Intrusive images are a common phenomenon in post-traumatic stress disorder (PTSD; American Psychological Society, 2013). Imagery-Rescripting (ImRs; Arntz & Weertman, 1999) is an experiential technique for targeting intrusive images and is gaining popularity as a treatment for PTSD (Arntz, 2012). Although there is evidence to suggest that ImRs is an effective treatment of PTSD (see Arntz, 2012), it is currently unclear how ImRs works. The aims of the present study were 1) to develop a coding scheme that captured important factors of ImRs session, and 2) to apply this coding scheme prospectively to investigate how certain factors might relate to treatment outcome. The study used thematic analysis (Braun & Clarke, 2006) to develop an ImRs coding scheme. Next, a single case experimental design was employed to track six participants over the course of their ImRs therapy for PTSD. Session content captured by the coding scheme was compared to changes in weekly outcome measures to investigate whether the presence of certain codes related to a reduction in PTSD symptoms. Results suggested a number of factors might be important for determining treatment outcome. Specifically, Attitude towards ImRs, Activation of the image, Ability to follow ImRs, Activation of original internal processes and internal processes during the re-script, Believability and Attitude towards the outcome are suggested as potentially important factors for determining ImRs efficacy. Study strengths, limitations and clinical implications are discussed. Recommendations for future research, including in-depth investigation of individual factors are suggested.

M.A. / Violence being a prominent and invasive factor in South Africa has left many people feeling powerless, hopeless and incapable of dealing and coping with the effects that exposure to trauma has produced. This idea appears even more disturbing if one considers that military personnel will inevitably be exposed to some form of trauma in their employment history. As a result of this traumatic exposure, many people develop post traumatic stress disorder or symptoms thereof. The literature ind icates that certain variables may increase vulnerability for the development of this disorder. The purpose of this research was to evaluate whether or not there is a relationship between Post Traumatic Stress (PTS) symptoms and axis II personality traits using Millon’s Clinical Multiaxial Inventory (MCMI - III) as a measure. The results of which will have major implications for our understanding of PTS, as well as aid in the deployment of military personnel. The sample comprised 5853 military personnel who completed the MCMI III as part of a yearly project to determine their mental health status. Inferential and descriptive statistical analyses were used on the data. It was found, in accordance with previous literature findings, that narcissistic, antisocial and borderline personality styles are the best predictors of PTS. In addition, the study found that there is a significant relationship between PTS and various personality styles, namely depressive, schizotypal, borderline, passive -aggressive, compulsive, antisocial and narcissistic personality styles. It is recommended that if the MCMI-III is used to scan military personnel prior to combat, those with high scores on borderline, narcissistic and antisocial personality scales, should be subjected to a more in-depth evaluation.

In the pathophysiology of traumatic brain injury (TBI), the amygdala remains understudied, despite involvement in processing emotional and stressful stimuli associated with anxiety disorders, such as post-traumatic stress disorder (PTSD). Because the basolateral amygdala (BLA) integrates inputs from sensory and other limbic structures coordinating emotional learning and memory, injury-induced changes in circuitry may contribute to psychiatric sequelae of TBI. This study quantified temporal changes in dendritic complexity of BLA neurons after experimental diffuse TBI, modeled by midline fluid percussion injury. At post-injury days (PIDs) 1, 7, and 28, brain tissue from sham and brain-injured adult, male rats was processed for Golgi, glial fibrillary acidic protein (GFAP), or silver stain and analyzed to quantify BLA dendritic branch intersections, activated astrocytes, and regional neuropathology, respectively. Compared to sham, brain-injured rats at all PIDs showed enhanced dendritic branch intersections in both pyramidal and stellate BLA neuronal types, as evidenced by Sholl analysis. GFAP staining in the BLA was significantly increased at PID1 and 7 in comparison to sham. However, the BLA was relatively spared from neuropathology, demonstrated by an absence of argyrophilic accumulation over time, in contrast to other brain regions. These data suggest an early and persistent enhancement of dendritic complexity within the BLA after a single diffuse TBI. Increased dendritic complexity would alter information processing into and through the amygdala, contributing to emotional symptoms post-TBI, including PTSD.

