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Clarke V, Goddard A, Wellings K, Hirve R, Casanovas M, Bewley S, Viner R, Kramer T, Khadr S. Medium-term health and social outcomes in adolescents following sexual assault: a prospective mixed-methods cohort study. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1777-1793. [PMID: 34370051 PMCID: PMC10627884 DOI: 10.1007/s00127-021-02127-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe medium-term physical and mental health and social outcomes following adolescent sexual assault, and examine users' perceived needs and experiences. METHOD Longitudinal, mixed methods cohort study of adolescents aged 13-17 years recruited within 6 weeks of sexual assault (study entry) and followed to study end, 13-15 months post-assault. RESULTS 75/141 participants were followed to study end (53% retention; 71 females) and 19 completed an in-depth qualitative interview. Despite many participants accessing support services, 54%, 59% and 72% remained at risk for depressive, anxiety and post-traumatic stress disorders 13-15 months post-assault. Physical symptoms were reported more frequently. Persistent (> 30 days) absence from school doubled between study entry and end, from 22 to 47%. Enduring mental ill-health and disengagement from education/employment were associated with psychosocial risk factors rather than assault characteristics. Qualitative data suggested inter-relationships between mental ill-health, physical health problems and disengagement from school, and poor understanding from schools regarding how to support young people post-assault. Baseline levels of smoking, alcohol and ever drug use were high and increased during the study period (only significantly for alcohol use). CONCLUSION Adolescents presenting after sexual assault have high levels of vulnerability over a year post-assault. Many remain at risk for mental health disorders, highlighting the need for specialist intervention and ongoing support. A key concern for young people is disruption to their education. Multi-faceted support is needed to prevent social exclusion and further widening of health inequalities in this population, and to support young people in their immediate and long-term recovery.
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Affiliation(s)
- Venetia Clarke
- The Havens Sexual Assault Referral Centres, King's College Hospital, Denmark Hill, London, SE5 9RS, UK
| | - Andrea Goddard
- The Havens Sexual Assault Referral Centres, King's College Hospital, Denmark Hill, London, SE5 9RS, UK
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London, W2 1NY, UK
| | - Kaye Wellings
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Raeena Hirve
- Department of Women and Children's Health, King's College London, c/o 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7NH, UK
| | - Marta Casanovas
- Division of Psychiatry, Imperial College London, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK
| | - Susan Bewley
- Department of Women and Children's Health, King's College London, c/o 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7NH, UK
| | - Russell Viner
- Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 3EH, UK
| | - Tami Kramer
- Division of Psychiatry, Imperial College London, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK
| | - Sophie Khadr
- The Havens Sexual Assault Referral Centres, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
- Department of Women and Children's Health, King's College London, c/o 10th Floor North Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7NH, UK.
- Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 3EH, UK.
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Lee J, Shin J, Chae S, Chun J, Choi JW, Lee JY, Park TW, Kim KM, Kim K, Kim JW. The Factors Affecting Longitudinal Course of Posttraumatic Stress Disorder Symptoms in Sexual Assault Victims. Psychiatry Investig 2023; 20:1061-1068. [PMID: 37997334 PMCID: PMC10678143 DOI: 10.30773/pi.2023.0077] [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] [Received: 03/08/2023] [Revised: 07/05/2023] [Accepted: 08/22/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVE This study aimed to identify the factors affecting posttraumatic stress disorder (PTSD) symptom remission prospectively through a 1-year follow-up of sexual assault (SA) victims. METHODS A total 65 female SA victims who visited the crisis intervention center were included. Self-administered questionnaires regarding PTSD symptoms and PTSD related prognostic factors were conducted at both recruitment (T1) and 1 year after recruitment (T2). The multivariate analyses were used to determine the significant predictors of PTSD remission/non-remission state 1 year after SA. RESULTS In logistic regression analysis, both anxiety and secondary victimization were identified as significant factors explaining the results on PTSD remission/non-remission state at T2 (Beck's Anxiety Inventory [BAI], p=0.003; Secondary Victimization Questionnaire, p=0.024). In a linear mixed analysis, both depression and anxiety were found to be significant variables leading to changes in Posttraumatic Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition from T1 to T2 (BAI, p<0.001; Center for Epidemiological Studies Depression Scale, p<0.001). CONCLUSION Depression, anxiety symptoms, and secondary victimization after SA were associated with PTSD symptom non-remission 1 year after SA.
