Hintergrund: Der Einfluss verschiedener Faktoren auf den Behandlungsverlauf kriegstraumatisierter deutscher Soldaten ist bisher nicht untersucht. Methoden: Die vorliegende Studie betrachtet erstmals den Einfluss störungsspezifischer und traumabezogener Prädiktoren auf den stationären Behandlungserfolg einsatzbedingter posttraumatischer Belastungsstörungen und komorbider psychischer Erkrankungen bei deutschen Bundeswehrsoldaten nach einer kognitiv-behavioralen Gruppentherapie. Weitere demografische und militärische Ausgangsvariablen werden explorativ analysiert. Ergebnisse: Die Anzahl der erlebten Traumatisierungen und die Summe der Komorbiditäten der Patienten zeigen sich als wesentliche Prädiktoren für die kurz- und langfristige Veränderung der Trauma- und Beschwerdesymptomatik innerhalb der Therapie. Schlussfolgerung: Konsequenzen für eine verbesserte stationäre therapeutische Versorgung traumatisierten Soldaten werden diskutiert.

1.
Alliger-Horn C, Mitte K, Zimmermann P: Komorbidität und Behandlung einsatzbedingter psychischer Traumastörungen durch Kognitiv-behaviorale Gruppentherapie im Bundeswehrkrankenhaus Berlin. Wehrmedizinische Monatsschrift 2010;54:182-185.
2.
Alliger-Horn C, Mitte K, Zimmermann R: Evaluation einer stationären Kognitiv-behavioralen Gruppentherapie für einsatzbedingte psychische Erkrankungen deutscher Soldaten. Z Psychiatr Psychol Psychother 2014;62:183-190.
3.
Bollinger AR, Riggs DS, Blake DD, Ruzek JI: Prevalence of personality disorders among combat veterans with posttraumatic stress disorder. J Trauma Stress 2000;13:255-270.
4.
Bolton EE, Lambert JF, Wolf EJ, Raja S, Varra AA, Fisher LM: Evaluating a cognitive-behavioral group treatment program for veterans with posttraumatic stress disorder. Psychological Service 2004;1:140-146.
5.
Booth-Kewley S, Highfill-McRoy RM, Larson GE, Garland CF: Psychosocial predictors of military misconduct. J Nerv Ment Dis 2010;198:91-98.
6.
Borkenau P, Ostendorf F: NEO-Fünf-Faktoren Inventar (NEO-FFI) nach Costa und McCrae. Göttingen, Hogrefe, 1993.
7.
Bradley R, Greene PD, Russ MAE, Dutra BAL: A multidimensional meta-analysis of psychotherapy for PTSD. Am J Psychiatry 2005;162:214-227.
8.
Calhoun KS, Resick PA: Posttraumatic stress disorder; in Barlow DH (ed): Clinical Handbook of Psychological Disorders. New York, Guilford Press, 1992, pp 48-98.
9.
Cinkaya F, Schindler A, Hiller W: Wenn Therapie vorzeitig scheitert. Z Klin Psychol Psychother 2011;40:224-234.
10.
Cloitre M: Effective psychotherapies for posttraumatic stress disorder: a review and critique. CNS Spectr 2009;14:32-43.
11.
Crocq L, Crocq M: Trauma and personality in the causation of war neuroses; in Belenky G (ed): Contemporary Studies in Combat Psychiatry. Westport, Greenwood Press, 1987, pp 103-116.
12.
Davidson JR, Kudler HS, Saunders WB, Erickson L, Smith RD, Stein RM, Lipper S, Hammett EB, Mahorney SL, Cavenar J: Predicting response to amitriptyline in posttraumatic stress disorder. Am J Psychiatry 1993;150:1024-1029.
13.
Derogatis LR: Brief Symptom Inventory (BSI), administration, scoring and procedures manual, third edition. Mineapolis, National Computer Services, 1993.
14.
