospective study of a cohort sample of injured Kuwaiti First Gulf War survivors designed to investigate the prevalence of psychiatric morbidity due to combat and exposures to traumatic events. The study included two main phases. The first phase conducted in 1998, and in 2003 the second phase was executed. This study was designed to investigate the contribution of combat physical injury to the neurobiology of posttraumatic stress disorder (PTSD), prevalence rates of PTSD, depression, anxiety and other psychological morbidity, and predictors of chronic PTSD. The first assessment was in 1998 and the second assessment in 2003 that involved biological investigations. Beside the clinical interview and the physical examination of the site of injury, multiple psychological scales and questionnaires were used. Based on DSM-IV criteria of PTSD, after the second assessment the population of this study were classified to: Chronic PTSD(have PTSD at both assessments), Delayed PTSD (have PTSD only on the second assessment), Recovered (have PTSD only in the first assessment), and Never PTSD (have no PTSD in both assessments). The biological assessment include: blood investigations, BMI, and visual analogue. The data of the study were analyzed based on the four PTSD subgroups. In the first chapter an introduction to the First Gulf War was presented followed by the second chapter that discussed literature review. The third chapter tackled the methods used in this study. The fourth to the sixth chapters discussed the results of this study regarding prevalence of Chronic PTSD, Cortisol and PTSD and Thyroid hormones and PTSD respectively. The last chapter presented the limitations and strengths of the study. There were three main hypotheses. First: combat injured survivors with chronic PTSD have cluster of symptoms severity similar to delayed PTSD after 13 years of the trauma and the prevalence of chronic PTSD is constant over time. Second: low cortisol levels observed in chronic PTSD are constant with chronicity, normalize with recovery, unrelated to degree of disability, and are influenced by comorbid disorders. Third: there is minor role for thyroid hormones in chronic PTSD. All of registered Kuwaiti combat injured survivors at the Social Development Office in Kuwait, were approached to voluntary participate in this study. Of 234 individuals 212 participate in the first stage, and out of these 123 participate in the second stage with the addition of 33 new cases that were not examined in 1998 but were registered in SDO after 1998. An informed consent was taken from the participants at both phases. The participants were assessed using General Health Questionnaire, Trauma Questionnaire, Clinician Administered PTSD Scale, Eysenck Personality Questionnaire, Symptom Checklist-90 Revised, and Life Event Scale. Questionnaires and scales applied in the first stage were applied in the second stage with the addition of Impact of Event Scale, Composite International Diagnostic Interview and Scale of Gulf War Syndrome. Biochemical assessment comprised cortisol level, thyroxine (fT4), free triiodothyronine (fT3) and thyroid stimulating hormone (TSH). The blood samples were taken before starting the interview. Physical assessment involved measurements of: pulse rate, systolic and diastolic blood pressure, waist-hip circumference, body mass index and visual analogue before and after the interview. Data entry program using Statistical Package for Social Scientists was used to enter data and analysis. The prevalence rate of delayed onset PTSD (14.6%), chronic PTSD (15.4) recovered from PTSD (22.8%) and never had PTSD (47.2%). With chronic PTSD there are higher cluster of PTSD symptoms severity, not related to severity of physical injury, has more prevalence of PTSD associated symptoms, higher comorbid psychiatric disorders. Intrusions, avoidance and arousal are PTSD cluster of symptoms more predictive of future development of PTSD after the injury. There was a low baseline cortisol level with chronic PTSD, and it was significantly lower in participants with delayed PTSD. Furthermore trauma itself rather than PTSD diagnosis may have an impact on cortisol level. Other psychiatric comorbidity has an enhancing effect on cortisol level. The levels of thyroid hormones were within the normal range. The trend of thyroid function in delayed and chronic PTSD is lower fT3, and TSH and higher fT4 levels, with higher fT3 levels in delayed PTSD compared to chronic PTSD. It was found that the higher severity of trauma score with PTSD the higher fT3 mean values. / Thesis (Ph.D.) - University of Adelaide, School of Medicine, 2008

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)

Le PTSD s’accompagne classiquement de troubles de la mémoire verbale et d’une altération de certaines régions cérébrales. Cependant, peu d’études ont porté sur des populations féminines victimes de traumatismes civils. Au cours de trois études utilisant l’imagerie par résonance magnétique (IRM), nous avons évalué l’état des corrélats cérébraux des mémoires épisodique et de travail chez des patientes victimes d’abus sexuel. Nos travaux ont mis en évidence une forte correspondance entre les régions cérébrales qui sous-tendent un encodage verbal durable et celles qui sont habituellement affectées au cours du PTSD. De plus, nous avons démontré l’absence de réduction volumétrique de ces régions dans un échantillon de patientes. Enfin, nous avons observé chez ces dernières une modification potentiellement compensatoire du profil d’activation fonctionnelle cérébrale lors du traitement verbal en mémoire de travail d’éléments liés et non-liés au traumatisme vécu. Ces résultats suggèrent une spécificité de mécanismes neurocognitifs du PTSD liée au genre et supportent l’intérêt de l’utilisation de la remédiation cognitive dans sa prise en charge. / PTSD is classically associated with verbal memory impairments and specific brain alterations. However, few studies have investigated the population of female victims of civilian traumas. During three studies using magnetic resonance imaging, we investigated the condition of the brain correlates of episodic and working memory in patients with sexual abuse-related PTSD. Our work has highlighted an important matching between the brain regions underlying strong verbal memories encoding and those that are usually affected by PTSD. Moreover, we demonstrated the absence of volumetric shrinking of these regions in our sample. Finally, we noticed a potentially compensatory alteration of functional activation pattern in this population during verbal working memory processing of trauma-related and unrelated items. These results suggest a gender-dependent specificity of PTSD neurocognitive mechanisms and further support the interest of using cognitive remediation in its treatment.

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)

No description available.

In 2009, South African police statistics revealed that more than 68 332 women were raped in the country. The evidence from independent researchers has shown that SAPS statistics are highly susceptible to under-reporting and the actual figure is more than double this amount. One pervasive feature of the phenomenology of rape is post-traumatic stress disorder (PTSD). PTSD is a highly debilitating condition with severe individual and societal costs. The condition takes a critical toll on occupational functioning, schooling and personal relationships and is associated with depression, suicide risk, self-harming behaviours and alcohol-abuse problems. The Ehlers and Clark (2000) cognitive model represents the most efficacious treatment for PTSD but the approach is severely under-utilised by South African practitioners working with sexual trauma. The reasons for such under-utilisation relate to a lack of exposure and training surrounding the model and concerns about the transportability of the treatment to a multi-cultural context. One method of addressing these barriers to treatment delivery is through systematic case-based research. Systematic case-based research offers a complementary means of refining theory and developing evidence-based practice in the context of a developing country. The method offers an intensive analysis and description of the particular phenomena under study within its real-life context. It allows the researcher to intensively examine and identify the specific aspects of the therapist’s responses and client’s reactions that contributed to significant change. Unlike efficacy studies, generalisability in case-study research is based on replication on a case-by-case basis and the creation of case law. This research study uses a systematic-case study approach to investigate the applicability of the Ehlers and Clark (2000) model in the treatment of rape-related PTSD in South Africa. The study aims to demonstrate the transportability of the model and develop a needed evidence base for service providers in the country. Seven women participated in the project and lent their treatment process to the research. The participants varied in terms of age, race, culture, socio-economic status and the nature of their sexual trauma. Through synoptic thematic analysis of their therapy process specific client-related personal aspects, client-related contextual factors and state-level factors were found to impede treatment delivery and implementation. The implications of these aspects for clinical practice and social policy are comprehensively discussed.