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Trautmann S, Kräplin A, Muehlhan M, Fuchs FO, Loesch B, Wittgens C. The ad-libitum taste test as measure of momentary alcohol use in the laboratory: an investigation of construct validity and confounding factors. Psychopharmacology (Berl) 2024; 241:913-923. [PMID: 38141076 PMCID: PMC11031463 DOI: 10.1007/s00213-023-06518-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
RATIONALE The ad-libitum taste test is a widely used covert measure of motivation to consume alcohol in the laboratory. However, studies on its construct validity and potential confounding factors are scarce. OBJECTIVES This study aimed to evaluate the construct validity of the ad-libitum taste test by examining the association of ad-libitum alcohol consumption with typical alcohol use and craving, and investigating potential moderation by trait anxiety, depressiveness, current mood, and drinking motives. METHODS A sample of 264 young male individuals were offered two 0.33 l glasses of beer. Participants were instructed to rate the characteristics of each drink, while the percentage of beverages containing alcohol consumed was assessed. Associations of ad-libitum consumption with typical alcohol use and craving were assessed using non-parametric and piecewise regressions. Moreover, moderator analysis with trait anxiety, depressiveness, current mood, and drinking motives was carried out. RESULTS Ad-libitum alcohol consumption was associated with typical alcohol use and alcohol craving. However, these associations decreased at high consumption levels. Associations between ad-libitum consumption, typical alcohol use, and craving were stable across several conditions, except that the association between ad-libitum consumption and craving increased with higher social, conformity, and coping drinking motives. CONCLUSIONS The ad-libitum taste test appears to be a valid measure of the motivation to drink alcohol in laboratory studies in young male adults, although this validity might be compromised at high levels of ad-libitum consumption. Consideration of these factors can contribute to further refining the ad-libitum taste test as a valuable tool for assessing motivation to consume alcohol in laboratory studies.
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Affiliation(s)
- Sebastian Trautmann
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
- Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, ICPP, Am Kaiserkai 1, 20457, Hamburg, Germany.
| | - Anja Kräplin
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische University Dresden, Dresden, Germany
| | - Markus Muehlhan
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany
- ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Fée Ona Fuchs
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany
- Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, ICPP, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Beate Loesch
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany
- Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, ICPP, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Charlotte Wittgens
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany
- Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, ICPP, Am Kaiserkai 1, 20457, Hamburg, Germany
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Muehlhan M, Spindler C, Nowaczynski S, Buchner C, Fascher M, Trautmann S. Where alcohol use disorder meets interoception: A meta-analytic view on structural and functional neuroimaging data. J Neurochem 2024. [PMID: 38528368 DOI: 10.1111/jnc.16104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/27/2024]
Abstract
Alcohol use disorder (AUD) has been associated with changes in the processing of internal body signals, known as interoception. Changes in brain structure, particularly in the insula, are thought to underlie impaired interoception. As studies specifically investigating this association are largely lacking, this analysis takes an approach that compares meta-analytic results on interoception with recently published meta-analytic results on gray matter reduction in AUD. A systematic literature search identified 25 eligible interoception studies. Activation likelihood estimation (ALE) was used to test for spatial convergence of study results. Overlap between interoception and AUD clusters was tested using conjunction analysis. Meta-analytic connectivity modeling (MACM) and resting-state functional connectivity were used to identify the functional network of interoception and to test where this network overlapped with AUD meta-analytic clusters. The results were characterized using behavioral domain analysis. The interoception ALE identified a cluster in the left middle insula. There was no overlap with clusters of reduced gray matter in AUD. MACM analysis of the interoception cluster revealed a large network located in the insulae, thalami, basal nuclei, cingulate and medial frontal cortices, and pre- and postcentral gyri. Resting state analysis confirmed this result, showing the strongest connections to nodes of the salience- and somatomotor network. Five of the eight clusters that showed a structural reduction in AUD were located within these networks. The behavioral profiles of these clusters were suggestive of higher-level processes such as salience control, somatomotor functions, and skin sensations. The results suggest an altered salience mapping of interoceptive signals in AUD, consistent with current models. Connections to the somatomotor network may be related to action control and integration of skin sensations. Mindfulness-based interventions, pleasurable touch, and (deep) transcranial magnetic stimulation may be targeted interventions that reduce interoceptive deficits in AUD and thus contribute to drug use reduction and relapse prevention.
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Affiliation(s)
- Markus Muehlhan
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
- ICAN Institute of Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Hamburg, Germany
| | - Carolin Spindler
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
| | - Sandra Nowaczynski
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
- ICAN Institute of Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Hamburg, Germany
- Department of Addiction Medicine, Carl-Friedrich-Flemming-Clinic, Helios Medical Center Schwerin, Schwerin, Germany
| | - Claudius Buchner
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
| | - Maximilian Fascher
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
- ICAN Institute of Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Hamburg, Germany
| | - Sebastian Trautmann
- Department of Psychology, Faculty of Human Sciences, MSH Medical School Hamburg, Hamburg, Germany
- ICPP Institute of Clinical Psychology and Psychotherapy, MSH Medical School Hamburg, Hamburg, Germany
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Thomas S, Schäfer J, Kanske P, Trautmann S. Patterns of social-affective responses to trauma exposure and their relation to psychopathology. PLoS One 2024; 19:e0289664. [PMID: 38442107 PMCID: PMC10914253 DOI: 10.1371/journal.pone.0289664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 02/01/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION Traumatic event exposure is a risk factor for the development and maintenance of psychopathology. Social-affective responses to trauma exposure (e.g. shame, guilt, revenge, social alienation) could moderate this relationship, but little is known about their relevance for different types of psychopathology. Moreover, the interplay of different social-affective responses to trauma exposure in predicting psychopathology is poorly understood. METHODS In a sample of N = 1321 trauma-exposed German soldiers, we examined cross-sectional associations of trauma-related social alienation, revenge, guilt and shame with depressive disorder, alcohol use disorder, posttraumatic stress disorder and dimensional measures of depression and anxiety. Latent class analysis was conducted to identify possible patterns of social-affective responses to trauma exposure, and their relation to psychopathology. RESULTS All social-affective responses to trauma exposure predicted current posttraumatic stress disorder, depressive disorder, alcohol use disorder and higher depressive and anxiety symptoms. Three latent classes fitted the data best, reflecting groups with (1) low, (2) moderate and (3) high risk for social-affective responses to trauma exposure. The low-risk group demonstrated the lowest expressions on all psychopathology measures. CONCLUSIONS Trauma-related social alienation, shame, guilt, and revenge are characteristic of individuals with posttraumatic stress disorder, depressive disorder, alcohol use disorder, and with higher anxiety and depressive symptoms. There was little evidence for distinctive patterns of social-affective responses to trauma exposure despite variation in the overall proneness to show social-affective responses. Social-affective responses to trauma exposure could represent promising treatment targets for both cognitive and emotion-focused interventions.
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Affiliation(s)
- Sarah Thomas
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Judith Schäfer
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Philipp Kanske
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany
- ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
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Budde H, Amatriain-Fernández S, Trautmann S. Potential of Control Conditions for Nonspecific Treatment Effects in Noninferiority Trials. JAMA Psychiatry 2023; 80:522-523. [PMID: 36920358 DOI: 10.1001/jamapsychiatry.2023.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Affiliation(s)
- Henning Budde
- Faculty of Human Sciences, Institute for Systems Medicine, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Sandra Amatriain-Fernández
- Institute of Sport Science, Department for the Psychology of Human Movement and Sport, Friedrich Schiller University Jena, Jena, Germany
| | - Sebastian Trautmann
- Faculty of Human Sciences, Institute for Clinical Psychology and Psychotherapy, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
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Miethe S, Wigger J, Wartemann A, Fuchs FO, Trautmann S. Posttraumatic Stress Symptoms and its Association with Rumination, Thought Suppression and Experiential Avoidance: a Systematic Review and Meta-Analysis. J Psychopathol Behav Assess 2023. [DOI: 10.1007/s10862-023-10022-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
AbstractPosttraumatic stress disorder (PTSD) is a severe mental disorder causing high individual and societal costs. The use of maladaptive emotion regulation (ER) strategies has been identified as a potential contributing factor. This meta-analysis aimed to quantify the associations between PTSD symptoms and rumination, thought suppression and experiential avoidance. The systematic literature search resulted in 5574 studies, 75 of which were included in the analysis. From those eligible studies 189 effect sizes were obtained. For symptoms of posttraumatic stress, large effects were found for associations with rumination (r = .52) and experiential avoidance (r = .48), whereas a medium effect size was found for thought suppression (r = .29). With respect to different PTSD symptom clusters, associations ranged between r = .35 and r = .41 for associations with intrusive re-experiencing, between r = .39 and r = .41 for associations with avoidance, between r = .50 and r = .53 for associations with alterations in cognitions and mood and between r = .41 and r = .45 for associations with alterations in arousal and activity. Few available studies provide some evidence that associations might be somewhat reduced but still substantial in longitudinal compared to cross-sectional studies. These findings provide valuable targets for future investigations with the long-term goal of improving targeted interventions for the prevention and treatment of PTSD symptoms.
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Thomas S, Hummel KV, Schäfer J, Wittchen HU, Trautmann S. Harassment and its association with depressive symptoms and suicidal behavior: The role of perceived stigma and nondisclosure. Psychol Serv 2023; 20:84-93. [PMID: 34968122 DOI: 10.1037/ser0000610] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Social factors play a crucial role in moderating the impact of severe stressful events on mental health. Exposure to harassment, hence to unwanted negative behavior that is intended to cause harm and/or is perceived as harmful and hostile, is a social factor thought to have particularly strong negative effects on mental health, including depressive symptoms and suicidal behavior. However, little is known about mediating mechanisms. Using data of N = 1,483 participants 12 months following military deployment, the hypothesis was examined that the cross-sectional association of perceived harassment with depressive symptoms and risk for suicidal behavior (suicide ideation and plans) is partially mediated by increased perceived mental health stigma and nondisclosure. Mediation analyses were performed using path analysis. Harassment was associated with depressive symptoms and risk for suicidal behavior. When investigated separately, both nondisclosure and perceived stigma partially mediated the association of harassment with depressive symptoms and with suicidal behavior. When considered simultaneously, both nondisclosure and, to a lesser extent, perceived stigma partially mediated the association of harassment with depressive symptoms, but only nondisclosure mediated the association of harassment with suicidal behavior. These results are consistent with the assumption that nondisclosure and perceived mental health stigma following harassment contribute to depressive symptoms and risk for suicidal behavior, whereby nondisclosure is more relevant compared to perceived stigma. Nondisclosure could lead to adverse outcomes by increasing distress, limiting social support, and inhibiting help-seeking. Interventions that increase disclosure might be a promising target for early interventions following harassment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Sarah Thomas
- Institute of Clinical Psychology and Psychotherapy
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Thomas S, Kanske P, Schäfer J, Hummel KV, Trautmann S. Examining bidirectional associations between perceived social support and psychological symptoms in the context of stressful event exposure: a prospective, longitudinal study. BMC Psychiatry 2022; 22:736. [PMID: 36443716 PMCID: PMC9703701 DOI: 10.1186/s12888-022-04386-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND After stressful event exposure, higher perceived social support is a well-established correlate of decreased risk for psychological symptoms, including depressive, anxiety and posttraumatic stress (PTS) symptoms. However, longitudinal data on the direction of this association and the stability of perceived social support are scarce and have yielded mixed results, with a particular lack of prospective studies. We aimed to investigate changes in perceived social support and bidirectional associations between perceived social support and psychological symptoms in a prospective, longitudinal study. METHODS A sample of German soldiers was assessed before and after deployment to Afghanistan. Group-based trajectory modelling was used to investigate the stability of perceived social support and to identify possible distinguishable trajectories of perceived social support. Bidirectional associations between perceived social support (general and workplace) and psychological symptoms (depressive, anxiety and PTS) were examined using gamma regressions. RESULTS Average levels of perceived general social support did not change, while perceived workplace social support increased slightly (t(344) = 5.51, p < .001). There were no distinguishable trajectories of perceived social support. Higher perceived general (Mean ratio (MR) = 0.84, 95% CI = [0.74, 0.95]) and workplace social support (MR = 0.82, 95% CI = [0.72, 0.92]) predicted lower depressive symptoms, but not anxiety or PTS symptoms. Only higher PTS (MR = 0.95, 95% CI = [0.91, 0.99]) and higher depressive symptoms (MR = 0.96, 95% CI = [0.93, 0.99]) predicted lower perceived general social support. CONCLUSIONS Perceived social support can remain relatively stable under exposure to environmental stressors such as military deployment. Higher perceived social support could protect against depressive symptoms via a stress-buffering mechanism, while support may need to be more tailored to individual needs for a protection against PTS symptoms. Individuals with elevated depressive and PTS symptoms might have impaired abilities or opportunities to access social support after stressful event exposure. Future studies could investigate distressing social emotions and associated maladaptive social cognitions as possible mechanisms in the association between symptoms and lower perceived social support. Especially with respect to PTS symptoms, future studies could focus on conditions that enable individuals to benefit from social support.
