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Background Traumatic experiences can lead to posttraumatic stress disorder (PTSD). For young children, even minor, inconspicuous looking events can lead to posttraumatic stress symptoms. Trauma-focused treatment with Eye Movement Desensitization and Reprocessing (EMDR) offers children an age-adapted intervention to help them successfully process traumatic experiences. So far, there has been a lack of well evaluated trauma-focused treatments for young children. Methods These case series examine the effectiveness of a short-term treatment with EMDR therapy for children showing PTSD symptoms after experiencing a single incident induced trauma. Five children between 5 and 10 years of age who developed PTSD after a single incident trauma received a manualized EMDR treatment for 6 weeks (mean number of sessions: seven including a mean number of EMDR sessions: 3.4). Posttraumatic stress symptoms were assessed prior to treatment, following treatment and at a 3-month follow-up with standardized instruments for caregivers and children. Results PTSD symptoms decreased for all children after completing the treatment from clinical to non-clinical level. Reductions in vegetative hyperarousal, fears and clinging behaviour were achieved. Furthermore, reductions in the parental stress levels, as well as a recovery of everyday routine and everyday stability were observed. Conclusion Short-term EMDR treatment appears to be a promising treatment for single incident trauma in young children providing a potentially successful quick and safe psychological treatment for children. Results contribute to the knowledge of feasibility and acceptability of short-term, trauma-focused treatments of children with EMDR. Replication of the results of these case series in larger samples using a randomized controlled design is warranted.

Background: fn individuals with mental disorders, the COVID-19 pandemic involves acute distress and the risk of long-term effects. A model is required that is able to capture bio-psychosocial pandemic stress loads and can be drawn upon to institute psychotherapeutic rehabilitative treatment. Method: During the first lockdown in Germany, we developed and applied the FACT-19 model parallel to established psychometric tests in psychosomatic and psychotraumatologic care. Outcomes: FACT-19 captures the consequences of the pandemic for individual patients/rehabilitated. These include existing (e. g. general medical) risk factors, acute pandemic stress loads {deadly danger, existential fear, isolation, alarm dynamics) and environmental facilitators and barriers. An example case illustrates the institution of a case strategy. Conclusion: The FACT-19 model is a suggested approach for measuring the biopsychosocial effects of pandemics, preparing therapeutic interventions, and pooling assessments of the need for rehabilitative treatment over and above the routine psychometric tests. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Abstract (German) Hintergrund: Die COVI D-19-Pandem ie fuhrt bei Menschen mit psychischen Storungen zu Akutbelastungen und Risiken von Langzeitfolgen. Wir benotigen ein geeignetes Modell zur bio-psycho-sozialen Erfassung der pandemischen Stressbelastung, um psychotherapeutische und rehabilitative Leistungen einzuleiten. Methode: Zeitgleich mit dem ersten Lockdown haben wir das FACT-19-Modell entwickelt und parallel zur klinischen und psychometrischen symptomerfassung in der psychotraumatologischen und psychosomatischen Versorgung angewendet. Ergebnisse: Der FACT-19 erfasst die individuellen pandemiebedingten Folgen inklusive bestehender Risikofaktoren (z.B. allgemeinmedizinisch), akuter pandemischer Stressbelastung (letale Bedrohung, Existenzangst, Isolation, Befurchtungsdynamik) sowie um weit bezogener Forderund Barrierefaktoren. Ein Fallbeispiel zeigt die Ableitung einer Fallkonzeption. Schlussfolgerung: Das FACT-19-Modell ist ein Losungsvorschlag zur Erfassung biopsycho- sozialer pandemischer Auswirkungen, Vorbereitung therapeutischer Interventionen und Bundelung der Bedarfsfeststellung rehabilitativer Leistungen uber gangige psychometrische symptomskalen hinaus. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Psychotherapie ist die Methode der Wahl bei Posttraumatischer Belastungsstorung (PTBS), dennoch kommt eine Psychopharmakotherapie bei PTBS in der klinischen Praxis haufig zum Einsatz. Bei der Uberarbeitung der S3-Leitlinie Posttraumatische Belastungsstorung erfolgte zu dieser Frage die Sichtung internationaler Leitlinien sowie von Meta­analysen der letzten funf Jahre. Internationale Leitlinien und neuere Meta­analysen kommen ubereinstimmend zu dem Schluss, dass Pharmakotherapie geringere Effektstarken zeigt als traumafokussierte Psychotherapie. Eine Psychopharmakotherapie soll deshalb weder als alleinige noch als primare Therapie der PTBS eingesetzt werden. Einige Psychopharmaka – wie Sertralin, Paroxetin und Venlafaxin – zeigten jedoch moderate Effekte. Benzodiazepine sollten auser bei Suizidalitat bei PTBS oder kurz zuruckliegendem Trauma als kontraindiziert angesehen werden.

