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Fung HW, Yuan GF, Liu C, Lin ESS, Lam SKK, Wong JYH. Prevalence and clinical correlates of dissociative symptoms in people with complex PTSD: Is complex PTSD a dissociative disorder? Psychiatry Res 2024; 339:116076. [PMID: 38996630 DOI: 10.1016/j.psychres.2024.116076] [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: 06/19/2024] [Revised: 06/23/2024] [Accepted: 06/29/2024] [Indexed: 07/14/2024]
Abstract
The extent to which complex post-traumatic stress disorder (C-PTSD) can be conceptualized as a dissociative disorder remains an ongoing debate. This study investigated the prevalence and correlates of dissociative symptoms in people with C-PTSD. We analyzed baseline data from an international randomized controlled trial. A total of 165 intervention seekers who met the ICD-11 criteria for C-PTSD completed standardized self-report measures of trauma, C-PTSD symptoms, dissociative symptoms, depressive symptoms, and work and social impairments. In this sample, only 42.3 % of participants exhibited clinically significant dissociative symptoms. Dissociative symptoms had a unique association with depressive symptoms and work and social impairments in our participants with C-PTSD, even after controlling for trauma exposure and C-PTSD symptoms. The data does not support the theory that C-PTSD is a dissociative disorder. However, the findings highlight the importance of recognizing dissociation in people with C-PTSD.
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Affiliation(s)
- Hong Wang Fung
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong.
| | | | - Caimeng Liu
- School of Education Science, Leshan Normal University, Leshan, China
| | - Eleanor Sui Sum Lin
- Institute of Epidemiology and Health Care, University College London, London, United Kingdom.
| | - Stanley Kam Ki Lam
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Janet Yuen-Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong.
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Lam SKK, Cheung CTY, Wang EKS, Ng ASY, Fung HW. A prospective study of nightmare disorder among Chinese adults in Hong Kong: Persistence and mental health outcomes. Behav Sleep Med 2024; 22:530-539. [PMID: 38369868 DOI: 10.1080/15402002.2024.2318264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
OBJECTIVES Previous studies showed that nightmares are prevalent and are associated with negative health outcomes. However, no empirical data is available demonstrating the extent to which nightmare disorder persists over time. Current literature provides a limited understanding of the trajectory and wider mental health outcomes of nightmare disorder. This longitudinal study examined the persistence and mental health outcomes of nightmare disorder. METHODS A total of 230 Hong Kong Chinese adults completed standardized assessments twice with an interval of about 6 months. RESULTS Over half (66.7%) of the participants with probable nightmare disorder at baseline remained to meet the DSM-5 criteria for the disorder at follow-up. Participants with probable nightmare disorder at baseline were significantly more likely to screen positive for PTSD (82.1% vs 18.3%) (p < .001) (p < .001), and they reported higher rates of mental health service usage at both timepoints (p = .001 to .003). Baseline nightmare disorder severity was negatively associated with subsequent self-rated mental health (β = -.151, p = .010) and self-esteem (β = -.141, p = .009) and it also predicted subsequent PTSD symptoms (β = .122, p = .012). CONCLUSIONS This study provides first empirical data showing that nightmare disorder could be persistent over time. Nightmare disorder symptoms are associated not only with PTSD symptoms but also with a broader range of mental health issues. This study points to the public health importance of identifying and managing nightmare disorder symptoms in the community. Additionally, the presence of nightmare disorder symptoms may be a helpful indicator for identifying post-traumatic stress.
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Affiliation(s)
- Stanley Kam Ki Lam
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - Edward K S Wang
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Albe Sin Ying Ng
- Department of Psychology, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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Mak BSW, Zhang D, Powell CLYM, Leung MKW, Lo HHM, Yang X, Yip BHK, Lee EKP, Xu Z, Wong SYS. Effects of mindfulness-based cognitive therapy for Chinese adults with PTSD symptoms: protocol for a randomised controlled trial. BMC Psychiatry 2024; 24:400. [PMID: 38812001 PMCID: PMC11134912 DOI: 10.1186/s12888-024-05840-x] [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: 04/16/2024] [Accepted: 05/13/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Emerging evidence supports mindfulness as a potential psychotherapy for post-traumatic stress disorder (PTSD). Individuals with subthreshold PTSD experience significant impairment in their daily life and functioning due to PTSD symptoms, despite not meeting the full diagnostic criteria for PTSD in DSM-5. Mindfulness skills, including non-judgmental acceptance, attentional control and openness to experiences may help alleviate PTSD symptoms by targeting characteristics such as intensified memory processing, dysregulated hyperarousal, avoidance, and thought suppression. This trial aims to test the effects of mindfulness-based cognitive therapy (MBCT) when compared to an active control. METHOD AND ANALYSIS This 1:1 randomised controlled trial will enroll 160 participants with PTSD symptoms in 2 arms (MBCT vs. Seeking Safety), with both interventions consisting of 8 weekly sessions lasting 2 h each week and led by certified instructors. Assessments will be conducted at baseline (T0), post-intervention (T1), and 3 months post-intervention (T2), with the primary outcome being PTSD symptoms measured by the PTSD checklist for DSM-5 (PCL-5) at T1. Secondary outcomes include depression, anxiety, attention, experimental avoidance, rumination, mindfulness, and coping skills. Both intention-to-treat and per-protocol analyses will be performed. Mediation analysis will investigate whether attention, experimental avoidance, and rumination mediate the effect of mindfulness on PTSD symptoms. DISCUSSION The proposed study will assess the effectiveness of MBCT in improving PTSD symptoms. The findings are anticipated to have implications for various areas of healthcare and contribute to the enhancement of existing intervention guidelines for PTSD. TRIAL REGISTRATION NUMBER ChiCTR2200061863.
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Affiliation(s)
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Maria Kwan Wa Leung
- Department of Family Medicine & Primary Health Care, New Territories East Cluster, Hospital Authority, Hong Kong, China
| | - Herman Hay Ming Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xue Yang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Benjamin Hon Kei Yip
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Eric Kam Pui Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zijun Xu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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Tan J, Shi W, Yuan GF, Lowe SR, Liu J. Perceived barriers and influencing factors of psychological help-seeking amongst Chinese nurses exposed to COVID-19. J Res Nurs 2024; 29:203-213. [PMID: 38883255 PMCID: PMC11179599 DOI: 10.1177/17449871241236387] [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: 06/18/2024] Open
Abstract
Background The COVID-19 pandemic has caused psychological problems among nurses worldwide. However, their willingness to seek professional help is relatively low, due to perceived barriers that have remained unknown. Aims This study analysed the potential barriers and influencing factors of psychological help-seeking among nurses participating in community COVID-19 epidemic prevention work. Methods Five variables - depression, anxiety, post-traumatic stress syndrome, social support and mental health literacy - were measured from a sample of 667 nurses. Latent class analysis identified homogeneous classes about psychological help-seeking barriers and multinomial logistic regression identified factors associated with potential grouping outcomes. Results Three categories were identified: major barriers (N = 17, 2.5%), stigma and accessibility barriers (N = 132, 21.2%) and low barriers (N = 518, 76.4%). Mental health literacy was significantly correlated with the 'low barriers' class (OR = 0.953, B = -0.047, p = 0.03), whereas depression (OR = 1.091, B = 0.085, p = 0.011) had a slightly positive effect on being in the 'stigma and accessibility barriers' class. Conclusions During pandemics or other social health crises, nurses may experience psychological barriers to help seeking. Communities and hospitals should consider increasing the resources available for psychological counselling services, improving mental health awareness and literacy that may help reduce depression levels and promote mental health.
