victims trauma ptsd dicky pelupessy

Victim, Trauma and

PTSD

Dicky Pelupessy

Faculty of Psychology, Universitas Indonesia Crisis Center, Faculty of Psychology, Universitas

Indonesia

The 11th ASEAN Course on Victimology and Victim Assistance Faculty of Law, Universitas Indonesia

Outline of the

presentation

 _Trauma

 _{Traumatic event}

 _{Impact of traumatic events to victims}

 _{Post-Traumatic Stress Disorder (PTSD)}

Trauma

 _{Meaning: wound}

Psychological Trauma

 _{Human reactions to trauma-provoking events} or traumatic events (Roberts, 2002).

 _Accidents

 _{Childhood abuse}  _Combat

 _{Criminal assault}  _Rape

 _Torture

Psychological Trauma

 _{Not reactions per se}

 _{Technically refers to the event (Yule, 1999;}

Diagnostic and Statistical Manual of Mental

Disorders, 4th edition, Text Revision

(DSM-IV-TR) American Psychiatric

Association

[APA]

 _Trauma:

…direct personal experience of an event that

involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another

 _{By definition, limited to events that “threatened}

death or serious injury, or other threat to one’s physical integrity”

 _{Roberts (2005); Briere & Scott (2002): include}

events that extremely upsetting and at least temporarily overwhelms the individual’s

Traumatic Event

 _{An event that is traumatic. An event that}

creates psychological wound.

Traumatic event

 _{Briere & Scott (2006)’s Major Types:}

1 . Natural disasters

2 . Mass interpersonal violence

3 . Large-scale transportation accidents

4 . House or other domestic fires

5 . Motor vehicle accidents

Traumatic event

 _{Briere & Scott (2006)’s Major Types (continued):}

7 . Stranger physical assault

8 . Partner battery

9 . Torture

10 . War

11 . Child abuse

 _{Roberts (2005)’s trauma-provoking events:}

1 . Violent crimes

2 . Crisis-prone situations

3 . Natural disasters

4 . Accidents

Victim’s reactions to

traumatic events

 _{Victims = directly and personally experiencing,}

witnessing, or learning from others (secondary trauma)

 _{Typical reactions immediately after the event: shock &}

denial

 _{Other common reactions: an unusual feeling of being}

easily startled, difficulty concentrating, outbursts of irritability, feelings of emotional numbness, recurrent anxiety over personal safety or the safety of loved ones, an inability to let go of distressing mental images or

thoughts, anxiety about, and avoidance of, specific reminders of the event, feelings of helplessness,

powerlessness, and lack of control, feelings of guilt, etc.

Victim’s reactions to

traumatic events

 _{Longer term reactions: flashbacks, physical}

symptoms, emotional problems (unpredictable emotions), and strained relationships.

 _{Revictimization: those who have experienced}

Victim’s reactions to

traumatic events

 _{Revictimization (continued)}

(1) the effects of childhood trauma that have lasted into adulthood

(2) the effects of more recent sexual or physical assaults

(3) the additive effects of childhood trauma and adult assaults (for example, flashbacks to both childhood and adult victimization experiences)

Victim’s reactions to

traumatic events, if

persist…

 _{A disorder, Post-Traumatic Stress Disorder (PTSD)}

 _{Meeting DSM-IV Criteria for PTSD and the}

symptoms must last for more than a month and must significantly affect important areas of life (Yeager & Roberts, 2005)

 _{Main class of symptoms:}

 _{Intrusive re-experiencing of the trauma}

 _{Avoidant behaviors}

Prevalence of PTSD

 _{Not all people exposed to a traumatic event go}

on to develop PTSD

 _{Depends on:}

 _{Individual differences}

 _{The nature and severity of the traumatic event}

e.g. over 50% - the sinking of the cruise ship

Prevalence of PTSD After Disaster

(World Health Organization, 2005)

Description After Disaster: 12 month prevalance

rates Severe disorder

(e.g., psychosis, severe depression, severely disabling form of anxiety disorder, etc)

3-4%

Mild or moderate mental disorder

(e.g., mild and moderate forms of depression and anxiety disorders, including of PTSD)

20%

Moderate or severe psychological distress

that does not meet criteria for disorder, that

resolves over time or mild distress that does not resolve over time

30-50%

Mild psychological distress

Treatment

 _{Psychological First Aid (PFA)}

 _{Exposure Therapy}

 _{Psychodynamic Psychotherapy}

 _{Hypnosis and Guided Imagery}

 _{Psychological Debriefing or Critical Incident Stress} Debriefing (CISD)

 _{Eye Movement Desensitization and Reprocessing (EMDR)}

 _{Pharmacotherapy}

 _{Group Therapy}