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The efficacy of psychological debriefing (PD) has been subject to extensive debate in recent years. The controversy started with articles by Bisson and Deahl (1) and Raphael et al. (2), in which it was concluded that the empirical documentation for the effect of the method was next to non‐existent. Later, Wessely et al. (3) evaluated the randomized and controlled trials of brief psychological crisis interventions, and concluded that there was no evidence that debriefing can prevent trauma‐related symptoms, such as PTSD. On that basis, they further recommended that the use of PD should cease.
Objective: To identify literature concerning the effectiveness of PD analyse results according to different criteria of success and different uses of the intervention format.
Results: Results indicate that, in general, debriefing does not prevent psychiatric disorders or mitigate the effects of traumatic stress, even though people generally find the intervention helpful in the process of recovering from traumatic stress. The intervention holds potential as a screening procedure, and there may be economic arguments for continued use. When used with adherence to traditional descriptions of treatment group, events, group format, leadership and time spent, a preventive effect emerges. No tendency according to timing was found.
Conclusion: Current uses of PD are problematic. The concept needs to be redefined, and the scope of application must be revised. The objectives for use need to be clarified.
Arendt, M. & Elklit, A. (2001). Effectiveness of Psychological Debriefing. Acta Psychiatrica Scandinavica, 104, 423-437.
Childhood sexual abuse (CSA) is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood. Objective: This study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses.
There was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology. Conclusions: The relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses.
Shevlin, M., McElroy, E., Elklit, A., Murphy, S., Murphy, J., & Hyland, P (2016). Prevalence and Predictors of Axis I Disorders in a Large Sample of Treatment-Seeking Victims of Sexual Abuse and Incest. European Journal of Psychotraumatology, 7. Doi: 10.3402/ejpt.v7.30686.
Elklit, A (2018). Incestofre i behandling. Odense: CSM Danmark og Videnscenter for Psykotraumatologi, Syddansk Universitet (1-20).
Elklit, A. Shevlin, M., Murphy, J., Hyland, P., Murphy, S. & Fletcher, S. (2016): Behandling af psykologiske følger efter seksuelle overgreb i barndommen - En forskningsoversigt. Odense: Videnscenter for Psykotraumatologi. 1-43
Elklit, A. Shevlin, M., Murphy, S., Hyland, P. & Fletcher, S.(2017): Treatment of Danish Survivors of Childhood Sexual Abuse. Research Briefing.Odense: Videnscenter for Psykotraumatologi (1-19).
Fletcher, S., Armour, C., Elklit, A. (2017). Predictors of PTSD treatment response trajectories in a sample of childhood sexual abuse survivors: The role of social support, coping and PTSD symptom clusters. Journal of Anxiety Disorders.
Shevlin, M., Murphy, S., Elklit, A., Hyland, P., & Murphy, J. (2017). Typologies of child sexual abuse: An analysis of multiple abuse acts among a large sample of treatment-seeking survivors of childhood sexual abuse. Psychological Trauma: Theory, Research, Practice, and Policy. Doi: 10.1037/tra0000268
Murphy, S., Elklit, A., Hyland, P., Murphy, J., & Shevlin, M. (2017). A Cross-Lagged Panel Study of Dissociation and PTSD in a Treatment-Seeking Sample of Victims of Childhood Sexual Abuse. Journal of Clinical Psychology. Doi: 10.1002/jclp.2243
Elklit, A. (2016). Treatment of Danish Survivors of Child Sexual Abuse – a Cohort Study. Behavioral Sciences, 5, 589-601. Doi: 10.3390/bs40x000x
Lahav, Y., & Elklit, A. (2016). The cycle of healing-dissociation and attachment during treatment of CSA survivors. Child Abuse & Neglect, 60, 67-76
Murphy, S., Elklit, A., Hyland, P., & Shevlin, M. (2016). Insecure attachment orientations and posttraumatic stress in a female treatment-seeking sample of survivors of childhood sexual abuse: A cross-lagged panel study. Traumatology, 22(1), 48-55.
