[Participation Restriction and its Prediction in Victims of Acts of Violence During the Proceedings Under the Victims Compensation Act: A File-Based Exploratory Cohort Study]. / Teilhabebeeinträchtigung und deren Prädiktion bei Opfern von Gewalttaten im Verfahren nach dem Opferentschädigungsgesetz: Eine aktenbasierte explorative Kohortenstudie.

After an act of violence, affected individuals not only suffer psychological and physical damage, but also impairment in their professional, social and societal participation. So far, however, no studies have been conducted examining the severity of participation restrictions and prognostically relevant characteristics. Using a category system, sociodemographic information as well as trauma-, crime- and health-specific characteristics of adult victims of acts of violence, whose entitlement to benefits were recognized under the German Victims Compensation Act (OEG), were recorded from files. Based on psychiatric assessments of damage, participation restrictions were also assessed post-hoc based on the International Classification of Functioning, Disability and Health (ICF). The data are extracted from 99 files; 72 of those affected were female. The average age of the victims at the time of the offence was 25 years. 53 were victims of sexual violence, 24 were victims of forms of bodily injury and 45 were victims of other acts of violence. 29 victims experienced more than one type of violence. All had at least one mental disorder with pathological significance. An average of four years passed between the first and second psychiatric assessment. While 85 of those affected stated that they had been employed before the offence, the number of employees dropped to 53 after the offence. The most pronounced participation restriction was found in professional participation. A multiple regression analysis revealed that a higher degree of participation restriction was associated with lack of employment and a stronger negative impact after the crime as well as the victim's familiarity with the perpetrator; but not associated with a mental disorder or a lack of a victim's trustworthy relationships. In future, participation restrictions should regularly be assessed based on the ICF during the psychiatric assessment. The results suggest that particularly benefits for professional participation are to be granted within the framework of the OEG.

Cognitive-Emotional Aspects of Post-Traumatic Stress Disorder in the Context of Female Genital Mutilation.

Around 200 million women and girls worldwide are affected by female genital mutilation/cutting (FGM/C). FGM/C is a procedure that harms or alters the external female genitals for non-medical reasons, and is usually performed on children. Often, this procedure leads to severe consequences for the women's physical and mental health. In a cross-sectional sample of 112 women seeking medical counseling, physical and mental health characteristics associated with FGM/C were examined and possible predictors for the development of post-traumatic stress disorder (PTSD) in women affected by FGM/C were identified. A total of 55.4% (n = 66) of the women reported symptom levels of probable PTSD. Predictors for higher PTSD symptomology were an older age at the time of the FGM/C procedure, feelings of guilt and the centrality of the event in the woman's life. Thus, cognitive-emotional processing was found to play an important role in the emergence of PTSD in women suffering from FGM/C. However, interventions taking into consideration these characteristics are mostly lacking and need to be investigated further in the context of FGM/C.

[Psychological Strain due to Female Genital Mutilation: An Explorative Analysis in the Context of Medical Counselling]. / Psychische Belastung durch weibliche Genitalverstümmelung: Eine explorative Untersuchung im Rahmen einer medizinischen Sprechstunde.

Female genital mutilation (FGM) is a procedure that injures or removes parts of the external female genitals for nonmedical reasons and without the consent of the affected girls. Often this procedure leads to severe consequences for the women's physical and mental health. Reconstructive surgery can reduce these symptoms. In an exploratory study of 97 women seeking medical counselling, characteristics of the sample were analysed descriptively, reasons for reconstructive surgery were examined and agreement between the women's knowledge with the results of the medical examination was assessed. 56.7% (n=55) of the women examined were suspected to suffer from PTSD. Relief of pain was the reason most frequently mentioned for reconstructive surgery (45.4%; n=44). Accordance between women's knowledge of anatomic structures and the degree of mutilation with the results of the medical examination was low (κ=0.09). In addition to surgical measures, women suffering from FGM should be offered psychotherapeutic assistance. To improve the understanding on the effect of psychotherapy after FGM, sound longitudinal studies are indispensable.

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.