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Lotzin A, Stahlmann K, Acquarini E, Ajdukovic D, Ajdukovic M, Anastassiou-Hadjicharalambous X, Ardino V, Bondjers K, Bragesjö M, Böttche M, Dragan M, Figueiredo-Braga M, Gelezelyte O, Grajewski P, Javakhishvili JD, Kazlauskas E, Lenferink L, Lioupi C, Lueger-Schuster B, Mooren T, Sales L, Tsiskarishvili L, Novakovic IZ, Schäfer I. A longitudinal study of risk and protective factors for symptoms of adjustment disorder during the COVID-19 pandemic. Eur J Psychotraumatol 2024; 15:2318944. [PMID: 38644753 PMCID: PMC11036902 DOI: 10.1080/20008066.2024.2318944] [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: 09/12/2023] [Accepted: 12/28/2023] [Indexed: 04/23/2024] Open
Abstract
Background: The COVID-19 pandemic caused multiple stressors that may lead to symptoms of adjustment disorder.Objective: We longitudinally examined relationships between risk and protective factors, pandemic-related stressors and symptoms of adjustment disorder during the COVID-19 pandemic, as well as whether these relationships differed by the time of assessment.Method: The European Society for Traumatic Stress Studies (ESTSS) ADJUST Study included N = 15,169 participants aged 18 years and above. Participants from 11 European countries were recruited and screened three times at 6-month intervals from June 2020 to January 2022. Associations between risk and protective factors (e.g. gender), stressors (e.g. fear of infection), and symptoms of adjustment disorder (AjD, ADNM-8) and their interaction with time of assessment were examined using mixed linear regression.Results: The following predictors were significantly associated with higher AjD symptom levels: female or diverse gender; older age; pandemic-related news consumption >30 min a day; a current or previous mental health disorder; trauma exposure before or during the pandemic; a good, satisfactory or poor health status (vs. very good); burden related to governmental crisis management and communication; fear of infection; restricted social contact; work-related problems; restricted activity; and difficult housing conditions. The following predictors were associated with lower AjD levels: self-employment or retirement; working in healthcare; and face-to-face contact ≥ once a week with loved ones or friends. The effects of the following predictors on AjD symptoms differed by the time of assessment in the course of the pandemic: a current or previous mental disorder; burden related to governmental crisis management; income reduction; and a current trauma exposure.Conclusions: We identified risk factors and stressors predicting AjD symptom levels at different stages of the pandemic. For some predictors, the effects on mental health may change at different stages of a pandemic.
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Affiliation(s)
- Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
| | - Katharina Stahlmann
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Marina Ajdukovic
- Department of Social Work, Faculty of Law, University of Zagreb, Zagreb, Croatia
| | | | | | - Kristina Bondjers
- National Centre for Disaster Psychiatry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- National Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Maria Bragesjö
- Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
| | - Maria Böttche
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | | | - Margarida Figueiredo-Braga
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
- Trauma Observatory, Centre for Social Studies (CES), University of Coimbra, Coimbra, Portugal
| | - Odeta Gelezelyte
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | | | | | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Lonneke Lenferink
- Department of Psychology, Health, & Technology, Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, the Netherlands
| | - Chrysanthi Lioupi
- Psychology Program, School of Ηumanities, Social Sciences and Law, University of Nicosia, Nicosia, Cyprus
| | - Brigitte Lueger-Schuster
- Unit of Psychotraumatology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Trudy Mooren
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Luisa Sales
- Trauma Observatory, Centre for Social Studies (CES), University of Coimbra, Coimbra, Portugal
- Unit of Psychiatry, Hospital Militar, Coimbra, Portugal
| | | | - Irina Zrnic Novakovic
- Unit of Psychotraumatology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - ADJUST Study Consortium
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kazlauskas E, Gelezelyte O, Kvedaraite M, Ajdukovic D, Johannesson KB, Böttche M, Bondjers K, Dragan M, Figueiredo-Braga M, Grajewski P, Anastassiou-Hadjicharalambous X, Javakhishvili JD, Lioupi C, Lueger-Schuster B, Mouthaan J, Bagaric IR, Sales L, Schäfer I, Soydas S, Tsiskarishvili L, Novakovic IZ, Lotzin A. Psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) in 9230 adults across seven European countries: Findings from the ESTSS ADJUST study. J Affect Disord 2023; 335:18-23. [PMID: 37164064 DOI: 10.1016/j.jad.2023.05.007] [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: 10/28/2022] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND The four-item Patient Health Questionnaire-4 (PHQ-4) is a widely used screening measure for depression and anxiety. OBJECTIVES This study aimed to test factor structure and measurement invariance in an adult sample of the general population across seven European countries. METHOD A total sample of 9230 adults, 71.3 % female, Mage = 44.35 (SD = 14.11) from seven countries (Austria, Croatia, Georgia, Germany, Lithuania, Portugal, and Sweden) participated in the study. We applied confirmatory factor analysis (CFA) to examine the factor structure and measurement invariance testing to evaluate measurement equivalence across countries, gender, and age groups. RESULTS The CFA yielded that a two-factor PHQ-4 model with separate depression and anxiety factors had the best fit. Partial scalar measurement invariance was established across different groups based on gender, age, and country. CONCLUSIONS The PHQ-4 is a valid and reliable measure that can be applied to screen for depression and anxiety in the general population. LIMITATIONS The limitation of the study includes the sampling, which resulted in the sample structure with the majority of females, predominantly of high education and from urban communities.
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Affiliation(s)
- Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Lithuania.
| | - Odeta Gelezelyte
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Lithuania
| | - Monika Kvedaraite
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Lithuania
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia
| | - Kerstin Bergh Johannesson
- National Centre for Disaster Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Maria Böttche
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Germany
| | - Kristina Bondjers
- National Centre for Disaster Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, Sweden; Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway
| | | | - Margarida Figueiredo-Braga
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Portugal; Trauma Observatory, Centre for Social Studies (CES), University of Coimbra, Portugal
| | | | | | | | - Chrysanthi Lioupi
- Psychology Program, School of Ηumanities, Social Sciences and Law, University of Nicosia, Cyprus
| | - Brigitte Lueger-Schuster
- Unit of Psychotraumatology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Austria
| | - Joanne Mouthaan
- Department of Clinical Psychology, Institute of Psychology, Faculty of Social and Behavioural Sciences, Leiden University, the Netherlands
| | - Ines Rezo Bagaric
- Department of Social Work, Faculty of Law, University of Zagreb, Croatia
| | - Luisa Sales
- Trauma Observatory, Centre for Social Studies (CES), University of Coimbra, Portugal; Unit of Psychiatry, Hospital Militar, Coimbra, Portugal
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Suzan Soydas
- Department of Clinical Psychology, Faculty of Social and Behavioral Sciences, Utrecht University, the Netherlands
| | - Lela Tsiskarishvili
- Faculty of Arts and Science, Institute of Addiction Studies, Ilia State University, Tbilisi, Georgia; The Georgian Centre for Psychosocial and Medical Rehabilitation of Torture Victims, Tbilisi, Georgia
| | - Irina Zrnic Novakovic
- Unit of Psychotraumatology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Austria
| | - Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Lotzin A, Krause L, Acquarini E, Ajdukovic D, Ardino V, Arnberg F, Böttche M, Bragesjö M, Dragan M, Figueiredo-Braga M, Gelezelyte O, Grajewski P, Anastassiou-Hadjicharalambous X, Javakhishvili JD, Kazlauskas E, Lenferink L, Lioupi C, Lueger-Schuster B, Tsiskarishvili L, Mooren T, Sales L, Stevanovic A, Zrnic I, Schäfer I, ADJUST Study Consortium. Risk and protective factors, stressors, and symptoms of adjustment disorder during the COVID-19 pandemic - First results of the ESTSS COVID-19 pan-European ADJUST study. Eur J Psychotraumatol 2021; 12:1964197. [PMID: 34992755 PMCID: PMC8725769 DOI: 10.1080/20008198.2021.1964197] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/22/2021] [Indexed: 12/15/2022] Open
Abstract
Background The COVID-19 pandemic exposes individuals to multiple stressors, such as quarantine, physical distancing, job loss, risk of infection, and loss of loved ones. Such a complex array of stressors potentially lead to symptoms of adjustment disorder. Objective This cross-sectional exploratory study examined relationships between risk and protective factors, stressors, and symptoms of adjustment disorder during the first year of the COVID-19 pandemic. Methods Data from the first wave of the European Society of Traumatic Stress Studies (ESTSS) longitudinal ADJUST Study were used. N = 15,563 participants aged 18 years and above were recruited in eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. Associations between risk and protective factors (e.g. gender, diagnosis of a mental health disorder), stressors (e.g. fear of infection, restricted face-to-face contact), and symptoms of adjustment disorder (ADNM-8) were examined using multivariate linear regression. Results The prevalence of self-reported probable adjustment disorder was 18.2%. Risk factors associated with higher levels of symptoms of adjustment disorder were female gender, older age, being at risk for severe COVID-19 illness, poorer general health status, current or previous trauma exposure, a current or previous mental health disorder, and longer exposure to COVID-19 news. Protective factors related to lower levels of symptoms of adjustment disorder were higher income, being retired, and having more face-to-face contact with loved ones or friends. Pandemic-related stressors associated with higher levels of symptoms of adjustment disorder included fear of infection, governmental crisis management, restricted social contact, work-related problems, restricted activity, and difficult housing conditions. Conclusions We identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder.