Elklit, A., Christiansen, D., Palic, S., Karsberg, S. & Eriksen, S.B. (2014). Impact of Traumatic Events on Posttraumatic Stress Disorder among Danish Survivors of Sexual Abuse in Childhood. Journal of Child Sexual Abuse, 23(8), 918-934. Doi: 10.1080/10538712.2014.964440
The present review will help consolidate knowledge on psychological violence by evaluating whether frequency, severity or actual “type” of psychological violence produces the most harm. A thorough quality assessment will help overcome potential limitations regarding expected variations in terminology and assessment of psychological violence.
Dokkedahl, S., Kok, R., Murphy, S., Kristensen, T.R., Bech-Hansen, D., Elklit, A. (2019). The Psychological Subtype of Intimate Partner Violence and its Effect on Mental Health: Protocol for A Systematic Review and Meta-Analysis. Systematic Reviews, 8(1), 198-2xx. Doi: 10.1186/s13643-019-1118-1.
Dokkedahl, S. B. & Elklit, A. (2019). Understanding the Mutual Partner Dynamic of Intimate Partner Violence: A Review. Partner Abuse, 10(3).
Dokkedahl, S. B. & Elklit, A. (2018). Undersøgelse af indbyrdes vold. Odense: Videnscenter for Psykotraumatologi, Syddansk Universitet. (pp 1-101). (2. udgave, 2019)
In this paper we present a description of a new, Horizon2020, Marie Curie Sklodowska Action funded, research and training program called CONTEXT, or the ‘COllaborative Network for Training and EXcellence in psychoTraumatology’. The three objectives of the program are put forward, each of which refers to a key component of the CONTEXT program. First, we summarise the twelve 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 program 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.
Vallières, F., Hyland, P., Murphy, J., Hansen, M., Shevlin, M., Elklit, A., Ceannt, R., Armour, C., Wiedemann, N., Munk, M., O’Hare, G., Spitz, P., Askerod, D., Black-well, N., McCarthy, A., O’Dowd, L., Scott, S., Reid, T., Mokake, A., Halpin, R., Perera, C., Gleeson, C., Frost, R., Flanagan, N., Aldamman, K., Tamrakar, T., Vang, M.L., Sherwood, L., Travers, A., Pedersen, I.H., Walshe, C., McDonagh, T., & Bramsen, R.H. (2017): Training the Next Generation of Psychotraumatologists: A New Collaborative Network for Training and Excellence in Psychotraumatology (CONTEXT). European Journal of Psychotraumatology, 9, 1421001. Doi: 10.1080/20008198.2017.1421001
Selsbæk, S., Jørgensen, L. K., & Elklit, A. (2019). De regionale centre for seksuelt misbrug: Rapport over effekt af behandling 2018 – et fokus på senfølger af seksuelle overgreb i barndommen. Odense: Videnscenter for Psykotraumatologi.
Selsbæk, H. S., & Elklit, A. (2017). De regionale centre for seksuelt misbrug. Rapport over effekt af behandling 2016: Et fokus på senfølger af seksuelle overgreb i barndommen. Odense: Videnscenter for Psykotraumatologi.
Elklit, A., Shevlin, M., Murphy, J., Hyland, P., Murphy, S., & Fletcher, S. (2016). Behandling af psykologiske følger efter seksuelle overgreb i barndommen: En forskningsoversigt. Syddansk Universitet.
Karstoft, K-I., Beck Hansen, N., Eriksen, S. B., & Elklit, A. (2014). Effekt af Behandling – et fokus på senfølger af seksuelle overgreb i barndommen. Odense: Videnscenter for Psykotraumatologi.
Research has documented severe mental health problems in female victims of intimate partner violence (IPV). Therefore, providing effective treatment is pivotal. Few studies have investigated the effects of intervention programs on reducing the harmful consequences of IPV.