Many traumatised individuals suffering from deployment related PTSD report severe problems in their relationships. Up until now, the therapeutic interventions used by the German Armed Forces have rarely targeted these problems through the integration of partners. For this reason, a Program designed specifically for couples was developed. In this prospective study equine-assisted psychotherapy was applied to soldiers and their spouses. The study population consisted of n = 36 couples, divided in n = 20 therapy group with a inpatient equine-assisted intervention and a 16-couples control group. After the intervention, numerous significant improvements occurred in the therapy group in the areas of current, somatic and communication problems, depressive symptoms and partnership quality but not in the control group. PTSD was reduced significantly on the sub-scale associated with negative thoughts. These results show that the intervention is an effective way to improve partnership quality and reduce the stressors that the partners of afflicted service members face.

Das medizinische Versorgungssystem in Deutschland war auf die Behandlung von Patienten mit Migrationshintergrund nicht eingestellt und wurde durch die hohe Zahl gefluchteter Menschen mit einer Traumafolgestorung uberrascht. Die interkulturelle Behandlung stellt den Regelfall dar. Allerdings fehlen noch immer qualifizierte Sprach- und Kulturmittler sowie interkulturell kompetente Behandler in ausreichender Zahl.

Background The aim of this study was to investigate whether bullying among students is associated with symptoms of posttraumatic stress disorder (PTSD), and whether associations are comparable to other traumatic events leading to PTSD. Methods Data were collected from 219 German children and adolescents: 150 students from grade six to ten and 69 patients from an outpatient clinic for PTSD as a comparison group. Symptoms of PTSD were assessed using the Children’s Revised Impact of Event Scale (CRIES) and the Posttraumatic Symptom Scale (PTSS-10). A 2 × 5 factorial analysis of variance (ANOVA) with the factors gender (male, female) and group (control, conflict, moderate bullying, severe bullying, traumatized) was used to test for significant differences in reported PTSD symptoms. Results Results showed that 69 (46.0%) students from the school sample had experienced bullying, 43 (28.7%) in a moderate and 26 (17.3%) in a severe way. About 50% of the severe bullying group reached the critical cut-off point for suspected PTSD. While the scores for symptoms of PTSD were significantly higher in bullied versus non-bullied students, no significant differences were found between patients from the PTSD clinic and students who experienced severe bullying. Conclusions Our findings suggest that bullying at school is highly associated with symptoms of PTSD. Thus, prevention of bullying in school may reduce traumatic experiences and consequent PTSD development.

Fur posttraumatische Belastungsstorungen (PTBS) wurde im deutschen Sprachraum erst Ende des letzten Jahrhunderts die Notwendigkeit einer spezifischen und professionellen Hilfe erkannt. Dabei hat diese Storung fur viele Berufsgruppen und Institutionen eine grose Bedeutung. Fruher wurde die PTBS primar als Angststorung verstanden; heute geht man insbesondere von Storungen des Gedachtnisses aus. Im Folgenden beschaftigen wir uns mit den definierten Symptomkategorien der diagnostischen Manuale, mit der neurobiologischen Modellbildung sowie mit den Behandlungsansatzen der PTBS.

