Treatment Resistant Symptoms of Complex PTSD Caused by Torture During War

Vito Zepinic

Abstract


Objective: The purpose of this study was to evaluate the severity and complexity of a treatment resistant PTSD caused by torture during war. The inclusive criteria included the experience of torture and no efficacy of provided therapy after five years of being treated due to severe war-related PTSD.
Method: The study was conducted on 24 treatment resistant PTSD patients from former Yugoslavia who had been tortured during their captivity as the POW. Despite being already diagnosed and treated due to their war-related PTSD, all patients were screened by the Structured Clinical Interview for DSM-IV (SCID), MMPI, and the Posttraumatic Stress Diagnostic Scale (PDS).
Results: Results of the initial assessment revealed that 19 out of 24 patients satisfied criteria for treatment resistant symptoms of complex PTSD due to severe trauma experience.
Conclusion: The treatment resistant PTSD is very a complex condition that requires various ways to make real contact with, endeavour congruent, emphatic and unconditional positive regards for the patients. It is important that clinicians do not use a ‘copping’ but qualitative and idiographic individual approach to each patient finding differences value alongside.


Keywords


Complex trauma; POW (captivity); Torture; Treatment resistance

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References


Allen, J. G. (2005). Coping with trauma (2nd edition), American Psychiatric Publishing, Washington DC.

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders – DSM-IV-TR, Washington DC.

Archibald, H. C., & Tuddenham, R. D. (1965). Persistent stress reaction after combat. Archieves of General Psychiatry, 12, 475-482.

Axelroad, R. S., Morgan, A. C., Southwick, M. S. (2005). Symptoms of posttraumatic stress disorder and borderline personality disorder in veterans of operation desert storm. American Journal of Psychiatry, 162, 270-275.

Boon, S. (1997). The treatment of traumatic memories in DID: Indications and contra-indications, Dissociation, 10, 65-79.

Branscomb, L. P. (1991). Dissociation in combat-related posttraumatic stress disorder. Dissociation, 4, 13-20.

Bremner, J. D. (1997). Trauma, memory, and dissociation. American Psychiatric Association, Washington DC.

Bremner, J. D. (1999). Acute and chronic responses to psychological trauma: Where do we go here? American Journal of Psychiatry, 156, 349-351.

Bremner, J. D., & Brett, E. (1997). Trauma-related dissociative states and long-term psychopathology in posttraumatic stress disorder. Journal of Traumatic Stress, 10, 37-49.

Breslan, N., Davis, G. C, & Andreski, P., et al. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archive of General Psychiatry, 48, 216-222.

Briere, J., Spinazzola, J. (2005). Phenomenology and psychological assessment of complex posttraumatic stress, Journal of Traumatic Stress, 5, 401-412.

Brown, R.,& Kulik, J. (1977). Flashbulb memories, Cognition, 3, 73-99.

Courtois, A. C. (2004). Complex trauma, complex reactions: Assessment and treatment. Psychotherapy: Theory, Research, Practice, Training, 41, 412-425.

Courtois, A. C., & Ford, J. D. (2009). Treating complex traumatic stress disorder. Guilford Press, New York.

David, D., Kutcher, G. S., Jackson, E. I., & Mellman, T. A. (1999). Psychotic symptoms in combat-related posttraumatic stress disorder, Journal of Clinical Psychiatry, 60, 29-32.

Davidson, J. R. T., Hughes, D., & Blazer, D., et al. (1991). Posttraumatic stress disorder in the community: An epidemiological study. Psychological Medicine, 21, 713-721.

Ford, J. D., Courtois, A. C., Steele, K., van der Hart, O., & Nijenhius, E. R. S. (2005). Treatment of complex posttraumatic self-dysregulation. Journal of Traumatic Stress, 5, 437-447.

Frueh, C. B., Turner, M. .S., Beidel, C. D., Mirabella, F. R., & Jones, J. W. (1996). Trauma management therapy: a preliminary evaluation of a multicomponent behavioural treatment for chronic combat-related PTSD. Behaviour Research and Therapy, 34, 533-543.

Herman, J. (1992). Trauma and recovery. Basic Books, New York.

Horowitz, M. J. (2001). Stress Response Syndrome (4th ed.). Jason Aronson Inc., New York.

