While much is known about the long-term effects of childhood sexual abuse (CSA) on women in adulthood, little is currently known about their self-care efforts. Given the paucity of research on self-care for survivors, particularly those who are also mothers, and the potential importance of self-care for both themselves and their children, the main goal of the present study was to explore these women’s perceptions and practices of self-care. A grounded theory approach was chosen for this exploration as it provided a sensitive and open-ended methodology which garnered an in-depth understanding of self-care for survivor mothers. The current study combined classic grounded theory (GT) research methods with photovoice methods to explore self-care from the perspective of CSA survivor mothers. Analyses of interview and photograph data from 14 survivor mothers resulted in an original basic social process for understanding how these women care for themselves, feel better, and engage in healing in the context of past violence and trauma. Complex interactive behavioural patterns were identified that recreated a whole self out of damaged fragments; these were conceptualized as “reconstituting a damaged self”. This basic social process was comprised of three main stages, including: emotional de-paining, safetying, and authenticating and returning to self. Several substages within each of these main stages were also identified. Findings were discussed in relation to four theoretical frameworks. Future research directions and clinical implications for this neglected population were suggested. Reconstituting a damaged self can be a long process for sexual abuse survivor mothers involving taking small safe steps, for the most part, on one’s own.

The psychosocial well-being of survivors of armed conflicts, forced displacement, and/or natural disasters is becoming more and more an integral component of holistic humanitarian response. Yet many organisations rely on broad, generalised manuals or guidelines which do not take into account the unique characteristics of societies and target populations. This paper describes the author’s research with disaster survivors in Java, Indonesia, and refugee in Sweden, aiming to characterise the process of recovery, adaptation and integration through beneficiaries’ own words. The author looks at how theory can be applied, such as whether a hierarchy of needs can be universally relevant, how the host Swedish society affects refugees’ experiences, which so-called “states of being” subjects experience, and how religion and cultural differences like individualism and collectivism influence one’s ability to regain psychosocial well-being. The author used both in-depth interviews and quantitative questionnaires to obtain data. Results showed an incredible level of resilience and positivity among all groups, though Indonesians reported family, spirituality and the community as major helping factors, while many refugees in Sweden pointed to their own individual determination and will to succeed. Many Indonesians identified economic livelihood as the biggest remaining gap, while refugees in Sweden spoke of language skills, educational qualifications and employment as keys to success and integration. Many challenges and gaps remain, especially for newly arrived refugees facing an increasingly difficult job market and fewer opportunities.

Tyrimo problema. Lyginant su nacistinių represijų aukų tyrimų gausa, komunistinio režimo vykdytų represijų psichologinės pasekmės yra mažai tyrinėtos. Lietuvoje atliktas išsamus tremtinių, politinių kalinių ir kitų nukentėjusiųjų tyrimas, tačiau duomenų apie sovietinės traumos poveikį antrajai kartai dar beveik nėra. Neklinikinė represuotų asmenų vaikų imtis Lietuvoje iki šiol nebuvo tyrinėta. Todėl šiuo tyrimu nusprendėme išsiaiškinti, koks yra antrosios kartos patyrimas, kokia potrauminė simptomatika būdinga šiems žmonėms, ar jų savijauta siejasi su lytimi ir tuo, kas iš tėvų: mama, tėvas ar abu, išgyveno represijas. Taip pat siekėme palyginti represuotų asmenų ir jų vaikų potrauminės simptomatikos išreikštumą, nustatyti sąsajas tarp vaikų ir tėvų psichinės sveikatos. Metodika. Tyrime dalyvavo 62 represuotų asmenų vaikai, kurių amžiaus vidurkis 43,21 m. Su dauguma iš jų buvo susisiekta, padedant jų tėvams (atsitiktinai atrinktiems iš sąrašo), dalyvavusiems sovietų ir nacių represijų psichologinių padarinių tyrime. Represuotųjų vaikams buvo paštu išsiųstas klausimynas, į kurį įtraukti klausimai, susiję su tėvų patirtomis represijomis ir jų įtaka nukentėjusiųjų vaikams, taip pat metodikos, kurios buvo naudotos tiriant nuo represijų nukentėjusius žmones: Harvardo traumos klausimyno (HTK) pirma dalis, Traumos simptomų klausimynas (TSK-35), Vidinės darnos skalė (SOC-13), papildomai įtraukta Becko Nevilties skalė (BHS). Rezultatai. Dauguma represuotų asmenų vaikų mano, kad tėvų... [toliau žr. visą tekstą] / Background: In comparison with large amount of studies of Nazi repression, psychological effects of Soviet repression are little investigated. There is a comprehensive study of the survivors in Lithuania, but we have very little data on the effects of Soviet trauma on the second generation. There were no investigations in the nonclinical sample of the children of survivors in Lithuania. So in this study we tried to answer the first questions about experience of the second generation. We had the aim to compare posttraumatic symptoms of first and second generations. Gender differences of the offsprings of survivors were considered, also psychological health of those, who have mother, father or both parents survivors, was compared. Methods: 62 children of survivors (23 men and 39 women) participated in this research, mean age of participants was 43,21 years (SD=7,82). Most of them were accessed through their parents (randomly selected from the list of survivors), who participated in research of psychological effects of Soviet and Nazi repression. The questionnaire which was sent to the members of second generation consisted of questions, related to their parents‘ experienced repression and its impact on children of survivors, the same methods, which were used by investigating survivors, were included: Harvard Trauma Questionnaire, Traumatic Symptom Checklist, Sense of Coherence Scale, besides, Beck Hopelessness Scale was used. Results: Most children of survivors think, that... [to full text]

