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Rhodes A, Wilson C, Zelenkov D, Adams K, Poyant JO, Han X, Faugno A, Montalvo C. "The Psychiatric Domain of Post-Intensive Care Syndrome: A Review for the Intensivist". J Intensive Care Med 2024:8850666241275582. [PMID: 39169853 DOI: 10.1177/08850666241275582] [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: 08/23/2024]
Abstract
Post-intensive care syndrome (PICS) is a clinical syndrome characterized by new or worsening changes in mental health, cognition, or physical function that persist following critical illness. The psychiatric domain of PICS encompasses new or worsened psychiatric burdens following critical illness, including post-traumatic stress disorder (PTSD), depression, and anxiety. Many of the established predisposing and precipitating factors for the psychiatric domain of PICS are commonly found in the setting of critical illness, including mechanical ventilation (MV), exposure to sedating medications, and physical restraint. Importantly, previous psychiatric history is a strong risk factor for the development of the psychiatric domain of PICS and should be considered when screening patients to diagnose psychiatric impairment and interventions. Delirium has been associated with psychiatric symptoms following ICU admission, therefore prevention warrants careful consideration. Dexmedetomidine has been shown to have the lowest risk for development of delirium when compared to other sedatives and has been the only sedative studied in relation to the psychiatric domain of PICS. Nocturnal dexmedetomidine and intensive care unit (ICU) diaries have been associated with decreased psychiatric burden after ICU discharge. Studies evaluating the impact of other intra-ICU practices on the development of the psychiatric domain of PICS, including the ABCDEF bundle, depth of sedation, and daily spontaneous awakening trials, have been limited and inconclusive. The psychiatric domain of PICS is difficult to treat and may be less responsive to multidisciplinary post-discharge programs and targeted interventions than the cognitive and physical domains of PICS. Given the high morbidity associated with the psychiatric domain of PICS, intensivists should familiarize themselves with the risk factors and intra-ICU interventions that can mitigate this important and under-recognized condition.
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Affiliation(s)
- Allison Rhodes
- Tufts Medical Center, Boston, MA, USA
- Tufts University School of Medicine, Boston, MA
| | | | | | - Kathryne Adams
- Tufts Medical Center, Boston, MA, USA
- Tufts University School of Medicine, Boston, MA
| | | | - Xuan Han
- Tufts Medical Center, Boston, MA, USA
- Tufts University School of Medicine, Boston, MA
| | - Anthony Faugno
- Tufts Medical Center, Boston, MA, USA
- Tufts University School of Medicine, Boston, MA
| | - Cristina Montalvo
- Tufts Medical Center, Boston, MA, USA
- Tufts University School of Medicine, Boston, MA
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Davies JN, Harty SC, Boden JM. The roles of extraversion and neuroticism in the relationship between childhood adversity and adolescent substance misuse. Personal Ment Health 2024; 18:238-247. [PMID: 38476098 DOI: 10.1002/pmh.1611] [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: 10/26/2023] [Revised: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024]
Abstract
Although the influences of extraversion and neuroticism on the relationship between childhood adversity and substance misuse have been considered in adults, they are not yet clear and have not been examined among adolescent samples. This study sought to investigate the relationship between childhood adversity and adolescent substance misuse, alongside the influences of extraversion and neuroticism, using data from a longitudinal birth cohort study. Statistical analyses were performed on a longitudinal dataset provided by the Christchurch Health and Development Study (CHDS). After controlling for confounds, childhood adversity was a significant predictor of substance use disorder symptoms in adolescence. Moderation analyses showed that experiences of childhood adversity were most strongly associated with adolescent substance use disorder symptoms at higher levels of extraversion and at higher levels of neuroticism. Among adolescents who have experienced childhood adversity, extraversion and neuroticism may be risk factors for substance use disorder. By encouraging professionals to target adolescent substance misuse intervention and prevention approaches towards those who have experienced childhood adversity and are high in extraversion and/or neuroticism, these findings may help to diminish the prevalence of adolescent substance misuse and improve the health of adolescents.
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Affiliation(s)
- Jodie N Davies
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Seth C Harty
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Joseph M Boden
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, Christchurch, New Zealand
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Bajo M, García-Jiménez GM, Stavraki M, Díaz D. Positive Mental Health of Frontline Healthcare Professionals during COVID-19 First Wave and Second Wave in Spain: The Protective Role of Social Recognition. Int J Behav Med 2024; 31:527-537. [PMID: 37316752 DOI: 10.1007/s12529-023-10190-1] [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] [Accepted: 06/03/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND The study of the COVID-19 disease consequences on healthcare professionals' mental health has drawn a great interest in psychology and other behavioral sciences. Previous studies mainly focused on professionals' health in terms of psychopathology, therefore, there is no research examining their positive mental health during both the first and the second wave. Also, there is no research studying healthcare professionals' social recognition during the pandemic and the influence of this variable on professionals' positive health. METHODS Following the WHO's recommendations, our objective was to measure pathology (i.e., anxiety and traumatic intensity), positive health (i.e., Hedonic, Psychological and Social Well-being) and social recognition in a sample of 200 healthcare professionals in the frontline care of Covid-19 patients. RESULTS In both waves, participants showed high levels of anxiety and traumatic intensity, although, as expected, in the second (vs. the first) wave psychopathological symptoms decreased. Concerning positive health indicators, in the second wave, health professionals showed more hedonic and psychological well-being than in the first one. However, in the second wave social well-being was lower than in the first wave, an expected though apparently paradoxical result, linked to the decrease in healthcare professionals' social recognition between the first and the second wave. In fact, bootstrapping procedures and Sobel Test confirm the mediating role of social recognition on the effect of Covid-19 wave on social well-being. CONCLUSIONS Public institutions, governments, and society in general, should recognize health professionals' work, given that social recognition is a fundamental protection factor for social well-being.
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Affiliation(s)
- Miriam Bajo
- Universidad de Castilla la Mancha, Ciudad Real Medical School, Department of Medical Psychology, Camino de Moledores S/N, 13071, Ciudad Real, Spain.
| | - Gemma María García-Jiménez
- Universidad de Castilla la Mancha, Ciudad Real Medical School, Department of Medical Psychology, Camino de Moledores S/N, 13071, Ciudad Real, Spain
| | - Maria Stavraki
- Universidad de Castilla la Mancha, Ciudad Real Medical School, Department of Medical Psychology, Camino de Moledores S/N, 13071, Ciudad Real, Spain
| | - Darío Díaz
- Universidad de Castilla la Mancha, Ciudad Real Medical School, Department of Medical Psychology, Camino de Moledores S/N, 13071, Ciudad Real, Spain
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Dale SK, Wright IA, Madhu A, Reid R, Shahid NN, Wright M, Sanders J, Phillips A, Rodriguez A, Safren SA. A Pilot Randomized Control Trial of the Striving Towards EmPowerment and Medication Adherence (STEP-AD) Intervention for Black Women Living with HIV. AIDS Behav 2024:10.1007/s10461-024-04408-w. [PMID: 39012452 DOI: 10.1007/s10461-024-04408-w] [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] [Accepted: 06/03/2024] [Indexed: 07/17/2024]
Abstract
Black women living with HIV (BWLWH) face adversities associated with lower HIV medication adherence, viral non-suppression, and mental health symptoms (e.g., post-traumatic stress disorder) such as trauma/violence, racism, HIV-related discrimination/stigma, and gender-related stressors. We developed the first intervention based in cognitive behavioral therapy and culturally congruent coping for BWLWH to increase medication adherence and decrease PTSD symptoms by enhancing resilience, self-care, engagement in care, and coping for trauma, racism, HIV-related discrimination/stigma, and gender-related stressors. A pilot randomized control trial was conducted with BWLWH and histories of trauma who were at risk for their HIV viral load remaining or becoming detectable (i.e., below 80% medication adherence, detectable viral load in the past year, and/or missed HIV-related appointments). 119 BWLWH were assessed at baseline and 70 met inclusion criteria, completed one session of Life-Steps adherence counseling, and were randomized to either nine sessions of STEP-AD (Striving Towards EmPowerment and Medication Adherence) or ETAU (enhanced treatment as usual consisting of biweekly check-ins). Women completed a post intervention follow up assessment (3 months post baseline) and 3-month post intervention follow-up (6 months post baseline). Via STATA the difference-in-difference methodology with mixed models compared STEP-AD to ETAU on changes in outcomes over time. BWLWH in STEP-AD compared to E-TAU had significantly higher ART adherence (estimate = 9.36 p = 0.045) and lower likelihood of being clinically diagnosed with PTSD (OR = .07, estimate = - 2.66, p = 0.03) as well as borderline significance on higher CD4 count (estimate = 161.26, p = 0.05). Our findings suggest preliminary efficacy of STEP-AD in improving ART adherence, mental health, and immune function.
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Affiliation(s)
- Sannisha K Dale
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA.
| | - Ian A Wright
- Department of Economics, Miami Herbert Business School, University of Miami, Miami, FL, USA
| | - Aarti Madhu
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Rachelle Reid
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Naysha N Shahid
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Mya Wright
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Jasmyn Sanders
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Arnetta Phillips
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Allan Rodriguez
- Clinical Immunology, Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Steven A Safren
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
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Pinedo M, Escobar C. Childhood Parental Deportations, Immigration Enforcement Experiences, and Posttraumatic Stress Disorder Among US-Born Latino Adults, 2021. Am J Public Health 2024; 114:S495-S504. [PMID: 39083744 PMCID: PMC11292276 DOI: 10.2105/ajph.2024.307660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 08/02/2024]
Abstract
Objectives. To examine how having a parent deported in childhood and immigration enforcement encounters relate to posttraumatic stress disorder (PTSD) among a sample of US-born Latinos. Methods. In 2021, a national sample of 1784 US-born Latinos was recruited to complete a questionnaire. The questionnaire elicited data on sociodemographics, mental health, and immigration-related experiences. The dependent variable was past-year symptoms of PTSD. Immigration-related variables included (1) having a parent deported during their childhood, (2) having a (nonparent) family member deported, (3) fear of having a parent or loved one deported, (4) fear of immigration enforcement encounters, and (5) having experienced an immigration raid. A multivariable logistic regression was conducted to examine independent associations between immigration-related variables and PTSD. Results. Having a parent deported during childhood was associated with more than twice the odds of meeting criteria for PTSD symptoms. Having a loved one deported, fearing the deportation of a loved one, and having experienced an immigration raid were all associated with PTSD. Conclusions. It is imperative to better understand the long-term implications of immigration policies in perpetuating health inequities among US-born Latinos. (Am J Public Health. 2024;114(S6):S495-S504. https://doi.org/10.2105/AJPH.2024.307660) [Formula: see text].
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Affiliation(s)
- Miguel Pinedo
- Miguel Pinedo and Christian Escobar are with the Department of Kinesiology & Health Education, College of Education, University of Texas, Austin
| | - Christian Escobar
- Miguel Pinedo and Christian Escobar are with the Department of Kinesiology & Health Education, College of Education, University of Texas, Austin
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Navarra-Ventura G, Godoy-González M, Gomà G, Jodar M, Sarlabous L, Santos-Pulpón V, Xifra-Porxas A, de Haro C, Roca O, Blanch L, López-Aguilar J, Fernández-Gonzalo S. Occurrence, co-occurrence and persistence of symptoms of depression and post-traumatic stress disorder in survivors of COVID-19 critical illness. Eur J Psychotraumatol 2024; 15:2363654. [PMID: 38881386 PMCID: PMC11185090 DOI: 10.1080/20008066.2024.2363654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 05/22/2024] [Indexed: 06/18/2024] Open
Abstract
Background: Intensive care unit (ICU) admission and invasive mechanical ventilation (IMV) are associated with psychological distress and trauma. The COVID-19 pandemic brought with it a series of additional long-lasting stressful and traumatic experiences. However, little is known about comorbid depression and post-traumatic stress disorder (PTSD).Objective: To examine the occurrence, co-occurrence, and persistence of clinically significant symptoms of depression and PTSD, and their predictive factors, in COVID-19 critical illness survivors.Method: Single-centre prospective observational study in adult survivors of COVID-19 with ≥24 h of ICU admission. Patients were assessed one and 12 months after ICU discharge using the depression subscale of the Hospital Anxiety and Depression Scale and the Davidson Trauma Scale. Differences in isolated and comorbid symptoms of depression and PTSD between patients with and without IMV and predictors of the occurrence and persistence of symptoms of these mental disorders were analysed.Results: Eighty-nine patients (42 with IMV) completed the 1-month follow-up and 71 (34 with IMV) completed the 12-month follow-up. One month after discharge, 29.2% of patients had symptoms of depression and 36% had symptoms of PTSD; after one year, the respective figures were 32.4% and 31%. Coexistence of depressive and PTSD symptoms accounted for approximately half of all symptomatic cases. Isolated PTSD symptoms were more frequent in patients with IMV (p≤.014). The need for IMV was associated with the occurrence at one month (OR = 6.098, p = .005) and persistence at 12 months (OR = 3.271, p = .030) of symptoms of either of these two mental disorders.Conclusions: Comorbid depressive and PTSD symptoms were highly frequent in our cohort of COVID-19 critical illness survivors. The need for IMV predicted short-term occurrence and long-term persistence of symptoms of these mental disorders, especially PTSD symptoms. The specific role of dyspnea in the association between IMV and post-ICU mental disorders deserves further investigation.Trial registration: ClinicalTrials.gov identifier: NCT04422444.
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Affiliation(s)
- Guillem Navarra-Ventura
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Godoy-González
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Spain
| | - Gemma Gomà
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Jodar
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Spain
- Neurology Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Leonardo Sarlabous
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Verónica Santos-Pulpón
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Alba Xifra-Porxas
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Candelaria de Haro
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Oriol Roca
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Lluís Blanch
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Josefina López-Aguilar
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Sol Fernández-Gonzalo
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, International Excellence Campus, Bellaterra, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Xie YJ, Hao C, Tian L, Yan L, Liao X, Wang HH, Gao Y, Zhang D, Liu ZM, Cheng H, Ngai FW. Influence of Nurses' Perceptions of Government Policies and COVID-19 Risks on Their Mental Health Status: A Web-Based Cross-Sectional Study. Int J Ment Health Nurs 2024. [PMID: 38886916 DOI: 10.1111/inm.13382] [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: 08/11/2023] [Revised: 06/01/2024] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
This study aimed to understand nurses' perceptions of COVID-19-related policies and risks during the outbreak of COVID-19 in Hong Kong and to determine how their perceptions influenced their mental health status. A web-based online survey among Hong Kong nurses was conducted. The questionnaire included a self-designed 5-point Likert scale with 17 items to assess the nurses' perceptions of COVID-19-related policies and risks, as well as the Davidson Trauma Scale (DTS), the Perceived Stress Scale (PSS), the Patient Health Questionnaire-2 (PHQ-2) and the Generalised Anxiety Disorder scale (GAD) for measurement of posttraumatic stress disorder (PTSD), stress, depression and anxiety, respectively. Of 592 nurses enrolled, 30.6% had PTSD (DTS total score ≥40), and 80.4%, 19.9% and 16.4% had moderate-to-high levels of stress (PSS-10 score ≥14), depression (PHQ-2 score ≥3) and anxiety (GAD score ≥3), respectively. The top three concerned aspects were 'worried about themselves and friends to suffer this disease' (84.5%), 'insufficient number of isolation wards' (81.8%) and 'insufficient number of personal protective equipment' (74.3%). Logistic regression analyses showed that more negative perception on 'personal protective equipment in the healthcare institutions', 'the confidence in HK's control of COVID-19', 'worried about themselves and friends to suffer this disease' and 'self-perceived risk of infection' indicated higher severity of the four mental health problems (all p < 0.01). The perception on 'public gathering ban', 'the number of isolation wards' and 'expected time to control COVID-19' were significantly associated with PTSD and stress (all p < 0.05). Nurses' perception on government policies and COVID-19 risks played an important role in predicting their mental health status. Policy makers should be aware of nurses' psychological responses and provide timely and targeted emotional support to nurses amid and after the COVID-19 pandemic.
