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Menschen, die organisierte Gewalt erlebt haben, leiden oft unter ausgeprägten Folgesymptomen bis hin zu schweren dissoziativen Störungen. Öffentliche Diskussionen um die Glaubwürdigkeit ihrer Schilderungen können die Behandlung für die Betroffenen und ihre Therapeut*innen erschweren. Das ändert aber kaum etwas an Therapiezielen und Vorgehen, da stets auch subjektives und damit nicht überprüfbares Erleben im Fokus einer Psychotherapie steht.

Die Forderung von Entwicklungsprozessen ist ein essenzielles Therapieziel bei Patienten, die an den Folgen von Vernachlassigung, dem Verlust nahestehender Menschen und Traumatisierungen in der Kindheit leiden. Therapeutische Zuwendung und gute Beziehung allein sind nicht ausreichend, um Personlichkeitsentwicklung gezielt zu fordern. Psychotherapie mit dem Ziel der Forderung von Personlichkeitsentwicklung wird besonders wirksam, wenn multimethodale Therapieangebote im Rahmen eines Gesamtbehandlungsplans in zielgerichteter und koordinierter Weise zum Einsatz kommen. Hierbei sind insbesondere Therapieformen von Bedeutung, die es ermoglichen, korrigierende handlungsbezogene neue Erfahrungen zu gewinnen. Insbesondere erlebnisbasierte Therapiemethoden, z. B. Musik-, Tanz- und Kunsttherapie sowie Psychodrama und andere Gruppentherapien mit interaktionellem Ansatz, bieten hierfur gute Einsatzmoglichkeiten. Der Einsatz multimethodaler Behandlungsmethoden sollte in der Behandlung von Patienten mit Personlichkeitsstorungen auch im ambulanten Therapiesetting ermoglicht werden.

An auxiliary power supply for stages of a semiconductor-based Marx generator has been designed and tested. The auxiliary power supply converts the Marx generator's stage voltage ranging from 50 V to 1000 V to stabilized voltages of 7 V and 18 V at a total output power of up to 1.5 W. It comprises a transformer for insulation between input and both outputs and features a flyback converter design. The on-time of the MOSFET switch has been designed to vary between approximately 1 ��s and 20 ��s depending on the generator's stage voltage. The power supply has been tested successfully in an 8-stage Marx generator.

Eye Movement Desensitization and Reprocessing (EMDR) ist eine manualisierte Therapiemethode zur konfrontativen Bearbeitung von traumaassoziierten Symptomen. Sie wird vornehmlich zur Behandlung der posttraumatischen Belastungsstörung (PTBS) eingesetzt, inzwischen aber auch bei weiteren Störungen mit Traumabezug. Der Beitrag ordnet EMDR als Methode der Bearbeitung von Traumafolgesymptomen ein und zeigt neue Studienergebnisse dazu auf.

More than 1 million Syrian refugees have sought asylum in Europe since 2011. Disastrous conditions in their country and an arduous flight increased the risk for the emergence of physical and mental problems, especially in children. We performed a comprehensive medical and psychological examination in 96 Syrian refugee children aged 0–14 years in a German reception camp. Parents were interviewed and answered questions on health, flight and living conditions. In the children, we found most frequently somatic and in particular dental problems, incomplete immunization state and mental disorders. Post-traumatic stress disorder (PTSD) was diagnosed in 30.2 per cent of the children. Fifty-seven per cent of the parents reported somatic complaints; most of them were neurological (e.g. headache) and sleep disorders. Syrian refugee children show a significant rate of PTSD, somatic disorders and incomplete immunization state. The separation from family members during flight and physical complaints of the parents were identified as risk factors for PTSD in the children of our study. Early combined acute and preventive health-care management for children and their parents is indicated.

Extraction of protein from macroalgae, currently defined as “novel food”, is challenging and limited information about the health impacts of these proteins is available. Here, we report on a non-thermal, chemical-free green macroalgae Ulva sp. protein extraction by osmotic shock combined with pulsed electric fields (PEF) followed by hydraulic pressure. The extracted proteins were identified and annotated to allergens using sequence similarity. The allergenicity potential of PEF extracted proteins was compared to osmotic shock extracts and complete Ulva sp. proteome, extracted with the thermochemical method. The PEF extracts contained ‘superoxide dismutase’ (SOD), a known food allergen, osmotic shock extract contained ‘troponin C’, and thermochemical extract contained two additional potential food allergens ‘aldolase A’ and ‘thioredoxin h’. This study shows an importance and the need for deep investigation of algal proteins and protein extraction technology health impacts prior to large-scale release to the market of “novel food” derived proteins.

