The thesis focuses on posttraumatic growth in adolescents and young adults. The subject of the research is finding and tracking reactions and changes that emerge after a specific stimulus - an existentially experienced trauma, where at the core is realizing the threat of life and afterwards thinking about one's own death. The theoretical part deals with psychological and philosophical sources of current concepts of post-traumatic growth. These sources support our assumption that for the specific course of post-traumatic reactions and changes the subject category or objective severity of events is not relevant. It is the respondents own perception of a life threat. We also deal with a particular PTG model by Tedeschi and Calhoun, whose concept of changes after a major life event was chosen as the starting point for our research and whose PTGI questionnaire is used in the quantitative part. In the empirical part we chose mixed research design. First, a quantitative part of the research was carried out, involving 407 respondents aged 17-25. The aim of this part was to determine the rate of post-traumatic growth and to demonstrate that perceived life threats occur among respondents across all event categories. The personal perception of a life threat will result into a higher score achieved in both...

The diploma thesis deals with the mental health of war journalists in the period when this profession is undergoing significant changes. In the theoretical part, the thesis has the ambition to briefly describe the main development points of this profession from its inception to the present, which we define as a period of new wars. This is characterized by the increased danger faced by war journalists, as their originally respected, protected status has become the target of murder and kidnapping. The work of a war journalist has been transformed mainly in countries where media houses no longer have the funds to run foreign newsrooms and pay for the journeys of their journalists. Therefore, the phenomenon of freelance journalism has flourished, which gives journalists freedom at the cost of poor financial rewards and reduced security. However, the main topic of the work is the mental health of war journalists. Work stress, burnout syndrome, depression and post-traumatic disorder are mentioned as the main psychological pitfalls that the war journalist faces. An anomaly is identified that although an ordinary woman is more likely to develop PTSD than a man, a war journalist has the same probability as her male equivalent. Thus, the research part, through conducting semi-structured interviews, focuses...

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Background and objectives: Despite a generally good prognosis, testicular cancer can be a life-altering event. We explored perceived positive and negative life changes after testicular cancer in terms of frequency, demographic and disease-related predictors, and associations with depression and anxiety. Materials and methods: All testicular cancer survivors receiving follow-up care at two specialized outpatient treatment facilities were approached at follow-up visits or via mail. We assessed a total of N = 164 patients (66% participation rate, mean time since diagnosis: 11.6 years, SD = 7.4) by the Posttraumatic Growth Inventory (PTGI, modified version assessing positive and negative changes for each of 21 items), Patient-Health-Questionnaire-9 (PHQ-9), and Generalized-Anxiety- Disorder-Scale-7 (GAD-7). We conducted controlled multivariate regression analyses. Results: Most survivors (87%) reported at least one positive change (mean number: 7.2, SD = 5.0, possible range: 0–21). The most frequent perceived positive changes were greater appreciation of life (62%), changed priorities in life (62%), and ability rely on others (51%). At least one negative change was perceived by 33% (mean number of changes: 1.1, SD = 2.5). Negative changes were most frequent for decreases in self-reliance (14%), personal strength (11%), and ability to express emotions (9%). A higher socioeconomic status was associated with more positive changes ( = 0.25, 95% CI 0.08 to 0.42); no other association with demographic and disease-related predictors emerged. While positive life changes were not associated with depression ( = 0.05, 95% CI 0.17 to 0.07) and anxiety ( = 0.00, 95% CI 0.13 to 0.13), more negative life changes were significantly associated with higher depression ( = 0.15, 95% CI 0.03 to 0.27) and anxiety ( = 0.23, 95% CI 0.11 to 0.36). There was no significant interaction of positive and negative changes on depression or anxiety. Conclusions: Although positive life changes after testicular cancer are common, a significant number of survivors perceive negative changes in life domains that have been primarily investigated in terms of personal growth. Early identification of and psychosocial support for patients who perceive predominantly negative changes may contribute to prevention of prolonged symptoms of anxiety and depression.

