This action research based thesis focuses on work-related psychological trauma and its management, within the context of the British police service. A case study on one force facilitates detailed exploration of ways in which police occupational culture may impede the provision and acceptance of trauma management schemes. A national questionnaire-based survey of United Kingdom police forces establishes the scope and nature of their trauma management provisions and identifies strengths and weaknesses. Few trauma research studies have concentrated upon the affective domain of the British police service and there is limited understanding of how personal emotions are managed in the police organisation, or how its culture can affect the individual's experience of work-related trauma in an unhelpful way. The study aims to increase knowledge and understanding in this area and to assist British police forces in their attempts to reduce police sickness absences and ill health retirements, which may result from exposure to workrelated trauma. Two main study concerns are addressed by different means. The thesis is arranged as an introduction that includes discussion of the methodological approach adopted, seven chapters, conclusions and recommendations. Chapter one sets the scene by scrutinising the police service as a modern work organisation. Having clarified the basic principles of British policing, it outlines how the service has developed, exploring the difficulties and tensions police officers at all levels experience in trying to fulfil their current roles and responsibilities. Chapter two looks at the nature and potential effects of 'critical' incidents and traces the history of trauma recognition and critical incident debriefing, discussing the current debate on the efficacy of the latter and its value for police personnel. Chapter three examines current national and local police trauma management provisions and chapter four focuses on the identification and management of key risks posed to the police organisation, arising from work-related trauma. Chapter five explores police officers' experiences of trauma through descriptions of three 'service' roles and critical incident scenarios and by focusing on how certain aspects of police culture may intensify and prolong their initial distress. Chapter six shows the ways in which the police organisation seeks to manage its members' emotions through its selection, training and socialisation processes and how its success in doing so can impede the delivery and takeup of trauma management services. Chapter seven then outlines the main theoretical concepts underpinning the thesis, explaining why the police organisation requires officers to manage their emotions in particular ways and outlining mechanisms it has adopted as corporate defences against anxiety. A summary of conclusions follows and the thesis ends with recommendations to effect improvements to the quality and consistency of services being offered.

This thesis focuses on the topic of human trafficking and exploitation from the perspective of the trafficked persons themselves. Using the interpretative phenomenological analysis seeks to determine the lived experience of these people. Data were obtained through semi-structured interviews with 4 respondents who are clients of the organization La Strada ČR. These interviews were recorded and they were subsequently analyzed according to IPA. Trafficking and exploitation had a significant impact on the lives and experiences of these people. Interpersonal relationships are affected the most, especially the ability to establish contacts with strangers. Also relationships with families are disturbed because of fear of rejection and misunderstanding of what you went through. People live in fear for their safety and future. Interpersonal relationships are on the other side one of the elements helping to manage the traumatic event and their absence deepens negative experiences. KEY WORDS Trafficking in human beings and exploitation, interpretative phenomenological analysis, experience of trafficked people, psychological trauma

The purpose of the present thesis was twofold. First, to study the role of emotional arousal in memory processes, and secondly, to relate this concept to empirical findings of amnesia. In both clinical and experimental settings it has been observed that remembering is impaired for events occurring prior to, and after a traumatic critical event. This memory impairment is also demonstrated for the traumatic event per se. In relation to these phenomena an interaction is commonly observed such that remembering of events aquired in a state of high emotionality, or arousal, is inferior to events aquired in neutral low arousal conditions at short test intervals, but superior at delayed test intervals. The general notion to be tested was how and to what extent these phenomena are mediated by an increase in emotional arousal. In order to test this hypothesis a series of experiments was designed so that retrograde and anterograde amnesia, and amnesia for the traumatic event, could be studied so as to evaluate the locus of the emotional arousal and amnesia effects with respect to encoding (attention), storage (consolidation), and retrieval (reconstruction). Emotional arousal was induced by sources associated with the to-be-remembered (TBR) material (traumatic pictures), and by sources not associated with the TBR-material (injections of adrenalin). Memory performance was measured by recall and recognition techniques. Amnesia was obtained only when the source of arousal was associated with the TBR-items. It was concluded that amnesia in connection to hightened emotional arousal depends on attention demanding characteristics of the traumatic event, rather than physiological properties of hightened arousal per se. An interaction between factors at encoding and retrieval was proposed as an explanation for the amnesia effects obtained. An interpretation in terms of consolidation has, throughout this thesis, been shown to be invalid in explaining the memory phenomena referred to. / digitalisering@umu.se

