Trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse: risk or benefit?
Background: Mental disorders during pregnancy are common and affect the health of mother and child. Despite a relatively high prevalence rate, treatment options have not been investigated systematically. Particularly symptoms of posttraumatic stress disorder (PTSD) may increase significantly during...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2020-12-01
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| Series: | European Journal of Psychotraumatology |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/20008198.2019.1697581 |
| _version_ | 1797954529888567296 |
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| author | Julia Becker-Sadzio Friederike Gundel Agnes Kroczek Stefanie Wekenmann Alexander Rapp Andreas J. Fallgatter Saskia Deppermann |
| author_facet | Julia Becker-Sadzio Friederike Gundel Agnes Kroczek Stefanie Wekenmann Alexander Rapp Andreas J. Fallgatter Saskia Deppermann |
| author_sort | Julia Becker-Sadzio |
| collection | DOAJ |
| description | Background: Mental disorders during pregnancy are common and affect the health of mother and child. Despite a relatively high prevalence rate, treatment options have not been investigated systematically. Particularly symptoms of posttraumatic stress disorder (PTSD) may increase significantly during the course of pregnancy. However, proper guidelines for psychotherapeutic treatment of PTSD during pregnancy do not exist. Objective: In this article, we aimed at discussing the effects of untreated PTSD on pregnancy and postpartum mother-child bonding as well as exposure therapy during pregnancy. Method: To do so, we present the case of a pregnant woman with complex PTSD following childhood sexual abuse. At the time of hospitalization, the patient was pregnant in the second trimester and reported intrusive re-experiencing of the traumatic events, nightmares, anxiety and helplessness as well as an impairing level of irritability during social situations. After a careful discussion of the case within our department and at the annual conference of the German Association of Psychiatry, Psychotherapy and Psychosomatics, we decided to treat the patient with dialectical behavior therapy for PTSD (DBT-PTSD) including exposure therapy under the regular observation of a gynecologist. Psychometric measurements (Davidson Trauma Scale (DTS) and Borderline Symptom- List-23 (BSL-23) were used to observe the course of treatment regarding common PTSD-symptoms and disturbances in self-organization (DSO). Results: The intensity of intrusions and hyperarousal increased from the date of admission, reached the maximum when exposure started and decreased below baseline-level at the end of treatment. Avoidance behavior continually decreased from the beginning until the end of therapy. Decreased BSL-23 values show major improvements regarding DSO. To our knowledge, the course of pregnancy was not affected by treatment-induced psychological and physical symptoms.Conclusions: DBT- PTSD is a potential treatment option for patients suffering from PTSD during pregnancy. Yet, further (epigenetic) research in this field is urgently needed. |
| first_indexed | 2024-04-10T23:20:05Z |
| format | Article |
| id | doaj.art-a01eeeb08cc044d19a477c78cdeb1471 |
| institution | Directory Open Access Journal |
| issn | 2000-8066 |
| language | English |
| last_indexed | 2024-04-10T23:20:05Z |
| publishDate | 2020-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of Psychotraumatology |
| spelling | doaj.art-a01eeeb08cc044d19a477c78cdeb14712023-01-12T15:31:31ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662020-12-0111110.1080/20008198.2019.16975811697581Trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse: risk or benefit?Julia Becker-Sadzio0Friederike Gundel1Agnes Kroczek2Stefanie Wekenmann3Alexander Rapp4Andreas J. Fallgatter5Saskia Deppermann6University Hospital TuebingenUniversity Hospital TuebingenUniversity Hospital TuebingenUniversity Hospital TuebingenKlinikum StuttgartUniversity Hospital TuebingenUniversity Hospital TuebingenBackground: Mental disorders during pregnancy are common and affect the health of mother and child. Despite a relatively high prevalence rate, treatment options have not been investigated systematically. Particularly symptoms of posttraumatic stress disorder (PTSD) may increase significantly during the course of pregnancy. However, proper guidelines for psychotherapeutic treatment of PTSD during pregnancy do not exist. Objective: In this article, we aimed at discussing the effects of untreated PTSD on pregnancy and postpartum mother-child bonding as well as exposure therapy during pregnancy. Method: To do so, we present the case of a pregnant woman with complex PTSD following childhood sexual abuse. At the time of hospitalization, the patient was pregnant in the second trimester and reported intrusive re-experiencing of the traumatic events, nightmares, anxiety and helplessness as well as an impairing level of irritability during social situations. After a careful discussion of the case within our department and at the annual conference of the German Association of Psychiatry, Psychotherapy and Psychosomatics, we decided to treat the patient with dialectical behavior therapy for PTSD (DBT-PTSD) including exposure therapy under the regular observation of a gynecologist. Psychometric measurements (Davidson Trauma Scale (DTS) and Borderline Symptom- List-23 (BSL-23) were used to observe the course of treatment regarding common PTSD-symptoms and disturbances in self-organization (DSO). Results: The intensity of intrusions and hyperarousal increased from the date of admission, reached the maximum when exposure started and decreased below baseline-level at the end of treatment. Avoidance behavior continually decreased from the beginning until the end of therapy. Decreased BSL-23 values show major improvements regarding DSO. To our knowledge, the course of pregnancy was not affected by treatment-induced psychological and physical symptoms.Conclusions: DBT- PTSD is a potential treatment option for patients suffering from PTSD during pregnancy. Yet, further (epigenetic) research in this field is urgently needed.http://dx.doi.org/10.1080/20008198.2019.1697581trauma exposure therapy during pregnancycomplex posttraumatic stress disordertrauma focused dialectical behaviour therapytransgenerational effects of ptsdtreatment-induced transgenerational effects |
| spellingShingle | Julia Becker-Sadzio Friederike Gundel Agnes Kroczek Stefanie Wekenmann Alexander Rapp Andreas J. Fallgatter Saskia Deppermann Trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse: risk or benefit? European Journal of Psychotraumatology trauma exposure therapy during pregnancy complex posttraumatic stress disorder trauma focused dialectical behaviour therapy transgenerational effects of ptsd treatment-induced transgenerational effects |
| title | Trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse: risk or benefit? |
| title_full | Trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse: risk or benefit? |
| title_fullStr | Trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse: risk or benefit? |
| title_full_unstemmed | Trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse: risk or benefit? |
| title_short | Trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse: risk or benefit? |
| title_sort | trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse risk or benefit |
| topic | trauma exposure therapy during pregnancy complex posttraumatic stress disorder trauma focused dialectical behaviour therapy transgenerational effects of ptsd treatment-induced transgenerational effects |
| url | http://dx.doi.org/10.1080/20008198.2019.1697581 |
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