Neurofeedback Treatment of Negative Symptoms in Schizophrenia: Two Case Reports.

Negative symptoms of schizophrenia, like diminished emotional expression and a dearth of self-initiated behavior do not respond reliably to anti-psychotic medication or to conventional psychotherapeutic approaches. Starting from evidence on the probable neural basis of such symptoms and on the effectiveness of neurofeedback with other psychological disorders, the present case study applied 20 sessions of EEG neurofeedback to a 45-year-old female and a 30-year-old male, both diagnosed with severe negative symptoms of schizophrenia. In both cases GAF scores were improved significantly and at the end of treatment, both patients did not meet the diagnostic criteria of negative symptomatology any longer. Symptom reduction went along with an obvious improvement of social, interpersonal, and cognitive abilities according to the clinical impression. Detailed data analysis revealed that these improvements went along with corresponding changes of EEG parameters and with distinct patterns and strategies of change in each of the two individuals. The results suggest that EEG neurofeedback should be examined on a larger scale as it offers a promising alternative to existing treatment approaches for negative symptoms in schizophrenia.

Differential relationships of PTSD and childhood trauma with the course of substance use disorders.

A large body of research documents the link between Posttraumatic Stress Disorder (PTSD) and the course of Substance Use Disorders (SUD). Similar relationships have been reported between Childhood Trauma (CT) and the course of illness in patients with SUD even in the absence of PTSD, but few studies have examined differential effects of PTSD and CT (independent of PTSD) in this population. We used the International Diagnostic Checklist (IDCL) and the Posttraumatic Diagnostic Scale (PDS) to diagnose PTSD in a sample of patients with SUD (N = 459). The Childhood Trauma Questionnaire (CTQ) and the European Addiction Severity Index (EuropASI) were administered to assess childhood trauma and addiction related problems including comorbid psychopathological symptoms. The sample was divided into three groups: patients with experiences of CT and PTSD (CT-PTSD), experiences of CT without PTSD (CT-only), and neither experiences of CT nor PTSD (No trauma) to examine their differential associations with the course and severity of SUD. Patients of both the CT-PTSD (n = 95) and the CT-only group (n = 134) reported significantly higher levels of anxiety and depression as well as more suicidal thoughts and suicide attempts during their lifetime than the No trauma group (n = 209). Regarding most variables a graded association became apparent, with the highest level of symptoms in the CT-PTSD group, an intermediate level in the CT-only group and the lowest level in the No trauma group. The CT-PTSD group also differed in almost all substance use variables significantly from the No trauma group, including a younger age at first use of alcohol and cannabis, more cannabis use in the last month, and more lifetime drug overdoses. Our results confirm the relationships of both CT and PTSD with psychiatric symptoms in patients with SUD. Thus, it seems important to include both domains into the routine assessment of SUD patients. Specific treatments for comorbid PTSD but also for other consequences of childhood trauma should be integrated into SUD treatment programs.

Adopting Basic Principles of the United Nations Academic Impact Initiative (UNAI): Can Cultural Differences Be Predicted from Value Orientations and Globalization?

The United Nations Academic Impact (UNAI) Initiative has set forth 10 Basic Principles for higher education. In the present study, a 10 item self-report questionnaire measuring personal endorsement of these principles has been tested by self-report questionnaires with university and post-graduate students from Austria, China, Cyprus, India, Nigeria, and Slovakia (total N = 976, N = 627 female, mean age 24.7 years, s = 5.7). Starting from the assumptions of Moral Foundations Theory (MFT), we expected that personal attitudes toward the UNAI Basic Principles would be predicted by endorsement of various moral foundations as suggested by MFT and by the individual's degree of globalization. Whereas for the Austrian, Cypriot, and Nigerian sub- samples this assumption was largely confirmed, for the Chinese, Indian, and Slovak sub- samples only small amounts of the variance could be explained by regression models. All six sub-samples differed substantially with regard to their overall questionnaire responses: by five discriminant functions 83.6% of participants were classified correctly. We conclude that implementation of UNAI principles should adhere closely to the cultural requirements of the respective society and, where necessary should be accompanied by thorough informational campaigns about UN educational goals.

