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Examining the Efficacy of a Pilot Virtual Group Treatment for Survivors of Complex Trauma 复杂创伤幸存者试点虚拟群体治疗的疗效研究
IF 1.9 Q3 PSYCHIATRY Pub Date : 2025-08-06 DOI: 10.1016/j.ejtd.2025.100585
Jacqueline L. Kinley , Sandra M. Reyno

Background

Complex trauma experiences can result in a range of chronic and impairing Complex PTSD symptoms and co-morbid mental illness.

Aim

This study aimed to evaluate the efficacy of a pilot virtual, group treatment program for individuals with Complex PTSD and comorbid depression and anxiety symptoms.

Method

The study employed a within group, pre-post design with 3-month follow-up. Participants completed self-report measures of Complex PTSD symptoms, dissociative symptoms, negative beliefs about self and others, emotion regulation, psychological symptoms (anxiety, depression, stress), resilience, and progress in psychotherapy.

Results

Participants reported significant positive changes in severity of psychological symptoms, emotion regulation, beliefs about self and others, resilience, dissociative symptoms, as well as PTSD, DSO (disturbances in self-organization) and Complex PTSD symptoms at post-treatment. These gains were maintained at follow-up except for dissociative symptoms. Participants were significantly less likely to meet diagnostic criteria for PTSD, DSO, and Complex PTSD at post-treatment and for DSO and Complex PTSD (but not PTSD) at follow-up.

Conclusion & Implications

Findings suggest that the Dynamic attachment-focused Relational Treatment (DaRT) program is an effective intervention for individuals with Complex-PTSD and comorbid mental illness. The treatment may have significant implications for enhancing service capacity for individuals struggling with the chronic and pervasive residual impacts of complex trauma.
背景:复杂的创伤经历可导致一系列慢性和损害性的复杂创伤后应激障碍症状和共病精神疾病。目的本研究旨在评估一种试验性虚拟群体治疗方案对复杂PTSD伴抑郁和焦虑症状个体的疗效。方法采用组内、岗前设计,随访3个月。参与者完成了复杂创伤后应激障碍症状、分离症状、对自我和他人的消极信念、情绪调节、心理症状(焦虑、抑郁、压力)、恢复力和心理治疗进展的自我报告测量。结果治疗后,受试者在心理症状、情绪调节、自我和他人信念、恢复力、解离症状以及PTSD、自组织障碍(DSO)和复杂PTSD症状的严重程度上均出现了显著的积极变化。除分离症状外,这些改善在随访中保持不变。受试者在治疗后符合PTSD、DSO和复杂PTSD诊断标准的可能性显著低于随访时符合DSO和复杂PTSD诊断标准的可能性(但不符合PTSD)。结论,研究结果表明,以依恋为中心的动态关系治疗(DaRT)是一种对复杂创伤后应激障碍和共病精神疾病个体的有效干预。治疗可能有显著的影响,以提高服务能力的个人与慢性和普遍的残余影响的复杂创伤。
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引用次数: 0
From childhood trauma to intimate harm: the role of maladaptive schemas in re-experiencing abusive relationships 从童年创伤到亲密伤害:适应不良图式在再次经历虐待关系中的作用
IF 1.9 Q3 PSYCHIATRY Pub Date : 2025-08-05 DOI: 10.1016/j.ejtd.2025.100584
Parisa Khanbeigi , Fatemeh SadeghMohammadi , Kosar Shafiei Rezvani Nejad , Zinat sadat Mirpour

Background

The tendency to re-experience abusive relationships (TREAR) is a maladaptive relational pattern linked to early adverse experiences and ingrained cognitive-emotional schemas. While prior studies have examined these constructions separately, the combined contribution of adverse childhood experiences (ACEs) and early maladaptive schemas (EMS) to TREAR remains underexplored, especially in non-Western populations. The aim of this study was to determine the relationship of the tendency to re-experience abusive relationships with adverse childhood experiences and early maladaptive schemas in Iranians.

Methods

The research design was cross-sectional, descriptive, and correlational. The statistical population consisted of individuals over 18 years old residing in Gilan province, Iran. Data were gathered in 2024 using an internet-based convenience sampling method. An online survey was conducted to collect data and included the following instruments: Demographic Characteristics Questions, the Adverse Childhood Experiences–Abuse Short Form (ACE-ASF), the Early Maladaptive Schemas Questionnaire (YSQ-S3), and the Tendency to Re-experience Abusive Relationships Scale (TREARS). A total of 894 individuals received the survey, but only 272 participated in the research. Of the participants, 72.1% were female, 28.3% were married.

Results

A large number of participants (81%) reported abuse in childhood, and more than half (56.3%) had high TREAR scores. People with a history of physical, emotional, or sexual abuse were more likely to show signs of TREAR. We found strong links between TREAR and EMS (r = 0.705, p < 0.001), across all 18 schema domains. While demographic factors alone explained just 11% of TREAR, including ACE scores raised this to 18.3%. However, once EMS scores were added, the model explained 55.1% of TREAR, demonstrating that EMS plays a large role in perpetuating this cycle.