Objectives To examine the associations of Intimate partner violence (IPV) with stress-related sleep disturbance (measured using the Ford Insomnia Response to Stress Test [FIRST]) and poor sleep quality (measured using the Pittsburgh Sleep Quality Index [PSQI]) during early pregnancy. Methods This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding IPV history, and sleep traits. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CIs) were calculated using logistic regression procedures. Results Lifetime IPV was associated with a 1.54-fold increased odds of stress-related sleep disturbance (95% CI: 1.08–2.17) and a 1.93-fold increased odds of poor sleep quality (95% CI: 1.33–2.81). Compared with women experiencing no IPV during lifetime, the aOR (95% CI) for stress-related sleep disturbance associated with each type of IPV were: physical abuse only 1.24 (95% CI: 0.84–1.83), sexual abuse only 3.44 (95%CI: 1.07–11.05), and physical and sexual abuse 2.51 (95% CI: 1.27–4.96). The corresponding aORs (95% CI) for poor sleep quality were: 1.72 (95% CI: 1.13–2.61), 2.82 (95% CI: 0.99–8.03), and 2.50 (95% CI: 1.30–4.81), respectively. Women reporting any IPV in the year prior to pregnancy had increased odds of stress-related sleep disturbance (aOR = 2.07; 95% CI: 1.17–3.67) and poor sleep quality (aOR = 2.27; 95% CI: 1.30–3.97) during pregnancy. Conclusion Lifetime and prevalent IPV exposures are associated with stress-related sleep disturbance and poor sleep quality during pregnancy. Our findings suggest that sleep disturbances may be important mechanisms that underlie the lasting adverse effects of IPV on maternal and perinatal health.

There is convincing evidence that demonstrates traumatic stress and aggressive behavior are highly related among adolescents. The evidence is less clear regarding the direction of this relation. The purpose of this study was to examine the reciprocal longitudinal relations between physical aggression and traumatic stress among a predominantly African American sample of middle school students. Support was found for traumatic stress predicting increased levels of physical aggression across the winter to the spring of the sixth grade for boys and across all waves from the fall of the seventh grade to the fall of the eighth grade for both boys and girls. Conversely, physical aggression during the winter of the sixth grade predicted a decrease in traumatic stress in the spring of the sixth grade for both boys and girls. These findings suggest that interventions may need to incorporate skills that are aligned with trauma-informed care practices in order to reduce traumatic stress and physical aggression among adolescents.

There is a growing body of research in support of the relationship between self-compassion and psychological health (Neff, Kirkpatrick & Rude, 2007). However, studies are limited on the malleability of self-compassion specifically within clinical populations, and its influence on psychiatric symptom reduction (Raes, 2011). This study therefore aimed to explore self-compassion, through examination of the underlying components (self-kindness, common humanity and mindfulness), and their impact on maladaptive functioning, specifically for participants diagnosed with PTSD. The study used an exploratory mixed methods design, with eight participants recruited by their attendance at two PTSD CBT/IPT (with self-compassion) group treatment interventions. Participants were adults, with a diagnosis of PTSD and a history of recurrent or current depression. Participants attended a group interview and two therapists who facilitated each treatment group were also interviewed. Participants completed quantitative measures pre and post intervention; Self-Compassion Scale (Neff, 2003a) and Clinician-Administered PTSD Scale (Blake et al., 1995), and session data was recorded using the PTSD checklist (PCL-C; Weathers, Litz, Huska & Keane, 1994) and the Session Feedback Form (AccEPT Primary Care Psychological Therapies Service). The findings demonstrate the importance that individuals place on self-compassion in their PTSD recovery, particularly in relation to self-kindness and the generation of positive self-belief and a compassionate inner-voice. The study also indicates that a clinically significant change in self-compassion is possible for individuals with PTSD, supporting the malleability of self-compassion within clinical populations.

