The role of factors which influenced individual differences in post-trauma outcome were explored using a multi-method design, in response to recommendations in the literature that self-report data should be incorporated into studies of post-traumatic stress disorder (PTSD). In part 1, a psychophysiological study with process interviews was tested for feasibility and acceptability with a small-scale sample (n = 17) and found individual differences between how participants described responding to trauma-related picture stimuli. Five primary response types were identified: avoidance, acceptance, increased attendance, dismissal and confrontation. In part 2, resilient and recovered individuals (n = 11) were interviewed in depth about their experiences of coping with trauma and transcripts were analysed using an interpretative phenomenological approach. Themes identified were attitudes and beliefs, emotion regulation, narrative development, support and safety and recovery. Some resilient participants described initial use of avoidance as a coping strategy but moved from this position towards acceptance of their trauma in their recovery journey. Therefore avoidance may play a more helpful role than has previously been thought. The importance of specific attributes of factors positively associated with recovery from trauma and potential interactions between these factors was discussed.

Multiple traumas, including sexual vulnerabilities, sexual abuse, and sexualized violence, remain substantially higher among Indigenous peoples in Canada than among non-Indigenous peoples. These trends are rooted in a colonial history that includes systemic racism, a deprivation of lands and culture and other intergenerational traumas. Mental health sequelae following sexual vulnerabilities such as abuse and violence may include mood disorders, low self-worth, posttraumatic stress and a range of issues related to anxiety—yet Western mental health services are typically under-used by Indigenous peoples managing these issues. Indigenous mental health and healing services are explored as a more culturally appropriate and successful alternative for Indigenous clients experiencing multiple traumas.

This dissertation looks at ways in which memories of traumatic events are revisited and reshaped by mnemonic communities during the Second Temple period. I focus on the social dimensions of traumatic memory that shape collective identity. I consider ways in which the earlier sites of memories of the exodus, the destruction of the first temple, and the Babylonian exile are reactivated and reshaped by mnemonic communities in constructing exclusive collective identities through discourses of exile, separation, and restoration. Drawing on theoretical frameworks from post-Holocaust thought that I outline in Chapter 1, I argue that the language in Ezra-Nehemiah (Chapter 2), 2 Maccabees (Chapter 3), Daniel (Chapter 4), and Damascus Document and Pesher Habakkuk (Chapter 5) is consistent with processes of identity formation in which trauma is construed as a founding, generative, and integrative identity. In developing themes of collective trauma and memory, I focus on Marianne Hirsch’s work on postmemory and Dominick LaCapra’s theories on founding traumas and the conversion of absence and loss. I apply these theories to the aforementioned Second Temple texts by arguing that notions of purity and impurity are established through the memory and postmemory of catastrophic events, including the destruction of the first temple, Babylonian exile, and the persecution by Antiochus IV Epiphanes in 167-164 B.C.E. The producers of these texts mask structural trauma (i.e., the transhistorical absence represented as the loss of an original identity) in its representation of historical trauma and narrate the process of restoration as the recovery of an original identity and unity, which never existed as it is represented in the texts. Chapter 6 is an analysis of notions of purification, hybrids, and multidirectional memory. Engaging with the work of Bruno Latour, I discuss the production and proliferation of hybrids, which emerge from discourses and practices of separation and purification. I use Latour as a segue into Michael Rothberg’s work on multidirectional memory, which shows that those whom some communities attempt to mnemonically and discursively eliminate or purify often share a collective pasts and/or identities.

Counterfactuals generated by people who have experienced traumatic life events were examined to elucidate their significance for the coping process. In Study 1, 93 respondents were interviewed 4-7 years after the loss of their spouse or child in a motor vehicle accident. In Study 2, 124 respondents were interviewed 3 weeks and 18 months following the death of their child to Sudden Infant Death Syndrome. Across these two studies it was found that (a) counterfactuals that undid the traumatic event were commonly reported; (b) the focus of counterfactuals was typically on one's own (in)actions, rather than on the behavior of others; (c) the more freguently respondents were undoing the event, the more distress they reported; and (d) this relation held even after controlling for more general ruminations. In Study 3, 106 respondents were interviewed one week following their spinal cord injury. In this study, self-implicating counterfactuals were shown to predict ascriptions of self-blame, controlling for causal attributions and foreseeability estimates. Taken together, these field data suggest that counterfactuals play an important role in how people cope with traumatic life events. Possible roles that these counterfactual thoughts might play are discussed.

