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Margaret Spottswood, John Fortney, Jessica A Chen, Dimitry Davydow, Hsiang Huang
Posttraumatic stress disorder (PTSD) occurs following acute threatening events in approximately 12.5% of the primary care population. OBJECTIVE: The aim of this article is to advance evidence-based clinical practice and collaborative care approaches to PTSD by summarizing targeted-care guidelines. METHOD: This narrative literature review addresses important aspects of PTSD and management options, in conjunction with expert opinion when indicated. Guidelines were included if they targeted treatment of PTSD in the primary care setting or if the treatments described could be provided in the primary care setting...
January 4, 2019: Harvard Review of Psychiatry
Henrik Kessler, Emily A Holmes, Simon E Blackwell, Anna-Christine Schmidt, Johanna M Schweer, Anna Bücker, Stephan Herpertz, Nikolai Axmacher, Aram Kehyayan
OBJECTIVE: The core clinical feature of posttraumatic stress disorder (PTSD) is recurrent intrusive memories of trauma. This study aimed to test a novel and simple intervention, inspired by the concepts of concurrent task interference and memory reconsolidation, to reduce the occurrence of intrusive memories among inpatients with complex PTSD. METHOD: In this open-label single case series 20 patients with longstanding complex PTSD in inpatient treatment monitored the occurrence of intrusive trauma memories (intrusions) over the course of their admission (5 to 10 weeks)...
December 2018: Journal of Consulting and Clinical Psychology
Ephraim S Grossman, Yaakov S G Hoffman, Amit Shrira, Mordechai Kedar, Menachem Ben-Ezra, Mirza Dinnayi, Ari Z Zivotofsky
Complex post-traumatic stress disorder (CPTSD) is a psychiatric diagnosis that includes three additional symptom clusters beyond those necessary for post-traumatic stress disorder (PTSD) diagnosis. CPTSD is typically associated with a prolonged trauma exposure in which a person's destiny is under the control of other people and escape is not an option. Insomnia prevalence in women suffering from CPTSD was compared to the prevalence of insomnia in those with no-PTSD and those with only PTSD. Yazidi women (N = 108, age = 24...
November 19, 2018: Psychiatry Research
Amit Shrira, Benjamin Mollov, Chantal Mudahogora
The research on survivors of genocide has focused on PTSD, but complex PTSD (CPTSD) and its potential effect on intergenerational transmission are understudied. This study assessed complex PTSD and resilience among Tutsi genocide survivors (n = 60, mean age = 52.27 [SD = 6.27]) and their offspring (n = 60, mean age = 21.21 [SD = 1.78]). Offspring of parents suffering from PTSD or CPTSD reported more secondary traumatization symptoms relative to offspring of parents without PTSD (p < 0...
November 19, 2018: Psychiatry Research
L Røberg, L Nilsen, J I Røssberg
Background : Exposure to potentially traumatizing events, defined as events involving actual or threatened death or serious injury, is associated with an elevated risk of developing enduring physical, psychological and social problems. Complex post-traumatic stress disorder (PTSD) is a disorder that can occur after prolonged and repeated trauma. At least 30% of the sexually abused population is male, but in spite of this fact, treatment research focusing on male victims is virtually non-existent in comparison to research on female victims...
2018: European Journal of Psychotraumatology
Tobias Hecker, Stephanie Huber, Thomas Maier, Andreas Maercker
Forced migration is one of the major challenges currently facing the international community. Many refugees have been affected by traumatic experiences at home and during their flight, putting them at a heightened risk of developing trauma-related disorders. The new version of the International Classification of Diseases (ICD-11) introduced two sibling disorders, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). So far, little is known about risk and protective factors in refugees that are specifically associated with the disturbances in self-organization (DSO) characteristic of CPTSD...
November 15, 2018: Journal of Traumatic Stress
Paul J Rosenfield, Alexandra Stratyner, Sumru Tufekcioglu, Susan Karabell, Jennifer McKelvey, Lisa Litt
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...
September 2018: Journal of Psychiatric Practice
F Vallières, R Ceannt, F Daccache, R Abou Daher, J Sleiman, B Gilmore, S Byrne, M Shevlin, J Murphy, P Hyland
OBJECTIVE: Support for ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) is growing; however, few studies include refugees or examine the clinical utility of PTSD/CPTSD classifications. This study sought to provide the first evaluations of (i) the factor structure of ICD-11 PTSD/CPTSD amongst refugees in the Middle East; and (ii) the clinical utility of the International Trauma Questionnaire (ITQ) to identify PTSD/CPTSD in a humanitarian context. METHOD: Participants were 112 treatment-seeking Syrian refugees living in Lebanon...