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Affiliation(s)
- Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Chun Hao
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Longben Tian
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Linjia Yan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaoli Liao
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Harry Haoxiang Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Usher Institute, Deanery of Molecular, Genetic & Population Health Sciences, The University of Edinburgh, Edinburgh, UK
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong SAR, China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhao-Min Liu
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Huilin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Fei Wan Ngai
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Sandnes R, Le Floch M, Riquin E, Nocus I, Müller JB, Bacro F. Parental stress and mental health outcomes following very preterm birth: A systematic review of recent findings. J Affect Disord 2024; 355:513-525. [PMID: 38556094 DOI: 10.1016/j.jad.2024.03.154] [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: 04/13/2023] [Revised: 03/06/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND In recent years, there has been a wide array of research studies published on parental mental health and stress following very preterm birth. This review aims at reviewing the prevalence and risk factors of long-term parental depression, anxiety, post-traumatic stress symptoms and parenting stress following very preterm birth. METHODS We searched PubMed, PsychINFO and Web of Science for descriptive, cross-sectional and longitudinal studies published between January 2013 and August 2022. RESULTS 45 studies met our inclusion criteria. In the first two years, depression, anxiety, post-traumatic stress symptoms and parenting stress were present in ∼20 % of mothers of extreme and very low birth weight (E/VLBW) infants. Long-term psychological distress symptoms could be observed, although few studies have focused on symptoms into school age and longer. Fathers of VLBW infants might experience more psychological distress as well, however, they were only included in ten studies. We found that parental distress is more common when the co-parent is struggling with mental health symptoms. Many risk factors were identified such as social risk, history of mental illness, interpersonal factors (i.e. social support) and child-related factors (i.e. intraventricular hemorrhage, disability, use of medical equipment at home). LIMITATIONS Several studies have methodological issues, such as a lack of control of known confounders and there is a large variety of measures employed. CONCLUSION Important risk factors for stress and mental health symptoms were identified. More evidence is needed to determine if long-term symptoms persist into school age. Research should focus on taking a family-based approach in order to identify preventive strategies and resilience factors in parents of VLBW infants.
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Affiliation(s)
- Ramona Sandnes
- Faculty of Psychology, Centre de Recherche en Education de Nantes (CREN - UR 2661), Nantes University, Nantes, France.
| | - Marine Le Floch
- Department of Child and Adolescent Psychiatry, University Hospital of Angers, France
| | - Elise Riquin
- Department of Child and Adolescent Psychiatry, University Hospital of Angers, France; Univ Angers, [CHU Angers], LPPL EA4638, F-49000 Angers, France; Fondation de Santé des Étudiants de France, clinique de Sablé sur Sarthe, Sablé sur Sarthe, France
| | - Isabelle Nocus
- Faculty of Psychology, Centre de Recherche en Education de Nantes (CREN - UR 2661), Nantes University, Nantes, France
| | - Jean Baptiste Müller
- Loire Infant Follow-Up Team (LIFT) Network, Pays de Loire, France; Department of Neonatal Medicine, Nantes University Hospital, Nantes, France
| | - Fabien Bacro
- Faculty of Psychology, Centre de Recherche en Education de Nantes (CREN - UR 2661), Nantes University, Nantes, France
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9
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Parker M, May PA, Marais AS, de Vries M, Kalberg WO, Buckley D, Hasken J, Hoyme HE, Seedat S. Influence of childhood trauma and traumatic stress on a woman's risk of having a child with a fetal alcohol spectrum disorder. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:1176-1188. [PMID: 38702143 PMCID: PMC11178454 DOI: 10.1111/acer.15334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 03/22/2024] [Accepted: 04/07/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Maternal risk factors for having a child diagnosed on the fetal alcohol spectrum disorders (FASD) continuum are complex and include not only the quantity, frequency, and timing of alcohol use but also a woman's physical stature, socio-economic status, and pregnancy-related factors. Exposure to trauma may predispose women to a range of physiological and mental disorders. A woman's mental and physical health may in turn influence her probability of having a child with FASD. This study investigated the role of maternal childhood trauma and lifetime traumatic stress on prenatal alcohol consumption and on the risk of having a child with FASD. METHODS A nested, case-control study was conducted for maternal risk assessment. Study participants were mothers of first-grade learners from five rural communities in the Western Cape Province of South Africa who were assessed for FASD. Face-to-face surveys were conducted, which included mental health and trauma assessment questionnaires. RESULTS In logistic regression analyses, higher maternal childhood trauma scores were associated with an increased likelihood of having a child diagnosed with FASD, although the increase in risk was modest (OR = 1.014, p = 0.015). In addition, structural equation modeling investigated relationships between maternal drinking, childhood trauma, traumatic stress, and a child's FASD diagnosis. Traumatic stress and drinking during pregnancy, but not lifetime alcohol use, were associated with maternal childhood trauma. Lifetime alcohol use influenced drinking during pregnancy, which in turn was significantly associated with having a child diagnosed on the continuum of FASD. CONCLUSION No direct influence of maternal childhood trauma on FASD diagnosis could be demonstrated. However, maternal trauma may indirectly contribute to the risk of having a child diagnosed with FASD.
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Affiliation(s)
- Michelle Parker
- Department of Psychiatry and SAMRC Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Philip A May
- Department of Psychiatry and SAMRC Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa
- Center on Alcohol, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, New Mexico, USA
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, North Carolina, USA
| | - Anna-Susan Marais
- Department of Psychiatry and SAMRC Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Marlene de Vries
- Department of Psychiatry and SAMRC Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Wendy O Kalberg
- Center on Alcohol, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, New Mexico, USA
| | - David Buckley
- Center on Alcohol, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, New Mexico, USA
| | - Julie Hasken
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, North Carolina, USA
| | - H Eugene Hoyme
- Department of Psychiatry and SAMRC Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa
- Sanford Children's Genomic Medicine Consortium, Sanford Health, Sioux Falls, South Dakota, USA
| | - Soraya Seedat
- Department of Psychiatry and SAMRC Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa
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10
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Sun X, Tao Q, Cui Q, Liu Y, Cheng S. Non-pharmacological interventions to prevent PICS in critically ill adult patients: a protocol for a systematic review and network meta-analysis. Syst Rev 2024; 13:132. [PMID: 38745174 PMCID: PMC11095022 DOI: 10.1186/s13643-024-02542-z] [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: 07/26/2023] [Accepted: 04/23/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Postintensive care syndrome (PICS) is common in critically ill adults who were treated in the intensive care unit (ICU). Although comparative analyses between types of non-pharmacological measures and usual care to prevent PICS have been performed, it remains unclear which of these potential treatments is the most effective for prevention. METHODS To obtain the best evidence for non-pharmaceutical interventions in preventing PICS, a systematic review and Bayesian network meta-analyses (NMAs) will be conducted by searching nine electronic databases for randomized controlled trials (RCTs). Two reviewers will carefully screen the titles, abstracts, and full-text papers to identify and extract relevant data. Furthermore, the research team will meticulously check the bibliographic references of the selected studies and related reviews to discover any articles pertinent to this research. The primary focus of the study is to examine the prevalence and severity of PICS among critically ill patients admitted to the ICU. The additional outcomes encompass patient satisfaction and adverse effects related to the preventive intervention. The Cochrane Collaboration's risk-of-bias assessment tool will be utilized to evaluate the risk of bias in the included RCTs. To assess the efficacy of various preventative measures, traditional pairwise meta-analysis and Bayesian NMA will be used. To gauge the confidence in the evidence supporting the results, we will utilize the Confidence in NMA tool. DISCUSSION There are multiple non-pharmacological interventions available for preventing the occurrence and development of PICS. However, most approaches have only been directly compared to standard care, lacking comprehensive evidence and clinical balance. Although the most effective care methods are still unknown, our research will provide valuable evidence for further non-pharmacological interventions and clinical practices aimed at preventing PICS. The research is expected to offer useful data to help healthcare workers and those creating guidelines decide on the most effective path of action for preventing PICS in adult ICU patients. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42023439343.
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Affiliation(s)
- Xiaoying Sun
- School of Nursing, Sun Yat-Sen University, Guangzhou, 510080, China
- The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qian Tao
- The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qing Cui
- Department of Respiratory and Intensive Care Medicine, Shenzhen People's Hospital, Shenzhen, 518020, China
| | - Yaqiong Liu
- School of Nursing, Suzhou Medical College, Soochow University, Suzhou, 215006, China
| | - Shouzhen Cheng
- The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China.
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11
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Koek RJ, Avecillas-Chasin J, Krahl SE, Chen JW, Sultzer DL, Kulick AD, Mandelkern MA, Malpetti M, Gordon HL, Landry HN, Einstein EH, Langevin JP. Deep brain stimulation of the amygdala for treatment-resistant combat post-traumatic stress disorder: Long-term results. J Psychiatr Res 2024; 175:131-139. [PMID: 38733927 DOI: 10.1016/j.jpsychires.2024.05.008] [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: 03/03/2024] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024]
Abstract
Deep brain stimulation (DBS) holds promise for neuropsychiatric conditions where imbalance in network activity contributes to symptoms. Treatment-resistant Combat post-traumatic stress disorder (TR-PTSD) is a highly morbid condition and 50% of PTSD sufferers fail to recover despite psychotherapy or pharmacotherapy. Reminder-triggered symptoms may arise from inadequate top-down ventromedial prefrontal cortex (vmPFC) control of amygdala reactivity. Here, we report long-term data on two TR-PTSD participants from an investigation utilizing high-frequency amygdala DBS. The two combat veterans were implanted bilaterally with quadripolar electrodes targeting the basolateral amygdala. Following a randomized staggered onset, patients received stimulation with adjustments based on PTSD symptom severity for four years while psychiatric and neuropsychiatric symptoms, neuropsychological performance, and electroencephalography were systematically monitored. Evaluation of vmPFC-Amygdala network engagement was assessed with 18FDG positron emission tomography (PET). CAPS-IV scores varied over time, but improved 55% from 119 at baseline to 53 at 4-year study endpoint in participant 1; and 44%, from 68 to 38 in participant 2. Thereafter, during 5 and 1.5 years of subsequent clinical care respectively, long-term bilateral amygdala DBS was associated with additional, clinically significant symptomatic and functional improvement. There were no serious stimulation-related adverse psychiatric, neuropsychiatric, neuropsychological, neurological, or neurosurgical effects. In one subject, symptomatic improvement was associated with an intensity-dependent reduction in amygdala theta frequency power. In our two participants, FDG-PET findings were inconclusive regarding the hypothesized mechanism of suppression of amygdala hyperactivity. Our findings encourage further research to confirm and extend our preliminary observations.
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Affiliation(s)
- Ralph J Koek
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, 760 Westwood Blvd., Room 58-229, Los Angeles, CA, USA, 90095-1759; Psychiatry Service, Mental Health and Behavioral Sciences, Sepulveda Ambulatory Care Center, VAGLAHS, 16111 Plummer St. (116A-11), North Hills, CA, USA, 91343.
| | - Josue Avecillas-Chasin
- Department of Neurosurgery University of Nebraska Medical Center College of Medicine, 42nd and Emile, Omaha, Nebraska USA, 68198.
| | - Scott E Krahl
- Department of Neurosurgery, University of California at Los Angeles (UCLA), 300 Stein Plaza Driveway Suite 420, Los Angeles, CA, 90095, USA; Research Service, VAGLAHS (Clinical Neurophysiology), 16111 Plummer St., Building 1, North Hills, CA, USA, 91343.
| | - James Wy Chen
- Department of Neurology, UCLA, 710 Westwood Plaza, Los Angeles, CA, 90095, USA; Neurology Service (Epilepsy Center of Excellence), VAGLAHS, 11301 Wilshire Blvd, Los Angeles, CA, USA, 90073.
| | - David L Sultzer
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, 760 Westwood Blvd., Room 58-229, Los Angeles, CA, USA, 90095-1759; Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine Institute for Memory Impairments and Neurological Disorders, 3214 Biological Sciences III, Irvine, CA, USA, 92697-4545.
| | - Alexis D Kulick
- Psychology Service (Neuropsychology), Mental Health and Behavioral Sciences, VAGLAHS, 16111 Plummer St. (116A-11) North Hills, CA, USA, 91343.
| | - Mark A Mandelkern
- Imaging Department, VAGLAHS, 11301 Wilshire Blvd, Los Angeles, CA, USA, 90073.
| | - Maura Malpetti
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK.
| | - Hailey L Gordon
- STEM Pathways at Boston University, 610 Commonwealth Avenue, Room 402, Boston, MA, 02215, USA.
| | | | - Evan H Einstein
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, 760 Westwood Blvd., Room 58-229, Los Angeles, CA, USA, 90095-1759
| | - Jean-Philippe Langevin
- Department of Neurosurgery, UCLA, 300 Stein Plaza Driveway Suite 420, Los Angeles, CA, 90095, USA; Southwest VA Epilepsy Center of Excellence, 11301 Wilshire Blvd, Bldg 500 (10H2), Los Angeles, CA, USA, 90073.
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12
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Elbogen EB, Graziano RC, LaRue G, Cohen AJ, Hooshyar D, Wagner HR, Tsai J. Food Insecurity and Suicidal Ideation: Results from a National Longitudinal Study of Military Veterans. Arch Suicide Res 2024; 28:644-659. [PMID: 37165670 PMCID: PMC10636240 DOI: 10.1080/13811118.2023.2200795] [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] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Research examining social determinants of suicide risk in veterans suggests a potential link between food insecurity and subsequent suicidal ideation in military veterans. The objective of this study is to investigate, if and how, food insecurity predicts subsequent suicidal ideation in a nationally representative longitudinal survey of veterans. METHODS A national longitudinal survey was analyzed of participants randomly drawn from over one million U.S. military service members who served after September 11, 2001. N = 1,090 veterans provided two waves of data one year apart (79% retention rate); the final sample was representative of post-9/11 veterans in all 50 states and all military branches. RESULTS Veterans with food insecurity had nearly four times higher suicidal ideation one year later compared to veterans not reporting food insecurity (39% vs 10%). In multivariable analyses controlling for demographic, military, and clinical covariates, food insecurity (OR = 2.37, p =.0165) predicted suicidal ideation one year later, as did mental health disorders (OR = 2.12, p = .0097). Veterans with both food insecurity and mental health disorders had a more than nine-fold increase in predicted probability of suicidal ideation in the subsequent year compared to veterans with neither food insecurity nor mental health disorders (48.5% vs. 5.5%). CONCLUSION These findings identify food insecurity as an independent risk marker for suicidal ideation in military veterans in addition to mental disorders. Food insecurity is both an indicator of and an intervention point for subsequent suicide risk. Regularly assessing for food insecurity, and intervening accordingly, can provide upstream opportunities to reduce odds of suicide among veterans.
