European Journal of Trauma & Dissociation最新文献

Objective

According to clinical models of personality, patients with dissociative identity disorder (DID) who have experienced demonic possession (psychiatric possession syndrome or PPS) may present two profiles: the schizo-paranoid profile (characteristic of psychotic spectrum disorder or PSD) and the hysteroid-histrionic profile (characteristic of affective disorders). The present study aimed to examine the clinical and statistical evidence of these phenotypic personality structures in patients with PPS and DID (with and without PSD).

Methods

The design of this investigation was based on structural equation modeling. A total of 303 patients were diagnosed with DID without psychosis and 306 were diagnosed with DID with PSD; the diagnosis was made by clinical professionals who collaborated on this research and conducted the assessment tests. All patients completed clinical questionnaires on their personality structures, and dissociation level was also measured. The physician-psychiatrist assessed each patient using the Psychiatric Possession Syndrome Checklist (PPS-C), a new hetero-applied questionnaire on the symptomatic intensity of PPS.

Results

The results led to the conclusion that both personality structures were 65 %–66 % predictive of possession syndrome. Dissociative symptoms attributable to DID modulated the PPS variance by 21 % to 26 %. Validity evidence has been obtained for the combined phenotypic personality model that integrates DID and PSD structures.

Conclusions

We discuss the psychopathological and therapeutic implications of the analysis on the dissociative mechanisms involved in each personality phenotype. We also provide a graphical summary of the PPS symptoms, organized into a normalized distribution, which may prove useful for professional practice. Additionally, we present potential clinical scores from the PPS-C.

Introduction and Aims

Early childhood is crucial for the development of social and emotional competencies, significantly influenced by parental interactions. While the impact of maternal psychopathology has been extensively studied, less is known about the effect of paternal trauma on parenting behaviors and subsequent child development. This study examines the effects of fathers' traumatic experiences on their psychopathology, quality of feeding interactions, and children's emotional and behavioral functioning.

Methods

A sample of 100 fathers and their two-year-old children participated in this cross-sectional study. Paternal psychopathology was assessed using the Symptom Checklist-90-Revised (SCL-90-R), and trauma exposure was measured with the Traumatic Experience Checklist (TEC). Parent-child feeding interactions were evaluated using the Scala di Valutazione delle Interazioni Alimentari (SVIA), and children's emotional and behavioral outcomes were assessed using the Child Behavior Checklist (CBCL 1,5-5).

Results

Fathers with past trauma displayed significantly higher levels of psychopathological symptoms and engaged in poorer quality feeding interactions compared to controls. These paternal characteristics were associated with higher scores on maladaptive outcomes in children's CBCL, indicating worse emotional and behavioral functioning.

Conclusions

The findings suggest that paternal trauma is linked to increased psychopathological risks and negatively affects the quality of paternal feeding interactions, which in turnith children's emotional and behavioral development. These results underscore the importance of integrating paternal trauma into clinical assessments and interventions to support family dynamics and promote healthier developmental outcomes in children.

Background

Imagery Rescripting (ImRs) has received increasing attention in the past decades. It proved to be effective in reducing symptoms associated with aversive memories in a range of mental disorders, including anxiety disorders, eating disorders, and posttraumatic stress disorder. Given its proposed working mechanisms, ImRs may also be a relevant treatment strategy for prolonged grief disorder (PGD), where negative appraisals, helplessness, and unmet needs play a key role as maintaining factors.

Objective

We aimed to illustrate how ImRs may be used in the treatment of PGD.

Method

We present examples of clinical cases for several central themes in PGD: (1) Unfulfilled responsibilities, self-blame, and guilt; (2) Third-party failures, other-blame, and anger; (3) Unfinished businesses, troubled minds, and regrets; (4) Unsatisfactory goodbyes; (5) Emotional loneliness; 6) Shattered self-identity and reduced self-clarity.

Results

Based on the case examples, we illustrate how ImRs may be applied for each theme.

Conclusion

We hope to inspire clinicians to apply and researchers to investigate ImRs as a treatment strategy for PGD.