Conclusion

The result indicated that early maladaptive schemas play a key role in the relationship between adverse childhood experiences and adult revictimization tendencies. These results showed the necessity of combining schema-targeted and trauma-sensitive therapies to stop re-experiencing abusive relationships and help people build safer and healthier relationships.
重新体验虐待关系的倾向(TREAR)是一种适应不良的关系模式,与早期的不良经历和根深蒂固的认知-情感图式有关。虽然先前的研究已经分别研究了这些结构,但不良童年经历(ace)和早期适应不良图式(EMS)对TREAR的综合贡献仍未得到充分探讨,特别是在非西方人群中。本研究的目的是确定伊朗人再次经历虐待关系的倾向与不良童年经历和早期适应不良图式之间的关系。方法采用横断面、描述性、相关性研究设计。统计人口包括居住在伊朗吉兰省的18岁以上的个人。数据收集于2024年,采用基于互联网的便捷抽样方法。通过在线调查收集数据,包括以下工具:人口统计学特征问题、不良童年经历-虐待简短表格(ACE-ASF)、早期适应不良图式问卷(YSQ-S3)和再体验虐待关系倾向量表(TREARS)。共有894人接受了调查,但只有272人参与了研究。在参与者中,72.1%为女性,28.3%为已婚。结果大量参与者(81%)报告童年受虐待,超过一半(56.3%)的TREAR得分较高。有身体、情感或性虐待史的人更有可能表现出TREAR的迹象。我们发现TREAR和EMS之间存在很强的联系(r = 0.705, p < 0.001),跨越所有18个模式域。虽然人口因素只解释了11%的TREAR,但包括ACE分数在内,这一比例上升到了18.3%。然而,一旦加入EMS分数,该模型解释了55.1%的TREAR,表明EMS在延续这一循环中发挥了重要作用。结论早期适应不良图式在儿童不良经历与成人再受害倾向的关系中起关键作用。这些结果表明,有必要将针对图式和创伤敏感的治疗相结合,以阻止再次经历虐待关系,并帮助人们建立更安全、更健康的关系。
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引用次数: 0
Associations between safety aid usage and posttraumatic stress symptoms in trauma-exposed young adults 在创伤暴露的年轻人中,安全援助的使用与创伤后应激症状之间的关系
IF 1.9 Q3 PSYCHIATRY Pub Date : 2025-08-05 DOI: 10.1016/j.ejtd.2025.100587
Amanda M. Raines , Joseph W. Boffa , Chelsea R. Ennis , Jason T. Goodson , Michael J. McDermott

Introduction

Safety aids, also known in the literature as safety behaviors, are maladaptive cognitive and behavioral strategies designed to prevent or reduce anxiety and/or distress. Research has shown that repeated use of such behaviors (e.g., hypervigilance, situational avoidance, checking behaviors, thought suppression) contributes to the development and maintenance of various anxiety and related disorders. However, less work has examined the role of safety aids in posttraumatic stress.

Method

Using a trauma-exposed sample of undergraduate students, the current study sought to examine mean levels of safety aid usage among individuals with (n = 35) and without probable PTSD (n = 57).

Results

Results revealed a significant difference between the two groups on overall safety aid usage and escape/avoidance and monitoring/vigilance behaviors. In particular, mean levels were higher among trauma-exposed individuals with probable PTSD compared to trauma-exposed individuals without probable PTSD.