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Affiliation(s)
- Jiani Tan
- Research Student, Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Wei Shi
- Associate Professor, Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Guanzhe Frank Yuan
- Associate Professor, School of Education Science, Leshan Normal University, Leshan, China
| | - Sarah R Lowe
- Associate Professor, Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Jiahe Liu
- Research Student, School of Mathematics and Statistics, The University of Melbourne, Melbourne, Australia
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5
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Ran MS, Wang C, Cai J, Deng ZY, Mu YF, Huang Y, Zhang W, Song HJ, Deng AP, Qiu CJ, Shen WW, Chen Y, Zhang L, Meng XD, Huang XH, Chen T, Meng YJ, Chen J, Liu T, Li B, Long J, Liu B, Gao R, Chen XC, Liu GL. The mutual overlapping impact of stress and infection on mental health problems in adolescents and youths during and after COVID-19 pandemic in China. J Affect Disord 2024; 347:500-508. [PMID: 38065477 DOI: 10.1016/j.jad.2023.12.009] [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: 08/12/2023] [Revised: 10/26/2023] [Accepted: 12/02/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND It is unclear about the mutual impact of COVID-19 related psychological stress and infection on mental health of adolescent and youth students. This study aimed to explore the mutual impact of COVID-19 related psychological stress and infection on mental health problems among students. METHODS This study was conducted from December 14, 2022 to February 28, 2023 in Sichuan, China. Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, PTSD Checklist for DSM-5, Insomnia Severity Index, and Internet Addiction Test were used. Participants were grouped by COVID-19 infection and psychological stress level. The differences among groups were compared, and logistic regression analysis was used to investigate risk factors for depression, anxiety, PTSD and insomnia among groups. RESULTS Of 90,118 participants, 82,873 (92.0 %) finished the questionnaires and were included in the study. Of 82,873 participants, 33,314 (40.2 %) reported to be infected with COVID-19. Participants had depression symptoms (38.1 %), anxiety symptoms (31.8 %), PTSD (33.9 %), insomnia (34.0 %), and internet addiction (60.3 %). Compared with participants uninfected with low psychological stress level, the risk for symptoms of depression, anxiety, PTSD and insomnia increased by 9.6 %, 12.3 %, 6.6 %, and 12.0 % in participants infected with low psychological stress level (p < 0.001), 106.8 %, 125.9 %, 125.2 %, and 95.7 % in participants uninfected with high psychological stress level (p < 0.001), and 147.3 %, 161.1 %, 158.7 %, and 141.0 % in participants infected with high psychological stress level (p < 0.001). LIMITATION This study is a cross-sectional design, and no causal associations should be inferred. Infection status was based on self-report of participants with infectious symptoms. CONCLUSION COVID-19 related psychological stress and infection per se have mutually overlapping impacts on mental health problems among students. Further health policies and psychosocial interventions should be developed to reduce mutually overlapping impact and improve the long-term mental health among students.
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Affiliation(s)
- Mao-Sheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Cong Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jia Cai
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhong-Yue Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yun-Fei Mu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yi Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Hong-Jun Song
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Outpatient Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ai-Ping Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Outpatient Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Chang-Jian Qiu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wen-Wu Shen
- West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yan Chen
- West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Lan Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xian-Dong Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xue-Hua Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ting Chen
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ya-Jing Meng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jin Chen
- Department of Clinical Epidemiology and Evidence-Based Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ting Liu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Bin Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jiang Long
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China
| | - Ru Gao
- Wenjiang People's Hospital, Chengdu, Sichuan 610037, China
| | - Xiao-Chuan Chen
- Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
| | - Ge-Ling Liu
- West China Health School, Sichuan University, Chengdu, Sichuan 610000, China
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Yang L, Chen W, Chen D, He J, Wang J, Qu Y, Yang Y, Tang Y, Zeng H, Deng W, Liu H, Huang L, Li X, Du L, Liu J, Li Q, Song H. Cohort profile: the China surgery and anesthesia cohort (CSAC). Eur J Epidemiol 2024; 39:207-218. [PMID: 38198037 PMCID: PMC10904502 DOI: 10.1007/s10654-023-01083-4] [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: 05/01/2023] [Accepted: 11/12/2023] [Indexed: 01/11/2024]
Abstract
The China Surgery and Anaesthesia Cohort (CSAC) study was launched in July 2020 and is an ongoing prospective cohort study recruiting patients aged 40-65 years who underwent elective surgeries with general anaesthesia across four medical centres in China. The general objective of the CSAC study is to improve our understanding of the complex interaction between environmental and genetic components as well as to determine their effects on a wide range of interested surgery/anaesthesia-related outcomes. To achieve this goal, we collected enriched phenotypic data, e.g., sociodemographic characteristics, lifestyle factors, perioperative neuropsychological changes, anaesthesia- and surgery-related complications, and medical conditions, at recruitment, as well as through both active (at 1, 3, 7 days and 1, 3, 6, 12 months after surgery) and passive (for more than 1 year after surgery) follow-up assessments. We also obtained omics data from blood samples. In addition, COVID-19-related information was collected from all participants since January 2023, immediately after COVID-19 restrictions were eased in China. As of July 18, 2023, 12,766 participants (mean age = 52.40 years, 57.93% were female) completed baseline data collection (response rate = 94.68%), among which approximately 70% donated blood and hair samples. The follow-up rates within 12 months after surgery were > 92%. Our initial analyses have demonstrated the incidence of and risk factors for chronic postsurgical pain (CPSP) and postoperative cognitive dysfunction (POCD) among middle-aged Chinese individuals, which may prompt further mechanistic exploration and facilitate the development of effective interventions for preventing those conditions. Additional studies, such as genome-wide association analyses for identifying the genetic determinants of CPSP and POCD, are ongoing, and their findings will be released in the future.
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Affiliation(s)
- Lei Yang
- Department of Anesthesiology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
| | - Wenwen Chen
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Dongxu Chen
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Junhui He
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Junren Wang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuanyuan Qu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yao Yang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuling Tang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Huolin Zeng
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Wanxin Deng
- Surgical Anesthesia Center, The First People's Hospital of Longquanyi District, Chengdu, China
| | - Hongxin Liu
- Surgical Anesthesia Center, The First People's Hospital of Longquanyi District, Chengdu, China
| | - Lining Huang
- Department of Anesthesiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuze Li
- Department of Anesthesiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lei Du
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jin Liu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Li
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, Chengdu, China.
- Med-X Center for Informatics, Sichuan University, Chengdu, China.
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
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Fung HW, Lam SKK, Chien WT, Ling HWH, Wu ZY, Ross CA, Chau AKC. Reliability and Mental Health Correlates of a Single-Item Measure of Self-Rated Mental Health (SRMH) in the Chinese Context. Healthcare (Basel) 2024; 12:122. [PMID: 38201026 PMCID: PMC10778785 DOI: 10.3390/healthcare12010122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/13/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
The use of single-item measures of self-rated mental health (SRMH) has been increasingly valued in epidemiologic research. However, little is known about the reliability and mental health correlates of SRMH in Chinese populations. This study examined the reliability and mental health correlates of SRMH in three Chinese samples. We analyzed data collected from two convenience samples of Chinese adults from Hong Kong and/or Taiwan (Sample 1: N = 205; Sample 2: N = 377), and a random sample of Taiwan psychiatric inpatients (Sample 3: N = 100). Our results showed that the single-item measure of SRMH had moderate to good test-retest reliability (intraclass correlation [ICC] = 0.75) in Sample 1 and acceptable reliability between the self-report and interviewer-administered versions (ICC = 0.58) in Sample 3. It had a high positive correlation with self-esteem and a moderately high negative correlation with depression. It also had a consistently negative correlation with borderline personality disorder symptoms and post-traumatic stress disorder symptoms. The SRMH score was also associated with psychiatric service usage. These findings contribute to the body of knowledge regarding the use of a single-item measure of SRMH to assess overall self-perceived mental health in Chinese communities.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.K.K.L.); (W.T.C.)
