Managing delayed-onset post-traumatic stress disorder triggered by the Syrian war, COVID-19, and an earthquake: A case report on therapy for a sexual abuse survivor using continuous exposure and digital communication

A clinically significant number of patients suffer from delayed-onset post-traumatic stress disorder (delayed-onset PTSD), where symptoms appear at least six months after the traumatic event. This case report describes the combined use of pharmacotherapy with cognitive‒behavioral therapy (CBT) and N...

Full description

Saved in:
Bibliographic Details
Main Authors: Hussam Gharib, Mohamed Bassam Hayek, Ahmad Shathel Omar Dakkak, Rana Khaled, Salam Alchabani, Aya Rajoub, Mohamad Sami Mawardi, Reem Hasan Obaydo
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:SSM - Mental Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666560325000234
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849335888410050560
author Hussam Gharib
Mohamed Bassam Hayek
Ahmad Shathel Omar Dakkak
Rana Khaled
Salam Alchabani
Aya Rajoub
Mohamad Sami Mawardi
Reem Hasan Obaydo
author_facet Hussam Gharib
Mohamed Bassam Hayek
Ahmad Shathel Omar Dakkak
Rana Khaled
Salam Alchabani
Aya Rajoub
Mohamad Sami Mawardi
Reem Hasan Obaydo
author_sort Hussam Gharib
collection DOAJ
description A clinically significant number of patients suffer from delayed-onset post-traumatic stress disorder (delayed-onset PTSD), where symptoms appear at least six months after the traumatic event. This case report describes the combined use of pharmacotherapy with cognitive‒behavioral therapy (CBT) and Narrative Exposure Therapy (NET) to treat symptoms of delayed-onset PTSD in a young Syrian girl who experienced recurring flashbacks of repeated sexual abuse that began several years prior. The death of her brother, the COVID-19 pandemic, and a subsequent earthquake in Aleppo-Syria at 2023 triggered memories of prolonged physical abuse, that were not contextually related. The patient coped with these distressing memories and unwanted thoughts through behavioral avoidance. She received treatment through psychiatric clinic sessions, and WhatsApp communication (due to confidentiality concerns), combining pharmacological therapy with psychological support. The treatment included cognitive restructuring, narrative exposure, and identifying triggers, leading to the reprocessing of trauma-related memories. Her PTSD symptoms reached a non-observable stage of PTSD, even when she was confronted with thoughts or contextual situations.
format Article
id doaj-art-0762556804ff4a7c8d35d7a254a92dcd
institution Kabale University
issn 2666-5603
language English
publishDate 2025-06-01
publisher Elsevier
record_format Article
series SSM - Mental Health
spelling doaj-art-0762556804ff4a7c8d35d7a254a92dcd2025-08-20T03:45:08ZengElsevierSSM - Mental Health2666-56032025-06-01710041110.1016/j.ssmmh.2025.100411Managing delayed-onset post-traumatic stress disorder triggered by the Syrian war, COVID-19, and an earthquake: A case report on therapy for a sexual abuse survivor using continuous exposure and digital communicationHussam Gharib0Mohamed Bassam Hayek1Ahmad Shathel Omar Dakkak2Rana Khaled3Salam Alchabani4Aya Rajoub5Mohamad Sami Mawardi6Reem Hasan Obaydo7Department of Pharmacology, Faculty of Pharmacy, Ebla Private University, 22743, Idlib, Syria; Corresponding author. Pharmacology, Faculty of Pharmacy, Ebla Private University, Syria.Department of Neurology, Ibn Khaldun Hospital for Mental and Psychiatric Diseases, Aleppo, SyriaDepartment of Psychiatry and Behavioral Sciences, Ibn Khaldun Hospital for Mental and Psychiatric Diseases, Aleppo, SyriaGraduated from the Faculty of Pharmacy, Ebla Private University, Idlib, SyriaGraduated from the Faculty of Pharmacy, Ebla Private University, Idlib, SyriaGraduated from the Faculty of Pharmacy, Ebla Private University, Idlib, SyriaGraduated from the Faculty of Pharmacy, Ebla Private University, Idlib, SyriaDepartment of Analytical and Food Chemistry, Faculty of Pharmacy, Ebla Private University, 22743, Idlib, Syria; Corresponding author. Analytical Chemistry, Faculty of Pharmacy, Ebla Private University, Syria.A clinically significant number of patients suffer from delayed-onset post-traumatic stress disorder (delayed-onset PTSD), where symptoms appear at least six months after the traumatic event. This case report describes the combined use of pharmacotherapy with cognitive‒behavioral therapy (CBT) and Narrative Exposure Therapy (NET) to treat symptoms of delayed-onset PTSD in a young Syrian girl who experienced recurring flashbacks of repeated sexual abuse that began several years