Tesi sul tema "Post-traumatic stress disorder – Patients Case studies"

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1

Payne, Charmaine. "Breaking the silence : Zanele's journey to recovery". Thesis, Rhodes University, 2007. http://hdl.handle.net/10962/d1007651.

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Abstract (sommario):
This study employed a case-based research design to document the psychological assessment and treatment of Zanele, a 15-year-old black Xhosa speaking female who was raped twice in 2006 by the same perpetrator. The aim of the study was to explore whether, the model for assessment and intervention for posttraumatic stress disorder (PTSD) developed by Ehlers and Clark (2000) was effective and transportable to the South African context. Zanele had a sufficient understanding of English for assessment to proceed without use of an interpreter. She reported a number of PTSD symptoms which were causing her significant distress and had impacted on her social and educational functioning. These included flashbacks of the perpetrator's face when she looked at the faces of black men, nightmares about the traumas she had endured and feeling isolated from others. A number of cognitive techniques were utilised in this study, however the central interventions included working with triggers, imagery rehearsal techniques with a focus on nightmares, and reliving with cognitive restructuring within and outside reliving. Psychoeducation and increasing her social support were also important components of the intervention. Her progress was monitored by means of several self-report measures which were displayed in graphic and tabular form. In addition, a thematically selective narrative of the assessment and first 23 sessions of the intervention was written which documents some of the central processes set in motion by the interventions. These results provide evidence that this model was both effective and transportable to the South African population. In addition, the study demonstrated that it is possible for a white English speaking clinician to work with a black Xhosa speaking individual and make substantial therapeutic gains.
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2

Smith, Tracy-Ann. "Frozen in time to reclaiming one's life: the evaluation of the Ehlers and Clark Cognitive Therapy Model in the assessment and treatment of a hijacking survivor". Thesis, Rhodes University, 2006. http://hdl.handle.net/10962/d1002569.

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Abstract (sommario):
The aim of this research study was achieved by providing support for the effectiveness and the transportability of the Ehlers and Clark (2000) cognitive therapy model for the assessment and treatment of PTSD. Furthermore, the contextual factors which were important in this case were investigated and documented. However, research within the social sciences will inevitably produce various limitations due to the unique individuals and dynamic phenomena that are studied.
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3

Van, der Linde Francois. "Past trauma, anxious future a case-based evaluation of the Ehlers and Clark model for PTSD applied in Africa". Thesis, Rhodes University, 2007. http://hdl.handle.net/10962/d1002584.

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Abstract (sommario):
This research report documents the therapeutic intervention undertaken with a 23-year-old Swazi rape victim. The format of this research report takes the form of a case study that follows the principles proposed by Fishman (2005). Its aim is to document the treatment process of an individual of African decent in order to establish whether the treatment model can be effective in clinical settings and in contexts and cultural settings different from that in which it was developed. The Ehlers and Clark (2000) cognitive therapy model for post-traumatic stress disorder (PTSD) was utilised to assess, conceptualise, and treat the case. The client entered therapy three years after being raped for a third time. The case formulation identified factors maintaining the disorder as well as how other traumatic and abusive events earlier in her life influenced her response to the rapes. Data consisted off audio-tape recordings and detailed written synopses of each assessment and therapy session, psychometric measurement instruments and self-report scales completed throughout the intervention, material written by the client, and a research interview conducted by an independent party. She was treated for PTSD and comorbid depression over a period of five months in accordance with the principles described by Ehlers and Clark and a narrative of the treatment process was written. The case narrative in conjunction with quantitative data suggested that this model assisted the client in initiating a healing process. As such the model was found to be both effective and transportable to an African context. Various points of discussion are highlighted, including the challenges of working with PTSD and comorbid major depression, the client-therapist relationship, and that a client and therapist from different cultures, backgrounds, and with different home languages can work together effectively using the Ehlers and Clark model.
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4

Padmanabhanunni, Anita. "A series of systematic case studies on the treatment of rape-related PTSD in the South African context implications for practice and policy". Thesis, Rhodes University, 2011. http://hdl.handle.net/10962/d1002544.

