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Biomedical subjects

Harald J Freyberger

Publications and source records attributed to Harald J Freyberger.

At least 19 recordsLinked to original sources
PubMed2006

[Observed, pursued, disintegrated--mental disorders among victims of non-criminal repressions in the former GDR].

OBJECTIVE: While there are numerous studies on the mental sequelae of political imprisonment in the former German Democratic Republic (GDR), there is little knowledge about the prevalence of mental disorders in victims of other forms of political persecution. METHODS: 74 individuals, who were subject to non-criminal repressions in the GDR, were investigated by means of a standardized psychiatric interview. RESULTS: They had been exposed to a variety of reprisals such as observations, purposeful indiscretions, arranged professional failure and other forms of social marginalization. At least one mental disorder was found in 60 % of the participants. Affective disorders were the most common ones with a lifetime prevalence of 38 %, followed by anxiety (23 %) and somatoform disorders (28 %). CONCLUSIONS: The frequency of mental disorders in our sample of politically persecuted people was higher than in the general population and similar to that of political prisoners, who only show higher rates of anxiety and posttraumatic stress disorders.

Adult↗
PubMed2006

Sixty years later: post-traumatic stress symptoms and current psychopathology in former German children of World War II.

BACKGROUND: The aim of the study was to determine the amount of trauma impact, post-traumatic stress symptoms and current psychopathological distress in a sample of former German children of World War II. METHODS: 93 participants were recruited through the local press, and assessed using the modified Post-traumatic Diagnostic Scale (PDS) and the Symptom Checklist (SCL-90-R). RESULTS: Subjects reported a high qualitative and quantitative degree of trauma exposure. 13.8% reported PTSD-related symptoms after the war, and 10.8% reported current symptoms. PTSD symptoms after World War II were significantly correlated with current psychopathological distress. CONCLUSIONS: In line with other studies, our data document a high degree of trauma exposure during warchildhood. In comparison with other studies on PTSD in warchildren, there is a persisting high prevalence of war-associated PTSD symptoms in this sample. Despite some methodological limitations, our data underline the urgent need for further studies on the ageing group of former children of World War II.

Age Factors↗
PubMed2006

Predictors of attention problems for the period from pre-teen to early teen years.

OBJECTIVE: This longitudinal study investigated the scope, persistence, and predictors of attention problems (AP) over a period of time from pre-teen (7-12 years) to early teen years (13-17 years). METHOD: AP evaluations used the Child Behavior Checklist (CBCL) and a semi-structured interview (C-SSAGA-P) with the parents. In addition, data relating to birth complications, family histories of affective disorders and alcohol-use disorders, home supervision, emotional, social and behavioral problems, school performance and school activities at two different measurement points were also collected. RESULTS: The findings indicate a high degree of comorbidity between AP and emotional and behavioral problems, difficulties in school, social problems and peer rejection. Furthermore, a cross-sectional association between childhood AP and parental affective disorders was also evident. Longitudinally, there was no increase in AP over the age span covered by the study, and symptoms often did not persist over time. Multiple regression analyses confirmed poorer school performance, problems with peers and AP at time point 15 as predictors for subsequent AP. CONCLUSION: The findings indicate that AP symptoms do not occur more frequently in early teen than in pre-teen years, and tend to be temporary phenomena. Difficulties in school and with peers were noted as particularly strong predictors of subsequent AP.

Adolescent↗
PubMed2006

The role of trauma and PTSD-related symptoms for dissociation and psychopathological distress in inpatients with schizophrenia.

BACKGROUND: To investigate the relationship between dissociative experiences, psychopathological distress, a history of trauma and posttraumatic symptoms in adult schizophrenia. METHODS: Eighty-seven schizophrenic inpatients returned self-questionnaires [Dissociative Experience Scale (DES); Symptom Checklist (SCL-90-R); PTSD Symptom Scale (PDS)]. Based upon this self-rating, 14 of the participants fulfilled the cut-off definition of PTSD according to DSM-IV criteria, 43 had a history of trauma without a self-rated diagnosis of PTSD. DES scores were also compared to a convenience sample of 297 non-clinical controls. RESULTS: We found no significant impact of trauma alone but a significant influence of posttraumatic symptomatology on the level of current psychopathological distress (GSI) and the DES subscale absorption. However, in logistic regression, posttraumatic symptomatology was associated with GSI but not with DES. Schizophrenic patients even without trauma or posttraumatic symptoms had significantly higher scores in all three DES subscales than non-clinical controls. CONCLUSION: Pronounced posttraumatic symptoms in schizophrenia are associated with severe additional psychopathological distress whereas the increase in dissociation (absorption) in this group of patients may be secondary to the increase in symptom load. However, schizophrenia itself seems to be associated independently from trauma and pathological posttraumatic conditions with a broad range of dissociative symptoms.

