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Illness, Health and Grief

Our research on this subject covers a wide field, ranging from chronic illnesses and grief to eating disorders and traumas. At this page you will find a list of our completed and ongoing subjects related to the research area.










Projects related to the field of research:


Ongoing projects

Completed projects

The World Health Organization's 11th revision to the International Classification of Diseases manual (ICD-11) will differentiate between two stress-related disorders: PTSD and Complex PTSD (CPTSD). ICD-11 proposals suggest that trauma exposure which is prolonged and/or repeated, or consists of multiple forms, that also occurs under circumstances where escape from the trauma is difficult or impossible (e.g., childhood abuse) will confer greater risk for CPTSD as compared to PTSD. The primary objective of the current study was to provide an empirical assessment of this proposal.

Current issue:
Hyland, P., Murphy, J., Shevlin, M., Vallieres, F., McElroy, E., Elklit, A., Christoffersen, M. & Cloitre, M. (2017): Variation in post-traumatic response: the role of trauma type in predicting ICD-11 PTSD and CPTSD symptoms. Social Psychiatry Psychiatric Epidemioligy. Doi: 10.1007/s00127-017-1350-8
Related publications:
Murphy, S., Elklit, A., Dokkedahl, S. & Shevlin, M. (2016). Testing the validity of the proposed ICD-11 PTSD and complex PTSD criteria using a sample from Nothern Uganda. European Journal of Psychotraumatology. Doi: 10.3402/ejpt.v7.32678

Andersen, T. E., Hansen, M., Ravn, S. L., Seehus, R., Nielsen, M., & Vægter, H. B.(2017). Validation of the PTSD-8 scale in chronic pain patients. Pain Medicine, 19(7), 65-72. Doi: 10.1093/pm/pnx166

5–15% of people with concussion experience post-concussion symptoms (PCS) >3 months post-injury. The etiology of PCS is complex, with interacting biological, psychological, and environmental factors. Attachment styles (AS) is grounded in childhood and activated when one is exposed to stressful situations in order to feel secure. AS may be important to understand how interpersonal processes affect the development of PCS and illness responses. The aim of this study was to explore the associations between AS, illness perception, illness behavior and symptom reporting in young persons with a recent concussion.
Results: 1101 patients responded. Using linear regression models, the ECR-RS anxiety score was positively associated with the PCS score: 2.1(95%CI 1.6; 2.6), p < 0,001, whereas the ECRRS avoidance score was negatively associated with the PCS score: −3,3 (95%CI -4.3; −2.3), p < 0,001. Structural equation model analyses showed significant associations between ECR-RS dimensions and B-IPQ, BRIQ and RPQ scores.
Conclusion: Knowledge about the role of various attachment styles for the development of persisting PCS may contribute to the understanding of why young persons with concussion have very different illness courses.

Current issue:
Tuborgh, A., Svendsen, S. W., Schröder, A., Elklit, A., Hunter, J. & Rask, C. U., jun. (2019). Attachment style and symptom reporting in young persons with concussion. Journal of Psychosomatic Research. 121, 123. Doi: 10.1016/j.jpsychores.2019.03.072


Caring for a child with a chronic and life-threatening disease such as severe childhood epilepsy is a predictor of high levels of depression, anxiety, and post-traumatic stress disorder (PTSD) in caregivers. Caregiver-perceived stress may challenge the sustainment of a positive caregiver-child relation, and more significant behavioral dysfunctions are seen in children where the caregiver-child relation is challenged; this, in turn, imposes more stress on the family.
The Objectives in this study was to assess the prevalence of psychopathology and the level of stress in parents of children with severe epilepsy to gain a better understanding of parental support needs.

Current issue:
Jakobsen, A. V., Møller, R. S., Nikaronova, M., & Elklit, A. (2020) The impact of severe pediatric epilpsy on experienced stress and psychopathology in parents. Epilepsy & Behavior, 113. Doi: 10.1016/j.yebeh.2020.107538

The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge.

Methods: A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012 and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC). Primary outcome was health-related quality of life (HRQOL) at 12 months. Secondary outcomes were sense of coherence (SOC), anxiety, depression, and post-traumatic stress disorder (PTSD) assessed at 3 and 12 months after ICU discharge including utilization of healthcare services at 12 months.

