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ICD-11 复杂创伤后应激障碍的记忆与身份理论。

The memory and identity theory of ICD-11 complex posttraumatic stress disorder.

机构信息

Maynooth University, Department of Psychology.

Ulster University, School of Psychology.

出版信息

Psychol Rev. 2023 Jul;130(4):1044-1065. doi: 10.1037/rev0000418.


DOI:10.1037/rev0000418
PMID:37338431
Abstract

The 11th version of the () includes complex posttraumatic stress disorder (CPTSD) as a separate diagnostic entity alongside posttraumatic stress disorder (PTSD). CPTSD is defined by six sets of symptoms, three that are shared with PTSD (reexperiencing in the here and now, avoidance, and sense of current threat) and three (affective dysregulation, negative self-concept, and disturbances in relationships) representing pervasive "disturbances in self-organization" (DSO). There is considerable evidence supporting the construct validity of CPTSD, but no theoretical account of its development has thus far been presented. A theory is needed to explain several phenomena that are especially relevant to CPTSD such as the role played by prolonged and repeated trauma exposure, the functional independence between PTSD and DSO symptoms, and diagnostic heterogeneity following trauma exposure. The memory and identity theory of CPTSD states that single and multiple trauma exposure occur in a context of individual vulnerability which interact to give rise to intrusive, sensation-based traumatic memories and negative identities which, together, produce the PTSD and DSO symptoms that define CPTSD. The model emphasizes that the two major and related causal processes of intrusive memories and negative identities exist on a continuum from prereflective experience to full self-awareness. Theoretically derived implications for the assessment and treatment of CPTSD are discussed, as well as areas for future research and model testing. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

第十一版《精神疾病诊断与统计手册》(DSM-5)将复杂创伤后应激障碍(CPTSD)作为一个独立的诊断实体与创伤后应激障碍(PTSD)并列。CPTSD 由六组症状定义,其中三组与 PTSD 共享(当下的重新体验、回避和当前威胁感),三组(情感失调、消极自我概念和人际关系障碍)代表普遍存在的“自我组织障碍”(DSO)。有大量证据支持 CPTSD 的结构有效性,但迄今为止尚未提出其发展的理论解释。需要有一种理论来解释几个与 CPTSD 特别相关的现象,例如长时间和反复创伤暴露的作用、PTSD 和 DSO 症状之间的功能独立性,以及创伤暴露后的诊断异质性。CPTSD 的记忆和身份理论指出,单一和多种创伤暴露发生在个体易感性的背景下,相互作用产生侵入性、基于感觉的创伤记忆和消极身份,共同产生 PTSD 和 DSO 症状,定义 CPTSD。该模型强调,侵入性记忆和消极身份这两个主要的相关因果过程存在于从无反射体验到完全自我意识的连续体中。讨论了 CPTSD 的评估和治疗的理论推导意义,以及未来研究和模型测试的领域。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。

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Clin Psychol Psychother. 2025

[2]
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[3]
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Clin Psychol Psychother. 2025

[4]
Reporting, Forgetting, or Reimagining: A Developmental Theory of Traumatic and Adverse Childhood Memories.

Clin Child Fam Psychol Rev. 2025-6

[5]
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J Med Case Rep. 2025-5-31

[6]
Psychological therapies for post-traumatic stress disorder in children and adolescents.

Cochrane Database Syst Rev. 2025-5-6

[7]
The International Trauma Interview (ITI): development of a semi-structured diagnostic interview and evaluation in a UK sample.

Eur J Psychotraumatol. 2025-12

[8]
A network analysis of ICD-11 complex PTSD symptoms in the treatment-seeking population in Iran.

BMC Psychiatry. 2025-3-4

[9]
Trauma and identity predictors of ICD-11 PTSD and complex PTSD in a trauma-exposed Colombian sample.

Int J Soc Psychiatry. 2025-5

[10]
Post-traumatic stress disorder: evolving conceptualization and evidence, and future research directions.

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