Discussion

Findings are discussed with regard to prior research and treatment recommendations.
安全辅助,在文献中也被称为安全行为,是一种旨在预防或减少焦虑和/或痛苦的不适应认知和行为策略。研究表明,反复使用这些行为(如过度警惕、情境回避、检查行为、思想抑制)有助于各种焦虑和相关障碍的发展和维持。然而,研究安全辅助在创伤后应激中的作用的工作较少。方法使用创伤暴露的本科生样本,本研究试图检查有(n = 35)和没有可能的创伤后应激障碍(n = 57)个体的安全援助使用的平均水平。结果两组在安全援助的总体使用、逃离/回避和监测/警戒行为上存在显著差异。特别是,与没有创伤后应激障碍的创伤暴露者相比,创伤暴露者可能患有PTSD的平均水平更高。讨论结果讨论之前的研究和治疗建议。
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引用次数: 0
What happens to DID clients after an earthquake: A case series 地震后DID客户端会发生什么:一个案例系列
IF 1.9 Q3 PSYCHIATRY Pub Date : 2025-08-05 DOI: 10.1016/j.ejtd.2025.100586
B. Uysal, M.S. Tepedelen, Z.Z. Kablama-Yardım, E. Akyüz, F.B. Bircan, M.F. Cinisli, M. Yanık
On February 6, 2024, following two major earthquakes in Türkiye, over 35,000 buildings collapsed, and approximately 50,000 people lost their lives. In response, our university psychology department established a psychotherapy center in the affected region as a social responsibility project, providing services for seven months. During this period, 820 clients were reached, and dissociative identity disorder (DID) was identified in 16 of them (around 2%). The identification was made possible by a team experienced in DID, who incorporated it into routine differential diagnosis. The clients, aged 12 to 37, included 13 females. Analysis revealed that DID symptoms worsened for 11 clients after the earthquake, with increased issues such as anger and, in some cases, the emergence of new alternate identities. One child client experienced the first appearance of an alternate identity after the earthquake. These findings emphasize the necessity of monitoring DID patients after disasters and delivering treatments specifically tailored to their needs.
2024年2月6日,在日本发生两次大地震后,超过35000座建筑物倒塌,大约5万人丧生。为此,我校心理学系作为社会责任项目,在灾区建立了心理治疗中心,提供为期7个月的服务。在此期间,我们接触了820名来访者,其中16人(约2%)被确诊为分离性身份障碍(DID)。鉴别是由一个在DID经验丰富的团队实现的,他们将其纳入常规鉴别诊断。客户年龄在12至37岁之间,其中包括13名女性。分析显示,11名患者的DID症状在地震后恶化,出现了更多的问题,如愤怒,在某些情况下,出现了新的替代身份。一个孩子在地震后第一次经历了另一个身份的出现。这些发现强调了灾后监测DID患者并提供专门针对其需求的治疗的必要性。
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引用次数: 0
Mobilisation du lien au défunt dans le traitement du deuil chronique en EMDR: métaphore de « la mémoire vivante du disparu » 在慢性丧亲治疗中运用与死者的联系:隐喻“逝者的鲜活记忆”
IF 1.9 Q3 PSYCHIATRY Pub Date : 2025-07-23 DOI: 10.1016/j.ejtd.2025.100582
Pascale Amara, Guy Gimenez
<div><h3>Introduction</h3><div>La prise en charge psychothérapeutique des troubles du deuil a fait l’objet de nombreuses recherches et est actuellement un domaine qui tend à s’émanciper d’attitudes thérapeutiques basées sur des postulats cliniques anciens. La clinique de l’attachement ainsi que des approches thérapeutiques innovantes sont venues nourrir la créativité de cliniciens soucieux de l’efficacité thérapeutique. Par exemple s’adresser intérieurement au défunt, questionner le rapport aux rituels, articuler la dimension psychotraumatique, ont ouvert des voies thérapeutiques prometteuses.</div></div><div><h3>Objectif</h3><div>L’importance thérapeutique du réaménagement psychique du lien au défunt apparait de façon récurrente dans les résultats cliniques obtenus dans la thérapie EMDR de patients souffrant de troubles du deuil. Les approches thérapeutiques traditionnelles centrées sur la perte mobilisent la question du désinvestissement de la relation au défunt pour s’ouvrir à de nouveaux liens, mais la question de l’héritage psychique du défunt comme ressource à mobiliser est peu ou incomplètement abordée. L’hypothèse soutenue est que l’ensemble des représentations psychiques issues de la relation au défunt est un support d’étayage pertinent à prendre en compte dans la psychothérapie des endeuillés. Nous présentons un outil clinique favorisant la mobilisation de cette réalité psychique internalisée dans l’espace thérapeutique. Cet outil est une métaphore nommée « la mémoire vivante du disparu ».</div></div><div><h3>Méthode</h3><div>Après un rappel de la clinique des troubles du deuil et une synthèse des approches thérapeutiques recommandées et émergentes, nous présentons du matériel clinique obtenu lors de trois thérapies EMDR de patients souffrant de deuils récents ou pathologiques. Des émergences imaginaires disruptives observées principalement dans la phase de désensibilisation convoquent un lien positif au défunt et projettent le patient dans un réaménagement subjectif pacifié de la relation à ce dernier, amenant une sédation des symptômes douloureux. La métaphore est proposée si le patient n’est pas spontanément connecté à la représentation interne du défunt.</div></div><div><h3>Résultat</h3><div>Il apparait une convergence dans la psychothérapie EMDR d’endeuillés entre la mobilisation d’éléments mnésiques ou représentationnels positifs relatifs au défunt, un réaménagement psychique structurant intégrant le décès, et une amélioration thérapeutique observable sur le plan clinique.</div></div><div><h3>Discussion</h3><div>Cette convergence milite en faveur de l’efficience d’une approche en EMDR mobilisant le réaménagement du lien interne au défunt pour nourrir la nécessaire mutation psychique déclenchée par le décès. Les observations cliniques sont articulées à des cadres conceptuels et des approches cliniques émergentes. La vividité et l’étrangeté de certaines productions imaginaires à effet thérapeutique immédiat nous amènent à questionne
悲伤障碍的心理治疗管理一直是许多研究的主题,目前是一个倾向于从基于旧临床假设的治疗态度中解放出来的领域。依恋诊所和创新的治疗方法激发了对治疗效果感兴趣的临床医生的创造力。例如,在内心与死者交谈,质疑与仪式的关系,阐明心理创伤的维度,已经开辟了有希望的治疗途径。在EMDR治疗悲伤障碍患者的临床结果中,与死者联系的心理重建的治疗意义反复出现。传统的以损失为中心的治疗方法利用了从与死者的关系中撤资的问题,以打开新的联系,但很少或没有充分解决死者的精神遗产作为一种资源的问题。支持的假设是,从与死者的关系中产生的所有心理表征都是在丧亲心理治疗中需要考虑的相关支持。我们提出了一种临床工具,在治疗空间中促进这种内化的心理现实的动员。这个工具被比喻为“逝者的活记忆”。方法回顾了悲伤障碍的临床情况,并总结了推荐和新兴的治疗方法,我们介绍了从最近或病理悲伤患者的三种EMDR治疗中获得的临床材料。主要在脱敏阶段观察到的假想的破坏性发作唤起了与死者的积极联系,并将患者投射到与死者关系的平静主观重新安排中,导致痛苦症状的镇静。如果病人没有自发地与死者的内部表征联系起来,就会提出这个比喻。其结果是,在EMDR丧亲心理治疗中,与死者相关的积极记忆或表征元素的动员、整合死亡的结构化心理重建和临床可观察到的治疗改善之间出现了趋同。讨论这种融合为EMDR方法的有效性进行了宣传,该方法涉及与死者的内部联系的重新安排,以维持由死亡引发的必要的心理突变。临床观察与新出现的概念框架和临床方法相联系。一些具有直接治疗效果的想象产品的生动和奇异使我们质疑这种动态的心理本质。结论EMDR在某些方面比其他人文主义方法不那么指导性,因此揭示了主观解决的途径,通常是意想不到的。这种独特的治疗可以被视为一种“哨点”方法,使有用的临床结果可见。除了悲伤及其并发症,它还为探索其他临床领域开辟了可能性,在定性和定量研究的框架内,旨在发展心理治疗的知识。
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引用次数: 0
Trouble dissociatif complexe et régression dans un contexte de traumatisme transgénérationnel: Étude de cas clinique intégrative 代际创伤背景下复杂分离障碍与回归:综合临床案例研究
IF 1.9 Q3 PSYCHIATRY Pub Date : 2025-07-23 DOI: 10.1016/j.ejtd.2025.100583
Rimmel Ainad-Tabet, Rahma Nefzi