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Affiliation(s)
- Jaewon Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jiyoon Shin
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soohyun Chae
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jeeyoung Chun
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Won Choi
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Tae-Won Park
- Department of Psychiatry, Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Kyoung Min Kim
- Department of Psychiatry, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Kihyun Kim
- Department of Social Welfare, College of Social Sciences, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jae-Won Kim
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
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Dworkin ER, Jaffe AE, Bedard-Gilligan M, Fitzpatrick S. PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies. TRAUMA, VIOLENCE & ABUSE 2023; 24:497-514. [PMID: 34275368 PMCID: PMC8766599 DOI: 10.1177/15248380211032213] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Sexual assault is associated with higher rates of posttraumatic stress disorder (PTSD) than other traumas, and the course of PTSD may differ by trauma type. However, the course of PTSD after sexual assault has not been summarized. The aim of this meta-analysis was to identify the prevalence and severity of PTSD and changes to the average rate of recovery in the 12 months following sexual assault. METHOD Authors searched four databases for prospective studies published before April 2020 and sought relevant unpublished data. Eligible studies assessed PTSD in at least 10 survivors of sexual assault in at least two time points, starting within 3 months postassault. Random effects linear-linear piecewise models were used to identify changes in average recovery rate and produce model-implied estimates of monthly point prevalence and mean symptom severity. RESULTS Meta-analysis of 22 unique samples (N = 2,106) indicated that 74.58% (95% confidence interval [CI]: [67.21, 81.29]) and 41.49% (95% CI: [32.36, 50.92]) of individuals met diagnostic criteria for PTSD at the first and 12th month following sexual assault, respectively. PTSD symptom severity was 47.94% (95% CI: [41.27, 54.61]) and 29.91% (95% CI: [23.10, 36.73]) of scales' maximum severity at the first and 12th month following sexual assault, respectively. Most symptom recovery occurred within the first 3 months following sexual assault, after which point the average rate of recovery slowed. CONCLUSIONS Findings indicate that PTSD is common and severe following sexual assault, and the first 3 months postassault may be a critical period for natural recovery.
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Affiliation(s)
- Emily R Dworkin
- 12353University of Washington School of Medicine, Seattle, WA, USA
| | - Anna E Jaffe
- University of Nebraska, Lincoln-Lincoln, NE, USA
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Cheng P, Wang L, Zhou Y, Ma W, Zhao G, Zhang L, Li W. Post-traumatic stress disorder and depressive symptoms among firefighters: a network analysis. Front Public Health 2023; 11:1096771. [PMID: 37213609 PMCID: PMC10193951 DOI: 10.3389/fpubh.2023.1096771] [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: 11/12/2022] [Accepted: 04/04/2023] [Indexed: 05/23/2023] Open
Abstract
Background Firefighters, as first responders with a high risk of occupational exposure to traumatic events and heavy working stress, have a high prevalence of PTSD symptoms and depressive symptoms. But no previous studies analyzed the relationships and hierarchies of PTSD and depressive symptoms among firefighters. Network analysis is a novel and effective method for investigating the complex interactions of mental disorders at the symptom level and providing a new understanding of psychopathology. The current study was designed to characterize the PTSD and depressive symptoms network structure in the Chinese firefighters. Method The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) and the Self-Rating Depression Scale (SDS) were applied to assess PTSD and depressive symptoms, respectively. The network structure of PTSD and depressive symptoms was characterized using "expected influence (EI)" and "bridge EI" as centrality indices. The Walktrap algorithm was conducted to identify communities in the PTSD and depressive symptoms network. Finally, Network accuracy and stability were examined using the Bootstrapped test and the case-dropping procedure. Results A total of 1,768 firefighters were enrolled in our research. Network analysis revealed that the relationship between PTSD symptoms, "Flashback" and "Avoidance," was the strongest. "Life emptiness" was the most central symptom with the highest EI in the PTSD and depression network model. Followed by "Fatigue" and "Interest loss." Bridge symptoms connecting PTSD and depressive symptoms in our study were "Numb," "High alertness," "Sad mood," and "Compunction and blame," successively. The data-driven community detection suggested the differences in PTSD symptoms in the clustering process. The reliability of the network was approved by both stability and accuracy tests. Conclusion To the best of our knowledge, the current study first demonstrated the network structure of PTSD and depressive symptoms among Chinese firefighters, identifying the central and bridge symptoms. Targeting interventions to the symptoms mentioned above may effectively treat firefighters suffering from PTSD and depressive symptoms.
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Affiliation(s)
- Peng Cheng
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lirong Wang
- Xiangya School of Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Ying Zhou
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wenjing Ma
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Guangju Zhao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Li Zhang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Weihui Li
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- *Correspondence: Weihui Li,
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Trauma in Rapes and Assaults. CHILDREN 2021; 8:children8121143. [PMID: 34943338 PMCID: PMC8700209 DOI: 10.3390/children8121143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 11/18/2022]
Abstract
Psychological trauma primarily affects children and adolescents; it mostly results from physical and sexual maltreatment. In the Medico-Judicial Unit Center for Sexual Violence Victims in Tours, France, which I joined in 1992 for research and to give treatment, underage patients represented about three-quarters of patients. At the same time, a national survey was conducted in collaboration with Marie Choquet’s “Adolescent Health” group (INSERM), which targeted several thousand adolescents representing the general population. It revealed that almost one out of five adolescents had experienced physical or sexual assault, and that although the number of sexual assaults probably does not exceed that of physical assaults, most of the time their psychological consequences do considerably exceed those of physical assaults. Several symptoms appear after experiencing rapes or assaults. They have a distinct semiology and independent evolutions. We isolated three of them: dissociative and phobic traumatic syndrome, re-experiencing traumatic syndrome, and borderline-like traumatic syndrome. They are generally triggered all at the same time or in close succession. Re-experiencing traumatic syndrome is profound, but the other two are often more worrying, particularly in relation to children and adolescents, because they generate disorders in their psychological development.
