Inpatient treatment of (complex) posttraumatic stress disorders: a therapy evaluation
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| Format: | Thesis Book |
| Language: | English |
| Published: |
Berlin
Logos-Verl.
2005
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| Subjects: | |
| Online Access: | Inhaltstext Inhaltsverzeichnis |
| Physical Description: | IX, 201 S. graph. Darst. |
| ISBN: | 3832509259 |
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| adam_text | Table of Contents
Table of Contents
Table of Contents i
1 Introduction 1
2 The Concept of PTSD 4
2.1 PTSD: A brief historical overview 4
2.2 The Concept of PTSD 7
2.3 Symptoms of PTSD 8
2.3.1 Intrusive recollections 8
2.3.2 Avoidance or Numbing Responses 8
2.3.3 Hyper-arousal Symptoms 9
2.4 PTSD Classification in ICD-10 and DSM-IV 10
2.5 Differential Diagnosis 13
2.6 Comorbidity 14
3 The Concept of complex PTSD 17
3.1 (Complex) PTSD 17
3.2 Diagnostic Criteria for Complex PTSD 18
3.2.1 Affect Dysregulation 18
3.2.2 Alterations in Attention or Consciousness 18
3.2.3 Alterations in Self-perception 20
3.2.4 Alterations in Relation with Others 20
3.2.5 Somatization 21
3.2.6 Alterations in Systems of Meaning 23
3.3 Differential Diagnosis of Complex PTSD: Distinctions between DESNOS,
PTSD and BPD 24
3.3.1 Complex PTSD (DESNOS) versus PTSD 24
3.3.2 DESNOS and BPD 25
4 Epidemiology of PTSD 28
4.1 Issues in epidemiological Studies 28
4.2 Types of epidemiological studies 32
4.2.1 Specific traumatic events 32
4.2.2 Traumatic events in specific occupational groups 33
4.2.3 Victims of specific type of events 35
4.2.4 Stratified population samples 36
4.2.5 Prospective population samples 38
5 Psychological Models of PTSD 40
5.1 Learning (Conditioning) Theory 40
i
Table of Contents
5.2 Theory of Learned Helplessness 42
5.3 Emotional processing theory 43
5.4 Stress Response Theory 45
5.5 Information-processing Models of PTSD 47
5.6 Two more Recent Theories of PTSD 48
5.6.1 Dual Representation Theory 48
5.6.2 Ehlers Clark s Cognitive Model of PTSD 52
5.7 Psychobiological Models of PTSD 57
6 Treatment Methods for PTSD 61
6.1 Brief Psychodynamic Treatment of PTSD 61
6.1.1 Initial Phase 62
6.1.2 Middle Phase 63
6.1.3 Final Phase 64
6.2 Cognitive Behavioural Therapy 64
6.2.1 Breathing Retraining 65
6.2.2 Psycho-educational Component 66
6.2.3 Exposure Technique 66
6.2.3.1 In Vivo (Real-life) Exposure Technique 67
6.2.3.2 In Sensu (Imaginal) Prolonged Exposure ; 68
6.2.4 Systematic Desensitization 69
6.2.5 Cognitive Restructuring 69
6.3 Anxiety Management Approaches 70
6.4 Eye-Movement Desensitization and Reprocessing (EMDR) 71
6.4.1 EMDR Treatment Procedure 72
6.5 Hypnotherapy 74
6.6 Group Therapy 76
6.7 Pharmacotherapy 77
6.8 Creative Art Therapies 79
6.9 Psychodynamic Imaginative Trauma Therapy (PITT) 80
6.9.1 Stabilization phase 83
6.9.2 Trauma exposition 83
6.9.3 The integration phase 86
6.9.4 Clinic Setting 86
7 Research Methodology 89
7.1 Some Research Issues 89
7.2 Methodology 90
7.3 Assessment Tools 91
7.3.1 Socio-demographic questionnaire 92
7.3.2 Impact of Event Scale (IES) 92
7.3.3 Symptom Checklist-90-R (SCL-90-R) 93
ii
Table of Contents
7.3.4 Beck Depression Inventory (BDI) 93
7.3.5 Dissociative Experiences Scale (DES) 94
7.3.6 Childhood Trauma Questionnaire (CTQ) 95
7.3.7 Visual Analogue Scale on Self-Soothing 96
7.3.8 Helping Alliance Questionnaire (HAQ) 97
7.3.9 Documentation of Clinical Data 98
7.3.10 Assessment of Treatment Components 98
7.3.11 Veranderungsfragebogen des Erlebens und Verhaltens (VEV) 99
8 Research Questions and Hypotheses 100
8.1 Overview of some related Researches 100
8.2 Research Questions 108
8.3 Hypotheses 109
8.3.1 Hypotheses on self-soothing, PTSD, and general psychopathology 109
8.3.2 Hypotheses on Childhood Trauma 111
8.3.3 Hypotheses on therapeutic alliance 112
8.3.4 Hypotheses on treatment gain maintenance 113
9 Socio-demographic and Clinical Data 114
9.1 Socio-demographic Data 114
9.1.1 Inpatients Sample Description 114
9.1.2 Waitlist Patients Sample Description 115
9.1.3 Socio-demographic Data of Inpatients Group 115
9.1.4 Socio-demographic Data of Waitlist Patients Group 116
9.2 Clinical Data 118
9.2.1 Clinical Data of Inpatients 118
9.2.2 Clinical Data of the Waitlist Patients Group 119
9.3 Comparison of Inpatients and Waitlist Group Samples 120
10 Statistical Analyses and Results 122
10.1 Examination of the hypotheses on self-soothing 122
10.1.1 Statistical Preparations 122
10.1.2 Results of the Hypotheses on Self-Soothing 124
10.2 Results of the hypotheses on PTSD Symptoms 126
10.3 Hypotheses on PTSD Related Symptoms and General Psychopathology 131