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Affiliation(s)
- Sarah Thomas
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Philipp Kanske
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany ,grid.419524.f0000 0001 0041 5028Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Judith Schäfer
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Katrin Veronika Hummel
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany. .,Department of Psychology, Faculty of Human Science, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany. .,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany.
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Lech S, Herrmann W, Trautmann S, Schwantes U, Gellert P, Behr J, Buspavanich P. Depression in primary care and the role of evidence-based guidelines: cross-sectional data from primary care physicians in Germany. BMC Health Serv Res 2022; 22:1279. [PMID: 36280876 PMCID: PMC9594952 DOI: 10.1186/s12913-022-08631-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/30/2022] [Indexed: 11/14/2022] Open
Abstract
Background Depression is the most common mental health burden worldwide. Primary care physicians (PCPs) play a key role in the care provision for people with depression. The first objective of the present study was to examine the health care situation of depression in primary care, focusing on the cooperation between PCPs and mental health specialists. Secondly, we aimed at examining the role of the German S3 Guideline for Unipolar Depression in the primary care provision. Methods Data of N = 75 PCPs were analysed from a cross-sectional online survey. Analysis of descriptive information on the current status of primary health care and depression was conducted. Further, to examine factors that are related to the usage of guidelines, multiple regression was performed. Results Only 22.1% of PCPs described the quality of cooperation with ambulatory mental health specialist as good. The most frequent problems in the cooperation were of structural nature (49.3%, long waiting list, few therapy units, as well as barriers in the communication and the information exchange). With regard to the role of the guideline, 65% of PCPs reported never or seldom using the guideline and 31.7% of PCPs perceived the guideline as not useful at all. In addition, perceived usefulness of the S3 guideline was positively associated with the usage of the guideline. Results of the logistic regression revealed a significant association between the usage of the German S3 Guideline for Unipolar Depression and rating of perceived usefulness of the guideline (OR: 4.771; 95% CI: 2.15–10.59; p < 0.001). Conclusion This study highlights the central role of PCPs and demonstrates major barriers in the outpatient health care provision of depression. Present findings suggest a strong need for collaborative health care models to resolve obstacles resulting from fragmented mental health care systems. Finally, reported perceived barriers in the implementation of the German S3 Guideline for Unipolar Depression indicate the urge to involve PCPs in the development of evidence-based guidelines, in order to ensure a successful implementation and usage of guidelines in clinical practice.
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Affiliation(s)
- Sonia Lech
- grid.6363.00000 0001 2218 4662Institute for Medical Sociology and Rehabilitation Science, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany ,grid.473452.3Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany ,grid.6363.00000 0001 2218 4662Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Wolfram Herrmann
- grid.6363.00000 0001 2218 4662Institute of General Practice, Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sebastian Trautmann
- grid.461732.5ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany ,grid.461732.5Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
| | - Ulrich Schwantes
- grid.473452.3Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Paul Gellert
- grid.6363.00000 0001 2218 4662Institute for Medical Sociology and Rehabilitation Science, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Joachim Behr
- grid.473452.3Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany ,Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany ,grid.6363.00000 0001 2218 4662Research Department of Experimental and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Pichit Buspavanich
- grid.473452.3Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany ,Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, Brandenburg University of Technology Cottbus-Senftenberg and Brandenburg Medical School, Potsdam, Germany ,grid.6363.00000 0001 2218 4662Department of Psychiatry and Psychotherapy, Gender Research in Medicine & Institute of Sexology and Sexual Medicine, Charité – Universitätsmedizin Berlin, Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Wittgens C, Muehlhan M, Kräplin A, Wolff M, Trautmann S. Underlying mechanisms in the relationship between stress and alcohol consumption in regular and risky drinkers (MESA): methods and design of a randomized laboratory study. BMC Psychol 2022; 10:233. [PMID: 36243742 PMCID: PMC9568994 DOI: 10.1186/s40359-022-00942-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/05/2022] [Indexed: 11/15/2022] Open
Abstract
Background Excessive alcohol consumption and alcohol use disorders (AUD) are among the leading preventable causes of premature morbidity and mortality and are considered a major public health concern. In order to reduce the individual and societal burden of excessive alcohol use, it is crucial to identify high-risk individuals at earlier stages and to provide effective interventions to prevent further progression. Stressful experiences are important risk factors for excessive alcohol consumption and AUDs. However, the underlying biological and psychological mechanisms are still poorly understood.
Methods The project “Underlying mechanisms in the relationship between stress and alcohol consumption in regular and risky drinkers (MESA)” is a randomized controlled study that started in December 2018 and is conducted in a laboratory setting, which aims to identify moderators and mediators of the relationship between acute stress and alcohol consumption among regular and risky drinkers. Regular and risky drinkers are randomly assigned to a stress induction or a control condition. Several processes that may mediate (emotional distress, endocrine and autonomic stress reactivity, impulsivity, inhibitory control, motivational sensitization) or moderate (trait impulsivity, childhood maltreatment, basal HPA-axis activity) the relation between stress and alcohol consumption are investigated. As primary dependent variable, the motivation to consume alcohol following psychosocial stress is measured. Discussion The results of this study could help to provide valuable targets for future research on tailored interventions to prevent stress-related alcohol consumption.
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Affiliation(s)
- Charlotte Wittgens
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany. .,ICPP Institute for Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany.
| | - Markus Muehlhan
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany.,ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Hamburg, Germany
| | - Anja Kräplin
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische University Dresden, Dresden, Germany
| | - Max Wolff
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sebastian Trautmann
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany. .,ICPP Institute for Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany.
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Miethe S, Muehlhan M, Trautmann S. The association between repetitive negative thinking and distress across mental disorders: Preliminary findings from an outpatient treatment-seeking sample. Psychiatry Res 2022; 311:114478. [PMID: 35287044 DOI: 10.1016/j.psychres.2022.114478] [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: 06/10/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 10/19/2022]
Abstract
Distress is a characteristic of various mental disorders. The transdiagnostic construct repetitive negative thinking (RNT) has been suggested to contribute to distress. However, there is little evidence that this association can actually be found across diagnostic categories. We analyzed this association for phobias, other anxiety disorders, stress disorders, depressive disorders and substance use disorders in 194 treatment-seeking individuals. RNT was associated with distress across all diagnostic categories with high effect sizes. Except for phobias, these associations were not attributable to general emotion regulation abilities. RNT might contribute to distress in several mental disorders which underlines its potential for transdiagnostic interventions.
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Affiliation(s)
- Sandra Miethe
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Markus Muehlhan
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Hamburg, Germany
| | - Sebastian Trautmann
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany.
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Wittgens C, Fischer MM, Buspavanich P, Theobald S, Schweizer K, Trautmann S. Mental health in people with minority sexual orientations: A meta-analysis of population-based studies. Acta Psychiatr Scand 2022; 145:357-372. [PMID: 35090051 DOI: 10.1111/acps.13405] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/13/2022] [Accepted: 01/23/2022] [Indexed: 12/23/2022]
Abstract
AIMS To conduct a meta-analysis of population-based studies to quantify the association between sexual minority status (lesbian women, gay men, and bisexual people) and the risk of common mental disorders (depressive disorders, alcohol use disorders (AUD), anxiety disorders, and suicidality). METHOD PubMed, PsycInfo, Web of Science, the Cochrane Library Database, the Applied Social Sciences Index and Abstracts, and ProQuest were searched for relevant studies published between 2000 and May 2020. The PRISMA guidelines were followed for selection processes. Twenty-six studies met the inclusion criteria which included a total of 519,414 heterosexuals, 10,178 lesbian/gay people and 14,410 bisexual people. RESULTS Lesbian/gay people (ORs between 1.97, 95% [CI = 1.76, 2.19] and 2.89, 95% [CI = 2.41,3.38]) and bisexual people (ORs between 2.70; 95% [CI = 2.21,3.18], and 4.81; 95% [CI = 3.63, 5.99]) had a higher risk for mental disorders than heterosexuals for all investigated diagnostic categories. The risk for depression (OR = 2.70; 95% [CI = 2.21, 3.18]) and suicidality (OR = 4.81; 95% [CI = 3.63, 5.99]) was higher in bisexual compared with lesbian/gay people. Exploratory meta-regressions revealed no evidence for a decrease in mental health differences between people with minority sexual orientations and heterosexuals in more recent years of data assessment, except for AUD. CONCLUSIONS These findings clearly suggest disparities in mental health between people with minority sexual orientations and heterosexual people. There is a lack of data regarding a wider spectrum of sexual orientations and mental disorders and studies in non-Western countries.
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Affiliation(s)
- Charlotte Wittgens
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Mirjam M Fischer
- Institute of Sociology and Social Psychology (ISS), Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
| | - Pichit Buspavanich
- Department of Psychiatry, Psychotherapy and Psychosomatics, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.,Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sabrina Theobald
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany
| | - Katinka Schweizer
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Sebastian Trautmann
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
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12
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Spindler C, Mallien L, Trautmann S, Alexander N, Muehlhan M. A coordinate-based meta-analysis of white matter alterations in patients with alcohol use disorder. Transl Psychiatry 2022; 12:40. [PMID: 35087021 PMCID: PMC8795454 DOI: 10.1038/s41398-022-01809-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Received: 07/28/2021] [Revised: 01/04/2022] [Accepted: 01/13/2022] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Besides the commonly described gray matter (GM) deficits, there is growing evidence of significant white matter (WM) alterations in patients with alcohol use disorder (AUD). WM changes can be assessed using volumetric and diffusive magnetic resonance imaging methods, such as voxel-based morphometry (VBM) and diffusion tensor imaging (DTI). The aim of the present meta-analysis is to investigate the spatial convergence of the reported findings on WM alterations in AUD. METHODS Systematic literature search on PubMed and further databases revealed 18 studies eligible for inclusion, entailing a total of 462 AUD patients and 416 healthy controls (up to January 18, 2021). All studies that had used either VBM or DTI whole-brain analyzing methods and reported results as peak-coordinates in standard reference space were considered for inclusion. We excluded studies using approaches non-concordant with recent guidelines for neuroimaging meta-analyses and studies investigating patient groups with Korsakoff syndrome or other comorbid substance use disorders (except tobacco). RESULTS Anatomical likelihood estimation (ALE) revealed four significant clusters of convergent macro- and microstructural WM alterations in AUD patients that were assigned to the genu and body of the corpus callosum, anterior and posterior cingulum, fornix, and the right posterior limb of the internal capsule. DISCUSSION The changes in WM could to some extent explain the deteriorations in motor, cognitive, affective, and perceptual functions seen in AUD. Future studies are needed to clarify how WM alterations vary over the course of the disorder and to what extent they are reversible with prolonged abstinence.