Results: At 12 months, we found no differences in HRQOL between groups (mean difference in the Physical Component Summary score, 1.41 [95 % CI, −1.53 to 4.35; p = 0.35] (n = 235); and in the Mental Component Summary score, 1.92 [95 % CI, −1.06 to 4.90; p = 0.11] (n = 235). No differences were found on self-reported SOC (p = 0.63), anxiety (p = 0.68), depression (p = 0.67), PTSD (p = 0.27), or the utilization of healthcare services including rehabilitation. We found a difference on anxiety, when a cut-off point ≥11 was applied, in per protocol analysis of complete cases at 3 months favoring the intervention (8.8 % vs. 16.2 %, p = 0.04).

Conclusions: The tested recovery program was not superior to standard care during the first 12 months post-ICU.

Current issue:
Jensen, J., Egerod, I., Overgaard, D., Bestle, M., Elklit, A., Jakobsen, L.S. & Laurid-sen, H. (2016). A recovery program to improve quality of life, sense of coherence and psychological health in ICU survivors: A multicenter randomized controlled trial, the RAPIT study. Intensive Care Medicine 42(11), 1733-1743. Doi: 10.1007/s00134-016-4522-1

In more than 90% of whiplash accidents a good explanation regarding the association between trauma mechanism, organic pathology, and persistent symptoms has failed to be provided.
Objective: We predicted that the severity of chronic whiplash-associated disorder (WAD), measured as number of whiplash symptoms, pain duration, pain-related disability, and degree of somatisation would be associated with the number of post-traumatic stress disorder symptoms (PTSD). Secondly, we expected attachment-anxiety to be a vulnerability factor in relation to both PTSD and WAD.
Design: Data were collected from 1,349 women and 360 men suffering from WAD from the Danish Society for Polio, Traffic, and Accident Victims. The PTSD symptoms were measured by the Harvard Trauma Questionnaire. All three core PTSD clusters were included: re-experiencing, avoidance, and hyperarousal. Attachment security was measured along the two dimensions, attachment-anxiety and attachment-avoidance, by the Revised Adult Attachment Scale.
Results: PTSD symptoms were significantly related to the severity of WAD. In particular, the PTSD clusters of avoidance and hyperarousal were associated with the number of whiplash symptoms, disability, and somatisation. Attachment-anxiety was significantly related to PTSD symptoms and somatisation but not to pain and disability. A co-morbidity of 38.8% was found between the PTSD diagnosis and WAD, and about 20% of the sample could be characterised as securely attached.
Conclusions: The PTSD clusters of avoidance and hyperarousal were significantly associated with severity of WAD. The study emphasises the importance of assessing PTSD symptomatology after whiplash injury. Furthermore, it highlights that attachment theory may facilitate the understanding of why some people are more prone to develop PTSD and WAD than others.


Current issue:
Andersen, T. E., Elklit, A. & Vase, L.(2011) The Relationship between Chronic Whiplash-Associated Disorder and Posttraumatic Stress Attachment-Anxiety may be a Vulnerability Factor. European Journal of Psychotraumatology , 2. Doi: 10.3402/ejpt.v2i0.5633

The current study investigated relationships between different experiences of child maltreatment (CM) and disordered eating (DE) in a large population-based sample of Danish young adults. Participants completed a structured interview comprising socio-demographic, psychological and physical domains. Questions regarding CM, DE, PTSD symptoms and self-esteem were analyzed using chi-square-tests, ANOVAs, hierarchical regression, and multiple mediation analyses. Participants with a history of CM experienced higher levels of DE than non-abused individuals. PTSD symptoms and self-esteem appeared to differentially mediate the relationship between three classes of CM and DE. Whereas the relation between emotional and sexual abuse with DE was partially mediated via participants' level of PTSD symptoms and self-esteem with emotional abuse having a stronger impact on self-esteem and sexual abuse more strongly influencing PTSD symptoms, the relation between polyvictimization and DE was fully mediated by PTSD and self-esteem, mainly due to the indirect effect via PTSD.

Current issue:
Wolf, N. & Elklit, A. (2018). The impact of different types of child maltreatment on disordered eating in adulthood: A mediating role of PTSD and self-esteem? Journal of Child and Adolescent Trauma, 1-12. Doi: 10.1007/s40653-018-0224-x

Related publications:

Rønholt, S., Beck, N.N., Karsberg, S. & Elklit, A. (2012). Post-Traumatic Stress Symptoms and Childhood Abuse Categories in a National Representative Sample: Associations to Body Mass Index (BMI). European Journal of Psychotraumatology.

