Orientador: Sílvia Regina Brandalise / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-17T02:55:11Z (GMT). No. of bitstreams: 1 Perina_ElisaMaria_D.pdf: 1193619 bytes, checksum: 7cda6c283059389c190b1f4ec5abc432 (MD5) Previous issue date: 2010 / Resumo: Com o surgimento de novos recursos diagnósticos e terapêuticos, o tratamento das crianças e adolescentes com câncer resultou em significativo aumento da sobrevida. Os efeitos tardios relacionados a doença e ao tratamento causam impacto na saúde e na qualidade de vida dos jovens recuperados de câncer, abrindo a discussão dos limites da cura frente a toxicidade e qualidade. Com o objetivo de avaliar a qualidade de vida relacionada a saúde de adolescentes sobreviventes de câncer na infância e verificar sua relação com ansiedade, depressão e estresse pós-traumático, realizou-se um estudo quantitativo transversal analítico com 208 adolescentes, entre 13 e 18 anos, que se encontravam ha mais de três anos fora de terapia, em seguimento multiprofissional no Ambulatório da Clinica Apos o Termino da Terapia do Centro Infantil de Investigações Hematológicas Dr. Domingos A. Boldrini, no período de marco de 2009 a abril de 2010. Utilizaram-se o Questionário Pediátrico de Qualidade de Vida PedsQL¿ - Relato do adolescente e Relato dos pais sobre o adolescente - 13 a 18 anos para a determinação do escore de qualidade de vida relacionada a saúde, a Escala Hospitalar de Ansiedade e Depressão ("Hospitalar Anxiety and Depression Scale" - HAD) e a Versão Civil da Avaliação de Estresse pós-traumático ("Post- Traumatic Stress Disorder Checklist - Civilian Version). Constataram-se diferenças dos aspectos, atividade, sumários e escore total de qualidade de vida do PedsQL¿ entre os adolescentes segundo o gênero e o tipo de câncer. Houve correlação significativa e diferença entre a avaliação dos adolescentes e dos pais. Comprovou-se a relação inversa entre a qualidade de vida e a idade, a ansiedade, a depressão e o estresse pós-traumático. Apesar de apresentarem seqüelas físicas e comprometimento no aspecto funcional, a qualidade de vida dos adolescentes foi considerada satisfatória, baseado no escore total do PedsQLTM. A identificação precoce das necessidades dos sobreviventes, no programa de seguimento de sobreviventes de câncer na infância, e dos fatores de risco para o desencadeamento de efeitos tardios, somáticos ou psicossociais, permitira estruturar novas intervenções para a sua efetiva reabilitação. / Abstract: With the emergence of new diagnostic and therapeutic resources, the treatment of children and adolescents with câncer resulted in a significant increase in survival. Secondary effects of the disease impact the health and quality of life of young people recovered from câncer. Aiming to evaluate the quality of life related to adolescent health in childhood câncer survivors and to assess its relation to anxiety, depression and posttraumatic stress, we conduct an analytical cross-sectional quantitative study with 208 adolescents between 13 and 18 years, off therapy for more than three years in After Completion of Therapy Clinic of Children's Center of Hematologic Investigation Dr. Dominic A. Boldrini (Centro Infantil de Investigações Hematológicas Dr. Domingos A. Boldrini, Campinas, SP, Brazil), from March 2009 to April 2010. We used the Pediatric Quality of Life Inventory PedsQL¿ Generic Score Scale Adolescent ages 13-18 years - Self-report by adolescent and Report from parents of adolescents, the Hospital Anxiety and Depression Scale and the Post-Traumatic Stress Disorder Checklist - Civilian Version. Differences were observed at aspects, activity, summaries, and total score of the PedsQL¿ among adolescents according to gender and type of câncer. There was significant correlation and difference between the assessment of adolescents and their parents. Proved the inverse relationship between quality of life and age, anxiety, depression and post-traumatic stress. Although they present no physical disability and impairment in the functional aspect, the quality of life for adolescents was considered satisfactory, based on PedsQL¿. Early identification of the needs of survivors in the after completion of therapy clinic follow, and risk factors for the onset of late effects, somatic or psychosocial interventions new structure will allow for their effective rehabilitation. / Doutorado / Saude da Criança e do Adolescente / Doutor em Saude da Criança e do Adolescente

