Les fentes labiales et palatines (FLP) sont les malformations faciales humaines les plus fréquentes. Selon l'origine ethnique et/ou géographique des populations étudiées, elles peuvent concerner jusqu'à 1 /500 naissances. La venue au monde d'un enfant porteur de FLP est un événement particulièrement stressant et traumatisant pour les parents. Une écoute attentive des familles dont l'un des enfants est porteur de FLP révèle l'importance du contexte psychologique et les risques d'une structuration disharmonieuse des relations parents-enfant avec leurs conséquences sur le développement de l'enfant. Dans une démarche éthique de bienfaisance, il est donc primordial de prendre en compte ces risques et de mieux connaitre le vécu des parents par rapport à cette malformation et de ses conséquences sur le développement de l'enfant. Quatre études cliniques multidisciplinaires et multicentriques dont un Projet Hospitalier de Recherche Clinique (PHRC) national, ont été ainsi élaborées et réalisées avec cet objectif. Les résultats montrent qu'il est urgent d'améliorer la qualité de cette information et de l'accompagnement des parents, et cela, dès l'annonce. Il s'agit de soutenir ces parents pour " investir " cet enfant si "différent" de celui attendu et espéré. L'organisation de cette prise en charge doit être renforcée entre les équipes médicales intervenant avant et après la naissance afin d'améliorer la prise en compte thérapeutique et sociétale de ces enfants et de leurs parents. / Cleft lip and patate (CLP) are the most common facial malformations in humans. Depending on the ethnie and/or geographical origin of the populations studied, they can affect up ta 1 /500 of newborn infants.Careful consideration of families concerned shows the importance of the psychological context, and the repercussions of a disharmonious structuring of the parent-child relationship on the child's development.The prospective, multidisciplinary and multi-centre studies described here aimed to assess the psychological perceptions of parents of children affected by CUP over the year following the birth,and to analyse the degree of psychological suffering experienced by the child, and the parent-child relationship. The results show that it is urgent to improve the quality of the information given to the parents, and their accompaniment and support, as soon as the malformation is disclosed. Parents need support to become "committed" to their child, so "different" from their hopes and expectations. The organisation of this support needs to be reinforced between medical teams before the birth and after, so as to improve the way the condition is catered for, from both the therapeutic and the social viewpoint. We believe the results of this research will enable us ta develop new methods to lessen the psychological impact of the malformation on the parents, and improve treatment for the children in the long term.

D.Litt et Phil. / For over a decade, from the late 1970's to October 1992, a war raged in Mozambique that resulted in what has been described as, one of the "most terrible genocides in the history of Africa". Over 4 million people were displaced during this war. Conservative estimates put the number of Mozambicans who sought refuge in South Africa at 250 000. This study examines the trauma created by the war, and its psycho-social outcomes, from the perspective of women refugees who came to settle in villages in the Nkomazi region of Mpumalanga province, in South Africa. Posttraumatic stress disorder, the concept which dominates research in the field of trauma studies, was based on research with male war veterans in western industrial societies. Recently a body of work has emerged which questions the validity of applying posttraumatic stress disorder to contexts of massive social conflict, and its utility in cross cultural contexts. This body of work suggests that an understanding of extreme trauma and its outcomes requires careful consideration of the social and cultural dimensions of trauma. The inclusion of a cultural formulation in the latest edition of the Diagnostic and Statistical Manual for Mental Disorder, DSM-IV, reinforces a growing acknowledgement amongst mental health researchers of the influence of culture on mental health and disorder. The gaps in research on African women survivors of war and the lack of standardised assessment tools, makes this an exploratory study which uses qualitative research methods. Unstructured interviews were conducted with 30 Mozambican women refugees to explore their experiences and definitions of trauma, the psycho-social outcomes of the trauma, and coping and survival in the aftermath of the war. The magnitude of the trauma evident in the research findings called for a conceptual definition which reflects multiple risks and the interdependence of social and individual trauma. Thematic analysis and qualitative coding of the interview data revealed clinically well defined posttraumatic stress disorder symptoms and locally specific discourses of suffering framed by cultural beliefs, social practices and historical experiences. Their testimony and observations in the field, revealed that the survivors demonstrated a capacity to survive and reconstruct their lives. Their coping strategies and survival tactics were fundamentally shaped by socio-historical experiences and the limits and possibilities contained in the recovery environment. The results of this study suggest an approach to examining the complex relationship between trauma and its consequences, which abstracts neither trauma nor its victims from cultural and social-historical contexts.