Fragestellung: Alpträume können bei Kindern, wie auch bei Erwachsenen, als Symptom für eine Traumatisierung gelten. Daher ist zu vermuten, dass bei traumatisierten Kindern und Jugendlichen die Alptraumbelastung höher ist als bei nicht traumatisierten Kindern und Jugendlichen. Methodik: Insgesamt nahmen 38 traumatisierte und 40 nicht traumatisierte Kinder und Jugendliche an der Untersuchung teil. Anhand eines Fragebogens wurde die Alptraumbelastung (u. a. die Alptraumhäufigkeit und die empfundene Intensität) erfasst. Ergebnisse: Die Ergebnisse zeigen, dass traumatisierte Kinder und Jugendliche signifikant mehr Alpträume berichten (9.7 Alpträume pro Monat) und diese als intensiver und furchtauslösender bewerten als die Teilnehmer der Kontrollgruppe (1.7 Alpträume pro Monat). Die Anzahl der Alpträume bei traumatisierten Mädchen ist im Vergleich zu der Anzahl der Alpträume bei traumatisierten Jungen doppelt so hoch. Zudem geben traumatisierte Kinder und Jugendliche signifikant häufiger an, Angst vor einer Traumwiederholung zu haben, sich während des Alptraums hilflos und sich am Tag durch den Traum nachhaltig beeinträchtigt zu fühlen. Schlussfolgerung: Patienten mit einer Traumatisierung erleben in ihren Träumen mehr Gewalt und Lebensbedrohung. Eine erhöhte Alptraumbelastung ist damit auch bei Kindern und Jugendlichen ein Merkmal einer vorausgegangenen Traumatisierung.

Objective: Over the past years, 35 trauma outpatient units have been established in accordance with the Crime Victims' Compensation Act in the federal state of North Rhine-Westphalia (Germany) for both children and adolescents as well as for adults. They are operated by the social welfare authorities and, since 2008, by the regional authorities of Westphalia-Lippe and Rhineland. They enable victims to receive qualified psychotraumatological help within the first few days after suffering violence. Since trauma units have now been set up across most parts of this federal state, the time has come to assess the effectiveness of their acute care provision to victims of violence. Methods: In 2007, on the order of the Ministry of Labour, Health and Social Affairs of the federal state of North Rhine-Westphalia, trauma outpatient units were subjected to scientific evaluation. In 17 trauma outpatient units, a data assessment protocol was officially implemented that included repeat measurements (immediately before the initial contact, after completion of intervention, at follow-up six months after intervention) of traumatized subjects aged 14 and older. Socio-demographic data were gathered, and the scores of the Impact of Event Scale - Revised (IES-R), the Symptom Checkliste-27 (SCL-27), the simplified Beck Depressions Inventory (BDI-V), the Global Assessment of Functioning Scale (GAF) as well as the Cologne Risk Index (CRI) (expert rating) were collected. Results: Nearly three-fourths (65.9 %) of the traumatic experiences of the 211 patients investigated can be characterized as type-1 traumatisation. 31.8 % of patients were victims of crimes involving violations of the right to sexual self-determination (94.0 % of sexual offences being committed against girls and women). Crimes against physical integrity, which according to crime statistics are the most frequent of crimes against individuals (88.8 %, 34.8 % females), were suffered by 36.0 % of all patients of the trauma outpatient units (63.2 % being females). In 57.1 % of the victims, the interval between the traumatic event and initial intervention was less than a month. In 51.7 % (n = 109), suspicion of PTBS (F43.1) was raised at the initial presentation. The average of all instruments yielded an effect size of d = 1.04 (SD = 0.28) in a pre-post comparison. Pair-wise comparison showed highly significant differences in averages between pre and post (that is, between initial and follow-up measurements) in the sense of marked symptom reduction for all scales. Conclusions: The services of the trauma outpatient units are utilized in a timely and targeted fashion. The calculated effects show that the trauma outpatient units offer highly effective services to crime victims seeking help there. Language: de