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Abstract (sommario):
In 2009, South African police statistics revealed that more than 68 332 women were raped in the country. The evidence from independent researchers has shown that SAPS statistics are highly susceptible to under-reporting and the actual figure is more than double this amount. One pervasive feature of the phenomenology of rape is post-traumatic stress disorder (PTSD). PTSD is a highly debilitating condition with severe individual and societal costs. The condition takes a critical toll on occupational functioning, schooling and personal relationships and is associated with depression, suicide risk, self-harming behaviours and alcohol-abuse problems. The Ehlers and Clark (2000) cognitive model represents the most efficacious treatment for PTSD but the approach is severely under-utilised by South African practitioners working with sexual trauma. The reasons for such under-utilisation relate to a lack of exposure and training surrounding the model and concerns about the transportability of the treatment to a multi-cultural context. One method of addressing these barriers to treatment delivery is through systematic case-based research. Systematic case-based research offers a complementary means of refining theory and developing evidence-based practice in the context of a developing country. The method offers an intensive analysis and description of the particular phenomena under study within its real-life context. It allows the researcher to intensively examine and identify the specific aspects of the therapist’s responses and client’s reactions that contributed to significant change. Unlike efficacy studies, generalisability in case-study research is based on replication on a case-by-case basis and the creation of case law. This research study uses a systematic-case study approach to investigate the applicability of the Ehlers and Clark (2000) model in the treatment of rape-related PTSD in South Africa. The study aims to demonstrate the transportability of the model and develop a needed evidence base for service providers in the country. Seven women participated in the project and lent their treatment process to the research. The participants varied in terms of age, race, culture, socio-economic status and the nature of their sexual trauma. Through synoptic thematic analysis of their therapy process specific client-related personal aspects, client-related contextual factors and state-level factors were found to impede treatment delivery and implementation. The implications of these aspects for clinical practice and social policy are comprehensively discussed.
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5

Karpelowsky, Belinda Jodi. "Imagery and the transformation of meaning in psychotherapy for post-traumatic stress disorder: a hermeneutic case study". Thesis, Rhodes University, 2004. http://hdl.handle.net/10962/d1002509.

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Abstract (sommario):
This study discusses the assessment and treatment of a 21-year old male who had suffered multiple traumas, which had culminated in the death of his younger brother. He presented with Acute Stress Disorder. The literature review examines a diverse range of theorists and discourses, that have addressed the psychological consequences of trauma and highlights the complexity of the phenomena involved. The case study, located in the South African context, aims to sensitise the reader to the unique dilemmas facing each trauma survivor, and serves to highlight specifically those areas, which are pertinent and further more contribute significantly to the recovery process. The case narrative consists of a detailed synopsis of the therapy process, extracted from the session record notes documented at the time. Several other sources of information, including contributions from the participant, were used to verify and validate the accuracy of the data included. The narrative is written in a style that conveys the intensity of the nature of trauma work and the manner in which both patient and clinician are frequently confronted with very difficult emotional work. Finally the discussion examines the case narrative through the use of a set of carefully selected hermeneutic questions. These focused on (I) key concepts from the work of Robert Lifton who highlights the existential dimensions of the impact of trauma; (2) the role of the image in encapsulating the complex traumatic and post-traumatic experience of the survivor as well as facilitating the emotional processing of the trauma is examined; (3) the contribution to the process of therapy of aspects of the therapeutic relationship; and (4) the concept of recovery in relation to the question of what constitutes 'trauma work'. In conclusion, several meta-theoretical issues related to trauma, the strengths and weaknesses inherent to the research and relevant future areas of research are highlighted.
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6

Koen, Gary. "Understanding and treating combat-related post traumatic stress disorder: a soldier's story". Thesis, Rhodes University, 1992. http://hdl.handle.net/10962/d1006879.

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Abstract (sommario):
This work documents the treatment of a 20-year-old male suffering from Post Traumatic Stress Disorder as a result of his experience during two years of national service as an Operations "Ops" Medic in the South African Defence Force. The literature review is drawn largely from the body of work emerging from the Vietnam War, and in particular the work of Robert Lifton and Erwin Parson is considered. The case study consists of a detailed synopsis of the treatment based upon material from the therapy sessions. This section hopes to accurately convey the experience of working with someone suffering from Post Traumatic Stress Disorder and provide insight into the dynamics of such a therapeutic relationship. Finally the discussion examines the links between the theory and the treatment and attempts to understand the various factors which shaped and influenced the final outcome of the therapy. Special consideration is given to showing how essentially cognitive restructuring techniques are successfully utilised within a more existential, psychodynamic framework. Furthermore, there is a paucity of literature on the subject of combat-related Post Traumatic Stress Disorder in South Africa and it is hoped that this work will both point to a need for further research in this field whilst simultaneously provide guidance for those who wish to become involved in working with individuals suffering from Post Traumatic Stress Disorder.
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7

Acheson, Kerry. "The phenomenolgoical experience of posttraumatic growth in the context of a traumatic bereavement". Thesis, Rhodes University, 2009. http://hdl.handle.net/10962/d1004456.

