Cette thèse a pour visée principale de faire avancer les connaissances de la littérature concernant les différences hommes-femmes dans le trouble de stress aigu (TSA) et le trouble de stress post-traumatique (TSPT), chez une population de victimes d’actes criminels graves (VAC). L’étude comprend deux objectifs principaux. Tout d’abord, l’évaluation de la présence et de l’intensité de réactions péri-traumatiques, soit la dissociation et la détresse. Ensuite, nous avons étudié si ces facteurs étaient associés à la survenue d’un TSA, chez les VAC et s’ils prédisaient différemment le TSA en fonction du genre. Dans le cadre d’un deuxième article et comme objectif secondaire de la thèse, l’impact des réactions péri-traumatiques a aussi été vérifié, mais cette fois sur le développement subséquent d’un TSPT. Également pour cet objectif, nous nous sommes concentrés sur le rôle du genre dans la prédiction de la relation. Des entrevues d’évaluation clinique ont été effectuées auprès de 214 victimes (125 femmes). Plus précisément, le TSA a été évalué, dans le cadre de l’article 1 à l’aide de l’Acute Stress Disorder Interview (ASDI), puis le TSPT à l’aide de l’entrevue semi-structurée du SCID pour une mesure diagnostique catégorielle et avec l’échelle modifiée des symptômes traumatiques (ÉMST), dans l’article 2. Cette échelle produit un score en continu de sévérité et de fréquence des symptômes. Les variables péri-traumatiques ont été évaluées à l’aide de questionnaires auto-rapportés, soit le Questionnaire des expériences dissociatives péri-traumatiques et l’Inventaire de détresse péri-traumatique. Les résultats du premier article démontrent que les femmes vivraient globalement plus de détresse péri-traumatique que les hommes, alors qu’il n’y aurait pas de différence de genre pour les expériences dissociatives. Ces réactions péri-traumatiques seraient toutes deux des prédicteurs d’un TSA tant chez les hommes que les femmes. Des différences de genre seraient présentes dans l’association de la détresse et du TSA lorsque des évènements potentiellement traumatiques passés étaient considérés. Pour les hommes, une présence élevée de détresse péri-traumatique et plusieurs antécédents de potentiels évènements traumatiques les rendraient plus vulnérables au développement d’un TSA. Chez les femmes, de potentiels traumas antérieurs augmenteraient le risque de présenter des symptômes du TSA seulement lorsqu’un niveau élevé de détresse péri-traumatique était présent lors du crime. Le deuxième article de la thèse démontre à nouveau que les réactions péri-traumatiques sont des facteurs de risque, mais cette fois pour le développement d’un TSPT. Cependant, aucune différence de genre n’a été observée concernant la capacité prédictive de ces variables. En effet, quelques mois après l’événement, la dissociation et la détresse péri-traumatiques demeurent des variables d’intérêt à considérer pour prévenir la survenue d’un TSPT, mais ce tant pour les victimes hommes que femmes. Cette deuxième étude a également confirmé l’importance du trouble de stress aigu comme facteur de risque au développement d’un TSPT chez une population de victimes d’actes criminels violents. Ces résultats, les limites de l’étude, des pistes de recherche futures, ainsi que les implications cliniques pour le traitement du TSA et du TSPT seront discutés de manière détaillée dans cette thèse doctorale. / This thesis aimed to contribute to the acute stress disorder (ASD) and post traumatic stress disorder (PTSD) literature in terms of gender differences among crime victims. Precisely, we were interested in the intensity and presence of peritraumatic reactions namely, dissociation and distress, among men and women victims of violent crimes. Two objectives were pursued. First, we evaluated whether peritraumatic dissociation and distress were significant risk factors for ASD development and if these acute stress reactions’ predictive capacity, differed according to gender. A second objective was to investigate if peritraumatic dissociation and distress significantly predicted PTSD development according to gender. Globally, in this research project, we were interested in determining the impact of gender in the prediction of the above-mentioned relationship . Semi-structured interviews; the Acute Stress Disorder Interview (ASDI) in the first article and the Structured Clinical Interview for DSM-IV (SCID) in the second article were conducted with 214 victims (125 women, Mage=39.6yrs) to assess ASD and PTSD respectively. Data on peritraumatic variables were collected through self-report questionnaires, the Peritraumatic Dissociative Experience Questionnaire and the Peritraumatic Distress Inventory. Peritraumatic dissociation and distress were both significant risk factors for ASD in men and women. Women presented higher peritraumatic distress levels compared to men victims. Gender differences were revealed through past potential traumatic experiences, where they have a cumulative impact on ASD risk development for men, but having few past potential traumas could be a protective factor for women. In the second article, findings reveal that acute stress variables were both significantly related to more PTSD symptoms, although no gender differences were identified. An acute stress disorder diagnosis was also confirmed as an important predictor of PTSD in victims of violent crimes. These results, study limitations, directions for future research as well as clinical implications for ASD and PTSD treatment will be discussed.

