Narrative Exposure Therapy in challenging and conditions

Titolo Rivista MALTRATTAMENTO E ABUSO ALL’INFANZIA
Autori/Curatori Susanne Breinlinger, Ann-Kathrin Pütz, Natalie R. Stevens, Daniela Mier, Inga Schalinski, Michael Odenwald
Anno di pubblicazione 2021 Fascicolo 2020/3 Lingua Inglese
Numero pagine 14 P. 37-50 Dimensione file 209 KB
DOI 10.3280/MAL2020-003004
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Patients with past exposure to adverse experiences are frequent in clinical services, many of them suffering from co-occurring Posttraumatic Stress Disorder (PTSD). Despite first evi-dence that encourages diagnostics and trauma therapy provision for PTSD, complex cases are often excluded from evidence-based treatments. First, we review the evidence of PTSD treatment for two groups of complex cases: patients with psychotic disorders and pregnant refugee women. Second, we report on how NET is applied to these groups in specialized treatment centres and how the technique is adapted to the specific needs. We encourage cli-nicians to build up concepts of integrated treatment for complex cases including NET as one core component.

I pazienti con storie passate di esperienze sfavorevoli accedono spesso ai servizi clinici; molti di questi presentano sintomi post-traumatici in comorbidità. Nonostante l’evidenza scientifica incoraggi l’utilizzo di terapie trauma-focali per il DPTS, i casi complessi sono spesso esclusi da questi protocolli basati sull’evidenza. Innanzittutto, l’articolo presenta una revision dell’evidenza circa il trattamento del DPTSD in due gruppi di casi complessi: pazienti con disturbi psicotici e donne rifugiate in stato di gravidanza. Di seguito, viene spiegato in che modo la NET viene utilizzata con questi pazienti in centri specialistici e come la tecnica è stata adattata per i loro bisogni specifici. Si incoraggiano i clinici a basarsi su trattamenti integrati nei casi complessi includendo la NET come componente chiave dei protocolli.

Keywords:Psicosi, gravidanza, trauma, DPTS, rifugiati.