Introduction

Dissociative disorders often emerge as a response to early and persistent trauma, particularly in contexts of psychosocial and familial adversity.

Clinical observation

We present the case of a 50-year-old woman with a chronic dissociative disorder in a context marked by transgenerational trauma, family overload, and socioeconomic precarity. Symptoms included dissociative episodes, severe memory disturbances, regressive behaviors, and pseudodementia-like features.

Results

Neuropsychological assessments and medical investigations ruled out any neurodegenerative pathology. An integrative care approach — including psychiatric hospitalization, psychotherapeutic follow-up, and family support — led to a stabilization of dissociative episodes and improved functional autonomy.

Conclusion

This case highlights the importance of considering complex trauma and family history when assessing dissociative disorders. A global therapeutic strategy focused on psychological safety, emotional needs, and family engagement can foster a favorable clinical outcome.

Introduction

Les troubles dissociatifs apparaissent souvent en réponse à des traumatismes précoces et persistants, notamment dans des contextes socio-familiaux précaires.

Observation clinique

Nous présentons le cas d’une femme de 50 ans présentant un trouble dissociatif chronique, dans un contexte de traumatismes transgénérationnels, de surcharge familiale et de précarité psychosociale. Les symptômes incluent des absences, des troubles mnésiques sévères, des comportements régressifs et des signes pseudodémentiels.

Résultats

Le bilan neuropsychologique et les examens médicaux ont exclu une pathologie neurodégénérative. Une prise en charge intégrative, incluant une hospitalisation, un suivi psychothérapeutique et le soutien familial, a permis une stabilisation des épisodes dissociatifs et une amélioration de l’autonomie fonctionnelle.