Die Autoren gehen der Frage nach,welche Kriterien die tiefenpsychologisch fundierte (TP) und analytische Psychotherapie (AP) erfullen muss, um eine Lege-artis-Behandlung traumatisierter Patienten auf dem gegenwartigen Forschungsstand zu gewahrleisten. Spezielle Anforderungen und Modifikationen der beiden Richtlinienverfahren ergeben sich aus dem Erkenntnisstand interdisziplinarer Forschungsansatze, in dem psychobiologische Forschungsergebnisse und Modellvorstellungen mit Konzepten und Ergebnissen empirischer Psychotherapieforschung konvergieren.Zur Zeit der Entwicklung von TP/AP war dieser interdisziplinare Ansatz noch auser Reichweite. Inzwischen liegen fur die TP/AP elaborierte traumaspezifische Konzepte vor und weisen eine gunstige empirische Forschungslage auf.Die Anpassung der TP/AP an die Erfordernisse von Traumapatienten sollte nach Ansicht der Autoren nach dem Motto verfahren: “Soviel Reform wie notig, soviel Tradition wie moglich”,um wertvolle und bewahrte Behandlungsprinzipien der beiden Verfahren nicht zu gefahrden.

After disasters, the individual health and well-being of first responders and affected population are affected for years. Therefore, psychosocial help is needed. Although most victims recover on their own, a minority of survivors, members of rescue teams, or relatives develop long-term, disaster-related psychic disorders, such as post-traumatic stress disorder (PTSD). This subgroup especially should receive timely and appropriate psychosocial help. Many European countries offer post-disaster psychosocial care from a variety of caregivers (i.e., professionals and volunteers, non-governmental organizations, church or commercial organizations). Therefore, European standards for providing post-disaster psychosocial support currently is required. This article describes the project European Guideline for Target Group-Oriented Psychosocial Aftercare—Implementation, supported by the European Commission.

Nightmares may be seen as a symptom of traumatization in both children and adults. Nightmares are assumed to be more frequent and more distressing among traumatized children and adolescents than among those without trauma. A total of 38 traumatized and 40 nontraumatized children and adolescents were surveyed.Nightmare-induced stress was measured with a questionnaire comprised of nine items (some of which concerned nightmare frequency and perceived intensity).Traumatized children and adolescents overall report a significantly higher number of nightmares, which they perceive in a more intense and frightening way than their control group counterparts. Traumatized children and adolescents reported an average of 9.7 nightmares per month compared to 1.7 in nontraumatized participants. The number of nightmares in traumatized girls was twice that in traumatized boys.Traumatized children and adolescents report fears of dream repetitions as well as feelings of helplessness during the nightmares and are thus influenced during the daytime significantly more often. Traumatized patients have more life-threatening and violent dreams. An increased frequency of nightmare and distress is also a specific feature in traumatized children and adolescents.Fragestellung: Alpträume können bei Kindern, wie auch bei Erwachsenen, als Symptom für eine Traumatisierung gelten. Daher ist zu vermuten, dass bei traumatisierten Kindern und Jugendlichen die Alptraumbelastung höher ist als bei nicht traumatisierten Kindern und Jugendlichen. Methodik: Insgesamt nahmen 38 traumatisierte und 40 nicht traumatisierte Kinder und Jugendliche an der Untersuchung teil. Anhand eines Fragebogens wurde die Alptraumbelastung (u. a. die Alptraumhäufigkeit und die empfundene Intensität) erfasst. Ergebnisse: Die Ergebnisse zeigen, dass traumatisierte Kinder und Jugendliche signifikant mehr Alpträume berichten (9.7 Alpträume pro Monat) und diese als intensiver und furchtauslösender bewerten als die Teilnehmer der Kontrollgruppe (1.7 Alpträume pro Monat). Die Anzahl der Alpträume bei traumatisierten Mädchen ist im Vergleich zu der Anzahl der Alpträume bei traumatisierten Jungen doppelt so hoch. Zudem geben traumatisierte Kinder und Jugendliche signifikant häufiger an, Angst vor einer Traumwiederholung zu haben, sich während des Alptraums hilflos und sich am Tag durch den Traum nachhaltig beeinträchtigt zu fühlen. Schlussfolgerung: Patienten mit einer Traumatisierung erleben in ihren Träumen mehr Gewalt und Lebensbedrohung. Eine erhöhte Alptraumbelastung ist damit auch bei Kindern und Jugendlichen ein Merkmal einer vorausgegangenen Traumatisierung.