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13
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Gammoh O, Aljabali AAA, Tambuwala MM. The crosstalk between subjective fibromyalgia, mental health symptoms and the use of over-the-counter analgesics in female Syrian refugees: a cross-sectional web-based study. Rheumatol Int 2024; 44:715-723. [PMID: 38285107 PMCID: PMC10914905 DOI: 10.1007/s00296-023-05521-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/13/2023] [Indexed: 01/30/2024]
Abstract
Suboptimal fibromyalgia management with over-the-counter analgesics leads to deteriorated outcomes for pain and mental health symptoms especially in low-income countries hosting refugees. To examine the association between the over-the-counter analgesics and the severity of fibromyalgia, depression, anxiety and PTSD symptoms in a cohort of Syrian refugees. This is a cross-sectional study. Fibromyalgia was assessed using the patient self-report survey for the assessment of fibromyalgia. Depression was measured using the Patient Health Questionnaire-9, insomnia severity was measured using the insomnia severity index (ISI-A), and PTSD was assessed using the Davidson trauma scale (DTS)-DSM-IV. Data were analyzed from 291. Among them, 221 (75.9%) reported using acetaminophen, 79 (27.1%) reported using non-steroidal anti-inflammatory drugs (NSAIDs), and 56 (19.2%) reported receiving a prescription for centrally acting medications (CAMs). Fibromyalgia screening was significantly associated with using NSAIDs (OR 3.03, 95% CI 1.58-5.80, p = 0.001). Severe depression was significantly associated with using NSAIDs (OR 2.07, 95% CI 2.18-3.81, p = 0.02) and CAMs (OR 2.74, 95% CI 1.30-5.76, p = 0.008). Severe insomnia was significantly associated with the use of CAMs (OR 3.90, 95% CI 2.04-5.61, p < 0.001). PTSD symptoms were associated with the use of CAMs (β = 8.99, p = 0.001) and NSAIDs (β = 10.39, p < 0.001). Improper analgesics are associated with poor fibromyalgia and mental health outcomes, prompt awareness efforts are required to address this challenge for the refugees and health care providers.
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Affiliation(s)
- Omar Gammoh
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, PO BOX 566, Irbid, 21163, Jordan.
| | - Alaa A A Aljabali
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Yarmouk University, PO BOX 566, Irbid 21163, Jordan
| | - Murtaza M Tambuwala
- Lincoln Medical School, University of Lincoln, Brayford Pool Campus, Lincoln, LN6 7TS, UK.
- College of Pharmacy, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, UAE.
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14
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Presseau C, Carney JR, Kline NK, Grimshaw AA, DeMoss L, Gunderson C, Portnoy GA. Child Maltreatment, Adult Trauma, and Mental Health Symptoms Among Women Veterans: A Scoping Review of Published Quantitative Research. TRAUMA, VIOLENCE & ABUSE 2024:15248380241234345. [PMID: 38468375 DOI: 10.1177/15248380241234345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
The objective of this scoping review was to describe and synthesize the measures, methods, and key findings of published quantitative research examining the influence of child maltreatment (i.e., abuse and/or neglect) and adult trauma exposure on mental health symptoms among women Veterans. A systematic search from database inception to June 2023 generated 18,861 unique articles retrieved and independently screened for eligibility. A total of 21 articles met pre-established inclusion criteria: (a) quantitative data and results within a sample or subsample of U.S. women veterans, (b) published in a peer-reviewed journal, and (c) examining variables of interest simultaneously (i.e., child maltreatment, adult trauma exposure, mental health symptom) in quantitative analyses. Reviewed literature showed a lack of uniformity in measurement and methodologies to evaluate women veterans' lifetime trauma exposure in relation to mental health. Studies most frequently used self-report survey data to evaluate exposure to child maltreatment and/or adult trauma with convenience samples of women veterans (52.4%, n = 11) and examined depressive and/or posttraumatic stress symptomatology. Findings demonstrate the need for additional research attending to the interplay between child maltreatment and adult trauma exposures in relation to women veterans' mental health using comprehensive assessment, longitudinal methods, and understudied as well as more representative samples.
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Affiliation(s)
- Candice Presseau
- VA Connecticut Healthcare System, West Haven, USA
- Yale School of Medicine, New Haven, CT, USA
| | | | | | | | | | - Craig Gunderson
- VA Connecticut Healthcare System, West Haven, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Galina A Portnoy
- VA Connecticut Healthcare System, West Haven, USA
- Yale School of Medicine, New Haven, CT, USA
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15
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Meyer K, Schoofs N, Hildebrandt A, Bermpohl F, Priebe K. What to think or how to think - is symptom reduction in posttraumatic symptomatology associated with change in posttraumatic cognitions or perseverative thinking? A latent change score model approach. Psychother Res 2024:1-16. [PMID: 38412334 DOI: 10.1080/10503307.2024.2316009] [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: 08/31/2023] [Accepted: 02/01/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE Patients with posttraumatic stress disorder (PTSD) report changes in what they think of the world and themselves, referred to as posttraumatic cognitions, and changes in how they think, reflected in increased perseverative thinking. We investigated whether pre-post therapy changes in the two aspects of thinking were associated with pre-post therapy changes in posttraumatic symptom severity. METHOD 219 d clinic patients with posttraumatic stress symptoms received trauma-focused psychotherapy with cognitive behavioral and metacognitive elements. The posttraumatic cognitions inventory (PTCI), the perseverative thinking questionnaire (PTQ), and the Davidson trauma scale (DTS) were applied at two occasions, pre- and post-therapy. Using latent change score models, we investigated whether change in PTCI and change in PTQ were associated with change in DTS and its subscales. We then compared the predictive value of PTQ and PTCI in joint models. RESULTS When jointly modeled, change in overall DTS score was associated with change in both PTCI and PTQ. Concerning DTS subscales, reexperiencing and avoidance were significantly associated with change in PTCI, but not in PTQ. CONCLUSION Results indicate that both aspects of cognition may be valuable targets of psychotherapy. A focus on posttraumatic cognitions might be called for in patients with severe reexperiencing and avoidance.
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Affiliation(s)
- Kristina Meyer
- Department of Psychiatry and Neurosciences, Psychiatric University Clinic of the Charité at St. Hedwig-Hospital, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Nikola Schoofs
- Department of Psychiatry and Neurosciences, Psychiatric University Clinic of the Charité at St. Hedwig-Hospital, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andrea Hildebrandt
- Department of Psychology, Psychological Methods and Statistics, Carl von Ossietzky Universität Oldenburg, Berlin, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Neurosciences, Psychiatric University Clinic of the Charité at St. Hedwig-Hospital, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Kathlen Priebe
- Department of Psychiatry and Neurosciences, Psychiatric University Clinic of the Charité at St. Hedwig-Hospital, Charité Universitätsmedizin Berlin, Berlin, Germany
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16
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Khoshakhlagh AH, Al Sulaie S, Mirzahosseininejad M, Yazdanirad S, Orr RM, Laal F, Bamel U. Occupational stress and musculoskeletal disorders in firefighters: the mediating effect of depression and job burnout. Sci Rep 2024; 14:4649. [PMID: 38409336 PMCID: PMC10897186 DOI: 10.1038/s41598-024-55468-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 02/23/2024] [Indexed: 02/28/2024] Open
Abstract
The firefighting profession carries a heightened risk of musculoskeletal disorders. A firefighter's job is physically demanding and includes activities such as running, climbing, dragging, and lifting. Often, these tasks are unpredictable, performed in harsh environments, and have been found to cause psychological stress. The purpose of this study was to investigate the effects of occupational stress on work-related musculoskeletal disorders (WRMSD) in firefighters. In addition, the mediating effects of depression and job burnout on proposed relationships were examined. Data informing this study were collected using a survey questionnaire. The survey questionnaire included the Beck Depression Inventory, the Center for Epidemiological Studies Depression Scale (CES-D), the Maslach Burnout Inventory, the Post Traumatic Stress Disorder Inventory (PCL), and the Nordic Musculoskeletal Questionnaire. Collected data were analyzed using structural equation modeling approach in AMOS. The results of the 2339 responding firefighters suggest that work related stress is positively related to WRMSDs in firefighters and can lead to musculoskeletal symptoms through four paths, being emotional exhaustion, personal accomplishment, CES-D total score, and depersonalization. Through depersonalization, job stress had the most significant impact on musculoskeletal symptoms (coefficient = 0.053). Furthermore, the results showed that post-traumatic stress disorders (PTSD) can affect musculoskeletal symptoms through ten paths, again through depersonalization, PTSD had the most significant impact on musculoskeletal symptoms (coefficient = 0.141). The results of this study suggest that organizations should design interventions and policies to prevent and manage occupational stress, depression, and job burnout to negate its undesired consequences on firefighters' health (i.e. WRMSD).
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Affiliation(s)
- Amir Hossein Khoshakhlagh
- Department of Occupational Health, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Saleh Al Sulaie
- Department of Mechanical and Industrial Engineering, College of Engineering and Computers in Al-Qunfudah, Umm Al-Qura University, 21955, Makkah, Saudi Arabia
| | - Marziyeh Mirzahosseininejad
- Fire Safety Section of Department of Health, Safety and Environment of Sarcheshmeh Copper Complex, National Iranian Copper Industries Co, Rafsanjan, Kerman, Iran
| | - Saeid Yazdanirad
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Robin Marc Orr
- Tactical Research Unit, Bond University, Gold Coast, Australia
| | - Fereydoon Laal
- Department of Occupational Health Engineering, Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.
| | - Umesh Bamel
- OB & HRM Group, International Management Institute New Delhi, New Delhi, India
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17
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Solis ACDO, Corchs F, Duran ÉP, Silva C, Del Real N, Araújo ÁC, Wang YP, Lotufo-Neto F. Self-reported bruxism in patients with post-traumatic stress disorder. Clin Oral Investig 2024; 28:152. [PMID: 38363350 DOI: 10.1007/s00784-024-05534-4] [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: 09/18/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE The present study aimed to investigate the association between self-reported awake/sleep bruxism, and orofacial pain with post-traumatic stress disorder (PTSD). METHODS A case-control study with a convenience sample was designed. Participants were recruited from a university-based Trauma Ambulatory. The diagnosis of PTSD was established through a clinical interview and the Structured Clinical Interview (SCID-I/P). Thirty-eight PTSD patients and 38 controls completed the Research Diagnostic Criteria for Temporomandibular Disorders Axis-II to categorize awake/sleep bruxism and orofacial pain. Following this, we performed a short clinical examination of the temporomandibular joint and extraoral muscles. RESULTS Adjusted logistic regression analysis showed that awake bruxism was associated with PTSD (OR = 3.38, 95% CI = 1.01-11.27, p = 0.047). Sleep bruxism was not associated with any covariate included in the model. In a Poisson regression model, PTSD (IRR = 3.01, 95% CI = 1.38-6.55, p = 0.005) and the muscle pain/discomfort (IRR = 5.12, 95% CI = 2.80-9.36, p < 0.001) were significant predictors for current orofacial pain. CONCLUSIONS PTSD was associated with self-reported awake bruxism and low-intensity orofacial pain. These conditions were frequent outcomes in patients previously exposed to traumatic events. CLINICAL RELEVANCE We suggest including a two-question screening for bruxism in psychiatry/psychology interviews to improve under-identification and to prevent harmful consequences at the orofacial level.
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Affiliation(s)
- Ana Cristina de Oliveira Solis
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil.
| | - Felipe Corchs
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
| | - Érica Panzani Duran
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
| | - Cláudio Silva
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
| | - Natalia Del Real
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
| | - Álvaro Cabral Araújo
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
| | - Yuan-Pang Wang
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
- Departamento e Instituto de Psiquiatria (LIM-23), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Francisco Lotufo-Neto
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
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18
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Ripoll J, Chela-Alvarez X, Briones-Vozmediano E, Fiol de-Roque MA, Zamanillo-Campos R, Ricci-Cabello I, Llobera J, Calafat-Villalonga C, Serrano-Ripoll MJ. Impact of COVID-19 on mental health of health care workers in Spain: a mix-methods study. BMC Public Health 2024; 24:463. [PMID: 38355471 PMCID: PMC10865523 DOI: 10.1186/s12889-024-17979-z] [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: 12/22/2023] [Accepted: 02/04/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Spain's lockdown measures couldn't prevent the severe impact of the COVID-19 first wave, leading to high infections, deaths, and strain on healthcare workers (HCWs). This study aimed to explore the mental health impact on HCWs in the Balearic Islands during the initial months of the pandemic, the influencing factors, and the experiences of those in a COVID-19 environment. METHODS Using a mixed-methods approach, the study encompassed quantitative and qualitative elements. Cross-sectional survey data from April to June 2020 comprised HCWs who were emailed invitations. The survey covered demographics, work, clinical and COVID-19 variables, along with psychological distress and PTSD symptoms, using validated measures. Additionally, semi-structured interviews with HCWs offered qualitative insights. RESULTS Three hundred thirty-six HCWs averaging 46.8 years, mainly women (79.2%), primarily nurses in primary care with over 10 years of experience. Anxiety symptoms were reported by 28.8%, 65.1% noted worsened sleep quality, and 27.7% increased psychoactive drug usage. Psychological distress affected 55.2%, while 27.9% exhibited PTSD symptoms. Gender, age, experience, COVID-19 patient contact, and workload correlated with distress, PTSD symptoms, sleep quality, and psychoactive drug usage. Interviews uncovered discomfort sources, such as fear of infection and lack of control, leading to coping strategies like information avoidance and seeking support. LIMITATIONS Static cross-sectional design, non-probabilistic sample, and telephone interviews affecting non-verbal cues, with interviews conducted during early pandemic lockdown. CONCLUSIONS HCWs faced significant psychological distress during the pandemic's first wave, underscoring the necessity for robust support and resources to counteract its impact on mental health.
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Affiliation(s)
- J Ripoll
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - X Chela-Alvarez
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain.
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain.
