复杂创伤及其诊断意义

Thiago Viola, Rodrigo Grassi-Oliveira, A. Renner, B. Schiavon
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引用次数: 10

摘要

长期暴露于具有人际关系性质的多重创伤性事件,特别是在发育过程中,已经显示出心理后果和症状,这些后果和症状不包括在目前的创伤后应激障碍(PTSD)诊断标准中。这些儿童期和青春期的消极和慢性情况进一步证明,存在与对许多创伤影响的复杂(不)适应相关的精神病理综合征。缺乏一个连贯和可靠的诊断对这些患者的症状识别和治疗计划产生负面影响。本研究的目的是回顾创伤的定义,提出了复杂创伤的概念,并探讨其临床意义和诊断类别由此产生的概念。复杂创伤和创伤后应激障碍之间的差异提出了重要的问题,随后对创伤后应激障碍的症状和共病障碍的调查,以及创伤后应激障碍诊断的局限性。考虑到与复杂创伤相关的精神病理学影响,本文讨论了在《精神疾病诊断与统计手册》第5版中纳入新诊断类别的可能性,作为创伤后精神病理学谱系的一部分。
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Trauma complexo e suas implicações diagnósticas
Prolonged exposure to multiple traumatic events of an interpersonal nature, particularly during development, has shown psychological consequences and symptoms not included among the current diagnostic criteria of post-traumatic stress disorder (PTSD). These negative and chronic situations during childhood and adolescence provide further evidence of the existence of a psychopathological syndrome associated with complex (dis)adaptations to a number of traumatic effects. The absence of a cohesive and reliable diagnosis for these patients negatively affects symptom identification and treatment planning. The aim of the present study was to review the definition of trauma, presenting the concept of complex trauma and investigating its clinical implications and the diagnostic categories deriving from this construct. Important questions are raised about differences between complex trauma and PTSD, followed by an investigation of PTSD symptoms and comorbid disorders, as well as the limitations of PTSD diagnosis. Taking into consideration the psychopathological impact associated with complex trauma, the article discusses the possibility of including a new diagnostic category in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders is discussed, as part of the spectrum of post-traumatic psychopathologies.
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发文量
5
审稿时长
16 weeks
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