European Journal of Trauma & Dissociation最新文献

The effectiveness of Reconsolidation of Traumatic Memories for Complex PTSD – A pilot quasi-experimental study from a wellness centre in India 重新整合创伤记忆对复杂创伤后应激障碍的疗效--印度一家健康中心的试点准实验研究

IF 2 Q3 PSYCHIATRY

European Journal of Trauma & Dissociation

Pub Date : 2024-10-31 DOI: 10.1016/j.ejtd.2024.100480

Gunjan Y Trivedi , Neha Pandya , Parishi Thakore , Hemalatha Ramani , Riri G Trivedi , Soundappan Kathirvel

Complex Post-Traumatic Stress Disorder (CPTSD), based on ICD-11 guidelines, is differentiated from PTSD by several unique characteristics. Prolonged or frequent exposure to an event or series of events of extremely threatening or horrific nature increases the risk for CPTSD in adults. For PTSD, Reconsolidation of Traumatic Memories (RTM) has emerged as an effective intervention. There are limited studies on how to address CPTSD. Hence, RTM's effectiveness for CPTSD has not yet been established. In India, there are very few studies on PTSD (focusing mainly on natural disasters and violence), none on CPTSD and none on the effectiveness of RTM. Unfortunately, India, with >400 million young individuals and with high prevalence and limited identification of mental health issues, has a major gap in this area. This quasi-experimental pilot study aimed to assess the effectiveness of the RTM intervention for individuals with CPTSD at a wellness centre in India.

The participants (>18 years, n = 107) who reached out to a wellness center for help were assessed by two trained therapists (including a psychologist) based on the presenting problems for CPTSD using the International Trauma Questionnaire. Additional assessments included Major Depression Inventory and Generalized Anxiety Disorder-7. Based on the index-trauma framework, RTM intervention was delivered. Post-measurements were done (a) after one month or at least after five sessions and (b) after three months.

After one month (or five sessions), the CPTSD status changed to “none” (no diagnosis) for 80 and “PTSD” for 2 individuals. The results were sustained post-three months (n = 30). The paired t-test confirmed the overall reduction in CPTSD score after one month compared to baseline and even after three months compared to after one month, based on statistical significance (p < .01). The findings confirmed the effectiveness of RTM intervention for individuals with CPTSD. The study's limitations (quasi-experimental design, urban, English-speaking Indians) could be addressed in future work.

根据 ICD-11 指南，复杂创伤后应激障碍（CPTSD）与创伤后应激障碍有几个独特的特征。长期或频繁接触极具威胁性或恐怖性的事件或系列事件会增加成人罹患 CPTSD 的风险。对于创伤后应激障碍，创伤记忆再巩固（RTM）已成为一种有效的干预措施。关于如何治疗 CPTSD 的研究还很有限。因此，RTM 对 CPTSD 的有效性尚未确定。在印度，关于创伤后应激障碍的研究很少（主要集中在自然灾害和暴力方面），关于 CPTSD 的研究也很少，关于 RTM 的有效性的研究也很少。不幸的是，印度有 4 亿年轻人，精神健康问题的发病率高且识别能力有限，因此在这一领域存在很大差距。这项准实验性试点研究旨在评估 RTM 对印度一家健康中心 CPTSD 患者的干预效果。向健康中心求助的参与者（>18 岁，n = 107）由两名训练有素的治疗师（包括一名心理学家）使用国际创伤问卷对 CPTSD 现象问题进行评估。其他评估包括重度抑郁量表和广泛性焦虑症-7。根据创伤指数框架，进行 RTM 干预。一个月（或五个疗程）后，80 人的 CPTSD 状态变为 "无"（无诊断），2 人的 CPTSD 状态变为 "创伤后应激障碍"。这一结果在三个月后（n = 30）得以持续。配对 t 检验证实，与基线相比，一个月后 CPTSD 得分总体下降，与一个月后相比，三个月后 CPTSD 得分甚至下降，这在统计学上具有显著性（p <.01）。研究结果证实了 RTM 干预对 CPTSD 患者的有效性。研究的局限性（准实验设计、城市、讲英语的印度人）可在今后的工作中加以解决。

{"title":"The effectiveness of Reconsolidation of Traumatic Memories for Complex PTSD – A pilot quasi-experimental study from a wellness centre in India","authors":"Gunjan Y Trivedi , Neha Pandya , Parishi Thakore , Hemalatha Ramani , Riri G Trivedi , Soundappan Kathirvel","doi":"10.1016/j.ejtd.2024.100480","DOIUrl":"10.1016/j.ejtd.2024.100480","url":null,"abstract":"<div><div>Complex Post-Traumatic Stress Disorder (CPTSD), based on ICD-11 guidelines, is differentiated from PTSD by several unique characteristics. Prolonged or frequent exposure to an event or series of events of extremely threatening or horrific nature increases the risk for CPTSD in adults. For PTSD, Reconsolidation of Traumatic Memories (RTM) has emerged as an effective intervention. There are limited studies on how to address CPTSD. Hence, RTM's effectiveness for CPTSD has not yet been established. In India, there are very few studies on PTSD (focusing mainly on natural disasters and violence), none on CPTSD and none on the effectiveness of RTM. Unfortunately, India, with >400 million young individuals and with high prevalence and limited identification of mental health issues, has a major gap in this area. This quasi-experimental pilot study aimed to assess the effectiveness of the RTM intervention for individuals with CPTSD at a wellness centre in India.</div><div>The participants (>18 years, <em>n</em> = 107) who reached out to a wellness center for help were assessed by two trained therapists (including a psychologist) based on the presenting problems for CPTSD using the International Trauma Questionnaire. Additional assessments included Major Depression Inventory and Generalized Anxiety Disorder-7. Based on the index-trauma framework, RTM intervention was delivered. Post-measurements were done (a) after one month or at least after five sessions and (b) after three months.</div><div>After one month (or five sessions), the CPTSD status changed to “none” (no diagnosis) for 80 and “PTSD” for 2 individuals. The results were sustained post-three months (<em>n</em> = 30). The paired <em>t</em>-test confirmed the overall reduction in CPTSD score after one month compared to baseline and even after three months compared to after one month, based on statistical significance (<em>p</em> < .01). The findings confirmed the effectiveness of RTM intervention for individuals with CPTSD. The study's limitations (quasi-experimental design, urban, English-speaking Indians) could be addressed in future work.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Résistance et trauma: introduire l'existence 抵抗与创伤：介绍存在

