Below you will find a description of some of the projects the Danish Center of Psychotraumatology has been involved in:

The role of age and mode of delivery in the STEPS intervention: a longitudinal pilot-study in treatment of posttraumatic stress symptoms in Danish survivors of sexual assault.
2020
DOI: 10.1080/20008198.2019.1701778

Background: The STEPS programme has been successfully implemented as a group-based treatment of trauma symptoms after rape for adolescents. The STEPS intervention was translated from Dutch to Danish and offered to adults in addition to adolescents as well as an individual intervention in addition to a group-based intervention at a Danish Centre for Rape Victims through 2011 to 2014. The programme was translated from Dutch to Danish and expanded to adults in addition to adolescents as well as to an individual intervention in addition to a group-based intervention at a Danish Centre for Rape Victims through 2011 to 2014.

Objective: The present study observes development in trauma symptoms and ICD-11 diagnostic status during an adapted version of the intervention programme ‘STEPS’ for survivors of sexual assault.

Methods: A prospective uncontrolled study was conducted, monitoring symptoms of posttraumatic stress and other trauma-related symptomatology before treatment, after treatment and at 6 and 12 months' follow up for 103 referrals receiving individual or group-based STEPS. Tentative diagnoses of posttraumatic stress disorder (PTSD) and complex PTSD were assigned to participants according to the ICD-11 to observe the development in diagnostic status across time, and multilevel modelling was used to assess the development of symptom severity and to assess the moderating effect of age-group and mode of delivery.

Results: A loglinear function representing large and statistically significant decline in symptomatology over time provided the best fit for all measures of trauma-related symptomatology. The decline was not moderated by age-group or mode of intervention. Dropout rates were independent of mode of intervention and age.

Conclusion: The adaption of the STEPS programme to adults and as an individual intervention is feasible and maintains effect sizes comparable to those observed in the original intervention. Further research using randomized controlled trials is needed to ascribe the observed effect to the STEPS programme.

Covariates of Burnout and Secondary Traumatisation in Professionals Working with Child Survivors of Trauma: A Research Synthesis
2020
DOI: 10.1093/bjsw/bcz117

Background: It has been demonstrated that working with trauma-exposed children increases the risk for developing secondary traumatisation (ST) and burnout (BO). High correlations between ST and BO have been reported, suggesting an empirical overlap between the constructs.  

Objective: The purpose of the present review was to synthesise research investigating covariates of BO and ST to explore whether this overlap extends to covariates.

Methods: Seven research databases were searched for studies investigating covariates of both BO and ST. Identified studies were screened in accordance with predefined inclusion and exclusion criteria, resulting in thirteen articles being included for further review. Fourteen covariates were examined in two or more of the included studies and were synthesised according to the ‘levels of evidence approach’. 

Results: Some individual and operational factors appeared to be equally related to BO and ST. There was a predominance of equivocal evidence for and against the salience of different covariates as well as an over-representation of demographic factors compared to organisational and operational factors in the current literature.

Conclusion: More research investigating the nature of the overlap between BO and ST is needed, and future research would benefit from integrating covariates supported in the work and organisational literature with covariates from the psychotraumatological literature. 

Secondary traumatisation, burnout and functional impairment among child protection workers: Findings from a Danish survey
2020
DOI: 10.1080/20008198.2020.1724416

Background: Child-protection workers are at elevated risk for secondary traumatization. However, research in the area of secondary traumatization has been hampered by two major obstacles: the use of measures that have unclear or inadequate psychometric properties and equivocal findings on the degree of associated functional impairment.

Objective: To assess the relationship between secondary traumatization and burnout using exploratory structural equation modelling (ESEM) and to assess the relationship between secondary traumatization and functional impairment.

Methods: A survey of Danish child-protection workers was conducted through the Danish Children Centres (N = 667). Secondary traumatization was measured using the Professional Quality of Life-5 (ProQoL-5) and burnout using the Oldenburg Burnout Inventory.

Results: A three-factor ESEM model provided the best fit to the data, reflecting factors consistent with the structure of secondary traumatization and burnout. The factors were differentially related to trauma-related and organizational variables in ways consistent with existing evidence. All factors were significantly related to functional impairment.

Conclusion: The findings supported the discriminant validity of secondary traumatization and burnout while highlighting methodological issues around the current use of sum-score approaches to investigating secondary traumatization. The current study supported the clinical relevance of secondary traumatization by linking it explicitly to social and cognitive functional impairment.