The Psycho-Lexical Approach in Exploring the Field of Values: A Reply to Schwartz.

We reply to each of the issues raised by Schwartz in a commentary on our article on a comparison of value taxonomies. We discuss two approaches, mentioned in that commentary, the lexical approach and the theory-driven approach, especially with respect to their capacities in covering the domain of values and with respect to the representation of important values in a useful structure. We refute the critique by Schwartz that the lexical approach is superfluous, because his theory "toward universals in values" would already cover all values, and that their mutual relationships are relevant to individuals around the globe. We explain the necessity and strength of the lexical approach in taxonomizing the value domain, both within and across languages. Furthermore, we argue that principal components analysis (PCA) and simultaneous component analysis (SCA) are most adequate in arriving at a satisfactory structuring of the great many values in terms of both underlying constructs and their facets. We point to a misrepresentation in Schwartz's circular model, and we review some misunderstandings on the side of Schwartz with respect to our results in comparison with those proceeding from his circular model.

Relationships between a Dissociative Subtype of PTSD and Clinical Characteristics in Patients with Substance Use Disorders.

The increasing support for a dissociative subtype of post-traumatic stress disorder (PTSD-D) has led to its inclusion in DSM-5. We examined relationships between PTSD-D and relevant variables in patients with substance use disorders (SUD). The sample comprised N = 459 patients with SUD. The International Diagnostic Checklist and the Posttraumatic Diagnostic Scale were used to diagnose PTSD. In addition, participants completed the Childhood Trauma Questionnaire and the Dissociative Experiences Scale. The course of SUD was assessed by means of the European Addiction Severity Index. One-fourth of participants fulfilled a diagnosis of PTSD (25.3%). Patients with PTSD-D (N = 32, 27.6% of all patients with PTSD) reported significantly more current depressive symptoms, more current suicidal thoughts, more lifetime anxiety/tension, and more suicide attempts. The PTSD-D group also showed a significantly higher need for treatment due to drug problems, higher current use of opiates/analgesics, and a higher number of lifetime drug overdoses. In a regression model, symptoms of depression in the last month and lifetime suicide attempts significantly predicted PTSD-D. These findings suggest that PTSD-D is related to additional psychopathology and to a more severe course of substance-related problems in patients with SUD, indicating that this group also has additional treatment needs.

Turkish Migrant Women with Recurrent Depression: Results from Community-based Self-help Groups.

The study focuses on psychosocial functioning of female Turkish immigrants in Austria with recurrent depressive disorder participating in self-help groups. Self-help groups guided by group leaders of Turkish descent should increase autonomy in participants, providing the opportunity to follow their ethnic health beliefs. Turkish immigrant women (n = 43) with recurrent depressive disorder participated in self-help groups over four months. Qualitative data of participants and group leaders, containing interviews, group protocols and supervision protocols of group leaders were analyzed using the qualitative content analysis for effects on psychosocial function, such as interaction with others, illness beliefs and benefit from self-help group. Women reported feelings of being neglected and violated by their husbands. They stated that they had gained strength and had emancipated themselves from their husbands. Self-help groups functioned as social resources and support for changes in participants' lives. Further interventions should integrate the functional value of depressive symptoms and focus on social support systems and social networks.

A qualitative study of cognitive-behavioral therapy for Iranian migrants with mild/moderate depression in Austria.

