Negative and positive childhood experiences across developmental periods in psychiatric patients with different diagnoses – an explorative study

BACKGROUND: A high frequency of childhood abuse has often been reported in adult psychiatric patients. The present survey explores the relationship between psychiatric diagnoses and positive and negative life events during childhood and adulthood in psychiatric samples. METHODS: A total of 192 patients with diagnoses of alcohol-related disorders (n = 45), schizophrenic disorders (n = 52), affective disorders (n = 54), and personality disorders (n = 41) completed a 42-item self-rating scale (Traumatic Antecedents Questionnaire, TAQ). The TAQ assesses personal positive experiences (competence and safety) and negative experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas, and alcohol and drugs abuse) during four developmental periods, beginning from early childhood to adulthood. Patients were recruited from four Psychiatric hospitals in Germany, Switzerland, and Romania; 63 subjects without any history of mental illness served as controls. RESULTS: The amount of positive experiences did not differ significantly among groups, except for safety scores that were lower in patients with personality disorders as compared to the other groups. On the other side, negative experiences appeared more frequently in patients than in controls. Emotional neglect and abuse were reported in patients more frequently than physical and sexual abuse, with negative experiences encountered more often in late childhood and adolescence than in early childhood. The patients with alcohol-related and personality disorders reported more negative events than the ones with schizophrenic and affective disorders. CONCLUSIONS: The present findings add evidence to the relationship between retrospectively reported childhood experiences and psychiatric diagnoses, and emphasize the fact that a) emotional neglect and abuse are the most prominent negative experiences, b) adolescence is a more 'sensitive' period for negative experiences as compared to early childhood, and c) a high amount of reported emotional and physical abuse occurs in patients with alcohol-related and personality disorders respectively

Narrative Exposure Therapy - a short term intervention for traumatic stress disorders after war, terror or torture

Schauer M, Neuner F, Elbert T. Narrative Exposure Therapy - a short term intervention for traumatic stress disorders after war, terror or torture. Cambridge, MA: Hogrefe & Huber; 2005

Erzähl' um dein Leben - Traumatherapie bei Opfern von Gewalt und Terror in Krisenregionen

Schauer M, Neuner F, Elbert T. Erzähl' um dein Leben - Traumatherapie bei Opfern von Gewalt und Terror in Krisenregionen. Gehirn & Geist. 2003;(5):34-38

Testimony-Therapie als Psychotherapie für Überlebende staatlicher Gewalt

Neuner F, Schauer M, Elbert T. Testimony-Therapie als Psychotherapie für Überlebende staatlicher Gewalt. Zeitschrift für politische Psychologie. 2001;9(1):585-600

Narrative Exposition

Neuner F, Schauer M, Elbert T. Narrative Exposition. In: Maercker A, ed. Posttraumatische Belastungsstörungen. Heidelberg: Springer; 2009: 301-318

Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: a study of Somali combatants

Odenwald M, Hinkel H, Schauer E, et al. Use of khat and posttraumatic stress disorder as risk factors for psychotic symptoms: a study of Somali combatants. Soc Sci Med. 2009;69(7):1040-1048.The chewing of the khat leaves, which contain the amphetamine-like cathinone, is a traditional habit in Somalia. Our objective was to explore the effects of khat use and Posttraumatic Stress Disorder (PTSD) on paranoid symptoms and to test a potential causal chain. We report on a cross-sectional study in Somalia that was conducted in 2003. Trained local staff interviewed 8723 personnel of armed groups in seven regional convenience samples. Of them, 8124 were included in the analysis. We assessed current khat use, PTSD symptoms, functional drug use and paranoid ideation using items from the Composite International Diagnostic Interview (CIDI) and the Somali version of the Posttraumatic Stress Diagnostic Scale (PDS). Applying the causal steps approach, in a series of logistic regression models, we used PTSD as independent and paranoia as outcome variable; the quantity of khat use was defined as mediator variable and functional drug use as moderator. The results showed that respondents with PTSD used khat more frequently. Khat chewers with PTSD reported a higher intake compared to khat chewers without PTSD. Among excessive khat chewers with PTSD, paranoia was most frequent. The greatest amount of khat use was among respondents with PTSD who indicated that they found drugs help them to forget war experiences. The proposed mediated moderation model was supported by the data, i.e. besides the direct effects of PTSD and functional drug use on paranoia, the amount of khat use appeared to be a mechanism, by which paranoia is caused. We conclude that in our data we have uncovered a relationship between khat, PTSD and paranoia. Khat is functionally used by respondents with PTSD. Findings support a dose effect: the more khat consumption and when a respondent has PTSD, the higher the odds for paranoid ideation. However, the proposed causal chain needs to be confirmed in longitudinal studies. Demobilization and reintegration programs in Somalia need to be prepared to deal with complex psychological problems

A Narrative Exposure Treatment as intervention in a Macedonia's refugee camp: a case report

Neuner F, Schauer M, Roth WT, Elbert T. A Narrative Exposure Treatment as intervention in a Macedonia's refugee camp: a case report. Behavioural and Cognitive Psychotherapy. 2002;30(02):205-209

Prävalenz der Posttraumatischen Belastungsstörung (PTSD) und Möglichkeiten der Ermittlung in der Asylverfahrenspraxis

Gäbel U, Ruf M, Schauer M, Odenwald M, Neuner F. Prävalenz der Posttraumatischen Belastungsstörung (PTSD) und Möglichkeiten der Ermittlung in der Asylverfahrenspraxis. Zeitschrift für Klinische Psychologie und Psychotherapie. 2005;35(1):12-20

A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an african refugee settlement.

Neuner F, Schauer M, Klaschik C, Karunakara U, Elbert T. A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an african refugee settlement. Journal of consulting and clinical psychology. 2004;72(4):579-587.Little is known about the usefulness of psychotherapeutic approaches for traumatized refugees who continue to live in dangerous conditions. Narrative exposure therapy (NET) is a short-term approach based on cognitive-behavioral therapy and testimony therapy. The efficacy of narrative exposure therapy was evaluated in a randomized controlled trial. Sudanese refugees living in a Ugandan refugee settlement (N = 43) who were diagnosed as suffering from posttraumatic stress disorder (PTSD) either received 4 sessions of NET, 4 sessions of supportive counseling (SC), or psychoeducation (PE) completed in 1 session. One year after treatment, only 29% of the NET participants but 79% of the SC group and 80% of the PE group still fulfilled PTSD criteria. These results indicate that NET is a promising approach for the treatment of PTSD for refugees living in unsafe conditions

KIDNET - Narrative Expositionstherapie (NET) für Kinder

Ruf M, Schauer M, Neuner F, Schauer E, Catani C, Elbert T. KIDNET - Narrative Expositionstherapie (NET) für Kinder. In: Landolt MA, Hensel T, eds. Traumatherapie bei Kindern und Jugendlichen. Göttingen: Hogrefe; 2007: 84-109