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain.
| | - E Briones-Vozmediano
- Departamento de Enfermería y Fisioterapia Grupo de estudios en sociedad, salud, educación y cultura (GESEC), Universidad de Lleida.Grup de Recerca en Cures en Salut (GRECS), Institut de Recerca Biomèdica (IRB) de Lleida, Lleida, 25001, Spain
| | - M A Fiol de-Roque
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - R Zamanillo-Campos
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
| | - I Ricci-Cabello
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - J Llobera
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
| | - C Calafat-Villalonga
- Department of Psychology, University of the Balearic Islands, Palma, 07122, Spain
| | - M J Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Palma, 07002, Spain
- Grup de Recerca Atenció Primària i Promoció (GRAPP-caIB) Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, Hospital Universitari Son Espases 79, Palma, 07120, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Palma, 07120, Spain
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Khoshakhlagh AH, Sulaie SA, Yazdanirad S, Orr RM, Laal F. Relationships between job stress, post-traumatic stress and musculoskeletal symptoms in firefighters and the role of job burnout and depression mediators: a bayesian network model. BMC Public Health 2024; 24:468. [PMID: 38355498 PMCID: PMC10868075 DOI: 10.1186/s12889-024-17911-5] [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: 07/31/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Job stress, post-traumatic stress disorder (PTSD), and negative psychological outcomes in firefighters can be caused, or aggravated, by their work. These mental disorders can impart musculoskeletal symptoms. This study aimed to investigate relationships between musculoskeletal and psychological disorders in a population of firefighters using a Bayesian network model. METHODS This cross-sectional study, conducted in 2022, included 2339 firefighters who completed questionnaires during their rest periods. The questionnaires comprised of demographical information, the Occupational Stress Questionnaire-HSE, the PTSD Checklist, Maslach Burnout Inventory, Center for Epidemiologic Studies - Depression scale (CES-D), and Nordic Musculoskeletal Questionnaire. GeNIe academic software was used to analyze the Bayesian network. RESULTS High job stress and high PTSD each increased the probability of musculoskeletal symptoms by 34%. When combined, high job stress and high PTSD increased the probability of musculoskeletal symptoms by 37%. Among the mediator's burnout and depression, depression had the highest association with musculoskeletal symptoms. CONCLUSIONS Job stress and PTSD can increase musculoskeletal symptoms and are influenced by psychological mediators (like burnout and depression). Adopting preventive and therapeutic measures to mitigate job stress and PTSD, mitigate and rehabilitate WMSD, and manage associated mediators are critical for the mental and physical health of firefighters.
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Affiliation(s)
- Amir Hossein Khoshakhlagh
- Department of Occupational Health, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Saleh Al Sulaie
- Department of Mechanical and Industrial Engineering, College of Engineering and Computers in Al-Qunfudah , Umm Al- Qura University, 21955, Makkah, Saudi Arabia
| | - Saeid Yazdanirad
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
- School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Robin Marc Orr
- Tactical Research Unit, Bond University, Gold Coast, Australia
| | - Fereydoon Laal
- Department of Occupational Health Engineering, Social Determinants of Health Research Center , Birjand University of Medical Sciences, Birjand, Iran.
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May PA, Hasken JM, de Vries MM, Marais AS, Abdul-Rahman O, Robinson LK, Adam MP, Manning MA, Kalberg WO, Buckley D, Snell CL, Seedat S, Parry CD, Hoyme HE. Maternal risk factors for fetal alcohol spectrum disorders: Distal variables. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:319-344. [PMID: 38105110 PMCID: PMC10922553 DOI: 10.1111/acer.15246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/09/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND A variety of maternal risk factors for fetal alcohol spectrum disorders (FASD) have been described in the literature. Here, we conducted a multivariate analysis of a large array of potential distal influences on FASD risk. METHODS Interviews were conducted with 2515 mothers of first-grade students whose children were evaluated to assess risk for FASD. Topics included: physical/medical status, childbearing history, demographics, mental health, domestic violence, and trauma. Regression modeling utilized usual level of alcohol consumption by trimester and six selected distal variables (maternal head circumference, body mass index, age at pregnancy, gravidity, marital status, and formal years of education) to differentiate children with FASD from control children. RESULTS Despite individual variation in distal maternal risk factors among and within the mothers of children with each of the common diagnoses of FASD, patterns emerged that differentiated risk among mothers of children with FASD from mothers whose children were developing typically. Case-control comparisons indicate that mothers of children with FASD were significantly smaller physically, had higher gravidity and parity, and experienced more miscarriages and stillbirths, were less likely to be married, reported later pregnancy recognition, more depression, and lower formal educational achievement. They were also less engaged with a formal religion, were less happy, suffered more childhood trauma and interpersonal violence, were more likely to drink alone or with her partner, and drank to deal with anxiety, tension, and to be part of a group. Regression analysis showed that the predictor variables explain 57.5% of the variance in fetal alcohol syndrome (FAS) diagnoses, 30.1% of partial FAS (PFAS) diagnoses, and 46.4% of alcohol-related neurodevelopmental disorder (ARND) diagnoses in children with FASD compared to controls. While the proximal variables explained most of the diagnostic variance, six distal variables explained 16.7% (1 /6 ) of the variance in FAS diagnoses, 13.9% (1 /7 ) of PFAS, and 12.1% (1 /8 ) of ARND. CONCLUSIONS Differences in distal FASD risks were identified. Complex models to quantify risk for FASD hold promise for guiding prevention/intervention.
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Affiliation(s)
- Philip A. May
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, 500 Laureate Way, Kannapolis, NC 28081, United States
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
- Center on Alcoholism, Substance Abuse and Addictions, The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, United States
| | - Julie M. Hasken
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, 500 Laureate Way, Kannapolis, NC 28081, United States
| | - Marlene M. de Vries
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Anna-Susan Marais
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Omar Abdul-Rahman
- Department of Pediatrics, New York- Presbyterian Weill Cornell Medicine, Columbia University, 505 E 70 St, New York, NY 10021
| | - Luther K. Robinson
- Department of Pediatrics, State University of New York, 1001 Main Street, Buffalo, NY 14203, United States
| | - Margaret P. Adam
- Department of Pediatrics, University of Washington, 1959 NE Pacific Street, Seattle, WA 98175, USA
| | - Melanie A. Manning
- Department of Pathology and Pediatrics, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, United States
| | - Wendy O. Kalberg
- Center on Alcoholism, Substance Abuse and Addictions, The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, United States
| | - David Buckley
- Center on Alcoholism, Substance Abuse and Addictions, The University of New Mexico, 2650 Yale SE, Albuquerque, NM 87106, United States
| | - Cudore L. Snell
- School of Social Work, Howard University, Washington D.C., 20059, USA
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
| | - Charles D.H. Parry
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parowvallei, Cape Town, 7505, South Africa
| | - H. Eugene Hoyme
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town 7505, South Africa
- Sanford Children’s Genomic Medicine Consortium, Sanford Health, 1600 W. 22 St. Sioux Falls, SD, 57117, United States
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21
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Ponting C, Bond M, Rogowski B, Chu A, Lieberman AF. Childhood and adulthood trauma exposure: Associations with perinatal mental health and psychotherapy response. J Trauma Stress 2024; 37:178-186. [PMID: 37908028 DOI: 10.1002/jts.22989] [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: 05/05/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023]
Abstract
Trauma exposure is strongly linked to maternal posttraumatic stress disorder (PTSD) and depressive symptoms during the perinatal period; however, childhood trauma exposure is often assessed without accounting for adult exposure. This study tested the unique impacts of childhood and adulthood trauma exposure on PTSD and depressive symptoms among pregnant women (N = 107, 82.9% Latina) enrolled in a nonrandomized intervention study. Regression analyses at baseline showed positive associations between trauma exposure and PTSD symptoms irrespective of trauma timing, childhood: B = 1.62, t(91) = 2.11, p = .038; adulthood: B = 2.92, t(91) = 3.04, p = .003. However only adulthood trauma exposure, B = 1.28, t(94) = 2.94, p = .004, was positively associated with depressive symptoms. Mixed-effects analyses of variance revealed interaction effects of time and adulthood trauma exposure, indicating that women with high degrees of adulthood trauma exposure had higher baseline levels of PTSD, F(1, 76.4) = 6.45, p = .013, and depressive symptoms, F(1, 87.2) = 4.88, p = .030, but showed a more precipitous decrease posttreatment than women with lower levels of adulthood trauma exposure. These findings support the clinical relevance of assessing both childhood and adulthood trauma exposure during the perinatal period given their impacts on baseline symptoms and psychotherapy response.
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Affiliation(s)
- Carolyn Ponting
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, USA
| | - Melissa Bond
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, USA
| | - Belén Rogowski
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, USA
| | - Ann Chu
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, USA
| | - Alicia F Lieberman
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, USA
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Sultana E, Shastry N, Kasarla R, Hardy J, Collado F, Aenlle K, Abreu M, Sisson E, Sullivan K, Klimas N, Craddock TJA. Disentangling the effects of PTSD from Gulf War Illness in male veterans via a systems-wide analysis of immune cell, cytokine, and symptom measures. Mil Med Res 2024; 11:2. [PMID: 38167090 PMCID: PMC10759613 DOI: 10.1186/s40779-023-00505-4] [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: 01/04/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND One-third of veterans returning from the 1990-1991 Gulf War reported a myriad of symptoms including cognitive dysfunction, skin rashes, musculoskeletal discomfort, and fatigue. This symptom cluster is now referred to as Gulf War Illness (GWI). As the underlying mechanisms of GWI have yet to be fully elucidated, diagnosis and treatment are based on symptomatic presentation. One confounding factor tied to the illness is the high presence of post-traumatic stress disorder (PTSD). Previous research efforts have demonstrated that both GWI and PTSD are associated with immunological dysfunction. As such, this research endeavor aimed to provide insight into the complex relationship between GWI symptoms, cytokine presence, and immune cell populations to pinpoint the impact of PTSD on these measures in GWI. METHODS Symptom measures were gathered through the Multidimensional fatigue inventory (MFI) and 36-item short form health survey (SF-36) scales and biological measures were obtained through cytokine & cytometry analysis. Subgrouping was conducted using Davidson Trauma Scale scores and the Structured Clinical Interview for Diagnostic and statistical manual of mental disorders (DSM)-5, into GWI with high probability of PTSD symptoms (GWIH) and GWI with low probability of PTSD symptoms (GWIL). Data was analyzed using Analysis of variance (ANOVA) statistical analysis along with correlation graph analysis. We mapped correlations between immune cells and cytokine signaling measures, hormones and GWI symptom measures to identify patterns in regulation between the GWIH, GWIL, and healthy control groups. RESULTS GWI with comorbid PTSD symptoms resulted in poorer health outcomes compared with both Healthy control (HC) and the GWIL subgroup. Significant differences were found in basophil levels of GWI compared with HC at peak exercise regardless of PTSD symptom comorbidity (ANOVA F = 4.7, P = 0.01,) indicating its potential usage as a biomarker for general GWI from control. While the unique identification of GWI with PTSD symptoms was less clear, the GWIL subgroup was found to be delineated from both GWIH and HC on measures of IL-15 across an exercise challenge (ANOVA F > 3.75, P < 0.03). Additional differences in natural killer (NK) cell numbers and function highlight IL-15 as a potential biomarker of GWI in the absence of PTSD symptoms. CONCLUSION We conclude that disentangling GWI and PTSD by defining trauma-based subgroups may aid in the identification of unique GWI biosignatures that can help to improve diagnosis and target treatment of GWI more effectively.
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Affiliation(s)
- Esha Sultana
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
- Department of Psychology and Neuroscience, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
| | - Nandan Shastry
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
- Department of Psychology and Neuroscience, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
| | - Rishabh Kasarla
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
- Department of Psychology and Neuroscience, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
| | - Jacob Hardy
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
- Department of Psychology and Neuroscience, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
| | - Fanny Collado
- Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
- Miami Veterans Affairs Medical Center, Miami, FL, 33125, USA
| | - Kristina Aenlle
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
- Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
- Miami Veterans Affairs Medical Center, Miami, FL, 33125, USA
| | - Maria Abreu
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
- Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
- Miami Veterans Affairs Medical Center, Miami, FL, 33125, USA
| | - Emily Sisson
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Kimberly Sullivan
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Nancy Klimas
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
- Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA
- Miami Veterans Affairs Medical Center, Miami, FL, 33125, USA
| | - Travis J A Craddock
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA.
- Department of Psychology and Neuroscience, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA.
- Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA.
- Department of Computer Science, Nova Southeastern University, Ft. Lauderdale-Davie, FL, 33314, USA.
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Di Paola LE, Mahler M, Sala Lozano A, Nardi MA, Ladenheim RI, García Diéguez M. Development of a list of minimum procedures for certifying competence in gastrointestinal endoscopy by the Delphi method. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2024; 116:29-34. [PMID: 35360911 DOI: 10.17235/reed.2022.8553/2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
BACKGROUND within the frame of reference of any medical specialty, having a consensus list of the type and number of practices characterizing its professional work is key. Thus, the goal of this study was to define a list of minimum procedures to ensure competence in gastrointestinal endoscopy based on a structured consensus process, and to explore the views of leading experts in gastrointestinal endoscopy regarding endoscopist training in Argentina and the need for competence certification. MATERIALS AND METHODS this research entailed a mixed-methods prospective study including using the Delphi method as focus group qualitative research technique, followed by a structured survey. RESULTS the final consolidated list included 17 procedures deemed essential for competence certification in gastrointestinal endoscopy. Given the dispersion found in the range of minimum numbers required for competence a decision was made to use the median value. For upper gastrointestinal endoscopy the minimum number of procedures was set at 200, whereas 150 was established for videocolonoscopy. CONCLUSION this list is a key item in the development of a gastrointestinal endoscopy training framework and competence certification program.
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Affiliation(s)
- Leandro Esteban Di Paola
- Secretaría de Formación y Acreditación, Asociación Endoscopistas Digestivos de Buenos Aires , Argentina
| | - Manuel Mahler
- Secretaría de Formación y Acreditación, Asociación Endoscopistas Digestivos de Buenos Aires , Argentina
| | - Ariana Sala Lozano
- Secretaría de Formación y Acreditación, Asociación Endoscopistas Digestivos de Buenos Aires , Argentina
| | - María Amelia Nardi
- Departamento de Posgrado, Instituto Universitario del Hospital Italiano, Argentina
| | | | - Marcelo García Diéguez
- Centro de Estudios Educ. de Profesionales de Salud, Universidad Nacional del Sur , Argentina
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24
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Kremyar AJ, Ben-Porath YS, Sellbom M, Gervais RO. Assessing posttraumatic stress disorder symptom clusters with the Minnesota Multiphasic Personality Inventory-3 in a forensic disability sample. J Clin Psychol 2023; 79:2798-2822. [PMID: 37597252 DOI: 10.1002/jclp.23581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/17/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVE Previous evidence indicates that scales from the Minnesota Multiphasic Personality Inventory (MMPI) family of instruments can measure self-reported posttraumatic stress disorder (PTSD) symptomology and differentiate symptom clusters, including in forensic disability assessments. However, limited research has examined assessment of PTSD symptoms with the MMPI-3, the most recent MMPI instrument. The goal of the current study was to identify the strongest MMPI-3 scale predictors of individual PTSD symptom clusters, measured via self-report. METHODS Using a sample of 716 disability claimants (54.2% men; Mage = 42.98, SD = 10.87; 81.8% White), correlation, regression, and dominance analyses were performed to examine associations between scores on MMPI-3 scales and latent PTSD symptom cluster factors derived using confirmatory factor analyses from items of the Detailed Assessment of Posttraumatic Stress (DAPS), and to identify the strongest predictor of each symptom cluster when MMPI-3 scales were concurrently considered. RESULTS Results indicate that conceptually expected MMPI-3 scale scores were meaningfully associated with PTSD symptom cluster factors, with the MMPI-3 Anxiety-Related Experiences (ARX) scale demonstrating the strongest and most consistent associations across symptom clusters. CONCLUSIONS Results of the current study largely converge with previous empirical studies of self-reported PTSD symptoms in disability claimant settings with the MMPI instruments. Interpretive implications for the MMPI-3, limitations, and future research directions are discussed.