  1. Baas, M. A., van Pampus, M. G., Braam, L., Stramrood, C. A., & de Jongh, A. (2020). The effects of PTSD treatment during pregnancy: systematic review and case study. European Journal of Psychotraumatology, 11(1), 1762310. DOI: 10.1080/20008198.2020.1762310
  2. de Bont, P., van den Berg, D., van der Vleugel, B., de Roos, C., de Jongh, A., van der Gaag, M., & van Minnen, A. (2016). Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders. Psychological Medicine, 46(11), 2411-2421. DOI: 10.1017/S0033291716001094
  3. Dopfer, C., Vakilzadeh, A., Happle, C., Kleinert, E., Müller, F., Ernst, D., … & Wetzke, M. (2018). Pregnancy related health care needs in refugees – A current three center experience in Europe. International Journal of Environmental Research and Public Health, 15(9), 1934.
  4. Fazel, M., Stratford H.J., Rowsell, E., Chan, C., Griffiths, H. & Robjant, K. (2020). Five Applications of Narrative Exposure Therapy for Children and Adolescents Presenting With Post-Traumatic Stress Disorders. Frontiers in Psychiatry, 11, 19.
  5. Heslehurst, N., Brown, H., Pemu, A., Coleman, H., & Rankin, J. (2018). Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews. BMC Medicine, 16(1), 89.
  6. Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617-627.
  7. Lemon, E., Vanderkruik, R., Arch, J. J., & Dimidjian, S. A. (2020). Treating Anxiety During Pregnancy: Patient Concerns About Pharmaceutical Treatment. Maternal and Child Health Journal, 24(4), 439-446.
  8. Levey, E. J., Gelaye, B., Koenen, K., Zhong, Q.-Y., Basu, A., Rondon, M. B., … & Williams, M. A. (2018). Trauma exposure and post-traumatic stress disorder in a cohort of pregnant Peruvian women. Archives of Women’s Mental Health, 21(2), 193-202.
  9. Lysaker, P. H., & LaRocco, V. A. (2008). The prevalence and correlates of trauma-related symptoms in schizophrenia spectrum disorder. Comprehensive Psychiatry, 49(4), 330-334.
  10. Muzik, M., McGinnis, E. W., Bocknek, E., Morelen, D., Rosenblum, K. L., Liberzon, I., Seng, J., & Abelson, J. L. (2016). PTSD symptoms across pregnancy and early postpartum among women with lifetime PTSD diagnosis. Depression and Anxiety, 33(7), 584-591.
  11. National Collaborating Centre for Mental Health. (2018). Antenatal and postnatal mental health, The NICE guideline on clinical management and service guidance updated edition. National Clinical Guideline Number 192.
  12. Pabst, A., Schauer, M., Bernhardt, K., Ruf-Leuschner, M., Goder, R., Elbert, T., … & Seeck-Hirschner, M. (2014). Evaluation of narrative exposure therapy (NET) for borderline personality disorder with comorbid posttraumatic stress disorder. Clinical Neuropsychiatry, 11(4), 108-117.
  13. Read, J., Hammersley, P., & Rudegeair, T. (2007). Why, when and how to ask about childhood abuse. Advances in Psychiatric Treatment, 13(2), 101-110.
  14. Reques, L., Aranda-Fernandez, E., Rolland, C., Grippon, A., Fallet, N., Reboul, C. Godard, N., & Luhmann, N. (2020). Episodes of violence suffered by migrants transiting through Libya: a cross-sectional study in “Médecins du Monde’s” reception and healthcare centre in Seine-Saint-Denis, France. Conflict and Health 14(12), 1-6.
  15. Ronconi, J. M., Shiner, B., & Watts, B. V. (2014). Inclusion and exclusion criteria in randomized controlled trials of psychotherapy for PTSD. Journal of Psychiatric Practice, 20(1), 25-37.
  16. Schäfer, I., Fisher, H. L., Aderhold, V., Huber, B., Hoffmann-Langer, L., Golks, D., … & Harfst, T. (2012). Dissociative symptoms in patients with schizophrenia: relationships with childhood trauma and psychotic symptoms. Comprehensive Psychiatry, 53(4), 364-371.
  17. Schalinski, I., Breinlinger, S., Hirt, V., Teicher, M. H., Odenwald, M., & Rockstroh, B. (2017). Environmental adversities and psychotic symptoms: The impact of timing of trauma, abuse, and neglect. Schizophrenia Research, 205, 4-9. doi. 10.1016/j.schres.2017.10.034.
  18. Schalinski, I., Fischer, Y., & Rockstroh, B. (2015). Impact of childhood adversities on the short-term course of illness in psychotic spectrum disorders. Psychiatry Research, 228(3), 633-640.
  19. Schalinski, I., Schauer, M., & Elbert, T. (2015). The shutdown dissociation scale (Shut-D). European Journal of Psychotraumatology, 6(1), 25652.
  20. Schalinski, I., Teicher, M. H., Carolus, A. M., & Rockstroh, B. (2017). Defining the impact of childhood adversities on cognitive deficits in psychosis: an exploratory analysis. Schizophrenia Research, 192, 351-356.
  21. Schalinski, I., Teicher, M. H., Nischk, D., Hinderer, E., Müller, O., & Rockstroh, B. (2016). Type and timing of adverse childhood experiences differentially affect severity of PTSD, dissociative and depressive symptoms in adult inpatients. BMC Psychiatry, 16(1), 295.
  22. Schauer, M., & Elbert, T. (2010). Dissociation following traumatic stress: Etiology and treatment. Journal of Psychology, 218, 109-127.
  23. Seng, J. S., D’Andrea, W., & Ford, J. D. (2014). Complex mental health sequelae of psychological trauma among women in prenatal care. Psychological Trauma: Theory, Research, Practice, and Policy, 6(1), 41.
  24. Seow, L. S. E., Ong, C., Mahesh, M. V., Sagayadevan, V., Shafie, S., Chong, S. A., & Subramaniam, M. (2016). A systematic review on comorbid post-traumatic stress disorder in schizophrenia. Schizophrenia Research, 176(2-3), 441-451.
  25. Smith, M. V., Gotman, N., & Yonkers, K. A. (2016). Early childhood adversity and pregnancy outcomes. Maternal and Child Health Journal, 20(4), 790-798.
  26. Sperlich, M., Seng, J. S., Li, Y., Taylor, J., & Bradbury‐Jones, C. (2017). Integrating trauma‐informed care into maternity care practice: conceptual and practical issues. Journal of Midwifery & Women’s Health, 62(6), 661-672.
  27. Teicher, M. H., & Samson, J. A. (2013). Childhood maltreatment and psychopathology: A case for ecophenotypic variants as clinically and neurobiologically distinct subtypes. American Journal of Psychiatry, 170(10), 1114-1133.
  28. van den Berg, D. P., de Bont, P. A., van der Vleugel, B. M., de Roos, C., de Jongh, A., van Minnen, A., & van der Gaag, M. (2015a). Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial. JAMA Psychiatry, 72(3), 259-267.
  29. van den Berg, D. P., de Bont, P. A., van der Vleugel, B. M., de Roos, C., de Jongh, A., van Minnen, A., & van der Gaag, M. (2015b). Trauma-focused treatment in PTSD patients with psychosis: symptom exacerbation, adverse events, and revictimization. Schizophrenia Bulletin, 42(3), 693-702.
  30. van Minnen, A., Zoellner, L. A., Harned, M. S., & Mills, K. (2015). Changes in comorbid conditions after prolonged exposure for PTSD: a literature review. Current Psychiatry Reports, 17(3), 549.
  31. Varese, F., Smeets, F., Drukker, M., Lieverse, R., Lataster, T., Viechtbauer, W., … & Bentall, R. P. (2012). Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective-and cross-sectional cohort studies. Schizophrenia Bulletin, 38(4), 661-671.
  32. Vigod, S., & Steiner, M. (2016). Biomarkers of Perinatal Psychopathology In Wenzel, A. (Ed), The Oxford Handbook of Perinatal Psychology. Oxford: Oxford University Press.
  33. Volpe, E. M., Quinn, C. R., Resch, K., Douglas, V., & Cerulli, C. (2017). Assessing the feasibility and acceptability of narrative exposure therapy to address IPV-related mental health in parenting and pregnant adolescents. Journal of Family Violence, 32(4), 439-452.
  34. Weinreb, L., Wenz-Gross, M., & Upshur, C. (2018). Postpartum outcomes of a pilot prenatal care-based psychosocial intervention for PTSD during pregnancy. Archives of Women’s Mental Health, 21(3), 299-312.
  35. Westen, D., Novotny, C. M., & Thompson-Brenner, H. (2004). The empirical status of empirically supported psychotherapies: assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin, 130(4), 631-663. DOI: 10.1037/0033-2909.130.4.631

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Susanne Breinlinger, Ann-Kathrin Pütz, Natalie R. Stevens, Daniela Mier, Inga Schalinski, Michael Odenwald, Narrative Exposure Therapy in challenging and conditions in "MALTRATTAMENTO E ABUSO ALL’INFANZIA" 3/2020, pp 37-50, DOI: 10.3280/MAL2020-003004