scholarly journals Surviving violent, traumatic loss after severe political persecution: lessons from the evaluation of a Venezuelan asylum seeker

2021 ◽  
Vol 14 (3) ◽  
pp. e239025
Author(s):  
Jennifer H McQuaid ◽  
Michelle Alejandra Silva ◽  
Katherine C McKenzie
Keyword(s):  
Traumatic Loss ◽  
Statistical Manual ◽  
Cultural Rights ◽  
Diagnostic And Statistical Manual ◽  
High Commissioner ◽  
Persistent Complex Bereavement ◽  
Mental Health Effects ◽  
Political Persecution ◽  
Persistent Complex Bereavement Disorder

In July 2019, the United Nations High Commissioner for Refugees (UNHCR) released a report urging the Venezuelan government to take immediate action to address the ‘grave violations of economic, social, civil, political and cultural rights’ occurring in the country. This case study highlights the human rights violations occurring in Venezuela through the case of a Venezuelan woman who experienced political persecution and traumatic loss resulting from her opposition to the ruling socialist party. As the clinical team of evaluators explored the mental health effects of surviving threats on her own life and the politically motivated assassination of her husband, it was agreed that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition did not fully capture the extent of her suffering. Case discussion broadens the lens beyond the client’s experiences of posttraumatic stress disorder (PTSD) and depression to include persistent complex bereavement disorder, and emphasises the importance of addressing the sequelae of traumatic loss in a multifaceted way that broadens understanding of emotional functioning postmigration.

Cultural Context in DSM Diagnosis: An American Indian Case Illustration of Contradictory Trends

2019 ◽  
Vol 57 (4) ◽  
pp. 567-580 ◽  
Author(s):  
Melanie E. Langa ◽  
Joseph P. Gone
Keyword(s):  
American Indian ◽  
Cultural Context ◽  
Illness Experience ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
History Of ◽  
Culturally Diverse Populations ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder

Recent revisions of the Diagnostic and Statistical Manual of Mental Disorders ( DSM) increasingly acknowledge the importance of cultural context for the diagnosis of mental illness. However, these same revisions include evolving diagnostic criteria that simultaneously decontextualize particular disorders such as Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD). As a result, the DSM reflects a contradictory role for context in psychiatric diagnosis. The case analysis presented here frames the consequences of this contradictory trend for an American Indian woman with a history of DSM-IV MDD and PTSD, whose diagnostic portrait is substantively altered in light of more recent DSM-5 criteria. Specifically, consideration of this respondent’s bereavement-related illness experience suggests that a sociocentric cultural frame of reference, which places high value on interdependent personal relationships, is not well-captured by DSM-5’s revised MDD or PTSD criteria, or the newly proposed categories of traumatic bereavement or Persistent Complex Bereavement Disorder. The respondent’s illness experience argues for greater recognition of this contradictory diagnostic trend, suggesting a need for future resolution of this tension toward more valid diagnosis for culturally diverse populations.

A case series: Efficacy of short term EMDR on patients with persistent complex bereavement disorder (PCBD)

2017 ◽  
Vol 41 (S1) ◽  
pp. S360-S361
Author(s):  
F.D. Usta ◽  
A.B. Yasar ◽  
A.E. Abamor ◽  
M. Caliskan
Keyword(s):  
Sleep Disturbances ◽  
Case Series ◽  
Traumatic Loss ◽  
Degree Relative ◽  
Current Case ◽  
Prolonged Grief ◽  
Persistent Complex Bereavement ◽  
Competing Interest ◽  
Persistent Complex Bereavement Disorder ◽  
Emdr Therapy