Purpose

To find the most effective ways to support and rehabilitate children suffering from the effects of sexual abuse to improve their quality of life, restore their psychological well-being and provide them with appropriate social support.

Methods

The research used the analytical method and a typological approach.

Results

Different types of sexual violence experienced by children including incest, sexual rape, internet rape and sexual exploitation were explored. In addition, the work identified risk factors that contribute to sexual abuse and protective factors that reduce the probability of such incidents occurring. As a result of the research, a programme of work with child victims of sexual abuse was developed, which included six specific stages aimed at the rehabilitation of a child traumatised by sexual abuse. The programme includes getting to know the traumatised child, assessing the fact of sexual abuse, planning the child's care, conducting therapeutic and rehabilitation measures, implementing social and psychological support and monitoring the results of rehabilitation.

Conclusion

This research can be used by professionals in the fields of psychology, psychotherapy, social work and medicine who work with children and adolescents who have experienced such trauma.

Background

The Trauma Symptoms Checklist-26 (TSC-26) has been used to measure negative affectivity, somatization, and dissociation in several Danish studies, but it has never been validated.

Method

Using data from five studies involving 1576 participants, the factor structure of the TSC- 26 was explored using confirmatory factor analysis (CFA). Correlation analyses of the associations between scales on the TSC-26 total score, its subscales, and scores on scales measuring related constructs were carried out. Independent samples t-tests of exposure variables were conducted. A test-retest analysis was performed, and Cronbach's alpha was calculated as measures of reliability.

Results

The CFA confirmed the expected three-factor structure of the TSC-26, which obtained an acceptable fit with three modifications. The correlation analyses showed strong correlations between TSC-26 and related scales. Independent samples t-tests found significant differences in TSC-26 scores between high- and low trauma exposure groups. Both measures of reliability resulted in high reliability coefficients for the whole scale as well as subscales. Reliability measures and test-retest coefficients were excellent.

Conclusion

The total score of the TSC-26 can validly be used to measure negative affectivity, somatization, and dissociation in samples of traumatized individuals. A few scale modifications and the development of a cut-off score are recommended in future studies.

Background

Hollywood has demonstrated an interest in dissociative identity disorder (DID), but unfortunately, films and television series have portrayed DID in captivating storylines at the expense of individuals living with DID. These representations of DID are often stigmatizing, stereotypical, and inaccurate.

Objective

The present study aimed to explore the impact of media portrayals on patients’ views of themselves and their treatment.

Method

A total of 377 individuals with DID completed an online survey about their perceptions of the impact of DID representations in the media, and 151 of those participants reported that media portrayals of DID had an impact on their mental health treatment. Reflexive thematic analysis was used to analyze qualitative data.

Results

Of those participants who reported an impact on their treatment, an overwhelming majority (n = 129) reported the impact to be negative. Five superordinate themes emerged: 1.) portrayals are inaccurate and perpetuate myths among clinicians, 2.) portrayals impact patients’ experiences of themselves and access to treatment, 3.) lack of clinical training and influence of media portrayals lead to negative outcomes, 4.) portrayals lead to maltreatment by clinicians, and 5.) importance of specialty treatment not based on media portrayals.

Conclusions

The present study found that inaccurate, stigmatizing media depictions of DID perpetuate misconceptions about DID and contribute to delays in seeking treatment and getting accurately diagnosed, and increased shame and self-loathing among individuals with DID.

In Malaysia, most psychotherapies were introduced in the 1980s and 1990s. Unfortunately, the development and availability of new psychotherapies have been comparatively slower and neglected in Malaysia, particularly in the context of trauma-focused psychotherapy. A new therapeutic model, schema therapy, has been hypothesized as a potential alternative for trauma treatment. This study adapted schema therapy to be culturally specific for Malaysia and conducted an interventional randomized controlled trial to investigate its effectiveness. The study focused on female young adults in Malaysia who had experienced repeated and continuous trauma.

