Sexual and/or physical abuse in childhood and adolescence can lead to the development of a variety of psychological diseases and problems. Recent studies especially highlight the connection between these types of abuse and posttraumatic stress disorder (PTSD). Even though it is known that PTSD leads to severe health problems, there are only few evidence-based psychotherapeutic interventions for adolescents and young adults who developed PTSD after the experience of sexual and/or physical abuse.
The aim of the E-KVT-project is the evaluation of a treatment manual which is particularly focused on the treatment of adolescents and young adults. The manual is based on the Cognitive Processing Therapy (CPT) – a therapeutical approach that has already been evaluated for adults. Additional components of E-KVT are aspects of emotional and behavioral training (Verhaltensmanagement?) as well as skill training for coping with typical developmental tasks. The treatment consists of reliable elements and has already been audited in a pilot study. The results showed an improvement for almost all participating patients.
Beside the evaluation of this treatment procedure, our multicenter trial investigates other aspects, such as neuronal correlates of PTSD, epigenetic markers etc.
The study administration is represented by Prof. Rita Rosner (KU Eichstätt-Ingolstadt).
The subproject in Bielefeld is supervised by Prof. Frank Neuner. We are trying to find neuronal correlates for information processing in adolescents and young adults with PTSD and would like to find out about how E-KVT influences this information processing. For questions upon the project, please contact the project coordinator for Bielefeld, Fabian Klein, M.Sc..
Further information (in German) upon the therapy and the multicenter trial can be found here: http://www.traumatherapie-jugendliche.de/
It is known that human attention is sensitive to aversive stimuli, in particular to negative cues that indicate a threat to the physical integrity. In social anxiety biased attention processes are known to play a crucial role in the maintenance and development of the disorder. Recent research has shown that these biases emerge in reaction to various threat cues (i.e. emotional facial expression or emotional words). However, the extend to which these findings represent a general hypersensitivity or disorder specific activation of a threat detection system remains unclear. In addition, the question whether attention biases can be transferred to stimuli that are associated with a social rather than a physical threat has mostly been neglected in research. To disentangle attention processes in social anxiety we analyze electrophysiological data to determine the time course of attention biases and their disorder specificy. Moreover, in comparing cortical reactions to emotional words (i.e. swear words) and emotional facial expression we thought to analyze if attention processes can be transferred to symbolic representations of social threat.
Dipl. Psych. Pascal Wabnitz, Prof. Dr. Frank Neuner, M.Sc. Fabian Klein, BSc. Melissa Preuße in cooperation with PD Dr. Ulla Martens, Osnabrück University
- Wabnitz, P., Martens, U., & Neuner, F. (2012). Cortical reactions to verbal abuse: Event-related brain potentials reflecting the processing of socially threatening words. NeuroReport. 23(13), 774-779.
In contrast to other forms of violence and psychological traumatization, most survivors of organized violence have encountered not only one single stressful event, but rather a whole series of traumatic events occurring over an extended period of time. Such experiences can cause serious psychological and somatic distress and interfere with a healthy development of children. Thus, in addition to suffering from medical conditions, a substantial proportion of survivors of war and torture suffer from chronic psychological disorders such as posttraumatic stress disorder (PTSD) or depression, both of which can persist for long periods of time or even, on occasion, develop in the years or decades following persecution. Furthermore, high rates of psychological disorders may contribute to the translation of war violence into family violence, thus contributing to a vicious circle of violence across generations.
This project line builds on previous work in refugee settlements as well as conflict areas in Uganda, Rwanda, Somalia, Sri Lanka, and Afghanistan. It pursues the following goals:
Epidemiology of the social and psychological consequences of organized violenceThe aim is to develop reliable and valid strategies for the assessment of trauma cosequences on individual, family and community level across different cultures. In addition to stress reactions, potential predictors and mediators of stress reactions (i.e. traumatic events, poverty, family violence, social loss, collective identity, etc.) should be assessed to analyze the relationship between organized violence and stress rections as well as organized violence and familiy/community violence.
Development and evaluation of intervention strategiesThe development and successful evaluation of pragmatic treatment strategies such as Narrative Exposure Therapy (NET) by our working group has been considered as one of the milestones of mental health intervention research in conflict areas. Using randomized controlled trials, NET has been evaluated with child and adult war victims in Uganda, Rwanda, Sri Lanka and other countries.
A next step of intervention research will be the development of interventions beyond the individual level. In particular, methods to prevent the translation of war violence into family and community violence will be developed an evaluated.
Currently a focus of research is on interventions with formerly abducted child soldiers in Northern Uganda
For more information about clinical field research and interventions in countries affected by war and conflicts, please visit the website of vivo foundation.
Catani,C., Gewirtz, A., Wieling, L., Schauer, E., Elbert, T., & Neuner, F.(2010). Tsunami, war, and cumulative risk in the life of Sri Lankan school children , Child Development , 81(4), 1176-91.
Ertl, V., Pfeiffer, A., Saile, R., Schauer, E., Elbert, T., & Neuner, F.(2010). Validation of a mental health assessment in an African conflict population , Psychological Assessment , 22(2), 318-24.
Neuner, F. (2010). Assisting war-torn populations - Should we prioritize reducing daily stressors to improve mental health? Comment on Miller and Rasmussen (2010) ,Soc Sci Med, Epub ahead of print.
Catani, C. , Kohiladevy, M., Ruf, M., Schauer, E., Elbert, T. & Neuner, F. (2009). Treating children traumatized by war and Tsunami: A comparison between exposure therapy and meditation-relaxation in North-East Sri Lanka , BMC Psychiatry, 9:22.
Catani, C., Schauer, E., Elbert, T., Missmahl, I., Bette, J.P. & Neuner, F. (2009) War trauma, child labour, and family violence: Life adversities and PTSD in a sample of school children in
Neuner, F., Onyut, P., Ertl. V., Schauer, E., Odenwald, M. & Elbert, T. (2008) Treatment of posttraumatic stress disorder by trained lay counsellors in an African refugee settlement - a randomized controlled trial . Journal of Consulting and Clinical Psychology, 76, 686-694.
The aim of this project line is to determine the relationship between stressful life events, including child abuse and neglect, and mental disorders. Cross-sectional and longitudinal epidemiolgical studies are used to examine prevalence rates of maltreatment and violence within groups of normal adolescents and young adults as well as in various patient groups. The investigation of potential moderators at the level of neurobiology, self report, and behavior observation aims at the development of a neurocognitive model of the mechanisms that relate stress and pathology. The long-term goal is to develop a trans-diagnostical treatment modul for stress-related mental disorders.
Related ongoing research project at the outpatient clinic of the University of Bielefeld
- Adenauer, H., Catani, C., Keil, J., Aichinger, H, & Neuner, F. (2009). Is freezing an adaptive reaction to threat? Evidence from heart rate reactivity to emotional pictures in victims of war and torture. Psychophysiology , 47(2), 315-22
- Adenauer, H., Pinösch, S., Catani, C., Keil, J., Aichinger, H.,Kißler, J. & Neuner, F (2010). Early processing of threat cues in posttraumatic stress disorder ? evidence for a cortical vigilance-avoidance reaction , Biological Psychiatry, 68, 451-458.
- Catani, C. , Adenauer, H., Keil, J., Aichinger, H., Neuner, F. (2009). Pattern of cortical activation during processing of aversive stimuli in traumatized survivors of war and torture, European Archives of Psychiatry and Clinical Neuroscience , 259(6),340-51.