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Abstract (sommario):
The present study involves an exploration of the phenomenological expenence of posttraumatic growth in the context of a traumatic bereavement. An idiographic case study of a student who had witnessed her mother's death twelve years previously was conducted. Semi-structured interviews elicited data which was analysed using interpretative phenomenological analysis (IP A). Posttraumatic growth was found to have developed with regards to self-perception, relationships, and also in a broader spiritual and existential domain. The findings of this study shed light on the extant posttraumatic growth literature. In particular, findings were discussed in relation to the posttraumatic growth model as proposed by Calhoun and Tedeschi (2006). As posttraumatic growth is a relatively young concept, further research is needed in order to understand the meaning of reported growth more fully. While posttraumatic growth has been investigated in the context of bereavement, future research should distinguish more clearly between growth following traumatic and non-traumatic bereavement. Posttraumatic growth has received minimal empirical attention in South Africa, and therefore exploration of this area is suggested in the future.
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8

Sebuhoro, Célestin. "Quête de l'identité chez l'adolescent rwandais rescapé du génocide: approche développementale et différentielle". Doctoral thesis, Universite Libre de Bruxelles, 2005. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210928.

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9

Feldmann, Olaf Theodor. "Cue incubation in posttraumatic stress disorder amongst members of the South African Police". Thesis, 2014. http://hdl.handle.net/10210/10266.

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Abstract (sommario):
M.A. (Psychology)
The present study was undertaken in an attempt to understand and ascertain the nature of PTSD in the South African Police leading to chronic illness and work-related dysfunctions as well as to investigate the possibility of triggering events leading to the loss of latency in PTSD. The specific hypothesis for this study was that a significant proportion of members of the SAP who report for medical treatment of stress-related physical or psychological complaints, will show PTSD in conjunction with a triggering stimulus event prior to the manifestations of the first clinical signs of PTSD. The testing of the hypothesis, entailed utilizing an experimental group. consisting of a number of police officers, who had been referred for psychological and/or medical treatment for work-related disorders. None of these subjects had previously been diagnosed with PTSD. A control group was used that consisted of police officers who had not seen active duty in an area where a traumatic stress disorder event could take place. These subjects were subjected to assessment of PTSD by means of the Mississippi Scale for Combat-Related PTSD, and concomitant stress-related events by means of the Life Experiences Survey. Alienation was assessed by the means of the VSVA. Indices of psychophysiological reactivity were obtained by means of galvanic skin response deviation and heart rate deviation to specific stimuli, including neutral stimuli, war-related stimuli and stimuli with political content.
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10

Luther, Roxanne. "An in-depth exploration of the personality structure of adult female psychiatric patients with a history of childhood trauma by utilising personality assessment". Diss., 2019. http://hdl.handle.net/10500/25876.

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Abstract (sommario):
The experience of complex childhood trauma produces a ripple-effect that psychologically impacts trauma survivors’ functioning in multiple areas. The aim of the current study was to investigate and describe the interplay between complex trauma, subsequent personality development and later psychopathology by means of the multiple case study method of six female psychiatric patients attending treatment at a tertiary psychiatric hospital within Gauteng, South Africa. This was accomplished by assessing and qualitatively analysing the results of a carefully selected battery of personality and other psychometric assessments presented to study participants. The results indicated that the experience of complex childhood trauma impacted the study participants’ personality in predictable ways, which further influenced the psychopathology they displayed as psychiatric patients. These findings aid in describing the psychological impact of complex trauma on the research participants, and also offers support for reconnecting past traumas to the current psychopathologies of psychiatric patients.
Psychology
M.A. (Clinical Psychology)
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11

Mashiapata, Matome Jack. "Psycho-educational intervention with students suffering from post-traumatic stress". Diss., 2003. http://hdl.handle.net/10500/1168.

