Rolf Kleber

Utrecht University | UU · Division of Clinical and Health Psychology

Objective: Using data from a randomized controlled trial on psychotherapy for posttraumatic stress disorder (PTSD) in older adults (aged >55), this study aimed at analysing the efficacy of two psychological interventions in terms of self-reported symptoms, comorbid psychopathology and resilience outcomes. Method: Thirty-three outpatients (age 55...

Background: A substantial proportion of clinical World War Two survivor offspring reports intrusions about war events they did not experience themselves. Objective: To help identify factors that contribute to the development of such indirect intrusions (i.e. intrusions about non-self-experienced traumatic events), we examined the personal character...

Background International humanitarian aid workers (iHAWs) are motivated strongly to travel abroad to help communities affected by war, famine, disaster and disease. They expose themselves to dangers and hardships during their field assignments. Despite working under such challenging circumstances, most workers remain healthy. The objective of the p...

How traumatic events (TEs) should be defined, and how specific TEs are for Post-traumatic Stress Disorder (PTSD) were examined in a general mental health care population. Three definitions of TEs were defined, according to the PTSD criteria of DSM-IV. Half of the sample reported any TE, with a high prevalence of TEs among non-PTSD disorders. Previo...

Background An emerging body of empirical research on trauma-focused interventions for older adults experiencing symptoms of posttraumatic stress disorder or PTSD has yielded encouraging results. Nevertheless, up to date, the evidence remains scattered and is developed within rather specific groups, while studies have focused mostly on individual ps...

Among stress-related disorders, post-traumatic stress disorder (PTSD) takes a central position. Although the percentage of older adults suffering from this condition appears to be lower than among younger adults, PTSD among them often presents a serious condition with high comorbidity rates. In this contribution, recent insights into post-traumatic...

Objective: Findings on the relationship between social support and mental health problems after potentially traumatic events vary across studies. Aim of our longitudinal study is to assess to what extent initial postdisaster mental health, somatic, and social functioning problems affect social support 1.5 years later. This is relevant for the disc...

Research findings show humanitarian work impacts one's health. We conducted a prospective observational study among 618 international humanitarian aid workers (iHAWs)’ recruited from 76 countries to investigate health changes and ill-health risk factors after mostly short-term (<1 year) medical emergency assignments. The aid workers were assigned t...

Introduction: Qualitative studies have described the rather unique styles of Balinese people to adjust to adversity. No quantitative research assessing psychopathology among bereaved individuals has been performed yet. This study estimated the prevalence of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD) and depression among be...

Objectives Little is known about the 12-month prevalence of potentially traumatic events (PTEs) and to what extent the type of PTE is a risk factor for post-event lack of social support. In addition, it is largely unknown if pre-event mental health problems and loneliness, and demographics are risk factors for a lack of support. Aim of the present...

Background Resettled refugees exposed to trauma and loss are at risk to develop mental disorders such as posttraumatic stress disorder (PTSD) and persistent complex bereavement disorder (PCBD). Post-migration stressors have been linked to poor mental health and smaller treatment effects.AimOur aim was to evaluate reductions in PTSD and PCBD symptom...

Aggression after military deployment is a common occurrence in veterans. Neurobiological research has shown that aggression is associated with a dysfunction in a network connecting brain regions implicated in threat processing and emotion regulation. However, aggression may also be related to deficits in networks underlying communication and social...

Background: Previous research has indicated that one out of ten naturally bereaved individuals develops prolonged grief disorder (PGD). Less is known about the prevalence of PGD following unnatural deaths, such as accidents, disasters, suicides, or homicides. The aim of this study was to compute the pooled prevalence of PGD and to determine possibl...

The 12-month and lifetime prevalence of posttraumatic stress disorder (PTSD) in different country populations has been assessed while using clinical interviews. Because this methodology is relatively time-consuming and resource-intensive, disaster health researchers adopted instruments, like the Trauma Screening Questionnaire (TSQ). This study (1)...

Negative events may not only linger on in the form of intrusive memories in the minds of those directly exposed but also in those who are only indirectly confronted with these events. The aim of the present study was to investigate if intrusions referring to indirectly experienced traumatic events do indeed occur, and to compare their frequency and...

