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Diagnostische und klinische Aspekte der komplexen posttraumatischen Belastungsstörung

Diagnostic and clinical aspects of complex post-traumatic stress disorder

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Zusammenfassung

Das Symptomspektrum von Patienten mit schwersten und lang anhaltenden Traumatisierungen wird durch die Diagnosekriterien der posttraumatischen Belastungsstörung nur unzureichend erfasst. Ergänzend wurde daher die Diagnose der komplexen posttraumatischen Belastungsstörung vorgeschlagen. Diese beschreibt ein Symptombild, das Störungen der Affektregulation, dissoziative Symptome und Somatisierung, gestörte Selbstwahrnehmung, Störungen der Sexualität und Beziehungsgestaltung sowie Veränderungen persönlicher Glaubens- und Wertvorstellungen umfasst. Eine Fülle heterogener Symptome, die sonst als komorbide Störungsbilder zu klassifizieren wären, wird hierdurch auf ein einheitliches ätiologisches Modell zurückgeführt. Dabei werden die jeweiligen Symptome als Bewältigungsstrategien und nicht primär als Defizite verstanden. Aus dem Verständnis der ätiologischen Zusammenhänge lassen sich spezielle psychotherapeutische Behandlungsstrategien für komplex traumatisierte Patienten ableiten, die sich bereits in der Praxis bewährt haben.

Summary

The symptomatology of patients suffering in the aftermath of severe and prolonged traumatization is not entirely covered by the diagnostic criteria of post-traumatic stress disorder (PTSD). Consequently, the concept of complex PTSD was proposed, including symptoms of affective dysregulation, dissociation and somatization, alterations in self-perception, altered relationships with others, and altered systems of meaning. Thereby, a variety of symptoms usually classified as comorbid disorders are combined in a single etiological model. The whole symptomatology is considered as more or less effective adaptation strategies and not primarily as deficits. This understanding of the underlying etiology in subjects with complex traumatizations opens perspectives for new psychotherapeutic treatment strategies which have already shown effectiveness in daily practice.

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  1. Abteilung Psychosomatik und Psychotherapie, Medizinische Hochschule Hannover

    M. Sack

  2. Abteilung Psychosomatik und Psychotherapie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625 , Hannover

    M. Sack

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Sack, M. Diagnostische und klinische Aspekte der komplexen posttraumatischen Belastungsstörung. Nervenarzt 75, 451–459 (2004). https://doi.org/10.1007/s00115-003-1612-4

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