SAMMANFATTNING Bakgrund: Enligt WHO begås årligen cirka 800 000 självmord av människor världen över. I Sverige år 2012 begick 1151 personer suicid. Att förlora ett barn kan medföra en försämrad psykisk hälsa som följd. Studien har vårdvetenskapen som teoretisk referensram med fokus på hälsa, lidande och människan både som individ och del av en helhet. Syfte: Syftet är att beskriva upplevelsen av psykisk hälsa hos föräldrar vars barn genomfört suicid. Metod: Systematisk litteraturstudium med latent innehållsanalys av sex kvalitativa och två kvantitativa artiklar. Resultat: Resultatet presenteras i tre teman: Den utlämnade människan, den lidande människan och den förnyande människan. Frekvent förekom känslor av skuld, maktlöshet, utanförskap och svårigheter att gå vidare i livet, självdestruktiva tankar och handlingar, ångest, depression och sorg. Även glimtar där föräldrar lyckats finna hopp, tröst och stöd återfinns i resultatet. Konklusion: Föräldrar som förlorat ett barn genom suicid upplever i stor utsträckning försämrad psykisk hälsa. Resultatet visade att över tid förbättrades den psykiska hälsan hos flera föräldrar. Somliga hjälps av att ha stöd av andra, andra av att ge stöd medan ytterligare andra behövde stillhet och avskildhet. Den stora variation som resultatet uppvisar indikerar att ett individbaserat bemötande behöver praktiseras.

While much is known about the long-term effects of childhood sexual abuse (CSA) on women in adulthood, little is currently known about their self-care efforts. Given the paucity of research on self-care for survivors, particularly those who are also mothers, and the potential importance of self-care for both themselves and their children, the main goal of the present study was to explore these women’s perceptions and practices of self-care. A grounded theory approach was chosen for this exploration as it provided a sensitive and open-ended methodology which garnered an in-depth understanding of self-care for survivor mothers. The current study combined classic grounded theory (GT) research methods with photovoice methods to explore self-care from the perspective of CSA survivor mothers. Analyses of interview and photograph data from 14 survivor mothers resulted in an original basic social process for understanding how these women care for themselves, feel better, and engage in healing in the context of past violence and trauma. Complex interactive behavioural patterns were identified that recreated a whole self out of damaged fragments; these were conceptualized as “reconstituting a damaged self”. This basic social process was comprised of three main stages, including: emotional de-paining, safetying, and authenticating and returning to self. Several substages within each of these main stages were also identified. Findings were discussed in relation to four theoretical frameworks. Future research directions and clinical implications for this neglected population were suggested. Reconstituting a damaged self can be a long process for sexual abuse survivor mothers involving taking small safe steps, for the most part, on one’s own.