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Karataş RD, Altınöz AE, Eşsizoğlu A. Post-traumatic stress disorder and related factors among female victims of sexual assault required to attend a University Hospital in Turkey: A cross-sectional cohort study. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2020; 30:79-94. [PMID: 32307807 DOI: 10.1002/cbm.2145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 07/08/2019] [Accepted: 03/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is one of the most common consequences of sexual assault, but it is not invariable. AIM Our aim was to investigate pre-, peri- and post-traumatic factors associated with post-traumatic stress disorder among adult women who had been sexually assaulted. METHODS All women attending a specialist university clinic for victims of sexual assault referred by the courts for a mental health assessment were invited to participate. At the time, the Turkish penal code required such referral (the year up to September 2015). Consenting women completed a sociodemographic information form, the Traumatic Stress Symptom Checklist, the Multidimensional Scale of Perceived Social Support, the Short Form-36 reflecting perceived quality of life, the Beck Depression Scale and the Beck Anxiety Scale. RESULTS Sixty women were eligible and agreed to participate. Two-thirds of them (41, 68%) reported features of PTSD. In bivariate analyses, the women with PTSD also rated themselves as having a wide range of health and social disadvantages. Self-perceived poverty of social support and having suicidal thoughts were independently associated with PTSD. CONCLUSIONS Although the rate of mental health and social problems among the women with PTSD were high, less than a third had actually sought help for their difficulties. While a requirement in the penal code that such women should have a psychiatric assessment seems over-intrusive and has since been dropped, our findings suggest that more efforts should be made to ensure that such women have help available if they want it.
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Affiliation(s)
| | - Ali Ercan Altınöz
- Department of Psychiatry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Altan Eşsizoğlu
- Department of Psychiatry, Private Practice, Eskişehir, Turkey
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7
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MacGregor KE, Villalta L, Clarke V, Viner R, Kramer T, Khadr SN. A systematic review of short and medium-term mental health outcomes in young people following sexual assault. J Child Adolesc Ment Health 2020; 31:161-181. [PMID: 31805838 DOI: 10.2989/17280583.2019.1665533] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: Sexual assault peaks in adolescence, yet sequelae at this age are not well understood. This systematic review aimed to describe mental health outcomes following sexual assault in young people. Method: Two reviewers independently searched databases, screening publications from 1990 to 2018. Inclusion criteria included: longitudinal studies, systematic reviews, and meta-analyses with ≥50% participants aged ten to 24 years; baseline mental health assessment prior to/or <8 weeks post-assault with follow-up ≥ 3 months after the initial assessment.Results: 5 124 titles and abstracts were screened, with 583 papers examined in full. Ten studies met inclusion criteria (sample size 31 to 191). Five studies examined rates of post-traumatic stress disorder (PTSD), reporting rates of up to 95% within one month and up to 60% at 12 months post-assault. Studies evaluating post-traumatic (n = 5) and anxiety (n = 3) symptom scores showed symptoms were highest in the immediate aftermath of the trauma, generally reducing over four to 12 months post-assault. Depressive symptomology appeared to vary between studies (n = 5). However, the majority showed symptoms decreasing over the same time period.Conclusions: Psychopathology is common following sexual assault in young people. Most studies observed reduced rates over time, but there is a paucity of longitudinal research. Psychopathology during the first year after sexual assault is an important treatment target to consider.
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Affiliation(s)
- Kirsten E MacGregor
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Laia Villalta
- Centre for Psychiatry, Imperial College London, London, UK
| | | | - Russell Viner
- University College London Great Ormond Street Institute of Child Health, London, UK
| | - Tami Kramer
- Centre for Psychiatry, Imperial College London, London, UK
| | - Sophie N Khadr
- University College London Great Ormond Street Institute of Child Health, London, UK.,The Havens, Sexual Assault Referral Centres, London, UK
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Villalta L, Khadr S, Chua KC, Kramer T, Clarke V, Viner RM, Stringaris A, Smith P. Complex post-traumatic stress symptoms in female adolescents: the role of emotion dysregulation in impairment and trauma exposure after an acute sexual assault. Eur J Psychotraumatol 2020; 11:1710400. [PMID: 32002143 PMCID: PMC6968575 DOI: 10.1080/20008198.2019.1710400] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/17/2019] [Accepted: 12/04/2019] [Indexed: 12/02/2022] Open
Abstract
Background: Adolescents are at high risk of sexual assault compared to any other age group. The pattern of post-traumatic stress symptoms plus life-impairing disturbances in self-organization (emotion dysregulation, negative self-concept and interpersonal problems) is termed Complex Post-Traumatic Stress Disorder (CPTSD). Research about CPTSD after sexual assault in adolescents is limited owing to the challenges associated with assessing this group. This study aims to determine the frequency and structure of CPTSD, and the relationship of emotion dysregulation with impairment and additional trauma exposure among adolescents who have been sexually assaulted. Method: Prospective cohort study of adolescents attending the Sexual Assault Referral Centres serving London over a 2-year period. We conducted cross-sectional analyses (n = 99) on data collected 4-5 months after sexual assault, and Confirmatory Factor Analyses (CFA) and Latent Class Analyses (LCA) to determine the CPTSD profile. CTPSD was defined according to the ICD-11, selecting symptom indicators from the following measures: Strengths and Difficulties Questionnaire (SDQ), Children's Revised Impact of Event Scale (CRIES-13), Short version of the Mood and Feelings Questionnaire (S-MFQ), The Development and Well-Being Assessment (DAWBA). We analysed the association of CPTSD symptom domains with impairment (measured with the SDQ, and the Children's Global Assessment Scale; C-GAS) and with additional trauma exposure. Results: The frequency of ICD-11 PTSD was 59%, and of ICD-11 CPTSD was 40%. CPTSD symptoms showed a strong fit for a correlated 4-factor model, and LCA distinguished a class of participants with high levels of CPTSD symptoms. Emotion dysregulation was associated with impairment in functioning and exposure to trauma beyond other self-organization disturbances and core PTSD symptoms. Conclusions: Disturbances in self-organization are frequent in sexually assaulted adolescents, and emotion dysregulation is associated with impairment and further exposure to trauma. Emotion dysregulation should be considered in preventive and treatment strategies for these vulnerable youth.
