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This dissertation investigated social support, coping strategies, and posttraumatic growth among cancer patients in China. Study 1 examined sources of social support to explore helpful social support and unhelpful social support from different sources. Optimal matching theory (Cutrona & Russell, 1990) and Goldsmith’s (2004) social support theory served as the theoretical framework for Study 1. Twenty cancer patients in a cancer hospital were recruited to participate in phone interviews. An analysis of the detailed notes of the interviews revealed the major sources of patients’ social support came from family members and nurses. Patients described much more helpful support than unhelpful social support. Several other issues were discussed that were not covered by the research questions but were salient in the interviews were also discussed, such as nondisclosure practices in China and the use of euphemism when disclosing a cancer diagnosis in East Asian countries. The purpose of Study 2 was to test a model of the relationships between social support, uncontrollability appraisal, adaptive coping strategies, and posttraumatic growth. Two rounds of data collection were conducted among 201 cancer patients in a cancer hospital in China. The results of the hierarchical multiple regression indicated that, controlling for demographic factors such as age and education, social support and adaptive coping were positively correlated with posttraumatic growth. Uncontrollability, however, was not significantly correlated with posttraumatic growth. The results of the structural equation model indicated that higher levels of social support predicted higher levels of adaptive coping, higher levels of uncontrollability appraisal predicted lower levels of adaptive coping, and higher levels of adaptive coping predicted higher levels of posttraumatic growth. Moreover, adaptive coping was a mediator between social support and growth, as well as a mediator between uncontrollability and posttraumatic growth. The implications of the findings and the contributions of the dissertation are discussed. / Media & Communication

Objective: A sizable body of literature has now examined posttraumatic stress (PTS) symptoms in youth in the aftermath of disaster. Meta-analysis is the preferred tool with which to inform funding decisions, service delivery, and public policy. Method: The present meta-analysis quantitatively synthesized this literature (k=96 studies; Total N = 74,154), summarizing the magnitude of overall associations between disasters and youth PTS, and identifying child, disaster, and study method factors associated with variations in the magnitude of these associations. Results: Despite variability across studies, disasters had a significant effect on youth PTS symptoms, falling in the small-to-medium range of magnitude. Aspects related to pre-existing child characteristics, the disaster and the child’s disaster exposure, and study methodology are significantly associated with variations in the magnitude of disaster effects on youth PTS symptoms. Specifically, female gender, higher death toll, closer proximity, personal loss, and perceived threat and distress at the time of the event were each associated with increased post-disaster PTS in youth. Regarding methodological factors, studies conducted within the first year postdisaster, studies that used established PTS measures, and studies that relied on childreport data identified a significant effect on youth PTS, whereas studies conducted after the first year, studies relying on non-established measures, and studies relying on parentreport data did not. Conclusion: In the aftermath of disasters, governmental funding agencies and private foundations provide substantial resources for child services following disasters. The present meta-analytic findings can help to inform optimal allocation of these resources and targeted intervention efforts, as well as the development and refinement of new interventions for youth suffering in the aftermath of disasters. / Psychology

Indiana University-Purdue University Indianapolis (IUPUI) / US military personnel often experience ongoing distress after being exposed to traumatic events, and many develop posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Both general theories of stress and coping and cognitive theories of PTSD suggest that traumatic events give rise to distress by negatively influencing important beliefs and goals related to the self, other people, and the world. According to these theories, more positive belief- and goal-systems are associated with less severe symptoms of distress. Two constructs that tap into these systems are general self-efficacy and subjective meaning in life. The overall goal of the current study was to examine the ways general self-efficacy and subjective meaning in life relate to posttraumatic stress and depressive symptoms and symptom clusters in US military personnel, both cross-sectionally and longitudinally. Data from a VA-funded intervention study (n = 191) were examined. Results demonstrated that meaning in life is consistently associated with posttraumatic stress and depressive symptoms and symptom clusters cross-sectionally, whereas general self-efficacy is only associated with some aspects of depressive symptoms. Longitudinal analyses further revealed that meaning in life is associated with the Cluster D symptoms of PTSD and the cognitive-affective symptoms of depression. Interpretations, possible explanations, implications, and future directions are provided. Continued research in this area may identify important targets for treatment that enhance ongoing efforts to facilitate recovery from trauma.