M.A. / The goal of the present study was to investigate the relationship between trait anxiety, years of service and posttraumatic stress disorder in the South African Police Service. This study was regarded as important because posttraumatic stress can have a significant influence on the personal life and work-related performance of police officers. One hundred and twenty white, male police officers volunteered to participate in the study. A structural model of the relationships between trait anxiety, years of service and posttraumatic stress was postulated. The model specified that trait anxiety and years of service influence posttraumatic stress both individually and jointly. Trait anxiety is operationalised by means of the IPAT Anxiety Scale and posttraumatic stress disorder by means of the Posttraumatic Stress Disorder Interview Schedule. The fit of the postulated model with the observed data was investigated by means of structural equation modelling. The results indicated that the postulated model showed an acceptable fit with the observed data. The estimated parameters of the model indicated that the subscales of the IPAT Anxiety Scale and the Posttraumatic Stress Disorder Interview Schedule are good indicators of their respective constructs. It was further shown that trait anxiety and years of service have a significant influence on posttraumatic stress disorder. The results support those of previous studies where it was shown that these variables can influence posttraumatic stress disorder. The present study emphasizes that trait anxiety may predispose police officers to the development of trait anxiety. The study also shows that if police officers are exposed to extended periods of traumatic experiences, they run the risk of developing posttraumatic stress disorder.

M.A. / The present study was undertaken in an attempt to understand and ascertain the relation between personality traits and posttraumatic stress (PTSD) in the South African Police Service (SAPD) leading to chronic illness and work-related dysfunctions. The specific hypothesis for this study will show that by means of the Comrey Personality Scales (CPS) a statistic significant distinction between police officers with PTSD and police officers without PTSD exists. The testing of the hypothesis entailed a group of 120 functional police officers that consists of white, male nonofficers. They worked in the Pretoria area of the SAPD. The PTSD status of the subjects was assessed by means of the PTDS Interview Guide of Watson, Juba, Manifold, Kucala and Anderson (1991). Police officers that met the criteria for PTSD by means of the PTSD Interview Guide were place in one group (PTSD-group, n = 414. Police officers that did not meet the criteria were placed in another group (Non-PTSD-group, n = 79). Personality traits were measured by means of the CPS. There was a significant difference between the personality traits of the PTSDgroup in comparison with the Non-PTSD-group. The PTSD-group appears to be more compulsive and ordered, more introspective, more neurotic, more sensitive and more defensive in comparison with the Non-PTSD-group. It is postulated that these personality traits can possibly cause policemen to be more susceptible for the development of PTSD.

M.A. (Psychology) / South Africa in 1997 is commonly seen as one of the most violent non-war countries in the world. Crime has become so much part of the daily routine of the average South African, that it is almost accepted as the norm. This study investigates the experiences of six persons, directly affected by a violent crime. The researcher endeavours to relate the constructions the victims hold around their experience of a car-jacking as truthful as possible and thus uses the paradigm of social constructionism ...

Magister Psychologiae - MPsych / South Africa is a country with one of the highest crime rates in the world, resulting in much violence and trauma. Trauma debriefing models are used with groups and individuals in an attempt to facilitate the trauma recovery process and prevent the development of post-traumatic stress disorder (PTSD). There has been much debate on the efficacy of trauma debriefing over the past two decades with few qualitative studies exploring the utility of debriefing. A phenomenological methodology was used in this study, with the aim of understanding how participants experienced the process of trauma debriefing and what aspects were perceived as helpful or unhelpful. Semi-structured in- depth interviews were conducted with six adults who received debriefing following a single traumatic event, by volunteer lay counsellors from the Community Intervention Centre (CIC) based at the Milnerton Medi-Clinic.