Objectifs : Examiner les difficultés psychosociales chez des adolescents exposés, âgés entre 14 et 18 ans, dans les neuf (9) mois suivants la tragédie ferroviaire. Comparer les adolescents qui atteignent le seuil clinique du trouble de stress post-traumatique (TSPT) à ceux qui ne l’atteignent pas, en fonction de la sévérité d’exposition, des symptômes de dépression, d’anxiété et autres problématiques associées. Méthode : Les analyses ont été faites auprès d’un échantillon de convenance de 227 jeunes, dont la moyenne d’âge est de 15,96 ans, des niveaux secondaires III, IV et V et vivant dans le secteur de Lac-Mégantic, en Estrie au Québec. Résultats : Près de la moitié (41,5 %) des adolescents rapportent avoir été sévèrement exposés à l’accident ferroviaire et le tiers (29,6 %) présentent un niveau de sévérité du TSPT atteignant le seuil clinique. Il semble y avoir une tendance où les filles sont proportionnellement plus nombreuses à rapporter des symptômes du TSPT, de dépression et d’anxiété comparativement aux garçons. La majorité des adolescents présentent une consommation non problématique de substances psychoactives (SPA), alors que pour 8 %, celle-ci serait à risque ou problématique. Les actes de délinquance, principalement non violents, sont davantage identifiés chez les garçons. Les adolescents qui atteignent le seuil clinique du TSPT ont été plus sévèrement exposés lors de la tragédie et sont davantage dépressifs et anxieux. Aucune relation significative n’est observée entre le TSPT et la consommation de SPA et le nombre d’actes de délinquance. Conclusions : Suite à l’accident ferroviaire, cette étude démontre la proportion importante des adolescents qui souffrent de symptômes du TSPT et de problèmes de santé mentale associés. / Objectives: To examine the psychosocial difficulties in a group of exposed adolescents aged 14 to 18 nine months after the railway accident. Compare adolescents who reach the clinical level of post-traumatic stress disorder (PTSD) to those who do not, depending on range severity of exposure and on symptoms of depression, anxiety and other related issues. Methods: The analyses were conducted on a suitability sample of 227 young people, with an average age of 15.96 years, in secondary levels III, IV and V, and living in the Mégantic sector of the Eastern Townships in the province of Quebec. Results: Almost half (41.5%) of adolescents report being severely exposed to the railway accident and one third (29.6%) has described severe PTSD symptoms reaching the clinical threshold. In addition, there appears to be a tendency for a higher proportion of girls compared to boys to have PTSD problems and depression and anxiety symptoms. The majority of adolescents report a non-problematic use of psychoactive substances, while 8% are at risk or problematic. Delinquency, mainly non-violent, is more common among boys. Adolescents who reach a clinical threshold of PTSD symptoms have been more severely exposed to the tragedy and report feeling more depressed and anxious. There was no significant relationship between PTSD and externalized behaviours. Conclusion: The results of the study highlight the relationship between a traumatic event such as the railway accident and the presence of PTSD symptoms as well as of internalized behaviours in a group of adolescents.

M.A. (Psychology) / Please refer to full text to view abstract

There appears to be a growing body of literature focusing on PTSD and HIV-related PTSD (the diagnosis of HIV being the significant traumatic event) amongst HIV-positive samples, but only a few African studies that attempt to estimate the prevalence of PTSD amongst HIV-positive people, and even fewer that attempt to estimate the prevalence of HIV-related PTSD. The systemic review presented in this study is currently fully inclusive and is the most up-to-date available. Estimates of the prevalence of PTSD and HIV-related PTSD in South Africa range from 0.7 to 54.1% and, 4.2 to 40% respectively. The current cross-sectional study made use of a mixed-method approach to investigate traumatic life events, PTSD and HIV-related PTSD within a primary health-care centre in KwaZulu-Natal. The quantitative sample consisted of 159 adults (18-50 years) who were compliant on ARV medication. Using the CIDI-PTSD module, the adapted CIDI-PTSD module for HIV, and IES-R, findings indicated that 62% had reported some kind of traumatic event in their lifetime, with 29.6% of participants meeting the criteria for lifetime PTSD, and 40.9% meeting the criteria for lifetime HIV-related PTSD. Altogether, 57.9% of individuals met the criteria for some form of PTSD (either regular PTSD or HIV-related PTSD), and 12.6% met the criteria for both PTSD and HIV-related PTSD. Of the different categories of traumatic events, interpersonal violence has the highest rate of PTSD, followed by a diagnosis of and living with HIV, and then disaster. Furthermore, the IES-R was compared for its usefulness as a screening measure for PTSD against both the CIDI, but results suggest that it is an inferior screening measure to the PDS. The qualitative study consisted of six participants who were examined using IPA methodology informed by the Ehlers and Clark (2000) Model of trauma. Their experiences revealed experiences of stigma, a number of negative appraisals, negative emotions and coping behaviours. Some of the latter might serve as compensatory mechanisms to avoid negative judgements. Hypervigilance seems to be a feature of ARV-compliance that might confer added vulnerability to PTSD and other anxiety disorders.

