Das überwiegend männliche Einsatz- und Rettungspersonal (Polizei, Feuerwehr, Sanitäter, Justizvollzugsbedienstete) zeigt nach berufsbedingten Traumata häufig Schwierigkeiten bei der Akzeptanz von psychotherapeutischen Hilfsangeboten. Im vorliegenden Beitrag wird diese Problematik anhand von Fallbeispielen sowie konzeptuellen Überlegungen des Zusammenhangs zwischen Männlichkeit und Therapiemotivation diskutiert. Klinische Erfahrungen zu männerspezifischen Komplikationen der Posttraumatischen Belastungsstörung (PTBS) und das Modell eines Risikoprofils männlicher Traumaopfer in Einsatzberufen («Alpha-Männer») werden dargestellt, sowie theoretische Einordnungen in sozialkognitive Theorien der Männlichkeit und Entstehungsmodelle von Traumafolgen vorgenommen. Der Beitrag schließt mit der Skizzierung eines Interventionsvorschlags für berufsbedingte Traumata in den männertypischen Berufsbereichen. / Persons in the predominately male domains of high-risk occupational groups (police, fire department, rescue teams, prison guards) often show difficulties in accepting psychological help after traumatization. The paper presents case reports and conceptual discussion of the relationship between masculinity and treatment motivation. Clinical experiences on male-specific complications of posttraumatic stress disorder (PTSD) and a high risk profile of male work-related trauma victims (‘alphaman’) are discussed. Theoretical discussion furthermore includes social cognitive theories of masculinity and of development of PTSD. The paper concludes with suggestions for interventions relevant to the outlined problems. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Background: A recent epidemiological analysis on premenstrual dysphoric disorder (PMDD) in the community revealed increased rates of DSM-IV posttraumatic stress disorder (PTSD) among women suffering from PMDD. Aims: To explore whether this association is artifactual or might have important pathogenic implications. Methods: Data come from a prospective, longitudinal community survey of an original sample of N¼1488 women aged 14–24, who were followed-up over a period of 40 to 52 months. Diagnostic assessments are based on the Composite International Diagnostic Interview (CIDI) using the 12-month PMDD diagnostic module. Data were analyzed using logistic regressions (odds ratios) and a case-by-case review. Results: The age adjusted odds ratio between PTSD and threshold PMDD was 11.7 (3.0–46.2) at baseline. 10 women with full PTSD and at least subthreshold PMDD were identified at follow-up. Most reported an experience of abuse in childhood before the onset of PMDD. Some had experienced a life-threatening experience caused by physical attacks, or had witnessed traumatic events experienced by others. 3 women reported more than one traumatic event. Conclusions: A case-by-case review and logistic regression analyses suggest that women with traumatic events and PTSD have an increased risk for secondary PMDD. These observations call for more in-depth analyses in future research.

The effectiveness of memory specificity training (MeST) was compared with standard cognitive processing therapy (CPT) in treatment of individuals with posttraumatic stress disorder. Eighteen adults aged 18-36 were randomly assigned to the MeST intervention (n = 9) or to the active control group (n = 9) of CPT. Both treatments were administered in group format across 6 weeks. MeST consisted of 6 weekly sessions, while CPT consisted of 12 biweekly sessions. The trial was undertaken in the Psychology Clinic of the University of North Texas, with randomization to conditions accomplished via computer random number generator. The primary outcome measure was change in PTSD symptoms post-treatment from baseline. Sixteen individuals (13 women and 3 men; MeST n = 8 and CPT n = 8) completed treatment and their data was analyzed. MeST significantly decreased PTSD symptomology at post-treatment and these results were maintained at 3 months post-treatment. MeST was found to be as effective as the established CPT intervention at reducing PTSD symptomology. Both MeST and CPT significantly increased participants' ability to specify memories upon retrieval at post-treatment, with results maintained at follow-up. There were no significant effects of MeST or CPT in ability to increase overall controlled cognitive processing at post-treatment or follow-up. No individual in either group reported any adverse effects during treatment or at 3 months follow-up. MeST appears to hold promise as an efficacious treatment option for PTSD. MeST was as effective as CPT in reducing symptoms of PTSD, but required only half the number of treatment sessions to accomplish these gains. Replication of these findings in larger samples is encouraged.

