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Bachem R, Maercker A, Levin Y, Köhler K, Willmund G, Bohus M, Koglin S, Roepke S, Schoofs N, Priebe K, Wülfing F, Schmahl C, Stadtmann MP, Rau H, Augsburger M. Assessing complex PTSD and PTSD: validation of the German version of the International Trauma Interview (ITI). Eur J Psychotraumatol 2024; 15:2344364. [PMID: 38687289 PMCID: PMC11062267 DOI: 10.1080/20008066.2024.2344364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 04/08/2024] [Indexed: 05/02/2024] Open
Abstract
Background: With the introduction of the ICD-11 into clinical practice, the reliable distinction between Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) becomes paramount. The semi-structured clinician-administered International Trauma Interview (ITI) aims to close this gap in clinical and research settings.Objective: This study investigated the psychometric properties of the German version of the ITI among trauma-exposed clinical samples from Switzerland and Germany.Method: Participants were 143 civilian and 100 military participants, aged M = 40.3 years, of whom 53.5% were male. Indicators of reliability and validity (latent structure, internal reliability, inter-rater agreement, convergent and discriminant validity) were evaluated. Confirmatory factor analysis (CFA) and partial correlation analysis were conducted separately for civilian and military participants.Results: Prevalence of PTSD was 30% (civilian) and 33% (military) and prevalence of CPTSD was 53% (civilians) and 21% (military). Satisfactory internal consistency and inter-rater agreement were found. In the military sample, a parsimonious first-order six-factor model was preferred over a second-order two-factor CFA model of ITI PTSD and Disturbances in Self-Organization (DSO). Model fit was excellent among military participants but no solution was supported among civilian participants. Overall, convergent validity was supported by positive correlations of ITI PTSD and DSO with DSM-5 PTSD. Discriminant validity for PTSD symptoms was confirmed among civilians but low in the military sample.Conclusions: The German ITI has shown potential as a clinician-administered diagnostic tool for assessing ICD-11 PTSD and CPTSD in primary care. However, further exploration of its latent structure and discriminant validity are indicated.
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Affiliation(s)
- Rahel Bachem
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | - Yafit Levin
- School of Social Work, Ariel University, Ariel, Israel
| | - Kai Köhler
- Bundeswehr Center for Military Mental Health, Berlin, Germany
| | - Gerd Willmund
- Bundeswehr Center for Military Mental Health, Berlin, Germany
| | - Martin Bohus
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
| | - Stefanie Koglin
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Roepke
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Nikola Schoofs
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Kathlen Priebe
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Felix Wülfing
- Department of Psychiatry and Neurosciences, Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
| | - Manuel P. Stadtmann
- Eastern Switzerland University of Applied Sciences, Competence Centre for Mental Health, St. Gallen, Switzerland
| | - Heinrich Rau
- Bundeswehr Center for Military Mental Health, Berlin, Germany
| | - Mareike Augsburger
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
- Klenico Health AG, University of Zurich startup, Zürich, Switzerland
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Bachem R, Mazza A, Eberle DJ, Maercker A. A new approach to cultural scripts of trauma sequelae assessment: The sample case of Switzerland. PLoS One 2024; 19:e0301645. [PMID: 38626140 PMCID: PMC11020718 DOI: 10.1371/journal.pone.0301645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/19/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND The novel concept of cultural scripts of trauma sequelae captures culture-specific expressions of posttraumatic distress (e.g., cognitive, emotional, interpersonal, psychosomatic changes) and their temporal associations. Cultural scripts of trauma sequelae complement pan-cultural (etic) diagnoses, such as posttraumatic stress disorder (PTSD) and Complex PTSD, as well as the cultural syndromes concept. OBJECTIVE This study aimed to develop the cultural scripts of trauma inventory (CSTI) for German-speaking Switzerland and to explore temporal associations of script elements. METHOD Five semi-structured focus groups were conducted with psychotraumatologists (n = 8) and Swiss trauma survivors (n = 7). The interview schedule included open questions about different domains of potential posttraumatic changes (emotions, cognitions, worldviews, interpersonal relationships, body-related experiences, behavior, and growth). Data were analyzed using qualitative content analysis. RESULTS The Swiss CSTI includes 57 emic elements that represent salient trauma sequelae (30 conformed with a theoretically derived item pool, 27 were newly phrased). Temporal script associations were visualized in a network, whereby self-deprecation, the urge to function and overcompensate, and the urge to hide and endure suffering had the highest number of connections. CONCLUSION While many posttraumatic changes identified in the present work seem to mirror pan-cultural phenomena represented in the Complex PTSD concept (e.g., self-deprecation), others (e.g., urge to function and perform, urge to hide and endure suffering) may be prominently related to Swiss culture with its value orientations. Knowledge about cultural scripts of trauma sequelae may provide a culture-specific framework that can help to understand individual experiences of distress and enable mental health practitioners to administer culturally sensitive interventions. Pending further validation, the Swiss CSTI bears the potential to advance culture-sensitive assessment of trauma sequelae.
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Affiliation(s)
- Rahel Bachem
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Amelie Mazza
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - David J. Eberle
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
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Mutuyimana C, Maercker A. How meaning in life and vitality are associated with posttrauma outcomes: A systematic review. J Trauma Stress 2024. [PMID: 38580621 DOI: 10.1002/jts.23040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 04/07/2024]
Abstract
When confronted with a traumatic event, people may suffer from adverse posttraumatic outcomes, such as posttraumatic stress disorder (PTSD) or complex PTSD (CPTSD). Positive psychology research has shown that meaning in life and vitality are potentially correlated protective factors against negative developments following trauma exposure that can lead to PTSD or CPTSD. This systematic review aimed to synthesize global empirical research findings, emphasizing the impact of meaning in life and vitality on both PTSD and CPTSD. A search of empirical studies was performed within the Embase, Scopus, and Web of Science core collection databases, as well as PsycInfo, using the PRISMA checklist. A total of 29 studies were included after a systematic exclusion process. The collective findings from 22 studies examining meaning in life and five studies focusing on vitality revealed a consistent negative association with symptoms of PTSD. No study that explored the associations among meaning in life, vitality, and CPTSD was found. In contrast to vitality, meaning in life has been extensively studied in relation to traumatic stress worldwide, and few discrepancies in results were found. This systematic review identified the need to intensify scientific efforts in capitalizing on meaning in life as a possible target for psychological interventions, especially for trauma survivors globally, and to consider vitality as a protective factor that needs more empirical attention in relation to posttraumatic stress. Furthermore, there is a need for studies that encompass diverse target samples and employ longitudinal study design to examine the associations between protective factors and CPTSD.
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Affiliation(s)
- Celestin Mutuyimana
- Division of Psychopathology and Clinical Intervention, Institute of Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- Collegium Helveticum, Switzerland
| | - Andreas Maercker
- Division of Psychopathology and Clinical Intervention, Institute of Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
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Maercker A, Bachem R, Mutuyimana C, Eberle D. [Toward Cultural Scripts of Trauma Sequelae]. Psychother Psychosom Med Psychol 2024. [PMID: 38580308 DOI: 10.1055/a-2276-4992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
BACKGROUND The concept of cultural scripts has proven to be very useful for describing depression-like psychological complaints in different cultural regions of the world. The article presents the galaxy model and its implementation in the model of cultural scripts theoretically for the first time and connects these with cultural psychological value research. A new, extensive series of research projects aims to investigate post-trauma -related psychological complaints in various regions of the world. METHODS The work in two countries/regions began with focus groups in which elements of cultural scripts were collected by traumatized clients and/or by (therapeutic) experts. For this purpose, a theory-based framework of possible post-traumatic script elements was provided. In Switzerland, focus groups were conducted with patients and experts. Focus groups were conducted with genocide survivors and other trauma victims in Rwanda and three East African countries. The evaluation was semi-quantitative. RESULTS In Switzerland, around 50 symptoms and changes were mentioned as script elements (e. g. still having to function). Approximately 100 symptoms and changes were mentioned as script elements in East Africa (e. g. loss of dignity). The first temporal connections (i. e. strong scripts) were found for the Swiss scripts (e. g. self-devaluation - urge to function). In the East African study, cultural value orientations underlying the script groupings were also assessed (e. g. community reputation). DISCUSSION The illustrative results presented here demonstrate the galaxy model and the suitability of the cultural script concept for recording the effects of trauma. There are differences and similarities in the two world regions examined so far. Further steps at the two study sites will be the temporal connections and the relationships to value orientations. The studies will be started at the other study sites in the following years.
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Affiliation(s)
- Andreas Maercker
- Psychopathologie und Klinische Intervention, Universität Zürich, Schweiz
| | - Rahel Bachem
- Psychopathologie und Klinische Intervention, Universität Zürich, Schweiz
| | | | - David Eberle
- Psychopathologie und Klinische Intervention, Universität Zürich, Schweiz
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Dworschak C, Heim E, Kuhn N, Schwager J, Tröster A, Maercker A. User-centered development of an internet-based CBT intervention for the treatment of loneliness in older individuals. Internet Interv 2024; 35:100720. [PMID: 38328277 PMCID: PMC10847952 DOI: 10.1016/j.invent.2024.100720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/18/2023] [Accepted: 01/30/2024] [Indexed: 02/09/2024] Open
Abstract
Background Loneliness is a widespread phenomenon associated with a number of negative health outcomes. Older individuals may constitute one important target group with a need for effective interventions. However, despite evidence showing that addressing maladaptive social cognition (e.g., via cognitive behavioral therapy [CBT]) is the most effective intervention strategy for reducing loneliness, most existing programs aimed at older individuals do not use that method. Further, in terms of mental health service use, older individuals have been found to be an extremely undertreated population. When developing interventions, active involvement of end users in the development process is essential to increase later uptake. Objective The aim of the present study was to develop an internet-based CBT intervention for loneliness in older individuals (i.e., aged ≥65 years) applying a user-centered design. The present report provides an in-depth description of the development process. Methods Two phases of qualitative data collection were conducted in parallel with intervention development using a sample of N = 12 participants including both potential end users (i.e., older adults) as well as experts (i.e., psychotherapists). Measures included semi-structured interviews and usability testing. Results In Phase 1 interviews, participants indicated that they were predominantly positive about the idea of an internet-based program for loneliness targeting older individuals. Individualization and interactivity were named as crucial features. In Phase 2, usability testing of a prototype program provided important insights into technical barriers to intervention use. Further, participants reported that they were missing content on philosophy/theology and the role of descendants/relatives. Valuable insights from Phase 1 and Phase 2 were incorporated into the intervention program resulting in a 7-module internet-based self-help CBT intervention. Discussion Findings of this study highlight the significance of including relevant stakeholders in the development process of an intervention. Additionally, results emphasize the high acceptance of internet-based interventions in this population, but also underline the need for considering age-specific aspects when developing treatments.
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Affiliation(s)
- Christine Dworschak
- University of Zurich, Department of Psychology, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Switzerland
| | - Eva Heim
- University of Lausanne, Department of Psychology, Quartier UNIL-Mouline, 1015 Lausanne, Switzerland
| | - Nadine Kuhn
- University of Zurich, Department of Psychology, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
| | - Jessica Schwager
- University of Zurich, Department of Psychology, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
| | - Alicia Tröster
- University of Zurich, Department of Psychology, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
| | - Andreas Maercker
- University of Zurich, Department of Psychology, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Switzerland
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Kleva CS, Keeley JW, Evans SC, Maercker A, Cloitre M, Brewin CR, Roberts M, Reed GM. Examining accurate diagnosis of complex PTSD in ICD-11. J Affect Disord 2024; 346:110-114. [PMID: 37918575 DOI: 10.1016/j.jad.2023.10.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/13/2023] [Accepted: 10/21/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Complex posttraumatic stress disorder (complex PTSD), the most frequently suggested new category for inclusion by mental health professionals, has been included in the Eleventh Revision of the World Health Organization's International Classification of Diseases (ICD-11). Research has yet to explore whether clinicians' recognition of the distinct complex PTSD symptoms predicts giving the correct diagnosis. The present study sought to determine if international mental health professionals were able to accurately diagnose complex PTSD and identify the shared PTSD features and three essential diagnostic features, specific to complex PTSD. METHODS Participants were randomly assigned to view two vignettes and tasked with providing a diagnosis (or indicating that no diagnosis was warranted). Participants then answered a series of questions regarding the presence or absence of each of the essential diagnostic features specific to the diagnosis they provided. RESULTS Clinicians who recognized the presence or absence of complex PTSD specific features were more likely to arrive at the correct diagnostic conclusion. Complex PTSD specific features were significant predictors while the shared PTSD features were not, indicating that attending to each of the specific symptoms was necessary for diagnostic accuracy of complex PTSD. LIMITATIONS The use of written case vignettes including only adult patients and a non-representative sample of mental health professionals may limit the generalizability of the results. CONCLUSIONS Findings support mental health professionals' ability to accurately identify specific features of complex PTSD. Future work should assess whether mental health providers can effectively identify symptoms of complex PTSD in a clinical setting.