The present study examined the effects of a specific three-phase intervention program for female victims of IPV on psychological symptoms (PTSD, anxiety, and depression) and perceived social support. Results showed a significant effect of the intervention program on reducing psychological symptoms and increasing levels of perceived social support. Effect sizes ranged from medium to very high. Significant positive effects were found for each of the treatment phases.
Hansen, N.B., Eriksen, S.B. & Elklit, A. (2014) Effects of an intervention program for female victims of intimate partner violence on psychological symptoms and perceived social support. European Journal of Psychotraumatology, 5. Doi: 10.3402/ejpt.v5.24797.
Eriksen, S. B., Hansen, N. B. & Elklit, A. (2015).
Ud af voldens skygge II. Evaluering af rådgivning- og behandlingseffekt. Odense: Videnscenter for Psykotraumatologi, Syddansk Universitet, 1-89.
Beck, N. & Elklit, A. (2012) Ud af voldens skygge. Evaluering af rådgivning og behandlingseffekt. Videnscenter for Psykotraumatologi, Syddansk Universitet. pp. 1-79.
Elklit, A.(2005). Kan akutte reaktioner forudsige vedvarende traumatiske reaktioner hos voldsofre? Forskningsnyt fra Psykologien, 14(4), 27-28.
Elklit, A. & Kristiansen, E.(1995). Voldsofrets reaktioner. I Kristiansen, E. (ed.). Voldsom ungdom. Randers Kommune (26-27).
Elklit, Anna & Elklit, A.(1993). Ti ud af femten voldsofre er utilfredse med retssystemet. Psykolog Nyt, 47(16), 564-566.
Elklit, A.(1993) To ud af tre voldsofre har problemer ét år efter overfaldet. Forskningsnyt fra psykologien, 2 (1-2), 20-21.
Elklit, A.(1993) Det kropslige aspekt i traumearbejdet. I A. Elklit (ed.): Psykologisk be-handling af voldsofre - en symposierapport. København: Dansk Psykologisk Forlag, 86-93.
Elklit, A.(1993). Offer for vold. Aarhus Universitetsforlag.
Elklit, A. (red.)(1993) Psykologisk behandling af voldsofre - en symposierapport. København: Dansk Psykologisk Forlag (1. udg. 1992 Psykologisk Institut, Aarhus Universitet).
Elklit, A.(1991) Rotters sætningsfuldendelsestest i en komparativ undersøgelse af voldsofre. Nordisk Psykologi, 43 (2), 107-121.
Elklit, A.(1989) Behandling af voldsofre. Nordisk Psykologi, 41(1), 75-79.
Laursen, H. & Elklit, A.(2009) Traumer hos børn på heldagsskole. Psykologisk Pædagogisk Tidsskrift, 46 (1-2), 9-24.
The aim of the present study was to investigate service utilization and satisfaction with service delivery among victims of rape and sexual assault. The victims completed a questionnaire comprising questions about whether they felt they received the appropriate help following an assault and whether they were met with positive staff attitudes within the public treatment system. The victims completed the questionnaire at three different time points: one month, three months and six months following an assault. Results showed that a high number of victims were satisfied with the support and treatment they received from psychologist and other part of the public help system. However, a high number of victims also reported receiving insufficient help from the social service and the police. Results are discussed in terms of consequences for victim recovery and the importance of receiving feedback from the victims in order to improve public service provision for victims of rape and sexual assault.
Nielsen, L. H., Beck Hansen, N. & Elklit, A. (2014). Service Utilization and Satisfaction with Service Providers in Help-Seeking Victims of Rape and Sexual Assault. US - China Law Review, 11(9), 1176-1191.
