The role of negative cognitions, emotion regulation strategies, and attachment style in complex post‐traumatic stress disorder: Implications for new and existing therapies

Karatzias, Thanos; Shevlin, Mark; Hyland, Philip; Brewin, Chris R.; Cloitre, Marylène; Bradley, Aoife; Kitchiner, Neil J; Jumbe, Sandra; Bisson, Jonathan I.; Roberts, Neil P.

doi:10.1111/bjc.12172

Cited by 59 publications

(51 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Those strategies gave them the feeling of being in control of their lives. These results are consistent with recent evidence from Karatzias and colleges [52], reporting negative trauma-related cognitions about the self as a most important factor in CPTSD. Likewise, retrospectively, the participants felt regret and anger for not being able to address the real issues causing their condition.…”

Section: Discussionsupporting

confidence: 92%

Why do I have to suffer? Symptom management, views and experiences of persons with a CPTSD: a grounded theory approach

et al. 2018

View full text Add to dashboard Cite

Background: For the 11th version of the International Classification of Diseases, a new stress related diagnosis has been proposed: complex post-traumatic stress disorder (CPTSD). It is described as a chronic condition with several severe and concurrent symptoms. In the literature, these symptoms are discussed as a common reason for seeking psychiatric treatment as they can influence and impair the quality of life not only for affected persons but also for their social and familial system. Aim: This research studies symptom management in everyday life by exploring and reconstructing the views, perceptions, experiences, facilitators and barriers of adults with CPTSD. Methods: A theoretical sampling was used to recruit 18 to 65 years old patients diagnosed with CPTSD from an inpatient setting. The 17 semi-structured interviews were audio recorded and transcribed verbatim. The transcriptions were uploaded into MAXQDA, and a Grounded Theory method based on Corbin and Strauss was used to analyse the data. Results: We provide a process model with 5 interacting phases: trauma experience, emotional ignorance, overcompensation, paroxysm, and perspectives. Each phase is specified with subcategories. Conclusions: The participants did not recognise their symptoms as such and were unaware of their diagnosis for many years. Nevertheless, they used various resources and were able to develop skills and techniques to deal with their symptoms and to function on a day-today basis. Overall, the process of symptom management was extremely exhausting for the participants and they felt left alone with it. The participants were eager to gain support from healthcare professionals and, when necessary, financial support from the government. Thus, these results indicate an essential need to develop support and tailored interventions for the symptom management of persons with a CPTSD. Trial registration: Ethical approval was obtained from the Swiss Cantonal Ethic Commission (Nr 201,500,096). This research was also registered at the World Health Organization Clinical Trials Search Portal through the German Clinical Trial Register, Trial DRKS00012268.

show abstract

Section: Discussionsupporting

confidence: 92%

Why do I have to suffer? Symptom management, views and experiences of persons with a CPTSD: a grounded theory approach

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Clinicians should be acutely aware of the symptom profiles of ICD‐11 PTSD and CPTSD, and consider a diagnosis of CPTSD to be especially pertinent in cases where there is a history of interpersonal trauma (in childhood or in adulthood). It is critical that clinicians are cognizant of, and accurately diagnose, CPTSD, given that it is (a) so highly comorbid with a range of life‐threatening conditions, and (b) may require enhanced interventions distinct from those currently offered for PTSD (Karatzias, Shevlin, et al, ). Work is ongoing to test the efficacy and acceptability of specific clinical interventions for CPTSD (Karatzias, Shevlin, et al, ) however, accurate recognition of CPTSD in general practice, and referral for appropriate interventions will facilitate recovery from the deleterious effects of CPTSD.…”

Section: Discussionmentioning

confidence: 99%

“…CPTSD has been shown to occur more frequently after exposure to traumatic events that are of an interpersonal nature, that are difficult or impossible to escape from, and particularly when occurring during early development (e.g., childhood sexual abuse, torture, captivity; see Karatzias, Cloitre, et al, ). CPTSD is also a more impairing condition than PTSD (Karatzias et al, ) and may require enhanced interventions, which are quantitatively and qualitatively different to those currently offered for PTSD (Karatzias, Shevlin, et al, ). Little is currently known about the risk factors that differentiate PTSD and CPTSD after traumatic exposure, or, how frequently other mental and physical health disorders co‐occur with PTSD and CPTSD.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and comorbidity of ICD‐11 PTSD and complex PTSD: Findings from a trauma‐exposed population based sample of adults in the United Kingdom

