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1.
Am J Clin Hypn ; 62(1-2): 95-117, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31265370

RESUMEN

This article explores how hypnotic strategies can be used within a polyvagal science framework to help create more secure attachment within the therapeutic relationship, as well as within the client in terms of ego-state relationships. Principles of safety and connection are emphasized, along with specific strategies to access the attachment circuits of the ventral vagal system, including the necessity of being present with the client without agenda. Uses of hypnosis related to safety and connection and methods to work with the center core self to facilitate empowerment, self-cohesion, and conflict-free experience are also reviewed. From an ego-state therapy perspective, a discussion of hypnosomatic approaches to connect with preverbal, nonverbal, and somatic aspects of self to accomplish developmental repair and facilitate secure attachment is also offered, along with case examples. A three-step model, which attempts to integrate polyvagal, somatic, and hypnotic approaches, is offered by the author to help structure corrective experiences for clients with trauma.


Asunto(s)
Ego , Hipnosis , Relaciones Profesional-Paciente , Encéfalo/fisiopatología , Humanos , Modelos Psicológicos , Apego a Objetos , Trastornos por Estrés Postraumático/fisiopatología , Trastornos por Estrés Postraumático/terapia , Alianza Terapéutica
2.
Eur J Psychotraumatol ; 10(1): 1688935, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31839899

RESUMEN

Background: Posttraumatic stress disorder (PTSD) involves a complex interaction of biological, psychological, and social factors. Numerous studies have demonstrated genetic variation associated with the development of PTSD, primarily in adults. However, the contribution of low frequency and rare genetic variants to PTSD is unknown to date. Moreover, there is limited work on genetic risk for PTSD in child and adolescent populations. Objective: This preliminary study aimed to identify the low frequency and rare genetic variation that contributes to PTSD using an exome array. Method: This post-disaster, adolescent sample (n = 707, 51% females, M age = 14.54) was assessed for PTSD diagnosis and symptom count following tornado exposure. Results: Gene-based models, covarying for ancestry principal components, age, sex, tornado severity, and previous trauma identified variants in four genes associated with diagnosis and 276 genes associated with symptom count (at p adj < .001). Functional class analyses suggested an association with variants in the nonsense class (nonsynonymous variant that results in truncation of, and usually non-functional, protein) with both outcomes. An exploratory gene network pathway analysis showed a great number of significant genes involved in brain and immune function, illustrating the usefulness of downstream examination of gene-based findings that may point to relevant biological processes. Conclusions: While further investigation in larger samples is warranted, findings align with extant PTSD literature that has identified variants associated with biological conditions such as immune function.

3.
Eur J Psychotraumatol ; 10(1): 1697582, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31839901

RESUMEN

Background: Misappraisals in evaluating the trustworthiness of others may be one mechanism contributing to the interpersonal difficulties individuals with posttraumatic stress disorder (PTSD) face. Objective: This study used a translational experimental design to examine the behavioural and neural correlates underlying the appraisal of facial stimuli morphed on dimensions of trustworthiness across three groups: individuals with high posttraumatic stress symptoms (HPTS), low posttraumatic stress symptoms (LPTS), and healthy controls (HC). Methods: Participants (N = 70) rated how trustworthy to untrustworthy they perceived three facial morphs (trustworthy, neutral, and untrustworthy) while undergoing electroencephalography (EEG). Results: Behavioural results showed that the HPTS group rated the untrustworthy morph as more untrustworthy than the HC group (ß = 0.20, SE = .07, 95% CI [0.06, 0.33], z = 2.88, p = .004). The HPTS group also showed no variation in response time across morphs ( X 2 (2) = 0.92, p = 0.63), while the LPTS and HC groups did ( X 2 (2) = 9.60, p = .008; X 2 (2) = 23.62, p < .001). EEG data revealed significant group by morph interactions at the N170 latency and the Vertex Positive Potential (VPP): the HPTS and LPTS identified the untrustworthy morph faster than the HCs, but diverged to the degree to which they encoded each facial morph. Conclusions: Taken together our results suggest that HPTS individuals demonstrate an early attentional avoidance of faces morphed on dimensions of trustworthiness. This early, preconscious, avoidance may be one mechanism contributing to the miscalculations individuals with PTSD make in interpersonal situations.