10.4 Results of the Hypotheses on Childhood Trauma 138
10.5 Hypotheses on Therapeutic Alliances 141
10.6 Hypotheses on treatment gain maintenance 146
11 Exploratory Studies 159
11.1 Scales of SCL-90-R and Self-Soothing 159
11.2 Impact of Event Scales (IES) 159
11.3 Assessment of Therapy Components 161
11.4 Alterations in Experiences and Behaviours 165
iii
Table of Contents
12 Discussion 168
13 Conclusion 178
References 180
iv
Table of Contents
List of Tables
Table 2.1: Comparison of ICDIO-DCR and DSM-IV Diagnostic Criteria for PTSD 11
Table 4.1. List of Studies Evaluating the Prevalence of PTSD 31
Table 6.1: Phases of PITT 84
Table 7.1: Order of Administration of the Questionnaires 99
Table 8.1: Results of reviewed Inpatient PTSD Treatment Studies 107
Table 9.1: Table of Return Flow 114
Table 9.2: Frequencies for the socio-demographic Data of both groups 117
Table 9.3: Frequencies for the clinical data of both groups 121
Table 10.1: Reliability and Factor Analysis for the self-soothing scale 123
Table 10.2: Summary of the Reliability analysis for self-soothing scale 123
Table 10.3: Correlations coefficient-tests for the self-soothing scale 124
Table 10.4: t-tests for the hypotheses on Self-Soothing 124
Table 10.5: t-tests for PTSD symptoms of Intrusion and Avoidance 126
Table 10.6: Correlations coefficient-tests for the relationship between self-soothing, and
intrusive and avoidance symptoms 129
Table 10.7: Explanation of Variances for the Dependent Variable Intrusion 130
Table 10.8: Hierarchical Multiple Regression Analysis for the Dependent Variable Intrusion 130
Table 10.9: Explanation of Variances for the Dependent Variable Avoidance 131
Table 10.10: Hierarchical Multiple Regression Analysis for the dependent variable Avoidance 131
Table 10.11: t-tests for the hypothesis on Somatization, Anxiety, and Depression 132
Table 10.12: Non-parametric tests for the hypothesis on Dissociation 135
Table 10.13: t-tests for the hypothesis on General Symptom Severity 136
V
Table of Contents
Table 10.14: Means and Standard Deviations of the major scales of the study at the 1 and 2nd
assessment time periods 137
Table 10.15: Correlations coefficient-tests for the relationships between histories of childhood
trauma, and intrusion, avoidance, dissociation, anxiety, and depression 139
Table 10.16: Explanation of Variances for the Dependent Variable Dissociation 139
Table 10.17: Hierarchical Multiple Regression Analysis for the Dependent Variable Dissociation 140
Table 10.18: Explanation of Variances for the Dependent Variable Anxiety 140
Table 10.19: Hierarchical Multiple Regression Analysis for the Dependent Variable Anxiety 140
Table 10.20: Correlations between Helping Alliance and Measurements of Treatment Outcome... 141
Table 10.21: Table of means and standard deviations of the dependent variables under the
groups of Helping Alliance 142
Table 10.22: Multivariate Tests for the effects of Helping Alliance on treatment outcome 143
Table 10.23: Tests of Between-Subjects Effects of Helping Alliance 143
Table 10.24: Measure of Association between Study Completers and Drop-outs 146
Table 10.25: Table of means and standard deviations of study dropouts and completers on
the major scales of the study 147
Table 10.26: t-tests for Equality of Means of Study Dropouts and Completers on the major
scales of the study 147
Table 10.27: Means and Standard Deviations of the major scales over the three assessment
time periods 148
Table 10.28: Multivariate Tests for the effects of Groups on the major scales of the study 149
Table 10.29: Results of the Univariate Tests for the Effect of Time and Group on the major
scales of the analysts 150
Table 10.30: Tests of within-subject contrasts for the three assessment periods 151
Table 10.31: Tests of Within-Subjects Contrasts for Inpatients and Waitlist patients on the
time factor 153
Table 10.32: Tests of Between-Subjects Effects on the dependent variables over the three
assessment periods 153
vi
Table of Contents
Table 10.33: Overall multivariate test results for the effects of group and time on the major
scales of the study 154
Table 10.34: Paired Samples t-tests for the major scales over the three assessment time periods.... 154
Table 11.1: Classifications of Patients based on their total scores on the IES 160
Table 1 J.I: Table of assessed benefits from the various treatment components 162
Table 11.2: Results of t-tests for experiential and behavioural changes 165
vii
Table of Contents
List of Figures
Figure 10.1: Illustration of Group Differences on Self-Soothing over the first two assessment
