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Sanftenberg L, Beutel A, Friemel CM, Kosilek RP, Schauer M, Elbert T, Reips UD, Gehrke-Beck S, Schubert T, Schmidt K, Gensichen J. Barriers and opportunities for implementation of a brief psychological intervention for post-ICU mental distress in the primary care setting - results from a qualitative sub-study of the PICTURE trial. BMC Prim Care 2023; 24:113. [PMID: 37149603 PMCID: PMC10163700 DOI: 10.1186/s12875-023-02046-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 03/27/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND The results of critical illness and life-saving invasive measures during intensive care unit treatment can sometimes lead to lasting physical and psychological impairments. A multicentre randomized controlled trial from Germany (PICTURE) aims to test a brief psychological intervention, based on narrative exposure therapy, for post-traumatic stress disorder symptoms following intensive care unit treatment in the primary care setting. A qualitative analysis was conducted to understand feasibility and acceptance of the intervention beyond quantitative analysis of the main outcomes in the primary study. METHODS Qualitative explorative sub-study of the main PICTURE trial, with eight patients from the intervention group recruited for semi-structured telephone interviews. Transcriptions were analysed according to Mayring's qualitative content analysis. Contents were coded and classified into emerging categories. RESULTS The study population was 50% female and male, with a mean age of 60.9 years and transplantation surgery being the most frequent admission diagnosis. Four main factors were identified as conducive towards implementation of a short psychological intervention in a primary care setting: 1) long-term trustful relationship between patient and GP team; 2) intervention applied by a medical doctor; 3) professional emotional distance of the GP team; 4) brevity of the intervention. CONCLUSION The primary setting has certain qualities such as a long-term doctor-patient relationship and low-threshold consultations that offer good opportunities for implementation of a brief psychological intervention for post-intensive care unit impairments. Structured follow-up guidelines for primary care following intensive care unit treatment are needed. Brief general practice-based interventions could be part of a stepped-care approach. TRIAL REGISTRATION The main trial was registered at the DRKS (German Register of Clinical Trials: DRKS00012589) on 17/10/2017.
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Affiliation(s)
- Linda Sanftenberg
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Nußbaumstr. 5, 80336, Munich, Germany.
| | - Antina Beutel
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Nußbaumstr. 5, 80336, Munich, Germany
| | - Chris Maria Friemel
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Nußbaumstr. 5, 80336, Munich, Germany
| | - Robert Philipp Kosilek
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Nußbaumstr. 5, 80336, Munich, Germany
| | - Maggie Schauer
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | | | - Sabine Gehrke-Beck
- Charité - Universitätsmedizin Berlin, Institute of General Practice and Family Medicine, Berlin, Germany
| | - Tomke Schubert
- Charité - Universitätsmedizin Berlin, Institute of General Practice and Family Medicine, Berlin, Germany
| | - Konrad Schmidt
- Charité - Universitätsmedizin Berlin, Institute of General Practice and Family Medicine, Berlin, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Nußbaumstr. 5, 80336, Munich, Germany
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Potter F, Dohrmann K, Rockstroh B, Schauer M, Crombach A. The impact of experiencing severe physical abuse in childhood on adolescent refugees' emotional distress and integration during the COVID-19 pandemic. Front Psychol 2022; 13:1023252. [PMID: 36506980 PMCID: PMC9729708 DOI: 10.3389/fpsyg.2022.1023252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background Accumulating evidence highlights the importance of pre- and post- migration stressors on refugees' mental health and integration. In addition to migration-associated stressors, experiences earlier in life such as physical abuse in childhood as well as current life stress as produced by the COVID-19-pandemic may impair mental health and successful integration - yet evidence on these further risks is still limited. The present study explicitly focused on the impact of severe physical abuse in childhood during the COVID-19 pandemic and evaluated the impact of these additional stressors on emotional distress and integration of refugees in Germany. Methods The sample included 80 refugees, 88.8% male, mean age 19.7 years. In a semi-structured interview, trained psychologists screened for emotional distress, using the Refugee Health Screener, and integration status, using the Integration Index. The experience of severe physical abuse in childhood was quantified as a yes/no response to the question: "Have you been hit so badly before the age of 15 that you had to go to hospital or needed medical attention?" Multiple hierarchical regression analyses further included gender, age, residence status, months since the start of the COVID-19 pandemic and length of stay in Germany to predict emotional distress and integration. Results Two regression analyses determined significant predictors of (1) emotional distress (adjusted R 2 = 0.23): duration of being in the pandemic (ß = 0.38, p < 0.001) and severe physical abuse in childhood (ß = 0.31, p = 0.005), and significant predictors of (2) integration (adjusted R 2 = 0.53): length of stay in Germany (ß = 0.62, p < 0.001), severe physical abuse in childhood (ß = 0.21, p = 0.019) and emotional distress (ß = -0.28, p = 0.002). Conclusion In addition to migration-associated stressors, severe physical abuse in childhood constitutes a pre-migration risk, which crucially affects the well-being, emotional distress and integration of refugees in Germany.
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Affiliation(s)
- Flurina Potter
- Department of Psychology, University of Konstanz, Konstanz, Germany,*Correspondence: Flurina Potter,
| | - Katalin Dohrmann
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | | | - Maggie Schauer
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Anselm Crombach
- Department of Psychology, University of Konstanz, Konstanz, Germany,Department of Psychology, University of Saarbrücken, Saarbrücken, Germany
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Kaltenbach E, McGrath PJ, Schauer M, Kaiser E, Crombach A, Robjant K. Practical guidelines for online Narrative Exposure Therapy (e-NET) - a short-term treatment for posttraumatic stress disorder adapted for remote delivery. Eur J Psychotraumatol 2021; 12:1881728. [PMID: 34025923 PMCID: PMC8128121 DOI: 10.1080/20008198.2021.1881728] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Indexed: 01/05/2023] Open
Abstract
Background: Online therapy has become increasingly desirable and available in recent years, with the current COVID-19 pandemic acting as a catalyst to develop further protocols enabling therapists to conduct online treatment safely and efficaciously. Offering online treatment potentially means that treatments are available to clients who would otherwise have no access, closing the gap in the provision of mental health services worldwide. Objective: This paper focuses on practical guidelines using online Narrative Exposure Therapy (e-NET). It aims to be an addition to the general manual of NET to enable therapists to deliver online treatment. The face-to-face version of NET is a well-known short-term and evidence-based treatment for posttraumatic stress disorder; e-NET is currently being tested in several additional trials. Methods: The differences between NET and e-NET are elaborated and depicted in detail. Results: Difficulties encountered in e-NET delivery, e.g. confidentiality, dealing with interruptions, comorbid symptoms among others, are similar to those that occur during face to face interventions but the solutions have to be adapted. Dissociation is often regarded as a challenge in face-to-face treatment, and requires particular attention within the online setting. Therefore, tools for addressing dissociation in this particular setting are presented. Conclusions: These practical guidelines show the advantages as well as the challenges therapists face when conducting e-NET. They aim to empower therapists working with trauma clients to conduct e-NET confidently and safely.
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Affiliation(s)
- Elisa Kaltenbach
- Centre for Research in Family Health, IWK Health Centre, Halifax, Canada.,vivo international, Konstanz, Germany
| | - Patrick J McGrath
- Centre for Research in Family Health, IWK Health Centre, Halifax, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Maggie Schauer
- vivo international, Konstanz, Germany.,Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Elisabeth Kaiser
- vivo international, Konstanz, Germany.,Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Anselm Crombach
- vivo international, Konstanz, Germany.,Department of Psychology, University of Konstanz, Konstanz, Germany
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Kaltenbach E, Hermenau K, Schauer M, Dohrmann K, Elbert T, Schalinski I. Trajectories of posttraumatic stress symptoms during and after Narrative Exposure Therapy (NET) in refugees. BMC Psychiatry 2020; 20:312. [PMID: 32552778 PMCID: PMC7298826 DOI: 10.1186/s12888-020-02720-y] [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: 06/21/2019] [Accepted: 06/09/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Trauma-focused therapy approaches are recommended as treatment for posttraumatic stress disorder (PTSD). This includes the treatment of trauma-related suffering in refugee populations. However, there is a lack of knowledge about symptom trajectories in refugees living in volatile conditions. This has led to fear of "retraumatisation" and general skepticism in clinicians concerning the use of exposure therapy. METHODS To test the relevance of this concern, we investigated PTSD symptom trajectories and potentially influencing factors during the course of Narrative Exposure Therapy (NET) in a refugee sample living in Germany. Refugees filled out the PTSD Checklist prior to each treatment session and also during follow-up interviews. Therapists continuously documented positive and negative life events as well as the content of the treatment sessions. Additionally, structured clinical interviews were conducted pre-treatment and at follow-up time points. RESULTS On average, clients presented with substantial decreases in PTSD symptoms already during and after NET. However, symptom trajectories differed and ranged from fast responders to slow responders to no immediate response during treatment. Importantly, a persistent worsening of symptoms was not observed, also not after exposure to the most distressing events. In contrast, stressful life experiences seemed to aggravate PTSD symptoms. CONCLUSIONS Consistent with earlier studies, NET leads to clinically and behaviorally relevant reductions in PTSD symptoms both throughout and following treatment in refugees living in volatile conditions. Concerns about imaginal exposure in refugees were not substantiated. While stressful life events contributed to transient symptom increases, they weren't found to prevent the overall effectiveness of NET. TRIAL REGISTRATION NCT02852616.
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Affiliation(s)
- Elisa Kaltenbach
- Department of Psychology, University of Konstanz, Konstanz, Germany. .,Centre for Research in Family Health, IWK Health Centre, Halifax, NS, Canada. .,Vivo International e.V., Konstanz, Germany.
| | - Katharin Hermenau
- grid.9811.10000 0001 0658 7699Department of Psychology, University of Konstanz, Konstanz, Germany ,Vivo International e.V., Konstanz, Germany
| | - Maggie Schauer
- grid.9811.10000 0001 0658 7699Department of Psychology, University of Konstanz, Konstanz, Germany ,Vivo International e.V., Konstanz, Germany
| | - Katalin Dohrmann
- grid.9811.10000 0001 0658 7699Department of Psychology, University of Konstanz, Konstanz, Germany ,Vivo International e.V., Konstanz, Germany
| | - Thomas Elbert
- grid.9811.10000 0001 0658 7699Department of Psychology, University of Konstanz, Konstanz, Germany ,Vivo International e.V., Konstanz, Germany
| | - Inga Schalinski
- grid.9811.10000 0001 0658 7699Department of Psychology, University of Konstanz, Konstanz, Germany ,Vivo International e.V., Konstanz, Germany ,Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany
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Aab A, Abreu P, Aglietta M, Albuquerque I, Albury J, Allekotte I, Almela A, Alvarez Castillo J, Alvarez-Muñiz J, Anastasi G, Anchordoqui L, Andrada B, Andringa S, Aramo C, Asorey H, Assis P, Avila G, Badescu A, Bakalova A, Balaceanu A, Barbato F, Barreira Luz R, Baur S, Becker K, Bellido J, Berat C, Bertaina M, Bertou X, Biermann P, Biteau J, Blaess S, Blanco A, Blazek J, Bleve C, Boháčová M, Boncioli D, Bonifazi C, Borodai N, Botti A, Brack J, Bretz T, Bridgeman A, Briechle F, Buchholz P, Bueno A, Buitink S, Buscemi M, Caballero-Mora K, Caccianiga L, Calcagni L, Cancio A, Canfora F, Carceller J, Caruso R, Castellina A, Catalani F, Cataldi G, Cazon L, Cerda M, Chinellato J, Chudoba J, Chytka L, Clay R, Cobos Cerutti A, Colalillo R, Coleman A, Coluccia M, Conceição R, Condorelli A, Consolati G, Contreras F, Convenga F, Cooper M, Coutu S, Covault C, Daniel B, Dasso S, Daumiller K, Dawson B, Day J, de Almeida R, de Jong S, De Mauro G, de Mello Neto J, De Mitri I, de Oliveira J, de Oliveira Salles F, de Souza V, Debatin J, del Río M, Deligny O, Dhital N, Díaz Castro M, Diogo F, Dobrigkeit C, D’Olivo J, Dorosti Q, dos Anjos R, Dova M, Dundovic A, Ebr J, Engel R, Erdmann M, Escobar C, Etchegoyen A, Falcke H, Farmer J, Farrar G, Fauth A, Fazzini N, Feldbusch F, Fenu F, Ferreyro L, Figueira J, Filipčič A, Freire M, Fujii T, Fuster A, García B, Gemmeke H, Gherghel-Lascu A, Ghia P, Giaccari U, Giammarchi M, Giller M, Głas D, Glombitza J, Gobbi F, Golup G, Gómez Berisso M, Gómez Vitale P, Gongora J, González N, Goos I, Góra D, Gorgi A, Gottowik M, Grubb T, Guarino F, Guedes G, Guido E, Halliday R, Hampel M, Hansen P, Harari D, Harrison T, Harvey V, Haungs A, Hebbeker T, Heck D, Heimann P, Hill G, Hojvat C, Holt E, Homola P, Hörandel J, Horvath P, Hrabovský M, Huege T, Hulsman J, Insolia A, Isar P, Jandt I, Johnsen J, Josebachuili M, Jurysek J, Kääpä A, Kampert K, Keilhauer B, Kemmerich N, Kemp J, Klages H, Kleifges M, Kleinfeller J, Krause R, Kuempel D, Kukec Mezek G, Kuotb Awad A, Lago B, LaHurd D, Lang R, Legumina R, Leigui de Oliveira M, Lenok V, Letessier-Selvon A, Lhenry-Yvon I, Lippmann O, Lo Presti D, Lopes L, López R, López Casado A, Lorek R, Luce Q, Lucero A, Malacari M, Mancarella G, Mandat D, Manning B, Mantsch P, Mariazzi A, Mariş I, Marsella G, Martello D, Martinez H, Martínez Bravo O, Mastrodicasa M, Mathes H, Mathys S, Matthews J, Matthiae G, Mayotte E, Mazur P, Medina-Tanco G, Melo D, Menshikov A, Merenda KD, Michal S, Micheletti M, Middendorf L, Miramonti L, Mitrica B, Mockler D, Mollerach S, Montanet F, Morello C, Morlino G, Mostafá M, Müller A, Muller M, Müller S, Mussa R, Nellen L, Nguyen P, Niculescu-Oglinzanu M, Niechciol M, Nitz D, Nosek D, Novotny V, Nožka L, Nucita A, Núñez L, Olinto A, Palatka M, Pallotta J, Panetta M, Papenbreer P, Parente G, Parra A, Pech M, Pedreira F, Pȩkala J, Pelayo R, Peña-Rodriguez J, Pereira L, Perlin M, Perrone L, Peters C, Petrera S, Phuntsok J, Pierog T, Pimenta M, Pirronello V, Platino M, Poh J, Pont B, Porowski C, Prado R, Privitera P, Prouza M, Puyleart A, Querchfeld S, Quinn S, Ramos-Pollan R, Rautenberg J, Ravignani D, Reininghaus M, Ridky J, Riehn F, Risse M, Ristori P, Rizi V, Rodrigues de Carvalho W, Rodriguez Rojo J, Roncoroni M, Roth M, Roulet E, Rovero A, Ruehl P, Saffi S, Saftoiu A, Salamida F, Salazar H, Salina G, Sanabria Gomez J, Sánchez F, Santos E, Santos E, Sarazin F, Sarmento R, Sarmiento-Cano C, Sato R, Savina P, Schauer M, Scherini V, Schieler H, Schimassek M, Schimp M, Schlüter F, Schmidt D, Scholten O, Schovánek P, Schröder F, Schröder S, Schumacher J, Sciutto S, Scornavacche M, Shellard R, Sigl G, Silli G, Sima O, Šmída R, Snow G, Sommers P, Soriano J, Souchard J, Squartini R, Stanca D, Stanič S, Stasielak J, Stassi P, Stolpovskiy M, Streich A, Suarez F, Suárez-Durán M, Sudholz T, Suomijärvi T, Supanitsky A, Šupík J, Szadkowski Z, Taboada A, Taborda O, Tapia A, Timmermans C, Todero Peixoto C, Tomé B, Torralba Elipe G, Travaini A, Travnicek P, Trini M, Tueros M, Ulrich R, Unger M, Urban M, Valdés Galicia J, Valiño I, Valore L, van Bodegom P, van den Berg A, van Vliet A, Varela E, Vargas Cárdenas B, Veberič D, Ventura C, Vergara Quispe I, Verzi V, Vicha J, Villaseñor L, Vink J, Vorobiov S, Wahlberg H, Watson A, Weber M, Weindl A, Wiedeński M, Wiencke L, Wilczyński H, Winchen T, Wirtz M, Wittkowski D, Wundheiler B, Yang L, Yushkov A, Zas E, Zavrtanik D, Zavrtanik M, Zehrer L, Zepeda A, Zimmermann B, Ziolkowski M, Zong Z, Zuccarello F. Data-driven estimation of the invisible energy of cosmic ray showers with the Pierre Auger Observatory. Int J Clin Exp Med 2019. [DOI: 10.1103/physrevd.100.082003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Müller-Bamouh V, Ruf-Leuschner M, Dohrmann K, Elbert T, Schauer M. Gewalterfahrungen und psychische Gesundheit im Verlauf bei unbegleiteten minderjährigen Flüchtlingen in Deutschland. Zeitschrift für Klinische Psychologie und Psychotherapie 2019. [DOI: 10.1026/1616-3443/a000564] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Hintergrund: Über die seelische Gesundheit von minderjährigen Flüchtlingen, die ohne sorgeberechtigte Person nach Deutschland gereist sind, liegen bisher kaum Daten und keinerlei längsschnittliche Untersuchungen vor. Fragestellung: Ziel ist es daher, die psychische Gesundheit im Zusammenhang mit stressvollen Erfahrungen (insbesondere familiäre und organisierte Gewalterfahrungen) sowie deren Entwicklung nach etwa zwei Jahren bei unbegleiteten minderjährig Geflüchteten in Deutschland zu untersuchen. Methode: In einer Querschnittsstudie wurden belastende Erlebnisse sowie posttraumatische, depressive und psychosomatische Symptome bei 57 unbegleiteten und 22 begleiteten minderjährig eingereisten Flüchtlingen mittels strukturierter klinischer Interviews untersucht. Nach durchschnittlich 20 Monaten wurde eine Subgruppe der unbegleiteten Minderjährigen erneut untersucht. Ergebnisse: Ein Drittel der Teilnehmer erfüllte die Kriterien einer PTBS-Diagnose nach DSM-IV. Nach Einbezug einer Gruppe begleiteter minderjähriger Flüchtlinge zeigte sich, dass vor allem organisierte und familiäre Gewalterfahrungen sowie die Dauer der Flucht bedeutsame Prädiktoren hinsichtlich der PTBS-Symptomschwere waren. Für das psychische Wohlbefinden insgesamt waren die erfahrene Gewalt in der Herkunftsfamilie, bestehende Freundschaften und das Vorhandensein von Privatsphäre relevant. Ergebnisse einer Folgeuntersuchung mit einer Teilgruppe der UMF etwa 20 Monate später zeigten, dass die psychische Beeinträchtigung im Durchschnitt unverändert hoch geblieben war. Fazit: Die Möglichkeit einer frühzeitigen psychischen Untersuchung mit Erfassung kindlicher Gewalterlebnisse sowie ein verbesserter Zugang zu einer traumafokussierten Behandlung mit Sprachmittlern sind wichtig, um Leid zu reduzieren und Integration zu ermöglichen.
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Affiliation(s)
| | | | - Katalin Dohrmann
- Klinische Psychologie, Universität Konstanz und vivo international e.V
| | - Thomas Elbert
- Klinische Psychologie, Universität Konstanz und vivo international e.V
| | - Maggie Schauer
- Klinische Psychologie, Universität Konstanz und vivo international e.V
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Serpeloni F, Radtke KM, Hecker T, Sill J, Vukojevic V, de Assis SG, Schauer M, Elbert T, Nätt D. Does Prenatal Stress Shape Postnatal Resilience? - An Epigenome-Wide Study on Violence and Mental Health in Humans. Front Genet 2019; 10:269. [PMID: 31040859 PMCID: PMC6477038 DOI: 10.3389/fgene.2019.00269] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 03/12/2019] [Indexed: 12/24/2022] Open
Abstract
Stress during pregnancy widely associates with epigenetic changes and psychiatric problems during childhood. Animal studies, however, show that under specific postnatal conditions prenatal stress may have other, less detrimental consequences for the offspring. Here, we studied mental health and epigenome-wide DNA methylation in saliva following intimate partner violence (IPV) during pregnancy in São Gonçalo, a Brazilian city with high levels of violence. Not surprisingly, mothers exposed to pregnancy IPV expressed elevated depression, PTSD and anxiety symptoms. Children had similar psychiatric problems when they experienced maternal IPV after being born. More surprisingly, when maternal IPV occurred both during (prenatal) and after pregnancy these problems were absent. Following prenatal IPV, genomic sites in genes encoding the glucocorticoid receptor (NR3C1) and its repressor FKBP51 (FKBP5) were among the most differentially methylated and indicated an enhanced ability to terminate hormonal stress responses in prenatally stressed children. These children also showed more DNA methylation in heterochromatin-like regions, which previously has been associated with stress/disease resilience. A similar relationship was seen in prenatally stressed middle-eastern refugees of the same age as the São Gonçalo children but exposed to postnatal war-related violence. While our study is limited in location and sample size, it provides novel insights on how prenatal stress may epigenetically shape resilience in humans, possibly through interactions with the postnatal environment. This translates animal findings and emphasizes the importance to account for population differences when studying how early life gene–environment interactions affects mental health.
