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Supplement 1, 2011

5. POSTER PRESENTATIONS

Article: 7235 | Published online: 09 May 2011

Moslem Abbasi, Mehdi Samadzadeh, Bita Shahbazzadegan:

The Comparison of Executive Function in Children with Learning Disorder and Normal Children in Arak………………………………………133

Tamer Aker, Banu Yilmaz, Ilgin Gokler Danisman, Nuray Karanci:

Capacity Building for Disaster Psychosocial Services: A Collaborative Project………………………………………133

Eva Alisic, Maaike Van Schaijk, Jet Strijker, Arend Groot:

Children and Fatal Domestic Violence………………………………………133

Fernando Almeida, Anita Santos:

Homeless in Portugal – An Exploratory Study………………………………………134

Tonny Andersen, Per Andersen, Ask Elklit:

The Traumatized Chronic Pain Patient-Prevalence of PTSD in Two Consecutive Samples Referred to Rehabilitation………………………………………134

Cherie Armour, Christopher Layne, James Naifeh, Mark Shevlin, Jon Elhai:

Assessing the Factor Structure of Posttraumatic Stress Disorder Symptoms in War-Exposed Youths with and without Criterion A2 Endorsement………………………………………134

Rikke Sophie Bak, Anja Hareskov Jensen, Elena Madsen:

Time Passes but the Trauma Stays – The Long-Term Consequences of Rape………………………………………135

Rikke Sophie Bak, Anja Hareskov Jensen, Elena Madsen:

The Effect of Psychological Treatment on Trauma Symptoms………………………………………135

Hendrik Berth, Maria Böttche, Christine Knaevelsrud, Philipp Kuwert:

Course of Affects in an Online-Therapy for Traumatized Persons of Word War 2………………………………………135

Brian Bride, Sara Kintzle, Robert Vandenberg, Paul Roman:

Structure of Secondary Traumatic Stress Symptoms in Substance Abuse Counselors………………………………………136

Silvia Carvalho Fernando, Thomas Beblo, Nicole Schlosser, Kirsten Terfehr, Bernd Löwe, Oliver Tobias Wolf, Carsten Spitzer, Martin Driessen, Katja Wingenfeld:

The Impact of Childhood Trauma on Emotion Regulation in Borderline Personality Disorder and Major Depression………………………………………136

Sofia Castro, José Carlos Rocha, Virgínia Silva:

Multiple Losses Effects on Complicated Grief and Emotional Regulation………………………………………136

Sofia Castro:

Multiple Losses effects on Complicated Grief and Emotional Regulation………………………………………137

Dorte Christiansen, Ask Elklit:

Secondary Victims of Rape………………………………………………………………………………137

Flávia Sofia Corrêa, José Carlos Rocha:

Traumatic Symptoms and Emotion Regulation as Predictors of Marital Adjustment after Perinatal Loss………………………………………137

Maria Crespo, Mar Gómez:

Post-Traumatic Stress Disorder: Beyond the Re-Experimentation, Avoidance and Affective Numbing, and Physiological Activation………………………………………138

Maria Crespo, Maria Arinero:

Psychological Treatment for Women Victims of Violence by Their Intimate Male Partner: The Differential Effect of Individual and Group Therapy………………………………………138

Edyta Dembinska, Krzysztof Rutkowski, Lukasz Müldner-Nieckowski, Jerzy Sobanski, Agnieszka Murzyn, Michal Mielimaka:

Schizophrenia as a Marital Stressor – Marital Functioning and Coping Mechanisms in Marital Crisis………………………………………138

Aida Dias, Luisa Sales, Rolf Kleber:

Relations between Childhood Trauma and Psychological Symptoms in the Portuguese Population………………………………………139

Daniel N. Ditlevsen, Ask Elklit:

The Trauma Type Related Variance of Gender Difference in PTSD Prevalence: A Meta-analysis of 18 Nordic Convenience Samples………………………………………139

Ask Elklit, Lone M. Steenberg, Tine Hansen:

School Bullying: A Cross-Cultural Study of Prevalence and Psychological Consequences………………………………………140

Ask Elklit, Mark Shevlin:

Sexual Victimization and Anxiety and Mood Disorders: A Case Control Study Based on the Danish Registry System………………………………………140

Ask Elklit, Ditte Jensen:

Trauma Exposure and PTSD in Indian Adolescents………………………………………140

Elisabete Ferreira, José Rocha, Tânia Silva, Catarina Gonçalves, Fábio Moreira:

Complicated Grief, PTSD and Emotional Regulation in Parents who Lost a Child………………………………………140

Renate Fohrafellner, Brigitte Lueger-Schuster:

Neuropsychological Functions in Correlation with Posttraumatic Stress Symptoms in Unaccompanied Refugee Minors………………………………………141

Bruno Frade:

The Multidimensional Nature of Traumatic Events Impacts………………………………………141

Sheila Frankfurt, Patricia Frazier:

Identifying Longitudinal Symptom Trajectories following Sexual Assault Using Latent Growth Curve Analyses………………………………………141

Tobias Glück, Matthias Knefel:

Perspectives on the Influence of Climate Change on PTSD and Traumatic Stress. Reviewing the Recent Literature on Climate Change Regarding Psychological Trauma………………………………………142

M. Mar Gómez, María Crespo:

Posttraumatic Symptoms: How Do they Cluster? Towards a Revision of the Diagnostic Criteria for the PSD………………………………………142

M. Mar Gómez, María Crespo:

Measure of Post-Traumatic Stress Disorder in Spain: presentation of the Global Assessment of Posttraumatic Stress Questionnaire (Evaluación Global de Estrés Postraumático, EGEP)………………………………………143

Diego Gomez-Baya, Susana Paino:

The Influence of Thought Control Strategies on the Severity of PTSD Symptoms in a Sample of Battered Women………………………………………143

Diego Gomez-Baya:

Comorbid Posttraumatic Stress Disorder and Depression after Domestic Violence: Differences in Coping………………………………………144

Diego Gomez-Baya:

Posttraumatic Growth after domestic violence: The Role of Emotional Intelligence………………………………………144

Catarina Gonçalves:

Complicated Grief, Emotional Regulation and Traumatic Stress in Drug Addicts………………………………………144

Bettina Gregor, Ulrich S. Tran:

Where are the Differences? The Dodo Bird Verdict and the Relative Efficacy of Bona Fide Psychotherapies in Posttraumatic Stress Disorder: Meta-Analysis and Comparison with other Psychological Disorders………………………………………144

Angelika Haase, Matthias Schützwohl:

How is Posttraumatic Stress Disorder Treated in Outpatients? An Investigation of the Current Practice Patterns in Germany………………………………………145

Maj Hansen, Tonny Andersen, Cherie Armour, Ask Elklit, Sabina Palic:

PTSD-8: A Short PTSD Inventory………………………………………145

Leonie Hoijtink, Hans te Brake, Michel Dückers:

Literature Review of Psychosocial Resilience after Disasters………………………………………145

George Hu:

Soiled Linen: Trauma and treatment in Southeast Asian Victims of Sex Trafficking………………………………………146

Satoshi Ikeno:

Multilayer traumatic experiences among the survivors of the East Japan Great Earthquake that occurred on March 11th, 2011: Update of the current situation………………………………………146

Boaz Kahana, Eva Kahana, Loren Lovegreen, Baruch Kahana, Jane Brown, Sandra Dunkin:Typology of Coping with Cancer Among Older Adults………………………………………146

Eva Kahana, Boaz Kahana, Madeline VanGunten, Loren Lovegreen:

Reflecting Back on the Experience of Diagnosis by Elderly Cancer Survivors………………………………………147

Nancy Kassam-Adams, Patrick Palmieri, Justin Kenardy, Douglas Delahanty:

The Child PTSD Prediction Project: An International Collaboration to Create Predictive Tools for Child PTSD Risk after Acute Trauma………………………………………147

Evaldas Kazlauskas, Kristina Domanskaja:

How Train Drivers React to Railway Accidents: A Qualitative Approach………………………………………147

Evaldas Kazlauskas, Irma Skruibiene, Danute Gailiene, Ieva Starinskaite:

Posttraumatic Growth Among Lithuanian Survivors of Political Violence: A Qualitative Study………………………………………148

Evaldas Kazlauskas:

Diary Measures of Traumatic Stress: Ambulatory Assessment Approach………………………………………148

Christine Kern, Brigitte Forstner, Verena Menken, Karl Heinz Brisch:

SAFE® (Safe Attachment Formation for Educators) in Infant Day Care………………………………………148

Matthew Kimble, Laura Batterink, Elizabeth Marks, Cordelia Ross, Kevin Fleming:

ERP Evidence of Expectancy Bias in PTSD………………………………………149

Namik Kirlic, Adela Langrock:

Ten Years After the War: Externalizing Behaviors in a Sample of Bosnian Young Adults………………………………………149

Miro Klaric, Aleksandra Stevanovic, Tanja Franciskovic, Bozo Petrov, Suzana Jonovska:

Marital Quality and Relationship Satisfaction in Wives of War Veterans Suffering from PTSD………………………………………149

Grit Klinitzke, Gregor Weißflog, Elmar Brähler:

20 Years after the German Reunification: Mental Health Problems of Political Prisoners in the Former German Democratic Republic (GDR)………………………………………150

Miriam Köhler, Claudia Bredenbeck, Dieter Wagner, Kurt Mosetter, Gottfried Fischer, Robert Bering:

Ten Years Anniversary of the Center of Psychotraumatology in Northrhine Westfalia/ Krefeld………………………………………150

Hannah Korn:

The Impact of Posttraumatic and Acculturative Stress to the Subjective Mental Health Status of Bosnian Refugees in Austria………………………………………150

Sandy Krammer, Keti Simmen-Janevska, Andreas Maercker:

The Influence of Social-Interpersonal Factors and Reminiscence Styles on the Association Between Potentially Traumatic Events Dduring Childhood and Cognitive Decline in Old Age………………………………………151

Marion Kruesmann, Andreas Mueller-Cyran:

Primary Prevention for Rescue Service Personal………………………………………151

Anna Krutolewitsch, Andreas Maercker:

Co-Rumination in the Context of the Social Facilitation Model of PTSD: Secondary Traumatization and “Co-Rumination” on Emergency Worker………………………………………151

Maria Ksiazak, Joanna Gordziejuk-Nowak:

EU Reception Directive vs. Deportations on Dublin 2 Regulation………………………………………152

Iwona Kuzlik, Malgorzata Wawrzyniak:

Temperament, Basic Hope and Coping Strategy Choice by Individuals after Trauma………………………………………152

Marina Kvitsaridze, Marina Baliashvili, Ramaz Sakvarelidze, Tinatin Norakidze:

SRRS Specificity in Georgia (Local and Displaced Populations)………………………………………152

Annika Lindahl Norberg, Ulla Forinder:

Parents of Children with Potentially Fatal Disease: What is the Trauma?………………………………………153

Andreea Lita, Stefan Lita:

The Influence of Cognitive Schemas on the Social Problem Solving Abilities of Police Officers………………………………………153

Sabine Löffler, Bogausch Anja, Karin Pöhlmann, Rainer Knappe, Peter Joraschky:Wound and Growth: Meaning in Life and Coping with Posttraumatic Stress………………………………………153

Michelle Lonergan, Olivera-Figueroa A. Lening, Alain Brunet:

Propranolol's Effects on Long-Term Emotional Memory Consolidation and Reconsolidation: A Meta-Analysis………………………………………154

Angela Ioanna Loulopoulou:

De-Pathologising Trauma: A Positive Psychology Framework when Working with Victims of Trauma………………………………………154

Dália Marcelino, Maria João Figueiras:

Predictors of Posttraumatic Stress in a Sample of Portuguese Firefighters………………………………………155

Javier Martin-Peña, Miranda Olff, Alvaro Rodriguez-Carballeira:

Chronic Exposure to Terrorist Threats in the Basque Country: Psychosocial Consequences Suffered by the Victims of ETA………………………………………155

Marlene Matos, Anita Santos, Andreia Machado, Carla Machado:

Group Intervention with Battered Women: An Outcome Study………………………………………155

Stephen Messer:

Differential Effectiveness of Psychological and Pharmacotherapy Interventions for PTSD: A Meta-Analytic Review………………………………………156

Elena Mikhaylova, Natalia Evstegneeva:

Specific Features of Verbal Memory in Patients of Hospital for Veterans of War with High Blood Pressure and PTSD Symptoms………………………………………156

Irene Niedermayer:

Multi-professional Treatment of Traumatized Young Unaccompanied Refugees in a Stationary Youth Welfare Project………………………………………156

Ewa Odachowska:

The Influence Sense of Life on Identity Crisis and the Coping Process in Crisis Situation Related to the Child′s Chronic Illness………………………………………157

Misari Oe, Ulrich Schnyder, Sonja Schumacher, Christoph Mueller-Pfeiffer, Frank H. Wilhelm, Chantal Martin-Soelch:

Lower Plasma DHEA Concentration in the Long-Term after Severe Accidental Injury………………………………………157

Astrid Pabst, Udo Gerigk, Sukran Erdag, Melanie Altmann, Gunnar Paulsen, Josef Aldenhoff:

Interdisciplinary Therapy of Traumatised Refugees in a Psychiatric Context – A Model Project………………………………………157

Duarte Pacheco, Bruno Frade, Mónica Sá, Ana Andrade, José Rocha:

Predictive Model of Complicated Grief Six Months After Loss on a Portuguese Population………………………………………158

Jennifer Pearce, Jonathan Bisson:

The European Network for Traumatic Stress – Training & Practice (TENTS-TP) Project………………………………………158

Bojana Pejuskovic, D. Lecic-Tosevski, Stefan Priebe, Oliver Toskovic:

Posttraumatic Stress Disorder in Serbia………………………………………158

Laura Pielmaier, Andreas Maercker:

Is there PTSD after Severe Traumatic Brain Injury? A New Screening Strategy………………………………………159

Laura Pielmaier, Andreas Maercker:

Psychological Impact of Severe Traumatic Brain Injury on Close Relatives………………………………………159

Soili Poijula:

Long-Term Post-Traumatic Mental Disorders of the Family Members of the Homicide Victims………………………………………159

Bruna Profaca, Gordana Buljan Flander, Marija Bacan, Dragana Mateskovic:

Coping Strategies in Children Exposed to Different Kinds of Traumatic Events………………………………………160

Samir Qouta, Esa Palosaari, Marwan Diab:

Effectiveness of Psychosocial Intervention among War-Traumatized Children: Mental Health and Socio-Emotional Development: A Cluster Randomized Controlled Study………………………………………160

Nevena Repic, Anja Stecker, Sonja Düllmann, Wolfgang Senf, Sefik Tagay:

Trauma and PTSD in Dermatological Patients………………………………………160

Krzysztof Rutkowski, Edyta Dembinska, Lukasz Müldner – Nieckowski, Jerzy Sobanski, Agnieszka Murzyn, Michal Mielimaka:

Late Consequences of Early Childhood Trauma………………………………………161

Marcin Rzeszutek:

Post Traumatic Stress Disorder (PTSD), Temperament, Stress Coping Styles and Social Support In HIV- Positive People………………………………………161

Bettina Schiller, Daniela Strasser, Daniela Wintner, Elisabeth Zeilinger, Brigitte Lueger-Schuster:

Children of War – The Impact of World War II and the Occupation of Austria on the Mental Health in the Elderly. Post-traumatic Stress Disorder and Current Psychopathology………………………………………161

Katinka Schweizer, Franziska Brunner, Benjamin Gedrose, Hertha Richter-Appelt:

Understanding Traumatic Stress in Sexual Minorities: Coping with Atypical Sex Development, Gender Variance and Intersex Treatment………………………………………162

Dawid Scigala:

Seeking Sensation, Gender and the Psychological Tendency to Risky Behavior among Drivers who Commit Traffic Offenses Chronically. The Analysis of the Example of the Causes and Victims of Traffic Accidents………………………………………162

Sandra Sendas, Angela Maia:

The Life Stories of Portuguese Colonial War Veterans with and wihout PPST………………………………………163

Heide Siller, Barbara Juen:

Are Reactions to (Traumatic) Stress Gendered?………………………………………163

Tânia Silva, José Rocha, Elisabete Ferreira, Catarina Gonçalves, Fábio Moreira:

Comorbidity between Complicated Grief, Post-traumatic Stress Disorder and Depression………………………………………163

Keti Simmen-Janevska, Sandy Krammer, Andreas Maercker:

Childhood Adversities and Health in Old Age: The Role of Motivational Competencies………………………………………164

Helen Sinclair, Marianne Moutray, Sandra Peake, Marie-Therese O'Hagan:

Integrating Formal and Experiential Learning Methodologies in a New Undergraduate Programme in Trauma Studies in a Post- Conflict Society in Northern Ireland: Issues and Dilemmas.………………………………………164

Johan Siqveland:

Posttraumatic Stress and Chronic Pain – A Longitudinal Study of Chronic Pain Patients………………………………………164

Annemarie J.M. Smith, Wim Chr. Kleijn:

Complex Trauma, Quality of Life and Coping by Refugees Applying for Daytreatment………………………………………165

Ewelina Smoktunowicz, Roman Cieslak, Beata Basinska:

The Effects of Secondary Traumatic Stress on Work Engagement and Job Burnout: Testing the Mediating Effect of Self-Efficacy and the Moderating Effect of Mortality Salience………………………………………165

Virgiana Sousa:

Construction and Validation of Complicated and Healthy Grief Prototype Narratives………………………………………165

Katharina Stigler:

Traumatic Experiences in Childhood and their Duration into Adulthood………………………………………166

Daniela Strasser, Bettina Schiller, Daniela Wintner, Elisabeth Zeilinger, Brigitte Lueger-Schuster:

Children of War – Impact of World War II and the Occupation Period in Austria on Psychological Well-being among the Elderly Population. Traumatic Experiences during War and PTSD………………………………………166

Magdalena Swirkula, Jerzy Trzebinski:

Alexithymia, Sense of Coherence, Basic Hope and Acute Stress Disorder………………………………………166

Anja Symmank, Ilona Croy, Thomas Hummel, Schellong, Julia:

Treatment Follow-Up in Patients with Complex Posttraumatic Stress Disorder Using Olfactory Examinations………………………………………167

Zsuzsanna Tanyi:

Diagnosis of Cancer: A Source of Posttraumatic Growth………………………………………167

Sanja Temnik, Maja Smrdu:

Growing up with a Mother who Suffers from Depression: A Case Study………………………………………167

Marilena Tettamanzi, Fabio Sbattella:

Stress or Well Being in Health Operators: A Research about Italian Nurses………………………………………168

Julia Ting, Steeve LePage:

A Canadian Approach to Serving Veterans and Military Personnel with Operational Stress Injuries………………………………………168

Tracey Vick, Victoria Hampton, Robert Newcombe, Jonathan Bisson:

Self-Report Questionnaire Performance in Survivors of Critical Illness Admission………………………………………168

Daniela Wintner, Bettina Schiller, Daniela Strasser, Elisabeth Zeilinger, Brigitte Lueger-Schuster:

Children of War – Consequences of World War II and the Occupation of Austria on the Mental Health of the Elder Generation. An Analysis of Risk and Resilience Factors Concerning PTSD.………………………………………169

Charlotte Wittekind, Christoph Muhtz, Michael Kellner, Steffen Moritz, Lena Jelinek:

Neuropsychological Functioning and Biased Information Processing in Posttraumatic Stress Disorder (PTSD) Following Displacement After World War II………………………………………169

Banu Yilmaz, Ayla Hocaoglu:

Long Term Effects of the Last Turkish Migration (1989) from Bulgaria to Turkey: An Investigation in Terms of World Assumptions, Resilience, Perceived Social Support, and Life Satisfaction………………………………………170

Jerzy Zadecki:

Chronic PTSD and Racial Profile………………………………………170

Ayten Zara:

Working Towards Ending Child Sexual Abuse in Turkey………………………………………170

Ana Laura Zavala Guillén, Lorena Ríos:

"Neither Alive, nor Dead": Disappearance and Restitution of the Identity of Kidnapped Children during the last Argentine Dictatorship………………………………………171

Elzbieta Zdankiewicz-Scigala:

Seeking Sensation, Hardiness and Sense of Coherence as Moderators Post-Traumatic Growth in Soldiers during Peacekeeping Missions………………………………………171

Katarzyna Zukowska, Roman Cieslak:

The Effect of Social Support on Secondary Traumatic Stress and Posttraumatic Growth: The Mediating Role of Self-Efficacy………………………………………171

Abbasi Moslem, Samadzadeh, Mehdi; Shahbazzadegan, Bita, Ardabil University

5. POSTER PRESENTATIONS

The Comparison of Executive Function in Children with Learning Disorder and Normal Children in Arak

The aim of this study was the comparison of executive function in children with learning disorder and children without learning disorder in Arak. The samples of the study consisted of children with learning disorder aged 9 to 15 years from several junior high schools and an education center for intellectually disabled children and normal children of junior high schools. The samples consisted of 40 male students, 20 participant had learning disorder and 20 participant without who were chosen randomly. For collecting data, Raven's on colored matrices, Connors' rating scale for ADHD, flowers and hearts test, visual research test and Simon's test ? and ?? were used. For data analysis, MANOVA test and LSD test were used. The results showed that there was a significant difference between the executive function of children with and without learning disorder (< 0/00). There was also a significant difference between the inhibitions function and working memory in the two groups.