Grief is a normal response to loss of someone to whom a bond was formed; however, prolonged grief is considered pathological. Persistent complex bereavement disorder (PCBD) is defined as a persistent longing for the deceased over 12 months. Several treatment ways have been used for traumatic loss including eye movement desensitization and reprocessing (EMDR). In the current case series, effectiveness of EMDR on three PCBD patients will be indicated. Three patients applied to the clinic with similar complaints based on different traumatic backgrounds; commonly, all experienced death of a first-degree relative. Complaints of the patients were over-thinking about the deceased, sleep disturbances, self-blaming, social isolation, avoiding talks about lost relative, and loss of interest in activities. After pre-interviews, they were advised EMDR therapy. One session of EMDR was applied to two of the patients, and two EMDR sessions were conducted on one of them. After the sessions, the patients reported not feeling guilty about the loss anymore, returning their normal routines, feeling better, and showing decreased avoidance. Additionally, the scores of scales (CAPS, BAI, BDI, and IES-R) significantly declined. EMDR therapy can show successful results in a shorter time than other treatment ways used for PCBD treatment [1].Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals A cognitive approach to persistent complex bereavement disorder (PCBD)

2017 ◽  
Vol 10 ◽  
Author(s):  
Michael Duffy ◽  
Jennifer Wild
Keyword(s):  
Cognitive Model ◽  
Diagnostic Category ◽  
Post Traumatic Stress ◽  
Cognitive Approach ◽  
Prolonged Grief ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
International Statistical Classification ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder

AbstractPersistent complex bereavement disorder (PCBD) has been included in the appendix of the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders as a condition for further study, and a new diagnostic category of prolonged grief disorder (PGD) is likely to be added to the International Statistical Classification of Diseases and Related Health Problems (ICD-11) (Maercker et al., 2013). Whilst there is increasing evidence that prolonged grief has distinct characteristics (Bryant, 2012), there are clinical features that overlap with post-traumatic stress disorder (PTSD), such as intrusive memories, emotional numbing, and avoidance of trauma or loss reminders. Here we describe how the cognitive model for persistent PTSD (Ehlers and Clark, 2000) and trauma-focused cognitive therapy for PTSD (Ehlers et al., 2005) have been helpful in treating persistent complex grief.

scholarly journals Reciprocal Associations Among Symptom Levels of Disturbed Grief, Posttraumatic Stress, and Depression Following Traumatic Loss: A Four-Wave Cross-Lagged Study

2019 ◽  
Vol 7 (6) ◽  
pp. 1330-1339 ◽  
Author(s):  
Lonneke I. M. Lenferink ◽  
Angela Nickerson ◽  
Jos de Keijser ◽  
Geert E. Smid ◽  
Paul A. Boelen
Keyword(s):  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Clinical Samples ◽  
Depression Symptoms ◽  
Depression Symptom ◽  
Significant Other ◽  
Traumatic Loss ◽  
Persistent Complex Bereavement ◽  
Persistent Complex Bereavement Disorder ◽  
Reciprocal Associations

Disturbed grief, operationalized as persistent complex bereavement disorder (PCBD), correlates with yet differs from posttraumatic stress disorder (PTSD) and depression symptoms. However, knowledge about temporal associations among these symptoms is limited. We aimed to enhance our understanding of the etiology of loss-related distress by examining temporal associations among PCBD, PTSD, and depression symptom levels. Dutch people ( N = 172) who lost significant other(s) in a plane disaster completed questionnaires for PCBD, PTSD, and depression 11, 22, 31, and 42 months after the disaster. Cross-lagged analyses revealed that changes in PCBD symptom levels have a greater impact on changes in symptom levels of PTSD and depression than vice versa. Our findings contradict the notion that PTSD and depression symptoms should be addressed before grief in treatment. Pending replication of our findings in clinical samples, we tentatively conclude that screening and treatment of grief symptoms has potential value in preventing long-lasting distress.

