1
|
Sanchez M, Fouques D, Gorgiard C, Soussy A, Romo L. Intimate Partner Sexual Violence: An Exploratory Study on Sexual Victimization Profiles Among Survivors of Intimate Partner Violence in France. Violence Against Women 2024; 30:1731-1759. [PMID: 38477712 DOI: 10.1177/10778012241238241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Intimate partner sexual violence (IPSV) is a common form of intimate partner violence (IPV). This study aimed to (a) identify a typology of intimate partner sexual victimization among French women victims of IPV on the basis of the frequency of various forms of sexual violence and (b) evaluate whether these profiles differ in several clinical characteristics. A total of 93 women consulting a specialized hospital service were recruited. Cluster analyses suggested four profiles: highly frequent rapes (5.4%), predominant sexual coercion (20.4%), medium frequency of all forms (20.4%), and low frequency of all forms (19.4%). Further person-centered research focusing on IPSV is warranted.
Collapse
Affiliation(s)
| | - Damien Fouques
- Laboratoire Psychopathologie et Processus de Changement, ED 224, Université Paris 8 Vincennes-Saint-Denis, Saint-Denis, France
| | | | - Annie Soussy
- Unité Médico-Judiciaire, Hôpital Intercommunal de Créteil, Créteil, France
| | - Lucia Romo
- Unité de Recherche CLIPSYD, Université Paris Nanterre, Nanterre, France
| |
Collapse
|
2
|
O'Donald F, Gunter E, Castle A, Warner R, Moore F. An evaluation of survive and thrive: a 10-week group psychoeducational course for adult interpersonal trauma survivors in Scotland. Cogn Behav Ther 2024:1-18. [PMID: 38525889 DOI: 10.1080/16506073.2024.2333961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/18/2024] [Indexed: 03/26/2024]
Abstract
Emerging evidence supports a phased approach to trauma treatment, including manualised group-based interventions, to facilitate symptom reduction resulting from complex trauma sequelae. This study investigates the efficacy of Survive and Thrive, a 10-week group psychoeducational course for adult survivors of interpersonal trauma. Between August 2019 and February 2022, participants were enrolled on the course. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) and Difficulties in Emotion Regulation Scale-Short Form (DERS-SF) were administered pre-intervention and immediately post-intervention. In addition, thematic analysis was applied to qualitative feedback. Results revealed significant reductions in CORE-OM and DERS-SF scores post-intervention, with minimal variability in scores attributed to group delivery (either face-to-face or online). The thematic analysis demonstrated that normalising trauma symptoms and providing coping skills positively impacted participants' experiences. At the same time, the breadth and nature of the content were observed to be an occasional barrier to engagement. In summary, this study proposes that group-based psychoeducational interventions are generally effective for those with mild-to-moderate symptoms of complex trauma. However, further evidence is needed to offer more nuanced recommendations for identifying individuals who may benefit the most from these interventions.
Collapse
Affiliation(s)
- Frederick O'Donald
- Department of Clinical Psychology, NHS Tayside, Dundee, Scotland
- School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland
| | - Elise Gunter
- Department of Clinical Psychology, NHS Tayside, Dundee, Scotland
| | - Ailie Castle
- Department of Clinical Psychology, NHS Tayside, Dundee, Scotland
| | - Rachel Warner
- Department of Clinical Psychology, NHS Tayside, Dundee, Scotland
| | - Fhionna Moore
- Department of Clinical Psychology, NHS Tayside, Dundee, Scotland
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| |
Collapse
|
3
|
Chen S, Yin Y, Zhang Y, Jiang W, Hou Z, Yuan Y. Childhood abuse influences clinical features of major depressive disorder by modulating the functional network of the right amygdala subregions. Asian J Psychiatr 2024; 93:103946. [PMID: 38330856 DOI: 10.1016/j.ajp.2024.103946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/16/2024] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
Childhood trauma and the amygdala play essential roles in major depressive disorder (MDD) mechanisms. However, the neurobiological mechanism among them remains unclear. Therefore, we explored the relationship among the amygdala subregion's abnormal functional connectivity (FC), clinical features, and childhood trauma in MDD. We obtained resting-state functional magnetic resonance imaging (fMRI) in 115 MDD patients and 91 well-matched healthy controls (HC). Amygdala subregions were defined according to the Human Brainnetome Atlas. The case vs. control difference in FCs was extracted. After controlling for age, sex, and education years, the mediations between the detected abnormal FCs and clinical features were analyzed, including the onset age of MDD and the Hamilton Depression Scale-24 (HAMD-24) reductive rate. Compared with HC subjects, we found, only the right amygdala subregions, namely the right medial amygdala (mAmyg.R) and the right lateral amygdala (lAmyg.R), showed a significant decrease in whole-brain FCs in MDD patients. Only childhood abuse experiences were significantly associated with amygdala subregion connectivity and clinical features in MDD patients. Additionally, The FCs between the mAmyg.R and extensive frontal, temporal, and subcortical regions mediated between the early life abuses and disease onset or treatment outcome. The findings indicate that the abnormal connectivity of the right amygdala subregions is involved in MDD's pathogenesis and clinical characteristics.
Collapse
Affiliation(s)
- Suzhen Chen
- Department of Psychosomatics, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yingying Yin
- Department of Psychosomatics, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yuqun Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenhao Jiang
- Department of Psychosomatics, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhenghua Hou
- Department of Psychosomatics, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatics, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China; Jiangsu Provincial Key Laboratory of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
| |
Collapse
|
4
|
Leiva-Bianchi M, Nvo-Fernandez M, Villacura-Herrera C, Miño-Reyes V, Parra Varela N. What are the predictive variables that increase the risk of developing a complex trauma? A meta-analysis. J Affect Disord 2023; 343:153-165. [PMID: 37802323 DOI: 10.1016/j.jad.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/08/2023] [Accepted: 10/02/2023] [Indexed: 10/08/2023]
Abstract
In 2018, Complex Post Traumatic Stress Disorder (CPTSD) was officially recognized as a distinct syndrome in the International Classification of Diseases, 11th Revision (ICD-11). This recognition aimed to differentiate between neurotic disorders secondary to stressful situations and somatoform disorders, and disorders specifically associated with stress. The inclusion of CPTSD in the ICD-11 marked the culmination of two decades of research focused on understanding its symptoms, treatments, and risk factors. However, despite the progress made, a comprehensive meta-analysis to elucidate the specific risk factors and impact on the development of CPTSD is still lacking. The objective of this article is to conduct such a meta-analysis. A total of 24 studies were selected for analysis, and the findings revealed several key risk factors associated with the development of CPTSD. The main risk factor identified is having experienced sexual abuse in childhood (k = 12; OR = 2.880). In addition, childhood physical abuse (k = 11; OR = 2.841), experiencing emotional neglect during childhood (k = 5; OR = 2.510), physical abuse throughout life (k = 8; OR = 2.149) and being a woman (k = 13; OR = 1.726) were also significant risk factors.
Collapse
Affiliation(s)
- Marcelo Leiva-Bianchi
- Laboratory of Methodology, Behavioural Sciences and Neuroscience, Faculty of Psychology, Universidad de Talca, Chile
| | - Marcelo Nvo-Fernandez
- Laboratory of Methodology, Behavioural Sciences and Neuroscience, Faculty of Psychology, Universidad de Talca, Chile.
| | - César Villacura-Herrera
- Laboratory of Methodology, Behavioural Sciences and Neuroscience, Faculty of Psychology, Universidad de Talca, Chile; Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Chile
| | - Valentina Miño-Reyes
- Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Chile
| | - Nicol Parra Varela
- Laboratory of Methodology, Behavioural Sciences and Neuroscience, Faculty of Psychology, Universidad de Talca, Chile
| |
Collapse
|
5
|
Ng ASY, Chan WS. Sleep Quality, Sleep-Related Experiences, and Dissociation in Adult Survivors of Childhood Trauma. Behav Sleep Med 2023; 21:659-670. [PMID: 36409021 DOI: 10.1080/15402002.2022.2148669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Exposure to traumatic stress in childhood increases the risk of sleep disturbances. Preliminary evidence suggests that the relationship between childhood trauma and sleep may depend on trauma chronicity. Additionally, little is known about the relationship between sleep and dissociation, a common symptom in post-traumatic stress disorder. This study examined sleep quality, sleep-related experiences, and dissociation in survivors of childhood trauma with different trauma chronicity. METHOD Nine-hundred-and-fourteen community-dwelling adults completed an online survey. They were divided into three groups: no childhood trauma, short-term childhood trauma, and chronic childhood trauma. RESULTS We found that survivors of chronic childhood trauma had poorer sleep quality than survivors of short-term childhood trauma and individuals without a history of childhood trauma, controlling for age, number of trauma types experienced, psychological distress, and PTSD symptoms. The relationship between dissociation and sleep quality was moderated by trauma chronicity such that dissociation was associated with better sleep quality only in the chronic trauma group. Dissociation was positively associated with sleep-related experiences regardless of trauma exposure and trauma chronicity. CONCLUSION Our findings highlighted the differential impact of acute and chronic traumatic stress on sleep, and suggested that the relationship between dissociation and sleep could depend on trauma chronicity.
Collapse
Affiliation(s)
- Albe S Y Ng
- Department of Psychology, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Wai Sze Chan
- Department of Psychology, University of Hong Kong, Pok Fu Lam, Hong Kong
| |
Collapse
|
6
|
Chiu HTS, Alberici A, Claxton J, Meiser-Stedman R. The prevalence, latent structure and psychosocial and cognitive correlates of complex post-traumatic stress disorder in an adolescent community sample. J Affect Disord 2023; 340:482-489. [PMID: 37573893 DOI: 10.1016/j.jad.2023.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/21/2023] [Accepted: 08/04/2023] [Indexed: 08/15/2023]
Abstract
Complex PTSD has received growing attention in recent years. However, the validity, prevalence and risk factors of this diagnosis remain unclear. This study examined PTSD presentations in adolescents using diagnostic criteria and latent class analysis (LCA). It then explored the role of demographics factors, trauma history factors, psychopathology factors and cognitive factors in predicting different PTSD presentations. A cross-sectional data comprising self-report measures of 342 community adolescents (12-15 years) were collected and analysed. 2.3 %, 5.6 % and 10 % of adolescents met the criteria for PTSD, CPTSD and disturbances in self-organisation (DSO) respectively. A three-class model (healthy class, CPTSD class and DSO class) were generated from LCA. Adolescents with CPTSD were most likely to be female and endorsed the most overall trauma types, interpersonal trauma types, depression, anxiety and maladaptive cognitive processes, followed by adolescents with DSO and subsequently healthy adolescents. CPTSD appeared to be a more common presentation than PTSD among community adolescents. The relatively high prevalence of DSO is noteworthy and suggests that DSO is not necessarily accompanied by PTSD. Given the strong associations between CPTSD and cognitive processes implicated in PTSD, CPTSD as a construct might be conceptually similar to PTSD.