O proposito deste estudo e avaliar o impacto psicologico da vivencia hospitalar de individuos que sofrem complicacoes pos-operatoria, partindo do pressuposto de que a intercorrencia agrava o quadro clinico com repercussoes na esfera psiquica destes pacientes. Teoricamente enfoca a evolucao do conceito de trauma na teoria freudiana, partindo do desamparo primordial (hilflosigkeit) ate a nova concepcao de angustia, levando em consideracao o fator economico, a nocao de a posteriori (nachträglichkeit) e a compulsao a repeticao. Com o intuito de ampliar a compreensao do fenomeno, o estudo percorre a etiologia do trauma para outros teoricos: Sandor Ferenczi, sobre o narcisismo da doenca; Donald W. Winnicott, que correlaciona o trauma a vivencia do fracasso do ambiente, a imprevisibilidade, ao excesso de tempo de exposicao a situacao desorganizadora, e a elevacao do nivel de dependencia. A constancia desta situacao leva ao que Maksud Khan nomeou de trauma cumulativo. A hipotese e a de que esta experiencia hospitalar pode promover um trauma psiquico, na medida em que o individuo se ve diante de uma situacao imprevisivel, que pode lhe causar transbordamento emocional pelo estado de desamparo, impotencia e risco da perda de sua integridade fisica -, que inibe uma elaboracao psiquica. Apos a alta hospitalar tais fatores podem, ainda, desencadear efeitos pos-traumaticos, acarretando-lhe, assim, uma dificuldade adaptativa. Para Moty Benyakar isto significa que o evento disruptivo pode promover um vivenciar traumatico dado a magnitude do impacto no psiquismo. Metodologicamente, para melhor compreensao do processo psiquico, faz-se um estudo longitudinal, de seis sujeitos, iniciando enquanto estes se encontram hospitalizados (situacao potencialmente traumatica), tres e seis meses apos a alta hospitalar. Na aplicacao do metodo qualitativo o estudo baseia-se na coleta de dados com entrevistas e na aplicacao reduzida da tecnica projetiva do TAT (Thematic Apperception Test). Pelo metodo quantitativo os pacientes sao submetidos a aplicacao da escala de avaliacao do transtorno de estresse pos-traumatico (CAPS Clinician Administred PTDS Scale). Esta pesquisa foi realizada em Hospital Escola de Universidade Publica, apos a aprovacao do Comite de Etica desta instituicao e do Comite de Etica para Seres Humanos do Instituto de Psicologia da Universidade de Sao Paulo. Atraves dos resultados obtidos na pesquisa pode-se constatar que ha uma relacao direta entre o evento e os seus efeitos no psiquismo. Pelo proprio carater disruptivo da instituicao hospitalar, dos encargos dos problemas de saude e do entorno (familiar, socioeconomico) o individuo vivencia uma vulnerabilidade fisica e psiquica. Contudo constatou-se que a dimensao da repercussao psiquica esta diretamente associada ao quadro clinico dos pesquisados, e ao tempo que ficam expostos a situacao potencialmente traumatica. Sendo este um fator fundamental na incidencia dos sintomas do Transtorno de Estresse Pos-traumatico. Com base neste estudo psicologico das complicacoes pos-operatorias, espera-se possibilitar aos profissionais de saude um novo olhar ao promover sua conscientizacao sobre problemas advindos desta experiencia, nao so aos individuos como, tambem, aos familiares, levantando a possibilidade de, se necessario, recorrerem a uma assistencia psicologica e/ou psiquiatrica / The objective of this study is to assess the psychological impact in subjects who stay in hospital after suffering from post-operative complications, on the assumption that the clinical picture gets worse causing troubles in the psychic area of these patients. Theoretically it focuses the evolution of the concept of trauma according to Freudian theory, since the primordial abandonment (hilflosigkeit) up to the new concept of distress, considering the economical situation, the concept