Araştırma Makalesi
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Cinsel İstismar Mağduru Kompleks Travma Sonrası Stres Bozukluğu olan Kız Ergenlerde Grup EMDR Uygulaması

Yıl 2020, , 43 - 51, 29.12.2020
https://doi.org/10.18863/pgy.686609

Öz

Bu çalışmanın amacı daha önce afet ve savaş ilişkili travmalarda kullanılmış olan Grup EMDR Protokolünün, Karmaşık Travma Sonrası Stres Bozukluğu (TSSB) olan kız ergenlerde depresyon ve travma skorlarına etkisinin olup olmadığını araştırmaktır. Araştırma bu alanda ergenlerde yapılmış ilk çalışmadır. Bu amaçla 13 kız ergene iki grup halinde 3 seans Grup EMDR protokolü uygulanmıştır. Olgular daha önce cinsel istismara uğrayan ve en az 6 aydır standart medikal tedaviler uygulanan vakalardır. Olgulara çalışma öncesinde ve seanslar tamamlandıktan 1 ay sonra Çocuklar için Travma Sonrası Stres İndexi ve Çocuklar için Depresyon Ölçeği uygulanmıştır. Olguların yaş ortalaması 16 (min:14 max: 17) idi. Olgulardan %84,6'si (n:11)' ü daha önce birden fazla travmatik olay yaşamıştı. Depresyon skorları ortalaması terapi öncesinde 19 (±6,4) terapi sonrası 1. ay takibinde 11,4 (±5,5), Travma sonrası stres indexi skorları terapi öncesinde 53,5 (±7,5 ), terapi sonrası 1. ay takipte 39,34 (±8,6) olarak bulunmuştur. Hem depresyon hem de travma skorlarında terapi öncesi ile sonrası arasında istatistiksel olarak anlamlı fark saptanmıştır. Karmaşık TSSB bireyin hayatını birçok yönden etkileyen bir psikiyatrik bozukluktur. Standart psikotrop medikasyon travma sonrası stres belirtilerini azaltmada kısmi etkiye sahip olmakla birlikte yeterli etkiye sahip değildir. Grup terapisi daha çok toplu travmatik olaylarda kullanılmış olmakla birlikte bu çalışma ile birlikte Karmaşık TSSB' lerde de kullanılabileceği gösterilmiştir..