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Affiliation(s)
- Laia Villalta
- Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, University of Barcelona (UB), Barcelona, Spain
| | - Sophie Khadr
- Population, Policy & Practice Research Programme, UCL Institute of Child Health, London, UK.,The Havens Sexual Assault Referral Centres, King's College Hospital, London, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kia-Chong Chua
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tami Kramer
- The Centre for Mental Health, Imperial College London, London, UK
| | - Venetia Clarke
- The Havens Sexual Assault Referral Centres, King's College Hospital, London, UK
| | - Russell M Viner
- Population, Policy & Practice Research Programme, UCL Institute of Child Health, London, UK
| | - Argyris Stringaris
- Mood Brain & Development Unit, Emotion and Development Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Patrick Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Dworkin ER, Schumacher JA. Preventing Posttraumatic Stress Related to Sexual Assault Through Early Intervention: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2018; 19:459-472. [PMID: 27681005 PMCID: PMC5373931 DOI: 10.1177/1524838016669518] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Sexual assault survivors come into contact with a variety of community responders after assault, and these interactions may play an important role in mitigating distress. Given theoretical understandings of the importance of early experiences in the development of posttraumatic stress (PTS), early contact with formal systems (e.g., health care, criminal justice, social services) and informal responders (e.g., friends, family) might be particularly important in preventing PTS. However, the effectiveness of these early interventions is unclear. Understanding the key elements of early interventions, both formal and informal, that successfully prevent the development of PTS could help to improve community responses to sexual assault and ultimately promote survivor well-being. In this systematic review, we investigate the types of experiences with responders in the early aftermath of assault that are associated with PTS, the duration of effects on PTS, and the role of the timing of these responses in the development of PTS. Findings indicate that responder contact alone is not typically associated with significant differences in PTS, and there is insufficient evidence to indicate that the timing of seeking help is associated with PTS, but the quality of services provided and perceptions of interactions with certain responders appear to be associated with PTS. Although many effects were short-lived, interventions that were perceived positively may be associated with lower PTS up to a year postassault. These findings support the importance of offering best practice interventions that are perceived positively, rather than simply encouraging survivors to seek help.
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Affiliation(s)
- Emily R Dworkin
- 1 University of Mississippi Medical Center, Jackson, MS, USA
- 2 G.V. "Sonny" Montgomery VA Medical Center, Jackson, MS, USA
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Mental and sexual health outcomes following sexual assault in adolescents: a prospective cohort study. THE LANCET CHILD & ADOLESCENT HEALTH 2018; 2:654-665. [PMID: 30119759 DOI: 10.1016/s2352-4642(18)30202-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Young people are disproportionately affected by sexual assault, yet longitudinal data are sparse. This paper examines the characteristics of adolescents presenting to sexual assault services and mental and sexual health outcomes after an assault. METHODS This was a prospective cohort study in adolescents aged 13-17 years attending the Sexual Assault Referral Centres serving Greater London, UK, over 2 years. Baseline interviews (T0) were done less than 6 weeks after an assault to collect data on sociodemographic and assault characteristics and psychological symptoms, with follow-up interviews (T1) at 4-5 months after the assault. Four psychological symptom questionnaires were used at T0 and T1: The Child Revised Impact of Events Scale, the Short Mood and Feelings Questionnaire, the Screen for Child Anxiety Related Disorders, and the Strengths and Difficulties Questionnaire. The primary outcome was prevalence of any psychiatric disorder at T1, assessed using the Development and Wellbeing Assessment. Secondary outcomes at T1 were pregnancy, sexually transmitted infections, and sexual health screening since the assault. FINDINGS Between April 15, 2013, and April 20, 2015, 141 (29%) of 491 eligible young people were recruited to the study (134 females; mean age 15·6 years [SD 1·27]), and 106 (75%) of 141 participants had T1 interviews (99 female). At T0, psychological symptom scores showed that 115 (88%) of 130 females were at risk for depressive disorder, 90 (71%) of 126 were at risk for anxiety disorders, and 116 (91%) of 128 were at risk for post-traumatic stress disorder, with symptoms largely persisting at T1. 68 (80%) of 85 females who had a diagnostic assessment at T1 had a psychiatric disorder, with multiple disorders in 47 (55%) of 85. Anxiety, post-traumatic stress, and major depressive disorders were the commonest diagnoses. Presence of a psychiatric disorder was associated with baseline psychosocial vulnerability (previous social services involvement, mental health service use, self-harm, or sexual abuse), but not assault characteristics. At T1, four (4%) of 105 females had been pregnant since the assault, 14 (12%) of 119 had a sexually transmitted infection diagnosed between T0 and T1, and nine (8%) of 107 reported re-victimisation since the assault. INTERPRETATION Vulnerable adolescents have the double disadvantage of being at risk for both sexual assault and associated psychiatric disorders, highlighting the need for comprehensive support after an assault. Feasibility and effectiveness of prevention programmes should be investigated. FUNDING National Institute for Health Research Policy Research Programme grant (115/0001).