Aker Tamer, Kocaeli University; Yilmaz, Banu, Ankara University; Gokler Danisman, Ilgin, Maltepe University; Karanci, Nuray, Middle East Technical University

Capacity Building for Disaster Psychosocial Services: A Collaborative Project

Traumatic stress in the case of complex emergencies is usually an outcome of the cumulative impact of multiple disaster stressors and their subsequent secondary effects. Considering the effects of disasters on individuals and their communities, the need for developing and implementing culturally-relevant disaster psychosocial intervention models becomes clear. Turkey and Pakistan are two countries which have gone through traumatic experiences due to different types of disasters through out their history. Considering the historical bounds and socio-cultural similarities in between, Turkey and Pakistan agreed upon a collaboration to develop a disaster psychosocial program applicable in both countries. This project aims at developing a comprehensive model that incorporates psychosocial efforts starting from preventive pre-disaster planning and preparedness to post-disaster relief work and long-term interventions, congruent with the socio-cultural structure of both Turkey and Pakistan. It is believed that this project provides a chance of a mutual capacity building and development of first rate disaster psychosocial services in both countries. This collaboration can also function as a model for other eastern countries in dealing with disasters. In this presentation we want to present the outcomes of the first two years of this collaborative project between Turkey and Pakistan.

Authors’ note: This research is a part of an international scientific project supported by the Scientific and Technological Research Council of Turkey.

Alisic Eva; Van Schaijk, Maaike; Strijker, Jet; Groot, Arend, Psychotrauma Center for Children and Youth

Children and Fatal Domestic Violence

Children who survive fatal domestic partner violence lose both their parents and their home at once: one parent is killed, the other parent is detained (or sometimes has committed suicide), and it is impossible to stay at home due to lack of caregivers and/or sealing of the house. We examined the cases of children whose biological father killed the biological mother or vice versa (N = 25 families, concerning 38 children). Two researchers coded event characteristics, child characteristics, and mental health care advice from clinical assessment reports. The majority of the children (84%) had been confronted with the death of their mother by their father. For only a few children (17%) it was clear that they had not been present at the time of the killing; many children have possibly seen or heard the death of their parent. The children showed a variety of posttraumatic reactions, including severe sleeping problems, reexperiencing, feelings of guilt, feeling unsafe, posttraumatic play, behavior problems, and emotional numbing. In most cases (57%) trauma-focused therapy was suggested for the child (e.g., Eye Movement Desensitization and Reprocessing). The findings point to the seriousness of the symptoms of children who are confronted with fatal domestic violence. Mental health care advice and practical guidelines will be further discussed.

Almeida Fernando; Santos, Anita, Instituto Superior da Maia

Homeless in Portugal – An Exploratory Study

In the Universal Declaration of Human Rights (1948) (Article 25, n° 1) everyone has the right to have an adequate housing. Homeless are those individuals that live in public space, in an emergency shelter, or in precarious conditions, or even in temporary housing. In this sense, homeless are individuals suffering from privation of their human rights. The reasons can be due to lack of habitation, familiar problems, financial difficulties, unemployment or even mental illness. Our work focuses on this last reason, specially the psychopathology symptoms and substance abuse that homeless in the urban zone of Oporto, Portugal, present. Until now, there is no research indicating the psychopathology disorders in this population, so this is an exploratory work. Our sample of 100 homeless individuals is one of convenience, since it was collected in institutions that provide support to the homeless. Firstly, a socio-demographic questionnaire was applied. Then we applied the BECK Depression Inventory-II and Brief Symptom Inventory to address psychopathological symptoms. Michigan Alcohol Screening Test and Drug Use Disorders Identification Test were applied to assess alcohol and substance abuse. Having in mind that we do not assess directly the traumatic stress symptoms, it will be interesting to identify specific symptoms related to this disorder in this population. Preliminary results will be presented and debated. Future research addressing traumatic stress will be considered, as well as implications to practice.

Andersen Tonny, National Center for Psychotraumatology; Andersen, Per, Anaesthesia-Intensive Care and Pain Center South; Elklit, Ask, National Center for Psychotraumatology

The Traumatized Chronic Pain Patient-Prevalence of PTSD in Two Consecutive Samples Referred to Rehabilitation

Prevalence rates of PTSD in chronic pain patients referred to tertiary pain rehabilitation range from 9.5% to 34.7%. Studies are limited by an emphasis on samples with only one pain diagnosis and the use of inadequate diagnostic tools not in accordance with the DSM-IV criteria. Correctly classifying chronic pain patients with PTSD is important because the co-morbidity is found to compromise treatment success. Avoidance behavior and pain sensitisation are possible mechanisms maintaining the two disorders. Objective: To assess the prevalence of PTSD in patients referred consecutively to pain rehabilitation and to investigate whether specific pain diagnoses and sensitisation were significantly related to PTSD. Design: Data were collected from two multidisciplinary pain centres. A total of 304 patients were assessed for PTSD with the Harvard Trauma Questionnaire and for pain sensitisation at admission by anaesthetists. Results: 23% fulfilled the DSM-IV criteria for PTSD. Traffic accidents were the third most reported traumatic incident and accounted for one fourth of the total PTSD cases. Neither, gender nor pain diagnoses were associated with PTSD. Pain sensitisation were associated with PTSD symptoms, p < .001. Conclusions: The high prevalence of PTSD cases emphasise the importance of screening for PTSD at admission for tertiary pain rehabilitation.

Armour Cherie, University of Southern Denmark co. University of Ulster; Layne, Christopher, UCLA/ Duke University; Naifeh, James, Uniformed Services Bethesda; Shevlin, Mark, University of Ulster; Elhai, Jon, University of Toledo

Assessing the Factor Structure of Posttraumatic Stress Disorder Symptoms in War-Exposed Youths with and without Criterion A2 Endorsement

Posttraumatic stress disorder's (PTSD) tripartite factor structure proposed by the DSM-IV is rarely empirically supported. Other four-factor models (King et al., 1998; Simms et al., 2002) have proven to better account for PTSD's latent structure; however, results regarding model superiority are conflicting. The current study assessed whether endorsement of PTSD's Criterion A2 would impact on the factorial invariance of the King et al. (1998) model. Participants were 1572 war-exposed Bosnian secondary students who were assessed two years following the 1992–1995 Bosnian conflict. The sample was grouped by those endorsing both parts of the DSM-IV Criterion A (A2 Group) and those endorsing only A1 (Non-A2 Group). The factorial invariance of the King et al. (1998) model was not supported between the A2 vs. Non-A2 Groups; rather, the groups significantly differed on all model parameters. The impact of removing A2 on the factor structure of King et al. (1998) PTSD model is discussed in light of the proposed removal of Criterion A2 for the DSM-V.

Bak Rikke Sophie; Hareskov Jensen, Anja; Madsen, Elena, Aarhus University Hospital

Time Passes but the Trauma Stays – The Long-Term Consequences of Rape

Introduction: A number of public Sexual Assault Centres have been established in Denmark in the past ten years. However, due to a lack of financial resources most centres are only able to offer help to survivors within the first week after the assault. Thus, as many survivors make initial contact with the centre months and years after the assault, they are not eligible for help despite their severe psychological suffering. Objective: To identify the psychological long-term consequences of sexual assaults for women who contacted the centre at a minimum of six months post assault. Method: Women (N = 59) aged 15-61 years, participated in the project (M = 26; SD = 12.0). The women completed a number of standardised questionnaires in relation to their degree of traumatization. Information regarding the demographic characteristics of the sample was also collected. Results: 76% had experienced completed rape, 7% other kinds of sexual assaults 64% of the assaults were perpetrated by a person acquainted to the survivor, 21% by a partner or ex-partner, 14% by a stranger 72% of the women met all three criteria for PTSD. Conclusions: In accordance with research in the area, the current study demonstrated that a sexual assault results in severe negative psychological consequences which do not disappear unaided over time. Hopefully in the future the resources of the Sexual Assault Centres will meet the demand and thus be able to provide the professional help to all those in need.

Bak Rikke Sophie; Hareskov Jensen, Anja; Madsen, Elena, Aarhus University Hospital

The Effect of Psychological Treatment on Trauma Symptoms

Introduction: Women who have experienced a sexual assault are regarded as high risk cases for suffering severe mental and physical difficulties particularly if they do not receive the appropriate help. A study at the Sexual Assault Centre in Aarhus, Denmark, showed that almost 75% of women who had experienced a sexual assault were traumatized. Objective: To evaluate the psychological effect of a cognitive treatment programme in relation to a sample of women (N = 47) who have experienced a sexual assault, at a minimum of six months prior to the treatment commencing. Method: The women participated in a cognitive treatment program 10 times either in groups (n = 25) or individual sessions (n = 22). A questionnaire was filled out by the women before treatment, directly post-treatment and at follow-up six months post-treatment. The degree of traumatization (i.e. PTSD-symptoms) was measured by using The Trauma Symptom Checklist and the Harvard Trauma Questionnaire. The differences before and post-treatment were assessed by using related t-test. Results: The statistical analysis showed a significant decrease in all PTSD symptom groups. This significant decrease was maintained in the follow-up study (N = 13) six months post-treatment. Conclusion: The study indicated that the traumatized women benefit from psychological treatment. Therefore, this study suggests that every individual who has experienced a sexual assault should be offered the appropriate psychological treatment. Hopefully, this will be implemented in clinical practice in the future.

Berth Hendrik, University Hospital Carl Gustav Carus; Böttche, Maria, bzfo-Behandlungszentrum für Folteropfer Berlin e.V.; Knaevelsrud, Christine, Free University of Berlin; Kuwert, Philipp, Ernst-Moritz-Arndt-Universität Greifswald

Course of Affects in an Online-Therapy for Traumatized Persons of Word War 2

Background: More than 65 years after the end of World War 2, there are numerous persons in Germany, who were traumatized through events like rape, bombing or escape. The internet site lebenstagebuch.de offers an Integrative Testimonial Therapy (ITT) for those people. The therapy altogether covers 11 sessions of writing, in which, besides the trauma, further life-events are focused. Methods: In context of the therapy, online-written texts were analyzed for anxiety affects with the Dresden anxiety dictionary, a German computer version of the Gottschalk-Gleser content-analysis of speech. The texts of N = 50 persons (mean-age: 71.1 years, 68% female) who completely attended and finished the therapy so far, were included. Results: The different therapy phases are displayed significantly, analyzing the scales death anxiety, mutilation anxiety, shame anxiety, diffuse anxiety and the total score of the Gottschalk-Gleser analysis. The highest affective load can be seen for the texts describing the traumatic events in the beginning of the therapy and the final letter, which addresses oneself as the former child. Discussion: The content-analytic findings support the so far collected questionnaire-based data for the effectiveness of the ITT for elderly traumatized persons. The results of the content-analysis can be used for identification of notably burdened persons or therapy episodes.

Bride Brian; Kintzle, Sara; Vandenberg, Robert; Roman, Paul, University of Georgia

Structure of Secondary Traumatic Stress Symptoms in Substance Abuse Counselors

Substance abuse counselors (N = 851) employed in community treatment programs affiliated with the National Institute (USA) on Drug Abuse Clinical Trials Network completed the Secondary Traumatic Stress Scale. We used M plus to conduct confirmatory factor analyses of four alternate models of the structure of secondary traumatic stress symptoms. The models tested included: (1) a single factor model; (2) a three-factor model congruent with the DSM-IV-TR criteria for PTSD; (3) a four-factor model congruent with Simms et al.'s (2002) model of PTSD; and a four-factor model congruent with King et al.'s (1998) model of PTSD. Maximum likelihood estimation was used for identifying parameter values and a variety of fit indices (i.e., SRMR, RMSEA, CFI, NNFI, IFI, and AIC) were used to estimate model fit. Results revealed Models 2 (DSM-IV-TR) and Model 4 (King et al.) to be mis-specified due to highly correlated factors suggesting a lack of fit for each of these models. Models 1 (single factor) and 3 (Simms et al.) fit the data well as indicated by fit indices, parameter values, and R 2 values. These results support the continued use of the STSS total score in research on secondary traumatic stress. However, future research should continue to examine the underlying factor structure of secondary traumatic stress, as there is evidence that it may vary in different populations.

Carvalho Fernando Silvia, Evangelisches Krankenhaus Bielefeld; Beblo, Thomas; Schlosser, Nicole; Terfehr, Kirsten; Löwe, Bernd, University Medical Center Hamburg-Eppendorf & Schön Klinik Hamburg-Eilbek; Wolf, Oliver Tobias, Ruhr-University Bochum; Spitzer, Carsten, University Medical Center Hamburg-Eppendorf & Schön Klinik Hamburg-Eilbek; Driessen, Martin, Evangelisches Krankenhaus Bielefeld; Wingenfeld, Katja, University Medical Center Hamburg-Eppendorf & Schön Klinik Hamburg-Eilbek

The Impact of Childhood Trauma on Emotion Regulation in Borderline Personality Disorder and Major Depression

Early life stress is suggested to play a critical role in the development of Borderline Personality Disorder (BPD) and Major Depressive Disorder (MDD), but the underlying mediating factors remain not fully understood. This study aimed to investigate emotion regulation difficulties, childhood trauma, and their associations in a sample of BPD (n = 49) and MDD (n = 48) patients and 63 healthy control subjects. Multiple regressions were used to evaluate the predictive value of childhood trauma on self-reported emotion regulation. The results support an association between maltreatment experiences and emotion regulation difficulties. More specific, emotional neglect was associated with less frequent use of cognitive reappraisal, which is considered to be an adaptive strategy to regulate emotions. We discuss the theoretical and clinical relevance of these findings.

Castro Sofia; Rocha, José Carlos; Silva, Virgínia, UnIPSa

Multiple Losses Effects on Complicated Grief and Emotional Regulation

Multiple losses can have an impact in grief duration and in ability of effective use of coping strategies. The effects of the number of traumatic events on post-traumatic stress (PTS) are well known, however, there is no evidence of effects with multiple losses on complicated grief (CG) and emotional regulation (ER). The present study aims to evaluate the impact of the number of losses on CG, on post-traumatic stress and on ER. The design of the study is comparative and predictive with CG and ER as dependent and the number of past losses as independent variables. The sample consists of 140 participants (university students and elders sub-samples, age M = 38.7, SD = 26.6). Instruments used are a socio-demographic questionnaire, the Complicated Grief Inventory, the Impact of Events Scale–Revised and the Difficulties in Emotion Regulation Scale. We used ANOVA to compare groups with different number of losses concerning its effects on ER, CG and TS; in both sub-samples, the number of losses increased and, through multiple linear regression, it predicts CG and PTS. Number of losses also predicts ER (Difficulties Engaging in Goal-Directed Behavior) in the university student sub-sample but there is no evidence of this effect in the total sample. These results show the importance of number of losses on symptomatology of CG and PTS. Future researches can address the moderated role of ER in this process.

Castro Sofia, UnIPSa

Multiple Losses effects on Complicated Grief and Emotional Regulation

Multiple losses and the time between them can have an impact on grief duration and on the effective use of coping strategies. It is well known that the number of traumatic events effects post-traumatic outcomes; however, there is no evidence of such effects with multiple losses on complicated grief (and emotional regulation.The present study aims at evaluating the impact of the number of losses on complicated grief, on post-traumatic stress and on emotional regulation. In a two-group design the effect of multiple losses on complicated grief and emotional regulation was assessed. The samples to evaluate the emotional regulation outcomes consisted of 100 university students (age M = 22.1, SD = 2.02). To evaluate complicated grief and post-traumatic stress 140 people (Age M = 38.7, SD = 26.6) were assessed. Instruments used were a socio-demographic questionnaire, the Complicated Grief Inventory, the Impact of Events Scale–Revised and the Difficulties in Emotion Regulation Scale.

We used ANOVA to compare the groups regarding the different numbers of losses and their effects on emotional regulation, complicated grief and traumatic stres. In both groups, high numbers of losses predicted complicated grief and traumatic stress. However, this did not apply for emotional regulation. In the student sample the number of losses best predicted traumatic stress while in other sample complicated grief was best predicted by multiple losses.

Christiansen Dorte; Elklit, Ask, National Centre for Psychotraumatology

Secondary Victims of Rape

The present study examined the impact of sexual assault on 107 secondary rape victims, including both family members, romantic partners, and friends of male and female rape victims. We found a high degree of traumatic impact in the sample with an estimated 24% of the respondents meeting criteria for a diagnosis of posttraumatic stress disorder (PTSD). A more recent assault, low efforts to support the PV, recurrent thoughts about having been able to prevent the assault, lack of social support, and feeling let down by others were all predictive of higher PTSD severity.

Corrêa Flávia Sofia; Rocha, José Carlos, UnIPSa

Traumatic Symptoms and Emotion Regulation as Predictors of Marital Adjustment after Perinatal Loss

The perinatal loss is the death of the fetus in the last weeks of pregnancy or the death of the newborn in the first weeks after delivery. It is a paradoxical situation and difficult to accept, as the baby is born and dies unexpectedly. In these situations, couples are confronted with intense stress and it is important to concern with the coping process and emotion regulation.

The purpose of this research is to investigate which factors predict marital adjustment of perinatally bereaved parents. The study is transversal and multi-centric, using the Dyadic Adjustment Scale (DAS), the Scale of Emotion Regulation Difficulties ( EDRE), Impact of Events Scale-Revised (IES-R) and the Perinatal Grief Scale (PGS). We used a multiple linear regression, in order to determine which factors predict marital adjustment, because perinatal loss can strain the relationship between parents. Both parents may describe higher levels of marital dissatisfaction than expected. There is evidence that perinatal loss may be associated with poorer psychological health outcomes, particularly with PTSD symptoms (> 25%). Long-term sequelae of perinatal bereavement may include parental discord and separation, possibly related to PTSD-symtpoms. Traumatic effects of perinatal bereavement on couples and its relation with emotion regulation are discussed aiming for a better evaluation and intervention.

Crespo Maria; Gómez, Mar, University of Madrid

Post-Traumatic Stress Disorder: Beyond the Re-Experimentation, Avoidance and Affective Numbing, and Physiological Activation

As referred to in various studies, persons living, witnessing or having knowledge of a traumatic event may have post-traumatic symptoms apart from the ones included in the criteria for posttraumatic stress disorder (PTSD), that is, re-experimentation, avoidance and affective numbing, and physiological activation according to DSM IV-TR. Even the APA in its recent proposal for the fifth edition of the DSM, identified the presence of other post-traumatic symptoms as guilt, anger, or shame. The present study assessed the presence of these symptoms in victims of traumatic events. Participants were 175 people aged over 18, who had suffered at least a traumatic event one month before assessment. The posttraumatic symptoms were measured with the Global Assessment of Posttraumatic Stress (Evaluación Global Estrés Postraumático, EGEP), an instrument developed and validated by this study research team. This instrument also includes 9 symptoms related to feelings of guilt or responsibility, mistrust, unreality, depersonalization and negative valuation of oneself, all together named Subjective Clinical Symptoms (SCS). Data show the presence and intensity of the SCS as well as their relationship with the post-traumatic symptoms described in the DSM-IV-TR classification. Results are discussed in reference to the DSM V proposal.

