Posttraumatic stress and co-morbidity following myocardial infarction among older patients: the role of coping

Posttraumatic Stress Disorder and Chronic Idiopathic URTICARIA: the Role of Coping and Personality

This study compared the severity of chronic idiopathic urticaria (CIU) and psychiatric symptoms between patients with different levels of posttraumatic stress disorder (PTSD) and investigated a model depicting the interrelationship between PTSD from past trauma, personality traits, coping strategies, CIU severity and psychiatric symptom severity. One hundred CIU and 60 allergy patients participated in the study, completing measures on PTSD, psychiatric symptoms, personality traits and coping strategies. The results showed that for CIU patients, 7%, 40 and 34% met the diagnostic criteria for no-PTSD, partial-PTSD and full-PTSD respectively whereas for allergy patients, 15%, 45 and 18% met the same criteria. Apart from CIU, psychiatric symptom severity differed significantly between diagnostic groups. PTSD was associated with coping strategies which were in turn associated with CIU severity and psychiatric symptom severity. PTSD was not significantly associated with personality. Emotion-focused coping mediated PTSD and CIU severity, PTSD and psychiatric symptom severity and neuroticism and CIU severity. To conclude, psychiatric symptom severity varies depending on the level of PTSD among CIU patients. Neurotic patients with a high level of PTSD from past trauma show raised CIU and psychiatric symptom severity when using emotion-focused coping strategies.

Posttraumatic Stress Disorder Among Older Patients with Chronic Obstructive Pulmonary Disease

This study explored (1) the incidence of posttraumatic stress disorder (PTSD) resulting from past trauma among older patients with COPD and (2) whether PTSD and COPD severity would relate to psychiatric co-morbidity and health-related quality of life. Eighty-five older patients completed the Hospital Anxiety and Depression Scale, the Chronic Respiratory Questionnaire, the Posttraumatic Stress Diagnostic Scale and the Medical Outcomes Short Form 12. The results showed that 55, 39 and 6 % had no, partial and full-PTSD respectively. Partial least squares showed that PTSD was significantly correlated with COPD severity which in turn was significantly correlated with health-related quality of life and psychiatric co-morbidity. Mediational analysis showed that the emotional symptoms of COPD mediated between PTSD and the mental health functioning of health-related quality of life and between PTSD and depression. To conclude, PTSD from past trauma was related to the severity of COPD for older patients. In particular, it impacted on the elevated emotional arousal of COPD severity. In turn, COPD severity impacted on older patients' general psychological well-being and depression.

Correlates of psychological distress among urban trauma-exposed adults: Influence of age and coping preferences

OBJECTIVE

This article examines direct and moderating effects of age on coping preferences for psychological distress among a sample of trauma-exposed adults to inform treatment approaches for this population.

METHOD

Using data from a community survey of trauma-exposed, urban-dwelling adults (n = 181), direct and moderating effects of coping preferences on the relationship between age and psychological distress were examined using hierarchical linear regression.

RESULTS

Direct effects with distress were supported for age, gender, and coping preferences of avoidance and positive reframing. No direct effects with problem-focused coping were present; however, a significant interaction resulted with the relationship between age and level of reported distress.

DISCUSSION

Problem-focused coping may provide a buffering effect on experiences with distress for older trauma-exposed adults. Findings highlight the benefits of directive and action-oriented approaches to care for aging adults. Implications for future intervention research and clinical considerations for treating trauma over the life course are discussed. (PsycINFO Database Record

Posttraumatic stress in older adults: when medical diagnoses or treatments cause traumatic stress

Most older patients adapt after catastrophic medical diagnoses and treatments, but a significant number may develop posttraumatic stress disorder (PTSD) symptoms. PTSD symptoms create added burden for the individual, family, and health care system for the patient's recovery. Medical-related PTSD may be underdiagnosed by providers who may be unaware that these health problems can lead to PTSD symptoms. Treatment research is lacking, but pharmacologic and nonpharmacologic approaches to treatment may be extrapolated and adjusted from the literature focusing on younger adults. Additional study is needed.

