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Liu J, Teh WL, Tan RHS, Chang SSH, Lau BJ, Chandwani N, Tor PC, Subramaniam M. Evaluating a maladaptive personality-informed model of social support and post-traumatic stress disorder. J Affect Disord 2024; 361:209-216. [PMID: 38821368 DOI: 10.1016/j.jad.2024.05.164] [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: 01/06/2024] [Revised: 04/23/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Social support is a robust predictor of post-traumatic stress disorder (PTSD). Although the inverse relationship between perceived social support and PTSD (social causation model) is supported, less is understood about the antecedents of the social causation model. Further, there is limited research in non-Western psychiatric populations that experience elevated rates of trauma and PTSD (e.g., mood disorders). The present study evaluated whether cumulative traumatic life events influenced current PTSD symptoms through maladaptive personality traits and perceptions of social support among Asian patients with mood disorders. METHODS A total of 200 Asian patients (77.5 % Chinese) with mood disorders were assessed for maladaptive personality traits, perceptions of social support, cumulative traumatic life events, PTSD, and depressive symptoms. Structural equation modelling was conducted to evaluate the extended social causation model. RESULTS The extended social causation model demonstrated acceptable fit to the data (Comparative Fit Index [CFI] = 0.90; absolute Root Mean Square Error of Approximation [RMSEA] = 0.08). There were significant indirect effects of cumulative traumatic life events on current PTSD symptoms (β = 0.29, p < .001; 85 % variance explained) and depressive symptoms (β = 0.28, p < .001; 69 % variance explained). LIMITATIONS Results may not be generalizable beyond the Singapore population due to the socio-cultural and environmental context. CONCLUSIONS The present findings provide conceptual support for a maladaptive personality-informed model of social support and PTSD, which could better inform trauma-focused interventions in preventing and treating the debilitating effects of PTSD in psychiatric populations.
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Affiliation(s)
- Jianlin Liu
- Research Division, Institute of Mental Health, Singapore.
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore
| | | | | | - Boon Jia Lau
- Department of Mood & Anxiety, Institute of Mental Health, Singapore
| | - Nisha Chandwani
- Department of Mood & Anxiety, Institute of Mental Health, Singapore
| | - Phern Chern Tor
- Department of Mood & Anxiety, Institute of Mental Health, Singapore
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Bourassa KJ, Sbarra DA. Trauma, adversity, and biological aging: behavioral mechanisms relevant to treatment and theory. Transl Psychiatry 2024; 14:285. [PMID: 38997260 PMCID: PMC11245531 DOI: 10.1038/s41398-024-03004-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 06/20/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
Although stress and adversity are largely universal experiences, people exposed to greater hardship are at increased risk for negative health consequences. Recent studies identify accelerated biological aging as a mechanism that could explain how trauma and adversity gives rise to poor health, and advances in this area of study coincide with technological innovations in the measurement of biological aging, particularly epigenetic profiles consistent with accelerated aging derived from DNA methylation. In this review, we provide an overview of the current literature examining how adversity might accelerate biological aging, with a specific focus on social and health behaviors. The most extensive evidence in this area suggests that health-compromising behaviors, particularly smoking, may partially explain the association between adversity and accelerated aging. Although there is relatively less published support for the role of social behaviors, emerging evidence points to the importance of social connection as a mechanism for future study. Our review highlights the need to determine the extent to which the associations from adversity to accelerated aging are consistent with causal processes. As we consider these questions, the review emphasizes methodological approaches from the causal inference literature that can help deepen our understanding of how stress and trauma might result in poor health. The use of these methodologies will help provide evidence as to which behavioral interventions might slow aging and improve health, particularly among populations that more often experience adversity and trauma.
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Affiliation(s)
- Kyle J Bourassa
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA.
- Geriatric Research, Education, and Clinical Center, Durham Veteran Affairs (VA) Health Care System, Durham, NC, USA.
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA.
| | - David A Sbarra
- Department of Psychology, University of Arizona, Tucson, AZ, USA
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Borgers T, Rinck A, Enneking V, Klug M, Winter A, Gruber M, Kraus A, Dohm K, Leehr EJ, Grotegerd D, Förster K, Goltermann J, Bauer J, Dannlowski U, Redlich R. Interaction of perceived social support and childhood maltreatment on limbic responsivity towards negative emotional stimuli in healthy individuals. Neuropsychopharmacology 2024:10.1038/s41386-024-01910-6. [PMID: 38951584 DOI: 10.1038/s41386-024-01910-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 06/16/2024] [Accepted: 06/18/2024] [Indexed: 07/03/2024]
Abstract
Childhood maltreatment (CM) is associated with increased limbic activity, while social support is linked to decreased limbic activity towards negative stimuli. Our study aimed to explore the interaction of perceived social support with CM, and their combined impact on limbic activity in negative emotion processing. A total of 130 healthy individuals (HC) underwent a negative emotional face processing paradigm. They were divided into two groups based on the Childhood Trauma Questionnaire: n = 65 HC without CM matched with n = 65 HC with CM. In a region-of-interest approach of the bilateral amygdala-hippocampus-complex (AHC), regression analyses investigating the association of CM and perceived social support with limbic activity and a social support x CM ANCOVA were conducted. CM was associated with increased AHC activity, while perceived social support tended to be associated with decreased AHC activity during negative emotion processing. The ANCOVA showed a significant interaction in bilateral AHC activity (pFWE ≤ 0.024) driven by a negative association between perceived social support and bilateral AHC activity in HC without CM. No significant association was observed in HC with CM. Exploratory analyses using continuous CM scores support this finding. Our results suggest that CM moderates the link between perceived social support and limbic activity, with a protective effect of perceived social support only in HC without CM. The lack of this effect in HC with CM suggests that CM may alter the buffering effect of perceived social support on limbic functioning, highlighting the potential need for preventive interventions targeting social perception of HC with CM.
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Affiliation(s)
- Tiana Borgers
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
| | - Anne Rinck
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Melissa Klug
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Anna Kraus
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Förster
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jochen Bauer
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychology, University of Halle, Münster, Germany
- German Center for Mental Health (Deutsches Zentrum für Psychische Gesundheit), Halle, Germany
- Center for Intervention and Research on adaptive and maladaptive brain circuits underlying mental health (C-I-R-C), Halle, Germany
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Wang L, Chen Y, Li Z, Zhou Y, Li J, Lv X, Yu Z, Gao X. The Influences of Adverse Childhood Experiences and Social Support on Male Teenagers' Gaming Motivation: A Moderated Network Analysis. J Pediatr Health Care 2024; 38:486-496. [PMID: 38456863 DOI: 10.1016/j.pedhc.2024.02.002] [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: 07/18/2023] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Strong gaming motivations can lead to gaming-related health problems, but how gaming motivations are formed is unclear. Therefore, we examined the impact of early life experiences on gaming motivations. METHODS Questionnaire data on the gaming motivations, adverse childhood experiences, and social support of 2,171 teenaged online game players were modeled using moderated network analysis. RESULTS All adverse childhood experience components positively correlated with achievement and escapism motivations (weight range: 0.08-0.40). Social support from friends (weight = -0.04) negatively moderated the relationship between achievement motivation and other adverse childhood experiences and positively moderated (weight = 0.01) the relationship between escapism motivation and familial dysfunction. DISCUSSION The findings indicate that adverse childhood experiences foster negative gaming motivations. Additionally, social support moderates the relationship between adverse childhood experiences and gaming motivations. These findings offer valuable insights that nursing practitioners can apply to gaming-related health problem interventions and prevention in teenagers.
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Affiliation(s)
- Ling Wang
- Ling Wang, Psychological counselor, Faculty of Psychology, Southwest University, Chongqing, China.; Ling Wang, Psychological counselor, Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China
| | - Yanyuan Chen
- Yanyuan Chen, Vice president of Huawei Technical School, Chongqing, China
| | - Zhen Li
- Zhen Li, Psychological counselor, School of Education, Sichuan Vocational and Technical College, Suining, China
| | - Yuhong Zhou
- Yuhong Zhou, Psychological counselor, Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiayu Li
- Jiayu Li, Psychological counselor, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xin Lv
- Xin Lv, Faculty of Psychology, Southwest University, Chongqing, China
| | - Zhixiang Yu
- Zhixiang Yu, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xuemei Gao
- Xuemei Gao, Professor of psychology, Faculty of Psychology, Southwest University, Chongqing, China.; Xuemei Gao, Professor of psychology, Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing, China..
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Yoshino Y, Unoki T, Hata K, Ito K. Association of social support before ICU admission with postdischarge mental health symptoms in ICU patients: a single-centre prospective cohort study in Japan. BMJ Open 2024; 14:e082810. [PMID: 38904131 PMCID: PMC11191801 DOI: 10.1136/bmjopen-2023-082810] [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: 12/21/2023] [Accepted: 05/31/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVES Mental health problems after discharge from the intensive care unit (ICU) interfere with physical recovery and seriously affect daily life. Social support has been suggested to be associated with mental health but has not been sufficiently characterised. This study aimed to evaluate the association of social support before ICU admission with mental health after ICU discharge. DESIGN Prospective cohort study. SETTING Medical-surgical ICU of a hospital in Japan. PARTICIPANTS Patients admitted to the ICU for more than 48 hours were surveyed on social support prior to ICU admission, and 3 months after discharge from the ICU, mental health questionnaires were mailed to the patient. PRIMARY OUTCOME MEASURES Post-traumatic stress disorder (PTSD)-related symptoms were measured using the Impact of Event Scale-Revised, and anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale. RESULTS A total of 153 patients were enrolled; the prevalence of PTSD-related symptoms, anxiety and depressive symptoms 3 months after discharge from the ICU was 11.3%, 14.0% and 24.6%, respectively. Multivariate analysis using linear regression models adjusted for age, sex and years of education for PTSD-related symptoms, anxiety and depressive symptoms revealed that social support (β=-0.018, 95% CI: -0.029 to 0.006, p=0.002) and female sex (β=0.268, 95% CI: 0.005 to 0.531, p=0.046) were independent factors associated with the severity of depressive symptoms. In addition, sex differences were observed in the association between depressive symptoms and social support (p for interaction=0.056). CONCLUSIONS Higher social support before ICU admission was not associated with PTSD symptoms after ICU discharge, although it may be associated with a lower prevalence depressive symptoms after ICU discharge. Therefore, it is important to provide necessary social support when needed.
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Affiliation(s)
- Yasuyo Yoshino
- Department of Nursing, Komazawa Women's University, Inagi, Tokyo, Japan
- Doctoral Program, Graduate School of Nursing, Sapporo City University, Sapporo, Hokkaido, Japan
| | - Takeshi Unoki
- Department of Adult Health Nursing, School of Nursing, Sapporo City University, Sapporo, Hokkaido, Japan
| | - Kimiko Hata
- Yokosuka General Hospital Uwamachi, Yokosuka, Kanagawa, Japan
| | - Kiyoe Ito
- Yokosuka General Hospital Uwamachi, Yokosuka, Kanagawa, Japan
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Handelzalts JE, Kalfon-Hakhmigari M, Raichin A, Peled Y. Postpartum acute stress disorder symptoms, social support, and quality of couple's relationship associations with childbirth PTSD. Front Psychiatry 2024; 15:1310114. [PMID: 38915847 PMCID: PMC11194715 DOI: 10.3389/fpsyt.2024.1310114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 05/09/2024] [Indexed: 06/26/2024] Open
Abstract
Background We aimed to examine the hypothesized negative associations between childbirth post-traumatic stress disorder (PTSD) symptoms (using the two-factor model of birth-related and general symptoms), social support, and a couple's relationship quality at 8-12 weeks postpartum. This analysis considered the longitudinal positive shared variance with acute stress disorder (ASD) symptoms measured shortly after birth, while accounting for obstetric and demographic variables. Methods Participants included 246 mothers who gave birth at the maternity ward of a tertiary healthcare center. Self-report questionnaires were used 1-4 days postpartum (T1): Demographic information, the Birth Satisfaction Scale-Revised (BSS-R), and the National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS). At T2 (8-12 weeks postpartum), the Multidimensional Scale of Perceived Social Support (MSPSS), the Dyadic Adjustment Scale (DAS-7), and the City Birth Trauma Scale (BiTS). Results In partial support of our hypotheses, three hierarchical regression analyses revealed a significant positive contribution of ASD symptoms to childbirth PTSD general symptoms (β = .33, p <.001) and the total score (β = .29, p <.001), but not to birth-related symptoms. Social support (β = -.21, p = .003) and the quality of the couple's relationship (β=-.20, p = .003) showed negative associations with the BiTS general symptoms. Conclusion Our study enhances understanding of the shared variance between childbirth ASD and PTSD, supporting the factor structure of general and birth-related symptoms as different aspects of childbirth PTSD and highlighting the negative association of social support and the quality of a couple's relationship with PTSD general symptoms, suggesting potential avenues for targeted interventions.
