Thesis (PhD (Psychiatry))--University of Stellenbosch, 2005. / Many gaps remain in our current state of knowledge about the epidemiology, phenomenology, neurobiology, and psychopharmacology of posttraumatic stress disorder (PTSD) in children and adolescents. Empirical evidence, particularly in non-Western settings, is sparse and there is little convergent understanding of the interrelationship of epidemiological factors, PTSD symptom expression, full and partial syndromes, disorders comorbid with PTSD, and pharmacotherapeutic interventions. Clinicians are faced with the difficult task of treating this often complicated and debilitating disorder in youth in the absence of data from well-controlled clinical trials. The studies detailed here are a point of departure for understanding the confluence that exists between epidemiological, phenomenological, and pharmacotherapeutic aspects of adolescent PTSD. Two studies were conducted to investigate the prevalence and effects of violence exposure and PTSD, clinical and functional correlates of full and partial syndromes, and associated gender differences in school and clinic samples, respectively. Two preliminary open-label trials assessed the efficacy and safety of a selective serotonin reuptake inhibitor (SSRI) in adolescents with at least moderate severity PTSD. The results indicate that (i) partial PTSD is a common nosological entity in adolescents, (ii) gender-related differences in PTSD, even if not manifest in differences in prevalence (i.e., in the rates of trauma exposure and full and partial PTSD), may well manifest in symptom expression (i.e., higher symptom burden in girls), associated morbidity, and functional impairment, and (iii) SSRIs may be effective in treating core PTSD symptoms in this age group. While not yet demonstrated, the partial subtype may have similar biological underpinnings to full PTSD in adolescents and may benefit from similar pharmacotherapeutic interventions. This is an area deserving of further investigation. Controlled SSRI data are needed to establish if these should be agents of choice for paediatric PTSD.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-08-24T12:53:35Z No. of bitstreams: 1 Camila Parducci Arruda.pdf: 1424524 bytes, checksum: a6c5ccf063f5a352f8ee4c104eeb5aea (MD5) / Made available in DSpace on 2017-08-24T12:53:35Z (GMT). No. of bitstreams: 1 Camila Parducci Arruda.pdf: 1424524 bytes, checksum: a6c5ccf063f5a352f8ee4c104eeb5aea (MD5) Previous issue date: 2017-08-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / In the world’s population, about 20% of women and 5% to 10% of men report having been sexually abused in childhood (WHO, 2014). This research approached the theme from the theory and practice of Analytical Psychology, and aimed at conducting a clinical study of a five year old girl with a complaint of sexual abuse. The psychodynamics and emotional state of the child are described based on an interpretive and symbolic analysis of her graphic and verbal expressions. The qualitative method used was that of the case study. The analysis is based upon impressions gained and data gathered during six psychodiagnostic sessions that included anamnesis with the mother of the child, application of HTP, CAT-A, drawing of the Person in the Rain, spontaneous graphic productions, observations of play and the child’s behavior. The case study identified signs of complex trauma (VAN DER KOLK, 2005), with characteristics that frequently occur in cases of child sexual abuse, such as dissociative defenses, sadness, lowered self-esteem, insecurity, graphic expressions of imprisonment and contents that clearly held sexual connotations. It was found that the therapeutic setting offers a protective and all-encompassing place for the expression of anguish and pain in cases of victimization and/or complaint of sexual abuse, as well as for the symbolic disclosure of the trauma and its consequences. The study concludes that early psychological intervention is fundamental to minimize severe prognosis when child sexual abuse is suspected and to assist the child in his/her development / Na população mundial, cerca de 20% das mulheres e de 5 a 10% dos homens relatam ter sofrido abuso sexual na infância (OMS, 2014). O presente trabalho aborda o tema a partir da teoria e prática da Psicologia Analítica, e seu objetivo foi realizar um estudo clínico de uma menina de cinco anos com queixa de abuso sexual. Descreveu-se a psicodinâmica e o estado emocional da criança e realizou-se uma análise interpretativa e simbólica de suas expressões gráficas e verbais. O método qualitativo utilizado foi o do estudo de caso. A análise realizada foi elaborada a partir de seis sessões de psicodiagnóstico, compostas por anamnese com a mãe da criança, aplicação de HTP, CAT-A, desenho da Pessoa na Chuva, produções gráficas espontâneas, observações do jogo lúdico e do comportamento da criança. O estudo de caso identificou indícios de trauma complexo (VAN DER KOLK, 2005), com características que se apresentam com frequência em casos de abuso sexual infantil, tais como defesas dissociativas, tristeza, autoestima rebaixada, insegurança, expressões gráficas de aprisionamento e com marcante significado sexual. Pôde-se perceber que o setting terapêutico oferece um espaço continente para expressão de angústias e dores em casos de vitimização e/ou queixa de abuso sexual, assim como para o desvelamento simbólico do trauma e de suas consequências. Conclui-se que a intervenção psicológica precoce é fundamental para minimizar prognósticos graves nos casos de suspeita de abuso sexual infantil e auxiliar a criança em seu desenvolvimento

