Sense of Coherence (SOC) and mindfulness are known protective factors against psychopathology, also in older age. We set out to investigate the influence of SOC and mindfulness on posttraumatic ...symptoms and cognitions in the context of lifetime trauma in elderly persons with a history of childhood war-experiences.
Elderly Austrians (N = 97) filled in questionnaires on traumatic lifetime experiences and posttraumatic symptoms (ETI), posttraumatic cognitions (PTCI), SOC (SOC-13) and mindfulness (FFMQ). We expected the influence of SOC scores on posttraumatic symptoms and cognitions to be on one hand influenced by mindfulness. On the other hand, we expected that both aspects would uniquely explain fewer posttraumatic symptoms and cognitions.
Participants reported various lifetime traumas (M = 2.42), including experiences during World War II (WWII) as children and adolescents. Mindfulness partially mediated the association of SOC scores with posttraumatic cognitions, but not with posttraumatic symptoms. However, in a two-stage mediation model, mindfulness significantly predicted posttraumatic symptoms via its effects on posttraumatic cognitions.
Although SOC was the strongest predictor of posttraumatic symptoms, mindfulness influenced the severity of posttraumatic symptoms via its effects on posttraumatic cognitions. We discuss implications for mindfulness-based interventions on trauma-related cognitions in the elderly.
Many trauma survivors seem to be reluctant to seek professional help for mental health issues. The present study aimed to enhance the understanding of perceived barriers and facilitators to mental ...health service use in adult survivors of institutional abuse (IA) in foster care. It further aimed to explore survivors’ suggestions on how to increase mental health service use. Semi-structured interviews were conducted with 46 adult IA survivors. The interview guideline comprised questions regarding (1) self-perceived barriers and (2) facilitators to mental health services, as well as (3) suggestions on how to facilitate mental health service use. A thematic analysis was conducted to identify themes from the interview transcripts. Barriers and facilitators were compared with previous findings of a systematic review on trauma survivors. The most prominent barrier themes were Lack of knowledge and treatment-related doubts, Concerns related to stigma, shame & rejection, and Trauma-specific barriers. A barrier that seemed to be characteristic for IA survivors was Previous negative experiences with child care workers or other professionals in foster care institutions. Key themes that were identified from the survivors’ suggestions were also found in the perceived facilitators, namely Specific psychotherapist recommended by significant others, professionals, or institutions, as well as Treatment costs covered. Receiving Social support from significant others or professionals was a further prominent facilitator to mental health service use. These findings reinforce the importance of multi-professional strategies and evidence-based interventions to increase CM survivors’ mental health service use.
Background
: While in recent years epidemiological
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Tobias M. Glück and Ulrich S. Tran contributed equally to this work. They wrote the paper and conducted the statistical analysis, Brigitte ...Lueger-Schuster designed and supervised the project and contributed in writing and revising the paper.
studies on World War (WW) II-related traumatization and prevalence of posttraumatic stress disorder (PTSD) in elderly persons have been conducted for various European countries, for Austria, these numbers are unknown.
Objective
: The focus of this epidemiologic study was to picture the current mental health status and prevalence of PTSD and lifetime traumatic events in Austria's elderly with respect to WWII and subsequent occupation.
Method
: In an interdisciplinary approach of psychologists and historians, 316 elderly Austrians (born before 1946) were interviewed for symptoms of PTSD and lifetime traumatization (Traumatic Life Events Questionnaire, PTSD Checklist-Civilian Version), current mental health (Brief Symptom Inventory), wartime-related trauma, and traumatic experiences with occupational forces. These factors were also compared regarding the zone of occupation (Allied vs. Soviet). Data were collected between March and September 2010.
Results
: 97.5% of the sample reported at least one lifetime trauma. War-related traumata were reported by 92.7% and non-war-related traumata by 82.3%; 40.2% experienced traumatic events with occupational forces. PTSD was present in 1.9% of the sample and up to 13.9% taking subthreshold PTSD into account. Both, the presence of symptoms indicative of PTSD and subthreshold PTSD implied weaker current mental health (regarding General Distress: odds ratios up to 25.51; 95% CI = 9.82 to 66.27). Independent of PTSD diagnosis persons from the Soviet occupied zone showed higher levels of Interpersonal Sensitivity, Global Distress, and Phobic Anxiety. Prevalence of PTSD was independent of gender.
