Division of Psychiatry, University College London, London, UK.
Translational Psychiatry Research Group, Mental Health Neuroscience Department, Division of Psychiatry, Institute of Mental Health, University College London, London, UK.
Eur J Psychotraumatol. 2023;14(1):2165024. doi: 10.1080/20008066.2023.2165024.
Research has previously distinguished between complex post-traumatic stress disorder (CPTSD) and PTSD, with the former including a range of disturbances in self-regulatory capacities in addition to difficulties associated with PTSD. Clinical guidelines have previously recommended a phase-based approach for the treatment of CPTSD, yet the final 'reintegration' phase of treatment has been overlooked in research, with limited evidence into its value and effectiveness, and inconsistencies in its definitions and understanding. We set out to define and determine the key principles of 'reintegration' and to specify the components and method of delivery of treatment. Leading national and international clinical and academic experts in CPTSD were interviewed and asked about their views of how 'reintegration' should be defined, its role in the treatment of CPTSD, what it should be composed of, the key principles of its delivery, and how it should be evaluated. We analysed transcripts of the interviews following the principles of Codebook Thematic Analysis. We conducted 16 interviews with leading national and international experts with at least 10 years' experience of treating people with CPTSD. Themes derived from our analysis demonstrated that while the definition and composition of reintegration varied greatly between experts, the key principles in its delivery were consistent across all experts. The results of this study lay the foundation for a framework of what reintegration is and how it can be used in, but also highlight the need for more research to be conducted on the role of reintegration in the treatment of CPTSD. Consensus for the definition and composition of reintegration is still yet to be reached. Possible measures for evaluating reintegration should also be explored in the future.
先前的研究已经区分了复杂性创伤后应激障碍 (CPTSD) 和创伤后应激障碍 (PTSD)，前者除了 PTSD 相关的困难外，还包括一系列自我调节能力的障碍。临床指南之前曾推荐 CPTSD 的基于阶段的治疗方法，但研究中忽略了治疗的最终“整合”阶段，其价值和有效性的证据有限，其定义和理解也不一致。我们着手定义和确定“整合”的关键原则，并具体说明治疗的组成部分和方法。对 CPTSD 领域的国内和国际领先的临床和学术专家进行了采访，并询问了他们对“整合”应该如何定义、它在 CPTSD 治疗中的作用、它应该由什么组成、其交付的关键原则以及如何评估的看法。我们根据 Codebook 主题分析的原则分析了采访记录。我们对 16 位具有至少 10 年治疗 CPTSD 经验的国内和国际领先专家进行了采访。我们的分析结果表明，尽管专家对整合的定义和组成差异很大，但在其交付的关键原则上，所有专家都是一致的。这项研究的结果为整合的内容和如何在治疗中使用整合奠定了基础，但也强调了需要对整合在 CPTSD 治疗中的作用进行更多的研究。对于整合的定义和组成仍未达成共识。未来还应探讨评估整合的可能措施。