Kaynakça

  • Allon, M. (2015). EMDR group therapy with women who were sexually assaulted in the Congo. Journal of EMDR Practice Research, 9(1), 28-34.
  • Allon, M. (2015). EMDR group therapy with women who were sexually assaulted in the Congo. Journal of EMDR Practice Research, 9(1), 28-34.
  • Artigas, L., Jarero, I., Alcalá, N., & Cano, T. (2014). The EMDR Integrative GroupTreatment Protocol For Children (IGTP). In.
  • Artigas, L., Jarero, I., Mauer, M., López Cano, T., & Alcalá, N. (2000). EMDR and traumatic stress after natural disasters: Integrative treatment protocol and the butterfly hug. Paper presented at the Poster presented at the EMDRIA Conference, Toronto, Ontario, Canada.
  • Association, A. P. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub.
  • Bang, Y. R., Park, J. H., & Kim, S. H. (2015). Cut-off scores of the children's depression inventory for screening and rating severity in Korean adolescents. Psychiatry investigation, 12(1), 23.
  • Brewin, C. R., Cloitre, M., Hyland, P., Shevlin, M., Maercker, A., Bryant, R. A., . . . Rousseau, C. (2017). A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD. Clinical psychology review, 58, 1-15.
  • Capezzani, L., Ostacoli, L., Cavallo, M., Carletto, S., Fernandez, I., Solomon, R., . . . Cantelmi, T. (2013). EMDR and CBT for cancer patients: Comparative study of effects on PTSD, anxiety, and depression. Journal of EMDR Practice Research 7(3), 134-143.
  • Dworkin, M. (2003). Integrative approaches to EMDR: Empathy, the intersubjective, and the cognitive interweave. Journal of Psychotherapy Integration, 13(2), 171.
  • Gekker, M., Coutinho, E. S. F., Berger, W., da Luz, M. P., de Araújo, A. X. G., da Costa Pagotto, L. F. A., . . . Mendlowicz, M. V. (2018). Early scars are forever: Childhood abuse in patients with adult-onset PTSD is associated with increased prevalence and severity of psychiatric comorbidity. Psychiatry research, 267, 1-6.
  • Jahanfar, A., Fereidouni, Z., Behnammoghadam, M., Dehghan, A., & Bashti, S. (2020). Efficacy of Eye Movement Desensitization and Reprocessing on the Quality of Life in Patients with Major Depressive Disorder: A Randomized Clinical Trial. Psychology Research Behavior Management, 13, 11.
  • Jarero, I., & Artigas, L. (2010). The EMDR integrative group treatment protocol: Application with adults during ongoing geopolitical crisis. Journal of EMDR Practice Research, 4(4), 148.
  • Jarero, I., & Artigas, L. (2012). The EMDR Integrative Group Treatment Protocol: EMDR group treatment for early intervention following critical incidents. Revue Européenne de Psychologie Appliquée/European Review of Applied Psychology, 62(4), 219-222.
  • Jarero, I., Artigas, L., Montero, M., & Lena, L. (2008). The EMDR integrative group treatment protocol: Application with child victims of a mass disaster. Journal of EMDR Practice Research, 2(2), 97.
  • Jarero, I., Artigas, L., Uribe, S., & García, L. E. (2016). The EMDR integrative group treatment protocol for patients with cancer. Journal of EMDR Practice Research, 10(3), 199-207.
  • Jarero, I., Roque-López, S., Gómez, J., & Givaudan, M. (2014). Third research study on the provision of the EMDR integrative group treatment protocol with child victims of severe interpersonal violence. Revista Iberoamericana de Psicotraumatología y Disociación, 6(2), 1-22.
  • Karadag, M., Gokcen, C., & Sarp, A. S. (2019). EMDR therapy in children and adolescents who have post-traumatic stress disorder: a six-week follow-up study. International journal of psychiatry in clinical practice, 1-6.
  • Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of general psychiatry, 52(12), 1048-1060.
  • Kovacs, M. (1985). The children's depression inventory (CDI). Psychopharmacol bull, 21, 995-998.
  • Maslovaric, G., Zaccagnino, M., Mezzaluna, C., Perilli, S., Trivellato, D., Longo, V., & Civilotti, C. (2017). The effectiveness of eye movement desensitization and reprocessing integrative group protocol with adolescent survivors of the Central Italy Earthquake. Frontiers in psychology, 8, 1826.
  • Maxfield, L. (2008). EMDR treatment of recent events and community disasters. In: Springer.
  • Meentken, M. G., van der Mheen, M., van Beynum, I. M., Aendekerk, E. W., Legerstee, J. S., van der Ende, J., . . . Moll, H. A. (2020). EMDR for children with medically related subthreshold PTSD: short-term effects on PTSD, blood-injection-injury phobia, depression and sleep. European Journal of Psychotraumatology, 11(1), 1705598.
  • Mevissen, L., Didden, R., Korzilius, H., & de Jongh, A. (2017). Eye movement desensitisation and reprocessing therapy for posttraumatic stress disorder in a child and an adolescent with mild to borderline intellectual disability: A multiple baseline across subjects study. Journal of applied research in intellectual disabilities, 30, 34-41.
  • Moreno-Alcázar, A., Treen, D., Valiente-Gómez, A., Sio-Eroles, A., Pérez, V., Amann, B. L., & Radua, J. (2017). Efficacy of eye movement desensitization and reprocessing in children and adolescent with post-traumatic stress disorder: A meta-analysis of randomized controlled trials. Frontiers in psychology, 8, 1750.
  • Pynoos, R. S., Frederick, C., Nader, K., Arroyo, W., Steinberg, A., Eth, S., . . . Fairbanks, L. (1987). Life threat and posttraumatic stress in school-age children. Archives of general psychiatry, 44(12), 1057-1063.
  • Ressler, K. J., Mercer, K. B., Bradley, B., Jovanovic, T., Mahan, A., Kerley, K., . . . Myers, A. (2011). Post-traumatic stress disorder is associated with PACAP and the PAC1 receptor. Nature, 470(7335), 492-497.
  • Rosenbaum, S., Stubbs, B., Ward, P. B., Steel, Z., Lederman, O., & Vancampfort, D. (2015). The prevalence and risk of metabolic syndrome and its components among people with posttraumatic stress disorder: a systematic review and meta-analysis. Metabolism, 64(8), 926-933.
  • Shapiro, F. (1996). Eye movement desensitization and reprocessing (EMDR): Evaluation of controlled PTSD research. Journal of behavior therapy experimental psychiatry, 27(3), 209-218.
  • Shapiro, F. (2017). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures: Guilford Publications.
  • Spinhoven, P., Penninx, B. W., van Hemert, A. M., de Rooij, M., Elzinga, B. M. J. C. a., & neglect. (2014). Comorbidity of PTSD in anxiety and depressive disorders: Prevalence and shared risk factors. Child abuse neglect, 38(8), 1320-1330.
  • Valiente-Gómez, A., Moreno-Alcázar, A., Treen, D., Cedrón, C., Colom, F., Perez, V., & Amann, B. L. (2017). EMDR beyond PTSD: A systematic literature review. Frontiers in psychology, 8, 1668.
  • Yunitri, N., Kao, C.-C., Chu, H., Voss, J., Chiu, H.-L., Liu, D., . . . Chou, K.-R. (2020). The effectiveness of eye movement desensitization and reprocessing toward anxiety disorder: A meta-analysis of randomized controlled trials. Journal of Psychiatric Research.
  • Yurtsever, A., Konuk, E., Akyüz, T., Zat, Z., Tükel, F., Çetinkaya, M., . . . Shapiro, E. (2018). An eye movement desensitization and reprocessing (EMDR) group intervention for Syrian refugees with post-traumatic stress symptoms: Results of a randomized controlled trial. Frontiers in psychology, 9, 493.