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Affiliation(s)
- Christopher S Kleva
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Spencer C Evans
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Andreas Maercker
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Marylene Cloitre
- National Center for PTSD, Division of Dissemination and Training, VA Palo Alto Health Care System, CA, USA; Department of Psychiatry and Behavioral Sciences, Standford University, Stanford, CA, USA
| | - Chris R Brewin
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Michael Roberts
- Office of Graduate Studies and Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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Rusmir M, Rohner SL, Maercker A, Salas Castillo AN, Thoma MV. Predictors and (in-)stability of ICD-11 complex posttraumatic stress disorder in older adults: findings from a longitudinal study in Switzerland. Eur J Psychotraumatol 2024; 15:2299618. [PMID: 38258813 PMCID: PMC10810634 DOI: 10.1080/20008066.2023.2299618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Objective: There is a lack of research on complex post-traumatic stress disorder (CPTSD) in older individuals, with little known about the temporal course of CPTSD. Therefore, this study assessed and compared the demographic characteristics, adverse childhood experiences (ACE), and well-being of Swiss older adults with and without probable CPTSD. The (in-)stability of probable CPTSD was also examined in relation to the predictive value of various emotion-related factors.Methods: A longitudinal study was conducted in Switzerland with N = 213 participants (Mage = 69.98 years, SD = 10.61; 45.5% female). Data was collected via face-to-face assessments at baseline and follow-up, 21 months apart. The German version of the International Trauma Questionnaire was used to screen for (C)PTSD. Standardized instruments were used to assess ACE as well as the predictors anger, embitterment, emotion regulation, and meaning in life.Results: From the total sample, n = 16 participants (7.5%) were identified as having probable CPTSD, with only five of these (31.25%) having probable CPTSD at both baseline and follow-up. Individuals with and without probable CPTSD differed significantly regarding age and employment status. Significant predictors of probable CPTSD were anger (β = 0.16), embitterment (β = 0.06), cognitive reappraisal (β = -0.41), and the presence of meaning in life (β = -0.10).Conclusions: Probable CPTSD appears to be relatively unstable over the course of a 21-month period in older individuals. The links between CPTSD and emotion-related predictors highlight potential targets for intervention.
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Affiliation(s)
- Milan Rusmir
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Shauna L. Rohner
- Competence Centre for Mental Health, Department of Health, OST – University of Applied Sciences of Eastern Switzerland, St. Gallen, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
| | - Aileen N. Salas Castillo
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
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Sabé M, Chen C, El-Hage W, Leroy A, Vaiva G, Monari S, Premand N, Bartolomei J, Caiolo S, Maercker A, Pietrzak RH, Cloître M, Kaiser S, Solmi M. Half a Century of Research on Posttraumatic Stress Disorder: A Scientometric Analysis. Curr Neuropharmacol 2024; 22:736-748. [PMID: 37888890 PMCID: PMC10845098 DOI: 10.2174/1570159x22666230927143106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 10/28/2023] Open
Abstract
We conducted a scientometric analysis to outline clinical research on posttraumatic stress disorder (PTSD). Our primary objective was to perform a broad-ranging scientometric analysis to evaluate key themes and trends over the past decades. Our secondary objective was to measure research network performance. We conducted a systematic search in the Web of Science Core Collection up to 15 August 2022 for publications on PTSD. We identified 42,170 publications published between 1945 and 2022. We used CiteSpace to retrieve the co-cited reference network (1978-2022) that presented significant modularity and mean silhouette scores, indicating highly credible clusters (Q = 0.915, S = 0.795). Four major trends of research were identified: 'war veterans and refugees', 'treatment of PTSD/neuroimaging', 'evidence syntheses', and 'somatic symptoms of PTSD'. The largest cluster of research concerned evidence synthesis for genetic predisposition and environmental exposures leading to PTSD occurrence. Research on war-related trauma has shifted from battlefield-related in-person exposure trauma to drone operator trauma and is being out published by civilian-related trauma research, such as the 'COVID-19' pandemic impact, 'postpartum', and 'grief disorder'. The focus on the most recent trends in the research revealed a burst in the 'treatment of PTSD' with the development of Mhealth, virtual reality, and psychedelic drugs. The collaboration networks reveal a central place for the USA research network, and although relatively isolated, a recent surge of publications from China was found. Compared to other psychiatric disorders, we found a lack of high-quality randomized controlled trials for pharmacological and nonpharmacological treatments. These results can inform funding agencies and future research.
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Affiliation(s)
- Michel Sabé
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland
| | - Chaomei Chen
- College of Computing & Informatics, Drexel University, Philadelphia, PA, USA
| | - Wissam El-Hage
- CHRU de Tours, Clinique Psychiatrique Universitaire, Centre Régional de Psychotraumatologie CVL, 37540 Saint-Cyr-sur-Loire, France; UMR 1253, iBrain, INSERM, Université de Tours, 37000 Tours, France
| | - Arnaud Leroy
- Univ Lille, INSERM, Lille Neuroscience & Cognition Centre (U-1172), Plasticity & SubjectivitY Team, CHU Lille, Fontan Hospital, General Psychiatry Department & Centre National de Ressources et Résilience Pour les Psychotraumatismes (CN2R Lille - Paris), 59000 Lille, France
| | - Guillaume Vaiva
- CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Department of Psychiatry, Univ. Lille, F-59000, Lille, France
| | - Silvia Monari
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland
| | - Natacha Premand
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland
| | - Javier Bartolomei
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland
| | - Stefano Caiolo
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Andreas Maercker
- Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | - Robert H. Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Health Care System, West Haven, Connecticut, USA
| | - Marylène Cloître
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, USA; and Department of Psychiatry and Behavioral Sciences, Stanford University, USA
| | - Stefan Kaiser
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada
- Department of Mental Health, The Ottawa Hospital, Ontario, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ontario, Ottawa
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Department of Child and Adolescent Psychiatry, Charité Universit¨atsmedizin, Berlin, Germany
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Thoma MV, Salas Castillo AN, Maercker A. [Psychotherapy for elderly patients]. Psychother Psychosom Med Psychol 2023; 73:516-528. [PMID: 38048814 DOI: 10.1055/a-1993-9570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
A particular feature of the demographic change is the growing proportion of elderly and very elderly people. In Western countries, this is largely due to improved medical care for age-associated diseases. There is still comparatively little knowledge about mental health disorders in old age, their age-typical clinical presentation and specific psychotherapeutic treatment.
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Abstract
This study investigated the association between prolonged grief (PG) severity and meaning-making narration in a cross-cultural context, and specifically aimed to illustrate the role of value orientation in shaping the grieving process. 30 Chinese and 22 Swiss parents who lost their child were asked to narrate and appraise specific memories to reflect their self-evaluation of traditional and modern values. The self-reported Prolonged Grief Disorder Scale (ref ICD-11) assessed PG severity. Compared with the Swiss sample, the Chinese sample provided more elaborated memories, which was not associated with symptom severity. Both Chinese and Swiss bereaved parents with more severe PG provided more narratives of loss-related memories, particularly in response to modern values. They also provided more appraisals of negative meanings for self-defining memories, particularly in relation to their traditional values. These findings indicate that, despite cultural differences in narration tendency, PG severity in bereaved parents was associated with the maladaptive integration of autobiographical memories across different cultures, in relation to value orientations. A clinical implication is the potential value of facilitating narrations of grieving clients that center on value orientations to mitigate the hardship of the personal loss.
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Affiliation(s)
- Daiming Xiu
- University of Zurich
- The University of Hong Kong
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11
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Pandi-Perumal SR, van de Put WACM, Maercker A, Hobfoll SE, Mohan Kumar V, Barbui C, Mahalaksmi AM, Chidambaram SB, Lundmark PO, Khai TS, Atwoli L, Poberezhets V, Rajesh Kumar R, Madoro D, Andrés Marín Agudelo H, Hoole SRH, Teixeira-Santos L, Pereira P, Saravanan KM, Vrdoljak A, Meira E Cruz M, Ramasubramanian C, Tay AK, Grønli J, Sijbrandij M, Sivasubramaniam S, Narasimhan M, Mbong EN, Jansson-Fröjmark M, Bjorvatn B, de Jong JTVM, Braakman MH, Eisenbruch M, Acuña-Castroviejo D, van der Velden K, Brown GM, Partinen M, McFarlane AC, Berk M. Harbingers of Hope: Scientists and the Pursuit of World Peace. Clin Psychol Eur 2023; 5:e13197. [PMID: 38357426 PMCID: PMC10863676 DOI: 10.32872/cpe.13197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
The ongoing wars in many regions-such as the conflict between Israel and Hamas-as well as the effects of war on communities, social services, and mental health are covered in this special editorial. This article emphasizes the need for international efforts to promote peace, offer humanitarian aid, and address the mental health challenges faced by individuals and communities affected by war and violence.
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Affiliation(s)
- Seithikurippu R Pandi-Perumal
- Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Division of Research and Development, Lovely Professional University, Phagwara, Punjab, India
| | - Willem A C M van de Put
- Section of International Health Policy, Institute for Tropical Medicine Antwerp, Antwerp, Belgium
- Institute of International Humanitarian Affairs (IIHA), Fordham University, Bronx, NY, USA
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | - Stevan E Hobfoll
- STAR Consultants - STress, Anxiety and Resilience, Salt Lake City, UT, USA
| | | | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Arehally Marappa Mahalaksmi
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, India
| | - Saravana Babu Chidambaram
- Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, India
| | - Per Olof Lundmark
- Department of Optometry, Radiography and Lightning Design, University of South-Eastern Norway, Kongsberg, Norway
- National Centre for Optics, Vision and Eye Care, Kongsberg, Norway
| | - Tual Sawn Khai
- School of Graduate Studies, Lingnan University, Hong Kong SAR, China
| | - Lukoye Atwoli
- Medical College East Africa, Brain and Mind Institute, The Aga Khan University, Nairobi, Kenya
| | - Vitalii Poberezhets
- Department of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | | | - Derebe Madoro
- Department of Psychiatry, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| | | | | | - Luísa Teixeira-Santos
- Center for Health Technology and Services Research, Porto, Portugal
- Nursing School of Coimbra, Coimbra, Portugal
| | - Paulo Pereira
- Environmental Management Laboratory, Mykolas Romeris University, Vilnius, Lithuania
| | - Konda Mani Saravanan
- Department of Biotechnology, Bharath Institute of Higher Education & Research, Chennai, India
| | - Anton Vrdoljak
- Faculty of Civil Engineering, Architecture and Geodesy, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Miguel Meira E Cruz
- Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Lisbon, Portugal
| | | | - Alvin Kuowei Tay
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Janne Grønli
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Meera Narasimhan
- Department of Neuropsychiatry and Behavioral Science, School of Medicine, University of South Carolina, Columbia, SC, USA
| | - Eta Ngole Mbong
- MOMENTUM Integrated Health Resilience (MIHR), IMA World Health, Goma, North Kivu, Democratic Republic of Congo
| | - Markus Jansson-Fröjmark
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Stockholm Health Care Services, Region of Stockholm, Stockholm, Sweden
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Joop T V M de Jong
- Cultural Psychiatry and Global Mental Health, Amsterdam UMC, Amsterdam, The Netherlands
- Boston University School of Medicine, Boston, MA, USA
| | - Mario H Braakman
- Transcultural Forensic Psychiatry, Tilburg Law School, Department of Criminal Law, Tilburg University, Tilburg, The Netherlands
| | - Maurice Eisenbruch
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Darío Acuña-Castroviejo
- Centro de Investigación Biomédica, Departamento de Fisiología, Facultad de Medicina, Instituto de Biotecnología, Universidad de Granada, Granada, Spain
| | - Koos van der Velden
- Public Health, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gregory M Brown
- Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Markku Partinen
- Sleep Medicine, Helsinki Sleep Clinic, Helsinki, Finland
- Department of Clinical Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | - Alexander C McFarlane
- Psychiatry, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Barwon Health, Geelong, Australia
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Mutuyimana C, Maercker A. Elements of cultural scripts of trauma sequelae among trauma victims in East Africa. Front Psychol 2023; 14:1206503. [PMID: 37928575 PMCID: PMC10623154 DOI: 10.3389/fpsyg.2023.1206503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023] Open
Abstract
Background As a new, unifying approach to mapping the cultural expressions of trauma sequelae, cultural scripts of trauma sequelae are empirically investigated here for the first time in a primarily qualitative study. Elements of Cultural Scripts of Trauma (CST) include the typical symptoms and appraisals of changes of those who have experienced traumatic events. These elements refer to the value orientations in the given culture. Aims To identify post-traumatic cultural scripts' elements and their groupings, as expressed by trauma survivors from the East African population, and to explore the cultural values that serve as a reference to such scripts' elements. Methods Semi-structured, in-depth interviews were conducted in nine focus groups of trauma survivors and trauma experts. Grounded theory was the basis for the content analysis, and MAXQDA was used for coding and grouping. Semi-quantitative analyses of the frequency of groupings followed. Results The study extracted 270 elements of the cultural scripts of trauma. Three stages of cultural scripts' elements were identified including unspeakable, heart wounds and painful scars and growth. The reported elements are only those in the three last stages and they are grouped into six categories, such as cognitive appraisals, worldview, interpersonal relationships, body-related, positive changes and changes in family interest and management, while the elements of the first stages are not codable as the survivors do not yet get the words of their expressions. The cultural values that served as a reference consisted of holding the sadness, Christianity, community reputation, solidarity, social connectedness, social cynicism, and reproductiveness, among others. Discussion This comprehensive study with participants from several countries in East Africa collected a large number of elements of cultural scripts of trauma for this regional area. Notably, these elements were based mostly on man-made traumas, such as the genocide against the Tutsis in Rwanda. Further steps in the CST investigation are subject to future studies, such as a more systematic investigation of the relationship with cultural values and the temporal relationships within the scripts.
