European Journal of Trauma & Dissociation最新文献

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

Classical and contemporary theoretical approaches emphasize that significant events during childhood have important implications throughout life regarding developmental psychopathology and psychological health. Previous research has shown significant associations between early complex trauma, affective temperament, and maladaptive parenting with symptomatology. However, how trauma experiences are amplified and/or augmented and how they impact the regulation of psychological needs remains unclear. Therefore, the present study aims to explore a sequential path model from early complex trauma to psychological needs with multiple mediators. Data were collected from a convenience sample (N = 644) who responded to several questionnaires in a cross-sectional design. Early complex trauma correlated positively with early maladaptive schemas and affective temperament. A significant sequential path model showed that early complex trauma is related to difficulties in the regulation of psychological needs, with significant contributions from affective temperament, maladaptive parenting, and early maladaptive schemas. Results support the notion that several variables may mediate relationships between trauma experiences and the regulation of psychological needs. Implications for the development of an integrative early disorder determinants theory are discussed.

This article studies the therapeutic journey of a migrant woman who fled to France from an Eastern European country in order to escape from her country following the serious violence she suffered over the last 15 years. This case study is part of an inpatient stay in an innovative crisis unit based on the "Art Cru" setting, which is a therapeutic mediation method using art inspired by psychoanalytical and humanist currents. This setting seeks to deploy the processes of symbolisation from the sensory traces and primary forms of symbolisation. Through this study, we question the relevance of certain therapeutic mediations employing creative expression in an intense and regular way with patients for whom verbal communication can be an obstacle to the therapeutic process.

Doctors at the French Telemedical Assistance Service (TMAS) provide support to ship captains via teleconsultation for the management of medical emergencies during navigation. In response to this emerging demand for psychological or psychiatric care, TMAS doctors have been calling as and when required on a specialised platform known as the Resource Center for Psychological Assistance at Sea (CRAPEM), based in Saint Nazaire, France, since 2020. The study objective was to compare the management of psychiatric emergencies at sea by TMAS doctors alone versus TMAS doctors assisted by CRAPEM. We conducted a retrospective, descriptive epidemiological study between 1 January 2020 and 31 December 2021. We extracted data from AppliCCMM on patient characteristics, ship characteristics, management characteristics including final decision (treatment on board, disembarkation, diversion, evacuation or death) from previously identified diagnostic coding. Decisions were compared for “case” versus “control” using Chi-2 tests. Differences were considered significant if the P value was below 0.05. The analysis therefore focused on 21 patient cases and 63 patient controls. A comparison of the final decisions shows that patients in the CRAPEM group receive significantly (p < 0.001) less treatment on board. This difference is probably related to the fact that the patients for whom TMAS doctors seek advice from CRAPEM have more serious conditions. CRAPEM is a new organization aimed at improving the management of psychiatric illnesses in seafarers and, in our case, acute-phase psychological and psychiatric emergencies. Given the specific characteristics of the maritime environment, its intervention improves the management of patients at sea.

Attachment Trauma (AT) is a known clinical heuristic in Psychology. However, different perspectives on it have emerged, leading to heterogeneity and confusion. In pursuit of clarity, this paper aims to navigate the perspectives surrounding AT through an integrative review. The review identifies six distinct lines of research. The initial three, falling under the attachment research tradition, include 1. Infant disorganized attachment, 2. Unresolved/disorganized adult states of mind, and 3. Adult fearful attachment in personality Psychology. The subsequent three, falling under the trauma research tradition, encompass 4. Complex Post Traumatic Stress Disorder (cPTSD), 5. Early adverse experiences, and the 6. Biological correlates of trauma. By elucidating the commonalities and disparities between these research programs the paper underscores how they seem to converge on the core concept of AT. Ultimately, a new definition of AT is put forward: “varying and long-lasting biological, psychological, and relational consequences resulting from incomplete encoding and integration of emotionally overwhelming experiences within an attachment relationship”. The definition is explained in depth, highlighting how AT may be framed as a diverse set of adaptations, rather than a diagnosis, that may nevertheless lead to maladjustment and increased risk of psychopathology. Moreover, it is argued that the biological and evolutionary nature of the attachment bond is what distinguishes the AT concept from its alternatives (e.g.,relational trauma, betrayal trauma) in terms of solidity and explanatory power.

Objective

This study aimed to perform a transcultural translation of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) and assess its reliability within the Thai context.