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Affiliation(s)
- Carolin Spindler
- grid.461732.5Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany ,grid.461732.5ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany
| | - Louisa Mallien
- grid.461732.5Department of Human Medicine, Faculty of Medicine, Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany
| | - Sebastian Trautmann
- grid.461732.5Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany ,grid.461732.5ICPP Institute for Clinical Psychology and Psychotherapy, Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany
| | - Nina Alexander
- grid.461732.5Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany ,grid.10253.350000 0004 1936 9756Department of Psychiatry and Psychotherapy, Philipps University Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany ,grid.10253.350000 0004 1936 9756Center for Mind, Brain and Behavior, Philipps University Marburg, Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Markus Muehlhan
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany. .,ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
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13
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Trautmann S, Wittgens C, Muehlhan M, Kanske P. The Role of Socio-Affective and Socio-Cognitive Mechanisms in the Processing of Witnessed Traumatic Events. Front Psychiatry 2022; 13:830218. [PMID: 35360123 PMCID: PMC8963708 DOI: 10.3389/fpsyt.2022.830218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sebastian Trautmann
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Charlotte Wittgens
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
| | - Markus Muehlhan
- Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany.,ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Hamburg, Germany
| | - Philipp Kanske
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
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14
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Hummel KV, Trautmann S, Venz J, Thomas S, Schäfer J. Repetitive negative thinking: transdiagnostic correlate and risk factor for mental disorders? A proof-of-concept study in German soldiers before and after deployment to Afghanistan. BMC Psychol 2021; 9:198. [PMID: 34924023 PMCID: PMC8686273 DOI: 10.1186/s40359-021-00696-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Disorder-specific forms of Repetitive Negative Thinking (RNT) are associated with multiple diagnostic categories, indicating a transdiagnostic nature. Few studies examined content-independent RNT processes across groups of diagnosed mental disorders. Moreover, theory describes RNT processes as critically involved in the etiology of mental disorders, empirical evidence however is scarce. We first tested the transdiagnostic nature by examining levels of RNT across groups of internalizing and externalizing mental disorders compared to healthy individuals and explored RNT levels in a comorbid disorder-group. Second, we examined whether RNT predicts incident psychopathology. METHODS In a sample of German soldiers (n = 425) scheduled for deployment in Afghanistan, we compared RNT levels between diagnosed groups with alcohol use disorders, anxiety disorders and healthy individuals cross-sectionally. Exploratory analyses were conducted comparing a comorbid disorder-group to healthy individuals and to both single-disorder-groups. Longitudinally, we examined the predictive value of pre-deployment RNT levels for incident psychopathology after deployment (n = 167). RNT was measured using the Perseverative Thinking Questionnaire (PTQ), DSM-IV diagnoses were assessed using the standardized Composite International Diagnostic Interview (CIDI). RESULTS Cross-sectional comparisons revealed that soldiers with alcohol use disorders and anxiety disorders showed significantly higher degrees of RNT compared to healthy soldiers. RNT levels in those with comorbid disorders were significantly higher compared to healthy soldiers but also compared to both single-disorder-groups. Longitudinal analyses revealed that higher levels of RNT prior to deployment were associated with a higher risk to have any incidental mental disorder after deployment. This however is only attributable to individuals with a PTQ score above a cut-off of 15. CONCLUSIONS Findings provide evidence for RNT as a transdiagnostic correlate and a vulnerability factor for the development of mental disorders.
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Affiliation(s)
- Katrin V Hummel
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | | | - John Venz
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Sarah Thomas
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Judith Schäfer
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
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15
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Fares-Otero NE, Trautmann S. Addressing the Interactive Effects of Maltreatment and COVID-19 Related Stressors on the Neuropsychological Functioning in Children. Front Psychol 2021; 12:764768. [PMID: 34899509 PMCID: PMC8653797 DOI: 10.3389/fpsyg.2021.764768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
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16
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Morrison CA, Auniņš A, Benkő Z, Brotons L, Chodkiewicz T, Chylarecki P, Escandell V, Eskildsen DP, Gamero A, Herrando S, Jiguet F, Kålås JA, Kamp J, Klvaňová A, Kmecl P, Lehikoinen A, Lindström Å, Moshøj C, Noble DG, Øien IJ, Paquet JY, Reif J, Sattler T, Seaman BS, Teufelbauer N, Trautmann S, van Turnhout CAM, Vořišek P, Butler SJ. Bird population declines and species turnover are changing the acoustic properties of spring soundscapes. Nat Commun 2021; 12:6217. [PMID: 34728617 PMCID: PMC8564540 DOI: 10.1038/s41467-021-26488-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/24/2021] [Indexed: 11/28/2022] Open
Abstract
Natural sounds, and bird song in particular, play a key role in building and maintaining our connection with nature, but widespread declines in bird populations mean that the acoustic properties of natural soundscapes may be changing. Using data-driven reconstructions of soundscapes in lieu of historical recordings, here we quantify changes in soundscape characteristics at more than 200,000 sites across North America and Europe. We integrate citizen science bird monitoring data with recordings of individual species to reveal a pervasive loss of acoustic diversity and intensity of soundscapes across both continents over the past 25 years, driven by changes in species richness and abundance. These results suggest that one of the fundamental pathways through which humans engage with nature is in chronic decline, with potentially widespread implications for human health and well-being.
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Affiliation(s)
- C A Morrison
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - A Auniņš
- Faculty of Biology, University of Latvia, Jelgavas iela 1, Riga, LV-1004, Latvia
- Latvian Ornithological Society, Skolas iela 3, Riga, LV-1010, Latvia
| | - Z Benkő
- Romanian Ornithological Society/BirdLife Romania, Cluj-Napoca, Romania
- Evolutionary Ecology Group, Hungarian Department of Biology and Ecology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - L Brotons
- InForest JRU (CTFC-CREAF), Solsona, 25280, Spain
- CREAF, Cerdanyola del Vallès, 08193, Barcelona, Spain
- CSIC, Cerdanyola del Vallès, 08193, Barcelona, Spain
| | - T Chodkiewicz
- Museum and Institute of Zoology, Polish Academy of Sciences, Wilcza 64, 00-679, Warszawa, Poland
- Polish Society for the Protection of Birds (OTOP), ul. Odrowaza 24, 05-270, Marki, Poland
| | - P Chylarecki
- Museum and Institute of Zoology, Polish Academy of Sciences, Wilcza 64, 00-679, Warszawa, Poland
| | - V Escandell
- Sociedad Española de Ornitología (SEO/BirdLife), Madrid, Spain
| | - D P Eskildsen
- Dansk Ornitologisk Forening, BirdLife Denmark, Vesterbrogade 138-140, DK-1620, København V, Denmark
| | - A Gamero
- European Bird Census Council-Czech Society for Ornithology, Na Bělidle 34, 15000, Prague 5, Czechia
| | - S Herrando
- CREAF, Cerdanyola del Vallès, 08193, Barcelona, Spain
- European Bird Census Council-Catalan Ornithological Institute, Natural History Museum of Barcelona, Plaça Leonardo da Vinci 4-5, 08019, Barcelona, Catalonia, Spain
| | - F Jiguet
- Centre d'Ecologie et des Sciences de la Conservation, UMR7204 MNHN-CNRS-SU, Paris, France
| | - J A Kålås
- Norwegian Institute for Nature Research, P.O. Box 5685, Torgarden, NO-7485, Trondheim, Norway
| | - J Kamp
- University of Göttingen, Department of Conservation Science, Bürgerstr. 50, 37073, Göttingen, Germany
- Dachverband Deutscher Avifaunisten (DDA), An den Speichern 2, 48157, Münster, Germany
| | - A Klvaňová
- European Bird Census Council-Czech Society for Ornithology, Na Bělidle 34, 15000, Prague 5, Czechia
| | - P Kmecl
- DOPPS - BirdLife Slovenia, Tržaška cesta 2, SI-1000, Ljubljana, Slovenia
| | - A Lehikoinen
- Finnish Museum of Natural History, FI-00014 University of Helsinki, P.O. Box 17, Helsinki, Finland
| | - Å Lindström
- Biodiversity Unit, Department of Biology, Lund University, Ecology Building, S-223 62, Lund, Sweden
| | - C Moshøj
- Dansk Ornitologisk Forening, BirdLife Denmark, Vesterbrogade 138-140, DK-1620, København V, Denmark
| | - D G Noble
- British Trust for Ornithology, The Nunnery, Thetford, Norfolk, IP24 2PU, UK
| | - I J Øien
- NOF-BirdLife Norway, Sandgata 30 B, NO-7012, Trondheim, Norway
| | - J-Y Paquet
- Natagora, Département Études, Traverse des Muses 1, B-5000, Namur, Belgium
| | - J Reif
- Institute for Environmental Studies, Faculty of Science, Charles University in Prague, Prague, Czechia
- Department of Zoology and Laboratory of Ornithology, Faculty of Science, Palacký University Olomouc, 17 Listopadu 50, 771 43, Olomouc, Czechia
| | - T Sattler
- Swiss Ornithological Institute, Seerose 1, 6204, Sempach, Switzerland
| | - B S Seaman
- BirdLife Österreich, Museumsplatz 1/10/8, A-1070, Wien, Austria
| | - N Teufelbauer
- BirdLife Österreich, Museumsplatz 1/10/8, A-1070, Wien, Austria
| | - S Trautmann
- Dachverband Deutscher Avifaunisten (DDA), An den Speichern 2, 48157, Münster, Germany
| | - C A M van Turnhout
- Sovon Dutch Centre for Field Ornithology, P.O. Box 6521, 6503 GA, Nijmegen, Netherlands
- Department of Animal Ecology and Ecophysiology, Institute for Water and Wetland Research, Radboud University, P.O. Box 9010, 6500 GL, Nijmegen, Netherlands
| | - P Vořišek
- European Bird Census Council-Czech Society for Ornithology, Na Bělidle 34, 15000, Prague 5, Czechia
- Department of Zoology and Laboratory of Ornithology, Faculty of Science, Palacký University Olomouc, 17 Listopadu 50, 771 43, Olomouc, Czechia
| | - S J Butler
- School of Biological Sciences, University of East Anglia, Norwich, UK.
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17
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Hummel KV, Schellong J, Trautmann S, Kummer S, Hürrig S, Klose M, Croy I, Weidner K, Kirschbaum C, Steudte-Schmiedgen S. The predictive role of hair cortisol concentrations for treatment outcome in PTSD inpatients. Psychoneuroendocrinology 2021; 131:105326. [PMID: 34182250 DOI: 10.1016/j.psyneuen.2021.105326] [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: 01/15/2021] [Revised: 04/30/2021] [Accepted: 06/11/2021] [Indexed: 11/18/2022]
Abstract
Psychological treatments of posttraumatic stress disorder (PTSD) are associated with non-response rates of up to 50%. This fact highlights the need to identify characteristics of poorer treatment outcome. Among others, previous evidence focused on the role of dysfunctional cortisol secretion which has been related to the development, maintenance and treatment of PTSD. Particularly, promising evidence stems from research using hair cortisol analysis which allows for a reliable assessment of cortisol secretion over several months. Another variable that has been linked to both HCC and non-response to treatment is childhood maltreatment (CM). In order to examine the predictive value of pre-treatment hair cortisol concentrations (HCC), treatment-related changes in HCC as well as CM for changes in PTSD symptomatology, we set up a prospective study in which we followed 52 female PTSD patients over the course of a trauma-focused inpatient treatment. Specifically, 3-month integrated HCC were assessed at treatment entry, at discharge and on average five months later accompanied by assessments of PTSD, overall and depressive symptomatology. CM was measured at treatment entry. Self-report indices improved following inpatient treatment. No evidence for pre-treatment HCC to be associated with changes in PTSD symptoms was revealed. However, attenuated pre-treatment HCC predicted less improvement in overall symptomatology from treatment entry to discharge. This effect lost significance after adjusting for baseline dissociative symptoms. Neither changes in HCC nor CM were predictive of treatment response. Pre-treatment cross-sectional analyses revealed no association between HCC and CM. The current hair cortisol data provided little evidence for a predictive role of lower long-term integrated cortisol secretion for poorer inpatient treatment outcome. If corroborated by further research in larger PTSD samples with much more methodological rigor, these data might be a valuable basis for future tailored research projects.
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Affiliation(s)
- Katrin V Hummel
- Faculty of Psychology, Technische Universität Dresden, Germany
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany
| | | | - Sylvia Kummer
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany
| | - Sabine Hürrig
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany
| | - Michael Klose
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany
| | - Ilona Croy
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany
| | | | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany.
