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O trauma complexo e a sua expressão sintomatológica
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A relação entre a exposição a situações traumáticas e manifestações psicopatológicas é conhecida há muito. A exposição precoce, recorrente e prolongada a múltiplos eventos traumáticos de natureza interpessoal pode levar o indivíduo a um quadro clínico mais complexo (Herman, 1992; Van der Kolk et al., 2005), atualmente denominado de Trauma Complexo. Os sintomas diagnósticos deste tipo de trauma têm constituido critérios da Perturbação do Stress Pós-Traumático, contudo, estes últimos parecem insuficientes na definição do Trauma Complexo, devido às consequências e complexidade sintomatológica deste.
O presente estudo visa explorar a relação entre a sintomatologia traumática subjacente ao Trauma Complexo, correspondente à entidade nosológica denominada Disorders of Extreme Stress, Not Otherwise Specified (DESNOS) e outras sintomatologias clínicas mais gerais. Para tal, a investigação foca dois principais objetivos: 1) compreender em que medida o Trauma Complexo pode estar associado a outras sintomatologias clínicas, como a ansiedade, a depressão, entre outras e 2) analisar a relação entre as dimensões associadas ao Trauma Complexo e o Índice Geral de Sintomas Psicopatológicos.
A amostra é constituída por 338 participantes, com idade igual ou superior a 18 anos. Foram administrados os instrumentos de avaliação: Questionário Sociodemográfico e versões portuguesas do Self-Report Inventory for Disorders of Extreme Stress (SIDES-SR) e BSI (Inventário de Sintomas Psicopatológicos).
As dimensões do Trauma Complexo, principalmente a Alteração na Autoperceção e a Desregulação dos Afetos e Impulsos, estão significativamente correlacionadas com o Índice Geral de Sintomas. Também se verificou a associação entre as dimensões específicas do Trauma Complexo e outras sintomatologias clínicas gerais, havendo uma maior associação entre: 1) Desregulação dos Afetos e Impulsos e Alteração na Autoperceção com a Sensibilidade Interpessoal, Hostilidade e Psicoticismo; 2) Depressão com a Ansiedade e Alteração do Sistema de Significados. A Hostilidade e o Psicoticismo revelaram ter um efeito mais significativo relativamente à sintomatologia do Trauma Complexo.
The relationship between exposure to traumatic situations and psychopathological manifestations is long known. Early, recurrent and prolonged exposure to multiple traumatic events of an interpersonal nature may lead the individual to a more complex clinical picture (Herman, 1992; Van der Kolk et al., 2005), currently called complex Trauma. The diagnostic symptoms of this type of trauma have constituted criteria of the disturbance of the Post-Traumatic Stress, however, the latter seem insufficient in the definition of complex trauma, due to the consequences and symptomatological complexity of this. The present study aims to explore the relationship between the traumatic symptoms underlying the Complex Trauma, corresponding to the nosological entity called Disorders of Extreme Stress, Not Otherwise Specified (DESNOS) and other clinical symptoms more general. To this end, research focuses on two main objectives: 1) to understand the extent to which the complex Trauma may be associated with other clinical symptoms, such as anxiety, depression, among others and 2) to analyze the relationship between the dimensions associated with the Complex Trauma and the general index of psychopathological symptoms. The sample consists of 338 participants, aged 18 years or more. Evaluation instruments were administered: demographic questionnaire and Portuguese versions of the Self-Report Inventory for Disorders of Extreme Stress (Sides-SR) and BSI (Inventory of Psychopathological Symptoms). The dimensions of Complex Trauma, especially the alteration in self-perception and the deregulation of affections and impulses, are significantly correlated with the general index of symptoms. There was also the association between the specific dimensions of the complex Trauma and other general clinical symptoms, with a greater association between: 1) Deregulation of Affections and Impulses and Alteration in Self-perception with Interpersonal Sensibility, Hostility and Psychoticism; 2) Depression with the Anxiety and Alteration of the System of Meanings. Hostility and Psychoticism have shown a more significant effect on the symptoms of Complex Trauma.
The relationship between exposure to traumatic situations and psychopathological manifestations is long known. Early, recurrent and prolonged exposure to multiple traumatic events of an interpersonal nature may lead the individual to a more complex clinical picture (Herman, 1992; Van der Kolk et al., 2005), currently called complex Trauma. The diagnostic symptoms of this type of trauma have constituted criteria of the disturbance of the Post-Traumatic Stress, however, the latter seem insufficient in the definition of complex trauma, due to the consequences and symptomatological complexity of this. The present study aims to explore the relationship between the traumatic symptoms underlying the Complex Trauma, corresponding to the nosological entity called Disorders of Extreme Stress, Not Otherwise Specified (DESNOS) and other clinical symptoms more general. To this end, research focuses on two main objectives: 1) to understand the extent to which the complex Trauma may be associated with other clinical symptoms, such as anxiety, depression, among others and 2) to analyze the relationship between the dimensions associated with the Complex Trauma and the general index of psychopathological symptoms. The sample consists of 338 participants, aged 18 years or more. Evaluation instruments were administered: demographic questionnaire and Portuguese versions of the Self-Report Inventory for Disorders of Extreme Stress (Sides-SR) and BSI (Inventory of Psychopathological Symptoms). The dimensions of Complex Trauma, especially the alteration in self-perception and the deregulation of affections and impulses, are significantly correlated with the general index of symptoms. There was also the association between the specific dimensions of the complex Trauma and other general clinical symptoms, with a greater association between: 1) Deregulation of Affections and Impulses and Alteration in Self-perception with Interpersonal Sensibility, Hostility and Psychoticism; 2) Depression with the Anxiety and Alteration of the System of Meanings. Hostility and Psychoticism have shown a more significant effect on the symptoms of Complex Trauma.
Descrição
Tese de mestrado, Psicologia (Secção de Psicologia Clínica e da Saúde, Núcleo de Psicologia Clínica Dinâmica), Universidade de Lisboa, Faculdade de Psicologia, 2018
Palavras-chave
Traumas Semiologia (Medicina) Personalidade Psicopatologia Teses de mestrado - 2018