of a posteriori (nachtraglichkeit) and the repetition compulsion. Aiming to offer a deeper understanding of the phenomenon, the study works with the etiology of trauma by other theorists: Sandor Ferenczi, about the narcissism of the disorder; Donald W. Winnicott, who relates the trauma to the experience of the environment failure, the unpredictability, the length of time facing a disordering situation, and the raising in dependence level. The constancy of this situation leads to what Maksud Khan called as cumulative trauma. The hypothesis is that in-hospital experience might provide a psychic trauma in so far as the subject has faced an unpredictable situation that might cause an overflow of emotions feeling abandoned, powerless and at the risk of losing physical integrity -, inhibiting a psychic elaboration. After having been discharged from hospital, such factors might also trigger post traumatic effects, implying into an adapting difficulty. According to Moty Benyakar, the disruptive event might provide a traumatic experience due to the great impact in the psychism. Methodologically for a better understanding of the psychic process, a longitudinal study has been made, with a number x of subjects, starting while they are in hospital (a potentially traumatic situation), from three to six months after they had been discharged from hospital. Applying the qualitative method the study has been based on the data collected through interviews and in the reduced application of the projective technique of TAT ( Thematic Apperception Test). Through the quantitative method the patients have been submitted to the application of the evaluation scale on the post-traumatic stress disorder (CAPS - Clinician Administered PTDS Scale). This research was carried out at the Hospital Escola da Universidade Publica, after the approval of the Comite de Etica ( Ethics Committee) of this institution and the Comite de Etica para Seres Humanos ( Ethics Committee for Human Beings) of the Instituto de Psicologia (Psychology Institute) of Universidade de Sao Paulo (USP). Through the results provided by the research, it was observed that there is a direct relation between the event and the effects in the psychism. For the own disruptive aspect in hospital, the burdens of health disorders and other surroundings ( familiar, socio- economic problems), the subject lives in a physical and psychic vulnerability. However it was pointed out that the dimension of the psychic repercussion is directly linked to the clinical picture of the six subjects who are studied, and the length of time that they have been exposed to the potentially traumatic situation. And this factor is extremely important in the incidence of the symptoms of the Post-Traumatic Stress Disorder. This psychological study of the post- traumatic surgery complications is meant to bring to health professionals much more awareness about the problems that come after this experience, not only for the subjects as well as to the relatives, who should be allowed to require, whenever necessary, some psychological and/or psychiatric treatment

Antalet flyktingar i Sverige ökar och därmed behovet av behandling. Multidisciplinär behandling används för flyktingar då de ofta lider av post-traumatiskt stress syndrom (PTSD), psykisk och somatisk komorbiditet, samt social problematik. Studiens syfte var att undersöka behandlingseffekter på PTSD-symtom och komorbida ångest- och depressionssymtom, samt undersöka prediktorer för utfall. Mätningar från 49 patienter på två specialistkliniker användes för att undersöka skillnader mellan före och efter behandling på skalorna PTSD Checklist-Civilian och Hopkins Symtom Checklist-25.Resultaten visade statistiskt signifikant effekt på både PTSD-symtom (p < 0,001,d = 1,46) och komorbida symtom (p < 0,001, d = 1,28). Prediktorer som hade samband med utfallet var ålder och nivå av PTSD-symtom innan behandling. Resultaten påvisar en begränsad kliniskt signifikant effekt av behandling och en modell för prediktion som förklarar en stor del av variansen (R 2 = 33 %). Stort bortfall mellan mätning före och efter behandling minskar generaliserbarheten.