Background: Western countries are facing many challenges hosting refugees from several regions in the world. Many of them are severely traumatized and suffer from a variety of mental health symptoms, which complicates the identification and treatment of refugees at risk. This study examined subgroups based on a broad range of psychopathology, and s...

Background Although bereavement is likely a common stressor among patients referred to a psychotrauma clinic, no study has yet examined the co‐occurrence and relationships between symptoms of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and major depressive disorder symptoms in this population. Method In a sample of patien...

Exposure to war and violence has major consequences for society at large, detrimental impact on people’s individual lives, and may also have intergenerational consequences. To gain more insight into these intergenerational consequences, research addressing the impact of the Holocaust on offspring is an important source of information. The aim of th...

Psychological trauma has developed into a very common concept in the scientific community, in mental health care, as well as in popular language and mass media. The purpose of this article is to show the relevance of the discipline of traumatic stress studies to the field of public mental health by examining central concepts and findings concerning...

Background: To date, most studies on the mental health of refugees in Europe have focused on the prevalence and treatment of psychopathology. Little is known about those who illegally reside in the host country, referred to, in the Netherlands, as undocumented asylum seekers. There are indications that mental health and psychosocial problems are mo...

Objective: Exposure to potentially traumatic events (PTEs) has been identified as a risk factor for various psychological problems in adolescents generally and in young refugees. The aim of this study was to examine whether individual resilience (assessed as a personality characteristic) can protect adolescents in diverse contexts from negative ef...

Background: To explore cognitive recovery during and after Narrative Exposure Therapy from the patient’s perspective, autobiographical material and interview responses were qualitatively analyzed. Method: Using a framework of cognitive development, patient-reported outcomes from four senior Dutch citizens (57–81 years of age) were examined. All par...

Background Evidence-based treatment and age-specific services are required to address the needs of trauma-affected older populations. Narrative exposure therapy (NET) may present an appropriate treatment approach for this population since it provides prolonged exposure in a lifespan perspective. As yet, however, no trial on this intervention has be...

Background: Narrative exposure therapy (NET) is a short-term psychological treatment for post-traumatic stress disorder (PTSD) that has been investigated in various contexts among traumatized refugees and other trauma survivors. Sustained treatment results have been reported, but the methodological quality of the trials needs a more thorough examin...

Aim To evaluate the feasibility and effect of a 10-session creative arts in psychotherapy group programme on posttraumatic stress symptoms, behavioural problems, and posttraumatic growth, in children who experienced a traumatic event. Design A multicentre non-randomized controlled trial with a treatment and a control condition conducted in South A...

PTSD & PTG datafile.dat. (DAT)

Background: In 2009, an aeroplane crashed near Amsterdam. To remedy unmet mental health needs, active outreach was used to identify victims at risk for post-traumatic stress disorder (PTSD) and depression. Objective: The active outreach strategy was evaluated by examining the accuracy of screening methods in predicting PTSD and depression, self-rep...

Background: Child maltreatment (CM) is associated with long-lasting poor health outcomes, as well as increased levels of disability and health-services consumption across the life-span. However, less is known about how CM consequences can be reduced during adulthood. We investigated professional opinions on how to mitigate long-term consequences o...

Research showed that more than 30% of patients with Posttraumatic Stress Disorder (PTSD) do not benefit from evidence-based treatments: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) or Eye Movement Desensitization and Reprocessing (EMDR). These are patients with prolonged and multiple traumatization, with poor verbal memory, and patients wit...

Child maltreatment (CM) is highly prevalent and one of the most injurious conditions that children may experience. Because it is often-clandestine, it is difficult to assure that existing prevention and treatment mechanisms reach those in need. CM’s consequences may take a long time to be recognized and expressed. We discuss the need to increase pu...

Exposure to mass trauma may bring about increased sensitivity to new or ongoing stressors. It is unclear whether sensitivity to stress associated with ethnic minority/immigrant status may be affected by severe exposure to mass trauma. We examined whether the loss of loved ones or home due to a disaster is associated with more persistent disaster-re...

Corrigendum to “Do prolonged grief disorder symptoms predict post-traumatic stress disorder symptoms following bereavement? A cross-lagged analysis” [Compr Psychiatry 80 (2018) 65–71] The authors regret that “β” in the abstract of the published article was written as “β−”. The corrected abstract is as follows: Abstract Background: Bereavement ca...