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11
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Darves-Bornoz JM. [Personality and somatic disorders]. Encephale 2018; 44:471-475. [PMID: 29891099 DOI: 10.1016/j.encep.2018.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 02/08/2018] [Accepted: 02/12/2018] [Indexed: 11/29/2022]
Abstract
In the title of this text, by somatic disorders we mean those physical illnesses clearly related to a non-psychiatric medical field, frequently termed psychosomatic illnesses and somatoform disorders. For forty years, a trend of thought has focused with pertinence on the psychological peculiarities in patients with severe somatic diseases. Moreover, causality was often supposed in the regularly mentioned association between personality features and somatoform disorders. However, the revival of the study of the earlier field of relationships between mind and body by Briquet, Charcot, Janet and Freud in his first period has led to the reassessment of the meaning of these observations. This reexamination is marked out by several assertions. Two of them work as preliminaries to argumentation: 1. existential wounds may produce long-lasting personality alterations; 2. existential wounds may produce somatoform disorders. These phenomena have been rediscovered over the last few years among assaulted subjects as well as war veterans in whom a frequent occurrence of somatizations has been, in addition, closely linked to the incidence of behavior or personality disorders. Two theses then emerge: 1. somatic diseases may produce long-lasting personality alterations; 2. until now no premorbid personality univocally predisposing to somatic diseases could be found. Indeed, during the 1980s a growing body of negative results coming from retrospective and prospective studies as well as anatomical comparisons have accumulated upon the potential role of certain personality factors in the incidence of somatic illnesses. This dialectic leads to the connection of two corollary assertions: 1. "pensée opératoire" and "alexithymia" in patients with somatic diseases may represent only an effect of the announcement or chronicity of the organic disease; 2. the old "dissociative hysteria" with somatic manifestations finds its substratum in existential wounds and not in pre-trauma personality. Indeed, on the one hand, recent publications do not allow the assertion to be confirmed that alexithymia and "pensée opératoire" predispose to somatizations. On the other hand, personality disorders in subjects with "dissociative hysteria" as well as their somatoform symptoms appear mainly as an effect of an existential wound and express in fact the Janetian concept of "a drop in Psychological Tension". Then, in spite of their differences, conversion and psychosomatic symptoms share the property of being a primitive response to existential wounds in which the subject cannot produce any appropriate psychic or behavioral response to his distress. Light is shed on these phenomena when put alongside the field of "fixed ideas" thought of by Pierre Janet as the recourse to archaic automatisms. Indeed, the experience which contradicts the vision of existence provokes an "unspeakable terror". It is mentally unrepresented or represented in too slight a way. In such cases, no previous personality prevails, but the resulting personality often appears modified, including when the breakdown of vision of the existence results from the diagnosis of an illness or its protracted course.
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Affiliation(s)
- J-M Darves-Bornoz
- Unité ambulatoire de psychiatrie de liaison, hôpital Beaujon (Assistance publique-Hôpitaux de Paris), 100, boulevard du Général-Leclerc, 92110 Clichy, France.
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12
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Georgia EJ, Roddy MK, Doss BD. Sexual Assault and Dyadic Relationship Satisfaction: Indirect Associations Through Intimacy and Mental Health. Violence Against Women 2018; 24:936-951. [PMID: 29332518 DOI: 10.1177/1077801217727371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rates of child and adult sexual assault (SA) among women are staggering and place women at risk for intra- and interpersonal difficulties. However, the independent contributions of child and adult SA or the mechanisms of this risk are unknown. This study's goal was to examine the indirect effects of child and adult SA on women's own and partner's relationship functioning through their impact on women's mental health, emotional intimacy, and sexual intimacy. Results revealed that the association of women's child SA with both her own and her partner's relationship satisfaction operated through emotional intimacy. Considerations for the study of women with a history of SA in the context of couple functioning are discussed.
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13
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Koss MP, Bailey JA, Yuan NP, Herrera VM, Lichter EL. Depression and PTSD in Survivors of Male Violence: Research and Training Initiatives to Facilitate Recovery. PSYCHOLOGY OF WOMEN QUARTERLY 2016. [DOI: 10.1111/1471-6402.00093] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Male violence is an enduring feature of women's lives from childhood through old age. The review covers child sexual abuse, rape, and partner violence with emphasis on the prevalence of violence, its mental health consequences, the course of recovery, and mediators and moderators of traumatic impact. The primary focus is depression and posttraumatic stress disorder, the two major diagnostic entities through which postassault emotions and behaviors have been conceptualized and measured. The effects of psychiatric conceptualizations of victimization and patterns of individual recovery are critically reviewed. The PTSD paradigm as the sole foundation for most victimization research is also debated. Following the review, mental health services for victimized women are examined. The article concludes with public policy recommendations to improve the availability and accessibility of mental health services with emphasis on reaching those survivors who are less likely to consult the formal system.