Posttraumatic stress disorder (PTSD) is a diagnosis given after the development of maladaptive behavior following exposure to traumatic events. This is the first quantitative study regarding the Swedish emergency dispatching population (n = 97) and posttraumatic (secondary traumatic) stress. The main research question for this study was: “How prevalent are clinically significant posttraumatic stress symptoms among Swedish emergency dispatchers?”; the secondary research question formed became: “What relationship, if any, can be found between the prevalence of clinically significant posttraumatic stress symptoms and other psychological ailments such as depression and burnout?”. The study used a digital questionnaire containing the screening tests ProQoL, MADRS-S and PCL-C to examine the prevalence of symptomology among dispatchers. The participants answers are then analyzed using correlation matrices, one sample t-tests, reliability analyses and descriptives to identify correlations, prevalence rates and other statistically significant items. 57 of the 97 respondents (58.8%) reported symptoms that were above the cutoff to suspect moderate PTSD, 50 of the 97 respondents (51.5%) reported symptoms that were above the cutoff to suspect mild depression and 76 of the 97 respondents (76.3%) reported symptoms that were above the cutoff to suspect burnout. The study concludes that there is an elevated prevalence of PTSD symptoms among Swedish emergency dispatchers (Student’s t = 3.85, Cohen’s d = 0.391, p <.001) and that these symptoms are significantly and positively correlated to symptoms of burnout (r = 0.740, p < .001) and depression (r = 0.820, p < .001). / Posttraumatiskt stresstillstånd (PTSD) är en diagnos som ges efter utvecklingen av maladaptive beteende till följd av exponering till traumatiska händelser. Detta är den första kvantitativa studie som riktar sig mot den svenska nödsamtalsoperatörs populationen (n = 97) angående posttraumatisk (sekundär traumatisk) stress. Den primära frågeställningen i denna studie blev: “Hur prevalent är klinisk signifikant posttraumatiskt stressymptom hos svenska nödsamtalsoperatörer?”; den sekundära frågeställningen blev: ”Vilken relation, om någon, kan finnas mellan prevalensen av klinisk signifikanta posttraumatiska stressymptom och andra tillstånd av psykologisk ohälsa såsom depression och utmattning?”. Studien använde ett digitalt frågeformulär som innehöll screeningtesterna ProQoL, MADRS-S och PCL-C för att undersöka prevalensen av symptombilden hos nödsamtalsoperatörer.  Deltagarnas svar analyserades med hjälp av korrelationsmatriser, one sample t-tester, reliabilitets analyser samt descriptives för att identifiera korrelationer, prevalensen samt andra signifikanta statistik. 57 utav 97 respondenter (58,8%) rapporterade symptom som låg över gränsen för att misstänka måttlig PTSD, 50 utav 97 respondenter (51,5%) rapporterade symptom som låg över gränsen för att misstänka mild depression och 76 utav 97 respondenter (76,3%) rapporterade symptom som låg över gränsen för att misstänka utmattning. Studien drar slutsatsen att det finns en högre prevalens av PTSD symptom hos svenska nödsamtalsoperatörer (Student’s t = 3,85, Cohen’s d = 0,391, p <,001) samt att dessa symptom är signifikant och positivt korrelerade med symptomen för både utmattning (r = 0,740, p < ,001) och depression (r = 0,820, p < ,001).

The purpose of the present study was to explore a theoretically based social-cognitive model of posttraumatic stress disorder (PTSD) by investigating attachment-related and social-cognitive predictors of PTSD in a sample of 125 post-9/11 U.S. combat veterans. Subjects completed an online survey assessing PTSD symptomology, attachment-related internal working models, perceived social support, and mentalizing capacity. Path analysis provided empirical support for a respecified version of the model. More negative internal working model of self and poorer mentalizing capacity predicted higher PTSD symptom levels. Contrary to previous findings, greater perceived social support predicted higher, not lower, PTSD symptom levels. Mentalizing capacity mediated the relationship between internal working model of self and PTSD symptoms in a complementary manner, whereas perceived social support as a mediator was dampening. The relationship between internal working model of others and PTSD symptom levels was fully mediated by perceived social support, which buffered the effect of negative working model of others on PTSD symptom levels. These findings underscore the importance of social-cognitive processing, rooted in early attachment experiences, in the development and symptomology of PTSD in trauma-exposed veterans. In preparing clients for trauma work, clinicians may consider employing modalities that promote earned secure attachment and highlight mentalization in the therapeutic change process.