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.K.K.L.); (W.T.C.)
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China;
| | - Zi Yi Wu
- Yuli Hospital Ministry of Health and Welfare, Hualien 981, Taiwan;
| | - Colin A. Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, TX 75080, USA;
| | - Anson Kai Chun Chau
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China;
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China
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Fung HW, Hung SL, Ling HWH, Lee VWP, Lam SKK. A Preliminary Longitudinal Analysis of Symptom Management, Post-traumatic Stress, and Depressive Symptoms in Chinese Adults with Dissociative Symptoms. J Trauma Dissociation 2024; 25:129-143. [PMID: 37394873 DOI: 10.1080/15299732.2023.2231908] [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: 08/07/2022] [Accepted: 06/04/2023] [Indexed: 07/04/2023]
Abstract
People with dissociative symptoms are generally poly-symptomatic and require high levels of healthcare resources. Post-traumatic stress disorder (PTSD) and depressive symptoms are two major disabling comorbid symptoms in people with dissociative symptoms. While the sense of control over symptoms may be associated with PTSD and dissociative symptoms, the interplay among these factors over time remains unexplored. This study examined the predictors of PTSD and depressive symptoms in people with dissociative symptoms. Longitudinal data from 61 participants with dissociative symptoms were analyzed. Participants completed self-report measures of dissociative, depressive, and PTSD symptoms and the sense of control over symptoms two times (T1 & T2) with an interval of over one month. PTSD and depressive symptoms were not transient or time-specific, but they persisted over time in our sample. Hierarchical multiple regression analyses revealed that, after controlling for age, treatment usage and baseline symptom severity, T1 symptom management scores (β = -.264, p = .006) negatively predicted T2 PTSD symptoms, while T1 PTSD symptoms (β = .268, p = .017) positively predicted T2 depressive symptoms. T1 depressive symptoms (β = -.087, p = .339) did not predict T2 PTSD symptoms. The findings highlight the importance of improving symptom management skills and treating comorbid PTSD symptoms when working with people with dissociative symptoms.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Suet Lin Hung
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | | | - Stanley Kam Ki Lam
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong
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9
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Li F, Gu H, Tokac U, Werner K, Fish AF, Lou Q. A Multisample Path Analysis Including a Novel Psychological Indicator, Attitude Toward Life, After the First Wave of COVID-19. SAGE Open Nurs 2024; 10:23779608231215580. [PMID: 38204585 PMCID: PMC10777797 DOI: 10.1177/23779608231215580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/04/2023] [Accepted: 11/05/2023] [Indexed: 01/12/2024] Open
Abstract
Introduction During the COVID-19 outbreak, China applied a unique volunteerism system in which nurses and physicians traveled to the epicenter to care for patients. During the same period, another group, nurse and physician nonvolunteers, stayed at their home hospitals outside of the epicenter and cared for patients without COVID-19. Yet only one Chinese study examined psychological responses comparing these groups. Objective To explore whether relationships among compassion satisfaction, general health, attitude toward life, satisfaction with life, perceived stress, and posttraumatic stress disorder (PTSD) symptomatology differ between volunteers and nonvolunteers. Attitude toward life is examined for the first time in COVID-19 research. Methods A cross-sectional study was conducted (259 nurse and physician volunteers, 330 nurse and physician nonvolunteers). Online survey data were analyzed using multisample path analysis. Results There was no significant difference between volunteer and nonvolunteer models. In the volunteer model, paths significantly related to PTSD symptomatology included compassion satisfaction (total effect, β = -0.12), general health (total effect, β = -0.09), attitude toward life (direct effect, β = -0.30; total effect, β = -0.30), and perceived stress (direct effect, β = 0.30; total effect, β = 0.30), and in nonvolunteers included general health (direct effect, β = -0.11; total effect, β = -0.11) and attitude toward life (direct effect, β = -0.47; total effect, β = -0.47). Conclusion No significant difference between models means both groups could benefit from psychological intervention. Within each model, significant paths were identified. For volunteers, counselors might focus on compassion satisfaction and perceived stress and, for both volunteers and nonvolunteers, on health and attitude toward life. Delivering counseling based on key indicators in China may help prevent or mitigate PTSD. Globally, researchers could identify factors to target and determine to whom long-term counseling might be directed. Findings about attitude toward life lay the groundwork for future research.
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Affiliation(s)
- Fan Li
- College of Nursing, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Haiping Gu
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Umit Tokac
- College of Nursing, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Kimberly Werner
- College of Nursing, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Anne F. Fish
- College of Nursing, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Qingqing Lou
- The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
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10
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Fung HW, Cong CW, Tan CS, Yuan GF, Liu C, He KL, Hung SL, Lee VWP. Is teacher violence a form of betrayal trauma? Relationship with mental health problems among young adults. CHILD ABUSE & NEGLECT 2023; 145:106436. [PMID: 37690435 DOI: 10.1016/j.chiabu.2023.106436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/20/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Childhood trauma is one of the most preventable risk factors for mental health problems. Considering the substantial amount of time that young people spend in school during their early years, it is important to understand the potential impacts of teachers' behaviors on students' mental health. OBJECTIVES This study examined the relationship between exposure to teacher violence and mental health problems. PARTICIPANTS AND SETTING An international sample of young adults aged 18 to 24 (N = 283). METHODS Participants completed self-report measures of childhood trauma, exposure to teacher violence, depressive symptoms, post-traumatic stress, and alcohol misuse. RESULTS Exposure to teacher violence could be reliably and validly measured using the Teacher Violence Scale (TVS). Current mental health problems - including depressive symptoms, post-traumatic stress, and alcohol misuse - were associated with exposure to teacher violence during high school years, but not with childhood non-betrayal trauma. CONCLUSIONS Our findings expand the application of the betrayal trauma theory to school settings and point to the importance of preventing and managing teacher violence. It is important to provide more support and training to teachers and enhance monitoring measures in schools. More research on the prevalence and correlates of exposure to teacher violence is needed. We also provided first evidence supporting the reliability and validity of the English version of the TVS to facilitate future research.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong.
| | - Chin Wen Cong
- Department of Social Science, Faculty of Social Science and Humanities, Tunku Abdul Rahman University of Management and Technology, Malaysia
| | - Chee-Seng Tan
- School of Psychology, Wenzhou-Kean University Wenzhou, Zhejiang China.
| | - Guangzhe Frank Yuan
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States; Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
| | - Caimeng Liu
- College of Teacher Education, Institute of Education Science, Leshan Normal University, Leshan, China
| | - Kyle Langjie He
- Department of Social Work, Hong Kong Baptist University, Hong Kong.
| | - Suet Lin Hung
- Department of Social Work, Hong Kong Baptist University, Hong Kong.