Crespo Maria; Arinero, Maria, University of Madrid

Psychological Treatment for Women Victims of Violence by Their Intimate Male Partner: The Differential Effect of Individual and Group Therapy

Group therapy has been considered a good alternative for women victims of violence by their intimate male partner, since it could provide possibilities to normalize symptoms as well as to break their isolation state. On the other hand, individual therapy could fit women demands and scheduling constraints. This study compares the long-term efficacy of a brief psychotherapeutic cognitive-behavioral program for female victims of violence by their intimate partner in individual vs. group format. The intervention program included: psycho-education, breath control, training to improve self-esteem, cognitive restructuring, problem-solving, planning pleasant activities, exposure therapy and relapse prevention. 53 battered women were randomized into one of two formats of the same programs: group one (n = 28) and individual (n = 25). The treatment was carried out in 8 weekly sessions. Measures of posttraumatic symptoms, anxiety, depression and self-esteem were analyzed at pre- and post-treatment, and at 1-, 3-, 6- and 12-months follow-ups. Results show a pronounced decrease of posttraumatic, depressive and anxiety symptoms, which maintained in the different measure moments, with scarce difference between the two formats of the programs though the adherence was better in the individual format. The results and their clinical implications are discussed.

Dembinska Edyta; Rutkowski, Krzysztof; Müldner-Nieckowski, Lukasz; Sobanski, Jerzy; Murzyn, Agnieszka; Mielimaka, Michal, agiellonian University Medical College Kraków

Schizophrenia as a Marital Stressor – Marital Functioning and Coping Mechanisms in Marital Crisis

A large number of research indicates that health problems are significant marital stressors. It is suggested that different health problems pose different challenges for couples. Among other possible health stressors individual psychopathology plays an important role in marital functioning. It interferes with important aspects of the marriage such as skillful communication, adaptive emotional regulation and the ability to be mentally and emotionally available and supportive. Research suggests that greater levels of psychopathology are associated with lower levels of marital satisfaction.

The aim of the study was assessment of the marital functioning and the functioning of the whole family in a marital crisis situation where one spouse suffered from schizophrenia. Two groups of couples seeking marital therapy were compared: couples where one spouse had schizophrenia and couples in which neither spouse had psychiatric or somatic illness. The main research tool was the Polish version of Family Assessment Measure III by M. Cierpka. Assessment of both marital and family functioning covered the following aspects: Task Accomplishment, Role Performance, Communication, Affective Expression, Emotional Involvement, Control, and Values & Norms. Families of people suffering from schizophrenia are distinguished by better (than in the case of healthy families in crisis) functioning of the marriage in most of aspects under research as well as in some aspects of the family functioning.

Surprisingly in situation of marital crisis having a spouse suffering from schizophrenia is associated with higher levels of marital satisfaction. Probably couples dealing with major mental illness have more efficient coping strategies e.g. they turn for professional support before the marital crisis escalates.

Dias Aida, Utrecht University; Sales, Luisa, Centro de Trauma; Kleber, Rolf, Utrecht University

Relations between Childhood Trauma and Psychological Symptoms in the Portuguese Population

Childhood Trauma has been studied as an important risk factor for adult suffering. In recent years, empirical research has shown that childhood trauma can harm neurologic and psychosocial functioning and lead to psychopathologic vulnerability. This work aims to explore the relations between childhood trauma, assessed with the Childhood Trauma Questionnaire, and psychological symptoms, assessed with the Brief Symptom Inventory, in a group of 1200 subjects from the Portuguese general population. Also studied will be PTSD symptoms caused by other traumatic events in addition to childhood trauma. These data were collected with the Posttraumatic Diagnosis Scale and the Impact Event Scale Revised. The main goals of this research are the identification of the most common childhood traumas in the Portuguese population and the analysis of psychological consequences, as well as the investigation of the effects of child traumas on post-traumatic stress symptoms, when subjects are exposed to other traumas. Preliminary results pointed the emotional abuse as the most identified form of childhood trauma by the subjects. Emotional abuse is positively correlated with the psychological symptoms. Significant higher scores of childhood trauma were also found in subjects that reported PTSD symptoms caused by other traumatic injuries.

Ditlevsen Daniel N.; Elklit, Ask, National Centre for Psychotraumatology

The Trauma Type Related Variance of Gender Difference in PTSD Prevalence: A Meta-analysis of 18 Nordic Convenience Samples

The aim of the study was to examine a possible trauma type related variance in the gender difference of posttraumatic stress disorder (PTSD) prevalence. An analysis was conducted on 18 convenience sample studies including data from a total of 5220 participants. The Harvard Trauma Questionnaire – part IV was used to assess PTSD and subclinical PTSD. Cohen's d was used to measure variance in gender differences. Trauma types included disasters and accidents, violence, loss, malignant and non-malignant diseases. The results showed an overall gender difference in PTSD prevalence similar to previous findings. Thus, women had a two-fold higher prevalence of PTSD than men. Dimensional measures were associated with higher effect sizes. Gender differences in subclinical PTSD were larger than differences in PTSD. Gender differences were highest in the disaster and accident trauma type, followed by loss and non-malignant diseases. In violence and malignant disease, the differences were smallest. The findings support the existence of a trauma type related variance in gender differences in PTSD prevalence.

Elklit Ask; Steenberg, Lone M; Hansen, Tine, National Centre for Psychotraumatology

School Bullying: A Cross-Cultural Study of Prevalence and Psychological Consequences

Bullying is known to be a serious problem amongst school children, but few studies have investigated variables associated with bullying, the relationship between these variables and only a few studies have been cross-cultural. The data was collected from three national representative probability samples (Denmark, Lithuania, Iceland) and one total population sample (Faroe Island); in total 1,466 students with a mean age of 14.2 years (SD = 1.52). The prevalence of bullying, the relationship between bullying and demographic variables, attachment, basic assumptions, negative affectivity, somatization, and PTSD, and the relationship among these variables were analyzed. The prevalence of victims of bullying in the total sample was 24.6%. Cross-cultural differences in the prevalence of being bullied were found. Adolescents of single parents had increased risks of being bullied. Being bullied correlated significantly with fearful attachment and lower self-worth, and bullied victims had significantly more symptoms of negative affectivity, somatization, and PTSD.

Elklit Ask, National Centre for Psychotraumatology; Shevlin, Mark, University of Ulster

Sexual Victimization and Anxiety and Mood Disorders: A Case Control Study Based on the Danish Registry System

This study aimed to examine the relationship between rape and subsequent psychiatric diagnosis of anxiety or mood disorders. Data from the Danish Civil Registration System and the Danish Psychiatric Central Register were used to identify a sample of females who had visited a centre for rape victims during an index year and their subsequent psychiatric records were compared to a matched control group. While controlling for demographic variables and previous psychiatric disorders, the effect of sexual victimization increased the likelihood of a subsequent diagnosis of an anxiety disorder (OR 6.3) but not a mood disorder (OR 1.6).

Elklit Ask, National Centre for Psychotraumatology; Jensen, Ditte, NOOR

Trauma Exposure and PTSD in Indian Adolescents

Objective: To investigate the prevalence of exposure to potentially traumatic events and the prevalence of Posttraumatic Stress Disorder (PTSD) among Indian adolescents from Pune city. Method: A sample of 411 Indian 9 th graders, (M = 14.15 years) from two schools, reported exposure to 20 potentially traumatizing and distressing events. Results: 70% of the females and 85% of the males had been exposed to or witnessed at least one traumatizing or negative life event. The most common events were: death of someone close, traffic accident, serious illness, witnessing other people being injured or killed, and coming close to being injured or killed. The lifetime prevalence of PTSD was 10% but another 16.5% reached the level of subclinical PTSD. The males reported a higher exposure (direct as well as indirect) than the females to all the events, but no significant gender difference was found in the life time prevalence of PTSD. Living in a single-parent household meant increased risk of developing PTSD and a significant difference in the PTSD prevalence was found between the two schools in the study.

Ferreira Elisabete; Rocha, José; Silva, Tânia; Gonçalves Catarina; Moreira, Fábio, UnIPSa

Complicated Grief, PTSD and Emotional Regulation in Parents who Lost a Child

The death of a child is a massive traumatic event, which can be associated with serious mental health problems and predicts higher levels of complicated grief compared to other losses. The knowledge about the relative effect of emotional regulation difficulties may influence future interventions. The aim was to describe the prevalence of complicated grief and PTSD, and its relationship to emotional adjustment difficulties in parents who lost children. We evaluated two groups: 110 bereaved adults and 19 parents who lost children (73.7% mothers and 26.3% fathers).The Inventory of Complicated Grief, the Impact of Event Scale-Revised and the Difficulties in Emotional Regulation Scale were used. We observed 94.7% of participants who lost children suffering from complicated grief (ICG > 24) and PTSD (IES-R > 34). Dimensions of difficulties in emotional regulation have high correlations with the symptoms of both complicated grief and PTSD: Nonacceptance of Emotional Responses, Difficulties Engaging in Goal-directed Behaviors, Impulse Control Difficulties, Limited Access to Emotional Regulation Strategies and Lack of Emotional Clarity,with r values between .49 and .79. In a multiple linear regression, difficulties in emotional regulation predicted complicated grief (R 2 = .558) and PTSD (R 2 = .456) for parents who lost children. These results allow us to verify the high prevalence of comlicated grief and PTSD, and the importance of difficulties in emotional regulation in predicting complicated grief in bereaved parents.

Fohrafellner Renate; Lueger-Schuster, Brigitte, University of Vienna

Neuropsychological Functions in Correlation with Posttraumatic Stress Symptoms in Unaccompanied Refugee Minors

In the study “Neuropsychological functions in correlation with posttraumatic stress symptoms in unaccompanied refugee minors” the correlation between posttraumatic stress symptoms and selective attention as well as spatial visualization ability in unaccompanied refugee minors was investigated. Additionally the possible co-morbid influence of anxiety and depressive symptoms was determined. Participants were unaccompanied refugee children aged 15 to 17 years; adolescents in youth centres served as control subjects. The data collection was done with Stressful Life Events Questionnaire (SLE) for number of experienced stressful life events, Reactions of Adolescents to Traumatic Stress (RATS) for posttraumatic stress symptoms, Hopkins Symptom Checklist-37A (HSCL-37A) for psychosocial symptoms, Frankfurter Aufmerksamkeitsinventar (FAIR) for selective attention and Rey-Osterrieth Complex Figure Test (RCFT) for spatial visualization ability. Results indicated that although unaccompanied refugee minors had significant higher posttraumatic stress symptoms than the controls, they achieved higher scores regarding the quality of attention. Within the unaccompanied refugee children group a significant negative correlation of posttraumatic stress symptoms with the “marked value”, which indicates self-control, and the quality of attention was found. Anxiety and depression had influence only on the “marked value”. Concerning spatial visualization ability no group differences or correlations were found. All participants reached regarding selective attention and spatial visualization ability on average results within the norm. The reduction of quality of attention by posttraumatic stress symptoms needs more attention.

Frade Bruno, UnIPSa

The Multidimensional Nature of Traumatic Events Impacts

Living through traumatic events transforms people in a way that they realize what post-traumatic stress feels like. Also, there are instruments that give meaning to what sometimes does not seem to be so clear. The Impact of Event Scale – Revised (IES-r) is frequently used to evaluate traumatic events on clinical and research contexts, but item increments and the evolution of post-traumatic stress construct and the factorial structure has nurtured the debate in recent years with controversy. The first version of IES by Horowitz (1979) integrated symptoms of Avoidance and Intrusion, Weiss and Marmar version (1997) integrated Hyperarousal symptoms and Rocha (2006) in a Portuguese validation study considered a latent factor called Emotional Numbing. In consideration of this discussion we attempted to understand the factorial instability of this instrument in a large and diverse sample (N = 639) including university students (n = 373); people addicted to drugs (n = 224) and elders (n = 40) aged 17 to 96 years (M = 29.43; SD = 16.28). Analyses demonstrated different factor solutions from those found in the literature and will be discussed as well as explanations are explored, taking into account sub-samples diversity. These results support a relevant discussion on the multidimensional nature of the impact of traumatic events in different groups that may justify new research approaches.

Frankfurt Sheila; Frazier, Patricia, University of Minnesota

Identifying Longitudinal Symptom Trajectories following Sexual Assault Using Latent Growth Curve Analyses

Few longitudinal studies have assessed change in symptoms over time following sexual assault. Most studies of post-assault outcomes report group means; however, this masks great individual differences in symptom trajectories. Recent research by Bonanno (e.g., Bonanno, 2004) has found four common trajectories of symptoms after traumatic events: chronic and severe symptoms (10-30% of people), delayed onset of symptoms (5–10%), a recovery trajectory in which symptoms abate over time (15-35%), and a resilient trajectory in which symptoms remain at low levels over time (35-55%). Thus, resilience is the most common. This is the first study to use latent growth curve analysis to identify symptom trajectories following sexual assault. Data were collected from a community sample of female sexual assault survivors initially seen at hospital emergency rooms in Minneapolis, MN (N = 171). Participants were surveyed at 2 weeks, and 2, 6, and 12 months post-assault. Outcome measures assessed symptoms of PTSD, depression, anxiety, phobic anxiety, and hostility. As in other research, findings generally identified four classes of trajectories that differed markedly in terms of overall symptom levels and course of recovery over time. As in other research, the chronic distress class was generally the least common; the recovery/resiliency classes were generally the most common. Additional analyses will use m easures of prior sexual victimization to predict symptom trajectories.

Glück Tobias; Knefel, Matthias, University of Vienna

Perspectives on the Influence of Climate Change on PTSD and Traumatic Stress. Reviewing the Recent Literature on Climate Change Regarding Psychological Trauma

With this article we want to give an overview over the recent literature on climate change and mental health, identifying aspects which are related to traumatic stress and PTSD-causing factors. Although there is a growing body of research literature on the topic, it seems that there has been no review particularly looking at issues regarding the impact of natural disasters and other traumatic stressors related to climate change and traumatic stress (e.g. PTSD) in different populations. Using existing frameworks on climate change and mental health we will examine potential risk factors in terms of traumatic stress which will be of particular relevance in the future. Also we will embed postulated risk factors and pathways of traumatic stress in context of climate change into these theoretical models, assessing them for their quality and validity. With this article we want to contribute to an increasing body of knowledge about the psychotraumatic impact of a changing global climate. Emphasising this perspective may encourage policy makers, researchers and suppliers of mental health care alike to create improved reactions to these events and facilitate the adaption of effective interventions, preparing for future decades affected by climate change.

Gómez M. Mar; Crespo, María, University of Madrid

Posttraumatic Symptoms: How Do they Cluster? Towards a Revision of the Diagnostic Criteria for the PTSD

There is growing evidence of the problems of the present conceptualization and grouping of the posttraumatic symptoms in criteria of the diagnostic classifications, namely the DSM by the APA, based on experts’ consensus. In order to find the basic structure of posttraumatic stress disorder (PTSD), several researches have found quite different models applying the factor analysis procedure. Hence there are open questions yet to be adressed, such as how the 17 posttraumatic symptoms included in the APA criteria are grouped. Moreover, it would be relevant to inquire the relationship between these symptoms and some others, not included in the criteria, that have shown their clinical relevance (e.g. guilty feeling, shame, distrust…). The aim of this study is to analyze the dimensionality of the posttraumatic symptoms, considering both the symptoms included in the APA diagnostic criteria and other clinical subjective symptoms. Participants were 175 people aged over 18, who had suffered at least a traumatic event one month before assessment. The posttraumatic symptoms were measured with the Global Assessment of Posttraumatic Stress (Evaluación Global de Estrés Postraumático, EGEP) developed and validated by our team. Principal components factor analysis was applied. Results are discussed considering the PTSD criteria of the proposed DSM V revision.

Gómez M. Mar; Crespo, María, University of Madrid

Measure of Post-Traumatic Stress Disorder in Spain: Presentation of the Global Assessment of Posttraumatic Stress Questionnaire (Evaluación Global de Estrés Post-traumático, EGEP)

A review of the instruments currently available for assessment of post-traumatic stress disorder (PTSD) shows different problems: the vast majority does not asses all criteria proposed by the diagnostic classification DSM IV-TR; have been validated with a people subjected to very specific traumatic events; do not include other post-traumatic symptoms (not listed in the DSM); and do not establish a relationship between symptoms and the traumatic event. Moreover instruments saving these difficulties are highly demanding.

Having these problems in mind, the aims of the study were: to design a self-report measure for the diagnosis and characterization of PTSD in adults in Spanish; and to validate it with people that have suffered diverse types of traumatic events. The designed assessment tool, called EGEP, consists of 60 items and 3 sections: the first one refers to the assessment of the traumatic event; the second, evaluation of symptoms (both included in the diagnostic criteria and relevant and not included in them); and the third, the functioning level of the person. 175 people participated. Psychometric features, reliability, validity and diagnostic performance referring to the CIDI-PTSD section, are presented.

Gomez-Baya Diego; Paino, Susana, University of Huelva

The Influence of Thought Control Strategies on the Severity of PTSD Symptoms in a Sample of Battered Women

Purpose: A central focus in the literature on Post-traumatic Stress Disorder (PTSD) has been on identifying factors that contribute to the development and maintenance of symptoms. The purpose of this study was to analyze the influence of thought control strategies on the severity of PTSD symptoms in battered women. Methods: A cross-sectional study was carried out with a sample of 114 battered women, who were interviewed and were asked to complete the White Bear Suppression Inventory (Wegner and Zanakos, 1994), the Thought Control Questionnaire (Wells and Davies, 1994) and the Severity of PTSD Symptoms Scale (Echeburua, Corral, Amor, Zubizarreta and Sarasua, 1997). Results: Descriptive analyses showed a high severity of PTSD symptoms and a frequent use of thought suppression. On the one hand, independent samples t-tests indicated that women who were more likely to use distraction and less likely to use self-punishment and suppression, as strategies of thought control, reported less severe PTSD symptoms. On the other hand, logistic regression analyses showed that both self-punishment and suppression strategies predicted clinical severity of PTSD according to proposed cutoff points. Discussion: These results suggest the need to include specific modules related to thought control strategies in the psychological treatment for PTSD in battered women.

Gomez-Baya Diego, University of Huelva

Comorbid Posttraumatic Stress Disorder and Depression after Domestic Violence: Differences in Coping

Purpose: The aims were to analyze differences in severity of Posttraumatic Stress Disorder (PTSD) symptoms and maladjustment due to PTSD-depression comorbidity in women who had been exposed to domestic violence, and to explore the coping strategies that contribute to this comorbidity. Methods: A sample of 114 battered women, who received assistance in various institutions, was interviewed and asked to respond to Severity of PTSD Symptoms Scale (Echeburua, Corral, Amor, Zubizarreta and Sarasua, 1997), BDI (Beck, Rush, Shaw and Emery, 1979), Brief COPE (Carver, 1997) and Maladjustment Scale (Echeburua, Corral and Fernandez-Montalvo, 2000). Results: Descriptive analyses indicated that almost half of the sample presented PTSD-depression comorbidity. ANOVAs showed that the group with PTSD-depression comorbidity reported more severe PTSD symptoms and more maladjustment. Discriminant analysis indicated that positive reframing, self-distraction and self-blame, significantly distinguished between comorbid and non-comorbid groups. Lastly, MANOVA showed that the group with PTSD-depression comorbidity was less likely to use positive reframing and self-distraction, and more likely to use self-blame. Discussion: These results indicate that people with PTSD-depression comorbidity report more severe PTSD symptoms and more maladjustment, and suggest that differences in coping contribute to this comorbidity.

