MA (Psychology) / Department of Psychology

Objective: Previous studies have established an association between number of traumatic experiences and alexithymia. The present study examines this relationship in a large-scale representative sample of the German general population (N=2,507) and explores the potential mediating effects of posttraumatic symptomatology, particularly avoidance/numbing. Methods: Alexithymia was assessed with the German version of the Toronto Alexithymia Scale (TAS-20). Posttraumatic symptomatology was operationalized by the symptom score of the modified German version of the Posttraumatic Symptom Scale, and traumatic experiences were assessed with the trauma list of the Munich Composite International Diagnostic Interview. Two mediation analyses were conducted. Results: Of the total sample, 24.2% (n=606) reported at least one traumatic experience, 10.6% (n=258) were classified as alexithymic, and 2.4% (n=59) fulfilled the criteria of posttraumatic stress disorder (PTSD). Participants who had survived five or more traumatic experiences had significantly higher alexithymia sum scores. The PTSD symptom cluster avoidance/numbing mediated the association between the number of traumatic experiences and alexithymia. Conclusions: Our findings illustrate an association between number of traumatic experiences and alexithymia and the influence of emotional avoidance and numbing within this relationship. The significant relationship between alexithymia and number of traumatic experiences in a general population sample further supports the concept of multiple and complex traumatization as associated with alexithymia. The results suggest the importance of further investigations determining the causal impact of alexithymia both as a potential premorbid trait and as consequence of traumatization. Lastly, future investigations are needed to clarify alexithymia as a distinct trauma-relevant characteristic for better diagnostics and specialized trauma-integrative therapy.

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Variables predicting the effects of surgery in patients with low back pain Abstract The theoretical part of the thesis summarizes the knowledge about pain and its types, especially chronic pain. Than we focus on low back pain and currently used approaches in the treatment of this syndrome. In this work we summarize the influence of central sensitization and adverse life experineces and posttraumatic stress disorder on pain (especially low back pain). In the practical part, we investigated the effect of central sensitization and adverse life events and posttraumatic stress disroder on the effect of spinal surgery in low back region. The results were obtained using Central Sensitization Inventory (CSI), PTSD Cecklist dor DSM-5 (PCL- 5) a Life Event Checklist (LEC-5 Standard), Short Form 36 Helth Survey Questionnaire (SF- 36), NASS Lumbar Spine Questionnaire. The obtained data were statistically evaluated and processed. Higher scores of CSI and LEC-5 (more adverse life events) were both statistically significantly correlated with worse low back surgery outcomes. At the same time, a statistically significant relationship between PCL-5 (checklist of PTSD symptoms) and CSI was confirmed. Keywords Pain, central sensitization, adverse life experiences, adverse life events, PTSD, posttraumatic stress disorder,...

Evidence from self-reports and laboratory studies suggests that recall of nontrauma autobiographical memories may be disturbed in posttraumatic stress disorder (PTSD), but investigations in everyday life are sparse. This study investigated unintentional nontrauma and trauma memories in trauma survivors with and without PTSD (N = 52), who kept an autobiographical memory diary for a week. We investigated whether unintentional nontrauma memories show an overgeneral memory bias and further memory abnormalities in people with PTSD, and whether unintentional trauma memories show distinct features. Compared to the no-PTSD group, the PTSD group recorded fewer nontrauma memories, which were more overgeneral, more often from before the trauma or related to the trauma, were perceived as distant, and led to greater dwelling. Trauma memories were more vivid, recurrent, and present and led to greater suppression and dwelling. Within the PTSD group, the same features distinguished trauma and nontrauma memories. Results are discussed regarding theories of autobiographical memory and PTSD.

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In the United States, approximately 7.7 million individuals are affected by posttraumatic stress disorder (PTSD) at any given time. Though women are likelier to develop PTSD symptoms, men are exposed to more traumatic events in their lifetimes. Empirically- supported PTSD options exist, however clinical application of these treatments may not consistently culminate in beneficial outcomes. Dance Movement Therapy (DMT) has demonstrated positive treatment outcomes for a variety of mental and physical disorders. Nonetheless, there is a lack of robust research related to the treatment experiences of men who have participated in DMT for trauma-related symptoms. The purpose of this phenomenological study was to explore this research gap. Focusing on adult male trauma survivors, the research question addressed the lived experiences of participating in DMT and the meaning ascribed to this involvement. Eleven adult male participants were interviewed via audio-recorded telephone interviews consisting of semistructured interview questions. Through a constructivist lens, the modified Van Kaam method of analysis was implemented revealing 4 emergent themes. The findings of this explorative study suggested positive PTSD symptom outcomes for all 11 participants including improvements in social belongingness, social acceptance, quality of life, and a reduction in symptoms of anxiety and depression. Accordingly, the findings of this research may help to advance social change through broadening clinical awareness of the beneficial neurogenic treatment advantages of somatic and creative interventions such as DMT for PTSD. Moreover, these findings may augment existing research related to movement- based treatment options for individuals coping with PTSD and trauma-related symptoms.

