PTSD and complex PTSD manifestations in Sub-Saharan Africa: A systematic review of qualitative literature

IF 4.1 Q1 PSYCHIATRY
Marion Bovey , Nadine Hosny , Felicia Dutray , Eva Heim
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引用次数: 0

Abstract

Complex post-traumatic stress disorder (CPTSD) was introduced in the ICD-11 as a new diagnosis and was framed in accordance with WHO guidelines of clinical utility and cross-cultural applicability. CPTSD diagnosis comprises PTSD symptoms in addition to specific symptoms related to the organization of the self (DSO). Cross-cultural validity of the DSO symptoms is still being debated as cultural norms significantly influence how individuals perceive themselves and manage their emotions and relationships. The aim of this systematic review was to understand how PTSD and DSO symptoms were experienced and expressed by individuals from Sub-Saharan Africa (SSA) by exploring qualitative literature. Searches were conducted on nine databases using search terms for countries, methods, symptoms, and trauma exposure. Fifty studies were included. Results confirmed the presence of the three DSO clusters. However, their manifestation differed significantly from the defined diagnostic criteria, highlighting the importance of considering cultural factors in the diagnostic process. Additionally, the review indicated that structural factors played significant roles in shaping the interpretation of trauma-related distress in this cultural context. Thus, we propose to create and implement a cultural module as an add on to the actual CPTSD assessment tools to account for cultural and structural variations in the SSA population and improve diagnosis accuracy. In this perspective, more emic research is needed to gain a deeper understanding of how trauma-related distress is perceived, experienced, and interpreted in SSA.

撒哈拉以南非洲的创伤后应激障碍和复杂的创伤后应激障碍表现:定性文献的系统回顾
复杂创伤后应激障碍(CPTSD)作为一种新的诊断被引入 ICD-11 中,其框架符合世界卫生组织关于临床实用性和跨文化适用性的指导方针。CPTSD 诊断包括创伤后应激障碍症状以及与自我组织相关的特定症状(DSO)。DSO 症状的跨文化有效性仍存在争议,因为文化规范会极大地影响个人如何看待自己以及如何管理自己的情绪和人际关系。本系统性综述旨在通过探索定性文献,了解撒哈拉以南非洲地区(SSA)的个人如何体验和表达创伤后应激障碍和 DSO 症状。我们使用国家、方法、症状和创伤暴露等检索词在九个数据库中进行了检索。共纳入 50 项研究。结果证实了三个 DSO 群组的存在。但是,它们的表现形式与定义的诊断标准有很大不同,这突出了在诊断过程中考虑文化因素的重要性。此外,综述还表明,在这种文化背景下,结构性因素对创伤相关痛苦的解释起着重要作用。因此,我们建议创建并实施一个文化模块,作为 CPTSD 实际评估工具的附加模块,以考虑到 SSA 人口中的文化和结构差异,提高诊断的准确性。从这个角度来看,我们需要开展更多的情绪研究,以便更深入地了解在 SSA 中与创伤相关的痛苦是如何被感知、体验和解释的。
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来源期刊
SSM. Mental health
SSM. Mental health Social Psychology, Health
CiteScore
2.30
自引率
0.00%
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0
审稿时长
118 days
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