IF 2 Q3 PSYCHIATRY

European Journal of Trauma & Dissociation

Pub Date : 2024-10-28 DOI: 10.1016/j.ejtd.2024.100477

Jean-Michel DARVES-BORNOZ MD, PhD

Resilience is implicitly thought as a capacity that some have, but that no one has done much to obtain, so that the notion of resistance to narcissistic and traumatic wounds, remains necessary. Resistance evokes an unconscious obstruction in metapsychology, or martial in history. The meaning in our case is different: resisting trauma is an emotional and intellectual effort to move beyond a stupefying awareness. This includes that: perception is not neutral; existence fragments the psyche; both intergenerational and adversity determine distinct self-states. The article presents five theses upon which existential analysis can rely. The latter re-founds existences where usual therapies renounces to do so: persistent traumatic states. Symptoms may disappear in course of analysis, including excessive dissociative archaic defences, physical or mental, although it aims elsewhere. Existential analysis seeks to reveal to subjects that they are abdicating their freedom if they consider received ideas about the world as free choices.

复原力被隐含地认为是一种能力，有些人拥有这种能力，但没有人做过什么来获得这种能力，因此，抵抗自恋和创伤的概念仍然是必要的。在元心理学中，"抵抗 "是一种无意识的阻碍，在历史学中，"抵抗 "是一种武术。在我们的案例中，其含义有所不同：抵抗创伤是一种情感和智力上的努力，以超越令人窒息的意识。这包括：感知不是中性的；存在使心理支离破碎；代际和逆境决定了不同的自我状态。文章提出了存在论分析可以依赖的五个论点。后者在常规疗法放弃的地方重新发现存在：持续的创伤状态。在分析过程中，症状可能会消失，包括过度的分离性古老防御，身体或精神上的，尽管它的目标在别处。存在主义分析试图向研究对象揭示，如果他们将关于世界的既定观念视为自由选择，那么他们就是在放弃自己的自由。

引用次数: 0

Adverse childhood experiences and dissociation among Italian public psychology service users 意大利公共心理服务使用者的不良童年经历和分离现象

IF 2 Q3 PSYCHIATRY

European Journal of Trauma & Dissociation

Pub Date : 2024-10-28 DOI: 10.1016/j.ejtd.2024.100476

Giuseppe Scimeca, Marianna Ardito, Rosario D'Avenia

Different studies have provided evidence that adverse childhood experiences (ACEs) are associated with mental health problems as a function of racial and ethnic diversity. The aim of the present study was thus to study the association between ACEs and dissociation in a sample of Southern Italian public psychology service (PPS) users. A sample of 183 adults who requested psychotherapeutic treatment within an Italian PPS was recruited. ACEs were assessed via the Adverse Childhood Experiences Questionnaire (ACE-Q). Dissociative symptoms were assessed via the Dissociative Experiences Scale (DES-II) and the Somatoform Dissociation Questionnaire (SDQ-20). Dissociative syndromes were assessed via two scales of the Millon Clinical Multiaxial Inventory (MCMI-III): the Somatoform Syndrome (H) and the Post-Traumatic Stress Disorder Syndrome (R) scales. The most common types of ACEs in our sample were emotional neglect and emotional abuse. The number of ACEs showed a significant association with all the different measures of dissociation administered. Logistic regression analysis for the DES-II resulted in a solution made up of sexual abuse and parental separation or divorce. The regression analysis for the SDQ-20 resulted in a solution made up of emotional abuse, physical neglect, and parental separation or divorce. Sexual abuse positively predicted PTSD scale scores, while no solution was found for somatoform disorder. ACEs and dissociation were strongly associated in this study, but the nature of this association depended on the aspect of dissociation under investigation, particularly when we considered the distinction between dissociative symptoms versus syndromes. Cultural characteristics and clinical implications for public services are discussed.