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Affiliation(s)
- Jonathan E. Handelzalts
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yaffo, Tel-Aviv, Israel
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | | | - Adi Raichin
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yaffo, Tel-Aviv, Israel
| | - Yoav Peled
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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7
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Meuleman EM, Karremans JC, van Ee E. Stronger together: the longitudinal relations between partner responsiveness, dyadic coping and PTSD recovery. Eur J Psychotraumatol 2024; 15:2358682. [PMID: 38836379 PMCID: PMC11155418 DOI: 10.1080/20008066.2024.2358682] [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: 11/16/2023] [Accepted: 05/12/2024] [Indexed: 06/06/2024] Open
Abstract
Background: Past research has primarily focused on negative associations between PTSD and relationships. Therefore, this investigation delves into the potential positive role of these relational aspects in aiding PTSD recovery during treatment.Objective: This study aimed to examine the impact of dyadic coping and perceived partner responsiveness on treatment trajectories of PTSD patients.Method: The study included 90 participants, who were requested to complete online questionnaires twice, with a six-month gap between the measures.Results: The results from linear regression analyses indicated that perceived partner responsiveness had a positive effect on PTSD recovery, whereas dyadic coping had the opposite effect: higher levels of dyadic coping were associated with an increase in posttraumatic stress symptoms over time. Additional examination of the subscales indicated that heightened communication between clients and partners regarding stress was related with increased posttraumatic stress symptoms.Conclusions: These findings underscore the importance and complexity of effective and supportive communication between patients with PTSD and their partners. While existing literature supports both perceived partner responsiveness and dyadic coping as beneficial, this study indicates that only perceived partner responsiveness positively impacted PTSD recovery.
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Affiliation(s)
- Eline M. Meuleman
- Psychotraumacentrum Zuid-Nederland, 's-Hertogenbosch, the Netherlands
| | - Johan C. Karremans
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Elisa van Ee
- Psychotraumacentrum Zuid-Nederland, 's-Hertogenbosch, the Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
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Serier KN, Zhao Z, Vogt D, Kehle-Forbes S, Smith BN, Mitchell KS. The impact of stress and well-being during the COVID-19 pandemic on mental health in U.S. veterans. Stress Health 2024; 40:e3357. [PMID: 38126682 DOI: 10.1002/smi.3357] [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: 05/11/2023] [Revised: 09/15/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023]
Abstract
The COVID-19 pandemic disrupted life around the globe and negatively impacted mental health (MH), including among military veterans. Building on previous research with U.S. veterans, the present study examined the association between a broad array of pandemic stressors and well-being on MH outcomes. A total of 372 veterans (51.3% women) from all service eras completed measures of posttraumatic stress disorder and depression during early (timepoint 1 [T1]) and peri-pandemic (timepoint 2 [T2]) periods. Pandemic-related stressors and well-being (satisfaction in life domains) were assessed at the peri-pandemic timepoint (T2). Logistic regression analyses were used to investigate associations between stressors and well-being with the likelihood of a probable MH diagnosis at T2 controlling for T1 MH status. More negative physical and MH impacts of the pandemic in addition to fewer positive consequences and lower satisfaction with paid work, finances, health, romantic relationships, and social life were associated with a higher likelihood of a probable T2 MH diagnosis. COVID infection was associated with lower odds of a probable T2 MH diagnosis. There were significant indirect effects, such that physical and MH impacts of the pandemic were associated with T2 MH via well-being. Overall, these findings highlight the role of stress and well-being on MH during a global pandemic. Interventions to address well-being may be important to address veteran MH during other periods of stress. Future research should examine the generalizability of study findings and further investigate factors that contribute to veterans' MH resilience during stressful life experiences.
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Affiliation(s)
- Kelsey N Serier
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Ziyu Zhao
- National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Dawne Vogt
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Shannon Kehle-Forbes
- Minneapolis VA Healthcare System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Brian N Smith
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Karen S Mitchell
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
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Dowgwillo EA, Ruchensky JR. The influence of trauma symptoms on interpersonal attributions in daily life. J Trauma Stress 2024; 37:410-421. [PMID: 38538306 DOI: 10.1002/jts.23036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 06/14/2024]
Abstract
There is well-documented evidence that trauma exposure can disrupt relationships. However, limited research has examined whether posttraumatic stress symptoms (PTSS) moderate interpersonal processes in daily life. To this end, undergraduates (N = 98) completed a measure of PTSS at baseline. They then completed smartphone-based surveys after every interpersonal interaction that lasted longer than 3 min. for 10 days. These surveys assessed perceptions of self and other agency and communion as well as feelings of rejection, neglect, abandonment, worthlessness, emptiness, guilt, and shame. Results of multilevel modeling suggest that interpersonal perception and PTSS predicted 10%-26% of the variance in outcomes. Regarding agency, more agentic participants reported higher levels of negative attributions, γs = .47-.56. Participants also reported higher rejection and guilt when they experienced their interaction partner as more agentic than usual, γs = .07, and PTSS did not moderate these associations. For communal perceptions, participants who experienced themselves and others as warmer than other participants reported fewer negative outcomes, γs = -.44--.58. Individuals also reported more negative outcomes when they experienced themselves and others as warmer than they usually did, γs = -.10--.28, and PTSS moderated these associations. The negative associations between self- and other communion ratings and feelings of neglect, abandonment, and shame were stronger in individuals with higher PTSS scores. Together, these findings support continued efforts to understand the ways in which trauma exposure and PTSS disrupt interpersonal dynamics in daily life.
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Affiliation(s)
- Emily A Dowgwillo
- Department of Psychology, University of Detroit Mercy, Detroit, Michigan, USA
| | - Jared R Ruchensky
- Department of Psychology, Sam Houston State University, Huntsville, Texas, USA
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Zhang D, Yuan T, Huang A, Li X, Yang L, Wang C, Liu M, Lei Y, Sun L, Li J, Zhang L, Zhang J. Validation of the Chinese version of the Oslo-3 Social Support Scale among nursing students: a study based on Classical Test Theory and Item Response Theory models. BMC Nurs 2024; 23:360. [PMID: 38816705 PMCID: PMC11137908 DOI: 10.1186/s12912-024-02033-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/21/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Nursing students are encountering a range of health issues. Assessing social support is a key component in most questionnaire surveys related to health status, aiming to investigate the relationships and mechanisms between health status and social support to enhance overall health. Therefore, it is essential to seek out appropriate instruments to evaluate social support for nursing students. The Oslo-3 Social Support Scale (OSSS-3) is a reliable and concise instrument for evaluating social support. To date, there have been no studies validating the OSSS-3 based on Item Response Theory (IRT) models. Also, an officially validated Chinese version has not been found. The current research intended to verify the Chinese version of the OSSS-3. METHODS The OSSS-3 was translated into Chinese and culturally adapted. Subsequently, the OSSS-3 was validated by employing the Classical Test Theory (CTT) and IRT models. RESULTS The split-half reliability was 0.622. The Cronbach's α coefficient was 0.687. The correlations between each item and total scores varied from 0.723 to 0.835. The retest coefficient was 0.907. The content validity index was 0.933. A single common factor was extracted and accounted for 61.559% of the variance. The item loading values on the single factor were between 0.743 and 0.814. The communalities were between 0.552 and 0.663. There was no variance between males and females (P = 0.055). The difference in scores between the top (30%) and bottom (30%) groups attained significance. IRT models results revealed that the discrimination parameters ranged from 1.39 to 2.33 and difficulty parameters increased monotonically. CONCLUSION The OSSS-3 demonstrates satisfying psychometric properties and is a proper instrument for measuring social support in Chinese nursing students.
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Affiliation(s)
- Dongmei Zhang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Yijiang District, Wuhu City, Anhui Province, P.R. China
| | - Ting Yuan
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Yijiang District, Wuhu City, Anhui Province, P.R. China
| | - Anle Huang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Yijiang District, Wuhu City, Anhui Province, P.R. China
| | - Xiaoping Li
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Yijiang District, Wuhu City, Anhui Province, P.R. China
| | - Liu Yang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Yijiang District, Wuhu City, Anhui Province, P.R. China
| | - Congzhi Wang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Yijiang District, Wuhu City, Anhui Province, P.R. China
| | - Mingming Liu
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Yijiang District, Wuhu City, Anhui Province, P.R. China
| | - Yunxiao Lei
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Yijiang District, Wuhu City, Anhui Province, P.R. China
| | - Lu Sun
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Yijiang District, Wuhu City, Anhui Province, P.R. China
| | - Jing Li
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Yijiang District, Wuhu City, Anhui Province, P.R. China
| | - Lin Zhang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Yijiang District, Wuhu City, Anhui Province, P.R. China.
| | - Jing Zhang
- Nursing Department, the People's Hospital of Yingshang, 566 Ganluo Road, Chengbei New District, Yingshang County, Anhui Province, P.R. China.
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de Dios-Duarte MJ, Arias A, Barrón A. Impact of Psychosocial Factors on the Activity of Crohn's Disease: A Cross-Sectional Analysis of Social Support, Stress, and Flare-Up Incidence. J Clin Med 2024; 13:3086. [PMID: 38892797 PMCID: PMC11172725 DOI: 10.3390/jcm13113086] [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: 04/02/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: Crohn's disease is a chronic and debilitating intestinal disorder that alternates between remission and active flare-ups, often leading to hospitalization. Social support is known to enhance adaptation to the disease and modulate stress perception in patients, while stress may exacerbate symptoms. The aim of this study was to examine the roles of perceived stress and social support in Crohn's disease and their impact on the frequency of flare-ups. Methods: A cross-sectional observational study was conducted, assessing stress and social support in a cohort of 91 patients with Crohn's disease during flare-up and remission phases. The Perceived Stress Scale (PSS-14) and a Social Support Questionnaire were utilized for evaluation. We examined the relationship between stress and social support in Crohn's disease. The interaction between the variables studied was also observed, considering the stage of the disease. Finally, we carried out an analysis of the influence of these two variables on the development of flare-ups in Crohn's disease. Results: The study revealed that patients experience higher stress levels during flare-ups and that these levels are amplified by a lack of social support. A significant relationship was identified between the levels of social support and the occurrence of flare-ups, indicating that better social support is associated with fewer flare-ups. Conclusions: Patients with Crohn's disease in the flare-up phase are subject to considerable stress. A deficit in social support is linked to an increase in stress levels. The interaction between social support and stress plays a critical role in the development of flare-ups.
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Affiliation(s)
| | - Andrés Arias
- Faculty of Social Work, Social Work Department, Complutense University of Madrid, 28223 Madrid, Spain;
| | - Ana Barrón
- Faculty of Psychology, Social Psychology Department, Complutense University of Madrid, 28223 Madrid, Spain;
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Tinsae T, Shumet S, Tadesse G, Takelle GM, Rtbey G, Melkam M, Andualem F, Nakie G, Segon T, Koye S, Fentahun S, Alemu WG. Post-traumatic stress disorder in the Ethiopian population dwelling in war-affected communities: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1399013. [PMID: 38784164 PMCID: PMC11112411 DOI: 10.3389/fpsyt.2024.1399013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
Background Post-traumatic stress disorder (PTSD) is a significant mental health concern globally, particularly prevalent in populations exposed to war and conflict. This systematic review and meta-analysis aim to examine the prevalence and factors associated with PTSD among the Ethiopian population residing in war-affected communities. Methods The review was reported according to the PRISMA guidelines. Related eligible published articles were searched in electronic online databases such as PubMed, Scopus, Web of Science, MEDLINE/PubMed, Scopus, Embase, Science Direct, Web of Science, Google Scholar, and Google, which reported the prevalence and risk factors of PTSD among people dwelling in the war-affected area until January 2024. The relevant data was extracted using a Microsoft Excel spreadsheet. The meta-analysis was conducted using STATA version 11. The estimated pooled prevalence and risk factors were estimated using a random effect model. The potential risk of publication bias was checked using a funnel plot and Egger's statistical test. Results A total of nine published studies with 6107 participants were analyzed in this meta-analysis. The estimated pooled prevalence of PTSD among people living in war-affected areas was 48.4%, with a 95% CI (37.1, 59.8). This study found a higher prevalence of PTSD among women than men. Being female (OR= 2.2, 95% CI: 1.2, 4.3), witnessing a murder of a loved one (OR= 3.0, 95% CI: 1.2, 7.5), depression symptoms (OR= 2.8, 95% CI: 1.4, 5.6), and anxiety symptoms (OR= 3.4, 95% CI: 1.4, 8.0), a close family member killed or seriously injured (OR= 3.1, 95% CI: 1.2, 7.7), a moderate and high perceived threat to life (OR= 3.4, 95% CI: 1.3, 9.1), and poor social support (OR= 4.4, 95% CI: 1.1, 18.7) were associated with post-traumatic stress disorder. Conclusion The result of this study shows the high prevalence rate of PTSD in people living in war-affected areas. disparities in PTSD prevalence, with women being at higher risk, and identified risk factors were witnessing the murder of a loved one, experiencing depression and anxiety, and perceived threat to life. Addressing PTSD in war-affected communities requires comprehensive interventions that consider both individual and contextual factors. Systematic review registration www.crd.york.ac.uk/PROSPERO/, identifier CRD42024501384.