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Affiliation(s)
- Fernanda Serpeloni
- Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany.,Department of Studies in Violence and Health Jorge Careli, National School of Public Health of Rio de Janeiro - National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Karl M Radtke
- Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany.,Evolutionary Biology and Zoology, Department of Biology, University of Konstanz, Konstanz, Germany
| | - Tobias Hecker
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Johanna Sill
- Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Vanja Vukojevic
- Division of Molecular Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland
| | - Simone G de Assis
- Department of Studies in Violence and Health Jorge Careli, National School of Public Health of Rio de Janeiro - National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Maggie Schauer
- Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Thomas Elbert
- Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Daniel Nätt
- Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
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Sill J, Popov T, Schauer M, Elbert T. Rapid brain responses to affective pictures indicate dimensions of trauma-related psychopathology in adolescents. Psychophysiology 2019; 57:e13353. [PMID: 30807662 PMCID: PMC6991163 DOI: 10.1111/psyp.13353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 01/26/2019] [Accepted: 01/26/2019] [Indexed: 12/30/2022]
Abstract
A variety of mental disorders are related to deviant brain activity, but these neural alterations do not validate psychiatric diagnostic categories. High symptom overlap and variable symptom patterns encourage a dimensional approach. Following the logic of the Research Domain Criteria (RDoC), we investigated trauma survivors for symptom clusters that might be associated with characteristics of ERPs, in particular with the early posterior negativity (EPN) elicited during affective picture processing. In rapid serial visual presentation, 90 adolescents (40 male/50 female, age M = 15.0 ± 2.5 years) who had been exposed to varying amounts of traumatic stress passively viewed a stream of high‐arousing positive and low‐arousing neutral pictures taken from the International Affective Picture System (IAPS). Using standardized interviews, symptoms of trauma‐related mental disorders were assessed (including those for PTSD, depression, borderline personality disorder, and behavioral problems). A principal component analysis was performed to derive potential dimensions of psychopathology. Multiple regression analysis confirmed a factor comprising problems concentrating, sleeping difficulties, and mistrust as a predictor of a larger EPN difference between high‐arousing positive and low‐arousing neutral IAPS pictures (β = 0.19, p < 0.05). Sex predicted the magnitude of the EPN (β = 0.45, p < 0.001). Male adolescents displayed a stronger EPN suppression than female adolescents. The result suggests that problems concentrating, sleeping difficulties, and mistrust seem to be trans‐diagnostic elements related to diminished early emotional discrimination represented by the EPN. Furthermore, our findings indicate that the EPN in response to emotional processing is modulated by sex. Based on the RDoC heuristic, symptom clusters that may be associated with the early posterior negativity (EPN) elicited during affective picture processing were investigated in youth trauma survivors. Analysis confirmed a factor comprising problems concentrating, sleeping difficulties, and mistrust as a predictor of a larger EPN difference between high arousing positive and low arousing neutral IAPS pictures using rapid serial visual presentation (RSVP). The EPN component was also modulated by sex. The findings also extend those of prior research on emotional processing confirming that EPN suppression can also be found in adolescents.
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Affiliation(s)
- Johanna Sill
- Department of Psychology, Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
| | - Tzvetan Popov
- Department of Psychology, Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
| | - Maggie Schauer
- Department of Psychology, Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
| | - Thomas Elbert
- Department of Psychology, Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
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Gensichen J, Schultz S, Adrion C, Schmidt K, Schauer M, Lindemann D, Unruh N, Kosilek RP, Schneider A, Scherer M, Bergmann A, Heintze C, Joos S, Briegel J, Scherag A, König HH, Brettschneider C, Schulze TG, Mansmann U, Linde K, Lühmann D, Voigt K, Gehrke-Beck S, Koch R, Zwissler B, Schneider G, Gerlach H, Kluge S, Koch T, Walther A, Atmann O, Oltrogge J, Sauer M, Schnurr J, Elbert T. Effect of a combined brief narrative exposure therapy with case management versus treatment as usual in primary care for patients with traumatic stress sequelae following intensive care medicine: study protocol for a multicenter randomized controlled trial (PICTURE). Trials 2018; 19:480. [PMID: 30201053 PMCID: PMC6131807 DOI: 10.1186/s13063-018-2853-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Traumatic events like critical illness and intensive care are threats to life and bodily integrity and pose a risk factor for posttraumatic stress disorder (PTSD). PTSD affects the quality of life and morbidity and may increase health-care costs. Limited access to specialist care results in PTSD patients being treated in primary care settings. Narrative exposure therapy (NET) is based on the principles of cognitive behavioral therapy and has shown positive effects when delivered by health-care professionals other than psychologists. The primary aims of the PICTURE trial (from "PTSD after ICU survival") are to investigate the effectiveness and applicability of NET adapted for primary care with case management in adults diagnosed with PTSD after intensive care. METHODS/DESIGN This is an investigator-initiated, multi-center, primary care-based, randomized controlled two-arm parallel group, observer-blinded superiority trial conducted throughout Germany. In total, 340 adult patients with a total score of at least 20 points on the posttraumatic diagnostic scale (PDS-5) 3 months after receiving intensive care treatment will be equally randomized to two groups: NET combined with case management and improved treatment as usual (iTAU). All primary care physicians (PCPs) involved will be instructed in the diagnosis and treatment of PTSD according to current German guidelines. PCPs in the iTAU group will deliver usual care during three consultations. In the experimental group, PCPs will additionally be trained to deliver an adapted version of NET (three sessions) supported by phone-based case management by a medical assistant. At 6 and 12 months after randomization, structured blinded telephone interviews will assess patient-reported outcomes. The primary composite endpoint is the absolute change from baseline at month 6 in PTSD symptom severity measured by the PDS-5 total score, which also incorporates the death of any study patients. Secondary outcomes cover the domains depression, anxiety, disability, health-related quality-of-life, and cost-effectiveness. The principal analysis is by intention to treat. DISCUSSION If the superiority of the experimental intervention over usual care can be demonstrated, the combination of brief NET and case management could be a treatment option to relieve PTSD-related symptoms and to improve primary care after intensive care. TRIAL REGISTRATION ClinicalTrials.gov, NCT03315390 . Registered on 10 October 2017. German Clinical Trials Register, DRKS00012589 . Registered on 17 October 2017.
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Affiliation(s)
- Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Pettenkoferstr. 8a, 80336, Munich, Germany.
| | - Susanne Schultz
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Pettenkoferstr. 8a, 80336, Munich, Germany
| | - Christine Adrion
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Konrad Schmidt
- Institute of General Practice of the Charité, Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany.,Institute of General Practice and Family Medicine, Jena University Hospital, Bachstr. 18, 07743, Jena, Germany
| | - Maggie Schauer
- Clinical Psychology, University of Konstanz, 78457, Konstanz, Germany
| | - Daniela Lindemann
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Pettenkoferstr. 8a, 80336, Munich, Germany
| | - Natalia Unruh
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Pettenkoferstr. 8a, 80336, Munich, Germany
| | - Robert P Kosilek
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Pettenkoferstr. 8a, 80336, Munich, Germany
| | - Antonius Schneider
- Institute of General Practice, Technical University of Munich, Klinikum rechts der Isar, Orleansstr. 47, 81667, Munich, Germany
| | - Martin Scherer
- Department of General Practice / Primary Care, University Medical Center Hamburg-Eppendorf, Haus West 37, Martinistr. 52, 20246, Hamburg, Germany
| | - Antje Bergmann
- Department of General Practice/Clinic of General Medicine - Medical clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Christoph Heintze
- Institute of General Practice of the Charité, Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Stefanie Joos
- Institute for General Practice and Interprofessional Health Care, University Clinic Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Josef Briegel
- Department of Anaesthesiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Andre Scherag
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Bachstr. 18, 07743, Jena, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Ulrich Mansmann
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Klaus Linde
- Institute of General Practice, Technical University of Munich, Klinikum rechts der Isar, Orleansstr. 47, 81667, Munich, Germany
| | - Dagmar Lühmann
- Department of General Practice / Primary Care, University Medical Center Hamburg-Eppendorf, Haus West 37, Martinistr. 52, 20246, Hamburg, Germany
| | - Karen Voigt
- Department of General Practice/Clinic of General Medicine - Medical clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Sabine Gehrke-Beck
- Institute of General Practice of the Charité, Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Roland Koch
- Institute for General Practice and Interprofessional Health Care, University Clinic Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Bernhard Zwissler
- Department of Anaesthesiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Gerhard Schneider
- Clinic for Anesthesiology, Technical University of Munich, Klinikum rechts der Isar, Orleansstr. 47, 81667, Munich, Germany
| | - Herwig Gerlach
- Clinic for Anesthesiology, Operative Intensive Care and Pain Management, Vivantes Klinikum Neukölln, Rudower Str. 49, 12351, Berlin, Germany
| | - Stefan Kluge
- Center for Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Thea Koch
- Clinic of Anesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Andreas Walther
- Clinic for Anesthesiology and Operative Intensive Care, Klinikum Stuttgart - Katharinenhospital, Kriegsbergerstr. 60, 70174, Stuttgart, Germany
| | - Oxana Atmann
- Institute of General Practice, Technical University of Munich, Klinikum rechts der Isar, Orleansstr. 47, 81667, Munich, Germany
| | - Jan Oltrogge
- Department of General Practice / Primary Care, University Medical Center Hamburg-Eppendorf, Haus West 37, Martinistr. 52, 20246, Hamburg, Germany
| | - Maik Sauer
- Department of General Practice/Clinic of General Medicine - Medical clinic III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Julia Schnurr
- Institute for General Practice and Interprofessional Health Care, University Clinic Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
| | - Thomas Elbert
- Clinical Psychology, University of Konstanz, 78457, Konstanz, Germany
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Waldhauser GT, Dahl MJ, Ruf-Leuschner M, Müller-Bamouh V, Schauer M, Axmacher N, Elbert T, Hanslmayr S. The neural dynamics of deficient memory control in heavily traumatized refugees. Sci Rep 2018; 8:13132. [PMID: 30177846 PMCID: PMC6120867 DOI: 10.1038/s41598-018-31400-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/17/2018] [Indexed: 11/09/2022] Open
Abstract
Victims of war, torture and natural catastrophes are prone to develop posttraumatic stress disorder (PTSD). These individuals experience the recurrent, involuntary intrusion of traumatic memories. What neurocognitive mechanisms are driving this memory disorder? Here we show that PTSD symptoms in heavily traumatized refugees are related to deficits in the effective control of memory retrieval. In a think/no-think task, PTSD patients were unable to forget memories that they had previously tried to suppress when compared to control participants with the same trauma history but without PTSD. Deficits in voluntary forgetting were clinically relevant since they correlated with memory intrusions in everyday life. Magnetoencephalography (MEG) recorded during suppression attempts revealed that PTSD patients were unable to downregulate signatures of sensory long-term memory traces in the gamma frequency band (70-120 Hz). Thus, our data suggest that the inability to suppress unwanted memories through modulation of gamma activity is related to PTSD symptom severity.
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Affiliation(s)
- Gerd T Waldhauser
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, 44801, Bochum, Germany.
| | - Martin J Dahl
- Max Planck Institute for Human Development, 14195, Berlin, Germany
| | | | | | - Maggie Schauer
- Department of Psychology, University of Konstanz, 78457, Konstanz, Germany
| | - Nikolai Axmacher
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, 44801, Bochum, Germany
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, 78457, Konstanz, Germany
| | - Simon Hanslmayr
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, Birmingham, United Kingdom
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11
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Elbert T, Schauer M, Moran JK. Two pedals drive the bi-cycle of violence: reactive and appetitive aggression. Curr Opin Psychol 2018; 19:135-138. [DOI: 10.1016/j.copsyc.2017.03.016] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 03/26/2017] [Indexed: 11/17/2022]
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12
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Schauer M, Robjant K. Commentary on Scheidell et al. (2018): En-counting adversities; the 'building blocks' of psychopathology. Addiction 2018; 113:57-58. [PMID: 29226536 DOI: 10.1111/add.14067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Maggie Schauer
- Center of Excellence for Psychotraumatology, University of Konstanz, Konstanz, Germany.,vivo international e.V., Konstanz, Germany
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13
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Ullmann E, Bornstein SR, Lanzman RS, Kirschbaum C, Sierau S, Doehnert M, Zimmermann P, Kindler H, Schauer M, Ruf-Leuschner M, Fegert JM, von Klitzing K, Ziegenhain U. Countering posttraumatic LHPA activation in refugee mothers and their infants. Mol Psychiatry 2018; 23:2-5. [PMID: 29133953 PMCID: PMC5754471 DOI: 10.1038/mp.2017.235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- E Ullmann
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany,Department of Medicine, Technische Universität Dresden, Carl Gustav Carus, Dresden, Germany,Department of Medicine, University of Dresden, Fetscherstraße 74, Dresden D-01307, Germany. E-mail:
| | - S R Bornstein
- Department of Medicine, Technische Universität Dresden, Carl Gustav Carus, Dresden, Germany,Faculty of Life Sciences & Medicine, Endocrinology and Diabetes, Kings College London, London, UK
| | - R S Lanzman
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - C Kirschbaum
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - S Sierau
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - M Doehnert
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - P Zimmermann
- Department of Psychology/Developmental Psychology, University of Wuppertal, Wuppertal, Germany
| | - H Kindler
- German Youth Institute, Munich, Germany
| | - M Schauer
- Center of Excellence for Psychotraumatology, University of Konstanz, Konstanz, Germany
| | - M Ruf-Leuschner
- Center of Excellence for Psychotraumatology, University of Konstanz, Konstanz, Germany
| | - J M Fegert
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Ulm, Ulm, Germany
| | - K von Klitzing
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - U Ziegenhain
- Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Ulm, Ulm, Germany
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Abstract
Background: Cross-sectional studies indicate that a substantial proportion of refugees have psychiatric disorders. However, longitudinal studies on the course of psychiatric symptoms and on influencing factors are scarce. The current study investigates the development of symptoms in an untreated refugee sample in Germany and seeks to identify potential predictors. Methods: Over the course of 1 year, 57 refugees participated in monthly assisted self-reports on the phone assessing emotional distress. At the same time, semi-annual, semi-structured clinical interviews focusing on posttraumatic stress disorder (PTSD) and depression were conducted. The overall dropout rate for the year was 23% for the assisted self-reports and 33% for the clinical interviews. Results: Symptoms did not systematically change over the course of the year. On the individual level, a reliable change in PTSD symptoms was observed in 13% who showed improvement and 24% who showed worsening symptoms. Figures for depression symptoms were 24 and 16% respectively. A higher number of traumatic experiences was related to a greater intensity of PTSD symptoms. In addition, postmigrational stressors were associated with a worsening of PTSD symptoms over the course of the year. Emotional distress was associated with current negative life events, unemployment, and frequent visits to physicians. Conclusions: There is on average no improvement or worsening of symptoms over the period of 1 year. However, individual courses vary, and thus show the importance of risk factors. Accordingly, the identification of risk factors such as trauma load and postmigrational stressors can be useful to determine the need of further monitoring and to provide appropriate interventions when necessary.
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Affiliation(s)
- Elisa Kaltenbach
- Clinical Psychology and Clinical Neuropsychology, Universität Konstanz, Konstanz, Germany
| | - Maggie Schauer
- Clinical Psychology and Clinical Neuropsychology, Universität Konstanz, Konstanz, Germany
| | - Katharin Hermenau
- Clinical Psychology and Clinical Neuropsychology, Universität Konstanz, Konstanz, Germany
| | - Thomas Elbert
- Clinical Psychology and Clinical Neuropsychology, Universität Konstanz, Konstanz, Germany
| | - Inga Schalinski
- Clinical Psychology and Clinical Neuropsychology, Universität Konstanz, Konstanz, Germany
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15
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Aab A, Abreu P, Aglietta M, Al Samarai I, Albuquerque I, Allekotte I, Almela A, Alvarez Castillo J, Alvarez-Muñiz J, Anastasi G, Anchordoqui L, Andrada B, Andringa S, Aramo C, Arqueros F, Arsene N, Asorey H, Assis P, Aublin J, Avila G, Badescu A, Balaceanu A, Barbato F, Barreira Luz R, Beatty J, Becker K, Bellido J, Berat C, Bertaina M, Bertou X, Biermann P, Biteau J, Blaess S, Blanco A, Blazek J, Bleve C, Boháčová M, Boncioli D, Bonifazi C, Borodai N, Botti A, Brack J, Brancus I, Bretz T, Bridgeman A, Briechle F, Buchholz P, Bueno A, Buitink S, Buscemi M, Caballero-Mora K, Caccianiga L, Cancio A, Canfora F, Caramete L, Caruso R, Castellina A, Catalani F, Cataldi G, Cazon L, Chavez A, Chinellato J, Chudoba J, Clay R, Cobos A, Colalillo R, Coleman A, Collica L, Coluccia M, Conceição R, Consolati G, Contreras F, Cooper M, Coutu S, Covault C, Cronin J, D’Amico S, Daniel B, Dasso S, Daumiller K, Dawson B, de Almeida R, de Jong S, De Mauro G, de Mello Neto J, De Mitri I, de Oliveira J, de Souza V, Debatin J, Deligny O, Díaz Castro M, Diogo F, Dobrigkeit C, D’Olivo J, Dorosti Q, dos Anjos R, Dova M, Dundovic A, Ebr J, Engel R, Erdmann M, Erfani M, Escobar C, Espadanal J, Etchegoyen A, Falcke H, Farmer J, Farrar G, Fauth A, Fazzini N, Fenu F, Fick B, Figueira J, Filipčič A, Fratu O, Freire M, Fujii T, Fuster A, Gaior R, García B, Garcia-Pinto D, Gaté F, Gemmeke H, Gherghel-Lascu A, Ghia P, Giaccari U, Giammarchi M, Giller M, Głas D, Glaser C, Golup G, Gómez Berisso M, Gómez Vitale P, González N, Gorgi A, Gorham P, Grillo A, Grubb T, Guarino F, Guedes G, Halliday R, Hampel M, Hansen P, Harari D, Harrison T, Harton J, Haungs A, Hebbeker T, Heck D, Heimann P, Herve A, Hill G, Hojvat C, Holt E, Homola P, Hörandel J, Horvath P, Hrabovský M, Huege T, Hulsman J, Insolia A, Isar P, Jandt I, Johnsen J, Josebachuili M, Jurysek J, Kääpä A, Kambeitz O, Kampert K, Keilhauer B, Kemmerich N, Kemp E, Kemp J, Kieckhafer R, Klages H, Kleifges M, Kleinfeller J, Krause R, Krohm N, Kuempel D, Kukec Mezek G, Kunka N, Kuotb Awad A, Lago B, LaHurd D, Lang R, Lauscher M, Legumina R, Leigui de Oliveira M, Letessier-Selvon A, Lhenry-Yvon I, Link K, Lo Presti D, Lopes L, López R, López Casado A, Lorek R, Luce Q, Lucero A, Malacari M, Mallamaci M, Mandat D, Mantsch P, Mariazzi A, Mariş I, Marsella G, Martello D, Martinez H, Martínez Bravo O, Masías Meza J, Mathes H, Mathys S, Matthews J, Matthews J, Matthiae G, Mayotte E, Mazur P, Medina C, Medina-Tanco G, Melo D, Menshikov A, Merenda KD, Michal S, Micheletti M, Middendorf L, Miramonti L, Mitrica B, Mockler D, Mollerach S, Montanet F, Morello C, Mostafá M, Müller A, Müller G, Muller M, Müller S, Mussa R, Naranjo I, Nellen L, Nguyen P, Niculescu-Oglinzanu M, Niechciol M, Niemietz L, Niggemann T, Nitz D, Nosek D, Novotny V, Nožka L, Núñez L, Ochilo L, Oikonomou F, Olinto A, Palatka M, Pallotta J, Papenbreer P, Parente G, Parra A, Paul T, Pech M, Pedreira F, Pękala J, Pelayo R, Peña-Rodriguez J, Pereira L, Perlin M, Perrone L, Peters C, Petrera S, Phuntsok J, Piegaia R, Pierog T, Pimenta M, Pirronello V, Platino M, Plum M, Porowski C, Prado R, Privitera P, Prouza M, Quel E, Querchfeld S, Quinn S, Ramos-Pollan R, Rautenberg J, Ravignani D, Ridky J, Riehn F, Risse M, Ristori P, Rizi V, Rodrigues de Carvalho W, Rodriguez Fernandez G, Rodriguez Rojo J, Rogozin D, Roncoroni M, Roth M, Roulet E, Rovero A, Ruehl P, Saffi S, Saftoiu A, Salamida F, Salazar H, Saleh A, Salesa Greus F, Salina G, Sánchez F, Sanchez-Lucas P, Santos E, Santos E, Sarazin F, Sarmento R, Sarmiento-Cano C, Sato R, Schauer M, Scherini V, Schieler H, Schimp M, Schmidt D, Scholten O, Schovánek P, Schröder F, Schröder S, Schulz A, Schumacher J, Sciutto S, Segreto A, Shadkam A, Shellard R, Sigl G, Silli G, Sima O, Śmiałkowski A, Šmída R, Smith B, Snow G, Sommers P, Sonntag S, Squartini R, Stanca D, Stanič S, Stasielak J, Stassi P, Stolpovskiy M, Strafella F, Streich A, Suarez F, Suarez Durán M, Sudholz T, Suomijärvi T, Supanitsky A, Šupík J, Swain J, Szadkowski Z, Taboada A, Taborda O, Theodoro V, Timmermans C, Todero Peixoto C, Tomankova L, Tomé B, Torralba Elipe G, Travnicek P, Trini M, Ulrich R, Unger M, Urban M, Valdés Galicia J, Valiño I, Valore L, van Aar G, van Bodegom P, van den Berg A, van Vliet A, Varela E, Vargas Cárdenas B, Varner G, Vázquez R, Veberič D, Ventura C, Vergara Quispe I, Verzi V, Vicha J, Villaseñor L, Vorobiov S, Wahlberg H, Wainberg O, Walz D, Watson A, Weber M, Weindl A, Wiencke L, Wilczyński H, Wileman C, Wirtz M, Wittkowski D, Wundheiler B, Yang L, Yushkov A, Zas E, Zavrtanik D, Zavrtanik M, Zepeda A, Zimmermann B, Ziolkowski M, Zong Z, Zuccarello F. Inferences on mass composition and tests of hadronic interactions from 0.3 to 100 EeV using the water-Cherenkov detectors of the Pierre Auger Observatory. Int J Clin Exp Med 2017. [DOI: 10.1103/physrevd.96.122003] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
Abstract
Appetitive aggression describes a biologically-driven form of aggressive behaviour and violence characterized by positive affect. In contrast to reactive aggression, which has the function of resisting a threat, and reducing concomitant negative emotional arousal and anger, appetitive aggression underlies the pleasure of violence. A prototypical example is hunting, which can in turn transfer to the hunting of humans and can even result in bloodlust, and killing for its own sake. At the physiological level, this morally illicit pleasure is accompanied by an adrenalin surge, the release of cortisol and endorphins. In order to activate reward systems via appetitive aggression, their moral and cultural restraints need to be overridden. For example, armed groups work to dehumanize the enemy. Once initiated, a positive feedback loop is generated: As the individual commits more acts of violence with elements of positive affect, the tendency to commit them grows, and they begin to be perceived more positively. A latent passion for fighting and dominance can probably be evoked in almost all men and in some women. The cumulative outcome of whole groups, tribes, or communities enacting this aggression is war and destruction, to the point of trying to extinguish entire ethnic groups:“… and yes, human beings, hundreds of thousands of otherwise normal people, not professional killers, did it.” (from “The Killers in Rwanda Speak” by Jean Hatzfeld, 2005). Thus, appetitive aggression, the disposition towards a lust for violence, is by no means a psychopathological anomaly but an intrinsic part of the human behavioural repertoire. Morality, culture and the state monopoly on violence constitute the guards that regulate aggression potential and to channel it into socially useful forms.