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background Following the recently published 11th version of the WHO International Classification of Diseases (ICD‐11), we sought to examine the risk factors and comorbidities associated with posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). Method Cross‐sectional and retrospective design. The sample consisted of 1,051 trauma‐exposed participants from a nationally representative panel of the UK adult population. Results A total of 5.3% (95% confidence interval [CI] = 4.0–6.7%) met the diagnostic criteria for PTSD and 12.9% (95% CI = 10.9–15.0%) for CPTSD. Diagnosis of PTSD was independently associated with being female, being in a relationship, and the recency of traumatic exposure. CPTSD was independently associated with younger age, interpersonal trauma in childhood, and interpersonal trauma in adulthood. Growing up in an urban environment was associated with the diagnosis of PTSD and CPTSD. High rates of physical and mental health comorbidity were observed for PTSD and CPTSD. Those with CPTSD were more likely to endorse symptoms reflecting major depressive disorder (odds ratio [OR] = 21.85, 95 CI = 12.51–38.04) and generalized anxiety disorder (OR = 24.63, 95 CI = 14.77–41.07). Presence of PTSD (OR = 3.13, 95 CI = 1.81–5.41) and CPTSD (OR = 3.43, 95 CI = 2.37–4.70) increased the likelihood of suicidality by more than three times. Nearly half the participants with PTSD and CPTSD reported the presence of a chronic illness. Conclusions CPTSD is a more common, comorbid, debilitating condition compared to PTSD. Further research is now required to identify effective interventions for its treatment.

show abstract

“…Granted that a good working alliance is important for successful TFT (Capaldi, Asnaani, Zandberg, Carpenter, & Foa, 2016; Cloitre, Chase Stovall-McClough, Miranda, & Chemtob, 2004; Keller, Zoellner, & Feeny, 2010), we were interested in whether patients were able to develop an adequate working alliance with the therapists in this treatment rotation model. Especially because attachment problems may be present along with PTSD symptoms (Karatzias et al, 2018), a clinical relevant question is whether people with attachment problems are able to build adequate therapeutic alliances with the different therapists in the therapist rotation model.…”

Section: Introductionmentioning

confidence: 99%

Therapist rotation: a novel approach for implementation of trauma-focused treatment in post-traumatic stress disorder

Minnen

Hendriks

Kleine

et al. 2018

European Journal of Psychotraumatology

View full text Add to dashboard Cite

Background: Trauma-focused treatments (TFTs) for patients with post-traumatic stress disorder (PTSD) are highly effective, yet underused by therapists.Objective: To describe a new way of implementing (adequate use of) TFTs, using a therapist rotation model in which one patient is treated by several therapists.Method: In this article, we will present two examples of working with therapist rotation teams in two treatment settings for TFT of PTSD patients. We explore the experiences with this model from both a therapist and a patient perspective.Results: Our findings were promising in that they suggested that this novel approach reduced the therapists’ fear of providing TFT to PTSD patients, increased perceived readiness for TFT, and decreased avoidance behaviour within TFT sessions, possibly leading to better implementation of TFT. In addition, the therapeutic relationship as rated by patients was good, even by patients with insecure attachment styles.Conclusions: We suggest that therapist rotation is a promising novel approach to improve implementation of TFT for PTSD.

show abstract

The role of negative cognitions, emotion regulation strategies, and attachment style in complex post‐traumatic stress disorder: Implications for new and existing therapies

Abstract: Results suggest that cognitive-behavioural interventions might be useful for the treatment of CPTSD. Targeting negative thoughts and attachment representations while promoting skills acquisition in emotional regulation hold promise in the treatment of CPTSD.

Cited by 59 publications

References 28 publications

Why do I have to suffer? Symptom management, views and experiences of persons with a CPTSD: a grounded theory approach

Why do I have to suffer? Symptom management, views and experiences of persons with a CPTSD: a grounded theory approach

Risk factors and comorbidity of ICD‐11 PTSD and complex PTSD: Findings from a trauma‐exposed population based sample of adults in the United Kingdom

Therapist rotation: a novel approach for implementation of trauma-focused treatment in post-traumatic stress disorder

Contact Info

Product

Resources

About