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Affiliation(s)
- Celestin Mutuyimana
- Division of Psychopathology and Clinical Intervention, Department of Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Division of Psychopathology and Clinical Intervention, Department of Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
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13
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Bermudez T, Maercker A, Bierbauer W, Bernardo A, Fleisch-Silvestri R, Hermann M, Schmid JP, Scholz U. The role of daily adjustment disorder, depression and anxiety symptoms for the physical activity of cardiac patients. Psychol Med 2023; 53:5992-6001. [PMID: 37743836 PMCID: PMC10520595 DOI: 10.1017/s0033291722003154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/01/2022] [Accepted: 09/19/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Physical activity (PA) is crucial in the treatment of cardiac disease. There is a high prevalence of stress-response and affective disorders among cardiac patients, which might be negatively associated with their PA. This study aimed at investigating daily differential associations of International Classification of Diseases (ICD)-11 adjustment disorder, depression and anxiety symptoms with PA and sedentary behaviour (SB) during and right after inpatient cardiac rehabilitation. METHODS The sample included N = 129 inpatients in cardiac rehabilitation, Mage = 62.2, s.d.age = 11.3, 84.5% male, n = 2845 days. Adjustment disorder, depression and anxiety symptoms were measured daily during the last 7 days of rehabilitation and for 3 weeks after discharge. Moderate-to-vigorous PA (MVPA), light PA (LPA) and SB were measured with an accelerometer. Bayesian lagged multilevel regressions including all three symptoms to obtain their unique effects were conducted. RESULTS On days with higher adjustment disorder symptoms than usual, patients engaged in less MVPA, and more SB. Patients with overall higher depression symptoms engaged in less MVPA, less LPA and more SB. On days with higher depression symptoms than usual, there was less MVPA and LPA, and more SB. Patients with higher anxiety symptoms engaged in more LPA and less SB. CONCLUSIONS Results highlight the necessity to screen for and treat adjustment disorder and depression symptoms during cardiac rehabilitation.
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Affiliation(s)
- Tania Bermudez
- Applied Social and Health Psychology Unit, University of Zurich, Zurich, Switzerland
- Department Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Andreas Maercker
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
- Psychopathology and Clinical Intervention Unit, University of Zurich, Zurich, Switzerland
| | - Walter Bierbauer
- Applied Social and Health Psychology Unit, University of Zurich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
| | | | | | - Matthias Hermann
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Zurich, Switzerland
| | | | - Urte Scholz
- Applied Social and Health Psychology Unit, University of Zurich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
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14
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Fischer IC, Pietrzak RH, Maercker A, Shalev AY, Katz IR, Harpaz-Rotem I. Post-traumatic stress disorder: rethinking diagnosis. Lancet Psychiatry 2023; 10:741-742. [PMID: 37499676 DOI: 10.1016/s2215-0366(23)00227-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 07/29/2023]
Affiliation(s)
- Ian C Fischer
- US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - Robert H Pietrzak
- US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Andreas Maercker
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | - Arieh Y Shalev
- Department of Psychiatry, New York University Grossman School of Medicine New York, NY, USA
| | - Ira R Katz
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; US Department of Veterans, Office of Mental Health and Suicide Prevention, VA Central Office, Washington DC, USA
| | - Ilan Harpaz-Rotem
- US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA; Department of Psychology and the Wu Tsai Institute, Yale University, New Haven, CT, USA.
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15
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Hennemann S, Killikelly C, Hyland P, Maercker A, Witthöft M. Somatic symptom distress and ICD-11 prolonged grief in a large intercultural sample. Eur J Psychotraumatol 2023; 14:2254584. [PMID: 37767693 PMCID: PMC10540649 DOI: 10.1080/20008066.2023.2254584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 07/12/2023] [Indexed: 09/29/2023] Open
Abstract
Background: Grief is a multi-faceted experience including emotional, social, and physical reactions. Research in ICD-11 prolonged grief disorder (PGD) in different cultural contexts has revealed different or potentially missing grief symptoms that may be relevant.Objective: This study thus aimed to explore the prevalence of somatic symptom distress and its associations with grief and negative affect in a culturally diverse sample of bereaved individuals with symptoms of PGD.Methods: Based on cross-sectional survey data from the Measurement and Assessment of Grief (MAGIC) project, this study included 1337 participants (mean age 23.79 yrs, 76.1% female) from three regions (USA: 62.3%, Turkey/Iran: 24.2%, Cyprus/Greece: 13.5%), who experienced a loss of a significant other. Associations between somatic symptom distress (Somatic Symptom Scale, SSS-8), symptoms of PGD (International Prolonged Grief Disorder Scale, IPGDS-33), anxiety (Generalized Anxiety Disorder Questionnaire, GAD-7), depression (Patient Health Questionnaire, PHQ-9) as well as demographic and loss related characteristics were investigated. Three hundred and thirteen participants (23.4%) scored above the proposed cut-off for clinically severe PGD.Results: 'High' or 'very high' levels of somatic symptom distress were more frequent in a possible PGD group (58.2%), than in a non-PGD group (22.4%), p < .001, as divided per cut-off in the IPGDS. In a multiple regression analysis, PGD symptoms were significantly but weakly associated with somatic symptom distress (β = 0.08, p < .001) beyond demographics, loss-related variables, and negative affect. Negative affect (anxiety and depression) mediated the relationship of PGD symptoms with somatic symptom distress and the indirect effect explained 58% of the variance.Conclusions: High levels of somatic symptom distress can be observed in a substantial proportion of bereaved across cultures. Our findings suggest that PGD is related to somatic symptom distress partly and indirectly through facets of negative affect.
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Affiliation(s)
- Severin Hennemann
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Clare Killikelly
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Andreas Maercker
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
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16
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Eberle DJ, Maercker A. Stress-associated symptoms and disorders: A transdiagnostic comparison. Clin Psychol Psychother 2023; 30:1047-1057. [PMID: 37092756 DOI: 10.1002/cpp.2858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/16/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023]
Abstract
The ICD-11 features a new group of disorders specifically associated with stress, which are interlinked by various symptoms, such as intrusive memory symptoms. Although research interest in these new ICD-11 diagnoses is growing rapidly, so far, no studies have systematically investigated the transdiagnostic distribution of stress-associated symptoms in these disorders. In the present study, 447 individuals completed a series of online questionnaires, which measured various stress-associated symptoms, e.g., flashbacks, preoccupation or yearning. Findings showed that the majority of correlations between the measured psychopathological constructs was between 0.30 and 0.60. Furthermore, with regard to specific diagnostic groups, a complex variation of stress-associated symptoms was observed, with preoccupation as a predominant symptom in all disorders. Results demonstrate that stress-associated symptoms are inherently interconnected yet possess an individual variation in different disorders. Furthermore, findings illustrate that preoccupation represents a major feature in all stress-associated disorders.
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Affiliation(s)
- David J Eberle
- Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Andreas Maercker
- Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zürich, Switzerland
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17
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Maercker A. How to deal with the past? How collective and historical trauma psychologically reverberates in Eastern Europe. Front Psychiatry 2023; 14:1228785. [PMID: 37692311 PMCID: PMC10483133 DOI: 10.3389/fpsyt.2023.1228785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Traumatic stress studies have recently addressed the issue of 'historical trauma' that well explain the impact of collective or totalitarian trauma. The example of former communist Eastern Europe shows that there are many individual and socio-psychological consequences that still have effects today. This paper summarizes concepts and findings on 'historical traumas' that describe such long-lasting effects. The focus is on the side of the victims and their family descendants and thus also on the moral heirs of the dissidents, e.g., the Russian NGO Memorial. Analogous to developments in psychotraumatology, increasing knowledge in this area can explain psychosocial pathologies but also help develop effective remedies. This includes the development of a culture of remembrance, socio-therapeutic interventions and increased sensitivity towards those patients and clients who have such a personal legacy.
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Affiliation(s)
- Andreas Maercker
- Department of Psychology, University of Zurich, Zürich, Switzerland
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18
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Kasinger C, Schulz AC, Ulke C, Maercker A, Beutel M, Brähler E. Historical and regional particularities in the prevalence of traumatic events and posttraumatic stress disorder in East and West Germany. BMC Public Health 2023; 23:1601. [PMID: 37608365 PMCID: PMC10463859 DOI: 10.1186/s12889-023-16534-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/16/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Epidemiological research on the prevalence of traumatic events and PTSD has shown that there are significant differences between countries, due to their different history and socialization processes. In the case of Germany, this is particularly relevant. Germany was divided into two states from 1949 to 1990. This study examines the prevalence of traumatic events and PTSD in the formerly divided East and West Germany. METHODS For the prevalence of traumatic events, we used data from four representative surveys (years 2005, 2007, 2008, and 2016) with a total of N = 9,200 respondents. For the analyses of PTSD prevalence, we used data from three representative surveys (years 2005, 2007, 2008) with a total of N = 6676 respondents. We compared different birth cohorts, persons living in the former West vs. East Germany, and the application of different diagnostic criteria using a chi-square test. RESULTS The overall one-month prevalence rate for PTSD was 3.4% (3.0% for men and 3.8% for women). We found significant differences in the occurrence of traumatic events between genders, different age cohorts as well as between people who live in East and West Germany. Significant differences in the prevalence of PTSD can only be observed for different age cohorts. Most of the age effects are due to traumatic events related to World War II (WWII). Prevalence rates for PTSD were higher when the diagnostic criterions of the DSM-V were applied compared to the criterions of the DSM-IV. CONCLUSIONS Our data suggests that socio-political factors may need to be considered when accounting for differences in occurrence rates of traumatic events, but not for prevalence rates of PTSD, between East and West Germany. People who have experienced WW II have a higher risk of suffering from PTSD. Future epidemiological trauma research should take historical and regional peculiarities of countries into account.
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Affiliation(s)
- Christoph Kasinger
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Heidestraße 146, 60385, Frankfurt am Main, Germany.
| | - Ann-Christin Schulz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Heidestraße 146, 60385, Frankfurt am Main, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Andreas Maercker
- Department of Psychology, Division Psychopathology and Clinical Intervention, University of Zurich, Zuerich, Switzerland
| | - Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Heidestraße 146, 60385, Frankfurt am Main, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Heidestraße 146, 60385, Frankfurt am Main, Germany
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19
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Horn AB, Zimmerli L, Maercker A, Holzer BM. The worse we feel, the more intensively we need to stick together: a qualitative study of couples' emotional co-regulation of the challenge of multimorbidity. Front Psychol 2023; 14:1213927. [PMID: 37637914 PMCID: PMC10450955 DOI: 10.3389/fpsyg.2023.1213927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Being faced with multimorbidity (i.e., being diagnosed with at least two chronic conditions), is not only demanding in terms of following complicated medical regimes and changing health behaviors. The changes and threats involved also provoke emotional responses in the patients but also in their romantic partners. This study aims at exploring the ways of emotional co-regulation that couples facing multimorbidity express when interviewed together. Method N = 15 opposite sex couples with one multimorbid patient after an acute health crisis that led to hospitalization were asked in a semi-structured interview about how they found ways to deal with the health situation, what they would recommend to other couples in a similar situation, and how they regulated their emotional responses. Interviews were analyzed qualitatively following open, axial, and selective coding, as in the grounded theory framework. Results Emerging categories from the romantic partners' and the patients' utterances revealed three main categories: First, overlapping cognitive appraisals about the situation (from fighting spirit to fatalism) and we-ness (construing the couple self as a unit) emerged as higher order factor from the utterances. Second, relationship-related strategies including strategies aimed at maintaining high relationship quality in spite of the asymmetric situation like strengthening the common ground and balancing autonomy and equity in the couple were often mentioned. Third, some couples mentioned how they benefit from individual strategies that involve fostering individual resources of the partners outside the couple relationship (such as cultivating relationships with grandchildren or going outdoors to nature). Discussion Results underline the importance of a dyadic perspective not only on coping with disease but also on regulating the emotional responses to this shared challenging situation. The utterances of the couples were in line with earlier conceptualizations of interpersonal emotion regulation and dyadic perspectives on we-disease. They broaden the view by integrating the interplay between individual and interpersonal regulation strategies and underline the importance of balancing individual and relational resources when supporting couples faced with chronic diseases.
