• Title/Summary/Keyword: Complex PTSD

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Treatment of Complex PTSD by using Eye Movement Desensitization and Reprocessing - A Case Report - (복합적 외상후 스트레스 장애의 안구운동 민감소실 및 재처리 요법을 이용한 치료 - 증례보고 -)

  • Kim, Nam-Hee
    • Anxiety and mood
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    • v.2 no.2
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    • pp.142-146
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    • 2006
  • People who were exposed to chronic interpersonal traumas in their early life consistently demonstrate complex psychological disturbances and many of them meet the criteria for proposed diagnosis of complex posttraumatic stress disorder (complx PTSD). The author reports a case of the successful sequential integrative treatment mainly composed of eye movement desensitization and reprocessing (EMDR) in a complex PTSD patient. The patient did not respond to the previous treatment with psychotropic medications and supportive psychotherapy. Twelve sessions of EMDR and three sessions of supportive psychotherapy were done for the patient. Psychological assessments were performed before starting the treatment and a week after completing the treatment. After the treatment, the patient improved on all the psychological scales and behavioral measures. This case suggests that the sequential integrative treatment mainly composed of EMDR may be effective for complex PTSD patients.

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Differences in Self- and Other-concept in the Single and Complex Trauma Type Groups (단순 및 복합외상 유형 집단의 자기-와 타인-개념의 차이: 자극 제시시간에 따른 정보처리 편향을 중심으로)

  • Kim, YeSeul;Lee, Jong-Sun
    • Journal of the Korea Convergence Society
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    • v.12 no.2
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    • pp.233-246
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    • 2021
  • The present study aimed to investigate whether there would be differences in the severity of PTSD symptoms, self and others concepts between trauma types. Among 166 university students, 61 (simple trauma's n = 31, complex trauma's n = 30) finally met the criteria and completed the Life Events Checklist, Impact of the Event Scale-Revised, and the emotional Stroop task. The results were as follows: firstly, PTSD symptoms were higher in complex trauma group than single trauma group. Secondly, response time in the complex trauma group was longer in the condition that the negative word related to 'self' was presented for 2 seconds compared to the single trauma group. These results suggest that the complex trauma group has different features at least in the severity of PTSD symptoms and the concept of the self, compared with the single trauma group. Finally, the therapeutic implications and limitations of the study were discussed.

Effects of Acceptance and Commitment Therapy(ACT) on Complex PTSD Symptoms, Acceptance, and Post-traumatic Growth of College Students with Childhood Emotional Abuse (수용전념치료(ACT)가 아동기 정서적 피학대 경험이 있는 대학생의 복합 PTSD 증상, 수용 및 외상 후 성장에 미치는 효과)

  • You, SaeBom;Son, ChongNak
    • Journal of Digital Convergence
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    • v.16 no.3
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    • pp.561-572
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    • 2018
  • The purpose of this study is to examine the effect of Acceptance and Commitment Therapy(ACT) on Complex PTSD symptoms, acceptance and post-traumatic growth of college students with childhood emotional abuse. Four hundred and fifty students in university completed Acceptance and action Questionnaire(AAQ-II), Structured interview for disorders of extrem stress(SIDES), Korea version posttraumatic growth inventory(K-PTGI). 14 participants was selected from that result. 7 participants were assigned to the ACT group and the others were in the control group. ACT program was administered for 8 sessions twice a week for 2 month, approximately 100 minutes. There was no treatment in the control group. All participants completed post-test at the end of treatment and then follow-up test after 6 weeks. The results were that complex PTSD symptoms level in ACT group was significant decreased and acceptance and post-traumatic growth level in ACT group were significant increased than those in control group at the end of treatment and the follow-up period. Finally, the implications and the limitations of this study, and the suggestions for future study were also discussed.

The Changes in Biogenic Amines and Cortisol in Patients with Posttraumatic Stress Disorder After Long-Term Pharmacological Treatment (외상후 스트레스장애 환자에서 장기 치료에 따른 카테콜아민과 코르티솔 변화)

