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Transcending disciplinary silos
Published in Johanna Lynch, A Whole Person Approach to Wellbeing, 2020
There is an increased diagnostic awareness of life story, even in psychiatric diagnostic categories. The DSM diagnostic categories of Dissociation, Post Traumatic Stress Disorder, Borderline Personality Disorder and the proposed Developmental Trauma Disorder acknowledge the traumatic aetiology of the psychopathology (Kate and Dorahy 2019). Although the new ICD-11 diagnosis of Complex Post Traumatic Stress Disorder (C-PTSD) still does not acknowledge subjective forms of stress, it at least acknowledges the impact of adverse events on emotion regulation, sense of self and interpersonal relationships (Maercker et al. 2013). Trauma researchers have consistently identified a person’s stressful life story as a common thread that may help to explain the extraordinary numbers of people with comorbid psychiatric diagnoses (Ross 2000). This common thread of life story is one of the overarching themes of this book – and provides a useful way to maintain focus on the whole.
Glossary of terms
Published in Patricia A. Murphy, A Career and Life Planning Guide for Women Survivors:, 2020
Post-traumatic stress disorder: Post-traumatic stress disorder (PTSD) is defined in the American Psychiatric Association’s fourth edition of its diagnostic manual (DSM-IV). Its numerical code is 309.81. See the chapter titled, Naming the Trauma. See complex post-traumatic stress disorder. The major difference between these disorders appears to be that PTSD is a one-time traumatic event as opposed to an extended period of traumatic experience(s) (e.g., months or years of wife battering).
Post-traumatic stress disorder and substance use
Published in David B Cooper, Practice in Mental Health—Substance Use, 2018
In 1994, the DSM-IV working party investigated the concept of Complex PTSD (CPTSD).42,43 Complex PTSD is postulated to be generated by exposure to repeated multiple traumatic exposure in early development, and most likely to develop in those exposed to multiple trauma below the age of 26 years.44–46 Typically, many CPTSD sufferers are adult survivors of sexual abuse. Complex PTSD is characterised by three areas of disturbance:49Symptoms: of PTSD, Affective, Dissociative and Somatic.Characterological changes: relating to control, relationships, and self-perception.Repeated harm: a propensity to repeat harm: to the self; by others and of others.
Posttraumatic Growth in Complex PTSD
Published in Psychiatry, 2019
The concept of complex post-traumatic stress disorder (Complex PTSD) was first introduced by Judith Herman, who emphasized its importance as a distinct entity in order to foster better treatment and reduce stigma associated with some of its presenting symptoms (Herman, 1992). Recently formally delineated in the 2018 International Classification of Diseases (ICD-11), the disorder is characterized by PTSD symptoms (re-experiencing of the trauma, nightmares, avoidance, startle, hypervigilance) originating in the context of significant early trauma, to which are added “disturbances in self- organization” marked by affective dysregulation, negative self-concept, and disturbances in relationships (Karatzias et al., 2017). In the DSM-V, although a dissociative subtype of PTSD was added, complex PTSD per se was not delineated as a separate diagnosis (Friedman, 2013). Complex PTSD may develop following exposure to extremely threatening or horrific, most commonly prolonged or repetitive events, from which escape is difficult or impossible (e.g., torture, prolonged domestic violence, repeated childhood sexual or physical abuse) (World Health Organization, 2018). Strongly associated with this diagnosis (Hyland et al., 2017), in this article we primarily address complex PTSD in CSA survivors, as this is the population we most frequently encounter in our clinical work.
Can gestation be considered as trauma in adolescent girls: post-traumatic stress disorder in teen pregnancy*
Published in Journal of Obstetrics and Gynaecology, 2020
Aslı Sürer Adanir, Arif Önder, Gül Alkan Bülbül, Aysel Uysal, Esin Özatalay
The CPTSD-RI scores of the study group were also compared with the control group in terms of PTSD scores and clinically significant PTSD. The PTSD scores of the study group were significantly higher than those of the healthy controls. When the groups were compared in terms of clinically significant PTSD, 20 of the pregnant adolescents manifested clinically significant (total 42.6%; moderate 21.3%, and severe and extremely severe 21.3%) degrees of PTSD symptoms, whereas clinically significant PTSD was observed in only 23.3% of the healthy controls (n = 10). Although the difference did not reach statistical significance (p = .052), we might have expected a significant relationship if the sample size was larger.
Considerations of Dissociation, Betrayal Trauma, and Complex Trauma in the Treatment of Incest
Published in Journal of Child Sexual Abuse, 2020
David M. Lawson, Sinem Akay-Sullivan
Dorrepaal et al. (2014) conducted a meta-analysis of seven RCT studies that targeted female survivors of child abuse with (CA)-related PTSD or CA-related cPTSD. Six studies employed CBT models and one study used present-focused person-centered therapy. Six studies included wait list groups for controls. Fours studies were comprised of participants diagnosed with cPTSD based on the Structured Interview for Disorders of Extreme Stress while three studies included clients with CA-related PTSD. Treatment outcomes for the CA-related PTSD groups indicated large effect sizes for treatment and moderate recovery and improvement rates. Treatments that included trauma processing demonstrated larger effect sizes for treatment although recovery and improvement rates were not significantly different from other treatments. Results for the CA-related cPTSD participants were less positive, indicating no superior effect sizes for trauma processing. Acquisition of emotion regulation skills resulted in more positive recovery and improvement rates and less drop out when compared to memory processing. Of particular importance, effect sizes were highest in those cPTSD studies that employed the higher exclusion criteria (e.g., DID, substance abuse, and suicidality) and lower inclusion rates. When comparing the CA-related PTSD to the cPTSD groups, treatment effects, recovery, and improvement rates were more positive for the CA-related PTSD group. The authors concluded that several treatment components were effective with CA-related PTSD, but these same treatments were less effective with cPTSD, such as exposure interventions. Finally, generalizability was limited, especially with cPTSD populations given the fact that most participants were self-referred, Caucasian, well education, and largely employed. This analysis clearly distinguished between treatment effects for PTSD and cPTSD.