| 1. |
- de Graaff, Anne M., et al.
(author)
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Scalable psychological interventions for Syrian refugees in Europe and the Middle East : STRENGTHS study protocol for a prospective individual participant data meta-analysis
- 2022
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In: BMJ Open. - : BMJ. - 2044-6055. ; 12:4
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Journal article (peer-reviewed)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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| 2. |
- Hautle, Lara-Lynn, et al.
(author)
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Adults with a history of childhood maltreatment with and without mental disorders show alterations in the recognition of facial expressions
- 2023
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In: European Journal of Psychotraumatology. - : Informa UK Limited. - 2000-8198 .- 2000-8066. ; 14:2
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Journal article (peer-reviewed)abstract
- Background: Individuals with child maltreatment (CM) experiences show alterations in emotion recognition (ER). However, previous research has mainly focused on populations with specific mental disorders, which makes it unclear whether alterations in the recognition of facial expressions are related to CM, to the presence of mental disorders or to the combination of CM and mental disorders, and on ER of emotional, rather than neutral facial expressions. Moreover, commonly, recognition of static stimulus material was researched. Objective: We assessed recognition of dynamic (closer to real life) negative, positive and neutral facial expressions in individuals characterised by CM, rather than a specific mental disorder. Moreover, we assessed whether they show a negativity bias for neutral facial expressions and whether the presence of one or more mental disorders affects recognition. Methods: Ninety-eight adults with CM experiences (CM+) and 60 non-maltreated (CM-) adult controls watched 200 non-manipulated coloured video sequences, showing 20 neutral and 180 emotional facial expressions, and indicated whether they interpreted each expression as neutral or as one of eight emotions. Results: The CM+ showed significantly lower scores in the recognition of positive, negative and neutral facial expressions than the CM- group (p < .050). Furthermore, the CM+ group showed a negativity bias for neutral facial expressions (p < .001). When accounting for mental disorders, significant effects stayed consistent, except for the recognition of positive facial expressions: individuals from the CM+ group with but not without mental disorder scored lower than controls without mental disorder. Conclusions: CM might have long-lasting influences on the ER abilities of those affected. Future research should explore possible effects of ER alterations on everyday life, including implications of the negativity bias for neutral facial expressions on emotional wellbeing and relationship satisfaction, providing a basis for interventions that improve social functioning.
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| 3. |
- Hoffman, Joel, et al.
(author)
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Mapping the availability of translated versions of posttraumatic stress disorder screening questionnaires for adults : A scoping review
- 2022
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In: European Journal of Psychotraumatology. - : Informa UK Limited. - 2000-8198 .- 2000-8066. ; 13:2
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Research review (peer-reviewed)abstract
- Background: The most used questionnaires for PTSD screening in adults were developed in English. Although many of these questionnaires were translated into other languages, the procedures used to translate them and to evaluate their reliability and validity have not been consistently documented. This comprehensive scoping review aimed to compile the currently available translated and evaluated questionnaires used for PTSD screening, and highlight important gaps in the literature.Objective: This review aimed to map the availability of translated and evaluated screening questionnaires for posttraumatic stress disorder (PTSD) for adults.Methods: All peer-reviewed studies in which a PTSD screening questionnaire for adults was translated, and which reported at least one result of a qualitative and /or quantitative evaluation procedure were included. The literature was searched using Embase, MEDLINE, and APA PsycInfo, citation searches and contributions from study team members. There were no restrictions regarding the target languages of the translations. Data on the translation procedure, the qualitative evaluation, the quantitative evaluation (dimensionality of the questionnaire, reliability, and performance), and open access were extracted.Results: A total of 866 studies were screened, of which 126 were included. Collectively, 128 translations of 12 different questionnaires were found. Out of these, 105 (83.3%) studies used a forward and backward translation procedure, 120 (95.2%) assessed the reliability of the translated questionnaire, 60 (47.6%) the dimensionality, 49 (38.9%) the performance, and 42 (33.3%) used qualitative evaluation procedures. Thirty-four questionnaires (27.0%) were either freely available or accessible on request.Conclusions: The analyses conducted and the description of the methods and results varied substantially, making a quality assessment impractical. Translations into languages spoken in middle- or low-income countries were underrepresented. In addition, only a small proportion of all translated questionnaires were available. Given the need for freely accessible translations, an online repository was developed.
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| 4. |
- Lüönd, Antonia M., et al.
(author)
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Don’t get too close to me: depressed and non-depressed survivors of child maltreatment prefer larger comfortable interpersonal distances towards strangers
- 2022
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In: European Journal of Psychotraumatology. - : Taylor & Francis. - 2000-8198 .- 2000-8066. ; 13:1
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Journal article (peer-reviewed)abstract
- Background: Childhood maltreatment (CM) is frequently linked to interpersonal problemssuch as difficulties in social relationships, loneliness, and isolation. These difficulties mightpartly stem from troubles regulating comfortable interpersonal distance (CIPD).Objective: We experimentally investigated whether CM manifests in larger CIPD and whetherall subtypes of CM (i.e., physical, emotional, or sexual abuse and physical or emotional neglect)affect CIPD.Methods: Using the stop-distance method (i.e. a team member approached participants untilthe latter indicated discomfort), we assessed CIPD in 84 adults with a self-reported history ofCM (24 with depressive symptoms) and 57 adult controls without a history of CM (withoutdepressive symptoms).Results: Adults with CM showed a larger CIPD (Mdn = 86 cm) than controls (Mdn = 68 cm), andCIPD was largest for those with CM combined with current depressive symptoms (Mdn =145 cm) (p’s < .047). In the latter group, all subtypes of CM were associated with a largerCIPD compared to controls (p’s < .045). In the CM group without depressive symptoms, onlythose with emotional abuse (p = .040) showed a larger CIPD than controls.Conclusions: These results add to findings of differential socio-emotional long-termconsequences of CM, depending upon the subtype of CM. Future research should explorewhether a larger CIPD has a negative impact on social functioning in individuals exposed toCM, particularly in those with depressive symptoms.