This study presents the conception and development of a microwave (MW) applicator based on a TM010 cavity and a pulsed MW source, both custom-designed for evaluation of MW disruption of microalgae. The objective is the selective heating of microalgae immersed in their environment. The applicator enables exposing microalgae suspension to MW in continuous flow mode and monitoring the energy absorbed by the sample. The design was based on dielectric characteristics of microalgae in water, but other solvents might be considered. A tuning element ensures efficient MW coupling into the samples whose relative permittivity ranges from 10 to 80. The applicator includes a customized power supply operating a commercial magnetron source in pulse mode. The MW pulses are in the range of multiple kilowatts with adjustable duration in the microseconds range. The applicator enables to reach a power density in the microalgae sample beyond 1010 W/m3. Preliminary proof-of-principle experiments of MW disruption on fresh microalgae biomass Auxenochlorella protothecoides followed by lipid extraction enabled almost complete lipid recovery, while yields were negligible on untreated samples. Total energy consumption was below 4.2 MJ per kg of dry microalgae. Finally, the applicator characteristics are promising for future upscaling and deployment in the industry.

Various applications of the pulsed electric field technology (PEF), spanning from basic research to industrial scale, demand for different high voltage pulse generation concepts. The required pulse duration ranges from nanoseconds to milliseconds. Pulse amplitudes of several 100 V up to some 100 kV have to be generated. This article introduces the basics of pulse generator concepts based on capacitive energy storage. After illustrating the fundamentals of capacitor charging, capacitive pulse forming concepts for various applications will be introduced. Traditional concepts range from single capacitor discharging across transmission line based generators, pulse forming network generators up to multiple stage Marx generators for high energy transfer to material to be treated at high mass flow conditions. Switches are important components of pulse generators. Traditional gas discharge switches and semiconductor switches will be compared for generator implementations in the field of pulsed electric field assisted food processing.

Decisions on the implementation of innovative concepts and technologies into automotive pre-treatment lines are regularly marked by uncertainty regarding trade-offs between economic, ecological and technical aspects. Large amounts of water are consumed during the production in car body painting plants. It is hardly possible to avoid that certain microorganisms (MOs) proliferate in process water and pre-treatment bath tanks. If the bacterial load increases too much, the quality of the paint finish is likely to be impaired. Therefore, chemical biocides are regularly used in pre-treatment and dip coating plants. However, repeated use of the same biocides can lead to resistance of some MOs strains. In addition, stricter legislation is gradually withdrawing certain biocides from the market, making it more difficult to obtain approval for newly designed active substances. Hence, conventional decontamination methods might no longer work in the future. The Pulsed Electric Field (PEF)-Treatment is an innovative technology within the field of pre-treatment lines. By applying high voltage pulses (kV range, µs duration), a high field strength is generated in the process fluid, across the cell membrane of the MOs, which permeabilises the cell membrane. As a result, the MOs lose their cell interior (cytoplasm), and most likely die.

Objective Trauma-focusing treatments such as eye movement desensitization and reprocessing (EMDR) are highly effective in reducing the core symptoms of posttraumatic stress disorder (PTSD), for example, intrusive memories and flashbacks, hyperarousal, and avoidance. Additionally, suffering from PTSD is often accompanied by a broader set of mental comorbidities and complaints such as depression, anxiety disorders or somatization, and disturbed self-regulation abilities. According to the Adaptive Information Processing model (Shapiro, 2001), the processing of pathogenic memories can help not only to reduce the PTSD symptoms but also accompanying complaints additionally. Method In an eye movement desensitization and reprocessing treatment study of 116 patients suffering from PTSD, we targeted the course of additional symptoms and structural skills using the Symptom Checklist-90 SCL-90, Beck Depression Inventory, Toronto Alexithymia Scale-20, and Hannover Selbstregulationsinventar in a pre-post design. Results The results showed that apart from alleviating the PTSD symptoms, exposure-based treatment of pathogenic memories led to a significant decrease in accompanying symptoms such as depression, anxiety, and somatization. Furthermore, patients improved their structural abilities with regard to emotional perception and differentiation, controlling impulses, tolerating frustration, and regulating self-esteem. Conclusion PTSD core symptoms and comorbid complaints are closely interlinked and can be seen as a traumatic-stress cluster, which is accompanied by significant impairments in self- and emotion regulation. Therefore, treatment concepts should explicitly foster emotional processing and structural abilities to target the posttraumatic stress responses entirely. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The challenging demands of pulsed electron beam devices (such as the GESA device) with respect to their pulsed power supply have led to the development of a new semiconductor-based Marx generator. At a maximum output voltage of 120 kV and 600-A pulse current for a duration of up to 100 μS, stepwise arbitrary output waveforms are desired. A fast rise time of the generator is achieved by using fast switching circuitry, low inductance capacitors, and a low inductance stage arrangement. For low jitter triggering of all stages and efficient signal transmission, the generator uses an optical bus system for communication. Due to the inherent dynamic load characteristics of the GESA device, the generator features a fast overcurrent protection scheme. This paper presents selected design aspects of the generator and their validation in a small-scale assembly able of delivering up to 8 kV at 600-A load current.

