scholarly journals Complex PTSD: Psychotherapy of Prolonged Traumatization

2021 ◽  
Vol 29 (3) ◽  
pp. 69-87
Author(s):  
M.A. Padun

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.

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.


1994 ◽  
Vol 24 (1) ◽  
pp. 15-27 ◽  
Author(s):  
Brenda Parry-Jones ◽  
William Ll. Parry-Jones

SynopsisPost-traumatic stress disorder was first recognized as a diagnostic category embracing reactions in response to overwhelming environmental stress ‘outside the range of usual human experience’ in DSM-III (APA, 1980). Such abnormal stressors are by no means a product of the twentieth century but have featured, sporadically, in all societies from the earliest civilizations. Longitudinal investigations of traumatic stress have rarely gone further back than the nineteenth century, and have been concerned, almost exclusively, with adverse effects following railway accidents and military combat. The present study, utilizing a mid-eighteenth century medical source, presents an analysis of the impact of a natural disaster on members of a peasant family trapped in an avalanche in the Italian Alps in 1755.


Author(s):  
Dean G. Kilpatrick ◽  
Matthew J. Friedman ◽  
Amanda K. Gilmore

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.


2020 ◽  
Vol 12 (12) ◽  
pp. 495-502
Author(s):  
Kamran Baqai

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.


Dramatherapy ◽  
2022 ◽  
pp. 026306722110682
Author(s):  
Lee-Anne Widnall

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.


2020 ◽  
pp. bmjmilitary-2020-001622 ◽  
Author(s):  
Dominic Murphy ◽  
C Williamson ◽  
J Baumann ◽  
W Busuttil ◽  
N T Fear

IntroductionData are emerging showing the adverse consequences on mental health of the general public due to the COVID-19 pandemic. Little is known about the needs of veterans with pre-existing mental health difficulties during the COVID-19 pandemic.MethodsData were collected through a cross-sectional online survey from a randomly selected sample (n=1092) of military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 25.2% (n=275). Participants were asked to complete a range of standardised mental health outcomes (post-traumatic stress disorder (PTSD): Post-traumatic Stress Disorder Checklist, common mental health difficulties (CMDs): 12-Item General Health Questionnaire, difficulties with anger: 5-Item Dimensions of Anger Reactions—Revised and alcohol misuse: Alcohol Use Disorders Identification Test) and endorse a list of potential stressors related to changes to daily life resulting from COVID-19. Regression analyses were fitted to explore predictors of mental health severity.ResultsIt was observed that symptoms of common mental disorder and PTSD (69.3% and 65.0%, respectively) were the most commonly reported to have been exacerbated by the pandemic. Lack of social support and reporting increasing numbers of stressors related to COVID-19 were consistently associated with increasing severity of a range of mental health difficulties.ConclusionsOur findings suggest veterans who had pre-existing mental health difficulties prior to the outbreak of COVID-19 may be at increased risk of experiencing CMDs as a result of the pandemic. Intervening to improve levels of social support and offering practical guidance to better manage any additional stressors relating to the pandemic may provide strategies to help reduce the burden of mental health symptoms.


Author(s):  
Andreas Maercker

Abstract Background The diagnosis of complex post-traumatic stress disorder (CPTSD) was proposed several decades ago by scientist-practitioners, almost parallel to the first description of the diagnosis of post-traumatic stress disorder (PTSD). In the previous International Classification of Diseases, version 10 (ICD-10) issued by the World Health Organization (WHO), this symptom constellation was termed ‘enduring personality change after catastrophic experience’. This diagnosis has not been clinically influential, nor has it been subjected to much research. Thus, in a multi-stage process of ICD-11 development, the diagnosis of CPTSD was developed. Methods This paper provides a review of the historical lines of development that led to the CPTSD diagnosis, as well as the results since the ICD-11 publication in 2018. Results The CPTSD diagnosis comprises the core symptoms of the – newly, narrowly defined – PTSD diagnosis, the three symptom groups of affective, relationship, and self-concept changes. The diagnosis is clinically easy to use in accordance with the WHO development goals for the ICD-11 and has shown good psychodiagnostic properties in various studies, including good discrimination from personality disorder with borderline pattern. Conclusion The scholarly use of the new diagnosis has resulted in an increasing number of published studies on this topic in the diagnostic and therapeutic fields.


Sign in / Sign up

Export Citation Format

Share Document