Symptom management in complex post-traumatic stress disorder (ICD-11), view and experience of patients and their relatives: a mixed methods approach (Research Proposal)

Stadtmann, Manuel P.; Maercker, Andreas; Binder, Jochen; Schnepp, Wilfried

doi:10.1186/s13104-017-2790-7

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…This study is part of larger mixed-method research to investigate symptom management and the social process of adult inpatients with CPTSD [33]. The literature [34,35] recommends Grounded Theory as a suitable method to investigate phenomena with little scientific evidence.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2018

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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.

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Section: Methodsmentioning

confidence: 99%

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

et al. 2018

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“…As part of a larger research project [ 64 ], this study was conducted at the psychiatric institution Integrierte Psychiatrie Winterthur - Zurcher Unterland (ipw). Ipw is a non-profit, community-based organization that provides psychiatric services in the city of Winterthur in the Canton of Zurich, Switzerland.…”

Section: Methodsmentioning

confidence: 99%

“…However, there is little evidence to this effect and to the best of our knowledge no corresponding study has investigated the role of relatives during symptom management of patients with CPTSD. This is the third study of a larger mixed method research project to investigate symptom management and the social process of persons affected with CPTSD and their relatives [ 64 ]. In our first quantitative descriptive study we were able to identify adult CPTSD inpatients.…”

Section: Introductionmentioning

confidence: 99%

Mastering life together - symptom management, views, and experiences of relatives of persons with CPTSD: a grounded theory study

Stadtmann

Maercker

Binder

et al. 2018

J Patient Rep Outcomes

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BackgroundComplex posttraumatic stress disorder is described as a chronic condition with several severe and concurrent symptoms. Symptoms influence and impair not only the affected individuals but also their social surroundings and their relatives. The literature describes relatives as a key factor in managing symptoms, both as a barrier and a facilitator.AimThis research aimed to explore and to reconstruct the views, perceptions, experiences, facilitations and barriers of relatives who support the symptom management of persons with CPTSD in everyday life.MethodsA theoretical sampling was used to recruit for an interview 18- to 65-year-old relatives of patients with diagnosed CPTSD. The 17 semi-structured interviews were audio-recorded and transcribed verbatim. The transcriptions were uploaded into MAXQDA, and a Grounded Theory method based on that of Corbin and Strauss was used to analyse the data.ResultsWe provide a process model with 5 interacting phases: the initial situation, state of permanence, being an anchor, recognizing limits, and potential outcomes. Each phase is further divided into subcategories.DiscussionParticipants experienced their condition as unpredictable. Although they mastered different strategies through own exploration and in cooperation, there is a clear need for more education, advice and support for relatives caring for those affected by CPTSD. Health care services should consider providing family support, educational services and increase the involvement of relatives in treatment. Over all, well-supported relatives can play a facilitative, key role in improving symptom management.Trial registrationEthical 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.

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“…This study is the first part of a larger project to investigate the symptom management and the social process of adult inpatients with CPTSD [37]. A single-side prospective descriptive design using routinely collected data was selected to generate the results.…”

Section: Methods Study Designmentioning

confidence: 99%

Proposed ICD-11 complex posttraumatic stress disorder, characteristics and symptoms of adults in an inpatient psychiatric setting: A descriptive study

Stadtmann¹,

Maercker²,

Binder³

et al. 2018

J Clin Invest Stud

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Background: Applying the framework of ICD-11, complex posttraumatic stress disorder will be diagnosed using the core criteria of a posttraumatic stress disorder and the presence of three additional symptoms that identify 'disturbances in self-organization': affective dysregulation, negative self-concept and disturbances in relationships. An understanding of characteristics and the symptom burden of patients with a complex posttraumatic stress disorder, hospitalised in psychiatric hospitals, is vital to develop interventions and therefore improve services. Methods:The recruitment of adults in a psychiatric inpatient setting took place in the form of a consecutive sample. The data base for this prospective descriptive study comprised data collected during regular inpatient treatment available from the internal clinic database: The sociodemographic information was collected using a clinical questionnaire and symptom values were assessed with the Brief Symptom Inventory, the Beck Depression Inventory and the Impact of Events Scale -Revised. Patients were additionally assessed using the International Trauma Questionnaire.Results: 133 agreed to participate, 47.4% (n = 63) of the patients did not fulfil the inclusion criteria of diagnosis. The final sample comprised 50 female and 20 male participants. On average, the patients were 37.84 years old (SD = ± 11.2) and 50.0% (n = 35), single people. 72.9% (n = 51) had completed secondary school or had higher education and 84.3% (n = 59) of the participants were unemployed. 92.9% indicated having a form of childhood traumatic experience and all participants had more than two trauma events. Overall, there were gender differences in the perceived symptom burden and manifestation in the symptom domains. Conclusion:The findings indicate that there may be several adverse factors related to complex posttraumatic stress disorder. The impairment was much more likely to be severe and have an impact on the functional level. The present research adds new results to the growing literature.

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Symptom management in complex post-traumatic stress disorder (ICD-11), view and experience of patients and their relatives: a mixed methods approach (Research Proposal)

Cited by 7 publications

References 25 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

Mastering life together - symptom management, views, and experiences of relatives of persons with CPTSD: a grounded theory study

Proposed ICD-11 complex posttraumatic stress disorder, characteristics and symptoms of adults in an inpatient psychiatric setting: A descriptive study

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