Background

Trauma-focused cognitive-behavioural therapy (CBT) and eye movement desensitisation and reprocessing therapy (EMDR) are efficacious treatments for post-traumatic stress disorder (PTSD), but few studies have directly compared them using well-powered designs and few have investigated response patterns.

Aims

Roughly, one out of four patients with a substance use disorder (SUD) also meets criteria for PTSD. Both disorders seem to be highly intertwined. Two chapters of this thesis focus on the development of a screening questionnaire to detect PTSD within substance abuse treatment centers. For this purpose, a PTSD screener from the United States army was used, the Primary Care posttraumatic stress disorder screen (PC-PTSD). Based on the results of this study a new screener was assembled and cross-validated: the Jellinek-PTSD screening questionnaire (J-PTSD).

In de ontwikkeling naar betere herkenning, diagnostiek en behandeling van de mogelijke gevolgen van traumatische ervaringen spelen vele belangrijke vragen. In dit hoofdstuk komt aan de orde de vraag of er behoefte is aan een brede benadering van 'traumaspectrumstoornissen'. De tweede vraag , die in het vervolg daarop aan de orde komt betreft de omvang en mogelijke complexiteit van een traumatische ervaring (of ervaringen) die kan leiden tot een stoornis.

Background: Violence in childhood is associated with mental health problems and risk of revictimisation. Less
is known about the relative importance of the various types of childhood and adult victimisation for adult
mental health.
Objective: To estimate the associations between various types of childhood and adult violence exposure, and
their combined associations to adult mental health.
Method: This study was a cross-sectional telephone survey of the Norwegian adult population; 2,435 women

Brief eclectic psychotherapy for PTSD (BEPP) is an evidence-based therapeutic approach that combines and integrates elements from psychodynamic, cognitive-behavioral, and directive psychotherapy. Psychoeducation is done jointly with the patient and his or her partner. Exposure, a structured writing task, and memorabilia are used to help patients accessing, feeling and expressing their suppressed emotions related to the traumatic experience. In the domain of meaning stage, patients will learn how they and their view of the world have changed, and that they have become “sadder but wiser”.

Brief eclectic psychotherapy for PTSD (BEPP), developed during the 1980s and 1990s of the last century, has proven to be as effective as other trauma-focused treatments (Gersons et al. 2000; Lindauer et al. 2005; Bradley et al. 2005; NICE 2005; Bisson et al. 2013; Schnyder et al. 2011). What makes BEPP special is that it is a comprehensive treatment especially developed for PTSD in which effective elements from different psychotherapy schools have been integrated into a logical sequence.

Ten years after a brutal and protracted war, Sierra Leone remains very much in recovery. Despite the need for increased and long term mental health services, such resources remain scarce. Mental health capacity building is required, and includes: the community sensitisation of mental illness and treatment; the training of health professionals and lay persons; the advocacy for changes in national mental health policy; and the provision of mental health services.

In the aftermath of the war in Bosnia Herzegovina, a task group of Swedish experts organised and supported training of community psychiatry and social work as part of the mental health reform. Among the basic principles of the programme were a close cooperation with the Ministry of Health, personal continuity, exchange of knowledge and long term engagement. With the support of the programme, community mental health centres were created and staffed with a team consisting of: a psychiatrist, four nurses, a psychologist and a social worker.

There is a growing consensus concerning the scope and components of mental health and psychosocial interventions needed to assist populations exposed to mass conflict. The Adaptation and Development after Persecution and Trauma (ADAPT) model offers a unifying, conceptual framework to underpin policy and practice in the field