4.
Rev Esc Enferm USP ; 53: e03529, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31800820

RESUMEN

OBJECTIVE: To evaluate the effect of meditation on the psychological stress level of women with breast cancer. METHOD: A systematic literature review performed in the LILACS, PubMed, Scopus, CINAHL and Web of Science databases. RESULTS: The sample consisted of 22 studies using Mindfulness, Transcendental Meditation, and Contemplative Self-Healing Meditation techniques. There was a significant effect of meditation on stress reduction, post-traumatic stress symptoms, self-reported stress, and chronic stress verified. In some studies, the effect was associated with decreased cortisol and increased telomerase. CONCLUSION: Meditation has shown positive effects in reducing physical and emotional symptoms such as psychological stress, depression, anxiety, fatigue, fear of recurrence and rumination, representing an efficient strategy for coping with the disease and improving quality of life.

5.
Eur J Psychotraumatol ; 10(1): 1694766, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31807235

RESUMEN

Background: The 11th revision of the International Classification of Diseases includes a new chapter of stress-related disorders and presents two distinct sibling conditions: Posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). Studies show that PTSD and CPTSD are associated with different levels of symptom burden, comorbidity and functional impairment, but have not yet addressed the qualitative and quantitative differences in work-related impairment between the two diagnoses. Objective: The aim of this study was to replicate differences in symptom severity, global distress, and the number of comorbid diagnoses between three groups that suffer from no PTSD, PTSD, or CPTSD. More importantly, we evaluated whether the three groups differ in indicators of functional impairment such as qualitative and quantitative working capacity. Finally, this study supplies information on prevalence rates of PTSD and CPTSD in a clinical sample suffering from psychosomatic complaints. Methods: Participants were 662 patients of a Psychosomatic Rehabilitation Clinic (age M = 50.99, SD 8.99 years; 70.1% female). Self-report screening instruments were administered to participants at the beginning of their inpatient psychotherapy. Multivariate analysis of variance and Chi Square tests were utilized to assess group differences in symptom severity, comorbidity and work-related impairment. Results: A prevalence of 13.3% CPTSD and 9.5% PTSD was found among the current sample. CPTSD was associated with heightened symptom burden and more comorbid diagnoses. More importantly, CPTSD was associated with a significantly lowered qualitative and quantitative working capacity compared to PTSD and no-PTSD. Conclusions: The high prevalence, greater psychopathological burden and work-related impairments in CPTSD compared to PTSD highlight the need for developing and evaluating new interventions in rehabilitation that address the complexity of the new disorder.

6.
Rev Infirm ; 68(256): 37-39, 2019 Dec.
Artículo en Francés | MEDLINE | ID: mdl-31870479

RESUMEN

When subjected to potentially traumatic events, children can develop psychological trauma with varying levels of severity. For preventive and therapeutic purposes, these psychological traumas must be assessed and managed by psychologists and/or psychiatrists who are well-trained and experienced.


Asunto(s)
Trauma Psicológico , Trastornos por Estrés Postraumático , Niño , Familia , Humanos , Psicología Infantil
7.
Soins ; 64(841): 9-11, 2019 Dec.
Artículo en Francés | MEDLINE | ID: mdl-31864517

RESUMEN

Post-traumatic stress disorder is an adjustment disorder combining psychological and physical symptoms. Faced with the pain associated with post-traumatic stress disorder, it is important to know how to differentiate between the pain linked to the physical injury at the time of the traumatic event and the psychogenic pain. Identifying these pains and studying their aetiology, combined with an assessment of the patient's psychological state and life history, enables multi-disciplinary care to be put in place to improve the patient's prognosis and can help to improve recognition of these disorders.