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Affiliation(s)
- Andrew J Kremyar
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Yossef S Ben-Porath
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Martin Sellbom
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Roger O Gervais
- Neurobehavioural Associates Inc., Edmonton, Alberta, Canada
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
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25
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Wu Y, Guo Y, Xu N, Zhang H, Xiu Y, Lin D, Ying W. Risk factors for post-traumatic stress disorder in nurses from the regional medical alliance during the COVID-19 epidemic: A prospective cross-sectional study. Heliyon 2023; 9:e20289. [PMID: 37771525 PMCID: PMC10522950 DOI: 10.1016/j.heliyon.2023.e20289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023] Open
Abstract
Mental health issues among nursing professionals have been increasingly reported during the coronavirus disease (COVID-19) pandemic. However, there is a paucity of research on post-traumatic stress disorder (PTSD) among nurses working in Medical Alliances. In this study, we aimed to investigate the risk factors associated with PTSD in the Regional Medical Alliance (MA) in Shantou (China) during the COVID-19 pandemic. A total of 1286 nurses from four MA hospitals participated in the study from February to March 2020. Our findings revealed that the incidences of PTSD, depression, anxiety, and sleep disorders among nurses from MA were 15.6%, 35.5%, 18.3%, and 36.4%, respectively. Moreover, PTSD was positively correlated with depression, anxiety, and sleep disorders. In addition, the results of logistic regression analysis showed that working in a tertiary hospital, older age, more severe depression, more severe anxiety, and prevalent sleep disorders were independent risk factors for PTSD among nurses. Therefore, mental health interventions targeting high-risk nurses in MA with an incidence of PTSD are urgently needed.
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Affiliation(s)
- Yanchun Wu
- Nursing Research Institute, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Yulian Guo
- Nursing Department, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Nuo Xu
- Nursing Department, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Hong Zhang
- Nursing Department, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Yuqi Xiu
- School of Nursing, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Danna Lin
- School of Nursing, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Wenjuan Ying
- Nursing Research Institute, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, 515041, China
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Macia KS, Carlson EB, Palmieri PA, Smith SR, Anglin DM, Ghosh Ippen C, Lieberman AF, Wong EC, Schell TL, Waelde LC. Development of a Brief Version of the Dissociative Symptoms Scale and the Reliability and Validity of DSS-B Scores in Diverse Clinical and Community Samples. Assessment 2023; 30:2058-2073. [PMID: 37653563 PMCID: PMC10478338 DOI: 10.1177/10731911221133317] [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] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
The Dissociative Symptoms Scale (DSS) was developed to assess moderately severe types of dissociation (depersonalization, derealization, gaps in awareness and memory, and dissociative reexperiencing) that would be relevant to a range of clinical populations, including those experiencing trauma-related dissociation. The current study used data from 10 ethnically and racially diverse clinical and community samples (N = 3,879) to develop a brief version of the DSS (DSS-B). Item information curves were examined to identify items with the most precision in measuring above average levels of the latent trait within each subscale. Analyses revealed that the DSS-B preserved the factor structure and content domains of the full scale, and its scores had strong reliability and validity that were comparable to those of scores on the full measure. DSS-B scores showed high levels of measurement invariance across ethnoracial groups. Results indicate that DSS-B scores are reliable and valid in the populations studied.
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Affiliation(s)
- Kathryn S. Macia
- National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA
- Stanford University School of Medicine, Palo Alto, CA, USA
| | - Eve B. Carlson
- National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA
- Stanford University School of Medicine, Palo Alto, CA, USA
| | | | | | | | | | | | | | | | - Lynn C. Waelde
- Stanford University School of Medicine, Palo Alto, CA, USA
- Palo Alto University, CA, USA
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27
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Raeder R, Clayton NS, Boeckle M. Narrative-based autobiographical memory interventions for PTSD: a meta-analysis of randomized controlled trials. Front Psychol 2023; 14:1215225. [PMID: 37829075 PMCID: PMC10565228 DOI: 10.3389/fpsyg.2023.1215225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/25/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction The aim of this systematic review and meta-analysis is to evaluate the efficacy of narrative-based interventions (NBIs) for individuals with post-traumatic stress disorder (PTSD). Investigating the efficacy of NBIs should yield insight on autobiographical memory (AM) phenomena implicated in PTSD onset and recovery, leading to improved intervention protocols. Furthermore, by analyzing how NBIs influence maladaptive AM distortions, we hope to shed light on the theorized narrative architecture of AM more generally. Methods A systematic literature search was conducted according to PRISMA and Cochrane guidelines in MEDLINE, EMBASE, PsychINFO, and PubMed. Additional studies were then also identified from the reference lists of other relevant literature and considered for inclusion. Studies were then evaluated for adherence to the inclusion/exclusion criteria and assessed for risk of bias. Various meta-analyses were performed on included studies to understand how NBIs may or may not influence the overall effect size of treatment. Results The results of the meta-analysis of 35 studies, involving 2,596 participants, suggest that NBIs are a viable and effective treatment option for PTSD, yielding a statistically significant within-group effect size and decrease in PTSD symptomatology at both post-treatment [g = 1.73, 95% CI (1.23-2.22)] and 3-9 month follow-up assessments [g = 2.33, 95% CI (1.41-3.26)]. Furthermore, the difference in effect sizes between NBIs compared to active and waitlist controls was statistically significant, suggesting that NBIs are superior. Sub-analyses showed that NET provided a stronger effect size than FORNET, which may be due to the nature of the traumatic event itself and not the treatment protocol. While evidence of small study and publication bias was present, a weight-function model and trim-and-fill method suggested it was not influencing the overall results. Discussion This meta-analysis presents strong evidence supporting the use of NBIs in the treatment of PTSD. Clear similarities can be identified between NBIs included in this analysis that make them distinct from non-NBI interventions, which are reviewed in the discussion. Controlled comparisons between NBIs and non-NBIs would help to further understand AM mechanisms of action implicated in recovery and how various interventions facilitate them. Future research should also aim to elucidate the full range of AM impairment in individuals with PTSD to gain insight on how other memory capabilities, such as the ability to mentally simulate the future, are implicated in the pathogenesis of PTSD.
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Affiliation(s)
- Robert Raeder
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Nicola S. Clayton
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Markus Boeckle
- Scientific Working Group, Karl Landsteiner University of Health Sciences, Krems, Austria
- Department of Transitory Psychiatry, University Hospital Tulln, Tulln, Austria
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Castillejos DG, Rubio ML, Ferre C, de Los Ángeles de Gracia M, Bodí M, Sandiumenge A. Psychological symptoms in difficult-to-sedate critical care survivors. Nurs Crit Care 2023; 28:679-688. [PMID: 34549485 DOI: 10.1111/nicc.12714] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 08/22/2021] [Accepted: 09/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Critical care survivors often experience symptoms of anxiety, depression, or post-traumatic stress disorder (PTSD). AIMS To determine the prevalence and severity of psychological symptoms during the first 6 months after discharge from the intensive care unit (ICU) and to evaluate its association with patients who are difficult to sedate during admission. DESIGN Descriptive, prospective analysis of psychological symptoms in survivors from medicosurgical ICU over a 2-year period. METHODS All ICU survivors who required mechanical ventilation (MV) for more than 24 hours were followed for 6 months after their ICU discharge. ICU outcome and complications as well as the presence of psychological symptoms, 1 to 3 to 6 months after discharge were prospectively evaluated through phone interviews comparing the incidence and intensity of patients who were difficult to sedate during their ICU stay with those who were not. Descriptive analysis and multivariate logistic regression were performed. RESULTS Data were obtained for 195 patients, of whom 30% experienced difficult sedation (DS). Difficult-to-sedate patients were younger (P = .001), less critically ill (APACHE II score P = .002), and more likely to engage in harmful use of alcohol (P = .001) and psychoactive/psychotropic drug abuse. They also spent longer times on MV and in the ICU (P = .001). Anxiety incidence at 1 to 3 to 6 months post-discharge was significantly higher in DS patients than in those who were not (87.7% vs 45.4%, 75.5% vs 29.0%, and 70.8% vs 23.7%; P < .01), respectively. Depression incidence was also significantly higher in the DS group (82.4% vs 43.1%, 66% vs 33.9%, and 60.4% vs 27.2%; [P = .001]) at 1 to 3 to 6 months, respectively. A higher percentage of patients in the DS group reported symptoms of PTSD at 1 month (28.1% vs 11.5%) (P = .007) when compared with non-DS group. CONCLUSIONS Critical care survivors who are difficult to sedate during their ICU stay are more likely to present psychological sequelae. Early identification of at-risk patients is necessary to implement appropriate preventive strategies. RELEVANCE TO CLINICAL PRACTICE Patients who are difficult to sedate in the ICU may develop psychological disorders upon discharge, which may negatively affect their recovery. The prevention of DS and the early detection of psychological disorders are essential to minimize its subsequent impact.
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Affiliation(s)
| | | | - Carmen Ferre
- Department of Nursing, Rovira i Virgili University, Tarragona, Spain
| | | | - María Bodí
- University Hospital Joan XXIII/IISPV/URV Tarragona/CIBERES, Tarragona, Spain
| | - Alberto Sandiumenge
- Medical Trasplant Coordinator, University Hospital Vall d'Hebron, Barcelona, Spain
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Boutros SW, Zimmerman B, Nagy SC, Unni VK, Raber J. Age, sex, and apolipoprotein E isoform alter contextual fear learning, neuronal activation, and baseline DNA damage in the hippocampus. Mol Psychiatry 2023; 28:3343-3354. [PMID: 36732588 PMCID: PMC10618101 DOI: 10.1038/s41380-023-01966-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 01/06/2023] [Accepted: 01/16/2023] [Indexed: 02/04/2023]
Abstract
Age, female sex, and apolipoprotein E4 (E4) are risk factors to develop Alzheimer's disease (AD). There are three major human apoE isoforms: E2, E3, and E4. Compared to E3, E4 increases while E2 decreases AD risk. However, E2 is associated with increased risk and severity of post-traumatic stress disorder (PTSD). In cognitively healthy adults, E4 carriers have greater brain activation during learning and memory tasks in the absence of behavioral differences. Human apoE targeted replacement (TR) mice display differences in fear extinction that parallel human data: E2 mice show impaired extinction, mirroring heightened PTSD symptoms in E2 combat veterans. Recently, an adaptive role of DNA double strand breaks (DSBs) in immediate early gene expression (IEG) has been described. Age and disease synergistically increase DNA damage and decrease DNA repair. As the mechanisms underlying the relative risks of apoE, sex, and their interactions in aging are unclear, we used young (3 months) and middle-aged (12 months) male and female TR mice to investigate the influence of these factors on DSBs and IEGs at baseline and following contextual fear conditioning. We assessed brain-wide changes in neural activation following fear conditioning using whole-brain cFos imaging in young female TR mice. E4 mice froze more during fear conditioning and had lower cFos immunoreactivity across regions important for somatosensation and contextual encoding compared to E2 mice. E4 mice also showed altered co-activation compared to E3 mice, corresponding to human MRI and cognitive data, and indicating that there are differences in brain activity and connectivity at young ages independent of fear learning. There were increased DSB markers in middle-aged animals and alterations to cFos levels dependent on sex and isoform, as well. The increase in hippocampal DSB markers in middle-aged animals and female E4 mice may play a role in the risk for developing AD.
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Affiliation(s)
- Sydney Weber Boutros
- Department of Behavioral Neuroscience, OHSU, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
- Department of Psychological Sciences, Boise State University, 2133 W Cesar Chavez Ln, Boise, ID, 83725, USA
| | - Benjamin Zimmerman
- Department of Behavioral Neuroscience, OHSU, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
- Advanced Imaging Research Center, OHSU, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
- Helfgott Research Institute, NUNM, 2201 SW First Avenue, Portland, OR, 97201, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 N, Matthews Avenue, Urbana, IL 61801, USA
| | - Sydney C Nagy
- Department of Behavioral Neuroscience, OHSU, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Vivek K Unni
- Department of Neurology, OHSU, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
- Jungers Center for Neurosciences Research, OHSU; and OHSU Parkinson Center, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Jacob Raber
- Department of Behavioral Neuroscience, OHSU, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
- Department of Neurology, OHSU, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
- Departments of Psychiatry and Radiation Medicine, OHSU, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
- Division of Neuroscience, ONPRC, 505 NW 185th Ave, Beaverton, OR, 97006, 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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Gammoh O, Durand H, Abu-Shaikh H, Alsous M. Post-traumatic stress disorder burden among female Syrian war refugees is associated with dysmenorrhea severity but not with the analgesics. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2023. [DOI: 10.29333/ejgm/13089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Dysmenorrhea association with post-traumatic stress disorder (PTSD) has not been studied in refugees. We aimed to examine the associations between dysmenorrhea severity, dysmenorrhea analgesics self-medications, and PTSD in a cohort of Syrian war refugees residing in Jordan.<br />
This is a cross-sectional study based on predetermined inclusion criteria held at Caritas primary care centers in Jordanian districts between September and October 2022. The participants’ demographics and analgesic self-medication type were recorded through a structured questionnaire. The dysmenorrhea severity was measured by (working ability, location, intensity, days of pain, and dysmenorrhea) WaLiDD scale, PTSD was measured by Davidson trauma scale (DTS)-DSM-IV.<br />
Data from 347 Syrian female war refugees were analyzed. The multivariate analysis showed that dysmenorrhea severity demonstrated significantly higher estimates for PTSD (10.48 [6.72-14.23], p=0.001), however, the analgesic type was not associated with PTSD burden.<br />
In conclusion, dysmenorrhea severity, but not self-medication, was associated with a higher PTSD burden.
