scholarly journals A cry for help: Dramatherapists can intervene to change the language and environment in mental health care by engaging critically with the new diagnostic category of Complex PTSD

Dramatherapy ◽  
2022 ◽  
pp. 026306722110682
Author(s):  
Lee-Anne Widnall
Keyword(s):  
Mental Health ◽  
Diagnostic Category ◽  
International Classification Of Diseases ◽  
Diagnostic Model ◽  
Post Traumatic Stress ◽  
Healthcare Settings ◽  
Cry For Help ◽  
Classification Of Diseases ◽  
Post Traumatic ◽  
Management Approaches

In funded healthcare settings, access to dramatherapy and other arts therapies is limited. Patients suffering the long-term emotional effects of childhood or prolonged trauma are often not helped by short-term funded therapies. These therapies that engage in the diagnostic model of suffering with disorder specific research speak little to those suffering multiple traumas. This leaves dramatherapists unable to reach those most in need of their skills. At the same time, survivors are left bewildered and shamed again as they ‘fail’ to benefit from the limited symptom management approaches on offer. While the diagnostic model of suffering may be approaching obsolescence, what still seems a long way away is a major overhaul of the mainstream understanding of suffering and mental health that could fuel a reorganisation of how services are delivered and research conducted. In this context, the new diagnostic criteria of Complex Post Traumatic Stress Disorder in the International Classification of Diseases-11 provides an opportunity and perhaps even a rallying cry for dramatherapists to evidence how our skills can provide a framework and method for survivors to re-imagine themselves and understand and claim their place in the world by loosening the chains of fear and shame.

scholarly journals Complex PTSD: Psychotherapy of Prolonged Traumatization

2021 ◽  
Vol 29 (3) ◽  
pp. 69-87
Author(s):  
M.A. Padun
Keyword(s):  
Traumatic Stress ◽  
Complex Trauma ◽  
Diagnostic Category ◽  
International Classification Of Diseases ◽  
Emotional Dysregulation ◽  
Post Traumatic Stress ◽  
Classification Of Diseases ◽  
Post Traumatic ◽  
The Impact

The article considers a new diagnostic category — complex post-traumatic stress disorder (CPTSD), introduced into the International Classification of Diseases (ICD-11). Differences in the mechanism of influence of situational and prolonged trauma are analyzed. CPTSD diagnostic criteria are compared to PTSD and BPD (borderline personality disorder) symptoms. The term “disturbances in self-organi¬zation” is analyzed, which explains the main mechanism of the impact of complex trauma and includes emotional dysregulation, disturbances in self-perception and relationships. Psychotherapeutic approaches developed for PTSD were shown to be insufficient for the treatment of CPTSD. The article reviews an approach to CPSTD therapy based on the consensus of experts in the field of post-traumatic stress and its possible limitations are discussed. “Component based psychotherapy” — another approach to CPTSD therapy — is described. Specific features of psychotherapy for complex trauma are discussed.

scholarly journals Clinical implications of the proposed ICD-11 PTSD diagnostic criteria

2018 ◽  
Vol 49 (3) ◽  
pp. 483-490 ◽  
Author(s):  
Anna C. Barbano ◽  
Willem F. van der Mei ◽  
Richard A. Bryant ◽  
Douglas L. Delahanty ◽  
Terri A. deRoon-Cassini ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Traumatic Events ◽  
International Classification Of Diseases ◽  
Post Traumatic Stress ◽  
Case Identification ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Post Traumatic ◽  
Projected Changes ◽  
Moderate Range

AbstractBackgroundProjected changes to post-traumatic stress disorder (PTSD) diagnostic criteria in the upcoming International Classification of Diseases (ICD)-11 may affect the prevalence and severity of identified cases. This study examined differences in rates, severity, and overlap of diagnoses using ICD-10 and ICD-11 PTSD diagnostic criteria during consecutive assessments of recent survivors of traumatic events.MethodsThe study sample comprised 3863 survivors of traumatic events, evaluated in 11 longitudinal studies of PTSD. ICD-10 and ICD-11 diagnostic rules were applied to the Clinician-Administered PTSD Scale (CAPS) to derive ICD-10 and ICD-11 diagnoses at different time intervals between trauma occurrence and 15 months.ResultsThe ICD-11 criteria identified fewer cases than the ICD-10 across assessment intervals (range −47.09% to −57.14%). Over 97% of ICD-11 PTSD cases met concurrent ICD-10 PTSD criteria. PTSD symptom severity of individuals identified by the ICD-11 criteria (CAPS total scores) was 31.38–36.49% higher than those identified by ICD-10 criteria alone. The latter, however, had CAPS scores indicative of moderate PTSD. ICD-11 was associated with similar or higher rates of comorbid mood and anxiety disorders. Individuals identified by either ICD-10 or ICD-11 shortly after traumatic events had similar longitudinal course.ConclusionsThis study indicates that significantly fewer individuals would be diagnosed with PTSD using the proposed ICD-11 criteria. Though ICD-11 criteria identify more severe cases, those meeting ICD-10 but not ICD-11 criteria remain in the moderate range of PTSD symptoms. Use of ICD-11 criteria will have critical implications for case identification in clinical practice, national reporting, and research.

