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Moallem BI, Wen Z, Hammoud MZ, Su W, Pace-Schott EF, Milad MR. Impact of trauma type on neural mechanisms of threat conditioning and its extinction. J Psychiatr Res 2024; 178:50-58. [PMID: 39121707 DOI: 10.1016/j.jpsychires.2024.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 07/22/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024]
Abstract
Trauma type moderates the impact of trauma exposure on clinical symptomatology; however, the impact of trauma type on the neural correlates of emotion regulation is not as well understood. This study examines how violent and nonviolent trauma differentially influence the neural correlates of conditioned fear and extinction. We aggregated psychophysiological and fMRI data from three studies; we categorized reported trauma as violent or nonviolent, and subdivided violent trauma as sexual or nonsexual. We examined skin conductance responses (SCR) during a fear conditioning and extinction paradigm. For fMRI data analyses, we conducted region-specific and whole-brain analyses. We examined associations between beta weights from specific brain regions and CAPS scores. The group exposed to violent trauma showed significantly higher SCR during extinction recall. Those exposed to nonviolent trauma showed significantly higher functional activation during late extinction learning. The group exposed to violent trauma showed higher functional connectivity within the default mode network (DMN) and between the DMN and frontoparietal control network. For secondary analyses of sexual vs nonsexual trauma, we did not observe any between-group differences in SCR. During late extinction learning, the group exposed to sexual trauma showed significantly higher activation in the prefrontal cortex and precuneus. During extinction recall, the group exposed to nonsexual trauma showed significantly higher activation in the insular cortex. Violent trauma significantly impacts functional brain activations and connectivity in brain areas important for perception and attention with no significant impact on brain areas that modulate emotion regulation. Sexual trauma impacts brain areas important for internal perception.
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Affiliation(s)
- B Isabel Moallem
- Department of Psychiatry, School of Medicine, New York University, New York, NY, 10016, USA; Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, TX, 77054, USA
| | - Zhenfu Wen
- Department of Psychiatry, School of Medicine, New York University, New York, NY, 10016, USA; Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, TX, 77054, USA
| | - Mira Z Hammoud
- Department of Psychiatry, School of Medicine, New York University, New York, NY, 10016, USA; Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, TX, 77054, USA
| | - Wenjun Su
- Department of Psychiatry, School of Medicine, New York University, New York, NY, 10016, USA
| | - Edward F Pace-Schott
- Sleep and Anxiety Disorders Laboratory, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, 02129, USA
| | - Mohammed R Milad
- Department of Psychiatry, School of Medicine, New York University, New York, NY, 10016, USA; Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, TX, 77054, USA.
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Sherman DS, Burnett HJ, Lindstrom D. Engagement in Meaningful Activity Mediates the Relationship Between Stressful Life Events and Functional Resilience. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:689-698. [PMID: 38520308 DOI: 10.1177/15394492241237746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
Resilience during stressful life events is a priority for administering the most client-centered care as possible. Occupational therapy practitioners have the unique opportunity to support resilience through promoting meaningful participation. The current study aims to understand the associations between meaningful activity engagement, resilience, and stressful life events. We specifically focused on answering if meaningful participation mediates the relationship between stressful life events and resilience. 492 participants from a non-clinical convenience sample of Amazon's MTurk completed the study. Participants completed an online survey and reported their experiences of stressful life events, resilience, well-being, and meaningful participation. We used SPSS and PROCESS to analyze our data. Stressful event severity and resilience were inversely related. When accounting for the effect of meaningful participation, the relationship became non-significant, indicating evidence of mediation. Implications: Focusing on measuring meaningful participation may be worth studying in further research.
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Keen MA, Greene TE, Robinson BA, Morris CS, Ingram PB. Assessment of PTSD and Trauma Symptoms With the MMPI-3 in College Students: Validity and Incremental Utility of the Anxiety Related Experiences (ARX) Scale. J Pers Assess 2024; 106:561-573. [PMID: 38394449 DOI: 10.1080/00223891.2024.2315127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
Post Traumatic Stress Disorder (PTSD) is heterogeneous in nature, which complicates diagnostic efforts and makes accurate assessment tools critical. The MMPI family of instruments are widely used broadband measures of psychopathology, including trauma symptomology. The MMPI-3's Anxiety Related Experiences scale (ARX) is an expansion of the MMPI-2-RF Anxiety (AXY) scale which has historically represented the MMPI family's best measure of trauma symptoms. This study expands research on ARX in 2 samples of college students (n = 332 [PCL-5 Criterion] & n = 58 [CAPS-5 Criterion]) by examining ARX's incremental, criterion, and classification validity. ARX incrementally predicted PCL-5 total and cluster scores beyond that accounted for by AXY (R2Δ = .01-.09). ARX accounted for the most unique variance, beyond RCd and RC7, in CAPS-5 interview ratings of intrusion symptoms (R2Δ = .16). ARX was strongly related to trauma symptomology broadly (r = .42-.58) and demonstrated strong screening ability at T65 (sensitivity = .37-.40; specificity = .91-.92) and stronger diagnostic screening at T75 (sensitivity = .31; specificity = .93). We discuss clinical considerations when using ARX for assessing PTSD.
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Affiliation(s)
- Megan A Keen
- Department of Psychological Sciences, Texas Tech University
| | - Tina E Greene
- Department of Psychological Sciences, Texas Tech University
| | | | - Cole S Morris
- Department of Psychological Sciences, Texas Tech University
| | - Paul B Ingram
- Department of Psychological Sciences, Texas Tech University
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Bunt SC, Doggett H, Wilmoth K, Hynan LS, Tamez I, Didehbani N, Stokes M, Miller SM, Bell KR, Cullum CM. Posttraumatic stress symptoms in recovery from concussion. J Clin Exp Neuropsychol 2024:1-11. [PMID: 39215645 DOI: 10.1080/13803395.2024.2395331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Previous literature suggests that lingering concussion symptoms may be influenced by psychological factors. The relationship of posttraumatic stress symptoms (PTSS) during recovery with pre-existing/injury related factors and concussion symptomology is not fully understood. Identification of factors contributing to symptoms of posttraumatic stress may provide guidance to improve treatment following concussion. METHOD This study included 287 participants (Male 40.42%, n = 116; Female 59.58%, n = 171) aged 13-75 years diagnosed with a recent concussion at one of the North Texas Concussion Registry (ConTex) specialty concussion clinic sites. Preinjury emotional history, injury related factors, and emotional state at time of initial evaluation were analyzed as predictors of post-traumatic stress symptoms (PCL-5) during recovery. RESULTS Sixty-one percent of participants endorsed at least one PTSS. Correlations were found between initial Sport Concussion Assessment Tool 5Ⓡ (SCAT5) total emotional symptom severity and screening measures for anxiety (GAD-7; r = .453, p < .001) and depression (PHQ-8; r = .550, p < .001) symptom scores. Of the measures from the initial visit included in the multiple regression model predicting severity of PTSS at follow-up (R2 = 0.554, β < .001), three measures predicted PTSS severity: initial SCAT5 total emotional symptom severity (β = 0.565, p < .001), PHQ-8 score (β =.166, p = .009), and GAD-7 score (β = 0.119, p = .044). CONCLUSIONS Symptoms of anxiety and depression along with specific SCAT5 emotional symptoms present at the time of initial evaluation may serve to predict overall level of PTSS and increased risk for PTSS during recovery. PTSS may be another dimension of response to injury and concussion recovery, with a large percentage of individuals endorsing at least one PTSS. Clinicians can utilize brief assessments such as the SCAT5 at the time of initial clinical evaluation to identify those at risk for PTSS following concussion.
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Affiliation(s)
- Stephen C Bunt
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Hannah Doggett
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Kristin Wilmoth
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX, USA
| | - Linda S Hynan
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
- Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX, USA
| | - Ingrid Tamez
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Nyaz Didehbani
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX, USA
| | - Mathew Stokes
- Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Orthopedics, Texas Scottish Rite Hospital for Children, Dallas, TX, USA
| | - Shane M Miller
- Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Orthopedics, Texas Scottish Rite Hospital for Children, Dallas, TX, USA
- Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Kathleen R Bell
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, UT Southwestern Medical Center, Dallas, TX, USA
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Hagos TG, Tamir TT, Workneh BS, Abrha NN, Demissie NG, Gebeyehu DA. Acute stress disorder and associated factors among adult trauma patients in Ethiopia: a multi-institutional study. BMC Psychiatry 2024; 24:418. [PMID: 38834988 DOI: 10.1186/s12888-024-05861-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/22/2024] [Indexed: 06/06/2024] Open
Abstract
INTRODUCTION Acute stress disorder (ASD) is a mental disorder that happens after someone experienced traumatic event within duration of less than a month. Other studies conducted in different countries revealed that adults with a trauma had experienced acute stress disorder. This results in substantial distress and interferes with social and day to day activities. Despite the high burden of this problem, very little is known about the prevalence and risk factors for acute stress disorder in adults with traumatic injuries in Ethiopia. OBJECTIVE This study was aimed to assess the prevalence of acute stress disorder and associated factors among adult trauma patients attending in northwest Amhara Comprehensive Specialized Hospitals, Ethiopia 2022. METHODS An institutional based cross-sectional study design was employed among 422 adult trauma patients from May- June 2022. Systematic sampling technique was applied to recruit study participants. Data were collected through interviewer administered questionnaires using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, acute stress disorder measurement tools. Then, it was entered into Epi-Data version 4 and exported to STATA version 14 for analysis. Bivariate and multivariable binary logistic regressions model were carried out to identify factors significantly associated acute stress disorder. RESULT The prevalence of acute stress disorder among adult trauma patients in northwest Amhara comprehensive specialized hospitals was found to be 44.15% (95% CI: 39.4%, 49.0%) with 99% of response rate. In multivariate logistic analysis younger age (21-29) (AOR = 0.33 95% CI: 0.14-0.77), (30-39) (AOR = 0.35 95% CI: 0.15-0.85), (40-49) (AOR = 0.28 95% CI: 0.10-0.76) respectively, presence of complication (AOR = 2.22 95% CI: 1.36-3.60), prolonged length of hospital stay (AOR = 1.89 95% CI: 1.21-2.95) and having low (AOR = 3.21, 95% CI: 1.66-6.19) and moderate (AOR = 1.99, 95%, CI: 1.14-3.48) social support were factors significantly associated with acute stress disorder. CONCLUSION AND RECOMMENDATION This study showed that the prevalence of acute stress disorder among the adult study participants who experienced traumatic events was high as compared to other literatures. Age, complication, prolonged hospital stay and social support were factors significantly associated with ASD at p-value < 0.05. This indicates the need for early identification and interventions or ASD care services from health workers of psychiatric ward.
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Affiliation(s)
- Tewodros Guay Hagos
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nega Nigussie Abrha
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Negesu Gizaw Demissie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Ayelegne Gebeyehu
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Carrard V, Berney S, Bourquin C, Ranjbar S, Castelao E, Schlegel K, Gaume J, Bart PA, Schmid Mast M, Preisig M, Berney A. Mental health and burnout during medical school: Longitudinal evolution and covariates. PLoS One 2024; 19:e0295100. [PMID: 38626104 PMCID: PMC11020803 DOI: 10.1371/journal.pone.0295100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/28/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Medical students' rate of depression, suicidal ideation, anxiety, and burnout have been shown to be higher than those of the same-age general population. However, longitudinal studies spanning the whole course of medical school are scarce and present contradictory findings. This study aims to analyze the longitudinal evolution of mental health and burnout from the first to the last year of medical school using a wide range of indicators. Moreover, biopsychosocial covariates that can influence this evolution are explored. METHOD In an open cohort study design, 3066 annual questionnaires were filled in by 1595 different students from the first to the sixth year of the Lausanne Medical School (Switzerland). Depression symptoms, suicidal ideation, anxiety symptoms, stress, and burnout were measured along with biopsychosocial covariates. The longitudinal evolution of mental health and burnout and the impact of covariates were modelled with linear mixed models. RESULTS Comparison to a same-aged general population sample shows that medical students reported significantly more depression symptoms and anxiety symptoms. Medical students' mental health improved during the course of the studies in terms of depression symptoms, suicidal ideation, and stress, although suicidal ideation increased again in the last year and anxiety symptoms remained stable. Conversely, the results regarding burnout globally showed a significant worsening from beginning to end of medical school. The covariates most strongly related to better mental health and less burnout were less emotion-focused coping, more social support, and more satisfaction with health. CONCLUSION Both improvement of mental health and worsening of burnout were observed during the course of medical school. This underlines that the beginning and the end of medical school bring specific challenges with the first years' stressors negatively impacting mental health and the last year's difficulties negatively impacting burnout.
