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1.
  • Sijbrandij, M., et al. (författare)
  • Strengthening mental health care systems for Syrian refugees in Europe and the Middle East : integrating scalable psychological interventions in eight countries
  • 2017
  • Ingår i: European Journal of Psychotraumatology. - : Taylor and Francis Ltd.. - 2000-8198 .- 2000-8066. ; 8:sup2
  • Tidskriftsartikel (refereegranskat)abstract
    • The crisis in Syria has resulted in vast numbers of refugees seeking asylum in Syria’s neighbouring countries as well as in Europe. Refugees are at considerable risk of developing common mental disorders, including depression, anxiety, and posttraumatic stress disorder (PTSD). Most refugees do not have access to mental health services for these problems because of multiple barriers in national and refugee specific health systems, including limited availability of mental health professionals. To counter some of challenges arising from limited mental health system capacity the World Health Organization (WHO) has developed a range of scalable psychological interventions aimed at reducing psychological distress and improving functioning in people living in communities affected by adversity. These interventions, including Problem Management Plus (PM+) and its variants, are intended to be delivered through individual or group face-to-face or smartphone formats by lay, non-professional people who have not received specialized mental health training, We provide an evidence-based rationale for the use of the scalable PM+ oriented programmes being adapted for Syrian refugees and provide information on the newly launched STRENGTHS programme for adapting, testing and scaling up of PM+ in various modalities in both neighbouring and European countries hosting Syrian refugees. © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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2.
  • Haim-Nachum, S., et al. (författare)
  • Childhood maltreatment is linked to larger preferred interpersonal distances towards friends and strangers across the globe
  • 2024
  • Ingår i: Translational Psychiatry. - : Springer Nature. - 2158-3188. ; 14:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Childhood maltreatment (CM) is thought to be associated with altered responses to social stimuli and interpersonal signals. However, limited evidence exists that CM is linked to larger comfortable interpersonal distance (CID) – the physical distance humans prefer towards others during social interactions. However, no previous study has investigated this association in a comprehensive sample, yielding sufficient statistical power. Moreover, preliminary findings are limited to the European region. Finally, it is unclear how CM affects CID towards different interaction partners, and whether CID is linked to social functioning and attachment. To address these outstanding issues, adults (N = 2986) from diverse cultures and socio-economic strata completed a reaction time task measuring CID towards an approaching stranger and friend. Higher CM was linked to a larger CID towards both friends and strangers. Moreover, insecure attachment and less social support were associated with larger CID. These findings demonstrate for the first time that CM affects CID across countries and cultures, highlighting the robustness of this association.
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3.
  • Kempf, W., et al. (författare)
  • MUM1 expression in cutaneous CD30+ lymphoproliferative disorders : A valuable tool for the distinction between lymphomatoid papulosis and primary cutaneous anaplastic large-cell lymphoma
  • 2008
  • Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 158:6, s. 1280-1287
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Primary cutaneous CD30+ lymphoproliferative disorders include lymphomatoid papulosis (LyP) and primary cutaneous CD30+ anaplastic large T-cell lymphoma (ALCL). Because of overlapping histological features, it is impossible to distinguish ALCL from LyP on histological grounds. MUM1 (Multiple Myeloma oncogene 1) is expressed in systemic ALCL and classical Hodgkin lymphoma. MUM1 expression has not been studied in detail in CD30+ lymphoproliferative disorders. Objectives: To examine the expression of MUM1 in CD30+ lymphoproliferative disorders and to assess its value as a diagnostic marker. Methods: Thirty-one formalin-fixed paraffin-embedded specimens of LyP (n = 15), primary cutaneous ALCL (n = 10), secondary cutaneous infiltrates of systemic ALCL (n = 4) and secondary cutaneous Hodgkin lymphoma (n = 2) were analysed by immunohistochemistry with a monoclonal antibody against MUM1. Results Results: Positive staining for MUM1 was observed in 13 cases of LyP (87%), two cases of primary cutaneous ALCL (20%), four cases of secondary cutaneous ALCL (100%) and two cases of secondary cutaneous Hodgkin lymphoma (100%). In 11 of 13 LyP cases (85%), MUM1 was displayed by the majority, i.e. 50-90%, of the tumour cells. In contrast to LyP and secondary cutaneous ALCL, only two cases of primary cutaneous ALCL (20%) harboured MUM1-positive tumour cells. There was a statistically significant difference in the expression of MUM1 between LyP and primary cutaneous ALCL (P = 0.002) and between primary cutaneous ALCL and secondary cutaneous ALCL (P = 0.015). Conclusions: MUM1 expression is a valuable tool for the distinction of LyP and ALCL and thus represents a novel adjunctive diagnostic marker in CD30+ lymphoproliferative disorders. © 2008 The Authors.
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4.