This study aimed to elucidate changes in volatile, phenolic, and oenological profiles of wines vinified from Pulsed Electric Fields (PEF)-treated and untreated Merlot grapes during bottle storage of up to 150, 90, and 56 days at 4 &deg, C, 25 &deg, C, and 45 &deg, C, respectively, through chemometrics technique. Wines produced from untreated grapes and those PEF-treated at four different processing conditions (electric field strength 33.1 and 41.5 kV/cm and energy inputs between 16.5 and 49.4 kJ/kg) were used for the bottle storage study. Results showed that hydroxycinnamic and hydroxybenzoic acids in all stored wines, regardless vinified from untreated and PEF-treated grapes, increased as a function of time and temperature, while anthocyanins and selected esters (e.g., ethyl butanoate) decreased. Extreme storage temperature, at 45 &deg, C particularly, resulted in a higher amount of linalool-3, 7-oxide in all stored wines. After prolonged storage, all wines produced from grapes PEF-treated with four different processing conditions were shown to favor high retention of phenolics after storage but induced faster reduction of anthocyanins when compared to wines produced from untreated grapes. Moreover, some volatiles in wines vinified using PEF-treated grapes, such as citronellol and 2-phenylethyl acetate, were found to be less susceptible towards degradation during prolonged storage. Production of furans was generally lower in most stored wines, particularly those produced from PEF-treated grapes at higher energy inputs (&gt, 47 kJ/kg). Overall, PEF pre-treatment on grapes may improve storage and temperature stability of the obtained wines.

With decreasing available land and fresh-water resources, the oceans become attractive alternatives for the production of valuable biomass, comparable to terrestrial crops. Seaweed cultivation for food, chemicals, and fuels is already under intensive development, yet efficient technologies for separation of major components are still missing. We report a food-grade process for the extraction of proteins from a green macroalga, Ulva sp., using high-voltage pulsed electric field (PEF) cell-membrane permeabilization, coupled with mechanical pressing to separate liquid and solid phases. We showed that a PEF treatment, at 247 kJ/kg fresh Ulva, delivered through 50 pulses of 50 kV, applied at a 70.3 mm electrode gap on the 140 g fresh weight of Ulva sp., resulted in an ∼7-fold increase in the total protein extraction yield compared to extraction by osmotic shock. The PEF extract of 20% protein content showed 10–20 times higher antioxidant capacity than β-Lactoglobulin (β-Lg), bovine serum albumin, and potato pr...

A new modular pulsed-power source with fast rise time and step-wise arbitrary output waveform generation is currently under development to drive the Gepulste Elektronenstrahlanlage device investigated at the Institute for Pulsed Power and Microwave Technology (IHM). Acknowledging the complex design procedures necessary to set up a modular pulsed-power source for voltages of up to 120 kV, this paper focuses on the circuit design for a single stage and its validation prior to the generator assembly. Using a semiconductor-based Marx generator topology, the stages are designed to have an output voltage of 1 kV with a pulse current of up to 600 A. When connected to an ohmic load, the measured current rise times are in the order of 46 ns resulting in the current rise rates of up to 10 kA/ $\mu \text{s}$ using the commercial devices. The step-wise arbitrary output waveform is created by generating the switching commands on the stage using a microprocessor and a fast optical synchronization unit. Effective stage shielding is verified by operating the stage in a 100-kV, 2.5-kA electromagnetic interference test bed. This paper presents the design considerations and the corresponding measurements.

