101
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Pappaccogli M, Di Monaco S, Georges CM, Petit G, Eula E, Ritscher S, Lengelé JP, Fanelli E, Severino F, Renkin J, Avataneo V, Wallemacq P, Toennes SW, de Timary P, Rabbia F, Persu A. Predictors of blood pressure control in patients with resistant hypertension after intensive management in two expert centres: the Brussels-Torino experience. Blood Press 2019; 28:336-344. [DOI: 10.1080/08037051.2019.1633908] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Marco Pappaccogli
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Silvia Di Monaco
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Coralie M.G. Georges
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Géraldine Petit
- Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Elisabetta Eula
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Sabrina Ritscher
- Institute of Legal Medicine, Department of Forensic Toxicology, University Hospital Frankfurt, Goethe-University, Frankfurt, Frankfurt/Main, Germany
| | - Jean-Philippe Lengelé
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Department of Nephrology, Grand Hôpital de Charleroi, Gilly, Belgium
| | - Elvira Fanelli
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Francesca Severino
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Jean Renkin
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Valeria Avataneo
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Pierre Wallemacq
- Clinical Chemistry Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Centre for Toxicology and Applied Pharmacology, Université Catholique de Louvain, Brussels, Belgium
| | - Stefan W. Toennes
- Institute of Legal Medicine, Department of Forensic Toxicology, University Hospital Frankfurt, Goethe-University, Frankfurt, Frankfurt/Main, Germany
| | - Philippe de Timary
- Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Franco Rabbia
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
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102
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Mahoney CT, Benight CC. The Temporal Relationship Between Coping Self-Efficacy and Dissociation in Undergraduate Students. J Trauma Dissociation 2019; 20:471-487. [PMID: 30924408 DOI: 10.1080/15299732.2019.1597805] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Dissociation is a lack of information integration resulting from a process that ranges on a continuum from normative experiences (e.g., daydreaming) to a pervasive traumatic response involving alterations and/or fragmentation in mental processes such as memory, emotion, and perception. Perceived coping self-efficacy (CSE) is a cognitive appraisal ability utilized to regulate internal and external stressors that arise from traumatic events, and is crucial for effective adaptation after extreme stress or trauma. Thus, CSE may be a critical component in decreasing dissociative experiences following a traumatic event. In the present study, 136 undergraduate students (M age = 22.36 years, SD = 6.27; 81% female, 69.1% Caucasian, 77.2% attended some college) completed self-report measures of trauma, dissociation, and coping self-efficacy. All measures were completed by the same participants at two different time points (Time 1 and Time 2) two months apart; all participants reported a history of exposure to at least one Criterion A traumatic event (according to the DSM-5) at Time 1. We hypothesized that CSE for posttraumatic coping demands at Time 2 would mediate the relationship between dissociation at Time 1 and dissociation at Time 2, and subsequently found evidence of significant mediation, 95% CI [.02, .18]. These findings suggest that initial levels of persistent dissociation negatively predict CSE, which in turn directly and negatively influence persistent dissociation at a later time point. This highlights how CSE may serve as a protective factor against persistent dissociation.
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Affiliation(s)
- Colin T Mahoney
- a Department of Psychology , Idaho State University , Pocatello , ID , USA
| | - Charles C Benight
- b Department of Psychology , University of Colorado at Colorado Springs , Colorado Springs , CO , USA
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103
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Leiler A, Bjärtå A, Ekdahl J, Wasteson E. Mental health and quality of life among asylum seekers and refugees living in refugee housing facilities in Sweden. Soc Psychiatry Psychiatr Epidemiol 2019; 54:543-551. [PMID: 30580381 DOI: 10.1007/s00127-018-1651-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/12/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION In 2015, there was a high influx of refugees to Sweden, creating an extreme situation where individuals were forced to remain in large housing facilities for long periods. The present study aims to describe the mental health and quality of life of these individuals. METHODS Data, based on 510 individuals, were obtained by means of a questionnaire at open screenings conducted at or nearby refugee housing facilities. Of the participating refugees, 367 were asylum seekers and 143 had received a residence permit but were still awaiting a more permanent housing solution. The questionnaire included measures of depressive symptoms (PHQ-9), symptoms of anxiety (GAD-7), risk of having post-traumatic stress disorder (PC-PTSD), and quality of life (WHOQOL-BREF). RESULTS Of the total sample, 56-58.4% reported clinically significant levels of symptoms of depression, anxiety and risk of having PTSD. Prevalence estimates were higher among asylum seekers than among those who had received their residence permit. Quality of life was generally rated below population norms and correlated negatively with mental health outcomes. CONCLUSIONS Individuals residing in refugee housing facilities show high levels of psychological distress and rate their quality of life as low. Asylum seekers score higher than those having received a residence permit. These results are troublesome since the wait time for asylum decisions has lengthened considerably after 2015. The results of the present study calls for the urgency of societal actions to shorten the asylum process and improve conditions at the housing facilities.
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Affiliation(s)
- Anna Leiler
- Department of Psychology, Mid Sweden University, 831 25, Östersund, Sweden.
| | - Anna Bjärtå
- Department of Psychology, Mid Sweden University, 831 25, Östersund, Sweden
| | - Johanna Ekdahl
- Department of Psychology, Mid Sweden University, 831 25, Östersund, Sweden
| | - Elisabet Wasteson
- Department of Psychology, Mid Sweden University, 831 25, Östersund, Sweden
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104
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Berg L, Charboti S, Montgomery E, Hjern A. Parental PTSD and school performance in 16-year-olds - a Swedish national cohort study. Nord J Psychiatry 2019; 73:264-272. [PMID: 31134834 DOI: 10.1080/08039488.2019.1620852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aim: Posttraumatic stress disorder (PTSD) in parents can have severe consequences also for their children. Prevalence of PTSD is high among refugees. Refugee children have been reported to perform poorly in school. The aim of this study was to investigate the impact of PTSD in refugee and native Swedish parents on children's school performance and to compare the impact of PTSD with that of other major psychiatric disorders. Methods: Register study where multiple regression models were used to analyse school performance in 15-16-year-olds in a national cohort (n = 703,813). PTSD and other major psychiatric disorders (bipolar, depression and/or psychotic disorders) were identified from out- and in-patient hospital care. Results: Maternal and paternal PTSD were associated with lower grades, with adjusted effects of 0.30-0.37 SD in refugee and 0.46-0.50 SD in native Swedish families. Impact of PTSD was greater than that of other psychiatric disorders and comorbidity to PTSD did not increase this impact. Although the impact of PTSD on grades was greater in children in native Swedish families, consequences with regard to eligibility to secondary education were greater for children in refugee families, where 35% of these children were ineligible. Conclusions: Parental PTSD has major consequences for children's school performance and contributes to the lower school performance in children in refugee families in Sweden. Identification and treatment of PTSD in refugee parents is important for offspring educational achievement. Psychiatric clinics and treatment centres need to have a strategy for support, including educational support, to the offspring of their patients with PTSD.
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Affiliation(s)
- Lisa Berg
- a Department of Public Health Sciences , Stockholm University , Stockholm , Sweden.,b Centre for Health Equity Studies , Stockholm University/Karolinska Institutet , Stockholm , Sweden
| | | | - Edith Montgomery
- d Department of Public Health, Danish Research Centre for Migration, Ethnicity and Health , University of Copenhagen , Copenhagen , Denmark
| | - Anders Hjern
- b Centre for Health Equity Studies , Stockholm University/Karolinska Institutet , Stockholm , Sweden.,e Department of Medicine, Clinical Epidemiology , Karolinska Institutet , Stockholm , Sweden
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105
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Do TTH, Correa-Velez I, Dunne MP. Trauma Exposure and Mental Health Problems Among Adults in Central Vietnam: A Randomized Cross-Sectional Survey. Front Psychiatry 2019; 10:31. [PMID: 30853915 PMCID: PMC6395446 DOI: 10.3389/fpsyt.2019.00031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/18/2019] [Indexed: 11/13/2022] Open
Abstract
Background: There is relatively little evidence about the psychological and social impacts of trauma exposure in the general population in East Asian countries. Vietnam has a long history of war and poverty, is prone to natural disasters and has high mortality related to traffic accidents. The mental health systems may be inadequate to cope with the resultant trauma. Objectives: This research examines the lifetime prevalence of single and multiple traumas and the association between trauma exposure and depression, anxiety and post-traumatic stress disorder (PTSD) among a randomly selected sample of the adult population in Thua Thien-Hue province in central Vietnam. Methods: Six hundred and eight Vietnamese adults aged 18 years or older participated in the survey. The main tools in the face-to-face interview included the Life Event Checklist (LEC) to measure trauma exposure, the Hospital Anxiety and Depression Scale (HADS) and the PTSD Checklist for DSM-IV (PCL-IV). Hierarchical multiple logistic regression was used to examine associations between trauma exposure and mental health. Results: Forty seven percent of the participants experienced at least one traumatic event in their lifetime and about half of these people were exposed to multiple traumas. The prevalence of depression, anxiety, and PTSD symptoms among the total sample was 12.7, 15.5, and 6.9%, respectively. Prevalence of PTSD among those reporting trauma exposure was 14.8%. Exposure to a higher number of trauma types was associated with increased risk of having depression, anxiety, and PTSD symptoms. Interpersonal traumas were strongly associated with symptoms of all three mental disorders while non-interpersonal traumas were only associated with depressive symptoms. Conclusion: Our findings indicate high burden of lifetime trauma and mental ill health in the adult population of central Vietnam and show a cumulative effect of multiple traumas on symptoms of the three mental disorders. Interpersonal trauma appears to have a more harmful effect on mental health than non-interpersonal trauma. Efforts to improve mental health in Vietnam should focus on reducing risk of preventable interpersonal trauma in every stage of life, and more broadly, ensure greater availability of trauma-sensitive mental health programs and services.