M.A. / Little is known about how police officers who are exposed to daily traumatic stressors in their working environment cope with these experiences, or how the coping strategies that they utilize mediate the levels of psychological distress and possible development of Posttraumatic Stress Disorder (PTSD). Focusing on 109 Brixton Flying Squad members of the South African Police Service, this exploratory study assessed the coping strategies and levels of psychological distress reported by these officers following traumatic exposure. The study examined the relative frequency of using eight ways of coping (as assessed by the Ways of Coping Checklist-Revised) with traumatic policing experiences and the association between the use of those coping strategies and subsequent development of symptomatologies and PTSD. Consistent with previous studies with combat veterans, police officers predominantly used emotion-focused coping strategies to cope with traumatic stressors. Nearly a third of the police officers met psychometric criteria for a positive screening diagnosis for PTSD. Results indicated that PTSD positive subjects tended to use relatively more escape –avoidance in coping with trauma, as opposed to PTSD negative subjects. Significantly higher levels of psychological distress, especially depression were also found for PTSD positive subjects, and the use of emotion-focused strategies was positively related to greater PTSD symptom severity and elevated levels of psychological distress. Findings demonstrated the mediating role of coping strategies that have the potential to become either adaptive or maladaptive to occupational and psychological functioning. These preliminary findings are discussed in-relation to methodologic and clinical issues.

This thesis compares the different trauma received at the three major hiding places for Jewish children in Belgium during the Holocaust: Christian establishments, private families, and Jewish orphanages. Jewish children hidden at Christian establishments received mainly religious trauma and nutritional, sanitary, and medical neglect. Hiding with private families caused separation trauma and extreme hiding situations. Children staying at Jewish orphanages lived with a continuous fear of being deported, because these institutions were under constant supervision of the German occupiers. No Jewish child survived their hiding experience without receiving some major trauma that would affect them for the rest of their life. This thesis is based on video interviews at Shoah Visual History Foundation and Blum Archives, as well as autobiographies published by hidden children.

The purpose of the study was to record the post-traumatic symptoms resulting from the September 11th tragedy, as observed in students by their teachers and counselors throughout a six-month period.

The terrorist attack of September 11th has been widely viewed as a traumatic event. Traumatic events have demonstrated psychological, emotional, behavioral, developmental and physiological detriment to individuals. Among older adults there may be compounding factors such as losses of function, resources, friends, family, and support.

The purpose of this study was to examine what, if any, symptoms of a traumatic stress reaction were still being experienced by police officers, as a result of the events of September 11, 2001, who were geographically distant from the events of that day. Participants included 60 police officers at two southern California law enforcement agencies.

Convergence of technology has made access to the Internet faster, easier and cheaper. Criminals, including paedophiles, child abusers and pornography traders make use of this technology to commit criminal offences. Computer Forensic Examiners (CFEs) are members of the Cyber Crime Unit, a professional, specialised unit of the South African Police Service (SAPS) who are responsible for computer forensic examination including the investigation of child pornographic images. The aim of the study was to seek understanding on what psychological effects the CFEs experienced when working with the images and was conducted from within the social constructionism and the narrative frameworks. The images had a severe impact on the CFEs as was clearly uncovered in the stories of six CFEs who participated in this study. The participants' stories were recorded and transcribed after which the application of thematic content analysis found that the participants all suffered similar negative effects. These findings were integrated with the findings of a focus group as well as with the findings of a similar study that was conducted during the same time by the Crimes against Children Research Center at the University of New Hampshire and resulted in identifying symptoms of trauma and stress experienced by the CFEs. Based on these results recommendations regarding the support for the CFEs were made. / Psychology / M.A. (Psychology)