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Abstract (sommario):
Violent crime and trauma are very common within the society and students at the technikon are as exposed to these traumatic situations that characterize the broader national context as anybody. The purpose of this study was to explore therapeutic intervention techniques that can be used by the educational psychologist in assisting students suffering from post-traumatic stress. The phenomena of post-traumatic stress and post-traumatic stress disorder were studied with reference to the DSM IV classification and description. Traumatic events and stressors among students were outlined. A case study was conducted with a subject selected at the technikon who was suffering from post-traumatic stress due to earlier physical abuse and violence she experienced at home. The Trauma-100-Questionnaire was used to investigate the extent of the trauma and the results showed that the subject was involved with negative self-talk and employed ego defence mechanisms. An analysis of the subject's problem was done through the relations theory and various techniques from the literature study were implemented in therapy with the subject.
Educational Studies
M.Ed. (Guidance and Counselling)
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12

Dietrich, Anne Marie. "PTSD and associated features as predictors of revictimization and perpetration with samples of adults abused during childhood". Thesis, 2003. http://hdl.handle.net/2429/15159.

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Abstract (sommario):
Two-hundred and twenty-four participants who reported a history of child abuse trauma were recruited from the internet, clinical (community outpatient) and prison settings and completed a battery of assessment measures, including Briere's Child Maltreatment Interview Schedule (CMIS) (slightly modified), Detailed Assessment of Traumatic Stress (DAPS), Cognitive Distortion Scale (CDS), and Inventory of Altered Self Capacities (IASC); van der Kolk's Self Inventory of Disorders of Extreme Stress (SIDES-SR); Nijenhuis's Somatoform Dissociation Questionnaire (SDQ-20); and a modification of the CMIS to assess for adult victimization experiences (Adult Victimization Survey or AVS; Dietrich, unpublished instrument). It was hypothesized that Posttraumatic Stress Disorder (PTSD), Affect Dysregulation, and Problems with Interpersonal Relatedness would be associated with later revictimization experiences during adulthood with this sample, and that disturbances in ability to regulate self capacities and other complex posttraumatic sequelae would be associated with perpetration of physical or sexual violence during adulthood. Data were analyzed for 207 individuals who reported childhood maltreatment per the CMIS. Results provide partial support for the hypotheses. Women were significantly more likely to report revictimization, and male inmates were significantly more likely to perpetrate against others. Whereas PTSD and Somatoform Dissociation are the strongest dynamic predictors of any sexual or physical revictimization, Impaired Self Capacities are more often associated with revictimization by intimate partners in particular. Trauma-specific dissociation was associated with a decreased risk of revictimization, whereas peritraumatic and trait dissociation did not enter predictive models. Posttraumatic sequelae were not associated with increased risk of physical perpetration with these samples; however, IASC scores were associated with an increased risk of sexual perpetration and victim-based cognitive distortions were associated with decreased odds of sexual violence. These findings provide partial support for the Complex PTSD (Herman, 1992a) construct. Results are discussed in terms of implications for treatment, further study, and classification. Limitations are noted.
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13

Engelbrecht, Gerhardina Cornelia. "Cognitive dissonance in trauma: the conflict between belief, autobiographical memory and overt behaviour". Diss., 2015. http://hdl.handle.net/10500/19956.

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Abstract (sommario):
Text in English
This research was aimed at giving a voice to three women, who are constructed as having had a traumatic event recalled from their autobiographical memory. To achieve this objective an epistemological framework of social constructionism was used to investigate autobiographical memory recall of trauma. Three in-depth interviews were conducted with participants who constructed themselves as having had a traumatic event. A case study approach was used to gain access to the information and to compare themes. The research explored the way in which dissociation, voluntary thought suppression, minimisation and outright denial enabled the three participants to alter unbearable memories through the use of recurring themes. To interpret these stories the content of the themes was analysed using thematic content analysis. The participants represented different cultures, languages and religions. In sharing their symptoms this did not necessarily mean they attached the same meaning to a specific theme, as individual meaning-making corresponded to the individual‟s background and history and their perception of the trauma. The stories related by the three participants revealed a shattered worldview that brought them into opposition with community norms and standards, which the narrators experienced as silencing and judgemental. In this regard the researcher‟s aim was to generate information from the participants themselves. This inquiry into the personal trauma stories and meanings suited a qualitative research approach, a form of methodology that allowed personal insight into the meanings the three participants attributed to their trauma and the autobiographical recall of trauma. At the same time it allowed a co-constructed reality to take shape between the researcher‟s reality and the participant‟s reality, always acknowledging the importance of their being the expert of their own individual trauma memory. This is in contrast to a quantitative approach which focuses on numbers to quantify the results; a qualitative approach on the other hand is a personal, rich information-gathering tool that takes into account the emotions and meaning-making of each individual story without any intention to generalise the information gathered to a larger population It is hoped that through this research there is a realisation that although trauma victims share symptoms, the meaning-making of the individual attached to this trauma is influenced by their society and history within their respective environments.
Psychology
M.A. (Psychology)
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14

Bukman, Marie-Jeanne. "The development of a new identity through the process of bereavement counselling : a qualitative study". Thesis, 2017. http://hdl.handle.net/10500/22649.