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Affiliation(s)
- Trang Thi Hanh Do
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Ignacio Correa-Velez
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Michael P Dunne
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.,Institute for Community Health Research, Hue University, Hue, Vietnam
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106
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Boffa JW, Schmidt NB. Reductions in anxiety sensitivity cognitive concerns prospectively mitigate trauma symptom development. Behav Res Ther 2018; 113:39-47. [PMID: 30593974 DOI: 10.1016/j.brat.2018.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 12/05/2018] [Accepted: 12/17/2018] [Indexed: 11/30/2022]
Abstract
Identifying a malleable pre-trauma risk marker for posttraumatic stress is crucial to preventing symptom development among at-risk individuals. One such candidate is anxiety sensitivity cognitive concerns (ASCC), which represents the fear of psychological incapacitation due to anxious arousal. While the extant literature suggests that applying ASCC interventions prior to trauma exposure should mitigate development of posttraumatic stress symptoms (PTSS), this has not been formally tested. We examined whether individuals randomized to receive a Cognitive Anxiety Sensitivity Treatment (CAST; n = 44) prior to a trauma film paradigm would report lower film-specific PTSS after one week compared to individuals randomized to a physical health education training control condition (n = 47). Results revealed that post-intervention ASCC and week-one PTSS were both lower among the CAST condition, and reductions in ASCC mediated the relationship between intervention condition and follow-up PTSS. The current study demonstrated that reducing ASCC prior to an analog trauma can mitigate the development of PTSS. This is critical for establishing ASCC as a causal risk factor for PTSS and encourages the use of ASCC interventions in samples at-risk for trauma exposure.
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Affiliation(s)
- Joseph W Boffa
- Department of Psychology, Florida State University, 1107, W. Call St, Tallahassee, FL, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, 1107, W. Call St, Tallahassee, FL, USA.
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107
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Aslaner D, Solmaz M, Kulacaoglu F, Ardic FC, Balcioglu YH, Kose S. Lifetime post-traumatic stress disorders in female trauma victims in an outpatient sample from Turkey. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1556910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Dilek Aslaner
- Department of Psychiatry, Health Sciences University Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - Mustafa Solmaz
- Department of Psychiatry, Health Sciences University Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - Filiz Kulacaoglu
- Department of Psychiatry, Health Sciences University Bagcilar Research and Training Hospital, Istanbul, Turkey
- Department of Psychiatry, Cerkezkoy State Hospital, Tekirdag, Turkey
| | - Ferhat Can Ardic
- Department of Psychiatry, Health Sciences University Bagcilar Research and Training Hospital, Istanbul, Turkey
| | - Yasin Hasan Balcioglu
- Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Forensic Psychiatry Unit, Istanbul, Turkey
| | - Samet Kose
- Department of Psychology, Hasan Kalyoncu University, Gaziantep, Turkey
- Department of Psychiatry, University of Texas Medical School of Houston, Houston, USA
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108
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Violent interpersonal trauma predicts aggressive thoughts and behaviors towards self and others: findings from the National Comorbidity Survey-Adolescent Supplement. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1361-1370. [PMID: 30255381 DOI: 10.1007/s00127-018-1607-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The purpose of the current study is to examine the relation between adolescent traumatic event exposure and aggression directed towards the self and others. Theoretical perspectives underscore the particularly pernicious effects of violent traumas intentionally perpetrated by others in terms of negative posttraumatic outcomes. However, a careful comparison of trauma type in relation to aggression has not been done with youth. The current project, therefore, examined differences between youth with a history of violent interpersonal trauma (VIT) compared to those with a non-violent trauma type history in terms of aggressive behavior directed towards others as well as aggressive self-directed thoughts (suicidal ideation). METHOD The sample was drawn from the National Comorbidity Survey-Replication and consisted of 1928 adolescents (M = 15.4; SD = 1.47 years), each assigned to one of four age- and gender-matched trauma history groups. RESULTS Consistent with hypotheses, among trauma-exposed youth, those who had experienced or witnessed a VIT (compared to those reporting a non-VIT only) evidenced elevated aggression, even after controlling for a number of theoretically relevant covariates (e.g., gender, age, household income, demographic factors). CONCLUSION Results indicate that youth with a history of VIT may be at unique risk for experiencing aggression directed towards others and the self compared to those without this specific trauma history. This is important because trauma type is an easily assessed indicator of potentially elevated risk for these types of deleterious outcomes. Findings are situated in a research agenda aimed at continuing to refine our understanding of the link between interpersonal trauma and aggression.
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109
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Farhood L, Fares S, Hamady C. Correction to: PTSD and gender: could gender differences in war trauma types, symptom clusters and risk factors predict gender differences in PTSD prevalence? Arch Womens Ment Health 2018; 21:735-743. [PMID: 29971554 DOI: 10.1007/s00737-018-0874-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AbstractThe female-male ratio in the prevalence of post-traumatic stress disorder (PTSD) is approximately 2:1. Gender differences in experienced trauma types, PTSD symptom clusters, and PTSD risk factors are unclear. We aimed to address this gap using a cross-sectional design. A sample of 991 civilians (522 women, 469 men) from South Lebanon was randomly selected in 2007, after the 2006 war. Trauma types were grouped into disaster and accident, loss, chronic disease, non-malignant disease, and violence. PTSD symptom clusters involved re-experiencing, avoidance, negative cognitions and mood, and arousal. These were assessed using parts I and IVof the Arabic version of the Harvard Trauma Questionnaire (HTQ). Risk factors were assessed using data from a social support and life events questionnaire in multiple regression models. Females were twice as likely as males to score above PTSD threshold (24.3 vs. 10.4%, p ˂ 0.001). Total scores on all trauma types were similar across genders. Females scored higher on all symptom clusters (p < 0.001). Social support, social life events, witnessed traumas, and domestic violence significantly were associated with PTSD in both genders. Social support, social life events, witnessed traumas and domestic violence were significantly associated with PTSD in both genders. Conversely, gender difference in experienced traumas was not statistically significant. These findings accentuate the need to re-consider the role of gender in the assessment and treatment of PTSD.
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Affiliation(s)
- Laila Farhood
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon. .,Psychiatry Department, American University of Beirut Medical Center, Beirut, Lebanon.
| | - Souha Fares
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Carmen Hamady
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
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110
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PTSD and gender: could gender differences in war trauma types, symptom clusters and risk factors predict gender differences in PTSD prevalence? Arch Womens Ment Health 2018; 21:725-733. [PMID: 29802463 DOI: 10.1007/s00737-018-0849-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/09/2018] [Indexed: 01/24/2023]
Abstract
The female-male ratio in the prevalence of post-traumatic stress disorder (PTSD) is approximately 2:1. Gender differences in experienced trauma types, PTSD symptom clusters, and PTSD risk factors are unclear. We aimed to address this gap using a cross-sectional design. A sample of 991 civilians (522 women, 469 men) from South Lebanon was randomly selected in 2007, after the 2006 war. Trauma types were grouped into disaster and accident, loss, chronic disease, non-malignant disease, and violence. PTSD symptom clusters involved re-experiencing, avoidance, negative cognitions and mood, and arousal. These were assessed using parts I and IV of the Arabic version of the Harvard Trauma Questionnaire (HTQ). Risk factors were assessed using data from a social support and life events questionnaire in multiple regression models. Females were twice as likely as males to score above PTSD threshold (24.3 vs. 10.4%, p ˂ 0.001). Total scores on all trauma types were similar across genders. Females scored higher on all symptom clusters (p < 0.001). Social support, social life events, witnessed traumas, and domestic violence significantly were associated with PTSD in both genders. Social support, social life events, witnessed traumas and domestic violence were significantly associated with PTSD in both genders. Conversely, gender difference in experienced traumas was not statistically significant. These findings accentuate the need to re-consider the role of gender in the assessment and treatment of PTSD.
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111
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Frans Ö, Åhs J, Bihre E, Åhs F. Distance to threat and risk of acute and posttraumatic stress disorder following bank robbery: A longitudinal study. Psychiatry Res 2018; 267:461-466. [PMID: 29980125 DOI: 10.1016/j.psychres.2018.06.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 05/17/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
Abstract
Identifying pathways through which environmental risk factors influence PTSD is important for understanding PTSD etiology. Here, we hypothesized that the physical proximity to threat influences PTSD risk by increasing ASD following trauma. One hundred six bank employees who had experienced a bank robbery participated in the study. A longitudinal design assessing ASD at day 2 and PTSD at day 30 was used to test the hypothesis. Participants also indicated their location in the bank at the time of the robbery. ASD was identified in 40 (38%) and PTSD in 16 (15%) of the robbery victims. Distance to the robber had a strong effect on ASD (OR 3.51, 95% CI 1.94-6.34) and a somewhat lesser effect on PTSD (OR 2.15, 95% CI 1.04-4.46), indicating that the effect of proximity to threat on PTSD 1 month following trauma could be mediated by its effect on ASD 2 days following trauma. Using structural equation modeling, we confirmed that the effect of distance on PTSD was fully mediated by ASD. These findings suggest that proximity to threat may increase PTSD risk by enhancing the acute stress response following trauma.
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Affiliation(s)
- Örjan Frans
- Department of Psychology, Uppsala University, Box 1225, Uppsala S-752 43, Sweden.
| | - Jill Åhs
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Eva Bihre
- Department of Psychology, Uppsala University, Box 1225, Uppsala S-752 43, Sweden
| | - Fredrik Åhs
- Department of Psychology, Uppsala University, Box 1225, Uppsala S-752 43, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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112
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Lifetime Trauma and Depressive Symptomatology Among Older American Indians: The Native Elder Care Study. Community Ment Health J 2018; 54:740-747. [PMID: 29159495 DOI: 10.1007/s10597-017-0179-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 11/03/2017] [Indexed: 10/18/2022]
Abstract
We examined the association between lifetime traumatic events with or without trauma response symptoms and depressive symptomatology in American Indians aged ≥ 55 years from a tribe in the Southeastern US (N = 362). Twenty-three percent of the sample experienced a traumatic event without trauma-response symptoms, whereas 14% experienced a traumatic event with at least one trauma-response symptom. After adjustment for sociodemographic characteristics and social support, participants who experienced a traumatic event with one or more trauma-response symptoms had higher odds of clinically relevant depressive symptomatology compared to (1) those who never experienced a traumatic event [odds ratio (OR) 3.2, p < 0.05], (2) and those who experienced a traumatic event without further symptoms (OR 3.7, p < 0.05). Our results suggest that mental health providers who serve older American Indians should consider the experience of traumatic events followed with response symptoms as a potential risk factor for further disruptions in psychological functioning.