scholarly journals Complex post-traumatic stress disorder in participants of the military actions in the operation militarygroups in the view of the eleven edition of the International classification of diseases

2019 ◽  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Life Questionnaire ◽  
Post Traumatic Stress ◽  
Classification Of Diseases ◽  
Post Traumatic

The introduction of the new concept of complex post-traumatic stress disorder (cPTSD) in the International Classification of Diseases of the 11th Edition deserves attention in a country where active fighting is taking place. The increase in the number of PTSD sufferers among military personnel and civilians on the territory of hostilities increases the likelihood of PTSD occurring among the contingent. At present, we have no experience in the diagnosis of cPTSD. The objective of our study, along with the diagnosis of PTSD symptoms, is to use a quality of life questionnaire to evaluate the symptoms of cPTSD. The result revealed that the level of community and service support was below average, indicating the need to improve community social support. The self-realization of the combatants has a low average level, which further influences the level of adaptation after the end of the service. Physical and psychological well-being are also low, and this indicator to the need for psychological and physical rehabilitation of demobilized soldiers. At the same time, communication with friends and family, performance were at a high enough level, and these are positive factors that influence the adaptation to civilian life. Summarizing the research, we suggest that in order to organize the help of the combatants more effectively, it is necessary to evaluate, along with a purely psychiatric diagnosis of PTSD, the level of social and physical adaptation of patients with PTSD.

Examining the prevalence of complex PTSD in an inpatient DBT service for females with a primary diagnosis of EUPD

2021 ◽  
Vol 2 (1) ◽  
pp. 79-95
Author(s):  
Deborah Morris ◽  
◽  
Elanor Lucy Webb ◽  
Jessica Holmes ◽  
Katharine Reynolds ◽  
...  
Keyword(s):  
Functional Impairment ◽  
International Classification Of Diseases ◽  
Primary Diagnosis ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Diagnostic Thresholds ◽  
Clinical Presentations ◽  
Classification Of Diseases ◽  
Post Traumatic ◽  
Emotionally Unstable Personality Disorder

In response to differential clinical presentations of survivors of multiple or chronic exposure to trauma, complex post-traumatic stress disorder (CPTSD) has been included in the 11th revision of the International Classification of Diseases (ICD-11). A growing body of research has explored the prevalence of CPTSD in a range of populations, yet its prevalence in adults diagnosed with Emotionally Unstable Personality Disorder (EUPD) has been subject to limited evaluation, including in individuals requiring specialist inpatient care. The International Trauma Questionnaire (ITQ) was administered to 42 females with primary diagnoses of EUPD admitted to a specialist DBT service. Twenty-eight (66.8%) participants met full diagnostic criteria for either PTSD (11.9%, n=5) or CPTSD (54.8%, n=23). Additionally, PTSD and CPTSD symptomatology were highly prevalent in participants who did not meet the functional impairment criteria. Significant differences in the prevalence of CPTSD were found, dependent on whether a measure of functional impairment was included. This is the first study to explore the prevalence of CPTSD in an inpatient EUPD sample, using diagnostic thresholds. The findings highlight the importance of attending to trauma as well as EUPD-related needs. Theoretical, clinical and future research implications are discussed.

scholarly journals Beyond “PTSD”: How stories and artworks that “make strange” can serve as signposts on new maps toward the communalization of military trauma

2017 ◽  
Vol 4 ◽  
Author(s):  
LAUREN SPRING
Keyword(s):  
Mental Health ◽  
Transformative Learning ◽  
Modern Art ◽  
Diagnostic Category ◽  
Post Traumatic Stress ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Military Trauma ◽  
Post Traumatic ◽  
Critical Literature