Collapse
Affiliation(s)
- Henry Tak Shing Chiu
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
| | - Alice Alberici
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Jade Claxton
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| |
Collapse
|
7
|
Suomi A, Bolton A, Pasalich D. The Prevalence of Post-Traumatic Stress Disorder in Birth Parents in Child Protection Services: Systematic Review and Meta-analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:1032-1046. [PMID: 34736361 DOI: 10.1177/15248380211048444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Birth parents of children in the statutory child protection system have disproportionally high rates of trauma exposure and mental health problems, however, little is known about the extent to which this population display symptoms of Post-Traumatic Stress Disorder (PTSD) or Complex PTSD. This study provides a systematic review and meta-analysis of the PTSD rates in parent samples involved in the child protection services. METHOD Articles were identified by searching PSYCINFO, Medline, CINAHL, and PILOTS. The search included terminology pertaining to parents, trauma, and child protective services and we included all peer-reviewed articles that reported a valid measure of PTSD and child protection service involvement. RESULTS Fifteen studies were included in the review with a combined prevalence estimate for PTSD based on 11 studies (n = 4871) was 26.0% (95% CI 20.0-32.0%) for mothers, and estimate based on three studies (n = 2606) was 13.0% (95% CI 7.0%-18.0%) for fathers and 23.0% (95% CI 17.0-29.0) for all parents based on 7848 responses. Four studies that did not report prevalence rates, reported sample mean scores for PTSD that were consistently higher than in general population. Factors associated with parents' PTSD symptoms included mental health co-morbidities, victimization of physical and sexual violence, and perpetration of child abuse. CONCLUSION There are high rates of PTSD in parents involved in the protective system, thus more targeted efforts are needed to identify and adequately address trauma symptoms of parents as part of child protection interventions.
Collapse
Affiliation(s)
- Aino Suomi
- Institute of Child Protection Studies, 95359Australian Catholic University, Canberra, VIC, Australia
- Research School of Population Health, 2219Australian National University, Canberra, ACT, Australia
| | - Annalese Bolton
- Matilda Centre, University of Sydney, Sydney, NSW, Australia
- Forensic Psychology Clinic, 7800University of New South Wales, Sydney, NSW, Australia
| | - Dave Pasalich
- Research School of Psychology, 2219Australian National University, Canberra, ACT, Australia
| |
Collapse
|
8
|
Jongedijk RA, Boelen PA, Knipscheer JW, Kleber RJ. Unity or Anarchy? A Historical Search for the Psychological Consequences of Psychotrauma. REVIEW OF GENERAL PSYCHOLOGY 2023. [DOI: 10.1177/10892680231153096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The field of traumatic stress is often referred to as being in a state of controversy and lack of continuity. Throughout history, disputes repeatedly centered on defining the psychological consequences of severe adverse events and on their causes. Even to this day this is current. To understand these controversies, an extensive historical literature review is presented of how mental consequences of trauma have been described in history, of the circumstances in which this took place, and of the disputes that have influenced the conceptualization of these mental responses. We found psychotrauma always being surrounded by controversy. Significant heterogeneity in symptom expression has been described over the centuries to this day. Some symptoms appeared steadily over many decades, but often each time period showed its own core symptoms. At syndrome level, we found an acute condition, one with longer duration, and a complex condition. Also here, definitions varied over the decades. Finally, causes have always been debated, such as biological, psychological, socio-economic, cultural, political, or legal. To better reflect the described ongoing variation in symptomatology, a more flexible diagnostic approach is proposed with a combination of both staging and subtyping that offers room for a more flexible, symptom-oriented, and personalized perspective.
Collapse
Affiliation(s)
- Ruud A. Jongedijk
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
- ARQ Centrum’45, Oegstgeest, The Netherlands
| | - Paul A. Boelen
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
- ARQ Centrum’45, Oegstgeest, The Netherlands
| | - Jeroen W. Knipscheer
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
- ARQ Centrum’45, Oegstgeest, The Netherlands
| | - Rolf J. Kleber
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| |
Collapse
|
9
|
Pires R, Ferreira AS, Paulino M, Marques JG, Henriques-Calado J, Gonçalves B. The Self-Administered Version of the Structured Interview for Disorders of Extreme Stress (SIDES-SR) in a Clinical and Non-Clinical Portuguese Sample. Behav Sci (Basel) 2022; 12:bs12120468. [PMID: 36546951 PMCID: PMC9774498 DOI: 10.3390/bs12120468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/04/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022] Open
Abstract
Disorders of Extreme Stress Not Otherwise Specified (DESNOS) refers to a constellation of symptoms deriving from chronic interpersonal trauma, inflicted by caregivers or in the context of intimate relationships. The Structured Interview for Disorders of Extreme Stress-Self-Report (SIDES-SR) was designed for the assessment of DESNOS. This study aimed to validate the Portuguese version of the SIDES-SR in the community (N = 814; Mage = 40.09, SD = 14.25, 39.2% male, 60.8% female) and clinical (N = 310; Mage = 42.49, SD = 12.47, 57.7% male, 42.3% female) samples. It had three objectives: (1) to validate the SIDES-SR rationally derived domains in the community sample; (2) to characterise the reliability of the SIDES-SR scales in both samples; and (3) to explore mean differences in the SIDES-SR results in both samples. The Portuguese SIDES-SR confirmed the six clinical domains of DESNOS and demonstrated acceptable internal consistency levels, similar to those obtained in prior research. Highly significant differences and large and very large effect sizes between the community and clinical samples were found for all the SIDES-SR domains. DESNOS symptomatology was shown to be more frequent in females and the clinical sample reported a higher frequency of traumatic events in life, specifically interpersonal trauma. The results support the relevance of the SIDES-SR for clinical practice in the assessment of the DESNOS diagnosis.
Collapse
Affiliation(s)
- Rute Pires
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal
- Correspondence:
| | - Ana Sousa Ferreira
- Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal
- Business Research Unit, Instituto Universitário de Lisboa (ISCTE-IUL), Av. das Forças Armadas, 1649-026 Lisboa, Portugal
| | - Marco Paulino
- Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal
- Faculdade de Medicina, Clínica Universitária de Psiquiatria e Psicologia Médica, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - João Gama Marques
- Faculdade de Medicina, Clínica Universitária de Psiquiatria e Psicologia Médica, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
- Consulta de Esquizofrenia Resistente, Hospital Júlio de Matos, Centro Hospitalar Psiquiátrico de Lisboa, Av. do Brasil, 53, 1749-002 Lisboa, Portugal
| | - Joana Henriques-Calado
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal
| | - Bruno Gonçalves
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal
| |
Collapse
|
10
|
Reed GM, First MB, Billieux J, Cloitre M, Briken P, Achab S, Brewin CR, King DL, Kraus SW, Bryant RA. Emerging experience with selected new categories in the ICD-11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. World Psychiatry 2022; 21:189-213. [PMID: 35524599 PMCID: PMC9077619 DOI: 10.1002/wps.20960] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Among the important changes in the ICD-11 is the addition of 21 new mental disorders. New categories are typically proposed to: a) improve the usefulness of morbidity statistics; b) facilitate recognition of a clinically important but poorly classified mental disorder in order to provide appropriate management; and c) stimulate research into more effective treatments. Given the major implications for the field and for World Health Organization (WHO) member states, it is important to examine the impact of these new categories during the early phase of the ICD-11 implementation. This paper focuses on four disorders: complex post-traumatic stress disorder, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. These categories were selected because they have been the focus of considerable activity and/or controversy and because their inclusion in the ICD-11 represents a different decision than was made for the DSM-5. The lead authors invited experts on each of these disorders to provide insight into why it was considered important to add it to the ICD-11, implications for care of not having that diagnostic category, important controversies about adding the disorder, and a review of the evidence generated and other developments related to the category since the WHO signaled its intention to include it in the ICD-11. Each of the four diagnostic categories appears to describe a population with clinically important and distinctive features that had previously gone unrecognized as well as specific treatment needs that would otherwise likely go unmet. The introduction of these categories in the ICD-11 has been followed by a substantial expansion of research in each area, which has generally supported their validity and utility, and by a significant increase in the availability of appropriate services.
Collapse
Affiliation(s)
- Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Michael B First
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals, Lausanne, Switzerland
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care, Menlo Park, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Peer Briken
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sophia Achab
- Outpatient Treatment Unit for Addictive Behaviors ReConnecte, Geneva University Hospitals, Geneva, Switzerland
- Psychological and Sociological Research and Training Unit, Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Chris R Brewin
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Daniel L King
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
11
|
The latent structure of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD in a general population sample from USA: A factor mixture modelling approach. J Anxiety Disord 2022; 85:102497. [PMID: 34785481 DOI: 10.1016/j.janxdis.2021.102497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/13/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022]
Abstract
The validity of ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD), as measured by the International Trauma Questionnaire (ITQ; Cloitre et al., 2018) has been supported in many factor analytic and mixture modelling studies. There is, however, a paucity of research investigating the latent structure of the ITQ using factor mixture modelling (FMM). FMM was applied to data collected from a nationally representative sample of U.S. adults (N = 1834). FMM results demonstrated strong support for a two-factor second-order model with four qualitatively distinct latent classes: a 'PTSD class', a 'CPTSD class', a 'DSO' (Disturbances in Self-Organisation) class and a 'low symptoms class'. Sexual abuse increased likelihood of membership to the 'CPTSD' (OR = 3.22) and physical abuse decreased likelihood of membership to the 'PTSD' (OR=0.51). Trauma exposure in adulthood predicted 'PTSD' and 'CPTSD' class membership. The 'CPTSD class' was characterised by higher levels of psychopathological co-morbidities and poorer psychological wellbeing compared to all other classes. Results provide additional support for the validity of PTSD and CPTSD as measured by the ITQ.
Collapse
|
12
|
Vasileva AV. [Post-traumatic stress disorder in the focus of international research: from soldier heart to ICD-11]. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:72-81. [PMID: 36279231 DOI: 10.17116/jnevro202212210172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The article presents the evolution of the post-traumatic stress disorder (PTSD) definition from various war syndromes to PTSD definition as a sovereign disorder and complex PTSD appearance in ICD-11 as distinct diagnosis. It is focused on the epidemiology, gender issues, clinical features and differential diagnostic PTSD aspects. It is considered elaboration of the new international clinical guidelines for the anxiety disorders including PTSD, the new pharmaceutical and psychotherapeutic treatment algorithms for PTSD based on the evidence based research data is presented. Additionally as an illustration case vignette is described.
