Article

A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity

Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 10/2009; 22(5):399-408. DOI: 10.1002/jts.20444
Source: PubMed

ABSTRACT Exposure to multiple traumas, particularly in childhood, has been proposed to result in a complex of symptoms that includes posttraumatic stress disorder (PTSD) as well as a constrained, but variable group of symptoms that highlight self-regulatory disturbances. The relationship between accumulated exposure to different types of traumatic events and total number of different types of symptoms (symptom complexity) was assessed in an adult clinical sample (N = 582) and a child clinical sample (N = 152). Childhood cumulative trauma but not adulthood trauma predicted increasing symptom complexity in adults. Cumulative trauma predicted increasing symptom complexity in the child sample. Results suggest that Complex PTSD symptoms occur in both adult and child samples in a principled, rule-governed way and that childhood experiences significantly influenced adult symptoms.

1 Follower
 · 
143 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This article examines the experiences of nine rape survivors who participated in the Silent Protest, an annual protest march at Rhodes University that aims to highlight the sexual abuse of women, validate the harm done, and foster solidarity among survivors. Participants responded to a semi-structured interview focusing on the context of their rape and its impact, and their experiences of participation in the Protest. In the first phase of data analysis, synoptic case narratives were written. In the second, themes from participants' experience were identified using interpretative phenomenological analysis. In the third, the data were examined in light of questions around the extent to which participation contributed to healing. Participants reported experiences of validation and empowerment but the majority were suffering from posttraumatic stress disorder. In some cases, participation had exacerbated self-blame and avoidant coping. Recommendations are made about the provision of psychoeducation and counseling at such events. © The Author(s) 2015.
    Qualitative Health Research 02/2015; DOI:10.1177/1049732315573201 · 2.19 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although links between adverse childhood experiences (ACEs) and problems in adulthood are well-established, less is known regarding links between exposure to trauma during childhood and adolescence and high-risk behavior in adolescence. We tested the hypothesis that cumulative exposure to up to 20 different types of trauma and bereavement/loss incrementally predicts high-risk adolescent behavior beyond demographic variables. Adolescents reporting exposure to at least 1 type of trauma (n = 3,785; mean age = 15.3 years; 62.7% girls) were selected from the National Child Traumatic Stress Network Core Data Set (CDS). Logistic regression analyses tested associations among both demographic variables and number of types of trauma and loss exposure as predictors, and 9 types of high-risk adolescent behavior and functional impairment (attachment difficulties, skipping school, running away from home, substance abuse, suicidality, criminality, self-injury, alcohol use, and victim of sexual exploitation) as criterion variables. As hypothesized, hierarchical logistic regression analyses revealed that each additional type of trauma exposure significantly increased the odds ratios for each problem behavior (range = 1.06–1.22) after accounting for demographic variables. Some demographic variables (female gender, public insurance eligibility, and older age) were also associated with increased likelihood for some outcomes. Study findings extend previously identified links between childhood trauma and problems later in life to include high-risk behavior and functional impairment during adolescence. The findings underscore the need for a trauma-informed public health approach to systematic screening, prevention, and early intervention for traumatized and bereaved youth in child service systems. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Psychological Trauma Theory Research Practice and Policy 01/2014; 6(Suppl 1):S40-S49. DOI:10.1037/a0037799 · 0.89 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although studies consistently report high rates of comorbid posttraumatic stress disorder (PTSD) and HIV infection, development and testing of PTSD treatment interventions in HIV-infected adults is limited. As such, the purpose of this review was twofold. First, this review augments the three existing reviews of research for PTSD in HIV-infected adults conducted within the past 10 years. We found two empirically supported cognitive-behavioral therapy-based interventions for the treatment of trauma-related symptoms in HIV-infected adults. Due to the continued limited number of effective interventions for this population, a second aim of our review was to draw from the expansive field of effective PTSD interventions for the general population to propose ways that future clinical intervention research may be tailored for HIV-infected adults. Therefore, in addition to a review, we conceptualized this paper as an opportunity to generate an ideal preview of the field of intervention research in this population. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
    The Journal of the Association of Nurses in AIDS Care: JANAC 03/2015; 26(2):127-38. DOI:10.1016/j.jana.2014.11.001 · 1.23 Impact Factor

Full-text (3 Sources)

Download
291 Downloads
Available from
Jun 4, 2014