ADRIA LITHOSPHERE INVESTIGATION ALPHA - Cruise No. M86/3, January 20 - February 04, 2012, Brindisi (Italy) - Dubrovnik (Croatia)

The Adriatic Sea and underlying lithosphere remains the least investigated part of the Mediterranean Sea. To shed light on the plate tectonic setting in this central part of southern Europe, R/V METEOR cruise M86/3 set out to acquire deep penetrating seismic data in the Adriatic Sea. M86/3 formed the core of an amphibious investigation crossing Adria from the Italian Peninsula into Montenegro/Albania. A total of 111 OBS/OBH deployments were successfully carried out, in addition to 47 landstations both in Italy and Montenegro/Albania, which recorded the offshore airgun shots. In the scope of this shoreline-crossing study, the aim is to quantify the shallow geometry, deep boundaries and the architecture of the southern Adriatic crust and lithosphere and to provide insights on a possible decoupling zone between the northern and southern Adriatic domains. Investigating the structure of the Adriatic crust and lithospheric mantle and analyzing the tectonic activity are essential for understanding the mountain-building processes that underlie the neotectonics and earthquake hazard of the Periadriatic region, especially in the vicinity of local decoupling zones

Mental health care for refugees in Germany: Needs and barriers

Dumke L. Mental health care for refugees in Germany: Needs and barriers. Bielefeld: Universität Bielefeld; 2024.As a result of multiple traumas and stressors experienced before, during, and after migration, a significant proportion of refugees are at risk of developing mental health problems. If untreated, severe mental illness often persists for years. The detrimental impact of untreated mental health problems on affected individuals, their families, and communities underscores the importance of available and accessible mental health services for refugees. However, even in high-income countries with well-established mental health systems, there is evidence of a significant gap between the mental health needs and treatment for refugee populations. Several barriers to accessing mental health care for refugees in high-income countries have been identified in previous research and are summarized in this dissertation in an overview of systematic and scoping reviews. The studies conducted as part of this dissertation shed further light on relevant barriers and provide additional data on access to mental health care for refugees in Germany. Specifically, the studies encompassed detailed investigations of rates of mental health service use among refugees (Article 1) and relations with demand-side factors, such as the perceived need for treatment (Article 1) and explanatory models of mental illness (Article 2). In addition, the studies examined rates of mental health treatment provision to refugee patients (Article 3) and associations with supply-side barriers, including providers' perceptions of practical barriers (Article 3) and their attitudes toward refugees (Article 4). The findings demonstrate the importance of more comprehensive and contextualized assessments to provide robust information on indicators of mental health service use among refugee populations and to rigorously test prevailing assumptions about barriers to accessing mental health care. Furthermore, the current findings shift the focus from demand-side to supply-side barriers, highlighting the need to consider systemic factors and structural determinants, such as health policies and the role of mental health professionals as gatekeepers to care. In this context, our findings have important practical implications for promoting equity and efficiency in access to mental health care for refugees in high- income countries such as Germany

Othering refugees: Psychotherapists' attitudes toward patients with and without a refugee background

Dumke L, Neuner F. Othering refugees: Psychotherapists' attitudes toward patients with and without a refugee background. Psychotherapy Research . 2022.Objective: A large proportion of refugees present with psychological disorders that require psychotherapy as first-line treatment. However, even in countries with well-established psychotherapy system, refugees continue to face barriers to care. Psychotherapists' attitudes toward refugees may also impede access to psychotherapy, as it is evident that stereotypes of health professionals contribute to health care disparities. However, little is known about psychotherapists' attitudes toward refugees. Methods: In a cross-sectional online study of N = 2002 outpatient psychotherapists in Germany (M-age = 54.48 years, 73.1% female), a vignette experiment was applied to examine differences in therapists' attitudes toward refugee patients from the Middle East and non-refugee patients. Subsequently, associations between attitudes and psychotherapists' characteristics (e.g., provision of treatment for refugees) were analyzed.Results: Results showed significant differences between therapists' attitudes toward refugee and non-refugee patients (eta(2)(p) = .23), with more therapy-hindering attitudes toward refugee patients. Higher therapy-hindering attitudes were significantly associated with less frequent provision of psychotherapy for refugees.Conclusion: Our findings provide initial evidence that psychotherapists perceive refugee patients as deviant from the norm and that these divergent attitudes may relate to disparities in mental health care. To avoid such a process of othering, training for psychotherapists should question stereotypes toward refugees