Jeder Vierte erleidet im Laufe seines Lebens einen Verkehrsunfall. Obwohl psychische Folgen verbreitet und vielfältig sind, bleiben sie oft unbeachtet oder ihnen wird erst Aufmerksamkeit zuteil, wenn wenn das Leiden oder die Beeinträchtigung durch sie zu stark werden oder die Symptomatik sich längst chronifiziert hat. Am Lehrstuhl für Klinische Psychologie und Psychotherapie der TU Dresden wurde in Zusammenarbeit mit der Christoph-Dornier-Stiftung für Klinische Psychologie in Dresden ein Forschungsprojekt zu psychischer Traumatisierung nach Verkehrsunfällen durchgeführt. Schwerpunkt dieser Studie war es, herauszufinden, inwieweit psychische Beeinträchtigungen wenige Tage nach einem Verkehrsunfall sowie 3 und 6 Monate danach auftreten und welche auslösenden bzw. aufrechterhaltenden Faktoren für die psychischen Beeinträchtigungen zu finden sind. Zu diesem Zweck wurden in einer Unfallklinik Patienten mit einer Fragebogenbatterie untersucht, die dort nach einem Verkehrsunfall eingeliefert worden waren. Die Auftretenshäufigkeit von posttraumatischer Belastungssymptomatik steigt über den Untersuchungszeitraum hinweg leicht an, dies gilt sowohl für klinische als auch subklinische Symptomatik. Interessant sind hier v.a. die verschiedenen Verlaufstypen. Die Gedanken-kontrollstrategien "Ablenkung" und "Sorgen" scheinen beim Umgang mit auftretenden Intrusionen eine relevante Rolle im Zusammenhang mit der posttraumatischen Belastungssymptomatik spielen. Weiterhin zeigte sich, daß Variablen wie die subjektiv wahrgenommene Kontrollierbarkeit der Unfallsituation oder die Beschäftigung mit der Frage "Warum gerade ich?" Einfluß auf die Entwicklung posttraumatischer Symptomatik ausüben. Die Ergebnisse der Studie haben mehrere Implikationen: Erstens konnte repliziert werden, daß posttraumatische Belastungssymptomatik nach Verkehrsunfällen ein relevantes Problem ist, das nicht einfach ignoriert werden darf. Zweitens konnten Erkenntnisse über den längsschnittlichen Verlauf der Symptomatik bereitgestellt werden, die eine Früherkennung von potentiellen Betroffenen näher rücken läßt. Drittens und letztens konnte die wichtige Rolle der kognitiven Variablen bei der Entstehung einer Posttraumatischen Belastungsstörung nach Verkehrsunfällen untermauert werden.