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Affiliation(s)
- Valerie Carrard
- Department of Psychiatry, Psychiatric Liaison Service, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Sylvie Berney
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Céline Bourquin
- Department of Psychiatry, Psychiatric Liaison Service, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Setareh Ranjbar
- Department of Psychiatry, Psychiatric Epidemiology and Psychopathology Research Centre, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Psychiatric Epidemiology and Psychopathology Research Centre, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Katja Schlegel
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Jacques Gaume
- Department of Psychiatry, Addiction Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Pierre-Alexandre Bart
- Department of Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Marianne Schmid Mast
- Faculty of Business and Economics (HEC Lausanne), Department of Organizational Behavior, University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Psychiatric Epidemiology and Psychopathology Research Centre, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Alexandre Berney
- Department of Psychiatry, Psychiatric Liaison Service, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
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Tesfaye AH, Sendekie AK, Kabito GG, Engdaw GT, Argaw GS, Desye B, Angelo AA, Aragaw FM, Abere G. Post-traumatic stress disorder and associated factors among internally displaced persons in Africa: A systematic review and meta-analysis. PLoS One 2024; 19:e0300894. [PMID: 38557637 PMCID: PMC10984478 DOI: 10.1371/journal.pone.0300894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Internally displaced people (IDPs), uprooted by conflict, violence, or disaster, struggle with the trauma of violence, loss, and displacement, making them significantly more vulnerable to post-traumatic stress disorder (PTSD). Therefore, we conducted a systematic review and meta-analysis to assess the prevalence and associated factors of PTSD among IDPs in Africa. METHODS A comprehensive search of electronic databases was conducted to identify relevant studies published between 2008 and 2023. The search included electronic databases such as PubMed, CABI, EMBASE, SCOPUS, CINHAL, and AJOL, as well as other search sources. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Data were extracted using Microsoft Excel, and analysis was performed using STATA 17 software. The quality of the included studies was assessed using the JBI quality appraisal tool. A random-effects model was used to estimate the pooled prevalence of PTSD and its associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics was used to assess heterogeneity. The protocol for this review has been registered with PROSPERO (ID: CRD42023428027). RESULTS A total of 14 studies with a total of 7,590 participants met the inclusion criteria. The pooled prevalence of PTSD among IDPs in Africa was 51% (95% CI: 38.-64). Female gender (OR = 1.99, 95% CI: 1.65-2.32), no longer married (OR = 1.93, 95% CI: 1.43-2.43), unemployment (OR = 1.92, 95% CI: 1.17-2.67), being injured (OR = 1.94, 95% CI: 1.50-1.50), number of traumatic events experienced [4-7(OR = 2.09, 95% CI: 1.16-3.01), 8-11 (OR = 2.09, 95% CI: 2.18-4.12), 12-16 (OR = 5.37, 95% CI: 2.61-8.12)], illness without medical care (OR = 1.92, 95% CI: 1.41-2.29), being depressed (OR = 2.97, 95% CI: 2.07-3.86), and frequency of displacement more than once (OR = 2.13, 95% CI: 1.41-2.85) were significantly associated with an increased risk of PTSD. CONCLUSIONS The findings of this systematic review and meta-analysis highlight the alarming prevalence of PTSD among IDPs in Africa. Female gender, marital status, number of traumatic events, ill health without medical care, depression, and frequency of displacement were identified as significant risk factors for PTSD. Effective interventions and the development of tailored mental health programs are needed to prevent PTSD among IDPs, focusing on the identified risk factors.
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Affiliation(s)
- Amensisa Hailu Tesfaye
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ashenafi Kibret Sendekie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gebisa Guyasa Kabito
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Garedew Tadege Engdaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Girum Shibeshi Argaw
- Department of Nursing, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Belay Desye
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abiy Ayele Angelo
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Giziew Abere
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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8
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Fearon D, Perlman CM, Leatherdale S, Hirdes JP, Dubin J. Classification of traumatic life events and substance use among persons admitted to inpatient psychiatry in Ontario, Canada. J Psychiatr Res 2024; 172:236-243. [PMID: 38412786 DOI: 10.1016/j.jpsychires.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/09/2024] [Accepted: 02/01/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Trauma is commonly overlooked or undiagnosed in clinical care settings. Undetected trauma has been associated with elevated substance use highlighting the need to prioritize identifying individuals with undetected trauma through common characteristics. OBJECTIVE The purpose of this study is to identify classifications of traumatic life experiences and substance use among persons admitted to inpatient psychiatry in Ontario and to identify covariates associated with classification membership. STUDY DESIGN A population-based retrospective cohort study was conducted using interRAI Mental Health (MH) assessment data. Individuals were included who experienced traumatic life events (N = 10,125), in Ontario, Canada between January 1, 2015, to December 31, 2019. RESULTS Eight latent classes were identified that ranged from low (i.e., Class 1: Interpersonal Issues, Without Substance use) to high (i.e., Class 8: Widespread Trauma, Alcohol & Cannabis Addiction) complexity patterns of traumatic life events and substance use indicators. Classifications with similar trauma profiles were differentiated by patterns of substance use. For example, individuals in Class 2: Safety & Relationship Issues, Without Substance use and Class 3: Safety & Relationship Issues, Alcohol & Cannabis both had many estimates centered around the experience of victimization (e.g., victim of sexual assault, victim of physical assault, victim of emotional abuse). Multinomial logistic regression models highlighted additional factors associated with classifications such as homelessness, where those who were homeless were 2.09-4.02 times more likely to be in Class 6: Widespread Trauma & Substance Addiction. INTERPRETATION Trauma exposures are complex and varied among persons in inpatient psychiatry and can be further differentiated by substance use patterns. These findings provide a population-based estimate of the trauma experiences of persons in inpatient settings in Ontario, Canada. Findings demonstrate the importance of using comprehensive assessment to support clinical decision making in relation to trauma and substance.
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Affiliation(s)
- Danielle Fearon
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
| | | | - Scott Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - John P Hirdes
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Joel Dubin
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
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9
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Shen D, Chang L, Su F, Huang S, Xu H, Si Y, Wang F, Xue Y. The gut microbiome modulates the susceptibility to traumatic stress in a sex-dependent manner. J Neurosci Res 2024; 102:e25315. [PMID: 38439584 DOI: 10.1002/jnr.25315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/30/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
Post-traumatic stress disorder (PTSD), a psychological condition triggered by exposure to extreme or chronic stressful events, exhibits a sex bias in incidence and clinical manifestations. Emerging research implicates the gut microbiome in the pathogenesis of PTSD and its roles in stress susceptibility. However, it is unclear whether differential gut microbiota contribute to PTSD susceptibility in male and female rats. Here, we utilized the single prolonged stress animal model and employed unsupervised machine learning to classify stressed animals into stress-susceptible subgroups and stress-resilient subgroups. Subsequently, using 16S V3-V4 rDNA sequencing, we investigated the differential gut microbiota alterations between susceptible and resilient individuals in male and female rats. Our findings revealed distinct changes in gut microbiota composition between the sexes at different taxonomic levels. Furthermore, the abundance of Parabacteroides was lower in rats that underwent SPS modeling compared to the control group. In addition, the abundance of Tenericutes in the stress-susceptible subgroup was higher than that in the control group and stress-resilient subgroup, suggesting that Tenericutes may be able to characterize stress susceptibility. What is particularly interesting here is that Cyanobacteria may be particularly associated with anti-anxiety effects in male rats. This study underscores sex-specific variations in gut microbiota composition in response to stress and sex differences should be taken into account when using macrobiotics for neuropsychiatric treatment, highlighting potential targets for PTSD therapeutic interventions.
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Affiliation(s)
- Dan Shen
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, China
| | - Liang Chang
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, China
| | - Feng Su
- College of Future Technology, Peking University, Beijing, China
| | - Shihao Huang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Hubo Xu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yue Si
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Feng Wang
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang, China
| | - Yanxue Xue
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
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10
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Giacomo FD, Strippoli MPF, Castelao E, Amoussou JR, Gholam M, Ranjbar S, Glaus J, Marquet P, Preisig M, Plessen KJ, Vandeleur CL. Risk factors for mood disorders among offspring of parents with bipolar disorder: Findings from a discordant-sibling study. Psychiatry Res 2023; 330:115615. [PMID: 38007982 DOI: 10.1016/j.psychres.2023.115615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 11/28/2023]
Abstract
The purpose of this naturalistic, prospective study was to identify risk factors for mood disorders in offspring of parents with bipolar disorder (BPD) using the discordant-sibling design by comparing premorbid psychopathology or symptoms, temperament, personality traits and coping style as well as the perception of family-related characteristics among affected and unaffected siblings within the same family. This approach controls for confounding by unmeasured genetic and environmental factors shared within families. Our sample comprised 24 families of a parent with BPD with at least one child that developed BPD or major depressive disorder (n = 31), and at least one child who did not. Offspring were followed for a mean duration of 16.2 (s.d: 4.6) years. Information was collected from the offspring themselves. Generalized linear mixed models only revealed differences in three dimensions of the Dimension of Temperament Survey-Revised (DOTS-R) version: Offspring with mood disorders scored higher on "Approach-withdrawal", "Rhythmicity for daily habits", and "Task orientation" than their unaffected siblings. The higher scores, and not lower scores as expected, on these temperament dimensions observed in offspring that subsequently developed mood disorders may reflect increased vulnerability, but they could also mirror premorbid mood swings or strategies to cope with them.
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Affiliation(s)
- Francesca Di Giacomo
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland.
| | - Marie-Pierre F Strippoli
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Enrique Castelao
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Joëlle Rosselet Amoussou
- Psychiatry Library, Education and Research Department, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Mehdi Gholam
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Setareh Ranjbar
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Jennifer Glaus
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Pierre Marquet
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland; International Research Unit in Neurodevelopment and Child Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland and Laval University, QC, Canada
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Kerstin Jessica Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Caroline L Vandeleur
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
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11
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Allwood MA, Robinson JN, Kim H. Youth Exposure to Gun, Knife, and Physical Assaults: Assessing PTSD Symptoms Across Types of Assaults, Race, Ethnicity, Sex, and Context. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11545-11568. [PMID: 37409648 DOI: 10.1177/08862605231185300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
This study examined posttraumatic stress disorder (PTSD) symptoms in relation to physical assaults and weapons-related victimization, as well as the moderating roles of demographic characteristics and the context of victimization. The sample consisted of 910 racially and ethnically diverse adolescents and young adults from an urban commuter college in the Northeast U.S. Findings include significant sex differences and racial differences in reported victimization and symptoms. Men reported significantly more physical assaults, gun victimizations, and knife victimizations than women. Black participants reported significantly more gun victimization than all other groups, and Black, White, and Asian participants reported significantly more physical assault experiences than Latinx participants. Individuals victimized by physical assault or by gun victimization were more than twice as likely to report clinically significant PTSD symptoms than individuals without such experiences, even after adjusting for demographic differences. In addition, for gun victimization in the community, a two-way interaction (gun victimization by race) and a three-way interaction (gun victimization by race by sex) were significantly associated with clinically significant PTSD symptoms. Gun victimization in the community, which disproportionately impacts Black men, was the only context in which PTSD symptoms were highest for men compared to women. The overall finding of lower PTSD symptoms among men suggests that clinical practice must include an intentional focus on violence victimization, including the use of weapons, as well as the various ways that distress might manifest among men. In addition to symptoms of PTSD, other symptoms of distress, including substance use, anger, and retaliatory aggression, should be considered. Public policy and public health must also direct attention to the use of weapons in violence victimization and the proliferation of weapons violence.
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Affiliation(s)
| | - Janelle N Robinson
- John Jay College, City University of New York, USA
- The University of the West Indies, Mona Campus, Jamaica
| | - Hyun Kim
- John Jay College, City University of New York, USA
- University of South Alabama, Mobile, USA
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12
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Smith RL, Dick DM, Amstadter A, Thomas N, Salvatore JE. A longitudinal study examining the associations between interpersonal trauma and romantic relationships among college students. Dev Psychopathol 2023; 35:1346-1357. [PMID: 34903311 PMCID: PMC9192832 DOI: 10.1017/s0954579421001243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We examined the associations between the developmental timing of interpersonal trauma exposure (IPT) and three indicators of involvement in and quality of romantic relationships in emerging adulthood: relationship status, relationship satisfaction, and partner alcohol use. We further examined whether these associations varied in a sex-specific manner. In a sample of emerging adult college students (N = 12,358; 61.5% female) assessed longitudinally across the college years, we found precollege IPT increased the likelihood of being in a relationship, while college-onset IPT decreased the likelihood. Precollege and college-onset IPT predicted lower relationship satisfaction, and college-onset IPT predicted higher partner alcohol use. There was no evidence that associations between IPT and relationship characteristics varied in a sex-specific manner. Findings indicate that IPT exposure, and the developmental timing of IPT, may affect college students' relationship status. Findings also suggest that IPT affects their ability to form satisfying relationships with prosocial partners.