不同的研究证明，童年的不良经历（ACEs）与心理健康问题有关，这与种族和民族多样性有关。因此，本研究旨在研究意大利南部公共心理服务（PPS）使用者样本中的ACE与分离之间的关联。研究人员在意大利一家公共心理服务机构招募了 183 名要求接受心理治疗的成年人。ACE通过童年不良经历问卷（ACE-Q）进行评估。分离症状通过分离体验量表（DES-II）和躯体形式分离问卷（SDQ-20）进行评估。分离综合征通过米隆临床多轴量表（MCMI-III）的两个量表进行评估：躯体形式综合征量表（H）和创伤后应激障碍综合征量表（R）。在我们的样本中，最常见的 ACE 类型是情感忽视和情感虐待。ACE 的数量与所有不同的解离度量表都有显著关联。DES-II 的逻辑回归分析得出的解决方案是性虐待和父母分居或离婚。对 SDQ-20 进行回归分析后得出的解决方案由情感虐待、身体忽视和父母分居或离婚组成。性虐待对创伤后应激障碍量表得分有积极的预测作用，而对躯体形式障碍则没有发现任何解决方案。在本研究中，ACE 与解离密切相关，但这种关联的性质取决于所调查的解离方面，特别是当我们考虑到解离症状与综合症之间的区别时。本研究讨论了文化特征和对公共服务的临床影响。

{"title":"Adverse childhood experiences and dissociation among Italian public psychology service users","authors":"Giuseppe Scimeca, Marianna Ardito, Rosario D'Avenia","doi":"10.1016/j.ejtd.2024.100476","DOIUrl":"10.1016/j.ejtd.2024.100476","url":null,"abstract":"<div><div>Different studies have provided evidence that adverse childhood experiences (ACEs) are associated with mental health problems as a function of racial and ethnic diversity. The aim of the present study was thus to study the association between ACEs and dissociation in a sample of Southern Italian public psychology service (PPS) users. A sample of 183 adults who requested psychotherapeutic treatment within an Italian PPS was recruited. ACEs were assessed via the Adverse Childhood Experiences Questionnaire (ACE-Q). Dissociative symptoms were assessed via the Dissociative Experiences Scale (DES-II) and the Somatoform Dissociation Questionnaire (SDQ-20). Dissociative syndromes were assessed via two scales of the Millon Clinical Multiaxial Inventory (MCMI-III): the Somatoform Syndrome (H) and the Post-Traumatic Stress Disorder Syndrome (R) scales. The most common types of ACEs in our sample were emotional neglect and emotional abuse. The number of ACEs showed a significant association with all the different measures of dissociation administered. Logistic regression analysis for the DES-II resulted in a solution made up of sexual abuse and parental separation or divorce. The regression analysis for the SDQ-20 resulted in a solution made up of emotional abuse, physical neglect, and parental separation or divorce. Sexual abuse positively predicted PTSD scale scores, while no solution was found for somatoform disorder. ACEs and dissociation were strongly associated in this study, but the nature of this association depended on the aspect of dissociation under investigation, particularly when we considered the distinction between dissociative symptoms versus syndromes. Cultural characteristics and clinical implications for public services are discussed.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring the interplay between dreams, Early Maladaptive Schemas and demanding parenting style in Malaysia: A qualitative study 探索马来西亚儿童的梦想、早期适应不良模式和苛刻的养育方式之间的相互作用：定性研究

IF 2 Q3 PSYCHIATRY

European Journal of Trauma & Dissociation

Pub Date : 2024-10-26 DOI: 10.1016/j.ejtd.2024.100478

Jin Chien Gan, Shubashini Mathialagan, Amos En Zhe Lian

The demanding parenting style is a dysfunctional parenting behaviour which involves strict rules, overprotectiveness, high standards, and little affection or emotional support. It is commonly found in the Asian community. Extensive studies have suggested that this parenting style would contribute to various severe impacts, which include the development of early maladaptive schemas (EMS). Interestingly, EMS has been found to represent itself in dreams through themes and symbols. With this, the current study employed qualitative interviews to analyse the relationship between EMS and dreams in eight Malaysian young adults who experienced demanding parenting styles. The current study found that a demanding parenting style is associated with six EMS, which are (1) abuse/mistrust, (2) failure, (3) pessimism/negativity, (4) unrelenting standard/hypercriticalness, (5) approval seeking/recognition seeking, and (6) social isolation/alienation. These EMS manifested themselves in dreams. Based on these findings, the use of EMS in dream analysis has the potential to be an effective mediator to understand and explore the individuals’ past history.

苛刻型教养方式是一种功能失调的教养行为，包括严格的规则、过度保护、高标准、很少关爱或情感支持。这种教养方式常见于亚裔社区。大量研究表明，这种养育方式会造成各种严重影响，其中包括早期适应不良图式（EMS）的形成。有趣的是，EMS 被发现会通过主题和符号在梦中表现出来。有鉴于此，本研究采用定性访谈的方式，分析了八名马来西亚年轻人的EMS与梦境之间的关系。本研究发现，苛刻的养育方式与六种EMS有关，分别是：(1) 虐待/不信任；(2) 失败；(3) 悲观/消极；(4) 无情的标准/过度挑剔；(5) 寻求认同/认可；(6) 社会孤立/疏远。这些 EMS 表现在梦境中。基于这些发现，在梦境分析中使用 EMS 有可能成为了解和探索个人过去历史的有效中介。

