The neural dynamics of deficient memory control in heavily traumatized refugees

Abstract Victims of war, torture and natural catastrophes are prone to develop posttraumatic stress disorder (PTSD). These individuals experience the recurrent, involuntary intrusion of traumatic memories. What neurocognitive mechanisms are driving this memory disorder? Here we show that PTSD symptoms in heavily traumatized refugees are related to deficits in the effective control of memory retrieval. In a think/no-think task, PTSD patients were unable to forget memories that they had previously tried to suppress when compared to control participants with the same trauma history but without PTSD. Deficits in voluntary forgetting were clinically relevant since they correlated with memory intrusions in everyday life. Magnetoencephalography (MEG) recorded during suppression attempts revealed that PTSD patients were unable to downregulate signatures of sensory long-term memory traces in the gamma frequency band (70–120 Hz). Thus, our data suggest that the inability to suppress unwanted memories through modulation of gamma activity is related to PTSD symptom severity

Soziale Traumatisierung durch Eltern und Gleichaltrige – unterschätzt und übersehen

Iffland B, Neuner F. Soziale Traumatisierung durch Eltern und Gleichaltrige – unterschätzt und übersehen. In: Müller J, Ruf-Leuschner M, Grimmer B, Knaevelsrud C, Dammann G, eds. Traumafolgen - Forschung und therapeutische Praxis . Psychotherapie in Psychiatrie und Psychosomatik. Stuttgart: Kohlhammer; 2022

Epigenetic modifications of the glucocorticoid receptor gene are associated with the vulnerability to psychopathology in childhood maltreatment

Stress, particularly when experienced early in life, can have profound implications for mental health. Previous research covering various tissues such as the brain, suggests that the detrimental impact of early-life stress (ELS) on mental health is mediated via epigenetic modifications including DNA methylation. Genes of the hypothalamic-pituitary-adrenal axis--in particular, the glucocorticoid receptor (hGR) gene--stand out as key targets for ELS. Even though the link between hGR methylation and either ELS or psychopathology is fairly well established, the mutually dependent relationships between ELS, DNA methylation and psychopathology remain to be uncovered. The specific psychopathology an individual might develop in the aftermath of stressful events can be highly variable, however, most studies investigating hGR methylation and psychopathology suffer from being limited to a single symptom cluster of mental disorders. Here, we screened volunteers for childhood maltreatment and analyzed whether it associates with hGR methylation in lymphocytes and a range of measures of psychological ill-health. hGR methylation in lymphocytes most likely reflects methylation patterns found in the brain and thus provides valuable insights into the etiology of psychopathology. We find the interaction between childhood maltreatment and hGR methylation to be strongly correlated with an increased vulnerability to psychopathology providing evidence of epigenome × environment interactions. Furthermore, our results indicate an additive effect of childhood maltreatment and hGR methylation in predicting borderline personality disorder (BPD)-associated symptoms, suggesting that the combination of both ELS and DNA methylation that possibly represents unfavorable events experienced even earlier in life poses the risk for BPD.publishe

Effects of psychotherapy on DNA strand break accumulation originating from traumatic stress

Background: Previous research reveals an association between traumatic stress and an increased risk for numerous diseases, including cancer. At the molecular level, stress may increase carcinogenesis via increased DNA damage and impaired DNA repair mechanisms. We assessed DNA breakage in peripheral blood mononuclear cells from individuals with post-traumatic stress disorder (PTSD) and measured the cellular capacity to repair single-strand breaks after exposure to ionizing X-radiation. We also investigated the effect of psychotherapy on both DNA breakage and DNA repair. Methods: In a first study we investigated DNA breakage and repair in 34 individuals with PTSD and 31 controls. Controls were subdivided into 11 trauma-exposed subjects and 20 individuals without trauma exposure. In a second study, we analysed the effect of psychotherapy (Narrative Exposure Therapy) on DNA breakage and repair. Thirty-eight individuals with PTSD were randomly assigned to either a treatment or a waitlist control condition. Follow-up was performed 4 months and 1 year after therapy. Results: In study 1 we found higher levels of basal DNA breakage in individuals with PTSD and trauma-exposed subjects than in controls, indicating that traumatic stress is associated with DNA breakage. However, single-strand break repair was unimpaired in individuals with PTSD. In study 2, we found that psychotherapy reversed not only PTSD symptoms, but also DNA strand break accumulation. Conclusion: Our results show - for the first time in vivo - an association between traumatic stress and DNA breakage; they also demonstrate changes at the molecular level, i.e., the integrity of DNA, after psychotherapeutic interventions. © 2014 S. Karger AG, Base