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Affiliation(s)
- Rebecca L. Smith
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
| | - Danielle M. Dick
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Box 980033, Richmond, Virginia 23298
| | - Ananda Amstadter
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Box 980126, Richmond, VA 23298
| | - Nathaniel Thomas
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
| | | | - Jessica E. Salvatore
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Box 980126, Richmond, VA 23298
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13
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Ambresin G, Strippoli MPF, Vandeleur CL, de Roten Y, Despland JN, Preisig M. Correlates of chronic depression in the general population: results from the CoLaus|PsyCoLaus study. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1179-1191. [PMID: 36949341 PMCID: PMC10366283 DOI: 10.1007/s00127-023-02462-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/08/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE Previous population-based studies have partially provided inconsistent results regarding the co-variates of chronic depression, which were likely to be attributable to methodological limitations. The present paper that compared people with chronic major depressive disorder (MDD), non-chronic MDD and no mood disorder in the community focused on specific atypical and melancholic depression symptoms and subtypes of MDD, family history (FH) of mood disorders, measured physical cardio-vascular risk factors (CVRF), personality traits, coping style and adverse life-events. METHODS Data stemmed from a population-based cohort including 3618 participants (female 53%, n=1918; mean age 50.9 years, s.d. 8.8 years). Among them 563 had a lifetime history of chronic MDD, 1060 of non-chronic MDD and 1995 of no mood disorder. Diagnostic and FH information were elicited through semi-structured interviews, CVRF were assessed through physical investigations. RESULTS The major findings were that chronic MDD was associated with increase in appetite/weight and suicidal ideation/attempts during the most severe episode, higher exposure to life-events in adulthood, higher levels of neuroticism, lower levels of extraversion and lower levels of informal help-seeking behavior but less frequent FH of MDD compared to non-chronic MDD. CONCLUSION Chronic MDD is associated with a series of potential modifiable risk factors which are accessible via psychotherapeutic approaches that may improve the course of chronic MDD.
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Affiliation(s)
- Gilles Ambresin
- University Hospital of Lausanne, Lausanne, Switzerland.
- General Practice and Primary Health Care Academic Centre, The University of Melbourne, Melbourne, Australia.
| | | | | | - Yves de Roten
- University Hospital of Lausanne, Lausanne, Switzerland
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14
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Hambrick EP, Williams JL, Hardt MM, Collins JO, Punt SE, Rincon Caicedo M, Zhang EA, Maras M, Lopez Mader L, Stiles R, Nelson EL. Disseminating early interventions for disaster mental health response using the ECHO model. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2213-2228. [PMID: 36870075 DOI: 10.1002/jcop.23023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 06/14/2023]
Abstract
Extension for Community Healthcare Outcomes (ECHO)-based telementoring was evaluated for disseminating early disaster interventions, Psychological First Aid (PFA) and Skills for Psychological Recovery (SPR), to school professionals throughout rural, disaster-affected communities further affected by COVID-19. PFA and SPR complemented their Multitiered System of Support: PFA complemented tier 1 (universal) and SPR tier 2 (targeted) prevention. We evaluated the outcomes of a pretraining webinar (164 participants, January 2021) and four-part PFA training (84 participants, June 2021) and SPR training (59 participants, July 2021) across five levels of Moore's continuing medical education evaluation framework: (1) participation, (2) satisfaction, (3) learning, (4) competence, and (5) performance, using pre-, post-, and 1-month follow-up surveys. Positive training outcomes were observed across all five levels, with high participation and satisfaction throughout, and high use at the 1-month follow-up. ECHO-based telementoring may successfully engage and train community providers in these underused early disaster response models. Recommendations regarding training format and using evaluation to improve training are provided.
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Affiliation(s)
- Erin P Hambrick
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Joah L Williams
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Madeleine M Hardt
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Jen O Collins
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Stephanie E Punt
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | | | - E Alice Zhang
- Department of Occupational Therapy Education, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Melissa Maras
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Luisa Lopez Mader
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Robert Stiles
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Eve-Lynn Nelson
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas, USA
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15
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Öst LG, Enebrink P, Finnes A, Ghaderi A, Havnen A, Kvale G, Salomonsson S, Wergeland GJ. Cognitive behavior therapy for adult post-traumatic stress disorder in routine clinical care: A systematic review and meta-analysis. Behav Res Ther 2023; 166:104323. [PMID: 37257304 DOI: 10.1016/j.brat.2023.104323] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/25/2023] [Accepted: 04/26/2023] [Indexed: 06/02/2023]
Abstract
Although different cognitive behavioral therapies (CBT) have strong research support for treatment of adult post-traumatic stress disorder (PTSD) more knowledge is needed about the performance of CBT in routine clinical care. The present study is a systematic review and meta-analysis of CBT for PTSD in adults treated in routine clinical care. Ovid MEDLINE, Embase OVID, and PsycINFO were systematically searched for studies published until the end of May 2022. The effectiveness of CBT, methodological quality, and moderators of treatment outcome were examined, and benchmarked by meta-analytically comparing with efficacy studies for PTSD. Thirty-three studies, comprising 6482 participants, were included. The within-group effect sizes (ES) for PTSD-severity at post-treatment (1.75), and follow-up (1.70), on average 6 months post-treatment, were large. The effectiveness studies had very similar ESs as efficacy studies at post-treatment (1.75 vs. 1.72) and follow-up (1.70 vs. 2.02), based on the benchmarking analysis. As the heterogeneity was large, we can only cautiously consider CBT for PTSD an effective treatment when delivered in routine clinical care. The outcomes of effectiveness studies for PTSD seem to be comparable to the results obtained in efficacy studies. PROSPERO REGISTRATION ID: CRD42021228828.
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Affiliation(s)
- Lars-Göran Öst
- Department of Psychology, Stockholm University, Sweden; Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Pia Enebrink
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anna Finnes
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Academic Primary Care Center, Region Stockholm, Sweden
| | - Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Audun Havnen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway; Division of Psychiatry, St. Olavs Hospital, Trondheim, Norway
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Norway
| | - Sigrid Salomonsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Gro Janne Wergeland
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Norway
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16
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Gao B, Qu YC, Cai MY, Zhang YY, Lu HT, Li HX, Tang YX, Shen H. Phytochemical interventions for post-traumatic stress disorder: A cluster co-occurrence network analysis using CiteSpace. JOURNAL OF INTEGRATIVE MEDICINE 2023:S2095-4964(23)00048-1. [PMID: 37380564 DOI: 10.1016/j.joim.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 03/16/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE This study investigated trends in the study of phytochemical treatment of post-traumatic stress disorder (PTSD). METHODS The Web of Science database (2007-2022) was searched using the search terms "phytochemicals" and "PTSD," and relevant literature was compiled. Network clustering co-occurrence analysis and qualitative narrative review were conducted. RESULTS Three hundred and one articles were included in the analysis of published research, which has surged since 2015 with nearly half of all relevant articles coming from North America. The category is dominated by neuroscience and neurology, with two journals, Addictive Behaviors and Drug and Alcohol Dependence, publishing the greatest number of papers on these topics. Most studies focused on psychedelic intervention for PTSD. Three timelines show an "ebb and flow" phenomenon between "substance use/marijuana abuse" and "psychedelic medicine/medicinal cannabis." Other phytochemicals account for a small proportion of the research and focus on topics like neurosteroid turnover, serotonin levels, and brain-derived neurotrophic factor expression. CONCLUSION Research on phytochemicals and PTSD is unevenly distributed across countries/regions, disciplines, and journals. Since 2015, the research paradigm shifted to constitute the mainstream of psychedelic research thus far, leading to the exploration of botanical active ingredients and molecular mechanisms. Other studies focus on anti-oxidative stress and anti-inflammation. Please cite this article as: Gao B, Qu YC, Cai MY, Zhang YY, Lu HT, Li HX, Tang YX, Shen H. Phytochemical interventions for post-traumatic stress disorder: A cluster co-occurrence network analysis using CiteSpace. J Integr Med. 2023; Epub ahead of print.
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Affiliation(s)
- Biao Gao
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China; Teaching and Research Support Center, Naval Medical University, Shanghai 200433, China
| | - Yi-Cui Qu
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Meng-Yu Cai
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Yin-Yin Zhang
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Hong-Tao Lu
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Hong-Xia Li
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Yu-Xiao Tang
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China
| | - Hui Shen
- Department of Naval Nutrition and Food Hygiene, Naval Medical University, Shanghai 200433, China.
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17
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Pitts BL, Eisenberg ML, Bailey HR, Zacks JM. Cueing natural event boundaries improves memory in people with post-traumatic stress disorder. Cogn Res Princ Implic 2023; 8:26. [PMID: 37103666 PMCID: PMC10140198 DOI: 10.1186/s41235-023-00478-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 04/10/2023] [Indexed: 04/28/2023] Open
Abstract
People with post-traumatic stress disorder (PTSD) often report difficulty remembering information in their everyday lives. Recent findings suggest that such difficulties may be due to PTSD-related deficits in parsing ongoing activity into discrete events, a process called event segmentation. Here, we investigated the causal relationship between event segmentation and memory by cueing event boundaries and evaluating its effect on subsequent memory in people with PTSD. People with PTSD (n = 38) and trauma-matched controls (n = 36) watched and remembered videos of everyday activities that were either unedited, contained visual and auditory cues at event boundaries, or contained visual and auditory cues at event middles. PTSD symptom severity varied substantial within both the group with a PTSD diagnosis and the control group. Memory performance did not differ significantly between groups, but people with high symptoms of PTSD remembered fewer details from the videos than those with lower symptoms of PTSD. Both those with PTSD and controls remembered more information from the videos in the event boundary cue condition than the middle cue or unedited conditions. This finding has important implications for translational work focusing on addressing everyday memory complaints in people with PTSD.
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Affiliation(s)
| | | | | | - Jeffrey M Zacks
- Washington University in St. Louis, St. Louis, MO, 63130, USA.
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18
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Liang Y, Wu R, Huang Q, Liu Z. Sex Differences in Patterns of Childhood Traumatic Experiences in Chinese Rural-To-Urban Migrant Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040734. [PMID: 37189983 DOI: 10.3390/children10040734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/14/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Children and adolescents are likely to be exposed to various types of childhood traumatic experiences (CTEs) with gender-specific patterns. Rural-to-urban migrant children have been demonstrated a greater risk of CTE exposure than local children. However, no study has investigated sex differences in the patterns of CTEs and predictive factors among Chinese children. METHODS A large-scale questionnaire survey of rural-to-urban migrant children (N = 16,140) was conducted among primary and junior high schools in Beijing. Childhood trauma history, including interpersonal violence, vicarious trauma, accidents and injuries was measured. Demographic variables and social support were also examined. Latent class analysis (LCA) was utilized to examine patterns of childhood trauma, and logistic regression was used to examine predictors. RESULTS Four classes of CTEs were found among both boys and girls, labeled low trauma exposure, vicarious trauma exposure, domestic violence exposure, and multiple trauma exposure. The possibility of various CTEs in the four CTE patterns was higher among boys than girls. Sex differences also manifested in predictors of childhood trauma patterns. CONCLUSIONS Our findings shed light on sex differences in CTE patterns and predictive factors in Chinese rural-to-urban migrant children, suggesting that trauma history should be considered along with sex, and sex-specific prevention and treatment programs should be developed.
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Affiliation(s)
- Yiming Liang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Ruiyao Wu
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Qi Huang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
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19
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Thomas S, Kanske P, Schäfer J, Hummel KV, Trautmann S. Examining bidirectional associations between perceived social support and psychological symptoms in the context of stressful event exposure: a prospective, longitudinal study. BMC Psychiatry 2022; 22:736. [PMID: 36443716 PMCID: PMC9703701 DOI: 10.1186/s12888-022-04386-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND After stressful event exposure, higher perceived social support is a well-established correlate of decreased risk for psychological symptoms, including depressive, anxiety and posttraumatic stress (PTS) symptoms. However, longitudinal data on the direction of this association and the stability of perceived social support are scarce and have yielded mixed results, with a particular lack of prospective studies. We aimed to investigate changes in perceived social support and bidirectional associations between perceived social support and psychological symptoms in a prospective, longitudinal study. METHODS A sample of German soldiers was assessed before and after deployment to Afghanistan. Group-based trajectory modelling was used to investigate the stability of perceived social support and to identify possible distinguishable trajectories of perceived social support. Bidirectional associations between perceived social support (general and workplace) and psychological symptoms (depressive, anxiety and PTS) were examined using gamma regressions. RESULTS Average levels of perceived general social support did not change, while perceived workplace social support increased slightly (t(344) = 5.51, p < .001). There were no distinguishable trajectories of perceived social support. Higher perceived general (Mean ratio (MR) = 0.84, 95% CI = [0.74, 0.95]) and workplace social support (MR = 0.82, 95% CI = [0.72, 0.92]) predicted lower depressive symptoms, but not anxiety or PTS symptoms. Only higher PTS (MR = 0.95, 95% CI = [0.91, 0.99]) and higher depressive symptoms (MR = 0.96, 95% CI = [0.93, 0.99]) predicted lower perceived general social support. CONCLUSIONS Perceived social support can remain relatively stable under exposure to environmental stressors such as military deployment. Higher perceived social support could protect against depressive symptoms via a stress-buffering mechanism, while support may need to be more tailored to individual needs for a protection against PTS symptoms. Individuals with elevated depressive and PTS symptoms might have impaired abilities or opportunities to access social support after stressful event exposure. Future studies could investigate distressing social emotions and associated maladaptive social cognitions as possible mechanisms in the association between symptoms and lower perceived social support. Especially with respect to PTS symptoms, future studies could focus on conditions that enable individuals to benefit from social support.