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Affiliation(s)
- Andrea B. Horn
- CoupleSense: Health and Interpersonal Emotion Regulation Lab, University Research Priority Program “Dynamics of Healthy Aging,” University of Zurich, Zurich, Switzerland
- Center of Gerontology, Healthy Longevity Center, University of Zurich, Zurich, Switzerland
- Gerontopsychology and Gerontology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Lukas Zimmerli
- Department of Internal Medicine, Cantonal Hospital Olten (KSO), Olten, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Barbara M. Holzer
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
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Levin Y, Ben-Ezra M, Hamama-Raz Y, Maercker A, Goodwin R, Leshem E, Bachem R. The Ukraine-Russia war: A symptoms network of complex posttraumatic stress disorder during continuous traumatic stress. Psychol Trauma 2023:2023-97700-001. [PMID: 37561433 DOI: 10.1037/tra0001522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
OBJECTIVE This study is aimed to test the symptoms network of International Classification of Diseases, 11th Revision (ICD-11) complex posttraumatic stress disorder (CPTSD) symptoms, using data collected from Ukrainian civilians during the 2022 Russia-Ukraine war. Findings can inform our understanding of the stress response in individuals exposed to continuous trauma and give insight into the nature of CPTSD during the war. METHOD A network analysis was conducted on CPTSD symptoms as assessed by the International Trauma Questionnaire using data from a nationally representative sample of 2,000 Ukrainians. RESULTS While PTSD and disturbances in self-organization clusters did not enmesh, several communities within these clusters were merged. Results highlight that in terms of strength centrality, emotional dysregulation (emotional numbing) and a heightened sense of threat (SoT) were most prominent. CONCLUSION The results confirm the ICD-11 structure of CPTSD but suggest that continuous traumatic stress manifests in more condensed associations between CPTSD symptoms and that emotional regulation may play a vital role in activating the CPTSD network. War-exposed populations could be provided with scalable, brief self-help materials focused on fostering emotion regulation and an SoT. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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21
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Zhou N, Zhao Y, Smith KV, Killikelly C, Stelzer E, Maercker A, Xi J, Helm PJ. Existential isolation and prolonged grief in bereaved people: The moderating role of culture. Clin Psychol Psychother 2023; 30:862-872. [PMID: 36861327 DOI: 10.1002/cpp.2846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/02/2023] [Accepted: 02/26/2023] [Indexed: 03/03/2023]
Abstract
OBJECTIVE Existential isolation refers to an individual's awareness of the unbridgeable gulf between oneself, other people and the world. This kind of isolation has been found to be higher in individuals with nonnormative experiences, such as racial or sexual minorities. Bereaved individuals may experience a stronger sense of existential isolation and feel that no one shares their feelings or perceptions. However, research on bereaved people's experiences of existential isolation and its effects on post-loss adaptation is scarce. This study aims to validate the German and Chinese versions of the Existential Isolation Scale, investigate cultural and gender differences in existential isolation and explore the associations between existential isolation and prolonged grief symptoms in German-speaking and Chinese bereaved individuals. METHODS A cross-sectional study with 267 Chinese and 158 German-speaking bereaved participants was conducted. The participants completed self-report questionnaires assessing existential isolation, prolonged grief symptoms, social networks, loneliness and social acknowledgement. RESULTS The results indicated that the German and Chinese versions of the Existential Isolation Scale demonstrated adequate validity and reliability. No cultural or gender differences (or their interaction) were found for existential isolation. Higher existential isolation was associated with elevated prolonged grief symptoms, which was further moderated by the cultural group. The relationship between existential isolation and prolonged grief symptoms was significant for the German-speaking bereaved people but not significant for those from China. CONCLUSION The findings highlight the role of existential isolation in the adaptation to bereavement and how different cultural backgrounds moderate the effect of existential isolation on post-loss reactions. Theoretical and practical implications are discussed.
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Affiliation(s)
- Ningning Zhou
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Yiming Zhao
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Kirsten V Smith
- Centre for Anxiety Disorders and Trauma, Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Clare Killikelly
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Eva Stelzer
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Andreas Maercker
- Department of Psychology, University of Zürich, Zürich, Switzerland
| | - Juzhe Xi
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Peter J Helm
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri, USA
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22
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Mutuyimana C, Maercker A. Clinically relevant historical trauma sequelae: A systematic review. Clin Psychol Psychother 2023; 30:729-739. [PMID: 36716783 DOI: 10.1002/cpp.2836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The purpose of this systematic review (SR) was to present the current state of research on historical trauma, and the topics closely related to its semantic space that include intergenerational trauma, collective trauma, and extended cultural bodily and mental responses, in order to identify gaps in the literature that need to be addressed. METHODS A search of empirical studies from 1990 to 2022 was performed via Scopus, Web of Science, MEDLINE, EBSCOhost-PsychInfo, and Embase, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. RESULTS The initial search yielded 1012 studies, 52 of which were included in the current review. The results show that the historical trauma concept has a high potential for new research in the field of Global Mental Health. Gaps in the literature were identified, including a lack of standard features of historical trauma, and assessments of historical trauma in additional contexts than its original fields of application with Indigenous Americans. CONCLUSION Although the introduction of the concept of historical trauma was intended to fill the gap of trauma-related difficulties not covered by the criteria of post-traumatic stress disorder (PTSD), this concept needs further scientific refinement.
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Affiliation(s)
| | - Andreas Maercker
- Department of Psychology, University of Zurich, Zurich, Switzerland
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23
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Zhou N, Smith KV, Stelzer E, Maercker A, Xi J, Killikelly C. How the bereaved behave: a cross-cultural study of emotional display behaviours and rules. Cogn Emot 2023:1-17. [PMID: 37357869 DOI: 10.1080/02699931.2023.2219046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Cultural norms may dictate how grief is displayed. The present study explores the display behaviours and rules in the bereavement context from a cross-cultural perspective. 86 German-speaking Swiss and 99 Chinese bereaved people who lost their first-degree relative completed the adapted bereavement version of the Display Rules Assessment Inventory. Results indicated that the German-speaking Swiss bereaved displayed more emotions than the Chinese bereaved. The Chinese bereaved, but not the German-speaking Swiss bereaved, thought that bereaved people should display more emotions than they actually did when they were with their close others (but not when they were alone). Bereaved people endorsed more emotional expression "when alone" than "when with close others", demonstrating a social disconnection tendency, which was more evident in the Chinese sample. Bereaved people endorsed more expression of positive emotions (e.g. affection/love) and less expression of powerful negative emotions (e.g. blame/guilt, anger) across cultures. Compared to their Chinese counterparts, the German-speaking Swiss sample indicated more actual expressions for most emotion types (i.e. joy/happiness, affection/love, sadness, anger, and denial) but thought bereaved people should express more joy/happiness and less blame/guilt. The results suggest that bereaved people's display behaviours and rules are influenced by culture, situation, and type of emotion.
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Affiliation(s)
- Ningning Zhou
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
| | - Kirsten V Smith
- Centre for Anxiety Disorders and Trauma, Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Eva Stelzer
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Andreas Maercker
- Department of Psychology, Zurich University, Zurich, Switzerland
| | - Juzhe Xi
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
| | - Clare Killikelly
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
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24
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Forstmeier S, Zimmermann S, van der Hal E, Auerbach M, Kleinke K, Maercker A, Brom D. Effect of Life Review Therapy for Holocaust Survivors: A randomized controlled trial. J Trauma Stress 2023. [PMID: 37155933 DOI: 10.1002/jts.22933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 05/10/2023]
Abstract
Despite the therapeutic needs of aging Holocaust survivors, no randomized controlled trial (RCT) of psychotherapy exists for this population, with very few on older adults in general. This RCT aimed to compare the efficacy of Life Review Therapy for Holocaust survivors (LRT-HS) relative to a supportive control group. Holocaust survivors with a probable diagnosis of full or subsyndromal posttraumatic stress disorder (PTSD) or depressive disorder were included. Exclusion criteria were probable dementia, acute psychotic disorder, and acute suicidality. The predefined primary endpoint was the course of PTSD symptom scores. In total, 49 of 79 consecutive individuals assessed for eligibility were randomized and included in the intent-to-treat analyses (LRT-HS: n = 24, control: n = 25; Mage = 81.5 years, SD = 4.81, 77.6% female). Linear mixed models revealed no statistically significant superiority of LRT-HS for PTSD symptoms at posttreatment, with moderate effect sizes, Time x Condition interaction: t(75) = 1.46, p = .148, dwithin = 0.70, dbetween = 0.41, but analyses were significant at follow-up, with large effect sizes, t(79) = 2.89, p = .005, dwithin = 1.20, dbetween = 1.00. LRT-HS superiority for depression was observed at posttreatment, t(73) = 2.58, p = .012, but not follow-up, t(76) = 1.08, p = .282, with moderate effect sizes, dwithin = 0.46-0.60, dbetween = 0.53-0.70. The findings show that even in older age, PTSD and depression following exposure to multiple traumatic childhood events can be treated efficaciously using an age-appropriate treatment that includes structured life review and narrative exposure.
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Affiliation(s)
- Simon Forstmeier
- Department of Psychology, Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen, Siegen, Germany
| | - Sarah Zimmermann
- Department of Psychology, Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen, Siegen, Germany
| | - Elisheva van der Hal
- AMCHA, The National Israeli Center for Psychosocial Support of Survivors of the Holocaust and the Second Generation, Jerusalem, Israel
| | - Martin Auerbach
- AMCHA, The National Israeli Center for Psychosocial Support of Survivors of the Holocaust and the Second Generation, Jerusalem, Israel
| | - Kristian Kleinke
- Department of Psychology, Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen, Siegen, Germany
| | - Andreas Maercker
- Department of Psychology, Psychopathology and Clinical Interventions, University of Zurich, Zurich, Switzerland
| | - Danny Brom
- Metiv, The Israel Psychotrauma Center, Jerusalem, Israel
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25
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Maercker A. Erinnerungskulturen der Psychologie: Der Fall der Wiederbeisetzung von Richard Avenarius nach 125 Jahren in Zürich. Psychologische Rundschau 2023. [DOI: 10.1026/0033-3042/a000613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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26
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Asbrand J, Gerdes S, Breedvelt J, Guidi J, Hirsch C, Maercker A, Douilliez C, Andersson G, Debbané M, Cieslak R, Rief W, Bockting C. Clinical psychology and the COVID-19 pandemic: A mixed methods survey among members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT). Clin Psychol Eur 2023; 5:e8109. [PMID: 37064999 PMCID: PMC10103154 DOI: 10.32872/cpe.8109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 11/21/2022] [Indexed: 04/03/2023] Open
Abstract
Background
The COVID-19 pandemic has affected people globally both physically and psychologically. The increased demands for mental health interventions provided by clinical psychologists, psychotherapists and mental health care professionals, as well as the rapid change in work setting (e.g., from face-to-face to video therapy) has proven challenging. The current study investigates European clinical psychologists and psychotherapists’ views on the changes and impact on mental health care that occurred due to the COVID-19 pandemic. It further aims to explore individual and organizational processes that assist clinical psychologists’ and psychotherapists’ in their new working conditions, and understand their needs and priorities.
Method
Members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT) were invited (N = 698) to participate in a survey with closed and open questions covering their experiences during the first wave of the pandemic from June to September 2020. Participants (n = 92) from 19 European countries, mostly employed in universities or hospitals, completed the online survey.
Results
Results of qualitative and quantitative analyses showed that clinical psychologists and psychotherapists throughout the first wave of the COVID-19 pandemic managed to continue to provide treatments for patients who were experiencing emotional distress. The challenges (e.g., maintaining a working relationship through video treatment) and opportunities (e.g., more flexible working hours) of working through this time were identified.
Conclusions
Recommendations for mental health policies and professional organizations are identified, such as clear guidelines regarding data security and workshops on conducting video therapy.
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27
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Killikelly C, Maercker A. The cultural supplement: A new method for assessing culturally relevant prolonged grief disorder symptoms. Clin Psychol Eur 2023; 5:e7655. [PMID: 37065001 PMCID: PMC10103155 DOI: 10.32872/cpe.7655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 11/14/2022] [Indexed: 04/03/2023] Open
Abstract
Background
The new diagnosis of prolonged grief disorder (PGD) is both an opportunity and a challenge for researchers, clinicians, and bereaved individuals. The latest definition of PGD includes a refreshing and novel feature: the cultural caveat, i.e., clinicians must determine that the grief presentation is more severe and of longer duration than would be expected by an individual’s culture and context. Currently, there are no guidelines on how to operationalize the cultural caveat in mental health care settings.
Method
To respond to this important demand we have developed, piloted, and tested the cultural supplement module of the International Prolonged Grief Disorder scale (IPGDS). The cultural supplement aims to provide clinicians with a catalogue of culturally relevant symptoms of grief that indicate probable PGD alongside a simple framework for cultural adaptation for use in specific clinical settings.
Results
In this short report we outline the rationale and aim of the cultural supplement and provide a summary of our latest validation studies of the IPGDS with bereaved German-speaking, Chinese and Swiss migrant individuals. We also provide a step-by-step framework for adaptation of the cultural supplement that clinicians and researchers may use when working with different cultural groups.