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113
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Stover CS, Keeshin B. Research domain criteria and the study of trauma in children: Implications for assessment and treatment research. Clin Psychol Rev 2018; 64:77-86. [PMID: 27863803 PMCID: PMC5423862 DOI: 10.1016/j.cpr.2016.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 05/07/2015] [Accepted: 11/07/2016] [Indexed: 10/20/2022]
Abstract
By definition, the Diagnostic and Statistical Manual (DSM) diagnosis of posttraumatic stress disorder (PTSD) requires exposure to a traumatic event. Yet, the DSM diagnostic requirements for children and adolescents for PTSD may fail to capture traumatized youth with significant distress and functional impairment. Many important studies have utilized PTSD diagnosis as a mechanism for grouping individuals for comparative studies examining brain functioning, neuroendocrinology, genetics, attachment, and cognition; however, focusing only on those with the diagnosis of PTSD can miss the spectrum of symptoms and difficulties that impact children who experience trauma and subsequent impairment. Some studying child trauma have focused on examining brain and biology of those with exposure and potential impairment rather than only those with PTSD. This line of inquiry, complementary to PTSD specific studies, has aided our understanding of some of the changes in brain structure and neuroregulatory systems at different developmental periods following traumatic exposure. Application of the Research Domain Criteria (RDoC) framework proposed by NIMH to the study of child trauma exposure and subsequent impairment is an opportunity to examine domains of function and how they are impacted by trauma. Research to date has focused largely in the areas of negative valence, regulatory, and cognitive systems, however those studying complex or developmental trauma have identified an array of domains that are impacted which map onto many of the RDoC categories. This paper will review the relevant literature associated with child trauma as it relates to the RDoC domains, outline areas of needed research, and describe their implications for treatment and the advancement of the field.
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Affiliation(s)
- Carla Smith Stover
- University of South Florida, 13301 Bruce B. Downs Blvd., Tampa, FL 33647, Salt Lake City, Utah, United States.
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114
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Bernhard A, Martinelli A, Ackermann K, Saure D, Freitag CM. Association of trauma, Posttraumatic Stress Disorder and Conduct Disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2018; 91:153-169. [DOI: 10.1016/j.neubiorev.2016.12.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 11/28/2016] [Accepted: 12/19/2016] [Indexed: 11/30/2022]
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115
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Petit G, Berra E, Georges CM, Capron A, Huang QF, Lopez-Sublet M, Rabbia F, Staessen JA, Wallemacq P, de Timary P, Persu A. Impact of psychological profile on drug adherence and drug resistance in patients with apparently treatment-resistant hypertension. Blood Press 2018; 27:358-367. [DOI: 10.1080/08037051.2018.1476058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Géraldine Petit
- Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Elena Berra
- Department of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Department of Medical Sciences, Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Turin, Italy
| | - Coralie M.G. Georges
- Department of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Arnaud Capron
- Clinical Chemistry Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Center for Toxicology and Applied Pharmacology, Université Catholique de Louvain, Brussels, Belgium
| | - Qi-Fang Huang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, Faculty of Medicine, University of Leuven, Belgium
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Marilucy Lopez-Sublet
- Department of Internal Medicine and Arterial Hypertension, Avicenne University Hospital, Bobigny Cedex, France
| | - Franco Rabbia
- Department of Medical Sciences, Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Turin, Italy
| | - Jan A. Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, Faculty of Medicine, University of Leuven, Belgium
- R&D Group VitaK, Maastricht University, Maastricht, The Netherlands
| | - Pierre Wallemacq
- Clinical Chemistry Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Center for Toxicology and Applied Pharmacology, Université Catholique de Louvain, Brussels, Belgium
| | - Philippe de Timary
- Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Alexandre Persu
- Department of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
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Song H, Fang F, Tomasson G, Arnberg FK, Mataix-Cols D, Fernández de la Cruz L, Almqvist C, Fall K, Valdimarsdóttir UA. Association of Stress-Related Disorders With Subsequent Autoimmune Disease. JAMA 2018; 319:2388-2400. [PMID: 29922828 PMCID: PMC6583688 DOI: 10.1001/jama.2018.7028] [Citation(s) in RCA: 198] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Psychiatric reactions to life stressors are common in the general population and may result in immune dysfunction. Whether such reactions contribute to the risk of autoimmune disease remains unclear. OBJECTIVE To determine whether there is an association between stress-related disorders and subsequent autoimmune disease. DESIGN, SETTING, AND PARTICIPANTS Population- and sibling-matched retrospective cohort study conducted in Sweden from January 1, 1981, to December 31, 2013. The cohort included 106 464 exposed patients with stress-related disorders, with 1 064 640 matched unexposed persons and 126 652 full siblings of these patients. EXPOSURES Diagnosis of stress-related disorders, ie, posttraumatic stress disorder, acute stress reaction, adjustment disorder, and other stress reactions. MAIN OUTCOMES AND MEASURES Stress-related disorder and autoimmune diseases were identified through the National Patient Register. The Cox model was used to estimate hazard ratios (HRs) with 95% CIs of 41 autoimmune diseases beyond 1 year after the diagnosis of stress-related disorders, controlling for multiple risk factors. RESULTS The median age at diagnosis of stress-related disorders was 41 years (interquartile range, 33-50 years) and 40% of the exposed patients were male. During a mean follow-up of 10 years, the incidence rate of autoimmune diseases was 9.1, 6.0, and 6.5 per 1000 person-years among the exposed, matched unexposed, and sibling cohorts, respectively (absolute rate difference, 3.12 [95% CI, 2.99-3.25] and 2.49 [95% CI, 2.23-2.76] per 1000 person-years compared with the population- and sibling-based reference groups, respectively). Compared with the unexposed population, patients with stress-related disorders were at increased risk of autoimmune disease (HR, 1.36 [95% CI, 1.33-1.40]). The HRs for patients with posttraumatic stress disorder were 1.46 (95% CI, 1.32-1.61) for any and 2.29 (95% CI, 1.72-3.04) for multiple (≥3) autoimmune diseases. These associations were consistent in the sibling-based comparison. Relative risk elevations were more pronounced among younger patients (HR, 1.48 [95% CI, 1.42-1.55]; 1.41 [95% CI, 1.33-1.48]; 1.31 [95% CI, 1.24-1.37]; and 1.23 [95% CI, 1.17-1.30] for age at ≤33, 34-41, 42-50, and ≥51 years, respectively; P for interaction < .001). Persistent use of selective serotonin reuptake inhibitors during the first year of posttraumatic stress disorder diagnosis was associated with attenuated relative risk of autoimmune disease (HR, 3.64 [95% CI, 2.00-6.62]; 2.65 [95% CI, 1.57-4.45]; and 1.82 [95% CI, 1.09-3.02] for duration ≤179, 180-319, and ≥320 days, respectively; P for trend = .03). CONCLUSIONS AND RELEVANCE In this Swedish cohort, exposure to a stress-related disorder was significantly associated with increased risk of subsequent autoimmune disease, compared with matched unexposed individuals and with full siblings. Further studies are needed to better understand the underlying mechanisms.
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Affiliation(s)
- Huan Song
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar Tomasson
- Department of Epidemiology and Biostatistics, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Department of Rheumatology, University Hospital, Reykjavík, Iceland
- Centre for Rheumatology Research, University Hospital, Reykjavík, Iceland
| | - Filip K. Arnberg
- National Centre for Disaster Psychiatry, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Lorena Fernández de la Cruz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Unnur A. Valdimarsdóttir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Wong A, Lee HS, Lee HP, Choi YK, Lee JH. Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth Following Indirect Trauma from the Sewol Ferry Disaster, 2014. Psychiatry Investig 2018; 15:613-619. [PMID: 29940715 PMCID: PMC6018149 DOI: 10.30773/pi.2017.12.03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 12/03/2017] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The definition of psychological trauma, which was traditionally restricted to immediate and direct experience, is now expanding to include mediated or vicarious experience. So the present study aims to examine the relationship between the negative effects and the positive outcomes to a national disaster by assessing the posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth of the general public. METHODS A nationwide survey of the Korean population (n=811) who were exposed to the Sewol ferry disaster through the media participated in this research, completing a self-report questionnaire consisting of demographic characteristics, Impact of Event Scale-Revised- Korean, and Korean-Stress-related Growth Scale-Revised. The participants were divided into three groups according to the severity of PTSD symptoms, then one-way ANOVA were conducted. RESULTS The results revealed 30.4% of the sampled participants reported stress symptoms equivalent to partial or full PTSD. Posttraumatic growth was significantly higher in the full and the partial PTSD symptom groups when compared to the normal group [F (2, 759)=20.534, p<0.001]. At a subscale level, mature thinking showed a more significant result [F (2,759)=23.146, p<0.001] than religious growth [F (2, 180.984)=4.811, p<0.01]. CONCLUSION The results indicated a general linear trend between the severity of PTSD symptoms and posttraumatic growth level, suggesting that indirect trauma also induces both PTSD symptoms and posttraumatic growth like direct trauma does. The theoretical implications based on these findings were discussed.
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Affiliation(s)
- Aekyeong Wong
- Posttraumatic Growth Center, Department of Psychiatry, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea
| | - Hong-Seock Lee
- Posttraumatic Growth Center, Department of Psychiatry, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea
| | - Heung-Pyo Lee
- Department of Psychology, Daegu Cyber University, Daegu, Republic of Korea
| | - Yun-Kyeung Choi
- Department of Psychology, Keimyung University, Daegu, Republic of Korea
| | - Jae-Ho Lee
- Department of Psychology, Keimyung University, Daegu, Republic of Korea
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Cernvall M, Sveen J, Bergh Johannesson K, Arnberg F. A pilot study of user satisfaction and perceived helpfulness of the Swedish version of the mobile app PTSD Coach. Eur J Psychotraumatol 2018; 9:1472990. [PMID: 29805783 PMCID: PMC5965023 DOI: 10.1080/20008198.2018.1472990] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/19/2018] [Indexed: 11/30/2022] Open
Abstract
Background: There is a need for accessible interventions in the aftermath of traumatic events with documented efficacy for preventing or reducing negative mental health consequences. The PTSD Coach is a mobile app that has shown to be effective in reducing symptoms of posttraumatic stress (PTSS). Objective: The purpose of the current study was to evaluate the user satisfaction, perceived helpfulness and potential reductions of PTSS and symptoms of depression among participants using the Swedish version of the PTSD Coach. Method: This was an uncontrolled pre-test post-test open trial including participants recruited from the community via advertisement and from an ongoing observational study who had experienced a potentially traumatic event in the last five years. Participants had access to the Swedish PTSD Coach app for four weeks. Results: Eleven participants (mean age = 38.6, female = 8) completed the study. Nine of the participants met criteria for full or partial PTSD. Results from the PTSD Coach Survey indicated that participants found the app slightly to moderately helpful and were slightly to moderately satisfied with the app. Nominal but not statistically significant reductions of medium effect sizes in PTSS (PCL-5) and depression (PHQ-9) from pre- to post-assessment were found. In interviews, participants indicated that they found elements such as learning about PTSD, breathing exercises and monitoring symptoms helpful in managing symptoms. However, several participants indicated that they had not used the app as much as they had intended to. Participants also had suggestions for improvements such as enhanced app structure and better guidance regarding how to use the app. Conclusions: The perceived helpfulness and user satisfaction were slightly lower compared to research on the original version of the app. Experiences from the study are discussed and a future controlled study of the Swedish version of the PTSD Coach is suggested.
