Background Individually both migraine and post-traumatic stress disorder (PTSD) prevalence estimates are higher among women. However, there is limited data on the association of migraine and PTSD in women during pregnancy. Methods We examined the association between migraine and PTSD among women attending prenatal clinics in Peru. Migraine was characterized using the International Classification of Headache Disorders (ICHD)-III beta criteria. PTSD was assessed using the PTSD Checklist-Civilian Version (PCL-C). Multivariable logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (CI) after adjusting for confounders. Results Of the 2922 pregnant women included, 33.5% fulfilled criteria for any migraine (migraine 12.5%; probable migraine 21.0%) and 37.4% fulfilled PTSD criteria. Even when controlling for depression, women with any migraine had almost a 2-fold increased odds of PTSD (OR: 1.97; 95% CI: 1.64–2.37) as compared to women without migraine. Specifically, women with migraine alone (i.e. excluding probable migraine) had a 2.85-fold increased odds of PTSD (95% CI: 2.18–3.74), and women with probable migraine alone had a 1.61-fold increased odds of PTSD (95% CI: 1.30–1.99) as compared to those without migraine, even after controlling for depression. In those women with both migraine and comorbid depression, the odds of PTSD in all migraine categories were even further increased as compared to those women without migraine. Conclusion In a cohort of pregnant women, irrespective of the presence or absence of depression, the odds of PTSD is increased in those with migraine. Our findings suggest the importance of screening for PTSD, specifically in pregnant women with migraine.

This research involved the holistic, individualized treatment of patients with post traumatic stress disorder (PTSD), employing homoeopathic medicine. Post traumatic stress disorder can lead to a variety of complications which may diminish or destroy interpersonal relationships, may handicap the patient occupationally or recreationally, or may lead to substance abuse. Research has indicated that patients with PTSD are more likely to have a personality disorder; a previous history of depression, abuse or substance abuse or a family history of psychopathology. Given this, it is presumed that PTSD can occur in anyone who has experienced trauma and sufficient stress. In order to reduce post traumatic stress severity, treatment should emphasise and acknowledge that mental, emotional, behavioural and social factors contribute to trauma. This study involved ten patients (plus two additional) who participated in five homoeopathic consultations, over a period of four months. The appropriate homoeopathic remedy, or similimum, was determined using each patient’s distinguishing mental, emotional and physical symptoms. Each participant completed the Researcher’s Questionnaire at each consultation and recorded their stress episodes on a calendar to be handed in at each follow-up appointment. These results, together with holistic progress as noted by the researcher at every consultation, were used to determine the efficacy of homoeopathy on post traumatic stress disorder. The intent of the research was to prove that treatment should be specific and individualistic, irrespective of the diagnosis. This study aimed to provide a holistic therapy for PTSD and the results indicated that the similimum treatment in sufferers of post traumatic stress disorder was effective in reducing post traumatic stress frequency, severity, and intensity. Moreover, improvement in mental and emotional wellbeing, sleep patterns, appetite, and energy levels were noted in all the patients. / Dr. R. Mistry Dr. A. Fourie

