Phenomenology and psychological assessment of complex posttraumatic states

Boston University, Boston, Massachusetts, United States
Journal of Traumatic Stress (Impact Factor: 2.72). 10/2005; 18(5):401-12. DOI: 10.1002/jts.20048
Source: PubMed


The authors offer a framework for the assessment of psychological responses associated with exposure to early onset, multiple, or extended traumatic stressors. Six prominent and overlapping symptoms clusters are described: altered self-capacities, cognitive symptoms, mood disturbance, overdeveloped avoidance responses, somatoform distress, and posttraumatic stress. A strategy for the structured, psychometrically valid assessment of these outcomes is introduced, and specific recommendations for use of various generic and trauma-specific child and adult measures are provided. Implications of trauma assessment for treatment planning are discussed.

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Available from: Joseph Spinazzola, Jun 27, 2014
    • "Au plan psychodynamique, ce type d'expériences réduit, voire annule parfois, l'habileté et les mécanismes de défense habituels de l'individu pour maîtriser, contenir et anticiper les évènements, court-circuitant du même coup sa capacité à « mentaliser » et « traiter » la charge émotionnelle qui leur est associée : peur, honte, culpabilité, tristesse, etc. (Bion, 1962 ;Fonagy, Gergely, Jurist, & Target, 2002 ;Mason, 1971). Le souvenir traumatique est alors réprimé et isolé, totalement ou en partie, mais demeurerait actif psychiquement, produisant des symptômes, notamment dissociatifs , dans le rapport à l'autre et à soi, toujours prêts à resurgir à travers des évènements rappelant l'expérience traumatique rémanente (Briere & Spinzzola, 2005 ;Collin-Vézina & Cyr, 2003). Certains auteurs avancent l'hypothèse que la perpétuation des effets du traumatisme aux générations suivantes prendrait en partie sa source dans la qualité émotionnelle « symbolicide » des évènements traumatiques (Guyotat, 2005 ;Roussillon, 2012). "
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    • "However, in a minority of those affected , involuntary stress reactions will continue in the long run (Norris et al., 2009; Vogt et al., 2014). To be able to cope with this distress, a person may develop persistent emotion regulation strategies such as avoidance strategies or negative cognitive alterations , tension-reducing behaviors such as binge eating (Briere and Spinazzola, 2005), and/or strict control strategies (Briere and Scott, 2007; Litwack et al., 2014). Knowledge is limited about the pathways between exposure to a TE and its association with development of an ED or ED severity, and role the timing of the traumatic exposure may have (Brewerton , 2007; Briere and Spinazzola, 2005). "
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    • "Research in human and nonhuman primates has demonstrated that the greater the number of traumatic events occurring in an individual's lifetime, the more severe the posttraumatic symptomatology may be (Bradshaw et al., 2008; Briere & Spinazzola, 2005; Brune et al., 2006). In humans, increased difficulties in affect regulation and self-control that are comorbid with diagnoses of CPTSD may result in increased incidents of SIB (Briere & Gil, 1998; Dyer et al., 2009). "
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