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Redican E, Vang ML, Komischke-Konnerup K, Elklit A, Shevlin M, O'Connor M. Operationalization, implications and correlates of the cultural deviance criterion for ICD-11 and DSM-5 prolonged grief disorder. Death Stud 2023:1-12. [PMID: 38147040 DOI: 10.1080/07481187.2023.2297061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Prolonged Grief Disorder (PGD) is included in ICD-11 and DSM-5-TR and includes a requirement of cultural deviance. This study examined endorsement rates and factors associated with endorsement of this criterion among Danish bereaved spouses (n = 425) and their adult children (n = 159) four years post-loss. In total, 7.5% (n = 44) participants endorsed this criterion. Both including and excluding the criterion, the prevalence rates for probable DSM-5-TR PGD were 1.4% (n = 8) and 1.7% (n = 10), respectively and for probable ICD-11 PGD were 1.4% (n = 8) and 2.2% (n = 13), respectively. Age and gender of the deceased, age of the bereaved, greater grief severity, and comorbid psychopathology were positively associated with endorsement of the criterion. Findings demonstrate low endorsement of the cultural deviation criterion, that its inclusion excludes several potential PGD cases, and unanticipated associations with several factors raise questions about the criterion's validity.
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Affiliation(s)
- E Redican
- Department of Psychology, Ulster University, Coleraine, UK
| | - M L Vang
- National Centre for Psychotraumatology, Department of Psychology, University of Southern, Odense, Denmark
- Unit for Bereavement Research, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - K Komischke-Konnerup
- Unit for Bereavement Research, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - A Elklit
- National Centre for Psychotraumatology, Department of Psychology, University of Southern, Odense, Denmark
| | - M Shevlin
- Department of Psychology, Ulster University, Coleraine, UK
| | - M O'Connor
- Unit for Bereavement Research, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
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Dokkedahl SB, Kirubakaran R, Bech-Hansen D, Kristensen TR, Elklit A. The psychological subtype of intimate partner violence and its effect on mental health: a systematic review with meta-analyses. Syst Rev 2022; 11:163. [PMID: 35948921 PMCID: PMC9364557 DOI: 10.1186/s13643-022-02025-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The present study examines the association between psychological violence and posttraumatic stress disorder (PTSD), depression, and anxiety, while comparing the specific subtypes of psychological violence and simultaneously focusing on methodological shortcomings. METHOD A systematic review and random-effects meta-analyses were applied on the three main outcomes: PTSD, depression, and anxiety. Four electronic databases were searched (PsycINFO, PubMed, EMBASE, and Web of Science), and a total of 194 studies were included (k = 149 for meta-analyses). GRADEpro was used to evaluate the certainty of the evidence from the meta-analyses. RESULTS Psychological violence had strong associations with the three main outcomes, with the strongest association for PTSD in both female and male victims. Coercive control was particularly associated with PTSD for female victims, while emotional/verbal and dominance/isolation had the strongest association with depression. Although the identified studies were characterized by gender bias, psychological violence appear to affect male mental health too. DISCUSSION Findings from the meta-analyses support the notion that psychological violence is a traumatic experience, which is strongly association with PTSD and other common mental health problems linked to trauma. GRADEpro rated the certainty of evince to be low, and thus, our confidence in the estimated effect is limited. Gender bias, the applied terminology, and other methodological shortcomings are discussed. Despite the substantial amount of research on this topic, more research is needed before we can draw any final conclusions on the effect of psychological violence on mental health.