December 2018: Acta Psychiatrica Scandinavica
Thanos Karatzias, Philip Hyland, Aoife Bradley, Claire Fyvie, Katharine Logan, Paula Easton, Jackie Thomas, Sarah Philips, Jonathan I Bisson, Neil P Roberts, Marylene Cloitre, Mark Shevlin
BACKGROUND: Two 'sibling' disorders have been proposed for the fourthcoming 11th version of the International Classification of Diseases (ICD-11): post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD). Examining psychological factors that may be associated with CPTSD, such as self-compassion, is an important first step in its treatment that can inform consideration of which problems are most salient and what interventions are most relevant. AIMS: We set out to investigate the association between self-compassion and the two factors of CPTSD: the PTSD factor (re-experiencing, avoidance, sense of threat) and the Disturbances in Self-Organization (DSO) factor (affect dysregulation, negative self-concept and disturbances in relationships)...
October 2, 2018: Behavioural and Cognitive Psychotherapy
Yael Dagan, Joel Yager
OBJECTIVE: Although abuse of bupropion to achieve euphoria or a stimulant-like effect has been described in the literature, to our knowledge abuse of bupropion XR to control binge eating and reduce appetite by a patient with eating disorder has not been previously reported. METHOD: We report the case of a 22-year-old woman with bulimia nervosa and complex PTSD who abused bupropion XR to doses that at peak reached 3,000-4,500 mg/day. She suffered from adverse effects including headaches, tachycardia, anxiety, insomnia, and, finally, grand mal seizures...
September 19, 2018: International Journal of Eating Disorders
Dina Weindl, Brigitte Lueger-Schuster
BACKGROUND: A broad range of psychopathological sequelae was found in adult survivors of institutional childhood maltreatment (IM). Childhood maltreatment is also associated with lower self-esteem (SE). In previous qualitative research, adult survivors of IM reported feelings of worthlessness and self-doubts, but research on IM and its associations with SE is still scarce. METHOD: To investigate the emotional facet of SE in 46 adult survivors of IM in foster care settings provided by the City of Vienna we used the Emotional SE subscale of the Multidimensional Self-Esteem Scale ('Multidimensionale Selbstwertskala', MSWS) and applied a semi-structured interview with open-ended questions...
September 17, 2018: BMC Psychology
Maria Böttche, Thomas Ehring, Antje Krüger-Gottschalk, Heinrich Rau, Ingo Schäfer, Julia Schellong, Anne Dyer, Christine Knaevelsrud
Background : The proposed ICD-11 criteria for trauma-related disorders define posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (cPTSD) as separate disorders. Results of previous studies support the validity of this concept. However, due to limitations of existing studies (e.g. homogeneity of the samples), the present study aimed to test the construct validity and factor structure of cPTSD and its distinction from PTSD using a heterogeneous trauma-exposed sample. Method : Confirmatory factor analyses (CFAs) were conducted to explore the factor structure of the proposed ICD-11 cPTSD diagnosis in a sample of 341 trauma-exposed adults ( n  = 191 female, M  = 37...
2018: European Journal of Psychotraumatology
M Cloitre, M Shevlin, C R Brewin, J I Bisson, N P Roberts, A Maercker, T Karatzias, P Hyland
OBJECTIVE: The purpose of this study was to finalize the development of the International Trauma Questionnaire (ITQ), a self-report diagnostic measure of post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD), as defined in the 11th version of the International Classification of Diseases (ICD-11). METHOD: The optimal symptom indicators of PTSD and CPTSD were identified by applying item response theory (IRT) analysis to data from a trauma-exposed community sample (n = 1051) and a trauma-exposed clinical sample (n = 247) from the United Kingdom...
December 2018: Acta Psychiatrica Scandinavica
Livia Ottisova, Patrick Smith, Sian Oram
Trafficked children are frequently exposed to multiple traumatic events, including during their recruitment, transit, and exploitation. It has been hypothesized that such exposures can lead to the development of Complex Posttraumatic Stress Disorder (PTSD). Complex PTSD includes (in addition to the core PTSD symptoms of re-experiencing, avoidance, and hyperarousal) disturbances in affect regulation, dissociation, self-concept, interpersonal relationships, somatization, and systems of meaning. This historical cohort study aimed to investigate Complex PTSD in trafficked children with a diagnosis of PTSD and compare these with nontrafficked controls exposed to single or multiple trauma...
