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.

Different studies showed a substantially higher rate of different psychological symptoms like PTSD, depression and anxiety in mothers after preterm birth compared with mothers after at term birth. Anyhow lots of mothers stay well and do not develop any symptom after preterm birth. This raises the question, which factors help women to stay well (salutogenous factors) and which factors may support the development of symptoms (pathogenous factors). Little research in this context has dealt with the role of shame and guilt and personal resilience factors like a high sense of coherence. For this reason the medium-term effects of shame and guilt and personal resilience on the outcome of mothers’ adjustment to preterm birth shall be investigated in the current study. This is done in the framework of a multidimensional model for the study of psychological effects of trauma (Maercker, 2003). Aspects of outcome in this study are different psychological symptoms, psychological, physiological and social wellbeing and posttraumatic grow. Grounded in the Personality-System-Interaction-Theory (PSI-Theory, Kuhl, 2001) the functions of different components of shame and guilt and a resilient self-protection-system for the mothers’ adjustment were postulated, tested and discussed. 88 mother after preterm birth before 35 weeks gestational age were asked a few days after preterm birth (T1) and three to four month later (T2, N = 59) in terms of the important variables. Statistical data analyses mainly via regression calculation indicate according to other results in shame and guilt research a substantial dysfunctional effect of shame on mothers’ psychological adjustment, which is partly mediated through the feeling of anger. Feelings of shame and anger mediated in parts the relation between level of trauma intensity and outcome. On the other side there are no or opposing effects of reparation oriented guilt especially related to symptoms of intrusion and hyperarousal (PTSD), which shows an adaptive component of guilt. A resilient self-protection-system in terms of high self determination, low self fragmentation, and a high sense of coherence (SOC) were found to protect against the development of symptoms while high action orientation showed functional effects in relation to psychological and social wellbeing. The cross-sectional data supported the postulated mediation of the relation between self-protection-system and outcome through feelings of shame and anger, whereas longitudinal data support an independent impact of shame and guilt on the one side and personal resilience on the other. There were only little results in relation to posttraumatic grows. Clinical implications of results and consequences for further research are discussed.

No description available.

Text in English / Disasters are global phenomena, often occurring without warning and with physical and psychological consequences among those affected. In May 2008, refugee and migrants living in South Africa were exposed to xenophobic violence, which may be described as a human caused disaster using the Shultz, Espinel et al. (2008) definition of disaster. Refugee and migrant women were particularly vulnerable during this time due to heightened risk for exposure to violence and pathology. During 2014, a mixed methods convergent study was conducted in Johannesburg to determine the presence of acute stress disorder symptoms (ASD), posttraumatic growth (PTG) and experiences of xenophobic violence among refugee and migrant women. One hundred and three refugee and migrant women completed a selfadministered questionnaire, while semi-structured individual interviews were conducted with a sub-set of 22 women.The quantitative results showed a positive, linear association between moderate ASD-total symptoms, as assessed by the Stanford Acute Stress Reaction Questionnaire (SASRQ) (Cardeña, Classen, Koopman, & Spiegel, 2014) and moderate posttraumatic growth-total, assessed by the posttraumatic growth inventory (PTGI) (Tedeschi & Calhoun, 1996). All ASD symptom subscales were predictors of posttraumatic growth. The qualitative results from both the SASRQ open-ended responses and semi-structured responses showed that refugee and migrant women were adversely affected by the xenophobic violence, with a prevailing fear that the xenophobic violence would re-occur. There was convergence in the quantitative findings and the qualitative findings for the pathological and adaptive outcomes. Policymakers must address xenophobic violence by working towards prevention of this type of violence. In instances where policies fail to address or prevent xenophobic violence, disaster programmes should consider xenophobic violence in disaster planning. Further to this, mental health intervention programmes should not only focus on alleviating ASD symptoms but also emphasise enhancing PTG. / Psychology / M.A. (SS (Psychology))

The purpose of this qualitative study is to explore how narrative therapy may facilitate not only a lessening of distressing symptoms for bereaved persons, but may also facilitate growth in identity. Five case studies are presented. The participants were chosen to illuminate different grief experiences. The case studies include a description of grieving people from different backgrounds, each with a unique relationship with the person or people who died, all of whom had different causes of death such as suicide, murder and natural causes. These differences provide an opportunity to explore the application of the therapy model with a range of grief experiences. A full and rich description of the experiences of the participants yield insight into the shared themes such as the impact of social expectations of how a grieving person should conduct him or herself, difficult physical and emotional experiences, the many losses flowing from the death, as well as an in-depth discussion of the identity growth that takes place as the bereaved person takes on different roles and tasks. Postmodern epistemology and social constructivism informed the praxis and interpretation of narrative therapy as bereavement model. Narrative therapy is shown as especially effective for grief therapy with therapeutic tenets such as deconstructing and creating richer narratives and alternative stories that enables the bereaved to explore diverse aspects of their character. The emphasis on what remains rather than what is lost, and the concept of remembering the loved one who died in the community of those who stay behind, transmute the loss-story to one of remembering and incorporating, which tends to bring significant emotional relief. This study contributes towards the field of growth through bereavement for which there seems to be a paucity in research. Furthermore, it provides additional evidence for post-traumatic growth in general, especially with the assistance of narrative therapy. / Psychology / Ph. D. (Psychology)