M.A. / The prevalence of rape in the world and particularly in South Africa, calls for the understanding of the factors involved in rape. In particular, it is necessary to understand rape in terms of the victim, not just in terms of the prevalence, causes and social consequences of rape. The victim’s experience of rape is complicated and takes place over a journey that progresses from the assault, through her responses and psychological and social reactions to her recovery from the trauma. It is imperative that a clear understanding of previous research is gained in order to understand the existing epistemological picture of the rape victim’s experience. This dissertation has intended to achieve this understanding by reviewing the literature that has explored rape victim’s responses after the rape, the psychological and social impact the rape has had and the recovery process after the rape. In each of these instances the factors that are identified by research as influencing the rape victim’s experience are surveyed. The victim’s responses to rape are traumatic. It is therefore important to understand the nature of trauma and in particular Post Traumatic Stress Disorder (PTSD). Rape Trauma Syndrome (RTS) in particular describes the traumatic responses of a rape victim. There are factors that influence the extent that the victim experiences responses to a rape. These factors include the extent to which a victim is believed about the rape, the extent to which it is thought that the victim precipitated the assault. Her own attributions about the rape will also influence her responses, as well as the nature of the assault, the level of violence, prior victimisation, past psychological treatment or mental illness, poor social support and other life stresses experienced at the same time as the rape. The victim does not only respond to the traumatic experience after a rape, but may also experience the psychological impact a rape may have. Reactions such as fear, anxiety, anger, aggression, guilt, shame, doubt, depression and psychopathology may be experienced as psychological reactions to a rape. The victim may also experience the impact a rape can have on her social functioning. She may withdraw socially and experience problems in her sexual functioning. The research reviewed indicated that there are factors that influence the extent that these reactions may impact on the victim’s life, if at all. These factors include: participation in the justice system, social support received after the rape, 8 cognitive appraisals made by the victim and possible psychological problems prior to the assault. The final part of a victim’s journey is the recovery. Recovery can be described the psychological work that is required by the victim. As with the responses and reactions that a rape victim experiences, the recovery process is also a journey that is dependent on many influencing factors. The factors that are identified as influencing the recovery process of the victim, both by enhancing it and by hindering it, include: demographic variables of the victim, previous victimisation, functioning before the rape (including chronic life stress and family grief, the nature of the assault, the relationship of the victim to the assailant, social support received after the rape, and the meaning the victim gives to the ordeal. This study of the existing literature concerning the journey of the rape victim through the responses she has after the rape, to the impact of the rape on her psychological and social functioning, to her recovery has highlighted the importance of influencing factors on this journey. It has also been noted by this study that there is a lack of evidence that can shed light on the factors that may influence the South African rape victim’s experience.