The utilization of a post-traumatic stress disorder (PTSD) diagnostic framework for categorizing the psychological adjustment of breast cancer (BC) patients has been debated. We wanted to study the prevalence of PTSD and predictors for PTSD. DESIGN. The current study is a one-year follow-up of 64 early BC patients. METHODS. PTSD, subclinical PTSD, delayed onset PTSD and several theory-driven predictive variables were examined. RESULTS. Thirteen per cent of the patients showed full symptoms of disease-related PTSD compared with 7% at the initial study (6 weeks after diagnosis). Considerable changes were observed in all PTSD clusters (intrusion, avoidance, and arousal), in most cases representing a decrease in symptom level. Immature defence style, emotional coping, avoidant behaviour, and negative affectivity were all implicated as predicting variables in a hierarchical multiple regression analysis which explained 65% of the variability of PTSD severity one year after diagnosis. CONCLUSIONS. This study highlights the PTSD diagnosis as being highly relevant in oncology settings. Early screening for the above-mentioned four variables may help early identification of the patients most at risk of developing PTSD.

Current issue:
Elklit, A. & Blum, A. (2010): Psychological adjustment one year after the diagnosis of breast cancer: a prototype study of delayed PTSD. British Journal of Clinical Psychology, 50, 350-363. Doi: 10.1348/014466510X527676

  • Elklit, A. & O’Connor, M. (2003). Ældre, der sørger – om posttraumatisk stress for-styrrelse hos ældre efterladte og betydningen af personlighed for sorgreaktionen. Psykolog Nyt, 57, (21), 3-11.
  • Elklit, A. & O’Connor, M. (2005). Post-traumatic stress disorder in a Danish population of elderly bereaved. Scandinavian Journal of Psychology, 46, 439-445.
  • 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 & 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.

Parents who have lost an infant prior to, during, or following birth often interpret the event as highly traumatic. The present systematic review included 46 articles based on 31 different studies of posttraumatic stress disorder (PTSD) in parents bereaved by infant death. The PTSD prevalence in mothers differed widely across studies with estimated rates at 0.6–39%. PTSD in fathers following infant loss has been less extensively studied but PTSD levels were generally much lower than in mothers with reported prevalence rates at 0–15.6% across studies. PTSD symptoms were not found to differ much depending on whether the death occurred prior to, during, or following birth and nor was gestational age consistently associated with PTSD severity. A number of risk and protective factors have been found to be associated with PTSD severity. Relevant focus areas for future research are presented along with considerations for future pregnancies and children. The suffering associated with PTSD following infant loss is overwhelming because of the rates at which such losses occur around the world. For this reason, it is problematic that not all types of infant loss resulting in sufficient symptoms of re-experiencing, avoidance, and arousal can elicit a DSM-5 PTSD diagnosis.

Current issue:
Christiansen, D. M. (2017). Posttraumatic stress disorder in parents following infant death: A systematic review. Clinical Psychology Review, 51, 60-74. Doi: 10.1016/j.cpr.2016.10.007

Related publications

Murphy, S., Shevlin, M., & Elklit, A. (2014). Psychological Consequences of Pregnancy Loss and Infant Death in a Sample of Bereaved Parents. Journal of Loss and Trauma, 19(1), 56-69. Doi: 10.1080/15325024.2012.735531

Shevlin, M., Boyda, D., Elklit, A. & Murphy. S. (2014). Adult attachment styles and the psychological response to infant bereavement. European Journal of Psychotraumatology. 5: 23295. Doi: 10.3402/ejpt.v5.23295

Christiansen, D., Olff, M. & Elklit, A. (2013). Parents bereaved by infant death: PTSD symptoms up to 18 years after the loss. General Hospital Psychiatry, 35(6), 605-611. Doi:10.1016/j.genhosppsych.2013.06.006

O’Connor, M. & Elklit, A. (2010). Forståelse og behandlingen af sorgforløb. Stjernen, 19 (3), 14-18.

O’Connor, M. & Elklit, A. (2004). Forståelse og behandlingen af sorgforløb. Psykolog Nyt, 58, (22), 3-9.

Jind, L & Elklit, A. (1998). Cognitive Processing of Emotional Loss. Paper presented at the 4th Congress of the International Society for Cultural Research and Activity Theory, Aarhus, June 7-11, 1998. In Hedegaard, M. & Chaiklin, S. (Eds.): Activity Theory and Cultural Historical Approaches to Social Practice. Aarhus, Denmark: Department of Psychology, University of Aarhus. 289-290.

