Category Archives: Fagartikkel

Does dissociation moderate treatment outcomes of narrative exposure therapy for PTSD? A secondary analysis from a randomized controlled clinical trial

I lag med Håkon Stenmark, Frank Neuner og Hans M. Nordahl har jeg skrevet en artikkel hvor vi undersøker om dissosiative symptomer, som derealisasjon og depersonalisering, påvirker behandllingsutfall av narrativ eksponeringsterapi for PTSD hos alvorlig traumatiserte flyktninger og asylsøkere. Abstract kan leses under, mens fulltekst kan leses i Behaviour Research and Therapy.

 

Abstract

Dissociative symptoms, especially depersonalisation and derealisation, are often perceived as a contraindication for exposure-based treatments of posttraumatic stress disorder (PTSD) despite limited empirical evidence. The present paper examines whether derealisation and depersonalisation influence the treatment outcomes of narrative exposure therapy (NET) and treatment as usual (TaU) among severely traumatised asylum seekers and refugees. We performed a secondary analysis of a recently published randomized controlled multicentre trial comparing NET and TaU for the treatment of PTSD in asylum seekers and refugees. In order to investigate whether depersonalisation and derealisation moderate treatment outcomes, a number of moderated multiple, blockwise regression analyses were conducted. Missing data were handled with multiple imputation. The main finding from intention-to-treat analyses is that derealisation and depersonalisation overall do not moderate the treatment outcomes of either NET or TaU. The treatment condition was the most stable predictor of residual gain scores across outcome measures, with NET being associated with lower residual gain scores indicating better treatment outcomes. The present study substantiates and extends previous research indicating that dissociative symptoms such as derealisation and depersonalisation do not moderate the treatment outcome of exposure-based treatments for PTSD.

 

Highlights

  • Dissociation is often perceived as a contraindication for exposure-based treatments for PTSD.

  • We examined whether depersonalisation or derealisation moderated treatment outcomes of NET and TaU.

  • Derealisation and depersonalisation did not moderate treatment outcomes of NET or TaU.

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Randomiserte kontrollerte studier av psykologisk behandling for samtidig posttraumatisk stresslidelse og ruslidelse

  • Fagartikkel skrevet i lag med Rolf W. Gråwe og Ellen Margrethe Hoxmark. Artikkelen er publisert i januarutgaven av Tidsskrift for Norsk Psykologforening. Engelsk abstract følger under, mens fulltekst kan leses i Tidsskrift for Norsk Psykologforening.

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Narrative exposure therapy for posttraumatic stress disorder in tortured refugees: A preliminary uncontrolled trial

Abstract

Torture has severe mental health effects, especially in terms of posttraumatic stress disorder (PTSD) and depression. However, there is still a lack of empirical treatment studies. The present paper presents data on 16 torture survivors receiving 10 sessions of narrative exposure therapy (NET). Symptoms of PTSD and depression, assessed by Clinician-Administered PTSD Scale (CAPS) and Hamilton Rating Scale for Depression (HRSD), decreased significantly from pre-treatment to 6-month follow-up, with Cohen’s d effect sizes of 1.16 and 0.84, respectively. Although treatment gains were moderate, further research on evidence-based treatments for PTSD and depression in refugee torture survivors is warranted.

 

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Predictors of psychological sequelae of torture among South African former political prisoners

Abstract

The present study investigated potential predictors of the psychological sequelae of torture among 143 former political activists who had been detained during the apartheid era in South Africa. Using multiple regression analyses, the authors found that the number of times detained for political reasons, negative social support, strong religiousness, female gender, and number of days detained significantly predicted psychological distress and symptoms of traumatization as measured by the Harvard Trauma Questionnaire (adjusted R 2 = .183) and the Hopkins Symptom Checklist-25 (adjusted R 2 = .152). The number of times detained for political reasons, negative social support, strong religiousness, and female gender emerged as salient risk factors for psychological distress, whereas duration of imprisonment appeared to protect against posttraumatic symptoms. This article discusses these results in terms of the current research on factors associated with traumatization

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Psykologi og tortur: Faglige og etiske utfordringer for psykologer sett i lys av FNs torturkonvensjon

Abstract

For mange står tortur som selve symbolet på menneskerettighetskrenkelser, og retten til frihet fra tortur er kanskje den mest grunnleggende av alle menneskerettighetene. Likevel er tortur utbredt. Dette har vidtfavnende konsekvenser også for psykologisk virksomhet, og psykologprofesjonen er viktig for å realisere rettighetene i FNs torturkonvensjon.

 

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