The present study examined the relationship between coping and psychological and psychosomatic distress of 25 individuals who experienced the same severe, acute traumatic event: the violent shooting that killed 23 people and severely injured 20 more in Luby's Cafeteria in Killeen, Texas, on October 16, 1991. Distress was assessed by one-month pre-event and post-event scores on the SCL-90R, Psychosomatic Questionnaire, and by a Life Event Questionnaire score for the year before the incident. Coping was measured by a modified version of the Ways of Coping Scale (Folkman et al., 1986) and Response Style Questionnaire (Nolen-Hoeksema & Morrow, 1991). All post-event distress scores, except the Psychosomatic score, significantly increased over their corresponding pre-event scores regardless of gender. Although female distress scores were consistently higher than male scores, gender was predictive of post-event distress only for the SCL-90R Anxiety, Somatization, and Global Severity Index scales. The only pre-event score found to be predictive of post-event distress was the Psychosomatic scale. Regression analysis, with demographic and pre-event variables controlled, found a significant positive relationship between Escape/Avoidance coping and one-month post-event levels of Anxiety and Psychosomatic distress. Findings were discussed in the context of the process-oriented stress-illness model and were compared to current disaster and crime victimization literature. Implications for helping professionals, methodological issues, and implications for future research were explored.

“The body can write on the skin from the inside—the soul, the mind, and the passions rise to the surface in boils, blushes, and rashes, and the invisible inside speaks by writing from the other side of the page”. -James Elkins Skin not only covers but reveals what is behind it. I utilize its language as indicator of flaws and pathologies. I depict and manipulate this, not just as it already exists with the human body, but as projections of my psychological states onto inanimate objects. Proposing that sight is a kind of touch, we touch with our minds, through memory, experience, and emotions. Empathetic looking involves projecting ourselves onto the objects as each simultaneously projects itself onto us.

Introduction: This thesis examined the impact of PTSD with Major Depressive Disorder on PTSD severity among Toronto Transit Commission employees who were exposed to a workplace traumatic event, and also the predictors of PTSD severity, mental health treatment seeking, and return to work over the six month study period. Methods: This study utilized data that was collected prospectively from the APT study participants. Information about Axis-I diagnosis and PTSD severity were collected from the SCID-I and the Modified PTSD Symptom Scale respectively. Results: PTSD without MDD (N=29) and PTSD with MDD (N=37) groups were compared. The variables: depression severity (p=0.01), female (p=0.01), non-Caucasian (p=0.01), workplace related stress (p=0.02), and lifetime trauma (p=0.01) significantly predicted PTSD severity. The BPI group significantly predicted mental health treatment seeking (p<0.01) after controlling other variables. Conclusion: This study highlights the substantial risk for experiencing greater PTSD severity after a workplace traumatic event in TTC employees.

Introduction: This thesis examined the impact of PTSD with Major Depressive Disorder on PTSD severity among Toronto Transit Commission employees who were exposed to a workplace traumatic event, and also the predictors of PTSD severity, mental health treatment seeking, and return to work over the six month study period. Methods: This study utilized data that was collected prospectively from the APT study participants. Information about Axis-I diagnosis and PTSD severity were collected from the SCID-I and the Modified PTSD Symptom Scale respectively. Results: PTSD without MDD (N=29) and PTSD with MDD (N=37) groups were compared. The variables: depression severity (p=0.01), female (p=0.01), non-Caucasian (p=0.01), workplace related stress (p=0.02), and lifetime trauma (p=0.01) significantly predicted PTSD severity. The BPI group significantly predicted mental health treatment seeking (p<0.01) after controlling other variables. Conclusion: This study highlights the substantial risk for experiencing greater PTSD severity after a workplace traumatic event in TTC employees.