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Affiliation(s)
- Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Shegaye Shumet
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gebresilassie Tadesse
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Girmaw Medfu Takelle
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gidey Rtbey
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Girum Nakie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Segon
- Department of Psychiatry, Mattu University, Mettu, Ethiopia
| | - Selam Koye
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Wondale Getinet Alemu
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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13
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Laustsen LM, Ejlskov L, Chen D, Lasgaard M, Gradus JL, Østergaard SD, Grønkjær MS, Plana-Ripoll O. Interaction between mental disorders and social disconnectedness on mortality: a population-based cohort study. Br J Psychiatry 2024:1-8. [PMID: 38708564 DOI: 10.1192/bjp.2024.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
BACKGROUND Despite the recognised importance of mental disorders and social disconnectedness for mortality, few studies have examined their co-occurrence. AIMS To examine the interaction between mental disorders and three distinct aspects of social disconnectedness on mortality, while taking into account sex, age and characteristics of the mental disorder. METHOD This cohort study included participants from the Danish National Health Survey in 2013 and 2017 who were followed until 2021. Survey data on social disconnectedness (loneliness, social isolation and low social support) were linked with register data on hospital-diagnosed mental disorders and mortality. Poisson regression was applied to estimate independent and joint associations with mortality, interaction contrasts and attributable proportions. RESULTS A total of 162 497 individuals were followed for 886 614 person-years, and 9047 individuals (5.6%) died during follow-up. Among men, interaction between mental disorders and loneliness, social isolation and low social support, respectively, accounted for 47% (95% CI: 21-74%), 24% (95% CI: -15 to 63%) and 61% (95% CI: 35-86%) of the excess mortality after adjustment for demographics, country of birth, somatic morbidity, educational level, income and wealth. In contrast, among women, no excess mortality could be attributed to interaction. No clear trends were identified according to age or characteristics of the mental disorder. CONCLUSIONS Mortality among men, but not women, with a co-occurring mental disorder and social disconnectedness was substantially elevated compared with what was expected. Awareness of elevated mortality rates among socially disconnected men with mental disorders could be of importance to qualify and guide prevention efforts in psychiatric services.
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Affiliation(s)
- Lisbeth Mølgaard Laustsen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Linda Ejlskov
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Danni Chen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Mathias Lasgaard
- DEFACTUM - Public Health Research, Central Denmark Region, Aarhus, Denmark; and Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Jaimie L Gradus
- Boston University School of Public Health, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
| | - Søren Dinesen Østergaard
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Marie Stjerne Grønkjær
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Oleguer Plana-Ripoll
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; and National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
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14
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Yang J, Gao Y, Wang W, Wang J, Wang Y, Yuan L. Interventions to address parenting stress among caregivers of children with chronic diseases: An umbrella review. J Clin Nurs 2024; 33:1626-1646. [PMID: 38323676 DOI: 10.1111/jocn.17060] [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: 01/14/2023] [Revised: 12/15/2023] [Accepted: 01/23/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Caregivers of children with chronic diseases suffer from great parenting pressure, which directly affects the treatment and rehabilitation of children, reduces the quality of life of caregivers and damages family functioning. Existing reviews have not systematically summarized and evaluated interventions for parenting stress in caregivers of children with chronic diseases. DATA SOURCES Embase, PubMed, Web of Science, OVID, CNKI, CBM, Wan Fang and Cochrane Library were searched for eligible reviews in November 2021 and October 2022. METHODS Two reviewers independently screened titles and abstracts, reviewed full texts of articles for eligibility, and appraised the quality of reviews using JBI. The quality of the evidence was assessed using GRADE. Findings are reported in accordance with PRISMA checklist. Narrative summaries grouped findings by intervention types. RESULTS Out of 2632 records, we included 21 systematic reviews for a synthesis. Interventions for parenting stress in children with chronic diseases were divided into seven categories. Cognitive behavioural interventions, psychosocial interventions, child behavioural and/or developmental parent interventions and synthesized interventions have shown high-level evidence in reducing parenting stress for caregivers of children with chronic diseases. Furthermore, outcome measures and intervention protocols were highly heterogeneous across interventions. CONCLUSIONS This umbrella review suggest that reducing the parenting stress of caregivers of children with chronic diseases can directly target caregivers' parenting stress through cognitive behavioural interventions/psychosocial interventions and/or provide guidance to parents on the behavioural and developmental problems of children with chronic diseases. A more standardized approach to outcome measures is essential to assess efficacy and compare interventions across studies. RELEVANCE TO CLINICAL PRACTICE The findings provide information and evidence for reducing parenting stress among caregivers of children with chronic diseases to guide the development of comprehensive intervention strategies. PATIENT OR PUBLIC CONTRIBUTION Patient or public contribution does not apply to this study.
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Affiliation(s)
- Jinrong Yang
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yuqin Gao
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, China
| | - Weiren Wang
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, China
| | - Junyan Wang
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, China
| | - Yanjie Wang
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, China
| | - Lulu Yuan
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning Province, China
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15
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Chen JA, Shofer J, Barnes ML, Livingston WS, Upham M, Simpson TL. Military Sexual Trauma As a Risk Factor for Treatment Non-Response from an Online, Self-Management Posttraumatic Stress Disorder Treatment for Women Veterans. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:2214-2237. [PMID: 38073465 DOI: 10.1177/08862605231216722] [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: 12/17/2023]
Abstract
Women veterans are exposed to high rates of trauma, including military sexual trauma (MST), and face unique barriers to posttraumatic stress disorder (PTSD) treatment. Telehealth interventions that are tailored to women veterans' unique lived experiences may improve treatment engagement and outcomes. It is important to ascertain how beneficial new telehealth interventions are in the context of different patient characteristics and trauma types, particularly for lower-intensity telehealth interventions (e.g., web-based programs or apps). This secondary analysis of a randomized clinical trial conducted in a sample of 102 women veterans examines predictors of treatment response to a self-management, telehealth intervention for PTSD: Delivery of Self Training and Education for Stressful Situations-Women Veterans (DESTRESS-WV). In the trial, women veterans with PTSD received either an online cognitive behavioral intervention with phone coaching, or phone monitoring alone. We examined associations between baseline patient characteristics (demographics, trauma types, and clinical symptoms) and treatment outcome at post-treatment, 3 months, and 6 months, focusing on the association between treatment outcome and MST. Our primary outcomes were changes in PTSD (PTSD Symptom Checklist, Version 5, PCL-5) and depression (8-item Patient Health Questionnaire, PHQ-8) in the full sample, adjusting for treatment condition. Women veterans who identified MST as the primary trauma for which they were seeking PTSD treatment experienced a nearly nine-point lesser improvement on the PCL-5 than those seeking PTSD treatment for other trauma types (e.g., childhood abuse, combat trauma; p = .0073). Similar patterns were found for depression symptoms. To our knowledge, this is the first study to examine the association between trauma type and treatment outcomes within the context of a self-management, telehealth treatment for PTSD. While the study was not powered to examine differential treatment response for patient subgroups, our exploratory findings suggest that gaps remain in providing effective PTSD care for women veterans who experienced MST.Trial registration: The trial and analysis plan were preregistered in ClinicalTrials.gov (Identifier: NCT02917447).
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Affiliation(s)
- Jessica A Chen
- VA Puget Sound Healthcare System, Seattle, WA, USA
- University of Washington School of Medicine, Seattle, WA, USA
| | - Jane Shofer
- VA Puget Sound Healthcare System, Seattle, WA, USA
- University of Washington School of Medicine, Seattle, WA, USA
| | | | - Whitney S Livingston
- National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System, Jamaica Plain, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | | | - Tracy L Simpson
- VA Puget Sound Healthcare System, Seattle, WA, USA
- University of Washington School of Medicine, Seattle, WA, USA
- Center of Excellence in Substance Addiction Treatment & Education, VA Puget Sound Healthcare System, Seattle, WA, USA
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16
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Weiss-Dagan S, Taubman-Ben-Ari O. Perceived stress and personal growth following the transition to military service: The role of sense of coherence and perceived social support. Stress Health 2024:e3406. [PMID: 38646939 DOI: 10.1002/smi.3406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/04/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
Relying on personal growth and structuration theories, we aimed to examine the internal (sense of coherence/SOC and help-seeking/HS) and external (perceived social support) resources that contribute to soldiers' personal growth following the transition to military service. We also investigated the role that perceived social support plays in moderating the relationship between SOC and personal growth, and between HS and personal growth. Two-hundred-and-seventy-one compulsory service soldiers (of whom 135 were men and 136 were women) completed self-report questionnaires between 6 and 12 months post-recruitment. The results showed both linear and curvilinear associations between soldiers' perceived stress and personal growth; SOC, HS, and perceived social support were positively correlated with personal growth; and perceived social support moderated both SOC and HS correlations with personal growth. Empirical evidence of personal growth in the transition to military service has been scant. Transitioning from civilian life to military service can be stressful and even traumatic but it can also provide opportunities for personal development. Our findings shed light on contributors to personal growth in the transition to military service, with both internal and external resources found to help one gain personal growth. It is evident that in order for soldiers to thrive, both perceived social support and active help-seeking are key factors.
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Affiliation(s)
- Shlomit Weiss-Dagan
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat-Gan, Israel
| | - Orit Taubman-Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, Ramat-Gan, Israel
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17
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Mao Y, Chen J, Liu X, Dang J, Schiöth HB. Social support predicted subsequent subjective well-being during the COVID-19 pandemic: a prospective study. BMC Public Health 2024; 24:943. [PMID: 38566183 PMCID: PMC10986123 DOI: 10.1186/s12889-024-18473-2] [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: 04/19/2023] [Accepted: 03/28/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Subjective well-being (SWB) is associated with social support in cross-sectional studies. However, it remains unclear whether and how social support predicts SWB longitudinally, especially during the COVID-19 contingency. METHODS By adopting a prospective design, the current work addressed this research question in a sample of 594 participants from the U.K. The data were collected via the online platform, Prolific, at two time points (June, 2020 and August, 2021) with a 14-month interval. Descriptive analysis and a moderated mediation model were conducted to test the proposed hypotheses. RESULTS Baseline social support was a significant predictor of subjective well-being (SWB) 14 months later, even after controlling for baseline SWB and other covariates such as personality traits. Additionally, affect balance (i.e., the affective component of SWB) fully mediated the link between baseline social support and subsequent life satisfaction (i.e., the cognitive component of SWB). Moreover, household income moderated this relationship, indicating a stronger mediation for individuals with lower monthly household income. CONCLUSION The present work sheds light on the underlying mechanism and boundary condition of the association between social support and different components of SWB during the COVID-19 pandemic.
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Affiliation(s)
- Yanhui Mao
- Institute of Applied Psychology, Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, China
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Junpeng Chen
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Xinqi Liu
- Institute of Applied Psychology, Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, China
| | - Junhua Dang
- School of Education, Huaibei Normal University, Anhui, China.
- Anhui Engineering Research Center for Intelligent Computing and Application on Cognitive Behavior (ICACB), Anhui, China.
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Helgi B Schiöth
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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18
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Sippel LM, Liebman RE, Schäfer SK, Ennis N, Mattern AC, Rozek DC, Monson CM. Sources of Social Support and Trauma Recovery: Evidence for Bidirectional Associations from a Recently Trauma-Exposed Community Sample. Behav Sci (Basel) 2024; 14:284. [PMID: 38667080 PMCID: PMC11047467 DOI: 10.3390/bs14040284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/27/2024] [Accepted: 03/21/2024] [Indexed: 04/29/2024] Open
Abstract
Although the association between post-traumatic stress disorder (PTSD) and social support is well documented, few studies have tested the causal pathways explaining this association at several points in the acute post-trauma recovery period or examined whether the association varies for different sources of social support. To address these gaps, 151 community individuals (mean age = 37.20 years, 69.5% women) exposed to trauma within the previous 6 months were recruited to complete measures of PTSD and social support from intimate partners, friends, and relatives four times in 1 year. In line with recent recommendations for research on social support and PTSD symptoms, random intercept cross-lagged panel modeling (RI-CLPM) was used to examine dynamic changes between PTSD severity and social support over time. The pattern of RI-CLPM cross-lagged coefficients indicated that positive deviations from one's expected stable level of total social support (across all sources) sped up the recovery of PTSD symptoms at the end of the post-trauma year, and more severe PTSD symptoms than expected based on one's expected stable level of PTSD started eroding social support midway through the assessment year. When specific sources of social support were analyzed separately, the association between within-person increases in social support from friends at any given time point accelerated the recovery from PTSD across the entire year. Among participants with intimate partners (n = 53), intimate partner support did not predict PTSD symptoms, but more severe PTSD symptoms at any given time point predicted less support at the following time point. Results from this longitudinal study provide additional support for the bidirectional relationship between PTSD and social support over time and suggest that perceived social support from friends may be especially helpful during trauma recovery.
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Affiliation(s)
- Lauren M. Sippel
- Department of Veterans Affairs Northeast Program Evaluation Center, West Haven, CT 06516, USA
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
- National Center for PTSD, West Haven, CT 06516, USA
| | - Rachel E. Liebman
- Centre for Mental Health, University Health Network, Toronto, ON M5G 2C4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Department of Psychology, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
| | - Sarah K. Schäfer
- Leibniz Institute for Resilience Research, 55122 Mainz, Germany
- Technische Universität Braunschweig, 38106 Braunschweig, Germany
| | - Naomi Ennis
- Department of Psychology, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
| | - Alexandra C. Mattern
- VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, USA
| | - David C. Rozek
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Candice M. Monson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
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19
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Howe ES, Dworkin ER. The day-to-day relationship between posttraumatic stress symptoms and social support after sexual assault. Eur J Psychotraumatol 2024; 15:2311478. [PMID: 38376992 PMCID: PMC10880566 DOI: 10.1080/20008066.2024.2311478] [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: 05/24/2023] [Accepted: 12/21/2023] [Indexed: 02/22/2024] Open
Abstract
Background: Experiencing sexual assault is associated with a significant increase in risk for developing posttraumatic stress disorder and related concerns (e.g. alcohol misuse). Cross-sectional and longitudinal evidence suggests that social support may be both broadly protective against and eroded by posttraumatic stress symptoms. However, little is known about how different aspects of social support and posttraumatic stress symptoms influence each other in the weeks and months immediately following sexual assault, when posttraumatic stress (PTS) symptoms first emerge.Objective: The present study assessed the day-to-day relationship between social support and PTS in a sample of distressed, alcohol-using, recently-assaulted female survivors participating in a clinical trial of an app-based intervention (N = 41).Method: Participants completed 3 weeks of daily diaries starting within 10 weeks of sexual assault. Mixed-effects models were used to examine prior-day and same-day relationships between PTS and four social support constructs (social contact, emotional support, pleasantness of social interactions, and talking about sexual assault).Results: Results indicate that higher quantity and pleasantness of social interactions over the full sampling period was associated with lower PTS symptoms on any given day. Experiencing better-than-typical social interactions on one day was associated with lower than typical PTS symptoms on that day and the next day. On days when participants discussed their sexual assault with others, they tended to be having higher than usual PTS symptoms.Conclusions: Findings suggest that increasing the quantity and pleasantness of social interactions soon after sexual assault might protect against worsening posttraumatic stress symptoms.Trial registration: ClinicalTrials.gov identifier: NCT03703258.
