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https://doi.org/10.24869/spsih.2026.145

Effectiveness of the Group ESTAIR Approach in the Treatment of Complex PTSD in Croatian War Veterans

Marina Letica Crepulja ; Katedra za psihijatriju i psihološku medicinu, Medicinski fakultet, Sveučilište u Rijeci, Braće Branchetta 20, 51000 Rijeka, Hrvatska; Klinika za psihijatriju, Klinički bolnički centar Rijeka, Referentni centar za posttraumatski stresni poremećaj Ministarstva zdravstva Republike Hrvatske, Krešimirova 42, 51000 Rijeka, Hrvatska *
Aleksandra Stevanović ; Klinika za psihijatriju, Klinički bolnički centar Rijeka, Referentni centar za posttraumatski stresni poremećaj Ministarstva zdravstva Republike Hrvatske, Krešimirova 42, 51000 Rijeka, Hrvatska; Fakultet zdravstvenih studija, Sveučilište u Rijeci, Nikole Cara Emina 5, 51000 Rijeka, Hrvatska
Jasna Grković ; Katedra za psihijatriju i psihološku medicinu, Medicinski fakultet, Sveučilište u Rijeci, Braće Branchetta 20, 51000 Rijeka, Hrvatska; Klinika za psihijatriju, Klinički bolnički centar Rijeka, Referentni centar za posttraumatski stresni poremećaj Ministarstva zdravstva Republike Hrvatske, Krešimirova 42, 51000 Rijeka, Hrvatska
Mersad Muminović ; Katedra za psihijatriju i psihološku medicinu, Medicinski fakultet, Sveučilište u Rijeci, Braće Branchetta 20, 51000 Rijeka, Hrvatska; Klinika za psihijatriju, Klinički bolnički centar Rijeka, Referentni centar za posttraumatski stresni poremećaj Ministarstva zdravstva Republike Hrvatske, Krešimirova 42, 51000 Rijeka, Hrvatska
Jasmina Kardoš ; Klinika za psihijatriju, Klinički bolnički centar Rijeka, Referentni centar za posttraumatski stresni poremećaj Ministarstva zdravstva Republike Hrvatske, Krešimirova 42, 51000 Rijeka, Hrvatska

* Dopisni autor.

Sažetak

Complex post-traumatic stress disorder (CPTSD)
is a more intricate form of post-traumatic psychopathology,
characterized by PTSD symptoms and
disturbances in self-organization, including emotional
dysregulation, negative self-concept, and
interpersonal difficulties. Among war veterans,
CPTSD occurs frequently, and a substantial number
of patients show a poor therapeutic response
to standard psychotherapeutic and pharmacological
interventions. Modular approaches, such as
ESTAIR (Enhanced Skills Training in Affective and
Interpersonal Regulation), have been developed with the aim of treating the more complex dimensions
of post-traumatic difficulties. The aim
of this study was to examine the feasibility and
effectiveness of a group-adapted ESTAIR program
in Croatian war veterans with long-term
and treatment-resistant CPTSD. A naturalistic,
non-randomized study was conducted over 14
months on a sample of 90 veterans assigned
to either the ESTAIR or the control group. The
group treatment included modules on emotion
regulation, self-concept, and interpersonal relationships
over 18 weeks, alongside standard psychiatric
care. Outcome assessment was carried
out using the ITQ, LEC-5, PHQ-9, GAD-7, and
AUDIT-C instruments before treatment, after
the intervention, and during follow-up. The results
showed a statistically significant reduction
in overall CPTSD symptoms, PTSD symptoms,
and disturbances in self-organization in the ESTAIR
group compared with the control group.
Significant group × time interactions were found
for PTSD (p = 0.042), disturbances in self-organization
(p = 0.006), and total ITQ score (p =
0.003), indicating more pronounced improvement
in the treatment group over time. The most
marked improvement was observed after the
module focused on self-concept. The dropout rate
was 4.3%, with good acceptability of the group
modular approach. No significant changes were
found in symptoms of depression, anxiety, or alcohol
use. Conclusion: The findings support the
use of modular and phase-oriented interventions
in the treatment of complex PTSD and point to
the potential of the ESTAIR approach in working
with veterans suffering from long-term, chronic
difficulties related to CPTSD.

Ključne riječi

psychotrauma; complex PTSD; ESTAIR; war veterans; modular psychotherapy

Hrčak ID:

352265

URI

https://hrcak.srce.hr/352265

Datum izdavanja:

15.6.2026.

Podaci na drugim jezicima: hrvatski

Posjeta: 0 *