Ce travail de thèse raconte un cheminement de clinicienne, avec des allers retours entre une pratique psychothérapeutique et une réflexion conceptuelle, tentant de cheminer vers une démarche intégrative permettant d’aborder les situations psychotraumatologiques complexes. Guidée par l’envie d’apprendre, mais aussi par la mise à l’épreuve du terrain, nous avons élargi pas à pas notre démarche psychotraumatologique, pour aboutir à la proposition d’un modèle intervention intégratif et original. Nous espérons que ce modèle puisse permettre au clinicien de s’adapter, sans se perdre, à la réalité complexe des personnes souffrant de traumatisations complexes et chroniques. La présentation de différentes publications et de cas cliniques illustrera ce cheminement de pensée et de pratiques pour arriver à un modèle rigoureux pouvant être soumis à l’épreuve scientifique et au terrain. / This thesis tells a journey of a clinician, with back and forth between a psychotherapeutic practice and conceptual thinking, trying to move towards an integrative approach for addressing complex situations in psychotraumatology. Guided by the desire to learn, but also examining field practice, we have expanded, step by step, our psychotraumatologic approach, coming to a proposal of an integrative and original treatment model. We hope this model may allow clinicians to adapt to the complex reality of complex and chronic traumatized persons, without getting lost. The presentation of different publications and clinical cases illustrate this line of thought and practices in order to achieve a rigorous model that can be subjected to scientific testing as well as put to the proof of the psychotherapy field.

Thesis (Ph.D. (Psychology)) --University of Limpopo, 2016 / Literature has shown that war has negative psychological consequences and long-term effects on war veterans that can be passed on from generation to generation. Little is known about Zimbabwe war veterans` conceptualisation of trauma. The study was aimed at developing a culturally appropriate psychological model for Zimbabwean war veterans. The research objectives were; 1)To explore the Zimbabwean war veterans’ conceptualisation of complex trauma. 2)To establish how Zimbabwean war veterans cope with complex trauma in their lives. 3) To develop a culturally relevant psychological trauma model for war veterans in Zimbabwe. The study was qualitative and the phenomelogical research approach was adopted. The research was informed by the Afrocentric paradigm. Criterion sampling was used to select twenty-six participants. Sixteen individual interviews and two focus group discussions were conducted. Data were analysed using thematic content analysis. The research revealed five major themes covering the experiences of complex trauma among war veterans in Zimbabwe. These themes are social, economic, spiritual, political and personal trauma. Research findings also identified cultural notions of trauma. The participants` had their own way of conceptualising trauma in their local language. The following broad themes that described the participants` coping strategies were identified; appraisal coping, social coping, problem focused coping, emotion focused coping and spiritual coping. Their coping strategies were informed by their culture, experiences and social context. From these themes a cultural model of trauma was developed. The model is unique as it acknowledges the importance of the cultural context in the conceptualisation of trauma and the need to be knowledgeable about local constructs, meanings and languages that inform world views. The model validates propositions by the Afrocentric paradigm that trauma in African contexts is multifaceted. The study recommends the need to be culturally sensitive to understand an individual`s behaviour, explanations of distress, symptom presentation and coping strategies. The study recommends a holistic and contextual approach when intervening among war veterans in Zimbabwe.

Breast ironing (BI) practice is a common practice in Cameroon. Most villages and towns continue with BI because they believe it constitutes a positive cultural lifestyle. However, public health officials and other advocates have branded BI as a harmful traditional practice because of the traumatic impact it has on the women who experience it. The purpose of this quasi-experimental study was to examine the perceived long-term health-related outcomes of BI and the quality of life changes on these women. Underpinning this study was the betrayal theory of trauma. A survey was used to collect data from 230 women. Descriptive analysis of the data showed, BI was more prevalent in some regions of Cameroon and among some ethnic groups more than others. A chi-square test revealed a strong relationship that women who experienced BI perceived long-term physical, psycho-social, and emotional health-related outcomes and negative quality of life changes during and after the practice. A multiple logistic regression model was conducted to examine the relative odds of exposure of other independent predictors on the outcome variable. The chi-square test on severe pain and marital/ family health; breast scars and frequent pain; stress and feeling inferior; sadness and pain, revealed a P-value < .001. The odd ratio (OR) of the confounding predictors breast scars, frustration, shame, depression, self-esteem; burns; abscesses revealed an Exp(B)/ OR