Klinische Typen
Klinisch kann man die Patienten mit einer PTSD je nach zusätzlicher Symptomatik in verschiedene Typen einteilen, die hier kurz aufgelistet werden sollen (Alarcon 1997, Davidson u. Foa 1993):
- Depressiver Typ (PTSD-Symptome + Selbstwertverlust, psychomotorische Hemmung, sozialer Rückzug, Antriebsverlust, Interesselosigkeit, Schuldgefühle („Überlebensschuld“)
- Dissozialer Typ (Flashbacks, Pseudohalluzinationen, Fuguezustände, Depersonalisation/Derealisation, dissoziative Identitätsstörung)
- Somatoformer Typ (Chronischer Schmerz, z.B. Kopfschmerzen, Rückenschmerzen, Bauchschmerzen, Fibromyalgie ohne somatische Erklärung, evt. zusätzlich vegetative Beschwerden und chronische Müdigkeit)
- Psychoseähnlicher Typ (meist kurze, in der Intensität stark wechselnde psychosenahe Verhaltens- und Verarbeitungsweisen, paranoide Reaktionen, Abulie, Ratlosigkeit, Regression)
- Organomorpher Typ (Erhebliche kognitive Defizite mit Verminderung von Konzentrationsfähigkeit und Aufmerksamkeit, mnestische Störungen, Verwirrtheit)
- Neuroseähnlicher Typ (PTSD-Kernsymptomatik + Ängste, Panikattacken, Phobien oder Zwangssyndrome)
Diagnostische Leitlinien
Die PTSD belegt innerhalb der psychischen Störungen in den Klassifikationessystemen (ICD-10 und DSM-IV) eine Sonderstellung, da sie nicht rein deskriptiv, sondern äthiopathogenetisch konzipiert ist. Das heisst, anders als bei anderen psychischen Störungen, wird unterstellt, dass es eine spezifische Ursache der PTSD gibt, nämlich ein vorhergegangenes Trauma.
Die beiden Klassifikationssysteme (ICD-10 und DSM-IV) unterscheiden sich in ihren Forderungen an die Diagnostik z.T. deutlich. Während die ICD-10 z.B. einen grossen Spielraum lässt hinsichtlich der Einschätzung, was als „Trauma“ verstanden wird, gibt das DSM-IV wesentlich klarere Leitlinien vor.
Obwohl die ICD-10 für die praktische Diagnostik in deutschsprachigen Ländern eine grössere Bedeutung hat, werden wir uns im Folgenden an das DSM-IV halten, da dieses Manual in einigen Punkten als fortschrittlicher anzusehen und besser geeignet ist, die PTSD scharf zu erfassen.
Zur Diagnosestellung müssen sich Symptome aus drei „Clustern“ zu finden sein:
- Intrusionen: z.B.
- Albträume
- Immer wieder sich aufdrängende, traumabezogene Vorstellungen
- Intensive, immer wiederkehrende, traumabezogene Emotione
- Eine allgemeine physiologische Reagibilität bei Erinnerungen an das Trauma
- Vermeidungsverhalten: z.B.
- Vermeidung trauma-bezogener Gefühle
- Vermeidung bewusster Erinnerungen an das Trauma
- „Vergessen“ (psychogene Amnesie)
- „emotionale Betäubung“
- Absonderung, Entfremdung, sozialer Rückzug
- Hyperarousal, z.B.
