The effect of narrative exposure therapy on disturbed self organisation in patients suffering from complex post traumatic stress disorder : quasi-experimental pre-post intervention pilot study on a sample of Syrian refugees in Dar El Zahra hospital Tripoli North Lebanon

Abstract

The ICD 11 proposed Complex Post Traumatic Disorder (CPTSD) as a new diagnosis within the spectrum of trauma disorders encompassing two clusters, Post-Traumatic Stress Disorder (PTSD) symptoms and Disturbances in Self-organization (DSO) symptoms. The PTSD cluster encompasses three symptoms, (i) Re-experiencing of the trauma in here and now; (ii) Deliberate avoidance of traumatic reminders; and (iii) sense of current threat. And the DSO cluster encompasses three symptoms, (i)affective dysregulation;(ii) negative self-concept; and(iii) disturbed relationships. Evidence based treatment for CPTSD is still a debatable issue. Extensive literature discussed trauma focused therapy as an evidence based treatment for PTSD, yet thorough research in literature did not yield any study discussing its effect on the additional DSO cluster in CPTSD. One of the evidence based therapies approved by the APA (2019) for treating PTSD is Narrative Exposure Therapy (NET). However, its efficacy on CPTSD is still unknown. The current research aims at examining the effect of NET on the DSO cluster of symptoms. Twelve participants from the Syrian Refugee population in North Lebanon, suffering from CPTSD, were treated with NET in an uncontrolled quasi experimental study. The International Trauma Questionnaire (ITQ) was used pre and post NET intervention. The posttest PTSD scores indicated mild or zero PTSD symptoms (all answers were less than the cut off of 2). On the other hand, all patients had significant decrease in their DSO symptoms severity, yet only 66.67% of patients' scores indicated zero or mild severity of symptoms, after NET intervention. Research results suggest that NET may be effective in treating CPTSD.