Introduction: Cancer survivors continue to experience psychological distress and challenges in their daily lives long after the completion of treatment. Caregivers play a pivotal role in the lives of cancer survivors by providing support in various domains of their lives. The cancer experience between support persons and cancer survivors is intertwined. The interdependence theory will serve as a theoretical framework to guide the purposes of this study. Objective:The purpose of this research was to gain a better understanding of unmet needs of caregivers supporting long-term cancer survivors and explore how fulfilling the needs of caregivers influenced the psychological well-being of cancer survivors. Specifically, an emphasis was placed on exploring the level of dependence present in marital relationships, and how this impacted the relationship between caregiver unmet needs and the psychological outcomes of cancer survivors. Method: Data was drawn from The Cancer Support Persons’ Unmet Needs Survey (SPUNS) (Campbell et al., 2009) and The Cancer Survivors’ Unmet Needs Survey (SUNS) (Campbell et al., 2009). Regression models tested for significant interactions between caregiver unmet needs and factors influencing survivor dependence with psychological distress in cancer survivors. Results: Findings revealed main effects between caregivers’ depression, anxiety, and stress with the respective psychological outcomes in cancer survivors. Caregivers’ concerns about the future predicted elevated depression in cancer survivors. Caregivers with needs pertaining to information or emotions predicted higher anxiety in cancer survivors. Information needs, future concerns, and health care access and continuity needs of caregivers predicted higher survivor stress. Conversely, work and financial needs of caregivers predicted lower depression, anxiety and stress in cancer survivors. Significant interactions were found for caregivers’ concerns about the future by recurrence of diagnosis with decreased survivor anxiety, health care needs of support persons by recurrence of illness with increased survivor anxiety, caregivers’ personal needs by severity of illness with higher survivor anxiety, support persons’ emotional needs by severity of illness with lower survivor anxiety, caregivers’ emotional needs by severity of illness and decreased survivor stress, and finally, support persons’ health care needs by severity of illness with higher survivor stress. Conclusion: Findings did not fully support the hypotheses of this present study. Nonetheless, the significant results revealed in the findings would be useful to generate alternative hypotheses in future studies regarding interdependence, unmet needs and psychological well-being. The findings for the present study will also provide direction towards improvement in treating caregivers and cancer patients as a conglomerate, and inform programs, services and policies in cancer care.

As the number of cancer survivors continues to rise, there is an increasing need for psychological research to better understand and help individuals cope with their cancer journey. According to Socioemotional Selectivity theory (SST), shortened time perspective and mortality awareness heighten the importance of social and emotional goals. In the present analysis, SST is applied to the unmet needs of cancer survivors. This is done to provide a better understanding of the association between unmet needs of cancer survivors and the impact of such needs on the survivors' psychological well-being, especially in the case of survivor’s awareness of his/her mortality. In keeping with SST theory, we anticipated that for those with higher mortality awareness (e.g., recurrence of cancer, older age, greater mortality ratio), high unmet social and emotional needs, above else, will be associated with lower psychological well-being. Partial support was found for these hypotheses and results are discussed in terms of their contribution to a better understanding of the nature of psychological well-being of cancer survivors.