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Affiliation(s)
- Thomas Elbert
- Department of Psychology, University Konstanz Deutschland
| | - James K. Moran
- Department of Psychology, University Konstanz Deutschland
| | - Maggie Schauer
- Department of Psychology, University Konstanz Deutschland
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Platz Batista da Silva N, Schauer M, Hornung M, Lang S, Beyer LP, Wiesinger I, Stroszczynski C, Jung EM. Intrasurgical dignity assessment of hepatic tumors using semi-quantitative strain elastography and contrast-enhanced ultrasound for optimisation of liver tumor surgery. Clin Hemorheol Microcirc 2017; 64:735-745. [PMID: 27767982 DOI: 10.3233/ch-168029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the efficacy of strain elastography (SE) using semi-quantitative measurement methods compared to constrast enhanced ultrasound during liver tumor surgery (Io-CEUS) for dignity assessment of focal liver lesions(FLL). MATERIAL AND METHODS Prospective data acquisition and retrospective analysis of US data of 100 patients (116 lesions) who underwent liver tumor surgery between 10/2010 and 03/2016. Retrospective reading of SE color patterns was performed establishing groups depending on dominant color (>50% blue = stiff, inhomogenous, >50% yellow/red/green = soft tissue). Semi-quantitative analysis was performed by Q-analysis based on a scale from 0 (soft) to 6 (stiff). 2 ROIs were placed centrally, 5 ROIs in the lesion's surrounding tissue. Io-CEUS was performed by bolus injection of 5-10 ml sulphurhexaflourid microbubbles evaluating wash-in- and -out- kinetics in arterial, portal venous and late phase. Histopathology after surgical resection served as goldstandard. RESULTS 100 patients (m: 65, f: 35, mean age 60.5 years) with 116 liver lesions were included. Lesion's size ranged from 0.5 to 8.4 cm (mean 2.42 cm SD±1.44 cm). Postoperative histology showed 105 malignant and 11 benign lesions. Semi-quantitative analysis showed central indurations of >2.5 in 76/105 cases suggesting malignancy. 7 benign lesions displayed no central indurations correctly characterized benign by SE. ROC-analysis and Youden index showed a sensitivity of 72.4% and specificity of 63.6% assuming a cut-off of 2.5. Io-CEUS correctly characterized 103/105 as malignant. Sensitivity was 98%, specificity 72.7%. CONCLUSION Strain elastography is a valuable tool for non-invasive characterization of FLLs. Semi-quantitative intratumoral stiffness values of >2.5 suggested malignancy. However, sensitivity of Io-CEUS in detecting malignant lesions was higher compared to SE. In conclusion SE should be considered for routine use during intraoperative US in addition to Io-CEUS for optimization of curative liver surgery.
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Affiliation(s)
| | - M Schauer
- Department of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany
| | - M Hornung
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - S Lang
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - L P Beyer
- Departement of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - I Wiesinger
- Departement of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - C Stroszczynski
- Departement of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - E M Jung
- Departement of Radiology, University Hospital Regensburg, Regensburg, Germany
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Kaltenbach E, Härdtner E, Hermenau K, Schauer M, Elbert T. Efficient identification of mental health problems in refugees in Germany: the Refugee Health Screener. Eur J Psychotraumatol 2017; 8:1389205. [PMID: 29163869 PMCID: PMC5687797 DOI: 10.1080/20008198.2017.1389205] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 03/21/2017] [Accepted: 08/29/2017] [Indexed: 11/06/2022] Open
Abstract
Background: A substantial number of refugees present with mental disorders. This appears particularly acute in the currently increasing refugee populations in Europe. Although EU guidelines demand the identification and support of vulnerable individuals such as survivors of trauma, no adequately validated and comprehensive mental health screening instruments for refugees residing in Europe currently exist. Objective: We studied the feasibility, validity, and reliability of the Refugee Health Screener-15 (RHS-15) - a time-efficient and easy-to-implement screening developed by Hollifield et al. (2013) - as a self-rating and interview instrument. Methods: A sample of refugees from different countries (N = 86), representative of those who had arrived around the turn of the year 2015/2016 in Germany, filled in the RHS-15 on their own. A semi-structured clinical interview was later conducted with a random subsample (n = 56). Results: Fifty-two percent of the refugees examined screened positive in the RHS-15, thus indicating current mental health problems. The RHS-15 showed a good feasibility, reliability, and validity in both the self-rating and the interview version. It detected clinically relevant mental health problems when PTSD, depression, anxiety, or somatization problems were present. A shorter 13-item version proved to be equally valid. Conclusions: Together with previous research on the RHS in refugees living in the US, this suggests that the RHS is a time-efficient and accurate instrument that is able to detect common mental health problems in a wide range of refugees. Prospectively, the RHS could be used as an instrument for identifying vulnerable refugees, for example, by integrating it in the initial medical examination in the host community, thereby initiating support.
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Affiliation(s)
- Elisa Kaltenbach
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Eva Härdtner
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | | | - Maggie Schauer
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, Konstanz, Germany
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19
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Augsburger M, Dohrmann K, Schauer M, Elbert T. Relations between traumatic stress, dimensions of impulsivity, and reactive and appetitive aggression in individuals with refugee status. Psychol Trauma 2016; 9:137-144. [PMID: 27831734 DOI: 10.1037/tra0000227] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Traumatic stressors and other forms of adversities, especially when experienced during childhood, shape aggressive behavior. Effects of differential dimensions of impulsivity on the relationship between psychological trauma, reactive aggression (defensive survival response to threat), and appetitive aggression (the pleasure of attacking and fighting) have not yet been assessed. METHOD Using structural equation modeling, we sought to uncover precursors of reactive and appetitive aggression investigating a sample of 94 adult individuals with refugee status. We were interested in direct effects of childhood maltreatment and posttraumatic stress disorder (PTSD) and indirect effects via impulsivity dimensions. RESULTS For reactive aggression there was a direct link between childhood maltreatment and (a) PTSD symptoms and (b) marginal sensation seeking. Childhood maltreatment and sensation seeking best predicted appetitive aggression. There was no evidence for indirect effects of impulsivity. CONCLUSIONS Fear-driven response to perceived threat based on inadequate cognitive appraisal is assumed to cause pathological reactive aggression, whereas excessive appetitive aggression can be explained by repeated experiences of thrill and excitement during violent acts. Prevention of early traumatic stress and adversities seems key to breaking the cycle of violence. (PsycINFO Database Record
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Aab A, Abreu P, Aglietta M, Ahn EJ, Al Samarai I, Albuquerque IFM, Allekotte I, Allen JD, Allison P, Almela A, Alvarez Castillo J, Alvarez-Muñiz J, Ambrosio M, Anastasi GA, Anchordoqui L, Andrada B, Andringa S, Aramo C, Arqueros F, Arsene N, Asorey H, Assis P, Aublin J, Avila G, Badescu AM, Baus C, Beatty JJ, Becker KH, Bellido JA, Berat C, Bertaina ME, Bertou X, Biermann PL, Billoir P, Biteau J, Blaess SG, Blanco A, Blazek J, Bleve C, Blümer H, Boháčová M, Boncioli D, Bonifazi C, Borodai N, Botti AM, Brack J, Brancus I, Bretz T, Bridgeman A, Briechle FL, Buchholz P, Bueno A, Buitink S, Buscemi M, Caballero-Mora KS, Caccianiga B, Caccianiga L, Cancio A, Canfora F, Caramete L, Caruso R, Castellina A, Cataldi G, Cazon L, Cester R, Chavez AG, Chiavassa A, Chinellato JA, Chirinos Diaz JC, Chudoba J, Clay RW, Colalillo R, Coleman A, Collica L, Coluccia MR, Conceição R, Contreras F, Cooper MJ, Coutu S, Covault CE, Cronin J, Dallier R, D'Amico S, Daniel B, Dasso S, Daumiller K, Dawson BR, de Almeida RM, de Jong SJ, De Mauro G, de Mello Neto JRT, De Mitri I, de Oliveira J, de Souza V, Debatin J, Del Peral L, Deligny O, Dhital N, Di Giulio C, Di Matteo A, Díaz Castro ML, Diogo F, Dobrigkeit C, D'Olivo JC, Dorofeev A, Dos Anjos RC, Dova MT, Dundovic A, Ebr J, Engel R, Erdmann M, Erfani M, Escobar CO, Espadanal J, Etchegoyen A, Falcke H, Fang K, Farrar GR, Fauth AC, Fazzini N, Ferguson AP, Fick B, Figueira JM, Filevich A, Filipčič A, Fratu O, Freire MM, Fujii T, Fuster A, Gallo F, García B, Garcia-Pinto D, Gate F, Gemmeke H, Gherghel-Lascu A, Ghia PL, Giaccari U, Giammarchi M, Giller M, Głas D, Glaser C, Glass H, Golup G, Gómez Berisso M, Gómez Vitale PF, González N, Gookin B, Gordon J, Gorgi A, Gorham P, Gouffon P, Griffith N, Grillo AF, Grubb TD, Guarino F, Guedes GP, Hampel MR, Hansen P, Harari D, Harrison TA, Harton JL, Hasankiadeh Q, Haungs A, Hebbeker T, Heck D, Heimann P, Herve AE, Hill GC, Hojvat C, Hollon N, Holt E, Homola P, Hörandel JR, Horvath P, Hrabovský M, Huege T, Hulsman J, Insolia A, Isar PG, Jandt I, Jansen S, Jarne C, Johnsen JA, Josebachuili M, Kääpä A, Kambeitz O, Kampert KH, Kasper P, Katkov I, Keilhauer B, Kemp E, Kieckhafer RM, Klages HO, Kleifges M, Kleinfeller J, Krause R, Krohm N, Kuempel D, Kukec Mezek G, Kunka N, Kuotb Awad A, LaHurd D, Latronico L, Lauscher M, Lautridou P, Lebrun P, Legumina R, Leigui de Oliveira MA, Letessier-Selvon A, Lhenry-Yvon I, Link K, Lopes L, López R, López Casado A, Lucero A, Malacari M, Mallamaci M, Mandat D, Mantsch P, Mariazzi AG, Marin V, Mariş IC, Marsella G, Martello D, Martinez H, Martínez Bravo O, Masías Meza JJ, Mathes HJ, Mathys S, Matthews J, Matthews JAJ, Matthiae G, Maurizio D, Mayotte E, Mazur PO, Medina C, Medina-Tanco G, Mello VBB, Melo D, Menshikov A, Messina S, Micheletti MI, Middendorf L, Minaya IA, Miramonti L, Mitrica B, Molina-Bueno L, Mollerach S, Montanet F, Morello C, Mostafá M, Moura CA, Müller G, Muller MA, Müller S, Naranjo I, Navas S, Necesal P, Nellen L, Nelles A, Neuser J, Nguyen PH, Niculescu-Oglinzanu M, Niechciol M, Niemietz L, Niggemann T, Nitz D, Nosek D, Novotny V, Nožka H, Núñez LA, Ochilo L, Oikonomou F, Olinto A, Pakk Selmi-Dei D, Palatka M, Pallotta J, Papenbreer P, Parente G, Parra A, Paul T, Pech M, Pedreira F, Pękala J, Pelayo R, Peña-Rodriguez J, Pepe IM, Pereira LAS, Perrone L, Petermann E, Peters C, Petrera S, Phuntsok J, Piegaia R, Pierog T, Pieroni P, Pimenta M, Pirronello V, Platino M, Plum M, Porowski C, Prado RR, Privitera P, Prouza M, Quel EJ, Querchfeld S, Quinn S, Rautenberg J, Ravel O, Ravignani D, Revenu B, Ridky J, Risse M, Ristori P, Rizi V, Rodrigues de Carvalho W, Rodriguez Rojo J, Rodríguez-Frías MD, Rogozin D, Rosado J, Roth M, Roulet E, Rovero AC, Saffi SJ, Saftoiu A, Salazar H, Saleh A, Salesa Greus F, Salina G, Sanabria Gomez JD, Sánchez F, Sanchez-Lucas P, Santos EM, Santos E, Sarazin F, Sarkar B, Sarmento R, Sarmiento-Cano C, Sato R, Scarso C, Schauer M, Scherini V, Schieler H, Schmidt D, Scholten O, Schoorlemmer H, Schovánek P, Schröder FG, Schulz A, Schulz J, Schumacher J, Sciutto SJ, Segreto A, Settimo M, Shadkam A, Shellard RC, Sigl G, Sima O, Śmiałkowski A, Šmída R, Snow GR, Sommers P, Sonntag S, Sorokin J, Squartini R, Stanca D, Stanič S, Stapleton J, Stasielak J, Strafella F, Stutz A, Suarez F, Suarez Durán M, Sudholz T, Suomijärvi T, Supanitsky AD, Sutherland MS, Swain J, Szadkowski Z, Taborda OA, Tapia A, Tepe A, Theodoro VM, Timmermans C, Todero Peixoto CJ, Tomankova L, Tomé B, Tonachini A, Torralba Elipe G, Torres Machado D, Travnicek P, Trini M, Ulrich R, Unger M, Urban M, Valbuena-Delgado A, Valdés Galicia JF, Valiño I, Valore L, van Aar G, van Bodegom P, van den Berg AM, van Vliet A, Varela E, Vargas Cárdenas B, Varner G, Vázquez JR, Vázquez RA, Veberič D, Verzi V, Vicha J, Videla M, Villaseñor L, Vorobiov S, Wahlberg H, Wainberg O, Walz D, Watson AA, Weber M, Weindl A, Wiencke L, Wilczyński H, Winchen T, Wittkowski D, Wundheiler B, Wykes S, Yang L, Yapici T, Yelos D, Zas E, Zavrtanik D, Zavrtanik M, Zepeda A, Zimmermann B, Ziolkowski M, Zong Z, Zuccarello F. Testing Hadronic Interactions at Ultrahigh Energies with Air Showers Measured by the Pierre Auger Observatory. Phys Rev Lett 2016; 117:192001. [PMID: 27858429 DOI: 10.1103/physrevlett.117.192001] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Indexed: 06/06/2023]
Abstract
Ultrahigh energy cosmic ray air showers probe particle physics at energies beyond the reach of accelerators. Here we introduce a new method to test hadronic interaction models without relying on the absolute energy calibration, and apply it to events with primary energy 6-16 EeV (E_{CM}=110-170 TeV), whose longitudinal development and lateral distribution were simultaneously measured by the Pierre Auger Observatory. The average hadronic shower is 1.33±0.16 (1.61±0.21) times larger than predicted using the leading LHC-tuned models EPOS-LHC (QGSJetII-04), with a corresponding excess of muons.
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Affiliation(s)
- A Aab
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Germany
| | - P Abreu
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | - M Aglietta
- Osservatorio Astrofisico di Torino (INAF), Torino, Italy
- INFN, Sezione di Torino, Italy
| | - E J Ahn
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - I Al Samarai
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, France
| | | | - I Allekotte
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), Argentina
| | - J D Allen
- New York University, New York, New York, USA
| | - P Allison
- Ohio State University, Columbus, Ohio, USA
| | - A Almela
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Argentina
| | | | | | | | | | - L Anchordoqui
- Department of Physics and Astronomy, Lehman College, City University of New York, Bronx, New York, USA
| | - B Andrada
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - S Andringa
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | - C Aramo
- INFN, Sezione di Napoli, Italy
| | - F Arqueros
- Universidad Complutense de Madrid, Spain
| | - N Arsene
- University of Bucharest, Physics Department, Romania
| | - H Asorey
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), Argentina
- Universidad Industrial de Santander, Colombia
| | - P Assis
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | - J Aublin
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, France
| | - G Avila
- Observatorio Pierre Auger, Argentina
- Observatorio Pierre Auger and Comisión Nacional de Energía Atómica, Argentina
| | - A M Badescu
- University Politehnica of Bucharest, Romania
| | - C Baus
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Germany
| | - J J Beatty
- Ohio State University, Columbus, Ohio, USA
| | - K H Becker
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | | | - C Berat
- Laboratoire de Physique Subatomique et de Cosmologie (LPSC), Université Grenoble-Alpes, CNRS/IN2P3, France
| | - M E Bertaina
- INFN, Sezione di Torino, Italy
- Università Torino, Dipartimento di Fisica, Italy
| | - X Bertou
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), Argentina
| | - P L Biermann
- Max-Planck-Institut für Radioastronomie, Bonn, Germany
| | - P Billoir
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, France
| | - J Biteau
- Institut de Physique Nucléaire d'Orsay (IPNO), Université Paris 11, CNRS-IN2P3, France
| | | | - A Blanco
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | - J Blazek
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - C Bleve
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Italy
- INFN, Sezione di Lecce, Italy
| | - H Blümer
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Germany
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - M Boháčová
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - D Boncioli
- INFN Laboratori del Gran Sasso, Italy
- Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Física, Brazil
| | - C Bonifazi
- Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Física, Brazil
| | - N Borodai
- Institute of Nuclear Physics PAN, Poland
| | - A M Botti
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - J Brack
- Colorado State University, Fort Collins, Colorado, USA
| | - I Brancus
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Romania
| | - T Bretz
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - A Bridgeman
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - F L Briechle
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - P Buchholz
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Germany
| | - A Bueno
- Universidad de Granada and C.A.F.P.E., Spain
| | - S Buitink
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
| | - M Buscemi
- Università di Catania, Dipartimento di Fisica e Astronomia, Italy
- INFN, Sezione di Catania, Italy
| | | | | | - L Caccianiga
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, France
| | - A Cancio
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Argentina
| | - F Canfora
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
| | | | - R Caruso
- Università di Catania, Dipartimento di Fisica e Astronomia, Italy
- INFN, Sezione di Catania, Italy
| | - A Castellina
- Osservatorio Astrofisico di Torino (INAF), Torino, Italy
- INFN, Sezione di Torino, Italy
| | | | - L Cazon
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | - R Cester
- INFN, Sezione di Torino, Italy
- Università Torino, Dipartimento di Fisica, Italy
| | - A G Chavez
- Universidad Michoacana de San Nicolás de Hidalgo, Mexico
| | - A Chiavassa
- INFN, Sezione di Torino, Italy
- Università Torino, Dipartimento di Fisica, Italy
| | | | | | - J Chudoba
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - R W Clay
- University of Adelaide, Australia
| | - R Colalillo
- INFN, Sezione di Napoli, Italy
- Università di Napoli "Federico II", Dipartimento di Fisica, Italy
| | - A Coleman
- Pennsylvania State University, University Park, Pennsylvania, USA
| | | | - M R Coluccia
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Italy
- INFN, Sezione di Lecce, Italy
| | - R Conceição
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | - F Contreras
- Observatorio Pierre Auger, Argentina
- Observatorio Pierre Auger and Comisión Nacional de Energía Atómica, Argentina
| | | | - S Coutu
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - C E Covault
- Case Western Reserve University, Cleveland, Ohio, USA
| | - J Cronin
- University of Chicago, Chicago, Illinois, USA
| | - R Dallier
- SUBATECH, École des Mines de Nantes, CNRS-IN2P3, Université de Nantes, France
- Station de Radioastronomie de Nançay, France
| | - S D'Amico
- INFN, Sezione di Lecce, Italy
- Università del Salento, Dipartimento di Ingegneria, Italy
| | - B Daniel
- Universidade Estadual de Campinas (UNICAMP), Brazil
| | - S Dasso
- Instituto de Astronomía y Física del Espacio (IAFE, CONICET-UBA), Argentina
- Departamento de Física and Departamento de Ciencias de la Atmósfera y los Océanos, FCEyN, Universidad de Buenos Aires, Argentina
| | - K Daumiller
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | | | | | - S J de Jong
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Netherlands
| | - G De Mauro
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
| | | | - I De Mitri
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Italy
- INFN, Sezione di Lecce, Italy
| | | | - V de Souza
- Universidade de São Paulo, Inst. de Física de São Carlos, São Carlos, Brazil
| | - J Debatin
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | | | - O Deligny
- Institut de Physique Nucléaire d'Orsay (IPNO), Université Paris 11, CNRS-IN2P3, France
| | - N Dhital
- Michigan Technological University, Houghton, Michigan, USA
| | - C Di Giulio
- Università di Roma "Tor Vergata", Dipartimento di Fisica, Italy
- INFN, Sezione di Roma "Tor Vergata", Italy
| | - A Di Matteo
- INFN, Sezione di L'Aquila, Italy
- Università dell'Aquila, Dipartimento di Chimica e Fisica, Italy
| | | | - F Diogo
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | - C Dobrigkeit
- Universidade Estadual de Campinas (UNICAMP), Brazil
| | - J C D'Olivo
- Universidad Nacional Autónoma de México, Mexico
| | - A Dorofeev
- Colorado State University, Fort Collins, Colorado, USA
| | - R C Dos Anjos
- Universidade Federal do Paraná, Setor Palotina, Brazil
| | - M T Dova
- IFLP, Universidad Nacional de La Plata and CONICET, Argentina
| | - A Dundovic
- Universität Hamburg, II. Institut für Theoretische Physik, Germany
| | - J Ebr
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - R Engel
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - M Erdmann
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - M Erfani
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Germany
| | - C O Escobar
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
- Universidade Estadual de Campinas (UNICAMP), Brazil
| | - J Espadanal
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | - A Etchegoyen
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Argentina
| | - H Falcke
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Netherlands
- Stichting Astronomisch Onderzoek in Nederland (ASTRON), Dwingeloo, Netherlands
| | - K Fang
- University of Chicago, Chicago, Illinois, USA
| | - G R Farrar
- New York University, New York, New York, USA
| | - A C Fauth
- Universidade Estadual de Campinas (UNICAMP), Brazil
| | - N Fazzini
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A P Ferguson
- Case Western Reserve University, Cleveland, Ohio, USA
| | - B Fick
- Michigan Technological University, Houghton, Michigan, USA
| | - J M Figueira
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - A Filevich
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - A Filipčič
- Experimental Particle Physics Department, J. Stefan Institute, Slovenia
- Laboratory for Astroparticle Physics, University of Nova Gorica, Slovenia
| | - O Fratu
- University Politehnica of Bucharest, Romania
| | - M M Freire
- Instituto de Física de Rosario (IFIR)-CONICET/U.N.R. and Facultad de Ciencias Bioquímicas y Farmacéuticas U.N.R., Argentina
| | - T Fujii
- University of Chicago, Chicago, Illinois, USA
| | - A Fuster
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Argentina
| | - F Gallo
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - B García
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM) and Universidad Tecnológica Nacional-Facultad Regional Mendoza (CONICET/CNEA), Argentina
| | | | - F Gate
- SUBATECH, École des Mines de Nantes, CNRS-IN2P3, Université de Nantes, France
| | - H Gemmeke
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik (IPE), Germany
| | - A Gherghel-Lascu
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Romania
| | - P L Ghia
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, France
| | - U Giaccari
- Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Física, Brazil