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Affiliation(s)
- Sarah Thomas
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Philipp Kanske
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany ,grid.419524.f0000 0001 0041 5028Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Judith Schäfer
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Katrin Veronika Hummel
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany. .,Department of Psychology, Faculty of Human Science, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany. .,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany.
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20
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Bahji A, Di Nota PM, Groll D, Carleton RN, Anderson GS. Psychological interventions for post-traumatic stress injuries among public safety personnel: a systematic review and meta-analysis. Syst Rev 2022; 11:255. [PMID: 36434683 PMCID: PMC9701019 DOI: 10.1186/s13643-022-02112-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 11/02/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Public safety personnel (PSP) are exposed to potentially psychologically traumatic events (PPTE) far more often than the general public, which increases the risk for various post-traumatic stress injuries (PTSIs). While there are many evidence-based psychological interventions for PTSI, the effectiveness of each intervention for PSP remains unclear. OBJECTIVES The current study assessed the effectiveness and acceptability of psychological interventions for PTSI among PSPs. METHODS A systematic review and random-effects meta-analysis were performed on the effectiveness and acceptability of psychotherapies for PTSIs (i.e., symptoms of depression, anxiety, post-traumatic stress disorder) among PSP. The review adhered to the PRISMA reporting guidelines and used standardized mean differences (Cohen's d), rate ratios (RR), and their 95% confidence intervals (95% CI) to measure pooled effect sizes across studies; negative d values and RR values less than one indicated a reduction in symptoms compared to baseline or control groups. In addition, heterogeneity was quantified using I2, and publication bias was evaluated using Egger's test. RESULTS The analyses included data from eight randomized controlled trials representing 402 PSP (79.4% male, 35.3 years). Psychological interventions included narrative exposure therapy (n = 1), cognitive behavioral therapy (n = 2), eclectic psychotherapy (n = 2), eye-movement desensitization and reprocessing (n = 1), supportive counseling (n = 2), and group critical incident stress debriefing (n = 1). The interventions were associated with statistically significant reductions in symptoms associated with PTSD (d = - 1.23; 95% CI - 1.81, - 0.65; 7 studies; I2 = 81%), anxiety (- 0.76; 95% CI - 1.28, - 0.24; 3 studies; I2 = 47%), and depression (d = - 1.10; 95% CI - 1.62, - 0.58; 5 studies; I2 = 64%). There were smaller but statistically significant improvements at follow-up for symptoms of PTSD (d = - 1.29 [- 2.31, - 0.27]), anxiety (d = - 0.82 [- 1.20, - 0.44]), and depression (d = - 0.46 [- 0.77, - 0.14]). There were no statistically significant differences in dropout rates (RR = 1.00 [0.96, 1.05]), suggesting high acceptability across interventions. CONCLUSIONS There is preliminary evidence that psychotherapies help treat PTSIs in PSP; however, the shortage of high-quality studies on PSP indicates a need for additional research into treating PTSI among PSP. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42019133534.
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Affiliation(s)
- Anees Bahji
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Paula M Di Nota
- Office of Applied Research and Graduate Studies, Justice Institute of British Columbia, Vancouver, BC, Canada
| | - Dianne Groll
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
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Thomas EB, Stegall MS, Farley KE, Pawlak SA. A Multidisciplinary Pelvic Pain Clinic: Integrated Health Psychology in a Specialty Care Setting. J Womens Health (Larchmt) 2022; 31:1639-1644. [PMID: 35704283 PMCID: PMC9836695 DOI: 10.1089/jwh.2022.0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose: Chronic pelvic pain (CPP) is a relatively common health problem, impacting around 25 million women globally. This study details the development of a multidisciplinary women's CPP clinic at a major U.S. academic medical center, and examines associations between mood, pain symptoms, and trauma history. Materials and Methods: Data were collected from 96 subjects, including self-report measures (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Brief Trauma Questionnaire), pain intensity ratings, psychiatric diagnoses, and relevant medical history. Results: Most subjects reported at least one traumatic experience. Nearly half of subjects met criteria for an anxiety disorder and/or a depressive disorder. Most subjects were diagnosed with pelvic floor dysfunction, and more than half were referred to physical therapy. Women with abdominal/pelvic surgery history reported more traumatic experiences than women without surgical history. Women with a history of sexual abuse reported trying more medications and seeking care from a greater number of providers. Many reported pain duration of >2 years. Conclusions: Study findings related to mental health and trauma support a multidisciplinary CPP approach that includes a clinical health psychology component. Future research may investigate the therapeutic processes that apply to this population to identify targeted efficacious interventions.
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Affiliation(s)
- Emily B.K. Thomas
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Manny S. Stegall
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Kathryn E. Farley
- Department of Physical Medicine and Rehabilitation, UnityPoint Health, St. Luke's Hospital, Cedar Rapids, Iowa, USA
| | - Stacey A. Pawlak
- Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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22
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Swanberg KM, Campos L, Abdallah CG, Juchem C. Proton Magnetic Resonance Spectroscopy in Post-Traumatic Stress Disorder-Updated Systematic Review and Meta-Analysis. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2022; 6:24705470221128004. [PMID: 36237981 PMCID: PMC9551353 DOI: 10.1177/24705470221128004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 09/06/2022] [Indexed: 11/06/2022]
Abstract
A stressor-related disorder wherein traumatic experience precipitates protracted
disruptions to mood and cognition, post-traumatic stress disorder (PTSD) is
associated with wide-ranging abnormalities across the body. While various
methods have investigated these deviations, only proton magnetic resonance
spectroscopy (1H MRS) enables noninvasive measurement of
small-molecule metabolites in the living human. 1H MRS has
correspondingly been employed to test hypotheses about the composition and
function of multiple brain regions putatively involved in PTSD. Here we
systematically review methodological considerations and reported findings, both
positive and negative, of the current 1H-MRS literature in PTSD
(N = 32 studies) to communicate the brain regional metabolite alterations
heretofore observed, providing random-effects model meta-analyses for those most
extensively studied. Our review suggests significant PTSD-associated decreases
in N-acetyl aspartate in bilateral hippocampus and anterior cingulate cortex
with less evident effect in other metabolites and regions. Model heterogeneities
diverged widely by analysis (I2 < 0.01% to 90.1%) and suggested
regional dependence on quantification reference (creatine or otherwise). While
observed variabilities in methods and reported findings suggest that
1H-MRS explorations of PTSD could benefit from methodological
standardization, informing this standardization by quantitative assessment of
the existing literature is currently hampered by its small size and limited
scope.
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Affiliation(s)
- Kelley M. Swanberg
- Department of Biomedical Engineering,
Columbia
University Fu Foundation School of Engineering and Applied
Science, New York, NY, USA
- Kelley M. Swanberg, Department of
Biomedical Engineering, Columbia University Fu Foundation School of Engineering
and Applied Science, 351 Engineering Terrace, 1210 Amsterdam Avenue, New York,
NY 10027, USA.
| | - Leonardo Campos
- Department of Biomedical Engineering,
Columbia
University Fu Foundation School of Engineering and Applied
Science, New York, NY, USA
| | - Chadi G. Abdallah
- Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, USA
- Clinical Neuroscience Division, Department of Veterans Affairs
National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut
Healthcare System, West Haven, CT, USA
- Psychiatry and Behavioral Sciences,
Baylor College
of Medicine, Houston, TX, USA
| | - Christoph Juchem
- Department of Biomedical Engineering,
Columbia
University Fu Foundation School of Engineering and Applied
Science, New York, NY, USA
- Department of Radiology, Columbia University College of Physicians and
Surgeons, New York, NY, USA
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Wa Mwenda Jonas KA, Kisungu Basile K, Jean Baptiste KN, Alyousef HA, Meng H. Associations between posttraumatic stress symptoms and abuse experiences in child and adolescent girls from a Central African country. J Trauma Stress 2022; 35:1432-1444. [PMID: 35642389 DOI: 10.1002/jts.22843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 11/11/2022]
Abstract
Posttraumatic stress disorder (PTSD) is frequently reported among survivors of abuse. However, there is a paucity of research examining the association between PTSD and abuse, including polyvictimization, in nonconflict areas of the Democratic Republic of Congo (DRC). We aimed to investigate the prevalence and correlates of PTSD among girls in nonconflict zones who experienced at least one type of abuse. Participants in this cross-sectional study were 3,011 middle-school girls, aged 11-18 years, who attended randomly selected schools and completed questionnaires. The probable PTSD prevalence was 67.5%. The rate of probable PTSD increased with the number of experienced abuse types over a 12-month period. The findings demonstrated associations between probable PTSD and exposure to five (86.9%), four (63.9%), and three types of abuse (60.1%). The strongest association was observed between probable PTSD and experiencing five types of abuse, OR = 26.806, 95% CI [19.303, 37.225]; associations were also found between PTSD and abuse with a weapon, OR = 4.341, 95% CI [3.519, 5.354]; rape with penetration, OR = 4.728, 95% CI [3.447, 6.484]; and experiencing three, OR = 6.625, 95% CI [4.325, 10.148], or four types of abuse, OR = 7.114, 95% CI [5.025,10.070]. The findings of this study underscore the importance of the need for psychological and physical health care for girls who have been exposed to abuse, regardless of the number of abuse experiences or abuse types she has experienced.
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Affiliation(s)
| | - Kalema Kisungu Basile
- Department of School and Professional Orientation, National Pedagogical University, Kinshasa, Congo
| | | | - Hala Ayaman Alyousef
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Heng Meng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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24
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Miller ML, Stevens NR, Lowell GS, Hobfoll SE. Communal mastery and associations with depressive and PTSD symptomatology among urban trauma-exposed women. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2022; 28:513-522. [PMID: 34291970 PMCID: PMC9628780 DOI: 10.1037/cdp0000473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: Racial and ethnic minority women from low-resource urban communities experience disproportionately high rates of trauma exposure. Higher rates of lifetime trauma exposure are strongly associated with subsequent psychological sequela, specifically depression and posttraumatic stress disorder (PTSD). Communal mastery is the ability to cope with challenges and achieve goals by being closely interconnected with friends, family, and significant others. Yet, it is unknown if communal mastery is protective specifically against PTSD and depressive symptoms. Method: Participants (N = 131) were Black and Latina women (88.5% Black, mean monthly income: < $750) recruited from an urban outpatient obstetric-gynecological clinic at an academic medical center. Participants completed an online questionnaire that assessed trauma history, PTSD and depressive symptoms, types of individualistic coping, social support, and communal mastery. Results: Hierarchical multiple regression models demonstrated that communal mastery is uniquely associated with fewer PTSD symptoms (β = -.23, p = .003). More severe trauma history, more use of passive coping skills, and poorer social support were also significantly associated with PTSD symptoms, explaining over half of the variance in PTSD symptoms. Although significantly correlated, communal mastery was not uniquely associated with fewer depressive symptoms (β = -.13, p = .201). Conclusions: These findings suggest that connectedness as assessed through communal mastery serves as an important shield against the effects of traumatic stress for Black and Latina women. Future research would benefit by exploring interventions that aim to increase communal mastery in order to help highly trauma-exposed racial and ethnic minority women in low-resource environments. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Michelle L. Miller
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Natalie R. Stevens
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Gina S. Lowell
- Department of Pediatrics, Rush University Medical Center, Chicago, IL
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25
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Abass K, Gyasi RM, Katey D, Frempong F, Garsonu EK. Flood exposure and psychological distress among Ghanaian adults in flood-prone settings. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 835:155481. [PMID: 35490804 DOI: 10.1016/j.scitotenv.2022.155481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
Urban floods have long-term mental health implications, yet this subject remains largely neglected in flood-related studies. This paper examines the psychological distress (PD) of adults exposed to floods in Ghana. Cross-sectional data involving 767 flood-prone community-dwelling household heads aged ≥20 years were analyzed [mean = 47.3 years (SD = 13.7); males = 61.4%]. We used the Exposure to Flood-related Events Scale, and PD was assessed with the Kessler Psychological Distress Scale (K10). Ordinary Least Squares (OLS) regressions evaluated crude and adjusted associations of flood exposure with PD. The mean scores of PD (37[SD = 8]) and exposure to flood events (6[SD = 3]) significantly varied by age and sex (p < .05). After full adjustment for potential confounders, exposure to flood events was significantly and positively associated with PD index in the total sample (β = 0.030; p < .005), among male participants (β = 0.019; p < .05) and female participants (β = 0.048; p < .001). Furthermore, age-wise analysis revealed significant association of flood exposure with PD in young adults (β = 0.033; p < .001) but not in older adults (β = 0.048; p = .062). Exposure to floods increased the risk of PD. Policy and public health efforts to manage PD should include selective flood reduction interventions, including land use regulations and sustained public education.