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Affiliation(s)
- Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Linda Krause
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | | | - Filip Arnberg
- Department of Neuroscience, National Centre for Disaster Psychiatry, Uppsala University, Uppsala, Sweden
| | - Maria Böttche
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Maria Bragesjö
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | | | - Margarida Figueiredo-Braga
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, PortoPortugal
- Trauma Observatory, Centre for Social Studies (CES), University of Coimbra, Portugal
| | - Odeta Gelezelyte
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | | | | | | | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Lonneke Lenferink
- Department of Psychology, Health, & Technology, Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, The Netherlands
| | - Chrysanthi Lioupi
- School of Ηumanities, Social Sciences and Law, University of Nicosia, Nicosia, Cyprus
| | | | | | - Trudy Mooren
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Luisa Sales
- Trauma Observatory, Centre for Social Studies (CES), University of Coimbra, Portugal
- Unit of Psychiatry, Hospital Militar, Coimbra, Portugal
| | - Aleksandra Stevanovic
- Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Irina Zrnic
- Unit of Psychotraumatology, Faculty of Psychology, University of Vienna, ViennaAustria
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Bakic H, Ajdukovic D. Resilience after natural disasters: the process of harnessing resources in communities differentially exposed to a flood. Eur J Psychotraumatol 2021; 12:1891733. [PMID: 34992751 PMCID: PMC8725694 DOI: 10.1080/20008198.2021.1891733] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/26/2021] [Accepted: 02/05/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Disasters negatively impact mental health and well-being. Studying how people adapt and recover after adversity is crucial for disaster preparedness and response. Objective: This study examined how differentially affected communities harness their resources to adapt to the aftermath of a flood. We predicted that stronger individual, interpersonal, and community resources protect against psychosocial resource loss and, through that, are related to fewer symptoms of posttraumatic stress and depression and higher life satisfaction. We also predicted that these effects would be stronger in a flooded community, compared to a threatened, but non-flooded community. Method: Participants were randomly sampled community members from two neighbouring municipalities. One municipality was severely flooded during the 2014 floods in South East Europe (affected community, na = 223), the other was threatened but not flooded (comparison community, nc = 224). Interviews were conducted one and a half years after the disaster using the Connor-Davidson Resilience Scale 10-item version, the Multidimensional Scale of Perceived Social Support, the Community Resources Scale, the Psychosocial Resource Loss Scale, the PTSD Checklist for DSM-5, the Center for Epidemiological Studies Depression Scale Revised and the Satisfaction with Life Scale. Results: Stronger individual, interpersonal, and community resources were found to be related to better post-disaster outcomes directly and indirectly through psychosocial resource loss. In the affected community, interpersonal resources and community social capital and engagement were stronger predictors of positive adaptation. In the comparison community, community economic development and trust in community leadership were more important. Conclusion: This study provides evidence that people affected by disasters can harness their individual, interpersonal, and community resources to recover and adapt. Post-disaster interventions should aim to strengthen family and community ties, thus increasing available social support and community connectedness.
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Affiliation(s)
- Helena Bakic
- Department of Psychology, University of Zagreb, Zagreb, Croatia
| | - Dean Ajdukovic
- Department of Psychology, University of Zagreb, Zagreb, Croatia
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Lotzin A, Acquarini E, Ajdukovic D, Ardino V, Böttche M, Bondjers K, Bragesjö M, Dragan M, Grajewski P, Figueiredo-Braga M, Gelezelyte O, Javakhishvili JD, Kazlauskas E, Knefel M, Lueger-Schuster B, Makhashvili N, Mooren T, Sales L, Stevanovic A, Schäfer I. Stressors, coping and symptoms of adjustment disorder in the course of the COVID-19 pandemic - study protocol of the European Society for Traumatic Stress Studies (ESTSS) pan-European study. Eur J Psychotraumatol 2020; 11:1780832. [PMID: 33029321 PMCID: PMC7473046 DOI: 10.1080/20008198.2020.1780832] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 05/19/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND During the current COVID-19 pandemic, the people in Europe are exposed to self-isolation, quarantine, job loss, risk of contracting COVID-19, or grief of loved ones. Such a complex array of stressors may lead to symptoms of adjustment disorder or posttraumatic stress disorder. This research protocol describes a study launched by the European Society of Traumatic Stress Studies (ESTSS) to investigate the impact of the COVID-19 pandemic on symptoms of adjustment disorder across European countries. OBJECTIVE The longitudinal online cohort study aims (1) to explore psychosocial reactions to the COVID-19 pandemic across ten European countries; (2) to examine the relationships between risk and resilience factors, stressors and symptoms of adjustment disorder during the pandemic; and (3) to investigate whether these relationships are moderated by coping behaviours. METHOD In ten countries (Austria, Croatia, Georgia, Germany, Italy, Lithuania, Netherlands, Poland, Portugal, and Sweden), between 1,000 and 2,000 participants will be recruited, depending on the size of the country. Participants will be assessed at two timepoints with a six-month interval. Following a conceptual framework based on the WHO's social framework of health, an assessment of risk and resilience factors, COVID-19 related stressors and pandemic-specific coping behaviours will be measured to estimate their contribution to symptoms of adjustment disorder. The Adjustment Disorder New Module 8 (ADNM-8) will be used to assess symptoms of adjustment disorder. As a secondary measure, symptoms of posttraumatic stress disorder will be measure using the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). DATA ANALYSIS The relative contribution of risk factors, resilience factors, and stressors on symptoms of adjustment disorder or symptoms of posttraumatic stress disorder will be estimated using multilevel analysis. To determine the moderating effects of different types of coping behaviours on these relationships, a multilevel mediation analysis will be carried out.
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Affiliation(s)
- Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Elena Acquarini
- Department of Communication Sciences, Humanities and International Studies (DISCUI), University of Urbino, Italy
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Vittoria Ardino
- Department of Communication Sciences, Humanities and International Studies (DISCUI), University of Urbino, Italy
| | | | - Kristina Bondjers
- Division of Clinical Psychological Intervention, National Centre for Disaster Psychiatry, Uppsala University, Uppsala, Sweden
| | - Maria Bragesjö
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Margarida Figueiredo-Braga
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Odeta Gelezelyte
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | | | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Matthias Knefel
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | | | - Nino Makhashvili
- Institute of Addiction Studies, Ilia State University, Tbilisi, Georgia
| | - Trudy Mooren
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Luisa Sales
- Centre of Trauma, Centre for Social Studies (CES), University of Coimbra, Portugal
| | - Aleksandra Stevanovic
- Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Jankovic J, Bremner S, Bogic M, Lecic-Tosevski D, Ajdukovic D, Franciskovic T, Galeazzi G, Kucukalic A, Morina N, Popovski M, Schützwohl M, Priebe S. Trauma and suicidality in war affected communities. Eur Psychiatry 2020; 28:514-20. [DOI: 10.1016/j.eurpsy.2012.06.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 05/12/2012] [Accepted: 06/05/2012] [Indexed: 11/15/2022] Open
Abstract
AbstractPurposeThe aim was to assess whether experiences of war trauma remain directly associated with suicidality in war affected communities when other risk factors are considered.Materials and methodsIn the main sample 3313 participants from former Yugoslavia who experienced war trauma were recruited using a random sampling in five Balkan countries. In the second sample 854 refugees from former Yugoslavia recruited through registers and networking in three Western European countries. Sociodemographic and data on trauma exposure, psychiatric diagnoses and level of suicidality were assessed.ResultsIn the main sample 113 participants (3.4%) had high suicidality, which was associated with number of potentially traumatic war experiences (odds ratio 1.1) and war related imprisonment (odds ratio 3) once all measured risk factors were considered. These associations were confirmed in the refugee sample with a higher suicidality rate (10.2%).Discussion and conclusionsNumber of potentially traumatic war experiences, in particular imprisonment, may be considered as a relevant risk factor for suicidality in people affected by war.
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Olff M, Bakker A, Frewen P, Aakvaag H, Ajdukovic D, Brewer D, Elmore Borbon DL, Cloitre M, Hyland P, Kassam-Adams N, Knefel M, Lanza JA, Lueger-Schuster B, Nickerson A, Oe M, Pfaltz MC, Salgado C, Seedat S, Wagner A, Schnyder U. Screening for consequences of trauma - an update on the global collaboration on traumatic stress. Eur J Psychotraumatol 2020; 11:1752504. [PMID: 32489523 PMCID: PMC7241533 DOI: 10.1080/20008198.2020.1752504] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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] [Indexed: 02/08/2023] Open
Abstract
This letter provides an update on the activities of "The Global Collaboration on Traumatic Stress" (GC-TS) as first described by Schnyder et al. in 2017. It presents in further detail the projects of the first theme, in particular the development of and initial data on the Global Psychotrauma Screen (GPS), a brief instrument designed to screen for the wide range of potential outcomes of trauma. English language data and ongoing studies in several languages provide a first indication that the GPS is a feasible, reliable and valid tool, a tool that may be very useful in the current pandemic of the coronavirus disease 2019 (COVID-19). Further multi-language and cross-cultural validation is needed. Since the start of the GC-TS, new themes have been introduced to focus on in the coming years: a) Forcibly displaced persons, b) Global prevalence of stress and trauma related disorders, c) Socio-emotional development across cultures, and d) Collaborating to make traumatic stress research data "FAIR". The most recent theme added is that of Global crises, currently focusing on COVID-19-related projects.