D. Litt. et Phil. / This research focuses on the development of a short term action centered clinical personological treatment programme for adult emergency rescue workers who developed secondary traumatic stress disorder (STSD)/compassion fatigue and co-morbid symptoms of burnout as a result of exposure to critical incidents. A programme, comprising three sessions, was developed incorporating previously tested cognitive behavioural techniques with clinical personological theory as well as newly developed behavioural techniques tailored to the cross cultural South African context. The need for the study arose out of the lack of scientific validated data regarding the treatment of STSD/compassion fatigue among emergency rescue workers as well as the need for a cost-effective treatment programme that would address the serious need of emergency rescue workers in South Africa who for the most part need to make do without any employee wellbeing programmes. The effects of STSD/compassion fatigue are often as debilitating as that of PTSD. It hampers the sufferer unable to operate as well as they previously did. As a result they may present with lower productivity at work as well as various psycho-social problems and be at risk of substance abuse. This ultimately has a negative impact on the victims of trauma they are responsible for rescuing. Various theoretical models are discussed on the etiology of STSD/compassion fatigue, including the constructivist development al theory by McCann and Pearlman (1990) as well as Valent’s (2003) bio-social theory on survival strategies. Treatment approaches are investigated and critiqued, including, the accelerated recovery program (ARP) as developed by Gentry, Baranowsky and Dunning (2003) under the direction of Figley (2003) for the treatment and prevention of compassion fatigue, critical incident stress debriefing as first formally described by Mitchell in 1983 for the treatment of acute traumatic stress reactions, as well as Saakvitne and Pearlman’s (1992) constructivist self-developmental treatment program for vicarious traumatization, based on the constructivist self development al theory developed by McCann and Pearlman (1990). The theories and therapies underlying the intervention programme include various cognitive behavioural and personological principles to offer a person specific practical solutions for their personality type and psychological needs. The hypotheses were formulated with regard to significant improvement of symptoms of STSD/compassion fatigue as result of the intervention programme. The co-morbid symptoms of burnout are also evaluated for a decrease, without significantly reducing their capacity for compassion satisfaction. A test re- test quasi-experimental analysis with two independent groups was required, in order to determine whether there will be a statistically meaning full reduction in the prevalence of symptoms of secondary traumatic stress disorder (STSD)/compassion fatigue and the co-morbid symptoms of burnout amongst emergency rescue staff who had been instructed in an Action Centred Personological Treatment Plan. In an effort to attain spatial and temporal control a sample population was selected with a cluster sampling method from the greater Gauteng emergency rescue staff. They included paramedics, fire fighters and ambulance staff. The specific municipality had been incorporated into a greater Gauteng metropolis in the past two years. Potential subjects for both the experimental and control group were obtained through drawing personnel files, using random sampling. A sample of 17 participants was included in the intervention group and 17 participants were included in a non-intervention group. This was representative of 80% of the total population group of emergency rescue staff in this particular municipality. Existing psychometric assessment instruments were utilised to generate data for the experimental analysis. The measurement instruments included, the Millon inventory of personality styles (MIPS) to customise a cognitive behavioural treatment programme, the Compassion fatigue and satisfaction questionnaire to verify symptoms of STSD/compassion fatigue and burnout, and the British Columbia burnout questionnaire to confirm symptoms of burnout. The quantitative data was supported by information gathered from a clinical social history questionnaire. This information was used as part of the discussion of the results as a means to enhance the former descriptive results. The action centred personological treatment programme proved to be effective in the treatment of symptoms of STSD/compassion fatigue and burnout without significantly reducing the candidates’ potential for compassion satisfaction.

M.A. / One of the most perturbing factors of South Africa's communal existence is the high rates of violent crime and the high incidence of Post-Traumatic Stress Disorder JPTSD) amongst all communities. Crime-related PTSD is a problem of epidemic proportions. Therapeutic and mental health services for trauma related counselling are limited and in some communities non-existent. It is therefor essential to develop preventative programmes aimed at equipping individuals with the skills to avoid possible trauma-inducing situations such as vehicle hijacking. It was decided to utilise a vehicle hijacking management and -prevention programme developed especially for the purposes of a "short course" intervention approach. The experimental intervention was performed to provide skill and increase levels of personal competence in handling, or, ideally, avoiding a hijacking. A sample group of 35 was selected out of a white upper middle-class, middle aged population. The subjects were exposed to the intervention. The results indicated that the intervention produced significant positive change in self-efficacy beliefs in the experimental groups. Possible limitations of the study were sample sizes and the inherent nature of the groups. It was not possible to examine the relationship between sex and efficacy beliefs. No non-whites subjects were utilised and thus the relationship between race and efficacy beliefs was also not examined. It is recommended that the intervention programme be refined further and validated scientifically in order to be utilised in future research.

M.A. / This study was conducted in light of several feminist texts that have critiqued the diagnostic criteria for posttraumatic stress disorder in the DSM-IV-TR. These texts have argued that the current criteria, particularly Criterion A, are gender-biased and exclude many of the kinds of life events that are unique to women. This study sought to conduct an in-depth exploration of life events that do not meet the DSM-IV-TR‟s Criterion A but that nevertheless precipitated all of the other manifestations of PTSD. For the purpose of this study, two gender-specific traumatic events were selected, namely childbirth and miscarriage or stillbirth. A feminist and phenomenological approach was taken and the study was formulated as a critique of the DSM-IV-TR diagnostic criteria of PTSD. The research question was formulated as follows: Should the Criterion A definition of a traumatic event be expanded to include any experience that an individual defines as traumatic? A semi-structured interview was conducted with three participants complying with the specific population criteria. The interviews were transcribed and analysed through qualitative data analysis processes. The research methodology and analysis processes needed to be adapted due to the phenomenological nature of the research study. A comparison between the symptoms presented by the participants and the diagnostic criteria of PTSD, revealed that all three participants complied with all the DSM-IV-TR criteria except for Criterion A(1) and therefore could not be formally diagnosed with PTSD. It was also revealed that the women‟s experiences and reactions to the traumatic events were very similar, especially the fear caused due to feeling out of control. Therefore it was concluded that the essence of the traumatic experience was loss of control. The research question was positively answered, because it was concluded that each individual experiences events differently due to internal perceptions and the individualised meanings which are allocated to the event. Therefore the Criterion A definition of a traumatic event should be expanded to include any experience that an individual defines as traumatic.