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| 5. |
- Perrin, Sean, et al.
(author)
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Cognitive Therapy for PTSD in Children and Adolescents
- 2017
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In: Evidence-Based Treatments for Trauma Related Disorders in Children and Adolescents. - Cham : Springer International Publishing. - 9783319461380 - 9783319461366 ; , s. 187-207
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Book chapter (peer-reviewed)
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| 6. |
- Perrin, Sean, et al.
(author)
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Cognitive Therapy for PTSD in Children and Adolescents
- 2024
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In: Evidence-Based Treatments for Trauma-Related Disorders in Children and Adolescents. - 9783319461366 - 9783319461380 ; , s. 187-207
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Book chapter (peer-reviewed)abstract
- Children and adolescents exposed to traumatic events are at high risk of developing posttraumatic stress disorder (PTSD). With the rare exception of very young children, their PTSD presentations at the symptom level are similar to those of trauma-exposed adults, as are their patterns of psychiatric comorbidity, particularly for adolescents. Untreated, at least a significant proportion will carry on with symptoms at or above the diagnostic threshold or at sub-threshold levels that are still clinically impairing. The presence of untreated or poorly treated PTSD symptoms leaves the young person at significantly increased risk of developing other psychiatric disorders, a worsening of any pre-existing conditions, and with greater long-term impairments in educational, family, and peer functioning. Fortunately, evidence-based treatments exist with the first-line recommendation being trauma-focused cognitive behavioral therapies, with a growing body of evidence for the efficacy of eye movement desensitization and reprocessing therapy (EMDR). This chapter provides an update on the state of the literature with respect to the evidence base for trauma-focused CBT, and in particular for an explicitly cognitive approach, originally developed for use with adults and successfully adapted for use with children and adolescents across the age range. The chapter describes the theoretical underpinning for this approach, guidance on reliving (a form of exposure to update the trauma memory) and the modification of trauma-related beliefs (two primary target in treatment),
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| 7. |
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| 8. |
- Pfaltz, Monique C., et al.
(author)
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Social Functioning in Individuals Affected by Childhood Maltreatment : Establishing a Research Agenda to Inform Interventions
- 2022
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In: Psychotherapy and Psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 91:4, s. 238-251
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Research review (peer-reviewed)abstract
- Childhood maltreatment (CM) is linked to impairments in various domains of social functioning. Here, we argue that it is critical to identify factors that underlie impaired social functioning as well as processes that mediate the beneficial health effects of positive relationships in individuals exposed to CM. Key research recommendations are presented, focusing on: (1) identifying attachment-related alterations in specific inter- and intrapersonal processes (e.g., regulation of closeness and distance) that underlie problems in broader domains of social functioning (e.g., lack of perceived social support) in individuals affected by CM; (2) identifying internal (e.g., current emotional state) and external situational factors (e.g., cultural factors, presence of close others) that modulate alterations in specific social processes; and (3) identifying mechanisms that explain the positive health effects of intact social functioning. Methodological recommendations include: (1) assessing social processes through interactive and (close to) real-life assessments inside and outside the laboratory; (2) adopting an interdisciplinary, lifespan perspective to assess social processes, using multi-method assessments; (3) establishing global research collaborations to account for cultural influences on social processes and enable replications across laboratories and countries. The proposed line of research will contribute to globally develop and refine interventions that prevent CM and further positive relationships, which - likely through buffering the effects of chronic stress and corresponding allostatic load - foster resilience and improve mental and physical health, thereby reducing personal suffering and the societal and economic costs of CM and its consequences. Interventions targeting euthymia and psychological well-being are promising therapeutic concepts in this context.
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| 9. |
- Witteveen, Anke B., et al.
(author)
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Post-disaster psychosocial services across Europe : the TENTS project
- 2012
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In: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 75:9, s. 1708-1714
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Journal article (peer-reviewed)abstract
- At present post-disaster activities and plans seem to vary widely. An adequate estimation of the availability of post-disaster psychosocial services across Europe is needed in order to compare them with recently developed evidence-informed psychosocial care guidelines. Here we report on the results of a cross-sectional web-based survey completed in 2008 by two hundred and eighty-six representatives of organizations involved in psychosocial responses to trauma and disaster from thirty-three different countries across Europe. The survey addressed planning and delivery of psychosocial care after disaster, methods of screening and diagnosis, types of interventions used, and other aspects of psychosocial care after trauma. The findings showed that planning and delivery of psychosocial care was inconsistent across Europe. Countries in East Europe seemed to have less central coordination of the post-disaster psychosocial response and fewer post-disaster guidelines that were integrated into specific disaster or contingency plans. Several forms of psychological debriefing, for which there is no evidence of efficacy to date, were still used in several areas particularly in North Europe. East European countries delivered evidence-based interventions for PTSD less frequently, whilst in South- and South-Eastern European countries anxiety suppressing medication such as benzodiazepines were prescribed more frequently to disaster victims than in other areas. Countries across Europe are currently providing sub-optimal psychosocial care for disaster victims. This short report shows that there is an urgent need for some countries to abandon non-effective interventions and others to develop more evidence based and effective services to facilitate the care of those involved in future disasters.
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