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Affiliation(s)
- Esther S. Howe
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Emily R. Dworkin
- Department of Psychiatry & Behavioral Science, University of Washington School of Medicine, Seattle, WA, USA
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20
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Zhang D, Li X, Zhang M, Huang A, Yang L, Wang C, Yuan T, Lei Y, Liu H, Hua Y, Zhang L, Zhang J. The mediating effect of resilience and COVID-19 anxiety on the relationship between social support and insomnia among healthcare workers: a cross-sectional study. Front Psychiatry 2024; 15:1328226. [PMID: 38414504 PMCID: PMC10896830 DOI: 10.3389/fpsyt.2024.1328226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/29/2024] [Indexed: 02/29/2024] Open
Abstract
Background Insomnia in healthcare workers has become a topic of concern in the health system. The high infectivity and longevity of the COVID-19 pandemic have resulted in great pressure and a high incidence of insomnia among healthcare workers. Insomnia among healthcare workers has a negative impact on high-quality healthcare services in addition to their health. Thus, it's necessary to explore insomnia's underlying mechanisms. Object The present research's aims were threefold: explored the association between social support, resilience, COVID-19 anxiety, and insomnia among healthcare workers during the pandemic, elucidated the underlying mechanism of insomnia, and offered recommendations for improving the health of these workers. Materials and methods A cross-sectional design was adopted. From May 20 to 30, 2022, 1038 healthcare workers were selected to fill out the Oslo 3-item Social Support Scale, the eight-item Athens Insomnia Scale, the Coronavirus Anxiety Scale, and the Brief Resilience Scale. Descriptive statistics and correlations were analyzed by SPSS 25.0. Mediation analysis was conducted by Mplus 8.3 using 5000 bootstrap samples. Results Of the participating 1038 healthcare workers, the prevalence of insomnia was 41.62% (432/1038). Significant associations were found involving insomnia, resilience, COVID-19 anxiety, and social support. Insomnia was directly affected by social support. Moreover, three indirect pathways explain how social support affected insomnia: resilience's mediating role, COVID-19 anxiety's mediating role, and the chain-mediation role of resilience and COVID-19 anxiety. Conclusion The results validated our hypotheses and supported the opinion of Spielman et al. 's three-factor model of insomnia. Social support of healthcare workers has an indirect impact on insomnia in addition to its direct one via independent and chain-mediation effects of resilience and COVID-19 anxiety.
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Affiliation(s)
- Dongmei Zhang
- School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Xiaoping Li
- School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ming Zhang
- School of Innovation and Entrepreneurship, Wannan Medical College, Wuhu, Anhui, China
| | - Anle Huang
- School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Liu Yang
- School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Congzhi Wang
- School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Ting Yuan
- School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Yunxiao Lei
- School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Haiyang Liu
- Student Health Center, Wannan Medical College, Wuhu, Anhui, China
| | - Ying Hua
- School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Lin Zhang
- School of Nursing, Wannan Medical College, Wuhu, Anhui, China
| | - Jing Zhang
- Nursing Department, The People's Hospital of Yingshang, Yingshang, Anhui, China
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21
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Sorjonen K, Melin B. Spurious prospective effects between general and domain-specific self-esteem: A reanalysis of a meta-analysis of longitudinal studies. PLoS One 2024; 19:e0298158. [PMID: 38349888 PMCID: PMC10863855 DOI: 10.1371/journal.pone.0298158] [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: 05/05/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
A recent meta-analysis, of 38 studies with data from 43 independent samples (total N = 24,668), claimed evidence for positive reciprocal prospective effects, and hence for both top-down and bottom-up processes, between general and domain-specific self-esteem. However, the meta-analytic cross-lagged effects were estimated while adjusting for a prior measurement of the outcome variable and it is known that such adjusted cross-lagged effects may be spurious due to correlations with residuals and regression to the mean. In the present reanalyses, we found all of the prospective effects to be spurious. Consequently, claims about increasing prospective effects and top-down and bottom-up processes between general and domain-specific self-esteem can be questioned. It is important for researchers to be aware of the limitations of cross-lagged panel analyses, and of analyses of correlational data in general, in order not to overinterpret findings.
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Affiliation(s)
- Kimmo Sorjonen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Bo Melin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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22
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Muysewinkel E, Vesentini L, Van Deynse H, Vanclooster S, Bilsen J, Van Overmeire R. A day in the life: psychological impact on emergency responders during the 22 March 2016 terrorist attacks. Front Psychiatry 2024; 15:1353130. [PMID: 38410678 PMCID: PMC10894950 DOI: 10.3389/fpsyt.2024.1353130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction Terrorist attacks can cause severe long-term mental health issues that need treatment. However, in the case of emergency responders, research is often vague on the type of stressors that emergency responders encounter. For example, in addition to the threat that they work under, studies have shown that ill-preparation adds to the stress experienced by emergency responders. However, few studies have looked into the experience of emergency responders. In this study, we looked at the experience of emergency responders during the 22 March 2016 terrorist attacks in Belgium. Methods We used a qualitative design, in which we interviewed different types of emergency responders. Police officers, nurses, soldiers, firefighters, and Red Cross volunteers were included. Interviews were coded by two researchers and analyzed using a thematic approach. Results Four large themes were developed: constant threat and chaos, frustrations with lack of preparedness and training, ethical decisions, and debriefings. In addition, although emergency responders encountered constant threat, they often felt that they were ill-prepared for such attacks. One specific example was their lack of training in tourniquet usage. Furthermore, in a disaster setting, the emergency responders had to make life-and-death decisions for which they were not always prepared. Finally, debriefings were conducted in the aftermath of the attacks. Whereas most were perceived as positive, the debriefings among police officers were viewed as insufficient. Conclusions Emergency responding to terrorist attacks has many different dimensions of events that can cause stress. Our study revealed that preparation is key, not only in terms of material but also in terms of ethics and debriefings.
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Affiliation(s)
- Emilie Muysewinkel
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Public Health, Vrije Universiteit Brussel, Brussel, Belgium
| | - Lara Vesentini
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Helena Van Deynse
- Department of Public Health, Vrije Universiteit Brussel, Brussel, Belgium
| | - Stephanie Vanclooster
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Roel Van Overmeire
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
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23
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Müller-Engelmann M, Bahnemann L, Kümmerle S. The effects of a combination of cognitive interventions and loving-kindness meditations (C-METTA) on guilt, shame and PTSD symptoms: results from a pilot randomized controlled trial. Eur J Psychotraumatol 2024; 15:2308439. [PMID: 38323870 PMCID: PMC10851818 DOI: 10.1080/20008066.2024.2308439] [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: 07/25/2023] [Accepted: 12/22/2023] [Indexed: 02/08/2024] Open
Abstract
Background: Trauma-related guilt and shame are crucial for the development and maintenance of PTSD (posttraumatic stress disorder). We developed an intervention combining cognitive techniques with loving-kindness meditations (C-METTA) that specifically target these emotions. C-METTA is an intervention of six weekly individual treatment sessions followed by a four-week practice phase.Objective: This study examined C-METTA in a proof-of-concept study within a randomized wait-list controlled trial.Method: We randomly assigned 32 trauma-exposed patients with a DSM-5 diagnosis to C-METTA or a wait-list condition (WL). Primary outcomes were clinician-rated PTSD symptoms (CAPS-5) and trauma-related guilt and shame. Secondary outcomes included psychopathology, self-criticism, well-being, and self-compassion. Outcomes were assessed before the intervention phase and after the practice phase.Results: Mixed-design analyses showed greater reductions in C-METTA versus WL in clinician-rated PTSD symptoms (d = -1.09), guilt (d = -2.85), shame (d = -2.14), psychopathology and self-criticism.Conclusion: Our findings support positive outcomes of C-METTA and might contribute to improved care for patients with stress-related disorders. The study was registered in the German Clinical Trials Register (DRKS00023470).
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Affiliation(s)
- Meike Müller-Engelmann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, Frankfurt/Main, Germany
- Faculty Human Sciences, Department Psychology, Medical School Hamburg, Hamburg, Germany
| | - Luisa Bahnemann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, Frankfurt/Main, Germany
| | - Stella Kümmerle
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe-University Frankfurt, Frankfurt/Main, Germany
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24
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van Stolk-Cooke K, Price M, Dyar C, Zimmerman L, Kaysen D. Associations of past-year overall trauma, sexual assault and PTSD with social support for young adult sexual minority women. Eur J Psychotraumatol 2024; 15:2287911. [PMID: 38293771 PMCID: PMC10833114 DOI: 10.1080/20008066.2023.2287911] [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: 06/01/2023] [Accepted: 11/11/2023] [Indexed: 02/01/2024] Open
Abstract
Background: Young adult sexual minority women (SMW) are at elevated risk for sexual assault (SA), posttraumatic stress disorder (PTSD), and inadequate social support. While SA and PTSD can lead to reductions in social support from close significant others, the impact of SA and PTSD on SMWs' social support has not previously been assessed.Objective: This study examined the associations of past year SA and PTSD with SMW's social support from intimate partners, family, and friends. It was hypothesized that SA and PTSD would be negatively associated with support from partners, family and friends, and that PTSD would moderate the effect of SA on support in early adulthood.Method: Young adult SMW in the United States (N = 235) who were M = 23.93 (SD = 2.15) years old, primarily lesbian or bisexual (n = 186, 79.1%) and White (n = 176, 74.9%) completed measures on past year exposure to SA and non-SA trauma, PTSD, and social support from intimate partners, family and friends.Results: PTSD was associated with less social support from partners, (b = -0.06, SE = 0.02, p = .010, R2change = .02), family, (b = -0.06, SE = 0.03, p = .025, R2change = .02), and friends, (b = -0.07, SE = 0.02, p = .008, R2change = .02). There was a significant interaction between PTSD and SA on social support from partners (b = -0.01, SE = 0.01, p = .047, R2change = .01). Neither non-SA nor SA trauma was associated with support from family or friends.Conclusions: Results underscore the potential impact of recent SA on intimate partnerships for young adult SMW with more severe PTSD. Future work should explore how addressing PTSD and improving social support quality may help SMW recover from traumatic experiences and ameliorate the effects of SA on intimate partnerships.
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Affiliation(s)
- Katherine van Stolk-Cooke
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
- Psychology Department, State University of New York (SUNY Geneseo), Geneseo, NY, USA
| | - Mathew Price
- Department of Psychological Sciences, University of Vermont, Burlington, VT, USA
| | - Christina Dyar
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Lindsey Zimmerman
- National Center for PTSD, Dissemination and Training Division, Palo Alto, CA, USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
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25
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Geuzinge R, Visse M, Vermetten E, Duyndam J. Differentiating social environments of high-risk professionals and specialised nurses: a qualitative empirical study on social embeddedness. Eur J Psychotraumatol 2024; 15:2306792. [PMID: 38289061 PMCID: PMC10829832 DOI: 10.1080/20008066.2024.2306792] [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: 07/29/2023] [Accepted: 01/08/2024] [Indexed: 02/01/2024] Open
Abstract
Objective: High-risk professionals and specialised nurses in hospitals are frequently exposed to potentially traumatic events. Psychotrauma researchers have extensively studied personal risk factors of traumatisation among high-risk professionals, but it is hard to understand psychological functioning when professionals are decontextualised from their social environment. Generally, it has been well documented that to reduce the risk of posttraumatic stress disorder (PTSD) or other mental health problems related to traumatisation, it is essential to be embedded in a supportive social environment. However, study results among and within these occupational groups show great variety and even inconsistencies as to what is a supportive social environment.Method: This ethnographical research, including participant observation, in-depth interviews, and document analysis, explored the social environment of firefighters, police officers, ambulance paramedics, specialised nurses, and military personnel and aims to explore their social connections and embeddedness. We performed a thematic content analysis of data to identify themes related to social or emotional support, social relationships, and stress or traumatisation.Results: An analysis of the observational field notes, which covered 332 h of participant observation and 71 evenly distributed formal in-depth interviews, identified four themes related to social connections and embeddedness: Family, Hierarchical relations versus autonomy, Group versus individual, and Conditional family 'love'. Results revealed that the military, police, and professional firefighters have family-like hierarchical connections and highly value group unity. Paramedics and most specialised nurses, however, tend to value individuality and autonomy in their work relationships.Conclusion: This research shows noticeable differences in the social environments and social connections of these professionals, which implicates that prevention and mental health treatment might also have to be differentiated among occupational groups.