Child-centred play therapy is not the preferred treatment approach for Posttraumatic Stress Disorder (PTSD), because of the limited research demonstrating this treatment as a proper approach for childhood trauma. The purpose of this case study was to explore and describe the process of child-centred therapy with a four-year-old child with PTSD. An exploratory descriptive case study approach was utilised as it allowed for an in-depth description of a phenomenon in its therapeutic context. Data was collected through multiple sources to establish a comprehensive database. The data was analysed through Alexander’s content analysis and Guba’s model of trustworthiness. Findings included themes observed in the research participant dealing with PTSD of perfectionism, control, shame, mistrust, needing control, and perfectionism. The therapist’s application of Axline’s principles indicated these principles being enough for treating PTSD in a child. Some of those principles had immediate impact while others were cumulative in their effect.

This qualitative study, with elements of co-operative enquiry and phenomenology, endeavoured to describe the impact of rape on the occupations of women who have been raped. Data were gathered from participants who were clients at Rape Crisis, Observatory, through 4 unstructured focus groups and analyses to explore changes in their occupations. What emerged was that the participants were all dissatisfied with their occupations. The overwhelming impact of symptoms of Post Traumatic Stress Disorder (PTSD) on all their occupations was discussed. A dynamic between Person, Occupation and Environment impacted on the occupational engagement and avoidance by the participant. Recommendations for the rape survivors, service providers and family members were made.

Thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in the Department of Psychology, Faculty of Arts at the University of Zululand, South Africa, 2012. / This qualitative study investigated the prevalence of post-traumatic stress disorder within the mining industry. It further reviewed systems used to manage the same disorder following a disastrous mining accident in the Slater Coal Mines. There are key challenges that were reviewed as part of improving diagnosis and management of post-traumatic stress disorder. Two focus groups consisting of six African mineworkers, working in the Slater Coal Mines, were conducted. All participants were isiZulu speakers. The data was analysed using grounded theory, which is a qualitative technique. In using this data analysis technique, data labelling, open coding, axial coding and selective coding were the steps that were followed as a guide. Research findings indicated that post-traumatic stress disorder is prevalent within the mining industry and differs from post-traumatic stress. Existence of post-traumatic stress disorder was represented by symptoms such as intrusive thoughts, avoidant behaviours and terror. Further, causes of mining accidents and accident management measures were the findings. Different work conditions were implicated in the study as contributing to trauma in the mines in addition to accidents that happen underground.

Perinatal mood disorders such as postpartum depression and postpartum posttraumatic stress disorder are an area of growing concern. There have been few studies regarding ways to identify women at risk of developing these disorders in the antepartum period. During the antepartum period, women attend prenatal appointments with their provider to assess the health of their pregnancy. This period is ideal to administer emotional health questionnaires to identify if patients may be at risk of developing postpartum mood disorders. The aim of this study was to identify if there are differences on antepartum emotional health questionnaire scores between women who have postpartum mood disorders, and those who do not. The data come from 19 women undergoing scheduled cesarean deliveries at Boston Medical Center. The questionnaires collected information about stress, depression, anxiety, and symptoms of postpartum depression and posttraumatic stress disorder. We compared the scores of the women who had postpartum depression and postpartum posttraumatic stress disorder to the women who did not, to examine if the scores in the antepartum period correlated with postpartum mood disorders. We did not find any differences between the postpartum depression group, but did find a difference on one questionnaire between the postpartum posttraumatic stress disorder group. Within our cohort, we found similar incidences of postpartum depression, postpartum posttraumatic stress disorder, and self-harm/suicidal ideations compared to national incidences. Future studies should include more participants and a more heterogenous cohort as it pertains to cesarean delivery type, indication for cesarean delivery, intrapartum events, and histories of depression, anxiety, posttraumatic stress disorder, and other mood disorders. Although we only found a difference on one questionnaire for one of the postpartum mood disorders, future studies should prioritize the antepartum period as a time to identify and address concerns of postpartum mood disorders.

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