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Affiliation(s)
- Miranda Olff
- Department of Psychiatry, Amsterdam Neuroscience & Public Health, Amsterdam UMC, Amsterdam, The Netherlands.,ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Anne Bakker
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Paul Frewen
- Department of Psychiatry, Western University, London, Canada
| | - Helene Aakvaag
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Douglas Brewer
- Ramsay Health Care, The Hollywood Clinic, Perth, Australia
| | - Diane L Elmore Borbon
- Policy Program, UCLA-Duke University National Center for Child Traumatic Stress, Washington, DC, USA
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, Stanford University, Menlo Park, CA, USA
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Nancy Kassam-Adams
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Center for Pediatric Traumatic Stress, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Juliana A Lanza
- Traumatic Stress Unit, Psychiatric Emergency Hospital, Buenos City, Argentina.,Human Factors, Emergency Medical Care System (SAME), Buenos Aires City, Argentina
| | | | | | - Misari Oe
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Monique C Pfaltz
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Carolina Salgado
- Department of Psychiatry, Medical School of Universidad Catolica Del Maule, Chile
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anne Wagner
- Department of Psychology, Ryerson University, Toronto, Canada and Remedy, Toronto, Canada
| | - Ulrich Schnyder
- Department of Psychiatry, Amsterdam Neuroscience & Public Health, Amsterdam UMC, Amsterdam, The Netherlands.,ARQ National Psychotrauma Centre, Diemen, The Netherlands.,Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Psychiatry, Western University, London, Canada.,Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia.,Ramsay Health Care, The Hollywood Clinic, Perth, Australia.,Policy Program, UCLA-Duke University National Center for Child Traumatic Stress, Washington, DC, USA.,National Center for PTSD Dissemination and Training Division, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, Stanford University, Menlo Park, CA, USA.,Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland.,Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Center for Pediatric Traumatic Stress, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,University of Vienna, Vienna, Austria.,Traumatic Stress Unit, Psychiatric Emergency Hospital, Buenos City, Argentina.,Human Factors, Emergency Medical Care System (SAME), Buenos Aires City, Argentina.,Faculty of Psychology, Clinical Psychology, University of Vienna, Vienna, Austria.,UNSW School of Psychology, UNSW Sydney, Australia.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.,Department of Psychiatry, Medical School of Universidad Catolica Del Maule, Chile.,Department of Psychiatry, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Psychology, Ryerson University, Toronto, Canada and Remedy, Toronto, Canada.,Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Bakic H, Ajdukovic D. Stability and change post-disaster: dynamic relations between individual, interpersonal and community resources and psychosocial functioning. Eur J Psychotraumatol 2019; 10:1614821. [PMID: 31191829 PMCID: PMC6541896 DOI: 10.1080/20008198.2019.1614821] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 08/16/2018] [Revised: 03/10/2019] [Accepted: 04/19/2019] [Indexed: 01/07/2023] Open
Abstract
Conservation of Resources (COR) theory defines psychological stress as the result of a threat or actual loss of resources, or lack of resource gain. Given that disasters present a significant risk for resource loss, the aim of this study was to examine the dynamic relationship between the change in different levels of resources and the change in psychosocial functioning. A random sample of N= 224 community members from a municipality affected by the 2014 Southeast Europe floods were interviewed one and a half and two and a half years post-disaster, using the Connor-Davidson Resilience Scale 10-item version, the Multidimensional Scale of Perceived Social Support, the Community Resources Scale - the Social Capital and Community Engagement subscale, the PTSD Checklist for DSM-5, the Center for Epidemiological Studies Depression Scale-Revised and the Satisfaction with Life Scale. The results of the Latent Difference Scores modelling indicate that the increase in resources was related to a decline in post-traumatic stress (PTS) and depression symptoms and increase in life satisfaction, and vice versa. Interpersonal resources were significantly related to all measured psychosocial outcomes, individual resources to PTS and life satisfaction and community resources to life satisfaction only. The mean level of resources remained the same, but a significant inter-individual variability in resource change was found: for some, they have increased, and for some decreased over time. Furthermore, resources changed independently: an increase in one was not related to an increase in another. These findings highlight the importance of resource gain and loss for psychosocial outcomes and call for targeted post-disaster interventions that can, by increasing the levels of resources in affected communities, decrease the levels of symptoms and increase well-being.
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Affiliation(s)
- Helena Bakic
- Department of Psychology, University of Zagreb, Zagreb, Croatia
| | - Dean Ajdukovic
- Department of Psychology, University of Zagreb, Zagreb, Croatia
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9
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van Loenen T, van den Muijsenbergh M, Hofmeester M, Dowrick C, van Ginneken N, Mechili EA, Angelaki A, Ajdukovic D, Bakic H, Pavlic DR, Zelko E, Hoffmann K, Jirovsky E, Mayrhuber ES, Dückers M, Mooren T, Gouweloos-Trines J, Kolozsvári L, Rurik I, Lionis C. Primary care for refugees and newly arrived migrants in Europe: a qualitative study on health needs, barriers and wishes. Eur J Public Health 2019; 28:82-87. [PMID: 29240907 DOI: 10.1093/eurpub/ckx210] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background In order to provide effective primary care for refugees and to develop interventions tailored to them, we must know their needs. Little is known of the health needs and experiences of recently arrived refugees and other migrants throughout their journey through Europe. We aimed to gain insight into their health needs, barriers in access and wishes regarding primary health care. Methods In the spring of 2016, we conducted a qualitative, comparative case study in seven EU countries in a centre of first arrival, two transit centres, two intermediate-stay centres and two longer-stay centres using a Participatory Learning and Action research methodology. A total of 98 refugees and 25 healthcare workers participated in 43 sessions. Transcripts and sessions reports were coded and thematically analyzed by local researchers using the same format at all sites; data were synthesized and further analyzed by two other researchers independently. Results The main health problems of the participants related to war and to their harsh journey like common infections and psychological distress. They encountered important barriers in accessing healthcare: time pressure, linguistic and cultural differences and lack of continuity of care. They wish for compassionate, culturally sensitive healthcare workers and for more information on procedures and health promotion. Conclusion Health of refugees on the move in Europe is jeopardized by their bad living circumstances and barriers in access to healthcare. To address their needs, healthcare workers have to be trained in providing integrated, compassionate and cultural competent healthcare.
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Affiliation(s)
- Tessa van Loenen
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.,Pharos, Centre of Expertise on Health Disparities, Utrecht, The Netherlands
| | - Marrigje Hofmeester
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Nadja van Ginneken
- Department of Psychological Science, University of Liverpool, Liverpool, UK
| | | | - Agapi Angelaki
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Science, University of Zagreb, Zagreb, Croatia
| | - Helena Bakic
- Department of Psychology, Faculty of Humanities and Social Science, University of Zagreb, Zagreb, Croatia
| | - Danica Rotar Pavlic
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Erika Zelko
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Kathryn Hoffmann
- Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Elena Jirovsky
- Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Sophie Mayrhuber
- Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Michel Dückers
- Netherlands Institute for Health Services Research, Utrecht, The Netherlands.,Impact, National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Arq Psychotrauma Expert Group, Diemen, The Netherlands
| | - Trudy Mooren
- Foundation Centrum '45, Arq, Diemen, The Netherlands
| | - Juul Gouweloos-Trines
- Impact, National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Arq Psychotrauma Expert Group, Diemen, The Netherlands
| | - László Kolozsvári
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
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10
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Schäfer I, Hopchet M, Vandamme N, Ajdukovic D, El-Hage W, Egreteau L, Javakhishvili JD, Makhashvili N, Lampe A, Ardino V, Kazlauskas E, Mouthaan J, Sijbrandij M, Dragan M, Lis-Turlejska M, Figueiredo-Braga M, Sales L, Arnberg F, Nazarenko T, Nalyvaiko N, Armour C, Murphy D. Trauma and trauma care in Europe. Eur J Psychotraumatol 2018; 9:1556553. [PMID: 30637092 PMCID: PMC6319458 DOI: 10.1080/20008198.2018.1556553] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/05/2018] [Accepted: 11/09/2018] [Indexed: 12/22/2022] Open
Abstract
The European countries have a long history of exposure to large-scale trauma. In the early 1990s the increasing awareness of the consequences of trauma within the mental health community led to the foundation of local societies for psychotraumatology across Europe and the European Society of Traumatic Stress Studies (ESTSS), which celebrated its 25th anniversary in 2018. The focus of this article is to describe the current state of care for survivors of trauma in the 15 European countries where ESTSS member societies have been established. Brief descriptions on the historical burden of trauma in each country are followed by an overview of the care system for trauma survivors in the countries, the state-of-the-art of interventions, current challenges in caring for survivors and the topics that need to be most urgently addressed in the future. The reports from the different countries demonstrate how important steps towards a better provision of care for survivors of trauma have been made in Europe. Given the cultural and economic diversity of the continent, there are also differences between the European countries, for instance with regard to the use of evidence-based treatments. Strategies to overcome these differences, like the new ESTSS training curricula for care-providers across Europe, are briefly discussed.