Multiple traumas, including sexual vulnerabilities, sexual abuse, and sexualized violence, remain substantially higher among Indigenous peoples in Canada than among non-Indigenous peoples. These trends are rooted in a colonial history that includes systemic racism, a deprivation of lands and culture and other intergenerational traumas. Mental health sequelae following sexual vulnerabilities such as abuse and violence may include mood disorders, low self-worth, posttraumatic stress and a range of issues related to anxiety—yet Western mental health services are typically under-used by Indigenous peoples managing these issues. Indigenous mental health and healing services are explored as a more culturally appropriate and successful alternative for Indigenous clients experiencing multiple traumas.

Up to this point much of what has been learned regarding individuals' stress responses has been derived from the study of individuals who have suffered from psychopathology or physical illness. Recent research, however, has demonstrated a shift in focus toward individuals who effectively cope with stressful experiences. For example, previous research has identified a type of "conversion" process whereby an initially traumatic event is evaluated and later recognized to have positive effects through its assimilation into a new cognitive framework emphasizing psychological growth and adaptation. The present study investigated the conversion phenomenon, examining the relationship between older and younger subjects' perceptions of significant events and their current level of mental health, self-esteem and religious orientation. Results found conversion to be related to religiosity but not to age, self-esteem or transient mental health status. The findings are discussed and implications for future research are identified.

This dissertation looks at ways in which memories of traumatic events are revisited and reshaped by mnemonic communities during the Second Temple period. I focus on the social dimensions of traumatic memory that shape collective identity. I consider ways in which the earlier sites of memories of the exodus, the destruction of the first temple, and the Babylonian exile are reactivated and reshaped by mnemonic communities in constructing exclusive collective identities through discourses of exile, separation, and restoration. Drawing on theoretical frameworks from post-Holocaust thought that I outline in Chapter 1, I argue that the language in Ezra-Nehemiah (Chapter 2), 2 Maccabees (Chapter 3), Daniel (Chapter 4), and Damascus Document and Pesher Habakkuk (Chapter 5) is consistent with processes of identity formation in which trauma is construed as a founding, generative, and integrative identity. In developing themes of collective trauma and memory, I focus on Marianne Hirsch’s work on postmemory and Dominick LaCapra’s theories on founding traumas and the conversion of absence and loss. I apply these theories to the aforementioned Second Temple texts by arguing that notions of purity and impurity are established through the memory and postmemory of catastrophic events, including the destruction of the first temple, Babylonian exile, and the persecution by Antiochus IV Epiphanes in 167-164 B.C.E. The producers of these texts mask structural trauma (i.e., the transhistorical absence represented as the loss of an original identity) in its representation of historical trauma and narrate the process of restoration as the recovery of an original identity and unity, which never existed as it is represented in the texts. Chapter 6 is an analysis of notions of purification, hybrids, and multidirectional memory. Engaging with the work of Bruno Latour, I discuss the production and proliferation of hybrids, which emerge from discourses and practices of separation and purification. I use Latour as a segue into Michael Rothberg’s work on multidirectional memory, which shows that those whom some communities attempt to mnemonically and discursively eliminate or purify often share a collective pasts and/or identities.