Moral injury (MI) is associated with severe blame-related emotion and the development of psychopathology including posttraumatic stress disorder (PTSD). Little is known about how MI events are neurally processed when PTSD is comorbid, limiting the development of tailored interventions. Thus, this thesis sought to provide a novel, multi-method examination of the biological underpinnings of moral injury and relevant behavioural correlates. Study one provides the first investigation into the neural activation patterns elicited during MI event recall in military members and public safety personnel with PTSD, relative to MI-exposed civilian controls. In PTSD, emotional processing is challenged by heightened sensory information. Here, we provide evidence of heightened viscerosensory information processing (i.e. internal gnawing or gastrointestinal constriction related to blame-based emotion) during MI event recall, which appears to exert a strong influence over cortical regions facilitating moral cognitive processes including emotion regulation, autobiographical memory integration, and social cognition. Overwhelming visceral sensations can elicit defensive behaviour including tonic immobility (TI), a defensive response that facilitates viscerosensory dampening. Interestingly, more severe negative alterations in cognition and mood were associated with viscerosensory dampening in our PTSD group, pointing towards a compensatory pattern of emotional numbing. Studies two and three explore two posttraumatic symptoms consistent with emotional numbing: alexithymia and posttraumatic TI. In study two, we explore posttraumatic TI as a survival-based dissociative response and test a new measure of posttraumatic TI. In study three, we provide evidence that alexithymia is associated with an altered (muted) pattern of emotion-specific bodily sensation. This thesis provides a framework for embodied MI event processing in PTSD and highlights the importance of assessing the somatic experience of MI and screening for TI responses and emotional numbing as part of PTSD symptomatology. The evidence presented here suggests sensorimotor-based approaches and bottom-up regulatory strategies may be useful adjuncts to MI event processing. / Dissertation / Doctor of Philosophy (PhD) / Moral injury (MI) is a psychosocial-spiritual injury that can occur when deeply held values are violated either by oneself or a trusted other; it produces considerable pain and social alienation. MI has been linked to suicide and the development of posttraumatic stress disorder (PTSD), a mental health condition associated with distressing symptoms and reduced functioning in important areas of life, including social relationships. This thesis focuses on how MI events are processed by military members and public safety personnel, who are both at risk for MI and PTSD. We investigate how shame is experienced in the brain and body, and explore how intensified visceral sensations may become overwhelming (e.g., pit in stomach, vomiting) prompting emotional numbing or difficulties remaining embodied in the present moment (e.g., zoning out, freezing up). By understanding MI event processing when PTSD is present, we hope to gain insight into more effective treatments for these individuals.

No description available.

Objective: We aimed to assess psychological distress in patients with intracranial neoplasia, a group of patients who suffer from severe functional, neurocognitive and neuropsychological side effects, resulting in high emotional distress. Methods: We conducted a cross-sectional study, including inpatients with brain tumours. Eligible patients completed validated self-report questionnaires measuring depression, anxiety, distress, symptoms of posttraumatic stress disorder (PTSD), fear of progression and health-related quality of life. The questionnaire set was completed after brain surgery and receiving diagnosis and before discharge from hospital. Results: A total of n = 31 patients participated in this survey. Fourteen of them suffered from malignant (n = 3 metastatic neoplasia) and 17 from benign brain tumours. Mean values of the total sample regarding depression (M = 9.28, SD = 6.08) and anxiety (M = 6.00, SD = 4.98) remained below the cut-off ≥ 10. Mean psychosocial distress (M = 16.30, SD = 11.23, cut-off ≥ 14) and posttraumatic stress (M = 35.10, SD = 13.29, cut-off ≥ 32) exceeded the clinically relevant cut-off value in all the patients with intracranial tumours. Significantly, more patients with malignant (79%) than benign (29%) brain tumours reported PTSD symptoms (p = 0.006). Conclusion: Distress and clinically relevant PTSD symptoms in patients with intracranial neoplasia should be routinely screened and treated in psycho-oncological interventions immediately after diagnosis. Especially, neuro-oncological patients with malignant brain tumours or metastases need targeted support to reduce their emotional burden.

South Asians are the third fastest growing racial/ethnic minority group in the United States with distinct cultural characteristics. The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted racial and ethnic minorities in the U.S, including South Asians, across several life domains: work, home life/education, social activities, economic, emotional and physical health, infection, quarantine, and positive changes. The COVID-19 pandemic may have critically impacted South Asians with traumatic event experiences and posttraumatic stress disorder (PTSD) symptom severity across several life domains. Limited work suggests high rates of interpersonal traumas and substantial PTSD symptom severity in the South Asian community. Uniquely, the current study examined which life domains impacted by the COVID-19 pandemic associated with a greater count of traumatic event types, interpersonal vs. non-interpersonal traumas, and PTSD symptom severity. Results revealed that negative experiences in social activities, as well as distress in economic, emotional, and physical health domains, were significantly associated with the count of traumatic event types. Negative social activity experiences, and distress in the economic and emotional health domains, were also significantly associated with PTSD symptom severity. Quarantine and physical health domains significantly associated with the count of interpersonal traumas, while COVID-19-related experiences (in social, quarantine, and infection domains) significantly associated with the count of non-interpersonal traumas. Findings inform clinically relevant pandemic research in a vulnerable population and provide trauma and PTSD prevalence estimates in the South Asian community.