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11
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Forkus SR, Raudales AM, Rafiuddin HS, Weiss NH, Messman BA, Contractor AA. The Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5: A Systematic Review of Existing Psychometric Evidence. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2023; 30:110-121. [PMID: 37378352 PMCID: PMC10292741 DOI: 10.1037/cps0000111] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
The PTSD Checklist for DSM-5 (PCL-5) is a widely used self-rated measure of DSM-5 PTSD symptoms. The goal of this systematic review was to synthesize research on the psychometric properties of the PCL-5 to guide clinical and research applications. We focused on reliability, validity, factor structure, optimal cutoff scores, and sensitivity to clinical change indices. A systematic review of the literature following PRISMA guidelines was conducted using PubMed, PsycINFO, CINAHL, and PTSDpubs with search terms capturing selected psychometric indices of the PCL-5. The inclusion criteria were: peer-reviewed publication in English; primary focus on the PCL-5 psychometrics; empirical study; and study with adult samples. The search yielded 265 studies; 56 papers (amounting to 64 studies) met inclusion criteria and were reviewed. Findings generally indicated evidence for: acceptable internal consistency and test-retest reliability; construct validity; a 7-factor Hybrid Model; recommended cutoff scores between 31-33; and ability to index sensitivity to clinical change. To further advance knowledge and applications of the PCL-5, we need more research on abbreviated versions of the PCL-5, bifactor modeling as applied to the PCL-5, as well as on PCL-5 item difficulty estimates, discrimination parameters, and clinical change score estimates.
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Affiliation(s)
| | | | | | - Nicole H. Weiss
- Department of Psychology, University of Rhode Island, RI, USA
| | - Brett A. Messman
- Department of Psychology, University of North Texas, Denton, TX, USA
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12
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He D, Yuan M, Dang W, Bai L, Yang R, Wang J, Ma Y, Liu B, Liu S, Zhang S, Liao X, Zhang W. Long term neuropsychiatric consequences in COVID-19 survivors: Cognitive impairment and inflammatory underpinnings fifteen months after discharge. Asian J Psychiatr 2023; 80:103409. [PMID: 36549172 PMCID: PMC9751007 DOI: 10.1016/j.ajp.2022.103409] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Emerging evidence shows that cognitive dysfunction may occur following coronavirus disease 19 (COVID-19) infection which is one of the most common symptoms reported in researches of "Long COVID". Several inflammatory markers are known to be elevated in COVID-19 survivors and the relationship between long-term inflammation changes and cognitive function remains unknown. METHODS We assessed cognitive function and neuropsychiatric symptoms of 66 COVID-19 survivors and 79 healthy controls (HCs) matched with sex, age, and education level using a digital, gamified cognitive function evaluation tool and questionnaires at 15 months after discharge. Venous blood samples were collected to measure cytokine levels. We performed correlation analyses and multiple linear regression analysis to identify the factors potentially related to cognitive function. RESULTS The COVID-19 survivors performed less well on the Trails (p = 0.047) than the HCs, but most of them did not report subjective neuropsychiatric symptoms. Intensive care unit experience (β = -2.247, p < 0.0001) and self-perceived disease severity (β = -1.522, p = 0.007) were positively correlated, whereas years of education (β = 0.098, p = 0.013) was negatively associated with the performance on the Trails. Moreover, the abnormally elevated TNF-α levels (r = -0.19, p = 0.040) were negatively correlated with performance on the Trails in COVID-19 group. CONCLUSION Our findings suggest that COVID-19 survivors show long-term cognitive impairment in executive function, even at 15 months after discharge. Serum TNF-α levels may be an underlying mechanism of long-term cognitive impairment in patients recovering from COVID-19.
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Affiliation(s)
- Danmei He
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Minlan Yuan
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
| | - Wen Dang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Lin Bai
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Runnan Yang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Jingyi Wang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Yao Ma
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Bo Liu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Shiyu Liu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Simai Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Xiao Liao
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Zhang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China; West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China; Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
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13
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Fung HW, Chien WT, Chan C, Ross CA. A Cross-Cultural Investigation of the Association between Betrayal Trauma and Dissociative Features. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1630-NP1653. [PMID: 35467456 DOI: 10.1177/08862605221090568] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Betrayal trauma theory proposes that betrayal and non-betrayal traumas are different in terms of their nature and impacts. The theory predicts that dissociation is more strongly related to betrayal than to non-betrayal trauma, however there is a lack of cross-cultural evaluation of the theory. One competing theory is the socio-cognitive model, which proposes that dissociative amnesia (DA) and identity dissociation (ID) are the results of social influence and are not trauma-related conditions. This study aimed to test the hypotheses based on betrayal trauma theory and investigated the relationship between trauma, dissociation and other mental health problems in two culturally different convenience samples of people seeking web-based educational interventions for dissociation (N = 83 English speakers and N = 82 Chinese speakers). Compared with childhood non-betrayal trauma, childhood betrayal trauma had a statistically stronger relationship with dissociation and borderline personality disorder (BPD) symptoms in both samples. DA and ID symptoms were cross-culturally associated with childhood betrayal trauma after controlling for other variables (including sample membership, age, depression levels, medication treatment and non-betrayal trauma). Participants with DA/ID symptoms reported significantly more trauma-related symptoms in both samples. The findings supported the cross-cultural application of the betrayal trauma theory for dissociative features and BPD symptoms. Implications for research and practice (e.g., child protection, assessment for survivors of childhood betrayal trauma) are highlighted.
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Affiliation(s)
- Hong Wang Fung
- The Department of Applied Social Sciences, 177361The Hong Kong Polytechnic University, Hong Kong
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Wai Tong Chien
- Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Chitat Chan
- The Department of Applied Social Sciences, 177361The Hong Kong Polytechnic University, Hong Kong
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas, United States
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14
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Fung HW, Černis E, Shum MHY. Self-stigma predicts post-traumatic and depressive symptoms in traumatized individuals seeking interventions for dissociative symptoms: a preliminary investigation. Eur J Psychotraumatol 2023; 14:2251778. [PMID: 37682581 PMCID: PMC10494730 DOI: 10.1080/20008066.2023.2251778] [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: 04/04/2023] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 09/09/2023] Open
Abstract
Background: Previous studies showed that self-stigma is associated with poor clinical outcomes in people with serious mental illness, and is associated with post-traumatic stress disorder (PTSD). However, less is known about self-stigma in people with dissociative symptoms, which are often related to psychological trauma. This study examined whether baseline self-stigma would be associated with dissociative, PTSD and depressive symptoms at post-intervention, after controlling for treatment usage and baseline symptom severity, in a sample of traumatized Chinese adults undertaking a psychoeducation intervention for dissociative symptoms.Methods: We conducted a secondary analysis of data from a 60-day web-based psychoeducation programme. A total of 58 participants who provided data before and after the intervention were included for analysis. Hierarchical regression analyses were conducted.Results: In this highly traumatized, dissociative, and symptomatic help-seeking sample, baseline self-stigma was associated with PTSD (β = .203, p = .032) and depressive (β = .264, p = .025) symptoms at post-intervention, even after controlling for baseline symptom severity, age, location, number of sessions attended in the web-based psychoeducation programme, and use of psychological treatments for PTSD/dissociative symptoms. However, self-stigma was not associated with dissociative symptoms (p = .108).Conclusions: This is the first study showing that self-stigma is a significant predictor of comorbid symptoms (i.e. PTSD and depressive symptoms) in people seeking interventions for dissociative symptoms. The findings that post-traumatic and dissociative symptoms have different relationships to self-stigma also highlight the possibility dissociation might be an independent psychological construct closely associated with trauma, but not merely a PTSD symptom, although further studies are necessary. The preliminary findings call for more efforts to understand, prevent, and address self-stigma in people with trauma-related mental health issues such as dissociative symptoms.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Emma Černis
- School of Psychology, University of Birmingham, Birmingham, UK
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15
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Fung HW, Chan C, Chien WT, Chong YY, Ross CA. The Acceptability and Potential Benefits of a Web-Based Psychoeducation Program for People with Pathological Dissociation: A Pilot Evaluation Study. J Trauma Dissociation 2023; 24:95-110. [PMID: 36050905 DOI: 10.1080/15299732.2022.2119457] [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] [Indexed: 12/27/2022]