The objective of the diploma work "Psychological Trauma and its Effects on Human's Life" is to find out the impact of an unexpected traumatic experience which appears in one's life. The theoretical background characterizes briefly the topic of psychological traumatic experiences, their origin, features and forms. It also discusses stress phenomenon, adaptation, defence and managing mechanisms, the ones which help people to deal with strain and difficulties. In the context of extreme stress impacts, the main part focuses on posttraumatic stress disorder as one of the most frequent diagnostic categories. This disorder appears as a consequence of insufficient treatment of a serious traumatic experience which manifests itself by persistence of mental and somatic problems. The work also deals with other consequences of trauma in the psychological and social sphere including posttraumatic growth. The thesis also deals with different trauma reactions and risk and protective factors influencing trauma processing and trauma reactions. The research project (Methodological analysis) provides with case studies and show trauma progress, processing and coping with a traumatic experience. It evaluates and confirms negative and positive impact and influence of psychical trauma on human's life.

Women with histories of interpersonal trauma (physical, sexual, or psychological abuse experienced during childhood, adolescence, and adulthood) are more likely to experience posttraumatic stress symptoms (PTSS) and to develop physical health problems than women without trauma histories. In fact, PTSS and posttraumatic stress disorder (PTSD) have been established in the literature as mediators of the relation between interpersonal trauma and physical health outcomes (e.g., Resnick et al., 1997; Schnurr & Green, 2004). What remains to be determined is a clear understanding of the various mechanisms explaining why individuals with trauma histories, and subsequently PTS symptoms, go on to develop physical health problems. The purpose of this study was to examine the role of health risk behaviours, specifically sexual risk taking and substance use, as possible mechanisms through which interpersonal trauma and PTSS might influence physical health. These relations were examined, through structural equation modelling, in a sample of 475 women currently attending university. Models were tested separately for sexual traumas (childhood sexual abuse and sexual assault experienced during adolescence and adulthood) and nonsexual interpersonal traumas (physical and psychological maltreatment by parents in childhood, witnessing violence between parents, and intimate partner violence in their own relationships). Results indicated that PTSS severity partially mediated pathways from both types of interpersonal trauma, sexual and nonsexual, to adverse health outcomes, contributing to the existing theory that one’s psychological response to a trauma may be more important in determining physical health outcomes than the trauma itself. Furthermore, a significant indirect pathway was found to link nonsexual trauma to risky sexual behaviours through PTSS severity. In addition, PTSS severity fully mediated the relation between nonsexual trauma and substance use behaviours. These latter findings suggest that the likelihood of engaging in substance use and/or risky sexual behaviours may be greater in trauma survivors who are suffering from posttraumatic stress symptoms. Contrary to hypotheses, no significant pathways were found from risky sexual behaviours or substance use to physical health outcomes in the context of trauma variables and PTSS severity. Consequently, these health risk behaviours were not found to operate as mechanisms explaining the link from PTSS severity to physical health outcomes. Limitations and alternative hypotheses are presented. Implications for clinical interventions and recommendations for future research are discussed. / Graduate / 0621 / 0622 / 0384

People all over the world do experience some kind of trauma during their lives. Some may experience more than one trauma, and some may experience more intense trauma, but sooner or later we all experience trauma. Sadly, our children are not excluded. The first aim of this study, was to investigate the influence of trauma on the lives of children in their mid childhood years. The following questions were asked: · What are the specific developmental tasks for middle childhood, regarding their physical, cognitive, affective, social, religious, moral and esthetical development? · What about trauma is so traumatic? · Are there any recognisable and predicted effects, present in children who experienced trauma? · And last, but not least, how do children understand and experience a traumatic death? The second aim of this study was to develop a trauma counselling program for children who experienced a trauma. The program had to focus on the specific needs of children in their mid childhood years. In order to do this, the following points were looked at: · What is the current understanding of trauma? Are there any counselling programs for