Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees

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BMC Psychiatry. BioMed Central. 2020, 20, 312. eISSN 1471-244X. Available under: doi: 10.1186/s12888-020-02720-y
Zusammenfassung

Background
Trauma-focused therapy approaches are recommended as treatment for posttraumatic stress disorder (PTSD). This includes the treatment of trauma-related suffering in refugee populations. However, there is a lack of knowledge about symptom trajectories in refugees living in volatile conditions. This has led to fear of “retraumatisation” and general skepticism in clinicians concerning the use of exposure therapy.

Methods
To test the relevance of this concern, we investigated PTSD symptom trajectories and potentially influencing factors during the course of Narrative Exposure Therapy (NET) in a refugee sample living in Germany. Refugees filled out the PTSD Checklist prior to each treatment session and also during follow-up interviews. Therapists continuously documented positive and negative life events as well as the content of the treatment sessions. Additionally, structured clinical interviews were conducted pre-treatment and at follow-up time points.

Results
On average, clients presented with substantial decreases in PTSD symptoms already during and after NET. However, symptom trajectories differed and ranged from fast responders to slow responders to no immediate response during treatment. Importantly, a persistent worsening of symptoms was not observed, also not after exposure to the most distressing events. In contrast, stressful life experiences seemed to aggravate PTSD symptoms.

Conclusions
Consistent with earlier studies, NET leads to clinically and behaviorally relevant reductions in PTSD symptoms both throughout and following treatment in refugees living in volatile conditions. Concerns about imaginal exposure in refugees were not substantiated. While stressful life events contributed to transient symptom increases, they weren’t found to prevent the overall effectiveness of NET.

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Fachgebiet (DDC)
150 Psychologie
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Trauma therapy, Symptom trajectories, Refugee, Imaginal exposure, PTSD
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ISO 690KALTENBACH, Elisa, Katharin HERMENAU, Maggie SCHAUER, Katalin DOHRMANN, Thomas ELBERT, Inga SCHALINSKI, 2020. Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees. In: BMC Psychiatry. BioMed Central. 2020, 20, 312. eISSN 1471-244X. Available under: doi: 10.1186/s12888-020-02720-y
BibTex
@article{Kaltenbach2020-06-17Traje-50136,
  year={2020},
  doi={10.1186/s12888-020-02720-y},
  title={Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees},
  volume={20},
  journal={BMC Psychiatry},
  author={Kaltenbach, Elisa and Hermenau, Katharin and Schauer, Maggie and Dohrmann, Katalin and Elbert, Thomas and Schalinski, Inga},
  note={Article Number: 312}
}
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