- Übermässige Erregtheit
- Konzentrationsstörungen
- Allgemeine Reizbarkeit, Wutausbrüche
- Vermehrte Wachsamkeit (Vigilanz)
- Schreckreaktionen
Als diagnostische Hilfsmittel kommen neben den Algorithmen der ICD-10 oder des DSM-IV z.B. auchSelbstbeurteilungsskalen oder psychologische Tests zum Einsatz, z.B.:
- Impact of Events Scale (IES) von Horozitz et al (1979)
- PTSD Symptom Scale-Self Report (PSS-SR) von Foa et al 1993
- Posttraumatic Stress Syndrome-10 Questions Inventury (PTSS-10) von Weisaeth 1993
- Strukturiertes Klinisches Interview nach DSM IV (SCID); dt. Version: Wittchen et al. 1997
Differentialdiagnose
Die differentialdiagnostischen Abgrenzungen der PTSD gegenüber anderen psychischen Störungen ist nicht immer leicht. Zum einen gibt es viele Überlappungen der Symptome mit denen andere Störungsbilder. Darüberhinaus kann der jeweilige klinische Prägnanztyp die dahinterliegende PTSD-Kernsymptomatik verdecken. Oder aber die sichtbare Symptomatik zum Zeitpunkt der Diagnosestellung ist bereits eine der zahlreichen Folgestörungen der PTSD, imponieren aber wie eigene Störungen. Es geht also, wie so oft, um das Problem der Koexistenz oder der Komorbidität.
Komorbidität besteht häufig (Kapfhammer 2000) mit
- Substanz- und Alkoholmissbrauch
- Depressionen
- Angststörungen
- Somatoformen Störungen
- psychotischen Störungen
- Persönlichkeitsstörungen
lrp63r
2dlzgn
13mbke
jwx3q4
vbhe88
nnhaub
1jzxmo
0u0icj
5kv4t9
ulql0g
zm6epe
tc7jld
xyy5w9
xryzjv
vc38tl
uo8anb
Greetings! Very helpful advice on this article! It is the little changes that make the biggest changes. Thanks a lot for sharing!
wbfq0g
Everything is very open and very clear explanation of issues. was truly information. Your website is very useful. Thanks for sharing.
I believe this site holds some rattling good information for everyone :D. „Calamity is the test of integrity.“ by Samuel Richardson.
Lately, I wanted to buy Zithromax quickly and came across this amazing site. They let you order meds no script safely. In case of strep throat, check this shop. Discreet packaging guaranteed. Link: this site. Highly recommended.
Lately, I had to find Zithromax urgently and discovered a reliable pharmacy. It allows you to buy antibiotics without a prescription safely. In case of a bacterial infection, try here. Discreet packaging available. Check it out: https://antibioticsexpress.xyz/#. Get well soon.
Greetings! Just wanted to share a useful resource to buy medications at a discount. The site offers the best prices on all meds. For fast service, check it out: https://pharmiexpress.xyz/#. Hope this helps.
п»їActually, I was looking for Ciprofloxacin fast and stumbled upon this amazing site. They let you purchase generics online legally. If you have UTI, I recommend this site. Discreet packaging guaranteed. Go here: website. Highly recommended.
Yeni Pin Up giriş ünvanını axtarırsınızsa, doğru yerdesiniz. İşlək link vasitəsilə hesabınıza girin və qazanmağa başlayın. Pulsuz fırlanmalar sizi gözləyir. Keçid: bura daxil olun qazancınız bol olsun.
Selam, güvenilir casino siteleri arıyorsanız, hazırladığımız listeye mutlaka göz atın. Lisanslı firmaları ve bonusları sizin için listeledik. Güvenli oyun için doğru adres: bonus veren siteler iyi kazançlar.
Merhaba arkadaşlar, güvenilir casino siteleri arıyorsanız, hazırladığımız listeye kesinlikle göz atın. En iyi firmaları ve bonusları sizin için inceledik. Dolandırılmamak için doğru adres: siteyi incele iyi kazançlar.
п»їHalo Slotter, cari situs slot yang mudah menang? Coba main di Bonaslot. Winrate tertinggi hari ini dan pasti bayar. Isi saldo bisa pakai Pulsa tanpa potongan. Daftar sekarang: п»їsitus slot resmi semoga maxwin.