EMDR Integrative Group Treatment for Female Adolescents Victims of Sexual Abuse with Complex Posttraumatic Stress Disorder

Yıl 2020, , 43 - 51, 29.12.2020
https://doi.org/10.18863/pgy.686609

Öz

The aim of this study was to investigate the effect of the Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol (EMDR-IGTP), which was previously used in disaster and war related traumas, on depression and trauma scores in female adolescents with Post-Traumatic Stress Disorder. This is the first study with adolescents in this field. For this purpose, 13 female adolescents underwent 3 sessions of Group EMDR protocol. The cases had history of sexual abuse and had been given standard medical treatment for at least 6 months. The Posttraumatic Stress Index and the Children Depression Inventory were administered to the patients before therapy sessions and then 1 month after the sessions were completed. The mean age of the patients was 16 (min: 14 max: 17). 84,6% (n: 11) of the cases had experienced more than one traumatic event before. The mean Child Depression Inventory scores were 19 (± 6.4) before therapy and 11,4 (± 5.5) at 1-month follow-up, Post-Traumatic Stress Index scores were 53.5 (± 7.5) before therapy, and 39.4 (± 8.6) at 1-month follow-up. There was a statistically significant difference in both depression and trauma scores before and after follow-up. Complicated PTSD is a psychiatric disorder that affects lives of individuals in many ways. Although standard psychotropic medication has a partial effect in reducing post-traumatic stress symptoms, this is insufficient. Group therapy has been used mostly in collective traumatic events; it has been shown that can use effective in complex PTSD as well with this study.

