Thomas Elbert

Publications (476) View all

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  Available from: Thomas Elbert

  Article: Treatment of traumatized victims of war and torture: a randomized controlled comparison of narrative exposure therapy and stress inoculation training.

  D Hensel-Dittmann, M Schauer, M Ruf, C Catani, M Odenwald, T Elbert, F Neuner
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  ABSTRACT: The aim of the present randomized controlled trial was to compare the outcome of 2 active treatments for posttraumatic stress disorder (PTSD) as a consequence of war and torture: narrative exposure therapy (NET) and stress inoculation training (SIT). Twenty-eight PTSD patients who had experienced war and torture, most of them asylum seekers, received 10 treatment sessions of either NET or SIT at the Outpatient Clinic for Refugees, University of Konstanz, Germany. Posttests were carried out 4 weeks after treatment, and follow-up tests were performed 6 months and 1 year after treatment. The main outcome measure was the PTSD severity score according to the Clinician-Administered PTSD Scale (CAPS) at each time point. A significant reduction in PTSD severity was found for NET, but not for SIT. A symptom reduction in the NET group occurred between pretest and the 6-month follow-up examination, the effect size being d = 1.42 (for SIT: d = 0.12), and between pretest and the 1-year follow-up, the effect size being d = 1.59 (for SIT: d = 0.19). The rates and scores of major depression and other comorbid disorders did not decrease significantly over time in either of the 2 treatment groups. The results indicate that exposure treatments like NET lead to a significant PTSD symptom reduction even in severely traumatized refugees and asylum seekers.
  Psychotherapy and Psychosomatics 08/2011; 80(6):345-52. · 6.28 Impact Factor
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  Available from: Thomas Elbert

  Article: Transgenerational impact of intimate partner violence on methylation in the promoter of the glucocorticoid receptor.

  K M Radtke, M Ruf, H M Gunter, K Dohrmann, M Schauer, A Meyer, T Elbert
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  ABSTRACT: Prenatal exposure to maternal stress can have lifelong implications for psychological function, such as behavioral problems and even the development of mental illness. Previous research suggests that this is due to transgenerational epigenetic programming of genes operating in the hypothalamic-pituitary-adrenal axis, such as the glucocorticoid receptor (GR). However, it is not known whether intrauterine exposure to maternal stress affects the epigenetic state of these genes beyond infancy. Here, we analyze the methylation status of the GR gene in mothers and their children, at 10-19 years after birth. We combine these data with a retrospective evaluation of maternal exposure to intimate partner violence (IPV). Methylation of the mother's GR gene was not affected by IPV. For the first time, we show that methylation status of the GR gene of adolescent children is influenced by their mother's experience of IPV during pregnancy. As these sustained epigenetic modifications are established in utero, we consider this to be a plausible mechanism by which prenatal stress may program adult psychosocial function.
  Translational psychiatry. 01/2011; 1:e21.
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  Available from: Michael Odenwald

  Article: The consumption of khat and other drugs in Somali combatants: a cross-sectional study.

