Klett-Cotta-Verlag Psychology
Wissenschaft

Traumata und psychotische Psychopathologie


August 2017, 11. Jahrgang, Heft 3, pp 180-194

DOI 10.21706/tg-11-3-180



Zusammenfassung
Traumatische Erlebnisse verursachen vielfältige psychopathologische Symptome, die die Grenzen der diagnostischen Zuordnung überschreiten. Die Beurteilung und diagnostische Wertung psychotischer Psychopathologie im Kontext von Traumatisierungen stellt hierbei eine besondere Herausforderung dar. Seit Schneiders Veröffentlichung der sogenannten Erstrangsymptome wurde eine Spezifität für die Diagnose einer Schizophrenie angenommen. Erst mit der Veröffentlichung des DSM-5 wurde der diagnostische Stellenwert der Erstrangsymptome grundsätzlich in Frage gestellt. Hierzu haben die Auseinandersetzung mit den Folgen von Traumatisierungen und die Wiederentdeckung von Janets Modell der Dissoziation geführt. Das Modell der Dissoziation nimmt mittlerweile eine bedeutende Rolle bei der Interpretation stressassoziierter psychotischer Psychopathologie ein. Die historische Entwicklung der psychiatrischen Diagnostik und die Schwierigkeiten, traumaassoziierte Psychopathologie einzuordnen, sind eng miteinander verbunden. In der vorliegenden Übersicht werden historische, biologische und klinisch-pragmatische Aspekte der differentialdiagnostischen Einordnung von psychotischen Symptomen vorgestellt.

Abstract
Trauma and Psychotic Psychopathology
Traumatic experiences cause a variety of psychopathological symptoms that exceed the limits of the current diagnostic manuals. The diagnostic evaluation of psychotic psychopathology poses a special challenge in the context of psychological traumatization. Since Schneider’s publication of the so-called first-rank symptoms their specificity has been assumed for the diagnosis of schizophrenia and has only been questioned since the publication of the DSM-5. This development is influenced by the acknowledgment of traumatization and its sequelae. Furthermore, the re-discovery of Janet’s model of dissociation plays an important role in the interpretation of stress-related psychotic symptoms. The historical development of psychiatric diagnostics and the difficulties of classifying trauma-associated psychopathology are closely linked. The present review presents historical, biological and clinical pragmatic aspects of the differential diagnoses of psychotic symptoms.

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