engleski

Course ID : Complexity of Posttraumatic stress reaction

Normal reaction to trauma: Sy. of phychical exaustion, Acute reaction to stress, Acute PTSD, Partial PTSD/LAC PTSD, PTSD, Enduring pesonality changes/DESNOS/Complex PTSD, PTSD psychosis, Other disorders on axis I and II (MDD, MPD, panic attacks etc.), Enduring personality changes/DESNOS/Complex PTSD DESNOS. Does it exist as a new entity: Exists as a special feature of PTSD (Complex PTSD), Consequence of extreme traumatic experiance only (DES), Consequence of extreme stressors but not described in other entities (DESNOS), ICD-10: consequence of catastrophical experiences, enduring change, DSM-IV TR: possible existence, but needs additional research evidence Why it develops and what is the cause? Neurophysiological and psychological adaptation to alostasys. Consequence of secondary and tertiary dissociations. Consequence of morphological changes in nuclei and pathways responsible for memory processing. DESNOS: Alterations in the beliefs system (despair, hopelesness, loss of acquired beliefs) ; Probable predictors of course ; Cronification of symptoms ; Comorbidity, particularly with depression ; Somatizations ; Significant affective regression, non-tolerance of affects, anhedonia, aleksitimia. Proneness to retraumatization by apparently insignificant stressfull events or common life events. Internal images of damaged object realm, patterns of aggresion and victimization, "conservation of withdrawal" (Lansen, 2000). Psychosis and PTSD: Present state of art: Few published papers/studies (20 out of 15 000 in PILOTS), "Blocking" diagnostic category (acute psyhotic epizode lasting over a month is classified withing some of the other diagnostic categories) - state similar to the DSM-I-Gross stress reaction. Our experiances: Psychotic features, PTSD psychoses, Psychotic feathures in PTSD, Common in PTSD (in our researche 18% of veterans with PTSD ; in rare researches from 15 to 40%), Mostly auditory halucitanions (not intrusions) and paranoid ideations (not cognitive distorsions), Positive correlation with D group of symptoms, Clinical impression - role of underlying personality diorder. What are the modalities of therapeutic action? Possible curative principles: "Second generation" therapeutic approach (readjustment to the everyday life, "homecoming", working through retraumatization). Psychopharmacotherapy combined with psychotherapy Working through traumatic experience is not the primary golal ; it often causes precipitation or enhancement of PTSD symptoms. Symbolic meaning of traumatic experience.

posttraumatic stress reaction; diagnosis; therapy

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