This qualitative study was carried out to investigate the effectiveness of cognitive-behavioral therapy (CBT) for Iranian migrants suffering from major depressive disorder (MDD) and living in Austria for an average of 14 years. The qualitative data were collected through interviews based on the Farsi version of the Structured Clinical Interview for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). However, to obtain more information from the participants, they were asked to talk in more detail about their childhood and teenage years, reasons for immigration, their lifestyle before and after immigration, and their social activities. Interviews were conducted at four time points: preintervention, postintervention, 1-month follow-up, and 6-month follow-up. Patients who did not complete the interventions were interviewed on a voluntary basis to explain their reasons. Preintervention interviews were conducted to get some useful information about participant's' expectations of psychotherapy, especially group-based cognitive-behavioral therapy (GCBT), and also to assess the reasons for depression from their own point of view. The postintervention interviews were conducted to examine the participants' psychological situations as well as the reasons for positive effects of interventions. The interviews on average lasted 50 minutes, and field notes were taken. The results of this study showed a reduction in depression symptoms after the interventions. However, the effect of treatment was not persistent. The findings suggest that the main reasons behind Iranian migrants' depression in Austria is related to their dysfunctional acculturation attitude. The effectiveness of GCBT for Iranian migrants with depression also may be related to their sociocultural background.

Social Support from Sponsorships as a Moderator of Acculturative Stress: Predictors of Effects on Refugees and Asylum Seekers.

N = 63 refugees and asylum seekers, 27 women and 36 men with a mean age of 33.08 years (SD = 10.3) from Chechnya and Afghanistan were granted sponsorships for six months and were randomized to an intervention and a waiting-list control group. Only participants with a history of traumatization benefited from the intervention. For the traumatized sub-sample, sponsorships led to a significant and stable decrease in anxiety, depression, and psychological problems as compared to the control group, with effect sizes comparable to those of psychotherapy. The effects being rather palliative than instrumental, however, sponsorships did not instigate improvements in acculturation, societal contact, or coping capability. Women benefited more from the intervention than men, and Afghans more than Chechen.

Group Interventions were not Effective for Female Turkish Migrants with Recurrent Depression - Recommendations from a Randomized Controlled Study.

We tested group interventions for women with a Turkish migration background living in Austria and suffering from recurrent depression. N = 66 participants were randomized to: (1) Self-Help Groups (SHG), (2) Cognitive Behavior Therapy (CBT) Groups, and (3) a Wait-List (WL) Control condition. Neither SHG nor CBT were superior to WL. On an individual basis, about one third of the participants showed significant improvements with respect to symptoms of depression. Younger women, women with a longer duration of stay in Austria and those who had encountered a higher number of traumatic experiences, showed increased improvement of depressive symptoms. The results suggest that individual treatment by ethnic, female psychotherapists should be preferred to group interventions.

Post-traumatic stress in asylum seekers and refugees from Chechnya, Afghanistan, and West Africa: gender differences in symptomatology and coping.

BACKGROUND: Internationally, a high number of refugees are in need of help as a consequence of post-traumatic stress or acculturation problems. AIMS: The present study investigated the gender-specific requirements for such interventions taking clinical symptoms as well as coping strategies into account. METHODS: Five psychometric instruments assessing anxiety, depression, posttraumatic stress, somatic symptoms, and social adaptation were administered and semi-structured interviews with n = 150 asylum seekers and refugees from Chechnya, Afghanistan, and West Africa were conducted. RESULTS: On the level of total test scores, women reported significantly more somatic symptoms than men but there were no further gender differences. On the item level of the questionnaires as well as with respect to the categories obtained from the interview data, marked gender differences were found. Women, as compared to men, reported more somatic symptoms, emotional outbursts, and loss of sexual interest, while men reported detachment. For women, typical coping strategies were concentrating on their children and various indoor activities, while men preferred looking for work and socializing. CONCLUSION: Social psychiatric interventions should take gender-specific symptoms and coping strategies into account. For asylum seekers and refugees, same gender client-therapist dyads and groups are highly recommended.

The effectiveness of psychotherapy with refugees and asylum seekers: preliminary results from an Austrian study.