The psychiatric system, in large part due to its reliance on the Diagnostic and Statistical Manual (DSM), has a tendency to pathologize ordinary human reactions to difficult life events, and to individualize treatments for “mental illness.” This article builds on existing literature that is critical of psychiatry and proposes that art and stories that ‘make strange’ and elude easy interpretation may serve as a powerful counterpoint or complement to the ‘standard way of doing things’ when it comes to mental health care. Using military trauma as an example, this article highlights the inadequacies of Post Traumatic Stress Disorder (PTSD) as a diagnostic category; and, drawing from critical literature in the field and the author’s own experiences working with groups of traumatized veterans, it illustrates how and why ancient mythology and modern art especially may serve as useful tools for those who are having problems with living. The ‘disorienting dilemmas’ and consciousness-raising discussions such works evoke have the potential to touch on vital, nuanced, and philosophical aspects of trauma and suffering that are too often overlooked by the psychiatric profession.Keywords: military trauma; mental health; modern art; theatre; ancient mythology; transformative learning; museums; PTSD.

Classification and descriptive psychopathology of post-traumatic stress disorder and other stressor-related disorders

2020 ◽  
pp. 819-828
Author(s):  
Dean G. Kilpatrick ◽  
Matthew J. Friedman ◽  
Amanda K. Gilmore
Keyword(s):  
Diagnostic Criteria ◽  
International Classification Of Diseases ◽  
Post Traumatic Stress ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Wide Range ◽  
Classification Of Diseases ◽  
Post Traumatic

This chapter addresses the new section in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) called ‘Trauma and stressor-related disorders’. All diagnoses within this category have two things in common: (1) a discrete traumatic/adverse event or experience that preceded the onset or aggravation of symptoms; and (2) a wide range of cognitions, emotions, and behaviours embedded within DSM-5 diagnostic criteria for each disorder. The chapter also discusses the comparable proposed diagnostic criteria for the eleventh edition of the International Classification of Diseases (ICD-11). Current considerations and challenges regarding the classification of stressor-related disorders are reviewed.

scholarly journals PTSD in paramedics: history, conceptual issues and psychometric measures

2020 ◽  
Vol 12 (12) ◽  
pp. 495-502
Author(s):  
Kamran Baqai
Keyword(s):  
Psychological Trauma ◽  
International Classification Of Diseases ◽  
Stressful Events ◽  
Post Traumatic Stress ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Psychometric Measures ◽  
Classification Of Diseases ◽  
Post Traumatic

Post-traumatic stress disorder (PTSD) is more common in paramedics than in the general population because of the stressful and distressing nature of their work. Forms of PTSD associated with chronic stress and repeated trauma are scarcely researched among paramedics. This is striking as this workforce is potentially more likely to be affected by these types of PTSD. Diagnostic processes are still largely based on acute rather than chronic psychological trauma. PTSD diagnosis has been influenced by sociological perceptions of mental illness and changes in diagnostic criteria. Criteria for the diagnosis of PTSD in the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases have changed in the past decade, which may facilitate more appropriate diagnoses of PTSD in paramedics. Paramedics often have a complex aetiology of PTSD resulting from experiences of both chronic and acute events. Questionnaires that cover exposure to both individual and repeated stressful events are required to enable further research in the area of PTSD in paramedics.

scholarly journals Assessing the Feasibility of Providing a Family Skills Intervention, “Strong Families”, for Refugee Families Residing in Reception Centers in Serbia

2021 ◽  
Vol 18 (9) ◽  
pp. 4530
Author(s):  
Aala El-Khani ◽  
Karin Haar ◽  
Milos Stojanovic ◽  
Wadih Maalouf
Keyword(s):  
Mental Health ◽  
Parenting Practices ◽  
Humanitarian Aid ◽  
Post Traumatic Stress ◽  
Emotional Challenges ◽  
Refugee Families ◽  
Quantitative Results ◽  
Post Traumatic ◽  
Family Mental Health ◽  
Anxiety Depression

War exposure and forced displacement threatens the wellbeing of caregivers and their children, leaving them at risk of negative outcomes, such as elevated rates of anxiety, depression and post-traumatic stress disorder. The importance of engaged, responsive and stable parenting for positive child wellbeing has been documented across diverse cultural and economic backgrounds. Despite the higher need for caregivers to be nurturing in challenging settings, they struggle to provide adequate support for their children due to lack of resources or their inability to deal with their own emotional challenges. A feasibility study was conducted of a new, open-access and light-touch family skills intervention, Strong Families (for families in humanitarian and challenged settings) on refugee families residing in Reception Centers in Serbia. Questionnaires and interviews were completed by participating caregivers and facilitators. Qualitative results indicated that the intervention was feasible to run in this humanitarian context, that caregivers viewed the intervention as culturally acceptable and complemented the quantitative results that showed promise for enhancing child behavior and family functioning tested indicators. Despite being a light intervention, Strong Families indicated improvement on child mental health, parenting practices and parent and family adjustment skills. Prioritizing family mental health and functioning as a primary need that parallels that of accessing physical medical care, sanitation and clean water must be the definitive next step in humanitarian aid.

