The study of coping with stress has been disjointed, lacking a coherent model. The present work proposes a theoretical framework for understanding coping based on approach and avoidance. Approach and avoidance are discussed in terms of the psychoanalytic concepts of defense and working through and other historical precursors as well as recent research on coping with traumatic events. Two experiments are presented. The first consists of a scale-construction study of the Cohen Roth Approach Avoidance Scale, a self- report measure of coping strategies. A revised version of this scale is proposed based on factor-analytic data from a mixed-stress sample. Experiment 2 is a study of the long-term impact of rape. Seventy-three women, who were victims of rape an average of eight years ago, were given questionnaires covering the following areas: demographics, nature of the assault, coping styles, and current level of functioning. Most of the sample was found to still be in moderate to severe distress. The relationships between outcome and demographics, situational variables, and behavior after the assault are discussed in the context of prior research in this area. Approach and avoidance strategies, measured by the revised Cohen Roth Approach Avoidance Scale, had a complex relationship with outcome. This relationship is discussed in the context of the theoretical model of coping presented in the Introduction, focusing on the difficulty women have in resolving the trauma of rape. / This thesis was digitized as part of a project begun in 2014 to increase the number of Duke psychology theses available online. The digitization project was spearheaded by Ciara Healy.

M.A. (Clinical Psychology) / Despite similarities, shame is expressed differently among individuals. The aim of this study is to explore the lived experience of shame in two female victims of acquaintance rape. Using the tenets of Interpretative Phenomenological Analysis (IPA), a case study approach was adopted. The findings revealed how the female victims' relationship with the known assailants influenced the experience of shame. Moreover, encountering acquaintance rape twice had implications for how shame was experienced. For instance, intense self-blame and the belief in being inherently flawed was evident. Of equal importance, in both women, anger manifested primarily as indignation. Furthermore, shame manifested primarily as feeling dirty and having elements of moral impurity. However, shame did not affect the self-identity of one of the participants; instead she displayed resistance to the notion of shame affecting her global self. Thus, the study concluded that despite similarities in some features, the manifestation of shame in the context of acquaintance rape is different from in other contexts. These findings have implications for future research and clinical practice. Ultimately, this study adds to the discourse on shame in women in the context of acquaintance rape in South Africa. Moreover, it provides a theoretical framework that enables the therapist or healthcare worker to intervene with clients in such a context.

We have conducted a phenomenological research with four women victims of rape in order to discover the impact of the elements which give meaning to their lives, on their recovery. The results of our research demonstrate that overall the elements of the meaning of life have been beneficial for women's recovery. The elements that were identified are the importance of children, the philosophy of life, the goals to achieve, the significant relationships, the financial autonomy and helping others. Those elements have been identified in two previous researches. However two new elements appeared which are the attachment to their job and the development of their skills analysis. Our theoretical framework appeals to social work, sociology, psychology, psychiatry and philosophy. Our vision is feminist.

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This study examined the relation between level of rape acknowledgement and levels of PTSD symptoms reported in female college students. Subjects were administered the Sexual Experiences Survey (SES), the PTSD Interview, and a demographics questionnaire. Subjects were then grouped into the following categories based on their responses to the SES: reported rape victims, acknowledged rape victims, unacknowledged rape victims, and a control group of non-rape subjects. Small sample analyses did not reveal the expected linear relation between the two variables. Only the acknowledged group showed greater PTSD symptoms. The unacknowledged and control groups did not significantly differ on overall PTSD symptom severity, or on any cluster of PTSD symptoms. Naturalistic selection factors are discussed that could have affected the outcome of the study.

Prevention of HIV following sexual assault is an important aspect of rape care. This includes taking Post Exposure Prophylaxis for 28 days. The present study aimed to provide an in-depth understanding of social and environmental factors that predisposed, promoted and also served as barriers to adherence to post exposure prophylaxis to prevent HIV infection after sexual assault in women in the Eastern Cape Province. The study involved a purposive sample of women who were offered Post Exposure Prophylaxis (PEP) after a sexual assault. Sixteen women were accessed at the Sinawe Referral Centre and participated in the study. Their ages ranged from 16 to 73 years. An interview guide was developed to assist the researcher, and semistructured, in-depth interviews were used to collect data. These women were interviewed at the end of 28 days of taking the prophylactic medication. The data were analyzed inductively using grounded theory. Only three women completed the 28 days of PEP treatment. Participants gave different explanations for why they did not complete the treatment with only four participants returning to the centre for their medication. Some reported having no money for transport; others mentioned deciding to discontinue the medication because of its side-effects. Poor support systems, both within the community and the health services, including the provision of conflicting information also played a role. The study showed that few women were able to complete their PEP medication and knowledge about the service and access to it were the main factors that lead to non-adherence. There is an urgent need for the improvement of PEP services particular in the support to the women during the period of taking the PEP treatment to ensure protection from HIV after a sexual assault. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2008.

