複雜性創傷後壓力症候群:修订间差异

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修正國際疾病與相關健康問題統計分類連結為中文 內容擴充
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一些研究人員認為,C-PTSD與[[創傷後壓力症候群|PTSD]]、{{link-en|身體化症|somatization disorder}}、[[解離性身份疾患]]和[[邊緣性人格障礙]]不同但相似。<ref name="TAR">{{cite book| first = Judith L. | last = Herman | name-list-format = vanc |title=Trauma and Recovery: The Aftermath of Violence--From Domestic Abuse to Political Terror|url=https://archive.org/details/traumarecovery00herm_0| url-access = registration |access-date=29 October 2012|date=30 May 1997|publisher=Basic Books|isbn=978-0-465-08730-3}}</ref> 其主要差異是個人核心自我認同的扭曲和嚴重的{{link-en|情緒失調|emotional dysregulation}}。<ref name = "Brewin_2017">{{cite journal | vauthors = Brewin CR, Cloitre M, Hyland P, Shevlin M, Maercker A, Bryant RA, Humayun A, Jones LM, Kagee A, Rousseau C, Somasundaram D, Suzuki Y, Wessely S, van Ommeren M, Reed GM | display-authors = 6 | title = A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD | journal = Clinical Psychology Review | volume = 58 | pages = 1–15 | date = December 2017 | pmid = 29029837 | doi = 10.1016/j.cpr.2017.09.001 | url = http://mural.maynoothuniversity.ie/11577/1/Hyland_Review_2017.pdf }}</ref> 美國精神病學家和學者{{link-en|朱迪思·赫爾曼(Judith Herman)|Judith Herman}}於1992年在她的《創傷與復原》一書以及隨附的文章中首次描述了這種疾病。<ref name="TAR" /><ref name="Herman1992">{{Cite journal | vauthors = Herman JL | title = Complex PTSD: A syndrome in survivors of prolonged and repeated trauma | doi = 10.1007/BF00977235 | journal = Journal of Traumatic Stress | volume = 5 | issue = 3 | pages = 377–391 | year = 1992 | pmid = | pmc = | url = http://202.68.89.83/NR/rdonlyres/D4D172A3-372C-4EC9-B27C-16CC2FF079C7/119065/49SCJE_EVI_00DBHOH_BILL9236_1_A15599_CooperLegalBa.pdf }}{{Dead link|date=July 2019 |bot=InternetArchiveBot |fix-attempted=yes }}</ref><ref>{{cite journal | vauthors = van der Hart O, Nijenhuis ER, Steele K | title = Dissociation: An insufficiently recognized major feature of complex posttraumatic stress disorder | journal = Journal of Traumatic Stress | volume = 18 | issue = 5 | pages = 413–23 | date = October 2005 | pmid = 16281239 | doi = 10.1002/jts.20049 | url = http://www.onnovdhart.nl/wp-content/uploads/2008/09/jts_complex_%20ptsd.pdf }}</ref>
在世界衛生組織(WHO){{link-en|對[[國際疾病相關健康問題的國際統計分類|International Statistical Classification of Diseases and Related Health Problems}}]]的第11版([[ICD-11]])中收錄了該疾病。將C-PTSD標準納入[[精神疾病診斷與統計手冊]](DSM)之提案尚未通過[[美國精神病學協會]](APA)的私人批准委員會批准。複雜性創傷後壓力症候群也獲得[[美國退伍軍人事務部]](VA),{{link-en|澳大利亞衛生直轄區|Healthdirect Australia}}(HDA)和[[國民保健署|國家衛生局]](NHS)認可。
 