Collapse
Affiliation(s)
- A V Vasileva
- Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
- Mechnikov North-Western State Medical University, St. Petersburg, Russia
| |
Collapse
|
13
|
Alessi EJ, Hutchison C, Kahn S. Understanding COVID-19 through a Complex Trauma Lens: Implications for Effective Psychosocial Responses. SOCIAL WORK 2021; 67:swab045. [PMID: 34694385 DOI: 10.1093/sw/swab045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/19/2020] [Accepted: 11/18/2020] [Indexed: 06/13/2023]
Abstract
The psychosocial impact of COVID-19 on individuals, families, and communities will likely persist for years to come. While briefing notes informed by disaster psychology and crisis management have been released to guide social workers and other mental health professionals in their work during the pandemic, the far-reaching impacts of COVID-19 may require inclusion of additional theories of trauma and resilience. Thus, this article first examines the application of complex trauma theory as an effective framework for assessing the psychosocial impacts of the pandemic, especially among individuals with prior trauma exposure, those with preexisting mental illness, and communities affected by marginalization and historical trauma. Authors then discuss the importance of using trauma-informed practice to address the effects of the pandemic on both individual and community levels during this unprecedented moment in history.
Collapse
|
14
|
de Silva U, Glover N, Katona C. Prevalence of complex post-traumatic stress disorder in refugees and asylum seekers: systematic review. BJPsych Open 2021; 7:e194. [PMID: 34649634 PMCID: PMC8570104 DOI: 10.1192/bjo.2021.1013] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/15/2021] [Accepted: 08/26/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Refugees and asylum seekers often report having experienced numerous complex traumas. It is important to understand the prevalence of complex post-traumatic stress disorder (CPTSD), which can follow complex traumas. AIMS This systematic review aims to summarise the available literature reporting the prevalence in refugees and asylum seekers of three operationalised definitions of CPTSD: the ICD-11 diagnostic criteria, the ICD-10 criteria (for enduring personality change after catastrophic experience) and the DSM-IV criteria (for disorders of extreme stress not otherwise specified). METHOD Six electronic databases were searched for studies reporting the prevalence of CPTSD in adult refugee and/or asylum-seeking samples. Owing to heterogeneity between the studies, a narrative synthesis approach was used to summarise studies. Methodological quality was assessed using the Joanna Briggs Critical Appraisal Checklist for Prevalence Studies. This systematic review has been registered with PROSPERO (registration number CRD42020188422, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=188422). RESULTS Systematic searches identified 15 eligible studies, with 10 examining treatment-seeking samples and five using population samples. CPTSD prevalence in treatment-seeking samples was between 16 and 38%. Prevalence in population samples ranged from 2.2 to 9.3% in four studies, with the fifth reporting a much higher estimate (50.9%). CONCLUSIONS This review highlights both the high prevalence of CPTSD in treatment samples and the lack of research aiming to establish prevalence of CPTSD in refugee and asylum-seeking populations. Understanding the prevalence of these disabling disorders has implications for policy and healthcare services for the appropriate promotion, planning and provision of suitable treatment and interventions for this highly traumatised population.
Collapse
Affiliation(s)
| | - Naomi Glover
- Division of Psychiatry, University College London, UK
| | - Cornelius Katona
- Division of Psychiatry, University College London, and Helen Bamber Foundation, UK
| |
Collapse
|
15
|
Philippens IHCHM, Draaisma L, Baarends G, Krugers HJ, Vermetten E. Ketamine treatment upon memory retrieval reduces fear memory in marmoset monkeys. Eur Neuropsychopharmacol 2021; 50:1-11. [PMID: 33915317 DOI: 10.1016/j.euroneuro.2021.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 12/21/2022]
Abstract
Emotionally arousing experiences are retained very well as seen in posttraumatic stress disorder (PTSD). Various lines of evidence indicate that reactivation of these memories renders them labile which offers a potential time-window for intervention. We tested in non-human primates whether ketamine, administered during fear memory reactivation, affected passive (inhibitory) avoidance learning. For the consolidation of contextual emotional memory, the unescapable foot-shock paradigm in a passive avoidance task with two compartments (dark vs illuminated) was used. After entering the dark compartment, marmoset monkeys received four random foot-shocks (1 mA, 4 s) within 15-min. This stressful exposure increased the saliva cortisol and heart rate and impaired REM-sleep (p<0.05). One week later the monkeys were re-exposed to the stressful situation for the reconsolidation of the fearful experience. During the re-exposure the monkeys were treated with ketamine (0.5 mg/kg) or saline. In week 3, the monkeys were placed in the experimental setting to test their memory for the fearful experience. In contrast to the vehicle-treated monkeys, who avoided the dark compartment, the ketamine-treated monkeys entered the dark compartment that was previously associated with the fearful experience (p<0.05). Post-mortem analysis of the hippocampus showed that ketamine-treated animals exhibited less doublecortin positive neurons and BrdU-labeled cells in the dentate gyrus. This study reveals that a single low dose of ketamine, administered upon fear retrieval in monkeys, reduce contextual fear memory and attenuate neurogenesis in the hippocampus. These are important findings for considering ketamine as a potential candidate to target traumatic memories in PTSD.
Collapse
Affiliation(s)
- Ingrid H C H M Philippens
- Biomedical Primate Research Centre (BPRC), Animal Science Department, Lange Kleiweg 161, 2288 GJ Rijswijk, the Netherlands.
| | - Laurijn Draaisma
- Biomedical Primate Research Centre (BPRC), Animal Science Department, Lange Kleiweg 161, 2288 GJ Rijswijk, the Netherlands
| | - Guus Baarends
- Biomedical Primate Research Centre (BPRC), Animal Science Department, Lange Kleiweg 161, 2288 GJ Rijswijk, the Netherlands
| | - Harm J Krugers
- Faculty of Science, Swammerdam Institute for Life Sciences, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, the Netherlands
| | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands; ARQ National Psychotrauma Center, Diemen, the Netherlands
| |
Collapse
|
16
|
Eilers R, Rosner R. Die einfache und komplexe Posttraumatische Belastungsstörung in der Praxis. KINDHEIT UND ENTWICKLUNG 2021. [DOI: 10.1026/0942-5403/a000342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Die ICD-11 enthält reformulierte Kriterien für die Posttraumatische Belastungsstörung (PTBS) und die neue Diagnose komplexe PTBS (kPTBS). Fragestellung: Wie wirken sich die Neuerungen auf die Diagnostik und Behandlung von Kindern und Jugendlichen aus? Methode: In dieser Übersichtsarbeit werden die neuen Kriterien vorgestellt und mit früheren Diagnosemanualen verglichen. Bisherige Forschungsergebnisse zu PTBSICD-11 und kPTBS bei Kindern und Jugendlichen werden zusammengefasst und diskutiert. Ergebnisse: Die PTBSICD-11-Kriterien führen eher zu geringeren Prävalenzraten verglichen mit PTBSICD-10, PTBSDSM-IV und PTBSDSM-5. Erste Studien weisen darauf hin, dass evidenzbasierte traumafokussierte Therapiemanuale auch zur Behandlung der kPTBS geeignet sind. Diskussion und Schlussfolgerung: Die Anwendung neuer Kriterien stellt Praktiker_innen und Forscher_innen vor Herausforderungen. Bisherige Ergebnisse deuten an, dass die kPTBS gut behandelbar ist.
Collapse
Affiliation(s)
| | - Rita Rosner
- Katholische Universität Eichstätt-Ingolstadt
| |
Collapse
|
17
|
Nierop N, van den Eshof P, Brandt C. A practical approach to sexual abuse allegations: Netherlands Expert Committee for Equivocal Sexual Abuse Allegations. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2021; 28:841-853. [PMID: 35694651 PMCID: PMC9176321 DOI: 10.1080/13218719.2021.1873203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Equivocal sexual abuse allegations are those in which the details of the alleged offence(s) are uncertain. The circumstances are ambiguous, there is limited evidence, and it is unclear how police investigations should proceed. This article discusses the challenges such allegations pose for police, prosecution, judges and mental health experts, and advocates for the use of multidisciplinary expert opinion during the investigation. The practical application of this approach by the Netherlands Expert Committee for Equivocal Sexual Abuse Allegations (LEBZ) is described, which has assessed over 900 cases since its inception in 1999. The LEBZ approach represents a significant innovation in police and criminal justice responses to equivocal allegations of sexual assault, which warrants consideration in other jurisdictions.
Collapse
Affiliation(s)
- Nicole Nierop
- Netherlands National Police, Driebergen, the Netherlands
| | | | - Cleo Brandt
- Netherlands National Police, Driebergen, the Netherlands
| |
Collapse
|
18
|
Kimmell J, Mendenhall E, Jacobs EA. Deconstructing PTSD: Trauma and emotion among Mexican immigrant women. Transcult Psychiatry 2021; 58:110-125. [PMID: 32046617 DOI: 10.1177/1363461520903120] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The symptomatology for Post-Traumatic Stress Disorder (PTSD) narrowly focuses on particular diagnostic frames and a single triggering event. Such narrow definitions of trauma and recovery have been heavily critiqued by anthropologists and cultural psychiatrists for overlooking cultural complexity as well as the effects of multiple and overlapping events that may cause someone to become "traumatized" and thereby affect recovery. This article investigates how subjective reporting of traumatic experience in life history narratives relates to depressive and PTSD symptomatology, cultural idioms, and repeated traumatic experiences among low-income Mexican immigrant women in Chicago. We interviewed 121 Mexican immigrant women and collected life history narratives and psychiatric scales for depression and PTSD. Most women spoke of the detrimental effects of repeated traumatic experiences, reported depressive (49%) and PTSD (38%) symptoms, and described these experiences through cultural idioms. These data complicate the PTSD diagnosis as a discrete entity that occurs in relation to a single acute event. Most importantly, these findings reveal the importance of cumulative trauma and cultural idioms for the recognition of suffering and the limitation of diagnostic categories for identifying the needs of those who experience multiple social and psychological stressors.