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18
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Thomas S, Hummel KV, Schäfer J, Wittchen HU, Trautmann S. The role of harassment and group cohesion for depressive and anxiety symptoms. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement 2021. [DOI: 10.1037/cbs0000283] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Fares-Otero NE, Trautmann S, Pfaltz MC, Rodriguez-Jimenez R. Letter to the Editor: Targeting adverse stress-related consequences of the COVID-19 crisis in individuals with psychotic disorders and childhood maltreatment. J Psychiatr Res 2021; 138:453-455. [PMID: 33964683 PMCID: PMC9750188 DOI: 10.1016/j.jpsychires.2021.04.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/01/2021] [Accepted: 04/20/2021] [Indexed: 02/01/2023]
Affiliation(s)
- Natalia E. Fares-Otero
- Corresponding author. Department of Psychiatry, Biomedical Research Institute, University Hospital 12 de Octubre (imas12), Avda. de Córdoba s/n, 28041, Madrid, Spain
| | | | - Monique C Pfaltz
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Faculty of Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roberto Rodriguez-Jimenez
- Department of Psychiatry, Biomedical Research Institute, University Hospital 12 de Octubre (imas12), Faculty of Medicine, Complutense University of Madrid (UCM), Madrid, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain
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20
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Fares-Otero NE, Pfaltz MC, Rodriguez-Jimenez R, Schäfer I, Trautmann S. Childhood maltreatment and social functioning in psychotic disorders: a systematic review protocol. Eur J Psychotraumatol 2021; 12:1943872. [PMID: 36877473 PMCID: PMC10075514 DOI: 10.1080/20008198.2021.1943872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Indexed: 10/20/2022] Open
Abstract
Background: Childhood maltreatment (CM) is thought to play a key role in the etiology and course of psychotic disorders (PD). In addition, CM is related to neurobiological and clinical characteristics that can lead to poor social functioning. However, the extent to which CM and social functioning are directly associated in individuals with PD, is unclear. Therefore, we aim to systematically review the literature to provide an estimate on the strength of the association between CM and different domains of social functioning in PD and to summarize potential moderators and mediators of this association.Methods and analysis: To identify relevant studies, we will systematically search the following databases: Pubmed (Medline), PsycInfo, Embase, Web of Science (Core Collection), and Pilots (trauma), manually search reference lists and contact experts in the field. Studies will be included if they investigate and report on the association between CM (exposure) and social functioning (outcome) in adults with PD. Two independent reviewers will screen titles, abstracts and full texts according to eligibility criteria, perform data extraction and assess study quality according to a modified version of the Newcastle-Ottawa Scale.Analysis: Effect estimates will be pooled in a meta-analysis. Heterogeneity and publication bias will be assessed and the effects of potential moderators (genetic factors, type of diagnosis, duration of illness, type of CM and age at the time of CM exposure) will be analyzed using meta-regressions. Candidate moderators and mediators (neurocognition, cognitive schemas, comorbidities, stress sensitivity, attachment) will be also examined qualitatively.Ethics and dissemination: Because this review will make use of already published data, ethical approval will not be sought. This work has the potential to inform upcoming investigations on the association between the exposure to CM in PD and social functioning. PROSPERO registration number CRD42020175244.
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Key Words
- abuso infantil, negligencia, cognicivón social, relaciones interpersonales, funcionamiento en la comunidad, psicosis, revisión sistemática
- child abuse, neglect, social cognitive skills, interpersonal relationships, community functioning, psychosis, systematic review
- 人际关系
- 儿童虐待
- 忽视
- 社会功能
- 社会认知技能
- 精神病
- 系统综述
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Affiliation(s)
- Natalia E Fares-Otero
- Department of Psychiatry, Biomedical Research Institute, University Hospital 12 De Octubre (Imas12), Madrid, Spain.,Universidad Internacional de la Rioja, Spain
| | - Monique C Pfaltz
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Faculty of Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roberto Rodriguez-Jimenez
- Department of Psychiatry, Biomedical Research Institute, University Hospital 12 De Octubre (Imas12), Faculty of Medicine, University Complutense de Madrid (UCM), Madrid, Spain, CIBERSAM (Biomedical Research Networking Centre in Mental Health), Madrid, Spain
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Trautmann
- Department of Psychology, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
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21
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Schindler L, Stalder T, Kirschbaum C, Plessow F, Schönfeld S, Hoyer J, Trautmann S, Steudte-Schmiedgen S. Cognitive functioning in posttraumatic stress disorder before and after cognitive-behavioral therapy. J Anxiety Disord 2020; 74:102265. [PMID: 32623282 DOI: 10.1016/j.janxdis.2020.102265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 05/22/2020] [Accepted: 06/16/2020] [Indexed: 11/24/2022]
Abstract
Although substantial evidence suggests altered executive functioning and autobiographical memory in posttraumatic stress disorder (PTSD), the clinical significance of these findings remains unclear. Here, we investigated the effects of cognitive-behavioral therapy (CBT) on different aspects of cognitive functioning (working memory, interference susceptibility, conflict adaptation, autobiographical memory) in PTSD patients in a pre-post control group design with a nested cross-sectional element. Cross-sectional analyses at baseline were conducted on 58 PTSD patients, 39 traumatized (TC), and 45 non-traumatized controls (NTC). Intervention effects were investigated before and after 25 CBT sessions in 25 PTSD and 34 untreated NTC individuals assessed in parallel. At baseline, PTSD patients showed higher conflict adaptation than the NTC group and less autobiographical memory specificity than both control groups, suggesting particularly the latter to be a correlate of PTSD. No consistent evidence for treatment-induced improvements in cognitive functioning emerged on the group level or from associations between intra-individual clinical and cognitive changes. Analyses on the role of cognitive functioning on subsequent treatment effects revealed a predictive effect of backward digit span on CBT-induced reductions of depressiveness, but no other significant effects. Our findings highlight the need for further research to identify more relevant predictors of differential treatment response.
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Affiliation(s)
- Lena Schindler
- Faculty of Psychology, Technische Universität Dresden, Germany.
| | - Tobias Stalder
- Department Erziehungswissenschaften und Psychologie, Universität Siegen, Germany.
| | | | - Franziska Plessow
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Sabine Schönfeld
- Faculty of Psychology, Technische Universität Dresden, Germany; Department of Psychology, Lund University, Sweden.
| | - Jürgen Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany.
| | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany; Department of Psychology, Medical School Hamburg, Germany.
| | - Susann Steudte-Schmiedgen
- Faculty of Psychology, Technische Universität Dresden, Germany; Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Germany.
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22
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Pellissier V, Schmucki R, Pe'er G, Aunins A, Brereton TM, Brotons L, Carnicer J, Chodkiewicz T, Chylarecki P, Del Moral JC, Escandell V, Evans D, Foppen R, Harpke A, Heliölä J, Herrando S, Kuussaari M, Kühn E, Lehikoinen A, Lindström Å, Moshøj CM, Musche M, Noble D, Oliver TH, Reif J, Richard D, Roy DB, Schweiger O, Settele J, Stefanescu C, Teufelbauer N, Touroult J, Trautmann S, van Strien AJ, van Swaay CAM, van Turnhout C, Vermouzek Z, Voříšek P, Jiguet F, Julliard R. Effects of Natura 2000 on nontarget bird and butterfly species based on citizen science data. Conserv Biol 2020; 34:666-676. [PMID: 31701577 DOI: 10.1111/cobi.13434] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 10/21/2019] [Accepted: 10/30/2019] [Indexed: 06/10/2023]
Abstract
The European Union's Natura 2000 (N2000) is among the largest international networks of protected areas. One of its aims is to secure the status of a predetermined set of (targeted) bird and butterfly species. However, nontarget species may also benefit from N2000. We evaluated how the terrestrial component of this network affects the abundance of nontargeted, more common bird and butterfly species based on data from long-term volunteer-based monitoring programs in 9602 sites for birds and 2001 sites for butterflies. In almost half of the 155 bird species assessed, and particularly among woodland specialists, abundance increased (slope estimates ranged from 0.101 [SD 0.042] to 3.51 [SD 1.30]) as the proportion of landscape covered by N2000 sites increased. This positive relationship existed for 27 of the 104 butterfly species (estimates ranged from 0.382 [SD 0.163] to 4.28 [SD 0.768]), although most butterflies were generalists. For most species, when land-cover covariates were accounted for these positive relationships were not evident, meaning land cover may be a determinant of positive effects of the N2000 network. The increase in abundance as N2000 coverage increased correlated with the specialization index for birds, but not for butterflies. Although the N2000 network supports high abundance of a large spectrum of species, the low number of specialist butterflies with a positive association with the N2000 network shows the need to improve the habitat quality of N2000 sites that could harbor open-land butterfly specialists. For a better understanding of the processes involved, we advocate for standardized collection of data at N2000 sites.