An Austrian Non-Governmental Organization (NGO) offered psychotherapy to 37 asylum seekers and refugees (21 of them female) with a mean age of 36.1 years (s = 7.5), with the majority of them from Chechnya or Afghanistan. Comparative data between the start of therapy and the time of evaluation revealed a highly significant positive effect (d = 0.77), while most therapies were still going on. By a retrospective measure of perceived change, 85% of the participants reported significant improvements. The results show that even under difficult conditions, when working with asylum seekers and refugees, psychotherapy can be effective.

Do human values reflect job decisions and prosocial and antisocial behavior? A contribution towards validating the Austrian Value Questionnaire by group comparisons.

The Austrian Value Questionnaire was developed on the basis of the Lexical Approach to account for specific facets of values in Austrian culture. It comprises 54 items, constituting five scales, Intellectualism, Harmony, Religiosity, Materialism, and Conservatism, and 13 subscales. To assess construct validity, hypotheses on human values were derived from the literature and tested in Austrian samples of Catholic priests and nuns (n=30, 8 women, M age=52.6 yr.), community servants (n=30, all men, M age=21.4 yr.), and students of psychology (n=33, 19 women, M age=23.8 yr.) and economics (n=33, 18 women, M age=23.8 yr.), prisoners (n=40, 9 women, M age=34.9 yr.), and drivers who had been fined for driving while intoxicated (n=35, 5 women, M age=34.6 yr.). Participants were volunteers. Previous and more recent findings from the USA, Canada, Germany, and Switzerland provided similar results for community servants, students of economics, prisoners, and intoxicated drivers, and thus, the hypotheses for these groups were largely confirmed. Most earlier findings for priests and nuns and students of psychology were not replicated, however. Taking into account that values may change over time and variously in different cultures, the results pose an argument for the construct validity of the newly developed questionnaire.

Psychosocial correlates of the impact of road traffic accidents among South African drivers and passengers.

The aim of the study was to investigate the psychosocial consequences and coping strategies among accident victims in South Africa. Participants (138 drivers and 141 passengers) who had been involved in a road traffic accident were approached and interviewed in public places. In both groups the median age group was between 25 years and 34 years. In 34 accidents (12.2%) a family member was killed, in 68 accidents (24.4%) a non-family member was killed in the accident. In 272 accidents 197 (72.4%) persons (both drivers and passengers) were injured and 168 (61.7%) were hospitalized. Eighty-seven drivers (63%) did not perceive themselves at fault and 51 (37%) did. Following the road traffic accident both drivers and passengers showed a significant decline of their well-being. Drivers who perceived themselves to be at fault did not cope better than those not perceiving themselves at fault. Passengers related to the drivers showed more decline in their well-being than those not related. Path analysis for drivers found that holding oneself responsible had a direct, and mediated by self-blame, guilt and family distress, negative effect on personal well-being. In the passengers group, holding the driver or others responsible led, mediated by increased self-blame, feelings of guilt, and family distress, to lower psychological well-being (PWB). Findings have relevant implications for the development of coping strategies to aid victims of road traffic accidents in dealing with their trauma in this African context, which may differ to those in Western societies.

Superstition, risk-taking and risk perception of accidents among South African taxi drivers.

The aim of this study was to investigate taxi drivers' superstition and risk perception of accidents as well as risk-taking in an urban area in South Africa. One hundred and thirty drivers of minibuses, so-called "taxis" were interviewed on the basis of: (1) a superstition scale; (2) a risk-taking scale; (3) a list of perceived causes of road traffic accidents. Drivers showed largely superstitious attitudes and expressed a high degree of risk-taking behavior. Superstition was positively correlated with the number of self-reported accidents the drivers had been involved in and the number of accidents they had witnessed. Path analysis revealed a direct path from superstition to accident involvement while the influence of formal education was negligible. Risk-taking was inversely correlated with driving experience and the number of accidents witnessed but not so with the number of accidents involved in. There was no clear pattern of associations between superstition and risk-taking and perceived causes of accidents. Superstition and risk-taking were slightly and inversely correlated with each other. It is concluded that superstition represents an attitude that is associated with a driver's accident risk, and further research on superstitious attitudes among South African drivers is advocated.