2018, Número 2
<< Anterior Siguiente >>
Salud Mental 2018; 41 (2)
Effective therapies for the treatment of complex posttraumatic stress disorder: A qualitative systematic review
Fernández FC, Serrano-Ibáñez ER, Ruiz-Párraga GT, Ramírez MC, Esteve ZR, López MAE
Idioma: Ingles.
Referencias bibliográficas: 37
Paginas: 81-90
Archivo PDF: 425.76 Kb.
RESUMEN
Antecedentes. La literatura actual muestra una diferenciación entre los síntomas de trastorno por estrés postraumático
y estrés postraumático complejo (TEPTC). Si bien los tratamientos psicológicos para el primer tipo
de sintomatología están claramente establecidos, son menos conocidas las intervenciones para el TEPTC.
Objetivo. Evaluar la eficacia de las terapias psicológicas para reducir los síntomas del TEPTC.
Método. Se
realizó una revisión sistemática cualitativa basada en la guía de publicación PRISMA. Se usaron cuatro bases
de datos:
Medline, Pilots, Psycinfo y
Pubmed. Con base en criterios previamente definidos, tres revisores independientes
eligieron los trabajos en dos fases: preselección (criterios para TEPTC, tratamiento psicológico
replicable, datos sobre efectos) y selección (considerando tres criterios adicionales: tipo de estudio, de participantes
y de intervención).
Resultados. De los 615 encontrados, se preseleccionó un total de 25 artículos
para revisión de texto completo, de los cuales se seleccionaron un total de ocho. Cinco trabajos incluyeron
población adulta (a excepción de un estudio, todos eran ensayos clínicos controlados aleatorizados) y el
resto infantil (diseño pre-post-tratamiento, con o sin grupo control). Mayoritariamente, los componentes de
los tratamientos para adultos fueron: psicoeducación, reestructuración cognitiva y exposición. Los estudios
con muestras infantiles incluyeron técnicas más heterogéneas, si bien el uso del EMDR y
mindfulness fueron
comunes a dos de las intervenciones.
Discusión y conclusión. Dada la escasez de estudios encontrados y
los problemas de control metodológico, no es posible destacar un tratamiento de elección para el TEPCT con
eficacia superior al resto. Se requiere de más investigación en este ámbito.
REFERENCIAS (EN ESTE ARTÍCULO)
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Washington, DC: American Psychiatric Association.
Anda, R. F., Felitti, V. J., Walker, J., Whitfield, C. L., Bremner, J. D., Perry, B. D., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neurosciences, 256(3), 174-186. doi: 10.1007/s00406-005-0624-4
Anda, R. F., Butchart, A., Felitti, V. J., & Brown, D.W. (2010). Building a framework for global surveillance of the public health implications of adverse childhood experiences. American Journal of Preventive Medicine, 39(1), 93-98. doi: 10.1016/j.amepre.2010.03.015
Blankenship, D. M. (2017). Five Efficacious Treatments for Posttraumatic Stress Disorder: An Empirical Review. Journal of Mental Health Counseling, 39(4), 275-288. doi: 10.17744/mehc.39.4.01
Bolles, M. (2001). Bolles Sensory Learning Method. Positive Health Online, 18(5). Retrieved from: http://www.positivehealth.com/article/learning-difficulties/ bolles-sensory-learning-method
Bremner, J. D. (2003). Long-term effects of childhood abuse on brain and neurobiology. Child & Adolescent Psychiatric Clinics of North America, 12(2), 271-292.
Busuttil, W. (2009). Complex post-traumatic stress disorder: a useful diagnostic framework? Psychiatry, 8(8), 310-314.
Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. V., & Bryant, R. A. (2014). Distinguising PTSD, Complex PTSD and Borderline Personality Disorder: A latent class analysis. European Journal of Psychotraumatology, 5(1), 1-10. doi: 10.3402/ejpt.v5.25097
Cook, A., Blaustein, M., & Spinazolla, J. (2003). Complex trauma in children and adolescents. Washington, DC: National Child Traumatic Stress Network.
Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., … Gaynes, B. N. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical Psychology Review, 43, 128-141. doi: 10.1016/j.cpr.2015.10.003.
Dorrepaal, E., Thomaes, K., Smit, J. H., Veltman, D. J., Hoogendoorn, A. W., van Balkom, A. J. L. M., & Draijer, N. (2013). Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study. European Journal of Psychotrumatology, 4(1), 1-7. doi: 10.3402/ejpt. v4i0.21171
Dowd, H. & McGuire, B. E. (2011). Psychological treatment of PTSD in children: an evidence-based review. The Irish Journal of Psychology, 32(1-2), 25-39. doi: 10.1080/03033910.2011.611612
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., … Marks, J.S. (1998). Relationship of childhood abuse to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245-258.
Feske, U. (2008). Treating low-income and minority women with posttraumatic stress disorder. A pilot study comparing prolonged exposure and treatment as usual conducted by community therapist. Journal of Interpersonal Violence, 23(8), 1027-1040. doi: 10.1177/0886260507313967
Goldsmith, R. E., Freyd J. J., & DePrince A. P. (2012). Betrayal Trauma: associations with psychological and physical symptoms in young adults. Journal of Interpersonal Violence, 27(3), 547-567. doi: 10.1177/0886260511421672
Herman, J. L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5(3), 377-391.