Conclusion

Ce cas illustre l’importance de prendre en compte les facteurs traumatiques complexes et l’histoire familiale dans l’évaluation des troubles dissociatifs. Une approche globale centrée sur la sécurité psychique, le soutien familial et la reconnaissance des besoins affectifs permet une évolution favorable.
解离性障碍通常是对早期和持续性创伤的反应,特别是在社会心理和家庭逆境的背景下。临床观察:我们报告一名患有慢性分离性障碍的50岁女性,她的背景是跨代创伤、家庭负担过重和社会经济不稳定。症状包括分离性发作、严重记忆障碍、行为退化和假性痴呆样特征。结果神经心理学评估和医学检查排除任何神经退行性病理。综合护理方法——包括精神病住院治疗、心理治疗随访和家庭支持——导致分离发作的稳定和功能自主性的提高。结论本病例强调了在评估分离性障碍时考虑复杂创伤和家族史的重要性。注重心理安全、情感需求和家庭参与的整体治疗策略可以促进良好的临床结果。简介:烦恼、解离、幻影、记忆、心理障碍、心理创伤、心理障碍、心理障碍、心理障碍、心理障碍、心理障碍、心理障碍等。临床观察:原发性变性人患有慢性分离性人格障碍,变性人患有创伤性人格障碍,变性人患有家族性人格障碍,变性人患有社会心理障碍。假的symptômes包括假的缺席,假的麻烦,假的渡假的渡假,假的渡假的渡假的渡假。所有的神经心理学检查都不能排除神经病学上的病变。1次康复治疗,包括1次住院治疗、1次精神康复治疗、1次家庭康复治疗、1次康复治疗、1次康复治疗、1次康复治疗、1次康复治疗。结论:病例分析表明,人格障碍、创伤性情结、家族史、人格障碍和人格障碍对人格障碍的影响。一个approche整体展开的质量安全炸药psychique le soutien家族等la侦察des甚至affectifs允许一个进化有利。
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引用次数: 0
The utilisation of deep brain reorienting (DBR) in the treatment of two clients with dissociative identity disorder (DID) 脑深部定向治疗分离性身份认同障碍的临床观察
IF 2 Q3 PSYCHIATRY Pub Date : 2025-07-17 DOI: 10.1016/j.ejtd.2025.100579
Anna Gerge

Objective

To (i) describe how the deep brain reorienting (DBR) theory can be applied in understanding the development of dissociative identity disorder (DID) and (ii) describe the implementation of the DBR method in two single cases with clients with DID.

Methods

This study aimed to assess the effectiveness of deep brain reorienting psychotherapy (DBR) related to the DBR theory as a lens of understanding of the development and treatment of DID, exemplified with two single-case vignettes of clients presenting DID. In the first part of the paper, the theory of DBR is briefly discussed in relation to the development of DID, a condition where severe relational trauma and adjacent childhood traumatisation is hypothesized to be connected to the development of the symptomatology. In the second part, two single-case studies with two DID-clients diagnosed with SCID-D aim to provide initial evidence of how clients with DID experienced and responded to DBR therapy as part of longer phase specific therapies. The client of case I was treated with 30 DBR sessions and the client of case II was treated with 70 DBR sessions. Their pre- and post-DBR treatment measures consisted of instruments to measure PTSD and complex PTSD symptoms, psychoform and somatoform dissociation, general symptomatology, and access to positive states of mind. The outcome measures were assessed through percentage of nonoverlapping data (PND) a nonparametric measure used to assess the effectiveness of interventions in single-case experimental designs (SCEDs). The clients also provided verbal and written statements regarding their experiences during and after the DBR intervention.

Results

After the introduction of DBR in their therapies, when measured by the posttraumatic checklist (PCL-5), the international trauma questionnaire (ITQ), the somatoform dissociation questionnaire (SDQ-5), the Dissociative Experiences Scale II (DES-II), the DES-taxon (DES-T), the Symptom Checklist–90 revised (SCL–90-R), the symptomatology of client I was significantly lowered on all measures apart from the SDQ-5 when analysed with PND. For client II the measurements on PCL-5, SDQ-5 and SCL-90-R were significantly lowered. Their self-assessed positive states of mind, measured with the PSOM-scale, were heightened. Both clients expressed that DBR was a valuable treatment modality through their summarized verbal and written statements.

