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Background: To date, there has been little research into effective strategies for preventing the detrimental effects of stigma on the well-being of people with mental illness.Aim: The present research set out to identify adaptive strategies for dealing with the stigma of mental illness.Methods: On the basis of the responses of 355 people with mental illness (PWMI) a standardized questionnaire assessing 10 identity management strategies was developed. Participants also reported their personal experiences with stigma, depression and self-esteem.Results: Hierarchical regression analyses showed that after controlling for depression and stigmatizing experiences, the strategies of community involvement, humour and positive ingroup stereotyping were related to higher self-esteem. Secrecy, selective disclosure and attempts at overcompensation or disproving stereotypes were related to lower self-esteem. The following strategies were unrelated to self-esteem: comparing the present social position of PWMI with that in the past, normalization of the illness within a medical model, information seeking and selective withdrawal.Conclusions: PWMI should be encouraged to seek support within their community and to develop a positive image of their ingroup. [ABSTRACT FROM PUBLISHER]

More often than is generally assumed: according to 2 metaanalyses, an average of about 25% of all cases of PTSD are not definitively diagnosed with post-traumatic stress disorder (PTSD) until 6 months or more after their trauma. Its prevalence varies widely depending on the given population. Delayed onset PTSD is diagnosed in military personnel much more often than in the civilian population (38,2 vs. 15,3%) . The divergence in PTSD's prevalence numbers is attributed to differences in its definition, methodology, and target population, as well as the type of trauma. The longer the observation period, the more likely it is that the PTSD diagnosis will be delayed. Several influencing factors have been identified for its emergence and persistence. Some experts insist that "bridge symptoms" be defined when patients are diagnosed as suffering from delayed onset PTSD. Although frequent, they are not necessarily present. We discuss an example thereof provided by political prisoners in the former GDR exhibiting different courses of PTSD as well as its delayed-manifestation subtype., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Childhood trauma can have a negative impact on the development of personal and social resources in later adulthood. This is problematic, because resources can be a protective factor against the development of psychiatric disorders and are potentially beneficial for therapy outcomes. The current study considered the association between childhood trauma and resources as well as the impact of these 2 factors on psychopathology and symptom reduction in a psychiatric in-patient sample. We anticipated negative relationships between resources and the extent of childhood traumatization as well as resources and psychiatric symptoms. We also expected a positive association between trauma and symptoms. Furthermore, we assumed that higher current resources would be associated with a higher symptom reduction and more severe traumatization in childhood with a lower reduction of symptoms. These hypotheses were tested with correlation and regression analysis in a sample of n=93 patients with depressive and posttraumatic symptomatology in a psychiatric clinic in Offenburg. As expected, we found negative associations between resources and childhood trauma as well as resources and symptoms. However, contrary to our predictions, we could only find a significant association between childhood traumatization and posttraumatic, but not depressive symptoms. Also, there was no significant association between resources or childhood trauma and therapy outcome. The reported associations are relevant concerning the prevention of psychiatric disorders and thus have multiple implications for the development and use of preventive and therapeutic interventions., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

This five year long-term follow-up study estimated the prevalence of Posttraumatic Stress Disorder (PTSD) and other mental health problems in traffic accident victims. 70 patients were invited for a personal interview to assess mental disorders (DIA-X), depression (BDI), mental distress (SCL-90-R), and psychosocial (SDS) and physical impairments at least five years after their first admission to a university hospital (Department of Traumatology). Prevalence of PTSD was 10%, and another 14.2% of the patients also had a partial PTSD. Other mental disorders had a lower prevalence (7.2%). Patients with PTSD did not differ in sociodemographic characteristics from patients without PTSD. PTSD patients were more depressed and showed more general psychological distress. Furthermore, PTSD was associated with impairments in job, social interaction, and leisure activities. Persistent medical and mental problems correlated highly with PTSD. Implications for secondary prevention of persistent mental health problems of traffic accident patients are discussed in their connection with PTSD.