Maercker Andreas, Hecker Tobias
Psychologisches Institut, Psychopathologie und Klinische Intervention, Universität Zürich, Binzmühlestr. 14, Box 17, 8050, Zürich, Schweiz.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016 Jan;59(1):28-34. doi: 10.1007/s00103-015-2259-6.
This paper addresses consequences of exposure to violence and trauma. Traumata are defined as events with an extraordinary threat or catastrophic extent. Beside Posttraumatic Stress Disorder (PTSD), affected people may develop Complex PTSD, Prolonged Grief Disorder or Adjustment Disorder as direct consequences of exposure with extreme stress. Indirect trauma-related disorders are amongst others Major Depression, Substance Dependency and Personality Disorders. These disorders develop often comorbid to PTSD. The likelihood to develop a PTSD at one point during the life course is 1-4% in Germany. A PTSD is diagnosed if for any length of time the traumatic situation is re-experienced (e.g. in pictures or nightmares), potential triggers are avoided, emotional reactivity is numb and a permanent hyperarousal is experienced. The intensity, the duration and the frequency of traumatic experiences as well as the lack of social support after the trauma are important risk factors for the development of a PTSD. In the last two decades successful treatment approaches for PTSD have been developed. The main focus of all evidence-based treatment approaches is the exposure in sensu of the traumatic experiences. Behavioral therapy approaches have shown to be most effective in the treatment of PTSD. A better understanding of the consequences of exposure to violence and trauma may help us to identify people at risk for developing trauma-related disorders already at an early stage.
本文探讨了接触暴力和创伤的后果。创伤被定义为具有非凡威胁或灾难性程度的事件。除创伤后应激障碍(PTSD)外,受影响的人可能会发展出复杂性创伤后应激障碍、持续性悲伤障碍或适应障碍,作为接触极端压力的直接后果。与创伤间接相关的障碍包括重度抑郁症、物质依赖和人格障碍等。这些障碍通常与创伤后应激障碍并发。在德国,一生中某个时刻患创伤后应激障碍的可能性为1%-4%。如果在任何时间段内再次体验创伤情境(如在图片或噩梦中)、避免潜在触发因素、情绪反应麻木且经历永久性的过度警觉,即可诊断为创伤后应激障碍。创伤经历的强度、持续时间和频率,以及创伤后缺乏社会支持,都是发展为创伤后应激障碍的重要风险因素。在过去二十年中,已经开发出了成功治疗创伤后应激障碍的方法。所有循证治疗方法的主要重点都是对创伤经历进行实际暴露。行为治疗方法在治疗创伤后应激障碍方面已被证明最为有效。更好地理解接触暴力和创伤的后果,可能有助于我们在早期阶段就识别出有发展出与创伤相关障碍风险的人群。