Causal Attributions for Mental Health Problems Scale (MH-CAUSE)

Only a small proportion of refugees requiring treatment actually receive psychotherapy. Alongside structural barriers, it has been hypothesized that causal attributions for mental health problems that deviate from Western explanatory models may reduce refugees’ help-seeking behavior. Prevailing assumptions suggest that refugees predominantly hold causal beliefs that are incompatible with the rationales of psychotherapy. Testing these assumptions requires a reliable assessment tool to evaluate refugees’ causal beliefs. Therefore, we developed the Causal Attributions for Mental Health Problems Scale (MH-CAUSE) and validated it in a sample of Middle Eastern refugees living in Germany (N = 429). This OSF page contains the data and analyses code used for the psychometric evaluation of the questionnaire

Barriers in psychotherapeutic care for refugees – A survey among psychotherapists in Germany

A large proportion of refugees show symptoms of mental health problems that require psychotherapy as first-line treatment. However, even in countries with a well-established psychotherapy system, refugees still encounter barriers to care. In a survey of 2002 outpatient psychotherapists in Germany, we collected data on treatment barriers and on the integration of refugees into regular psychotherapeutic practice

The role of psychotherapists' perceived barriers in providing psychotherapy to refugee patients

Access to psychotherapy is critical to improving mental health, but only a small proportion of refugees receive treatment in the regular psychotherapeutic care system in high-income countries. In previous research, outpatient psychotherapists reported several barriers to more frequent treatment of refugee patients. However, it is unclear to what extent these perceived barriers contribute to the poor provision of services to refugees. In a survey of N = 2002 outpatient psychotherapists in Germany, we collected data on perceived barriers to treatment of refugees and on the integration of refugees into regular psychotherapeutic practice. Half of the psychotherapists reported not to treat any refugee patients. In addition, therapies provided for refugees were, on average, 20% shorter than for other patients. Regression analyses showed direct negative associations between psychotherapists’ overall perception of barriers with the number of refugees treated and the number of sessions offered to refugee patients, even when controlling for sociodemographic and workload-related characteristics. Correlation analyses on the level of specific types of barriers further revealed that particularly language-related barriers and lack of contact with refugee patients are negatively correlated with the number of refugees treated and the number of sessions for refugees. Our findings indicate that the integration of refugees into regular psychotherapeutic care could be improved by measures to connect psychotherapists with refugee patients as well as professional interpreters and to ensure coverage of costs for therapy, interpreters, and related administrative tasks

The role of psychotherapists' perceived barriers in providing psychotherapy to refugee patients

Dumke L, Wilker S, Kotterba A, Neuner F. The role of psychotherapists' perceived barriers in providing psychotherapy to refugee patients. Clinical Psychology and Psychotherapy. 2023.Access to psychotherapy is critical to improving mental health, but only a small proportion of refugees receive treatment in the regular psychotherapeutic care system in high-income countries. In previous research, outpatient psychotherapists reported several barriers to more frequent treatment of refugee patients. However, it is unclear to what extent these perceived barriers contribute to the poor provision of services to refugees. In a survey of N=2002 outpatient psychotherapists in Germany, we collected data on perceived treatment barriers and on the integration of refugees into regular psychotherapeutic practice. Half of the psychotherapists reported that they do not treat refugee patients. In addition, therapies provided for refugees were, on average, 20% shorter than for other patients. Regression analyses showed direct negative associations between psychotherapists' overall perception of barriers with the number of refugees treated and the number of sessions offered to refugee patients, even when controlling for sociodemographic and workload-related characteristics. Correlation analyses on the level of specific types of barriers further revealed that particularly language-related barriers and lack of contact with the refugee populationare negatively correlated with the number of refugees treated and the number of sessions for refugees. Our findings indicate that the integration of refugees into regular psychotherapeutic care could be improved by measures to connect psychotherapists with refugee patients as well as professional interpreters and to ensure coverage of costs for therapy, interpreters and related administrative tasks. © 2023 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd

Externalizing problems mediate the relation between teacher and peer violence and lower school performance