Posttraumatic growth, defined as positive psychological changes in the aftermath of adversity and suffering, is a relatively recent focus in psychological research. The addition of this concept to the literature has provided a new, more resiliency-based framework through which to view survivors of various forms of trauma. Despite estimates that over half of all sexual assaults are not reported to the authorities, current crime statistics indicate that 1 in 4 women are sexually assaulted in their lifetime (Campbell & Wasco, 2005). Given the large percentage of the population that is impacted by sexual assault, it is essential that professionals better understand the factors that influence the successful healing and growth that can occur post-trauma. The purpose of this study was to further expand the literature on posttraumatic growth in sexual assault survivors by considering this phenomenon through the lens of attachment theory. Specifically, this study tested a proposed model of the inter-relationships among subjective and objective perceptions of threat during the sexual assault, adult romantic attachment, and posttraumatic growth. It was hypothesized that adult romantic attachment and parent-child attachment would mediate the relationship between subjective, or perceived threat, defined as the victim's perception of life threat, and objective threat, defined as the severity of the sexually aggressive act perpetrated on the victim, and posttraumatic growth. Finally, it was hypothesized that subjective threat appraisal would better predict posttraumatic growth than objective threat appraisal. Contrary to hypotheses, results of the study indicated that adult romantic attachment and parent-child attachment did not mediate the relationship between subjective and objective threat appraisal and posttraumatic growth. Thus, both path analytic models were not viable. However, exploratory analysis indicated that both subjective and objective threat appraisal were directly related to posttraumatic growth, with subjective perceived threat appraisal accounting for more of the variance.

Thesis (MA)--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: The issue of rape in South Africa has been widely documented and debated in the form of academic, legal, governmental and media reports. The statistics that inform us both of the incidence of rape and the number of women who report rape to the police have been vehemently contested. Secondary victimization of rape survivors by police, medical and legal officials, has been reported internationally in studies conducted in the United Kingdom, the United States and South Africa. The present study explored 16 women’s experiences of reporting rape to the police in historically disadvantaged communities. Qualitative semi-structured interviews were aimed at eliciting information about the nature of their experiences with the police and how their complaints were responded to and dealt with by police personnel. Six categories and 18 themes emerged out of a grounded theory analysis performed on the data. All of the participants were reportedly dissatisfied with the manner in which they were treated or the way in which their cases were handled by the South African Police Service (SAPS). The results implied the existence of rape myths in police official’s attitudes towards rape survivors, and the need to create awareness around the rights of rape survivors who report rape to the police, as well as to educate police officers with regards to the sensitivity of the issue of rape. Keywords: rape myths; secondary victimization; police; survivors; criminal justice system; feminism; gender relations; rape in South Africa. / AFRIKAANSE OPSOMMING: Die onderwerp van verkragting in Suid-Afrika is deuglik debateer en dokumenteer deur middel van akademiese, wetlike, regeering en media verslagte. Die statistieke wat ons in kennis stel van die aantal insidente van verkragtings en die aantal vrouens wat verkragting reporteer is gedurig in ‘n vurige en teenstrydige toestand. Sekondêre viktimisering van verkragting oorlewendes deur die polisie, mediese en wetlike amptenare, is geraporteer op internasionale vlak in studies wat gedoen is in die Verenigde Koningkryk, die Verenigde State en Suid-Afrika. Hierdie studie dek die ervarings van 16 vrouens, vanuit historiese agtergeblewe gemeenskappe, se raportering van verkragting aan die polisie. Kwalitatiewe semi-gestruktureerde onderhoude is gemik daarop om inligting tot die lig te bring oor die natuur van hul ervaringe met die polisie, hoe daar op hul aanklagte reaggeer is en hoe die polisie dit hanteer het. Ses katogorieë en 18 temas was die resultaat vanuit ‘n gegronde teorie analisie wat gedoen is op die data. Al die vrouens was ongelukkig met die manier waarop hul beweerde behandeling, of oor hul sake hanteer was deur die Suid-Afrikaanse Polisie Diens (SAPD). Die resultate het gewys op die bestaan van verkragtingsmites in polisie amptenare se houding teenoor die verkragting oorlewendes, en die behoefte om ‘n bewustheid te skep oor die regte van verkraging oorlewendes wat verkragting raporteer aan die polisie, as ook om polisie offisiere te onderrig ten opsigte van sensitiwiteit teenoor die saak van verkragting. Sleutelwoorde: verkragtingsmites; sekondêre viktimisasie; polisie; oorlewendes; kriminele justisie sisteem; feminisme; geslagsverhoudings; verkragting in Suid- Afrika.

The relation between dissociative symptoms and posttraumatic stress disorder (PTSD) was investigated in women who had experienced trauma or sexual assault. Subjects were administered the Dissociative Experiences Scale (DES), the Sexual Experiences Scale (SES), and the PTSD Interview (PTSD-I). Subjects were grouped according to their scores on the SES and the PTSD-I. Analysis of variance revealed a relation between DES scores and PTSD symptom severity scores. Correlational analyses showed a relation between dissociative symptoms and PTSD symptom severity but not recency of trauma. Three factors from a previously published factor analysis of the DES were found to contribute to the DES scores of PTSD subjects.