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Affiliation(s)
- Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya.
| | - Daniel Katey
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Foster Frempong
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Emmanuel Kofi Garsonu
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
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26
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Rieder JK, Kleshchova O, Weierich MR. Estradiol, stress reactivity, and daily affective experiences in trauma-exposed women. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2022; 14:738-746. [PMID: 34726450 PMCID: PMC9046469 DOI: 10.1037/tra0001113] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Women experience higher risk for PTSD following trauma compared with men. Fluctuations in ovarian hormones might contribute to this greater vulnerability, given that estradiol is associated with affect and stress reactivity. Our objective was to test the relations between menstrual cycle-related changes in estradiol, affect, stress reactivity, and trauma-related symptoms. METHOD We assessed trauma-related symptoms in ethnically diverse naturally cycling women with a history of trauma during a clinical interview. Participants also completed a 10-day ecological momentary assessment (EMA) that included lower- and higher-estradiol phases. We tested associations between estradiol and PTSD symptoms and stress reactivity to a trauma reminder using Spearman correlation and Wilcoxon rank-sum tests. We tested the effect of menstrual cycle day on daily affect using multilevel modeling. RESULTS Estradiol was negatively associated with symptom severity (rs = -.36), and participants in low- versus high-estradiol cycle phases at interview had higher sympathetic (r = .35) and lower hypothalamic-pituitary-adrenal axis (r = .41) reactivity. Across the EMA period, participants showed a decrease in daily PTSD symptoms (b = -.39), negative (b = -.11) and positive (b = -.24) affect, and variability in daily valence (b = -.07) and arousal (b = -.08), from the low- to high-estradiol phase. CONCLUSIONS Consistent with prior evidence of more aversive affective experiences in low-estradiol states, lower estradiol was associated with higher trauma-related symptoms. In addition, trauma-exposed women showed a discordant pattern of stress reactivity to a trauma reminder, higher daily symptoms, and greater affective lability in a low-estradiol phase. Given that our sample consisted of high-functioning trauma-exposed women, these results should be replicated in women with PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Jenna K. Rieder
- College of Humanities & Sciences, Thomas Jefferson University
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27
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Ghazali SR, Chen YY, Mohamad M, Yein LP, Razali ZA, Pauzi N, Majani AF. Lifetime trauma, symptoms of psychological disturbance, and suicidal ideation among university students in Malaysia. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03297-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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28
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Harris CE, Allbaugh LJ, Kaslow NJ. Childhood Physical Abuse and Antisocial Traits: Mediating Role of Posttraumatic Stress Symptom Clusters. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:249-259. [PMID: 35600521 PMCID: PMC9120298 DOI: 10.1007/s40653-021-00364-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 06/03/2023]
Abstract
Posttraumatic stress symptoms (PTSS) are associated with both childhood physical abuse (CPA) and antisocial (AS) traits, yet their potential as mediators of the CPA-AS traits link is understudied and the specific roles of individual symptom clusters in this relation is unknown. The current study aimed to examine the mediational role of PTSS in the relation between CPA and AS traits in a sample of low-income African American women with histories of intimate partner violence (IPV). It was hypothesized that avoidance would emerge as a significant mediator, whereas reexperiencing, numbing, and hyperarousal would not. Participants (N = 150) were recruited from a level-1 trauma public hospital and evaluated as part of a randomized controlled trial of a group therapy intervention for low-income, African American women suicide attempters with histories of IPV. The Childhood Trauma Questionnaire (CTQ), Posttraumatic Diagnostic Scale (PDS), and International Personality Disorder Examination-Screening Questionnaire (IPDE-SQ) were used to measure variables of interest. Using bootstrapping analyses, a parallel mediation model compared PTSS clusters as potential mediators of the CPA-AS traits relation, controlling for IPV. When reexperiencing, avoidance, numbing, and hyperarousal were entered simultaneously as potential mediators, only avoidance emerged as a significant mediator of the CPA-AS traits link. Avoidance symptoms may play a unique role in the link between early experiences of CPA and later AS traits among multiply traumatized African American women. Findings have implications for understanding AS traits in the context of early life trauma and suggest that targeting specific PTSS clusters (e.g., avoidance) may improve treatment outcomes for women in this population.
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Affiliation(s)
- Catherine E. Harris
- Department of Psychology, John Jay College of Criminal Justice, City University of New York, 524 W. 59th Street, New York, NY 10019 USA
| | | | - Nadine J. Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
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Keulen J, Spuij M, Deković M, Boelen PA. Heterogeneity of posttraumatic stress symptoms in bereaved children and adolescents: Exploring subgroups and possible risk factors. Psychiatry Res 2022; 312:114575. [PMID: 35500332 DOI: 10.1016/j.psychres.2022.114575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/25/2022]
Abstract
Bereaved youths are at risk of developing posttraumatic stress (PTS), but there are large individual differences in presentation and severity of PTS symptoms among bereaved youths. The study sought to identify subgroups based on the distribution of self-rated loss-related PTS symptoms in a sample of 264 bereaved youths (aged 7-18). Based on latent class analysis, we identified three subgroups: no disturbance (37.9%), intermediate disturbance (39.0%) and pervasive disturbance (23.1%). Subgroups differed in PTS severity and symptom configuration. Specifically, avoidance was relatively more pronounced in bereaved youth with no and intermediate PTS disturbance, whereas emotional numbing was relatively more pronounced in bereaved youth with intermediate and pervasive PTS disturbance. Associations between subgroup membership, emotional stability and demographic and loss-related variables were also examined. Multinomial logistic regression indicated that youths in the pervasive disturbance subgroup reported lower emotional stability than youths in the no disturbance subgroup. Other variables were unrelated to subgroup membership. The study highlights the importance of considering the heterogeneity in PTS symptomatology in the diagnoses and treatment of loss-related traumatic stress in bereaved youth. Moreover, it underscores the need for further research on possible risk and protective factors involved in the maintenance and development of this traumatic stress.
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Affiliation(s)
- Janna Keulen
- Department of Clinical Child & Family Studies, Utrecht University, Utrecht, the Netherlands.
| | - Mariken Spuij
- Department of Clinical Child & Family Studies, Utrecht University, Utrecht, the Netherlands
| | - Maja Deković
- Department of Clinical Child & Family Studies, Utrecht University, Utrecht, the Netherlands
| | - Paul A Boelen
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; ARQ National Psychotrauma Centre, Diemen, the Netherlands
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30
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Expressive suppression a mediating variable between stress and procrastination in eating behavior disorder. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns3.6325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Eating disorders (EDs) are psychiatric illnesses in which emotions play an important role in their development and maintenance. These disorders are associated with expressive suppression, stress, and procrastination. The purpose of this work was to explain eating disorders from stress and procrastination, with expressive suppression as a mediating variable. It was attended by 918 students from three universities in Ecuador. The information was collected through four instruments: inventory of eating disorders, perceived stress scale, Tuckman procrastination scale and emotional regulation questionnaire. The data was analyzed through a mediational analysis in the Jasp program, version 15. The independent variables were: procrastination and stress, the dependent variable was risk of experiencing bulimia (REB) and the mediating variable was expressive suppression. Procrastination and stress, mediated by expressive suppression, were found to have no statistically significant effect on EBR. Procrastination has a direct effect on REB, although stress does not, and the model between expressive suppression and REB explains a good percentage of the variance.
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31
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Torres ERS, Luo J, Boehnlein JK, Towns D, Kinzie JD, DeBarber AE, Raber J. Apolipoprotein E Isoform-specific changes related to stress and trauma exposure. Transl Psychiatry 2022; 12:125. [PMID: 35347119 PMCID: PMC8960860 DOI: 10.1038/s41398-022-01848-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/06/2022] [Accepted: 02/09/2022] [Indexed: 11/19/2022] Open
Abstract
Post-Traumatic Stress Disorder (PTSD) is a highly prevalent mental health disorder. Due to the high level of variability in susceptibility and severity, PTSD therapies are still insufficient. In addition to environmental exposures, genetic risks play a prominent role and one such factor is apolipoprotein E. The protein (apoE) is functionally involved in cholesterol transport and metabolism and exists as 3 major isoforms in humans: E2, E3, and E4. To model the role of apolipoprotein E isoform in stress-related changes in behavior and cognition, female and male mice (3-5 months of age) expressing E2, E3, or E4 were used. Mice were either placed into control groups or exposed to chronic variable stress (CVS), which has been shown to induce PTSD-like behavioral and neuroendocrine changes. E2 mice showed a unique response to CVS compared to E3 and E4 mice that included impaired spatial learning and memory, increased adrenal gland weight, and no increase in glucocorticoid receptor protein levels (normalized to apoE levels). In addition, the cholesterol metabolite 7-ketocholesterol was elevated in the cortex after CVS in E3 and E4, but not E2 female mice. E2 confers unique changes in behavioral, cognitive, and biomarker profiles after stress exposure and identify 7-ketocholesterol as a possible novel biomarker of the traumatic stress response. We further explored the relationship between E2 and PTSD in an understudied population by genotyping 102 patients of Cambodian and Vietnamese ethnicity. E2 carriers demonstrated a higher odds ratio of having a PTSD diagnosis compared to E3/E3 carriers, supporting that the E2 genotype is associated with PTSD diagnosis after trauma exposure in this population.
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Affiliation(s)
- Eileen Ruth S Torres
- Department of Behavioral Neuroscience, Oregon Health & Science University, 3181SW Sam Jackson Park Road, L470, Portland, OR, 97239, USA
| | - Jenny Luo
- Department of Chemical Physiology & Biochemistry, Oregon Health & Science University, Portland, OR, 97239, USA
| | - James K Boehnlein
- Department of Psychiatry, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, UHN-80, Portland, OR, 97201-3098, USA
- VA Northwest Mental Illness Research, Education and Clinical Center (MIRECC), Washington DC, USA
| | - Daniel Towns
- Department of Psychiatry, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, UHN-80, Portland, OR, 97201-3098, USA
| | - J David Kinzie
- Department of Psychiatry, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, UHN-80, Portland, OR, 97201-3098, USA
| | - Andrea E DeBarber
- Department of Chemical Physiology & Biochemistry, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Jacob Raber
- Department of Behavioral Neuroscience, Oregon Health & Science University, 3181SW Sam Jackson Park Road, L470, Portland, OR, 97239, USA.
- Departments of Neurology, Psychiatry, and Radiation Medicine and Division of Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, 97239, USA.
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32
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Lahav Y, Allende S, Talmon A, Ginzburg K, Spiegel D. Identification With the Aggressor and Inward and Outward Aggression in Abuse Survivors. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:2705-2728. [PMID: 32659159 DOI: 10.1177/0886260520938516] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Childhood abuse survivors may display both inward and outward aggression manifested in self-injurious behavior (SIB) and violent acts toward others. Scrutinizing the literature reveals that the relational dynamics between victims and their perpetrators might be involved in these phenomena. Yet, research on this subject matter has been sparse. Filling this gap, this study investigated the contribution of the singular bonds between victims and their perpetrators, known as identification with the aggressor, in explaining survivors' aggression. The study was conducted among 306 Israeli college/university students who reported a history of childhood abuse. Results revealed that levels of adopting the perpetrator's experience, identifying with the perpetrator's aggression, and replacing one's agency with that of the perpetrator were significantly associated with survivors' inward and outward aggression. Moreover, profile type-that is, having high versus low levels of identification with the aggressor-was implicated in participants' SIBs, urge to harm others, and violent acts toward others, above and beyond the effects of gender and posttraumatic stress disorder (PTSD) symptoms. The present findings suggest that identification with the aggressor might make survivors prone to the re-enactment of past abusive dynamics, which, in turn, could eventuate in aggression toward themselves and others.
