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Etat de Stress Postraumatique (ESPT) suite à l'accouchement : nouvelles recherches et évaluation de la prise en charge avec la psychothérapie EMDR (Eye Movement desensibilisation and Reprocessing)

Abstract : A traumatic birth experience and its consequences are representing a major health issue in women, much too often underestimated (Ayers, 2004). However some women develop posttraumatic stress disorder (PTSD) following childbirth. Prevalence is estimated about 2% of women presenting postpartum PTSD, one third present clinically significant symptoms of PTSD (2 reviews: Olde et al., 2006; Denis & Callahan, 2009). Part 1: A quantitative longitudinal study was carried out within 400 women and with four times of evaluation (late pregnancy and 2, 6, 12 month postpartum. At 2 month postpartum, 163 women answered the questionnaire, 32 women (19.6%) presented symptoms of PTSD postpartum. At six month postpartum, 97 women were followed and 11 presented symptoms of PTSD (16.5%). Multifactor and longitudinal analysis showed significant differences between women within “PTSD group” or “control group” in relation to self-efficacy, coping and quality of life. At twelve month postpartum, 80 women answered questionnaire, 11 presented symptoms of PTSD (11.5%). Regression analysis indicates gynecological or obstetrical history, presence of prepartum depression and coping strategies such as blame and difficulties in positive re-interpretation of a given situation as predicting postpartum PTSD symptoms. The effect of perception of support for autonomy provided by health professionals on the score of PTSD at one year following birth is mediated by using coping strategy “blame” at T2. Part 2: Our qualitative study was implemented in order to understand health professionals perception of the postpartum PTSD development. Qualitative interviews were conducted. Furthermore, a research protocol was elaborated for a treatment of women presenting PTSD following childbirth and for evaluating the effects of psychotherapy (EMDR treatment). Conclusion: These results confirm the presence of postpartum PTSD in some women. Following these results, clinical implications are offered to improve the provided health care
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Astrid Krings - George. Etat de Stress Postraumatique (ESPT) suite à l'accouchement : nouvelles recherches et évaluation de la prise en charge avec la psychothérapie EMDR (Eye Movement desensibilisation and Reprocessing). Psychologie. Université de Lorraine, 2013. Français. ⟨NNT : 2013LORR0339⟩. ⟨tel-01751034⟩

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