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Behandlung der PTBS bei Erwachsenen

  • Mareike AugsburgerEmail author
  • Robert Bering
  • Maria Böttche
  • Thomas Ehring
  • Ulrich Frommberger
  • Ursula Gast
  • Tobias Hecker
  • Arne Hoffmann
  • Birgit Kleim
  • Christine Knaevelsrud
  • Volker Köllner
  • Johannes Kruse
  • Astrid Lampe
  • Peter Liebermann
  • Annett Lotzin
  • Andreas Maercker
  • Helga Mattheß
  • Tanja Michael
  • Frank Neuner
  • Heinrich Rau
  • Olaf Reddemann
  • Ulrich Sachsse
  • Ingo Schäfer
  • Julia Schellong
  • Wolfgang Wöller
Chapter

Zusammenfassung

Die zentralen Bausteine der Diagnostik einer Posttraumatischen Belastungsstörung (PTBS) sind die Erfassung der traumatischen Ereignisse sowie die assoziierten Folgen auf symptomatischer und funktionaler Ebene. Für die Diagnosestellung nach der International Statistical Classification of Diseases and Related Health Problems (ICD-10) [16] sind die dort definierten Kriterien und für die funktionale Gesundheit das Klassifikationssystem der Internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF) relevant [17]. Dabei sollte die spezifische Diagnosestellung der PTBS in eine Gesamtdiagnostik eingebettet sein, welche die Aus- und Nachwirkungen auf die aktuelle Lebenssituation, komorbide Symptome sowie Chronifizierungsfolgen erfasst, aber auch salutogenetische Faktoren und den prätraumatischen Status erfragt. Über die Diagnose hinaus sollten sowohl die resultierenden Beeinträchtigungen der Aktivität und Teilhabe als auch die allgemeinen (Familien-, Wohn- und Arbeitssituation, regionale medizinische/psychotherapeutische Versorgung, gesundheitlicher Status) und spezifischen Kontextfaktoren erhoben werden. Hierzu gehören z. B. Täterkontakte, dependente Gewaltbeziehungen sowie z. B. der Rechts- und Aufenthaltsstatus bei Flüchtlingen [18]. Als Prozedere bei der Diagnostik wird häufig die folgende Sequenz eingehalten: Erhebung der Traumavorgeschichte sowie der Spontansymptomatik in der Anamnese, Durchführung eines Fragebogentests als Screening der Symptomintensität sowie bei entsprechender Indikation die Durchführung eines diagnostischen Interviews [2]. Ergänzend sollte potenziell bestehende Komorbidität explizit berücksichtigt und erfasst werden. Bei der Traumaanamnese (Erhebung früherer traumatischer Erfahrungen und Indextrauma) ist es in der Regel initial nicht notwendig bzw. indiziert Details der traumatischen Erfahrung zu explorieren, sondern ausreichend, eine kurze Beschreibung des Erlebten zu erheben. Ein Beharren auf detaillierten Beschreibungen während der ersten Interaktionsphase kann sich potenziell negativ auf die Therapie- und Beziehungsgestaltung auswirken [3].

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Copyright information

© Ingo Schäfer, Ursula Gast, Arne Hofmann, Christine Knaevelsrud, Astrid Lampe, Peter Liebermann, Annett Lotzin, Andreas Maercker, Rita Rosner, Wolfgang Wöller 2019

Authors and Affiliations

  • Mareike Augsburger
    • 1
    Email author
  • Robert Bering
    • 2
  • Maria Böttche
    • 3
    • 4
  • Thomas Ehring
    • 5
  • Ulrich Frommberger
    • 6
    • 7
  • Ursula Gast
    • 8
  • Tobias Hecker
    • 9
  • Arne Hoffmann
    • 10
  • Birgit Kleim
    • 11
    • 12
  • Christine Knaevelsrud
    • 13
  • Volker Köllner
    • 14
  • Johannes Kruse
    • 15
  • Astrid Lampe
    • 16
  • Peter Liebermann
    • 17
  • Annett Lotzin
    • 18
  • Andreas Maercker
    • 19
  • Helga Mattheß
    • 20
  • Tanja Michael
    • 21
  • Frank Neuner
    • 22
  • Heinrich Rau
    • 23
  • Olaf Reddemann
    • 24
  • Ulrich Sachsse
    • 25
  • Ingo Schäfer
    • 26
  • Julia Schellong
    • 27
  • Wolfgang Wöller
    • 28
  1. 1.Universität Zürich, Psychologisches InstitutAbteilung Psychopathologie und Klinische InterventionZürichSchweiz
  2. 2.Alexianer Krefeld GmbHKrefeldDeutschland
  3. 3.Zentrum ÜBERLEBEN gGmbHBerlinDeutschland
  4. 4.Freie Universität BerlinAB Klinisch Psychologische InterventionBerlinDeutschland
  5. 5.MünchenDeutschland
  6. 6.Klinik für Psychiatrie und Psychotherapie, Medizinische FakultätUniversitätsklinikum Freiburg Albert-Ludwigs-Universität FreiburgFreiburg im BreisgauDeutschland
  7. 7.MediClin Klinik an der LindenhöheOffenburgDeutschland
  8. 8.MittelangelnDeutschland
  9. 9.Psychopathologie und Klinische InterventionZürichSwitzerland
  10. 10.EMDR-Institut DeutschlandBergisch GladbachGermany
  11. 11.Psychiatric University Hospital (PUK)University of ZurichZürichSwitzerland
  12. 12.Department of PsychologyUniversity of ZurichZürichSwitzerland
  13. 13.FB ErziehungswissenschaftBerlinGermany
  14. 14.Charité – Universitätsmedizin BerlinBerlinDeutschland
  15. 15.Klinik für Psychosomatik und PsychotherapieUniversitätsklinikum Gießen und Marburg GmbHGießenDeutschland
  16. 16.InnsbruckAustria
  17. 17.Praxis Peter LiebermannLeverkusenDeutschland
  18. 18.Kl. für Psychiatrie und PsychotherapieUniversitätsklinikum Hamburg-EppendorfHamburgGermany
  19. 19.Psychologisches InstitutUniversität ZürichZürichSwitzerland
  20. 20.DuisburgDeutschland
  21. 21.Klinische Psychologie und PsychotherapieUniversität des SaarlandesSaarbrückenDeutschland
  22. 22.Universität BielefeldAbteilung für PsychologieBielefeldDeutschland
  23. 23.Bundeswehrkrankenhaus BerlinBerlinDeutschland
  24. 24.Institut für Allgemeinmedizin (ifam)Centre for Health and Society (chs)DüsseldorfDeutschland
  25. 25.RosdorfDeutschland
  26. 26.Klinikum Hamburg-EppendorfHamburgGermany
  27. 27.Universitätsklinikum Carl Gustav Carus, an der Technischen Universität DresdenKlinik und Poliklinik für Psychotherapie und PsychosomatikDresdenDeutschland
  28. 28.keineBonnGermany

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