Zusammenfassung
Die Studie überprüft die Effektivität des Einsatzes der Life-Stressor Checklist (LSC-R)
zur Diagnostik von Traumafolgestörungen. Vor dem Hintergrund des Dose-Response Effektes
zwischen der Anzahl unterschiedlicher traumatischer Stressorexpositionen und dem Ausmaß
der Traumasymptomatik wird die Validität einer quantitativen Auswertung der Checkliste
analysiert. 130 Patienten wurden mit der LSC-R, der IES-R (PTBS Symptome) und der
SCL-90-R befragt. Eine Expertenbeurteilung schätzte die Relevanz traumatischer Erfahrungen
für die Störungsgenese ein. Der Dose-Effekt replizierte sich deutlich mit r=0,71.
Ein Cut-off von ≥6 ergab eine 75%tige Übereinstimmung mit dem Expertenurteil. Außerdem
differenzierte der Summenwert der Traumacheckliste innerhalb von Hochrisikogruppen
und zeigte eine Übereinstimmung mit der Schwere der Traumatiserungsform. Im Ergebnis
stellt die quantitative Auswertung der Traumacheckliste ein effektives Screening für
Patientinnen und Patienten mit Traumafolgestörungen dar.
Abstract
The study examines the effectiveness of applying the Life-Stressor Checklist (LSC-R)
in diagnosing trauma-related disease. The validity of a quantitative analysis of the
checklist is evaluated in consideration of the dose-response effect between the number
of different traumatic stressor expositions and the degree of trauma-related symptoms.
The trauma checklist LSC-R was applied to 130 patients. Data on psychological symptoms
was collected with the help of IES-R (PTSD symptoms) and SCL–90-R, the relevance of
traumatic experiences for the genesis of disorders was assessed by expert evaluation.
The dose effect replicated clearly with r=0.714 and a cut-off of ≥6 yielded a 75%
agreement with the expert evaluation. The total value of the trauma checklist showed
a differentiation within high-risk groups and also agreement with the severity of
the traumatization. The quantitative analysis of the trauma checklist permits an effective
screening for identifying trauma-related disease.
Key words
trauma related psychological disease - trauma checklist - posttraumatic stress disorder
Literatur
1
Kilpatrick DG, Ruggiero KJ, Acierno RE. et al .
Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity:
Results from the National Survey of Adolescents.
J Consult Clin Psychol.
2003;
71
692-700
2
Felitti VJ, Anda RF, Nordenberg D. et al .
Relationship of childhood abuse and household dysfunction to many of the leading causes
of death in adults. The Adverse Childhood Experiences (ACE) Study.
Am J Prev Med.
1998;
14
245-258
3
Dirkzwager AJ, Grievink L, Velden van der PG. et al .
Risk factors for psychological and physical health problems after a man-made disaster.
Br J Psychiatry.
2006;
189
144-149
4
Widom CS, DuMont K, Czaja SJ.
A prospective investigation of major depressive disorder and comorbidity in abused
and neglected children grown up.
Arch Gen Psychiatry.
2007;
64
49-56
5
Nelson EC, Heath AC, Madden PA. et al .
Association between self-reported childhood sexual abuse and adverse psychosocial
outcomes.
Arch Gen Psychiatry.
2002;
59
139-145
6 Maercker A, Rosner R. Psychotherapie der posttraumatischen Belastungsstörungen..
Stuttgart: Thieme; 2006
7 Roth G, Münte TF. Neurobiologische Grundlagen psychischer Traumatisierung.. In:
Seidler GH, Laszig P, Micka R, Nolting BV , Hrsg. Aktuelle Entwicklungen in der Psychotraumatologie.
Giessen: Psychosozial-Verlag; 2003: 9-34
8
Kessler RC, Sonnega A, Bromet E. et al .
Posttraumatic stress disorder in the National Comorbidity Survey.
Arch Gen Psychiatry.
1995;
52
1048-1060
9
Mcquaid JR, Pedrelli P, McCahill ME. et al .
Reported trauma, post-traumatic stress disorder and major depression among primary
care patients.
Psychol Med.
2001;
31
1249-1257
10
Lecrubier Y.
Posttraumatic Stress disorder in primary care: a hidden diagnosis.
J Clin Psychiatry.
2004;
65
(S 01)
49-54
11 Kolk van der BA. The assessment and treatment of complex PTSD.. In: Yehuda R ,
Hrsg. Treating Trauma Survivors with PTSD. Washington DC: American Psychiatric Press;
2002: 127-157
12
Mylle J, Maes M.
Partial posttraumatic stress disorder revisited.
J Affect Disord.
2004;
78
37-48
13
Hart van der O, Nijenhuis ER, Steele K.
Dissociation: an insufficiently recognized major feature of complex posttraumatic
stress disorder.
J Trauma Stress.
2005;
18
413-423
14 Sachsse U. Traumazentrierte Psychotherapie.. Theorie, Klinik und Praxis. Stuttgart:
Schattauer; 2004
15
Briere J, Spinazzola J.
Phenomenology and psychological assessment of complex posttraumatic states.
J Trauma Stress.
2005;
18
401-412
16
Green BL, Goodman LA, Krupnick JL. et al .
Outcomes of single versus multiple trauma exposure in a screening sample.
J Trauma Stress.
2000;
13
271-286
17
Neuner F, Schauer M, Karunakara U. et al .
Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress
disorder through previous trauma among West Nile refugees.
BMC Psychiatry.
2004;
4
34
18
Eytan A, Gex-Fabry M, Toscani L. et al .
Determinants of postconflict symptoms in Albanian Kosovars.
J Nerv Ment Dis.