Conclusions

After 30 respectively during 70 DBR sessions, the clients' dissociation and comorbid symptoms decreased significantly, as measured by self-assessments measures and analysed with PND. Thus, a preliminary cautious enthusiasm is reasonable. Clients with DID may benefit from DBR. Future research is required to address generalizability to a larger population of dissociative clients. To examine whether DBR can be a treatment of choice for highly dissociative clients, includi
目的(i)描述深部脑重定向(DBR)理论如何应用于理解分离性身份认同障碍(DID)的发展;(ii)描述DBR方法在两个分离性身份认同障碍患者的案例中的实施。方法本研究旨在评估深层脑重定向心理治疗(DBR)的有效性,以DBR理论为视角来理解DID的发展和治疗,并以两例患有DID的患者为例。在本文的第一部分中,简要讨论了DBR理论与DID发展的关系,假设严重的关系创伤和相邻的童年创伤与症状学的发展有关。在第二部分中,对两名诊断为SCID-D的DID患者进行了两例单例研究,旨在提供DID患者如何将DBR治疗作为长期特异性治疗的一部分的初步证据。病例1的患者接受30次DBR治疗,病例2的患者接受70次DBR治疗。他们在dbr前和dbr后的治疗措施包括测量PTSD和复杂PTSD症状、精神和躯体形式分离、一般症状学和获得积极心态的工具。结果测量通过非重叠数据百分比(PND)进行评估,这是一种用于评估单例实验设计(SCEDs)干预措施有效性的非参数测量。客户还提供了口头和书面陈述关于他们在DBR干预期间和之后的经历。结果采用DBR治疗后,患者1在创伤后检查表(PCL-5)、国际创伤问卷(ITQ)、躯体形式解离问卷(SDQ-5)、解离体验量表(DES-II)、解离分类单元(DES-T)、症状检查表- 90修订版(SCL-90-R)中除SDQ-5外,其他各项指标均显著降低。对于患者II, PCL-5、SDQ-5和SCL-90-R的测量值显著降低。他们自我评估的积极心态(用psom量表测量)得到了提高。两位患者通过总结口头和书面陈述,表示DBR是一种有价值的治疗方式。结论在70个DBR疗程中,分别进行30次后,通过自我评估测量和PND分析,患者的分离和共病症状显著减少。因此,初步的谨慎热情是合理的。患有DID的客户可能会从DBR中受益。未来的研究需要解决的普遍性更大的人口分离的客户。为了检验DBR是否可以作为高度分离患者的治疗选择,包括DID,需要对DBR治疗分离性障碍的疗效进行随机对照试验。需要深入的现象学和神经科学评估来验证DBR治疗分离性障碍的可行性和改变作用。
{"title":"The utilisation of deep brain reorienting (DBR) in the treatment of two clients with dissociative identity disorder (DID)","authors":"Anna Gerge","doi":"10.1016/j.ejtd.2025.100579","DOIUrl":"10.1016/j.ejtd.2025.100579","url":null,"abstract":"<div><h3>Objective</h3><div>To (i) describe how the deep brain reorienting (DBR) theory can be applied in understanding the development of dissociative identity disorder (DID) and (ii) describe the implementation of the DBR method in two single cases with clients with DID.</div></div><div><h3>Methods</h3><div>This study aimed to assess the effectiveness of deep brain reorienting psychotherapy (DBR) related to the DBR theory as a lens of understanding of the development and treatment of DID, exemplified with two single-case vignettes of clients presenting DID. In the first part of the paper, the theory of DBR is briefly discussed in relation to the development of DID, a condition where severe relational trauma and adjacent childhood traumatisation is hypothesized to be connected to the development of the symptomatology. In the second part, two single-case studies with two DID-clients diagnosed with SCID-D aim to provide initial evidence of how clients with DID experienced and responded to DBR therapy as part of longer phase specific therapies. The client of case I was treated with 30 DBR sessions and the client of case II was treated with 70 DBR sessions. Their pre- and post-DBR treatment measures consisted of instruments to measure PTSD and complex PTSD symptoms, psychoform and somatoform dissociation, general symptomatology, and access to positive states of mind. The outcome measures were assessed through percentage of nonoverlapping data (PND) a nonparametric measure used to assess the effectiveness of interventions in single-case experimental designs (SCEDs). The clients also provided verbal and written statements regarding their experiences during and after the DBR intervention.</div></div><div><h3>Results</h3><div>After the introduction of DBR in their therapies, when measured by the posttraumatic checklist (PCL-5), the international trauma questionnaire (ITQ), the somatoform dissociation questionnaire (SDQ-5), the Dissociative Experiences Scale II (DES-II), the DES-taxon (DES-T), the Symptom Checklist–90 revised (SCL–90-R), the symptomatology of client I was significantly lowered on all measures apart from the SDQ-5 when analysed with PND. For client II the measurements on PCL-5, SDQ-5 and SCL-90-R were significantly lowered. Their self-assessed positive states of mind, measured with the PSOM-scale, were heightened. Both clients expressed that DBR was a valuable treatment modality through their summarized verbal and written statements.</div></div><div><h3>Conclusions</h3><div>After 30 respectively during 70 DBR sessions, the clients' dissociation and comorbid symptoms decreased significantly, as measured by self-assessments measures and analysed with PND. Thus, a preliminary cautious enthusiasm is reasonable. Clients with DID may benefit from DBR. Future research is required to address generalizability to a larger population of dissociative clients. To examine whether DBR can be a treatment of choice for highly dissociative clients, includi","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100579"},"PeriodicalIF":2.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696642","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
Childhood trauma is associated with theory of mind deficits in obsessive-compulsive disorder 童年创伤与强迫症的心理理论缺陷有关
IF 2 Q3 PSYCHIATRY Pub Date : 2025-07-16 DOI: 10.1016/j.ejtd.2025.100581
Tamini Soondrum , Jie Fan , Feng Gao , Xiang Wang , Qian Liu , Yao Liu , Jingjie Lu , Quanhao Yu , Hongyu Du , Xiongzhao Zhu

Background

Previous studies have shown that social impairments such as Theory of Mind (ToM) may be influenced by childhood trauma (CT), however the extent to which CT influence ToM ability, and whether OCD patients with CT are more vulnerable to ToM deficits than healthy controls (HC) have never been established. Therefore, this study attempts to understand the effect of CT on ToM ability in OCD.