  • Mitteldorf, C., et al. (författare)
  • Tumor Microenvironment and Checkpoint Molecules in Primary Cutaneous Diffuse Large B-Cell Lymphoma - New Therapeutic Targets
  • 2017
  • Ingår i: American Journal of Surgical Pathology. - : Lippincott Williams and Wilkins. - 0147-5185 .- 1532-0979. ; 41:7, s. 998-1004
  • Tidskriftsartikel (refereegranskat)abstract
    • Programmed death ligand 1 (PD-L1) is expressed by 20% to 57% of systemic diffuse large B cell lymphomas (DLBCLs). PD-L1 expression in primary cutaneous DLBCL (pcDLBCL) has not been studied so far. Sixteen paraffin-embedded tissue samples of pcDLBCL (13 leg type [LT], 3 others [OT]) were investigated for PD-1, PD-L1, and CD33 expression and the cellular composition of the tumor microenvironment, focusing on myeloid-derived suppressor cells (MDSCs) and tumor-associated macrophages. Membrane-bound PD-L1 expression by the tumor cells was observed in all samples, albeit to a variable extent (19.9%). As expected, most DLBCL-LT (10 cases) were classified as activated B cell like type, with a higher PD-L1 score (21.9%) compared with that of the germinal center B cell like type (7.7%). The surrounding infiltrate consisted predominately of CD163(+) M2 rather than CD68(+) macrophages (CD68:CD163=1:4 to 6). Moreover, a considerable proportion of CD33(+) MDSCs with PD-L1 coexpression was admixed. Tumor cells expressed CD33 to variable degrees (2% to 60%). The number of MDSCs or M2 macrophages did not correlate with pcDLBCL subtypes LT or OT. T cells were only a minor component of the tumor microenvironment. We propose that PD-L1(+) tumor cells and PD-L1(+) MDSCs shield the tumor against PD-1(+) tumor-infiltrating lymphocytes, consequently leading to inhibition and diminution of tumor-infiltrating lymphocytes. Moreover, we found a polarization to M2 macrophages, which may contribute to the poor prognosis of DLBCL patients. Thus, targeting of tumor cells and MDSCs using anti-PD-1/anti-PD-L1 or anti-CD33 antibodies might be a worthwhile new approach to treat this aggressive form of cutaneous B-cell lymphoma. © 2017 Wolters Kluwer Health, Inc. All rights reserved.
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5.
  • Spaaij, J., et al. (författare)
  • Feasibility and acceptability of Problem Management Plus (PM+) among Syrian refugees and asylum seekers in Switzerland : a mixed-method pilot randomized controlled trial
  • 2022
  • Ingår i: European Journal of Psychotraumatology. - : Taylor and Francis Ltd.. - 2000-8198 .- 2000-8066. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Syrian refugees in Switzerland face several barriers in accessing mental health care. Cost-effective psychological interventions are urgently needed to meet the mental health needs of refugees. Problem Management Plus (PM+) is an evidence-based, psychological intervention delivered by trained non-specialist ‘helpers’. Objective: To assess the feasibility and acceptability of PM+ among Syrian refugees in Switzerland. Methods: We conducted a single-blind pilot randomized controlled trial (RCT) with Syrian refugees impaired by psychological distress (K10 > 15 and WHODAS 2.0 > 16). Participants were randomized to PM+ or Enhanced Treatment As Usual (ETAU). Participants were assessed at baseline, and 1 week and 3 months after the intervention, and completed measures indexing mental health problems and health care usage. Semi-structured interviews were conducted with different stakeholders. Results: N = 59 individuals were randomized into PM+ (n = 31) or ETAU (n = 28). N = 18 stakeholders were interviewed about facilitators and barriers for the implementation of PM+. Retention rates in the trial (67.8%) and mean intervention attendance (M = 3.94 sessions, SD = 1.97) were high. No severe events related to the study were reported. These findings indicate that the trial procedures and PM+ were feasible, acceptable and safe. Conclusions: The findings support the conduct of a definitive RCT and show that PM+ might have the potential to be scaled-up in Switzerland. The importance, as well as the challenges, of implementing and scaling-up PM+ in high-income countries, such as Switzerland, are discussed. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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6.
  • Bartoli, E., et al. (författare)
  • Perceived Acceptability of Child Maltreatment as a Moderator of the Association Between Experiences of Child Maltreatment and Post-Traumatic Symptoms : A Cross-Cultural Study
  • 2024
  • Ingår i: Journal of Interpersonal Violence. - : SAGE Publications. - 0886-2605 .- 1552-6518. ; 39:15-16, s. 3764-3790
  • Tidskriftsartikel (refereegranskat)abstract
    • Despite the well-documented link between child maltreatment (CM) and mental health, evidence suggests substantial variability in the post-traumatic sequelae of CM across cultures. The perceived acceptability of CM in one’s community might moderate the association between CM and mental health, but little research has been conducted on it so far. This study examined how the perceived acceptability of CM may influence the relationship between CM experiences and post-traumatic symptoms in individuals from four different continents and if the pattern of associations is the same across countries. We recruited a sample of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122). We administered online questionnaires and performed multiple group moderation analyses for total CM, neglect, physical abuse, emotional maltreatment, sexual abuse, and exposure to domestic violence (DV). A significant positive main effect of CM on post-traumatic symptoms was found in the overall sample and in Cameroon; in Germany, only neglect and emotional maltreatment were positively associated to post-traumatic symptoms. Moderation effects were identified; the perceived acceptability of neglect in Cameroon and Germany and of exposure to DV in Cameroon had a dampening effect on the relationship between CM experiences and post-traumatic symptoms. Our findings confirm that CM experiences entail long-term post-traumatic sequelae that can vary across cultures and CM subtypes and further our understanding of this issue by showing that the perceived acceptability of CM may be an understudied moderator. 