Gomez-Baya Diego, University of Huelva

Posttraumatic Growth after Domestic Violence: The Role of Emotional Intelligence

Purpose: Posttraumatic growth is the experience of positive change (including an increased appreciation for life, more meaningful interpersonal relationships, an increased sense of personal strength, recognition of new possibilities for one's life, and spiritual development) as a result of the struggle with a traumatic event. The purpose of this study was to analyze the role of emotional intelligence in the posttraumatic growth in battered women. Methods: A cross-sectional study was carried out with a sample of 114 battered women, who were interviewed and were asked to complete the Trait Meta-Mood Scale-24 (Salovey, Mayer, Goldman, Turvey and Palfai, 1995) and the Posttraumatic Growth Inventory (Tedeschi and Calhoun, 1996). Results: On the one hand, independent samples t-tests indicated that women with higher emotional intelligence (characterized by low or moderate emotional attention, high emotional clarity and high emotional repair) reported higher posttraumatic growth. On the other hand, stepwise regression analyses showed that emotional repair was the only significant predictor of posttraumatic growth (in all its different dimensions). Discussion: These results suggest the influence of emotional regulation skills (especially the emotional repair) on posttraumatic growth after experiencing domestic violence.

Gonçalves Catarina, UnIPSa

Complicated Grief, Emotional Regulation and Traumatic Stress in Drug Addicts

The death of someone significant usually is a severely traumatic life event. A considerable part of the general population has symptoms of Complicated Grief (CG) after loss of someone significant. For drug addicts this is an issue that can be more empirically supported. Its relation with emotion eegulation can enlight new guidelines for interventions in addiction.

This study aims to make a regression model for CG, with independent variables: emotion regulation difficulties and traumatic stress symptoms, as well as know the CG influence on consumption behaviour situations after loss. We evaluated 50 individuals (15 women and 35 men) with a mean age of 35.20 years (SD = 7.99), drug addicts in outpatient treatment and history of losses, using the following assessment instruments: Difficulties in Emotion Regulation Scale, Beck Depression Inventory, Impact of Event Scale-Revised and Inventory of Complicated Grief.

We observed a prevalence rate of 74.0% of CG (ICG > 24). Through multiple regression, Difficulties Engaging in Goal-Directed Behaviour predicts 20,3% of the CG and Difficulties in Impulse Control predicts 16,0% of the trauma. After loss, 86.2% of participants in non-abstinent treatment have symptoms of CG, regardless of substance, while 13.8% of abstinent in treatment present no CG. These results suggest the integration of aspects of the grieving process in addict's treatments.

Gregor Bettina; Tran, Ulrich S., University of Vienna

Where are the Differences? The Dodo Bird Verdict and the Relative Efficacy of Bona Fide Psychotherapies in Posttraumatic Stress Disorder: Meta-Analysis and Comparison with other Psychological Disorders

There is a current debate on whether bona fide psychotherapies differ in efficacy in the treatment of posttraumatic stress disorder (PTSD). While Benish, Imel and Wampold (2008) presented meta-analytical evidence that the dodo bird verdict may not be refuted (i.e., no differences seem to exist), Ehlers et al. (2010) argue that this finding is based on overgeneralization and a biased selection of the available evidence. Moreover, other meta-analyses found equivalent efficacy only for trauma-focused treatments, but not for other therapies. Our contribution expands on this subject by investigating two specific issues that seem of importance in this debate. Firstly, we examined the influence of the different meta-analytical methods that were used in the investigations on this subject and replicated the meta-analysis of Benish et al. (2008), updated for recently published primary studies. Secondly, therapies of the same type may differ in efficacy in the treatment of one disorder but not another. This is a new argument in favour of relevant specific factors of therapies and against the dodo bird verdict. To explore this possibility, we also compared our meta-analytic results on bona fide treatments of PTSD with results of updated meta-analyses on bona fide treatments of depression and alcohol use disorders.

Haase Angelika; Schützwohl, Matthias, University of Technology Dresden

How is Posttraumatic Stress Disorder Treated in Outpatients? An Investigation of the Current Practice Patterns in Germany

Background: In the past years, several guidelines for the treatment of posttraumatic stress disorder (PTSD) have been presented, e.g. by ISTSS (Foa et al., 2008), NICE (2005) and AWMF (2006). Studies from the USA, however, showed that evidence-based and recommended interventions such as exposure therapy are not as often used as expected (e.g. Becker et al. 2004). Until now it is not known, how far outpatient treatment of PTSD in Germany is based on these guidelines. Methods: In this study, we are investigating therapists treating patients with PTSD in an outpatient setting in two different German Federal Lands (Saxony and Hesse) using a questionnaire in a paper-pencil as well as an online version. We ask them about their experiences in treating outpatients with PTSD, their qualifications as well as their use of various interventions in their therapeutic work with patients with PTSD as a function of the type of traumatisation (complex vs. non-complex). Results: Data about clinical practice of treating outpatients with PTSD in Germany are discussed. We will point out which interventions are established to treat PTSD and if there are differences in the choice of interventions as a function of the type of traumatisation. Moreover, we will identify the main predictors for using other interventions than the evidence-based exposure therapy. Discussion: The current practice of treatment of PTSD in Germany will be compared to that from other countries, e.g. the USA or the Netherlands (van Minnen et al. 2010), as well as with the Guidelines. If necessary we will disclose starting points for an optimization of the daily practice routine.

Hansen Maj; Andersen, Tonny; Armour, Cherie; Elklit, Ask; Palic, Sabina, National Center for Psychotraumatology

PTSD-8: A Short PTSD Inventory

Traumatic events pose great challenges on mental health services in scarcity of specialist trauma clinicians and services. Simple short screening instruments for detecting adverse psychological responses are needed. Several brief screening instruments have been developed. However, some are limited, especially in relation to reflecting the posttraumatic stress disorder (PTSD) diagnosis. Recently, several studies have challenged pre-existing ideas about PTSD's latent structure. Factor analytic research currently supports two four factor models. One particular model contains a dysphoria factor which has been associated with depression and anxiety. The symptoms in this factor have been hailed as less specific to PTSD. The scope of this article is therefore to present a short screening instrument, based on this research; Posttraumatic Stress Disorder (PTSD) – 8 items. The PTSD-8 is shown to have good psychometric properties in three independent samples of whiplash patients (n = 1710), rape victims (n = 305), and disaster victims (n = 516). Good test-retest reliability is also shown in a pilot study of young adults from families with alcohol problems (n = 56).

Hoijtink Leonie; te Brake, Hans; Dückers, Michel, Stichting Impact

Literature Review of Psychosocial Resilience after Disasters

Background: Although resilience is a concept increasingly used in various scientific fields, its definition is subject of debate. The aim of this literature review is to provide an overview of the conceptualisation of psychosocial resilience, synthesize similarities and differences between definitions, and to establish determinants of resilience. In addition the relationship between government and citizens’ resilience is taken into account. Methods: A literature research was undertaken in Pubmed, Embase and Picarta databases. Results: A widely accepted definition for resilience is lacking, but in general, resilience is conceptualised as ‘bouncing back’ after an event in a way that exemplifies (a) returning to an initial situation, or (b) establishing a new equilibrium in which an individual, group, community or system can deal with its altered context. Several factors can be discerned, which are associated with resilience on individual and community levels. Discussion: Most existing measuring instruments focus solely on individual psychological factors. This review indicates that, in order to realise a more complete picture of resilience, community factors are also relevant. Testing the predictive value of factors currently found is encouraged. Internationally, policy makers will benefit from a concise, reliable instrument that enables adequate prediction of resilience.

Hu George, Alliant International University

Soiled Linen: Trauma and Treatment in Southeast Asian Victims of Sex Trafficking

One of the most egregious human rights offenses of our time is a modern-day version of slavery called sex trafficking. The International Labor Organization estimates that 1.39 million people worldwide are forced into commercial sexual exploitation, and that 40-50% of these are children. Additionally, UNICEF reports that most human trafficking in East Asia and the Pacific is into child prostitution. As commerce and infrastructure in Southeast Asia continues to develop, so does the demand for child prostitutes, fueled in part by economic and cultural factors that combine to victimize the most vulnerable of children. This research will examine the phenomenon of sex trafficking in Southeast Asia, the cultural factors that underpin the supply and demand, the presentation of trauma symptoms in the victims, and the best practices used to treat victims in the region. This research was conducted in Cambodia, India, and Vietnam, and will focus specifically on how cultural factors are being used in the region to provide a relevant model of treatment and aftercare, including narrative therapy techniques, trauma-focused cognitive behavioral therapy, and community integration. Additional focuses include the effect of community trauma after the Vietnam War and the reign of the Khmer Rouge, and how symptoms of community trauma have fueled sex trafficking.

Ikeno Satoshi, Kwansei Gakuin University

Multilayer traumatic experiences among the survivors of the East Japan Great Earthquake that occurred on March 11th, 2011: Update of the current situation

The purpose of this poster presentation is to show the update of the multilayer traumatic experiences among the survivors of the East Japan Great Earthquake that happened on March 11th, 2011.

In addition to the first shake of the 9.0 magnitude earthquake, tremendous disruption caused by the “tsunami” completely destroyed several cities in the Tohoku area. Further, the radiation leakage from the Fukushima nuclear power plant forced 50,000 people to evacuate outside their hometown. As of March 31st, 2011, the death toll rises up to 11,000 and more than 16,000 people are still missing. About 3,000 people are injured and 150,000 buildings are significantly damaged. More than 200,000 people are currently evacuating to temporary shelters. Already 55 people, however, died in those shelters due to poor conditions. The survivors are struggling with multiple traumas such as missing family members, loss of jobs, collapse of communities, and an uncertain future.

Gathering information from multiple sources, the poster indicates the following aspects of post-disaster issues: 1) geographic information of the damage, 2) demographic data of the victims, 3) current crisis response services and their effects, 4) psychosocial needs among evacuees, and 4) implications for future trauma care approach and research.

Kahana Boaz, Cleveland State University; Kahana, Eva; Lovegreen, Loren, Case Western Reserve University; Kahana, Baruch, Marshfield Clinic, Wisconsin; Brown, Jane; Dunkin, Sandra, Case Western Reserve University

Typology of Coping with Cancer among Older Adults

A qualitative study of 174 elderly cancer survivors (mean age 81, SD = 7.5) yielded patient perspectives on their cancer journey. This paper focuses on coping strategies patients found most useful during their illness. A psychologist and a physician coded responses, using a staged content-analysis process. Coping themes were rank ordered, based on frequency of mention. The Networkers (N = 35) benefited from turning to others for support. Take Charge Copers (N = 25) achieved success by taking active steps in illness management. Pious Copers (N = 24) relied on religion, praying, or spirituality. Stay Positive Copers (N = 23) maintained positive attitudes through reappraisal and positive comparisons. Busy Bees (N = 14) occupied themselves to deflect challenges of cancer. Get Treated and Move On (N = 12) was the motto of those who felt their treatments cured them. Passers By (N = 11) chose not to dwell on having cancer. Delegators (N = 5) relied on others to take action on their behalf. Emotionally Afflicted (N = 3) expressed their frustrations. Benefit Finders (N = 3) offered themes of post-traumatic growth. Our typology reflects instrumental, intrapsychic, escape oriented, and emotional coping orientations which fit a stress theoretical framework. A major indicator of resilience among elderly cancer patients is equanimity in pursuit of their lives. Old age may offer a resource for cancer survivorship.

Kahana Eva, Case Wester Reserve University; Kahana, Boaz, Cleveland State University; VanGunten, Madeline; Lovegreen, Loren, Case Western Reserve University

Reflecting Back on the Experience of Diagnosis by Elderly Cancer Survivors

Our paper focuses on perspectives of elderly cancer survivors regarding their experiences and their coping during start of their career as a cancer patient. We used a qualitative approach to understand the lived experience of survivorship. In-depth interviews were conducted with 174 older adult participants in a community survey (mean age 81 years) who reported a cancer diagnosis. Questions focused on adaptive tasks faced by patients and coping strategies employed to deal with receiving their diagnosis. Upon receiving a cancer diagnosis, older adults seldom relayed experiences of shock or dismay. Most emphasized their determination to fight the disease. Less than 10 percent reported fear as a response to their diagnosis. Adaptive tasks patients faced upon diagnosis included cognitive, emotion and social support regulation, and proactive illness and role management. These data support prior findings regarding the protective influence of old age in responding to a diagnosis of life threatening illness. The "on-time" interpretation of having a cancer diagnosis may diminish the stressfulness of receiving a diagnosis and may enhance the patients’ ability to proactively cope with the reality of their illness. Our findings also underscore the continuing future orientation and “will to live” reflected in the proactive determination of older adults to fight their cancer.

Kassam-Adams Nancy, Children's Hospital of Philadelphia; Palmieri, Patrick, Summa Health System; Kenardy, Justin, University of Queensland; Delahanty, Douglas, Kent State University

The Child PTSD Prediction Project: An International Collaboration to Create Predictive Tools for Child PTSD Risk after Acute Trauma

The Child PTSD Prediction Project aims to develop and test a set of PTSD risk assessment tools suitable for screening children at multiple time points after acute trauma exposure, to reliably identify those at highest risk of persistent PTS symptoms. The project employs secondary analysis of existing data from prospective studies in the US, Europe, and Australia that have assessed more than 2500 children following acute trauma. Data include pre-trauma factors, peri-trauma person and event characteristics, acute physiological data, as well as post-traumatic responses. Our aim is to design a multi-point screening process and examine the efficacy of combinations of screening results across time vs single screening points. Results will lay the groundwork for prospective testing and validation of sequenced risk assessment tools in clinical and research settings with children who have experienced distinct types of acute trauma. The project is also creating a rich data archive to enhance research on early risk factors and trajectories of PTS symptom development in children. Studies can be included in the PTSD after Acute Child Trauma (PACT) archive if child data was collected prospectively after acute trauma with at least 1 predictor assessed within 3 months of the event, and traumatic stress outcomes assessed a month or more later.

Kazlauskas Evaldas; Domanskaja, Kristina, Vilnius University

How Train Drivers React to Railway Accidents: A Qualitative Approach

Background: While railway systems in most European countries are very efficient, railway accidents still occur sometimes causing injuries and suffering. Train drivers are the key persons in such accidents, and in most cases they experience traumatization. One of the complicating factors is, that train drivers are operating the train and are involved as witnesses at the same time. Studies in this field are rare, and we conducted a study using a qualitative approach trying to identify how Lithuanian train drivers react to railway accidents, when they were driving the train. Methods: 11 male train drivers aged from 31 to 59 participated in our study. All train drivers were involved in an accident, where at least one person either died, or experienced serious injuries. Semi-structured interviews with train drivers were analyzed using the Thematic Analysis method (Boyatzis, 1998). Results: Our study revealed that train drivers treat accidents differently. The accident caused many negative feelings such as guilt, fear, anger, helplessness, and sadness. Train drivers talked about physical body reactions after the accident. The fact of extreme stress was also reported in related post-accident memories, dreams and ruminations about the event. Participants of the study emphasized the importance of their social environment after these accidents. Train drivers used emotional, social, physical, cognitive, philosophical, and religious coping strategies after these traumatic events.

Kazlauskas Evaldas, Vilnius University; Skruibiene, Irma, Youth Psychological Aid Center; Gailiene, Danute; Starinskaite, Ieva, Vilnius University

Posttraumatic Growth among Lithuanian Survivors of Political Violence: A Qualitative Study

Background: Positive changes following trauma have been widely accepted as post-trauma exposure related phenomena by mental health professionals in the last decade. The aim of the present study was to assess posttraumatic growth domains in a sample of Lithuanian survivors of political oppression using qualitative methods. Methods: 103 elderly survivors of Soviet political violence who reported political persecution related positive changes participated in our study. 103 brief personal written self-reports about positive changes after trauma (ranging from 2 to 72 words, 23.5 words on average) have been rated by three psychologists. Rating system was based on the work of Calhoun and Tedeschi (1998, 2004). Political activity was added as additional domain after suggestion by raters. Interrater reliability was high for all domains with kappa ranging from 0.79 to 0.91. Results: Research data fitted theoretical model good, with only 2.9% survivors who reported posttraumatic growth, did not reporting any of five PTG domains. The majority of survivors experienced political oppression related personal changes 59.2%, spiritual change 23.3%, relating to others 16.5%, new possibilities 21.4%, appreciation of life 10.5%, and political activity/patriotism 12.6. Conclusion: This qualitative study supports Calhoun's and Tedeschi's theory. However, we suggest to consider additional domains dealing with different survivor groups.

Kazlauskas Evaldas, Vilnius University

Diary Measures of Traumatic Stress: Ambulatory Assessment Approach

Background: There is a constant need for valid and reliable traumatic stress assessment methods. Self-report scales and interviews are dominating in the field of psychotraumatology so far. However, traumatic stress reactions as emotional anxiety reactions fluctuate over time, and recent technological developments might provide us with a new method to assess dynamic processes of traumatic stress reactions. Prolonged longitudinal data using daily measurements with a help of PDA or smartphones might provide new insights into the nature of traumatic stress reactions and give us new theoretical understanding of traumatic stress. Main goal of present study is development of methods for daily monitoring of traumatic stress and trauma related social interpersonal factors. Methods: Survivors of major accidents with physical injuries at Rehabilitation Center participated in this study. Traumatic stress reactions and social interactions are measured using smartphones HTC HD2 and MyExperience software. One week daily measurements with one patient with at least three daily data inputs are done: morning, afternoon and evening measures. Results: Study is still in progress and pilot study results will be presented at ECOTS.

Kern Christine; Forstner, Brigitte; Menken, Verena; Brisch, Karl Heinz, Dr. von Hauner's Children's Hospital-University of Munich

SAFE® (Safe Attachment Formation for Educators) in Infant Day Care

Introduction: The development of infant day care units will expand in Germany within the next years. Since educators will have a huge influence on the development of children's attachment patterns a group training program for educators SAFE ® (Safe Attachment Formation for Educators) was implemented in 12 day care units in the city of Munich. The training is targeted on the modulation of behavior that leads to a secure partnership between educators and children as well as parents and their children: Children's attachment behavior with mother and educator is measured in Ainsworth's strange situation. Educator's and parent's attachment representation are tested with the Adult Attachment Projective (AAP; George et al., 1997) before and after day care entry. Their traumatic life events are measured with the Posttraumatic Stress Diagnostic Scales (PDS, Foa, E.B.). Results: We assessed 39 educators with the AAP. 45.2% displayed the U category and unresolved in the cemetery story dealing with stories about death and loss. Only 20% of the 30 mothers that joined our study were unresolved in the AAP. 80% of them showed an organized attachment representation. All of the babies we assessed with the mother in Ainsworth's strange situation were organized attached. Discussion: In contrary to our expectation, a high percentage of educators displayed the category for unresolved status of attachment respresentation. This could have an impact on the attachment quality of the infants in day care.

Kimble Matthew, Middlebury College; Batterink, Laura, University of Oregon; Marks, Elizabeth; Ross, Cordelia, Middlebury College; Fleming, Kevin, Norwich University

ERP Evidence of Expectancy Bias in PTSD

Posttraumatic stress disorder (PTSD) is a disorder that theoretically and clinically is thought to be associated with hypervigilance for potentially threatening or trauma relevant stimuli. This study used the N400 event-related potential (ERP) to investigate expectancies for threatening endings to ambiguous sentence stems. The N400 ERP is thought to reflect the amount of effort required to integrate a stimulus into a given context. In sentence reading tasks, the N400 is reliably larger when a word is semantically unexpected given the preceding context. Method: In this study, fifty-seven trauma survivors read ambiguous sentence stems on a computer screen that were completed with either an expected (“The unfortunate man lost his… wallet ”), unexpected (“The unfortunate man lost his… artist ”), or threatening word endings (“The unfortunate man lost his… leg ”). Results: Participants with PTSD, as compared to those without, showed significantly smaller N400s to threatening sentence endings suggesting enhanced expectancies for threat. Behavioral responses supported this conclusion. Conclusions: These findings are consistent with the clinical presentation of hypervigilance and theoretical models that emphasize increased attention and expectancies for threatening and trauma relevant stimuli.

