ARQ Centrum’45 (en)

The first aim of this dissertation was to contribute to existing knowledge on support after crises by studying elements of a supportive work environment that facilitates the wellbeing of high-risk professionals. The second aim focused on identifying individuals with high levels of distress after crises. Early identification of those in need of support is essential for timely referral to professional aid. 

1 Background

Background: In 2013, the Clinician-Administered PTSD Scale, the golden standard to assess PTSD, was adapted to the DSM-5 (CAPS-5).

Objective: This project aimed to develop a clinically relevant Dutch translation of the CAPS-5 and to investigate its psychometric properties.

Police officers exposed to potentially traumatic events (PTE) are at a heightened risk of developing posttraumatic stress disorder (PTSD). Little is known about trauma‐focused psychotherapy outcomes in the police. In this naturalistic study, we evaluated whether PTE exposure and baseline clinical characteristics predicted PTSD symptom reduction during treatment and residual PTSD symptoms posttreatment. In consecutive referrals to a specialized mental health service for police officers (N = 665), PTSD was measured pre‐ and posttreatment using structured clinical interviews.

Individuals diagnosed with posttraumatic stress disorder (PTSD) show remarkably different symptom presentations. Identification of diagnostic profiles of PTSD may contribute to knowledge about treatment modifications to enhance treatment effectiveness. The present study aimed to identify symptom severity classes among 236 Dutch veterans based on a broad range of psychopathology outcomes, including PTSD, using Latent Profile Analysis (LPA).

Background
Child maltreatment (CM) is associated with long-lasting poor health outcomes, as well as increased levels of disability and health-services consumption across the life-span. However, less is known about how CM consequences can be reduced during adulthood. We investigated professional opinions on how to mitigate long-term consequences of CM in a public health (PH) perspective.

Child maltreatment (CM) is highly prevalent and one of the most injurious conditions that children may experience. Because it is often-clandestine, it is difficult to assure that existing prevention and treatment mechanisms reach those in need. CM’s consequences may take a long time to be recognized and expressed. We discuss the need to increase public health actions when the person reaches adulthood to mitigate the consequences of CM.

Highlights

•Psychometric properties of DSM-5 PCBD and ICD-11 PGD have not been previously compared.

•A three-factor model of PCBD and a two-factor model of PGD yielded acceptable fit.

•The prevalence of probable PCBD (6.4%) was significantly lower than PGD (18.0%).

•Predictive validity differed between PCBD and PGD.

•Findings provide preliminary evidence for the validity of PCBD and PGD.

Research showed that more than 30% of patients with Posttraumatic Stress Disorder (PTSD) do not benefit from evidence-based treatments: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) or Eye Movement Desensitization and Reprocessing (EMDR). These are patients with prolonged and multiple traumatization, with poor verbal memory, and patients with emotional over-modulation. Retelling traumatic experiences in detail is poorly tolerated by these patients and might be a reason for not starting or not completing the recommended treatments.

Ways of dealing with bereavement and grief are influenced by the norms of one’s cultural identity. Cultural assessment of bereavement and grief is therefore needed for a comprehensive evaluation of grief-related psychopathology and for negotiating appropriate treatment. Cultural aspects of bereavement and grief include cultural traditions related to death, bereavement, and mourning as well as help seeking and coping.