Adolescent↗
PubMed2006

Dopamine D3 receptor and schizophrenia: a widened scope for the immune hypothesis.

Schizophrenia may be related to immunity as is suggested by many findings of altered immune parameters in schizophrenic patients. How immune alterations might be involved in the emergence of psychosis is still unclear. Clearly, however, the dopamine hypothesis has been confirmed in recent studies, which implies a crucial role for dopamine and the dopamine D2 receptor (D2R) within the pathogenesis of schizophrenia. The Dopamine D3 receptor (D3R) is considered to have autoreceptor properties modulating the synthesis and release of dopamine, thereby possibly antagonizing the dopamine D2-receptor-mediated effects of dopamine and has been found reduced in schizophrenic patients during acute psychosis and increasing in the advent of negative schizophrenic symptoms. Immune parameters apparently influence the expression of dopamine receptors by means of their capability to induce regulatory factors involved in the expression of dopamine receptor subtypes, such as the neurotrophins, associations of which with psychosis have been reported repeatedly. Here, we propose a hypothesis of immune alterations that influence the production of distinct neurotrophins such as BDNF and NGF that, as animal studies suggest, influence the expression of dopamine receptor subtypes. This mechanism could result in a decrease of D3R and a consecutive relative preponderance of D2R and thereby connect immune alterations and schizophrenia.

Animals↗
PubMed2006

Negative perceived paternal parenting is associated with dopamine D2 receptor exon 8 and GABA(A) alpha 6 receptor variants: an explorative study.

Twin studies suggest a genetic influence upon perceived parenting. The D(2) dopaminergic receptor is involved in the modulation of social behaviors, and might influence parenting and its perception. A polymorphism (E8) in exon 8 of the D(2) receptor gene (DRD2) has been previously associated with alcoholism-related phenotypes. Similarly, the Pro385Ser variant of GABRA6, the polymorphic gene for GABA(A) receptor alpha6 subunit, has been associated with alcohol- and depression-related traits; and rat pups maintained a more immature GABAR phenotype after brief separation distress. The relationships among DRD2 (E8) and GABRA6 (Pro385Ser) polymorphisms, and perceived parenting were studied here. The association of DRD2 (E8) and GABRA6 (Pro385Ser) genotypes and perceived parental rearing behavior (short-EMBU; questionnaire concerning own memories concerning upbringing) were determined in 207 unrelated adults using multivariate analysis of variance. Temperaments (Temperament and Character Inventory; TCI) were included as covariates. Probands with DRD2 (E8) A/A genotype showed higher scores for father rejection (P = 0.011), parents overprotection (P = 0.021), and father overprotection (P = 0.016) in the total group. An interaction between DRD2 and GABRA6 genotypes on father rejection (P = 0.010) and parents rejection (P = 0.030) was also observed. Further analyses showed that these associations were restricted to the female subgroup only; however, secondary gender-specific analyses were not corrected for multiple testing. Our findings support a role for DRD2 (E8) and GABRA6 (Pro385Ser) in perceived parenting.

Adult↗
PubMed2006

Individual characteristics, familial experience, and psychopathology in children of mothers with borderline personality disorder.

