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Assessment of dissociation in Bosnian treatment-seeking refugees in Denmark

机译:丹麦在波斯尼亚寻求治疗的难民中的种族隔离评估

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Background: Dissociative experiences are common in traumatized individuals, and can sometimes be mistaken for psychosis. It is difficult to identify pathological dissociation in the treatment of traumatized refugees, because there is a lack of systematic clinical descriptions of dissociative phenomena in refugees. Furthermore, we are currently unaware of how dissociation measures perform in this clinical group. Aims: To describe the phenomenology of dissociative symptoms in Bosnian treatment-seeking refugees in Denmark. Method: As a part of a larger study, dissociation was assessed systematically in 86 Bosnian treatment-seeking refugees using a semi-structured clinical interview (Structured Interview for Disorders of Extreme Stress dissociation subscale; SIDES-D) and a self-report scale (Dissociative Experiences Scale; DES). Results : The SIDES-D indicated twice as high prevalence of pathological dissociation as the DES. According to the DES, 30% of the refugees had pathological dissociation 15 years after their resettlement. On the SIDES-D, depersonalization and derealization experiences were the most common. Also, questions about depersonalization and derealization at times elicited reporting of visual and perceptual hallucinations, which were unrelated to traumatic re-experiencing. Questions about personality alteration elicited spontaneous reports of a phenomenon of "split" pre- and post-war identity in the refugee group. Whether this in fact is a dissociative phenomenon, characteristic of severe traumatization in adulthood, needs further examination. Conclusions: Knowledge of dissociative symptoms in traumatized refugees is important in clinical settings to prevent misclassification and to better target psychotherapeutic interventions. Much development in the measurement of dissociation in refugees is needed.
机译:背景:分离经历在受过创伤的人中很普遍,有时可能会被误认为是精神病。由于缺乏对难民解离现象的系统临床描述,因此很难确定在治疗受难难民中的病理分离。此外,我们目前尚不清楚该临床组中的解离措施如何执行。目的:描述丹麦波斯尼亚寻求治疗的难民中分离症状的现象学。方法:作为一项较大研究的一部分,使用半结构化临床访谈(极度压力解离障碍子问卷结构化访谈; SIDES-D)和自我报告量表(86个波斯尼亚寻求治疗的难民)对解离进行了系统评估。离体经验量表; DES)。结果:SIDES-D的病理学分离率是DES的两倍。根据DES的数据,重新安置15年后,有30%的难民患有病理性分离。在SIDES-D上,最常见的是去个性化和去现实化的经历。同样,关于去人格化和去现实化的问题有时会引发视觉和知觉幻觉的报告,这与创伤性的重新体验无关。有关人格改变的问题引发了有关难民群体战前和战后身份“分裂”现象的自发报道。这是否实际上是一种分离现象,是成年后严重外伤的特征,需要进一步检查。结论:了解受创伤难民的分离症状对于防止临床分类错误和更好地针对心理治疗干预而言非常重要。需要在衡量难民的离婚率方面取得很大进展。

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