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Affiliation(s)
- S B Dokkedahl
- Danish National Center of Psychotraumatology, Department of Psychology, Campusvej 55, 5230, Odense M, Denmark. .,University of Southern Denmark, Odense, Denmark.
| | - R Kirubakaran
- Prof. BV Moses Centre for Evidence-Informed Healthcare and Health Policy, Christian Medical College, Vellore, India
| | - D Bech-Hansen
- Danish National Center of Psychotraumatology, Department of Psychology, Campusvej 55, 5230, Odense M, Denmark.,University of Southern Denmark, Odense, Denmark
| | - T R Kristensen
- Centre for Persons Subjected to Violence, Center of Social Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - A Elklit
- Danish National Center of Psychotraumatology, Department of Psychology, Campusvej 55, 5230, Odense M, Denmark.,University of Southern Denmark, Odense, Denmark
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Tuborgh A, Svendsen SW, Elklit A, Hunter J, Jensen JS, Schröder A, Nielsen JF, Thastum MM, Næss-Schmidt ET, Rask CU. Attachment and symptom reporting in adolescents and young adults after a concussion. J Psychosom Res 2021; 150:110603. [PMID: 34509710 DOI: 10.1016/j.jpsychores.2021.110603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The incidence of hospital-treated concussion is 100-300/100,000 person years. Reporting of long-lasting post-concussion symptoms (PCS) is estimated at 5-15%. Attachment insecurity is a potential vulnerability factor for physical illness and poorer disease outcomes in general. This study aimed to explore associations between attachment insecurity and PCS in young people sustaining a concussion. METHODS This cross-sectional study was embedded in a cohort of 15-30-year-old patients (n = 3080) 3 months after sustaining a concussion. Data were obtained from a database and questionnaires. PCS were measured by the Rivermead Post-Concussion Symptoms Questionnaire and attachment dimensions (anxiety and avoidance) by the Experiences in Close Relationships-Relationship Structures Questionnaire. Multiple linear regression models were performed to investigate the association between the attachment dimensions and PCS with adjustment for demographic, injury-related and psychological factors and with additional testing for interaction between the attachment dimensions. RESULTS In the final study sample, comprising 973 patients (31.6%), we found an interaction between the attachment dimensions. Hence, the effect of attachment anxiety on PCS was statistically insignificant at low avoidance (25th percentile) but significant at high avoidance (75th percentile, β = 0.64 (95%CI: 0.02; 1.26)), whereas the effect of attachment avoidance was significant regardless of level of attachment anxiety (25th percentile, β = 1.09 (95%CI: 0.18; 2.01); 75th percentile, β = 2.71 (95%CI: 1.80; 3.61)). CONCLUSION Attachment insecurity, especially characterised by high avoidance in combination with high anxiety, also called fearful attachment, is associated with PCS. Considering the attachment perspective can potentially improve health care for this patient group.
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Affiliation(s)
- A Tuborgh
- Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital, Psychiatry, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
| | - S W Svendsen
- Hammel Neurorehabilitation Centre, University Research Clinic, Aarhus University, Denmark; Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Denmark; Department of Public Health, Section of Environmental Health, University of Copenhagen, Denmark
| | - A Elklit
- Department of Psychology, National Centre of Psycho-traumatology, University of Southern Denmark, Denmark
| | - J Hunter
- Department of Psychiatry, Sinai Health System, University of Toronto, Canada
| | - J S Jensen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
| | - A Schröder
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
| | - J F Nielsen
- Hammel Neurorehabilitation Centre, University Research Clinic, Aarhus University, Denmark
| | - M M Thastum
- Hammel Neurorehabilitation Centre, University Research Clinic, Aarhus University, Denmark; Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
| | - E T Næss-Schmidt
- Hammel Neurorehabilitation Centre, University Research Clinic, Aarhus University, Denmark
| | - C U Rask
- Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital, Psychiatry, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
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Møller L, Augsburger M, Elklit A, Søgaard U, Simonsen E. Traumatic experiences, ICD-11 PTSD, ICD-11 complex PTSD, and the overlap with ICD-10 diagnoses. Acta Psychiatr Scand 2020; 141:421-431. [PMID: 32049369 PMCID: PMC7317379 DOI: 10.1111/acps.13161] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study investigated the frequency of traumatic experiences, prevalence rates of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD), and overlap with ICD-10 classified disorders in outpatient psychiatry. METHOD Overall, 165 Danish psychiatric outpatients answered the International Trauma Questionnaire, the Life Event Checklist, and the World Health Organization Well-being Index. ICD-10 diagnoses were extracted from the hospital record. Chi-square analysis, t-tests, and conditional probability analysis were used for statistical analysis. RESULTS Nearly, all patients (94%) had experienced at least one traumatic event. CPTSD (36%) was more common than PTSD (8%) and had considerable overlap with ICD-10 affective, anxiety, PTSD, personality, adjustment and stress-reaction disorders, and behavioural and emotional disorders with onset usually occurring in childhood and adolescence. ICD-11 PTSD overlapped with ICD-10 anxiety, PTSD, adjustment and stress-reaction disorders, and behavioural and emotional disorders with onset usually occurring in childhood and adolescence. A subgroup of patients with ICD-10 PTSD (23%) did not meet criteria for ICD-11 PTSD or CPTSD. CONCLUSION Traumatic experiences are common. ICD-11 CPTSD is a highly prevalent disorder in psychiatric outpatients. One quarter with ICD-10 PTSD did not meet criteria for either ICD-11 PTSD or CPTSD. PTSD and CPTSD had considerable overlap with ICD-10 disorders.