{"title":"Exploring the interplay between dreams, Early Maladaptive Schemas and demanding parenting style in Malaysia: A qualitative study","authors":"Jin Chien Gan, Shubashini Mathialagan, Amos En Zhe Lian","doi":"10.1016/j.ejtd.2024.100478","DOIUrl":"10.1016/j.ejtd.2024.100478","url":null,"abstract":"<div><div>The demanding parenting style is a dysfunctional parenting behaviour which involves strict rules, overprotectiveness, high standards, and little affection or emotional support. It is commonly found in the Asian community. Extensive studies have suggested that this parenting style would contribute to various severe impacts, which include the development of early maladaptive schemas (EMS). Interestingly, EMS has been found to represent itself in dreams through themes and symbols. With this, the current study employed qualitative interviews to analyse the relationship between EMS and dreams in eight Malaysian young adults who experienced demanding parenting styles. The current study found that a demanding parenting style is associated with six EMS, which are (1) abuse/mistrust, (2) failure, (3) pessimism/negativity, (4) unrelenting standard/hypercriticalness, (5) approval seeking/recognition seeking, and (6) social isolation/alienation. These EMS manifested themselves in dreams. Based on these findings, the use of EMS in dream analysis has the potential to be an effective mediator to understand and explore the individuals’ past history.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Parent-Child EMDR therapy for children aged 0–4 years: Protocol, pilot-data, and case study 针对 0-4 岁儿童的亲子 EMDR 治疗：方案、试点数据和案例研究

IF 2 Q3 PSYCHIATRY

European Journal of Trauma & Dissociation

Pub Date : 2024-10-19 DOI: 10.1016/j.ejtd.2024.100475

Marianne Went , Arianne Struik , Eline Möller , Bonne J.H. Zijlstra , Anja Dumoulin , Gerinda van Haaften , Roos Rodenburg

This article describes the Parent-Child EMDR protocol for children (0–4 years) and provides a summary of treatment data of an explorative pilot study with 18 children aged 0–4 years, illustrated with a case study. The Parent-Child EMDR protocol follows the EMDR standard protocol with adaptations only where imperative due to the age of the child and integrating research in the field of infant mental health, attachment, memory, and EMDR and its working mechanisms. As such, it provides an alternative to Storytelling (Lovett, 1999, 2015), which uses a preconstructed narrative predominantly focusing on resourcing and cognitive information. The brief customized treatment consists of a combination of the following components: preparation, EMDR with child and parents, EMDR for the parent, if necessary, parent-child interaction sessions, and parental guidance sessions. Focus lays on the child and parents’ internal associative processes after maximum activation of the child and parent's traumatic material, to allow the child's and parent's inherent capacity to integrate, through associations and by using the adaptive information experienced in their interaction during the session. Through this process, the parent-child interaction and attachment relationships improve, as well as the parent's mentalizing ability and confidence.

In an explorative pilot study, treatment data of 18 children between 0 and 4 years were gathered to obtain insight into the Parent-Child EMDR protocol and its effect on PTSD symptoms. Therapists scored PTSD symptom clusters of the DC 0–5 criteria. All children lost their PTSD diagnosis after treatment. A case example illustrates the use of this protocol in more detail. The Parent-Child EMDR protocol is a promising short and customized treatment to help child and parents overcome their trauma symptoms, resume normal development, and build healthy attachment relationships.

本文介绍了针对儿童（0-4 岁）的亲子 EMDR 方案，并提供了一项探索性试点研究的治疗数据摘要，该研究涉及 18 名 0-4 岁儿童，并通过一个案例进行了说明。亲子EMDR方案遵循EMDR标准方案，仅在必要时根据儿童的年龄进行调整，并整合了婴儿心理健康、依恋、记忆、EMDR及其工作机制等领域的研究。因此，它是讲故事（Lovett，1999 年，2015 年）的替代方案，后者使用预先构建的叙事，主要侧重于资源和认知信息。简短的定制治疗由以下部分组合而成：准备、儿童和父母的 EMDR、父母的 EMDR（如有必要）、亲子互动课程和父母指导课程。在最大限度地激活儿童和父母的创伤材料后，重点放在儿童和父母的内部联想过程上，让儿童和父母通过联想，利用他们在治疗过程中互动体验到的适应信息，发挥其固有的整合能力。在一项探索性试点研究中，收集了 18 名 0 至 4 岁儿童的治疗数据，以深入了解亲子 EMDR 方案及其对创伤后应激障碍症状的影响。治疗师根据 DC 0-5 标准对创伤后应激障碍症状群进行评分。所有儿童在治疗后都不再被诊断为创伤后应激障碍。一个案例更详细地说明了该方案的使用。亲子 EMDR 方案是一种很有前途的短期定制治疗方法，可帮助儿童和父母克服创伤症状，恢复正常发育，并建立健康的依恋关系。

{"title":"Parent-Child EMDR therapy for children aged 0–4 years: Protocol, pilot-data, and case study","authors":"Marianne Went , Arianne Struik , Eline Möller , Bonne J.H. Zijlstra , Anja Dumoulin , Gerinda van Haaften , Roos Rodenburg","doi":"10.1016/j.ejtd.2024.100475","DOIUrl":"10.1016/j.ejtd.2024.100475","url":null,"abstract":"<div><div>This article describes the Parent-Child EMDR protocol for children (0–4 years) and provides a summary of treatment data of an explorative pilot study with 18 children aged 0–4 years, illustrated with a case study. The Parent-Child EMDR protocol follows the EMDR standard protocol with adaptations only where imperative due to the age of the child and integrating research in the field of infant mental health, attachment, memory, and EMDR and its working mechanisms. As such, it provides an alternative to Storytelling (Lovett, 1999, 2015), which uses a preconstructed narrative predominantly focusing on resourcing and cognitive information. The brief customized treatment consists of a combination of the following components: preparation, EMDR with child and parents, EMDR for the parent, if necessary, parent-child interaction sessions, and parental guidance sessions. Focus lays on the child and parents’ internal associative processes after maximum activation of the child and parent's traumatic material, to allow the child's and parent's inherent capacity to integrate, through associations and by using the adaptive information experienced in their interaction during the session. Through this process, the parent-child interaction and attachment relationships improve, as well as the parent's mentalizing ability and confidence.</div><div>In an explorative pilot study, treatment data of 18 children between 0 and 4 years were gathered to obtain insight into the Parent-Child EMDR protocol and its effect on PTSD symptoms. Therapists scored PTSD symptom clusters of the DC 0–5 criteria. All children lost their PTSD diagnosis after treatment. A case example illustrates the use of this protocol in more detail. The Parent-Child EMDR protocol is a promising short and customized treatment to help child and parents overcome their trauma symptoms, resume normal development, and build healthy attachment relationships.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Représentations d'attachement, traits de personnalité limite en émergence et comportements extériorisés d'enfants maltraités et issus de la population générale 受虐待儿童和普通儿童的依恋表征、新出现的边缘型人格特征和外化行为