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Affiliation(s)
- Martin Cernvall
- Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Josefin Sveen
- Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | | | - Filip Arnberg
- Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, Sweden
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119
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Boffa JW, Norr AM, Tock JL, Amir N, Schmidt NB. Development of the Interpretation Bias Index for PTSD. COGNITIVE THERAPY AND RESEARCH 2018; 42:720-734. [PMID: 31749509 DOI: 10.1007/s10608-018-9915-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cognitive models of posttraumatic stress disorder (PTSD) implicate interpretation biases as a maintaining factor of symptoms. Existing measures index symptoms and negative beliefs in PTSD patients, but not threatening interpretation of socially-ambiguous information, which would further inform cognitive models of PTSD. Here we describe the development of a measure of interpretation bias specific to individuals with PTSD. Studies 1 and 2 utilized analog samples to identify the smallest set of items capable of differentiating PTSD-specific interpretation biases. Study 3 utilized a clinical sample to examine the factor structure of the 9-item Interpretation Bias Index for PTSD (IBIP). A bifactor model fit the IBIP best, comprising a general PTSD factor and two subfactors. The IBIP was most strongly related to PTSD symptoms and demonstrated sensitivity and specificity to detecting true PTSD cases. The IBIP has potential clinical utility for tracking interpretation bias in PTSD, or even screening for PTSD diagnoses.
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Affiliation(s)
- Joseph W Boffa
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Aaron M Norr
- VA Puget Sound Health Care System, Seattle, WA, United States.,University of Washington School of Medicine, Seattle, WA, United States
| | - Jamie L Tock
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Nader Amir
- San Diego State University, San Diego, CA, United States.,University of California San Diego, San Diego, CA, United States
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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120
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Cramm H, Murphy S, Godfrey CM, Dekel R, McKeown S. Experiences of children exposed to parental post-traumatic stress disorder while growing up in military and veteran families: a systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2018; 16:852-859. [PMID: 29634510 DOI: 10.11124/jbisrir-2017-003523] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The objective of this review is to understand how parental Post-Traumatic Stress Disorder (PTSD) might impact children growing up in military and veteran families. The following question will guide and inform the review: What is the experience of children growing up in military families where the military or veteran parent is living with post-traumatic stress disorder?
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Affiliation(s)
- Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Susanne Murphy
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Christina M Godfrey
- Queen's Collaboration for Health Care Quality: a Joanna Briggs Institute Center of Excellence
| | - Rachel Dekel
- The Louis and Gabi Weisfeld School of Social Work, Multidisciplinary Centre for Mass Trauma Research, Israeli Centres of Research Excellence (I-Core), Bar-Ilan University, Ramat-Gan, Israel
| | - Sandra McKeown
- Bracken Health Sciences Library, Queen's University, Kingston, Canada
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121
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Levey EJ, Gelaye B, Koenen K, Zhong QY, Basu A, Rondon MB, Sanchez S, Henderson DC, Williams MA. Trauma exposure and post-traumatic stress disorder in a cohort of pregnant Peruvian women. Arch Womens Ment Health 2018; 21:193-202. [PMID: 28905129 PMCID: PMC5849493 DOI: 10.1007/s00737-017-0776-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 09/04/2017] [Indexed: 11/28/2022]
Abstract
Women have a higher prevalence of post-traumatic stress disorder (PTSD) than men, with a peak during the reproductive years. PTSD during pregnancy adversely impacts maternal and infant health outcomes. The objectives of this study were to estimate the prevalence of antepartum PTSD symptoms in a population of pregnant Peruvian women and to examine the impact of number of traumatic events and type of trauma experienced. The Traumatic Events Questionnaire was used to collect data about traumatic exposures. The Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C) was used to assess PTSD. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). Three thousand three hundred seventy-two pregnant women were interviewed. Of the 2920 who reported experiencing one or more traumatic events, 41.8% met criteria for PTSD (PCL-C score ≥ 26). A quarter of participants had experienced four or more traumas, and 60.5% of those women had PTSD. Interpersonal trauma was most strongly associated with PTSD (aOR, 3.20; 95% CI, 2.74-3.74), followed by unspeakable trauma (aOR, 2.87; 95% CI, 2.35-3.50), and structural trauma (aOR, 1.39; 95% CI, 1.15-1.67). These findings indicate the high prevalence of PTSD during pregnancy in the Peruvian population, which is relevant to other countries suffering from terrorism, war, or high rates of violence. This underscores the importance of screening for PTSD in pregnancy.
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Affiliation(s)
- Elizabeth J Levey
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA.
- Harvard Medical School, Boston, MA, 02115, USA.
- Institute for Juvenile Research, University of Illinois College of Medicine, Chicago, IL, 60608, USA.
| | - Bizu Gelaye
- Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Karestan Koenen
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02115, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Qiu-Yue Zhong
- Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Archana Basu
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02115, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | | | - Sixto Sanchez
- Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - David C Henderson
- Department of Psychiatry, Boston Medical Center, Boston, MA, 02118, USA
- Boston University School of Medicine, Boston, MA, 02118, USA
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Bonnan-White J, Hetzel-Riggin MD, Diamond-Welch BK, Tollini C. "You Blame Me, Therefore I Blame Me": The Importance of First Disclosure Partner Responses on Trauma-Related Cognitions and Distress. JOURNAL OF INTERPERSONAL VIOLENCE 2018; 33:1260-1286. [PMID: 26598290 DOI: 10.1177/0886260515615141] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Trauma recovery processes may be understood within a socioecological model. Individual factors (such as sex of the survivor) and microsystem factors (including trauma characteristics) have been studied extensively. However, there is a paucity of research examining the effects of macrosystem factors on the impact of trauma-especially examining how the response of the first person to whom the survivor disclosed affects trauma-related cognitions and distress. Sixty-three college student participants reported a history of disclosing at least one traumatic event in an online, anonymous survey. Participants also provided information on the first person they told about the trauma, the social reactions of that person, general social reactions to trauma disclosure, the participants' trauma-related cognitions and psychological distress (PTSD, other mental health issues), details about the traumatic event, and basic demographic information. Paired sample t tests showed that participants experienced the responses of the first person they told about their trauma as more favorable than the responses of the all of the people to whom they told about the event. Women and survivors of non-interpersonal trauma reported more supportive responses than men and survivors of interpersonal trauma. Hierarchical linear regressions showed that interpersonal trauma and victim blame on the part of the first person the survivor told were associated with more negative trauma-related cognitions. Interpersonal trauma, emotional support, and victim blame were associated with a greater degree of trauma-related distress. The results suggest that participants perceived the response of the first person they told as more beneficial than the response of the rest of their exosystem. However, the reactions of the first person the survivor told differed based on the sex of the survivor and the type of trauma they experienced. Consistent with previous research, interpersonal trauma and victim blame by the first person the survivor told about the trauma were associated with more trauma-related distress and negative cognitions. Trauma-related distress was also associated with greater emotional support by the disclosure partner. The results support the use of the socioeological model to better understand the complex nature of trauma recovery and have implications for prevention.
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Exposure to interpersonal violence and risk of post-traumatic stress disorder among women with borderline personality disorder. Psychiatry Res 2018; 262:311-315. [PMID: 29494867 DOI: 10.1016/j.psychres.2018.01.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 01/23/2018] [Accepted: 01/26/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study aims to determine the validity of the Karolinska Interpersonal Violence Scale (KIVS), as a screening tool for PTSD, among women with borderline personality disorder (BPD) and severe suicidal behavior. METHOD 106 women with BPD and at least two suicide attempts were assessed with the KIVS for exposure to interpersonal violence as a child and as an adult. The screening ability of the KIVS for the diagnosis of PTSD was analyzed using receiver operating characteristic curve analysis. RESULTS PTSD diagnosis was valid for 61 (58%) women with BPD. The KIVS - exposure of lifetime interpersonal violence, displayed fair accuracy of predicting diagnosis of PTSD (area under the curve 0.79, confidence interval [0.71, 0.88]) and performed well (sensitivity 0.90 and specificity 0.62), with a cut-off score of 4 (range 0-10). Poly-traumatization was not significantly related to PTSD diagnosis as compared to single traumatization, whereas sexual victimization was significantly more prevalent in women with PTSD diagnosis, as compared to other types of traumatic events. CONCLUSION A score of 4 or more on the KIVS - exposure to interpersonal lifetime violence presents well as a screening instrument for risk of PTSD, among women with BPD.
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Persu A, Petit G, Georges C, de Timary P. Hypertension, a Posttraumatic Stress Disorder? Time to Widen Our Perspective. Hypertension 2018; 71:811-812. [PMID: 29555667 DOI: 10.1161/hypertensionaha.118.10608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Alexandre Persu
- From the Department of Cardiology, Cliniques Universitaires Saint-Luc (A.P., C.G.), Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc (G.P., P.d.T.), and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (A.P.), Université Catholique de Louvain, Brussels, Belgium.
| | - Géraldine Petit
- From the Department of Cardiology, Cliniques Universitaires Saint-Luc (A.P., C.G.), Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc (G.P., P.d.T.), and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (A.P.), Université Catholique de Louvain, Brussels, Belgium
| | - Coralie Georges
- From the Department of Cardiology, Cliniques Universitaires Saint-Luc (A.P., C.G.), Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc (G.P., P.d.T.), and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (A.P.), Université Catholique de Louvain, Brussels, Belgium
| | - Philippe de Timary
- From the Department of Cardiology, Cliniques Universitaires Saint-Luc (A.P., C.G.), Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc (G.P., P.d.T.), and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (A.P.), Université Catholique de Louvain, Brussels, Belgium
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Beck CT, Anderson BA. “Being With Woman”: Is There a Cost for Midwives and Students Attending Traumatic Births? INTERNATIONAL JOURNAL OF CHILDBIRTH 2018. [DOI: 10.1891/2156-5287.7.4.181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Witnessing and/or providing care during a traumatic birth increases vulnerability to secondary traumatic stress, with potential effects on mental health of and attrition among the midwifery workforce. With the global shortage of the midwifery workforce, retention and peak functioning are critical to the well-being of childbearing women and their infants. PubMed, Scopus, CINAHL, and PsycINFO databases were searched to identify studies that examined secondary traumatic stress in both midwives and midwifery students. Fifteen studies were located from eight different countries. Four of these studies examined secondary traumatic stress in midwifery students and 11 in practicing midwives. This article discusses the limited research on secondary traumatic stress among midwives and students who have attended or witnessed traumatic births. The vulnerability and potential workforce attrition of midwives and students experiencing secondary traumatic stress are highlighted. The development of a comprehensive body of literature is needed on prevalence, impact, clinical implications, and healing strategies addressing this workforce issue.