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Affiliation(s)
- Renate Geuzinge
- Humanism and Social Resilience, University of Humanistic Studies, Utrecht, the Netherlands
| | - Merel Visse
- Care Ethics, University of Humanistic Studies, Utrecht, the Netherlands
| | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Joachim Duyndam
- Humanism and Social Resilience, University of Humanistic Studies, Utrecht, the Netherlands
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26
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Eid K, Bjørk MH, Gilhus NE, Torkildsen Ø. Adverse Childhood Experiences and the Risk of Multiple Sclerosis Development: A Review of Potential Mechanisms. Int J Mol Sci 2024; 25:1520. [PMID: 38338799 PMCID: PMC10855716 DOI: 10.3390/ijms25031520] [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: 12/20/2023] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Adverse childhood experiences (ACEs), such as abuse, neglect, and household dysfunction, contribute to long-term systemic toxic stress and inflammation that may last well into adulthood. Such early-life stressors have been associated with increased susceptibility to multiple sclerosis (MS) in observational studies and with the development of experimental autoimmune encephalomyelitis in animal models. In this review, we summarize the evidence for an ACE-mediated increase in MS risk, as well as the potential mechanisms for this association. ACEs dysregulate neurodevelopment, stress responses, and immune reactivity; they also alter the interplay between the immune system and neural networks. All of this may be relevant for MS risk. We further discuss how ACEs induce epigenetic changes and how the toxic stress caused by ACEs may reactivate the Epstein-Barr Virus (EBV), a key risk factor for MS. We conclude by suggesting new initiatives to obtain further insights into this topic.
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Affiliation(s)
- Karine Eid
- Department of Neurology, Haukeland University Hospital, Jonas Lies vei 71, 5053 Bergen, Norway; (M.-H.B.); (N.E.G.)
- Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway;
| | - Marte-Helene Bjørk
- Department of Neurology, Haukeland University Hospital, Jonas Lies vei 71, 5053 Bergen, Norway; (M.-H.B.); (N.E.G.)
- Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway;
- NorHead, Norwegian Center for Headache Research, 5021 Bergen, Norway
| | - Nils Erik Gilhus
- Department of Neurology, Haukeland University Hospital, Jonas Lies vei 71, 5053 Bergen, Norway; (M.-H.B.); (N.E.G.)
- Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway;
| | - Øivind Torkildsen
- Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway;
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, 5021 Bergen, Norway
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27
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Bourassa KJ, Garrett ME, Caspi A, Dennis M, Hall KS, Moffitt TE, Taylor GA, Ashley-Koch AE, Beckham JC, Kimbrel NA. Posttraumatic stress disorder, trauma, and accelerated biological aging among post-9/11 veterans. Transl Psychiatry 2024; 14:4. [PMID: 38184702 PMCID: PMC10771513 DOI: 10.1038/s41398-023-02704-y] [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: 10/10/2023] [Revised: 11/27/2023] [Accepted: 12/05/2023] [Indexed: 01/08/2024] Open
Abstract
People who experience trauma and develop posttraumatic stress disorder (PTSD) are at increased risk for poor health. One mechanism that could explain this risk is accelerated biological aging, which is associated with the accumulation of chronic diseases, disability, and premature mortality. Using data from 2309 post-9/11 United States military veterans who participated in the VISN 6 MIRECC's Post-Deployment Mental Health Study, we tested whether PTSD and trauma exposure were associated with accelerated rate of biological aging, assessed using a validated DNA methylation (DNAm) measure of epigenetic aging-DunedinPACE. Veterans with current PTSD were aging faster than those who did not have current PTSD, β = 0.18, 95% CI [0.11, 0.27], p < .001. This effect represented an additional 0.4 months of biological aging each year. Veterans were also aging faster if they reported more PTSD symptoms, β = 0.13, 95% CI [0.09, 0.16], p < 0.001, or higher levels of trauma exposure, β = 0.09, 95% CI [0.05, 0.13], p < 0.001. Notably, veterans with past PTSD were aging more slowly than those with current PTSD, β = -0.21, 95% CI [-0.35, -0.07], p = .003. All reported results accounted for age, gender, self-reported race/ethnicity, and education, and remained when controlling for smoking. Our findings suggest that an accelerated rate of biological aging could help explain how PTSD contributes to poor health and highlights the potential benefits of providing efficacious treatment to populations at increased risk of trauma and PTSD.
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Affiliation(s)
- Kyle J Bourassa
- Geriatric Research, Education, and Clinical Center, Durham VA Health Care System, Durham, USA.
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Health Care System, Durham, USA.
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, USA.
| | | | - Avshalom Caspi
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, US
- Department of Psychology and Neuroscience, Duke University, Durham, USA
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Center for the Study of Population Health & Aging, Duke University Population Research Institute, Durham, USA
| | - Michelle Dennis
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Health Care System, Durham, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, US
| | - Katherine S Hall
- Geriatric Research, Education, and Clinical Center, Durham VA Health Care System, Durham, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Health Care System, Durham, USA
- Department of Medicine, Division of Geriatrics, Duke University, Durham, USA
| | - Terrie E Moffitt
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, US
- Department of Psychology and Neuroscience, Duke University, Durham, USA
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Center for the Study of Population Health & Aging, Duke University Population Research Institute, Durham, USA
| | - Gregory A Taylor
- Geriatric Research, Education, and Clinical Center, Durham VA Health Care System, Durham, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Health Care System, Durham, USA
- Department of Integrative Immunobiology, Duke University Medical Center, Durham, USA
| | | | - Jean C Beckham
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Health Care System, Durham, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, US
| | - Nathan A Kimbrel
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Health Care System, Durham, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, US
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, USA
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28
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Tanrıkulu AB, Kaya H, Örüm MH, Akyıldırım S. Prevalence and determinants of post-traumatic stress disorder in patients with schizophrenia 2 years after an earthquake in Turkey. Int J Psychiatry Med 2024; 59:65-82. [PMID: 37272858 DOI: 10.1177/00912174231180467] [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] [Indexed: 06/06/2023]
Abstract
OBJECTIVES High rates of post-traumatic stress disorder (PTSD) have been observed in earthquake survivors many years after the event. However, its prevalence among patients with schizophrenia is largely unknown. This study, which was conducted two years after the 2020 Elazığ earthquake, sought to identify risk factors for earthquake-related PTSD among patients with schizophrenia and healthy subjects. METHODS Adult patients with schizophrenia (N = 103) and healthy subjects (N = 103) who had survived the earthquake were recruited from affected areas in the Eastern Anatolian Region of Turkey, Elazığ. A detailed questionnaire of earthquake-related risk factors, the Brief Coping Orientation to Problems Experienced (Brief COPE), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Clinician-Administered PTSD scale for DSM-V (CAPS-5) scale were administered to participants. RESULTS Twelve percent of the patients with schizophrenia and 25% of the healthy subjects had earthquake-related PTSD diagnoses two years after the 2020 Elazığ earthquake. Healthy subjects had a significantly higher rate of earthquake-related PTSD when compared to patients with schizophrenia. Religious coping, self-blaming, less emotional support seeking, and going to a safer place on the night of the earthquake were found to be associated with PTSD in patients with schizophrenia. History of traumatic events, self-blaming, and less social support from family were found to be associated with a PTSD diagnosis in healthy subjects. CONCLUSIONS The earthquake in Turkey created a situation such that significant symptoms of PTSD remained present at two years following the event in both patients diagnosed with schizophrenia and healthy subjects. Patients with schizophrenia have different risk factors for the development of PTSD when compared with healthy subjects. Clinical interventions should consider risk factors, coping strategies, and perceived social support when seeking to prevent earthquake-related PTSD.
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Affiliation(s)
- Ali Baran Tanrıkulu
- Department of Psychiatry, Elazığ Mental Health and Diseases Hospital, Elazığ, Turkey
| | - Hilal Kaya
- Department of Psychiatry, Elazığ Mental Health and Diseases Hospital, Elazığ, Turkey
| | - Mehmet Hamdi Örüm
- Department of Psychiatry, Elazığ Mental Health and Diseases Hospital, Elazığ, Turkey
| | - Sümeyya Akyıldırım
- Department of Psychiatry, Elazığ Mental Health and Diseases Hospital, Elazığ, Turkey
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29
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Chen Z, Song X, Lee TMC, Zhang R. The robust reciprocal relationship between loneliness and depressive symptoms among the general population: Evidence from a quantitative analysis of 37 studies. J Affect Disord 2023; 343:119-128. [PMID: 37797753 DOI: 10.1016/j.jad.2023.09.035] [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: 04/10/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Loneliness has long been associated with depressive symptoms, but there is no evidence on the question of "which comes first". To help us to answer this question, this study conducted a meta-analysis using a cross-lagged formula to examine the reciprocal relations between loneliness and depressive symptoms, as well as potential moderators. METHODS The meta-analytic dataset consisted of 37 studies with sample sizes ranging from 52 to 5991. Effect sizes (including autoregressive effects and lagged coefficients) were included. We computed weighted mean effect sizes for the correlation effect and cross-lagged effect between loneliness and depressive symptoms. We also performed a meta-regression to investigate potential moderators. RESULTS The results showed that loneliness and depressive symptoms reciprocally predicted each other over time with similar effect sizes. There was no moderation of our overall effect size in either direction by time interval between measurements, the proportion of female participants, mean age of the sample, or type of measurement. LIMITATIONS Caution should be taken in drawing final conclusions about the relative strength of reciprocal effects between loneliness and depressive symptoms due to the potential influence of varied research focus in the included studies, which could affect the effect size. CONCLUSIONS These findings advance the study of the relationship between loneliness and depressive symptoms by providing evidence that the link between them is symmetrically reciprocal and robust, which may help clinicians to develop effective intervention methods.
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Affiliation(s)
- Zhijia Chen
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiaoqi Song
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Tatia M C Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong; Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China
| | - Ruibin Zhang
- Cognitive control and Brain Healthy Laboratory, Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China; Center for Brain Science and Brain-Inspired Intelligence, Guangdong-Hong Kong-Macao Greater Bay Area, Guangzhou, China; Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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30
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Huang J, Liu X. Anxiety, depression, and their comorbidity among Chinese college students during the COVID-19 lockdown in the post-epidemic era: an online cross-sectional survey. BMC Psychiatry 2023; 23:923. [PMID: 38066524 PMCID: PMC10709836 DOI: 10.1186/s12888-023-05442-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/05/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic continues to affect the mental health of college students in the post-epidemic era. We assessed the status and related factors of college students who are vulnerable to anxiety and depression during the COVID-19 lockdown. METHODS This cross-sectional study was conducted two weeks after the beginning of the COVID-19 lockdown, from November 6, 2022, to December 2, 2022, with 1176 valid samples using convenience sampling. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to measure levels of anxiety and depression in college students. Factors related to anxiety, depression, and their comorbidity were analyzed using binary logistic regression. RESULTS The prevalence of anxiety, depression, and their comorbidity were 27.04%, 34.10%, and 25.60%, respectively. There was a higher risk of anxiety, depression, and their comorbidity among those who were currently living in rural areas. Compared with individuals with low monthly living expenses, those with higher monthly living expenses were less prone to anxiety, depression, and their comorbidity. CONCLUSIONS High prevalence of anxiety, depression, and their comorbidity were detected among college students during the COVID-19 lockdown. These were most common among college students who were senior students, had abnormal body mass index (BMI), were rural area residents, did study arts and humanities, were one-child in the family, and had low monthly living expenses and poor academic performance. Intervention practitioners and policymakers should formulate individualized prevention and intervention measures during the COVID-19 lockdown in the post-epidemic and possible future pandemics for college students.
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Affiliation(s)
- Jinghong Huang
- School of Health Management, Fujian Medical University, Fuzhou, China
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaojun Liu
- School of Health Management, Fujian Medical University, Fuzhou, China.
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31
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Sippel LM, Knopp KC, Wachsman T, Khalifian CE, Glynn SM, Morland LA. An examination of relationship satisfaction as a predictor of outcomes of brief couple therapy for posttraumatic stress disorder. J Trauma Stress 2023; 36:1115-1125. [PMID: 37898980 DOI: 10.1002/jts.22984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 10/31/2023]
Abstract
The pretreatment quality of intimate relationships can promote or interfere with couple therapy for posttraumatic stress disorder (PTSD) treatment response. We tested whether baseline relationship satisfaction predicted clinical and process outcomes in two dyadic treatments for PTSD. Using data from a randomized trial comparing brief cognitive behavioral conjoint therapy (bCBCT) for PTSD to PTSD family education (PFE) among 137 military veterans and their partners (N = 274, Mage = 42.3 years, 46.7% White, 81.0% male veteran partner), we examined whether baseline relationship satisfaction (Couples Satisfaction Index; CSI-32) predicted change in PTSD symptom severity (Clinician Administered PTSD Scale for DSM-5; CAPS-5), psychosocial functioning (Brief Inventory of Psychosocial Functioning; B-IPF), and relationship satisfaction at posttreatment and 6-month follow-up. We also explored associations with process outcomes (working alliance, treatment satisfaction, dropout). In both treatment conditions, neither partner's baseline CSI-32 score moderated change in veteran CAPS-5 or B-IPF score or any process variable. However, baseline CSI-32 scores moderated both partners' CSI-32 score change during bCBCT and PFE; participants who scored in the distressed range at baseline (n = 123) experienced significant improvements in relationship satisfaction, β = .199, whereas there was no change among those in the nondistressed range at baseline (n = 151), β = .025. Results suggest bCBCT and PFE are effective in improving PTSD symptoms and psychosocial functioning regardless of whether a couple is experiencing clinically significant relationship distress; further, these treatments improve relationship satisfaction for the most distressed individuals.