IF 2 Q3 PSYCHIATRY

European Journal of Trauma & Dissociation

Pub Date : 2024-10-17 DOI: 10.1016/j.ejtd.2024.100472

Olivier Didier , Miguel M. Terradas , Rosalie Guillemette , Ana Carolina Rengel

Introduction

Abused children, especially those in residential care, show more externalized behaviors than children from the general population. These externalized behaviors may be a developmental consequence of different forms of abuse perpetrated by the parent, whose role is to support the child. Child maltreatment can also result in emerging borderline personality features (EBPT) related to socio-cognitive, emotional, relational, behavioral, and identity deficits.

Objective

The main objective of this research is to explore the links between the child's representations of maternal support and the presence of EBPF and externalized behaviors.

Method

Thirty-three foster care children and 40 children from the general population (7 to 12 years old) participated in the study. A semi-structured play activity measuring the child's representations of maternal support and a questionnaire assessing EBPF were administered to the children. The adult responsible for the child completed a questionnaire evaluating externalized behaviors.

Results

Mean comparisons confirm an increased presence of externalized behaviors and EBPF among the children in residential care. Representations of the mother as being unsupportive are associated with more EBPF. The increased presence of EBPF is linked to more externalized behaviors. Regression analysis attests to the mediating role of EBPF in the relationship between children's representations of maternal support and externalized behaviors.

Conclusion

These findings underscore the role of the mother-child relationship in personality development. An altered mother-child relationship appears to lead to deficits, particularly in the child's ability to manage situations that arouse aggression.

导言：与普通儿童相比，受虐待儿童（尤其是寄宿儿童）表现出更多的外化行为。这些外化行为可能是父母不同形式虐待的发展结果，而父母的角色是抚养儿童。本研究的主要目的是探讨儿童对母亲支持的表述与 EBPF 和外化行为之间的联系。方法33 名寄养儿童和 40 名普通儿童（7 至 12 岁）参加了本研究。研究人员对儿童进行了一项半结构化游戏活动，以测量儿童对母亲支持的表述，并对 EBPF 进行了问卷评估。负责照顾儿童的成人填写了一份评估外化行为的问卷。结果平均比较证实，寄宿儿童的外化行为和 EBPF 有所增加。认为母亲不支持自己的表象与 EBPF 增加有关。EBPF的增加与更多的外化行为有关。回归分析证明，EBPF 在儿童的母亲支持表象与外化行为之间起着中介作用。母子关系的改变似乎会导致儿童的缺陷，尤其是在处理引起攻击行为的情境方面。

{"title":"Représentations d'attachement, traits de personnalité limite en émergence et comportements extériorisés d'enfants maltraités et issus de la population générale","authors":"Olivier Didier , Miguel M. Terradas , Rosalie Guillemette , Ana Carolina Rengel","doi":"10.1016/j.ejtd.2024.100472","DOIUrl":"10.1016/j.ejtd.2024.100472","url":null,"abstract":"<div><h3>Introduction</h3><div>Abused children, especially those in residential care, show more externalized behaviors than children from the general population. These externalized behaviors may be a developmental consequence of different forms of abuse perpetrated by the parent, whose role is to support the child. Child maltreatment can also result in emerging borderline personality features (EBPT) related to socio-cognitive, emotional, relational, behavioral, and identity deficits.</div></div><div><h3>Objective</h3><div>The main objective of this research is to explore the links between the child's representations of maternal support and the presence of EBPF and externalized behaviors.</div></div><div><h3>Method</h3><div>Thirty-three foster care children and 40 children from the general population (7 to 12 years old) participated in the study. A semi-structured play activity measuring the child's representations of maternal support and a questionnaire assessing EBPF were administered to the children. The adult responsible for the child completed a questionnaire evaluating externalized behaviors.</div></div><div><h3>Results</h3><div>Mean comparisons confirm an increased presence of externalized behaviors and EBPF among the children in residential care. Representations of the mother as being unsupportive are associated with more EBPF. The increased presence of EBPF is linked to more externalized behaviors. Regression analysis attests to the mediating role of EBPF in the relationship between children's representations of maternal support and externalized behaviors.</div></div><div><h3>Conclusion</h3><div>These findings underscore the role of the mother-child relationship in personality development. An altered mother-child relationship appears to lead to deficits, particularly in the child's ability to manage situations that arouse aggression.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anxio-depressive disorders, traumatic symptoms, and suicidality among limb amputees: A cross-sectional and prospective study 肢体截肢者的焦虑抑郁障碍、创伤症状和自杀倾向：横断面和前瞻性研究

IF 2 Q3 PSYCHIATRY

European Journal of Trauma & Dissociation

Pub Date : 2024-10-15 DOI: 10.1016/j.ejtd.2024.100471

Jihane Moussaoui , Achraf Tebbaa El Hassali , Manal Gharibi , Omar Agoumi , Adnane Benzirar , Abdeljaouad Najib , Mohammed Barrimi

Introduction

Limb amputation represents an ultimate therapeutic option in certain severe or progressive pathologies. We conducted this study to describe anxio- depressive disorders, traumatic symptoms, and suicidality among limb amputees, as well as factors associated with their occurrence.