Horowitz, M. J., & Zilberg, N. (1983). Regressive Alterations in the self concept, American Journal of Psychiatry, 140, 284-289.

Kardiner, A. (1941). The traumatic neurosis of war. Hoeber, New York.

Marmar, R. C., Weiss, S. D., Schlenger, E. W., & Fairbank, A. J., et al. (1994). Peritraumatic dissociation and Posttraumatic stress in male Vietnam theatre veterans. American Journal of Psychiatry, 151, 902-907.

Friedman, M. J. (1997), Posttraumatic stress disorder. Journal of Clinical Psychiatry, 58, 33-36.

McNally, R. J., Lasko, N. B., Macklin, M. J., & Pitman, R. K. (1995). Autobiographical memory disturbance in combat-related posttraumatic stress disorder. Behaviour Research and Therapy, 33, 610-630.

Mollica, R. (1988). Post-traumatic therapy and Victims of Violence, Brunner-Mazel, New York.

Morina, N., & Ford, J. D. (2008). Complex sequelae of psychological trauma among Kosovar civilian war victims. International Journal of Social Psychiatry, 425-436.

Oguendo, M., Brent, A. D., Birmaher, B., Greenhill, L., et al. (2005). Posttraumatic stress disorder comorbid with Major Depression: Factors mediating the association with suicidal behaviour. American Journal of Psychiatry, 162, 560-566.

O’Toole, B. I., Marshall, R. P., Schureck, R. J., & Dobson, M. (1999). Combat, dissociation, and posttraumatic stress disorder in Australian Vietnam veterans, Journal of Traumatic Stress, 12, 625-640.

Silove, D., Steel, Z., McGorry, P., Miles, V., & Drobny, J. (2002). The impact of torture on posttraumatic stress symptoms in war-affected Tamil refugees and immigrants, Comprehensive Psychiatry, 43, 49-55.

Southwick SM, Morgan CA, Nikolaou AL, Charney DS: Consistency of memory for combat-related traumatic events in veterans of Operation Desert Storm, American Journal of Psychiatry, 1997, 154, 173-177.

Tennant, C. C., Goulston, K. J. (1986). Dent OF: The psychological effects of being a prisoner of war: forty years after release. American Journal of Psychiatry, 143, 618-621.

Shalev, A.Y., Freedman, S., Pery, T., & Brandes, D., et al. (1998). Prospective study of Posttraumatic stress disorder and Depression following trauma. American Journal of Psychiatry, 155, 630-637.

van der Kolk, B. A., Herron, N., & Hostetles, A. (1994). The history of trauma in psychiatry, Psychiatric Clinic of North America, 1994, 17, 583-600.

van der Kolk, B. A., Ruth, S. H., Pelcowitz, D., Sunday, S., & Spinazzola, J. (2005). Disorder of extreme stress, Journal of Traumatic Stress, 18, 389-399.

Wilson, J. P., & Drozdek, B. (Eds.). (2004). Broken Spirit. Routledge, New York.

Zahava, S., Neria, Y., Ohry, A., Waysman, M., Ginzburg, K. (191914). PTSD among Israeli former prisoners of war and soldiers with combat stress reaction: a longitudinal study. American Journal of Psychiatry, 151, 554-559.

Zepinic, V. (1997). Psychosocial characteristics of war-related Posttraumatic stress disorder (Chapter 10). In B. Ferguson & D. Barnes (Eds.), Perspectives on Transcultural Mental Health, TCMHS, Sydney.

Zepinic, V. (2001). Suicidal risk with war-related Posttraumatic stress disorder (Chapter 14). In B. Raphael & A. E. Malak (Eds.). Diversity and Mental Health in Challenging Times, TCMHS, Sydney.

Zepinic, V. (2008). Healing traumatic memories: A case study. Dynamische Psychiatrie, 5-6, 279-287.

Zepinic, V. (2010a). Defining a war-related psychological trauma: Is that an impossible task? The International Journal of Medicine, 3, 376-383.

Zepinic, V. (2010b). Treating the war-related complex trauma using Dynamic Therapy, The International Journal of Medicine, 3, 384-390.

Zepinic, V. (2011). Hidden Scars: Understanding and Treating Complex Trauma. Xlibris, London.

Zepinic, V. (2012). The Self and Complex Trauma. Xlibris, London.

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DOI: http://dx.doi.org/10.3968/7551

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