Thesis (M.A. (Hons.))--University of Wollongong, 2006. / Typescript. Includes bibliographical references: leaf 159-171.

Thesis (M.S.W.)--Smith College School for Social Work, 2008. / Typescript. Includes bibliographical references (leaves 21-30, 41-51, 66-70).

Despite the growing recognition of the prevalence of domestic violence worldwide, there is an increasing number of women reporting abuse, and there are those who have died at the hands of their abusers. Many of these domestic violence situations involve children who grow up carrying the physical and/or emotional scars of abuse into adulthood, which also has negative implications for their social well-being. This study adopts a qualitative approach to analysing emerging themes relating to the experiences of eight adult participants (four men and four women) who have lived in domestically violent homes during their childhood. The study deals with definitions of abuse, the social, physical, emotional, cognitive, behavioural and psychological effects of abuse and identifies the social consequences of growing up in a violent home. With reference to the research interviews, it is the researcher’s finding that if there is violence in the home, children’s socialisation will be impaired. The results of the study support the hypothesis that the socialisation of adults and their ability to form healthy relationships are hindered by being exposed to domestic violence during childhood. In terms of the goals of intervention, the basic principle is that children need to be provided with a safe environment, appropriate discipline and a secure relationship with an attentive caregiver. The ultimate goal of intervention is to prevent further harm and promote recovery. Socio-educational goals include being taught to communicate and settle differences without the use of violence, to promote the development of well-adjusted social beings. / Educational Foundations / M. Ed. (Socio-Education)

M.Ed. (Educational Psychology) / The main aim of this research inquiry was to explore the use of indigenous knowledge by Black-African educational psychologists in South Africa when working with children who have been traumatised. I hoped that the results would provide a better understanding of how indigenous knowledge can be applied in therapeutic interventions in a way that takes into account the client’s cultural preferences. Mental health professionals are becoming more aware that cultural customs and beliefs have considerable influence on therapeutic interventions. The Western conceptualisation of health and illness is insufficient in a culturally diverse society like the one found in South Africa. There is a need to explore how traditional concepts can be incorporated into psychology and how indigenous knowledge can contribute to the wellbeing of a person, from a culturally congruent worldview. In indigenous knowledge, there is recognition that communities have their own definition of healing needs and strategies when addressing trauma. The perception and beliefs about the causation, communication and acknowledgement of the problem are all culturally constructed and can influence psychotherapy. However, there is a lack of research on applying indigenous knowledge in therapy, specifically in the context of children who have been exposed to exploitative trauma (abuse) and loss (death). As such, there is a need in South Africa for the development of psychotherapeutic interventions that are culturally valid, which can be applied to children who have been traumatised. The research approach employed within this study is qualitative. A phenomenological design was followed. The overarching framework was that of social constructivism. I interviewed five black educational psychologists who live in the Gauteng area through the use of snowball sampling. Data was generated through semi-structured interviews. The data collection and analysis process was done through the use of thematic analysis, whereby certain themes were revealed. The psychotherapeutic interventions that were discerned were based mostly on the trauma children experienced due to child abuse and the death of parents. These included 1) use of oral traditions comprising stories, folklore, proverbs and metaphors; 2) rituals, comprising visiting the grave, communication with ancestors through the slaughter of animals and cleansing ceremonies involving the slaughter of animals; 3) games, specifically masekitlana; 4) music, especially singing and drums; 5) the use of Ubuntu to support clients through care, as well as using available family systems to promote systemic support. These interventions are thought to be useful as they are non-threatening; they allow clients to express themselves, they are a way of relating/identifying, they release emotion and they help to release any “impurity”. With the choice of psychotherapeutic interventions, it is important to consider the “goodness of fit” or congruency between the culture and belief system of both the therapist and client. The findings of the study could make a contribution to the field of psychotherapy in South Africa, since it makes a strong case for the inclusion of psychotherapeutic interventions that are sensitive to cultural differences and meet the needs of children’s cultural beliefs.