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Affiliation(s)
- Mary P. Koss
- Mel and Enid Zuckerman Arizona College of Public Health, Health Promotion Sciences, University of Arizona
| | - Jennifer A. Bailey
- Mel and Enid Zuckerman Arizona College of Public Health, Health Promotion Sciences, University of Arizona
| | - Nicole P. Yuan
- Mel and Enid Zuckerman Arizona College of Public Health, Health Promotion Sciences, University of Arizona
| | - Veronica M. Herrera
- Social Development Research Group, School of Social Work, University of Washington; Veronica M. Herrera, Stone Center, Wellesley College
| | - Erika L. Lichter
- Department of Maternal and Child Health, Harvard University School of Public Health
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14
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Frías Á, Martínez B, Palma C, Farriols N. Clinical impact of comorbid major depression in subjects with posttraumatic stress disorder: A review of the literature. NORDIC PSYCHOLOGY 2016. [DOI: 10.1080/19012276.2016.1162106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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15
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Abstract
In this literature review, authors analyzed the history of studies on psychogenic (stress-included) depressions and the current state of the problem. The status of these diseases in classification systems, main directions of current research, proposed conceptions and perspectives of future studies in the filed are considered.
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Affiliation(s)
- E I Voronova
- Sechenov First Moscow State Medical University, Moscow
| | - E B Dubnitskaya
- Sechenov First Moscow State Medical University, Moscow; Mental Health Research Center, Moscow
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16
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Identifying risk factors for PTSD in women seeking medical help after rape. PLoS One 2014; 9:e111136. [PMID: 25340763 PMCID: PMC4207776 DOI: 10.1371/journal.pone.0111136] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 09/22/2014] [Indexed: 11/19/2022] Open
Abstract
Objectives Rape has been found to be the trauma most commonly associated with Posttraumatic Stress Disorder (PTSD) among women. It is therefore important to be able to identify those women at greatest risk of developing PTSD. The aims of the present study were to analyze the PTSD prevalence six months after sexual assaults and identify the major risk factors for developing PTSD. Methods Participants were 317 female victims of rape who sought help at the Emergency Clinic for Raped Women at Stockholm South Hospital, Sweden. Baseline assessments of mental health were carried out and followed up after six months. Results Thirty-nine percent of the women had developed PTSD at the six month assessment, and 47% suffered from moderate or severe depression. The major risk factors for PTSD were having been sexually assaulted by more than one person, suffering from acute stress disorder (ASD) shortly after the assault, having been exposed to several acts during the assault, having been injured, having co-morbid depression, and having a history of more than two earlier traumas. Further, ASD on its own was found to be a poor predictor of PTSD because of the substantial ceiling effect after sexual assaults. Conclusions Development of PTSD is common in the aftermath of sexual assaults. Increased risk of developing PTSD is caused by a combination of victim vulnerability and the extent of the dramatic nature of the current assault. By identifying those women at greatest risk of developing PTSD appropriate therapeutic resources can be directed.
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17
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Elklit A, Christiansen DM. Risk factors for posttraumatic stress disorder in female help-seeking victims of sexual assault. VIOLENCE AND VICTIMS 2013; 28:552-568. [PMID: 23862315 DOI: 10.1891/0886-6708.09-135] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Posttraumatic stress disorder (PTSD) is common in the aftermath of rape and other sexual assault, but the risk factors leading to PTSD following rape have been shown to differ from those related to PTSD following nonsexual assault. This prospective study examined risk factors for PTSD severity in 148 female help-seeking victims of sexual assault. Approximately 70% of the victims experienced significant levels of traumatization, with 45% reporting symptoms consistent with a probable PTSD diagnosis. Regression analyses showed that relationship with the assailant, number of assailants, the nature of the assault, perceived positive social support, support satisfaction, feeling let down by others, and prior exposure to sexual trauma did not significantly predict PTSD severity at the final level of analysis. In accordance with suggestions by Dancu, Riggs, Hearst-Ikeda, and Shoyer (1996), it is suggested that this is partly caused by a very high degree of traumatization in the sample. Instead, previous nonsexual traumatic experiences and negative affectivity accounted for 30% of the variance in PTSD severity. Although more research is needed on risk factors of assault-related PTSD, these findings suggest that although sexual assault is associated with a high degree of PTSD severity, prior nonsexual victimization and high levels of negative affectivity appear to further increase the vulnerability toward developing symptoms of assault-related PTSD.