Elklit, A. (1996). Fire forskellige sorgmønstre. Landsforeningen Spædbarnsdød, Stjernen, 5 (5), 17-18.

Christiansen, D. M. (2019). The trauma of infant loss. International Journal of Birth & Parent Education, 6(2), 15-19.

Christiansen, D. M. (2017). Posttraumatic stress disorder in parents following infant death: A systematic review. Clinical Psychology Review, 51, 60-74. Doi: 10.1016/j.cpr.2016.10.007

Elklit, A. & Guðmundsdóttir, D. B. (2006): Assessment of guidelines for good psychosocial practice for parents who have lost an infant through perinatal or postnatal death. Nordic Psychology, 58(4), 315-330.

Jind, L., Elklit, A. & Christiansen, D. (2010): Cognitive Schemata and Processing among Parents Bereaved by Infant Death. Journal of Clinical Psychology in Medical Settings, 17 (4), 366-377. Doi: 10.1007/s10880-010-9216-1

Christiansen, D., Olff, M., & Elklit, A. (2013). Parents bereaved by infant death: PTSD symptoms up to 18 years after the loss. General Hospital Psychiatry, 35(6), 605-611. Doi: 10.1016/j.genhosppsych.2013.06.006

Murphy, S., Shevlin, M., & Elklit, A. (2014). Psychological Consequences of Pregnancy Loss and Infant Death in a Sample of Bereaved Parents. Journal of Loss and Trauma, 19(1) 56-69.

Shevlin, M., Boyda, D., Elklit, A. & Murphy. S. (2014). Adult attachment styles and the psychological response to infant bereavement. European Journal of Psychotraumatology. 5. Doi: 10.3402/ejpt.v5.23295

Elklit, A. & Jind, L. (1999). Forældrereaktioner på spædbarnsdød, København: Forlaget Skolepsykologi/Dansk Psykologisk Forlag,  1-152.

Elklit, A. (1999). Kønsforskelle, social støtte og trivsel i parforhold hos forældre, der har mistet et spædbarn.  Stjernen, 8 (1), 33-37.

Elklit, A. (1997). En profil af forældre, der har mistet et spædbarn: Hvad skete der ved dødsfaldet, og hvordan forholdt forældrene sig til det. Stjernen, 6 (4), 5-9.

Elklit, A. (1997). Hvor belastede er forældre, der har mistet et spædbarn? Stjernen, 6(5), 5-9.

Elklit, A. (1996). Fire forskellige sorgmønstre. Stjernen, 5 (5), 17-18.

The aim of the study was to compare the prevalence of posttraumatic stress disorder (PTSD) in 44 adolescent and young adult survivors of childhood cancer and identify which psychological factors predict the degree of traumatization. Mean time since diagnosis was 76 months. The PTSD prevalence was 18%. Time since diagnosis was associated with less PTSD severity. Females had higher level of PTSD than males. Age at diagnosis and treatment types were not associated with PTSD. Female gender, low self-worth, immature defence style, lack of close attachment, emotional coping and somatization explained 70% of the total traumatization variance.

Current issue:
Jeggesen, A., Gudmundsdóttir, D. B. & Elklit, A. (2012).Posttraumatic Stress Disorder in Adolescent and Young Adult Survivors of Childhood Cancer. Nordic Psychology, 64, 291-304.Doi: 10.1080/19012276.2012.768037

The current study evaluated the psychological sequelae in 66 parents of extreme low and very low birth weight infants (mean weight of 842 g). Parents who had given birth within a 3-year period prior to the study were chosen from the archives of a neonatal ward and surveyed regarding posttraumatic stress, coping strategies, and social support. Thirty-five percent of the parents reported that their child had a handicap. Twenty percent of the women met the criteria of posttraumatic stress disorder (PTSD) at the time of the study, and an additional 10% met the criteria for a subclinical PTSD diagnosis. Female gender, handicap of the child, general distress during hospitalization, distressing contact with hospital staff, experienced distress at homecoming, and emotional coping, explained 72% of the degree of traumatization. Psychological support and intervention is recommended during the hospital stay of a premature infant who has a handicap and after the homecoming to prevent the development of chronic PTSD and reduce the associated distress.

Current issue:
Elklit, A., Hartvig, T., & Christiansen, M. (2007). Psychological Sequelae in Parents of Extreme Low and Very Low Birth Weight Infants. Clinical Psychology in Medical Settings, 14, 238-247.