  • Kang, Suk-Hoon;Chung, Moon-Young;Kim, Tae-Yong;Chung, Hae-Gyung
    • Anxiety and mood
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    • v.4 no.1
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    • pp.19-27
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    • 2008
  • Objective : This study was conducted to evaluate the changes in the levels of neurotransmitters and cortisol in patients with chronic posttraumatic stress disorder (PTSD) and to evaluate their correlation with symptoms after long-term pharmacological treatment. Methods : Twenty-eight Vietnam veterans with chronic PTSD and 34 non-PTSD patients were consecutively recruited. The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD) and Hamilton Anxiety Scale (HAS) were used to evaluate symptom severity. High performance liquid chromatography (HPLC) was used to measure the plasma levels of epinephrine, norepinephrine, and dopamine, and a radioimmunoassay (RIA) was performed to evaluate the plasma level of cortisol. Results : Plasma cortisol was significantly lower in PTSD patients than in control subjects, while there was no significant difference in plasma epinephrine, norepinephrine and dopamine between the two groups. The scores of M-PTSD, CAPS, HAMD and HAMA were signigicantly higher in PTSD patients than control group. Conclusion : After long-term treatment, the levels of neurotransmitters in PTSD patients returned to within the normal range, and the patients' symptoms showed some improvement. However, the core symptoms of PTSD continued to appear intermittently, and they are thought to be associated with hormonal systems, such as the HPA axis. It is also suggested that PTSD should be considered to be a complex disorder associated with multiple systems and that combinations of the effective medications for each system should be used to treat patients with PTSD.

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The Effects of School Violence in Adolescents on Complex Post-traumatic Stress Disorder Symptoms - Focus on Moderating Effect of Self-esteem - (청소년의 학교폭력 피해 경험이 복합 외상 후 스트레스에 미치는 영향 - 자아존중감의 조절효과를 중심으로 -)

  • Cho, Sunghui;Kim, Hyesun
    • The Journal of the Korea Contents Association
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    • v.21 no.12
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    • pp.621-631
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    • 2021
  • This study examines the effect of adolescents' experiences of school violence on complex post-traumatic stress disorder(cPTSD) and the moderating effect of self-esteem on this relationship. For this purpose, the data surveyed on 291 adolescents was used in the study, and the research model was verified through moderated regression analysis. The results are as follows: Experience of school violence and self-esteem had a significant effect on cPTSD. It was confirmed that self-esteem had moderated an effect of the experience of school violence on cPTSD. Even if the level of experiences of school violence was the same, high self-esteem could reduce the cPTSD. Based on the results of the study, methods to reduce the problem of school violence among adolescents and the cPTSD caused by it were suggested.

Comparison of the Anxiety and Depression According to the Patterns of Temperament and Character in Patients with Posttraumatic Stress Disorder (외상후 스트레스장애 환자의 기질 및 성격 유형에 따른 우울 및 불안 차이)

  • Kim, Kyungwon;Kim, Daeho;Kim, Eunkyeong
    • Anxiety and mood
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    • v.15 no.2
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    • pp.94-100
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    • 2019
  • Objective : The purpose of this study was to investigate differences in anxiety and depression symptoms, comorbidity according to the patterns of temperament and character in patients with posttraumatic stress disorder (PTSD). Methods : The temperament and character inventory (TCI), beck depression inventory (BDI) and beck anxiety inventory (BAI) were administered to 151 PTSD patients classified into four groups of adaptation, vulnerable temperament, immature personality and composite vulnerability according to the results of the Temperament and Character Inventory (TCI). MANOVA and Chi-square tests were conducted to analyze differences in BDI, BAI, temperament and character scores and rate of comorbid disorders between the four groups. Results : The immature character and complex vulnerability group showed the higher rate of comorbid depression disorder. Anxiety and depression severity were significantly different among groups, especially depression severity had higher scores in the immature character and complex vulnerability groups and anxiety severity had higher scores in the complex vulnerability group than adaptive group. The immature character and complex vulnerability groups showed significantly lower score on the temperament scale of reward dependence and persistent. Conclusion : The results demonstrate the significance of adaptive characteristics on anxiety and depression symptoms regardless of vulnerable temperaments, and its consequent role in the management of character factors relative to intervention regarding PTSD.

Complex Trauma and Disorder of Extreme Stress(DESNOS) (복합외상과 극단적 스트레스 장애)

  • Park, Seon-Cheol;Kim, Seok-Hyeon
    • Anxiety and mood
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    • v.5 no.2
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    • pp.80-88
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    • 2009
  • Disorder of Extreme Stress, Not Otherwise Specified (DESNOS) is the proposed diagnosis that meets the severe, complex, and prolonged psychological sequela of victims with chronic traumatization (e.g., family violence, incest, and childhood sexual or physical abuse). The hallmarks of DESNOS are a multiplicity of symptoms (e.g., somatization, dissociation, and depression), pathological changes in relationships, identity disturbances, and a propensity to experience repeated harm and injury at the hands of oneself and others. DESNOS can be directly assessed by Structured Interview of Disorder of Extreme Stress (SIDES) and Self- Report Inventory of Disorder of Extreme Stress (SIDES-SR). The treatment of DESNOS should be phaseoriented and involve movement back and forth among three basic stages : 1) stabilization ; 2) trauma processing ; 3) reintegration.