Previous research indicates that those with a history of abuse have an increased risk to experience subsequent traumatic events. This study utilized a convenience sample of undergraduate students to examine the reaction of those with a history of abuse to subsequent traumatic experiences. In addition, the study assessed the level of posttraumatic growth an individual experiences following childhood abuse. The level of posttraumatic growth was examined to determine if the growth allowed for participants to better handle successive traumas. Those with a history of abuse experienced higher levels of symptomology following a successive traumatic event. Results did not support the hypothesis that among those with a history of abuse, lower levels of posttraumatic growth would predict higher levels of symptoms following a later trauma. Implications and limitations of the study, as well as directions for future research are discussed.

Severe motor vehicle accidents (MVAs) represent one of the most often occurring psychological traumas, and are a leading cause of Posttraumatic Stress Disorder (PTSD). However, not all persons develop PTSD after traumatic events and a great proportion of patients who show symptoms initially recover over time. This has stimulated research of psychological and biological factors that explain development and maintenance of the disorder. Fortunately, this highly distressing condition can be effectively treated, e.g. via cognitive behavioral therapy (CBT). However, brain mechanisms underlying changes due to psychological therapy in PTSD are almost unknown (Roffman, Marci, Glick, Dougherty, & Rauch, 2005). On the other hand there are observations of positive changes following trauma called Posttraumatic Growth (PTG), which have stimulated research of associated psychological processes and factors. However, there is a lack of research about the relation of biological variables (e.g. measures of brain function) and PTG. Theories of brain asymmetry and emotion (Davidson, 1998b, 2004b; Heller, Koven, & Miller, 2003) propose that asymmetries of brain activation are related to certain features of human emotion (e.g. valence, approach or withdrawal tendencies, arousal). Whereas an enormous increase in the understanding of structural and functional abnormalities in PTSD could be achieved in the last decades due to neuroimaging research, there are still numerous unanswered questions. Especially, there is only little research explicitly examining activation asymmetries in PTSD. Furthermore, as mentioned, research is sparse investigating alterations of brain function that are associated with successful psychological treatment of PTSD. Finally, there is no published study examining how measures of brain function are related to PTG. This thesis presents 3 studies investigating electroencephalographic (EEG) asymmetries in survivors of severe motor vehicle accidents. The first part of the thesis (chapter 2) is devoted to a literature review about description (chapter 2.1), epidemiology (chapter 2.2 and 2.3), risk factors (chapter 2.4), psychological theories (chapter 2.5), biological mechanisms particularly neuroimaging findings (chapter 2.6), and treatment of PTSD (chapter 2.7.). Chapter 2.8 gives a short review on definition and research of Posttraumatic Growth. Chapter 2.9 provides an overview of models and research regarding brain asymmetry and emotion. In chapter 3.1, a study is presented that investigated hemispheric asymmetries (EEG alpha) among MVA survivors with PTSD, with subsyndromal PTSD, and without PTSD as well as non-exposed healthy controls during a baseline condition and in response to neutral, positive, negative, and trauma-related pictures (study I). Next, the findings of study II are presented (chapter 3.2). This study examined the effect of