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Affiliation(s)
- L. Møller
- Psychiatric Research Unit, Region ZealandSlagelseDenmark,Department of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark,Clinic for Traumatized Refugees, Region ZealandSlagelseDenmark
| | - M. Augsburger
- Division of PsychopathologyDepartment of PsychologyUniversity of ZurichZurichSwitzerland
| | - A. Elklit
- Department of PsychologyNational Centre of PsychotraumatologyUniversity of Southern DenmarkOdenseDenmark
| | - U. Søgaard
- Psychiatric Research Unit, Region ZealandSlagelseDenmark,Department of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - E. Simonsen
- Psychiatric Research Unit, Region ZealandSlagelseDenmark,Department of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
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Louison Vang M, Ali SA, Christiansen DM, Dokkedahl S, Elklit A. The role of age and mode of delivery in the STEPS intervention: a longitudinal pilot-study in treatment of posttraumatic stress symptoms in Danish survivors of sexual assault. Eur J Psychotraumatol 2020; 11:1701778. [PMID: 32082508 PMCID: PMC7006682 DOI: 10.1080/20008198.2019.1701778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 10/22/2019] [Accepted: 11/11/2019] [Indexed: 11/05/2022] Open
Abstract
Background: The STEPS programme has been succesfully implemented as a group-based treatment of trauma symptoms after rape for adolescents. The STEPS intervention was translated from Dutch to Danish and offered to adults in addition to adolescents as well as an individual intervention in addition to a group-based intervention at a Danish Centre for Rape Victims through 2011 to 2014. The programme was translated from Dutch to Danish and expanded to adults in addition to adolescents as well as to an individual intervention in addition to a group-based intervention at a Danish Centre for Rape Victims through 2011 to 2014. Objective: The present study observes development in trauma symptoms and ICD-11 diagnostic status during an adapted version of the intervention programme 'STEPS' for survivors of sexual assault. Methods: A prospective uncontrolled study was conducted, monitoring symptoms of posttraumatic stress and other trauma-related symptomatology before treatment, after treatment and at 6 and 12 months' follow up for 103 referrals receiving individual or group-based STEPS. Tentative diagnoses of posttraumatic stress disorder (PTSD) and complex PTSD were assigned to participants according to the ICD-11 to observe the development in diagnostic status across time, and multilevel modelling was used to assess the development of symptom severity and to assess the moderating effect of age-group and mode of delivery. Results: A loglinear function representing large and statistically significant decline in symptomatology over time provided the best fit for all measures of trauma-related symptomatology. The decline was not moderated by age-group or mode of intervention. Dropout rates were independent of mode of intervention and age. Conclusion: The adaption of the STEPS programme to adults and as an individual intervention is feasible and maintains effect sizes comparable to those observed in the original intervention. Further research using randomized controlled trials is needed to ascribe the observed effect to the STEPS programme.
