Cognitive ego-disturbances in the elderly who have become victims of organized violence

It is not easy to diagnose the sequelae of organized violence as they might become manifest at older age. The concept of Posttraumatic Stress Disorder (PTSD) gives to little to hang on. A more specific diagnosis such as the D ESNOS (Disorders of Extreme Stress Not Otherwise Specified) which was propo sed for (but not included in) the DSM IV is lacking. In the ICD-10 we find the diagnosis "Durable personality changes after catastrofic experiences" b ased on five global criteria which are not validated yet. From a clinical p oint of view there is a need for a testable and operational concept of the enduring posttraumatic personality changes. The concept of the posttraumati c self disorder is chosen here. It consists of disorders of the physical se lf the abject relational self and the historical self. In this article the historical self is described in more detail. Different empirical findings a re discussed to illustrate that experience of one's own life history might be disturbed after having been submitted to organized violence. This can le ad to serious complaints and functional psychological interferences. Self d isorders are part of these late and durable posttraumatic phenomenology.