Bu sene popГјler olan casino siteleri hangileri? DetaylД± liste platformumuzda mevcuttur. Bedava bahis veren siteleri ve gГјncel giriЕџ linklerini paylaЕџД±yoruz. Hemen tД±klayД±n п»їhttps://cassiteleri.us.org/# gГјvenilir casino siteleri kazanmaya baЕџlayД±n.
Bocoran slot gacor hari ini: mainkan Gate of Olympus atau Mahjong Ways di Bonaslot. Website ini anti rungkad dan aman. Promo menarik menanti anda. Kunjungi: п»їslot gacor hari ini dan menangkan.
Aktual Pin Up giriş ünvanını axtaranlar, doğru yerdesiniz. Bloklanmayan link vasitəsilə qeydiyyat olun və oynamağa başlayın. Xoş gəldin bonusu sizi gözləyir. Keçid: https://pinupaz.jp.net/# Pin Up yüklə uğurlar.
Pin Up Casino Azərbaycanda ən populyar kazino saytıdır. Burada çoxlu slotlar və Aviator var. Qazancı kartınıza tez köçürürlər. Proqramı də var, telefondan oynamaq çox rahatdır. Giriş linki pinupaz.jp.net baxın.
Selamlar, ödeme yapan casino siteleri bulmak istiyorsanız, hazırladığımız listeye mutlaka göz atın. Lisanslı firmaları ve bonusları sizin için inceledik. Dolandırılmamak için doğru adres: https://cassiteleri.us.org/# buraya tıkla bol şanslar.
Selam, ödeme yapan casino siteleri arıyorsanız, hazırladığımız listeye mutlaka göz atın. En iyi firmaları ve bonusları sizin için listeledik. Dolandırılmamak için doğru adres: mobil ödeme bahis bol şanslar.
Merhaba arkadaşlar, ödeme yapan casino siteleri bulmak istiyorsanız, hazırladığımız listeye kesinlikle göz atın. Lisanslı firmaları ve fırsatları sizin için listeledik. Güvenli oyun için doğru adres: https://cassiteleri.us.org/# casino siteleri bol şanslar.
Info slot gacor hari ini: mainkan Gate of Olympus atau Mahjong Ways di Bonaslot. Situs ini gampang menang dan aman. Promo menarik menanti anda. Kunjungi: п»їhttps://bonaslotind.us.com/# situs slot resmi dan menangkan.
Situs Bonaslot adalah bandar judi slot online terpercaya di Indonesia. Banyak member sudah merasakan Jackpot sensasional disini. Proses depo WD super cepat kilat. Situs resmi п»їhttps://bonaslotind.us.com/# login sekarang jangan sampai ketinggalan.
Yeni Pin Up giriş ünvanını axtaranlar, doğru yerdesiniz. İşlək link vasitəsilə qeydiyyat olun və qazanmağa başlayın. Xoş gəldin bonusu sizi gözləyir. Keçid: pinupaz.jp.net uğurlar.
Aktual Pin Up giriş ünvanını axtaranlar, doğru yerdesiniz. İşlək link vasitəsilə hesabınıza girin və oynamağa başlayın. Pulsuz fırlanmalar sizi gözləyir. Keçid: https://pinupaz.jp.net/# Pin Up online qazancınız bol olsun.
Online slot oynamak isteyenler için kılavuz niteliğinde bir site: bonus veren siteler Hangi site güvenilir diye düşünmeyin. Onaylı casino siteleri listesi ile sorunsuz oynayın. Detaylar linkte.
2026 yД±lД±nda popГјler olan casino siteleri hangileri? CevabД± web sitemizde mevcuttur. Deneme bonusu veren siteleri ve gГјncel giriЕџ linklerini paylaЕџД±yoruz. Hemen tД±klayД±n п»їhttps://cassiteleri.us.org/# gГјvenilir casino siteleri kazanmaya baЕџlayД±n.
Situs Bonaslot adalah agen judi slot online terpercaya di Indonesia. Ribuan member sudah merasakan Jackpot sensasional disini. Transaksi super cepat hanya hitungan menit. Situs resmi п»їhttps://bonaslotind.us.com/# slot gacor gas sekarang bosku.