Among all biomass constituents, the ashes are major hurdles for biomass processing. Ashes currently have low market value and can make a non-negligible fraction of the biomass dry weight significantly impacting its further processing by degrading equipment, lowering process yield, inhibiting reactions and decreasing products qualities. However, most of the current treatments for deashing biomass are of poor efficiency or industrial relevance. This work is the first report on the use of Pulsed Electric Field (PEF) to enhance deashing of biomass from a high ash content green marine macroalga, Ulva sp., using hydraulic pressing. By inducing cell permeabilization of the fresh biomass, PEF was able to enhance the ash extraction from 18.4% (non-treated control) to 37.4% of the total ash content in average, significantly enhancing the extraction of five of the major ash elements (K, Mg, Na, P and S) compared to pressing alone.

Zusammenfassung Hintergrund Zielsetzung war die Weiterentwicklung eines Screeninginstruments zur Diagnostik der komplexen Posttraumatischen Belastungsstörung (kPTBS). Das Screening zur kPTBS (SkPTBS) erfasst a) potenziell traumatische Erfahrungen, b) Risiko- und Schutzfaktoren sowie c) Symptome der kPTBS. Das SkPTBS von Dorr et al. (2016) und wurde entsprechend dem aktuellen ICD-Diagnosevorschlag zur kPTBS überarbeitet wird hier in seiner Revisionsfassung validiert. Methode Folgen von potenziellen Traumatisierungen wurden bei Patienten der psychosomatischen Rehabilitation und bei Patienten in einer traumatherapeutischen universitären Institutsambulanz erfasst. Die Patienten füllten das Screening zu Beginn ihrer Behandlung aus (N=525, davon n=359 Rehabilitanden und n=157 Patienten in der Ambulanz; mittleres Alter 48 Jahre, 68% Frauen). Die gestellte Diagnose kPTBS sowie Ergebnisse des SKID und des Interviews zur komplexen PTBS (IkPTBS) dienten als primäre Validierungskriterien. Ergebnisse 88 Patienten (17%) wurden mit kPTBS diagnostiziert. Die Trennschärfe der metrischen Items des SkPTBS war zufriedenstellend. Die interne Konsistenz betrug Cronbachs α=0.91. Die eindimensionale faktorielle Struktur der ersten Auflage des SkPTBS konnte bestätigt werden. Der SkPTBS sagt zuverlässig die Diagnose kPTBS vorher. Sein Gesamtwert korrelierte moderat mit posttraumatischen (IES-15), dissoziativen (DES-Taxon) und depressiven Symptomen (BDI-II, PHQ-9) sowie der globalen Symptombelastung (SCL-90-R). Normen für verschiedene Alters-, Diagnose- und Settinggruppen wurden erstellt. Schlussfolgerung Mit dem revidierten SkPTBS liegt ein praktikables und ökonomisches Instrument zur Erfassung von Risikopatienten für kPTBS vor. Es wird frei zur Verfügung gestellt und kann zur Diagnostik und Therapieplanung genutzt werden.

Merlot grapes have high proportion of anthocyanins protected inside cell vacuoles but the thick skins limit their extractability. This study investigated the effect of a continuous Pulsed Electric Fields (PEF at 500 kg/h) system operated at high-intensity electric field strengths (>30 kV/cm) combined with energy inputs ranging from 4.7 to 49.4 kJ/L on anthocyanins extraction and colour intensity of Merlot musts during a 4-day cold maceration. Considerable amount of anthocyanins with different chemical features was extracted instantaneously due to PEF treatment at high-intensity electric field strength, in which the amount was higher than those extracted from non PEF-treated Merlot followed by 4 days maceration. During maceration, malvidin derivatives were the most significant anthocyanins contributing (r > 0.71, p < 0.05) to the changes in colour intensity of PEF-treated musts. This finding suggests that malvidin derivatives are good indicators to predict the efficiency of specific PEF process condition in reducing the length of cold maceration while achieving maximum colour intensity in the musts. This research is important either for the wine and beverage industries. Industrial relevance text: Previous PEF studies mainly investigated the effect of low-intensity electric field strength (30 kV/cm) using Marx generator for the first time in the literature. Marx generator has a tendency to produce high-intensity electric field strength, up to 80 kV/cm, but the impact on plant materials intended for food application are not well studied. In this study, Merlot grapes were continuously treated with PEF at high-intensity electric field strength at a flow rate of 500 kg/h while many previous studies conducted trial at approximately 100–200 kg/h in conjunction with low-intensity electric field strength (200 kg/h) at the commercial scale. In this study, we have successfully showed that high-intensity electric field strengths (33.1 and 41.5 kV/cm) of PEF were efficient (i.e. instantaneous extraction) in extracting all types of anthocyanins with different chemical features from the thick-grape skins of Merlot. Therefore, grape juice with more elaborated anthocyanin composition and intense colour was produced at a large scale immediately after PEF. The extracted anthocyanins were found to be stable over time after PEF treatment in which the issues on anthocyanin stability and colour development have never been considered in many previous studies, but are important quality aspects that beverage industry desired.