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Affiliation(s)
- Lauren M Sippel
- Department of Veterans Affairs Northeast Program Evaluation Center, West Haven, Connecticut, USA
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
- Department of Veterans Affairs National Center for PTSD Evaluation Division, West Haven, Connecticut, USA
| | - Kayla C Knopp
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Tamara Wachsman
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Chandra E Khalifian
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Shirley M Glynn
- VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA
| | - Leslie A Morland
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Department of Veterans Affairs National Center for PTSD Women's Health Sciences Division, Boston, Massachusetts, USA
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Fletcher S, Mitchell S, Curran D, Armour C, Hanna D. Empirically Derived Patterns of Posttraumatic Stress and Growth: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:3132-3150. [PMID: 36367208 PMCID: PMC10594833 DOI: 10.1177/15248380221129580] [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: 06/16/2023]
Abstract
The relationship between posttraumatic stress (PTS) and posttraumatic growth (PTG) has been extensively studied; however, the nature of the relationship remains unclear. Inconsistencies in the literature could be, in part, due to the use of variable level approaches. Person centered methods may further our understanding of this relationship, as they enable the identification of clinically meaningful subgroups based on PTS/PTG scores. This review aimed to identify commonly found subgroups of PTS and PTG, clinically relevant factors that distinguish the subgroups and to critically appraise the utility of categorizing individuals into subgroups based on PTS/PTG scores. Five databases (Embase, Medline, Web of Science, PILOTS, and PsycINFO) were searched. Seven studies (with a total of eight study samples; n = 6,776) met the eligibility criteria. A narrative synthesis of the findings revealed that the majority of the analyses (n = 6) found three patterns of PTS/PTG. These were categorized as: (1) low PTS/PTG (representing 26.89% of the entire sample), (2) high PTS/PTG (weighted mean percentage = 20.05%), and (3) low PTS/high PTG (weighted mean percentage = 43.1%). The role of social support was examined in five studies and higher social support was consistently found to predict membership in the low PTS/high PTG class. All five studies that examined the role of trauma characteristics found that it was a significant predictor of class membership. These findings could inform the developments of tailored interventions. The utility of person-centered approaches was discussed and recommendations to improve the application and reporting of such methods were made.
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Affiliation(s)
| | | | - David Curran
- School of Psychology, Queen’s University Belfast, UK
| | - Cherie Armour
- School of Psychology, Queen’s University Belfast, UK
| | - Donncha Hanna
- School of Psychology, Queen’s University Belfast, UK
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Chen XY, Shi X, Li C, Fan F. Longitudinal associations between social support trajectories and quality of life mediated by depressive symptoms: A 10-year cohort study of Wenchuan earthquake. J Adolesc 2023; 95:1702-1714. [PMID: 37674388 DOI: 10.1002/jad.12239] [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: 03/03/2023] [Revised: 07/11/2023] [Accepted: 08/17/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Previous studies on associations between social support and quality of life (QoL) have usually employed a variable-centered approach, without considering individual variances in time-varying changes in social support. This study explores trajectories of social support and whether depressive symptoms mediate associations between social support trajectories and QoL 10 years after an earthquake. METHODS Seven hundred and forty-four Chinese adolescents exposed to the Wenchuan earthquake were surveyed on social support at 6-, 18-, and 24-months and depressive symptoms at 30-months postearthquake (T30m ). They provided valid data on QoL after 10 years of the earthquake (T10y ). The latent class growth analysis was used to estimate social support trajectories. Mediation analysis was then conducted to test whether depressive symptoms at T30m mediated associations between social support trajectories and QoL at T10y . RESULTS Three trajectories of social support were identified: low decreasing (31.6%), moderate decreasing (55.4%), and persistent high (13.0%) groups. Depressive symptoms significantly mediated the effects of social support trajectories (relative to the low support trajectory) on future QoL (95% CIs: 0.70-1.78 and 1.41-3.37 for moderate decreasing and persistent high groups, respectively). CONCLUSIONS Social support shows individual differences over time. Moderate and high social support trajectories improve 10-year QoL partly by reducing depressive symptoms. Therefore, interventions aimed at enhancing social support and reducing depressive symptoms may be more effective in enhancing QoL in the aftermath of disasters.
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Affiliation(s)
- Xiao-Yan Chen
- Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
| | - Xuliang Shi
- College of Education, Hebei University, Hebei, China
| | - Chao Li
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Fang Fan
- Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
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Sorjonen K, Melin B. Prospective associations between social support and posttraumatic stress disorder may be spurious: A re-meta-analysis of longitudinal studies and a simulation. J Affect Disord 2023; 340:174-180. [PMID: 37557992 DOI: 10.1016/j.jad.2023.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 07/18/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023]
Abstract
A recent meta-analysis concluded to have found proof for both a social causation model, according to which social support protects against posttraumatic stress disorder (PTSD), and a social selection model, which claims that PTSD erodes social support. However, the prospective cross-lagged effects were estimated while adjusting for a prior measurement of the outcome and this method is vulnerable for spurious findings due to correlations with residuals and regression toward the mean. The present re-analyses of the meta-analytic effects indicated that depending on used model one can choose to claim that social support has either a decreasing, an increasing, or no prospective effect on subsequent change in PTSD symptom severity, and vice versa. Therefore, claims over and above a negative cross-sectional correlation between social support and PTSD, including the social causation and social selection models, can be questioned. The findings were validated by analyses of simulated data, which indicated that prospective effects were not necessary for the observed meta-analytic associations.
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Affiliation(s)
- Kimmo Sorjonen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Bo Melin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Meijer L, Franz MR, Deković M, van Ee E, Finkenauer C, Kleber RJ, van de Putte EM, Thomaes K. Towards a more comprehensive understanding of PTSD and parenting. Compr Psychiatry 2023; 127:152423. [PMID: 37722204 DOI: 10.1016/j.comppsych.2023.152423] [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: 07/03/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND The impact of post-traumatic stress disorder (PTSD) on parenting and the parent-child relationship has been well-documented in the scientific literature. However, some conceptual and methodological challenges within this research field remain. PROCEDURE We reflect on a number of challenges that we identified while examining the literature in preparation of an individual participant data meta-analysis on the relationships between PTSD and parenting. FINDINGS We address 1) the presence of 'trauma-islands'; 2) the need for transdiagnostic theoretical frameworks for mechanisms between PTSD and parenting; 3) the lack of developmental perspectives; 4) the overuse of self-reported retrospective measures; 5) the need to study more diverse samples and cultural contexts; and 6) the lack of research on resilience and post-traumatic growth in parenting. Based on these reflections, we offer suggestions on strategies for responding to these challenges through: 1) welcoming open science; 2) working towards shared theoretical frameworks; 3) doing more longitudinal research 4) expanding the methodological palette; 5) centering lived experience; and 6) taking systemic inequality into account. CONCLUSION With this commentary, we aim to open a discussion on next steps towards a more comprehensive understanding of the association between PTSD and parenting, and inspire collaborative research.
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Affiliation(s)
- Laurien Meijer
- Sinai Centrum Arkin Mental Health Care, Amstelveen, Laan van de Helende Meesters 2, 1186 AM Amstelveen, the Netherlands; Department of Interdisciplinary Social Science, Utrecht University, Padualaan 14, 3584 CH Utrecht, the Netherlands.
| | - Molly R Franz
- Department of Psychology, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, United States
| | - Maja Deković
- Department of Clinical Child and Family Studies, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands
| | - Elisa van Ee
- Psychotraumacentrum Zuid Nederland, Den Bosch, Bethaniestraat 10, 5211 LJ 's Hertogenbosch, the Netherlands; Behavioural Science Institute, Radboud University, Thomas Van Aquinostraat 4, 6525 GD Nijmegen, the Netherlands
| | - Catrin Finkenauer
- Department of Interdisciplinary Social Science, Utrecht University, Padualaan 14, 3584 CH Utrecht, the Netherlands
| | - Rolf J Kleber
- Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands; ARQ National Psychotrauma Centre, Diemen, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands
| | - Elise M van de Putte
- Wilhelmina Children's Hospital / University Medical Center Utrecht, Lundlaan 6, 3584 EA Utrecht, the Netherlands
| | - Kathleen Thomaes
- Department of Psychiatry, Amsterdam University Medical Centre/VUmc, Laan van de Helende Meesters 2, 1186 AM Amstelveen, the Netherlands
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36
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Bi Y, Xiao Y, Pan X, Zhang Y, Yang Q, Hu L. Long-term post-traumatic stress symptoms in COVID-19 survivors and its risk factors: a two-year longitudinal cohort study. Psychiatry Res 2023; 329:115523. [PMID: 37812942 DOI: 10.1016/j.psychres.2023.115523] [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: 05/14/2023] [Revised: 09/22/2023] [Accepted: 09/30/2023] [Indexed: 10/11/2023]
Abstract
The COVID-19 pandemic has led to widespread mental health problems, necessitating the investigation of longitudinal mental health changes, associated risk factors, and neural mechanisms in survivors. We recorded demographics, mental health, social support, and potential exposures in survivors at 3 months (n = 189), 6 months (n = 47), and 2 years (n = 69) post-discharge and collected brain imaging data at the second timepoint. Control groups included non-COVID-19 locals (3 months: n = 188, 6 months: n = 42, 2 years: n = 71). Results indicated that female survivors exhibited higher post-traumatic stress symptoms (PTSS) and depression levels than female controls for up to 2 years, along with higher anxiety level for up to 6 months. Male survivors had higher PTSS, depression, and anxiety levels than male controls at 2 months. Moreover, COVID-related trauma and low social support were risk factors for PTSS and negative emotions in survivors. Neuroimaging revealed increased amygdala activity in male survivors and correlations between hippocampus activity and depression symptoms as well as between right hippocampus activity and social support. Our study emphasized the importance of monitoring mental wellness in COVID-19 survivors and underscored the crucial role of social support in mitigating mental health problems.
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Affiliation(s)
- Yanzhi Bi
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Yian Xiao
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xinyu Pan
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yuqi Zhang
- Department of Psychology, The University of Hong Kong, Hong Kong, SAR, China
| | - Quanqi Yang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Li Hu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
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Lietzau SB, Aiken BE, Cooney CC, Dardis CM. Social Reactions to Disclosures of Intimate Partner Stalking and Unwanted Pursuit Behaviors: Associations With PTSD, Academic Outcomes, and Empowerment. Violence Against Women 2023:10778012231209015. [PMID: 37885258 DOI: 10.1177/10778012231209015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Among college survivors of unwanted pursuit behaviors (UPBs; 40.1%, n = 189) or intimate partner stalking (IPS, i.e., UPBs causing emotional distress; 32.1%, n = 151), the present study examined effects of social reactions to disclosures on post-traumatic stress disorder (PTSD) symptomatology, academic outcomes, and personal empowerment. Compared to UPB survivors, IPS survivors were more likely to disclose and reported higher positive and negative reactions to disclosure as well as greater frequency of UPBs/IPS, IPV, and PTSD symptoms. Among both groups, only negative social reactions were positively associated with PTSD symptoms. However, among IPS (but not UPB) survivors, only positive social reactions were related to academic outcomes and empowerment when controlling for PTSD and IPS frequency. Implications for research and practice are discussed.
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Affiliation(s)
| | | | - Caroline C Cooney
- Women's Health Sciences Division, National Center for PTSD, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
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Van Hoy A, Rzeszutek M. Trajectories of burnout and psychological well-being among psychotherapists during the Covid-19 pandemic: Results of a 1-year prospective study. Stress Health 2023; 39:854-870. [PMID: 36698253 DOI: 10.1002/smi.3230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/19/2022] [Accepted: 01/22/2023] [Indexed: 01/27/2023]
Abstract
The main goal of this study was to investigate the trajectories of the changes in burnout and subjective well-being (SWB) among psychotherapists in relation to social support, self-efficacy, sociodemographic, and work-related factors, with additional control for the subjectively experienced Covid-19 related distress. This study was carried out over a 1-year period during the critical time of the Covid-19 pandemic. We reached 226 Polish psychotherapists, of which 207 psychotherapists (91.6%) participated in all three measurements. The participants completed the following measurements: the Maslach Burnout Inventory-Human Service Survey, the Satisfaction with Life Scale, the General Self-Efficacy Scale, the Multidimensional Scale of Perceived Social Support, and a questionnaire regarding sociodemographic, work-related factors and Covid-19 related distress. Several trajectories were observed for both burnout and SWB, which were differently associated with the level of social support, self-efficacy, and sociodemographic and work-related factors. We did not find a significant relationship between Covid-19 related distress and the inclusion of either burnout or SWB trajectories. This study calls for greater interest in the psychological health of psychotherapists. More specifically, our findings may entail some implications for the practice of psychotherapy by creating customized intervention programs to reduce burnout and enhance well-being in this specific occupation.