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Affiliation(s)
- Ask Elklit
- National Center for Psychotraumatology, Denmark
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18
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Kaysen D, Atkins DC, Moore SA, Lindgren KP, Dillworth T, Simpson T. Alcohol Use, Problems, and the Course of Posttraumatic Stress Disorder: A Prospective Study of Female Crime Victims. J Dual Diagn 2011; 7:262-279. [PMID: 23538605 PMCID: PMC3607458 DOI: 10.1080/15504263.2011.620449] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE This study examines whether alcohol use disorder status and consequences of drinking moderate the course of PTSD over the first 6 months following trauma exposure in a sample of female victims of interpersonal violence. METHODS Female sexual and physical assault victims (n = 64) were recruited through police, hospital, and victim service agencies. Women completed structured clinical interviews and self-report measures within the first five weeks, three months, and six months post-trauma with 73% retention across all three time points (n = 47). Analyses were conducted using Hierarchical Linear Modeling using alcohol abuse/dependence, peak alcohol use, and consequences during the 30 days prior to assault as moderators of the course of PTSD over time. RESULTS Women with alcohol use disorder at baseline had lower initial PTSD symptoms but also less symptom recovery over time than women without alcohol use disorder. This pattern of results was also found for those with high negative drinking consequences during the month prior to the assault. Baseline alcohol use was not found to significantly moderate PTSD course over the 6 months. CONCLUSIONS Findings suggest that negative consequences associated with alcohol use may be a risk factor for PTSD. Incorporating assessment of drinking problems for women presenting early post-trauma may be useful for identifying PTSD risk.
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Affiliation(s)
- Debra Kaysen
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington
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19
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Edmondson D, Chaudoir SR, Mills MA, Park CL, Holub J, Bartkowiak JM. From Shattered Assumptions to Weakened Worldviews: Trauma Symptoms Signal Anxiety Buffer Disruption. JOURNAL OF LOSS & TRAUMA 2011; 16:358-385. [PMID: 24077677 DOI: 10.1080/15325024.2011.572030] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The fundamental assertion of worldview-based models of posttraumatic stress disorder is that trauma symptoms result when traumatic experiences cannot be readily assimilated into previously held worldviews. In two studies, we test the anxiety buffer disruption hypothesis, which states that trauma symptoms result from the disruption of normal death anxiety-buffering functions of worldview. In Study 1, participants with trauma symptoms greater than the cutoff for PTSD evinced greater death-thought accessibility than those with sub-clinical or negligible symptoms after a reminder of death. In Study 2, participants with clinically significant trauma symptoms showed no evidence of worldview defense though death-thoughts were accessible. These results support the anxiety buffer disruption hypothesis, and suggest an entirely new approach to experimental PTSD research.
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Affiliation(s)
- Donald Edmondson
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center
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20
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Posttraumatic stress symptoms and trajectories in child sexual abuse victims: an analysis of sex differences using the national survey of child and adolescent well-being. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2009; 37:727-37. [PMID: 19221872 DOI: 10.1007/s10802-009-9300-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Very few studies have prospectively examined sex differences in posttraumatic stress symptoms and symptom trajectories in youth victimized by childhood sexual abuse. This study addresses that question in a relatively large sample of children, drawn from the National Survey of Child and Adolescent Well-Being, who were between the ages of 8-16 years and who were reported to Child Protective Services for alleged sexual abuse. Sex differences were examined using t tests, logistic regression, and latent trajectory modeling. Results revealed that there were not sex differences in victims' posttraumatic stress symptoms or trajectories. Whereas caseworkers substantiated girls' abuse at higher rates than boys' abuse and rated girls significantly higher than boys on level of harm, there were not sex differences in three more objective measures of abuse severity characteristics. Overall, higher caseworker ratings of harm predicted higher initial posttraumatic stress symptom levels, and substantiation status predicted shallower decreases in trauma symptoms over time. Implications for theory and intervention are discussed.
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21
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Darves-Bornoz JM, Alonso J, de Girolamo G, de Graaf R, Haro JM, Kovess-Masfety V, Lepine JP, Nachbaur G, Negre-Pages L, Vilagut G, Gasquet I. Main traumatic events in Europe: PTSD in the European study of the epidemiology of mental disorders survey. J Trauma Stress 2008; 21:455-62. [PMID: 18956444 DOI: 10.1002/jts.20357] [Citation(s) in RCA: 146] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A potentially traumatic event (PTE) contributes to trauma through its frequency, conditional probability of posttraumatic stress disorder (PTSD), and experience of other PTEs. A cross-sectional survey was conducted, enrolling 21,425 adults nationally representative of six European countries. Using the WHO-Composite International Diagnostic Interview, 8,797 were interviewed on 28 PTEs and PTSD. Prevalence of 12-month PTSD was 1.1%. When PTSD was present, the mean number of PTEs experienced was 3.2. In a multivariate analysis on PTEs and gender, six PTEs were found to be more traumatic, and to explain a large percentage of PTSD, as estimated by their attributable risk of PTSD: rape, undisclosed private event, having a child with serious illness, beaten by partner, stalked, beaten by caregiver.
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22
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Kaysen D, Pantalone DW, Chawla N, Lindgren KP, Clum GA, Lee C, Resick PA. Posttraumatic stress disorder, alcohol use, and physical health concerns. J Behav Med 2008; 31:115-25. [PMID: 18095150 DOI: 10.1007/s10865-007-9140-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2007] [Accepted: 11/14/2007] [Indexed: 10/22/2022]
Abstract
PTSD is a risk factor for alcohol problems and both in turn have been independently associated with increased health problems. However, it is unclear whether alcohol use moderates the relationship between PTSD and health. Participants were battered women (N = 336) recruited from local domestic violence shelters and non-shelter victim-assistance agencies. A 2 (PTSD diagnosis) x 3 (abstainer, infrequent/light, regular/heavy drinking) ANCOVA was conducted, with injuries and length of abuse as covariates and health concerns as the dependent variable. Main effects for PTSD and alcohol use were significant but not the interaction. Women with PTSD reported the greatest number of health concerns. Women who abstained from drinking and those who drank regularly/heavily reported more health concerns than the infrequent/light drinkers. Health concerns associated with PTSD do not appear to be due to problem drinking. In addition, infrequent/light drinking, even for women with PTSD, may be associated with fewer health concerns.