Over the past years, 35 trauma outpatient units have been established in accordance with the Crime Victims' Compensation Act in the federal state of North Rhine-Westphalia (Germany) for both children and adolescents as well as for adults. They are operated by the social welfare authorities and, since 2008, by the regional authorities of Westphalia-Lippe and Rhineland. They enable victims to receive qualified psychotraumatological help within the first few days after suffering violence. Since trauma units have now been set up across most parts of this federal state, the time has come to assess the effectiveness of their acute care provision to victims of violence.In 2007, on the order of the Ministry of Labour, Health and Social Affairs of the federal state of North Rhine-Westphalia, trauma outpatient units were subjected to scientific evaluation. In 17 trauma outpatient units, a data assessment protocol was officially implemented that included repeat measurements (immediately before the initial contact, after completion of intervention, at follow-up six months after intervention) of traumatized subjects aged 14 and older. Socio-demographic data were gathered, and the scores of the Impact of Event Scale - Revised (IES-R), the Symptom Checkliste-27 (SCL-27), the simplified Beck Depressions Inventory (BDI-V), the Global Assessment of Functioning Scale (GAF) as well as the Cologne Risk Index (CRI) (expert rating) were collected.Nearly three-fourths (65.9 %) of the traumatic experiences of the 211 patients investigated can be characterized as type-1 traumatisation. 31.8 % of patients were victims of crimes involving violations of the right to sexual self-determination (94.0 % of sexual offences being committed against girls and women). Crimes against physical integrity, which according to crime statistics are the most frequent of crimes against individuals (88.8 %, 34.8 % females), were suffered by 36.0 % of all patients of the trauma outpatient units (63.2 % being females). In 57.1 % of the victims, the interval between the traumatic event and initial intervention was less than a month. In 51.7 % (n = 109), suspicion of PTBS (F43.1) was raised at the initial presentation. The average of all instruments yielded an effect size of d = 1.04 (SD = 0.28) in a pre-post comparison. Pair-wise comparison showed highly significant differences in averages between pre and post (that is, between initial and follow-up measurements) in the sense of marked symptom reduction for all scales.The services of the trauma outpatient units are utilized in a timely and targeted fashion. The calculated effects show that the trauma outpatient units offer highly effective services to crime victims seeking help there.

Als junge Wissenschaft uberwindet die Psychotraumatologie die klassische Aufspaltung psychischer und neurobiologischer Prozesse und beschreibt sie als dynamisches Bedingungsgefuge. Vor diesem Hintergrund werden folgende neurobiologischen Mechanismen diskutiert, die zur Verfestigung der Posttraumatischen Belastungsstorung (PTBS) beitragen. Hierzu gehoren: ■ Lateralisation der Blutzirkulation im Flash-Back. Hiermit werden Phanomene der Sprachlosigkeit in Zusammenhang gebracht, die durch eine Broca-Supression entstehen. Blockade der Informationsverarbeitung, die zu einer Desynchronisation von expliziten und impliziten Gedachtnisfunktionen fuhrt. ■ Chronische Dysregulation von Hormonen und Neurotransmittern der Stresachse. ■ Suppression der Frontalhirnaktivitat, die zu einer Fehlfunktion von kognitiver Steuerung und Integrationsfahigkeit des Psychotraumas fuhren soll. Diese Befunde werden im Kontext des Vier-Ebenen-Modells zur Neurobiologie der PTBS und im Verlaufsmodell der Psychotraumatisierung entwickelt und diskutiert.