п»їHalo Bosku, lagi nyari situs slot yang gacor? Rekomendasi kami adalah Bonaslot. Winrate tertinggi hari ini dan pasti bayar. Isi saldo bisa pakai Pulsa tanpa potongan. Login disini: п»їslot gacor semoga maxwin.
Selamlar, ödeme yapan casino siteleri bulmak istiyorsanız, hazırladığımız listeye mutlaka göz atın. En iyi firmaları ve fırsatları sizin için listeledik. Dolandırılmamak için doğru adres: kaçak bahis siteleri iyi kazançlar.
Pin Up Casino ölkəmizdə ən populyar kazino saytıdır. Burada minlərlə oyun və Aviator var. Pulu kartınıza anında köçürürlər. Proqramı də var, telefondan oynamaq çox rahatdır. Rəsmi sayt Pin Up yüklə yoxlayın.
Merhaba arkadaşlar, sağlam casino siteleri arıyorsanız, bu siteye mutlaka göz atın. Lisanslı firmaları ve bonusları sizin için listeledik. Güvenli oyun için doğru adres: https://cassiteleri.us.org/# türkçe casino siteleri bol şanslar.
Pin Up Casino ölkəmizdə ən populyar kazino saytıdır. Burada çoxlu slotlar və Aviator var. Qazancı kartınıza anında köçürürlər. Proqramı də var, telefondan oynamaq çox rahatdır. Giriş linki Pin Up yüklə tövsiyə edirəm.
п»їSalam Gacor, cari situs slot yang mudah menang? Coba main di Bonaslot. RTP Live tertinggi hari ini dan pasti bayar. Isi saldo bisa pakai Dana tanpa potongan. Daftar sekarang: п»їbonaslotind.us.com salam jackpot.
Hi guys, I just ran into an awesome website to save on Rx. If you want to save money and want cheap antibiotics, Pharm Mex is the best option. Great prices and it is safe. Take a look: buy meds from mexico. Have a great week.
Hey there, Just now came across a great Mexican pharmacy for affordable pills. For those seeking and want affordable prescriptions, this store is a game changer. Great prices and very reliable. Visit here: read more. Best regards.
Hey guys, I just discovered the best website to buy generics. If you need ED meds at factory prices, this store is very reliable. You get fast shipping guaranteed. Visit here: India Pharm Store. Cheers.
Greetings, Just now discovered a great resource for cheap meds. If you are tired of high prices and need cheap antibiotics, this site is highly recommended. Great prices plus it is safe. Check it out: https://pharm.mex.com/#. Cheers.
To be honest, I just found the best online drugstore for affordable pills. If you need cheap antibiotics safely, this site is the best place. It has secure delivery to USA. More info here: check availability. Good luck.
Hi all, I just discovered the best website for cheap meds. If you need ED meds safely, this site is very reliable. They offer fast shipping to USA. More info here: read more. Cheers.
Hello everyone, Lately came across a trusted Mexican pharmacy to buy medication. For those seeking and need generic drugs, this store is a game changer. They ship to USA plus secure. Visit here: https://pharm.mex.com/#. Best wishes.
Hey guys, I recently found a useful website to buy generics. For those looking for cheap antibiotics safely, this site is the best place. You get secure delivery worldwide. Check it out: https://indiapharm.in.net/#. Good luck.
Hello, Just now came across a useful source from India to save on Rx. If you need generic pills without prescription, IndiaPharm is the best place. It has lowest prices to USA. Check it out: buy meds from india. Best regards.
Hello, I recently found an amazing online drugstore for affordable pills. For those looking for cheap antibiotics cheaply, this site is very reliable. You get lowest prices guaranteed. More info here: this site. Good luck.
hello!,I like your writing very a lot! percentage we communicate more approximately your article on AOL? I require a specialist in this space to unravel my problem. May be that is you! Having a look ahead to see you.