Abstract
Pathological dissociation is a common trauma-related condition and is associated with considerable health and social care needs. People with pathological dissociation typically require psychosocial interventions, but there are many challenges in providing such interventions for this vulnerable population. An important question that remains unexplored is whether web-based interventions are acceptable and beneficial for people with pathological dissociation. This paper reports the findings of a pilot evaluation study of a web-based psychoeducation program for people with pathological dissociation. A total of 80 participants were included. The preliminary findings revealed that: most participants were satisfied with the web-based program (e.g., most participants agreed that the program helped them understand [94.1%] and manage [66.7%] their mental health conditions and remain hopeful for recovery [78.4%]); and participants had improvements in symptom management (large effect; partial eta squared = .143) and self-esteem (medium-to-large effect; partial eta squared = .111) after the program. However, no improvements in clinical symptoms were observed on measures of post-traumatic or dissociative symptoms. The dropout rate at posttest was 36.3%. This is one of the first studies that evaluated web-based interventions for people with pathological dissociation. Although the web-based program is well-accepted by the participants and might be associated with some potential benefits, the limitations of this pilot study should be acknowledged. Implications are discussed in terms of the directions for future developments of the program and the needs for further evaluation.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Chitat Chan
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Shatin, China
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Shatin, China
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas, USA
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16
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Hoffman J, Ben-Zion Z, Arévalo A, Duek O, Greene T, Hall BJ, Harpaz-Rotem I, Liddell B, Locher C, Morina N, Nickerson A, Pfaltz MC, Schick M, Schnyder U, Seedat S, Shatri F, Sit HF, von Känel R, Spiller TR. Mapping the availability of translated versions of posttraumatic stress disorder screening questionnaires for adults: A scoping review. Eur J Psychotraumatol 2022; 13:2143019. [PMID: 38872602 PMCID: PMC9724641 DOI: 10.1080/20008066.2022.2143019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 10/26/2022] [Indexed: 11/26/2022] Open
Abstract
Background: The most used questionnaires for PTSD screening in adults were developed in English. Although many of these questionnaires were translated into other languages, the procedures used to translate them and to evaluate their reliability and validity have not been consistently documented. This comprehensive scoping review aimed to compile the currently available translated and evaluated questionnaires used for PTSD screening, and highlight important gaps in the literature.Objective: This review aimed to map the availability of translated and evaluated screening questionnaires for posttraumatic stress disorder (PTSD) for adults.Methods: All peer-reviewed studies in which a PTSD screening questionnaire for adults was translated, and which reported at least one result of a qualitative and /or quantitative evaluation procedure were included. The literature was searched using Embase, MEDLINE, and APA PsycInfo, citation searches and contributions from study team members. There were no restrictions regarding the target languages of the translations. Data on the translation procedure, the qualitative evaluation, the quantitative evaluation (dimensionality of the questionnaire, reliability, and performance), and open access were extracted.Results: A total of 866 studies were screened, of which 126 were included. Collectively, 128 translations of 12 different questionnaires were found. Out of these, 105 (83.3%) studies used a forward and backward translation procedure, 120 (95.2%) assessed the reliability of the translated questionnaire, 60 (47.6%) the dimensionality, 49 (38.9%) the performance, and 42 (33.3%) used qualitative evaluation procedures. Thirty-four questionnaires (27.0%) were either freely available or accessible on request.Conclusions: The analyses conducted and the description of the methods and results varied substantially, making a quality assessment impractical. Translations into languages spoken in middle- or low-income countries were underrepresented. In addition, only a small proportion of all translated questionnaires were available. Given the need for freely accessible translations, an online repository was developed.HIGHLIGHTS We mapped the availability of translated PTSD screening questionnaires.The quality of the translation and validation processes is very heterogenous.We created a repository for translated, validated PTSD screening questionnaires.
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Affiliation(s)
- Joel Hoffman
- School of Psychology, UNSW Australia, Sydney, Australia
| | - Ziv Ben-Zion
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
| | - Adrián Arévalo
- Facultad de Medicina & Neuron Research Group Lima, Universidad de Piura, Lima, Perú
- Facultad de Medicina "San Fernando", Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Or Duek
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
| | - Talya Greene
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Brian J Hall
- Center for Global Health equity, New York University (Shanghai), Shanghai, People's Republic of China
- School of Global Public Health, New York University, New York, NY, USA
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
| | | | - Cosima Locher
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Naser Morina
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Monique C Pfaltz
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Matthis Schick
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Soraya Seedat
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Fatlinda Shatri
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hao Fong Sit
- Department of Psychology, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tobias R Spiller
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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17
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Fung HW, Chien WT, Ling HWH, Ross CA, Lam SKK. The mediating role of post-traumatic stress disorder symptoms in the relationship between childhood adversities and depressive symptoms in two samples. CHILD ABUSE & NEGLECT 2022; 131:105707. [PMID: 35714440 DOI: 10.1016/j.chiabu.2022.105707] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Childhood adversities have been increasingly recognized as a significant risk factor for depression. However, the underlying mediating mechanism between childhood adversities and depression requires further investigation. The literature shows that childhood adversities are also closely associated with post-traumatic stress disorder (PTSD) symptoms and that PTSD symptoms can predict depressive symptoms. It remains unexplored whether PTSD symptoms can act as a mediator between childhood adversities and depression. OBJECTIVES The primary goal of this study was to examine whether PTSD symptoms would mediate the relationship between childhood adversities and depressive symptoms. PARTICIPANTS AND SETTING We examined in a convenience sample of Hong Kong adults aged 18 or above (N = 418) whether PTSD symptoms would mediate the relationship between childhood adversities and depressive symptoms. We then examined and compared the results with those in another convenience sample of Chinese-speaking young adults (mainly from Taiwan and Hong Kong) aged between 18 and 24 (N = 205). Participants in both samples completed online surveys that included measures of childhood adversities, PTSD symptoms and depressive symptoms. RESULTS Childhood adversities were significantly associated with depressive symptoms; and this relationship was mediated by PTSD symptoms in both samples. CONCLUSION This study is one of very few studies demonstrating that PTSD symptoms mediate the relationship between childhood adversities and depressive symptoms. Our findings suggest that addressing unresolved PTSD symptoms for adults with childhood adversities may help in preventing or treating depressive symptoms. Therefore, PTSD symptoms should be taken into account in the prevention and management of depression.
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Affiliation(s)
- Hong Wang Fung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; The Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, TX, United States
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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18
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Boyd JE, Cameron DH, Shnaider P, McCabe RE, Rowa K. Sensitivity and specificity of the Posttraumatic Stress Disorder Checklist for DSM-5 in a Canadian psychiatric outpatient sample. J Trauma Stress 2022; 35:424-433. [PMID: 34791713 DOI: 10.1002/jts.22753] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/02/2021] [Accepted: 07/28/2021] [Indexed: 11/07/2022]
Abstract
The Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) is a widely used, self-report measure that is employed to assess PTSD symptom severity and determine the presence of probable PTSD in various trauma-exposed populations. The PCL-5 is often administered in clinical settings as a screening tool for PTSD, with a suggested cutoff score of 33 indicating a probable PTSD diagnosis. Recent research indicates that a higher cutoff may be required in psychiatric samples. In the present study, we aimed to determine the sensitivity and specificity of the PCL-5 in a Canadian outpatient psychiatric sample and establish an optimal cutoff score for detecting probable PTSD in this sample. Participants were 673 individuals who reported a history of trauma exposure and were assessed using a semistructured interview and self-report measures. Individuals diagnosed with PTSD (N = 193) reported a mean PCL-5 score of 56.57, whereas individuals without PTSD (N = 480) reported a mean score of 33.56. A score of 45 was determined to be the optimal cutoff score in this sample, balancing sensitivity and specificity while detecting a probable diagnosis of PTSD. Consistent with findings in other psychiatric samples, these findings indicate that in an outpatient psychiatric sample with a history of exposure to a variety of trauma types, a higher cutoff score is required to determine probable PTSD. In addition, given the estimated rate of false positives even with a higher cutoff, follow-up diagnostic assessments are recommended.