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Ricciardelli R, Tamara T, Mitchell MM, Groll D, Afifi T, Nicholas Carleton R. Exposures to Potentially Psychologically Traumatic Events Among Provincial Correctional Workers in Ontario, Canada. VIOLENCE AND VICTIMS 2022; 37:77-100. [PMID: 35165161 DOI: 10.1891/vv-d-21-00009] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We know little about potentially psychologically traumatic events (PPTE) exposures among provincial correctional workers in diverse occupational positions and even less regarding how exposure to events are associated with mental health disorders. We designed the current study to unpack and quantify estimates of the frequencies that correctional workers, across occupational roles, experience exposure to diverse incidents. We categorized 1,338 of our 1,487 participants into six occupational categories and our measures included established self-report items measuring PPTE exposure and mental disorder symptoms. Almost all correctional workers reported exposures to most PPTE types. Correctional workers collectively report exposures to physical assault (90.2%) and sudden violent death (81.8%), with many (3.1%-46%) reporting 11+ exposures (M = 10.01, SD = 4.29). We found significant differences in exposure patterns across correctional worker categories; specifically, we found a higher prevalence of exposure to toxic substances, physical assault, assault with a weapon, severe human suffering, sudden accidental or sudden violent death, among those working in institutional correctional services (e.g., governance, correctional officers). PPTE exposure and all assessed mental health disorder symptom profiles were closely related, as correctional workers report high exposure to PPTE. Population attributable fractions indicated that the burden of mental disorders among provincial correction workers might be reduced by between 38%-70% if PPTE exposures were eliminated from the population. We conclude with recommendations for mental health related policies, such as investing in peer and psychologically support, as well as interventions for exposure to PPTE and readiness to inform strategies for employee mental health and well-being.
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Rieder JK, Kleshchova O, Weierich MR. Trauma Characteristics Moderate the Relation Between Estradiol and Trauma-Related Symptoms. J Trauma Stress 2022; 35:246-256. [PMID: 34390027 PMCID: PMC8840997 DOI: 10.1002/jts.22725] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 05/10/2021] [Accepted: 06/20/2021] [Indexed: 02/03/2023]
Abstract
Women are more likely to develop posttraumatic stress disorder (PTSD) than men, and fluctuations in gonadal hormones might contribute to this vulnerability. Low-estradiol states are associated with aversive affective experiences, including trauma-related symptoms. However, the impact of trauma characteristics on the relation between estradiol and trauma-related symptoms is unknown. We used a clinical interview and 10-day ecological momentary assessment (EMA) that spanned low- and high-estradiol menstrual cycle phases to test trauma type, chronicity, and timing as moderators of the association between estradiol and trauma-related symptoms in 40 naturally cycling young women. We tested interactions between trauma characteristics and (a) estradiol on self-reported symptoms and (b) menstrual cycle-related change in estradiol on change in symptoms. Sexual, chronic, and earlier trauma was associated with more severe symptoms as reported during the interview, rs = .51-.33, but not mean symptoms across the EMA. Estradiol at the time of the interview was inversely associated with symptoms in women with sexual but not nonsexual trauma, interaction: B = -12.62 (SE = 5.28), p = .022. Menstrual cycle-related change in estradiol was inversely associated with change in symptoms in women with chronic trauma, B = -9.65 (SE = 3.49), p = .006, and earlier trauma, B = 0.71 (SE = 0.34), p = .036, but not discrete or later trauma. Sexual, chronic, or early trauma exposure might confer higher symptom vulnerability in low-estradiol states. Clinicians who work with women with particular trauma histories might anticipate menstrual cycle-related variation in symptoms.
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Affiliation(s)
- Jenna K. Rieder
- College of Humanities and Sciences, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Olena Kleshchova
- Department of Psychology, University of Nevada, Reno, Reno, Nevada, USA
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Yun YH, Sim JA. The Association of the Health Management Strategy with Subjective Health and Well-being Outcomes in General Population. J Korean Med Sci 2021; 36:e340. [PMID: 34962113 PMCID: PMC8728590 DOI: 10.3346/jkms.2021.36.e340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/05/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND People face many obstacles to overcoming crisis in life and proactively manage life crises. This study aimed to evaluate the association of self-management strategy with subjective health and well-being for the general South Korean population. METHODS We recruited 1,200 respondents using an equal-probability sampling method from March to May 2018. A questionnaire including life version of the Smart Management Strategy for Health Assessment Tool (SAT-Life), the five Health Status Questionnaire, Short Form-12, McGill Quality of Life Questionnaire (MQOL), Patient Health Questionnaire-9 (PHQ-9), and Satisfaction With Life Scale (SWLS) was administered to participants. RESULTS In multiple stepwise logistic regression model adjusted with basic demographic variables (age, sex, region, education and monthly income level), core strategy was independently associated with physical, mental, social, spiritual, and general health status (adjusted odds ratios [aORs], 1.97-2.92). Preparation strategy was independently associated with physical, mental, spiritual, and general health status (aORs, 2.36-3.31). Implementation strategy was independently associated with physical, social, spiritual, and general health status (aORs, 2.22-2.42). Core strategy and implementation strategy were independently associated with higher Physical Component Score (aORs, 2.21-2.29) and higher Mental Component Score (aORs, 1.68-1.76). Core strategy and preparation strategy were independently associated with lower PHQ-9 (aORs, 2.63-3.74). Pearson's correlation coefficients between scores on SAT-Life and the other factors (MQOL social support, MQOL spiritual well-being, and SWLS) explain having significant correlations ranging from 0.41-0.43. CONCLUSION Self-management strategies of health might be encouraged to manage subjective health and well-being outcomes.
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Affiliation(s)
- Young Ho Yun
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea.
| | - Jin-Ah Sim
- School of AI Convergence, Hallym University, Chuncheon, Korea
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Berney A, Carrard V, Berney S, Schlegel K, Gaume J, Gholam M, Bart PA, Preisig M, Wac K, Schmid Mast M, Bourquin C. Study protocol for the ETMED-L project: longitudinal study of mental health and interpersonal competence of medical students in a Swiss university using a comprehensive framework of empathy. BMJ Open 2021; 11:e053070. [PMID: 34862292 PMCID: PMC8647527 DOI: 10.1136/bmjopen-2021-053070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Physician interpersonal competence is crucial for patient care. How interpersonal competence develops during undergraduate medical education is thus a key issue. Literature on the topic consists predominantly of studies on empathy showing a trend of decline over the course of medical school. However, most existing studies have focused on narrow measures of empathy. The first aim of this project is to study medical students' interpersonal competence with a comprehensive framework of empathy that includes self-reported cognitive and affective empathy, performance-based assessments of emotion recognition accuracy, and a behavioural dimension of empathy. The second aim of the present project is to investigate the evolution of mental health during medical school and its putative link to the studied components of interpersonal competence. Indeed, studies documented a high prevalence of mental health issues among medical students that could potentially impact their interpersonal competence. Finally, this project will enable to test the impact of mental health and interpersonal competence on clinical skills as evaluated by experts and simulated patients. METHODS AND ANALYSIS This project consists of an observational longitudinal study with an open cohort design. Each year during the four consecutive years of the project, every medical student (curriculum years 1-6) of the University of Lausanne in Switzerland will be asked to complete an online questionnaire including several interpersonal competence and mental health measures. Clinical skills assessments from examinations and training courses with simulated patients will also be included. Linear mixed models will be used to explore the longitudinal evolutions of the studied components of interpersonal competence and mental health as well as their reciprocal relationship and their link to clinical skills. ETHICS AND DISSEMINATION The project has received ethical approval from the competent authorities. Findings will be disseminated through internal, regional, national and international conferences, news and peer-reviewed journals.
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Affiliation(s)
- Alexandre Berney
- Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Valerie Carrard
- Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Sylvie Berney
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Katja Schlegel
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Jacques Gaume
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Alcohol Treatment Centre, Lausanne University Hospital, Lausanne, Switzerland
| | - Mehdi Gholam
- Institute of Mathematics, EPFL, Lausanne, Switzerland
| | - Pierre-Alexandre Bart
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Martin Preisig
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Centre for Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Lausanne, Switzerland
| | - Katarzyna Wac
- Department of Computer Science, University of Geneva, Geneva, Switzerland
| | - Marianne Schmid Mast
- Department of Organizational Behavior, University of Lausanne, Lausanne, Switzerland
| | - Céline Bourquin
- Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Stovall MC, Firkins J, Hansen L, Dieckmann NF, van Ryn M. Personality Traits and Traumatic Outcome Symptoms in Registered Nurses in the Aftermath of a Patient Safety Incident. J Patient Saf 2021; 17:e1652-e1659. [PMID: 32604193 DOI: 10.1097/pts.0000000000000740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the relationship between personality traits (perfectionism and neuroticism) and the traumatic outcomes of reexperiencing, avoidance, and alcohol abuse severity of registered nurses (RNs) who have been involved with a patient safety incident (PSI). We hypothesized that higher scores for perfectionism and neuroticism would predict higher reexperiencing and avoidance symptoms in RNs in the aftermath of a PSI. Also, RNs with higher perfectionism and neuroticism sum scores would be more likely to abuse alcohol. METHODS A descriptive, correlational study design was used to characterize the relationships of personality traits and potential traumatic outcomes of RNs in the aftermath of a PSI. The Almost Perfect Scale-Revised, Neuroticism Scale, Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, and Alcohol Use Disorders Identification Test-Consumption measures were administered to RNs licensed in Oregon and New York. RESULTS Perfectionist-discrepancy personality traits (P < 0.01) were the strongest predictors for reexperiencing symptoms and neuroticism (P < 0.05) was the strongest predictor for avoidance symptoms, when controlling for sociodemographics and experience. We found a negative linear relationship between perfectionism-order and alcohol abuse severity (β = -0.15, P < 0.01; confidence interval, -0.24 to 0.05). CONCLUSIONS This study demonstrated a statistically significant relationship between perfectionism-discrepancy and reexperiencing as well as between neuroticism and reexperiencing and avoidance, each explaining 4% of variance of their model. The results add to the nurse second victim literature by validating 2 posttraumatic stress disorder symptoms in RNs in the aftermath of a PSI. Registered nurses with perfectionism-order were less likely to abuse alcohol.
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Affiliation(s)
- Mady C Stovall
- From the Oregon Health & Science University, School of Nursing, Portland, Oregon
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Stout DM, Powell S, Kangavary A, Acheson DT, Nievergelt CM, Kash T, Simmons AN, Baker DG, Risbrough VB. Dissociable impact of childhood trauma and deployment trauma on affective modulation of startle. Neurobiol Stress 2021; 15:100362. [PMID: 34258336 PMCID: PMC8259305 DOI: 10.1016/j.ynstr.2021.100362] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/26/2022] Open
Abstract
Trauma disorders are often associated with alterations in aversive anticipation and disruptions in emotion/fear circuits. Heightened or blunted anticipatory responding to negative cues in adulthood may be due to differential trauma exposure during development, and previous trauma exposure in childhood may also modify effects of subsequent trauma in adulthood. The aim of the current investigation was to examine the contributions of childhood trauma on affective modulation of startle before and after trauma exposure in adulthood (a combat deployment). Adult male participants from the Marine Resilience Study with (n = 1145) and without (n = 1312) a history of reported childhood trauma completed an affective modulation of startle task to assess aversive anticipation. Affective startle response was operationalized by electromyography (EMG) recording of the orbicularis oculi muscle in response to acoustic stimuli when anticipating positive and negative affective images. Startle responses to affective images were also assessed. Testing occurred over three time-points; before going on a 7 month combat deployment and 3 and 6 months after returning from deployment. Startle response when anticipating negative images was greater compared to pleasant images across all three test periods. Across all 3 time points, childhood trauma was consistently associated with significantly blunted startle when anticipating negative images, suggesting reliable effects of childhood trauma on aversive anticipation. Conversely, deployment trauma was associated with increased startle reactivity post-deployment compared to pre-deployment, which was independent of childhood trauma and image valence. These results support the hypothesis that trauma exposure during development vs. adulthood may have dissociable effects on aversive anticipation and arousal mechanisms. Further study in women and across more refined age groups is needed to test generalizability and identify potential developmental windows for these differential effects.
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Affiliation(s)
- Daniel M. Stout
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Susan Powell
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | | | - Dean T. Acheson
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Caroline M. Nievergelt
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | | | - Alan N. Simmons
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Dewleen G. Baker
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Victoria B. Risbrough
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
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Xu H, Zhang H, Huang L, Wang X, Tang X, Wang Y, Xiao Q, Xiong P, Jiang R, Zhan J, Deng F, Yu M, Liu D, Liu X, Zhang C, Wang W, Li L, Cao H, Zhang W, Zhou H, Wang W, Yin L. Increased symptoms of post-traumatic stress in school students soon after the start of the COVID-19 outbreak in China. BMC Psychiatry 2021; 21:330. [PMID: 34217234 PMCID: PMC8254054 DOI: 10.1186/s12888-021-03339-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 06/23/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The outbreak of Coronavirus Disease 2019(COVID-19) caused psychological stress in Chinese adults population. But we are unaware of whether the pandemic causes psychological stress on children. METHODS We used the Children's Impact of Event Scale questionnaire (CRIES-13) to investigate the degree of Post-traumatic Stress (PTSD) symptoms caused by the pandemic in students selected from schools in Sichuan, Jiangsu, Henan, Yunnan, and Chongqing provinces of China. RESULTS A total of 7769 students(3692 male and 4077 female), aged 8-18 years, were enrolled in the study, comprising 1214 in primary schools, 2799 in junior high schools and 3756 in senior high schools. A total of 1639 students (21.1%) had severe psychological stress reactions. A large proportion of senior high school students (23.3%) experienced severe psychological stress, and they had the highest median total CRIES-13 score. Female students were more likely to experience severe psychological stress and had higher median CRIES-13 total scores than males. CONCLUSION COVID-19 has placed psychological stresses on primary and secondary school students in China. These stresses are more likely to reach severe levels among female students and senior high school students.