Collapse
|
19
|
Mellor R, Werner A, Moussa B, Mohsin M, Jayasuriya R, Tay AK. Prevalence, predictors and associations of complex post-traumatic stress disorder with common mental disorders in refugees and forcibly displaced populations: a systematic review. Eur J Psychotraumatol 2021; 12:1863579. [PMID: 34992745 PMCID: PMC8725775 DOI: 10.1080/20008198.2020.1863579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: The inclusion of complex post-traumatic stress disorder (CPTSD) in ICD-11 represents a turning point for the field of traumatic stress, with accumulative evidence of this disorder in refugees and displaced populations. Objective: The objectives of this systematic review are to examine, in refugee and displaced populations: 1) the prevalence of CPTSD; 2) factors contributing to CPTSD; and 3) and associations between CPTSD and other common mental disorders including: PTSD, depression, anxiety and somatisation. Method: We followed the Joanna Briggs Institute Methodology for Systematic Reviews. Papers published in English language were included, with date of publication between 1987 and June 2019. We searched six relevant databases: MEDLINE, PsycINFO, Embase, Scopus, CINAHL, and PILOTS, and the grey literature. We included observational studies with prevalence data on CPTSD. Results: 19 articles met all inclusion criteria. Quality assessment was performed on each included study using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Based on this, 13 moderate and high-quality studies were included in our narrative synthesis. The included studies reported prevalence of CPTSD in refugees and displaced populations ranging from 2% to 86%. Conclusions: Reasons for the wide variation in prevalence may include contextual and geographical differences, the influence of post-migration difficulties, and sample population characteristics such as treatment seeking versus general population. We found higher prevalence rates (range: 16-82%) in more studies with treatment seeking samples, followed by convenience and snowball samples (40-51%), and lower rates in more studies utilising random sampling techniques (2-86%). Consistent with the broader literature, the studies in our review supported an association for complex post-traumatic stress disorder with prolonged, repeated trauma, and post-migration living difficulties, with the latter association being specific to refugee and displaced populations. Further research on this construct in this population group, including effective treatments, is required.
Collapse
Affiliation(s)
- Rachel Mellor
- University of New South Wales, Sydney, Australia.,Rural and Remote Mental Health Service, Barossa Hills Fleurieu Local Health Network, Mount Barker, Australia
| | - Allison Werner
- Rural and Remote Mental Health Service, Barossa Hills Fleurieu Local Health Network, Mount Barker, Australia
| | - Batool Moussa
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Mohammed Mohsin
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Psychiatry Research and Teaching Unit, Liverpool Hospital, NSW Health, Sydney, Australia
| | | | - Alvin Kuowei Tay
- School of Psychiatry, University of New South Wales, Sydney, Australia
| |
Collapse
|
20
|
Lechner-Meichsner F, Steil R. A clinician rating to diagnose CPTSD according to ICD-11 and to evaluate CPTSD symptom severity: Complex PTSD Item Set additional to the CAPS (COPISAC). Eur J Psychotraumatol 2021; 12:1891726. [PMID: 36877471 PMCID: PMC9754030 DOI: 10.1080/20008198.2021.1891726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background: Researchers who wish to study stress-related disorders need to use valid, reliable, and sensitive instruments and the Clinician-administered PTSD Scale (CAPS) constitutes the gold standard in the assessment of posttraumatic stress disorder (PTSD). While the CAPS corresponds with PTSD criteria according to the DSM-5, researchers face a challenge with the forthcoming ICD-11: ICD-11 introduces the new diagnosis Complex PTSD (CPTSD) that does not exist in DSM-5.Objective: Researchers as well as clinicians will need to assess the incidence and prevalence of CPTSD and will want to evaluate treatment effects according to both criteria sets. However, using two clinician-rated interviews is often not feasible and a burden to patients, particularly in psychotherapy research.Method & Results: We have therefore developed the Complex PTSD Item Set additional to the CAPS (COPISAC). This clinician rating is an easy-to-use and economic addition to the CAPS that permits assessing diagnosis and evaluating symptom severity of CPTSD. COPISAC consists of three items that assess disturbances in self-regulation including prompts for symptom description and frequency, and two additional items assessing impairment. Diagnostic status and severity ratings for CPTSD are possible. Items that account for the specific forms of trauma which the ICD-11 describes as precursors of CPTSD (e.g. torture, being enslaved) are further suggested as additions to the Life Events Checklist.Conclusion: With an introduction of COPISAC at this point, we aim at suggesting an easy transition into diagnosing CPTSD and evaluating its course over treatment.
Collapse
Affiliation(s)
| | - Regina Steil
- Department of Psychology, Goethe University Frankfurt, Frankfurt, Germany.,Center for Mind, Brain and Behavior, Center for Mind, Brain and Behavior (CMBB, University of Marburg and Justus Liebig University Giessen, Germany
| |
Collapse
|
21
|
Frost R, Murphy J, Hyland P, Shevlin M, Ben-Ezra M, Hansen M, Armour C, McCarthy A, Cunningham T, McDonagh T. Revealing what is distinct by recognising what is common: distinguishing between complex PTSD and Borderline Personality Disorder symptoms using bifactor modelling. Eur J Psychotraumatol 2020; 11:1836864. [PMID: 33425242 PMCID: PMC7759200 DOI: 10.1080/20008198.2020.1836864] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Despite concerns of conceptual similarity, increasing evidence supports the discriminant validity of Complex Posttraumatic Stress Disorder (CPTSD) and Borderline Personality Disorder (BPD). However, all studies to date have assumed a categorical model of psychopathology. In contrast, dimensional models of psychopathology, such as the Hierarchical Taxonomy of Psychopathology model (i.e. HiTOP model), recognise shared vulnerability across supposedly discrete disorders. Accounting for shared vulnerability between CPTSD and BPD symptoms may help to better reveal what is unique about these constructs. Objective: To identify the distinct and shared features of CPTSD and BPD via the application of dimensional modelling procedures. Method: Confirmatory bifactor and confirmatory factor analysis were employed to identify the optimal latent structure of CPTSD and BPD symptoms amongst a convenience sample of Israeli adults (N = 617). Additionally, structural equation modelling was used to identify risk factors associated with these constructs. Results: The latent structure of CPTSD and BPD symptoms was best explained by a bifactor model including one 'general' factor (i.e. vulnerability to all symptoms) and three 'specific' correlated factors (i.e. vulnerability to PTSD, DSO, and BPD symptoms, respectively). CPTSD symptoms were more readily distinguished from the general factor whereas BPD symptoms were not as easily distinguished from the general factor. CPTSD symptoms reflecting a negative self-concept and BPD symptoms reflecting an alternating self-concept were the most distinctive features of CPTSD and BPD relative to the general factor, respectively. Most of the risk factors were associated with the general vulnerability factor, consistent with the predictions of dimensional models of psychopathology regarding shared risk across supposedly distinct psychiatric constructs. Conclusion: Consistent with a dimensional model of psychopathology, CPTSD and BPD shared a common latent structure but were still distinguishable. CPTSD and BPD symptoms may be most effectively distinguished based on the phenomenology of self-concept symptoms.
Collapse
Affiliation(s)
- Rachel Frost
- School of Psychology, Ulster University, Derry, Northern Ireland.,Clinical Services Department, Dublin Rape Crisis Centre, Dublin, Ireland
| | - Jamie Murphy
- School of Psychology, Ulster University, Derry, Northern Ireland
| | - Philip Hyland
- Department of Psychology, University of Maynooth, Kildare, Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland
| | | | - Maj Hansen
- THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Cherie Armour
- School of Psychology, Queens University, Belfast, Northern Ireland
| | - Angela McCarthy
- Clinical Services Department, Dublin Rape Crisis Centre, Dublin, Ireland
| | | | - Tracey McDonagh
- THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.,Probation Board for Northern Ireland, Belfast, Northern Ireland
| |
Collapse
|
22
|
Rink J, Lipinska G. Evidence of distinct profiles of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD in a South African sample. Eur J Psychotraumatol 2020; 11:1818965. [PMID: 33282146 PMCID: PMC7685205 DOI: 10.1080/20008198.2020.1818965] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Both post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD) have been included in the 11th edition of the International Classification of Diseases (ICD-11). Although the validity of CPTSD has been controversial, a growing number of studies support the distinction between PTSD and CPTSD. However, the majority of this research has originated in high-income countries (HICs), whereas the prevalence of trauma experience associated with PTSD/CPTSD diagnosis is significantly higher in low- and middle-income countries (LMICs). Objective: This study assessed whether a sample from an LMIC setting produced distinct classes that reflect ICD-11 criteria for PTSD and CPTSD. Furthermore, this study investigated whether childhood trauma distinguished between PTSD and CPTSD. Method: International Trauma Questionnaire responses from a sample of South African university undergraduates were used as indicator variables in a latent class analysis (LCA). Chi-squared tests of independence and Kruskal-Wallis H tests were used to assess between-class differences. Results: The LCA identified four distinct classes: a PTSD class with elevated symptoms of PTSD, but low endorsement of disturbances in self-organization (DSO; symptoms that are specific to CPTSD); a CPTSD class with elevated symptoms of PTSD and DSO; a DSO class with low symptoms of PTSD, but elevated symptoms of DSO; and a Low class with low endorsements on all symptoms. Regarding childhood trauma, participants in the CPTSD class had more severe childhood abuse and neglect, specifically emotional abuse and neglect, than participants in the PTSD class. Conclusions: Findings were consistent with the distinction between PTSD and CPTSD symptom profiles in the ICD-11. Our findings support a similar qualitative distinction between PTSD and CPTSD in our LMIC context, as previously reported in HICs. This distinction is especially relevant in LMICs because of the significant number of individuals vulnerable to these disorders.
Collapse
Affiliation(s)
- James Rink
- Applied Cognitive Science and Experimental Neuropsychology Team (ACSENT), Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Gosia Lipinska
- Applied Cognitive Science and Experimental Neuropsychology Team (ACSENT), Department of Psychology, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
23
|
Lloyd S, Larivée A. Time, trauma, and the brain: How suicide came to have no significant precipitating event. SCIENCE IN CONTEXT 2020; 33:299-327. [PMID: 34096495 DOI: 10.1017/s0269889721000065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this article, we trace shifting narratives of trauma within psychiatric, neuroscience, and environmental epigenetics research. We argue that two contemporary narratives of trauma - each of which concerns questions of time and psychopathology, of the past invading the present - had to be stabilized in order for environmental epigenetics models of suicide risk to be posited. Through an examination of these narratives, we consider how early trauma came to be understood as playing an etiologically significant role in the development of suicide risk. Suicide, in these models, has come to be seen as a behavior that has no significant precipitating event, but rather an exceptional precipitating neurochemical state, whose origins are identified in experiences of early traumatic events. We suggest that this is a part of a broader move within contemporary neurosciences and biopsychiatry to see life as post: seeing life as specific form of post-traumatic subjectivity.