Materials and Methods

This was a cross-sectional and prospective descriptive and analytical study conducted over a two-year period from October 2020 to October 2022, at the following departments of the Mohammed VI University Hospital Center in Oujda: Traumatological and Orthopedic Surgery departements A and B, and Peripheral Vascular Surgery departement, involving 122 patients.

Results

The average age of our patients was 46.42 ± 14.76 years, with a predominance of males (male-to-female ratio of 2.21). Preoperative assessment of patients occurred 6 to 24 h before amputation. Immediate postoperative evaluation took place on average 2.18 ± 1.53 days after surgery, ranging from 1 to 8 postoperative days. The prevalence of anxio-depressive disorders according to the MINI scale was 77 %, comprising Depression (9 %), Adjustment Disorder (36.9 %), Acute Stress Disorder (20.5 %), Post-Traumatic Stress Disorder (6.6 %), and Anxiety Disorders (10.7 %), with suicide attempts reported in 16.4 % of cases. The mean score on the Hamilton Depression Rating Scale for our patients was 10.81 ± 3.27, on the Hamilton Anxiety Rating Scale was 16.33 ± 5.54, and on the Ducher Suicide Risk Scale was 0.82 ± 1.33.

Conclusion

The occurrence of postoperative anxio-depressive disorders, traumatic symptoms, and suicidal behavior is associated with the following factors: male sex, personal history of depression, family history of psychiatric disorders, quality of diagnostic disclosure, postoperative sleep disturbances, postoperative panic attacks, psychological support, and socio-professional reintegration.

导言截肢是某些严重或进展性疾病的最终治疗选择。我们开展了这项研究，以描述肢体截肢者的焦虑抑郁症、创伤症状和自杀倾向，以及与之相关的因素。材料与方法这是一项横断面前瞻性描述性分析研究，研究时间为 2020 年 10 月至 2022 年 10 月，为期两年，在乌季达穆罕默德六世大学医院中心的以下部门进行：结果患者平均年龄（46.42 ± 14.76）岁，男性居多（男女比例为 2.21）。患者的术前评估在截肢前 6 至 24 小时进行。术后即时评估平均在术后 2.18 ± 1.53 天进行，时间从术后 1 天到 8 天不等。根据MINI量表，焦虑抑郁症的发病率为77%，包括抑郁症（9%）、适应障碍（36.9%）、急性应激障碍（20.5%）、创伤后应激障碍（6.6%）和焦虑障碍（10.7%），其中16.4%的病例有自杀企图。患者的汉密尔顿抑郁评分量表（Hamilton Depression Rating Scale）平均得分为 10.81 ± 3.27，汉密尔顿焦虑评分量表（Hamilton Anxiety Rating Scale）平均得分为 16.33 ± 5.54，杜彻自杀风险量表（Ducher Suicide Risk Scale）平均得分为 0.82 ± 1.33。结论术后焦虑抑郁障碍、创伤症状和自杀行为的发生与以下因素有关：男性、个人抑郁史、家族精神病史、诊断披露质量、术后睡眠障碍、术后惊恐发作、心理支持和社会职业重新融入。

{"title":"Anxio-depressive disorders, traumatic symptoms, and suicidality among limb amputees: A cross-sectional and prospective study","authors":"Jihane Moussaoui , Achraf Tebbaa El Hassali , Manal Gharibi , Omar Agoumi , Adnane Benzirar , Abdeljaouad Najib , Mohammed Barrimi","doi":"10.1016/j.ejtd.2024.100471","DOIUrl":"10.1016/j.ejtd.2024.100471","url":null,"abstract":"<div><h3>Introduction</h3><div>Limb amputation represents an ultimate therapeutic option in certain severe or progressive pathologies. We conducted this study to describe anxio- depressive disorders, traumatic symptoms, and suicidality among limb amputees, as well as factors associated with their occurrence.</div></div><div><h3>Materials and Methods</h3><div>This was a cross-sectional and prospective descriptive and analytical study conducted over a two-year period from October 2020 to October 2022, at the following departments of the Mohammed VI University Hospital Center in Oujda: Traumatological and Orthopedic Surgery departements A and B, and Peripheral Vascular Surgery departement, involving 122 patients.</div></div><div><h3>Results</h3><div>The average age of our patients was 46.42 ± 14.76 years, with a predominance of males (male-to-female ratio of 2.21). Preoperative assessment of patients occurred 6 to 24 h before amputation. Immediate postoperative evaluation took place on average 2.18 ± 1.53 days after surgery, ranging from 1 to 8 postoperative days. The prevalence of anxio-depressive disorders according to the MINI scale was 77 %, comprising Depression (9 %), Adjustment Disorder (36.9 %), Acute Stress Disorder (20.5 %), Post-Traumatic Stress Disorder (6.6 %), and Anxiety Disorders (10.7 %), with suicide attempts reported in 16.4 % of cases. The mean score on the Hamilton Depression Rating Scale for our patients was 10.81 ± 3.27, on the Hamilton Anxiety Rating Scale was 16.33 ± 5.54, and on the Ducher Suicide Risk Scale was 0.82 ± 1.33.</div></div><div><h3>Conclusion</h3><div>The occurrence of postoperative anxio-depressive disorders, traumatic symptoms, and suicidal behavior is associated with the following factors: male sex, personal history of depression, family history of psychiatric disorders, quality of diagnostic disclosure, postoperative sleep disturbances, postoperative panic attacks, psychological support, and socio-professional reintegration.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ethical approach in a posttraumatic stress disorder 创伤后应激障碍的伦理方法