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Affiliation(s)
- Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Naomi Vandamme
- Belgian Institute for Psychotraumatology, Trauma Center Limburg, Hasselt, Belgium
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Wissam El-Hage
- UMR 1253, iBrain, Université de Tours, CHRU de Tours, Inserm, Tours, France
| | - Laurine Egreteau
- Laurine Egreteau, CHRU de Tours, Clinique Psychiatrique Universitaire, Tours, France
| | | | | | - Astrid Lampe
- Department of Medical Psychology and Psychotherapy, University Medical Hospital Innsbruck, Innsbruck, Austria
| | - Vittoria Ardino
- Dipartimento di Scienze dell'Uomo, Urbino University, Urbino, Italy
| | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Joanne Mouthaan
- Department Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Marit Sijbrandij
- Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | | | - Maja Lis-Turlejska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Margarida Figueiredo-Braga
- Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Social Studies (CES) of the University of Coimbra, Coimbra, Portugal
| | - Luísa Sales
- Department of Psychiatry of the Military Hospital of Coimbra, Centre of Trauma (CES) of the University of Coimbra, Coimbra, Portugal
| | - Filip Arnberg
- National Centre for Disaster Psychiatry, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Tetiana Nazarenko
- Non-Governmental organization ‘Ukrainian Society of Overcoming the Consequences of Traumatic Events’ (USOCTE), Kyiv, Ukraine
| | - Natalia Nalyvaiko
- International Institute of Depth Psychology, Non-Governmental organization ‘Ukrainian Society of Overcoming the Consequences of Traumatic Events’ (USOCTE), Kyiv, Ukraine
| | - Cherie Armour
- School of Psychology, Institute of Mental Health Sciences, Faculty of Life & Health Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Dominic Murphy
- Research Department, Combat Stress, Leatherhead, UK & King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, UK
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11
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Rurik I, Kolozsvári LR, Aarendonk D, Angelaki A, Ajdukovic D, Dowrick C, Dückers M, Hoffmann K, Jancsó Z, Jirovsky E, Katz Z, Mechili EA, van den Muijsenbergh M, Nánási A, Petelos E, Rotar-Pavlic D, Sifaki-Pistolla D, Tamás H, Roland P, Ungvári T, Lionis C. [Primary care of refugees and migrants. Lesson learnt from the EUR-HUMAN project]. Orv Hetil 2018; 159:1414-1422. [PMID: 30146908 DOI: 10.1556/650.2018.31187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/19/2022]
Abstract
In 2015, local wars, starvation and misery in some Middle Eastern, Asian and African countries forced millions of people to leave their homelands. Many of these people migrated toward Europe, reaching Hungary as well. The refugee crisis created significant challenges for all national healthcare systems across Europe. Limited attention has been given to the extent to which health service provision for refugees and migrants has become a task for primary health care (PHC), which has been unprepared as a profession and pressured by the enormous workload. Hungarian primary care was involved only to an extent in the refugees' health care, as most of the migrants entering Hungary wanted to move forward to other countries. The need for evidence-based patient-centred interventions to assess refugee healthcare needs, and for training programmes for rapid capacity-building for integrated PHC was addressed by the EUropean Refugees - HUman Movement and Advisory Network (EUR-HUMAN) project, which 7 European countries developed together. The overall aim of the EUR-HUMAN project is to enhance the knowledge and expertise of European member states who accept refugees and migrants in addressing their health needs, safeguarding them from risks, while at the same time to minimize cross-border health risks. This initiative focuses on addressing the early arrival period, transition and longer-term settlement of refugees in European host countries. A primary objective of this project is to identify, design and assess interventions to improve PHC delivery for refugees and migrants with a focus on vulnerable groups. The structure, the main focus and outputs of the project are described and summarized in this paper, providing relevant information and access to educational materials for Hungarian (primary care) physicians. The EUR-HUMAN project was operated in 2016 under the auspices of the European Commission and funded by the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA). Orv Hetil. 2018; 159(35): 1414-1422.
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Affiliation(s)
- Imre Rurik
- Családorvosi és Foglalkozás-egészségügyi Tanszék, Debreceni Egyetem, Népegészségügyi Kar Debrecen, Móricz Zs. krt. 22., 4032
| | - László Róbert Kolozsvári
- Családorvosi és Foglalkozás-egészségügyi Tanszék, Debreceni Egyetem, Népegészségügyi Kar Debrecen, Móricz Zs. krt. 22., 4032
| | | | - Agapi Angelaki
- Clinic of Social and Family Medicine, School of Medicine, University of Crete Greece
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb Croatia
| | - Christopher Dowrick
- Institute of Psychology, Health and Society, University of Liverpool United Kingdom
| | - Michel Dückers
- Netherlands Institute for Health Services Research (NIVEL) Utrecht, The Netherlands
| | - Kathryn Hoffmann
- Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna Austria
| | - Zoltán Jancsó
- Családorvosi és Foglalkozás-egészségügyi Tanszék, Debreceni Egyetem, Népegészségügyi Kar Debrecen, Móricz Zs. krt. 22., 4032
| | - Elena Jirovsky
- Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna Austria
| | - Zoltán Katz
- Műveleti Medicina Tanszék, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs
| | | | - Maria van den Muijsenbergh
- Department of Primary and Community Care, St Radboud University Medical Centre Nijmegen, The Netherlands
| | - Anna Nánási
- Családorvosi és Foglalkozás-egészségügyi Tanszék, Debreceni Egyetem, Népegészségügyi Kar Debrecen, Móricz Zs. krt. 22., 4032
| | - Elena Petelos
- Clinic of Social and Family Medicine, School of Medicine, University of Crete Greece
| | - Danica Rotar-Pavlic
- Department of Family Medicine, Medical Faculty, University of Ljubljana Slovenia
| | | | - Hajnalka Tamás
- Családorvosi és Foglalkozás-egészségügyi Tanszék, Debreceni Egyetem, Népegészségügyi Kar Debrecen, Móricz Zs. krt. 22., 4032
| | - Palla Roland
- Családorvosi és Foglalkozás-egészségügyi Tanszék, Debreceni Egyetem, Népegészségügyi Kar Debrecen, Móricz Zs. krt. 22., 4032.,PROMO-MED Kft. Győrújbarát
| | - Tímea Ungvári
- Családorvosi és Foglalkozás-egészségügyi Tanszék, Debreceni Egyetem, Népegészségügyi Kar Debrecen, Móricz Zs. krt. 22., 4032
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete Greece
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12
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Dückers MLA, Thormar SB, Juen B, Ajdukovic D, Newlove-Eriksson L, Olff M. Measuring and modelling the quality of 40 post-disaster mental health and psychosocial support programmes. PLoS One 2018; 13:e0193285. [PMID: 29489888 PMCID: PMC5830995 DOI: 10.1371/journal.pone.0193285] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 12/13/2017] [Indexed: 11/19/2022] Open
Abstract
Disasters can have an enormous impact on the health and well-being of those affected. Internationally, governments and service providers are often challenged to address complex psychosocial problems. Ideally, the potentially broad range of support activities include a coherent, high-quality mental health and psychosocial support (MHPSS) programme. We present a theory-driven quantitative analysis of the quality of 40 MHPSS programmes, mostly implemented in European disaster settings. The objective is to measure quality domains recognized as relevant in the literature and to empirically test associations. During the EU project "Operationalizing Psychosocial Support in Crisis" (OPSIC) an evaluation survey was designed and developed for this purpose and completed by 40 MHPSS programme coordinators involved in different mass emergencies and disasters. We analysed the survey data in two steps. Firstly, we used the data to operationalize quality domains of a MHPSS programme, tested constructs and assessed their internal consistency reliability. A total of 26 out of 44 survey items clustered into three of the four domains identified within the theoretical framework: "planning and delivery system" (Cronbach's alpha 0.82); "general evaluation criteria" (Cronbach's alpha 0.82); and "essential psychosocial principles" (Cronbach's alpha 0.75). "Measures and interventions applied", theoretically a potential fourth domain, could not be confirmed to empirically cluster together. Secondly, several models with associations between domains and measures and interventions were tested and compared. The model with the best fit suggests that in MHPSS programmes with a higher planning and delivery systems score, a larger number of measures and interventions from evidence-informed guidelines are applied. In such programmes, coordinators are more positive about general evaluation criteria and the realization of essential psychosocial principles. Moreover, the analyses showed that some measures and interventions are more likely to be applied in programmes with more evolved planning and delivery systems, yet for most measures and interventions the likelihood of being applied is not linked to planning and delivery system status, nor to coordinator perceptions concerning psychosocial principles and evaluation criteria. Further research is necessary to validate and expand the findings and to learn more about success factors and obstacles for MHPSS programme implementation.
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Affiliation(s)
- Michel L. A. Dückers
- Impact – National knowledge and advice centre for psychosocial care concerning critical incidents, Diemen, The Netherlands
- NIVEL – Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- Arq Psychotrauma Expert Group, Diemen, The Netherlands
- * E-mail:
| | - Sigridur B. Thormar
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Barbara Juen
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Dean Ajdukovic
- Department of Psychology, University of Zagreb, Zagreb, Croatia
| | - Lindy Newlove-Eriksson
- CRISMART – Crisis Management Research and Training, Swedish Defence University and Royal Institute of Technology, KTH, Stockholm, Sweden
| | - Miranda Olff
- Arq Psychotrauma Expert Group, Diemen, The Netherlands
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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13
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Lionis C, Petelos E, Mechili EA, Sifaki-Pistolla D, Chatzea VE, Angelaki A, Rurik I, Pavlic DR, Dowrick C, Dückers M, Ajdukovic D, Bakic H, Jirovsky E, Mayrhuber ES, van den Muijsenbergh M, Hoffmann K. Assessing refugee healthcare needs in Europe and implementing educational interventions in primary care: a focus on methods. BMC Int Health Hum Rights 2018; 18:11. [PMID: 29422090 PMCID: PMC5806359 DOI: 10.1186/s12914-018-0150-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 01/24/2018] [Indexed: 11/10/2022]
Abstract
The current political crisis, conflicts and riots in many Middle Eastern and African countries have led to massive migration waves towards Europe. European countries, receiving these migratory waves as first port of entry (POE) over the past few years, were confronted with several challenges as a result of the sheer volume of newly arriving refugees. This humanitarian refugee crisis represents the biggest displacement crisis of a generation. Although the refugee crisis created significant challenges for all national healthcare systems across Europe, limited attention has been given to the role of primary health care (PHC) to facilitate an integrated delivery of care by enhancing care provision to refugees upon arrival, on transit or even for longer periods. Evidence-based interventions, encompassing elements of patient-centredness, shared decision-making and compassionate care, could contribute to the assessment of refugee healthcare needs and to the development and the implementation of training programmes for rapid capacity-building for the needs of these vulnerable groups and in the context of integrated PHC care. This article reports on methods used for enhancing PHC for refugees through rapid capacity-building actions in the context of a structured European project under the auspices of the European Commission and funded under the 3rd Health Programme by the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA). The methods include the assessment of the health needs of all the people reaching Europe during the study period, and the identification, development, and testing of educational tools. The developed tools were evaluated following implementation in selected European primary care settings.
