Verbesserte Diagnostik von Traumafolgestörungen durch den Einsatz der Life-Stressor Checklist

 

 Buy Article Permissions and Reprints

Zusammenfassung

Die Studie überprüft die Effektivität des Einsatzes der Life-Stressor Checklist (LSC-R) zur Diagnostik von Traumafolgestörungen. Vor dem Hintergrund des Dose-Response Effektes zwischen der Anzahl unterschiedlicher traumatischer Stressorexpositionen und dem Ausmaß der Traumasymptomatik wird die Validität einer quantitativen Auswertung der Checkliste analysiert. 130 Patienten wurden mit der LSC-R, der IES-R (PTBS Symptome) und der SCL-90-R befragt. Eine Expertenbeurteilung schätzte die Relevanz traumatischer Erfahrungen für die Störungsgenese ein. Der Dose-Effekt replizierte sich deutlich mit r=0,71. Ein Cut-off von ≥6 ergab eine 75%tige Übereinstimmung mit dem Expertenurteil. Außerdem differenzierte der Summenwert der Traumacheckliste innerhalb von Hochrisikogruppen und zeigte eine Übereinstimmung mit der Schwere der Traumatiserungsform. Im Ergebnis stellt die quantitative Auswertung der Traumacheckliste ein effektives Screening für Patientinnen und Patienten mit Traumafolgestörungen dar.

Abstract

The study examines the effectiveness of applying the Life-Stressor Checklist (LSC-R) in diagnosing trauma-related disease. The validity of a quantitative analysis of the checklist is evaluated in consideration of the dose-response effect between the number of different traumatic stressor expositions and the degree of trauma-related symptoms. The trauma checklist LSC-R was applied to 130 patients. Data on psychological symptoms was collected with the help of IES-R (PTSD symptoms) and SCL–90-R, the relevance of traumatic experiences for the genesis of disorders was assessed by expert evaluation. The dose effect replicated clearly with r=0.714 and a cut-off of ≥6 yielded a 75% agreement with the expert evaluation. The total value of the trauma checklist showed a differentiation within high-risk groups and also agreement with the severity of the traumatization. The quantitative analysis of the trauma checklist permits an effective screening for identifying trauma-related disease.