IF 2 Q3 PSYCHIATRY

European Journal of Trauma & Dissociation

Pub Date : 2024-10-13 DOI: 10.1016/j.ejtd.2024.100473

Sami Richa , Lyna Chami , Nathalie Richa , Wissam El-Hage

Background and objective

We will discuss autonomy, beneficence, non-maleficence and justice regarding trauma.

Method

A review of some papers regarding this subject and our experience nourished from our clinical practice.

Results

Respect of these ethical issues is important in order to improve to promote healing and resilience of subjects suffering from PTSD.

Conclusions

Ethical issues are important in all psychiatric and psychological issues.

背景和目的我们将讨论有关创伤的自主性、受益性、非恶意性和公正性。方法回顾了有关这一主题的一些论文以及我们在临床实践中积累的经验。结果尊重这些伦理问题对于改善创伤后应激障碍患者的治疗和恢复能力非常重要。结论伦理问题在所有精神和心理问题中都很重要。

引用次数: 0

The moderating role of sleep hours in the relationship between childhood trauma and depressive symptoms: A longitudinal investigation 睡眠时间对童年创伤与抑郁症状之间关系的调节作用：纵向调查

IF 2 Q3 PSYCHIATRY

European Journal of Trauma & Dissociation

Pub Date : 2024-10-13 DOI: 10.1016/j.ejtd.2024.100474

Chak Hei Ocean Huang , Hong Wang Fung , Tsz Ying Nathalie Tsui , Guangzhe Frank Yuan , Caimeng Liu , Chu Wing Lai , Janet Yuen-Ha Wong

Although childhood trauma has been identified as one of the major risk factors for depression, the potential mechanisms behind this relationship remain less clear. As sleep disturbances are associated with both childhood trauma and depression, this study examined the moderating effects of sleep hours on this relationship. The sample consisted of young adults from an international longitudinal survey project (N = 146). Participants completed validated screening measures of childhood trauma and depressive symptoms and reported their sleep hours at baseline (T1), and then reported their depressive symptoms again at follow-up (T2) after 3 months. Multiple regression and moderation analyses were used to analyze the data. T1 childhood trauma was positively correlated to depressive symptoms at both T1 (r = 0.26, p < .01) and T2 (r = 0.21, p < .05). After controlling for demographic variables and T1 depressive symptoms, T1 sleep hours significantly predicted T2 depressive symptoms (β = 0.136, p = .038). Furthermore, the number of sleep hours moderated the effects of T1 childhood trauma on T2 depressive symptoms. T1 childhood trauma predicted T2 depressive symptoms only when sleep hours were low (B = 0.2056, p = .0075). This study provided evidence that childhood trauma was significantly associated with aggravated depressive symptoms under sleep deprivation. Proactive management of sleep problems might be beneficial to people with childhood trauma. Future studies are needed to evaluate sleep-focused interventions for childhood trauma survivors.

虽然童年创伤已被确定为抑郁症的主要风险因素之一，但这种关系背后的潜在机制仍然不太清楚。由于睡眠障碍与童年创伤和抑郁症都有关联，本研究探讨了睡眠时间对这种关系的调节作用。样本由国际纵向调查项目中的年轻人组成（N = 146）。参与者完成了童年创伤和抑郁症状的验证筛选测量，并在基线（T1）时报告了他们的睡眠时间，然后在 3 个月后的随访（T2）中再次报告了他们的抑郁症状。数据分析采用了多元回归和调节分析法。在 T1（r = 0.26，p < .01）和 T2（r = 0.21，p < .05）阶段，童年创伤与抑郁症状呈正相关。在控制了人口统计学变量和第一阶段抑郁症状后，第一阶段的睡眠时间显著预测了第二阶段的抑郁症状（β = 0.136，p = .038）。此外，睡眠时数还能调节第一阶段童年创伤对第二阶段抑郁症状的影响。只有当睡眠时数较少时，第一阶段的童年创伤才会预测第二阶段的抑郁症状（B = 0.2056，p = .0075）。这项研究证明，在睡眠不足的情况下，童年创伤与抑郁症状的加重有显著关联。积极解决睡眠问题可能对童年创伤患者有益。今后还需要开展研究，评估针对童年创伤幸存者的睡眠干预措施。