Asunto(s)
Dolor/epidemiología , Trastornos Psicofisiológicos/epidemiología , Trastornos por Estrés Postraumático/epidemiología , Humanos , Dolor/psicología
8.
Adv Exp Med Biol ; 1192: 53-93, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31705490

RESUMEN

Psychiatric disorders such as addiction (substance use and addictive disorders), depression, eating disorders, schizophrenia, and post-traumatic stress disorder (PTSD) are severe, complex, multifactorial mental disorders that carry a high social impact, enormous public health costs, and various comorbidities as well as premature morbidity. Their neurobiological foundation is still not clear. Therefore, it is difficult to uncover new set of genes and possible genetic markers of these disorders since the understanding of the molecular imbalance leading to these disorders is not complete. The integrative approach is needed which will combine genomics and epigenomics; evaluate epigenetic influence on genes and their influence on neuropeptides, neurotransmitters, and hormones; examine gene × gene and gene × environment interplay; and identify abnormalities contributing to development of these disorders. Therefore, novel genetic approaches based on systems biology focused on improvement of the identification of the biological underpinnings might offer genetic markers of addiction, depression, eating disorders, schizophrenia, and PTSD. These markers might be used for early prediction, detection of the risk to develop these disorders, novel subtypes of the diseases and tailored, personalized approach to therapy.


Asunto(s)
Conducta Adictiva/genética , Depresión/genética , Trastornos de Alimentación y de la Ingestión de Alimentos/genética , Esquizofrenia/genética , Trastornos por Estrés Postraumático/genética , Trastornos Relacionados con Sustancias/genética , Marcadores Genéticos , Humanos , Psiquiatría
9.
J Music Ther ; 56(4): 315-347, 2019 Nov 19.
Artículo en Inglés | MEDLINE | ID: mdl-31696919

RESUMEN

Music therapy treatment is increasingly being used to promote health, enhance quality of life, and improve functioning in military personnel, but evidence on the use of music interventions with military service members is still emerging. The purpose of this scoping review was to synthesize the available literature regarding music therapy treatment with military personnel by identifying the types of information available, key characteristics, and gaps in the knowledge base. The review was completed using the methodological framework proposed by Arksey and O'Malley. A total of 27 publications met the criteria for review. The results included anecdotal reports, white papers/ briefs, case studies, historical reviews, clinical program descriptions, and research studies. Both active duty and veteran service members were represented in the literature, and post-traumatic stress disorder and traumatic brain injury were the most commonly listed conditions among those served. Music therapy services were offered in both group and individual formats, and drumming was the most common music intervention cited. Most publications accurately represented music therapy, and the historical reviews highlighted the connection between the development of the field of music therapy and the use of music with military personnel. Several gaps were identified, including a lack of specificity in reporting, low levels of evidence, and limited inclusion of women service members.


Asunto(s)
Personal Militar/psicología , Musicoterapia , Calidad de Vida , Trastornos por Estrés Postraumático/terapia , Femenino , Humanos
10.
Fortschr Neurol Psychiatr ; 87(11): 638-641, 2019 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-31756746

RESUMEN

This text examines post-traumatic stress disorders and trauma sequel disorders in adolescence, focusing in particular on the problem of transition. On the one hand, on the diagnostic level traumatizations are often not PTSD-specific, but rather self-help and self-medication measures as well as alcohol and drug addiction and dissociality, which are often not sufficiently questioned in the adult psychiatric system. On the other hand, it is about the further development and implementation of trauma pedagogical approaches, especially for young people who grow up in critical high-risk constellations or who are already in institutions of youth welfare or integration assistance. Here, not only a blatant lack of initial, further and continuing training for the occupational groups involved is noted, but also a lack of empirical therapy studies.


Asunto(s)
Trastornos por Estrés Postraumático/complicaciones , Trastornos por Estrés Postraumático/psicología , Trastornos Relacionados con Sustancias/complicaciones , Adolescente , Humanos , Trastornos por Estrés Postraumático/terapia , Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/terapia
11.
Nurs Clin North Am ; 54(4): 503-515, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31703776

RESUMEN

Mental illness and injury, including post-traumatic stress disorder, represents a significant source of disability and morbidity among military and veteran populations. This article explores the pathophysiology, identification, and treatment of military service-connected trauma-related and stressor-related disorders. Particular attention is given to trauma informed care, evidence-based practice recommendations, and the sequencing of psychotherapy and pharmacotherapy in pursuit of optimal patient outcomes.