Kirlic Namik; Adela Langrock, The University of Tulsa

Ten Years After the War: Externalizing Behaviors in a Sample of Bosnian Young Adults

At this time, very little is known about the psychological impact of the difficult post-war situation in Bosnia-Herzegovina (BH) among young adult survivors of the 1992–1995 war. While several studies have explored the immediate impact of the war on the psychological well-being of children and adolescents, none have considered it within the context of the difficult political, economic, and psychosocial post-war environment. This study examined externalizing behaviors of 134 young adults in BH ten years after the war, while simultaneously evaluating their association with the presence and severity of current post-war stressors. The findings showed a high percentage of participants with clinical levels of externalizing behaviors, including excessive aggressive, rule-breaking, and intrusive behaviors, as well as moderate levels of stress regarding the post-war environment, and a strong correlation between the two. A series of analysis of variance tests discovered that stress-free personal/professional relationships and leisure activities may serve as protective factors against the less controllable stressors, such as the difficult post-war political and economic environment, and bleak educational prospects and outlook for future. Overall, findings suggested that the difficult post-war environment in BH continuously affects the psychological well-being of young adults.

Klaric Miro, University of Mostar; Stevanovic, Aleksandra; Franciskovic, Tanja, University of Rijeka; Petrov, Bozo, University of Mostar; Jonovska, Suzana, Psychiatric Hospital Rab

Marital Quality and Relationship Satisfaction in Wives of War Veterans Suffering from PTSD

PTSD in war veterans and its complex emotional and behavioral characteristics affect veterans' partners and the quality of their relationships. Partners of war veterans can also be traumatized by war and can develop PTSD. The study explored how post-traumatic stress disorder affect's marital quality and satisfaction in war veterans’ wives suffering from PTSD. The Harvard Trauma Questionnaire (HTQ) and Dyadic Adjustment Scale (DAS) encompassed 154 war veterans and their wives who had been treated at Mostar Clinical Hospital in Bosnia and Herzegovina for combat-related PTSD as well as 77 veterans and their wives who did not suffer from PTSD. The results indicate that wives of PTSD-affected veterans have low marital quality, partner relationships are more complex when the wife also suffers from PTSD and, in such cases, marital quality is even lower. The results highlight the importance of recognizing PTSD in wives of traumatized veterans, as well as the importance of family-oriented approaches in the treatment of PTSD.

Klinitzke Grit; Weißflog, Gregor; Brähler, Elmar, University of Leipzig

20 Years after the German Reunification: Mental Health Problems of Political Prisoners in the Former German Democratic Republic (GDR)

More than 200.000 people were incarcerated for political reasons (e.g. the illegal crossing of the border, contact to persons in the western countries etc.) in the former German Democratic Republic (GDR). Traumatic maltreatments led to physical and psychological suffering even many years after the incident. To investigate the long-term consequences of political imprisonment in the GDR, 157 persons were recruited from the Saxon Memorial Foundation to participate in a postal survey in 2008. Sociodemographic data and psychosocial outcome variables (e.g. mental health problems [SCL-27]) were assessed in a cross-sectional study. Compared to a representative sample of German general population (n = 615), the former political prisoners (mean age: 65; male: 82,2%) showed significantly more mental health problems in general and on every symptom subscale even 20 years after the German Reunification. No gender effects regarding the subscales were detected. A lot of variables showing the circumstances of the imprisonment (e.g. duration of or age at the imprisonment) are significantly associated with the symptoms of mental health. The traumatic experiences of politically persecuted people in the former GDR caused long-term mental sequelae, which persist until now. In the treatment of an individual's mental problems, the societal-biographical context has to be regarded.

Köhler Miriam; Bredenbeck, Claudia; Wagner, Dieter, Alexianer-Institute of Psychotraumatology Berlin/Krefeld; Mosetter, Kurt, Society for Regulation Medicine,; Fischer, Gottfried, German Institute for Psychotraumatology; Bering, Robert, Alexianer-Institute of Psychotraumatology Berlin/Krefeld

Ten Years Anniversary of the Center of Psychotraumatology in Northrhine Westfalia/ Krefeld

In 2001 the Alexianer GmbH in Krefeld set up a Center of Psychotraumatology (CoP) to serve as a pre-operating study concerning the supply in Cologne victim aid. Through this a gap of supply was closed to make prompt assistance for victims of violent crime, natural disasters, accidents and other serious life events possible. Today the CoP has an independent status in the psychiatric health care of Northrhine-Westfalia. A four-layered offering of treatment is the result, made up of a device of inpatient treatment, rehabilitation, liaison psychiatry and outpatient clinics in Krefeld, Duisburg, Meerbusch and Cologne. For this the CoP is arranged and disposed to a catchments area of 5 up to 7 million citizens for Posttraumatic Stress Disorder (PTSD) and complex PTSD. The medical attendance has following outline: first the therapy is based on cognitive psychodynamic models. It ranges from first counselling to vocational rehabilitation. Second the Target Group Intervention Program is part of early intervention conceptual preparedness. We summarize our research on crisis intervention programs, effectiveness of psychotherapy, psychopharmacology, Myoreflextherapy and neurobiological parameters of PTSD and complex PTSD. We conclude that specialized departments for psychotraumatology are needed. Over this, the CoP is part of a cross boarder infrastructure to be prepared on local and pan-European disasters.

Korn Hannah, University of Vienna

The Impact of Posttraumatic and Acculturative Stress to the Subjective Mental Health Status of Bosnian Refugees in Austria

The body of research on consequences of posttraumatic stress in refugee populations is growing steadily. However, little scientific attention has been directed towards the impact of acculturative stress, even though postmigration stress has been recognized as an important factor for poor subjective mental health. This is particularly important since a growing number of people are involuntarily displaced and forced to resettle in other countries. Posttraumatic experiences and the ongoing adaptional stress increase the vulnerability to mental health problems. Therefore, this study examines not only the impact of posttraumatic stress, but also the impact of cultural adaption demands to levels of mental health symptoms in a clinical and a nonclinical community group of Bosnian refugees several years after their migration to Austria. Instruments for assessment are the GHQ-28 to assess the occurrence and severity of general health symptoms, the IES-22 to measure the posttraumatic reactions, the LAS to examine the degree of cultural adaption and a socio-demographic questionnaire. The study contributes to a better understanding of the various difficulties refugees are confronted with after migration and its impact on subjective mental health. Additionally, implications for mental health professionals working with refugees are being discussed.

Krammer Sandy; Simmen-Janevska, Keti; Maercker, Andreas, University of Zurich

The Influence of Social-Interpersonal Factors and Reminiscence Styles on the Association between Potentially Traumatic Events during Childhood and Cognitive Decline in Old Age

Background: Recent studies indicate that PTSD appears to be associated with cognitive decline in the elderly, whereby social factors seem to exert an important impact. For instance: social support seems to negatively influence both the development and maintenance of PTSD and the development of dementia. In addition, the importance of social factors is emphasized by the interpersonal socio-contextual model by Maercker and Horn. As previous findings from our group (e.g. younger age being a risk factor for PTSD) suggest, traumatic events during childhood may lead to long lasting and severe consequences over the lifespan. Aim: The aim is to analyze the mediating effect of specific social-interpersonal factors (social support, network size, loneliness, disclosure, social acknowledgment, attachment style, forgiveness, relationship satisfaction) and reminiscence styles (interpersonal, integrative, obsessive and escapistic) on the association between potentially traumatic events during childhood and cognitive decline in old age. Methods: This cross-sectional study aims to recruit approximately 150 subjects (above the age of 70) with potentially traumatic childhood events. A test battery including measures on childhood trauma, PTSD, developmental trauma disorder, cognitive decline and social-interpersonal factors is implemented. Outlook: This poster will present preliminary results on the mediating association outlined above.

Kruesmann Marion, LMU Munich; Mueller-Cyran, Andreas, Archiepiscopal Chair of Munich

Primary Prevention for Rescue Service Personal

Volunteer fire fighters are exposed to a higher risk of developing posttraumatic disorders than the average general population. The potency of follow-up interventions is controversial, randomized studies show no effect on a reduction of trauma related symptoms. Some years ago emphasis has been placed upon measures of primary prevention like trainings unlinked to acute incidents as a part of the brigades‘ basic or advanced training. In this study 15 fire brigades received training accompanied by questionnaires before, immediately after, half a year and two years after training (2008). Identical data was collected from 15 control brigades. Questions on factual knowledge supplied insights on transfer of training content. Questions on subjective stress supplied data on whether trained brigades reported lower stress-results than control brigades. 1795 sets of data, referring to 745 individuals, are available. The results show that trained brigades come with significantly higher knowledge relevant for trauma-prevention. The average subjective stress reported by field personnel based at trained brigades is lower than in control brigades. The results show clearly that a nationwide implementation of primary prevention trainings, not only as a genuine task but also as an expression of responsible staff welfare, should urgently be tended to by official institutions.

Krutolewitsch Anna, Maercker, Andreas, University of Zurich

Co-Rumination in the Context of the Social Facilitation Model of PTSD: Secondary Traumatization and “Co-Rumination” on Emergency Workers

Background: The work of forces of different professions (firefighters, civil defense, police and rescue personnel) may lead to secondary trauma, as it is often connected with the experience of serious or fatal injuries, heavy deformed or dying victims, but also with the emotional contact with patients and their families. In addition, the work of forces is accompanied by time and performance pressure on site and by continuous pressure to make decisions and take responsibility for the lives of others. Objective: Based on the proposed social facility model of PTSD by Maercker (2010), the role of another interpersonal factor, “co-rumination” (Rose, 2002) is investigated. Co-rumination is the extensive and repeated discussion of problems with close friends and colleagues. It is speculated about the negative consequences of the problem and negative emotions are addressed and discussed separately. Method: 168 responders participated in the study voluntarily (53 employees of the medical emergency service and 115 employees of the fire department). Outlook: The effect of the factor “co-rumination” on the development of secondary traumatization was examined and the interpersonal factors, such as disclosure of the traumatic experience and experienced social esteem were compared.

Ksiazak Maria, International Humanitarian Initiative Foundation; Gordziejuk-Nowak, Joanna

EU Reception Directive vs. Deportations on Dublin 2 Regulation

The presentation is based on data on the access of medical and psychological assistance of asylum seekers in Poland gathered from two research projects of International Humanitarian Initiative Foundation and the Association of Legal Intervention that I participated in as a psychologist. The majority of the asylum seekers come to Poland from Chechnya and are traumatized due to the ongoing conflict and human rights violations including torture. The asylum seekers with PTSD undergoing treatment and therapy in other EU countries are not able to continue this treatment when deported to Poland. After the deportation vulnerable individuals and families are often locked in deportation centres. The children in deportation centres do not have access to school education and there is no access to psychotherapy at all. Families have to spend up to one year in these facilities. PTSD or even the psychological trauma of the children are not regarded sufficient reason to allow asylum seekers to move to open reception centres. The need for setting up minimal standards for assistance to asylum seekers with PTSD across Europe is essential if asylum seekers rights to health and rehabilitation are to be respected.

Kuzlik Iwona; Wawrzyniak, Malgorzata, Warsaw School of Social Sciences and Humanities

Temperament, Basic Hope and Coping Strategy Choice by Individuals after Trauma

The aim of this study was the revision of the presumption, regarding to antiquated trauma influence on process of coping with its consequences. It was assumed, that even if victims of trauma were fighting actively during suffering, or they were passive, it would have an influence on the posttraumatic adaptation process. Participants: 246 women and 221 men, age 19-56. The following tools were used: Childhood Incidents Scale, Coping Responsens Inventory, the Zuckerman's Sensation-Seeking Scale, BHI Questionnaire. It was found that the selection of specific coping strategies is influenced by taking action [in the crisis situation], the number of traumatic incidents one was exposed to, subjective intensity of stress, recurrence of the event, perception of effectiveness of the action taken, extent of confiding in others, strength of sensation seeking and basic hope. The study leads to a key conclusion about the role of basic hope and sensation seeking as moderators of constructive coping by the individual confronted with the crisis situation.

Kvitsaridze Marina; Marina, Baliashvili, Grigol Robaqidze University; Sakvarelidze, Ramaz, Tbilisi Medical University; Norakidze, Tinatin, Tbilisi State University

SRRS Specificity in Georgia (Local and Displaced Populations)

The Social Readjustment Rating Scale (SRRS) is widely recognized as a tool to measure the stress level. Different psychological and cultural factors may affect the stress exposure in different groups. The attempt was undertaken to study the stressors in Georgian population.

The modified version of SRRS was developed. The experts were asked to identify the events that may cause stress in contemporary Georgian society. This list was amended by the stressors described in the literature (Holmes & Rahe, 1967). The amended list was piloted to receive the final version for further research.

The final list of 70 stressors was assessed by 500 respondents (local residents and internally displaced people). The results were compared to the data described in the literature. The weight of the stressors appeared to be different in Georgian and western populations.

Also, difference was revealed in the two groups – local residents and internally displaced people. Factors, inducing stress in local residents, were often less stressogenic for the displaced. Compared to the locals, the displaced persons reacted less acutely to interpersonal conflicts, death of a spouse, drug or alcohol-addiction etc. However, they were more exposed to change of profession or employment, living conditions, social isolation, loss of the territories etc.

Lindahl Norberg Annika, Karolinska Institute; Forinder, Ulla, Stockholm University

Parents of Children with Potentially Fatal Disease: What is the Trauma?

It has previously been demonstrated that parents of children with serious medical conditions may exhibit post-traumatic stress symptoms (PTSS) although the child's treatment is successfully completed. Usually researchers presume that “learning that one's child has a life-threatening disease” is the critical event. However, it has not been comprehensively examined which parts of the illness experience actually are perceived as traumatically stressful. Often physical and psychological difficulties remain for the child, even when the treatment is completed. The aim of the present paper was to start with a simple model to explore whether present deficiencies in the child's function after completed stem cell transplant (SCT) are associated with PTSS in the parents. Within a larger study assessing parental reactions to paediatric SCT, a questionnaire for self report was used among 284 parents (161 mothers and 123 fathers). Though stepwise hierarchical regression analysis we found that the parent's perception of the child's present condition had a significant impact on PTSS, over and above the severity of the traumatic memories from the illness and treatment. In conclusion, we may not automatically presume that experiences associated with PTSS in this group disappear just because the potentially lethal disease is cured.

Lita Andreea, Romanian Police; Lita, Stefan, Romanian Ministry of Administration and Interior,

The Influence of Cognitive Schemas on the Social Problem Solving abilities of Police Officers

Policemen represent a population who are at high risk for posttraumatic stress, therefore the study investigates whether cognitive schemas could be a predictor for understanding behaviour exhibited by sample like policemen who must cope with multiple and conflicting demands. The sample consists of 150 police officers who have filled in two questionnaires: the Young Schema Questionnaire-Short form (1998) and the Social Problem-Solving Inventory (D'Zurilla & Nezu, 1990). The main hypothesis was that cognitive schema would play an important explicative role in understanding policemen's social problem solving abilities. We conducted regression analyses with two major components of the social problem-solving process (problem orientation and problem-solving proper) as dependent variables and cognitive schema scales as independent measures. The preliminary data confirmed the main hypothesis showing that: the problem orientation abilities are explained (R 2 = 34, F = 9.62, p = .000) by low scores on failure-FA, subjugation-SB and abandonment-AB, whereas the problem-solving abilities are explained (R 2 = 33, F = 9.23, p = .000) by high scores on punishment-Pu, as well as low scores on dependence-Di and social isolation-Si. The results are interesting especially because all the subjects represent a very special population which have to deal with a variety of social issues.

Löffler Sabine, University Hospital Dresden; Bogausch, Anja; Pöhlmann, Karin; Knappe, Rainer, Arbeitsgemeinschaft für Verhaltensmodifikation Deutschland e.V.; Joraschky, Peter, University Hospital Dresden

Wound and Growth: Meaning in Life and Coping with Posttraumatic Stress

Traumatic experiences can be existential experiences, which lead to fundamental changes in the experience of meaning in life (Yalom 1989). Recent findings indicate, that a strong sense of meaning can be helpful for coping with straining life events (Groß 2007; Vickberg et al. 2001). This study investigated, (1) how personal meaning systems change after a traumatic event and (2) which relations exist between the individual meaning structure or the subjective sense of meaning and the coping with traumatic life events and psychological well-being. 62 female psychotherapy patients suffering from a post traumatic stress disorder filled in questionnaires measuring the sense of meaning in life, psychological well-being and coping with the trauma. Personal meaning systems were assessed qualitatively. Results showed, that a stonger sense of meaning in life and a more sustainable meaning system were associated with less posttraumatic stress symptoms, more posttraumatic growth and better psychological well-being. Those, who were able to develop new contents of meaning in life, showed less symptoms of posttraumatic stress and could use the traumatic event more effectively as an impulse for personal maturing. To conclude, there exists a significant relation between the concept of meaning in life and the coping with traumatic events as well as psychological well-being in general.

Lonergan Michelle, Douglas Mental Health University Institute; Lening, Olivera-Figueroa A., Fernand-Seguin Research Center; Brunet, Alain, Douglas Mental Health University Institute

Propranolol's Effects on Long-Term Emotional Memory Consolidation and Reconsolidation: A Meta-Analysis

Background: Considering the pivotal role of negative emotional experiences in the persistence of mental disorders, preventing or reversing the consolidation of such memories may open the door to a novel treatment approach. Several studies suggest that the noradrenergic beta-blocker propranolol abolishes the enhancement of emotional memory during memory consolidation or reconsolidation. Thus, we conducted a meta-analysis on the use of propranolol to block consolidation and reconsolidation of emotional memories in healthy adults. Methods: After a multilingual database search, 16 double-blind studies with random assignment involving one drug and one placebo condition were included, and data was extracted. Results: Compared to placebo, propranolol given before memory consolidation subsequently reduced recall for new negatively valenced stories, pictures, word lists, situations, and scripts, g = 0.44, (95% CI = 0.14-0.74). Moreover, compared to placebo, propranolol before memory reconsolidation reduced the expression of cue-elicited fear responses later on, g = 0.64 (95% CI = 0.05-1.23). Conclusion: Propranolol shows promise in reducing memory for new as well as recalled emotional material in healthy adults. It remains to be demonstrated that more powerful emotional memories in clinical populations can be durably weakened as well, thus bringing about symptomatic relief.

Loulopoulou Angela Ioanna, The Medical Foundation for the Care of the Victims of Torture

De-Pathologising Trauma: A Positive Psychology Framework when Working with Victims of Trauma

The notion of ‘trauma’ in the field of psychology has traditionally been regarded as synonymous to a psychopathological state, namely Post-Traumatic Stress Disorder. In accordance to that, at a political and societal level, ‘trauma’ has most commonly been considered as rendering the individual who has had traumatic experiences in a victimised/helpless position. The present study challenges these positions and through comparative research emphasises that they are not consistent with recent findings either within the field of positive psychology or the study of the refugee experience. By means of a critical investigation critical of the i) key points of, and developments in positive psychology, as well as ii) the research conducted in, and the clinical material derived from the area of the refugee experience, the study argues that ‘trauma growth’ theories can be considered an integral part of positive psychology theory and practice. Such integration allows for new ground upon which professionals, working with individuals who experience trauma, can build evidence-based challenges to the pathologised and victim- related view of ‘trauma’ still used and promoted in psychology and politics. Moreover, the study emphasises that the present findings can already mobilise professionals towards a strength-focused approach in the psychotherapeutic treatment of sufferers from traumatic events.

Marcelino Dália; Figueiras, Maria João, UIPES-ISPA

Predictors of Posttraumatic Stress in a Sample of Portuguese Firefighters

Objective: The aim of this study is to investigate the predictors of posttraumatic stress associated with critical incidents experienced by Portuguese Firefighters. Methods: This is a prospective study in which 446 Portuguese Firefighters with ambulance emergency training completed a questionnaire at two points: July 2009 (T1) and November 2009 (T2). The measures were PTSD, peritraumatic dissociation, distress, health complaints, psychological well-being and socio-demographic variables. Results: The majority of the firefighters had experienced critical incidents in their work. Over time there was a decrease in PTSD symptoms and peritraumatic dissociation, an increase of health complaints, and a significant improvement in psychological well-being. Correlational analyses indicated a negative association between symptoms and psychological well-being at the two time points. The predictors of PTSD were traumatic incident-related, peritraumatic dissociation, psychological distress and health complaints at both assessments. Conclusions: Firefighters are at risk to develop health symptoms due to work related stressors. However, the results suggest that shifts in symptomatology may be associated with the time of the year in which the assessments took place. Further research should explore whether these symptoms increase in peak times of critical incidents over the year.

