Verläufe von Traumafolgen bei ehemaligen politisch Inhaftierten der DDR: Ein 15-Jahres-Follow-up

Zusammenfassung: Hintergrund: In einer Mitte der 1990er Jahre untersuchten Stichprobe ehemaliger politisch Inhaftierter der DDR wurden im 15-Jahres-Follow-up die Veränderungen der Diagnose- und Symptomprävalenzen der posttraumatischen Belastungsstörung (PTBS) sowie anderer psychischer Störungen untersucht. Zudem wurden die durch Kliniker erhobenen Diagnosenverläufe mit den retrospektiven subjektiven Einschätzungen der Studienteilnehmer verglichen. Methode: Dreiundneunzig ehemals politisch inhaftierte Personen nahmen an der Folgestudie teil (85% Wiederteilnahme), ihr mittleres Alter betrug 64Jahre. Diagnosen und Symptome wurden mittels strukturierter klinischer Interviews sowie Fragebögen erfasst. Die retrospektiven subjektiven Verlaufseinschätzungen der Teilnehmer wurden mittels eines PTBS-Symptomindex basierend auf 4Symptomgruppen (Intrusionen, Vermeidung, Numbing, Hyperarousal) errechnet. Ergebnisse: Eine aktuelle PTBS lag bei 33% vor (1997: 29%). Nur ca. in der Hälfte der Fälle lag diese schon 1994 vor, bei der anderen Hälfte handelt es sich um neu-inzidente bzw. remittierte Fälle. Nächsthäufige Diagnosen waren Major-Depression, Episode (26%), Panik (mit oder ohne Agoraphobie: 24%) sowie somatoforme Störungen (19%). Im PTBS-Symptomprofil nahmen Intrusionen, Flashbacks bzw. Entfremdungsgefühl im Zeitverlauf ab, Reizbarkeit und Schreckreaktionen hingegen zu. Die subjektive Selbsteinschätzung der PTBS-Symptomverläufe durch die Studienteilnehmer ergab im Vergleich mit den Diagnostikern häufiger ein resilientes ("nie PTBS") oder verzögertes und seltener ein remittiertes Verlaufsmuster. Schlussfolgerung: Die Ergebnisse sprechen für eine traumabezogene Langzeitmorbidität, die allerdings instabiler ist als bisher angenomme

The development of the Quality Indicator for Rehabilitative Care (QuIRC): a measure of best practice for facilities for people with longer term mental health problems.

BACKGROUND: Despite the progress over recent decades in developing community mental health services internationally, many people still receive treatment and care in institutional settings. Those most likely to reside longest in these facilities have the most complex mental health problems and are at most risk of potential abuses of care and exploitation. This study aimed to develop an international, standardised toolkit to assess the quality of care in longer term hospital and community based mental health units, including the degree to which human rights, social inclusion and autonomy are promoted. METHOD: The domains of care included in the toolkit were identified from a systematic literature review, international expert Delphi exercise, and review of care standards in ten European countries. The draft toolkit comprised 154 questions for unit managers. Inter-rater reliability was tested in 202 units across ten countries at different stages of deinstitutionalisation and development of community mental health services. Exploratory factor analysis was used to corroborate the allocation of items to domains. Feedback from those using the toolkit was collected about its usefulness and ease of completion. RESULTS: The toolkit had excellent inter-rater reliability and few items with narrow spread of response. Unit managers found the content highly relevant and were able to complete it in around 90 minutes. Minimal refinement was required and the final version comprised 145 questions assessing seven domains of care. CONCLUSIONS: Triangulation of qualitative and quantitative evidence directed the development of a robust and comprehensive international quality assessment toolkit for units in highly variable socioeconomic and political contexts

Recovery from Posttraumatic Stress Symptoms: A Qualitative Study of Attributions in Survivors of War

This study was funded by a grant from the European Commission, contract number INCO-CT-2004-50917

Long-Term Impact of War on Healthcare Costs: An Eight-Country Study

PMCID: PMC3251588This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Infidelity-Revealing Snapchat Messages Arouse Different Levels of Jealousy Depending on Sex, Type of Message and Identity of the Opposite Sex Rival

Research highlighting sex-differentiated jealousy resulting from imagined scenarios has now been reaffirmed when the infidelity-revealing message is discovered on a social media platform. Participants in the current study were presented with both sexually and emotionally charged infidelity-revealing scenarios featuring a same-sex sibling, a friend and a stranger in the format of a ‘Snapchat’ message. Men indicated significantly higher jealousy to sexual as opposed to emotional messages with the reverse pattern evident in women. Sex differences were also evident in the extent of jealousy elicited by ‘third-party’ identity. Women were significantly more jealous when the imagined infidelity occurred between their sister compared to both a best friend and a stranger with males showing significantly lower jealousy directed towards their brother compared to a stranger. These findings are supportive not only of a parental investment (PI) interpretation of sex differences in jealousy but also an interpretation consistent with aspects of inclusive fitness theory