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Affiliation(s)
- V Pellissier
- Sorbonne Université, MNHN-CNRS-UPMC, UMR7204-CESCO, 43 rue Buffon, CP 135, Paris, 75005, France
- Section for Ecoinformatics & Biodiversity, Department of Bioscience, Aarhus University, Aarhus, DK 8000, Denmark
| | - R Schmucki
- Sorbonne Université, MNHN-CNRS-UPMC, UMR7204-CESCO, 43 rue Buffon, CP 135, Paris, 75005, France
- Centre de Synthèse et d'Analyse sur la Biodiversité, Immeuble Henri Poincaré, Domaine du Petit Arbois, Avenue Louis Philibert, Aix-en-Provence, 13857, France
- NERC Centre for Ecology & Hydrology, Wallingford, Oxfordshire, OX10 8EF, U.K
| | - G Pe'er
- German Centre for Integrative Biodiversity Research (iDiv), Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Department Economics and Department Ecosystem Services, UFZ - Helmholtz Centre for Environmental Research, Permoserstr. 15, Leipzig, 04318, Germany
| | - A Aunins
- Faculty of Biology, University of Latvia, Jelgavas iela 1, Riga, LV-1004, Latvia
- Latvian Ornithological Society, Skolas iela 3, Riga, LV-1010, Latvia
| | - T M Brereton
- Butterfly Conservation, Manor Yard, East Lulworth, Wareham, Dorset, BH20 5QP, U.K
| | - L Brotons
- CSIC-CREAF, 08193 Cerdanyola del Vallès, Catalonia, Spain
- Catalan Ornithological Institute, Natural History Museum of Barcelona, Plaça Leonardo da Vinci 4-5, Barcelona, Catalonia, 08019, Spain
- InForest JRU (CEMFOR-CTFC), Solsona, Catalonia, 25280, Spain
| | - J Carnicer
- CSIC-CREAF, 08193 Cerdanyola del Vallès, Catalonia, Spain
- Department of Evolutionary Biology, Ecology, and Environmental Sciences, University of Barcelona, Catalonia, 08028, Spain
| | - T Chodkiewicz
- Museum and Institute of Zoology, Polish Academy of Sciences, Wilcza 64, Warszawa, 00-679, Poland
- Polish Society for the Protection of Birds (OTOP), ul. Odrowaza 24, Marki, 05-270, Poland
| | - P Chylarecki
- Museum and Institute of Zoology, Polish Academy of Sciences, Wilcza 64, Warszawa, 00-679, Poland
| | - J C Del Moral
- Sociedad Española de Ornitología (SEO/BirdLife), Melquíades Biencinto 34 ES-28053, Madrid, Spain
| | - V Escandell
- Sociedad Española de Ornitología (SEO/BirdLife), Melquíades Biencinto 34 ES-28053, Madrid, Spain
| | - D Evans
- European Topic Centre on Biological Diversity, 57 rue Cuvier, Paris, 75005, France
| | - R Foppen
- Sovon Dutch Centre for Field Ornithology, PO Box 6521, Nijmegen, 6503 GA, The Netherlands
| | - A Harpke
- Department of Community Ecology, UFZ - Helmholtz Centre for Environmental Research, Theodor-Lieser-Strasse 4, Halle/Saale, 06120, Germany
| | - J Heliölä
- Finnish Environment Institute (SYKE), Biodiversity Centre, P.O. Box 140, Helsinki, FI-00251, Finland
| | - S Herrando
- Catalan Ornithological Institute, Natural History Museum of Barcelona, Plaça Leonardo da Vinci 4-5, Barcelona, Catalonia, 08019, Spain
- InForest JRU (CEMFOR-CTFC), Solsona, Catalonia, 25280, Spain
| | - M Kuussaari
- Finnish Environment Institute (SYKE), Biodiversity Centre, P.O. Box 140, Helsinki, FI-00251, Finland
| | - E Kühn
- Department of Community Ecology, UFZ - Helmholtz Centre for Environmental Research, Theodor-Lieser-Strasse 4, Halle/Saale, 06120, Germany
| | - A Lehikoinen
- Finnish Museum of Natural History, University of Helsinki, P.O. Box 17, Helsinki, FI-00014, Finland
| | - Å Lindström
- Department of Biology, Biodiversity Unit, Lund University, Ecology Building, Lund, SE-223 62, Sweden
| | - C M Moshøj
- DOF-BirdLife Denmark, Vesterbrogade 140, Copenhagen V, DK-1620, Denmark
| | - M Musche
- Department of Community Ecology, UFZ - Helmholtz Centre for Environmental Research, Theodor-Lieser-Strasse 4, Halle/Saale, 06120, Germany
| | - D Noble
- BTO, The Nunnery, Thetford, Norfolk, IP24 2PU, U.K
| | - T H Oliver
- School of Biological Sciences, Harborne Building, Whiteknights Campus, University of Reading, Berkshire, RG6 6AS, U.K
| | - J Reif
- Institute for Environmental Studies, Faculty of Science, Charles University, Prague, Czech Republic
- Department of Zoology and Laboratory of Ornithology, Faculty of Science, Palacký University in Olomouc, 17. listopadu 50, Olomouc, 771 43, Czech Republic
| | - D Richard
- European Topic Centre on Biological Diversity, 57 rue Cuvier, Paris, 75005, France
| | - D B Roy
- NERC Centre for Ecology & Hydrology, Wallingford, Oxfordshire, OX10 8EF, U.K
| | - O Schweiger
- Department of Community Ecology, UFZ - Helmholtz Centre for Environmental Research, Theodor-Lieser-Strasse 4, Halle/Saale, 06120, Germany
| | - J Settele
- German Centre for Integrative Biodiversity Research (iDiv), Halle-Jena-Leipzig, Deutscher Platz 5e, Leipzig, 04103, Germany
- Department of Community Ecology, UFZ - Helmholtz Centre for Environmental Research, Theodor-Lieser-Strasse 4, Halle/Saale, 06120, Germany
| | - C Stefanescu
- CSIC-CREAF, 08193 Cerdanyola del Vallès, Catalonia, Spain
- Museu de Ciències Naturals de Granollers, Francesc Macià 51, Granollers, Catalonia, 08402, Spain
| | - N Teufelbauer
- BirdLife Austria, Museumplatz 1/10/8, Wien, A-1070, Austria
| | - J Touroult
- UMS 2006 PatriNat AFB, CNRS, MNHN; CP41, 36 rue Geoffroy Saint-Hilaire, Paris, 75005, France
| | - S Trautmann
- DDA, An den Speichern 6, Münster, 48157, Germany
| | | | - C A M van Swaay
- Dutch Butterfly Conservation and Butterfly Conservation Europe, P.O. Box 506 NL 6700 AM, Wageningen, The Netherlands
| | - C van Turnhout
- Sovon Dutch Centre for Field Ornithology, PO Box 6521, Nijmegen, 6503 GA, The Netherlands
- Department of Animal Ecology & Ecophysiology, Institute for Water and Wetland Research, Radboud University, P.O. Box 9010, Nijmegen, 6500 GL, The Netherlands
| | - Z Vermouzek
- Czech Society for Ornithology, Na Bělidle 252/34, Prague, CZ-150 00, Czech Republic
| | - P Voříšek
- Department of Zoology and Laboratory of Ornithology, Faculty of Science, Palacký University in Olomouc, 17. listopadu 50, Olomouc, 771 43, Czech Republic
- Czech Society for Ornithology, Na Bělidle 252/34, Prague, CZ-150 00, Czech Republic
| | - F Jiguet
- Sorbonne Université, MNHN-CNRS-UPMC, UMR7204-CESCO, 43 rue Buffon, CP 135, Paris, 75005, France
| | - R Julliard
- Sorbonne Université, MNHN-CNRS-UPMC, UMR7204-CESCO, 43 rue Buffon, CP 135, Paris, 75005, France
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23
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Muehlhan M, Höcker A, Miller R, Trautmann S, Wiedemann K, Lotzin A, Barnow S, Schäfer I. HPA axis stress reactivity and hair cortisol concentrations in recently detoxified alcoholics and healthy controls with and without childhood maltreatment. Addict Biol 2020; 25:e12681. [PMID: 30307081 DOI: 10.1111/adb.12681] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 08/27/2018] [Accepted: 08/27/2018] [Indexed: 01/09/2023]
Abstract
Childhood maltreatment (CM) is a strong risk factor for alcohol dependence (AD) and is associated with a more severe course of the disease. Alterations of the hypothalamic-pituitary-adrenal (HPA) axis may play an important role in this relationship. The aim of the present study was to systematically investigate potential alterations in HPA functioning associated with AD diagnosis and CM. Four study groups were recruited: AD patients with (n = 29; 10♀) and without (n = 33; 8♀) CM and healthy controls with (n = 30; 20♀) and without (n = 38; 15♀) CM. Cumulative cortisol secretion was measured by hair cortisol concentration (HCC). To measure HPA axis response to the Trier social stress test (TSST), saliva and blood samples were analysed for adrenocorticotropic hormone (ACTH) and cortisol. In the AD groups, the period of hair growth covered acute alcohol consumption and withdrawal. The TSST was scheduled after completion of withdrawal. Irrespective of CM, higher HCCs and reduced ACTH and cortisol levels before and after TSST were observed in AD patients. The analyses did not reveal any differences between AD patients with and without CM. Healthy controls with CM had lower plasma cortisol levels compared with those without CM. The results suggest that AD is strongly related to HPA axis functioning, which may superimpose possible differences between AD patients with and without CM. Future studies should investigate whether biologically different subtypes of AD with and without CM can be identified in earlier stages or before the development of AD.
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Affiliation(s)
- Markus Muehlhan
- Department of Psychology, Faculty of Human ScienceMedical School Hamburg Hamburg Germany
- Institute of Clinical Psychology and Psychotherapy, Faculty of PsychologySchool of Science, Technische Universität Dresden Dresden Germany
| | - Anja Höcker
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Robert Miller
- Institute of General Psychology, Biological Psychology and Methods in Psychology, Faculty of PsychologySchool of Science, Technische Universität Dresden Germany
| | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Faculty of PsychologySchool of Science, Technische Universität Dresden Dresden Germany
| | - Klaus Wiedemann
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Annett Lotzin
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
- Center for Interdisciplinary Addiction ResearchUniversity of Hamburg, University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Sven Barnow
- Department of Clinical Psychology and PsychotherapyRuprecht‐Karls‐University Heidelberg Heidelberg Germany
| | - Ingo Schäfer
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
- Center for Interdisciplinary Addiction ResearchUniversity of Hamburg, University Medical Center Hamburg‐Eppendorf Hamburg Germany
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24
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Thomas S, Höfler M, Schäfer I, Trautmann S. Childhood maltreatment and treatment outcome in psychotic disorders: a systematic review and meta-analysis. Acta Psychiatr Scand 2019; 140:295-312. [PMID: 31357235 DOI: 10.1111/acps.13077] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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] [Accepted: 07/24/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Childhood maltreatment (CM) plays an important role in the aetiology and course of psychotic disorders and is associated with characteristics that could be relevant for treatment. We aimed to conduct a systematic review and meta-analysis on the association between CM and treatment outcome in psychotic disorders. METHODS Treatment outcome was defined as change in psychotic symptoms or in social or occupational functioning between first and last reported measurement in the course of a pharmacological and/or psychological treatment. RESULTS Twelve treatment results from seven studies (636 patients, average treatment duration: 59.2 weeks) were included. CM was related to poorer treatment outcomes in psychotic disorders (OR = 1.51, 95% CI = [1.08, 2.10]). There is evidence that this association might increase with illness duration and increasing age and might be stronger in schizophrenia samples. CONCLUSIONS Childhood maltreatment is highly understudied with regard to treatment outcome in psychotic disorders. The need for more studies is emphasized by the fact that this meta-analysis reveals evidence for a poorer treatment response in patients with CM. If this association is confirmed, the identification of patients with CM and the consideration of associated clinical and biological conditions could contribute to improve treatment outcome in psychotic disorders.
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Affiliation(s)
- S Thomas
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - I Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychology, Medical School Hamburg, Hamburg, Germany
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25
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Schäfer L, Schellong J, Hähner A, Weidner K, Hüttenbrink KB, Trautmann S, Hummel T, Croy I. Nocturnal Olfactory Stimulation for Improvement of Sleep Quality in Patients With Posttraumatic Stress Disorder: A Randomized Exploratory Intervention Trial. J Trauma Stress 2019; 32:130-140. [PMID: 30681196 DOI: 10.1002/jts.22359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 09/11/2018] [Accepted: 09/20/2018] [Indexed: 11/06/2022]
Abstract
Posttraumatic stress disorder (PTSD) is characterized by sleep impairment and nightmares. As pleasant odors presented during sleep affect the emotional tone of dreams without inducing arousal, we investigated whether sleep patterns in PTSD can be improved via nocturnal olfactory stimulation. Participants were 40 inpatients with PTSD (n = 35 women; age range: 20-59 years) who completed a randomized, patient-blind, placebo-controlled trial. Baseline measurement for 5 consecutive nights was followed by a 5-night experimental intervention or placebo trial. During the intervention, patients received nocturnal stimulation with a pleasant odor (odor condition) or clean air (placebo condition) via an olfactometer that delivered inspiration-triggered stimuli in a nasal tube or via an odorized nasal clip. After each night, the patients completed standardized questionnaires that assessed sleep parameters and dream content. Each night, sleep efficiency, sleep onset latency, and wakefulness after sleep onset were monitored with a motion biosensor. Baseline assessment revealed that PTSD severity was associated with poorer sleep outcomes. An interaction effect showed that nocturnal odorization affected dream intensity. Post hoc tests revealed an improvement in the group that used the nasal clip as compared to baseline, d = 0.68. No negative effects were observed after odorization with the nasal clip. Considering the limited sample size, the study indicates that nocturnal olfactory stimulation may serve as a low-cost concomitant intervention to improve sleep quality in PTSD.
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Affiliation(s)
- Laura Schäfer
- Department of Psychotherapy and Psychosomatic Medicine, Technische Universität, Dresden, Germany
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, Technische Universität, Dresden, Germany
| | - Antje Hähner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Technische Universität, Dresden, Germany
| | | | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität, Dresden, Germany
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität, Dresden, Germany
| | - Ilona Croy
- Department of Psychotherapy and Psychosomatic Medicine, Technische Universität, Dresden, Germany
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26
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Trautmann S, Beesdo-Baum K. The Treatment of Depression in Primary Care. Dtsch Arztebl Int 2018; 114:721-728. [PMID: 29143731 DOI: 10.3238/arztebl.2017.0721] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 09/28/2016] [Accepted: 07/11/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND General practitioners play a key role in the care of patients with depressive disorders. We studied the frequency and type of treatment of depressive disorders in primary care. METHODS In a cross-sectional epidemiological study on a particular day in six different regions in Germany, 253 physicians and 3563 unselected patients were asked to fill in a questionnaire assessing the diagnosis and treatment of depression. A total of 3431 usable patient data sets and 3211 sets of usable data from both the patient and the physician were subjected to further analysis. RESULTS 68.0% of the 490 patients in primary care who were classified as depressed according to the Depression Screening Questionnaire received treatment from their general practitioner or in other care settings; the probability of being treated by the general practitioner was higher for patients whose diagnosis was recognized by the general practitioner (92.8%) than for the remaining depressed patients (47.8%). On the day of data recording, 54.1% of the depressed patients were under treatment by the general practitioner and 21.2% had been referred to specialized treatment. Approximately 60% of the depressed patients were not being treated, as recommended in the guidelines, with antidepressant drugs, psychotherapy, or both. The likelihood of being treated in conformity with the guidelines depended on whether or not the general practitioner had made the diagnosis of depression (odds ratio [OR] = 7.5; 95% confidence interval = [4.9; 11.6]; p <0,001); it was also higher if the general practitioner had an additional qualification in psychotherapy (OR = 1.9; [1.1; 3.4]; p = 0.022). CONCLUSION The finding that a relevant proportion of patients with depressive disorders in primary care are inadequately treated indicates the need to improve general practitioners' ability to diagnose these conditions and determine the indication for treatment.