Collapse
|
24
|
Jankovic-Rankovic J, Oka RC, Meyer JS, Gettler LT. Forced migration experiences, mental well-being, and nail cortisol among recently settled refugees in Serbia. Soc Sci Med 2020; 258:113070. [DOI: 10.1016/j.socscimed.2020.113070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/01/2020] [Accepted: 05/18/2020] [Indexed: 10/24/2022]
|
25
|
Winstanley EL, Mahoney JJ, Lander LR, Berry JH, Marshalek P, Zheng W, Haut MW. Something to despair: Gender differences in adverse childhood experiences among rural patients. J Subst Abuse Treat 2020; 116:108056. [PMID: 32741501 DOI: 10.1016/j.jsat.2020.108056] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/18/2020] [Accepted: 05/31/2020] [Indexed: 01/27/2023]
Abstract
Existing research has demonstrated that patients in treatment for an opioid use disorder (OUD) have high rates of adverse childhood experiences (ACE) compared to community-based samples. While research has documented important gender differences in ACEs in patients with OUD receiving treatment in urban areas, research has not shown whether these findings would generalize to rural and Appalachian areas, which are known to have lower ACE scores. We conducted a secondary analysis of existing clinical data, utilizing intake assessment data from a rural Appalachian outpatient buprenorphine program. We restricted the sample to patients with an OUD who presented for treatment between June 2018 and June 2019 (n = 173). The clinical intake assessment included a modified 17-item ACE instrument that patients self-administered. More than half (54.3%) of patients reported having experienced 4+ categories of adverse childhood experiences. On average, females endorsed 4.5 categories of adverse experiences, whereas males endorsed 3.3 (p < 0.00); female patients were significantly more likely to have experienced sexual abuse (42.4% versus 10.6%, p < 0.00). Alarmingly, 25.9% of females and 8.2% of males reported being forced to have sex before age 18. Disproportionately high rates of childhood adversities, particularly among females, may partially explain despair in rural Appalachian areas. OUD treatment programs should conduct clinical assessments of trauma and integrate trauma-informed care into drug treatment, especially for female patients residing in rural Appalachia.
Collapse
Affiliation(s)
- Erin L Winstanley
- West Virginia University, School of Medicine and Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, WV, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States.
| | - James J Mahoney
- West Virginia University, School of Medicine and Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, WV, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States
| | - Laura R Lander
- West Virginia University, School of Medicine and Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, WV, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States
| | - James H Berry
- West Virginia University, School of Medicine and Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, WV, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States
| | - Patrick Marshalek
- West Virginia University, School of Medicine and Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, WV, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States
| | - Wanhong Zheng
- West Virginia University, School of Medicine and Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, WV, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States
| | - Marc W Haut
- West Virginia University, School of Medicine and Rockefeller Neuroscience Institute, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, Morgantown, WV, United States; West Virginia University, School of Medicine, Department of Neuroscience, United States; West Virginia University, School of Medicine, Department of Neurology, United States; West Virginia University, School of Medicine, Department of Radiology, United States
| |
Collapse
|
26
|
Fjeldsted R, Teasdale TW, Bach B. Childhood trauma, stressful life events, and suicidality in Danish psychiatric outpatients. Nord J Psychiatry 2020; 74:280-286. [PMID: 31833427 DOI: 10.1080/08039488.2019.1702096] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Increasing evidence points to an association between adverse life experiences and suicide risk, which include childhood trauma and maltreatment as well as recent stressful life events. Accordingly, the assessment of childhood trauma and recent stressful life events might contribute to the detection of suicidal risk in a clinical setting.Aim: To investigate the association of childhood trauma and current stressful life events with suicidal behavior and improve identification of suicidality in psychiatric outpatients.Method: The Childhood Trauma Questionnaire (CTQ), the Stressful Life Events (SLE) questionnaire, and the Suicide Behaviors Questionnaire-Revised (SBQ-R) were administered to 103 psychiatric outpatients (77% women). We employed binary logistic regression analysis to estimate the statistical risk of suicide attempt for patients being exposed to childhood trauma and the influence of recent stresssful life events. A ROC-analysis was used to estimate the ability of CTQ to predict suicidal behavior.Results: A substantial association between suicidal behavior and severe childhood trauma was found (OR = 3.68), whereas no significant association was found for recent stressful life events. The result was tested against possible confounding demographic factors (sex, age, job status, educational level and marital status). Childhood trauma was found to explain around 15% of the total variance in suicidality.Conclusion: The findings partially supported our hypothesis that childhood traumas (but not recent stressful life events) may play a substantial role in suicidality, and therefore assessment of childhood trauma may contribute to the detection of suicidal behavior in a psychiatric outpatient population. However, longitudinal research and replication in other populations are warranted for more conclusive findings.
Collapse
Affiliation(s)
- Rita Fjeldsted
- Psychiatric Clinic Slagelse, Psychiatric Services Region Zealand, Slagelse, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Bo Bach
- Psychiatric Research Unit, Psychiatric Services Region Zealand, Copenhagen, Denmark
| |
Collapse
|
27
|
Cloitre M, Brewin CR, Bisson JI, Hyland P, Karatzias T, Lueger-Schuster B, Maercker A, Roberts NP, Shevlin M. Evidence for the coherence and integrity of the complex PTSD (CPTSD) diagnosis: response to Achterhof et al., (2019) and Ford (2020). Eur J Psychotraumatol 2020; 11:1739873. [PMID: 32341764 PMCID: PMC7170304 DOI: 10.1080/20008198.2020.1739873] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 12/14/2022] Open
Abstract
This letter to the editor responds to a recent EJPT editorial and following commentary which express concerns about the validity of the ICD-11 complex PTSD (CPTSD) diagnosis. Achterhof and colleagues caution that latent profile analyses and latent class analyses, which have been frequently used to demonstrate the discriminative validity of the ICD-11 PTSD and CPTSD constructs, have limitations and cannot be relied on to definitively determine the validity of the diagnosis. Ford takes a broader perspective and introduces the concept of 'cPTSD' which describes a wide ranging set of symptoms identified from studies related to DSM-IV, DSM-V and ICD-11 and proposes that the validity of the ICD-11 CPTSD is in question as it does not address the multiple symptoms identified from previous trauma-related disorders. We argue that ICD-11 CPTSD is a theory-driven, empirically supported construct that has internal consistency and conceptual coherence and that it need not explain nor resolve the inconsistencies of past formulations to demonstrate its validity. We do agree with Ford and with Achterhof and colleagues that no one single statistical process can definitively answer the question of whether CPTSD is a valid construct. We reference several studies utilizing many different statistical approaches implemented across several countries, the overwhelming majority of which have supported the validity of ICD-11 as a unique construct. We conclude with our own cautions about ICD-11 CPTSD research to date and identify important next steps.
Collapse
Affiliation(s)
- Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA
| | - Chris R. Brewin
- Clinical Educational & Health Psychology, University College London, London, UK
| | | | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
- Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Thanos Karatzias
- NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
| | | | - Andreas Maercker
- Division of Psychopathology and Clinical Intervention Zurich, University of Zurich, Switzerland
| | - Neil P. Roberts
- Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK
- Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland
| |
Collapse
|
28
|
Letica-Crepulja M, Stevanović A, Protuđer M, Grahovac Juretić T, Rebić J, Frančišković T. Complex PTSD among treatment-seeking veterans with PTSD. Eur J Psychotraumatol 2020; 11:1716593. [PMID: 32166005 PMCID: PMC7054953 DOI: 10.1080/20008198.2020.1716593] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/27/2019] [Accepted: 12/31/2019] [Indexed: 01/14/2023] Open
Abstract
Background: In the ICD-11 hierarchical classification structure, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) are separate and distinct but also 'sibling' disorders, meaning that the diagnoses follow from the parent category of traumatic stress disorders. Objective: The aim of this study was to examine the prevalence of CPTSD in treatment-seeking war veterans with PTSD more than 20 years after the exposure to cumulative war-related trauma(s). The second aim was to examine if there was an association between demographic and psychosocial variables and CPTSD or PTSD. Method: A sample of 160 male war veterans with PTSD referred to the outpatient service of the PTSD Referral Centre at the Clinical Hospital Centre (CHC) Rijeka participated in a cross-sectional study. Psychiatric comorbidity was assessed using the Mini-International Neuropsychiatric Interview (MINI) and participants completed validated self-report measures: The Life Events Checklist for DSM-5 (LEC-5), International Trauma Questionnaire (ITQ). Results: In total, 80.63% of the sample met criteria for a probable diagnosis of CPTSD. The study revealed that there was no significant difference in the length of deployment, in the intensity of the PTSD symptoms, types of trauma exposure and pharmacotherapeutic treatment between PTSD and CPTSD group. It was found that veterans with PTSD were more likely to be divorced and to participate in PTSD clubs. On the other hand, veterans with CPTSD were significantly more likely to have higher levels of functional impairment and comorbidity with general anxiety disorder (GAD) compared to the PTSD group. Conclusions: This study supports the proposition that a prolonged trauma of severe interpersonal intensity such as war is related to high rates of CPTSD among treatment-seeking veterans, years after the war. The distinction between PTSD and complex PTSD may help the selection of person-centred treatment interventions that would target specific mental health and functional problems in patients.
Collapse
Affiliation(s)
- Marina Letica-Crepulja
- Department for Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.,Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center for Posttraumatic Stress Disorder of the Ministry of Health of the Republic of Croatia, Rijeka, Croatia
| | - Aleksandra Stevanović
- Department for Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.,Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center for Posttraumatic Stress Disorder of the Ministry of Health of the Republic of Croatia, Rijeka, Croatia
| | - Marina Protuđer
- Department of Addiction Prevention and Treatment, Teaching Institute of Public Health of Primorsko-Goranska County, Rijeka, Croatia
| | - Tanja Grahovac Juretić
- Department for Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.,Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center for Posttraumatic Stress Disorder of the Ministry of Health of the Republic of Croatia, Rijeka, Croatia
| | - Jelena Rebić
- Department for Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.,Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center for Posttraumatic Stress Disorder of the Ministry of Health of the Republic of Croatia, Rijeka, Croatia
| | - Tanja Frančišković
- Department for Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.,Department of Psychiatry, Clinical Hospital Center Rijeka, Referral Center for Posttraumatic Stress Disorder of the Ministry of Health of the Republic of Croatia, Rijeka, Croatia
| |
Collapse
|
29
|
Karatzias T, Levendosky AA. Introduction to the Special Section on Complex Posttraumatic Stress Disorder (CPTSD): The Evolution of a Disorder. J Trauma Stress 2019; 32:817-821. [PMID: 31814160 DOI: 10.1002/jts.22476] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 11/11/2019] [Indexed: 11/10/2022]
Abstract
The inclusion of complex posttraumatic stress disorder (CPTSD) in the 11th revision of the International Classification of Diseases is an important development in the field of psychotraumatology. Complex PTSD was developed as a response to a clinical need to describe difficulties commonly associated with exposure to traumatic stressors that are predominantly of an interpersonal nature. With this special section, we bring attention to this common condition following exposure to traumatic stressors that only recently has been designated an official diagnosis. In this introduction, we review the history of CPTSD as a new condition and we briefly introduce the papers for the special section in the present issue of the Journal of Traumatic Stress. It is our hope that the work presented in the special section will add to an ever-expanding evidence base. We also hope that this work inspires further research on the cultural validity of CPTSD, its assessment, and treatment.