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A social model of posttraumatic stress disorder: Interpersonal trauma, attachment, group identification, disclosure, social acknowledgement, and negative cognitions. JOURNAL OF THEORETICAL SOCIAL PSYCHOLOGY 2018. [DOI: 10.1002/jts5.17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Asselmann E, Wittchen HU, Lieb R, Perkonigg A, Beesdo-Baum K. Incident mental disorders in the aftermath of traumatic events: A prospective-longitudinal community study. J Affect Disord 2018; 227:82-89. [PMID: 29053980 DOI: 10.1016/j.jad.2017.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/11/2017] [Accepted: 10/01/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Few strictly prospective-longitudinal community studies examined the role of traumatic events for risk of developing a broad range of incident mental disorders over several years. METHOD A representative community sample of adolescents and young adults (n = 2797, baseline age 14-24) was prospectively examined in up to three assessment waves over up to 10 years. Traumatic events and DSM-IV mental disorders were assessed at each wave using the DIA-X/M-CIDI. Associations between traumatic events (meeting the DSM-IV A1-criterion for posttraumatic stress disorder, PTSD) or qualifying traumatic events (meeting the DSM-IV A2-criterion) at baseline and incident disorders at follow-up were tested with logistic regressions adjusted for gender and age. RESULTS While traumatic and qualifying traumatic events at baseline were related to various baseline disorders, considerably fewer associations were found in strictly prospective analyses with incident disorders at follow-up as outcomes. After adjustment for baseline disorders, only (a) the association of traumatic events with incident specific phobias (Odds Ratio, OR = 1.6) and (b) the associations of qualifying traumatic events with incident specific phobias (OR = 1.6), PTSD (OR = 2.5) and major depressive episodes (OR = 1.4) remained significant. CONCLUSION Targeted prevention and early intervention among traumatized individuals may be particularly beneficial to lower the incidence of specific phobias and MDE besides PTSD. LIMITATIONS Associations between traumatic events and incident mental disorders might be underestimated, as cases developing psychopathology immediately after trauma exposure prior to baseline were excluded in our strictly prospective analyses.
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Affiliation(s)
- Eva Asselmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany.
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Germany
| | - Roselind Lieb
- Max Planck Institute of Psychiatry, Munich, Germany; Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Axel Perkonigg
- Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany
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Kuhn E, van der Meer C, Owen JE, Hoffman JE, Cash R, Carrese P, Olff M, Bakker A, Schellong J, Lorenz P, Schopp M, Rau H, Weidner K, Arnberg FK, Cernvall M, Iversen T. PTSD Coach around the world. Mhealth 2018; 4:15. [PMID: 29963560 PMCID: PMC5994444 DOI: 10.21037/mhealth.2018.05.01] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/03/2018] [Indexed: 11/06/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) is a global public health problem. Unfortunately, many individuals with PTSD do not receive professional care due to a lack of available providers, stigma about mental illness, and other concerns. Technology-based interventions, including mobile phone applications (apps) may be a viable means of surmounting such barriers and reaching and helping those in need. Given this potential, in 2011 the U.S Veterans Affairs National Center for PTSD released PTSD Coach, a mobile app intended to provide psycho-education and self-management tools for trauma survivors with PTSD symptoms. Emerging research on PTSD Coach demonstrates high user satisfaction, feasibility, and improvement in PTSD symptoms and other psychosocial outcomes. A model of openly sharing the app's source code and content has resulted in versions being created by individuals in six other countries: Australia, Canada, The Netherlands, Germany, Sweden, and Denmark. These versions are described, highlighting their significant adaptations, enhancements, and expansions to the original PTSD Coach app as well as emerging research on them. It is clear that the sharing of app source code and content has benefited this emerging PTSD Coach community, as well as the populations they are targeting. Despite this success, challenges remain especially reaching trauma survivors in areas where few or no other mental health resources exist.
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Affiliation(s)
- Eric Kuhn
- VA National Center for PTSD, VA Palo Alto Healthcare System, Menlo Park, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Christianne van der Meer
- Academic Medical Centre, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands
| | - Jason E. Owen
- VA National Center for PTSD, VA Palo Alto Healthcare System, Menlo Park, CA, USA
| | - Julia E. Hoffman
- VA National Center for PTSD, VA Palo Alto Healthcare System, Menlo Park, CA, USA
| | - Richard Cash
- Phoenix Australia, Department of Psychiatry, the University of Melbourne, Melbourne, Australia
| | | | - Miranda Olff
- Academic Medical Centre, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands
- Arq Psychotrauma Expert Group, Diemen, The Netherlands
| | - Anne Bakker
- Academic Medical Centre, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Patrick Lorenz
- Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Matthias Schopp
- Department of Computer Science, Universität der Bundeswehr München, Munich, Germany
| | - Heinrich Rau
- German Armed Forces Center for Military Mental Health (Psychotraumazentrum), Berlin, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Filip K. Arnberg
- National Centre for Disaster Psychiatry, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Martin Cernvall
- National Centre for Disaster Psychiatry, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Thomas Iversen
- Department of Psychology, Aarhus University, Aarhus, Denmark
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Abstract
This study evaluates contributors to the mental health status of Palestinians, Syrians, and nonrefugee residents of Lebanon's Shatila Refugee Camp. Primary health care clinic patients in Shatila were screened for mental illness between 2012 and 2013 using the K6, the Primary Care Posttraumatic Stress Disorder (PTSD), and the Modified Mini International Neuropsychiatric Interview. Logistic regressions enabled the consideration of potential contributors to participants' positive mental illness screens. The sample (n = 254) included 63.4% Palestinians, 18.5% Syrians, and 18.1% nonrefugees. People lived in the camp for 21.1 years (±17), 63% had stable housing and 78% had war event exposure. Mental illness prevalence was 51.6% in total (34.8% serious mental illness [SMI] alone, 5.1% PTSD alone, 11.4% comorbid SMI/PTSD, and 0.08% comorbid psychotic spectrum disorder SMI/PTSD). For Palestinians and nonrefugees, respectively, stable housing accounted for a 79% and a 98% reduction in positive SMI screen risk. For Syrians, access to paid employment accounted for a 66% risk reduction. Stable living situations and economically productive employment for those trapped in a refugee situation, even in the face of war trauma, seem most important for ensuring reduced mental disorder risk.
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130
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Naumann DN, McLaughlin A, Thompson CV, Hardy E, Fellows JL, Crombie NC. Acute stress and frontline healthcare providers. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/jpar.2017.9.12.516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- David N Naumann
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - Aisling McLaughlin
- Medical Directorate, Assurance, Quality and Strategy, NHS England, Birmingham, UK
| | - Christopher V Thompson
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - Elaine Hardy
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - Jodie L Fellows
- Birmingham & Solihull Mental Health Foundation NHS Trust, Birmingham, UK
| | - Nicholas C Crombie
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
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131
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Tragno M, Ferreira Y, Tarquinio P, Duveau A, Tarquinio C. Impacts de la violence au travail selon l’identité de genre des victimes : étude exploratoire. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2017. [DOI: 10.1016/j.ejtd.2017.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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132
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The Importance of Assessing for Childhood Abuse and Lifetime PTSD in Bariatric Surgery Candidates. J Clin Psychol Med Settings 2017; 24:341-354. [DOI: 10.1007/s10880-017-9518-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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133
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Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE): A Pilot Study in Alcohol-dependent Women. J Addict Med 2017; 11:119-125. [PMID: 28079572 DOI: 10.1097/adm.0000000000000286] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Posttraumatic stress disorder (PTSD) and substance use disorders are highly comorbid. Effective treatments are largely lacking. This pilot study evaluated the safety and feasibility of a novel intervention, Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), in preparation for a randomized controlled trial. METHODS Twenty-two treatment-seeking women with current DSM-IV-TR PTSD and alcohol dependence (AD) were recruited. Participants received COPE. Safety and feasibility were evaluated, as were efficacy-related outcomes: PTSD and depression symptom severity, alcohol use, craving, and dependence severity. RESULTS No adverse events occurred. COPE was implemented in routine clinical practice. Among the assessed women, 95.8% were eligible to participate. Treatment attendance and completion were higher than in previous studies. Post treatment, all efficacy-related outcomes, including PTSD and depression symptom severity, alcohol use, craving, and dependence severity, were significantly reduced. CONCLUSIONS COPE was safe and feasible to use. Concerns that trauma-focused, exposure-based therapy might promote relapse in this population appear unwarranted. Our findings provide initial evidence suggestive of COPE efficacy for comorbid PTSD and AD in women. These results provide a strong rationale for investigating the efficacy of COPE for comorbid PTSD and AD in women in a randomized controlled trial.
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134
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Wallin Lundell I, Sundström Poromaa I, Ekselius L, Georgsson S, Frans Ö, Helström L, Högberg U, Skoog Svanberg A. Neuroticism-related personality traits are associated with posttraumatic stress after abortion: findings from a Swedish multi-center cohort study. BMC WOMENS HEALTH 2017; 17:96. [PMID: 28969621 PMCID: PMC5625823 DOI: 10.1186/s12905-017-0417-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 08/08/2017] [Indexed: 11/23/2022]
Abstract
Background Most women who choose to terminate a pregnancy cope well following an abortion, although some women experience severe psychological distress. The general interpretation in the field is that the most consistent predictor of mental disorders after induced abortion is the mental health issues that women present with prior to the abortion. We have previously demonstrated that few women develop posttraumatic stress disorder (PTSD) or posttraumatic stress symptoms (PTSS) after induced abortion. Neuroticism is one predictor of importance for PTSD, and may thus be relevant as a risk factor for the development of PTSD or PTSS after abortion. We therefore compared Neuroticism-related personality trait scores of women who developed PTSD or PTSS after abortion to those of women with no evidence of PTSD or PTSS before or after the abortion. Methods A Swedish multi-center cohort study including six Obstetrics and Gynecology Departments, where 1294 abortion-seeking women were included. The Screen Questionnaire-Posttraumatic Stress Disorder (SQ-PTSD) was used to evaluate PTSD and PTSS. Measurements were made at the first visit and at three and six month after the abortion. The Swedish universities Scales of Personality (SSP) was used for assessment of Neuroticism-related personality traits. Multiple logistic regression analyses were performed to investigate the risk factors for development of PTSD or PTSS post abortion. Results Women who developed PTSD or PTSS after the abortion had higher scores than the comparison group on several of the personality traits associated with Neuroticism, specifically Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility and Embitterment. Women who reported high, or very high, scores on Neuroticism had adjusted odds ratios for PTSD/PTSS development of 2.6 (CI 95% 1.2–5.6) and 2.9 (CI 95% 1.3–6.6), respectively. Conclusion High scores on Neuroticism-related personality traits influence the risk of PTSD or PTSS post abortion. This finding supports the argument that the most consistent predictor of mental disorders after abortion is pre-existing mental health status.