Conclusions
: Our results corroborate findings from other European countries that PTSD is a common disorder in the elderly due to WWII experience and that PTSD and trauma affect mental health even across long periods of time. Postwar distressing conditions also pose a further risk factor for symptomatology and distress in later years.
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War-related traumata in childhood and young-adulthood may have long-lasting negative effects on mental health. The focus of recent research has shifted to examine positive adaption despite traumatic ...experiences, i.e. resilience. We investigated personal and environmental factors associated with resilience in a sample of elderly Austrians (N = 293) who reported traumatic experiences in early life during World War II and subsequent occupation (1945-1955).
After reviewing different concepts of resilience, we analysed our data in a 3-phased approach: Following previous research approaches, we first investigated correlates of PTSD and non-PTSD. Secondly, we compared a PTSD positive sample (sub-threshold and full PTSD, n = 42) with a matched control sample regarding correlates of resilience and psychometrically assessed resilience (CD-RISC). Thirdly, we examined factors of resilience, discriminating between psychologically healthy participants who were exposed to a specific environmental stressor (having lived in the Soviet zone of occupation during 1945-1955) from those who were not.
A smaller number of life-time traumata (OR = 0.73) and a medium level of education (OR = 2.46) were associated with better outcome. Matched PTSD and non-PTSD participants differed in psychometrically assessed resilience mainly in aspects that were directly related to symptoms of PTSD. Psychologically healthy participants with an environmental stressor in the past were characterized by a challenge-oriented and humorous attitude towards stress.
Our results show no clear picture of factors constituting resilience. Instead, most aspects of resilience rather appeared to be concomitants or consequences of PTSD and non-PTSD. However, special attention should be placed on a challenge-oriented and humorous attitude towards stress in future definitions of resilience.
Anger is a known factor that adds to the distress caused by mental health problems in traumatized samples. Limited strategies for emotion regulation play a key role in this relationship. People with ...a history of severe trauma frequently report less adaptive emotion regulation strategies, low self-esteem, and high levels of anger. To our knowledge, their interrelationship has not yet been sufficiently researched.
We investigated the mediating role of self-esteem in the relation between emotion regulation strategies and different forms of anger (trait anger and anger rumination) in an Austrian sample of adult survivors of childhood abuse in foster care homes (n=220).
The relationship of emotion regulation strategies (DERS), trait anger (STAXI), anger rumination (DAQ), and self-esteem (MSWS) was assessed using two mediation models. Both models showed significant mediation effects. Self-esteem mediated 26% of the effect of emotion regulation on trait anger and 57.5% of the effect of emotion regulation on anger rumination.
Self-esteem potentially supports adaptive emotion regulation through its beneficial effects on distressing emotional states. As a practical implication for treatment, it may be assumed that supporting adaptive emotion regulation strategies and self-esteem positively influences anger in traumatized patients.
Wartime rape is an atrocity with long-lasting impacts not only on victims but whole societies. In this brief report, we present data on experience and witness of sexual violence during World War II ...(WWII) and subsequent time of occupation and on indicators of mental health in a sample of elderly Austrians.
Interviews of 298 elderly Austrians from a larger epidemiological study on WWII traumatization were analyzed for the impact of experience and witness of sexual violence during the wartime committed by occupational forces. Interviews comprised a biographical/historical section and psychological measures (BSI, TLEQ, PCL-C). Participants were recruited in all nine provinces of Austria with respect to former zones of occupation (Western Allied/Soviet).
Twelve persons reported direct experience of sexual violence, 33 persons witnessed such atrocities. One third of the victims and 18.2% of the witnesses reported post-traumatic stress disorder (PTSD full/subthreshold). Sexual violence occurred more often in the former Soviet zone. Victims and witnesses displayed higher odds of post-traumatic symptoms and symptoms of depression and phobic fear than non-victims. Furthermore, witnesses displayed higher levels of aggression compared to victims and non-witnesses.
