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Artículos de revisión

Vol. 6 Núm. 15 (2026): Simbiosis, Revista de Educación y Psicología

Intervenciones de Tercera Generación en el Abordaje del Trauma Complejo: Una Revisión Sistemática

Third-wave interventions in the treatment of complex trauma: A systematic review
Publicado
2026-09-03

El trauma complejo, derivado de la exposición prolongada a eventos traumáticos interpersonales, representa un desafío significativo para la salud mental contemporánea. El objetivo fue analizar la eficacia y pertinencia de las terapias de tercera generación, específicamente la Terapia Dialéctico-Conductual (DBT), la Terapia de Aceptación y Compromiso (ACT) y las intervenciones basadas en mindfulness y compasión, en el abordaje del trauma complejo. Se realizó una revisión sistemática de la literatura, se consultaron PubMed, Scopus, Google Scholar, Latindex y Redalyc y se incluyeron 15 documentos publicados entre 2015 y 2025. La evidencia sugiere beneficios de estas intervenciones sobre la regulación emocional, el autoconcepto y las relaciones interpersonales, dimensiones centrales del TEPT-C. Se concluye que las terapias de tercera generación ofrecen un enfoque contextualizado y potencialmente útil, aunque se requieren más estudios específicos sobre TEPT-C y adaptación cultural.

Complex trauma, arising from prolonged exposure to interpersonal traumatic events, constitutes a significant challenge in contemporary mental health. This study aimed to analyze the efficacy and relevance of third-wave therapies-specifically Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and mindfulness- and compassion-based interventions-in addressing complex trauma. A systematic literature review was conducted, searching databases such as PubMed, Scopus, Google Scholar, Latindex, and Redalyc; 15 studies published between 2015 and 2025 were included. The evidence suggests that these interventions provide benefits in emotion regulation, self-concept, and interpersonal relationships, which are core dimensions of C-PTSD. In conclusion, third-wave therapies offer a contextualized and potentially effective approach, though further research focused specifically on C-PTSD and cultural adaptation is required.