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Affiliation(s)
- Inger Wallin Lundell
- Department of Women's and Children's Health, Uppsala University, -751 85, Uppsala, SE, Sweden. .,Sophiahemmet University, Box 5605, - 114 86, Stockholm, SE, Sweden.
| | - Inger Sundström Poromaa
- Department of Women's and Children's Health, Uppsala University, -751 85, Uppsala, SE, Sweden
| | - Lisa Ekselius
- Department of Neuroscience/Psychiatry, Uppsala University, -75185, Uppsala, SE, Sweden
| | - Susanne Georgsson
- Sophiahemmet University, Box 5605, - 114 86, Stockholm, SE, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institute, -171 77, Stockholm, SE, Sweden
| | - Örjan Frans
- Department of Psychology, Uppsala University, Box 1225, -751 42, Uppsala, SE, Sweden
| | - Lotti Helström
- Department of Clinical Science and Education, Karolinska Institute, -118 83, Stockholm, SE, Sweden
| | - Ulf Högberg
- Department of Women's and Children's Health, Uppsala University, -751 85, Uppsala, SE, Sweden
| | - Agneta Skoog Svanberg
- Department of Women's and Children's Health, Uppsala University, -751 85, Uppsala, SE, Sweden
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135
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Itzhaky L, Gelkopf M, Levin Y, Stein JY, Solomon Z. Psychiatric reactions to continuous traumatic stress: A Latent Profile Analysis of two Israeli samples. J Anxiety Disord 2017; 51:94-100. [PMID: 28709689 DOI: 10.1016/j.janxdis.2017.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 06/21/2017] [Accepted: 06/27/2017] [Indexed: 11/26/2022]
Abstract
Many individuals worldwide are exposed to continuous traumatic stress (CTS). However, the psychiatric sequela of CTS and the relevance of posttraumatic stress disorder (PTSD) diagnostic criteria in this situation have yet to be determined. Filling this gap, the present study assessed psychiatric reactions to CTS and the relationship between such reactions and functional impairment among two representative samples of adults exposed to ongoing shelling over 6 (n=387) and 9 years (n=468). Assessment included PTSD symptomatology (i.e., intrusion, avoidance, hyperarousal), anxiety, somatization, and depression. Profile categorization aimed to underscore variations in symptom clustering and severity, and determine whether or not a profile is dominated by PTSD symptoms. Latent Profile analyses (LPA) of sample I revealed four distinct symptoms profiles: (1) 'symptomatically resilient'; (2) 'symptomatically low-moderate'; (3) 'symptomatically moderate-high'; and (4) 'symptomatically overall high'. LPA of sample II revealed three distinct symptoms profiles: (1) 'symptomatically resilient'; (2) 'symptomatically low-moderate'; (3) "symptomatically moderate-high". Moreover, profile variation was implicated in dysfunction. Consistent with studies focusing on single trauma exposure, the findings revealed that the most prevalent profile was the symptomatically resilient, indicating that most people exposed to CTS seem to evince a scarce number of psychiatric symptoms. Moreover, reactions to CTS proved broader than the existing PTSD symptomatology. Examining symptom dominance and severity in relation to impairment and dysfunction, and clinical considerations are discussed.
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Affiliation(s)
- Liat Itzhaky
- I-Core Research Center for Mass Trauma, The Bob Shappell School of Social Work, Tel-Aviv University, Israel.
| | - Mark Gelkopf
- Department of community health, University of Haifa, Israel; NATAL, Israel Trauma Center for Victims of Terror and War, Israel
| | - Yafit Levin
- I-Core Research Center for Mass Trauma, The Bob Shappell School of Social Work, Tel-Aviv University, Israel
| | - Jacob Y Stein
- I-Core Research Center for Mass Trauma, The Bob Shappell School of Social Work, Tel-Aviv University, Israel
| | - Zahava Solomon
- I-Core Research Center for Mass Trauma, The Bob Shappell School of Social Work, Tel-Aviv University, Israel
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136
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Levey EJ. Supporting institutional caregivers in a children's home in rural south India. INSTITUTIONALISED CHILDREN EXPLORATION AND BEYOND 2017; 4:221-225. [PMID: 32864397 DOI: 10.1177/2349301120170217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Orphans and other institutionalized children frequently have histories of maltreatment prior to entering institutional care. Better understanding the impact of these maltreatment experiences is essential to meeting the needs of these children. Institutional caregivers are challenged to address the unique and complex needs of these children. A team of child psychiatrists and mental health specialists visited a children's home in south India to provide consultation to the caregivers. The cases of two adolescent girls illustrate two distinct presentations following histories of significant maltreatment and early loss. One of the girls was significantly dysregulated. The other was struggling academically after leaving the home but was better able to regulate her affective states. The team recommended supporting the children's existing defensive structures and allowing them to speak about any past traumas on their own terms without being pushed to do so. The team also considered the self-regulating function of the cultural practices in which the children engaged and encouraged them to continue these activities.
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Affiliation(s)
- E J Levey
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital; Boston, MA; USA; Harvard Medical School; Boston, MA; USA
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137
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Abstract
BACKGROUND In contrast to the high demographic relevance of the older population, relatively little is known about prevalence rates, the typologies/symptom profiles and effective therapeutic approaches for posttraumatic stress disorder (PTSD) in older adults. AIM The aim of the present article is to provide an overview of prevalence rates, typologies of PTSD and effective treatment approaches for PTSD in the elderly. RESULTS Compared to younger cohorts, the group of older people has a markedly lower PTSD prevalence in the vast majority of epidemiological studies. There is a comparable structure over all age classes (i. e. classes with low, moderate and high symptoms) with respect to the symptom profile of PTSD. There are currently only a few controlled treatment studies for the cohort of older adults. The published controlled or randomized controlled interventional studies suggest that trauma-focused and narrative approaches seem to be effective in the treatment of PTSD in the elderly. CONCLUSION Future research should take account of the results so far in order to verify the existing preliminary results and to deal with current limitations. Randomized controlled trials are required, which should include a heterogeneous sample of elderly people and examine different therapeutic approaches in their effectiveness and feasibility in this cohort.
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138
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Günther A, Sackey P, Bjärtå A, Schandl A. The relation between skin conductance responses and recovery from symptoms of PTSD. Acta Anaesthesiol Scand 2017; 61:688-695. [PMID: 28421596 DOI: 10.1111/aas.12890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 03/03/2017] [Accepted: 03/12/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND The purpose was to investigate if potentially stressful reminders of the intensive care unit (ICU) stay influenced variability in transient skin conductance responses, and whether such changes were associated with post-traumatic stress symptoms (PTSS), and development of symptoms over time. METHODS Thirty patients with an ICU length of stay > 48 h were included in the study. Within the week after ICU discharge (T1), patients were exposed to authentic ICU sound and questions regarding traumatic ICU memories while skin conductance reactivity was monitored. PTSS was assessed using PTSS-10 at T1 and again 3 months later (T2). Changes in number of skin conductance fluctuations per second (NSCF) between baseline and during the cueing conditions and in relation to PTSS scores (T1) were investigated. PTSS scores at T2 and changes between T1 and T2 (PTSS-CS) were used to investigate if reactivity in NSCF could predict symptoms of PTSD. RESULTS The results showed increases in NSCF during both situational and verbal cueing, compared to baseline. However, no relation to PTSS scores was indicated. Negative correlations between NSCF during situational cueing and both PTSS-T2 and PTSS-CS were found among women, but not among men. CONCLUSION A low variability, or reactivity in skin conductance responses to situational cues could imply a risk of developing, or not being able to recover from, symptoms of PTSD in women. As such, the measurement could be used to predict this risk in women. However, further studies are necessary to evaluate this area of application.
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Affiliation(s)
- A. Günther
- Perioperative Medicine and Intensive care; Karolinska University Hospital Solna; Stockholm Sweden
- Department of Cardiothoracic Surgery and Anaesthesiology; Karolinska University Hospital Solna; Stockholm Sweden
| | - P. Sackey
- Perioperative Medicine and Intensive care; Karolinska University Hospital Solna; Stockholm Sweden
- Institution of Physiology and Pharmacology; Karolinska Institutet; Stockholm Sweden
| | - A. Bjärtå
- Department of Psychology; Division of Social Sciences; Mid Sweden University; Östersund Sweden
| | - A. Schandl
- Perioperative Medicine and Intensive care; Karolinska University Hospital Solna; Stockholm Sweden
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139
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Thompson CV, Naumann DN, Fellows JL, Bowley DM, Suggett N. Post-traumatic stress disorder amongst surgical trainees: An unrecognised risk? Surgeon 2017; 15:123-130. [DOI: 10.1016/j.surge.2015.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 09/21/2015] [Accepted: 09/22/2015] [Indexed: 10/22/2022]
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140
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Abstract
Adverse childhood experiences can deleteriously affect future physical and mental health, increasing risk for many illnesses, including psychiatric problems, sleep disorders, and, according to the present hypothesis, idiopathic nightmares. Much like post-traumatic nightmares, which are triggered by trauma and lead to recurrent emotional dreaming about the trauma, idiopathic nightmares are hypothesized to originate in early adverse experiences that lead in later life to the expression of early memories and emotions in dream content. Accordingly, the objectives of this paper are to (1) review existing literature on sleep, dreaming and nightmares in relation to early adverse experiences, drawing upon both empirical studies of dreaming and nightmares and books and chapters by recognized nightmare experts and (2) propose a new approach to explaining nightmares that is based upon the Stress Acceleration Hypothesis of mental illness. The latter stipulates that susceptibility to mental illness is increased by adversity occurring during a developmentally sensitive window for emotional maturation—the infantile amnesia period—that ends around age 3½. Early adversity accelerates the neural and behavioral maturation of emotional systems governing the expression, learning, and extinction of fear memories and may afford short-term adaptive value. But it also engenders long-term dysfunctional consequences including an increased risk for nightmares. Two mechanisms are proposed: (1) disruption of infantile amnesia allows normally forgotten early childhood memories to influence later emotions, cognitions and behavior, including the common expression of threats in nightmares; (2) alterations of normal emotion regulation processes of both waking and sleep lead to increased fear sensitivity and less effective fear extinction. These changes influence an affect network previously hypothesized to regulate fear extinction during REM sleep, disruption of which leads to nightmares. This network consists of a fear circuit that includes amygdala, hippocampus, and medial prefrontal cortex and whose substantial overlap with the stress acceleration findings allows the latter to be incorporated into a wider, more developmentally coherent framework.