{"title":"The moderating role of sleep hours in the relationship between childhood trauma and depressive symptoms: A longitudinal investigation","authors":"Chak Hei Ocean Huang , Hong Wang Fung , Tsz Ying Nathalie Tsui , Guangzhe Frank Yuan , Caimeng Liu , Chu Wing Lai , Janet Yuen-Ha Wong","doi":"10.1016/j.ejtd.2024.100474","DOIUrl":"10.1016/j.ejtd.2024.100474","url":null,"abstract":"<div><div>Although childhood trauma has been identified as one of the major risk factors for depression, the potential mechanisms behind this relationship remain less clear. As sleep disturbances are associated with both childhood trauma and depression, this study examined the moderating effects of sleep hours on this relationship. The sample consisted of young adults from an international longitudinal survey project (<em>N</em> = 146). Participants completed validated screening measures of childhood trauma and depressive symptoms and reported their sleep hours at baseline (T1), and then reported their depressive symptoms again at follow-up (T2) after 3 months. Multiple regression and moderation analyses were used to analyze the data. T1 childhood trauma was positively correlated to depressive symptoms at both T1 (<em>r</em> = 0.26, <em>p</em> < .01) and T2 (<em>r</em> = 0.21, <em>p</em> < .05). After controlling for demographic variables and T1 depressive symptoms, T1 sleep hours significantly predicted T2 depressive symptoms (<em>β</em> = 0.136, <em>p</em> = .038). Furthermore, the number of sleep hours moderated the effects of T1 childhood trauma on T2 depressive symptoms. T1 childhood trauma predicted T2 depressive symptoms only when sleep hours were low (<em>B</em> = 0.2056, <em>p</em> = .0075). This study provided evidence that childhood trauma was significantly associated with aggravated depressive symptoms under sleep deprivation. Proactive management of sleep problems might be beneficial to people with childhood trauma. Future studies are needed to evaluate sleep-focused interventions for childhood trauma survivors.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142532403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring cognitive behavioral mechanisms related to dissociation among patients suffering from schizophrenia: A pilot study 探索精神分裂症患者与分离相关的认知行为机制：试点研究

IF 2 Q3 PSYCHIATRY

European Journal of Trauma & Dissociation

Pub Date : 2024-10-09 DOI: 10.1016/j.ejtd.2024.100469

A Vancappel , J Graux , W El-Hage

Introduction

Dissociation is a challenging syndrome present in multiple psychiatric disorders for which no gold standard treatment exists. Recently, some authors have developed a Cognitive Behavioral Model of dissociation, offering new insights for psychotherapy. However, this model has primarily been assessed in patients suffering from PostTraumatic Stress Disorder (PTSD). Therefore, the aim of this study is to explore the relevance of this conceptualization in patients suffering from schizophrenia.

Method

We recruited 20 patients (15 men) suffering from schizophrenia. After providing consent, they completed self-reported questionnaires assessing dissociation, PTSD, beliefs about emotion, beliefs about dissociation, mindfulness abilities, and emotion regulation. Then, they responded to three open-ended questions exploring the triggers of dissociation and strategies used to counteract it.

Results

We found a low prevalence of the different cognitive-behavioral mechanisms related to dissociation in our sample. However, we found significant relationships between these mechanisms and dissociative symptoms. This relationship was also identified in the qualitative analysis.

Conclusion

The present results offer primary data supporting the relevance of the cognitive-behavioral conceptualization of dissociation in patients suffering from schizophrenia. Further studies should be conducted with larger samples and include additional variables to enhance the understanding of dissociation in this population.

简介：解离症是一种具有挑战性的综合征，存在于多种精神障碍中，目前尚无金标准治疗方法。最近，一些学者提出了解离的认知行为模型，为心理治疗提供了新的见解。然而，这一模型主要是针对创伤后应激障碍（PTSD）患者进行评估的。因此，本研究旨在探讨这一概念在精神分裂症患者中的相关性。在征得同意后，他们填写了自我报告问卷，评估解离、创伤后应激障碍、对情绪的信念、对解离的信念、正念能力和情绪调节能力。然后，他们回答了三个开放式问题，这些问题探讨了解离的诱因和应对解离的策略。然而，我们发现这些机制与解离症状之间存在重要关系。结论目前的研究结果提供了初步数据，支持认知行为概念化的解离与精神分裂症患者的相关性。进一步的研究应该在更大的样本中进行，并加入更多的变量，以加深对这一人群解离现象的理解。

{"title":"Exploring cognitive behavioral mechanisms related to dissociation among patients suffering from schizophrenia: A pilot study","authors":"A Vancappel , J Graux , W El-Hage","doi":"10.1016/j.ejtd.2024.100469","DOIUrl":"10.1016/j.ejtd.2024.100469","url":null,"abstract":"<div><h3>Introduction</h3><div>Dissociation is a challenging syndrome present in multiple psychiatric disorders for which no gold standard treatment exists. Recently, some authors have developed a Cognitive Behavioral Model of dissociation, offering new insights for psychotherapy. However, this model has primarily been assessed in patients suffering from PostTraumatic Stress Disorder (PTSD). Therefore, the aim of this study is to explore the relevance of this conceptualization in patients suffering from schizophrenia.</div></div><div><h3>Method</h3><div>We recruited 20 patients (15 men) suffering from schizophrenia. After providing consent, they completed self-reported questionnaires assessing dissociation, PTSD, beliefs about emotion, beliefs about dissociation, mindfulness abilities, and emotion regulation. Then, they responded to three open-ended questions exploring the triggers of dissociation and strategies used to counteract it.</div></div><div><h3>Results</h3><div>We found a low prevalence of the different cognitive-behavioral mechanisms related to dissociation in our sample. However, we found significant relationships between these mechanisms and dissociative symptoms. This relationship was also identified in the qualitative analysis.</div></div><div><h3>Conclusion</h3><div>The present results offer primary data supporting the relevance of the cognitive-behavioral conceptualization of dissociation in patients suffering from schizophrenia. Further studies should be conducted with larger samples and include additional variables to enhance the understanding of dissociation in this population.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0