cognitive behavioral therapy on measures of EEG activity. Therefore, EEG activity before and after CBT in comparison to an assessment only Wait-list condition was measured. In chapter 3.3 a correlational study (study III) is presented that examined the relationship between frontal brain asymmetry and selfreported posttraumatic growth after severe MVAs. Finally, in chapter 4 the findings are summarized and discussed with respect to (1) the state/trait debate in frontal asymmetry research and (2) current psychological theories of PTSD and PTG. In addition, the use of neuroscientific research for psychotherapy is discussed. Suggestions are presented for future goals for “brain” research of PTSD and treatment of PTSD. / Schwere Verkehrsunfälle stellen eines der am häufigsten vorkommenden psychologischen Traumata dar, und sind eine Hauptursache der Posttraumatischen Belastungsstörung (PTBS). Jedoch entwickeln nicht alle Personen nach traumatischen Ereignissen eine PTBS und bei einem Großteil remittieren anfängliche PTBS-Symptome. Dies stimulierte die Erforschung von psychologischen und biologischen Faktoren, die die Entstehung und Aufrechterhaltung der PTBS erklären. Glücklicherweise kann die PTBS effektiv, z.B über die kognitive Verhaltenstherapie (KVT), behandelt werden. Jedoch sind Gehirnmechanismen, die mit klinischen Änderungen aufgrund der psychologischen Therapie in PTSD einhergehen, nahezu unbekannt (Roffman, Marci, Glick, Dougherty, Rauch, 2005). Auf der anderen Seite gibt es Berichte von positiven Änderungen nach traumatischen Ereignissen, die als Posttraumatische Reifung (PTR) bezeichent werden. Dies hat in kürzerer Vergangenheit die Forschung von verbundenen psychologischen Prozessen und Faktoren stimuliert. Jedoch gibt es kaum Untersuchungen über die Beziehung von biologischen Variablen (z.B Messungen der Gehirnfunktion) und PTR. Diese Arbeit präsentiert 3 Studien, die electroenzephalographische (EEG) Asymmetrien bei Opfern schwerer Verkehrsunfälle untersuchten. Der erste Teil der Arbeit (Kapitel 2) widmet sich einer Literaturrezension über: die Beschreibung (Kapitel 2.1), Epidemiologie (Kapitel 2.2 und 2.3), Risikofaktoren (Kapitel 2.4), psychologische Theorien (Kapitel 2.5), biologische Mechanismen besonders Neuroimaging Ergebnisse (Kapitel 2.6), und Behandlung der PTBS (Kapitel 2.7.). Kapitel 2.8 gibt einen kurzen Überblick über die Definition und Forschung zur Posttraumatischen Reifung. Kapitel 2.9 gibt eine Übersicht zu aktuellen Modellen und empirischen Befunden bezüglich Gehirnasymmetrien und Emotionen. Kapitel 3.1 präsentiert eine Studie, in der hemisphärische Asymmetrien (im EEG-Alpha Band) bei Unfallopfern mit PTBS, subsyndromaler PTBS, und ohne PTBS sowie gesunden Kontrollpersonen ohne Unfall untersucht wurden: während einer Ruhemessung und einer Emotionsinduktions-bedingung (neutrale, positive, negative und trauma-spezifische Bilder) (Studie I). Danach werden die Ergebnisse der Studie II (Kapitel 3.2) präsentiert. Hier wurde die Wirkung der kognitiven Verhaltenstherapie auf Messungen der EEG-Aktivität untersucht. Deshalb wurde EEG-Aktivität vor und nach einer KVT im Vergleich mit einer Warten-Gruppe gemessen. Kapitel 3.3 präsentiert eine Korellationsanalyse (Studie III), bei der die Beziehung zwischen der frontalen Gehirnasymmetrie und posttraumatischer Reifung untersucht wurde. Am Ende der Arbeit (Kapitel 4) werden die Ergebnisse zusammengefasst und in Bezug auf (1) die state/trait-Debatte im Rahmen der Asymmetrie-Forschung diskutiert sowie (2) ein Bezug zu aktuellen psychologische Theorien von PTSD und PTG hergestellt. Außerdem wird der Nutzen von neurobiologischer Forschung für die Psychotherapie besprochen. Dabei werden Vorschläge für zukünftige Projekte für die "Gehirn"-Forschung im Zusammenhang mit der PTBS, deren Behandlung und PTG gemacht.