The effectiveness of schema therapy was compared with Trauma-Focused Cognitive Behavioral Therapy (Tf-CBT). Each group comprised 15 participants who received 16 one-hour therapy sessions over a span of 4 months. Post-traumatic stress disorder (PTSD) symptoms were measured during the pre-test, post-test, and 3-month follow-up assessments. Additionally, semi-structured qualitative interviews were conducted with participants from both the schema therapy and Tf-CBT groups to gain a deeper understanding of the differences between the two psychotherapeutic approaches.

Both quantitative and qualitative analyses demonstrated that schema therapy exhibited superior short-term and long-term effectiveness compared to Tf-CBT in reducing PTSD symptoms. These findings support the viability of schema therapy as an effective option for addressing trauma in the Malaysian context.

The renewed interest in entactogens and classical psychedelics, particularly in the context of psychotraumatology, has led to the positioning of psychedelic-augmented psychotherapy (PAP) as a highly promising therapeutic approach for traumatic dissociation. In this comprehensive review, findings from empirical studies are combined with observations of patients' phenomenological experience manifesting during the course of PAP. The implications of PAP in relation to the ‘structural dissociation model,’ which assumes the presence of an emotional part (EP) and of an apparently normal part (ANP) of the personality, are highlighted. Three different pathogenic dynamics are considered that typically occur in complexly traumatized patients: phobic avoidance of traumatic memories, contextualization deficit and traumatic attachment.

In summary, by re-evaluating phenomenological experiences against the background of neurobiological mechanisms, PAP offers a promising avenue for a deeper understanding and therapeutic resolution of traumatic dissociation, which could fundamentally improve the treatment paradigm for many trauma-related disorders.

Posttraumatic stress disorder (PTSD) is a highly heterogeneous disorder (Galatzer-Levy & Bryant, 2013). Mixture modeling has been used to identify homogeneous subgroups of individuals based on patterns of PTSD symptom expression. However, most of these studies are based on DSM-IV rather than DSM-5 PTSD criteria. In addition, these studies employ different indicators of latent class membership, which contributes to variability in the number and nature of latent classes identified. Additionally, there is relatively limited construct validity evidence of identified latent classes. To address these limitations, a latent class analysis (LCA) of DSM-5 PTSD symptoms was conducted in a sample of undergraduate students (N = 322) who met criteria for a subthreshold diagnosis of PTSD. The current study aimed to replicate and extend findings from the limited number of LCAs of DSM-5 PTSD criteria and examine how resulting classes meaningfully differ in external correlates. Findings revealed a three-class solution: Low Anhedonia/Externalizing Behaviors (EB), Moderate Symptoms, and High Symptoms of PTSD. Relative to the other classes, the High Symptoms class was characterized by elevated anxiety and somatic symptoms on the Personality Assessment Inventory (PAI; Morey, 1991). Relative to the Low Anhedonia/EB, the Moderate Symptoms class was characterized by numerous psychopathology domains, including depression and borderline personality traits. Results from this study suggest that, beyond classes characterized by similar PTSD symptom severity across symptoms, some individuals with similar overall PTSD symptom severity differed based on depressive symptom characteristics. Implications and future directions are discussed.

Background

Recent papers highlighted psychosocial and occupational risks for merchant seafarers. Officers as an occupational group were on of the most exposed. They are exposed to psychological traumatic events. During their training courses cadets have to embark onboard each year. The aim of this study was to investigate traumatic experiences and risk factors in French merchant Navy cadets.

Methods

Our study is an observational self-report study using an anonymous questionnaire in two time periods. In 2011, analysis of first embarkment period and in 2022 self-administrated questionnaire.

Results

This two-part study highlights frequent exposure to professional situations (19 %) with a risk of psychological impact, particularly post-traumatic stress. The main causes found are related to the conduct of the ship, weather conditions, incidents on board and piracy.

Conclusions

The high rate of exposure to events with high levels of stress and their diversity seems to us to highlight the need for prevention, information, and action on its various sources, but also on all the psychosocial factors to which seafarers are exposed