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7.
  • Dammann, G., et al. (författare)
  • Facial Affective Behavior in Borderline Personality Disorder Indicating Two Different Clusters and Their Influence on Inpatient Treatment Outcome : A Preliminary Study
  • 2020
  • Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 11
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The purpose of the present study was threefold: first, to investigate the facial affective behavior in patients with a borderline personality disorder (BPD); second, to examine whether these patients could be divided into clusters according to facial affective behavior; and third, to test whether these clusters would influence the inpatient treatment outcome. Methods: Thirty inpatients with BPD were assessed with the Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID I, SCID II) and had to complete a series of questionnaires before and directly after the 12-week long inpatient treatment. Facial affective behavior was recorded during the structured interview for personality organization (STIPO) and afterward coded with the emotional facial action coding system (EMFACS). Measures on psychopathology [beck depression inventory (BDI), Spielberger state and trait anxiety inventory (STAI), Spielberger state and trait anger inventory (STAXI), and symptom cheklist-90-revised (SCL-90-R)], interpersonal problems [Inventory of Interpersonal Problems (IIP)], and personality organization [inventory of personality organization (IPO)] were administered. Results: Cluster analysis before the treatment yielded two groups that differed in general facial expressivity, and regarding the display of anger, contempt, and disgust. The effect sizes of the repeated measures ANOVAs showed that persons with higher scores on the affective facial expressions benefitted more from the treatment in terms of STAI state anxiety, STAXI state and trait anger, IIP total, and the two scales primitive defenses and identity diffusion of the IPO, whereas persons with lower scores benefitted more on the scale IPO reality testing. Conclusion: Our results indicated some initial trends for the importance of facial affective behavior in patients with BPD and their treatment outcome. © Copyright © 2020 Dammann, Rudaz, Benecke, Riemenschneider, Walter, Pfaltz, KÃŒchenhoff, Clarkin and Gremaud-Heitz.
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8.
  • de Graaff, Anne M., et al. (författare)
  • Scalable psychological interventions for Syrian refugees in Europe and the Middle East : STRENGTHS study protocol for a prospective individual participant data meta-analysis
  • 2022
  • Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction The World Health Organization's (WHO) scalable psychological interventions, such as Problem Management Plus (PM+) and Step-by-Step (SbS) are designed to be cost-effective non-specialist delivered interventions to reduce symptoms of common mental disorders, such as anxiety, depression and post-traumatic stress disorder (PTSD). The STRENGTHS consortium aims to evaluate the effectiveness, cost-effectiveness and implementation of the individual format of PM+ and its group version (gPM+), as well as of the digital SbS intervention among Syrian refugees in seven countries in Europe and the Middle East. This is a study protocol for a prospective individual participant data (IPD) meta-analysis to evaluate (1) overall effectiveness and cost-effectiveness and (2) treatment moderators of PM+, gPM+ and SbS with Syrian refugees. Methods and analysis Five pilot randomised controlled trials (RCTs) and seven fully powered RCTs conducted within STRENGTHS will be combined into one IPD meta-analytic dataset. The RCTs include Syrian refugees of 18 years and above with elevated psychological distress (Kessler Psychological Distress Scale (K10>15)) and impaired daily functioning (WHO Disability Assessment Schedule 2.0 (WHODAS 2.0>16)). Participants are randomised into the intervention or care as usual control group, and complete follow-up assessments at 1-week, 3-month and 12-month follow-up. Primary outcomes are symptoms of depression and anxiety (25-item Hopkins Symptom Checklist). Secondary outcomes include daily functioning (WHODAS 2.0), PTSD symptoms (PTSD Checklist for DSM-5) and self-identified problems (PSYCHLOPS). We will conduct a one-stage IPD meta-analysis using linear mixed models. Quality of evidence will be assessed using the GRADE approach, and the economic evaluation approach will be assessed using the CHEC-list. Ethics and dissemination Local ethical approval has been obtained for each RCT. This IPD meta-analysis does not require ethical approval. The results of this study will be published in international peer-reviewed journals.
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9.