Past research on adult memory for childhood sexual abuse (CSA) has provided support for the phenomenon of forgetting and subsequent recovery of the memories, after a period of time. This phenomenon, however, remains a source of debate and is still not fully understood by researchers and psychological and legal practitioners. The research has provided conflicting evidence about the factors which are thought to lead to CSA forgetting for extensive periods of time, in addition to the processes involved in forgetting, triggering and later remembering of the abuse memories by adult survivors. This study utilised a mixed method to investigate and explore the factors and processes associated with CSA forgetting, triggering and later remembering, in a sample of Australian adult CSA survivors (N = 77). Participants were asked to complete a test booklet, containing the Traumatic Events Questionnaire (TEQ), Symptom Checklist-90-Revised (SCL-90-R), Dissociative Experiences Scale II (DES II), Impact of Events Scale - Revised (IES-R), a scale designed to measure persistence of memory (Loftus), and a scale designed to measure emotional intensity at the time of the abuse and now (Williams). Participants were then asked to participate in a semi-structured interview. Seventy-one participants completed the interview process. Five separate analyses were conducted on the data. Methodological issues, such as the use of retrospective data and corroboration of the abuse were outlined. All participants were asked to provide details about any corroboration they had received that the abuse had occurred. The participants were streamed into one of three categories of forgetting (Always Remembered, n = 28; Partial Forgetting, n = 16; and Extensive Forgetting, n = 33). The first analysis (Stage One Analysis One) examined the factors thought to be associated with CSA forgetting, such as abuse parameters (TEQ), current psychological functioning (SCL-90-R), persistence of memory (Loftus), emotional intensity at the time of the abuse and now (Williams), the trauma response experienced at the time of the abuse (IES-R), and current dissociation (DES II), to determine the significant differences between the three groups. A significant difference was found regarding the age at which the abuse commenced, with the Extensive Forgetting group reporting an earlier age at which the abuse commenced. Significant differences were found on the variable that related to being abused by an aunt or uncle, and on the current experience of hostility (SCL-90-R sub-scale), and on the current levels of anger (Williams Emotional Intensity) experienced by the participants. Significant differences between the groups were also found on two of the Persistence of Memory items, namely clarity of memory and participants' memory of the tastes related to the abuse. Finally, a significant difference was found on the participants' current dissociation levels, with the Extensive Forgetting group reporting higher levels of current dissociation than the other two groups. Statistical profiles for each of the three groups were constructed, based on the mean scores of the SCL-90-R, IES-R and DES II, for use in the Stage Two, Analysis Two, profile comparison. Stage Two, Analysis One, provided a qualitative analysis relating to the experience of always remembering the abuse. The aim of this analysis was to provide a deeper understanding of why some participants (n = 23) did not forget about their abuse, when other participants reported being able to forget for a period of time. The results indicated that participants' responses formed clusters, such as older age at abuse onset, failed dissociative mechanisms, constant reminders, and others. Stage Two, Analysis Two, presented and compared each participant's profile against the statistical profiles constructed in Stage One. The participant's profiles included a summary of their TEQ responses and interview responses, in addition to their Stage One test booklet scores. The comparison was made, firstly, on a specific basis against the mean scores obtained by each category of forgetting, and secondly, on a broader basis, against the score range for each measure of the statistical profile. This was done to determine if there was a "typical" member of each category of forgetting and to investigate the within-group differences. The specific profile comparison demonstrated that there was no "typical" member of any of the three groups, with participants varying widely in their scores and patterns of scores. However, when the profile comparison was broadened to include score ranges, 61% of participants, who always remembered the abuse, 44% of participants who partially forgot the abuse, and 47% of participants who extensively forgot their abuse, matched the profile of a "typical" member of their relevant category of forgetting. Stage Two, Analysis Three, provided an in-depth qualitative exploration on the process involved in CSA forgetting, triggering and later remembering, for a selection of participants who reported partially forgetting the abuse (n = 6), and extensively forgetting the abuse (n = 10). Participants' interview responses were transcribed verbatim and analysed, using Interview Analysis. This analysis explored the differences between participants, from the two categories of forgetting, on their experiences of CSA forgetting, triggering and later remembering, in addition to exploring how these participants were able to forget about the abuse; what events triggered their abuse memories; and how the initial memories returned. Issues of memory recovery, while in therapy or under hypnosis, were also explored. Stage Two, Analysis Four, presented the case study of a participant, who had been identified as an "outlier", due to her high score on the DES II, claims of being able to remember abuse incidents that occurred prior to the age of two years, diagnosis of DID, and the substantiated conviction and sentencing of her abuser, based on her recovered memories of the abuse and corroboration from her sister and mother. Her case was examined against some of the criticisms often made by false memory supporters. This thesis found that some CSA survivors forgot about their abuse, either partially or extensively. The thesis also found support for some, but not all, of the factors that previous researchers have identified as being associated with CSA forgetting by adult survivors, specifically the individual's age at the time the abuse commenced and the individual's ability to dissociate from the abuse. The research then explored, in-depth, the issues of: CSA remembering, CSA survivor profiling, and the "how" of CSA forgetting, triggering and later remembering, by adult survivors.

Child survivors of the Holocaust have only recently been recognized as a distinguishable group of individuals who survived the war with a different experience to the older survivors. This thesis focuses on a specific group of child survivors, those who survived by going into hiding. In hiding, some remained "visible" by hiding within convents, orphanages or with Christian families. Others were physically hidden and had to disappear from sight. Most children often combined these two experiences in their hiding. / The intent of this study was to explore the experience of these hidden children using Giorgi’s empirical phenomenological methodology and to gain a richer understanding of the nature of this experience. Phenomenological analyses of the recorded and transcribed interviews of 11 child survivors were conducted and organized into meaning units which subsequently yielded situated structures from which the general structures evolved. / These analyses revealed that the defining moment of being hidden for these children was the suppression of their identities as Jews. By being hidden, they had to deny the essence of their core selves, including their names, family details and connections to others in an effort to conceal their Jewishness. Other structures to emerge as part of hiding were the pervading fear which enveloped their entire experience in hiding and the sense of suspended normality during this period, which sometimes extended over a period of years. A "cut-offness" and personality constriction seemed to be present throughout the descriptions of these children and appears to have developed as a method of coping with the trauma of their childhood. Overlaying all of this were general insecurities about the capriciousness of the war and the contextual specifics of their actual hiding places to which each child had to adjust. Connections/relationships to another person seemed to be highly significant in the dynamics of the everyday during the experience of hiding and often shaped some of the psychological and emotional experiences of hiddenness.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 4 uppsatser.