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Affiliation(s)
- Tore Nielsen
- Dream and Nightmare Laboratory, Center for Advanced Research in Sleep Medicine, CIUSSS-NÎM - Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada.,Department of Psychiatry, Université de Montreal, Montreal, QC, Canada
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141
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Lamoureux-Lamarche C, Vasiliadis HM. Lifetime traumatic events, health-related quality of life, and satisfaction with life in older adults. Qual Life Res 2017; 26:2683-2692. [PMID: 28534094 DOI: 10.1007/s11136-017-1593-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2017] [Indexed: 01/07/2023]
Abstract
PURPOSES The aims were to assess the association between lifetime traumatic events and post-traumatic stress syndrome (PTSS) and health-related quality of life (HRQOL) and satisfaction with life stratified by gender among a community-dwelling sample of older adults. METHODS Data used came from the ESA-Services study (2011-2013) and included a large convenience sample of 1811 older adults. Traumatic events were measured using a list of 14 events. PTSS was measured using the Impact of Event Scale-Revised. HRQOL and life satisfaction were measured with the EQ-5D-3L and the Satisfaction With Life Scale. Multivariate regression analyses were used to assess the association between traumatic events, PTSS, and quality of life. RESULTS Respondents had a mean age of 73.90 years (SD: 6.13, range 65-97). Our results showed that exposure to violence (OR 4.88, CI 2.72-8.77), an accident (OR 2.33, CI 1.29-4.22), and sexual abuse (OR 2.26 CI 1.17-4.37) was associated with PTSS only in women. No traumatic event was associated only in men. The interaction between gender and exposure to violence and life-threatening disease of a close one was significant. Experiencing violence (β = -0.04, p < 0.01), a natural disaster (β = -0.04, p = 0.02), a life-threatening disease (β = -0.04, p < 0.01), and sexual abuse (β = -0.04, p < 0.01) were associated with a lower HRQOL only in women. No traumatic event was associated in men. Interactions between event and gender were significant for natural disaster, life-threatening disease of a close one, sexual abuse, and other type of traumatic events. A life-threatening disease (β = -0.90, p < 0.01) was associated with a reduced life satisfaction only in men and the exposure of violence (β = -1.18, p < 0.01) was associated with lower life satisfaction in women. CONCLUSION Our study could help healthcare professionals to identify and monitor traumatic events that are at higher risk to be associated with PTSS and a lower quality of life for older men and women.
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Affiliation(s)
- Catherine Lamoureux-Lamarche
- Faculty of Medicine and Health Sciences, University of Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada. .,Research Centre, Charles-Le Moyne Hospital, 150 Place Charles-Le Moyne, Bureau 200, Longueuil, QC, J4K 0A8, Canada.
| | - Helen-Maria Vasiliadis
- Faculty of Medicine and Health Sciences, University of Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada.,Research Centre, Charles-Le Moyne Hospital, 150 Place Charles-Le Moyne, Bureau 200, Longueuil, QC, J4K 0A8, Canada
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142
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Dückers MLA, Olff M. Does the Vulnerability Paradox in PTSD Apply to Women and Men? An Exploratory Study. J Trauma Stress 2017; 30:200-204. [PMID: 28329423 DOI: 10.1002/jts.22173] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Recent research suggests that greater country vulnerability is associated with a decreased, rather than increased, risk of mental health problems. Because societal parameters may have gender-specific implications, our objective was to explore whether the "vulnerability paradox" equally applies to women and men. Lifetime posttraumatic stress disorder (PTSD) prevalence data for women and men were retrieved from 11 population studies (N = 57,031): conducted in Australia, Brazil, Canada, France, Lebanon, Mexico, Netherlands, Portugal, Sweden, Switzerland, and the United States. We tested statistical models with vulnerability, gender, and their interaction as predictors. The average lifetime PTSD prevalence in women was at least twice as high as it was in men and the vulnerability paradox existed in the prevalence data for women and men (R2 = .70). We could not confirm the possibility that gender effects are modified by socioeconomic and cultural country characteristics. Issues of methodology, language, and cultural validity complicate international comparisons. Nevertheless, this international sample points at a parallel paradox: The vulnerability paradox was confirmed for both women and men. The absence of a significant interaction between gender and country vulnerability implies that possible explanations for the paradox at the country-level do not necessarily require gender-driven distinction.
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Affiliation(s)
- Michel L A Dückers
- NIVEL-Netherlands Institute for Health Services Research, Utrecht, The Netherlands.,Impact-National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Diemen, The Netherlands.,Arq Psychotrauma Expert Group, Diemen, The Netherlands
| | - Miranda Olff
- Arq Psychotrauma Expert Group, Diemen, The Netherlands.,Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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143
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Feldman DB. Stepwise Psychosocial Palliative Care: A New Approach to the Treatment of Posttraumatic Stress Disorder at the End of Life. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2017; 13:113-133. [PMID: 28753122 DOI: 10.1080/15524256.2017.1346543] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Although evidence-based therapies for Posttraumatic Stress Disorder (PTSD) exist for physically healthy populations, these often do not adequately address PTSD in dying patients. Particularly because these interventions require 8-16 weekly sessions, and the median stay in U.S. hospices is 17.5 days (National Hospice and Palliative Care Organization [NHPCO], 2015 ), there is a potentially serious timing mismatch. Moreover, these treatments may temporarily increase trauma symptoms (Nishith, Resick, & Griffin, 2002 ), resulting in some patients dying in greater distress than had they not received care. The Stepwise Psychosocial Palliative Care (SPPC) model presented in this article compensates for these difficulties by embracing a palliative care approach to PTSD. Although it utilizes techniques drawn from existing PTSD interventions, these are re-ordered and utilized in a time-responsive, patient-centered manner that takes into account prognosis, fatigue, and logistical concerns. The SPPC approach is further considered with respect to existing social work palliative care competencies (Gwyther et al., 2005 ) and a case study is used to demonstrate its application.
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Affiliation(s)
- David B Feldman
- a Department of Counseling Psychology , Santa Clara University , Santa Clara , California , USA
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144
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Swan S, Keen N, Reynolds N, Onwumere J. Psychological Interventions for Post-traumatic Stress Symptoms in Psychosis: A Systematic Review of Outcomes. Front Psychol 2017; 8:341. [PMID: 28352239 PMCID: PMC5348513 DOI: 10.3389/fpsyg.2017.00341] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 02/22/2017] [Indexed: 11/19/2022] Open
Abstract
Individuals with severe mental health problems, such as psychosis, are consistently shown to have experienced high levels of past traumatic events. They are also at an increased risk of further traumatisation through victimization events such as crime and assault. The experience of psychosis itself and psychiatric hospitalization have also been recognized to be sufficiently traumatic to lead to the development of post-traumatic stress (PTS) symptoms. Rates of post-traumatic stress disorder (PTSD) are elevated in people with psychosis compared to the general population. The current guidance for the treatment of PTSD is informed by an evidence base predominately limited to populations without co-morbid psychiatric disorders. The systematic review therefore sought to present the current available literature on the use of psychological treatments targeting PTS symptoms in a population with a primary diagnosis of a psychotic disorder. The review aimed to investigate the effect of these interventions on PTS symptoms and also the effect on secondary domains such as psychotic symptoms, affect and functioning. Fifteen studies were identified reporting on cognitive behavior therapy, prolonged exposure, eye movement desensitisation and reprocessing and written emotional disclosure. The review provides preliminary support for the safe use of trauma-focused psychological interventions in groups of people with severe mental health problems. Overall, the interventions were found to be effective in reducing PTS symptoms. Results were mixed with regard to secondary effects on additional domains. Further research including studies employing sufficiently powered methodologically rigorous designs is indicated.
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Affiliation(s)
- Sarah Swan
- South London and Maudsley NHS Foundation Trust London, UK
| | - Nadine Keen
- South London and Maudsley NHS Foundation TrustLondon, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Nicola Reynolds
- South London and Maudsley NHS Foundation TrustLondon, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
| | - Juliana Onwumere
- South London and Maudsley NHS Foundation TrustLondon, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondon, UK
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145
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Levey EJ, Gelaye B, Bain P, Rondon MB, Borba CPC, Henderson DC, Williams MA. A systematic review of randomized controlled trials of interventions designed to decrease child abuse in high-risk families. CHILD ABUSE & NEGLECT 2017; 65:48-57. [PMID: 28110205 PMCID: PMC5346446 DOI: 10.1016/j.chiabu.2017.01.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 12/18/2016] [Accepted: 01/05/2017] [Indexed: 05/24/2023]
Abstract
Child abuse is a global problem, and parents with histories of childhood abuse are at increased risk of abusing their offspring. The objective of this systematic review is to provide a clear overview of the existing literature of randomized controlled trials evaluating the effectiveness of interventions to prevent child abuse. PubMed, PsychINFO, Web of Science, Sociological Abstracts, and CINAHL were systematically searched and expanded by hand search. This review includes all randomized controlled trials (RCTs) of interventions designed to prevent abuse among mothers identified as high-risk. Of the eight studies identified, only three found statistically significant reductions in abuse by any measure, and only two found reductions in incidents reported to child protective services. While much has been written about child abuse in high-risk families, few RCTs have been performed. Only home visitation has a significant evidence base for reducing child abuse, and the findings vary considerably. Also, data from low- and middle-income countries are limited.