  • Drescher, A., et al. (författare)
  • Problems after flight : understanding and comparing Syrians'€™ perspectives in the Middle East and Europe
  • 2021
  • Ingår i: BMC Public Health. - : BioMed Central Ltd. - 1471-2458. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Syrian refugees and asylum seekers (SRAs) face multiple stressors after flight, which may vary due to different geographic, economic, cultural and socio-political contexts in the host countries. Past research has recognised the importance of participants’ own perspectives. The aims of this multi-country study were to identify and compare self-reported problems of SRAs between various settings. Methods: A semi-structured client-generated outcome measurement was used to collect data among adult SRAs in Jordan (N = 61), Turkey (N = 46) and Switzerland (N = 57) between September 2018 and November 2019. Answers were analysed following thematic analysis. Results: Over half of the participants reported practical problems with an emphasis on camp-related problems (Jordan), finances (Turkey), employment (Jordan and Switzerland) and government regulations (Switzerland), followed by psychological, and social issues. Conclusion: This study highlights the impact of local contextual factors on wellbeing. The findings emphasise that planning preventative procedures and mental health care services for SRAs need to consider local challenges affecting the population in specific countries. © 2021, The Author(s).
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10.
  • Kiselev, N., et al. (författare)
  • Structural and socio-cultural barriers to accessing mental healthcare among Syrian refugees and asylum seekers in Switzerland
  • 2020
  • Ingår i: European Journal of Psychotraumatology. - : Taylor and Francis Ltd.. - 2000-8198 .- 2000-8066. ; 11:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Due to their experiences of major stressful life events, including post-displacement stressors, refugees and asylum seekers are vulnerable to developing mental health problems. Yet, despite the availability of specialized mental health services in Western European host countries, refugees and asylum seekers display low mental healthcare utilization. Objective: The aim of this study was to explore structural and socio-cultural barriers to accessing mental healthcare among Syrian refugees and asylum seekers in Switzerland. Method: In this qualitative study, key-informant (KI) interviews with Syrian refugees and asylum seekers, Swiss healthcare providers and other stakeholders (e.g. refugee coordinators or leaders) were conducted in the German-speaking part of Switzerland. Participants were recruited using snowball sampling. Interviews were audiotaped and transcribed, and then analysed using thematic analysis, combining deductive and inductive coding. Results: Findings show that Syrian refugees and asylum seekers face multiple structural and socio-cultural barriers, with socio-cultural barriers being perceived as more pronounced. Syrian key informants, healthcare providers, and other stakeholders identified language, gatekeeper-associated problems, lack of resources, lack of awareness, fear of stigma and a mismatch between the local health system and perceived needs of Syrian refugees and asylum seekers as key barriers to accessing care. Conclusions: The results show that for Syrian refugees and asylum seekers in Switzerland several barriers exist. This is in line with previous findings. A possible solution for the current situation might be to increase the agility of the service system in general and to improve the willingness to embrace innovative paths, rather than adapting mental healthcare services regarding single barriers and needs of a new target population. © 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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11.
  • Kossowsky, J., et al. (författare)
  • The separation anxiety hypothesis of panic disorder revisited : A meta-analysis
  • 2013
  • Ingår i: American Journal of Psychiatry. - : American Psychiatric Association. - 0002-953X .- 1535-7228. ; 170:7, s. 768-781
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Evidence suggests that childhood separation anxiety disorder may be associated with a heightened risk for the development of other disorders in adulthood. The authors conducted a metaanalysis to examine the relationship between childhood separation anxiety disorder and future psychopathology. Method: PubMed, PsycINFO, and Embase were searched for studies published through December 2011. Case-control, prospective, and retrospective cohort studies comparing children with and without separation anxiety disorder with regard to future panic disorder, major depressive disorder, any anxiety disorder, and substance use disorders were included in the analysis. Effects were summarized as pooled odds ratios in a random-effects model. Results: Twenty-five studies met all inclusion criteria (14,855 participants). A metaanalysis of 20 studies indicated that children with separation anxiety disorder weremore likely to develop panic disorder later on (odds ratio=3.45; 95% CI=2.37-5.03). Five studies suggested that a childhood diagnosis of separation anxiety disorder increases the risk of future anxiety (odds ratio=2.19; 95% CI=1.40-3.42). After adjusting for publication bias, the results of 14 studies indicated that childhood separation anxiety disorder does not increase the risk of future depression (odds ratio=1.06; 95% CI=0.78- 1.45). Five studies indicated that childhood separation anxiety disorder does not increase the risk of substance use disorders (odds ratio=1.27; 95% CI=0.80-2.03). Of the subgroup analyses performed, differences in comparison groups and sample type significantly affected odds ratio sizes. Conclusions: A childhood diagnosis of separation anxiety disorder significantly increases the risk of panic disorder and any anxiety disorder. These results support a developmental psychopathology conceptualization of anxiety disorders.
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12.