2004;
192
664-671
19
Marshall GN, Schell TL, Elliott MN. et al .
Mental health of Cambodian refugees 2 decades after resettlement in the United States.
JAMA.
2005;
294
571-579
20
Schumm JA, Briggs-Phillips M, Hobfoll SE.
Cumulative interpersonal traumas and social support as risk and resiliency factors
in predicting PTSD and depression among inner-city women.
J Trauma Stress.
2006;
19
825-836
21
Shalev AY, Tuval R, Frenkiel-Fishman S. et al .
Psychological responses to continuous terror: a study of two communities in Israel.
Am J Psychiatry.
2006;
163
667-673
22
Klaric M, Klaric B, Stevanovic A. et al .
Psychological consequences of war trauma and postwar social stressors in women in
Bosnia and Herzegovina.
Croat Med J.
2007;
48
167-176
23
Vinck P, Phan PN, Stover E. et al .
Exposure to war crimes and implications for peace building in northern Uganda.
JAMA.
2007;
298
543-554
24
Hepp U, Gamma A, Milos G. et al .
Inconsistency in reporting potentially traumatic events.
Br J Psychiatry.
2006;
188
278-283
25
Widom CS, Dutton MA, Czaja SJ. et al .
Development and validation of a new instrument to assess lifetime trauma and victimization
history.
J Trauma Stress.
2005;
18
519-531
26
Mollica RF, Caridad KR, Massagli MP.
Longitudinal study of posttraumatic stress disorder, depression, and changes in traumatic
memories over time in Bosnian refugees.
J Nerv Ment Dis.
2007;
195
572-579
27 Flatten G. Abriss über den aktuellen Stand bei den Traumafolgestörungen ASD und
PTSD.. In: Seidler GH, Laszig P, Micka R, Nolting BV , Hrsg. Aktuelle Entwicklungen
in der Psychotraumatologie. Giessen: Psychosozial-Verlag; 2003: 35-54
28 Wittchen HU, Pfister H. DIA-X Interviews. Frankfurt: Swets Test Service Deutschland;
1997
29 Wolfe JW, Kimerling R, Brown PJ. et al .Psychometric review of the Life Stressor
Checklist Revised.. In: Stamm BH , Hrsg. Measurement of Stress, Trauma, and Adaption.
Lutherville: Sidran Press; 1996
30 Norris FH, Hamblen JL. Standardized self-report measures of civilian trauma and
PTSD.. In: Wilson JP, Keane TM , Hrsg. Assessing psychological Trauma and PTSD. New
York: Guilford Publications; 2004: 63-76
31
McHugo GJ, Caspi Y, Kammerer N. et al .
The assessment of trauma history in women with co-occurring substance abuse and mental
disorders and a history of interpersonal violence.
J Behav Health Serv Res.
2005;
32
113-127
32
Quimette P, Read J, Brown PJ.
Consistency of retrospective reports of DSM-IV criterion A traumatic stressors among
substance use disorder patients.
J Trauma Stress.
2005;
18
43-51
33
Maercker A, Schützwohl M.
Erfassung von psychischen Belastungsfolgen: Die Impact of Event Skala-revidierte Version
(IES-R).
Diagnostica.
1998;
44
130-141
34 Franke G. SCL-90-R. Die Symptom-Checkkliste von Derogatis.. Deutsche Version. Göttingen:
Beltz; 1995
35
Creamer M, Bell R, Failla S.
Psychometric properties of the Impact of Event Scale-Revised.
Behav Res Ther.
2003;
41
1489-1496
36
Lipschitz DS, Bernstein DP, Winegar RK. et al .
Hospitalized adolescents’ reports of sexual and physical abuse: a comparison of two
self-report measures.
J Trauma Stress.
1999;
12
641-654
37
Kremers IP, Giezen van AE, Does van der AJ. et al .
Memory of childhood trauma before and after long-term psychological treatment of borderline
personality disorder.
J Behav Ther Exp Psychiatry.
2007;
38
1-10
38
Roemer L, Litz BT, Orsillo SM. et al .
Increases in retrospective accounts of war-zone exposure over time: the role of PTSD
symptom severity.
J Trauma Stress.
1998;
11
597-605
39
Banyard VL, Williams LM, Siegel JA.
The long-term mental health consequences of child sexual abuse: an exploratory study
of the impact of multiple traumas in a sample of women.
J Trauma Stress.
2001;
14
697-715
40
Perkonigg A, Pfister H, Stein MB. et al .
Longitudinal course of posttraumatic stress disorder and posttraumatic stress disorder
symptoms in a community sample of adolescents and young adults.
Am J Psychiatry.
2005;
162
1320-1327
41 Rothschild B. Der Körper erinnert sich. Essen: Synthesis Verlag; 2002
42 Boos A. Kognitive Verhaltenstherapie nach chronischer Traumatisierung.. Göttingen:
Hogrefe; 2005
43
Moore SA, Zoellner LA.
Overgeneral autobiographical memory and traumatic events: an evaluative review.
Psychol Bull.
2007;
133
419-437
44
Bernstein DP, Fink L, Handelsman L. et al .
Initial reliability and validity of a new retrospective measure of child abuse and
neglect.
Am J Psychiatry.
1994;
15
1132-1136
45
Müller C, Teschner M, Assaloni H. et al .
Eine ambulante Stabilisierungsgruppe zur Verbesserung der Emotionsregulation bei komplexen
posttraumatischen Störungen.
Psychother Psych Med.
2007;
57
364-372
Korrespondenzadresse
Oliver Ungerer
Brandenburg Klinik
Psychosomatik
Brandenburgallee 1
16321 Bernau
Email: ungerer@brandenburgklinik.de