Transient cerebral ischemia causes extensive cell death in hippocampal CA1 pyramidal cells and selective loss of interneurons in the dentate hilus. Many hippocampal interneurons can be classified by their contents of somatostatin (SS) and/or neuropeptide Y (NPY). Following ischemia in the rat, most of the NPY immunoreactivity is permanently lost in hippocampus. Furthermore, SS interneurons in the dentate hilus die, whereas CA1 interneurons survive and their expression of SS mRNA and peptide returns to preischemic levels within 16 days after ischemia. We have addressed the following questions: (1) Does the loss of NPY involve a specific downregulation in surviving CA1 interneurons that pre-ischemically expressed both SS and NPY? (2) Can the subpopulation of dying interneurons in hilus be identified from their preischemic coexpression of SS and NPY? We investigated the coexpression of SS mRNA and NPY peptide using combined in situ hybridization and immunocytochemistry. Cells containing one or both markers were counted in control sections and sections taken 2-16 days after ischemia from the hippocampal formation. In CA1, a decrease in the number of neurons containing NPY alone as well as a decrease in the number of neurons coexpressing NPY and SS was observed, whereas the number of neurons containing SS alone increased 16 days after ischemia. We conclude that neurons coexpressing SS and NPY before ischemia added to the number of neurons containing SS alone after ischemia, because NPY expression was selectively down regulated in the coexpressing population. In hilus, we demonstrated both survival and ischemic cell death of neurons expressing either SS, NPY or both, indicating that hilar interneurons dying from ischemia cannot unequivocally be identified from their preischemic colocalization of SS and NPY.

Following transient global ischemia most of the neurons containing somatostatin in the fascia dentata of the dorsal hippocampal formation die, while somatostatinergic neurons in the CA1 region survive. The neurons react to ischemia with a transiently reduced expression of somatostatin mRNA and peptide. We have tested the hypothesis that this selective vulnerability is solely related to those somatostatinergic neurons which do not express the calcium-binding protein parvalbumin. Postischemic changes were studied in rat dorsal hippocampus at 2 and 16 days after 10 min of global cerebral ischemia using a four-vessel occlusion model. We performed a double-staining visualizing the mRNA coding for somatostatin by non-radioactive in situ hybridization and parvalbumin protein by immunocytochemistry. Only 5% of the somatostatinergic cells in the fascia dentata contained parvalbumin. The number of somatostatinergic cells was permanently reduced following ischemia. Among surviving neurons we found cells with and without parvalbumin expression. Thus, expression of parvalbumin is not predictive for survival of somatostatinergic cells in the fascia dentata. In contrast, in CA1, 37% of the somatostatinergic cells contained parvalbumin. These cells were unaffected by the transient ischemic period. The somatostatinergic cells lacking parvalbumin showed transiently reduced mRNA levels at day 2, but recovered to control values at the 16th postischemic day. Thus, expression of the calcium-buffering protein parvalbumin coincides with resistance of somatostatinergic neurons in CA1 to transient effects of ischemia. We conclude that the calcium-buffering capacity of parvalbumin may partially contribute to the protection of somatostatinergic neurons from ischemia in the dorsal hippocampus. However, the survival of somatostatinergic cells without parvalbumin indicates the importance of other factors as well.