July 2018: Behavioral Medicine
P Hyland, R Ceannt, F Daccache, R Abou Daher, J Sleiman, B Gilmore, S Byrne, M Shevlin, J Murphy, F Vallières
Background: The World Health Organization will publish its 11th revision of the International Classification of Diseases (ICD-11) in 2018. The ICD-11 will include a refined model of posttraumatic stress disorder (PTSD) and a new diagnosis of complex PTSD (CPTSD). Whereas emerging data supports the validity of these proposals, the discriminant validity of PTSD and CPTSD have yet to be tested amongst a sample of refugees. Methods: Treatment-seeking Syrian refugees ( N  = 110) living in Lebanon completed an Arabic version of the International Trauma Questionnaire ; a measure specifically designed to capture the symptom content of ICD-11 PTSD and CPTSD...
2018: Global Mental Health
Leonhard Kratzer, Peter Heinz, Rebecca Schennach, Günter Karl Schiepek, Frank Padberg, Andrea Jobst
BACKGROUND: There is a lack of studies investigating the effectiveness of inpatient trauma-focused psychotherapy of complex post-traumatic stress disorder. The first aim of this retrospective investigation was to analyze the course of PTSD. Second, possible predictors of treatment response were investigated. METHODS: 150 inpatients of Clinic St. Irmingard with complex PTSD following childhood physical and childhood sexual abuse were assessed regarding childhood abuse, PTSD symptomatology, mindfulness, dissociation and general psychopathology...
May 30, 2018: Psychotherapie, Psychosomatik, Medizinische Psychologie
Menachem Ben-Ezra, Michal Mahat-Shamir, Louisa Lorenz, Osnat Lavenda, Andreas Maercker
In line with ICD-11 new conceptualization of Adjustment disorder (AjD), a self-report Adjustment Disorder-New Module (ADNM) was developed and validated. Nevertheless, the ADNM-20 is a long research tool and potentially problematic in the use in epidemiological and clinical studies. The present study introduces the brief ADNM-8 and the ultra-brief ADNM-4, examines their validity and establishes cut-off scores for their clinical use. The study used a representative national sample of 1003 Israelis who reported on the ICD-11 stress spectrum ranging from AjD, PTSD, complex PTSD and complicated grief...
August 2018: Journal of Psychiatric Research
Philip Hyland, Mark Shevlin, Claire Fyvie, Thanos Karatzias
The American Psychiatric Association and the World Health Organization provide distinct trauma-based diagnoses in the fifth edition of the Diagnostic and Statistical Manual (DSM-5), and the forthcoming 11th version of the International Classification of Diseases (ICD-11), respectively. The DSM-5 conceptualizes posttraumatic stress disorder (PTSD) as a single, broad diagnosis, whereas the ICD-11 proposes two "sibling" disorders: PTSD and complex PTSD (CPTSD). The objectives of the current study were to: (a) compare prevalence rates of PTSD/CPTSD based on each diagnostic system; (b) identify clinical and behavioral variables that distinguish ICD-11 CPTSD and PTSD diagnoses; and (c) examine the diagnostic associations for ICD-11 CPTSD and DSM-5 PTSD...
April 2018: Journal of Traumatic Stress
Evangelia Giourou, Maria Skokou, Stuart P Andrew, Konstantina Alexopoulou, Philippos Gourzis, Eleni Jelastopulu
Complex posttraumatic stress disorder (Complex PTSD) has been recently proposed as a distinct clinical entity in the WHO International Classification of Diseases, 11th version, due to be published, two decades after its first initiation. It is described as an enhanced version of the current definition of PTSD, with clinical features of PTSD plus three additional clusters of symptoms namely emotional dysregulation, negative self-cognitions and interpersonal hardship, thus resembling the clinical features commonly encountered in borderline personality disorder (BPD)...
March 22, 2018: World Journal of Psychiatry
Andreas Laddis
This article methodically gathers concepts and findings from related disciplines to propose that there is a fundamental, disorder-specific psychological impairment, which defines Complex Posttraumatic Stress Disorder (PTSD) as etiologically different from simple PTSD. This impairment is a flawed working model for restoration of trust when one partner fears betrayal. This working model is legacy of childhood relationships with manipulative caretakers who kept the child powerless to test the trustworthiness of their reasons to break promises and to fail the child's expectations...
March 22, 2018: Journal of Trauma & Dissociation
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