Asunto(s)
Práctica Clínica Basada en la Evidencia , Personal Militar/estadística & datos numéricos , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/fisiopatología , Terapia Cognitivo-Conductual , Humanos , Trastornos por Estrés Postraumático/terapia
15.
Eur J Psychotraumatol ; 10(1): 1673062, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31681464

RESUMEN

Objective: Due to traumatic experiences and highly prevalent post-migration stressors, refugees are vulnerable for developing psychopathology. To date, research has mainly evaluated trauma-focused therapies, targeting post traumatic stresss symptoms. Treatments targeting post-migration stressors are relatively understudied. The present cohort study evaluated the potential effectiveness of 7ROSES, a transdiagnostic intervention that aims to increase self-efficacy among treatment-seeking refugees in dealing with post-migration stressors. Because it can be applied by non-specialist health care workers, it can be disseminated on a large scale, thereby increasing options for psychosocial support for refugees. Method: Forty-nine refugees (65% male, average age: 36.02 years, SD = 8.52) with psychopathology were included. Before and after participation in 7ROSES, self-efficacy was measured using the General Self-Efficacy Scale (GSES), and general psychopathology using the Brief Symptom Inventory (BSI). Results: Completers analysis yielded a significant increase in GSES scores (Z = -2.16, p = .03) and significant decrease in BSI scores (Z = -2.05, p = .04) with medium-small effects (both r = -.28). Intent-to-treat analysis, using predictive mean matching imputation, yielded significant results for the GSES (p = .012) but not for the BSI (p = .14) with small effects (GSES r = .14, BSI r = .12). Reliable change indices established negative change in 3%, no change in 70%, and positive change in 27% based on the GSES; percentages were 11.5%, 65.5%, and 23%, respectively, based on the BSI. Conclusion: Findings provide preliminary evidence that 7ROSES could improve self-efficacy and general mental health in refugees with psychopathology.

16.
Eur J Psychotraumatol ; 10(1): 1676005, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31681466

RESUMEN

Background: Although the family constitutes the prime source of risk and resilience for the well-being of children growing up in adverse conditions, the mental health of children living in refugee camps has rarely been investigated in conjunction with their parents' mental health. Objectives: To examine the prevalence of posttraumatic stress disorder (PTSD) and other mental health problems among Burundian refugee children and their parents living in Tanzanian refugee camps and to identify patterns of comorbidity among children and their parents based on PTSD symptom levels and functional impairment. Methods: We recruited a representative sample of 230 children aged 7-15 years and both of their parents (n = 690) and conducted separate structured clinical interviews. Latent Class Analysis was applied to identify patterns of comorbidity. Results: Children and parents were exposed to multiple traumatic event types. In total, 5.7% of children fulfilled DSM-5 criteria for PTSD in the past month and 10.9% reported enhanced levels of other mental health problems. 42.6% indicated clinically significant functional impairment due to PTSD symptoms. PTSD prevalence was higher among mothers (32.6%) and fathers (29.1%). Latent Class Analysis (LCA) revealed a familial accumulation of PTSD symptoms as children with high symptom levels and impairment were likely to live in families with two traumatized parents. Conclusions: Although the number of children who need support for trauma-related mental health problems was relatively low, taking into account parental trauma could aid to identify at-risk children with elevated PTSD symptom levels and impairment even in the face of existing barriers to mental health care access for children in refugee camp settings (e.g. lack of targeted services, prioritization of managing daily stressors).

17.
Eur J Psychotraumatol ; 10(1): 1684225, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31741719

RESUMEN

Background: Epidemiological studies have reported high rates of post-traumatic stress disorder (PTSD) among asylum seekers from Sub-Saharan Africa. In order to provide appropriate and culturally sensitive mental health care for this group, further knowledge about treatment preferences might be necessary. Objective: We aimed to provide insights into help-seeking intentions and lay beliefs about cures for PTSD held by asylum seekers from Sub-Saharan Africa living in Germany. Methods: To address this objective, we used a quantitative and qualitative methodological triangulation strategy based on a vignette describing symptoms of PTSD. In the quantitative part of the study, asylum seekers (n = 119), predominantly from Eritrea (n = 41), Somalia (n = 36), and Cameroon (n = 25), and a German comparison sample without a migration background (n = 120) completed the General Help-Seeking Questionnaire (GHSQ). In the qualitative part, asylum seekers (n = 26) reviewed the results of the questionnaire survey within eight focus group discussions sampled from groups of the three main countries of origin. Results: Asylum seekers showed a high intention to seek religious, medical, and psychological treatment for symptoms of PTSD. However, asylum seekers indicated a higher preference to seek help from religious authorities and general practitioners, as well as a lower preference to enlist psychological and traditional help sources than Germans without a migration background. Furthermore, asylum seekers addressed structural and cultural barriers to seeking medical and psychological treatment. Conclusion: To facilitate access to local health care systems for asylum seekers and refugees, it might be crucial to develop public health campaigns in collaboration with religious communities. When treating asylum seekers and refugees from Sub-Saharan Africa, practitioners should explore different religious and cultural frameworks for healing and recovery in order to signal understanding and acceptance of varying cultural contexts.