Training the next generation of psychotraumatologists: COllaborative Network for Training and EXcellence in psychoTraumatology (CONTEXT)
2018
DOI: 10.1080/20008198.2017.1421001

In this paper we present a description of the Horizon2020, Marie Skłodowska-Curie Action funded, research and training programme CONTEXT: COllaborative Network for Training and EXcellence in psychoTraumatology.

The three objectives of the programme are put forward, each of which refers to a key component of the CONTEXT programme. First, we summarize the 12 individual research projects that will take place across three priority populations: (i) refugees and asylum seekers, (ii) first responders, and (iii) perpetrators and survivors of childhood and gender-based violence. Second, we detail the mentoring and training programme central to CONTEXT. Finally, we describe how the research, together with the training, will contribute towards better policy, guidelines, and practice within the field of psychotraumatology.

Was psychological debriefing dismissed too quickly? An assessment of the 2002 Cochrane review.
2019

Emergency personnel and first responders are often exposed to potentially traumatic incidents which can increase the risk of acute stress reactions and ultimately post-traumatic stress symptoms. Psychological Debriefing (PD) has been used as an early group crisis intervention to minimize the risk of acute stress reactions as a result of dealing with traumatic incidents among the emergency services population. Despite its ongoing use within the emergency services for the past three decades, the effectiveness of PD has been a source of considerable debate in academia, with a Cochrane Review concluding PD to be ineffective. This discrepancy between research and practice compels a thorough examination. This paper thus assesses the abovementioned Cochrane Review and the studies included in it based on the Cochrane Handbook’s guidelines on interventions to ascertain if PD has been adequately evaluated as an early group crisis intervention. The findings indicate that PD is worth being reassessed when implemented on the target population it was originally intended for—group of emergency personnel and first responders.

Modeling Patterns of Polyvictimiztion and Their Associations with Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in the Israeli Population.
2019
DOI: 10.1002/jts.22455

Although evidence is accumulating for the conceptual validity of the ICD-11 proposal for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD), our understanding of the specificity of trauma-related predictors is still evolving. Specifically, studies utilizing advanced statistical methods to model the association between trauma exposure and ICD-11 proposals of traumatic stress and differences in profiles of trauma exposure are lacking. Additionally, time since trauma and a clear memory of the trauma are yet to be examined as predictors of PTSD and CPTSD.

We analyzed trauma exposure as reported by a general population sample of Israeli adults (N = 834), using latent class analysis, and the resultant classes were used in regression models to predict PTSD and CPTSD operationalized both dimensionally and categorically.

Four distinct groups were identified: child and adult interpersonal victimization, community victimization–male, community victimization–female, and adult victimization. These groups were differentially related to PTSD and CPTSD, with only child and adult interpersonal victimization consistently predicting CPTSD and disturbances in self-organization. When modeled dimensionally, PTSD was associated with the child and adult interpersonal victimization and adult victimization groups, whereas only the child and adult interpersonal victimization group was predictive of PTSD when operationalized categorically. The roles of time since trauma and a clear memory of the trauma differed across PTSD and CPTSD.

These findings support the use of trauma typologies for predicting PTSD and CPTSD and provide important insight into the distribution of trauma exposure in the Israeli population.

Intergenerational Trauma Among Refugees: Preventing The Transmission of Trauma From Parent To Child
2017

Background: Psychological distress associated with trauma is communicable from one generation to the next, however the mechanisms by which this occurs is less well understood. A concern for the EU is to prevent trauma experienced by parents being transmitted to subsequent generations.

Objective: Explore how parent-child communication can inhibit intergenerational transmission of trauma-based psychological distress.

Methods: Observational and psychological assessment methods will be employed to study the effects of parent-child communication on intergenerational transmission of distress.

Secondment: The fellow will register in the University of Southern Denmark from January 2017-March 2018, and conduct their non-academic placement in Spirasi from April 2018-January 2020. The PhD degree will be awarded from the University of Southern Denmark.

Innovation: Research Project 4 will explore the specific parent-child mechanisms that prevent or exacerbate the transmission of trauma-related distress from parent to child. Recommendations will be made to directly inform current treatment programmes of individuals who have a history of torture and who have been recently reunited with their children.

Deliverables: (4.7) Identification of strategies to prevent the parent-to-child transmission of trauma for asylum seekers who are survivors of torture. (4.8) Evidence-based recommendations for the treatment of individuals with a history of torture and that have recently been reunited with their children.