Considering to power converter systems, the characterization and modeling of wide band gap semiconductors at switching frequencies in the MHz area are very important. In the following a method is presented in order to characterize and build up a non-linear model for a diode at frequencies up to 500 MHz.

A 149-stage Marx-type pulse generator is currently being tested. The generator delivers substantially rectangular pulses with a voltage amplitude of up to 120 kV at a rise time of approximately 100 ns into a resistive load. The generator has been designed for a peak current of 600 A. In order to generate rectangular pulses up to a pulse length of 100 µs with a moderate stage capacitance the droop of the output voltage can be compensated by subsequently activating additional stages.

An electroporation reactor comprises a treatment area for the application of pulsed electric fields to biological tissue. A homogeneous opening of cells within the whole treatment area can be achieved by applying a homogeneously distributed electric field of sufficient field strength and also sufficient total energy to the tissue. However, such an ideal homogeneous electric field can be achieved in a closed volume only. Inlet and outlet of an electroporation reactor designed for a continuous flow of material involve inhomogeneities of the electric field. Such inhomogeneities cause additional losses due to current flowing also in low-field regions, which are ineffective for electroporation. Depending on the design of the electrode system also the electric field in the center of the electroporation area might be to some extend inhomogeneous. So the specific energy required for the treatment of a defined volume of material depends on the electrode design. When comparing this specific energy to the specific energy required in the ideal case of a treatment area with a homogeneous field, a factor describing the energy efficiency of the electrode design can be defined. The paper describes this approach in more detail.

Macroalgae are potential feedstock for biorefineries. However, integration of macroalgae into biorefinery network requires new processing technologies that will lead to energy efficient and zero waste conversion of macroalgae biomass into food, chemicals and fuels. Here we report on the selective extraction of proteins from green macroalgae from Ulva genus by electroporation with energy efficient pulsed electric field (PEF) process. We show that application of 75 pulses with an average electric field strength of 2.964 ± 0.007 kV cm − 1 , and pulse duration 5.70 ± 0.30 μs, delivered at approximately 0.5 Hz, combined with hydraulic pressing of the treated samples for 5 min with force of 45 daN cm − 2 led to the total protein concentration of 59.13 ± 3.82 μg mL − 1 in the extracted juice. The final temperature of the extracted juice was 35.50 ± 2.02 °C. The energy consumption of the process is 251 ± 3 kWh kg − 1 of protein. We show that PEF process is selective and its extraction efficiency and damage are protein specific.

In industrial applications electroporation-assisted extraction processes are about to replace conventional extraction. The devices for PEF treatment are designed specifically to the needs of each application. However, the design process of the electrode system and field geometry inside a PEF treatment reactor consists in general of similar steps to scale from laboratory-scale experiments done in batches up to a large-scale device operating continuously. Thereby, the electrode system might be tailored specifically to an application. In contrast to a closed PEF treatment reactor for batch processing with homogeneous electric field distribution an open electrode system with inlet and outlet section involves additional losses due to inhomogeneities of the electric field geometry. The article describes a novel approach to scale up an electrode design and to define for it an optimum operating voltage with respect to high energy efficiency in a straight-forward design process based on scaling laws. Moreover, a new method is presented to derive an efficiency factor for any given electrode geometry. It is based on a comparison of the specific power required for operating the electrode system under investigation inside a PEF treatment reactor to the specific power for a cubical PEF treatment chamber with homogeneous field distribution. Examples are given based on the design of a PEF treatment reactor for crushed grapes. Industrial relevance PEF treatment devices for electroporation-assisted extraction are becoming increasingly interesting for industrial applications due to the benefits they offer with respect to product quality and energy savings. Challenges when transferring pulse parameters as obtained from laboratory scale experiments to industrial scale devices arise from electric field inhomogeneities in PEF treatment reactors designed for continuous flow. This work therefore presents a novel method to evaluate the electric field distribution inside the PEF treatment reactor with respect to energy efficiency. The derived scaling laws enable an energy-efficient up-scaling of any given electrode profile towards large scale for products such as sugar beets, potatoes, apples or crushed grapes in a straight-forward design process.