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Affiliation(s)
- Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, University Campus, Voutes, Heraklion, 70013, Crete, GR, Greece.
| | - Elena Petelos
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, University Campus, Voutes, Heraklion, 70013, Crete, GR, Greece
| | - Enkeleint-Aggelos Mechili
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, University Campus, Voutes, Heraklion, 70013, Crete, GR, Greece
| | - Dimitra Sifaki-Pistolla
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, University Campus, Voutes, Heraklion, 70013, Crete, GR, Greece
| | - Vasiliki-Eirini Chatzea
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, University Campus, Voutes, Heraklion, 70013, Crete, GR, Greece
| | - Agapi Angelaki
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, University Campus, Voutes, Heraklion, 70013, Crete, GR, Greece
| | - Imre Rurik
- Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Danica Rotar Pavlic
- Department of Family Medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Christopher Dowrick
- Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - Michel Dückers
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Helena Bakic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Elena Jirovsky
- Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Sophie Mayrhuber
- Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | | | - Kathryn Hoffmann
- Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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14
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Schnyder U, Schäfer I, Aakvaag HF, Ajdukovic D, Bakker A, Bisson JI, Brewer D, Cloitre M, Dyb GA, Frewen P, Lanza J, Le Brocque R, Lueger-Schuster B, Mwiti GK, Oe M, Rosner R, Schellong J, Shigemura J, Wu K, Olff M. The global collaboration on traumatic stress. Eur J Psychotraumatol 2017; 8:1403257. [PMID: 29435201 PMCID: PMC5800488 DOI: 10.1080/20008198.2017.1403257] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 11/02/2017] [Indexed: 11/18/2022] Open
Abstract
Trauma is a global issue. The great majority of the global burden of disease arising from mental health conditions occurs in low- and middle-income countries (LMICs), among populations in political, economic, and/or cultural transition and those struck by forced migration. These mental health problems frequently arise as a result of traumatic events that adversely affect adults, children, and families, including war, mass violence, natural disasters, and accidents. In response to this, the International Society for Traumatic Stress Studies (ISTSS) launched the Global Initiative to have a stronger global impact on trauma-related issues. As part of this initiative, the Global Collaboration was established by representatives of eight professional organizations active in the field of traumatic stress. The group decided to focus on childhood abuse and neglect as its first collaboration. They collected guidelines worldwide, providing the basis for a synthesized core guide for prevention and treatment that can be customized for specific cultural contexts. The resulting 'Internet information on Childhood Abuse and Neglect' (iCAN) is a comprehensive guide for adults who have been affected by childhood abuse and neglect, as well as for the survivors' significant others. It is currently provided in eight languages, and is freely available at the homepage of ISTSS and other websites. A second achievement of the Global Collaboration is the validation of the Computerized Childhood Attachment and Relational Trauma Screen (CARTS), a self-report measure designed to measure occurrences of childhood maltreatment, and its translation into multiple languages, including Croatian, Dutch, French, Georgian, German, Italian, Japanese, Norwegian, Russian, and Spanish. A study is currently planned to collect normative responses to the questionnaire, and to conduct cross-cultural comparisons. The Global Collaboration's success may be seen as an encouraging step towards a truly global structure in the field of traumatic stress.
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Affiliation(s)
- Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Helene F. Aakvaag
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Anne Bakker
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Douglas Brewer
- Ramsay Health Care, The Hollywood Clinic, Perth, Australia
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Department of Psychiatry and Behavioral Sciences, Stanford University, Menlo Park, CA, USA
| | - Grete A. Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul Frewen
- Department of Psychiatry, Western University, London, Canada
| | - Juliana Lanza
- Argentine Society for Psychotrauma, Buenos Aires, Argentina
| | - Robyne Le Brocque
- School of Nursing, Midwifery, and Social Work, University of Queensland, Brisbane, Australia
| | | | - Gladys K. Mwiti
- Oasis Africa Centre for Transformational Psychology & Trauma, Nairobi, Kenya
| | - Misari Oe
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - Jun Shigemura
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Japan
| | - Kitty Wu
- Asian Society for Traumatic Stress Studies, Hong Kong, China
- Clinical Psychological Services, Kwai Chung Hospital, Hospital Authority, Hong Kong, China
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
- Arq Psychotrauma Expert Group, Diemen, The Netherlands
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Taylor LK, Merrilees CE, Corkalo Biruski D, Ajdukovic D, Cummings EM. Complexity of Risk: Mixed-Methods Approach to Understanding Youth Risk and Insecurity in Postconflict Settings. Journal of Adolescent Research 2017. [DOI: 10.1177/0743558416684950] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In settings of intergroup conflict, identifying contextually relevant risk factors for youth development is an important task. In Vukovar, Croatia, a city devastated during the war in former Yugoslavia, ethno-political tensions remain. The current study utilized a mixed-methods approach to identify two salient community-level risk factors (ethnic tension and general antisocial behavior) and related emotional insecurity responses (ethnic and nonethnic insecurity) among youth in Vukovar. In Study 1, focus group discussions ( N = 66) with mothers, fathers, and adolescents of age 11 to 15 years old were analyzed using the constant comparative method, revealing two types of risk and insecurity responses. In Study 2, youth ( N = 227, 58% male, M = 15.88, SD = 1.12 years) responded to quantitative scales developed from the focus groups, discriminate validity was demonstrated, and path analyses established predictive validity between each type of risk and insecurity. First, community ethnic tension (i.e., threats related to war/ethnic identity) significantly predicted ethnic insecurity for all youth (β = .41, p < .001). Second, experience with community antisocial behavior (i.e., general crime found in any context) predicted nonethnic community insecurity for girls (β = .32, p < .05) but not for boys. These findings are the first to show multiple forms of emotional insecurity at the community level; implications for future research are discussed.
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Biruski DC, Ajdukovic D, Stanic AL. When the world collapses: changed worldview and social reconstruction in a traumatized community. Eur J Psychotraumatol 2014; 5:24098. [PMID: 25279101 PMCID: PMC4162982 DOI: 10.3402/ejpt.v5.24098] [Citation(s) in RCA: 20] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 08/01/2014] [Accepted: 08/05/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Traumatic experience can affect the individual's basic beliefs about the world as a predictable and safe place. One of the cornerstones in recovery from trauma is reestablishment of safety, connectedness, and the shattered schema of a worldview. OBJECTIVE This study explored the role of negatively changed worldview in the relationship between war-related traumatization and readiness for social reconstruction of intergroup relations in a post-conflict community measured by three processes: intergroup rapprochement, rebuilding trust, and need for apology. It was hypothesized that more traumatized people are less supportive of social reconstruction and that this relationship is mediated by the changed worldview. METHOD The study included a community random sample of 333 adults in the city of Vukovar, Croatia, that was most devastated during the 1991-1995 war. Six instruments were administered: Stressful Events Scale, Impact of Event Scale-Revised, Changed Worldview Scale, and three scales measuring the post-conflict social reconstruction processes: Intergroup Rapprochement, Intergroup Trust and Need for Apology. RESULTS Mediation analyses showed that the worldview change fully mediated between traumatization and all three aspects of social reconstruction. CONCLUSIONS In a population exposed to war traumatization the worldview change mediates post-conflict social recovery of community relations.
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Affiliation(s)
- Dinka Corkalo Biruski
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia
| | - Ajana Löw Stanic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia
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Priebe S, Gavrilovic J, Bremner S, Ajdukovic D, Franciskovic T, Neri G, Kucukalic A, Lecic-Tosevski D, Morina N, Popovski M, Schützwohl M, Bogic M, Matanov A. Course of post-traumatic stress disorder following war in the Balkans: 1-year follow-up study. Psychol Med 2013; 43:1837-1847. [PMID: 23190477 DOI: 10.1017/s0033291712002681] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [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] [Indexed: 11/05/2022]
Abstract
BACKGROUND Prevalence rates of post-traumatic stress disorder (PTSD) following the experience of war have been shown to be high. However, little is known about the course of the disorder in people who remained in the area of conflict and in refugees. Method We studied a representative sample of 522 adults with war-related PTSD in five Balkan countries and 215 compatriot refugees in three Western European countries. They were assessed on average 8 years after the war and reinterviewed 1 year later. We established change in PTSD symptoms, measured on the Impact of Events Scale - Revised (IES-R), and factors associated with more or less favourable outcomes. RESULTS During the 1-year period, symptoms decreased substantially in both Balkan residents and in refugees. The differences were significant for IES-R total scores and for the three subscales of intrusions, avoidance and hyperarousal. In multivariable regressions adjusting for the level of baseline symptoms, co-morbidity with depression predicted less favourable symptom change in Balkan residents. More pre-war traumatic events and the use of mental health services within the follow-up period were associated with less improvement in refugees. CONCLUSIONS Several years after the war, people with PTSD reported significant symptom improvement that might indicate a fluctuating course over time. Co-morbid depression may have to be targeted in the treatment of people who remained in the post-conflict regions whereas the use of mental health services seems to be linked to the persistence of symptoms among refugees.
