Early childhood trauma and disorders of extreme stress as predictors of treatment outcome with chronic posttraumatic stress disorder

Ford, Julián D.; Kidd, Phyllis

doi:10.1023/a:1024497400891

Cited by 195 publications

(134 citation statements)

References 67 publications

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“…These include the use of a self-report version of the SIDES, rather than the interviewer version validated by Ford and Kidd (1998), reliance on clinician rather than research ratings of the diagnostic variables, use of retrospective self-report to assess trauma history, and inclusion of only two specific psychiatric diagnoses and the general class of severe affective/anxiety disorders within the study sample. Prospective research documenting the longitudinal relationships of childhood trauma, mechanisms of self-regulation, and both CPTSD/DESNOS and BPD are needed in order to confirm mediated relationships suggested by the cross-sectional results from this study.…”

Section: Discussionmentioning

confidence: 99%

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Affect dysregulation, psychoform dissociation, and adult relational fears mediate the relationship between childhood trauma and complex posttraumatic stress disorder independent of the symptoms of borderline personality disorder

Dijke

Hopman

Ford

2018

European Journal of Psychotraumatology

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Objective: Complex posttraumatic stress disorder (CPTSD) as defined by the Disorders of Extreme Stress Not Otherwise Specified (DESNOS) formulation is associated with childhood relational trauma and involves relational impairment, affect dysregulation, and identity alterations. However, the distinct contributions of relational impairment (operationalized in the form fears of closeness or abandonment), affect dysregulation (operationalized in the form of overregulation and under-regulation of affect), and identity alterations (operationalized in the form of positive or negative psychoform or somatoform dissociation) to the relationship between childhood trauma and CPTSD/DESNOS have not been systematically tested. Method and Results: In a clinical sample of adults diagnosed with severe and chronic psychiatric and personality disorders (n = 472; M = 34.7 years, SD = 10.1), structural equation modelling with bootstrap 95% confidence intervals demonstrated that the association between childhood trauma and CPTSD/DESNOS symptoms in adulthood was partially mediated by under-regulation of affect, negative psychoform dissociation, and adult relational fears of closeness and of abandonment. These results also were independent of the effects of borderline personality disorder (BPD) symptoms. Conclusions: Some, but not all, hypothesized components of the DESNOS formulation of CPTSD statistically mediate the relationship between childhood trauma and adult CPTSD/DESNOS. These relationships appear specific to CPTSD/DESNOS and not to the effects of another potential sequelae of childhood trauma BPD. Replication with prospective longitudinal studies is needed.

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Section: Discussionmentioning

confidence: 99%

“…C PTSD-symptoms as defined by DESNOS were confirmed using the Dutch self-report version of the Structured Interview for Disorders of Extreme Stress Not Otherwise Specified (SIDES-rev; Ford & Kidd, 1998; Van Dijke & Van der Hart, 2002). The SIDES-rev-NL total score was internally consistent in this sample (Cronbach’s alpha = 0.91).…”

Section: Methodsmentioning

confidence: 99%

Affect dysregulation, psychoform dissociation, and adult relational fears mediate the relationship between childhood trauma and complex posttraumatic stress disorder independent of the symptoms of borderline personality disorder

Dijke

Hopman

Ford

2018

European Journal of Psychotraumatology

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“…For example, more severe and complex posttraumatic outcomes frequently are associated with a life history of multiple interpersonal victimization experiences, often beginning with extended childhood abuse and neglect, and associated disruption of the parent-child attachment system (e.g., Ford & Kidd, 1998;Zlotnick et al, 1996). Such maltreatment not only may produce lasting sequelae itself, but also is a risk factor for being revictimized in the future (Neumann, Houskamp, Pollock, & Briere, 1996) and for responding to later traumatic events with more severe and complex symptoms (e.g., Bremner, Southwick, Johnson, Yehuda, & Charney, 1993).…”