Background: Due to advances in the diagnosis and treatment of congenital heart disease (CHD), the number of adults who are surviving with congenital heart disease (ACHD) is constantly growing. Until recently, the psychological effects of CHD had been widely neglected. Current research provides evidence for an increased risk of emotional distress in ACHD. The concept of illness identity attempts to explain how patients experience and integrate their CHD into their identities. The present study investigated illness identity in relation to clinical parameters and psychological functioning. Psychometric properties of the German version of the Illness Identity Questionnaire (IIQD) were examined. Methods: Self-reported measures on illness identity and psychological functioning (HADS-D) were assessed in a representative sample of 229 ACHD (38 &plusmn, 12.5 (18&minus, 73) years, 45% female) at the German Heart Center Munich. Descriptive analyses and multiple regression models were conducted. Confirmatory factor analysis was performed to validate the IIQD. Results: The IIQD demonstrated good reliability. The originally-postulated four-factor structure could not be replicated. Anatomic disease complexity and functional status significantly influenced illness identity. Illness identity accounted for unique variances in depression and anxiety: Maladaptive illness identity states (i.e., , engulfment and rejection) were associated with higher emotional distress, whereas adaptive illness (i.e., , acceptance and enrichment) identity states were linked to lower emotional distress. Conclusions: Illness Identity emerged as a predictor of emotional distress in ACHD. Findings raise the possibility that interventions designed to target a patient&rsquo, s illness identity may improve psychological well-being and cardiac outcomes in ACHD.

Background: Currently, there is controversy on the possible benefits of dual-attention tasks during eye movement desensitization and reprocessing (EMDR) for patients with posttraumatic stress disorder (PTSD). Methods: A total of 139 consecutive patients (including 85 females) suffering from PTSD were allocated randomly among 3 different treatment conditions: exposure with eyes moving while fixating on the therapist's moving hand (EM), exposure with eyes fixating on the therapist's nonmoving hand (EF), and exposure without explicit visual focus of attention as control condition (EC). Except for the variation in stimulation, treatment strictly followed the standard EMDR manual. Symptom changes from pre- to posttreatment were measured with the Clinician-Administered PTSD Scale (CAPS) by an investigator blinded to treatment allocation. Results: In total, 116 patients completed the treatment, with an average of 4.6 sessions applied. Intention-to-treat analysis revealed a significant improvement in PTSD symptoms with a high overall effect size (Cohen's d = 1.96, 95% CI: 1.67-2.24) and a high remission rate of PTSD diagnosis (79.8%). In comparison to the control condition, EM and EF were associated with significantly larger pre-post symptom decrease (ΔCAPS: EM = 35.8, EF = 40.5, EC = 31.0) and significantly larger effect sizes (EM: d = 2.06, 95% CI: 1.55-2.57, EF: d = 2.58, 95% CI: 2.01-3.11, EC: d = 1.44, 95% CI: 0.97-1.91). No significant differences in symptom decrease and effect size were found between EM and EF. Conclusions: Exposure in combination with an explicit external focus of attention leads to larger PTSD symptom reduction than exposure alone. Eye movements have no advantage compared to visually fixating on a nonmoving hand.

We show that the solutions to the Cauchy problem for a wave equation with critical exponential nonlinearity in 2 space dimensions scatter for arbitrary smooth, compactly supported initial data.