Methods

The PCL-5 underwent a comprehensive translation process, including forward and backward translation, assessment by an expert panel, and comprehension testing by 10 patients with posttraumatic stress disorder (PTSD). The internal consistency of the overall scale and its subscales was examined using a sample of 100 patients with psychiatric disorders. Test-retest reliability was tested on Day 0 and Day 14. Confirmatory factor analyses were performed to assess structural validity and goodness-of-fit.

Results

Experts’ assessment of item-objective congruence indicated a satisfactory alignment of all items. The patients with PTSD demonstrated a strong understanding of the questionnaire. The translated PCL-5 exhibited excellent internal consistency (α = 0.96) with robust internal consistency of all subscales (α ranging from 0.86 to 0.91). The test-retest reliability was high (r = 0.82). Among the three structural models tested, the seven-factor Hybrid model provided the best fit to the data. Notably, patients with personality disorders scored the highest.

Conclusions

The Thai version of the PCL-5 demonstrates reliability, making it a valuable instrument for clinical application and future research among the Thai population. Patients with comorbid personality disorders may score higher on the PCL-5.

From 1948 to 1989, former Czechoslovakia was ruled by the Communist Party that persecuted active citizens and political figures who organized under initiative Charter 77. During the 1970s and 1980s, Operation Asanace (meaning “cleansing”) took place as a systematic way to expel Charter 77 activists and other totalitarian regime adversaries from the communist country by implementing physical, psychological, and systemic abuse. This qualitative study explored the experiences of seven primary victims of Operation Asanace by conducting focus groups and analyzing the emerging themes. Results show that various changes in national identity, feelings of hopelessness, otherness and alienation were present, together with several losses and diverse reactions from individuals in their vicinity. Our study also highlights enduring traits of entrepreneurship and activism, resilience, adaptation to adversities, alongside evidence of post-traumatic growth, contributing to the body of knowledge regarding the psychological consequences of confronting an authoritarian regime.

Introduction

Currently, limited evidence exists for any psychotherapeutic treatment for schizotypal or paranoid personality disorders (SPD; PPD). However, schema therapy (ST) seems a promising candidate, focussing on ameliorating the consequences of childhood trauma through building a healing personal relationship and working on the integration and regulation of the total range of emotions with experiential exercises, e.g., imagery work.

Method

The current case report presents a 38-year-old male with SPD, PPD, comorbid substance abuse, and an extensive trauma history. He initially presented with pronounced social isolation, emotional inhibition and avoidance, and a persistent sense of being different than other people. The patient received 63 sessions of individual ST over a course of 20 months.

Results

Limited reparenting and empathic confrontation were the primary interventions, as the patient found it hard to engage in experiential exercises and activate emotion. When engaging with difficult emotions, the patient would often exhibit a swift sequence of schema modes, or even dissociate. This meant that the therapist would hold back in challenging or confronting the patient to more emotionally intensive work. The effect of therapy resulted only in small changes in schemas and modes during therapy, and some changes in the expression of anger, but no effect on personality disorder or symptom levels at the end of treatment and follow-up. However, the patient was adherent to the treatment and did not exhibit exacerbation of his condition.

Conclusion

ST seems safe and acceptable for this case of SPD and PPD. Should the treatment have been more effective, it might have been beneficial to insist on experiential work. We recommend extensive support and supervision when treating SPD and PPD. Further work is needed to adapt and handle the specific challenges this patient group poses, as well as studies on the effect of ST for these disorders.

Dismissal of an individual's emotional experience by their significant others can have a massive impact on the psychological well-being of the individual. Betrayal trauma discusses the prevalent social phenomenon and its short- as well as long-term impacts on an individual. This study focused on betrayal trauma in romantic relationships. It aimed to find its relation with an individual's self-esteem and attachment styles, with trust as a mediating variable. The tools used in the study- were the partner betrayal trauma trust scale, adult attachment scale and self-esteem scale, each of which was a self-report measurement scale circulated among young adults in the Indian population. The study consisted of 140 participants (n = 140) with a mean age of 21.7 and a standard deviation (SD) of 2.05. The participants included 85% female, 16% male, 3% of the participants identified as genderfluid, and 2% of the participants preferred not to mention their gender. The results from the study show that betrayal trauma in romantic relationships is related to an individual's attachment style and self-esteem. A positive significant correlation was found between betrayal trauma, self-esteem and attachment style, which reveals the impact of betrayal trauma on the psychological well-being of an individual. These findings may aid mental health practitioners in helping young adults resolve their relationship crises and enhance their lifestyles in India.