Clinicians' understanding of International Statistical Classification of Diseases and Related Health Problems, 10th Revision diagnostic criteria: F62.0 enduring personality change after catastrophic experience

Beltran, Ruth O.; Llewellyn, Gwynnyth; Silove, Derrick

doi:10.1016/j.comppsych.2008.04.006

Cited by 28 publications

(18 citation statements)

References 31 publications

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“…It has been argued for many years that chronic or repeated trauma leads to a more severe form of PTSD. The ICD-10 contained a partly overlapping predecessor diagnosis of 'enduring personality change after catastrophic experiences', which had very rarely been used in clinical practice and research [61]. The ICD-11 defines complex PTSD as consisting of the three core PTSD symptoms described above accompanied by problems in affect regulation, negative self-beliefs, and relationship difficulties [62].…”

Section: Complex Ptsdmentioning

confidence: 99%

Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

Stein

Szatmári

Gäebel

et al. 2020

BMC Med

162

121

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An update of the chapter on Mental, Behavioral and Neurodevelopmental Disorders in the International Classification of Diseases and Related Health Problems (ICD) is of great interest around the world. The recent approval of the 11th Revision of the ICD (ICD-11) by the World Health Organization (WHO) raises broad questions about the status of nosology of mental disorders as a whole as well as more focused questions regarding changes to the diagnostic guidelines for specific conditions and the implications of these changes for practice and research. This Forum brings together a broad range of experts to reflect on key changes and controversies in the ICD-11 classification of mental disorders. Taken together, there is consensus that the WHO's focus on global applicability and clinical utility in developing the diagnostic guidelines for this chapter will maximize the likelihood that it will be adopted by mental health professionals and administrators. This focus is also expected to enhance the application of the guidelines in non-specialist settings and their usefulness for scaling up evidence-based interventions. The new mental disorders classification in ICD-11 and its accompanying diagnostic guidelines therefore represent an important, albeit iterative, advance for the field.

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Section: Complex Ptsdmentioning

confidence: 99%

Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

Stein

Szatmári

Gäebel

et al. 2020

BMC Med

162

121

View full text Add to dashboard Cite

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“…Indeed, impulsivity, negative self-perception, somatization, survivor guilt, hostility, disturbed emotional responses, and low self-esteem have been identified as persisting personality changes that emerge as a result of extreme trauma ( Beltran and Silove, 1999 ). Supportive of these diagnostic criteria, hostile and/or mistrustful attitudes specifically have been identified as prominent symptoms following catastrophic experience in a qualitative analysis conducted with 24 trauma clinicians ( Beltran et al, 2008 ). Beltran and colleagues addressed critics’ ongoing concerns regarding the reliability, validity, and clinical utility of this diagnostic category, as well as skepticism that personality could be fundamentally altered by events in adulthood ( Beltran et al, 2008 ).…”

Section: Introductionmentioning

confidence: 99%

“…Supportive of these diagnostic criteria, hostile and/or mistrustful attitudes specifically have been identified as prominent symptoms following catastrophic experience in a qualitative analysis conducted with 24 trauma clinicians ( Beltran et al, 2008 ). Beltran and colleagues addressed critics’ ongoing concerns regarding the reliability, validity, and clinical utility of this diagnostic category, as well as skepticism that personality could be fundamentally altered by events in adulthood ( Beltran et al, 2008 ).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy

Wagner

Mithoefer²,

Mithoefer³

et al. 2017

J Psychopharmacol

122

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A growing body of research suggests that traumatic events lead to persisting personality change characterized by increased neuroticism. Relevantly, enduring improvements in Post-Traumatic Stress Disorder (PTSD) symptoms have been found in response to 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. There is evidence that lasting changes in the personality feature of “openness” occur in response to hallucinogens, and that this may potentially act as a therapeutic mechanism of change. The present study investigated whether heightened Openness and decreased Neuroticism served as a mechanism of change within a randomized trial of MDMA-assisted psychotherapy for chronic, treatment-resistant PTSD. The Clinician-Administered PTSD Scale (CAPS) Global Scores and NEO PI-R Personality Inventory (NEO) Openness and Neuroticism Scales served as outcome measures. Results indicated that changes in Openness but not Neuroticism played a moderating role in the relationship between reduced PTSD symptoms and MDMA treatment. Following MDMA-assisted psychotherapy, increased Openness and decreased Neuroticism when comparing baseline personality traits with long-term follow-up traits also were found. These preliminary findings suggest that the effect of MDMA-assisted psychotherapy extends beyond specific PTSD symptomatology and fundamentally alters personality structure, resulting in long-term persisting personality change. Results are discussed in terms of possible mechanisms of psychotherapeutic change.

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“…Although there were some commonalities, the differences between DESNOS and EPCACE perpetuated the divergence in formulations concerning the core elements of a putative C-PTSD construct, a key issue being whether the term referred to a constellation of symptoms (19, 20), or to deeper and enduring characterological changes occurring in reaction to prolonged exposure to gross forms of human rights abuse (18, 20). …”

Section: Introductionmentioning

confidence: 99%

The Relationship of Complex Post-traumatic Stress Disorder and Post-traumatic Stress Disorder in a Culturally Distinct, Conflict-Affected Population: A Study among West Papuan Refugees Displaced to Papua New Guinea

et al. 2017

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Background: Controversy continues about the validity of the construct of complex post-traumatic stress disorder (C-PTSD). In particular, questions remain whether C-PTSD can be differentiated from post-traumatic stress disorder (PTSD) and, secondarily, other common mental disorders. The examination of these issues needs to be expanded to populations of diverse cultural backgrounds exposed to prolonged persecution. We undertake such an inquiry among a community sample of West Papuan refugees exposed to extensive persecution and trauma. Methods:We interviewed over 300 West Papuan refugees using the Refugee-Mental Health Assessment Package to record symptoms of PTSD, C-PTSD, major depressive disorder (MDD), and complex grief (CG). We used first-and second-order confirmatory factor analysis (CFA) to test aspects of the convergent and discriminant validity of C-PTSD.results: The CFA analysis supported both a one-factor and two-factor model of PTSD and C-PTSD. Nested model comparison tests provide support for the parsimonious one-factor model solution. A second-order CFA model of PTSD and C-PTSD produced a poor fit. The modified three-factor multi-disorder solution combining a traumatic stress (TS) factor (amalgamating PTSD and C-PTSD), MDD, and CG yielded a good fit only after removing three CG domains (estrangement, yearning, and behavioral change), a model that produced large standardized residuals (>0.20).conclusion: The most parsimonious model yielded a single TS factor combining symptom domains of C-PTSD and PTSD in this culturally distinct community exposed to extensive persecution and conflict-related trauma. There may be grounds for expanding the scope of psychological treatments for refugees to encompass this wider TS response. Our findings are consistent with theoretical frameworks focusing on the wider TS reaction of refugees exposed to human rights-related traumas of mass conflict, persecution, and displacement.

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Clinicians' understanding of International Statistical Classification of Diseases and Related Health Problems, 10th Revision diagnostic criteria: F62.0 enduring personality change after catastrophic experience

Cited by 28 publications

References 31 publications

Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy

The Relationship of Complex Post-traumatic Stress Disorder and Post-traumatic Stress Disorder in a Culturally Distinct, Conflict-Affected Population: A Study among West Papuan Refugees Displaced to Papua New Guinea

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