19.
Eur J Psychotraumatol ; 10(1): 1682929, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31762947

RESUMEN

Background: Individuals with a high prevalence of child maltreatment, e.g. those with borderline personality disorder, tend to see neutral facial expressions as negative. Objective: Our aim was to assess whether this bias is present in individuals with posttraumatic stress disorder (PTSD) and whether it is linked to child maltreatment. Methods: Thirty-nine PTSD participants, 44 traumatized and 35 non-traumatized healthy controls watched 300 one-second movies showing 30 neutral and 270 emotional facial expressions, and indicated whether they interpreted each as a neutral or as one of nine emotional expressions. Results: PTSD individuals did not perform differently than the two control groups in the recognition and interpretation of neutral facial expressions (p's < .300). Higher levels of childhood sexual and emotional abuse, and physical neglect were linked to more interpretations of neutral facial expressions as contempt (p's < .043), and (for sexual abuse and physical neglect) to more interpretations of neutral facial expressions as anger (p's < .014). Comparisons of statistical model fits suggested that childhood sexual abuse was the most relevant predictor of recognition accuracy in our sample. Alexithymia, state dissociation, interpersonal trauma, and number of experienced trauma types were not associated with deficits in the interpretation of neutral expressions. Conclusions: Child maltreatment, especially sexual abuse, may shape the interpretation of neutral facial expressions. Future research should explore whether the observed biases extend to real-life situations. If so, therapists might improve the therapeutic relationship with patients with a history of child maltreatment by paying more attention to their own non-verbal communication and their patients' responses to it. Furthermore, similarly to individuals with high depressive and high social anxiety symptoms, facial expression recognition training might counteract negativity bias in individuals with a history of childhood (sexual and emotional) abuse, and (physical) neglect.

20.
Eur J Psychotraumatol ; 10(1): 1682931, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31762948

RESUMEN

Background: Major Depressive Disorder (MDD) in adolescence has a high prevalence and risk of disability, but current treatments show limited effectiveness and high drop-out and relapse rates. Although the role of distressing experiences that relate to the development and maintenance of MDD has been recognized for decades, the efficacy of a trauma-focused treatment approach for MDD has hardly been studied. Objective: To determine the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy as a stand-alone intervention in adolescents diagnosed with MDD. We hypothesized that reprocessing core memories related to the onset and maintenance of MDD using EMDR therapy would be associated with a significant decrease in depressive and comorbid symptoms. Method: We recruited 32 adolescents (12-18 years) fulfilling DSM-IV criteria for mild to moderate-severe MDD from an outpatient youth mental health care unit. Treatment consisted of six weekly 60-min individual sessions. Presence or absence of MDD classification (ADIS-C), symptoms of depression (CDI), symptoms of posttraumatic stress (UCLA), anxiety (SCARED), somatic complaints (CSI), and overall social-emotional functioning (SDQ) were assessed pre and post-treatment and 3 months after treatment. Results: 60.9% of the adolescents completing treatment no longer met DSM-IV criteria for MDD after treatment anymore, and 69.8% at follow-up. Multilevel analyses demonstrated significant posttreatment reductions of depressive symptoms (CDI: Cohen's d = 0.72), comorbid posttraumatic stress, anxiety and somatic complaints, while overall social-emotional functioning improved. These gains were maintained at 3-month follow-up (Cohen's d = 1.11). Severity of posttraumatic stress reactions significantly predicted the posttreatment outcome; however, duration of MDD, number of comorbid disorders, or having a history of emotional abuse, emotional neglect or physical neglect were not predictive for outcome. Conclusions: This is the first study suggesting that EMDR therapy is associated with a significant reduction of depressive symptoms and comorbid psychiatric problems in adolescents with mild to moderate-severe MDD.

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