scholarly journals Paranoia in patients attending child and adolescent mental health services

2021 ◽  
pp. 000486742098141
Author(s):  
Jessica C Bird ◽  
Emma C Fergusson ◽  
Miriam Kirkham ◽  
Christina Shearn ◽  
Ashley-Louise Teale ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Network Analyses ◽  
Self Harm ◽  
Post Traumatic ◽  
Peer Difficulties

Objective: Paranoia may be particularly prevalent during adolescence, building on the heightened social vulnerabilities at this age. Excessive mistrust may be corrosive for adolescent social relationships, especially in the context of mental health disorders. We set out to examine the prevalence, symptom associations, and persistence of paranoia in a cohort of young people attending child and adolescent mental health services. Method: A total of 301 patients (11–17 years old) completed measures of paranoia, affect, peer difficulties and behavioural problems. Clinicians also rated each participant’s psychiatric symptoms. Patterns of association were examined using linear regressions and network analyses. In total, 105 patients repeated the measures several months later. Results: Most of the adolescents had affective disorders ( n = 195), self-harm/suicidality ( n = 82), or neurodevelopmental conditions ( n = 125). Few had suspected psychosis ( n = 7). Rates of paranoia were approximately double compared with previous reports from the general population. In this patient sample, 35% had at least elevated paranoia, 15% had at least moderate paranoia, and 6% had high paranoia. Paranoia had moderate associations with clinician-rated peer difficulties, self-harm, and trauma, and small associations with clinician-rated social anxiety, depression, generalised anxiety, and educational problems. Network analyses showed paranoia had the strongest unique relationship with peer difficulties. Paths from peer difficulties to anxiety, self-harm, post-traumatic stress disorder symptoms, and behavioural problems were all via paranoia. Both self-harm and post-traumatic stress disorder were solely associated with paranoia in the network. Paranoia remained persistent for three-quarters and was associated with greater psychological problems over time. Conclusion: Paranoia is relatively common and persistent across a range of clinical presentations in youth. When paranoia occurs alongside emotional problems, important peer interactions may be adversely affected. Wider consideration of paranoia in adolescent patients is needed.

scholarly journals Physiological parameters of mental health predict the emergence of post-traumatic stress symptoms in physicians treating COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
T. Dolev ◽  
S. Zubedat ◽  
Z. Brand ◽  
B. Bloch ◽  
E. Mader ◽  
...  
Keyword(s):  
Mental Health ◽  
Sleep Quality ◽  
Traumatic Stress ◽  
A Priori ◽  
Treatment Strategies ◽  
Physiological Measures ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Post Traumatic

AbstractLack of established knowledge and treatment strategies, and change in work environment, may altogether critically affect the mental health and functioning of physicians treating COVID-19 patients. Thus, we examined whether treating COVID-19 patients affect the physicians’ mental health differently compared with physicians treating non-COVID-19 patients. In this cohort study, an association was blindly computed between physiologically measured anxiety and attention vigilance (collected from 1 May 2014 to 31 May 31 2016) and self-reports of anxiety, mental health aspects, and sleep quality (collected from 20 April to 30 June 2020, and analyzed from 1 July to 1 September 2020), of 91 physicians treating COVID-19 or non-COVID-19 patients. As a priori hypothesized, physicians treating COVID-19 patients showed a relative elevation in both physiological measures of anxiety (95% CI: 2317.69–2453.44 versus 1982.32–2068.46; P < 0.001) and attention vigilance (95% CI: 29.85–34.97 versus 22.84–26.61; P < 0.001), compared with their colleagues treating non-COVID-19 patients. At least 3 months into the pandemic, physicians treating COVID-19 patients reported high anxiety and low quality of sleep. Machine learning showed clustering to the COVID-19 and non-COVID-19 subgroups with a high correlation mainly between physiological and self-reported anxiety, and between physiologically measured anxiety and sleep duration. To conclude, the pattern of attention vigilance, heightened anxiety, and reduced sleep quality findings point the need for mental intervention aimed at those physicians susceptible to develop post-traumatic stress symptoms, owing to the consequences of fighting at the forefront of the COVID-19 pandemic.

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