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Affiliation(s)
- Elizabeth J Levey
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, 5 Longfellow Pl., Suite 215, Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA; Institute for Juvenile Research, University of Illinois College of Medicine, 1747 W Roosevelt Rd., Chicago, IL 60608, USA.
| | - Bizu Gelaye
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA 02115, USA
| | - Paul Bain
- Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA
| | - Marta B Rondon
- Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Urb Ingeniería, San Martin de Porras, Lima, Peru
| | - Christina P C Borba
- Boston Medical Center, Department of Psychiatry, 840 Harrison Ave., Boston, MA 02118, USA; Boston University School of Medicine, 72 East Concord St., Boston, MA 02118, USA
| | - David C Henderson
- Boston Medical Center, Department of Psychiatry, 840 Harrison Ave., Boston, MA 02118, USA; Boston University School of Medicine, 72 East Concord St., Boston, MA 02118, USA
| | - Michelle A Williams
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA 02115, USA
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146
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The epidemiology of post-traumatic stress disorder in Norway: trauma characteristics and pre-existing psychiatric disorders. Soc Psychiatry Psychiatr Epidemiol 2017; 52:11-19. [PMID: 27757493 PMCID: PMC5226978 DOI: 10.1007/s00127-016-1295-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 10/10/2016] [Indexed: 11/22/2022]
Abstract
PURPOSE The prevalence of PTSD differs by gender. Pre-existing psychiatric disorders and different traumas experienced by men and women may explain this. The aims of this study were to assess (1) incidence and prevalence of exposure to traumatic events and PTSD, (2) the effect of pre-existing psychiatric disorders prior to trauma on the risk for PTSD, and (3) the effect the characteristics of trauma have on the risk for PTSD. All stratified by gender. METHOD CIDI was used to obtain diagnoses at the interview stage and retrospectively for the general population N = 1634. RESULTS The incidence for trauma was 466 and 641 per 100,000 PYs for women and men, respectively. The incidence of PTSD was 88 and 31 per 100,000 PYs. Twelve month and lifetime prevalence of PTSD was 1.7 and 4.3 %, respectively, for women, and 1.0 and 1.4 %, respectively, for men. Pre-existing psychiatric disorders were risk factors for PTSD, but only in women. Premeditated traumas were more harmful. CONCLUSION Gender differences were observed regarding traumatic exposure and in the nature of traumas experienced and incidences of PTSD. Men experienced more traumas and less PTSD. Pre-existing psychiatric disorders were found to be risk factors for subsequent PTSD in women. However, while trauma happens to most, it only rarely leads to PTSD, and the most harmful traumas were premeditated ones. Primary prevention of PTSD is thus feasible, although secondary preventive efforts should be gender-specific.
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147
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Kolaitis GA, Meentken MG, Utens EMWJ. Mental Health Problems in Parents of Children with Congenital Heart Disease. Front Pediatr 2017; 5:102. [PMID: 28534022 PMCID: PMC5421144 DOI: 10.3389/fped.2017.00102] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 04/20/2017] [Indexed: 11/30/2022] Open
Abstract
This review will provide a concise description of mental health problems in parents of children with a (non-syndromic) congenital heart disease (CHD) during different stressful periods. Predictors of these problems and also implications for clinical practice will be mentioned. Having a child with CHD can be very stressful for parents, who have to face overwhelming emotions and also extra physical, financial, and other practical challenges. Parental distress has been reported in 30-80% of parents and appears not to be related to severity of CHD. Parental mental health, parenting, the parent-child relationship, and parental quality of life can all be affected. Parents, and especially mothers, are at risk of psychological distress, anxiety, depression, somatization, hopelessness, and posttraumatic stress symptoms, which in turn may influence mother's responsiveness. In the long term, the majority of parents adapt successfully to living with a child with CHD, but approximately 40% report a need for psychosocial care. These families may be helped by early psychosocial interventions to alleviate stress and reduce children's emotional and behavioral problems. A holistic approach to early psychosocial interventions should aim at improving coping and enhance parenting. During routine medical checkups, medical professionals should ask about parental stress, family functioning, and psychosocial functioning of the child and, when needed, adequate psychosocial care should be provided.
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Affiliation(s)
- Gerasimos A Kolaitis
- Department of Child Psychiatry, Medical School, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Maya G Meentken
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, Netherlands
| | - Elisabeth M W J Utens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, Netherlands.,Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands.,Academic Center for Child Psychiatry the Bascule/Department Child and Adolescent Psychiatry, Academic Medical Center, Amsterdam, Netherlands
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148
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Dückers MLA, Alisic E, Brewin CR. A vulnerability paradox in the cross-national prevalence of post-traumatic stress disorder. Br J Psychiatry 2016; 209:300-305. [PMID: 27445357 DOI: 10.1192/bjp.bp.115.176628] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 04/07/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Determinants of cross-national differences in the prevalence of mental illness are poorly understood. AIMS To test whether national post-traumatic stress disorder (PTSD) rates can be explained by (a) rates of exposure to trauma and (b) countries' overall cultural and socioeconomic vulnerability to adversity. METHOD We collected general population studies on lifetime PTSD and trauma exposure, measured using the WHO Composite International Diagnostic Interview (DSM-IV). PTSD prevalence was identified for 24 countries (86 687 respondents) and exposure for 16 countries (53 038 respondents). PTSD was predicted using exposure and vulnerability data. RESULTS PTSD is related positively to exposure but negatively to country vulnerability. Together, exposure, vulnerability and their interaction explain approximately 75% of variance in the national prevalence of PTSD. CONCLUSIONS Contrary to expectations based on individual risk factors, we identified a paradox whereby greater country vulnerability is associated with a decreased, rather than increased, risk of PTSD for its citizens.
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Affiliation(s)
- Michel L A Dückers
- Michel L. A. Dückers, PhD, Impact - National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Arq Psychotrauma Expert Group, Diemen, and NIVEL- Netherlands Institute for Health Services Research, Utrecht, The Netherlands; Eva Alisic, PhD, Monash University Accident Research Centre, Monash University, Melbourne, Australia; Chris R. Brewin, PhD, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Eva Alisic
- Michel L. A. Dückers, PhD, Impact - National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Arq Psychotrauma Expert Group, Diemen, and NIVEL- Netherlands Institute for Health Services Research, Utrecht, The Netherlands; Eva Alisic, PhD, Monash University Accident Research Centre, Monash University, Melbourne, Australia; Chris R. Brewin, PhD, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Chris R Brewin
- Michel L. A. Dückers, PhD, Impact - National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Arq Psychotrauma Expert Group, Diemen, and NIVEL- Netherlands Institute for Health Services Research, Utrecht, The Netherlands; Eva Alisic, PhD, Monash University Accident Research Centre, Monash University, Melbourne, Australia; Chris R. Brewin, PhD, Department of Clinical, Educational and Health Psychology, University College London, London, UK
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149
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Palm A, Danielsson I, Skalkidou A, Olofsson N, Högberg U. Violence victimisation-a watershed for young women's mental and physical health. Eur J Public Health 2016; 26:861-867. [PMID: 26743590 PMCID: PMC5054268 DOI: 10.1093/eurpub/ckv234] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The association between victimisation and adverse health in children is well established but few studies have addressed the effect of victimisation, especially multiple victimisations, in older adolescents and young adults. The aim of this study was to assess self-reported health in young women (15-22 years) victimised to one or more types of violence, compared with non-victimised. METHODS: Young women visiting youth health centres in Sweden answered a questionnaire constructed from standardised instruments addressing violence victimisation (emotional, physical, sexual and family violence), socio-demographics, substance use and physical and mental health. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and attributable risk (AR) were assessed. RESULTS: Of 1051 women (73% of eligible women), 25% were lifetime victims of one type of violence and 31% of two or more types of violence. Sexual-minority young women were more victimised than heterosexual women. Violence victimisation increased the risk for adverse health outcomes, especially evident for those multiply victimised. Victims of two or more types of violence had AOR 11.8 (CI 6.9-20.1) for post-traumatic stress symptoms, 6.3 (CI 3.9-10.2) for anxiety symptoms and 10.8 (CI 5.2-22.5) for suicide ideation. The AR of victimisation accounted for 41% of post-traumatic stress symptoms, 30% of anxiety symptoms and 27% of suicide ideation. Stratified analyses showed that lower economic resources did not influence health negatively for non-victimised, whereas it multiplicatively reinforced ill-health when combined with violence victimisation. CONCLUSION: Violence victimisation, and particularly multiple victimisations, was strongly associated with mental ill-health in young women, especially evident in those with low economic resources.
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Affiliation(s)
- Anna Palm
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Gynaecology and Obstetrics, Sundsvall Hospital, Sundsvall, Sweden
| | - Ingela Danielsson
- Department of Clinical Sciences Obstetrics and Gynaecology, Umeå University, Umeå, Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Niclas Olofsson
- Division of Social Medicine and Public Health Science, Department of Medicine and Health, Linköping University, Linköping, Sweden
| | - Ulf Högberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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150
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Garey L, Cheema MK, Otal TK, Schmidt NB, Neighbors C, Zvolensky MJ. The sequential pathway between trauma-related symptom severity and cognitive-based smoking processes through perceived stress and negative affect reduction expectancies among trauma exposed smokers. Am J Addict 2016; 25:565-72. [PMID: 27658236 DOI: 10.1111/ajad.12442] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/03/2016] [Accepted: 09/06/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Smoking rates are markedly higher among trauma-exposed individuals relative to non-trauma-exposed individuals. Extant work suggests that both perceived stress and negative affect reduction smoking expectancies are independent mechanisms that link trauma-related symptoms and smoking. Yet, no work has examined perceived stress and negative affect reduction smoking expectancies as potential explanatory variables for the relation between trauma-related symptom severity and smoking in a sequential pathway model. Methods The present study utilized a sample of treatment-seeking, trauma-exposed smokers (n = 363; 49.0% female) to examine perceived stress and negative affect reduction expectancies for smoking as potential sequential explanatory variables linking trauma-related symptom severity and nicotine dependence, perceived barriers to smoking cessation, and severity of withdrawal-related problems and symptoms during past quit attempts. RESULTS As hypothesized, perceived stress and negative affect reduction expectancies had a significant sequential indirect effect on trauma-related symptom severity and criterion variables. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Findings further elucidate the complex pathways through which trauma-related symptoms contribute to smoking behavior and cognitions, and highlight the importance of addressing perceived stress and negative affect reduction expectancies in smoking cessation programs among trauma-exposed individuals. (Am J Addict 2016;25:565-572).
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Affiliation(s)
- Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas
| | - Mina K Cheema
- Department of Psychology, University of Houston, Houston, Texas
| | - Tanveer K Otal
- Department of Psychology, University of Houston, Houston, Texas
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida
| | | | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas. .,Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas.
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