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Affiliation(s)
- Hanmei Xu
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Hang Zhang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Lijuan Huang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Xiaolan Wang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Xiaowei Tang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Yanping Wang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Qingqing Xiao
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 Sichuan China
| | - Ping Xiong
- Chengdu Engineering Technical Vocational School, Chengdu, 610300 Sichuan China
| | - Rongqiu Jiang
- Chengdu Vocational & Technical College of Industry, Chengdu, Sichuan 610218 China
| | - Jie Zhan
- Xuchuan Middle School, Zigong, 643000 Sichuan China
| | - Fang Deng
- The Fourth People’s Hospital of Chengdu, Chengdu, 610036 Sichuan China
| | - Mingya Yu
- Jiangsu Academy of Educational Sciences, Nanjing, 210013 Jiangsu China
| | - Dong Liu
- Wenquan Second Central Primary School, Donghai County, Lianyungang, 222315 Jiangsu China
| | - Xuejun Liu
- Jiangsu Shuangdian Primary School, Rudong County, Nantong, 226404 Jiangsu China
| | - Chunli Zhang
- The Sixth Middle School of Jianshui County, Honghe Prefecture, Jianshui County, 654300 Yunnan China
| | - Wenjun Wang
- Egongyan Primary School, Jiulongpo District, Chongqing, 404000 China
| | - Lu Li
- The 12th Elementary School of Nanyang City, Nanyang, 473002 Henan China
| | - Hongmei Cao
- Hou Central School, Xuzhou, 221000 Jiangsu China
| | - Wenchao Zhang
- grid.263906.8The primary School Attached to SouthWest University, Chongqing, 400700 China
| | - Hongping Zhou
- Chengdu Shuangliu Yongan Middle School, Chengdu, 610219 Sichuan China
| | - Wo Wang
- grid.203458.80000 0000 8653 0555University-Town Hospital of Chongqing Medical University, Chongqing, 401331 China
| | - Li Yin
- Mental Health Center, West China Hospital of Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041, Sichuan, China. .,Institute for System Genetics, Frontiers Science Center for Disease-related Molecular Network, Chengdu, 610041, Sichuan, China.
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Welner M, Burgess A, O'Malley KY. Psychiatric and legal considerations in cases of Fetal Abduction by Maternal Evisceration. J Forensic Sci 2021; 66:1805-1817. [PMID: 34156091 DOI: 10.1111/1556-4029.14788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/29/2022]
Abstract
Fifteen cases of Fetal Abduction by Maternal Evisceration (FAMAE) reported to the National Center for Missing and Exploited Children during 1987-2011 outline the findings from a review of the forensic psychiatric considerations and legal course of each of the cases. Most offenders confessed to law enforcement within a short time of being placed under arrest in statements reflecting a continued effort to manage impressions and minimize culpability. Psychiatric assessment is invariably central to the legal disposition of FAMAE cases, as the defendant's goal is to diminish the perception of culpability/criminal responsibility and mitigate sentencing. Of those sentenced in the United States, nine defendants received life without parole, two received the death penalty (one executed), and one received a minimum of 30 years. Two abductors committed suicide and were not sentenced. Proffered diagnoses at trial included psychogenic amnesia, pseudocyesis, dissociative disorder, and delusional disorder; however, these rarely stood up to court scrutiny. Psychiatric experts showed the greatest variance in diagnosis over what to call the feigned pregnancy. In addition to delusional disorder and dissociative disorder, pseudocyesis, factitious disorder/pregnancy, pseudopregnancy, schizophrenia, and PTSD were among the various diagnoses proposed. A differential diagnosis for many FAMAE offenders may also include borderline personality disorder. Future research accounting for those women claiming false pregnancy who do not become homicidal will clarify whether FAMAE is the extreme endpoint of a fertility identity disorder.
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Affiliation(s)
| | - Ann Burgess
- School of Nursing, Boston College, Chestnut Hill, MA, USA
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Ajdacic-Gross V, Ajdacic L, Xu Y, Müller M, Rodgers S, Wyss C, Olbrich S, Buadze A, Seifritz E, Wagner EYN, Radovanovic D, von Wyl V, Steinemann N, Landolt MA, Castelao E, Strippoli MPF, Gholamrezaee MM, Glaus J, Vandeleur C, Preisig M, von Känel R. Backtracing persistent biomarker shifts to the age of onset: A novel procedure applied to men’s and women’s white blood cell counts in post-traumatic stress disorder. Biomark Neuropsychiatry 2021. [DOI: 10.1016/j.bionps.2021.100030] [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: 11/28/2022] Open
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Chin DL, Zeber JE. Mental Health Outcomes Among Military Service Members After Severe Injury in Combat and TBI. Mil Med 2021; 185:e711-e718. [PMID: 31889174 DOI: 10.1093/milmed/usz440] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/25/2019] [Accepted: 11/06/2019] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Studies examining the mental health outcomes of military personnel deployed into combat zones have focused on the risk of developing post-traumatic stress disorder conferred by mild or moderate traumatic brain injury (TBI). However, other mental health outcomes among veterans who sustained critical combat injuries have not been described. MATERIALS AND METHOD We examined the associations of moderate and severe TBI and combat injury with the risk for anxiety and mood disorders, adjustment reactions, schizophrenia and other psychotic disorders, cognitive disorders, and post-traumatic stress disorder. We conducted a retrospective cohort study of U.S. military service members critically injured in combat during military operations in Iraq and Afghanistan from February 1, 2002, to February 1, 2011. Health care encounters from (1) the Department of Defense (DoD) Trauma Registry (TR), (2) acute and ambulatory care in military facilities, and (3) civilian facilities are reimbursed by Tricare. Service members who sustained severe combat injury require critical care. We estimated the risk of mental health outcomes using risk-adjusted logit models for demographic and clinical factors. We explored the relationship between TBI and the total number of mental health diagnoses. RESULTS Of the 4,980 subjects who met inclusion criteria, most injuries occurred among members of the Army (72%) or Marines (25%), with mean (SD) age of 25.5(6.1) years. The prevalence of moderate or severe TBI was 31.6% with explosion as the most common mechanism of injury (78%). We found 71% of the cohort was diagnosed with at least one poor mental health condition, and the adjusted risk conferred by TBI ranged from a modest increase for anxiety disorder (odds ratio, 1.27; 95% confidence interval [CI], 1.11-1.45) to a large increase for cognitive disorder (odds ratio, 3.24; 95% CI, 2.78-3.77). We found TBI was associated with an increased number of mental health diagnoses (incidence rate ratio, 1.52; 95% CI, 1.42-1.63). CONCLUSIONS Combat-associated TBI may have a broad effect on several mental health conditions among critically injured combat casualties. Early recognition and treatment for trauma-associated mental health are crucial to improving outcomes among service personnel as they transition to post-deployment care in the DoD, Department of Veterans Affairs, or community health systems.
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Affiliation(s)
- David L Chin
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 N. Pleasant Street, Amherst, MA 01003
| | - John E Zeber
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 N. Pleasant Street, Amherst, MA 01003.,Central Texas Veterans Health Care System, Temple TX 76504
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Childhood adversity trajectories and PTSD in young adulthood: A nationwide Danish register-based cohort study of more than one million individuals. J Psychiatr Res 2021; 136:274-280. [PMID: 33621913 DOI: 10.1016/j.jpsychires.2021.02.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/05/2021] [Accepted: 02/12/2021] [Indexed: 12/18/2022]
Abstract
We examine the association between trajectories of childhood adversities and Post-Traumatic Stress Disorder (PTSD) using a register-based Danish cohort. The DANish LIFE Course (DANLIFE) cohort includes and prospectively follows all individuals born in Denmark from 1980. We estimated the rate of PTSD diagnosed from age 16, according to childhood adversity trajectories from age 0 to 16 (n = 1 277 548). Trajectories were previously defined into 5 groups: Low Adversity, Early Life Material Deprivation, Persistent Material Deprivation, Loss or Threat of Loss, And High Adversity. We then estimated adjusted relative hazard ratios (aHR), and absolute hazards differences of PTSD according to childhood adversity trajectories in adjusted survival analysis. All analyses were stratified by sex. Individuals were followed for a median of 10·1 years a fter their 16th birthday, and 4966 individuals were diagnosed with PTSD. Compared with the low adversity group, children exposed to childhood adversity were more likely to be diagnosed with PTSD. The aHR for PTSD varied from 1·4 (95% CI: 1·3-1·5) in the Early Life Material Deprivation group, to 3·7 (3·3-4·1) in the High Adversity group, which corresponds to 8·3 extra cases of PTSD per 10 000 person years. The relative associations were comparable in men and women, but approximately twice as many women compared with men were affected. We report a clear association between exposure to childhood adversities and PTSD in young adulthood. The highest burden was among women in the high adversity group.
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Xu Y, Vandeleur C, Müller M, Seifritz E, Kleim B, von Känel R, Wagner EYN, Strippoli MPF, Castelao E, Gholamrezaee MM, Preisig M, Ajdacic-Gross V. Retrospectively assessed trajectories of PTSD symptoms and their subsequent comorbidities. J Psychiatr Res 2021; 136:71-79. [PMID: 33578109 DOI: 10.1016/j.jpsychires.2021.01.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/11/2021] [Accepted: 01/29/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Dynamic trajectories of psychopathology, such as post-traumatic stress disorder (PTSD) provide a key to understanding human adjustment processes after trauma exposure. Recent studies have suggested more heterogeneous mental health outcomes than the initially identified four adjustment trajectories. To explore this heterogeneity, we investigated the after-trauma adjustment patterns of psychopathology based on retrospective lifetime data. This was first carried out on the PTSD symptoms (PTSS, including no symptoms, few symptoms, partial and full PTSD), and secondly together with their post-trauma comorbidities. METHODS Data of trauma and the post-trauma mental disorders were collected for a large and randomly selected community sample, resulting in a N = 960 trauma-exposed subsample. Pattern recognition as carried out by latent class analysis (LCA) was implemented on this subsample. LCA was first exploited to identify the potential trajectory patterns of PTSS and next to explore the patterns of mental adjustments when additional post-trauma comorbid disorders, such as anxiety, mood and substance use disorders, were assessed. RESULTS Four PTSS trajectory patterns were found, namely resilient, chronic, recovered, and delayed onset, consistent with findings from longitudinal PTSD studies. When post-trauma comorbidities were evaluated, other than the trajectory pattern of delayed onset which retained a low comorbidity profile, the other three split respectively and paired up with either low, moderate or high comorbidity profile. CONCLUSIONS Mental health outcomes after trauma exposure were considerably more complex than the four previously established adjustment trajectories. Here, we uncovered additional and more heterogeneous adjustment patterns comprised of PTSS trajectories and post-trauma comorbidity profiles.
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Affiliation(s)
- Yanhua Xu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
| | - Caroline Vandeleur
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Birgit Kleim
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - En-Young N Wagner
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marie-Pierre F Strippoli
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mehdi M Gholamrezaee
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
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Ferretti F, Gualtieri G, Bossini L, Olivola M, Del Matto L, Desantis S, Fagiolini A, Pozza A, Coluccia A. Convergence between clinician-rated and patient-reported PTSD symptoms in a specialized outpatient service: The moderator role of gender. Perspect Psychiatr Care 2021; 57:761-769. [PMID: 32853435 DOI: 10.1111/ppc.12611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/02/2020] [Accepted: 08/14/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Posttraumatic stress disorder (PTSD) includes different symptoms: re-experiencing, avoidance of reminders and numbing, and hyperarousal. Although questionnaires are widely used, clinician-administered interviews provide a more comprehensive exploration of symptoms. Few studies examined the convergence between clinician-rated and patient-reported general severity and symptoms, with mixed findings. We explored the association between clinician-rated and patient-reported general severity and symptoms and the moderator role of gender in PTSD patients referred to a specialized outpatient service. DESIGN AND METHODS The Clinician-Administered PTSD Scale and Davidson Trauma Scale were administered to 56 patients. FINDINGS Patients classified by clinicians as with higher avoidance/numbing symptoms and women classified with higher hyperarousal symptoms reported higher general severity. PRACTICE IMPLICATIONS The assessment of the patients reporting high severity should focus on hyperarousal, particularly for women.