本研究之目的是檢驗因應與創傷後成長隨時間變化的相互關聯性，除了重複驗證因應與創傷後成長的時序關係之外，考量創傷後成長不同向度之間可能具有不同特性，本研究也進一步探討不同向度的創傷後成長與不同因應向度之間的關係是否有所差異。創傷後成長方面，除了將創傷後成長視為單一構念之外，以Ho等人(2013)針對台灣女性乳癌樣本之因素分析結果為基礎，將創傷後成長初步分為個體內PTG與個體間PTG；因應向度方面，則根據探索性因素分析之結果將因應策略分為自我導向式因應、社會導向式因應和逃避因應等三個因應向度。 本研究採用縱貫研究法，針對中部某教學醫院之初診斷女性乳癌患者進行為期兩年的追蹤研究，分別在術後三個月(T1)、術後半年(T2)、術後一年(T3)以及術後兩年(T4)進行調查，測量參與者在癌症壓力之後所使用的因應策略及創傷後成長，最後完成四個時間點測量的研究參與者共283人。統計分析方法方面，因考量因應與創傷後成長會隨時間而變動的可能性，故採用適合縱貫資料且能估計變項發展軌跡的潛在成長模式 (Latent growth model) 來進行資料分析。 研究結果顯示不同向度的因應與不同向度的創傷後成長之間關聯性不同，但此差異是反映在不同因應向度之間，至於相同因應與不同向度PTG之間的結果則無太大差異：在測量初始點，不管是哪一種因應方式，都跟整體PTG、不同向度PTG具有交互預測的關係，但在斜率方面，只有自我導向因應與整體PTG以及不同向度的PTG具有相互預測性。但是否區分個體內PTG和個體間PTG，對於因應與創傷後成長之關聯性結果差異不大。過去對於PTG是單一構念或多因素的爭論方興未艾，後續討論也納入是否有必要區分創傷後成長不同向度的必要性，最後討論本研究之限制，並提供未來研究可供參考之方向。 / Aims: The purpose of this article was to examine the time-varying reciprocal relationships between coping and posttraumatic growth (PTG) as well as their domains. PTG was divided into two dimensions－intrapersonal PTG (intra-PTG) and interpersonal PTG (inter-PTG) as suggested in Ho et al. (2013) while coping was divided into self-sufficient coping, socially-supported coping, and avoidant copingbased on the results of our exploratory factor analysis (EFA). Methods: Participants were Taiwanese women underwent surgery for breast cancer. Measures of PTG and coping were assessed at three-month, six-month, one-year and two-year. Of the 358 women who were recruited, 283 completed all four measures and were included in the analyses. As coping and PTG may change over time, the data was analyzed using latent growth curve model (LGM). Results: Our results showed that there’re different relationships between coping strategies and PTG dimensions. At the initial measure, all kinds of coping strategies have a reciprocal relationship with PTGs, but when it comes to the directions between slopes of coping and PTG, only self-sufficient coping has a reciprocal relationship with PTG. There’s almost no difference while comparing different PTG dimensions models. In other words, there’s almost no difference in LGM models between intra-PTG and inter-PTG. In the end of the study, the necessity of the division of PTG and limitations of this study were discussed.

