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Liu S, Xu R, Liu L. Influencing Factors of Acute Stress Disorder Among Frontline Nurses in Wuhan, China. J Psychosoc Nurs Ment Health Serv 2021; 59:38-47. [PMID: 34110951 DOI: 10.3928/02793695-20210324-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The current study aimed to investigate the influencing factors of acute stress disorder (ASD) in frontline nurses delivering care in a hospital for COVID-19 in Wuhan, China. In this cross-sectional study, 298 frontline nurses were surveyed during the first month of direct care delivery for patients with COVID-19 via the Stanford Acute Stress Reaction Questionnaire, Simplified Coping Style Questionnaire, and Multidimensional Scale of Perceived Social Support. Through logistic regression analysis, we identified the influencing factors of ASD. Our results showed that 13.8% of participants had ASD; frontline nurses were affected by ASD symptoms in different degrees; higher perceived social support from friends and colleagues were the major protective factors of ASD; and a negative coping style was a risk factor for ASD. Psychological crisis management interventions aimed at frontline nurses may be essential to prevent ASD during public health crisis events. [Journal of Psychosocial Nursing and Mental Health Services, 59(9), 38-47.].
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Segal A, Wald I, Pine DS, Halpern P, Bar-Haim Y. Attention control therapy for acute stress disorder: A randomized controlled trial. Depress Anxiety 2020; 37:1017-1025. [PMID: 32442355 DOI: 10.1002/da.23040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A subset of people exposed to traumatic events develop acute stress disorder (ASD), and approximately half of people with ASD develop posttraumatic stress disorder (PTSD). This randomized controlled trial examined the efficacy of internet-delivered attention control therapy (ACT), previously shown to reduce PTSD symptoms, as an adjuvant to treatment as usual in the community for patients with ASD. METHODS About 119 participants with ASD were randomly assigned to ACT or treatment as usual in the community within the first month following their traumatic event. PTSD symptoms and attention patterns were measured. RESULTS A significant reduction in stress-related symptoms was noted across participants with no difference between the two groups. Approximately half of the participants developed PTSD 2 months after the trauma. High attention bias variability was associated with elevated PTSD symptoms. However, attention bias variability did not change due to the therapy sessions. CONCLUSIONS Internet-delivered ACT was no more effective in reducing risk for PTSD in participants with ASD than treatment as usual in the community. Although elevated attention bias variability was detected in the patients with ASD, ACT failed to engage this cognitive target. Finally, ACT-based prevention research should proceed with caution given the possibility that this intervention might be associated with symptom worsening as indexed by the Clinical Global Impression scale.
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Affiliation(s)
- Adva Segal
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Wald
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Daniel S Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, Intramural Research Program, National Institutes of Mental Health, Bethesda, Maryland
| | - Pinchas Halpern
- Department of Emergency Medicine, The Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Lin LY, Wang J, Ou-Yang XY, Miao Q, Chen R, Liang FX, Zhang YP, Tang Q, Wang T. The immediate impact of the 2019 novel coronavirus (COVID-19) outbreak on subjective sleep status. Sleep Med 2020; 77:348-354. [PMID: 32593614 PMCID: PMC7831667 DOI: 10.1016/j.sleep.2020.05.018] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022]
Abstract
Background An outbreak of the 2019 novel coronavirus (COVID-19) has been ongoing in China since January 2020. The threat of infection affects the work and life of most of the population and may also damage sleep. This study aims to examine the subjective sleep status and mental health of the population during the peak of the COVID-19 epidemic. Method The data were collected through an online questionnaire with a sample of 5461 individuals in China from February 5, 2020, to February 23, 2020. Participants were divided into four groups based on their degree of threat from COVID-19: Group 1 was most closely associated with COVID-19, including inpatients diagnosed with COVID-19, first-line hospital workers and first-line management staff; Group 2 included outpatients diagnosed with COVID-19 and patients who developed a fever and visited the hospital; Group 3 included people related to Group 1 or 2, such as their colleagues, relatives, friends and rescuers; and Group 4 was the farthest removed from contact with COVID-19, covering the general public affected by COVID-19 prevention strategies. The Insomnia Severity Index (ISI), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Acute