Screening for Posttraumatic Stress Disorder in Refugees: Comparison of the Diagnostic Efficiency of Two Self-Rating Measures of Posttraumatic Stress Disorder.

There is a high prevalence of posttraumatic stress disorder (PTSD) in the refugee population. In order to identify affected individuals and offer targeted help, there is an urgent need for easily understandable, reliable, valid, and efficient screening measures. The aim of the present study was to compare the diagnostic efficiency of the Process of Recognition and Orientation of Torture Victims in European Countries to Facilitate Care and Treatment (PROTECT) questionnaire (PQ) to that of the eight-item short-form Posttraumatic Diagnostic Scale (PDS-8) and the Patient Health Questionnaire (PHQ-9). Using structured clinical interviews, the prevalence rates of PTSD and major depression episode (MDE) were assessed in a refugee sample (N = 118), and receiver operating characteristic analyses were determined and compared. Of participants in the sample, 29.7%, 95% CI [22.0%, 38.5%], were diagnosed with PTSD and 33.1%, 95% CI [24.4%, 41.9%], were diagnosed with MDE. The area under the curve (AUC) for all measures was moderate, AUCs = 0.79-0.86; hence, measures did not differ in terms of their discriminatory abilities. Using the favored cutoff points, sensitivity and specificity were 80-97% and 60-70%, respectively. In terms of their discriminatory abilities, none of the investigated measures can be favored more than the others. Thus, for detection of these two disorders, the shorter PQ could be more efficient. Because the high co-occurrence of PTSD and MDE might limit the explanatory power of results in the present study, the findings should be cross-validated in the future.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Tamizaje para Trastorno de Estrés Postraumático en Refugiados: Comparación de la Eficiencia Diagnóstica de 2 Medidas de auto-reporte para el Trastorno de Estrés Postraumático TAMIZAJE PARA TEPT EN REFUGIADOS Hay una alta prevalencia de Trastorno de Estrés Postraumático (TEPT) en la población de refugiados. Se requieren con urgencia medidas de tamizaje fácilmente comprensibles, confiables, válidas y eficientes, para identificar a los individuos afectados y ofrecer ayuda focalizada. El objetivo del presente estudio fue comparar la eficiencia diagnóstica del cuestionario PROTECT (PQ) con la de la forma corta de 8 ítems de la Escala de Diagnóstico Postraumático (PDS-8, por sus siglas en inglés) y del Cuestionario sobre la Salud del Paciente (PHQ-9, por sus siglas en inglés). Mediante el uso de entrevistas clínicas estructuradas, se evaluaron las tasas de prevalencia de TEPT y Episodio Depresivo Mayor (EDM) en una muestra de refugiados (n=118), además de determinar y comparar los análisis de las características operativas del receptor. De los participantes en la muestra, 29.7%, IC 95% [22.0%, 38.5%], fueron diagnosticados con TEPT y 33.1%, IC 95% [24.4%, 41.9%] fueron diagnosticados con EDM. El área bajo la curva (AUC en sus siglas en inglés) para todas las mediciones fue moderada, AUCs=.79-.86; por lo tanto, las mediciones no difirieron en términos de su capacidad discriminatoria. Usando los puntos de corte favorecidos, la sensibilidad y especificidad fueron 80-97% y 60-70% respectivamente. En términos de su capacidad discriminatoria, ninguna de las medidas investigadas puede ser favorecida más que las otras. Por lo tanto, al detectar estos dos trastornos, la PQ breve puede ser más eficiente. Dado que la co-ocurrencia de TEPT y EDM podría limitar el poder explicatorio de los resultados del presente estudio, los resultados deben ser validados de forma cruzada en el futuro.

Cognitive distortions in anorexia nervosa and borderline personality disorder.

Thought-shape fusion (TSF) is a cognitive distortion associated with eating disorders (ED). A similar distortion, thought-abandonment fusion (TAbF), is assumed to occur in borderline personality disorder (BPD). In this study the specificity of TSF in participants with anorexia nervosa (AN) and TAbF in participants with BPD was examined. 63 patients completed questionnaires assessing the manifestation of trait-TAbF and trait-TSF, as well as relevant psychopathology. Nonparametric conditional inference trees were used to test for cognitive disorder-specificity. Participants with AN exhibited higher trait-TSF-scores than those with BPD, when participants with BPD and a co-occurring AN were removed. Trait-TSF in participants with AN seemed to be disorder-specific. Participants with BPD and a co-occurring AN had the highest TAbF-scores. The specificity hypothesis could only be partially confirmed for trait-TAbF: while participants with BPD and a co-occurring AN tended to have the highest trait-TAbF scores, high mean values could also be found in participants with AN. The results indicate that TAbF is not specific to BPD, but may also play a role in AN. Both distortions seem to play a role in the maintenance of the respective disorders.

[Psychodynamic Oriented Multimodal Therapy for Inpatients with Borderline Personality Disorder: Effectiveness, Response, and Dropout]. / Stationäre psychodynamisch orientierte multimodale Therapie von Patienten mit Borderline-Persönlichkeitsstörung: Wirksamkeit, Response und Drop-out.

Psychodynamically oriented multimodal therapy approaches are efficacious for outpatients with borderline personality disorder (BPD). Until now, no study has reported the effectiveness, response, and dropout in a psychodynamic oriented multimodal therapy program for inpatients (PDOMT). In this study, we compared the results of 269 individuals seeking a 3-month inpatient treatment with previous studies for BPD inpatients by examining 269 individuals. The Borderline Personality Index (CUT-20-R) was used as the main outcome measure. Therapy outcome was defined in effect size (ES), response, and remission rates. In the pre-post comparison of the CUT-20-R, the ES was 0.74. The response and the remission rates were 34.6% and 2.6%. 50.6% of participants remained unchanged, 6.7% deteriorated, and 27.5% finished treatment prematurely. Male gender and patients with a dependent personality disorder increased the dropout risk. The results suggest that PDOMT might be effective for some, but not all BPD patients. Due to methodological shortcomings of the chosen strategy, future research should examine the effectiveness of PDOMT in a randomized controlled trial.

[Effectiveness of CBT on Unemployed Compared to Employed Individuals Suffering from Prevalent Mental Disorders - A Naturalistic Study]. / Effektivität von kognitiver Verhaltenstherapie bei arbeitslosen und erwerbstätigen Patienten mit prävalenten psychischen Störungen ­ Eine naturalistische Studie.

Background Unemployed individuals suffer more from mental strain than those who have jobs. Up until now, little information could be found regarding the effectiveness of cognitive behavioral therapy (CBT) for unemployed people with mental disorders. The aim of this study was to compare the impact of CBT on employed versus unemployed individuals in a naturalistic setting. Methods 92 outpatients with prevalent mental disorders (depression and anxiety) were matched post-hoc and assessed pre-treatment, post-treatment, and at follow-up. Results Unemployed individuals were more impaired at all assessment points. The multi-level analysis showed that both groups benefited equally. Moderate-to-large effect sizes were found in both groups. At follow-up-assessment, one third of the unemployed sample and one-fifth of those with jobs were classified as unimpaired. The job integration rate was 26%. Discussion The effect sizes indicate that CBT is beneficial for both groups. However, unemployed participants were as impaired at post-treatment as the employed were at pre-treatment. The job integration rate of 26% was comparable to the general integration rate in Germany (25%), although no work-focused interventions were carried out during the adjustment period. Conclusions CBT is effective for unemployed individuals, but because the unemployed participants were still more impaired at post-treatment, they might have a higher risk of relapse.