Countering posttraumatic LHPA activation in refugee mothers and their infants

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Supplementary Material for: Die KINDEX-App - ein Instrument zur Erfassung und unmittelbaren Auswertung von psychosozialen Belastungen bei Schwangeren in der täglichen Praxis bei Gynäkologinnen, Hebammen und in Frauenkliniken

<b><i>Hintergrund:</i></b> Der Konstanzer Index (KINDEX) ist ein strukturiertes Interview, das entwickelt wurde, um bereits pränatal zuverlässig und umfassend Risiken für eine beeinträchtigte psychische Entwicklung des Kindes und der Mutter zu erfassen. Um eine unmittelbare automatisierte Auswertung zu ermöglichen, haben wir das Instrument in Form einer Tablet-gestützten Anwendung (KINDEX-App) weiterentwickelt, die die schwangere Frau eigenständig bedienen kann. <b><i>Methoden:</i></b> In dieser Studie kam die KINDEX-App in gynäkologischen Praxen und in Frauenkliniken bei insgesamt N = 956 schwangeren Frauen als Selbstbeurteilungsinstrument zum Einsatz. Zur Bestimmung der Validität des Instruments wurden Vergleiche der Prävalenzen der erhobenen psychosozialen Belastungen mit repräsentativen Studien vorgenommen und Cronbachs alpha wurde berechnet. Des Weiteren wurde die Akzeptanz des Instrumentes sowohl bei den schwangeren Frauen als auch bei Gynäkologinnen und Hebammen erhoben. <b><i>Ergebnisse:</i></b> Die Prävalenzzahlen aus unserer Erhebung entsprechen weitgehend anderen Befunden, die in vergleichbaren Kollektiven erhoben wurden, wodurch die externe Validität der App angenommen werden kann. Die Anzahl fehlender Werte war äußerst gering (< 6%) und lässt den Schluss auf eine gute Akzeptanz zu. Die interne Konsistenz der App lag im akzeptablen Bereich (α = 0,68). <b><i>Schlussfolgerungen:</i></b> Die KINDEX-App ist ein praktikables und valides Screening-Instrument zur Erfassung psychosozialer Belastungsfaktoren bereits während der Schwangerschaft und bildet damit eine gute Basis für die Prävention und frühe Intervention, sodass eine gelingende Mutter-Kind-Bindung und eine gesunde kindliche Entwicklung gefördert werden können

Supplementary Material for: Effects of Psychotherapy on DNA Strand Break Accumulation Originating from Traumatic Stress

<b><i>Background:</i></b> Previous research reveals an association between traumatic stress and an increased risk for numerous diseases, including cancer. At the molecular level, stress may increase carcinogenesis via increased DNA damage and impaired DNA repair mechanisms. We assessed DNA breakage in peripheral blood mononuclear cells from individuals with post-traumatic stress disorder (PTSD) and measured the cellular capacity to repair single-strand breaks after exposure to ionizing X-radiation. We also investigated the effect of psychotherapy on both DNA breakage and DNA repair. <b><i>Methods:</i></b> In a first study we investigated DNA breakage and repair in 34 individuals with PTSD and 31 controls. Controls were subdivided into 11 trauma-exposed subjects and 20 individuals without trauma exposure. In a second study, we analysed the effect of psychotherapy (Narrative Exposure Therapy) on DNA breakage and repair. Thirty-eight individuals with PTSD were randomly assigned to either a treatment or a waitlist control condition. Follow-up was performed 4 months and 1 year after therapy. <b><i>Results:</i></b> In study 1 we found higher levels of basal DNA breakage in individuals with PTSD and trauma-exposed subjects than in controls, indicating that traumatic stress is associated with DNA breakage. However, single-strand break repair was unimpaired in individuals with PTSD. In study 2, we found that psychotherapy reversed not only PTSD symptoms, but also DNA strand break accumulation. <b><i>Conclusion:</i></b> Our results show - for the first time in vivo - an association between traumatic stress and DNA breakage; they also demonstrate changes at the molecular level, i.e., the integrity of DNA, after psychotherapeutic interventions