Is Complex Post Traumatic Stress Disorder a Valid Construct in Refugee Survivors of Torture and War Trauma
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Dyck, Murray
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O'Donovan, Analise
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Abstract
PTSD does not include many of the symptoms shown by adults exposed to multiple, sustained interpersonal trauma. Disorders of Extreme Stress Not Otherwise Specified (DESNOS), Enduring Personality Change after Catastrophic Experience (EPCACE) and Adult Onset Complex Post Traumatic Stress Disorder (AO-CPTSD) are ways of defining the syndrome that is believed to develop after such events. This study assessed the validity of DESNOS, EPCACE and AO-CPTSD in a community sample (N = 37) of refugees. A structured interview was constructed to measure the context and type of traumatic events that participants were exposed to and symptoms of DESNOS, EPCACE, PTSD, Major Depression (MDD) and Somatisation Disorder. Analyses were conducted to assess 1) the prevalence of complex trauma symptoms; 2) whether complex trauma syndromes were more strongly associated with each other than to PTSD, MDD and Somatisation; 3) whether complex trauma syndromes were observed in the absence of PTSD; 4) whether the loss of a person’s pre trauma identity differentiates groups who have – and have not – been exposed to coercive control; and 5) whether certain types of trauma events were more likely to be associated with developing complex trauma symptoms. Results indicated that refugees who had experienced multiple traumatic events, sometimes even including being tortured, commonly have the symptoms that are hypothesized to comprise complex trauma syndromes. However, AO-CPTSD was not well-defined and included items that did not contribute to definition of the syndrome. Adding items measuring autonomy and interpersonal relatedness increased the cohesiveness of the syndrome.
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Thesis (PhD Doctorate)
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Doctor of Philosophy in Clinical Psychology (PhD ClinPsych)
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School of Psychology
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The author owns the copyright in this thesis, unless stated otherwise.
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Post traumatic stress disorder
Torture survivor psychology
War trauma survivor psychology
Refugees, psychological aspects