War inevitably impacts on the lives of soldiers who participate in them. The impact often suggests a negative nature, leaving some soldiers with permanent physical and emotional scars. Some soldiers will return from war suffering from several psychological disorders as the result of their exposure to combat trauma. Pathologies such as post-traumatic stress disorders, anxiety and mood disorders are not uncommon. Yet, for others war has provided them with numerous positive experiences from which they can find meaning for themselves. It was Aaron Antonovsky who developed the idea of salutogenesis, mainly focussing on the psychological factors that allow individuals to find meaning in their adversity. This study attempts to investigate the impact of service rendered in the South African Special Forces during the Angolan war on current levels of well-being and sense of coherence amongst former Special Forces members. It is commonly known that these soldiers were exposed to severe battle related conditions, often working behind enemy lines for unknown periods of time whilst being self-reliant. It would seem that most of these soldiers have adapted adequately to society 15 years after their participation in the Angolan war (South Africa’s “Border War”). Some of these soldiers have achieved success in many different ways after leaving Special Forces. Some have embarked into the world of business and others chose professional careers and then there are those who became successful entrepreneurs. A sample of 32 respondents was collected. All of the respondents were members of the South African Special Forces during the Angolan war but have resigned since. The respondents were requested to complete a questionnaire consisting of a biographical information section, Antonovsky’s 13-item Orientation to Life Questionnaire (OLQ) and Diener’s Satisfaction With Life Scale (SWLS). The purpose was to determine the respondents’ current sense of coherence and level of well-being and to determine to what extent service in Special Forces has contributed to these levels. Descriptive and inferential statistics were used to analyse the data. Inferential statistics included Chi-square, Fisher’s exact test, Spearman correlation coefficient and the t-test. Analysis of data suggests that the sample currently measures high on both levels of sense of coherence and well-being. The means of both OLQ and SWLS of this sample compare higher to any other samples they were administered to. However, statistically no clear correlation could be determined between service rendered in Special Forces and current levels of well-being. Respondents did however indicate that they feel that their service in Special Forces did have a positive impact on their lives and their current levels of functioning. / Dissertation (MA (Clinical Psychology))--University of Pretoria, 2007. / Psychology / unrestricted

Bakgrund: Personalen är den viktigaste tillgången inom vården och därför är det viktigt att de får det stöd som de behöver för att undvika stress och psykisk utmattning. Personal som arbetar i arbetsmiljöer där kritiska och traumatiska händelser uppstår löper en större risk att drabbas av psykisk ohälsa i form av utbrändhet, depressioner samt stress och även posttraumatisk stressyndrom (PTSD). Personalstöd har visat sig leda till såväl lägre sjukfrånvaro som mindre personalomsättning. Det finns olika former av personalstöd, ute i verksamheterna används oftast kamratstöd, avlastningssamtal och debriefing. Syfte: Syftet med denna studie var att undersöka förekomst av riktlinjer samt att beskriva dess innehåll för personalstöd efter kritiska och traumatiska händelser på ett antal anestesiavdelningar i Sverige. Metod: Metoden som användes var av kvantitativ och kvalitativ ansats och analysen genomfördes med manifest innehållsanalys. Resultat: 28 frågeformulär skickades ut, av dessa erhölls fjorton svar och sju utav dessa hade avdelningsspecifika riktlinjer för personalstöd. Riktlinjerna granskades och tre kategorier urskiljdes; syfte och mål med riktlinjerna, förebygga och stödja samt arbetsmiljö. De stödåtgärder som framkom var avlastningssamtal, debriefing, krisstöd, enskilt krisstöd, ceremonier samt emotionellt stöd och eftersnack. Avlastningssamtal var den vanligaste stödåtgärden. Slutsats: Ungefär hälften av de anestesiavdelningarna som erhöll frågeformulär valde att inte medverka i studien. Endast sju anestesiavdelningar av de som medverkade hade riktlinjer trots att lagar och föreskrifter säger att arbetsgivaren ska tillhandahålla riktlinjer för personalstöd. Klinisk betydelse: Förhoppningen är att denna studie ska vara ett stöd för verksamheter vid utformning av riktlinjer samt vid uppdatering av befintliga riktlinjer för personalstöd efter kritiska och traumatiska händelser. / Background: The personnel are the most important asset in health care and it is therefore important that they receive the support they need to avoid stress and mental fatigue. Personnel which works in environments where critical and traumatic events occur is at a higher risk of mental illness in form of burnout, depression, stress and also post-traumatic stress disorder (PTSD). Support to personnel has been found to contribute both to lower absenteeism as well as a lower personnel turnover. There are various forms of personnel support, the most commonly used types within operations are co-worker support, relief conversations and debriefing. Aim: The aim of this survey was to investigate the presence of guidelines and its contents for personnel support after critical and traumatic events in a number of anesthesia departments in Sweden Method: The method used was quantitative and qualitative approach, and the analysis was performed with manifest content analyze. Result: 28 questionnaires were sent out, of these were fourteen responses received and seven of these had guidelines for personnel support. The guidelines were reviewed and three categories were distinguished; purpose and goals of the guidelines, prevention and support, and work environment. Support methods that emerged was relief conversations, debriefing, crisis support, individual crisis support, ceremonies, emotional support and after talk. Relief conversations were found to be the most common method. Conclusion: Approximately half of the anesthesia departments that received questionnaires decided to don’t participate in the study. Only seven anesthesia departments of those who participated had guidelines, despite the fact that laws and regulations say that the employer shall provide guidelines for personnel support. Clinical significance: It is wished that this study will provide support for activities when developing guidelines, and also when updating already existing guidelines for personnel support after critical and traumatic events.