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Validation of the Korean Version of the Trauma Symptom Checklist-40 among Psychiatric Outpatients (정신건강의학과 외래환자 대상 한국판 외상 증상 체크리스트(Trauma Symptom Checklist-40)의 타당도 연구)

  • Park, Jin;Kim, Daeho;Kim, Eunkyung;Kim, Seokhyun;Yun, Mirim
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.35-43
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    • 2018
  • Objectives : Effects of multiple trauma are complex and extend beyond core PTSD symptoms. However, few psychological instruments for trauma assessment address this issue of symptom complexity. The Trauma Symptom Checklist-40 (TSC-40) is a self-report scale that assesses wide range of symptoms associated with childhood or adult traumatic experience. The purpose of the present study was to evaluate the validity of the Korean Version of the TSC-40 in a sample of psychiatric outpatients. Methods : Data of 367 treatment-seeking patients with DSM-IV diagnoses were obtained from an outpatient department of psychiatric unit at a university hospital. The diagnoses were anxiety disorder, posttraumatic stress disorder, depressive disorder, adjustment disorder and others. Included in the psychometric data were the TSC-40, the Life events checklist, the Impact of Event Scale-Revised, the Zung's Self-report Depression Scale, and the Zung's Self-report Anxiety Scale. Cronbach's ${\alpha}$ for internal consistency were calculated. Convergent and concurrent validity was approached with correlation between the TSC-40 and other scales (PTSD, anxiety and depression). Results : Exploratory factor analysis of the Korean Version of TSC-40 extracted seven-factor structure accounted for 59.55% of total variance that was contextually similar to a six-factor structure and five-factor structure of the original English version. The Korean Version of TSC-40 demonstrated a high level of internal consistency. (Cronbach's ${\alpha}=0.94$) and good concurrent and convergent validity with another PTSD scale and anxiety and depression scales. Conclusions : Excellent construct validity of The Korean Version of TSC-40 was proved in this study. And subtle difference in the factor structure may reflect the cultural issues and the sample characteristics such as heterogeneous clinical population (including non-trauma related disorders) and outpatient status. Overall, this study demonstrated that the Korean version of TSC-40 is psychometrically sound and can be used for Korean clinical population.

The Association Between Childhood Interpersonal Trauma and Psychiatric Symptom Complexity, and the Mediating Impact of Dissociation (아동기 대인관계 외상, 정신 증상의 복잡성 및 해리의 매개 효과)

  • Kim, Yaeseul;Kim, Seok Hyeon;Kim, Daeho;Kim, Eun Kyoung;Kim, Jiyeong;Choi, Nayeon
    • Anxiety and mood
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    • v.18 no.2
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    • pp.72-79
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    • 2022
  • Objective : Any traumatic event can be a risk factor, for subsequent mental disorder. However, childhood trauma, especially in interpersonal nature, is associated with later development of complex symptom patterns. This study examined the role of dissociation as a mediator between childhood trauma and symptom complexity. Methods : A pooled data of 369 psychiatric outpatients at a university-affiliated hospital was analyzed for descriptive statistics, group differences, and bivariate correlation analysis to verify a structural model. The questionnaires included the Symptom Checklist-90-Revised, the Trauma History Screen, the Dissociative Experiences Scale-Taxon, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : When other trauma variables were controlled, childhood interpersonal trauma had significant correlation with symptom complexity (r=0.155, p=0.003). Among the paths analyzed, that of childhood interpersonal trauma and dissociation showed the greatest impact on symptom complexity (b=9.34, t=5.75, p<0.001). Based on the significance of the indirect impact, the results suggest a complete mediation impact of dissociation on symptom complexity. Conclusion : This study validated that childhood interpersonal trauma impacts symptom complexity, through the sequential mediating impact of dissociation. Thus, clinicians should understand childhood interpersonal trauma, dissociation, and symptom patterns in a complex and interacting mode, and develop effective pertinent treatment strategies.