Stress Disorder Scale (ASDS) were used. Results Threat degree of COVID-19 (groups) had significant correlations with insomnia, depression, anxiety, and stress (p < 0.05, p < 0.01). Age, gender, and area (Hubei province or other provinces) had significant correlations with insomnia (p < 0.01). A total of 1380 (24.46%) participants were suspected of having major depression based on the PHQ-9. Additionally, 1042 (18.47%) participants were suspected of having generalized anxiety disorder based on the GAD-7. A total of 892 (15.8%) of the participants had Acute Stress Disorder (ASD) according to the ASDS. The prevalence of clinical insomnia during the outbreak was 20.05% (1131) according to the ISI. The factors of satisfaction with the current sleep pattern and how perceptible the symptoms of the current sleep pattern are to other people (p < 0.05) and the middle (difficulty staying asleep) and terminal (waking up too early) (p < 0.01) factors of the ISI were significantly different across groups. A total of 1129 (20.01%) participants spent more than one hour awake in bed. Conclusion The results indicated that insomnia is more severe in people who are female, young, living in the epicenter and experiencing a high degree of threat from COVID-19. As prevention and treatment efforts continue with regard to COVID-19, the general public has developed poor sleep hygiene habits, which deserve attention.
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Affiliation(s)
- Li-Yu Lin
- Department of Psychology and Sleep, Nanjing Hospital of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Jie Wang
- Computer Information Systems, Indiana University Northwest, Gary, IN, USA
| | - Xiao-Yong Ou-Yang
- Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan Province, China
| | - Qing Miao
- Department of Pneumology, Xiyuan Hospital, China Academy Chinese Medical Sciences, Beijing, China
| | - Rui Chen
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Feng-Xia Liang
- College of Acupuncture-Moxibustion and Orthopedics, Hubei University of Chinese Medicine, Wuhan, Hubei Province, China
| | - Yang-Pu Zhang
- Department of Physical Medicine and Rehabilitation, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, Hubei Province, China
| | - Qing Tang
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Ting Wang
- Department of Psychology and Sleep, Nanjing Hospital of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China.
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Kobayashi D, Hayashi H, Kuga H, Kuriyama N, Terasawa Y, Osugi Y, Takahashi O, Deshpande G, Kawachi I. Alcohol consumption behaviours in the immediate aftermath of earthquakes: time series study. BMJ Open 2019; 9:e026268. [PMID: 30850415 PMCID: PMC6429926 DOI: 10.1136/bmjopen-2018-026268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Earthquakes are a distressing natural phenomenon that can disrupt normal health-related behaviours. The aim of this study was to investigate changes in alcohol consumption behaviours in the immediate aftermath of mild to moderate earthquakes. SETTING This retrospective cohort study was conducted at a large academic hospital in Tokyo, Japan from April 2004 to March 2017. PARTICIPANTS We included all adult patients presenting with acute alcohol intoxication in the emergency room. PRIMARY AND SECONDARY OUTCOME MEASURES Our outcome was the number of such patients per 24 hours period comparing days with and without earthquake activity. We mainly focused on mild to moderate earthquakes (Shindo scale of less than 3). We conducted a simple generalised autoregressive conditional heteroscedasticity (GARCH) analysis, followed by a multivariate GARCH, including year-fixed effects and secular changes in alcohol taxation. Subanalyses were conducted by gender and age group. RESULTS During the study period, 706 earthquakes were observed with a median Shindo scale of 2 (IQR: 1). During this period, 6395 patients were admitted with acute ethanol intoxication; the mean age was 42.6 (SD: 16.9) years and 4592 (71.8%) patients were male. In univariate analyses, the occurrence of daytime earthquakes was marginally inversely related to the number of acutely intoxicated patients (β coefficient: -0.19, 95% CI -0.40 to 0.01). This finding remained similar in multivariate analyses after adjustment for covariates. In analyses stratified by gender, the inverse association between daytime earthquakes and alcohol intoxication was only observed among men (p<0.03 for males and p=0.99 for females). In subanalyses by age, older people were less likely to be admitted to the hospital due to acute alcohol intoxication on days with daytime earthquakes (p=0.11), but this was not the case for younger people (p=0.36). CONCLUSION On days when a mild to moderate daytime earthquake occurred, the number of patients with acute alcohol intoxication was lower compared with days without earthquakes. Even milder forms of potentially catastrophic events appear to influence social behaviour; mild to moderate earthquake activity is associated with the avoidance of excessive alcohol consumption.