 
==症狀==
===兒童與青少年===
PTSD的診斷最初是為遭受單一事件創傷(例如[[性侵]])或[[戰爭]]中經歷過創傷的成年人開發的。<ref name = traumacenter>{{cite web | url=http://www.wmich.edu/traumacenter/pdf/Complex%20Trauma%20and%20Developmental%20Trauma%20Disorder1%5D.pdf | title=Complex Trauma And Developmental Trauma Disorder | publisher=National Child Traumatic Stress Network | access-date=14 November 2013 | archive-url=https://web.archive.org/web/20131205105733/http://www.wmich.edu/traumacenter/pdf/Complex%20Trauma%20and%20Developmental%20Trauma%20Disorder1%5D.pdf | archive-date=5 December 2013 | url-status=dead }}</ref> 但是,許多孩子的情況截然不同。兒童可能會遭受長期創傷,例如:[[虐待]]、[[家庭暴力]]、[[機能不全家庭|家庭失能]](英語:dysfunction),和可能包括和主要照顧者的[[依戀]]中斷。<ref name = Ford>{{cite journal | vauthors = Ford JD, Grasso D, Greene C, Levine J, Spinazzola J, van der Kolk B | title = Clinical significance of a proposed developmental trauma disorder diagnosis: results of an international survey of clinicians | journal = The Journal of Clinical Psychiatry | volume = 74 | issue = 8 | pages = 841–9 | date = August 2013 | pmid = 24021504 | doi = 10.4088/JCP.12m08030 }}</ref> 大部分情況是孩子的照顧者造成創傷。<ref name = traumacenter>{{cite web | url=http://www.wmich.edu/traumacenter/pdf/Complex%20Trauma%20and%20Developmental%20Trauma%20Disorder1%5D.pdf | title=Complex Trauma And Developmental Trauma Disorder | publisher=National Child Traumatic Stress Network | access-date=14 November 2013 | archive-url=https://web.archive.org/web/20131205105733/http://www.wmich.edu/traumacenter/pdf/Complex%20Trauma%20and%20Developmental%20Trauma%20Disorder1%5D.pdf | archive-date=5 December 2013 | url-status=dead }}</ref> PTSD診斷未考慮兒童發育階段如何影響其症狀以及創傷如何影響兒童的成長。<ref name = traumacenter/> '''發育創傷障礙'''(英語:developmental trauma disorder,縮寫為DTD)一詞被提議視為兒童期的C-PTSD。<ref name = Ford/> 這種創傷的發展方式使兒童處於患精神和醫學疾病的風險中。<ref name = Ford/> {{link-en|貝索·馮·德·克洛|Bessel van der Kolk}}博士將DTD解釋為遭遇許多[[人際]]創傷,例如:人身傷害、性傷害、[[暴力]]或[[死亡]]。也可以透過主觀事件,如:遺棄,背叛,失敗或羞恥造成。<ref name=":0">{{cite web | url=http://www.traumacenter.org/products/Developmental_Trauma_Disorder.pdf | title=Developmental trauma disorder | publisher=Psychiatric Annals | year=2005 | access-date=14 November 2013 | vauthors = van der Kolk B | pages=401–408}}</ref> 在兒童時期反復遭受創傷將導致不同於PTSD的症狀。<ref name=":0" /> 庫克等人在七個方面描述了其症狀和行為特徵:<ref name="NCTSNWhitePaper">{{Cite book| editor-last = Cook | editor-first = Alexandra | editor2-last = Blaustein | editor2-first = Margaret | editor3-last = Spinazzola | editor3-first = Joseph | editor4-last = van der Kolk | editor4-first = Bessel| name-list-format = vanc | date = 2003 | title = Complex Trauma in Children and Adolescents: White Paper from the National Child Traumatic Stress Network, Complex Trauma Task Force | publisher = National Child Traumatic Stress Network | url = http://nursebuddha.files.wordpress.com/2011/12/complex-trauma-in-children.pdf | access-date = 2013-11-14}}</ref><ref name="Cook2005" />
* ''依戀''-「存在關係界限的問題,缺乏信任,社會孤立,難以感知和回應他人的情緒狀態」
* ''生物學''-「感覺-運動發育障礙,[[感覺統合]]困難,{{link-en|身體化症|Somatization}}和醫療問題增加」
* ''情感或情緒調節''-「調節不良,難以識別、表達情緒與內在狀態,難以溝通需求、欲望和願望」
 
===成人===
 
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==外部連結==
*[https://freeryou.com/2126/cptsd/ CPTSD介紹與創傷反應類型4F(《第一本複雜性創傷後壓力症候群療癒聖經》譯者陳思含的blog)]
*{{dmoz|Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress/|創傷後症候群}}
** [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)]