OBJECTIVE: The aim of this study was to examine individual characteristics, familial experience, and psychopathology of children of mothers with borderline personality disorder (BPD). METHOD: Children of mothers with BPD were compared to children of mothers (1) with depressive disorders, (2) with cluster C personality disorders, and (3) without psychiatric conditions, including temperament dimensions, perceived parenting behavior, and psychopathology. RESULTS: Compared to other groups, children of mothers with BPD demonstrated higher scores on the temperament dimension of harm avoidance. Moreover, they tended to perceive their mothers as being overly protective. Regarding psychopathology, these children exhibited a higher prevalence of emotional and behavioral problems than comparison groups. Particularly significant was the finding that children of mothers with BPD described themselves as having very low self-esteem. CONCLUSIONS: Children of mothers with BPD are exposed to a combination of risk factors and are at greater risk of emotional, behavioral, and somatic problems. Early treatment of children at risk may help prevent these children from developing severe psychopathology.

Adolescent↗
PubMed2006

Alexithymia in obsessive-compulsive disorder - results from a family study.

BACKGROUND: Previous studies have suggested an association between alexithymia and obsessive-compulsive disorder (OCD). However, it is unclear to which extent alexithymic traits in OCD patients reflect familial deficits in cognitively processing and communicating feelings that are also present in their first-degree relatives. This study investigates the hypotheses of an elevated level of alexithymia in subjects with OCD and their first-degree relatives compared to controls and their first-degree relatives. METHODS: 82 cases with OCD and 169 first-degree relatives were compared to 76 controls and 144 first-degree relatives from a German family study on OCD (GENOS). All subjects completed the 20-item Toronto Alexithymia Scale (TAS-20). Direct or family informant interviews were carried out with the German version of the Schedule for Affective Disorders and Schizophrenia - lifetime version for anxiety disorders (DSM-IV). RESULTS: OCD was associated with significantly higher scores of alexithymia. However, first-degree relatives of OCD cases and of controls did not differ in TAS-20 scores. In linear regression analyses, the TAS-20 total score showed significant intrafamilial associations within the families of control subjects but not within families of OCD cases. CONCLUSION: OCD is a severe mental disorder that is associated independently from other current comorbid axis I disorders with deficits in identifying and expressing feelings. However, alexithymia does not represent a familial risk factor for OCD.

Adult↗
PubMed2006

Familiality of obsessive-compulsive disorder in nonclinical and clinical subjects.

OBJECTIVE: Studies of the familiality of obsessive-compulsive disorder (OCD) have yielded inconsistent results. This study compared the familial aggregation of OCD in first-degree relatives of community subjects with never-treated OCD, outpatients with OCD, and comparison subjects. METHOD: Fifteen persons from the community with untreated OCD were matched on age and interview type (direct or through family informants) with 90 OCD patients from four treatment facilities and 70 comparison subjects. Direct or indirect interviews using the German-language version of the Schedule for Affective Disorders and Schizophrenia-Lifetime Version for Anxiety Disorders (DSM-IV) were obtained from 58, 285, and 247 first-degree relatives, respectively, of the three groups. The rate of OCD in case versus comparison relatives was assessed with chi-square tests, and odds ratios were calculated for risk estimation. Cox proportional hazards analysis was used to estimate the age-related risk of relatives of being affected by OCD. RESULTS: Cox proportional hazards analyses revealed a 6.2-fold higher risk (hazard ratio) for relatives of all OCD cases for definite OCD and a 2.2-fold higher risk for subclinical OCD compared with relatives of comparison subjects. For relatives of community subjects with OCD, the risk for definite OCD (10.3% versus 5.6%) was 1.6, and the risk for subclinical OCD (15.4% versus 4.1%) was 3.4 compared with relatives of OCD patients from treatment sites. CONCLUSIONS: These results from the first controlled European family study of OCD confirm earlier U.S. data on the familiality of OCD in patients recruited from treatment facilities. The finding of a comparable familial aggregation of definite OCD and a higher familial aggregation of subclinical OCD in relatives of never-treated persons with OCD from the community strongly supports the impact of familial-genetic factors in OCD.

Ambulatory Care↗
PubMed2006

Frequency, clinical and demographic correlates of pathological dissociation in Europe.