Conclusion
To date, this is the first PGD questionnaire based on the ICD-11, and the first to include a cultural supplement that can be adapted to different contexts and groups. This cultural supplement will provide clinicians and researchers an easy-to-use assessment tool with the aim to improve the global applicability of the ICD-11 PGD definition.
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28
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Zhou N, Wei Y, Killikelly C, Xu X, Stelzer EM, Maercker A, Xi J, Smith KV. The relationship between social acknowledgment and prolonged grief symptoms: a multiple mediation effect of beliefs about the goodness and controllability of grief-related emotions. Eur J Psychotraumatol 2023; 14:2220633. [PMID: 37377086 DOI: 10.1080/20008066.2023.2220633] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 05/21/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Social acknowledgment is a protective factor for survivors of trauma. However, the role of social acknowledgment in association with prolonged grief symptoms has not yet been established.Objectives: The current study aims to explore the relationship between social acknowledgment and prolonged grief via two beliefs foundational to how people think about grief-related emotions (1) goodness (i.e. whether emotions are desirable, useful, or unwanted and harmful), and (2) controllability (i.e. whether emotions are regulated according to our will or involuntary, arising of their own accord). These effects were explored in two different cultural samples of bereaved people.Methods: One hundred and fifty-four German-speaking and two hundred and sixty-two Chinese bereaved people who lost their loved ones completed questionnaires assessing social acknowledgment, beliefs about the goodness and controllability of grief-related emotions, and prolonged grief symptoms.Results: Correlation analyses showed that social acknowledgment was positively linked with stronger beliefs about the goodness and controllability of grief-related emotions and negatively related to prolonged grief symptoms. Beliefs about the goodness and controllability of grief-related emotions correlated negatively with prolonged grief symptoms. Multiple mediation analyses suggested that beliefs about the controllability and goodness of grief-related emotions mediated the link between social acknowledgment and prolonged grief symptoms. Cultural groups did not moderate the above model.Conclusion: Social acknowledgment may be related to bereavement adjustment consequences via the roles of beliefs about the goodness and controllability of grief-related emotions. These effects seem to be consistent cross-culturally.
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Affiliation(s)
- Ningning Zhou
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
| | - Yicheng Wei
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
| | - Clare Killikelly
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Xin Xu
- Department of Psychology, School of Education, Soochow University, Suzhou, People's Republic of China
| | - Eva M Stelzer
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Andreas Maercker
- Department of Psychology, School of Education, Soochow University, Suzhou, People's Republic of China
| | - Juzhe Xi
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
| | - Kirsten V Smith
- Centre for Anxiety Disorders and Trauma, Department of Experimental Psychology, University of Oxford, Oxford, UK
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29
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Thoma M, Bernays F, Maercker A, Rohner SL. MENTAL HEALTH RESILIENCE IN SWISS OLDER ADULT SURVIVORS OF CHILD WELFARE–RELATED MALTREATMENT. Innov Aging 2022. [PMCID: PMC9766098 DOI: 10.1093/geroni/igac059.1672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Minors affected by child welfare practices in Switzerland during the last century had a high risk for exposure to childhood trauma and maltreatment. Several studies with this cohort demonstrated substantially higher levels of clinically-relevant psychopathology in older adult survivors in comparison to non-affected control individuals. However, these studies also revealed that not all affected individuals developed mental health disorders over their lifespan. To date, this mental health resilience in survivors of an advanced age is still insufficiently understood. Therefore, this study aimed to assess and compare the resilience profiles of older adults who were formerly affected by child welfare-related trauma and maltreatment (risk group, RG; n = 132; Mage = 71 years) and non-affected, age-matched controls (control group, CG; n = 125). Within the RG, approximately one-third of the individuals had no current or lifetime DSM-5 mental health disorders. In comparison to the survivors with a history of mental ill-health, these individuals were older, had a higher income, and expressed a higher subjective satisfaction with their socio-economic status. Furthermore, they reported less early-life physical abuse, and had lower levels of neuroticism, as well as empathy-related characteristics. In addition, they showed higher levels of self-esteem and trait resilience. Group differences between the RG and CG highlight the importance of considering past adversity in the understanding of mental health resilience in later life.
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Affiliation(s)
- Myriam Thoma
- University of Zurich, Zurich, Zurich, Switzerland
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30
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McCutchen C, Hyland P, Maercker A, Thoma MV, Rohner SL. The Effects of Social Support on ACEs and Mental Health in Ireland. Journal of Loss and Trauma 2022. [DOI: 10.1080/15325024.2022.2124264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Andreas Maercker
- Department of Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zürich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging,” University of Zürich, Zürich, Switzerland
| | - Myriam V. Thoma
- Department of Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zürich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging,” University of Zürich, Zürich, Switzerland
| | - Shauna L. Rohner
- Department of Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zürich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging,” University of Zürich, Zürich, Switzerland
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31
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Kazlauskas E, Maercker A. Title of "Ambassador of Clinical Psychology and Psychological Treatment" Awarded to Danutė Gailienė. Clin Psychol Eur 2022; 4:e7747. [PMID: 36398005 PMCID: PMC9667336 DOI: 10.32872/cpe.7747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The paper presents professional activities and the major works of an ambassador of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT), Prof. Danutė Gailienė. Prof. Gailienė is among the most influential European clinical psychologists who contributed to clinical psychology training, research, and practice in former post-communist East European countries. Her entire career was dedicated to the development of clinical psychology, and through her work, Prof. Gailienė demonstrated how even in an oppressive and politically difficult environment, it is possible to keep the integrity and work up to higher standards.
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Affiliation(s)
- Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Andreas Maercker
- Department of Psychology, Division Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
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32
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Pfluger V, Rohner SL, Eising CM, Maercker A, Thoma MV. Associations Between Complex Trauma Exposure in Childhood/Adolescence and Psychopathology in Older Age: The Role of Stress Coping and Coping Self-Perception. J Child Adolesc Trauma 2022; 15:539-551. [PMID: 35958721 PMCID: PMC9360395 DOI: 10.1007/s40653-021-00419-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/26/2021] [Indexed: 06/15/2023]
Abstract
Complex trauma exposure in childhood and/or adolescence is common and has repeatedly been linked to mental ill-health across the lifespan. While the correlates of complex trauma and mental health are well-studied in individuals up to middle adulthood, correlates in older adulthood, as well as potential mediators of this relationship, such as stress coping, are insufficiently studied. Therefore, this study aimed to (a) examine the mental health of Swiss older adults affected by complex trauma exposure in childhood and/or adolescence, in comparison to non-affected individuals; and (b) to examine the potential mediating role of coping strategies and coping self-perception. Data from N = 257 participants (complex trauma [CT] group: n = 161; M age = 69.66 years, 48.4% female; non-complex trauma [nCT] group: n = 96; M age = 72.49 years, 42.7% female) were assessed using self-report questionnaires and a clinical interview. The CT group presented with significantly more current and lifetime mental health disorders, more disadvantageous coping strategies, and significantly lower coping self-perception, compared to the nCT group. Mediation analyses revealed that maladaptive coping and coping self-perception were relevant mediators of the relationship between complex trauma exposure and psychopathology. Results suggest that complex trauma exposure in childhood and/or adolescence can have a lasting impact on mental health in later life and can be negatively associated with stress coping. Findings emphasize the relevance of a lifespan perspective in research and clinical practice for addressing consequences of complex trauma exposure.
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Affiliation(s)
- Viviane Pfluger
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Shauna L. Rohner
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Carla M. Eising
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- Dynamics of Healthy Aging”, University Research Priority Program, University of Zurich, Zurich, Switzerland
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33
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Mutuyimana C, Maercker A. Development and validation of the Clinical Aspects of Historical Trauma Questionnaire in Rwandan genocide survivors. J Trauma Stress 2022; 35:1189-1200. [PMID: 35349733 PMCID: PMC9543537 DOI: 10.1002/jts.22829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/10/2022]
Abstract
Historical trauma is a relatively new concept in the literature, and investigations are needed to clarify its clinical aspects and develop instruments to measure its sequelae. The purpose of this study was to develop the Clinical Aspects of Historical Trauma Questionnaire (CAHTQ), which is meant to capture trauma sequelae in different contexts, and provide initial psychometric information. Participants were survivors of the genocide against the Tutsi in Rwanda (N = 261) aged 32-87 years (M = 46.30 years, SD = 11.95) who completed a preliminary version of the CAHTQ, constructed based on theoretical and content-related consideration, as well as the International Trauma Questionnaire, Fatalism Scale, Public Health Depression Questionnaire, Brief Coping Inventory, Forgiveness Questionnaire, and Sentiment of Reconciliation Questionnaire to test the discriminant and convergent validity of the CAHTQ. Exploratory factor analysis was conducted to reduce the number of items and extract factors; confirmatory factor analysis (CFA) was conducted to confirm the measure's dimensionality. The final questionnaire includes 20 items and five subscales. The items demonstrated good internal consistency, Cronbach's α = .91, and the CFA demonstrated a very good fit of the model to the data, χ2 (60, N = 261) = 271, CFI = .963 = , TLI = .956, SMRR = .052, RMSEA = .052. The CAHTQ was developed to capture the clinical aspects of historical trauma sequelae. Unlike comparable previously developed instruments, this questionnaire can be used for various historical traumas globally, and its suitability for this purpose will be the focus of future studies.
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34
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Maercker A, Cloitre M, Bachem R, Schlumpf YR, Khoury B, Hitchcock C, Bohus M. Complex post-traumatic stress disorder. Lancet 2022; 400:60-72. [PMID: 35780794 DOI: 10.1016/s0140-6736(22)00821-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/19/2022] [Accepted: 04/27/2022] [Indexed: 12/21/2022]
Abstract
Complex post-traumatic stress disorder (complex PTSD) is a severe mental disorder that emerges in response to traumatic life events. Complex PTSD is characterised by three core post-traumatic symptom clusters, along with chronic and pervasive disturbances in emotion regulation, identity, and relationships. Complex PTSD has been adopted as a new diagnosis in the ICD-11. Individuals with complex PTSD typically have sustained or multiple exposures to trauma, such as childhood abuse and domestic or community violence. The disorder has a 1-8% population prevalence and up to 50% prevalence in mental health facilities. Progress in diagnostics, assessment, and differentiation from post-traumatic stress disorder and borderline personality disorder is reported, along with assessment and treatment of children and adolescents. Studies recommend multicomponent therapies starting with a focus on safety, psychoeducation, and patient-provider collaboration, and treatment components that include self-regulatory strategies and trauma-focused interventions.
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Affiliation(s)
- Andreas Maercker
- Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland.
| | - Marylene Cloitre
- National Center for PTSD Division of Dissemination and Training and Department of Psychiatry and Behavioural Sciences, Stanford University, CA, USA
| | - Rahel Bachem
- Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | | | | | - Caitlin Hitchcock
- MRC Cognition and Brain Science Unit, University of Cambridge, Cambridge, UK; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Martin Bohus
- Heidelberg University, Heidelberg Germany and Ruhr University, Bochum, Germany
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35
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Pfluger V, Rohner SL, Eising CM, Maercker A, Thoma MV. Internalizing Mental Health Disorders and Emotion Regulation: A Comparative and Mediational Study of Older Adults With and Without a History of Complex Trauma Exposure. Front Psychol 2022; 13:820345. [PMID: 35814079 PMCID: PMC9260226 DOI: 10.3389/fpsyg.2022.820345] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/17/2022] [Indexed: 12/04/2022] Open
Abstract
Individuals with complex trauma exposure (CTE) in early life (i.e., childhood/adolescence) are at heightened risk for developing problems in various domains of functioning. As such, CTE has repeatedly been linked to internalizing mental health disorders, such as depression and anxiety, as well as emotion dysregulation across the lifespan. While these correlates of CTE are comparatively well studied up to middle adulthood, they are insufficiently studied in older adulthood. Therefore, this study aimed to (a) compare Swiss older adults with and without a CTE history regarding current and lifetime internalizing mental health disorders and emotion regulation strategies; and (b) to examine the potential mediating role of emotion regulation in the mental health disparities between these groups. A total of N = 257 participants (age = 49-95 years; 46.3% female) were assessed in a retrospective, cross-sectional study, using two face-to-face interviews. The CTE group (n = 161; M age = 69.66 years, 48.4% female) presented with significantly more current and lifetime internalizing mental health disorders than the non-affected (nCTE) group (n = 96; M age = 72.49 years, 42.7% female). The CTE group showed significantly higher emotion suppression and lower emotion reappraisal compared to the nCTE group. Mediation analysis revealed that the two emotion regulation strategies were significant mediators between CTE history and internalizing mental health disorders. Findings emphasize the relevance of emotion (dys-)regulation in understanding mental health disparities in older age and deciding about treatment strategies. Research and practice should pay more attention to the needs of this high-risk group of older individuals.