Objectives: Dissociation is a prevalent phenomenon among veterans with post-traumatic stress disorder (PTSD) that may interfere with the effectiveness of treatment. This study aimed to replicate findings of a dissociative PTSD subtype, to identify corresponding patterns in coping style, symptom type, and symptom severity, and to investigate its im...

Background: Little is known about the development of Prolonged Grief Disorder (PGD) symptoms over time in adults. For clinical purposes, it would be useful to have knowledge about early indicators of a problematic grief trajectory. Objective: This study aimed to identify classes of bereaved individuals with similar trajectories of PGD symptoms and...

Introduction: Prehospital providers are at increased risk for psychological distress. Support at work after critical incidents is believed to be important for providers, but current guidelines are in need of more scientific evidence. This study aimed to investigate: (1) to what extent prehospital providers experience support at work; (2) whether s...

Anger and aggression are common mental health problems after military deployment. Anger and aggression have been associated with abnormalities in subcortical and cortical levels of the brain and their connectivity. Here, we tested brain activation during the processing of emotional stimuli in military veterans with and without anger and aggression...

Older adults present a growing population in our society and in our mental health system. Among older adults, PTSD is a serious, but frequently hidden psychiatric disorder with various potential trajectories. Elderly patients may have been exposed to multiple traumatic events. Narrative Exposure Therapy (NET) was developed to address cumulative tra...

Relationships between the corticotropin-releasing hormone receptor 1 (CRHR1) [rs878886] and serotonin transporter promoter polymorphism (5-HTTLPR), with resilience and satisfaction with life were examined in 172 adolescents; 70 refugee adolescents living in the Netherlands and 102 non-refugee (Dutch) adolescents. Genetic variation in the CRHR1 was...

Problems involving anger and aggression are common after military deployment, and may involve abnormal responses to threat. This study therefore investigated effects on neural activation related to threat and escapability among veterans with deployment experience. Twenty-seven male veterans with anger and aggression problems (Anger group) and 30 Co...

Background/Objective: Childhood maltreatment (CM) has been associated with revictimization and post-traumatic stress disorder (PTSD). However, this relation is hardly examined in South European countries, and in community samples. We tested these associations in a convenience sample of 1,200 Portuguese adults in the community. Method: Data were col...

Although the literature on positive adjustment following traumatic events is growing, only a few studies have examined this phenomenon in young refugees. Using the social-ecological framework, the aim of this study was to identify factors and processes that according to young refugees promote their resilience. A total of 16 treatment-seeking refuge...

This chapter examines the usefulness of the conceptualization of trauma in contemporary French theory for a better understanding of the core of organizational trauma. Starting with a short historical background, it investigates the contribution from contemporary French authors to current knowledge on psychotraumatology. The current position of the...

Anger and aggression are frequent problems in deployed military personnel. A lowered threshold of perceiving and responding to threat can trigger impulsive aggression. This can be indicated by an exaggerated startle response. Fifty-two veterans with anger and aggression problems (Anger group) and 50 control veterans were tested using a startle expe...

Mental health problems following loss can manifest as heterogeneous symptomatology that may include symptoms of Prolonged Grief Disorder (PGD), Post-Traumatic Stress Disorder (PTSD), and Major Depressive Disorder (MDD). However, the co-occurrence of symptoms of these three disorders is still only partially explored. The aims of this study were to i...

Objectives: Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at imp...

Existing tools for evaluating psychosocial interventions (un-validated self-reporting questionnaires) are not ideal for use in non-Western conflict settings. We implement a generic method of treatment evaluation, using client and counsellor feedback, in 18 projects in non-Western humanitarian settings. We discuss our findings from the perspective o...

In contrast with traumatic experiences, there is a dearth of studies on the link between trauma symptoms, disconnected (frightened, threatening and dissociative) parenting behavior, extremely insensitive parenting behavior and child attachment. This study extends previous work on the impact of posttraumatic stress disorder (PTSD) on families by stu...

It has been hypothesized that adult attachment representations guide caregiving behavior and influence parental sensitivity, and thus affect the child's socio-emotional development. Several studies have shown a link between posttraumatic stress disorder (PTSD) and reduced parental sensitivity, so it is possible that PTSD moderates the relationship...