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Sorjonen K, Ingre M, Melin B, Nilsonne G. Unmasking artifactual links: A reanalysis reveals No direct causal relationship between self-esteem and quality of social relations. Heliyon 2023; 9:e20397. [PMID: 37767502 PMCID: PMC10520822 DOI: 10.1016/j.heliyon.2023.e20397] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 09/29/2023] Open
Abstract
A meta-analysis conducted by Harris and Orth (2020) found positive prospective cross-lagged effects between quality of social relations and self-esteem in included longitudinal studies. Harris and Orth concluded that the link between self-esteem and quality of social relations is reciprocal and characterized by a positive feedback loop. However, meta-analytic effects were estimated while controlling for a prior measurement of the outcome and such effects are known to be susceptible to artifactual (i.e. spurious) effects due to correlations with measurement errors and reversion to mediocrity. We reanalyzed the same data and found paradoxical effects indicating, simultaneously, both increasing and decreasing effects between self-esteem and social relations. These findings suggest that prospective effects between self-esteem and quality of social relations are artifactual rather than due to a true reciprocal effect. Thus, these findings have important theoretical implications and challenge both the risk regulation model, which posits that self-esteem has a causal effect on quality of social relations, and the sociometer theory, which claims that quality of relations is the cause and self-esteem the effect. The present results prompt further investigation into the underlying mechanisms driving these artifactual associations. Additionally, the study highlights the importance of considering methodological limitations in future meta-analyses to improve the accuracy of causal inferences.
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Affiliation(s)
- Kimmo Sorjonen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Michael Ingre
- Department of Gastroenterology and Hepatology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden
- Institute for Globally Distributed Open Research and Education (IGDORE), Stockholm, Sweden
| | - Bo Melin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Gustav Nilsonne
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Meta-Research Innovations Center (METRICS), Stanford University, Palo Alto, USA
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40
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Georgescu T, Nedelcea C. Pretrauma risk factors and posttraumatic stress disorder symptoms following subsequent exposure: Multilevel and univariate meta-analytical approaches. Clin Psychol Psychother 2023. [PMID: 37690794 DOI: 10.1002/cpp.2912] [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: 06/01/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
The endeavour to comprehend why certain individuals develop posttraumatic stress disorder (PTSD) symptoms subsequent to experiencing traumatic events, while others do not, underscores the paramount importance of pretraumatic risk factors. This meta-analysis summarises the extant results of studies assessing risk factors prior exposure and PTSD symptoms following an index event on the same participants. It includes 43 studies (N = 19,239) yielding 174 effect sizes of pretraumatic risk factors categories such as demographic factors, cognitive factors, personality traits, coping styles, psychopathology, psychophysiological and environmental factors, which were examined using a three-level meta-analysis. Additionally, univariate random-effects meta-analyses were performed to separately investigate individual risk factors reported in more than one study. The findings revealed significant, small and medium associations for all categories, except for demographic factors and coping styles, also highlighting that certain individual risk factor domains (i.e. previous mental disorders, negative emotionality, sleep complaints and PTSD symptoms) represent the strongest predictors for PTSD symptoms after subsequent exposure. Several moderators were also investigated for individual risk factors. Future research could benefit from considering the interplay of pretraumatic risk factors to draw a more complex picture of the aetiology and underlying mechanisms of PTSD symptoms.
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Affiliation(s)
- Teodora Georgescu
- Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, Romania
| | - Cătălin Nedelcea
- Department of Psychology and Cognitive Sciences, University of Bucharest, Bucharest, Romania
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Rowland B, Swami N, Prattley J, Duffy J, Macdonald JA, Perales F, Mansour KA, Quinn B. Depressive symptoms and social support among Australian men: A 7-year longitudinal study. Aust N Z J Psychiatry 2023; 57:1243-1252. [PMID: 36717775 DOI: 10.1177/00048674221151000] [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] [Indexed: 02/01/2023]
Abstract
BACKGROUND Mental health disorders are ranked globally as the single largest contributor to non-fatal ill-health. Social support can be a means of reducing and managing depression. However, depression can also impact on a person's level of social support. OBJECTIVE As men typically have fewer sources of social support than females, this study investigated the bi-directional associations between depressive symptoms and perceived levels of social support among Australian males, aged 18-63. METHODS Three waves of panel data from Ten to Men: The Australian Longitudinal Study on Male Health collected over 7 years (2013-2020) were used. A random intercept cross-lagged panel analysis with 5112 participants was undertaken. Mediating effects and indirect and total effects for lagged and cross-lagged pathways were also examined. RESULTS Over time, greater social support was found to be associated with lower depression levels, and simultaneously greater levels of depression was found to be associated with lower levels of social support. Standardised cross-lagged effects between waves were mostly similar (β = 0.10). However, mediation analyses identified that only the total effect size of the association for depression at wave 1 predicting social support at wave 3 (β = -0.29) was significant. Mediated effects of social support at wave 1 predicting depression at wave 3 were not significant. LIMITATIONS These include the number of years between each wave, and data were collected during the COVID pandemic. CONCLUSION The study provides robust longitudinal evidence supporting the notion that social support and depression are both a cause and consequence of the other. However, the long-term effects of depression reducing social support were longer lasting than the effects of social support reducing depression.
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Affiliation(s)
- Bosco Rowland
- Australian Institute of Family Studies, Melbourne, VIC, Australia
- Faculty of Medicine, Eastern Health Clinical School, Monash Addiction Research Centre, Monash University, Melbourne, VIC, Australia
- Faculty of Health, Centre for Social, Early, Emotional Development, Deakin University, Geelong, VIC, Australia
| | - Neha Swami
- Australian Institute of Family Studies, Melbourne, VIC, Australia
| | | | - Jacob Duffy
- Australian Institute of Family Studies, Melbourne, VIC, Australia
| | - Jacqui A Macdonald
- Faculty of Health, Centre for Social, Early, Emotional Development, Deakin University, Geelong, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Faculty of Medicine, Dentistry & Health Sciences, Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Francisco Perales
- Faculty of Humanities and Social Sciences, School of Social Science, The University of Queensland, QLD, Australia
| | - Kayla A Mansour
- Faculty of Health, Centre for Social, Early, Emotional Development, Deakin University, Geelong, VIC, Australia
| | - Brendan Quinn
- Australian Institute of Family Studies, Melbourne, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Behaviours and Health Risks Program, Burnet Institute, Melbourne VIC, Australia
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Behrendt D, Boß L, Hannibal S, Kunzler AM, Wessa M, Lehr D. Feasibility and efficacy of a digital resilience training: A pilot study of the strengths-based training RESIST. Internet Interv 2023; 33:100649. [PMID: 37545556 PMCID: PMC10400467 DOI: 10.1016/j.invent.2023.100649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 08/08/2023] Open
Abstract
Background Work-related stress is a risk factor for a number of adverse health and work outcomes. Resilience trainings are a promising approach for adequately dealing with work stress and keeping employees mentally healthy. However, results of previous resilience trainings have been heterogeneous, ranging from null findings to large effects. Existing digital resilience interventions show a lack of consistency in terms of an underlying theoretical framework and methods used to foster resilience. Positive Appraisal Style Theory of Resilience offers an innovative conceptualization of resilience. Strengths-based cognitive behavioral therapy is a corresponding therapeutically method reflecting resilience as a resource-oriented process of dealing with stress. Based on this background, a new hybrid web-and app-based digital resilience intervention for employees named RESIST was developed. Objective The first aim of the study was to investigate the feasibility of the newly developed training RESIST regarding its usability, user behavior, user experience and motivation to use. Second, the study sought to explore preliminary effects of the intervention on reducing stress and enhancing resilience by conducting a pilot randomized controlled trial. Methods The feasibility study was conducted in three phases. First, the usability of the app was investigated in a pre-test with five participants using a thinking-aloud method. Second, the preliminary efficacy of the training was examined in a pilot randomized controlled trial. A sample of 30 employees were randomized either to receive the resilience training (n = 15) or to be member of a control group (n = 15). The primary outcome was measuring perceived stress. Secondary outcomes included measures of resilience and depressive symptoms. Third, semi-structured interviews were undertaken with six participants of the resilience training group on training content, motivation for use, and user experience. Results Overall, results indicate that RESIST can be a feasible training for resilience promotion and stress reduction with high user satisfaction. Analysis of covariance showed that, relative to controls, participants who received RESIST reported significantly lower stress scores at post-intervention (F1,27 = 16.91, p < 0.001; Cohen's d = 1.57; 95 % CI 0.71-2.43) than controls. Significant differences, with moderate-to-large effect sizes, were also detected for general resilience and various resilience factors. Conclusions Results are promising and provide hope that a hybrid web- and app-based resilience intervention based on strengths-based cognitive behavioral therapy can have a positive impact on dealing adequately with stress and improve resilience of employees.
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Affiliation(s)
- Dörte Behrendt
- Department of Health Psychology and Applied Biological Psychology, Institute for Sustainability Education and Psychology, Lueneburg, Germany
| | - Leif Boß
- Department of Health Psychology and Applied Biological Psychology, Institute for Sustainability Education and Psychology, Lueneburg, Germany
| | - Sandy Hannibal
- Department of Health Psychology and Applied Biological Psychology, Institute for Sustainability Education and Psychology, Lueneburg, Germany
| | - Angela M. Kunzler
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Institute for Evidence in Medicine, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University, Mainz, Germany
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute for Sustainability Education and Psychology, Lueneburg, Germany
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Córdoba-Salgado O, Andrews AR, Davidson TM, Galea S, Ruggiero KJ. Longitudinal and bidirectional associations between posttraumatic stress disorder and emotional support among disaster-affected men and women. J Trauma Stress 2023; 36:727-737. [PMID: 37309234 DOI: 10.1002/jts.22949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 06/14/2023]
Abstract
Research has demonstrated a negative association between social support and symptoms of posttraumatic stress disorder (PTSD). This has been interpreted as a protective influence of social support against the development of posttraumatic stress symptoms (PTSS). Research on the opposite association is more limited, but findings suggest that PTSS have a negative impact on social support. There is conflicting evidence that these effects are moderated by gender. Few studies have assessed both associations and gender moderation in a postdisaster context. We examined the longitudinal and bidirectional effects of emotional support and PTSS and whether gender moderates these effects among U.S. survivors of the 2017-2018 season. Participants (N = 1,347) were assessed at four time points over 1 year. Bidirectional effects were assessed using cross-lagged, autoregressive analyses with the combined sample (Model 1) and grouped by gender (Model 2) to assess gender moderation. The results supported small bidirectional negative effects of social support and PTSS on one another from one assessment point (e.g. Wave 1) to the subsequent point (e.g., Wave 2) for all waves, βs = -.07-.15, p < .001-p = .040. Multigroup analyses suggested the effects were not significantly different by gender. Overall, the results suggest that social support and PTSS may mutually diminish one another. Such effects may result in a positive or negative cascade wherein high PTSS may lead to lower social support and, therefore, even higher PTSS and vice versa. These findings support the importance of including social support in interventions to promote PTSS prevention and recovery.
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Affiliation(s)
| | - Arthur R Andrews
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Tatiana M Davidson
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
| | - Kenneth J Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA
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Alfuqaha OA, Al-Masarwah UM, Farah RI, Yasin JA, Alkuttob LA, Muslieh NI, Hammouri M, Jawabreh AE, Aladwan DA, Barakat RO, Alshubbak NH. The Impact of Turkey and Syria Earthquakes on University Students: Posttraumatic Stress Disorder Symptoms, Meaning in Life, and Social Support. Behav Sci (Basel) 2023; 13:587. [PMID: 37504034 PMCID: PMC10376520 DOI: 10.3390/bs13070587] [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: 06/10/2023] [Revised: 06/30/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
(1) Background: Earthquakes are natural disasters that often result in significant loss of life and property. The objective of this study is to explore the frequency of symptoms associated with posttraumatic stress disorder (PTSD), levels of meaning in life (ML), and perceived social support (SS) among university students in the aftermath of the earthquake that occurred in Turkey and Syria in 2023. (2) Methods: This study utilizes a cross-sectional correlation design to achieve its objectives among 603 university students from two public universities using an online survey (via Google Forms). The survey was launched one month after the earthquake in Turkey and Syria and concluded on 6 April 2023. (3) Results: The results indicate that a total of 158 university students, constituting 26.20% of the sample, reported extreme symptoms of PTSD. The results also indicate that 184 students (30.51), and 140 students (23.22%) reported low levels of ML and SS, respectively. Female students were significantly more vulnerable to experiencing PTSD symptoms, as well as difficulties in finding ML and SS. Finally, results revealed that students who were pursuing postgraduate studies had a greater likelihood of exhibiting symptoms indicative of PTSD. (4) Conclusions: It is recommended that universities provide support services and resources for students experiencing PTSD symptoms.