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Artículos de revisión

Referencias

  1. Aravind, A., Agarwal, M., Malhotra, S., & Ayyub, S. (2025). Effectiveness of acceptance and commitment therapy on mental health issues: A systematic review. Annals of Neurosciences, 32(4), 321–327. https://doi.org/10.1177/09727531241300741
  2. Beaumont, E., & Hollins Martin, C. J. (2015). A narrative review exploring the effectiveness of compassion-focused therapy. Counselling Psychology Review, 30(1), 21–32. https://doi.org/10.53841/bpscpr.2015.30.1.21
  3. Billings, J., Greene, T., Kember, T., Grey, N., El-Leithy, S., Lee, D., & colleagues. (2020). Supporting hospital staff during COVID-19: Early interventions. Occupational Medicine, 70(5), 327–329. https://doi.org/10.1093/occmed/kqaa098
  4. Bohus, M., Kleindienst, N., Hahn, C., Müller-Engelmann, M., Ludäscher, P., Steil, R., Fydrich, T., Kuehner, C., Resick, P. A., Stiglmayr, C., Schmahl, C., & Priebe, K. (2020). Dialectical behavior therapy for posttraumatic stress disorder (DBT-PTSD) compared with cognitive processing therapy (CPT) in complex presentations of PTSD in women survivors of childhood abuse: A randomized clinical trial. JAMA Psychiatry, 77(12), 1235–1245. https://doi.org/10.1001/jamapsychiatry.2020.2148
  5. Boyd, J. E., Lanius, R. A., & McKinnon, M. C. (2018). Mindfulness-based treatments for posttraumatic stress disorder: A review of the treatment literature and neurobiological evidence. Journal of Psychiatry & Neuroscience, 43(1), 7–25. https://doi.org/10.1503/jpn.170021
  6. Cloitre, M., Courtois, C. A., Charuvastra, A., Carapezza, R., Stolbach, B. C., & Green, B. L. (2011). Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices. Journal of Traumatic Stress, 24(6), 615–627. https://doi.org/10.1002/jts.20697
  7. Courtois, C. A., & Ford, J. D. (Eds.). (2009). Treating complex traumatic stress disorders: An evidence-based guide. Guilford Press. https://books.google.com/books/about/Treating_Complex_Traumatic_Stress_Disord.html?id=D64qDQAAQBAJ
  8. DBT Iberoamérica. (s. f.). Formación en DBT y otras terapias contextuales. https://dbtiberoamerica.com/
  9. Del Castillo Drago, H., Bedoya Olaya, A. D., & Caballero Andrade, M. A. (2022). El trauma psicológico y las heridas afectivas: Una revisión sobre sus definiciones y abordajes para la clínica psicológica. Revista de Psicología, 11(2), 121–143. https://doi.org/10.36901/psicologia.v11i2.1401
  10. Eichfeld, C., Farrell, D., Mattheß, M., Bumke, P., Sodemann, U., Ean, N., Phoeun, B., Direzkia, Y., Firmansyah, F., Sumampouw, N. E. J., & Mattheß, H. (2019). Trauma stabilisation as a sole treatment intervention for post-traumatic stress disorder in Southeast Asia. Psychiatric Quarterly, 90(1), 63–88. https://doi.org/10.1007/s11126-018-9598-z
  11. Fiorillo, D., McLean, C., Pistorello, J., Hayes, S. C., & Follette, V. M. (2017). Evaluation of a web-based acceptance and commitment therapy program for women with trauma-related problems: A pilot study. Journal of Contextual Behavioral Science, 6(1), 104–113. https://doi.org/10.1016/j.jcbs.2016.11.003
  12. Frostadottir, A. D., & Dorjee, D. (2019). Effects of mindfulness based cognitive therapy (MBCT) and compassion focused therapy (CFT) on symptom change, mindfulness, self-compassion, and rumination in clients with depression, anxiety, and stress. Frontiers in Psychology, 10, Article 1099. https://doi.org/10.3389/fpsyg.2019.01099
  13. Gallo, G. G., Curado, D. F., Machado, M. P. A., Espíndola, M. I., Scattone, V. V., & Noto, A. R. (2023). A randomized controlled trial of mindfulness: Effects on university students’ mental health. International Journal of Mental Health Systems, 17, Article 32. https://doi.org/10.1186/s13033-023-00604-8
  14. Gilbert, P. (2010). Compassion focused therapy: Distinctive features. Routledge. https://doi.org/10.4324/9780203851197
  15. Harned, M. S., Schmidt, S. C., Korslund, K. E., & Gallop, R. J. (2021). Does adding the dialectical behavior therapy prolonged exposure (DBT PE) protocol for PTSD to DBT improve outcomes in public mental health settings? A pilot nonrandomized effectiveness trial with benchmarking. Behavior Therapy, 52(3), 639–655. https://doi.org/10.1016/j.beth.2020.08.003
  16. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press. https://books.google.com/books?vid=ISBN1572304812
  17. Herman, J. L. (1992). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. Basic Books. https://books.google.com/books/about/Trauma_and_recovery.html?id=tOFGAAAAMAAJ
  18. Hilton, L., Maher, A. R., Colaiaco, B., Apaydin, E., Sorbero, M. E., Booth, M., Shanman, R. M., & Hempel, S. (2017). Meditation for posttraumatic stress: Systematic review and meta-analysis. Psychological Trauma: Theory, Research, Practice, and Policy, 9(4), 453–460. https://doi.org/10.1037/tra0000180