Martin-Peña Javier, University of Barcelona; Olff, Miranda, University of Amsterdam; Rodriguez-Carballeira, Alvaro, University of Barcelona

Chronic Exposure to Terrorist threats in the Basque Country: Psychosocial Consequences Suffered by the Victims of ETA

Introduction: Few studies have focused on the effects of exposure to terrorist threats, a form of chronic violence that has been poorly understood. This research aims to examine the psychosocial consequences of ETA's terrorist threats in victims in the Basque Country ( Spain). Earlier we collected qualitative data on the effects of terrorist violence to determine the relevant psychosocial domains in these type of victims. Method: Quantitative data were collected with an online survey in a sample of 85 victims: (Male = 60%; Age 40-49 years; public sector: 57,6%; political activity as a main reason for violence = 51,8%). Results: The results showed a high impact of terrorist threats on contextual, cognitive and emotional elements, but not significantly on their behavior. Disorders in family relations, social activities and daily plans (91,8%), and in the needs for security and protection (88,2%) scored highest in terms of context. Strong perceptions of social vulnerability and loss of freedom (89,4%) were relevant in terms of cognition. Anger (88,2%) and fear (87,1%) scored most in terms of emotion. Written testimonies of victims about the effects suffered will be shown. Conclusion: Victims of ETA terrorist threats suffered on social, cognitive and emotional domains. Limitations and implications will be discussed.

Matos Marlene, University of Minho; Santos, Anita, Instituto Superior da Maia; Machado, Andreia; Machado, Carla, University of Minho

Group Intervention with Battered Women: An Outcome Study

Violence against women in intimate relationships has damaging implications for the victims, not only socially, but also in behavioral and psychological domains. Intimate victimization is associated with high rates of depression and anxiety disorders, dissociation, suicide attempts, substance abuse, traumatic stress disorder, sexual problems, and cognitive disturbances such as hopelessness, low self-esteem and somatisation (Briere & Carol, 2004). The growing number of abused women asking for specialized help has been emphasizing the importance of innovative answers. According to Tutty, Bidgood and Rothery (1993), group intervention is one of the most common treatments concerning women victims. However, studies about intervention efficacy are scarce. A group intervention with women that were in an abusive relationship was implemented with a cognitive-behavioral approach. The main goals were: to cease partner violence; to decrease clinical symptoms such as traumatic stress, to reduce victim's isolation, to promote empowerment and skills to the reorganization of life projects. Three experimental groups were conducted, with measures of clinical symptoms and beliefs towards violence before the group beginning, in every session, at the end and at follow-up session. Preliminary outcome results of the group intervention will be presented, namely in relation to traumatic stress. Findings’ implications for professionals practice, institutional intervention and for the victim's well-being will be discussed.

Messer Stephen, Nova Southeastern University

Differential Effectiveness of Psychological and Pharmacotherapy Interventions for PTSD: A Meta-Analytic Review

Posttraumatic stress disorder (PTSD) is estimated to affect 8-9% of individuals in the population at some point in their lives. PTSD constitutes a major public health morbidity and mortality burden, highlighting the importance of prevention and intervention efforts. Treatment guidelines for PTSD include empirical reviews of the literature and meta-analyses. Generally, the recommendations are quite complementary. The current study follows the PRISMA recommendations. Subgroup and meta-regression analyses will examine relations such as baseline severity of PTSD symptoms, gender, comorbidity, depression diagnosis, baseline symptom scores, and attrition with psychological and pharmacologic treatments of PTSD.

Mikhaylova Elena; Evstegneeva, Natalia, Smolensk Regional Hospital for War Veterans

Specific Features of Verbal Memory in Patients of Hospital for Veterans of War with High Blood Pressure and PTSD Symptoms

It is known that post-traumatic stress disorder (PTSD) is often associated with verbal memory deficits (G. Johnsen, 2007, J. Wild, 2008). Also, it has been shown that higher diastolic blood pressure is associated with impaired cognitive status in men and women 45 years of age and older (G. Tsivgoulis, 2009). The relationship of stress and high blood pressure is also well known. The aim of our study was to compare the performance of verbal memory in patients with these two disorders. The average age of the patients was 57.37 years, 65% had complaints with high blood pressure. We identified the relevant diagnostic criteria of PTSD in 15% of patients, all of them also had the diagnosis of arterial hypertonia (AH). There were memory complaints in 2/3 of patients with AH alone and only 1/3 of patients with PTSD combined with AH. According to the results on verbal memory, patients with PTSD show better results in the immediate and delayed recall of words. Other verbal memory tasks, such as recalling categories of words (for example, beginning with a particular letter, or plants/animals names) were also better in patients with PTSD and hypertension than in patients with AH without PTSD. The delayed recall of words in patients with normal blood pressure, which had been used as a control group, was better than the group with AH and PTSD and in the group with AH alone.

Niedermayer Irene, Verein Projekt Integrationshaus

Multi-Professional Treatment of Traumatized Young Unaccompanied Refugees in a Stationary Youth Welfare Project

Caravan is a social educational project for accommodating unaccompanied minor refugees with increased care need. The care need result from massive mental health problems (sleeping disorders, anxiety disorders, depressive conditions, PTSD, concern around relatives left and problems related to adjusting to the new environment) as well as partly considerable somatic problems. Here the spectrum ranges from disabilities requiring treatment to severe somatic conditions, such as heart disease up to serious consequences caused by FGM.

The inhabitant population of the latter 3 years was examined in the following data (15.11.2007-15.11.2010). In this period 77 young adolescents lived in Caravan, 38 males and 39 females at the age of 13,7-17,8 (average 16,3). The average duration of stay amounted to 389,9 days (range 40-1559). The largest group of inhabitants (30) originate d from Afghanistan, 9 came from Somalia-altogether adolescents from 22 countries lived in Caravan during the last 3 years.

The psychological care covers a detailed anamnesis and an appropriate continuing treatment on voluntary basis (40 responded to this offer well). Focus of the psychological support was resource-oriented stabilization and activation. Additionally to the psychological support an intensive, medicamentous psychiatric treatment was necessary in many cases. 30 (38.96%, 15 boys, 15 girls) of the unaccompanied refugees received also psychiatric treatment during their stay, which usually was covered by appropriate child and youth-psychiatric departments.

Odachowska Ewa, Warsaw School of Humanites and Social Psychology

The Influence of Sense of Life on Identity Crisis and the Coping Process in Crisis Situation Related to a Child′s Chronic Illness

After the diagnosis that the child is mentally handicapped or chronically ill parents experience great sorrow, as it may occur at the loss of a loved one. It was assumed that the situation of parents of children with developmental disorders are associated with chronic stress. This may cause grieving, anxiety and guilt. The study therefore verified the hypothesis about the sense of life and the type of disease from the parent's identity crisis and coping processes.

Mechanisms to cope with stress resulting from the child's disability were examined. The Coping Responses Inventory, the level of awareness of the meaning of life in new situations was examined using the Purpose in Life Test (PIL). The survey was conducted in two ways: 57 mothers of children with physical and intellectual disabilities participated. In the second study, 81 fathers of children with intellectual disabilities were examined.

The results showed significant differences in the levels of the sense of life between the two groups. Parents of mentally handicapped children experienced significantly higher levels of crisis evaluation as compared to parents of children with physical disabilities. There were also strategies disclosed to cope with the situation of the child's disability between mothers and fathers, as well as depending on the type of child's disability.

Oe Misari, Schnyder, Ulrich; Schumacher, Sonja; University Hospital Zurich; Mueller-Pfeiffer, Christoph, University Hospital Zurich and Massachusetts General Hospital and Harvard Medical School; Wilhelm, Frank H., University of Salzburg; Martin-Soelch, Chantal, University Hospital Zurich

Lower Plasma DHEA Concentration in the Long-Term after Severe Accidental Injury

Dehydroepiandrosterone (DHEA) and its metabolite dehydroepiandrosterone sulfate (DHEA-S), which are also adrenal gland products, have prominent effects on GABA A receptor activity. DHEA(S) may play a role in resilience and in successful adaptation to stress. The aim of our study was to test chronic/long-term DHEA(S) changes in participants who had developed PTSD after severe accidental injury. We measured plasma DHEA and DHEAS concentrations as well as the DHEA-cortisol ratio in 13 survivors who developed PTSD after severe accidents 10 years ago but were remitted at the time of the investigation, 14 survivors who did not develop PTSD after a severe accidents 10 years ago (trauma-controls), and 16 age and gender matched healthy participants, who did not experience any traumatic events in their lifetime. In order to disentangle the influence of manifest PTSD symptoms on the plasma DHEA(S) concentrations, we tested only participants with remitted PTSD. A significant group effect was found for plasma DHEA concentration (F (2, 39) = 3.900, p = 0.03), but not for DHEAS concentration (F (2, 40) = 0.913, p = 0.4) and DHEA-cortisol-ratio (F (2, 40) = 2.103, p = 0.1). Post-hoc tests evidenced a significantly lower DHEA concentration in trauma-controls compared to no-trauma (p = 0.03, Bonferroni corrected for multiple comparisons). Lower DHEA might represent a chronic dysfunction in trauma survivors.

Pabst Astrid; Gerigk, Udo; Erdag, Sukran; Altmann, Melanie; Paulsen, Gunnar; Aldenhoff, Josef, Zentrum für Integrative Psychiatrie ZIP GmbH

Interdisciplinary Therapy of Traumatised Refugees in a Psychiatric Context – A Model Project

Since 1998 the Centre for Integrative Psychiatry in Kiel/Germany offers a multiprofessional therapy for severely traumatised refugees /applicants for asylum. Because of legal restrictions there are difficulties in the access to the German health system. Furthermore they have fears of the unknown. A missing work permit and the communal accomodation often lead to massive psycho-social difficulties, and conduce to a maintenance and/or worsening of the health situation. Since 2008 a multiprofessional therapy approach has been developed in a project sponsored by the Europaen Fund for Refugees (EFF). The goal was/is to improve the medical-psychiatric and psycho-social situation of patients.

Besides a psychiatric-medicinal treatment, psychological conversations and social-psychiatric assistance, occupational therapy and physiotherapy as well as language teaching are offered. One focus is the Narrative Exposure Therapy (NET)-a treatment for trauma spectrum disorders.

In 2010, 56 patients from 16 different nations received a treatment with the assistance of qualified interpreters. A significant improvement of the health situation could be achieved, whereas the comprehensive, flexible assistance on the medical and psycho-social level proved successfull.

Pacheco Duarte; Frade, Bruno; Sá, Mónica; Andrade, Ana; Rocha, José, UnIPSa; Centro de Investigação em Ciências da Saúde, Instituto Superior de Ciências da Saúde, CESPU

Predictive Model of Complicated Grief Six Months after Loss on a Portuguese Population

The prediction of the results after a loss, including factors that allow early identification of patients likely to present Complicated Grief (CG), is notoriously difficult. The aim of this prospective, descriptive and multicorrelacional study is to provide a predictive model of CG six months after a loss. The sample consisted of 52 individuals referred by Primary Health Care, that were evaluated 2 months (T1) and 6 months (T2) after loss, with Portuguese versions of the Beck Depression Inventory (BDI), the Impact of Event Scale – Revised (IES-r), the Inventory of Complicated Grief (ICG), the Family Adaptability and Cohesion Evaluation Scale – III and a socio-demographic questionnaire. CG regression model 6 months after death was statistically significant (F = 19.148, p = 0.016), explaining 99.2% of this variable, having trauma and specially avoidance and an import role in this variation. Two months after death, Kinship explains 30% and concomitant symptoms (depression and trauma) explains 22% of the model. The prevalence of psychopathology in this sample is higher than in other studies. This study also suggests high comorbidity between depression, trauma and complicated grief, in both time points, with a considerable predictive ability. It reinforces the importance of early identification of issues related to complicated grief, especially at the level of Primary Health Care units.

Pearce Jennifer; Bisson, Jonathan, Department of Psychological Medicine

The European Network for Traumatic Stress – Training & Practice (TENTS-TP) Project

From May 2009 to May 2011, the EU funded the TENTS-TP project (The European Network for Traumatic Stress-Training & Practice). This project aimed to widely disseminate and implement evidence-based care to those affected by traumatic events that promotes social inclusion throughout the entire European region. TENTS-TP will improve resiliency within member and partner countries through enabling them to appropriately manage the psychosocial consequences of traumatic events.

TENTS-TP partners completed a systematic review, conducted a Delphi process and developed a curriculum that would effectively integrate mental health promotion and disorder prevention into the training and practice of professionals in mental health and social services. This curriculum was disseminated by identifying professionals responsible for teaching and training in the field and providing them with an evidence-based practice teaching package and equipping them to implement this in a sustainable manner in partner countries through the use of a Train-The-Trainers model. The Train-The-Trainer workshops in partner countries throughout Europe were planned for March 2011-May 2011. These workshops help to raise levels of knowledge and expertise of the end users of the project (mental health and social service professionals) which will result in improved services to those affected by traumatic events.

Pejuskovic Bojana; Lecic-Tosevski, D., Institute of Mental Health; Priebe, Stefan, Unit for Social and Community Psychiatry, Barts and the London School of Medicine, Queen Mary, University of London; Toskovic, Oliver, School of Philosophy

Posttraumatic Stress Disorder in Serbia

Background and Objectives: Epidemiological studies on posttraumatic stress disorder (PTSD) in Europe show a lifetime prevalence rate of 2-6% and a current prevalence of 1% in adult population. Lifetime (5–10%) and current (1-1%) PTSD prevalence rates in the United States are higher than PTSD prevalence in the European studies. The objectives of this study were to examine the prevalence of lifetime and current PTSD in the general adult Serbian population and to detect the most stressful life events. Methods: The sample consisted of 640 subjects chosen by random walk technique in five regions of the country. Assessment has been carried out by the Life Stressor Checklist-Revised (LSCL-R), The Impact of Event Scale Revised (IES-R) and MINI-5. Results: Our findings have shown a high level of current (18.8%) as well as life-time PTSD (32.3%). The bombardment, being expelled from home, siege, sudden unexpected death of a close person, combat, non-sexual assault, lack of food or water were the stressful events most likely to be associated with PTSD. Conclusions: This study was part of a large international multicentric study and one of first that examined the occurrence and prevalence rates of PTSD in general population of some European countries. Our findings have shown a significantly high level of PTSD in our population which is a big challenge for psychiatrists but also a burden for health system and the whole community.

Pielmaier Laura; Maercker, Andreas, University of Zurich

Is there PTSD after Severe Traumatic Brain Injury? A New Screening Strategy

Background: There is a controversy on the existence of posttraumatic stress disorder (PTSD) after severe traumatic brain injury (sTBI). We developed a strategy to improve screening for PTSD in this population (e.g., broaden trauma definition from the injury-producing incident to potentially traumatizing post-accident conditions). Aim of this study was to screen for PTSD in patients with sTBI, and to investigate stress-associated factors. Method: 151 patients with sTBI scoring ‘severe’ or ‘critical’ on the Abbreviated Injury Scale were screened for PTSD using an adapted version of the Short Screening Scale for DSM-IV PTSD at 3 and 6 months after injury (n = 115/126; both assessments n = 90). Data were collected prospectively within the PEBITA research network on sTBI in Switzerland. Results: 5 (4.3%) patients screened positive at 3 months and 4 (3.2%) at 6 months. Symptom severity was associated with functional impairment due to brain injury, quality of life, perceived societal disapproval and dysfunctional disclosure tendencies. There was no correlation with initial injury severity, but negative appraisals of the incidence and its consequences (A2 criterion), and of the lack of memory positively correlated with PTSD symptom severity. Conclusion: We believe that the proposed screening strategy improves the detection of patients who might suffer PTSD after sTBI.

Pielmaier Laura; Maercker, Andreas, University of Zurich

Psychological Impact of Severe Traumatic Brain Injury on Close Relatives

Background: Experiencing a life threatening illness such as severe traumatic brain injury (sTBI) of a close relative can cause posttraumatic stress (PTS). We prospectively investigated the course of stress reactions in sTBI patient's relatives, and identified potential predictors of symptom severity. Methods: PTS related symptoms were assessed in 162 close relatives ( = proxies) of patients suffering from sTBI at 3 and 6 months post-accident (n = 117/130; both assessments n = 90) applying the Impact of Event Scale Revised (IES-R). Data collection was embedded in a large scale study on sTBI in Switzerland (PEBITA research network). Results: At 3 months, proxies’ IES-R subscale scores were 8.98 SD 6.36 for intrusions, 7.27 SD 6.53 for avoidance, and 8.26 SD 6.81 for hyperarousal; at 6 months they were 9.0 SD 7.66, 7.23 SD 6.51, and 6.96 SD 6.57, respectively. PTS symptom severity was associated with higher age, quality of life, perceived social acknowledgement, and dysfunctional disclosure tendencies. Although they were independent from any measure of patient's physical or functional impairment, they showed significant correlations with patients’ PTS levels. Conclusions: The physical trauma of a close relative can be traumatizing and cause PTS. Because they might play a major role in care giving, it is important to pay attention to the needs of patient's close relatives after sTBI.

Poijula Soili, Oy Synolon Ltd

Long-Term Post-Traumatic Mental Disorders of Family Members of Homicide Victims

In Finland 125 people a year die as victims of homicide. A sample was drawn from 576 homicide victims recorded in the police results data system in the years 1999, 2004-2007. The postal enquiry was sent to 295 family members. Standardised self-evaluation questionnaires used were the Hogan Grief Reaction Checklist, the Prolonged Grief Inventory-13, the Impact of Event Scale, the Pittsburgh Sleep Quality Index and the Raitsalo-Beck Depression Inventory.

The postal enquiry was answered by 131 (44%) bereaved family members: 92 women (70%), 39 men (30%). Mean age was 47 years. 89% lost one family member and 11% lost 2 or more family members. 24% of the family members were diagnosed with a new physical illness and 35% with a new mental health disorder. Intensity of misery caused by grief was 103.9 (men 79.6 vs. women 113.9). Other reactions of grief except for panic behaviour decreased. 11 (8%) family members fulfilled all criteria of prolonged grief disorder. 37% suffered PTSD. 51% suffered from depression. 47% had a significant sleeping disorder. Women suffered more from new physical and mental illnesses. An exceptionally large share – about half – of family members of homicide victims suffer from PTSD.

Profaca Bruna; Buljan Flander, Gordana; Bacan, Marija; Mateskovic, Dragana, The Child Protection Centre Zagreb

Coping Strategies in Children Exposed to Different Kinds of Traumatic Events

Coping refers to various behaviours and strategies used by an individual in response to stressful situations. Coping strategies are important prerequisites of growth and development and significant factors in the etiology of psychological and somatic problems. Children do not have a wide scope of coping strategies to rely on. The coping skills developed in childhood and adolescence affect the coping styles a person uses in adult life.

The aim of this paper is to present coping strategies used by children after various traumatic events to which they have been exposed. The clinical study was conducted in The Child Protection Centre and involved three groups of school children: those who have witnessed domestic violence (N = 46),children exposed to bullying (N = 43) and children exposed to traumatic events outside their families (N = 35). The Coping Strategies Inventory for Children and Adolescents – SUO (Vulić Prtorić, 2002) was used. This scale is divided into 7 subscales with conceptually distinct coping categories: problem solving, cognitive restructuring, expressing feelings, disctraction, avoidance, friends' support and family support. Results from all three groups show that children most frequently use distraction and avoidance strategies, and less frequently problem solving strategies. The study also presents specific differences between the groups which can be used for further research and treatmant goals.

