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Tanrıkulu AB, Kaya H, Örüm MH, Akyıldırım S. Prevalence and determinants of post-traumatic stress disorder in patients with schizophrenia 2 years after an earthquake in Turkey. Int J Psychiatry Med 2024; 59:65-82. [PMID: 37272858 DOI: 10.1177/00912174231180467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES High rates of post-traumatic stress disorder (PTSD) have been observed in earthquake survivors many years after the event. However, its prevalence among patients with schizophrenia is largely unknown. This study, which was conducted two years after the 2020 Elazığ earthquake, sought to identify risk factors for earthquake-related PTSD among patients with schizophrenia and healthy subjects. METHODS Adult patients with schizophrenia (N = 103) and healthy subjects (N = 103) who had survived the earthquake were recruited from affected areas in the Eastern Anatolian Region of Turkey, Elazığ. A detailed questionnaire of earthquake-related risk factors, the Brief Coping Orientation to Problems Experienced (Brief COPE), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Clinician-Administered PTSD scale for DSM-V (CAPS-5) scale were administered to participants. RESULTS Twelve percent of the patients with schizophrenia and 25% of the healthy subjects had earthquake-related PTSD diagnoses two years after the 2020 Elazığ earthquake. Healthy subjects had a significantly higher rate of earthquake-related PTSD when compared to patients with schizophrenia. Religious coping, self-blaming, less emotional support seeking, and going to a safer place on the night of the earthquake were found to be associated with PTSD in patients with schizophrenia. History of traumatic events, self-blaming, and less social support from family were found to be associated with a PTSD diagnosis in healthy subjects. CONCLUSIONS The earthquake in Turkey created a situation such that significant symptoms of PTSD remained present at two years following the event in both patients diagnosed with schizophrenia and healthy subjects. Patients with schizophrenia have different risk factors for the development of PTSD when compared with healthy subjects. Clinical interventions should consider risk factors, coping strategies, and perceived social support when seeking to prevent earthquake-related PTSD.
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Affiliation(s)
- Ali Baran Tanrıkulu
- Department of Psychiatry, Elazığ Mental Health and Diseases Hospital, Elazığ, Turkey
| | - Hilal Kaya
- Department of Psychiatry, Elazığ Mental Health and Diseases Hospital, Elazığ, Turkey
| | - Mehmet Hamdi Örüm
- Department of Psychiatry, Elazığ Mental Health and Diseases Hospital, Elazığ, Turkey
| | - Sümeyya Akyıldırım
- Department of Psychiatry, Elazığ Mental Health and Diseases Hospital, Elazığ, Turkey
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Henry MC, Sanjuan PM, Stone LC, Cairo GF, Lohr-Valdez A, Leeman LM. Alcohol and other substance use disorder recovery during pregnancy among patients with posttraumatic stress disorder symptoms: A qualitative study. DRUG AND ALCOHOL DEPENDENCE REPORTS 2021; 1:100013. [PMID: 36843908 PMCID: PMC9948915 DOI: 10.1016/j.dadr.2021.100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
Background About 5% of women are pregnant at substance use disorder (SUD) treatment entry, and pregnant women with SUD often belong to marginalized groups experiencing social, economic, and health care barriers associated with stigma from prenatal substance use. Pregnant women in SUD treatment have high rates of trauma and posttraumatic stress disorder (PTSD). This study sought to (1) examine the lived experiences of pregnant individuals with PTSD symptoms in SUD treatment and (2) understand the roles of systematic or contextual barriers to the pursuit of prenatal abstinence. Methods We draw upon in-depth semi-structured interviews to examine relationships between SUD, psychological trauma/PTSD experience, social resources, and lived experiences among patients in prenatal SUD treatment with PTSD symptoms. Our sample was pregnant patients (N = 13) with prior DSM-5 Criterion A trauma and current PTSD symptoms enrolled in a comprehensive program integrating prenatal care, substance use counseling, medication for opioid use disorder and case management at three sites affiliated with an urban academic medical center in New Mexico. Results Using thematic analysis, four main themes identified structural forces influencing alcohol and drug use: (a) lack of access or ability to obtain resources, (b) substance use to cope with negative affect, (c) social stigma, and (d) interpersonal relationships. Conclusions Despite receiving high-quality integrated prenatal and SUD care, these pregnant patients with PTSD symptoms in SUD treatment still experienced substantial social and structural hurdles to achieving abstinence during pregnancy.