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Affiliation(s)
- Jenna E Boyd
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Duncan H Cameron
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Philippe Shnaider
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Randi E McCabe
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Karen Rowa
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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19
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Wu ZY, Fung HW, Chien WT, Ross CA, Lam SKK. Trauma and dissociation among inpatients diagnosed with schizophrenia spectrum disorders in Taiwan. Eur J Psychotraumatol 2022; 13:2105576. [PMID: 35979506 PMCID: PMC9377227 DOI: 10.1080/20008066.2022.2105576] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background: The overlapping symptoms of schizophrenia and dissociation have been increasingly recognized. This paper explains why it is reasonable to expect that there would be a substantial subgroup of patients diagnosed with schizophrenia spectrum disorders (SSDs) who suffer from pathological dissociation. Objective: As little is known about the prevalence of dissociative disorders and symptoms among patients with SSDs, we investigated the prevalence of dissociative disorders and symptoms among patients with SSDs. Method: We used both self-report measures and structured interviews to examine dissociative disorders and symptoms in a randomly recruited sample of inpatients with a clinical diagnosis of SSDs in Taiwan (N = 100). Results: Over 60% of participants exhibited pathological dissociation, and 54% had a dissociative disorder according to structured interview data; three participants met the DSM-5 diagnostic criteria for dissociative identity disorder. The concurrent validity of pathological dissociation in this sample was similar to that of depression among patients with schizophrenia reported in the literature. Participants with a dissociative disorder were more likely to report high-betrayal traumas and meet DSM-5 criteria for post-traumatic stress disorder; they also reported more psychotic symptoms than those without a dissociative disorder. Conclusions: This was one of very few studies that used structured interviews to examine pathological dissociation in patients with SSDs. The results indicate that pathological dissociation in SSDs is not uncommon. Clinical assessment should include measures of dissociation to facilitate early identification.
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Affiliation(s)
- Zi Yi Wu
- Yuli Hospital Ministry of Health and welfare, Hualien County, Haulien, Taiwan
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas, United States
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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20
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Mahmud KH, Ahmed R, Tuya JH. Geographic variability of post-disaster mental health: case study after the 2017 flood in Bangladesh. GEOSPATIAL HEALTH 2021; 16. [PMID: 34726034 DOI: 10.4081/gh.2021.1018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/08/2021] [Indexed: 06/13/2023]
Abstract
Every year Bangladesh faces enormous damages due to flooding. Facing these damages the Government adopts various recovery approaches. However, the psychological dimension of any disaster is generally overlooked in disaster management. Researchers have found that the spatial distribution of post-disaster mental health can help the authorities to apply recovery procedures where they are most needed. For this research, Posttraumatic Stress Checklist (PCL-5), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to estimate posttraumatic stress, major depressive disorder and anxiety following three episodes of severe floods in 2017 that affected at least 8 million people. To better understand the spatial pattern of psychological vulnerability and reach a comprehensive scenario of post-disaster mental health, Moran's I was applied for spatial autocorrelation and Pearson's correlation and regression analysis for a study of the relationship between the psychological aspects. It was found that psychological vulnerability showed a spatial clustering pattern and that there was a strong positive linear relationship among psychological aspects in the study area. This research might help to adopt disaster management policies that consider the psychological dimension and spatial distribution of various psychological aspects to identify areas characterized by high vulnerability and risk so that they can be reached without delay.
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Affiliation(s)
| | - Raju Ahmed
- Department of Geography and Environment, Jahangirnagar University, Savar.
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21
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Kukreti S, Ahorsu DK, Strong C, Chen IH, Lin CY, Ko NY, Griffiths MD, Chen YP, Kuo YJ, Pakpour AH. Post-Traumatic Stress Disorder in Chinese Teachers during COVID-19 Pandemic: Roles of Fear of COVID-19, Nomophobia, and Psychological Distress. Healthcare (Basel) 2021; 9:1288. [PMID: 34682968 PMCID: PMC8535533 DOI: 10.3390/healthcare9101288] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 09/23/2021] [Indexed: 12/20/2022] Open
Abstract
There are limited data concerning the prevalence of post-traumatic stress disorder (PTSD) among teachers. Therefore, the present study estimated the prevalence of PTSD among mainland Chinese teachers during the COVID-19 pandemic and to construct a model with mediation and moderation effects to explain the PTSD. Data collection was conducted in schools in the Jiangxi province between October and November 2020 among k-12 schoolteachers. An online survey, including five different psychometric scales, was used to collect data. All participants were assessed for PTSD using the Chinese version of the PTSD Checklist for DSM-5 (PCL-5). Hayes' PROCESS Model 8 was used to examine the potential factors explaining a higher PTSD scores. A total of 2603 teachers from k-12 schools participated. With the cutoff score at 31, the prevalence of PTSD was 12.3% but decreased to 1.0% when the cutoff score was at 49. Nomophobia moderated the effects of Fear of COVID-19 Scale on PTSD. The findings suggest that fear of COVID-19 among teachers leads to PTSD via psychological distress, highlighting the moderating effect of nomophobia in this association. Based on the study's findings, psychological interventions and educational training are needed to reduce fear among teachers at higher risk of developing PTSD.
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Affiliation(s)
- Shikha Kukreti
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (S.K.); (C.S.)
| | - Daniel Kwasi Ahorsu
- Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong;
| | - Carol Strong
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (S.K.); (C.S.)
| | - I-Hua Chen
- Chinese Academy of Education Big Data, Qufu Normal University, Qufu 273165, China
| | - Chung-Ying Lin
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan; (S.K.); (C.S.)
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan;
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham NG1 4FQ, UK;
| | - Yu-Pin Chen
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan; (Y.-P.C.); (Y.-J.K.)
- Department of Orthopedic Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Yi-Jie Kuo
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan; (Y.-P.C.); (Y.-J.K.)
- Department of Orthopedic Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Amir H. Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, 55318 Jönköping, Sweden;
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Sun L, Yi B, Pan X, Wu L, Shang Z, Jia Y, Tao X, Zhao F, Xie W, Sun Z, Bai Y, Liu W. PTSD Symptoms and Sleep Quality of COVID-19 Patients During Hospitalization: An Observational Study from Two Centers. Nat Sci Sleep 2021; 13:1519-1531. [PMID: 34548832 PMCID: PMC8449687 DOI: 10.2147/nss.s317618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/03/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The outbreak of COVID-19 has developed into a pandemic. Data are required that specifically address the psychological consequences in COVID-19 confirmed patients. This study mainly aimed to examine posttraumatic stress disorder (PTSD) symptoms and sleep quality among COVID-19 confirmed patients during hospitalization. METHODS An observational study was conducted in two designated hospitals in Wuhan, China. Data were collected from 190 patients hospitalized with laboratory-confirmed COVID-19 infection between February 10, 2020 and March 13, 2020. RESULTS The mean age of the 190 confirmed patients was 55.7 years (SD = 13.7), of which 96 (50.5%) were female and 88 (46.3%) had family members or acquaintances infected with COVID-19. Lymphocytopenia was presented in 62 (32.6%) patients and 25 (13.2%) patients showed oxygen desaturation. The prevalence of high PTSD symptoms was 22.6% among the 190 patients. The median time from symptom onset to first medical visit and hospitalization was 2 days (IQR, 1-5) and 16 days (IQR, 10-27), respectively. Patients' PTSD symptoms were positively related to the time from symptom onset to first medical visit (r = 0.156, p < 0.05) and hospitalization (r = 0.181, p < 0.01). There were significant correlations between sleep quality and PTSD symptoms (r = 0.312-0.547, p < 0.01). CONCLUSION The prevalence of high PTSD symptoms was 22.6% among hospitalized COVID-19 patients. Early diagnosis and treatment of COVID-19 symptoms are beneficial to infected patients both physically and psychologically. With the recovery of physical symptoms, psychological intervention is desired to promote the trauma recovery in COVID-19 patients.