Our results corroborate previous findings that wartime rape has long-lasting effects over decades on current mental health and post-traumatic distress in victims and witnesses. We recommend integration of psychotraumatological knowledge on consequences of sexual violence on mental health into geriatric care and the education of dedicated personnel.
We aimed to compare treatment results in and outside of a randomized trial and to confirm factors influencing outcome in a large retrospective cohort of nonmetastatic medulloblastoma treated in ...Austria, Switzerland and Germany.
Patients with nonmetastatic medulloblastoma (n = 382) aged 4 to 21 years and primary neurosurgical resection between 2001 and 2011 were assessed. Between 2001 and 2006, 176 of these patients (46.1%) were included in the randomized HIT SIOP PNET 4 trial. From 2001 to 2011 an additional 206 patients were registered to the HIT 2000 study center and underwent the identical central review program. Three different radiation therapy protocols were applied. Genetically defined tumor entity (former molecular subgroup) was available for 157 patients.
Median follow-up time was 7.3 (range, 0.09-13.86) years. There was no difference between HIT SIOP PNET 4 trial patients and observational patients outside the randomized trial, with 7 years progression-free survival rates (PFS) of 79.5% ± 3.1% versus 78.7% ± 3.1% (P = .62). On univariate analysis, the time interval between surgery and irradiation (≤ 48 days vs ≥ 49 days) showed a strong trend to affect PFS (80.4% ± 2.2% vs 64.6% ± 9.1%; P = .052). Furthermore, histologically and genetically defined tumor entities and the extent of postoperative residual tumor influenced PFS. On multivariate analyses, a genetically defined tumor entity wingless-related integration site-activated vs non-wingless-related integration site/non-SHH, group 3 hazard ratio, 5.49; P = .014) and time interval between surgery and irradiation (hazard ratio, 2.2; P = .018) were confirmed as independent risk factors.
Using a centralized review program and risk-stratified therapy for all patients registered to the study center, outcome was identical for patients with nonmetastatic medulloblastoma treated on and off the randomized HIT SIOP PNET 4 trial. The prognostic values of prolonged time to RT and genetically defined tumor entity were confirmed.
The psychological sequelae of institutionalized abuse and its long-term consequences has not been systematically documented in existing literature in regarding social support once disclosure has been ...made. Reporting abuse is crucial, in particular for adult victims of childhood IA within the Catholic Church. Nevertheless, there is ongoing controversy about the benefits of disclosure. Our study examines the interaction of disclosure and subsequent social support in relation to mental health. We look into the times of disclosure, the behaviour during the disclosure to a commission as adults, different level of perceived social support, and the effect on mental health.
The data were collected in a sample of financially compensated adult survivors who experienced institutionalized abuse during their childhood, using instruments to measure perceived social support, reaction to disclosure, PTSD, and further symptoms.
High levels of perceived social support after early disclosure result in a higher level of mental health and contribute to less emotionally reactive behaviour during disclosure of past institutionalized abuse. Highly perceived levels of social support seem to play a crucial role in mental health, but this inference may be weakened by a possible interference of a lasting competence in looking for social support versus social influences.
Future research should thus disentangle perceived social support into the competence of looking for social support versus socially influenced factors to provide more clarity about the positive association of perceived social support and mental health.
Item response models were used to study changes in strategy use in a spatial task induced by a mental rotation training. Application of the Linear Logistic Model with Relaxed Assumptions (LLRA) ...showed differential training-related improvement in different item types, with the strongest improvement in items requiring spatial cognition. Application of Mixed Rasch Models (MRM) showed two latent classes of participants at pretest—one using a spatial strategy, the other using a pattern comparison strategy. Theoretical strategy classifications showed that the training caused almost all participants who used the pattern strategy at pretest to shift to a spatial strategy. Results are discussed both from a substantive and from a methodological perspective.
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