time periods 125
Figure 10.2: Illustration of Group Differences on Intrusion over the first two assessment
time periods 127
Figure 10.3: Illustration of Group Differences on Avoidance over the first two assessment
time periods 128
Figure 10.4: Illustration of Group Differences on Somatization over the first two assessment
time periods 133
Figure 10.5: Illustration of Group Differences on Anxiety over the first two assessment
time periods 133
Figure 10.6: Illustration of Group Differences on Depression over the first two assessment
time periods 134
Figure 10.7: Illustration of Group Differences on Dissociation over the first two assessment
time periods 135
Figure 10.8: Illustration of Group Differences on GSI over the first two assessment time periods.. 138
Figure 10.9: Illustration of the Relationship between Helping Alliance and Self-Soothing 144
Figure 10.10: Illustration of the Relationship between Helping Alliance and Intrusion 144
Figure 10.11: Illustration of the Relationship between Helping Alliance and Avoidance 145
Figure 10.12: Illustration of the Relationship between Helping Alliance and Global Severity
Index (GSI) 145
Figure 10.13: Illustration of between-subjects differences on somatization over the three
assessment time periods 155
Figure 10.14: Illustration of between-subjects differences on Anxiety over the three assessment
time periods 156
Figure 10.15: Illustration of between-subjects differences on GSI over the three assessment
time periods 156
Figure 10.16: Illustration of between-subjects differences on depression over the three
assessment time periods 157
viii
Table of Contents
Figure 10.17: Illustration of between-subjects differences on intrusion over the three
assessment time periods 157
Figure 10.18: Illustration of between-subjects differences on Avoidance over the three
assessment time periods 158
Figure 10.19: Illustration of between-subjects differences on self-soothing over the three
assessment time periods 158
Figure 11.1: Illustration of clinically significant trauma over the three assessment time periods.... 160
Figure 11.1: Illustration of received Benefits from Individual therapy 163
Figure 11.2: Illustration of received Benefits from Men Forum 164
Figure 11.3: Illustration of assessed symptomatic improvement 164
Figure 11.4: Illustration of the Differences between both Patient Groups on VEV 167
ix
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| spelling | Aligwekwe, Uzoma G. Verfasser (DE-588)130271071 aut Inpatient treatment of (complex) posttraumatic stress disorders a therapy evaluation Uzoma G. Aligwekwe Berlin Logos-Verl. 2005 IX, 201 S. graph. Darst. txt rdacontent n rdamedia nc rdacarrier Zugl.: Innsbruck, Univ., Diss., 2005 Psychotherapie (DE-588)4047746-0 gnd rswk-swf Posttraumatisches Stresssyndrom (DE-588)4361388-3 gnd rswk-swf (DE-588)4113937-9 Hochschulschrift gnd-content Posttraumatisches Stresssyndrom (DE-588)4361388-3 s Psychotherapie (DE-588)4047746-0 s DE-604 text/html http://deposit.dnb.de/cgi-bin/dokserv?id=2655714&prov=M&dok_var=1&dok_ext=htm Inhaltstext HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=013367865&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Aligwekwe, Uzoma G. Inpatient treatment of (complex) posttraumatic stress disorders a therapy evaluation Psychotherapie (DE-588)4047746-0 gnd Posttraumatisches Stresssyndrom (DE-588)4361388-3 gnd |
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| title | Inpatient treatment of (complex) posttraumatic stress disorders a therapy evaluation |
| title_auth | Inpatient treatment of (complex) posttraumatic stress disorders a therapy evaluation |
| title_exact_search | Inpatient treatment of (complex) posttraumatic stress disorders a therapy evaluation |
| title_full | Inpatient treatment of (complex) posttraumatic stress disorders a therapy evaluation Uzoma G. Aligwekwe |
| title_fullStr | Inpatient treatment of (complex) posttraumatic stress disorders a therapy evaluation Uzoma G. Aligwekwe |
| title_full_unstemmed | Inpatient treatment of (complex) posttraumatic stress disorders a therapy evaluation Uzoma G. Aligwekwe |
| title_short | Inpatient treatment of (complex) posttraumatic stress disorders |
| title_sort | inpatient treatment of complex posttraumatic stress disorders a therapy evaluation |
| title_sub | a therapy evaluation |
| topic | Psychotherapie (DE-588)4047746-0 gnd Posttraumatisches Stresssyndrom (DE-588)4361388-3 gnd |
| topic_facet | Psychotherapie Posttraumatisches Stresssyndrom Hochschulschrift |
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