Nielsen, L. H., Hansen, M., Elklit, A. & Bramsen, R. H. (2016). Sexual assault victims participating in research: Causing harm when trying to help? Archives of Psychiatric Nursing, 30, 412-417. Doi: 10.1016/j.apnu.2016.01.0170883-9417
Affective computing is a multidisciplinary field that studies the various ways by which computational processes are able to elicit, sense, and detect manifestations of human emotion. While the methods and technology delivered by affective computing have demonstrated very promising results across several domains, their adoption by healthcare is still at its initial stages. With that aim in mind, this commentary paper introduces affective computing to the readership of the journal and praises for the benefits of affect-enabled systems for prognostic, diagnostic and therapeutic purposes.
Holmgård, C., Yannakakis, G. N., Karstoft, K.I. & Andersen, H. S. (2013). Stress Detection for PTSD via the StartleMart Game. Affective Computing and Intelligent Interaction (ACII), 523 - 528.
Karstoft, K.-I. & Elklit, A.: Spilbaseret behandling af veteraner med PTSD - en manual til individuel, kognitiv behandling med spilbaseret eksponering. Odense: Center for Psykotraumatologi, Syddansk Universitet. pp. 1-24. 2012. Rapporten kan findes
Conclusions: There is no evidence from randomized trials of a beneficial effect of eHealth interventions on IPV. More high-quality trials are needed, and we recommend harmonizing outcome reporting in IPV trials by establishing core outcome sets.
Linde, D. S., Bakiewicz, A., Normann, A. K., Hansen, N. B., Lund, A., & Rasch, V. (2020) Intimate Partner Violence and Electronic Health Interventions: Systematic Review and Meta-Analysis of Randomized Trials. Journal of Medical Internet Research. 22(12). Doi: 10.2196/22361
The aim of this study is to qualitatively explore the experiences of patients with PTSD with regard to using an mHealth app as a stand-alone intervention before commencing psychotherapeutic treatment.
Riisager, L., Christensen, A. B., Scharff, F. B., Arendt, I., Ismail, I., Lau, M. E., & Moeller, S. B. (2021). Patients' Experiences of Using a Self-help App for Posttraumatic Stress Disorder: Qualitative Study. JMIR formative research, 5(8), e26852. doi.org/10.2196/26852
Elklit, A. & Nielsen, L.H. (2008). Public Subsidized Assistance for Psychological Counseling in The Danish Public National Health Insurance Service. Brief Treatment and Crisis Intervention, 8(4), 352-357. Doi: 10.1093/brief-treatment/mhn022
Elklit, A.(2006) Risikofaktorer i forbindelse med kompliceret sorg – Traume & PTSD. Nordisk tidsskrift for palliativ medisin, 23(1), 49-54.
Elklit, A.(2007) Krisehjælp og krisestyring? Psykolog Nyt, 61 (19), 26-30
Elklit, A., Isidor, S., Kristensen T. E., Konnerup, A., Lyngby, M. & Obaidi, M.(2007). Psykologisk krisehjælp – ydelser, ordninger og behov. København: Dansk Krise- og Katastrofepsykologisk selskab og Psykologisk Institut, Aarhus Universitet. 1-149.
Elklit, A.(2006). Krisehjælp og territoriekamp Psykolog Nyt,14, 26.
Elklit, A.(1999). Krisehjælp til alle? Psykolog Nyt, 53 (17), 12-15.
Elklit, A. & Vesterby, A.(1999). Integreret krisehjælp til voldtægtsofre. Psykolog Nyt, 53 (20), 9 –11.
Elklit, A.(1997): Kropslige og transpersonlige behandlingsformer indenfor posttraumatisk kriseintervention. Psykologisk Pædagogisk Rådgivning, 34, 50-59.
Elklit, A.(1993): Det kropslige aspekt i traumearbejdet I A. Elklit (ed.): Psykologisk behandling af voldsofre - en symposierapport. København: Dansk Psykologisk Forlag, 86-93.
Dokkedahl, S. B., & Elklit, A. (2018). Undersøgelse af indbyrdes vold. Syddansk Universitet. Videnscenter for Psykotraumatologi.