Masath FB, Scharpf F, Dumke L, Hecker T. Externalizing problems mediate the relation between teacher and peer violence and lower school performance. Child Abuse & Neglect. 2022;135: 105982.BACKGROUND: The association between children's exposure to family violence and poor academic outcomes is well-established. Less is known about how exposure to violence in the school context, i.e., by teachers and by peers, affects academic functioning. Moreover, the role of children's mental health problems in this link has hardly been examined.; OBJECTIVES: We examined direct and indirect associations between children's experiences of violence by teachers and peers and children's mental health and school functioning while controlling for children's experiences of parental violence.; PARTICIPANTS: Using a multistage random sampling approach, we obtained a representative sample of 914 students (50.5% girls, Mage=12.58years) from 12 primary schools in Tanzania.; METHODS: In structured interviews, students' experiences of violence and mental health problems were assessed. Students' academic performance and absenteeism were documented using school records. Associations were examined using structural equation modeling.; RESULTS: Experiences of more teacher and peer violence were each significantly associated with higher externalizing problems (teachers: beta=0.27 [95%-CI: 0.12, 0.47]; peers: beta=0.17, [95%-CI: 0.07, 0.32]). Higher externalizing problems were significantly associated with poorer academic performance (beta=-0.13, [95%-CI: -0.23, -0.02]), implying significant indirect associations between students' experiences of teacher violence (beta=-0.04, [95%-CI: -0.08, -0.01]) and peer violence (beta=-0.02, [95%-CI: -0.05, -0.01]) and their academic performance via externalizing problems.; CONCLUSION: Exposure to violence at school may impair children's academic performance indirectly by increasing attention and behaviour problems. Further investigations in longitudinal studies and implementation of interventions to reduce violence in schools are indicated. Copyright © 2022 Elsevier Ltd. All rights reserved

Mental health problems moderate the association between teacher violence and children's social status in East Africa: A multi-informant study combining self- and peer-reports.

Hecker T, Dumke L, Neuner F, Masath FB. Mental health problems moderate the association between teacher violence and children's social status in East Africa: A multi-informant study combining self- and peer-reports. Development and psychopathology. 2021.School victimization has been negatively associated with children's social status. However, previous studies have primarily focused on peer victimization, leaving a significant knowledge gap regarding violence by teachers. We hypothesized that, when almost all children experience violence by teachers, not only the experience of violence, but also other factors, for example, mental health problems, may influence children's social preference and centrality. We therefore examined potential moderation effects of children's internalizing and externalizing problems. We implemented a multistage cluster randomized sampling approach to randomly chose fifth- and sixth-grade students from primary schools throughout Tanzania. Using a multi-informant approach, data were collected from 643 children (51.0% girls, Mage = 12.79 years). Results showed inconsistent direct associations between teacher violence and social status, whereas mental health problems were consistently associated with lower social status. Significant interaction effects were found for internalizing problems; that is, teacher violence was associated with lower social status for increasing internalizing problems. However, no interaction effects were found for externalizing problems. The findings underline the burden of exposure to violence by teachers and the importance of mental health for children's social functioning. Knowledge about interrelations can be applied in interventions to effectively reduce violence by teachers toward students

Trauma, genes, or spirits? Development of a scale to provide a more nuanced understanding of refugees' causal attributions for mental health problems

Dumke L, Wilker S, Ibrahim H, Hohaus C, Neuner F. Trauma, genes, or spirits? Development of a scale to provide a more nuanced understanding of refugees' causal attributions for mental health problems. SSM - Mental Health. 2023;4: 100276.Only a small proportion of refugees requiring treatment actually receive psychotherapy. Alongside structural barriers, it has been hypothesized that causal attributions for mental health problems that deviate from Western explanatory models may reduce refugees' help-seeking behavior. Prevailing assumptions suggest that refugees predominantly hold causal beliefs that are incompatible with the rationales of psychotherapy. Testing these assumptions requires a reliable assessment tool to evaluate refugees' causal beliefs. Therefore, we developed the Causal Attributions for Mental Health Problems Scale (MH-CAUSE) and validated it in a sample of Middle Eastern refugees living in Germany (N = 429). The outcomes of the psychometric analysis, which included exploratory and confirmatory factor analysis, internal consistency, and convergent validity, indicate that the MH-CAUSE is a suitable instrument for assessing refugees' causal beliefs about mental health problems. Our findings suggest that refugees' causal attributions are in line with a biopsychosocial-spiritual model of mental illness. Contrary to common assumptions, the majority of participants predominantly explained mental illness via psychosocial and biomedical causes, whereas spiritual beliefs were relevant only for a minority of participants. We observed significant associations between causal beliefs and help-seeking attitudes and behavior. However, effect sizes were only small to moderate. While mental health beliefs might contribute to mental health inequities, alleged cultural differences of refugees should not be overemphasized