Collapse
Affiliation(s)
- Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, United Kingdom.,NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, United Kingdom
| | - Alytia A Levendosky
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| |
Collapse
|
30
|
Folke S, Nielsen ABS, Andersen SB, Karatzias T, Karstoft KI. ICD-11 PTSD and complex PTSD in treatment-seeking Danish veterans: a latent profile analysis. Eur J Psychotraumatol 2019; 10:1686806. [PMID: 31762954 PMCID: PMC6853202 DOI: 10.1080/20008198.2019.1686806] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/01/2019] [Accepted: 10/03/2019] [Indexed: 12/14/2022] Open
Abstract
Background: The WHO International Classification of Diseases, 11th version (ICD-11), includes a trauma-related diagnosis of complex posttraumatic stress disorder (CPTSD) distinct from posttraumatic stress disorder (PTSD). Results from previous studies support the validity of this distinction. However, no studies to date have evaluated the ICD-11 model of PTSD and CPTSD in treatment-seeking military veterans. Objective: To determine if the distribution of symptoms in treatment-seeking Danish veterans was consistent with the ICD-11 PTSD and CPTSD symptom profiles. Based on previous studies, we hypothesized that separate classes representing PTSD and CPTSD would be found that membership of a potential CPTSD-class would be predicted by a larger number of childhood traumas, and that a potential distinction between PTSD and CPTSD would be supported by differences in sociodemographic and functional outcomes. Method: Participants (N = 1,541) were formerly deployed Danish soldiers who completed proxy measures of ICD-11 PTSD and disturbances in self-organization (DSO) symptoms, along with self-report measures of traumatic life events, prior to starting treatment at the Military Psychology Department of the Danish Defence. Results: All hypotheses were supported. Latent profile analysis (LPA) revealed separate classes representing PTSD and CPTSD. In comparison to the PTSD-class, membership of the CPTSD-class was predicted by more childhood traumatic experiences, and members of this class were more likely being single/divorced/widowed and more likely to use psychotropic medication. Besides a PTSD-class and a CPTSD-class, LPA revealed a Low Symptoms-class, a Moderate DSO-class, a Hyperarousal-class, and a High DSO-class, with clear differences in functional outcomes between classes. Conclusion: Findings replicate previous studies supporting the distinction between ICD-11 PTSD and CPTSD. In addition, there seem to be groups of treatment-seeking military veterans that do not fulfil full criteria for a trauma-related disorder. Further research should explore subsyndromal PTSD and CPTSD profiles in veterans and other populations.
Collapse
Affiliation(s)
- Sofie Folke
- Research and Knowledge Centre, the Danish Veterans Centre, Ringsted, Denmark
- Department of Military Psychology, the Danish Veterans Centre, Copenhagen, Denmark
| | - Anni B. S. Nielsen
- Research and Knowledge Centre, the Danish Veterans Centre, Ringsted, Denmark
- The Research Unit and Section of General Practice, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Søren Bo Andersen
- Research and Knowledge Centre, the Danish Veterans Centre, Ringsted, Denmark
| | - Thanos Karatzias
- School of Health and Social Care, Napier University, Edinburgh, UK
- Rivers Centre for Traumatic Stress, NHS, Lothian, Edinburgh, UK
| | - Karen-Inge Karstoft
- Research and Knowledge Centre, the Danish Veterans Centre, Ringsted, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
31
|
Rocha J, Rodrigues V, Santos E, Azevedo I, Machado S, Almeida V, Silva C, Almeida J, Cloitre M. The first instrument for complex PTSD assessment: psychometric properties of the ICD-11 Trauma Questionnaire. ACTA ACUST UNITED AC 2019; 42:185-189. [PMID: 31596316 PMCID: PMC7115434 DOI: 10.1590/1516-4446-2018-0272] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 06/04/2019] [Indexed: 11/21/2022]
Abstract
Objective: The ICD-11 Trauma Questionnaire (ITQ) was developed as a joint effort by researchers from several countries to evaluate post-traumatic stress (PTSD) and complex-PTSD (C-PTSD) symptoms. This study is part of a multi-center international collaborative research project that aims to provide psychometric support for this initial instrument in different languages, considering the specific contexts related to complex traumatization. This study verified the psychometric characteristics of the Portuguese version of the ITQ, evaluating symptoms beyond those described the existing literature. Methods: We examined the results of a convenience sample totaling 268 Portuguese and Angolan participants. Two instruments were applied: the ITQ, which evaluates symptoms resulting from a traumatic life event, and the Life Events Checklist (LEC), which evaluates stressful life events. The general characteristics of the scales are described, and reliability analysis and validity studies were performed. Results: Cronbach’s alpha varied between 0.84 and 0.88, and the exploratory factorial analysis results were consistent with the concept of C-PTSD, with five components explaining 61.58% of scale variance. Conclusion: The results suggest good psychometric characteristics for the Portuguese version of the ITQ, and thus it can be included in protocols intended evaluating complex traumatic symptoms.
Collapse
Affiliation(s)
- José Rocha
- Cooperativa de Ensino Superior, Politécnico e Universitário (CESPU), Instituto Universitário de Ciências da Saúde (IUCS), Gandra, Portugal
| | - Verónica Rodrigues
- Centro de Psicologia do Trauma e do Luto (CPTL), Vila Nova de Gaia, Portugal
| | - Emanuel Santos
- Centro de Psicologia do Trauma e do Luto (CPTL), Vila Nova de Gaia, Portugal
| | - Inês Azevedo
- Cooperativa de Ensino Superior, Politécnico e Universitário (CESPU), Instituto Universitário de Ciências da Saúde (IUCS), Gandra, Portugal
| | - Sónia Machado
- Cooperativa de Ensino Superior, Politécnico e Universitário (CESPU), Instituto Universitário de Ciências da Saúde (IUCS), Gandra, Portugal
| | - Vera Almeida
- Cooperativa de Ensino Superior, Politécnico e Universitário (CESPU), Instituto Universitário de Ciências da Saúde (IUCS), Gandra, Portugal
| | - Celina Silva
- Escola de Formação de Técnicos de Saúde (EFTS), Huambo, Angola
| | | | - Maryléne Cloitre
- Institute for Trauma and Stress, NYU Child Study Center, New York, USA
| |
Collapse
|
32
|
Mulloy CW. Learning to yield: body psychotherapy and complex posttraumatic stress disorder. BODY MOVEMENT AND DANCE IN PSYCHOTHERAPY 2019. [DOI: 10.1080/17432979.2019.1673822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Charlotte W. Mulloy
- Graduate School of Counselling and Psychology, Somatic Counselling, Naropa University Boulder, Boulder, CO, USA
| |
Collapse
|
33
|
#SportToo: Implications of and Best Practice for the #MeToo Movement in Sport. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2019. [DOI: 10.1123/jcsp.2018-0065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
34
|
Farina B, Liotti M, Imperatori C. The Role of Attachment Trauma and Disintegrative Pathogenic Processes in the Traumatic-Dissociative Dimension. Front Psychol 2019; 10:933. [PMID: 31080430 PMCID: PMC6497769 DOI: 10.3389/fpsyg.2019.00933] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/08/2019] [Indexed: 12/13/2022] Open
Abstract
Epidemiological, clinical, and neurobiological studies of the last 30 years suggest that traumatic attachments during the early years of life are associated to specific psychopathological vulnerabilities based on dissociative pathogenic processes. It has been observed that the dissociative pathogenic processes caused by these traumatic attachments either may contribute to the genesis of well-defined mental disorders (e.g., dissociative disorders) or may variably occur in many other diagnostic categories, complicating their clinical pictures and worsening their prognosis. For this reason, we proposed to define the dimension of psychopathological outcomes linked to traumatic attachments and dissociative pathogenic processes as the “traumatic-dissociative” dimension (TDD). The clinical complexity of the TDD requires specific training to enable mental health professionals to recognize the signs of traumatic developments and to implement specific treatment strategies. The present article aims to review some crucial points about the clinical meaning and treatment strategies of the TDD, the dissociative pathogenic processes characterizing the TDD, as well as of the role of attachment trauma in the TDD. We also focused on the clinical and theoretical evidence suggesting that dissociation and dis-integration may be considered two different processes but highly correlated. The usefulness of clinical reasoning in terms of psychopathological dimensions, instead of distinct diagnostic categories, as well as several therapeutic implications of these issues was finally discussed.
Collapse
Affiliation(s)
- Benedetto Farina
- Department of Human Sciences, European University of Rome, Rome, Italy.,Traumatic Treatment Unit, Centro Clinico De Sanctis, Rome, Italy
| | | | | |
Collapse
|
35
|
Lies J, Jones L, Ho R. The management of post-traumatic stress disorder and associated pain and sleep disturbance in refugees. BJPSYCH ADVANCES 2019. [DOI: 10.1192/bja.2019.7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
SUMMARYMore than 68 million people worldwide have been forcibly displaced and one-third of these are refugees. This article offers an overview of the current literature and reviews the epidemiology and evidence-based psychological and pharmacological management of post-traumatic stress disorder (PTSD), sleep disturbance and pain in refugees and asylum seekers. It also considers the relationship between sleep disturbance and PTSD and explores concepts of pain in relation to physical and psychological trauma and distress. During diagnosis, clinicians must be aware of ethnic variation in the somatic expression of distress. Treatments for PTSD, pain and sleep disturbance among refugees and asylum seekers are essentially the same as those used in the general population, but treatment strategies must allow for cultural and contextual factors, including language barriers, loss of freedom and threat of repatriation.LEARNING OBJECTIVESAfter reading this article you will be able to:
•recognise the challenges faced by the large number of refugees worldwide•understand the relationship between PTSD, sleep disturbance and pain in refugees•broadly understand the evidence for psychological and pharmacological therapy for treating PTSD, sleep disturbance and pain in refugees.DECLARATION OF INTERESTNone.