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Affiliation(s)
- Othman A Alfuqaha
- Counseling and Mental Health Department, Faculty of Educational Sciences, The World Islamic Sciences & Education University W.I.S.E., Amman 11947, Jordan
| | - Uday M Al-Masarwah
- Counseling and Mental Health Department, Faculty of Educational Sciences, The World Islamic Sciences & Education University W.I.S.E., Amman 11947, Jordan
| | - Randa I Farah
- Nephrology Division, Internal Medicine Department, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Jehad A Yasin
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Leen A Alkuttob
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Nour I Muslieh
- Prince Salma Bnt Abdullah Nursing College, Al al-Bayt University, Al.Mafraq 130040, Jordan
| | - Mouath Hammouri
- Department of Nursing, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan
| | - Afnan E Jawabreh
- Department of Obstetrics and Gynecology, The University of Jordan, Amman 11942, Jordan
| | - Duaa A Aladwan
- Counseling and Mental Health Department, Faculty of Educational Sciences, The World Islamic Sciences & Education University W.I.S.E., Amman 11947, Jordan
| | - Randah O Barakat
- Counseling and Mental Health Department, Faculty of Educational Sciences, The World Islamic Sciences & Education University W.I.S.E., Amman 11947, Jordan
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45
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Meuleman E, Sloover M, van Ee E. Involving a Significant Other in Treatment of Patients With PTSD Symptoms: A Systematic Review of Treatment Interventions. TRAUMA, VIOLENCE & ABUSE 2023; 24:2034-2044. [PMID: 35389279 DOI: 10.1177/15248380221082939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Previous studies have called for the inclusion of social support in the treatment of PTSD. The current review identifies interventions for adults with PTSD symptoms, which include a significant other as a source of social support. 11 articles focusing on eight interventions were found, including a total of 495 participants who had experienced trauma. These interventions were divided according to level of involvement of the significant other in treatment. Significant others were either passively or actively involved in the treatment. Preliminary results show that interventions actively involving a significant other in the treatment of the patient with posttraumatic stress symptoms were most effective in reducing PTSD symptoms. The current review provides recommendations for future research and suggests that significant others should be actively involved in the treatment of PTSD symptoms.
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Affiliation(s)
- Eline Meuleman
- Psychotraumacentrum Zuid Nederland, Reinier van Arkel, 's-Hertogenbosch, The Netherlands
| | - Mèlanie Sloover
- Psychotraumacentrum Zuid Nederland, Reinier van Arkel, 's-Hertogenbosch, The Netherlands
| | - Elisa van Ee
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
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46
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Koehler F, Schäfer SK, Lieb K, Wessa M. Differential associations of leisure music engagement with resilience: A network analysis. Int J Clin Health Psychol 2023; 23:100377. [PMID: 36896003 PMCID: PMC9988545 DOI: 10.1016/j.ijchp.2023.100377] [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: 11/03/2022] [Accepted: 02/02/2023] [Indexed: 03/08/2023] Open
Abstract
Background/Objective Several factors associated with resilience as the maintenance of mental health despite stress exposure can be strengthened through participation in leisure time activities. Since many people listen to or make music in their leisure time, the aim of the present study was to provide insights into the architecture of how resilience relates to passive and active music engagement. Method 511 participants regularly listening to and/or making music completed an online survey on resilient outcomes (i.e., mental health and stressor recovery ability), different resilience factors (e.g., optimism, social support), quantitative music engagement (i.e., time spent with music listening/making) and qualitative music engagement (i.e., use of music listening/making for mood regulation). Results Bivariate correlations showed that subjects spending more time with music making reported better stressor recovery ability and less mental health problems, while partial correlational network analysis revealed no unique associations for quantitative music engagement. Regarding qualitative music engagement, people using music-based mood regulation reported lower mental health, mindfulness, and optimism, but also higher social support. A more heterogeneous pattern emerged for single music-based mood regulation strategies. Conclusions Our findings highlight the importance of the individual (mal-)adaptive use of music, painting a more nuanced picture of music engagement and resilience.
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Affiliation(s)
- Friederike Koehler
- Leibniz Institute for Resilience Research, Wallstraße 7, Mainz 55122, Germany
- Centre of Excellence in Music, Mind, Body and Brain, Department of Music, Art and Culture Studies, University of Jyväskylä, Seminaarinkatu 15, 40014 Jyväskylä, Finland
| | - Sarah K. Schäfer
- Leibniz Institute for Resilience Research, Wallstraße 7, Mainz 55122, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Wallstraße 7, Mainz 55122, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research, Wallstraße 7, Mainz 55122, Germany
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg University Mainz, Wallstraße 3, Mainz 55122, Germany
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Jaffe AE, Walton TO, Walker DD, Kaysen DL. Social support and treatment utilization for posttraumatic stress disorder: Examining reciprocal relations among active duty service members. J Trauma Stress 2023; 36:537-548. [PMID: 36728194 PMCID: PMC10293030 DOI: 10.1002/jts.22908] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/16/2022] [Accepted: 12/02/2022] [Indexed: 02/03/2023]
Abstract
Evidence-based treatments for posttraumatic stress disorder (PTSD) are underutilized by active duty service members in the United States. Social support may help service members overcome avoidance and facilitate treatment utilization. In turn, treatment utilization may improve social support. To evaluate these possibilities, the aim of the current study was to examine potential reciprocal associations between social support and treatment utilization among service members. Secondary analyses were conducted on a randomized controlled trial of 161 U.S. military service members with PTSD. Participants completed assessments of perceived social support and attendance at individual therapy sessions at baseline and 3- and 6-month follow-ups. To determine reciprocal relations between social support and treatment utilization, a Bayesian approach was used to estimate a random-intercept cross-lagged panel model with a two-part variable for treatment utilization (i.e., any therapy, and if so, dose). There were no between-person associations between average social support and treatment utilization. One prospective cross-lagged within-person association emerged as significant: social support at 3 months was negatively associated with any therapy use at 6 months; the model explained 26.1% of the variance in this observed variable. The findings revealed that low social support promoted subsequent treatment utilization, but such treatment did not lead to changes in social support. This suggests service members with PTSD may have been motivated to attend individual therapy in pursuit of social connection and support. Future research is needed to determine if reciprocal associations between various forms of social support and therapy utilization differ by treatment modality.
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Affiliation(s)
- Anna E Jaffe
- Department of Psychology, University of Nebraska-Lincoln, Nebraska, Lincoln, USA
| | - Thomas O Walton
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Denise D Walker
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Debra L Kaysen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, California, Stanford, USA
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, California, Menlo Park, USA
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48
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Lewis C, Bailey L, Ariti C, Kitchiner NJ, Roberts NP, Simon N, Bisson JI. Social support as a predictor of outcomes of cognitive behavioral therapy with a trauma focus delivered face-to-face and via guided internet-based self-help. J Trauma Stress 2023; 36:511-523. [PMID: 37277907 DOI: 10.1002/jts.22947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 06/07/2023]
Abstract
There is mounting evidence that cognitive behavioral therapy with a trauma focus (CBT-TF) delivered via guided internet-based self-help is noninferior to CBT-TF delivered face-to-face for individuals with posttraumatic stress disorder (PTSD) of mild-to-moderate severity. The availability of multiple evidence-based treatment options creates a need to determine predictors of outcome to enable clinicians to make informed treatment recommendations. We examined perceived social support as a predictor of treatment adherence and response among 196 adults with PTSD enrolled in a multicenter pragmatic randomized controlled noninferiority trial. Perceived social support was measured using the Multidimensional Scale of Perceived Social Support and PTSD was assessed using the Clinician-Administered PTSD Scale for DSM-5. Linear regression was used to explore the associations between different dimensions of perceived social support (i.e., from friends, family, and significant others) and posttraumatic stress symptoms (PTSS) at baseline. Linear and logistic regression were used to determine whether these dimensions of support predicted treatment adherence or response for either treatment modality. Lower baseline perceived social support from family was associated with higher levels of PTSS, B = -0.24, 95% CI [-0.39, -0.08], p = .003, but the same did not apply to social support from friends or significant others. We did not find evidence that any dimension of social support predicted treatment adherence or response for either treatment. This work does not indicate that social support is a factor that can help predict the suitability of psychological therapy for PTSD delivered via guided internet-based self-help versus face-to-face.
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Affiliation(s)
- Catrin Lewis
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Leah Bailey
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Cono Ariti
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Neil J Kitchiner
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff University, Cardiff, United Kingdom
- Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, United Kingdom
| | - Neil P Roberts
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff University, Cardiff, United Kingdom
- Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, United Kingdom
| | - Natalie Simon
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff University, Cardiff, United Kingdom
- Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, United Kingdom
| | - Jonathan I Bisson
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff University, Cardiff, United Kingdom
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Zhang D, Qin L, Huang A, Wang C, Yuan T, Li X, Yang L, Li J, Lei Y, Sun L, Liu M, Liu H, Zhang L. Mediating effect of resilience and fear of COVID-19 on the relationship between social support and post-traumatic stress disorder among campus-quarantined nursing students: a cross-sectional study. BMC Nurs 2023; 22:164. [PMID: 37193966 DOI: 10.1186/s12912-023-01319-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 04/25/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND The emergency of Omicron variants, spreading in China and worldwide, has sparked a new wave of the coronavirus disease 2019 (COVID-19) pandemic. The high infectivity and persistence of the pandemic may trigger some degrees of post-traumatic stress disorder (PTSD) for nursing students experiencing indirect trauma exposure to the epidemic, which hinders the role transition from students to qualified nurses and exacerbates the health workforce shortage. Thus, it's well worth an exploration to understand PTSD and its underlying mechanism. Specifically, PTSD, social support, resilience, and fear of COVID-19 were selected after widely literature review. This study aimed to investigate the relationship between social support and PTSD among nursing students during COVID-19, to address the mediating role of resilience and fear of COVID-19 between social support and PTSD, and to provide practical guidance for nursing students' psychological intervention. METHODS From April 26 to April 30, 2022, 966 nursing students from Wannan Medical College were selected by the multistage sampling method to fill the Primary Care PTSD Screen for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Brief Resilience Scale, Fear of COVID-19 Scale, and Oslo 3 Items Social Support Scale. Data were analyzed by descriptive statistics, spearman's correlation analysis, regression analysis, and path analysis. RESULTS 15.42% of nursing students had PTSD. There were significant correlations between social support, resilience, fear of COVID-19, and PTSD (r =-0.291 ~ 0.353, P <0.001). Social support had a direct negative effect on PTSD (β =-0.216; 95% confidence interval, CI: -0.309~-0.117), accounting for 72.48% of the total effect. Analysis of mediating effects revealed that social support influenced PTSD through three indirect pathways: the mediated effect of resilience was statistically significant (β =-0.053; 95% CI: -0.077~-0.031), accounting for 17.79% of the total effect; the mediated effect of fear of COVID-19 was statistically significant (β =-0.016; 95% CI: -0.031~-0.003), accounting for 5.37% of the total effect; the chain mediating effect of resilience and fear of COVID-19 was statistically significant (β =-0.013; 95% CI: -0.022~-0.006), accounting for 4.36% of the total effect. CONCLUSION The social support of nursing students not only directly affects PTSD, but also indirectly affects PTSD through the separate and chain mediating effect of resilience and fear of COVID-19. The compound strategies targeted at boosting perceived social support, fostering resilience, and controlling fear of COVID-19 are warranted for reducing PTSD.
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Affiliation(s)
- Dongmei Zhang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China
| | - Li Qin
- The Dean's Office, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China
| | - Anle Huang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China
| | - Congzhi Wang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China
| | - Ting Yuan
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China
| | - Xiaoping Li
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China
| | - Liu Yang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China
| | - Jing Li
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China
| | - Yunxiao Lei
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China
| | - Lu Sun
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China
| | - Mingming Liu
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China
| | - Huan Liu
- Department of Hemodialysis, The First Affiliated Hospital of Wannan Medical College, 2 Zheshan West Road, Wuhu City, An Hui Province, P. R. China.
| | - Lin Zhang
- School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P. R. China.
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50
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van Stolk-Cooke K, Legrand AC, Brier ZMF, Price M. A preliminary evaluation of the supportive other experiences questionnaire: Integrating the perspectives of SS providers after traumatic injury. J Affect Disord 2023; 335:440-449. [PMID: 37172656 DOI: 10.1016/j.jad.2023.04.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/04/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Social support is a protective factor against the development of Posttraumatic Stress Disorder (PTSD). However, examinations of the social support after trauma have relied primarily on the self-reports of trauma survivors to the exclusion of their support providers. A new measure, the Supportive Other Experiences Questionnaire (SOEQ) was adapted from a well-established behavioral coding schema of support behaviors to capture social support experiences from the support provider perspective. METHOD 513 Concerned Significant Others (CSOs) recruited on MTurk who had served as support providers to a traumatically injured romantic partner were recruited to respond to SOEQ candidate items and other relevant measures of psychopathology and relational factors. Factor analytic, correlational and regression analyses were conducted. RESULTS Confirmatory factor analytic results of SOEQ candidate items provide evidence for three support types (i.e., informational, tangible, and emotional) and two support processes (i.e., frequency, difficulty), producing a final 11-item version of the SOEQ. Evidence of convergent and discriminant validity provide good psychometric support for the measure. Evidence of construct validity was derived from support for two hypotheses: (1) difficulty providing social support is negatively associated with CSO perceptions of trauma survivor recovery, (2) social support provision frequency is positively associated with relationship satisfaction. LIMITATIONS Though factor loadings for support types were significant, several were small, limiting interpretability. Cross-validation in a separate sample is needed. CONCLUSIONS The final version of the SOEQ demonstrated promising psychometric properties, and can provide key information one the experiences of CSOs as social support providers for trauma survivors.
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Affiliation(s)
- Katherine van Stolk-Cooke
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Alison C Legrand
- Department of Psychology, University of Vermont, Burlington, VT, USA
| | - Zoe M F Brier
- Department of Psychology, University of Vermont, Burlington, VT, USA
| | - Matthew Price
- Department of Psychology, University of Vermont, Burlington, VT, USA
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