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Affiliation(s)
- Fabio Ferretti
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Giacomo Gualtieri
- Legal Medicine Unit, Santa Maria alle Scotte University Hospital of Siena, Siena, Italy
| | - Letizia Bossini
- Department of Molecular Medicine, School of Medicine, University of Siena, Siena, Italy.,Department of Mental Health, University of Siena Medical Center (AOUS), Siena, Italy
| | - Miriam Olivola
- Department of Molecular Medicine, School of Medicine, University of Siena, Siena, Italy.,Department of Mental Health, University of Siena Medical Center (AOUS), Siena, Italy
| | - Laura Del Matto
- Department of Molecular Medicine, School of Medicine, University of Siena, Siena, Italy.,Department of Mental Health, University of Siena Medical Center (AOUS), Siena, Italy
| | - Serena Desantis
- Department of Molecular Medicine, School of Medicine, University of Siena, Siena, Italy.,Department of Mental Health, University of Siena Medical Center (AOUS), Siena, Italy
| | - Andrea Fagiolini
- Department of Molecular Medicine, School of Medicine, University of Siena, Siena, Italy
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Anna Coluccia
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
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46
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Dhungana S, Koirala R, Ojha SP, Thapa SB. Quality of life and its association with psychiatric disorders in outpatients with trauma history in a tertiary hospital in Kathmandu, Nepal: a cross-sectional study. BMC Psychiatry 2021; 21:98. [PMID: 33593325 PMCID: PMC7885479 DOI: 10.1186/s12888-021-03104-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/16/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Quality of life is an important indicator of health and has multiple dimensions. It is adversely affected in patients with trauma history, and psychiatric disorders play an important role therein. Studies in trauma-affected populations focus mainly on the development of psychiatric disorders. Our study explored various aspects of quality of life in trauma patients in a clinical setting, mainly focusing on the association of psychiatric disorders on various domains of quality of life. METHODS One hundred patients seeking help at the psychiatry outpatient of a tertiary hospital in Kathmandu, Nepal, and with history of trauma were interviewed using the World Health Organization Composite International Diagnostic Interview version 2.1 for trauma categorization. Post-traumatic stress disorder symptoms were assessed using the Post-Traumatic Stress Disorder Checklist-Civilian Version; while the level of anxiety and depression symptoms was assessed using the 25-item Hopkins Symptom Checklist-25. Quality of life was assessed using the World Health Organization Quality Of Life-Brief Version measure. Information on sociodemographic and trauma-related variables was collected using a semi-structured interview schedule. The associations between psychiatric disorders and quality of life domains were explored using bivariate analyses followed by multiple regressions. RESULTS The mean scores (standard deviations) for overall quality of life and health status perception were 2.79 (.87) and 2.35 (1.11), respectively. The mean scores for the physical, psychological, social and environmental domains were 12.31 (2.96), 11.46 (2.84), 12.79 (2.89), and 13.36 (1.79), respectively. Natural disaster was the only trauma variable significantly associated with overall quality of life, but not with other domains. Anxiety, depression and post-traumatic stress disorder were all significantly associated with various quality of life domains, where anxiety had the greatest number of associations. CONCLUSION Quality of life, overall and across domains, was affected in various ways based on the presence of psychiatric disorders such as anxiety, depression and post-traumatic stress disorder in patients with trauma. Our findings therefore emphasize the need to address these disorders in a systematic way to improve the patients' quality of life.
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Affiliation(s)
- Saraswati Dhungana
- Department of Psychiatry and Mental Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal. .,Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Rishav Koirala
- grid.5510.10000 0004 1936 8921Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,Brain and Neuroscience Center, Kathmandu, Nepal
| | - Saroj Prasad Ojha
- grid.80817.360000 0001 2114 6728Department of Psychiatry and Mental Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Suraj Bahadur Thapa
- grid.80817.360000 0001 2114 6728Department of Psychiatry and Mental Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal ,grid.5510.10000 0004 1936 8921Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,grid.55325.340000 0004 0389 8485Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Baroni C, Lionetti V. The impact of sex and gender on heart-brain axis dysfunction: current concepts and novel perspectives. Can J Physiol Pharmacol 2021; 99:151-160. [PMID: 33002366 DOI: 10.1139/cjpp-2020-0391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The heart-brain axis (HBA) recapitulates all the circuits that regulate bidirectional flow of communication between heart and brain. Several mechanisms may underlie the interdependent relationship involving heterogeneous tissues at rest and during specific target organ injury such as myocardial infarction, heart failure, arrhythmia, stroke, mood disorders, or dementia. In-depth translational studies of the HBA dysfunction under single-organ injury should include both male and female animals to develop sex- and gender-oriented prevention, diagnosis, and treatment strategies. Indeed, sex and gender are determining factors as females and males exhibit significant differences in terms of susceptibility to risk factors, age of onset, severity of symptoms, and outcome. Despite most studies having focused on the male population, we have conducted a careful appraisal of the literature investigating HBA in females. In particular, we have (i) analyzed sex-related heart and brain illnesses, (ii) recapitulated the most significant studies simultaneously conducted on cardio- and cerebro-vascular systems in female populations, and (iii) hypothesized future perspectives for the development of a gender-based approach to HBA dysfunction. Although sex- and gender-oriented research is at its infancy, the impact of sex on HBA dysfunction is opening unexpected new avenues for managing the health of female subjects exposed to risk of lifestyle multi-organ disease.
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Affiliation(s)
- Carlotta Baroni
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Vincenzo Lionetti
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
- UOS Anesthesiology and Intensive Care Medicine, Fondazione Toscana G. Monasterio, Pisa, Italy
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48
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Ricciardelli R, Czarnuch S, Afifi TO, Taillieu T, Carleton RN. Public Safety Personnel's interpretations of potentially traumatic events. Occup Med (Lond) 2021; 70:155-161. [PMID: 32040152 PMCID: PMC7252499 DOI: 10.1093/occmed/kqaa007] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Many public safety personnel (PSP) experience trauma directly or indirectly in their occupational role, yet there remain barriers to accessing care or seeking help. Aims To understand how PSP interpret different potentially traumatic events and how perceived eligibility for being traumatized is determined among PSP. Methods We analysed open-ended comments provided by over 800 PSP in a survey designed to assess the prevalence of post-traumatic stress injuries and other mental disorders. Results We found evidence that a trauma hierarchy may exist among PSP. Certain experiences may be interpreted as more traumatic, based on both the event and the PSP role in the actual event. For example, involvement in a shooting may be interpreted as more traumatic than arriving on the scene later. Similarly, a single event may be deemed more traumatic than an accumulation of events. The role of the individual and social context in shaping experiences and interpretations of trauma may be largely ignored in line with confirmation biases. Conclusions The role that individuals and social contexts play in shaping experiences and interpretations of trauma appear suppressed by perceptions of a trauma hierarchy, facilitating systematic discrediting or valuation of some experiences, therein evidencing that trauma is subjective and reinforcing barriers to care seeking. A trauma hierarchy may also propagate stigma and legitimize discrimination regarding mental health. We argue that recognizing, engaging with, and dismantling the perception of a trauma hierarchy may help create a respectful and open occupational culture supportive of mental health needs.
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Affiliation(s)
- R Ricciardelli
- Department of Sociology, Memorial University of Newfoundland, St. John's, Newfoundland A1C 5S7, Canada
| | - S Czarnuch
- Department of Electrical and Computer Engineering and Discipline of Emergency Medicine, Memorial University of Newfoundland, St. John's, Newfoundland A1C 5S7, Canada
| | - T O Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba R3E 0W3, Canada
| | - T Taillieu
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba R3E 0W3, Canada
| | - R N Carleton
- Department of Psychology, University of Regina, Regina, Saskatchewan S4S 0A2, Canada
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49
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Boelen PA. Dampening of positive affect is associated with posttraumatic stress following stressful life events. Eur J Psychotraumatol 2021; 12:1851077. [PMID: 33505637 PMCID: PMC7817208 DOI: 10.1080/20008198.2020.1851077] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Treatments for posttraumatic stress (PTS) are effective for many but not all people. There is a continued need to further our understanding of psychological mechanisms involved in the development and maintenance of PTS. Research has examined dysregulation of negative affect (NA) in PTS but relatively little attention has been paid to the role of dysregulation of positive affect (PA) in PTS. Objective: The current study sought to examine the incremental role of PA dysregulation - specifically self-focused and emotion-focused rumination (strategies to upregulate PA) and dampening (a strategy downregulating PA) in explaining variance in PTS, while taking into account neuroticism, plus more often-researched processes of NA regulation (i.e. brooding and reflection) and experiential acceptance and mindfulness - broader regulatory styles involved in PTS. Method: Data were available from 473 students who completed measures about stressful life events experienced, PTS, and measures of PA dysregulation and all other variables of interest. Results: Zero order correlations showed that dampening of PA but not self-focused and emotion-focused regulation of PA were associated with PTS total scores and PTS clusters of re-experiencing, avoidance, and hyperarousal. Multiple regression analyses revealed, among other things, that dampening of PA, neuroticism, brooding, and mindfulness (but not emotion-focused and self-focused rumination about PA, reflection, and experiential acceptance) explained unique proportions of variance in PTS when taking into account the shared variance between these variables. Conclusions: Future research may continue addressing difficulties in regulating PA alongside difficulties regulating NA to improve the understanding of mechanisms maintaining PTS and to examine the usefulness of interventions improving PA regulation in the treatment of PTS.
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Affiliation(s)
- Paul A Boelen
- Department of Clinical Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands.,ARQ National Psychotrauma Centre, Diemen, The Netherlands
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50
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Broder JC, Gao CX, Campbell TCH, Berger E, Maybery D, McFarlane A, Tsoutsoulis J, Ikin J, Abramson MJ, Sim MR, Walker J, Luhar A, Carroll M. The factors associated with distress following exposure to smoke from an extended coal mine fire. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 266:115131. [PMID: 32682019 DOI: 10.1016/j.envpol.2020.115131] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/17/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
In February 2014, the coalmine adjacent to the Hazelwood Power Station in the Latrobe Valley of Victoria, Australia, caught fire, with residents from the nearby town of Morwell and the wider area exposed to smoke for six weeks. Although there was evidence linking the mine-fire event with psychological distress, no studies have evaluated the degree of distress in relation to the level of smoke exposure. We aimed to investigate the exposure-response relationship between particulate matter 2.5 μm or less in diameter (PM2.5) released during the Hazelwood mine fire event and long-term symptoms of posttraumatic distress in the affected community, including the consideration of other key factors. A total of 3096 Morwell residents, and 960 residents from the largely unexposed comparison community of Sale, were assessed for symptoms of posttraumatic distress 2.5 years after the Hazelwood incident using the Impact of Events Scale-Revised (IES-R). Individual-level PM2.5 exposure was estimated by mapping participants' self-reported location data on modelled PM2.5 concentrations related to the mine fire. Multivariate linear regression was used to evaluate the exposure-response relationship. Both mean and peak exposure to mine fire-related PM2.5 were found to be associated with participant IES-R scores with an interaction effect between age and mean PM2.5 exposure also identified. Each 10 μg/m3 increase in mean PM2.5 exposure corresponded to a 0.98 increase in IES-R score (95% CI: 0.36 to 1.61), and each 100 μg/m3 increase in peak PM2.5 exposure corresponded to a 0.36 increase (95% CI: 0.06 to 0.67). An age-effect was observed, with the exposure-response association found to be stronger for younger adults. The results suggest that increased exposure to PM2.5 emissions from the Hazelwood mine fire event was associated with higher levels of psychological distress associated with the mine fire and the most pronounced effect was on younger adults living in the affected community.
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Affiliation(s)
- Jonathan C Broder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Caroline X Gao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia; Orygen, Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Timothy C H Campbell
- Monash Rural Health Churchill, Monash University, Northways Road, Churchill, Victoria, 3842, Australia
| | - Emily Berger
- Faculty of Education, Monash University, 29 Ancora Imparo Way, Clayton, Victoria, 3800, Australia
| | - Darryl Maybery
- Monash Rural Health, Monash University, 15 Sargeant Street, Warragul, Victoria, 3820, Australia
| | - Alexander McFarlane
- Centre for Traumatic Stress Studies, The University of Adelaide, 30 Frome Road, South Australia, 5005, Australia
| | - Jessica Tsoutsoulis
- Monash Rural Health, Monash University, 15 Sargeant Street, Warragul, Victoria, 3820, Australia
| | - Jillian Ikin
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Michael J Abramson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Judi Walker
- Monash Rural Health Churchill, Monash University, Northways Road, Churchill, Victoria, 3842, Australia
| | - Ashok Luhar
- Aerosol and Chemistry Modelling, Climate Science Centre, CSIRO Oceans and Atmosphere, 107-121 Station Street, Aspendale, Victoria, 3195, Australia
| | - Matthew Carroll
- Monash Rural Health Churchill, Monash University, Northways Road, Churchill, Victoria, 3842, Australia.
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