  • Mitteldorf, C., et al. (författare)
  • Expression of programmed death-1 (CD279) in primary cutaneous B-cell lymphomas with correlation to lymphoma entities and biological behaviour
  • 2013
  • Ingår i: British Journal of Dermatology. - : Blackwell Publishing Ltd. - 0007-0963 .- 1365-2133. ; 169:6, s. 1212-1218
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Programmed death-1 (PD-1/CD279) is a cell-surface protein expressed in activated T cells and a subset of T lymphocytes including follicular helper T cells (TFH). The interaction between PD-1 and its ligands plays a role in immune response and evasion of malignancies. In nodal follicular lymphoma, the number of intratumoral PD-1-positive lymphocytes is associated with overall survival. Objectives To investigate 28 cases of primary cutaneous B-cell lymphoma, including the subtypes PCFCL (n = 10), PCMZL (n = 10) and DLBCL-LT (n = 8) for the number and density of PD-1-positive cells. Methods Immunohistochemical staining and a computerized morphometric analysis for evaluation were applied. The results were correlated with the clinical outcome. To distinguish between activated T cells and TFH we performed PD-1/bcl-6 double staining and compared these results with CXCL-13 staining. Double staining for PD-1 and PAX-5 was used to investigate whether tumour cells were positive for PD-1. Results The PD-1-positive cells represented tumour-infiltrating T cells (TILs). Only a minor subset was represented by TFH. Patients with DLBCL-LT had a significantly lower number of PD-1-positive TILs than those with PCMZL (P = 0·012) and PCFCL (P = 0·002) or both (P = 0·001). The difference between PCMZL and PCFCL did not reach significance (P = 0·074). The tumour cells were negative for PD-1. Conclusions A higher number of PD-1-expressing cells was found in indolent PCMZL and PCFCL than in high-malignant DLBCL-LT. The PD-1-positive cells represented not only TFH, but also other activated T cells as a part of the tumour microenvironment. The tumour cells in all investigated types of PCBCL did not show aberrant PD-1 expression. What’s already known about this topic? In nodal follicular lymphoma, the number of intratumoral programmed death (PD)-1-positive lymphocytes is associated with overall survival. No data exist for primary cutaneous B-cell lymphoma (PCBCL). What does this study add? A higher number of PD-1-expressing cells was found in indolent primary cutaneous marginal zone lymphoma and primary cutaneous follicle centre lymphoma, in contrast to the more aggressive diffuse large B-cell lymphoma, leg type. PD-1-positive cells do not represent only follicular helper T cells. The tumour cells in all investigated types of PCBCL did not show aberrant PD-1 expression. © 2013 British Association of Dermatologists.
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13.
  • Mitteldorf, C., et al. (författare)
  • Galectin-3 Expression in Primary Cutaneous CD30-Positive Lymphoproliferative Disorders and Transformed Mycosis Fungoides
  • 2015
  • Ingår i: Dermatology. - : S. Karger AG. - 1018-8665 .- 1421-9832. ; 231:2, s. 164-170
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In nodal anaplastic large cell lymphoma, strong expression of galectin-3 (Gal-3) has been found, but only very few cases of primary cutaneous lymphoma have so far been examined. Objectives: To investigate 11 primary cutaneous anaplastic large cell lymphomas (PCALCL), 47 lymphomatoid papuloses (LYP) and 14 cases of transformed mycosis fungoides with CD30 expression (MF-T) for Gal-3 expression. Methods: A Gal-3 score was applied using a photo-based morphometric evaluation program. Double staining for CD30 and Gal-3 was performed. Furthermore, we recorded the cellular and extracellular sublocalization of the signal. Results: The Gal-3 expression in CD30+ tumor cells was significantly lower in MF-T in contrast to CD30+ lymphoproliferative disorders (CD30 LPD; p < 0.001), but we found no differences between PCALCL and LYP (p = 0.42). In PCALCL Gal-3 was more often localized in the cytoplasm in contrast to LYP, in which an equal distribution in the cytoplasm and the nucleus was more common (p = 0.9). Conclusions: The lower Gal-3 expression in MF-T in comparison to CD30 LPD might be an additional criterion to differentiate both entities. The different sublocalization of the Gal-3 signal might reflect a different biological function and behavior. © 2015 S. Karger AG, Basel.
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14.
  • Mitteldorf, C., et al. (författare)
  • PD-1 and PD-L1 in neoplastic cells and the tumor microenvironment of Merkel cell carcinoma
  • 2017
  • Ingår i: Journal of cutaneous pathology. - : Blackwell Publishing Ltd. - 0303-6987 .- 1600-0560. ; 44:9, s. 740-746
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Merkel cell carcinoma (MCC) is an aggressive neoplasm, which is often associated with Merkel cell polyomavirus (MCPyV). Programmed death-1 (PD-1) and its ligand PD-L1 are key players of the tumor microenvironment (TME). Methods: Fourteen paraffin-embedded tissue samples of MCC were stratified by their MCPyV detection. Apart from PD-L1 and PD-1, the TME was further characterized for the expression of CD33, FOXP3 and MxA. Results: We observed PD-1 in 2 of 12 tumors. PD-L1 expression by tumor cells was found in 7 of 8 MCPyV(+) samples and was detected particularly in the periphery. The tumor cells were surrounded by a shield of PD-L1/CD33 immune cells. Expression of PD-L1 by the tumor cells was higher in areas with a denser immune infiltrate. CD33(+) cells without direct tumor contact were PD-L1 negative. Only a low number of FOXP3(+) regulatory T-cells was admixed. Tumor cells of MCPyV(−) samples were mostly PD-L1 negative. Conclusions: Our data demonstrate that PD-L1 expression occurs in tumor and immune cells, in areas in which they are close in contact. Interferon seems to play a role in this interaction. We postulate that PD-L1(+)/CD33(+) cells shield the tumor against attacking PD-1(+) immune cells. Therefore, next to anti-PD-1/PD-L1 antibodies, blockade of CD33 seems to be a promising therapeutic approach. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
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15.
