Complex PTSD in survivors of intimate partner violence: risk factors related to symptoms and diagnoses.

Background: In 2018, the World Health Organization proposed a new diagnosis entitled Complex Posttraumatic Stress Disorder (CPTSD) in the ICD-11. It is a diagnosis that encompasses the classic symptoms of PTSD, along with symptoms of disturbances in self-organization (DSO). Although this disorder has been studied in several countries and populations, research on the population of women survivors of intimate partner violence (IPV) is scarce. Objectives: 1) To analyse the prevalence of CPTSD and PTSD according to ICD-11 criteria; 2) To analyse the associations between CPTSD symptomatology and severity of violence, level of fear, resilience and strategies of emotion regulation; 3) To analyse which risk factors (severity of violence, level of fear, resilience and strategies of emotion regulation) may differ between female survivors with CPTSD or PTSD. Method: 162 women IPV survivors who completed a socio-demographic and violence-related interview, as well as questionnaires to assess PTSD and CPTSD, severity of violence, resilience and emotion regulation strategies. Results: The results showed a higher prevalence of CPTSD (39.50%), compared to PTSD (17.90%). Moreover, a high level of fear was related to re-experiencing in the here and now, avoidance, current sense of threat and disturbances in relationships. Low levels of resilience and maladaptive emotion regulation strategies such as expressive suppression were related to affective dysregulation, negative self-concept and disturbances in relationships. Finally, the results showed that maladaptive emotion regulation strategies differentiated between meeting CPTSD and PTSD criteria in women survivors of IPV. Conclusion: The findings of this study indicated that CPTSD was twice as prevalent as PTSD within the sample. Moreover, maladaptive emotion regulation strategy as expressive suppression was the main variable related to experiencing CPTSD, in contrast to PTSD. These findings may have important implications for the design of specific treatments aimed at women survivors of IPV, who also suffer CPTSD.

Antecedentes: En 2018, la Organización Mundial de la Salud propuso en la CIE-11 un nuevo diagnóstico denominado trastorno de estrés postraumático complejo (TEPTC). Se trata de un diagnóstico que engloba los síntomas clásicos del TEPT y los síntomas de alteraciones de la auto-organización (AAO). Aunque este trastorno se ha estudiado en varios países y poblaciones, la investigación en la población de mujeres supervivientes de violencia de género (VG) es escasa.Objetivos: 1) Analizar los porcentajes de TEPTC y TEPT según los criterios de CIE-11; 2) Analizar las asociaciones entre los síntomas de TEPTC con la gravedad de la violencia, nivel de miedo, resiliencia y estrategias de regulación emocional; 3) Analizar qué factores de riesgo (gravedad de la violencia, nivel de miedo, resiliencia y estrategias de regulación emocional) diferencian entre sufrir TEPTC o TEPT en mujeres supervivientes de VG.Método: Las participantes fueron 162 mujeres supervivientes de VG que completaron una entrevista sociodemográfica y de violencia, así como cuestionarios para evaluar el TEPT y el TEPTC, gravedad de la violencia, resiliencia y estrategias de regulación emocional.Resultados: Los resultados mostraron una mayor prevalencia de TEPTC (39,50%) que de TEPT (17,90%). Además, un alto nivel de miedo se relacionó con la reexperimentación en el aquí y ahora, evitación, sensación actual de amenaza y alteraciones en las relaciones. Bajos niveles de resiliencia y estrategias desadaptativas de regulación emocional como la supresión de la expresión, se relacionaron con los síntomas de desregulación afectiva, autoconcepto negativo y alteraciones en las relaciones. Por último, los resultados mostraron que las estrategias desadaptativas de regulación emocional diferenciaban entre cumplir los criterios de TEPTC y TEPT en mujeres supervivientes de VG.Conclusión: Este estudio mostró que el TEPTC es dos veces más prevalente que el TEPT en la presente muestra de mujeres supervivientes de VG. Además, la estrategia desadaptativa de regulación emocional de supresión de la expresión fue la principal variable relacionada con presentar TEPTC en contraste con el TEPT. Estos hallazgos podrían tener importantes implicaciones para el diseño de tratamientos específicos dirigidos a las mujeres supervivientes de VG que sufren TEPTC.

The role of antiphospholipid autoantibodies in the cognitive deficits of patients with systemic lupus erythematosus.

OBJECTIVE: To analyze the role of the antiphospholipid autoantibodies (aPL) on the neuropsychological deficits in systemic lupus erythematosus (SLE) patients, comparing groups of patients with antiphospholipid syndrome (APS; n = 15), SLE with aPL (n = 12), and SLE without aPL (n = 27), and a healthy control group (n = 31). METHODS: Patients fulfilled the American College of Rheumatology SLE classification criteria or the Sydney criteria for APS. All participants were woman, and groups were matched on age and education. A standardized cognitive examination classified patients as cognitively declined or impaired according to the American College of Rheumatology. RESULTS: Differences between the groups were found in all of the studied variables, comprising attention and executive functions (sustained and selective attention, fluency, and inhibition), and memory (verbal and visual). Post-hoc analyses showed cognitive performance was equivalent between APS and SLE with aPL. Differences between SLE without aPL and control groups were found only in four of the 10 studied variables, while differences in all but two memory variables were found between SLE without aPL and control groups. Furthermore, cognitive deficit was three times more frequent in APS and SLE with aPL patients than for the control group (80%, 75%, and 16%, respectively), and two times more frequent compared to SLE patients without aPL (48%). CONCLUSIONS: Our results support the relationship between aPL and cognitive symptoms in SLE. Also, almost half of the patients with SLE and no aPL showed cognitive problems, pointing to the multifactorial causes of cognitive problems in SLE. Future research with larger sample size is guaranteed to replicate our results.