children available, and how do they work? · There are a vast majority of intervention techniques available, the most popular techniques – playtherapy, bibliotherapy, grouptherapy, arttherapy and narrative therapy, were briefly discussed. · Finally a graphic presentation of a new trauma counselling program was included. To see whether this trauma counselling program could help children to overcome posttraumatic symptoms and prevent posttraumatic stress-disorder, it was implemented during two case studies. · The first case study was a girl that had been bitten by dogs twice. As a result of this trauma, she developed an unnatural fear of dogs. The trauma counselling program was implemented, and after a few weeks the girl was able to conquer and control her fear of dogs. · The second case study was a boy who needed to accept his father’s suicide. The trauma counselling program was adapted to suit his specific needs, and once again the program helped the boy to understand and accept his father’s suicide. The success of these two case studies, lead to the acceptance of this study’s hypothesis, namely, that if one developed a trauma counselling program that are compatible with the needs of children in their mid childhood years, it will help children to accept and overcome trauma. Therefore posttraumatic stress symptoms will be reduced and post-traumatic disorder will be prevented. / Dissertation (MEd (Learning Support, Guidance and Counselling))--University of Pretoria, 2006. / Educational Psychology / unrestricted

The purpose of this analysis was to present a systematic review of the effectiveness of child and adolescent PTSD early intervention programs implemented within 3 months following a potentially traumatic event (PTE). The mean weighted effect sizes of the early interventions were calculated, and study variables were encoded for potential moderator variables. A statistically significant mean weighted effect size of -.26 was calculated at final follow up measures, indicating that children receiving early interventions reported lower scores on PTSD outcome measures. The individual studies’ effect sizes at follow-up showed mixed results, thus CBT-based interventions were used as a moderator variable which showed to be a significant moderator in the effectiveness of early interventions. Early interventions programs also seemed to be effective in reducing anxiety outcomes measures, but not depression. Study implications and directions for future research are presented, explaining the need for more long-term follow-up, more early interventions for different types of trauma, and more research in general so that additional potential moderator variables can be identified, allowing experts and researchers valuable information needed to develop effective early interventions following potentially traumatic events.

Aims. Provision and need for mental health services among military personnel are a major concern across nations. Two recent comparisons suggest higher rates of mental disorders in US and UK military personnel compared with civilians. However, these findings may not apply to other nations. Previous studies have focused on the overall effects of military service rather than the separate effects of military service and deployment. This study compared German military personnel with and without a history of deployment to sociodemographically matched civilians regarding prevalence and severity of 12-month DSM-IV mental disorders. Method. 1439 deployed soldiers (DS), 779 never deployed soldiers (NS) and 1023 civilians were assessed with an adapted version of the Munich Composite International Diagnostic interview across the same timeframe. Data were weighted using propensity score methodology to assure comparability of the three samples. Results. Compared with adjusted civilians, the prevalence of any 12-month disorder was lower in NS (OR: 0.7, 95% CI: 0.5–0.99) and did not differ in DS. Significant differences between military personnel and civilians regarding prevalence and severity of individual diagnoses were only apparent for alcohol (DS: OR: 0.3, 95% CI: 0.1–0.6; NS: OR: 0.2, 95% CI: 0.1–0.6) and nicotine dependence (DS: OR: 0.5, 95% CI: 0.3–0.6; NS: OR: 0.5, 95% CI: 0.3–0.7) with lower values in both military samples. Elevated rates of panic/agoraphobia (OR: 2.7, 95% CI: 1.4–5.3) and posttraumatic stress disorder (OR: 3.2, 95% CI: 1.3–8.0) were observed in DS with high combat exposure compared with civilians. Conclusions. Rates and severity of mental disorders in the German military are comparable with civilians for internalising and lower for substance use disorders. A higher risk of some disorders is reduced to DS with high combat exposure. This finding has implications for mental health service provision and the need for targeted interventions. Differences to previous US and UK studies that suggest an overall higher prevalence in military personnel might result from divergent study methods, deployment characteristics, military structures and occupational factors. Some of these factors might yield valuable targets to improve military mental health.