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Affiliation(s)
| | - Hana Hayashi
- McCann Health, McCann Public Health, Tokyo, Japan
| | - Hironori Kuga
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nagato Kuriyama
- Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Yasuhiro Osugi
- General Internal Medicine, Fujita Health University, Toyoake, Japan
| | | | | | - Ichiro Kawachi
- Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, USA
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Khazaie H, Mohammadi H, Naghdi H, Yazdani N, Zakiei A, Najafi F. Prediction of sleep quality and insomnia severity by psychological disorders and acute stress among earthquake survivors in Sarpol-e Zahab, Iran, 2017. ARCHIVES OF TRAUMA RESEARCH 2019. [DOI: 10.4103/atr.atr_32_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Geng F, Zhou Y, Liang Y, Fan F. A Longitudinal Study of Recurrent Experience of Earthquake and Mental Health Problems Among Chinese Adolescents. Front Psychol 2018; 9:1259. [PMID: 30079047 PMCID: PMC6062966 DOI: 10.3389/fpsyg.2018.01259] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/29/2018] [Indexed: 11/20/2022] Open
Abstract
Background: The effects of recurrent exposure to disasters on adolescents’ mental health have rarely been studied. We examined the effects of two earthquake experiences 5 years apart in a longitudinal cohort of Chinese adolescents. Methods: A total of 858 adolescents were assessed in September, 2011 (3.5 years after the Wenchuan earthquake, 1.5 years before Ya’an earthquake, T1) and April, 2013 (1 week after the Ya’an earthquake, T2). Participants’ Wenchuan earthquake experiences and symptoms of post-traumatic stress disorder (PTSD) and depression were assessed at T1, and their Ya’an earthquake experiences, Acute Stress Disorder (ASD), PTSD, and depression were assessed at T2. Results: Structural equation models showed a positive relationship between Ya’an earthquake experiences and symptoms of ASD, PTSD, and depression at T2. T1 PTSD symptoms significantly increased T2 ASD, PTSD, and depression symptoms, and also mediated the relationships between Wenchuan earthquake experiences and T2 ASD, PTSD, and depression symptoms. T1 Depression symptoms also significantly increased T2 ASD, PTSD, and depression symptoms, but only mediated the association between Wenchuan earthquake experiences and T2 depression symptoms. In addition, Wenchuan earthquake experiences moderated the effects of Ya’an earthquake experiences on ASD symptoms and PTSD symptoms but not depression. Conclusion: Repeated to exposure to disasters have adverse additive effects on adolescents’ mental health. Adolescents who experience one disaster may be sensitive to the negative impact of subsequent ones.
