查詢結果分析
來源資料
頁籤選單縮合
| 題 名 | 複雜性創傷後壓力症：診斷、理論與臨床實務的回顧與展望=Complex Posttraumatic Stress Disorder: A Review and Prospect of Diagnosis, Theory, and Clinical Practice |
|---|---|
| 作 者 | 蘇逸人; 何雨珊; | 書刊名 | 臨床心理學刊 |
| 卷 期 | 19:2 2025.12[民114.12] |
| 頁 次 | 頁84_1-98 |
| 分類號 | 178.8 |
| 關鍵詞 | 複雜性創傷後壓力症; 診斷; 心理治療; Complex posttraumatic stress disorder; Diagnosis; ICD-11; Psychotherapy; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6550/ACP.202512_19(2).0002 |
| 中文摘要 | 背景：複雜性創傷後壓力症（complex posttraumatic stress disorder [CPTSD]）是一種創傷後可能出現的嚴重心理疾患，常見於長期經歷人際創傷的個體。該診斷於近年被世界衛生組織納入《國際疾病分類》第11版（International Classification of Diseases Eleventh Revision [ICD-11]），以補充傳統PTSD解釋長期持續人際創傷的心理後遺症上之不足。方法：本文回顧CPTSD的早期論述與ICD-11診斷的發展脈絡，並整合近期實徵與臨床證據。回顧重點涵蓋診斷界定、評估、流行病學以及診斷的建構效度，同時介紹新近提出的CPTSD理論模型、專家共識的治療方向，以及在地研究進展。結果：ICD-11 CPTSD由PTSD三大核心症狀與自我組織障礙（disturbances in self-organization）症狀群組成。多項研究支持該診斷的建構效度，可與邊緣人格障礙症予以區分。童年不當對待為CPTSD的主要風險因子，近期提出的「層疊模型」（cascade model）與「記憶與認同理論」（memory and identity theory）凸顯童年創傷、依戀、創傷記憶及負向認同在CPTSD發展上的角色。在心理治療上，晚近專家共識主張採用階段性或循序取向，如Herman的創傷復原三階段與Cloitre等人的情感與人際調節技能訓練（Skills Training in Affective and Interpersonal Regulation）敘事治療。臺灣近年亦對社區成人、海洛因成癮者及政治暴力倖存者及其家屬進行探討，初步顯示CPTSD的在地臨床與社會意涵。結論：ICD-11 CPTSD的診斷正式化，標誌著創傷心理學／精神醫學的重要進展。現有證據支持其診斷獨立性與臨床價值，新興的心理理論與心理治療模式亦展現應用潛力。未來國際與本地研究應持續探究其發展歷程、跨文化適用性與臨床介入。 |
| 英文摘要 | Background: Complex posttraumatic stress disorder (CPTSD) is a severe mental disorder that may develop following trauma exposure and is commonly observed among individuals who have experienced prolonged interpersonal trauma. CPTSD was formally introduced into the International Classification of Diseases 11th Revision (ICD-11) by the World Health Organization. Its inclusion addresses limitations of traditional PTSD in capturing the psychological sequelae of chronic and prolonged interpersonal traumas. Method: This article reviews the early conceptualizations of CPTSD, the development of its ICD-11 diagnosis, and synthesizes recent empirical and clinical evidence. Key areas include diagnostic definition, assessment, epidemiology, and construct validity. Additionally, emerging theoretical models, expert consensus on treatment, and findings from local studies are discussed. Results: ICD-11 CPTSD is defined by the three core PTSD symptom clusters together with disturbances in self-organization (DSO). Numerous studies have supported its construct validity and demonstrated clear distinctions from borderline personality disorder. Childhood maltreatment has been identified as a major risk factor. Recent models, including the Cascade Model and the Memory and Identity Theory, highlight the roles of early trauma, attachment, traumatic memory, and negative identity in the development of CPTSD. In terms of treatment, expert consensus recommends a phased or sequenced approach, exemplified by Herman's three-stage model of recovery and Cloitre's Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy. In Taiwan, emerging research on community adults, heroin-dependent patients, political violence survivors, and their families has begun to document the clinical and social significance of CPTSD. Conclusion: The formal recognition of CPTSD in ICD-11 marks a significant advance in trauma psychology and psychiatry. Current evidence supports its diagnostic independence and clinical value, while new theoretical models and treatment interventions show considerable promise. Future international and local research should continue to clarify its developmental pathways, cross-cultural applicability, and clinical interventions. |
本系統中英文摘要資訊取自各篇刊載內容。