  19. Jasbi, M., Sadeghi Bahmani, D., Karami, G., Omidbeygi, M., Peyravi, M., Panahi, A., Mirzaee, J., Holsboer-Trachsler, E., & Brand, S. (2018). Influence of adjuvant mindfulness-based cognitive therapy (MBCT) on symptoms of post-traumatic stress disorder (PTSD) in veterans: Results from a randomized control study. Cognitive Behaviour Therapy, 47(5), 431–446. https://doi.org/10.1080/16506073.2018.1445773
  20. Kamstra, A. C., de Vries, S. O., Brilman, M. F., Vasilev, P., Alma, M. A., van Asselt, A. D. I., De Wolf, M., Schoevers, R. A., & Jörg, F. (2025). Inpatient dialectical behavior therapy combined with trauma-focused therapy for PTSD and borderline personality disorder symptoms: Study design of the naturalistic trauma therapy study. Frontiers in Psychiatry, 16, Article 1538267. https://doi.org/10.3389/fpsyt.2025.1538267
  21. Karatzias, T., Shevlin, M., Fyvie, C., Hyland, P., Efthymiadou, E., Wilson, D., Roberts, N. P., Bisson, J. I., Brewin, C. R., & Cloitre, M. (2017). Evidence of distinct profiles of posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) based on the new ICD-11 Trauma Questionnaire (ICD-TQ). Journal of Affective Disorders, 207, 181–187. https://doi.org/10.1016/j.jad.2016.09.032
  22. Kelly, M. M., Reilly, E. D., Ameral, V., Richter, S., & Fukuda, S. (2022). A randomized pilot study of acceptance and commitment therapy to improve social support for veterans with PTSD. Journal of Clinical Medicine, 11(12), Article 3482. https://doi.org/10.3390/jcm11123482
  23. Lecannelier, F., Guajardo, H., Kushner, D., Barrientos, C., & Monje, G. (2021). La complejidad del trauma complejo del desarrollo: Una propuesta del modelo de apego y complejidad (MAC). Revista de Psicoterapia, 32(120), 105–124. https://doi.org/10.33898/rdp.v32i120.463
  24. Liu, Q., Zhu, J., & Zhang, W. (2022). The efficacy of mindfulness-based stress reduction intervention 3 for post-traumatic stress disorder (PTSD) symptoms in patients with PTSD: A meta-analysis of four randomized controlled trials. Stress and Health, 38(4), 626–636. https://doi.org/10.1002/smi.3138
  25. Luo, X., Che, X., Lei, Y., & Li, H. (2021). Investigating the influence of self-compassion-focused interventions on posttraumatic stress: A systematic review and meta-analysis. Mindfulness, 12(12), 2865–2876. https://doi.org/10.1007/s12671-021-01732-3
  26. Organización Mundial de la Salud. (2022). Clasificación Internacional de Enfermedades para estadísticas de mortalidad y morbilidad (11.ª revisión). https://icd.who.int/browse11/l-m/es
  27. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
  28. Polusny, M. A., Erbes, C. R., Thuras, P., Moran, A., Lamberty, G. J., Collins, R. C., Rodman, J. L., & Lim, K. O. (2015). Mindfulness-based stress reduction for posttraumatic stress disorder among veterans: A randomized clinical trial. JAMA, 314(5), 456–465. https://doi.org/10.1001/jama.2015.8361
  29. Prillinger, K., Goreis, A., Macura, S., Hajek Gross, C., Lozar, A., Fanninger, S., Mayer, A., Oppenauer, C., Plener, P. L., & Kothgassner, O. D. (2024). A systematic review and meta-analysis on the efficacy of dialectical behavior therapy variants for the treatment of post-traumatic stress disorder. European Journal of Psychotraumatology, 15(1), Article 2406662. https://doi.org/10.1080/20008066.2024.2406662
  30. Rowe-Johnson, M. K., Browning, B., & Scott, B. (2025). Effects of acceptance and commitment therapy on trauma-related symptoms: A systematic review and meta-analysis. Psychological Trauma: Theory, Research, Practice, and Policy, 17(3), 668–675. https://doi.org/10.1037/tra0001785
  31. Toledo Sisalima, J. A., & Luzuriaga Mera, J. (2024). Adicción sexual y trauma psicológico: Orientaciones para el abordaje psicoterapéutico. Revista Ecuatoriana de Psicología, 7(18), 220–237. https://doi.org/10.33996/repsi.v7i18.120
  32. Valdez, C. R., Brabeck, K. M., Barajas-Gonzalez, R. G., Ayón, C., & Rojas-Flores, L. (2024). Sociopolitically and trauma-informed public health practice with Latinx families: Conceptual framework and best practices. American Journal of Public Health, 114(S6), S485–S494. https://doi.org/10.2105/AJPH.2024.307589
  33. Vonderlin, R., Priebe, K., Müller-Engelmann, M., Fydrich, T., Steil, R., Resick, P. A., Schmahl, C., Lindauer, P., Kleindienst, N., & Bohus, M. (2024). Long-term effects of dialectical behaviour therapy for posttraumatic stress disorder and cognitive processing therapy 9 months after treatment termination. European Journal of Psychotraumatology, 15(1), Article 2393061. https://doi.org/10.1080/20008066.2024.2393061