For healthcare agencies and other professionals to most efficiently provide aid following large scale community tragedies, agencies and professionals must understand the determinants that lead individuals to require and seek various forms of help. This study examined Andersen's Behavioral Model of Healthcare Use and its utility in predicting service use in a population of students at Virginia Tech following the shootings on April 16, 2007. Data were gathered from surveys given to students at Virginia Tech three months following the shootings and at a one year follow-up. Logistic regression was used to determine variables that predicted service use. Female gender, prior exposure to traumatic events, higher pre-event functioning, higher social support, higher levels of posttraumatic stress and higher psychological distress were found to be predictive of higher probability of service use. Exploratory hypotheses related to the prediction of outcomes as well as service use as a mediator between predictors and outcomes were also examined. Implications for the use of Andersen's model in predicting service use and equitable and efficient distribution of services are discussed. / Ph. D.

African Americans have reported higher levels of Posttraumatic Stress Disorder (PTSD) symptoms than their Caucasian counterparts in some studies. Variables hypothesized to contribute to differential levels of PTSD symptoms between African Americans and Caucasians that have not been adequately explored in these studies include ethnicity, resource loss, religious coping, and social support. The purpose of this study was to test portions of a model that characterizes the relationship between traumatic events and PTSD symptoms in African Americans and Caucasians. It was hypothesized that ethnicity, perceived ethnic identity, socioeconomic status (SES), resource loss, religious coping, family support, and professional support would be significant predictors of PTSD symptoms. Data from 59 African American children and adolescents, aged 4 to 20, and 54 of their Caucasian counterparts from the Residential Fire Project were used to examine the role of ethnicity, SES, resource loss, religious coping, family support, and professional support in the development of PTSD symptoms. Data from 86 African Americans and 417 Caucasians, aged 15 to 21 from the National Comorbidity Survey (NCS), were used to examine the role of ethnicity, perceived ethnic identity, SES, religious coping, family support, mental healthcare, and non-mental healthcare in the development of PTSD symptoms. Participants in the Fire Project were interviewed individually, and completed self-report questionnaires. Results indicated that only resource loss factors contributed significantly to the prediction of variance in PTSD symptoms. Participants in the NCS were also interviewed individually. Results indicated that mental healthcare, family support, SES, ethnicity, and religious coping contributed significantly to the prediction of variance in PTSD symptoms in this sample. Findings are discussed within a psychosocial model. / Master of Science

Although the number of rapes in South Africa is increasing, there are limited resources to which women can turn in their time of need. This is especially true with regard to spousal rape. The lack of supportive interventions exacerbates the posttraumatic stress women experience due to rape. In order to address this concern, this research seeks to identify and evaluate, by means of questionnaires, various therapy methods which are utilised by pastoral counsellors as well as secular service providers within South Africa. Both Christian women and women who are not affiliated with the Christian religion who have in some way sought assistance from the church and who have experienced spousal rape related posttraumatic stress are interviewed and the results are utilized to propose an alternative approach to pastoral counselling with persons who suffer from rape-related posttraumatic stress. Gender sensitivity is crucial to this approach. This thesis consists of seven chapters. In Chapter 1, Spousal Rape – a challenge for pastoral counselling, explains the motivation for the thesis and gives the research framework. Chapter 2 explores the phenomenon of rape, considering stranger, acquaintance, and spousal rapes. Chapter 3 develops the phenomenon of traumatic stress, particularly as it relates to spousal rape, and Chapter 4 covers the questionnaires returned, and interviews of spousal rape victims. The relevance of spirituality is covered in Chapter 5, and in Chapter 6, a counselling model is proposed with regard to the counselling of spousal rape victims. Chapter 7 deals with the transformation and emotional healing of these victims. There are ten appendixes connected, some containing information, consent and interview questionnaires used with the participants and the remainder contain information such as the Sexual Offences Bill, and DSM-IV diagnostic criteria as they relate to this thesis. / Thesis (PhD)--University of Pretoria, 2012. / Practical Theology / unrestricted