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Affiliation(s)
- M Louison Vang
- School of Psychology, Ulster University, Northern Ireland, UK.,The Collaborative Network for Training and Excellence in Psychotraumatology (CONTEXT).,National Center for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - S A Ali
- National Center for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - D M Christiansen
- National Center for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - S Dokkedahl
- National Center for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - A Elklit
- National Center for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
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Abstract
Background: Individuals with intellectual disability respond differently to traumatic events, compared to the general population, which makes post-traumatic stress disorder (PTSD) symptoms difficult to recognize. The current study aims to examine the presence of undetected PTSD among individuals with intellectual disability and a known history of trauma exposure. Method: Nine individuals, who have not previously been diagnosed with PTSD, were evaluated for PTSD symptoms through case reports, which include descriptions of medical history, symptoms and behavior described in the former diagnostic reports, potential traumatic experiences, current symptoms and behavior in accordance to the Lancaster and North Gate Trauma Scale, and PTSD criteria from DM-ID. Results: Four out of the nine participants met the DM-ID criteria for PTSD. Conclusions: The current findings highlight the importance of including cognitive impairment and developmental level in the screening, referral and treatment process of PTSD.
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Affiliation(s)
- A. Borghus
- Department of Psychology, National Center for Psychotraumatology, University of Southern Denmark, Odense, Denmark
| | - S. Dokkedahl
- Department of Psychology, National Center for Psychotraumatology, University of Southern Denmark, Odense, Denmark
| | - A. Elklit
- Department of Psychology, National Center for Psychotraumatology, University of Southern Denmark, Odense, Denmark
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7
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Hansen NB, Hansen M, Campbell R, Elklit A, Hansen OI, Bramsen RH. Are rape cases closed because of rape stereotypes? Results from a Danish police district. Nordic Psychology 2018. [DOI: 10.1080/19012276.2018.1470552] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- N. B. Hansen
- National Centre for Psychotraumatology, ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - M. Hansen
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, MI, Denmark
| | - R. Campbell
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - A. Elklit
- National Centre for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - O. I. Hansen
- Institute of Forensic Medicine, Section of Clinical Forensic Medicine, University of Aarhus, Aarhus, Denmark
- The Sexual Assault Centre, Aarhus University Hospital, Aarhus, Denmark
| | - R. H. Bramsen
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, MI, Denmark
- The Sexual Assault Centre, Aarhus University Hospital, Aarhus, Denmark
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Ekstrøm M, Sonne C, Carlsson J, Bech P, Elklit A. The treatment of traumatised refugees with sertraline versus venlafaxine in combination with psychotherapy – a randomised clinical study. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background and aimToday we lack sufficient evidence to conclude which type of treatment approach that is most efficient when it comes to trauma-affected refugees. That is a problem for both patients and doctors as well as for society. Also there is a lack of studies, which examine the relation between psychosocial resources and treatment efficiency, in order to find reliable predictors of treatment outcome. This study therefore aims to produce new evidence within this field in order to optimise treatment for trauma-affected refugees with complex PTSD.MethodsThe study included 207 patients referred to Competence Centre for Transcultural Psychiatry between April 2012 and September 2013. Patients were randomised into one of the two treatment groups: a sertraline group (n = 109) or a venlafaxine group (n = 98). Patients in both groups received the same manual based cognitive behavioural therapy, specially adapted to this group of patients. The trial endpoints were PTSD-and depression symptoms and social functioning, all measured on validated ratings scales. Furthermore the study examined the relation between expected outcome of treatment from a range of predictors and the relation to the treatment results for the individual patient.ResultsData are presently being analysed and results will be ready for the conference.ConclusionThe study is among the largest randomised studies ever conducted on pharmacological treatment among traumatised refugees. It is expected to bring forward new knowledge about clinical evaluation and medical treatment of traumatised refugees.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Andersen T, Karstoft KI, Brink O, Elklit A. Pain-catastrophizing and fear-avoidance beliefs as mediators between post-traumatic stress symptoms and pain following whiplash injury - A prospective cohort study. Eur J Pain 2016; 20:1241-52. [DOI: 10.1002/ejp.848] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2015] [Indexed: 11/06/2022]
Affiliation(s)
| | | | - O. Brink
- Aarhus University; Aarhus Denmark