Methods

81 OCD patients and 108 healthy controls were included in this study. ToM deficits were assessed on four dimensions, namely first and second order affective and cognitive ToM. The effect of CT on ToM deficits was assessed using the 2 × 2 Analysis of Covariance (ANCOVAs) and the hierarchical regression.

Results

Simple effect analysis revealed a positive effect of CT>No CT in OCD and effect of OCD>HC in CT for both affective and cognitive second-order ToM deficits. Within the OCD group, emotional abuse was found to have an effect on affective ToM deficits (p = .028) and sexual abuse on cognitive ToM deficits (p = .040).

Conclusions

Only OCD patients with CT showed deficits on second order cognitive and affective ToM and emotional and sexual abuse were the most influential CT subtypes on second-order ToM deficits in OCD.
以往的研究表明,心理理论(ToM)等社会障碍可能受到童年创伤(CT)的影响,但CT对心理理论能力的影响程度,以及患有CT的强迫症患者是否比健康对照组(HC)更容易出现心理理论缺陷,这些都尚未得到证实。因此,本研究试图了解CT对强迫症患者ToM能力的影响。方法选择强迫症患者81例,健康对照108例。从一、二级情感和认知四个维度对认知障碍进行评估。采用2 × 2协方差分析(ANCOVAs)和层次回归评估CT对ToM缺陷的影响。结果简单效应分析显示,CT检查对OCD有积极作用,CT检查对情感和认知二级ToM缺陷均有积极作用。在OCD组中,发现情绪虐待对情感ToM缺陷有影响(p = 0.028),性虐待对认知ToM缺陷有影响(p = 0.040)。结论只有CT表现为二级认知和情感性ToM缺陷的强迫症患者,情感和性虐待是对强迫症二级ToM缺陷影响最大的CT亚型。
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引用次数: 0
Impact of crisis events on the family and technologies of psychological support to overcome the consequences 危机事件对家庭的影响及克服后果的心理支持技术
IF 2 Q3 PSYCHIATRY Pub Date : 2025-07-15 DOI: 10.1016/j.ejtd.2025.100580
Tetiana Pashko , Olesia Tovstukha , Liliia Chernovska , Inessa Serhieieva , Olha Chumak

Background

The ongoing war in Ukraine has triggered a large-scale humanitarian crisis, severely affecting the structure and well-being of families. The disruption of family roles, prolonged separation, and psychological trauma have created long-term consequences for both adults and children.

Objective

The aim of this study was to identify the key consequences of the humanitarian crisis for Ukrainian families and to develop evidence-based recommendations for psychosocial support.

Method

The research combined a survey of families affected by the war in Ukraine with a content analysis of relevant literature. The sample included families who directly experienced the impact of displacement, loss, and social instability.

Results

The study revealed significant changes in family dynamics, including role confusion due to loss of employment or physical injury, emotional disconnection caused by prolonged separation, and an increased risk of relationship breakdown. Children were identified as particularly vulnerable, with symptoms such as emotional instability, academic decline, and, in some cases, severe psychological disorders. Post-traumatic stress disorder (PTSD) emerged as a central challenge, influencing communication patterns, emotional availability, and behavior within families. The study also systematized effective technologies for crisis recovery, including individual and family therapy, online counseling, and the use of digital self-help tools.