Studies show that traumatic stress symptoms are common in parents of children admitted to the pediatric intensive care unit (PICU). Family-centred care (FCC) has shown promising potential in reducing levels of traumatic stress in this group of parents.
Objectives: To investigate the association between parents' experience of nursing care and levels of traumatisation, to identify potential gender differences within this group, and to examine the possible relationships among the severity of a child's illness, the parents' fear of losing their child, and the parents' experience of support and development of acute stress disorder (ASD) symptoms.
Ethical issues/approval: This study was approved by The Central Denmark Regional Committee on Health Research Ethics and by the Danish Data Agency  and data were stored, protected and destroyed according to their regulations.
Methodology/design: This cross-sectional study involved 90 parents of children admitted to PICU at the University Hospital of Aarhus from August 2011 to August 2012. The parents filled out a self-report questionnaire package at the time of their child's discharge from the hospital.
Results: The experience of support from the nurses was high in both parents and was associated with ASD. About one-third of the parents had ASD or subclinical ASD. No significant gender differences existed when symptoms were measured dimensionally. When measured categorically, 17% of the mothers and 7% of the fathers had ASD. Mothers with very young children had higher levels of acute stress; fathers whose children had high illness severity scores exhibited more acute stress.

Study limitations: Limitations have been identified in relation to the sample size of the study, the cross-sectional design and the short amount of time the families were in contact with PICU.
Conclusion: The fathers and mothers were very pleased with the perceived care at the unit. The experienced care was positively associated with acute stress, but not with illness severity, or fear of losing the child. More research is needed to understand the dynamics of family-centred care.

Current issue:
Mortensen, J., Simonsen, B. O., Eriksen, S. B., Skovby, P., Dall, R. & Elklit, A. (2014). Family-centred care and traumatic symptoms in parents of children admitted to PICU. Scandinavian Journal of Caring Sciences, 29(3), 495-500. Doi: 10.111/scs.12179

The purpose of the study was to investigate Wallander and Varni’s (1998) disability-stress coping model in a sample of 105 Icelandic parents of chronically ill children. The Revised Adult Attachment Scale (RAAS), the Attributional Scale (AS), the Defence Style Questionnaire (DSQ), the Sense of Coherence Scale (SOC), the World Assumption scale (WAS), The Coping Style Questionnaire (CSQ), The Impact on Family scale (IFS), the Trauma Symptom Checklist (TSC), and the Harvard Trauma Questionnaire (HTQ), were completed by the parents of children with various diseases. Despite the heterogeneity of the sample in terms of disease type, PTSD was present in 13.2% of the parents and an additional 28.6% had subclinical PTSD. Emotional coping, extent of daily care, time since diagnosis, and changes in employment due to the disease explained 71% of the variance in HTQ total score.

Current issue:
Guðmundsdóttir, H., Guðmundsdóttir, D., & Elklit, A.(2006) Risk and resistance factors for psychological distress in Icelandic parents of chronically ill children: An application of the the Wallander and Varni’s disability-stress coping model. Clinical Psychology in Medical Settings, 13, 299-306.

We hypothesised that being diagnosed with gynaecological cancer influences adult attachment and occurrence of depression and post‐traumatic stress disorder (PTSD). The main aim of the study was to assess changes in the attachment dimensions, PTSD and depression from baseline to 5‐month post‐treatment. Further, we evaluated the association between attachment avoidance/anxiety dimensions and PTSD/depression among women newly diagnosed with ovarian, endometrial, or cervical cancer.
Methods: Consecutive Danish‐speaking women aged 20 to 75 years and treated surgically for primary gynaecological cancer were eligible. All patients were offered a rehabilitation programme consisting of two face‐to‐face sessions and two phone calls carried out by a nurse. Patients were asked to complete the Revised Adult Attachment Scale, the Harvard Trauma Questionnaire and the Major Depression Inventory at baseline and at 5‐month follow‐up. In all, 151 women consent to participate in the sessions where 51 fulfilled Revised Adult Attachment Scale questionnaire and contribute with socio‐demographic data.
Results: We found significant positive changes within the attachment anxiety dimension among women with ovarian cancer, a significant reduction of PTSD among endometrial cancer patients and insignificant changes in depression among all cancer types. The attachment anxiety dimension significantly increased the odds for PTSD and depression.
Conclusions: Depression and PTSD were prevalent among ovarian and cervical cancer patients. The adjustment of rehabilitation according to patients' attachment anxiety dimension contains possibilities for indirect impact on PTSD and depression symptoms