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Affiliation(s)
- S Priebe
- Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.
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Matanov A, Giacco D, Bogic M, Ajdukovic D, Franciskovic T, Galeazzi GM, Kucukalic A, Lecic-Tosevski D, Morina N, Popovski M, Schützwohl M, Priebe S. Subjective quality of life in war-affected populations. BMC Public Health 2013; 13:624. [PMID: 23819629 PMCID: PMC3716711 DOI: 10.1186/1471-2458-13-624] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 05/02/2013] [Indexed: 11/17/2022] Open
Abstract
Background Exposure to traumatic war events may lead to a reduction in quality of life for many years. Research suggests that these impairments may be associated with posttraumatic stress symptoms; however, wars also have a profound impact on social conditions. Systematic studies utilising subjective quality of life (SQOL) measures are particularly rare and research in post-conflict settings is scarce. Whether social factors independently affect SQOL after war in addition to symptoms has not been explored in large scale studies. Method War-affected community samples were recruited through a random-walk technique in five Balkan countries and through registers and networking in three Western European countries. The interviews were carried out on average 8 years after the war in the Balkans. SQOL was assessed on Manchester Short Assessment of Quality of Life - MANSA. We explored the impact of war events, posttraumatic stress symptoms and post-war environment on SQOL. Results We interviewed 3313 Balkan residents and 854 refugees in Western Europe. The MANSA mean score was 4.8 (SD = 0.9) for the Balkan sample and 4.7 (SD = 0.9) for refugees. In both samples participants were explicitly dissatisfied with their employment and financial situation. Posttraumatic stress symptoms had a strong negative impact on SQOL. Traumatic war events were directly linked with lower SQOL in Balkan residents. The post-war environment influenced SQOL in both groups: unemployment was associated with lower SQOL and recent contacts with friends with higher SQOL. Experiencing more migration-related stressors was linked to poorer SQOL in refugees. Conclusion Both posttraumatic stress symptoms and aspects of the post-war environment independently influence SQOL in war-affected populations. Aid programmes to improve wellbeing following the traumatic war events should include both treatment of posttraumatic symptoms and social interventions.
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Affiliation(s)
- Aleksandra Matanov
- Unit for Social and Community Psychiatry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Cherry Tree Way, London E13 8SP, United Kingdom.
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Van Parys H, Wyverkens E, Provoost V, Ravelingien A, Raes I, Somers S, Stuyver I, De Sutter P, Pennings G, Buysse A, Anttila VS, Salevaara M, Suikkari AM, Listijono DR, Mooney S, Chapman MG, Res Muravec U, Pusica S, Lomsek M, Cizek Sajko M, Parames S, Semiao-Francisco L, Sato H, Ueno J, van den Wijngaard L, Mochtar MH, van Dam H, van der Veen F, van Wely M, Derks-Smeets IAP, Habets JJG, Tibben A, Tjan-Heijnen VCG, Meijer-Hoogeveen M, Geraedts JPM, van Golde R, Gomez-Garcia E, de Die-Smulders CEM, van Osch LADM, Habets JJG, Derks-Smeets IAP, Tibben A, Tjan-Heijnen VCG, Geraedts JPM, van Golde R, Gomez-Garcia E, Kets CM, de Die-Smulders CEM, van Osch LADM, Gullo S, Donarelli Z, Coco GL, Marino A, Volpes A, Sammartano F, Allegra A, Nekkebroeck J, Tournaye H, Stoop D, Donarelli Z, Lo Coco G, Gullo S, Marino A, Volpes A, Coffaro F, Allegra A, Diaz DG, Gonzalez MA, Tirado M, Chamorro S, Dolz P, Gil MA, Ballesteros A, Velilla E, Castello C, Moina N, Lopez-Teijon M, Chan CHY, Chan CLW, Leong MKH, Cheung IKM, Chan THY, Hui BNL, van Dongen AJCM, Huppelschoten AG, Kremer JAM, Nelen WLDM, Verhaak CM, Sun HG, Lee KH, Park IH, Kim SG, Lee JH, Kim YY, Kim HJ, Cho JD, Yoo YJ, Frokjaer V, Pinborg A, Larsen EC, Heede M, Stenbaek DS, Henningsson S, Nielsen AP, Svarer C, Holst KK, Knudsen GM, Emery M, DeJonckheere L, Rothen S, Wisard M, Germond M, Stenbaek DS, Toftager M, Hjordt LV, Jensen PS, Holst K, Holland T, Bryndorf T, Bogstad J, Hornnes P, Frokjaer VG, Dornelles LMN, MacCallum F, Lopes RCS, Piccinini CA, Passos EP, Bruegge C, Thorn P, Daniels K, Imrie S, Jadva V, Golombok S, Arens Y, De Krom G, Van Golde RJT, Coonen E, Van Ravenswaaij-Arts CMA, Meijer-Hoogeveen M, Evers JLH, Geraedts JPM, De Die-Smulders CEM, Ghazeeri G, Awwad J, Fakih A, Abbas H, Harajly S, Tawidian L, Maalouf F, Ajdukovic D, Pibernik-Okanovic M, Alebic MS, Baccino G, Calatayud C, Ricciarelli E, de Miguel ERH, Stuyver I, Wierckx K, Verstraelen H, Van Glabeke L, Van den Abbeel E, Gerris J, T'Sjoen G, De Sutter P, Monica B, Calonge RN, Peregrin PC, Cserepes R, Kollar J, Wischmann T, Bugan A, Pinkard C, Harrison C, Bunting L, Boivin J, Fulford B, Boivin J, Theusink-Kirchhoff N, van Ravenswaaij-Arts CMA, Bakker MK, Volks C, Papaligoura Z, Papadatou D, Bellali TH, Thorn P, Wischmann T, Wischmann T, Thorn P, Jarvholm S, Broberg M, Thurin-Kjellberg A, Weitzman G, Van Der Putten-Landau TM, Chudnoff S, Panagopoulou E, Tarlatzis B, Tamhankar V, Jones GL, Magill P, Skull JD, Ledger W, Hvidman HW, Specht IO, Pinborg A, Schmidt KT, Larsen EC, Andersen AN, Freeman T, Zadeh S, Smith V, Golombok S, Whitaker LHR, Reid J, Wilson J, Critchley HOD, Horne AW, Zadeh S, Freeman T, Smith V, Golombok S, Peterson B, Pirritano M, Schmidt L, Volgsten H, Wyverkens E, Van Parys H, Provoost V, Ravelingien A, Raes I, Somers S, Stuyver I, Pennings G, De Sutter P, Buysse A, Hudson N, Culley L, Law C, Denny E, Mitchell H, Baumgarten M, Raine-Fenning N, Blake L, Jadva V, Golombok S, Lee KH, Sun HG, Park IH, Kim SG, Lee JH, Kim YY, Kim HJ, Kim KH. Psychology and counselling. Hum Reprod 2013. [DOI: 10.1093/humrep/det218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Morina N, Ajdukovic D, Bogic M, Franciskovic T, Kucukalic A, Lecic-Tosevski D, Morina L, Popovski M, Priebe S. Co-occurrence of major depressive episode and posttraumatic stress disorder among survivors of war: how is it different from either condition alone? J Clin Psychiatry 2013; 74:e212-8. [PMID: 23561242 DOI: 10.4088/jcp.12m07844] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [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: 04/11/2012] [Accepted: 01/10/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Major depressive episode (MDE) and posttraumatic stress disorder (PTSD) have been shown to be the most common mental disorders following traumatic war experiences and have been found to frequently co-occur. This study, designed as a randomized cross-sectional interview survey, aimed to identify whether the co-occurence of MDE and PTSD following exposure to war-related experiences is associated with different demographics, exposure to previous traumatic events, and clinical characteristics than either condition alone. METHOD After a random-walk technique was used to randomly select participants, face-to-face interviews were conducted among war-affected community samples in 5 Balkan countries (N = 3,313) in the years 2006 and 2007. The mean age of participants was 42.3 years, and all participants had experienced potentially traumatic events during war in the countries of the former Yugoslavia. Current prevalence rates of MDE and PTSD and suicide risk were assessed using the Mini-International Neuropsychiatric Interview. Levels of general psychological distress, posttraumatic stress, and quality of life were assessed with self-reports. RESULTS 30.5% of the sample met DSM-IV diagnostic criteria for either MDE or PTSD, and 9.1% had both disorders. Participants with concomitant MDE and PTSD reported significantly higher numbers of prewar and postwar traumatic events than participants with PTSD only and higher numbers of war-related events than those with MDE only (all P values < .001). Participants with both MDE and PTSD had significantly higher levels of general psychological and posttraumatic stress symptoms, a higher suicide risk, and lower levels of quality of life than participants with either condition alone (all P values < .001). CONCLUSIONS Concomitant MDE and PTSD are associated with the experience of different traumatic events and are characterized by more general psychological distress than either condition alone. The assessment of concomitant MDE and PTSD can facilitate better identification of individuals with severe psychopathology and poor quality of life. People with co-occurrence of MDE and PTSD may require specific health care programs following war.
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Affiliation(s)
- Nexhmedin Morina
- Department of Clinical Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands.