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Affiliation(s)
- Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, TU Dresden; Behavioral Epidemiology, TU Dresden; Center for Clinical Epidemiology and Longitudinal Studies, TU Dresden
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27
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Muehlhan M, Höcker A, Miller R, Trautmann S, Wiedemann K, Lotzin A, Barnow S, Schäfer I. HPA axis stress reactivity and hair cortisol concentrations in recently detoxified alcoholics and healthy controls with and without childhood maltreatment. Addict Biol 2018. [PMID: 30307081 DOI: 10.1111/adb.12681.] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Childhood maltreatment (CM) is a strong risk factor for alcohol dependence (AD) and is associated with a more severe course of the disease. Alterations of the hypothalamic-pituitary-adrenal (HPA) axis may play an important role in this relationship. The aim of the present study was to systematically investigate potential alterations in HPA functioning associated with AD diagnosis and CM. Four study groups were recruited: AD patients with (n = 29; 10♀) and without (n = 33; 8♀) CM and healthy controls with (n = 30; 20♀) and without (n = 38; 15♀) CM. Cumulative cortisol secretion was measured by hair cortisol concentration (HCC). To measure HPA axis response to the Trier social stress test (TSST), saliva and blood samples were analysed for adrenocorticotropic hormone (ACTH) and cortisol. In the AD groups, the period of hair growth covered acute alcohol consumption and withdrawal. The TSST was scheduled after completion of withdrawal. Irrespective of CM, higher HCCs and reduced ACTH and cortisol levels before and after TSST were observed in AD patients. The analyses did not reveal any differences between AD patients with and without CM. Healthy controls with CM had lower plasma cortisol levels compared with those without CM. The results suggest that AD is strongly related to HPA axis functioning, which may superimpose possible differences between AD patients with and without CM. Future studies should investigate whether biologically different subtypes of AD with and without CM can be identified in earlier stages or before the development of AD.
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Affiliation(s)
- Markus Muehlhan
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany.,Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, School of Science, Technische Universität Dresden, Dresden, Germany
| | - Anja Höcker
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Robert Miller
- Institute of General Psychology, Biological Psychology and Methods in Psychology, Faculty of Psychology, School of Science, Technische Universität Dresden, Germany
| | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, School of Science, Technische Universität Dresden, Dresden, Germany
| | - Klaus Wiedemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Barnow
- Department of Clinical Psychology and Psychotherapy, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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28
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Trautmann S, Reineboth M, Trikojat K, Richter J, Hagenaars MA, Kanske P, Schäfer J. Susceptibility to others' emotions moderates immediate self-reported and biological stress responses to witnessing trauma. Behav Res Ther 2018; 110:55-63. [PMID: 30243101 DOI: 10.1016/j.brat.2018.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 08/20/2018] [Accepted: 09/07/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The peri-traumatic stress response is a strong predictor of symptom development after trauma exposure. Regarding witnessing trauma, the stress response might depend on the susceptibility to others' emotions (emotional contagion, EC). This study investigated whether EC moderates the immediate stress response using a trauma film paradigm. METHODS Ninety-five healthy participants were randomly exposed to a trauma or a neutral film. Perceived stressfulness of the film and pre-to post-film changes in self-reported anxiety, heart rate and saliva cortisol levels were assessed. EC towards negative and positive emotions was measured using the emotional contagion scale and its emotion-specific subscales. RESULTS Overall, the trauma film was perceived as distressing and elicited an increase in self-reported anxiety, heart rate and saliva cortisol levels relative to the neutral film. EC towards negative emotions was positively related to the perceived stressfulness of the film, increased anxiety and increased heart rate. The association with saliva cortisol levels was also in the expected direction, but not statistically significant. These associations were not found for EC towards positive emotions. DISCUSSION EC towards negative emotions may be an important predictor of trauma exposure outcomes. Further research should clarify its specific contribution in witnessing and undergoing trauma.
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Affiliation(s)
- Sebastian Trautmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Magdalena Reineboth
- Department of Personality Psychology and Assessment, Technische Universität Chemnitz, Chemnitz, Germany
| | - Katharina Trikojat
- Department of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Jan Richter
- Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Muriel A Hagenaars
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
| | - Philipp Kanske
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Judith Schäfer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Trautmann S, Richard-Lacroix M, Dathe A, Schneidewind H, Dellith J, Fritzsche W, Deckert V. Plasmon response evaluation based on image-derived arbitrary nanostructures. Nanoscale 2018; 10:9830-9839. [PMID: 29774907 DOI: 10.1039/c8nr02783h] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The optical response of realistic 3D plasmonic substrates composed of randomly shaped particles of different size and interparticle distance distributions in addition to nanometer scale surface roughness is intrinsically challenging to simulate due to computational limitations. Here, we present a Finite Element Method (FEM)-based methodology that bridges in-depth theoretical investigations and experimental optical response of plasmonic substrates composed of such silver nanoparticles. Parametrized scanning electron microscopy (SEM) images of surface enhanced Raman spectroscopy (SERS) active substrate and tip-enhanced Raman spectroscopy (TERS) probes are used to simulate the far-and near-field optical response. Far-field calculations are consistent with experimental dark field spectra and charge distribution images reveal for the first time in arbitrary structures the contributions of interparticle hybridized modes such as sub-radiant and super-radiant modes that also locally organize as basic units for Fano resonances. Near-field simulations expose the spatial position-dependent impact of hybridization on field enhancement. Simulations of representative sections of TERS tips are shown to exhibit the same unexpected coupling modes. Near-field simulations suggest that these modes can contribute up to 50% of the amplitude of the plasmon resonance at the tip apex but, interestingly, have a small effect on its frequency in the visible range. The band position is shown to be extremely sensitive to particle nanoscale roughness, highlighting the necessity to preserve detailed information at both the largest and the smallest scales. To the best of our knowledge, no currently available method enables reaching such a detailed description of large scale realistic 3D plasmonic systems.
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Affiliation(s)
- S Trautmann
- Leibniz Institute of photonic technology (IPHT), Albert-Einstein-Straße 9, D-07745 Jena, Germany.
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Höfler M, Venz J, Trautmann S, Miller R. Writing a discussion section: how to integrate substantive and statistical expertise. BMC Med Res Methodol 2018; 18:34. [PMID: 29665780 PMCID: PMC5905138 DOI: 10.1186/s12874-018-0490-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 04/01/2018] [Indexed: 12/25/2022] Open
Abstract
Background When discussing results medical research articles often tear substantive and statistical (methodical) contributions apart, just as if both were independent. Consequently, reasoning on bias tends to be vague, unclear and superficial. This can lead to over-generalized, too narrow and misleading conclusions, especially for causal research questions. Main body To get the best possible conclusion, substantive and statistical expertise have to be integrated on the basis of reasonable assumptions. While statistics should raise questions on the mechanisms that have presumably created the data, substantive knowledge should answer them. Building on the related principle of Bayesian thinking, we make seven specific and four general proposals on writing a discussion section. Conclusion Misinterpretation could be reduced if authors explicitly discussed what can be concluded under which assumptions. Informed on the resulting conditional conclusions other researchers may, according to their knowledge and beliefs, follow a particular conclusion or, based on other conditions, arrive at another one. This could foster both an improved debate and a better understanding of the mechanisms behind the data and should therefore enable researchers to better address bias in future studies.
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Affiliation(s)
- Michael Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. .,Chair of Clinical Psychology and Behavioural Neuroscience, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - John Venz
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Robert Miller
- Faculty of Psychology, Technische Universität Dresden, Dresden, Germany.,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
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Trautmann S, Muehlhan M, Kirschbaum C, Wittchen HU, Höfler M, Stalder T, Steudte-Schmiedgen S. Biological stress indicators as risk markers for increased alcohol use following traumatic experiences. Addict Biol 2018; 23:281-290. [PMID: 28105726 DOI: 10.1111/adb.12487] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/30/2016] [Accepted: 11/28/2016] [Indexed: 12/31/2022]
Abstract
Alcohol misuse is a common sequela of traumatic event experiences causing considerable morbidity and mortality. Although biological stress indicators have been identified as useful risk markers for the development of trauma-related disorders, no such biological indicators exist for the risk of increased alcohol use after trauma exposure. This is the first study to prospectively investigate the predictive value of long-term cortisol levels and acute stress reactivity for the risk of increased alcohol use following traumatic events. Male soldiers were examined before and 12 months following deployment using a standardized diagnostic interview. We analyzed the moderating role of baseline hair cortisol concentrations (HCCs, n = 153) as well as baseline salivary cortisol and alpha-amylase stress reactivity in response to a laboratory stressor (n = 145) in the association between new-onset traumatic events (according to the DSM-IV A1 criterion) and subsequent daily alcohol use. No main effects of pre-traumatic HCC or salivary stress markers on subsequent change in alcohol use were observed. However, we found that with decreasing HCC, the number of new-onset traumatic events was more strongly associated with subsequent alcohol use independent from changes in posttraumatic stress disorder symptoms. No such relation was seen for the acute stress reactivity data. Taken together, this study provides first evidence suggesting that individual differences in long-term cortisol regulation are involved in the association between traumatic experiences and subsequent alcohol use. HCC may thus serve as a potential target in the early identification of individuals vulnerable for increased alcohol use following traumatic events.
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Affiliation(s)
- Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy; Technische Universität Dresden; Dresden Germany
| | - Markus Muehlhan
- Institute of Clinical Psychology and Psychotherapy; Technische Universität Dresden; Dresden Germany
| | - Clemens Kirschbaum
- Institute of Biological Psychology; Technische Universität Dresden; Dresden Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy; Technische Universität Dresden; Dresden Germany
| | - Michael Höfler
- Institute of Clinical Psychology and Psychotherapy; Technische Universität Dresden; Dresden Germany
| | - Tobias Stalder
- Institute of Biological Psychology; Technische Universität Dresden; Dresden Germany
- Clinical Psychology; University of Siegen; Siegen Germany
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Trautmann S. S22-4INSIGHTS INTO THE MECHANISMS UNDERLYING THE RELATIONSHIP BETWEEN STRESS AND ALCOHOL CONSUMPTION. Alcohol Alcohol 2017. [DOI: 10.1093/alcalc/agx075.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Trautmann S, Goodwin L, Höfler M, Jacobi F, Strehle J, Zimmermann P, Wittchen HU. Prevalence and severity of mental disorders in military personnel: a standardised comparison with civilians. Epidemiol Psychiatr Sci 2017; 26:199-208. [PMID: 27086743 PMCID: PMC6998688 DOI: 10.1017/s204579601600024x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/22/2016] [Indexed: 11/06/2022] Open
Abstract
AIMS Provision and need for mental health services among military personnel are a major concern across nations. Two recent comparisons suggest higher rates of mental disorders in US and UK military personnel compared with civilians. However, these findings may not apply to other nations. Previous studies have focused on the overall effects of military service rather than the separate effects of military service and deployment. This study compared German military personnel with and without a history of deployment to sociodemographically matched civilians regarding prevalence and severity of 12-month DSM-IV mental disorders. METHOD 1439 deployed soldiers (DS), 779 never deployed soldiers (NS) and 1023 civilians were assessed with an adapted version of the Munich Composite International Diagnostic interview across the same timeframe. Data were weighted using propensity score methodology to assure comparability of the three samples. RESULTS Compared with adjusted civilians, the prevalence of any 12-month disorder was lower in NS (OR: 0.7, 95% CI: 0.5-0.99) and did not differ in DS. Significant differences between military personnel and civilians regarding prevalence and severity of individual diagnoses were only apparent for alcohol (DS: OR: 0.3, 95% CI: 0.1-0.6; NS: OR: 0.2, 95% CI: 0.1-0.6) and nicotine dependence (DS: OR: 0.5, 95% CI: 0.3-0.6; NS: OR: 0.5, 95% CI: 0.3-0.7) with lower values in both military samples. Elevated rates of panic/agoraphobia (OR: 2.7, 95% CI: 1.4-5.3) and posttraumatic stress disorder (OR: 3.2, 95% CI: 1.3-8.0) were observed in DS with high combat exposure compared with civilians. CONCLUSIONS Rates and severity of mental disorders in the German military are comparable with civilians for internalising and lower for substance use disorders. A higher risk of some disorders is reduced to DS with high combat exposure. This finding has implications for mental health service provision and the need for targeted interventions. Differences to previous US and UK studies that suggest an overall higher prevalence in military personnel might result from divergent study methods, deployment characteristics, military structures and occupational factors. Some of these factors might yield valuable targets to improve military mental health.