Conclusion

The findings highlight the urgent need for targeted psychosocial interventions for families affected by war. Practical recommendations include the development of adaptable support programmes that address trauma, preserve family cohesion, and promote emotional resilience across different family structures.
乌克兰正在进行的战争引发了大规模的人道主义危机,严重影响了家庭的结构和福祉。家庭角色的破坏、长期的分离和心理创伤对成人和儿童都造成了长期的影响。本研究的目的是确定人道主义危机对乌克兰家庭的主要影响,并制定基于证据的社会心理支持建议。方法对乌克兰受战争影响的家庭进行调查,并对相关文献进行内容分析。样本包括直接遭受流离失所、损失和社会不稳定影响的家庭。结果该研究揭示了家庭动态的重大变化,包括由于失业或身体受伤导致的角色混乱,长期分离导致的情感脱节,以及关系破裂的风险增加。儿童被确定为特别脆弱的群体,其症状包括情绪不稳定、学业成绩下降,在某些情况下还存在严重的心理障碍。创伤后应激障碍(PTSD)作为一个核心挑战出现,影响着家庭中的沟通模式、情感可用性和行为。该研究还将危机恢复的有效技术系统化,包括个人和家庭治疗、在线咨询和数字自助工具的使用。结论研究结果强调,迫切需要对受战争影响的家庭进行有针对性的社会心理干预。切实可行的建议包括制定适应性支持方案,以解决创伤,保持家庭凝聚力,并促进不同家庭结构之间的情感弹性。
{"title":"Impact of crisis events on the family and technologies of psychological support to overcome the consequences","authors":"Tetiana Pashko ,&nbsp;Olesia Tovstukha ,&nbsp;Liliia Chernovska ,&nbsp;Inessa Serhieieva ,&nbsp;Olha Chumak","doi":"10.1016/j.ejtd.2025.100580","DOIUrl":"10.1016/j.ejtd.2025.100580","url":null,"abstract":"<div><h3>Background</h3><div>The ongoing war in Ukraine has triggered a large-scale humanitarian crisis, severely affecting the structure and well-being of families. The disruption of family roles, prolonged separation, and psychological trauma have created long-term consequences for both adults and children.</div></div><div><h3>Objective</h3><div>The aim of this study was to identify the key consequences of the humanitarian crisis for Ukrainian families and to develop evidence-based recommendations for psychosocial support.</div></div><div><h3>Method</h3><div>The research combined a survey of families affected by the war in Ukraine with a content analysis of relevant literature. The sample included families who directly experienced the impact of displacement, loss, and social instability.</div></div><div><h3>Results</h3><div>The study revealed significant changes in family dynamics, including role confusion due to loss of employment or physical injury, emotional disconnection caused by prolonged separation, and an increased risk of relationship breakdown. Children were identified as particularly vulnerable, with symptoms such as emotional instability, academic decline, and, in some cases, severe psychological disorders. Post-traumatic stress disorder (PTSD) emerged as a central challenge, influencing communication patterns, emotional availability, and behavior within families. The study also systematized effective technologies for crisis recovery, including individual and family therapy, online counseling, and the use of digital self-help tools.</div></div><div><h3>Conclusion</h3><div>The findings highlight the urgent need for targeted psychosocial interventions for families affected by war. Practical recommendations include the development of adaptable support programmes that address trauma, preserve family cohesion, and promote emotional resilience across different family structures.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100580"},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662077","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
Le retraitement des mémoires implicites dans la prise en charge de l’enfant adopté et sa famille: regards croisés de la thérapie des États du moi et de l’EMDR 对被收养儿童及其家庭照料中隐含的记忆的再处理:自我状态治疗与EMDR治疗的交叉视角
IF 2 Q3 PSYCHIATRY Pub Date : 2025-07-07 DOI: 10.1016/j.ejtd.2025.100576
Virginie Dhaese

Introduction

Cet article propose une réflexion clinique sur l’articulation entre la thérapie des États du Moi (TEM) et la thérapie E.M.D.R (Eye Movement Desensitization and Reprocessing) dans le cadre de l’accompagnement d’un enfant adopté et de sa famille. Il explore l’impact potentiel des mémoires implicites non intégrées, susceptibles de fragiliser le système intra-individuel de l’enfant ainsi que les dynamiques systémiques intrafamiliales.

Méthode:

A travers une approche intégrative, le cas clinique de Meghan et sa famille illustre comment la combinaison de la thérapie E.M.D.R et la TEM peuvent soutenir, de manière complémentaire, les processus de stabilisation, de réparation des liens intra et interindividuels, ainsi que l’intégration des expériences précoces traumatiques.

Résultat

L’intégration des mémoires implicites permet à Meghan de se libérer des comportements et émotions débordantes qu’elle vit avec une forme de « soudaineté » et une intensité non contrôlée. Elle peut, ainsi, mobiliser les ressources pour s’autoréguler, mieux appréhender les relations avec les autres et avec elle-même.

Conclusion

Le travail thérapeutique mené avec l’enfant et sa famille, à travers l’E.M.D.R et la TEM, semble encourager un processus d’intégration des expériences traumatiques précoces. Cette dynamique se manifeste notamment par une cohérence autobiographique narrative intra-et inter-individuelle, d’une part et une régulation émotionnelle, plus adaptée, à l’ici et le maintenant.
本文提出了自我状态治疗(EMT)和眼动脱敏和再加工(EMD.R)治疗在被收养儿童及其家庭护理框架内的联系的临床反思。它探讨了未整合的隐式记忆的潜在影响,这些记忆可能会削弱儿童的个人内部系统,以及家庭内部的系统动态。方法:通过一项综合性办法,梅根的临床病例和家人说明了如何组合疗法E.M.D.R TEM和支持、补充的方式,可以在稳定进程,联系修理厂interindividuels内外一体化,以及早期创伤经验。结果,隐式记忆的整合使梅根能够将自己从过度的行为和情绪中解放出来,她生活在一种“突然”和不受控制的强度中。因此,它可以调动资源来自我调节,更好地理解与他人和自己的关系。通过emd对儿童及其家庭进行的治疗工作R和EMT似乎鼓励了一个整合早期创伤经历的过程。这种动态表现在个体内部和个体之间的自传体叙事一致性,以及更适合于此时此地的情感调节。
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引用次数: 0
期刊
European Journal of Trauma & Dissociation
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