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Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil

BACKGROUND: Adolescents in low-resource urban settings in Brazil are often exposed to high levels of trauma that can result in post-traumatic stress disorder (PTSD). However, preliminary evidence indicates that PTSD tends to be under-reported in Brazilian health services, despite the high prevalence...

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Autores principales: Massazza, Alessandro, de Almeida, Juliana Feliciano, Quinlan-Davidson, Meaghen, da Silva, Renata Teixeira, Devakumar, Delanjathan, Peres, Maria Fernanda Tourinho, Lewis, Glyn, Kiss, Ligia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8932201/
https://www.ncbi.nlm.nih.gov/pubmed/35303808
http://dx.doi.org/10.1186/s12888-022-03821-6
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author Massazza, Alessandro
de Almeida, Juliana Feliciano
Quinlan-Davidson, Meaghen
da Silva, Renata Teixeira
Devakumar, Delanjathan
Peres, Maria Fernanda Tourinho
Lewis, Glyn
Kiss, Ligia
author_facet Massazza, Alessandro
de Almeida, Juliana Feliciano
Quinlan-Davidson, Meaghen
da Silva, Renata Teixeira
Devakumar, Delanjathan
Peres, Maria Fernanda Tourinho
Lewis, Glyn
Kiss, Ligia
author_sort Massazza, Alessandro
collection PubMed
description BACKGROUND: Adolescents in low-resource urban settings in Brazil are often exposed to high levels of trauma that can result in post-traumatic stress disorder (PTSD). However, preliminary evidence indicates that PTSD tends to be under-reported in Brazilian health services, despite the high prevalence of trauma. Additionally, little is known about the perceived applicability among clinicians of the new ICD-11 diagnosis of complex PTSD (CPTSD), despite its potential relevance for contexts of chronic trauma. The current study investigated local understandings of PTSD and CPTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city. METHODS: Semi-structured interviews were conducted with 58 health professionals working at both the primary care and specialized mental health levels in two areas of São Paulo city with high levels of community violence. RESULTS: Most participants knew about PTSD, but most did not know about CPTSD. There were mixed views concerning the commonality of PTSD among adolescents exposed to community violence. Many participants reported having no experience working with patients with the PTSD diagnosis. According to some, community violence was normalized by adolescents and health professionals, and did not result in PTSD. Others highlighted how they did not use psychiatric diagnoses in their practice, had critical perspectives towards psychiatric diagnoses and/or PTSD, or simply knew little about PTSD. Furthermore, many highlighted how the chronic nature of multiple traumas experienced by adolescents often resulted in complex clinical presentations characterised by many symptoms beyond PTSD. The diagnosis of CPTSD was considered appropriate to the context by many participants as it captured the complex traumatic histories and symptom presentations of adolescents exposed to community violence in Brazil. CONCLUSIONS: These findings have important implications for the assessment and treatment of mental health among adolescents exposed to community violence in Brazil. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-022-03821-6.
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spelling pubmed-89322012022-03-23 Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil Massazza, Alessandro de Almeida, Juliana Feliciano Quinlan-Davidson, Meaghen da Silva, Renata Teixeira Devakumar, Delanjathan Peres, Maria Fernanda Tourinho Lewis, Glyn Kiss, Ligia BMC Psychiatry Research BACKGROUND: Adolescents in low-resource urban settings in Brazil are often exposed to high levels of trauma that can result in post-traumatic stress disorder (PTSD). However, preliminary evidence indicates that PTSD tends to be under-reported in Brazilian health services, despite the high prevalence of trauma. Additionally, little is known about the perceived applicability among clinicians of the new ICD-11 diagnosis of complex PTSD (CPTSD), despite its potential relevance for contexts of chronic trauma. The current study investigated local understandings of PTSD and CPTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city. METHODS: Semi-structured interviews were conducted with 58 health professionals working at both the primary care and specialized mental health levels in two areas of São Paulo city with high levels of community violence. RESULTS: Most participants knew about PTSD, but most did not know about CPTSD. There were mixed views concerning the commonality of PTSD among adolescents exposed to community violence. Many participants reported having no experience working with patients with the PTSD diagnosis. According to some, community violence was normalized by adolescents and health professionals, and did not result in PTSD. Others highlighted how they did not use psychiatric diagnoses in their practice, had critical perspectives towards psychiatric diagnoses and/or PTSD, or simply knew little about PTSD. Furthermore, many highlighted how the chronic nature of multiple traumas experienced by adolescents often resulted in complex clinical presentations characterised by many symptoms beyond PTSD. The diagnosis of CPTSD was considered appropriate to the context by many participants as it captured the complex traumatic histories and symptom presentations of adolescents exposed to community violence in Brazil. CONCLUSIONS: These findings have important implications for the assessment and treatment of mental health among adolescents exposed to community violence in Brazil. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-022-03821-6. BioMed Central 2022-03-18 /pmc/articles/PMC8932201/ /pubmed/35303808 http://dx.doi.org/10.1186/s12888-022-03821-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Massazza, Alessandro
de Almeida, Juliana Feliciano
Quinlan-Davidson, Meaghen
da Silva, Renata Teixeira
Devakumar, Delanjathan
Peres, Maria Fernanda Tourinho
Lewis, Glyn
Kiss, Ligia
Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil
title Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil
title_full Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil
title_fullStr Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil
title_full_unstemmed Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil
title_short Local understandings of PTSD and complex PTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city, Brazil
title_sort local understandings of ptsd and complex ptsd among health professionals working with adolescents in violent neighbourhoods of são paulo city, brazil
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8932201/
https://www.ncbi.nlm.nih.gov/pubmed/35303808
http://dx.doi.org/10.1186/s12888-022-03821-6
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