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Affiliation(s)
- Omar Gammoh
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, JORDAN
| | - Hannah Durand
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, SCOTLAND
| | | | - Mervat Alsous
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, JORDAN
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Nguyen KA, Myers B, Abrahams N, Jewkes R, Mhlongo S, Seedat S, Lombard C, Garcia-Moreno C, Chirwa E, Kengne AP, Peer N. Symptoms of posttraumatic stress partially mediate the relationship between gender-based violence and alcohol misuse among South African women. Subst Abuse Treat Prev Policy 2023; 18:38. [PMID: 37349847 PMCID: PMC10288665 DOI: 10.1186/s13011-023-00549-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The association of traumatic experiences with problematic alcohol use has been described, but data on possible mediation effects of mental distress are sparse. We examined whether mental ill-health mediated the association between trauma exposure across the lifespan and alcohol use. METHOD We analysed cross-sectional data from a sample of rape-exposed and non-rape-exposed women, living in KwaZulu-Natal, with self-reported data on alcohol misuse (AUDIT-C cut-off ≥ 3) and exposure to childhood maltreatment (CM), intimate partner violence (IPV), non-partner sexual violence (NPSV), other traumatic events, and mental ill-health. Logistic regression and multiple mediation models were used to test the mediation effects of symptoms of depression and PTSS on the association between abuse/trauma and alcohol misuse. RESULTS Of 1615 women, 31% (n = 498) reported alcohol misuse. Exposure to any CM (adjusted odds ratio (aOR): 1.59, 95% confidence interval (CI): 1.27-1.99), as well as to sexual, physical and emotional CM, were independently associated with alcohol misuse. Lifetime exposure to any IPV (aOR:2.01, 95%CI:1.59-2.54), as well as to physical, emotional and economic IPV, NPSV (aOR: 1.75, 95%CI: 1.32-2.33), and other trauma (aOR:2.08, 95%CI:1.62-2.66), was associated with alcohol misuse. Exposure to an increasing number of abuse types, and other traumatic events, was independently associated with alcohol misuse. PTSS partially mediated the associations of CM, IPV, NPSV and other trauma exposures with alcohol misuse (ps ≤ 0.04 for indirect effects), but depression symptoms did not. CONCLUSIONS These findings highlight the need for trauma-informed interventions to address alcohol misuse that are tailored to the needs of women who have experienced violence.
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Affiliation(s)
- Kim A. Nguyen
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, 7505 and Durban, P.O. Box 19070, Tygerberg, 4091 South Africa
| | - Bronwyn Myers
- Mental Health, Alcohol, Substances, and Tobacco Research Unit, South African Medical Research Council, Cape Town, 7505 Substances South Africa
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6102 Australia
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001 South Africa
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001 South Africa
- Office of the Executive Scientist, South African Medical Research Council, Cape Town, 7505 South Africa
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001 South Africa
| | - Soraya Seedat
- SAMRC Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town, 7505 South Africa
| | - Claudia Garcia-Moreno
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization (WHO), Geneva, Switzerland
| | - Esnat Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Cape Town and Pretoria, 7505, 0001 South Africa
- School of Public Health, University of Witwatersrand, Johannesburg, 2193 South Africa
| | - Andre P. Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, 7505 and Durban, P.O. Box 19070, Tygerberg, 4091 South Africa
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, 7505 and Durban, P.O. Box 19070, Tygerberg, 4091 South Africa
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
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Campbell AA, Taylor KA, Augustine AV, Sherwood A, Wu JQ, Beckham JC, Hoerle JM, Ulmer CS. Nightmares: an independent risk factor for cardiovascular disease? Sleep 2023; 46:zsad089. [PMID: 36996027 DOI: 10.1093/sleep/zsad089] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/13/2023] [Indexed: 03/31/2023] Open
Abstract
STUDY OBJECTIVES Prior work has established associations between post-traumatic stress disorder (PTSD), disrupted sleep, and cardiovascular disease (CVD), but few studies have examined health correlates of nightmares beyond risks conferred by PTSD. This study examined associations between nightmares and CVD in military veterans. METHODS Participants were veterans (N = 3468; 77% male) serving since September 11, 2001, aged 38 years (SD = 10.4); approximately 30% were diagnosed with PTSD. Nightmare frequency and severity were assessed using the Davidson Trauma Scale (DTS). Self-reported medical issues were assessed using the National Vietnam Veterans Readjustment Study Self-report Medical Questionnaire. Mental health disorders were established using the Structured Clinical Interview for DSM-IV. The sample was stratified by the presence or absence of PTSD. Within-group associations between nightmare frequency and severity and self-reported CVD conditions, adjusting for age, sex, race, current smoking, depression, and sleep duration. RESULTS Frequent and severe nightmares during the past week were endorsed by 32% and 35% of participants, respectively. Those endorsing nightmares that were frequent, severe, and the combination thereof were more likely to also evidence high blood pressure (ORs 1.42, OR 1.56, and OR 1.47, respectively) and heart problems (OR 1.43, OR 1.48, and OR 1.59, respectively) after adjusting for PTSD diagnosis and other covariates. CONCLUSIONS Nightmare frequency and severity among veterans are associated with cardiovascular conditions, even after controlling for PTSD diagnosis. Study findings suggest that nightmares may be an independent risk factor for CVD. Additional research is needed to validate these findings using confirmed diagnoses and explore potential mechanisms.
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Affiliation(s)
| | - Kenneth A Taylor
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC, USA
| | - Ann V Augustine
- Durham Veterans Affairs (VA) Healthcare System, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jade Q Wu
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jean C Beckham
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Veterans Affairs VA Mid-Atlantic MIRECC Workgroup, Durham, NC, USA
| | - Jeffrey M Hoerle
- Veterans Affairs VA Mid-Atlantic MIRECC Workgroup, Durham, NC, USA
| | - Christi S Ulmer
- Durham Veterans Affairs (VA) Healthcare System, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham, NC, USA
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Bouclaous C, Fadlallah N, El Helou MO, Dadaczynski K. University students' experience of the Beirut port explosion: associations with subjective well-being and subjective symptoms of mental strain. J Ment Health 2023; 32:602-611. [PMID: 36322513 DOI: 10.1080/09638237.2022.2140785] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 08/09/2022] [Accepted: 08/29/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND On 4 August 2020, an explosion shook Beirut, killing more than 200 people and leaving thousands injured or homeless. AIMS This study examined mental health of university students through a cross-sectional online survey between December 2020 and January 2021. METHODS The questionnaire consisted of the WHO-5, sense of coherence (SoC), future anxiety, self-developed subjective symptoms of mental strain (SSMS), and items assessing proximity to explosion, extent of injury and house damage. Gender, study level and social status were used as sociodemographic characteristics. RESULTS Of 1042 participants, 30.8% were at 0-7 km from explosion; 38.1% reported physical injuries; and 12.4% saw their home damaged. Two third (60.3%) reported ≥3 SSMS, and 73.4% reported low well-being. Students with low well-being were more often female and master students (p < 0.001). Females were more often affected by ≥3 SSMS (p < 0.001). Regression analysis with low well-being as dependent variable revealed significant associations with study level (OR: 2.30-2.94), future anxiety (OR: 2.72-4.34) and SoC (OR: 1.81-5.61). For ≥3 SSMS, females (OR: 3.09), moderate/very close distance (OR: 2.13-4.98), injury/death of family member or friend (OR: 2.07-2.06), house damage (OR: 1.72) future anxiety (OR: 1.97-3.11) and SoC (1.79-2.88) were significant predictors. DISCUSSION Preventive mental health strategies that strengthen SoC and outlook on future could protect against SSMS and low well-being following major trauma.
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Affiliation(s)
- Carmel Bouclaous
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Najat Fadlallah
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mohamad Othman El Helou
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Kevin Dadaczynski
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Fulda, Germany
- Centre for Applied Health Science, Leuphana University Lueneburg, Lueneburg, Germany
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Abrahams N, Chirwa E, Mhlongo S, Seedat S, Myers B, Peer N, Kengne AP, Garcia-Moreno C, Lombard C, Jewkes R. Pathways to adverse pregnancy outcomes: exploring the mediating role of intimate partner violence and depression: results from a South African rape cohort study. Arch Womens Ment Health 2023; 26:341-351. [PMID: 37032357 PMCID: PMC10191987 DOI: 10.1007/s00737-023-01312-5] [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: 02/08/2023] [Accepted: 03/23/2023] [Indexed: 04/11/2023]
Abstract
Adverse pregnancy outcomes (APOs) are common occurrences that contribute to negative maternal and child health outcomes. Our aim was to test the hypothesis that trauma exposure and depression are drivers of the better-recognised risk factors for miscarriage, abortion and stillbirths. Our comparative cohort study based in Durban, South Africa recruited women who reported a recent rape (n = 852) and those who had never experienced rape (n = 853), with follow-up for 36 months. We explored APOs (miscarriage, abortion or stillbirth) among those having a pregnancy during follow-up (n = 453). Potential mediators were baseline depression, post-traumatic stress symptoms, substance abuse, HbA1C, BMI, hypertension and smoking. A structural equation model (SEM) was used to determine direct and indirect paths to APO. Overall, 26.6% of the women had a pregnancy in the follow-up period and 29.4% ended in an APO, with miscarriage (19.9%) the most common outcome, followed by abortion (6.6%) and stillbirths (2.9%). The SEM showed two direct pathways from exposure to childhood trauma, rape and other trauma, to APO which were ultimately mediated by hypertension and/or BMI, but all paths to BMI were mediated by depression and IPV-mediated pathways from childhood and other trauma to hypertension. Food insecurity mediated a pathway from experiences of trauma in childhood to depression. Our study confirms the important role of trauma exposure, including rape, and depression on APOs, through their impact on hypertension and BMI. It is critical that violence against women and mental health are more systematically addressed in antenatal, pregnancy and postnatal care.
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Affiliation(s)
- N Abrahams
- Gender & Health Research Unit, South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa.
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7935, Cape Town, South Africa.
| | - E Chirwa
- Gender & Health Research Unit, South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - S Mhlongo
- Gender & Health Research Unit, South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa
| | - S Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Dr, Parow, Cape Town, 7505, South Africa
- Department of Psychiatry, Faculty of Medicine and Health Sciences, South African Research Chair in Posttraumatic Stress Disorder, Stellenbosch University, Cape Town, South Africa
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - B Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie van Zijl Dr, Parow Valley, 7501, Cape Town, South Africa
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, 6102, Australia
- Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, Cape Town, 7700, South Africa
| | - N Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Francie van Zijl Dr, Parow Valley, 7501, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Rondebosch, Cape Town, 7700, South Africa
| | - A P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Francie van Zijl Dr, Parow Valley, 7501, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Rondebosch, Cape Town, 7700, South Africa
| | - C Garcia-Moreno
- HRP (The UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction), Department of Sexual and Reproductive Health and Research, World Health Organization (WHO), 1211, Geneva, Switzerland
| | - C Lombard
- Biostatistics Unit, South African Medical Research Council, Francie van Zijl Dr, Parow Valley, 7501, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - R Jewkes
- Gender & Health Research Unit, South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa
- Office of the Executive Scientist, South African Medical Research Council, Pretoria, 0001, South Africa
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Shaw RJ, Moreyra A, Simon S, Wharton E, Dowtin LL, Armer E, Goldman LW, Borkovi T, Neri E, Jo B, Hintz S, Van Meurs K, Horwitz SM. Group trauma focused cognitive behavior therapy for parents of premature infants compared to individual therapy intervention. Early Hum Dev 2023; 181:105773. [PMID: 37119727 PMCID: PMC10182567 DOI: 10.1016/j.earlhumdev.2023.105773] [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: 01/19/2023] [Revised: 03/28/2023] [Accepted: 04/07/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND The current study compares results of a group-based intervention developed to reduce symptoms of posttraumatic stress, depression, and anxiety in parents of premature infants with a prior study using an individual version of the treatment manual. METHODS 26 mothers of preterm infants (25-34 weeks' gestational age; >600 g) received 6 sessions of trauma-focused cognitive behavior therapy (CBT). Outcomes were compared with those of a previously published RCT, which tested an individual therapy based on the same model in a group of 62 mothers. Results were also compared across in-person and telehealth treatment. RESULTS From baseline to follow up, the individual intervention showed greater improvement in trauma symptoms assessed with the Davidson Trauma Scale (d = 0.48, p = 0.016), although both conditions showed clinically significant improvement. Similar patterns were found for maternal depression and anxiety. In-person treatment was found to be superior to telehealth treatment administered during the COVID-19 pandemic, although the difference was not significant. CONCLUSIONS Group-based trauma focused CBT is an effective treatment modality for parents of premature infants with symptoms of psychological distress but not as effective as individual therapy using the same treatment model.
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Affiliation(s)
- Richard J Shaw
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America.
| | - Angelica Moreyra
- Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, United States of America
| | - Stephanie Simon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - Emily Wharton
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - LaTrice L Dowtin
- PlayfulLeigh Psyched, Silver Spring, MD, United States of America
| | - Erin Armer
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | | | - Tonyanna Borkovi
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - Eric Neri
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - Susan Hintz
- Department of Pediatrics, Stanford University School of Medicine, United States of America
| | - Krisa Van Meurs
- Department of Pediatrics, Stanford University School of Medicine, United States of America
| | - Sarah M Horwitz
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, United States of America
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Ortigosa-Beltrán I, Jaén I, García-Palacios A. Processing negative autobiographical memories in a foreign language. Front Psychol 2023; 14:1133915. [PMID: 37260968 PMCID: PMC10227500 DOI: 10.3389/fpsyg.2023.1133915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/19/2023] [Indexed: 06/02/2023] Open
Abstract
The use of a foreign language has been introduced in the clinical setting as a form of emotional distance to help deal with negative experiences. However, the evidence of foreign language reducing emotionality during processing negative events is still scarce. This study aims to test whether the description and processing of a traumatic or highly emotional event in a foreign language could modulate the strength of the connection between traumatic symptomatology and emotional reaction. For this purpose, a sample of 128 healthy participants completed a series of questionnaires via an online platform. Firstly, their levels of distress, arousal and valence were assessed in their native language. Secondly, they were assigned to either the native language or the foreign language group and described a negative childhood event in the assigned language (English or Spanish), followed by five questions for processing the event. Next, their emotionality was assessed again in their native language. Finally, a questionnaire of traumatic stress symptoms and an avoidance scale were completed. Results showed that the relationship between traumatic symptomatology and emotionality was moderated by the language of processing the negative event. Specifically, traumatic symptomatology was more strongly associated with distress and arousal change when the processing task was performed in the native language. These findings suggest the influence of a foreign language on emotional reactivity when a negative experience is processed, which could be an essential tool in the treatment of disorders related to stress and trauma.
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Affiliation(s)
| | - Irene Jaén
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellón, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellón, Spain
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Godoy-González M, Navarra-Ventura G, Gomà G, de Haro C, Espinal C, Fortià C, Ridao N, Miguel Rebanal N, Oliveras-Furriols L, Subirà C, Jodar M, Santos-Pulpón V, Sarlabous L, Fernández R, Ochagavía A, Blanch L, Roca O, López-Aguilar J, Fernández-Gonzalo S. Objective and subjective cognition in survivors of COVID-19 one year after ICU discharge: the role of demographic, clinical, and emotional factors. Crit Care 2023; 27:188. [PMID: 37189173 PMCID: PMC10184095 DOI: 10.1186/s13054-023-04478-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/04/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Intensive Care Unit (ICU) COVID-19 survivors may present long-term cognitive and emotional difficulties after hospital discharge. This study aims to characterize the neuropsychological dysfunction of COVID-19 survivors 12 months after ICU discharge, and to study whether the use of a measure of perceived cognitive deficit allows the detection of objective cognitive impairment. We also explore the relationship between demographic, clinical and emotional factors, and both objective and subjective cognitive deficits. METHODS Critically ill COVID-19 survivors from two medical ICUs underwent cognitive and emotional assessment one year after discharge. The perception of cognitive deficit and emotional state was screened through self-rated questionnaires (Perceived Deficits Questionnaire, Hospital Anxiety and Depression Scale and Davidson Trauma Scale), and a comprehensive neuropsychological evaluation was carried out. Demographic and clinical data from ICU admission were collected retrospectively. RESULTS Out of eighty participants included in the final analysis, 31.3% were women, 61.3% received mechanical ventilation and the median age of patients was 60.73 years. Objective cognitive impairment was observed in 30% of COVID-19 survivors. The worst performance was detected in executive functions, processing speed and recognition memory. Almost one in three patients manifested cognitive complaints, and 22.5%, 26.3% and 27.5% reported anxiety, depression and post-traumatic stress disorder (PTSD) symptoms, respectively. No significant differences were found in the perception of cognitive deficit between patients with and without objective cognitive impairment. Gender and PTSD symptomatology were significantly associated with perceived cognitive deficit, and cognitive reserve with objective cognitive impairment. CONCLUSIONS One-third of COVID-19 survivors suffered objective cognitive impairment with a frontal-subcortical dysfunction 12 months after ICU discharge. Emotional disturbances and perceived cognitive deficits were common. Female gender and PTSD symptoms emerged as predictive factors for perceiving worse cognitive performance. Cognitive reserve emerged as a protective factor for objective cognitive functioning. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04422444; June 9, 2021.
