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.
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.
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.
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.
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
Joar Øveraas Halvorsen & Nora Sveaass
The main aim of the present paper is to make clear why human rights and human rights violations are of relevance for clinical psychologists, with specific reference to the United Nations Convention against Torture (UNCAT). We point to several issues pertaining to the relevance of UNCAT for clinical psychologists, e.g. the prohibition against torture, documentation of psychological sequelae of torture, psychosocial rehabilitation of torture survivors and the participation of clinical psychologists in monitoring bodies. We argue that clinical psychologists are in a unique position to ensure that rights are secured and that the obligations set forth by UNCAT are fullfilled. However, in order to do so, psychologists need to engage actively in issues and processes related to human rights in addition to their traditional roles.
Key words: United Nations Convention against Torture; human rights; torture; clinical psychology
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.