Background Eye movement desensitisation and reprocessing (EMDR) therapy is a first-line treatment for adults with post-traumatic stress disorder (PTSD). Some clinicians argue that with refugees, directly targeting traumatic memories through EMDR may be harmful or ineffective.AimsTo determine the safety and efficacy of EMDR in adult refugees with PT...

Objective: The aim of this study was to explore perceived posttraumatic growth (PTG) and its associations with potentially traumatic events (PTEs), dispositional optimism, perceived social support, posttraumatic stress disorder (PTSD) symptoms, and satisfaction with life (SWL) among adolescent refugees and asylum seekers. Method: A cross-section...

Background: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clin...

Although the five domains of posttraumatic growth (new possibilities, relating to others, personal strength, spiritual change and appreciation of life) have been studied extensively in adults, little is known about these domains and their correlates in children. We aimed to examine whether demographic and/or social characteristics are related to ch...

In 2009, a commercial airplane crashed near Amsterdam. This longitudinal study aims to investigate (1) the proportion of survivors of the airplane crash showing a probable posttraumatic stress disorders (PTSD) or depressive disorder, and (2) whether symptoms of PTSD and depression were predicted by trauma characteristics. Identifying these trauma c...

Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive...

Soldiers and veterans diagnosed with PTSD benefit less from psychotherapy than non-military populations. The current meta-analysis identified treatment predictors for traumatised soldiers and veterans, using data from studies examining guideline recommended interventions, namely: EMDR, exposure, cognitive, cognitive restructuring, cognitive process...

Objective. This article reviews available qualitative studies that report young refugees' ways of dealing with adversity to address their sources of resilience. Design. We searched five electronic databases. Twenty-six empirical studies were included in the review. A meta-ethnography approach was used to synthesize these qualitative studies. Result...

The question as to whether or not children can be affected by the traumatization of their parents has been the topic of a long-standing debate. This article provides a critical review of 72 research studies on traumatized parents with symptoms of posttraumatic stress disorder (PTSD), the parent-child interaction, and the impact on their nonexposed...

A previous prospective study on psychotrauma revealed that the experienced burden of this research is strongly predicted by the experienced burden of participating in previous research on politics and values, and research on personality and health, and not by PTSD symptoms, coping self-effi cacy and personality. Two subsequent surveys enabled us to...

A longitudinal study was conducted in order to assess the impact of the Ghislenghien disaster (July 30th, 2004) on physical, mental and social health in the affected population. The present study explored the risk for the development of four types of mental health disturbances (MHD) due to exposure to different aspects of this technological disaste...

Abstract Background This paper investigates risk factors for the development of posttraumatic stress symptoms in the different survivor groups involved in a technological disaster in Ghislenghien (Belgium). A gas explosion instantly killed five firefighters, one police officer and 18 other people. Moreover, 132 people were wounded among which many...

Art therapy has often been applied in the treatment of traumatized adults, and good results in clinical practice have been reported. However, although art therapy experts underline these benefits, the effectiveness of art therapy in trauma treatment has not been established by systematic review. The aim of this systematic review is to identify and...

Disasters are associated with a substantial psychosocial burden for affected individuals (including first responders) and communities. Knowledge about how to address these risks and problems is valuable for societies worldwide. Decades of research into post-disaster psychosocial care has resulted in various recommendations and general guidelines. H...

Child maltreatment (CM) is associated with poor long-term health outcomes. However, knowledge about CM prevalence and related consequences is scarce among adults in South European countries. We examined the self-reported prevalence of five different forms of CM in a community sample of 1,200 Portuguese adults; we compared the results with similar s...

Many refugees resettled in Western countries suffer from an accumulation of traumatic and current stressors that contribute to mental health problems and may complicate trauma-focused treatment. Consequently, the acceptability, safety, and efficacy of trauma-focused treatment with refugees have been a matter of clinical and scientific interest. In...

Er bestaat onder clinici veel onduidelijkheid over wat de concepten complex trauma en complexe posttraumatische stressstoornis (PTSS) behelzen. Dit heeft ongewenste consequenties voor de behandeling, omdat de behandelrichtlijnen voor complexe PTSS afwijken van die voor PTSS. In dit artikel wordt verhelderd wat er onder complex trauma en complexe PT...