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Adellund Holt K, Jensen PT, Gilså Hansen D, Elklit A, Mogensen O. Rehabilitation of women with gynaecological cancer: the association between adult attachment, post-traumatic stress disorder and depression. Psychooncology 2015; 25:691-8. [PMID: 26449611 DOI: 10.1002/pon.3996] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 09/05/2015] [Accepted: 09/07/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We hypothesised that being diagnosed with gynaecological cancer influences adult attachment and occurrence of depression and post-traumatic stress disorder (PTSD). The main aim of the study was to assess changes in the attachment dimensions, PTSD and depression from baseline to 5-month post-treatment. Further, we evaluated the association between attachment avoidance/anxiety dimensions and PTSD/depression among women newly diagnosed with ovarian, endometrial, or cervical cancer. METHODS Consecutive Danish-speaking women aged 20 to 75 years and treated surgically for primary gynaecological cancer were eligible. All patients were offered a rehabilitation programme consisting of two face-to-face sessions and two phone calls carried out by a nurse. Patients were asked to complete the Revised Adult Attachment Scale, the Harvard Trauma Questionnaire and the Major Depression Inventory at baseline and at 5-month follow-up. In all, 151 women consent to participate in the sessions where 51 fulfilled Revised Adult Attachment Scale questionnaire and contribute with socio-demographic data. RESULTS We found significant positive changes within the attachment anxiety dimension among women with ovarian cancer, a significant reduction of PTSD among endometrial cancer patients and insignificant changes in depression among all cancer types. The attachment anxiety dimension significantly increased the odds for PTSD and depression. CONCLUSIONS Depression and PTSD were prevalent among ovarian and cervical cancer patients. The adjustment of rehabilitation according to patients' attachment anxiety dimension contains possibilities for indirect impact on PTSD and depression symptoms. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- K Adellund Holt
- Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark.,Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark
| | - P T Jensen
- Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark.,Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark
| | - D Gilså Hansen
- Department of Public Health, National Research Centre of Cancer Rehabilitation, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | - A Elklit
- National Center of Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - O Mogensen
- Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark
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Elklit A, Shevlin M. Sexual victimization as a risk factor for residential mobility: A case–control study using the Danish registry system. Public Health 2009; 123:502-5. [DOI: 10.1016/j.puhe.2009.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Revised: 05/18/2009] [Accepted: 06/09/2009] [Indexed: 11/16/2022]
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12
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Elklit A, Nielsen LH. Public Subsidized Assistance for Psychological Counseling in the Danish Public National Health Insurance Service. ACTA ACUST UNITED AC 2008. [DOI: 10.1093/brief-treatment/mhn022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
The purpose of the study was to make a psychological profile of Danish women with Eating Disorders, who were not currently hospitalized. 75 women between the ages of 19 and 46 years participated. 22 participants suffered from a clinical eating disorder (ED). 20 women had previously suffered from a clinical ED, and 33 women had never suffered from ED. The study included sociodemographic data, problems in relation to eating and weight, exposure to stressful life events, and the following questionnaires: The Eating Disorder Inventory, the Rosenberg Self-Esteem Scale, the Coping Styles Questionnaire, the Perceived Stress Scale, the Defense Style Questionnaire, and the Trauma Symptom Checklist. Psychologically, women with ED differed significantly from women without ED by using a more primitive defense style, perceiving themselves as being more exposed to stress, using more inefficient methods of coping and having lower self-esteem. Unexpectedly, the study also showed that recovery from an ED was resulting in normalisation of both behavioral and psychological characteristics. The implications of these findings are discussed.
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Abstract
OBJECTIVE To identify literature concerning the effectiveness of psychological debriefing (PD) and analyse results according to different criteria of success and different uses of the intervention format. METHOD Literature search was made in databases PubMed, PsycInfo and Psychlit. Twenty-five studies were selected for a thorough description. Forty-two studies provided additional information. RESULTS Results indicate that, in general, debriefing does not prevent psychiatric disorders or mitigate the effects of traumatic stress, even though people generally find the intervention helpful in the process of recovering from traumatic stress. The intervention holds potential as a screening procedure, and there may be economic arguments for continued use. When used with adherence to traditional descriptions of treatment group, events, group format, leadership and time spent, a preventive effect emerges. No tendency according to timing was found. CONCLUSION Current uses of PD are problematic. The concept needs to be redefined, and the scope of application must be revised. The objectives for use need to be clarified.