| | | | | | - D Głas
- University of Łódź, Poland
| | - C Glaser
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - H Glass
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - G Golup
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), Argentina
| | - M Gómez Berisso
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), Argentina
| | - P F Gómez Vitale
- Observatorio Pierre Auger, Argentina
- Observatorio Pierre Auger and Comisión Nacional de Energía Atómica, Argentina
| | - N González
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - B Gookin
- Colorado State University, Fort Collins, Colorado, USA
| | - J Gordon
- Ohio State University, Columbus, Ohio, USA
| | - A Gorgi
- Osservatorio Astrofisico di Torino (INAF), Torino, Italy
- INFN, Sezione di Torino, Italy
| | - P Gorham
- University of Hawaii, Honolulu, Hawaii, USA
| | - P Gouffon
- Universidade de São Paulo, Inst. de Física, São Paulo, Brazil
| | - N Griffith
- Ohio State University, Columbus, Ohio, USA
| | | | | | - F Guarino
- INFN, Sezione di Napoli, Italy
- Università di Napoli "Federico II", Dipartimento di Fisica, Italy
| | - G P Guedes
- Universidade Estadual de Feira de Santana (UEFS), Brazil
| | - M R Hampel
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - P Hansen
- IFLP, Universidad Nacional de La Plata and CONICET, Argentina
| | - D Harari
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), Argentina
| | | | - J L Harton
- Colorado State University, Fort Collins, Colorado, USA
| | - Q Hasankiadeh
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - A Haungs
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - T Hebbeker
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - D Heck
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - P Heimann
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Germany
| | - A E Herve
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Germany
| | - G C Hill
- University of Adelaide, Australia
| | - C Hojvat
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - N Hollon
- University of Chicago, Chicago, Illinois, USA
| | - E Holt
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - P Homola
- Institute of Nuclear Physics PAN, Poland
| | - J R Hörandel
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Netherlands
| | - P Horvath
- Palacky University, RCPTM, Czech Republic
| | | | - T Huege
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - J Hulsman
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - A Insolia
- Università di Catania, Dipartimento di Fisica e Astronomia, Italy
- INFN, Sezione di Catania, Italy
| | - P G Isar
- Institute of Space Science, Romania
| | - I Jandt
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - S Jansen
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Netherlands
| | - C Jarne
- IFLP, Universidad Nacional de La Plata and CONICET, Argentina
| | - J A Johnsen
- Colorado School of Mines, Golden, Colorado, USA
| | - M Josebachuili
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - A Kääpä
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - O Kambeitz
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Germany
| | - K H Kampert
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - P Kasper
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - I Katkov
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Germany
| | - B Keilhauer
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - E Kemp
- Universidade Estadual de Campinas (UNICAMP), Brazil
| | - R M Kieckhafer
- Michigan Technological University, Houghton, Michigan, USA
| | - H O Klages
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - M Kleifges
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik (IPE), Germany
| | | | - R Krause
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - N Krohm
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - D Kuempel
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - G Kukec Mezek
- Laboratory for Astroparticle Physics, University of Nova Gorica, Slovenia
| | - N Kunka
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik (IPE), Germany
| | - A Kuotb Awad
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - D LaHurd
- Case Western Reserve University, Cleveland, Ohio, USA
| | | | - M Lauscher
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - P Lautridou
- SUBATECH, École des Mines de Nantes, CNRS-IN2P3, Université de Nantes, France
| | - P Lebrun
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | | | | | - A Letessier-Selvon
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, France
| | - I Lhenry-Yvon
- Institut de Physique Nucléaire d'Orsay (IPNO), Université Paris 11, CNRS-IN2P3, France
| | - K Link
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Germany
| | - L Lopes
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | - R López
- Benemérita Universidad Autónoma de Puebla (BUAP), Mexico
| | | | - A Lucero
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Argentina
| | | | - M Mallamaci
- INFN, Sezione di Milano, Italy
- Università di Milano, Dipartimento di Fisica, Italy
| | - D Mandat
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - P Mantsch
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - A G Mariazzi
- IFLP, Universidad Nacional de La Plata and CONICET, Argentina
| | - V Marin
- SUBATECH, École des Mines de Nantes, CNRS-IN2P3, Université de Nantes, France
| | - I C Mariş
- Universidad de Granada and C.A.F.P.E., Spain
| | - G Marsella
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Italy
- INFN, Sezione di Lecce, Italy
| | - D Martello
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Italy
- INFN, Sezione di Lecce, Italy
| | - H Martinez
- Centro de Investigación y de Estudios Avanzados del IPN (CINVESTAV), Mexico
| | | | - J J Masías Meza
- Departamento de Física and Departamento de Ciencias de la Atmósfera y los Océanos, FCEyN, Universidad de Buenos Aires, Argentina
| | - H J Mathes
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - S Mathys
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - J Matthews
- Louisiana State University, Baton Rouge, Louisiana, USA
| | | | - G Matthiae
- Università di Roma "Tor Vergata", Dipartimento di Fisica, Italy
- INFN, Sezione di Roma "Tor Vergata", Italy
| | - D Maurizio
- Centro Brasileiro de Pesquisas Fisicas (CBPF), Brazil
| | - E Mayotte
- Colorado School of Mines, Golden, Colorado, USA
| | - P O Mazur
- Fermi National Accelerator Laboratory, Batavia, Illinois, USA
| | - C Medina
- Colorado School of Mines, Golden, Colorado, USA
| | | | - V B B Mello
- Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Física, Brazil
| | - D Melo
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - A Menshikov
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik (IPE), Germany
| | - S Messina
- KVI-Center for Advanced Radiation Technology, University of Groningen, Netherlands
| | - M I Micheletti
- Instituto de Física de Rosario (IFIR)-CONICET/U.N.R. and Facultad de Ciencias Bioquímicas y Farmacéuticas U.N.R., Argentina
| | - L Middendorf
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - I A Minaya
- Universidad Complutense de Madrid, Spain
| | - L Miramonti
- INFN, Sezione di Milano, Italy
- Università di Milano, Dipartimento di Fisica, Italy
| | - B Mitrica
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Romania
| | | | - S Mollerach
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), Argentina
| | - F Montanet
- Laboratoire de Physique Subatomique et de Cosmologie (LPSC), Université Grenoble-Alpes, CNRS/IN2P3, France
| | - C Morello
- Osservatorio Astrofisico di Torino (INAF), Torino, Italy
- INFN, Sezione di Torino, Italy
| | - M Mostafá
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - C A Moura
- Universidade Federal do ABC (UFABC), Brazil
| | - G Müller
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - M A Muller
- Universidade Estadual de Campinas (UNICAMP), Brazil
- Universidade Federal de Pelotas, Brazil
| | - S Müller
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - I Naranjo
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), Argentina
| | - S Navas
- Universidad de Granada and C.A.F.P.E., Spain
| | - P Necesal
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - L Nellen
- Universidad Nacional Autónoma de México, Mexico
| | - A Nelles
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Netherlands
| | - J Neuser
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | | | | | - M Niechciol
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Germany
| | - L Niemietz
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - T Niggemann
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - D Nitz
- Michigan Technological University, Houghton, Michigan, USA
| | - D Nosek
- University Prague, Institute of Particle and Nuclear Physics, Czech Republic
| | - V Novotny
- University Prague, Institute of Particle and Nuclear Physics, Czech Republic
| | - H Nožka
- Palacky University, RCPTM, Czech Republic
| | - L A Núñez
- Universidad Industrial de Santander, Colombia
| | - L Ochilo
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Germany
| | - F Oikonomou
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - A Olinto
- University of Chicago, Chicago, Illinois, USA
| | | | - M Palatka
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - J Pallotta
- Centro de Investigaciones en Láseres y Aplicaciones, CITEDEF and CONICET, Argentina
| | - P Papenbreer
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - G Parente
- Universidad de Santiago de Compostela, Spain
| | - A Parra
- Benemérita Universidad Autónoma de Puebla (BUAP), Mexico
| | - T Paul
- Department of Physics and Astronomy, Lehman College, City University of New York, Bronx, New York, USA
- Northeastern University, Boston, Massachusetts, USA
| | - M Pech
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - F Pedreira
- Universidad de Santiago de Compostela, Spain
| | - J Pękala
- Institute of Nuclear Physics PAN, Poland
| | - R Pelayo
- Unidad Profesional Interdisciplinaria en Ingeniería y Tecnologías Avanzadas del Instituto Politécnico Nacional (UPIITA-IPN), Mexico
| | | | - I M Pepe
- Universidade Federal da Bahia, Brazil
| | | | - L Perrone
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Italy
- INFN, Sezione di Lecce, Italy
| | - E Petermann
- University of Nebraska, Lincoln, Nebraska, USA
| | - C Peters
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - S Petrera
- INFN, Sezione di L'Aquila, Italy
- Università dell'Aquila, Dipartimento di Chimica e Fisica, Italy
| | - J Phuntsok
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - R Piegaia
- Departamento de Física and Departamento de Ciencias de la Atmósfera y los Océanos, FCEyN, Universidad de Buenos Aires, Argentina
| | - T Pierog
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - P Pieroni
- Departamento de Física and Departamento de Ciencias de la Atmósfera y los Océanos, FCEyN, Universidad de Buenos Aires, Argentina
| | - M Pimenta
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | - V Pirronello
- Università di Catania, Dipartimento di Fisica e Astronomia, Italy
- INFN, Sezione di Catania, Italy
| | - M Platino
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - M Plum
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - C Porowski
- Institute of Nuclear Physics PAN, Poland
| | - R R Prado
- Universidade de São Paulo, Inst. de Física de São Carlos, São Carlos, Brazil
| | - P Privitera
- University of Chicago, Chicago, Illinois, USA
| | - M Prouza
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - E J Quel
- Centro de Investigaciones en Láseres y Aplicaciones, CITEDEF and CONICET, Argentina
| | - S Querchfeld
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - S Quinn
- Case Western Reserve University, Cleveland, Ohio, USA
| | - J Rautenberg
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - O Ravel
- SUBATECH, École des Mines de Nantes, CNRS-IN2P3, Université de Nantes, France
| | - D Ravignani
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - B Revenu
- SUBATECH, École des Mines de Nantes, CNRS-IN2P3, Université de Nantes, France
| | - J Ridky
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - M Risse
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Germany
| | - P Ristori
- Centro de Investigaciones en Láseres y Aplicaciones, CITEDEF and CONICET, Argentina
| | - V Rizi
- INFN, Sezione di L'Aquila, Italy
- Università dell'Aquila, Dipartimento di Chimica e Fisica, Italy
| | | | | | | | - D Rogozin
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - J Rosado
- Universidad Complutense de Madrid, Spain
| | - M Roth
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - E Roulet
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), Argentina
| | - A C Rovero
- Instituto de Astronomía y Física del Espacio (IAFE, CONICET-UBA), Argentina
| | | | - A Saftoiu
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Romania
| | - H Salazar
- Benemérita Universidad Autónoma de Puebla (BUAP), Mexico
| | - A Saleh
- Laboratory for Astroparticle Physics, University of Nova Gorica, Slovenia
| | - F Salesa Greus
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - G Salina
- INFN, Sezione di Roma "Tor Vergata", Italy
| | | | - F Sánchez
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | | | - E M Santos
- Universidade de São Paulo, Inst. de Física, São Paulo, Brazil
| | - E Santos
- Universidade Estadual de Campinas (UNICAMP), Brazil
| | - F Sarazin
- Colorado School of Mines, Golden, Colorado, USA
| | - B Sarkar
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - R Sarmento
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | | | - R Sato
- Observatorio Pierre Auger, Argentina
| | - C Scarso
- Observatorio Pierre Auger, Argentina
| | - M Schauer
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - V Scherini
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Italy
- INFN, Sezione di Lecce, Italy
| | - H Schieler
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - D Schmidt
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - O Scholten
- KVI-Center for Advanced Radiation Technology, University of Groningen, Netherlands
| | | | - P Schovánek
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - F G Schröder
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - A Schulz
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - J Schulz
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
| | - J Schumacher
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - S J Sciutto
- IFLP, Universidad Nacional de La Plata and CONICET, Argentina
| | - A Segreto
- INFN, Sezione di Catania, Italy
- INAF-Istituto di Astrofisica Spaziale e Fisica Cosmica di Palermo, Italy
| | - M Settimo
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, France
| | - A Shadkam
- Louisiana State University, Baton Rouge, Louisiana, USA
| | - R C Shellard
- Centro Brasileiro de Pesquisas Fisicas (CBPF), Brazil
| | - G Sigl
- Universität Hamburg, II. Institut für Theoretische Physik, Germany
| | - O Sima
- University of Bucharest, Physics Department, Romania
| | | | - R Šmída
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - G R Snow
- University of Nebraska, Lincoln, Nebraska, USA
| | - P Sommers
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - S Sonntag
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Germany
| | | | | | - D Stanca
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Romania
| | - S Stanič
- Laboratory for Astroparticle Physics, University of Nova Gorica, Slovenia
| | | | | | - F Strafella
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Italy
- INFN, Sezione di Lecce, Italy
| | - A Stutz
- Laboratoire de Physique Subatomique et de Cosmologie (LPSC), Université Grenoble-Alpes, CNRS/IN2P3, France
| | - F Suarez
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Argentina
| | | | | | - T Suomijärvi
- Institut de Physique Nucléaire d'Orsay (IPNO), Université Paris 11, CNRS-IN2P3, France
| | - A D Supanitsky
- Instituto de Astronomía y Física del Espacio (IAFE, CONICET-UBA), Argentina
| | | | - J Swain
- Northeastern University, Boston, Massachusetts, USA
| | | | - O A Taborda
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), Argentina
| | - A Tapia
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - A Tepe
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Germany
| | - V M Theodoro
- Universidade Estadual de Campinas (UNICAMP), Brazil
| | - C Timmermans
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Netherlands
| | | | - L Tomankova
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - B Tomé
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Portugal
| | - A Tonachini
- INFN, Sezione di Torino, Italy
- Università Torino, Dipartimento di Fisica, Italy
| | | | - D Torres Machado
- Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Física, Brazil
| | - P Travnicek
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - M Trini
- Laboratory for Astroparticle Physics, University of Nova Gorica, Slovenia
| | - R Ulrich
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - M Unger
- New York University, New York, New York, USA
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - M Urban
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | | | | | - I Valiño
- Universidad de Santiago de Compostela, Spain
| | - L Valore
- INFN, Sezione di Napoli, Italy
- Università di Napoli "Federico II", Dipartimento di Fisica, Italy
| | - G van Aar
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
| | | | - A M van den Berg
- KVI-Center for Advanced Radiation Technology, University of Groningen, Netherlands
| | - A van Vliet
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
| | - E Varela
- Benemérita Universidad Autónoma de Puebla (BUAP), Mexico
| | | | - G Varner
- University of Hawaii, Honolulu, Hawaii, USA
| | | | - R A Vázquez
- Universidad de Santiago de Compostela, Spain
| | - D Veberič
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - V Verzi
- INFN, Sezione di Roma "Tor Vergata", Italy
| | - J Vicha
- Institute of Physics (FZU) of the Academy of Sciences of the Czech Republic, Czech Republic
| | - M Videla
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - L Villaseñor
- Universidad Michoacana de San Nicolás de Hidalgo, Mexico
| | - S Vorobiov
- Laboratory for Astroparticle Physics, University of Nova Gorica, Slovenia
| | - H Wahlberg
- IFLP, Universidad Nacional de La Plata and CONICET, Argentina
| | - O Wainberg
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Argentina
| | - D Walz
- RWTH Aachen University, III. Physikalisches Institut A, Germany
| | - A A Watson
- School of Physics and Astronomy, University of Leeds, Leeds, United Kingdom
| | - M Weber
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik (IPE), Germany
| | - A Weindl
- Karlsruhe Institute of Technology, Institut für Kernphysik (IKP), Germany
| | - L Wiencke
- Colorado School of Mines, Golden, Colorado, USA
| | | | - T Winchen
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - D Wittkowski
- Bergische Universität Wuppertal, Department of Physics, Germany, Germany
| | - B Wundheiler
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
| | - S Wykes
- Institute for Mathematics, Astrophysics and Particle Physics (IMAPP), Radboud Universiteit, Nijmegen, Netherlands
| | - L Yang
- Laboratory for Astroparticle Physics, University of Nova Gorica, Slovenia
| | - T Yapici
- Michigan Technological University, Houghton, Michigan, USA
| | - D Yelos
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Centro Atómico Constituyentes, Comisión Nacional de Energía Atómica, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Argentina
| | - E Zas
- Universidad de Santiago de Compostela, Spain
| | - D Zavrtanik
- Experimental Particle Physics Department, J. Stefan Institute, Slovenia
- Laboratory for Astroparticle Physics, University of Nova Gorica, Slovenia
| | - M Zavrtanik
- Experimental Particle Physics Department, J. Stefan Institute, Slovenia
- Laboratory for Astroparticle Physics, University of Nova Gorica, Slovenia
| | - A Zepeda
- Centro de Investigación y de Estudios Avanzados del IPN (CINVESTAV), Mexico
| | - B Zimmermann
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik (IPE), Germany
| | - M Ziolkowski
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Germany
| | - Z Zong
- Institut de Physique Nucléaire d'Orsay (IPNO), Université Paris 11, CNRS-IN2P3, France
| | - F Zuccarello
- Università di Catania, Dipartimento di Fisica e Astronomia, Italy
- INFN, Sezione di Catania, Italy
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Ruf-Leuschner M, Brunnemann N, Schauer M, Pryss R, Barnewitz E, Liebrecht M, Kratzer W, Reichert M, Elbert T. Die KINDEX-App - ein Instrument zur Erfassung und unmittelbaren Auswertung von psychosozialen Belastungen bei Schwangeren in der täglichen Praxis bei Gynäkologinnen, Hebammen und in Frauenkliniken. Verhaltenstherapie 2016. [DOI: 10.1159/000448455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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22
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Stegmüller V, Regler J, Schauer M, Meisenzahl E. [Symptoms of posttraumatic stress disorder in Münchhausen's syndrome : Case study of an artificial disorder]. Nervenarzt 2016; 88:1314-1319. [PMID: 27439992 DOI: 10.1007/s00115-016-0171-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- V Stegmüller
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München, Nußbaumstr. 7, 80336, München, Deutschland.
| | - J Regler
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München, Nußbaumstr. 7, 80336, München, Deutschland
| | - M Schauer
- Kompetenzzentrum Psychotraumatologie, Universität Konstanz, Klinische Psychologie, Feursteinstr. 55, 78479, Reichenau, Deutschland
| | - E Meisenzahl
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität München, Nußbaumstr. 7, 80336, München, Deutschland.
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23
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Billich A, Schauer M, Frank S, Rosenwirth B, Billich S. HIV-1 Integrase: High-Level Production and Screening Assay for the Endonucleolytic Activity. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/095632029200300206] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The integration protein of the human immunodeficiency virus type 1 was purified from recombinant bacteria overproducing this enzyme. The final step of purification, namely chromatography on polyUsepharose, yielded a homogeneous protein preparation showing specific DNA cutting and joining activities. For a convenient assay of the endonuclease reaction, a 21-mer duplex oligonucleotide corresponding to the U5-LTR end of the viral DNA was radiolabeled at the dinucleotide that is removed by the enzyme. After the reaction, assay mixtures were passed through DEAE-cellulose filters which bind the substrate, but not the short radiolabeled product. Thus, an enzyme-dependent decrease of bound radioactivity was observed with time. Reaction rate was linearly dependent on enzyme concentration and the amount of substrate used was far below saturating concentrations. The reaction showed a pH-optimum at 7.5 and was strictly dependent on the presence of Mn2+. The presence of reducing agents like 2-mercaptoethanol was not essential for enzymatic activity. The assay was used to test selected compounds for their inhibitory potential against integrase. Typical inhibitors of DNA-topoisomerases did not inhibit the endonuclease reaction, with the exception of the intercalative agent actinomycin D which blocked the reaction with an IC50-value of 3 μM. Dextran sulphate inhibited the enzyme with an IC50 = 1.6 μg ml−1.
