Helpful and meaningful aspects of a psychoeducational programme to treat complex dissociative disorders: a qualitative approach.

Purpose: Complex dissociative disorders (CDDs) are prevalent among psychotherapy clients, and research suggests carefully paced treatment for CDDs is helpful. The purpose of the present study is to qualitatively explore helpful and meaningful aspects of the TOP DD Network programme, a web-based adjunctive psychoeducational programme for the psychotherapeutic treatment of clients with CDDs.Methods: TOP DD Network programme participants (88 clients and 113 therapists) identified helpful and meaningful aspects of their participation in response to two open textbox questions. Framework analysis was used to qualitatively analyze client and therapist responses.Findings: Participants found the TOP DD Network programme helpful and meaningful in nuanced ways. Three themes were created: (1) Components of the Programme (subthemes: content, structure), (2) Change-Facilitating Processes (subthemes: heightened human connection, receiving external empathy and compassion, contributing to something bigger, improved therapeutic work and relationship), and (3) Outcomes (subthemes: insight, increased hope, self-compassion, increased safety and functioning). The most emphasized theme was components of the programme, which captured its content and structure.Conclusion: Clients and therapists in the TOP DD Network programme described the programme's components and processes as helpfully facilitating positive outcomes in the treatment of CDDs. Therapists may consider integrating the components and processes in the programme into their practice with clients with CDDs.

The aim of the present study was to qualitatively explore significant aspects of the TOP DD Network programme through the experiences of complex dissociative disorder (CDD) clients and psychotherapists.Helpful and meaningful aspects of the programme included its components (i.e. content and structure), processes, and outcomes.This psychoeducational programme can be effective and result in improved therapeutic processes and outcomes for individuals with CDDs in psychotherapy.

Inpatient outcomes following admission to stabilization-focused complex trauma- and dissociation-specific unit.

OBJECTIVE: Individuals with histories of complex psychological trauma, such as those with dissociative disorders, are often high utilizers of inpatient services and thus warrant further research attention. The present study sought to examine whether treatment on a specialized inpatient trauma unit was associated with improvements in adaptive functioning, emotion regulation, and dissociation among patients experiencing complex posttraumatic and dissociative symptoms. METHOD: This study used archival data collected as part of treatment provided to inpatients (N = 54), the majority of whom had a dissociative disorder, at a specialized trauma disorders unit to analyze differences in scores between intake and discharge on measures of adaptive functioning, emotion regulation, and dissociation. RESULTS: Adaptive functioning and emotion regulation were significantly improved at discharge compared to intake, t(299) = -11.28, p < .001; t(305) = 8.54, p < .001, respectively, with very large effect sizes (d = 1.60; d = 1.20), and there was a significant decrease, t(311) = 2.15, p = .032, d = .30, in dissociative absorption. CONCLUSIONS: Our findings suggest that inpatient treatment modeled after expert consensus treatment guidelines is associated with significant improvements in adaptive functioning and emotion regulation and reduced dissociative absorption in individuals experiencing severe and acute complex posttraumatic and dissociative symptoms. Appropriate screening and symptom-specific treatment of complex posttraumatic and dissociative symptoms are recommended to improve outcomes for this population during inpatient hospital admission. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The independent and combined impact of moral injury and moral distress on post-traumatic stress disorder symptoms among healthcare workers during the COVID-19 pandemic.

Background: Healthcare workers (HCWs) across the globe have reported symptoms of Post-Traumatic Stress Disorder (PTSD) during the COVID-19 pandemic. Moral Injury (MI) has been associated with PTSD in military populations, but is not well studied in healthcare contexts. Moral Distress (MD), a related concept, may enhance understandings of MI and its relation to PTSD among HCWs. This study examined the independent and combined impact of MI and MD on PTSD symptoms in Canadian HCWs during the pandemic.Methods: HCWs participated in an online survey between February and December 2021, with questions regarding sociodemographics, mental health and trauma history (e.g. MI, MD, PTSD, dissociation, depression, anxiety, stress, childhood adversity). Structural equation modelling was used to analyze the independent and combined impact of MI and MD on PTSD symptoms (including dissociation) among the sample when controlling for sex, age, depression, anxiety, stress, and childhood adversity.Results: A structural equation model independently regressing both MI and MD onto PTSD accounted for 74.4% of the variance in PTSD symptoms. Here, MI was strongly and significantly associated with PTSD symptoms (ß = .412, p < .0001) to a higher degree than MD (ß = .187, p < .0001), after controlling for age, sex, depression, anxiety, stress and childhood adversity. A model regressing a combined MD and MI construct onto PTSD predicted approximately 87% of the variance in PTSD symptoms (r2 = .87, p < .0001), with MD/MI strongly and significantly associated with PTSD (ß = .813, p < .0001), after controlling for age, sex, depression, anxiety, stress, and childhood adversity.Conclusion: Our results support a relation between MI and PTSD among HCWs and suggest that a combined MD and MI construct is most strongly associated with PTSD symptoms. Further research is needed better understand the mechanisms through which MD/MI are associated with PTSD.

MI and MD were each independently associated with PTSD symptoms (including dissociation), when controlling for sex, age, childhood adversity, depression, anxiety and stress.Combining both MI and MD constructs into a single latent variable accounted for the greatest proportion of variance explained in PTSD symptoms among HCWs during the COVID-19 pandemic.Results suggest that expanding the construct of MI to include team and systemic organisational MD may be appropriate in the healthcare context.