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Affiliation(s)
- Fulei Geng
- School of Psychology, South China Normal University, Guangzhou, China.,Center for Studies of Psychological Application, South China Normal University, Guangzhou, China.,Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Ya Zhou
- School of Psychology, South China Normal University, Guangzhou, China.,Center for Studies of Psychological Application, South China Normal University, Guangzhou, China.,Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Yingxin Liang
- School of Psychology, South China Normal University, Guangzhou, China.,Center for Studies of Psychological Application, South China Normal University, Guangzhou, China.,Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, South China Normal University, Guangzhou, China.,Center for Studies of Psychological Application, South China Normal University, Guangzhou, China.,Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, China
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Dai W, Liu A, Kaminga AC, Deng J, Lai Z, Yang J, Wen SW. Prevalence of acute stress disorder among road traffic accident survivors: a meta-analysis. BMC Psychiatry 2018; 18:188. [PMID: 29895273 PMCID: PMC5998549 DOI: 10.1186/s12888-018-1769-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/29/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Road traffic accident (RTA), an unexpected traumatic event, may not only lead to death and serious physical injuries, but also could put survivors at an increased risk for a wide range of psychiatric disorders, particularly acute stress disorder (ASD). Early assessment of trauma-related psychological responses is important because acute trauma responses in the early post-traumatic period are among the robust predictors of long-term mental health problems. However, estimates of the prevalence of ASD among RTA survivors varied considerably across studies. Therefore, this meta-analysis aimed to identify the pooled prevalence of ASD among RTA survivors. METHODS A systematic literature search in the databases of PubMed, PsycINFO, PsycARTICLES, Embase and Web of Science was performed from their inception dates to December 2017. Subject headings were used to identify relevant articles, and the search strategy was adjusted across databases. Heterogeneity across studies was evaluated by Cochran's χ2 test and quantified by the I2 statistic. Subgroup analyses were performed to identify the pooled prevalence in relation to the country of study, instrument used to identify ASD, age, gender and traumatic brain injury. When significant heterogeneity was observed, the influence of some potential moderators was explored using meta-regression analyses. RESULTS Thirteen eligible studies conducted in 8 countries were included. A total of 2989 RTA survivors were assessed, of which 287 were identified with ASD. The overall heterogeneity was high across studies (I2=96.8%, P < 0.001), and the pooled prevalence of ASD among RTA survivors was 15.81% (95% confidence interval: 8.27-25.14%). Subgroup analyses indicated that the prevalence of ASD among RTA survivors differed significantly with regard to the country of study, instrument used to identify ASD, age and gender (P < 0.05). Meta-regression analyses showed that mean age of participants and quality assessment score were significant moderators for heterogeneity (P < 0.05). CONCLUSIONS Nearly one-sixth of RTA survivors suffer from ASD, indicating the need for regular assessment of early trauma responses among RTA survivors, as well as the importance of implementing early psychological interventions.
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Affiliation(s)
- Wenjie Dai
- 0000 0001 0379 7164grid.216417.7Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China ,0000 0001 2182 2255grid.28046.38OMNI Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON Canada ,0000 0000 9606 5108grid.412687.eOttawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON Canada ,0000 0001 2182 2255grid.28046.38School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON Canada
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
| | - Atipatsa C. Kaminga
- 0000 0001 0379 7164grid.216417.7Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China ,grid.442592.cDepartment of Mathematics, Mzuzu University, Mzuzu, Malawi
| | - Jing Deng
- 0000 0001 0379 7164grid.216417.7Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan China
| | - Zhiwei Lai
- Immunization Programme Department, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan China
| | - Jianzhou Yang
- grid.254020.1Department of Preventive Medicine, Changzhi Medical College, Changzhi, Shanxi China
| | - Shi Wu Wen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China. .,OMNI Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. .,Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada. .,School of Epidemiology, Public Health, and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
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Bryant RA. Acute stress disorder. Curr Opin Psychol 2017; 14:127-131. [PMID: 28813311 DOI: 10.1016/j.copsyc.2017.01.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 12/30/2016] [Accepted: 01/11/2017] [Indexed: 12/28/2022]
Abstract
Acute stress disorder (ASD) was introduced in DSM-IV to describe posttraumatic stress disorder (PTSD) symptoms that (a) occur in the initial month after trauma and (b) predict subsequent PTSD. Longitudinal studies have shown that most people who develop PTSD do not initially meet ASD criteria, which led to the decision in DSM-5 to limit the ASD diagnosis to describing acute stress reactions without any predictive function. Controlled trials have shown that trauma-focused cognitive behavior therapy is the treatment of choice for ASD, and is superior to pharmacological interventions. Recent longitudinal studies have challenged previous conceptualizations of the course of posttraumatic stress, and highlighted that people follow different trajectories of adaptation that are influenced by events that occur after the acute posttraumatic period.
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Affiliation(s)
- Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia.
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