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Affiliation(s)
- A. Billich
- Sandoz Research Institute, Department of Antiretroviral Therapy, Brunner Strasse 59, A-1235 Vienna, Austria
| | - M. Schauer
- Sandoz Research Institute, Department of Antiretroviral Therapy, Brunner Strasse 59, A-1235 Vienna, Austria
| | - S. Frank
- Sandoz Research Institute, Department of Antiretroviral Therapy, Brunner Strasse 59, A-1235 Vienna, Austria
| | - B. Rosenwirth
- Sandoz Research Institute, Department of Antiretroviral Therapy, Brunner Strasse 59, A-1235 Vienna, Austria
| | - S. Billich
- Sandoz Research Institute, Department of Antiretroviral Therapy, Brunner Strasse 59, A-1235 Vienna, Austria
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24
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Aab A, Abreu P, Aglietta M, Ahn EJ, Al Samarai I, Albuquerque IFM, Allekotte I, Allison P, Almela A, Alvarez Castillo J, Alvarez-Muñiz J, Alves Batista R, Ambrosio M, Aminaei A, Anastasi GA, Anchordoqui L, Andringa S, Aramo C, Arqueros F, Arsene N, Asorey H, Assis P, Aublin J, Avila G, Awal N, Badescu AM, Baus C, Beatty JJ, Becker KH, Bellido JA, Berat C, Bertaina ME, Bertou X, Biermann PL, Billoir P, Blaess SG, Blanco A, Blanco M, Blazek J, Bleve C, Blümer H, Boháčová M, Boncioli D, Bonifazi C, Borodai N, Brack J, Brancus I, Bretz T, Bridgeman A, Brogueira P, Buchholz P, Bueno A, Buitink S, Buscemi M, Caballero-Mora KS, Caccianiga B, Caccianiga L, Candusso M, Caramete L, Caruso R, Castellina A, Cataldi G, Cazon L, Cester R, Chavez AG, Chiavassa A, Chinellato JA, Chudoba J, Cilmo M, Clay RW, Cocciolo G, Colalillo R, Coleman A, Collica L, Coluccia MR, Conceição R, Contreras F, Cooper MJ, Cordier A, Coutu S, Covault CE, Cronin J, Dallier R, Daniel B, Dasso S, Daumiller K, Dawson BR, de Almeida RM, de Jong SJ, De Mauro G, de Mello Neto JRT, De Mitri I, de Oliveira J, de Souza V, Del Peral L, Deligny O, Dhital N, Di Giulio C, Di Matteo A, Diaz JC, Díaz Castro ML, Diogo F, Dobrigkeit C, Docters W, D'Olivo JC, Dorofeev A, Dorosti Hasankiadeh Q, Dos Anjos RC, Dova MT, Ebr J, Engel R, Erdmann M, Erfani M, Escobar CO, Espadanal J, Etchegoyen A, Falcke H, Fang K, Farrar G, Fauth AC, Fazzini N, Ferguson AP, Fick B, Figueira JM, Filevich A, Filipčič A, Fratu O, Freire MM, Fujii T, García B, Garcia-Gamez D, Garcia-Pinto D, Gate F, Gemmeke H, Gherghel-Lascu A, Ghia PL, Giaccari U, Giammarchi M, Giller M, Głas D, Glaser C, Glass H, Golup G, Gómez Berisso M, Gómez Vitale PF, González N, Gookin B, Gordon J, Gorgi A, Gorham P, Gouffon P, Griffith N, Grillo AF, Grubb TD, Guarino F, Guedes GP, Hampel MR, Hansen P, Harari D, Harrison TA, Hartmann S, Harton JL, Haungs A, Hebbeker T, Heck D, Heimann P, Herve AE, Hill GC, Hojvat C, Hollon N, Holt E, Homola P, Hörandel JR, Horvath P, Hrabovský M, Huber D, Huege T, Insolia A, Isar PG, Jandt I, Jansen S, Jarne C, Johnsen JA, Josebachuili M, Kääpä A, Kambeitz O, Kampert KH, Kasper P, Katkov I, Keilhauer B, Kemp E, Kieckhafer RM, Klages HO, Kleifges M, Kleinfeller J, Krause R, Krohm N, Kuempel D, Kukec Mezek G, Kunka N, Kuotb Awad AW, LaHurd D, Latronico L, Lauer R, Lauscher M, Lautridou P, Le Coz S, Lebrun D, Lebrun P, Leigui de Oliveira MA, Letessier-Selvon A, Lhenry-Yvon I, Link K, Lopes L, López R, López Casado A, Louedec K, Lucero A, Malacari M, Mallamaci M, Maller J, Mandat D, Mantsch P, Mariazzi AG, Marin V, Mariş IC, Marsella G, Martello D, Martinez H, Martínez Bravo O, Martraire D, Masías Meza JJ, Mathes HJ, Mathys S, Matthews J, Matthews JAJ, Matthiae G, Maurizio D, Mayotte E, Mazur PO, Medina C, Medina-Tanco G, Meissner R, Mello VBB, Melo D, Menshikov A, Messina S, Micheletti MI, Middendorf L, Minaya IA, Miramonti L, Mitrica B, Molina-Bueno L, Mollerach S, Montanet F, Morello C, Mostafá M, Moura CA, Muller MA, Müller G, Müller S, Navas S, Necesal P, Nellen L, Nelles A, Neuser J, Nguyen PH, Niculescu-Oglinzanu M, Niechciol M, Niemietz L, Niggemann T, Nitz D, Nosek D, Novotny V, Nožka L, Núñez LA, Ochilo L, Oikonomou F, Olinto A, Pacheco N, Pakk Selmi-Dei D, Palatka M, Pallotta J, Papenbreer P, Parente G, Parra A, Paul T, Pech M, Pȩkala J, Pelayo R, Pepe IM, Perrone L, Petermann E, Peters C, Petrera S, Petrov Y, Phuntsok J, Piegaia R, Pierog T, Pieroni P, Pimenta M, Pirronello V, Platino M, Plum M, Porcelli A, Porowski C, Prado RR, Privitera P, Prouza M, Quel EJ, Querchfeld S, Quinn S, Rautenberg J, Ravel O, Ravignani D, Reinert D, Revenu B, Ridky J, Risse M, Ristori P, Rizi V, Rodrigues de Carvalho W, Rodriguez Rojo J, Rodríguez-Frías MD, Rogozin D, Rosado J, Roth M, Roulet E, Rovero AC, Saffi SJ, Saftoiu A, Salazar H, Saleh A, Salesa Greus F, Salina G, Sanabria Gomez JD, Sánchez F, Sanchez-Lucas P, Santos E, Santos EM, Sarazin F, Sarkar B, Sarmento R, Sarmiento-Cano C, Sato R, Scarso C, Schauer M, Scherini V, Schieler H, Schmidt D, Scholten O, Schoorlemmer H, Schovánek P, Schröder FG, Schulz A, Schulz J, Schumacher J, Sciutto SJ, Segreto A, Settimo M, Shadkam A, Shellard RC, Sigl G, Sima O, Śmiałkowski A, Šmída R, Snow GR, Sommers P, Sonntag S, Sorokin J, Squartini R, Srivastava YN, Stanca D, Stanič S, Stapleton J, Stasielak J, Stephan M, Stutz A, Suarez F, Suarez Durán M, Suomijärvi T, Supanitsky AD, Sutherland MS, Swain J, Szadkowski Z, Taborda OA, Tapia A, Tepe A, Theodoro VM, Timmermans C, Todero Peixoto CJ, Toma G, Tomankova L, Tomé B, Tonachini A, Torralba Elipe G, Torres Machado D, Travnicek P, Trini M, Ulrich R, Unger M, Urban M, Valdés Galicia JF, Valiño I, Valore L, van Aar G, van Bodegom P, van den Berg AM, van Velzen S, van Vliet A, Varela E, Vargas Cárdenas B, Varner G, Vasquez R, Vázquez JR, Vázquez RA, Veberič D, Verzi V, Vicha J, Videla M, Villaseñor L, Vlcek B, Vorobiov S, Wahlberg H, Wainberg O, Walz D, Watson AA, Weber M, Weidenhaupt K, Weindl A, Welling C, Werner F, Widom A, Wiencke L, Wilczyński H, Winchen T, Wittkowski D, Wundheiler B, Wykes S, Yang L, Yapici T, Yushkov A, Zas E, Zavrtanik D, Zavrtanik M, Zepeda A, Zimmermann B, Ziolkowski M, Zuccarello F. Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy. Phys Rev Lett 2016; 116:241101. [PMID: 27367377 DOI: 10.1103/physrevlett.116.241101] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Indexed: 06/06/2023]
Abstract
We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8±0.7(stat)±6.7(syst) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principles calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.
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Affiliation(s)
- A Aab
- Universität Siegen, Fachbereich 7 Physik - Experimentelle Teilchenphysik, Siegen, Germany
| | - P Abreu
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - M Aglietta
- Osservatorio Astrofisico di Torino (INAF), Università di Torino and Sezione INFN, Torino, Italy
| | - E J Ahn
- Fermilab, Batavia, Illinois, USA
| | - I Al Samarai
- Institut de Physique Nucléaire d'Orsay (IPNO), Université Paris 11, CNRS-IN2P3, Orsay, France
| | - I F M Albuquerque
- Universidade de São Paulo, Instituto de Física, São Paulo, São Paulo, Brazil
| | - I Allekotte
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - P Allison
- Ohio State University, Columbus, Ohio, USA
| | - A Almela
- Universidad Tecnológica Nacional - Facultad Regional Buenos Aires, Buenos Aires, Argentina
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - J Alvarez Castillo
- Universidad Nacional Autónoma de México, México, Distrito Federal, Mexico
| | - J Alvarez-Muñiz
- Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - R Alves Batista
- Universität Hamburg, II. Institut für Theoretische Physik, Hamburg, Germany
| | - M Ambrosio
- Università di Napoli "Federico II" and Sezione INFN, Napoli, Italy
| | - A Aminaei
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
| | - G A Anastasi
- Università di Catania and Sezione INFN, Catania, Italy
| | - L Anchordoqui
- Department of Physics and Astronomy, Lehman College, City University of New York, Bronx, New York, USA
| | - S Andringa
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - C Aramo
- Università di Napoli "Federico II" and Sezione INFN, Napoli, Italy
| | - F Arqueros
- Universidad Complutense de Madrid, Madrid, Spain
| | - N Arsene
- University of Bucharest, Physics Department, Bucharest, Romania
| | - H Asorey
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
- Universidad Industrial de Santander, Bucaramanga, Colombia
| | - P Assis
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - J Aublin
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, Paris, France
| | - G Avila
- Observatorio Pierre Auger and Comisión Nacional de Energía Atómica, Malargüe, Argentina
| | - N Awal
- New York University, New York, New York, USA
| | - A M Badescu
- University Politehnica of Bucharest, Bucharest, Romania
| | - C Baus
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Karlsruhe, Germany
| | - J J Beatty
- Ohio State University, Columbus, Ohio, USA
| | - K H Becker
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - J A Bellido
- University of Adelaide, Adelaide, South Australia, Australia
| | - C Berat
- Laboratoire de Physique Subatomique et de Cosmologie (LPSC), Université Grenoble-Alpes, CNRS/IN2P3, Grenoble, France
| | - M E Bertaina
- Osservatorio Astrofisico di Torino (INAF), Università di Torino and Sezione INFN, Torino, Italy
| | - X Bertou
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - P L Biermann
- Max-Planck-Institut für Radioastronomie, Bonn, Germany
| | - P Billoir
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, Paris, France
| | - S G Blaess
- University of Adelaide, Adelaide, South Australia, Australia
| | - A Blanco
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - M Blanco
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, Paris, France
| | - J Blazek
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - C Bleve
- Dipartimento di Matematica e Fisica "E. De Giorgi" dell'Università del Salento and Sezione INFN, Lecce, Italy
| | - H Blümer
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Karlsruhe, Germany
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - M Boháčová
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - D Boncioli
- INFN, Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila), Italy
| | - C Bonifazi
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro, Rio de Janeiro, Brazil
| | - N Borodai
- Institute of Nuclear Physics PAN, Krakow, Poland
| | - J Brack
- Colorado State University, Fort Collins, Colorado, USA
| | - I Brancus
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | - T Bretz
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - A Bridgeman
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - P Brogueira
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - P Buchholz
- Universität Siegen, Fachbereich 7 Physik - Experimentelle Teilchenphysik, Siegen, Germany
| | - A Bueno
- Universidad de Granada and C.A.F.P.E., Granada, Spain
| | - S Buitink
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
| | - M Buscemi
- Università di Napoli "Federico II" and Sezione INFN, Napoli, Italy
| | | | - B Caccianiga
- Università di Milano and Sezione INFN, Milan, Italy
| | - L Caccianiga
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, Paris, France
| | - M Candusso
- Università di Roma II "Tor Vergata" and Sezione INFN, Roma, Italy
| | - L Caramete
- Institute of Space Science, Bucharest-Magurele, Romania
| | - R Caruso
- Università di Catania and Sezione INFN, Catania, Italy
| | - A Castellina
- Osservatorio Astrofisico di Torino (INAF), Università di Torino and Sezione INFN, Torino, Italy
| | - G Cataldi
- Dipartimento di Matematica e Fisica "E. De Giorgi" dell'Università del Salento and Sezione INFN, Lecce, Italy
| | - L Cazon
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - R Cester
- Università di Torino and Sezione INFN, Torino, Italy
| | - A G Chavez
- Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, Mexico
| | - A Chiavassa
- Osservatorio Astrofisico di Torino (INAF), Università di Torino and Sezione INFN, Torino, Italy
| | - J A Chinellato
- Universidade Estadual de Campinas, IFGW, Campinas, São Paulo, Brazil
| | - J Chudoba
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - M Cilmo
- Università di Napoli "Federico II" and Sezione INFN, Napoli, Italy
| | - R W Clay
- University of Adelaide, Adelaide, South Australia, Australia
| | - G Cocciolo
- Dipartimento di Matematica e Fisica "E. De Giorgi" dell'Università del Salento and Sezione INFN, Lecce, Italy
| | - R Colalillo
- Università di Napoli "Federico II" and Sezione INFN, Napoli, Italy
| | - A Coleman
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - L Collica
- Università di Milano and Sezione INFN, Milan, Italy
| | - M R Coluccia
- Dipartimento di Matematica e Fisica "E. De Giorgi" dell'Università del Salento and Sezione INFN, Lecce, Italy
| | - R Conceição
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - F Contreras
- Observatorio Pierre Auger, Malargüe, Argentina
| | - M J Cooper
- University of Adelaide, Adelaide, South Australia, Australia
| | - A Cordier
- Laboratoire de l'Accélérateur Linéaire (LAL), Université Paris 11, CNRS-IN2P3, Orsay, France
| | - S Coutu
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - C E Covault
- Case Western Reserve University, Cleveland, Ohio, USA
| | - J Cronin
- University of Chicago, Enrico Fermi Institute, Chicago, Illinois, USA
| | - R Dallier
- SUBATECH, école des Mines de Nantes, CNRS-IN2P3, Université de Nantes, Nantes, France
- Station de Radioastronomie de Nançay, Observatoire de Paris, CNRS/INSU, Nançay, France
| | - B Daniel
- Universidade Estadual de Campinas, IFGW, Campinas, São Paulo, Brazil
| | - S Dasso
- Instituto de Astronomía y Física del Espacio (IAFE, CONICET-UBA), Buenos Aires, Argentina
- Departamento de Física, FCEyN, Universidad de Buenos Aires and CONICET, Buenos Aires, Argentina
| | - K Daumiller
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - B R Dawson
- University of Adelaide, Adelaide, South Australia, Australia
| | - R M de Almeida
- Universidade Federal Fluminense, EEIMVR, Volta Redonda, Rio de Janeiro, Brazil
| | - S J de Jong
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
- Nikhef, Science Park, Amsterdam, Netherlands
| | - G De Mauro
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
| | - J R T de Mello Neto
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro, Rio de Janeiro, Brazil
| | - I De Mitri
- Dipartimento di Matematica e Fisica "E. De Giorgi" dell'Università del Salento and Sezione INFN, Lecce, Italy
| | - J de Oliveira
- Universidade Federal Fluminense, EEIMVR, Volta Redonda, Rio de Janeiro, Brazil
| | - V de Souza
- Universidade de São Paulo, Instituto de Física de São Carlos, São Carlos, São Paulo, Brazil
| | - L Del Peral
- Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - O Deligny
- Institut de Physique Nucléaire d'Orsay (IPNO), Université Paris 11, CNRS-IN2P3, Orsay, France
| | - N Dhital
- Michigan Technological University, Houghton, Michigan, USA
| | - C Di Giulio
- Università di Roma II "Tor Vergata" and Sezione INFN, Roma, Italy
| | - A Di Matteo
- Dipartimento di Scienze Fisiche e Chimiche dell'Università dell'Aquila and INFN, L'Aquila, Italy
| | - J C Diaz
- Michigan Technological University, Houghton, Michigan, USA
| | - M L Díaz Castro
- Universidade Estadual de Campinas, IFGW, Campinas, São Paulo, Brazil
| | - F Diogo
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - C Dobrigkeit
- Universidade Estadual de Campinas, IFGW, Campinas, São Paulo, Brazil
| | - W Docters
- KVI - Center for Advanced Radiation Technology, University of Groningen, Groningen, Netherlands
| | - J C D'Olivo
- Universidad Nacional Autónoma de México, México, Distrito Federal, Mexico
| | - A Dorofeev
- Colorado State University, Fort Collins, Colorado, USA
| | | | - R C Dos Anjos
- Universidade de São Paulo, Instituto de Física de São Carlos, São Carlos, São Paulo, Brazil
| | - M T Dova
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - J Ebr
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - R Engel
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - M Erdmann
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - M Erfani
- Universität Siegen, Fachbereich 7 Physik - Experimentelle Teilchenphysik, Siegen, Germany
| | - C O Escobar
- Fermilab, Batavia, Illinois, USA
- Universidade Estadual de Campinas, IFGW, Campinas, São Paulo, Brazil
| | - J Espadanal
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - A Etchegoyen
- Universidad Tecnológica Nacional - Facultad Regional Buenos Aires, Buenos Aires, Argentina
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - H Falcke
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
- Nikhef, Science Park, Amsterdam, Netherlands
- ASTRON, Dwingeloo, Netherlands
| | - K Fang
- University of Chicago, Enrico Fermi Institute, Chicago, Illinois, USA
| | - G Farrar
- New York University, New York, New York, USA
| | - A C Fauth
- Universidade Estadual de Campinas, IFGW, Campinas, São Paulo, Brazil
| | | | - A P Ferguson
- Case Western Reserve University, Cleveland, Ohio, USA
| | - B Fick
- Michigan Technological University, Houghton, Michigan, USA
| | - J M Figueira
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - A Filevich
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - A Filipčič
- Experimental Particle Physics Department, J. Stefan Institute, Ljubljana, Slovenia
- Laboratory for Astroparticle Physics, University of Nova Gorica, Nova Gorica, Slovenia
| | - O Fratu
- University Politehnica of Bucharest, Bucharest, Romania
| | - M M Freire
- Instituto de Física de Rosario (IFIR) - CONICET/U.N.R. and Facultad de Ciencias Bioquímicas y Farmacéuticas U.N.R., Rosario, Argentina
| | - T Fujii
- University of Chicago, Enrico Fermi Institute, Chicago, Illinois, USA
| | - B García
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), and Universidad Tecnológica Nacional - Facultad Regional Mendoza (CONICET/CNEA), Mendoza, Argentina
| | - D Garcia-Gamez
- Laboratoire de l'Accélérateur Linéaire (LAL), Université Paris 11, CNRS-IN2P3, Orsay, France
| | | | - F Gate
- SUBATECH, école des Mines de Nantes, CNRS-IN2P3, Université de Nantes, Nantes, France
| | - H Gemmeke
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik, Karlsruhe, Germany
| | - A Gherghel-Lascu
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | - P L Ghia
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, Paris, France
| | - U Giaccari
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro, Rio de Janeiro, Brazil
| | - M Giammarchi
- Università di Milano and Sezione INFN, Milan, Italy
| | - M Giller
- University of Łódź, Łódź, Poland
| | - D Głas
- University of Łódź, Łódź, Poland
| | - C Glaser
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - H Glass
- Fermilab, Batavia, Illinois, USA
| | - G Golup
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - M Gómez Berisso
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - P F Gómez Vitale
- Observatorio Pierre Auger and Comisión Nacional de Energía Atómica, Malargüe, Argentina
| | - N González
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - B Gookin
- Colorado State University, Fort Collins, Colorado, USA
| | - J Gordon
- Ohio State University, Columbus, Ohio, USA
| | - A Gorgi
- Osservatorio Astrofisico di Torino (INAF), Università di Torino and Sezione INFN, Torino, Italy
| | - P Gorham
- University of Hawaii, Honolulu, Hawaii, USA
| | - P Gouffon
- Universidade de São Paulo, Instituto de Física, São Paulo, São Paulo, Brazil
| | - N Griffith
- Ohio State University, Columbus, Ohio, USA
| | - A F Grillo
- INFN, Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila), Italy
| | - T D Grubb
- University of Adelaide, Adelaide, South Australia, Australia
| | - F Guarino
- Università di Napoli "Federico II" and Sezione INFN, Napoli, Italy
| | - G P Guedes
- Universidade Estadual de Feira de Santana, Feira de Santana, Brazil
| | - M R Hampel
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - P Hansen
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - D Harari
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - T A Harrison
- University of Adelaide, Adelaide, South Australia, Australia
| | - S Hartmann
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - J L Harton
- Colorado State University, Fort Collins, Colorado, USA
| | - A Haungs
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - T Hebbeker
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - D Heck
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - P Heimann
- Universität Siegen, Fachbereich 7 Physik - Experimentelle Teilchenphysik, Siegen, Germany
| | - A E Herve
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - G C Hill
- University of Adelaide, Adelaide, South Australia, Australia
| | - C Hojvat
- Fermilab, Batavia, Illinois, USA
| | - N Hollon
- University of Chicago, Enrico Fermi Institute, Chicago, Illinois, USA
| | - E Holt
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - P Homola
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - J R Hörandel
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
- Nikhef, Science Park, Amsterdam, Netherlands
| | - P Horvath
- Palacky University, RCPTM, Olomouc, Czech Republic
| | - M Hrabovský
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
- Palacky University, RCPTM, Olomouc, Czech Republic
| | - D Huber
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Karlsruhe, Germany
| | - T Huege
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - A Insolia
- Università di Catania and Sezione INFN, Catania, Italy
| | - P G Isar
- Institute of Space Science, Bucharest-Magurele, Romania
| | - I Jandt
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - S Jansen
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
- Nikhef, Science Park, Amsterdam, Netherlands
| | - C Jarne
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - J A Johnsen
- Colorado School of Mines, Golden, Colorado, USA
| | - M Josebachuili
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - A Kääpä
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - O Kambeitz
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Karlsruhe, Germany
| | - K H Kampert
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - P Kasper
- Fermilab, Batavia, Illinois, USA
| | - I Katkov
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Karlsruhe, Germany
| | - B Keilhauer
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - E Kemp
- Universidade Estadual de Campinas, IFGW, Campinas, São Paulo, Brazil
| | - R M Kieckhafer
- Michigan Technological University, Houghton, Michigan, USA
| | - H O Klages
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - M Kleifges
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik, Karlsruhe, Germany
| | | | - R Krause
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - N Krohm
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - D Kuempel
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - G Kukec Mezek
- Laboratory for Astroparticle Physics, University of Nova Gorica, Nova Gorica, Slovenia
| | - N Kunka
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik, Karlsruhe, Germany
| | - A W Kuotb Awad
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - D LaHurd
- Case Western Reserve University, Cleveland, Ohio, USA
| | - L Latronico
- Osservatorio Astrofisico di Torino (INAF), Università di Torino and Sezione INFN, Torino, Italy
| | - R Lauer
- University of New Mexico, Albuquerque, New Mexico, USA
| | - M Lauscher
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - P Lautridou
- SUBATECH, école des Mines de Nantes, CNRS-IN2P3, Université de Nantes, Nantes, France
| | - S Le Coz
- Laboratoire de Physique Subatomique et de Cosmologie (LPSC), Université Grenoble-Alpes, CNRS/IN2P3, Grenoble, France
| | - D Lebrun
- Laboratoire de Physique Subatomique et de Cosmologie (LPSC), Université Grenoble-Alpes, CNRS/IN2P3, Grenoble, France
| | - P Lebrun
- Fermilab, Batavia, Illinois, USA
| | | | - A Letessier-Selvon
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, Paris, France
| | - I Lhenry-Yvon
- Institut de Physique Nucléaire d'Orsay (IPNO), Université Paris 11, CNRS-IN2P3, Orsay, France
| | - K Link
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Karlsruhe, Germany
| | - L Lopes
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - R López
- Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - A López Casado
- Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - K Louedec
- Laboratoire de Physique Subatomique et de Cosmologie (LPSC), Université Grenoble-Alpes, CNRS/IN2P3, Grenoble, France
| | - A Lucero
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - M Malacari
- University of Adelaide, Adelaide, South Australia, Australia
| | - M Mallamaci
- Università di Milano and Sezione INFN, Milan, Italy
| | - J Maller
- SUBATECH, école des Mines de Nantes, CNRS-IN2P3, Université de Nantes, Nantes, France
| | - D Mandat
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | | | - A G Mariazzi
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - V Marin
- SUBATECH, école des Mines de Nantes, CNRS-IN2P3, Université de Nantes, Nantes, France
| | - I C Mariş
- Universidad de Granada and C.A.F.P.E., Granada, Spain
| | - G Marsella
- Dipartimento di Matematica e Fisica "E. De Giorgi" dell'Università del Salento and Sezione INFN, Lecce, Italy
| | - D Martello
- Dipartimento di Matematica e Fisica "E. De Giorgi" dell'Università del Salento and Sezione INFN, Lecce, Italy
| | - H Martinez
- Centro de Investigación y de Estudios Avanzados del IPN (CINVESTAV), México, Distrito Federal, Mexico
| | | | - D Martraire
- Institut de Physique Nucléaire d'Orsay (IPNO), Université Paris 11, CNRS-IN2P3, Orsay, France
| | - J J Masías Meza
- Departamento de Física, FCEyN, Universidad de Buenos Aires and CONICET, Buenos Aires, Argentina
| | - H J Mathes
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - S Mathys
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - J Matthews
- Louisiana State University, Baton Rouge, Louisiana, USA
| | | | - G Matthiae
- Università di Roma II "Tor Vergata" and Sezione INFN, Roma, Italy
| | - D Maurizio
- Centro Brasileiro de Pesquisas Fisicas, Rio de Janeiro, Rio de Janeiro, Brazil
| | - E Mayotte
- Colorado School of Mines, Golden, Colorado, USA