Higgins, J. P. T. & Green, S. (2011). Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). Retrieved from: www.cochrane-handbook.org
Jarero, I. & Artigas, L. (2009). EMDR Integrative Group Treatment Protocol. Journal of EMDR Practice and Research, 3(4), 287-288.
Jarero, I., Roque-López, S., & Gómez, J. (2013). The provision of an EMDR-based multicomponent trauma treatment with child victims of severe interpersonal trauma. Journal of EMDR Practice and Research, 7(1), 17-28. doi: 10.1891/1933-3196.7.1.17
Kagan, R., Henry, J., Richardson, M., Trinkle, J., & LaFrenier, A. (2014). Evaluation of Real Life Heroes Treatment for children with Complex PTSD. Psychological Trauma: Theory, Research, Practice and Policy, 6(5), 588-596. doi: 10.1037/ a0035879
Kaiser, E. M., Gillette, C. S., & Spinazzola, J. (2010). A controlled pilot-outcome study of sensory integration (SI) in the treatment of complex adaptation to traumatic stress. Journal of Aggression, Maltreatment & Trauma, 19(7), 699-720. doi: 10.1080/10926771.2010.515162
Karatzias, T., Shevlin, M., Fyvie, C., Hyland, P., Efthymiadou, E., Wilson, D., … Cloitre, M. (2017). Evidence of distinct profiles of Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) based on the new ICD-11 Trauma Questionnaire (ICD-TQ). Journal of Affective Disorders, 207(1), 181-187. doi: 10.1016/j.jad.2016.09.032
Lanktree, C. B., Briere, J., Godbout, N., Hodges, M., Chen, K., Trimm, L., … Freed, W. (2012). Treating multitraumatized, socially marginalized children: Results of a naturalistic treatment outcome study. Journal of Aggression, Maltreatment & Trauma, 21(8), 813-828. doi: 10.1080/10926771.2012.722588
Lansford, J. E., Dodge, K. E., Bates, J. E., Crozier, J., & Kaplow, J. (2002). A 12-year prospective study of the long-term effect of early child physical maltreatment on psychological, behavioural and academic problem in adolescents. Archives of Pediatric and Adolescent Medicine, 156(8), 824-830. doi: 10.1001/archpedi. 156.8.824
López-Soler, C. (2008). Las reacciones postraumáticas en la infancia y adolescencia maltratada: el trauma complejo. Revista de Psicopatología y Psicología Clínica, 13(3), 159-174. doi: 10.5944/rppc.vol.13.no.3.2008.4057
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine, 6(7): e1000097. doi: 10.1371/journal.pmed.1000097
National Center for PTSD (2016). Understanding PTSD and PTSD Treatment. Retrieved from: http://www.ptsd.va.gov/public/understanding_ptsd/booklet.pdf
Pelcovitz, D., Van Der Kolk, B. A., Roth, S., Mandel, F. S., Kaplan, S., & Resick, P. A. (1997). Development of a criteria set and a structured interview for disorders of extreme stress (SIDES). Journal of Traumatic Stress, 10(1), 3-17. doi: 10.1002/jts.2490100103
Perestelo-Pérez, L. (2013). Standards on how to develop and report systematic reviews in Psychology and Health. International Journal of Clinical and Health Psychology, 13(1), 49-57. doi: 10.1016/S1697-2600(13)70007-3
Reddemann, L. (2004). Psychodynamisch Imaginative Traumathrapie. PITT – Das Manual. Stuttgart: Pfeiffer bei Klett-Cotta.
Resick, P. A., Nishith, P., & Griffin, M. G. (2003). How well does cognitive-behavioral therapy treat symptoms of complex PTSD? An examination of child sexual abuse survivors within a clinical trial. CNS Spectrums, 8(5), 340-355. doi: 10.1017/S1092852900018605
Sachsse, U., Vogel, C., & Leichsenring, F. (2006). Results of psychodynamically oriented trauma-focused inpatient treatment for women with complex posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD). Bulletin of the Menninger Clinic, 70(2), 125-144. doi: 10.1521/bumc.2006.70.2.125
Shapiro, F. (1995). Eye movements desensitization and reprocessing (EMDR): Basic principles, protocols and procedures. New York: Guilford Press.
Shapiro, F. (2001). Eye movements desensitization and reprocessing (EMDR): Basic principles protocols and procedures (2nd edition). New York: Guilford Press.
Taylor, S., Asmundson, G. J. G., & Carleton, R. N. (2006). Simple versus complex PTSD: A cluster analytic investigation. Anxiety Disorders, 20(4), 459-472. doi: 10.1016/j.janxdis.2005.04.003
Van der Kolk, B. A. (2005). Developmental trauma disorder. Psychiatric Annals, 35(5), 401-408.
Van der Kolk, B. A. (2003). The neurobiology of childhood trauma and abuse. Child and Adolescent Psychiatric Clinics of North America, 12(2), 297-317.