  Michael Odenwald, Harald Hinkel, Elisabeth Schauer, Frank Neuner, Maggie Schauer, Thomas R Elbert, Brigitte Rockstroh
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  ABSTRACT: For more than a decade, most parts of Somalia have not been under the control of any type of government. This "failure of state" is complete in the central and southern regions and most apparent in Mogadishu, which had been for a long period in the hands of warlords deploying their private militias in a battle for resources. In contrast, the northern part of Somalia has had relatively stable control under regional administrations, which are, however, not internationally recognized. The present study provides information about drug abuse among active security personnel and militia with an emphasis on regional differences in relation to the lack of central governmental control-to our knowledge the first account on this topic. Trained local interviewers conducted a total of 8,723 interviews of armed personnel in seven convenience samples in different regions of Somalia; 587 (6.3%) respondents discontinued the interview and 12 (0.001%) were excluded for other reasons. We assessed basic sociodemographic information, self-reported khat use, and how respondents perceived the use of khat, cannabis (which includes both hashish and marijuana), psychoactive tablets (e.g., benzodiazepines), alcohol, solvents, and hemp seeds in their units. The cautious interpretation of our data suggest that sociodemographic characteristics and drug use among military personnel differ substantially between northern and southern/central Somalia. In total, 36.4% (99% confidence interval [CI] 19.3%-57.7%) of respondents reported khat use in the week before the interview, whereas in some regions of southern/central Somalia khat use, especially excessive use, was reported more frequently. Self-reported khat use differed substantially from the perceived use in units. According to the perception of respondents, the most frequent form of drug use is khat chewing (on average, 70.1% in previous week, 99% CI 63.6%-76.5%), followed by smoking cannabis (10.7%, 99% CI 0%-30.4%), ingesting psychoactive tablets (8.5%, 99% CI 0%-24.4%), drinking alcohol (5.3%, 99% CI 0%-13.8%), inhaling solvents (1.8%, 99% CI 0%-5.1%), and eating hemp seeds (0.6%, 99% CI 0%-2.0%). Perceived use of khat differs little between northern and southern Somalia, but perceived use of other drugs reaches alarmingly high levels in some regions of the south, especially related to smoking cannabis and using psychoactive tablets. Our data suggest that drug use has quantitatively and qualitatively changed over the course of conflicts in southern Somalia, as current patterns are in contrast to traditional use. Although future studies using random sampling methods need to confirm our results, we hypothesize that drug-related problems of armed staff and other vulnerable groups in southern Somalia has reached proportions formerly unknown to the country, especially as we believe that any biases in our data would lead to an underestimation of actual drug use. We recommend that future disarmament, demobilization, and reintegration (DDR) programs need to be prepared to deal with significant drug-related problems in Somalia.
  PLoS Medicine 01/2008; 4(12):e341. · 16.27 Impact Factor
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  Available from: Christian Wienbruch

  Article: Phonological but not auditory discrimination is impaired in dyslexia.

  Isabella Paul, Christof Bott, Sabine Heim, Christian Wienbruch, Thomas R Elbert
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  ABSTRACT: Deficient phonological skills are considered to be a core problem in developmental dyslexia. Children with dyslexia often demonstrate poorer performance than non-impaired readers when categorizing speech-sounds. Using the automatic mismatch response, we show that in contrast to this deficit at the behavioural level, neurophysiological responding in dyslexic children indicates their ability to automatically discriminate syllables. Therefore, the phonological deficit is unlikely to be caused by a temporal deficit or by a noisy functional organization in the respective representational cortex. We obtained measures of reading, spelling and categorical speech-perception from 58 dyslexic children and 21 control children. The children also participated in magnetoencephalographic measurements while being stimulated acoustically with the syllables /ba/ and /da/ in an oddball paradigm. Mismatch field (MMF) amplitudes between standard and deviant stimuli were obtained. Dyslexic children performed more poorly than control children on all test measures. However, the groups did not differ in MMF amplitude or latency. No correlations were found between MMF amplitudes and behavioural performance. These results were obtained with a large sample size and thus speak robustly against a general deficit in auditory discrimination in dyslexia. These results are compatible with the idea that decoding difficulties occur later in the processing stream where access to the phonological lexicon is attempted.
  European Journal of Neuroscience 12/2006; 24(10):2945-53. · 3.63 Impact Factor
• Article: Fleeting images: rapid affect discrimination in the visual cortex.

  Markus Junghöfer, Dean Sabatinelli, Margaret M Bradley, Harald T Schupp, Thomas R Elbert, Peter J Lang
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  ABSTRACT: Converging electrophysiological and hemodynamic findings indicate sensory processing of emotional pictures is preferred to that of neutral pictures. Whereas neuroimaging studies of emotional picture perception have employed stimulus durations lasting several seconds, recent electrocortical investigations report early visual cortical discrimination between emotionally arousing and neutral picture processing. Here, we use a hybrid picture presentation paradigm covering a range of rapid presentation rates (0.75-6 Hz), while visual system activity is recorded with functional magnetic resonance imaging. Results demonstrate widespread sensitivity to emotional arousal in the secondary and inferior temporal visual cortex. Furthermore, activity in the lateral inferior occipital and medial inferior temporal visual cortex revealed equivalent emotion-sensitive activation across all presentation rates. Results further support the notion that attention and perceptual processing are in part directed by underlying motivational systems.
  Neuroreport 03/2006; 17(2):225-9. · 1.66 Impact Factor