Die Posttraumatische Belastungsstörung (PTBS) nach sexueller Gewalt in der Kindheit geht häufig mit komorbiden Symptomen einher. Kognitiv-behaviorale Therapien haben sich als effektiv in der Behandlung der PTBS erwiesen. Die Datenlage zur PTBS nach sexueller Gewalt in der Kindheit ist jedoch gering. In der vorliegenden Dissertation wurden Fragestellungen zur Diagnostik und Therapie der PTBS nach sexueller Gewalt verfolgt. In Schrift 1 werden die Ergebnisse einer ambulanten Assessmentstudie präsentiert, in der 28 Patientinnen wiederholt zum intrusiven Wiederleben befragt wurden. Mit durchschnittlich 75 Intrusionen und 24 Flashbacks pro Woche fand sich eine hohe Symptombelastung. Die Schriften 2, 3 und 4 beziehen sich auf eine randomisiert-kontrollierte Studie. Patientinnen (N=74) wurden randomsiert einer 12-wöchigen stationären DBT-PTBS oder einer treatment-as-usual Warteliste zugewiesen. Die Ergebnisse, die in Schrift 2 beschrieben sind, zeigen eine signifikante Reduktion der posttraumatischen Symptomatik mit einer großen Zwischengruppen-Effektstärke (g=1.35). In Schrift 3 wird dargestellt, dass die Effekte auf die posttraumatische Symptomatik in Bezug auf mehrere traumatische Ereignisse geringer sind als die Effekte in Bezug auf das am stärksten belastende Ereignis. Schrift 4 beinhaltet Ergebnisse zu der Inanspruchnahme psychiatrisch-psychotherapeutischer Behandlung und den assoziierten Kosten. Im Jahr vor der DBT-PTBS fanden sich im Mittel jährliche Pro-Kopf-Kosten von  18100 € und 57 stationäre Tage. Im Jahr nach der DBT-PTBS waren die Inanspruchnahme mit durchschnittlich 14 Tagen und die mittleren Kosten von 7233 € deutlich geringer. Zusammengefasst sprechen die Ergebnisse für eine hohe Effektivität der DBT-PTBS. Zudem scheint die DBT-PTBS mit einer Reduktion stationärer Tage und entsprechender Kosten einherzugehen. Die Ergebnisse zur Diagnostik deuten darauf hin, dass ein Teil der Symptomatik mit dem üblichen diagnostischen Vorgehen nicht erfasst wird. / Posttraumatic stress disorder (PTSD) with co-occurring severe psychopathology is a frequent sequel of childhood sexual abuse (CSA). Cognitive-behavioral therapy has been shown to be efficacious in treating PTSD, but there is only limited data regarding patients with PTSD related to CSA. This dissertation focused on both the assessment and the treatment of PTSD related to CSA. Paper 1 presents data from an ambulatory assessment study. Patients (N=28) were provided with electronic diaries for repeated real-time assessment of intrusions and flashbacks. They reported an average of 75 intrusions and 24 flashbacks during the week of assessment. Papers 2, 3, and 4 present data from a randomized controlled trial. Patients (N=74) were randomized to either a 12-week residential DBT-PTSD program or a treatment-as-usual wait list. The results for primary and secondary outcomes are shown in Paper 2. Data revealed a significant reduction of posttraumatic symptoms with a large between-group effect size (g=1.35). Paper 3 provides results on the impact of the definition of the index trauma. When the index trauma included multiple traumas, PTSD severity scores were significantly higher, and improvements from pre- to post-treatment were significantly lower, compared to when the index trauma was defined as the worst trauma. Paper 4 presents data on the utilization of mental health care. The mean total costs were 18000 €  per patient during the year before and  7233 € during the year after DBT-PTSD. The significant cost reduction was due to large reductions in inpatient treatment days (on average 57 days before and 14 days after DBT-PTSD). To sum up, the findings show clear evidence for the efficacy of the DBT-PTSD program. Data further indicate that DBT-PTSD might contribute to reducing the mental health care costs. Also, the results suggest that the currently applied methods of assessing PTSD in patients with severe symptoms might miss aspects of clinically relevant symptomatology.

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