本研究主要目的在探討不同治療階段中創傷後成長與因應策略之關係。由於過去創傷後成長與因應策略之間的研究，均是將創傷後成長視為個體因應後的結果，而忽略創傷後成長的經驗對個體的影響，因此本研究透過雙面神模式的理論，以更多元的角度來檢視「創傷後成長」，並將追蹤三個時間點，根據不同治療階段進一步提出三個假設模式，並採用交叉延宕分析（Cross-lagged analyses）來檢驗。 研究方法採立意取樣，以中部某教學醫學之乳房中心的乳癌患者為對象，共262 人，蒐集患者之「基本資料」、「創傷後成長」及「因應策略」，並在術後三個月、術後六個月及術後一年進行問卷調查。資料分析以探索性因素分析將因應策略分為三個因素：「自我導向因應」、「社會導向因應」及「逃避因應」，並與創傷後成長進行交叉延宕分析。 研究主要發現如下：（一）診斷時年齡愈小及教育程度愈高者，可以預測術後三個月較高的「自我導向因應」、「社會導向因應」及「創傷後成長」；（二）術後三個月到六個月之間，「自我導向因應」與「創傷後成長」呈現互惠關係，即術後三個月較高的「自我導向因應」可以預測術後六個月較高的「創傷後成長」，而術後三個月較高的「創傷後成長」也可以預測術後六個月較高的「自我導向因應」；（三）術後六個月的「創傷後成長」可以預測術後一年的「社會導向因應」，即在術後六個月時「創傷後成長」愈高，可以預測後續較高的「社會導向因應」；（四）三個時間點中，「逃避因應」均無法預測「創傷後成長」，「創傷後成長」亦無法預測「逃避因應」。 最後將根據研究結果提出其貢獻與實務運用，並依據研究限制提出相關建議，以供臨床工作者與未來研究學者參考。 / This study is aimed to investigate the relationships between coping strategies and Posttraumatic Growth (PTG) on three different timing of the breast cancer treatment. According to Janus-Faced Model, PTG is assumed as both a coping effort and a coping result. In order to investigate the possible relationships between coping strategies and PTG, three hypothetic models were proposed and tested by cross-lagged analyses. By purposive sampling, 262 participants were recruited from the breast center unit at a hospital in central Taiwan. Demographic and disease-related information were gathered after surgery. The Posttraumatic Growth Inventory (PTGI) and the Brief Coping Orientations to Problems Experienced scale (Brief COPE) were assessed 3, 6 and 12 months later. The Brief COPE included 3 factors: self-sufficient coping, socially-supported coping and avoidant coping. Each was assumed to associate with PTG differently. Results of the current study were as follows: 1. Younger patients or women of higher education level reported more PTG, self-sufficient coping and socially-supported coping at T1. 2. The reciprocal relation was found between self-sufficient coping and PTG within 6 months postsurgery, which indicated the positive effect of T1 self-sufficient coping on T2 PTG, as well as the reciprocal effects of T1 PTG on T2 self-sufficient coping. 3. Higher level of PTG at T2 predicted more socially-supported coping at T3. 4. Within 1 year postsurgery, there were no significant cross-lagged effects between avoidant coping and PTG, but only autoregressive correlations within constructs over time. Implications of these findings are discussed, along with potential directions for future research.

The purpose of the present study was to examine the predictive power of some demographic variables and ways of coping, social support and perceived stress level in predicting burnout and posttraumatic growth levels of parents who have a child with autism. Data was collected by administering a socio-demographic form and four self-report questionnaires. These were the Questionnaire on Resources and Stress Short Form (QRS), Posttraumatic Growth Inventory (PTGI), Multidimensional Scale of Perceived Social Support (MSPSS), Ways of Coping Inventory (WCI), and Maslach Burnout Inventory (MBI). 136 adults representing 58 parent couples and 13 mothers and 7 fathers, with 71 mothers and 65 fathers who had a child with autism participated in this study. Data was collected in &Ouml / zel ilgi Special Education School, BariS Special Education School, Ankara University Center of Research for Children with Autism (O&Ccedil / EM), Bagcilar School for Children with Autism and Hacettepe University Child Psychiatry Clinic. The factor analysis of the MBI yielded two of the three factors of the original factor structure. The depersonalization factor was not found in this sample. It was found that, mothers were experiencing significantly higher emotional exhaustion than the fathers. The regression analysis results revealed that social support and problem solving/optimistic coping were significant predictors of posttraumatic growth among mothers. Social support, problem solving/optimistic coping, religiosity, age, years of marriage were the significant predictors of posttraumatic growth among fathers. Stress level was the only significant predictor of burnout and emotional exhaustion among mothers. Stress level was a significant predictor of both burnout and emotional exhaustion among fathers, but helplessness/self blaming approach was also a significant predictor of paternal burnout. Social support, problem solving/optimistic approach, and stress level were significant predictors of lack of personal accomplishment among mothers. Presence of a caregiver and helplessness/self blaming approach were the significant predictors of lack of personal accomplishment among fathers. The importance of the results for clinical interventions with parents and their shortcomings were discussed within the relevant literature.