  • Morina, N., et al. (författare)
  • The impact of enhancing perceived self-efficacy in torture survivors
  • 2018
  • Ingår i: Depression and anxiety (Print). - : Blackwell Publishing Inc.. - 1091-4269 .- 1520-6394. ; 35:1, s. 58-64
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Perceived self-efficacy (SE) is an important factor underlying psychological well-being. Refugees suffer many experiences that can compromise SE. This study tested the impact of enhancing perceived SE on coping with trauma reminders and distress tolerance in tortured refugees. Methods: Torture survivors (N = 40) were administered a positive SE induction in which they retrieved mastery-related autobiographical memories, or a non-SE (NSE) induction, and then viewed trauma-related images. Participants rated their distress following presentation of each image. Participants then completed a frustration-inducing mirror-tracing task to index distress tolerance. Results: Participants in the SE condition reported less distress and negative affect, and improved coping in relation to viewing the trauma-related images than those in the NSE condition. The SE induction also led to greater persistence with the mirror-tracing task than the NSE induction. Conclusions: These findings provide initial evidence that promoting SE in tortured refugees can assist with managing distress from trauma reminders, and promoting greater distress tolerance. Enhancing perceived SE in tortured refugees may increase their capacity to tolerate distress during therapy, and may be a useful means to improve treatment response. © 2017 Wiley Periodicals, Inc.
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16.
  • Müller-Engelmann, M., et al. (författare)
  • Psychometric Properties and Factor Structure of the German Version of the Clinician-Administered PTSD Scale for DSM-5
  • 2020
  • Ingår i: Assessment. - : SAGE Publications Inc.. - 1073-1911 .- 1552-3489. ; 27:6, s. 1128-1138
  • Tidskriftsartikel (refereegranskat)abstract
    • The Clinician-Administered PTSD Scale (CAPS) is a widely used diagnostic interview for posttraumatic stress disorder (PTSD). Following fundamental modifications in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the CAPS had to be revised. This study examined the psychometric properties (internal consistency, interrater reliability, convergent and discriminant validity, and structural validity) of the German version of the CAPS-5 in a trauma-exposed sample (n = 223 with PTSD; n =51 without PTSD). The results demonstrated high internal consistency (αs =.65-.93) and high interrater reliability (ICCs =.81-.89). With regard to convergent and discriminant validity, we found high correlations between the CAPS severity score and both the Posttraumatic Diagnostic Scale sum score (r =.87) and the Beck Depression Inventory total score (r =.72). Regarding the underlying factor structure, the hybrid model demonstrated the best fit, followed by the anhedonia model. However, we encountered some nonpositive estimates for the correlations of the latent variables (factors) for both models. The model with the best fit without methodological problems was the externalizing behaviors model, but the results also supported the DSM-5 model. Overall, the results demonstrate that the German version of the CAPS-5 is a psychometrically sound measure.
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17.
  • Olff, M., et al. (författare)
  • Screening for consequences of trauma–an update on the global collaboration on traumatic stress
  • 2020
  • Ingår i: European Journal of Psychotraumatology. - : Taylor and Francis Ltd.. - 2000-8198 .- 2000-8066. ; 11:1
  • Tidskriftsartikel (refereegranskat)abstract
    • This letter provides an update on the activities of “The Global Collaboration on Traumatic Stress” (GC-TS) as first described by Schnyder et al. in 2017. It presents in further detail the projects of the first theme, in particular the development of and initial data on the Global Psychotrauma Screen (GPS), a brief instrument designed to screen for the wide range of potential outcomes of trauma. English language data and ongoing studies in several languages provide a first indication that the GPS is a feasible, reliable and valid tool, a tool that may be very useful in the current pandemic of the coronavirus disease 2019 (COVID-19). Further multi-language and cross-cultural validation is needed. Since the start of the GC-TS, new themes have been introduced to focus on in the coming years: a) Forcibly displaced persons, b) Global prevalence of stress and trauma related disorders, c) Socio-emotional development across cultures, and d) Collaborating to make traumatic stress research data “FAIR”. The most recent theme added is that of Global crises, currently focusing on COVID-19-related projects.
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18.
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19.
  • Pfaltz, Monique C., et al. (författare)
  • Acoustic emotional processing in patients with borderline personality disorder : Hyper- or hyporeactivity?