Collapse
|
36
|
Typologies of PTSD clusters and reckless/self-destructive behaviors: A latent profile analysis. Psychiatry Res 2019; 272:682-691. [PMID: 30832187 DOI: 10.1016/j.psychres.2018.12.124] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 12/22/2018] [Accepted: 12/22/2018] [Indexed: 11/20/2022]
Abstract
Posttraumatic stress disorder (PTSD) is comorbid with diverse reckless and self-destructive behaviors (RSDBs). We examined the nature and construct validity (covariates of age, gender, depression severity, number of trauma types, functional impairment) of the optimal class solution categorizing participants based on PTSD symptom and RSDB endorsement. The sample included 417 trauma-exposed individuals recruited through Amazon's MTurk platform who completed the Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, the Posttrauma Risky Behaviors Questionnaire, and Patient Health Questionnaire-9. Latent profile analyses indicated an optimal three-class solution: the Low PTSD-RSDBs, High PTSD-Low RSDBs, and High PTSD-RSDBs classes. Multinomial logistic regression indicated that impairment and depression predicted the High PTSD-Low RSDBs vs. the Low PTSD-RSDBs classes. Impairment, age, being female, and depression predicted the High vs. Low PTSD-RSDBs classes. Number of trauma types, age, being female, and depression predicted the High PTSD-RSDBs vs. High PTSD-Low RSDBs classes. Results support the presence of a reckless behaviors subtype of PTSD (characterized by greater depression, greater impariment, greater number of trauma types, being male, and being younger), conducting comprehensive assessments of RSDBs for individuals reporting PTSD symptoms and of PTSD symptoms for individuals reporting RSDBs, and the need to tailor interventions to treat PTSD and RSDBs concurrently.
Collapse
|
37
|
Adams J, Mrug S, Knight DC. Characteristics of child physical and sexual abuse as predictors of psychopathology. CHILD ABUSE & NEGLECT 2018; 86:167-177. [PMID: 30308347 PMCID: PMC6289670 DOI: 10.1016/j.chiabu.2018.09.019] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 08/08/2018] [Accepted: 09/25/2018] [Indexed: 05/30/2023]
Abstract
Childhood physical and sexual abuse victims are at increased risk for developing depression, anxiety, and post-traumatic stress disorder (PTSD) in adulthood. Prior findings suggest abuse onset, duration, and severity moderate relationships between victimization and psychopathology. However, because these abuse characteristics are highly intercorrelated, their unique, individual effects on mental health outcomes remain unclear. To address this gap, the present study examined relationships between physical and sexual abuse characteristics and mental health outcomes and whether these relationships differed by sex. A diverse community sample of late adolescents and emerging adults (N = 1270; mean age = 19.68; 51% female) self-reported the onset, duration, and severity of physical and sexual abuse, as well as their depressive, anxiety, and PTSD symptoms. Results of a multivariate regression model (simultaneously evaluating all physical and sexual abuse characteristics) indicated that physical abuse onset in middle childhood and sexual abuse onset in middle childhood or adolescence were associated with all forms of psychopathology; and physical abuse onset at any time was uniquely linked with PTSD. Duration and severity of physical or sexual abuse did not predict psychopathology after accounting for time of onset. Multigroup analyses indicated that adolescence-onset and duration of sexual abuse respectively predicted anxiety and PTSD in females but not males, whereas sexual abuse severity predicted fewer PTSD symptoms in males but not females. Overall, results suggested that abuse occurring after age 5 may have the most deleterious impact on mental health.
Collapse
Affiliation(s)
| | - Sylvie Mrug
- University of Alabama at Birmingham, United States
| | | |
Collapse
|
38
|
Abstract
The World Health Organization (WHO) has included complex post-traumatic stress disorder (C-PTSD) in the final draft of the 11th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), which was published in June, 2018 and is scheduled to be submitted to WHO's World Health Assembly for official endorsement in 2019. Mental health providers will want to be informed about this diagnosis in order to provide effective treatment. Complex PTSD, or developmental PTSD as it is also called, refers to the constellation of symptoms that may result from prolonged, chronic exposure to traumatic experiences, especially in childhood, as opposed to PTSD which is more typically associated with a discrete traumatic incident or set of traumatic events. Although it has been a controversial diagnosis and is not included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), lines of evidence support its distinct profile and utility. In this case study, we elucidate and discuss some aspects of the diagnosis and its treatment.
Collapse
|
39
|
Lang CM, Edwards AJ, Mittler MA, Bonavitacola L. Dialectical Behavior Therapy With Prolonged Exposure for Adolescents: Rationale and Review of the Research. COGNITIVE AND BEHAVIORAL PRACTICE 2018. [DOI: 10.1016/j.cbpra.2017.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
40
|
Treatment processes and demographic variables as predictors of dropout from trauma-focused cognitive behavioral therapy (TF-CBT) for youth. Behav Res Ther 2018; 107:10-18. [DOI: 10.1016/j.brat.2018.05.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/15/2018] [Accepted: 05/14/2018] [Indexed: 11/22/2022]
|
41
|
Factor structures of Complex Posttraumatic Stress Disorder and PTSD in a community sample of refugees from West Papua. Compr Psychiatry 2018; 85:15-22. [PMID: 29936226 DOI: 10.1016/j.comppsych.2018.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 05/22/2018] [Accepted: 05/24/2018] [Indexed: 10/16/2022] Open
Abstract
OBJECTIVES The intention to include a category of Complex Posttraumatic Stress Disorder (CPTSD) in ICD-11 has renewed interest in this construct. Although growing evidence from high income countries supports the construct validity of CPTSD, little parallel research has been undertaken across cultures. We tested theoretically supported CPTSD structures (a one-factor, six-factor, one-factor higher-order, and two-factor higher order structure) in a community sample of West Papuan refugees living in a remote town, Kiunga, in Papua New Guinea (PNG). PROCEDURES A community-wide survey was conducted (2016-2017; response rate 85.5%) amongst 486 West Papuans. Culturally adapted measures were applied to assess cumulative traumatic exposure, postmigration living difficulties (PMLDs), CPTSD symptoms, and functional impairment. FINDINGS A six factor structure for CPTSD provided the best fit to the data, consistent with our past study amongst West Papuans. CONCLUSIONS The cross-cultural validity of our findings is supported by the isolation of West Papuan participants from services treating traumatic stress. To further support the universal applicability of CPTSD, our findings need to be confirmed amongst other refugee groups from diverse cultural backgrounds.
Collapse
|
42
|
Knefel M, Lueger-Schuster B, Karatzias T, Shevlin M, Hyland P. From child maltreatment to ICD-11 complex post-traumatic stress symptoms: The role of emotion regulation and re-victimisation. J Clin Psychol 2018; 75:392-403. [PMID: 29931669 PMCID: PMC6686279 DOI: 10.1002/jclp.22655] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 05/24/2018] [Accepted: 06/05/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Complex post-traumatic stress disorder (CPTSD) will be introduced in ICD-11 and comprises symptoms of PTSD and disturbances in self-organisation (DSO). The association of trauma with PTSD and DSO is not yet fully understood. We investigated the path from child maltreatment to PTSD and DSO and examined the mediating role of emotion regulation (ER) and adult interpersonal re-victimisation. METHOD Adult patients (N = 193) from a Scottish National Health Service clinic participated in the project. Participants completed measures of life events, ICD-11 PTSD and CPTSD, and ER. Path analysis was used to assess possible direct and indirect effects from childhood trauma on current post-traumatic psychopathology. RESULTS Overall results indicate that the path from child maltreatment to PTSD is a direct one, while the path to DSO is indirectly mediated by ER. CONCLUSIONS Future research should address the potentially beneficial effect of treatment protocols for CPTSD explicitly aiming at reducing ER difficulties.
Collapse
Affiliation(s)
- Matthias Knefel
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Brigitte Lueger-Schuster
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK.,NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, UK
| | - Phil Hyland
- School of Business, National College of Ireland, Dublin, Ireland
| |
Collapse
|
43
|
ICD-11 Prevalence Rates of Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in a German Nationwide Sample. J Nerv Ment Dis 2018; 206:270-276. [PMID: 29377849 DOI: 10.1097/nmd.0000000000000790] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Prevalence rates are still lacking for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) diagnoses based on the new ICD-11 criteria. In a nationwide representative German sample (N = 2524; 14-99 years), exposure to traumatic events and symptoms of PTSD or CPTSD were assessed with the International Trauma Questionnaire. A clinical variant of CPTSD with a lower threshold for core PTSD symptoms was also calculated, in addition to conditional prevalence rates dependent on trauma type and differential predictors. One-month prevalence rates were as follows: PTSD, 1.5%; CPTSD, 0.5%; and CPTSD variant, 0.7%. For PTSD, the highest conditional prevalence was associated with kidnapping or rape, and the highest CPTSD rates were associated with sexual childhood abuse or rape. PTSD and CPTSD were best differentiated by sexual violence. Combined PTSD and CPTSD (ICD-11) rates were in the range of previously reported prevalences for unified PTSD (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; ICD-10). Evidence on differential predictors of PTSD and CPTSD is still preliminary.
Collapse
|
44
|
Brewin CR, Cloitre M, Hyland P, Shevlin M, Maercker A, Bryant RA, Humayun A, Jones LM, Kagee A, Rousseau C, Somasundaram D, Suzuki Y, Wessely S, van Ommeren M, Reed GM. A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD. Clin Psychol Rev 2017; 58:1-15. [PMID: 29029837 DOI: 10.1016/j.cpr.2017.09.001] [Citation(s) in RCA: 309] [Impact Index Per Article: 44.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/18/2017] [Accepted: 09/05/2017] [Indexed: 11/27/2022]
Abstract
The World Health Organization's proposals for posttraumatic stress disorder (PTSD) in the 11th edition of the International Classification of Diseases, scheduled for release in 2018, involve a very brief set of symptoms and a distinction between two sibling disorders, PTSD and Complex PTSD. This review of studies conducted to test the validity and implications of the diagnostic proposals generally supports the proposed 3-factor structure of PTSD symptoms, the 6-factor structure of Complex PTSD symptoms, and the distinction between PTSD and Complex PTSD. Estimates derived from DSM-based items suggest the likely prevalence of ICD-11 PTSD in adults is lower than ICD-10 PTSD and lower than DSM-IV or DSM-5 PTSD, but this may change with the development of items that directly measure the ICD-11 re-experiencing requirement. Preliminary evidence suggests the prevalence of ICD-11 PTSD in community samples of children and adolescents is similar to DSM-IV and DSM-5. ICD-11 PTSD detects some individuals with significant impairment who would not receive a diagnosis under DSM-IV or DSM-5. ICD-11 CPTSD identifies a distinct group who have more often experienced multiple and sustained traumas and have greater functional impairment than those with PTSD.