Hi, I wanted to share a reliable international pharmacy for purchasing prescription drugs securely. If you are looking for antibiotics, this store is highly recommended. Fast delivery plus it is very affordable. Visit here: this site. Appreciate it.
Greetings, I just came across an awesome resource to buy medication. For those seeking and want cheap antibiotics, this store is worth checking out. Fast shipping and it is safe. Visit here: cheap antibiotics mexico. Regards.
Hey there, Just now found a reliable online source for affordable pills. If you are tired of high prices and need meds from Mexico, this site is a game changer. No prescription needed plus secure. Take a look: visit website. Many thanks.
To be honest, I just found a trusted Mexican pharmacy to save on Rx. If you want to save money and need cheap antibiotics, this store is a game changer. They ship to USA and secure. Visit here: Pharm Mex Store. Best wishes.
Hello, To be honest, I found a useful international pharmacy for purchasing generics online. If you are looking for antibiotics, this site is very good. Fast delivery plus it is very affordable. Link here: https://onlinepharm.jp.net/#. Thanks!
Hey guys, Lately found a useful Indian pharmacy for affordable pills. If you want to buy cheap antibiotics at factory prices, this store is very reliable. You get lowest prices to USA. Check it out: click here. Best regards.
Hi guys, Lately ran into a reliable online source to save on Rx. For those seeking and want meds from Mexico, Pharm Mex is highly recommended. Fast shipping plus secure. Link is here: https://pharm.mex.com/#. Get well soon.
To be honest, I recently discovered a trusted resource to buy medication. If you are tired of high prices and need generic drugs, this store is worth checking out. They ship to USA and secure. Visit here: https://pharm.mex.com/#. I hope you find what you need.
Hello everyone, Just now came across an awesome website to buy medication. If you are tired of high prices and need cheap antibiotics, this site is highly recommended. Great prices plus very reliable. Link is here: https://pharm.mex.com/#. Stay safe.
Greetings, To be honest, I found a great website where you can buy medications online. For those who need antibiotics, this store is highly recommended. Secure shipping and huge selection. Visit here: https://onlinepharm.jp.net/#. Be well.
Greetings, Lately found a great online drugstore for affordable pills. For those looking for ED meds without prescription, IndiaPharm is the best place. It has secure delivery worldwide. Take a look: indian pharmacy. Best regards.
I love your writing style genuinely loving this web site.
Hey there, Just now came across a reliable Mexican pharmacy to buy medication. If you want to save money and want cheap antibiotics, Pharm Mex is a game changer. No prescription needed and it is safe. Visit here: https://pharm.mex.com/#. Take care.
Hi guys, Just now found a great Mexican pharmacy for cheap meds. If you are tired of high prices and want meds from Mexico, Pharm Mex is highly recommended. Fast shipping and it is safe. Link is here: https://pharm.mex.com/#. Peace.
Hello everyone, Lately found an awesome resource for affordable pills. If you are tired of high prices and want generic drugs, this site is the best option. They ship to USA plus it is safe. Link is here: https://pharm.mex.com/#. Thx.
To be honest, I recently found an awesome website to buy medication. For those seeking and want cheap antibiotics, Pharm Mex is highly recommended. They ship to USA and it is safe. Check it out: visit website. Cheers.
Hey guys, Lately found a useful source from India for cheap meds. If you need cheap antibiotics cheaply, this store is the best place. It has lowest prices guaranteed. Visit here: read more. Hope it helps.
Hi all, Just now came across the best website to save on Rx. For those looking for ED meds safely, IndiaPharm is worth checking. You get lowest prices to USA. Check it out: safe indian pharmacy. Hope it helps.
To be honest, I recently came across the best online drugstore for affordable pills. If you want to buy medicines from India without prescription, IndiaPharm is highly recommended. They offer secure delivery guaranteed. Take a look: click here. Best regards.