Be Your Own Superhero: A Case of a Young Boy With Selective Mutism and Complex Comorbidities

2018 ◽  
Vol 17 (5) ◽  
pp. 348-365
Author(s):  
Maria Khan ◽  
Kimberly Renk
Keyword(s):  
Selective Mutism ◽  
Comorbid Conditions ◽  
Language Therapy ◽  
Statistical Manual ◽  
Speech And Language Therapy ◽  
Comorbid Anxiety ◽  
Diagnostic And Statistical Manual ◽  
Treatment Focus ◽  
Significant Impairment

This case study outlines the treatment of a 5-year-old Caucasian male who presented with symptoms of selective mutism (SM) along with significant impairment related to comorbid anxiety and speech difficulties. To address these symptoms, Integrated Behavior Therapy for Selective Mutism (IBTSM) was utilized for the treatment of this young boy’s SM and comorbid anxiety. An attachment focus was incorporated as a framework for conceptualizing his SM symptoms. As the treatment of this young boy’s symptoms proceeded, it became clear that his underlying speech difficulties needed to be addressed as well, as these difficulties were preventing expected progress to occur. Thus, this young boy’s treatment was individualized to fit his unique difficulties. In shifting the treatment focus to “being brave like a superhero,” significant decreases were achieved in this young boy’s overall internalizing and Diagnostic and Statistical Manual of Mental Disorders ( DSM)-related anxiety symptoms, facilitating a successful transition to speech and language therapy. This case study is distinctive in its description of the complexities that may come along with treating symptoms that appear consistent with SM along with other comorbid conditions and nuanced circumstances.

A Case Study: Effects of EMDR Therapy on a Patient with Persistent Complex Bereavement Disorder (PCBD)

2017 ◽  
Vol 41 (S1) ◽  
pp. S728-S728 ◽  
Author(s):  
A.B. Yasar ◽  
A.E. Abamor ◽  
F.D. Usta ◽  
S. Erdogan Taycan ◽  
M. Zengin Eroglu
Keyword(s):  
Small City ◽  
Working Mother ◽  
Loved One ◽  
Her Family ◽  
Marital Dissatisfaction ◽  
Persistent Complex Bereavement ◽  
Competing Interest ◽  
Persistent Complex Bereavement Disorder ◽  
Emdr Therapy

BackgroundLoss of a loved one is a distressing event that may result in grief characterized by emotional distress, longing of the dead, and dysfunctionality. Persistent complex bereavement disorder (PCBD) is differentiated by extended and damaging bereavement [1], which is being treated by some with EMDR [2]. In this study, the effects of an EMDR session on a patient with PCBD will be analyzed.CaseG.Ö. (45) is a married housewife who had been working, mother of a kid and a baby. She has lived with her family and her mother in a metropolitan city until her mother died a year ago, unexpectedly. Then, she quitted her job and they moved in a small city upon her husband's wish. The inpatient had complaints such as active suicidal thoughts, marital dissatisfaction and an ongoing deep sadness. EMDR therapy is applied on her grief and dysfunctional beliefs.ConclusionAfter one session of EMDR, her mood improved, her ruminations declined, she sought job, and became hopeful for the future. In our case, even one session of EMDR let remarkable improvements on PCBD. Indeed, as for other trauma-related issues, EMDR therapy can be utilized on PCBD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Comparison of Alcohol Use Disorders in DSM and ICD

2020 ◽  
Vol 66 (3) ◽  
pp. 143-153
Author(s):  
Jessica W. M. Wong ◽  
Friedrich M. Wurst ◽  
Ulrich W. Preuss
Keyword(s):  
Alcohol Use Disorders ◽  
International Classification Of Diseases ◽  
Clinical Use ◽  
Diagnostic Systems ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Historical Developments

Abstract. Introduction: With advances in medicine, our understanding of diseases has deepened and diagnostic criteria have evolved. Currently, the most frequently used diagnostic systems are the ICD (International Classification of Diseases) and the DSM (Diagnostic and Statistical Manual of Mental Disorders) to diagnose alcohol-related disorders. Results: In this narrative review, we follow the historical developments in ICD and DSM with their corresponding milestones reflecting the scientific research and medical considerations of their time. The current diagnostic concepts of DSM-5 and ICD-11 and their development are presented. Lastly, we compare these two diagnostic systems and evaluate their practicability in clinical use.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

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