Kaynakça

  • Allon, M. (2015). EMDR group therapy with women who were sexually assaulted in the Congo. Journal of EMDR Practice Research, 9(1), 28-34.
  • Allon, M. (2015). EMDR group therapy with women who were sexually assaulted in the Congo. Journal of EMDR Practice Research, 9(1), 28-34.
  • Artigas, L., Jarero, I., Alcalá, N., & Cano, T. (2014). The EMDR Integrative GroupTreatment Protocol For Children (IGTP). In.
  • Artigas, L., Jarero, I., Mauer, M., López Cano, T., & Alcalá, N. (2000). EMDR and traumatic stress after natural disasters: Integrative treatment protocol and the butterfly hug. Paper presented at the Poster presented at the EMDRIA Conference, Toronto, Ontario, Canada.
  • Association, A. P. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub.
  • Bang, Y. R., Park, J. H., & Kim, S. H. (2015). Cut-off scores of the children's depression inventory for screening and rating severity in Korean adolescents. Psychiatry investigation, 12(1), 23.
  • Brewin, C. R., Cloitre, M., Hyland, P., Shevlin, M., Maercker, A., Bryant, R. A., . . . Rousseau, C. (2017). A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD. Clinical psychology review, 58, 1-15.
  • Capezzani, L., Ostacoli, L., Cavallo, M., Carletto, S., Fernandez, I., Solomon, R., . . . Cantelmi, T. (2013). EMDR and CBT for cancer patients: Comparative study of effects on PTSD, anxiety, and depression. Journal of EMDR Practice Research 7(3), 134-143.
  • Dworkin, M. (2003). Integrative approaches to EMDR: Empathy, the intersubjective, and the cognitive interweave. Journal of Psychotherapy Integration, 13(2), 171.
  • Gekker, M., Coutinho, E. S. F., Berger, W., da Luz, M. P., de Araújo, A. X. G., da Costa Pagotto, L. F. A., . . . Mendlowicz, M. V. (2018). Early scars are forever: Childhood abuse in patients with adult-onset PTSD is associated with increased prevalence and severity of psychiatric comorbidity. Psychiatry research, 267, 1-6.
  • Jahanfar, A., Fereidouni, Z., Behnammoghadam, M., Dehghan, A., & Bashti, S. (2020). Efficacy of Eye Movement Desensitization and Reprocessing on the Quality of Life in Patients with Major Depressive Disorder: A Randomized Clinical Trial. Psychology Research Behavior Management, 13, 11.
  • Jarero, I., & Artigas, L. (2010). The EMDR integrative group treatment protocol: Application with adults during ongoing geopolitical crisis. Journal of EMDR Practice Research, 4(4), 148.
  • Jarero, I., & Artigas, L. (2012). The EMDR Integrative Group Treatment Protocol: EMDR group treatment for early intervention following critical incidents. Revue Européenne de Psychologie Appliquée/European Review of Applied Psychology, 62(4), 219-222.
  • Jarero, I., Artigas, L., Montero, M., & Lena, L. (2008). The EMDR integrative group treatment protocol: Application with child victims of a mass disaster. Journal of EMDR Practice Research, 2(2), 97.
  • Jarero, I., Artigas, L., Uribe, S., & García, L. E. (2016). The EMDR integrative group treatment protocol for patients with cancer. Journal of EMDR Practice Research, 10(3), 199-207.
  • Jarero, I., Roque-López, S., Gómez, J., & Givaudan, M. (2014). Third research study on the provision of the EMDR integrative group treatment protocol with child victims of severe interpersonal violence. Revista Iberoamericana de Psicotraumatología y Disociación, 6(2), 1-22.
  • Karadag, M., Gokcen, C., & Sarp, A. S. (2019). EMDR therapy in children and adolescents who have post-traumatic stress disorder: a six-week follow-up study. International journal of psychiatry in clinical practice, 1-6.
  • Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of general psychiatry, 52(12), 1048-1060.
  • Kovacs, M. (1985). The children's depression inventory (CDI). Psychopharmacol bull, 21, 995-998.