Doctor JN, Zoellner LA, Feeny NC: Predictors of health-related quality-of-life utilities among persons with posttraumatic stress disorder. Psychiatric Services 2011;62:272-277.
15.
Ehlers A, Clark DM, Dunmore E, Jaycox L, Meadows E, Foa EB: Predicting response to exposure treatment in PTSD: the role of mental defeat and alienation. J Trauma Stress 1998;11:457-471.
16.
Ehlers A, Steil R, Winter H, Foa EB: Deutschsprachige Übersetzung der Posttraumatic Diagnostic Scale von Foa (1995). Oxford, Warneford Hospital, Department of Psychiatry, 1996.
17.
Foa EB, Riggs DS, Massie ED, Yarczower M: The impact of fear activation and anger on the efficacy of exposure treatment for posttraumatic stress disorder. Behav Ther 1995;26:487-499.
18.
Foa EB, Rothenbaum BO, Riggs DS, Murdock TB: Treatment of post-traumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counselling. J Consult Clin Psychol 1991;59:715-723.
19.
Forbes DMA, Creamer M, Hawthorne G, Allen N: Comorbidity as a predictor of symptom change after treatment in combat-related posttraumatic stress disorder. J Nerv Ment Dis 2003;191:93-99.
20.
Hautzinger M, Bailer M, Worall H: BDI Beck-Depressions-Inventar, ed 2. Bern, Huber, 2005.
21.
Hofman SG, Smits JA: Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry 2008;69:621-632.
22.
Hyer L, Boyd S: Personality scales as predictors of older combat veterans with posttraumatic stress disorder. Psychol Rep 1996;79:1040-1042.
23.
Jacobi F, Uhmann S, Hoyer J: Wie häufig ist therapeutischer Misserfolg in der Psychotherapie? Ergebnisse aus einer verhaltenstherapeutischen Hochschulambulanz. Z Klin Psychol Psychother 2011;40:246-256.
24.
Jaycox LH, Foa EB, Morral AR: Influence of emotional engagement and habituation on exposure therapy for PTSD. J Consult Clin Psychol 1998;66:185-192.
25.
Mendes DD, Mello MF, Ventura P, Passarela CM, Mari JI: A systematic review on the effectiveness of cognitive behavioral therapy for posttraumatic stress disorder. Int J Psychiatry Med 2008;38:241-259.
26.
Perconte ST, Griger ML: Comparison of successful, unsuccessful and relapsed Vietnam veterans treated for posttraumatic stress disorder. J Nerv Ment Dis 1991;179:558-562.
27.
Perlman LM, Arnedt JT, Earnheart KL, Shirley KG, Gormann AA: Group cognitive-behavioral therapy for insomnia in a VA mental health clinic. Cogn Behav Pract 2008;15:426-438.
28.
Sharpless BA, Barber JP: A clinicians's guide to PTSD treatment for returning veterans. Prof Psychol Res Pr 2011;42:8-15.
29.
Tarrier N, Sommerfield C, Pilgrim H, Faragher B: Factors associated with outcome of cognitive-behavioral treatment of chronic post-traumatic stress disorder. Behav Res Ther 2000;38:191-202.
30.
Wittchen HU, Schönfeld S, Kirschbaum K, Thurau C, Trautmann S, Klotsche J, Höfler M, Hauffa R, Zimmermann P: Traumatic experiences and posttraumatic stress disorder in soldiers following deployment abroad how big is the hidden problem? Dtsch Ärztebl Int 2012;109:559-568.
31.
Wittchen HU, Zaudig M, Fydrich T: SKID-I und SKID-II. Strukturiertes Klinisches Interview für DSM-IV. Göttingen, Hogrefe, 1997.
32.
Van Minnen A, Arntz A, Keijsers GPJ: Prolonged exposure in patients with chronic PTSD: predictors of treatment outcome and dropout. J Behav Res Ther 2002;40:439-457.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.