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Affiliation(s)
- Viviane Pfluger
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Shauna L. Rohner
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Carla M. Eising
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
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Pfluger V, Fischer S, Maercker A, Thoma MV. Development and Psychometric Evaluation of the Reactions to Somatic Stress Questionnaire (RSSQ). European Journal of Health Psychology 2022. [DOI: 10.1027/2512-8442/a000113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Stress is a ubiquitous phenomenon in modern societies and is often accompanied by somatic sensations and symptoms, such as tension and nausea. Despite the inherent somatic component of stress, research on coping with stress has previously neglected to consider how somatic stress responses (i.e., somatic stress) may affect stress-coping behavior. Aim: To address this gap in the literature, this study introduces the concept of reactions to somatic stress (RSS). It also provides the first psychometric evaluation of the Reactions to Somatic Stress Questionnaire (RSSQ), a novel 16-item questionnaire that assesses hampering and facilitating RSS. Method: The RSSQ and a battery of questionnaires on related constructs were administered via an online survey to N = 265 participants from the general population. Results: Exploratory ( n = 133) and confirmatory ( n = 132) factor analyses yielded two dimensions of the RSSQ: Hampering RSS (RSS-H) and facilitating RSS (RSS-F). Both subscales showed good internal consistency (α = .81–.89). Correlations with body awareness, emotion regulation skills, and beliefs about stress indicated medium to high convergent and discriminant validity. The RSS-H and RSS-F scores significantly predicted maladaptive and adaptive coping behavior, respectively. This association remained stable after controlling for subjective stress and related measures. Limitations: Generalization of the obtained results is limited to healthy individuals. Conclusion: The study supports the theoretical assumptions underlying the RSS concept. The RSSQ suggests a promising way to assess reactions to somatic stress as they relate to coping with stress. The RSSQ could be used for clinical and health psychological testing or interdisciplinary research.
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Affiliation(s)
- Viviane Pfluger
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Ageing”, University of Zurich, Switzerland
| | - Susanne Fischer
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Ageing”, University of Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Ageing”, University of Zurich, Switzerland
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Eising CM, Maercker A, Malagurski B, Jäncke L, Mérillat S. A longitudinal resting-state functional connectivity analysis on trauma exposure and post-traumatic stress symptoms in older individuals. Neuroimage Clin 2022; 35:103052. [PMID: 35644110 PMCID: PMC9144015 DOI: 10.1016/j.nicl.2022.103052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 05/09/2022] [Accepted: 05/15/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Given the present demographic shift towards an aging society, there is an increased need to investigate the brain's functional connectivity in the context of aging. Trauma exposure and post-traumatic stress disorder (PTSD) symptoms are factors known to impact healthy aging and have been reported to be associated with functional connectivity differences. In the present study, we examined and compared differences in within-default mode network (DMN), within-salience network (SN) and between-DMN-SN functional connectivity, between trauma-exposed individuals with and without PTSD symptoms as well as non-traumatized individuals in a non-clininical older adult sample. METHODS Resting state functional MRI and behavioral data is taken from the Longitudinal Healthy Aging Brain Database Project (LHAB). For the present analysis, participants who completed the questionnaires on trauma exposure and PTSD symptoms (N = 110 individuals of which n = 50 individuals reported previous trauma exposure and n = 25 individuals reported PTSD symptoms; mean age = 70.55 years, SD = 4.82) were included. RESULTS The reporting of PTSD symptoms relative to no symptoms was associated with lower within-DMN connectivity, while on a trend level trauma-exposed individuals showed higher within-SN connectivity compared to non-trauma exposed individuals. Consistent with existing models of healthy aging, between-DMN-SN functional connectivity showed an increase across time in older age. CONCLUSION Present results suggest that alterations in within-DMN and within-SN functional connectivity also occur in non-treatment seeking older adult populations with trauma exposure and in association with PTSD symptoms. These changes manifest, alongside altered between-DMN-SN functional connectivity, in older age supposedly independent of aging-related functional desegregation.
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Affiliation(s)
- Carla M Eising
- University of Zürich, Psychopathology and Clinical Intervention, Institute of Psychology, Binzmuehlestrasse 14 / 17, 8050 Zürich, Switzerland; University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland.
| | - Andreas Maercker
- University of Zürich, Psychopathology and Clinical Intervention, Institute of Psychology, Binzmuehlestrasse 14 / 17, 8050 Zürich, Switzerland; University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland
| | - Brigitta Malagurski
- University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland
| | - Lutz Jäncke
- University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland; Division Neuropsychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14, 8050 Zurich, Switzerland
| | - Susan Mérillat
- University Research Priority Program "Dynamics of Healthy Aging", University of Zürich, Switzerland
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Maercker A, Wieser M, Wolfradt U, Frindte W, Gieseke J, Guski-Leinwand S, Richter H, Schmiedebach HP. Instrumentalisierung der Psychologie in der DDR? Psychologische Rundschau 2022. [DOI: 10.1026/0033-3042/a000589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Martin Wieser
- Department für Psychologie, Sigmund Freud PrivatUniversität Berlin
| | - Uwe Wolfradt
- Institut für Psychologie, Martin-Luther-Universität Halle-Wittenberg
| | | | - Jens Gieseke
- Leibniz-Zentrum für Zeithistorische Forschung Potsdam
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Rohner SL, Bernays F, Maercker A, Thoma MV. Salutary mechanisms in the relationship between stress and health: The mediating and moderating roles of Sense of Coherence—Revised. Stress Health 2022; 38:388-401. [PMID: 34448521 PMCID: PMC9291615 DOI: 10.1002/smi.3093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 11/05/2022]
Abstract
While chronic and acute stress are often associated with negative health, the sense of coherence-revised (SOC-R) is proposed to facilitate coping with stress and promote health. However, research is lacking on the specific mechanisms. Therefore, the current study aimed to investigate potential mediating and moderating mechanisms of SOC-R in the relationship between stress and health. Using a cross-sectional design, standardized questionnaires assessed SOC-R, acute (perceived) stress, early-life adversity (ELA; indicator for early-life chronic stress), mental and physical health, and satisfaction with life. Mediation and moderation analyses were conducted with N = 531 Irish adults (mean age: 59.5 years; 58.4% female). Regarding acute (perceived) stress, results showed that SOC-R and its Manageability subscale significantly mediated the association between perceived stress and mental health, and satisfaction with life. SOC-R and its Manageability subscale also significantly moderated the association between perceived stress and mental health. Regarding ELA, the Manageability subscale significantly mediated the association between ELA and mental health, and satisfaction with life; and the Balance subscale significantly mediated the association between ELA and physical health. SOC-R may provide a useful focus for stress-related research, with future longitudinal studies needed to examine SOC-R as a long-term modulating pathway between stress and health.
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Affiliation(s)
- Shauna L. Rohner
- Psychopathology and Clinical InterventionInstitute of PsychologyUniversity of ZürichZürichSwitzerland,University Research Priority Program “Dynamics of Healthy Aging”University of ZürichZürichSwitzerland
| | - Florence Bernays
- Department of Business AdministrationChair of Human Resource Management and LeadershipUniversity of ZürichZürichSwitzerland
| | - Andreas Maercker
- Psychopathology and Clinical InterventionInstitute of PsychologyUniversity of ZürichZürichSwitzerland,University Research Priority Program “Dynamics of Healthy Aging”University of ZürichZürichSwitzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical InterventionInstitute of PsychologyUniversity of ZürichZürichSwitzerland,University Research Priority Program “Dynamics of Healthy Aging”University of ZürichZürichSwitzerland
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Maercker A, Bernays F, Rohner SL, Thoma MV. A cascade model of complex posttraumatic stress disorder centered on childhood trauma and maltreatment, attachment, and socio-interpersonal factors. J Trauma Stress 2022; 35:446-460. [PMID: 34800054 PMCID: PMC9299117 DOI: 10.1002/jts.22756] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/11/2021] [Accepted: 08/18/2021] [Indexed: 01/04/2023]
Abstract
The present study proposes and tests a cascade model of complex posttraumatic stress disorder (CPTSD) focusing on childhood trauma and maltreatment, attachment, and socio-interpersonal factors. Multigroup path analysis was used to examine data from 126 individuals formerly affected by compulsory social measures and placements (CSMP) in their childhood and/or adolescence (i.e., risk group [RG]; M age = 70.8 years) and an age-matched control group (CG; n = 125; M age = 70.6 years). The final model confirmed the cascade structure, with stronger associations emerging in the RG. Childhood trauma and maltreatment were associated with attachment anxiety, β = |.20|-.30, which was related to all socio-interpersonal factors (i.e., disclosure of trauma, social acknowledgment, and social support), β = .27-|.54|; the latter were associated with substantial aspects of the CPTSD symptoms as well as life satisfaction, β = |.21|-.42. Among participants in the CG, we observed more direct, rather than mediated, paths to CPTSD symptoms. Adulthood trauma exposure did not follow the full cascade pattern but was associated with the socio-interpersonal factors. Nevertheless, more in-depth clinical knowledge of CPTSD and potential targets for psychological treatment may be gained from the confirmation of this newly proposed cascade model of CPTSD.
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Affiliation(s)
- Andreas Maercker
- Institute of Psychology, Division of Psychopathology and Clinical InterventionUniversity of ZürichZürichSwitzerland,University Research Priority Program: Dynamics of Healthy AgingUniversity of ZürichZürichSwitzerland
| | - Florence Bernays
- Institute of Psychology, Division of Psychopathology and Clinical InterventionUniversity of ZürichZürichSwitzerland
| | - Shauna L. Rohner
- Institute of Psychology, Division of Psychopathology and Clinical InterventionUniversity of ZürichZürichSwitzerland,University Research Priority Program: Dynamics of Healthy AgingUniversity of ZürichZürichSwitzerland
| | - Myriam V. Thoma
- Institute of Psychology, Division of Psychopathology and Clinical InterventionUniversity of ZürichZürichSwitzerland,University Research Priority Program: Dynamics of Healthy AgingUniversity of ZürichZürichSwitzerland
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Heim E, Karatzias T, Maercker A. Cultural concepts of distress and complex PTSD: Future directions for research and treatment. Clin Psychol Rev 2022; 93:102143. [DOI: 10.1016/j.cpr.2022.102143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 01/06/2022] [Accepted: 03/03/2022] [Indexed: 11/24/2022]
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Dworschak C, Heim E, Maercker A. Efficacy of internet-based interventions for common mental disorder symptoms and psychosocial problems in older adults: A systematic review and meta-analysis. Internet Interv 2022; 27:100498. [PMID: 35141136 PMCID: PMC8810404 DOI: 10.1016/j.invent.2022.100498] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although a high proportion of older adults suffer from common mental disorder symptoms and psychosocial problems, only a small number of older individuals seek psychological treatment. Internet-based interventions have the potential to bridge this treatment gap. However, while there is extensive literature on internet-based treatments in younger to middle-aged adults, research on older individuals is lacking. OBJECTIVE We aimed to summarize narratively and empirically the existing literature on the efficacy of internet-based interventions for the treatment of common mental disorder symptoms and psychosocial problems (loneliness, stress) in older individuals. METHODS This systematic review and meta-analysis was registered in PROSPERO (registration number: CRD42021235129). Systematic literature searches were conducted in PsycInfo, Ageline, Medline, CINHAL, and Psyndex. Studies were eligible for inclusion if they a) focused on older adults, b) assessed the efficacy of an internet-delivered psychological intervention, c) included a control condition and d) assessed common mental disorder symptoms or psychosocial problems as outcomes. Meta-analyses were conducted based on studies that included a passive, minimally active or placebo control condition to estimate pooled effects on overall symptom severity as well as on specific psychological outcomes. RESULTS 11 Studies met inclusion criteria, with the majority of interventions focusing on depression or anxiety symptoms and being based on CBT principles. Significant large effect of internet-based interventions for older adults were found for overall symptom severity (depression, anxiety, PTSD, stress) as well as for depression symptom severity. No significant effects were found for anxiety symptom severity. DISCUSSION Our findings provide preliminary support that internet-based interventions might be a feasible and effective intervention method for the treatment of common mental disorder symptoms and stress in older adults. However, research in this area is still at an early stage. More studies are needed to shed light on the role of various treatment and patient characteristics in the efficacy of internet-delivered treatments.
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Affiliation(s)
- Christine Dworschak
- University of Zurich, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
- Corresponding author.
| | - Eva Heim
- University of Lausanne, Institute of Psychology, Quartier UNIL-Mouline, 1015 Lausanne, Switzerland
| | - Andreas Maercker
- University of Zurich, Binzmühlestrasse 14/17, 8050 Zurich, Switzerland
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43
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Levin Y, Bachem R, Hyland P, Karatzias T, Shevlin M, Ben-Ezra M, Maercker A. Validation of the International Adjustment Disorder Questionnaire in Israel and Switzerland. Clin Psychol Psychother 2022; 29:1321-1330. [PMID: 35018693 DOI: 10.1002/cpp.2710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/26/2021] [Accepted: 12/28/2021] [Indexed: 11/05/2022]
Abstract
The ICD-11 has introduced a new conceptualization of adjustment disorder (AjD) as a stress response syndrome with core symptoms of preoccupations and failure to adapt to the stressor. The current study aimed to assess the reliability and validity of the International Adjustment Disorder Questionnaire (IADQ) in two culturally distinct samples from Israel and Switzerland. Two samples were recruited in Israel (N = 1142) and Switzerland (N = 699) during the initial stages of the COVID-19 pandemic. Confirmatory factor analysis indicated that a correlated two-factor model provided an excellent fit to the Israeli and Swiss sample data. The IADQ scores correlated strongly with another measure of AjD symptoms, and with symptoms of depression, anxiety, acute stress, and negative emotions whereas correlations with posttraumatic stress disorder, complex posttraumatic stress disorder, and positive emotions were weaker. In the Swiss sample, 18.8% met diagnostic criteria for probable AjD and 10.2% in the Israeli sample. The current study provides the first evidence of the validity of the German and Hebrew versions of the IADQ and can be used for the screening of this debilitating condition.