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Abstract (sommario):
The purpose of this qualitative study is to explore how narrative therapy may facilitate not only a lessening of distressing symptoms for bereaved persons, but may also facilitate growth in identity. Five case studies are presented. The participants were chosen to illuminate different grief experiences. The case studies include a description of grieving people from different backgrounds, each with a unique relationship with the person or people who died, all of whom had different causes of death such as suicide, murder and natural causes. These differences provide an opportunity to explore the application of the therapy model with a range of grief experiences. A full and rich description of the experiences of the participants yield insight into the shared themes such as the impact of social expectations of how a grieving person should conduct him or herself, difficult physical and emotional experiences, the many losses flowing from the death, as well as an in-depth discussion of the identity growth that takes place as the bereaved person takes on different roles and tasks. Postmodern epistemology and social constructivism informed the praxis and interpretation of narrative therapy as bereavement model. Narrative therapy is shown as especially effective for grief therapy with therapeutic tenets such as deconstructing and creating richer narratives and alternative stories that enables the bereaved to explore diverse aspects of their character. The emphasis on what remains rather than what is lost, and the concept of remembering the loved one who died in the community of those who stay behind, transmute the loss-story to one of remembering and incorporating, which tends to bring significant emotional relief. This study contributes towards the field of growth through bereavement for which there seems to be a paucity in research. Furthermore, it provides additional evidence for post-traumatic growth in general, especially with the assistance of narrative therapy.
Psychology
Ph. D. (Psychology)
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15

Smith, Soraya. "The circularity of trauma-addiction-trauma". Diss., 2016. http://hdl.handle.net/10500/21612.

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Abstract (sommario):
Text in English
The rationale for the study was to investigate the symbiotic connection of trauma and addiction. The focus is on childhood trauma and the turn to addictive practices to quell the memories and experiences endured as children. Chapter One discusses the methodology regarding the approach of the study and includes an introductory literature review of the phenomena. Additional literature is included in the ensuing chapters. A personal account of the motivation behind the research is chronicled in Chapter Two. In this chapter, I share with the readers my personal experiences around trauma and addiction in my family of origin. The notion of the blending of trauma and addiction is the focus of Chapter Three. It includes the approach to treatment of trauma and addiction as well as addiction counsellor training in the South African context. The storied lives of the participants and their experiences of trauma and addiction are encapsulated in Chapter Four. Finally, Chapter Five rounds off the study with the analyses of the narratives of the unique individuals who contributed to this research undertaking.
Psychology
M.A. (Psychology)
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16

Van, der Merwe Susanna Johanna. "Herdefiniering van identiteit as 'n proses van wording tydens die adolessent se verlies van 'n geliefde". Thesis, 2010. http://hdl.handle.net/10500/4048.

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Abstract (sommario):
Text in Afrikaans
This study is aimed at the development of strategies for therapists to be used with adolescents and late adolescents (15 to 20 years of age) who have lost a loved one. This will be done by focussing on the redefining of identity as a way of becoming. The starting point of the study is to be found in the problem formulation that the process of becoming of adolescents who have suffered the loss of a loved one, may be blocked because they do not have the necessary skills to overcome the loss. The second problem is that therapists do not have the necessary skills to empower these adolescents so that the redefining of identity can be achieved.
Social work
D. Diac. (Spelterapie)
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17

Pretorius, Suzanne. "'n Behoeftebepaling vir emosionele ondersteuning aan die adolessent met 'n terminaal siek ouer". Diss., 2007. http://hdl.handle.net/10500/1634.

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Abstract (sommario):
This study was undertaken as a qualitative needs assessment of emotional support to the adolescent with a terminally ill parent. Five participants in their adolescent life phase (14 to 18 years) with a terminally ill parent, participated in the study. Individual unstructured interviews were conducted with each participant, in order to assess their need for emotional support. With the consent of the parents and adolescents, the interviews were video-recorded and transcribed. Eight recurring themes were selected from the case studies and verified with the existing literature. The result of the study is the assessment of the need for emotional support to the adolescent with a terminally ill parent.
Social Work
M. Diac (Play Therapy)(Social Work)
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