Section: Etiologymentioning

confidence: 99%

Phenomenology and psychological assessment of complex posttraumatic states

2005

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The authors offer a framework for the assessment of psychological responses associated with exposure to early onset, multiple, or extended traumatic stressors. Six prominent and overlapping symptoms clusters are described: altered self-capacities, cognitive symptoms, mood disturbance, overdeveloped avoidance responses, somatoform distress, and posttraumatic stress. A strategy for the structured, psychometrically valid assessment of these outcomes is introduced, and specific recommendations for use of various generic and trauma-specific child and adult measures are provided. Implications of trauma assessment for treatment planning are discussed.Reactions to overwhelming psychological stressors can be viewed as residing on a complexity continuum. At one end are responses to adult-onset, single-incident, traumatic events (e.g., a motor vehicle accident, a mugging) that occur in individuals with adequate childhood development, a normoreactive nervous system, and no comorbid psychological disorders. At the opposite end are responses to early onset, multiple, extended, and sometimes highly invasive traumatic events, frequently of an interpersonal nature, often involving a significant amount of stigma or shame, that occur in individuals who, for a variety of reasons, may be more vulnerable to stress effects.Individuals at the high end of this complexity continuum are the subject of this article. These individuals are likely to experience a variety of posttraumatic symptoms and negative mood states, and often present with chronic affect regulation and interpersonal difficulties

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“…Additional symptoms were subsequently identified in individuals with PTSD who had suffered from childhood abuse, suggesting that the previously existing PTSD criteria did not capture all aspects of traumatic symptomatology 2 . The diagnostic category of complex PTSD (cPTSD) has been proposed as a form of PTSD, linked with early onset and prolonged interpersonal trauma 3 . cPTSD encompasses components of other psychiatric conditions such as mood and dissociative disorders.…”

Section: Introductionmentioning

confidence: 99%

“…cPTSD encompasses components of other psychiatric conditions such as mood and dissociative disorders. It is therefore a complicated condition with a poor prognosis and treatment efficacy [3][4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Complex posttraumatic stress disorder in traumatised asylum seekers: a pilot study

et al. 2014

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ENGLANDABSTRACT -Background and Objectives: Complex posttraumatic stress disorder (cPTSD), a construct associated with early onset and repeated interpersonal trauma, has not previously been assessed in asylum seekers who have experienced major human rights violations. The aim of this pilot study was to describe the cPTSD symptom profile in asylum seekers, and to compare this profile between three groups of people who have experienced: human trafficking, domestic violence and/or torture.Methods: Over a period of eight weeks, clinicians working at the Helen Bamber Foundation charity invited 48 patients currently receiving psychotherapy to take part in the study, of whom 30 (62.5%) agreed. The structured interview for disorders of extreme stress (SIDES) was used to assess cPTSD in 29 asylum seekers, as one patient withdrew during the interview.Results: Participants originated from 18 countries, 72.4% were female, the median age at trauma onset was 17 years and the duration of trauma was ten years. Eight (27.6%) participants were found to have cPTSD, defined as having all six symptom clusters, and 15 (51.7%) had five or more cPTSD symptom clusters. Age at trauma onset, duration of trauma, last trauma experience, gender and trauma type were not found to be associated with cPTSD presence.Conclusions: Extensive cPTSD symptoms were common in all participants, regardless of the nature of the trauma experienced. Future research is needed to enable generalisability of cPTSD symptom profile in asylum seekers.

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Early childhood trauma and disorders of extreme stress as predictors of treatment outcome with chronic posttraumatic stress disorder

Cited by 195 publications

References 67 publications

Affect dysregulation, psychoform dissociation, and adult relational fears mediate the relationship between childhood trauma and complex posttraumatic stress disorder independent of the symptoms of borderline personality disorder

Affect dysregulation, psychoform dissociation, and adult relational fears mediate the relationship between childhood trauma and complex posttraumatic stress disorder independent of the symptoms of borderline personality disorder

Phenomenology and psychological assessment of complex posttraumatic states

Complex posttraumatic stress disorder in traumatised asylum seekers: a pilot study

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