prior. The death of her brother, the COVID-19 pandemic, and a subsequent earthquake in Aleppo-Syria at 2023 triggered memories of prolonged physical abuse, that were not contextually related. The patient coped with these distressing memories and unwanted thoughts through behavioral avoidance. She received treatment through psychiatric clinic sessions, and WhatsApp communication (due to confidentiality concerns), combining pharmacological therapy with psychological support. The treatment included cognitive restructuring, narrative exposure, and identifying triggers, leading to the reprocessing of trauma-related memories. Her PTSD symptoms reached a non-observable stage of PTSD, even when she was confronted with thoughts or contextual situations.http://www.sciencedirect.com/science/article/pii/S2666560325000234Delayed-onset PTSDcognitive‒behavioral therapyContinuous exposureSexual harassmentWhatsApp communicationCase report
spellingShingle Hussam Gharib
Mohamed Bassam Hayek
Ahmad Shathel Omar Dakkak
Rana Khaled
Salam Alchabani
Aya Rajoub
Mohamad Sami Mawardi
Reem Hasan Obaydo
Managing delayed-onset post-traumatic stress disorder triggered by the Syrian war, COVID-19, and an earthquake: A case report on therapy for a sexual abuse survivor using continuous exposure and digital communication
SSM - Mental Health
Delayed-onset PTSD
cognitive‒behavioral therapy
Continuous exposure
Sexual harassment
WhatsApp communication
Case report
title Managing delayed-onset post-traumatic stress disorder triggered by the Syrian war, COVID-19, and an earthquake: A case report on therapy for a sexual abuse survivor using continuous exposure and digital communication
title_full Managing delayed-onset post-traumatic stress disorder triggered by the Syrian war, COVID-19, and an earthquake: A case report on therapy for a sexual abuse survivor using continuous exposure and digital communication
title_fullStr Managing delayed-onset post-traumatic stress disorder triggered by the Syrian war, COVID-19, and an earthquake: A case report on therapy for a sexual abuse survivor using continuous exposure and digital communication
title_full_unstemmed Managing delayed-onset post-traumatic stress disorder triggered by the Syrian war, COVID-19, and an earthquake: A case report on therapy for a sexual abuse survivor using continuous exposure and digital communication
title_short Managing delayed-onset post-traumatic stress disorder triggered by the Syrian war, COVID-19, and an earthquake: A case report on therapy for a sexual abuse survivor using continuous exposure and digital communication
title_sort managing delayed onset post traumatic stress disorder triggered by the syrian war covid 19 and an earthquake a case report on therapy for a sexual abuse survivor using continuous exposure and digital communication
topic Delayed-onset PTSD
cognitive‒behavioral therapy
Continuous exposure
Sexual harassment
WhatsApp communication
Case report
url http://www.sciencedirect.com/science/article/pii/S2666560325000234
work_keys_str_mv AT hussamgharib managingdelayedonsetposttraumaticstressdisordertriggeredbythesyrianwarcovid19andanearthquakeacasereportontherapyforasexualabusesurvivorusingcontinuousexposureanddigitalcommunication
AT mohamedbassamhayek managingdelayedonsetposttraumaticstressdisordertriggeredbythesyrianwarcovid19andanearthquakeacasereportontherapyforasexualabusesurvivorusingcontinuousexposureanddigitalcommunication
AT ahmadshathelomardakkak managingdelayedonsetposttraumaticstressdisordertriggeredbythesyrianwarcovid19andanearthquakeacasereportontherapyforasexualabusesurvivorusingcontinuousexposureanddigitalcommunication
AT ranakhaled managingdelayedonsetposttraumaticstressdisordertriggeredbythesyrianwarcovid19andanearthquakeacasereportontherapyforasexualabusesurvivorusingcontinuousexposureanddigitalcommunication
AT salamalchabani managingdelayedonsetposttraumaticstressdisordertriggeredbythesyrianwarcovid19andanearthquakeacasereportontherapyforasexualabusesurvivorusingcontinuousexposureanddigitalcommunication
AT ayarajoub managingdelayedonsetposttraumaticstressdisordertriggeredbythesyrianwarcovid19andanearthquakeacasereportontherapyforasexualabusesurvivorusingcontinuousexposureanddigitalcommunication
AT mohamadsamimawardi managingdelayedonsetposttraumaticstressdisordertriggeredbythesyrianwarcovid19andanearthquakeacasereportontherapyforasexualabusesurvivorusingcontinuousexposureanddigitalcommunication
AT reemhasanobaydo managingdelayedonsetposttraumaticstressdisordertriggeredbythesyrianwarcovid19andanearthquakeacasereportontherapyforasexualabusesurvivorusingcontinuousexposureanddigitalcommunication