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Affiliation(s)
- Yafit Levin
- Education Department, University of Ariel, Ariel, Israel.,School of Social Work, University of Ariel, Ariel, Israel
| | - Rahel Bachem
- University of Zurich, Institute of Psychology, Psychopathology and Clinical Intervention, Zurich, Switzerland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Co, Kildare, Ireland
| | - Thanos Karatzias
- Edinburgh Napier University, Edinburgh, Scotland, UK.,NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, Scotland, UK
| | - Mark Shevlin
- Psychology Research Institute, School of Psychology, Derry, Northern Ireland
| | | | - Andreas Maercker
- University of Zurich, Institute of Psychology, Psychopathology and Clinical Intervention, Zurich, Switzerland
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Karatzias T, Knefel M, Maercker A, Cloitre M, Reed G, Bryant RA, Ben-Ezra M, Kazlauskas E, Jowett S, Shevlin M, Hyland P. The Network Structure of ICD-11 Disorders Specifically Associated with Stress: Adjustment Disorder, Prolonged Grief Disorder, Posttraumatic Stress Disorder, and Complex Posttraumatic Stress Disorder. Psychopathology 2022; 55:226-234. [PMID: 35344963 DOI: 10.1159/000523825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 02/24/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The ICD-11 includes a new grouping for "disorders specifically associated with stress" that contains revised descriptions of posttraumatic stress disorder (PTSD) and adjustment disorder (AjD) and new diagnoses in the form of complex PTSD (CPTSD) and prolonged grief disorder (PGD). These disorders are similar in that they each require a life event for the diagnosis; however, they have not yet been assessed together for validity within the same sample. We set out to test the distinctiveness of the four main ICD-11 stress disorders using a network analysis approach. METHODS A population-based, cross-sectional design. A nationally representative sample of adults from the Republic of Ireland aged 18 years and older (N = 1,020) completed standardized measures of PTSD, CPTSD, AjD, and PGD. A network analysis was conducted at the symptom level. Outcome measures included the International Trauma Questionnaire, the Inventory of Complicated Grief, and the International Adjustment Disorder Questionnaire. RESULTS Consistent with the taxonomic structure of the ICD-11, our results showed that although the four conditions clustered independently at the disorder level, the specific symptoms of PTSD, CPTSD, PGD, and AjD clustered together very strongly but more strongly than with symptoms of the other disorders. The majority (61%) of the variation in each symptom could be explained by its neighboring symptoms. The strongest transdiagnostically connecting symptom was "startle response." DISCUSSION/CONCLUSION Mental health professionals caring for people who have experienced a range of stressors and traumatic life events can be confident in diagnosing these conditions that have clear diagnostic boundaries. Interventions addressing stress-associated disorders should be based on diagnostic assessment to ensure close fit between symptoms and treatment.
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Affiliation(s)
- Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, United Kingdom.,Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, United Kingdom
| | - Matthias Knefel
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Andreas Maercker
- Division of Psychopathology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Marylene Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Geoffrey Reed
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Sally Jowett
- NHS Education for Scotland, NHS Lothian, Edinburgh, United Kingdom
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
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45
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Levin Y, Karatzias T, Shevlin M, Ben-Ezra M, Maercker A, Bachem R. The network structure of ICD-11 adjustment disorder: A comparison of clinical and nonclinical samples. Eur Psychiatry 2022; 65:e43. [PMID: 35903852 PMCID: PMC9393912 DOI: 10.1192/j.eurpsy.2022.2303] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background International Classification of Diseases, 11th revision (ICD-11) adjustment disorder (AjD) is characterized by two main symptom clusters: preoccupation with the stressor and failure to adapt to the stressor. The network analytic approach provides important information on the structural validity of a disorder and reveals which symptoms are most prominent. To date, no study compared the network structure of AjD symptoms in clinical and nonclinical samples, which could potentially inform our understanding of psychopathological mechanisms that underlie AjD and identify core targets for therapy. Methods A network analysis was conducted on AjD symptoms as assessed by the Adjustment Disorder—New Module (ADNM-8) using data from 330 clinical participants from the UK and a nonclinical sample of 699 participants from Switzerland. Results Comparisons of network structure invariance revealed differences between the network structure of the clinical and the nonclinical samples. Results highlight that in terms of both edges strength and centrality, failure to adapt symptoms was more prominent in the clinical sample, while the preoccupation symptoms were more prominent in the nonclinical sample. Importantly, global strength was similar across networks. Conclusions Results provide evidence of the coherence of AjD in the ICD-11 as assessed by the ADNM questionnaire. They tentatively suggest that subclinical AjD may be characterized by emerging preoccupation symptoms that may result in failure to adapt and functional impairment in clinical manifestation of AjD. However, there is a need for replication and longitudinal research to further validate this hypothesis.
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Pandi-Perumal SR, Kumar VM, Pandian NG, de Jong JT, Andiappan S, Corlateanu A, Mahalaksmi AM, Chidambaram SB, Kumar RR, Ramasubramanian C, Sivasubramaniam S, Bjørkum AA, Cutajar J, Berk M, Trakht I, Vrdoljak A, Meira e Cruz M, Eyre HA, Grønli J, Cardinali DP, Maercker A, van de Put WACM, Guzder J, Bjorvatn B, Tol WA, Acuña-Castroviejo D, Meudec M, Morin CM, Partinen M, Barbui C, Jordans MJD, Braakman MH, Knaevelsrud C, Pallesen S, Sijbrandij M, Golombek DA, Espie CA, Cuijpers P, Agudelo HAM, van der Velden K, van der Kolk BA, Hobfoll SE, Devillé WLJM, Gradisar M, Riemann D, Axelsson J, Benítez-King G, Macy RD, Poberezhets V, Hoole SRH, Murthy RS, Hegemann T, Heinz A, Salvage J, McFarlane AC, Keukens R, de Silva H, Oestereich C, Wilhelm J, von Cranach M, Hoffmann K, Klosinski M, Bhugra D, Seeman MV. Scientists Against War: A Plea to World Leaders for Better Governance. Sleep Vigil 2022; 6:1-6. [PMID: 35317215 PMCID: PMC8930284 DOI: 10.1007/s41782-022-00198-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Seithikurippu R. Pandi-Perumal
- Somnogen Canada Inc., College Street, Toronto, Canada
- grid.412431.10000 0004 0444 045XSaveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | | | - Namasivayam Ganesh Pandian
- grid.258799.80000 0004 0372 2033Institute for Integrated Cell-Material Sciences (WPI-iCeMS), A210, Kyoto University Institute for Advanced Study, Yoshida Ushinomiya-cho, Sakyo-ku, Kyoto, 606-8501 Japan
| | - Joop T. de Jong
- grid.509540.d0000 0004 6880 3010Department of Cultural Psychiatry and Global Mental Health, Amsterdam UMC, Amsterdam, The Netherlands
- grid.189504.10000 0004 1936 7558Boston University School of Medicine, Boston, USA
| | - Sudalaikannu Andiappan
- grid.10214.360000 0001 2186 7912Department of Gandhian Studies and Ramalingar Philosophy, School of Religions, Philosophy and Humanist Thought, Madurai Kamaraj University, Madurai, Tamil Nadu India
| | - Alexandru Corlateanu
- grid.28224.3e0000 0004 0401 2738Department of Respiratory Medicine, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Arehally Marappa Mahalaksmi
- grid.411962.90000 0004 1761 157XDepartment of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, 570015 India
| | - Saravana Babu Chidambaram
- grid.411962.90000 0004 1761 157XDepartment of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, 570015 India
| | - Ramasamy Rajesh Kumar
- Global Community Educational Foundation (NGCEF), 7 Peterlee Pl, Hebersham, NSW 2770 Australia
| | | | - Sudhakar Sivasubramaniam
- grid.411780.b0000 0001 0683 3327Department of Biotechnology, Manonmaniam Sundaranar University, Tirunelveli, Tamil Nadu 627012 India
| | - Alvhild Alette Bjørkum
- grid.477239.c0000 0004 1754 9964Department of Safety, Chemistry and Biomedical Laboratory Sciences, Faculty of Engineering and Science, Western Norway University of Applied Sciences, Kronstad, Bergen, Norway
| | - JosAnn Cutajar
- grid.4462.40000 0001 2176 9482Department of Gender and Sexualities, Faculty for Social Wellbeing, University of Malta, Room # 114, Guze Cassar Pullicino Building, Msida, 2080 MSD Malta
| | - Michael Berk
- grid.414257.10000 0004 0540 0062Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Australia
| | - Ilya Trakht
- grid.21729.3f0000000419368729Department of Medicine, Columbia University, New York, NY USA
| | - Anton Vrdoljak
- grid.413034.10000 0001 0741 1142Faculty of Civil Engineering, Architecture and Geodesy, University of Mostar, Kampus Sveučilišta, Maticehrvatskeb. b, 88000 Mostar, Bosnia and Herzegovina
| | - Miguel Meira e Cruz
- grid.9983.b0000 0001 2181 4263Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Av. Prof. Egas Moniz, 1649–028 Lisboa, Portugal
| | - Harris A. Eyre
- grid.414257.10000 0004 0540 0062Deakin University, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon Health, Geelong, Australia
- grid.266102.10000 0001 2297 6811Global Brain Health Institute at University of California, San Francisco (UCSF), San Francisco, CA USA
- grid.8217.c0000 0004 1936 9705Trinity College Dublin, Dublin, Ireland
- grid.39382.330000 0001 2160 926XDepartment of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
- grid.36193.3e0000000121590079Neuroscience-Inspired Policy Initiative, Organisation for Economic Co-operation and Development (OECD) and the PRODEO Institute and Meadows Mental Health Policy Institute, Paris, France
- grid.267308.80000 0000 9206 2401Department of Psychiatry and Behavioral Sciences, University of Texas Health Sciences Center at Houston, Houston, TX USA
| | - Janne Grønli
- grid.7914.b0000 0004 1936 7443Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Dainiel P. Cardinali
- grid.412525.50000 0001 2097 3932Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Andreas Maercker
- grid.7400.30000 0004 1937 0650Psychopathology and Clinical Intervention, University of Zurich, Binzmuhlestr. 14/17, 8044 Zurich, Switzerland
| | - Willem A. C. M. van de Put
- grid.11505.300000 0001 2153 5088Section of International Health Policy, Institute for Tropical Medicine Antwerp, Antwerp, Belgium
- grid.256023.0000000008755302XInstitute of International Humanitarian Affairs (IIHA), Fordham University, Bronx, NY USA
| | - Jaswant Guzder
- Division of Social and Transcultural Psychiatry, 1033 Pine Ave, Montreal, Canada
- grid.414980.00000 0000 9401 2774Trauma and Global Health Program, Institute of Community and Family Psychiatry, Sir Mortimer B. Davis, Jewish General Hospital, Montreal, QC Canada
| | - Bjørn Bjorvatn
- grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- grid.412008.f0000 0000 9753 1393Norway and Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Wietse A. Tol
- grid.5254.60000 0001 0674 042XSection of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- grid.12380.380000 0004 1754 9227Athena Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- AArq International, Amsterdam, The Netherlands
| | - Darío Acuña-Castroviejo
- grid.4489.10000000121678994Centro de Investigación Biomédica, Departamento de Fisiología, Facultad de Medicina, Instituto de Biotecnología, Parque Tecnológico de Ciencias de la Salud, Universidad de Granada, 18016 Granada, Spain
| | - Marie Meudec
- grid.11505.300000 0001 2153 5088Outbreak Research Team and Department of Public Health, Institute of Tropical Medicine (ITM), Antwerpen, Belgium
| | - Charles M. Morin
- grid.23856.3a0000 0004 1936 8390École de Psychologie, Centre d’étude des troubles du sommeil, Centrede recherche CERVO/Brain Research Center, Université Laval, Québec, Canada
| | - Markku Partinen
- Helsinki Sleep Clinic, Terveystalo Healthcare, Valimotie 21, 00380 Helsinki, Finland
- grid.7737.40000 0004 0410 2071Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | - Corrado Barbui
- grid.5611.30000 0004 1763 1124WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
- grid.5611.30000 0004 1763 1124Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Mark J. D. Jordans
- grid.487424.90000 0004 0414 0756Research and Development Department, War Child Holland, Amsterdam, The Netherlands
- grid.7177.60000000084992262Amsterdam Institute of Social Science Research, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Mario H. Braakman
- grid.12295.3d0000 0001 0943 3265Department of Transcultural Forensic Psychiatry, Tilburg University, Tilburg, The Netherlands
| | - Christine Knaevelsrud
- grid.14095.390000 0000 9116 4836Psychologische Psychotherapeutin, Klinisch-Psychologische Intervention, Freie Universität Berlin, Fachbereich Erziehungswissenschaftund Psychologie, Habelschwerdter Allee 45, 14195 Berlin, Germany
| | - Ståle Pallesen
- grid.7914.b0000 0004 1936 7443Department of Psychosocial Science, University of Bergen, Christiesgt.12, 5015 Bergen, Norway
| | - Marit Sijbrandij
- Faculty of Behavioural and Movement Sciences, Clinical Psychology, World Health Organization (WHO) Collaborating Center, Van der Boechorststraat 7, 1081BT Amsterdam, Netherlands