Current issue: 
Adellund Holt, K., Jensen, P. T., Gilså Hansen, D.4, Elklit, A., Mogensen, O. (2016). Rehabilitation of Women with Gynaecological Cancer – the association between Adult Attachment, Post-Traumatic Stress Disorder, and Depression. Psych-Oncology, 25(6), 691-698. Doi: 10.1002/pon.3996
This paper examines degree of traumatisation, defence styles, coping strategies, symptomatology, and social support in a small sample of HIV‐positive men and women in an effort to ascertain the psychological implications of living with Human Immunodeficiency Virus (HIV). Traumatisation and the potentially mediating effects of defence styles have only been the subject of a few studies of HIV positives. The study is based on a socio‐demographic questionnaire, the Impact of Event Scale, the Defence Style Questionnaire, the Coping Styles Questionnaire, the Trauma Symptom Checklist, and the Crisis Support Scale. A degree of traumatisation that warrants treatment was found together with an association between particular coping strategies and symptomatology, and particular defence styles and symptomatology, respectively. Social support had increased over time, which is contrary to other research findings on social support.

Current issue:
Pedersen, S.S. & Elklit, A.(1998) Traumatisation, Psychological Defense Style, Coping, Symptomatology, and Social Support in HIV-positive: A Pilot Study. Scandinavian Journal of Psychology, 39 (2), 55-60.

Related publications:
Sørensen, H. & Elklit, A.(2005) Tidlig intervention over for HIV-positive: En psykosocial model for kriseintervention efter overbringelse af fatale diagnoser. Månedsskrift for praktisk lægegerning, 83 (3), 365-379.

Elklit, A.(1998) Traumatisering, forsvar og belastning hos HIV-positive. Forskningsnyt fra psykologien, 7 (5), 4-6.

Elklit, A.(1998) Psykisk sundhed, symptomatologi, social støtte og mestring hos HIV-positive: En litteraturoversigt. Nordisk Psykologi, 50 (2), 120-134.

The purpose of the study was to make a psychological profile of Danish women with Eating Disorders, who were not currently hospitalized. 75 women between the ages of 19 and 46 years participated. 22 participants suffered from a clinical eating disorder (ED). 20 women had previously suffered from a clinical ED, and 33 women had never suffered from ED. The study included sociodemographic data, problems in relation to eating and weight, exposure to stressful life events, and the following questionnaires: The Eating Disorder Inventory, the Rosenberg Self–Esteem Scale, the Coping Styles Questionnaire, the Perceived Stress Scale, the Defense Style Questionnaire, and the Trauma Symptom Checklist. Psychologically, women with ED differed significantly from women without ED by using a more primitive defense style, perceiving themselves as being more exposed to stress, using more inefficient methods of coping and having lower self–esteem. Unexpectedly, the study also showed that recovery from an ED was resulting in normalisation of both behavioral and psychological characteristics. The implications of these findings are discussed.

Current issue:
Blaase, H. & Elklit, A. (2001): Psychological characteristics of women with eating disorders – permanent or transient features. Scandinavian Journal of Psychology, 42, 467- 478.

Related publications:
Wolf, N. & Elklit, A. (2018). The impact of different types of child maltreatment on disordered eating in adulthood: A mediating role of PTSD and self-esteem? Journal of Child and Adolescent Trauma, 1-12. Doi: 10.1007/s40653-018-0224-x

Rønholt, S., Beck, N.N., Karsberg, S. & Elklit, A. (2012). Post-Traumatic Stress Symptoms and Childhood Abuse Categories in a National Representative Sample: Associations to Body Mass Index (BMI). European Journal of Psychotraumatology.