Although pathological dissociation (PD) has received increasing scientific attention in Anglo-American countries, European research on the frequency, clinical and demographic correlates of this discontinuous construct are lacking. An 8-item subscale of the Dissociative Experiences Scale, called the DES-Taxon, was administered to five samples comprising a non-clinical population, students, unselected psychiatric inpatients, eating-disordered inpatients and psychosomatic outpatients with a total of 1,759 adult participants. In the two non-clinical samples, the frequency of PD ranged between 0.3 and 1.8%. Its prevalence was highest in the psychiatric inpatients (5.4%) followed by the eating disorders (4.8%) and the psychosomatic outpatients (2.2%). PD was seen in all diagnostic groups and it was associated with more psychopathological distress and younger age. PD is frequently found in clinical populations in European countries, too. However, methodological problems relating to its empirical determination might obscure the clinical and scientific value of the construct.

Adolescent↗
PubMed2006

Borderline personality organization and dissociation.

The relationship between Kernberg's psychodynamic model of personality organization (PO) and dissociation has not yet been explored. Seventy-two nonclinical subjects and 222 psychiatric patients completed the Dissociative Experiences Scale and the Inventory of Personality Organization. Its Reality Testing subscale emerged as the most important predictor for all facets of dissociation. Discussing our results in the framework of Fonagy and coworkers' model of mentalization, we suggest that dissociation may reflect the preoedipal "pretend" mode of psychic functioning while impaired reality testing and psychotic experiences might be indicative of the "psychic equivalent" mode.

Adolescent↗
PubMed2006

Recent developments in the theory of dissociation.

Although the construct of dissociation was introduced into psychiatry at the end of the 19th century by Pierre Janet, the term still lacks a coherent conceptualization, which is partially reflected by differences in the classification of dissociative and conversion disorders in ICD-10 and DSM-IV. Given the clinical significance of dissociative psychopathology in numerous clinical conditions, it is very valuable that various efforts have been made to refine and to specify current conceptualizations in recent years. The most promising and convincing approaches converge in subdividing dissociation into qualitatively different types, i.e. pathological versus non-pathological dissociation, and "detachment" versus "compartmentalization". We review these concepts and discuss their scientific and clinical potential as well as their limitations.

Journal Article↗
PubMed2005

Gender-specific association of alexithymia and norepinephrine/cortisol ratios. A preliminary report.

OBJECTIVE: Alexithymia and posttraumatic stress disorder (PTSD) might share a neuroendocrine pattern characterized by increased urinary norepinephrine (N) and decreased cortisol (C) levels, resulting in a high N/C ratio, at least among male alcoholics. We aimed to explore if this association can also be found in other populations. METHODS: Twenty-four-hour urine samples were obtained from 12 major depressive disorder (MDD) patients and 23 healthy controls (HC) and tested for N and free C. Participants completed the 20-item Toronto Alexithymia Scale (TAS) and the Symptom Check List (SCL). RESULTS: Controlling for depression, the neuroendocrine parameters did not differ between the MDD and HC participants nor between women and men. The TAS was not associated with N, C or the N/C ratio in the MDD and HC participants nor in females alone. However, in men, the N/C ratio correlated significantly with the TAS (r = .80). CONCLUSIONS: Our preliminary findings indicate that alexithymia is associated with an increased noradrenergic activity and a decreased basal activity of the hypothalamic-pituitary-adrenal (HPA) axis among men. This gender difference may reflect divergent underlying neurobiological processes of alexithymia in men and women.

Adult↗
PubMed2005

Alexithymia and interpersonal problems.

BACKGROUND: Interpersonal relationships are substantially codetermined by nonverbal communication, e.g. facial affect. Given the deficits of nonverbal affect recognition and expression in alexithymia, we hypothesized that alexithymics had more interpersonal problems than nonalexithymic individuals, and that the various facets of the alexithymia construct are differentially related to interpersonal problems. METHOD: 149 subjects participating in an inpatient group psychotherapy program completed the Toronto Alexithymia Scale (TAS-20) and the Inventory of Interpersonal Problems (IIP-C) at the beginning of the treatment. The IIP-C was also administered to a subgroup at the end of the treatment. RESULTS: Based on the alexithymia scores, patients were classified as low- (TAS-20 score </=51), moderate- or high-alexithymic (TAS-20 score >/=61). High-alexithymic patients had significantly more interpersonal problems than low alexithymics, particularly in the IIP-C scales indicating hostility and social avoidance. The TAS-20 subscale difficulty describing feelings showed the highest correlations with interpersonal problems (r between 0.23 and 0.55). At the end of the treatment, the high alexithymics still scored highest on the IIP-C, but the magnitude of change in interpersonal problems did not differ across the groups. CONCLUSIONS: Our findings suggest that the interpersonal style of alexithymic individuals is characterized by a cold and socially avoidant behavior, corresponding to the predominantly insecure attachment pattern found in alexithymia. Additionally, our results indicate that group psychotherapy is as helpful for alexithymic as for nonalexithymic subjects with respect to interpersonal problems. Finally, we propose that alexithymia involves a reduced capacity to use social interactions for affect regulation.