| | - Diego Andrés Golombek
- grid.11560.330000 0001 1087 5626Universidad Nacional de Quilmes/CONICET, R.S. Peña 352, 1876 Bernal, Buenos Aires, Argentina
| | - Colin A. Espie
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
- grid.4991.50000 0004 1936 8948Sir Jules Thorn Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, Oxford, OX1 3QU UK
| | - Pim Cuijpers
- grid.12380.380000 0004 1754 9227Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- grid.12380.380000 0004 1754 9227WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
- grid.1374.10000 0001 2097 1371Faculty of Medicine, University of Turku, Turku, Finland
| | | | - Koos van der Velden
- grid.10417.330000 0004 0444 9382Department of Public Health, Radboudumc, Nijmegen, The Netherlands
| | - Bessel A. van der Kolk
- grid.189504.10000 0004 1936 7558Department of Psychiatry, Boston University School of Medicine, Boston, USA
| | | | - Walter L. J. M. Devillé
- National Knowledge and Advisory Center on Migrants, Refugees and Health (Pharos), Utrecht, The Netherlands
- grid.7177.60000000084992262Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Dieter Riemann
- grid.7708.80000 0000 9428 7911Leiter der Abteilung für Klinische Psychologie and Psychophysiologie, Zentrum für Psychische Erkrankungen, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Hauptstr. 5, 79104 Freiburg, Germany
| | - John Axelsson
- grid.10548.380000 0004 1936 9377Stress Research Institute, Stockholm University, 106 91 Stockholm, Sweden
- grid.4714.60000 0004 1937 0626Department Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Gloria Benítez-King
- grid.419154.c0000 0004 1776 9908Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Calzada México-Xochimilco No 101, Colonia San Lorenzo, Huipulco, 14370 Mexico City, CDMX México
| | - Robert D. Macy
- International Trauma Center, Beverly Farms, Beverly, MA 01915 USA
- grid.38142.3c000000041936754XHarvard Medical School-McLean Hospital Developmental Trauma, Boston, MA USA
- Boston Children’s Foundation, 850 Summer St, South Boston, MA 02127 USA
| | - Vitalii Poberezhets
- grid.446037.2Department of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | | | - Rangaswamy Srinivasa Murthy
- grid.416861.c0000 0001 1516 2246Formally of Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka India
| | - Thomas Hegemann
- Bayerisches Zentrumfür Transkulturelle Medizin, Landshuter Allee 21, 80637 München, Germany
| | - Andreas Heinz
- grid.6363.00000 0001 2218 4662Department Psychiatry and Neurosciences CCM, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jane Salvage
- grid.3575.40000000121633745Midwifery Leadership Consultant, World Health Organization, Geneva, Switzerland
- grid.15538.3a0000 0001 0536 3773Kingston University, London, UK
| | - Alexander C. McFarlane
- grid.1010.00000 0004 1936 7304Department of Psychiatry, The University of Adelaide, Adelaide, 5000 Australia
| | - Rob Keukens
- GGZ Ecademy Coöperatie UA, Keltenstraat 14, 5037 KD, Tilburg, The Netherlands
- Federation Global Initiative on Psychiatry (FGIP), P.O. Box 1956, 1200 BZ Hilversum, The Netherlands
- grid.3575.40000000121633745Supervisor Capacity Building Community Mental Health Ukraine World Health Organization, Geneva, Switzerland
| | - Harendra de Silva
- grid.8065.b0000000121828067Formally of Department of Paediatrics, University of Colombo, Colombo, Sri Lanka
| | - Cornelia Oestereich
- Institut für systemische Therapie und Beratung, Leisewitzstraße 26, 30175 Hannover, Germany
| | - Jochen Wilhelm
- grid.8664.c0000 0001 2165 8627DeutschesZentrum für Lungenforschung (DZL), Justus-Liebig-Universität Gießen (JLU), Gießen, Germany
| | - Michael von Cranach
- grid.434949.70000 0001 1408 3925Hochschule München, Eggenthal, Grub 4, 87653 München, Germany
| | - Klaus Hoffmann
- Forensic Psychiatry and Psychotherapy, Feursteinstr. 55, 78479 Reichenau, Germany
- grid.9811.10000 0001 0658 7699Zentrum für Psychiatrie Reichenau, Akademisches Lehrkrankenhaus der Universität Konstanz, Rechtsfähige Anstalt des öffentlichen Rechts, Reichenau, Germany
| | - Matthias Klosinski
- grid.6936.a0000000123222966Facharzt für Kinder- und Jugendpsychiatrie und -psychotherapie Systemischer Berater (SG), Systemischer Therapeut (SG), TU München, Klinikum rechts der Isar, München, Germany
| | - Dinesh Bhugra
- grid.13097.3c0000 0001 2322 6764Professor Emeritus, Mental Health and Cultural Diversity, Institute of Psychiatry, Psychology and Neuroscience, Kings College, London, SE5 8AF UK
| | - Mary V. Seeman
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada
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Thoma M, Bernays F, Eising C, Maercker A, Rohner S. Mental and Physical Health in Swiss Older Survivors of Enforced Child Welfare Practices. Innov Aging 2021. [PMCID: PMC8680753 DOI: 10.1093/geroni/igab046.2079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
It is the purpose of child welfare practices to provide a protective environment for minors. However, welfare practices for children and adolescents have also been linked to a higher risk for maltreatment, trauma, and deprivation. Due to such early-life adversity, affected individuals often report a life course depicted by further trauma, socio-economic disadvantage, mental and physical ill-health. Examination of the long-term health correlates of enforced child welfare practices, as well as potential mediators, have previously been neglected in later life. It was therefore the purpose of these studies to examine the long-term correlates of enforced child welfare practices; the associated maltreatment, trauma, and deprivation; and the physical and mental health outcomes in Swiss older survivors (n=132, MAGE=71 years) and an age-matched control group (n=125). These studies further examined the mediating role of socio-economic factors (e.g., education, income), self-esteem, and self-compassion. Mental health was assessed with a structured clinical interview; physical health, self-esteem, and self-compassion with psychometric instruments. Survivors reported significantly more types and severity of childhood maltreatment, trauma, and deprivation than the control group. They also reported significantly more lifetime and current mental health disorders and more physical illnesses. Socio-economic factors and self-esteem, but not self-compassion, acted as significant mediators. Exposure to maltreatment, trauma, and deprivation in childhood and adolescence is linked to poorer mental and physical health in later life. Potential targets for intervention and health-protective measures include socio-economic factors and self-esteem, which were found to diminish the detrimental long-term impact of early-life adversity and disadvantage into later life.
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Affiliation(s)
- Myriam Thoma
- University of Zurich, Zurich, Zurich, Switzerland
| | | | - Carla Eising
- University of Zürich, Zurich, Zurich, Switzerland
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Rohner S, Maercker A, Carr A, Thoma M. Aging in the Aftermath of Adversity: Later-Life Impact of Institutional Child Abuse and Disclosure. Innov Aging 2021. [PMCID: PMC8680735 DOI: 10.1093/geroni/igab046.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Until the 1990’s in Ireland, many children in institutional care experienced abuse and neglect, with lasting negative effects, including trauma symptoms and psychopathology. While trauma disclosure can be important for recovery, findings are inconsistent and often lack consideration of wider social and interpersonal contexts. As survivors of this historical adversity enter later-life stages, research is needed on the long-term impact and to clarify the role of disclosure. Therefore, this study aimed to examine the later-life impact of institutional child abuse on health and well-being, and the role of trauma disclosure and socio-interpersonal contexts in an older adult sample. Qualitative semi-structured interviews (60-120 minutes) were conducted with 17 Irish older adults, aged 50-77 years (mean age=60.7 years), who experienced childhood institutional abuse. Audio-recorded interviews were transcribed and analysed using Framework Analysis. Themes for ‘childhood and related later-life adversity’ included detrimental perceptions and interactions, re-exposure and reminders, failure of system and society, and cycle of abuse. Disclosure themes included successful, unsuccessful, and non-disclosure, as well as evidence of socio-interpersonal interactions (e.g., non-disclosure influenced by shame or fear, compounded by socio-cultural values, (lack of) social acknowledgment, or the power of the church in society). Results suggest that childhood institutional abuse can have long-term negative impacts into later life, including social, psychological, physical health, and socio-economic aspects. Disclosure results emphasize the need to consider the complex social, cultural, and interpersonal contexts within which an individual is embedded. This may enhance understanding and facilitate targeted health and social care services for this older adult population.
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Affiliation(s)
| | | | - Alan Carr
- University College Dublin, Dublin, Dublin, Ireland
| | - Myriam Thoma
- University of Zurich, Zurich, Zurich, Switzerland
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49
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Abstract
Abstract. Studies in patient or community samples suggest that many older adults who experience clinically significant psychopathology do not fit easily into our existing disorder classification systems. This affects older people with traumatic experiences, who in their senescence report multiple mental disturbances and reduced quality of life. Thus, there is a need to develop age-appropriate diagnostic criteria for posttraumatic stress disorder (PTSD). To date, the new ICD-11 has done this only in a very rudimentary way. This article gives a brief historical overview and names the reasons for these diagnostic problems. Subsequently, it proposes six plus one (male-only) features to be dominant and life-stage specific in older adults: posttraumatic nightmares and reenactments, impaired sleep, painful memories of traumatically lost close persons, hypervigilance including elevated startle response, weakness or asthenia, somatoform pain or chronic primary pain, and in males only: reckless or self-destructive behavior. Finally, it outlines future steps to improve the adequate recognition of clinical presentations of trauma sequelae.
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50
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Vancappel A, Jansen E, Bachem R, Bray A, Egreteau L, Réveillère C, Maercker A, El-Hage W. Validation of the French ADNM-20 in the assessment of emotional difficulties resulting from COVID-19 quarantine and outbreak. BMC Psychol 2021; 9:180. [PMID: 34774108 PMCID: PMC8590117 DOI: 10.1186/s40359-021-00683-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 11/01/2021] [Indexed: 12/04/2022] Open
Abstract
Background Multiple psychological consequences of the COVID-19 outbreak and quarantine have been described. However, there is a lack of global conceptualization. We argue that the stressful aspects of the situation, the multiple environmental consequences of the outbreak, and the diversity of symptoms observed in such a situation, suggest that Adjustment disorder (AD) is a promising way to conceptualize the psychological consequences of the outbreak and quarantine. The first aim of the study was to validate the French version of the ADNM. The second aim was to set out adjustment difficulties resulting from COVID-19 outbreak and quarantine. Method We recruited 1010 (840 women, 170 men) who consented online to participate. They filled out the French ADNM, visual analogic scales, HADS, IES, and the COPE, to evaluate coping strategies. Results We confirmed the factor structure of the ADNM and we found good psychometric properties. We found that 61.3% of participants presented an adjustment disorder related to COVID-19 outbreak. We found multiple risk factors and protective factors to AD due to quarantine and outbreak. We also identified the coping strategies negatively and positively associated with AD. Conclusion Adjustment disorder is a relevant concept to understand psychological manifestations caused by quarantine and outbreak. The French ANDM has good psychometric properties to evaluate such manifestations. The association between coping strategies and AD symptoms suggest that CBT may be the best intervention to help people suffering from AD. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00683-7.
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Affiliation(s)
- A Vancappel
- Pôle de Psychiatrie-Addictologie, Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France. .,Département de Psychologie, EE 1901 Qualipsy, Qualité de vie et Santé Psychologique, Université de Tours, Tours, France. .,UMR 1253, iBrain, Inserm, Université de Tours, Tours, France.
| | - E Jansen
- Pôle de Psychiatrie-Addictologie, Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France
| | - R Bachem
- Universität Zürich, Zurich, Switzerland
| | - A Bray
- Pôle de Psychiatrie-Addictologie, Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France
| | - L Egreteau
- Pôle de Psychiatrie-Addictologie, Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France
| | - C Réveillère
- Département de Psychologie, EE 1901 Qualipsy, Qualité de vie et Santé Psychologique, Université de Tours, Tours, France
| | | | - W El-Hage
- Pôle de Psychiatrie-Addictologie, Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France.,UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
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