| | | | - C Medina
- Colorado School of Mines, Golden, Colorado, USA
| | - G Medina-Tanco
- Universidad Nacional Autónoma de México, México, Distrito Federal, Mexico
| | - R Meissner
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - V B B Mello
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro, Rio de Janeiro, Brazil
| | - D Melo
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - A Menshikov
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik, Karlsruhe, Germany
| | - S Messina
- KVI - Center for Advanced Radiation Technology, University of Groningen, Groningen, Netherlands
| | - M I Micheletti
- Instituto de Física de Rosario (IFIR) - CONICET/U.N.R. and Facultad de Ciencias Bioquímicas y Farmacéuticas U.N.R., Rosario, Argentina
| | - L Middendorf
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - I A Minaya
- Universidad Complutense de Madrid, Madrid, Spain
| | - L Miramonti
- Università di Milano and Sezione INFN, Milan, Italy
| | - B Mitrica
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | | | - S Mollerach
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - F Montanet
- Laboratoire de Physique Subatomique et de Cosmologie (LPSC), Université Grenoble-Alpes, CNRS/IN2P3, Grenoble, France
| | - C Morello
- Osservatorio Astrofisico di Torino (INAF), Università di Torino and Sezione INFN, Torino, Italy
| | - M Mostafá
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - C A Moura
- Universidade Federal do ABC, Santo André, São Paulo, Brazil
| | - M A Muller
- Universidade Estadual de Campinas, IFGW, Campinas, São Paulo, Brazil
- Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - G Müller
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - S Müller
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - S Navas
- Universidad de Granada and C.A.F.P.E., Granada, Spain
| | - P Necesal
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - L Nellen
- Universidad Nacional Autónoma de México, México, Distrito Federal, Mexico
| | - A Nelles
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
- Nikhef, Science Park, Amsterdam, Netherlands
| | - J Neuser
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - P H Nguyen
- University of Adelaide, Adelaide, South Australia, Australia
| | - M Niculescu-Oglinzanu
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | - M Niechciol
- Universität Siegen, Fachbereich 7 Physik - Experimentelle Teilchenphysik, Siegen, Germany
| | - L Niemietz
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - T Niggemann
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - D Nitz
- Michigan Technological University, Houghton, Michigan, USA
| | - D Nosek
- Charles University, Faculty of Mathematics and Physics, Institute of Particle and Nuclear Physics, Prague, Czech Republic
| | - V Novotny
- Charles University, Faculty of Mathematics and Physics, Institute of Particle and Nuclear Physics, Prague, Czech Republic
| | - L Nožka
- Palacky University, RCPTM, Olomouc, Czech Republic
| | - L A Núñez
- Universidad Industrial de Santander, Bucaramanga, Colombia
| | - L Ochilo
- Universität Siegen, Fachbereich 7 Physik - Experimentelle Teilchenphysik, Siegen, Germany
| | - F Oikonomou
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - A Olinto
- University of Chicago, Enrico Fermi Institute, Chicago, Illinois, USA
| | - N Pacheco
- Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - D Pakk Selmi-Dei
- Universidade Estadual de Campinas, IFGW, Campinas, São Paulo, Brazil
| | - M Palatka
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - J Pallotta
- Centro de Investigaciones en Láseres y Aplicaciones, CITEDEF and CONICET, Villa Martelli, Argentina
| | - P Papenbreer
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - G Parente
- Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - A Parra
- Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - T Paul
- Department of Physics and Astronomy, Lehman College, City University of New York, Bronx, New York, USA
- Northeastern University, Boston, Massachusetts, USA
| | - M Pech
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - J Pȩkala
- Institute of Nuclear Physics PAN, Krakow, Poland
| | - R Pelayo
- Unidad Profesional Interdisciplinaria en Ingeniería y Tecnologías Avanzadas del Instituto Politécnico Nacional (UPIITA- IPN), México, Distrito Federal, Mexico
| | - I M Pepe
- Universidade Federal da Bahia, Salvador, BA, Brazil
| | - L Perrone
- Dipartimento di Matematica e Fisica "E. De Giorgi" dell'Università del Salento and Sezione INFN, Lecce, Italy
| | - E Petermann
- University of Nebraska, Lincoln, Nebraska, USA
| | - C Peters
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - S Petrera
- Dipartimento di Scienze Fisiche e Chimiche dell'Università dell'Aquila and INFN, L'Aquila, Italy
- Gran Sasso Science Institute (INFN), L'Aquila, Italy
| | - Y Petrov
- Colorado State University, Fort Collins, Colorado, USA
| | - J Phuntsok
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - R Piegaia
- Departamento de Física, FCEyN, Universidad de Buenos Aires and CONICET, Buenos Aires, Argentina
| | - T Pierog
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - P Pieroni
- Departamento de Física, FCEyN, Universidad de Buenos Aires and CONICET, Buenos Aires, Argentina
| | - M Pimenta
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - V Pirronello
- Università di Catania and Sezione INFN, Catania, Italy
| | - M Platino
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - M Plum
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - A Porcelli
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - C Porowski
- Institute of Nuclear Physics PAN, Krakow, Poland
| | - R R Prado
- Universidade de São Paulo, Instituto de Física de São Carlos, São Carlos, São Paulo, Brazil
| | - P Privitera
- University of Chicago, Enrico Fermi Institute, Chicago, Illinois, USA
| | - M Prouza
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - E J Quel
- Centro de Investigaciones en Láseres y Aplicaciones, CITEDEF and CONICET, Villa Martelli, Argentina
| | - S Querchfeld
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - S Quinn
- Case Western Reserve University, Cleveland, Ohio, USA
| | - J Rautenberg
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - O Ravel
- SUBATECH, école des Mines de Nantes, CNRS-IN2P3, Université de Nantes, Nantes, France
| | - D Ravignani
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - D Reinert
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - B Revenu
- SUBATECH, école des Mines de Nantes, CNRS-IN2P3, Université de Nantes, Nantes, France
| | - J Ridky
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - M Risse
- Universität Siegen, Fachbereich 7 Physik - Experimentelle Teilchenphysik, Siegen, Germany
| | - P Ristori
- Centro de Investigaciones en Láseres y Aplicaciones, CITEDEF and CONICET, Villa Martelli, Argentina
| | - V Rizi
- Dipartimento di Scienze Fisiche e Chimiche dell'Università dell'Aquila and INFN, L'Aquila, Italy
| | | | | | | | - D Rogozin
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - J Rosado
- Universidad Complutense de Madrid, Madrid, Spain
| | - M Roth
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - E Roulet
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - A C Rovero
- Instituto de Astronomía y Física del Espacio (IAFE, CONICET-UBA), Buenos Aires, Argentina
| | - S J Saffi
- University of Adelaide, Adelaide, South Australia, Australia
| | - A Saftoiu
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | - H Salazar
- Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - A Saleh
- Laboratory for Astroparticle Physics, University of Nova Gorica, Nova Gorica, Slovenia
| | - F Salesa Greus
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - G Salina
- Università di Roma II "Tor Vergata" and Sezione INFN, Roma, Italy
| | | | - F Sánchez
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | | | - E Santos
- Universidade Estadual de Campinas, IFGW, Campinas, São Paulo, Brazil
| | - E M Santos
- Universidade de São Paulo, Instituto de Física, São Paulo, São Paulo, Brazil
| | - F Sarazin
- Colorado School of Mines, Golden, Colorado, USA
| | - B Sarkar
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - R Sarmento
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | | | - R Sato
- Observatorio Pierre Auger, Malargüe, Argentina
| | - C Scarso
- Observatorio Pierre Auger, Malargüe, Argentina
| | - M Schauer
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - V Scherini
- Dipartimento di Matematica e Fisica "E. De Giorgi" dell'Università del Salento and Sezione INFN, Lecce, Italy
| | - H Schieler
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - D Schmidt
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - O Scholten
- KVI - Center for Advanced Radiation Technology, University of Groningen, Groningen, Netherlands
- Vrije Universiteit Brussel, Brussels, Belgium
| | | | - P Schovánek
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - F G Schröder
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - A Schulz
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - J Schulz
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
| | - J Schumacher
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - S J Sciutto
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - A Segreto
- Istituto di Astrofisica Spaziale e Fisica Cosmica di Palermo (INAF), Palermo, Italy
| | - M Settimo
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, Paris, France
| | - A Shadkam
- Louisiana State University, Baton Rouge, Louisiana, USA
| | - R C Shellard
- Centro Brasileiro de Pesquisas Fisicas, Rio de Janeiro, Rio de Janeiro, Brazil
| | - G Sigl
- Universität Hamburg, II. Institut für Theoretische Physik, Hamburg, Germany
| | - O Sima
- University of Bucharest, Physics Department, Bucharest, Romania
| | | | - R Šmída
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - G R Snow
- University of Nebraska, Lincoln, Nebraska, USA
| | - P Sommers
- Pennsylvania State University, University Park, Pennsylvania, USA
| | - S Sonntag
- Universität Siegen, Fachbereich 7 Physik - Experimentelle Teilchenphysik, Siegen, Germany
| | - J Sorokin
- University of Adelaide, Adelaide, South Australia, Australia
| | - R Squartini
- Observatorio Pierre Auger, Malargüe, Argentina
| | | | - D Stanca
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | - S Stanič
- Laboratory for Astroparticle Physics, University of Nova Gorica, Nova Gorica, Slovenia
| | | | - J Stasielak
- Institute of Nuclear Physics PAN, Krakow, Poland
| | - M Stephan
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - A Stutz
- Laboratoire de Physique Subatomique et de Cosmologie (LPSC), Université Grenoble-Alpes, CNRS/IN2P3, Grenoble, France
| | - F Suarez
- Universidad Tecnológica Nacional - Facultad Regional Buenos Aires, Buenos Aires, Argentina
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - M Suarez Durán
- Universidad Industrial de Santander, Bucaramanga, Colombia
| | - T Suomijärvi
- Institut de Physique Nucléaire d'Orsay (IPNO), Université Paris 11, CNRS-IN2P3, Orsay, France
| | - A D Supanitsky
- Instituto de Astronomía y Física del Espacio (IAFE, CONICET-UBA), Buenos Aires, Argentina
| | | | - J Swain
- Northeastern University, Boston, Massachusetts, USA
| | | | - O A Taborda
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - A Tapia
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - A Tepe
- Universität Siegen, Fachbereich 7 Physik - Experimentelle Teilchenphysik, Siegen, Germany
| | - V M Theodoro
- Universidade Estadual de Campinas, IFGW, Campinas, São Paulo, Brazil
| | - C Timmermans
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
- Nikhef, Science Park, Amsterdam, Netherlands
| | - C J Todero Peixoto
- Universidade de São Paulo, Escola de Engenharia de Lorena, Lorena, São Paulo, Brazil
| | - G Toma
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | - L Tomankova
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - B Tomé
- Laboratório de Instrumentação e Física Experimental de Partículas - LIP and Instituto Superior Técnico - IST, Universidade de Lisboa - UL, Lisboa, Portugal
| | - A Tonachini
- Università di Torino and Sezione INFN, Torino, Italy
| | - G Torralba Elipe
- Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - D Torres Machado
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro, Rio de Janeiro, Brazil
| | - P Travnicek
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - M Trini
- Laboratory for Astroparticle Physics, University of Nova Gorica, Nova Gorica, Slovenia
| | - R Ulrich
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - M Unger
- New York University, New York, New York, USA
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - M Urban
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - J F Valdés Galicia
- Universidad Nacional Autónoma de México, México, Distrito Federal, Mexico
| | - I Valiño
- Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - L Valore
- Università di Napoli "Federico II" and Sezione INFN, Napoli, Italy
| | - G van Aar
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
| | - P van Bodegom
- University of Adelaide, Adelaide, South Australia, Australia
| | - A M van den Berg
- KVI - Center for Advanced Radiation Technology, University of Groningen, Groningen, Netherlands
| | - S van Velzen
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
| | - A van Vliet
- Universität Hamburg, II. Institut für Theoretische Physik, Hamburg, Germany
| | - E Varela
- Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - B Vargas Cárdenas
- Universidad Nacional Autónoma de México, México, Distrito Federal, Mexico
| | - G Varner
- University of Hawaii, Honolulu, Hawaii, USA
| | - R Vasquez
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro, Rio de Janeiro, Brazil
| | - J R Vázquez
- Universidad Complutense de Madrid, Madrid, Spain
| | - R A Vázquez
- Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - D Veberič
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - V Verzi
- Università di Roma II "Tor Vergata" and Sezione INFN, Roma, Italy
| | - J Vicha
- Institute of Physics of the Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - M Videla
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - L Villaseñor
- Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, Mexico
| | - B Vlcek
- Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - S Vorobiov
- Laboratory for Astroparticle Physics, University of Nova Gorica, Nova Gorica, Slovenia
| | - H Wahlberg
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - O Wainberg
- Universidad Tecnológica Nacional - Facultad Regional Buenos Aires, Buenos Aires, Argentina
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - D Walz
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - A A Watson
- School of Physics and Astronomy, University of Leeds, Leeds, United Kingdom
| | - M Weber
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik, Karlsruhe, Germany
| | - K Weidenhaupt
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - A Weindl
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - C Welling
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - F Werner
- Karlsruhe Institute of Technology, Institut für Experimentelle Kernphysik (IEKP), Karlsruhe, Germany
| | - A Widom
- Northeastern University, Boston, Massachusetts, USA
| | - L Wiencke
- Colorado School of Mines, Golden, Colorado, USA
| | - H Wilczyński
- Institute of Nuclear Physics PAN, Krakow, Poland
| | - T Winchen
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - D Wittkowski
- Bergische Universität Wuppertal, Fachbereich C - Physik, Wuppertal, Germany
| | - B Wundheiler
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - S Wykes
- IMAPP, Radboud University Nijmegen, Nijmegen, Netherlands
| | - L Yang
- Laboratory for Astroparticle Physics, University of Nova Gorica, Nova Gorica, Slovenia
| | - T Yapici
- Michigan Technological University, Houghton, Michigan, USA
| | - A Yushkov
- Universität Siegen, Fachbereich 7 Physik - Experimentelle Teilchenphysik, Siegen, Germany
| | - E Zas
- Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - D Zavrtanik
- Experimental Particle Physics Department, J. Stefan Institute, Ljubljana, Slovenia
- Laboratory for Astroparticle Physics, University of Nova Gorica, Nova Gorica, Slovenia
| | - M Zavrtanik
- Experimental Particle Physics Department, J. Stefan Institute, Ljubljana, Slovenia
- Laboratory for Astroparticle Physics, University of Nova Gorica, Nova Gorica, Slovenia
| | - A Zepeda
- Centro de Investigación y de Estudios Avanzados del IPN (CINVESTAV), México, Distrito Federal, Mexico
| | - B Zimmermann
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik, Karlsruhe, Germany
| | - M Ziolkowski
- Universität Siegen, Fachbereich 7 Physik - Experimentelle Teilchenphysik, Siegen, Germany
| | - F Zuccarello
- Università di Catania and Sezione INFN, Catania, Italy
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Koenig AM, Schury K, Reister F, Köhler-Dauner F, Schauer M, Ruf-Leuschner M, Gündel H, Ziegenhain U, Fegert JM, Kolassa IT. Psychosocial Risk Factors for Child Welfare among Postpartum Mothers with a History of Childhood Maltreatment and Neglect. Geburtshilfe Frauenheilkd 2016; 76:261-267. [PMID: 27064835 DOI: 10.1055/s-0041-111172] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: Childhood maltreatment (CM) can increase the risk of psychosocial risk factors in adulthood (e. g. intimate partner violence, financial problems, substance abuse or medical problems). The transition to parenthood presents those affected by CM with particular challenges, in addition to usual birth-related stressors. Methods: In this cross-sectional study a total of 240 women were interviewed in the puerperium with respect to CM experiences, using the German version of the Childhood Trauma Questionnaire (CTQ). Current psychosocial risk factors (e. g. financial concerns, maternal mental illness, single parent) were assessed using the Constance Index (KINDEX) for early childhood risk factors. Associations between CM experience and psychosocial risk factors were calculated using simple correlation. Results: The average age of participants was 33 years. On the CTQ 13.8 % of participants reported emotional abuse, 6.7 % physical abuse and 12.5 % sexual abuse, while 32.1 % reported emotional neglect and 7.5 % physical neglect during childhood. With rising severity of CM, more psychosocial risk factors (KINDEX) were present. Conclusions: This study shows a clear association between experiences of maltreatment during childhood and the presence of psychosocial stressors among women in the puerperium. Regular screening for a history of CM and parental psychosocial stressors should be conducted early, i.e. during pregnancy, to avoid negative consequences for the child.
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Affiliation(s)
- A M Koenig
- Klinische & Biologische Psychologie, Universität Ulm, Institut für Psychologie und Pädagogik, Ulm
| | - K Schury
- Klinische & Biologische Psychologie, Universität Ulm, Institut für Psychologie und Pädagogik, Ulm
| | - F Reister
- Sektion Geburtshilfe, Univ.-Frauenklinik, Univ.-Klinikum Ulm, Ulm
| | - F Köhler-Dauner
- Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Ulm
| | - M Schauer
- Klinische Psychologie und Klinische Neuropsychologie, Universität Konstanz, Ulm
| | - M Ruf-Leuschner
- Klinische Psychologie und Klinische Neuropsychologie, Universität Konstanz, Ulm
| | - H Gündel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Ulm
| | - U Ziegenhain
- Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Ulm
| | - J M Fegert
- Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm, Ulm
| | - I-T Kolassa
- Klinische & Biologische Psychologie, Universität Ulm, Institut für Psychologie und Pädagogik, Ulm
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Weinhold SL, Göder R, Pabst A, Scharff AL, Schauer M, Baier PC, Aldenhoff J, Elbert T, Seeck-Hirschner M. Sleep recordings in individuals with borderline personality disorder before and after trauma therapy. J Neural Transm (Vienna) 2016; 124:99-107. [PMID: 26970970 DOI: 10.1007/s00702-016-1536-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 02/26/2016] [Indexed: 10/22/2022]
Abstract
Most individuals diagnosed with borderline personality disorder (BPD) have been exposed to severe and traumatic stressors and thus frequently present with symptoms of a posttraumatic stress disorder (PTSD). Severe sleep disturbances often accompany these complex cases, but changes of sleep parameters during therapy and the impact of sleep on treatment response have barely been studied. Narrative Exposure Therapy (NET) is an evidence-based approach for the treatment of trauma-related psychological disorders. To investigate the effect of NET on sleep in patients with BPD and comorbid PTSD, we screened 45 inpatients and outpatients who met the inclusion criteria of both diagnoses according to DSM-IV and who had a minimum of 2 weeks' stable medication. Patients were allocated to NET (N = 13) or treatment as usual (TAU; N = 8) in blocks. Polysomnographies and psychological questionares were performed before, directly and 6 months after the last therapy session. The aim of this pilot study was to investigate the effectiveness of trauma therapy by NET on sleep quantity (total sleep time) and sleep continuity (sleep efficiency and awakenings) in patients with comorbid BPD and PTSD. Participants of the NET group compared with those who received TAU showed an increased reduction in sleep latency from baseline to the end of therapy and a reduction in arousals over time. Patients with longer pre-treatment total sleep time and pre-treatment REM sleep duration showed a better outcome of NET with respect to PTSD symptoms. NET seems not lead to a change in sleep for the worse during therapy and seems to improve sleep as good as treatment as usual. Furthermore, our results provide evidence of an influence of sleep structure at baseline on treatment success later on.
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Affiliation(s)
- Sara Lena Weinhold
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Niemannsweg 147, 24105, Kiel, Germany
| | - Robert Göder
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Niemannsweg 147, 24105, Kiel, Germany.
| | - Astrid Pabst
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Niemannsweg 147, 24105, Kiel, Germany
| | - Anna-Lena Scharff
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Niemannsweg 147, 24105, Kiel, Germany
| | - Maggie Schauer
- Department of Psychology, University of Konstanz, Constance, Germany
| | - Paul Christian Baier
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Niemannsweg 147, 24105, Kiel, Germany
| | - Josef Aldenhoff
- Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Niemannsweg 147, 24105, Kiel, Germany
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, Constance, Germany
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Spyridou A, Schauer M, Ruf-Leuschner M. Prenatal screening for psychosocial risks in a high risk-population in Peru using the KINDEX interview. BMC Pregnancy Childbirth 2016; 16:13. [PMID: 26801404 PMCID: PMC4722714 DOI: 10.1186/s12884-016-0799-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 01/06/2016] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Prenatal stress and other prenatal risk factors (e.g. intimate partner violence) have a negative impact on mother's health, fetal development as well as enduring adverse effects on the neuro-cognitive, behavioral and physical health of the child. Mothers of low socio-economic status and especially those living in crime-ridden areas are even more exposed to a host of risk factors. Societies of extreme violence, poverty and inequalities, often present difficulties to provide adequate mental health care to the most needed populations. The KINDEX, a brief standardized instrument that assesses 11 different risk factors was used by midwives to identify pregnant women at-risk, in a suburban area with one of the highest levels of domestic violence in Lima. The instrument was designed to be used by medical staff to identify high-risk child-bearing women and, based on the results, to refer them to the adequate psychological or social support providers. The aim of this study is to assess the feasibility of psychosocial screening using the KINDEX in a Latin American Country for the first time, and to explore the relationship of the KINDEX with thee major risk areas, maternal psychopathology, perceived stress and traumatic experiences. METHODS The study was conducted in cooperation with the gynecological department of a general hospital in a suburban area of Lima. Nine midwives conducted interviews using the KINDEX of ninety-five pregnant women attending the gynecological unit of the hospital. From these, forty pregnant women were re-interviewed by a clinical psychologist using established instruments in order to assess the feasibility of the prenatal assessment in public health settings and the relationship of the KINDEX with maternal perceived stress, psychopathology symptoms and trauma load during pregnancy. RESULTS We found high rates of risk factors in the examined pregnant women comparable with those found in the general population. Significant correlations were found between the KINDEX sum score and the three risks areas, stress, psychopathology and trauma load as assessed in the Clinical Expert interviews. The different risks assessed by the KINDEX are related to higher levels of stress, psychopathology and trauma load, depending on the risk. CONCLUSIONS The relationship between past adverse experience and current stressors with perceived maternal stress, psychopathology symptoms and traumatic experiences confirm the importance of prenatal assessment for psychosocial risks. The use of KINDEX by midwives providing obstetrical care to pregnant women in urban Peru is feasible and can be used to identify high-risk women and refer them to the adequate mental health or social services for necessary attention and support. Early interventions are essential to mitigating the adverse effects of maternal stress, trauma and psychopathology on the fetus and child.
