There is a large consensus indicating that childhood trauma is significantly involved in the development of depression. The aim of this study was to examine the prevalence of retrospectively recalled childhood trauma in chronically depressed patients and to investigate a more specific relationship between trauma type and depression. We further asked for the influence of multiple experiences of childhood trauma on the vulnerability to a chronic course of depression in adulthood. 349 chronically depressed patients of the German LAC Depression Study completed the Childhood Trauma Questionnaire, a self-report measure of traumatic experiences in childhood. 75.6% of the chronically depressed patients reported clinically significant histories of childhood trauma. 37% of the chronically depressed patients reported multiple childhood traumatization. Experiences of multiple trauma also led to significantly more severe depressive symptoms. Stepwise multiple regression analysis suggested that childhood emotional abuse and sexual abuse were significantly associated with a higher symptom severity in chronically depressed adults. Yet, expanding the regression model for multiple exposures showed that multiplicity was the only remaining significant predictor for symptom severity in chronically depressed patients. Clinical implications suggest a precise assessment of childhood trauma in chronically depressed patients with a focus on emotional abuse, sexual abuse, and multiple exposures to childhood trauma. This trial is registered with registration number ISRCTN91956346.

Objective: The close relationship between social anxiety and eating disorders has attracted considerable scholarly attention in recent years. Shame has been identified as the key emotional symptom in the link between social anxiety and social phobia. While shame is commonly recognized as a meaningful construct for understanding eating disorders, empirical research into this issue has been lacking. Thus, the objective of this study was to determine the strength of influence shame and social anxiety have in the psychopathology of anorexia nervosa and bulimia nervosa compared with other clinical groups. Furthermore, the issue of whether shame can account for clinical group differences in the experienced levels of social anxiety was examined. Method: The sample consisted of 120 female inpatients, divided into four groups of 30 according to individual diagnoses: anorexia nervosa, bulimia nervosa, anxiety disorders and depression. The Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS) and the Internalized Shame Scale (ISS) were used to measure the target constructs for this investigation. Results: Patients with anorexia and bulimia nervosa have higher scores in internalized global shame than patients with anxiety disorders and depressions. In contrast to anorectic patients, however, patients with bulimia also have higher scores than the other two groups in the area of social performance anxiety; they also differ significantly from the anxiety disorders in terms of interaction anxiety. Once shame was partialled out, group differences of social anxiety were shown to disappear. Discussion: Both shame and social anxiety have to be regarded as important influencing factors in anorexia and bulimia nervosa, with shame making a significant contribution to the explanation of social anxieties. The interaction between shame and social anxiety as well as its relevance for eating disorders are discussed. With regards to the therapeutic implications, it would seem reasonable not only to focus on treating shame affect but also to specifically adopt a therapeutic strategy targeting social anxiety fears.

The independence of the concept of reflective functioning (RF) and its implications for the clinical stance are discussed.

Ré sultat d'une thé rapie psychanalytique et cognitivocomportementale à long terme chez des patients souffrant de dé pression chronique : un essai contrô lé avec allocation pré fé rentielle et randomisé e

Fructo-oligosaccharides (FOS) are soluble fibres which exert various effects in the gastrointestinal tract, and induce metabolic and endocrine changes. The effects are favourable in diabetes mellitus, and may be favourable in veal calves, which during late periods of fattening often develop hyperglycemia, glucosuria and insulin resistance, especially during high lactose intake. Based on this we have studied metabolic, endocrine and haematological traits in veal calves (Simmental x Red Holstein) fed FOS (10 g/day; group GrF) or no FOS (group GrC). Whole milk and milk replacer in both groups, on a kg body weight basis, were fed in identical amounts. Experiments, lasting for 3 weeks, started when calves were 10 weeks old and weighed 117 kg. During week 3 lactose was supplemented to enhance post-absorptive glucose loads. Feed intakes were similar in both groups, but weight gain tended to be higher in GrF than GrC. The post-prandial increase of glucose concentrations was significantly smaller, of lactate tended to be smaller, and growth hormone peak frequency tended to be lower, whereas maximal insulin concentrations reached post-prandially were significantly higher in GrF than GrC. Eosinophil granulocytes increased during FOS feeding. In conclusion, FOS had basically similar effects on metabolic and endocrine traits in veal calves as in animals and humans with diabetes mellitus, but changes were small, albeit more prominent after lactose loads.