Literatur

• 1 Kilpatrick DG, Ruggiero KJ, Acierno RE. et al . Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the National Survey of Adolescents.  J Consult Clin Psychol. 2003;  71 692-700
  CrossrefPubMedGoogle Scholar
• 2 Felitti VJ, Anda RF, Nordenberg D. et al . Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study.  Am J Prev Med. 1998;  14 245-258
  CrossrefPubMedGoogle Scholar
• 3 Dirkzwager AJ, Grievink L, Velden van der PG. et al . Risk factors for psychological and physical health problems after a man-made disaster.  Br J Psychiatry. 2006;  189 144-149
  CrossrefPubMedGoogle Scholar
• 4 Widom CS, DuMont K, Czaja SJ. A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up.  Arch Gen Psychiatry. 2007;  64 49-56
  CrossrefPubMedGoogle Scholar
• 5 Nelson EC, Heath AC, Madden PA. et al . Association between self-reported childhood sexual abuse and adverse psychosocial outcomes.  Arch Gen Psychiatry. 2002;  59 139-145
  CrossrefPubMedGoogle Scholar
• 6 Maercker A, Rosner R. Psychotherapie der posttraumatischen Belastungsstörungen.. Stuttgart: Thieme; 2006
  Google Scholar
• 7 Roth G, Münte TF. Neurobiologische Grundlagen psychischer Traumatisierung.. In: Seidler GH, Laszig P, Micka R, Nolting BV , Hrsg. Aktuelle Entwicklungen in der Psychotraumatologie. Giessen: Psychosozial-Verlag; 2003: 9-34
  Google Scholar
• 8 Kessler RC, Sonnega A, Bromet E. et al . Posttraumatic stress disorder in the National Comorbidity Survey.  Arch Gen Psychiatry. 1995;  52 1048-1060
  Google Scholar
• 9 Mcquaid JR, Pedrelli P, McCahill ME. et al . Reported trauma, post-traumatic stress disorder and major depression among primary care patients.  Psychol Med. 2001;  31 1249-1257
  CrossrefPubMedGoogle Scholar
• 10 Lecrubier Y. Posttraumatic Stress disorder in primary care: a hidden diagnosis.  J Clin Psychiatry. 2004;  65 (S 01) 49-54
  PubMedGoogle Scholar
• 11 Kolk van der BA. The assessment and treatment of complex PTSD.. In: Yehuda R , Hrsg. Treating Trauma Survivors with PTSD. Washington DC: American Psychiatric Press; 2002: 127-157
  Google Scholar
• 12 Mylle J, Maes M. Partial posttraumatic stress disorder revisited.  J Affect Disord. 2004;  78 37-48
  CrossrefPubMedGoogle Scholar
• 13 Hart van der O, Nijenhuis ER, Steele K. Dissociation: an insufficiently recognized major feature of complex posttraumatic stress disorder.  J Trauma Stress. 2005;  18 413-423
  CrossrefPubMedGoogle Scholar
• 14 Sachsse U. Traumazentrierte Psychotherapie.. Theorie, Klinik und Praxis. Stuttgart: Schattauer; 2004
  Google Scholar
• 15 Briere J, Spinazzola J. Phenomenology and psychological assessment of complex posttraumatic states.  J Trauma Stress. 2005;  18 401-412
  CrossrefPubMedGoogle Scholar
• 16 Green BL, Goodman LA, Krupnick JL. et al . Outcomes of single versus multiple trauma exposure in a screening sample.  J Trauma Stress. 2000;  13 271-286
  CrossrefPubMedGoogle Scholar
• 17 Neuner F, Schauer M, Karunakara U. et al . Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees.  BMC Psychiatry. 2004;  4 34
  CrossrefPubMedGoogle Scholar
• 18 Eytan A, Gex-Fabry M, Toscani L. et al . Determinants of postconflict symptoms in Albanian Kosovars.  J Nerv Ment Dis. 2004;  192 664-671
  PubMedGoogle Scholar
• 19 Marshall GN, Schell TL, Elliott MN. et al . Mental health of Cambodian refugees 2 decades after resettlement in the United States.  JAMA. 2005;  294 571-579
  CrossrefPubMedGoogle Scholar
• 20 Schumm JA, Briggs-Phillips M, Hobfoll SE. Cumulative interpersonal traumas and social support as risk and resiliency factors in predicting PTSD and depression among inner-city women.  J Trauma Stress. 2006;  19 825-836
  CrossrefPubMedGoogle Scholar
• 21 Shalev AY, Tuval R, Frenkiel-Fishman S. et al . Psychological responses to continuous terror: a study of two communities in Israel.  Am J Psychiatry. 2006;  163 667-673
  CrossrefPubMedGoogle Scholar
• 22 Klaric M, Klaric B, Stevanovic A. et al . Psychological consequences of war trauma and postwar social stressors in women in Bosnia and Herzegovina.  Croat Med J. 2007;  48 167-176
  PubMedGoogle Scholar
• 23 Vinck P, Phan PN, Stover E. et al . Exposure to war crimes and implications for peace building in northern Uganda.  JAMA. 2007;  298 543-554
  CrossrefPubMedGoogle Scholar
• 24 Hepp U, Gamma A, Milos G. et al . Inconsistency in reporting potentially traumatic events.  Br J Psychiatry. 2006;  188 278-283
