Event-related Potential in Trauma-Affected Refugees
2. Project period:
01-02-2016 – 31-01-2017
Hanieh Meteran (medical and research year student)
4. Supervisors and collaborative partners
- Jessica Carlsson Lohmann, CTP.
- Sigurd Wingaard Uldall, CTP.
- Erik Vindbjerg, CTP.
- Bob Oranje, UMC Utrecht Hersencentrum.
Refugee victims of severe traumatisation have endured experiences that often lead to a complex
form of PTSD, which apart from the core symptoms of hyperarousal, flashbacks and anxiety
encompasses persistent and pervasive impairments in affective, self and relational functioning (1).
Avoidance often takes the form of social isolation, making patients susceptible to depression and
cognitive understimulation (2,3). In our clinical experience, patients will often display hyperarousal
to unpredictable social situations, while being under engaged in relation to routine activities. We
would expect this relegation of resources to reflect in deficits in psychophysiological measures.
Contrary to PTSD among trauma-affected refugees, research into the neuropsychological
deficiencies schizophrenia is common. While being recognised as two distinctive diagnostic entities,
PTSD and schizophrenia also bare many resemblances and both common psychopathology (4,5) and
psychological mechanisms have been suggested (6). Despite the clinical common ground, no
research has looked into common neural underpinnings of these different diagnoses as far as we
To provide a better understanding of psychophysiological characteristics of trauma-affected
refugees and investigate the correlation between the psychophysiological measures and symptom
severity. Furthermore we will compare the deficiencies in psychophysiological measures in our
patient group with a group of patients suffering from schizophrenia. The choice of EEG measures
reflects an aim to potentially implement knowledge gained from this study into routine clinical
assessment of trauma-affected refugees, as well as an objective measure of treatment outcome.
7.1 Number of participants (N):
Adult trauma-affected refugees
7.3 Description of data and data collection
The study will include 30 trauma-affected refugees with PTSD recruited at Competence Centre
for Transcultural Psychiatry (CTP). 30 healthy control refugees matched on age, country of origin
and socioeconomic status will be recruited through www.forsøgsperson.dk (Danish online platform for people to sign up for study participation) and by use of snowball sampling. We will
measure neural activity with electroencephalography (EEG) using a psychophysiological battery,
which tests sensory-gating, sensorimotor gating, selective attention and mismatch negativity.
Study participants will undergo one day of interview and one day of psychophysiological
7.4 Application/acceptance from the Danish Data Protection Agency, the National ommittee
on Health Research Ethics:
Applied and awaiting final approval.
8. Expected results
We expect a difference in the psychophysiological measures between trauma-affected refugees
with and without chronic PTSD. The deficiencies will correlate with symptom severity. Compared to
the control group the deficiencies in the psychophysiological measures in trauma-affected refugees
with chronic PTSD will be closer to those in patients with schizophrenia.
9. Dissemination of results
Winter 2016/2017. Findings will be published in international peer-reviewed journals and presented
at relevant conferences.
1. Maercker A, Brewin CR, Bryant RA, Cloitre M, Van Ommeren M, Jones LM, et al. Diagnosis and
classification of disorders specifically associated with stress: Proposals for ICD-11. World
2. Buhman C, Mortensen EL, Lundstrøm S, Ryberg J, Nordentoft M, Ekstrøm M. Symptoms, Quality
of Life and level of functioning of traumatized refugees at Psychiatric Trauma Clinic in
Copenhagen. Torture. 2014;24(1):25–39.
3. Strijk PJ1, van Meijel B, Gamel CJ. Health and social needs of traumatized refugees and asylum
seekers: an exploratory study. Perspect Psychiatr Care. 2011 Jan;47(1):48-55.
4. Portin R, Kovala T, Polo-Kantola P, Revonsuo A, Müller K, Matikainen E. Does P3 Reflect
Attentional or Memory Performances, or Cognition more Generally? Scand J Psychol.
5. McFarlane AC, Lee Weber D, Clark CR. Abnormal stimulus processing in posttraumatic stress
disorder. Biol Psychiatry. 1993;34(5):311–20.
6. Javanbakht A. Sensory gating deficits, pattern completion, and disturbed fronto-limbic balance,
a model for description of hallucinations and delusions in schizophrenia. Med Hypotheses.