M.A. / The literature indicates that journalists who experience work related traumatic situations, are at risk for the development of Posttraumatic Stress Disorder (PTSD) (Teegen & Grotwinkel, 2001). Moreover, some journalists who develop this disorder do so after covering a relatively minor traumatic story (Castle, 2001). Certain temperament traits have been implicated as vulnerabilities to the development of Posttraumatic Stress Disorder (PTSD) in police officers (Henning, 1999). Few research studies have investigated temperament and sense of coherence as mediating factors for occupational stress in journalists exposed to trauma. The aim of the present study was to address this dearth by investigating whether there are statistically significant differences in the experience of trauma, temperament traits and sense of coherence of journalists with varied responses to occupational stress and trauma. The Impact of Event Scale-Revised was used to divide journalists into three groups, namely those with minor reactions to trauma (n=10), moderate reactions (n=24) and severe reactions of clinical importance (n=16). The first group of hypotheses posed in the study pertains to group differences and postulates that the three groups will have statistically significant differences regarding trauma exposure. The second group of hypotheses deals with group differences and postulates that the three groups of journalists will differ regarding certain temperament dimensions. The third group of hypotheses formulated for the study proposes group differences regarding sense of coherence. Analysis of Variance followed by the Scheffé post hoc multiple comparisons technique indicated statistically significant differences between the three groups regarding experience of trauma as measured by the Trauma Questionnaire; certain temperament-personality traits as measured by the Personality Assessment Inventory and the Zuckerman-Kuhlman Personality Questionnaire; and sense of coherence as measured by The Sense of Coherence Questionnaire. The study revealed that the group with severe reactions to stress and trauma had been exposed to intense trauma involving people and that they report significant emotional reactions to the trauma. The Personality Assessment Inventory indicated that the severe reactions group has temperament profiles characterised by somatic complaints, anxiety, depression, paranoia, borderline features, aggression, suicidal ideation, stress and treatment rejection. This group also showed greater neuroticism-anxiety and aggression-hostility prone temperament types than the other two groups as well as lower comprehensibility and manageability as indicated by the Sense of Coherence Scale. The results of the present study exhibit support that there are various factors that could have an impact on how journalists deal with the traumatic stories they cover and what their personal outcomes are after covering these stories. Journalists who develop severe PTSD have different perceptions of the trauma, temperament profiles and sense of coherence that impact on their ways of coping with the traumatic situations they face daily. Criticism of the study deals mainly with gender, age, race and the subjects' pre-testing history, which were not controlled for. Another possible shortcoming of the research is that the journalists were sourced from main stream publications as well as community papers. This might have had an impact on the amount and type of trauma the journalists were exposed to. It would have been preferable to include a greater number of participants in the study to more efficiently address the many variables. Lastly, pre-trauma temperament traits were not controlled for, due to the complexity and ethical complications involved in the subject matter. It is recommended that age, gender, race, pre-testing history and pre-trauma traits is controlled. This will however require a large sample of journalists, which was not available for the present study. It would also be beneficial to compare frequency and type of trauma exposure, PTSD and temperament in a comparative study where community journalists are compared with main stream journalists. Lastly, the development of South African measures for temperament, PTSD and trauma would be highly advantageous to this field of research.

Cognitive vulnerabilities have been implicated in the development of post-traumatic stress disorder and alcohol use disorders, two disorders that commonly co-occur. The comorbidity of these two disorders continues to pose a significant threat to the well being of university students. This study investigated the associations between the cognitive vulnerability of negative attributional style and both post-traumatic stress symptoms and alcohol use patterns. The number of reported traumatic events were also included in analyses. A battery of self-report questionnaires was completed by 123 university undergraduate students (mean age of 20.41 years). Negative attributional style was found to be significantly associated with post-traumatic stress symptoms, but not with alcohol use. It was also suggested that multiple traumas have an impact on post-traumatic stress, despite levels of alcohol use. These results suggested that the cognitive vulnerability of negative attributional style is predictive of posttraumatic stress in students and research in this area is valuable for increasing resilience, prevention and recovery among trauma survivors. Recommendations for future research, especially concerning multiple traumatisation is discussed.

A dissertation submitted to the Faculty of Arts. University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the Degree of Master of Arts (Clinical Psycholoqy). Johannesburg, August 1996 / This study aims to explore the relationship between intrusion and avoidance symptoms as described in the diagnostic category in the DSM-IV (American Psychiatric Association, 1994) and frequency and level of exposure to traumatogenic events. The effects of lay counselling after the event were taken into account in the analysis, and the sample consisted of voluntary First National Bank employees, who were exposed to more than one bank robbery between December 1989 and 1992. The hypotheses of the study were that an increasing number of exposures to potentially traumatogenic events, and increasing levels of exposure to potentially traurnatoqenic events would be related to the development of avoidant and intrusion symptoms. Further, it was hypothesised that the interaction of these two variables would also be significantly related to the development of avoidant and intrusive symptoms and the nature of this interaction was explored. The scale used to measure the symptoms was the impact of Events Scale (Horowitz, 1979). Level of exposure was measured on a four point scale, which included extreme exposure with physical injury; direct threat and coafrontatlon: indirect contact with the perpetrators, and the fourth category was indirect exposure, or secondary victimisation. The results indicated that level of exposure had a significant relationship with the development of both intrusion and avoidance symptoms. Contrary to expectations, frequency of exposure was not found to be related to symptomology and it was speculated that this might have been because of the crudeness of the measure. In this regard it is of note that level of exposure as measured in this study included frequency of exposure. The results indicated further that post trauma counselling was not significantly related to symptomology. The implications of these findings were discussed in the light of the general literature in PTSD.