Experts in traumatology have postulated traumatized children play differently than non-traumatized children. These differences are called posttraumatic play and include the behaviors of intense play, repetitive play, play disruption, avoidant play and negative affect. The purpose of this study is the continued development of the Trauma Play Scale through the addition of a normative sample. The Trauma Play Scale is an observation-based instrument designed to distinguish the play behaviors of children in play therapy with a history of interpersonal trauma when compared to non-traumatized children. The present study compares two samples of children. One group (n=6) currently in play therapy with a history of interpersonal trauma and another group (n=7) considered normally developing (cognitively, emotionally, socially, and physically) by their parents with no known history of interpersonal trauma. Trained raters blind to the trauma history of the children rated a series of eight consecutive video-recorded play therapy sessions for each participant. One-way analysis of variance statistics, including effect sizes were compute to determine the discriminant validity of the Trauma Play Scale. Traumatized children scored significantly higher on the Trauma Play Scale than non-traumatized children on all domains of the scale as well as the overall Average Trauma Play Scale score. Large effect sizes indicated strong relationships between group membership (trauma history versus normally developing) and scores on the Trauma Play Scale.

This thesis investigates the literature on trauma and grief in order to explore the existence of the phenomenon of traumatic grief in children. Appropriate therapies are explored for treating traumatic grief in children. The focus in this research is on non-directive art therapy as the literature has found it to be useful in traumatic circumstances. The therapeutic relationship and the focus on containment are valuable in addressing the primary need of the child in therapy especially when traumatic grief is to be addressed. A qualitative case study approach was chosen. Two case studies were selected to investigate the phenomenon of traumatic grief in children. Purposeful sampling was used to select the cases to observe the phenomenon of traumatic grief. The case studies included pre-therapy and post-therapy assessments, which included cognitive, emotional and behavioural assessments. Art therapy was found to address the problems in the two cases. / Educational Studies / M.Ed.