Although most victims of disasters recover on their own, a minority of survivors, uniformed services, and relatives develop long-term disaster related psychic disorders such as Posttraumatic Stress Disorder (PTSD). Especially this subgroup should receive timely and appropriate psychosocial help. In many EU countries is offered post-disaster psychosocial care by a variety of caregivers (i.e. professionals and volunteers, NGOs, church or commercial organizations). Therefore, European standardization of providing post-disaster psychosocial support is currently required. The presentation describes the project supported by the European Commission and named European Guideline for Target Group Oriented Psychosocial Aftercare – Implementation (EUTOPA-IP), supported by the European Commission. EUTOPA-IP has integrated two materials: German “Target Group Intervention Programme” and Dutch “Multidisciplinary guideline”, also with the experiences of experts in the area of psychosocial support from the EU countries. Main target is to develop a guideline for the uniformed services on the basis of the Multidisciplinary guideline for early psychosocial interventions, the adaptation of the Target group Oriented Intervention Program (TGIP) to the International Classification of Functioning, Disability and Health (ICF) and preparation and implementation of training program for various professional groups. The project aims at standardization of psychosocial aftercare in case of disasters as well as at the development of European network based on current findings in psychotraumatology. Early screening, supportive context, early preventive and curative psychosocial interventions, management of interventions, implications for the clinical field and future research are topics discussed in the project. Project consortium: – City of Cologne (Germany)– Centre of Psychotraumatology (Germany)– Impact (The Netherlands)– Spanish Society for Psychotraumatology and Traumatic Stress (Spain)– Charles University in Prague (Czech Republic)– Capital City of Dusseldorf, Department of Public Health (Germany).

The influence of transient cerebral ischemia on the expression of somatostatin (SS) mRNA and peptide in hippocampal neurons was studied in the rat. Animals survived 10 min of 4-vessel occlusion ischemia during systemic hypotension for 1 h, 1 day, 2 days, 4 days, and 16 days, respectively. SS mRNA and peptide were detected with nonradioactive probes in brain sections by means of in situ hybridisation and immunocytochemistry. Then SS mRNA and peptide positive neurons in hippocampus were counted. The neuronal expression of the two markers correlated well in control and ischemic sections. In the dentate hilus, SS mRNA and peptide were lost permanently from day 2 after ischemia, in parallel with ischemic cell death and loss of the neurons. In CA1, where all interneurons containing SS survive an ischemic insult, we found a transient decrease of SS mRNA and peptide at 2–4 days after ischemia. The SS mRNA was most reduced. We conclude that ischemia transiently reduces levels of SS mRNA and peptide in surviving hippocampal interneurons. This process is brief and delayed in mild ischemia, and not expressed in vulnerable hilar neurons.

Es werden Ergebnisse einer Befragung zu Psychotherapien berichtet, die von den behandelten Patientinnen und Patienten als gescheitert oder gar schadigend eingestuft wurden. Die uberwiegende Zahl der Untersuchungsteilnehmer weist komplexe psychische Traumatsierung in der Lebensgeschichte auf, insbesondere Erfahrungen mit als ablehnend erlebten primaren und sekundaren Bezugspersonen. Die Risikovariablen fur psychotherapeutischen Misserfolg, wie sie sich in dieser Studie zeigen, werden in den Zusammenhang der internationalen Misserfolgsforschung gestellt. Daruber hinaus wurden mit einer qualitativen Methodik 7 „Skripts” ermittelt, die eine typisierte Dramaturgie scheiternder Therapien wiedergeben und damit einer Logik psychotherapeutischer Fehlschlage zu entsprechen scheinen. Als Gegenmittel wird empfohlen, die dialektische Logik aufgespaltener „Beziehungsschemata” systematisch zu berucksichtigen, die als eine der Folgen komplexer Traumatisierung gelten kann. Es ergibt sich u. a. die Folgerung, in der psychotherapeutischen Ausbildung schulenubergreifend den Umgang mit Ubertragung und Gegenubertragung zu trainieren und traditionelle Psychotherapieformen „traumaadaptiert” weiter zu entwickeln.