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Affiliation(s)
- Marta Godoy-González
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Guillem Navarra-Ventura
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
| | - Gemma Gomà
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Candelaria de Haro
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Espinal
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Cristina Fortià
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Natalia Ridao
- Physical and Rehabilitation Medicine Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Nuria Miguel Rebanal
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Clinical Psychology and Psychobiology Department, Universitat de Barcelona, Barcelona, Spain
| | - Laia Oliveras-Furriols
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Carles Subirà
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Critical Care Department, Althaia Xarxa Assistencial Universitària de Manresa, IRIS Research Institute, Manresa, Spain
| | - Mercè Jodar
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Neurology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Verónica Santos-Pulpón
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Leonardo Sarlabous
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Fernández
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Critical Care Department, Althaia Xarxa Assistencial Universitària de Manresa, IRIS Research Institute, Manresa, Spain
| | - Ana Ochagavía
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Lluís Blanch
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Oriol Roca
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Josefina López-Aguilar
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Sol Fernández-Gonzalo
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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Buselli R, Corsi M, Veltri A, Marino R, Caldi F, Del Guerra P, Guglielmi G, Tanca C, Paoli M, Calabretta VM, Perretta S, Foddis R, Carrozzino MA. Comparison between Standard Expository Cognitive Behavioral Therapy (CBT-E) and Immersive Virtual Reality CBT (CBT-VR) for Rehabilitation of Patients Affected by Occupational Stress Disorders: Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095735. [PMID: 37174252 PMCID: PMC10178175 DOI: 10.3390/ijerph20095735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
Work-related stress presents a significant impact on work performance and physical health. It has been associated with the onset of a multitude of symptoms that can lead to occupational stress diseases, namely Adjustment Disorder and Post-Traumatic Stress Disorder. The literature has evidenced that "exposure therapy" of cognitive-behavioral training (CBT-E) seems to be the most effective technique to manage stress symptoms, including work stress diseases, and several studies have considered Virtual Reality (VR) as an adjuvant tool to exposure-based psychotherapy (CBT-VR) for the treatment of multiple psychiatric disorders. The aim of this study is to evaluate the effectiveness of CBT with exposure to stressful work scenarios in imaginative (CBT-E) and in immersive virtual reality (CBT-VR) scenarios in a group of workers affected by work-related stress disorders and compare the clinical and physiological outcomes between the two exposure techniques. A long-term goal would be to develop an evidence-based rehabilitation program as a treatment for the reintegration into work of patients affected by these psychiatric disorders.
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Affiliation(s)
- Rodolfo Buselli
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Center for Work-Related Stress and Occupational Mental Disorders, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Martina Corsi
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Center for Work-Related Stress and Occupational Mental Disorders, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Antonello Veltri
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Center for Work-Related Stress and Occupational Mental Disorders, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Riccardo Marino
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Center for Work-Related Stress and Occupational Mental Disorders, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Fabrizio Caldi
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Paolo Del Guerra
- Department of Public Health, Azienda USL Toscana Centro, 50053 Empoli, Italy
| | - Giovanni Guglielmi
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Camilla Tanca
- Scuola Superiore Sant'Anna, Institute of Communication, Information and Perception Technologies TECIP, 56100 Pisa, Italy
| | - Massimo Paoli
- Department of Public Health, Sovrintendenza Sanitaria Regionale Inail Toscana, 50144 Firenze, Italy
| | | | - Salvio Perretta
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
| | - Rudy Foddis
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, Cisanello, 56124 Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Marcello Antonio Carrozzino
- Scuola Superiore Sant'Anna, Institute of Communication, Information and Perception Technologies TECIP, 56100 Pisa, Italy
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May A, Balzan R, Williams AS, Wade TD, Paranjothy SM. Interventions for perinatal borderline personality disorder and complex trauma: a systematic review. Arch Womens Ment Health 2023; 26:295-309. [PMID: 37079042 DOI: 10.1007/s00737-023-01313-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/09/2023] [Indexed: 04/21/2023]
Abstract
Perinatal borderline personality disorder (BPD) and complex post-traumatic stress disorder (cPTSD) are associated with significant impairment to interpersonal functioning, and risk of intergenerational transmission of psychopathology. Evaluation of interventions, however, is scarce. To date, no systematic review has addressed interventions for perinatal BPD, cPTSD, and associated symptomatology. Given the modest evidence to support informed clinical guidelines, the objective of this systematic review is to synthesise the literature on interventions for perinatal BPD and cPTSD, and to generate future directions for research. A comprehensive literature search following PRISMA guidelines was conducted in PsycInfo, MEDLINE, Emcare, Scopus, and ProQuest Dissertations and Theses Global databases. Seven original studies were included, of which only two were randomised controlled trials, using less intensive comparison conditions. Results suggest an association between Dialectical Behavioural Therapy (DBT) group skills training, a multimodal therapeutic approach at a Mother-Baby Unit (MBU), and Child-Parent Psychotherapy with improved perinatal mental health outcomes and remission of symptoms. MBU admission and home-visiting programs were associated with healthy postpartum attachment relationships. Home-visiting programs and DBT group skills were additionally associated with improved maternal parenting capabilities. Conclusions to inform clinical guidelines are limited by a lack of credible comparison conditions, and low quantity and quality of evidence. The feasibility of implementing intensive interventions in real-world settings is dubious. Hence, it is suggested that future research considers utilising antenatal screening to identify at-risk mothers, and the implementation of early intervention, using robust designs that can inform robust conclusions.
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Affiliation(s)
- Alexandra May
- Flinders Institute for Mental Health and Wellbeing and Blackbird Initiative, College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia.
| | - Ryan Balzan
- Flinders Institute for Mental Health and Wellbeing and Blackbird Initiative, College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Anne Sved Williams
- University of Adelaide, Adelaide, Australia
- Women's and Children's Health Network, North Adelaide, South Australia, Australia
| | - Tracey D Wade
- Flinders Institute for Mental Health and Wellbeing and Blackbird Initiative, College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Sarah Marie Paranjothy
- Flinders Institute for Mental Health and Wellbeing and Blackbird Initiative, College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia
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Patrick J, Dale SK. Mental Health, Self-Care, and Engagement in Care among Black Women Living with HIV. Ethn Dis 2023; 33:116-123. [PMID: 38845736 PMCID: PMC11145728 DOI: 10.18865/ed.33.2-3.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Objectives Due to sociostructural factors, Black women living with human immunodeficiency virus (HIV) in the United States represent the highest percentage of women with HIV and experience mental health struggles that impact health behaviors. This study examines associations between mental health, self-care, medication adherence, engagement with healthcare, HIV-related healthcare visits, and hospitalization. Methods One hundred and nineteen Black women living with HIV in the Southeastern United States completed measures on scheduled visits (general and HIV-related healthcare), visits attended/missed/rescheduled, mental healthcare engagement (therapy and support groups), hospital visits (emergency room and overnight stays), medication adherence, and a clinician-administered interview assessing mental health. Results Higher self-care was associated with fewer emergency room visits (β=-0.31, P<.001) and hospitalizations (β=-0.22, P<.05). Higher post-traumatic stress disorder symptoms were associated with hospitalization (β=0.23, P<.05) and missed HIV-related visits (β=0.20, P<.05) but higher outpatient mental healthcare visits for group psychotherapy (β=0.20, P< .05). Higher suicidality was associated with lower HIV-related healthcare visits scheduled (β=-0.26, P<.01). Higher HIV load was associated with higher HIV-related healthcare visits scheduled (β=0.45, P<.001) and hospitalization (β=0.41, P<.001). Higher Wisepill medication adherence (β=-0.28, P<.01) and self-reported adherence (β=-0.33, P<.001) were associated with fewer HIV missed visits. Higher self-reported adherence was associated with fewer emergency room visits (β=-0.38, P<.001) and hospitalizations (β=-0.27, P<.001). Conclusions Our findings highlight the need for treating mental health symptoms and enhancing self-care among Black women living with HIV to improve engagement in care and health behaviors and decrease emergency room visits and hospitalization.
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Affiliation(s)
- Jordan Patrick
- Department of Psychology, University of Miami, Miami, FL
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Laccetta G, Di Chiara M, De Nardo MC, Terrin G. Symptoms of post-traumatic stress disorder in parents of preterm newborns: A systematic review of interventions and prevention strategies. Front Psychiatry 2023; 14:998995. [PMID: 36970259 PMCID: PMC10032332 DOI: 10.3389/fpsyt.2023.998995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 02/07/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundPreterm birth and subsequent NICU admission can be a traumatic experience for parents who may subsequently develop post-traumatic stress (PTS) disorder (PTSD). Given that developmental issues are common among children of parents with PTSD, interventions for prevention and treatment are essential.ObjectiveTo assess the most effective non-pharmacological interventions to prevent and/or treat PTS symptoms in parents of preterm newborns.MethodsSystematic review performed in accordance with the PRISMA statements. Eligible articles in English language were searched in MEDLINE, Scopus, and ISI Web of Science databases using the following medical subject headings and terms: “stress disorder, post-traumatic,” “parents,” “mothers,” “fathers,” “infant, newborn,” “intensive care units, neonatal,” and “premature birth.” The terms “preterm birth” and “preterm delivery” were also used. Unpublished data were searched in ClinicalTrials.gov website. All intervention studies published until September 9th, 2022 and including parents of newborns with gestational age at birth (GAb) <37 weeks which underwent ≥1 non-pharmaceutical interventions for prevention and/or treatment of PTS symptoms related to preterm birth were included. Subgroup analyses were conducted by type of intervention. The quality assessment was performed according to the criteria from the RoB-2 and the “NIH Quality Assessment Tool for Before-After studies.”ResultsSixteen thousand six hundred twenty-eight records were identified; finally, 15 articles (1,009 mothers, 44 fathers of infants with GAb ≤ 366/7 weeks) were included for review. A good standard of NICU care (effective as sole intervention: 2/3 studies) and education about PTSD (effective in association with other interventions: 7/8 studies) could be offered to all parents of preterm newborns. The 6-session Treatment Manual is a complex intervention which revealed itself to be effective in one study with low risk of bias. However, the effectiveness of interventions still remains to be definitively established. Interventions could start within 4 weeks after birth and last 2–4 weeks.ConclusionThere is a wide range of interventions targeting PTS symptoms after preterm birth. However, further studies of good quality are needed to better define the effectiveness of each intervention.
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Gammoh O, Bjørk MH, Al Rob OA, AlQudah AR, Hani AB, Al-Smadi A. The association between antihypertensive medications and mental health outcomes among Syrian war refugees with stress and hypertension. J Psychosom Res 2023; 168:111200. [PMID: 36848762 DOI: 10.1016/j.jpsychores.2023.111200] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/29/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Little is known about the association between antihypertensive drugs with mental health outcomes. We examined the association between the antihypertensive classes and other clinical patient features with symptoms of depression, anxiety, insomnia, and Post-Traumatic Stress Disorder (PTSD) in a cohort of Syrian war refugees with stress and hypertension residing in Jordan. METHODS This cross-sectional study recruited hypertensive Syrian refugees with stress. Depression severity was assessed using the Patient Health Questionnaire-9, anxiety was measured by The General Anxiety Disorder-7, the Insomnia Severity Index was used to evaluate sleep quality and PTSD was measured using Davidson Trauma Scale. To investigate the association between the different classes of antihypertensive medication and mental health outcomes we used multivariable regression models. RESULTS Of the 492 participants, 251 were men (51%), 234 (47.6%) were on β-blockers, 141 (28.7%) on diuretics, and 209 (42.5%) on Angiotensin Converting Enzyme Inhibitors (ACEIs)/Angiotensin Receptor Blockers (ARBs). Although the multivariate regression revealed the different classes of antihypertensives are not associated with mental health symptoms, however, physical activity is associated with lower adjusted odds for symptoms of depression (0.68 (0.46-0.99), p = 0.04), anxiety (0.60 (0.42-0.85),p = 0.005), insomnia (0.63 (0.44-0.91),p = 0.01) and dyslipidemia (3.48(0.29-6.69),p = 0.03) is associated with higher PTSD symptoms. LIMITATIONS The study subjects were not assessed for psychiatric diagnoses clinically. Further, we used a cross-sectional design that does not allow to measure longitudinal changes. CONCLUSIONS The association between antihypertensive drugs and mental health symptoms was not evident in the present study. Follow-up future studies are required.
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Affiliation(s)
- Omar Gammoh
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan.
| | - Marte-Helene Bjørk
- Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Osama Abo Al Rob
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Abdel Rahim AlQudah
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, The Hashemite University, Zarqa, Jordan
| | - Amjad Bani Hani
- Cardiovascular Surgery & Intensive Care, General Surgery Department, School of Medicine, The University of Jordan, Queen Rania Str. Jordan, Amman, Jordan
| | - Ahmed Al-Smadi
- Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
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Ramnarain D, Pouwels S, Fernández-Gonzalo S, Navarra-Ventura G, Balanzá-Martínez V. Delirium-related psychiatric and neurocognitive impairment and the association with post-intensive care syndrome-A narrative review. Acta Psychiatr Scand 2023; 147:460-474. [PMID: 36744298 DOI: 10.1111/acps.13534] [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: 06/28/2022] [Revised: 01/21/2023] [Accepted: 01/23/2023] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Delirium is common among patients admitted to the intensive care unit (ICU) and its impact on the neurocognitive and psychiatric state of survivors is of great interest. These new-onset or worsening conditions, together with physical alterations, are called post-intensive care syndrome (PICS). Our aim is to update on the latest screening and follow-up options for psychological and cognitive sequelae of PICS. METHOD This narrative review discusses the occurrence of delirium in ICU settings and the relatively new concept of PICS. Psychiatric and neurocognitive morbidities that may occur in survivors of critical illness following delirium are addressed. Future perspectives for practice and research are discussed. RESULTS There is no "gold standard" for diagnosing delirium in the ICU, but two extensively validated tools, the confusion assessment method for the ICU and the intensive care delirium screening checklist, are often used. PICS complaints are frequent in ICU survivors who have suffered delirium and have been recognized as an important public health and socio-economic problem worldwide. Depression, anxiety, post-traumatic stress disorder, and long-term cognitive impairment are recurrently exhibited. Screening tools for these deficits are discussed, as well as the suggestion of early assessment after discharge and at 3 and 12 months. CONCLUSIONS Delirium is a complex but common phenomenon in the ICU and a risk factor for PICS. Its diagnosis is challenging with potential long-term adverse outcomes, including psychiatric and cognitive difficulties. The implementation of screening and follow-up protocols for PICS sequelae is warranted to ensure early detection and appropriate management.