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Ajdukovic D, Olff M. 13th meeting of the European Society for Traumatic Stress Studies in 2013: selected papers. Eur J Psychotraumatol 2013; 4:23582. [PMID: 24371514 PMCID: PMC3873116 DOI: 10.3402/ejpt.v4i0.23582] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam & Arq Psychotrauma Expert Group, Diemen, the Netherlands
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Priebe S, Jankovic Gavrilovic J, Bremner S, Ajdukovic D, Franciskovic T, Galeazzi GM, Kucukalic A, Lecic-Tosevski D, Morina N, Popovski M, Schützwohl M, Bogic M. Psychological symptoms as long-term consequences of war experiences. Psychopathology 2013; 46:45-54. [PMID: 22890384 DOI: 10.1159/000338640] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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: 09/27/2011] [Accepted: 04/01/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS War experiences can affect mental health, but large-scale studies on the long-term impact are rare. We aimed to assess long-term mental health consequences of war in both people who stayed in the conflict area and refugees. METHOD On average 8 years after the war in former Yugoslavia, participants were recruited by probabilistic sampling in 5 Balkan countries and by registers and networking in 3 Western European countries. General psychological symptoms were assessed on the Brief Symptom Inventory and posttraumatic stress symptoms on the Impact of Event Scale-Revised. RESULTS We assessed 3,313 interviewees in the Balkans and 854 refugees. Paranoid ideation and anxiety were the severest psychological symptoms in both samples. In multivariable regressions, older age, various specific war experiences and more traumatic experiences after the war were all associated with higher levels of both general psychological and posttraumatic stress symptoms in both samples. Additionally, a greater number of migration stressors and having only temporary legal status in the host country were associated with greater severity of symptoms in refugees. CONCLUSIONS Psychological symptoms remain high in war-affected populations many years after the war, and this is particularly evident for refugees. Traumatic war experiences still predict higher symptom levels even when the findings have been adjusted for the influence of other factors.
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Affiliation(s)
- Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK.
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Pearce J, Jones C, Morrison S, Olff M, van Buschbach S, Witteveen AB, Williams R, Orengo-García F, Ajdukovic D, Aker AT, Nordanger D, Lueger-Schuster B, Bisson JI. Using a Delphi process to develop an effective train-the-trainers program to train health and social care professionals throughout Europe. J Trauma Stress 2012; 25:337-43. [PMID: 22648660 DOI: 10.1002/jts.21705] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [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] [Indexed: 11/11/2022]
Abstract
Research has shown that developing a Train-the-Trainers (TTT) program is important if agencies are to implement guidelines, but the most effective way to deliver a TTT program remains unanswered. This article presents data from a 3-round Internet-based Delphi process, which was used to help develop consensus-based guidelines for a TTT programme to deliver to health and social care professionals throughout Europe a curriculum on traumatic stress. In Round 1, 74 experts rated the importance of statements relating to the TTT field and then reassessed their scores in the light of others' responses in subsequent rounds. Forty-one (67%) of 61 statements achieved consensus (defined as having a mean score >7 or < 3 on the 0-9 rating scales used and 70% of participants scoring 7 and above or 3 and below) for inclusion. Key TTT components included interactive and practical presentations, delivery to groups of 7-12 people over 2 days, external and local expert facilitation, course manuals, refresher courses, and supervision. The Delphi process allowed a consensus to be achieved in an area in which there are limitations in the current evidence.
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Affiliation(s)
- Jennifer Pearce
- Department of Psychological Medicine, Cardiff University, Wales, United Kingdom
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Bogic M, Ajdukovic D, Bremner S, Franciskovic T, Galeazzi GM, Kucukalic A, Lecic-Tosevski D, Morina N, Popovski M, Schützwohl M, Wang D, Priebe S. Factors associated with mental disorders in long-settled war refugees: refugees from the former Yugoslavia in Germany, Italy and the UK. Br J Psychiatry 2012; 200:216-23. [PMID: 22282430 DOI: 10.1192/bjp.bp.110.084764] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [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] [Indexed: 11/23/2022]
Abstract
BACKGROUND Prevalence rates of mental disorders are frequently increased in long-settled war refugees. However, substantial variation in prevalence rates across studies and countries remain unexplained. AIMS To test whether the same sociodemographic characteristics, war experiences and post-migration stressors are associated with mental disorders in similar refugee groups resettled in different countries. METHOD Mental disorders were assessed in war-affected refugees from the former Yugoslavia in Germany, Italy and the UK. Sociodemographic, war-related and post-migration characteristics were tested for their association with different disorders. RESULTS A total of 854 war refugees were assessed (≥ 255 per country). Prevalence rates of mental disorders varied substantially across countries. A lower level of education, more traumatic experiences during and after the war, more migration-related stress, a temporary residence permit and not feeling accepted were independently associated with higher rates of mood and anxiety disorders. Mood disorders were also associated with older age, female gender and being unemployed, and anxiety disorders with the absence of combat experience. Higher rates of post-traumatic stress disorder (PTSD) were associated with older age, a lower level of education, more traumatic experiences during and after the war, absence of combat experience, more migration-related stress, and a temporary residence permit. Only younger age, male gender and not living with a partner were associated with substance use disorders. The associations did not differ significantly across the countries. War-related factors explained more variance in rates of PTSD, and post-migration factors in the rates of mood, anxiety and substance use disorder. CONCLUSIONS Sociodemographic characteristics, war experiences and post-migration stressors are independently associated with mental disorders in long-settled war refugees. The risk factors vary for different disorders, but are consistent across host countries for the same disorders.
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Affiliation(s)
- Marija Bogic
- Unit for Social and Community Psychiatry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK.
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Sabes-Figuera R, McCrone P, Bogic M, Ajdukovic D, Franciskovic T, Colombini N, Kucukalic A, Lecic-Tosevski D, Morina N, Popovski M, Schützwohl M, Priebe S. Long-term impact of war on healthcare costs: an eight-country study. PLoS One 2012; 7:e29603. [PMID: 22238627 PMCID: PMC3251588 DOI: 10.1371/journal.pone.0029603] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 12/01/2011] [Indexed: 12/01/2022] Open
Abstract
Objective Exposure to war can negatively affect health and may impact on healthcare costs. Estimating these costs and identifying their predictors is important for appropriate service planning. We aimed to measure use of health services in an adult population who had experienced war in the former-Yugoslavia on average 8 years previously, and to identify characteristics associated with the use and costs of healthcare. Method War-affected community samples in Bosnia-Herzegovina, Croatia, Kosovo, FYR Macedonia, and Serbia were recruited through a random walk technique. Refugees in Germany, Italy and the UK were contacted through registers, organisations and networking. Current service use was measured for the previous three months and combined with unit costs for each country for the year 2006/7. A two-part approach was used, to identify predictors of service use with a multiple logistic regression model and predictors of cost with a generalised linear regression model. Results 3,313 participants were interviewed in Balkan countries and 854 refugees in Western European countries. In the Balkan countries, traumatic events and mental health status were related to greater service use while in Western countries these associations were not found. Participants in Balkan countries with post traumatic stress disorder (PTSD) had costs that were 63% higher (p = 0.005) than those without PTSD. Distress experienced during the most traumatic war event was associated with higher costs (p = 0.013). In Western European countries costs were 76% higher if non-PTSD anxiety disorders were present (0.027) and 63% higher for mood disorders (p = 0.006). Conclusions War experiences and their effects on mental health are associated with increased health care costs even many years later, especially for those who stayed in the area of conflict. Focussing on the mental health impact of war is important for many reasons including those of an economic nature.
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Affiliation(s)
- Ramon Sabes-Figuera
- Centre for the Economics of Mental Health, Institute of Psychiatry, King's College London, London, United Kingdom.
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Morina N, Böhme HF, Ajdukovic D, Bogic M, Franciskovic T, Galeazzi GM, Kucukalic A, Lecic-Tosevski D, Popovski M, Schützwohl M, Stangier U, Priebe S. The structure of post-traumatic stress symptoms in survivors of war: confirmatory factor analyses of the Impact of Event Scale--revised. J Anxiety Disord 2010; 24:606-11. [PMID: 20430572 DOI: 10.1016/j.janxdis.2010.04.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [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: 01/23/2010] [Revised: 04/01/2010] [Accepted: 04/01/2010] [Indexed: 11/19/2022]
Abstract
The study aimed at establishing the factor structure of the Impact of Event Scale-Revised (IES-R) in survivors of war. A total sample of 4167 participants with potentially traumatic experiences during the war in Ex-Yugoslavia was split into three samples: two independent samples of people who stayed in the area of conflict and one sample of refugees to Western European countries. Alternative models with three, four, and five factors of post-traumatic symptoms were tested in one sample. The other samples were used for cross-validation. Results indicated that the model of best fit had five factors, i.e., intrusion, avoidance, hyperarousal, numbing, and sleep disturbance. Model superiority was cross-validated in the two other samples. These findings suggest a five-factor model of post-traumatic stress symptoms in war survivors with numbing and sleep disturbance as separate factors in addition to intrusion, avoidance and hyperarousal.
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Affiliation(s)
- Nexhmedin Morina
- Department of Clinical Psychology, University of Amsterdam, Roetersstraat 15, 1018 WB Amsterdam, The Netherlands.
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Priebe S, Bogic M, Ajdukovic D, Franciskovic T, Galeazzi GM, Kucukalic A, Lecic-Tosevski D, Morina N, Popovski M, Wang D, Schützwohl M. Mental Disorders Following War in the Balkans. ACTA ACUST UNITED AC 2010; 67:518-28. [PMID: 20439833 DOI: 10.1001/archgenpsychiatry.2010.37] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Stefan Priebe
- Unit for Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E13 8SP, England.