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Affiliation(s)
- Luna Sun
- Lab for Post-Traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Bin Yi
- Eastern Hepatobiliary Surgery Hospital, Shanghai; Department II of Infectious Disease, Huoshenshan Hospital, Wuhan, 430100, People’s Republic of China
| | - Xiao Pan
- Department of Medical Psychology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, People’s Republic of China
| | - Lili Wu
- Lab for Post-Traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Zhilei Shang
- Lab for Post-Traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Yanpu Jia
- Lab for Post-Traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Xiandong Tao
- Eastern Hepatobiliary Surgery Hospital, Shanghai; Department II of Infectious Disease, Huoshenshan Hospital, Wuhan, 430100, People’s Republic of China
| | - Feng Zhao
- Hongkou District of Changhai Hospital, Naval Medical University, Shanghai, 200081, People’s Republic of China
| | - Weifen Xie
- Department of Gastroenterology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, People’s Republic of China
| | - Zhuoer Sun
- Lab for Post-Traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
| | - Yonghai Bai
- Department of Medical Psychology, Changzheng Hospital, Naval Medical University, Shanghai, 200003, People’s Republic of China
| | - Weizhi Liu
- Lab for Post-Traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, People’s Republic of China
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23
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Ho SMY, Cheng CT, Shih SM, Taku K, Tedeschi RG. The Chinese version of Posttraumatic Growth and Depreciation Inventory-Expanded version (PTGDI-X) for cancer survivors. Support Care Cancer 2021; 30:237-249. [PMID: 34258631 DOI: 10.1007/s00520-021-06223-8] [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: 01/14/2021] [Accepted: 04/11/2021] [Indexed: 11/24/2022]
Abstract
Many patients with cancer report positive changes often referred to as posttraumatic growth (PTG). Some of these self-reported PTG may represent maladaptive illusions created by individuals to cope with the illness. A recently established Posttraumatic Growth and Depreciation Inventory - Expanded version (PTGDI-X) includes both PTG and posttraumatic depreciation (PTD) items. This inventory may provide a more balanced picture of the phenomenological world of cancer survivors. We examined the Chinese version of the PTGDI-X's applicability to cancer patients, and how PTG and PTD were related to posttraumatic stress symptoms. Two hundred sixty-five cancer survivors in Taiwan completed the Chinese version of the PTGDI-X, along with the PTSD Checklist for the DSM-5 to measure posttraumatic stress disorder (PTSD) symptoms. Confirmatory factor analysis showed that the factor structure of the PTGDI-X established in a multi-national study fit our data from cancer patients modestly well. The PTD score had a significant and positive correlation with PTSD symptoms, whereas the PTG and PTSD showed a significant curvilinear relationship in the form of an inverted U-shape. This study's results indicate that PTG and PTD are separated constructs with differential relationships with cancer outcomes. The Chinese version of the PTGDI-X is a viable instrument for psycho-oncological research. The PTD scores can provide useful information to guide cognitive interventions to reduce distorted cognitions. In contrast, the PTG scores can provide further information on the phenomenological world of cancer survivors. In this study, clinical implications and future studies were considered.
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Affiliation(s)
- Samuel M Y Ho
- Psychology Laboratory, Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China.
| | - Chih-Tao Cheng
- Department of Psychiatry, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.,Department of Psychology and Social Work, National Defense University, Taipei, Taiwan
| | | | - Kanako Taku
- Department of Psychology, Oakland University, Rochester, MI, USA
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24
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Yang X, Chen D, Chen Y, Wang N, Lyv C, Li Y, Jie J, Zhou T, Li Y, Zhou P. Geographical distribution and prevalence of mental disorders among healthcare workers in China: A cross-sectional country-wide survey: A cross-sectional study to assess mental disorders of healthcare workers in China. Int J Health Plann Manage 2021; 36:1561-1574. [PMID: 33966289 DOI: 10.1002/hpm.3186] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/21/2021] [Accepted: 02/21/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Reliable and detailed nationwide data on the prevalence and distribution of mental disorders among healthcare workers in China during the coronavirus disease 2019 (COVID-19) outbreak are scarce. METHODS We did a cross-sectional online survey from March 2 to 2 April 2020 and a total of 19,379 healthcare workers from 25 provinces participated. Depression, anxiety and post-traumatic stress disorder (PTSD) were assessed by the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and PTSD Checklist for DSM-5 (PCL-5), respectively. RESULTS The age-standardized prevalence of depression, anxiety and PTSD was 15.5%, 12.7% and 5.2%, respectively. Frontline workers had higher prevalence estimates than non-frontline workers (depression: 18.2% vs. 13.9%; anxiety: 14.7% vs. 11.6%; PTSD: 6.1% vs. 4.6%). Subgroups who were nurses, were married or had dependent children reported higher prevalence of depression, anxiety and PTSD. Despite of the large variations, the prevalence of mental disorders was lowest in East China, followed by Middle China, and highest in West China. CONCLUSION Healthcare workers faced enormous stress not only from the direct risk presented by the COVID-19 outbreak, but also from the profound changes in their professional practice. Prevalence of adverse psychological outcomes has a significant association with geographically distribution of health resources and regional economic level. Sufficient medical resource may be a protective factor to mental health condition of healthcare personnel when such a public health emergency happened.
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Affiliation(s)
- Xiaoguang Yang
- Department of Hospital Management, School of Public Health, Fudan University, Key Laboratory of Health Technology Assessment of National Health Commission (Fudan University), Shanghai, China
| | - Danni Chen
- Biostatistics, dMed Biopharmaceutical Co., Ltd, Shanghai, China
| | - Yuntao Chen
- Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Nan Wang
- Chinese Hospital Association, Beijing, China
| | - Chao Lyv
- Department of Hospital Management, School of Public Health, Fudan University, Key Laboratory of Health Technology Assessment of National Health Commission (Fudan University), Shanghai, China
| | - Yao Li
- Chinese Hospital Association, Beijing, China
| | - Junqin Jie
- Department of Hospital Management, School of Public Health, Fudan University, Key Laboratory of Health Technology Assessment of National Health Commission (Fudan University), Shanghai, China
| | - Taiqi Zhou
- Department of Hospital Management, School of Public Health, Fudan University, Key Laboratory of Health Technology Assessment of National Health Commission (Fudan University), Shanghai, China
| | - Yongbin Li
- Chinese Hospital Association, Beijing, China
| | - Ping Zhou
- Biostatistics, dMed Biopharmaceutical Co., Ltd, Shanghai, China
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25
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Meng J, Tang C, Xiao X, Välimäki M, Wang H. Co-occurrence Pattern of Posttraumatic Stress Disorder and Depression in People Living With HIV: A Latent Profile Analysis. Front Psychol 2021; 12:666766. [PMID: 34025528 PMCID: PMC8131520 DOI: 10.3389/fpsyg.2021.666766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The comorbidity of posttraumatic stress disorder (PTSD) and depression is common among people living with the HIV (PLWH). Given the high prevalence and serious clinical consequences of the comorbidity of these two disorders, we conducted a latent profile analysis to examine the co-occurrence pattern of PTSD and depression in PLWH. Methods: The data for this cross-sectional study of PLWH were collected from 602 patients with HIV in China. A secondary analysis using latent profile analysis was conducted to examine HIV-related PTSD and depression symptoms. Results: A four-class solution fits the data best, with the four classes characterized as asymptomatic (42.9%), mild symptoms (33.9%), low to moderate symptoms (19.8%), and high to moderate symptoms (3.4%). The severity of PTSD and depression symptoms was comparable in this solution, and no group was dominated by PTSD or depression. Conclusion: The absence of a distinct subcluster of PLWH with only PTSD or depression symptoms supports that PTSD and depression in PLWH are psychopathological manifestations after traumatic exposures. Health care staff should pay more attention to the existence of comorbid symptoms of individuals, develop integrated interventions for the symptoms cluster, and evaluate their effectiveness in clinical practice.
