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Deficit and defence – Gedächtnisstörungen nach Schödel-Hirn-Trauma unter Folter

  • Schwerpunkt trauma und erinnerung
  • Published:
Psychiatrie und Psychotherapie

Summary

The complex nature of posttraumatic memory disturbances is an essential diagnostic and forensic issue in the treatment of traumatised individuals. Torture survivors show several mental and physical symptoms of varying specificity. Considerations on differential diagnosis regarding ICD-10 and DSM-IV criteria are presented, and the necessity of a thorough clinical assessment of torture survivors including neuroimaging and neuropsychological testing is stressed. Memory disturbances in torture survivors are frequent and complex: fragments of traumatic memory may present within the period that defines posttraumatic amnesia. Moreover, a putative protective effect of posttraumatic amnesia regarding the development of a posttraumatic stress disorder has been suggested. Unstructured interviews and examinations of torture survivors can re-traumatise the patients. On the basis of the Istanbul Protocol we offer recommendations on handling severely traumatised patients, and address the basic forensic dilemma of the credibility of a torture survivor’s accounts.

Zusammenfassung

Die Komplexität von Gedächtnisstörungen posttraumatischer Natur ist ein zentrales diagnostisches und forensisches Problem im Umgang mit traumatisierten Menschen. Folterüberlebende stellen dabei eine besondere Patientenpopulation mit einer Reihe von psychischen und somatischen Symptomen unterschiedlicher Spezifität dar. Differentialdiagnostische Überlegungen anhand der ICD-10 und DSM-IV Kriterien demonstrieren die Notwendigkeit einer sorgfältigen klinischen Untersuchung von Folterüberlebenden, einschließlich bildgebender und testpsychologischer Verfahren. Gedächtnisstörungen bei Folterüberlebenden sind häufig und komplex: Traumatische Erinnerungsfragmente können innerhalb des Zeitraums der posttraumatischen Amnesie vorkommen. Dabei gibt es Hinweise für einen potentiell protektiven Effekt der posttraumatischen Amnesie für die Entstehung einer posttraumatischen Belastungsstörung. Durch unstrukturierte Befragungen und Untersuchungen eines Folterüberlebenden kann eine Retraumatisierung stattfinden. Anhand des Istanbul-Protokolls werden Empfehlungen für den Umgang mit schwer traumatisierten Menschen dargelegt, zudem wird das große forensische Dilemma der Glaubwürdigkeit des Erfahrungsberichts eines Folterüberlebenden thematisiert.

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  1. Klinische Abteilung für Biologische Psychiatrie, Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich

    Konstantinos Papageorgiou

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  1. Konstantinos Papageorgiou
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Correspondence to Konstantinos Papageorgiou.

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Eingelangt am 1. Juni 2011, angenommen am 1. Juni 2011

Deficit and defence – Memory disturbances due to torture induced traumatic brain injury

Die vorliegende Arbeit stellt die Überarbeitung eines Vortrags im Rahmen eines Symposiums „Trauma und Erinnerung – zur Psychopathologie des autobiographischen Gedächtnisses“ während der ÖGPP-Tagung in Gmunden am 28. April 2011 dar.

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Papageorgiou, K. Deficit and defence – Gedächtnisstörungen nach Schödel-Hirn-Trauma unter Folter. psychiatr. psychother. 7, 61–66 (2011). https://doi.org/10.1007/s11326-011-0157-6

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  • DOI: https://doi.org/10.1007/s11326-011-0157-6

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