Qouta Samir, Islamic University Gaza; Palosaari, Esa, University of Tampere; Diab, Marwan, Gaza Community Mental Health Programme

Effectiveness of Psychosocial Intervention Among War-Traumatized Children: Mental Health and Socio-Emotional Development: A Cluster Randomized Controlled Study

War trauma forms severe risks for child well-being and development. Fortunately, there are a number of interventions to help war-traumatized children that involve both therapeutic and resilience-enhancing elements. Less is known about their effectiveness. This randomized prospective study analyses whether a psychosocial intervention in school context can enhance mental health and socio-emotional development among children exposed to war in a context of general adversity. The questions concerning effectiveness are: (1) Do children in the intervention group show less PTSD and externalizing and internalizing symptoms than the waiting-list control group? (2) Do children in the intervention group enjoy better peer- and sibling relations and show more optimal emotion regulation than the waiting-list control group? Method Participants are 485 Palestinian boys and girls (10-13 years) exposed to trauma and losses in the context of the War on Gaza 2009. A half participated in an intervention based on Teaching Recovery Techniques (TRT) and the other half served as waiting-list controls. They reported PTSD and Strengths and difficulties (SDQ) and Peer and Sibling relations and Emotion regulation at baseline (T1), after the intervention (T2) and nine (T3) months follow-up. The results support the hypothesis of the effectiveness of psychosocial intervention to improve child mental health, but less so socio-emotional development.

Repic Nevena; Stecker, Anja; Düllmann, Sonja; Senf, Wolfgang; Tagay, Sefik, LVR Klinikum Essen

Trauma and PTSD in Dermatological Patients

Background: The aim of this study was to assess the PTSD prevalence with regard to trauma-related and psychopathological symptoms in dermatological in- and outpatients. Methods: 276 patients with skin diseases (M = 44.97 years, SD = 17.69; 55.4% women and 44.6% men) were examined with the Essen Trauma-Inventory (ETI), Brief Symptom Inventory (BSI) and the Chronic Skin Diseases Questionnaire. Results: 3.7% of the outpatients and 9.9% of the inpatients met the study criteria for PTSD according to DSM-IV though 70% of all participants reported at least one potentially traumatic event in their life. The most frequently experienced trauma in both groups was “severe illness”. In addition, patients with PTSD had significantly higher levels in psychopathological symptoms than patients without PTSD. Discussion: Our results suggest that PTSD in dermatological inpatients is more frequent than in dermatological outpatients. Therefore it would be enriching to consider the severity and role of trauma-related and psychopathological symptoms for future therapy concepts in the treatment of dermatological patients.

Rutkowski Krzysztof; Dembinska, Edyta; Müldner-Nieckowski, Lukasz; Sobanski, Jerzy; Murzyn, Agnieszka; Mielimaka, Michal, Jagiellonian University Medical College, Kraków

Late Consequences of Early Childhood Trauma

The aim of study is to show the late effects of early childhood trauma and trauma in adulthood for further development of the personality. The condition was that early childhood trauma is not remembered contrary to the trauma in adulthood. Subject and method: The subjects were 329 persons with traumatic experiences of deportation or imprisonment for political reasons. Value Survey compiled by Milton Rokeach, has been used for the research. The group was divided into two subgroups: those who were persecuted in early childhood (as maximum 5 years old) or adulthood. Discussion: In the presentation, emotional reactions of people deported from Poland to former USSR in the 1940s of the 20 th century have been presented. Most of them spent several years in deportation; some spent their early childhood there. The fact of spending several years under deportation in severe conditions, seeing people dying, a frequent loss of relatives and a constant feeling of threat left behind a solid trace in their personality. Even many years after deportation (about 50 to 60 years), it is possible to observe consequences disturbing daily functioning. Results: showed statistically important differences between the two groups of people traumatised in childhood or in adulthood. In declared values consequences of the experienced trauma are traced, they are shown by the fact that people give higher ranks to certain values, which are associated with lost values, such as, freedom. Conclusion: The study confirmed the importance of the early childhood trauma for the development of the personality even if trauma is not remembered.

Rzeszutek Marcin, University of Warsaw

Post Traumatic Stress Disorder (PTSD), Temperament, Stress Coping Styles and Social Support in HIV-Positive People

The aim of this research is to investigate the link between post traumatic stress disorder, temperament, stress coping styles and social support in HIV-positive people. In particular, this study focuses on evaluating personality and social predictors and moderators of traumatic stress, caused by a terminal illness. Participants are recruited from 100 adult HIV-positive patients of Wolski Hospital in Warsaw and also organizations helping people with HIV/AIDS. They completed personality and social support questionnaires and a special survey with basic, anonymous information about themselves and their disease. It was discovered that particular temperament traits and stress coping styles can increase the risk of PTSD in HIV-positive people. In addition, particular features of social support may be an important protective asset in case of trauma caused by a terminal illness. Understanding the role of the above mentioned variables in the PTSD dynamics in HIV-positive people can shed some light on psychological problems of those people and contribute for improving their quality of life.

Schiller Bettina, Strasser, Daniela; Wintner, Daniela; Zeilinger, Elisabeth; Lueger-Schuster, Brigitte, University of Vienna

Children of War – The Impact of World War II and the Occupation of Austria on the Mental Health in the Elderly. Post-traumatic Stress Disorder, and Current Psychopathology

Introduction: The aim of this study is to portray the current psychopathology of the elderly Austrian population, in which the events of World War II and the occupation of Austria is to be considered first. Particularly the topic of PTSD and its association to mental burden of the elderly shall be examined. Methods: After excluding the presence of dementia by MMSE, 316 Austrians, born before 1945 were interviewed in all Austrian federal states by trained interviewers. Every participant provided information about their historical background, using a structured interview, which was especially designed by experts in contemporary history and World War II. Furthermore, the elderly people were screened for symptomatic burden (BSI), trauma exposure after the post-war period (TLEQ), present symptoms of PTSD (PCL-C) and resilience (CDRISC). Results: The results are yet to be obtained. A high number of psychopathological symptoms in the elderly are expected, as shown in other studies. It is assumed that this is associated with existing PTSD symptoms. Discussion: Events of World War II often lead to psychopathological symptoms. Therefore, said symptoms and possible war-related traumas should get more attention in psychological interventions. The findings of this study will be discussed in relation to findings from other studies, treating this topic.

Schweizer Katinka; Brunner, Franziska; Gedrose, Benjamin; Richter-Appelt, Hertha, Universitätsklinikum Hamburg Eppendorf

Understanding Traumatic Stress in Sexual Minorities: Coping with Atypical Sex Development, Gender Variance and Intersex Treatment

Divergences of sex development (DSD), i.e. intersexuality, include a range of congenital conditions in which the development of chromosomal, gonadal or anatomical sex is atypical. As a result, a person's sex characteristics do not all correspond to one sex. In the past, medical practice has been aimed at quickly assigning infants with DSD to an “optimal gender”, at decreasing mental health risks and avoiding gender confusion by means of sex corrective interventions (e.g., genital surgery). This approach has received growing criticism because of the lack of follow-up studies and its potentially traumatizing effects. Advocacy groups have voiced the risk of Human Rights’ violations.

Data will be presented on treatment, psychosexual development and coping in adults with different DSD (n = 69). Most participants with 46, XY karyotype were assigned female and had received “feminizing” treatment. Satisfaction with treatment varied greatly between the DSD groups. Only 50% reported to feel certain about their gender identity, while 72% showed satisfaction with gender assignment. Gender satisfaction correlated negatively with treatment aspects (e.g. a large number of surgeries). 61% showed clinically relevant psychological distress, 25% scored high on dissociation. 45% had sought psychological help. The interplay of psychosexual and psychosocial risk factors in intersex individuals will be specified. Implications are drawn as to why therapy and research should focus more on trauma specific needs of members of sexual minorities.

Scigala Dawid, Warsaw School of Social Sciences and Humanities

Seeking Sensation, Gender and the Psychological Tendency to Risky Behavior among Drivers who Commit Traffic Offenses Chronically. The Analysis of the Example of the Causes and Victims of Traffic Accidents

It was assumed that the level of seeking sensation and gender are important predictors of psychological propensity to risky behavior. The study was conducted with 133 persons who were participants in training courses for people committing traffic violations commonly. Respondents were asked to complete the following tests: the sensation seeking scale V(SSS-V), Sex Role Inventory, State-Trait Anxiety Inventory (STAI) and Speeding Attitude Scale(SAS). It was also found that in the group of offenders there are significantly more individuals with a psychological masculine gender (26) and androgynous (20) than in the group of victims, respectively 12 and 9 people. The analysis showed a significant difference in the tendency to risky behavior among causers (M = 46.21) and victims (M = 39.47), traffic accidents U = 894, p < 0.05. Furthermore, the analysis of variation showed that young people with high level of sensation seeking present significantly higher levels of risky behavior on the road (M = 51.24) than older people, also with higher levels of search experience (M = 32.41), F(1,113) = 16.845, p < 0.001 than older people having a low level of sensation seeking (M = 38.38). Another study showed that the higher level of sensation seeking, the lower the level of anxiety disorders in the causes of traffic accidents, but not in victims with high level of sensation seeking.

Sendas Sandra, Maia Angela, Minho University

The Life Stories of Portuguese Colonial War Veterans wiht and wihout PTSD

Traumatic experiences challenge the cognitive-emotional schemes and the structures of meaning used by individuals. With this study we intend to understand and compare the organization of meaning made up by war veterans with and without PTSD for their life stories in the pre, peri and post military periods.

Participants (26 war veterans of the Portuguese Colonial War,15 of these with PTSD) were interviewed and the integral transcriptions of the interviews were analysed in accordance to the open, axial and selective modes of the grounded analysis codification.

The results showed that different theories emerged in each group, and these differences can be seen in each of the three considered periods of life. In the pre-military period, the emerging stories were Suffer to Survive (PTSD group) versus Strict Care Giving. During war the Functioning on Warrior Beast Mode versus from Military to Warrior describes the different war experiences and in the post military period Change to (Des)Integrate versus Change to (Re)Integrate are the PTSD vs non PTSD theories.

We concluded that after war experience, the different combinations of previous experiences, trauma exposure and resources may be decisive to meaning. Veterans are able to construe and psychopathology, resilience, and/or post traumatic growth is a never ended balance.

Siller Heide; Juen, Barbara, University of Innsbruck

Are Reactions to (Traumatic) Stress Gendered?

Many studies find women develop posttraumatic stress disorder twice as often as men (e.g. Tolin & Foa, 2006 Olff et al, 2007; Juen et al, 2008; Punamäki et al, 2005). Gender is also central in psychosocial support intervention. Relevant impacts on responses to disasters of men and women embrace cultural socialization, needs due to biological differences, role and status within community and family. These impacts also affect humanitarian aid workers in disaster settings. In the present study we examined humanitarian aid delegates from Austria according to their reactions to stress, coping strategies and gender. For the assessment of reactions and coping with stress we used PTSD Symptom Scale (Foa et al, 1993), Emergency Coping Style Questionnaire (Clohessy & Ehlers, 1999), Posttraumatic Growth Inventory (Tedeschi & Calhoun, 1996) and Gender Stereotypical Traits & Normative Gender Role Attitudes (Athenstaedt, 2000). We conducted interviews to acquire a detailed impression of men and women working in disaster settings. As expected humanitarian aid workers in disaster settings show only limited stress symptoms. The results indicate that differences in stress are not due to biological factors of sex, but to gender role. Our discussion centres on stress influenced by gender roles, gender traits and the field of activity of men and women in disaster setting.

Silva Tânia; Rocha, José; Ferreira, Elisabete; Gonçalves, Catarina; Moreira, Fábio, UnIPSa

Comorbidity between Complicated Grief, Post-Traumatic Stress Disorder and Depression

The Complicated Grief (CG) is associated with many complications of mental health, including increased risk for mood, anxiety and post-traumatic stress disorders (PTSD). In fact, the comorbidity between CG, PTSD and Depression (Dep.) is high. We evaluated 110 bereaved adults diagnosed with psychiatric disorders, using the following Portuguese version of assessment instruments: Inventory of Complicated Grief, Beck Depression Inventory, Impact of Event Scale-Revised and Difficulties in Emotional Regulation Scale. Regarding to co-morbidity between CG, Dep. and PTSD we verify a 70.9% prevalence of symptoms of CG co-morbid with Dep., 73.6% co-morbidity between CG and PTSD and a co-morbidity of 80% between Dep. and PTSD. Furthermore, is important to underline the co-morbidity of 69% between the three disorders: CG, Dep. and PTSD.

So, these results allow us to verify that the prevalence of disturbance of CG, PTSD and Depression in psychiatric patients is high and that the high co-morbidity existent between these three disorders is about twice the values obtained in literature. In fact, these results show that this is a weakened and affected population in various areas of psychopathology, not only in CG but also in PTSD and Dep.

The higher co-morbidity between CG and PTSD is justified by high prevalence of unexpected losses of the sample and by the traumatic nature of someone significant.

Simmen-Janevska Keti; Krammer, Sandy; Maercker, Andreas, University of Zurich

Childhood Adversities and Health in Old Age: The Role of Motivational Competencies

Background: Adverse/potentially traumatic events during childhood have been shown to favor the development of PTSD or have a negative impact on health in later life. Furthermore, an emerging body of research suggests that stressful experiences are associated with cognitive dysfunctions in old age. Recent studies have reported a beneficial relationship between motivational factors and different domains of psychological health on the one hand and cognitive functioning on the other hand. Self-efficacy, self-control and conscientiousness are relevant motivational factors often reported in the trauma literature. However, to date their role in samples of elderly with a history of adversity during childhood has been examined to a lesser extent. Objective: The purpose of the present study is to determine whether and how motivational competencies mediate the relationship between childhood adversity and health/cognitive status in old age. Method: The study is planned to include N = 150 subjects (≥ 70 years) with a history of adversity during childhood. Outlook: We present preliminary study results on the role of motivational factors. We conduct a mediation analysis in order to test: First, whether childhood adversity predicts health/cognitive status. Second, whether childhood adversity predicts motivational factors (mediators). Third, whether childhood adversity and motivational factors predict health/cognitive status.

Sinclair Helen, Queen's University, Belfast; Moutray, Marianne; Peake, Sandra; O'Hagan, Marie-Therese, WAVE Trauma Centre

Integrating Formal and Experiential Learning Methodologies in a New Undergraduate Programme in Trauma Studies in a Post-Conflict Society in Northern Ireland: Issues and Dilemmas

This presentation is innovative in raising an awareness of the issues and challenges experienced in educating and supporting students, from a range of backgrounds, enrolled on a BSc(Hons) Trauma Studies in Northern Ireland. One of the challenges in implementing a new trauma programme has been introducing systematic and rigorous research teaching into the student experience. Data sets include reflective discussions between staff. The programme team consists of two staff groups from the School of Nursing and Midwifery, Queen's University, Belfast and WAVE Trauma Centre. Preliminary results may also be available from a research study entitled'Challenges and issues experienced by students undertaking a BSc(Hons) Trauma Studies in a post conflict society: A Northern Irish perspective' commencing in 2011. Students have discussed experiences of living in a post conflict society. Historically individuals have been silenced due to the security issues of living in a society in conflict and the classroom has faciliated open discourse in a safe environmnet. Emotive and contraversial material has been explored and students perspectives have been broadened. Lecturers have experienced challenges in faciliating open expression of students experiences from diverse backgrounds and ensuring a research and educational focus is maintained.

Siqveland Johan, Akershus University Hospital

Posttraumatic Stress and Chronic Pain – A Longitudinal Study of Chronic Pain Patients

Previous research has found increased rates of exposure to a wide range of potentially traumatizing events in chronic pain patients as well as increased rates of PTSD. Patients with PTSD also commonly report somatic pain. The mediating factors explaining the links between pain and posttraumatic stress disorders are however insufficiently understood. The present study aims to assess the relevance of posttraumatic stress for the tractability of chronic pain. The current study recruits consecutively referred patients to a specialist pain clinic. The patients are interviewed at the beginning of an interdisciplinary pain treatment program and six months later. The first interview covers, demographic data, information about exposure to potentially traumatizing events, symptoms of posttraumatic stress, psychiatric diagnosis, self-reported pain and pain-related disability. The second interview assesses self-reported pain, psychiatric diagnosis and posttraumatic stress symptoms. It is hypothesized that having experienced potentially traumatizing events, having high levels of posttraumatic stress and depressive symptoms at the beginning of treatment will be positively related to treatment non-responding six months later. This poster reports from a longitudinal study currently in the data collection phase. Background, research design and preliminary findings are presented.

Smith Annemarie J.M.; Kleijn, Wim Chr., St. Centrum'45

Complex Trauma, Quality of Life and Coping by Refugees Applying for Daytreatment

Background: Patients applying for daytreatment for refugees of Long-stay In the Netherlands (LIN-group) in Centrum '45 are subjected to a psychodiagnostic procedure including measures of symptoms, quality of life and coping. Aim: Description of characteristics of the LIN-refugees in daytreatment groups and their diagnostic profile, quality of life, coping resources, basic assumptions and coping strategies. Furthermore, the relation between quality of life and coping will be explored. Method: During the intake procedure, LIN-refugees filled in the Harvard Trauma Questionnaire for posttraumatic symptoms, and the Hopkins Symptom Checklist-25 for anxiety and depression. Quality of life was explored by the WHO-QOL. Coping was measured using the Resources Questionnaire, the World Assumptions Scale and the Cope-easy. Results: The cultural and ethnic background of the LIN-refugees varied greatly, though all had experienced may different traumatic events and presented with a high symptom profile. Quality of life was positively related to self-efficacy and social resources and to the basic assumption of self-esteem. Conclusion: The results underscore the importance of personal and interpersonal resources for experienced quality of life in this group of severely traumatized and uprooted patients. Even when trauma-focused treatment may be limited in grouptreatment for refugees, the group format may have an indispensable function as vehicle for restoration of a positive sense of self and quality of life.

Smoktunowicz Ewelina, Warsaw School of Social Sciences and Humanities; Cieslak, Roman; Basinska, Beata, Gdansk University of Technology

The Effects of Secondary Traumatic Stress on Work Engagement and Job Burnout: Testing the Mediating Effect of Self-Efficacy and the Moderating Effect of Mortality Salience

This experimental study examined the direct and indirect impact of secondary traumatic stress (STS) on work engagement and job burnout. Two aims were addressed: (1) whether mortality salience moderates the impact of STS on work engagement and job burnout, and (2) whether secondary trauma self-efficacy mediates the effect of STS on work engagement and job burnout.

The participants were 106 Polish police officers, who filled out the Secondary Traumatic Stress Scale (Bride, Robinson, Yegidis & Figley, 2004), and our Secondary Trauma Self Efficacy Scale, followed by the mortality salience manipulation. After the experimental manipulation respondents completed the Utrecht Work Engagement Scale (Seppälä, Mauno, Feldt, Hakanen, Kinnunen, Tolvanen, & Schaufeli, 2009) and Oldenburg Burnout Inventory (Halbesleben & Demerouti, 2005). No evidence was found to support the role of mortality salience as a moderator of the relationship between STS and work engagement and between STS on job burnout. However, the results indicated the significant mediating effect of self-efficacy on the link between STS and work engagement, with high STS being a predictor of low self-efficacy and with low self-efficacy, in turn, being a predictor of low work engagement. Self-efficacy in dealing with secondary trauma mediated the effect of STS on job burnout, althoug h the effect was marginally significant.

Sousa Virgiana, UnIPSa

Construction and Validation of Complicated and Healthy Grief Prototype Narratives

The individual constructs, organizes himself and his experiences around coherent, complex and diverse narratives. In this sense the need arises to organize the discourse of prototype narratives for the experience of healthy Grief (HG) and complicated grief (CG). The aim is to build, validate and compare two prototype narratives: HG and CG. Participants are identified by a structured interview. Once narratives are collected, a content analysis is carried out that enables the construction of prototype narratives through 7 categories. When these two prototype narratives are built they are compared and validated. The instruments used are: sociodemographic questionnaire; interview for bereavement episodic recall and Inventory of Complicated Grief (ICG). For HR narrative we had 15 participants (6 women and 9 men, age M = 38.7 SD = 9.6) and for CG narratives 11 participants (ICG cutoff ≥25; 10 women and 1 man, age M = 46.2 SD = 10.5). Validation sample had 45 participants: 15 healthy adults without CG, 15 with CG and 15 psychotherapists. The narratives for both complicated and healthy grief are presented. We found differences concerning the context, the precipitating event, and the end results. Divergent and convergent validation results for CG prototype narrative allow discussion about the value of constructed narratives for practice and research.

