Katerina Naumova


The paper presents findings from the first prospective study that followes the course and changes in posttraumatic consequences over a period of five years in persons with long-term posttraumatic stress disorder related to the war conflict in Macedonia in 2001. The study consists of three assessments of mental health in persons diagnosed with PTSD. Data were collected with the Life Stressor Checklist-Revised, Mini International Neuropsychiatric Interview, Brief Symptom Inventory and the Impact of Event Scale-Revised. The findings confirm that the process of adaptation after cumulative traumatization is complex and has a variable course for most of the traumatized persons. Four trajectories of posttraumatic adaptation were determined: one positive (recovery), in over half of the respondents, and three maladaptive (remission, relapse and chronic PTSD trajectory) among other respondents. Confirmed risk factors for chronic trajectory of posttraumatic adaptation are lower number of experienced traumatic events prior to the first assessment, as well as increased severity of posttraumatic symptoms and comorbidity of at least two mental disorders in the second and third assessment. The expectations that certain sociodemographic variables, forced migration and increased number of experienced trauma are risk factors for chronic posttraumatic adaptation were not confirmed. Given the time distance and the social circumstances that followed the war traumatization, the findings highlight the need for interventions at the level of collective trajectories of posttraumatic adaptation, that represents the context for development and change of individual trajectories
of posttraumatic recovery.

Keywords: posttraumatic adaptation, chronic PTSD, trajectories, recovery

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