Complex posttraumatic stress disorder: evidence from the primary care setting

Sexual abuse is a common problem among female primary care medical patients. There is a wide spectrum of long-term sequelae, ranging from mild to the complex symptom profiles consistent with the theories of a posttraumatic sense of identity. Generally, the latter occurs in the context of severe, chr...

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Bibliographic Details
Published in:General hospital psychiatry 1998-07, Vol.20 (4), p.214-224
Main Authors: Dickinson, L.Miriam, deGruy, Frank Verloin, Dickinson, W.Perry, Candib, Lucy M
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Analysis of Variance
Anxiety disorders. Neuroses
Biological and medical sciences
Chi-Square Distribution
Child
Child Abuse, Sexual - psychology
Cluster Analysis
Depression - etiology
Dissociative Disorders - etiology
Family Health
Female
Humans
Medical sciences
Middle Aged
Post-traumatic stress disorder
Primary Health Care - statistics & numerical data
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Retrospective Studies
Somatoform Disorders - etiology
Stress Disorders, Post-Traumatic - classification
Stress Disorders, Post-Traumatic - etiology
Survivors - psychology
Syndrome
Victimology
Women's Health
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Summary:Sexual abuse is a common problem among female primary care medical patients. There is a wide spectrum of long-term sequelae, ranging from mild to the complex symptom profiles consistent with the theories of a posttraumatic sense of identity. Generally, the latter occurs in the context of severe, chronic abuse, beginning in childhood and often compounded by the presence of violence, criminal behavior, and substance abuse in the family of origin. In this study we search for empirical evidence for the existence of a complex posttraumatic stress syndrome in 99 women patients at 3 family practice outpatient clinics who report a history of sexual abuse. A structured interview was administered by trained female interviewers to gather data on family history and psychiatric symptoms and diagnoses. Empirical evidence from cluster analysis of the data supports the theory of a complex posttraumatic syndrome. The severity gradient based on symptoms roughly parallels the severity gradient based on childhood abuse and sociopathic behavior and violence in the family of origin, with the most severely abused subjects characterized by symptom patterns that fit the description of a complex posttraumatic stress syndrome.
ISSN:0163-8343
1873-7714
DOI:10.1016/S0163-8343(98)00021-8