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Affiliation(s)
- S. Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - L. Goodwin
- Department of Psychological Medicine, King's Centre for Military Health Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M. Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - F. Jacobi
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - J. Strehle
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - P. Zimmermann
- Centre for Psychiatry and Posttraumatic Stress, Federal Armed Forces Hospital Berlin, Berlin, Germany
| | - H.-U. Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Trautmann S, Aizpurua J, Götz I, Undisz A, Dellith J, Schneidewind H, Rettenmayr M, Deckert V. A classical description of subnanometer resolution by atomic features in metallic structures. Nanoscale 2017; 9:391-401. [PMID: 27924333 DOI: 10.1039/c6nr07560f] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Recent experiments have evidenced sub-nanometer resolution in plasmonic-enhanced probe spectroscopy. Such a high resolution cannot be simply explained using the commonly considered radii of metallic nanoparticles on plasmonic probes. In this contribution the effects of defects as small as a single atom found on spherical plasmonic particles acting as probing tips are investigated in connection with the spatial resolution provided. The presence of abundant edge and corner sites with atomic scale dimensions in crystalline metallic nanoparticles is evident from transmission electron microscopy (TEM) images. Electrodynamic calculations based on the Finite Element Method (FEM) are implemented to reveal the impact of the presence of such atomic features in probing tips on the lateral spatial resolution and field localization. Our analysis is developed for three different configurations, and under resonant and non-resonant illumination conditions, respectively. Based on this analysis, the limits of field enhancement, lateral resolution and field confinement in plasmon-enhanced spectroscopy and microscopy are inferred, reaching values below 1 nanometer for reasonable atomic sizes.
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Affiliation(s)
- S Trautmann
- Leibniz Institute of photonic technology (IPHT), Albert-Einstein-Straße 9, D-07745 Jena, Germany.
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Kuitunen-Paul S, Manthey J, Trautmann S, Pieper L, Wittchen HU, Rehm J. Alkoholabhängigkeit in der primärärztlichen Versorgung: Welche Patienten werden erkannt? Suchttherapie 2016. [DOI: 10.1055/s-0042-113143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Zusammenfassung
Ziel: Der Zugang zum Suchthilfesystem wird erschwert, wenn der Hausarzt die Alkoholabhängigkeit des Patienten nicht erkennt. Wir überprüften, wie gut hausärztliche und standardisierte klinische Diagnostik übereinstimmen.
Methodik: Die deutsche Stichprobe der europaweiten APC-Studie umfasst N=1 356 Patienten, für die Diagnosestellungen durch N=76 Hausärzte bzw. das Composite International Diagnostic Interview (CIDI) vorliegen. Beide Diagnosen wurden mittels gewichteter Regressionsanalyse verglichen.
Ergebnisse: Hausärzte und CIDI-Interview identifizierten gleichviele Fälle bei geringer Überschneidung. Hausärzte erkannten insbesondere ältere und männliche Abhängige. Patienten mit psychischen Komorbiditäten, auffälligem Konsummuster, Leberproblemen oder Alltagsbeeinträchtigungen wurden nicht überzufällig unterschiedlich diagnostiziert.
Schlussfolgerung: Standardisierte diagnostische Maßnahmen könnten dabei helfen, jüngere und weibliche alkoholabhängige Hausarztpatienten besser zu identifizieren.
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Affiliation(s)
- Sören Kuitunen-Paul
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
| | - Jakob Manthey
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
- Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden
| | - Sebastian Trautmann
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
| | - Lars Pieper
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
- Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden
- Professur für Behaviorale Epidemiologie, Technische Universität Dresden
| | - Hans-Ulrich Wittchen
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
- Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden
| | - Jürgen Rehm
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden
- Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden
- Centre for Addiction and Mental Health (CAMH), Toronto, Kanada
- Dalla Lana School of Public Health, University of Toronto, Kanada
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Kanada
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Trautmann S, Rehm J, Wittchen HU. The economic costs of mental disorders: Do our societies react appropriately to the burden of mental disorders? EMBO Rep 2016; 17:1245-9. [PMID: 27491723 DOI: 10.15252/embr.201642951] [Citation(s) in RCA: 334] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Trautmann S, Schönfeld S, Behrendt S, Heinrich A, Höfler M, Siegel S, Zimmermann P, Wittchen HU. Stress exposure and the risk for the onset of alcohol use disorders and nicotine dependence in deployed military personnel: the role of prior internalizing disorders. Addict Behav 2015; 43:89-96. [PMID: 25588794 DOI: 10.1016/j.addbeh.2014.12.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 12/04/2014] [Accepted: 12/18/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This prospective study aimed to investigate whether prior internalizing disorders (PIDs) moderate the relationship between stress exposure (SE) and the onset of alcohol use disorders (AUDs) and nicotine dependence (ND) in deployed military personnel. METHODS 358 male soldiers were examined directly before and 12months after return from deployment using standardized interviews. Combat experiences, concerns about family disruptions, and difficult living and working environment were assessed as different aspects of SE. PID diagnoses (mood disorders (PMDs), anxiety disorders (PADs)) and substance use disorders were defined according to the DSM-IV-TR. RESULTS PMDs were related to a stronger association between concerns about family disruptions and the risk of AUD onset (OR=7.7, 95% CI 1.8-32.8, p=0.006). The number of PID diagnoses (OR per diagnosis: 1.7, 95% CI 1.0-2.8, p=0.036) and PADs (OR: 2.6, 95% CI 1.1-6.3, p=0.038) were further related to a stronger association between difficult living and working environment and the risk of AUD onset. With regard to ND, PMDs were related to a weaker association between difficult living and working environment and the risk of ND onset (OR=0.4, 95% CI 0.2-0.8, p=0.013). CONCLUSIONS PIDs might be related to an increased risk for the onset of AUDs but not ND following SE. This effect is probably restricted to specific constellations of PADs, PMDs, comorbid PIDs and specific aspects of SE. These critical constellations of PIDs and SE might be a promising target for future research and could contribute to the development of preventive measures to reduce the risk of AUDs following SE.
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Heinrich A, Knappe S, Trautmann S, Schönfeld S, Hauffa R, Wittchen HU. Schlafprobleme bei Soldaten und die Rolle traumatischer Ereignisse bei Auslandseinsätzen. Zeitschrift für Klinische Psychologie und Psychotherapie 2015. [DOI: 10.1026/1616-3443/a000297] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Fragestellung: Schlafprobleme, ihre Auswirkungen und Implikationen sind besonders im Kontext militärischer Missionen ein bedeutsames, jedoch wenig untersuchtes Thema. Methoden: Eine repräsentative Stichprobe von 1478 deutschen Bundeswehrsoldaten wurde 12 Monate nach Ende ihres Auslandseinsatzes mittels des Pittsburgh Sleep Quality Index (PSQI) sowie zu psychischen Störungen (DSM-IV-TR) und traumatischen Ereignissen persönlich untersucht und mit N = 880 Soldaten ohne Auslandseinsatz verglichen. Ergebnisse: 41 % der Soldaten mit und 38 % der Soldaten ohne Auslandseinsatz erfüllten die PSQI-Kriterien für Schlafprobleme. Traumatische Einsatzereignisse waren mit mehr Schlafproblemen assoziiert (β: 0.7, 95 % KI: 0.4 – 1.0, p < .001). In Abhängigkeit der Anzahl traumatischer Einsatzereignisse wurde ein höherer PSQI-Gesamtwert bei inzidenten psychischen Störungen (β: 1.2, 95 % KI: 0.3 – 2.1, p = .011), aber auch bei Soldaten ohne psychische Störungen (β: 0.7, 95 % KI: 0.3 – 1.1, p = .001) berichtet. Schlussfolgerung: Auslandseinsätze scheinen in Abhängigkeit traumatischer Ereignisse das Ausmaß von Schlafproblemen bei Soldaten sowohl innerhalb als auch außerhalb des Kontextes psychischer Störungen zu erhöhen.
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Affiliation(s)
- Anke Heinrich
- Institut für Klinische Psychologie und Psychotherapie & Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden
| | - Susanne Knappe
- Institut für Klinische Psychologie und Psychotherapie & Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden
| | - Sebastian Trautmann
- Institut für Klinische Psychologie und Psychotherapie & Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden
| | - Sabine Schönfeld
- Institut für Klinische Psychologie und Psychotherapie & Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden
| | - Robin Hauffa
- Zentrum für Psychiatrie und Psychotraumatologie am Bundeswehrkrankenhaus, Berlin
| | - Hans-Ulrich Wittchen
- Institut für Klinische Psychologie und Psychotherapie & Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden
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Trautmann S, Schönfeld S, Heinrich A, Schäfer J, Zimmermann P, Wittchen H. Risk Factors for Common Mental Disorders in the Context of Military Deployment: a Longitudinal Study. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30244-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Trautmann S, Schönfeld S, Behrendt S, Heinrich A, Höfler M, Siegel S, Zimmermann P, Wittchen HU. Predictors of changes in daily alcohol consumption in the aftermath of military deployment. Drug Alcohol Depend 2015; 147:175-82. [PMID: 25499731 DOI: 10.1016/j.drugalcdep.2014.11.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 08/01/2014] [Revised: 10/22/2014] [Accepted: 11/21/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Several studies have documented factors related to increase in alcohol consumption in the context of stressful experiences. However, little is known about predictors of different courses of alcohol use in this context. This study aims to investigate diverse predictors and correlates of increase and decrease of average daily alcohol consumption (aDAC) in the aftermath of military deployment taking into account a variety of potentially relevant factors. METHODS N=358 soldiers were examined before (T1) and 12 months after return from deployment (T2) using standardized interviews. Change in aDAC was categorized into decreased (n=72), stable (n=215) and increased (n=71) aDAC. RESULTS Overall, aDAC did not change significantly between T1 and T2 (median change=0.0 g, inter quartile range=11.3g). Compared to stable aDAC, increase was characterized by a lower proportion of high-educated individuals (OR: 0.3 (0.1-0.7), p=0.008), lower rank (marginally significant: OR: 2.0 (1.0-4.1), p=0.050), and less acceptance (trend: MR: 0.97 (0.93-1.00), p=0.053). Correlates of increased aDAC were less social support (MR: 0.84 (0.71-0.99), p=0.043), more sleeping problems (MR: 1.15 (1.00-1.31), p=0.045) and more negative post-event cognitions following deployment (MR: 2.32 (1.28-4.21), p=0.006). Decrease in aDAC was predicted by lower PTSD symptom severity before deployment (MR: 0.34 (0.16-0.72), p=0.005) and less childhood emotional neglect (marginally significant: MR: 0.78 (0.60-1.00), p=0.050). CONCLUSIONS Increase and decrease in alcohol use after stressful experiences might have differential risk factors and correlates. Findings might stimulate future research that could result in improved measures to prevent increases as well as in interventions that could foster decreases in alcohol consumption in the context of stressful experiences.
