Stich, Courtney; (2023) Understanding and Treating Feelings of Being Contaminated in Refugees and Asylum Seekers with Post-traumatic Stress Disorder. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Overview. This thesis aims to understand and treat disgust and feelings of being contaminated (FBC) after trauma. The first chapter is an overview of the development of FBC within Post-traumatic Stress Disorder (PTSD), including the role of disgust. Then conducts a systematic review of the literature considering how best to treat disgust and FBC. The review suggests that FBC requires targeted treatment either within PTSD treatment or as a stand-alone treatment. There are promising results in reducing FBC use of mental imagery techniques. A model was developed to formulate FBC within PTSD. Chapter 2 is an empirical study investigating FBC and the feasibility of a novel treatment, Cognitive Restructuring and Imagery Modification (CRIM) in a refugee population with PTSD. The prevalence of FBC was high, with 27% of refugees endorsing symptoms. FBC was characterised in detail, linked with PTSD symptoms, and found in victims of sexual assault as well as other types of interpersonal violence, such as torture. The CRIM treatment was found to be acceptable and useful for participants, although, for some participants, gains made in treatment were not fully maintained at follow-up. In refugee populations, CRIM may be more useful within trauma-focused treatment for PTSD.

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