Text in Afrikaans / Summaries in English and Afrikaans / Die dood van 'n ouer he! 'n effek op die totale lewe van die kind en dompel die kind in emosionele nood wat terapeutiese begeleiding noodsaak. Na afloop van die afsterwe van 'n ouer, vind daar fisieke, emosionele, sosiale en kognitiewe veranderinge in die kind se lewe plaas waarop hy nie voorbereid is nie, en wat hy ook nie verstaan nie. Hierdie veranderinge veroorsaak dat die kind se leefwereld in so mate verander dat sy funksionering benadeel word. Daar is met hierdie studie gepoog om vas te stel watter effek die dood van 'n ouer op die kind he! en tot watter mate terapeutiese begeleiding die kind se emosionele nood kan verlig. Daar is in die studie gevind dat rou inderdaad 'n gekompliseerde proses is wat lei tot die ontstaan van talle onbeantwoorde vrae, gevoelens van magteloosheid en emosionele pyn. Kinders wat in rousmart verkeer word dikwels deur die samelewing misgekyk en kry as gevolg hiervan nie voldoende hulp nie. Di! lei tot die ontstaan van persoonlikheidsontwikkelingsprobleme, relasionele probleme en intra-psigiese probleme soos 'n swak selfbeeld, ego-verdedigingsmeganismes, persoonlike kwesbaarheid, ongunstige betekenisgewing en ongunstige belewenisse. Hierdie probleme veroorsaak dat die kind in sy selfaktualisering gerem word en as gevolg hiervan nie sy gegewe moontlikhede verwerklik nie. Die studie het verder bewys dat die kind wat 'n ouer aan die dood afgestaan het, wel deur middel van terapeutiese begeleiding deur 'n sielkundige gehelp kan word om die verlies van 'n ouer in so 'n mate te hanteer dat die faktore wat die kind se selfaktualisering rem, opgehef kan word. Die studie voorsien die sielkundige van riglyne ten opsigte van die proses van terapeutiese begeleiding aan die kind wat 'n ouer aan die dood afgestaan het. Riglyne word gebied ten opsigte van die hantering van die kind se onmiddellike situasie, die evaluasie van die kind-inrousmart, die vasstelling van doelstellings en doelwitte vir terapeutiese begeleiding, die selektering van terapeutiese tegnieke, die terapeutiese hulpverlening aan die kind, die hulpverlening aan die oorblywende ouer en die hulpverlening aan die onderwyser wat gemoeid is met die kind-in-rousmart. Riglyne word ook gebied ten opsigte van die terminering van terapie. / The death if a parent has an influence on the total life of a child and causes emotional trauma that necessitates therapeutic guidance. After the death of a parent, physical, emotional, social and cognitive changes occur in the child's life for which he is not prepared and that he also does not understand. These factors cause such a change in the child's life-world that his functioning is hampered. In this study it was endeavoured to determine what effect the death of a parent has on a child's life and to what extent therapeutic guidance can alleviate the child's emotional trauma. In this study it was found that mourning is indeed a complicated process that gives rise to countless unanswered questions, feelings of helplessness and emotional pain. Children suffering grief in mourning are often ignored by society and as result of this, they do not receive adequate assistance. This leads to problems concerned with the development of the personality, relational problems and intrapsychological problems such as a poor self-concept, ego defence mechanisms, personal vulnerability, negative ways of acquiring meaning and unfavourable ways of experiencing life. These problems give rise to the hampering of the child's selfactualisation and because of this he cannot realise his potential. The study has furthermore proved that the child who has lost a parent through death, can be helped by a psychologist. This can be done by means of therapeutic guidance so that the child can handle the loss of a parent to such an extent that the factors that hamper his self-actualisation can be removed. The study provides guidelines for therapeutic guidance to the child who has Jost a parent through death. Guidelines are given on handling the child's immediate situation, the evaluation of the child in mourning, the determination of aims and objectives for therapeutic guidance, the selection of therapeutic techniques, therapeutic assistance to the child, assistance to the remaining parent and assistance to the educator who is involved with the child in mourning. Guidelines are also given for the termination of therapy. / Educational Studies / D.Ed (Clinical Psychologist)

This thesis investigates the literature on trauma and grief in order to explore the existence of the phenomenon of traumatic grief in children. Appropriate therapies are explored for treating traumatic grief in children. The focus in this research is on non-directive art therapy as the literature has found it to be useful in traumatic circumstances. The therapeutic relationship and the focus on containment are valuable in addressing the primary need of the child in therapy especially when traumatic grief is to be addressed. A qualitative case study approach was chosen. Two case studies were selected to investigate the phenomenon of traumatic grief in children. Purposeful sampling was used to select the cases to observe the phenomenon of traumatic grief. The case studies included pre-therapy and post-therapy assessments, which included cognitive, emotional and behavioural assessments. Art therapy was found to address the problems in the two cases. / Educational Studies / M.Ed.