  • 2015
  • Ingår i: Journal of Personality Disorders. - : Guilford Publications. - 0885-579X .- 1943-2763. ; 29:6, s. 809-827
  • Tidskriftsartikel (refereegranskat)abstract
    • Earlier studies have demonstrated emotional overreactions to affective visual stimuli in patients with borderline personality disorder (BPD). However, contradictory findings regarding hyper- versus hyporeactivity have been reported for peripheral physiological measures. In order to extend previous results, the authors investigated emotional reactivity and long-term habituation in the acoustic modality. Twenty-two female BPD patients and 19 female nonclinical controls listened to emotionally negative, neutral, and positive sounds in two identical sessions. Heart rate, skin conductance, zygomaticus/corrugators muscle, and self-reported valence/arousal responses were measured. BPD patients showed weaker skin conductance responses to negative sounds than controls. The elevated zygomaticus activity in response to positive sounds observed in controls was absent in BPD patients, and BPD patients assigned lower valence ratings to positive sounds than controls. In Session 2, patients recognized fewer positive sounds than controls. Across both groups, physiological measures habituated between sessions. These findings add to growing evidence toward partial affective hyporeactivity in BPD. © 2015 The Guilford Press.
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20.
  • Pfaltz, Monique C., et al. (författare)
  • Processing of an ambiguous time phrase in posttraumatic stress disorder : Eye movements suggest a passive, oncoming perception of the future
  • 2021
  • Ingår i: Psychiatry Research. - : Elsevier. - 0165-1781 .- 1872-7123. ; 299
  • Tidskriftsartikel (refereegranskat)abstract
    • Metaphorically, the future can be perceived as approaching us (time-moving metaphor) or as being approached by us (ego-moving metaphor). Also, in line with findings that our eyes look more up when thinking about the future than the past, the future’s location can be conceptualized in upwards terms. Eye movements were recorded in 19 participants with PTSD and 20 healthy controls. Participants with PTSD showed downward and healthy controls upward eye movements while processing an ego/time-moving ambiguous phrase, suggesting a passive (time-moving) outlook toward the future. If replicated, our findings may have implications for the conceptualization and treatment of PTSD.
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21.
  • Wadji, D. L., et al. (författare)
  • Associations between experiences of childhood maltreatment and perceived acceptability of child maltreatment : A cross-cultural and exploratory study
  • 2023
  • Ingår i: International Journal of Child Abuse & Neglect. - : Elsevier. - 0145-2134 .- 1873-7757. ; 143
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Acceptable parental behaviors and practices toward a child vary across countries and may impact the risk of exposure to maltreatment. Conversely, prior experiences of maltreatment as a child may influence the acceptability of child maltreatment (CM) behaviors. Objective: This exploratory study examined the association between CM experiences and perceived acceptability of CM using data from four countries representing different cultures, living standards, and gross national income. Participants and setting: We recruited a convenience sample of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122) through online postings on social media. Methods: We administered questionnaires and conducted a three-stage hierarchical multiple regression with perceived acceptability of CM subscales as the dependent variable. Results: In all countries, higher scores of childhood neglect were associated with greater perceived acceptability of neglect in one's community (p <.001). Equally, our results showed that higher scores of childhood neglect or sexual abuse were associated with greater perceived acceptability of sexual abuse (p <.044). However, we did not find a significant relationship between other forms of CM (i.e., physical abuse, emotional maltreatment, exposure to domestic violence), and their perceived acceptability. Conclusions: Our findings suggest that experiences of some CM types, namely neglect and sexual abuse, may be associated with the perception that these are more acceptable within one's community. Perceived acceptability of CM might be a driver that can either prevent or perpetuate CM. Therefore, intervention and prevention programs could incorporate a deeper cross-cultural understanding and assessment of these social norms in order to foster meaningful behavioral changes. 
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22.
  • Wadji, D. L., et al. (författare)
  • How are experiences and acceptability of child maltreatment related to resilience and posttraumatic growth : a cross cultural study
  • 2023
  • Ingår i: European Journal of Psychotraumatology. - : Informa UK Limited. - 2000-8198 .- 2000-8066. ; 14:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Post-traumatic growth (PTG) and resilience, regarded as positive psychological change following a traumatic experience, are under-researched across cultures in people exposed to child maltreatment (CM). Objective: We investigated how experiences and the perceived acceptability of CM are related to resilience and PTG in countries with different cultures, living standards, and gross national income. Method: A total of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122) completed an online survey with self-reported questionnaires, including the Brief Resilience Scale and the Post Traumatic Growth Inventory-Short Form. Results: Across countries, self-reported male gender and age were positively associated with resilience, while experiences of physical abuse and emotional maltreatment were negatively associated with resilience. Experiences of emotional maltreatment were positively associated with PTG. Higher levels of PTG and resilience were found amongst Cameroonian participants as compared to other countries. Conclusion: Our results suggest that positive changes following CM can vary significantly across cultures and that experiences of specific CM subtypes, but not the perceived acceptability of CM, may be important for a deeper understanding of how individuals overcome trauma and develop salutogenic outcomes. Our findings may inform CM intervention programmes for an enhanced cultural sensitivity. 
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23.
