[Traumatization and posttraumatic stress disorder. Effect of type and number of traumatic experiences]. / Traumatisierung und posttraumatische Belastungsstörungen. Auswirkung von Art und Anzahl traumatischer Erfahrung.

OBJECTIVE: The number and type of traumatic experiences show differential associations with posttraumatic stress disorder (PTSD). OBJECTIVE: The associations of number and type of traumatic experiences with PTSD were investigated in a representative population sample in Germany. MATERIAL AND METHODS: Traumatic experiences and PTSD were assessed with a self-rating questionnaire in a sample of 2510 participants from the general German population. RESULTS: The risk of (partial) PTSD increased with an increasing number of traumatic experiences. In contrast interpersonal and accidental traumatization showed no substantial differences with respect to the risk of PTSD. CONCLUSION: To quantify the relevance of the number and type of traumatic experiences for onset and persistence of PTSD, a multidimensional and complex assessment of those experiences is necessary. This is a great challenge in epidemiological research on this topic.

[Trauma and posttraumatic stress symptoms in patients in German primary care settings]. / Trauma und posttraumatische Belastungssymptome bei Patienten in deutschen Hausarztpraxen.

BACKGROUND: Primary care settings have an important gatekeeping function to detect mental diseases, including trauma and posttraumatic stress disorders. OBJECTIVES: To assess the prevalence of trauma and posttraumatic symptoms in a first sample of northeast German primary care patients and to evaluate the diagnostic sensitivity and specificity of the general practitioners. MATERIAL AND METHODS: Traumatic experiences and posttraumatic stress disorders (PTSD) were assessed with self-rating questionnaires in a sample of N = 400 patients from 3 primary care facilities. Additionally, knowledge and diagnostic accuracy of the general practitioners were evaluated. RESULTS: According to the results of the patient health questionnaire (PHQ-15) data from all patients, the majority of patients questioned showed slight to moderate stress from somatic symptoms. Of the patients with complete data 7 % (n = 25) had a complete PTSD according to the results of the questionnaire, which was also identified in the medical assessment with a sensitivity of 40 %. The stress resulting from posttraumatic symptoms was closely associated with the extent of somatic complaints. CONCLUSION: Patients with a history of trauma and posttraumatic symptoms are prevalent in primary care settings. An early diagnosis by the general practitioner can help patients to receive adequate treatment. Patients with somatoform disorders in particular should be screened for trauma and posttraumatic symptoms.

Readiness to reconcile and post-traumatic distress in German survivors of wartime rapes in 1945.

BACKGROUND: Sexual violence and wartime rapes are prevalent crimes in violent conflicts all over the world. Processes of reconciliation are growing challenges in post-conflict settings. Despite this, so far few studies have examined the psychological consequences and their mediating factors. Our study aimed at investigating the degree of longtime readiness to reconcile and its associations with post-traumatic distress within a sample of German women who experienced wartime rapes in 1945. METHODS: A total of 23 wartime rape survivors were compared to age- and gender-matched controls with WWII-related non-sexual traumatic experiences. Readiness to reconcile was assessed with the Readiness to Reconcile Inventory (RRI-13). The German version of the Post-traumatic Diagnostic Scale (PDS) was used to assess post-traumatic stress disorder (PTSD) symptomatology. RESULTS: Readiness to reconcile in wartime rape survivors was higher in those women who reported less post-traumatic distress, whereas the subscale "openness to interaction" showed the strongest association with post-traumatic symptomatology. Moreover, wartime rape survivors reported fewer feelings of revenge than women who experienced other traumatization in WWII. CONCLUSIONS: Our results are in line with previous research, indicating that readiness to reconcile impacts healing processes in the context of conflict-related traumatic experiences. Based on the long-lasting post-traumatic symptomatology we observed that our findings highlight the need for psychological treatment of wartime rape survivors worldwide, whereas future research should continue focusing on reconciliation within the therapeutic process.

[Courses of affects in an internet-based writing therapy for elderly war trauma survivors. A content analytic approach]. / Affektverläufe in einer internetbasierten Schreibtherapie für ältere Kriegstraumatisierte. Ein inhaltsanalytischer Ansatz.