This study aimed to estimate the prevalence of severe Posttraumatic Stress Disorder (PTSD) symptoms and to identify factors associated with PTSD in survivors of intensive care unit (ICU) treatment following traumatic injury. Methods: Fifty-two patients who were admitted to an ICU through the emergency ward following traumatic injury were prospectively followed. Information on injury severity and ICU treatment were obtained through medical records. Demographic information and measures of acute stress symptoms, experienced social support, coping style, sense of coherence (SOC) and locus of control were assessed within one-month post-accident (T1). At the six months follow-up (T2), PTSD was assessed with the Harvard Trauma Questionnaire (HTQ). Results: In the six months follow-up, 10 respondents (19.2%) had HTQ total scores reaching a level suggestive of PTSD (N = 52), and 11 respondents (21%) had symptom levels indicating subclinical PTSD. Female, five illness factors: coma time, mechanical ventilation, sedation, benzodiazepine, pain relieving medication, and four psychological factors: symptoms of acute stress (T1), fear of death and/or feeling completely helpless and powerless in relation to the accident and/or ICU (T1), SOC (T1) and more external locus of control (T1) correlated significantly with PTSD symptoms at T2. In the linear regression analysis, female, length of sedation, dissociation (T1), hypervigilance (T1), and external locus of control predicted 58% of the variation of PTSD. Conclusions: High levels of PTSD symptoms occurred in 19.2% of respondents in six months following traumatic injury requiring ICU admission. Screening for the variables gender, length of sedation, dissociation, hypervigilance, and locus of control after ICU admission following traumatic injuries may help to predict who will develop PTSD.


Current issue:
Ratzer, M., Brink, O., Knudsen, L. & Elklit, A. (2014). Posttraumatic stress in intensive care unit survivors – a prospective study. Health Psychology and Behavioral Medicine, 2(1), 882-898. Doi: 10.1080/02646838.2014.945516
Related publications:
Ratzer, M., Romano, E. & Elklit, A. (2014). Posttraumatic Stress Disorder in Patients Following Intensive Care Unit Treatment: A Review of Studies Regarding Prevalence and Risk Factors. Journal of Treatment and Trauma, 3(2), 1-15. Doi: 10.4172/2167-1222.1000190

The development of persistent pain post-whiplash injury is still an unresolved mystery despite the fact that approximately 50% of individuals reporting whiplash develop persistent pain. There is agreement that high initial pain and PTSD symptoms are indicators of a poor prognosis after whiplash injury. Recently attachment insecurity has been proposed as a vulnerability factor for both pain and PTSD. In order to guide treatment it is important to examine possible mechanisms which may cause persistent pain and medically unexplained symptoms after a whiplash injury.
Aim: The present study examines attachment insecurity and PTSD symptoms as possible vulnerability factors in relation to high levels of pain and somatisation after sub-acute whiplash injury.
Methods: Data were collected from 327 patients (women = 204) referred consecutively to the emergency unit after acute whiplash injury. Within 1-month post injury, patients answered a questionnaire regarding attachment insecurity, pain, somatisation, and PTSD symptoms. Multiple mediation analyses were performed to assess whether the PTSD symptom clusters mediated the association between attachment insecurity, pain, and somatisation.
Results: A total of 15% fulfilled the DSM-IV symptom cluster criteria for a possible PTSD diagnosis and 11.6% fulfilled the criteria for somatisation. PTSD increased the likelihood of belonging to the moderate-severe pain group three-fold. In relation to somatisation the likelihood of belonging to the group was almost increased four-fold. The PTSD symptom clusters of avoidance and hyperarousal mediated the association between the attachment dimensions, pain, and somatisation.
Conclusion: Acknowledging that PTSD is part of the aetiology involved in explaining persistent symptoms after whiplash, may help sufferers to gain early and more suited treatment, which in turn may prevent the condition from becoming chronic.


Current issue:
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, 1-8.

Related publications:
Andersen, T. E. (2012). The development of chronic pain. A diathesis-stress perspective on whiplash associated disorders and other pain conditions. Ph.D. Syddansk Universitet.

Andersen, T. E., Elklit, A. & Vase, L.: (2011) The Relationship between Chronic Whiplash-Associated Disorder and Posttraumatic Stress - Attachment-Anxiety may be a Vulnerability Factor. European Journal of Psychotraumatology, 2. Doi: 10.3402/ejpt.v2i0.5633

Jones, A. & Elklit, A.(2007)The Association between Gender, Coping, and Whiplash Related Symptoms in Sufferers of Whiplash Associated Disorder. Scandinavian Journal of Psychology,48 (1), 75-80.

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.

Elklit, A.(2000) Følger af whiplash. København: PTU.

