Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil
Abstract Background Adolescents in low-resource urban settings in Brazil are often exposed to high levels of trauma that can result in post-traumatic stress disorder (PTSD). However, preliminary evidence indicates that PTSD tends to be under-reported in Brazilian health services, despite the high pr...
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-022-03821-6 |
| _version_ | 1818319700386381824 |
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| author | Alessandro Massazza Juliana Feliciano de Almeida Meaghen Quinlan-Davidson Renata Teixeira da Silva Delanjathan Devakumar Maria Fernanda Tourinho Peres Glyn Lewis Ligia Kiss |
| author_facet | Alessandro Massazza Juliana Feliciano de Almeida Meaghen Quinlan-Davidson Renata Teixeira da Silva Delanjathan Devakumar Maria Fernanda Tourinho Peres Glyn Lewis Ligia Kiss |
| author_sort | Alessandro Massazza |
| collection | DOAJ |
| description | Abstract Background Adolescents in low-resource urban settings in Brazil are often exposed to high levels of trauma that can result in post-traumatic stress disorder (PTSD). However, preliminary evidence indicates that PTSD tends to be under-reported in Brazilian health services, despite the high prevalence of trauma. Additionally, little is known about the perceived applicability among clinicians of the new ICD-11 diagnosis of complex PTSD (CPTSD), despite its potential relevance for contexts of chronic trauma. The current study investigated local understandings of PTSD and CPTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city. Methods Semi-structured interviews were conducted with 58 health professionals working at both the primary care and specialized mental health levels in two areas of São Paulo city with high levels of community violence. Results Most participants knew about PTSD, but most did not know about CPTSD. There were mixed views concerning the commonality of PTSD among adolescents exposed to community violence. Many participants reported having no experience working with patients with the PTSD diagnosis. According to some, community violence was normalized by adolescents and health professionals, and did not result in PTSD. Others highlighted how they did not use psychiatric diagnoses in their practice, had critical perspectives towards psychiatric diagnoses and/or PTSD, or simply knew little about PTSD. Furthermore, many highlighted how the chronic nature of multiple traumas experienced by adolescents often resulted in complex clinical presentations characterised by many symptoms beyond PTSD. The diagnosis of CPTSD was considered appropriate to the context by many participants as it captured the complex traumatic histories and symptom presentations of adolescents exposed to community violence in Brazil. Conclusions These findings have important implications for the assessment and treatment of mental health among adolescents exposed to community violence in Brazil. |
| first_indexed | 2024-12-13T10:13:17Z |
| format | Article |
| id | doaj.art-b46adc9fe6424e2c8d7f6569b658ac2d |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-12-13T10:13:17Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-b46adc9fe6424e2c8d7f6569b658ac2d2022-12-21T23:51:23ZengBMCBMC Psychiatry1471-244X2022-03-0122111510.1186/s12888-022-03821-6Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, BrazilAlessandro Massazza0Juliana Feliciano de Almeida1Meaghen Quinlan-Davidson2Renata Teixeira da Silva3Delanjathan Devakumar4Maria Fernanda Tourinho Peres5Glyn Lewis6Ligia Kiss7Department of Health Services Research and Policy, London School of Hygiene and Tropical MedicineDepartment of Preventive Medicine, School of Medicine, University of São PauloInstitute for Global Health, University College LondonSão Paulo Municipal Health Department- Medical Residency Program in PsychiatryInstitute for Global Health, University College LondonDepartment of Preventive Medicine, School of Medicine, University of São PauloDivision of Psychiatry, University College LondonInstitute for Global Health, University College LondonAbstract Background Adolescents in low-resource urban settings in Brazil are often exposed to high levels of trauma that can result in post-traumatic stress disorder (PTSD). However, preliminary evidence indicates that PTSD tends to be under-reported in Brazilian health services, despite the high prevalence of trauma. Additionally, little is known about the perceived applicability among clinicians of the new ICD-11 diagnosis of complex PTSD (CPTSD), despite its potential relevance for contexts of chronic trauma. The current study investigated local understandings of PTSD and CPTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city. Methods Semi-structured interviews were conducted with 58 health professionals working at both the primary care and specialized mental health levels in two areas of São Paulo city with high levels of community violence. Results Most participants knew about PTSD, but most did not know about CPTSD. There were mixed views concerning the commonality of PTSD among adolescents exposed to community violence. Many participants reported having no experience working with patients with the PTSD diagnosis. According to some, community violence was normalized by adolescents and health professionals, and did not result in PTSD. Others highlighted how they did not use psychiatric diagnoses in their practice, had critical perspectives towards psychiatric diagnoses and/or PTSD, or simply knew little about PTSD. Furthermore, many highlighted how the chronic nature of multiple traumas experienced by adolescents often resulted in complex clinical presentations characterised by many symptoms beyond PTSD. The diagnosis of CPTSD was considered appropriate to the context by many participants as it captured the complex traumatic histories and symptom presentations of adolescents exposed to community violence in Brazil. Conclusions These findings have important implications for the assessment and treatment of mental health among adolescents exposed to community violence in Brazil.https://doi.org/10.1186/s12888-022-03821-6Community violenceBrazilAdolescentsPTSDCPTSDICD-11 |
| spellingShingle | Alessandro Massazza Juliana Feliciano de Almeida Meaghen Quinlan-Davidson Renata Teixeira da Silva Delanjathan Devakumar Maria Fernanda Tourinho Peres Glyn Lewis Ligia Kiss Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil BMC Psychiatry Community violence Brazil Adolescents PTSD CPTSD ICD-11 |
| title | Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil |
| title_full | Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil |
| title_fullStr | Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil |
| title_full_unstemmed | Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil |
| title_short | Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil |
| title_sort | local understandings of ptsd and complex ptsd among health professionals working with adolescents in violent neighbourhoods of sao paulo city brazil |
| topic | Community violence Brazil Adolescents PTSD CPTSD ICD-11 |
| url | https://doi.org/10.1186/s12888-022-03821-6 |
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