BACKGROUND: The proven efficacy of the therapeutic approach of writing therapy for the treatment of post-traumatic stress disorder (PTSD) allows a broadening focus and an examination of therapeutic components as well as the written realisation of these on the word level. Prior content analyses showed that these primary data analyses provided valuable new findings allowing insights into the therapeutic process in addition to questionnaires. METHODS: Therapeutic texts from 51 patients were analysed using content analysis (Affective Dictionary Ulm). The aim of this work is to show differences in therapeutic components on a textual basis. RESULTS: There were differences in the frequency of use of emotions in the therapeutic components. In texts of trauma exposure, a significant increase of use of stressful word categories (fear, depression, and anxiousness) has been identified compared to biographical reconstruction texts. In texts of cognitive restructuring, the highest affective density is found in comparison to biographic reconstruction but also compared to trauma exposure, based on negative (depression, anxiousness, and fear) and positive (love, satisfaction, pleasure) affects equally. Patient characteristics (gender, education, age, partnership) had no influence on the expression of the affective density. CONCLUSION: Quantitative content analysis seems to be a promising approach in identifying and distinguishing components of writing therapy on the affective vocabulary level. The presented approach represents a possible extension of current practice and research.

[Psychiatric disorders and childhood trauma in prisoners with antisocial personality disorder]. / Psychische Störungen und Kindheitstraumata bei Strafgefangenen mit antisozialer Persönlichkeitsstörung.

Previous studies indicate high prevalence rates of mental disorders and trauma among prisoners. Based on a sample of 102 male German prisoners, the comorbidity and childhood trauma experiences in 72 criminals with antisocial personality disorder were investigated. Furthermore, associations of antisocial personality disorder and early traumatic experiences with the age at first conviction and the lifetime months of imprisonment were examined. Subjects had high rates of comorbid lifetime and current disorders as well as childhood trauma experiences. Physical abuse in childhood and adolescence was identified as a predictor for lifetime months of imprisonment, antisocial personality disorder was found to be a predictor for the age at first conviction. Our findings confirm the hypothesis of prisoners with antisocial personality disorder being a severely traumatized population with serious mental disorders. Traumatic childhood experiences and antisocial personality disorder are associated with criminality variables. This has important implications on preventive treatments as well as on how prison services are addressing these problems.

Differential effects of subcutaneous GLP-1 on gastric emptying, antroduodenal motility, and pancreatic function in men.

In this study of eight healthy male volunteers, we investigated the effects of graded doses of subcutaneous glucagon like peptide-1(7-36)amide (GLP-1) on: 1) the gastric emptying pattern of a mixed liquid meal (300 kcal); 2) pancreatic enzyme secretion; 3) antroduodenal motility; and 4) the glycemic response as well as releases of insulin, C-peptide, and glucagon. GLP-1, 0.125 nmol/kg, or 0.25 nmol/kg, or placebo was injected subcutaneously 5 min before meal ingestion. Subcutaneous GLP-1 dose-dependently prolonged the lag period (i.e., the time to reach maximal velocity of gastric emptying) by 46.2% (low dose) and 93.7% (high dose) (p < .05) but left unaltered maximal emptying velocity, total emptying time, and exponential emptying rate. With and without GLP-1, a fed motor pattern was induced by the meal and was terminated by an antral phase III when 98% of the meal had emptied. In parallel to the prolonged lag period, GLP-1 dose-dependently inhibited antral and duodenal motility and coordinated antroduodenal contractions by > 50% (low dose) and > 70% (high dose) (p < .05). GLP-1 initially reduced and thereafter transiently stimulated pancreatic enzyme secretion. This pattern correlated with the prolonged lag period and mirrored the delayed gastric emptying. GLP-1 retarded and diminished the postprandial glucose peak and reduced the total plasma glucose response by 46.6% (low dose) and by 59.4% (high dose) (p < .05). Both doses of GLP-1 delayed the postprandial insulin peak, enhanced total insulin release, and diminished postprandial responses of glucagon and pancreatic polypeptide. The duration of the lag period strongly correlated with the timing of postprandial glucose and insulin peaks (p < .001). The initial delay of gastric emptying, the enhancement of postprandial insulin release, and the inhibition of postprandial glucagon release were independent determinants (p < .01-.05) of the postprandial glucose response after subcutaneous administration of GLP-1.