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Affiliation(s)
- Andria Spyridou
- />Center of Excellence for Psychotraumatology, Department of Psychology, Clinical Psychology & Behavioral Neuroscience Unit, University of Konstanz, Post Box D 23, D-78457 Konstanz, Germany
- />vivo international, http://www.vivo.org
| | - Maggie Schauer
- />Center of Excellence for Psychotraumatology, Department of Psychology, Clinical Psychology & Behavioral Neuroscience Unit, University of Konstanz, Post Box D 23, D-78457 Konstanz, Germany
- />vivo international, http://www.vivo.org
| | - Martina Ruf-Leuschner
- />Center of Excellence for Psychotraumatology, Department of Psychology, Clinical Psychology & Behavioral Neuroscience Unit, University of Konstanz, Post Box D 23, D-78457 Konstanz, Germany
- />vivo international, http://www.vivo.org
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Mueller-Bamouh V, Ruf-Leuschner M, Dohrmann K, Schauer M, Elbert T. Are experiences of family and of organized violence predictors of aggression and violent behavior? A study with unaccompanied refugee minors. Eur J Psychotraumatol 2016; 7:27856. [PMID: 26886483 PMCID: PMC4756624 DOI: 10.3402/ejpt.v7.27856] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 03/13/2015] [Revised: 09/07/2015] [Accepted: 09/29/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is strong support for familial abuse as a risk factor for later delinquency and violent offending, whereas empirical evidence about the contribution of experienced organized violence to the cycle of violence is less clear. Nevertheless not all abused children do become violent offenders. This raises the question of which factors influence these children's risk of future aggressive behavior. Recent evidence suggests that the trait of appetitive aggression plays an important role in the prediction of aggressive behavior. OBJECTIVE The focus of the study is to investigate whether exposures to 1) organized; and 2) family violence equally contribute to aggressive behavior and how this is related to a trait of appetitive aggression. Furthermore it is of interest to uncover how the severity of posttraumatic stress disorder (PTSD) symptoms modulates associations between violent experiences and aggression. METHOD To answer these questions, we investigated unaccompanied refugee minors who had been exposed to varying levels of both violence types. Using structured interviews, experiences of organized and familial violence, self-committed aggressive acts, the trait of appetitive aggression, and PTSD symptoms were assessed in 49 volunteers. RESULTS A sequential regression analysis revealed that the trait of appetitive aggression and experienced family violence were independent and significant predictors of self-committed aggressive acts, altogether accounting for 70% of the variance. Exposure to organized violence, however, was not significantly associated with aggressive acts or appetitive aggression. PTSD symptom severity was not correlated with measures of aggression but with the exposure to familial and organized violence. CONCLUSIONS Results suggest that in addition to the impact of family violence, an elevated trait of appetitive aggression plays a crucial role in aggressive behavior and should be considered in psychotherapeutic treatment.
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Affiliation(s)
- Veronika Mueller-Bamouh
- Department of Psychology, University of Konstanz, Konstanz, Germany.,vivo international e.V. (www.vivo.org), Germany;
| | - Martina Ruf-Leuschner
- Department of Psychology, University of Konstanz, Konstanz, Germany.,vivo international e.V. (www.vivo.org), Germany
| | - Katalin Dohrmann
- Department of Psychology, University of Konstanz, Konstanz, Germany.,vivo international e.V. (www.vivo.org), Germany
| | - Maggie Schauer
- Department of Psychology, University of Konstanz, Konstanz, Germany.,vivo international e.V. (www.vivo.org), Germany
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, Konstanz, Germany.,vivo international e.V. (www.vivo.org), Germany
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Al-Shahrabani F, Angenendt S, Krausch M, Schauer M, Knoefel WT. Brustwandrekonstruktion und -stabilisation mit schraubenlosen Titan-Rippenklammern und -platten nach Sternumteilresektion bei solitärer Metastase eines Schilddrüsenkarzinoms. Zentralbl Chir 2015. [DOI: 10.1055/s-0035-1559900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Morath J, Moreno-Villanueva M, Hamuni G, Kolassa S, Ruf-Leuschner M, Schauer M, Elbert T, Bürkle A, Kolassa IT. Effects of psychotherapy on DNA strand break accumulation originating from traumatic stress. Psychother Psychosom 2015; 83:289-97. [PMID: 25116690 DOI: 10.1159/000362739] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 04/08/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous research reveals an association between traumatic stress and an increased risk for numerous diseases, including cancer. At the molecular level, stress may increase carcinogenesis via increased DNA damage and impaired DNA repair mechanisms. We assessed DNA breakage in peripheral blood mononuclear cells from individuals with post-traumatic stress disorder (PTSD) and measured the cellular capacity to repair single-strand breaks after exposure to ionizing X-radiation. We also investigated the effect of psychotherapy on both DNA breakage and DNA repair. METHODS In a first study we investigated DNA breakage and repair in 34 individuals with PTSD and 31 controls. Controls were subdivided into 11 trauma-exposed subjects and 20 individuals without trauma exposure. In a second study, we analysed the effect of psychotherapy (Narrative Exposure Therapy) on DNA breakage and repair. Thirty-eight individuals with PTSD were randomly assigned to either a treatment or a waitlist control condition. Follow-up was performed 4 months and 1 year after therapy. RESULTS In study 1 we found higher levels of basal DNA breakage in individuals with PTSD and trauma-exposed subjects than in controls, indicating that traumatic stress is associated with DNA breakage. However, single-strand break repair was unimpaired in individuals with PTSD. In study 2, we found that psychotherapy reversed not only PTSD symptoms, but also DNA strand break accumulation. CONCLUSION Our results show - for the first time in vivo - an association between traumatic stress and DNA breakage; they also demonstrate changes at the molecular level, i.e., the integrity of DNA, after psychotherapeutic interventions.
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Affiliation(s)
- Julia Morath
- Center of Excellence for Psychotraumatology, Clinical Psychology and Neuropsychology, University of Konstanz, Konstanz, Germany
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Spyridou A, Schauer M, Ruf-Leuschner M. Obstetric care providers are able to assess psychosocial risks, identify and refer high-risk pregnant women: validation of a short assessment tool - the KINDEX Greek version. BMC Pregnancy Childbirth 2015; 15:41. [PMID: 25884996 PMCID: PMC4343273 DOI: 10.1186/s12884-015-0462-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/30/2015] [Indexed: 12/20/2022] Open
Abstract
Background Prenatal assessment for psychosocial risk factors and prevention and intervention is scarce and, in most cases, nonexistent in obstetrical care. In this study we aimed to evaluate if the KINDEX, a short instrument developed in Germany, is a useful tool in the hands of non-trained medical staff, in order to identify and refer women in psychosocial risk to the adequate mental health and social services. We also examined the criterion-related concurrent validity of the tool through a validation interview carried out by an expert clinical psychologist. Our final objective was to achieve the cultural adaptation of the KINDEX Greek Version and to offer a valid tool for the psychosocial risk assessment to the obstetric care providers. Methods Two obstetricians and five midwives carried out 93 KINDEX interviews (duration 20 minutes) with pregnant women to assess psychosocial risk factors present during pregnancy. Afterwards they referred women who they identified having two or more psychosocial risk factors to the mental health attention unit of the hospital. During the validation procedure an expert clinical psychologist carried out diagnostic interviews with a randomized subsample of 50 pregnant women based on established diagnostic instruments for stress and psychopathology, like the PSS-14, ESI, PDS, HSCL-25. Results Significant correlations between the results obtained through the assessment using the KINDEX and the risk areas of stress, psychopathology and trauma load assessed in the validation interview demonstrate the criterion-related concurrent validity of the KINDEX. The referral accuracy of the medical staff is confirmed through comparisons between pregnant women who have and have not been referred to the mental health attention unit. Conclusions Prenatal screenings for psychosocial risks like the KINDEX are feasible in public health settings in Greece. In addition, validity was confirmed in high correlations between the KINDEX results and the results of the validation interviews. The KINDEX Greek version can be considered a valid tool, which can be used by non-trained medical staff providing obstetrical care to identify high-risk women and refer them to adequate mental health and social services. These kind of assessments are indispensable for the promotion of a healthy family environment and child development.
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Affiliation(s)
- Andria Spyridou
- University of Konstanz, Constance, Germany. .,Department of Psychology, University of Konstanz, Clinical Psychology & Behavioral Neuroscience Unit, Post Box 905, Constance, D-78457, Germany.
| | - Maggie Schauer
- University of Konstanz, Constance, Germany. .,Vivo international (www.vivo.org), Constance, Germany.
| | - Martina Ruf-Leuschner
- University of Konstanz, Constance, Germany. .,Vivo international (www.vivo.org), Constance, Germany.
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Karabatsiakis A, Hamuni G, Wilker S, Kolassa S, Renu D, Kadereit S, Schauer M, Hennessy T, Kolassa IT. Metabolite profiling in posttraumatic stress disorder. J Mol Psychiatry 2015; 3:2. [PMID: 25848535 PMCID: PMC4367823 DOI: 10.1186/s40303-015-0007-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 01/08/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Traumatic stress does not only increase the risk for posttraumatic stress disorder (PTSD), but is also associated with adverse secondary physical health outcomes. Despite increasing efforts, we only begin to understand the underlying biomolecular processes. The hypothesis-free assessment of a wide range of metabolites (termed metabolite profiling) might contribute to the discovery of biological pathways underlying PTSD. METHODS Here, we present the results of the first metabolite profiling study in PTSD, which investigated peripheral blood serum samples of 20 PTSD patients and 18 controls. We performed liquid chromatography (LC) coupled to Quadrupole/Time-Of-Flight (QTOF) mass spectrometry. Two complementary statistical approaches were used to identify metabolites associated with PTSD status including univariate analyses and Partial Least Squares Discriminant Analysis (PLS-DA). RESULTS Thirteen metabolites displayed significant changes in PTSD, including four glycerophospholipids, and one metabolite involved in endocannabinoid signaling. A biomarker panel of 19 metabolites classifies PTSD with 85% accuracy, while classification accuracy from the glycerophospholipid with the highest differentiating ability already reached 82%. CONCLUSIONS This study illustrates the feasibility and utility of metabolite profiling for PTSD and suggests lipid-derived and endocannabinoid signaling as potential biological pathways involved in trauma-associated pathophysiology.
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Affiliation(s)
- Alexander Karabatsiakis
- Clinical & Biological Psychology, Ulm University, Albert-Einstein Allee 47, 89081 Ulm, Germany
| | - Gilava Hamuni
- Clinical & Biological Psychology, Ulm University, Albert-Einstein Allee 47, 89081 Ulm, Germany
| | - Sarah Wilker
- Clinical & Biological Psychology, Ulm University, Albert-Einstein Allee 47, 89081 Ulm, Germany
| | | | | | - Suzanne Kadereit
- Department of Biology, University of Konstanz, Konstanz, Germany
| | - Maggie Schauer
- Clinical Psychology & Neuropsychology, University of Konstanz, Konstanz, Germany
| | | | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Ulm University, Albert-Einstein Allee 47, 89081 Ulm, Germany
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Stotz SJ, Elbert T, Müller V, Schauer M. The relationship between trauma, shame, and guilt: findings from a community-based study of refugee minors in Germany. Eur J Psychotraumatol 2015; 6:25863. [PMID: 26105045 PMCID: PMC4478074 DOI: 10.3402/ejpt.v6.25863] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [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: 08/28/2014] [Revised: 05/16/2015] [Accepted: 05/20/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The relationships between traumatic stress and self-conscious emotions, such as shame and guilt, remain to be fully explored, especially in refugees, who frequently are exposed to a multitude of stressors. OBJECTIVE The aim of the present study was to investigate shame and guilt in refugee minors and to assess to what extent a greater cumulative exposure to traumatic stressors would result not only in more severe posttraumatic stress disorder (PTSD) symptoms but also in higher levels of shame and guilt. METHODS Thirty-two male refugee minors, who were all below the age of 18 when they sought asylum in Germany, agreed to participate. At the time of the assessment, the age ranged from 11 to 20 years. Eighteen refugees had arrived without relatives in their host country ("unaccompanied minors"). In structured diagnostic interviews, a PTSD diagnosis was established using the UCLA PTSD Index. Posttraumatic guilt was assessed by means of the Trauma-related Guilt Inventory, and the Shame Variability Questionnaire was used to record the intensity, duration, and frequency of shame episodes. RESULTS Feelings of guilt and shame as well as trauma symptoms were all associated with the number of traumatic event types subjects had experienced. Posttraumatic guilt and shame were both correlated with PTSD symptom severity. CONCLUSIONS The findings indicate that cumulative stress such as exposure to multiple traumatic events poses a risk factor for the mental health including greater suffering and functional impairment due to shame and guilt.
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Affiliation(s)
- Sabrina J Stotz
- Department of Psychology, University of Konstanz, Konstanz, Germany;
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Veronika Müller
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Maggie Schauer
- Department of Psychology, University of Konstanz, Konstanz, Germany
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Abstract
The evolutionary model of the defense cascade by Schauer and Elbert (2010) provides a theoretical frame for a short interview to assess problems underlying and leading to the dissociative subtype of posttraumatic stress disorder. Based on known characteristics of the defense stages "fright," "flag," and "faint," we designed a structured interview to assess the vulnerability for the respective types of dissociation. Most of the scales that assess dissociative phenomena are designed as self-report questionnaires. Their items are usually selected based on more heuristic considerations rather than a theoretical model and thus include anything from minor dissociative experiences to major pathological dissociation. The shutdown dissociation scale (Shut-D) was applied in several studies in patients with a history of multiple traumatic events and different disorders that have been shown previously to be prone to symptoms of dissociation. The goal of the present investigation was to obtain psychometric characteristics of the Shut-D (including factor structure, internal consistency, retest reliability, predictive, convergent and criterion-related concurrent validity). A total population of 225 patients and 68 healthy controls were accessed. Shut-D appears to have sufficient internal reliability, excellent retest reliability, high convergent validity, and satisfactory predictive validity, while the summed score of the scale reliably separates patients with exposure to trauma (in different diagnostic groups) from healthy controls. The Shut-D is a brief structured interview for assessing the vulnerability to dissociate as a consequence of exposure to traumatic stressors. The scale demonstrates high-quality psychometric properties and may be useful for researchers and clinicians in assessing shutdown dissociation as well as in predicting the risk of dissociative responding.
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Affiliation(s)
- Inga Schalinski
- Department of Psychology, University of Konstanz, Konstanz, Germany;
| | - Maggie Schauer
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, Konstanz, Germany
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Spyridou A, Schauer M, Ruf-Leuschner M. Obstetric care providers assessing psychosocial risk factors during pregnancy: validation of a short screening tool - the KINDEX Spanish Version. Child Adolesc Psychiatry Ment Health 2014; 8:30. [PMID: 25670965 PMCID: PMC4323280 DOI: 10.1186/s13034-014-0030-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 06/12/2014] [Accepted: 12/08/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND High levels of stress due to diverse psychosocial factors have a direct impact on the mothers' wellbeing during pregnancy and both direct and indirect effects on the fetus. In most cases, psychosocial risk factors present during pregnancy will not disappear after delivery and might influence the parent-child relationship, affecting the healthy development of the offspring in the long term. We introduce a short innovative prenatal assessment to detect psychosocial risk factors through an easy to use instrument for obstetrical medical staff in the daily clinical practice, the KINDEX Spanish Version. METHODS In the present study midwives and gynecologists interviewed one hundred nineteen pregnant women in a public health center using the KINDEX Spanish Version. Sixty-seven women were then randomly selected to participate in an extended standardized validation interview conducted by a clinical psychologist using established questionnaires to assesses current stress (ESI, PSS-14), symptoms of psychopathology (HSCL-25, PDS) and traumatic experiences (PDS, CFV). Ethical approval was granted and informed consent was required for participation in this study. RESULTS The KINDEX sum score, as assessed by medical staff, correlated significantly with stress, psychopathology and trauma as measured during the clinical expert interview. The KINDEX shows strong concurrent validity. Its use by medical staff in daily clinical practice is feasible for public health contexts. Certain items in the KINDEX are related to the respective scales assessing the same risks (e.g.PSS-4 as the shorter version of the PSS-14 and items from the ESI) used in the validation interview. CONCLUSIONS The KINDEX Spanish Version is a valid tool in the hands of medical staff to identify women with multiple psychosocial risk factors in public health settings. The KINDEX Spanish Version could serve as a base-instrument for the referral of at-risk women to appropriate psychosocial intervention. Such early interventions could prove pivotal in preventing undesirable mother-child relationships and adverse child development.
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Affiliation(s)
| | - Maggie Schauer
- />University of Konstanz, Konstanz, Germany
- />Vivo International (www.vivo.org), Konstanz, Germany
| | - Martina Ruf-Leuschner
- />University of Konstanz, Konstanz, Germany
- />Vivo International (www.vivo.org), Konstanz, Germany
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Schauer M, Knoefel WT. Die diagnostische Herausforderung der mediastinalen Sarkoidose im Rahmen des Primärstagings eines Ösophaguskarzinoms. Zentralbl Chir 2014. [DOI: 10.1055/s-0034-1389317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Schalinski I, Moran J, Schauer M, Elbert T. Rapid emotional processing in relation to trauma-related symptoms as revealed by magnetic source imaging. BMC Psychiatry 2014; 14:193. [PMID: 24997778 PMCID: PMC4100056 DOI: 10.1186/1471-244x-14-193] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 01/30/2014] [Accepted: 07/03/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Traumatic stress leads to functional reorganization in the brain and may trigger an alarm response. However, when the traumatic event produces severe helplessness, the predominant peri-traumatic response may instead be marked by a dissociative shutdown reaction. The neural correlates of this dissociative shutdown were investigated by presenting rapidly presented affective pictures to female participants with posttraumatic stress disorder (PTSD), and comparing responses to a Non-PTSD control group. METHODS Event-related-magnetic-fields were recorded during rapid visual serial presentation of emotionally arousing stimuli (unpleasant or pleasant), which alternated with pictures with low affective content (neutral). Neural sources, based on the L2-surface-minimum-norm, correlated with the severity of the symptom clusters: PTSD, depression and shutdown dissociation. RESULTS For the early cortical response (60 to 110 ms), dissociation and PTSD symptom severity show similar spatial distributions of correlates for unpleasant stimuli. Cortical networks that could be involved in the relationships seem to be widespread. CONCLUSION We conclude that shutdown dissociation, PTSD and depression all have distinct effects on early processing of emotional stimuli.
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Affiliation(s)
- Inga Schalinski
- Department of Psychology, University of Konstanz, P,O, Box 905, 78457 Konstanz, Germany.
| | - James Moran
- Department of Psychology, University of Konstanz, P.O. Box 905, 78457 Konstanz, Germany
| | - Maggie Schauer
- Department of Psychology, University of Konstanz, P.O. Box 905, 78457 Konstanz, Germany
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, P.O. Box 905, 78457 Konstanz, Germany
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Morath J, Gola H, Sommershof A, Hamuni G, Kolassa S, Catani C, Adenauer H, Ruf-Leuschner M, Schauer M, Elbert T, Groettrup M, Kolassa IT. The effect of trauma-focused therapy on the altered T cell distribution in individuals with PTSD: evidence from a randomized controlled trial. J Psychiatr Res 2014; 54:1-10. [PMID: 24726027 DOI: 10.1016/j.jpsychires.2014.03.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 03/07/2014] [Accepted: 03/09/2014] [Indexed: 12/22/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with a reduced ratio of naïve cytotoxic T lymphocytes, an increased ratio of memory cytotoxic T lymphocytes, and a reduced proportion of FoxP3(+) regulatory T lymphocytes. This study investigated whether these immunological alterations are reversible through an evidence-based psychotherapeutic treatment. Therefore, 34 individuals with PTSD were randomly assigned to either a treatment condition of 12 sessions narrative exposure therapy (NET) or a waitlist control (WLC) group. PTSD symptoms were significantly reduced in the NET group, but not in the WLC group, four months post-therapy (effect size: Hedges' g = -1.61). One year after therapy, PTSD symptoms were improved even further in the NET group compared to baseline (Hedges' g = -1.96). This symptom improvement was mirrored in an increase in the originally reduced proportion of regulatory T cells (Tregs) in the NET group at the one-year follow-up, when comparing subgroups matched for baseline Treg numbers. However, no changes were found for the initially reduced proportion of CD45RA(+)CCR7(+) naïve T lymphocytes. In conclusion, NET was effective in reducing trauma-related PTSD symptoms and had a positive effect on the proportion of Tregs cells, thus demonstrating an effect of psychotherapy on an immunological level. Yet, the shift in the proportion of naïve and memory T lymphocytes in individuals with PTSD, discussed in the literature as a correlate of premature immunosenescence, was not reversible and thus might render these patients permanently more susceptible to infectious diseases.
