Internalisierung und Externalisierung als Ausprägungen einer gemeinsamen Störungs­dimension bei traumatisierten Patienten ^[*]

 

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Zusammenfassung

Sowohl bei Patienten mit komplexer Posttraumatischer Belastungsstörung (kPTBS; Herman, 1992) als auch bei Patienten mit Borderline Persönlichkeitsstörung (BPS) finden sich ana­mnestisch häufig Traumata. Zudem wurden hohe Komorbiditäten zwischen diesen Störungsbildern gefunden. Daher wurde überprüft, ob sich chronisch traumatisierte Patienten (N=266) unter Berücksichtigung von Persönlichkeitsakzentuierungen in internalisierende und externalisierende Subtypen klassifizieren lassen. Im dichotomen Mixed Rasch Modell folgten die Itemparameter einer 2-Klassenlösung dem postulierten Antwortmuster. In χ²-Tests fand sich bei Personen der Gruppe des internalisierenden Typus die Diagnose der kPTBS doppelt so häufig. Ein informationstheoretisches Maß favorisierte allerdings die Ein-Klassenlösung. Die vermutete Typologie musste verworfen werden, sodass ein eindimensionaler Ansatz zur Beschreibung der internalisierenden sowie externalisierenden Symptomatik bei chronisch traumatisierten Pa­tienten vorgeschlagen wird.

Abstract

In patients with complex posttraumatic stress disorder (complex PTSD; Herman, 1992) as well as in those with borderline personality disorder (BPD) traumata are often found anamnestically. Besides high comorbidity were found between both disorders. Thus it was examined whether internalizing and externalizing subtypes can be distinguished in chronic traumatized patients (N=266) accounting for personality accentuations. Item parameters of a 2-class solu­tion of the dichotomous Mixed Rasch Model were consistent with hypothesized patterns. χ²-tests indicated that patients subsumed to the internalizing group showed twice as much the diagnosis of complex PTSD. However an information criterion favored a one-class solution. Given that the analysis did not reveal 2 subtypes, a one-dimensional approach is suggested, that helps to describe internalizing and externalizing symptoms in chronic traumatized patients.

^* Diese Studie wurde im Jahre 2012 mit dem Nachwuchspreis der Deutschsprachigen Gesellschaft für Psychotraumatologie (DeGPT) der Falk von Reichenbach-Stiftung ausgezeichnet.

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