Very few studies have investigated posttraumatic stress disorder (PTSD) as a consequence of bereavement from terminal illness. Therefore, knowledge on the traumatizing effects of bereavement and risk factors for traumatization from bereavement is rather sparse. This study investigated prevalence and predictors of PTSD in a group of people who had recently lost a close relative due to incurable cancer. The participants were 132 persons who were assessed with the Harvard Trauma Questionnaire, the Trauma Symptom Checklist, and the Crisis Support Scale. One month after the loss, 29.5% of the subjects had clinical PTSD and an additional 26.2% reached a subclinical PTSD level. Negative affectivity, social support, and locus of control in relation to the loss predicted 57% of the variance in PTSD severity. A focus on these risk factors in early assessment after bereavement will help identify subjects at risk for developing PTSD as a result of bereavement.
Kristensen, T. E., Elklit, A. & Karstoft, K.-I. (2012): Post-traumatic stress disorder after bereavement: Early psychological sequelae of losing a close relative due to terminal cancer. Journal of Trauma and Loss, 17, 1-14. Doi: 10.1080/15325024.2012.665304
Kristensen, T. E., Elklit, A., Karstoft, K.-I., & Palic, S. (2013). Predicting Chronic Post-traumatic stress disorder in Bereaved Relatives: A 6-Month Follow-Up Study. American Journal of Hospice and Palliative Medicine, 31(4), 396-405. Doi: 10.1177/1049909113490066
All children and young people are a huge resource. We have never had such well-educated and competent youngsters in the Nordic countries as we do today. At the same time there are all the younger persons who claim to be suffering from mental illness, and young persons who, for various reasons, risk ending up in vulnerable situations. Growing mental illness amongst young people is one of the most serious public health challenges facing our Nordic society. The project Youth in the Nordic Region focuses on young persons who suffer from or are at risk of suffering from mental illness, as well as their situation at school and their later transition to work and providing for themselves. A further important topic of the project is early retirement and retirement on mental health grounds amongst young adults.
Oboke, H., Abio, A., Ocaka, F. K., Sodeman, M., Elklit, A. & Ovuga, E. (2017) Impact of mental health training on the mental well-being of lay counselors in Northern Uganda. Jacobs Journal of Community Medicine, 3(1), 31.
Oboke, H. & Whyte, S.R. (2019) Anger and Bitter Hearts: The Spread of Suicide in Northern Ugandan Families. Ethnos - Journal of Anthropology. Doi: 10.1080/00141844.2019.1629982.
Correctly identifying chronic pain patients with posttraumatic stress disorder (PTSD) is important because the comorbidity of a chronic pain condition and PTSD is found to compromise treatment success. In addition, the existence of PTSD is associated with pain sensitisation, elevated levels of pain, and disability. Furthermore, the diagnostic criteria for PTSD has changed dramatically in the last two decades which has had a profound impact on the reported prevalence rates of PTSD in chronic pain samples. To our knowledge, no study has employed the DSM-IV criteria for estimating the prevalence of PTSD in chronic pain patients referred consecutively for multidisciplinary pain rehabilitation. The aim of the present study was to assess the prevalence of significant traumatic stressors and PTSD in chronic pain patients referred consecutively to multidisciplinary pain rehabilitation. We wanted to investigate whether specific pain diagnoses were more related to PTSD than others. Moreover, we investigated the possible association of altered sensory processing (hypersensitivity or hyposensitivity) and PTSD.
Andersen, T. E., Andersen, P. G., Vakkala, M. A. & Elklit, A.(2012) The traumatised chronic pain patient – Prevalence of posttraumatic stress disorder - PTSD and pain sensitisation in two Scandinavian samples referred for pain rehabilitation. Scandinavian Journal of Pain, 3, 39-43.