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Affiliation(s)
- Julia Morath
- Center of Excellence for Psychotraumatology, Clinical Psychology and Neuropsychology, University of Konstanz, Germany
| | - Hannah Gola
- Clinical and Biological Psychology, Institute of Psychology and Education, University of Ulm, Albert-Einstein-Allee 47, 89069 Ulm, Germany
| | - Annette Sommershof
- Division of Immunology, Department of Biology, University of Konstanz, 78457 Konstanz, Germany
| | - Gilava Hamuni
- Clinical and Biological Psychology, Institute of Psychology and Education, University of Ulm, Albert-Einstein-Allee 47, 89069 Ulm, Germany
| | | | - Claudia Catani
- Clinical Psychology and Psychotherapy, University of Bielefeld, Germany
| | - Hannah Adenauer
- Center of Excellence for Psychotraumatology, Clinical Psychology and Neuropsychology, University of Konstanz, Germany
| | - Martina Ruf-Leuschner
- Center of Excellence for Psychotraumatology, Clinical Psychology and Neuropsychology, University of Konstanz, Germany
| | - Maggie Schauer
- Center of Excellence for Psychotraumatology, Clinical Psychology and Neuropsychology, University of Konstanz, Germany
| | - Thomas Elbert
- Center of Excellence for Psychotraumatology, Clinical Psychology and Neuropsychology, University of Konstanz, Germany
| | - Marcus Groettrup
- Division of Immunology, Department of Biology, University of Konstanz, 78457 Konstanz, Germany; Biotechnology Institute Thurgau at the University of Konstanz, 8280 Kreuzlingen, Switzerland
| | - Iris-Tatjana Kolassa
- Center of Excellence for Psychotraumatology, Clinical Psychology and Neuropsychology, University of Konstanz, Germany; Clinical and Biological Psychology, Institute of Psychology and Education, University of Ulm, Albert-Einstein-Allee 47, 89069 Ulm, Germany.
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Isele D, Teicher MH, Ruf-Leuschner M, Elbert T, Kolassa IT, Schury K, Schauer M. KERF–Ein Instrument zur umfassenden Ermittlung belastender Kindheitserfahrungen. Zeitschrift für Klinische Psychologie und Psychotherapie 2014. [DOI: 10.1026/1616-3443/a000257] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Hintergrund: Belastende Kindheitserfahrungen steigern das Risiko für Psychopathologie und beeinflussen die Erkrankungsschwere und den Behandlungserfolg. Validierte Instrumente zur umfangreichen Erfassung von Kindheitsbelastungen sind für die klinisch-psychologische Arbeit unabdingbar jedoch nur bedingt vorhanden. Fragestellung: Diese Arbeit stellt die Konstruktion und psychometrische Prüfung der Skala „Belastende Kindheitserfahrungen” (KERF), einem Instrument zur umfangreichen Erfassung von Kindheitsbelastungen vor. Die KERF beruht auf einer modifizierten Version des US-amerikanischen „Adversive Childhood Experiences” Index. Methode: Basierend auf den Daten von 165 Probandinnen wurden mit Rasch-Modellen zehn Subskalen modelliert. Korrelationen mit dem CTQ (Childhood Trauma Questionnaire) und Psychopathologie wurden bestimmt. Ergebnisse: Unterstützt durch konzeptuelle Überlegungen konnten zehn Subskalen gebildet werden. Wir fanden zufriedenstellende Assoziationen mit dem CTQ und Psychopathologie. Schlussfolgerungen: KERF ermöglicht eine detaillierte valide Erfassung belastender Kindheitserfahrungen.
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Abstract
Hintergrund: Die Prävalenz von Traumafolgestörungen bei erwachsenen Flüchtlingen ist bekanntermaßen hoch. Gleichzeitig zeigen auch Flüchtlingskinder multiple psychische Auffälligkeiten und Funktionseinschränkungen. Theorien zu generationsübergreifender Traumatisierung vermuten, dass die Posttraumatische Belastungsstörung (PTBS) der Eltern sowie familiäre Gewalt die psychische Gesundheit der Kinder maßgeblich beeinflussen. Doch auch andere Faktoren wie eigene traumatische Erfahrungen im Herkunfts- und Aufnahmeland oder die Lebensbedingungen im Exil stehen möglicherweise mit der psychischen Gesundheit der Kinder in Zusammenhang. Fragestellung: Ziel der vorliegenden Arbeit ist es, den Zusammenhang von PTBS, weiteren Traumafolgeerkrankungen und Gewalterfahrungen von Flüchtlingsmüttern und ihren Kindern transgenerational zu untersuchen. Methode: 41 Flüchtlingsmütter und ihre Kinder (Alter 11-18 Jahre) wurden mit Hilfe von standardisierten, psychodiagnostischen Instrumenten unabhängig voneinander interviewt. Bei den Kindern wurde das Ausmaß der erlebten familiären Gewalt, erlebte traumatische Ereignisse, Ängstlichkeit, Depressivität sowie PTBS erfasst. Bei den Müttern wurde das Ausmaß der erlebten familiären Gewalt in der Kindheit, Gewalterfahrungen in der Partnerschaft in den letzten 12 Monaten ebenso wie andere traumatische Ereignisse sowie PTBS und Depressivität erhoben. Ergebnisse: Die Schwere der PTBS-Symptomatik bei den Müttern zeigt keinen direkten Zusammenhang mit der PTBS-Symptomatik, der Ängstlichkeit und der Depressivität der Kinder. Die Schwere der mütterlichen PTBS-Symptomatik ist aber mit der vom Kind erlebten familiären Gewalt positiv assoziiert. Die von den Kindern berichtete Anzahl unterschiedlicher traumatischer Ereignistypen und das Ausmaß der familiären Gewalt korrelieren wiederum positiv sowohl mit deren PTBS-Symptomatik als auch mit deren Depressivität und Ängstlichkeit. Schlussfolgerung: Die Ergebnisse veranschaulichen, dass nicht die PTBS-Symptomatik der Mutter, sondern die von den Kindern selbst erlebten traumatischen Erfahrungen, einschließlich der erlebten familiären Gewalt, mit den Traumafolgeerkrankungen der Kinder in Zusammenhang stehen. Die PTBS-Symptomatik der Mutter steht jedoch mit der vom Kind erlebten familiären Gewalt in Zusammenhang. Psychotherapeutische, trauma-fokussierte Interventionen sind daher sowohl für Mütter als auch Kinder indiziert. Darüber hinaus können Elterntrainings sinnvoll sein, um langfristig den Zyklus der Gewalt zu durchbrechen.
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Affiliation(s)
| | - Maria Roth
- Kompetenzzentrum Psychotraumatologie Universität Konstanz & vivo international
| | - Maggie Schauer
- Kompetenzzentrum Psychotraumatologie Universität Konstanz & vivo international
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Baumann M, Zwissler B, Schalinski I, Ruf-Leuschner M, Schauer M, Kissler J. Directed forgetting in post-traumatic-stress-disorder: a study of refugee immigrants in Germany. Front Behav Neurosci 2013; 7:94. [PMID: 23966914 PMCID: PMC3736047 DOI: 10.3389/fnbeh.2013.00094] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 07/11/2013] [Indexed: 11/16/2022] Open
Abstract
People with post-traumatic stress disorder (PTSD) often suffer from memory disturbances. In particular, previous studies suggest that PTSD patients perform atypically on tests of directed forgetting, which may be mediated by an altered emotional appraisal of the presented material. Also, a special role of dissociative symptoms in traumatized individuals’ memory performance has been suggested. Here, we investigate these issues in traumatized immigrants in Germany. In an item-method directed forgetting task, pictures were presented individually, each followed by an instruction to either remember or forget it. Later, recognition memory was tested for all pictures, regardless of initial instruction. Overall, the PTSD group’s discrimination accuracy was lower than the control group’s, as PTSD participants produced fewer hits and more false alarms, but the groups did not differ in directed forgetting itself. Moreover, the more negatively participants evaluated the stimuli, the less they were able to discriminate old from new items. Participants with higher dissociation scores were particularly poor at recognizing to-be-forgotten items. Results confirm PTSD patients’ general discrimination deficits, but provide no evidence for a distinct directed forgetting pattern in PTSD. Furthermore, data indicate that, in general, more negatively perceived items are discriminated with less accuracy than more positively appraised ones. Results are discussed in the larger context of emotion and stress-related modulations of episodic memory, with particular focus on the role of dissociative symptoms.
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Affiliation(s)
- Michaela Baumann
- Department of Psychology, University of Konstanz , Konstanz , Germany
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Schalinski I, Elbert TR, Schauer M. Cardiac defense in response to imminent threat in women with multiple trauma and severe PTSD. Psychophysiology 2013; 50:691-700. [DOI: 10.1111/psyp.12051] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 02/25/2013] [Indexed: 11/29/2022]
Affiliation(s)
- I. Schalinski
- Department of Psychology; University of Konstanz; Konstanz; Germany
| | - T. R. Elbert
- Department of Psychology; University of Konstanz; Konstanz; Germany
| | - M. Schauer
- Department of Psychology; University of Konstanz; Konstanz; Germany
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Giebel G, Weierstall R, Schauer M, Elbert T. Female attraction to appetitive-aggressive men is modulated by women's menstrual cycle and men's vulnerability to traumatic stress. Evol Psychol 2013; 11:248-62. [PMID: 23531810 PMCID: PMC10481062] [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] [Received: 11/06/2012] [Accepted: 02/23/2013] [Indexed: 06/02/2023] Open
Abstract
Many studies have reported that during high fertility points in the menstrual cycle, women demonstrate increased preference for men with masculinized faces and bodies. In this study, we analyzed whether appetitive aggression in men serves as an additional signal for a favored partner choice. Appetitive aggression describes the intrinsic motivation to act violently even when not being threatened. This study evaluated the responses of 1212 women to one of four descriptions regarding a soldier´s experience after returning from war. The four vignettes included trauma related symptoms with high or low appetitive aggression, or no trauma related symptoms with high or low appetitive aggression. Participants rated their desirability for the soldier in regards to potential long-term and short-term relationships. Results indicate that women preferred a soldier high in appetitive aggression as a short-term mate but not as a long-term relationship. This preference for the "warrior" was higher for women in their fertile window of the menstrual cycle. We conclude that women in their fertile window prefer men exhibiting higher appetitive aggression as a short-term partner, revealing appetitive aggression in men may serve as a signal for a higher genetic fitness.
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Affiliation(s)
- Gilda Giebel
- Department of Psychology, University of Konstanz, Konstanz, Germany.
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Hecker T, Hermenau K, Maedl A, Hinkel H, Schauer M, Elbert T. Does perpetrating violence damage mental health? Differences between forcibly recruited and voluntary combatants in DR Congo. J Trauma Stress 2013; 26:142-8. [PMID: 23319373 DOI: 10.1002/jts.21770] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
As a consequence of the ongoing conflict in the Democratic Republic of the Congo (DRC), combatants are constantly involved in various forms of violence. Findings concerning the impact of perpetrating violence on mental health are contradictory, ranging from increasing to buffering the risk for mental ill health. The present study investigated the impact of perpetrating violence on mental health. In total, 204 forcibly recruited and voluntary male combatants (mean age = 24.61 years) from different armed groups in the eastern DRC took part in the study. In a semistructured interview, respondents were questioned about appetitive aggression and posttraumatic stress disorder (PTSD) as well as self-experienced violence and self-perpetrated violent offending. A multivariate analysis of variance (η(2) = .23) revealed that voluntary combatants perpetrated more violent acts (η(2) = .06) and showed higher appetitive aggression η(2) = .03). A moderated multiple regression analysis (R(2) = .20) showed that perpetrating violence was positively related to PTSD in forcibly recruited combatants, but not in voluntary combatants. Thus, perpetrating violence may not necessarily qualify as a traumatic stressor. Further studies might consider assessing the combatant's perception of committing violent acts.
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Affiliation(s)
- Tobias Hecker
- Department of Psychology, University of Konstanz, Konstanz, Germany.
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Giebel G, Weierstall R, Schauer M, Elbert T. Female Attraction to Appetitive-Aggressive Men is Modulated by Women's Menstrual Cycle and Men's Vulnerability to Traumatic Stress. Evol Psychol 2013. [DOI: 10.1177/147470491301100122] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Many studies have reported that during high fertility points in the menstrual cycle, women demonstrate increased preference for men with masculinized faces and bodies. In this study, we analyzed whether appetitive aggression in men serves as an additional signal for a favored partner choice. Appetitive aggression describes the intrinsic motivation to act violently even when not being threatened. This study evaluated the responses of 1212 women to one of four descriptions regarding a soldier's experience after returning from war. The four vignettes included trauma related symptoms with high or low appetitive aggression, or no trauma related symptoms with high or low appetitive aggression. Participants rated their desirability for the soldier in regards to potential long-term and short-term relationships. Results indicate that women preferred a soldier high in appetitive aggression as a short-term mate but not as a long-term relationship. This preference for the “warrior” was higher for women in their fertile window of the menstrual cycle. We conclude that women in their fertile window prefer men exhibiting higher appetitive aggression as a short-term partner, revealing appetitive aggression in men may serve as a signal for a higher genetic fitness.
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Affiliation(s)
- Gilda Giebel
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | | | - Maggie Schauer
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, Konstanz, Germany
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Hermenau K, Hecker T, Maedl A, Schauer M, Elbert T. Growing up in armed groups: trauma and aggression among child soldiers in DR Congo. Eur J Psychotraumatol 2013; 4:21408. [PMID: 24224078 PMCID: PMC3820919 DOI: 10.3402/ejpt.v4i0.21408] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [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] [Received: 05/13/2013] [Revised: 09/26/2013] [Accepted: 10/09/2013] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Child soldiers are often both victims and perpetrators of horrendous acts of violence. Research with former child soldiers has consistently shown that exposure to violence is linked to trauma-related disorders and that living in a violent environment is correlated with enhanced levels of aggression. OBJECTIVE To gain more insight into the experiences and the mental health status of former child soldiers, we conducted a survey with N=200 former child soldiers and adult combatants in the DR Congo. METHODS We conducted semi-structured interviews concerning military experiences, experienced and perpetrated violence, and mental health. RESULTS Former child soldiers reported more experienced and perpetrated violence, a greater severity of trauma-related suffering, as well as higher appetitive aggression than adult ex-combatants. Appetitive aggression was related to more perpetrated violence, higher military ranks, voluntary recruitment and higher rates of reenlistments in former child soldiers. CONCLUSIONS Our results indicate that growing up in an armed group is related to higher levels of trauma-related disorders and aggressive behavior. This may explain the challenge of reintegrating former child soldiers. It is thus important to consider mental health problems, particularly trauma-related disorders and aggressive behavior, of former child soldiers for designing adequate reintegration programs.
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Affiliation(s)
- Katharin Hermenau
- Department of Psychology, University of Konstanz, Konstanz, Germany ; vivo international, Allensbach, Germany
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Hecker T, Hermenau K, Maedl A, Schauer M, Elbert T. Aggression inoculates against PTSD symptom severity-insights from armed groups in the eastern DR Congo. Eur J Psychotraumatol 2013; 4:20070. [PMID: 23671766 PMCID: PMC3651955 DOI: 10.3402/ejpt.v4i0.20070] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 11/12/2012] [Revised: 04/03/2013] [Accepted: 04/12/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In the ongoing conflict in the Democratic Republic of the Congo (DRC), combatants are exposed to massive forms of violence and other traumatic stressors. Nevertheless, many combatants do not suffer from trauma-related disorders, although they have experienced numerous traumatizing events. Perceiving aggressive behavior as fascinating and arousing might be a defense against trauma-related disorders in the violent environment of war and conflict. OBJECTIVE Thus, in this study we investigated the relationship between the exposure to traumatic stressors, appetitive aggression, and posttraumatic stress disorder (PTSD) symptom severity. We hypothesized that cumulative traumatic experiences correlated positively and appetitive aggression negatively with PTSD symptom severity. METHOD In total, 105 voluntary male combatants from different armed groups in the eastern DRC took part in this study. In a semistructured interview, respondents were questioned about their exposure to traumatic stressors, the extent of appetitive aggression (Appetitive Aggression Scale) and their PTSD symptom severity (PTSD Symptom Scale - Interview). RESULTS A multiple sequential regression analysis showed that traumatic events were positively related to PTSD symptom severity. For participants with low to medium PTSD symptom severity, appetitive aggression correlated negatively with PTSD symptom severity. CONCLUSIONS The results of this study provide further support for earlier findings that repeated exposure to traumatic stressors cumulatively heightens the risk of PTSD and revealed that appetitive aggression buffers the risk of developing PTSD symptoms under certain circumstances. Thus, the perception of aggressive behavior as fascinating and arousing seem to help combatants to adapt to violent environments but may also be one reason for recurrent failure of reintegration programs for excombatants.
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Affiliation(s)
- Tobias Hecker
- Department of Psychology, University of Konstanz, Konstanz, Germany ; vivo international, Allensbach, Germany
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Matuschek C, Bölke E, Roth SL, Orth K, Lang I, Bojar H, Janni JW, Audretsch W, Nestle-Kraemling C, Lammering G, Speer V, Gripp S, Gerber PA, Buhren BA, Sauer R, Peiper M, Schauer M, Dommach M, Struse-Soll K, Budach W. Long-term outcome after neoadjuvant radiochemotherapy in locally advanced noninflammatory breast cancer and predictive factors for a pathologic complete remission : results of a multivariate analysis. Strahlenther Onkol 2012; 188:777-81. [PMID: 22878547 DOI: 10.1007/s00066-012-0162-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 05/16/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND An earlier published series of neoadjuvant radiochemotherapy (NRT-CHX) in locally advanced noninflammatory breast cancer (LABC) has now been updated with a follow-up of more than 15 years. Long-term outcome data and predictive factors for pathologic complete response (pCR) were analyzed. PATIENTS AND METHODS During 1991-1998, 315 LABC patients (cT1-cT4/cN0-N1) were treated with NRT-CHX. Preoperative radiotherapy (RT) consisted of external beam radiation therapy (EBRT) of 50 Gy (5 × 2 Gy/week) to the breast and the supra-/infraclavicular lymph nodes combined with an electron boost in 214 cases afterwards or-in case of breast conservation-a 10-Gy interstitial boost with (192)Ir afterloading before EBRT. Chemotherapy was administered prior to RT in 192 patients, and concomitantly in 113; 10 patients received no chemotherapy. The update of all follow-up ended in November 2011. Age, tumor grade, nodal status, hormone receptor status, simultaneous vs. sequential CHX, and the time interval between end of RT and surgery were examined in multivariate terms with pCR and overall survival as end point. RESULTS The total pCR rate after neoadjuvant RT-CHX reached 29.2%, with LABC breast conservation becoming possible in 50.8% of cases. In initially node-positive cases (cN+), a complete nodal response (pN0) after NRT-CHX was observed in 56% (89/159). The multivariate analysis revealed that a longer time interval to surgery increased the probability for a pCR (HR 1.17 [95% CI 1.05-1.31], p < 0.01). However, in large tumors (T3-T4) a significantly reduced pCR rate (HR 0.89 [95% CI 0.80-0.99], p = 0.03) was obtained. Importantly, pCR was the strongest prognostic factor for long-term survival (HR 0.28 [95% CI 0.19-0.56], p < 0.001). CONCLUSION pCR identifies patients with a significantly better prognosis for long-term survival. However, a long time interval to surgery (> 2 months) increases the probability of pCR after NRT-CHX.
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Affiliation(s)
- C Matuschek
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University of Duesseldorf, Germany
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Kroepil F, Schauer M, Raffel AM, Kröpil P, Eisenberger CF, Knoefel WT. Treatment of early and delayed esophageal perforation. Indian J Surg 2012; 75:469-72. [PMID: 24465104 DOI: 10.1007/s12262-012-0539-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 05/31/2012] [Indexed: 12/19/2022] Open
Abstract
Esophageal perforations are life threatening emergencies associated with high morbidity and mortality. We report on 22 consecutive patients (age 20-86; 13 female and 9 male) with an oesophageal perforation treated at the university hospital Duesseldorf. The patients' charts were reviewed and follow-up was completed for all patients until demission, healed reconstruction or death. Patients' history, clinical presentation, time interval to surgical presentation, and treatment modality were recorded and correlated with patients' outcome. Six esophageal perforations were due to a Boerhaave-syndrome, eleven caused by endoscopic perforation, two after osteosynthesis of the cervical spine and three foreign body induced. In 7 patients a primary local suture was performed, in 4 cases a supplemental muscle flap was interposed, and 7 patients underwent an oesophageal resection. Four patients were treated without surgery (three esophageal stent implantations, one conservative treatment). Eleven patients (50 %) were presented within 24 h of perforation, and 11 patients (50 %) afterwards. Time delay correlates with survival. In 17 (80.9 %) cases a surgical sufficient reconstruction could be achieved. One (4.7 %) patient is waiting for reconstruction after esophagectomy. Four (18.2 %) patients died. A small subset of patients can be treated conservatively by stenting of the Esophagus, if the patient presents early. In the majority of patients a primary repair (muscle flap etc.) can be performed with good prognosis. If the patient presents delayed with extensive necrosis or mediastinitis, oesophagectomy and secondary repair is the only treatment option with high mortality.
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Affiliation(s)
- F Kroepil
- Department of General-, Visceral and Pediatric Surgery, University of Duesseldorf, Medical Faculty, Moorenstr. 5, Duesseldorf, 40225 Germany
| | - M Schauer
- Department of General-, Visceral and Pediatric Surgery, University of Duesseldorf, Medical Faculty, Moorenstr. 5, Duesseldorf, 40225 Germany
| | - A M Raffel
- Department of General-, Visceral and Pediatric Surgery, University of Duesseldorf, Medical Faculty, Moorenstr. 5, Duesseldorf, 40225 Germany
| | - P Kröpil
- Department of Diagnostic and Interventional Radiology, University of Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - C F Eisenberger
- Department of General-, Visceral and Pediatric Surgery, University of Duesseldorf, Medical Faculty, Moorenstr. 5, Duesseldorf, 40225 Germany
| | - W T Knoefel
- Department of General-, Visceral and Pediatric Surgery, University of Duesseldorf, Medical Faculty, Moorenstr. 5, Duesseldorf, 40225 Germany
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Hecker T, Hermenau K, Maedl A, Elbert T, Schauer M. Appetitive aggression in former combatants--derived from the ongoing conflict in DR Congo. Int J Law Psychiatry 2012; 35:244-249. [PMID: 22420932 DOI: 10.1016/j.ijlp.2012.02.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Soldiers and combatants often report that committing violence can be appealing, fascinating and exciting (Elbert, Weierstall, & Schauer, 2010). This appetite for aggression was investigated in a sample of 224 former combatants from different armed groups and forces in eastern DRC. In a semistructured interview they were questioned about their military history, exposure to violence and perpetrated violence. Appetitive aggression was assessed with a 15-item-scale (Weierstall & Elbert, 2011), which was successfully implemented in comparable samples (Weierstall, Schalinski, Crombach, Hecker, & Elbert, submitted for publication). A sequential multiple regression was conducted to determine possible predictors of appetitive aggression. Perpetrated violence types, recruitment type, and joining as a child were significant predictors and explained 26% of the variability in appetitive aggression. Duration or military rank within the armed group and exposure to violence did not play a significant role. Thus, combatants reporting high levels of appetitive aggression are characterized by perpetrating a high number of violent acts, joining armed groups on their own accord and as children. Joining an armed group on one's own accord indicates pre-existing appetitive aggression. However, joining young and perpetrating violence on a regular basis seem to intensify the appetite for aggression.
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Affiliation(s)
- Tobias Hecker
- Department of Psychology, University of Konstanz, Konstanz, Germany.
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