SANTRAUKA Statistikos duomenys rodo, kad Lietuvoje labai paplitusios traumos. Kiekvienas pacientas pergyvena vienokias ar kitokias emocines reakcijas ir kaip atliktas tyrimas parodė, kad daugumai reikalinga parama susitaikant su esama padėtimi. Didelį vaidmenį, gydant pacientus po traumų atlieka slaugytojai. Slaugytojai ne tik atlieka fizinę slaugą, bet stebi ir vertina paciento psichoemocinę būseną. Keičiantis slaugos praktikai, t.y. didėjant slaugytojų kompetencijai būtina plėsti slaugytojų žinias apie potrauminį stresą, kokie streso simptomai pasireiškia pacientams patyrusiems fizinę traumą. Slaugytojai žinodami neigimo, pykčio, liūdėjimo seką gali padėti pacientui įveikti potrauminio streso sunkumus, teikiant atitinkančią poreikius, profesionalią pagalbą. Šio tyrimo tikslas išsiaiškinti darbingo amžiaus pacientų patyrusių fizines traumas psichologinės pagalbos poreikį esant stacionare . Atliekant tyrimą iškelti uždaviniai: pacientų amžiaus įtaka adaptacijai prie laikino nedarbingumo, ar pacientai po traumų norėtų kalbėti su slaugytoju apie psichoemocinę būseną, ar pacientams dėl patiriamo streso būna miego sutrikimų. Tyrimas atliktas Všį Vilniaus Greitosios Pagalbos Universitetinėje ligoninėje I – II traumatologiniuose skyriuose. Tyrime dalyvavo 146 pacientai, iš jų 56,8 proc.vyrai ir 43,2 proc. moterys ir 34 slaugytojos, dirbančios I – II traumatologijos skyriuose. Atlikus šį tiriamąjį darbą buvo padarytos tokios pagrindinės išvados: • Pacientams po traumos reikalinga... [toliau žr. visą tekstą] / SUMMARY Statistical facts shows, that traumas happen very often in Lithuania. Every patient goes through one or another emotional reaction. And study shows, that majority of these patients need support to put up with present situation. Taking care of patients after trauma nurses play very big role. Nurses do not only physical care, but also observe and evaluate patient‘s psycho emotional condition. Nursing practice is changing, competency of nurses is changing. It’s very important to widen nurses knowledge’s in post trauma stress. What kinds of stress symptoms are apparent in patients at the physical trauma? Nurses who know about anger, sorrow, etc. can help to overcome the post trauma stress, giving the professional help to the patients. The main aim of this trial is to explain the need of the psychological help to the patients. We tried to explain how the age is having influence on temporary disability. We also tried to explain whether they want to discuss about their psychological condition with nurses. Whether they have the dream disturbance after experienced stress. The trial is performed in I – II orthopedic – traumathology department Emergency hospital of Vilnius. 146 patients take a part during the trial (mail / female - 56,8 : 43,2 %).

Trauma är den vanligaste dödsorsaken under livets första fyra årtionden och kan orsaka stort lidande för den enskilda individen samt höga samhällskostnader. I Sverige saknas nationella och regionala riktlinjer för traumaomhändertagande, men ett flertal projekt pågår för att uppnå en säkrare traumavård. På grund av det låga antalet traumalarm av större dignitet får anestesisjuksköterskan, som ingår i det multiprofessionella traumateamet, efter genomgången Trauma Nursing Core Course (TNCC) -utbildning ringa praktisk övning vilket kan medföra en svårighet i att upprätthålla förvärvad kunskap. Syftet med studien var att beskriva anestesisjuksköterskans uppfattning av att kunna arbeta evidensbaserat vid omhändertagandet av en patient på akutmottagningen i samband med ett traumalarm. Semistrukturerade intervjuer genomfördes med sex verksamma anestesisjuksköterskor och analyserades med kvalitativ innehållsanalys. Efter bearbetning av data framträdde tre kategorier: krav på kunskap, krav på arbetssätt i akutrummet och möjlighet till utveckling. En rad specifika förutsättningar krävs för att anestesisjuksköterskan ska kunna arbeta evidensbaserat i samband med ett traumalarm. Det krävs att anestesisjuksköterskan har erhållit kunskap genom förvärvad erfarenhet i sina vardagliga anestesiologiska arbetsuppgifter, ett giltigt TNCC certifikat, delaktighet vid traumaövningar, debriefing efter traumalarm samt ges möjlighet till utveckling. Resultatet kan bidra till ökad medvetenhet hos anestesisjuksköterskor som medverkar i traumaomhändertagande att arbeta evidensbaserat, vilket i sin tur kan bidra till en ökad patientsäkerhet med förhoppningsvis minskat lidande för den enskilda patienten samt i förlängningen minskade kostnader för samhället.

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