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Affiliation(s)
- Debra Kaysen
- Center for Trauma Recovery, University of Missouri-St. Louis, St. Louis, MO, USA.
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23
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Kaysen D, Simpson T, Dillworth T, Larimer ME, Gutner C, Resick PA. Alcohol problems and posttraumatic stress disorder in female crime victims. J Trauma Stress 2006; 19:399-403. [PMID: 16788998 PMCID: PMC2958431 DOI: 10.1002/jts.20122] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Comorbidity between alcohol use and posttraumatic stress disorder (PTSD) has been well documented. However, there are few longitudinal studies with acute trauma samples. The present study examined symptoms of alcohol use disorders (AUDs) and PTSD longitudinally after assault. Female sexual (n = 69) and physical assault victims (n = 39) were assessed 2 to 4 weeks and 3 months post trauma. Women who had lifetime AUD had higher intrusive and avoidance symptoms than those who did not have AUD. Women who had any alcohol problems had higher PTSD symptoms. Participants who had alcohol problems had the same pattern of symptom recovery as those who did not have alcohol problems but remained more symptomatic over the 3 months. These findings suggest that early intervention strategies for women who have previous histories of alcohol problems and seek medical attention early post trauma may be indicated.
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Affiliation(s)
- Debra Kaysen
- University of Washington, Department of Psychiatry and Behavior Sciences, Seattle, WA 98195-6560, USA.
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24
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Nijenhuis ERS, van der Hart O, Kruger K, Steele K. Somatoform dissociation, reported abuse and animal defence-like reactions. Aust N Z J Psychiatry 2004; 38:678-86. [PMID: 15324331 DOI: 10.1080/j.1440-1614.2004.01441.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To test the hypotheses that among general psychiatric outpatients, somatoform dissociation is associated with posttraumatic stress symptoms and with reported potentially traumatizing events, especially with events that involve bodily threat from a person, also when reported age at onset, duration and subjectively rated impact of potentially traumatizing events are considered. METHOD Administration of self-report questionnaires evaluating the severity of somatoform and psychoform dissociation, posttraumatic stress-symptoms, and reported traumatizing events, using samples of consecutive and unselected psychiatric outpatients (n = 153). RESULTS Somatoform dissociation was strongly correlated with posttraumatic stress symptoms and with reported cumulative traumatization as assessed with two different self-report trauma questionnaires. Among a wide range of trauma types, bodily threat from a person best predicted somatoform dissociation. Emotional neglect and age further improved the prediction, but emotional neglect and abuse did not predict somatoform dissociation when interpersonal threat to the body was not reported. Somatoform dissociation was also best predicted by bodily threat when reported age at onset, duration and subjective impact of reported traumatization were included in the analyses. CONCLUSION This retrospective study suggests that recurrent interpersonal bodily threat may evoke animal defence-like psychobiological systems manifesting as somatoform dissociation and that this type of threat is often accompanied by emotional neglect. These hypotheses should now be tested in prospective studies.
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Affiliation(s)
- Ellert R S Nijenhuis
- Outpatient Department, Mental Health Care Drenthe, PO Box 30007, 9400 RA Assen, The Netherlands.
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25
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Nijenhuis ERS, Van der Hart O, Kruger K. The psychometric characteristics of the traumatic experiences checklist (TEC): first findings among psychiatric outpatients. Clin Psychol Psychother 2002. [DOI: 10.1002/cpp.332] [Citation(s) in RCA: 185] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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26
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Darves-Bornoz JM, Pierre F, Lépine JP, Degiovanni A, Gaillard P. Screening for psychologically traumatized rape victims. Eur J Obstet Gynecol Reprod Biol 1998; 77:71-5. [PMID: 9550204 DOI: 10.1016/s0301-2115(97)00244-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study aimed to determine whether the General Health Questionnaire, a simple psychological screening instrument, could be useful to non-specialists in screening for psychologically traumatized rape victims. STUDY DESIGN 285 rape victims (mean age 22.5, men 8%) attending consecutively a Consultation for Victims of Psychological Trauma at the University Hospital in Tours, France, were assessed through the Structured Interview for Post-Traumatic Stress Disorder (SI-PTSD), and the French 28-item version of the self-rated General Health Questionnaire (GHQ-28). RESULTS 70% had Post-Traumatic Stress Disorder (PTSD) and 72% a GHQ-28 overthreshold score. The principal component analysis of the GHQ-28 ratings yielded a 4-factor solution: social dysfunction, feeling of foreshortened future type of depression, somatoform complaints and hyperalertness anxiety. GHQ-28 reliability and validity in screening for PTSD were studied through computation of Cronbach's alpha coefficient (0.95), sensitivity (88%) and positive predictive value (86%). CONCCLUSION: Using the GHQ-28 is valid and appropriate for practical use.
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