For many decades, violence that is perpetuated by parents and loved ones against children in the name of physical child discipline or corporal punishment, has been a major concern for various governments and church leaders among most nations of the world. This does not only take into account hitting or beating a child with a stick, belt, slapping, or choking, but also spanking; especially when it is aggressive or excessive (Bradshaw 2009; Straus 1994; Kanyandago in Waruta & Kinoti 2005, Wolfe 1991; Carl 1985). A very prominent and highly respected religious figure, here in South Africa, Archbishop Emeritus Desmond Tutu, made the following notable assertion to show his support towards the elimination of the practice of corporal punishment in the home: I support the Global Initiative to eliminate all corporal punishment at home, at school, in institutions and community. … Progress towards abolishing corporal punishment is being made, but millions of the world’s children still suffer from humiliating acts of violence and these violations …can have serious lifelong effects. Violence begets violence and we shall reap whirlwind. Children can be disciplined without violence that instills fear and misery, and I look forward to church communities working with other organizations to… make progress towards ending all forms of violence against children. If we really want a peaceful and compassionate world, we need to build communities of trust where all children are respected, where home and school are safe places to be and where discipline is taught by example” (http://www.rapcan.org.za/wgpd/documents: Waterhouse 2012. Retrieved 23th February 2013). However, in spite of the various voices and movements against corporal punishment of children; especially the aggressive form of this practice (as will be analyzed later on in this study), the practice is still a common phenomenon in many African countries, including South Africa. Furthermore, as some research studies have shown, a literalistic view of certain texts of Scriptures in the OT (which are mostly from the Book of Proverbs) do not only seem to influence the widespread of corporal punishment of children, but also the abuse of this form of physical discipline (e.g., Prov. 13:24; 22:15; 23:13-14, 22:15) (Bradshaw 2009; Capps 1995; Straus 1994; Greven 1991). This assumption seems plausible, seeing that as Tripp T & Tripp M (2008:138) rightly allude to, as Christians, “God’s Word is our rule for faith and practice.” The authors, also expressed that, “the Biblical laws and standards sound oppressive and strict in our lawless, arrogant, twenty-first century culture.” However, it is important to also acknowledge that we, as Christians, can be wrong in our interpretation and application of certain Scriptures; thereby, leading to flawed practices (Pohlmann 2007; Pollard 1997). As Pollard (1997:91) has rightly observed, “Clearly, both personal experience and church history teach us that we can be wrong. It is vital, then, that we have a genuine humility as Christians. We must recognize our fallibility, and constantly reassess what we believe.” In other words, there are many well-meaning Christian parents who have put their children in harm’s way by frequently administering spanking to them in ways that are, evidently, excessive or aggressive: while claiming that they are obeying scriptural injunction on child discipline, and are also doing it for the moral and ethical good of their children (Bradshaw 2009; Greven 1991). The researcher, himself, was brought up in a Christian home; where the use and abuse of both high violence (e.g., beating a child with belt, stick, etc) and low violence (e.g., forcefully beating a child with bear hand) methods of physical child discipline were the order of the day (or a frequent occurrence). Furthermore, his well-meaning father often seemed to find justification for his actions based on scriptural grounds. Incidentally, the researcher noticed that this form of child discipline also seems to be widely used by many parents in his local church and many other Christian parents, whom he has come in contact with. And many of these parents seem not to be aware of the immediate and long term negative effects that aggressive corporeal punishment has on their children. The widespread of this phenomenon (corporeal punishment of children) and the traumatic impact it has on children, has led the researcher to do this research study in his local church context (a Pentecostal church), and to develop/propose a biblically sound or balanced model of pastoral care that can help pastors in rendering effective care, to those faced with this problem situation within the church. The theoretical frame work of this research study is based on Pollard’s model of positive deconstruction, as well as some contributions from Straus’ book Beating the Devil out of Them; Corporal Punishment in American Families. The purpose for choosing Pollard’s model of positive deconstruction was to help the researcher in: 1) Identifying the underlying worldview. 