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Bisson JI, Tavakoly B, Witteveen AB, Ajdukovic D, Jehel L, Johansen VJ, Nordanger D, Orengo Garcia F, Punamaki RL, Schnyder U, Sezgin AU, Wittmann L, Olff M. TENTS guidelines: development of post-disaster psychosocial care guidelines through a Delphi process. Br J Psychiatry 2010; 196:69-74. [PMID: 20044665 DOI: 10.1192/bjp.bp.109.066266] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [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] [Indexed: 11/23/2022]
Abstract
BACKGROUND How best to plan and provide psychosocial care following disasters remains keenly debated. AIMS To develop evidence-informed post-disaster psychosocial management guidelines. METHOD A three-round web-based Delphi process was conducted. One hundred and six experts rated the importance of statements generated from existing evidence using a one to nine scale. Participants reassessed their original scores in the light of others' responses in the subsequent rounds. RESULTS A total of 80 (72%) of 111 statements achieved consensus for inclusion. The statement 'all responses should provide access to pharmacological assessment and management' did not achieve consensus. The final guidelines recommend that every area has a multi-agency psychosocial care planning group, that responses provide general support, access to social, physical and psychological support and that specific mental health interventions are only provided if indicated by a comprehensive assessment. Trauma-focused cognitive-behavioural therapy (CBT) is recommended for acute stress disorder or acute post-traumatic stress disorder, with other treatments with an evidence base for chronic post-traumatic stress disorder being made available if trauma-focused CBT is not tolerated. CONCLUSIONS The Delphi process allowed a consensus to be achieved in an area where there are limitations to the current evidence.
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Affiliation(s)
- Jonathan I Bisson
- Department of Psychological Medicine and Neurology, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, UK.
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Abstract
The war-related process of disintegration of a highly integrated and multi-ethnic community is described using a series of studies done in the city of Vukovar (Croatia) as a case example. After analyzing the key points of the community social breakdown , the three roots of ongoing ethnic division are explored: the feelings of being betrayed by important others at life-important situations; massive suffering and traumatization; and lack of compassion and acknowledgment of the victimhood. These also influence the inner dynamic of the divided community in which the strong social norm is not to cross the ethnic lines in public. When the schools became divided after the war so that the Serb and Croat children started going to separate schools, opportunity to meet each other across the ethnic lines became and remained severely limited. The implications for children that grow up in an ethnically divided community are documented in a study of children's and parental inter-ethnic attitudes and behaviors. The study included 1,671 students aged 12 to 16 and their parents. It showed that the children had more out-group biases and negative attitudes, and were more likely to choose discriminative behaviors towards their peers from the ether ethnic group. Consequences for the future community inter-ethnic relations in the post-war societies and life limitations the children face are discussed.
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Stulhofer A, Graham C, Bozicevic I, Kufrin K, Ajdukovic D. HIV/AIDS-Related Knowledge, Attitudes And Sexual Behaviors as Predictors of Condom Use Among Young Adults in Croatia. ACTA ACUST UNITED AC 2007. [DOI: 10.1363/3305807] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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31
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Abstract
The social contexts in which the mass trauma of thousands of people occur and in which their recovery should progress have qualities that distinguish it in important ways from individualised trauma in which a person is a victim of a violent attack, rape or a traffic accident. Organised violence, such as wars, oppression by dictatorships and massive terrorist attacks are extreme cases in which hundreds or thousands of people are exposed to trauma in a short period of time. As such, it has multiple consequences that extend beyond the affected individuals and the symptoms they suffer. Although the symptoms may be similar, the social contexts in which individual victimisation and exposure to organised violence happen are very different. The social milieu in which the survivors of individual trauma and survivors of mass trauma are embedded is likewise different, with important consequences for recovery. Understanding the social context of the trauma helps create the right social intervention for healing at social and personal levels.
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Affiliation(s)
- Dean Ajdukovic
- Department of Psychology, University of Zagreb, 10000 Zagreb, Croatia.
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Karpati G, Ajdukovic D, Arnold D, Gledhill RB, Guttmann R, Holland P, Koch PA, Shoubridge E, Spence D, Vanasse M. Myoblast transfer in Duchenne muscular dystrophy. Ann Neurol 1993; 34:8-17. [PMID: 8517684 DOI: 10.1002/ana.410340105] [Citation(s) in RCA: 246] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
One biceps muscle of 8 patients with Duchenne muscular dystrophy was injected at 55 sites with a total of 55 million viable, purified, and contamination-free normal myoblasts (myoblast transfer). The other biceps of each patient was injected with a placebo to serve as a control. The procedure was blinded to the patients, parents, and investigators. Myoblasts derived from a biopsy specimen of the fathers were cultured and purified under strict conditions and carefully screened for microbial contamination. All patients received cyclophosphamide for immunosuppression for 6 or 12 months. No serious complications were observed after myoblast transfer, indicating that the procedure is safe. The overall therapeutic efficiency of myoblast transfer was poor as judged by the results in maximal voluntary force generation, dystrophin content of the muscle, magnetic resonance imaging of the muscle, and the lack of donor-derived DNA and dystrophin messenger RNA in the injected muscle. An improved efficiency of the take of myoblasts might be achieved by using younger cells and injecting the myoblasts with a myonecrotic agent (to increase the prevalence of regeneration) and a basal laminal fenestrating agent.
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Affiliation(s)
- G Karpati
- Montreal Neurological Institute, Quebec, Canada
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Pekovic DD, Lapointe N, Geoffroy G, Ajdukovic D, Michaud J. HIV p24 antigen in brains of children with AIDS: the antigen-containing cells do not react with monoclonal antibody to OKT4 or macrophage markers. AIDS 1988; 2:404-5. [PMID: 3146276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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34
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Pekovic DD, Gornitsky M, Ajdukovic D, Dupuy JM, Chausseau JP, Michaud J, Lapointe N, Gilmore N, Tsoukas C, Zwadlo G. Pathogenicity of HIV in lymphatic organs of patients with AIDS. J Pathol 1987; 152:31-5. [PMID: 3305846 DOI: 10.1002/path.1711520105] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
HIV antigens were searched for in the thymus, lymph nodes, bone marrow, and spleen of AIDS patients, by means of immunofluorescence technique. Human IgG against HIV and monoclonal antibodies against viral gag P24 protein yielded strong cytoplasmic fluorescence of cells in sections of the thymus, lymph nodes and spleen. Some cells containing HIV antigens were morphologically multinucleated giant cells. They reacted with monoclonal antibodies against helper/inducer T-cells (OKT4+), and were complexed with antibody or with complement as demonstrated by double-staining immunofluorescence technique. A large number of inflammatory cells infiltrated the thymus in areas containing cells expressing HIV antigens. These studies demonstrated an association of HIV virus with cytopathic and immunopathogenic reactions in lymphatic organs of AIDS patients, and are consistent with previous results, as well as indicative of a primary aetiologic role for the virus.
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Pekovic D, Ajdukovic D, Tsoukas C, Lapointe N, Michaud J, Gilmore N, Gornitsky M. Detection of human immunosuppressive virus in salivary lymphocytes from dental patients with AIDS. Am J Med 1987; 82:188-9. [PMID: 3642973 DOI: 10.1016/0002-9343(87)90416-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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36
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Pekovic D, Garzon S, Strykowski H, Ajdukovic D, Gornitsky M, Dupuy JM. Immunogold labeling of HTLV-III/LAV in H9 cells studied by transmission electron microscopy. J Virol Methods 1986; 13:265-9. [PMID: 2426297 DOI: 10.1016/0166-0934(86)90020-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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37
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Payment P, Ajdukovic D, Pavilanis V. [Rubella virus. II. Replication in Vero calls and effects of actinomycin Dand cycloheximide]. Can J Microbiol 1975; 21:710-7. [PMID: 804987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Budding at the plasmic membrane is the primary mode of production of rubella virus in Vero cells. Intense cytopathic effect is observed even if only 10% of the cells are infected. Actinomycin D has little effect on the multiplication of rubella virus but cycloheximide inhibits its growth. This inhibitiion is probably due to the reduction of cellular protein synthesis and not to a direct action of the inhibitorson the virus multiplication. Viral proteins in infected cells have not been demonstrated. The presence of a viral substance inhibiting normal cellular synthesis is discussed.
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Abstract
Separation of Vero cell membrane in a discontinuous sucrose gradient reveals five fractions. After infection a sixth fraction appears. It contains virioins but mostly modified membranes with subunits 5-6 nm in diameter, probably the hemagglutinin. None of the enzymes used was associated with this fraction. No modification of the other fractions was observed after infection.
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Payment P, Ajdukovic D, Pavilanis V. [Rubella virus. I. Morphology and structural proteins]. Can J Microbiol 1975; 21:703-9. [PMID: 1125860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Degradation of purified rubella virus by heat treatment (37, 45, or 56 degrees C) revealed the following structures. The viral envelope, a modified cellular membrane, bears spherical subunits, 5-6 nm in diameter, hexamers, or pentamers. Two glycoproteins, VP-2 (50 000 daltons) and VP-3 (63 000 daltons), are associated with the envelope. The nucleocapsid if formed by the condensation of the viral ribonucleic acid on acentral structure 10 nm in diameter. Only one protein, VP-1 (35 000 daltons) is present in the nucleocapsid. Similarity between rubella virus and Togaviruses is discussed.
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Payment P, Chagnon A, Côte JR, Ajdukovic D, Pavilanis V. Morphology of a latent virus associated with hamster cells BHK-21. Can J Microbiol 1972; 18:369-71. [PMID: 4115801 DOI: 10.1139/m72-057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The morphology of the latent virus (R virus) of the BHK-21/13S cell line is described in negative staining and thin sections. This virus contains ribonucleic acid (RNA) and matures at the endoplasmic reticulum membrane. After negative staining, it is an enveloped particle surrounded by numerous globular peplomers. Its size varies from 70 to 115 nm. The authors suggest to include it in the coronavirus group.
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