Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees

Neuner, Frank; Schauer, Maggie; Karunakara, Unni; Klaschik, Christine; Robert, Christina; Elbert, Thomas

doi:10.1186/1471-244x-4-34

Cited by 383 publications

(373 citation statements)

References 17 publications

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“…At the same time, the previously experienced traumatic events have probably increased the vulnerability for posttraumatic symptoms related to the tsunami. The finding that previous traumatic exposure is a significant predictor for the development of disaster-related PTSD supports a general dose-effect model of PTSD (Neuner et al, 2004) and might help to explain why PTSD rates after disaster are higher in developing countries, which are often characterized by high levels of violence.…”

Section: Discussionsupporting

confidence: 58%

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Post-tsunami stress: A study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka

et al. 2006

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At 3 to 4 weeks after theOn December 26, 2004, a giant tidal wave (tsunami) caused by an underwater earthquake in the Indian Ocean caused an unprecedented natural disaster in Indonesia, Sri Lanka, Thailand, and India. In Sri Lanka, the flood reached widespread coastal regions in all directions and caused more than 30,000 casualties. Countless inhabitants of these regions had to flee from their homes to provisional refugee camps or to the homes of relatives.

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Section: Discussionsupporting

confidence: 58%

“…For example, Bremner, Southwick, Johnson, Yehuda, and Charney (1993) showed that Vietnam veterans who had a previous history of childhood abuse were at higher risk for PTSD. In a study of civil war adult victims in Africa, a clear linear relationship between the number of traumatic event types and posttraumatic stress could be confirmed (Neuner et al, 2004).…”

mentioning

confidence: 91%

Post-tsunami stress: A study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka

et al. 2006

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“…However, the PTSD rate of 13% found in the semi-structured clinical interviews is comparatively low (Alpak et al, 2015; Führer et al, 2016), with a high number of participants showing a sub-syndromal PTSD (22%). Since PTSD depends on the cumulative exposure to traumatic stressors (Kolassa et al, 2010; Neuner et al, 2004), the PTSD rate will vary with the severity and frequency of life-threatening experiences. Further, manifest PTSD symptoms in refugees often appear after some time, when the so-called ‘honeymoon phase’ of euphoria and relief has passed (e.g.…”

Section: Discussionmentioning

confidence: 99%

Efficient identification of mental health problems in refugees in Germany: the Refugee Health Screener

Kaltenbach

Härdtner

Hermenau

et al. 2017

European Journal of Psychotraumatology

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Background: A substantial number of refugees present with mental disorders. This appears particularly acute in the currently increasing refugee populations in Europe. Although EU guidelines demand the identification and support of vulnerable individuals such as survivors of trauma, no adequately validated and comprehensive mental health screening instruments for refugees residing in Europe currently exist. Objective: We studied the feasibility, validity, and reliability of the Refugee Health Screener-15 (RHS-15) – a time-efficient and easy-to-implement screening developed by Hollifield et al. (2013) – as a self-rating and interview instrument. Methods: A sample of refugees from different countries (N = 86), representative of those who had arrived around the turn of the year 2015/2016 in Germany, filled in the RHS-15 on their own. A semi-structured clinical interview was later conducted with a random subsample (n = 56). Results: Fifty-two percent of the refugees examined screened positive in the RHS-15, thus indicating current mental health problems. The RHS-15 showed a good feasibility, reliability, and validity in both the self-rating and the interview version. It detected clinically relevant mental health problems when PTSD, depression, anxiety, or somatization problems were present. A shorter 13-item version proved to be equally valid. Conclusions: Together with previous research on the RHS in refugees living in the US, this suggests that the RHS is a time-efficient and accurate instrument that is able to detect common mental health problems in a wide range of refugees. Prospectively, the RHS could be used as an instrument for identifying vulnerable refugees, for example, by integrating it in the initial medical examination in the host community, thereby initiating support.

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“…Psychometric questionnaires included the trait measure of the State-Trait Anxiety Inventory (STAI) (Laux et al, 1981), Beck Depression Inventory (BDI) (Hautzinger et al, 1994), and Dissociation Experience Scale (DES) (Spitzer et al, 1998). Traumatic load was estimated by assessing the number of different traumatic event types experienced or witnessed (Neuner et al, 2004) as reported in the Posttraumatic Stress Diagnostic Scale (PDS) (Ehlers et al, 1996). The study protocol was approved by the local ethics committee.…”

Section: Participantsmentioning

confidence: 99%

Impact of emotion on cognition in trauma survivors: What is the role of posttraumatic stress disorder?

Mueller‐Pfeiffer

Martin‐Soelch

Blair

et al. 2010

Journal of Affective Disorders

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Background: Cognitive theories of anxiety disorders postulate an increased attentional bias to environmental cues associated with threat that underlies the exaggerated fear response. The role of trauma, which may represent strong competitive advantage for attention, remains unclear. We investigated the influence of trauma exposure and the presence of anxiety/stress disorders on the impact of emotional distractors on cognitive performance. Methods:Fourteen trauma-exposed subjects with PTSD, 12 trauma-exposed subjects with anxiety disorders other than PTSD, 12 trauma-exposed healthy subjects and 19 non-traumaexposed healthy controls participated in this study. The impact of emotion on cognition was determined by the Affective Stroop task that measures the effect of irrelevant emotional distractors on the speed of operant responding. Results:The speed of cognitive performance was significantly reduced in the presence of negative distractors versus neutral or positive distractors in subjects with PTSD, while there was no significant influence of the distractor type on performance in the other diagnostic groups (diagnosis-by-distractor type interaction, p<0.001). While negative distractors induced the same levels of anxiety and depersonalization in subjects with PTSD and subjects with other anxiety disorders, distractor-induced depersonalization was associated with slowing of cognitive performance in PTSD (p=0.02) but not in other groups.Limitations: Different types of anxiety disorders in the non-PTSD group might reduce the selectivity of the results; some subjects received medication possibly impacting on their cognitive functioning. Conclusions:The cognitive impairments in the presence of negative distractors specifically found in PTSD call for research into novel psychotherapeutic approaches, e.g. attentional training, for PTSD.

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Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees

Cited by 383 publications

References 17 publications

Post-tsunami stress: A study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka

Post-tsunami stress: A study of posttraumatic stress disorder in children living in three severely affected regions in Sri Lanka

Efficient identification of mental health problems in refugees in Germany: the Refugee Health Screener

Impact of emotion on cognition in trauma survivors: What is the role of posttraumatic stress disorder?

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