  Google Scholar
• 25 Widom CS, Dutton MA, Czaja SJ. et al . Development and validation of a new instrument to assess lifetime trauma and victimization history.  J Trauma Stress. 2005;  18 519-531
  CrossrefPubMedGoogle Scholar
• 26 Mollica RF, Caridad KR, Massagli MP. Longitudinal study of posttraumatic stress disorder, depression, and changes in traumatic memories over time in Bosnian refugees.  J Nerv Ment Dis. 2007;  195 572-579
  PubMedGoogle Scholar
• 27 Flatten G. Abriss über den aktuellen Stand bei den Traumafolgestörungen ASD und PTSD.. In: Seidler GH, Laszig P, Micka R, Nolting BV , Hrsg. Aktuelle Entwicklungen in der Psychotraumatologie. Giessen: Psychosozial-Verlag; 2003: 35-54
  Google Scholar
• 28 Wittchen HU, Pfister H. DIA-X Interviews. Frankfurt: Swets Test Service Deutschland; 1997
  Google Scholar
• 29 Wolfe JW, Kimerling R, Brown PJ. et al .Psychometric review of the Life Stressor Checklist Revised.. In: Stamm BH , Hrsg. Measurement of Stress, Trauma, and Adaption. Lutherville: Sidran Press; 1996
  Google Scholar
• 30 Norris FH, Hamblen JL. Standardized self-report measures of civilian trauma and PTSD.. In: Wilson JP, Keane TM , Hrsg. Assessing psychological Trauma and PTSD. New York: Guilford Publications; 2004: 63-76
  Google Scholar
• 31 McHugo GJ, Caspi Y, Kammerer N. et al . The assessment of trauma history in women with co-occurring substance abuse and mental disorders and a history of interpersonal violence.  J Behav Health Serv Res. 2005;  32 113-127
  CrossrefPubMedGoogle Scholar
• 32 Quimette P, Read J, Brown PJ. Consistency of retrospective reports of DSM-IV criterion A traumatic stressors among substance use disorder patients.  J Trauma Stress. 2005;  18 43-51
  CrossrefPubMedGoogle Scholar
• 33 Maercker A, Schützwohl M. Erfassung von psychischen Belastungsfolgen: Die Impact of Event Skala-revidierte Version (IES-R).  Diagnostica. 1998;  44 130-141
  Google Scholar
• 34 Franke G. SCL-90-R. Die Symptom-Checkkliste von Derogatis.. Deutsche Version. Göttingen: Beltz; 1995
  Google Scholar
• 35 Creamer M, Bell R, Failla S. Psychometric properties of the Impact of Event Scale-Revised.  Behav Res Ther. 2003;  41 1489-1496
  CrossrefPubMedGoogle Scholar
• 36 Lipschitz DS, Bernstein DP, Winegar RK. et al . Hospitalized adolescents’ reports of sexual and physical abuse: a comparison of two self-report measures.  J Trauma Stress. 1999;  12 641-654
  CrossrefPubMedGoogle Scholar
• 37 Kremers IP, Giezen van AE, Does van der AJ. et al . Memory of childhood trauma before and after long-term psychological treatment of borderline personality disorder.  J Behav Ther Exp Psychiatry. 2007;  38 1-10
  CrossrefPubMedGoogle Scholar
• 38 Roemer L, Litz BT, Orsillo SM. et al . Increases in retrospective accounts of war-zone exposure over time: the role of PTSD symptom severity.  J Trauma Stress. 1998;  11 597-605
  CrossrefPubMedGoogle Scholar
• 39 Banyard VL, Williams LM, Siegel JA. The long-term mental health consequences of child sexual abuse: an exploratory study of the impact of multiple traumas in a sample of women.  J Trauma Stress. 2001;  14 697-715
  CrossrefPubMedGoogle Scholar
• 40 Perkonigg A, Pfister H, Stein MB. et al . Longitudinal course of posttraumatic stress disorder and posttraumatic stress disorder symptoms in a community sample of adolescents and young adults.  Am J Psychiatry. 2005;  162 1320-1327
  CrossrefPubMedGoogle Scholar
• 41 Rothschild B. Der Körper erinnert sich. Essen: Synthesis Verlag; 2002
  Google Scholar
• 42 Boos A. Kognitive Verhaltenstherapie nach chronischer Traumatisierung.. Göttingen: Hogrefe; 2005
  Google Scholar
• 43 Moore SA, Zoellner LA. Overgeneral autobiographical memory and traumatic events: an evaluative review.  Psychol Bull. 2007;  133 419-437
  CrossrefPubMedGoogle Scholar
• 44 Bernstein DP, Fink L, Handelsman L. et al . Initial reliability and validity of a new retrospective measure of child abuse and neglect.  Am J Psychiatry. 1994;  15 1132-1136
  PubMedGoogle Scholar
• 45 Müller C, Teschner M, Assaloni H. et al . Eine ambulante Stabilisierungsgruppe zur Verbesserung der Emotionsregulation bei komplexen posttraumatischen Störungen.  Psychother Psych Med. 2007;  57 364-372
  Article in Thieme ConnectPubMedGoogle Scholar

Korrespondenzadresse

Oliver Ungerer

Brandenburg Klinik

Psychosomatik

Brandenburgallee 1

16321 Bernau

Email: ungerer@brandenburgklinik.de