Andersen, T. E., Karstoft, K-I., Brink, O. & Elklit, A. (2016). Pain-catastrophizing and fear-avoidance beliefs as mediators between post-traumatic stress symptoms and pain following whiplash injury – A prospective cohort study. European Journal of Pain, 20(8), 41-52. Doi: 10.1002/ejp.848
Andersen, T. E., Elklit, A., & Brink O. (2013). PTSD Symptoms Mediate the Effect of Attachment on Pain and Somatisation after Whiplash injury. Clinical Practice & Epidemiology in Mental Health, 9, 75-83. Doi: 10.2174/1745017901309010075
Elklit, A. & Jones, A.(2006) The Association between Anxiety and Chronic Pain After Whiplash Injury: Gender-specific Effects. Clinical Journal of Pain, 22 (5), 487-490.
Norby, C. & Elklit, A.(2003) Unge i sorg: erfaringer fra et gruppeforløb med unge, som har mistet en kræftsyg forælder. Psykologisk Pædagogisk Rådgivning, 40(5), 520-537.
Bak, R.S., Nielsen, S.S., Lasgaard, M., Bramsen, R.H. & Elklit, A. (2011) Stadig ramt. Odense: Videnscenter for Psykotraumatologi, Syddansk Universitet.
While extremely violent experiences, such as floods and earthquakes, possibly trigger post‐traumatic stress disorder (PTSD) in the elderly, more predictable stressors, such as loss of physical integrity or the death of a spouse in late life, are perceived as “Nontraumatic Age‐Related Stressors”, leading to the conclusion that, “although these life events are clearly stressful they do not approximate traumatic stressors”. Bereavement in late life generally has been considered a stressful, but not a traumatic experience.The most common studied sequelae are grief, “complicated” grief, and depression. Even in the large longitudinal US study of bereavement in the elderly, “Changing Lives of Older Couples” (CLOC), with over 3000 variables “that cover every aspect of social, psychological, and physical functioning of older adults”, PTSD is not included.
The objectives of this study were to examine psychological sequalae of loss of a spouse in late life especially the occurrence of post‐traumatic stress disorder (PTSD) and possible predictors of PTSD and symptom development. Fifty‐four bereaved Danes (mean age 75 years) from five geographically different areas were studied by the Harvard Trauma Questionnaire (HTQ), the Trauma Symptom Checklist (TSC), and the Crisis Support Scale (CSS). One month after the loss, 27% of the subjects had PTSD. Six months after the loss, this number decreased to 17%; if the A2 criterion was dismissed, the number increased to 24%. Lack of expressive ability, numbing, fear of death or illness, and helplessness in relation to the loss predicted 73% of the variance of the HTQ‐total scores. The study concluded that for a considerable number of elderly, losing a spouse in late life appeared to be a traumatic experience. Pre‐ and peritraumatic factors together with numbing were important predictors of traumatization.
Elklit, A. & O’Connor, M. (2005) PTSD in a Danish population of elderly bereaved. Scandinavian Journal of Psychology, 46, 439-445.
O’Connor & Elklit, A. (2015). Treating PTSD symptoms in older adults. In U. Schnyder & M. Cloitre: Evidence Based Treatments for Trauma-Related Psychological Disorders - A Practical Guide for Clinicians (pp. 381-397). Berlin: Springer.
Armour, C., O’Connor, M., Elklit, A. & Elhai, J. (2013) Assessing PTSD's Latent Structure in Elderly Bereaved European Trauma Victims: Evidence for a Five Factor Dysphoric and Anxious Arousal Model. Journal of Nervous and Mental Disease, 210(10), 901-906. Doi: 10.1097/NMD.0b013e3182a5befb
O’Connor, M. & Elklit, A. (2010) Forståelse og behandlingen af sorgforløb. Stjernen, 19 (3), 14-18.
Elklit, A. & O’Connor, M. (2003) Ældre, der sørger – om posttraumatisk stress forstyrrelse hos ældre efterladte og betydningen af personlighed for sorgreaktionen. Psykolog Nyt, 57(21), 3-11.