Stigler Katharina, Medical Center for Psychoanalysis und Psychotherapy Vienna

Traumatic Experiences in Childhood and their Duration Into Adulthood

This work tries to specify the consequences of traumatic experiences like violence on the health of the victims. Beside theoretical considerations on this topic, an investigation has been carried out to empirically test these assumptions. The statistical analysis has shown results which allow the statement that experienced physical violence is connected to posttraumatic stress disease and experienced sexual violence is linked to the diagnosis of a personality disorder, especially the borderline personality disorder. Due to these results a link between experienced physical violence, the psychosomatic symptoms and the posttraumatic stress disease as well as a link between experienced sexual violence, a high level of somatic symptoms and the borderline personality disorder can be seen. In addition, comparisons with a representative sample of the normal population (in Germany) showed more and more severe somatic symptoms for women with violence experiences. The statistical analysis has further shown differences in the level of somatoform dissociation for experienced physical violence as well as for posttraumatic disorders like the posttraumatic stress disease and the borderline personality disorder.

Strasser Daniela; Schiller, Bettina; Wintner, Daniela; Zeilinger, Elisabeth; Lueger-Schuster, Brigitte, University of Vienna

Children of War – Impact of WW II and the Occupation Period in Austria on Psychological Well-being among the Elderly Population. Traumatic Experiences during War and PTSD

Aim: 65 years ago a whole generation in Austria was exposed to WW II and allied occupation. The aim of the present study is to analyse trauma exposure differentiating between the zones of occupation, and their impact on psychological health, especially the presence of PTSD. Method: 316 people, born before 1945, were interviewed in all provinces of Austria. Trained interviewers provided a structured interview, including a symptom checklist (BSI), a screening for PTSD (PCL-C), a list of traumatic events (TLEQ), and an assessment of resilience (CD-RISC). A detailed historical questionnaire, designed in cooperation with specialists in contemporary history, was included. Results: A high exposure to different kinds of war traumata, like bombing, war captivity, combat exposure, sexual assault and traumatic experiences with occupation forces, according to historical data and studies in Germany, are expected. Differences between US, French, British and Soviet occupation zones in trauma exposure, and the relation to current PTSD, will be presented. Discussion: This multi-disciplinary study allows access to the complex subject of WW II in Austria from a psychological and historical perspective. For this reason a better understanding of psychopathological symptoms and problems of the war generation, focussing on care and psychological intervention, is expected.

Swirkula Magdalena; Trzebinski, Jerzy, Warsaw School of Social Sciences and Humanities

Alexithymia, Sense of Coherence, Basic Hope and Acute Stress Disorder

The purpose of two studies was to determine the relation and its nature between Alexithymia, SOC (Sense of Coherence), BH (Basic Hope) and ASD (Acute Stress Disorder) among patients suffering from myocardial infarction. It was assumed that there would be a positive correlation between Alexithymia's symptoms and ASD's symptoms. It was also assumed that there would be a negative correlation between SOC and BH and ASD. The 1st study included 30 patients, aged 44 to 85. The 2nd study included 60 patients, aged 47 to 84. Both studies were conducted between the 3rd and 7th day after myocardial infarction. The results indicated that the higher the level of SOC (1st study) and BH (2nd study), the lower the level of ASD. In both studies a significant positive correlations between Alexithymia and one of its symptoms – Difficulties Identifying Feelings and ASD were discovered. Moreover, significant interaction between Alexithymia and BH was proved in the 2nd study – there was a significantly higher level of Dissociation when levels of both BH and Alexithymia were lower than when the level of BH was low and of Alexithymia was high.

Symmank Anja, Croy, Ilona; Hummel, Thomas; Schellong, Julia, University of Dresden Medical School

Treatment Follow-Up in Patients with Complex Posttraumatic Stress Disorder Using Olfactory Examinations

Background: Patients with multiple trauma history show high participation of the limbic system in stimulus processing. Due to the projection of the olfactory system into the limbic system we wanted to find out, if those patients change their subjective emotional state as well as the more objective odor perception findings during multimodal inpatient treatment. Methods: To test this hypothesis we applied psychophysical measurements (Sniffin′ Sticks) in addition to different psychological questionnaires before and after intervention to 33 patients of an inpatient treatment in a psychosomatic clinic. The same measurements were performed on a healthy control group of 29 subjects. Results: We found significantly improved scores in patients after therapy in the questionnaires applied (Hamilton, IES-R Intrusion and STAI). In odor measurement we found reduced olfactory identification and discrimination abilities in the traumatized patients compared to the healthy controls before therapy and an improvement of the olfactory abilities of the traumatized patients up to the level of the controls after therapy. Conclusions: The results indicate improvement of emotional state due to psychotherapy concording with normalization of olfactory processing. The olfactory system projecting in the limbic system may be an important indicator of change processes in psychotherapy.

Tanyi Zsuzsanna, University of Debrecen

Diagnosis of Cancer: A Source of Posttraumatic Growth

Psychological trauma/crisis can be caused by several “events”: accidents, death, war, violence as well as life-threatening diseases like cancer. There is a large and still growing literature that documents related experience of people with cancer and identifies positive ways (growth) in which their lives have changed as a result of a cancer diagnosis.

Posttraumatic growth (PTG) is “the experience of positive change that occurs as a result of the struggle with highly challenging life crises” (Tedeschi & Calhoun, 2004). It is very important to emphasize that there can be robust individual differences in this reaction to traumas. According to the current literature, for example, the PTG is higher in the case of women, younger people and individuals with secure adult attachment.

In our research we focus on the associations between posttraumatic growth of adult patients with cancer and the following factors: features of cancer, demographic variables, quality of life, adult attachment and various characteristics of personality. The novelty of this study is that it takes the effect of different personality traits and types of attachment on posttraumatic growth into account. What kinds of personality traits show correlation with increased growth? Does higher quality of life involve more positive experiences? These are the central questions to which we try to answer.

Temnik Sanja, University of Primorska; Smrdu, Maja, University Psychiatric Clinic Ljubljana

Growing Up with a Mother who Suffers from Depression: A Case Study

Children of depressed mothers are at increased risk of developing mental health problems in childhood and later in life, even more so than children of depressed fathers (Tully, Iacono and McGue 2008). Parental mental illness is often described in terms of secondary trauma for the child, as living with serious mental illness can have traumatizing effects (Lombardo 2008). Depression interferes with or even prevents the mother from successfully fulfilling her parental role (Markowitz 2008), and is associated with difficulties in mother-child interaction. Home life with a depressed mother represents an important environmental risk factor for depression in the child, on top of heritability. Parental mental disorder involves considerable risk to the child's secure attachment (Maybery et al. 2005), which can negatively influence interpersonal relationships throughout the child's life. Qualitative research can provide insight into the experience of growing up with a parent suffering from mental disorder (Sollberger and Pletson 2007), as well as the experience of parenting from the perspective of people with mental disorder. We present a case study of a mother-daughter relationship where both parties suffer from depression, with special emphasis on problems in emotional and interpersonal functioning of the daughter throughout adolescence, associated with the mother's long-term depression.

Tettamanzi Marilena; Sbattella, Fabio, Catholic University of Milan

Stress or Well Being in Health Operators: A Research about Italian Nurses

A nurse faces everyday human suffering. Nurses have to enter in relationship with patients and their sufferance and they also have to communicate with patients’ relatives. Relationships with ill people and their families arouses intense and often negative emotions in nurses. These emotions can interfere with nurses’ psycho-social well being and they can evolve in traumatic experience or in burnout. The study aims to explore relationships between nurses’ communication competences, nurses’ styles of coping, burnout and nurses’ quality of life. We hypothise that proactive coping promotes psychological well being and it reduces risk of burnout. We also, hypothise a mediator effect played by nurses’ communication competences and strategies. Research involved 400 Italian nurses. A questionnaire ad hoc about communication with patients and their relatives, the Burn Out Inventory (Maslach, 1994), the Proactive Coping Inventory (Greenglass et al., 1999) and a questionnaire ad hoc about nurses quality of life were administered to each subject. Results confirm our hypothesises. Good communication competences play a moderator effect between proactive coping and well being or burnout. Coping strategies increase quality of life, but nurses show low levels in coping strategies. Results confirm the importance of nurses training in communication and in coping strategies.

Ting Julia; LePage, Steeve, British Columbia Operational Stress Injury Clinic

A Canadian Approach to Serving Veterans and Military Personnel with Operational Stress Injuries

The British Columbia Operational Stress Injury (BC OSI) Clinic was launched in Feb 2009 as a part of a network of 9 clinics across Canada. The clinic provides specialized mental health services to Veterans, members of the Canadian Forces, the Royal Canadian Mounted Police (RCMP) and their families living in BC, Canada who have ongoing difficulties as a result of service-related psychological injury and traumatic events (operational stress injury). BC has a population of approximately 4,419,974 and spans across 944,735 sq. km. To put this into perspective, our service coverage area is approximately three times larger than the size of France. Our nine-member multidisciplinary team works together to provide the following services: psychological and psychiatric assessments, individual psychotherapy, medication treatment, relationship and family counselling, education for family members, health care providers, and others interested in OSIs. We specialize in treating OSIs such as PSTD. One challenge of working with individuals who suffer from a disorder like PTSD is social isolation and avoidance of triggers. Our treatment philosophy is client-focused and to operationalize this, our clinicians travel (up to 2000 sq km) to provide treatment to those clients who are too symptomatic to travel to our clinic. In our poster presentation, we will discuss the unique aspects of this clinic. This includes providing services to clients using tele-mental health and outreach services. We will also address the challenges we have faced and our future directions.

Vick Tracey, Cardiff and Vale University Health Board; Hampton, Victoria; Newcombe, Robert; Bisson, Jonathan, Cardiff University

Self-Report Questionnaire Performance in Survivors of Critical Illness Admission

The detection of vulnerable survivors of critical illness admission who present with early traumatic stress symptoms may facilitate improved management of psychological outcomes. In non-psychiatric settings, necessary expertise to accurately detect PTSD is often lacking and detection of early symptoms may be best achieved through the use of standardised self report questionnaires that have been validated within the given population. This paper will describe the performance of four scoring rules of the Davidson Trauma Scale (DTS) (Davidson et al., 1997) and performance of the SPAN (Meltzer-Brody, 1999) to two scoring rules of the Clinician Administered PTSD scale (Blake, 1995) for DSM-IV (CAPS). The presence or absence of PTSD at each assessment and according to the scoring rules of the DTS and the SPAN, were cross-tabulated with those of the CAPS scoring rules for the relevant assessment. Sensitivity, specificity, positive and negative predictive values were calculated. Results show that the performance of the DTS and the SPAN were disappointing, although the DTS performed better than the SPAN. The sensitivity measures when compared to the CAPS varied considerably and confidence intervals were wide. Specificity was less varied for both questionnaires. The PPV and NPV were low and high respectively, and likely due to the low proportion of PTSD identified. This study highlighted the variation in the proportion of PTSD cases identified using the SPAN and four scoring systems of the DTS, when compared to the gold standard CAPS structured clinical interview.

Wintner Daniela; Schiller, Bettina; Strasser, Daniela; Zeilinger, Elisabeth; Lueger-Schuster, Brigitte, University of Vienna

Children of War – Consequences of World War II and the Occupation of Austria on the Mental Health of the Elder Generation. An Analysis of Risk and Resilience Factors Concerning PTSD

Aim: Contrary to the huge amount of studies on the topic of risk factors for the development of PTSD, factors of resilience are often let out. The aim of this study is to determine both the risk and resilience factors in a sample of WW II survivors in Austria. Method: A total of 316 persons in Austria were interviewed. In order to capture the historical background of the older population, with a focus on social support and social acknowledgment, an especially structured interview was developed in cooperation with experts of the Ludwig Boltzmann Institute with the research focus on effects of war. In addition, the following instruments were used: The CD-RISC to measure resilience, the PCL-C to measure PTSD symptoms and the TLEQ to measure traumatic experiences. Results: This study will examine the role of protective factors such as resilience, social support and social acknowledgment in protecting against PTSD. In addition, demographic factors (e.g. gender, marital status, level of education, etc.) will be analysed in regard to their relation to PTSD and resilience. The final conclusion is still in development. Discussion: The identification of resilience factors is expected to provide insight into possibilities of promoting healthy coping with traumatic experiences. The impact of resilience on PTSD will be discussed and compared to existing literature.

Wittekind Charlotte; Muhtz, Christoph; Kellner, Michael; Moritz, Steffen; Jelinek, Lena, University Hospital Hamburg-Eppendorf

Neuropsychological Functioning and Biased Information Processing in Posttraumatic Stress Disorder (PTSD) Following Displacement After World War II

Background: Many studies have reported deficits in learning and memory as well as biased information processing in individuals with PTSD. Consequences of trauma might not be limited to the people directly affected, but also concern close relatives, especially their children. The aim of the present study was to investigate transgenerational effects of PTSD on the cognitive performance and attentional bias in the respective offspring. Method: Individuals displaced as children from the former German Eastern territories during World War II (20 with PTSD, 24 without PTSD), 11 nondisplaced healthy controls and one of their adult children were compared as to their cognitive performance with a battery of neuropsychological tasks as well as to their processing of trauma-related stimuli (Stroop task). Results: Evidence for impaired cognitive functioning or biased information processing was neither found in individuals with PTSD nor their offspring. Discussion: Sample characteristics (e.g., highly resilient population, low symptom severity) and methodological aspects might explain our results. The null findings in the second generation might result from the fact that no neuropsychological deficits could be found in the parental generation or that parental PTSD does not affect the offspring′s neuropsychological profile.

Yilmaz Banu; Hocaoglu, Ayla, Ankara University

Long Term Effects of the Last Turkish Migration (1989) from Bulgaria to Turkey: An Investigation in terms of World Assumptions, Resilience, Perceived Social Support, and Life Satisfaction

Migration is the movement of people across a boundary to establish a new residence. The last century has witnessed major incidents of migration all around the world. According to an OECD report on international migration, approximately 190 million people live in a country other than the country she/he was born. The causes of migration are diverse, and some of these factors such as wars, conflicts, poor life standards are those that force people to leave the country they live in, and the others such as a better job, education, political freedom, and social security are those that motivate people to move to the new country where they target to live. Studies show that immigrants may experience some social and psychological problems resulting from culture change and the other associated difficulties. The aim of this study is to examine the long term effects of migration in terms of world assumptions, resilience, perceived social support, and life satisfaction in a sample of immigrants who migrated from Bulgaria to Turkey in 1989. The results of the study will be discussed in the light of the related literature.

Zadecki Jerzy, Edward Hines Jr.VA Hospital

Chronic PTSD and Racial Profile

The author presents this segment as a part og a large empirical study "Chronic PTSD and Treatment Outcome" after three decades since combat-related trauma (Vietnam War). Number of veterans registered for PTSD exam was quite large (1,600). Siginificanlty higher numbers of Blacks were not diagnosed with PTSD compared with Whites. Their chances for service connected benefits were compromised. Significanlty higher rate of unemployment was found among Blacks not diagnosed with PTSD than among Whites not diagnosed with PTSD. Questions raised by raters regarding reliability of narratives and validity of tests were higher toward Blacks than Whites, even their pre-treatment Mississippi was significantly higher that Mississippi scores for Whites. Eventually both groups were diagnosed with PTSD (benefit of the doubt was applied). Treatment satisfaction among ethnic groups did not reveal differences, and was pretty high. The cause of disparities between Blacks and Whites could be accounted for by a multiplicity of factors, ranging from bias among raters during the diagnostic process, to a wide range of confounding and contextual factors.

Zara Ayten, Istanbul Bilgi University

Working Towards Ending Child Sexual Abuse in Turkey

The sexual violence is one of the major problem for children in the Turkish society where these issues involve many psychological, social and cultural factors which need to be assessed in order to be altered. The violence towards children in a society is not only the responsiblity of the aggressors but also it is the responsibility of all individuals in that society. The society as a whole should recognise the violence problem and do something about it to prevent it happening. One of these prevention methods is to increase public awarness on violence and trauma towards children in order to develop appropriate and healthy attitudes in individuals. In order to achieve this, many mental health workers should be able to work together. Therefore, Istanbul Bilgi University Psychology students have set up the BILGI AÇIK KAPI (BAK) Group (www.bilgiacikkapi.com) as a project in order to: 1) Increase the public awareness on child sexual violence and its effects, 2) Provide contact information of professionals and NGOs to hard-to-reach groups such as traumatised people, 3) Provide fInancial and professional support to NGO's working towards ending sexual violence.

Zavala Guillén Ana Laura; Ríos, Lorena, Procuración General de la Nación Argentina

“Neither Alive, nor Dead”: Disappearance and Restitution of the Identity of Kidnapped Children during the Last Argentine Dictatorship

Introduction: During the last Argentine dictatorship, five hundred children were kidnapped along with their parents or were born or should have been born during the captivity of their mothers in the clandestine centers of detention and torture in the national territory. Taken away from their parents, these children were transferred forcibly by the repressive plan from family groups ideologically opposed to the military regime towards the family groups of genocide perpetrators or related people within the socioeconomic and political system that the dictatorship wanted to impose and with Christian moral. To date, only 102 children have been found. Content: Research could distinguish two situations; on the one hand, the kidnapped children were found in their childhood, and on the other hand, those who discovered their true origin in adulthood. While some refuse to know the truth – for example, rejecting to genetic testing- others find explanations to their memories that allow them to discover another new starting point. Conclusions: When the true personal story is revealed, the now young kidnapped children face multiple legal consequences – such as, the criminal conviction of kidnappers who were considered their real parents – and psychosocial costs that the State is obliged to redress by strategies that facilitate resilience. Methods: Study of cases which have come to justice.

Zdankiewicz-Scigala Elzbieta, Warsaw School of Social Sciences and Humanities

Seeking Sensation, Hardiness and Sense of Coherence as Moderators Post-Traumatic Growth in Soldiers during Peacekeeping Missions

It is assumed that personal moderators like sensation seeking, hardiness, sense of coherence and role identity are important personal factors in coping with trauma. The present paper is part of wider research project on subjective determinants and mechanisms of post-traumatic growth.

The research was carried out among 155 soldiers aged 19 to 50 (M = 31.87; SD = 8.00) serving in military units localized in two medium-sized towns of Poland. Questionnaire of events applied in studies allowed to specify the level of war stressors exposure. To identify personal moderators of war zone events adaptations the Sensation Seeking Scale, a shortened version of the Dispositional Resilience Scale and the Sense of Coherence Scale SOC-29 were used. The results of variance analysis confirm a higher degree of sensation seeking among soldiers who decided to participate in peacekeeping missions for the first time, excluding disinhibiton as an important factor. Sense of coherence turned out not to differentiate soldiers with various attitudes to peacekeeping missions, while hardiness and role identity significantly varied in soldiers who participated in missions from those who didn't want to participate again with soldiers who participated in missions several times.

Developmental changes affect mainly soldiers of high scores in hardiness, sense of coherence and role identity – the model of regression obtained in studies explain nearly 50% of scores variance. Straight-line dependence between posttraumatic growth and war trauma exposure was observed, but statistically significant results concern situations in which peacekeepers participated indirectly only.

Zukowska Katarzyna; Cieslak, Roman, Warsaw School of Social Sciences and Humanities

The Effect of Social Support on Secondary Traumatic Stress and Posttraumatic Growth: The Mediating Role of Self-Efficacy

The aims of the study were to examine whether (1) perceived social support has an effect on secondary trauma self-efficacy beliefs and (2) if those beliefs predict secondary traumatic stress and posttraumatic growth. Participants were 271 professionals (e.g., first responders, social workers) directly and indirectly exposed to trauma through their work. Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (Zimet et al., 1988), secondary trauma self-efficacy was evaluated with our scale developed from a trauma self-efficacy measure (Benight et al., 2004). Secondary Traumatic Stress Scale (Bride et al., 2004) and the Posttraumatic Growth Inventory – SF (Cann et al., 2010) were also applied. Mediation analysis showed that self-efficacy mediated the effect of perceived social support on secondary traumatic stress and on posttraumatic growth: (1) high perceived social support predicted higher self-efficacy beliefs, and (2) high level of self-efficacy predicted lower secondary traumatic stress and higher posttraumatic growth. The findings show that self-efficacy may be an important resource in dealing with indirect traumatization and that social support operates through self-efficacy in predicting secondary traumatic stress and posttraumatic growth.