The aim was to develop further a screening instrument for complex posttraumatic stress disorder (cPTSD). The screening for cPTSD (SkPTBS) tests a) potential traumatic experiences, b) influential features and risk factors, and c) symptoms of cPTSD. The SkPTBS by Dorr et al. (2016) was revised according to the current ICD-11 criteria set proposal for cPTSD and is explored in its revised edition.Impacts of long-lasting interpersonal trauma were tested in inpatients of psychosomatic rehabilitation and in patients consulting a university outpatient center for trauma therapy. Patients filled out the screening at the beginning of their treatment (N=525, among these n=359 rehabilitation patients and n=157 in the outpatient center, mean age 48 years, 68% female). Later diagnosed complex PTSD as well as results of the SCID and the Interview for complex PTSD (IkPTBS) served as primary validation criteria.88 patients (17%) were diagnosed with complex PTSD. Metric SkPTBS items were selective and the scale had an internal reliability of Cronbachs α=0.91. The one-dimensional factor structure was replicated. SkPTBS correlated moderately with posttraumatic symptoms measured by IES-15, with dissociative symptoms (DES-Taxon), depressive symptoms (in BDI-II, PHQ-9), and global symptom severity (in SCL-90-R). Finally, norms for different groups of age, diagnosis and treatment settings were developed.The SkPTBS revision is a feasible and brief instrument to identify patients at risk for complex PTSD. It is provided freely and can be applied for diagnostic and therapeutic purposes.Zielsetzung war die Weiterentwicklung eines Screeninginstruments zur Diagnostik der komplexen Posttraumatischen Belastungsstörung (kPTBS). Das Screening zur kPTBS (SkPTBS) erfasst a) potenziell traumatische Erfahrungen, b) Risiko- und Schutzfaktoren sowie c) Symptome der kPTBS. Das SkPTBS von Dorr et al. (2016) und wurde entsprechend dem aktuellen ICD-Diagnosevorschlag zur kPTBS überarbeitet wird hier in seiner Revisionsfassung validiert.Folgen von potenziellen Traumatisierungen wurden bei Patienten der psychosomatischen Rehabilitation und bei Patienten in einer traumatherapeutischen universitären Institutsambulanz erfasst. Die Patienten füllten das Screening zu Beginn ihrer Behandlung aus (N=525, davon n=359 Rehabilitanden und n=157 Patienten in der Ambulanz; mittleres Alter 48 Jahre, 68% Frauen). Die gestellte Diagnose kPTBS sowie Ergebnisse des SKID und des Interviews zur komplexen PTBS (IkPTBS) dienten als primäre Validierungskriterien.88 Patienten (17%) wurden mit kPTBS diagnostiziert. Die Trennschärfe der metrischen Items des SkPTBS war zufriedenstellend. Die interne Konsistenz betrug Cronbachs α=0.91. Die eindimensionale faktorielle Struktur der ersten Auflage des SkPTBS konnte bestätigt werden. Der SkPTBS sagt zuverlässig die Diagnose kPTBS vorher. Sein Gesamtwert korrelierte moderat mit posttraumatischen (IES-15), dissoziativen (DES-Taxon) und depressiven Symptomen (BDI-II, PHQ-9) sowie der globalen Symptombelastung (SCL-90-R). Normen für verschiedene Alters-, Diagnose- und Settinggruppen wurden erstellt.Mit dem revidierten SkPTBS liegt ein praktikables und ökonomisches Instrument zur Erfassung von Risikopatienten für kPTBS vor. Es wird frei zur Verfügung gestellt und kann zur Diagnostik und Therapieplanung genutzt werden.

Patients suffering from dissociative disorders are characterized by an avoidance of aversive stimuli. This includes the avoidance of emotions and, in particular, bodily perceptions. In the present pilot study, we explored the potential interoceptive accuracy deficit of patients suffering from dissociative disorders in a heartbeat detection task. Moreover, we investigated the impact of facial mirror-confrontation on interoceptive accuracy and the potential association between cardiac vagal tone derived from heart rate variability and interoceptive accuracy. Eighteen patients suffering from dissociative disorders and 18 healthy controls were assessed with the Mental Tracking Paradigm by Schandry for heartbeat detection at baseline and after confrontations exposing them to their own faces in a mirror (2 min each, accompanied by a negative or positive cognition). During the experiment, cardiac vagal tone was assessed. We used Pearson correlations to calculate potential associations between cardiac vagal tone and interoceptive accuracy. Patients performed significantly worse than the healthy controls in the heartbeat detection task at baseline. They displayed no significant increase in interoceptive accuracy following facial mirror-confrontation. In the patient group, higher cardiac vagal tone was associated with a more precise heartbeat detection performance. Dissociative disorder patients showed a considerable deficit in interoceptive accuracy. Our results fit with the assumption that highly dissociative patients tend to tune out the perceiving of bodily signals. To the extent that bodily signal perception may play a causal role in these disorders, therapeutic approaches enhancing interoceptive accuracy and cardiac vagal tone may be considered important and practicable steps to improve the therapy outcome of this patient group.