  • Weilenmann, S., et al. (författare)
  • Emotion transfer, emotion regulation, and empathy-related processes in physician-patient interactions and their association with physician well-being : A theoretical model
  • 2018
  • Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 9:AUG
  • Tidskriftsartikel (refereegranskat)abstract
    • Physicians experience many emotionally challenging situations in their professional lives, influencing their emotional state through emotion contagion or social appraisal processes. Successful emotion regulation is crucial to sustain health, enable well-being, foster resilience, and prevent burnout or compassion fatigue. Despite the alarmingly high rate of stress-related disorders in physicians, affecting not only physician well-being, but also outcomes such as physician performance, quality of care, or patient satisfaction, research on how to deal with emotionally challenging situations in physicians is lacking. Based on extant literature, the present article proposes a theoretical model depicting emotions, emotion regulation, and empathy-related processes and their relation to well-being in provider-client interactions. This model serves as a basis for future research and interventions aiming at improving physician well-being and professional functioning. As a first step, interviews with 21 psychiatrists were conducted. Results of qualitative and initial quantitative analyses provided detailed descriptions of the model’s components confirming its usefulness for detecting mechanisms linking emotion regulation and well-being in psychiatrist-patient interactions. Additionally, results lend preliminary support for the validity of the model, suggesting that successful regulation of emotions (i.e., achieving a desired emotional state) elicited by cyclical transfer processes in provider-client interactions is associated with both short- and long-term well-being and resilience. Furthermore, empathy-related emotions and their regulation seem to be linked to well-being. Based on the results of the present study, a prospective longitudinal study is under preparation, which is intended to inform effective interventions targeting emotion transfer, empathy-related processes, and emotion regulation in physicians’ professional lives. The model and results are also potentially applicable to other health care and social services providers. © 2018 Weilenmann, Schnyder, Parkinson, Corda, von KÀnel and Pfaltz.
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24.
  • Weilenmann, S., et al. (författare)
  • Experimental Induction of Emotional and Sexual Intimacy : Exploring the Validity of the German Fast Friends Procedure in Individuals with and without Childhood Maltreatment
  • 2022
  • Ingår i: Archives of Sexual Behavior. - : Springer Science and Business Media LLC. - 0004-0002 .- 1573-2800. ; 51:3, s. 1703-1719
  • Tidskriftsartikel (refereegranskat)abstract
    • The Fast Friends Procedure (FFP) is a widely used experimental paradigm to induce emotional intimacy. Besides exploring the validity of a German translation of the paradigm (n = 46), we developed an extension of the FFP that induces sexual intimacy and assessed heart rate, high-frequency heart rate variability, and electrodermal activity responses to the FFP and its extension. Furthermore, we examined its applicability to individuals with childhood maltreatment (n = 56), who frequently suffer from intimacy-related difficulties. Intimacy, positive affect, liking, and attraction increased during the FFP and partly during the sexual intimacy extension in both study groups. Moreover, both groups showed physiological responses consistent with positive social interactions. The use of the German FFP and its sexual intimacy extension can thus be recommended for research in the general population and in individuals with childhood maltreatment, although more studies are needed to further validate the paradigms. 
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25.
  • Weilenmann, S., et al. (författare)
  • Self-worth and bonding emotions are related to well-being in health-care providers : a cross-sectional study
  • 2021
  • Ingår i: BMC Medical Education. - : BioMed Central Ltd. - 1472-6920. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Interacting with patients can elicit a myriad of emotions in health-care providers. This may result in satisfaction or put providers at risk for stress-related conditions such as burnout. The present study attempted to identify emotions that promote provider well-being. Following eudaimonic models of well-being, we tested whether certain types of emotions that reflect fulfilment of basic needs (self-worth, bonding with patients) rather than positive emotions in general (as suggested by hedonic models) are linked to well-being. Specifically, we hypothesized that well-being is associated with positive emotions directed at the self, which reflect self-worth, and positive as well as negative emotions (e.g., worry) directed at the patient, which reflect bonding. However, we expected positive emotions directed at an object/situation (e.g., curiosity for a treatment) to be unrelated to well-being, because they do not reflect fulfilment of basic needs. Methods: Fifty eight physicians, nurses, and psychotherapists participated in the study. First, in qualitative interviews, they reported their emotions directed at the self, the patient, or an object/situation during distressing interactions with patients. These emotions were categorised into positive emotions directed towards the self, the patient, and an object/situation, and negative emotions directed towards the patient that reflect bonding. Second, providers completed questionnaires to assess their hedonic and eudaimonic well-being. The well-being scores of providers who did and did not experience these emotions were compared. Results: Providers who experienced positive emotions directed towards the self or the patient had higher well-being than those who did not. Moreover, for the first time, we found evidence for higher well-being in providers reporting negative patient-directed emotions during distressing interactions. There was no difference between providers who did and did not experience positive object/situation-directed emotions. Conclusions: These findings may point towards the importance of “eudaimonic” emotions rather than just positive emotions in interactions with patients. Emotions such as contentment with oneself, joy for the patient’s improvement, and, notably, grief or worry for the patient may build a sense of self-worth and strengthen bonding with the patient. This may explain their association with provider well-being. © 2021, The Author(s).
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