Certain individuals, such as police officers, are exposed to traumatic events as part of the occupational roles they fulfill. In order to prevent psychological illnesses; namely the Post-Traumatic Stress Disorder (PTSD) that results from work-related traumatic incidents, psychological interventions have been developed such as Critical Incident Stress Debriefing. The aim of the study was to explore the experiences and the perceptions of police members stationed at the South African Police Service (SAPS) Head Office in Pretoria, regarding the effectiveness of Trauma Debriefing within the SAPS environment. The researcher was motivated to choose this subject as a result of the challenges he faced while working as a Psychometrist and a Debriefer within the SAPS. Furthermore, the lack of research and literature studies concerning the effectiveness of trauma debriefing motivated the researcher to conduct the study. The qualitative approach was utilized in this study, and interviews were used to gather data about the experiences and perceptions of police members regarding the effectiveness of trauma debriefing. Utilizing an interview schedule, the researcher interviewed 10 respondents who were functional members of the SAPS. A systematic sampling method was used to select suitable respondents for the study. The type of research used was that of applied research, as the intention was to answer practical questions about the effectiveness of trauma debriefing within the SAPS. The exploratory design was utilized in this study, since there was limited information about the experiences and perceptions of police members in existence. The purpose of using this design was thus to explore the perceptions and experiences of police members regarding the effectiveness of trauma debriefing in order to provide new information about the topic. The researcher believes that this research will provoke some thought about new scientific research into this field of study. A discussion on the theoretical overview on trauma debriefing focused on the goals and theories of debriefing. In addition, a theoretical overview of the debriefing model adopted by the SAPS, the benefits of debriefing, the diagnostic criteria for PTSD and critical perspectives with regard to the effectiveness of trauma debriefing. The research findings indicated that trauma debriefing has been viewed and experienced by most respondents as good. Most police members perceived trauma debriefing as effective. Furthermore, police members perceived trauma debriefing as management=s support. The research findings however also indicated that trauma debriefing should be pro-active rather than reactive. Some respondents felt that debriefing should include an element of monitoring members, in order to check their progress. In addition, the study showed that there is a lack of follow-up services to debriefing cases attended. / Dissertation (MSoc.Sci (Employee Assistance Programme))--University of Pretoria, 2006. / Social Work / unrestricted

The death of a parent is one of the most serious stressors that can occur in a child’s life. The aim of this study was to describe an 11-year-old child’s journey through traumatic grief after the violent death of her mother. The conceptual framework utilised was Trauma-Focused Cognitive Behavioural Therapy (TF-CBT). The case study approach was applied as it provided a suitable research design in which to give an account of the subject in a therapeutic situation. A purposive sampling technique was utilised to select the research subject in the study. The following three principles of data collection were adhered to: a) using multiple sources of information, b) creating a case study database, and c) maintaining a chain of evidence. Irving Alexander’s content-analysis technique in conjunction with Guba’s model of trustworthiness was employed for data analysis. The finding that emerged from the study was the resilience shown by Linda in relation to her adaptive functioning following the trauma of witnessing the violent death of her mother. Conclusions and recommendations were made following the findings based on the information obtained during the therapy sessions.