Posttraumatic stress in older adults: when medical diagnoses or treatments cause traumatic stress

Most older patients adapt after catastrophic medical diagnoses and treatments, but a significant number may develop posttraumatic stress disorder (PTSD) symptoms. PTSD symptoms create added burden for the individual, family, and health care system for the patient's recovery. Medical-related PTSD may be underdiagnosed by providers who may be unaware that these health problems can lead to PTSD symptoms. Treatment research is lacking, but pharmacologic and nonpharmacologic approaches to treatment may be extrapolated and adjusted from the literature focusing on younger adults. Additional study is needed.

Psychobiology of PTSD in the acute aftermath of trauma: Integrating research on coping, HPA function and sympathetic nervous system activity

Research on the psychobiological sequelae of trauma has typically focused on long-term alterations in individuals with chronic posttraumatic stress disorder (PTSD). Far less is known about the nature and course of psychobiological risk factors for PTSD during the acute aftermath of trauma. In this review, we summarize data from prospective studies focusing on the relationships among sympathetic nervous system activity, hypothalamic-pituitary-adrenal function, coping strategies and PTSD symptoms during the early recovery (or non-recovery) phase. Findings from pertinent studies are integrated to inform psychobiological profiles of PTSD-risk in children and adults in the context of existing models of PTSD-onset and maintenance. Data regarding bidirectional relations between coping strategies and stress hormones is reviewed. Limitations of existing literature and recommendations for future research are discussed.

Coping with dating violence as a function of violence frequency and solution attribution: a structural modeling approach

This study presents a structural model of coping with dating violence. The model integrates abuse frequency and solution attribution to relate to college women's choices of coping strategies. Three hundred and twenty-four undergraduate women reported being targets of some physical abuse from a boyfriend and responded to questions regarding the abuse, their solution attribution, and their coping behaviors. Solution attribution mediated the relation between frequency of the abuse and coping. Abuse frequency had a positive effect on external solution attribution, and external solution attribution had a positive effect on the level of use of active coping, utilization of social support, denial, and acceptance.

PTSD in the elderly: the interaction between trauma and aging

BACKGROUND

Because an increasingly large cohort of individuals is approaching their elderly years, there is concern about how the healthcare system will cope with the greater demands placed upon it. One area of concern is the impact of trauma and post traumatic stress disorder (PTSD) in the aged. Although several reviews have highlighted the lack of knowledge and research on the topic, there still remain gaps in the literature. Nevertheless, some recent behavioral, endocrinological and neuroimaging studies may provide new insights into the discussion. The central aims of this paper are to summarize the etiological, epidemiological and clinical aspects of PTSD, trauma, and the elderly, and to integrate this knowledge with (i) what is known about PTSD in adults, and (ii) the behavioral, hormonal and cerebral changes associated with healthy aging.

METHODS

A comprehensive search was performed with ISI Web of Science and PubMed for articles pertinent to the psychology and biology of PTSD, trauma, and the elderly.

RESULTS

There exist both significant similarities and differences between adults and elderly with PTSD concerning cognitive and biological profile. Evidence suggests that PTSD in the elderly does not follow a simple clinical trajectory.

CONCLUSIONS

PTSD in the elderly must be considered within the context of normal aging. Strong claims about an interaction between PTSD and aging are difficult to make due to sample heterogeneity, but it is clear that PTSD in this age group presents unique aspects not seen in younger cohorts. Further research must integrate their studies with the biological, psychological, and social changes already associated with the aging process.

Symptoms of acute posttraumatic stress disorder in prostate cancer patients following radical prostatectomy

Psychological morbidity is increasingly reported in cancer survivors. The authors' objective was to determine the presence of acute posttraumatic stress disorder (PTSD) symptoms in prostate cancer (PC) patients following radical prostatectomy. Fifteen patients who underwent radical prostatectomy for localized prostate cancer were assessed for the presence of PTSD-related symptoms by completing the Davidson Trauma Scale (DTS), a month following the procedure. A group of 20 patients who underwent surgery for benign prostate hyperplasia (BPH) served as the control group. PTSD total scores were significantly higher in PC patients when compared with BPH patients, whose PTSD scores did not differ from those reported in the general population (32.6 ± 18.5 vs. 11.3 ± 9.7, p = .001). PTSD did not vary among PC patients when adjusted for educational status. PTSD symptoms are common among patients undergoing radical prostatectomy and independent of their educational level. Research investigating these aspects of posttreatment psychological adjustment is needed for developing well-targeted psychological interventions.