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 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 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 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.

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 Gender Differences and Comorbidities in U.S. Adults with Bipolar Disorder

2018 ◽  
Vol 8 (9) ◽  
pp. 168 ◽  
Author(s):  
Rikinkumar Patel ◽  
Sanya Virani ◽  
Hina Saeed ◽  
Sai Nimmagadda ◽  
Jupi Talukdar ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
International Classification Of Diseases ◽  
Primary Diagnosis ◽  
Post Traumatic Stress ◽  
Chi Square ◽  
Comorbidity Burden ◽  
Classification Of Diseases ◽  
Related Quality ◽  
Health Related ◽  
Bipolar Patients

Background: Past studies have evaluated the association of various comorbidities with bipolar disorder. This study analyzes differences in the prevalence and association of medical and psychiatric comorbidities in bipolar patients by gender. Methods: A retrospective analysis was conducted using the Nationwide Inpatient Sample (2010–2014). Using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes, we narrowed the study population to comprise those with a primary diagnosis of bipolar disorder and then obtained information about comorbidities. The differences in comorbidities by gender were quantified using chi-square tests and the logistic regression model (odds ratio (OR)). Results: Hypertension (20.5%), asthma (12.5%) and hypothyroidism (8.1%) were the top medical comorbidities found in bipolar patients. Migraine and hypothyroidism were seen three times higher in females (OR = 3.074 and OR = 3.001; respectively). Females with bipolar disorder had higher odds of comorbid inflammatory disorders like asthma (OR = 1.755), Crohn’s disease (OR = 1.197) and multiple sclerosis (OR = 2.440) compared to males. Females had a two-fold higher likelihood of comorbid post-traumatic stress disorder (PTSD) (OR = 2.253) followed by personality disorders (OR = 1.692) and anxiety disorders (OR = 1.663) compared to males. Conclusion: Women with bipolar disorder have a much higher medical comorbidity burden than men and may highly benefit from an integrated team of physicians to manage their condition and improve their health-related quality of life.

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 Development of the new CPTSD diagnosis for ICD-11

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Andreas Maercker
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
International Classification Of Diseases ◽  
Personality Change ◽  
World Health ◽  
Post Traumatic Stress ◽  
Multi Stage ◽  
Post Traumatic ◽  
Health Organization

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.

scholarly journals Exercise Addiction and Perfectionism: A Systematic Review of the Literature

2021 ◽  
Vol 8 (1) ◽  
pp. 144-155 ◽  
Author(s):  
Gizem Çakın ◽  
Ignatius Darma Juwono ◽  
Marc N. Potenza ◽  
Attila Szabo
Keyword(s):  
International Classification Of Diseases ◽  
Situational Factors ◽  
Future Research ◽  
Statistical Manual ◽  
Exercise Addiction ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
The Common ◽  
The Relationship

Abstract Background and aims Exercise addiction may be conceptualized as a behavioral addiction in which a person develops an unhealthy obsession with exercise and physical activity. While exercise addiction is not a formally recognized disorder in the Diagnostic and Statistical Manual or the International Classification of Diseases, it has been studied and connected to both personal and situational factors. Perfectionism is a feature that has been strongly linked to exercise addiction. The objective of this systematic literature review, performed by following the PRISMA protocol, was to examine relationships between exercise addiction and perfectionism while also considering the subdimensions of perfectionism in different groups. Methods Three databases (PsycINFO, PubMed/Medline, and SPORTDiscus) were examined. Sixty relevant articles were identified, of which 22 met inclusion criteria. Results The findings substantiate that perfectionism and its dimensions are weakly or moderately related to exercise addiction. This relationship has been observed in adults, adolescents, athletes, and patients with eating disorders. Of the 22 studies examined, only one did not identify an association between perfectionism or its subdomain(s) and exercise addiction. However, in most studies, the common variance between perfectionism and exercise addiction is relatively small, raising questions regarding the clinical relevance of the relationship. Conclusion Perfectionism is related to exercise addiction, but the strength of the relationship varies in different circumstances, which should be examined in future research.

scholarly journals Treatment of adult post-traumatic stress disorder using a future-oriented writing therapy approach

2009 ◽  
Vol 2 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Reginald D. V. Nixon ◽  
Leonard W. Kling
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Expressive Writing ◽  
Stress Disorder ◽  
Post Treatment ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Ptsd Severity

AbstractThe aim of this pilot study was to test whether a future-oriented expressive writing intervention is able to reduce post-traumatic stress disorder (PTSD) severity and associated symptoms such as depression and unhelpful trauma-related beliefs. In an uncontrolled pre-/ post-design participants attended 8 weeks of manualized therapy. Assessment was undertaken pre- and post-treatment, and participants also completed a 3-month follow-up assessment. Of the 17 participants who began therapy, 13 were treatment completers. Results indicated a significant decrease in PTSD severity, depression and unhelpful trauma-related cognitions from pre- to post-treatment and at 3-month follow-up. Clinically meaningful change was more modest; however, three participants reported PTSD remission at 3-month follow-up. It is concluded that expressive writing with a focus on achieving future goals and personal change may have some utility in reducing post-traumatic stress but future research will need to investigate this with greater methodological rigour before firm conclusions can be made.

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