Adult↗
PubMed2004

Decreased levels of dopamine D3 receptor mRNA in schizophrenic and bipolar patients.

Previous studies found an elevation of the dopamine D3 receptor (DRD3) mRNA as determined in peripheral lymphocytes in schizophrenic patients. The aim of this study was to test the hypothesis of elevated DRD3 mRNA in schizophrenia compared to bipolar disorder. Twenty-four patients, 13 schizophrenic and 11 bipolar, were included according to DSM-IV criteria. Psychometric measures were conducted using the Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Brief Psychiatric Rating Scale, Montgomery-Asberg Depression Rating Scale and Young Mania Rating Scale. mRNA was isolated from lymphocytes of venous blood samples and DRD3 mRNA was quantified using real-time reverse transcription PCR. We found a decrease in DRD3 mRNA in 13 schizophrenic (p = 0.009) and 11 bipolar (p = 0.023) patients as compared to controls. Medication history and severity of positive symptoms did not significantly influence DRD3 expression. Higher levels of DRD3 mRNA were correlated with negative schizophrenic symptoms. Interestingly, after treatment of patients with antipsychotics, DRD3 mRNA levels increased to similar levels as those of healthy controls. Bipolar patients, however, showed a slower increase in DRD3 mRNA levels after 3 weeks of therapy. Our findings suggest that the expression of DRD3 mRNA is reduced in schizophrenia and bipolar disorder, supporting the hypothesis of distorted homeostasis of dopamine receptor subtypes in psychotic disorder. The observed diminution was not specific for schizophrenia but also for bipolar disorder requiring further analysis of the regulatory factors involved in dopamine receptor subtype expression.

Adolescent↗
PubMed2004

Dissociation, hemispheric asymmetry, and dysfunction of hemispheric interaction: a transcranial magnetic stimulation approach.

The authors investigated the hypothesis that dissociation may represent a functional dysconnectivity syndrome using a transcranial magnetic stimulation (TMS) approach. Transcranial magnetic stimulation investigations that included motor thresholds and the transcallosal conduction time (TCT) reflecting the interhemispheric transfer were performed in 74 right-handed students. All subjects completed the Dissociative Experience Scale. The high dissociators had a significantly lower left hemispheric excitability than right hemispheric excitability. They also had a significantly shorter TCT from the left to the right hemisphere than did the low dissociators. These results suggest that the neural basis of dissociation may involve a cortical asymmetry with a left hemispheric superiority or, alternatively, a lack of right hemispheric integration.

Adolescent↗
PubMed2004

[The relationship between OPD features of personality structure and symptom-related and interpersonal outcome of inpatient psychotherapy].

OBJECTIVE: To investigate the prognostic relevance of the axis "structure" of operationalized psychodynamic diagnostics (OPD) with respect to the symptom-related and interpersonal outcome of inpatient psychotherapy by applying group comparisons as well as individual criteria. METHODS: The structural level of 102 psychiatric inpatients was related to the general and dissociative psychopathology (SCL-90; FDS-20) as well as interpersonal problems (IIP) at the beginning and at the end of inpatient treatment. RESULTS: There was a tendency toward an association between the structural level and psychopathological improvement. However, we did not find any clear relationship between structure and interpersonal difficulties either at the beginning or during the course of the treatment. The structural dimensions did not correlate with the reduction of psychopathology or interpersonal problems. From the patients perspective, however, overall personality structure, defence and object perception were important predictors for therapy success. CONCLUSIONS: In correspondence with other studies our findings suggest that consistent predictions on therapy outcome in regards to psychopathology and interpersonal problems are not possible on the basis of the axis "structure". The possible implications for a differential therapy indication are discussed.

Adult↗