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Affiliation(s)
- M Arendt
- Danish Red Cross and Department of Psychiatric Demography, Institute for Basic Psychiatric Research, Psychiatric Hospital in Aarhus, Skovagervej 2, 8240 Risskov, Denmark
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15
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Elklit A, Nørregaard J, Tibor B. [Occurrence and type of traumatic experiences among young Bosnian refugees in Denmark]. Ugeskr Laeger 1998; 160:4310-4. [PMID: 9679435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Prior research has shown that young refugees may be especially traumatised. The study includes 123 young Bosnian refugees, living at two Bosnian boarding-schools in Denmark who were given a revised version of the Harvard Trauma Questionnaire (HTQ). The subjects themselves have on average experienced seven traumatic events, and have either witnessed or had a family member experience an additional six events. Three-quarters have been shot at, have lost their homes and private possession and have been exposed to violence in the form of harassment or humiliation. Two-thirds have lost friends. Three-fifths have lived with uncertainty as to whether friends and family were alive or dead. More than half have seen dead and wounded people, have had their lives threatened and have thought that they would die. More than a third have lost close family members, have been wounded and have had their homes destroyed. Just under a third have been exposed to physical violence or have witnessed somebody being killed. A quarter have starved and been ill without being able to receive treatment. About a fifth have experienced captivity, torture and forced labour. 6% have been raped or exposed to other forms of sexual abuse. It is concluded that the young Bosnians examined are a multitraumatised group. Use of the HTQ increased the number of traumatic events quite considerably compared to the case notes.
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Affiliation(s)
- A Elklit
- Aarhus Universitet, Psykologisk Institut, Stefanshjemmet, Arhus
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Abstract
This paper examines degree of traumatisation, defence styles, coping strategies, symptomatology, and social support in a small sample of HIV-positive men and women in an effort to ascertain the psychological implications of living with Human Immunodeficiency Virus (HIV). Traumatisation and the potentially mediating effects of defence styles have only been the subject of a few studies of HIV positives. The study is based on a socio-demographic questionnaire, the Impact of Event Scale, the Defence Style Questionnaire, the Coping Styles Questionnaire, the Trauma Symptom Checklist, and the Crisis Support Scale. A degree of traumatisation that warrants treatment was found together with an association between particular coping strategies and symptomatology, and particular defence styles and symptomatology, respectively. Social support had increased over time, which is contrary to other research findings on social support.
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Affiliation(s)
- S S Pedersen
- Institute of Psychology, University of Aarhus, Denmark
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17
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Abstract
An explosion in a Danish supertanker under construction in 1994 caused the death of six workers and injured 15. Six months later 270 workers took part in this study, which analyses the relationships between objective stressors, the workers' own feelings and the reactions of their families after the explosion together with training, attitude to the workplace, general out-look, and received crisis help. Traumatisation, coping style and crisis support was assessed via the Impact of Event Scale (IES), the Coping Styles Questionnaire (CSQ) and the Crisis Support Scale (CSS). Emotionally, workers and their families were strongly affected by the explosion. The IES-score was 17.6 and the invasion score 9.1. The degree of traumatisation was higher in the group who had an 'audience position' than in the group who was directly hit by the explosion. Training in rescue work did not protect against adverse effects. Rescue work had a strong impact on the involved. Social support was a significant factor, that seems to buffer negative effects. High level of social integration, effective leadership in the situation, and professional crisis intervention characterised the disaster situation. All the same, 41 per cent of the workers reached the caseness criteria by Horowitz (IES > or = 19).
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Affiliation(s)
- A Elklit
- Institute of Psychology, University of Aarhus, Denmark
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