2) Analyzing the worldview. 3) Affirming the elements of truth in it (as every world view has some truth in it that needs to be recognizes and affirmed, which makes the process positive and 4) discovering the error in the worldview. These are the four elements in the process of positive deconstruction, as proposed by Pollard. Straus explores the phenomenon of corporal punishment and the traumatic effects of this method of child discipline both in term of its immediate and long term harm (later in life or in adulthood) psychological harm to children. The research methodology that was employed by the researcher in carrying out this research study is qualitative. Consequently, questionnaires were given out to 50 parents in the researcher’s church to fill. Also, one-on-one interviews were arranged with four parents, two children, and also with two pastoral caregivers in the church, on the issues of corporal punishment and child abuse within the Christian home. / Dissertation (MA Theol)--University of Pretoria, 2013. / gm2014 / Practical Theology / unrestricted

Hintergrund: Sexuelle Dysfunktionen sind ein häufiges Problem bei Patientinnen mit posttraumatischer Belastungsstörung (PTB). Kaum untersucht ist, ob ein Zusammenhang zwischen der Art des Traumas (sexuell vs. nichtsexuell) und der Häufigkeit sexueller Dysfunktionen bzw. Zufriedenheit besteht und welche Rolle komorbide Depressionen dabei spielen. Zudem wurden verschiedene Störungsbilder (PTB, Angst, Depression) in Bezug auf sexuelle Funktions-/Zufriedenheitsbeeinträchtigungen vergleichend untersucht (klinische Spezifität). Patientinnen und Methoden: Nach der standardisierten klinischen Diagnostik wurden 351 ambulante Psychotherapiepatientinnen folgenden 3 Gruppen zugeteilt: Patientinnen mit PTB (n = 89), mit anderen Angststörungen (n = 157) und mit depressiven Störungen (n = 105). Informationen zur sexuellen Zufriedenheit und Funktionsfähigkeit wurden mit dem Kurzfragebogen für Sexualität (KFS) erhoben. Die Art des Traumas (sexuell vs. nichtsexuell) wurde per Interview erfasst; Depressivität mit dem Beck-Depressions-Inventar (BDI). Ergebnisse: Sexuell traumatisierte PTB-Patientinnen haben ein 4-fach höheres Risiko, Beeinträchtigungen der sexuellen Funktionsfähigkeit zu erleben als PTB-Patientinnen mit nichtsexuellem Trauma. Bei Vorliegen einer depressiven Störung zusätzlich zur PTB steigt das Risiko für sexuelle Dysfunktionen um das 3-fache gegenüber PTB-Patientinnen ohne komorbide Depression. Mit der sexuellen Zufriedenheit hängt die Art des Traumas hingegen nicht zusammen. Während drei Viertel der PTB- und Depressionspatientinnen sexuelle Dysfunktionen berichten, gilt dies nur für jede zweite Angstpatientin (außer PTB). Diskussion: Sowohl die Art des Traumas als auch komorbide Depressionen stehen im Zusammenhang mit sexuellen Dysfunktionen bei PTB-Patientinnen. Insbesondere bei Patientengruppen mit einem erhöhten Risiko für Beeinträchtigungen der sexuellen Funktionen ist es wichtig, die Thematik bei therapeutischen Interventionen zu berücksichtigen. / Background: Sexual dysfunctions are a common problem in female patients with posttraumatic stress disorder (PTSD). However, only few studies have investigated the incidence of sexual dysfunctions in PTSD patients accounting for the type of traumatisation (sexual vs non-sexual), the role of co-morbid depression as well as the comparison to other psychiatric disorders (clinical specification). Patients and Methods: In this study, 351 female outpatients were tested with a standardised clinical diagnostic instrument and assigned to the following 3 groups: patients with PTSD (n = 89), with other anxiety disorders (n = 157) and with depressive disorders (n = 105). Information about aspects of sexual satisfaction und sexual functioning was assessed by a short questionnaire (‘Kurzfragebogen für Sexualität’, KFS). The type of trauma was assessed by interview, and the level of depressive symptoms with the Beck Depression Inventory (BDI). Results: The risk of suffering from sexual dysfunctions was 4 times higher for sexually compared to non- sexually traumatised patients, and 3 times higher in the case of co-morbid depression compared to PTSD patients without co-morbid depression. Yet, there was no association between sexual satisfaction and type of trauma. Only half of the patients with anxiety disorder (except PTSD) suffer from sexual dysfunctions compared to 3 out of 4 patients with depression or PTSD. Discussion: Both the type of trauma and co-morbid depression are related to sexual dysfunction in patients with PTSD. Especially with patient groups that hold an increased risk of developing sexual dysfunctions, it is important to consider this topic during therapeutic interventions. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.