Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Psychiatry |
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| Online Access: | http://link.springer.com/article/10.1186/s12888-020-02720-y |
| _version_ | 1818836033268088832 |
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| author | Elisa Kaltenbach Katharin Hermenau Maggie Schauer Katalin Dohrmann Thomas Elbert Inga Schalinski |
| author_facet | Elisa Kaltenbach Katharin Hermenau Maggie Schauer Katalin Dohrmann Thomas Elbert Inga Schalinski |
| author_sort | Elisa Kaltenbach |
| collection | DOAJ |
| description | Abstract 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. Trial registration NCT02852616 . |
| first_indexed | 2024-12-19T03:00:10Z |
| format | Article |
| id | doaj.art-5f3413eb418849b3b63d2ac537ed2332 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-12-19T03:00:10Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-5f3413eb418849b3b63d2ac537ed23322022-12-21T20:38:13ZengBMCBMC Psychiatry1471-244X2020-06-0120111410.1186/s12888-020-02720-yTrajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugeesElisa Kaltenbach0Katharin Hermenau1Maggie Schauer2Katalin Dohrmann3Thomas Elbert4Inga Schalinski5Department of Psychology, University of KonstanzDepartment of Psychology, University of KonstanzDepartment of Psychology, University of KonstanzDepartment of Psychology, University of KonstanzDepartment of Psychology, University of KonstanzDepartment of Psychology, University of KonstanzAbstract 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. Trial registration NCT02852616 .http://link.springer.com/article/10.1186/s12888-020-02720-yTrauma therapySymptom trajectoriesRefugeeImaginal exposurePTSD |
| spellingShingle | Elisa Kaltenbach Katharin Hermenau Maggie Schauer Katalin Dohrmann Thomas Elbert Inga Schalinski Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees BMC Psychiatry Trauma therapy Symptom trajectories Refugee Imaginal exposure PTSD |
| title | Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees |
| title_full | Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees |
| title_fullStr | Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees |
| title_full_unstemmed | Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees |
| title_short | Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees |
| title_sort | trajectories of posttraumatic stress symptoms during and after narrative exposure therapy net in refugees |
| topic | Trauma therapy Symptom trajectories Refugee Imaginal exposure PTSD |
| url | http://link.springer.com/article/10.1186/s12888-020-02720-y |
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