Collapse
Affiliation(s)
- Chris R Brewin
- Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Marylène Cloitre
- Division of Dissemination and Training, National Center for PTSD, Menlo Park, CA, USA
| | - Philip Hyland
- School of Business, National College of Ireland, Dublin, Ireland
| | - Mark Shevlin
- School of Psychology, University of Ulster, Coleraine, North Ireland
| | - Andreas Maercker
- Department of Psychology, Division of Psychopathology, University of Zurich, Switzerland
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | | | - Lynne M Jones
- FXB Center for Health and Human Rights, Harvard School of Public Health, Harvard University, Cambridge, MA, USA
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Cécile Rousseau
- Department of Psychiatry, McGill University Health Center, Montreal, Canada
| | | | - Yuriko Suzuki
- National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | | | - Mark van Ommeren
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Geoffrey M Reed
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland; Global Mental Health Program, Columbia University Medical Center, New York, NY, USA
| |
Collapse
|
45
|
Isosävi S, Diab SY, Kangaslampi S, Qouta S, Kankaanpää S, Puura K, Punamäki RL. MATERNAL TRAUMA AFFECTS PRENATAL MENTAL HEALTH AND INFANT STRESS REGULATION AMONG PALESTINIAN DYADS. Infant Ment Health J 2017; 38:617-633. [DOI: 10.1002/imhj.21658] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | | | | | | | | | - Kaija Puura
- University of Tampere
- University Hospital of Tampere
| | | |
Collapse
|
46
|
Huh HJ, Kim KH, Lee HK, Chae JH. The relationship between childhood trauma and the severity of adulthood depression and anxiety symptoms in a clinical sample: The mediating role of cognitive emotion regulation strategies. J Affect Disord 2017; 213:44-50. [PMID: 28189964 DOI: 10.1016/j.jad.2017.02.009] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/30/2017] [Accepted: 02/06/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Childhood trauma is an important factor in adverse mental health outcomes, including depression and anxiety. The purpose of the present study was to evaluate a hypothesized model describing a pathway of childhood trauma and its influence on psychiatric symptoms in patients with depressive disorder. In this model, childhood trauma was positively associated with current depression and anxiety symptoms, which were mediated by a cognitive emotional regulation strategy. METHOD Patients with depressive disorder (n=585, 266 men, 316 women) completed the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Childhood Trauma Questionnaire (CTQ), and Cognitive Emotion Regulation Questionnaire (CERQ). We divided the cognitive emotion regulation strategies into adaptive and maladaptive strategies using a CERQ subscore. We employed structural equation modeling (SEM) and simple/multiple mediation analyses. RESULTS The indirect effect of maladaptive strategies was significant in the relationship between overall childhood trauma and depression/anxiety severity, whereas the mediation effect of adaptive strategies was limited to depressive symptoms. With respect to specific types of trauma, maladaptive strategies mediated the association between emotional abuse and current depression/anxiety, while the mediation effect of adaptive strategies was limited to emotional neglect. LIMITATIONS This study's cross-sectional design does not allow establishment of causal relationships. Childhood trauma recall bias may be possible. CONCLUSIONS These findings support the hypothesized model in which childhood trauma is associated with adulthood depression/anxiety symptoms in clinical samples, and mediated by emotion regulation strategies. These results suggest that cognitive emotion dysregulation is an important factor affecting depression/anxiety symptoms in patients with childhood trauma.
Collapse
Affiliation(s)
- Hyu Jung Huh
- Stress Clinic, Health Promotion Center, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine
| | - Kyung Hee Kim
- Department of Psychology, The Catholic University of Korea
| | - Hee-Kyung Lee
- Department of Psychology, The Catholic University of Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine.
| |
Collapse
|
47
|
Tarquinio C, Houllé W, Tarquinio P. Discussion autour du traumatisme complexe : émergence du concept, étiologie et critères diagnostiques. SEXOLOGIES 2017. [DOI: 10.1016/j.sexol.2016.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
48
|
Denton R, Frogley C, Jackson S, John M, Querstret D. The assessment of developmental trauma in children and adolescents: A systematic review. Clin Child Psychol Psychiatry 2017; 22:260-287. [PMID: 26940119 DOI: 10.1177/1359104516631607] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The assessment of children and young people with history of complex developmental trauma presents a significant challenge to services. Traditional diagnostic categories such as post-traumatic stress disorder (PTSD) are argued to be of limited value, and while the proposed 'Developmental Trauma Disorder' definition attempts to address this debate, associated assessment tools have yet to be developed. This review builds on a previous review of assessment measures, undertaken in 2005. AIM To identify trauma assessment tools developed or evaluated since 2004 and determine which are developmentally appropriate for children or adolescents with histories of complex trauma. METHOD A systematic search of electronic databases was conducted with explicit inclusion and exclusion criteria. RESULTS A total of 35 papers were identified evaluating 29 measures assessing general functioning and mental health ( N = 10), PTSD ( N = 7) and trauma symptomatology outside, or in addition to, PTSD ( N = 11). Studies were evaluated on sample quality, trauma/adversity type, as well as demographic and psychometric data. Distinction was made between measures validated for children (0-12 years) and adolescents (12-18 years). CONCLUSION Few instruments could be recommended for immediate use as many required further validation. The Assessment Checklist questionnaires, designed with a developmental and attachment focus, were the most promising tools.
Collapse
Affiliation(s)
- Ruth Denton
- 1 School of Psychology, University of Surrey, UK
| | | | - Sue Jackson
- 1 School of Psychology, University of Surrey, UK.,2 Psychology, University of the West of England, UK
| | - Mary John
- 1 School of Psychology, University of Surrey, UK
| | | |
Collapse
|
49
|
Silove D, Tay AK, Kareth M, Rees S. The Relationship of Complex Post-traumatic Stress Disorder and Post-traumatic Stress Disorder in a Culturally Distinct, Conflict-Affected Population: A Study among West Papuan Refugees Displaced to Papua New Guinea. Front Psychiatry 2017; 8:73. [PMID: 28620322 PMCID: PMC5449451 DOI: 10.3389/fpsyt.2017.00073] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 04/13/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Controversy continues about the validity of the construct of complex post-traumatic stress disorder (C-PTSD). In particular, questions remain whether C-PTSD can be differentiated from post-traumatic stress disorder (PTSD) and, secondarily, other common mental disorders. The examination of these issues needs to be expanded to populations of diverse cultural backgrounds exposed to prolonged persecution. We undertake such an inquiry among a community sample of West Papuan refugees exposed to extensive persecution and trauma. METHODS We interviewed over 300 West Papuan refugees using the Refugee-Mental Health Assessment Package to record symptoms of PTSD, C-PTSD, major depressive disorder (MDD), and complex grief (CG). We used first- and second-order confirmatory factor analysis (CFA) to test aspects of the convergent and discriminant validity of C-PTSD. RESULTS The CFA analysis supported both a one-factor and two-factor model of PTSD and C-PTSD. Nested model comparison tests provide support for the parsimonious one-factor model solution. A second-order CFA model of PTSD and C-PTSD produced a poor fit. The modified three-factor multi-disorder solution combining a traumatic stress (TS) factor (amalgamating PTSD and C-PTSD), MDD, and CG yielded a good fit only after removing three CG domains (estrangement, yearning, and behavioral change), a model that produced large standardized residuals (>0.20). CONCLUSION The most parsimonious model yielded a single TS factor combining symptom domains of C-PTSD and PTSD in this culturally distinct community exposed to extensive persecution and conflict-related trauma. There may be grounds for expanding the scope of psychological treatments for refugees to encompass this wider TS response. Our findings are consistent with theoretical frameworks focusing on the wider TS reaction of refugees exposed to human rights-related traumas of mass conflict, persecution, and displacement.
Collapse
Affiliation(s)
- Derrick Silove
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, Liverpool Hospital, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Alvin Kuowei Tay
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, Liverpool Hospital, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Moses Kareth
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, Liverpool Hospital, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Susan Rees
- Psychiatry Research and Teaching Unit, Academic Mental Health Unit, Liverpool Hospital, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
50
|
Powers A, Fani N, Carter S, Cross D, Cloitre M, Bradley B. Differential predictors of DSM-5 PTSD and ICD-11 complex PTSD among African American women. Eur J Psychotraumatol 2017; 8:1338914. [PMID: 28649302 PMCID: PMC5475321 DOI: 10.1080/20008198.2017.1338914] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: Complex posttraumatic stress disorder (CPTSD) is proposed for inclusion in the ICD-11 as a diagnosis distinct from posttraumatic stress disorder (PTSD), reflecting deficits in affective, self-concept, and relational domains. There remains significant controversy over whether CPTSD provides useful diagnostic information beyond PTSD and other comorbid conditions, such as depression or substance use disorders. Objective: The present study examined differences in psychiatric presentation for three groups: traumatized controls, DSM-5 PTSD subjects, and ICD-11 CPTSD subjects. Method: The sample included 190 African American women recruited from an urban public hospital where rates of trauma exposure are high. PTSD was measured using Clinician Administered PTSD Scale for DSM-5 and CPTSD was measured using clinician administered ICD-Trauma Interview. Psychiatric diagnoses and emotion dysregulation were also assessed. In a subset of women (n = 60), emotion recognition was measured using the Penn Emotion Recognition Task. Results: There were significant differences across groups on current and lifetime major depression (p < .001) and current and lifetime alcohol and substance dependence (p < .05), with CPTSD showing the highest rates of comorbidities. CPTSD women also showed significantly higher levels of childhood abuse and lower rates of adult secure attachment. Multivariate analysis of variance showed significantly more severe PTSD and depression symptoms and, as expected, more severe emotion dysregulation and dissociation, compared to DSM-5 PTSD and traumatized control groups. Individuals with CPTSD also had higher levels of emotion recognition to faces on a computer-based behavioural assessment, which may be related to heightened vigilance toward emotional cues from others. CPTSD women had better facial emotion recognition on a computer-based assessment, which may suggest heightened vigilance toward emotional cues. Conclusions: Our results suggest clear, clinically-relevant differences between PTSD and CPTSD, and highlight the need for further research on this topic with other traumatized populations, particularly studies that combine clinical and neurobiological data.
Collapse
Affiliation(s)
- Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GAUSA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GAUSA
| | - Sierra Carter
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GAUSA
| | - Dorthie Cross
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GAUSA
| | - Marylene Cloitre
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GAUSA
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GAUSA.,Atlanta VA Medical Center, Atlanta, GAUSA
| |
Collapse
|