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 ;20(8):1241-52. Doi: 10.1002/ejp.848


This study investigated symptoms of eating disorder, depression, and anxiety among Roux-en-Y gastric bypass patients two years after surgery, and the relationship between these characteristics and weight loss. Respondents completed assessment questionnaires including Eating Disorder Inventory-2 (EDI-2), Harvard Anxiety and Depression Scale (HADS), and questions related specifically to binge eating. Forty-five patients (8 men, 37 women) out of 65 (67%) responded. Scores were significant higher on impulse regulation, interoceptive awareness, ineffectiveness, maturity fears and interpersonal distrust in comparison with a Danish norm group (p ≤ 0.05). The weight losses obtained after surgery varied from 12 to 60% of the starting weights. Binge eating and ineffectiveness were found to significantly correlate with weight loss variations after surgery (p ≤ 0.05). The results of this study indicate that knowledge of the potential influence of eating disorder symptoms on outcomes after bariatric surgery is needed in order to optimize weight outcomes following surgery.

► We investigate eating disorder symptoms in post-operative gastric bypass patients.
► Considerable weight loss variations were reported two years after surgery.
► Eating disorders symptoms were significantly related with weight loss variations.


Current issue:
Beck, N.N., Mehlsen, M. & Støving, R.K. (2012). Psychological Characteristics and Associations with Weight Outcomes two Years after Gastric Bypass Surgery: Postoperative Eating Disorder Symptoms are associated with Weight Loss Outcomes. Eating Behaviors, 13(4), 394-397.

The objectives of the present study were to examine the prevalence of posttraumatic stress disorder (PTSD) and to identify predicative risk factors for PTSD in bereaved people after a terminal illness. Fifty-four persons (mean age 60 years) participated in the study. Demographic, peritraumatic, and psychosocial factors were assessed in order to identify variables that affected PTSD severity. Six months after the loss, 21.6 % of the subjects had PTSD, an 8.6 % decrease from PTSD measured one month after the loss. Intake of medicine after the loss, place of death, not having a close intimate, negative affectivity, and the A2 criterion predicted 65 % of PTSD severity. A considerable number of the bereaved were still at great risk for developing PTSD six months after loss.

Current issue:
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

Related publications:
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

Studies of specific groups such as military veterans have found that posttraumatic stress disorder (PTSD) is linked to adverse health outcomes including unhealthy weight. The aim of this study was to examine the relationship between PTSD symptoms, experiences of childhood trauma and weight in a community sample. Methods: A stratified random probability survey was conducted in Denmark by the Danish National Centre for Social Research between 2008 and 2009 with 2,981 participants born in 1984, achieving a response rate of 67%. The participants were interviewed with a structured interview with questions pertaining PTSD symptomatology, exposure to childhood abuse, exposure to potentially traumatizing events, height, and weight. Underweight was defined by a body mass index (BMI)B18.5, overweight was defined by a BMI ≥ 25 and < 30 and obesity was defined by a BMI ≥ 30. Results: PTSD symptomatology and childhood abuse were significantly associated with both underweight and overweight/obesity. Childhood emotional abuse was especially associated with underweight, whereas sexual abuse and overall abuse were particularly associated with overweight/obesity. Conclusion: These findings indicate that health care professionals may benefit from assessing PTSD and childhood abuse in the treatment of both overweight and underweight individuals.

Current issue:
Roenholt, S., Beck, N. N., Karsberg, S. H & Elklit, A.(2012) Post-Traumatic Stress Symptoms and Childhood Abuse Categories in a National Representative Sample for a Specific Age Group: Associations to Body Mass Index. European Journal of Psychotraumatology, 3. Doi:10.3402/ejpt.v3i0.17188

The objectives of the present study were to examine whether living with an individual who suffered from epilepsy was a potentially traumatizing event and to identify predictive risk factors in developing post-traumatic stress disorder (PTSD). Methods: Six hundred fourteen respondents completed the Harvard Trauma Questionnaire, the Crisis Support Scale, the Hopkins Symptom Checklist—25, and the Dyadic Adjustment Scale. In addition, demographic variables were included in order to identify factors that might predict PTSD. Results: The percentage of the participants that fulfilled the symptom criteria of PTSD was 7.7%, and an additional 43.9% reported a subclinical level of PTSD. Clinical and subclinical anxiety was unveiled in 9.3% of the respondents. Conclusion: Partners were at risk of PTSD when living with a patient with epilepsy. Identified variables that explained PTSD were frequency and types of seizures medication, side effects, and objective and subjective epilepsy severity, anxiety, and depression. High level of social support decreased the level of traumatic stress

Current issue:
Norup, D. A. & Elklit, A. (2013). Post-traumatic stress disorder in Partners of People with Epilepsy. Epilepsy & Behavior, 27(1), 225-232. Doi: 10.1016/j.yebeh.2012.11.039

Last Updated 12.04.2021