  • Maslovaric, G., Zaccagnino, M., Mezzaluna, C., Perilli, S., Trivellato, D., Longo, V., & Civilotti, C. (2017). The effectiveness of eye movement desensitization and reprocessing integrative group protocol with adolescent survivors of the Central Italy Earthquake. Frontiers in psychology, 8, 1826.
  • Maxfield, L. (2008). EMDR treatment of recent events and community disasters. In: Springer.
  • Meentken, M. G., van der Mheen, M., van Beynum, I. M., Aendekerk, E. W., Legerstee, J. S., van der Ende, J., . . . Moll, H. A. (2020). EMDR for children with medically related subthreshold PTSD: short-term effects on PTSD, blood-injection-injury phobia, depression and sleep. European Journal of Psychotraumatology, 11(1), 1705598.
  • Mevissen, L., Didden, R., Korzilius, H., & de Jongh, A. (2017). Eye movement desensitisation and reprocessing therapy for posttraumatic stress disorder in a child and an adolescent with mild to borderline intellectual disability: A multiple baseline across subjects study. Journal of applied research in intellectual disabilities, 30, 34-41.
  • Moreno-Alcázar, A., Treen, D., Valiente-Gómez, A., Sio-Eroles, A., Pérez, V., Amann, B. L., & Radua, J. (2017). Efficacy of eye movement desensitization and reprocessing in children and adolescent with post-traumatic stress disorder: A meta-analysis of randomized controlled trials. Frontiers in psychology, 8, 1750.
  • Pynoos, R. S., Frederick, C., Nader, K., Arroyo, W., Steinberg, A., Eth, S., . . . Fairbanks, L. (1987). Life threat and posttraumatic stress in school-age children. Archives of general psychiatry, 44(12), 1057-1063.
  • Ressler, K. J., Mercer, K. B., Bradley, B., Jovanovic, T., Mahan, A., Kerley, K., . . . Myers, A. (2011). Post-traumatic stress disorder is associated with PACAP and the PAC1 receptor. Nature, 470(7335), 492-497.
  • Rosenbaum, S., Stubbs, B., Ward, P. B., Steel, Z., Lederman, O., & Vancampfort, D. (2015). The prevalence and risk of metabolic syndrome and its components among people with posttraumatic stress disorder: a systematic review and meta-analysis. Metabolism, 64(8), 926-933.
  • Shapiro, F. (1996). Eye movement desensitization and reprocessing (EMDR): Evaluation of controlled PTSD research. Journal of behavior therapy experimental psychiatry, 27(3), 209-218.
  • Shapiro, F. (2017). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures: Guilford Publications.
  • Spinhoven, P., Penninx, B. W., van Hemert, A. M., de Rooij, M., Elzinga, B. M. J. C. a., & neglect. (2014). Comorbidity of PTSD in anxiety and depressive disorders: Prevalence and shared risk factors. Child abuse neglect, 38(8), 1320-1330.
  • Valiente-Gómez, A., Moreno-Alcázar, A., Treen, D., Cedrón, C., Colom, F., Perez, V., & Amann, B. L. (2017). EMDR beyond PTSD: A systematic literature review. Frontiers in psychology, 8, 1668.
  • Yunitri, N., Kao, C.-C., Chu, H., Voss, J., Chiu, H.-L., Liu, D., . . . Chou, K.-R. (2020). The effectiveness of eye movement desensitization and reprocessing toward anxiety disorder: A meta-analysis of randomized controlled trials. Journal of Psychiatric Research.
  • Yurtsever, A., Konuk, E., Akyüz, T., Zat, Z., Tükel, F., Çetinkaya, M., . . . Shapiro, E. (2018). An eye movement desensitization and reprocessing (EMDR) group intervention for Syrian refugees with post-traumatic stress symptoms: Results of a randomized controlled trial. Frontiers in psychology, 9, 493.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Psikoloji
Bölüm Araştırma
Yazarlar

Mehmet Karadağ 0000-0002-4130-0494

Yayımlanma Tarihi 29 Aralık 2020
Kabul Tarihi 10 Mart 2020
Yayımlandığı Sayı Yıl 2020

Kaynak Göster

AMA Karadağ M. Cinsel İstismar Mağduru Kompleks Travma Sonrası Stres Bozukluğu olan Kız Ergenlerde Grup EMDR Uygulaması. Psikiyatride Güncel Yaklaşımlar. Aralık 2020;12:43-51. doi:10.18863/pgy.686609

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Psikiyatride Güncel Yaklaşımlar Creative Commons Atıf-Gayriticari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.