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Affiliation(s)
- Jingjing Meng
- Xiangya Nursing School of Central South University, Changsha, China
| | - Chulei Tang
- Xiangya Nursing School of Central South University, Changsha, China
| | - Xueling Xiao
- Xiangya Nursing School of Central South University, Changsha, China
| | - Maritta Välimäki
- Xiangya Nursing School of Central South University, Changsha, China.,Department of Nursing Science, University of Turku, Turku, Finland
| | - Honghong Wang
- Xiangya Nursing School of Central South University, Changsha, China
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Fung HW, Chan C, Ross CA, Wang EKS. Clinical Features of a Chinese Sample with Self-Reported Symptoms of Pathological Dissociation. J Trauma Dissociation 2021; 22:378-393. [PMID: 33427126 DOI: 10.1080/15299732.2020.1869651] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
People with pathological dissociation should receive proper clinical attention and timely support. Recent studies have shown that pathological dissociation is common in the Chinese context. However, little is known about the clinical features of Chinese people with pathological dissociation. This paper reports the first data regarding trauma histories, mental health symptoms, clinical diagnoses, service usages, stigma and psychosocial needs in a convenience sample of Chinese people who screened positive for pathological dissociation on a self-report measure (N = 72). This sample was characterized by a history of trauma and high levels of trauma-related symptoms and depression. Medication treatments were the most common interventions for them; many participants did not receive psychotherapy. We found no clinical differences between participants who had and had not received psychotherapy for post-traumatic/dissociative symptoms. This implies that many participants did not have the chance of receiving specific psychotherapy even though their trauma histories and clinical symptoms were as severe as those who were receiving specific psychotherapy. Stigma and unmet psychosocial needs were common in this sample and should receive more attention in the field. Implications for research and practice are highlighted. More dissociation-informed services are required for Chinese-speaking populations.
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Affiliation(s)
- Hong Wang Fung
- The Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Chitat Chan
- The Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas, USA
| | - Edward K S Wang
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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27
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Saadi A, Cruz-Gonzalez M, Hwang A, Cohen L, Alegria M. Associations Between Trauma, Sleep, and Cognitive Impairment Among Latino and Asian Older Adults. J Am Geriatr Soc 2021; 69:1019-1026. [PMID: 33399223 PMCID: PMC8290975 DOI: 10.1111/jgs.16986] [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] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND/OBJECTIVES Trauma survivors with chronic post-traumatic stress disorder (PTSD) have been found to have cognitive impairment. But little is known about these outcomes among Latino and Asians who comprise more than 80% of the U.S. immigrant population. They also experience disparities in PTSD and dementia care albeit increased exposure to trauma. This study aimed to (1) examine the association between trauma exposures and PTSD with cognitive impairment in a sample of Latino and Asian older adults; and (2) assess whether sleep quality attenuated the PTSD-cognitive impairment association. DESIGN Cross-sectional secondary analysis of baseline data from the Positive Minds-Strong Bodies randomized controlled trial on disability prevention. SETTING Community-based organizations serving minority or immigrant older adults in Massachusetts, New York, Florida, or Puerto Rico. PARTICIPANTS Hispanic/Latino and Asian/Pacific Islander adults aged 60 or older eligible per randomized controlled trial screening for elevated mood symptoms and minor-to-moderate physical dysfunction (n = 134 and n = 86, respectively). MEASUREMENTS Neuropsychiatric measures were cognitive impairment (Mini Montreal Cognitive Assessment (MoCA)), PTSD (Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual-5), trauma exposure (Brief Trauma Questionnaire), depression (Patient Health Questionnaire-9), generalized anxiety (Generalized Anxiety Disorder Scale-7), and daytime sleepiness (Epworth Sleepiness Scale). RESULTS Mean age was 72.8 years and 77.5 years for the Latino and Asian groups, respectively. The Asian group was 100% immigrant, whereas 70.2% (n = 92) of the Latino group was foreign-born. In unadjusted models, higher Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual-5 scores were associated with decreased odds of normal cognitive functioning (MoCA ≥25) in the Asian group (odds ratio (95% confidence interval) = .93 (.87, .99)), but not the Latino group (odds ratio (95% confidence interval) = .99 (.95, 1.05)). This association remained significant after adjusting for covariates. Daytime sleepiness did not moderate the association between PTSD and cognitive functioning in the Asian group. CONCLUSION Higher PTSD symptoms were associated with cognitive impairment in Asian, but not Latino, older adults. Clinicians serving older Asians should integrate trauma and cognitive screening to ensure this growing, underserved population receives appropriate evidence-based treatments.
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Affiliation(s)
- Altaf Saadi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mario Cruz-Gonzalez
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Andrew Hwang
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Lauren Cohen
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Margarita Alegria
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA USA
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28
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Fung HW, Chan C, Lee CY, Yau C, Chung HM, Ross CA. Validity of A Web-based Measure of Borderline Personality Disorder: A Preliminary Study. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2020; 17:443-456. [PMID: 32692638 DOI: 10.1080/26408066.2020.1760162] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Early identification of borderline personality disorder (BPD) is important as timely interventions are beneficial and cost-effective. Unrecognized BPD not only results in suffering for individuals and their families, but also leads to considerable social costs. Although web-based measures have the potential to facilitate screening assessment of BPD for research and clinical purposes, little is known about whether the results of web-based measures of BPD are valid. This preliminary study aims to examine the validity of a web-based measure of BPD. METHOD We analyzed data from five independent samples (N = 828 in total). RESULTS The web-based BPD measure had a consistent relationship with relevant variables, including trauma exposure, mental well-being, depression, post-traumatic stress, dissociation and psychotic features across samples. It was also strongly correlated with another BPD measure. The web-based BPD measure could discriminate between participants with and without BPD and the discrimination performance was excellent (area under the curve =.853). DISCUSSION The initial findings suggest that the web-based BPD measure used in the present study is valid and may be helpful for research and screening purposes, although it should be followed up with a more comprehensive assessment in clinical settings. Implications are discussed. Given the limitations in this study, further studies are needed.
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Affiliation(s)
- Hong Wang Fung
- The Department of Applied Social Sciences, The Hong Kong Polytechnic University , Hung Hom, Hong Kong
| | - Chitat Chan
- The Department of Applied Social Sciences, The Hong Kong Polytechnic University , Hung Hom, Hong Kong
| | | | - Carmen Yau
- The Department of Applied Social Sciences, The Hong Kong Polytechnic University , Hung Hom, Hong Kong
| | - Hei Man Chung
- Department of Social and Behavioural Sciences, City University of Hong Kong , Kowloon, Hong Kong
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma , Richardson, TX, USA
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