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Affiliation(s)
- Melissa C. Henry
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale Boulevard, SE, Albuquerque, NM 87106, United States
| | - Pilar M. Sanjuan
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale Boulevard, SE, Albuquerque, NM 87106, United States
- Department of Family and Community Medicine, University of New Mexico School of Medicine MSC08 4720, 1 University of New Mexico, Albuquerque, NM 87131, United States
| | - Lisa Cacari Stone
- College of Population Health, University of New Mexico Health Science Center, 1001 Medical Arts Ave NE, Albuquerque, NM 87102, United States
| | - Grace F. Cairo
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale Boulevard, SE, Albuquerque, NM 87106, United States
| | - Anthony Lohr-Valdez
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale Boulevard, SE, Albuquerque, NM 87106, United States
| | - Lawrence M. Leeman
- Department of Family and Community Medicine, University of New Mexico School of Medicine MSC08 4720, 1 University of New Mexico, Albuquerque, NM 87131, United States
- Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, MSC08 4720, 1 University of New Mexico, Albuquerque, NM 87131, United States
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Beck JG, Clapp JD, Unger W, Wattenberg M, Sloan DM. Moderators of PTSD symptom change in group cognitive behavioral therapy and group present centered therapy. J Anxiety Disord 2021; 80:102386. [PMID: 33799175 PMCID: PMC8487250 DOI: 10.1016/j.janxdis.2021.102386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 01/13/2021] [Accepted: 03/18/2021] [Indexed: 11/17/2022]
Abstract
To examine moderators of change during group-based intervention for Posttraumatic Stress Disorder (PTSD), multilevel models were used to assess trajectories of symptom clusters in male veterans receiving trauma focused Group Cognitive Behavioral Treatment (gCBT; N = 84) or non-trauma focused Group Present Centered Therapy (gPCT; N = 91; Sloan et al., 2018). Separate models were conducted for symptom clusters in each intervention, examining pre-treatment PTSD symptoms, pre-treatment depression severity, age, index trauma, and outcome expectancies as potential moderators. Unconditioned growth models for both gCBT and gPCT showed reductions in intrusions, avoidance, negative cognitions/mood, and arousal/reactivity (all p < .001). Distinct moderators of recovery emerged for each treatment. Reductions in avoidance during gCBT were strongest at high levels of pre-treatment PTSD symptoms (low PTSD: p = .964, d = .05; high PTSD: p < .001, d = 1.31) whereas positive outcome expectancies enhanced reductions in cognitions/mood (low Expectancy: p = .120, d = .50; high Expectancy: p < .001, d = 1.13). For gPCT, high levels of pre-treatment depression symptoms negatively impacted change in both intrusion (low depression: p < .001, d = .96; high depression: p = .376, d = .22) and arousal/reactivity (low depression: p < .001, d = .95; high depression: p = .092, d = .39) symptoms. Results support the importance of examining trajectories of change and their moderators for specific treatments, particularly when contrasting trauma focused and non-trauma focused treatments.
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Affiliation(s)
- J Gayle Beck
- University of Memphis, Department of Psychology, Memphis, TN, USA.
| | - Joshua D Clapp
- University of Wyoming, Department of Psychology, Laramie, WY, USA
| | | | | | - Denise M Sloan
- VA Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Department of Psychiatry, Boston, MA, USA
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Ding F, Wang X, Cheng C, He J, Zhao H, Wu D, Yao S. Psychometric Properties and Measurement Invariance of the Cognitive Emotion Regulation Questionnaire in Chinese Adolescents With and Without Major Depressive Disorder: A Horizontal and Longitudinal Perspective. Front Psychiatry 2021; 12:736887. [PMID: 34744827 PMCID: PMC8569313 DOI: 10.3389/fpsyt.2021.736887] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/27/2021] [Indexed: 12/27/2022] Open
Abstract
Objective: The purpose of this study was to examine the psychometric properties and posited nine-factor structure of the Chinese version of the Cognitive Emotion Regulation Questionnaire (CERQ-C) in high school students and adolescents with major depressive disorder (MDD), including assessment of measurement invariance of CERQ-C and its subscales across gender, time, and presence of depression. Methods: Chinese high school students from Hunan Province (N = 1,253) and adolescents with major depressive disorder (MDD) from the Medical Psychological Institute outpatient clinic at The Second Xiangya Hospital (N = 205) were enrolled. We examined the reliability, and model fit of the CERQ-C. Multigroup confirmatory factor analysis (CFA) was used to test measurement invariance of the subscales across gender, time, and presence of depression. Results: The CERQ-C subscales showed good internal consistency and moderate test-retest reliability in high school students and excellent internal consistency in adolescents with MDD group. The nine-factor model yielded adequate fit indices in different samples. Multigroup CFA confirmed that CERQ-C is strongly equivalent across gender, time, and presence of depression. Conclusions: The CERQ-C is a valid, reliable, and stable instrument for the evaluation of the cognitive emotion regulation (ER) strategies for different samples, including high school students and adolescents with MDD. The horizontal and longitudinal equivalences are strongly established.
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Affiliation(s)
- Fengjiao Ding
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Xin Wang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Chang Cheng
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Jiayue He
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Haofei Zhao
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Daxing Wu
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, China.,Medical Psychological Institute of Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, China
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