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Affiliation(s)
- S Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany.
| | - S Schönfeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany
| | - S Behrendt
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany
| | - A Heinrich
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany
| | - S Siegel
- Centre for Psychiatry and Posttraumatic Stress, Federal Armed Forces Hospital Berlin, Berlin, Germany
| | - P Zimmermann
- Centre for Psychiatry and Posttraumatic Stress, Federal Armed Forces Hospital Berlin, Berlin, Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany; Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, 01187 Dresden, Germany
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Trautmann S, Schönfeld S, Behrendt S, Schäfer J, Höfler M, Zimmermann P, Wittchen HU. Associations between lifetime PTSD symptoms and current substance use disorders using a five-factor model of PTSD. J Anxiety Disord 2015; 29:93-100. [PMID: 25527901 DOI: 10.1016/j.janxdis.2014.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/16/2014] [Accepted: 11/17/2014] [Indexed: 11/30/2022]
Abstract
This paper aimed to extend the existing knowledge on the association between PTSD symptoms, alcohol use disorders (AUD) and nicotine dependence (ND) by distinguishing between anxious and dysphoric arousal PTSD symptoms and by considering the putative contribution of additional comorbidity. Data stem from a cross-sectional study in a stratified, representative sample of 1483 recently deployed soldiers using standardized diagnostic interviews. All lifetime PTSD symptom clusters (occurrence of any symptom and number of symptoms) were associated with current AUD and ND in crude models except that anxious arousal was not related to AUD. Associations were reduced in magnitude when controlling for comorbidity. Current ND was related to the occurrence of any emotional numbing and to the number of re-experiencing symptoms above the contribution of other symptom clusters and comorbidity. In conclusion, associations between PTSD symptoms, AUD and ND may be partially attributable to additional comorbidity. Findings also yield further evidence for a role of emotional numbing and re-experiencing symptoms in the comorbidity between PTSD and ND and for a distinction between dysphoric and anxious arousal PTSD symptoms.
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Affiliation(s)
- S Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - S Schönfeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - S Behrendt
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - J Schäfer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - P Zimmermann
- Centre for Psychiatry and Posttraumatic Stress, Federal Armed Forces Hospital Berlin, Berlin, Germany
| | - H-U Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Zimmermann P, Höfler M, Schönfeld S, Trautmann S, Hauffa R, Kowalski J, Wittchen HU. Einsatzerlebnisse und einsatzbedingte psychische Erkrankungen deutscher Soldaten–empirische Struktur und prädiktive Wertigkeit traumatischer Stressoren. Zeitschrift für Klinische Psychologie und Psychotherapie 2014. [DOI: 10.1026/1616-3443/a000264] [Citation(s) in RCA: 7] [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: 11/04/2022]
Abstract
Theoretischer Hintergrund: Noch immer ist wenig über die empirische Struktur von traumatischem Stress und die Assoziationen zwischen Stressoren und psychischen Erkrankungen bekannt, insbesondere nach militärischen Auslandseinsätzen. Methode: 1483 Bundeswehrsoldaten, die 2009/2010 in Afghanistan eingesetzt waren, wurden mittels der militärischen Version eines diagnostischen Interviews (MI-CIDI) untersucht. Zwei Klassifikationsmodelle wurden auf die Items der Liste einsatzbezogener Stressoren des US-MHAT-VI-Reports angewendet und konfirmatorische Faktorenanalysen durchgeführt. Ergebnisse: Aufgrund hoher polychorischer Korrelationen zwischen Items verschiedener Klassen und hoch negativer Korrelationen innerhalb derselben Klasse ergaben die Faktorenanalysen keine zufriedenstellende Modellpassung. Es wurden auch keine unterschiedlichen prädiktiven Wertigkeiten im Hinblick auf einsatzbedingte psychische Erkrankungen gefunden. Schlussfolgerungen: Die Ergebnisse stimmen nicht mit denen vergangener Studien überein und sprechen für den Einfluss von spezifischen Einsatzbedingungen auf die Struktur traumatischer Stressoren.
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Affiliation(s)
| | - Michael Höfler
- Institut für klinische Psychologie und Psychotherapie und Center of Epidemiology and Longitudinal Studies (CELOS)
| | - Sabine Schönfeld
- Institut für klinische Psychologie und Psychotherapie und Center of Epidemiology and Longitudinal Studies (CELOS)
| | - Sebastian Trautmann
- Institut für klinische Psychologie und Psychotherapie und Center of Epidemiology and Longitudinal Studies (CELOS)
| | | | | | - Hans-Ulrich Wittchen
- Institut für klinische Psychologie und Psychotherapie und Center of Epidemiology and Longitudinal Studies (CELOS)
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Trautmann S, Schönfeld S, Behrendt S, Höfler M, Zimmermann P, Wittchen HU. Substance use and substance use disorders in recently deployed and never deployed soldiers. Drug Alcohol Depend 2014; 134:128-135. [PMID: 24210162 DOI: 10.1016/j.drugalcdep.2013.09.024] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 09/19/2013] [Accepted: 09/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Military studies investigating the prevalence of substance use (SU) and substance use disorders (SUD) and the relation between SU and mental disorders often lack a comprehensive assessment of SU, SUD and mental disorders and comparable groups of deployed and non-deployed personnel. There is also limited data regarding SU and SUD in the German military to date. METHODS Cross-sectional examination of n=1483 soldiers recently deployed in Afghanistan and 889 never deployed soldiers using a fully-standardized diagnostic interview (MI-CIDI) including a comprehensive substance section. RESULTS Across both groups, 12-months prevalence of DSM-IV alcohol use disorders was 3.1%, 36.9% reported binge drinking, 13.9% heavy drinking, 1.3% illegal drug use. 55.1% were regular smokers, 10.9% nicotine dependent. Although recently deployed soldiers revealed slightly higher rates in some measures, there were no significant differences to the never deployed regarding SU und SUD except that recently deployed soldiers smoked more cigarettes per day. The association of SU with mental mental disorders was substantially different though, revealing significant associations between SU and mental disorders only among recently deployed soldiers. CONCLUSIONS We do not find remarkable differences in the prevalence of SU and SUD between recently deployed and never deployed soldiers. Especially binge drinking and regular smoking were prevalent across both samples indicating needs for improved interventions. The finding that SU and mental disorders are only associated in recently deployed soldiers might have implications for improved screening and prevention and suggests that deployment might promote different pathways and mechanisms involved in the evolution of SU and mental disorders.
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Affiliation(s)
- S Trautmann
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany.
| | - S Schönfeld
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - S Behrendt
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - P Zimmermann
- "Center of Military Mental Health" (Zentrum für Psychiatrie und Psychotraumatologie am Bundeswehrkrankenhaus), 10115 Berlin, Germany
| | - H U Wittchen
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
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Wittchen HU, Schönfeld S, Kirschbaum C, Thurau C, Trautmann S, Steudte S, Klotsche J, Höfler M, Hauffa R, Zimmermann P. Traumatic experiences and posttraumatic stress disorder in soldiers following deployment abroad: how big is the hidden problem? Dtsch Arztebl Int 2012; 109:559-68. [PMID: 23130089 DOI: 10.3238/arztebl.2012.0559] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 06/01/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little is known about the frequency of traumatic event exposure and the development of post-traumatic stress disorder (PTSD) among German soldiers serving in Afghanistan. METHODS We studied a random sample consisting of 1599 soldiers who had served in the 2009/2010 ISAF mission in Afghanistan, stratified by deployment location and unit. Twelve months after their return to Germany, the soldiers were assessed with a Composite International Diagnostic Interview (CIDI) to establish the diagnoses of mental disorders and PTSD according to the DSM-IV. 889 similar soldiers who had not been deployed abroad were assessed in the same way. RESULTS 49.2% (95% confidence interval [CI]: 46.4 to 52.1) of the deployed soldiers experienced at least one traumatic event during their deployment, and 13% experienced more than three. The 12-month prevalence of PTSD among returning soldiers was 2.9% (95% CI: 2.1 to 4.1), while the service-related incidence after deployment was 0.9% (95% CI: 0.5 to 1.6). These figures imply a two- to fourfold elevation of the risk of PTSD. The risk of PTSD was highest among soldiers who had served in Kunduz (Afghanistan) and in combat units. Only half of all soldiers with PTSD sought professional help. CONCLUSION Deployment abroad is associated with a high frequency of traumatic experiences and a two- to fourfold elevation of the risk of PTSD. Each year, about 300 cases of PTSD develop for every 10 000 soldiers who return to Germany; thus, the cumulative number of returnees with PTSD from the beginning of German deployment abroad may currently run into the thousands. 45% of all PTSD cases, or about one in two, are neither diagnosed nor treated. Deployment abroad also substantially increases the risk of developing a number of other mental disorders.
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Affiliation(s)
- Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.
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Wittchen HU, Schönfeld S, Thurau C, Trautmann S, Galle M, Mark K, Hauffa R, Zimmermann P, Schaefer J, Steudte S, Siegert J, Höfler M, Kirschbaum C. Prevalence, incidence and determinants of PTSD and other mental disorders: design and methods of the PID-PTSD+3 study. Int J Methods Psychiatr Res 2012; 21:98-116. [PMID: 22605681 PMCID: PMC6878265 DOI: 10.1002/mpr.1356] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [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: 06/13/2011] [Revised: 10/23/2011] [Accepted: 03/15/2012] [Indexed: 11/08/2022] Open
Abstract
Investigation of the prevalence, incidence, and determinants of post-traumatic stress disorders (PTSD) and other mental disorders associated with military deployment in international missions poses several methodological and procedural challenges. This paper describes the design and sampling strategies, instruments, and experimental procedures applied in a study programme aimed to examine military deployment-related mental health and disorders (prevalence and trajectories) and to identify vulnerability and risk factors (e.g. age, gender, type of mission, rank, and duration of deployment and a wide range of neurobiological, psychological, social, and behavioural factors). The study comprised two components. The first component, a cross-sectional study, included 1483 deployed and 889 non-deployed German soldiers (response rate, 93%) who served during the 2009 International Security Assistance Force (ISAF) mission. A standardized diagnostic instrument (Composite International Diagnostic Interview, CIDI) coupled with established questionnaires was administered to detect and diagnose PTSD and a broad spectrum of mental disorders and mental health problems. The second component, a prospective-longitudinal study, included 621 soldiers examined before (2011) and after return (2012) from the ISAF mission. In addition to the CIDI and questionnaires, several experimental behavioural tests and biological markers were implemented to probe for incident mental disorders, mental health problems and risk factors. Our methods are expected to provide greater precision than previous studies for estimating the risk for incident deployment-related and non-deployment-related disorders and their risk factors. We expect the findings to advance our understanding of a wide spectrum of adverse mental health outcomes beyond PTSD.
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Affiliation(s)
- Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany.
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Abstract
We examined whether differences in abstinence orientation are related to differences in treatment patterns by analyzing assessment data from a total of 161 German treatment settings offering opioid maintenance therapy. According to an index value, settings were divided into low (LAOs), medium (MAOs), and high abstinence-oriented settings (HAOs). Logistic, multinomial logistic, and linear regression analyses were carried out. HAOs prescribed lower maximum dosages of methadone and enforced rules for handling of concomitant drug use more rigidly than MAOs and LAOs. Patients in HAOs were more likely to undergo psychotherapeutic and psychiatric treatment than in MAOs and LAOs. Limitations, conclusions, and future research are suggested.
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Affiliation(s)
- Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden, Germany.
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Beckmann H, Rumpf S, Bechtel N, Lange H, Saft C, Hoffmann R, Kraus P, Barth K, Trautmann S, Landwehrmeyer B, Reilmann R. Gait and posture in pre-manifest and symptomatic huntington's disease. KLIN NEUROPHYSIOL 2011. [DOI: 10.1055/s-0031-1272717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Beckmann H, Rumpf S, Bechtel N, Lange HW, Saft C, Hoffmann R, Kraus P, Barth K, Trautmann S, Landwehrmeyer B, Reilmann R. Objective motor phenotype assessment of gait and posture in pre-manifest and symptomatic Huntington's disease. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hochauf K, Bandt D, Pöhlmann C, Monecke S, Toma M, Trautmann S. Fatal varicella zoster virus infection as first manifestation of idiopathic CD4+ T-cell lymphocytopenia. Eur J Clin Microbiol Infect Dis 2006; 24:706-8. [PMID: 16261302 DOI: 10.1007/s10096-005-0033-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- K Hochauf
- Institute of Medical Microbiology and Hygiene, Faculty of Medicine Carl Gustav Carus, Technical University of Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
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