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Affiliation(s)
- Dharmanand Ramnarain
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.,Department of Intensive Care Medicine, Saxenburgh Medical Center, Hardenberg, The Netherlands.,Departmentof Medical and Clinical Psychology, Center of Research on Psychological and Somatic disease (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.,Department of General, Abdominal and Minimally Invasive Surgery, Helios Klinikum, Krefeld, Germany
| | - Sol Fernández-Gonzalo
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Guillem Navarra-Ventura
- Critical Care Center, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Vicent Balanzá-Martínez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
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45
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Sharma R, Dale SK. Using Network Analysis to Assess the Effects of Trauma, Psychosocial, and Socioeconomic Factors on Health Outcomes Among Black Women Living with HIV. AIDS Behav 2023; 27:400-415. [PMID: 35927538 PMCID: PMC10712664 DOI: 10.1007/s10461-022-03774-7] [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] [Subscribe] [Scholar Register] [Accepted: 06/25/2022] [Indexed: 11/01/2022]
Abstract
Black women living with HIV (BWLWH) face intersectional adversities impacting their wellbeing. This study utilized network analysis to assess the associations among adversities linked to racism, sexism, HIV stigma, and socioeconomic status (income, housing, education) and determine which adversities predict mental health outcomes, HIV viral load, and medication adherence more consistently among BWLWH. 119 BWLWH aged 18 years or older completed self-report measures on sociodemographics, adversity factors, and mental health outcomes. Viral load count was obtained through blood draws, and medication adherence was measured via Wisepill adherence monitoring device. Multiple regression analysis was used to assess if the more central factors in the network also predicted health outcomes more consistently than the less central factors. The four most central factors in the network were income, housing, gendered racial microaggression (GRM) frequency, and GRM appraisal. Multiple regression analysis revealed that GRM frequency, GRM appraisal, and the number of traumas contributed uniquely and were positively associated with both depressive symptoms and posttraumatic stress disorder symptoms. HIV-related discrimination contributed uniquely and was positively associated with HIV viral load.
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Affiliation(s)
- Ratanpriya Sharma
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Sannisha K Dale
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA.
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46
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Wilson TK, Riley A, Khetarpal SK, Abernathy P, Booth J, Culyba AJ. Exploring the Impact of Racism on Black Youth: A Multidimensional Examination of Discriminatory Experiences Across Place and Time. J Adolesc Health 2023; 72:246-253. [PMID: 36481250 PMCID: PMC10124122 DOI: 10.1016/j.jadohealth.2022.09.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Community violence disproportionally impacts Black youth. Experiences of racism and discrimination may create additional challenges for youth recovering from violence exposure. This study used ecological momentary assessment to elucidate how perceptions of racism and social support influence health and safety outcomes among Black youth following violence exposure. METHODS Twenty-five Black youth (14-19 years old, 60% female) who had witnessed violence within the past three months completed a baseline survey that assessed discrimination experiences, social support, post-traumatic stress symptoms (PTS), and perceived safety. Youth completed ecological momentary assessments three times daily for two weeks about the place they were in, people they were with, their current emotional state, and in-the-moment racism perceptions. Multilevel models estimated the relationship between overall and time-varying perceptions of racism and social support, PTS symptoms, and perceived safety. RESULTS Overall, 76% of youth reported at least one discrimination experience at baseline. Prior discrimination was associated with higher PTS (B = 1.86, p = .001) and depressive symptoms (B = 0.13, p = .013) at baseline. Youth who reported higher overall perceptions of racism in-the-moment reported higher PTS (B = 0.50, p = .002) and lower perceived safety (B = -0.53, p = .001). In-the-moment perceptions of racism were associated with lower perceived safety in that place (B = -0.09, p < .01). Emotional and instrumental support were associated with lower PTS and higher perceived safety (p < .05). DISCUSSION Experiences of racism and being in discriminatory places impacted youth's depressive symptoms, PTS symptoms, and perceived safety. Interventions attuned to in-the-moment experiences of racism, and that leverage social support, are needed to support Black youth exposed to violence and discrimination.
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Affiliation(s)
- Tyia K Wilson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Alexander Riley
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Susheel K Khetarpal
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Paul Abernathy
- Neighborhood Resilience Project, Pittsburgh, Pennsylvania
| | - Jaime Booth
- University of Pittsburgh, School of Social Work, Pittsburgh, Pennsylvania
| | - Alison J Culyba
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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47
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Mhlongo S, Seedat S, Jewkes R, Myers B, Chirwa E, Nöthling J, Lombard C, Peer N, Kengne A, Garcia-Moreno C, Dunkle K, Abrahams N. Depression and post-traumatic stress symptoms two years post-rape and the role of early counselling: Rape Impact Cohort Evaluation (RICE) study. Eur J Psychotraumatol 2023; 14:2237364. [PMID: 37642373 PMCID: PMC10467520 DOI: 10.1080/20008066.2023.2237364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 03/16/2023] [Accepted: 06/06/2023] [Indexed: 08/31/2023] Open
Abstract
Background: Survivors of sexual violence are at higher risk of adverse mental health outcomes compared to those exposed to other interpersonal traumas.Objective: To examine the trajectory of both post-traumatic stress disorder (PTSD) and depression as well as the role of early counselling over 24 months among rape survivors.Method: The South African Rape Impact Cohort Evaluation (RICE) study enrolled women aged 16-40 years attending post-rape care services within 20 days of a rape incident (n = 734), and a comparison group (n = 786) was recruited from primary health care. Women were followed for 24 months; the main study outcomes were depression and PTSD. Reports of early supportive counselling by the exposed group were also included. The analysis included an adjusted joint mixed model with linear splines to account for correlated observations between the outcomes.Results: At 24 months, 45.2% of the rape-exposed women met the cut-off for depression and 32.7% for PTSD. This was significantly higher than levels found among the unexposed. Although a decline in depression and PTSD was seen at 3 months among the women who reported a rape, mean scores remained stable thereafter. At 24 months mean depression scores remained above the depression cut-off (17.1) while mean PTSD scores declined below the PTSD cut-off (14.5). Early counselling was not associated with the trajectory of either depression or PTSD scores over the two years in rape-exposed women with both depression and PTSD persisting regardless of early counselling.Conclusion: The study findings highlight the importance to find and provide effective mental health interventions post-rape in South Africa.
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Affiliation(s)
- S. Mhlongo
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - S. Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Research Chair in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - R. Jewkes
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
- Office of the Executive Scientist, South African Medical Research Council, PretoriaSouth Africa
| | - B. Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - E. Chirwa
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - J. Nöthling
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - C. Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - N. Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - A.P. Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - C. Garcia-Moreno
- Department of Sexual and Reproductive Health and Research, World Health Organization (WHO)Geneva, Switzerland
| | - K. Dunkle
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - N. Abrahams
- Gender & Health Research Unit, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine: Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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48
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Siehl S, Sicorello M, Herzog J, Nees F, Kleindienst N, Bohus M, Müller-Engelmann M, Steil R, Priebe K, Schmahl C, Flor H. Neurostructural associations with traumatic experiences during child- and adulthood. Transl Psychiatry 2022; 12:515. [PMID: 36517466 PMCID: PMC9751132 DOI: 10.1038/s41398-022-02262-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Adverse experiences can lead to severe mental health problems, such as posttraumatic stress disorder (PTSD), throughout the lifespan. In individuals with PTSD, both global and local brain volume reductions have been reported-especially in the amygdala and hippocampus-while the literature on childhood maltreatment suggests a strong dependency on the timing of adverse events. In the present study, we pooled data from two studies to contrast the effects of reported trauma exposure during neurodevelopmentally sensitive periods in early life with trauma exposure during adulthood. A total of 155 women were allocated into one of six age-matched groups according to the timing of traumatization (childhood vs adulthood) and psychopathology (PTSD vs trauma-exposed healthy vs trauma-naïve healthy). Volumes of the amygdala and hippocampus were compared between these groups. Six additional exploratory regions of interest (ROI) were included based on a recent meta-analysis. Amygdala volume was strongly dependent on the timing of traumatization: Smaller amygdala volumes were observed in participants with childhood trauma and PTSD compared to the healthy control groups. In contrast, larger amygdala volumes were observed in both groups with trauma exposure during adulthood compared to the trauma-naïve control group. Hippocampal volume comparisons revealed no statistically significant differences, although the descriptive pattern was similar to that found for the amygdala. The remaining exploratory ROIs showed significant group effects, but no timing effects. The timing might be an important moderator for adversity effects on amygdala volume, potentially reflecting neurodevelopmental factors. Albeit confounded by characteristics like trauma type and multiplicity, these findings pertain to typical childhood and adulthood trauma as often observed in clinical practice and speak against a simple association between traumatic stress and amygdala volume.
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Affiliation(s)
- Sebastian Siehl
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany. .,Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
| | - Maurizio Sicorello
- grid.7700.00000 0001 2190 4373Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Julia Herzog
- grid.7700.00000 0001 2190 4373Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Frauke Nees
- grid.412468.d0000 0004 0646 2097Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Nikolaus Kleindienst
- grid.7700.00000 0001 2190 4373Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Martin Bohus
- grid.7700.00000 0001 2190 4373Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Meike Müller-Engelmann
- grid.7839.50000 0004 1936 9721Department of Clinical Psychology and Psychotherapy, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Regina Steil
- grid.7839.50000 0004 1936 9721Department of Clinical Psychology and Psychotherapy, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Kathlen Priebe
- grid.6363.00000 0001 2218 4662Department of Psychiatry and Psychotherapy, Charité–Universitätsmedizin, Berlin, Germany
| | - Christian Schmahl
- grid.7700.00000 0001 2190 4373Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Herta Flor
- grid.7700.00000 0001 2190 4373Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
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Kelton K, Van Voorhees EE, Elbogen EB, Workgroup VAMAMIRECC, Dillon KH. Correlates of Incarceration History Among Military Veterans. MILITARY PSYCHOLOGY 2022; 2022:577-589. [PMID: 36712896 PMCID: PMC9881233 DOI: 10.1080/08995605.2022.2141049] [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: 02/28/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022]
Abstract
Veterans with histories of incarceration are at greater risk for poor physical and mental health outcomes, yet prior research in this population has focused on specific subsets of veterans or a narrow range of predictors. We utilized the Bronfenbrenner Socioecological Model as the framework to evaluate correlates of incarceration history in a large sample of Iraq and Afghanistan-era veterans at four levels: demographic, historical, clinical, and contextual. Participants were 2,904 veterans (76.9% male; 49.5% White and 46.5% Black; mean age 38.08, SD = 10.33), 700 of whom reported a history of incarceration. Four logistic regression models predicting history of incarceration were tested, adding demographic, historical, clinical, and contextual variables hierarchically. In the final model, younger age (OR=0.99, 95% CI=0.98-1.00), male gender (OR of being female =0.28, 95% CI=0.21-0.38), belonging to a historically marginalized group (OR of being White =0.69, 95% CI=0.56-0.84), family history of incarceration (OR=1.47, 95% CI=1.10-1.94), adult interpersonal trauma (OR=1.39, 95% CI=1.28-1.51), problematic alcohol use (OR=1.03, 95% CI=1.02-1.05), drug abuse (OR=1.15, 95% CI=1.11-1.19), and unemployment (OR for being employed=0.76, 95% CI=0.62-0.92) were significantly associated with a history of incarceration. Implications of these findings for developing interventions and supporting systems to effectively target this high-risk population of veterans are discussed.
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Affiliation(s)
- Katherine Kelton
- Research & Development, Durham VA Health Care System, Durham, North Carolina, USA
| | - Elizabeth E. Van Voorhees
- Research & Development, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
| | - Eric B. Elbogen
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- National Center on Homelessness among Veterans, Washington, District of Columbia, USA
| | | | - Kirsten H. Dillon
- Research & Development, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
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50
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Vuong E, Peer N, Chirwa E, Mhlongo S, Lombard C, Hemmings S, Kengne AP, Abrahams N, Seedat S. Prospective Association of Circulating Adipokines with Cardiometabolic Risk Profile Among Women: The Rape Impact Cohort Evaluation Study. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:820-833. [PMID: 36340478 PMCID: PMC9629977 DOI: 10.1089/whr.2022.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Sexual violence is associated with poor cardiometabolic outcomes, yet the etiopathogenic pathways remain unclear. Adipokines may contribute to pathways in the development of cardiometabolic disease (CMD), including in vulnerable populations. Further investigation of adipokines among sexually traumatized individuals may inform cardiometabolic screening. This study aimed to investigate the association between circulating adipokines, metabolic syndrome (MetS), and longitudinal change in MetS components (namely abdominal obesity, blood pressure, lipid profile, and glycemic status) over a 1-year period in a cohort of rape exposed (RE) and rape unexposed (RUE) females. MATERIALS AND METHODS Seven hundred seventy-eight RE and 617 RUE black South African women aged 18-40 years were recruited for the Rape Impact Cohort Evaluation study. Nonfasting blood samples were analyzed for cardiometabolic variables and adipokine levels using enzyme-linked immunosorbent assay. Serum adiponectin was measured in both RE and RUE and resistin, leptin, and leptin/adiponectin (L/A) ratio in RE only. Associations between baseline serum adipokines, MetS, and its components were assessed at baseline and follow-up using adjusted linear and logistic regressions. RESULTS In the RE group, adiponectin, leptin, and L/A ratio were significantly associated with MetS prevalence cross-sectionally (all p ≤ 0.001). No adipokine marker was related to incident MetS at 12-month follow-up. In the RE group, significant longitudinal associations with high-density lipoprotein cholesterol were shown for adiponectin (β = 0.146 [0.064], p = 0.022) and leptin (β = 0.001 [0.002], p = 0.012). CONCLUSIONS Findings suggest that adipokines may have a potential role as biomarkers to identify RE individuals at high risk for CMD.
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Affiliation(s)
- Eileen Vuong
- South African Research Chairs Initiative (SARChI), PTSD Program, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa.,Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa.,Address correspondence to: Eileen Vuong, MBchB, MMed(Psych), Department of Psychiatry, Stellenbosch University, PO Box 241, Cape Town 8000, South Africa,
| | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa.,Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Esnat Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa.,School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Sian Hemmings
- South African Research Chairs Initiative (SARChI), PTSD Program, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa.,SAMRC/SU Genomics of Brain Disorders Unit, Stellenbosch University, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa.,Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa.,Faculty of Health Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Soraya Seedat
- South African Research Chairs Initiative (SARChI), PTSD Program, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa.,Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa.,SAMRC/SU Genomics of Brain Disorders Unit, Stellenbosch University, South Africa
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